HomeMy WebLinkAbout1980 - Building Sign Off Form and OKH Cert. of Appropriateness Form - - •a , - • •''.► _- • - 7-7.
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?LICANT:. 0 Cry•c•• �• C-;6:Ut'/f4'I•• r' • •-' ` • .- .BLDG••PERMIT;ND:• • '
:ATI ON 'PROPERTY: ' 2 - /e
!o -'a•;4': DATE.FILED: • + 'Q•
THE FOL OWING CHECK-OFF SHEET IS...
rDESIGNED TO:
-CLARIFY THE 'PROCEDURES AN'INDIVI•DUAL . •' .-
rT FOLLOW IN. ORDER TO OBTAIN. A PERMIT TO BUILD OR ALTER A .BUILDING. �TNE BUILDING
'ARTMENT'WILL:CHECK_.ON "-THE FOLLOWING: (A); • CONSERVANCY 'DISTRICTS: (B):'i HISTORICA1.
;TRICTS • (C)• ZON
: FLOOD PLAINS-7 _ING,•.AND WILL BE RESPONSIBLE FOR ASSISTING THE: •
'LICANT THROUGH THE FOLLOWING AGENCIES. : %%4.7.- • • • ;•.: • " `s• .•'... .:*:•'
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Application to
( (17
our
A) Old Kings Highway Regional Historic District Committee
10114141, in the Town of Yarmouth for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEG IES THAT APPLY:.
1. Exterior Building Construction: 0 New Building : Addition 0 Alteration
Indicate type of building: 0 House ❑ Garage. ❑ Commercial 0 Other
2. Exterior Painting: jz . •
3. Signs or Billboards: 0 New sign 0 Existing sign 0 Repainting existing sign
4. Structure: 0 Fence 0 Wall 0 Flagpole 0 Other •
(Please read other side for explanation and requirements). q
TYPE OR PRINT LEGIBLYrr • DATE ?/7/
0 o
ADDRESS OF PROPOSED WORK 7 7b vyA •P,-t u E ASSESSORS MAP NO. 2 T
•
OWNER. L00/ i) II/fl/1A ASSESSORS LOT NO. k" 7o
HOME ADDRESS SAS _ TEL NO. -?607 -.16 7
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary). •
%VO4 27- & /(S7 "', 6 .2 /x'2 PirertJ �r1?o0'77/ Po/LT
09k/ncw? in. nv IE2 /� C... MCIv XA 2yno /`off
t-of/f% 6. S /c405 /0 2myi2 _/R/t Mk/floor/1 Pore i
AGENT OR CONTRACTOR s2L ll P. gK! 7T-0 TEL NO. 3 a -1067
ADDRESS b h (1 m�.�'co jam-£ . ✓2/9?ou tOttr-----
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No.8,other side),including
materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed
locations of new signs. (Attach additional sheet,if necessary), r
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Signed
• Owner-Contractor-Agent
Space below line for Committee use.
Received by H.D.C.
Date The Certificate is hereby ,� '
Time' 91- "1"›.--11: 9
By �/v 7//112-
Approved IMPORTANT: If Certificate is approved, approval is subject to the day appeal period
provided in the Act. •
Disapproved ❑ Please return to: Yarmouth Historic District Committee �"