HomeMy WebLinkAbout18-A069-A1 0
,,:at% TOWN OF YARMOUT
S' ECEIVED
y 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-44
Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836 SEP 1 0 2018
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTE
YARMOUTH
• AMENDMENT FORM OLD KING'S HIGHWAY.
("MINOR CHANGE REQUEST")
A minor change request must be submitted within one year of the original approval date or while the work is still in
progress. Only a minor change may be approved by the Committee without the filing of a new application.
PLEASE TYPE OR PRINT LEGIBLY 7_ 9- �2n
Original Application#: , / N/l "- � bg Original Approval Date:
Address of proposed work: i'1 ti `)( l4 ta'U — S- tt: c itt•LI�f •
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Owner(s): 4O1'L1, tt (.�- CPq,�\ ISLA e> Phone#: Ol�gb- / ' 3 1 9 5Y
Mailing address: S . jci 1 \-v'-A-- S v ✓ wo�'T11 vv,i
a1)Q 1 ts01
Email: k1�Vk $, � �Preferred notification method:_PhonE+' Email_US Mail
Agent/Contractor: Phone#:
Email: Preferred notification method: Phone Email
Please describe proposed change(s)and attach plans/photos(as necessary):
Hi
C
Nod kul (a if b(Uf
Signed (Owner or Agent) Date 9-10-1 D
/Approved by OKH Denied by OKH lew C/Arequired9 Yes No
Reason for Denial: RECEIVED APPROVED
:Tr ; ; 2018 SEP 10 2018
YARMOUTH
I V'IN LLc.ttr. _ OLD KING'S I IIGHWAY
SOUTH YARMOUTH, MA
Signed OKH Chairman 07 6•��t Date 9//d/2 c(F
/Fl— /4ob9
AMENDMENT# {})
11/2015