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HomeMy WebLinkAbout20-E014TOWN OF YARMOUTH 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 Telephone (508) 398-2231 Ext. 1292-Fax (508) 398-0g36 G'S HIGHWAY HISTORIC DISTRICT COMM r[8 J 4 2o2aREffimeuN r[B ? g ]Z0:/0 !a APPLICATION FOR sorrrP.Y^{ctERK .ERTIFICATE oF EXEMPTI.N nppricalfx iJht#61{v+uro,ftt4he issuance of a certificate of Exemption under sections 6 and 7 of chapte r 470 ofActs of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs accompanying this application. Tvpe or print leqiblv: lu A dt6 )s # Owner(s):nwd Phone *, 7 2?-??f- C9 3 / All applications must be subm or accompanied by r owner approving submittal of application. Mailing address:{ tAddress of proposed Email: ".5. tfC Map/Lot Year built.)-{ Date /=^^o I Preferred notification method: Phone AqenUContractor: Mailing Address: Email r Signed (Owner or agent): For Committee use onlv: )a 1o,4 - ,&r^Jt /PL^< Ur-,Jil ('-fi*z- tJ'n tu;t rec/rr"'/y b- ndo,.-{ Phone #I 77*?9-CI a a26 7s notification method: Phone ,r/ Email tZeio- G4ry .,/i,r t0/4 %j-.,$7t ;2-S-- Za)O 66/f ;/. - /2r/u(4/r 4- lfif /t.c, ,4 st - /hlrc iZ/L - /27/.,'a Errlrt'at ,/"Approved _Approved with cha Reason for denial Date Signed:1 C6* Own erlcontractor/a gent is This certificate is good for aware thal a permit may be required from the Building Department. (Check other departments, also.)one year from approval date or upon date of expiration of Building Permit, whichever date shall be laier 2 YARMOUTH ?\'cast{&,*,' 2C-\-/ Rcvd ov, bl,/ AD Date: Amount v5.2017 -,t zoto Signed APPLICATION #: i =ECH r rED I y LU{U nl n Klf\ln'Q HlnL.llnrAv 2t6t2020 '@* IMG 7712.JPG tEBt&'" ) Ir \ RECEIVED rtB 1 s ?A?0 TOWN CLERK SOUTH YARMOUfH, ft4A https://mail.google.com/mail/u l1l#inboxtFMtcgxwGDDqlBWfmcnhDWTf NDhTwDWN?projector=1&messagepargd=0.1 1t1 '.,,#liF. ,,.t i '.rl , \l \