20-E055(-,
TOWN OF YARMOUTI 146 ROUTE 28, SOUTH YARMOUTH, MA 02664.4451rerephone (sos) 39s-2231 Ext. t2s2_Fax (S0-8) 3i,b-bil'6
BEC EIVED
0I 20?0
REcEtuEp KING'S HIGHWAY HISTORIC DISTRICT COMM
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Applicalion is hereby made ior the
Acts of 1973, as amended, for the
accompanying this application.
oro rint leqi blv,
Address of proposed work
Owner(s)
APPLICATTON FOR
RTIFICAT EOF EXEMPTI N
,t!- t2n rt;r Map/Lot #tl
Phone #: 6t7 6.. it.
issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 ofproposed work as described below and on plans, ara*irlg",'", photographs
;?tAll applicatlons must be sub mitted by owner or accompanied by letter from owner approving submittal of applicataon.Mailing address: ,/Bt9 el.wEit-9t-)O&r:tiE fi:-r7 C.:i/vT,:E aart O2,t4 Year built:
Email
AoenVContractor:k z,;i A.=Phone #.5-og I +(r 744.
Mailing Address:c
Email
___1_ Approved
Reason for denial
20-E055 144 Eileen St.
Approved via Email on Olt?ll2om
Preferred notification method: / phone ,/
_Denied
YARMOUTH
Email
Signed (Owner or agent)
For Committee use onlv:
Date:.4-h
Amount 26
castl€Kjl 3ert
Date Signed: _
D KING,
Alr1l
1.-t'1.2 a.t
Owner/contractor/agenl is aware lhal a permrt may be requrred I:I !e Byild:JrS Dgqarrmenr (Check other departmenls, atso.)oare o, exprlalion olBuilding perm[. whichever date shal be t;ter.
D
v5 20r 7
By: OKH Chair, Richard APPLICATION #
HIGHWAY
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Rcvd by:
oat", 7/ g,/zcract
Approved with changes
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