HomeMy WebLinkAbout446 Rt. 6A COETOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
.�.- Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836' '--RECCVry
OL® KING'S HIGHWAY HISTORIC DISTRICT COMMI7Ff3 2020
APPLICATION FOR I nruvivuTM
CERTIFICATE OF EXEMPTION OLD KING'S HIGHWAY
Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
Acts of 4973, as amended, for the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Type or print le tbl :
Address of proposed work: L Nle MA Ao Ute &A Map/Lot #
Owners): Gid1/sl*.,-.-_ Met'fsS a. C� Phone #:_%D�'J � 2q0 1
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: —salme as abdve °4 Year built:
Email: __. _-_ C6Cken 1d q 2 (92 gill ' Con -c.- Preferred notification method:
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Phone Email
Agent/Contractor: e Jg 19/406t k_1&4& $'"'r PM0'dd ZIV'rSr6/9 Phone#: 506–,0 L5" L& Ge)
Mailing Address:
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Email: conq Preferred notification method: LJ Phone
Description of Proposed Work Additional pages may be attached if necessa
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Signed (Owner or agent X /6. , _ Date: '14 Al I
9 Ownerlcontractorlagent is aware that a permit may be requited from the Building Department. (Check other departments, also.)
> This certificate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later.
ForCommitteeuse only:
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Amount V 0.0o
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Rcvd by:
Date Signed:
V5.2017
Approved
Reason for denial:
Signed:
Approved with changes Denied
APPLICATION #:U L -O
° Y TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
Telephone (568) 398-2231 Ext. 1292 Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
WAIVER OF 45 -DAY DETERMINATION
The applicant/applicant's agent understands and agrees that due to the current declared National
and State public health emergencies the determination of our Application for a Certificate of
Appropriateness/Deinolition/Exemption may not be made within 45 days of the filing of such
application.
The applicant agrees to extend the time frame within which a determination is to be made as
required by the OId King's Highway Regional Historic District Act.
SECTION 9 -meetings, FFearings, Tin:e for Making Determinations
"As soon as convenient after such public hearing; but in any event within forty-five (45) days
after the filing of application, or within such further tinge as the applicant shall allow in writing,
the Coininittee shall niake a determination on the application. "
Applicant understands that the review of this application will be scheduled as soon as the
situation allows.
Applicant/Agent Name (please print): A N1E-L�I s.S A (z,
Applicant/Agent signature: Date: `1 11 1
312020
CEIVED
SEP 2 3 2020
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Application #: f a%t
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