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° YAR`` TOWN OF YARMOUTH
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iii___. 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
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Telephone(508) 398-2231 Ext. 1292-Fax (508) 398-0836 ___
KING'S HIGHWAY HISTORIC DISTRICT COMMITTEENU g 6610
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APPLICATION FOR I OLD KING' HIGHWAY
�a,0IF CERTIFICATE OF EXEMPTION
TOWN C
Appbp ade for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
Acts of 1973, as a e6lfor the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Type or print legibly:
Address of proposed work:/ e0 pireec�,�P//yl yd Gywct� Map/Lot#
Owner : /CU�9 £ 7f?,Z2f /��iy'DJ✓Y✓Y i1 Phone#: ej- -Oa)^b--tit '
All applications must be submitted by owner/ or accompanied by letter from owner approving submittal of application.
Mailing address: 50 /V 'iIiIO1' l'C ex-yrJc Year built: y 913(p
Email: r&,^0,,,n e.-4 vJ e t/r✓'8 7c,v7 ,,,-el-Preferred notification method: / Phone Email
Agent/Contractor: DAJ/jei :5 t ti vO( /2))4V Ce":✓Yr/irtic.4- i p ✓i . n Phone#: c�C7't3- l 712,- 5.990
Mailing Address: /F, u1 t 'oloc,U t- /nlar�ie(�orrc, IAA 023-4-
Email ae vY'k l vey! W✓reFY'V✓7.014 • COM Preferred notification method: V Phone Email
Description of Proposed Work(Additional pages may be attached if necessary):
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Signed(Owner or agent): LJ & -7 ..-1 Date: /Col) 7 , ZDisr. v'
Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.)
i This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. —fl
For Committee use only: 7'
Date:
ii--01 -": igd✓ Approved Approved with cha es Den!
Amount%g 02 O Reason for denial: PPROVED.
�as K#: DEC - 5 2019
Rcvd by: 1 YARMOUTH
OLD KING'S HIGHWAY
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Date Signed:X 2V/5/2.c)" Signed: l' 6' APPLICATION#: 19-i10q
Silva Bros Construction
Jeffrey Silva
508-813-5950
Owner/Generol Controdor
je{{@silvobrosconstruction.com Murdock Street
www.silvobrosconstruction.com 43 Mu
ion.com 02346
Middleboro,MA
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SOUTH YARMOUTH, MA - Ay1
19'1)09
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