HomeMy WebLinkAbout19-E113 COE 0
-34 TOWN OF YARMOUTH RCFIVED
to 4' 1146 ROUTE 28. SOUTH YARMOUTH. MA 02664-4451 DEC 1 6 Cu i
" """�' Telephone(508) 398-2231 Ext. 1292-Fax (508) 398-0836
I
�` ' `:KfWUuJ f h
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE r�G'SHIGHWAY
DEL I / /ma APPLICATION FOR
y.,�,�„ CERTIFICATE OF EXEMPTION
-f rl rr,;r
Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Type or print legibly: y
Address of proposed work: #12- D I`i t' I w%�,) Lw`' Map/Lot# /'Z6..2 4S° (8
Owner(s): PIP TL� Phone#: G17 .(.'t# - / u7(.
All applications must e sub itted by owner or accompanied by letter from owner approving submittal of application.
Mailing address Year built
Email j i..'1.', Ft-11 T Lc. 4 6A1w, 1O `1 Preferred notification method: V.Phone Emad
_ A,
AAA'Agent/Contractor AA' it Nr' Pho c -6- 7 33 - A�g 3
Mailing Address. /69 141 of" c r. W 1 r(c2✓"'az f inn 6 Z b S S
Email: A06 IZf Cy r.Rk..1 ,cam Preferred notification method ✓ Phone Email
Description of Proposed Work (Additional pages may be attached if necessary):
jL i4't i(., i WTI :K-"ficV% D 0,13 tk t 4" G frvtN. oma) vviTti /vr�.w k viv1416
&or"Dori ,
Signed(Owner or agent) Z------- ..„. Date: /211/0/0
Owner/contractortagent is aware that a permit may be required 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
For Committee use only:
J
Fr*Date /•2 [(si /cj /Approved Approved with changes FODenied
Amount C70 Reason for denial: A
MI
'` D
Cash/CK#: q c-q 6
i
Rcvd by. AV — AHMUv I N
r'c HIGHWAY
Date Signed ja//7/j 9 _ Signed:ypati- �� ,iit[,44.d APPLICATION#: 19—C/13
jai w A. �°"° „„,.Q .,
}
rte_
F
s
1
Q
�" ,r
1
yR
[+
it, , ty .„ .
Cr) t 4" i - i
r Z
4
.......„_4... f0 -----•11111 ."''.--, ,,,,,„Nitisi 10
........... _ 1. por."0„3"......
„--.......,ap-- # i
.. _ :
Y
BIW. '@
ER
Ott A
0
. �.�. s
', I Q.
of
istAR
it
, Pil _,_...1 -"Altr* ' - 4 0 4-
z
r
1 444E
, - - or
4*-. a a t ,
i ` g
:11, _ . ,,-
, ,t _
,,
, . a
.., ..t ,
. , f j(Z� `„sm.:,
E`Ti4fit
er ;z
,,
�/- '-,,,, ` yip 'i $.,,
LJ tom' ¢
4
*lot
_ ,,,
9
at
IF kI
4
111.1111111111.1111p ,,,sworioaia -41"a"
at =sem -
s.
' .
,a, W
s
[ . ' .„,,,„„4 P 0, , -
- ` _ I r
aka-_--
g 4
n,
' 4 0 r 0
iti�, ;.
°,qyt i ,
..., . '...-1.;,
. ..
. '
. .
-,-..,...
..._.
- . .. .. .
. '.
...-".,
, . .
. ..
.,....,„. .„. . ..
lit. --
. .
- ........,,,,,,,..
. .....„ .. ,.....,...................... ..
..,.... 00000001.**"........ ..._ _ . . ..„ . „----,
. ..,......
... ,,.,..
.......„„. ....„...„ 4 0 -40
.,...,....,..,.
,.. ,
.4,,,A,.. .,. ..,..
. . .. .
.,........,.........____
i:
4.
.. . p
„
4 s -. 1 :i..
it.''T . , •
, i , ..----..t
4.- ..-->
- . - • , ,.... -VINME/10 I-
'it.-4-..,.4 ....„... —.....
- .4 , ..-, t
--- 0 -
- ...
' 4111101110 I AMMO'
-...,..
.241'
•....,, ,.:',:,4..,-/''3'.',.,'-''' 0
;4':',..,:t4,-?'.',,.''Z''•:'•-'. .
, .
0
MC
OM
• t
01501.
libAt„
•
•