Untitled (2) TOWN OF YARMOUTH
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1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292—Fax (508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
APPLICATION FOR
CERTIFICATE OF EXEMPTION
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:
Address of proposed work: 1O Gun Rock Road Map/Lot# 1 36-45
Owner(s): Paula MacNiece Phone#:508-394-4923
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 10 Gun Rock Road Year built: 1978
Email: psmacniece@comcast.net Preferred notification method: Phone X Email
Agent/Contractor: Phone#:
Mailing Address:
Email: Preferred notification method: Phone Email
Description of Proposed Work(Additional pages may be attached if necessary): RECEIVED
Installation of a 8x12 wood shed: APR 2 7 2021
Clapboard front painted Benjamin Moore Platinum Gray to match existing house
B & B sides and rear painted Benjamin Moore Platinum Gray to match existing house rA�tn i0u r,
Asphalt 3-tab roof shingles-Certainteed Moire Black- to match existing house JLD ICINGS HIGHWAY
To be built in backyard, bey° fen e (see photo)
Signed (Owner or agent): CDU Date: 9' 7- ?- 1
Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.)
r 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:
Date: r
lr Approved Approved with changes Denied
��(,,
�c Reason for denial:
Amount ' .\`1
Cash/CK#:
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Date Signed: Signed: APPLICATION I- 3 Z
V5 2017
. PLOT PLAN
FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) ED
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f (lot ft. rear)
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f this is a REAR YARD
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(NAME OF STREET)
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Information
/ (` Supplied by L ' C.C.
LARK NORTH POINT