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HomeMy WebLinkAbout21-A038-A1 z°117 TOWN OF YARMOUTH _F4 �. ; ._ R d 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451 Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836 OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE AMENDMENT FORM ("MINOR CHANGE REQUEST") A minor change request must be submitted within one year of the original approval date or while the work is still in progress. Only a minor change may be approved by the Committee without the filing of a new application. PLEASE TYPE OR PRINT LEGIBLY Original Application #:2 \ .A (? J Original Approval Date: 3 • 2 Z 202 f Address of proposed work: CO \.i\ c 'C'EN2-3Q Owner(s): T).PN Phone#: 402_ S29" (4g2- Mailing address: \ (z,V I �• `�C�( 4S$URC� PPS -50I Email: SCP-{0vJ F Q- 'LC. ME . C©M Preferred notification method: Phone mail US Mail Agent/Contractor: eQJI i a_c)m\EC,ZSI NPhone#: �=,QQj ?,(02 ag,A Email: C-YL\y-- e_ t21AQ_(j V F�"LS. CUM Preferred notification method: Phone I' Email Please describe proposed change(s) and attach plans/photos (as necessary): ENI_c a-611C YR 3‘CDO SLS Aci? tz-mi' ° (VEb POg-Ct Ptd QE.pca_ 6F cF\ROM 12 Wvi) 1B' u.-IV' ptnO CA4,A\L kN siS� ivk -to PC( -C Signed (Owner or Agent) Date 6, Z1• '2 0 Z /Approved by OKH Denied by OKH New C/A required? Yes No Reason for Denial: APPROVED RECEIVED JUL - 8 '1021 IJUN 242021 YARMOUTH 1 Ati�viliUl H OLD KING'S HIGHWAY OLD KIPIG'S HI(HWAY Signed OKH Chairman i)41 Date 7/s/2 '- I AMENDMENT#'D\ P 11/2015