HomeMy WebLinkAbout21-E071 TOWN N CLERK
TOWN OF YARMOUTH ,:2_Au 24F.+ :i6RE.c
F 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292-Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMCEivED
APPLICATION FOR AUG 1 6 2021
CERTIFICATE OF EXEMPTION r'rliiivl, -
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 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: 4-2_v \KJtat:NNA:7 Map/Lot# t2-L ' /t2_
Owner(s): C &-V> k, Phone#:43 199
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 4-Qt \pJ �QL 1 {� Mpt�-� 1 b 3T Year built:
Email: 166,c1.,_b. c .S E5 �M L. •C.DM Preferred notification method: >4 Phone Email
Agent/Contractor: 4kp k_Ovy).._vZ —__ Phone it: 4 •r• -1(2‘9.9)
Mailing Address:
Email: A.... J RSE GL • (.0.(v\._ Preferred notification method: El Phone El Email
Description of Proposed Work(Additional paqes may be attached if necessary):
W-4 C.--- _ t 1(49' X '2 G\ o 1JC31- L_
1396.-cam V oFZC -r J 11 — c_- -
TT* - A4-),C) STA3i7.-S Cha ter S1 FP_O�
Dcz - w1�$� � �t t ti
Talo ‘If
Signed(Owner or agent i„ ! _ _ ! •�_1 AWL Date: '2)0/- / 2_01A
Owner/contractor/agent 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: f
Date: 14/
1 °2-‘ v Approved Approved with changes Denied
Amount ^U •00 Reason for denial:
Cash/CK#:39 414P
a4.
Rcvd by: ,
AUG 2021
YA
OLD K NG'S HIGHWAY
Date Signed: 8 Y, L[ Signed: G-Z-p. g -E-01-4APPLICATION#:
V5.zov
{° YC TOWN OF YARMOUTH
O " `, 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451
4Z' Telephone(508)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/Demolition/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 Old King's Highway Regional Historic District Act.
SECTION 9-Meetings, Hearings, Time 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 time as the applicant shall allow in writing,
the Committee shall make 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): ►'`1 2L SOI'.
Applicant/Agent signatur Date: Qom'-1 `
Application #: � 1
3/2020