21-E081 iiie
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,, n,,,,z ,,q °:A" ':::P 1146 ROUTE 28, SOUTH YARMOUTH MA 02664-4451 0�T
--- --- Telephone (508) 398-2231 Ext. 1292-Fax(508) 398-0836 2�
K /OU7-I
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTE HIGHW
qY
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: Z d i�(:,,r k w,..oc v- 2. Map/Lot# ` `'i I 111-
Owner(s):
1Z_Owner(s): l ovs.& # '4-Sy'4Sy tu-t e )12,./' Phone#:
All applications must be su6mitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 2 v��_s 4vi.,,c;a' ZA Year built: r 4 73
Email: Preferred notification method: X Phone Email
Agent/Contractor: 1<ev i.,,, 7:k. ,:../' Phone#: &1 j /:I cr C-'7 2 C
Mailing Address: 140 ((c2v &r5 'oc_, k V., d, ✓04 6 tA-%ecstlf 'I-
G Email: c, . 1-,3-,A,,,./- c, c o C„„, , ,A.e ` Preferred notification method: Phone X Email
Description of Proposed Work(Additional pages may be attached if necessary):
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Signed(Owner or agent): Date:
> 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:
Date: WI 51 2,1
f Approved Approved with changes Denied
Amount ;4 Reason for denial:
Cash/CK#: E2-0(12
Rcvd by:
Date . -Signed: /C` /2. I Si ned: ( �, - PPALCATI N gg I #: 2,,VL--e—og' I
O
V5.2017
//7,/,% TOWN OF YARMOUTH
/ 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451
�//;-/ ! Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836
i*hii iii/i%/%/�i/'�
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-Jive (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): KQ r/ A -c1/4,
Applicant/Agent signature: Date: i o/5(zoti
Application#: 2-1--epg
3/2020
CERTIFICATE OF EXEMPTION FILING REQUIREMENTS
ALL exemption applications to include color photos of the front of the house&the location of proposed
work.
Additional requirements (Listed alphabetically by project type):
1. Additions or other structural changes (e.g., handicapped ramps, changed window location, decks, etc. not
visible from any way or public place:
a) Elevations/drawings (all 4 sides); 1/4"to 1' minimum scale
b) Color chips/samples for siding & roof, as well as for shutters, doors, etc. (Exception: If colors will match
existing house colors, please note it on application & make sure that color photos show roof and paint color.)
c) Plot/site plan showing location of changes (not necessary to changes to façade only).
d)Any other information that the applicant feels would assist OKH in determining the appropriateness of project.
2. Arbors &trellises:
a) Drawing showing dimensions and style. Detailed description of materials &colors.
b) Plot plan showing proposed location.
3. Commemorative plaques: Please note proposed location of plaque on photos.
4. Decks not over 50% visible from any way or public place:
a) Elevations providing specific information as to size of deck, style & height of balusters, location of stairs, etc.
b) Color chips/samples for decking, balusters, and rails. (Exception: If color will match existing house colors,
please note on application and make sure that photos show existing colors.)
c) Plot/site plan showing footprint of deck against footprint of house.
d)Any other information that the applicant feels would assist OKH in determining appropriateness of project.
5. Fences/walls/hedges/ornamental boulders:
a) Site plan indicating location of proposed work with running footage and gates, if any. Also, indicate on plan
any existing fences/walls/hedges. (Color coding helps.)
b) Provide picture/drawing illustrating style of proposed fence or wall; type of plant(s)for hedge. (Note: Height
should not exceed 4 feet.)
c) Indicate materials and colors for proposed fence or wall.
d)Any other information that the applicant feels would assist OKH in determining appropriateness of project.
6. Flagpoles:
a) Size, material, and color of pole
b) Plot plan showing location of pole relative to street/way&house/building.
7. Freshwater docks &piers:
a) Plot plan showing location of dock/pier.
b) Elevations/drawings of dock/pier; material/color list.
c) Copies of all required licenses & permits must be submitted.
8. Roofs:
a) Photos of existing roof(including photo of front of structure)
b) Description of proposed roof including material, style, & color. (Sample preferred.)
9. Sheds (not more than 120 square feet):
a) Elevations/drawings of all 4 sides; 1/4"to 1' minimum scale.
b) Color chips/samples for painted/stained sheds & roofs, as well as shutters, doors, window boxes, etc.
(Exception: If color will match existing house colors, please note on application & make sure that photos
show existing colors.)
c) Plot/site plan showing location of structure in relation to existing structures on property.
d)Any other information that the applicant feels would assist OKH in determining appropriateness of project.
10. Window/door replacements/garage door replacements:
a) List number&location of windows/doors to be replaced (can be indicated on photos).
b) List manufacturer, style, color, &grid pattern of windows.
c) Include photo or drawing of proposed garage door, material, and color.
V5/2017
To whom it may concern;
As owner of 20 Dartmoor Way, I give Kevin Fair authority to act as my agent for
this building project which is an 8'x 12' storage shed.
Th k.Yo u
Tom Trieber
10/5/2021
NOTES - J^ \-,.. ,,
•
1.DATUM IS NAVD88
2.THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO �/ •
BE USED FOR LOT UNE STAKING OR ANY OTHER i \ �1.�`''�.,
PURPOSE. `�
> V
3.CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING is/7 ,S
/ DIGSAFE(1-888-344-7233)AND VERIFYING THE •
• ;.-
LOCATION OF ALL UNDERGROUND&OVERHEAD UIIUT1ES `, j .
--.t PRIOR TO COMMENCEMENT OF WORK. j , /
i` ✓
/� �\ 4.EXISTING SEPTIC LOCATION PER TIE-CARD ON FILE '
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X. ,, ra_ LOCUS MAP
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dipi / y o- `--,,..______—•` ASSESSORS MAP 141 PARCEL 42
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• PROPOSED
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c , ZONING SUMMARY
/ ,;w' �,- �• I ZONING DISTRICT: R-40 DISTRICT
/,j ,i / / MIN. LOT SIZE 40,000 S.F.
^� ��� , "' MIN. LOT FRONTAGE 150'
EXISTING DWELLING TOP FNDN=2s.+' MIN. FRONT SETBACK 30'
/
/ / j116 ## I . � 1 MIN. SIDE SETBACK 20'
,,' 1 MIN. REAR SETBACK 20'
10 N MAX. BUILDING COVERAGE 25%
i / %
j / "' ' v-
y„ LOT 43
21,250±SF
•
1,
SITE PLAN
OF
#20 DARTMOOR WAY
YARMOUTHPORT, MA
PREPARED FOR
STEVE COOK
DATE: SEPTEMBER 21,2017
02-4541
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