22-A006 47 Sisters CircleTOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 R C "SIV ••D
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT C MN TTbE0212021
APPLICATION FOR
OLD KINGS HIGHWAY
CERTIFICATE OF APPROPRIATENESS
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as
amended, for proposed work as described below & on plans, drawings, photographs, & other supplemental info accompanying this
application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Categories That Apply: Indicate type of Building: Commercial --a� 1 Residential
1) Exterior Building Construction: New Building Addition _Alterations Reroof Garage
Shed Solar Panels Other:
2) Exterior Painting: Siding Shutters Doors _Trim
3) Signs/Billboards: New Sign Change to Existing Sign
4) Miscellaneous Structures: Fence Wail Flagpole
Other:
Pool Other:
Please type or print legibly:
Address of proposed work: 7ika Map/Lot # q3 9,3
Owner(s): PIlt L1 � a" _ Phone #: 77Gy �� ZO EQ�
All applicati ns must be submitted by owner or accompanied by letter from owner approving submittal of application.
on.
Mailing address: O WA p X X 5 . Ciff Q7 M L Year built:
Email: Preferred notification method:
Agent contractor:
Mailing Address:
Phone #:
Phone V Email
Email: Preferred notification method: Phone Email
Description of Proposed Work: �`,' ��,,
d � f ") � (rt e ung , xw- ay Xs`L� �
y �
&tT4P
Signed (Owner or agent): Date: _ 2.2 f
Ownerlcontractor/agent is aware that a permit is required from the Building Department. (Check other departments, also.)
If application is approved, approval is subject to a 10 -day appeal period required by the Act.
This certificate is good for one year from approval date or upon date of expiration of Building Permit. whichever date shall be later.
All new construction will be subject to inspection by OKH OKH-approved plans MUST be available on-site for framing & final inspections.
oni
Rcvd Date 1 ;tl
Amount
Cash/CK #f
Rcvd by:
45 Days:
Date Signed:
Approved Approved with Modifications Denied
Reason for Denial:_
Signed:
APPLICATION #: �9 .,AOOG
°�Yo TOWN OF YARMOUTH RECEIVED
O H 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451DEC 0 2 2021
Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836
YHRIViCjU t h
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTE OLD KING'S HIGHWAY
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 fling 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 am, event within.lorty-five (45) cicrt°v
after the filing of application, or within .such further tune as the applicant shrill allo►s, in uniting,
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
Applicant/Agent signature: Date:_ 10-2-2..
Application ##:
312020
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMI
Applicant's (Owner) Name
Property Address/Location
Hearing Date: �I'' jyD_
ABUTTERS' LIST
ERECEIVED
DEC 0 2 2021
YF1i: MOuTrj
Notices must be sent to the Applicant and abutters (including owners of land on any
public or private street or way) who's property directly abuts or is across the street from
the Applicant. Please provide the Assessor's Tax Map and Lot numbers oniv. The
OKH Office will send out notices using the addresses as they appear on the most recent
applicable tax list.
Note. Instructions for obtaining the abutters Map and Lot numbers can be found on the Old King's
Highway Department page on the Town website: www.yarmouth.ma.us
Applicant Information:
Abutter Information:
8.2018
Map Number Lot Number
X13 U. 3
q3
3
Application #:?'A -w&
a-7 j�,A
ne"p1
Notices must be sent to the Applicant and abutters (including owners of land on any
public or private street or way) who's property directly abuts or is across the street from
the Applicant. Please provide the Assessor's Tax Map and Lot numbers oniv. The
OKH Office will send out notices using the addresses as they appear on the most recent
applicable tax list.
Note. Instructions for obtaining the abutters Map and Lot numbers can be found on the Old King's
Highway Department page on the Town website: www.yarmouth.ma.us
Applicant Information:
Abutter Information:
8.2018
Map Number Lot Number
X13 U. 3
q3
3
Application #:?'A -w&
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