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HomeMy WebLinkAbout21-E120 46 Skipper Lane1. 11. TOWN O F YAR IIS O U T�&ECEIVED.1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 DEC 15 2021 Y Telephone (508) 998-2231 Ext. 1292 -Fax (508) 398-0836 r riiZivivw I r, QLQ KING'S HIGHWAY OLD KING'S HIGHWAY HISTORIC DISTRICT CONMrMEE APPLICATION FOR CERTIFICATE OF EXEMPTION Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 47€3 of Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs accompanying this application. i Type or print lealbty: F3 ► Address of proposed worts: � � G� � ly''rn Map/Lot # own Q i (7 VA Phone #: (�/ 7 �� �F6l7 All applications must be submitted by owner ora ompanied by letter from owner approving submittal of application. / Mailing address: 7� Year built - erred 1 G 6 Email:... 2 U� d/� W / F (erred no0ficafion math Phone Email Aaent/ Mailing Address: Phone #: _Z Email: �� S t3 CG - K)N- 0 I'VJ Preferred notification method: LooePhone �scrlatllon of Progoleg WoEh JAddIjj2[IgIIf Email Signed (Owner or agent). Bate:�- n Qwnerfcontract©€!agent is aware that a permit may be required from the Building Department. (Check other departments, also.) ➢ This certificate is goad for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later. For Committee use only: Date: Amount Cash/CK #: Rcvd by: Date Signed: VUG97 Approved Approved with changes Denied Reason for denial: Signed. APPLICATION #: IRI — G I D_ o q TOWN OF YARMOUT ECE1D 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664 51 Telephone (508) 398-2231 Ext 1292 Fax (50$) 395-0836 � DEC 1 2021 OLD MG'S HIGHWAY HISTORIC DISTRICT COMMTTEE YAhIVIVu r rt WAIVER OF 45 -DAY DETERMINATION The applicant/applicant's agent understands and agrees that due to the current declares) National and State public health emergencies the determination of our Application for a Certificate of Appropriateness/Dermot on/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 31 Meetings, Hearings, Time for Making Determinations "As soon as convenient after such public hearing; but in any event within forty-five (45;) dcrtw after the filing of application, ar within swchfurther 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 Blaine (please print): rC '} a '' Jii%t! [^ ca Applicant/Agent signature: _Date: Applications #: 91 - C':- M020 M02o