HomeMy WebLinkAbout21-E033 207 Center StTOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMM
APPLICATION FOR
CERTIFICATE OF EXEMPTION
RECEIVED
TTEE
I MAY 0 4 2021
YARMOUTH
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: Zy�� "`� Map/Lot # l 7
Owners : <J'J " ! ' ` • 4- Phone #: &0,3 - So �?'O W
All applications must be submitted by owner w accompanied by letter from owner a proving submittal of application.
Mailing address: 2-6 �-� � �'� r [i" f ' 'Uj* 19`x' Year built: 2,00
t (� cc,
Email f� (z-l--� ��- /t'\ Preferred notification method: Phone —"'Email
AgentlContractor: A,\ C -
Mailing Address:
Email:
Phone #: 5W - qU3 -
f'Y C)Z6 YS -
Preferred notification method: I - I Phone
Description of Proposed Work Additional pacles. may be attached if necessary):
(?k AT -fn -e j a n-1--7- w S k "-
Signed (Owner or agent):
pLN1Z D
2021
NjaaAarrt} y
Date: 0 q )
➢ Ownedcontractorlagent is aware that a permit may be required from the Building Department. (Check other departments, also.) j
➢ 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: '
Amount
Cash/CK #:
Rcvd by:
Approved y - Approved with changes Denied
Reason for denial: !'lam \ be—v1 S 1e--
Date Signed: J 14% 2Q01 I Signed: VI,Ll
V5 2017
APPLICATION #: L E M3
TOWN OF YARMOUTH
y 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
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. �r
Applicant/Agent Name (please
Applicant/Agent signature: Date: O7I3G Z('
i
Application #-
312020