HomeMy WebLinkAbout22-E001 18 Conway Drive0Y 0 TOWN OF YARMOUTH ;
z
°_ 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
i Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
JAN 0 4 2022
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE. j i t,
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: �`1��v �� �L�(�"^u�va�r� Map/Lot #
Phone #: CE q - 3ri i1 -!R-2,325
Owners): C_v-ty T i�\C_(-j IKcL1_1r
All applications must be submitted by owner or aco%mpanied by letter from owner approving submittal of application.
Mailing address: 11 Co Y. wz Ov- ,o„rClue Year built:
Email: GmLG—rtry S3 i Avv,wN,cup« Preferred notification method: Phone Email
Agent/Contractor: C l� C_ 6 k Phone #: rj$Lk - 5-6 3-y`(1L
Mailing Address: l )L J rra j r4�IL rtiy r M �}��3
Email: CCAC Y�r Aa,�. t�cAkr4,`1v"`"�'�ref rred notification method: Phone Email
Description of Proposed Work (Additional pages maybeattached` if tnecessary):
pQ YAC --3 Cor- r -'Ac
4u�,� W(T1144^sr< Cvu.� V'(V^` cov 04'v.� UCC. oA i r� �r- 1Xa%-'�
Vk 5 ��u 'P ro V^ C rl 11 floc
Signed (Owner or agent):
Date:
Owner/contractor/agent is aware that a permit may be required from the Building Department. (Check other departments, also.)
r 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: + iq;;.-
Amount 00
Cash/CK #: I
Rcvd by:
Date Signed:
Approved
Reason for denial:
Signed:
Approved with changes Denied
APPLICATION #: � f
0 TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-44��
Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836 .CrV
ED
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTE114AN Q 4 2022
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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 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 an event within fork' fine (45) day's
after the filing of application, or it thin such fitrther tinge 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)
Applicant/Agent signature:
CA C. �'
Application #:
312020
1
LRE:
"022H VAY
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15
4
BUILDING SETBACK REGULATIONS PER
BUILDING INSPECTOR OR BUILDING
COKAMISSIONER.
M t N. FRONT SETBACK
MIN. SIDE SETBACK d
MIN REAR SETBACK
-
LEGEND
EXISTING CONTOUR --
PROPOSED CONTOUR —
EXISTING SPOT ELEVATION
PROPOSED WATER SERVICE
TEST HOLE LOCATION
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