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HomeMy WebLinkAbout22-A021 42 Pompano Road**`
TOWN OF YARMOUTH
REr-�Iv" 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
FFbL&KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
r �+rlmu;j I ri APPLICATION FOR
1111G'S 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 COP ieS OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Cate pries That APRI Indicate type of Building: CommerciaPReroof
Residential
1) Exterior Buildin Construction: New Building 1l Addition Iterations IIGarage
Shed L Solar Panels Other:
2) Exterior Painting: Siding Shutters II Doors ❑Trim IIOther:
3) Signs/Billboards: n New Si n Change to Existing Sign
4) Miscellaneous Structures: Fence Wall IIFlagpole IIPool n
Other:
Please type or print legibly:
Address of proposed work:t 2 �o:v���,.} c iZ���1�;s r.�;;}`,.QeC� , M�} p`j� S _ Map/Lot # 3 tf
Owner(s). .,:�ce_kz r
All applications must be submitted by owner or
Phone Ol f')22-20&3
nied by letter from owner approving submittal of application.
Mailing address 2 ►*i,„v`C,C"ej L YrarlAl i�. (lr-�^L722 S Year built: P� ';�O
Email {; t j` (`AAA Preferred notification method: � Phone u Email
Agent/contractor: _A0 V ,A Li—, Ph
one #
Mailing Address:
Email: Preferred notification method: Phone Email
Description of Proposed Work:
Ar
Signed (Owner or agent): f�: Date: Z Z Z -2- 2--
OwnerlconVactorlageni 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.
Q new construction will be subject to inspection by OKH. OKH-approved plans MUST be available on-site for framing & final inspections
Rcvd Date: hh•
Amount
Cash/CK #
Rcvd by 1" 5,
45 Days:
Date Signed:
Approved Approved with Modifications Denied
Reason for Denial:
Signed:
APPLICATION #:
GENERAL SPECIFICATION SHEET
Project Address:
FOUNDATION: Material: Exposure (Not to exceed 18"):
CHIMNEY: Material/Calor: GUTTERS: Material/Color:
ROOF: Material: Pitch (7112 min) Height to Ridge: Color
SIDING: Material/Style: Front: ���� CESS Sides/Rear: COLOR CHIPS
Color: Front: Sides/Rear
TRIM: All windows & doors to be trimmed with
Material:
1X4 1x5 (Circle one.)
Color.-
DOORS:
olor:DOORS: Qty: Material: Color:
Style/Size (if not listed/shown on elevations):
STORM DOORS: Qty: Material: Color: r
GARAGE DOORS: Qty: MatT Style: Color:
WINDOWS: Qt Iside:' Front: Left: Right: Rear: Dolor:
Manufacturer/Series Material
Grilles (Required . Pattern (616, 2/1, etc } Grille Type: True Divided Lite:
Snap -In: Between Glass: Permanently Applied: =Exterior Interior
STORM WINDOWS: Qty: Material: Color:
SHUTTERS: MaYI:
Style: Paneled Louvered Color:
RECEIVED
FEB 0 2 2022
YAsiNiuu i r-,
SKYLIGHTS: Qty: Fixed Vented Size Color:
DECK: Size: Decking MatT Color:
Railing MatT Style: Color:
WALLSIFENCES* (Max 6' height): Height: MatT.
Style: Color.
(Show running footage & location on plot plan ) *Finished side of fence must face out from fenced in area.
UTILITY METERS/HVAC UNITS: Location: Screening:
LIGHTS: Qty: Style
Location(s):
LIGHT POSTS: Qty: Material;
Location(s):
Additional information:
Color:
Color:
2 -General
APPLICATION #:�+
0 TOWN OF YARMOUTH
$ 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451 i � �{� �
f Telephone (508) 398-2231 Ext. 1292 Fax 508 398-0836 11f
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE FEB 0 2 2022
UE. KItNG'S IG�lWAY
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 i ithln forty -f ti e (4) dans
after the filing of application. or irilhin such f n Cher 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
Applicant/Agent signature: Date: 2 72,
312020 Application #: R-D./AL99
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITT j '_.._'-.. _..�u.b
1� E
ABUTTERS' LIST FEB 0 2 2022
i ririivotJV 1 ri
Applicant's (Owner) Name: ni►
Property Address/Location: 'YV1 r
Hearing Date:$" ��—
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 onl . 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. armouth.ma.us
Map Number Lot Number
Applicant Information:
Abutter Information -
Application #:
81018 3
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