HomeMy WebLinkAbout22-E005 37 Katharyn Michael RoadFz-
FEB 0 7 2022
TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398•-2231 Ext. 1292 -Fax (508) 398-0836
NG'S HIGHWAY HISTORIC DISTRICT COMMITTEE
APPLICATION FOR
CERTIFICATE OF EXEMPTION
AMlip f&Wjdj for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
Rutss-amerrQea for the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Type or print IepiblY:_
Address ofproposed work: - Wty\"Ryiy Al 1 e -k f�t MaplLot# 6— e-i;f
Owners L_� i\ 1� �1 f e .S Phone #: (3 -
All applications must be submitted by owner or acro anied by letter from owner approving submittal of application.
Mailing address: - }�I)T�l �� I� Ie-Wn v, Year built
Email:
Preferred notification method:. Phone Email
ActentfContractor: 13-161 h%Ls Phone #:_5��
Mailing Address:'P G . a
Email:
Preferred notification method: -6 Phone Email
Description of Proposed Work (Additional pages may be attached if necessary):
NG'V�4P_
Signed (Owner or agent).
Date:
D ownerlcontractodagent is aware that a permit maybe required from the Building Department. (Check other departments, also.)
This certificate is good for one year from approval date or upon date of expiration of Building Permit. whichever date shat] be later. II
For Committee use only:
Date, _ 1 `I ! rTir�- .,
Amount
Cash/CK # ✓o
Revd by -
Date Signed
V5 2017
Approved Approved with changes Denied
Reason for denial:
Signed
APPLICATION #: �'� f OL
o TOWN OF YARMOUTH
p " y 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
N 3 Telephone (508) 398-2231 Exp. 1292 Fax (508) 398-0836 ^E�VED
OLD KING'S HIGHWAY HISTORIC DISTRICT CO ¢„�
FEB 0 7 2022
WAIVER OF 45 -DAY DETERMINATIO _. _ .YAHjv,uurrj
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.
Applicant/Agent Name (please print): /�//��!Jt. ya
Applicant/Agent signature:
m1olez
Application
312020
0136'
File No: ! 13 3 6
Client: !"corse & Newell Dead Bock: 4972 page: 277
0ner John •O.Webb Jr. ,Trustee of the planSook ._.Page: 35 Lo1(s�
37th Vat aryn-Michae Road Trust
Applicant: Kevin L & Karen S. Belken
�P Cert oI 1i Ile:
Census Tiact Na Wane Available Assessor's Purl for(s� _
1-10RTGAGE I NSPE; N I0N PLOT PLAN
Y A R lel O U T PaolbsGo �,
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I CERTIFY
TO MORSE S NEWELL.- SE14TRY
FEDERAL SAVINGS BANK AND ITS TITLE
INSURANCE
COMPANY, THAT THERE. ARE NO
VISIBLE EASEMENTS
OR ENCROACHMENTS
EXCEPT AS
SHOWN AND THAT THIS PLAN WAS
PREPARED UNDER MY
IMMEDIATE SUPERVI-
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