HomeMy WebLinkAbout22-E006 14 Richard Road,:3• .x,r TOWN OF YARMOUTH
Eli Y 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292, -Fax (508) 398-0836
FEB C S 2022 OLD KING'S HIGHWAY HISTORIC DISTRICT COMMI
YAF+MOiJ I t'
KING'S HIGHWAY 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.
Twe_or print legibly:
Address of ropos
Owner(s) work.- � CI,IJ� � � �-V'.�j Map/Lot # i1Ll
: 'i Phone 4:
All applications must be submitted by owner r acc panied by tetter frenn o er approving submittal of application.
Mailing address: S'5� Z- 1 y-- RQ (I)MIN�Year built O C�
Email. 2oG;Ct-i+ SS32� ,gt� Preferred notification method Phone Email
Agent/Contractor: t-t���L �`� {.l Phone #:
Mailing A dress:'_ �U'VA)�. ' � t`� Tl►� irj�5
�. A.r /
Email: -__ �L_�� (� 1 g' C� 1vt Pre`erred notificatio:, method Phone V Email
Description of Proposed Work (Additional pages may be attached if necessary):
x C. �C15 k FtuG -A5 ��'jw
LA-fLGC4�- ELAC,14, �S- �Lu - ILS
Signed (Owner or agent): Date.
> Ownerlcontractortagent is aware that a permit may be 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 shall be later.
For Committee use only:
Date. d 1 mw -
Amount 'q O. 00
Cash/CK a:
Rcvd by:
Date Signed
V5 2017
Approved Approved with changes
Reason for -denial:
Signed
Denied
APPLICATION #: 4/ f
From: patrick robichaud REc�'u�p
robichaud5532@gmail cc�82o2Z
Subject.: Picture of houseLO-LGKft
INGSUl
Date: Dec 6,2021 at 2:25:33 PM
To: kellyroofing@icioud.com
RECEIVED .-.
FEB to
0
$ 2027
w