HomeMy WebLinkAbout22-E011 92 Pheasant Cove CirTOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836 D
EC IlffPKING'S HIGHWAY HISTORIC DISTRICT COMMITTE
FEB .`L 8 2022 YAHMOUTH
'{AFt1iiC3i1TH
APPLICATION FOR OLD KING'S HIGHWAY
D KING'S HIGHWAY 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: t�
as ( a�— l � 41 ,t--
Map/Lot #
�!I
Owner(s): Vl !� I I Phone #: v ��� L
All applications must be submitted by owner or acco paniedf by letter from rom owner approving submittal of application.
Mailing address: �P /��D1��r Year built:
Email: 1� D I n �i i Preferred notification method: ✓ Phone V Email
Acient/Contractor:
Mailing Address:
Email:
Preferred notification method:
Description of Proposed Work Additional pages maV be attached if necessary):
�V) � n � aG � � a Cg
Signed (Owner or agent):
Phone #:
Phone Email
r�
f
Date: Z4J Y _2
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: A- Ag) -
Amount
Cash/CK
Rcvd by:
Date Signed:
V5.2017
Approved
Reason for denial:
Signed:
Approved with changes Denied
APPLICATION #: �?.� -e-01
°YAR TOWN OF YARMOUTH
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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 anv event within fortvfive (45) dans
after the filing of application, or within such.firrther time cis 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 prim,?—�
Applicant/Agent signature:
312020
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FEB 1 8 2022
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_Q...'.),KIN G's HIGHWAY
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DECEIVED
NOV 16 2021
YANVIuu'i h
Application #: r2;L 6-0
SALES AGREEMENT
FULLY INSURED br BONDED
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I N C O M P O R A T IL D Cl = WOBURN S IME f - WA A"TON, FLEA 01W7 - (M) i1s9_t234 667-5410 FAX (9M 6564M
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ON_ YOUR PROPERTY IN /ICCOREuAt WITH UAKTT f IES ANI
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