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HomeMy WebLinkAbout22-E016 101 Route 6ATOWN OF YARMOUTH 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836 KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE 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 le-gibly: Address of proposed work: ! O + ' i v t� �/ Map/Lot # J 1 I z Owner(s): /lef / b'� Phone #: L&3 `Jr JI I21. - Ail applications must be submitted by owner or accompanied by letter from owner approving submittal of application. /f Mailing address: 1 1 f/t C I�%rbf`i `�C'. �mala &tin D/o '7 -5 -Year built: 12a -7 Email: d m' A.,y i (V_ 6" 4"A C o a, Preferred notification method: Phone Email Agent/Contracor: P/T %6 e - Rr" i &1l U?_ /%7 Phone#: -9 ?r3V//-�P'o(3 Mailing Ad ress: 1 �3 VV C�•"v ll��_ 37/ 7 OS� D { �Iv1rS /0� Email: Q N t?- A , CO tlq Preferred notification method: Phone Email Description of Proposed Work (Additional pages may be attached if necessary): f A s N nPc/r Vv�1t� / /IG GrGt� �iYlis�: i Signed (Owner or agent): Date: o2lZ��Z Ownerlcontractorlagent 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 shall be later. For Committee use only: [late: Amount 'go. Cash/CK #: I N Jr Rcvd by: S� Date Signed: V52017 Approved Approved with changes Reason for denial: Signed: Denied APPLICATION #: d,-�- 6Dr }°Ya TOWN OF YARMOUTH O y 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 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): -bo/"W n , 4 Applicant/Agent signature: Date: RECOVER FEB 2 5 2022 YARMOU h Application #: L 312020 2122122, 11;22 AM Mail - Dominic Maloni - Outlook MUS AGREEMENT « kNO son so FULLY INSURED R BONDED -,4E8 2 5 2022 Ca Cl + uF�vc� vvv.rrY noow • soon, erf nfrf. Mn weeo . (sC�le) j9aasm. 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