170 Pleasant St Intent to Demo 2017° TOWN OF YARMOUTH
p' y 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
�x Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836
YARMOUTH HISTORICAL COMMISSION
NOTICE OF INTENT TO DEMOLISH A HISTORIC BUILDINd
To be submitted to the YHC along with Demolition Permit Application
RECEIVED
APR 18 2017
YARMOUTH
Date of Application: MARC44 ---L7 10 r Demolition: (circle one): Partial or EDa F MA -1,14
Building Address: `D ;�'d C,A-iA�&,!''1 4—
S r M `�At2 fit. H,
Assessor's Map # 5 f _ Parcel # Year bunt:
F�t-r., 1-e 190 L4 a o
Reason Building is Considered Historic (check all that apply): K4 f- k yo w w kcv�
Over 75 Years Old C -04 -1 -Ac W °`f
�. Located in the South Yarmouth/Bass River National Register Historic District
Listed on National Register of Historic Places
Resource for historic listings: Massachusetts Cultural Resource Information System: www.mhamagris.n_e C
Propa!ty Owner: L --Y �NflIZ �• �� �= Ciel &u^ eA- (19.`1 C.
Address: 1/L - -
C7Hown: wa
Pnone#: 7. (9-�_ - 3
Email"
Age,nt/Contractor:
V M St W 4t f I ?"I
'r-4 &- 0114 C State: ' Zip Code: a C 0
S--:�1..Zp Cell#. 2-67-- `-168- 7.6t
B1A
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Address: is 1nf, i 1-k S1_
City) awn; 4) State: h Zip Code: 10 I
Phone#: 21 7 - 14 t t -i - H .CG Cell# � i � - 3Z-- - 2Z.K
Email: d+c lnl— .oAa &,40 ar"A. t c.- . (o&% -_
Reason for demolition request: ` v A l N R b _f -E-1-t3' 0tv1S, �0
Proposed reuse of property:
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C&s ! C- "`
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Description of structure to be demolished: -
I hat "-x v om
Please include with application:
Color photographs of all sides of the structure being proposed for demolition
Map showing location of property
History of the building/property (if known)
updated 912015
r—
R.ED-EIVED
APR 18 2017
YARMOUTH
HISTORICAL COMMISSION
0mce Use Only
Pennit.�
AEtmmnt
NMI it cspires 180 days rri-3111
issue date
I XPRESS BUILDING PERMIT APPLICATION,
TOWN OF YARMOUTH
Yarmouth Building Departtuielit
1146 Route 28
South Yarmouth, MA 0266-4
r , P (50!09) 3`9S-2231 ,/Ext. 1261
CONSTRLICTICiN ADDnGSS: `'` t �--�• } ' _Sr� 1 •� ;�1 ? i'r1.(L, ' I' ( 4i—
i
ASSESSOR'S fNFOMMATION:
OWNER: �Ot�,OI2_
NAME
COINTRACTOR:
NAME
i Map: Parcel: 0 2
111
A
MAILfNG ADDRESS
A xl s
TEI., r
c) —- 4q57 r
i
'
L �esidenaal 0 Commercial ( Est. Cost of Construction $
i-Iorne Improvement Contractor Lie. "' `I .Jr I/� t
Construction Supervisor Lie.: �� V {
Workman's Compensation Insurance: (citecic one) /
_.
181711 the homeowner /? I ant the sole proprietor `1 +have
nWorker's Compensation Insurance 1
Insurance Company NmWrorkt:r's CoInp. Polic} ���i`f ^ � l J �l �S7 5F01 7
I
WORK TO BE PERFORTMED
Tent Duration _
�^ (Fire Reta3'das±i Ce3'ti�1Ca'lC alE3Clteti?;
WOOL, OOL, Stove
Siding: it o; Squares Replacement wiudows:
Replacement doors, ;T
Roofing: R of Squares ( j Remove esistina:;ntax. 2 layers)
1 Y Insulation
Old Kings HighwaY/Historie Rist. ( ) Replacing bice for ii€ce Pooi fencing
'The debriswill be disp edr�,
i I Location of raciiit}• r '�
I declare tinder penalties ❑ cru 1 Ell at the sta I Ei ent; hcreiEt
aired arc true and correct w the best ai my Istr t'Icelgc and belief'. I aiiderstvtd :hat aliv false .nts�Ycrt";?
SY3il l7C JUS[ L'3U5C for deFtEa rev , ti t of i 1 cense an or pray •ution under \d,L;,i.. Ch. 263, Section i. -
,applicant's Signature:
7
01viFers SI-Illn(are (m• attachment} -
L. - �bztc: ti IE t i�
Approved By:
Buildin_ Offitcial (or rie;E•usrcc`Daw:
Zoning Dlstriet:
Historical District: Yes No [ lood Plain Zone: Yrs bio
Water Resource Protection District: Within 100 rt. ol'Wetlands
Yes No
Yes \Np
APR��