HomeMy WebLinkAbout22-E022 37 Wianno Roada
TOWN 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 legibly:
Address of proposed work: 57 W 1 A M N O ROAD j VYkiV ) PO I?- ap/Lot #
Owners IhAi2CCrk (3 i sse cj- Phone#: -2o'-3--7D--
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: S�rVlf� AC ABbVG7 Yearbuilt viFo
Email 5S H l Preferred notification method: ✓ Phone Email
A t/Contractor:��]�ItU� t~+=1ltC� .` /fir dZ3�� Phone #:
Mailing Address:
Email: Preferred notification method- Phone Email
Description of Proposes! Work (Additional Pages may be attached if necessary):
J—G1S�Gli�C(+1ot1 0� d S [i� (-GCt ( FeytCr? inCiL c(t"i Ctfeen A4 -old -ed m-3il✓ atoi'6 01y
��o rl-�I lcn� S�tived wt- lk (ietS kfoc f- a.F '3S u)(anrto, A pj-CVL0Lc S O WAe-
0� MV �OL1.Se jn5�al(IeCj ` lkiS S-dAAe- -inCI*1-3 t✓l -(-t,e 100 -CLC �41d 0,,\G( 0��=
'51de 6( tke kouse .M [vl fires# t S In e yJe-Ac(c� �f e- -6e,nc e M O -A �
rp,e,,+�((,Ae. -f o �e -4ra�t Corrie w"f-e- && Lj P Mpe,-ftj -(-i.«As f -a 10 d-0EJP1
skeet a[-nslkanerr( drtwcvr-Ly,
Signed (Owner or agent): Date: _. 3
Oymer/contractor/agenl 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 or Building Permit. whichever date shall be later,
For Committee use only:
Date: 7 .;�f
Amount
Cash/CK #:
Rcvd by:
Date Signed:
V5 201 7
Approved Approved with changes
Reason for denial.
Signed:
Denied
APPLICATION �����'
# v
TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT CONMTTEE
WAIVER OF 45 -DAY DETERMINATION
The applicantlapplicant's agent understands and agrees that doe 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): K_AAc t a, 13 (S S e-U—
Applicant/Agent signature: Date: -2, j 2-2
G
MAR 0 9 2022
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