HomeMy WebLinkAbout4-A116 37 Church St July 2004...DMC14
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Old King's Highway Regional Historic District Committee
in the Town of Yarmouth for a
CERTIFICATE OF APPROPRIATENESS 2
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Application is hereby mane in triplicate, for the issuance of a Certificate of Appropriatenessder &ctio �
of Chapter 474, Acts and Resolves of Massachusetts, 1973, for proposed work as descrit�stl�beid�gand
Plans, drawings or photographs accompanying this application for: _ 1
CHECK CATEGORIES THAT APPLY: F
1. Exterior Building construction. ❑ New BuildingC';
Indicate h of ❑ House 13 Garage ❑ Commercial ❑❑ Other v
2. Exterior Painting: ❑
3. Signs or Billboards_ ❑ New Sign 0 Existing Sign ❑ Repainting existing sign
4. Structure: XFence ❑ Wall ❑ Flagpole ❑ Other
TYPE OR PRINT LEGIBLY DATE , - --/ _ Q t f
1
ADDRESS OF PROPOSED WORK Sr ASSESSORS MAP NO. --J-3
OWNER ASSESSORS LOT NO.
HOME ADDRESS. Z. TELEPHONE NO, d 137
AGENT OR CONTRACTOR �}x TELEPHONE NO
ADDRESS
USE ATTACHED SHEET IN PACKET FOR ABUTTING OWNERS
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done including materials to
be used. In case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet. if
necessary).
t06#� Sara'qt't- 4orre1 seC:d eta pl"Le 42j,*e allowed u�aa'�.�,�
h4-Fur�Ir �R.2.I v+ti�r.4,
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1►►. lt�>r rj�'
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Signed e
Owner Contractor -Agent
S ce below line for Committee use only.
Received by OKHC
Date -S-1
G ThiCpertificate is
Check #__L1
APPROVED ❑ Il4IPORTA
9
If Certificate is approved, approval is subject to the 10 day appeal period
provided in the Act. "'hiiluu i i i uL iiowi i I LE
DISAPPROVEDNlif?g
❑ Please return to: Yarmouth OKHC District Committee
Yarmouth To«n Hall, 1146 Route 28, S. Yarmouth, MA 42654
AMENDMENTS
DATE ((' d L S26d C/A # -411
ADDRESS .3 7 C41,k 1c 4E
Fr,vcyzcvr[L A/0 ,�xrg,�,O i� L'�u,�c� (S7-
� k;i G,rlct csTD{� ✓�`' �X �s 1,�G. �`)R,a�vr Iry �2 �8a�,
2.
3.
4.
I agree to the above conditions -
Owner/Agent OKH/Chairmary A
Signature Signature
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APPROVED
YARMOUTH COMMITTEE
OKHRD
SPECIFICATION SHEET (YARMOUTH OKHQ
Please fill out the form in its entirety providing color chips where
necessary. INDICATE LANDSCAPING, EXTERIOR LIGHTING & ELECTRIC METER ON SITE
PLANS FOR NEW HOUSES C(,
ADDRESS,
8
MATERIAL OF TRIM: (WOOD, VINYL, ALUMINUM)
SHUTTERS (WOOD/VINYL) (PANELED/LOUVERED)
COLOR:
FOUNDATION (18" MAX. EXPOSED): CONCRETE/OTHER DRIVEWAY:
COLOR:
o
WALKWAY: STEPS (INDICATE BItICK/CEMENI'/OTHER):
F
) o
(INDICATE SIZES IF NOT LISTED ON ELVATIONS)
SIDING TYPE & MATERIAL:
COR-=
M �
CHIMNEY (INDICATE BRICK/STUCCO/WOODFACED)
COLORZ
ROOF MATERIAL: PITCH (7/12 MIN.)
COLOR:
MAX. EXP.
WINDOWS (GRILLES REQUIItEDY-(WOOD/OTHER)
INDICATE STIES IF NOT LISTED ON ELEVATIONS:
DOORS (WOOD/OTHER)
(INDICATE SIZES AND STYLE IF NOT LISTED ON ELEVATIONS): COLOR:
TRIM: (ALL WINDOWS & DOORS TRIMMED WITH 1X4 / IX5)
COLOR:
MATERIAL OF TRIM: (WOOD, VINYL, ALUMINUM)
SHUTTERS (WOOD/VINYL) (PANELED/LOUVERED)
COLOR:
GUTTERS (WOOD/ALUMI 4W:
COLOR:
GARAGE DOORS: SIZE & STYLE:
COLOR:
STORM WINDOWS & DOORS:
COLOR:
(INDICATE SIZES IF NOT LISTED ON ELVATIONS)
SKYLIGHTS: TYPESIZE: COLOR:
WOOD DECK: SUE: COLOR:
WOOD FENCING (MAX. HEIGHT 6): STYLE:io 1 csd•� PL"`� ' COLOR: t -&}"r" y
(SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN) 'S' ` ~ • Wed uca d
RETAINING WALL: (P.T. OR FIELDSTONE --CONCRETE INAPPROPRIATE)
(SHOW LAYOUT & RUNNING FOOTAGE ON SITE PLAN)
SIGNS: (indicate size, style, colors) COLOR:
SIGN POST: (indicate size, style, color) COLOR:
ADDITIONAL
INFORMATION:
REV. 12/02
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