HomeMy WebLinkAbout22-A091 121 Union StreetTOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
i HIGHWAY HISTORIC DISTRICT COMMITTEE
APPLICATION FOR
CERTIFICATE OF APPROPRIATENESS
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as
amended, for proposed work as described below & on plans, drawings, photographs, & other supplemental info accompanying this
application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Categories That APPI Indicate type of Building: CommereRe
Residential
1) Exteri r Buildin Construction: New Building 0 Addition Iterationsof DGarage
Shed "Solar Panels Other:
2) Exterior Painting: OSiding Shutters F Doors []Trim Other:
3) Signs/Billboards: II New Si n Change to Existing Sign
4) Miscellaneous Structures: Fence Wall IIFlagpole IIPool 0
Please type or print legibly:
Other:
Address of proposed work: _17,1 UK taut. Map/Lot # 5
Owner(s): �A+M �5 o"rc> Phone #: -TZ`tiL ZL fo 114$
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 17,1 i VI �r` Year built: 14-1 S
Email: V-06 aa -0 ��^�' Preferred notification method: 11 Phone Email
Agenticontractor: ►ti �re L- ►c-fA S.-- 14 ti'n _ Phone #: '-(-r4 so., I zzz _
Mailing Address: jf /
Email: 14 1-4l0 GtkA t I Preferred notification method: Phone aEmail
Description of ProposedWork:
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Signed
loFSigned (Owner or agent): �' Date:
> Ownerlcontractorlagentis aware hat a permit is required from the Building Department. (Check other departments, also.)
> If application is approve appro al is subject to a 10 -day appeal period required by the Act.
> This certificate is good for o-77elear from approval date or upon date of expiration of Building Permit, whichever date shall be later.
All new construction will be subject to inspection by OKH. OKH-approved plans MUST be available on-site for framing & final inspections.
Rcvd Date:
Amount
Cash/CK #:
Rcvd by: L,S
45 pays
Date Signed:
Approved Approved with Modifications Denied
Reason for Denial:
Signed:
APPLICATION #:
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 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 nzake a determination on the application. -
Applicant understands that the review of this application will be scheduled as soon as the
situation allows. r—,\
Applicant/Agent Name (please print):
Applicant/Agent signature:
RECEIVED
J U L 19 2022
YAHIV10U i r-,
312020
cc
Application 9-
Date: 7 -t kL
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: w(S` sr4ly
Property Address/Location:
Hearing Date:
Notices must be sent to the Applicant and abutters (including owners of land on any
public or private street or way) who's property directly abuts or is across the street from
the Applicant. Please provide the Assessor's Tax Map and Lot numbers only. The
OKH Office will send out notices using the addresses as they appear on the most recent
applicable tax list.
Note: Instructions for obtaining the abutters Map and Lot numbers can be found on the Old King's
Highway Department page on the Town website: www.yarmouth.ma.us
Map Number Lot Number
Applicant Information:
Abutter Information:
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