23-A002 1A Walnut Street°`Y� TOWN OF YARMOUTH
0 e
FY a 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
'Q-� Telephone (508) 398-2231 Ext. 1292—Pax (508) 398-0836
OLD KING'S 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 C_ opieS OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEME TAL INFORMATION.
Check All Categories That Apply: Indicate type of Building: Commercial Residential
1) Exterior Building Construction: New Building Addition ZAlterations Reroof Garage
Shed ` Solar Panels Other:
2) Exterior Painting: Siding Shutters Doors _Trim
3) Sign illboards: New Sign
4) Misc neous Structures: Fence
Please type or print legibly:
Address of proposed work:
Owner(s): �� T-1
All applications must be submitted by o%
Mailing address:
Email:
Agent/contractor: n I
Mailing Address:
Change to Existing Sign
Other:
`Wall Flagpole Pool A Other:
W-41ayT (; e&7- f � Map/Lot # -( rd 3 {)
CNN
Phone #:
her or accompanied by letter from owner approving submittal of application.
MMMMU111M lug 1.J.71' XW
Description of Proposed Work: ! v
,�Gr .P1Z-14WY
Signed (Owner or agent):
Year built:
_ referred notification method:: Phone Email
`} Oy�� d Phone #: ID�Y./
�01►�Preferred notification method: Phone Email
ill;�e k `r et 4
I C A -IL � aa-ft�
� a
Date: 10, / rN �
.� Own erlcontractodagent is awa hat a permit is required from the Building Department. (Check other departments, also.)
➢ If application is approved, approval is subject to a 10-day appeal period required by the Act.
;o- This certificate is good for one year 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 �a ,
Cash/CK#: 3(ti Q
Rcvd by: IWi 5,
45 Days
Date Signed:
d�
Approved Approved with Modifications Denied
Reason for Denial_
Signed:
1 OW
APPLICATION #: —A
GENERAL SPECIFICATION SHEET
FOUNDATION: Material: (JGQ.j Exposure (Not to exceed 18" ):
CHI EY: Material/Color: GUTTERS: Material/Color: G car'�'Siu&
ROOF: Material: . N Pitch (7/12 min) i� Height to Ridge :"'L Color: S
I �
SIDING: Material/Style: Front:— Ji1��� Sides/Rear: COLOR CHIPS
Color: Front: ukL Sides/Rear: SQL
TRIM: All windows & doors to be trimmed with: 01x41x5 (Circle one
Material: _ y v F.
Ad
DOORS: Qty: ♦ . erial:
W—
Style/Size �(if not listed/shown on elevations):
STORM �pORS: Qty: Material:
GARAGIXOORS: Qty: MatT Style:
••111111FITTIMES
Color:
Color:
WINDOWS: Qtvlside:: Front: Leff: Right: Rear:
Manufacturer/Series: ;IMaterial:
Color: t ,
Color: W p
Grilles (Required): Pattern 6/6 2/1, etc.) Grille Type: True Divided Lite: _
Snap -In: Be een Glass: Permanently Applied: Exterior
STORM WAIDOWS: Qty: Material:
SHUTTERS: MatT
: Qty
Style: Paneled Louvered
Fixed Vented Size
Db,qK: Size: Decking MatT
R cling Mat'I: Style
WALLS ENCES* (Max W height): Height:
Styl Color:
(Show runn' g footage & location on plot plan.)
UTILITY ME S/HVAC UNITS: Location:
LIG)4: Qty: Style:
7 Location(s): _
LIGHX,Location(s):
STS: Qty: _
Additional information:
Material:
MatT
Color:
Color:
Color. -
Color:
Color:
Interior
"Finished side of fence must face out from fenced in area.
Screening:
Color:
Color:
2-General
APPLICATION #: 0—"/' j
TOWN OF YARMOUTH
OLD KINGS HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: ��� '��-i htn
Property Address/Location: f A hvj- S-hW+-
Hearing Date: i q
Notices must be sent to the applicant and abutters (including owners of land on any
public or private street or way) whose property directly abuts or is across the street from
the applicant. 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:
Application #: 27` A%,�)-
8.2018 3
C
Y
0
0
ro
ro
c
m
Co
m
N
N
N
M
kn
M
co
dip
n ■c.i'r
00
V- tz:
m rn
o MIS loo
80
ROp.D
wLn
ES -
m
r
LA
a
iY
4 0
b
G C
b �
rZ
6
A
O
poN�
W
N
N
O
5r.
mo
E
y
U
47
Q
F
Akan,
'.e
f
ip R�1 v
k
y j
1
i
tA
,Z
U
,;?--AxA;l-