23-E059 25 Dartmoor Way Approved1
TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
ECEIVFVW-�� Telephone (508) 398-2231 Ext. 1292--Fax (508) 398-0836
JUL 10 2023 OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
YARMOUTh APPLICATION FOR
D KING'S HIGHWAY . 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: '�Map/Lot# ILIr/38'
Owner : _- -cy-oni f H l kL 'Z-t;N O S4 i C -f Phone #: ' J1C~ yC)Y
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: &4 a. (a0 q-e-- Year built: f 1' T- I
L
h I 02
Email: µ r t tA: KL e � I k rr S Lf � referred fication method: Phone Email
��.._.—
A ent/Contractor: 1 Phone #:
Mailing Address:
Email:
Preferred notification method
Description of Proposed Work #Additional pages may be attached if necessary):
'5h-t S I OX I I
Signed (Owner or agent):
Phone Email
Date: 7 b- & Z
D Owner/contractortagent is aware thAt a permit may be required from the Building Deparlment. (Check other departments, also.)
a This certificate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later.
For Committee use, oniv:
Date:
Amount X' 10
Cash/CK #: 25yi
Rcvd by: Ills,
Date Signed: AW128
Approved Approved with Chang APPED
Reason for denial:
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FJir'_LJIA1AV
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Signed: APPI_iCATION #:
V5 2017
A'ALN TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-M51
UVIN
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 make a determination on the application. "
Applicant understands that the review of this application will be scheduled as soon as the
situation allows. ll�
Applicant/Agent Name (please print):
Applicant/Agent signature: Date:
�CFIVFFD
JUL 10 2023 APPROVED
YAhiVIUOIrs JUL 18 2023
KIN HIGHWAY
r HRMUl1 'Ch
Application #: _2` -CV57
312020
RECEIVED
JUL 10 2023 1
YAHAriUJI t,
OLD KINGS HIGHWAY f
Abutter s
Name
Lot #
If this is a
corner lot,
write in
name of street.
SME YARD
7
SHEIDS LESS THAN 150 SQ FT SHALL
RE PLACED A MINIMUM OI 30 FEET
FROM THE FRONT LOT LINE AND A
MINIMUM OF 6 FEET FROM SIDES AND
PLOT PLAN REAR LOT LINES
FOR LOT #
(1at................ft. zedr)
j
REAR YARD
1
S8T BAME
.i
a
('at..................ft. fzCntmm )
ni0
(NXMS OF STREET)
Infwmatian
SuPP11wA by
SIZE YARD
`1
f
Abutter's
Name
Lot #
If this is a
corner lot,
write in
name of street.
a
8
ro
APPROVED
JUL 18 2V3
YARMOU ; r-,
67-vo"