23-A110 30 Clinton DriveQ
TOWN OF YARMOUTH
EVF—D 1146 ROUTE 28, SOUTH YARMOUTH, MA 026644451
L� Telephone (508) 398-2231 Ext. 1292--Fax (508) 398-0836
AUG 2 5 20'L .,OL KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
f r-kniviQU 1 r, APPLICATION FOR
OLD KING'S H1GH1�+lAY _I 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 SNEET(S), ELEVATIONS, PHOTOS, & SUPPLEMEyTAL INFORMATION.
Check All Categories That Anely: Indicate type of Building: Commercial Residential
1) Exte i r Building Construction: New Building Addition _Alterations Reroof Garage
Shed Solar Panels Other:
2) Exterior Painting: Siding Shutters Doors Trim Other:
3) Signs/Billboards: New Sign Change to Existing Sign
4) Miscellaneous Structures: Fence Wall Flagpole Pool Other:
Please type or print legibly: Address of proposed work: y c_. /-
.AV,>,_'C>-iJC— Map/Lot#
Phone #: 77'1't)1e\ l�I�
All applications must be submittedby owner or accompanied by letter from owner approving submittal of application.
Mailing address: 30 G� "kVNtJ e , ki ,JjoS t'-ft A % Year built: J J L�'> S
Email: Preferred notification method:y Phone Email
Agent/contractor; - A-g, %ri,:bT irj x)l nt Rgl r,�! Phone #: �c� ` R C��'noa
Mailing Address: a S CQU-�✓t r rAe (Zol ,C4 .lint^ M A d Cr IS-�
Email: pint._�4�ai. Go,,,\ _ _ Preferred notification method: phone Email
Descriotion of P oposed Work:
Cvnsi-rucr— l-.), X ILe St�,� stne,� a� dhe i�t�;� c�hcr�e} si�,Lo
Signed (Owner or agent):
Date:
D Owner/contractor/agent is aware that 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.
D This certificate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later.
D All new construction will be subject to inspection by OKH. OKH-approved plans MUST be available on -site for framing & final inspections.
Rcvd Date: it �1��
Amount •10
Cash/GK #: 3qyo
Rcvd by: L 5 --
45 !Jays: KI T t 2 3
Approved Approved with Modifications Denied
Reason for Denial;
Signed:
Date Signed:... _ -- ---- - - -- _ — — --- -- --- ----
APPLICATION #: 6�-Ali0
GENERAL SPECIFICATION SHEET
Proiect Address:
FOUNDATION: Material: L&Acyei r< Exposure (Not to exceed 18"): L ~ Ce
CHIMNEY. Material/Color: _ t3 I Pr GUTTERS: Material/Color:_ 1P,
rT ROOF: Material: r,JL Sk1Mc S Pitch (7112 min) P 11� Height to Ridge: Ian - (P" Color: to +r`^k h.suu
SIDING: Material/Style: Front:6, p $ }W_ C�,�h-N�d,�, Sides/Rear: WV- Ab-rl -Kk OLOR CHIPS
Color: Front: M St� Sides/Rear: is Musa `
TRIM: All windows & doors to be trimmed with: 0
1x5 (Circle one.)
Material: L____ _ Color: _WVni}< .,
DOORS: Qty: 1 Material: 1c.1130-J Color: Tv A,,ktJ^ h,,,)i-[
Style/Size (if not listed/shown on elevations): o - `—`wC� 34P " A 71
STORM DOORS: Qty: Material:
Color:
GARAGE DOORS: Qty: t MatT Style: y+t Color: Wn ,,4r_
WINDOWS: /side:: Front: oZ Left: _ b Right: CU Rear: C� Color: W�i
Manufacturer/Series: KH Material:
Grilles (Required): Pattern (6/6, 2/1, etc.) & �p — Grille Type'. True Divid Lite:
Snap -In: Between Glass: Permanently Applied: Exterior Interior
STORM WINDOWS: Qty: 0> Material: Color: I
SHUTTERS: MatT ` Style: Paneled Louvered V Color: 1..�
SKYLIGHTS: Qty: D Fixed Vented Size
DECK: Size: Decking MatT
Railing MatT Style:
WALLS/FENCES* (Max W height): Height: Alfl _ Matt:
Color:
Color:
Color:
ECEIVED
AUG 2 5 2023
Style: Color:
(Show running footage & location on plot plan.) *Finished side of fence must face out from fenced in area.
UTILITY METERS/HVAC UNITS: Location: OF Screening:
LIGHTS: Qty: IM- Style:
Location(s):
LIGHT POSTS: Qty: d l�' Material:
Location(s):
Additional information:
Color:
Color:
r ai- MOU i'r-r
2-General
APPLICATION #: �;?rA1l
8.2018
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: R�L�4�U� S-� _
Property Address/Location: 3v Cu)tag q)r:Vt-
Hearing Date: 6ra 51,93
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:
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Application #:
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TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
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PINE HARBOR
WOOD PRODUCTS
259 Queen Anne Road I Harwich MA. 02645
(508) 430-2800 1 pineharbor.com I infogpineharbor.com
Homeowner Authorization
ECFi1/Fn
AUG 2 5 2023
YAHMUU1+,
I f 4as owner of the property
located at 5Q CiAlj�V _ d0e have
requested that Pine Harbor Wood Products apply for this building
permit on my behalf. Pine Harbor will be serving only as my
contractor and representative for matters relating to this
application. I will be acting as the applicant and will assume all
responsibilities associated with this permit.
As owner of the subject property, I authorize Pine Harbor Wood Products to file this
permit application in my name.
Signatur Date:
Pine Harbor Wood Products - 259 Queen Anne Road, Harwich MA, 02645
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