HomeMy WebLinkAbout23-E099 81 Lookout Road Approved,J
TOWN OF YARMOUTH
�EC 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext, 1292-Fax (508) 398-0836
DEC �' U 2V OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
rrl�SiviCliJj r,
p I(fNG'S H►GHW APPLICATION FOR
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.
Tv e- or print legibly: r_
Address of proposed work: ��, � _ "'S01"T Map/Lot #
Owners : ' �' Z-o )S Phone #: `c302
All applications must be submitted by owner accompanied by letter from owner approving submittal of application.
Mailing address:�_� _S Year built:
e
Email:
LO)Nferred notification method: x
Agent/Contractor: EIVI b i 6 ir�9 �- Phone #:
Mailing Address:
Email:
Preferred notification method:
Description of Proposed Work (Additional oases may be attached If necessary):
�tvl.Pi csW � �r—
Signed (Owner or agent):
Phone Email
Phone Email
Date: G 4 a
2),-5
➢ Owner/coniractorlagent is aware that a permit may be required from the Building Department. (Check other departments, also.)
➢ 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 only:
bate: p- ?;
Amount X , 0j
Cash/CK
Rcvd by L S
Approved Approved with changeAPPFIGMEW
Reason for denial:
Date Signed: 2 W Signed:
APPLICATION #: -6,0
v5 2017
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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 COMMTTEE
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; bill 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.
Applicant/Agent Name (please print):
Applicant/Agent signature: Date: 4
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CRVED
DEC t S 2023
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DEC o 8 2023
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RE!STERED LAND SURVEYORS
?5 HAtrsMOND. STREET — FLOOR 2
WORCESTER, MA 0161.0-1723
PHONE: 508— 752— 8885
FAX, 508--752-8895
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DEC C 8 2023
YMhIVIVU I I
MORTGAGE
INSPECTION PLAN
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NAME LOPS KATHRYN HORNYACK & JOHN WCHAEL HORNYACK
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LOCATION 81 LOOKOUT
ROAD
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YARMOUTH PORT, MA
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SCALE 1 = 40
DATE DS 1 i 23.
DEED BOOK/?ACE 123M/242
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