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23-E100 9 Hockanom Road Approved
' 3 ems _'`=•s,V jJn¢ : 3 RE TOWN OF YARMOUTH 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 " Telephone (508) 398-2231 Ext. 1292-Fax (508) 398-0836 RECFIV . OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE NEC 14 2023 APPLICATION FOR YAHN'IUiJ l r' CERTIFICATE OF EXEMPTION OLD KING'S HIGHWAY 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. Tyne or print legibly. �f Address of proposed work: Iqf ©COIL a n a Val z • Map/Lot # Owner(s1: I`e j±t S C6 axc 'fKr -1 rr Gs Z It j fr r ✓ -C Phone #: S©25' . '7 76 ® (,�32- All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address_ q &K&ZO v � Year built: Email; 54t V1 +e����[y1c[ '&� Preferred notification method: Phone LI-EM-ail Aoent/Contractor: Mailing Address: Email: Phone#: 5o0 Z 0e Preferred notification method: Phone _Email r5 , Cen-" 14 Q om^-. 44� /V iLc1rC4rw>< a a -C,(' a r 4 VL0- bi-rk Q� (",-C, vke� p` pcu7t O C,Z'i' vr- WC a-t k >r plCIC �r t�� cev Vw �(.t a �t�tct c� XSigned (Owner or agent): Date: I D ownerlcontractorlagent Is aware that a permit may be required from the Buiding Department. (Check other departments, also.) Y This certfricate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shelf be later. For Committee use only: Date: IlAjqb3 Amount L r 00 Cash1CK M ..-(0zAq_ Rcvd by: L 51 ZApproved Approved with changes APP D Reason for denial: JINN 7n -OLD 'WAY Date Signed:Signed: APPLICATION #: V52017 TOWN OF YARMOUTH 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451 Telephone (508) 398-2231 Ext. 1292 Fax (548) 398-0836 OLD KING'S HIGHWAY HISTORIC DISTRICT COMNUTTEE 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. Applicant/Agent Name (please print): Z!6!4c 0 2-jcDc- 1 Applicant/Agent signat e: Date: r _J DES 1 4 2023 1 ru-LIVILJV i I , APPROVED JAN 0 u 2024 OLD KIND'S HIGHWAY Application fl: 19Z - e 00 01411 11 W uj uj Wo po ON � a� IL o W w r A 3 Q N W O V ." T `' U Z W � � m CD m ,n ;n u' N � cli J `2 0 L U)3,o as (13 U C h O Q_ E o 0 C? 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