HomeMy WebLinkAbout24-A025 9 Pequod CircleTOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292-Fax (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 Sf.IBMIT 4 C_ O#1i@S OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Categories That Apply:, Indicate type of Building: Commercial Residential
1) Exterior 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: J,/Fence Wall Flagpole Pool Other:
Please type or print legibly:
Address of proposed work: �Y G l r �� 7 Map/Lot #
Owner(s): rz�L Phone #:y��73
All applications must be submitted by owner or accompanied 4by letter from owner approving submittal
/o-f application.
Mailing address: r L r �y(JyYr Year built:
Email:/ferred�notification method: one Email
Agenticontractor. J h A Phone M
Mailing Address:
Email: Preferred notification method: Phone Email
Description of Proposed Work: C 49 Al eel
Z6) d-es 0,(, l s a �-lirJ
Signed (Owner or agent): L/'LC Date: ZDZV
D Ownerlconlractodagent is aware that a permit is required from the Building Department (Check other departments, also.)
D If application is approved, approval is subject to a 1li-day appeal period required by the Act.
➢ This certificate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later.
➢ All now construction will be subject to Inspection by OKH. OKH-approved plans MUST be available on -site for framing & final inspections.
Rcvd Date: -2 .7I d`"t
Amount OAS'
CashlCK #: �0 3 1
Rcvd by: LI 51
45 Days:
Date Signed:
Approved Approved with Modifications Denied
Reason for Denial:
Signed:
APPLICATION M /
GENERAL
�SPECIFICATION SH
Project Address: �I i-j?v 1J,0d ("I'm
FOUNDATION: Material:
Exposure (Not to exceed 18"):
CHIMNEY: Material/Color: GUTTERS: Material/Color:
ROOF: Material: Pitch (7112 min) Height to Ridge: Color:
SIDING: Materal/Style: Front: Sides/Rear:
Color: Front: SideslRear:
TRIM: All windows & doors to be trimmed with: 1x 4 1x5 (Circle one.)
Material: Color:
DOORS: Qty: Material:
Style/Size (if not listed/shown on elevations):
STORM DOORS: Qty: Material:
GARAGE DOORS: Qty: MatT
WINDOWS: ide:: Front:
Manufacturer/Series.
Color:
Color:
Style: Color:
Left: Right: Rear:
Material:
Color:
Grilles (Required): Pattern (616, 211, etc.) Grille Type: True Divided Lite:
Snap -In: Between Glass: Permanently Applied: Exterior Interior
STORM WINDOWS: Qty: Material: Color:
SHUTTERS: Mefl:
Style: Paneled Louvered Color:
COLOR CHIPS
SKYLIGHTS: Qty: Fixed Vented Size Color:
DECK: Size: Decking MatT Color:
Railing MatT Style: Color: I
WALLSIFENCES* (Max V height): Height: Matif av, 01 l
Style: dlfllf i?/ // -Color:
(Show running footag6 & location on plot plan.) *Finished side of fence m, isT face out from fenced in area.
UTILITY METERSIHVAC UNITS: Location: Screening:
LIGHTS: Qty: I Style:
Color:
Location(s):
LIGHT POSTS: Qty: Material: Color:
Location(s):
Additional information:
2-General � - A.IP
APPLICATION #. / I w�'
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: A74i/,ac- (5,,
Property Address/Location:
Hearing Date:
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
Applicant Information:
Abutter Information:
Map Number
Lot Number
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Application #: 2q
8.2018 3
TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
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