24-A049 43 Medinah DriveRECEIVE®
APR 0 2 2024
TOWN OF YARMOUTH
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664- 451
Telephone (508) 398-2231 Ext. 1292-Fax (508) 398-0836
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 SUBMIT 4 covies OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Cate orles That AypjlL. Indicate type of Building: Commercial V Residential
1) Exterior Building Construction: New Building
V Shed Solar Panels Other:
Addition Alterations Reroof Garage
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: II11
Address of proposed work: 13 ME4/NAN &elYtv, Y4,000I -11MR7 MA Map/Lot # /63 La5
Owner(s): ;SOAK 14 . WkICh"r Phone M 77y - 99# ' o63 z/
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. e
Mailing address: � QDX 1075 _ 6114A)SyA&Z . AJ,4 0-24 3T Year built: I R-7g-
Email: T0AA1M W41CN?E' CDOCAST. Ng;' Preferred notification method: f/ Phone Email
Agenticontractor:
Mailing Address:
Email:
Phone #:
Preferred notification method
Description of Proposed Work:
NEW /0 z X *f Me srA410/4) C SA60 f IP1 PiAZ I✓4R401,
/tt
Signed (Owner or agent):
W
Phone Email
Date: 3 I aS' l 905L `/
• Owner/contractorlagent is awWre 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.
• This certificate is good for one year from approval date or upon date of expiration of Building Permit, whichever date shall be later.
• All new construction will be subject to inspection by OKH. OKH-approved plans MUST be available on -site for framing & final inspections.
Rcvd Date: t% .;I W
Amount d 5-Q
Cash/CK #: —I W,;z
Rcvd by: LA S
45 Days: !ql P1 2
Date Signed:
Approved Approved with Modifications Denied
Reason for Denial:
Signed:
1
APPLICATION #:
TOWN OF YARMOUTH
p` 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
45-DAY TIMEFRAME
WAIVER
Application #:
Project Address: L 3 Me Aih zh On\4
Application Received Date: _ 01,7 1 2t4
45 Day Decision Deadline: .5-11 of -.,�q
I/We, the undersigned owner, contractor, or agent, do hereby waive the
45-day timeframe for a determination on our application for a Certificate
of Appropriateness/Demolition/Exemption by the Old King's Highway
Historic District Committee for the following project:
S h.ed
Date:
RECEIVED
APR 0 2 2024
�ARiV1UUi h
3/2020
Signed:
O ner
Owner
ContractodAgent
%q— *qq
GENERAL SPECIFICATION SHEET
Proiect Address:
FOUNDATION: Material: Qwcp re A4O(:k Exposure (Not to exceed 18"):
CHIMNEY: Material/Color: ~ GUTTERS: Material/Color:
wE�+�RW000
ROOF: Material: 3-rm Q3+omct Pitch (7/12 min) /4 i? Height to Ridge: 7~ Color: G
SIDING: Material/Style: Front: QQM &J4104 Sides/Rear: &W * &77EA)
Color: Front: IV47UM L Sides/Rear: NA70M L,
TRIM: All windows & doors to be trimmed with: 1x 4 1x5 (Circle one.)
Material: i C U Color: W IV I T
DOORS: Qty: % Material: 64AO "W Color: 11/471IR4 L
Style/Size (if not listed/shown on elevations): '/ MOLE &Ad &4,10
STORM DOORS: Qty: N Material:
Color:
GARAGE DOORS: Qty: "", Mat'I: Style: Color:
WINDOWS: !side:: Front: 0 Left: i Right: O Rear: O Color:
Manufacturer/Series:
Material:
Grilles (Required): Pattern (6/6, 2/1, etc.) Grille Type: True Divided Lite:
Per Snap -In: Between Glass:manently Applied: Exterior Interior
STORM WINDOWS: Qty: Material:
Color:
SHUTTERS: MatT Style: Paneled Louvered Color:
SKYLIGHTS: Qty: Fixed Vented Size Color:
DECK: Size: Decking MatT Color:
Railing MatT Style: Color:
WALLS/FENCES* (Max 6' height): Height: Mat'I:
COLOR CHIPS
RECFivF
APR 0 G 2024
OLDS H1GHwnv
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:
LIGHTS: Cty: Style:
Location(s):
Screening:
Color:
LIGHT POSTS: Qty: Material: Color:
Location(s):
Additional information:
2-General
APPLICATION* ?q'10k0k4
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: t a'✓1 W1-1 "+
Property Address/Location: 14-3 M C V1 Z �i or,ve,
Hearing Date: L4 122 211
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:
RECEIVED
APR 0 L 2024
�ARM0i11 r
OLD KINGHIGHWAY
Map Number
Lot Number
C73 as
1�?a
v3
q
,:Roo
`7 "W
103
9"q 13-799
Application #: 94-Abl 1
8.2018 3
TOWN OF YARMOUTH
1140 Rot IT 2R,'iOl I II 1 %RNIOI'1'11, NI %SS \Cllt SI('I"IS 02GG4-4451
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APR 0 2 2024
rHrtovlUl� I r1 OLD K1NGS HIGHWAY
Abutter's
Name
Lot #
If this is a
corner lot,
write in
name of street.
LONG. A(Wo
PLOT PLAN
FOR LOT # a S
Addit1cm x � p°r acce"y buUding
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Name A-a0uv 4Z-4
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It this is a
corner lot,
write in
name of street.
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(NAME OF STREET)
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