HomeMy WebLinkAbout169 Route 6A Old Kings Highway Approval 02.13.25O°
o TOWN OF YARMOUTH Mffljopyy
1148 ROUTE 28 SOUTH YARMOUTH MA 02664 5 -44 1
Telephone (508) 398-2231 Ext. 1292—Fax (508) 398-0836
FEB 1 0 2025
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
Id King's Highway
iARNOUTH TOWN CLERK RE APPLICATION FOR Historic District
FEB 18125 A148:52 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.
Type or Print12gibly:
Address of proposed work: le / Map/Lot #
Ownerfsl: '--ee Phone #:
All applicatio must be eubmi by owner or accompanied by letter from owner approving submittal of application.
Mailing address: / m fT / /7 Year built: / ' J`~eq
Email: q /'C 0- 74u,- f/, HOC llC• 6flreferred notification method: Phone (Email
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Mailing Address: /
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Email: C P.Oc we r I P hr a C Preferred notification method: Phone
Delcriplign of Proposed
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Signed (Owner or agent): / Date:
lo Owner/contractortagent 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
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Date: d1
Amount W
Cash/CK #:
Rcvd by . ' S
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Reason for denial:
Date Signed Signed 5U k-1?14 e4'0? I
Old King's
ti 5 2017