HomeMy WebLinkAbout5180 10 Embassy Ln Old Kings Highway Approval 05.28.25TOWN OF YARMOIlTH �'tNNE
1146 ROUTE 28, SOUTH YARMOUTH. MA 02664-4451
Telephone (508) 398-2231 Ext 1292—Fax (508) 398-0836 MAY 0 n 2025
-
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
PARMOUTH TOWN CLERK RE Old I<.ng s Highway
MAY 29125 A149:26 APPLICATION FOR Historic District
CERTIFICATE OF APPROPRIATENESS
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1073 as
amended, for proposed work as described below & on plans, drawings, photographs, & other supplemental info accompanying this
application- PLEASE SUBMIT 4 copies OF SPEC SHEET($), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Calegories Thglindicate type of Building. Commercial ✓ Residential
1) Exterior Building Construction: New Building Addition Alterations Reroof Garage
Shed Solar Panels Other: 5%*b1Q9$A4r �4t1htNr." C1L-
2) Exterior Painting: Siding Shutters Doors ✓Trim 00 Other:
3) Signs/Billboards: New Sign Change to Existing Sign
4) Miscellaneous Structures: Fence Wall Flagpole Pool Other:
Please type or print legibly:
Address of proposed work: 4. -+EOM04QMap/Lot # I41.46
4 It 0
Owner(s� lb W_ -- _ Phone #: +
�rt9
4'46T. 666
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 10�.A- �� iD Year built: 2�1�
t
Email: referred notification method: Phone ✓ Email
Agenticontractor: OLAa1 *41 Phone #:
Mailing Address'
Email: Preferred notification method Phone ✓ Email
Pe-sgdRJM of PrgMed IN rk:
AVD S%*400W% kJo TOKV.'Tb 1Eras1'l*X6 04VAS.
tAproAr GOV CAP i7co",Iyro % ft%A.-IL T30 ILVy"ti Qax-
Signed (Owner or agent):
Date- I# ` R4
D Ownericontractor?agent is aware that a permit is requirMrom the Building Department (Check other departments also)
f If application is approved, approval is subject to a 10•day appeal period required by the Act
3� This certificate is good for one year from approval dale or upon date of exp ration of Building Permit. whichever date shall be later.
All new construction will be subject to_ftpeclion by OKH. OKH-approved plans MUST be available on -site for tramng & final inspections
For Commift se only,:
Rcvd Date Lj`5
Amount
Cash1CK #
Rcvd by' L-r
45 Days; (.011
Z Approved Approved with Modifications OMP
Reason for Denial:
Signed:
2iC
Date Signed / �
aS— A 0 6 5
APPLICATION #: