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Home My WebLink About26-A108 11 Embassy Lane ApprovedTOWN OF YARMOUTH 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 ' Telephone (508) 398-2231 Ext. 1292-Fax (508) 398-0836 OLD KINGS HIGHWAY HISTORIC DISTRICT COMMITTtit 021i JAW.40I11K Io N CLF-RK RE APPLICATION FOR ighway CEP SO °26 PKr/-' 1 CERTIFICATE OF APPROPRIATENESS Istrict Application is hereby made for issuanoe 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 CODIeS OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION. Check All Cateaories That Annly: Indicate type of Building: Commercial Residential 1) Exterior Building Construction: X New Building Shed _ Solar Panels Other. 2) Exterior Painting: Siding — 3) Signs/Billboards* New Sign Shutters AdditionAlterations Reroof Garage Doors Trim Other: C - ►_f\ Change to Existing Sign 4) Miscellaneous Structures: Fence Wall Flagpole Pool Other: Please type or print legibly: Address of proposed work: I L J _ Map/Lot # Owners) ° 1;, � Phone #: 14 t 3 - y _ . a All applications must be submitted by omor or accompanied by letter from owner approving submittal of application. Mailing address: -a Y r Year built- t l 7 a Email: Agenttoontractor notification method: Phone -Email � I 2 Phone # _ &� 0 qCM Mailing Address: _. _ ) �.ii_ „r 4-� x � o R Email: Prefered notification method: Phone Email Description of Proposed Work: � �• � � � . rJ `b C�._e Signed (Owner or agent): Date: ➢ Owner/contractor/agent is aware 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 toinspection by OKH OKH-approved plans MUST be available on -site for framing & final inspections Rcvd Date: Amount Cash/CK #: Rcvd by. L" -S 45 Days: Approved Reason for Denial: Signed- 4311ilow" Date Signed: 124 Approved with Modifications Denied SEP 2 8 2026 ,2s-A 1 08 APPLICATION( #: s Old King's Highway Historic District TOWN OF YARMOUTH OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451 Telephone (509) 398-2231 Ext.1292 Fax (508) 398-0836 STATEMENT OF UNDERSTANDING CHANGES TO AN OLD KING'S HIGHWAY APPROVED PLAN As property owner/contractor/agent for construction at Wi , Map/Lot I tF1 NIP C/A # a (o-- A 1-T Approval Date: so 1 certify that I understand the following requirements regarding any changes that may be required for this project: In accordance with paragraph 2(a) of section 1.03(General Procedures) of the OKH 972 CMR Rules and Regulations: Only minor changes may be approved by the Committee without the filing of a new application and a new hearing. Minor changes include alterations that can be done without a detrimental Impact on the overall appearance of the project such as altering a single window or door change or a minor change of colors. All minor changes by amendment will require the local Committee's or its designee's approval. All changes to previously OKH approved plans require notification to and approval from the local OKH Committee. Change requests must be submitted to the Committee In writing on the appropriate request form, which may be obtained from the OKH office. All change approvals must be obtained before incorporating the change into the project. If the change has been implemented prior to receipt of OKH approval, a Minor Change approval or Certificate of Appropriateness application for the revised plans is still required and will result in a doubled filing fee for the appropriate category of work. Failure to comply with the above statements will result in the Building Department issuing a stop -work order or delaying the issuance of an Occupancy Permit or final Inspection approval. I have read and understand the above statements. Date: dA his I Signed: lihur►n�lf" nn4ronl ff AM Qn e d: Highway SEP 2 8 2026 Old King's Highway ""°'"°MUM2' Historic District TOWN OF YARMOUTH OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451 Telephone (508) 398-2231 Ext.1292 Fax (508) 398-0836 STATEMENT OF UNDERSTANDING CHANGES TO AN OLD KING'S HIGHWAY APPROVED PLAN As property own erlcontractorlagent for construction at Em S , Map/Lot i ke CIA # 9 { — A Q ' Approval Date: gn ImIM4 I certify that I understand the following requirements regarding any changes that may be required for this project: In accordance with paragraph 2(a) of section 1.03(General Procedures) of the OKH 972 CMR Rules and Regulations: Only minor changes may be approved by the Committee without the filing of a new application and a new hearing. Minor changes include alterations that can be done without a detrimental impact on the overall appearance of the project such as altering a single window or door change or a minor change of colors. All minor changes by amendment will require the local Committee's or its designee's approval. All changes to previously OKH approved plans require notification to and approval from the local OKH Committee. Change requests must be submitted to the Committee in writing on the appropriate request form, which may be obtained from the OKH office. All change approvals must be obtained before incorporating the change into the project. If the change has been implemented prior to receipt of OKH approval, a Minor Change approval or Certificate of Appropriateness application for the revised plans is still required and will result in a doubled filing fee for the appropriate category of work. Failure to comply with the above statements will result in the Building Department issuing a stop -work order or delaying the issuance of an Occupancy Permit or final inspection approval. have read and understand the above statements. (Owner/Contractor/Agent) pff 4f:� ( hairman, Old King's Highway Cittee) SEP 2 8 7026 Old King's Highway U°°e'ed 5ni/2024 Historic District TOWN OF YAIMOUTH 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 R11 I M B WAIVER AUG 2 8 2028 Please sign and date this form Old King's Highway HistQr' District Application #: � 6 `" A 108 — Project Address: Application Received Date: 1V(;2 A2fv 45 Day Decision Deadline: toll Z��b 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: ,*-ej YDate: _ Signed: — F,� 6L-) �-?, Owner R Owner 5V��_. SEP 2 8 7076 Contractor/Agent Old King's Highway Historic District 28--A1.08 � GENERAL SPECIFICATION SHEET Project Address: FOUNDATION: Material: `5` i h 7'-_Exposure (Not to exceed 18"): CHIMNEY: Material/Color: /a GUTTERS: Material/Color: tt�� ROOF: Material: �S Pitch (7/12 min) �� Height to Ridge: ) i l rr Color: J �A C s i SIDING: Material/Style: Front: _. C? r` CA. L-4,k . es/Rear: C4 P-),A &A COLOR CHIPS Color: Front: (f YP 4�1 Sides/Rear: r � TRIM: All windows & doors to be trimmed with: 1 1 x5 (Circle one.) Material: r L 9kN Color: t DOORS: Qty: Material: bc 1-�� Color: Style/Size if not listed/shown on elevations): STORM DOORS: Qty: N_(� Material. - GARAGE DOORS: Qty: �AMat'I: _ WINDOWS: Qty/side:: Front: C--Q Left: Right: Color: Style: Color: Rear: Color: Manufacturer/Series: `� 1 Material. - Grilles (Required)- Patter 2/1 tc) �� Grille Type: True Divided Lite: Snap -In. � Between Glass: Permanently Applied: Exterior Interior STORM WINDOWS: Qty: Material: Color: SHUTTERS: Mat'l: Style: Paneled Louvered Color: SKYLIGHTS: Qty: Fixed Vented Size Color: DECK: Size: Decking Mat'I: Color: AW 1 8 7076 Old Kiri. ; .. Highway Historic District Railing Matl: Style: Color: WALLS/FENCES* (Max 6' hei Q Height, Mat'I; Style: or: (Show running footage & location o lan.) "Finished side of fence must face out from fe i 2 a vMM UTILITY METERSIHVAC UNITS: L ation: Screening: SEP 7 � )02g LIGHTS: Qty: Style: Color: Old King's Highway Location(s): Historic District LIGHT POSTS: Qty-. Material: Color: Location(s): Additional information: 26- a APPLICATION #: x ¢ Yc TOWN OF YARMOUTH I� OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE ♦ytEa ABUTTERS' LIST Applicant's (Owner) Name: Property Address/Location:;,--1 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 Kmg's Highway Department page on the Town website: www.varmouth.ma_us Map Number Lot Number Applicant Information: Abutter Information: nil � 9 R M� B All6 2 B 71126 Old King's Highway Historic District r�MR WLID SEP 2 B 2026 Old Kings Highway Historic DlstrlCt. Application #: 2 6 - Al 08 151177111 CALLAHAN JOHN F 1014 ROUTE 6A YARMOUTH PORT, MA 02675 1511 471 1 I VAILLANCOURT CHARLES J 9 EMBASSY LANE YARMOUTH PORT, MA 02675 1511 401 1 1 NGUYEN MAN 2 BRAY FARM RD NORTH YARMOUTH PORT, MA 02675 1511 481 1 1 MASON DENNIS L 10 EMBASSY LN YARMOUTH PORT 19:4 MA 02675 1511 461 1 1 JASAK SARA D TR 28 FENOR ST WEST SPRINGFIELD, MA 01089 Please use this signature to certify this list of properties directly abutting and across the street from the parcel located at: 11 Embassy Ln., Yarmouth Part, MA 02675 Assessors Map 151, Lot 46 W4PA&&v, Tara Monroe, Director of Assessing September 8, 2026 1511 761 1 I RIKER DEYSELUCIA M 2 LONGFELLOW DR WEST YARMOUTH. MA 02673 1511 451 1 1 CONNOLLY LAUREN 195 CENTER ST YARMOUTH PORT, MA 02675 Highway a !istoric District SEP 7 8 7026 Old King's Highway Historic District TY, �/� 11� Ij I kf14 AUG 2871126 Old King',:; Highway Historic District ri �+ ~ Ln *Ln _ rl L M`1 Ln ~ 1 rl Ln ♦ Ln . �. .M LM art �f Ln Lnp C Lu o �1 Q L If 9Ln 3 Ln LM $S Ln o W n � o Ln Ln ,1tm LM U 1" �. M LM IL ELn rn LM w rl ro � B� FF W VL 2 � u � o ffflll 7� u N � n e e3a � Rif c eii S i O �WW 61 In" 0�j�iLNR SEP282.025 Old Kings Highway Historic District 4 26- A 108 T • r i UFO low o- . UD �0 VCR-. SEP 2 8 2026 PLOT PLAN AIfG 't 8 107.E 04d Kings Highway Historic District FOR WT # Old K�ng'�, Highway Historic District �di� ]cc o! gmcaga W ac ovam=y buodkq Addidcrw with elarhed ]ins r--w--_-.�--------- SaMar"p dish (caaspad) Kau 0 - Abutters Name Lot # N this is a corner lot, write In name of street _r SWR TAM . TTT I I RZU TARD )loft .•, o •04....Fr. I yyy. =8 MD \20t.0658. 000..•...... •.ft 11 Embamy Lane 1� �! (NAME OF STREET) / ty home owner t SkID014 by Abutter's Name Lot # If this is a corner lot, write in name of street. 4 V 2 6 - A 1 0 8 2 Q r Attr z f! 711A Old Highway Historic District Lq 9 26-Al08 1lF 7 �7..� 'y .E'er•-.�.;' . f< T.•.. r# J c, x,. III -} ��.,s`.�r.,;� . ti.�s•_ �:�} "�.�. ' �"�+qI rl. III -, ,.�.,� `�.''- •..: y' � .-�,':'ri. �, � �= ail.. ' III .1 =l•': III y 'y'�s _:� � � _ jlil IIIII '� �- ■ i '-'{ �� ti F �• •}'.{t- _x .. 1. � r��iN�=�� ':- -i ►, m a 0 Y) C a C J