19-E064°tY TOWN OF YARMOUTH
y 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 RECRVED,
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
JUL 1 3 20'19
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE ; ;�r ,lviU , I H
APPLICATION FOR i OLD KII`IC'S ±HIGHWAY I
CERTIFICATE OF���
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 copies OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION.
Check All Categories That Apply:
1) Exterior Building Construction
Shed Solar Panels
2) Exterior Painting: Siding _
3) Signs/Billboards: New Sign
Indicate type of Building:
New Building Addition
Other:
Shutters Doors _Trim
Change to Existing Sign
Commercial —)(- Residential
Alterations Reroof Garage
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Other: 4
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4) Miscellaneous Structures: Fence Wall Flagpole Pool Other:
Please type or print legibly:
Address of proposed work:�s�G�GS der►/► _�. UCt t"W>yiAjfvlap/Lot # I
Owner(s): I c C� � U� t°l� `t Phone #:6Da-'7 �
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing - izrsr-sN- q�A1 .1�L� iAM1;1
Email:L r ��
Agent/contractor:
Mailing Address:
Year built: (
notification method: Phone Email
Phone #:
Email: Preferred notification method:
Description of Proposed Work:
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Signed (Owner or agent): Date: _
Phone Email
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> 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 to inspection by OKH. OKH-approved plans MUST be available on-site for framing & final inspections.
Rcvd Date:
Amount �y
Cash/CK #: 193
Rcvd by: .Q V
45 Days:
i/ Approved
Reason for Denial:
Signed: J C
Approved with Modifications Denied
JUL 2t3 Zff1T V
YARMOUTH
Date Signed: % Z 3 1.2 C' q
03/2018 1 APPLICATION #:
Project Address:
FOUNDATION: Material:
CHIMNEY: Material/Color:
GENERAL SPECIFICATION SHEET
Exposure (Not to exceed 18"):
GUTTERS: Material/Color:
ROOF: Material: Pitch (7/12 min) Height to Ridge: Color:
SIDING: terial/Style: Front: UO2A Sides/Rear: COLOR CHIPS
Color: Front: ides/Rear:
TRIM: All windows & doors to be trimmed with: 1x4 1x5 (Circle one.)
Material: Color:
0
DOORS: Qty: Material: Color:
Style/Size (if not listed/shown on elevations):
STORM DOORS: Qty: Material:
GARAGE DOORS: Qty: Mat'I:
WINDOWS: Qty/side:: Front: Left:
Manufacturer/Series:
Grilles (Required): Pattern (6/6, 2/1, etc.) _
Snap -In: Between Glass:
STORM WINDOWS: Qty:
SHUTTERS: Mat'I:
Color:
Style: Color:
_ Right: Rear: Color:
Material:
_ Grille Type: True Divided Lite: _
Permanently Applied: Exterior
Material:
Color:
Style: Paneled Louvered Color:
HC -170
RECRVED,
Interior JUL 15 2i,;j
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OLD KING'S HIGHWAY
SKYLIGHTS: Qty: Fixed Vented Size Color: APR E
DECK: Size: Decking Mat'I: Color: JUL 2 � LQiq
Railing Mat'I: Style: Color:
WALLS/FENCES* (Max s' YARMOUTH
height): Height: Mat'I: OLD KING'S HIGM/VAY
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: Screening:
LIGHTS: Qty: Style:
Location(s):
LIGHT POSTS: Qty: —
Location(s):
Additional information:
9/2016
Material:
2 -General
Color:
Color:
Ll t I T H x C. ILE Kit'
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APPLICATION #: ��
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