22-A095 15 Mallard StreetRECEIVED ��� TOWN OF YARMOUTH
° = 1146 ROUTP 28 SOUTH YARMOUTH MA 0266
AUG 0 4 2022 4--083
Telephone (508} 398-2231 Ext. 1292�Fax (508} 398-0836
YARMouTIALDRING'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 copies OF SPEC SHEET(S), ELEVATIONS, PHOTOS, & SUPPLEMENTAL INFORMATION,
Check All Cate pries That A I Indicate type of Building: Commercial Residential
1) Exterior Build' Construction: New Building � Addition Iterations Reroof EGarage
Shed Solar Panels Other:
2) Exterior Painting: IISiding Shutters Doors Trim IIOther: _
3) Signs/Billboards: 0 New Sin Change to Existing Sign
4) Miscellaneous Structures: Fence Wall 0Flagpole
Please type or print legibly:
Address of proposed work:
n n . I — n.r
Owner(s): 1 P
All applications must be submitted by owner or accompa
Mailing address: �J
Email: D it Ath 4 Al 0 •
Agent/contractor:
Mailing Address:
IIPool Other:
YI M/L ea@
firm 03.7
Phone #; 7V— — *J 4 " ro&rj
otter from owner approving submittal of application.
vWV/N 17!f 11.1111#97 Year built:
Preferred notification method: Phone Email
� G
Phone #: _/ V_a,) - v ilW 0 j
Email: Preferred notification method: Phone �Email
Description of Proposed Work: 1 f
0 54f
4a A& 3 terW Tooth • 4/1 a deffut 10 A s l c-4 e k"JI" h araC.
Signed (Owner or agent): 4p_.01 Date: r
l V/
Ovmerlcontractortagent is aware that a permit is required from the Building Department. (Check other departments, also.)
e If application is approved, approval is subject to a 10 -day appeal period required by the Act.
r 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: 1122
Amount
Cash/CK
Rcvd by: %, -5
45 Days:
Date Signed:
Approved Approved with Modifications Denied
Reason for Denial:
Signed:
APPLICATION #:
�p-Awls'
Project Address:
FOUNDATION: Material:
CHIMNEY: Material/Color:
GENERAL SPECIFICATION SHEET
Exposure (Not to exceed 18"):
GUTTERS: Material/Color:
ROOF: Material: Pitch (7112 min)
11 Height to Ridge: Color,
{ C TO r'1 wTL4 a jrkwl)
SIDING: Material/Style: Front: Cejar S��t,1�1 Sides/Rear: COLOR CHIPS
Color. front: Sides/Rear: ERE
TRIM: All windows & doors to be trimmed with: 1x 1x5 , (Circle one.)
Material: (✓�+� ,f A, � e �
c � T W ��� PDOORS: Qty: Material: M^G� !W►�yj.r Colar:Style/Size (if not listed/shown on elevations): r-
STORM DOORS: Qty: —L Material: w r/ 10 Color: (,/ lI
GARAGE DOORS: Qty: Mat'I: Style: Color:
WINDOWS: Qtylside:: Front: 1— Left: � Right:
Manufacturer/Series:
Rear: Color: w`lkt-
Material:
Grilles (Required : Pattern (616, 211, etc.) Grille Type: True Divided Lite:
Snap -In: — � Between Glass: Permanently Applied: =Exterior Interior
STORM WINDOWS: Qty: Material:
Color:
SHUTTERS: Mat'I: Style: Paneled Louvered Color:
SKYLIGHTS: Qty: Fixed Vented Size Color:
(fit -�Si<,� wr ,�j.
f�
DECK: Size: Decking Mat'l: Color:
Railing Mat'I: Style: Color:
WALLSIFENCES' (Max W height): Height: MatT
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: Qty: Style:
Location(s).-
LIGHT
ocation(s):
LIGHT POSTS: Qty: _
Location(s):
Additional information:
Material:
Screening:
Color:
Color:
2 -General
APPLICATION#: O� J� `�►�y
2
TOWN OF YARMOUTH
2020
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
WAIVER OF 45 -DAY DETERMINATION
The applicant/applicant's agent understands and agrees that due to the current declared National
and State public health emergencies the determination of our Application for a Certificate of
Appropriateness/Demolition/Exemption may not be made within 45 days of the filing of such
application.
The applicant agrees to extend the time frame within which a determination is to be made as
required by the Old King's Highway Regional Historic District Act.
SECTION 9 -Meetings, Hearings, Time for Making Determinations
"As soon as convenient after such public hearing; but in any event within firty-fivc} (d 5) dcr)ts
after the.iling of application, or zrrthrn such farther time as the applicant .shall allow in writing,
the Committee shall make a determination on the application. "
Applicant understands that the review of this application will be scheduled as soon as the
situation allows,
Applicant/Agent Name (please print): -&J.- �Uh
Applicant/Agent signature: A,•�r� _ Date: a�{%��
ECEIVED
AUG o 4 2022
FARMOUT n
312020
Application #: 2,-X,A)61 S_
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: Nos) E-2,-bn
Property Address/Location:
Hearing Date: _ 61' I;Y;g
Notices must be sent to the Applicant and abutters (including owners of land on any
public or private street or way) who's property directly abuts or is across the street from
the Applicant. Please Provide „the Assessor's Tax Map and Lot numbers only, 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
Map Number Lot Number
Applicant Information: L4 I
Abutter Information:
ECEIVED
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