22-A095 15 Mallard Street ApprovedECEIVED °*yeRc TOWN OF YARMOUTH
Y. x 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
AUG 0 4 2022 Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836
7AI`*QUj-i-0LDjKING'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 Categories That A f Indicate type of Building: Commercial Residential
1) Exterior BuildDSolarPanels*
ConstructionNew Building Addition Iterations Reroof Garage
Shed Other:
2) Exterior Painting: ImSiding Shutters n Doors []Trim FOther:
3) Signs/Billboards: II New Si n Change to Existing Sign
4) Miscellaneous Structures: Fence Wall IIFlagpole F Pool nOther:
Please type or print legibly: [J, 1
proposed AP� VI It GT �1 i�� �t eafpf ! Iq
Address of ro osed work: ok # �j / ?
Owner(s): l h Phone #: W/ - 0 J-6 rK X
3
All applications must be/submitted by owner or accompanied by letter from owner approving submittal of application.
C �
Mailing address: 1 h fda %qbG 1 ,%FQ1' gg O q Year built:
Email: ! llih d 1ili oJ'h Preferred notification method: Phone 11 Email
Agent/contractor: Phone #: -? 0 /- to - Fol ID j
Mailing Address
Email: Preferred notification method: Phone F Email
Description of Proposed Work:
Aildfok-, 10 5'JC of AOAC f
40 ^,1 S ferbej Toorh . All a klef i ar to A Q4cA a k0l2 A oche,
Signed (Owner or agent): �G..r �� Date:
Ownerlcont(aclorlagent 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 dale or upon date of expiration of Building Permit. whichever date shalt 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: �r` l )2
Amount q01-0
Cash1CK #. G rs h
Rcvd by: L' _5P
45 Days:
Date Signed: / 2 �o
y Approved Approved with Modifications Denied
1 APPLICATION #: �P'AU l s -
� TOWN OF YARMOUTH
0 x OLD KING'S HIGHWAY HISTORIC DISTRICT COMMIT
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-44 1 PRUVED
Telephone (508) 398-2231 Ext.1292 Fax (508) 398-0836 SEP 12 2022
STATEMENT OF UNDERSTANDING OLD YARIVK]11TH
KING'SFiIGNWAY
CHANGES TO AN OLD KING'S HIGHWAY APPROVED PLAN
As property owner/contractor/agent for construction at ?� 54,
Map/Lot J-3-7k CIA # e;�7�A Oq Approval Date:-
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 issuance of an Occupancy Permit or final
inspection approval.
I have read and understand the above statements.
i f
Date: / Signed:��
(Owner/Contractor/Agent)
Signed:
(Chairman, Old King's Hi way Committee)
HAOKH COMMITTr=PApplication Forms\Statemenl of Understanding 2015.docx
Updated 12/2015
Project Address:
FOUNDATION: Material:
CHIMNEY: Material/Color:
GENERAL SPECIFICATION SHEET
Exposure (Not to exceed 18"):
GUTTERS: Material/Color:
ROOF: Material: Pitch (7112 min) Height to Ridge: Color:
SIDING: Material/style: Front: cedar S'1'+!h) Sides/Rear: COLOR CHIPS
Color: Front: Sides/Rear:
TRIM: All windows & doors to be trimmed with: 1x 1x5 (Circle one.) RECEIVED
Material: lJ�►+ f JM b 4 e : +r-•
1 ,) � f ], AUL
G042022
Qty; Material! m •►G� fro+ &,r Color: W �{+r1 e 2022
YARMOU7 h
Style/Size (if not listed/shown on elevations): f i OLD KING'S HIGHWAY
STORM DOORS: Qty: _L Material: w ewr)fi Color: LAfI
GARAGE DOORS: Qty: MatT Style: Color:
WINDOWS: Qtylside:: Front: Left: Right: Rear: Color: (�Ij►l�t Cl(( rUl�'� CkrJJr�
Manufacturer/Series: Material:
Grilles (Required : Pattern (616,2/1, etc.) Grille Type: True Divided Lite:
Snap -In: --� Between Glass: = Permanently Applied: Exterior E::Lfnterior
STORM WINDOWS: Qty: Material: Color:
SHUTTERS: MatT Style: Paneled Louvered
SKYLIGHTS: Qty: Fixed Vented Size _
Calor:
Color:
APPROVED
SEP 12 2022
DECK: Size: Decking MatT Color: I
OLD YARVIOUTH
Railing MatT Style: Color:
WALLS/FENCES* (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 METERSIHVAC UNITS: Location: Screening:
LIGHTS: Qty: Style:
Location(s):
LIGHT POSTS: Qty: Material.-
Location(s):
aterial:Location(s):
Additional information:
Color:
Color:
2 -General 1;9�1llSr
APPLICATION M
°"'"� TOWN OF YARMOUTH
° 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
Telephone (508) 398-2231 Ext, 1292 Fox (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMUTTEE
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 tiling 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, Tinre for Making Determinations
"As soon as convenient after such public hearing; but in any event x,ithin jbnj,-
five (45) days
after the filing of application, or within such ftn•ther time as the applicant shall allmi, 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
Applicant/Agent signature: 000 Date: 01(1
RECEIVED
AUG 0 4 2022
YARMOW h
OLD KING'S HIGHWAY
312020
APPROVt
SEP 12 2022
YARMOUTH
Application 9: 29'A061S
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: oemk t—a-bn
Property Address/Location: 15- MA -d-6 5Y60f-
Hearing Date:
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: !
31 41
Abutter Information:
RECEIVED
-
AUG 0 4 2022
YARMOUi'h,
XD KING'S HIGHWAY
APPROVE®
SEP 1 2 2022
YARMOUTH
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Application #: 22-A015-
8.2018 3
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SHAPIRO MIRIAM R Please use this signature to certify this list of properties
12 DRAKE ST directly abutting and across the street from the parcel located at:
YARMOUTH PORT, MA 02675
15 Mallard St., Yarmouth Port, MA 02675
Assessors Map 137, Lot 47
1371 541 1 I
MURGIA JAMES R And Ma ado, Director of Assessing
RUTKOWSKI MURGIA S M Y 9
16 DRAKE ST, August 31, 2022
YARMOUTH PORT, MA 02675
1371 471 1 !
EATON DAVID
EATON NICOLE
11 CLINTON AVE
CHELMSFORD, MA 01824
1371 481 ! 1 • eC't'V�°-�
SHAPIRO MIRIAM R 11
GS
12 DRAKE ST +�
YARMOUTH PORT, MA 02675 AUG 31 Z�z2
0Lp KlNIv!(iu
�VV..Ay 1371 4fi1 1 1 I
VINCENT RICHARD L
VINCENT CHRISTINA F
14 MALLARD ST
YARMOUTH PORT, MA 02675
137! 551 1 1
EATON DONNA L TR
DONNA L EATON 2021 LIVING TRUST
26 DRAKE ST,
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YARMOUTH PORT, MA 02675
SEP 12 2022
1371 561 1 I
SWENSON SANDRA L
YARM( urh
OLD KINGS HIGHWAY
9329 MAINSAIL DR
BURKE , VA 22015
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