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11/03/2003 13:46 7819320860 NEWPRO PAGE 02/02
PAGE 02
11/03/2003 02:40 51508790623e
Application to
III
d " . '. 4IP'. ,f Old Kings Highway Regional Historic District Committee
1 AkillarAvai,
in the Town of Barnstable for a
CERTIFICATION OF EXEMPTION
Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section a and 7 of Chapter 470,
Acts and Resolves of Massachusetts, 1873, as amended for proposed work as described below and on plans,dr insp.or photo.
graphs accompanying this application, i# 03
TYPE OR_PRINT LEGIBLY ; ATE
f 6 ✓,r`�a✓" �EJ`''tASSESSORS MAP NO. 2-3-7 " 39 J
APDRESp Er PROfOSEO WOR oaf) � }
OWNER ! u1!` M AND p,A G , GJA1--�OJti ASUSSOPS LOT N , 01V J
s t JV ' 1 1, f. IA C.�J TEL.NO.i(5°V 2 r .5
HOME ADORES
AGENT OR CONTRACTOR ,le'6 z .
/- �fPJ olio � �,� �0
ADDRESS t ,, �1° ��7 of ` , TE1.M��
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This application is for exemption of proposed exterior construction on the ground that:
It 111 1t will not be visible from any wry or public place.
Q 121 it is within a category declared entitled to exemption by Old aable boils Highway Reglonel Historic District Commission.
(Cheek
' PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot,end,If an addition Is involved,s ow-
ing location of existing building. i
R cpz- et c_,e 0 KJ ��; �12 0 6 $ ot/l'ii
A Icicki eb 6u 601)/1/00'0-3 /00 oLoikii , L
G'IKCIO
A iv c_ des 11 0Aii ePlt Cite,C1 1- &00'3% c.1
f..A 1 j
V� I .- 6.119 C(.°6.°
SIGNED.
091A:enamor-Ape's'
apace below line for Committee sew.
Received by H.D.C. Thu Certificeto is hereby
Date 4 :r-------
' / 419 oii
Time_ - I/ __
By —.. Oat
0
Approved ❑ The categories of wdrk entitled to exemption are listed on
Disapproved 0 the back of this form.