Certificate of Appropriatenessord Kin g,, r,frlill iiHlilBl,l?*, committee
200 Main Street, Hyannis, Massachusetts 02601
Telephone ( 5 0 8) 8 624 7 87, Emall grayce. ro gers @town. b arnstab le. ma.up
APPLICATION FOR CERTIFICATE OF APPROPRIATENESS
Application is hereby made, with six (6) corplete, colored sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanlng ttris
application for:
Date Map & Parcel
Property Owner 3 r f-*r Phone A 51 -l-c>'L-L-7e1
Stre"t addr"ss t { \r-l . L-r, r Avr :'Fg-rU
5aS *"( 1G - O\a-l
q-'fnr-( @hJ yrytq,'r \. Lorrt
LGvnsn.Cofr
Email 5.r b, n
a'+l-a-t
Mailing address
Village \*\eiT- Bstz-l-: : rA'O-Er L'{A
(. o *b c>x l'Lq {,Bliz*r}r +
AgenVContractor |.;.*€.NA,a *xr, C\:-r , (-Phone 5o8 - )G,L
Agent Address 12- rAl$-sz--1+ 3rz:,s.8 Uo-*Email Q- rt< ,f1 . (- L, , , O et? t c-/-
a\'@.Ur* m^tl.aorn
Agent Signature
If approved, the Certi{icate of Appropriateness expires one vear from the stamped approval date or upon the expiration of a Building
Permit, whichever date shall be later. A ore year extension may be requested, in writing to the Old King's Highway Administrative
Assistant at 200 Main Street, Hyannis. MA 02601. This request must be received prior to the date of explration.
There is a 10 day appeal period plus a four day waiting period for all applications after which time your approval paperwork will be
available for pickup and building permit sign-off. All applications are subject to meeting any applicable building code requirements.
New Build Residential
Building Construction
Type of Building
Project
Landscape Feature
Signs
Garage
Commercial
OtherHouseBarnShed
I noor Windows/Doorc [--l Siding/Paintiog l-l Solu. I otte.
Wall I Flag Pole f] rooi l-l oth.t
l-l Replace Sign Repaint Sign f] ott..
Fence
New Sign
Description of Proposed Work 'Va- rZ-{ A'eC> i -ilr ezt--r .,L.r F-\ T-,D E.
r \-t
(:+r L&+
DENIED
for Comwittee ase only
By a vote of
Membets signatures
Conditions of Approval
APPROVED
,
a
CERTIFICATE OF APPROPRIATENESS_ SPEC SHEET
CHIMNEY Material i
Wtsr Color
k{EROOFMake & style a& us
Roof Pitch (s) - (7/12 minimum)
\r uL/i -ur4.-i-g. - Color
on plans fbr nett, building & maf or additions)
(}IITTI'R
WINDOWS, DOORS, TRrM, SHUTTERS, SKYLIGHTS
Window/Door Trim material
Size of cornerboards ii_h
" b ) Size of casing s (tX4 *tr) i' \i 4: -' i color j
_1a1 l*-r-tE--"]
Rakes I't member i-i-;--;l-t---"__] 2nd Member iti::-=.-;;L'Depth of overhalg i-tt------t
Make,Model i. -.i,1-;,li d- ie;r'
Divided Light i
;
Removable Interior Grills it,i
r Material I I Color
1
Windows:
Window Grills Exterior Glued Grills : I
No Grills i I
Grills Between Glass : ;
Grill Pattern
_-l
Doors:Style & Make Material Color
Garagedoors: Style i .-'.',
-r\----"--l
Sizeof opening
T - - _ _ _"-- - _ _ - _ _ - _ _ _ - r
Color ; I
Material
Shutters;Type & Style Material I
---------------+--J
Color :
Skylights:Type i
r
Make & Model :
Size ColorMaterial I
SIDING Type
Material
Clapboard . Shingie
White Cedar
u Other
Red Cedar I i
Paint color i- -L-{_-b-i;- iI- -- -e il-a*Q -
Other I i
L---!
FOUNDATION rvp. ilL;;;.=>...eiio"effi i [" ; {*',:^:.; @ax t2' exposed)
DECK Material i Color i i
!------------------l
SIGNS t-" i--"-.-trrr- ---r Materials Color i-
FENCE Type i- iiptit"r-ari,siraia-tit -ki,, -Color
Material L--r\^_,._
LIGHTING Type and location (free standing I
affixed to stmcture. illuminated)
i
Length
RETAING WALL Description i
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CERTIFICATE OF APPROPRIATENESS_ SPEC SHEET
CHIMNEY Material i
Wtsr Color
k{EROOFMake & style a& us
Roof Pitch (s) - (7/12 minimum)
\r uL/i -ur4.-i-g. - Color
on plans fbr nett, building & maf or additions)
(}IITTI'R
WINDOWS, DOORS, TRrM, SHUTTERS, SKYLIGHTS
Window/Door Trim material
Size of cornerboards ii_h
" b ) Size of casing s (tX4 *tr) i' \i 4: -' i color j
_1a1 l*-r-tE--"]
Rakes I't member i-i-;--;l-t---"__] 2nd Member iti::-=.-;;L'Depth of overhalg i-tt------t
Make,Model i. -.i,1-;,li d- ie;r'
Divided Light i
;
Removable Interior Grills it,i
r Material I I Color
1
Windows:
Window Grills Exterior Glued Grills : I
No Grills i I
Grills Between Glass : ;
Grill Pattern
_-l
Doors:Style & Make Material Color
Garagedoors: Style i .-'.',
-r\----"--l
Sizeof opening
T - - _ _ _"-- - _ _ - _ _ - _ _ _ - r
Color ; I
Material
Shutters;Type & Style Material I
---------------+--J
Color :
Skylights:Type i
r
Make & Model :
Size ColorMaterial I
SIDING Type
Material
Clapboard . Shingie
White Cedar
u Other
Red Cedar I i
Paint color i- -L-{_-b-i;- iI- -- -e il-a*Q -
Other I i
L---!
FOUNDATION rvp. ilL;;;.=>...eiio"effi i [" ; {*',:^:.; @ax t2' exposed)
DECK Material i Color i i
!------------------l
SIGNS t-" i--"-.-trrr- ---r Materials Color i-
FENCE Type i- iiptit"r-ari,siraia-tit -ki,, -Color
Material L--r\^_,._
LIGHTING Type and location (free standing I
affixed to stmcture. illuminated)
i
Length
RETAING WALL Description i
_-l
\r-f l\
\-\ a\
ame
North
I{EW BUILDINGS, ADDITION, OR COMMERICAL BUILDING
CHECKLIST _ CERTIFICATE OF APPROPRIATENESS
Subruit Six (6) complete colored sets, unless otherwise noted
for Certificate of Appropriateness
brochures or diagram
ofapplicant, street location, lnap and parcel
ofarchitect, engineer, or surveyor; original stamp & signature; date ofplan & revision dates
arrow, unitten and drawn to scale
---- .Changes to existing grades shown with one-foot contours
-_;/groposed & existing footprint ofbuilding and/or structures, and distance to lot lines
- i/-hoposed drivewaY location
--9.'broporrd limits of clearing for building (s), assessor structure (s), driveway and septic system
_--,' Retaining walls or accessory structures (e.g. pool, t€nnis court, cabana,barrL garage, etc)
.-.-. Buil$ttg Elw*tions
uP{ansat scale ofYo'= I foot; a unittendrawnscale
s/ftuns at a reduced scale to fit 8.5"x1I ot 11x17 paper
[' . Name of applicant, street location, map and parcel
._i,jj Name of Building Designer, or architect; original signature of plan preparer and stamp; plan date, and all revision dates'
*All new house or commercial building plans must have an original signature and stamp, if any, by a registered
Architeq member of AIBD, or a licensed Massachusetts Home Improveuent Contrac'tor, unless this requirement is
" ,. " waived by the Old King's Highway Historic District Commifree-
-' ,4. written and bar drawn scale"' /Elevations of all (affected) sides of the building, with dimensions including height from the natural grade adjacent to the
Building to the top of tire ridge; location and elevation of finished grade, roofpitch (s) dormer setbacks; trim style, window
, And door styles. Changes to existing building must be clouded on drawings.
/Window schedule on plans
-- -- ilOudsetpe Plan (drawn on a certified ferimeter plan containing the following)
.--- Name of applicant, sheet address, assessor's map and parcel number
.---- Name, address, and telephone number of the plan preparer, plan date, & date of revisions
_-_- The location of existing and proposed buildings and structures, and lot lines
.---- Natural features of site (i.e. rock outcroppings, streams, wetlands, etc)
_- Existing buffer areas to remain
__-_ Location and species of trees and plants
---- Driveway, parking areas, walkways, and patios, indicating materials to be used
_--_ Existing stone walls, and proposed walls including retaining yalls for slope retention or septic sptems
For removal of stone walls, you mustfile a demolition application
__--. All proposed exterior lighting and signs
.--... Sk€tch or Phatos of adjacent properties
--_- Asketch(s)toscaleorphotographsofnearbyadjacentbuildings,wherepresent,alongbothsidesofthesteetfrontage,
Showing the proposed new house or cornmercial building in scale and in relationship to the existing buildings.
t Please discuss with staffif you do not think this is relevant to your application.
,.y(fiotographs of all sides of existing buildings to rernain or being added to
Existing building, foot print
Building I (sq. ft.)taL4 Building 2 (sq. ft.)
Exiting building, gross floor area,,in9$din g area of-finjshed basement
Buildingl (sq.ft.) 5*n(t ?Q rr Building2 (sq.ft.)
New Building or addition, foot
Building 2 (sq. ft.)Building I (sq. ft.)
New Building or addition, gross floorCl/
Iinished basement
Building I (sq. ft.)
9a'(a
area
Building 2 (sq. ft.)
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