HomeMy WebLinkAboutBLD-81-643 ��, a\ of Fe.
�I`6-137
No. 4413
Application fo a Permit to Build
Fee must mpany this application �7
Yarmouth ..../c�2eL I 21819.8t../
TO THE BOARD:OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner TOM r-;-.42 ey Address '18 4// Ijcuit{/sLL 1?CI•
2. Name of Architect (if any) /VO/l/'
3. Name of Builder CRGacA./ AcRe5 13vrE.cflNCI CO
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4. Precinct No. 3 Lot No. Plan: Name or No. A. (K. SI - N 31
5. Name of Street NHo.R boa R LC, la/ v
6. Purpose of Building Suas IZD6'vl 17)4. 16
7. Material WOOEr
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8. Estimated cost of building 1717E-0.0 .0 0 71 tT
9. Dwelling
10. Cottage I o
11. Heat 1 A° tgatan. X p
12. Basement No D
13. Garage
14. Store
15. Shop
16. No. of stories
17. Is there to be a Store in the lower storey nn /
18. Size of Lot. No. of feet front 11"1,&) No. of feet rear ...... . /1e) No. of feet deep "V•
19. Size of building. No. of feet front 30 No. of feet side 28 No. of feet rear
20. Distance from nearest building: Front 2:26 ft.; side 3.0 ft.; side 452' ft.; rear AD
21. Distance back from line or street , from rear lot line , side line
Show by diagram the location of propsed building with relation to distances- from adjoining lots, on reverse side.
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Address !T'441 . .Q .'G.....1.1.1.!.�...LG
Street Name
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p Left Side Depth Of Lot
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ect: 'ol tGa -IVO/ I
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Right Side Depth of Lot . ./e:
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Street Name
APPLICANT: Fmk F,4.t t.ey BLDG . PERI:MIT NO.
LOCATION OF PROPERTY: geg ,Jj p hove ANL al DATE FILED:
A.M. FR- Al39
•
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN
INDIVIDUAL MUST FOLLOW IN ORDER TO OBTAIN A PERMIT TO BUILD OR ALTER A
BUILDING. THE BUILDING DEPARTMENT WILL CHECK ON THE FOLLOWING: (A) CON-
SERVANCY DISTRICTS (B) HISTORICAL DISTRICTS ( C) FLOOD PLAINS ZONING, AND
WILL BE RESPONSIBLE FOR ASSISTING THE APPICANT THROUGH THE FOLLOWING
AGENCIES.
1 . RESIDENTIAL BUILDING:
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEES
FOR SEWAGE DISPOSAL.
B) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE
OF WETLANDS. EXAMPLES: STREAMS, PONDS, RIVERS, OCEAN, BAY; BOGS,
MARSH, ETC.
2. COMMEROLAL.:BUILDING:
A) DIGIN.ak.HING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIRE'ENTS,
'TOPOGRAPHY SITE PLAN REVIE'1.
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS.
C) PL'NINING BOARD-TO SEE IF LOT COMPLIES WITH ZONING BY-LAWS.
p) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIPL SLATS, HEALTH RELATE
ACTIVITIES. EXAMPLES: SAUNA BATHS, SWIMMING POOLS, RESTAURANTS,
ETC.
s) FIRE DEPARTMENT-FOR PROPERTY PROTECTION, • PERSONAL SAFETY,
(SPRINKLERS, SMOKE DETECTORS) .
REVIEWED BY:
• ENGINEERING DEPA??TIFNT: YES ',DOES NOT APPLY c G *ATUR 1 - -46181618
1
N. CONSERVATION COMMITTEE: YES DOES NOT APPLYz IGNATUREARI DAT*86
3. PLANNING BOARD: YES DOES NOT APPLY SIGNATURE DATE
VI. BOARD OF HEALTH: YES DOES.NOT APPLY SIGNATURE ., .DATTJ
5 . FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
COI• SITS:
If