HomeMy WebLinkAboutBLD-81-868 xN� 1
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6, /CP1 s 5.7
if + i tion for a Permit t�Build No
plication
1 -Fee must accompany this appli tion
- a'"/ Yarmouth ... ... /( • 19.A./..
/2,-14- 5')
TO THE BOARD OF SELECTMEN '
The undersigned hereby applies for a permit to build, according to the following specifications: ._
1. Name of Owner (-Aur eNCe /3. PGNciA Address a i GRAmci V/64.4/ 13k,
2. Name of Architect (if any)
3. Name of Builder Glue&I At Iles Ru,j.c ii Co'
4. Precinct No. 3 Lot No. 5 Plan: Name or No. A.M. 81 — 1.1 S 1
5. Name of Street o?1 ."/ `_
6. Purpose of Building FA Aft'6.f Rc,c e/`
7.. Material Wood •
/5-/g 14-- / FAH iLi Pm 0W`/
8. Estimated cost of building 7400 . O
9. Dwelling //��
10. Cottage o� 1
11. Heat /-Nor U/Atela O
^ S0
12. Basement $Let °,L / .
13. Garage 4,o
14. Store /4 �!/�
15. Shop -
a
16. No. of stories
17. Is there to be a Store in the lower storey
18. Size of Lot. No. of feet front /2 o No. of feet rear .......//0 No. of feet deep ...I./iJ
19. Size of building. No. of feet front /if No. of feet side /4, No. of feet rear
20. Distance from nearest building: _Front ....86 ft.; side la ft.; side /4 ft.; rear...9G/ '
/
21. Distance back from line or street L7Q , from rear lot line 17/4-- , side line 4/
Show by diagram the location of propsed building with relation to distances from adjoining lots, on reverse side.
Name...GQ0a4/...f..A.<,'.R6.4S:../3.(!.a../.N.f/r Co
Address Th £3°X• t-•69 -/.f • Dare1/-4 4?/1cr
Street Name
p • . Leh Side Depth of Lot 7 I
1
r
r OP et n
i
0
m7 ^
..
z 0 r
I ° °
m 0
O
1
Right Side Depth of Lot - —.,
Street Name i .
1
APPLICANT: LAUPP c . 1'? I-oAicdA BLDG . PERMIT NO.
LOCATION OF PROPERTY: 3 1764PANd via w /.ZQ DATE FILED: /4 /cif/
_ A•M. St-MCI
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN
INDIVIDUAL LUST FOLLOW IN ORDER TO OBTAIN A PERJ9IT TO BUILD OR ALTER A
BUILDING. THE BUILDING DEPARTI3aIT WILL CHECK ON THE FOLLOWING: (A) CON-
SERVANCY DISTRICTS (B) HISTORICAL DISTRICTS (C) FLOOD PLAINS ZONING, AND
ILL BE RESPONSIBLE FOR ASSISTING THE APPICATIT THROUGH THE FOLLOWING
AGF2VCIES.
1. RESIDENTIAL BUILDING: •
A) CHECK. WITH THE HEALTH -DEPARTM NT IN REFERENCE TO SEPTIC. SYSTEMS - -
FOR SEWAGE DISPOSAL.
B) CHECK WITH CONSERVATION COTWITTEE IF THE LOT BORDERS ON ANY TYPE
OF li_PLANDS. EXAMPLES: STRRATIS, PONDS, RIVERS, OCIaN, BAY, BOGS,
MARSH, ETC.
2. C01a7EROFAL_:BUILDING:
A) ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE R=QUIRE?!ENTS,
• 'TOPOGRAPHY SITE PLAN REVIEW.
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF -WETLANDS.
C) PLANNING BOARD-TO SEE IF LOT COLLIES WITH ZONING BY-LAWS .
D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIP. rFIJTS, HEALTH RELATE •
ACTIVITIES. EKAI:T.PLES: SAUNA BATHS, SWIL1MING POOLS, •RESTAURANTS,
ETC.
TO FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY,
(SPRINKLERS, SMOKE DETECTORS) .
REVIEWED BY: _
(.A MIGIINEERING DEPARTMENT: YES , DOES NOT APPLY SIGNATUR ,`:DA_E
CONSERVATION COMMITTEE: YES DOES NOT APPI,yp..—' IGNATUR. i .4 0444
3. PLANNING BOARD: YES DOES NOT APPLY SIGNATURE / DATE
f j77
1---2r...'----BOARD OF HEALTH: YES'—DOES •NOT APPLY SIGNATURE rat_40.44,4 DATE
5 . FIRE DEPARTMENT:. YES DOES NOT APPLY SIGNATURE / DATE
CO1• :SITS: •
11.) No 'Q-ad roe,,./Oh.) cx