HomeMy WebLinkAboutBLD-80-007 is - `),
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No.
Application for a Permit to Build
on
Fee must accompa is applicati
Yarmouth /V ! 19 22
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications: �1
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1. ' Name of Owner Address '�`�`��"`
2. Name of Architect (if any)
3. Name of Builder-
4.
uilder 4. Precinct No. Lot No. A Plan: Name or No.
t.
5. Name of Street %5Y/4-1-1
6. Purpose of Building U)
7. Material
8. Estimated cost of building-76 ' 0
9. Dwelling !�
10. Cottage
11. Heat
12. Basement
13. Garage
14. Store
15. Shop
16. No. of stories
17. Is there to be a Store in the lower storey
18. Size of Lot. No. of feet front No. of feet rear No. of feet deep
19. Size of building. No. of feet front No. of feet side No. of feet rear
20. Distance from nearest building: Front ft.; side ft.; side ft.; rear
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.
Name oi"'.
Address. �� 2 l
Street Name
O Left Side Depth of Lot
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G
5.1
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o a
� M
0
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I
Right Side Depth of Lot
Street Name