HomeMy WebLinkAboutBLD-80-029 9
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`� Application for a Permit to uild
Fee must accompan this application
Yarmouth /> 1970
he.,
TO THE BOARD OF SELECTMEN
The undersigned hereby appliesfora permit to build, according to
the following specifications: (` /
pep, fll d 1/:lime LV4lddress �6. yye litte/N/ul�t
1. Name of Owner Du ERS/ F AFtr
2. Name of Architect (if any)
3. Name of Builder
4. Precinct No. 3 II J LotoJNo. S' Z Plan: Name or No. 9e'�et , — S 2
5. Name of Street J 56 tk /IDR 2i•
6. Purpose of Building O�a J 1 C.) cr K� LAM"C,e".2
7. Material rl4+C s rra A E #a- 2-
8. Estimated cost of building6.62w a •CQ43
9. Dwelling [ 6 Ne G e4 s r4<< /rf r;tram
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 distanceessfroo adj mn¢ ootttss,
on reve 1de,
Name t2^�•�^ �h�° ' _Wit Address .0,7i/ 7% j..11rN 71 _1. -
Street Name
•
. r j 0 Left Side Depth of Lot
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MI o
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0 0
e Ar
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• II l
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12— r
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'Right Side Depth of Lot ti
Street Name
III
.i 111
a .1/4 BUILDING PE_- T. REV--
APPLICANT:_ �� ' •Q/ g�� BLDG PERMIT NO: •
Yfrelitoy - Sr r- r��/ �IrF- " �1/�' - ; •
•
LOCATION D PROPERTY: /9' j'o d 7__1�_�10 tDR-= •- - DATE. FILED: ' -
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_ --CTHE BUILDING
DEPARTMENT WILL CHECK ON THE FOLLOWING: (A)' CONSERVANCY DISTRICTS (B)'• = HISTORICAL'. _-
DISTRICTS (C) - FLOOD PLAINS ZONING, AND,WILL BE RESPONSIBLE FOR ASSISTING THE -
APPLICANT THROUGH.THE FOLLOWING AGENCIES. -.
1 : RESIDENTIAL BUILDING: -..•.-: -
•
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE. TO SEPTIC SYSTEMS FOR SEWAGE - •
DISPOSAL: :•:- -
. -5) CHECK WITH CONSERVATION COP,MITTEE IF THE LOT'.BORDERS ON ANY TYPE OF WETLANDS_
EXAMPLES: STREAMS, PONDS, RIVERS, -OCEAN, -BAY, BOGS, MARSH,. ETC_ 4.•
. C) CHECK WITH PLANNING BOARD 'FOR LOT •RELEASE.=;•-: _ I._ -
2. COMMEPCIAL"BUILDING: - -=- - • _ - -
A) ENGINEERING DEPARTMENT-FOR. PARKING AND DRAINAGE •REQUIREMENTS, TOPOGRAPHY SITE _ -
PLAN REVIEW_ _ -
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS, . - -
. C) PLANNING BOARD-TO SEE IF LOT COMPLIES WITH ZONING BY-LAWS. .
a) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. •
EXAMPLES: ' SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC_
-E) FIRE DEPARTMENT--FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE '
DETECTORS). - •.
•
IGINEERING
ED SY: T -_-_-_-
DEPARTMENT: YESI DOESNOT- APPLY SIGNATUREtATEI r NSERVATION COMMITTEE: - YES- -DOES NOT:•APPLY'jSIGNATUR.' r - �- - -/•i'i% DATE//"/PD-
BOARD OF HEALTH: YES DOES NOT APPLY c.-rIGNA' i_ o 4 DAT9/b
- FIRE DEPARTMENT: • YES DOES NOT APPLY SIGNAT - DATE
DMMENTS: - _ ' _ -
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