HomeMy WebLinkAboutBLD-80-034 G4 \ c C. `y a
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tJ No. 7
Application for a Permit to Build
'Fee must accompany this application
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Yarmout {4:17::1:.1....r /...............19?
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TO THE BOARD OF SELECTMEN
The undersigned herebyreapplies for a permit to build, according to the following specifications:
1. Name of Owner t)-.'i a--1.4'4 J� n.H/�-° Address G f7 a"""Zlllw-+7 . &v 7j-A-14 —
2. Name of Architect (i( any) -,
3. Name of Builder 4....a '.„, ow: dj
4 .Precinct No. j r- 4%.' Loft No,0 10/4
j y Plan: Name or No. .5"cryr it 2— --.6 /76
5. Name of Street : (r (p. s i a �� r CD "c1.V-tt /6 u-''""
6. Purpose of Building
7. Material „ i -rd i w vy.,6 .
8. Estimated cost of building L/O, p�-0 .'
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9. Dwelling ` '
10. cottage p4
11. Heat ) C
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12. Basement
13. Garage 7 ,`
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 A " ' ' '+ 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 d/7'skances from adjoining lots, on reverse side.
Name " FNal- e.ae•' A ' 3)
Address S1...b...4,,,,,„L 7 iv. 1/7„,...0. - -
Street Name
p Left Side Depth of Lot '/
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Right Side Depth of Lot. _ !
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Street Name !/lLP <! V& _
BUILDING r'ERP: T REVIEW
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APPLICAtiT- ti-c _ BLDG PERMIT NO: - --
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LOCATION OF 'PROPERTY:
P ROPERTY:____-1p-.6__/ i.,U Gt . ��1�y-�-• 44. -'_ DATE. FILF_D
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 -
DEPARTME!T WILL CHECK ON THE- FOLLOWING: (A) ' . CONSERVANCY DISTRICTS (B)':` HISTORICAL• . _•
DISTRICTS (C) . FLOOD PLAINS ZONING, AND '.JILL BE RESPONSIBLE FOR ASSISTING THE _
APPLICANT THROUGH THE FOLLOWING AGENCIES .
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- - - .
1 . RESIDENTIAL 9UILDING:
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE. TO SEPTIC SYSTEMS FOR SEWAGE ' •
DISPOSAL.:.' .
• -B) CHECK 'WITH CONSERVATION COMMITTEE IF THE LOT',BOROERS ON ANY TYPE OF WETLANDS- ,
• EXAMPLES: STREAMS, PONDS, RIVEP.S, - OCEAN, BAY, BOGS, MARSH, . ETC. •
• C) CHECK WITH PLANNING BOARD 'FOR 1OT 'RI LEASE:_;•::_ ... . . • - - _ _ - - •_
2_ COMMEP.CIAC"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.
0) 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). . -
'EVIEWED BY: _ = _-
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ENGINEERING DEPARTMENT YES.VDOES NOTAPPLY - SIGNATURES }, / -K_OATEJ •
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CONSERVATION COMMITTEE: - YES ' _DOES NOT_APPLY 1/SIGNATUR e- _OATE000.
PLANNING BOARD: YES DOES NOT APPLY_SIG, •- , ="= : DATE- , j
BOARD OF HEALTH: . YES DOES NOT APPLY'SIGN ...W././ C:42 • DATE//��f"-
FIRE DEPARTMENT: • YES DOES NOT APPLY SIGN' T ' E - - DATE
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OMMENTS: - - -
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