HomeMy WebLinkAboutBLD-80-038 6,4-6,21._ 51- 7y167
No.
61E Application for a P mit to Build
Fee must ompany t is application
Yarmouth .... .LLrr s o a•..\••
19. ..Q.
TO THE BOARD OF SELECTMEN / / 0, .
1 ec/..i L 4-4 "p—••
The undersigned hereby applies for a permit to build, according to the following specifications: / �
1. Name of Owner 4 Address 17 �d. '` i / V
2. Name of Architect (if any) •
3. Name of Builder 4 ,
Ir4. Precinct No. ��yy � Lot No., Plan: Name or No. UG. L. 00 C
5. Name of Street f i ( ,1 P �(, izz Q t t le--1.
6. Purpose of Building �� //
'7. Material
8. Estimated cost of building .%0 °w
9. Dwelling •
10. Cottage t-te-cp
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 fom adjoi 'n lots n reverse side.
Name............�... j�� �,(/�J
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Address ff.� ..,f
Street Name
v
Left Side Depth of Lot
z
Se
0
z f
a 0
m
0
Right Side Depth of Lot
•
Street Name