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BLD-80-043
,R'd\l 36-'IS- \\ h .1 No. 3 / Application for a Permit Build Fee must accompany this applica ' n Ay Yarmouth 'ire....t 19 ?O /-ak- sd TO THE BOARD OF SELECTMEN The undersigned hereby applies for a permit to build, according to the following specifications: 1. Name of Owner5; mi.,k a 1\rd� Address l z3 6�J1lie ..i Sr- Sc . WA,r. 2. Name of Architect (if any) 3. Name of Builder kc•V Seri%kit Cu l 4. Precinct No. Lot No. Plan: Name or No. 5. Name of Street J 8. 3�.f2,.�-<-d-+..t9 C .6 )9/• , "�` p /}��, 6. Purpose of Building / L.�.f� `'tc) fl -� air —J 7. Material Woccl - Ir�t.1:5 - CciS. Iron - Fran, C/ln Sl'ebJi W/ �a(d �� I, 8. Estimated cost of building ��" °C3-� // __ "' f 9. Dwelling 1"lf2{k(b Gf`1,cIC 17"trisk 10. Cottage 11. Heat ,LL06k I rx¢lat desizs ,,• f iik 12. Basement Plat h 13. Garage 6,1 (---kJiL I ' 14. Store SJJ✓e oil ` .a Aid,. 15. Shop Il' �S 1a! W// SI-04CC 1 �l / l{ ill 11 -i- 16. No. of stories 11 ,,gr/LIC hit 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 Q., f JCL ,' Q hh Address 1 1)j iti l/C'ye St .,5v nr• Street Name o` Left Side Depth of Lot -4z Co m 7 w p 0 - 00 ^ • m r m o 1 1 - Right Side Depth of Lot Street Namer . . 47'..• " ' ' %v./ .I. I` .- •' ' • - :,'.'..:j A ..c• 4.D• ;.•.::". " 1.1 • ' • ' - 4! 14-...t.(4,1,4.:. '..1.. 'Wm.:: ‘. ',g*. ./.4. '... .. s. • •., IS ..,,••••0:0 •!. ti.2., • t .t......'••< •-• C .• ...., • , C. 6..•-"4 f'11 hi-*t ..• • 1,.t.l••' .... . '2. 4. e" •t r••••.e't. =rnr::, CPI 17.--t ten*,0.7.---'} :--4.' 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