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Application for a Permit to Build
• Fee must accompany thislpplication
Yarmouth ....!/J--3/ 19
TO THE BOARD OF SELECTMEN \..7.1 ,
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner CONRAD 11 . R a pi)E p\--r Address 2aa tanN Sf,i YARm6UM PORT ri'A ,
2. Name of Architect (if any) NONE
3. Name of Builder OW N L R
A.MAP
4. Precinct No. I Lot No. P 3 Plan: Name or No. 109 _ P 3
6. Name of Street 2 0 2. ("n 41 N ( le-4 .• 6- 4)
6. Purpose of Building wri I. I I Y SHIED FoR yA i'1 D -C:AIe D L l y I i L S' 4
/OX/O/
7: Material Woo. fRPin 4/ `iYwoo; SHCA mh'idi AN 66 f D/ ElgcK 0$141/44"Root
4
8. Estimated cost of building 5OO, MATE,R/cs.j
9. , DwellIng 11 I L ry s R .v
10. Cottage S 0 `l
11. Heat
12. Basement
13. Garage —
14. Store .
16. Shop
16. No. of stories t
17. Is there to be a Store in the lower storey /
18. Size of Lot. No. of feet front 4'3.21 No. of feet rear s z S/q
No. of feet deep ` $CC)
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19. Size of building. No. of feet front I 0 No. of feet side .l O No. of feet rear
ii r I POO t)oS
20. Distance from nearest building: Front ISO ft.; side7� ft.; side.? ft.; rear
q A! I
21. Distance back from line or street:. a 0,,, , from rear lot line .1.4 30! , side line ! ' !
Show by diagram the location of propsed building with relation to ' tances(from
��adjoi�ning lots, on reverse side.
Name....a(�QiK/(? f{1..1a 1`",I��0 . PO
r
Address �`02-- l tJ.G'�M ,?.I.:.Tr•.t � .I.0 t....111.f\
Street Name
• No N , r
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0 Left Side Depth of Lot
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Right Side Depth of Lot-. 3 6-07
Street Name 00"/Q
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i
g 1 „atostia
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ar: 7' .
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BUILDING
� PERMIT REVIEW
•
APPLICANT: COAT t,d-D 1-1 , (` It PP'1rt� I ' - - /� BLDG PERMIT N0:
LOCATION OF PROPERTY: 20 Z FI Al-Ll;T rIMIAlY j T Y/10360I/r/WR DATE. FILED:
THE FOLLOWING CHECK—OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN 'INDIVIOUAL'
MUST FOLLOW IN ORDER TO OBTAIN .A PERMIT TO BUILD OR ALTER A .BUILDING. % THE 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.
N.--I 6) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS.
EXAMPLES: STREAMS, PONDS, RIVERS, 'OCEAN, BAY, BOGS, MARSH,. ETC.
C) CHECK WITH PLANNING BOARD FOR LOTRELEASE. - =__ _ --
2. COMMERCIAC'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.
D) 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). - -
REVI D BY:
1: IQN INEERING DEPARTMENT: YES 1/6OES NOT APPLYSSIGNATURE �,�6
10,JTZ
:, DATE !k
2. CONSERVATION COMMITTEE: YES ' -DOES NOT:APPLY ✓SIGNATURE I_, _.", --.4 7, : 7-= DATE D, :p
•
4. =OARD OF HEALTH: YES DOES NOT APPLYL->SIGN4O? S/ . DATE:/;;Ab
$. . . _ . e ii - • DATE
COMMENTS: -
_ + _ "
•• � Application to
111701-
) Old Kings •Highway Regional Historic District Committee
a in the Town of Yarmouth for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: tin New Building 0 Addition ❑ Alteration 2 /
Indicate type of building: 0 House 0 Garage 0 Commercial aOther I0 Xlo UMW/ SNLD
2. Exterior Painting: 0 •
3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: ❑ Fence ❑ Wall 0 Flagpole 0 Other
(Please read other side for explanation and requirements).
TYPE OR PRINT LEGIBLY /} DATE bteefiacg 15 1973
ADDRESS OF PROPOSED WORK 2p2. l�AIN ST./yARiponPORT ASSESSORS MAP NO. IO
OWNER CONRAD N. tI%?4RTORIf S . P PPElzr _ASSESSORS LOT NO. P3
HOME ADDRESS 202 1u7Q/N sr ,YARmouru Fbltr;niA-Gans' TEL. NO.
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
Town or Y amourN (Lycuse, Hasa) • DoRo lY NQywn/r)/ r98 TARN sr.
him Rtc 6,05Ttck 2.01 I'hA►N St YhAXAP,; .Linty A . T[IFT-5 aNDYS/DEQ
RttEs Pr DotnaizlY rnnws:; RICHARD m.HARPER fR . P.oeoYau
ltG�EDCAR N/ . 0a5"-”Ina . Oa •
AGENT OR CONTRACTOR Note fi - BY Ow N QR TEL. NO. +�6 Lea907
ADDRESS
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No.8,other side), including
• materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed
locations of new signs. (Attach additional sheet, if necessary).
S1=k Air'itcntD stiEirr
Signedetrawai __
Owner-6ewereeterA,cM
Space below line for Committee use.
Received by H.D.C.
Date The Certificate is hereb A . .Aar S Date <A 1://to
Time C e O
•
By -e' .GI! s c
Approved IMPORTANT: If Certificate is approved, approval is subject to the 20 day appeal period
provided in the Act
Disapproved 0 Please return to: Yarmouth Historic District Committee
P.O. Box 124,Yarmouth Port,Mass.02675