HomeMy WebLinkAboutBLD-80-050 0.,
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Application ,fol a 'lermit to Build No. , .
,Fee'.mutt accompany,this api•lication
,. • Yarmouth ..1 I 19.492).
02 _7, 4
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications: ,,1
R 0 aclvY V, �p �/ Address s/��� '
1. Name of Owner ! !✓ (e -' ___
2. Name of Architect (if any) f ��
3. Name of Builder 0 B O .r f cR v N
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4. Precinct No. 4 Lot No. 41 Plan: Name or No. r/ ,/
5. Name of Street 09 gtiivr n/(- /-fame: w'y •• �f-
6. Purpose of Building . 0 J47 �L`'tl'eN 6-71-1,r It'd (-144n
7. Material WO 0 fl
8. Estimated cost of building 1*/0000/ 0dtik
,cw
9. Dwelling ~id
10. Cottage
11. Heat /J 7G 0�
12. Basement .2„...."Ct 14175: , 0 c
trairC7
13. Garage Ovate 0--0-0.4.41-C2--e �d 3 d
14. Store
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15. Shop `
16. No. of stories /i/y
17. Is there to be a Store in the lower storey
18. Size of Lot. No. of feet front 1/s No. of feet rear > / s- No. of feet deep /0s
19. Size of building. . No. of feet front 16 No. of feet side 3 P�� No. of feet rear Z9
if
20. Distance from nearest building: Front S1+� t:
0t .. ft.; ide.X.R.Cil"T`t'7 .; side ft.; rear
21. Distance back from line or street....-0 Fr , from rear lot line .3..45...E.T...., side line
Show by diagram the location of propsed building with relation to distances from adjoining lots,
s, on reverse side.
Name di "eev7ini
Address -57/ o rie
Street Name
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sR` f' ... Left Side Depth of Lot
—1
•
z
z
0
CD
m o
a
•
m h
o l
•
A 1
Right Side Depth of Lot
,
•
•
Street Name
•
f
BUILDING PERMIT REVIEW
APPLIgANT: f` !/. 6--A441"-- // BLDG PERMIT NO:
LOCATION OF PROPERTY: / 9 /yu�r . l 14./:)%i DATE FILED: get,-/ /W19
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIIVIDUAL
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.
B) 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 LOT RELEASE :,_ '_ :
2. COMMERCIAL"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).
REVIEWED BY:
1 . ENGINEERING DEPARTMENT: YES DOES NOT APPLY /SIGNATURE t i E a ' i. DATE 2/11‘55
2. CONSERVATION COMMITTEE: YES DOES NOT APPLY /SIGNATURE LL 's r_, DATE 211180
3. PLANNING BOARD: YES DOES NOT APPLYSIGNAT E :.' DATE
4. BOARD OF HEALTH: YES DOES NOT APPLYL)/SIGN TU =;+�>'�OAT '.
5. FIRE DEPARTMENT: YES DOES NOT APPLY SIGN E DATE
COMMENTS: k " .
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