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Application for a Permit o Build
Fee must accompany this app ation•
Yarmouth a/y 19.1.?p
07 -5C-
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, ac •rding to the following specifications:)i
9.44 4, Address R/ ' /3 7
1. . Name of Owner{JJ} �j' ei1 �J� 5+o 7�� V/S
2. Name of Architect (if any) Y
' CA -M,,
3. Name of Builder ��/f, �l S /7//2-..0 d /qt,P cc lz
4. Precinct No. Lot No. a Plan: Name or No. af,W5/OWcS- Co)38
5. Name of St atSer mice-1- RP
6. Purpose of Building — 17E-Wt C) < / 7?OE
7. Material /2)000 /1 nMe-
8. Estimated cost of building --- 95 06
9. Dwelling
10, Cottage
11. Heat 44,50b
12. Basement -/ 0-If
13. Garage 'Nov/5
14. Store
15r-Shop
C '1 , o. of stories - a
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 ... .e li
Show by diagram the location of propsed building with relation to ;,• •m •ini ivls .- •rse side
• Addressyl....f.3.F,..... (71/.. ....✓•• ..6.-4-01.-
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1
Rear of Lot ^�
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1 1 1
a . VM
G I o
b x
Un. �
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0 e
a
V,
a
Frontage of Lot f
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Street Name.. r..iO.46-1 / »
PLOT PLAN �o7 3-,rvc/ca-r W L