HomeMy WebLinkAboutBLD-80-059 ce," Ct.56117
ft Application for a Permit to Build
Fee must accompany thi application 2 c
Yarmouth c// 19.A 0
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner n g°LOa, Address p_ 3 --MAofe S Am)-C Ai o*4
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Seth,$
2. Name of Architect (if any) ,
3. Name of builder S7(4te
4. Precinct No. if Lot No. G/- sXeal- .Plan: Name or No:
r` -- 111
5. Name of Street >.3 er ichesj-
yy,, I N e
6. Purpose of Building (/tt-11(47 %'
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7. Material g,M G y
8. Estimated cost of building ; 1,"U A-v p /X i(
9. Dwelling A/C ._ '. •
1
10. Cottage AjC
11. Heat NO
12. Basementjl/C
13. Garage Ad() N
14. Store ^/O
15. Shop ida' .
16. No. of stories
17. Is there to be a Store in the lower storey to
18. Size of Lot. No. of feet front '> ' -',' No. o[,feet rear No. of feet deep
I q-�
19. Size of building. No. of feet front U No. of feet side 0 No. of feet rear l
20 Distance from nearest building: Front ft.; side ft.; side ft.; rear ,
t
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 ...4�.,....`4, - 1_1
Address
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Rear of Lot
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Frontage of Lot
Street Name ( ;t'C ofF ;Ade
de
PLOT PLAN
i BUILDING PERMIT REVIEW
APPLICANT: R. SCAOCC BLDG PERMIT NO:
LOCATION OF PROPERTY: PS 12t(Of. I(C ,4ItiQ al• CRMo`k DATE FILED: aV F'
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVIDUAL
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 PLANNINGBOARD 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:
6/1. ENGINEERING DEPARTMENT: YES DOES NOT APPLY yIGNATURE44,.
DATE S'o."`
/2. CONSERVATION COMMITTEE: YES DOES NOT APPLY V SIGNATURE 4/ NE ,r': DATE Listp
3. PLANNING BOARD: YES DOES NOT APPLY SIGNATUR DATE
4. BOARD OF HEALTH: YES DOES NOT APPLY SIGNATURE . DATE
5. FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
COMMENTS: