HomeMy WebLinkAboutBLD-80-085 Qaci T
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No. ...:1 t
gn Application for a Irmit to Build
,
.w iFee must accomp y this application
- Yarmouth 2 2 19
TO THE BOARD OF SELECTMEN
The undersigned herebyfapplies for a permit to build, according to/the following specifications:er
1. Name of Owner / l r a-/frt Edw-9/-1 The-Y vl t v 2, Address 9 y 5 a Keit R2i 444,4 . ni°4171
2. Name of Architect (if any) C
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3. Name of Sundey p uvt'c �/A�C ••. t> �
4. Precinct No. 84 Lot No. P 56 Plan: Name or No. ` PBS
5. Name of Stree(((03? ker: Rd £J /< k frno v f4
6. Purpose of Building r2 rvir Of S u
7. Material eOnGcL1.f>o ✓d �g-gtz QDpfr,re
8. Estimated cost of building 76 00. tc rnvr r r-y' ea-t • - I
ite fi trt re,ac tr
9. Dwelling / S � /t tel Orr
10. Cottage E c
3
11. Heat r(v '3
.....1.111:____—, i
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12. Basement ito 'kit-
13. Garage WO
14. Store jl(o
15. Shop /r G
16. No. of stories
17. Is there to be a Store in the lower storey do ,
r
18. Size of Lot. No. of feet front � No. of feet rear No. of feet deep 1..01-0r
19. Size of building. No. of feet front .....1 r' No. of feet side .Ir ' No. of feet rear
o= ar,
20. Distance from nearest building: Front ft.; side.../....O r ft.; side at o ft.; rear..,fi6t.fO.�.
21. Distance back from line or street p4.D , from rear lot line el / side line 1.0 1
Show by diagram the location of propsed building with relation to distances from adjoin B lots, n reverse side.
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Address.....1( ...tic .moi r' j I
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Street Name 3,Y &-4 ;J•.
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r Left Side Depth Of tot.. f a'. =r
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Right Side Depth of Lot /#01 .
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Street Name �0..lil..r 0' :
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--i BUILDING PERMIT REVIEW
APPL I CANT: I`-` em..eG y (eftnti._..2lf/1[^c.i J BLDG PERMIT N0:
LOCATION OF PROPE (Y: %p kt te ,1, 42..0 11.4,.,,44,2-x` DATE FILED - -
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED ,TO -CLARIFY PROCEDURES- AN INDIVIDUAL
MIST FOLLOW IN •ORDER .TO OBTAIN A PERMIT TO BUILD OR.ALTER A BUILDING. THE:BUILDING -
„ DEPARTMENT_WILLCHECK ON*THE FOLLOWING:- (A)_. CONSERVANCY DISTRICTS,-_ (B) ...HISTORICAL s
DISTRICTS IC) . FLOOD PLAINS ZONING, AND WILL BERESPONSIBLE FOR ASSISTING THE
` APPLICANT'THROUGHTHE FOLLOWING AGENCIES
1. RESIDENTIAL BUILDING F
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-FORPARKING 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 ,
11. ENGINEERING DEPARTMENT YES ✓ DOES NOT APPLY SIGNATUREV t�_it ,,, DATE 2184
2."'CONSERVATION COMMITTEE YES DOES NOT APPLYSIGNATURE ,_a; DATE 2 So
3. PLANNING BOARD: YES DOES NOT APPLY SIGNATU DATE
J4. BOARD OF HEALTH: YES DOES NOT APPLY 2-SIGNATb • at �J,fgG.,,,i, DAT
5. FIRE DEPARTMENT: YES DOES NOT APPLY SIGNAT ie. GATE
COMMENTS:
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