HomeMy WebLinkAboutBLD-80-093 1 �;o. p
`,, ` No.
Application for a ermit to Build
,Fee must acco any this application
. a-ry.j 19tU
Yarmouth
TO THE BOARD OF SELECTMEN •
The undersigned hereby_applies for a permit to build, according to the following specifications:
1. ;Name of Owner t,,,.. --YfrlA i,.t ,S ` r/
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Address ( �- ,
Cy )i-4-k..,ti e .t.sf.�S
2. ''Name of Architect (If any) e s �,
3. Name of Buildta
er;.�iYIcs /a?
4. Precinct No.3 : Lot No. -ea . Plan: Name or No. %f ed as
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5. Name of Street )e18 fic� 1 1 ad, S7, . '
6. Purpose of Building :A !•
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7. Material hh 11 J
8. Estimated cost of building!3.1 CYO - f
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_ „ Ami.` QCue- c:._ .
9. Dwelling .,_ J V
V
10. '.Cottage —' i q "( '7.fi r veal.
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it Heat rArret eiti rtduT i
fit" ro
12. Basement fit" / Z reefer rte4G��4.
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13. Garage r U /�
14. Store JAS C/fit' N r /v Pr ace o s rn
15. Shop A/3 As Qcr ef, t)C ✓A4^–YL'K.S' .
16. No. of stories �0 Ana a 05
17. Is'there to be a Store in the lower storey
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18. Size of Lat e•No. of fee'r`front :.w.Q • No\of'feet-rear 1/S No.,of"feet deep
19. Size of building. No. of feet front 3.9).:ger 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 • , side line
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'Show by diagram the location of propsed building with relation to distances from adjoining lots, on reverse side.
Name ,,.^. ^. 'r . _.....':f't'''''s.'. /1.• :- !.
Address ' `✓ / ,. l`. /.,
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Rear of Lot
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/17 ijjit '
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Frontage of Lot •
street Name::./..i..C. et( I i'"*".44).
PLOT PLAN
BBUILDING PER:CT REVIEW
APPLICANT: J r � � • BLDG PERMIT NO:
LOCATION OF PROPERTY: � � I'c/44 /y 'cdtfr DATE FILED: '
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.
i
1 . RESIDENTIAL BUILDING: .
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
DISPOSAL
B) CHECK WITHECONSERVATIOh 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,1.OT.'RELEASE.-:,' -- - ,::_ • --- - --- .-
2. COMMERCIAL-BUILDING t .
A) ENGINEERING DEPARTMENT-FOR- PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE _ _
PLAN 'REVIEW_' r :
B) CONSERVATION COMMITTEE IF; LOT BORDERS ANY TYPE OF WETLANDS. ._
C) PLANNING BOARD-TO SEEI LOT COMPLIES WITH ZONING±BY-LAWS. _-
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D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES-
EXAMPLES: - SAUNA BATHS, SWIMMING POOLS, RESTAURANTS,• ETC. . -
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"E) FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
REVIEWED� BY: - • y � _
1. ENGINEERING DEPARTMENT _ YES DOES NOT APPLY IGNATURE ms..;,..-/---1:,,,.. ,jRt�+ DATE3y _
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2. C ERVATION COMMITTEE- YES' -DOES NOT IAPPLY, JSIGNATUR=/94 afg 1; -_'DATFl�Z9/fid
3. PLANNING BOARD: : . YES DOES', NOT APPLY • SIGNATUR / .9: DATE- .. t.
4. BVRD OF HE'4,TH: YES DOES NOT APPLY!/SIGNA ' e � DATEZE
5. . FIRE DEPARTMENT: - YES DOES NOT APPLY SIGNAT r - DATE
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