HomeMy WebLinkAboutBLD-80-095 (3)it4 tu CY 0/re,
es-
6 -
No.
5 Application for a Per it to Build
"Fee must acco y this application
•
Yarmouthjir 0 19..... ...
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a/permit to build, according to the following specifications:
1. Name of Owner ? i°Wa/ K`�r`
7277214-, Address
2. Name of Architect (if any) •
3. Name of Builder /y • 2- erc �p
4. Precinct No. jr_� Lot No. 6 � Plan: Name or No.
5. Name of StreetPfr %41.402 /SCI 03
8. Purpose of Building ip FSG/Z 'pe n)
7. Material (
8. Estimated cost of building /2-1/ l
9. DwellingCAT
SO-010. Cottage
11. Heat
12., Basement
13. Garage
14. Store
15. Shop.
15.. No. of stories
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 , side line
Show by diagram the location of propsed building with relation to distances adjo g lo sloon reverse side.
Name
Address. /O;1l14�l/th e
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Street Name
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Right Side Depth of Lot
Street Name
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