HomeMy WebLinkAboutBLD-80-129 (Captain's Row) , . „ . 0 :
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n for a P rmit to Build Na.,
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'' r3OARD. ,Fee must accompa this application
DATE w, A^
Yarmouth .../e.. . : .F [ .-.19
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TO THE BOARD OF SELECTMEN -
The undersigned hereby applies for a permit to build,'according to the following specifications:
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1; Name of Owner �,.� 1,� Address �� >�'
2. Name of Architect (if any) S? .S`{ 4'0 •
3. Name of Builder S7E U& iCt ,,,,0 Si. Q
4. Precinct No. / Lot No. 'Al O \/Plan: Name or No. pt d . v
5. Name of Street GAJ ,ivtS I / � 64 A L4&iooT� / ),c
6. Purpose of Building fri772/G/UC E6/1Ot/A'(Z OA
7. Material wood 141411 Ca.v s 7 rWCT7oiv, OR14WAL.L f/nl& (GOO/cS •
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8. Estimated cost of buildin a2O 0/-0
9. —Dwe@tfig— .
10. eattage— r v e m /5 ''1 Fob'L 7-.1r
11. Heat • eJ L Af
12. -Basun eut r
13. Garage
14. 'Store •
15. Shop C.DIA.)-ppe.si6,V
16. 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 fromtine or street i from Rear lot line side line
Show by diagram the location of propsed building with relation to dist n es from adjo'nin5lo s on reverse side.
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Address..6•6 re;.44,21-
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Street Name
p Lett Side Depth of Lot...
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Right Side Depth of Lot
Street Name
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BUILDING PERMIT REVIEW - '
APPLICANT: - • /tQ- £ H � ' BLDG PERMIT NO: - •
LOCATION OF PROPERTY: 1\ �
j YAr FeetTi) • earc1 to '
DATE.FILED ( :
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE •PROCEDURES AN"ZNDIVIDUAL. 7 '•
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) -F.LOOD PLAINS-'ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE':= = - -
APPLICANT _THROUGH.THE FOLLOWING AGENCIES _ -'
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1. RESIDENTIAL BUILDING: •---: -
A) CHECK WITH THE HEALTH DEPARTMENt IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
DISPOSAL `S r
B) , CHECK WITH CONSERVATION (COMMITTEE IF THE LOT .BORDERS ON ANY TYPE OF WETLANDS
" EXAMPLES:- STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH,. ETC. - -..--2:-z.:::-..:- • ' -_
C) CHECK WITH PLANNING BOARD-FOR 10TRELEASE , •
2 COMMERCIAL BUILDING 1 ', 7.2---•-_,:7.-.1
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_ A) , ENGIN_EERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS; TOPOG2APHYSITE•
�- ' PLAN REVIEW ':' - t . -.+ ::. _ =
B) CONSERVATION COMMITTEE IF LOT BORDERS ANY TYPE OF WETLANDS -•
C) PLANNING BOARD TO DEE IF. LOT: COMPLIES WITH ZONING BY-LAWS. •- •
_ D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. --
-• SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC. - .
" •
E) FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE '
• DETECTORS)
`i _ � -
.
11EVIEWED BY ° x . Jt
1 ENGINEERING DEPARTMENT:.. YES 'V DOES NOT APPLY_ IGNATURE:_!e _A-7-". - �-,L•• DAT /Jt$i
CONSERVATION COMMITTEE:. YES � 77-
�� DATE i d'
3 t PLANNING BOARD: YES `: DOES NOT APPLY • SIGNATURE:' .:'DATE_-'
.4 BOARD OF HEALTH: YES DOES NOT APPLY ` SIGNATURE .: " DATE '
5. FIRE DEPARTMENT:. - - YES_DOES, NOT APPLY_SIGNATURE - - DATE • . -
COMMENTS. • -� -- =
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