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Application for a Permit to Build
Fee must accompany this application
Y 101_54` • Yarmouth ��!C��//d4 2 195-0
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TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:l: Name of Owner : }a'!
n't- Address �.u• � 6
2. Name of Architect (if any)
3. Name of Builder rit T m
4. Precinct No. Lot No. Plan: Name or No.
tal C941 � �`' try. rte .
5. Name of Street o__""�,
6. Purpose of Building 014-e-1- c-2 0 - i- `J Awl /Zt
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7: Material
8. Estimated cost of building '7O OI i1 d a
9. Dwelling ------
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10. Cottage v '-
11. Heat
12. Basement •
13. Garage
14. Store
15. Shop
16. No. of stories
17. Is there to be a Store In the lower storey Nd
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 rom adjoining lots on verse side.
Name - . ...�✓l�Q7 *t3
Addres ... S"P A p.c..,... 974.ux
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Street Name
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Left Side Depth of Lot
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1
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Right Side Depth of Lot
Street Name -
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