HomeMy WebLinkAboutBLD-80-148 1I ,i oKr1/t
'is ` Application for a Permit to Build No.
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Fee must accompany this plication
Yarmouth 3-2 f 19 lb
TO THE BOARD OF SELECTMEN
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The undersigned hereby applies for a permit to build, according to the following specifications:
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1: Name of Ownei / Address 3S f(fsTinsxf
2. Name of Architect (if any) Aft 4 2 ..
3. Name of Builder Rq( Spr', ,J(Le 69,
4. Precinct No. 9 Lot NoVel nog Plan: Name or No. .„5 7
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5. Name of Street 35--
,464,,464,74.)n'Tg aim_.
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6. Purpose of Building 50 0 )Lce.n1 / ,2 X / Z- "d t-vt� n„ N c /Y+r.1'
7. Material Woo finnit. .
8. Estimated cost of building ; '—'$00. / 911 S(l ,'
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9. Dwelling ..
10. Cottage ?A'
11. Heat /if0
12. Basement "C4AwL •
13. Garage `
14. Store
16. Shop •
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
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19. Size of building. No. of feet front ...L.2.. No. of feet side ...�c.. . No. of feet rear .�.4?
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 dicta es from adjo 1•ta, on reverse side.
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Street Name
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• Right Side Depth of Lot lV° '"{
Street Name
BUILDIKG PERtlIT REVIEW•
APPL?rANT:k..GC/ 1�%/ • BLDG PERMIT NO
t •:!f. •" 1 C DATE•FILED -
LOCATIOM OF PROPERTY �o Vy ��
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THE FOLLOWING CHECK-CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN •TNDIVIDUAL. - ••-,t
MUST FOLLOW. IN ORDER TO O OBTAIN. A PERMIT TO BUILD OR ALTER A .BUILDING. --THE BUILDING:;-`---. :
•DEPARTMENT.•WILL' CHECK•ON ..THE FOLLOWING: (A)• CONSERVANCY DISTRICTS (B);-:. HISTORICAL'.:.• _ -_-‘s...,
DISTRICTS (CrFLOOD PLAINS-'ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE -
• APPLICANT THROUGH•THE FOLLOWING AGENCIES.
1. ' RESIDENTIALS BUILDING: r -.
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
DISPOSAL `- _
B) =CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS .ON ANY TYPE OF WETLANDS
- ..r•. EXAMPLES: STREAMS, PONDS, . RIVERS,:OCEAN, -BAY, BOGS, MARSH,. ETC: • _.` _
C) CHEWITH PLANNING BOARD'FLOT RELEASE ", . - •. .` :J _
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2 COMMERCIAL BUILDING , `r s • .
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,A).';: ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS,_ TOPO QPHY SITE -
h PLAN R -. :' ` :
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. •
) FIRE DEPARTMENT-FOR PROPERTY
-EPROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE •
DETECTORS)
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REVI ED BY " '- -..•.„--..----,..;::_-,117- - t-. ''•`-
1 GINEERING DEPARTMENT YES {/ DOES NOT APPLY • IGNATURE i� _,,--f DATE.
2. NSERVAT3ON COMMITTEE:.. YES_•_DOES NOT APPLY"�f SIGNATUR DATm_
3. PLANNING BOARD: YES . DOES NOT APPLY_SIGNATU•E. • ti-. - sr: DATE
4 ' OARD OF HEALTH YES DOES NOT•APPLY=SIGNATUfjP •�� 9CC-T �� DATE / a•
5. FIRE DEPARTMENT: • YES DOES, NOT APPLY_SIGNATURE DATE_
COMMENTS.
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