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HomeMy WebLinkAboutBLD-80-156 p 33 I " 1 -p/ Application::for a Permit to Build No. �� Fee must accompany this application Yarmouth �^'— s3/ 19 g FO TO THE BOARD OF SELECTMEN The undersigned hereby applies for a permit to build, accordin ,to the following specifications: �— 1. Name of Owner/7, 95 /�/6lR /it F c NCLt', AddressOFg 277 Gel YAW ovr/ /VAlJ.c 2. Name of Architect (if any) GESRO-E :15oN /6HS LIdifT RD ygR/+'/duplaty- ?4t 3. Name of Builder 4. Precinct No. • Lot No. / z o A i Plan: Name or No. SP'C'T7 .k /( 2.. 5. Name of Street pFF /R. 6. Purpose of Building C(TGsn/D nAh n pF T.o i./ 7. Material , ) ' /,''I-T( ZZ. O '} Ta er.II r rA/c, ,( .. 10,sree.. tt14 Ce 8. Estimated cost of building : •: y; / . 9. Dwelling No 10. Cottage ,y.. 11. Heat rCA'F ? • '/J/Q. 12. Basement NQ 13. Garage No 14. Store /It. t .41eA 15. Shop Nb y� 16. No. of stories / - (L/Nti- t•.''r,: .-c'"t 0 00,, 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 "eNo. of feet side //if 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 from adjoining lots, on reverse side. Name Address.a _ 4• .. Street Name 1 . i OLeft Side Depth of Lot ` • C. 1 .13 .� r -- -OM a : ". . ^ . % 4 — m • i at Z r 0 0 0 .•••• �- r .-. . • �• • . 1 I . 1 - - , ( vg 1 - : .. .. 1 1 T r 4 1 t J a r— -- Right Side Depth of Lot a - +`, - . 4 . Street Name .. . t, .. - -+ '' BUILDING PERMIT REVIEW APPLICANT: /4)4 -r.r /e C `' ✓(: I) / w,./ C�-�//� BLDG PERMIT NO: LOCATION OF PROPERTY: Cr ;H DATE FILED: THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO `CLARIFY• THE PROCEDURES. AN INDIVIDUAL - MUST FOLLOW IN ORDER JO OBTAIN A PERMIT TO BUILD OR ALTER A BUILDING.-' THE -BUILDING, DEPARTMENT WILL CHECKON•THE FOLLOWING:. (A) CONSERVANCY DISTRICTS (B) HISTORICAL.. DISTRICTS (C) . FLOOD PLAINS ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE .<, ' • . =• . APPLICANT THROUGH THE FOLLOWING AGENCIES. 1. RESIDENTIAL BUILDING: A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE DISPOSAL:• :. B) CHECK WITH CONSERVATION.COMMT-7TFE IF-THE, LOTBORDERS ON ANY TYPE OF WETLANDS. EXAMPLES-F-___ - cnru9rLtY. STREAMS, PONDS, RIV(=RS, OCEANS BAY, BOGS, MARSH, ETC. .- C) CHECK WITH PLANNING BOARD FOR LOT RELEASE: :: 2. COMMERCIAL'BUILDING. t A) ENGINEERING -DEPARTMENT-FOR. PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN REVIEW 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. • E) FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE - DETECTORS). REVIEWED BY I. ENGINEERING DEPARTMENT: YES DOESNOT APPL.YY SIGNATURE i l r 1#. DATES/7)156 2. CONSERVATION COMMITTEE YES DOES NOT APPLY ✓SIGNATURE 1 .Li _4, , DATE 3 7 3. PLANNING BOARD: • . YES DOES NOT APPLYSIGNATUR • • J DATE 4. BOARD OF HEALTH YES DOES NOT APPLYt- IGNATUR 5 DATE �% 5. FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE - DATE COMMENTS: - • • - _