HomeMy WebLinkAboutBLD-80-166 AR g, Lu „it<@5fr: #
/ 5 0 A lication for a Permitt to Build No. 1 a41&AA, PP
Fee must accompany this application A� pD
Yarmouth ..fipf.1� 4 19.30
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. ✓Name of Owner eR 20R 1 Address!SS taiMBLEK (i DRIVE
Lt./.YAK Malin
2. Name of Architect (if any)` saris ,t;h, oa °Addesse 55o IQIo66
3. Name of Builder SAMEto llsoRdkaavn 11'W.53.
0101S
4. Precinct No. Lot No. Plan: Name or No. E7- N Ft •
' r f
5. /Name of Street�wlm(I N Iq¢.I UE.
6. .Purpose of Building Want IcaSIOENCE «UT&
7.. Material -
8. Estimated cost of building 4kpryo C Jos t /N e'ue ft O/ZCies
9. Dwelling / y� J'
10. Cottage A/ � .- / Res ,OO/
11. Heat ,{/c
12. Basement ,(e
•
13. Garage Ab
14. Store ,C/e)
15. Shop a
16. No. of stories E
17. Is there to be a Store in the lower storey Aid
•
18. Size of Lot. No, of feet front ....IP? No. of feet rear .WI No. of feet deep 1 CO
t
19. Size of building. No. of feet front �.G,tl1.47).... No, of feet side ...a.. 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 dist ces from adjoininae lots, on reverse side.
Name.. . at
�Addre s...$et...WI61 Lore U),Yefo.wwitfft Mass
�
1
Street Name
•
•
0 heft Side Depth of Lot #001 `
-a _ I:
r OD SS
n L.
Z ,,_
R 'ti ' • . - 0 g _ _„.
eo
CI f 6
.r. 6• • E y
ou.slf elicits
_' •
__
'flight Side Depth of Lot t1 t - r +
fg
A
Street Name 4ti�1A16
.Cl
*eel ��.
•
' ; ,, - BUILOIKG PERMIT REVIEW: / ..
' APPLICANT: • A; z i • •• - • BLDG PERMIT NO _
LOCATION OF 'PROPERTY: -• onera.EtOM 1 6.. DATE.FILED '` .-
•
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THEPROCEDURES AN'2NDIVIDUAL. -1:••-,
_ MUST FOLLOW. IN ORDER TO OBTAIN- A. PERMIT TO BUILD OR ALTER A .BUILDING. --THE BUILDING:. • _ ;j:=
•DEPARTMENT -WILL' C_HECK•ON -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 DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
..�
- 6) CHECK WITH CONSERVATION COMMITTEE i
IF THE LOT BORDERS ON ANY TYPE OF+WETLANDS .
EXAMPLES:. STREAMS, PONDS, _RIVERS,,'OCEAN,t‘:-..-:-1: :::•! :.
BAY, BOGS, MARSH,. ETC •_ -".
• C) CHECK•WITH PLANNINGYBOARD'FOR LOT RELEASE r �: :�
2 COMMERCIAL BUILDING =, . ' - ..
__\A) • ENGINEERING DEPARTMENT FOR.PARKING AND DRAINAGE REQUIREMENTS,._ TOPO •�=PHY SITE _
" PLAN REVIE% 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 DF HEALT -FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH TH RELATED ACTIVITIES. -•
EXAMPLES: ' SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC. • .
-E) ' FIRE DEPARTMENT FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE -
DETECTORS). —
f c t r
REVI▪ a ED BY:•',-:_• ; • . . :c _:, r 3 ' :.:.
- .- } ;
1; . ENGINEERING DEPARTMENT:._ YES j DOES NOT APPLY • IGNATURE:4+# __',:.---t--_--"/„.7.5 3 DATE i1ff-
2. NSERVATION COMMITTEE:*.YES:—.DOES NOT APPLY`_SIGNATURE .W/ '-jay.- ' - DATE A .
3 PLANNING-BOARD YES • DOES-NOT APPLY_SIGN URC � -I• : DATE'? .1-
4:
4:t�BOARD OF HEALTH. YES • DOES NOT APPLY ✓SIGN R �e� �'' -DATE S"G'
5. FIRE-DEPARTMENT:. _ = • YES ODES. NOT APPLY •` SIGNAI!''E •• • • ' - DATE - • --
COMMENTS: •
,..e: �r /2fa?n r 1..11..ft:ou e&er) f O.r ,9:04,.?�►'h It 7i ?lt'd3R4; -
a • sr
4.
t".::::.:.-: ::,
` ..t:;::::....:-.!:.......2,::. * t' '4 wJ "/� / L ^a t40::-..2:.;;;;;;L
— v �/- i� a `\ r '
° GG� as t ' i_•<::.:..`
a. G
• Y -- _♦▪1 fI•. iT. .▪S: y ' i 4 (^ , ' zt -1. SP -_- __- _- :-. z_ -,