HomeMy WebLinkAboutBLD-80-168 01 -- �� �
� b .. . _ Lr o Qi� 4.!f/ No.
III I /_ Application for a Permit to Build
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Tee must accompany this appli tion
Yarmouth April 7, ig 80
•
TO THE BOARD OF SELECTMEN
remodel
The undersigned hereby applies for a permit to 1tntld, according to the following specifications:
1. Name of Owner Professional Bldg. Trust Address 56 Oliver St.-Fitchburg,Ma.01420
2. Name of Architect (if any) NONE
3. Name of Builder PROF. BUILDERS (JOE ROLLO)
4. Precinct No. 3 Lot No. 3 Plan: Name or No.LC9190FA-MAP22K2
5. Name of Street 189 South Street
6. Purpose of Building Summer Dwelling (eFc fes"L or' (S r nig
g
1, Material New & Used jf++>Qe- P� '�E
8. Estimated cost of building$10,227 /Qv' *ftews
9. Dwelling 1)0,...ee. sa yr sine Clot s
tT�'
3
10. Cottage 4 4 t`} cc c.,(4 .
11. Heat Forced Air - Gas J
12. Basement NONE 3 A Rad r.uz
t tC/re OW"[fAl
13. Garage YES , Lit/ art 4+.
14. Store
NO ceftr
1 „tro setae
15. Shop NO
16. No. of stories 1 ,,-. , CArt eerta-al
17. Is there to be a Store in the lower storey NO
18. Size of Lot. No. of feet front .7..31.49 No. of feet rear 13.1,x.2.5 No. of feet deep ...107
19. Size of building. No. of feet front 45 No. of feet side 51 No. of feet rear 45
20. Distance from nearest building: Front 150 ? ft.; side 75 ft.; side 30 ft.; rear5000 ?
21. Distance back from line or street 812' , from rear lot line 631 , side line 75
Show by diagram the location of propsed building with relation to distances from adjoining lots, on reverse side.
Name Joseph J. Rollo
Address 45 Page Hill Rd. - Lunenburg,Ma.01462
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Rear of Lot
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Frontage of Lot
Street Name '
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PLOT PLAN
•� ,40, BUILDING ERt;IT REVIEW
•
APPLICANT: rd xissfoo 4/ 8 /d� •- /I? rUS .. • BLDG PERMIT NO:
LOCATION OF PROPERTY: /$'f Soo IA 31-, _ DATE.FILED: "
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN'INDIVIDUAL _
MUST FOLLOW IN ORDER TO OBTAIN A PERMIT TO BUILD OR ALTER A BUILDING. ...THE BUILDING
DEPARTMENT WILL CHECK ON-rim: FOLLOWING: -(A)- CONSERVANCY DISTRICTS (B)'.-:HISTORICAL.-
DISTRICTS (C) - FLOOD PLAINSZONING, 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. •
-
6) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS.
EXAMPLES: STREAMS, PONDS, RIVERS, -OCEAN, BAY, BOGS, MARSH,. ETC. •
•
C) CHECK WITH PLANNING BOARD FOR 1OT RELEASE:_,: -:,--- 2:. -c _-
Z COMMERCIAL BUILDING: -
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 REALTY.-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). - .
REVIEW D BY: - . zy_ r u
: 1 EN NEERING DEPARTMENT: YES • DOES NOT APPLY -. SIGNATURE --,,,,,m„.„ -T . " f/ ,, SATE
2. ONSERVATION COMMITTEE: • YESi _DOES NOT APPLY_SIGNATUR ITT"' .;- - DATE-----/2- .1-8
$p-
3 PL NING BOARD: YES DO NOT APPLY_SIGNATURE = DATE
4. OARD OF HEALTH: YES �/UOES NOT APPLY SIGNATURE f DATE l�
5. FIRE DEPARTMENT: • YES DOES NOT APPLY SIGNATURE DATE •
COMMENTS: .
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