HomeMy WebLinkAboutBLD-80-169 �o " 7 �� i3 k, ,, �
!9h.�+ OL ` No. //
I � Application for a ermit to Build
-Fee must ac pany this application
Yarmouth 9/r 19..&U.
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a pgrmit to build, according to the following specifications:
1. fame of Owner Jere a�lHAN. Address✓(O4 H4Vw000 Ave .
Yh4n41,41% MA. 022.64.:
2. Name of Architect (if any)p- ir. , . '1 " -, .
3. Name of Builder
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4. Precinct No. Lot No. Plan: Name r No.
5. Name of Street ✓ m Y 4/11-4-- UE` Se fr c 4
6. Purpose of Building
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7. Material ffiMISE.
8. Estimated cost of buildin OOU C /tls� I� la/jest)
9. Dwelling /
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10. Cottage .��P►�icf frR G
4
11. Heat A/Q
12. Basement Aid ••
13. Garage Nei
14. Store At
15. Shop AR/
16. No. of stories /
17. Is there to be a Store in the lower storey Pa
18. Size of Lot. No. of feet front No. of feet rear No. of feet deep
y � 7 / /
19. Size of building. No. of feet front /7 No. of feet side V 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 distancesfromdadjoining lots, on reversec- side.
'/Name..�..1"0/746 /V�J. `�*r
Address...�K '96 5. Ana P� Aft? ,..aa.a4 r
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Rear of Lot 11
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Frontage of Lot
, Street Name
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PLOT PLAN
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