HomeMy WebLinkAboutBLD-80-176 ,. (2A69 - Xy/ n
r� cciD No. 116
� )I Application for a Permit to Build
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Fee must accompany this applica A
Yarmouth /31/9/2/31/9/2/Z 14.19.7
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TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications: A '\\
1. Name of Owner L E0 N .' /3 E4, 0 Address 3 7 �!T4 ?U&� \w
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2. Name of Architect (if any) /170^/EC
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3. Name of Builder /yOta-
4. Precinct No. Lot No. Plan: Name or No.,
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5. Name of Street 3 9 R,7--.6 4 V F J
' 6. Purpose of Building 6- 4.'Q DFr' S f/-F/�
7. Material w 0 O O
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8. Estimated cost of building
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9. Dwelling _. J -
10. Cottage
11. Heat
12. Basement •
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13. Garage —
14. Store
15. Shop
16. No. of stories /
17. Is there to be a Store in the lower storey /`/ O
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18. Size of Lot. No. of feet front / ° e . No. of feet rear / 0 D No. of feet deep / ?0
19. Size of building. No. of feet front / / r 7 rr No. of feet side 7 , 2 rr No, of feet rear / r/ rr
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20. Distance from nearest building: Front 3 O r ft.; side 6- ' 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 lot , on reverse side.
NameName
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• Address 3 7 61? ..
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Rear of Lot
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Frontage of Lo-t (CO i
Street Name I."' k
PLOT PLAN
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