HomeMy WebLinkAboutBLD-80-193 PI r° ay— I •it? y
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• . Application for -a Permit Build
Fee must accompany this applic ion
Yarmouth 1/49 19 eb
TO THE BOARD OF SELECTMEN
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11 The undersigned hereby applies for a permit to build, according to the following specifications:
1, Name of Owner crone/Wry cr; c2k/iC V Ie5 Addressc ts'i R' '//rr
2. Name of Architect (if any) 6-eaAO (Cs
3. Name of Builder
4. Precinct No. Lot No. X /Q3 Plan: Name or No. A,✓ ar
51 Name of Street lb Cf&Lu.et /ep oU' rentneci
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61 Purpose of Building /b"e. /C,�CenlOu*77dnr- 7o eS7`eK/aZ
71 Material CUJOO10
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8. Estimated cost of building 4 f 0 (1)fie•
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9. Dwelling oft . QdK.9d er
10. Cottage 2 O Z f� o a H 4•
11. Heat /dpLN i(6 df S*FCD
12. Basement Do,teten T 20
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13. Garage
14. StoreI e /
15. Shop - j1 i�gear d,t1 Dor/)16. No. of stories
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 No. of feet side 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
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Show by diagram the location of propsed building with relation to distances from adjoining lots, o�side.
' Name .............. ..
Address
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— --Rearrof Lot .
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Frontage of Lot
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. . .Street Name . , . r , .........._., -.-:;- '31 ' ,'"'...-.3
PLOT PLAN .r. "‘\�i ,':7 ..�
_ BUILDING PERMIT REVIEW -
APPLICANT: - �OYYri/o --q-; CAayc' `:. .;.• - • BLDG PERMIT NO:
LOCATION OF 'PROPERTY: 'Z(v '' - `-' DATE.FILED: ": ' • ' -
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN-INDIVIDUAL- - ': -,i•_.
MUST FOLLOW IN ORDER TO OBTAIN_ A PERMIT TO BUILD OR ALTER A -BUILDING. -;THE BUILDING
DEPARTMENT'WILLCHECK ON :THE: FOLLOWING:• (A)' CONSERVANCY DISTRICTS (B):`. HISTORICAL •• --:- _;6
DISTRICTS (C) : FLOOD PLAINS-'ZONING,• AND WILL BE RESPONSIBLE FOR ASSISTING THE-:--_ =-.
APPLICANT THROUGH-THE FOLLOWING AGENCIES
i . RESIDENTIAL BUILDING: - t
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
DISPOSAL - .
B) 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 LOT RELEASE ;3/4-:::,....:.;.--_,- : c---_ ----.:_c_-„,...
2 COMMERCIAL-BUILDING t -
:Ai:. ENSINEERING DEPARTMENT-FOR-PARKING AND DRAINAGE REQUIREMENTS,_ TOPOGPAPHY SITE _
`` '2; PLAN REVIEW: •
B)i: 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 ' = •.r_:`
1: ENGINEERING DEPARTMENT: YESDOES-NOT APPLY_- SIGNATURE: ,,� -
Iii �.` DATE '(j,
- i d
2. CONSERVATION COMMITTEE: - YES=''_DOES NOT APPLY'/SIGNATURE - I ' --ems'/f = DATEift/ .-•
3 PLANNING BOARD YES ' DOES NOT APPLY -SIGNATU' -..:-•-•: :DATE ` •• rL
4: BOARD OF-HEALTH: YES • DOES NOT APPLY!/SIGNAT �% .t% DATE.
5. FIRE DEPARTMENT: _ - • YES ODES NOT APPLY___SIGNAT'E - DATE
COMMENTS :'
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