HomeMy WebLinkAboutBLD-80-195 (0�� xr f
S 4\4° Application for a Permit to Build No.
.Fee must accompany his application
Yarmouth Tr 19.0
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TO THE BOARD OF SELECTMEN •
The undersigned herebyheapplies a/�peerrmmit,to build, according to the following specifications: %, �/
1/Name of Owner /) `" w 0 •'J • 1,7\Address t9 42dii3/ Jetest"i��4 ;
2. Name of Architect (if any) ,
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3/ Name of Builder QS- -/ ,_ C ,4 -en _
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4. Precinct No. .3 Lot No. Q/ c- i Plan: Name or No. �/ 57
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5. Name of Street /.y�� J/' or- ‘,/ [ AM. S I - 5192 .
6. Purpose of Building p, ) '
7. Material or i t �{
et) is/ 2 ' )Y�fid.a d
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8. Estimated cost of building
9. Dwelling d i, i / fried-Mt- z ? 66A/1A/7" /
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10. Cottage ,U) j ` i 0412-0� ' iik di 7.a. 0 /(r' 0 C
11. Heat ii/0 J Iv '
12. Basement r1/0 i._. _-+lrt— ti • 00 .
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13. Garage I ) I ..t'a O __
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14. Store til D �___ __._ .._ . _% I0, O--v
15. Shop c,J U I
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16. No. of stories C -.
17. Is there to be a Store in the lower storey
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18. Size of Lot. No. of feet front ' C. 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
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21. Distance back from line or street y, trom rehriot line , side line
Show by diagram the location off]propsed building with relation to distances from adjoinin lots, on reverse side.
�' f �_ /c/�,s'}�, Name. 2 Cf42--3;n"A ... ���//J
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' Street Name .
r < o Lett Side Depth of Lot 42./(r (-9/
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h , Right Side Depth of Lot ......I .0..4.•0 D
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Street Name A
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• BUILDING PERMIT REVIEW -
AP LICANT: •' ,, • • BLDG PERMIT •N0
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LOCATION OF PROPERTY: •/f 2. • /-- -• -/i¢` DATE FILED
THE FOLLOWING CHECK OFF HEET 'IS DESIGNED -TO- CLARIFY THE -PROCEDURES AN INDIVIDUAL :