HomeMy WebLinkAboutBLD-80-196 Application for a Permit to Build •
Fee must accompany t application
• • Yarmouth .43.4a... ,rl �/9.. ..
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TO THE BOARD OF SELECTMEN ••
The undersigned hereby applies for a permit to build, according to the following specifications:
DR, T-N� Fiv , � , t. 7s' Co VR T s )?5c7
1. Name of Owner Al�v//�R'Tb jy� Address
t.GCs7r/EM A74-• °io g,3--'
2. Name of Architect(If any) • ___
3. Name of Builder S74Am- o.QS NA 7a tit
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4. Precinct No. 4 Lot No. c-7 8 Plan: Name or No. _7
A.M. S'1-CIS •
5 Name of Street 53 Pfit te_v 1/4-0-4
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6. Purpose.of Building it.T. 01, E'
7' Material tete ," , / ~ /44
8: Estimated cost of building Jae ',we? b• }
9. Dwelling. Si Co V A/=Cpr..I , ` Y7 2 1-
10. College •
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,� Jf
t —'f
12. Basement �l
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13, ..Garage
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14. Stole 2 ; '3 �• .
15. Shop
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16. No. of stories r p
17. Id there to be a Stole tri the Power storey
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4`^1h 'Nps of•feet rear No.•of feet deep
18. Size of Lot. No. of feet front • 1 ,....
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19. Size of,building. No of feet front'• �/ No. of feet sides.
/V No, of feet rear /y
20. Distance from nearest building: Froptft.; side ft.; side ft.; rear
21. Distance back from line or street, from rear lot line side line •
Show diagramP ps K g.'. 1
by the location of ro sed building with relation to distances from pd oinln¢ Iota, on reverse side;
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Name -A l * a c tz
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Street Name _ f V+ ci
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0 Lett Side Depth of Lot /a '! ' o B A
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Z
I 4
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444
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. . Right Side Depth of Lot O '.t:/..Q' ; , _1
Street Name
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No
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- ooUILDIRG PE?.✓,IT REVIEW- -
APPLICANT7 . f CLf elf_ • '. ' BLDG PERMIT NO
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LOCATION OF *PROPERTY' _ - , • ..i ,�' . 7 LV DATE- FILED
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• 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:;?'. ;:j= .
•DEPARTMENT •WILL' CHECK ON :THE. FOLLOWING: (A)• CONSERVANCY DISTRICTS (BY/1. HISTORICAL , -:Y.-_ I,
DISTRICTS (C): FLOOD PLAINS ZONING,- AND WILL BE RESPONSIBLE FOR *ASSISTING THE
APPLICANT THROUGH-THE FOLLOWING AGENCIES -
i
I. RESIDENTIAL BUILDING i -- . " '
A) CHECK WITH THE HEALTH DEPARTMENY Ii,/ REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
DISPOSAL. - - • J
- 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 ,' ' • • •_
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2 COMMERCIAL BUILDING - \ r= '
A) , ENGINEERING DEPARTMENT FOR PARKING AND'vDRAINAGE REQUIREMENTS,_ TOPD P PHY SITE
`,� _ PLAN REVIEW:i I� ,;--. .. 4 ` ~ y :
• B) CONSERVATION COMMITTEE—IF LOT BORDERS ANY TYPE OF WETLANDS.
C) PLANNING BOARD TO 'SEEIF LOT COMPLIES WITH ZONING BY—LAWS. •
D) BOARD OF HEALTP'FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: ' SAUNA . BATHS, SWIMMING'. POOLS, RESTAURANTS, ETC. - .
-E) FIRE DEPARTMENT—FORPROPERTYPROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS) ' . -
RE I ED BY:.'-' c< ° s :c- >. ;:
I. NGINEERING DEPARTMENT:.' YES y DOES NOT APPLY_1 SIGNATURE" 1 , i -- —1 - DATEWifb
2. CONSERVATION COMMITTEE:_ .YES. _DOES, NOT APPLY/t SIGNATURE -. t _i_ : I a; • -I "'t'' DATE4P4130
3. PLANNING BOARD YES DOES NOTAPPLY SIGNATOR • "' a•1: DATE- .• =.y
4 +BOARD OF HEALTH. YES_DOES NOT APPLYSIGNA UR , ,i /�/�9.' ,T DATE ��
S. FIRE DEPARTMENT: . - • YES DOESNOT,APPLY SIGNAT. • - DATE
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COMMENTS:
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