HomeMy WebLinkAboutBLD-80-198 6)/ 8c'i- v► co . LJ
. .. No. i 9.A
•kl \ir Application for a Per it to Build •
fee must accompany t ' application
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Yarmouth '�7 — Pt 3 19 cr---v
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TO THE BOARD OF SELECTMEN •
• The undersigned hereby appliesfor a permit to build, according to the following specifications:
1; Name of Owner Q ►t e(s es pia n' Address / r W9 t' Ise Pk Rd
2. Name of Architect (if any)JfiM•l.e b/ e.4.5e.4.5Q 0- '°L- • • - -
3. Name of Builder Q-,-", L t V c S a a C-
4.
4. Precinct No. Lot No. Plan: Name or No.
5. Name of Street ( f--- wolf S 0 ' R (I .4, .) el. .o
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6. Purpose of Building 6®/ S �� r� P
7. Material (N 4.26
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8. Estimated cost of building a..O 0 0 , J •
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9. Dwelling "
10. Cottage ,
11. Heat
12. Basement
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13. Garage
1i4. Store
15. Shop .
16. No. of stories
1,7. 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
1
Show by diagram the location of propsed building with relation to distance from adjoining lots, on reverse side.
• Name... Allir./ , . i
Address.I?.4 „hy. th
2
Street Name
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Left Side Depth of Lot
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2 7
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Right Side Depth of Lot
4
Street Name