HomeMy WebLinkAboutBLD-80-201 e ,Th.- ,, , ... e
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e,` \D 1 Application fora Permit to Build
Fee must t accompany this application
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Yarmouth Y..vW ,'l19 P-V
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner �jc er, /./.4-44.4.....c. Address G Ci
2. Name of Architect (if any)
3. - Name of Builder /✓. C:
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4. Precinct No. 3 Lot No. AI 4• Plan: Name or No. A•M•
5. Name of Street -vim` --- / 41
6. Purpose of Building
O el..; ---- ''a
7. Material .
�8. Estimated cost of building 114C�D 0 • -
tee-
I /179. Dwelling
10. Cottage jag
104- .71._ --italay \
11. Heat / 11\ '
12. Basement e.-1-4<taalaYS'" Cit 7� —
<7S"4 ,. .%2
13. Garage �tG
14. Store /t-
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15. Shop
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
Show by diagram the location of propsed building with relation to distanc/es fromdjoining lots, on reverse side.
Name !l[ 1'(/!w.... rti /��� . ...7-4..47:07,:t.
Address .if C2n.../e±tcf eet a'
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Street Name
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r Leh Side Depth of Lot
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g 1111*IL Xiik. 4
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1 '\4444741/4\71. .4 I I IN
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Right Side Depth of Lot
Street Name
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• 'BUILDING PER✓IT REVIEI.+ '. ;
AP PL ' ' BLDG PERMIT N0. •
LOCATION OF PROPERTY: !a aliffiP ' ` _ DATE.FILED: • t •
•4'
THE FOLLOWING CHECKOFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN ...INDIVIDUAL.
MUST FOLLOW. IN ORDER TO OBTAIN• A PERMIT TO BUILD OR ALTER A .BUILDING. -Z.-.THE BUILDING .
DEPARTMENT °WILL CHECK ON THE FOLLOWING:• (A)• CONSERVANCY DISTRICTS (B): HISTORICAL`.• "`' '•c'
DISTRICTS (Cl; FLOOD PLAINS.ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE'. -
APPLICANT THROUGH-THE FOLLOWING AGENCIES -
1. RESIDENTIAL BUILDING: - _
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
5) 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 LOT RELEASE , _ .
-'2. COMMERCIAL-BUILDING _ _
A) ENGINEERING DEPARTMENT FOR PARKING AND DRAINAGE REQUIREMENTS, TOPO:R PHY SITE -
PLAN REVIEW: ` • -
B) 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: *- _ . _ :_- . .:
1 ENGINEERING DEPARTMENT: YES DOES NOT APPLY SIGNATURE'S; JD- .2.7.-'•;z DATE _
2 CONSERVATION COMMITTEE: YES DOES NOT APPLYYSIGNAT-URE
3. PLANNING BOARD: YES ' DOES NOT APPLY_SIGNATU ! pj�'�id/ DATE•'
4
BOARD OF HEALTH: YES DOES NOT APPLYc/SIGNAT R i3y' « DATE
5. FIRE DEPARTMENT: _ YES DOES NOT APPLY_SIGNAT DATE
COMMENTS: • �\ CHAgG,E.' ro o0TStDE b%MEAtfloa3S OF 'Qutt.00KIS • 1 3
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