HomeMy WebLinkAboutBLD-80-203 UR•,
No. 3-O
Application for a Permit to Build
fee must accompany this application
Yarmouth A pi--; I a* 19 8'0
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner g6e hwry M Jahr. Fa, I( Address 30 1.t7a.Nc-s Lt4. 8 i •
p I+s cr e-t d, ►n4q s s
2. Name of Architect (if any) i
3, Name of Builder
43 Precinct No. (3 - Lot No. A - 1 9 Plan: Name or No. A./t4. L L .41 9
52 Name of Street $ tl o N e 5 901 • I
6i Purpose of Building Sc vc 6 In ed Po NG k 4.dd 41 4 ra n
•
7. Material Sre(-int, weocis
•
8. Estimated cost of building CZ 000 •o o
+ ' /62 a
9. Dwelling A/O �l
10. Cottage •• ''
11. Heat Wo 41a d
12. Basement NO / •
13. Garage
14. Store AL)
15. Shop 200
16. No. of stories 1
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 distances from adjoining lots,ts� on reverse side.
Name....dt.n2 A/•<i1lcle
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Address... !1. . . . (ds.G�
OJ Lo/
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Street Name — `
O Lett Side Depth of Lot-10
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o 0 +
z OV
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a0 o J 1
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fits
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4o — e
N S T
ZO' V.
Right Side Depth of Lot ..WO
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L. L,,
• Street Name
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• BUILDING PER"JIT REVIEW .'. , ,:
APPLICANT,: i, Ett --- BLDG PERMIT NO: -
i e � •� �7 / ,, 1) DATE•FILED. yZ. 2j-A •'
LOCATION EDF 'PROPERTY. � Vete/fa- liar - c��fil7�j �ryrlel?;=-•
•
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN •1NDIVIDUAL_ - -,i•
MUST FOLLOW IN ORDER TO OBTAIN• A PERMIT TO BUILD OR ALTER A- BUILDING. '=THE BUILDING •: -;
DEPARTMENT WILL CHECK ON --THE FOLLOWING: (A). CONSERVANCY DISTRICTS (B):== HISTORICAL:• _'A
DISTRICTS (C) : FLOOD PLAINS-'ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE -_ • ,.
APPLICANT THROUGH•THE FOLLOWING AGENCIES. . : • - • •
i. RESIDENTIAL BUILDING:
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
•
DISPOSALJ'�-
B) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS. ' •
EXAMPLES:- STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH,. ETC. • •.-••••• • -
. C)
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C) CHECK WITH PLANNING BOARD FOR 10T RELEASE y
2 COMMERCIAL-BUILDING • �+
_ _ - , - ,,
A) - ENGINEERING DEPARTMENT-FOR_ .PARKING AND +DRAIN.AGE REQUIREMENTS, TOPOnP.APHY •SITE =' ?
PLAN REVIEW� 1a,4
s) .: CONSERVATION COMMITTEE-IF LOTBORDERS ANY TYPE OF WETLANDS, . -
C) PLANNING BOARD-TO 'SEEIF LOT COMPLIES WITH ZONING BY-LAWS.
D) BOARD OFHEALTH-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)_
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• •3.-: ! -
REVIEWED BY: - C' _ ` --
1. ENGINEERING DEPARTMENT: YES t ODES NOT APPLY -- SIGNATURE*• , El ,iy l";K DATE L3
2. :• CONSERVATION COMMITTEE: YES " DOES NOT •APPLYSIGNATURE r :�. • DATE4ILif&
3. PLANNING BOARD: YES ' DOES NOT APPLY_SIGNAT- 'a�• �j-� DATE' ' �•
BOARD OF HEALTH: • -.YES ODES NOT APPLYI/SIGNATC"I_ a _%'t DAT ��E /
5. FIRE DEPARTMENT: _ . YES DOES NOT APPLY_SIGNATj. -
COMMENTS:. _ ;
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