HomeMy WebLinkAboutBLD-80-210 fail/ tNn. -Q-k0 Application for a Permit to Build
19)1
fee must accompany this ap li atlon
Yarmouth >1" ` 19 a b
02.51-50
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit' itto build, according to the following specifications:
1. Name of Owner jjrff• add Address 2et1�f
171 (5-77
2. Name of Architect (If any) •
3. Name of Builder 4/I -
4. Precinct No. 3 �t Lot NO, 2 1(2-1(2- Plan: Name or No.../ad
9
5. Name of Street 51(
S'(/'
6. Purpose of Building b)' ry� e_ ��j�Q - - .1)( /02
7. Material
8. Estimated cost of building gee.0O
9. Dwelling !ct-'
10. Cottage
11. Heat
12. Basement
19. Garage
14. Store
15. Shop
18. No. of stories
17. Is there to be a Store In the lower storey
18. Size of Lot. No. of feet front baa ' No. of feet rear / Da r No. of feet deep " as
19. Size of building. No. of feet front No, of feet side 16 No. of feet rear 8
20. Distance from nearest building: Front ..... d r ft.; side .2.6 ' ft.; side `s f ft.; rear
aa /
21. Distance back from line or street.....t..7 from rear lot line ....R , side line
Show by diagram the location of propsed building with relation to dist nces from� adjoining lots, on reverse side.
Name% e'/iL (L_
Address.Z.�tty d2-
Rear of Lot
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3
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i A. oTs
aaooaJo 1
mb zz viill 0
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Frontage of Lot 100 .
Street Name 1- z e -
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PLOT PLAN
D , No ER.✓iIT R t t .;; j
PPL ICANTi 1F�.tL e.;; n i BLDG PERMIT•N O: ' •
OCATION OF *PROPERTY: 311-9,• O? CL 4;:• -• • • =.'` DATE.FILED: -• • ' - •
THE 'FOLLWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN•INDIVIDUAL. - .• - : ''>
UST FOLLOW IN ORDER TO OBTAIN. A PERMIT TO BUILD OR ALTER A .BUILDING. =THE BUILDING-.;-=y: +, .- c
FPARTMENT-WILL'_CHECK•ON :THE_ FOLLOWING: (A): CONSERVANCY 'DISTRICTS; (B)*.A. HISTORICAL -• _ =_;i
STRICTS (C)_. FLOOD PLAINS'ZONING,• AND WILL BE RESPONSIBLE FOR ASSISTING THE -_
PLICANT THROUGH-THE FOLLOWING-AGENCIES:. = - "
RESIDENTIAL BUILDING '- -
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE •
DISPOSAL`',:' ' r :.:.:•t;...:::-; -.,!......::„•?- _
6) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERSONANY TYPE OF WETLANDS. -
•- EXAMPLES: STREAMS, PONDS, -RIVERS,:OCEAN, BAY, :BOGS, MARSH,. ETC: -.-_-•,;.;-••• ;••,- :- • ti '
- C) CHECK•WITH PLANNING BOARD FDR•LOT`RELEASE: , • . - --• _ -•:7:.-:---;.-Y-
COMMERCIAL-BUILDING =,:.. _ i ' = = w.
_• A) ;ENGINEERING DEPARTMENT_FOR. PARKING AND DRAINAGE REQUIREMENTS, TOPC • PHY SITE '%i
-
•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-FORPROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE ' :1, `
DETECTORS) - -
_ i _ - - - .._i .r. . - • i.
t • - ▪ ;--.4-.J:.-.-?__C: --_ a --' - - .-
IEWED BY � 1. ) =�1 ,
ENGINEERING DEPARTMENT YES be"DOES NOT APPLY - SIGNATURE kRI-Gr- . r•{•`+ 1 DATE:. r
CONSERVATION COMMITTEE ,YES > DOES NOT APPLY'�SIGNATURE -t'�- = d• • .t. =DATE �atMY4'.
PLANNING BOARD YESkir._DOES NOT APPLY'_SIGNATUr - DATE`- j:
BOARD OF HEALTH _ YES •' DOES NOT APPLYi%SIGNAT 4 ard. py; DATE�e2fr a ar
FIRE 'DEPARTMENT:. • YES DOES• NOT APPLY_SIGNAT - ' - - DATE ,-- lt '
• "
ENTS:
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