HomeMy WebLinkAboutBLD-80-211 PA") , 0P Application for a Permit to Build No.
iFee must accompan his application
Yarmouth .. .e/A Z ..1..19.R..a.
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner -2 �eyI /pleier VI kr-4J Address Qtr.. O4 {7//PM S
2. Name of Architect (if any) '74-o'—e----
3. Name of Builder abf,C/e!SW ''7�• J�0.
4. Precinct No. 3 Lot No.'1 Plan: Name or No. A.M. 3 f. -S']
5. Name of Street 9S U/L /vi,g/A - ,
6. Purpose of Building (2 /L /'Ty S�� Sera j % W dd�S#Of
7. Material' (,-, 1/ a
X/ / /
8. Estimated cost of building Z o
9. DweMng
10. cottage 7/
11. Heat IGS 7R5 /.46
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12. Basement j
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13. Garage
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14. Store
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
LL / 7
19. Size of building. No. of feet front 7..,1 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, on r verse side.
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Address....k14.G� ) fl / �.... 1 '`1,17,6A,
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Rear of Lot
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i4I 61
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a o ' 3
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Frontage of Lot
Street Name.96`...GeeC.. 0..t.t3
PLOT PLAN
A .
_ • BUILDING PERMIT REVIEW, / • 1:
PPL IC T: Pei! /L:• ;f�Y ' BLDG PERMIT NO
OCATION 0 ?Rol'RTY: r� /_ot 2- •
• DATE.FILED: " -
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN'TNDIVIOUAL. - ;r•-,'•:''`
UST FOLLOW. IN ORDER TO OBTAIN_ A PERMIT TO BUILD OR ALTER A .BUILDING. -;THE BUILDING. '-=. .a; ,.
EPARTMENT -WILL_CHECK ON :THE; FOLLOWING:• (A); CONSERVANCY DISTRICTS. (B):_-. HISTORICAL • t `�
ISTRICTS (C)c. FLOOD PLAINS'ZONING,• AND WILL BE RESPONSIBLE FOR ASSISTING THE==.•'= `.
PPLICAUT THROUGH•THE FOLLOWING AGENCIES ••••••,•.:
▪ RESIDENTIAL BUILDING -
E
A) CHECK WITH THE HEALTH DEPARTMEN'i IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE -
▪ DISPOSALC -
B) CHECK WITH CONSERVATION COMMITTEEIF THE LOT BORDERS ON ANY TYPE OF WETLANDS.'- `• `,`
EXAMPLES: STREAMS, PONDS, _RIVERS, OCEAN; -BAY, BOGS, MARSH,. ETC: : •• __ _ •
G) CHECK•WITHPLANNING BOARD FOR cLOT RELEASE
COMMERCIAL`BUILDING a ? "
- r
\A) ENGINEERING•DEPARTMENT-FOR•PARKING AND DRAINAGE REQUIREMENTS,. TOPOgw-PHY
PLAN REVIEW._ tr _
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. H_EALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. '
EXAMPLES: ' SAUNA . BATHS, 'SWIMMING POOLS, RESTAURANTS, ETC. . _ . '
T) FIRE DEPARTMENT-FOR' PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE '
DETECTORS) „ ,.: y'
IEWE B ;2'
s s — , ^} 't. a �.. : — ^ —'-. :'�; • • t '-•• o
1.. I ERING DEPARTMENT YES • DOES NOT APPLY' '•-SIGNATURE=$' . t ?-a -..e=it'll"- DATE+
E�La � �� f � —`-� 3r
SERVAT3ON COMMITTEE -YES:-':DOES NOT APPLY't%SIGNATURE t l_�' �-==�.�� 't`=DATE41Z5/95y$s
PLAN NG BOARD YES • DOES NOT APPLY_- SIGNAT 7: .. DATE. •
RD OF HEALTH: YESa--DOESNOT APPLY ' SIGNA URS � �% ' • 'DATE2 dr/• 14.1
FIRE DEPARTMENT:. -, YES DOES NOT APPLY_SIGNAT.ier • • - • - DATE^=
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