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HomeMy WebLinkAboutBLD-80-218 \'�,\ oV l ( 1'x{1 elf a74 ick- Build No. _.c2l f .4, a\4\6(1 Application for a Permit to u Fee must accompany this application c) Yarmouth y-n Id TO TO THE BOARD OF SELECTMEN The undersigned hereby applies for��++ a permit to build, according to the following specifications: �/ 1. Name of Owner Chn 2/eS JChn f/pj,Q Address le 3 fjTo2 cony S yii2mOUriti 2. Name of Architect (if any) 3. Name of Builder gnu/ Su/by/In 4. Precinct No. Lot No. '''/ Plan: Name or No. Shad '?? 5. Name of Street 63. AS'Tok (OAy E,091/.1/2/03-61/ 6. Purpose of Building Sun Poach - --- &?C/0s S on POiec k /O)(/ql 7. Material 1000 D Fanniev O 8. Estimated cost of building 1'z,J 00 �' 9. Dwelling,.-''''.--- 10. /10. Cottage /(/(/ 11. Heat knit 12. Basement n/d 13. Garage El 0 / .' j j 14. Store /tie • i . r V if, ._ . 15. Shop //jv' 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 / 4L , No. of feet side /6 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 reverse side. Name...&.../.sG.1( V..t /I .. Address...Z.22 /7!( n 5. levempg!.t.L1 • Street Name ' " Left Side Depth of Lot ISM -- a /; r. 7 V. .�% te. CD c tet' / 1 • 0 r - z � ^ m C" �' .. g p l; Right Side Depth of Lot ..................................... Street Name •• - i •i ' . 4r PPLICANT (h,wr I S=• SA:;7ac,bp,. . • . . o'• . .` • T . BLDG PERMIT NO: w OCATION'©F 'PROPERTY: ', ' • 6 . ' - '5 /1-24.7: i ' +;`,•;•'' • DATE.FILED: }. • rl - THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TD CLARIFY THE PROCEDURES AN"INDIVIDUAL. ' '• -,'• ' ' UST FOLLOW IN _ORDER TO 'OBTAIN. A PERMIT TO BUILD OR ALTER A .BUILDING. ' THE BUILDING.;;.`- : ., EPAP,TMENT -WILL_ '_CHECK ONTHE FOLLOWING: - (A)' CONSERVANCY 'DISTRICTS. (B):•a. HISTORICAUL:- � '-., ISTRICTS (C) : FLOOD PLAINS-'ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE': '_•`. .- .:;i PPLICANT THROUGH.THE FOLLOWING-AGENCIES: : . 14 _ r s.. - r - .:t.:;..:1.._r._. . RESIDENTIAL BUILDING r _ - A) ' CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE DISPOSAL `S - _ , B) 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 FDR•10T`RELEASE '• , _ _ _ — ' COMMERCIAL-BUILDING ` _• A) ;▪ ENGINEERING DEPARTMENT-FOR:PARKING AND DRAINAGE REQUIREMENTS,, TOPCFu=•PHY SITE'_, •?' :' !%- " - PLAN REVIEW el: CoNscRiiAiliiu COMMITTEE—IF LOT BORDERS ANY TYPE OF WETLANDS. .. L.,- �Y C) PLANNING BOARD=TO 'SEE IF LOT_ COMPLIES WITH ZONING•BY-LAWS. • o) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS,. HEALTH RELATED ACTIVITIES. • EXAMPLES: • SAUNA. BATHS, SWIMMING POOLS, RESTAURANTS, ETC. . • r -E) FIRE DEPARTMENT-FOR: PROPERTY/ PROTECTION, PERSONAL\SAFETY, (SPRINKLERS, SMOKE ' *••' DETECTORS). -- - ' 5 I WED�Yc L :-C_ - _ "-.r _=--=. - -. -T 's ,3 D/y.P. N ERING DEPARTMENT:•= YES►/DOES NOT APPLY_-SIGNATURE Z& *•`- `2 =z DATE i• ,' . c, r • • C cit, COMMITTEE: .YES- -DOES NOT APPLY'rY SIGNATURE " c_ .1•.Yt- DATE • )• tai '„'":, PLANNI G BOARD YES - DOES NOT APPLY_' SIGNATURE -j 1' = DATE`- BQ D OF HEALTH YES DOES NOT APPLYvSIGNATUREi'�zf (1(" p r '•' -DA TO/4 ",' FIRE- DEPARTMENT .: - • YES DOES NOT APPLY_SIGNATURE • . - - DATE°-4, _` ; '1ENTS: • j : s i s r �r.4_� y. is • .i . . _ J • s i : ‘2"'...(--..-.: yam . t �.Y f- .45.24.:%..41 Y •1 ._Y: T _ -' r ! . gra-. :I'::::i.---,.. js:: • • •• i-: - e..,• d. » - _ _ •tom .�» f.-s�_:i~. _•�i�.+•z•�_ _ _- - »_ - � _ -