HomeMy WebLinkAboutBLD-80-224 No. 9
\\ r1 • Application for a Permit to Build
;' • Fee must accompany,this pplication
May 4C o
Yarmouth Ut 19
TO THE BOARD OF SELECTMEN '
The undersigned hereby applies for a permit to build, accordingccto the following specifications:
CII/9124-e4• 1. Name of Owner � -e4 /1 t .79n2c/i m1 Cy0,0 9g Address an ?uST«."22 frl to. /At-mod/4
2. Name of Architect (if any) S4miz:: - '
3. Name of Builder SNm%
4. Precinct No. t Lot No. '11-• Plan: Name or No./}:/y. a5 4
5. Name of Street .C?osz4: 22, to. Mc.a,e4
.
6. Purpose of Building Ri ec wa-g, a p
7. Material F,e*nc 0�®__4 �� c�pp aO'Xo2
8. Estimated cost of buildidg 4 0004-0 91' / est.t. t-sed •
9. Dwelling Mo Ao'X 20 7rV�-( loI
10. Cottage iJ o 1
11. 'Heat Nc9 0-C,
12. Basement No 4C0
:S .
13. Garage &1-eo -
0.0,<70 8ritro
14. Store N o
700 ,j'_ y"
15. Shop /VP
0
16. No. of stories I
17. Is there to be a Store in the lower storey /o
18. Size of Lot. No.of feet front No. of feet rear No: of feet deep
19. Size of building. No. of feet front aKit5 X zo No. of feet side No. of feet rear
20. Distance from nearest building: Front ft.; side ft.; side ft.; rear
21. Distance back front line or street from rear lot line side line
Show by diagram the location of propsed building with relation to//distances�from adjo' lots, on reverse side.
' Name...1....f1"M/�`b c ��nn ti— I// �yf
Address DO geel; 10fa-.4tY.Kh:XFC. /!a .
Street Name -"
p Left Side Depth of Lot
--I
r .�
z
z
ca
0
n
0
r
m
o
e
•
1
t' .�
int
Right Side Depth of Lot
1
•
Street Name •
•
BL'ILDIt:G PERMIT REVIEW
APPLICANT. 444 -41-7/7 cBLDG PERMIT NO: -`
LOCATION OF "PROPERTY �D tri, `- 'Z" ar+c:60 t J DATE FILED MAr:'y / •
,'THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE •PROCEDURES AN •1NDINIOUAL
MUST FOLLOW. IN DREIER TO 'OBTAIN PERMIT-TO BUILD OR ALTER ,A -BUILDING. -=7HE BUILDING
..;` = i:,
•DEPARTMENT"WILL' CHECK-ON :THE FOLLOWING: (A): CONSERVANCY DISTRICTS; (B)':Y HISTORICAL ••
, 'DISTRICTS (CrFL00D PLAINS-'ZONING, AND.WILL BE RESPONSIBLE FOR ASSISTING THE
APPLICANT THROUGH•THE FOLLOWING AGENCIES _
: i. ' RESIDENTIAL BUILDING: —
A) CHECKWITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FORe.SEWAGE •
s ?:� DISPOSAL �iy
B) - CHEEK WITHCONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS
EXAMPLES STREAMS, PONDS, RIVERS, OCEAN, BAY, .BOGS, MARSH,_ ETC -
C) CHECK▪ WITH PLANNING BOARD •FOR LOT RELEASE
. n = —
2 COMMERCIAL• BUILDING - �,~ , r m a Y - :
•
A) ; ENGINEERING DEPARTMENTFOR• PARKING ND AI
ADRNAGE REQUIREMENTS,• TOPO •7 PHY SITE —
r'•` •- PLAN REVIEW. sr .r,` + , :.
t.-7r:0.z CONSERVATION COMMITTEE IF LOT BORDERS ANY TYPE OF WETLANDS _
C) PLANNING BOARD TO SEE IF LOT,: COMPLIESWITH ZONING BY—LAWS.
•
•
• r BOARD OF2. 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
�/ Via`•` ±s y
1 vENyINEERING DEPARTMENT YES OES NOT APPLY
CONSERVATION COMMITTE 'YES DOES NOT APPLY /SIGNATOR ,� u' �$'�,,tL DAT
cO - VSIGNATOR _ � '' DAT
2 - E: '• _sit; � �,
3 PUNNING BOARD YES DOES NOT APPLY SIGNATUi•da ''7 ,f -"6 -. DATE -` -•
4 `BOARD OF HEALTH YES DOES NOT APPLY _SIGNAT�'TN
...5. FIRE DEPARTMENT:. YES DOES: NOT APPLY ' SIGNAT DATE
COMMENTS: =,
r w -
a :• ! J t u 'et Tat � ( �. a — 1•=-!
^Ki i. - 1 1.4 a ..._ � tz tAr rI. ft .,ty
A a yr r `-
✓ Y 4. -�Y , �i L
✓ _ 1
•
+ ey. 3 _ar • , C ., L c a . y , t
J - C - • 1_ R- r 1 _ • p !
.71
r _ S : , _
a
a
— —
I
K 1
_-
I \a/
TT4,`
•
4 • "ro-t
f „,
. • \ VI; _
v- I
•
itfu4 .
-
24 ' t I
;‘) •
0
0
dUr cur certience, niQb
8s) rz_Achu 17 A..;
PL.A AJ 6 C)/e Our
ce9,ence
0-1H e Re woe)
-T-HeA) it-1 19- ic rocs T7 0 A-/
0 Ai -C- kr/em / d
in cic 7-3;$ fri E.