HomeMy WebLinkAboutBLD-80-229 �p 0°7-
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\v .. No. ...9-a-
�5`` \� Application for a Pe mit to Build
Fee must accompan his application
' Yarmouth 5 // 19..1d
0
Jr' !O` /V
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according top { Mowing specifications:
•1. Name of Owner alit% fit/S, ,Fs /9214:4112;"4076 9 A . @ 71'.
2. Name of Architect (if any) 1nQY1��
3. Name of Builder ia,.1 e O. C 1 .x.. 31 ' Got_ ( 4 // no.)
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4. Precinct No. ' Lot No. Plan: Name No. 3 a. -- V u
5. Name of Street 767/404,ar Dfl.w e. . ,
6. Purpose of Building
7. Material4 --
de es it
8. Estimated cost of building NTi 00000 Ac/ r C' b¢
14 fire Slier4-b{"Y
9. Dwelling
2..o �.da L.4-1)cy
10. Cottage 24_, 4141.1.0.
i1.°
11. Heat n I UY1-2.-, '-
y4
12. Basement (!A.a-u' ' rt-ce-
!fie O
13. Garage /714--
14. Store new-.
15. Shop air
16. No. of stories Q'1 1/4.9.----
17. Is there to be a Store in the lower storey air '
18. Size of Lot. No. of feet front f 01-5 ' No. of feet rear / 43'5No: of feet deep ........L $a ,
J. f
19. Size of building. No. of feet front 2.12.e. . Np. of feet side ....../6 No. of feet rear
20. Distance from nearest building: Front , 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 dist es from adjoiningghots,on reverse side.
Name J I/ .,..!!
3 Address .
/ l Off%'"w mac„
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Street-Name
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06
0 Left Side Depth of Lot......... .l�5
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Right Side Depth of Lot '2551
7
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4-., Street NdcOe69Q147s1M1.44?"
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yr
. - BBUILDING PER.✓.IT REVIEW .
APPLICANT. '�i ' • - BLDG PERMIT NO
/!rte �� eyn `.
LOCATION OF PROPERTY-
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ROPERTY �p• Y{�pjjt-4124-( � _ :: : zt
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN-INDIVIDUAL- - -.-
MUST FOLLOW.IN ODDER TO OBTAIN- A PERMIT TO BUILD OR ALTER A BUILDING. ";THE BUILDING •-.-` . -..
`_ -DEPARTMENT -WILL`_CHECK'ON -THE.. FOLLOWING:- (A); CONSERVANCY DISTRICTS: (B):-'' HISTORICAL _
DISTRICTS (C) FLOOD PLAINS'ZONING,• AND WILL BE.RESPONSIBLE FOR ASSISTING THE
7' APPLICANT,THROUGH•THE FOLLOWING AGENCIES _ '
7. - RESIDENTIAL BUILDING.
A) - CHECK WITH -THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE '
l= DISPOSAL ` -
• e) 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 FOR _OT RELEASE , - n.":: =r
S K _
2 COMMERCIAL-BUILDING = -
-A ENGINEERING DEPARTMENT FOR PARKING AND DRAINAGE REQUIREMENTS, TOP ;abekur. SITE —
` PLAN REVIEW: - `
�-• tB) , CONSERVATION COMMITTEE IF LOT~BORDERS ANY TYPE OF WETLANDS _
C), PLANNING BOARD TO SEE IF LOT COMPLIES WITH ZONING BY—LAWS.
• D) BOARD OF HEALTP 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 : .y - _ ==
7 ENGINEERING DEPARTMENT YES �/• DOES NOT APPLY SIGNATURE ,r,e., ` DAT
y CONSERVATION COMMITTEE: YES = DOES NOT APPLY7SIGNATURE - S,- �i �, _ - '.:'
3 PLANNING BOARD: YES ' DOES NOT APPLY GNATUR S r_IAT Gv ;
4. /BOARD OF HEALTH: YESd�OES NOT.APPLYSIGNAT 1111", „� �.l �?i�✓iATES,S .
ior
5. FIRE DEPARTMENT: _ :•,-.. YES DOES NOT APPLY_SIGNA . - DATE
COMMENTS
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