HomeMy WebLinkAboutBLD-80-261 •
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c--• Application for a Permit to Build No.
•
Fee m accompany this application•
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Yarmouth .. !/L. if.........19 Id
7 . s=a Pa
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
'Vl. Name of Owner S?g"Z CJ /7RG//D f0J/4'7 litddress /4'rw,91 wo.t7 9 ST.
4_05•&NA4tCC o'd/l /
2. Name of Architect (if any)
3. Name of Builder
4 Precinct No. Lot No. Plan: Name or No.
% V°• Name.of Street 43 A Cies Ave .6. Purpose of Building -- C/onn- roU PORCL / IN 54% 1 J J(d e�
7. Material F/LAM_ �j
8. Estimated cost of building'/ /0-25CJ70
9. Dwelling - t
10. Cottage Aid
O rdS a'a drill/
11. Heat /7_, /J�
12. Basement !r/l
13. Garage '
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
19. Size of building. No. of feet front 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 relati n to distances from adjoining lots, on reverse s e.
Name. ..GZI/a....fir 7
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/Address lit W... ..�7....($ 1 ACC//a) �ct
Rear of Lot
t kes eti-F pC) L fto k
C(o s eci, (k) rc2 K I-EC FQ N,
1 I,44 1
t i
E. I
! I � "(trek),
h
c
0 0 �
t 8,
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w a
Frontage of Lot �{ • A /J
Street Name.....l..L G�e cs /'l tic 7 3
PLOT PLAN
f
,�s• BLDG PERMIT.
PLICANT- '���:��• r¢�bIJ`��`l� `�Niy '� -:
CATION OF -PRQPERTY: ' ''q3; 'd 0114..:.....W,Par • ▪ - DATE.FICED. el/se • •
- :,f'r:•.1-I., •:..'••: ••••.'z' ' . ,:• .i- •i. 2.: -••••••_.•,.•••S..• ••••• . --;":"--,••••:::-.-=THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE 'PROCEDURES AN'INDIVIDUAL.
ST FOLLOW IN ORDER TO OBTAIN, A PERMIT TO BUILD OR ALTER A .BUILDING. - THE BUILDING:;: Vii': ti:�
PARTMENT_VILC CHECK ON -THE: FOLLOWING: (A)' CONSERVANCY DISTRICTS_ (B):'. HISTORICAL`-- -r
STRICTS • (C) • FLOOD PLAINS:ZONING,� AND WILL BE RESPONSIBLE FOR ASSISTING THE: :;=-=� :;• ,• •
PLICANT THROUGH•THE FOLLOWING AGENCIES:::- _
•▪ RESIDENTIAL BUILDING: • • _ - -A) • CHECK WITH THE HEALTH DEPARTMEN`f IN REFERENCE TO SEPTIC SYSTEMS FORjSEWAGE ' • -
DISPOSAC••-•;,_-.:• - _ -_; -_ • , _ • - t:i % _ .t.(-•••••-•
▪ B) CHECK WITH CONSERVATION COMMITTEE IF THE' LOT BORDERSYON ANY TYPE. OF-WETLANDS. .-
EXAMPLES:. STREAMS, PONDS, RIVERS,:OCEAN; BAY, BOGS, MARSH,. ETC: ; : :_' _•'
C) _ - -
CHECK•WITH PLANNING _BOARD_FDRaOT�REIEASE`:_"=''" _ - �- -r4::•:•;:.1-2.1.-
DING: ~i- rr' ::: :- r4-•;• •- - _ at:
COMHERCIAL BUIL ;'2 = _ - - - -S '•
._+ i;Jr::?'c=�'":�'. : -•�. '•s�:r%-__ ::i:;�c• ..�_•- L. _ .�::`.^.i. '•-?v-w,: .•.. s_l:T, _:. ..•,�� ='
ENGINEERING .17
DEPARTMENT-FOR.PARKING AND DRAINAGE REQUIREMENTS TOPC•i•� PHY SITE°= -
'• . __ PLAN •••••7.11•.;• _•' : �::x•.: _ -__ _-_ - _;�,.:_•_,. - -• .i.:
B) .:. CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS:.`-*:-' _' .== -• _
C) ..- PLANNING BOARD=-TO -SEE IF LOT_ COMPLIES WITH ZONING BY-LAWS. . -
•
a) 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).':• ..� _ •• - - ,
•
_ _ _ �l _ •,,• • • fY i �S�ter- ' _•
- 't •_�S-I •:ti'l'- _ _ _ -.f._ _ ••Z•-• . _ t- ry1� YC-_ �- ±�•�C't
EWED BYe •• . - __ • __ '-;s _ _ -_s.=_-•
ENGINEERING •DEPARTMENT:._ YES DOES NOT APPLY SIGNATURE:= t - a
_ '_ - �r✓ . ..�L: DATE
_ .� _ • •..i::r• f z. - S1'• - ss- • .4•7e`r� .tet-f5:;- c..ii •r%f .F.
CONSERVATION COMMITTEE ',YES:''_DOES NOT APPLY- • SIGNATURE y i";,7� 4.71. DAT• .-,
PLANNING BOARD: :-S •• --=.' 7-YES `••' DOES. NOT APPLY_• SIGNATU: �' �_ - _`" ==:z^ DATE-L'" •=