HomeMy WebLinkAboutBLD-80-263 tan J o ( ? G‘ �'4�' 3
No.
Iri1� Application for a Permit to Build
1‘°' 7
11 Fee must accompany this applicationQ
Yarmouth ....�!6.. //� 19
‘...../zy
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit/ to build, according to the following specifications: /f
1: Name of Owner �� 1C.D e1/4P/V a CJC_ Address 6 �" 'io� L
2. Name of Architect (if
f any) S4
,€ t..,
3. Name of Builder -a.a 12t ._.
4. Precinct No. Lot No. Plan: Name or No.
Act5. Name of Street Gg-/]OA$S. pOiu'l,
6. Purpose of Building
7. Material
Cji
1 X3a-�
8. Estimated cost of building ,67‘46n .14-0
��� fcfc4 I6
1. Dwelling5e��
10: Cottage '�/4 -' '14). -4444 o��
11. Heat
12. Basement
13. Garage
14. Store
i
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
j
19. Size of building. No. of feet front ,/.. No. of feet side .2.� .../ No. of feet rear ./ i
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 distan. s from adjoining ots, on reverse ide.
Name..... A—
i
•
Address .. 4.2(7'�- L .iL /
. ..
1
•
• 1 `r o. . ..tai
.,
Rear of Lot '\ " ���..a..••. b�J144A0jii
. o:.-- - -1_,.......„.„....,..
-\ .. . - ..'
II
2 4.
.,
L-f-i L -,
a c
V
o
e a ` b z
c m
Z b
CD m
e t4... y
wan 4
. Frontage of Lot •
Street Name
• PLOT PLAN \ • .,
._ . . . :,.
. •\
•
. •f'. BLDG PERMIT NO:
PL I CANT: • �i911�� L1/4.4.11' .•jj.... .. _ _ .. .. - •
CATION OF •PROPERTY4!z%L . er -'r "- • DATE.FILEDi - • • . _
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN-ZNDIVIDUAL.- .=
ST FOLLOW IN' ORDER TO -OBTAIN_ A PERMIT TO BUILD OR ALTER A:BUILDING. - THE BUILDING:;='-='
PARTMENI•WILL:CHECK.ON ;THEtFOLLOWING:• (A); CONSERVANCY DISTRICTS- (B)(B);.---i. HISTORICAL.: -r=..A.?
STRICTS • C) . FLOOD PLAINS-ZONING, AND WILL BE RESPONSIBLE FOROR-ASSISTING,THE:= ,
PCI CANT THROUGH-THE FOLLOWING AGENCIES::: 2C' 'C'-`
lalc
:".:.:1_•.
_ _ - 1b:.:-:t*:fIf. '' '
r. . -Fi.: _:fi• : t- J _ _ _ .• - 1.:-7 : -sty _..tL - _
•
- RESIDENTIAL BUILDING: " :: 7C _ _
A) • CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR/SEWAGE '
DISPOSAL.`. ' " - .:-z! .....L2';':::1,-•;....:i-.0- . _. - •; .c_ • -- • `_:'
`-�•7 , r.e ::vi 's• - - f'-'• -
• 6) CHEEK-WITH. CONSERVATION COMMITTEE IF THE LOT BORDERSONANY TYPE. OF� WETLANDS.
EXAMPLES:. STREAMS, %PONDS, RIVERS, OCEAN; BAY, BOGS, MARSH,: ETC: I
C) CHECK•W_ITHPLANNING __BOARD_FOR."LOT `RELEASE:_ `_: - __ : -
moi. _ .4.4.-.1: t - ::e-;77:::-1.--...
_ L _. ..:+.71';.:;7:::-...:_ \ _ f' ▪ • :1t:,...:1:-.7.1:•-k._ '. Q-r=
• COMMERCIAL-BUILDING:- - . - _ _ - - �f�-- -• -r:T=' =="`'•' =g 1 -
••A) . ENGINEERING DEPARTMENT-FOR-PARKING AND DRAINAGE REQUIREMENTS,. TOPC. PHY SITE X,
rt._ �._. - f. .^i, - _ '- of x.!.
. . PLAN REVIEW. _ It.1".._._ _ �t : r.-47..::.7.; • __ _ ;r-�•- _ -• _
• CONSERVATI-ON COMMITTEE-IF. LOT BORDERS ANY^TYPE OF WETLANDS. .'-''-' -`- -' -"t-1:-•
C)
C) .. PLANNING BOARD-TO -SEE IF LOT_ COMPLIES WITH ZONING BY-LAWS. '- • - -
DEA
) BOARD OF, REALTY.-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. . -•t...
EXAMPLES: • SAUNA . BATHS, SWIMMING POOLS, RESTAURANTS, ETC. : ' .• _ . . _ -_
T) FIRE DEPARTMENT-FOR' PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE'' • rt•
DETECTORS); [ • - _ • ` ' -
. . . - . . . -_ _ . . " _ _ ... ..
=_ :-•v zarr-=-•;'r:ir- _.'fes .
EYED _,` _ -s; r -; :.,.
moi: _ :: : .--:.-,,f . --• -:... __ _ ''•_- _ _ _�•.__--_ •__" .�s•r_,' .•,fes.
•
ENGINEERING DEPARTMENT: ' YESOES NOT APPLY_SIGNATURE 1` ',ice/,t DATE y �
CONSERVAT30N COMMITTEE: :YES: OES NOT APPLY' ' SIGNATURE ' = DATE /9 •rte
- - :-
PLANNING BOARD: -•' C• ' t-YES 'f'•DOES-. NOT APPLY' . •SIGNATURE -R.-- ' •=ti's% DATE=' •_f;: -_-
BOARD OF HEALTH: _YES DOES NOT APPLY ••_SIGNATURE-: ▪• • DATE: .' .'-.
FIRE DEPARTMENT:. _ - • YES ODES- NOT APPLY •_S.IGNATURE • ` • - DATE"i=t y •
ENTS: • -
rf:
'•,, ._ _• •• - . ^ �•:- _'t• /�J,,. _i• _ 1.t7.� - o1i-�''-" _�:' - :fes
al _ _i:• <` %. t•. _[` .r a_'i•.y :i.- J▪ :- •''•"Sr ::Y1 J-^:•- .F.: -- ; _ "-ZC_..17.=- _
7:7
':'4'..
-i�. :f ___ _ C.45'.: a`: • if• ...31 ;:l. t,'.k.. ��•__ � ;!.!...;r:. _ iii. _41.1":::.:7:::'".•.a'�.▪ '.: -
,- -- Y, .Y-' :;., +ra- d- i v{':. L- - -s_. :. - - • _ _ �.
a ea ' it _ _ •S .i.•i•z - wit ..•--- ` _ _..^--- -r:... t t tC-e •�
-_i : �+'f�•�i�-+•.�• - •ate � ' - i �.._�_ - - 'z':: . r.-,▪ __ ••rri5•_- -4.':'.`r_ �'�aa: