HomeMy WebLinkAboutBLD-80-540 I'"\\(- 5 1 b k..) 3 (..- W
IQ
i 9 Application ermit to wild No.
Fee must accompany this appli on
• L Yarmouth .7/I7 t 19 °
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
J74- •
1. Name of Owner U €1Ceept-i.„ d-fr-eaK- Address i 0-7" "ill1gun
2. Name of Architect (if
any)
�''� ,7 •
A
3. Name'of Builder C� ( ,
4. .Precinct No.' 3 .. ? Lot No. ( Plan: Name or No. A.M. 35 - W (
G#-3-$- *y,�9 PF
5. ,Name o[ Street o
6. Purposerof Building �d%
7. Material-y`t , ,. t"� nBLQDQ,, D
8. Estimated cost of building I) Ott• (�� " Y e), � y r
9. Dwelling i - .J�J A O �,CaP 1/
.65 10. Cottage 114:410 6-V1-41/any. ab (y�^✓( r✓
11. Heat •.
CC� vu
12. Basement --r•••••-•-c.... J
13. Garage .--""v .,
14. Store Z' ,
15. Shop ,
16. No. of stories
17. Is there to be a Store in the lower storey
18. Size of Lot. No. 'of feet fronli 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
0
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 adjoiningy/ lots, n reevversee e.
•
Named /
,./(�.--1
r iff—
Street Name r x•
v
p Left Side Depth of Lot
z
o2 ^l o
- y 0
0
t..
U
Right Side Depth of Lot
Street Name
Ir
BUILDING PERMIT REVIEW
APPLICANT: ,aLL v BLDG. PERMIT NO:
LOCATIOIN OF PROPERTY: 9,a7 `77fjnc DATE FILED:
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN
INDIVIDUAL MUST FOLLOW IN ORDER 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 APPLICANT THROUGH THE
FOLLOWING AGENCIES.
RESIDF2 TIAL BUILDING:
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTTIC SYSTEMS FOR
SEWAGE DISPOSAL.
B) CHECK WITH CONSERVATION COTIIIIITTEE IF THE LOT BORDERS ON ANY TYPE OF
WETLANDS. EXAMPLES: STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH.
C) CHECK WITH PLANNING BOARD FOR LOT RELEASE.
COMMERCIAL BUILDING:
A) ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS, TOPOG-
RAPHY SITE PLAN REVIEW:
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS.
C) PLANNING BOARD-TO SEE IF LOT COMPLIES WITH ZONING BY-LAWS.
D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED
ACTIVITIES. EXAMPLES: SAUNA BATHS, SWILMING POOLS, RESTAURANTS, ETC.
E) FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS,
SMOKE DETECTORS) .
REVIEWED BY: /
ENGINEERING DEPARTMENT: YES V DOES NOT APPLY SIGNATURE •�� 4 „ DATE/PA?
COMMITTEE: YES DOES NOT APPLY V // SIGNATUR •i���1i��A L DATD9f14b
BOARD OF HEALTH: YES DOES NOT APPLY SIGNATUR/ DATE
FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
COMMENTS:
A/MUrn C#*.'GF . /3viwnve.. Pfistehasts
9X4.