HomeMy WebLinkAboutBLD-80-266 c k
ore' ILL
No.
t\AQ / r Application for a P rmit to Build
Fee must accompany his application c
Yarmouth j"'F) 197 0
02-e n
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner a r-, "aa—re"aarret2S Address At/.mS . St . W AL�ot S,'MA
2. Name of Architect (if any) NOtC
3. Name of BuilderZ Y ICs O ?T �� to 2..c) N • OA 41 N Sl• S" pa>zri�OUTc—f
4. Precinct No. .3 Lot No. 4. Plan: Name or No. A.M. 59-34
5. Name of Street 6S WC CL-k L'.x00C) �) . :D• 1/41A
6. 'Purpose of Building 4e4-14"--\.` s 'L2co v1/4,‘„
7. Material a-2__ c72 r3cxrc tc.
8. Estimated cost of building 41..-0e) P tct> v t O L3 t 19 M
9. Dwelling me-is
10. Cottage n)'p
11. Heat sePtEr NfJNE
12. Basement /00
13. Garage /J p
14. Store p0
15. Shop NO
16. No. of stories WG'--
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Ct
17. Is there to be a Store in the lower storey IUb
18. Size of Lot. No. of feet front No. of feet rear No. of feet deep
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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 relation
-t-o distances from adjoining lots, on reverse side.
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Address rZett...U.0n!S.RvlAuar •
Street Name
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0 Leh Side Depth of Lot
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Right Side Depth of Lot
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Street Name .,
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PLICANT: fil'"A 5' 'Ey .. -4 ccsit.-ri......5. •. :t: : .. .. BLDG PERMIT •N0: - '
CATION OF 'PROPERTY: it " •6«;I`t2•r7- 'Zi-' 6cj.. DATE.FILED: ,.y0/ • •"
•
THE FOLLOWING CHECK-OFF SHEET IS"DESIGNED TO CLARIFY THE PROCEDURES Anion-doll-AL - •.=-,'_r'
ST FOLLOW IN. ORDER TO 'OBTAIN- A PERMIT TO BUILD OR ALTER A .BUILDING. ' THE BUILDING. '=-4n-
PARTMENT• WILL.CHECK ON :THE-, FOLLOWING:. E BUI• LDING:74-4 DISTRICTS (B):tHISTORICALC-=
STRICTS • (C) . S:
FLOOD PLAINZONING,- AND WILL BE RESPONSIBLE FOR -ASSISTING THE • =,: ' .• •,
PLICAlTF ..74-::---4::
HROUGH•THE FOLLOWING`AGENCIES. -- .F.,...•••........:-...•:_. •�' ::........•,-_-_.••:::„.,_•:_.:::•-.44--...•_ • ' ~
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RESIDENTIAL BUILDING: _ ▪ - _ • i
A) CHECK WITH THE HEALTH CEPA-RTMENY I▪ •N REFERENCE TO SEPTIC SYSTEMS FOR_SEWAGE ••
DISPOSAL.`- ' _--'= '; • - - Ll; - _ :.
B) •CHECK•WITH CONSERVATION i COMMITTEE IF THE' LOT BORDERS rON ANY TYPE. OF�WETLANDS.--.`'•=;' :
. EXAMPLES:_ STREAMS, PONDS, .RIVERS,:OCEAN: BAY, . BOGS, MARSH,. ETC: ' ';,`-:
C) CHECK-WITH PLANNING BOARD FOR•10T :RELEASE: - '•-2 '' -= • =
COMM-ERG IAL BUILDING: _ -_-';_ .= - : ::4'.'.•.‘7':..:1' _ -
'A). • ENGINEERING DEPARTMENT-FOR.PARKING AND DRAINAGE REQUIREMENTS TOPC. PHY.- SITE- =- .
.44 VPLAN REVIEW: ._ . :r::: } : - , . ▪ :r'.' , ray- r
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS, _••-
. , .. . _ _ . - ,.�_: ,.. . . . _ - = • . . - � .. --
C) .. PLANNING BOARD zSEE EENG BY-L
IF LOT_ COMPLIES WITH ZONING' - • - y
D) BOARD OF, HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. - .. • .
EXAHPLES: ' SAUNA. BATHS, SWIMMING POOLS, RESTAURANTS, ETC. : - . . • _
• •
-E) FIRE DEPARTMENT-F_ OR• PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE r
DETECTORS). . - =:•' - - _
•
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ENGINEERING DEPARTMENT:.= YES 1F -DOES NOT APPLY SIGNATURE.�.�. :- r .: DATE '[�; .,��,
• ,. .=1-•-v..,.-.. .. , .:, r,T . l _ _. _._- „'E.-s DATEt�'loj6o •
CONSERVATION COMMITTEE: .YES '-_DOES NOT 'APPLY' SIGNATURE• to::.-t.-€I .. :.. . . `K
PLANNING BOARD: ::4=' -- YES '-• " DOES NOT APPLY_Sri GNAT ®"• `: 5x` DATE.? �:
BOARD OF HEACTHs •/ ,YES••••••• DOES NOT APPLY t%SI GN TORE- •• .--' , :` a •K DATEi2�7. �f/��`,,`,,�
FIRE DEPARTMENT:, - .. . _ - • YES_DDES, NOT}APPLY_SIGNAT r • - ' • • - DATE -
ENT.: -
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