HomeMy WebLinkAboutBLD-80-268 Ac. .,ekt,D A
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-a° Application for a Permit �o P old No.
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Fee must accompany this application
Yarmouth
2/—212)
TO THE BOARD OF SELECTMEN
The undersigned hereby/ applies for a permit to build, according to the following specifications:
1. Name of OwnerfAt/p MR�/B///grORQA jU/ Address
2. Name of Architect (iffoh./.4
any) ,, / -•, (/
3. Name of Builder oh4R/es S/'9"^'t/
4. Precinct No. c� ! / Lot No. A 6 Plan: Name or No. /�/�e5 sok S l /
5. Name of Street lCa/G/l7,40S 4's. n� ��- A( Al?/
6. Purpose of.Building SVN DE4�2No //00/
7. Material ( t
er
8. Estimated cost of building 9� 5Q
9. Dwelling '/ ;
10. Cottage / c /
11. Heat 3 7/ / X oz0 y/ 1�
12. Basement
13. Garage
14. Store
15. Shop
16. No. of stories
6 ,
17. Is there to be a Store in the lower storey /xVO .
18. Size of Lot. No. of feet front '2.0 No. of feet rear 7 D No. of feet deep ...9....:.......
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19. Size of building. No. of feet front. .., d % y No. of feet side !' 0 No. of feet rear 97
20. Distance from nearest building: •Front '�ire.s4.2:ft.; side 2.. ft.; side .//°d 0 ft.; rear.. .Z11
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21. Distance back from line or street /2-1 , from rear lot line side line
Show by diadem the location of propsed building with relation to distances from adjoining lots, on reverse si
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Name. ,( �/// J ;Q
Address.i1 UN /
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Rear of Lot
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Frontage of Lot
Street Name...CQ.ta.Mz3.a.$...AUs,.r , +. .. - .f
PLOT PLAN >` 'ti,
� BUILDIUG PE??IT REVIEW-.'. -, •
` APPLICANT. (%1/4ft/ 6 - "-71'rV d-/C. BLDG PERMIT N0:
LOCATION OF PROPERTY: '/ T :` La/cid/ti S' NI/E: DATE^FILED - • :
_ ' THE FOLLOWING CHECKOFF. SHEET SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVIDUAL
MUST FOLLOW. IN ORDER TO OBTAIN- A PERMIT TO BUILD OR ALTER A .BUILDING. �T
' HE 'BUILDING'•;.-
....:DEPARTMENT.'WILL' CHECK_ ON -THE:- FOLLOWING:- (A): CONSERVANCY DISTRICTS: (B):•'I. HISTORICAL_.. =,
: DISTRICTS (C) F:LOOD PLAINS-:ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING THE•. . _
APPLICANT THROUGH-THE FOLLOWING AGENCIES. . . • _
i. •-' RESIDENTIAL BUILDING ` _ -- -
A): CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR.SEWAGE
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6) -CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS
EXAMPLES: f STREAMS, PONDS, . RIVERS,;OCEAN; BAY, BOGS, MARSH,. ETC.
C) CHECK•WITH-PLANNING BOARD FDR lOT RELEASE , `
_ `Z COMMERCIAL BUILDING i : ,
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A). ENGINEERING DEPARTMENT FOR PARKING
AND DRAINAGE REQUIREMENTS, TOPO PHY SITE
,- `' ' REVIEW:-4:::;•-PLAN r, T
5) CONSERVATION COMMITTEE IF LOT BORDERS ANY TYPE OF WETLANDS _
C) PLANNING BOARD TO SEE IF LOT COMPLIES WITH ZONING BY-LAWS.
D) BOARD OF HEALTFrFOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: 5A ; ATH5 SWIMMING POOLS, RESTAURANTS, ETC. - . .
E) FIRE DEPARTMENT FDR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS) '
i• • t _ _t- _ _ Er
REVIEW BY _ �7 • '_ --_, ,� : i
i G NEERING DEPA RTMENT YES VDOES NOT APPLY SIGNATURE_ ta. .., J a DATE $d
t
• C NSERVAT3ON COMMITTEE . YES '- DOES NOT APPLYSIGNATUREgA� rel:/ice DATE
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3. PL NNING BOARD YES ` DOES_NOT APPLY_ !GN.AT - � `mac DAT t_
4 B6ARD OF HEALTH: YES DOES NOT APPLY]/SIGNA ��L1�_catr4 DATV •
.5. FIRE DEPARTMENT: :.-.-LYES DOES. NOT APPLY ' SIGNAT E DATE
COMMENTS -
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