HomeMy WebLinkAboutBLD-80-284 •
7a
-711
fq1y, Application for a Permit to Buil
tO � -Fee must acco pany this applicati y/
Yarmouth .. jC - 19 �J
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner t9/LL/.1✓r 3 / '1/4 Address r e's'3 4 /v c'L ito rJ�✓
2. Name of Architect (if any) . _ .. . . ..
3. Name of Builder to be 2T G' ,,N-R?et e--
4.
4. Precinct No. Lot No. e Plan: Name or No. w /'Y40.1-� `c�
6. Name of Street 5 ,&,C A . /Zen" Pl f�
6. Purpose of Building #70/3 C /1 /p f X a DI p0fl ht NO Hear
7. Material C O I, C.4 e r c"L Ah .
•
8. Estimated cost of building a, y o a —
J °
9. Dwelling r7
10. Cottage
11. Heat
12. Basement
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 relation to distances from adjoining lots, on reverse side.
Name ,lam CL/�...Z TD a
Address
Street'Name nn�
so
r Left Side Depth of Lot
v
z ,-1\z
-. /r® poReA ay .a f�—� o
I°.
ci 4, ...
)/`S %l
1"
l/
Right Side Depth of Lot
Street Name .. ..CJ ,.5-5-1(el`jP2e.-9
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C. ! - •
BUILDING PERMIT REVIEW
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•
APPLICANT: A/4..• 1a9,Pnt .. ,9 ,,,- , BLDG PERMIT NO:
LOCATION OF PROPERTY: 5-73.t_ff //,. 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.
RESIDENTIAL BUILDING:
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE DISPOSAL.
B) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS.
EXAMPLES: STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH, ETC.
C) CHECK WITH PLANNING BOARD FOR LOT RELEASE.
COMMERCIAL BUILDING:
A) ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN
REVIEW.
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS.
IC) PLANNING BOARD- TO SEE IF LOT COMPLIES WITH TONING BY-LAWS.
D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC.
E) FIFO; DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
rREVIEWED BY:
V
ENGINEERING DEPARTMENT: YESDOES NOT APPLY SIGNATURE 52c' si 4 DATE .6'f/Aa
NSERVATION COMMITTEE: YES_DOES-NOT.APPLY SIGNATURE 52 .,r67117,•••-‘-
DATE 010e
PLANNING BOARD: YES DOES NOT APPLY_SIGNATURE DATE
BOARD OF HEALTH: YES L—ItES NOT APPLY SIGNATURE c DATE S'A%/�
FIRE DEPARTMENT: YDATE
ES DOES NOT APPLY SIGNATURE . rr
.Yrs •.
COMMENTS: