HomeMy WebLinkAboutBLD-80-288 � J No.
h Application for a P• rmit to Build
Fee must accompa this application yy� .w!
Yarmouth I ,I
.4.---14. 1
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit totbuild, according to the following specifications:
1. Name of Owner-ah `(f, Sa.ben Address,30 Gdaohay,'. fon ('
t0trot-lcm WI/an/ •
2. Name of Architect (if any) •
I 3. Name of Builder Robe-tkW. Sect beh ,:, t
4. Precinct No. Lot No. 7 7 „ Plan: Name or Noo •54.-M1P
A�M� �
L.
5. Name of Stye)GJ (1,4 hi nrio n e.• ,
i F-0 4 t JLC
6. Purpose of Building z iv a a-q e- She- + (,o ;iii� t- I-
7. Material W 0 D da r
4
8. Estimated cost of building *4100,OD ,(
9. Dwelling /0i ff°'-
10. cottage /0 'D rl X i.L O I . 5) 4ope .ot1101,
,
11. Heat -
12. Basement ,rte
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 a /loco 11 j- No. of feet rear No. of feet deep
19. Size of building. No. of feet front 1..1 1 No. of feet side /9" No. of feet rear /CV
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 dista ces rom adjoining lots, o reverse side.
,. / .J �_ On•rJ.//
Name .
Address36? Ce-)en / flti o_ '
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Street Name •
It
K
15
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4.
o Left Side Depth of Lot ' S
v as zir-
z ,i >
s, 1 yzt
y -1` 1 rrottat Q `�..
$ a _shed o°
z iivjr,..
e' C¢ 2
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- - ,` "Z X A
A - W
VI • ,. f.-- ..IL 1 If
o
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�' C
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Right Side Depth of Lot . .� a — C 4
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L iStreet Name/1 Name/1)0'44111f 47h c • 11+
IU 1"•.11 _ - .3• 1•
•r ,� ' BLDG••PERMIT-NO • '
CATION OF -PROPERTY:ijf JO0hSfl lf101'"; ' •e '- • DATE.FILED: '3 3"O S-a• ' `
kJ.Ro"�.:1�a-r• •,-,• '�1. . •tea *.
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE _PROCEDURES AN'INDIQI'D AL. - ;=-, •r:•.
ST FOLLOW IN. ORDER TO OBTAIN, A PERMIT TO BUILD OR ALTER A .BUILDING. - THEBUILDING.;:2'•='.ry--
PARTMENT WILL. CHECK ON:THE. FOLLOWING;.* (A) CONSERVANCY DISTRICTS_ (B):•6 HISTORICAL:;
STRICTS - (C) : FLOOD PLAINS•*ZONING,- AND WILL SE RESPONSIBLE FOR ASSISTING THE
PLICANT THROUGH•THE FOLLOWING AGENCIES:,: ..--..;•::-. .---..•4 , '.--v.:':•;.,.:.• + -
RESIDENTIAL BUILDING: '^::'c' �_ :,,9: .•::. : c_ . ; :•- -•.
A) • CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE ' . .
DISPOSAL`` : _ :.,
•• �:..- �: -.— >-',. : i ., •s'�• -•'•'. .: �. �~ _�' '•- "- _• ...�• =. :�•"• !...�•�:'•: . •-f..-':: •.
•
B)"CHECK WITH, CONSERVATION COMMITTEE IF THE' LOT BORDERSONANY TYPE. OFWETLANDS. -` =•:•r ;
- EXAMPLES:, STREAMS, PONDS, _RIVERS;:OCEAN; 'BAY, BOGS, MARSH,. ETC: - ' `: 7.
C) CHECK-WITHJPLANNING BOARD_10R•LOT•_RELEASE-?;= m; -...- ,i f - .Lsc C -7.••!-;-_,-_;;.:--_- • rT = - _ ---__ ::-4% _Thi -- __ _ -1: _ i.:1::" 7:1 _ _ -�_,T.T.
COMMERCIAL BUILDING: _ *r -.: • =..4-:.,.` .7._
`. •a.
•A)• : ENGINEERING DEPARTMENT-FOR.PARKING ANDDRAINAGE REQUIREMENTS,. TOPC:•'APHY SITE'_ ...-1-:.-.4.4
zia PLAN REVIEW: _ y__ : _ _^•_ . • _' =_ .• '4-....t.• -::..-••-••••:_t...-.` ;. -3s :-I.-
"B) ., CONSERVATIONCOMMITTEE-IF LOT. BORDERS ANY TYPE OF WETLANDS. :'-* . - '
C) PLANNING BOARD=TO -SEEIF LOT COMPLIES WITH ZONING BY-LAWS.
D) BOARD OF. HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. . •
EXAMPLES: ' SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC. . • - -
`E) - FIRE DEPARTMENT-FOR 'PROPERTY PROTECTION,.PERSONAL.ISAFETY, (SPRINKLERS, SMOKE ' C-.,
DETECTORS). - • . - - :. ; - _ : _ - :j
- - —ate - - -- :._. - - ••.�.•J-_:A. --• :- _• •'e .
BY: - -'6J.j.�CT. - _ _ -- ,'.;_r i _ 7-7•.;.,1:7:;„ :-.-.:‘• - _r 's_r�:...•7
(-WED - •,_-_4.:• _ _ ,' _ -:4•a. .7.---,_.--..-- -` :--i,,F• -t-_='_"�:jr.;
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INEERING DEPARTMENT':.- YES_DOES NOT APPLY SIGNATURE.-''-='. tz _Z DATE /( • d:
SERVATION -COMMIT•TEE .YES_'_DOES NOT APPLY}•• SIGNATORE'r'j ' it ''7_= DATEtJ3
.3.� ...- :. '• ,•_'T- _••- ...1 .,v}e•--�C. _.. _• ��.:!•_- F:..: _v:'.�:- . : .. S 7:
rte:'- _r _:
PLANNING BOARD. = -� ' "••YES kDOES NOT APPLY'_• SIGNATURES?"':: • -�_'%'7' • ` ='% - DATE - --i'• .-
BbARD OF HEALTH: YES-/DOES• -NOT APPLY_SIGNATURE ':'DATE
.-
FIRE DEPARTMENT:, - .. . _ - • YES • DOES NOT APPLY_SIGNATURE •' ' • - DATE,=iiti$: = •
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