HomeMy WebLinkAboutBLD-80-295 ® r)
No. `�[,�!!/��/y7 Cr."
n + Application for a Permit to Build
` ( " Fee must accompany thi application 1 /y o
Yarmouth 19E6—
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications: '
i 1. Name of Owner 1W't2.41,51\1Z.5. 2v\--aal twitemsoteOddress G6Z SNCL, 5Ait\C l.'1. •
2. Name of Architect (If any) ^t0 INC ttra5vV‘O Ntp�A. 1cc0\b
3. Name of Builder.ThgUb.� CS 201'3. VSAM FJ - ao 4AV .
4. Precinct No. � Lot No. a Plan: Name or No. A. M. $- P S i
15. Name of Street 4.- (C:0 ";14(.1-1.--1.4S- C. r-Tiie Wt-e-ecC Y`O •
i 6. Purpose of Building 5In6 (..0 F•AWt.I Lt.( tU-'w_1-•t WC-\
7. Material O U
t 8. Estimated cost of building / wse�� Lues Z -ca)c,U
-11,Lt' •k_(-V►JcR W\QvAOWS
9. Dwelling (Vtr- tE W n-4� AL `%)Aw l Nit
10. Cottage - fat can Y C. 4.4-e.02 trer?.c y w r rn
: 11. Heat 7 sell)rat 00..4 SI
12. Basement yo 6 eel v a e
13. Garage
)7V
13. / £I ! o 014/0.
14. Store
' 15. Shop
4
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 t• . t: f =• . ing lots, on reverse side.
Name.®:.... f
A. .ss
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• Rear ofLot : . .►y.j .'. J..a �...r rNFyStia
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S• t JO,?J LAT
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Frontage of Lot
Street Name
PLOT PLAN
N ,=\ � �. •
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�,..‘ Application to
"_ "•'``"y Old Kings Highway Regional Historic District C-otnmittee
N j1
1 in the Town of Yarmouth for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY: •
1. Exterior Building Construction: 0 New Building 0 Addition ❑ Alteration .
Indicate type of building: 0 House 0 Garage ❑ Commercial 0 Other •
2. Exterior Painting: 0 •
3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: 0 Fence 0 Wall ❑ Flagpole 0 Other
(Please read other side for explanation and requirements). 5 8
TYPE OR PRINT LEGIBLY �`A.TTEE�� •-•, S I�
ADDRESS OF PROPOSED WORK 91; \c r_ Y^r-`nk-\ T ASSESSORS MAP NO. ���
EF
OWNER YWIP 4 Yom' V-A-ver Viatercint .n. � ASSESSORS LOT 60.P ail
HOME ADDRESS ( A7- PATEL. NO.
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
'l,e AT TA-c-A-4----IN -1c4
AGENT OR CONTRALTO . AS)rrvrrr `Th<� C',t, TEL NO. -ASr 7293
ADDRESS 7b N . tMe1 \ Esq': S ( ( N? LALt\ Yvta,(N7r
DETAI LED DESCRIPTION OF PROPOSED WORK: Give``all particulars of work to be done(see No.8,other side), including
materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed
locations of new signs. (Attach additional sheet, if necesiary).
laelnAoc�t rV t eX tCr rk1C t3( ti4vf3
t.epia,c.a us \ ickt
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Tt-1- ` Ct-k-Y2�� csL1at >J� ` - S
Signed _ -.1_ 1wilh.
t Owne-Co r t ,` y vat
Space below line for Committee use. A
ReceivedbyH.D.C.
Date l /J/� The Certificate is hereby �/%�/ ./r�,i J Date t 1�.�
Time L`'✓ /a /' �•�� trix ie,. .../
q / 1
.. // i if
f , _______4;,,• ApprovedPC IMPORTANT If Certificate is approved, approval is subject to the day aTal period
provided in the Act. //1
Disapproved 0 Please return to: Yarmouth Historic District Committee
P.O Box 124 Yarm t P Mau.0. 675
BUILDING PERMIT REVIEW -s
APPLICANT% 1M12 3 Wt.25 VoY"rr' BLDG PERMIT NO:
LOCATION OF PROPERTY: 'Rkc t e r rl4 l).1.tr p"'J DATE FILED: 4I ' stn
R oLJ-rte?
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.
C) PLANNING BOARD- TO SEE IF LOT COMPLIES WITH ZONING Hi-LAWS.
D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIRPMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC.
E) FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
MEWED BY:
EN INEERING DEPARTMENT: YES /DOES NOT APPLY SIGNATURE 1,jai € 4 DATE G/3)50
SERVATION CCMMITTEE: YES DOFS_NOT:APPLY /SIGNATURE L _� . I ,, DATE 4/3/S o
,P/LANNING BOARD: YES FOES NOT APPLY SIGNATURE DATE
1OARD OF HEALTH: YES----DOES NOT APPLY SIGNATURE DATED 7V60
FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
COMMENTS. I) N ADD:tiong To THE. EX%STIN6 -Dw6LL.:14Cs