HomeMy WebLinkAboutBLD-80-300 4ii ,:55 `�
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*--..„,,,,r( Application for a Permit to ild
fit Pi 6 Fee must accompany t ' pplication
Yarmouth lir 19tr
Tp THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, accordingccto the following specifications: �j� c '
. 1. Name of Owner 3 In t,OdGhC?ee �/ Address ,.Vt ��Q-m -ft `�"' z'a
2. Name of Architect (�y �/ _ _ ..._ .
3. Name of Builder ? r
4. Precinct No. Lot No. Plan: Name or No.
5. Name of Street � 'Ott if . 6`"`�`{`D'`
6. Purpose of Building
7: Material ./1.--i l . fitrcrnct. . v O'`n
a7uRc"
`�`-t W urOot✓S,
8. Estimated cost of building /5�
9. Dwelling -, J Sr ADD •
io. Cottage ')00 4/0 t.
Cooveer S I 'x 'f'
11. Heat •••71'O - s4'' 2-0
12. Basement : 'U' '
13. Garage /YGd
t4. Store LS!/l
15. Shop (�
16. No. of stories /
17. Is there to be a Store in the lower storey nz9
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
§how by diagram the location of propsed building with relation to distances f om adjoining lots,o reverse aid .
Name....... .... .. . Q•
Address..-7.7 2 2.
Street Name
O Left Side Depth of Lot
r .. ..MP
z
z
Pt
Bu
0
0
n
m r
m r
0
1
1
i 1
J
i
Right Side Depth of Lot
.r'
Street Name
" f
•
BUILDING PERMIT REVIEW
APPLICANT: N<cnifeLc.d ZrltL.W y BLDG PERMIT NO:
LOCATION OF PROPERTY: 721s H.d-exf f, . 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, BOOS, 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 BY-LAWS.
TO BOARD OF HEALTH FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC.
E) FIRE DEPARTMENT FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
REVIEWED BY: ///�
ENGINEERING DEPARTMENT: ' YES DOES NOT APPLY_4IGNATURE i;/. ' ,"2 DATE 1/s/ro
CONSERVATION CO MITTEE:I/YES_DOES:NOT.APPLY ✓ SIGNATURE 7 ` DATE 6/SPD
PLANNING BOARD: YES DOES NOT APPLY SIGNATURE DATE
BOARD OF HEALTH: 1/ YES ES NOT APPLY SIGNATURE@ A)- r�tiL���9 i4/J DATE 6/Y/Sl�)
FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE / DATE •
Y
COMMENTS:
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