HomeMy WebLinkAboutBLD-80-313 ^ \.S / GMK) 3 3
Permit to Build No.
�` &� Application for a
• Fee must accompany this applicati
Yarmouth/.... sa
VCO
TO THE BOARD OF SELECTMEN
i
The undersigned hereby applies for a permit to build, according to the following specifications: G
1.' Name of Owner /y/CKi�6c c a � 4,70, ,a
7S✓ . Address 928 ,gjJ ✓7, JO C. �;vo -1
2. Name of Architect (if any) ere coo flc ,,ice/c.oc-/Ea,.r.J,—r6 4/.53-0‹ 4c,
3. Name of Builder t/ y .Ar.ret o,,,/
4. Precinct No. ,21 Lot No.& hi/ Plan: Name or No 41C.C, s QtU 1514
5; Name of Street te.aorc i.e rit- os-- 9 .}.01)j 01l
6: Purpose of Building /ICaTA/c_ J
7. Material WOO.0 Fit •,ys „ .l
A debt(CIL/ 10 L-xista5 Neff,
8. Estimated cost of buildinf/01ODD'0° LfQ.
9. Dwelling i • •
10. Cottage /210
P
11. Heat C7
12. Basement 4 eit
13. Garage
14. Store 0-'-
15.
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 c rF.....f2/..L/..f.:. No. of feet rear No: of feet deep
�/ 37TG /0c .4-1..../19. Size of building. No. of feet front rl..R No. of feet side •3L No. of feet rear ....j..f.2
e
20. Distance from nearest building: Front .44/01ft.; side 2 Z ' ft,; side ft.; rear
'1.. Distance back from line or street 8e '11 , from rear lot line ' side line
Show by diagram the location of propsed building with relation to di ances from adjoining lots,o reverse side.
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Address � . �, . r
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Street Name — .—
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o Left Side Depth of Lot
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• Right Side Depth of Lot / rc
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Street Name
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BUILDING PERMIT REVIEW
APPLICAnt /C.K/.w/c c.co de9C?Y eon/,' • BLDG PERMIT NO:
LOCATION ROPERTY: Scat" "c ` DATE FILED: (/n/m
,$�rti�OKr2�E%CS e4A209
• /O . Z8, Sv . yR-c,of]),
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVILUAL 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 SEFFIC 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 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 SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
REVIEWED BY:
ENGINEERING DEPARTMENT: YES/DOES NOT APPLY SIGNATURE (4 e�-77a�.4 DATE 01 e1 e
CONSERVATION CCI 4ITTEE: IN)_DOES:NOT=APPLY1SIGNATURE v2pi� DATE f//s'a
PLANNING BOARD: YES DOES NOT APPLY SIGNATURE DATE
BOARD OF HEALTH: YES 'tES NOT APPLY SIGNATURE BATEG /o
FIRE DEPARTHLL T: YES r✓ DOES NOT APPLY SIGNATURE/ZP4 ,1. deal,1, DATE//0/�D
COMMENTS:
9) .
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