HomeMy WebLinkAboutBLD-80-325 1.1'7" 070 ' 6-i 614 €0.41764
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�y.GD Application for a Permi to Build No.
Fee must accompany this a lication
Yarmouth �— J`3 19..P
ri 6- 13-P
TO THE BOARD OF SELECTMEN
The undersigned hereby applies
/for a permit to build, according to the following specifications:
1. Name of Owner • .i / .Q tf•Yt�. Address C & / A t11 i
2. Name of Architect (if any) / - G
3. Name of Builder A a,. e-
4.
4. Precinct No. Lot No.Q Plan: Name or No. AM ao
5. Name of Street ,r„ Q gJLco(f
i
6 Purpose of Building W +a L t! N p {- C{ TU ?At( T/b N
71 Material oaL 4 1 N t fi o 1 ni b
8. Estimated cost of building ,00
9. Dwelling J
10. Cottage 3
11. Heat
12. Basement
13. Garage (Ea
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 y.. No. of feet rear No. of feet deepA
d i , Y"
19. Size of building. N�o`f� front 0 No. of feet side / 0 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..f
Address I .J...74 rye Anti S'%-_
Street Name
•
v
Left Side Depth of Lot
r .= --
Z C� —
g
o
ism i
O
0
m ^ �
0 1
Y elZa
1 I
Right Side Depth of Lot
i
Street Name •
BUILDING PERMIT REVIEW
APPLICANT: r l/ �i •rTf , / 5 5 y, �c'�e r BLDG PERMIT NO:
LOCATION OF PROPERTY: CU I N /4 A i v DATE FILED:
�
THE FOLLOWING CHECK-OFF SHEEP 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 WETLANIS.
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).
IE�WED BY: /
6 G DEPARTMENT: YES /DOES NOT APPLY SIGNATURE µ E, DATE Ci/3/So
SL4 ERRVVAT ON CCMMITTEE: YESDOES:NOT.APPLY ✓SIGNATURE alae „vee& DATE (01/3/8b
£ANN/NG BOARD: YES DOES NOT APPLY SIGNATURE DATE
IkRD OF HEALTH: YESL,DOES NOT APPLY SIGNATURE f/!.w-4. DATE 4a
IRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE ^
4
IMMENTS:
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