HomeMy WebLinkAboutBLD-80-333 ig_
��' ✓ No. .355
+I `1 al (� Application for a Permit to Build
�� Fee must accompan this application
IV Yarmouth cP 0 19..O22.
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner sCJ.-e'wwr'y' ��'d Aote�r(ess
2. Name of Architect (if n'A�v.'t (/Aany)
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3. Name of Builder � , f"
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4. Precinct No. Lot No. a / Plan: Name or No.nM yS - 0/
5: Name of Street f . e2o-cv-ce. . /2-R• /
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6. Purpose of Building
7. Material
8. Estimated cost of building 'Co 0 0 D o
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9. Dwelling
10. Cottage
11. Heat
12. Basement
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 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 to distances from adjoining lots, on reverse side.
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Address
Street Name
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Right Side Depth of Lot
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Street Name
BUILDING PERMIT REVIEW
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CATION
' - • • n ms's? '� DATE FILED: N0:
CATION OF PROPERTY: °ii , en, �ir,rc./ �,• DATE FILED:
3 FOLLOWING CHECK-OFF SHEEP IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVIDUAL MUST
LLOW IN ORDER TO OBTAIN A PERMIT TO BUILD OR ALTER A BUILDING. THE BUILDING DEPARTMENT
LL CHECK ON THE FOLLOWING: (A) CONSERVANCY DISTRICTS (B) HISTORICAL DISTRICTS (C) FLOOD
1INS ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING_THE APPLICANT THROUGH THE FOLLOWING
ENCIES.
SIDENTIAL BUILDING:
CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE DISPOSAL.
CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS.
EXAMPLES: STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH, ETC.
CHECK WITH PLANNING BOARD FOR LOT RELEASE.
MMERCIAL BUILDING:
ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN -
REVIEW.
CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS.
PLANNING BOARD- TO SEE IF LOT COMPLIES WITH ZONING BY-LAWS.
BOARD OF HEALTH FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: SAUNA BATHS, SWIMMING FOOLS, RESTAURANTS, ETC.
FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
'VIEWED BY?
GIN NG PARTMENT: YES /DOES NOT APPLY SIGNATURE atitint DATE 6'Zo,Bo
NSERVA ON COMMITTEE: YFS_DOES:NOT.APPLY /SIGNATURE RaEjla.:zzo. DATE 4l200'8n
NNING BOARD' YES DOES NOT APPLY SIGNATURE DATE
MU) OF-I .ALTH: YES ! DOES NOT APPLY SIGNATURE_ DATEG_ddl
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RE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE -
ETNTS:
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