HomeMy WebLinkAboutBLD-80-384 1M-- L/ b
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` i 4,1/4sApplication for ‘rnit to Build
Fee must mpany this application
Yarmouth . .
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..7.0 1)9...i
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner ,47-el e.,yl 1,0 s AlO u A` Address Z3 q V p'�/4 i q SI
2. Name of Architect (if any) ' % V " n 0 5 /
b - bM„�i't ,air
3. Name of Builder ^'
4. Precinct No. 4•• - - • Lot No. Cr . O' Plan: Name or No. 2 T.
5. 1 Name of Street 3 �l� r /h/a 5-1.t. _ AM. 23-Elo
6. Purpose of Building 0u-�` //�y (.F
7 /
7. Material / " � ��
8. Estimated cost of building7-0,04-4 V rj L j t U -C14 efi
9. Dwelling
10. Cottage
11. Heat
12. Basement ---- 1
13. Garage
14. Store
15: Shop
16. No. of stories O e• \
17. Is there to be a Store in the lower storey -+- • --------
___
___ 18.—Size of Lot.— 'No,of feet front 1 �4 Wo?df i�4t 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 1 from rear lot line - side line
Show by diagram the location of propsed building with relation to distan a from adjoining
lots, on reverse side.
Name.�a* � ...2in
Address. .7. .. ./ . . . .. r....... ..J
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Rear of Lot
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Frontage of Lot • ILO.0
Street Name VI.If 1.4/.1.0 51—
PLOT PLAN
BUILDING PERMIT REVIEW
APPLI(ANT�`/ c. ,/ '�' BUG PERMIT NO:
IDCA`tON OF PROPERTY:\V7'tXr /rl/q/ ./ DATE FILED:
C ,4' 77/ - 34155
OI[Ay
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. •
f
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 WETLANIS.
EXAMPLES: STREAMS, PONDS/RIVERS, OCEAN, .`pAY, ;BOGS, MARSH, ETC.
.. ..... . ... L! '-' '.1`.:'.. ;
C) CHECK WITH PLANNING BOAR) FOR LOT RELEASE. •. .
COMMERCIAL. BUILDING:
C.‘
A) ENGINEERING DEPARTMENT—FOR PARKING AND'DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN
REVIEW. °
, .
B) CONSERVATION COfMITTEE-IF LOT BORDERS ANY 'TYPO OF WETLANDS.
C) PLANNING BOARD— TO SEE IF LOT COMPLIES WITH ZONING BY—LATS.
D) BOARD OF HEALTH—FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: SAUNA BATHS, SWIMMINGtPOOIS, RESTAURANTS, ETC.
E) FIRE DEPARTMENT—FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
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REVIEWED BY:
ENGINEERING DEPARTMENT: YES DOES NOT APPLY SIGNATURE L_ �• * 4. %. DATE 7/1480
CONSERVATION COMMITTEE: YES DOES_NOT APPLY /SIGNATURE 41 E _W
/SIGNATURE ., ,2, DATE /110180
PLANNING BOARD:- ___ —YES — DOES NOT APPLY` SIGNATURE � DATE "_' —
BOARD OF HEALTH: YFSZ ES NOT c�IPPLYSIGNATURE 'i- ri��L L� DATE—Y/0/0
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FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
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COMMENTS: . .I,, }
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