HomeMy WebLinkAboutBLD-80-425 Application for a Pe mit to Build No. a a�
Fee ust accompan his application
Yarmouth �w 7 1'2'19
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
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1. Name of Owner dlVplec L a+r'r••lCc.. 3s. Address /
2. Name of Architect (if any) -
3. Name of guilder „i 7
4. . Precinct No. 3 Lot No. 2.775 Plan: Name or No. Ac, M. 29-MI-22.3
5. Name of Street �'Q e tV
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6. Purpose of Building „,4717-.574.
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7. Material ,uI/� `'
8. Estimated cost of building
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9. Dwelling „tp as 0 C. gr
10. Cottage QC' (— Z„ it rt 4 F
il. Heat /w0 i7 T/{e.' pKdvlavt'
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12. Basement �0
13. Garage ivt-O
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 fronlj No. of feet rear No. of feet deep
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19. Size of building. No. of feet front .rf..p No. of feet side ...... ',!' No. of feet rear /e l
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 distan : m adjoinin lon reverse side.
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Street Name ^g 44, r.
o • Left Side Depth or Lot" '
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• Right side Depth or Lot ._.... � w' -
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i• BUILDII:G PER?IT REV E6 : t �_
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+�r -`, . • BLDG PERMIT NO
PPLIC�I'IT �PN- lt�E . -L' C=Aw /Kg • .
OCATION OF PROPERTY: $�,Y• r.Se-=' DATE.FILED: • . -
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE •PROCEDURES AN. INDIVIDUAL. - .--•'-.tr:
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UST FOLLOW IN ORDER TO OBTAIN, A PERMIT TO BUILD OR ALTERA .BUILDING. - THE BUILDING'.:='-==. 5:-.
EPARTMENT'WILLL_CHECK-ON :THE; FOLLOWING: (A)` CONSERVANCY DISTRICTS (13)-c; HISTORICAL - -
ISTRICTS (C) . FLOOD PLAINS_'ZONING,• AND WILL BE RESPONSIBLE FOR -ASSISTING _THE'= ;:c-
PPLICANT TH?OUGH•THE FOLLOWING AGENCIES: : :- ":
• RESIDENTIAL BUILDING
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE
DISPOSAL`S ` i- - • _ _ !
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_. `RELEASE:' , _ L r _ _ ^: