HomeMy WebLinkAboutBLD-80-429 gyNo. 212-1j
�► 1$4 Application for a Permi to Build
Fee must accompany this apt ication
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Yarmouth / �? 190
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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 L.4 b yS .t..3 n ill ESS 1L4' K address <4.6 VY)e i/n t c J'✓T , 7 em c o w(
2. Name of Architect (if any) /
3. Name of Builder A2.4..yy�
4. Precinct No. Lot No. /j Plan: Name or No. /9 — Asir
5. Name of Street 'j(6 /Gt2iJ4%/ny2otic-t /04 `Cf),V
6. Purpose of Building /g//o (wiry Rapp)
7. Material 1 / ! D
8. Estimated cost of building/90 �X�6 = �D
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9. Dwelling &S O°
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
4.
19. Size of building. No. of feet front ..J 6'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 distan s from adjoining lots, o reverse side.
Name .. / '�,JJ..
Addres 1l f72z..P/!d.S, -nA DY! '
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Street Name
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r - Left Side Depth of Lot
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02 o m
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11 J_c_ 1 1
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Right Side Depth of Let
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Street Name .-23.4:(7)46./a/L //W i...„
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B DING 1'ERNi1T EVIEW
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PLICANT: ri4Mes 5f7h5Ae// BLDG PERMIT NO: .
CATZONe0':' PROPERTY: Coe P4egR/Moe/NTT /94'OO/f//JLL • DATE FILED: •
E FOLLOWINGICK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVIEUAL 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
&INS ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING:THE APPLICANT THROUGH THE FOLLOWING
ENCIES.
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SIDFI4TIAL BUILDING:
CHECK WITH THE HEALTH DEPARTMENT IN RFEFERVCE TO SEPTIC SYSTEMS FOR SEWAGE DISPOSAL.
CHECK WITH CONSERVATION COIXITTEE 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.
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2ERCIAL BUILDING:
ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN •,
REVIEW.
CONSERVATION COf•IIfITTEE-IF LOT BORDERS ANY TYPD OF WETLANDS.
PLANNING BOARD- TO SEE IF LOT COMPLIES WITH ZONING BY-LAYS.
BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES.
EXAMPLES: SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC. •
FIRE DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY; (SPRINKLERS, SMOKE
DETECTORS).
/ •
IEWED BY: /
/ DEPARTMENT: YES ✓DOES NOT APPLY SIGNATURE �/ i V
�� DATE 7/2 Viii
SE /ATION COMMITTEE: YES DOES:NOT APPLY ✓SIGNATURE , _ e ,sot
- DATE7 )P
V�G RD: YES_IDES NOT APPLY SIGNATUREfieft DATE(
) OF HEALTH: YES DOES NOT APPLY_SIGNATURE U" DATE ,�1
DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
IDITS: 1