HomeMy WebLinkAboutBLD-80-439 t. _ w 07�-�, , Cil .
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`� Application for a Permit to-Build No.
Fee must accompany this lication p Q
YarmouthV —v�c,, 19�
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according Ito the following specifications:
1. Name of Owner AI-I EtZ J ttogra5aAJ Address72C) [,JItJ3IO-C() 11'Rai/ 4t"•
2. Name of Architect (if any)
3. Name of Builder
4. Precinct No. 4- Lot No. `7 Plan: Name or No. A.M. 3 4-Y 1
5. Name of Street % Q i'N low Rta y RI''
6. Purpose of Building Oa L . h1.671)
7. Material LJUV J `i- /1 .510/144 / 5t7IN&r /Cf
8. Estimated cost of building 3 dv ,
9. Dwelling NO
10. Cottage $3 b
11. Heat POP O
12. Basement d L) 1i
13. Garage X) O -
14. Store Pb
15. Shop N 6
16. No. of stories p t1/4-7
17. Is there to be a Store in the lower storey and
q v
18. Size of Lot. No. of feet front/ itcs F/ No. of feet rear gt 1/2 — No. of feet deep / / ;Cr
19. Size of building. No. of feet front a.� No. of feet side ....12.1.....[ No. of feet rear ..Q
2 , 22
r7 .2 20 y? /
20. Distance from nearest building: Front ...3'I ft.; side...5 / ft.; side....W.-I / ft.; rear
21. Distance back from line or street .4.b/..Zfrom rear lot line . , side line &,'4 IT
Show by diagram the location of propsed building with relation to distances from adj ping lots on reverse side.
Name
Address.. •d tialocv
Street Name
'9 /
O
Left Side Depth of Lot la?Q
-.1
. r
P.
Z
m o &
core
s+ 0
Z
or
0 0
I o
r
o
al
e
CO .\
M
e
`L tr 1 `
rrb
FV
Right Side Depth of Lot ...//l
Street Name i
7
T
J
BUILDING PERMIT REVIEW
•
APPLICAZ$:6-)A C7 e- -NT BLDG PERMIT NO: •
IACATIONICF PROPERTY:nO t:jlNr,Jo41 6/0/ /R> DATE FILED: •
HE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVIDUAL MUST .
WOLLOW IN ORDER TO OBTAIN A PERMIT TO BUILD OR ALTER A BUILDING. THE BUILDING DEPARTMENT
ILL 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
4GE,NCIES. ;
ESIDEENTIAL BUILDING:
CO CHECK WITH THE,HEALTH.DEPARTMENT IN REFEREtiiCE 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. •
-
IM(ERCIAL BUILDING:
t,
) ENGINEERING DEPARTMENT-FOR, PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN
REVIEW. S-.: A '
) CONSERVATION�COM.MITTEE-IF LOT BORDERS ANY TYPD 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 POOLS, RESTAURANTS, ETC.
FIRE DEPARTMFNT=FORtPROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS). , ,;
(L-,L -
n f_ •
VIEWED BY:
NEERING DEPARTMENT: YES ✓ DOES NOT APPLY SIGNATURE iliugjE, P • DATE $r s/sb
N ERVATION COMMITTEE: ` Y'5_DOES:NOT:APPLY ✓SIGNATURE E. aA&. DATE SrS,Bo
ANNING BOARD: YES DOES NOT APPLYSIGNATURE I DATE
'ARD OF HEALTH: YFS./�OES NOT APPLY • SIGNATURE 11:1 /46rALAWilef DATE
IRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
PMTS: • . -
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