HomeMy WebLinkAboutBLD-80-446 Rt1\10 7
\% ` Application for a Permit to Build
Fee must accompany this application
Yarmouth 4Q9.° "4 94 Q�8....19 8
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, accord' the following speciificaations: /�
1. Name of Owner to(415 t 1)y 1'^ Address 9! w2 b9 V RI.
2. Name of Architect (if any)
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3. Name of Builder 11. Nebo,, t l �"7�:01
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4. Precinct No. ¢ (� JLot No. 't Plan: Name or No. A.M, i 7- K 5r'
5. Name of Street'lj(`e 6 S4 r t U
6. Purpose of Building 9 re e?ewu7 .Q aaYnSc
7. Material I 44 Fr ew/�,t//C /o/./� t oZ
8. Estimated cost of building 4000 7 I /.
9. Dwelling
10. Cottage 7-
11. Heat fijglLC �$
12. Basement O
13. Garage ✓ /ee.< `m% 9✓ 0 T
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arte2-e.? 8
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14. Store
15. Shop
16. No. of stories
17. Is there to be a Store in the lower storey
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18. Size of Lot. No. 'of feet front /J.,/ & No. of feet rear •..7 2. /0 No. of feet deep 90
19. Size of building. No. of feet front a f No. of feet side a'2— No. of feet rear .2..V..................
20. Distance from nearest building: Front ... ft.; side ft.; side ft.; rear
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21. Distance back from line or street 3..! , from rear lot line 3 if side line ./Q..h.1 Q
Show by diagram the location of propsed building with relation to distances from adjoining lots, on reverse side.
Name A...Eb.c.r Pt..L o'I
14
Nic1`Address 47• R..0 ..�.?2rl.Z�.., .er:.fi trt...1.5
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Street Name
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Q.0 Left Side Depth of Lot 9 0
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• Right Side Depth of Lot . 90 -
Street Name 44r
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RENEYC?OTHERS, INC. TAPE SURVEY
ENGINEERS $ SURVEYORS 200/45.
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P. O. BOX 434 NAME ` O /as /�,{/ ..f/�.//�U_&%%/
WORCESTER MASS. 01613 LOCATION 57 .11 /3 : AL,„- -f-`i
755-1285 ' 755-1286 M/A ST y����1LZCl 1f / n/
REGITRY--5.,12.4 S_T1BLS S'SCALE. /" Zoe DATE _._ /nJ�2Ce l924P
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DO Not USE tars PWT, PLA"1
TO ERECTEE$.CES%-SHRUBBERY
OR ANCILLARY. ST UC IBES.
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' WE, HERESY, co-wry THAT THIS.PROPER=
. IS SC7 IN THE SPECIAL FLOOD HAZARD,
�714 AREA AS SHOWN ON THE HUD {=EDEPAI:
y � INSURANCE MAPA o9 . DATED/O
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BUILDING PERMIT REVIEW
APPLICANT: 00 }ja vbor put L(4; / Ceor BLDG PERMIT NO:
LOCATION OF P PERTY: 59 �U/PCLCler RI' • DATE FILED: •
1
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
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
4GENCIES.
ESIDENTIAL BUILDING:
4) CHECK MITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE DISPOSAL.
) CHECK WITH CONSERVATION COM•fITTEE 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.
)M(ERCIAL BUILDLNG:
) ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN .
REVIEW.
) CONSERVATION COdMITTEE-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 DEPARTMENT-FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
.VIE4'ED BY:
G//IIN /DNEER/.ING DEPARTMENT: YES /DOES NOT APPLY SIGNATURE 041043 DATE DATE S15f 80
NSERVATION COMMITTEE: YES V D0 S_NOT'APPLYSIGNATURE G� �ZfrC- . DATE c/W"
ANNING BOARD: YES DOES NOT APPLY SIGNATURE I DATE
OF HEALTH: YES t-ItES NOT APPLY_SIGNATURE �d t� , DATE 5/_/7/
IRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
OMMENTS:: -