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. n7e�, D 1. o`, cL
, -Issue dare
EXP ' SS SHED PERMIT APPLIC • p, E I V E D
TOWN OF YARMOUTH
Yarmouth Building Department SAN 10 219
1146 Route 28
South Yarmouth,MA 02664 EDBy _ -• r :NT
(508)398-2231` �
E . 1261 •
CONSTRUCI7ONADDRESS: 24 cake , W YMn ) '\A A VM4 /r�'7
ASSESSOR'S INFORMATION: 1 1
,uI `• Parcel: / (.�
OWNER: Vii ►1f 101N5Apt ' 5• 2L Jew. i Oct 5os3 -41//-0 `Z9
PRESENT AD TEL r
CONTRACTOR: t 114kV [ me �( aih c& O, n t V(ned 5E30 '.Deoo
TEL NAME MAILING ADD
,Residential ❑ ...„.- •tti 2 Est Cost of consmx tion S '1(''7 c"-)c . e
Home Improvement Contractor Lie.B 1 O®Q JS Construction Supervisor Lie.les-}A -of saccs
Workman's Compensation Insurance: (check .. )
0 I am the homeowner
,,,', ❑ I am th sole proprietor X I have Worker's Compensation InsuranceraI 1 D },
Insurance Company Name: 1�uIAe �\ltf�f )pk.4l Worker's Comp.Policyf&.CC-(9OD '4bo h57-2oJ&�
SHED INFORMATION
ler
New 2( Size L I D ` z A' 6'
x H1019" Corner Lot:Yes No 1ti
Per Town of Yarmouth Zoning . Sec 2015 E:
Side and rear setbacks for accessory luildings less than 1S0 square feet and single story, shall be 6feet in all districts, but
in no case built closer than 12 feet to other building.
Replace existing* Size LL z W V�c\c
z H 1 �\
'The debris will bedisposed ofat(95 0 - - 'q.R{4 - IW.Z
c � (Y
, EA '
Location of Facility
I declare under pe . ' of perjury that the • , ..-,.herein contained are
will be just cense far._nisi. of,, li•- • and r ,•and correct to the best of my knowledge and belief I mtderstmtd that any false answer(s)
7 , tinder M.O.?Ch.268,Section I.
Applicants Signature: A� �y.. )11".
`a)/t Dem <Ufl(1IJ 5�o\gOwner,Sigeature(ora .chin Date: C
App wed Br ` • Date' l -e !
BuildingOfficial or /�'/
( designee) EMAIL ADDRESS:
Zoning District
IItstoricel Di .'ct ❑ Yes 0 No Flood Plain Zone: ❑ Yes 0 No
Water Resat', e Protection District: Within 100 ft of Wetlands:'s•
❑ es ❑ No ❑ Yes ❑ No
"'Note:Conservation review required if within 100 ft.of Wetlands
9/13
rims !!ARBOR
. �� 20001/0001
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,600 Washington Seed •
f Brief"AU 92111
Workers'
Coatpaustisa 4.1 . • • , y
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FOR LOT I
Ad�ate with dashed or accessory-!until-
Well. posal (cesspool) ED
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I (lot................it. rear) �
Abutter's Q.
Name �j ) -
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Name
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name of
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bs Commonwealth of Musseltusetts
?Del etemf al Il al Matte
Boston.MA02111
Td 617-711-4900 at 404 a 1-87741ASSAFg
Revisal 1142-Dd Fa 1617-727-7749
WWW.nma.4tw/tfs