HomeMy WebLinkAbout1972 Feb 11 - Application for Permit to BuildDISPV,AL IryJ1A1.�cnG i.; -. a� --mss
(No Building Permit shall be issued until a Dispo al Q
Works Construction Permit has first been obtained.) No. ..... J.....
Q
pplication for a Permit to Build
Fee must accompany this application �� y
Yarmouth. a,l/A................19.{. 2—
TO THE BOARD OF SELECTMEN: ,
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The undersigned hereby applies for a permit to build, according to the following specifications:
Name of Owner Address z,/Q
Name of Architect (if any) Iq C�
Name of Builder
Precinct No.
Lot No. 02 7. Plan: Name or No.
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Name of Street G7�'
Purpose of Building
Material (Lumber Shall be Graded "Standard #2" or Better)
Estimated cost of building 16
Dwelling l/ /� �r.zsT 17r.
MASTER'S LICENSE #A-9208
CottageVia%
Heat Cata oni Electric
Basement l/
RESIDENTIAL AND COMMERCIAL
13. Garage v
14. Store 17 JOHN STREET TELEPHONE
MANSFIELD, MASS. 02048
339-8774
1-0. Shop
16. No. c -f stories -t
17. Is there to be a store in lower story?
18. Size of lot. No. of feet front ...... U............ No. of feet rear ......................... No. of feet deep .. v..........
19. Size of building. No. of feet front
..... yy..........
No. of feet side.... 02..Y............
No. of feet rear....���/........
20. Distance from nearest buildings:
Front ....................
ft.; side....".3. .......ft.;
side .................. ft.; rear..`x'�...ft.
21. Distance back from line or street ....2.6
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from rear lot line ....y5. .........,
side line ....../.. .......
Show by diagram the location of proposed building with relation to distances from adjoining lots, on reverse side.
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Name......... ............•••••; �/.. .....................�.. .............
A LICENSED INSTALLER MUST OBTAIN
Address ....�.�
SEWAGE PERMIT AND INSTALL SYSTEM. NO
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SYSTEM TO BE COVERED UNTIL INSPECTED.