HomeMy WebLinkAboutBLD-92-916TOWN OF YARMOUTH
MATTACMEES Applic ion for a Permit to Build. ,:.No..
�RCOPRTE�j9
UPON FINAL APPROVAL; MAP Y, LOT
FEE MUST ACCOMPANY THIS APPLICATION. "DATE -2) 19 ala'
The undersigned hereby applies fora peArmit to build
accor ' g to the following specifications
. Name ofro ert owner �� fL �^ �"� W T Tel. 3ES 7d 36N r v
Address 6 99—AY F" Al- %�H P09 TAll
2. Name of Architect (if any) Tel.
3. Name of builder —Address
4. License No. Te 1.
5. Name of Mason Address
6. icense Na Tel.
V;l Construction address
8. Date of subdivision Approval
P P Aft
9. Private dwelling ❑ Estimated Cost /
10. Multi family ❑
11. Commercial ❑
12. Other ❑
13. No. of stories
14. Foundation - Full ❑ Half ❑ Crawl ❑ Slab ❑
15. Materials — Wood ❑ Cement ❑ Other ❑
16. Type of heat - Oil ❑ Gas ❑ Electric ❑ 'Other ❑
17.Garage —1D 2 E
18. Swimming pool - Size
19. Storage shed — 'Size
20. Stove — Wood ❑ Coal L
n zone zone
DO NOT WRITE IN THIS SPACE
Type of room
Kitchen
Dining Rm.
Living Rm.
Bed Rm.
Bath
Deck
Closed porch
Family Rm.
Sun room
Garage
Shed
Alterations
21. Size of lot: No. of feet front No. of feet rear No. of feet deep
22. Size of building. No. of feet front No. of feet side No. of feet rear
23. Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line 6r street From rear lot line Side line
25. H.I.C.R. No.
LOT RELEASED BY Signature ----
PLANNING BOARD Address
Date
No.
'1tlt.��7LJ�TV Y C71YJ 1HLLH1 1Vi`il Li'1G'l�(�LlJ ! -�= ___ �.-
i
- Permit -.
A b; idirig permit is required for the installation of ary solid fuel burning appliance. The buitdirc permit r,
installation inspection are limited to the stove installation and not to the stove construction.'
Stove
A. New Used V AIA SSU
S. Type; radiant V urc e D [' Ftp-- Circulating
C. Manufacturer V/1 f j� 11 A Lao. No. 'A'
Names Mcdel No. NC / Collar size ' `�
Dimensions/Height •A `� ` Length old it Width /4
Chimney Seri Al 0 y,4d-
A. New Existing
3. Size (flue area) " X St'it
C. Other appliances attached to flue (Numcer and flue size) metro__
D. Prefab (Manufacturer—name and type)
S. Masonry/Lined Flue liner
Unlined i1y06 manurac:urea
F. Height (refer to diagrams) `I ` ti '1 re /I !4Z C -CZ -j=-: cao'�
t
C. ilMNEY HEiGi i
Hearth (rcn-ccmpus-&=eJ
A. Matenais 6, n, CnB*f l • % rrH C
.. Suo-door cpnstruc::cn CM„ 911
C. Minimum cirnensicns i refer:c ciacraml
C:earances and Wail Prctec:icn i see scve !nstailarc:': c:earances chart)
S. a. Type ci avail prcter::cn prcvice� �l�.,f' '�-�%'?,�
C:earanoes (refer*- ciacr ams)
4.
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7 9V
H EA Fir'
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