HomeMy WebLinkAboutBLD-93-750 �Ir •�F•Yq� Cq WSJ /0!93
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6, p1 Application for a Permit to Build No. 7 513
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UPON FINAL APPROVAL ' MAP `I ( LOT R-/lo
FEE MUST ACCOMPANY THIS APPLICATION. DATE _ / 197'
The undersigned hereby applies for a permit to build 10/9e
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according to the following specifications
Name ofproperty owner i)largovri4e T. Ty a4i✓I Tel. 31Oa-Q78
Address a µ U Frre��,rn �2 � Varm.04, onri-, nit 0265"
2.Name of Architect(if any) Tel.
l/3. Name ofbuilder SI-ove MOO' TC Address Nafwichtort MS-
4.
S4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
t-7 Construction address 34 ?reer4ar Y ntink.U-I1OVY�
Flood District n
8. Date of subdivision Approval plain zone Zone /� LTi
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
b S�aut Type of room No.
10. Multi family 0 fr.-1 ,VdQ , Aid-0A Si l
11. Commercial 0 Kitchen
12. Other _5,, or Dining Rm.
13. No. of stories Living Rm.
Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood 0 Cement 0 Other 0 Deck
16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
17. Garage — 1 0 2 ❑ Family Rm.
Sun room
18. Swimming pool - Size Garage
19. Storage shed — Size Shed
20. Stove — Wood% Coal ❑ 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 or street From rear lot line Side line
25. H.I.C.R. No.
LOT RELEASED BY 1---Signature f11,11� t tz�n , )1/0A/1PLANNING BOARD _Address aU r/1412.141d/, acs
Date U70/I ttotiii 0(0 PA o1,07.5"
WOOD STOVE INSTALLATION CHECKLIST
Permit .
A building permit is required for the installation of any solid fuel burning appliance. The building permit ands', 9 g 31
installation inspection are limited to the stove installation and not to the stove construction.� ,, /�0
Stove Y
A. New �� Used �—
B. Type/radiant_(—1 Circulating
C. Manufacturer 3 0171 -. Lao.No.
Name/Model No. Collar size
Dimensions/Height aY`' Length Ate}" Width 72
Chimney , '' t
A. New Existing /-------
B. Size(flue area) 't
C. Other appliances attached to flue(Number and flue size) '
D. Prefab(Manufacturer—name and type)
E. MasonryiLined Flue liner
Unlined op,s manwacufert
F. Height(refer to diagrams) cap
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a
I CVEZ to I I O\SR IO IT I IZII MAIN.
I
I {2 Min 2 Mit I
3 Miry tG' 3,MIN. t—tl�%��
1 _. IN. _
18"MIN.
Clg HEARTH
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CHIMNEY HEIGHT
Hearth(ncn•cemcustible)
A. Materials
E. Suo•flccrconstruc:lon •--- -
C. Minimum cimensions(refer to ciagram) Yy- ff�� 'I��
Clearances and Wail Protection Isee stove installation clearances cn rt) hf tgaff¢4,tt . ,- $'(Q4 n j0 Q
A. Type cf wail protection provicec U (L n
E. Clearances(refer to diagrams) /e�Q5�p 3 roG
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FIREPLACE . CORNER WALL/CENTER
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