HomeMy WebLinkAboutBLD-93-834 1.V. 7-03/44... I ! et ({ aa/ /oja ��
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e64,Cani5eW i Application for a Permit to Build No. 23
UPON FINAL APPROVAL �I)•eall \ MAP /Z"C LOT !_ / Z
FEE MUST ACCOMPANY THIS APPLICATION. DATE ' (2T707k 19 q )
\The undersigned hereby applies for a permit to build /a/,e/i-
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\according to the following specifications Qo21 47�
\ 1. Name of property owner EDWnko r IRNNt 7?eymot.OS Tel. 3? 34 I t
N. Address .I5/ Covey Da. yan your/F t.arrr h1\rr oac." v
2.Name of Architect(if any) Tel.
\3. Name of builder ._Dad Joy y Address Pe rr N,i. Mosr .
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
\7. Construction address ..?N ('nv ey D R. pat-wet-4 NJvr4 pear, Mors e 2675
/FloodDistrict R yZ�
8. Date of subdivision Approval - plain zone C` Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
10. Multi family 0 \ a00.0a �O`Db f a Type of room No.
11. Commercial 0 a - ,ao `
Kitchen
12. Other ❑ 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 ❑ 2 ❑ Family Rm.
Sun room
18. Swimming pool - Size Garage
19. Storage shed — Size Shed
\20. Stove — Wood R Coal /ill 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 \Signature _ t tretri A ++ IA_
PLANNING BOARD Address _2y , iivt.vk.0
Date - \ .. d ' �%
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