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HomeMy WebLinkAboutBLD-90-492 011S7-n_.-- --cif-Yeti? 'rA TOWN OF ' MOUTH 0t H' l HMATTACN 5 J �:4L- f- Application for a Permit to Build No. 4CP UPON FINAL APPROVALS • MAP LOT FEE MUST ACCOMPANY THIS APPLICATION. DATE - g/y / 1990 The undersigned hereby applies for a permit to build 00 according to the following specifications 1. Name of property owner Pau-/ '`T rein. 'ea4 / Tel.7&O 38W Address r Olive ee ''5 (gel, y h.1-7(--/Agent,uM m'9- 074,73. 2.Name of Architect(if any) Tel. a Name of builder erLv- c-& . Address 4. License No. Tel. 5. Name of Mason Address 6. License No. Tel. ��//� $7.Construction address d4 &yn.ee S (4 &hsf /,4>een�)t�i /4"9-62e73 ood Di§trict 8. Date of subdivision Approval plain zone Zone 9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE Type of room No. 10. Multi family 0 /. 6-o 11. Commercial 0 Kitchen 12. Other 0 at a C-(7 Dining Rm. 13. No.of stories Living Rm. Bed Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab ❑ Bath 15. Materials — Wood 0 Cement 0 Other 0 Deck 16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch 17.Garage — 1 ❑ 2 ❑ Family Rm. Sun room 18. Swimming pool - Size Garage 19. Storage shed — Size Shed 20. Stove — Wood Coal ❑ ct- Alterations 21. Size of lot: No. of feet front No. of feet rear No.of feet deep 22. Size of building: No. of feet front No.of feet side No. of feet rear 23. Distance from nearest building: Front Ft. side Ft.side Rear 24. Distance back from line or street From rear lot line //�� Side line LOT RELEASED BY Signature � ,6 ?' PLANNING BOARD Address dc?-- ''_ - A 'S Date /Jlrl}- % , alin7/9 4P 623 WOOD STOVE INSTALLATION CHECKLIST C.1. L.' " n- Permit A building permit is required for the installation cf any solid fuel burning appliance. The building permit and installation inspection are limited to the stove installation and not to the stove construction. ��� L/ / rC Stove /5+ A. New L Used.- B. Typeiradiant , el S � Circulating C. Manufacturer Vt mi. rtvlerin 5 (..p C44 n 615 Lao.No. Namei Model No. !! Collar size ?" DimensionstHeight cZf" Length /7 " Wicth 3/ '' Chimney •••-•-.....- A. New Existing B. Size(flue area) C. Other appliances attached to flue(Number and flue size) D. Prefab(Manufacturer-name and type) E. Masonry/Lined Flue liner 'on. Unlined type i manurac:ureq F. Height(refer to ciagrams) cap a cvaz Ic' I I C`SF IC I I TZ" MIY, 2 Mk 2 M:t 3'YIIN. ,o. tC• ',MIN. I : 124 MIAI L� 1 1$,N. (Fug.t sr I 4 0 HEARTH CHIMNEY HEIGHT Hearth(ncn-comcusnbie) `f 60---A B. Materials E. Suo4ioorconsrucaon r C. Minimum aces and ; ection c.e stove © . // i 6 Clearances and Wall Protection i see stove mstadancn clearances chart) f/!Gr'/'�,/ 76:2 A. Type of wall protection provided B. Clearances(refer to ciacrams) —"Kt \\17..- — Hizitri Xl r/ / l I I t • FIREPLACE CORNER WALL/CENTER 13