HomeMy WebLinkAboutBLD-90-606 c0i syA,
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e<t*•,..: Appli ation for a Permit to Build No. (o0b
Cts CID
UPON FINAL APPROVAL \-• MAP 1 t LOT Nfe
FEE MUST ACCOMPANY THIS APPLICATION. DATE/ 19 90
The undersigned hereby applies for a permit to build /d/q/ 90
according to the following specifications
'1. Name of property owner 75A yip /lrtie✓ Tel. 3951-011'76
Address 77 ea-,nrni! Av, S. y/#Ieiu,€-K. .un
‘54`2.Name of Architect(if any) � Tel.
'.. .3. Name of builder—rep i( P1/4-1- ,S€QVIG.es Address CederrLAII-e , A +-
4. License No. Tel. tag=Mit
5. Name of Mason Address
6. License No. Tel.
— 7. Construction address '7'1 k'4 ioVk L- ,4v. . Fp+o . M
FloodS " Dist t
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 1 KO160
11. Commercial ❑ o 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
Family Rm.
17. Garage — 1 ❑ 2 ❑ Sun room
18. Swimming pool - Size Garage
19. Storage shed — Siz
a Shed
X20. Stove —Wood % Coal 0 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 The}4.3-L-4 ' +12.
PLANNING BOARD — Address --/- CIA-1--C-
Date
tt. cDate J