HomeMy WebLinkAboutBLD-90-615 -Y ,..
, POSTED
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IC/too-0,0 0,0 Application for a Permit to Build No. CC
/o -16--90
UPON FINAL APPROVAL MAP .51 LOT S 9
FEE MUST ACCOMPANY THIS APPLICATION. DATE /)//5- 19 1d
The undersigned hereby applies for a permit to build /%6790
acct rding to the following specifications //
V(. Name of property owner. 441 4e4 Tel. 770-of/76
Address J-r-c' ,4 /u• tC�/i
2.Name of Architect(if any) Tel.
3. Name of builder ali,Er1I I Address
4. License No. K" Tel.
5. Name of Mason• Address
6. License No. Te
7. Construction address Cit �' , /' -a a-c.- it/!
Flood District
8. Date of subdivision Approval / plain zone V • Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 7/1‘40' 6d 1A - ., rna_
11. Commercial 0 Kitchen
12. Other 0 _ Dining Rm.
13. No. of stories i V 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 0 2 ❑ Sun room
18. Swimming pool - Size Garage
19. Storage shed =Size Shed
20. Stove - Wood & Coal Sti-de-1-- Alterations
21. Size of lot: No. of feet front No. of feet rear • No. of feet deep
22. Size of building: Na 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"--/ .-- -•
'
PLANNING BOARD Address 7 Te-2er5oA AUe
Date • Lt)%j4Mv,.7/ .(Mit W x '7 3 . .
WOOD STOVE INSTALLATION CHECKLIST
• Permit
A building permit is required for the installation of any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and not to the stove construction. it•
StoveO • D/MO
A. New Used I
B. Type/radiant Circulating
C. Manufacturer *CZ/59N 57aC kA-,rel Lab.No.
Name/Model No. /4 in ,- Collar size err
Dimensions/Height ) . Length Z rr Width ft
Chimney
A. New Existing
B. Size(flue area) $ 7
C. Other appliances attached to flue(Number and flue size) /1/G/v
D. Prefab(Manufacturer—name and type) >� ?v-
E. Masonry/Lined Flue liner •
Unlined (type(i manufacturer)
F. Height(refer to diagrams) cap
a
I °vex.to I I ovER IG 1 112° MIN.
1 Cr
--A 12MIFL 2 MI^�. I '
4..5•MIK {;o' IC` - 3'INI14.
12a
UIN.
t ..s 18. MN.
(FUcl45H
1 AL_E`i35'G^
ri i•'— . HEARTH
CHIMNEY HEIGHT .
Hearth(non-comoustible)
A. Materials '
B. Sue-floor construction Cd�0I69G
C. Minimum dimensions(refer to ciagram)
Clearances and Wall Protection(see stove installation clearances chart)
tvntg)a
A. Type of wall protection proviced
B. Clearances(refer to diagrams)
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FIREPLACE CORNER WALUCENTER
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