HomeMy WebLinkAboutBLD-90-721 pF•Y4
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:te-- O Application for a Permit to Build No. 9tal
UPON FINAL APPROVAL e /c?' 15 _9 MAP / 7L 17- 6<
FEE MUST ACCOMPANY THIS APPLICATION. DATE /2-7rl 19 q0
The undersigned hereby applies for a permit to build AvAc 9d
accordingor/ to the following specifi ons f--ao°Z" 02 C`S
I ame of property owner weed_8 _ �a��/9� � ���
Uzi Tel.
Address` /'V" �--r4e the : v
2.Name of Architect(ifany) /
4/4�f`/4 er . �oas� Tel.
3. Name of builder_ Address
4. License No. Tel.
5. Name of Mason _ Address
6. License No. Tel.
9:Construction address 70'7 co,—e77- Eve . La /c1 r'in,n Oc A -c-.A
d District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
10. Multi family ❑ j 50 Type of room No.
11. Commercial 0 rw Kitchen
12. Other O Dining Rm.
13. No. of stories 0Living Rm.
g� Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 O U- Bath
15. Materials — Wood 0 Cement 0 Other 0 Deck
16. Type of heat — Oil 0 Gas 0 Electric 0 Other ❑ Closed porch
17. Garage — 1 ❑ 2 ❑ Family Rm.
Sun room
18. Swimming pool - Size Garage
19. Storage shed — Size / Shed
20. Stove — Wood 0 Coal( -ZCd2e- 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
At.
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LOT RELEASED BY Signature A. . _ . ,_a - �•�., a / -
PLANNING BOARD Address 7/7 rO G,c3Dc%c'.VS _ilk.' �. ' Or,
Date 74%c7{/ycroqff
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