HomeMy WebLinkAboutBLD-90-724 (33B Forest Road) ,Ygit 61 t
ts; pi TOWN OF RMOUTH
• MATTACM[[�yl..'!
S /�"1 i
4abATI) ,/ Application for a Permit to Build No. 702 V
UPON FINAL APPROVAL Pf )a' -'I-1°MAP L& ' LOTCe
FEE MUST ACCOMPANY THIS APPLICATION. DATE /Alit 1990
The undersigned hereby applies for a permit to build 01111 90
according to the following specifications
1. Name of property owner - �-Ei4-,�• Tel 374A-�3 fob
Address �� 4 sL SA, 4
2.Name of Architect(if any) Tel.
3. Name of builder �f n , Address
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
7. Construction address -3,3 zrr4.ai dee( idif
Flood District
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
0-16,
11. Commercial 0 J,4.,Lp Kitchen
12. Other 0 Dining Rm.
13. No. of stories Living Rm.
Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 as 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 0 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. `' i_/
PLANNING BOARD Address L33 ,� usiri��c -
Date )14/-4 )(-4-€41'4i 4' `71,-4_,. 4026G ci