HomeMy WebLinkAboutBLD-90-732 is- _ D TOWN 0 ARMOUTH
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% .% Application for a Permit to Build No.
UPON FINAL APPROVAL ✓ MAP in/ LOT 5-----C3-
FEE
`FEE MUST ACCOMPANY THIS APPLICATION. DATE / 19 90
The undersigned hereby applies for a permit to build /7/7/9v
according to the following specifications " 7 "Te�/9l��
1. Name of property owner ef/giStnakt< 7. CAA H6u 117- l. 391-89+9
Address Ica heitsaxt. St. S. )1Ac e1/4 001-14
2.Name of Architect(if any) Tel.
3. Name of builder_ ow u e R. Address
4. License No. Tel.
5. Name of Mason - Address
6. License No. Tel. '
7. Construction address / 0 ,eli-r;+i -A ,-
ood District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling ( Estimated Cost DO NOT WRITE IN THIS SPACE
10. Multi family 0 . D, 0-0 -------. Type of room No.
11. Commercial ❑ - Kitchen
12. Other 0 Dining Rm.
G a61-0
Living Rm.
13. No. of stories 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 ❑ Electric 0 Other 0 Closed porch
17. Garage — 1 0 2 ❑ Family Rm.
Sun room
18. Swimming pool - Size Garage
19. Storage shed — Size,„..--' Shed
20. Stove — Wood LzYCoal ❑ 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 ( .t. v1'2 /41,, 'CZ_ _
PLANNING BOARD Address
Date
WOOD STOVE INSTALLATION CHECKLIST
r'ills, U. L. l" /Vf l
Permit '`ØK I ..ice
A building pear ti' s 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. '
G✓ / ' j� n ,
Stove 1,,G�
A. New Used
B. Type/radiant 1...-- Circulating /99 96
C. Manufacturer <tr A,✓r) 1 At Lab.No.
Name/Model No. Collar size 3-1 `
Dimensions/Height 592'J Length 4•r. / Width �`��.z •
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. MasonryiLined Flue liner
Unlined 'typo 8 manwacturer)
F. Height(refer to diagrams) cap
/ a
t Io R10I ieNt,Y.
ea 10 I T
�¢�2 Nlty Z tvil.�
j IZ
I MIN.
000:00,
le MN.
(FU LASH
t PL�E;^01CF:
0� HEARTH
�
CHIMNEY HEIGHT
A.Hearth
Mat (ncn-comoustible) 0 k ,/A///4i /. l`
A. Materials • ,3 /
aC. Suomuor mdimensons CL / �7
C. Minimum dimensions(refer to ciagrami
Clearances and Wall Protection(see stove installation clearances chart)
A. Type of wall protection proviced
B. Clearances(refer to diagrams)
____,44 • --,
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FIREPLACE CORNER WALUCENTER
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