HomeMy WebLinkAboutBLD-90-733 N
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cs-c .�..:55,c% Application for a Permit to Build No. y 3 3
UPON FINAL APPROVAL f✓ �� ��7 MAP 737 LOT • c..i--.2--
FEE MUST ACCOMPANY THIS APPLICATION. DATE 12=s--3 19. 7 6
The undersigned hereby applies for a permit to build /cs,-A779D
according to the following specifications /�'7/70
(----1-1. Name of property owner C1-) 442t5 /J - (Th LLtT Tel562-"k6
. Address /C io Pilo 1 i0 3ks- F--) I-AJ_ '71422 A
2.Name of Architect(if any) Tel.
3. Name of builder a 6- N'f2 Address
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
7. Construction address $t9-h'i£- /15 i9L61t4't_/ ipi1 /4unti pi.
Flood . Di trict 4
8. Date of subdivision Approval plain zone ' Zone
9. Private dwelling ❑ Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 -1-7 6 0.6 ,� �
r/ o1D, o'er ,lGgeoh s/oaz.
11. Commercial ❑ Kitchen
12. Other li Dining Rm.
13. No. of stories • Living Rm.
Bed Rm.
14. Foundation - Full 0 Half ❑ Crawl 0 Slab ❑ Bath
15. Materials - Wood 0 Cement 0 Other 0 Deck .
16.Type of heat - Oil 0 Gas 0 Electric 0 Other 0 Closed porch
17. Garage - 1 0 2 0 Family Rm.
Sun room
18. Swimming pool - Size Garage
19. Storage shed - Size Shed
20. 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 rearto ' e Side line
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LOT RELEASED BY rSignature
PLANNING BOARD Address /5 YJ&t -
Date ' v/`Z""'`"" / t 7 i
,a it :1). . Application to
•„ .'�r,.) Old Kings Highway Regional Historic District Committee allr
� 1 t 1 in the Town of Yarmouth for a ct(
CERTIFICATION OF EXEMPTION X0
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Application is hereby made, in triplicate, for the issuance of a certificate of exemption finder St 2tion 6,?nd 7 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, as amended for proposed work as describe4)below aFon plani,drawings, or photo•
graphs accompanying this application. -
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TYPE OR PRINT LEGIBLY &DATE .. 77)
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ADDRESS OF PROPOSED WORK A Ot4u pOS 011 L kV- ;ASSESSORS MAP NO. 1 3
1
OWNER r 14 IA et. 1=.5 A.1 - -713 C L ler ASSESSORSLOTNO. S a
HOME ADDRESS / ST h40in.3c+ i✓ L- �/- TEL. NO. 76.E-664PC
AGENT OR CONTRACTOR
ADDRESS ' TEL. NO.
This application is for exemption of proposed exterior construction on the ground that:
v. (1) It will not be visible from any way or public place.
❑ (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission.
(Check applicable box)
PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot, and, if an addition is involved,show-
ing location of existing building.
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New •
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[ 04✓/bib A.) cN /
SIGNED61 4
Space below line for Committee use. Owner-Contractor•Agent
4
7) 4 /1/)/= 0)
Received by H.D.C. The Cer ifiEate is hereby
Date a/y`7° �c✓j \ 7 ,` i i
N-�� r `.-tom., ,.�.. // r/ re y,v , '.i ice! .
Time �� r ,,,,,/,,,,-/ �.^ ',..,.i -..,
By we/ Date
C
i
Approved 0 the categories of work entitled to exemption are listed on
Disapproved 0 the back of this form.
WOOD STOVE INSTALLATION CHECKLIST
. Permit •--- •
A building permit is required for the installation cf any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and not to the stove construction.
Stove
A. New Used Ur&O1
B. Type/radiant Circulating t- .
C. Manufacturer /gnu* Lao.No.
Name/Model No. N Collar size
Dimensions/Height til
i I Length c/4•" Width 3S a
Chimney .I/'°
A. New Existing
B. Size(flue area) SX 1 Z
C. Other appliances attached to flue(Number and flue size) go-N IC
D. Prefab(Manufacturer—name and type) !`H/i4 �L y
E. MasonryiLined Flue liner •
Unlined (type d manutaeturert
F. Height(refer to diagrams) cap
•
a
cvgz Ict 1 I C !CII 1. _ 112`( MIN.
MN.
•
3'mimIC' - "'MN.I, c X '
_ 1 1IN.
I La
Irk-
F I le AC
AC:S-^'Lr.
pc.7.1 .
HEARTH
X 33/9°
CHIMNEY HEIGHT 1 V Q it /alt/lyo
Hearth(non-ccmcust,ble) G�CTL'
A. Matena!s G
oil S. Sue-flea ccnstrucnon t(
C. Minimum cimersicns;refer too.acraml
Clearances and Wail Protection isee stove instadaecn c!e=_rances chart) .
A. Type of wail pretectcn crcvicec
S. Clearances(refer to ciagrams)
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FIREPLACE CORNER WALL/CENTER .
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