HomeMy WebLinkAboutBLD-80-119 4/20 d�i>' t: No. Il
u "•' 3 ��� Application for a .Permit to Build
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Fee must accompa this application
Yarmouth 3 /'1 19.A "
.3-i 7-ft)
TO THE BOARD OF SELECTMEN
The undersigned hereb applies for a permit to build, according to the following specifications:/ ti24
A
L Name of Owner�� ,.r 6j ,/X-^�� Address Jig ✓ iG ^"0 `
2. Name of Architect (if any)
3. Name of Builder o 'er
4. Precinct No. ��[[ Lot No. L� Plan: Name or No.
5. Name of StreeEZ W2E&a- p Qat t�'�'/
6. Purpose of Building & t1-et.( A-GZz`a
7. Material
8. Estimated cost of building 4i,1/0 0 °
9. Dwelling
10. Cottage
11. Heat
12. Basement
13. ' Garage
14. Store •
15. Shop '
16. No. of stories
17. Is there to be a Store in the lower storey
18. Size of Lot. No. of feet front No. of feet rear No. of feet deep
19. Size of building. No. of feet front 1 No. of feet side No. of feet rear
20. Distance from nearest building: Front ft.; side ft.; side ft.; rear
21. Distance back from line or street , from rear lot line side line
Show by diagram the location of propsed building with relation to d noes from ad' ' ' g lots, on reverse side.
Nam ... x ule:: '.. ... .
Address-9,72 41.4S f ci "1/ .. tit tfn..!
Street Name
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O Left Side Depth of Lot -
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r .
a
z
m ° 1
^ e
Z
0
0 O !
e.
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0
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Right Side Depth of Lot
t
Street Name
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WOOD STOVE INSTALLATION CHECKLIST 0P /Ii
• Permit
'A 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.
Stove a : C
SJ
A) aew ✓ Used
B) Type/radiant ✓ Circulating
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C) Manufacturer CApa�vc Lab. label 11L Spec / z/ t2
Name/Model No. CoA/ Ceexc, Collar size a "
Dimensions/Height a y" Length /est Width /9 t
Chimney
A) New / Existing
B) Size (flue area) 8'"
C) Other appliances attached to flue (Number and flue size) /xret
D) Prefab(Manufacturer—name and type) `J4uZ/&.747;
E) Masonry/Lined 1.---"-
Unlined
Unlined Flue liner , i:44/JrCTs,P4I'e %«-
(type & manufacturer)
F) Height (refer to diagrams) . ...le cap cy40
•
I I OVII IO I , 14
IZ T//..
OVII IO
I QT ha' Z X
�Iwiw
9 nin c+Ip. /o' �4. �
TIO.
I ` I I
(Fa Vatb
_ atter+ rade)
Or
Li... A HEARTH
CHIMNEY HEIGHT
Hearth(min. 1 hr. fire resistance) A) Materials construction
//�� -//
B) Sub-floor construction LJda� A ir nt
C) Minimum dimensions (refer to diagram) ' ,
Clearances and Wall Protection(see stove installation clearances chart)
A) Type of wall protection provided)! l2.a..- i d-.e //. a d'►/ .41. c/
• B) Clearances (refer to diagrams) Ste.-.. T`r�/u4.7"�see, 30"tylX9e
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9
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FIREPLACE CORNER
WALL/CENTER