HomeMy WebLinkAboutBLD-80-152 (64 West Yarmouth Road) ottO J� il
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L,t lv (u? ... No. /5a.
flit' Application for a Permit to Build •
Fee must accompany this application �`
Yarmouth /71-11r-C.‘ 'z t 19..R v
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TO THE BOARD OF SELECTMEN
The undersigned hereby'ebapplies for a permit to build, according to the following specifications:/ / ,
1. Name of Owner, re-Fon B/A-1 9 4n y)/ Address 6y 1y�J 1 j774{i rrwv I✓!'_get
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2. Name of Architect (if any) rmUflTl /"Q
3. Name of builder
4. Precinct No. Lot No. Plan: Name or No.
5. Name of Street, 6 4/1/470VO,t,
Re( - (4 P Craq--
6. Purpose of Building ,�j<Z vC S�r1S'L
7. Material
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8. Estimated cost of 3eitdf-'gStF•u.e- .lJv co.
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 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
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Show by diagram the location of propsed building with relation to 'stance from e.' ,,. ng lots, r•�erse side.
Name�� • o •
Address .t.a
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Street Name
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o : Left Side Depth of Lot
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Right Side Depth of Lot
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Street Name
WOOD STOVE INSTALLATION CHECKLIST.
Permit
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) uew Used
B) Type/radiant ✓ Circulating
C) Manufacturer G,..27„ P, Lab. label / y- L
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Name/Model No. c,.ap ,g,�Collar size '
Dimensions/Height „2 ",,, Length at. Width /4 '
Chimney
A) New Existing✓
(1) Size flue area j1.1-6rct
C) Other appliances attached to flue Number and flue size) i✓oN£'
D) Prefab(Manufacturername and type) s-c. c
E) Masonry/Lined
Unlined Flue liner
(type & manufacturer)
F) Height (refer to diagrams) 45-1 cap
Iover Jo' I , I_ T/
TI * n.
ever 10
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/o /2
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ewers sale)
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La. lir T
Nor HEARTH
CHIMNEY HEIGHT '
Hearth(min. 1 hr. fire resistance) A) Materials Qyccl
B) Sub-floor construction ott.,..d
C) Minimum dimensions (refer to diagram) '
Clearances and Wall Protection(seestove installation clearances chart)
A) Type of wall protection provided
B) Clearances (refer to diagrams)
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FIREPLACE CORNER WALL/CENTER I