HomeMy WebLinkAboutBLD-80-209 velL� -Gi °�7,
I,� No. a 0 2
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,� � Application for a Permit to Build
Fee must accompan this application
Yarmouth Z Y....19fn.....
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TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications: �/
1. Name of Owner /U/aa by,L Address /� /�
2. Name of Architect (If any) -..
3. Name of Builder --,,,r,„10
4. Precinct No. Lot No. / Plan: Name or No.
5. Name of Street / a7tJCf/s,$ .<s-��o. Po'rcc,n'� ��j - /
8. Purpose of Building ho o c/ J2 vice
7. Material
8. Estimated cost of bullding �/cv.00 �} [�
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9. Dwelling
10. Cottage
11. Heat
12. Basement
13. Garage
14. Store •
15. Shop
18. 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
Show by diagram the location of propsed building with relation to distancesst/ from adjoining lots on re%rae side
Name...d../Sa t1.L.rere45.�.(//���'�a ��� //j/
Address /Z ./.�.G.r ' ••yLrL�!/.!�?.?.T'G.'.a"F:f�F'
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Rear of Lot ;
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Frontage of Lot
Street Name
PLOT PLAN
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:WO. OD STOVE INSTALLATION CHECKLIST
t�Permit
ci
' 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) New Used
B) Type/radiant ✓ Circulating
C) Manufacturer CTArrrs°A) Lab. label #'i/ /c/Y2-
Name/Model No. rr -tColiar size: .5"
Dimensions/Height 4/%y' Length /53/j" Width �2,2"
Chimney
A) New ✓ Existing
B) Size (flue area) lo "
C) Other appliances attached to flue (Number and flue size) /lf 6
D) Prefab(Manufacturer—name and type)/frg7A'% ,rc7s • ',nib R_ h S'S
E) Masonry/Lined Z3/Sr/l2tr / /
Unlined J Flue liner/HeatS -/72-174/4.1.5-5/0.Ttype & manufacturer)))
F) Height (refer to diagrams) 7)11 cap
O Vae i0 I le man.
.va•CO s�.
?min. is Io' A i .
Trn.
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' ieem.
«� (furl/ash )
a
ace CST rd.
Ell 7
4E3 HEARTH
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CHIMNEY HEIGHT
Hearth(min. 1 hr. fire resistance) A) Materials Arta �z
B) Sub-floor construction c?,,,n,,,,7-7.
C) Minimum dimensions (refer to diagram) ,
Clearances and Wall Protection(seestove installation clearances chart)
• A) Type of wall protection provided $r,C k '
B) Clearances (refer to diagrams) .
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Th FIREPLACE CORNER WALL/CENTER I