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HomeMy WebLinkAboutBLD-80-327 • rns\c,o Y/— 6 oz 7(0 61 , J 1, No. 3c2 1/2 tApplication for a Permit to Build Fee must accompany this application Yarmouth .. ..11iG.ae...../., ....19.. Q - 6G/6n TO THE BOARD OF SELECTMEN The undersigned hereby applies for a permit to build, according to the following specifics ons: fr 1. Name of Owner /4 ' eeeellf/'✓ t /r 7 Address /2 p I i /er __ _or .� 2. Name of Architect (if any) /- I .Y .. _ . . . 9 3. Name of Builder - �� -ear _ . 4. Precinct No. Lot No. PPlaann: Name or No. 5. Name of Streetd /,,-�- x�i/�ti��7�'LD /�, �i( zti 6 Purpose of Building _l 7; Material \ -444-0-51C-Ci 8. Estimated cost of building )? /1 , C9--10 — 9. Dwelling _,D 10. Cottage �(/ 11. Heat 12. Basement • 13. Garage V 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 Show by diagram the location of propsed building with relation to distances from adjoining I is n reverse side. t Name .. ,..c...ezit Address.,[. er./ ./. . .c... ..C.....Rc. e Street Name _. -o o Left Side Depth of Lot -d { r Z co m p - y 0 z O : 0o e 0 p -- -- Right Side Depth of Lot Street Name 4� .T WOOD STOVE INSTALLATION CHECKLI� ♦ 1 •j e1 ' i i"� 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 -- '=;� -- t -- I . I _ _�� c=__ • A) i1ew —� U4Used_:. . _ ---t---:-'----------- 1-‘4., - F r, B) Type/r slant - -.10-7--:- Circulating . :_ . " -et I C) ManufacturerMIS Cab. label , ` Name/Model No. ,- -, ,___H Collar size - - . - �i _� Dimensl s/Height � ��! Length �tf /��Wldth_,� :., I t / Chirnne % . i' A) • New /lipExisting s -B) Size (Nue area) 6, I' i , , .. i 'C) Other appliances attached to flue (Number and flue size) Ot_itjrz.. . - D) Prefab(Manufacturer—name. and type) • - E) Masonry/Lined a, (et-7- Unlined f Flue liner c- -_� = _, ___ (type & manufacturer) r F) Height (refer to diagrams) 9 //a tl cap t: 12 min. Al - J OVer IO • rsr10 I • Cr ¢ IA - \ Tit (fuel/ask ) _ �; ... test rale I i- * L...... 1►.I HEARTH . . . CHIMNEY HEIGHT I • 4 - - - � �. ' - - Hearth(min. t hr fire resistance) A) Materials B) Sub-floor construction ' -=' C) Minimum dimensions (refer to diagram) Clearances and Wall Protection(see stove installation clearances chart) A) Type of wall protection provided - B) Clearances (refer to diagrams) -- - - t • 17 - - — i ' ' '"-' WALL/CENTER FIREPLACE - „-- ,,, ;1s.. ,:. - CORNER «e:i it..- it w < 1