HomeMy WebLinkAboutBLD-80-391 to m
kiA
� J No. 3 9 I
Application or a Permit to B Build
Fee ust accompany this application �/
Yarmouth /9 19.1r6.
TO THE BOARD OF SELECTMEN 7—/1/4-132"
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner VI(.30Rf AND 12toaa i Address 6-3 C112GU� f Rc( . I.1 ti7 •
2. Name of Architect (if any)
3. Name of Builder
4. Precinct No. // Lot N/o.. o1y/(� Plan: Name or No.
5. Name of Street 5`3aRv,7' IcJ' • „fie) .(S 3) wood SIO
6. Purpose of Building
•
7. Material
/�/}w�
8. Estimated cost of building�f✓" .
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 fronq 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 lots, on reverse side. - _ `
Name �f.1/ a �• L.l ..........
Address ,. 73 C/.[.4i, f j`..1...1.. _..l�s •. Gi �
Street Name
• v
p Leh Side Depth of Lot
-i
r. w
Z
a p�
0 R C
•4 Y Q
z WC r
0
C
_ I
t ,
Right Side Depth of Lot
Street Name
i
'+,>r1WO0D STOVE INSTALLATION CHECKLIST ,
Permit - . -
A building permit is required for the installation of any solid fuel burning
C
• Appliance..• The building permit and installation inspection are limited to the
stove installation and not to the stove construction.
Stove . c , — }__ 1--:-.:---SI.',
' B) Type/radiant - --r=.: Circulating ra .:._f_.'-/ti •
C) Manufacturer, • • • Lab label
. -
r t
Name/Model No:;.S..ti agy,n ton sire ^. 4_i� -
Dimensions/Height. - ,Q " Length --"— Width -/g �_al Y
r
Chimney YI. 1 ; ._.. �: .,._-�`, .r
.`A) New i ' • Existing ' . K - =
- .B) Size (flue area) 3(• i'X•2710r,
, SC) Other appliances attached to flue (Number and flue size) (r
D) Prefab(Manufacturer—name- and__ type) - •
E) Masonry/Lined - ;%o. '` . .
Unlined X Flue liner" '
• __ _, ___�. - --- . _ _ „,•.- (type & manufacturer)
F) Height (refer to diagrams) • ` "cap
•
,,
1 I over to 12 mon .
Ai �O �• i
T
Milieu.
Biwa,. a}lo _ ro• _ ir
;X
I
x
IB mIR
(fuel.... .)
'
it ' I HEARTH
CHIMNEY HEIGHT ". . '
A)
Hearth( Materials _
min 1 hr fire resistance) 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 _I
• ' B) Clearances (refer to diagrams) -- - -- -
; X . _ .•- , •
�_
17 '
I'e'FIREPLACE" •.- .i , r:-..— • WALL/CENTER
•• .-.- rr ar' c . CORNER seeif lbs.- • is