HomeMy WebLinkAbout0195 INDIAN HILL ROAD f
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Assessor's map and lot number .... .�.C1......:........CJ.:
a 7' SEPTIC SYSTEM MUST BE
INSTILLED IN
`- Sewage,Permit number ......................... ...... .......... y"✓ITF! q!�l COMPLIAq CE
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Y y�FTNET�� ; . TOWN OF BARN=Q ° ��BLE TOWN
`4 Z BA"STODLE,
°01639. BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ....... . e:.wc..... .............................................................
TYPE OF CONSTRUCTION . . ......••�••• :�'.`:`.�....................................................................................................
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.............. .......<..`�...19. 7.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..........3 ...... ...... ...... ZJ ...........................................................
ProposedUse \\ 1 v4 .1 y................................. .... ..........................................................................................
Fire District .........
Zoning District .....Q.........t............................... 4.�.
Name of Owner !�Cam. `!�?. :? ................Address �. ....by.n...
Nameof Builder ....................................................................Address ....................................................................................
Name of Architect ..................................................................Address .................................................................................
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Numberof Rooms ..... .......................................................Foundation ..id..... .. ,v ` ... .....................
Exterior s1-.W. .� �`^..... l/�Roofin ..................................
Floors S.. Interior
Heating l.v f Plumbing - �- �i.. �-
Lam.__................... ...---
... ................. ...........................................Approximate CostO
Fireplace
Definitive Plan Approved by Planning Board ________________________________19________. Area ...................ate.
Diagram of Lot 'and Building with Dimensions Fee :. .••
SUBJECT TO APPROVAL OF BOARD OF HEALTH
77
I hereby agree to conform to all the Rules. and Regulations of the Town of B r ble re rdi the above
construction.
Name ..........I........................... . ...............................
Blakely, George W.
1 1/2 story
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f"��° of Construction --, -------
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� Mot ��`- ! Lot .....................x
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% PERMIT,REFUSED
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