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To the: INSPECTOR OF BUILDINGS:
The undersigned hereby apply for a permit to { alter / build } according to the following specifications and the plans filed herewith: |
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Street and No. |
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2. |
Owner |
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3. |
Architect |
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4. |
Builder |
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5. |
Class of Construction |
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Zoning |
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DESCRIPTION OF PROPOSED CONSTRUCTION |
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6. |
Size of Lot |
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7. |
Size of Building |
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8. |
Distance from Street |
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9. |
Distance from lot Lines |
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10. |
Number of Stories |
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11. |
Foundation on Filled Land |
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12. |
Foundation Material |
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13. |
Roof Truss Construction |
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14. |
Duplicate Plans |
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15. |
Estimated Cost |
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CONSTRUCTION AND PLOT PLANS IN DUPLICATE MUST BE SUBMITTED TO
AND APPROVED BY THIS DEPARTMENT BEFORE A PERMIT WILL BE GRANTED
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The applicant shall locate proposed building with due regard to lines, grades
and sewer location obtained from the Town Engineer. |
I hereby certify that the dimensions and other information
on the plans are correct and that all applicable provisions of Statutes,
Regulations and By-Laws will be complied with. The above is
subscribed to and executed by me under the penalties of perjury in
accordance with Section 1-A of Chapter 268, General Laws. |
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Owner's Signature |
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Builder's Signature |
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License No. |
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Home Improvement Contractor Reg. No. |
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