Return home___
| Complete and Return all copies to the Code Enforcement Officer | ||||||
| I. Location Street N S E W side of __________________________________ |
From Tax Maps Map - Lot _____________ |
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| II. Type of Improvement __ Renovation __ New Building __ Addition __ Repair __ Wrecking __ Foundation only __ Other: |
III. Total Cost of Improvements (materials & labor) $___________ | |||||
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| V. Details of New Work (all dimensions in feet) | ||||||
| Type of Water Supply __ private __ individual __ shared |
Type of Sewage Disposal __ septic system __ cesspool __ other: plumb. permit or DEP lic. # |
Heating Fuel __ oil __ electric __ gas __ other: |
Cooking Fuel __ oil __ electric __ gas __ other: |
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| Dim. of new building ___ x ___, of new addition ___ x ___, No. stories ____ | ||||||
| Foundation (type) __________ thickness __________ cellar __________ | ||||||
| Type of frame wood______ style roof __________ roofing __________ | ||||||
| If garage __ __ attached __ separate dimensions ___ x ___, No. Stories ___ | ||||||
| If dwelling __ No. rooms to be finished ___ Baths ___ Sq. Ft. floor area ___ | ||||||
| Fireplaces: __ no __ yes # ____ Woodstoves: __ no __ yes # ____ | ||||||
| General description of work (interior, exterior, finish, etc.) Note: All housing construction should provide access for emergency vehicles. |
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| VI. Identification | Address | Zip | Tel. No. | |||
| Owner: | ||||||
| Contractor: | ||||||
| Electrician: | ||||||
| Architect: | ||||||