Town of Wales Building Permit Application

District:   □ Growth   □ General Use   □ Limited Rural

Map:  _________   Lot:    _________    Lot of Record (year): _____________

Historical Building?  Yes □   No □      If Yes, Year:  _____________

Is Lot in:  □ Subdivision  □ Flood Plain  □ Shoreland Zoning[1]

Office Use Only

   Permit#: _____________________

   Issue Date:  __________________

   Fee Amount:  $________________

   Approved by (initials) __________

Applicant:  ______________________________________________________ Phone:  ___________________________

Address:  _________________________________________________________________________________________

Owner:  _________________________________________________________ Phone:  __________________________

Address: __________________________________________________________________________________________

Property Street Address:  _____________________________________________________________________________

Contractor’s Name:  ________________________________________________ Phone:  _________________________

Address: _________________________________________________________________________________________

Proposed Use:  □ Single Family  □ Mobile Home  □ Garage  □ Addition  □ Barn  □ Renovations  □ Storage

                         □ Modular Home  □ Other (Please describe):_____________________________________________

                         □ Year Round Use    □  Seasonal Use

Brief Project Description:  __________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

Estimated Cost (Market Value of Labor & Materials): $________________  Finished Size:  ______________________

Will Building have plumbing?  □ Yes  □ No     Exterior Plmbg Permit# __________ Interior Plmbg Permit# ________

                                                                                           (Attach copy of Exterior and Interior Plumbing Permits)

Construction Details:

Foundation:  □ Slab  □ Posts 
□ Concrete Block  □ Concrete

Basement:  □ Yes  □ No

Headroom: ________ Floor: ________

Number of Stories:

  Present:        _____________

  Proposed:  ______________

Height of Building(s):

  Present:       ____________________

  Proposed:    ____________________

No. of Bathrooms:

  Present:       ____________________

  Proposed:    ____________________

No. of Bedrooms:

  Present:       ____________________

  Proposed:    ____________________

Framing Studs:  ____x____,____ O.C.

Rafters:  _____x_____,_____ O.C.

Joists:  _____x_____,_____ O.C.

Interior Finish:

 □  Unfinished  □  Drywall

 □  Other: _______________

Floor Covering: 

 □ Subfloor Only  □ Carpet
 □ Linoleum  □ Other: ___________

Heating: 

 □ None  □ Hot Water  □ Hot Air
 □ Other ______________________

Lighting:

 □ None  □ 200 AMP  □ 100 AMP

 □ 60 AMP  □ Breakers

Plumbing (Number of Fixtures):

  Present:       ____________________

  Proposed:    ____________________

Present Septic System is Approved for:  _______________ Bedrooms

Additional Permits, Approvals, and Inspections Required:

□ Plumbing Permit   □ Driveway Entrance Permit   □ Site Plan   □ Minor Subdivision   □ Major Subdivision  
□ Proof of Legal Standing   □ Deed   □ Shoreland   □ Fire Chief   □ Fire Marshall   □ D.E.P.   □ Planning Board
□ Board of Appeals  □  Culvert Inspection   □ Other: ___________________________________________________

Property Information

More than one use existing on the Property:

Accessory Use:  _________________________________

 □ Non-Conforming

Frontage:   _____________________ Ft.

□ Non-Conforming

Setbacks:                     □ Non-Conforming

____________           ____________          ____________

       Front                           Side                              Rear

Number of Dwelling Units presently existing on this lot:

  _____ Units    
Other structures:  ________________________________

Lot Size (sq. ft. or Acres):  _________________________

Contiguous Lots (Lot #’s):  ________________________

□ Non-Conforming

Total Sq. Ft. of ALL Buildings:

  Present:       ____________________

  Proposed:    ____________________

Lot Coverage (In Percent)

  Present:       ____________________

  Proposed:    ____________________

  District %    ____________________

Incompatible Uses:  (Buffer Requirement)

 □ Agricultural □  Forestry  □ Commercial
 □ Other: _____________________________________

DRAW A DIAGRAM OF PROPOSED BUILDING AND EXISTING BUILDING(S) WITH THE LOCATIONS AND DISTANCES OF THE WELL, SEPTIC TANK, LEACH FIELD, BOUNDARY LINES, DRIVEWAY, ADJOINING LAND OWNERS, LOT DIMENSIONS IN FEET, STREET LAND IS SERVICED BY, AND ANY OTHER ISSUES THAT MAY EFFECT THE PLACEMENT OF THE NEW STRUCTURE. (Or attach Site Plan or Blueprints)