Code Officer Travis Tardif
Office hours vary by week -- check town website
897-3207
INSTRUCTIONS FOR PERMIT APPLICATION
The applicant is required to submit information needed on the permit form, incomplete applications will be returned without a permit. These instructions are provided to help you make out the application and to allow your application to be reviewed as quickly as possible. If you are unable to fill the application out completely, come in and meet with the Code Officer.
# 1
#2
# 2a
#3
# 4
# 5
#6
# 7
#8
Property owner - the legal owner of the property
Phone- legal owners phone number
If you are building, putting in, or changing the use of an existing driveway from a vacant lot to a
lot with a home on it, you must have a State Driveway permit before a building permit can be issued. Driveways on town maintained roads require a permit from the Road Commissioner. Property address - where is the property located that the work will be done
Owners address- this is the owners mailing address.
Contractors- person who is doing the work
Phone- phone of person doing the work
Contractor's address- address of person doing the work
Map- tax map number of property
Lot- lot number on tax map for this property
Zone- zoning district of property found on Zoning Map at town office Lot of Record- what year did you buy the property?
Contiguous lots- do you own more than one lot that touch? Yes or No.
Historical Building- is the building on the national Historic Register? Yes or No Proposed use- residential, recreational, commercial?
Special Zones- check any special zones the project is in then initial and date
Project description- describe what you intend to do including size of structure and
any decks garages etc.
#9
#10
# 11
# 12
# 13
# 14
# 15
Cost- estimated cost of the project.
# 16
# 17
# 18
# 19
Height of building - present height to peak then proposed height
# 20
# 21
# 22
# 23
# 26
#27
# 28
#29
#30
Number of stories- present number then proposed number.
Number of bathrooms- present number of full and half baths, then proposed
number
Number of bedrooms- present number of bedrooms then proposed number Present septic system is approved for- found on the front of your septic plans for
the system that will serve the structure
Year round use- check if the property will be used year round or seasonal Frontage- how many feet of road frontage does the lot contain? If the lot also has
shore frontage, please write that figure and indicate shore frontage. More than one existing use on the property- is the property used as residential
only, or is there a commercial use also?
Setbacks- write down how many feet the proposed structure will be from the
road, the sides of the property lines, and the rear property line. All town roads unless otherwise indicated are three rod roads (49 1⁄2 feet wide). Front, side and rear setbacks must be at least 25 feet from property lines and roads right-of-ways for new structures. Shoreline setbacks vary by district.
How many dwelling units are presently on the lot- write down one, if there is only one single family structure on the lot. Write down two if there is a home and an apartment, trailer or other dwelling unit on the lot.
Lot size- how large is the lot that you intend to build on? One acre? Two acres?
#31
# 32
#33
#34
Total SQ. FT. of all buildings- disregard this if the building is not located in a Shoreland
area. - otherwise write down the total square feet of all buildings including decks and out buildings within the Shoreland area now and after the structure is built. (The Shoreland Zoning map located at the town office can be used if needed.) Lot coverage (in percentage)- disregard this if the building is not located in a
Shoreland area. Write down the percent of the lot that is covered by all
impervious surfaces, these would include roads and driveways, patios, roofs, etc. areas that will not allow water to sink into the ground. Present, and after the project is completed.
Part of an existing subdivision - was the current lot ever part of a subdivision?
If yes please indicate the name of the original subdivision. Read sign and date the application.
SHORELAND AREAS
If you are doing an activity that will expose soil in a Shoreland Area, this application must be accompanied with a written soil and erosion control plan.
Your plan should include;
A site sketch of the property showing the areas to be cleared, and areas to remain wooded or undisturbed, including the required vegetated buffer along the shoreline.
In addition to the buffer strip, clearing is limited in all areas within the 250 feet of the water or upland edge of the wetland to 25% of the lot or 10,000 sq. ft., whichever is greater. This includes buildings, lawns, driveways, and septic systems.
Also show the location of silt fence, hay bales, and diversion ditches used during construction.
Include the location of permanent structures, such as landscape walls, terraces, and patios. Remember that these features must also meet shoreland setbacks and not be located within the 100 foot buffer strip.
A schedule for temporary and permanent mulching and revegetation must be attached. At a minimum all disturbed sites need to be temporarily mulched within one week.
Town of Livermore Building or Use
Permit Application
1. Property Owner:
3. Property Address:
4. Owners Address:
5. Contractor:
7. Contractor's Address:
2. Phone
6. Phone:
For office use only
Permit No.
Issue Date:
Fee Amount:
Approved by:
2a. If access to property is from a state or town road have you attached your Driveway permit?
8. Map
9. Lot
10. Zone
11. Lot of Record What year:
12. Contiguous Lots
Lot No. (S)
13. Historical Building? What year:
14. Proposed Use:
15. Cost:
16. Special Zones
Shoreland
Wetlands
Initials
Flood Zone
Lowlands
1
Sand Dune
Date
C.E.O.
17. Project Description:
18. Number of Stories
Present
*
Proposed
19. Height of Buildings
Present Proposed
ft.
20. No. of Bathrooms
Present
ft.
Proposed
full
half
21. Number of Bedrooms
Present Proposed
22. Present Septic System
is approved for:
23.
Year round use
Bedrooms
Seasonal use
*
Proposed = Total, existing + requested
F-2-1
24. The following inspections must be done on all structures.
Also erosion controls and setbacks will be inspected.
Mechanical, gas, electrical, plumbing inspection shall be made prior to concealment and before fixtures are installed.
State mandated fire code, including: egress windows, tread height and width, closet door locks, etc.
Final inspection after the permitted work is complete and prior to occupancy.
Unless otherwise indicated all town roads are three rod (49 1⁄2 foot wide) roads and setbacks will be measured based on this distance. State roads may be wider.
26. ROAD FRONTAGE
Nonconforming
28. SETBACKS
Ft.
Property Information
27. MORE THAN ONE USE EXISTING ON THE PROPERTY, Accessory use:
Nonconforming
NONCONFORMING
29. How many dwelling units are presently
existing on the lot:
Left Side
Right Side
Front
Rear
30. LOT SIZE (IN SQ. FT. OR ACRES)
Nonconforming
31. TOTAL SQ. FT. OF ALL BUILDINGS
Present
Proposed
32. Lot coverage (in percent)
Present
Proposed
Zone %
33. LOT PART OF AN EXISTING SUBDIVISION?
Yes
No
Original name of Subdivision
34. BUILDING PERMITS DO NOT INCLUDE PLUMBING, SEPTIC OR ELECTRICAL WORK.
Building permits are valid for one year; any false information may invalidate a building permit and stop all work. Signing authorizes inspections necessary to issue permit and insure compliance with regulations. Applicants acknowledge that they will comply with all town codes and laws.
Applicant
Date
F-2-2
Plot Plan
PLEASE INCLUDE ALL SETBACK DISTANCES FROM PROPERTY BOUNDARIES, ROADS, STREETS AND RIGHT OF WAYS; ALL WETLANDS AND WATER BODIES; ANY EXISTING WELLS AND SEPTIC SYSTEMS. INCLUDE SHORELAND SETBACK OR FLOOD ELEVATIONS IF APPLICABLE. SHOW ALL PROPOSED DECKS AND PORCHES.
Note; Distance from road right of way must be at least 25 feet to any part of new structure.
Name of Road
Minimum distance to new structure from center of road
feet
Town of Livermore Building or Use Permit Application continued
Front or Rear View
Side View
Elevations