29-359 ZONING •
DISTRICT
USE
FRONT YARD
SIDE -D SIDE YARD
REAR -D
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NOTES and Data — (For department use)
i
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — %'umbc°r, street, rite, and State ZIP code Tel. No.
Owner or i
Lessee
Bui der's
L.
License No.
Contractor
3.
Architect or ------ -
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
Permit number '
Building
Permit issued 19
Building
Permit Fee $
Certificate of Occupancy
Approved by:
Drain Tile
Plan Review Fee — `
t TI LE
o� ro
(rzty of Xort4amptou
$ � �lxss�lciplsctfs
Offire of the �nsprrtor of 3guilbings APPLICATION FOR
ZONING PERMIT AND
Page Plot BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
f ZONING
I•
AT (LOCATION) .r1y� ° r ^� DISTRICT
LOCATION (NO.) (STREET)
OF .BETWEEN I AND
BUILDING (CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
y
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13) number o units— — — — --� !"
J 20❑ Industrial
3� Alteration (See 2 above)
14 Transient hotel, motel,
21 Parking garage
4 0 Repair, replacement or dormitory — Enter number
5 F-1 Wrecking (If multifamily residential, of units ——————— — -i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other — Specify``' 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational o
B. OWNERSHIP 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed upe of buildings, e.g., food
processing plant, machine shop, laundry building a't,h9spital, elementary
10.,-,Cost of improvement••••••..,....,.. school, secondary school, college, parochial school;;'parking garage for,
14epartment store, rental office building, office building.at industrial plant.
To be installed but not included If.use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS m
30�.Masonry (wall bearing) 40 ❑ Public or private company 49• Number of stories..•... area, ...
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square Feet n floor area,
all floors, bored on exterior
32 ❑ Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other — Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ....................... r
F. PR CIRAL,TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
'35 s
Will there be central air 52. Outdoors..............
conditioning?
6 L. RESIDENTIAL BUILDINGS ONLY V1
37 Ele tdty 44❑ Yes 45 ❑ No 53. Number of bedrooms.............. I
38 Coal ' '
39 ❑ Other — Specify Will there be an elevator? F01..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms Partial........
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this applicationi h�lr` wy
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY_ .,. TITLE
DATE 19
— DEPT. FILE COPY
ZO
7-
CITY OF xox rPTON BUILDING a a
NoftniR.Cit .N, ph, PERMIT VALIDATION
29 - 359
DATE ggptember 28,_19 22 _ PERMIT NO. 493
APPLICANT Maureen Novotny ADDRESS P1_Acrehreok TIr- �
13
(NO I (STREET) (CONTR'S LICENSE)
PERMIT TO &M n mn (_} STORY =ad y NUMBER OF
'�
(TYPE OF IMPR ��1r � �VEMENT) NO. (PROPPOS�EEDDyUSSE) DWELLING UNITS
ZONING
AT (LOCATION) 251 Ac.rebrook Drive DISTRICT IMA
(N0.) (STREET)
a BETWEEN _-_Austin Circle AND 11st3n aaire-le
(CROSS STREET). (CROSS .STREET)
a
a LOT
m SUBDIVISION LOT BLOCK SIZE
a
m 0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
Ir - (TYPE) -
IL REMARKS: Add chi aneyt f= waW stoV@
AREA OR PERMIT
VOLUME (CUBIC/SQUARE FEET) ESTIMATED COST $ FEE $ IA on
t
OWNER NuAlzeei{ NQyp} v 8UlLDIN/7/DE P
ADDRESS 231 Aembi�t�ok D-vine BY
(Affidavit on reverse side of application to be completed by alt o agent of owner)