18D-058 (39) ZONING
FRONT DISTRICT
- .
SIDE YARD SIDE •
REAR YARD
IX. SITE OR PLOT PLAN For Applicant
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — %'timber, strcc°t, cit., aml Stutc ZIP code Tel. No.
r
Owner or
Lessee
5 ( l L f �5 � iderz
2. a��Li_ense 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.
Signatur ap 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
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check 0_bttaitned 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
Bui Iding
Permit issued 19
Building
Permit Fee $
Certificate of Occupancy
Approved by:
Drain Tile
Plan Review Fee S—
TITLE
O� O
CEzt� of Nort4ainvton
$ � �lsssadplsetfs
�6 •
(office of the �nsvertor of `Puilbings APPLICATION FOR
ZONING PERMIT AND
Page Plot BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) DISTRICT
' (STREET)
OF
CATION (STREET)
BETWEEN
(CROSS STREET)
BUILDING (CjRO,SaSrySTREET) y f//1�� f
lGyyL,wy 73�`f�"�d` `,N"' `�.+'f.T �$'"-•i WY T BLOCK SIZE �r6..J L.f.?'_../+.-K�a'J..f
TTVVrvry �
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 171
1>< New building Residential Nonresidential
2 ❑ Addition([/ 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 of units— — — — --> 20 ❑ Industrial
3,K Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 El Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential,
of units —————-- — -� 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
g ( ❑
6 ❑ Moving (relocation) p ❑
17 Other — Specify 25 Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
28 0 Tanks, towers \ ',
8,K Private (individual, corporation,
nonprofit institution, etc.) 29X Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement„•••........... I of school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is be'gg changed, enter proposed use.
in the above cost 1 /
a. Electrical......
b. Plumbing ..................... c,.,i..., / % i°...
�' 1--�i'(.� � r�/il CJIi/fc"mot,
% r' /+
c. Heating, air conditioning.......... r
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. y
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS m
48. Number of stories................
30 Masonry (wall bearing) 40 Public or private company 49. Total square Feet of floor area,
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) all floors, based on exterior C'
32 Structural steel
dimensions ..................... 4t
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 Z Public or private company
50. Total land area, sq. ft. ........... ����^y
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ....................... 0
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
354 Gas Will there be central air 52. Outdoors........................
36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 F—] Electricity 44®.Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? Full..........
54. Number of
bathrooms
46F__1 Yes 47�No Partial.......