28-005 (6) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT 7
USE
FRONT ■
SIDE YARD SIDE YARD
REAR YARD
NOTES
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IV. IDENTIFICATION To be completed by a// applicants I
Name Mailing address Number, sirccl, ,it%, and '�Iaw ZIP code Tel. No.
Lessee
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
Qv
DO N 0 T WRlTE 8ELQW TH | 8 L | NE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started A pproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approva I Check Obtained Number By Permit or Approval Check Obtained Number By
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADE S
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
Permit number
Building
Permit issued 19
Building
Permit Fee $
Approved by:
Drain Tile
Plan Review Fee
� r
(rity of Xort4ainp ton
$ � #�lsssaclptsetfs
T O fire of the �nspertor of Auitbings
APPLICATION FOR
Plot 1 ZONING PERMIT AND
Page — BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
r ZONING
I. AT (LOCATION) �°"� � g , 1✓ '+ A DISTRICT
LOCATION (NO.) REET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET) {�\
LOT
SUBDIVISION LOT BLOCK SIZE
CA
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D M
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 [2� lew building Residential Nonresidential
2 Addition(1 residential, enter number
/ 12 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
units -------- — --� 22 ❑ Service station, repair garage
5 ❑ Wrecking (If multifamily residential, of
enter number of units in building in 15 Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) f
17 ❑ Other — Specify �� =-�—K.�.�.,:�;- 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP
v 27 ❑ Stores, mercantile
-"�:= '
8 ❑ Private (individual, corporation, _ f } ® 28 ❑ Tanks, towers
nonprofit institution, etc.) , - 'S 29 ❑ 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................ Q 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 being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing ..................... 1
, -
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$
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
0
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS m
30 D Masonry (wall bearing) 40 ❑ Public or private company 49• Number u stories.......area, .
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet n floor area,
all Floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
` '0E ' 42 Public or private company 50. Total land area, sq. ft. ...........
34� Other — Speci/y �C itr' l�� ❑ P
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
C° /-T- PARKING SPACES
51. Enclosed ....................... r
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
46 ❑ Yes 47 ❑ No 54. Number of bathrooms
Partial.......
?,
1 hereby certify that the proposed_ work is authorized by the owner of record
and I have been authorized by the owner to make this application:as :his:
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. PILE COPY
Zp
CITY OF NORTON BUILDING �a
NORTHAZ:I IMj YAW# PERMIT VALIDATION
28 - 5
DATE Sei)tember 16, 19 77 PERMIT NO. 464
APPLICANT Summ Rauthier ADDRESS 3(* Sylvester Road
(NO.) (STREET) _ (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Tletaekwj G$rjj _(1 ) STORY C DWELLING UNITS
(TYPE OF IMPROVE NT) NO, (P .POSED USE)
�)�
ZONING
AT (LOCATION) 394 S (lve8ter Road DISTRICT
(NO.) (STREET)
a BETWEEN AND
rn
(CROSS STREET). (CROSS STREET)
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
CD
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
0:
o REMARKS: Consi nac+'t aarage_& sto=ge area
AREA OR PERMIT
VOLUME ESTIMATED COST $ 1,�2�Q FEE $ 10-00-
(CUBIC/SQUARE FEET)
OWNER Louis% F` A S plan Re»th_inr
B U I LD I N D E
ADDRESS 394 yY13m,%ter Road- Nnrtba=tnn
/
BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)