HomeMy WebLinkAbout101 Abbe Road Ext. r TO THE ]BUELDING INSPECTOR
of 11:16 APPLICATION FOR
TOWN OF SOUTH WV4DSOIt, COW PLAN EXAMINATION A N D
BUILDING PERMIT
IMPORTANT — Applicant to complete all ituns in sections: 1, It, III, IV, and IX. �
Q
I• AT (LOCATION) /�/ �� 8xf O\/everts I�p OGtOC PLLf 1/�'� ZONDISTINGRICT
LOCATION (NO.) (STREET)
OF BETWEEN Abbe R4 Lw • AND Aleve(rs Re4`
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND SOST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For•'Wrecking" most recent use
1 JZ New building Residential Nonresidential
2F7 Addition(1/residential, enter number 12 F7 One family 18 Amusement, recreational
Of new housing units added, i/ any.in Pace D, 13) 13 F7 Two or more family — Enter 19 Church, other religious
number Of units— — — — i 20 Q Industrial
3 � Alteration (See 2 above)
14 Transient hotel, motel,
4 � Repair, replacement � 21 � Parking garage
1 P P or dormitory — Enter number
5 a Wrackig (ifnumber multifamily
residential,
building n q ------- — 22 a Ma;pealstans tutionoii garage
9 / o/ units i
enter
of
15 Garage
Pan D, 13)
16 7 Carport 24 Office, bank, professional
6 F7 Moving (relocation)
17 F7 Other — Spec:/y 25 Public utility i
7 [-1 Foundation only
26 School, library, other educational i
B. OWNERSHIP 27 Stores, morcan+ile
28 Tanks, towers
8 Private (individual, corporation, 29 Other — Spec:Jy
nonprofit institution, ate.)
9 ,0
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 budding at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,, OQD school, secondary school, college, parochial school, parking garage for
department store, rental office building, office budding 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............
......... R ecrt 0-ri — R o4x X-Pa Va Ova
b. Plumbing ......................
e. Heating, air conditioning.........
d. Other(elevator, etc.)...........—
11. TOTAL COST OF IMPROVEMENT S QDQ
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — Li
for wrecking, complete only Part J, for all others skip t IV,
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 LJ Masonry (wall bearing) 40 Public or private company 48- Number of stories...............
31 Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ..................... 00
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 420 Public or private company �• Total lend area, sq. ff. ...........
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed .......................
357 Gas Will that* be central air 52. Outdoors.......................
36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37F7 Electricity 44❑ Yes 45 N No 53. Number of bedrooms..............
36 Coal AI
A*a Other— Specify AI A' Will there be an elevator? 54. Number of Full..........
SeQ Sat bathrooms
Q. �❑ Yes �Er No Partial........
IV. IDENTIFICATION — To b c mpl ted by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
owner ur T .S' . VV/ is to S lli✓ah Ave. So. k1j W d r of 6�1'f;�S/9
Lessee o��7�
z. O INN o .Sd. Wz WSQr- 6-'ol (� a3`69
C ontroc•or 06 a 7
3. 7a OF So,WA o� S w Sy//vay � . Soo /ns-10r
Architect or o6 Q7 y
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
1). ON/ %svo Sw/lIvay 4vP
DO 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 S
MECHANICAL
ELECTRICAL $
OTHER S
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date
Permit or Approval Check Obtaained 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
Bui Iding
Permit issued 19
Building
Permit Fee S
App ved b
Lin—
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