HomeMy WebLinkAbout106 Berle Road (9)TO THE BUILDING INSPECTOR
of the APPLICATION FOR
PLAN EXAMINATION ANDOFSOUTHwCONK. BUILDING PERMIT
IMPORTANT— Applicant to complete all items in sections: 1, 11, 11 , IV, and IX.
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ZONI Q
I.7 DISTiAT (LOCATION)
LOCATION INO.) STREET)
OF BETWEEN AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D o
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use
1 New building Residential Nonresidential
2 Addition(It 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
3 Alterati n (See 2 above)
number of units— — — — 20 Industrial
14 Transient hotel, motel, 21 Parking garage4 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
6 Moving (relocation)
17 Other — SpeciJy (r 25/U Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP GWA2j1r= SIA N hu- 270 Stores, mercantile
8 LK Private(individual, corporation,
28 Tanks, towers
nonprofit institution,etc.) L01 G 29 Other — SpeciJy
9 Public (Federal, State, or
local government)
C. COST Omit cents) Nonresidential — Describe in detail proposed use of buildings, .g.,f ad
processing plant, machine shop, laundry building at hospital,elementary
10. Cost of improvement,,,,,,,,,,,,,,,, O 00 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 ......................
c.Heating, air conditioning.........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT S Od
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
30 Mae my(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 ....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company Total land area, sq.ft. ...........
43 Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL
51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors.......................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 No 53. Numb r f b dro me.............
38 0 C al
39 Oth r— Specify Will ther b an el vator?
54. Number f
Full..........
46 Y s 47 No bathr me
Portlal........
IV. IDENTIFICATION — To b complet d by all applicants
Nam Meiling eddr ss — Number, street, city, and State ZIP cod TTel. No.
Owner or LJ o r
Lessee
2. 02 1-11-319swo JLV(,
Contractor
3.
Architect or
Engineer
The owner of this building and the undersigned agree to conform to all applicable laws of this jurisdiction.
Si nature f applicant Address Application dot
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check
Plan Review Date Plans BY Date Plans BY NotesFeeStartedApproved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval I Check Date Number B Permit or Approval I Check Date Number BPPObtainedYPPObtained Y
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
V11. VALIDATION
Building
Permit numb r 11453
Building
Permit issued April 1 19 80
Bui Iding
Permit Fee $ 30.00
Approved by:
Air TITLE