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NOTES and Data — (For department use)
D 0 NOT WRITE B E Loy T H I S LINE
V. PLAN REVIEW RECORD -- For office use
Plans Review Required Check Plan Review Date Plans Date Plans
Fee Started By Approved BY Notes
13UILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
'$
0
V111. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
`r
s,
i
APPI,IZ�l� OM FOR
PLAN Fl,---'XAMINATION AND
BUIL.,I]ING PERMIT
IMPORTANT -- Applicant to complete all items in sections: 1, I1, /it, IV, and IX.
337 State
Road
ZONING 1-3
AT (LOCATION)
DISTRICT
LOCATION
(NO.)
(STREET)
Faunce Corner Rd.
Speaker St .
OF
BETWEEN
AND
BUI
LDING
(CROSS STREET)
(CROSS STREET)
Plat
75 31
LOT c12QQ fit.
q
SUBDIVISION
LOT
BL
BLOCK SIZE
0
II.
TYPE AND COST OF BUILDING —
All applicants complete Parts A — D
A.
TYPE
OF IMPROVEMENT
D. PROPOSED USE — For "Wrecking"
most recent use
1 R]
New building
Residential
Nonresidential
2
Addition (If residential, enter number
12 ❑ One family
18 Amusement, recreational
of new housing units added, if any,
in Part D, 13)
13 Two or more fami ly -- Enter
19 Church, other: religious
3 �
Alteration (See 2 above)
number of units -- - - -- -->-
14 Transient hotel,
20 � Industrial
4
Repair, replacement
motel,
- or dormitory - Enter number
21 Parking garaple
5 ❑
Wrecking (If multifamily 'residential,
of units -- -- -- - - - - .-- --;�
22 � Service statiQ;n, repair garage
enter number of units in building in
15 Garage
23 Hospital, insiiitutional
6
Part D, 13)
Moving (relocation)
16 Carport rt
a
24 Office, bank,, rofessional
❑ P
7 �
Foundation
17 Other - Specify y
25 Public uti lit),,
only
26 School, librarmy, other educational
27 R] Stores, mercointi le
B. OWNERSHIP
8'
j
Private (individual, corporation,
28 Tanks, tower1-s
nonprofit institution, etc.)
29 Other - Spefcif y
9
Public (Federal, State, or
local government)
C.
COST
(Omit cnts4,a
Z ��
- Nonresidential - Describe in detail proposed use of bui ldlings, e.g., food
processing plant, machine
P 9 P
shop, laundry building at hos itall elementary
P� Y 9 P Y
10.
Cost of improvement,....** , , , , , , , , ,
""'�==
school, secondary school,
col le,ge, parochial school, parkintg garage for,
department store, rental office building, office building at •«j`dustrial plant.
To be installed but not included
If use of existing building
is being changed, enter prop o ed' se.
in the above cost
a. Electrical,......... . . . . . . . . . . . 09
e
;
C.-
c
b. Plumbing ................... 0 0 0.
C. Heating, air conditioning..........
d. Other (elevator, etc.), ........... .
O
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 sl;;ip to IV.
E.
PRINCIPAL TYPE OF FRAME
G. TYPE OF SEWAGE DISPOSAL
J.
DIMENSIONS
1
F.-2-Masonry30
(wall bearing)
40 Public or private company
4$. Number of
31 �
Wood frame
41 � Private (septic tank, etc.)
49. uare feet of floor area, Total square
all floors, based on exterior
32
Structural steel
'
dimensions ...............,.......
4
33
Reinforced concrete
Ho TYPE OF WATER SUPPLY
v
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 .................,.......
F. PRINCIPAL TYPE OF HEATING FUEL
I. TYPE OF MECHANICAL
35
Gas
Will there be central air
52. Outdoors ....... . .. ........,., , , , , ,
18
36
Oil
conditioning?
L.
RESIDENTIAL BUILDINGS Qik,%ILY
37
Electricity
44 Yes 45 No
53. Number of bedrooms
38
Coal
.........t, , , , , ,
39
Other -- Specify
Will there be an elevator?
Full
54. Number of
46 Yes 47 No
bathrooms
Partial, .-...... ,
z
O
N
M
M