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1987-779 ,��_ FT'iT��l= ..-•,,.. a. n.. _ _ .. :$,: , i : ._'V[y�y+.. +ry • P4' 'Tli`;' ^ .. .e .�.;. —, �'y+. c N# j 1 F i CERTIFICATE 1 iJ OF V 1VC Lf TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK [aft November ib lq 88 Thu is to certify that work requested to be dune as shown by Permit No. 87- 779 has been completed. This *tructmve may be occupied as a Morel Office and Living Quarters l te , 9 French Mountain Motel 4 Owner LutIghw gas Warner ? By Order Town Board i TOWN OF QLIEENSBURY F Building & Zonins Inspector i BUILDING PERMIT TOWN OF QUEENSBURY No. $7- 779 WARREN COUNTY, NEW YORK o ,r PERMISSION is hereby granted to Luther Warner w OWNER of property located at Rte 9 French Mountain Motel Street. Road or Ave. ! I in the Town of Queensbury, To Construct or place a _ Motel Office & Living Space at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_ t . OWNER'S Address is Box 3203 Lake George , N . Y . 12801 r c r+ 2. CONTRACTOR or BUILDER 'S Name � Dave Harrington w CD rP 3. CONTRACTOR or BUILDER'S Address rf Hudson Falls , N . Y . 12839 4. ARCHITECT'S Name M ro G1 n S. ARCHITECT'S Address G rt B. TYPE of Construction — (Please indicate by X) r rt (X) Wood Frame ( ) Masonry S ) Steel l 1 M I-� 7- PLANS and Specifications "! No. 38 ' x 441 as per plot plan , specifications and application . 8. Proposed Use Motel office and living. quarters � r rr m r C> $5 . 04 C/o �,• June 1 , 88 $ 120 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES 79 �' n IIf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbury before the expiration data_) r Dated at the Town of Queensbury this 20th Day of November 19 $7 .C��. SIGNED BY � "' -�' � for the Town of Queensbury Building and Zoning Inspector _ n ro TO BE COMPLETED BY BLDG . DEPT . aw n / l� Application No . Jil7wre ©/ �lteenj6ut Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 ; x .. 1 ` _ ` I/ Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queen§4>ury, New York 12801 Variance No . NOVrI 2 Site Plan Review No . NU 01987 Lj/ Approve y : � '�" ':.11LC?i Nti . ., i�F. (;1{ y [ l `.. :i= f 'r• APPLICATION FOR BUILDING AND ZONING PERMIT t A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOvJING . The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description , plans and specifications submitted , and such special conditions as may be indicated on the Permit . The owner of this property is : ,, c( Y ----- P . O. Address l �,3^ �-o _.__ +� A-Z Tel . •� C7C�7 Property Location : / Tax Map Street number or building lot number Subdivision name ( if applicable) THE PERSON RASPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O. Address Tel . NO . Name of builder U `Address /'J r.! SGs �}/ r -4Tel . Name of plumber ( rmI" e Address ������Tel . Name of mason' p Vo & S Address -r f r �1�,1 t�' Tel . NATURE OF PROPOSED WORK : * ZONING INFORMATION : `}Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building drawn reasonably to scale and attached hereto , Alteration to a building * showing clearly and distinctly all buildings , (no change to exterior dimensions ) * whether existing or proposed and indicate all Other work. (describe) � set-back dimensions from property lines . Give * street and number or lot number and indicate whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED • * of septic disposal area . * * COMPLETE INFORMATION REQUIRED BELOW _ * Size of property / .S6-S ft X 34-97• ft _ * Existing building ( s) Size ft x ft . PROPOSED BUILDING AND USE : * Existing buildings ) Use Size of new structure 3 ft X 'A� £tom 42 Foundation-pier/slab raw partial/ * Proposed building , distance from property line (circ e one ) Front yard n� ft Rear yard ft No . of stories (habitable space ) Side yards * / ft and. ft Height ( grade to ridge ) Z ft if on corner , setback from side street ft If residential , no . of families No . of rooms ( excluding baths ) * OCCUPANCY INFORMATION No . of bedrooms * PRIMARY.' BUILDING - No . of bathrooms Z `W one family dwelling Primaryheating system e � LQ_C-_rf2tf. _ 5 * Two family dwelling Type of fuel ----- * Multiple dwelling / Number of units No . of fireplaces to be installed V/1 Py-2_ * Permanent occupancy Will a wood stove be installed? Transient occupancy Central Air conditioning? �. Business BUILDING STYLE, PRIMARY STRUCTURE Industrial / --- --- * _..Other �nFt� ,� Ranch Contemporary g cabin if addition , what will use be Raised rand Mansion Duplex ' - Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) Attached garage/one car/ two car/ car Private storage building ESTIMATED MARKET VALUE OF x Other CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . '�Denril Will any second-hand or ungraded -- lumber be used? If so , for what ? LCD �r Foundation wall material. Thickness Depth of foundation below grade (to bottom of foot '^ Ing) _ Will there be a cellar? V)41> Heated or unheated? 1� -Floor- sq. footage - sq ft Will there be a basement? V�-Will any portion be used as living space? ( If so , what port sq. ft . - - Type of use? --"� Type of roof - loped flat/shed/other Material of roof Size , wood studs "x C.z=� it spacing LL' "o . c . lengthft . Joists ( floor beams ) Ist . floor _ "X, �� "' spacingAA . c . span{S i � ft . Joists ( floor beams) 2nd . floor 2.. "X 1[ ".. spacing . c _ spa nl ft . Overlays ( ceiling beams ) "X " spacing "o . c . span ft . Roof rafters " x " spacing o . c . span ftf Roof trusses (pre-engineered) spacings" o . c . span _ft . Exterior wall finish 'T1 c ray{, -L of what material? WC DXr� f 1 {C, interior wall finish mac_ If a garage is to be attached , describe materials to be used for FIRE SEPARATION : 11V) c_`�>Y\Q VN O C�x ty y . Is there to be an opening between garage and dwelling? If so will a Fire-rated door , enclosure , and self-closing device be provided? -' Will a flue-lined chimney be installed? o Height above roof ft . Depth of chimney foundation below grade �-----' ft . Depth of firepl h mac : in , Water supply - Municipal r private well ,/ SEPTIC SYSTEM _ nce from ANY private well ( including adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury A F F I D A V I T County of Warren STATE OF NEW YORK I swear that to the best of my knowledge and belief the statements contained in this application , together with the plans and specifications submitted , are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertaining to the proposed work shall be complied with, whether specified or not , and that such work is authorized by the owner . SWORN TO BEFORE ME THIS Signature Owner , owner ' s agent , arcnrrect , contractor day of 19 Notary Public , Warren County , N . Y . SPECIAL CONDITIONS OF THE PERMIT : By _ --- ----- TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following : 1 . Grass floor area 2 . Type of heat 3 . is the building mechanically cooled ? 4 , Percentage of area of windows and doors A . Over 16 % Only 1 . F�b value of gross area of walls , roof / ceilingr7and floors exposed to ambient conditions ° ass 2 , Floor over heated spaces YES NO a . Are foundation walls insulated ? YES 1 . If YES , what is the R value ? 3 , Slab on grade YES NO a , If YES , what is the value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 , Type of insulation B . Under 16 % Only 1 . R value of roof and flo rs exposed to ambient conditions_ 2 . R value of exterior walls q �C 3 . R value of glazed area ti,. 4 . R value of doors - 1 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab a . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement /cellar wails ( below grade ) 10 . Type of insulation C . Controls a 1 . Thermostat maximum heat setting D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO a . If YES , R value of duct installation b . R, value of duct in other areas E , Piping Insulation II 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating 1 . Performance efficiency Gf� 2 . Temperature control setting maximum G . For Swimming Pool Only 1 , Maximum heating Telephone No . �' ( applicant ' s signaa re ) 'toyown df APPLICATION FOR SEPTIC .DISPOSAL PERMIT DATE �1A © / S LOCATION OF PROPERTY FOR INSTALLATION F �r,' /►tc � / r ) t /' V( Owner's Name: h 6 L*1 & S {�.rel-I yt- °1 Telephone: 7 'a;2- ; �O Address: _ kan 3 C� j Installer's Name: _ Telephone: Number of bedrooms (residential only Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: Flat Rolling Steep Slope % of slope Soil Nate: circle one: Sand Loam Clay Other / Depth: feet Grxn d Water: At what depth? feet Bedrock. or Impervious Material: At what depth? _ feet Percolation test: circle one: not required required. J rate min. inch. Domestic water supply: circle one; Municipal Well Other IF domestic water supply is a Well*, Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM : Septic Tank _ gal. (minimum size; 1,000 gal.) TILE FIELD: Each Trench feet J Total system length feet SEEPAGE PIT(S) : Number of J Size each feet by feet Size of stone to be used # / Depth or Thickness _ feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLED (over) c/ Section Il Septic System Inspections: A. All applications for septic system installation, alteration or repair, as required by the Town of Queensbury Sanitary Sewage Ordinance, shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing: 1 .) the proposed location of the system 2.) location and distance to lot lines 3.) location and distance to structures 4.) location and distance to any water supply 5.) size and dimensions of all tanks, distribution boxes, tile fields and/or drywells B. No system shall be covered before inspection and approval by the building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine of up to $250.00. C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further construction. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Ddsposal Ordinance. �`- Signature of responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE .9awn Of QuQan .1dury BUILDING and ZOT41NG DiEPARTM0 98 Bay and javiland Road,york R.O- i 8 Queensbury, N i2gCli ��� r REPORT BUILDING f t35pECTOR � NAMEr +C.� � ' ✓+w's LOCATION ff Pertni'b Nam` ' �� *'f* * * I,AIIII*� * APPgpVEI7 III,, YES 140 Footing/pier Forms Fo,andation WaterProofin9 Back.f i 11 Framin Roof in siding neer Masonry '~~ Rough IF I' ing Relief Val es�-� �--'�� Ext . Porche Finished Flo rs interior wrrim stairs & Railer �3s Cellar gain Ti e Concrete Floors Plbg . Fixtures Gar . Firep roof i Door Closers. Suoye Deti.ecto Chimney • xtssvz.�Txota • Foundati.on Floors Walls Ceiling x13sPECTxCfl3�� FxzsAL Ex.>r T?aCAL y 17RxVF�WA`I ,p�ppRoVAL �-- Final auilding suruey Next s cheduledlinspeceian { call when ready) / inn • ry n nspector 4ua. 6/sE' and-vl o �u.eeres � ei +'� �o cu+: ARTM�NI Bu1�QIP3Ca and yt7N{fIG QEP 1 Box 98 Bay and laviland Road. F�.Q Oueensbury. New York 128fli �� SPEC� QR ` 5 REpORYi BllIL IN 47Le NAME ` LOCATION Permit {3ta . Footin<3�pier FOrtnS Foundation Waterproof in9 ,pao]cfi3-1 F rama-ng goofing Siding e M asond gY' umb in Rou Relief Valves '• RXt . porches urs gin tshed F1 Inter for Tr rm Stairs & Raii ' gs T7ralln, le Cellar Concrete F1 ors�Y� res y Fire roofing �3__� --- J� rs Door CID Smoke 1]e ectors _. Chimney INSU7..M�T 4PI Founda ion Floors Walls FI£IA3 Er�gCTRICAI pR"iVE.WA'Y AppRpVAI.v - ----��r Final Building Sur w CGa llhy r ay7 NeY uled inspe sched ction s Re'marks" y s mw■"oo G and Z �,'� . t Bc�x 9 aJ 6U1LC11P1G oad. 12$4i Bay and Haviland tdt4ew •fork Queensbury, CTf7R ' S S2�PClft� f SUILS7ING NAMEfZ � (01 P+atnit T3c' ' ate * _�* _* * * ✓* p,FT'FttJV SS3 -* S -go Ift �.oQ,tinE3lPjex forms F undati.on 5ac]cf ill goof in9 S idin9 -~-- Y Veneer Masonr __��-------�"� ..�.----- _-- — gel �e P�ches Ex t 'Floor v in ishe d TriVa Interior PaiL t Stairs p i Tn`� +e Cellar grain concrete Floors fixtures Ga _ fireProofin9 Closers Dmo-ke Ue'tectors C hiraney l,p,TI413 = Fo�dation !�- Floors � ! Walls CeilinLSCTFI AL I73S1' E IF114 AL DRI- isup f NP"P[Z Sur �e'Yr�-�'"�� vines] Buildin - ready ed inspection (call next schedul ��pen y � u,rt� 10W++ O ARTAnENT j3UWt. NNG and ZONING DEP Bay and 1a�vjjand N$ Yank 128�x 98 aueenslnury, aUILDItlG INSPrCTC1R ' S REp [3R4'r NAME f '- f yj LOCATION D a t e PF ROV Ei7* -* y's f"No i Footiin'1fPreror�s vounda+tion Water1:)r0ofi119 Ba fill inCj Roof rng grdinr3 Vene Ma In ugh P1 umbiTs gel ref V alyes Ext Porch es Finished Floors Interior Tr im stairs & 3iailings� �� Cellar gr'n Tile i _e Concrete V-jb3 • Fixtures___ _-_----- Gar Fireproof int3_ �--- uoo.r Closers_ ----- 5moke pet ,,tt.ors Chimney �. It1�uUS.I-�TION c ` Foundat L-on Floors 4dalls r - - Ce5L iCAL I£15psCT1014 F 1N ET,ECT UK'LVEWN-y AFYF.OVAL�--�'��~~� Final Building, all whet' ready' Inspection t schedu Nex le y �wttr� n ., r3in9 Inspector + � .Jow11 " oNkN Qss�a.a�tinE*�� !-f and x 1 BOY 98 BiSiLi]iN'C' Oad, �.�' and Havi}and R ,(Ork 12801 I OueensburY. New � R � 501LDiNG iPSSF, �C"YCiR � E.PiJR j _ + LOCA ION / ' Y_ Perms �" ' * * * * _ Yes No Date* * * * * * * yr s rAF'7PROVEF FCyQtin9/'pxsx r" arm's WaterPr�'fing_ gackf ill F r arkinr3 ROof ing siding Veneer Masonr P l.usn'birig Roux M Relic- f valves es gxt . f,orcb -1 Finished Floors for Trim�� -- . late stairs cellar P. Drain "Tile GoncrQte 'Floors P1bg F fixture s Gar . F3Lrevroofing Door C105" oke Detectors Chimney "iI3S[}I.A'TS C7t3 Foundation Floors Ceiling CT TCNlL Xt3sFECSS �--- F S t3 p,L F LE till; Next schedul-ed iectiot� ( cal nsp l wlneY'XFin ea Y) _ lr,emaX�s~ . �' ,ram � ���� [,r_^►� I `1 C"row". Q '�Cuee►� Sbetr NIN'G L]EPAFtTMEC1T g�yILDING and ', 0 . 1 BOX 98 Bay and }{aviland �eaw vo k 12801 ()ueensburyl 'BUILDING IhiSFECTC3R + REFC)RT NAME /� C....f. LpCAT1pN permit - Date�___�--� * * * * * tic) t ooinv/1 e FO ( Foundation W aterpr,o f ing Back€ ill Framing Roof ing Siding BasOrn' veneer Rough Plumbing -- _ --- �..�--- Relief valves _---- Ext _ Porches Finished Floors Interior Railings Stairs `Tiles---- Cellar Drain Concrete Floors-�--' �Plbg - �- �- Fixtures ----Gar - F' ireProofing .-- Door Closers_.----- Smoke Detectors_ ---- Chimney IN SUI JP,TION Foundati.on Floors Walls Ceiling CTRUIC IN pECTION F I14 A31 Ey APP RR[JV AL nlrl�FwA 8ury .y Final. Building tlaxt scheduled insP e Lion (Gall- ,,Then ready) Remarlcs� a 1 dr+_ 1 Building Inspector TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 22$ Q1 TELEPHONE ( 5I8 ) 792- 5832 BUILDING INSPECTOR` S REPORT REQUEST FOR IN RECEIVED NAME Z,OCATION/ DATE O`! ` /r APPROVED YES J .NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL INSULATIO , FOUNDATI FLOORS WALLS CEILING L INSPECTIO CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES LS �- STAIRS-CLEARANCE & VALVE PLUMBING FIXTURES/R LI INTERIOR TRIM/PRIV CY B RS FINISHED FLOORS GARAGE FIREPROOF NG DOOR C LOSER (S) SMOKE DETECTOR �- FINAL ELECTRICA INSPECTION FINAL APPROVAL F CONSTRUCTION A SIGNED CER IFICATE OF OCCUPANCY MUST BE OBTAINED FR THE BUILDING DEPARTMENT BEFORE THESE PREMIS ARE OCCUPIED ! i REMARKS: 1 1 4 �f INSPECTOR TOWN OF gUEENSBURY BUILDING AND CODES DEPARTMENT BAX & HAVII.AND ROADS QUEENSBURY, NEW YORK 12801 TELEPHONE ( 518 ) 792-5832 BUILDING INSPECTOR' S REPORT R INSPECTION RECEIVED }� s 1G D to REQUEST om/ x NAME LOCATION �_, PERMIT # DATE ---- � A. PROVED Ec NO FOOTINGIPTE FORMS MONOLITHIC PD �PRooFSNG�� FOUNDATIONNIDAm L SACKFILL APPRO ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-1 INSETLATXON: FOUNDATION FLOORS WALLS CEILING 'isCFINAL, INSPECTION = CHIMNEY HEIGHT ROOFING SIDING ES/ EXTERNAL PORCH CES+ RRAI STAIRS-CLEARAN LS VAL PLUMBING FIXTUR SVACX DOORS �- INTERIOR TRIMI FINISHED FLU GARAGE FIREP OOFING DOOR CLOSER S) SMOKE DETE TORS FINAL ELECT AL OF CON qRu IAL INSPECT-T ON FINAL APPR A SIGNED CERTIFICATE OF OCCUPANCY BEFORE S BE BUI ING OBTSE PREMISE STHE ARE OCCUP ED;EPARTMENT THE REMARKS : lillle ecf I INSPECTOR BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YOHK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP /I DATE CITY OR VILLAGE TOyYMSHIP STREET ANO NO, OR C C'�f■ COUNTY - , ROAD AND POLE NO. �y.,1 I• i, {y„ A t I riN 44 1 1 PDLE NO CROSS STREETS 1$ r+ PREM SE L L TE 7 r ; OCCUPANT'S ILbIfVO C7 ON BLOCK LOT OWNER'S NAME '-� Ot'r I ANCY A!!` AND ADDRESS ' ! �.�} VUAWFNT�m . • Y .7 ,f / t r, y�. /. �:��,r . f • TEL, BSUPPLIED Iq,r �yi / //! r 1 FROM THEIR (`y- . P/f/r / `.p / '` OFFICE BUILDING IS NEW OLD ❑ WORK f-� DEFECTS IS NEW ADDITIONAL l) REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU STALLED NUMBER OF OUTLETS Ma of FIXI A BRANCH Lea` Lamp Reall"WA a MOTORS HEATERS CIRCUITS OFFICE USE tim CollingNLY silMty MIaII Recepla somba Pntdam Bracket No. Type M.P. Wtdfe A-fta. Eath Ne. E,al, No. Go"" INSPECTION Dow- sick $ttb- bass new mum fat Ff. 2nd FI, 34d FI. RE(MAKttb: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: OO NOT USE THIS SPACE. This apPlicaticn if intended to opener the aEoea•Iisfad ageipment to be inspected Brat if at funs of i You are authorized to make the itupecoon and mdiust the fee to cover the addtttpnal rW0000 ieM tlsarc is found tatditio al equipmunt ttet aMama listed, SIZE OF Mu*l r&4 M ProYidad by the appFaant.. MAINS FEEDERS ELECTRtLAA 1WS TOTAL CHARACTER WATTS O OF R E%POSED GAS TIME SIGN CONCEALED TRANSFORMERS OF WORK T BE VA STARTED COMPLETED SIZE (CAPACITY} SERVICE OVERHEAD SIZE OF SIGN ENTERS UNDERGROUND MAKER BUILDING OF SIGN tNSPECTI% N REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID pELAY BY GIVING PULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICAT{ON MAY BE RETURNED. DATE OF PRINT.NAME AND DRESS APPUCA0291m, _ NAME OF ,f� - ',� _ TURE APPLICANT I Lt'I it '" W iy 1'f ' Y dF SIGAPPLICANT { 'FI ".Mu `" �._ 'l.�^C-�-""\ STREET x -- CITY OR ADDRESS , r• TELEpHdNE POST OFFICE --.. -} ZIP LICENSE NO, CODE ± _ �. �_,''�'," WHEN APPLICABLE +6 EL (REV. t/se) . AfEPAR'ATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING