1987-823 a
c ' CERTIFICATE OF OCC�..7I'AN"+CY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
} Date _ /�- 19
This is to certify that work requested to be done as shown by Permit No. 87- 823
has been completed.
This structure may be occupied as a One Famlly Dwelling
Location 7 Stanet�x�r� � ry
David Harvey
G7rwrner
By C rder Town Bawd
TOWN OF QU'EENSBURY
fdl3 f d f
Building 6 Zoning inspector
Y ^ BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87_823 �
WARREN COUNTY, NEW YORK
�
PERMISSION is hereby granted to David Harvey * i
OWNER of property located at Lot # 17 Stonehurst Street, Road or Ave.
in the Town of Queensbury, To Construct or place a One family Dwelling
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_
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1 . OWNER'S Address is RD 1 Box 1432 �
Lake George , N . Y . 12801
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2. CONTRACTOR or BUILDER 'S Name
Same
3. CONTRACTOR or BUILDER'S Address. C
O
rr
Same
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4. ARCHITECT'S Name zn
rt
d
M
G
H
5_ ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by XI
I N Wood Frame I ) Masonry ( i Steel
7. PLANS and Specifications o
26 ' x 72 ' as per plot plan , specifications and application including 4
N�septle system and attached two car ,garage .
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I�
S. Proposed Use
One Family Dwelling
to
N
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$5 . 00 CIO aka
$ 171 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 1 , 19 88
(if 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 date.)
Dated at the Town of Queensbury this 7th Day of , December 19 87
SIGNED BY Z C' � . AL e� for the Town of Queensbury
Building and Zoning I nspector
TO BE COMPLETED BY BLDG. DEFT .
�] / Application No .
.✓Oran Oiseen � 6uMt Permit Issued 19 ! Ir l� . _. ..
BUILDING and ZONING DEPARTMENTPermit Expires 19
Bay and Havlland Road, R.D. 1 Box 9$ Zoning Designation NOV 2 ��{�7r
Queensbury, New York 12801 variance No .
r� Site Plan Review No . r 1111L_QPI vG a CODE -
1 Approved by : �-�4
APPLICATION FOR
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING .
The under:,igned 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 .
---------�� . . . _, ,_-------- . . . . - -.--- - ....W.eeee __,.._..
The owner of this property is : JJsrrN
Il
P. O. Address i .� L �' k �y 3 L u +fie G e� r A/ . _ Tel '193 `✓ / 1- c<
Property Location : S+)p et 4* �_--•S rI .-.+e + :i Tax Map No .
Street number or building lot number
Subdivision name (if applicable) J' ` - e - 5
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
- Name P. O. Address �-� E G rTCaj 0 No .
Name of builder Jaty , ek VI1 . dress IV - ` Tel .
Name of plumber 1 e_.-r o2 a r- Address W G , n ' � 5 t Glctis idel .
Name of mason -%dL 5. C n 5�. PV a s Gw_d-Address 5- ' _r 42 1- x n -Dr . / _ jz//�e1 .
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 AFFECTEDa
of septic disposal area .
*
* COMPLETE INFORMATION REQUIRED BELOW .
* Size of property as c' ft X ft .
* Existing buildings ) Size ft X ft .
PROPOSED BUILDING AND USE : * Existing building (s ) Use
Size of new structure ft X / ft
Foundation-pier/slab/crawl/partial f proposed building, distance from property line
(circle one)
* Front yard /� �'�„ � ft Rear yard ,r-- ft
No * of stories (habitable space) 4 �,
side yards �"V ft and � ft
Height ( grade to ridge ) c� "] If on corner , setback from side street ft
If residential , no . of families
Noe of rooms ( excluding 'baths)
OCCUPANCY INFORMATION
No . of bedrooms 147f PRIMARY BUILDING -
No. of bathrooms _one family dwelling
Primary heating system no- cCgf" % Two family dwelling
Type of fuel o Il Multiple dwelling / Number of units
No . of fireplaces to be lnstalled.. _ * permanent occupancy
Will a wood stove be installed? rn+� * Transient occupancy
Central Air conditioning?� !0 4> Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch contemporary Log cabin * Other
Raised ranch Mansion Duplex * If addition ' what will use be?
Split level Old style Bungalow
Cape Cod Cottage Other * ACCESSORY BUILDING--
Colonial Row Town House * Detached garage/one car/ t r/ car
Jr CIRCLE ONE PLEASE ) * `Attached garage/one cart wo car car
* * * re * + * * * ar * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF '� Other
CONSTRUCTION f c} � �e> 0C7 _ _ _
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET,, TO BE COMPLETED !
Form BPA 4/86 md--vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS *
Type of construction , wood frame , fire safe , etc . W ' �'�� vtiy 1Z
Will any second-hand or ungraded lumber be used? If so, for what? C]
Foundation wall material ! O b L0 �1rz-- Thickness
Depth of foundation below grade (to bottom of footing) `
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft
Will there be a basement? _�Z Will any portion be used as living space? _ +r}
( If so , what portion? sq. ft . - - Type of use?
Type of roof - mope fla shed/other Material. of roof ccs �p u� S ,; e
Size , wood studs�_"'X + spacing L_4 '"o . c . length ` * ft .
Joists ( door ]beams ) 1st . floor -*"X / a " spacing "a . c . span / ft .
Joists ( Floor beams) 2nd . floor ,"�{ c" " spacing_,Lr6, "'o , c , spanRft.
Overlays (ceiling Dams ) cl- "X _C,.." spacing AE, "o . c . span /eP� ft.
Roof rafters _"X " spacing-LJ.60 . c . span lig ft .
Roof trusses (Pre-engineered) spacing "'o . c . span ft .
Exterior wall finish Ly * &A 5, c r' � ot Of what material? 4:4
Interior wall finish , .. I -
if a garage is to be attached , describe materials to . be used for FIRE SEPARATION :
/ )ry , � t
Is there to be an opening between garage and dwelling?�� If so will a Fire-rated
door , enclosure, and self-closing device be provided? k/
Will a flue-lined chimney be installed? Height above roof ft .
Depth of chimney foundation below grade..&A_ft «
Depth of fireplace hearth ft , in
Water supply - Municipal or p vate wel
SEPTIC SYSTEM _ Distance from private well ( i.ncludIng adjoining properties / SS_' ft .
(A separate application is necessary for any repair or new installation of septic system)
Town of f Warren A F F i D A V I T STATE OF NEW YORK
County of Warren
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 ^-- . .Cy'�^ - �°_ �- ---- ---- ------------
Owner, owner ' s agent , arcn ce , 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 :
10 Gross floor area 1 �� ' +� 5 •
2 . Type of heat cn 1
ti +
3 . Is the building mechanically cooled ? ! �7
4 . Percentage of area of windows and doors /
A . Over 16 % Only
1 . Uo value of gross area of walls , roof / ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a . Are foundation walls insulated ? YES NO
1 . if YES , what is the R value ?
3 . Slab on grade YES NO
a . if YES , what is the R 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 l } roof and floors exposed to ambient conditions _
2 . R value of exterior walls K C:)
3 . R value of glazed area
4 . R value of doors IC
5 . R value of floors over unheated spaces fl
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation T heated slab
8 . R value of heated basement / cellar walls ( above grade ) / 0
9 . R value of heated basement / cellar walls ( below grade ) / Ca
10 . Type of insulation l e - ku5 5 4-
C . Controls o
1 . Thermostat maximum heat setting
D . Duct Systems
10 is duct system installed in unheated spaces ? YES NO
a . If YESF R value of duct installation
b . R value of duct in other areas
E . Piping Insulation �7
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation'
F . Service Water Heating
1 . Performance efficiency a45 y'
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating
Telephone No . �% 9 3 7 / 5~4;z ~
( applicant ' s signatu
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE / 1 / / G ! + ` ■�� 1
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: i " t �' "1M Telephone: 7 �i - 7 1 Sa
Address:
Installer's Name: i\ le k � ko N c ';e v--J e r Se rJ x � c Telephone: % r�. " a :`� j a
Number of bedrooms (residential only) i
Total daily flow (compute @ 150 gal per bedroom) > O
Topography: circle one FlaO Rolling Steep Slope % of slope _
Soil Natame: circle one: Sand Loam Clay Other / Depth: feet
Ground. Water: At what depth? NA feet
Bedrock or Impervious Material: At what depth? h A feet
Percolation test: circle one n t~required required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other _
IF domestic water supply is a We11:
Separation: W atersupply from Septic absorption / 3'� 'D feet
PROPOSED SYSTEM : Septic Tank / 0_a_ C> gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench '5� feet / 'Total system length Q !S�c' feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # �„ .T / Depth or Thickness feet
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
(over)
Section II 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, the 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 $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and ail requirements
of the Town of Queensbury 'Sanitary Sewage Disposal. C kxUnai.nce.
Signature of responsible person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . HOME OF NATURAL BEAUTY . . . A GOOD- PLACE TO LIVE
c7 Qtege r �eer�
BU11�CNT
11NG and Zdhil{VG R T$ox 98
j PAR
Bay and Hav"and m 1
oueensbury. New ork
SEPTIC DISpoSAL SYSTEM I[3SPECTION
LOCAT ION
PERMIT
Clay
Sand - Loam ,�,R - 140
SOIL TYP Test Required?
Percolat3.on rate - Min/Inch
Percolation
TYPE of S STEM of total anc; Ch
tia f field
Length engt ach trench
Depth of itenches
III lip
Size of gra el of)
SEEPAGE PIT 'El3umba f t_
Size-
Gravel size
pxpI-IqG = tank
Bldg . X
Tank to +diet - t d/pl
i NO Partial
Dist. box to YES YES
Openings $e ,r
LOCATION) �,Ao,Txor� �l!„ t.
todaioFont taabnsKo zPti
Fuda toounty -
f t.
to lot line —fct.
Absorpt i n one)
Separ;EL't of pits PROP RTY (c �rcle
LOCATI OF SYSTEM ON yht side
Fron
Rear - Left si3e
t
CCKMEN IS
,jM� IIf
TnX
.,;Era 'P1
SYSTM4 USE APPROVE
L
piuil
ng Inspector
01/816 Ttd v1
_ /nwn n� 'oC'weereabc� r
gulLOYNG and ZONING DEPARTME 98
Say and Haviland Ne YorD. i Bo
oueensbu ry.
01
BUILDING INSPECTOR ' S REPORT
fdAME f/C
If
LOCATION ` 5'
Perini
i40 - .J
gate ;L I
* * * * * * * * * * *foe
S rzo
_ YE
F4oCing/pier Forms
Foundation
Waterproofing
laackf ill
F rami ng
Roof ing
Siding
Masonry Veneer —
Rough Plumbing --�
Relief Valves
Ext . Porches
Finished Floors
interior Trim
stairs pailings
Cellar Drain 'rile
Concrete Floors
Plbg - Fixtures
Gar . F i r,eproof i g
Door closers
Smoke Detecto s
Chimney
I1.3 SIMNTION
Foundation
Floors
Walls
Ceiling
E"IN AL Fy,EC R7CCAL IIISPEC'TIO
AL
DRIVEWSuildingv Survey
Final
s insp
action (call when ready )
Next cheduled
Remarks-
' spectar
psuildln
6/86 Md-vl
�Yr cc'']� �teeert -l � u ��
� 1 _ lotvo,, of
gufLDfNG and ZC)NING f]EPARTMEfVT
j gay and HaIII Road. Box $B
i C]ueensbury, New York 1280ti
BU i LID I NG i NSPECT (7R ' S REPORT
N A Mi"
LoCAT 1 ON
e� ���/ �1� permit rlo - __,--------
dat * * * * * * * * * * 140
APPROVEO
Footing/Fier Forms
Foundation
Waterproofing
gackfill
aming
goofing
Siding
Masonry veneer ----
Rough Plumbing
Relief valves
F:xt . Porches Finished floors
Interior 'Trim
Stairs & Railings
cellar Drain Tile
concrete Floors
Flbq , Fixtures
Gar _ Fireproof g
17oor C.lnsers
Smoke petecto s
(,h imn ey V
1.%Tl()N
v Founaation
Floors
walls
Ceili.rn7
F' IL*1,i'sL L:L1 CTRTCAL IDISPEC"1'ICS
17R1VIwAY APPROVAL
Final Building Survey
ection ( call when ready)
Next scheduled in-s p
gelua r ks-
xl-i � >?
,4
cling n pector
6/66 mcl-vl
._. tV11 of Q" eenibury
gU1l.D1NG and ZONING DEPARTmE T
Bay and Haviland Road, R.D .
Queensbury. New York 12801
BUILDING INSPECTOR ' S REPORT
NAME � �P
s /
LOCATION `� . '111 1 a + ] -<
Ferm
i t f3o . � brie
Dai.E 2 * *
App�ROVED91
- Y S No
'ooting/pier Forms
1�a ndation
Waterproofing
I3ackfiI I
Framing
Roofing
Siding
Masonry ven er
Rough Fluwbi g
Relief Halves
Ext . porches
Finished Floors
Interior Trim
Stairs K Railings
Cellar Drain Til
Concrete Floors
1'lbg . Fixtures
Gar . Fireproof ng
Door Closers
Smoke Detect rs
Ch iron ey
IN SU I,AT I ON
Faundation
Floors
Walls
Ceiling
FINAL El ECTRICAL IN 5F'ECTION
CIRIVEWAY APPRCIVSLrvey�-� - �-
Final Building
ins ection ( call when ready )
Next scheduled P
Remarks-
Building inspector
6/66 and-vl
��` _lottin o Queenshttry
/r BUILDING and ZONING DEPARTMENT
6f/ Bay and Haviland Road, R. D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEJ4 INSPECTION
NAME..
LOCAT ION.,,. `c
DATE /• / PERMIT NO. 1f f
i
SOIL TYPE - Sand - Loam - Clay
Percolation Test Required? YES
Percolation rate - Min/inch /
TYPE of SYSTEM:
Absorption f ' eld , total lenth �'��/
Length of ea h trench
Depth of tre hes
Size of grave
SEEPAGE PITS4N er of
Size- ft. X f .
Gravel size
PIPING : size
, e
Bldg . to tank _i
Tank to dist . box
Dist. box to fie / f
Openings sealed? Y $ NO Partial
LOCATION/SEPA IONS :
Foundation to ank Cjft.
Foundation to absorpti n +fit *
Absorption t lot line eft .
Separation pits -"" ft.
LOCATION YSTEM ON PR PERTY (circle one)
Front - e r Left side Right side -
COMMENT
4
i
1
SYSTEM USE APPROVED YES NO
Buiil Inspector
01/86 and vl
TOWN OF QUEENSBURY
Building Department
impaclsarr Rapr�rt Dade /
Aiame
Permit No. Weather
emarks
r -
Exca�ka ll
tion -
ootin Forms -
Footin 4 Piers -
Foundation -
Cement Coat -
Water roofing
sackfill -
Final surveyr -
Framin -
Sheathin -
Roof Fel t
Poo fin
Siding
Masonr Veneer
Rou h Pill JI
Relief Valves
Wall Board
Ext , Porches
Finished Floor
Interior Trim
Stairs & Ra.ilin s
Cellar pr . Tit a _-------
Concrete Floors --
P3 Fixtures
Gar . Fire roo€i ---- --
Poor Closers — --
Chimne
Water Meter in t .
Se tic A rova
Floors
Foonda tion _.
xnsrulation Walls
Ceilin
Building Inspector
REMARKS �f�
c� r
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D_ 1 Box 96
oueensbury. New York 12801
BUILDING INSPECTOR ' S REPORT
NAME ,,/
Lo
LOCAT I O �{+`✓� rrr
Elate ermit
,�/-� Nr APPROVED YE NO
&, oting/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext , Porches
Finished Floors
Interior Trim
stair's & Railings
Cellar Drain Til
Concrete Floors
Plbg . Fixtures
Gar . Fireproof ng
'poor Closers
Smoke Detect s
Chimney
INSUIL TION :
Foundation
Floors
Walls ,
Ceiling
FINAL 'ELECT CAL INSP'ECTJ�W
DRIVEWAY APPR
Final Building Survey
Next scheduled inspection (call when ready
Remarks-
169
auilding Inspector
6/86 and-vl
BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIFI£D.
_s GATE _.._..
CITY OR {t/ , � � J
VILLAGE TOMMFIIP S -J� a' COUNTY lrV �A l f
ROADEAND AND +w_ " -. -} . ' .-•, ;:. F-. _, ,�' '_ �C c - "� t1 t '% roLE ND_
PROWS BETVWE'STR�EETS aAT s � '� V � r1 r\ I���-..:C S/Y I JL " �' C.
PREMISES LOGA SECTION BLOCK LOT_
OCCUPANT'S BLNLGING
NAME OCCUPANCY r '
DNNEfi^S NAME '
AND ADDRESS y 4 rA , . �fj TEL. `Y �Lh
J . , r't t -
CLMRIERT
BSLr PLIED I, i . , t' r Y"�1 47 ti"'\ ^v'-^-1 i-�. FROM TNEIR . .. ��pp � �L � � OFFICE
FECTS
BUILDING NEW M C LO ❑ IISRK NETY N, ADDITIONAL Q REMOVED 0
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
Flw
NUMBER OF OUTLETS LAMReempolmAlls MOTORS HEATERS CIRCUITS OFFICE USE
Le ONLY
tuft iiM AterJt"I
t>•Nlaa Iwr R„�,tP.4 s+t.:Ilrt flatYdawR w.sruc No. rtfxtt �„xp'y fMe. a.. Na. A.WAL INSPECTION
Dwa
aNle
aa.al
Tat R.
2mel Ff.
ad FL
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE_ OO NOT USE THIS SPACE.
This aePlicatien n: wstwmmd to c w the aboaa4isled egeipwtent m be inspaclnd but if at imam of intPacIiwn d ere is found o"Norol etMllpm moot not also" listed.
veto we "w-= to make the itttparden and adjust the faro to cwar 'Mr rWicionM aaoiptnwttt, as Proridwd 4v IN&APPlioowt.
Wdre OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE INUMBERI ICAPACITYI
STARTED COMPLETED SIZE OF SIGN
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS OF SIGN
IEDING
INSPECTION REQUESTED {�
ON FLEOR NEAR AS NEIY OLD u
AVOID DELAY SY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF ! / I
Mil ST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION
PRINT NAME-AND ADDRESS 4 r -
NAME OF y'v a. f- y! C --1x SIGNATURE A,�,.♦ ! it t i -- [4•'�.. +�
APPLICANT } `. . "r �. l� r OF APPLICANT _ Y'`
STREET 11L7DIRESS},, 4_"'i TELEPHONE.
CPDST OFFICE "~'- �L. C." {:. c .L ' ` 7 'n,/� Z� I -.:, •.1� TIFI N APPLICABLE
.to � ER". tlttel A "SEPARATE APP\LICATIONf1MUST BE FILET] FOR EACH .SEPARATE BUILDING
A50 /
9s�