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� -.�- , <br /> �, . . <br /> ' CI'1'Y OF .I:VrTt1:TT P�IL�fIT N0. 1�� �3 _ <br /> DEl'nP,Th1�3h'!` OP COA1:IU::T'I'Y DHI�F:LOP;�IENT <br /> EUILUING PJ:��IIT aIFPL:ICI.TIO:: VILUtlTIOi� s vi c�� <br /> ` YEI�•II'P FliL � BF.� <br /> DI�TE � 2 v- 7 y <br /> ADDRESS OF CONSTR:TC'PION Y70RK � ��� G q ''� �"� 'e"� " � ✓� <br /> L�GAL DSSCRIPTION: LOT "Z �f BLOCY. PLAT �a � %(� �qr ��� <br /> �CY`fs` <br /> ' UNPLATTED D�SCRIPTI0:7 <br /> i ---- <br /> ` REDfODEL <br /> BUILDING DL•'SCRIPTIOi1: NEW ADDIPIOV OR REPAIR <br /> # OF UNITS OCCUPA::CY OR Uc� STORIES <br /> IS THIS A CHANGE OF BUILDING OCCUPANCY: YES NO � <br /> CONTRACTOR 0�7NER ���CJ �4"r"+ Q^^ /�✓'P <br /> MIIILI�G b;t1ILING �.. .--� <br /> ADJRESS ADDRESS /� (/.Q-�^-t � � �✓�+ <br /> ' C� � Lu3 <br /> PHONE NUDSBER PHONE NU:fIIER � S S�- � ��� � <br /> CONTRACTOR' S LICENSE L':S.BER <br /> • SIGNATURE <br /> � C�/ �� 2w ��D S S <br /> � <br /> f10TE: THE r�PPLICA\T SHALL PILL Ii1 ALL :'+BOVE IILT�I:i�S CO.7P?��TELY INCLUDN <br /> Tii� PLOT ?'L:::: Si:ETCcI 0`: RS1R �F TfiIS SFiErT. T3IE APPLICA"'P 7S RESPOidSIBLE <br /> 10I2 tILL li:POP�^_�TIOi: ��3ICH IS f ut iv`ISHED 0\ THE APPLICATIOid . ANY CH.�i�GES <br /> IN Tt1E INFOR:;tI'iI0^:, PLOT PLAN OR BUILDING PLANS SHALL BE SUIIDiI4'TED TO TI:E <br /> INSPECTI0�7 DIVISIQ:1 P03 i�t PRO`.''AL BEFOi2E PROCEEDI�:G FIITH TI�E CON RUCTIOV <br /> WORK. / ' <br /> APPROVr1L: <br /> 1. PLANNIrG YLlr� DATE %-.10 - 7�/ <br /> 2. ENGINEERING <br /> TRI�FFIC DI\�ISIO\ <br /> Z9ATliR SERVIC� <br /> SE�•:ER SERVICE <br /> PUIILIC SEP.��ICE SECTI02I <br /> ?. INSPECTION DEPIRT:•1E�IT � 2� FF---- <br /> A . PIRE t•;�IFSIIAL <br /> I�OTE: AI�L CO::STRUC"iIO:: �•:O::i: SilALL CO>�PLI' �•:ITII i.PPLICAB.T�T� CODES, t•:OTP•.S <br /> ON DP.AI•7I:�GS , i�.^vD Ii�Si�;:CPIO-`S <br /> —t _. <br />