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- CONSTRUC�I�{ON <br /> PERMIT �PPLICr�TI�N � <br /> COMDINl1710N • QUILDING • MECfiANICAL • °LUMUING <br /> UWNL11 MMl AUU111.Si � LIY 1'/1UNG <br /> 1J!-'.. (.'os��':I: LF I/ n C�I-aN� i'�G':'-cJ / . <br /> �� ✓IION6 LICGNSt NV <br /> ANC111TLC70HOLSIUNLC MAILAOUIlEiS <br /> GENIlIALCUNTfIACTO�� MAIIADUHC55 PMONE � LICENF[ NU. <br /> T�N1ES l. `le �'FAc� if"Sn �✓/°!M/T ���-/ 71f � <br /> MlG/IANICAL CUNTHACTU(i MAII AODRL55 PHON6 � UCENSf NO. <br /> PIUMUING CONTRACTOH MAIL ADPRtSu PHONE UCENSE NU. <br /> PCRMIT . CLASSOFIYORK ' <br /> ❑COMUINATION <br /> ❑OUILDING ❑7WNIOING ❑MLCHANICAL <br /> ❑NCW ❑AOOITIUN ❑ALTEIIAfIqN ❑IIU'N11 <br /> VAWATION Of WOFK �/ . . ..-._.. ...""-" <br /> _nU �JDEMOL�SN ❑�ENCE ❑$IGN ❑11V1�1MINfi 1'Uql. <br /> 5 r'-�� 5 U F\' _ <br /> DESLHIU[WOFK ' <br /> ��i' /1C!/S/� t� . E"/�IOi�C �P �/'/�S !-/CG;" � J:J 7 L . Gc✓: AN /7 <br /> vnoroseouse OTHERFERMITS ORAPPROVAIS <br /> � ' J� RE ZC.iNE � SPECIqI USE . <br /> LlGAL L1t5CNIVTIUN OF PROPERTV lSNOW UkLOW OR A7T/.CM <br /> FOUR'' �CO-,'P_i/G�51 r sr �VARIA�ICE � SF'ORLINE � <br /> �LOT�c_s�u BLOCK �� OF�a ` ��r`S I - � • <br /> SEPA CHECK LIST REQUIRED <br /> , - 00 - � - �co �t' YES <br /> y�. NO <br /> ,�'( OS E - �Si2RNp _ � <br /> VOO ADURCSS <br /> j � �MECHAIJICAL <br /> PLUM6ING , TrNe oF I:NEHGV <br /> �t{/�� ❑ELF.C. <br /> � , NO. � TYPE OF EdU17MENT, _ FEE <br /> -�' .—_ � <br /> AIfiCOt�D. UNITS-M.P. kA.� _� <br /> � NO. TYPE OF FIXTURE OR ITEtd FEE ;tt�RiI�ERATio!+ Un�rti ��N. En _-? <br /> fln1H11iUti 5�--�-- ' - -UOilEnS MP. EA. _ "-..•!-"-'--_�__T <br /> CLUi��ES WnS��Elt ' �pnCEn .11R S�S7EN O.T.U. ME.'1. � <br /> UISHI'lASMERS � — �.. . � '-""""—"— -� . <br /> OItI1dKING FpUNTAINS � "- ' ' '-'—"' '-"'" -- � <br /> Fl ObH DNAINS � _ $PAC[ h /lAll MEATERS - H.T.U. .^ � <br /> KITC'�hN tiINKti & OISN. UNIT HEA`Ep$ A.T.V. _ � <br /> ' —_-- {�- �� <br /> 1MIi $INKS i EVl�PO��nT�VE COOLENS _y__ ___I__, � <br /> C1O111E5D:tYERS � � <br /> HOOI- DHAINS HAIN LF:AUGl15 � _ ___,_ .--r— <br /> SH(117tH IIA1H5 VEYI'IIATICN FAN � <br /> SLHVICE $INKS RANGE NOOU __ � <br /> SU��1p5 - SEWAGE {'UM11P NH HpNOLING UNIT' " -C.f.!d. <br /> VIIINALS � " _""_._""_._ .. _... ...____. ' <br /> - _ '-_ <br /> 1V/11ENClOtiCTS � . . . ..: .. .__'. ._._._. __ . . . _ ._..._.. .."_ ""_�� <br /> \YA16n HF.ni[IIS �� LLLCI'RIC � .._ �vn7EN HEATlfi. _ ._ . ._. _".i_� <br /> 1W15N dA51N5 • 1 _ _ 1'AC. BVILT FIRCPLACE l4,C1111.iNEV 1 . . _..__ 1 <br /> . .._. . _ . __ .. . _. . .' ' __.. '" ' _T_.� <br /> LAUNDflV Tf7AY5 _ GnS. SVSTEnI:_NO OP OUTU.IS '. L_ <br /> . � . . .._ - " "SUItTOfA4._5. ... _.. ... I <br /> 1 _ "_"'__'PENbi1t .-S ..'__"'__� <br /> ' � _'_'__-T�-_'— '-10TA1 FIE�. 5 '---1 <br /> SUU TOTAL � 71115 PElihtlT ULCO\�ES NU� 4 AND VOiU ti \YU11Y, i111 C(1NtiTRVC <br /> PEHMIT $�_=1 11pN AV f11qR11ED IS NOI COvd41lNC[[t lY�F111N f'0 U.\v�:. pR rt <br /> TOTAL FEE � : CUNSTIIUC�ION Ofi WOIi� Ci SU5�9�NbCO 011,Af1l�NOPN[O F(lfl .1 <br /> WATER Sf.RVICE SIZF. OIOG. SUPPLY 512E �'����IOD OP 110 DAYS nT �NV nMh nf rEH�vOnK c:Cnnn.�ENCtU. <br /> �ee�e.�� y I IICHlIIV CEIITIFY �HAI I IInVC NfAU AND E'�AR4NlI1 TIIIS A? <br /> H 4 pc ACA 1 C� JCIU�.I'K HtANYAHUStTl7ACK PUCATIUN AND KNOW TUl SAht! TOIIL TfiUE �1NUl'OHHIti. AlL <br /> ' PROVISIONS OF lA1VS ANO OII[IINANCES GOVlI14�N1: iM15 TYPEi <br /> O( WOIIK W�LL BE C0�IPUED WIIl1 W1ICTNEf1 YVCCIFIlU ��FREIVI <br /> �USL 'lON! � W7 ARLA �/AChNTSITk OR NOT, T116 G1IANTWG OF q oEH�lli pOCS NOT PHESUME TOI <br /> GIVE ��UTUOf11TY TO V�OIAfh UN CnNtll f11C �'�1UVISiONS OF� <br /> � ❑VG$ ❑NO , ANV OTIIEfi STATE 011 LOCAL ln�'� ��«�VLl�TIN�i CONtiTf1UCTION <br /> T�PE OF CONST. OCCVPANCY(:NOUY NU.OF DWl�LING ��� T„k VCRPORMANCE O! CONSTIIUC710N, ' <br /> UNITS <br /> SIZE OF ULDG. NO.OF STOHIES MA%.OCC. LOAD � <br /> �(�7Czl����I,� �,�)/_.N-l" t '�E�' L' /� �: �,. <br /> �_�--�}- <br /> $14fIATUfICOfCONTRACTOI1�,bHAV�1I.AC:LNT rJnT[ <br /> IIIIGZUNh IIA::tMLNi IINtSPNINKll11'-- <br /> � RlOVIHEU 'I.�NLHICKNUA41�it 1'LANGILC1. PLl <br /> QY[5 ❑NO �p�; IIECEIPI Nf� <br /> SPlC�AI CONOITIONS' <br /> � FE[5 .�. VAIU TATION � . __FFT_ . <br /> I <br /> �_�___— _ ".'_'_ I <br /> ----•- I aui�owc s_....---_..—'-- — '_" � <br /> -�-r--• <br /> __ � <br /> SEPA REVIEW COMPLETE � ❑YES ❑ NO � ��<<IMIIINfI .---•• � <br /> � <br /> confact plonninq dOPL MLCIIANICAI � ;,� <br /> - . � <br /> , onun i <br /> �� —"-T <br /> N'�'UCAbON/.lUI1lUY�-•- �IAMYU1lU�UYY�. - �^^+uv�o u+uw+r�.l-�r vENALTV _— SEGJO:IId_ . ! ___" � . <br /> L .. �� <br /> . . , , <br /> tOTAI � <br /> __l <br />