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Home My WebLink About24024-ZIHI/~lll} (,}1' IIi:.t~l,lll ............... 3 !;F.T,r~ OF I'I.ANS ............... ,qlJRVF, Y ........................ (:IIF. CK ......................... SIr, PT !C FOltH ................... OMi hling ^I'I~I.IC^'I'IOI'I FOR I~l,l].l}llqC, I'I';IIHI'I' I NS'I'IHJCT.I OlqS Date ................ , 19 .... 'lhi:; ~pl)licali(~ I,~l.",t be c{a,q)lelely filled in by lylx~.;riler or in inl[ n(xl mdxnltled to the of plans, accurate plot plan I.o ncale. I~ according t:o nch~k,le. 'lhe ~k c{~l I~ thin nl~llcntio, ~my ~1: 1~ c{~mm~l I~rore is~m~e o[ I~Hldlng I'emit. IIixm all~al o[ this nl~lication, the l~ihling lnsl~:lor uill inmm n l~ihllng l?emit Io Ihe nlq~lica.t. S,ch nh*ill I~ kept ~ tl~ llt'onises nvnilnble for inslmcticw~ IIit(Xl~lx~L the ~) lalildil~ ~tmll I~ <rcuplel or un*l in ~,)le or in I~ql-I: For a.y I.irlxme Omtever until n (~rtil'ic,le (~:{:Ul~.,:y ~mll Imve I~n grant~l by tl~ Ihdhlinll hml~clor. AI'I'I.I(~TI(~ I~i Ifl~l~llY ~I1[ to I1~ I~Hhli,g I~im~l~nt For Ihe isstmm:e o[ a I~Hhllng Pen,it I~r~amnt Io Ihe hling 7x~ ~)~{lis[a~e o[ I.he '1~ ~[ ~11~1~1, ~t[rolk (5~ml:y, ~, York, mM olher nl~>llcable (~nc:ril~{I. 'lbe applicant ngr~n Io c(a,~ly ~ith nil tq~licnble I~, ordhmire~, (Sip. lint:ute of nl~plJcant, or n~e, ir ;I cm ix~lnl ~il*lle Oletl}er *g~dicm~t i~ _~'~[{' le~s~, agent, axchlt~t, enghmr, general c~mtrae~or, elec~rici;m, ph~l~tr ~r .................................. .... p.. ................................ i~,,~ ,,r ,~ .l: 1.-~.ims ............ ~.~ .[~.~ .................................................................. (ns r~ the I~l~ ioll or I~ll'est de~l) II nl~li~mnt [~ a COrlg~rali~, slglmture ~}f duly mlll~ri~l of ricer. (H;,,.'? taxi I il h_' of corl~rnte officer) I~llhler,.; I.ic~!rme Ixi~ .......................... ? ......... Ir. lecilrjcimm l.ice,,se I~, .... .~..;-~....~..~..~...~.... Olher 'l'r*~k.~.q I.icens~ ~ ..................... I. Itx'nti{~ of lnal ~ O~i{:ll prOl~l ~.k .ill I~ ~k~ ........ ;~ .................... : ....... ; ....................... Ik*me ~lli~r St r~t Ibmnlet ~,lxlivlsi{~ ~.i]~.Q.b:?:.~[: ~¢)~.~) ........ lril.I ml, ~.. ~.~.!.~ ..... lt~t .~. ~.1 ........ a. Exlsti,ll u,m m~l ~:CUl~,~:y ................. ~. ~.~;~ ~. k.. ~.~D .................................. I~.)l,,,,: (,l: (~),k (dm.(:k ~Jli(J~ al~)li(:.hle): li.~ Ik(ihlinl~ ...~..i... /~klitio, i .......... .Mle~mion .......... I~:l~li, ............ I~i,~ul ............. I~i~d i~ ioli ............ I I' Ik~l I iJJllI IlJlJ~l Ill; ([~]l 1 ilJl~ iud I :i . ......... .~ JJider I l: iAI:ii I~liJi ) (:illllel (: j~ J or IllJ ~(J I~:l:lll~ll~:~, ~J~C i [y il[ll II[(~ lll~J (~xl J]lll I)[ ~il(:Jl I yl~ o( II[ie ...................... IJill~:luiilxl~i ol: (~xi~l jll~ ltllJ~:LIII(~IJj il: Jill.y: i~I(xll ................ J~ill' . .............. I~q)lh ................. J~:Jl~ll ......................... J~.ilx~l' Ill: J]l()l ii]ii ...................... J~ljill .................... Ii]ii'iL .................... ~Jtl.:r of [~l()rie~t ............... , ~' ..~iH,~ ....}.~.~ ................ ~,,,i...f~ (if o,/.. .... ~ ................ ,,,,,, ,,r u~,,,-i,,,,,,~ ..................... ~,,,, ,,r r.,,,.. ~,,,,,..~ ...~.: .~..-..~.~.Y4: ~.~ ............. I~m~ I'J"lx-r~d (:,x,.~ ,~x:l i(.~ viol.i ~ z.~y z,x~i.l[ I,~, m',li,m,~:~ o, , ~gul m i(x~: ...... ~ ~ .......... J/ill Io( I~ rel:,~xb(I ...~fi~ ........ V/ill ex,:e~ fill ~.L ~ ~(~lo~n~nt ~H, em~ P,b.~o~ IJ~b,~(~ ......... ~'"~" ')~: ~x"~' ')[ "(" "~" ': ...... Corp. ' .................... Ib~l~] o1: ArdlJle(:[ .................................... ~ll'~ .............................. I]~o~] I~) ............... l~.~i~ ()J: (2~11 ri~(:l()r ................................... ~Jlit~t~ ............................... J$1()le Ii) ............... *11" YES, [[llllllll 'llilt 'II~ISI1]~i II~1~.11'1' I~Y IV(I~]~111~1). ';.-'- ............ ~: _.~.~ ....... NI:ilFY [RLIIL DlJq(3 ()EPA:T'fP,.,EP.~ [ ,~ T 715~: 't'l(~2 9 .',M TO 4 ?,',.,l F<))I CODEs. ~JOl' i~ESPONSIBL E FOR OESI6N OR CONSTflUCTION ~HROR8 duly !~..~llll, ihqx).s(_~i m.I .q;ly.,i IJlnl Il(:! i.~i (lut ;llil)li(:~ull Ik~ Ih(: ((~(~lll llJCll)r , ~r~lll ~ (:(il ixn-.le ()[i:~.e"r, el (~.) .ppi i(:m i(.l[ Ih.I .~1 ~[lll[~lelllll (:Olllailx~ll iH Ih/II .pill il:hi ion lil(~ I lie [() Ihe I~1: I~[ hi~ lux~le(ll~(~ taxi IxH /el; [ll~l Ii,al Ih(~ ~)~( ~ii I Ix~ I~ i:ou~d iii Ib~ .~l~f~r ~el: I:o~ Ih i(i Ihe al)iH il:hi:ion fi led ....... .... ............. CLAIRE t.. loc' 0 C~ I!