HomeMy WebLinkAbout24025-Z I;OItM N~,).
TO%.~14 oF IiOU'I'II(.]I.I)
BIJ I I,I) I N(; t)El~^i(THIr-HT
'1'O~ N Il^lA,
!;OTH'II()I,I), Fl.¥
TF, I.: 7 ("~ ~-
AI'I'I.IC^TIOH Iq)il IIIIII.DIN(~ I'l~.llttl'l'
IJ(ll~l(ll t)l: Ill,.~'H.'lll ...............
3 .ql~.T.q ~)F I'l./~H~ ...............
.qlJRVl~. ¥ ........................
(:III~CK .........................
.qI~.PT I C FORH ...................
NOT ! F ¥:
C.,, .......
................. L 1 .q .~ .~ ......
Date ................ ~ 19...
:). 'lhi, nl~Itlicatitxl ,,mt Ix c¢,,¥1etely fillcsl in I~y I?lKa.nlter or h~ ink ~il,I md~nJtt;ed lo I.he IktJhlJnl~ hmlector
I
(fl~.~j? n)~l t ille of (:Oil,)rate
(J)atlC I ipl
fie CO[J~PLETE FOI:I C.O.
ALL CONSI'I:;tlCTION SHALL
THE REQUIRE,~ENTS OF THE N.Y.
STATE CONSTRUCTION &
CODES. NOT RESPONSIBLE FOR
D[SIGN OR CONSTRUCTION ~RRORS
· l~il,ll duly ~,~,~llu, iI~l~j:;~::~ lull n~lytl Ilull lie i,'t the illipI il:mil
II,pi il:all i(lll~ IIIill. ;Ill IIIilI(~IRIIJll (:ulllail~(I ill tllili llJlllJ il:id Jill) JJl(~ I Jl~ Il) Ihe I~tll; ()l: hill lu~l~llie IIiKJ Iml leii taxi
Ih;il Illt~ ~)lll uill I~ I~rl:uui.~d iii Ilia II~ilIiK]r Ii~l] I(l[lll iii Ille illliiJi(:ill il)ll I'ihM IJlalt~illl.
--.'~ .(.5. ~.,,,, ,¢ .......... (... ~ ........
CLAIRE L GLEW ( App111 mil )
NO
\
\
\
\
od