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HomeMy WebLinkAbout844_1_001_165.50-1-59_171_CHURCH_NA I r7 Permit Records For Saratoga Springs Building Department PERMIT NO. Applicant Phone No. Date Owner r/ •^ f l -�''-`��C;tE`-'f�-,�,, � Phone No. Date C. O. is Issued COMMENT ON PLANS: Address Architectj' '� Phone No. Date Plans & Specs Received & No. of Copies Name of Person Submitting Plans Name of Person Receiving Plans Proposed Location Type of Plans Reviewed By —One Family —School —Two Family —Church —Apt. House —Commercial —Pre Fab —Addition Review of Plans: Date Sent To Whom Date Plans Returned to: Owner Arch. Other Plans Resubmitted: By Date Plans Rechecked By: Date Check Following Items Before Permit is Issued: —Certificate of Insurance —Engineer's Letter —Supt's Approval —Board of Health Approval —State Labor Dept. Review L Truss Certification —Sewer Permit —NYS Code Review —Water Dept. —Planning Board Approval —Zoning Classification —Highway Dept. —Board of Appeals Variance —Approval Stamp on Plans —Site Inspection —Fire Department CITY OF SARATOGA SPRINGS BUILDING DEPARTMENT (518)587-3550 INSPECTOR REPORT Job Site I 1 1 c%NL,ttxatessT. Permit# 2-0-1`f25 File# ct�f`fi Footings Foundation Insulation before before Rough Rough before Septic Other OD Concrete Backfill Framing Plumbing Sheetrock I F )--t 1 l F i M 5+.4 Pen- Prw P iii ctzo P 1Zc- Passed) Reinspection Failed Required , Stop Work Inspection Date 1-12.4-41c),-L.- Inspector tZB gict -"lr File No. 14 '--� APPLICATION FOR BUILDING PERMIT -- CITY OF SARATOGA SPRINGS Building Department, Department of Public Safety • City Hall, Saratoga Springs, New York 12866 -- [518] 587-3550 Application is hereby made to the Building Department for the issuance of a Building Permit pursuant to the N.Y. State Uniform Fire Prevention and Bulding Code for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations and'all conditions .expressed on this application which are part of these requirements, and also will allow all Inspectors to enter the premises for the required inspections. The following regulations shall apply: A. Application must be filled in completely and submitted to the Building Department. B. Application must be accompanied by: 1 . Plot plan showing lot dimensions; buildings on the lot and their distances to one another and to the lot lines; and a detailed description of' the layout of the property. 2. Complete set of plans showing proposed ,construction and a complete set of specifications. . ; , 3. Appropriate permit fee. { C. Work covered by this application shall not commence prior to permit issuance. D. Occupancy of a building or premises to which this application applies shall not occur • prior to the issuance of a Certificate of Occupancy by this Department. E. Any deviation from approved plans 'must be'authorized by the approval of revised plans subject to the same procedure established for the examination of the original plans. F. Building Department shall' be notified [minimum notice - 24 hours in advance] according to the required schedule of inspections, which shall include but not limited to: - 1 . Foundation footing before. pouring concrete 2. Foundation before -backfill 3. Secure surveyor's location of foundation and submit to Building Department 4. Plumbing, heating; framing, electrical "and'insulation before closing in of work. 5. Prior to occupancy, final inspection..for Certificate of. Occupancy. G. All electrical work needs inspections by and a certificate, of compliance from an approved inspection agency. . : _' H. The building permit is effective for one year from the date of issuance unless conditioned for a lesser period of time. , . For office use Zoning Information Application No. il'8qS Zoning Districte 45.5 -['q Permit No. 2 +ZA - Sect-Blk-Lot :(?�aA/ • Date Applied O In �1 P-111. Lot Width Lot Area 4!9 issue/day date Z, (B e t No. of Bedrooms -=,----=-` Permit t Yp e 1st "='------'-' 14-0›. 320 Permit fee -�, ,g No. of Stories ---7-----t s-----12nd. Floor Area s1 Bldg, Height •-7------t' Basement Area --------r • Job Site /7`C /eCj da(ea-.r— Yard Dimensions for Principal Building Front 1.45 Rear Akio Left 470 Right 115 + Owner 1A S k-`1 fmn.4t° Accessory Building _ Distance To Address rn C}10461.( 4or Principal building ] Left lot line. A Part44%, Rear lot line Right lot line ` 14Q 'Y 1 r Phone sn 406230 + Applicant 1.1- S *Pib� Is job site in a floodplain? yes_ no C �, Is job site in a historic district? yes X no Address ' A %y Nif Phone Construction Costs �,C + Contractor e---. "r �` Basic Improvement0141010 : $ \ Address Electrical Plumbing Heating . Phone ,--- Other -6910Siigeo of 90 a Oi' \ Comp. Carrier TOTAL COST $ /SOD.00 Policy No • % If ?AGE2 SPECIFICATIONS. & MATERIALS CHART----,--- GENERAL SIZE MATERIAL SPECIFICATIONS OTHER FOOTINGS ^.�. .� ��� psi DRAIN - --- ,going to: SLAB �— w.' psi FOUNDATION WALL a • WATERPROOFING .. .. , ems.. VENT — COLUMNS, PIERS y, e--fi --, psi GIRDERS EXTERIOR WALL STUD zik 4 - . vrer : ' Aiwehe 0.c. INTERIOR WALL STUD FLOOR JOIST, 1st FLOOR FLOOR JOIST, 2nd FLOOR CEILING JOIST ROOF RAFTER • ZS - COLLAR TIES 2)44 5icop ofmcit, 0.c. RIDGE 4 ._ si FLOOR SHEATHING ' . ' I' r. s iq yi WALL SHEATHING . )r.,_ _. ) , ,,,v, ./.41? . - ROOF SHEATHING ... —. , r..,..,,,.„,,,,,,. op • , INSULATION i 4f SIZE MATERIAL VAPOR BARRIER R–F ,' FOUNDATION —OUTSIDE FOUNDATION =INSIDE UNDER SLAB • EXTERIOR WALLS CEILING/ROOF i FINISH WORK . SIZE MATERIAL mmomm. `' UNDERLAY OTHER EXTERIOR'WALLS INTERIOR WALLS ' '+':•s ?r FLOOR .F iC > • CEILING ROOF r- . •._- `,.,_ MISCELLANEOUS '' • SIZE --- MATER.,'-_- 1 „,/////72.."7/ 1 • ..� .-.,r3 ...eyy :,%-.-- .rry,¢..., -v-r*"*"19sT,r:CS-rffi4 J,Pla rzTgw8' » Page 3 HEATING SYSTEM PLUMBING - # UNITS & VENT SIZE TYP FUEL SINKS LAVORAT EI S VENT-MATER SIZE _ TOILETS /SHOWER SEWER - TYPE - CITY PRIVATE DESCRIBE (DRAW ON SITE • AN) WATER SUPPLY - CITY , PRIVATE CHIMNEY AND/OR FIREPLACE : MAT AL FLUE SIZE GARAGE TYPE : ATTACH.: DETACHED " `- UNDER — ,O. CARS '— GARAGE/DWELL SEPARATION : Door Type Hr. Fire Ra ng aterials: Hr. Fire Rating 'ORCH: FOOTING FOUNDATION ADDITIONAL INFORMATION: 77/43 4F(7 UC.47 c / . /d'T7w()ED :�� �� 8`x ,g' �` o .._ e-trame,-----dicatraammE,' Al111111111N% M14 401 -1 ....1 STATE OF NEW YORK ss: •- .t of being duly sworn deposes - -a e is the applicant previously named. He _ e _° of said owner or owners, and is duly authorized to perform or have . - 'oriu he said work and to make and file this application; that all st. -ments contained in this ication are true to the best of his knowledg- -nd belief, and that the work will be per • -.d in the manner set forth in t. - application and in the plans and specifications filed t - with. ti Swor o before me This day of 19 Signature of Owner Notary Public County Signature of Applicant . . PAGE #4 Date Location .e Permit/Filo No. * LOCATE MAIN BUILDING, ACCESSORY BUILDINGS, AND ANY ADDITIONS, GIVING ALL PERTINENT YARD DIMENSIONS. 144 REAR LOT LINE 55 ft 3. 1 i _ ...., , l A---- - -..... ..--... . . .‘. • . ......., REAR YARD 80 ft - LEFT RIGHT LOT LOT " LI NE 4. . LI NE 1. • I ft •,, \\ • .• . ,ki• ,, s ,,. LE F tkit .--10 BUILDING - VAR"); - . . 1 . . .... • . ... "..1 . .1 . . 1 / ' • . . I .'.. FRONT • YARD t , ., .. i - , . -VP ft , .., : . - - • I Y . 1 i 1 , < FRONT LOT LINE 5.5 f t v ---- • . ..,)S 4T7,941, D '' Lliqi/ig. 1e1510 - • 1 • I, .. . _. . .... . .,. . .._ ....._ ..,- ...... ..,....,....._.._ , , :,•,,,_, 11:4.4'.4-4., •,....... - ....:-..,--- . S. - . .;.3.: ......,. .,...). ....a. ,fi.',., r., LIBERTYGUARD DELUXE HOMEOWNERS POLICY DECLARATIONS 77RENEWAL A LIBERTY MUTUAL FIRE: INSURANCE COMPANY (s L-1 BOSTON, MASSACHUSETTS POLICY NUMBER I H32 -221—635756-001 0 THESE DECLARATIONS EFFECTIVE 02/26/01 NAMED INSURED AND MAILING ADDRESS JAMES J FRANCO RESIDENCE PREMISES INSURED: EMILY EVERETT FRANCO SAME AS MAIL ADDRESS 171 CHURCH ST SARATOGA SPRINGS NY 12866-1224 POLICY PERIOD: 02/26/01 To 02/26/02 FOR SERVICE CALL OR WRITE: 12 : 01AM STANDARD TIME AT THE 3258 ROUTE. 9 RESIDENCE PREMISES SARATOGA SPRINGS NY 12866 518-583 -1600 CLAIMS: 800-252 -5730 SECTION I AND II: COVERAGES AND LIMITS UNDER YOUR LIBERTYGUARD HOMEOWNERS POLICY I:COVERAGE A — YOUR DWELLING $160, 000 COVERAGE B — OTHER STRUCTURES ON RESIDENCE PREMISES $16, 000 COVERAGE C — PERSONAL PROPERTY WITH REPLACEMENT COST $112, 000 COVERAGE D — LOSS OF USE OF YOUR RESIDENCE PREMISES $32, 0.0:0. II:COVERAGE E — PERSONAL LIABILITY (EACH OCCURRENCE) $300, 0;0!0 COVERAGE F — MEDICAL PAYMENTS TO OTHERS (EACH PERSON) $1,000 DEDUCTIBLE: LOSSES COVERED UNDER SECTION I ARE SUBJECT TO A DEDUCTIBLE OF $500 PREMIUM SUMMARY: FORMS AND ENDORSEMENTS SHOWN ARE MADE PART OF YOUR POLICY HO 00 03 04 91 BASE COST FOR THE COVERAGES AND LIMITS SHOWN ABOVE $ 457 HO 0453 04 91 CREDIT CARD, FUND TRANSFER CARD, FORGERY AND COUNTERFEIT MONEY $1, 000 $ 0 FMHO-752 09/87 PERSONAL PROPERTY REPLACEMENT COST $ 25 SECTION II COVERAGES EXTENDED: HO 24 70 04 91 SECTION II EXTENDED TO A LOCATION AT: $ 23 LOCATION 1: 739 ROGERS AVE APT 2R BROOKLYN NY 11226 1 FAMILY RENTED ($ 23) HO 24 93 04 91 WORKERS COMPENSATION $ 3 COVERAGE E INCREASED LIMIT $ 15 PROTECTIVE DEVICE CREDITS: 6 .0% -$ 31 2% SMOKE DETECTOR 4% FIRE EXTINGUISHERS & DEAD BOLT MULTIPLE POLICY DISCOUNT 5% —$ 26 NET PREMIUM $ 466 OTHER ENDORSEMENTS MADE PART OF YOUR POLICY: HO 01 31 12 95 SPECIAL PROVISIONS HO 04 16 04 91 PROTECTIVE DEVICES HO 23 43 04 91 NO COVG-HOME DAYCARE BUS FMHO-949 09/91 SEXUAL MOLESTATION EXCL 2330 CHNG FACSIMILE SIGNATURE 2323 ANNUAL MEETING DATE FMI-10 775 R3 COUNTERSIGNED 01/08/01 . RA..(YETAIT IflSID T \ j 1.4„ AUTHORIZED REPRESENTATIVE • • • • • • • • • JAMES J FRA CQ .� 3 S E+ EMILY E FRANCO: � -1 I c i 1 -a. s�.s ar c — z,ri-�G�t� cp-cnA r4-`.S acr' i-t DZj s Sc�a7t, 11/16/01 FRI 16:23 FAX L 002 11''°' ' ty r, Certificate of Property Insurance This is to certify that << J-]Fra�iC &- mi lt'Everett Fr Cnd o is insured for the coverage and Name of Policyholder(s) $_500;000 l at l tiy� provisions of a 1Hotnm:owner policy under H32-221-635756-00 for $160,000 dwelling (type of policy) (policy number) (Amount) subject to a deductible of _-$500 for a period of one year,from 02/26/2001 to 02/26/2002 (Amount) Date Date for property located at _�- 171 Church St.Saratoga Springs NY 12866 , h'urricaue deductible where applicable Annual Premium 5489.00 Paid in Full YES Replacement Cost Coverage Yes E No Endorsement Effective Date _ Expanded Replacement H Functional Replacement Li LISERT'Y MUTUAL FIRE INSURANCE COMPANY This certification or verification of insurance is not an insurance policy and does not amend,extend or alter the coverage afforded by the policies listed herein, Mail address if different from Notwithstanding any requirement,term or condition of any contract or other property address. document with respect to which this certificate or verification of insurance may be issued or may pertain,the insurance afforded by the policies described herein is subject to all the terms,exclusions and conditions of such policies. DA t 111 ZthON.4.p.0( _ - SECRETARY Loss,if any,payable to the insured and the"loss payee" shown below as their interest may appear: fry:^ Countrywide Home Loans Inc Countersigned by: It's Successors and/or Assigns A.TIMA "' Authorized Representative Po Box 10212 Van Nuys CA91410 Local Liberty Mutual Office 3258 Rt 9 Second"loss payee" if app.li.cable. Address Saratoga Springs NY 12866 Date 11/16/01 • • PS 3700 R4 IA c440 A OvEgx frizA-cire-pes 44:12.7,44‘ , NY ( -. -' ''' Too ue edaNce. ‘-2x4's -44 , L'oo kv-16 , 4 :1 '...42- CT 7.3 ?LA 410", ) 1,40 baa c) 0 ovEL itire ... SI tx- FAciA, Cm) :).FFi T S---- '400,IX CoRrtEX rfoi&e."7 ____--------. ttZ 4)01 ' - 2— 2o' .,a2oRS 6.i-a Aew7i-ti ix 4.-$a‘,P_V,,A I _______, 1_0 ' 244 MiWytai ___ (1) e' --7 u i•-- ° * 6-0 * 4 4,4ii\--,t.: / / *2 zie+)1 limfifts: ce 5; \ ...4,,-; ilf liONO,C. co\ *1%W.* cf 07356h ff:, OFESSI% 'Z , l'.-Zei100/411200e/09,Aderri-i— , tol , - • s em, Cc 4 w p .� � N r tif\A _\.,:),q •�� - r _ ,1 i • •tiii, 1 , it . _ , , _ _ - -- --- 1 •1 „.___ $ . . 1,N. - 1--- d 1 4... ,.,... . ..1.._ 'ft...4 -.1 c\- \ - '2_ . . _ ,N..) _ _ N.... _ ._ - ..____ III .1 ri n . , IN . . , . : ---- -- If _ 1 co..„ . vi i°- — • ri t2,---1 ._i . .ecif -� U liz \. i - , ,,,,...:.,•.::;1. z --it 2 ,,:.,.. ...;.,,.i. . . . ,„ r 1 -. • •c I -I. ,,_, :,:•,.f. ., ! . r‘‘,.:',:. ,::: i i t .. 1 _ t... • , 1 • N • rtt ',g r 0 W 7q) X N F t fl AZ {°1 W IN �3» * s of--- t --( -h � • C k ZG , -% 13 " � ); ii cid 0 -_ ` . a ''tri.** ' r,t‘ _ . 1 <A, O O t-6 . is,. . .. . cER Ir 67,3 eft v .. Affidavit of Exemption to Show Sp c Proof of !orkers' Compensation.Insurance • Coverage fora 1,2,3 or 4 Fa wily 'Ovv er-occupied..Residence Under penalty of perjury,I certify that I am the owner of the 1,2,3or 4`family,owner-occupied residence (mcluding condominiums) listed on the building permit that I am applying for, and I am not required to show specific proof of workers' compensation insurance coverage for such residence because (please check the appropriate box): Al I am performing all the work for which the building permit was issued. ❑ I am not hiring,paying or compensating in any way,the individual(s)that is(are)performing all the work for which the building permit was issued or helping me perform such work. ❑ I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate-hours for all paid individuals on the jobsite)for which the building permit was issued. I also agree to either: + acquire appropriate workers'compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid mndividunls,on the jobsite)for work indicated on the building permit;OR + have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (ncluding condominiums)listed on th building permit that I am applying for,provide appropriate proof of workers' compensation coverage ` _ pe or proof of exemption_fromthat coverage on foams approved by the Chair of the NYS Workers'Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite) apermit for work . I • on the-buil . \ c— 4000! / (Sims . of Homeowner) (Date Signed) Home Telephone Number Sig S$? -D (Homeowner's Name Printed) . f Sworn to before me this i day of Property Address that requires the building permit: —1/41,- CX • 4. • (County ClerVorlNw•ry Public) PAMELA L.WIGGINS /24 NOTARY PUBLIC,State of New York No.01W16060441 Qualified fn Saratoga countts My Commission Expires -a.5 BP-1 (3/99) o- • -o • �CPTOG4 SA x : DESIGN REVIEW COMMISSION o _ CITY OF SARATOGA SPRINGS 7 :::�►�,' City Haft,474 BroaOwaN Saratoga Springs)New York 12866 /4CbRPOR A TED �9h 518-587-3550 518-587-6512 Fax www.saratoga-springs.org NOTICE OF DECISION • In the matter of the application of James Franco 171 Church Street Saratoga Springs, NY 12866 involving the premises at 171 Church Street in the City of Saratoga Springs, on an application for Architectural Review and the Design Review Commission met on November 1, 2001, and made the following decision: Nz Approved as submitted or shown on the attached plans ❑ Disapproved as submitted. ❑ Approved with the following conditions: The application for an accessory building is approved noting that the finish materials will be wood siding and not plywood, the siding is not to project beyond the corner boards and there will be trim and framing around the door. It was further noted that two new renderings would be submitted. As a result of this decision the applicant: aix may proceed with the required permit approval.process ❑ may not proceed with the required permit approval process The applicant is required to contact the Building Inspector to obtain a: ❑ Sign Permit )o Building Permit ❑ Demolition Permit // i 4-7 Date• / Chir Attachment cc: Building Inspector Applicant "Nig & n 4::5 .7: 1 4 .., , T., . ..... • t N O vX �� E diF ,4,5--- i A V i 1• a ti . ! V<\\(‘ ' - ' , ., li 1 , \\1/47 i . ...._ l'i 1 ,1 , , : ,..... . (....-; iP • • (V •S • ''. # 11/,?\ .t t, 18 . 0(„,-- . , N- =mat a ,.. . -6) •- A. zfi -i !•' i S ,• n W -a d of �\ ��2G� :1 f� 0 t _v j ' . _. 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I . 041 V0 /7 rirp; . 01.L.39a0L,N 2f)nit D W I , r7•11/0019? ; ' i . " oaPcSidsvid2 :,'i';,?-°•''._ 44`;1-1Att.ti...;4 { t ; I ! • wi — ; — — j I i— , 1" { I • -' i 1_ } i i i '-',:::;-1'4';',''' jp' L4 1 1 1 1 ' /' �• \ 1 t ` 1 L + 1 I . { 1. 11 i , 1 i } t l 6.. — t I i • I - i' I I --7_L-Zr- 1 I + i I _ yam; t -I ' 1 .l i -.1_j 3 1�.. i i i i Ti t ` I . . —._.._. -._ _. • - i L—_ �' — ' '11,-:a iI I i i i ' fi i I • �. I j i S • L— . Yt j — 1 I ,� r a __ ' i ! r 1 ,j}���i� , 1 I I t 4 ! � 14! I ! I T-4T i c + i ___— 1_._ — _--,1— I I. 1 1 y ; i • I �, { , 1 I tf t�" a :a'. � - -a'-- .:- f•—,- t:.-. { i H i• ---� - -.-- -. .I-. i----fr---1--t-- -- ..,,_ -----JI 1 .. 1 _!_ jn I 17 1tIII —+ it I t — — t .,_ — 1. LIT3tII I i ? _- i s A I { 1. i i J - • i ..i } 1 • I i77•1',•--7-14 ,• I t 1 j i I. l :1 • { — I 'i — i CITY OF SARATOGA SPRINGS BUILDING DEPARTMENT (518)587-3550 INSPECTOR REPORT Job Site /7 f C i}-,-17._C11 s .(. �j Permit# File# 7271C/ Footings Foundation Insulation before before Rough Rough before Septic Other Final Concrete. Backfill Framing Plumbing Sheetrock 5 f-ft�v 9TH -- NV 0 i RZ\J-1()-1..._ i .rro P 1.4 Passed Reinspection Failed , Required Stop Work Inspection Date 5i 3o 0 Z) Inspector ,,e,_ Pit ri /7/ C,/,-at St, ,,„,v„„,,r '�JJ:V::V::V::V::V.'DJJDJd:V.':V::V.':V;�l;V n 'pJ.'DJ.':V.':V:LL.VtAArkAaArx:VJ.' :V:'..1'7J.'.)J.':V:7J.'L.C''A.A':V;.I.U'JJ;.I•l::V::V:;V:JJ.': Ar.kA 7J:�.J.".V.':V.':V.':V::V.'l-� e.• THE NEW YORK BOARD OF FIRE UNDERWRITERS c • BUREAU OF ELECTRICITY < • I.. , 41 STATE STREET,ALBANY,NEW YORK 12207 . C Date :7,..:.:IG'sd ,.,)n 1N1:7^ Application/Vo.on file I O 512 A 3 5 8 6 6 9 C THIS CERTIFIES THAT �J C only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of C i C 0C ic, in the following location; C Basement ❑ 1st FL. ❑ 2nd Fl. Ota':%u'.t'.:.2 Section Block - Lot C was examined on 'i)"2.1‘,:"73 and found to be in compliance with the'requirem.ents of this Board. C • • FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS c OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY VAPOR AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. < i C C C SI DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS C • AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS AMT. WATTS iC �' IX NO.OF FEET f C i C SERVICE DISCONNECT NO.OF S E R V I C E C f AMT. AMP. TYPE METER EQUIP. 1 2W 1 0 3W 3 2 3W 32 4W NO.OF .COND. OF CA.C.WIND. NO.OF HI-LEG A.W.G NO.OF NEUTRALS A.W.G. C PECCR.0- OF HI-LEG OF NEUTRAL 14 / 2 / C icc OTHER APPARATUS: C C 4_11 G C C el < • C • C • r VVAi•I-VvV•)'V V. �( - ..•, • 1r,-l.ir..r Ir. !i .i , T, -3 C..-";•t,*> ,OG ar BRANCH MANAGER C I Per C - ,r ,YYYYYYWY6YYaGrsoiNlYatretrerYA'`GYirYiY6Yd/6YiYVIVlYmfY6YY6YY6YWY6YYtGYeY6YYarraYorrwr AiYY�fIreCYYYYYYWWiWbUiYYfYYiYYnt1, COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.