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SITE.WORK DATE ID/SIG.TS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathino d&.r-ao1 4$)llzltttt1
<br />Shear Wall a I
<br />Framinq q tvil tx I
<br />lnsulation/Eneroy
<br />Drywall
<br />'€x|.ttnt. tatn <ll,.lli,)
<br />-fiy'own Coat
<br />lr/asonry
<br />T-Bar PAO\ + 4+ l^./f A/E719,)
<br />Handicap Req. ,+{ exf 7[rdlrc -A-/ {,
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif
<br />FINAL TllSlrq )
<br />Certif icate ol Occupancy
<br />Nptes, Remarks, Etc
<br />o o
<br />T.
<br />KA
<br />ce lo4
<br />(.ai,-iza
<br />d.
<br />Y.,
<br />| 1 colrl,rl
<br />DK
<br />i ekJA^,<.'llat' y'vtl
<br />7b/,9-' /k -/^? i,aubtvwt *r/-* fll/n/T_I=T
<br />,\s
<br />i
<br />eu
<br />s
<br />B - INSPECTOR RECORD
<br />()lrNt:R IltrtLt)ER Dt:t-caR,\ rl(tN
<br />I hr rrby !ftnn unds pcnahy or l).qury rnir L'n cxcnu fft,m rhc contrlos Liccnsc L.w lbr lhc lollosing rcr$n ( s( 1).1 1 .5
<br />Busirc\s ifil Profc$n,n Cod.): An, Cily or Counry which rcquircs a pcrmir ro con{tucr- r rcr nnprcvc, dcnmlish ,{ ENn ,n,
<br />nrucrurr. rritr lo irs hsurmc. rho rcqunc\ rhr spdionr rrn \rchFnnn ro fiL r s8trcd s cmnt rhar hcor shc n liccnan pu6ua;r
<br />lo lhc nmvisiotrs oi rhc Conr0crols Liccnql L0* (Chalrcr 9. Commcmin8 siri sccrt,n 7fix).f Division :l oflhc sunnc$ .ird
<br />Professioni Codc) or rhar hcorihe i\.rcFtr rhcdridnand lh. trsn lu rh. Jlc8.d crcnpriotr. Anyvnn nrnofSs.^rio!70.r15 ht rny
<br />|Ppli.!nr fff a p.nnir strhj..rsrhc r!flic,trrIoi.irilr.trdlryorn.rr .th!fl Iivc hu"drcd dollon (550(,)
<br />Ls\osrcr.lrh.pmp.y,ormycDlorccsqnhRa!.\r\rh.ns'L.omF-trsario..r'illdolhc*trkadrhcinnhismr
<br />inrctrdcd ororic.cdiorsrlc(Sa.7O1,1.BusinesannPmac$ion\Codc:lhcContadoisl-tcnsctf,wdocsnorafplyto.no$n.rot
<br />rhc pDpcny who l,rilds or i'npnrk\ rlEtu)n, dd who d(.s kh wo hnn{lforhcsclforthrcu8hhiso!hcro*ncmployccs.
<br />Irovidcd rhor such impmlrrm* m mr idcrh or olTcEn tor $h li lxNcKr rhc h{ildin! or impmtftnr is $h {nhir orc }tar
<br />or..hplcri.n, rhc own& Buildcr wiu hirc ilE budcn of Fmlin8 lhd tE or shc dil mr 6uitl or i,rrDw rhc rn Fny ftt rltr puq$$ or
<br />L aoancrofrhcnmpcdy. rn.xcu\ivclr..nliNrin! wirh licctr(d ..nhcn,s ro con(rucl rhc onlccr (Se 704.1, Bu\i'ru$
<br />lnd Pmlis\ion Cadc:'Inc Colrracrois l-iccn\c lls d{rs nor rypl, b anown$ofpn,pcntwho huildsor imtbvcs rhcrcon.
<br />a.d sho oihds ror su.h rroj(r! lith ! Conrr..rois) liccn*d puNu,or b rhc Coikactn\ t-i.cnr Lrw)
<br />I ncrcnrDr undd Scliun . B & P.C for lhtr rc^.n
<br />O{ner
<br />]YOf,f,Ets^I1;OIIIDNIAIIAN
<br />Il[cla&LlMN
<br />I hdchyrlltr rutrdc|,cr.lryol Jicrjury.rc.llhcnnh*inEdc.ltr!rion\
<br />-l
<br />h!!e andwilldDinrain o Ccn iaElrc ot G,n*nr ro Sclalnsulc for sorkcrJ .o np. nsi' ion. .s providcd lor byS€crionlT00oflnc
<br />tjbor cclr, rbr lhc lcrr.iiMmc oI the *ork lbr which I hc pcflnil k issucd
<br />I hrlc rntl *ill n,rintrii Norkrri ...rtri\rrn ir\uh.c,r\rcqut.dbyS..rionl7(xl.llhcli6orC,xlc.lnrrhctMlarmnirco,
<br />rl'r qork 1,tr trhichil,n |tnnir i\ i\\uL\l M!w.rkc'{ roNfcfqrnr rnNc crricr d tDlicy nun,hs rrc:
<br />h.f,"/,i,tI.cdiaylhrr hrhc pcrroirutrccol the work rirr*l,i.h rhi\ n ilnir i\ is\ucd,I \hrll iord'ntk)y rnypcrsotr in rtrym!nm!
<br />$ $ro$c$m subjc.rro rhc sorkda .omp.n\arnr L,esorcri'rorni.. aMaErccrhal iIl should lEom \uhidr brrt
<br />wo*crl conrpctrsrri{)n povkbis ofS..ti.n:17(X}ofrhc tjbor C.dc. t sholllonh*ilh mnrpl, *irhlho{ pmvisknrr.
<br />WARNINGT Frituru ro (rurc Norkcn'convEnsarion orm8c is uDhsfll MJ \hrll srhiti an rnpk,tcr lo diminaltcMllics ond
<br />civil fincs np k, o c huhdrcd lhousand dollam (irian ro rhc.od.rcoftpcns,rion. dumBcs os rmridcd lor rhc
<br />Sccr( r 1076,,fLhc L t r CI,lc. intcrcn rn.l
<br />o*".,,..-- zl .l I ( n
<br />I hcEhy.lllnn undcr pcnrlryor pc'jtry rhar I n liccn{d
<br />uf rhc Bunnc$,nd Ptults\ior Codc. nnd nry liccn$ i\ll;:|;l :,,*pl,,*,*".ins
<br />wi,h scc,i,n 7mo) of t)iui\i.n I
<br />Z
<br />I hcrchy rf,nn' under Nmxyorp.rjurylhal lhcrc is r cotrslruclnrn
<br />hsucd (scc l(A7.Cn. C ).
<br />ngcNy l.rrhcllcrntrtrrncc olrlt sork ktrwhi(hlhi\ Jrnnil is
<br />Lcrdci\ Addrc$:
<br />-
<br />IITLICANLD&CLABTIION
<br />I hmby dltD undcr pcnllly ot pcrjur, otu ofrh. fdlosi'l9 d.cldi(,rs
<br />oc xnin,r Pfn1n$Asb.{os Norillcurn Fcdcrrl Rc8ullliur\ l'lillc.{r. PM6)
<br />Rcquir.d txu$ of Nulifi .drion
<br />I cdifyrl'{ I hr(c rr:dr)n\ r!pluri.nntul rr lh. rh,v. ini,ntrdkr tr rorc.r I rl.{ r'..nrdi \ rh r l Cir! rtrJ Counr,
<br />o'Jin ncc\r d Srrrc trtrvsrldriDE ion-rnlh.rchyrurlrrncrrprusc rxtvc!.lrhisCilydiCotrnryt)cnrnulxrilt
<br />rnlir. rrrri,nrd tn)t)cdv ntr id
<br />ADplionl {r All.nl sisnslur.
<br />harutt J oru" (
<br />/rh
<br />hil:l'1
<br />Pool Fence
<br />qti
<br />(!
<br />brda,
<br />_lccnityrhrr ihr fcJcnl rc&ulnlions rcAndirS .slicslos rcnNvil irc norqrpLiclblc b rhi\ tn+cr
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