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r I TOWN OF , GROTON'. _ ' ti ,: ,
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♦ _.Y a PLANNING ' BOARD.' `ILI
i, ,, Tue'sday ,rJanuary 10 , 1984 t'''A z.,
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f . ' ' George, , Totman ,4 Chairman Ly : Teresa ; Robinson , Town Supervisor
, + atRoger` ;Gleason ' Uce Chairman f Js Colleen Pierson ; Town Clerk •
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4ti ' '= } Nancy; ' Ostrander Cot Secretary
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I I J.im MacNesil ;.I J : ; {„
$ I". Lyl e . .Raymond ' `' f, f ' I
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> = Mike Post , ' . , � t_ r ':
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I G;: Totman ca3led = the .meetin'g to orders,, R . Gleas:on moved the minutels f '
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ro'f the. I ast `-meeting be ' appr,,oved ;"- J . ) MacNe01 s 'L dl6d Tthe motion; all • 3, •
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" " iiir favor motion carrieds r
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♦ 1 "a Opened 'discussion "on .revision of% 4Town ' Forms + 'a
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" v L'. Raymond :..f I , don ' t ' see why twe ." have :to go :) by what `0 her �' towns do . 1' '
' - G : Totman • They , gvef us a foundation .to work from We take< what ' otfi'er
.
I fit' ';f . +• towns ;ruse - and go ��from,: ;th e t"e or s;t ar ti;:f rom '.,,s c r ateh�`I and� make, up our zz =, _ . '; r ,{
;s, _ . . .
i ' , , It own What ' Colle'e`n is ; looking fo.r is "something.. s.imple'r : ` , Our new ' ' - •
, enforc"ement . , officerr does , not like = the , ones=- for the Ui,llage" of Groton:
: . ry , , ', i '7 fps. ° ✓, _ ' . ' L.
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, � 1 v : We can ` use onerformgfor a Building Permit and ' S,pecial: Permit or•`°,use': =
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a If' I,, ' _ Sre arate 'forms " ;=An k ideas '•,"or ; s+u,' estions ?: $ •k. '
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M f Post • How- many things> or •
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G , , Totman • zI <It ,clepe cls +` 'onk =the Ordinranc'e : -"Whereever ° a permlot is needed ; they
Ar fill out'; one } and ;give ;a`t to., the , Town 'Clerk '.and she w, il de.term '•ne if•
{ y •x #, :l' , fhey nee§d Ito apply-pl•y fo`r ;a .;S'pec'ial Permit . f • ; •. °` ,
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J, . MacNeil • , WhyA,,.not have , Lj ust' one form' and rche'ck what type of ` permit
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c z applying . forLL , 1':ding / special : s1, : .t,�«1' r . . '
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• k Gleason • ` The ^, biggest applications ' are ' for a � Ma� or or Minor , ' Sub -Division .
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q ` 1 d P'e The1 application f.o ah� ng r t s p rt rl do with sewers y mi i a iciila to r i i y
/ , i f FI , , 1 '4T�F y '. � lax I f. A . A+ ' J, S A t ,1• r /i ' i1 i'.t � � r
`' ' J MacNeil Do we need to •,know ' about;. that ?
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t F 1 - . i ) .� ' V In '„ tt e I i"I _yi f' 1 { y . .
x + ` ✓ `r` R'; Gleason • I'i think it ' is where mainly for the : HeaT'th Department ;/
t n s . ny r t .' i C S ,h $ .i' . a C t! Y
G;: Totman . ' , r. `You^ + look '� at th'e4 one: Gary', Wood 'made /up ' for the Town of Wallet
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and you can ' t get much" simptler� than•a .that .J _ ' The 'sketc•h is` put ton the '• ;
back (a.he same , as %IDrydeI , 0 When " we get •' .this we go to tfie Tax Map ' • I =;I
tt r hand determine do ,they ",_'own the ..property -In fhe" note ' it telhs you t`o ,
1 , ' . make" �" % plot 'plan , on the =back `and ' • it also ,l sts ,`4thexTax Map Number : `
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r R . ` Gleason Ours does too' ` but at ' as'k's = more ques,ti5on`s . It ` depends on who '
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r' sufilling; ,out the form ., Some' ' ndivduals might have. , a problem •.
7 , _. G✓: Totman • Our new iZ'oningVrOfficer for the Town ofI Groton Yis _L- Gary :Wood -
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'' t ° ijI - i , :;jai o;f: Uirg;il He is ' a1l'so `the ; Bull"ding Farid Fire Code Officer , and the '
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{ I ' ` 'Vi•llage. of 'Groton :' s Zoning Office"r He` has ' had 'theta schooling on .the'•
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L . Raymond . ; You,I.arel turnrng�pf - 0 a citizen , Zoning nOfficer to . - .-I:professionaI 11 Y.
Like' dire change , from a-.}citizen to to pr`ofessonalw_ propertyasseass,:or c
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T : ' R'otiinson • ' Ir wouldn ; t cla § sift' `him a` pro fe`sFFsional„ Zoning ; LOffi'cer ; but , . A `
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�r ., he is a professional engineer . ` ' f.
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G : Totman : With,' the , new State 'Fire I I Building Code Law; in . ,order tifor do ' „ ;. ; a
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i't' and do tit; riEght_h fyou '' have F to, have , some Atra ning.= '' Anyl)ody can 'take 'i * F r
d. 1 A 1 .-.'' R . � ) t t i Y -1 3 'r f' 1 b .: I ♦ i. Yr l N 1 :. , �
: the trafining _I , Towns and Count res. are pomp to group : to ether kto hire
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A 4 .' one per- son ' _ - Gary'Lwill be cominglr'to `our imeetings o ;we will discuss
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I`;' . °' T t any^ problems •` he has b with him . ' i ; w t tFL
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tv a r - t ,;i '" . d r l II f k 1 lr r ✓ . r" t or
Y L ; Raymond I justt wanted, ::to rsay I ttiankitrt < ar ,very ` good move getting" a _ ,
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tk ; 4 profes'sionalt ; toµ; d'o rth•is to r> ' I
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.I . y G ,t Totman : Col ,een , you ry have worked with' tthe forms the past ;;few years , r , �a 1II
F �' a.• Cr ,'it , , k : A , L • lF „o/ yV Y^ , 4 , T 1
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k "' ° ; we would like your comments 'on what yo I. would like', to _ see ,, what . ± `
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r y' < ' I ' .your probhems are : Most of the $'oard . have !never : worked ,with the forms , a
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J tC .4 Pi"erson : ,,,We have to have; new . Bui°lding 'Permit Applications' because the •' '
' ;one we . .are usingiwe don ' t need al'1 the, info'rmatront on<Fthere' . We 'haveY TI
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riot had to use plans and specs ,before ;,' we do nor . We: need ; the XIF c1 I n ; =`
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, - the tax1map. number „> the owner { of " ,the property , ' -we don ' t n'eed2part about
,: • ,. , 't 1 4 . t F , ' , I t . . a `" Y ' k < . -
:: • �, 4_ ' rr, - I ure of work , estimated , ,t;
I :'a corporation we need intended use tnat
' , r ' ' " cost' of construction Gary "aid we don ' a need that ' let ' tthe assessment
departfhent do their 7 obr I ' believe the i I
y ' ; p next 1. em c viers our multi , e
", dwelliin s. and , we ?ahould . Have ' tha.t ' ther'e "s.ome � face :°::, arba` e, r ' rinder- `retc : ;
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I `.don ' t knotac if..,, these items are 'needed• Q ' ` ant rr , r :
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` R, : Gleason Thati is f.or , the Health •Department .
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.'= r C• Pierson • ' •.The , Village I. I b,e more; , apt' .. to us:e that , informat,ion . ;than the
., 1 , r .y Town I . d th•ink;' a' hac`e - f: _ } r ,,
Ai ,, - p ork approval: received by Health `Department is
4
,r ', ' ,1 , rIeguired r Is it. ,neces,s'ary :to have ,,, in'su . IIe informa Lion ? -� � ' Y - .` _ ` `. '' o ' P� + y " .1 i .
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Na. Ostrander • No ' y8 on house or building 1'ateral� what is that ' ;ti ry :,
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I i r , t. , rot ` ' ' .�, r . ,�> r Y,, + 1 r• '. ) r 5 , e rti, ° t"; • « + .,1 1 tf
a r C Pierson • '. that . has " ''to do with - sewer O . , 11 '
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�G :;r Totman • : .' The' 'sk h,t the back G u d` her f `�
etc on can eliminate that " Vary wo 1 ,rat , ' b `
s see the sketch , 1 the ; back fora easier ,legibility, aHe would , 4 so like ' :AI % °j
' to 1
see.1 on ;"there _when ther•Bu` old."ing Permit was s.pproved . or -d'enied` or
s; , " turned rover ,<to the Appeals Board `'. for actrion`
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bV ;'rr T .; Robinson You have to have r ' I V ItaryF Statement: on ' there - ' If it is '
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om o , the Board tofr .A p al the next' tep wo
¢; Court if turned dotan ; you should •have • something: ther "; ` '', e ify
is a true statement ' ? 7y1 r
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C .° PYersron : ? h natorize ` every permit» that comes min* n,ow . The Notar riotoriz'es "T. i ` i , ! K a + L•'. 7 r t fir . . . 4. y t .
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y a +' Nos . xeferN° t`o attch'edYcopy of Application: forBuilding Permit ;. Groton ':
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r ;the sYgnatureV `only .not' the :,information . ' The :person s''tates - that • it is s >
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3'p ep would be
T `. Rob- nson : The �ppeals Board is a t e of Court , the next' sT.
r,, ' Court , ' ou s1hould, have': s.ome.• stat;ementthere swearing= o the truth of,
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,A , r C, . Pierson :¢ ;.?[ Wea•have .. -a Application , for Building • Perm-i; t diisapproyed , they . .. _ +
5` 3 apply for a ; vari•ance. ' ,i to the • Appeal. , Board , . ithat ' is granted;::; ` Wei t I ,
G:. •have .,'no idea whether _,the Permit .is 'approved later . You need , s,omethn'g
f ',; , ~ ' %" . , ` rr F -t',o tie `>:these 'E in ; ,TheE Town ; oft Dryyden 'Applicati,ori ^ to ';AppeaYls Board can ,
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ri b.e used yin , any,; way ,Jhere ,
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t > ;"I . a'=f 4 . A ✓yr J L. , Jti i�' ,k .' s • • , e ! .r . L, E 1.{ { '• , F.: r .' .. r i I ` jI
' ; } . A ° SUMMARY - OF CHANGES TO GROTONt°BUILDING P'ERMIT ,'APPLICATION
}; 1 i '
, TA = -" r ` r " ' i ` Nosx w re`fer to, a=tt.ached :copy , ' r1 t
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" z - . x `; ' ^ 1. ` Delete; ' 'cif ap.plricant or owner' corporation" { ..
5 ' Y: ` 2 . Dehete '"EstimateCost ' ' ` A` ;:� [, .
' N ^; Y, ' 3 . I I. , o`ve'r<s M iltipl:e Dwe.lrlings neededl somewhere `on; form A . `
' , :' ?' "' o, A. r - Me Tote Nos . 3 6 question: of Prieed ,• , use instead a place =
„ for ' t e 'a t n z
F ; L • , o , - appr>oval' , byx he H lth ±Depar „ me t ' A , .; , x
5 . Delete 4 a
:; � _ , s ,.; r 6 :A •1 [Delete :;insurance A'carrier ' I w ,
4 l .t , J 4 . I . , : . ,. , -1 q 1 T•4 -1. t r• 't
1 q rl ' . - r ' -.K. 7 : .:r.- , Move to,f,back -plot - plan ; , - -� • , l ; `
a . "t' r _ &r :47 ^ ' >+ i + :: r e4 > . .ii f A „ . .
r t r•1 9i' €11 . '` .+ix t [[ ttI .' . ,• . 7 r )A-1-t`,.. t •'. rA+ i"t P t MA . N I « •
It was decided to use . Dryden ' s - Application.: Afor `Building Permit . form;
I
, ' ` ` t '' "' ,X ° ` and; mo'di'fy it ``toff' Grot'on ' s purposes • Discu"ssionA followed •
' ` '' " x ,i ' . L � Raymond : : I`f we eliminate ^some oAof ;thet, 'things. from', ours that ewe d 'scil ed
` it would be '. simlar Ato Dry dens , down ' to the ba's:ic information. :
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+ ' C . Pierson: On the Special Permit we could cover' ` the Swirmmin Pool Ordi -r
g
x
t ? a '< ' nance , ` Junk "Yardw'••Orrd nance; ' 'an d^;gist each- 'on kit. +then" .. list ' '' otfiers ' % ' % .+:
+ z to cover ` ' , .a t > ' r F 4
• p -1 V To W
tt1 ' ,s - a A I r+ J c'; ¢ w S x a , • Y {t:U,. . ' n y 1,..''ST
t r ' , o- , - ,y, " _ '- r
4 ,G . Totman : You ' would also" ' have; the : grid ' form on the `back
P I "[ r
Po
4 ^ ii' .u' 1, t & , h . , + ` t -Y . ` r " t Fa 5. A i . ` ° ," ` y ' t is ,^ t y
} M • �+ f .•, i j f , f s x. i , r C [ , .,, , of f;. W ,..V - ; J 4
< R. Gleason,: The Junk Yard Permit has = special 'fixed questions you iaould
f r . , A . .x 5I.. •+ 'S" y r. t ,.e 7 r r i ftC } Fr-
ws t 'Eno. need on "the ,ot+her : ' ermits ^ `+ 4°f »< I r ,
,. (' t . Y t . ld t •k '� 7 4i . p 1 , 1iY . hA 3 yp , a^ ;,I.r , ' . Ii' "4
t ;� L° Raymond ? % % lU§ e the same form rand, put two ,Heading's to: be checked -` 7 F
Builda P a :1
ng ermit / S.pe'cialA Permit w lf : h
v 'ts .t t t ss f 3 ,r^', 5Y r' ,Y J i' ♦ A `'' .t . b, t°a. . otr ! 'f Ad, C t ` r .
J . MacNeil What differencie' would it 'make: if t=he property wasy ', purchased' "
1,I , , r ; the has t ,five , years , ti <` - '
k RPi`i Gleason : ; Would be va Kq,uestion if purchased ` n the 41ast year 'a' whot the ' $ ar'
, I . , . < o
r ; previous owner was onfthe Tax Map : . .. , f ^`
y ;, r r
' ` o u• 5' f 4. �; t [ { at `{ h c • ' It +, r J , , J � ry1 . •: irf rjr+' .: • 4 ,, t, !• ,t f. r ; _
G : , To man : You would have the Trax 'Map Number regardless : of who owns iit .+
, r A . , if t
z[ :rr « ^ cae can delete that � :3Chari'ge ` tle� Zoning Offeertto .Town Clerk.;, SCha'nge L•: `
4 . 1 i Parcel Number{ to- •TaxyMap � Number • - + + _
S # ` ii F. Y v '. F } -{+ s C. - t]'i yr " A ' r ry --'Y [ t 1 .. ' l .I` f . ,.. f - . ,
L , Raymond : If buyl , on_ land contra"ct"' ;the d.eve`loper is drffererit from the
TI
o
T.
f;` , r e owner 1,'` I I . 1L`, - l Y:' a r` { . $ r4 t A L •Y. rx4 }
• " >,,Ii. rr . `;,,,; C . - t U i�' t i ' , ! ;7 ' C r ° A I . b = j . [Y - V ,; II
'ir
p I + , f
t, IT ` , . 1 " ' A J K . (. y. ITT."'t` i ry A A 4 t .Y.
ol h
i -•.r. L L � - a e .s nµ ' ! *� /' C{ 8 C ` -,1 t y , ,- . ' r "'
,, Nos,., >refer ;to a'taacheI , Todof j colpy ' of?' Appl11
;i'cati`Motor ton � for ., Bui'lding „Permit , . Dryden
ILL I ,. • [ •} ..•t '.to S' i " < ♦:t ,.. r �i'.a9 1`' -4 w� ITT4J ! > tr•k. . ,Id r• u : :1 r r.p > r _
t k' r:n .r a .- I r
ry\ - f I • -
� , _ i,
S .' t I „ I 4 r ? t L l r . � sr
IIII
t rr. ti x , ' , w " s " , 5 ' •{ t , e a r -. ` r II II
III III I a
k \. 1 �. } r , t ad, r \ I at a 1 - ! ..1 i . 1 rr k I _ II
II
tIII II
II I
'� . '. ?. „ '' •. r t i,, r Tt, ,t ✓ r, t k _ ktr' .frY4 > i . 5 , 7 s '.[ ,V t II , •, Al v t
II F.IINFI III III
o
II
I III
II
I II
oI
iIII
II
aI
41
AI
II
III
II
II
II
II
III
o
III
III
I.
rI
J h . tom f r , t k -tr4 t; t' ar _ . , , '
n It 4, 1 � sl,e ✓ !. 'x1' ; t s t . .7, L e' - , , r r A `,' 5`5 n: Y. t '♦ .,, t ``
r ^ r+ r ': '} n ✓`[' a t It W ' t - -a s_ o S \ i5 't + v r t a
i
' 'G; s,Totman : ;CIS itI any of , ,our business , I We are only Ic t cerned with what
r 4' : ` is happeningp' to thata land . <Take °a piece of I I I-I omebody . : going to .
. t a , build on ; tdoes it comply witth the ordnance Is, itt our. business 'how.t, theya
; � got theI xland as Long as it is theirs ,z
{ I a . Yj I .N r' Oxr . lam " .. , , 5 : i•,r :i , , ; ' j 5 4 l '
/ , ♦ _ *'.a IT �. n IN t L t t � I m -" < I IN
`a' :'> T ` Rob ns'ono'' >} - The l name one the land contract' is .the owneI Is Fame until it •
a ✓ r : - 2•L ° N' - tt ,7 a 5 f .{ i t t +, r r ' a !
\ hw is paid-, off t , . 'r ` r a ti
a S t I r e. : � t y tr T } 'y t s ` 'L y, ]" I 5.
i k of, I \ ' Y i., -N& I .w t-L t J 5 _ . L 4 .4 ' i ✓ A i '..i ,q \ y" ; k b . . r,a t'rt i t -.•I 1 ^ ,' I . u . .. . t , k r' } A ,
Gi: Totman : , From our standpoint it is 5 jpist about the eland r, We can t reuse
S r., ', d r
>y: Y to ; issue aT p'ermit~ if you have a ,= separate contract with som;ebody';, else : _
r, r } P, 5
1. [have a . ,contraot , w th , a tigu- that {spays you can ' t build ; '.you ,come in , for : . � , ' .
..4 4..
a ; permits and we >: give` , t stor�you . It is not °,our vprtoblem it ,is the other
t s ' y r - - X r r ,M1 >-ti i '• w r } ,,.. >r 1 . ,�. v - G . ✓ « ,. r
( c -,. w Yt ; < . fellow 's' , , i i.} ''y .I IAd If ` k ' I i k +. 4 - ' r N I t , ' '
i r 4, ^`�s�t4 , d - ya () •l A , : r xi ' . r `I, I y '` ; . , ' 1 � ,, . ,,. } r
t, I . 1 1' ' S 1 r M! -1 r ! Y .4 5 M ) S a i '` M
t t t 'K 1 y L ♦ « YA ♦ "•, 1. F , » , ) 'F , r 4I y . . } 1rt t r ' , P
,J , r : 3k YY ri #, t 1 y rtr c :ir s ,
r J : MacNeil : Should wer= be invo.lved .r r `' x , r
5 \N 41 M ,L J (a, t
l f r I. 5Y. •, "� .,y r , t _ . ; t 5., r 4. t a - ,L r,. ` t: , t ,
I.H t 1 aM r 'ti ' tF i �t I. } sr - i l a . ' \ Vj "'- t t r . :! 4�yy �57 ' Qr ` • - } ,, ^ I . , . rx '
r r R . rNGleason : If4 we .'grantIT-a ' Permit for , somebody to do something ton ;a piece '
..,. . I � x' r tin k .:: - v' _ r >'•� t - 5 ', a Y I - , rrY r .t M
o�f property : he":va as and ' it; belongsF to ` somebody 'else , thie4 owner comes . 'in
h
a n 5 l.x y b . . t - tl� �, }` fr.. ,w 1 l M - ;t r i ,k r, } .,� L • , ,
'. _ a'nd says Lx'=you , granted that -' somebody could;:do , such and- such' on ;my " ,
L ` " proper=t-y,, and ; I ' dkdt' t say ?he ; couldz, therefore I ,'=m not `•going to = be bound ' S :. J
C
e T y r p r •. ♦ ,
' by Your; decision ' ; , � e. ; i
{ ,�' t r p t .. v ^- s Ji ' r e— r I 'S- ' ., [ v •, 1 4'.. e - .. t. t ( ' ; ^; t1,
t * . '.Q _ f [ >aI . i p P 'ivr ate I At �N. r l ' r , '. t t t f- l ,' ,, F 45 1 y i.
} xy It I CIA JP_•iertson, : -✓ ; 'Can we, ,issue a ' Buitlding Permit (to,; a person who is not thef 4 =
, s r , ( .
. i Va r ,; i# 4 , ., owner ori ' the Tax Map _ 1, , t a ' '� I
i , rI• (V in' , rt 54' S i t IY t , F tl �I t 5`l1V ri( t I '- j r .I 1 rI . .t 't } , .`( v ,.t ' '' , . . II I •' ' •.
rJ 5 :=- a ^� 1 r I y 4 t ) µ r i s .f V •4 n' :\ t . , , . •'.. _ 5 n
r ;: , G : Totman : OurY, res'pons bilit"yt is : the structure . on apiece of land ;
' '
L determine whether' .it . is `detrimental -;to the Towri•� Suppose 'zwe. ask , fort
i. , this :information and :tthet guy says It , is 'none of your business, , . It
"'' i=s no *business of` rthe Plannting Board .who owns the land h - x
St J- L ? i , r T t <: L 1M rr,55A I r' + r - <,
t i '4r 1 • [3 r, • ' •• ] y ,YT 7 \. � f _ : .•. , •s a { .4' '• t
x ` t ` • trFrtM :hPost :, , t ' r\ I think this statement at % he b`ottom ` ofrthe fI '4l- ' o erts "this y• 5
I r ,
t4 r
= a -h We are, nnokt ', preteriding 'to su_perceed any 'other contract; " _ 7 t
,tj t , _ 'g r I ` ( 71- :' F ;,.,. '� e w ✓ ^ ' t 4 t . ). .^ 5 I ., t ♦ - Y r1 n r
n t . a ( . y:r1 r- F -,t s < y ! j. h." F t - IY ^ r t L ' p ' y « T _. _, 1 ' i•, , r• 'er ° n . .
,d L �I ,t L:. Raymond,: ' If you „ 'are going Nto leave ^ t ' in =y", ou `,need line [ f.or ' applicant ',
".. iw xV
a and . ' owner 1 IL Y ., On-,. the Spedal ;Permit t it says ti owner of land and other_, if ,
yS. , ft , 2 4.. ✓ .. � i , t. Ir1 4r � l ,T J , k , F ' J ' �' It 'Ah. 5 ,�.` 5
Y ' ~ ' I , • '. t A a L J 1 ,v1 vA .A:, . - t I .'h + `
not owner
♦ t . l I , 1 P rr. i , u t ' o'nS ax A I ' w y p5 I I 1 , . ( }. ,
d rt - ,y � l i4 , • , I „. . , { F k i ., rt - "` t 5 ' : SLt
e &., F r \ 1 r .' r , M Y' . :., t - U . . .e ,y It, t y . . . 3 n =r
r () , . r
W I . G. Totman : I Where . it `°says owner of land • builder . after that change that
T . , = .`< + IJ _ « �-.. . r Sr tf t; ! r• + a: L 7 r r
< ' builder ' to "applicant , l _ :. ✓ _:.
I f y add t . ,, i o y'.F � , ' , . iu r yF. r . i -� aA t IF
f 4 F, r _ I ,¢ V a r f. .F k •< L ( I ( t 1 } C
s ;` ,T . Robinson:: Another I,thingt, with the,� newI Fkire . and 'Bu ' Id'ing� Code „ you might
{ ; ; have 'to know who" the builde"r / contractor ' is . , :, r n •
V -. it ~ e r { N tt '"P } 1i . '+. IV r ytaV , . , �m. , r it `4 ; \L , ' r ' '4
1
P AT J f``:. II ; • Pxv a, s y #' -r: t t t F` � I I t .,. a T, 1
,h I r` s . 'G Totman : ^,' Gary will ; be going > #to the scene3 ^and nspec theoo.:property ,, , t ;
•
'rat t L ' he will have to . know ;who the con' tract:or Lis ; ' if, any . Put . ' builder ' .. ' ,
-
. '
r , Frunder `' owner of iand,.';on ariotherlline :a' , The , fist' ` concerning ' Str'ucture '
! I t w {;
" ` ' S_ are �t"here for th`e benefit `o,f theA Fire: and Building Code , we rcan leave
•r , tL',_ II 4 . r _ ' . . ( 1 ro ri • r' 't a'4. ' L - 7.0 t ' L . e I r t I T - w
' = I t = y ; .rr , 'a's they are. I The hright hand list refers ;to , permits „ , , ,
} it i . _ y :.` C , r,.a TV it I, C - l G V a A '
�? A n '.r :. ,� `•- t1 V • 1 t • ; ` IkA , 't # t IA '! � 'S ' A - 1r-M y t ^ t ' t « t ',1♦ kL< 1' t ( nA I ` .,,•. ,a i
I xY I L Raymond : .' Do , we , issue , blasting I permits �'
rs ,, -.. t i x , .A w a . . , . . a . . , r r ! 1 - ,
'.Y t ° L 4. . ! . y to i A .,1 'n., > s-: : I
t' A ff <il MY`Y `4 1 . if t :. li a. r .:LI_ /r It :1 ' ' 1 t \•k. M—,I, IY R. li Y Z ,
; , „ }C . , PterI ' I 0 =L, k No , the State doe/ s[. �,,s _ L 4 t T '
jr; I -f• S y ,J} .. .; u J. - , ,, r i r" t•, i t -X : . n , _ - tL 1. ( 5 . y
(y ♦ ° t.' { I 4 (i a . ' ,- 'Y .I' e (T� , F . < I .� }' a r t ' . , IF a t, f r -• }
't+ nr t ry C 1 < , JI , "a i ;.�V J r - , . . > V 1
r L. Raymond %; 4 , SyDoe's the State `inform. . the 'Town, when someone has , a permit ' for ,
b1'asting ? py Ya, ,c ^ G x
N° 5xF r'r• •i r t ON t a "Y S I, o, .{I j f i . � t 4 � A r ' >r E +
1 '4 i . L III v xf 1. Y,. ^, tG at y:- dJ i t, t .. .. 5 4 I h . I - ..
7 e ! Lr
III
At
II IF
II
J L F ' ( a - • 1 y r - i{ J ,Y. I i Y 1 ar I t } Ak�« ; I I r • n ^ I-
- .{ , V , ' t 5 4 4 Sa" -l !• Mr` .-,(I t ' E 'x' t r . 4. ,a I w$- '
I.d t
' N ' r y '. v t k ✓ I y. s K ._' Z A 5 , a V Kra i s .. , r « I 3 r+ x
.I Wr 1 , 4 " 'L lI I * fix: a ,. + I 7 t,
a
do
41 L �ia,a: G # 1 ;'• a L a ; - r ; ` - \ J ! 4 .. •t . 5 Fall. \.
FIT - . I .. 4. ,, .. y I it , f.
41 a .. Ls, r "A .r . rt+r Yi• L 4'• Yr I 4; '{ v' iS r T f, ,A +L, .yc♦ cY fl. , " �, } ' a t _, , . . , . _r % I
} r ' . , r r 'Y '-�r)'S 1 "�:52 t' � 'i • I 5 'S ) Gtk lam`4N = fSt �4 ' AS '�s ,5 't _•,•)xir k.'L. ,A r t� pY + d { ;C f: ` I Y5t }' A t r v . '
r.
As
I iS ,.J ♦ I.t` 4v rl '.,ryy lid. i:',5 ror , - rs ( , �ri r P1. ' ati ` 14 , `lz + ' Ytx SyI Yr♦r r { rrri • L I L d . v r .' yam r • •r SI ''' `' },,I III
+ , *•' lief' ✓ :.� ri '•^.iS u,y , f - y# , p ¢R ab 'y� ,✓ ti ,y ,,, I ., 5 _ r r
tI
( ✓ 4 ,, , Tr I ; � . . t 1 >t:•• ; ) {r:; •L' r ,r5i I r,Ir i - -y, + ,d
II
eII
II.e1
I.
kI
I.
.
f S ' S P }tI r .a . J " e
y , k r S ; c tyy' n Y i-, ) {r . ,, .; i ' . 1 : f ti* t `,•t ,.
l - IW✓ t r y` d 4 t M .. .i J" �. ,2 �'4 'i".4 t - I r, 0 U .^ 1 - . `r}2 ' f } `Ir,'!
i t 1 t , ) + r
r i I ' ' }"1 . # h 1. c L — a r I a , i • a , r ' .a ♦ f 1 y ,.
i
C : Pierson :` ; �No , if: , you put it< in you still' would not •know of any %permits
4.
A , . c „ *fer
. . .. ) , 1 tY t d ' , i L ._ C` i f^ I.
II
L . 4Raymond: _ IF 'think. it should) be , put 'ti1n , for :our :own informatio ,j*
II
IIk
II
II
Iil
l.
sIIA
` h IA I �t I S v s A ., s r .Ii. u l ` , a I }. , O „ r4' Ya a t fr.. S er
} ? 1 , i ' r f� It✓ do Y , ..I, ° t i 415 f r If 1 5 ` • , • e, it a ,Lf` ,_ •^ ;
{, J ; MacNeiyl : . ' , ;Number of; : Familys Uni:.ts `' ,family Iuni,ts not• ink our Ordinance r: I '- r
-. ,t .I 5 . y r y y . I k, y. y r k R rt FA .
"
' it ise� dwelling units : ; rr 40, I ` x , ¥ I1 I , �tI s` , i
+ - ''i v , y 1 fJ ,A itfft t' tti .n` ♦+It t S , , v Ar 1
` . .,,' S + t r L , I Y fir, e I { • n + ♦J 1 ', rI a 7' { t r 'kT'j, +.y.P .I 5 I II
r ,I.; If11'. p (,, } 4 { F #f � t4r V; r r f
•` S .'1 ', 'ti r r y. : L r I .`T s, I ttI' I ,.fit. . , •' . '` ties}yr b , : , 5 b x n /•. . : �. ✓ v 5 , f ,< Y i. s .,. 11 -- , �.r rr a 1
f , ) SUMMARY. ,. OF ' CHIANGES TO DRYDEN BUhLDING `PERMITrAPPLICATTON f , '
x w ♦ . .x { k e,' t'? .,N t i1 r L, f 3 Ai r i Y } y r
J , P , .. v , ' r S ' A r .; - r i y i+ 1 " r fs ;l
' :; No's .° I er to`. attached ` copy, * _ . , : :^4 , x A, `,
t ` ` -, II ✓ t rS Al ' -• � : ' r 1 .- t t ' . ) I F - - }�. I • • Yf . '+ - ,, f
' f ' ' I J " < 4 _ 4
;, I s 2.,J r r a te , r
, r .� y AX -� - . . ° .n . ♦ t t •,. � r r I . • � l r SI , 4f ;.AI '
a 1 " , ,Tw;o headings'. Bii;ildirrg =Permit"/ Speciah. Permit with' Box '"
, 2 , , Change --.Town name r I I t '
r r r 1 , ! a r .. r W .. I :, 5 Y r s•
I K r3' :' ). Change rZonin'g Officer to "Town Clerk I
Is . r ' r7. t f-ti t r .eI Y ' • - S. . 4 r cAl v yA
` , , .: I Add' Feet $ , arid Date `fi'l:ed - s I '
A ," 5Y ` : Chan e Pa c N M s; t I
t ' - IAte f g r el 4 0 . , . Tax , ap No . ,
' t ' r .2 %, �' ., 6 : Changes Builder ` to= " " * ican- t �N. • .� LI
I - 1 , , I 7A:; , r De'1 ' `P rty r x�e d tBui;l der /FContractor ete rope monde tc : a d
r , , a ` fI II r ',` 8 •: , Delete ' I •' fProp'erty4'was Purchased , , etc'. '* '
1} Y 1 - I, �/ . - l " Y i -'tr r S. sket I' F a L
} y +, a ; ) r , , »+ , ) 1 a 1 1' , , I. q . s it c l • '♦} a r k
} r } 9 }, Delete Construction . and > name and address: a +
II- ,} A. I v lI I4 . - . i . k +' .1 {�, r - ' I , 5..,'' r ,r ar o,+ 1, . 1 rr : - = i1 r ti :5, ,t-
} - , 4 tr10 , r Change r' Family` to Dwelling? , ` : - ; ' } : - e
+ It " n n a- a . , . , ' .r t a. I a s - r Tr '. 1 IN I f k;• P
YY , r * ', ) H � > � lh, , d SE • R,, W; : Pr ; . . 1 .s tF I ;,.
` } 4. ' fq Is r4 ,k , t C rr �f ,iI rT °' . , '� I ,I ' r "' Y F. I f n' - j I l + V , , °r` t ' �.,, t i z ,
, 12• : Delete '. Town Clerk add Flood Hazard , Zone , 5 r;' ,
I r. r -I . +, .+ }1 rVrt � ri' I t I i t' ,.)r.. ' , . ,I , '.w vy , t 4.
3" Delet bl n '
, 1 Delete 'Dr'iveway r , , ' ' tytl ' ;L ;A
r ; = r 1' S;,. f Add' ' by ' and' "' date s, :) ' 2 f 1 t ,
l Y ry f ♦ f R ' ,' ✓. - , '4 -C , ?�, r r ,£ -!. k K - t r .. 3, I ' J r ♦ l
7 ( r : f to 16 .. Ad'd by- , and . Y date °I fr "' x
y 1T Add " Certific'ate `of Occupancy No ` and ( date a : ° " .'
Iik } s
I * , A ' "' t , 18 . Add Certificate ;of Compliance No0j and` Date
? 19 :a Add Notary) LStatement` ° -
o . i _ : °
r 4 .� ) s , r r h i .°' 6 4 1 A , ' , " I S r, i I. ' t s s }t ,t, 4 < r S , '.
Board ofAppeals form ., keep = it , `the sway it' is ' ;; { : ;` ,
r t + 7 M 1 I x ` 1 ' u .pL A f , ti 1 r;. . It #. r' 4 • ! ,Y I I '
y i 1 „ - II A ) ! 1k , rI' ,41 sy I4 •1, a,» Y t> M' 1 t• _ I ,♦• •,. j ;
r,. r a, ) ,. r fi ; , : S ref r f fi O . f �i - - r 't ' I 'yI � .`. } 3 A uik e, r..)r t '. .reed t Iv. ; ' - A ` r ~ Y
�° °' Building Permit - Add Tax , ^Map4 Number ' ands Eermit Number for iden'trfrication + «
t f.. 5 i
It
.V'+ \ YM t " t y f...y f 1 , i I h .Fp I hi I r 1i V se , Y 1 /.fz Su r L` r 4 ♦ a
' !' .. ,. n , 'S 'r S' ^S d Tlty .. ♦'i x t,C. ,lt h. »y 4P tn^'" AI r. 1, , t 1 „I.
II . t n ,S 1 r' u t z. rt r { .{ II -: "2 `'S , d J
y i d . l ♦ ✓, •14 r � J%, i t ` Y ii -:SJ IG ! 9• ,
" M :e Post : t t Hoia: many forms have wet"eliminated toni' ght � I I. I ' , ,
y
L •` a r }9 ' A. r .T r f Y, 5 t t a . a .} ♦+,,A4 SS ,, .' I 1' A I4 a nr , ' + 'L "_ .
r a13
C `° Pierson : I ' Il?1 have alh the ` forms '' together for the next meeting
N . ; ' v S i- t i ) , .Y A y e ` a, l - r : y Y' I n' ,yr
' 'I t f� . ' i 'r .I '`- x S l t.rF I y r / r .a , `f . . r )ir
1 . r At 4 -'t I' . 1 . • 1 . . .., ` , f - _
II
kI
eJ !` t .` J rA is . kr i a , Y I s - ♦ , , Y I ,, .
• h Discussion` on mul,tiple' rdwke he s : - ,` " I
S L }} I 2 1. 1 F -.\ t 'a„ . ) _ I - I y s 1. S I , 4
' . Ai 1 , rt ' f , a .4 , s >, r ' a, Y y ..1
N;: � Ostranderx: ' We 'can get '� a :compl'imentary copy of all : the State ',Codes . The ? • 14 ` s:
Y a : ; r Y, t - S . 1fr {,4'I 5, 1 <ft ''S f flY' S ,t one is . ,free • _' i' ~ Y `'kr " �fy + r! ( , ,C ,.. r� 'f I . „ fl , ..I.
.` I 1 , . • <^, t r v.: t *Z " r w ♦ . 56 e ' + ,�. >,g ,j - R,yr✓ ?l+ I ' a, . f rdl
T u:I ter , * ,1, y " I . % r ,< ' ; $``, f` r ` r? Alit agreed to )send [ forthem . . ' ''
4 4 y++ r -I Y "T Jt\l CAL t L . z �' 4 t I. .., >, }Z , 1.. T2 4 r. ,
MI i -- 1 r . , r , ♦ Y z aT.+ c , S' '+b ' 4y P w ,� ,z•, 1q1 f } ./ l .'. j L 4 , +l -. a r , S-) I / j''
S ' ' {{' b j i,.' " S y .:t ro w" •4 nkyy a , y S Y.: j 1 "La1.r "y ) Y
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: . N r Ostrander . Di'd the; •Bo` ardrrapprove' thex ,chan'ges ' ;we ma"de> >last ,month ? : `_ . _a, .,
♦ % . I ( Y i. ) { J t 4 ?' etr,$ .. > ! t .� . •5 {' i 'c: e ? ,. . � ,fi r wI.
1 . , f rrTt YSi' x ?S r'! st F , e 'I • }k` 7 . .like S• A r''`' „ '. ai VtSJ 'ir Y. Ito. `s 11 ,�) �'tti t1 ' ". ^�X. , I, mt ,hJ, I I �S t, 1 a 4 },ki l;. , i � [.
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t It , k, r'f ;I i `^• �jF 1 , kv. :,? t ,T'If , r� 4h,t L 4 r f., ry y,, 4. �' r 7 . n.. ^ U 'l - V}'
J ♦ 41 - .. :I f _ 5. ' wd' v + 7Cr - kk iS Y�, $ i .
r . G Totman 0 That was; rpassedr at the L . ,I.. . A, meeting change ' 2 ' to 4 ' 'to . ' l� Y r rt,S
f t vi- S Lt .4 a , a , ) , - I.. 'Kw e i f i 'm - + , : Y r e >;+
+' ° 1 1 1'* V- 4. I/' 1 lie s' . i � I rr$iM1 .)5 ) t. {d ' it r' 'L t r. -
.r` 3 to 5 ♦ and 5 � or more to 6 tior more r ,
{ . t I ` a1 9 il 1 t , t - f If a- .G - ` I r( I. )
t 4' VI >l l .. ✓ I ' - I , >'' fr _ fl ! ♦ . .;r, . ♦ L (. .i t 415, . . ;j Y. . ' rt i ' 4' . 1,� ; t K - I{:
•< .r �, 4s t- `� ' o f i 'L (. T s 2 ,i. t # I R r • rLlt r )f 5 r ,
T : ' Robinson : In';doin;g thin ^rwe accepted` thrat , to=ti; be done at aflater date '
- t r tee 1' '"i' r if I .y'S' Y� r t - )• , : ' v d• 1 `y. r 1 ,.., 1 u
when all, the changes, are completektas a Local *La r " They intent o,f. the it
iP q f ° 4 Ati i - . it
Board is there ; " ,-; t t I , , ' i
r. ',y 4 r- r ,4, I r 42 .r f - + r + } ,• r
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i J a , ae t* s 9r , t t} yy ¢ ,e. } e S S '/,J{+ r ,� t z t
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w "� r r si `a . `4 `, 't I J. x y rW .S ' . i .,STrt S-."I, '' C J � : ". H - ' ) 'rr , 5 -I % V ! .} r I
M {S `:! stA m. . S Fy n y r -, r 7 ? % ',! ,' l { ' F ) I N s .
r 1 r ,. - ra w ka a ` i f♦`^„r" ,y.. •t , � L r'. 4 ti 3w }1 3 .;+ 51 7. ,r 4 laj r •.ra r" 1
tt Y f j,. 'it t r'r 3 t r s r 4 l'r J I r , J'f- l.,y. rr N T% x a , ` r • t t d i t I� r '. r „ ♦ � s
tii l ! }, r 9 `" J r ;. :� i;- o- 1f R . F Ny4 ,. } z k M .
t♦ ,. Y , eI isyv `na a 'f _ t•a•1tr r . .ry r1 r arry �♦'i. 7R'l ifi'f fit * ' „? ma' s , Me . a , s l! Yvz. .r - h ' r
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t �� f1y�' 1r r Sr I , ry is Cam. r �.:
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ry .Y t '' t " _ : � R t4t a 5i < y'S } tli y..t t .ram 6 � d.
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6 .ry e * I " i it i yt +�ya .' �` t tt ,i .Pt t . '.
*' 1+ RI n '' ,I i r * L .. - tS . _ w c L J y, 4 f f: t s.1,, . i 3 d y y ;.
t
R Gleason : This, past year T had a Sub division approved Before he r
I F rV•,, a1I d t 4 .
f1II ` f. ` finally: bought ` it.rIj came back and» wanted "additional * 'land . A11 the
I { Y'i Y Rf f t i '" .R 'o, :...a . y,. `Y 1;. n • J r . I q t �I ,
n; i pap"er work was done on �the ;.,first . "parcel `so we e`1"osed on it ` My . ,
F: II, . o ' ,, �it1 h .-, Y" 'i 5 . t I Y A, ' 3 t . 'r t Y k .A i
Ar 1, : i a a questrori pis do I have • to go ;through anbther : subdivision to ' sell an f . •
; '�} p fix additional parcel ?' J ; � i A i \
i I i xt . a y ♦ n I f fi . y ( , a J t y :. ,
G Totman : ' �� _; ` Youkapplied for ' a `IA.Minoro _Sub -Di`slori and you sold one • p;arcelt . '
a 1 ,:fir i ({, 1 r 1 a . J . t
` ( > �How many acres ofr land ":you wanty to, sellf now? � u s
♦ Jt } tf 1 f.. f ,. stir« , r'I'`.t t I fby 9 l : ) f i , IY % I i I
it 'a t ylt,�• ro L . i4J, xo�" d i ..,7 Id . J .rr < a{ :' t{ l r. t >- ,Y' ' t
i i T3 - t I t .
, � ' ; R Gleason : 2 :6 " acres, ,, ` the firs. - parcel was 21. 1r they do n_ot total five
L +ts: L U i1' 6r -I, 1 r F ;, +ts .ti,. i A , f x : f
L . I acres ', the' whole , parcel; is ,more ,thantrf ve . �
t - „; = V µ I -v J rt ' (a a p ,i Y F d r
i
r1. - . l aR. r I` rt, 7 a 4, I :,E } ✓. . .
� ' a . ,� n I ii ♦ .,. a ? A J (✓ . < it T l f 'i r r1 - .ys
Ir i , _ I , . 1 . • , a ,X.:Fr Si„ Jf ;�', t 0:•: .a � , x tf rJE - .: > ^ ' n n a J FM.s t a x
G . , ° Totman • : t On . this ` part1cular ... dilvitsion .'there ,was , 2 acres and' you -
s rt, - ' "s t Ci r t .. •: it J. .y � . 1. . ,.t ,' ,
d ,, sold one parcel , 'the application was5 for one hparcel . The ,way ;the
i -'t •K' 1 . t.ti c j L i i It t + t t " ' ( . i 1 ,� r
i , '' „ � Otdinaii'ee ris, ;now ny,ou might :b.etterresubmit ,;fortanotherMinor Sub.=division :
a✓ yk.. ✓ :^., f # 3 t , . n 3 I i r ! ' f ri . 2 :, J :k y `
1 . V, 2 i . s 5 h , t V, ` . s1 St, I -t ' . -of" 'S„` 4 , y •,:' J
t 1 . 'e r J - r , i : .
i : I ;L R Gleason : I ' 1,Y ,have this to is,ubmit : at ; the next meeting.. : P � ; r 7 ;
1 . ,
+ 7. ,� t i, � • t L tl.. U71 ry, ^ -A* /. 4 ofr t rt s J 4 . „ � f h i r- '5... • > - t : t
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( . .!. f t i. � qT i i N. , r r . > ' •}' li o , i,
.. 1 G ',:. ' Totman :✓, t ? rThe ` nextPmeet,ing we,dwill . di,scuss a• ' Zoning < Ord'inancer,fyot
• .I ro : r " f Multiple Dwel' ;;. I & tYia:t ^ we •' can pr:esent•: to , tfi'e ,,Town Boardtfor` approval
y I 1 r
x , r ` � ; ' Right •riow you cannot * y%e allyt buildr a multip`1e " `dwelling in the Town . . J v ..
a` . i - I r
t ' ofar,` GrotonPr un'1'ess It is ` 840f sq : ft;. per 'unit : s }
5 � . I T y
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I J f j t it ' 'f rl 5 I �( :• . I Y h rJ , i '' •, ' .M1/' - ' .
sM - r J'. IIMdbNeil cmade _the motion .the meeting be` adjourned ; L- . Raymond "-s`econded .� . . A
;; th', motion A11 ipn > favor, . - Motion' catried ; ti a
r S 5 . '� .iJ' rI r ,r +t Ld L1 wt �..,t 7P r 37' . -.,�, > ry'.. 5, t .,,r:' ` tM I� ]F. - ; _ Ta
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I• 1 B. - i ro - . I I ,
1 f " Nexti re'gular ':meet ing '`of the : Gr'ot'on y L I ,I ning .Boar'd 'w 1 I be • Tuesday �n f ,.
+ r h - s yy a P er I• , I �, r . .
A Ja'rivary '' 17 , ;I at ' 8 : 'O:Ot fp Ems: ' jd ✓ � , ti ✓'
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; ' r �. ` y ° tRespectfully _ submittted ';° "
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y * . , II✓ Yt t t i. Iro Iy. ,t r • t t h I ' r for tF d1 ¢ ro ' 1 a • ; . I- .n f r r f, . _ 4 .
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" r .t . - l ry, J . •a �' J t x x '
+ ' y tit 'n r, i ,.'t . • -�
ro 5 t t t s t . t a,f L y ''"t i
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1 ' f . , � ♦ f '✓� t* Yes I1 . . I .. r *t r r ; ..i i _ . .
Make sketch on back , of building with distance from center of road & lot lines . Phone No .
TOWN OF GROTON, COUNTY OF TOMPKINS, NEW YORK $ FEE PAID NO .
APPLICATION FOR BUILDING PERMIT, CERTIFICATE OF USE, CERTIFICATE OF OCCUPANCY, SEPTIC SYSTEM
Two complete sets of plans and two complete sets of specifications must accompany this application .
The work covered by this application must not be commenced before the issuance of permit APPROVED BUILDING PERMIT
TOGETHER WITH APPROVED SET OF PLANS AND SPECIFICATIONS MUST BE AVAILABLE ON THE PREMISES FOR
INSPECTION THROUGHOUT THE PROGRESS OF THE WORK.
Electrical wiring must be inspected and approved by the New York Board of Fire Underwriters.
No building shall be occupied or used in whole or in part for any purpose until a certificate of occupancy has been granted by the
building department.
Location Zone
Street and Number and distance to nearest cross road Bate Map
Map Number Section Block Lot No . Was Filed
State whether applicant is owner, lessee, agent, architect, engineer, or builder :
Name and address of owner of premises:
Q If applicant or owner is a corporation, give names and titles of two officers and signature of duly authorized officer.
Name Title Signature
Name Title
Existing use and occupancy
Intended use and occupancy
P Y
Nature of work : New Building Addition Alteration Removal Septic System
ESTIMATED COST OF CONSTRUCTION $ Land value excluded .
1—If Dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
2— Maximum number of persons employed or reside Waterclosets Showers
3—Is garbage grinder to be used? Yes No Bedrooms Stories
4—Location to nearest public sewer
5—Has effort been made to connect to public sewer system? Yes No
6—Is property within a subdivision approved by the New York State Department of Health
Name of subdivision Date of approval
7—Is property in a subdivision approved by the planning board of the Town of Groton?
Date of Approval
8—Is a house or building lateral to be now constructed to connect to future St. lateral?
9--Compensation insurance carrier Policy No . Expiration date
10—Architect Address Phone No.
11--Contractor Address PhoneNo .
12— New Construction Additions to existing Buildings
Accessory Buildings
Lot Size
Front
Rear Insert additions
Depth or accessory
Dimensions of new buildings with
Construction dotted lines
Front Rear
Depth Stories
APPLICATION IS HEREBY MADE to the TOWN BOARD for the issuance of a Building Permit for the construction of buildings,
additions or alterations, or for removal or demolition, as herein described . The applicant agrees to comply with all applicable laws,
ordinances and regulations.
STATE OF NEW YORK )
COUNTY OF TOMPKINS ) ss. :
being duly sworn deposes and says that he is the applicant named, He is the
(Name of individual signing application)
(Contractor, agent, corporation officer, etc.) .
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application :
that all statements contained in this application are true to the best of his knowledge and belief, and that the work will be per-
formed in the manner set forth in this application and in the plans and specifications filed therewith .
Sworn to before me this
day of 19
(Signature of applicant)
Notary Public County
Examined 19 Disapproved 19
Approved 19 Permit Number 19
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