HomeMy WebLinkAbout2824 TP 28.-1-34.35 TWO FAMILY NEWI
TOWN OF ITHACA
>_r• APPLICATION FOR BUILDING PERMIT
'flue of Improvement
52001 - 103000
102001 - 20,000 - 20.00
20,001 - 30,000 - 30.00
303001 - 40,000 - 40.00
40,001 - 50,000 - 50.00
50,001 - 1002000 - 100.00
100,001 - 500,000 - 150.00
S00,001 - 1,0009000 - 200.00
1,0000001 b Over - 300.00
Make Checks Payable to the Town of Ithaca
Application is hereby made to BUILD , EXTEND
at I /! < tho C;rr IL
To be used for a -?a-'} •rno��i~
Structure is to be completed on or before
Landowner 1QP- Irn;,F. ' )U(�� ~ Build r
Landowner's Mailing Add.
-essCrf�_�-�
The Structure(s) will be as follows:
Type of Construction \
Number of Stories \
Number of Dwelling Units \
Percentage of Lot to be Occupied by All Structures
Plot Plan on Back of Application
or Attached
6� �,q, 33
3
Application Date
Permit Number
Date of Permit
Parcel Number
Zoning District
';e- c36
CONVERT�t-_, OR a structure or use land
Town of Ithaca, New York.
At a cost of $ y, dm
Telephone
Telephone�r7 -5'uS3
Square Feet of Floor Area:
Basement
First Floor
Second Floor
Over Second
Total Number of Rooms
Total Number of Bedrooms 3
Owner Occupied Yes No
Leased Yes No
THE
REQUIRED PERMITS HAVE BEEN OBTAINED AS FOLLOWS:
1.
From
Tompkins County Health Department --
Approval of Septic System and/or Well . . .
. . . . . . . . . . Date
Issued
2.
From
New York State Workers' Compensation Board --
Workers' Compensation b Disability Benefits
Insurance Certificate --
Req'd._
Workers' Compensation b Disability Benefits
Insurance Certificate --
Req'd._
3.
From
Town Building Inspector --
Water Tap, Town of Ithaca Water District . .
. . . . . . . . . . Date
Issued
Sewer Tap, Town of Ithaca Sewer District . .
. . . . . . . . . . Date
Issued
4.
From
Appropriate Highway Department --
Culverts . . . . . . . . . . . . . . . . . .
. . . . . . . . . . Date
Issued
5.
From
Town Building Inspector --
Multiple Residence Building Permit . . . . .
. . . . . . . . . . Date
Issued
Rec'd.
Rec'd.
i/-zz--74
.0110/
Not Req'd.
Not Req'd.---17/
The Undersigned hereby applies for permission to do the above in accordance with provisions of the Zoning Ordinance
and other Laws and Regulations of the Town of Ithaca, New York, or others having jurisdiction, and affirms that all
statements and information given herein are correct to the best of is/her knowledge and belief.
Date 111 k , 19
Signature of Landowner or Authorized Agent
BUILDING PERMIT (✓ J APPROVED by /Jf�l nQQ:
( } DENIED under AYt. , Sec.
of the Zoning Ordinance by _
APPEAL ACTION:
Date of Appeal
Date of Hearing
Date of Advertising
Board Members Notified
ZONING BOARD OF APPEALS DECISION:
Date
APPEAL FEE $10.00.
PROGRESS OF WORK -- Checked on:
Footings, prior to pouring concrete
Framing, prior to sheet rocking
Completion, on completion of all Work
Order to Refill Excavation Issued
,/ Order to Demolish Structure Issued
PLOT PLAN
INFORMATION TO BE SHOWN: 3.
1. Dimensions of lot. 4.
2. Distance of structures from: 5.
a. Road, 6.
b. Both side lot lines, 7.
c. Rear of lot. 8.
Dimensions of structures.
Names of neighbors who bound lot.
Setback of neighbors.
North arrow.
Street name and number.
Show existing structures in contrasting lines.
HEREBY CERTIFY that the structure for which this
Permit will be issued, or has been issued, will be
built, or has been built, according to the latest
Standards of the New York State Uniform Fire
Prevention and Building Code.
Signature of Landowner or Authorized Agent
�26 .............
OP--------- I . ... .....
.......... C/h xJ
........................
t riled
Cheqedbg
-t Lg
C
. .............. --------------- ............................ V
T
. NCN .. ...... ............................................................................................ ------- ...... .... .............. —.-
111ppeccof Dote ch"" by T24co7ded Subdiv
OL TOMPKIDTS COUNTY IDEPARTMFNT OF HEALTH - I
46LI-4 1287 TRU-MANSBURG ROAD, ITHACA, N. Y-273-72%
APPLICATION FOR SEWAGE ]DISPOSAL PERMIT 7JAN 2 1 1976
Health:
Commissioner of H,
Application is hereby made for a Construction Permit to install a private sewage dis
• A hereinafter described property, concerning which the following ' information is submitted:
Owner ......... To. rj ------- (Av. Phone
W Mailing Address y .......................... ........... .................. ......Address -P . 3._.54 4L 1. tt y ......... led ................................................................. ------------ -
uji Property Location ------ ................................. --------- I ................................. ........ -- ------
(n
Uj i Phone or
Cuntractor...................... -- .......................................................... Address ..........................................................................................
Existing-' --' -' -' -' --' -' -
Use of Building ................... New._..... ............ Lot Size
No Bed Rooms -------- *3 ........................ . No. Occupants --------- ....................... No. Apartment .-.-AJ04,e ..............
0 Garbage Grinder -Jlb ...... ;. Basement Fixtures (including laundry) --------------------- ...................... ...... .............
Vto or No
I Z. VA or FHA Financing --------- $4 A ........................... Bank --------------------------------------------- ........ ..
Water Supply. Existing .................... . Proposed .......... well ...... X ......... :Spring -------------------- : Public ------------
.j
CL
a. Describe Water Supply .................................................. .......... ....... ...................................................................................................
d;X
Ir
Da Signature ..................................................................... APPLICANT MUST COMPL-E- SITE -.P-LA'N ... S 'E T'C ... H"--"S'EE INSIDE PAGE
APPLICANT — DO NOT WRITE BELOW THIS LINE
Water Supply Depth - ----------------------------------- ft.: Depth Cssing - ---------------------------------- fi-;: Capacity ................ ------------- gph
Distance to Septic Tank .......... ft.; T5,Pispo ' kal Area ...... ------------------------ ............................... ft,
ti
Type Soil ............. - ............ le eL.
9.
'- e- . .....................................
Depth to Ground Water .................... ......... ----------------------------- ft-1 To Rock ----------------- ................................. ........... ------- ft.
Soil Tests
Node i Depth MinijWg
InchRo. lot Inch '2nd inch 3ed inch
Remarks............ ......... - ....... ...................
........... ......... ----
.................................
----------------------------------------
D4nign Rate ...................................... ---- ......... Clal. / S.F.; Sewage Flow ............. _-Gal. p�...D
F0 Sand
Approved for Sub -surface Disposal ............. Va�. ----------- F,r Fill ............................. r S n Filter --------------- 5
Disapproved: ------------------------------- ............................................................................ ...... - - ------------
.............. ------- , /42� 1-2?, �� - - - - - -
Y
2 M 5-65
F
SKETCH AND SPECIFICATIONS
BUILDING
EWER
SEPTIC
TANK
(See Attached Spers. for Additional d€lta_)
4" cast iron, Ieaded joints, mini muin grade " per foot, supported to prevent settling. Minimum dis-
tance to well 25 ft.
Water tight concrete, or Health Depactment approved tank; Capacity �J41'070_.....___. gals.; Minimuin
distance from house ........................ fr.; From water supply, 50 feet. Support On undisturbed ground free
of large stones. gashed gravel base is best_ Minirnun7 2 4" Diameter Manhole, to surface required.
SEWER FROINT
TANK TO DISPOSAL
AREA 4" NSF approved plastic or bituminIzed fibre pipe; Tight ioints, Nfinimuin grade " per foot -
I= iISTRIl3UTIDN 400
BOAC No. outlets ...... ................ Outlets all same level and 4" from bOtt0371; Inlet at least t" abaue o4Ltlets_
FILL Length ........................
ft,: Width ........................
ft.;
Depth
.............. ....... __ ft.. Use porous fill; Do not
use heavy clay soil.
Fill must be inspected
and
allowed
to settle 90 days before trepirhing, Do not
strip top soil within
50 feet of fill grid in fill
area-
See Fill
Specification Sheet for details,
TILE.
FIELD
LEAC14ING
PIT
SAND
FILTER
REMARKS
err NSF ap roved perforated pipe; Tots] ft_ _ ._ ?......._ : NO. laterals _.�J Length per
lateral ._,. ........... ft_, Grade not more than 1116" per ft. ,c t S ,�o_._._...._.— inches;
DenGh ._.. inches- Minimum any water supply . .......... ft,; Minimum
distance between center of ...I....... ft_: Use d" to 8" of. 3fai " washed grovel under the
and 2"'above tile- 01ding paper or straw over gravel b�cfore replacing earth: Do not strip soil,
nor work wet nor run heavy equipment over the field asta. Keep laterals out of driveways and
20 corn flanks, edge of fills, streams, froter drains, NvaterHnes and gaslines_
Minimum distance fr il9 any waters ply ft. ; Size inside (length ft.,
width or cliame e . ..................... ft„ del
e h I. ''low inlet ft.) ; Walls raf cinder llacl€ or
euuivalent with enings facing out; Use " i�o. 3 gravel 2irouncl walls. Use concrete Cover. Equiva-
lent precast ca to dry`wclls may be cd providing equal square footage of earth wall is pro-
vided and exc s en a,'ea is filled th -coarse stone.
I engt11 _
spected
-,. ft.; Width ._._. ._._. . ft.; Depth sand ...._... ... ft. ; Source of sand
.......... Chlor nat rJ7 nibee 50 ga!]cr1'is with ,;. tart' ' " inlet, Must be ia-
11
after placing sari _ ee Filter Specification Sheet for details.
............................... .I ......... ......-,. --.._._._._.._. _,
. .... ............................ ............. ................... ............. .,............................ I .....................
._..
........ ............................ ...._,`*_. ..................................... _.................................
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UTURE REF- RENC;E
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