1990-492 ''Y.x"At r .rrYr',, ,w ,.•�,.�,.1-, .xt.•jpp..r- _ ,. .
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 30 19 90
This is to certify that work requested to be done as shown by Permit No. 90-492
has been completed. •
This structure may be occupied as a Rinabz fgmihi dw411itZFr
Location Lot 26 Mabel Terrace-Herald Square
GUIDO PASSARELLI
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-492 P>
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to GUIDO PASSARELLI
O
OWNER of property located at Lot 26 Mabel Terrace—Herald Sq Street,Road or Ave.
cn
in the Town of Queensbury,To Construct or place a Single family dwelling
coat the above location in accordance to application together with plot plans and other information hereto filed and �
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
45 Herald Drive
Queensbury NY 12804
2. CONTRACTOR or BUILDERS Name
Al Cerrone
tli
3. CONTRACTOR or BUILDER'S Address
O
4. ARCHITECT'S Name
0
e-r
5. ARCHITECT'S Address
O.
6. TYPE of Construction—(Please indicate by X) y �
O
'-s
(x)Wood Frame ( ) Masonry ( )Steel ( )
w` n
N
7. PLANS and Specifications
No. 2611(56' Single family dwelling as per plot plan, specifications and application
including two-car attached garage and septic system. rn
8. Proposed Use
Single family dwelling
vq
258.00 JanuaryfD$ PERMIT FEE PAID —THIS PERMIT EXPIRES 31 19 91
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
f-+
Dated at the Town of Queensbury this St Day of July 19 90
iZ
1-4
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SIGNED BY for the Town of Queensbury aq
But mg and Zoning Inspector
TOWN OP QUEENSBURY
REVIEWED BY
eallkrirty FEE PAID $ o�4- *C/� o'
PERMIT NO. 9tl-�,� -
BUILDING PERMIT APPLICATION L g=
JUL ' 1990
80 DING Se CODE DEFT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION.. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS,RECEIVED A VALID BUILDING PERMIT.
Vii 19-
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
* * * * * * * * * * • * * * * * * * : « * * * * * • * * * • • * * • * * * • * •
�The owner of this property is: „�' d r-erkr ' +'.�
P.O. Address 'ed./0/, Tel. gr, fl/? /
Property Location ei Tax Map No.BV,5/ //
Has there been any split of this property since October 1, 1988? / , ii/G
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE / ;// l,El,i,\ LOT NO. 26
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING DES IS:
C A' (lieie,eeY7rt-e. . .
_. a - a �------�. m_
NATURE OF PROPOSED WORK: - ESTIMATED MARKET VALUE OF
•
Construction of a new building * CONSTRUCTION: $ /31; de), 17)
Addition to a building • COMPLETE INFORMATION REQUIRED BELOW:
* Size of property 700 ft x L ft.
Alteration to a building •
(no change to exterior dimensions) Existing Buildings(3) Size 3� ft. x z-ft.
a _Proposed building - distance from property line:
_Other work (Describe) • Front yard 44 ft. Rear yard �� ft.
• Side yards 5-0 ft. and 4) ft.
a
GROSS AREA OF PROPOSED STRUCTURE a
If on corner, setback from side street ft.
1st Floor sq. ft. 9e,.Z./i • OCCUPANCY INFORMATION
2nd Floor es-e sq. ft e- ._; -. • • Primary Building -
Other Floors sq. ft. 7 .••• One Family Dwelling
(not cellar or basement) �c� .. * Two Family Dwelling .
TOTAL FLOOR'AREA , '/ sq. ft. ''- 5 • Multiple Dwelling/Number of units
Size of new structure •ft x • Business
ft. • Industrial
Foundation-pier/slab/crawl/partial/full
(circle one) • Other
*
No. of stories (habitable space) •
Height (grade to ridge) Z5` ft. • If addition, what will use be?
If residential, no. of families_ •
No.of rooms(excluding baths_ ) '• Accessory Building
No. of bedrooms • Detached Garage ONE/TWO Car
No. of bathrooms • __
Primary heating system if/ee371"Rm • =Attached Garage ONE WO Car
Type of fuel_ •
,_Private storage building
No. of fireplaces to be installed / •
• Other
Will a wood stove be installed
Central Air conditioning re4 •
OV• ER
BUILDING PERMIT APPLICATION CONTt LED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe. etc. 431 7`,0wer„.-
Will any second-hand or upgraded lumber be used? If so. for what? A
Foundation wall material ,g./4-e.eL estweezdit__ Thickness
Depth of foundation below grade (to bottom of footing) r vi
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft.
Will there be a basement? lied Will any portion be used as living space? j o
(If so, what portion? sq ft. Type of use?
Type of roof - sloee 'flat/shed/other Material of.roof s-i ,//
Size, wood studs �"x 6 " spacing/6," o.c. length ' ft.
Joists (floor beams) 1st floor `�, "x fb "spacing /h "o.c. span /5 ft.
Joist (floor beams) 2nd floor Z. "x /0 " spacing / "o.c. span /5 ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing 211 ".o.c. span ;(6) ft.
Exterior wall finish S-WittiF of what material? may'/
Interior wall finish f z " , /1
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? ye.,e If so will a Fire-rated door, enclosure,
self-closing device be provided? tie.1
Will a flue-lined chimney be installed? '• Height above roof ?, ft.
Depth of chimney foundation below grade ft.
Depth of,fireplace hearth ft. in.:
Water supply - Municipal or private well Maivel
SEPTIC SYSTEM- Distance from ANY private well (including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
AME OF BUILDER74 ,/ e& ADDRESS ,1 4' TEL. NO. tjz
AME OF PLUMBER AI ADDRESS TEL. NO.
AME OF MASON wa ..14.0974efADDRESS l rs.1A— - TEL. NO. G'"4'
AME OF ELECTRICIAN �v ADDRESS TEL. NO. 7b-aewtr.
DECLARATION
To the best of my knowledge and belief the statements contained in this application. together with the
ins and specifications submitted, are a true and complete statement of all proposed work to be done on
• described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
l other laws pertaining to the proposed work shall be complied with, whether specified or not, and that
ch work is authorized by the owner.
Signature (�
0 nor, owner's agent, architect, contractor
'ECIAL CONDITIONS OP THE PERMIT:
BY -
/ � TOWN OF QUEENSBURY
' j APPLICATION FOR SEPTIC DISPOSAL PERMIT
Nipp-wrDATE: tom'L// 27 /ff
LOCATION OF PROPERTY FOR INSTALLATION Zr;v4 Mesa JUr' '
Owner' s Name: A .,
Address:
Installer' s Name: g Telephone: ; W-121
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography:' Circle one: Rolling Steep Slope % of Slope
Soil Nature: Circle one: Loam Clay Other /Depth:
Ground Water: At -what depth? "/, Feet
Bedrock or' 1mperViou`s Material : At what depth? Feet
Percolation test: Circle one: not required required
Rate - - - ,Min. Per Inch
Domestic, water supply: _:Circle one: k: unicipa Well Other
If domestic water supply is a. well:
Separation-: Water''supply from any septic absorption- I -et..
PROPOSED SYSTEM: Septic Tank ,4 d 0 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAG PIT(S): Number of /Size each d feet
by feet
Size of stone to be used #': /Depth or Thickness 2' feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
I have read the regulation; on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE;-:PERSON: E: 747
1
L
•
•
Septic System Inspections: -•
A. All applications for septic system installation, alteration or repair,
as required -by the Town of Queensbury Sanicary ,Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1.) the proposed location of the system
2.) location and distance to lot lines
3.). location and distance to structures
4.) locacion. and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspector. Failure to comply with this requirement may
result in the uncovering of the system by the installer and a fine
ul up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure co produce said plot plan at time of inspection may -)
result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installs—
cion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further
construction.
, Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
- Queensbury, New York 12804
. •
k,marks:
•
•
•
TOWN OF Q LIEENSB LIRY
Bay at Haviland Roads,Oueensbury,N.Y.12801-9725 •
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date z6r 19 ifei Permit No. f '7'9;,
'
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's Name , � � ,e APPLIANCE TYPE
,�,�
,l e ( Stove Coal Wood
Address ,, Furnace Hy sir it Boiler
Zero Clearance Circulating Unit
ale14449,441_4,--i 1-, ! ' zip /2.-PO
Phone ' 7s(-- 2,1 If Non-Masonry:
Owner's Name .",/` ..,L � .
Manufacturer //� /
Address Model Outlet Size
Zip Listed by Number
Phone CHIMNEY TYPE
Masonry: Block Brick Stone
Property location of proposed construction Flue: Tile Steel
Size:
Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost$
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$
SONRY FIREPLACES AND CHIMNEYS.
CASHIERS DEPARTMENT
\, TOWN OF QUEENSBURY, NEW YORK
Department: Fire Marshal Amount Collected Amount Refunded
Code Number Title '�..� „_.
A173 3389 (190)Public Safety
A233 2655 (230)Minor Sales
ce(� 'collected -rcfm or Refunded to: 4/i
Address:
___._e�--�- --
s
Dated:74 Td Town Clerk or Deputy r-..� - }
White:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
.
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TOWN OF QUEENSBURY al-e- ` ' ' if
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280i- . I
TELEPHONE (518) 792-5832 - *c
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED lr g
NAME �`j� .,f Al t ) (51.W�s 0 /
LOCATION .._0+ ( -\C.Y
�S�a
DATE 14 PERMIT # 9/) —q /
APPROVED
/ YES NO
FOOTING/PIERS g8
MONOLITHIC POUR FORMS 1
FOUNDATION/DAMP-PROOFIN
BACKFILL APPROVAL '
ROUGH PLUMBING
FRAMING I •
f'
ELECTRICAL ROUGH-IN • • "
INSULATION: t
FOUNDATION , ;
a .
FLOORS
WALLS ' 1 '
CEILING / '
FINAL INSPECTION: ,
CHIMNEY HEIGHT 1----
ROOFING ,,-
--SIDING -- -- ; - • -- --
,:-.'
EXTERNAL PORCHES/STE 1
STAIRS-CLEARANCE & L L'�
PLUMBING FIXTURES/RE VALVE
INTERIOR TRIM/PRIVACY OORS L,
• FINISHED FLOORS L -
GARAGE FIREPROOFING; A ,----
DOOR CLOSER(S) / 1
SMOKE DETECTORS / 1 v-
FINAL ELECTRICAL IN PECT(ON ��
_FINAL APPROVAL OF ONSTRUCT ON G�
OK TO ISSUE C/O O C/C s
A SIGNED CERTIFIC TE OF OCCUPANCY MUST BE
OBTAINED FROM T BUILDING DEPARTMENT BEFORE
THESE PREMISES RE OCCUPIED!
_
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REMARKS: •
�vIV. at- «....
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DEPART !/737 k;r
SNSP-EC R
TOWN OF QUEENSBURY .
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS � n
QUEENSBURY, NEW YORK 1280k `�
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED / 1719
NAME ,4-dd qF LOCATION )'/ �p Gi,J a I 44
DATE kb 19I) PERMIT # 9v' 2
APPROVED
0 (//eta j z YES NO
FOOTING/PIERS ',
MONOLITHIC POUR FORMS 1:
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN • ' •
INSULATION:
FOUNDATION i
FLOORS
WALLS
CEILING I •
FINAL INSPECTION:
CHIMNEY HEIGHT '
ROOFING 9
SIDING i
EXTERNAL PORE,GES/STEPS •
STAIRS-CLEARANCE & RAILS
PLUMBING FIURES/RELIEF VALVE
INTERIOR Ti IM/PRIVACY DOORS
FINISHED LOORS
GARAGE FIREPROOFING
DOOR CLO ER(S)
SMOKE D TECTORS
FINAL ELE TRICAL INSPECTION
_FINAL.AP ROVAL OF CONSTRUCTION
OK TO IS UE C/O OR C/G
A
A SIGNEr1 CERTIFICATE OF OCCUPANCY MUST BE
OBTAINS FROM THE BUILDING DEPARTMENT BEFORE
THESE PF4EMISES ARE OCCUPIED!
REMARKS:
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ARRIVE
NA 12//\(2)
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS /PM
QUEENSBURY, NEW YORK 1280-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 07/96
NAME ,/j1.1--G6) 6.424a/LIWZ:
LOCATION - G k � te4 2 e
f
DATE / , q0 /�PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POURFORMS
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
k ROUGH PLUMBING
/ FRAMING
ELECTRICAL ROUGFI-IN "
INSULATION:
FOUNDATION
FLOORS k" . . .
WALLS c'
CEILING
fr .
FINAL INSPECTIONi'
CHIMNEY HEIG#T I
--ROOFING-
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING F. XTURE`S/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED F'LOORS
GARAGE FIIfEPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION-6
_FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/O OR "C/C
f. t
A SIGNED ;CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BOLDING DEPARTMENT BEFORE
THESE PRMISES ARE OCCUPIED!
fi •
REMARKS:' f6 Vil aV eA L51T PPOI-T LIAic'
Orr -5 m-1 (-3 . -+ ice.-- RAJ 5
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DEPART ((" if 6 (/A.c
TMCDV' D
,_____. //:,.a.,2z- ._. .(,/e----17-k
.Downs KING
BUILDING a d ZcKING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queens ury, New York 12801
•PTIC DISP SA j'YST INSPECTION
NAMa y 1' A ,.Z(
LOCO I . 1 . w •Z,
docz
DATE / �0 'DE IT O. qC q 2—
SOIL TYPE - _ •0- Loa - Clay -
Percolation TestiRequirled? YES - NO
Percolation rate - Mi •/Inch _ '
i
TYPE of SYSTEM:
Absorption field,, to al length
Length of each tr'enc
Depth of trenches']'
Size of gravel
SEEPAGE PITS4Nuinb' of) �,
Size- ' ft. X ft. 4 a t5V-0-a-e_
Gravel size ,14V4-
PIPING: Size Type
Bldg. to tank 7 "L'C.-
Tank to dist. box `t, 4/ "/�
Dist. box to fiel• pit V /PvC.,
Openings sealed? , 40, NO Partial
LOCATION/SEPARAT ON :
Foundation to t.J k /p ft. (Y2e67,/?1_]
Foundation to aesor tion d-r? ft.
Absorption to lot line /z) ft.
•
Separation of pits 'f, > ft.
LOCATION OF SY - -ROPERTY(circle one)
.Fro t - Rear ,,- 5ide - Right side -
ZrOMMENTS: i
1 C5-6/2
S
40
SYSTEM USE I'PPROVE
0'.1° Buildi g I e for
01/86 and vl
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TOWN OF \QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVT,LAND ROADS
QUEENSBUR4 NEW YORK 1280k49/
TELEPHONE 1 (518) 792-5832 ,
UILDING INSPECOR'S REPORT
REQUEST FOR INSPECTION RECEIVED o/del
NAME r"! ZI%f� Zeef
LOCATION r? l A ,0.0 ,, -i
DATE )10 G18ERMIT # , 9�--151
APPROVED
.14 YES/ NO
V FOOTING/PIERS 1
MONOLITHIC POU' FORMS
FOUNDATION/DAM -PROD�jf�ING
BACKFILL APPRO L A
ROUGH PLUMBING ' • • ff
FRAMING I ,'
ELECTRICAL ROUG 'NI]
INSULATION: 1
FOUNDATION
FLOORS . . '/. . . . . .
WALLS 1 1 . • . . . .
CEILING 't;e'
FINAL INSPECTION: 1 •
CHIMNEY HEIGHT ;r •
ROOFING o f,, . .
SIDING '
it {
EXTERNAL PORCHES/STEPS
il
STAIRS-CLEARANCFE O RAILS .
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS , _
GARAGE FIREPROOFING' •
DOOR CLOSER(S)1
SMOKE DETECTORS , _
FINAL ELECTRICAL INSPECTION
_FINAL APPROVAL F CONSTRUCTION
OK TO ISSUE C/O OR C/C i
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM TEE BUILDING; DEPARTMENT BEFORE -
THESE PREMISES ARE OCCUPIED!
F
REMARKS: 10 /r P ki41
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DEPARTS / y
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT ' Att.)
BAY & HAVILAND ROAD:
QUEENSBURY, NEW YOR 128O -
/ ")
TELEPHONE (518) 79�'1-5832
BUILDING NSPECTO 'S REPORT
REQUEST FOR INSPEC ON RECE VED / o
NAME i( 0 at,LOCATION t1/..., din 1. y,(,�jj jDATE cP90 1 PE IT # 90 9 2_
APPROVED
YES NO
FOOTING/PIERS I
FONOLITHIC POUR FORS
OUNDATION/DAMP-PRO
BACKFILL APPROVAL 1 I
ROUGH PLUMBING ' 1 I
FRAMING t I
ELECTRICAL ROUGH-IN i 5
INSULATION:
FOUNDATION 1. I '
FLOORS . 11 '
WALLS l - . .
CEILING
FINAL INSPECTION: A
CHIMNEY HEIGHT
ROOFING I' t
SIDING I .
EXTERNAL PORCHES/$TE'S ' •
STAIRS-CLEARANCE RAILS .
PLUMBING FIXTURES!REIIEF VALVE
INTERIOR TRIM/PRI�VACYDOORS
FINISHED FLOORS
GARAGE FIREPROOFING 1 •
DOOR CLOSER(S) I
SMOKE DETECTORS ! 1
FINAL ELECTRICAL I SPECTION' '
_FINAL APPROVAL OF ONSTRi CTION
OK TO ISSUE C/O 01 C/C tt
A SIGNED CERTIFIC TE OF OkCUPANCY MUST BE
a
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES AR. OCCUPIEf
REMARKS: 0 v40 V/41' S
4f (A- r/ pP PrL1AJ(p.
ARRIVE /if
DEPART 3%50 /
.+II
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832 ���//111',J 1
BUI ING INSPECTOR'S REPORT
REQUEST FOR IN PECTION RECE/VED
NAME AmaLei2 I
LOCATION
DATE 4 f VO 1 PERMt # 9911 4
APPROVED
YES NO
X FOOTING/PIERS 1 X
MONOLITHIC POUR ORMS 1
FOUNDATION/DAMP ROOFING!
BACKFILL APPROVA !
ROUGH PLUMBING I
FRAMING t, !
ELECTRICAL ROUGH IN 1.
INSULATION: i
FOUNDATION
FLOORS k !
WALLS t !
CEILING !
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING ', I
SIDING tI -- -
EXTERNAL PORCHES/ EPS
STAIRS-CLEARANCE RAILS
PLUMBING FIXTURES ELIEF VALVE
INTERIOR TRIM/PRI °CY DOORS
FINISHED FLOORS
GARAGE FIREPROOF� NG1
DOOR CLOSER(S) t
SMOKE DETECTORS!
FINAL ELECTRICAL NSPE TION
_FINAL APPROVAL O CONS UCTION
OK TO ISSUE C/O €R C/C
A SIGNED CERTIF CATE OF CCUPANCY MUST BE
OBTAINED FROM T-E BUILDI G DEPARTMENT BEFORE
THESE PREMISES RE OCCUP DI
REMARKS:
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ARRIVE imilli I
DEPART I Z- 4) .'iiL it4/
INSP'CTOR I
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permitgio. Q0 6'q
Owner 4---t (Aldo AS.C.sz r-e- I
Occuparit (
Location L.6 42•• AI Lt,
No. Street
Town or City S State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by
No.
Date / C5 P. Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC:
900 Haddon Ave.,Collingswood,NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
OUTLETS WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
TORS H.P. 1/20 1/12 1/10 %a '/4 '/4 'la 'h '% 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
RK NUMBER
EACH SIZE
IPARATUS