2004-76741 TOWN OF QUEENSBURY
742 Bay Road,Queensburv,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20040767 Date Issued: Thursday, December 23, 2004
This is to certify that work requested to be done as shown by Permit Number P20040767
has been completed.
Tax Map Number:
523400-303-015-0001-032-000-0000
Location: 276 DIX Ave
Owner: NEW YORK JOB DEVELOPMENT AUTHORITY
Applicant:
CURTIS, MURPHY & JEFFREY'S CPA
This structure may be occupied as a:
By Order of Town Board
Commercial Alteration TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
011,
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040767 Application Number: A20040767
Tax Map No: 523400-303-015-0001-032-000-0000
Permission is hereby granted to: CI TRTTS_ MI TRPHY& 7F,FFREY'S CPA
For property located at: 276 DIX Ave
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: NEW YORK JOB DEVELOPMENT . Commercial Alteration 75,000.00
633 THIRD Ave Total Value 75,000.00
NEW YORK, NY 10017-67.54
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-767 CURTIS, MURPHY& JEFFREY'S CPA
2000 SQ FT COMMERCIAL INTERIOR ALTERATION
240.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, October 01, 2005
If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To of ensbu . Fr'i :y,October 01, 2004
SIGNED BY
r
141/4
for the Town of Queensbury.
Director of Building&Code En orcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
518)761-8256
A permit must be obtained before beginning construction. Permit File No.
No inspection will be made until applicant has received a Fee Paid bl40,CO
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the
Reviewed By:
application form.
Applicant: a;l.iA ,i1M"A'
1°'
l^^'` D L-it ,ti Owner: \J' p`^'
Address: ` 2 0 Sig ((2-0-1.2ic `i Address: i 0 Q.r' 11--v(.1. t
A
Phone#(sue),,22k- )73(,' Phone#(.f .,)7 (coo c 0
c 2-4-4
Property Location: Lot Number: House Number a-_
Subdivision Name: Tax Map Number: =5)3 1 1=x.—/--,..3
0 New Building: residence /commercial Estimated Market Value of Construction: $
5
g OC'C
O Addition:residence/ co m eial
If an Addition,what will use of new addition be?
Alteration: residence/ mmercial "
O No change to exterior size: residence/com'l
o Other work(describe
Check Occupancylnformation 1"Floor tad Floor Other floor Total
Below
sq.ft. sq.ft.
sq.ft. Square Feet
Single family dwelling
O Two family dwelling
o Townhouse
o Multifamily dwelling
of units
Office 4) t/ war
I o Mercantile
Manufacturing C P 3 2004
1 car detached garage
BURY02cardetachedgarageCODE
O 3 car detached garage
0 1 car attached garage
0 2 car attached garage
O 3 car attached garage
Storage building-
commercial
Storage building-
residential
o
r_
O.Other
Vc a - -.^•.59--What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?G
CX,--51-,\,5/ Type of Heating System: electric/ oil /4 wood /forced hot air/ baseboard/other:
A l/A Number of Fireplaces to be installed Number of Woodstoves to be installed A//4-
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder 'I/ -4 ('.,- -t om tl y , f,2_0
Plumber fe.-,,, _
Mason x/
Electrician '4 7(k C o ,. utic; .t.,.._ 7 4'& -- /St 0
Declaration: please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that I/we shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an4s Bull!Survey by a licensed surveyor;drawn to scale,showingactuallocationofallnewconstruction.
Th
Signature: Xis)11 al t sc-.rJ own6wner's agent,architect,contractor
i
7 GG %. tam.-,,. _
Commercial Final Inspection Report t
Office No.: (518) 761-8256 Date Inspection re•.est r,cei -•.
Queensbury Building&Code Enforcement Arrive: pm Depart:
742 Bay Road,Queensbury,NY 12804 Inspector's Initial :
NAME: C FT 1 h M L'A:kPt-0 Z L —'7(g 7
LOCATION: f ty- F 0 E DATE: 1 'L— `Z-3—04
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 sq. ft.
All Doors 36 in.w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36 (w)x 44"(1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 %2 doors
10%> 1000 sq. ft.
Hour Corridor Doors&Closers
Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 sq. ft. Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroo Gr-a—b-Baks/ s/Toilets
Handicapped Bath Parking Lot Si ag
Public Toilet Room andic pped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond
Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides b riveab rface 20'wide
Okay To Issue Temp. or ermanent C/
Okay To Issue C/C
Last printed 6/3/2003 9:27 AML:\PamW\Building$•Codes\Commercial Final Inspection Report.doc
1111b14 Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
1
Fire Marshal's Inspection Report
Request SCHEDULE
Received:
Pid
Permit# 0 11,7 INSPECTION ON: ' (- /
Name: 0A-i 5,i(Y)Un Pil Li l (- (P S 5
1
AM ISM ANYTIME
Location:c
APPROVED
N!A YES I NO COMMENTS
EXIT ACCESS
EXIT ENCLOSURE
EXIT DISCHARGE
MAIN AISLE WIDTH I, \_} C C C ) -
SECONDARY AISLE WIDTH
EXIT SIGN-NORMAL
EXIT SIGN-BATTERY
EMERGENCY LIGHTING i rl f
V 1
FIRE EXTINGUISHER HUNG
FIRE EXTINGUISHER
INSPECTION
FIRE EXTINGUISHER HYDRO
FIRE ALARM SYSTEM
FIRE ALARM -FAN SHUTDOWN
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION-KITCHEN
FIRE SUPPRESSION-GAS
ISLAND
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO ELECTRICAL
ELECTRIC WIRING ENCLOSED
COMBUSTIBLE WASTE
VEHICLE IMPACT PROTECTION
FIRE LANE
F.D.SIGNAGE-UTILITY ROOMS
NO SMOKING SIGNS
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN
OK THIS DATE OR • • NOT OK
4rair
INSPECTED BY
C O M D E V IL HRI S J I W OR D I LETT E RS 2 001/F IRE M A RS H A L I N S P E C T I O N RE P O RT 11022 001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
all131I'lizjo r
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request
c1 - 1 SCHEDULE
Received: Permit# 0 L AP INSPECTION ON: I) - /3-Gay
3 c
Name: C.•..mt-IS/ AI i
T
L 60, L S I ' PM ANYTIME
Location: Thu. t c-
APPROVED
N/A YE NO — ~ COMMENTS
EXITS _- --- -
AISLE WIDTHS
EXIT SIGNS-NORMAL _- -
l_``.
I I I 1 i ( ti i e, '(k Y")
BATTERY
EMERGENCY LIGHTING
v
FIRE EXTINGUISHERS
i
i`I`-- 0-\ c ' 4-( U2 CQ) -_
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES 4
STORAGE _ - F
COMPRESSED GAS-
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE ill
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN S
r.
CHIMNEY
MASONRY ROUGH IN
FINAL
CHIMNEY-'------._____
FACTORY BUILT ROUGH IN
WOOD
FINAL
STOVE ROUGH IN I
Y
FINAL
VENTED GAS
APPLIANCE ROUGH IN !
FINAL
FIREPLACE
f
MASONRY ROUGH IN
OK THIS DATE FOR CO T OK)
FINAL
FFIREPLACE
FACTORY BUILT ROUGH IN
I INSPECTED BY
COM DEV/CHRISJ/WORD/LETTERS2001/FIRE MARSHALINS PECTIONREPORTI1022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
i)
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection request -- - ed• i %1 I1 L
Enforcement Arrive: mil,epart: \.I am/ mQueensburyBuilding&Code J
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: ,'it
NAME: C c z^c vU i v r5 /t S
G+
PERMIT#: C7C —
LOCATION: b , fh,^ . DATE:WINNIMILIT
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 sq. ft.
All Doors 36 in.w/Lever Handles/Panic Hardware, if required
Exits At Grade Or Platform 36 (w)x 44"(1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap 1 Water Temp. 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site L -It)
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 'h doors
10%> 1000 sq. ft.
1
3/
4 Hour Corridor Doors&Closers
Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors rn A
Ceiling Fire Stopping, 3,000 sq. ft. Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24" kV p
Smoke Vents Or Fan, if required
Elevator Operation and Sage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
tappedath/ arking Lot Signage POMCA
J\
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond f\ \G V(11,Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides by 20' /Driveable Surface 20' wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C
Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc
Commercial Final Inspection Report fff'
etriik.--
kip---))0W ,
Office No.: (518) 761-8256 Date Inspection req -st re - •. //
C a T
Queensbury Building&Code Enforcement Arrive: a, pm. Depa : r
742 Bay Road, Queensbury,NY 12804 Inspector's Initia • -
NAME: (7 riit/
A-
ri4r
PERMIT -: I _.imp r,
LOCATION:
a 1
DATE: AVA /' T 6 w
COMMENTS:
yN
NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete J
Exterior Finish Grade Complete 6"in 10' or Equivalent 1
Interior/Exterior Guardrails 42 in. Platform/Decks 11`1
i\
i
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
C--‘ \Lj
Stair Handrail 34 in.-38 in./Step Risers 7"/Treads 11"
ey)C-3
Vestibules For Exit doors> 3000 sq. ft.
All Doors 36 in.w/Lever Handles/Panic Hardware, if required
Exits At Grade Or Platform 36 (w)x 44"(1)/Canopy or Equiv. Vcw.>W
pGasValveShut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap/Water Temp. 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy I Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site Viiao Q
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 %doors
10%> 1000 sq. ft.
3/
a Hour Corridor Doors&Closers
Firewalls/Fire Separation, 2 Hour, 3 Hour Complete/Fire I. F N.: ,,,-,
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 sq. ft. Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required v -vIA
Elevator Operation and Signage/Shaft Sealed
i
1
Handicapped Bathroom Grab Bars/Sinks/Toilets bib L Q\
Handicapped Bath/Parking Lot SignageIPublicToiletRoomHandicappedAccessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in. Beyond
Active Listening System and Signa.e Assembl S p ace
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides by 20' /Driveable Surface 20' wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C
Last printed 6/3/2003 9:27 AML:\PamW\Building&Codes\Commercial Final Inspection Report.doc
1 (. - iStU (0)
kt i - as i 6 0
111111111Town of Queensbury C"
iFir#Al Fire Marshal's Office
742 Bay Road
t" P
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request
Received: Permit# uC1 L11
SCHEDULE
I i,
IqINSPECTIONON: I
Name: C v-\+c) , N\''''`,1‘
1, S L.t n i k I 0
i i
A29 PM ANYTIME
Location: N u Lr
APPROVED71N/A YES NO COMMENTS
EXIT ACCESS S 4 c,is N
EXIT ENCLOSURE
X
J `la t r'1 A'"- -
r
L-0
EXIT DISCHARGE
MAIN AISLE WIDTH X
1\ -t t b,.zis.4Nck v t'-
SECONDARY AISLE WIDTH K
EXIT SIGN-NORMAL X
EXIT SIGN-BATTERY r- A C1 ci r.4, s
LwCr G( l L.
EMERGENCY LIGHTING
FIRE EXTINGUISHER HUNG 1r, n t mil.-I-T
FIRE EXTINGUISHER
INSPECTION 1-j t
FIRE EXTINGUISHER HYDRO J
t\v.
L' ''`T C • tl
FIRE ALARM
SYSTEMFIREALARM -FAN SHUTDOWN 5
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION-KITCHEN F p 0 13 (i''0,T
FIRE SUPPRESSION-GAS
t 4
ISLAND i v.-1-A9 \ r 5P)m I t r f S rm.
HOOD INSTALLATION 4
INTERIOR FINISHES Qk,i\b C voil S N t NSP
STORAGE
lCOMPRESSEDGASZs`7I ,t.t_ '\t.` C o t 11 .-t 4 i f 4 S
CLEARANCE TO SPRINKLERS A
CLEARANCE TO ELECTRICAL X nn
ELECTRIC WIRING ENCLOSED g 1 c Y\i 'S _y
A(let-1 0 .zct 5
COMBUSTIBLE WASTE
VEHICLE IMPACT PROTECTION
FIRE LANE C 6, &'`rts I N tI"5 t ri te ct LC.
F.D.SIGNAGE-UTILITY ROOMS X et
3
j ci c t..l2 1 C.Ct
NO SMOKING SIGNS
t
MAXIMUM OCCUPANCY SIGN
EMERGENCY EVAC PLAN G _ C) 7 CC r C' L 0 1.
0-k t I t-+ i O 0.) ,,
c-N .„--A \U ?11U>,A4 r.'-
OK THIS DATE OK FOR CO NOT OK
INSPECTED BY
COM DEV/CHRISJMIORDILETTERS2001/F IRE MARSHALI NSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
o --
4,zRoughPlumbing / IInsulation Inspection Report
Office No. (518) 761-8256 Date Inspection req -st rec ived:
Queensbury Building& Code Enforcement Arrive: am/p a D
742 Bay Road, Queensbury,NY 12804 Inspector's i ials:
NAME: C,,,kA,A, PERMIT #: 1-1'p
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Q Sc,cik
Y N N/A s,(
PVC: R-1,R-2, R-3,R-4 Drain/Vents
Cast Iron, Copper Drain/Vent/ Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
1 'A. inch min. Drain Size
Washing Machine Drain 2 inch min.
Head or Air Supply Test
Drain and Vents
5 PSI or 10 feet above highest
connection for 15 minutes
Cleanout every 100 feet/change of :irection
Water Supply Piping
Cooper Commercial
oper, CPVC,Pex One an, Two-Family
nsulation/Residential Chec)/Commercial Checkt p
Proper Vent, Attic Vent
Duct/Hot Water Piping Insulation
If required unheated,4 aces
Combustion Air Sup for Furnace
Duct work sealed erly/No duct tape
COMMENTS:
toff-- Y- tf\
L:\SueHemingway\Building.Codes.lnspection.FORMS\Rough Plumbing Insulation Repoitdoc November 17,2003
1t3? V\t J
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection re• est e•- ::: 10 1'3 0 oQ aht.
Queensbury Building & Code Enforcement Arrive: m/p ' t part: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initia s:
WI - 14 . j
NAME: CU; * f I Li.i,"CPRR / PERMIT#: C 'lb
LOCATION:
f/
1 j} INSPECT ON:i` V
J/
Q t
TYPE OF STRUCTURE:
fladifTIM .114
1./.1 N/A
Framing
Jack Studs/Headers
0 \
Bracing/Bridging1x1Joisthangers s
yJ \_ 'p t
Jack Posts/Main Beams
Exterior sheeting nailed properly
X .
12"O.C.
Headroom 6 ft. 8 in.
13(S—VIC\LLEVDOStairwells36in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls C--i2--f M'FTV'P 4jFe_.S>
Metal Strapping for Notches Top Plate V L , t2Z 4.6 k3F-
1 %z (w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses 1 L
Anchor Bolts 6 ft. or less on center LLE-? b)
Ice and snow shield 24 inches from wall
ik'c`Q—
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side '/z inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL \
Permit No. Cert. 84 7 8 Cut-in Card No.
Owner aa/(24%S 7
Crrne1264 Call
c
Location
L'zb
tI
K. , /
4
Installation Consisting of Z5 owe.`c Q I/e z'1 —
C
Installed By 73 `C/-4 P /..-- Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall b omptly made for inspection.
Inspectors of this Company shall have the privilege of makin in ections at any time, and if its
rules are violated,the Company shall have the right It r-IIke this icate.
t
Date 1 Z—Z— y^
f
INSPECTOR
I Member N.F.P.A.,I.A.E.I.