2005-608 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20050608 Date Issued: Wednesday, November 23, 2005
This is to certify that work requested to be done as shown by Permit Number P20050608
has been completed.
Tax Map Number. 523400-308-008-0001-004-000-0000
Location: 7 BURNT HILLS Dr
Owner. LARRY CLUTE
Applicant: CLUTE ENTERPRISES
This structure maybe occupied as a:
Fireplace By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the f
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code E orcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20050608 Application Number: A20050608
Tax Map No: 523400-308-008-0001-004-000-0000
Permission is hereby granted to: CLIITE ENTERPRISES
For property located at: 7 BURNT HILLS Dr
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. Tyne of Construction Value
Owner Address: GEORGE MABB
464 SHERMAN Ave Fireplace
QUEENSBURY NY 12804 Single Family Dwelling $135,000.00
Total Value $135,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-608
1466 SQ FT SINGLE FAMILY DWELLING
$175.92 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, August 17, 2006
(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 T e esday, August 17, 2005
rT;:r�
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement
CheckFFullsets
sidential Plan Review: One c& Two Family Dwellings
N/N/A
ans
ft.—Stamped
On Plans: 90 Wind Floor Loads 40 psf
70 Ground Snow Load Sleeping Areas and Attics 30 psf
Calculations:
Window Schedule With Glass Size ;
Door Schedule/Main Entrance 36"Door
Emergency Escape Or Bedrooms and Habitable Space
Above/Below grade,5.7 sq.ft.
Grade,5.0 sq. ft.
24"(h)x 20"(w)min.
44"Max.Height above floor
Residential Check Paperwork Compliance and Inspectors Checklist: OK
Dampproofing/Waterproofing Materials On Plans
Foundation Drainage On Plans,if required
6"Drop in 10'Exterior Grade
Framing Cross Section For Each Roof Line,Vertical Fire Stopping Every 10'Where
Required
Ice and Snow shield 24"Inside Exterior Wall/24"Inside Knee Walls
Platforms At Exterior Doors
Stairway Headroom 6' 8'All Stairs 36"Width
Stair Run and Rise
Winder Run and Rise
Spiral Not Allowed From 2nd Story
Smoke Detectors Battery Backup and Proper Location
Bathroom Fixtures Proper Clearance
Hall Width, 36"min.
Handrails More Than One Riser On Open Sides
Railing and Guards>30"/Basement Stairs Included/Closed Risers More Than 4"in Ht.
Safety Glazing Notes For Required Areas
Garage Fire Separation
Garage Floor Sloped
Attic Access
Roof over 30"—22"x 30"/Crawl Spaces 18"x 24"Access
Carbon Monoxide]Detector Lowest Sleeping Level
i
Soil Test Results, if required
Septic To Well Or Water Line Separation
All Paperwork Signed
Job Site Address: Date:
®caner; -� C L Application No. Pile No.
Ste✓
Building Permit — Calculation Sheet
Natural Light, Ventilation & Emergency Egress Requirements
Habitable Area of Req. Light Actual Req,Vent Actual Sq.Ft. Remarks
Room Room 8%of Room Light 4%of Room Vent Opening for
in Area Square Area Square Egress
Square Footage Footage
Feet
`( 4 Y
L'-ru \Z% t% L/ 1 'S
l
4
L:\Sueliemingway\Building.Fermit.FORMS\NatLight Ventil.Galcu lation.Sheet.doc
WINDOW SCHEDULE
Job Site/Address: �7 :.� x- - � 1 Date:
Owner: Application No.
Window Window Window Unit or Rough Rough SQ.FT. SQ.FT SQ.FT. Clear Clear Special Hardware
Number or Manufaturor Model/Type Stock Openin Opening GlassNis I Egress/Cle Opening Opening or Instructions
Letter on Name Numbe g Height ibie Vent ar Width In Height
Plan Call Width Light Opening Inches In Inches
Size
z �5 cod D2 7 tz's
Example Entry
A Andersen Narroline 3062 3' 2 6'5 1/2 15.30 8.36 6.01 34 24 16/35" Tempered
Double 1/3" 4411/16 Glazing
Hun
C:\Documents and Smings\Sue\Local Settings\Temp\Window Schedulo.doc
�� Richard A.Missita
High"Superintendent
DEPARTMENT
Home(518)798-5127
742 Bay Road • Queensbury,NY I2804 Michael F. Travis
DePulY High"Superintendent
Office Phone: (518) 761-$2!t (518)798-0413
Fax. (518) 745-4466
DRIVEWAY PERMIT
DATE: '���
APPLICANT NAME:
TELEPHONE NO.: _71 772-77
ADDRESS TO BE INSPECTED: 4'-tJU ch .
RETURN ADDRESS:
Applicant must show exact location and width of driveway(s)to be connected to the highway by
placing stakes at the specified location.
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The
following action has been taken:
STEP 1: ( )Preliminary Approval
NEED: ( )Slight Swale
( )Level with the road
( )Deep Swale
Size pipe to be used(if necessary)
{ )12" ( )1 S" ( )IS- ( )24" ( )36"
Preliminary inspection completed by DATE
Approval by Highway Supt. Deputy Supt
Upon completion,please resubmit this approved permit for a final approval.
STEP 2: { )Final Approval
O Rejected
DATE:
Richard A. Missita,Highway Superintendent
Fire Marshal's Office Town of Queensbury,742 Bay Road,Queensbury,NY
(518)761-8205
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel & vented gas appliances
Date �� 20 Permit No.
Application is hereby made to the Building&Codes Office 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 to perform required inspections.
NOTE to applicant: Rough-in and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
T �l (circle appropriate words)
Name: � �� � . Stove: wood coal pellet gas
Fireplace insert
Address:_� +["'+ (' ( Fireplace, factory-built: wood A�as
Fireplace, masonry: wood g
Furnace: wood gas oil
Phone: `?et 1 "?.>??
If non-masonary applicance, please provide
Owner: Lc,y t- Manufacturer Name:
Address: (42 '�- N✓e Model Number:
Chimney Information
Phone: ::7S 76 ` 2-77 (circle appropriate words)
Masonry block brick stone
Flue tile steel size: inches
Exact Address: =7 �-
of construction or installation Factory-Built
Manufacturer name:
Model Number:
Note: Listed By: Number: _ _
Construction IInstallation must
con orin to NYS Fire Prevention eft Building Indicate(circle) chimney material:
Code. Consult available Town of Queensbury
Handouts"regarding required inspections. Double wall / Triple ivall / Insulated / Direct venting
Chimney Liner
� Ca�ifer'�r Z��,psrtm�t--To�� oaPQu��uerbury, N8�Yorl�-- ---
1
Fire Marshal Code# $Collected $Rcfended Received fi-om (refunded to):_� )nn A uukr��
address: --
A 173 3389 (190) Public Safety
A 233 2655 (230)Minor Sales f.
DATE: `kL
` yi�wa�u2o- IOtvw G�cn./�oa Dr��„
White(Applicant) / Green(Fire Marshal) / Yellow(Bldg. Dept.) // Pink&Goldenrod(Cashier's Dept.)
Application for Permit— Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury NY 12804 (5 -8256
1. OWNER INFORMATION:
Office Use
Location of installation:
File Permit No.� �j
Tax Map N
I Fee Paid
Owner's Name:
CA
Address: L/
2. INSTALLER'S NAME ` }cr C a PHONE NO. �Z —Ka`77
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate # bedroom(s and multiply #of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm = �!�t3
1980 — 1991 x 130 gal/bdrm =
1991 —present x l 10 gal/bdrm =
Garbage Grinder Installed yes — / no
Spa or Hot Tub Installed yes^ / no
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
To o a h ature Ground Water Bedrock or Impervious Material Domestic Water Su k,
_sand
at what depth at what depth municipal
olling o m feet feet well
Steep slope clay �f well; water supply
slope other from any septic-system
depth: absorption is j t
other
Percolation Test: (To be completed by licensed professional engineer or arch test)
Rate. minute per inch
5. PROPOSED SYSTEM: For New Construction: All indr.idual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in a Planning Board approved subdi---ion). Add 250 gallons to the size
of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: L00o gallon (min. size 1,000 gal.)
Tile Field: each trench 't50 ft. Total System Length: 7�00 t
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # / depth or thickness jeCt
Bed System Size: x
Alternative System: length and/or size
6, HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capa ity gallons
` s
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of
Queensbury, any permit or approval granted which is based upon or is granted in re'liaince upon any
material misrepresentation or failure to make a material fact or circumstance known by or on behalf of
an applicant, shall be void.
I have read the re lat' s with r spect o this application and agree to abide b these and all requirements of
the Town of Quee u nit Se Disposal Ordinance.
Sign re of onsi le person Date
Town of Queensbury
Sewers and Sewage Disposal Chapter
Appendix C
ABSORPTION FIELD
SEPARATION REQUIREMENTS
S,r Aug
`.
Nlett.4. �K eiitT+�'R- Ei rt^w1+
'R
Appendix C
ABSORPTION FIELD
SEPARATION REQUIREMENTS
PO
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W"'k, �
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a►t
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FtCOr>,
0c
Permit No.
Building &Codes Office-Department of Community Development-Town of Queensbury Fee Paid '
742 Bay Road,Queensbury,NY 12804 Recreation Fee
Dave Hatin,Director codes@aueensburv.net
Phone: (518) 761-8256 FAX: (518) 745-4437
Principal Structure Building Permit Application
Application & Plans subject to review before issuance of a valid permit for construction.
Instructions: A permit must be obtained before beginning construction. No inspections will be made until the
applicant has received a valid building permit. All applicants' spaces on this application must be completed and
must appear on the application form.
Applicant/Builder C -Ae 19 <Xr�C_ Owner:
Address: (a A- -ok&z Address: 1 2 &,
Home Phone: Home Phone:
Email Address: �_y Email Address:
Cell Phone: 3 __XYS L, Cell Phone:
FAX Phone: -7L•(3 FAX Phone:
Person responsible for supervision of work with respect to building and codes compliance:
Name: C A
Address: Phone--
Location of proposed construction: Lot No. Legal Address: -7 yo�IA- -jr�.��`� Vic-•
Tax Map Number: "%;: s t — Lf Subdivision Name:
Estimated Cost of Construction: $ ��o
- p4eift C)F
�t
Proposed construction is for: Residential Use Commercial Use
Name of Business:
If proposed construction is an addition,what will use of new addition be?
New Addition Alteration Proposed Construction 1A Floor 21d floor Other Total Proposed
structure (Occupancy Type) Sq. Ft. sq.ft. Sq.Ft. Square feet Height
Ft.&in.
Single-Family DwellingS
Two-Family Dwelling
Townhouse
Multifamily Dwelling
Number of Units:
Office
Mercantile
Manufacturing
Other:
Attached Garage 1, 2, 3
Type of Heating System: Electric, Oil, as, Wood Forced Hot Air Baseboard, Other:
Is a fireplace and/or woodstove being installed, please refer to a separate application. ,A�ees —No
Applications are subject to Zoning Administrator, Code Compliance, and Structural Plan review.
The Building and Codes Office will allow commencement of your proposed project only after
issuance of your permit.
Declaration: Please sign below after you have carefully read the statement:
To the best of my knowledge, the statements contained in the 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 Codes, the Zoning Ordinance, and all other laws pertaining to the
proposed work shall be complied with,whether specified or noted, a such work is authorized by the owner.
Further, it is understood that I/we shall submit prior to a Certific of Occup ncy or Certificate of Compliance
being issued, as requested by the Zoning Administrator or D' ctor of B and Codes, an As-Built Survey by a
licensed surveyor, drawn to scale, showing actual locat' of all w
Date.7�5 L01�T Applicant/Builder Si atur
The application of dated is hereby approved and
permission granted for the construction, reco ruction or alteration of a building/and or accessory structure as set
forth above.
Date: Authorized Signature:
L:\Sue Hemingway\Building.Permit.FOR MS\Principal Structure Permit Application.doc V:12/14/04
1
Town of Queensbury Fire Marshal
161 742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 743-"37
Factory Built Gas F4replace/Stove Inspection Report
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
Permit# >>y Schedule Inspection `^ I �( f�} L'�- Time�- l� <am�pm anytime Inspector
Name` e - Address �La,�r. ( /S `may Rough in �ula
Appliance Manufacturer_,- — _ Model#
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides)
Firestop(s) Vertical Chase
Wall Penetration
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible _
construction within 10 feet �RU V
Gas Shut-Off Valve
Combustion Air
Hearth Extension(if any)
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if LP)
VVMW`� i-16; Yenow Zbe— r I Pink-Fin MAMW
Queensbury Building & Code Enforcement - Residential Final Inspection Office No.No.(518)761-8256 Arrive: am/p art: am/pm
Date Inspection request received: l f 3i �'> _ Inspector's Initials: h
NAME: � �{' -_ � d PERMIT#: C> S CoCid�
LOCATION: 7 u r-, DATE: �}� C
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimne •Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Co m lete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in, or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum %z"
Gypsum
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operating
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Temp 110
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors: ��-(�p��j D
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery backup:
Carbon Monoxide Detector
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/'/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Attic access 30 in.x 22 in,x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s . ft.-150 s . ft.vents
Building No./Add r s v si from road
Final Electrical ,(
Site Plan /Varian re uired
Final Survey Plot Plant
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C or C 10 Temporary/Permanent
L:\PamW\Building&Codes\Inspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04 -7!_
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No.(518)761-8256 - Arrive: am/ m Depart: �_hnvpm
Date Inspection request received: Inspector's Initials: �� �` 1
NAME: �1 L -� �— v� Y��� PERMIT#:
LOCATION: ��w t' ���_. �� DATE:
TYPE OF STRUCTURE: CC��,,
—°' Comment.
omment < 5
Y N N/A O
Chimney Ht./"B"Vent/Direct Vent Location ' } `
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Complete
Guard 30 in.or more(a)stairs,decks,patios
Guard at stairwell at 34 in. or more n 11
Guard at deck,porches 36 in. or more \�I
Exterior Finish Complete f-ve
Interior/Exterior il' 4 'Rams 3 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum ''/z"
Gypsum
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above rade
Gas Furnace shut-off within 30 ft.or within line of site
Oil Furnace shut-off at entrance to f imace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Ternp 110 _
Interior privacy/trim/doors/main entrance 36 in. ��6 V( � �UL!/ 1
Bathroom/Kitchen watertight / t✓*A)4)
Safe glazing/Window in stairwells safetyglazing DIP (- (�IlevC W
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area: /
Inter Connected: / Battery backup:
Carbon Monoxide Detector
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/'/<hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Attic access 30 in.x 22 in,x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s . ft.-150 s . ft.vents
Building No./Addr s vi 'ble _from road-
Final Electrical t _
Site Plan /Variance r ui ed A.teC Wk 6tgoc-K, v(t,�,11s 1 Fc/Z
Final Survey Plot Plan V
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C or C/O Temporary/Permanent
L:\PamW\Building&Codes\Inspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04 Vb.
:_ -- 4
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: // I/o,r
NAME: 0L'Ck-
LOCATION:
PERMIT#:
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review th
serve has be
Craig Brown, 7Aning Administrator
Notes:
NOV i
TOW
UILDING AND CODE r
L:\.SueHemingway\Building.Codes.Inspection.FORMSTinal Survey
Zoning Administrator.doc
MAP REFERENCE:
BURNT tiLL5 SUBDM54ON
DKC MOLDINGS. INC.
DATED= JULY 23. 2001
LAST REVISEDs JANUARY 17. 2002
BYl VAN DUSEN + STEVES
LAND SURVEYORS. LLG
LANDS N/F OF
DURKIN
LANDS N/F OF
MABB
IK
zi_y
S83051 '25-E
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r� LEE
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WOOD FRAMED 15,235.50 sq.ft. rn CV)
i HOUSE (UNDER 0.35 acres d
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- 84.48
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DECEIVED
0UTIUTIEs N83°51 '25
75 2,5RW NOV 1 8 2005
TOWN OF QUEENSBURY
BUILDING AND CODE
LEGEND:
2Z,= UTILITY POLE C.
BURNT HILLS SUBDIVISION WATER SHUT OFF
4
LOT 28
n
2
EMBER 8, 2005
A Q i'=20'
'WMMWRM ALMAYM OR AWIlIOR VE TO A SURY
u S MAP SEARM A�L�SURVEYORS SEAL 15 A Map of a Survey made for
MMAIM OF MCM 7200.90-MWM 2 OF*9
►"VM STATE Ex"""W'*
'oRLY cw"FM ME MIMRAL OF MIS SURVEY
limn"AM o um&W ME LAM"Aleft
eve S LS EEWR D,O�"Ai "U s- (LUTE ENTERPRISES S- 1
'CEMPMALONS OWICATID lfAE011 S1RfY MAT
MIS SURVEY VMS PREPARED N ACCOMOM%M*E
Land Surveyors ADWW
IffME "MW CM wPRA �RMWPW M&
BY ME 14M YOIMC STALE A590CIAMW OF PROFE�OIIN.
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To ME PO"FM U MI W%KWY 6 PREWAIM AM R*M E 1 OF 1
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169 Haviland Road Queensbury, New York 12804 I" CF USIM I4UW AND Town of Queensbury, Warren County, New York
(LUTE
(518) 792-8474 New York Lie. No. 50135 rNO, DATE DESCRIPTION DWG. NO. gg241A
Z7 tV..,
7
,r
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
C
Permit No........................................Cert. N2 93334 Cut-in Card No................................0
Owner.................. ...................... ..................... .....-........C-. .tl.%. .............................................
Location.............................. ./�................ay.%..n.S..�..v..%��........
Installation Consisting of.....aizw4si.....Ll..tzx.. I........ ..� ...C�.4.�..... .`1..su
.L..�...5..1..5,........�.....�=�.rzS..t.....,>......,�:..m.a./.4,�.....,Y�.�..,�..t....l2..Kr..,...../L:.<.,?y?..C�:.ey........
.........................................................................................................................................................
Installed By... t2.lLLo.s,c1..... �s ,r'a.l..C. .l.................Lic.No.................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued i;
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon thi
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if it
rules are violated,the Company shall have the right to revoke this certificate.
Date.......... ......... INSPECTO .... .. .... .. ..... ... ....................................
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pry pepart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials. �^..11 f�
NAME: 0-'L=U'-r6- PERMIT #: C5 a-- C�
LOCATION: -7 ?oikPl ►'-l.tLc5 K) INSPECT ON: 16) /TSe
TYPE OF STRUCTURE: l
Y N N/A
Rough Plumbing / Nail Plates
Plumbing Vent/ Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet change of direction
Pressure Test
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.I for 15 minutes
Insulation Residential Check / Commercial Check
Proper Vent Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS:
LAPam Whiting\Building&Codes\lnspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
Town of Queensbury Fire Marshal
742 Bay Road
Queensbary,NY 12804
761-8205/761-SM
fax 745-4437
Factory Built Gas Fireplace/Stove Inspection Reuort
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed
r
Permit# V "�G ®� Schedule Inspection Time am pm anytime Inspector V /CG—
Name Address 7 /J L)IN ! ) C — �7 2. Rough In_,,G Final_
Appliance Manufa• rer i0eg i G Model# 36 $f�✓�R� # �S�7d[�/7
Direct Vent V Facto Built Chimney Flue Size Double Wall Triple Wall Insulated
i'Y Y p
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides)
Firestop(s) Vertical Chase
Wall Penetration
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve
Combustion Air
Hearth Extension (if any)
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if LP)
WMW—&d1"&Dept. Yenow r Pink—Fire Marshal
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/p4 Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ,�
NAME: PERMIT #:
LOCATION: v c- INSPECT ON: /0 7-0,57
TYPE OF STRU URE:
Rough Plumbing J Nail Plates Y N N/A
Plumbing Vent/ Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction /44,—�(
Pressure Test `
Drain / Vent
Air/ Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air Head
P.S.I for 15 minutes
nsulation Residential Check / Commercial Check �D
Proper Vent Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace _
Duct work sealed properly / No duct toe
/,41 S
COMMENTS:
LAPam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
,r Town of Queensbury Fire Marshal
742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Fireplace I Stove Insaection Report
Notice: New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
Permit# C C--)I C'cS Schedule Inspection 1 L 7 C Time anytime uq:76
Name l l )� Address 1 L. Rough In Final
Appliance Manufacturer _ Model#
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated
- Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides)
o �Z
C.It, I
Firestop(s) Vertical Chase
Wail Penetration
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve
Combustion Air
Hearth Extension (if any)
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if LP)
White—
BuRding Mp Yellow r Pink—Fire Maz*a
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/p Depart: _ am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: 0 4- u`r65- PERMIT #: C,S� �b
LOCATION: ye✓7- INSPECT ON: 16 dS
TYPE OF STRUCTURE:
Y N N/A ' ` —
Rou h Plumbing / Nail Plates
Plumbing Vent / Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet / change of direction
Pressure Test
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
FO�P�S.I
r Supply Piping
Head
for 15 minutes
Insulation / Residential Check / Commercial Check
Proper Vent Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS:
LAPam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doe Revised February 15,2005
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p epart/ rrVpm
742 Bay Road,Queensbury,NY 12804 Inspector's Initialss
NAME: PERMIT#:
LOCATION: INSPECT ON: 7,0 - -
TYPE OF STRUCTURE:
Y N N/A COMMENTS
raming
Attic Access 22"x 30"minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '/z w) 16 gauge 8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire ll 2, 3,4 hour
irestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side Yz 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
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/Dun Depart: am
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
�)6?
NAME: PERMIT #:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
- 3 NIA
ou h Plumbing / Nail Plates
Plumbing Vent/ Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction
Pres5ure Test
rain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
essure Test
,I Water Supply Piping
Air / Head
50 P.S.I for 15 minutes
Insulation Residential Check / Commercial Check
Proper Vent Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS:
LAPam Whiting\Building&CodesUnspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doe Revised February 15,2005
Framing / Firestopping Inspection Report
Office No.(518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart:
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:e&tz—)
NAME: CA Cki2 PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCT F ^
I e
1 �
Y N N/A CQMMEkT
Framing 1�
Attic Access 22"x 30" minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %2 w 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
and water shield 24 inches from wall
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
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building;&Code Enforcement Arrive: am/pm Depart: i ar
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
9
NAME: _ V \ PERMIT#: �l
LOCATION: .'j_ N, INSPECT ON: _ l
TYPE OF STRUCTURE:
� � ' i-� Comments
b
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place The contractor is responsible for F
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab _
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R- _
Rough Grade 6 inch drop within 10 ft.
L:\SueHemingway\Building.Codes.InspectionTORMSWoundation Inspection Report.doc January 28,2003
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection r ue eceiv
Queensbury Building&Code Enforcement Arrive: am/ ep rt: a pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initia
NAME: _ E IT NO.:
LOCATION: 5 SPECT ON: —
RECHECK:
Comments and/or diagram
Soil T San Loam/Clay
Type of Wa-terCMunwipalY Well Water
Waterline separation distance f:V0k\,V ft.
Well separation distance ft.
Other wells: f}.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/Pit_ It
Opening Sealed /Partial
End Caps
Location/Separations
Foundation to tank
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan N
Engineer Report and As-Built Y N
Location of System on Property:
Front ea eft Side ight Side
Middle ont ddle Rear
S stem Use atus•
Approved
Partial Approved and needs to be re-inspected,please call the Building& Codes Office
Disapproved
Last revised 1/6/05
r
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4
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i
05
IJ
10
fj 3 i
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"I have seen or obs r be4ieve 1 saw evidence of,
a!1 objects su s houses, Is,trees;-fences,-etc., _ - -
shown o is oc merit. a{ represe t that[have
per -{{y r - _ s _nces forth on the diagram-
RE DAT 3 -- g -- -
C)ot __ _
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 5
Queensbury Building&Code Enforcement Arrive: am/pm Depart:IT4boPpm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
— —_ '
NAME: ,� ,., PERMIT#: __�S—
LOCATION: krn INSPECT ON: , <
TYPE OF STRUCTURE: C�
--o
Comme is
--! Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
r wet areas under slab
ackfill Approval
i
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:18ueHerningway\Building.Codes,Inspection.FORMS\roundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection e I
Queensbury Building&Code Enforcement Arrive: a m Depart: a p
742 Bay Rd., Queensbury,NY 12804 Inspector's h tla
) (�(� 09
NAME: _ ERMIT#:
LOCATION: __ _ j - INSPECT ON:
TYPE OF STRUCTURE:
Comments
y N N/A
F tings
Piers /
Monolithic Slab
Reinforcement in Place—
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
1.:\SueHeminoway\13uilding.C,odes.lnspcetion.FORMS\Foundation Inspection Report.doc January 28,2003
t
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
REScheck Solware Version 3.6 Release 2
Data filename: C:\Documents and Settings\CluteEnt2\My Documents\7 Burnt hills Drive.rck
COUNTY: Warren
STATE:New York
HDD: 7635
CONSTRUCTION TYPE: Detached 1 or 2 Family
HEATING TYPE:Non-Electric
WINDOW /WALL RATIO: 0.07
DATE: 08/16/05
DATE OF PLANS: 081605
PROJECT DESCRIPTION:
7 Burnt Hills Drive
Queensbury,NY 12804
DESIGNER/CONTRACTOR:
Clute Enterprises, Inc.
13 Dawn Road
Queensbury, NY 12804
COMPLIANCE: Passes
Maximum UA=278
Your Home UA= 178
36.0%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-V ue R-V eU Factor TEA
Ceiling 1: Flat Ceiling or Scissor Truss 1252 30.0 0.0 44
Wall 1: Wood Frame, 16" o.c. 1332 19.0 0.0 72
Window 1: Vinyl Frame, Double Pane 72 0.049 4
Window 2: Vinyl Frame, Double Pane 21 0.049 1
Door l: Solid 20 0.069 1
Door 2: Solid 19 0.069 1
Basement Wall 1: Solid Concrete or Masonry 740 0.0 10.0 55
Wall height: 8.0'
Depth below grade: 7.0'
Insulation depth: 5.0'
Furnace 1: Forced Hot Air, 90 AFUE
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building
plans, specifications, and other calculations submitted with this permit application. The proposed systems have been
designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design
Professional has stamped and si is page, they are attesting that to the best ofhis/her knowledge, belief and
professional judgment, such PKMS Vspecifications are in compliance with this Code.
Builder/Designer Date "7 0
RFScheck Inspection Checklist
New York State Energy Conservation Construction Code
REScheck Solware Version 3.6 Release 2
DATE: 08/16/05
Bldg.
Dept.
Use
Ceilings:
[ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation
Comments:
Above-Grade Walls:
[ ] 1. Wall 1: Wood Frame, 16" o.c., R-19.0 cavity insulation
Comments:
Basement Walls:
[ ] 1. Basement Wall 1: Solid Concrete or Masonry, 8.0' ht/7.0'bg/5.0' insul,
R-10.0 continuous insulation
Comments:
Exterior insulation must have a rigid, opaque, weather-resistant protective covering that
covers the exposed(above-grade)insulation and extends at least 6 in. below grade.
Windows:
[ ] 1. Window 1: Vinyl Frame, Double Pane, U-fctor. 0.049
For windows without labeled U-factors, describe features:
#Panes Frame Type Thermal Break? [ ]Yes [ ]No
Comments:
[ ) 2. Window 2: Vinyl Frame, Double Pane, U-factor: 0.049
For windows without labeled U-factors, describe katures:
#Panes Frame Type Thermal Break? [ ]Yes [ ]No
Comments:
Doors:
[ ] 1. Door 1: Solid, U-factor: 0.069
Comments:
[ ] 2. Door 2: Solid, U-factor: 0.069
Comments:
Heating and Cooling Equipment:
[ ] i 1. Furnace 1: Forced Hot Air, 90 AFUE or higher
Make and Model Number
Air Leakage:
[ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air
J leakage must be sealed.
[ ] Recessed lights must be 1)Type IC rated, or 2)installed inside an appropriate air-tight assembly
with a 0.5" clearance from combustible materials. Ifnon-IC rated, the fixture must be installed with a
3" clearance from insulation.
(
Vapor Retarder:
[ ] ( Required on the wane-in-winter side of all non-vented framed ceilings, walls, and floors.
(
( Materials Identification:
[ ) ( Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
[ ] ( Materials and equipment must be identified so that compliance can be determined.
[ ] ( Manufacturer manuals for all installed heating and cooling equipment and service water heating
( equipment must be provided.
[ ] ( Insulation R-values, glazing U-factors, and heating equipment efficiency must be clearly marked on
( the building plans or specifications.
(
( Duct Insulation:
[ ] ( Supply ducts in unconditioned attics or outside the building must be insulated to R-11.
[ ] Return ducts in unconditioned attics or outside the building must be insulated to R-6.
[ ] ( Supply ducts in unconditioned spaces must be insulated to R-11.
[ ] ( Return ducts in unconditioned spaces(except basements)must be insulated to R-
[ ) ( Return ducts in unconditioned spaces (except basements)must be insulated to R-2..
( Insulation is not required on return ducts in basements.
(
( Duct Construction:
[ ] ( All joints, seams, and connections must be securely fastened with welds, gaskets, mastics(adhesives),
( mastic-plus-embedded-fabric, or tapes. Tapes and mastics must be rated UL 181A or UL 18113.
( Exception: Continuously welded and locking-type longitudinal joints and seams on ducts
( operating at less than 2 in. w.g. (500 Pa).
[ ] ( The HVAC system must provide a means for balancing air and water systems.
(
( Temperature Controls:
[ ] ( Each dwelling unit has at lesat one thermostat capable ofautomatically adjusting the space
temperature set point of the largest zone.
(
( Electric Systems:
[ ] ( Separate electric meters are required for each dwelling unit.
(
( Fireplaces:
[ ] ( Fireplaces must be installed with tight fitting non-combustible fireplace doors.
[ ] ( Fireplaces must be provided with a source of combustion air, as required by the Fireplace construction
( provisions of the Building Code of New York State, the Residential Code of New York State or
( the New York City Building Code, as applicable.
(
( Service Water Heating:
[ ] ( Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the
( water heater has an integral heat trap or is part of a circulating system.
[ ] ( Insulate circulating hot water pipes to the levels in Table 1.
(
( Circulating Hot Water Systems:
[ ] Insulate circulating hot water pipes to the levels in Table L
(
( Swimming Pools:
[ ] ( All heated swimming pools must have an on/offheater switch and require a cover unless over 20%
( ofthe heating energy is from non-depletable sources. Pool pumps require a time clock.
(
Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 105 T or chilled fluids below 55 Cr must be insulated to the
levels in Table 2.
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating_Runouts Circulating Mains and Runouts
Temperature(Fl LID to V Up to 1.25" 1.5"to 2.0" "
170-180 0.5 1.0 1.5 2.0
140-169 0.5 0.5 1.0 1.5
100-139 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range(F) 2"Runouts 1" and Less 1.25" to 2" "t "
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(f)r f;ed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water, Refrigerant, 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD(Building Department Use Only)
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a f Gt„n.cts su s hoa sells traes, fences, etc.,
� g �
W!n 0 is oc ment. al represe t that have t I - _
r. u'lV it s nces forth on the diaggraml
k
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DATE