93-181BUILDING PERMIT
TOWN OF QUEENSBURY No 93-181
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to FOREST WOOD HOMES INC.
OWNER of property located at Lot 3 Hampton C-t. , Queenabmy Fone6.t III Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Singte Samity dole Ong
at 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
HCO2 Box 286P
wwcAensbung NY 12885
2.
CONTRACTOR or BUI LDERS Name
bame
3.
CONTRACTOR or BUILDER'S Address
4.
ARCHITECT'S Name
S.
ARCHITECT'S Address
6.
TYPE of Construction — (Please indicate by XI
(� ) Wood Frame ( I Masonry 1 ) Steel 1 1
7.
PLANS and Specifications
28' x48' Single bamity dwe Ling as pelt pto.t plan, bpecib.ica ionb
No. and appti.cati.on .incCudi.ng ;Wo cwt attached gaAage and bepti.c
zLgem.
8.
Proposed Use
Singte 6axity dweZUng
191.00 PERMIT FEE PAID —THIS PERMIT EXPIRES MAY 12 19 94
(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.)
Dated at the Town of Queensbury this
SIGNED BY
the Town of Queensbury
I
N
a
w
W,
c
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date OPt J . 14 19 L3
This is to certify that work requested to be done as shown by Permit No. 43-181
has been completed.
This structure may be occupied as a to bam i ey dwe t i,ng with
Vcan ac garage
1.ocadon Lox 3 Hamn.ton Cowit Q eenbbww Fow zt Phase III
owner Foneaz Wood Homes, Inc.
121-14-3
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
TOWN OF QUEENSBURY REVIEWED BY:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING & CODE ENFORCEMENT FEE PAID:
531 BAY ROAD
QUEENSBURY, NEW YORK 12804 PERMIT NO.
(518) 745-4447
BUILDING PERMIT APPLICATION
All applicants' spaces on this application MUST be completed ar,
signature of the applicant MUST appear on the application form.
OWNER OF PROPERTY:
Mailing Address:
Telephone Number(s):
PROPERTY LOCATION:
Wor
Subdivision Name: (JJAV,G
NATURE OF PROPOSED WORK:
V NEW BUILDING:
RESIDENCE/COMMERCIAL
ADDITION TO BUILDING:
RESIDENCE/COMMERCIAL
ALTERATION TO BUILDING:
RESIDENCE/COMMERCIAL
(NO CHANGE TO EXTERIOR SIZE)
OTHER WORK (DESCRIBE BELOW)
GROSS AREA OF P OPOSED STRUCTURE:
1ST FLOOR 7a SQ. FT.
s
2ND FLOOR D SQ. FT. G
OTHER FLOORS SQ. FT. t h
(not unfinished cellar or basemen
TOTAL FLOOR AREA: /29A SQ.
SIZE OF NEW STRUCTURE:
J
t)�
T.
FEET X FEET
Foundation Type: (.600-f aC
Number of Stories:
(habitable space only)
Height (grade to ridge): 2 feet
Number of fireplaces and/or woodstove
to be installed: --
"14ADi91633
NAME OF BUILDER/ADDRESS/PHONE:
NAME OF PLUMBER/ADDRESS/PHONE:
NAME OF MASON/ADDRESS/PHONE:
NAME OF ELECTRICAN/ADDRESS/PHC
ra
7= Lot No. _W13_
ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ cnom
OCCUPANCY INFORMATION:
PRIMARY BUILDING -
_Z�Single Family Dwelling
Two Family Dwelling
Family Dwelling
Office
Mercantile
Warehouse
Manufacturing
Other
IF ADDITION, USE OF NEW ADDITION:
ACCESSORY BUILDINGS:
Detached Garage - One/Two ar
Attached Garage - One wo Car
Private Storage Building
Commercial Storage Building
Other
Will any second-hand or ungraded
lumber be used? If so, for what?
0
Type of Heating System:
(circle all which a lies)
Elec it / Gas
Force / Wood
d Hot Air aseboard / Other
IRK AR RF.rARns TO BUILDING CODES IS:
To the best of my knowledge the statements contained in this appli-
cation, together with the plans and specifications submitted, ale 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 rk is authorized by the owner.
Further it is understood that I/we shall s bmi prior to a Certificate of
Occupancy or Certificate of Compliance bein ued, an AS BUILT PLOT PLAN
drawn to scale, showing actual location of r on premises.
Signature
(Owner, own r a ent, ar tect, contractor)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance Methods: PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component trade Offs
1&2 Family Dwellings; Multi -Family
Dwellings (3 stories or less)
PART 4* - Design by Component Performance
Commercial Buildings -Hi Rise Residential
*Requires submission of worksheets
AId 1-PPLIC��A��N�T''S NAME: PROPERTY LOCATION:
r
e utl'i'LlJiI lo.t _� 4,w� &0't
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - square feet/ /
2. Type of Heat - Electric Oil , Gas ✓ Other
3. Is building mechanically cooled? Yes _,VlNo /
4. Percentage of area of windows and doors _ Over 17% _/Under 17%
5.
R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO
R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof
R
b. Exterior walls
R-�f—
c. Glazed areas
R
d. Exterior doors
R
e. Floors over unheated spaces
R
f. Edge of slab on grade (heated building)
R
g. Basement/cellar walls (above grade)
R
h. Basement/cellar walls (below grade)
R
i. Heating/cooling-ducts-piping in unheated space
R
6.
Service (domestic) hot water heating device
Conforms to minimum efficiency per code � Yes
No
b PERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE
I
EXCEEDED
Ap
'i a t s S' natu\re Date. Phone
Nu e
INS
CTOR'S REMARKS:
I /
AVINk
VA L TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: 4Njp / n Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION:
Owner's Name: J"owdA/�ifimf
Owner's Mailing Address: h0Vr
Installer's Name: �I)iNff /u�g1GtfoJ Phone #:z?�
Number of bedrooms (if residential):
Total daily flow (residential -compute @ 150 gal. per bedroom): WI -
Topography -Circle One: lat Rolling Steep Slope % of Slope
Soil Nature -Circle One: San Loam Clay Other /Depth:
,99
Ground Water -At What Depth? O Feet
Bedrock or Impervious Material -At Wh t Depth? 0 $ Feet
Percolation Test -Circle One Not Required Required/Rate _Min. Per Inch
Domestic Water Supply -Circle One: Municipal Well Other
If domestic water supply is a e -
Separation: Water supply from any septic absorptionfeet
PROPOSED SYSTEM: Septic Tank /000 gal. (Minimum size: 1,000 gal.)
Tile Field: Each Trench A feet//Total System Length _2nZ feet
Seepage Pit(s): Number of
/ Size each: _ ft. x _ ft.
Size of Stone to be used: # Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size�of Each Gal.
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
I have read the regulation on the reverse jeuof
this heet and agree to abide
by these and all requirements of the ' wn eensbur Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:,�
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary 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) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No 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 of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
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 & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
TOWN OF QUEENSBURY
531 Bay Rd., Queenabury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date %r'�;:Z.:-` ,19 L Permit No.
i
APPLICATION IS HEREBY MADE to the Building Dept. 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.
Please fill out additional form if more than one appliance end/or chimney.
Applicant >"f�'> <<` APPLIANCE (check appropriate boxes)
Address ;- L'
-' k
F'
❑ STOVE: ❑ Wood ❑ Coal ❑ Pellet
}�.
❑ REPLACE INSERT
Zip
FIREPLACE, FACTORY -BUILT:
a -Wood ❑ Gas
Phone
�� %
7"
❑ FIREPLACE, MASONRY:
❑ Wood ❑ Gas
Owner
, n
,;_D
❑ FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address
IF NON -MASONRY:
Manufacturer: 'Jt x:1 _-
Zip
Model: Outlet: inches
Listed By: Number:
Phone
Exact address of proposed construction
CONSTRUCTIONANSTALLATION MUST
CONFORM TO NYS FIRE PREVENTION &
BUILDING CODE. CONSULT TOWN OF
QUEENSBURY HANDOUTS PROVIDED
REGARDING REQUIRED INSPECTIONS.
Dept: Fire Marshal
Code Number
Cashier's. Department
Title
A 173 3399 (190) Public Safety
A 233 2655 (230) Minor Sales
e Coe llected From Refunded
ess:
CHIMNEY (check appropriate boxes)
❑ MASONRY: ❑ Block ❑ Brick ❑ Stone
FLUE: ❑ Tile ❑ Steel
Size:
inches
❑ FACTORY -BUILT:
Manufacturer:
Model:
Listed By:
Number:
❑,.Double Wall
❑ Triple Wall
❑ Insulated
Town of Queensbury, New York
Amount Collected Amount Received
a
to: �i /l/, ;f4 n �_/
Dated: / 2/ f Town Clerk or Deputy:
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink do Goldenrod: Cashier's Dept.
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED / 4,3 /l
NAME
LOCATION
DATE 3 _PERMIT
TYPE OF STRUCTURE_ 5F�
RECHECK APPROVED
N/A I YES I NO
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESP
FOR PROVIDING PROTECTI
FREEZING FOR 48 HOURS
THE PLACEMENT OF THE C
MATERIALS FOR THIS PUR
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN
PLUMBING UNDER SLAB_
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/NA IN B AM
HEATING ROUGH -IN
INSULATION:
FOUNDATION WAL INT
FROM
LOWING
EONSI
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEA
SPACES
KtMAKKJ:
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r'YG'� .(•�r�T—OC/Y,xllfa'fT c�� (.�'tG
PL f4W j2& TeF4—G'iA,' 'V& 1-00 i r,L%; �
Ff� �EgvE�uurt���r�i��►G,�to�
ARRIVE '�'-Z6
DEPART
INSPEC OR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT /�/R-
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR IINNS"PECTION RECEIVED �/u/!�-?_
NAMELG
LOCATION
DATE 1/ 93 PERMIT #
TYPE OF STRUCTURE
RECHECK
MONOLITHIC POUR FORM
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 SIT
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN P ACE_
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM d-
HEATING ROUGH -IN
INSULATION: f
FOUNDATION WALLY EXTERIOR R-
FLOORS i R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEA
SPACES
ARRIVE ( 50
DEPART �7S
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPPECTION RE,CE/IVED 6,12_ lA13
NAME \7�/Q0d GC/G iV�DoY�X��
LOCATIONf
DATE (p - 3 PERMIT # i.? If/
TYPE OF
RECHECK
STRUCTURE
APPROVED
I N/A I YES I NO
MONOLITHIC POUR FORM
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 SI
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VEN S IN LACE_
PLUMBING UNDER SL1B
K FRAMING: t
JACK STUDS/HEADE S
BRACING/BRIDGING•,
JOIST HANGERS
JACK POSTS/MAIN M
HEATING ROUGH -IN
INSULATION:
FOUNDATION WAL S INTERIOR R-
FOUNDATION WA S EXTERIOR R-
FLOORS R—
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATE
SPACES
/ /1 T.lt4 Plv4 ,
ARRIVE/d J*�
DEPART . '/,�)
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 00 k�
NAMES Ae 1�g�ztt:xzo
LOCATION___,et 3��
DATE 2VZ4% PERMIT # 9;-/f/
TYPE OF STRUCTURE
RECHECK APPROVED
{ N/A I YES i NO
MONOLITHIC POUR FORM
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 S
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE_
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGW N
yINSULATION: Ar (L�y
/' FOUNDATION WALLS INTERIOR �R-
FOUNDATION WALLS EXTERIOR R-
FLOORS rARIN(mt C&j"A,, R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEAT
SPACES
Ls�WG�io�IC2uU�- ��°L ✓�'�
Uffbk-
ARRIVE I:i D�
DEPART tl; /p
IN4ECR
e.L�
TOWN OF QUEEN
BUILDING d CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name r,, .4
Location jjf,3 /✓.��Q .
Date i 10 Permit
SOIL TYP Sand- oam-Clay-
Results of Percolation Test -
(if applicable) Rate-Minute/Inch��
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench Po
Depth of trenches z.�r
Size of stone
SEEPAGE PITS: Nun
Size - ft. x �t
Stone size
PIPING: Size yp
—
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pj� p���
Openings Sealed? _ Yes N _? a� rtial
I 9
Foundation to Tank feet
Foundation to Absorption feet
feet
Conforms as per Plot Plan' - e No
LOCATION OF SYSTEM ON PROPERTY:
(circle one
Front - ea -Left Sid�%e - Right Side
Middle rout - Middle, ear
COMMENTS:
i
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
ng
TOM OF QUEENSBURY
531 BAY ROAD
QUEENSBURYURY, NEW PORK 12804
TELEPHONE (518) 745-44447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIYF
3
C6 /Y J PERMIT/'
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
_INSULATION _WOUDSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION ✓
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER 0 'RA ING
INTERIOR TRIM/PRIVACY, POORS
FINISH FLOORS: }�
BATH/KITCHEN WATER) GHT
OTHER FLOORS SWECPAOLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPTION
FIRE/DEMISE WALLS
FINAL ELECTRLGAik
OK TO ISSUE / R C/C
/7,e 7`4cs.f 49< Al-'
ARRIVE
DEPART I/
IN —ay-
TOM OF QIIEENSBURY
531 BAY ROAD
QUEENSBURYURY, NEW PORK 1280q/��
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED v 1 a
NAME
LOCATION Z,.- 3 q(/6 jNyy
DATE PERNIT# 93
TYPE OF STRUCTURE �5;CD Z,
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
vF00TING L,—WNDATION �,BACKFILL [,FRAMING
ROUGH PLUMBING FINAL ELECTRICAL LSEPTIC
_INSULATION _WOTDSTOVE/FIREPLACE
REMARKSf1s9
1 /JiAJ2.Ua i/ w7,yy y1{/L���
APPROVAL
CHIMNEY HEIGHT/LOCATION N/A YES NO
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS-
BATH/KITCHEN WATERTIGHT,
OTHER FLOORS SWEEPAB(E
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILIN
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPE TING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL /3
OK TO ISSUE C/O OR C/C
� lPoa/le/a//�
� �� ,d�v; ye 7t-
ARRIVE /, Y6'
DEPART % C"V
INSPECTOR
FIRE MAI
REQUEST�IVE
NAME (n�
LOCATION J�P
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
f ISPE EP7�0'
FY�L'I��11A�F9J��i[d�NP►I
-/�) Ld
f3-r 8 I
AM PM
0 I=./ APPROVED
3 —t g/lil4g N/A YES I NO
EXITS
AISLE WIDTHS
EXIT SIGNS _
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEMt
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE ❑ MASONRY ❑ FACTORY BLT.
❑ ROUGH -IN
❑ FINAL
REMARKS: ❑ OK TO THIS DATE
30
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r-oP-EST (l)o)np 1(..r,oe
Mloy 511993 SCAT- I'•:50'
DAVID J. BOLSTER
LIC. LAND SURVEYOR
22 BONNER DRIVE --
QUEENSBURY, NY 12804
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