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1985-035 r L CERTIFICATE (DIVA OCCUPANCY . TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date ' 31 19p This is to certify that work requested to be done as shown by Permit No. has been completed. This structure may be occupied as a one! Ve tr^i 1y Mw&A J A M �,l�iDAWI &r) T_ocation .16 " n ergr o efi Read Owner Sy Order Town Board 'TOWN OF QUEENSBURY I Building & Zoning Inspector I i CACfITIV'C "IFI$T A" TRIfi TIMG, frLEMS fNLLS FI Y 12i0} 1}ti�l4]•36}p c }-- r r C 1 1R JN n Y CERTIFICATE OF O CCUPA.N CI TOWN OF +QUEENSBURY WARREN COUNTY, NEW YORK Date r a 24 19 This is to certify that work requested to be done as shown by Permit No* has been completed. This structure may be occupied as a Cane—ran- ily Dvrellin� 0`0(9ular7 Location z'?inte-rc- reen Foad � ,7csc�Y� F' aca Owner I,popppY CFF7' Il 1CF�^ F CT CCCT ?F � .TTCs' By Order Town Board F' C?' F 0 D Y S& TOWN of QUEENSBURY Building & Zoning. Inspector i C Rt/ TIYr "IMST a'- •'R IM TIMG. G4EMS fALLS N Y 1 ago 5 IS 181793�3SSS s BUILDING PERMIT TOWN OF QUEENSBURY No. 85_ 35 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to OWNER of property located at _ Wi nt c rg. mad Street, Road or Ave. in the Town of Queensbury, To Construct or place a One r a>r i ll �]Z{ i n Q (M arl t t l a v ) C-1 at the above location in accordance to application together with plot plans and other information hereto filed and O approved and in compliance with the Town of Queensbury Building and Zoning ordinance_ (' m tx t . OWNER'S Address is 70 Helen Street co Lake George, New York w 2. CONTRACTOR or BUILDERS Name Caruso Enterprises , Inc . 3. CONTRACTOR or BUILDERS Address 340 Dean Road Hudson Falls , Nev: York `D 4. ARCHITECT'S Name I'U fD O 5. ARCHITECT'S Address } IL CL 6. TYPE of Construction — (Please indicate by X) ( N Wood Frame f ) Masonry I ) Steel f 1 7. PLANS and Specifications 241x521 per plot plan , specifications and No. application submitted including sewage system . THE ATTACHMENT OF THE Tin?O PARTS MUST BE APPROVED BY A Q a. Proposed Use LICENSED PROFES I AL (l One-Family Modular Dwelling nj w- ❑ w $ C Pam F- L'c4 $ 4 ' QR PERMIT FEE PAID - THIS PERMIT EXPIRES October �°� 85 � V ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the N town of Queensbury before the expiration date.) I--i N- Dated at the Town of Queensbury this rath Day of Marc kt 19 $ � SIGNET] BY „y+_gr for the Town of Queensbury Building and Zoning lnspecto ' �,, TOWN OF QUEENSBURY {,;pace inside block t=r lit, lille(I it, 11% WARREN C UN'TY. NEW YORK Buildinginsfx*cerrrl ppl it aticrtt No. . Application for PcI mit is.,ued 19. . BUILDING AND ZONING PERMIT l'venlit F.pires . I� Zt ]i1FFt;: Distri(i % Am- 1 rl NVork \irY ,t'i ii e�tl hr,� � 5 THREE ( 3 ) Copies of a PLOT PLAN, Drawn to scale lit ,et;ii Kf showingg the actual dimensions of the lot to be built upone exact size, and location on the lot of the buildi, Thng to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. TOWN air nUU:j;:-rqc :r', r7 liT1 A T r 09. s7 .S L9 f ! I r fC7'BTAINED BEFORE BEGINNING 'WORK A PERMIT MUST BE Ivry y ( c€ ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a perm to do the following work A.IIA. vAich will be done in accordance with the description, plans and specifi- ���� x� 4) 3) 415jr6, cations, and such special conditions as may indicated on the Permit- The owner of this pro rtt Is. s /ty// 074 p � g /] �� t/l . JJJ ✓ T- F� .Sy �.�. { V �� T - �_• � - p . 0 � / P�/- � . l. �C.`J' / The person responsibie for supervision of the work insofar as the Bttilding Code and the Zoning Ordinance��v is: �: ' R.L s '' . . ,��!.' !� 'r :t'!s . r- s.�5-e�, ,s�'c r�'r.�.'� �F'"P?. 1'd.� r✓!'s . . . . . , �,'�'y! 1.e'a> s ;: rtpME} op-6 ADORE SS} . r.`- � t'. �y . �✓y7.�I: . - �Cx! „�ET_. � e� Y�i'f� C r�' .�.�ar �' S:J�-f � Cr /� •. . . . . - . . Name of Builder . // / v �r . Address ,rJ .!�'�<. rm Name of Plumber,;., . . / r '!c . . . . Adclress . . . 4V.t Narne of Mason � Q fir. Lot Number . - . . . . . . . . L3nit . . . . . . Estimated glue of proposed work S , - . . . . . . . . Name of Village . . . . . /z, !n�. �. . _ °' G : . .,�7 c .e r rz s Name of Street . / . I `� ' �r '" �� �'� - . ' Side of street : north O, east ®: soutls ❑ . west ❑ r �jt t� S . 1' ! * . . . _ _ . . Distance from this cross street . . . . . . _ f6. <- - Ft , Nearest Cross Street . - �, .- Property is north [I . south 1r . east J , West [] from Cross Street If on Corner, which corner, northeast CI , northwest ❑ , southeast Cl , southwest (Designate by marking with an "X" in the correct space_) NATURE OFF PROPOSED WORK OCCUPANCY Main Buuilding Construction of a new building, One-{amity dwelling C� Addition to a building. Two-family dwelling D Alteration to a building. - . -family apartment house © Demolition of a building. Store building . . . . - - . . -car attached garage p (Other: . . . . . . . . . . . . . . . . . . . . . . . Accessory Building r'. . . . . . . . . . . . . , . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . One-car detached garage J Other work. Describe: . . . . rh � � red . .. . . . `Two-car detached garage r/ Private chicken house • ' ' ' ' ' �'! Private storage building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Other: , , . . . . . . , . . . . . . . . . . _ . . . . . . . . , , . . . . . . - . . ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building, or a change of occupancy. Indicate on the plot plan street names. the location and J size of the property, the location. size and setbacks of pro- posed buildings, and the location of all existing buildings. Show proposed building(:) in dotted line and existing >*v �, t �r �r�y ,+ se- ru huildin,g(s) in solid line. Size of property 1�1 ' ' . . . . ft. x . . . ft. `~. ) Size and use of existing buildings, if any •, { . . . . . Size of proposed building . ft. x ft. l#eight (from grade to ridge) . . . . . . . . . . j. . . . . . . . . . ft. Front yard . . . . . . . . . . . . . . . . . . . . . . . . ^~'.3 ft. Side yards . . . . . ft. and . . . . V 0/ 4 — G9✓�S - Rear yard - - . . . f, 6 . ! . . ft se +i If on corner, setback from side street . . . . . . . . . . . Note! All distances are wee, as rneasured froth street side line to nearest ,+hart of building. a rovaRf ? -73 _M lcont'd, 1 BUILDING SPECIFICA►TIONS., � ✓ � �° ;� Kind of constructions Wood frame, fire safe, etc,? . . . . . . . . . . . . . . . . . . . �`''. ':n; .? . . - . . . . . . . . . , . . - . . . . . . Will any second-hand lumber be used? . . . . 1r . . . . . If so, for what? . . . . . Material of foundation walls . . . . . . .0 .p ^x !? ,j�' , , . . . . . . . . . . . . . . . . . . . . . . . . . Thickness . . . . . . - . . . . Depth of foundation walls below ade . . . . . P gT . . . . . . . . . . Conti,�tuous foundation? . --. ,..�„ Will there be a cellar? . . fr'-- _ �� If so material of cell- ar fluor . . . . f .Y?. Type of roof: Sloped or flat? . . . . :'1!! ilk - �!? '7c, � . Material of roof . . - . . �!-. t - - !ar Size, wood studs . . . . . . . . . . . . . "� . • x . . . . . . . . . . . . . ", spacing . . - . . . - , . /G . ."o.c., length . . . . . . . !2'IDN . . . . ft. Size, floor beams, 1st floor . . . . . . . . . " x . . . . . . . . . . . . . ", spacing . . . . - . . . 1. . . ./6 "o.c., span . . . . . . . . . . . . . . ft. Size, floor beams, 2nd floor . . . lYr " x . . . . . . . . . . . . . . . ", spacing . . . . . . . . , . . . "o.c., span . . . . _ . . . . - - . . . ft. Size, ceiling beams . . . . . . . . . . . . . . . W . " x � . . . . - . , . . . . ", spacing e`.la . "o.c-, span - ft. Sine, roof rafters or beams . . . . . . . . . . '" x ,,�! . . �S rc q. . spacing . . . . . . . . . ./. 6 . . *so €., span . . .�. . . . . . . . . ft, Exterior finish . . . . . . . . . . . . . . . . . - . . , - - . . With what material ? - - . r� ! .1" < �' ._ Finish of interior walls . - . . . . � : . . . - 'a ?;+- - . . . . . . . . . . . . . . . . . . . . . . . . . . If garage is to be attached, of what material is wall between garage and main buij4ing to be constructed? Is there to be an opening between garage and building? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kind of heating system . . . . i rc', t . .? ,t. . . . . . . . . . . . . . . . . . . Oil burner or coal ? . . . . . . - . . . . . . . . . . . . . . . . . . . . - . Will a flue-lined chimney be provided? . . ./40' .r2.it . . . . . Depth of chimney foundation below grade . . - - . _ . . . . . , , . . Height of chimney above roof. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , - , . . . . . . . . . . . - . . . . . . . . . . . Will there be a fireplace? . . . . , Id . . . . . . . . . . . . . . . . Depth. of fireplace hearth . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . Will a toilet be installed? . . . . �e'`4'..3. . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . J• .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water su 1 ublic water supply or um �' '/ 1 . . . .L r+� -- ppyJp ppY pump) . . , - op! 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet . . . . . . . . . . . . . . . . . . . Will drainage system be provided with required traps, cleanouts, and vents? . . . /�". . . . . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT County of Warren State of New York I swear that w it, hey i of my knowledge and belief the statements ow tained in this application, torKber with the plans and spocifications gull mitred, are it true and cowl4 lete statement of all proposed work to be done on the described premtaea and that u0 ' eu of she BUILD- ING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shell he complied wftb�whether specified or not. and that such work is authorised by the owner. Sworn to before me this Signature . . . .. . . . . . .. GWNER, OWNER'S AGENT. ARCHITECT, t:ONTRACTGR dd . . . . . .. . . . . . . . . .. . . . .. . . .. day of.. . . . ... . ... . . .... . . . .. . ... . .. . . . . . . . . .. . ... . . 19. . . . NOTARY PUBLIC. WARREN COUNTY, N. Y. SPECIAL CONDITIONS OF THE PERMIT; By .... . . . .. . ... .. .. . .. .. .. .... . . .... . . . . . . .... . . . . .... . ..... . . . ... ... ... . .... .. . .. . . . . .... . . ......... tom. �(. TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL Of the following : �7 14 Gross floor area / _ r eX �+� V/ 2 , Type of heat 3 , Is the building mechanically cooled ? Ale) 4 , Percentage of area of windows and doors A , Over 16 % Only 1 , U value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 , Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO 1 , if YES , what is the. R value ? 3 . Slab on grade YES NO a , if YES , what is the R value of insulation around perimeter of float ? 4 . Is basement heated. ? YES NO a , R value of insulation 5 . Type of insulation B . Under 16 % Only 1 , R value of roof and floors exposed to ambient conditions 2 , R value of exterior wallsT 3 , R value of glazed area. � f 4 , R value of doors /3 3 5 . R value of floors over unheated spaces /�+f 6 . R value of slab edge insulation - unheated slab 7 , R value of slab insulation - heated slab 60 R value of heated basement / cellar walls ( above grade ) 9 _ R value of heated basement /cellar walls ( below grade ) 10 , Type of insulation C . Controls 1 , Thermostat maximum heat setting D , Duct Systems__ 10 is duct system installed in unheated spaces ? YES NO & '' a . If YES , R value of duct installation b , R value of duct in other areas E , piping Insulation 1 . Size of hot water or cooling carrying agent pipe /z 2 , R value of pipe insulation �'"`r�''r +z - - F . Service Water Heating 1 . performance efficiency 2 . 'temperature control setting maximum G , For Swimming Pool Only 1 . maximum heating Telephone No . !D [S � � � _ i �r 40' C pplicant ' s signature ) TOWN OF )UEENSBURY BUILDING i ZONING DEPARTMENT SEhTAGF DISPOSAL PERMIT APPLICATION l . Owner " s Name r�72,�. 74A V,5- 4e' "A d r e s s _._ ICJ Z/V too r' ,7 2 . E�roperty location / J rJ TT �r 3 r r i"� . 4 f" �' "f;"s ` 3 . Hume of person or firm responsible for installing system �lr Telephone No . Address 4 . Number of bedrooms ( residential buildings only) a 5 . Daily flow 100 gallons/day 6 . Sceptic tank capacity /JG' d C� gallons 7 . 'topography : flat , rolling , steep % of slope 8 . Nature of soil and depth_ -�)o`f. 96 if ground water , bedrock or impervious material is apparent at what depth does it begin? ft - 10 . Percolation test : A is required B is not required c if required what is the rate minutes/inch ll . Water supply : municipal well , other 1 12 . Type of system proposed : drywel ]f, the field , other Any contractor , corporation , individual , etc . engaged in - the construction of a sanitary sewage disposal system who covers the same before inspection , does not have an approved permit , or varies from the approved application will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinancee ,^ Date G 2� , c c e si-clzfature ot appl :Lcant On separate sheet of paper submit a diagram of the proposed septic system with all dimensions , including distance from any structure , distance from property line and domestic water supply , etc . Include all dimensions of the system itself . Form 3 - 82 0004 TOWN OF QUEENSiUR'Y Ruil&uz Department p a •� DAUB Jlow ^�-y Permpt No. Remarks i SxcatYa t3an Foot in Forms Footin & piers Founda t.f on Cement Coat Water raofin ,gackfill Final Survey Fray n Shea thin Roof Felt Raofln Siding Masonry Veneer Rou h Pl Relief Valves Wald Board Bart . Porches Finished Floor fnteriar Trim G Stairs & Railin s Cellar Dr . Tile Concrete Floors pl Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Inst . Se tic A royal Floors Foundation ,insulation Wale Ceilin d� Boil ing spector end c . ilk 4036660 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 41 STATE STREET, ALBANY, NEW YORK 12207 mots ,31st2B 11 . 1985 A licotion No, onfile 075419- 65 A642664 . _. THIS CrawriFiESS THAT the applicant maned oat the above applicatsori nuanber in the premises of only the ej ectrical eg"Wment as described below Dead rota a deacsd by w _ Joe Blca , wintergrem , Queensbury , New York outside 'Section 11%tock 4 Lot 19 in the foiiowing location; naseanent El lot F1[. ❑ 2nd F1I. facts exaPrtined sat and foTxnd to be in 4,oYn.plTance with the requirements of this Board* No DECKS [LIVENS DISH WASHERS EXHAIUST FANS FIXTURES RANGES COCIKI NLERS ACUM SVnTCHES INCANGESI F W W v AMT. K. W, AMT. K. W. AMT. K.W. AMT. W. AMT. H. P: K. OUT FUTURE AMJANCE FEEDERS SPRCIAY RES'I'T TIME G10CKS EE41 UNIT FWATERS MULTbt1UTM DUYIMER5 -. DRyERS FURNACE FAOTORS SYSTEMS AMT. WATM AMT. K. W. 011 N. P. +GAS FI. P. AMT. NO. A. W. G. AMT. AMP, AMT. AMPS. ?BANS.. AMT. H. P. NO. OF FEET S E E R V I C SERVICE DISCONNECT Na.aF NG. OF Nfurewis A. W. TR METER NO.OF CC. CONE- ti W. G. NO. OF Iir.4EG OF NEUTRAL AMT. AMP. TTPE EG IUW. I '~ ZW r 3W G X 3w 3 A 4w PER 8 # CC. LONG. 2-0 C£3 � x � 4 /0 � 2/ 0 DI Af►ARATUS: rises Inc > Caruso El C�]G�3 N 340 Uesn Road Rudsit.n Falls , New York 12639 BRANCH MANAGER Per . THIS COPY OF CERTkFICATE MUST NOT BE ALTERED IN ANY MANNER. COPY FOR BUILDING DEPARTMENT TOWN OF QUEENSSURY Building DOP&Ttment Lnrpectom - N*fie a G !1 P Or - W eatleaer Remarks Excao Lion Footi Forms Footin & Piers Foundation Cement coat Water roofin Bacxfill Final Surve Framin Sheathin Roof Felt Roofin Siding ,Masonry Veneer Rough PI Relief Valves Wall, Board Ext , Porches FiniShed Floor interior Trim Stairs & Railin s Cellar nr . Tile Concrete Floors T Pl ry Fixtures Gar . Fire roorin m or closers Chi.mne Water Meter inst • _. Se tic A roval insulation Walls Cell-in ctor RUilding inspe REMARKS LIT 5 BUILDING DEPT. COPY OF APPLICATION FORM 46-EL. NEW PORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH 81LIfLDING DEPT. WHEN REQUIRED, CITY OR VILLAGE TOWNSHIP .o r COUNTY rJ y ,r / �- STREET AND Np. OR / ROAD AND POLE No, 6 y { J BETWEEN WHAT TWO •F POLE NO.1,,.+ CROSS STREETS IS _� 1, SECTION �r BLOCK T LOT /'� •� PREMISES EFTS IS Wool/ !if sG� OCCUPANT'S ,/ NAME y f—, r f ( e BUILDING AWNER ADDRESS OCCUPANCY OIWIYER ND 'S NAME roc^ UR NT / J rY SUPPLIED BY & FROM THEIR /'f.w,, i _ '.f�. OFFICE BUILDING WORK IS NEW 9; ` OLD D REMODELED ❑ Is NEW L'�f may-AtrDITIdNAL J DEFECTS E© LIST BE LOIN ALL EQUIPMENT WHICH YOU INSTALLED REMOVED NUMBER OF OUTLETS No. of Fixtures & BRANCH Lars. Lamp Receptacles MOTORS HEATERS tion CIRCUITS LAMPS Ceiling Sid. Attaah't Eat Each G. ND, Wall RecepCle Switch Pendent Bracket No. Type No. No_ 4e EACH WATTS Out- ride Su b- base e BaSo- ment 1st Fl. 2nd Fl. 3rd Fl, REMARKS: LIS OTHER ELECTRICAL DEVICES NOT SET FORTH ABOV 00 NOT USE THIS SPACE. This application mtVV*d to corer the a6ore-listed puipmrnR to In tad but iF time of i you are wd+orised to a4e the ierspactiaa and adjust the Fee to corer the additional name found additional equipment not ahora Inta t. SIZE OF equipment, as Provided b'Y thee applicant. MAINS ,.r EL EC TR PC SIGN FEEDERS,Z ,�," LAMPS WTOTAL ATTS OMR CHARACTER XPOSED GAS TUBE SIGN OF WORK NCEALED TRANSFORMERS OF WORK TO BE VA STARTED COMPLETED SIN E OF SIGN (CAPACITY) SERVICE ENTERS MAKER DIN r OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLEMid ete� de - NEW © OLP AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION, ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF APPLICANT �,/r..'" 1�" f�1 DATE OF f / il�r / APPLICATION— J S STREET ADDRESS CITY OR POST OFFICE �f . 1 '`! �d ,may ,,r -• �" �. f ZIP LICENSE NO. —�---{ CODE NMEN APPLICA BI,E A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING TOWN OF QUEENSBURY Building Department leepeators Report Na=&��— - PermvA No. 8 S 3 5' weat}ia Remarks Excat}a tion Footing Forms v Footing & Piers Foundation Cement Coat Water roofin BackjFi l l Final Suxveli Framing Sheathing hoof Felt RooEln .Siding masonry veneer Rough PI Relief Valves Wall Board Ext . Porches Finished Floor Interior Trim 1 stairs & Railings Cellar Dr . Tile Concrete Floors PI , Fixtures _ Gar . Fire ronfin Daor Closers chimne Water Meter 2nst . Se tic Approval Floors Insulation Founda t i.on Walls Ceiling Beni dl gr Inspector REMARKS BUILDING DEPT_ COPY OF APPLICATION FORM 4S-EL, NEW YDRK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP. DATE 71 CITY OR VILLAGE TOWNSHIP y. a lA�` S /,,.+' V'✓ y COUNTY �/"'� "�'Y'Ir ,I.y STREET AND NO. OR ROAD AND POLEPOLS NO. BETWEEN WHAT Two � �. CROEMISE L SS STREETS IS R i fi. Y s 4 �,,5 SECTION 1 .^' BLOCK 47Z LOT P TE T 6y OCCUPANT'S BUILDING NAME 77✓ " ''�1+-., L eC +f' a3 OCCUPANCY / -J / N 37 a !Ss ir CWYNER#$ NAME [" f �., TE L. AND ADDRESS ,..�^ / CURRENT SUPPLIED �f. y' �--I FROM THEIR C-I'�/" /`. ,1 I/ -Jr OFFICE By BDEFECTS UILDING NEW L..f►'� OLD LJ IVN7R1{ NEW ❑ ADDITIONAL ❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED Ns. of Flatness B BRANCH OFFICE USE NUMBER Of OUTLETS Larne Reewelc o MOTORS HEATERS CIRCUITS Lrret ONLY A ' H.P. wet" No. Oaf INSPECTION Wall Typ Each EaelQedba It kab Pdm Bdret No Outr aMda beau dlaaa- ment let F1. 2trd FI. 3rd FI. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This rpfNicatiag is intended to corer the abmre-listed equipment to be irrspm tad but if at time Of inaPoulil n there fa found additiarrel aguiPmern not abate fisted, you are .wthowired to make the mapoction and adjust the fee to zoos` the additional 0"iv I nt, as prrwided by the applioam. S12E OF ELECTRIC SIGN TOTAL MAINS �'°' ` ' / FEEDERS Wrs" LAMPS WATTS CHARACTER r�"E7CPOSED GM TUBE SIGN OF WMORK CONCEALED TRANSFORMERS OF VA WORK TO BE (P/UMSERF - (CAPACITY) STARTED CONIPL£TED SIZE OF SIGN SERVICEPER OVERHEAD t^- UNDERGROUND MAKER EMTBUILDI /�' OF SICN INSPECTION REQUESTED ON OR AS NEAR AS NEW OLD POSSIBLE AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESSNAMOF DATE OF APPLICANT �� i�N'.S �.+���AF,',�Q 'A oeov ��R) -5 � � elf APPLICATION - STREET STREET ADDRESS `�' T d - rr ' "� TELEPHONE CITY OR w 41010 ." i 0 ,rj�,�A COOE11 „3, 41GEN APPLI POST OFFICE WHEN APPLICABLE 0.e EL iREV. 11047 A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING Y f To P` ,QUT.S/ G. .S/.4€'E'�.✓Grn.1f "� a Ico , fr'ous� ' 1 es uj w L j f 'o Lp E'aw.4.ev . 7 .rJZloe•~70 JE7 4p1`'F.4r A/ o 04e ' 417t q ��y�v v A. ,�./.ge.�l.✓cra.v CZ cr' I Q v Zq %Y iDvo 'u , e 4 , � „� � J K —_ w � ' '1 M � � V A jr I MAPSURVEY E MAP BY OF L^Nos O $ED 'Be CONY>EYED SY G L XA*ooprV'.4, V oe& T.441 . 4oeoelh/C710AI COULTER & M e C O R M A C K LICENSED LAND SURVEYORS 92 BAY STREET. GLENS FALLS. N.Y. 1ZWl Tel.: 518-792-SI45 T0WN : 0[IEEN' r4a&.P,e C0UNTY : LIIA. ",oV, N . Y. SCALE I10 * 300 TAX MAP SECTION //0 BLOCK 4 PARCEL /9 0ATE m / dlopuvAi�V ; l9BS