Loading...
1985-652 + ATE OF OCCUPANCY' CERTIFI TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK SLP [sate__ j c:1 v!4 5 19 3bixg � 3 -- 1q This is to certify that work requested to be done as shown by Permit No. , � - ? ham been cornpieted. via one,, , TAX i This structure may be occupied was a e-r a rr i 3 v T) • ] Z a r (- I.c►eatiot�l 2 CYL i1r►■ �Tc�t 1 � I-� e =ar. l' cres c2ut ,e' ivisirr - LTx er �T i � - herrrar ver.xa, C 0w,ner tn Y_a s e 1 By Order Town Board Trov 'N OF QUEENSBUItY i Building 6► zoning Inspector CREATIV[ - sMSTA PMOMrj"<f. GLENS FALLS, M Y e2p Sp » -ypp i CER TIFICATE OF OCCUPANCY TOWN OF QUEENSBURY . WARREN COUNTY. NEW YORK 14 � 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 I' ' '. Location U " J1t 7 .Icl : c-•C f: :S li' CL 1. W l. ; :L il; . . . .: U�ir_}', '[ 1. .. i' t .:'• •.L J� f i1 ' .1i:•''-Ti ':'•.i` ��j' By Order Town Board 7Y]WN OF QQUEENSBURY i Building & Zoning Inspector ' t KMATlyE �vMSTA POINTM4. GLENS FALLS M V d2"I f5+9IY93-maS9 �ulvn u� �etee+� 36itI'�f BUILDING and ZONING, DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 DATE 3 / 28 / 86 REGARDING : DWELLING LOCATED AT LOT 1 SHERMAN ACRES SUBDIVISION CONTRACTOR / OWNER - TIM CHASE BULIDING PERMIT # 85 - 652 THIS BUILDING HAS HAD LESS THAN THE REQUIRED NUMBER OF INSPECTIONS DURING CONSTRUCTION THE BUILDING DEPARTMENT SHALL ASSUME NO RESPONSIBILITY FOR CONSTRUCTION NOT INSPECTED . THE FINAL INSPECTION WAS MADE AND ALL VISIBLE PORTIONS APPEAR TO BE ACCEPTABLE , r ASST . BUILDINI INSPECTOR REGARDING THE ABOVE DWELLING : THERE IS A PATIO DOOR THAT DOES NOT HAVE SAFE EGRESS DUE TO THE FACT THAT THE ADJACENT DECK HAS NOT BEEN COMPLETED . THE HOMEOWNER ASSUMES ALL RESPONSIBILITY FOR ANY INJURIES OR DAMAGES ARISING FROM IT ' S USE , UNTIL CONSTRUCTION IS COMPLETED AND INSPECTED . 2 SIGNATURE , HOMEOWNER t DATEI cc , Homeowner Bldg . Dept . File Attachment to certificate caf occupancy ------------- BUIL DING PERMIT TOWN 4F +QUEENSBURY No. 8 5- Fi 52 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Tim C% OWNER of property located at F•3 Street, Road or Ave. in the Town of Queensbury, To Construct o Upper Sherman Avenue r place a 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 Queenshury Building and Zoning Ordinance. 1. OWNER'S Address is Po 0* Box fit Glens Falls , New York r2CO:NTRACTOR or BUI LOERs Name same ONTRACTOR ar BUILDER'S Address Same rb i✓ Cn 4. ARCHITECT'S Name [J7 :3;" PG r'S t iy1 ',S 5. ARCHITECT'S Address > � "..f Cn C [7. TYPE of Construction — (Please indicate by X) 0 { 24 Wood Frame t ) Masonry l ) Steel PLANS and Specifications f!9 W• 24 ' x301 per plot plan , specifications and ti N"' application submitted including two-car garage and. sewage s stem . $. Proposed Use One-Family Dwelling C O Faid o 80M 00 $ PERMIT FEE PAID — THIS PERMIT EXPIRES June 1 (If a longer period is required an application for to extension must be made to the Building and Zoning in � Lawn of Queensbury before the expiration date-) specter of the � F'• Dated at the Town of Queensbury this 13 th Day of November i9 ~ -- —8 5 �•C ,� ,qq SIGNED BYwL �c„ for the Town of Queensbury I�r 8uildirg and Zoning Inspector W, W• LQ TOWN 4F QVEEN$BUR i {Space inside block la be fined in b%- WARREN COUNTY. NEW YORK Building lnsprcttr►t1 Application for %loplicalion No. 1o[4YIIlII I %:.n[4l lq, . BUILDING AND ZONING PERMIT Pvj-111i4 Expirvs - i',, Oil IIMP Dititrirt f a PLOT PLAN, Drawn to scale aril +I , ,. ,•II !r� showry .q tits actual dimensions of the lot to be built k,•,11:111Kf' upon, Tha exact site. and location on the lot of the building to be erected or altered MUST BE SUB- . . . . . . . . . . MITTED WITH TdiS APPLICATION.' "! OWN (OFf�QLIEE�N] SBURY A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK i. `, 4 i65 ANSWER ALL OF THE FOLLOWING. 8d e" The undersigned hereby applies for a Permit to do the followin work /I M. � PIM g 71 1g11 11213111 § 16 which will be done in accordance with the description, plans and specifi. cations, and such special conditions as may be indicated on the permit. r f 0 The owner of J . sY# Zth. is: . . . . . _ . Z' 5 1a � /' r . . . . . . . . . . . . . . . . . . . . . . . .INA ma I o. sacwtasi . . . . The person responsibie: for supervision of the work insofar as the Building Code and the Zoning Ordinance apply i%: S ^ovo, %e, . . _ . . . iNA1iRE1 . . . _ . . - . (Po ADLFRE55) . . . . . . . . . . . - . . - . Name of Builder . . . . . . . . '�. '''�"!` . . Address . . . . . . . . . . . . . . - - . Name of Plumber . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . Name of Mason . . . . . . . . . . . Address . . . . . . Lot Number . . . . . . . . - . . Unit . . . . . . . . . . . . Estimated value of proposed work S 3g. Cz o0 Namo.of Village . . . . . .44teY•.s ►sr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . I . , . . . . . . . . . . Name of Street . . . . , . ! r Q. x 1?- . . . Jam, e c w.ra✓. !' 56- . . . Side of street: north M , as" C3 , mouth © . west ❑ Nearest Cross Street . , , . iC r►%J- u . . . i^ !! 1 C- . . . . . . . . . . . . . . . Distance frc,rn this cross street . . . . . � � -f . . . . . . . , . . . Ft. Property is north © , south ❑ , east K, west ❑ from Cross Street If on Corner, which corner, northeast t 1 , northwest ❑ . southeast U . southwest (Designate by marking with an "X" in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main BuNding © Addition to a building. One-family dwelling I� Alteration to a building. Two-family dwelling Q © Demolition of a building. -family apartment house Q Store building ❑ . �L . . . -car attached garage u h A � rt Other! . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I Accessory Building One-car detached garage © Other work. Describe: . . . . . . . . o . . . . . . . . . . . . . Two-car detached garage 0 Private chicken house Private storage building p . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building. or a change of occupancy. S Indicate on the plot plan street statues, the location and o size of the property, the location, site and setbacks of pro- posed buildings,posed buildings, and the locadott of all existing buildings. Show proposed building(s) in dotted line and existing tApPer Sktr..,^, IA.et, huilding(s) in solid line. a .era Size of property . . . . . .t.�' . . . . . ft. x . .� ce o . . . . . . ft. ! z Size and use of exist{ build{ it an existing buildings, y . . . . . . . . . . . . . . /W, W � Size of proposed building ft. $ Height Ifrom grade to ridge) Front yard YC . , it. , Side yards . . . . . . .P0 . . ,loft. and . . . . /. � f . .�J� . . ft. Rear yard . . . . . . . . . . . . . . . �. . ./ + Wl . . . . . . . . ft. saus14 If on tu ree corner, setback from side :ts ft. Note: All distances arc move..t, as measured from street side line to nearest pa rat of building. Iovs�a 7-73-1`1 (cont'd.) BUILDING SPECIFICATIONS.. . . .�. . Kind of construction. Wood frame, fire safe, etc.? . . . . . . . c' Will any second-hand lumber be used? If so, for what? . . . . . . . . . . . . . . . . . . . . . . . . . • , ;� . . . . . , Material of foundation walls . . � ''•�-1 AXI 3r, �. . . . . . . . . Thickness . . . f..� . . . . . . . . . . . . . Depth of foundation walls below grade . . . . . y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'Continuous foundation? W ill there be a cellar? . . . . . - . . - . If so, material of cellar floor �} . . . . . . . . . . . . . . . . . . . . Type of roof. Sloped or flat? - ter'.(•© (7I.::). Material of roof . _ . f33,t� • , 1 . . . . . . . . . . . . . . . . . . . Size, wood studs . . . . . . . . . . . . . . . . . . . " x . . . i spacing . , , ./. 0. . . . . . . ."COX., length . . . . . lS .•. . , , . ft. Size, floor beams, Ist floor . . . . ' . . . . . , . . ". spacing . . . . / . . . . . . ."o.c., spar[ Size, floor beams. 2nd floor . . . . . " x . . . . ", spacing . . . . . . . . . . . . . ."o.C., span . . . . Size, ceiling b p eams . _ . . . , , , . - . . . . . " x . . . . , Ce? . . . . . . . ". spacing . . . . �` �,. . . . . . . "o.c., San Site, roof rafters or beams_ . . . . .�. , . . . . " x . . . . . .�' . . . . . . . ", spacing . . . . . / � . . , . . . o,c., span �; . . . . . . With what material? . . L� ?'i. I . . . . . . . . . . . . . . . . . Exterior finish �. ; Finish of interior walls . , . SP. t" :`I; . C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If garage is to be attachsed, of what material is wa}l between ga. and main building to be constructed? . . .0 x]�'' . . . . . : lh) - . � �. . . . . . . . . ... . . . . . . . . . . . . . . . . . . ,i. . . . r� I s there to be an opening between ga�,gt�re, ar►ci building? . . . . . . .f" a .1 .(' . . . . w'.1: . . . L�C >. I ' . . }1J �/? f C? ZI �. Kind of heating system +G" .%, ; t L-. . . . . . . . . . . . . . . . 4i! burner or coal? . . .. . . , , . . , » , . . . . . Will a flue-lined chimney be provided? . . . . . . . . . . . . . . . Depth of chimney foundation below grade . . . . . . . . . . . . . . . . Height of chimney above roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . _ . _ _ . . . . . . Will there be a fireplace? . . Depth of fireplace hearth . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . Will a toilet be installed? . . . o, s, . . . . . . . . . . . . . . . . a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be install and connected to water su 1}l- . . +'� �� . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . , , Water supply (public water supply or pump) ut . .Y. . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . feet Will drainage system be provided with required traps, cleanouts, and vents? . . . . . . . c� �" ter. . . . . . . . . . . . . . . . . . . . . . . y f Town of Queensbury [ AFFIDAVIT County of Warren State of New York 1 swear that to Lr. ba+of my knowladW and belief the statements contained in this application, 100ether with the plane and spedficatiww suh• mitted, are a true and co."Aate statement of all prepoeed work to be done c eresibe[l ptevuars and flat all 0[ the BCFILD- ING CODE, THE ZONING ORDINANCE. and all other laws pertsinit� to wstrk oompthed wide, wLe�the�r specified or non, and that such work is autlwrised by the owner. Sworn to before me skis Signature .. . C . . . . . . . �. . . .�.. WNER. C1INNER' GENTRY. AR�L'k't. CONt'RACrOR day of. . . �1 :.C? s '_ 19 �'x. . � . . . . . . ... NOTARY PuaLlc, WAnIrrL" Cou"TY, N. Y. SPECIAL CONDITIONS OF THE PERMIT. By .. .. . . ... . .. . ... .... . . .. ... . . , 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 : 1 . Gross floor area (D -Z' C' 2 . Type of heat � et � ; L 3 . is the building mechanically cooled ? (Jra 4 . Percentage of area of windows and doors A . Over 16 % Only 14 Uo 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 floor ? 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. R-- 3 C+ 2 . R value of exterior walls P" } � 3 . R value of glazed area I+ 4 . R value of doors y 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab 8 . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement /cellar walls ( below grade ) 10 . Type of insulation �04fq ass c . Controls a 1 . Thermostat maximum heat setting � t> Do Duct Systems 1 . 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 2 . R value of pipe insulation F . Service Water " eating 1 . Performance efficiency 2 _ Temperature control setting maximum G . For Swimming Pool_ Only 1 . Maximum heating Telephone No . ` 3 Z3 � � ( applicant ' s signature ) TOWN OF QUFENSBURY BUILDING & ZONING 'DEPARTMENT SEWAGE DISPOSAL PERMIT APPLICATION 1 . Owner ' s Name_ , Address o "-N ev._S �A 5 r �j t rr Telephone No . 2 . Property location L6- ' S4. +Qsws,a Ac�af 3 . Name of person or firm responsible for installing system �C't V. Telephone No . kwQ -. Address 4e Number of bedrooms ( residential buildings only) 5 . Daily flow. 5 4 gallons/day 6 . Septic tank capacity gallons ? . Topography : la rolling , steep % of slope, pk 8 . Nature of soil and depth 90 if ground water , bedrock or impervious material is apparent at what depth does it begin? f t 0 10 . Percolation test : A is required B is not required C If required what is the rate minutes/ inch 11 . Water supply : municipal , well , other. 12 . Type of system proposed : drywell , the field , other 'tee R Any contractor ,. corporation , individual , etc . engaged in th4 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 fo in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance . Date — -� I� L signature o agplzcan On separate sheet of paper submit a dim 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 TOWN OF QUEENssURY Building Departmeiat . ors Raproe# ` Namrs Date f L.aceti°rs �_ .r 1� Pit llioti`x - c. — w eat6er Remarks Excat3a tion Footin Forms FondaFounda & Piers �-�T tsa�{,v6 �✓ t.i on CIIIeme1111111111111P .11.11,nt Coat Water roof.in +�aCacfi l l IP Final Survey F,ramin Shea thin Roof Pei t Roafin Si din Ma.sonr Veneer Rou h Pl Relief valves Wall Board Ext . Porches Finished Floor Interior !'rim Stairs & Railin Is Cellar Dr . Tile Concrete Floors F'1 Fixtures Gar . Fixe roofin Door Closers Chiarne Watex Meter Inst . Se tiC A royal Floors -insulation Foundation Walls Ceilin Rui1 ng Inspector REXARk's G +i TOWN OF QUEENSBURY Building Department LwApechwu R"N"t Date Name_ 'i f-Al C f-1 5& Location Pit No. -K 4� „tea Weather Exca jYa ti on Foot in Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Fraain Sheathing Roof Felt Roofin Si din Masonry Veneer Rough Pl Relief Valves Wall Board Ext . Porches Finished Floor Tntez1or Trim Stairs & Railings Cellar Dr . Tile Concrete Floors PI . Fixtures Gar . Fire roofin Door Closers chimney Water Meter Snst . Se tic Approval Floors Xnsulation Foundation n Wal I s ....---- JrJ !?I ! '•iEi *Z'1r� - Ceiling �-� 1A, Buil ing + nspector .REMARKS I S 0 r- Pzkr,44pI E1/ 6 5 F3 � F� rz� 1Pour� i .uCo a O k Si' 311 1*05 TOWN OF QUEENSBURY Building- Department Ins= Rat. Date Name _ 7f4 y_f.'L-^�t� Lgo L c:-pew t No. Sr C _ Weaatbesr Rema rJks ExCa�aisan Footing Forms Footing & Piers Foundation Cement Coat ` Water roofin BacJcfi.11 Final Survey r ` Frami.n " Sheathing ` Roof Fel t Roofin Siding Masonry Veneer Rough PI Relief valves Wall Board Ext . Porches Finished Floor .'interior Trim Stairs & Railings Cellar Dr . Tile Concrete Floors PI . Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Inst . Septic Approval Floors Insulation Foundation Walls I Cell-in h Building Inspector REMARKS R 4003361 THE NEW YORK BOARD OF FIRE UNDERWRITERS m BUREAU OF ELECTRICITY 41 STATE STREET. ALBANY. NEW YORK 12207 Da[e April 9 1986 Appliratlan ,Vo. on file 1 0 1 3 30-85 658311 � 3 . THIS CERTIFIES THAT only the electrical egsrip+nent as described below and intrachaced by the applicant named on the abase appacarian number ire the pr errE#wet of Tim. Chase . Sherman Avenue , Glens Falls , New York in Rhefallowins location; Basement L J lot Ft. ❑ 8nd Fl, Attic/outaide Section 121Biock * Lot 1 was examined on 3I2 6/f36 and found to be in compliance with the requirements of this Board. FIXTURE ft1?CTURES RANGES COOKI"ti IH3CIC5 IQYENS D15FI WASFIERS E]CHAUST MNS OUTLETS INCANDESCENT SWITCHES INCANDESCENT FIUOrESCEHT oWpW AMT, R. W. AMT. 16 46 16 15 1 2 F1t DRYERS FURNACE MOTORS IUTURE APPUANCE PEEOERS SPoCIAI !EC'PT TIME CLOCKS EEI t UINIT HRATptS MtIETI-0Ul LET IdMMERS AMT. K. W. Olt H. P- GAS H. P. AM a. AMT. AM►. AM7. AMMy. TRANS. A/y�T. H. P. tT AMT- WATT'b 1- Drye 3# 1 SERVICE OiSCQIVNECT HO. OF S E R V i C f AMP. AAV. tTFE i9tl e Rw r x sw a +r sw a x sW Nei. ERcA corNo. OF c cola. NG. of HI.LEG Gs HW. G. No- of HEurrA+s rrs r�ir�F'iiAi X 4 0 1 2 A s OTHER APPARATUS: Electric R g 3F-2."w 1-GFC1 s • • • • • . . . 2- 1 . 5kw I- Smoke Det . 22-1 . 0kw 1- o 05 kw Tim Chase , 7 1' BOX Erg Glensl Falls , New York 128(]I BRANCH MANAGER per This certificate must not be altered in any manner, return to the office of the Board if incorrect. Inspectors may be idartfified by rhiir cradenlialE. = COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOY'*VN OF QUEENSBURY Building- Depsrtmment '=-ram v � Wc�tl�ar Remarks Exca,�}a t s on Poot-inct Forms Footin & Piers Foundation Cement Coat Wa ter MOo fi n $aa,kfiit Final curve Framing Sheath ..n Roof' Fel t Roo.f.ingr Siding MaaI9RxY Veneer Rou h Pi Relief Valves Wall Board Ext0 Porches Finished Floor Fnterior Trim Stairs & Railin s Cellar Dr . Tile Concrete Floors Pl . Fixtures Gar . Fire roofin Door CIusers Chimne Water Meter lust . Se tic Approval Floors Tnsulation Foundation Walls Cei 1 i�»q BuIld�nspoT j REMARKS 1'x urovs I tisP�� r rv . ► 0A T^ vac C 4 1 cp X I r 1 f I t ! Sy 1 S 1� �-►c rtiz sln3 1�C,r-?�' � t " 2.L q TOWN OF QUEENSBURY Building Depsrtm.,t mamma Rat Daiba ��S FLAWation pen=it Na. 0 ,5 - ` S Wewtlaer Remarks Sxca�}a t2an ' Footin ForRIS pootIng & Piers Foundation i Cement Coat Water rroofin Btec�ir�.ill Final Survey Framin Sheaths Roof pal t Roof'in Sldin Masonry Veneer Rough Plbgw Relief Valves Wall Board i Ext . Parches Fin-ished Floor Z'nter f or Trim Stairs & Railings Cellar Dr . Tile ' Concrete Favors PI . Fixtures Gar . Fire roofin Door C.i osers ChI mne ' Water Meter 1'nst . Se tic .3pproval Floors • ^ Insulation Foundation Walls collina Build ng 1'nspector REMARKS TOWN OF CHJEENSBU RY B��za�� ,ue,�.rcmeAt Date N Peraoit No. ,Y ,�'� � ,S 2. Weaatla�ee • Remarks Sxca fra t� pn Footingr Forms Footing & Piers Founder tlon Cement Coat Water roofin aacxfill Final Survey Framin sheathin Roof Pei Roofi Sidin Masonry Veneer Rough PI bg, Relief Valves Wall Board Ext . Parches Finlshed Floor Interior Trim Stairs & Railings Cellar Dr . Tide Concrete Floors P,Zbgw Fixtures Gar . Fire raofin Door Closers chimney Water Meter Inst , .Se tiC Approval Floors Insulation Foundation ATalls -� ceil.ing 44 1 A4o%� 8uzldi y Inspector ,r^ REMARKS z12.m �-�V=2 `sue-UC-" C3Al/ (!-i`�-+D�.►C !?-[s-'i"'#�s 1..�s'd�' `I� Gc.�e t_c. f.3 /410 & 9(1 TOWN OF QUEENSBURY Building- Departwent Iar�aotwra Ra�ort Date 11_"0.� Name - L.oce ian Part Na. Ca 502 Wa.tl qw Remarks excaQa tx on FootInjForms pooting & Piers Foundation Cement Coat water roofin Back.eill Final Survey Framin Sheathi Roof Pei Roofin Siding Masonry Veneer Rough Pl Relief Valves Wall Board Ext . Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr . Tile Concrete Floors Plby . Fixtures Gar . Fireproofing Door Closers chimney Water Meter Tnst . Se tic Approval Floors Xnsulatlon Foundation Walls Ceiling �— Building Inspector REMARKS BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS, FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP. # DATE CITY OR !+ {' / VILLAGE } 1LOV, e TOWNSHIP STREET AND NO. OR r �1 Iti ROAD AND POLE NO. ���} �' ✓1'1 1�1 I�.j Q,� POLE NO. BETWEEN WHAT TWO CROSS STREETS FS r PREMISES LOCATED ' ~'' • ' "'S CJ L/�, L! /V SECTION BLOCK � LOT OC BUILDNG MEPANT'S ,.�,,,_ i t Q 1ti 'A s� �f OCCUP7ANCY Y f.r2 AND ADDRESS 0 it;} X. 7 Viet Il 'I l CURRENT BY IEO ,A �,tLac FROM THEIR _ /„S„ OFFICE BDEFECTS SUILDFNG NEW I�7e OLD ❑ 77FISORK NEW ADDITIONAL 0 REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS Lamp Receptacles tecepta�cless MOTORS HEATERS Vm CIRCUM OFFICE USE Lorca- I ONLY tlan Side Attach't H.P. Watts A.W.G. Coiling Side Roap'Ie Switch Pendant Bracket No. Type Each No. Each Na. Geuas INSPECTION Out- aide Sub- b"s Base- ment 1st FI. 2nd Pl. 3rd Fl. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: OO NOT USE THIS SPACE, ThiS application is intended to corer the above-listed equipment to be inspected but it at time of Inspection them is found additional equipment not above Itsted, you are authorized to make the Inspection and adjust the Ica to corer the additional equipment, as provided by the applicant. 512E OF 1 `+f ELECTRIC SIGN TOTAL MAINS { y_ FEEDERS LAMPS WATTS CHARACTER �^` EXPOSED OAS TUBE SIGN OF WORK C I C !R ' '� e„ /q ' d'-� CONCEALED TRANSFORMERS OF VA WORK TO BE ♦ /C, (��'� INUM BER) {CAPACITYI STARTED ,r 'r 4 COMP `flc` SIZE OF SIGN SERVICE OVERHEA UNDERGROUND MAKER ENTERS OF SIGN iLDIN INSPECTION REQUESTED ON OR AS NEAR AS // '� �f+ POSSIBLE {� I [ NEW © OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED, PRINT NAME AND ADDRESS NAMAPPL OF r � • wr' -A �� DATE OF I j +� ._._ ..._ ._.._ APPLICATION . �] STREET ADDRESS {'-* 4-+ ic. �^- TELEPHONE #' J CITY OR //'' f �t / �- ZIP POST OFFICE 't...% -"' + LA ` I '� !"•� t GOD LICENSE NO, E �`+ WHEN APPLICABLE 63 El. (REV. I/65) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING [ r13 Irks i i r f f G I