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1987-258 a 1 1 CERTIFICATE OF OCCUPANCY i TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK O Sri ilatc ""u" s �8 , 19 87 This is to certify that work requested to be done as shown by Permit No. 87—?_S.i3 "T i has been completed. ] Dry Own I This structure may be occ ied as a f7E xe-Fas:xi I y e 11 ixx g Location L t 45 liar ald ]]rive St . No.�.y �1 Owner Tracy d"' e gy s n SL i By Order Town Board TOWN OF QLJEENSBURY Building & Zoning Inspector 4 4 BUILDING PERMIT r TOWN OF QUEENSBURY No. 87-258 WARREN COUNTY, NEW YORK H H PERMISSION is hereby granted to Tracy and Peggy Nelson n 'E OWNER of property located at Lot 45 Marigold Drive { St . No . 1] Street, Road or Ave. W e—Family Dwe113nf; in the Town of Queensbury. To Construct or place a On _ _.. f4 at the above location in accordance to application together with plot plans and other information hereto filed and ua approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. to F2CO'N'TRACTOR WR"S Address is 9B Manor Drive Queensbury , New York 12801 0 or BU1 LDER'S Flame Stonebrook Builders n t-� f o Ko rr 3. CONTRACTOR or BUILDER'S Address G EtD # 2 Boas 348 o tin Queensbury , New York 12801 ad w r• rs p.. w 4. ARCHITECT'S Name r cn G. G C ly 5. ARCHITECT'S Address r}. m rn ,n 0 rt � rT 6. TYPE. of construction — (Please indicate by X) Z 0 (X) Wood Frame I ) Masonry 1 1 Steel 7. PLANS and Specifications 68 ' x28 ' per plot plan , specifications and application CD No. including sewage system and two-car attached garage . 1 w S. Proposed Use One-Family Dwelling E F' $ 5 . 00 C /O F $ 4 7q _ 00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 1 19 87 I'_6 (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 14th Day of _ May 19 87 SIGNED BY �^ry��,/-•2ao a` '0 for the Town of Queensbury Building and Zoning Inspector �',7' TO BE COMPLETED BY BLDG . DEPT . "TOWN OF (.iUEENSta+at_C' Application No . 7ouvn o/ 'Queen i "ry Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 MAY + 1987 Bay and Haviland Road, R. D. 1 'Box 98 zoning Designation Oueensbury, New York 12801 Variance No . __ BUILDING & CODE DEPT_ r� Site Plan Review No . ! /i �i� .4W d� l /�'� .7 93 3 7 Approved byyy: I �jo I '' d APPLICATION FOR FU I LD I NG AND ZONING PERMIT 1, k k '-- -- foe A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING . The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description , plans and specifications submitted , and such special conditions as may be indicated on the Permit . The owner of this property is : 121,� P. O. Address Fy2� Tel . Property Location :' &a.�-�.� �,./ ► l 00 Gl:"V elKlye - ei► Tax Map Street number f- building lot number Subdivision name (if applicable) ( /ea C7 / � e THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : VA-yrA1 Juhr f'r�r 1T I3avqx 3y� Name P . O. Address Tel . No . Name of builder S'slJleA3t�sul� [ jr/,al°c9ddress - p �/ / dr��/ Te7 . ,res � Name of plumber h Address Tel . Name of mason • Address Tel . NATURE OF PROPOSED WORK : ZONING INFORMATION : *,..Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTEDe _Addition to a building * drawn reasonably to scale and attached heretor Alteration to a building * showing clearly and distinctly all buildings . (no change to exterior dimensions ) * whether existing or proposed and indicate all Other work (describe) * set-back dimensions from property lines . Give * street and number or lot number and indicate * whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal. area . * * COMPLETE INFORMATION REQUIRED BELOW . * Size of property f Fa ft Xft . * Existing buildings ) size ? ft X f PROPOSED BUILDING AND USE : '" Existing buildings ) Use Size of new structure ft X...9,V ft Foundation-pier/slab/crawl/partial u l Proposed building , distance from property line (circle one ) Front yard ft Rear yard.... J ` ft No . of stories (habitable space ) �__� * Side yards Q ft and Syr '' ft Height ( grade to ridge ) _ If on corner , setback from side street ft If residential , no . of families ^ No . of rooms ( excluding baths ) �; * OCCUPANCY INFORMATION No . of bedrooms ,* PRIMARY BUILDING,No . of bathroomsjjtO ne family dwelli.ng Primary heating system2yec1aic CJALSP r{ /tJ * Two family dwelling Type of fuel 1r Multiple dwelling /' Number of units No . of fireplaces to be installed * Permanent occupancy Will a wood stove be installed? .&O Transient occupancy Central Air conditioning? Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Ranch Contemporary Log cabin * Other * If addition , what will use be? Raised ranch Mansion Duplex Split level Old style Bungalow " C e Cod Cottage Other " ACCESSORY BUILDING- Coloni Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * Attached garage/one car/ two Car/ ?r _Private storage building ESTIMATED MARKET VALUE OF —Other CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEETr TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . . Will any second-hand or ungraded lumber be used? If so , for what ? �s Foundation wall material _A& rE f�c� Thickness ,re Depth of foundation below grade (to bottom of footing ) Will there be a cellar?_gf,5.;.Ueated or unheated? 1. 0 is Floor sq. footage sq ft Will there be a basement? „ei�Will any portion be used as living space ? ( If so, what portion? sq . ft . - - Type of use? Type of roof - loped flat/shed/other �� Material of roof ,,f �ps Size , wood studs spacing _� o . c . length eft . joists ( Boor beams ) ist . Floor "X..Zif.� -" spacings "o . c . span /�y� -ft . Joists { floor beams} 2nd . floor x �"X rn " spacing s*'o . c0 span_1ie �� ft . Overlays ( ceiling beams ) _�ca "X spacing ,& "o . c . span. ,�_ft . Roof rafters _"X' " spacing-a . c . span_ 2 p _ ft . Roof trusses (pre-engineered) ,�s^�pac�ing "o . c . span ft . Exterior wall finish , 4 & .3r'Zwo A :k Of what material ? Interior wall finish e pt.-_ ae-'C4 If a garage is to be attached , describe materials to be used for FIRE SEPARATION : ' Is there to be an opening between garage and. dwelling? -y�1c If $o will a Fire-rated door , enclosure , and self-closing device be provided? S Will a flue-lined chimney be installed? _A/b Height above roof d ' ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft * in . water supply -1 or private well SEPTIC SYSTEM Distance from. ANY private well { including adjoining properties � e __ft . (A separate application is necessary for any repair or new installation of septic system) Town of f Warren p F C r n n V t T STATE OF NEW YORK County of warren f-i [ 1 1J 1"I V 1 I I swear that to the best of my knowledge and belief the statements contained in this application , together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertaining to the proposed work/shall be complied with , whether specified or not , an that such work is authorized by thr owner . SWORN TO B OR THIS Signatur - ---- -- _ ,' Owner , owner ' s a t , a - , contractor day cr£ 19 Notary Pubic , Warren County. N . Y . SPECIAL CONDITIONS OF THE PERMIT : ny TOWN OF QUEENSSURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YOR'K STATE ENERGY CONSERVATION CODE A permit trust be obtained before beginning work . ANSWER ALL of the following : 1 . Gross floor area 2 . Type of heat_ �G/' fc 3z2s 3 . Is the building mechanically cooled ?. A Percentage of area of windows and doors A . over 16 % Only 10 Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces YES NO NO a . Are foundation walls insulated ? E 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 ? 4a is basement heated ? YES N a . R value of insulation 5 . Type of insulation B . Under 16 % Only 1 . R value of roof and floorg exposed to ambient conditions. 0*M or 2 . R value of exterior walls ��� // 3 . R value of glazed area//_�,�r �.�= 4 . R value of doors �/+�F �' V"� 4CP ' 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 : -� '• " 'n i .� ,8e ,, 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 I . Is d�ycE system %xtStalled in unhe,�.:t�ed spaces ? Y No a ,. = f ygg , value of duct stallation b . R Val of duct in of er areas E . piping Insulation 1 . Size of hot water or cooling carrying agent pip e _ d _ 2 . R value of pipe insulation F . Service Water Heating cz 1 . Performance efficiency_ 2 . Temperature control setting maximum G . Far Max1maxv--heati " Telephone No . .�' r�� `/_ t:z ( applican a ure ) .k r, o/ QuFirrilisdrY APPLICATION FOR SEPTIC DISPOSAL PERMIT 9V1L01N Mond Z"+DNING DEPARTMENor *+c Hp • ilar►d 14d A G 1 E;• �A _ L, Y � :>8 r vure ' .:. �� y. itieev. vo* ^ 16;rl pAT'Er.,.L_ � - - . -x ■d�.3...,= � OG +C: l ] ; , � . CF F 0F' ERT7' FD* 1h5 '• FLLAT1Qta 49 � -4' ` sS � f:= n} a�v - s f d4p OWNER v S NAME f�t rc o G t /li'� L 1 � t1 ADDRE55 � :� /Y_I- j o � iv - � f} 1��3� � 91° , � h1. �-1� TEL INSTALLER ' S NAME S �� ►ti ,y � ��a�iTG T E L " L(2-C Number of bedrooms ( residential only) �a Total daily flow ( compute @ 150 Taal per bedroc►m) _ . _. CAL Topography Flat.: Rolling - Steep slope - ( circle one) % of slope Sail nature : and Loam Clay - Other 'Depth ft . Ground water -At what depth? ft. Bed -rock or impervious material - At what depth? ftm percolation, test - Not required - Required - -Rate 1PA ) d- ��� �,f.� � �, min-inch . Domestic water supply Munic.ip#�� Well - Other Separation - WaLtersupply ( i, f well ) from Septic absorption fte ProposeE S �:, stem : Septic tank Minimun size , 1000 gal . ) C_ F 1. ,'} 3 t.r: thickness x x x * r • . + x . . c x x u ' r x • x ♦ x x ! x x ! x x ♦ x x * f s ► x r ! Cori a separate paeCe cf paver , svbrr.it a diagram of the proposed system ► amh all e ? -rrmenrions shown ; anc3uding distance from any structure , distance fxcsn property lines and from ANY DOMESTIC WATER SUPPLY or shore - line of lake * strew` 4pond or wet-lar+as. ' Isaclu8e all dxmensicorss of r the system , itself . „ . . y, + • + . w . . . . x ,� . • x • r x x x t x . * w x ♦ x x • s x x g' 1: :: E G �. ..: C. }• Ce '.' ✓ G ,� f +'. t f` 4 C v. C' C i ? r o` i ?' r >: : ." (" r `1r t� C ''T Q v-n r f ra 'y F C *; £ t, L r4 4 ca E} cc n i GFc i Dr *: c ,: cc , .0 Z P r * r ( r 'f).. r^ r •- {; r p• ' ? 05 / 66 sr. d / v3 �,JpffJlt p� �ueen3be�r+� BUILDING and ZONING DEPARTMENT t^} I Bay and Haviland Road, R,O. 1 BOX 98 Queensbury, New 'Fork 12801 I' BUILDING INSPECTOR ' S 'REPORT NAME LOCATION .9zz , g r Date ? 1, / 127 Permit No . � / ` G3IIIpqpqpq� APPROVED YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing� Relief Valves Ext . Porches Finished Floors Interior Trim stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures C' r . Fireproof ` g Door Closers smoke Detect s Chimney INsuLATION Foundation Floors Walls Ceiling FINAL EL wr'J ICAL INSF'ECTIC1N� DRIVEWAY APPROVA► �� Final Building Survey Next scheduled inspection (call when ready ) Remarks- Building nspector 6/86 and-vl Down of 'Queenjl ury BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R.D. 1 Box 98 Queensbury. New York 12601 BUILDING INSPECTOR ' S REPORT NAME C A LOCATION Date / Permit �d - �.' APPROVED - 'YES NO Footing/pier For Ms Foundation waterproofing Backfill Framing Roof in Siding Masonry Veneer Rough plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Flours Plbg , Fixtures Gar . Fireproofing Door Closers Smoke 'Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROV Final Building Survey sp ection (call en read Next scheduled in Remarks- Building Inspector 6/86 and-vl � Jnwn n/ Queenjiury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D, 1 Box 98 Queensbury, New York 12801 SEPTIC €3 SP SAL SYSTEM INSPECTION NAMEI'� / LOCATION DATE <5/ PE IT NO . SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total length Length of each nch Depth of trenche Size of gravel_ SEEPAGE PITS4N r of) _ Size- ft. X ft. Gravel size PIPING : zK' Type Bldg . to tank Tank to dist . box Disto box to field t Openings sealed? S NO Partial LOCATION/SEPARATI S : Foundation to tG ft. . Foundation to a orpti , ft . Absorption to t line ft . Separation of its ft: LOCATION TEM ON PRO RTY (circle one) Front Rear Left side - ght side - CCMMENT SYSTEM USE APPROVED ES NO Building nspector 01/86 and vl awn o/ Queensbury BUILDING and ZONING DEPARTMENT Bay and Havifand Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAMEZy LOCATIO , Date/ PerMLt No . ✓ APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Baakfill Framing Roof ing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings 01 I Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors _ C�mney N NSUTAATION Foundation fGM� Floors `fills LoFeiling - FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready Remaricra-y�r"' qq /{ 1140V000e (//"Jf IJ AV (4/2 Bui g Inspector, 6/86 and-vl & CP _J'awn 01 Quee" i urey BUILDING and ZONING DEPARTMENT Bay and Maviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME I l �' , 0AC LOCATION e 01A Date f f Permit No - ✓ � APPROVED - YES No Footing/Pier Forms Foundation Waterproofing Backfill Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floor Interior Trim Stairs & Railin Cellar Drain Til Concrete Floors Plbg . Fixtures Gar . Fireproof ' g Door Closers Smoke Detec rs Chimney k'INSUI.ATI Foundat ' n Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready Remarks- & q ■ Building Inspector 6/86 and-vl awn OI Queensbury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.O. i Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME /�/" ,,,�,� �i r Date � Permit No . I 0f�f3— ✓ APPROVED - S NO Footing/Pier Forms Foundation Waterproofing Backfill �arningON Roofing Siding M sonry Veneer , LAough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL 'ELECTRICAL INSPECTION DRIVEWAY APPROV I. ' Final Building Survey Next scheduled inspection ( call when ready ) Remarks- ,rr,^I •�h- OK .s-r- 0 �53r on Building Inspector 6/86 and-vl r c'� _J©tun o/ Queens ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 i l SEPTIC DIS .O L SYSTEM INSPECTION NAME sd 1 LOCAT I ON`,/' d� �� ,ri"'! Vlf or DATE rf dl_ PERMIT NO , 0 �`✓c�f�j� SOIL TYPE - Sand - Loam - clay Percolation Test Required? Y - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorpti field , total ngt�hd Length of ach trench f' Depth of enches Size of gxa el SEEPAGE PIT umber ) Size- ft. t. Gravel size ' PIPING : S ' Bldg . to tank Tank to dirt . bo Dist. box to fi d/ Openings sealed NO Partial LOCATION/SEPA TIONSr Foundation to ank ft. Foundation to absorption t . Absorption t lot line ft. Separatio pits t. LOCATI YSTEM CAI PROPERTY (circle one) Front - ear - Left side - Right side - CC*IMENT Ole SYSTEM USE APPROVED YES Build n pector 01/86 and vl � � 1 �.+'auvn o� �ieeQn shurt� BUILDING and ZONING DEPARTMENT f n Bay and Haviland Road, R.D] 1 Sox 98 U Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing B, ckfill rarru ng Roofing ' Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim stairs & Railings Cellar Drain Tile Concrete Floors Plbg _ Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICA INSPECTION DRIVEWAY APPROV Final Building, Survey Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl _./ wn o/ Queenjg "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R, D_ 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT r NAME - p e :j "I Y LOCATION L a7 Ll�� cl,ri 11014 1); , Date a� f_ I' Permit No . !�k�7 ~c2js ov ✓ - APPROVED - YES NO Footing/Pier Forms X Foundation )(waterproof ing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches JO Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile AIX Concrete Floors Plbg . Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled Inspection (call when ready ) Remarks- Building ' Inspector 6/86 and-vl g1e, f BUILDING and ZONING DEPARTMENT I' Bay and Haviland Road, R.D. 1 Box 98 aueensbury. New York 12$01 s BUILDING INSPECTOR ' S REPORT offe LOCATION � IC4 z elz Dat e �'� Permit No . —E—`" 47 APPROVED - YES NO Footing/Pier Farms foundation waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile _. Concrete Floors Plbg _ Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready ) Remarks- 00 / 0 nuildin Inspector 6/86 and-vl BUILDING DEPT, COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT, WHEN REQUIRED. I* P. i DATE E TOWNSHIP COUNTY ,•.• i/'iG STREET AND NO. OR ...'yxs . .,Tr _ r ROAD AND PME NO. : / ,.%/' POLE NO. BETWEEN WHAT TWO CROSS STREETS IS / PREMISES LOCATE07 f/ { ' r r { ~7 tii-' :'yr! ft to f SECTION I - Af BLOCK / LOT ! OCCUPANT'S BUILDING NAMES-Y fi e OCCUPANCY OWNER IS NAME ANO ADDRESS _ i ,f�/ y r . >, f 1..� (f TEL, # ! '� J ✓�/ 1r SUPPLIED BY f !/f FROM THEIR e#" ez- OFFICE 131UILpING NEW OLD O is SIORK NEW ADDITIpNAL RDEFECTS EMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOIJ INSTALLED NUMBER OF OUTLETS No. of Ffxtatee A BRANCH Laue- ,. LSOW Reeepteelea MOTORS HEATERS CIRCUITS OFFICE USE tins ONLY Collins WWeall Riye�k Switch l+lEnderst Brrdtn Na tYW EiWE No- Wam Nr+- G yr' INSPECTION eOut hs Base• nEta•e let FL J 2nd Fl. 8rd Fl. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE, This application is intended to carer the ebovslieted equipment to M inspect ad but if at time of inspection there is fotl rod additional equ ipanent not whore listed, You are autl+orlzed to make the inspection and adjust the fee to corer the additional equipment, as Provided b the Y •PWicant. 512E OF ELECTRIC SIGN TOTAL MAINS FEEDERS I LAMPS WATTS CHARACTER _ EXPOSED GAS TUBE SIGN OF WORK - �'� CONCEALED TRANSFORMERS OF VA WORK TO BE (NUMBERI {CAPACITY) STARTED COMPLETED SIZE. OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS ILOI I OF SIGN INSPECTION REQUESTED . OR NEAR AS PO NEW OLD POSSIBLELE AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. l / r G PRINT NAME AND ADDRE S APPLICATION NAME OF =I * ' V SIGNATURE APPLECANT -^'`r i 1 * ri .... III , .e-= OF APPLICAN -. / STREET ADDRESS • r � "� 4 I . �r � 'tl��r r -TELEPHONE CITY OR �" f i �.1..f { CODE .` f WHEN APLICENSE P L ICASLE, POST OFFICE (,r! - f ," 46 EL (REV, 1/86) A 'SEPARATE APPLICATION MUST BE FILE❑y#OR EACHSEP RA•TE. �}� a GEORGE KUROSAKA JR.* P.E. FDG AUG S7 jo" No BUILDING SYSTEMS CONSULTANT POST OFFICE BOX NO. 660 GLENS FALLS, NEW YORK 12801 CERTIFICATION OF PANELS I OWNER TO BUILDING INSPECTOR - TOWN OF QUEENSUURY RAE +Rw Ifr^.' ff .! � e A TTN • Wm EjPI I T TO N n L U �iZ ]f PM PN'LESEMI AT S u l J�Y]].(y�y'yy14/Jy BUILDING & THE FOLLOWING WAS NOTED : I HAVE STUDIED ALL THE TECHNICAL INFORMATION FROM KOR'WALL INOUSTRIES-, INC — I N ME * THE 1 fR KORIIALL COMPOS I TE SANDWICH PANEL \� COP I ES aF THE f A Ei Q $ r,B C' l � THE FIRST BEINQ A JOINT NER ( NATIONAL EVALUATION REORT �BY I .C . B . F G F1C_C l R. 1 f] r A THE THREE NATIONAL CODES BUREAUS AND CAN CE Rt I FY THAT WHEN I NS.TAt I EU PF R 1&V _aRn. RFrn �E,CL_ METHODS !x PRACTICE+ 61­ T IS AN APPROVED ALTERNATE WALL !CONSTRUCTION SYSTEM AND APPROVABLE UNDER THE NVS—UFP. BC ON THIS BASIS NORMALLY: THE DOUBLE 2i1x6 " TOP PLATE ALONE WILL- BE ACCEPTABLE_. FQ„R. _S1SE .__&SHFADER_ . FO .R _ _ .._.. _ OPENINGS UP TO 41 IN WIDTH ON BEARINQ WALL & OF CLEAR SPAN ROOF TIRUSSTYPE__ I*.U .ILOIP94_ OP TO 301 IN WIDTH . WIDER BUILDING fx WIDER OPENINGS WILL NEED HEAOERJNQ OVER____., ,_ .._ , _ __ _ ,_ THE WIDTH TOF THE OPENING TO SPREAD THE LOAD OVER THE WINDOW BUCKS TO Slt,.l_ — HEADERS SHALL BE DESIGNED FOR EACH CASE ON=AN AS NEED BASIS_ THE AIR CONTROLII PANEL BEING A STRESSED— SKIM PANEL PROPERLY DESIGNED , MANUFACTU.R.ECI . AND fNSTALLED DOES NOT REQUIRE INTERMCDIATE STUDS AS—DOES. A _ STANDARD WOOD—FRAMED WALL SYSTEM . I HEREWITH CERTIFY THAT THE 11R—CONTROLII PANEL IS AN EQUI VAt EIV T �_ __r.� ALTERNATIVE CONSTRUCTION METHOD TO STANDARD 2117C6II AT 2411 WOOD —FRAME CONSTRmjQ-rION � AND MEET 'S &/ OR EXCEEDS THE NYS—UFPC&8C REQUIREMENTS FOR _ EQUI VALENCY OR 4;ISF__;�T_,_.� E N D Q F R E P O R T C)p Y COPIES Te? ��}`i' GIiiLF OF EP:3ir;EZR1NG � t . + r Md loo 4N IZAO 406 4A rVr 40 1 f aO 1