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1987-293 r { pv { +CER.TIFI+CA.TEE OF +CU�C+CI.JPA N rCY 1 TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK June 23 , 19Date �3b i This is to certify that work requested to be done as shown by Permit No. 8 7 - ' S 3 has been completed. I This may ay be occupied as a 0 e--Fam ' 1 Dweli. l:iu G�E: Dri �St . NO - 7 ) I,ocatian . Clerldon Eci.dge 5ubdiv3sioci Owner LILLIAN FARIS AND FRANK 1tiIC£lTEi2A By Order Town Board i TOWN OF +QUEENSBURY Building & Zoning inspector V BUILDING PERMIT L TOWN OF Q►UEENSBURY �.. No. 87-293 WARREN COUNTY, NEW YORK H. m PERMISSION is hereby granted to Lillian Paris and Frank Nicotera . m OWNER of property located at _ Lot 42 Marogold Drive ( St No 7) Street, Road or Ave. s� in the Town of Queensbury, To Construct or place a One—Family Dwelling. 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 Box 124 Mayflower Lane n Kattskill Bay , NY 12844 0 r* m �t w 2. CONTRACTOR or BUILDER 'S Name same [4. . CONTRACTOR or BLIILpER'S Address a rt same r-• ra m ARCHITECT'S Name o ri av PO o Oa S. ARCHITECT'S Address d Gr} W C C cr' m o. N• N cn 6- TYPE of Construction — (Please indicate 6y XI uo rt 0 . 0 { :4 Wood Frame I 1 Masonry ( ) Steel I I 6 7. PLANS and Specifications y 55 ' x36 ' per plot plan. , specifications and application No. including septic System and two-car attached garage . ' ra 8. Proposed Use rn One-Family Dwelling F-• °C $5 . 00 C/o $ 150 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Dec ' 1 19 87 F (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the OQ town of Queensbury before the expiration date_) Dated at the Town of Queensbury this 28th Day of Maur 79 87 SIGNED BY LGG�i' ,talf.,w for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . i� JkVrW `L 1} . e. ,�wY4�JL 7 / Application No . ILA V ULVn Oupen s urn Permit Issued 19 L BUILDING and ZONING DEPARTMENT permit Expires 19 t l � 7 Bay and Haviland Road, R. D. 1 Box 98 Zoning Designation ' mAy 8 r Queensbury, New York 12801 Variance No. Site Plan Review No . BUILDING & CODE DEFT. Appro 4 �edy : !44 /1/ „ 3 APPLICATION FOR ! F,UILDING AND ZONING PERMITJUL 4* 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 : e P 7i ri r P . O . Address l .2 ze} �i ram/ r^ Tel . 770 .�e�z Property Location : p / '��c ter 0 z� .C.. :>en- Tax Map Street number or building lot number r Subdivision name ( if applicable) f THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : G- / " ,:i i-e 4 Name: P . O . Address Tel . No . Name of builder I Address ,/l" ilrxX�e 3 Tel . e? 3' _f"s1"r5� plumber f ....... _......................._ Name of ,; _ ddres Tel . Name of mason .,d� y7 � Address Tel . .23 / NATURE OF PROPOSED WRK : * ZONING INFORMATION : construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building drawn reasonably to scale and attached hereto , _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 L�1 * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED . / * of septic disposal area . * COMPLETE INFORMATION REQUIRED BELOW . f/ * Size of property ,/'GEC./ ft X ft . Existing building ( s) Size .✓oW4ft X ft . * PROPOSED BUILDING AND USE : * Existing building ( s ) Use Al Size of new structure 50�ft X 3 (o f Foundation-pier/slab/crawl./part �'u�ll / * Proposed building, distance from property line (circle one ) * * Front yard Ay' CJ ft Rear yard r ft No . of stories (habitable space) * Side yards � p ft and J - ft Height ( grade to ridge ) S~ft If on corner , setback from side street t If residential , no . of families No . of rooms ( excluding baths ) d OCCUPANCY INFORMATION No . of bedrooms Ua' No . of bathrooms PRIMARY BUILDING - Primary heating system * _.,,k.On e family dwelling Type of fuel * Two family dwelling /F , _ No . of fireplaces to be installed Multiple dwelling / Number of units Permanent occupancy Will a wood stove be installed? Central Air conditioning? < Transient occupancy Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial Ranch Contemporary Log cabin * Other Raised ranch Mansion Duplex * If addition , what will use be .' split level Old style Bungalow Cape Cod Cottage Other ACCESSORY BUILDING- o ia Row Town House Detached garage/one car/ two r2Y car ( CIRCLE ONE PLEASE ) * y,KAttached garage/one icavl wo car/ car Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $ - - - Zl r"�+,}� © w J -f~ -� - - - - - - - - - - - INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . f,/C,rC.,C��,/�"`�/� �d� Will any second-hand or ungraded lumber be used? If so ,, for what ? �J Foundation wall material 7/ /r�o C V Thickness 5e ,�? a Depth of foundation below grade (to bottom of footing ) Will there be a cellar? FlHeated or unheated? (/,yam Floor sq . footage sq ft Will there be a basement? Will any portion be used as living space? ( If so , what portion? sq. ft . _ Type of use? Type of roof -- sloped/flat/shed/other r Material of roof Size , wood studs "X `" spacings"o . c . length dG' ft . Joists ( floor beams) lst . -floor Z_ "X "" spacings 7 "o . o . span_,/$ $Z4-ft . 'o? /1a40C /f e S�or• Joists ( floor beams) 2nd . floor �. "X 4' spacing / "o . c & span4��zzr fto Overlays (ceiling beams ) "X "' spacing / '"a . c . span Roof rafters -JW,41X - spacing �o . c . span ft . Roof trusses (pre-engineered) spacing o2 ` '"o . c . span .2 e ft . Exterior wail finish /�.iu «� Of what material? Interior wall finisb 1 ' If a garage i to be attached , "'describ materials to be used or FIRE SEPARATION . lre% . a ,y Is there to be an openi g between garage afid d ling? If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? Height above roof ,� ft . Depth of chimney foundation below grade ft . Depth of fireplace he th ft . in . Water supply r unicJ. or private well SEPTIC SYSTEM``----��f-I--stance from ANY private well ( including adjoining properties . f� ft . (A separate application is necessary for any repair or new installation of septi system) Town of A F F I D A V I T STATE OF NEW YOR.K eensbury Warren County off Warren 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, and that such work is authorized by the owner . SWORN TO BEFORE ME THIS Signature _F.' C_� Owner , o i s agent , arcnxr ect, contractor day of 19 Notary Public , Warren County, 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 2 . Type of heatL , 3 , Is the building mechanically cooled ? ,rL02 4 . Percentage of area of windows and doors Z2o `/' A . Over 16 % Only 1 . Uo value of gross area of walls , roof / ceiling a ;rd floors exposed to ambient con itions 2 , Floor over heated spaces %Inlated ? ES NO a . Are foundation walls YES NO 1 . I € YES , what is the R'' ;value ? l 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 S . Type of insulation B , Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions_ 2 . R value of exterior walls ,.�,2J"f .e6 � 3 . R value of glazed area r- 4 . R value of doors /1 5 . R value of floors over unheated spaces 4'I 6 , R value of slab edge insulation - unheated slab el a �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 C . Controls d � ^ 1 . Thermostat maximum heat setting ' } D , 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 pipe -S 2 . R value of pipe insulation F . Service Water Heating �, 1 . Performance efficiency FT /a 2 . Temperature control setting maximum G , For Swimming Pool Only 1 . Maximum heating Telephone No . d ( appl ' ant ' s signature ) 07 4p / - 3 r?z/ rrv�►t- a APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE � f tf LOCATION OF PROPERTY FOR INSTALLATION �r `e `, � GI rr' f s rc _4_- Owner's Name, � -/ few Telephone: : / � 75' C' Address: Installer's Name: S`• 2� r _ Telephone: Number of bedrooms (residential only) . 3 _ Total daily flow (compute @ 150 gal per bedroom) A, {�CJ Topography: circle one: Flat ' Rolling Steep Slope % of slope Sail Nature: circle one• San Loam Clay Other / Depth* J feet Ground Water: At what depth? feet Bedrock or Impervious 'Material: At what depth? ri zy feet min / Percolation test: circle one: not required required rate .r min. Inch. Domestic water supply- circle one: unicipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM : Septic Tank �� gal. (minimum size: 1 ,000 gal.) �--- SEEPAGE PIT(S) : Number of ._,_ / Size each feet by - �.1--- feet r Size of stone to be used # 2 I Depth or Thickness _ feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLED .*+Y1WYY�JI. (over) J i Section II 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, the fields and/or drywells Be 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. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal 0rclinance. Signature of responsible person : Date : Town of Queensbury Building and Code Department Bay at HaviIand Road Queensbury, New York 12801 (518) 792-5832 sE fTLED 1763 HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LINE awn 0/ QUQRrh BUILDING and ZONING DEPARTMENT Bay and Ha u Road. Fi 7. 1 Box 98 ensburyry, New York 12801 UI INSPECTOR ' S REPORT NAME.�L%� Cc '_._G' � r^ � LOCATION �G Date Permit N0 - �r APPROVED - 'YES NO Footing/Pier Forms Foundation Waterproofing Sackfill Framing .Roofing Siding Masonry Vene r Rough Plumbin Relief Valves k.xt . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbg . Fixtures Gar . Fireproof ng Door Closers :smoke Detect rs Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL_ Final Building Survey c ------ all when Remarks- 1 E3ui ldi g Inspec r 6/66 rnd-vl .JDUIIZ li� ��i QE�Ii3 �f4 M(� BUILDING and ZONING DEPARTMENT Bay and Nawiland Road, R.D. 1 Box 98 C}ueensbury, New York 12$01 SUiEKING INSPECTOR ' S REPORT NAME LOC,4T I ON yL h/z Date Permit No . ✓ APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Venee Rough Plumbin 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 — 2 "7 Wails Ceiling FINAL ELECTRIC L INSPECTION DRIVEWAY APPR Ai. Final Buildin Survey Next schedule inspection (call when ready} Remarks- c J Y" ." p 0E71..I V 710 (A-4el IL4 VbC okk o o ` , lT-1-1 r nr 1 /05 UtA-T-r 0AJ i kj Eau laing Inspec r 6/86 and-vl Low ' THE NEW YORK BOARD OF FIRE UNDERWRITERS �'� BUREAU OF ELECTRICITY I tlsd 41 STATE STRE ET, ALB ANY, NEW PORK 12207 Date August 11 s 1988 application No. on file 013017-87 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicome nametf on. the above apryplicstion number in the preymnisas of L Paris /F NicoteraE Lot 42 Marigold Drive , Queenabury , New York in the following location, ® Basement � lot Fl. ❑ an4 Fl. Out Section Bloch Lot was examined on 6/21 /P8 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING OECKS OVENS DISH WASHERS EXHAUST FANS y OUTLETS EPTA US SWITCMES INCANDESCENT FLLICOMSCENT AMT. K. W. AMT. K. W. AMT. K.W. T. K. W. AMT. H. P. £' 23 47 16 22 1 4 . 6 3 F DRYERS FURNACE !MOTORS PUTUN APMEANCR llRGR13 $1160At. MC'P1r TIAtaCLOCKS Sau UNIT HEATERS MMT14XHM DIP1MEES OIL H. P. 6A5 N. P. AMT. NG. A. W. G. AMT. AMR. AMT. HAWS. TRANS. AMT. PI. P. SYSTRMS AMT. WATT'S NO. CJF /1ET Range .5vo 1 Dryer SERVICE dISCONNECT NO. os S E R V I C E AMT. +CAMP. rrft y 1 .e' 2W 10 3M� S 0 9w 3 X 4W PE*aCOp CW WC-CGM NO.OF NI.LEG O HI-LEG NO. CK NEUTRALS OF W•TR L ] 2()o CB 1 X 1 4/0 L .. OTMER APPARATLISe 3 GFCI I; c c Room Beater : 3 2 . �J kw 4-- 1 .S kw 1- Smoke Detector Ny - 2 , 6 kw 4 4- 1 . d kw LTLLTAN G PARTS y P 0 BOX 124 MAYFLOWER LAZIE KA`PTSKILL BAY NY 12844 239 aiIAFICH ANAGER r Per ' This certificate must not be akered in any manner, return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST" NOT BE ALTERED IN ANY MANNER. ` Je�wn nI ueenj " ry 1 BUILDING and ZONING, DEPARTMENT � r Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT I ON DATE / 4 I'l PENT NO. SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM : Absorption field , total leng Length of 4pach trench Depth of t nches Size of gran 1: SEEPAGE PITS4 umbt,F of)/_ .. Size- 1% ft. _- f # IFI-. Gravel size PIPING : Size Type Bldg * to tank U Tank to list . bo + ! Ir"� Dist , box to fi d Openings Seale . ES NO Partial LOCATION/SEP TIONS : Foundation tank �? ft. Foundation o absorptio =ft . Absorption to lot line ^ft. ratio of pits f t. ON SYSTEM ON PROP TY (circle one ) Front - ear - Left side - ght side - \ C S c ] p�? t SYSTEM USE APPROVED YES Building Inspector 01/86 and vl Wi��IBUILDING and ZONING DEPARTMENT Say and Fiawiland Road, R.17. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME ��� LOCATION 1 1/ 2V'Ii,2''/ raG'Z Date fd � / 4 Permit No . 6 ~ � 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 Gar . Fireproofing Door Closers Smoke Detectors Chimney NINSULATION // ''��,,oundation Floors Walls Ceiling i FINAL ELECTRICAL. INSPECTIO _ DRIVEWAY APPROVAL Final Building Survey i Next scheduled inspection ( call when ready ) Remarks- . r 1uilding Inspector 6/86 and-vl BUILDING and .ZONING DEPARTMENT Bay and Haviland Road, R. O. 1 Box 98 Oueensbury. New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME ! T LOCATION DATE f PERMIT NO . � q SCIL TYPE - Sand - Loam _ Clay Percolation Test Required? YES NO Percolation rate - Min/Inch TYPE of SYS Absorption fie do total len th Length of each Tench Depth of trenche Size of gravel_ SEEPAGE PITS{Numbe of) Size- ft. X t. •• -r-° Gravel size PIPING : ize Type Bldg . to tank Tank to dirt . box Dist, box to field/ it Openings sealed? YES O Partial LOCATION/SEPARAT S : Foundation to t k ft. Foundation to a sorption ft . Absorption to I t line t, Separation of its f LOCATION OF SY TEM ON PROPERTY ( ircle one) Front - Rear Left side - Righ side - CCCIKMENTS : P ef f SYSTEM USE APPROVED YE NO Build n Inspector 01/86 and vl /�►.rr�! own of �ueerr ��ure� f BUILDING and ZONING DEPARTMENT ` V Bay and Haviland Road. R.D. i Box 98 Queensbury. New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION *y` DateSf Permit No . APPROVED - "YES No Footing/Pier Forms Foundation Waterproofing ggkfill aming Roofing siding >;Masonry Veneer ugh Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Flours plbgg Fixtures Gar . Fireproof-in Door Closers Smoke Detector Chimney 114SULATION Foundation Floors Walls Ceiling INSPECTION --- FINAL EL TRICAL DRIVEWAY APPROVkT,,_ Final B lding Survey Next scheduled inspection (call when ready Remarks- JD /Ayy �Nza S SAPS " �^ , c �//fir '�, �—✓ • . K-B► CL AtumT� Building I pector 6/86 and-vl ``� /own ofurtenshu+`+� l� ` SUILDING and ZONING CIEPARTMENT A /y� gay and Ha�iland Road, A.p_ 1 Box 98 e pueensbury. New York 12801 B 1 I SIG INSPECTOR ' S REPORT AT I ON `7r` DateJ� Permit i3o . f y * * * * * * * * * * * * NO APPROVED - YES Footing/Fier F rms I vFoun da t.ion 4r Waterproofing Backf111 Framing Roofing Siding Masonry Vene Rough Plumbin Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings_ ---�-- Cellar Drain Tile, .. Concrete Floors ors Fixtures Gar . Fireproofing Doer Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELE RICAL INSPECTIONr .� DRIVEWAY APPROVAL urney Final Building Next scheduled insp ection (call when ready Remarks- Building Inspector 6/SG and-vl flown O/ Q"'ge it "ry BUILDING and ZONING DEPARTMENT Say {]uee sbury, New York 12801 98 BUILDING INSPECTOR ' S REPORT NAME pie LOCATION 4/ c1n 111111 r1 Date / permit I3o . • "PROVED - YES No Footing/pier Forms aundat3on Waterproofing ackfill Framing Roof inq siding Masonry Veneer Rough Plumbs-ng Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbcg . Fixtures Oar . Fireproofing Door Closers Smoke Detectors Chiumey IN SUTLATION ; Foundation Floors Walls Ceiling FINNTI ELECTRICAL IN5PECTION�� DRIVEWAY APPROVSurvey ,,,.I Building Next scheduled inspection (call w13en ready Remarks- Builds Inspector 6/86 and-vl awn of BUILDING and ZONING DEPARTMENT l! Bay and Haviland Road, R.D. 1 Box 88 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME �-<1 � � l ct vt 1�C1 r i 5 LOCATION - y� a ✓' Date + ► / / permit NO : _ �( �I c� 93 APPROVED NO Footing/Pier Farms r a - - f- m Foundation waterproofing Backfill Framing Roof ing 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 wails Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APP'ROVA1. Final Building Survey Next scheduled inspection (call when rready Remarks- auilding Inspector 6/86 and-vl ©urn o� �ueert� b+uer • BUILDING and ZONING DEPARTM Y ENT Bay and Haviland Road, R- D. 1 Box 98 Queensbury. New York 12801 '? CI-3 — Ig ( 3z BUILDING INSPECTOR ' S REPORT NAME LCWA ION � oT ,i►1o+s ay 01 01Dr. Permit No , g`7- c") 93 Footing/Pier Forms S 4 APPROVED - YES NO 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 Floors plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling F-TNA- ' ELECTRICRL INSPECTION DRIVEWAY APPROV Final Building Survey Next scheduled inspection (call when ready Remarks- Building Inspector 6/86 and-vl BUILDING DEPT' COPY OF APPLICATION FORM 46-ELA NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT, WHEN REQUIRED. TEIMA A DA CITY y VILLAGE TIE STREET AND No OR TOWNSHIP ROAD AND POLE NO. COUNTY BETMIEEN WHAT TWO ' T00 CROSS STREETS IS FREMIS L TED? f OCCUPANTrS / ,y !POLE NO. NAME rdrov ' BUILDING BLOCK LOT AND ADDR OWNER'S NAME OCCUPANCY ESS ' ..�- OCC BiLDI ED EEL. #^ f✓ J ,�J��f �riv- IS FROM THEIRJO NEW Ode— OLD ElWORK �- OFFICE Is LIST BELOW ALL EQUIPMENT WHICH YOU DEFECTS VV INSTALLED REMOVES ADDITIONAL U REMOVED 0 Laces NUMBER OF OUTLETS Nm of Fixtures & don Lamp Recepesclss MOTORS CaBiny W� R� t Stvi HEATERS CIRCUIITTS OFFICE USE eospole tab Pendent Bracket Na TVPe H.P. W&M ONLY eDlaue* a Each N0. Each wa. A. INSPECTION Bub- allies- h»nt tst Fl, 2nd Fl. 3rd FF. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: ` DO NOT USE THIS SPACE. This aAPlica an is intanded to cover You authorized to make the ioYa-Meted e4�+jPrnM[ to be i OF the in+Peoti bon and adjust the Ire to cover t�nspectad eddixional but if MAINS e9uipmen as Prov dad by [ of to lsnd addloonal eyuipman! not Above listed, ePPlseant CHARACTER FEEDERS EL ECTR IC SIGN OF WORT( LAMPS TOTAL E%POSED GAS TUBE SIGN WATTS WORK TO BE CONCEALED TRANSFORMERS OF STARTED SERVICE COMPLETED iNUMBERI VA ENTERS OVERHEAD UIMOERQROUND SIZE OF SIGN (CAPACITY) 1 DIN MAKER R INSPECTION REQUESTED ON OF SIGN ON NEAR AS POSSISI BLELE AVOID DELAY D GIVING RILL AND ACCURATE INFORMATION, ALL SPACES MUST BE FI O IN OR OLD PRINT NAME AND ADDRESS APPL CANT E OF F APPLICATION MAY BE RETURNED. Ip -�,�,� DATE OF STREET ADDRESS r. 3r�' , i }/ APPLICATION_ '� J CITY OR TELEPHONE # G I (°e ,r J ��f' POST OFFICE + ZIP as EL (nEV, 7/BC) CODE,/,/�'dI ,S'� LICENSE NO. A SEPARATE A LfCATIf7IV MUST WHEN APPLICABLE BE Flf_ED FOR EACH SEPARATE SU0LDING cep - 1` Di S� 4.a&k- � /dGTG7Cn.od 7.o.s�,f 4 OF vvg _ 3 151 F L. r;- t DOESTATE OF NEW YORK DEPARTMENT OF HEALTH District Office 21 Bay Street Glens Falls, New York 12081 (518) 793-3893 David Axelrod, M.D. C'OJY missfooe.( OFFICE OF PUBLIC HEALTH Linda A Randolph, M D., M.P.H. Volucrar Br,air 5 Fear, RE L]is rfic:f Dirucicar June 12 , 1987 Mr . Roland Graves 40 Catherine Street Fort Ann, New York 12827 RE : Glendon Ridge Subdivision Queensbury (T) , Warren County Dear Mr . Graves : With regard to the subsurface disposal system for Lot 42 in the above noted subdivision , the substitution of seepage pit systems the fields appears acceptable . Very truly yours , Brian S . Fear , P .E . District Health Director BSF : ns cc : Town of Queensbury Building Department C