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1987-312 Id
i
MEN
CERTIFICATE OF OCCUPANCY
TOWN OF +QUEENSBURY
WARREN COUNTY. NEW YC]R -
October 29 19 87
Datel
This is to certify that work requested to be done as shown by Permit No. $ ]- 312
has been completed* [ -� �
This structure may be 'ed a. Addition is of f ice bui] dixtg
l cscarion uuaa ce r� r Club Roads
Cool Insurin Ag n (Ant cony NLushuta and iVeifeld)
I
By Order Town Board
TOWN aF QUEEmsukY
i
Building N Zoning Inspector
I
i
}
T E M P U R A R Y
CERTIFICATE OF C►CCUIPANC�'
i
TOWN OF QUEENSBURY
' WARREN COUNTY, NEW YORK
Date Sept . 43 19 `
T1�is is to certify that work requested to be done as shown by Permit No. 87- 312
ices been completed.
" i• structure may be occupied as`a Addition to Office Buflding
I
Quaker and Country Club Roads
Location
Cool Insuring Agency (Axithuny Mashuta & Ira Neifeld )
Clwcrcr
By Corder Town Sward
7OW"NF OF QUEENSBURY
i
8uildi !4' Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No 87-312
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Coal Insuring Agency (Anthony Mashuta and Ira Nelfeld) o
rp
OWNER of property located at Quaker and Country Club RoadsStreet, Road or Ave. 0
Addition to office building �
in the Town of Oueensbury, To Construct or place a , rI
at the above location in accordance to application together with plot plans and other information hereto filed and W F
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance_ ci °Q
» a
va
1 . OVNVER•SAddrassis Box 2074 Quaker Road 0 z
Queensbury , New York 12801 � c
0t
m
2. CONTRACTOR or BUILDERS Name rp
Barsons Construction Y
rn
m
r-A
3_ CONTRACTOR or BUILDER''S Addren
1241 Kings Road
Schenectady , NY
4. ARCHITECTS Name p
w
M
ro
rs
S. ARCHITECT'S Address
l�
h
0
G
D
6. TYPE of Construction — IPleese indicate by X) K
C
i XI Wood Frame I i Wtasonry I I Steel i I
G
c7"
7. PLANS and Specifications ;d
7320 sq . ft . addition per plot plan , specifications and application
No.
8. Proposed Use
Insurance Agency (additional office space )
Cu
5 . 00 C/O
$ 900 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Jan . 1 tg 88 rrr
0
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the P3
town of Ouaansbury before the expiration date„} rr
CJ
Dated at the Town of Oueensbury this 3rd Day of June 1987 0�-
rr,
SIGNED BY for the Town of Oueensbury m
Building and Zoning Inspect c'
i_j
Fv
Cf4
TO BE COMPLETED BY BLDG . DEPT .
tt�� / Application No . ICJIN►� 0E-
_lorun o/ Queen .shurey � iUEc�lI.Gati.
Permit Issued 19 E � t.. -..
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R U. 1 Box 98 Zoning Designatio Are
Oueensbury, New York 12801 Variance No . i MAY f pp
Site Plan Review No . M ZAi BU�LL3ING & 1987
Approved by ." ! 'CoDk� oE:P-i
APPLICATION FOR
{
BUILDING AND ZONING PERMIT
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 : Anthony Ma-ahuta and Ira Neifeld
P . O. Address Box 2074 , Ouaker Rd Tel . 793-5135
Property Location : Glens Falls NY 12.801 Tax Map No .
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Langer Dion Morse Architects , Rpl Tetclx _Park . `fm4', r.Rr 2R3-90nn
Name P . O. Address Tel . No .
Name of builder Barsons Cr_)nstr Cti.orAddress 1241 -Ki-ncfs Rd. ... Sch ` d . Tel- . 370-2761
Name of plumber Rug' 5; P1 jX4 ILt_g Address 22 Vics Ct Albv, NY, 122,05 'el . R69-8045 -
Name of mason Kpn Baldw; rn Address Haddock Pond Rd . , Fort Anil T'el • 792-8860
NATURE OF PROPOSED WORK : ,, ZONING INFORMATION :
_Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
X 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 e_r 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. 256 ft X 689 ft -
'� Existing buildings ) Size 120 ft X 55 ft -
PROPOSED BUILDING AND USE :
Existing building ( s ) Use. `7ffIce
Size of new structure _ 120 ft X_ ft
Foundation-pier slab/crawl/partial/full " Proposed building , distance from property line
circle one ) "
No . of stories (habitable space) 1 Front yard nc) h rig _ ft Rear yard 4R0 ft
ft . Side yards 70 ft and 60 ft
Height ( grade to ridge ) 28 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 bathr[aoms 2
One family dwelling
Primary heating system split systems Two family dwelling
Type of fuel�eleoi Multiple dwelling / Number of units
No . of fireplaces to be installed --
Will a wood stove be installed? no X Permanent occupancy
Central Air conditioning? yes * Transient occupancy
Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporary Log cabin * Other Raised ranch Mansion Duplex If addition , what will use be7. nusiness,, same
Split level Old style Bungalow a is ing
_Cane-__Cod Cottage Other ACCESSORY BUILDING-
Colonial Row Town House Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) Atta .�hed garage/one car/ two car/.car
* * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF Other
i ONF, TRUCTION
IRIFCRN7 SIDN ON pi.11LDINC. SFECIFICATIONSf ON REVER57E SIliE OF THIS SHEET , TO BE CCMPLETED !
BUILDING PERMIT APPLICF.TION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc . wr- A frame
Will any second-hand or ungraded lumber be used? If so , for what ? no
Foundation wall material hickness 10e1
Depth of foundation below grade ( to bottom of footing ) 5'
Will there he a cellar ? p© Heated or unheated ? N/A Floor sq . footage 7320 sq ft
Will there be a basement? ran Will any portion be used as living spr -e? N/A
( If so , what portion? sq . ft . - - Type of use?
Type of roof - sloped/flat/shed/other 51ot5ed Material of roof asphalt shingles
size , wood studs "X (_ " spacing 16 " o . c . length 11 ft .
.Ioi_sts ( floor beams ) lst . floor _ '" X " spacing " c . c . span ft .
Joists ( floor beams ) 2nd . floor '" X - " spacing "o , c . span ft .
overlays ( ceiling beams ) __ "X -- I spacing " o . c . span ft .
Roof rafters -_ "'X " spacing o . c . span ft .
Roof trusses (pre- engineered) spacing 24 " o . c . spar 40 ft .
Exterior wall finish mason ry Of what material ? brick
Interior wall finish painted sheutrock
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? N A If so will a Fire-rated
door , enclosure , and self- closing device be provided?
Will a flue- lined chimney be installed? N/A Height above roof ft .
Depth of chimney foundation below grade ft .
Depth of fireplace hearth - ft . in .
Water supply - Municipal or private well Municipal
SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft .
(A separate application is necessary for
TT��any repair or new installation of septic system)
Town of f Warren A F F I D A v I T STATE OF NEW YORK
County of Warren
I swear that to the hest of my knowledge and belief the statements contained
in this application , together with the plans and specif ' ::ations 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 �-�_�.r��� � -------- ---
Owner , owner ' s agent , arenirec onrctoar ^
day of 19
Notary Public , Warren County , N . Y .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * r
SPECIAL CONDITIONS OF THE PERMIT :
By
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application fore 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 7320
2 , Type of heat
3 . Is the building mechanically cooled ? es
4 . Percentage of area of windows and doors 10°
A . over 16 % Only
1 . 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 ?
3a 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 i6 % Only
10 R value of roof and floors exposed to ambient conditions,
41
2 . R value of exterior walls 21
3 . R value Of glazed area
-----
4 . R value of doors 6
5 . R value of floors over unheated spaces N/A
6 . R value of slab edge insulation - unheated slab 9
7 . R value of slab insulation - heated slab N/A
80 R value of heated basement/ cellar walls ( above grade ) N/A --
9 . R value of heated basement/cellar walls ( below grade ) N/A
100 Type of insulation rigid at foundation }aat
C . Controls
14 Thermostat maximum heat setting 82 °
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 2
E . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe_
2 . R value Of pipe insulation 2
ro Service Water Heating
1 . Performance efficiency 90
2 . Temperature control setting maximum
G . po+ swimming Pool Only
1 , Maximum heating N/A.
Telephone No . 370-2761 -
glicant ' s signatur
own of Queen3it " ry
BIJILD,T3G and 2owt4G ❑EpA'Rj-MENI
Bay and 4iavyland goad. R.0- I Box 98
Queensbury. New York 12801
BkJI L-DING INSPECTOR ' S FtEP(7RT
NArAE
Lo c A.T ION
permit
Date 140
c APPROVED - YES
Footing/'Fier Forms
Foundation
Waterproofing
Sac)cf i l l
Framing
Roof ing
Masonry Veneer__,___
Rough Plumbing
_ --
gelief
Valves
Ext . Porches
she CA Floors
)C3nterior 'Trim
ytStairs & Railings
Cellar Drain Tile
concrete bg _ tu Floors
Fixre s
Gar . Fireproofing
poor Closers
rnolke Detectors
Chimney
INSULATION -
Foundation
Floors
Walls
ceiling CAL INSPECTION
FINAL ELECT
Px OVAL
17RIVEWBui d ng Survey- �� ---��` � -
Final
.sled inspection
call when ready )
sched
ems- 2.
Ytema r
.- � ..
16 ?
f 9�ilding Ins ector
5/g�' and-vl
J09vn of Queendburey
(��!/l BUILDING and ZONING DEPARTMENT
!j Bay and liaailand Road, R.D. i Box 98
�I Queensbury, Now York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
/ �
Date �f Permzt Na .
APPROVED -*YES* *NO w
Footing/Pier Forms��
Foundation
waterproofing
ll
B 4 raramie
mir►g
Roofing
Siding
Masonry Veneer
Rough plumbing
Relief valves
Ext , porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
pl7bg . Fixtures
Gar . Fireproofs.
Door Closers
Smoke Detector
Chimney
I33SC1LATION
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSkrz% I' N�
DRIVEWAY APPROVAL
Final Building, Survey
Nextcheded inspection (call when ready )
Building inspector
6/86 and-Vl
THE NEW YORK BOARD 4F FIRE UNDERWRITERS
4003259 BUREAU OF ELECTRICITY �
j f 41 STATE STREET, ALBANY. NEW YORK 12207
Date September 23 . 1987 Application No- on file 014698-87
b954THIS CERTIFIES THAT a
a+sly the efaw:trical equiprneMt ear described be1aw and fntradsrced by the applicars nsrrasd era the oboes egPplicstiaes number in the pre— --- of
Cool Insuring Agency s Quaker Rd . , Queens bury s NY
in thefollowinglocation; ❑ Basement ® !at Fi. ❑ $nd Ft. sttIc outelde Section 618lock 1 Lot 1 . 1
eras examined on 9/ 11 /87 and,jound to be in eotnptionce with the requirements of this Board.
FIXTURE FIXTURES
MANGOS COOKING *"xS OVENS DISH WASHERS EXHAUST FANS
oI/TtS Errwcul5 SYMITCttES INCANDESCtNt FLUOtESCtNT
A AMT. K- W. AMT. X. W. AMT- K,w, AMT- X. W. AMT, H. P,
97 ?$ 31 18 79 3 iEr
DRYERS FURNACE MOTOR5 FIITIlER A!'ltfwNCE FEEDERS SrEp/yt REC'►T TIME CLOCKS EIEiI UWT HEATER; MULTI.OUTLET p1M,MEES
AMT. X. W- OIL K P. GAS X. P- AMT. MO. A. W. G. AM7. AMP- AMT. AMPS. TRANS. AMT. M. P. 57STRM5 AMT. WATTS
NO. OF Mal
SE WICS DISCOPMECT M. � S E R Y I C E
AMT- AMP. Tr" R I M ZW I 1 A 3W 130 3W 3.iE 4W NO. 0 CDC. CONO. OF CC C41VD. NO. OF HIALEG A- W: GG NO. OF NEUTRALS OF- WIMNEUTRAL
1 S00 eb 1 2 500 2 500
OTHER A"ARATUSt
panels 4 40 200
3 20 100
2—Zfci
x ,-��-,•, � Construction Coo '� "•"�R''
1241 Xln ;s Rd *
Scbenectedys NY 12303 BRANCH MANAGER _
I,,
Per— X
This certificate must not be altered in arty mannerm return to the officer of the Board if incorrect. Inspectors may be identified by their credemfals.
COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. �
down o� �ueer� s �ure�
BUILDING and ZONING DEPARTMENT
Bay and Haviiand Road, R.Q. 1 Box 98
Queensbury. New York 12$01
BUILDING INS" PECT©R ' S REPORT
NAME
LOCATION ;
Date
`��~ T Permit NQ . /
//* * APPRQVETJ* -AYES* NO
Footing/Pies Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext* porches
Finished Floors
interior 'Prim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Gh�, imney
✓INSULATION
Foundation
Floors
L44a11s
�i 1 ing
FINAL ELECTRICAL INSPEC' ION
DRIVEWAY AF"PRO'VAL�.
Final Building Survey
Next scheduled inspection (call when ready)
RemarkB-
Building inspector
6/86 and-vl
.. tvn o/ QueenJi"rry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME L
LOCATION
Date- / / (y(�- / Permit No . ,
✓ = APPROVED -- YES N4
Footing/Piet Forms
Foundation
Waterproofing
Sack£ill
.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-
town % a-NekA01c0
Bui ding Ins c r
6/86 and-vl
P 010
1
70tv0l O/ QL4Fen36Lery
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date _9s77 Perrn * t No .
✓ = 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 Til
J.o�oncrete Floors At. f7if
Pibg . 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
_Jow►� o� �uQen3burr�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date
=s��� �� � � Permit No . �/��` L
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 _
C llar Drain 'file
Lo oncrete Floors l�s
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
walls
Ceiling
FINAL ELECTRICAL INSPECTION
I)RIVFWAY APPROVAL
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks-
3
Building Inspector
6/86 and-vl
_70W" ©/ Queens6ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D_ I Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME +
LOCATION �,-
Date E'__ Permit Nov
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
.Rough Plumbing 1 ,q ca
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-
Building Inspector
6/86 and-vl
� 70W" O j Queei igur y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box g8
Oueensbury, New Y ork 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION 71,
Date / �7 Permit NO . A;2; _
✓ = APPROVED - YES NO
ting/Pier Forms
toundationerproofing
kfill
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-
Building inspector
6/86 and-vl
_5+ 131$7 ;Jowrr o ueerrshure�
SUILDIN6 and ZONING DEPARTMENT
Bay and Haviland Road, R-D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION U /,� � C� �+ ►/4d?�2�' L"Lf1�' �D
Date;7� � _ Permit No .
APPROVED - Y NO
Doting/Pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing_
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
1"1bg . Fixtures
Gar , Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready
Remarks-
f
Ffuilding Inspector
6/86 and-vl
_ `_Jaavn n� �ueen .f � ur�l
{ BLIILQINt; and ZONING DEPARTMENT
Bray and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME " r ox ✓ref ,YItw��
Ct�U�ll
LOCATION
Date. - Permit No .
✓ = APPeROVED - YES NO
A"oting/Pier Forms
Foundation
Waterproofing
Sackfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
IIRIVEWAY APPROVAL
Final Building, Survey
Nex duled inspection (call when ready )
Remark,;-
Building Inspector
6/66 and-vl
BUILDING DEPT, COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT& WHEN REQUIRED,
CITY CPR TEMP s DATE
VILLAGE _l
STREET AND NO. OR TOWNSHIP COUNTY
ROAD AND POLE NO
BETWEEN WHAT TWO POLE NO.
PREDM1 ETRL ET$ is
OCCLIPANT'S �* CTION BLOCK LOT
NAME �-��R.iI>f. BUILDING
OwNER'S NAME OCCUPANCY
AND ADDRESS cool
TEL. #
BYPPLIED
BUILDFNG FROM THEIR lift
is OFF#CE
NEW OLD Q Y1iORK DEFECT$
IS NEiN � ADOI TIONAL
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED REMOVED []
NUMBER OF OUTLETS No* of Flaxturs &
LanIP Reeaptedse MOTORS HEATERS BRANCH
bw CIRCUITS OFFICE USE
Camino Side Attsoh't ONLY
WNI RsgrP•#s Swiew Pendant Bracket NO. Type EH.h No. YYatb A.W.G.
Out- each Nn. Gauge INSPECTION
t#d.
Sub-
be"
Br.
irml
in FI.
znd FI.
3rd FI.
REMARKS: LIST OTHER ELECTRICAL Of V ICES NOT SET FORTH ABOVE;
DO NOT USE THIS SPACE_
This apPlibtion is intended tp saver the above-listed
v Or. ra Mrihorited to make the i equipmenttoinsPaei�ed iwR F# sf time Of inePeetion there :s 1"ml eddiliOnal
nepeerlon end adjust tM for to corer the additional equipment, m Provided 6 a 'UiP' nt nor above listed,
SIZE OF Y the PPiisynR.
MAINS FEEDERS ELECTRIC SIGN
LAMPS TOTAL
CHARACTER WATTS
OF WORK EXPOS GAS TUBE SIGN
CONCEALED TRANS FORM E RS OF
WORK TO 6E VA
STARTED (NUMBER]
SERVICE DVERFIE�Ap COMPL ETEO SIZE OF SIGN !CAPACITY)
Bu NO UNbERGROVNO MAKER
INSPECTION REQUESTED OF +SIGN
ON OR AS NEAR AS
POSSIBLE
AVOID DELAY BY DIVING FULL AND ACCURATE INFORMATION. ALL NGW OLD
MUST BE FILLED IN OR APPLICATION MAY B SPACES
RETUgNEp E , DATE OF
PRINT NAME AND ADDRESS NAME OF APPLICATION
F
APPLICANT �, V' SIGNATURE
OF APPLICANTf� r
STREET ADORESS
CITY OR TELEPHONE +l'1y7
POST OFFICE 21P LICENSE NOCODE .
ae EL (REV. IIBe) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
QUEENSBURY LABORATORY
Queensbury Water Department
R. D. 2, Box 386
Corinth Road
Glens Falls, N. Y. 12801
518 793-8866
REPORT OF BACTERIOLOGICAL EXAMINATION
Date Collected 5/ 19 /87 Sample No. 15521
Collected By Daniel Olson Time Collected 10 : 30
Sample Point _ Corn . of Quaker Rd & Glenwood Ave ( Plastic drain pipe }
Address _ Town of Queensbu y Building Dept ( Bill, Queensbur )
1 . Total Coliform ( */ 700 ml )
2. Plate Count ( */1 ml) TNTC
3. Fecal Coliform ( 4*/100 ml) 2
4. Free Chlorine mg/1
5. Other Drainage ditch
Procedure Used
Total Coliform = Membrane Filter with LES Endo Agar
Plate Count � 35c) C - 48 hr with Plate Count Agar
Fecal Coliform = Membrane Filter with mFC Agar
These results indicate that the water ( /was not) of a satisfactory sanitary
quality when the sample was collected.
l/ v
Chemist
TOWN OF OUEENSBURY WATER DEPARTMENT
R-D. 2 CORINTH ROAD * QUEENSBURY, NEW YORK 72801 •
Amerrrare W/M MEMBER
PHONE ?93,�Cc
Ms, e[rwbnn Yf MBER �VWV
THOMAS K- FLAHERTY. G.E.T.
Superintendent RALPH VAN DUSEN
QUEENSBURY LAB Chief Operator-Laboratory Director
The results of Our lab tests on the water sample submitted by you
indicates that according to state standards , the coliform count is
unsatisfactory for drinking water.
Further information regarding possible corrective action may be
obtained by consulting with :
New York State Department of Health
21 Bay Street
Glens Falls , New York 12801
Telephone - 793-3893 LW 00
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BARSONS Lr ll ur G3 OF
CONSTRUCTION CU.I INC.
1241 Kings Road
SCHENECTADY, NY 12303 DATE - Jon Nam, r
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518) 37��•�71 ATTENTION
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MAC, 'DreA±A
RE:
WE ARE SENDING YOU r �Attached ❑ Under separate cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
COPIES DATE No. DESCRIPTION
J L
LC41LIt %7
K M .
OWN
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval
XFor your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return corrected prints
XFor review and comment ❑
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS 4SMA4,41MO "b w L*A 4S W ( LeLw ' !;e llF /Ari ie I L r= 7' e� lIt ll,�f
COPY TO
SIGNED:
PRODUC12463 �MC, RnRe Km OWL. if enclosures are not as natede kindly notlry us at ..a.
BARSONS fL u` EEM OF
CONSTRUCTION CO., INC.
1241 Kings Road
SCHENECTADY, NY 12303 Joe ao
(518) 370A2761 wrreNr: H
RE:
WE ARE SENDING YOU AroAo ttached ❑ Under separate cover via the following items:
0 Shop drawings ❑ Prints ❑ Plans ❑ Samples CI Specifications
© Copy of letter ❑ Change order ❑
COPIES DATE NO. DESCRIPTION
SZ vD AgocA . fr.1 5
L-4 or
jr
L.4 4
1
THESE ARE TRANSMITTED as checked below:
For approval El Approved as submitted ❑ Resubmit copies for approval
CI For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested 0 Returned for corrections ❑ Return corrected prints
❑ For review and comment 0
Q FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO
SIGNED:
ngoun N" wc. Gran.ohm 01471. If anciPauraa are not as noted, kindly notify us at onevoor
COK insuring
ncys ZT ^.
Quaker Road I P.O. Box 2074 f Glens Falls, NY 12801 I Phone (518) 7793-5133
May 6 , 1987
Town of Queensbury
Town Office Building
Cor _ Bay and Havi1and Roads
Glens Falls , New York 12801
Re : Cool Insuring Agency , Inc . Expansion
Quaker Road , Glens Fails , New York
Gentlemen :
Please be advised that we are aware of the problems
with our current septic system at our office building on
Quaker Road . In view of the fact that Town sewers will
be available within the next two years , we are suggesting
a temporary solution to our overflow problem . We will be
contracting with Sanitary Sewer Service , Inc . for the
purposes of having our septic tank monitored on a weekly
basis . We anticipate having the tank checked weekly
and drained as necessary in order to avoid any overflow .
I assure you that this will be done on a weekly basis in
order to avoid any sanitary problems .
SIn rely yours ,
By : Ir Me
Vice President
COOL, INSURING AGENCY , INC .
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