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1987-593 CERTIFICATE CIF CJ+�+CU P AN'+�Y' TOWN OF +QU'EENSBURY WARREN COUNTY, NEW YORK Date y 6 , 14 ?�'j , . f'? N S This is to certify that work requested to be done as shown by Permit No. 67-593 has been completed. Thies structure may be occupied as a CJne-Family Dwe tlin Location # 9 Woodridge Northwest 4l111aage Owner Julie Gerry Beres By Carder Town Board PrOWlri OF QUEENSBURY Building & Zoning Inspector �.w BUILDING PERMIT TOWN OF QUEENSBURY b No. 87-593 WARREN COUNTY, NEW YORK N PERMISSION is hereby granted to Julie & Gerry Beres F ca I OWNER of property located at #9 Woodridge Northwest Village Street, Road or Ave. 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. C , I� 1 , OWNER'S Address is RR #3 Box 1595 rM Upper Sherman Ave . t7' Queensbury , N . Y . 12801 ry 2. CONTRACTOR or BUILDERS Name 44 Cabe Inc . ro *i m cn 3. CONTRACTOn or SUILpERS Address 64 Crandall St . Glens Falls , N . Y . 12801 z 4. ARC"ITECT"S Name H `¢ ert Fti' � a � o ro 0 w P1 rr H• S. ARCHITECTS Address c Oa r- to w aro ro 6. TYPE of Construction — (Pleas* indicate by %) TA Wood Frame I i Masonry { ) Steel { } 7- PLANS and Specifications No_ 64 ' x 38 ' per plot plan , specifications and application including � septic system and 3 car attached garage . ro 1 8_ Proposed use One-Family Dwelling r-• •-c $5000 CIOro 183 . 00 $ PERMIT FEE PAID — THIS PERMIT EXPIRES April 1 , 19 88 N (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Ov town of Queensbury before the expiration date_) Dated at the Town of Queensbury this 9th Day of Sept . 19 87 SIGNED BY ct^„� ,� � - for the Town of Queensbury Building and Zoning Inspector ^ +�/ TO BE COMPLETED BY BLDG . DEFT. JJ Application No. r.a , Owls Application gQ46col►r3 "ry Permit Issued 19 BUILDING and ZONING GEPARTAAENT Permit Expires 19 Bay and WaviFand Road, R.D. 1 Bow .r ; Zoning Designation 'Oueensbury, New York 12801 Variance No. _.- - site Revie AUG ` ✓ � �"� � �� Ap s F;tlftrD�IG� y..�,E;' 1']�r>r d1 APPLICATION FOR _ COX- &I'f4e BUILDING AND ZONING PERMIT )`° '� * * � .► .► a � +► .► . * a � e � ar ,I ar a ,. * . a � a a * � i► � a a .: ,r 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 : �] �.t ` 7l `o, P. O. Address 0 X Property Location "M, L,q G'x�© ('�G�vrJS"c 4J V4. It ck Tax Map Street number or building lot number' Subdivision name (if applicable) k-,% ot �,ay It�bk Z THE PERSON RESPONSIBLE FOR SUPERVISION CIF' WORK AS REGARDS BUILDING ES IS : Name.- P. O. Address Tel . No. Name of builder %::� ,C_ Address Tel . �]�1 �� S88 Name of plumber_ C> xj:nj N '"`:i'? �Addreas ttk A b L qR: Tel. Name of Mason 1c Address Ar ,�_ Tel -- -29 2k NATURE OF PROPOSED WORK : * ZONING INFORMATION : X 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 FOR DEMOLITION PERMIT, STATE SIZF: AND * whether interior or corner lot . Show location LOCATION OF STRUCTURES AFFECTED, of water supply and location and configuration of septic disposal area . * * CC04PL ETE INFORMATION REQUIRED BEELJOW . " Size of property Z440 ft X I ft . ' Existing building ( s ) Size ft X ft . PROPOSED BUILDING AND USE : * Existing building (41 ) Use Size of new structure (0.44 ft X 8 f Foundation-,pier/Slab/crawl/partia full ) * Proposed building, distance from property line (circle one ) * Hop of stories (habitable space) 2_ * prom yard $ ~1 ft Rear yard 1I 6 ft Height (grade to ridge ) 3 ft . . Side yards '3 Ir ft and S -S ft If residential, no. of families 1 * If on corner, setback from side street ft Noe of roorms (excluding baths) OCCUPANCY INFORMATION Noe of bedrooms 3. *No. of bathrooms PRIMARY BUILDING - V/ Primary heating system �,,-u ��r • Ve� One family dwelling Type of fuel L�, �` . » Two family dwelling No , of fireplaces to be installed * Multiple dwelling / Number of units Will a wood stave be installed? p + Permanent occupancy 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 levee Old style Bungalow Cape Cod Cottage Other * ACCESSORY ]BUILDING- Colonial Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) " attached garage/one car/ two car/ car * # �' ' * * * * * • * * * * * Private storage building ESTIMATED MARKET VALUE OF Other CONSTRUCTION INFORMATION ON ,BUILDING. SPECIFICATIONS. ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! For+n BFA /IV, m 1w% v L BUILDING PERMIT APPLICATION CONTINUED - HUfLOING SPECIFICATIONS ; Type Of construction , woad rams , fire safe , atc . Will any second-hand "o�ungr,aded lu Or be used? If so, for what ? (� Foundation wall material Gpr c \C kA nc"Ic. Thickness Depth of foundation below grade (to bottom of footing) lFet-a%-ti- Will there be a cellar?_ ES Heated or unheated? �h oor seq. footage s ft Will there be a basement? Will , an q ( If so, what por isms? T �' portion be used as living space? sq . ft . - Type of use? Type of roof - sloped lat/shed/other Material . of roof 1y� Size , wood st '"X� spacing y "o . ce, length ft . Joists ( floor beams) 18t . floor Z Mx_ rx spacing '•o . c . span / '� ft . Joists (floor beams) 2nd . floor Z "x�-tom" spacing•'o . c . span /6 ft . Overlays (calling beams ) ••x " spacing "a. c . span fte Roof rafters �X 7!f` spacing / 6 o . co span eft . Roof trusses (pre-engineered) spacing "o , c . span Zvi ft . Exterior wall finish ntlt�,, p 1c r+ Ive "Of what material ? 2:M r Interior wall finish� So �'� -- "" -�---- If a garage is to�be attached , describe materials to be used for rIR,E SE'PARATIONz Is the e�to b en opening between garage and dwelling?_ u ,�r,,� If so will a Zaire--rafted . � door, - enclosure, and self-closing device be provided? a - Will a flue-lined chimney be installed? Hei,911t above ro f ft * C7 Depth of chimney foundation .below grade Z 4 ft . Depth of .fireplace hearth ft . in �- a Water supply - Municipal �orprivaTe�Awell SEPTIC SYSTEM Distance from ANY pr vate well ( including adjoining properties _ _�/oa 000�f (A separate application is necessary for any repair or new installation of septic system) Town of f Warren A F F T D A V r T STATE: OF NEW YORK County of Warren L 1J rl 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 04 true and complete statement of all proposed work to be dune 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 OMRIer, Owner ` s ag n.- - cna.tect, contractor day of 19 Notary Public , Warren County , N . Y . # * * * * * * * * * & * * * * * * * * * . * * * * * • * : w * ,► SPECIAL CONDITIONS OF THE PERMIT : / TOWN OF QUEENSBURY i 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. 3 +La 2 . Type of heat cry +� 2�.+� 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors ./ �r Z drQ A . Over 16 % Only 1 . U value of gross area of walls , roof /ceiling and floors o exposed to ambient conditions 2 . Floor over heated spaces YES j NO a . Are foundation walls ins aced ? 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_ - V y « CLA e '%;5 B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. V z3. $r 2 . R value of exterior walls - 11 3 . R value of glazed area 4 . R value of doors '`. - ice 5 . R value of floor 8 over unheated spaces " 6 . R value Of slab edge insulation - . unheated slab, 7 , R value of slab insulation - heated slab All B . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement/cellar walls ( below grade ) 14 . Type of insulation Ilk- 'vaK c . controls 1 . Thermostat maximum heat setting N D . Duct Systems 10 is duct system installed in unheated spaces ? YES NO a . If YES , R value of duct installation b . R value of duct in other areas E . Piping Insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating a 1 . Performance efficiency <4� 4 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone No , ( applica ' s gnature ) +QQPP.� � u ,�y APPLICATION FOR SEPTIC DISPOSAL PERMIT 13VILDING end ZONiNG DEPARTMENT Bay and Havitand Road, R.D. I Box 98 Queensbury, New York 12801 DATE l�Qy^1 LOCATION OF PROPERTY FOR INSTALLATION OWNER ' S NAME E� C 'ti l � � �a ADDRESS y 3, , C- TEt - ")C41?) 91 ( 9 INSTALLER ' S NAME '"' �' g 3 - E-.SS$ C iD Q G. /� l4 c n Sa....a �. +� 4 T E L - 7 47 2-- S 6, St$ Number of bedrooms ( resident'ial only) Total daily flow ( compute 6 150 gal per bedroom) Topography : "Flat - Rolling - Steep slope - ( circle on : of slope Soll nature : Sand Loam Clay - Other Depth.2 I ti f t . Ground water -At what depth? / ft . Sed-rock or impervious material - At what depth? ft " Percolation test - Not required - Required - -Rate / Aj min- inch . Domestic water supply —Municipal Kell other Separation - Watersupply ( if well ) from Septic absorption _ /0 ft . Proposed System : Septic tank , 12.Jbf3 gal . ( Minimun size , 1000 gal . ) Tile Field - Each trench �f t . Total System legnth � f t . Seepage -pit ( s ) Number of Size each ft X ft �. Size of stone to be used 8 Depth or thickness fto IMPORTANT '. ! on a separate piece of paper , submit a diagram of the proposed system with all dimensions shown ; including distance from any structure , distance from property lines and from ANY V014ESTIC WATER SUPPLY or shore - line of lake ; stream , pond or wet - lands . Include all dimensions of the system , itself . • w • . * . . * +� w � ,e w * : * w w • • • � • rr +r . w • ,► * s w . , +� +r w .7 .have read the reguZations on the reverse side of this sheet and agree to abide by Leese and aZZ requirements of The Torun of Queensbury Sanitary Sewage visposaZ Ordinance . Signature of reepcneible person Date 05/ 86 and/ vl w Section 11 Septic System ? nspectionsr A . All applications for septic system installation , alteration or repair , as recauired by the Town of• pueensbury Sanitary Sewage ordinance , shall be submitted to the Buildina Department at least 24 hours before start of construction and shall include a plot plan showing : 1 ) the proposed location jof 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 , tile fields and/or drywells Be NO system shall be covered before inspectiron and approval by the Building Inspector . Failure t7o comply with this reauirement may result in the uncovering of the system by the , installer and a fine of up to $ 250 . 000 Ce An approved copy of the . pisst 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 ti .must be submitted to the pueensbury Build1no Department before further construction . i'7 ' ."/own o� �ueensburr� fBUILDING and ZONING DEPARTMENT ay and Haviland Road, R. D. 1 Box 98 B Queensbury, New York 12801 DING I NSPECTflR ' S REPORT" NAME LOCATION Date J�',� / � Permit No . 'i- yr ✓ = APPROVED - YES NO Foot ing/Pier Forms Foundation waterproofing Backfill Framing Roofing Siding Masonry eneer Rough Pl Ding Relie £ V lves Ext . Por hes Finished loots L Interior rim Stairs & flings Cellar Drai Tile Concrete Fl rs P1bg . Fixtur s Gar . Fireproo ing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRIC L INSPECTIO DRIVEWAY APPRO AL Final Building, Survey Next scheduled inspection (call wh n ready ) Remarks- �r,� eGGt Y Building Inspector 6/B6 and-vl , /x o ws� , i / `�Cueerr36urt�r 8�11LDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 ff Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT ION lc.� _ , '' -' f BATE PERMIT No.__ �- SOIL 'TYPE - Sand - Loam - Clay Percolation Test Required? YES - N Percolation ra - Min/Inch TYPE of SYSTEM: Absorption .field total le.ngt Length of each tr nch � Depth of trenches Size of gravel SEEPAGE PITS414_umber of) Size- ft. X t_ Gravel size - PIPING : i Bldg . to tank Typ Tank to dist. box C Ze, Dist • box to field Openings sealed.? ES NO Partial LOCATION/SEPARA.T S : Foundation to t k ft. Foundation to sorption t. Absorption to of line ft. Separation of pits ON OF' STEM ON PROPE circle one) Front Rear - Left side - Ri t side C NTS : SYSTEM USE APPROVED ES NO Bull g nspeotor 01/86 and vl flI _J'otuxe crupexrsburt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTORR tS REPORT NAME_ L O C A T I O N ?ZC Date_ /oT-_ Permit No . ✓ = 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 Wa1. T. s Ceiling FINA14 ELECTR CAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- I3ui ing Inspector G/86 and-vl a5lb 1lll .r] rGr► oitrn 0/ Q" eenjiury BUILDING and ZONING DEPARTMENT Bay and Maviland Road, R-D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAM LOCATION � /��,x,C '` '-2 /7, ,/ Date c--A�_/� Permit No . -G�✓�rf ✓ = APPROVED - YE No Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Values Ext . Porches Finished Floors Interior Trim Stairs 6 Railing's Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors C mney ,,,,4 JSULATICN : Foundation Floors Walls Ceiling FINAL ELECTRICAA INSPECTION DRIVEWAY APPROVAL YE Final Building Survey Next scheduled inspection (call when ready ) Remarks- �7 f r Jv Bu: l ing Unspector 6/a6 and-vl awn 0/ Quee" Jiury �f BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILD NSPECTOR ' S REPORT NAIVE !4 a�iZlJ �� S'� � 9 LOCATION Date o�G !'d / Ql;t Permit No _ r 59 Z5' ✓ — APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing ;w Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproof ' g Door Closers Smoke Detecto s Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECT CAL INSPECTION DRIVEWAY APPROVAL Final Building, Survey Next scheduled inspection ( call when ready ) Remarks-- ,,,, .2 r-/.� /L �?,/�[ .n 7 �C taid1latiorg Ins ector 6/86 and-vl ,_ tvn of Queen36uray BUILDING and ZONING DEPARTMENT Bay and Naviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 'Te_Azo v ,dryee' LOCATION ta? Lt�acaes �Qcri�E,r Lfe' //2S Date ,Permit No . APPROVED - YES NO Footing/Pier Forms Owo' Foundation Waterproofing Backfill VFraming Roofing Siding Masonry VeVg Rough Plum Relief Val Ext . Porch Finished F Interior T Stairs & R Cellar DraConcrete FPibg . FixtGar . FirepDoor Close Smoke Detec ors Chimney. INSULATION * Foundatio Floors Walls Ceiling FINAL EL CTRICA,L INSPECTION _ DRIVEWAY PPRO'VAL -- Final But ding Survey Next scheduled inspection ( call when ready ) Remark.s�J - ed ,/�d,V I /r+ T ��'s ce �✓;tI BM, it i g ector 6/86 and-vl e, r� f7 -. flou/n 0/ / ! BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 88 dueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 1 LOCAT ION Date f hermit No . for' APPROVED YES No Footing/Pier Forms Foundation waterproofing _ Bac�fill _ aL `aming v^" Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar _ Fireproof ' ng Door Closers Smoke Detect s Chimney. INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remark.s- c h7 ,}of k S 4.0 ds 40 s-l-.v.-�.�`_ Tawck StueS Gi.6061e w; ✓ C/o r ' ik f"' B sn In ecto 6/86 and-vl BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R-O. 1 Box 98 Queensbury, New York 12801 BUILDING INSPE TOR ' S REPORT NAME �o�*r ,S; LOCATION Date Permit o .ZZI- ✓ —1 PROVED - YES NO Footing/Pier F >d un.dation .terproofing Backfill Framing Roofing Siding MasonrMI:Lngs eer Rough ing Reliefes Ext , Ps Finisho s Interii ___St irs lingsCellar TileConcreoarsPlbg . resGar . FoofingL7c3or CsSmoke ors 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-vi fr BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME j ��j�f ,+ Rir1� LOCATION J /'7�r ,r, ,/ !v K�3�` -- colf Date 4 l ,1< Permit No . APPROV .D - Y 'S NO ooting/Pier Forms pA]CJLaTt ur Foundation Waterproofing BaCkfill Framing Roofing Siding Masonry Veneer _-... Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railing Cellar Drain Til Concrete Floors Plbg , Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney IN SUf LAT I ON Foundation Floors Walls Ceiling FINAL ELEC CAL INSPECTIO DRIVEWAY A PROVAL Final Buil ing Survey Next scheduled inspection { call when ready Remarks- fi{ 16$ Building Inspector 6/86 and-vl 1 `A g111LD1NG and Z0NING DEPARTMENT Bay and Haviland Road. R.D. i Box 96 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME - & uC! LOCATION Q s fj t1tefh G !~ Date_V —6.7 — Permit NO . APPROVED 'YEP No (Footing/Pier Forms ] LL 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 , Fireproof in Door Closers Smoke Detector Chimney IN sU I.ATION Foundation Floors walls Ceiling FINAL ELECTRICAL INSPECTION _ DRIVEWAY APPROVAL ...-- Final. Building; Survey T3et scheduled inspection �[ (call when ready F Remarks- r2 } Jr Buildi Inspector 6/F3Fa and-VI CERTiFIGAt c ^� BANK . Fl . Y - 12207 TH F. DiEW YORK B[7ARD OF i✓iRl+ V i4pERW AL. RiTER YOU ARE M+EREay REOUESTED TO 1NsrECrANPoSSUECERTlF+CATES FOR T04EFOLLOWlNG ELECTRJCAt Bu1LDING PERMIT NO. EOUIP&fUNT TO aE ImsTALLED ay Tiff UNDERsrONED.DArE TIEPA k., COUNTY CITY OR ,,.14, ,L ,� ` y �� (.; TOINNSHIF VILLAGE lv .-_d POLE I'll - STREET AND NO. OR ROAD AND POLE NO. BLOCK LOT TWO ^fit `+ Jy ,.,, �f.. ` r.\. SECTION BETWEEN WHAT CROSS ST R E FTS IS 1�*-. ^`:. BUILDING PREMISE AT£O> w OCCUPANCY OCCUPAN105 ,^a • 'rC 'tom-.��.. ��. TEL. I C1� NAME y OWNER'S NAME ( t'3 i' "� „} K, s "� 7 �^' OFFICE AND ADDRESS f'� FROM THEIR OFFECTS BY ppL1EQ 1 `t \ WORK NEW ADDITIONAL ❑ REMOVED � BUILDING NEW jaQ,,Il OLD Q IS IS LIST, EL[]W ALA EUUfPMEP1T WHlC1N Y'0� INSTALLED RANq OFFICE USE Ne. of Fixtures & MOTO�tS HEATERS CIRCU ONLY NUMBER OF OUTLETS LanIP RecePtaelse INSPECTION A H.P. Him Will Ne. Loll Sid+ Al bell! t Switch Pandant BrM:ka[ No. TV" Each . Cai1k+Y Wa11 Recael is Out• all Sub- be" Bar• meet lot FL. 2nd Fl. 3rd FL DO NOT USE THIS SPACE. REMARKS: LIST OTHER ELECTRICAL DEVICES I'll SET FORTH ABOVE: ion Mere is found ♦dd:tionM equipmem not above listed. ant, as provided by the applleant- i men[ to be in W.,.d Wrt it at timr of inspect his application is intended I cover the nay� doted to cover the addit+oral equipm TOTAL you are wthoria'ed to make the inePeet ELECTRIC SIGN WATTS LAMPS SIZE OF FEEDERS MAINS CONCEALED GAS TUBE SIGN VA CONCEAA LED TRANSFORMERS OF {CAP'ACITYI CHARACTER INUMBERI OF WORK WORK TO BE COMPLETED COMPLETD SIZE OF SIGN STARTED UNDERGROUND MAKER SERVICE OVERHEAD OF SIGN £N ILDifsG NEW ERS OLD INSPECTION REQUESTED 1 r ON OR AS NEAR AS DATE OF POSSi9L£ APPLICATION MUS"DIT BE FIL FILLED IN OR APPLICAND ^C14 M L BE SIGNATURE ALL SPACE 'yyl' SIGNATURE PRINT NAME AN� Ad'P p1�55 • • r ,- '-` !1 OF APPLICANT NAME OF i �---ft All L IC ANY p a 7E'L£PHONE _ I •� •, F� 2� 21P / LICENSE Nd. STREET ADDRESS } `t { �_.:'�, fi.•'. COOS " --=—WHEN APPLICASLE CITY OR POST OFFICE 46 EL (REV- 1lB6Y A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING i CF�� t�F �4:{� L. - CE � Lt i. 1Lm w •� �k 6 a iv OtL J �h, OP�E�'�� �4?'' r ,j J�ISULAr 1aA[ TOWN of C)UE -,a � 16 FEB I caut uEFIT. ITM Eno oS'- Sa' - o I.JEI-L 231.Sy faces ly 7hl,r /,n 47ecL ra1cQ o C�QcI�RL.e,t') �a '�5' S,6�T-i o,J IS f/J I I O o A IT,0A.1 To Lor,A--s I-�-o WA.)OAJ Sr— �„r TABLE 4 REQUIRED LENGTH OF ABSORPTION TRENCH \ �1 "_C '0 r(BASED ON 2 FT.WIDE TRENCH) rk t 4Cil C �4� FLOW RATE(GALS./DAY) - --- -- - 55' 1' 28R 38R 48R SBR 68R 300 400 500 600 700 800 900 1000 � '-- - 0-5 125 146 166 187 208 1 229 250 270 1 291 312 1 333 354 374 1 395 416 6- 7 150 175 200 225 250 275 300 325 350 375 400 425 450 475 500 Z Feed 8-10 167 194 222 250 278 306 333 361 389 417 444 472 500 528 556 z 11-15 188 219 250 281 313 344 375 406 438 469 500 531 563 594 625 S - 00� z 16-20 214 250 286 321 357 393 429 464 500 536 571 607 643 679 714 o _ a 21-30 250 292 333 375 417 458 500 542 583 625 667 708 750 792 833 - LOT - 3EQEj N0F,7 ESC V�LLRCxE 31-45 300 350 400 450 500 550 600 650 700 750 800 850 900 950 1000 CC 46-60 333 389 444 500 556 611 b6J 722 778 833 889 944 100010551111 #� w�OO(Z\�G,E DOSING DOSING OR ALTERNATE1. NOT REQUIRED ALTERNATE DESIGN DOSING GC4Z5 7-0 T%fSL®TS'Ii-eeUNOAf S U 13 Ot VI S c OAJ PZ^r 45 g-Ao&1A*A-T- . +�. (Jt5Ger88Co wf o,crc goBknts