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1987-732
_.�. .� v ,v.kgY: .v' .:cr .r ,.. r.. Vd .T . . .... If I CERTIFICA.':IEr" OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Dote DEeember 21 19 $2 This is to certify that v;0r7k requested to be done as shown by Permit No, 87- 732 has been completed, This structure may be occupied as a One Family L1welling Location 9 Spruce Ct . Owner John Benedict By Order Town Board TOWN OF QUEEN5HURY Building dr Zoning inspector ,r BUILDING PERMIT �i TOWN OF QUEENSBUR'Y No 87_732 � WARREN COUNTY NEW YORK o PERMISSION is hereby granted to John Benedict 4 OWNER of property located at 9 Spruce Ct . Street, Road or Ave. c 1 in the Town of Queensbury, To Construct or place a Addition to One Family 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 Sametz o t to 2. CONTRACTOR or BUI LOE R'S Name }° W m Duval Construction l] rT 3. CONTRACTOR or BUILDER'S Address 94 Webster Ave . Glens Falls , N . Y . 12801 4_ ARCHITECT'S Name m n 5. ARCHITECT'S Address ro rr, rt 6. TYPE of Construction — (Please indicate by X) (X) Wood Frame ( I Masonry i ) Steel ( ) €a a. 'i_ PLANS and Specifications N r't No. 20 ' x 32 11t per plot plan , specifications and application . 0 k � 8. Proposed Use o Addition (Family Room) to One Family Dwelling rh w $5 . 00 C/o IR $ 52 . 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES May 1 , 1988 (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 729th Day of October 19 87 SIGNED BY 5/,�fC' z X ef for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . / Application No . ; ortur� nueens�ure� `• 1 : !_ Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 11 Bay and Haviland Road, R. D. 1 Box 98 zoning Designation OCT 271987 Queensbury, New York 12801 variance "- Site P an Review No APP APPLICATION FOR I/ a 10 jVC4C t 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 indigcateddf on the��//Permit . wftftw� The-owner of-this property is /�/ ' 6 /// ynJ ;�•ti i)�c' --- ------ - --- P . O. Address 9 `z Tel . 2Z 5F Property Location : `= eU (=L 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 : �S r" !Name P . O. Address Tel . No . / Tel . Name of builder�rq� � Address �{f'� f;,•�- � T;( - Tel _ .`�3�i' �d"a p r , Address_ y r Name of 1 umbe .�, r'rr �--- Narne of mason „ �an rs Addresses �i L1� rrsy ( �,4., -tnp6 k� . Te1 . 17�-Qz NATURE OF PROPOSED WORK : 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 AND of water, supply and location and configuration LOCATION OF STRUCTURES AFFECTED . * of septic disposal area . COMPLETE INFORMATION REQUIRED BELOW . v / Size of property �/ Ee t f x r ft . Existing buildin s) "�,ft X ft . PROPOSED BUILDING AND USE : Existing building ( s ) Use ejVj,-- r�a,aaC1 J - Size of new structure _ft X // ft Foundation-pier/slab craw /partial/full Proposed building , distance from property line (circle one ) Front yard �` ft Rear yard �) /' ft No . of 5t4r3@S (habitable space ) dr _ i ft Height ( grade to ridge ) ' ft . Side yards ft and If on corner , setback from side streetS. ft If residential , no . of families e_7,U No . of rooms ( excluding baths ) O OCCUPANCY INFORMATION [r 'Nov of bedrooms // 4rQ PRIMARY BUILDING - No . of bathrooms /7i� f �e} d - * (One family dwelling Primary heating system r7 Two family dwelling Type of fuel pi . A � Multiple dwelling / Number of units Noe of fireplaces to be installed Permanent occupancy Will a wood stove he installed? Transient occupancy Central Air conditioning? Business BUILDING STYLE, PRIMARY STRUCTURE Industrial �, Other Ranc Contemporary Log cabin If addition , what will use be? _ .. . Raised ranch Mansion Duplex Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUILDING- ------ Colonial Row Town House * De arage/one car/ 't3arra- ca j%/ y car { CIRCLE ONE PLEASE ) Attached garage r/ two car/ car _Priv orage building ESTIMATED MARKET VALUE OF CONSTRUCTION $ �s*1 '1pr - - - - - - - _ _ INFORMATION ON BUILDING 'SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATICNdS : r Type of construction , wood frame , fire safe , etc . 7 yir.' Will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material �r Thickness Depth of foundation below grade (to bottom of footing) .4/ = .y" Will there be a ce liar?-A)CL.Heated orb heat l> Floor sq. footage sq ft Will there be a basement? 42a Will any portion be used as living space? .00 ( If so , what portion? sq, ft . - - Type of use? Type of roof - sloped/flat/shed/other Material of roof C1 , E Size , wood studs 'X it - " spacing "o . c . length � _ ft . Joists ( floor beams } 1st . floor "X _" spacing / "o . c . span___ f✓ ft . .foists ( floor beams ) 2nd . floor - "X " spacing "o . c . spank- ft . Overlays ( ceiling beams ) cx "X - - spacing � ./ "o . c . span,,�7,0 ft . Roof rafters ^_ __..'� X�!'�, - " spacing..Z ' o . c . span.�ft . Roof trusses (pre-engineered) spacing "o . c . span ft . Exterior wall finish ; ,r-rye � Of what material ? Interior wall finish % ,y ;. � amc;4 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? If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? Height above roof Depth of chimney foundation below grade . . ft . Depth of fireplace hearth n . water supply - Municipal or private well r r q;7-4!5 /x.�4e y ,r SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury County of Warren F I D A V I T STATE OF NEWYORx 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 the owner . SWORN TO BEFORE ME THIS Signature _= ��� �✓_�� Owner , owner ' s agent , arc itect , contractor day of 19 Notary Public , Warren County , N . Y . SPECIAL CONDITIONS OF THE PERMIT : 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 !T0 2 . Type of heat 3 . Is the building mechanically cooled ? & ) 4 _ Percentage of area of windows and doors Vy ~ A . Over 16 % Only —*-�• ��' 1 . Uo value of gross area of walls , , �roof / ceiling and floors exposed to ambient conditions v -l � . 4f,) C" 2 . Floor over heated spaces YES NO ,�^�, a . Are foundation walls insulated ? YES G 1 . If YES , what is the R value ? 3 . Slab on grade YES NO a . If YES , what is the R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation B . Under 16 % only 1 . R value^._ roof and floors exposed to ambient conditions. 2 . R value of exterior walls- 3 a R value of glazed area 4 . R value of doors 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation -- unheated slab 7 . R value of slab insulation - heated slab 8 . R value of heated basement/cellar walls ( above grade ) 9 . R value of heated basement /cellar walls ( below grade ) 10 . Type of insulation Co Controls 1 . Thermostat maximum heat setting (3V 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 \5' 7�p - - r E . Piping Insulation _ yy 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating 1 . Performance efficiency 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone No . �� ( applicant ' s signature ) THE NEW YORK BOARD 4F FIRE UNDERWRITERS I i i - BUREAU OF ELECTRICITY 41 STATE STREET, ALBANY, NEVV YORK 12207 Date ' ` �.. .Application ,N1 - on file . . ? - ry /� . THIS CERTIPiES THAT `{41 only the electrical equipment ae described below and Introdrsced by the applicant named on the above wrpplicat'ior► nsember in Chepnemieea of in the following location; 0 Basement ❑ Eat Fi. Q 2nd Fl. 'Section 114 Block Lot Jr. p �cas examined on and found to be in compliance with the requirements of this board. FIXTURE EFTAGLkS swtrcHEs R]LTLIRES RANGES COOKMlGt DECKS 71MA6HSHERS E%HAUST FANS OUTLETS tNCANDESCENT FUXMESCENT OTHER AMP, K. W. AMT K W AMW. K. w. µMT. N. A. DRYERS FURNACE MOTORS FUTURE APPLIANCE rzE RS SPECIAL RECTT TIME CLOCKS SnL oLITLET pil�lytERS AMP. X. w_ OIL H. ►, GAS H. ►. AMT. NO. A. W. 0- AMT- AMP- µMt. AM►S- TRANS. TEMSF FEET AMP. wATTs SERVICE 01SCONNECT NO. of S E R V" L C E AM7_ AA METER IP. TVFERQW 110` 7W 1 X 9w "J 1 3+w 3 }i Iw NO, CC. C4i�- OF Oc qtO NP, NO. of Hr.LEG OF H•0 No, or NEuxRA+s L+TR,ut OTHER APPARATUS: BRANCH MANAGER Per This certificate must not be aitemd 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, TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS io oer QUEENSBURY, NEW YORK 128 pg.. TELEPHONE (518) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME 3 LOCAT ipiV DATEFSRMIT x APPROVED YES NO FOOTINGfPI r MOiVOLITHIC OUR FORpyS FOUNDATION/D P—PROOFING BACKFILL APPR VAL ROUGH PLUMBING FRAMING ELECTRICAL ROUG IN ,INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION. CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESfST PS STAIRS—CLEARANCE & ILS PLUMBING FIXTURES1 E.LIEP VALVE INTERIOR TRIMfPRX CY DOORS FINISHED FLOORS GARAGE FIREPROOF NG DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL F CONSTRUCTION i r A ,SIGNED CERTI*'ICATE OF OCCUPANCY MUST BE OBTAINED FROM,o"THE BUILDING DEPARTMENT BEFORE THESE PREMISE'S ARE OCCUPIED! REMAR IN PEC R AG �] // 1- own of Queens6ury r /JBUILDING and ZONING, DEPARTMENT Bay and Hartland Road, R. b, I Box 98 Queensbury, New York 12801 I- DING INSPECTOR ' S REPORT NAME LOCATION Date - " /0, Permit No . ✓ = APPROVED - YES NO Footing/pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer zw� a ugh Plumb ng Relief Valve E:xt , Porches Finished Floo s Interior Trim Stairs & Raili gs Cellar Drain Ti e Concrete Floors Plug . Fixtures Gar . Fireproofing - Door Closers Smoke Detectors -""-'- Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRI AL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection [call when ready ) Remarks-- Build- nsp ctor 6/86 and -vl �.{ �' (J _.laurn a� �ueenshurt� u BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 128o7 ILDING INSPECTOR ' S REPORT AME LOCATION �? � Date /�� Permit No . ,,F ' p ✓ - APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry V eer Rough Plumb ' ng Relief Valve Ext . Porches Finished Floors Interior Trim - Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney ULATI ON Foundation Floors Walls Ceiling FINAL ELECTRICAL I SPECTION DRIVEWAY APPROVAL. Final Building Survey y -- Next scheduled inspection ( call when ready ) Remarks- 1 s 1 g nspector 6/86 and-vl BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Sox 98 /�} ] Oueensbury, New York 12801 J BUILDING INSPECTOR ' S REPORT NAME i LOCATIO C Date _c Permit No , ✓ = - Footing/Pier Forms APPROVED YES NO Foundation Waterproofing Backfill Gaming Roofing Siccing Masonry Ve eer Rough PI . ng Relief Valy Ext . Porches Finished Floc Interior Trim Stairs & Railin s Cellar Drain Til Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRS AL INSPECTION DRIVEWAY APPR VAL Final Buildin Survey Next scheduled inspection (call when ready ) Remarks- r ; Boil in spector 6/86 and-vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT RAY & HAVILAND ROADS '2UEENSBURY, NEW YORK 1280Z TELEPHONE (518) 792-5832 BUILDING INSPEzTpp r S ,1, ppORT REQUEST FOR INSPECTION RECEIVED NAME L0CA T.ION DATE PERMIT # APPROVED FOOTING/PIERS YES i NO MONOLITHIC POUR FORMS FOUNDATIONIDAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULAVXON: FOUNDATION FLOORS WALLS CEILING a FINAL INSPECTION: CHIMNEY HEIC.xHT ROOFING SIDING ✓ EXTERNAL PORC /STEPS ' ^ STAIRS—CT EARA CL & RAXLS PLUMBING FIX INTERIOR TRI /PRI FINISHED F i%CY DOORS RS GARAGE FIRE ROOFING DOOR CLOSER S) A. SMOKE DETEC Rs FINAL ELECTR AL IN.SPECTi ON FINAL APPROV OF CONSTRUCWTON A SIGNED CERTFICA TE OF OCCUPANCY MUST BE OBTAINED FROM ROM HE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: 2 . �Dt;a�ore_ INS ECTOR Lr•J1C TOWN OF QIIEENS $URY BUILDING AND CODES DEPARTMENT BAY & HAVXLAND ROADS QUEENSBURY, NEW YORK 128 pg,. TELEPHONE (5I8) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME . .. ;; • LOCAT TON y` DATE PERMIT 49 % APPROVED YES NO FOOTINGIPIERS MONOLXTHTC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFtLL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: ' FOUNDATION r' FLOORS WALLS CEILING i FINAL INSPECTION: CHIMNEY HEIGHT j ROOF.T NG SIDING EXTERNAL PORCf1�����S/STEP .STA.iTRS—CLf L r E & RAI S_ PLUMBING FXX!rgRESfRELX F VALVE INTERIOR TR-fM PRIVACY RS FXNTSHED FLOqRS GARAGE FIREP OOFING DOOR CLOSER ( ) - 4 SMOKE DETECTbRS ? --- FINAL ELECTRX4 L INSPECTXO FINAL APPROVA OF CONSTRUC4ION E A SXGNED CERIOXFICATE OF OCCUPANCY MUST BE OBTAINED FROei THE BUILDING DEPARTMENT BEFORE THESE PRE'MISkS ARE OCCUPXED: REMARKS: <0216 or T� t X SPECTOR TOWN OF QUEENSBURY BUrLDrNG AND CODES DEPARTMENTp1q BAY & HAVILAND ROADS QVEENS,BURY, NEW YORK 12BO4. TELEPHONE (518) 792-5832 BUILDI INSPECTOR ' S REPORT REQUEST SNSP CTrON REC'EIVE'D NAME �_------ — LOCATr did DATE / / PERMIT # ''%-did '� 106/4 APPROVED YES NO FOOTINGfPIERS MONOLITHIC POUR FO S FOUNDATr01V1DAMP—PR FIND BACKF'ILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN t INSULATION: FOUNDATION FLOORS WALLS CEILING f FINAL TNSPECTIONc CHrMV.EY HEIGHT ROOFING t SIDING EX2'ERNAL PORCHE (STEPS STAIRS—CLEARI & RA,TL S- �--- — PLUMBING FIXTVRESfRELIEF VALted — X'VTERIOR TRI J PRIVACY DOORS FINISHED F R,S GARAGE FIRE q�,FZNG DOOR CLOSER S) SMOKE DETEC RS FINAL ELECTR CAL INSPECTION FINAL APPROV L OF COhiSTRUCTrON A SIGNED CE TTFICATE OF OCCUPANCY --i—' — THESE ED FT M THE` BUILDING DEPARTM T BEFORE THESE PREMr ES ARE OCCUPIED! (REMARKS : Jp f tcd, ` — bill L k4l ' ._ f BUILDING and ZONING DEPARTMENT r+ Bay and Naviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Late // / Permit No . Footing/Pier Farms APPROVED - YES NO Foundation �. wa erproofing ack£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 Bxiilding Survey Next scheduled inspection ( call wizen ready } Remarks- 6/6fi and-vl Building nspector BUILDING and ZONING DEPARTMENT v' y and 1-lauiland Road, R. D. 1 Sox 98 ©ueensbury, New York 12801 UI ING INSPECTOR ' S REPORT ME LOCAT I O Datez/ 1,5F _ Permit No . J50� i ✓ = APPRO VED - YE NO G"Foatirig/Pier Forms ,.•,y�� G'' Foundation waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim stairs & Railings Cellar brain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECT ICAL INSPECTION DRIVEWAY APP VAL Final Building Survey Next scheduled Inspection (call when ready ) Remarks- -I . � Building Inspector 6/S6 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS, FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED, TEMR Ilt r i CITY ,.--; f VILLAGE STREET AND NO. OR y TOWNSHIP' i� . ROAD AND POLE NO. i COUNTY BETWEEN IIIIHAT T G WO 1"REMI ROSS STREETS IS POLE NO. TE T F'ANT" ME S E NON /f BUILDING B OCK LOT OWNERS NAME OCCUPANCY . AND AODRE SUPPLIED w TEL.ov BUILDING FROM THEIR IS MEW ❑ OL WORK �y a OFFICE IS NEW ,may ADDITIONAL ❑ DEFECTS LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED REMOVED Local NUMBER OF OUTLETS M R2= MOTORS HEATERS CIRCUITS OaifMp OFFICE USE 1tIW Valdh�It aM R Attomp'Ia Switch Rwlalarlt Bracket No. T Hx- ONLY Oat- Taa Eaalu - E o N . ^lIII*.'a- sic. INSPECTION Satr haae Br► mwlt Tat FI. 3ra1 III 3rd FI_ REMARKS- LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE_ ynu are tharia is to m atad� +ever this ands a joist aWifwnrrH to ha Irgpac tad hue i1 at time of inspection ad to ++wake rnpectror/ andla . SIZE MA f NSF �l+wr the IN to cwar the additional rquipwynt, w l ' rMO'� +KWiPrnant ..at mbo listed. Paola hY Itla a FEEDERS ELECTRIC SIGN CHARACTER LAMPS TOTAL OF WORK EXPOS Ep GAS TUBE SIGN WATTS MV RK TO BE CONCEALED TRANSFORMERS OF STARTED lMUMBERI VA ENTER5 ENTERS OVERHE yp AD COkIPLETED S12E OF SIGN K:APACITYI UNpERGHpUI I DIN MAKER INSPECTION REQUESTED OF SIGN ON OR AS NEAR AS POSSIBLE AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATfON, N" OLD ❑ ALL SPACES MUST BE FILLED !M OR APPLICATION MAY BE RETURNED, PRINT NAME AND ADDRESS DATE OFNAME OF r� APPLICAIVT�+hJ A.0 3 � / APPLICATION .✓�_�.r / rY �-� ��-- x SIGNATURE OF APPLICANT STREET ADDRESSCITY o �-4. � I✓d POST OFFICE TELEPHONE /11',,r ,}} /.,5�., �., ^� - • 4 ZIP LICENSE 0.CODE {.�f L `f WHEN AIM'LICABLE •e EL t +ev, r/ael_ A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING DUVAL CONSTRUCTION JaB ��'__J-'I�K RD # 1 BOX 559 SHEET MO_ OF GLENS FALLS, N.Y. 12801 (518) 798 1302 CALCULATED BY DATE CHECKEO BY DATE SCALE like- / r i 02 , w PRIXMR'f 2Ui4] InC. G.arm Ma:. OWL