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1987-709 C CN U TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 19 Sri 69 'This is to certify that work requested to be done as shown by Permit No. has been completed. ,tily L4IIre11 This structure y be occupied as a i cat Lwc f rs[ kj "1 (� E �1Z&�CC 4j r 11i:u.� .' Llr t III- .c� Location C;uN.-er uuilc.ers l _ry Owner By Order Town Board 1-gyti,rN OF QUEE /N+SBURY Building Zoning lnapector -' BUILDING PERMIT H TOWN OF QUEENSBURY No 87-709 � WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Queen Victoria ' s Grant 40 Elizabeth lane Street, Road or Ave. OWNER of property located at i in the Town of Queensbury, To Construct or place a } of Two 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. it m F2CONTR*ACTO ERS Address is Guyer Builders Inc . 119 Dunning Street C Ballston Spa , No Y . 12020 0 H R or BUILDER S Name Same ua H 3_ CONTRACTOR or SUI LOiER 'S Address R 4- ARCHVMCT"S Name C] tT7 F-` r• N 5. ARCHITECT'S Address W v" iC rY [7. PLANS PE of Construction — (Please indicate by 'X) 0 . N (X*Wood Frame { ) Masonry ( I Steel ( ? and Specifications M4DEl L No. 34 ' x 43 ' per plot plan , specifications and application includingseptic system, attached one car garage and driveway permit .posed Use H } of Two Family Dwelling o ~n w rJ• *x $5000 CIO c Ma $ 75 • 00 PERMIT FEE PAID — THIS PERMIT EXPIRES3r 1 , Z98i3 {If a longer Period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration data.) 22nd October 19 87 Dated at the Town of Queensbury this Day of SIGNED BY 7 f l - for the Town of Queensbury Building and Zoning Inspector LIX TO BE COMPLETED BX ti" . vxr a ) ;L �Ll `'=fir iy i r -", ti' LJ" Application No . BUi�RNG an ZONING DEPARTMENT Permit Expires 19 1_� t UCT 2 _. 1981� Bay and Ha► iland Road, R. D. 1 Box 98 Zoning Designation G}ueensbury, New York 12801 Variance No . Site view ZI f7 1 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 clone in accordance with the description , plans and specifications submittedg and such special conditions as may be indicated on the Permit . The owner of this property is : Gu er Builders Inc . 119 Dunning Street Ballston Spa , New York 12020 Tel , P. O. Address ( 518 ) 899-9161 Tax Map No . 121 4 Property Location : 40 Elizabeth Lane / / 2Y Street number or building lot number Subdivision name (if applicable) Queen Victoria ' s Grant THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : ( 518) 899-9161 Richard H. Guyer III Tele, No . Name F. D. Address Name of builder Guyer Builders , Inc . ddress 119 I7�uuzing Street Tel . ( 518) 899 -9161 ,p Imp Name of plumber--Guyer ers , InCoAddreas R tee Tel . - Name of mason Guyer z ]Cs nc .Address r►g tee Tel . MATURE 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 REQUIREDp5EI�W - * 100+ pxlan f t X 120 ft . size of property --ft . a * Existing buildings) size ft X PROPOSED BUILDING AND USE : ofl * Existing building ( s ) Use NLA Size of new strut a £t X 43 ft Foundation-pier slab crawl/partial/full Proposed building , see eplanm Property line circle one) * Front yard 30+ ft Rear yard 30+ ft . Now of stories (habitable space) I * Side yards IIIIII1 + ft and 15+ ft Height ( grade to ridge) 21 ' -d" ft . * if on corners setback from side street ft If residential , no . of families of 2 Noe of rooms (excluding baths) * OCCUPANCY INFORMATION Noe o bedrooms * PRIMARY BUILDING Noe obathrooms one family dwelling This }�e buim f r Prima heating system se ar a ectriC* -- Two family dwelling one s rqi in , � Type of fuel Electrl-c ty Multiple dwelling / Number of units >, No . of fireplaces to be installed * Permanent occupancy will a wood stove be installed? No * Transient occupancy Central Air conditioning? No Business * BUILDING STYLE, PRIMARY STRUCTURE * Industrial. other Ranch Contemporary Lo cabin * if a�dditi.on , what will use be? Raised ranch Mansion Duple Split level old style ,Bungalow * ACCESSORY BUILDING- Cape Cod Cottage Other car Town House " Detached garage/Mone car/ two car/ Colonial Row one car Attached garag Gar two car/CIRCLE ONE PLEASE ) .Private storageding ESTIMATED MARKET VALUE OF " Other CONSTRUCTION �_ t INFORMATION ON BUILDING SPECIFICATIONSs ON REVERSE SIDE OF THIS SHEET , To BE COMPLETEDI Form BPA 4/136 and-vl BUILDING PERMIT APPLICATION CONTINUED - e � BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . wood frame will any second-hand or ungraded lumber be used? If so , for what? no Foundation wall material concrete block Thickness Depth of foundation below grade (to bottom of footing ) 4b tAitlirlA Will there be a cellar? no heated or unheated? Floor sq. footage s ft Will there be a basement? nQ Will an q ( If sa, what por ' Y Portion be used as living space? sq. ft . - - Type of use? Type of roof - sl;7,lgxj d fat/shed/other Material of roof Fi aSs sh� nless Size , wood studs '• "' g ft . exterior walls 6 spacing 24 to len length 8 Joists ( floor beams ) lst . floor N/A "X " spacing "O . c . span N/A ft . Joists ( floor beams ) 2nd . floor s acin � Overlays (ceiling beams ) lox "" 24 '4 g ,' c . span N A ft . spacing o . c , span ITT/A ft . Roof rafters 2 It 1 " spacz��' ng 24 o . c . span 12 ft . Roof trusses (Pre-engineered) spacing 4 "o . c . span 43 ' ft .Exterior wall finish stained Of what material? 5 /800 x 4 ' x 8 ' texture 111 Interior wall finish gain s eetrock If a garage is to be attached , describe materials to be used for FIRE SEPARATION ; 1 /2 " type "X" sheetrock Is there to be an opening between garage -and dwelling? yea If so will a Fire-rated door , enclosure , and self-closing device be provided? yes Will a flue-lined chimney be installed? No Height above roof N/A ft . Depth of chimney foundation below grade N A ft . Depth of fireplace hearth N A ft . in . Water supply - Municipal or private well mun-icipal SEPTIC SYSTEM Distance from ANY private well ( including adjoining properties ft . (A separate application is necessary for an re air or new installation of septic system) See S . F. E. D. S . permit # 026252 Town of f Warren A F F 1 D A V I T STATE OF NEW YORK County of 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 . i Al SWORN To BEFORE ME THIS Signature __ Owner , o er ' s ag t cna z e ntractor - _ 5r'. day of Sy�sC 19 $ EiazABtrrH K t.Arvrrar- . a �. FiatarY Public. State of New Yolk f No. 4582007� eWaren Coty,aorary , Cluslffietl in Saratoga County Commission E)iVrm June 16, 1 i0v t ik tY Is yr Ill tt w • - nt Or 1k # It } * !r Ia tt Is Yr to .I 4" R * * w Is * R Y! * tk Is ! 9F * * �t SPECIAL CONDITIONS OF THE PERMIT : 963 Square feet living 288 Square foot garage - one stall 1224 @ $7 . 00/100'lor part of $5 , 00 One stall garage f $5 .00 CIO permit Total TOWN OF QUEENSSURY 00V x WARREN COUNTY . NEW YORK Application foss BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ,ENERGY CONSERVATION CODE A permit must be obtained before beginning work . A�iSwgR ALL of the following : 936 S . F . s. ; ' . : . 4 . Gross floor area 2 . Type of heat Baseboard electric 3 . Is the building mechanically cooled ? No 4 . percentage of area of windows and doors 15 . 9% A . Over 16 . Only 10 Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces 'YES No as Are foundation walls insulated ? 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 S . Type of insulation � . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions. R-38 U =0 026 2 . R value of exterior walls MEM R-23 . 5 U. =0 . 04+ 3 . R value of glazed area U • =0 . 20 4 . R value of doors R-14a9 50 R value of floors over unheated spaces. Xj6W N/A 6 . R value of slab edge insulation - unheated slab N/A 7 . R value of slab insulation - heated slab 12 . 5 8 . R value of heated basement/ cellar walls ( above grade ) NIA 90 R value of heated basement/ cellar walls ( below grade ) N/A 106 Type of insulation Fiberglass c . Controls 1 . Thermostat maximum heat setting Do Duct Systems N/A 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 N/A 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating 1 . Performance efficiency N/A 2 . Temperature control setting maximum G . For Swimming Pool only 1 . Maximum heating N/A Telephone No . ( 518) 899-9161 ( applicant ' s si nature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref : S . P . E .D. S . DATE _ September 23 / 87 permit # New York - 020Z525 MODEL L of E/L LOCATION OF PROPERTY FOR INSTALLATION 40 Elizabeth Lane Inc . Telephone: ( 518) 899-9161 Owner's Name: Guyer Builders , ep Address: 119 Dunning Street , Ballston Spa , New York 12020 _._Installer's Name: Guyer Builders , Inc. Telephone: ( 518) 899-9161 2 A, C , E, I , J , K, L, M Number of bedrooms (residential only) 2 3 F , G , H Total daily flow (compute Q 150 gal per bedroom) 300 Topography. circle one*. ( Flat Roiling Steep Slope 96 of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: 8 ' feet + Ground Water. At what depth? unknown 8 feet + Bedrock. or Impervious Material. At what depth? unknown feet Percolation test. circle one: not require required / rate min. inch. Domestic water supply: circle one: Municipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption N/A feet * PROPOSED SYSTEM: Septic Tank gal. (:minimum size: 1 ,000 ,gal.) TILE FIELD: Each Trench NIA feet / Total system length NIA feet * SEEPAGE PIT(S) : Number of / Size each feet by feet -` * Size of stone to be used # / Depth or Thickness feet sss * s * * * * * * s * * * s * ,Ross • s * * * * * sssss +ss * s * * asps * IMPORTANT * See S . P. E. D . S . ...Please...LLST NEW EQUIPMENT TO BE INSTALr .FTn permit & attached map , (over) Section 11 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 Z4 hours before start of construction and shall include a plot plan showing: l.) the propolsed ,location of the gystem Z.) 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, tale fields and/or drywells B. 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 $ZS0.00. 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. 1 have read the regulations above and agree to abide by the and all requirements of the Town of Quetmobury Sanitary Sewage Disposal C kNlinance. Signature of.responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792--583Z SETTLED 1763 , " HOME OF NATURAL BEAUTY ' . . A GOOD. PLACE TO LIVE ,-.Jown t.�� �ueere3r� urr�1 RUILOiNG and ZC)NING DEPARTMENT Bay and Haviland Roark. R-0. i Box 98 C?ueenslaury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION CrJ rJ �r Qr ,,11 Date � r��• Permit No . LJ G�ldr APPROVED* -* Y NO Footing/Pier Forms Foundation waterproofing Backfill Framing Roofing Siding Masonry Ven r Rough Plumbi. g Relief Valves l:xt . b�orcheS Finished Floor Interior Trim Stairs & Railing Cellar Drain Tile Concrete 'Floors plbq _ Fixtures Gar . Fireproofin Doc) r closers Smoke Detcctors Chimney INSULATION : Foundation Floors Walls c,e i 1 i ng . FINAL ELECTRICAL INSPECTION I)itIVEWAY APPROVAL Final Building Survey — Next scheduled inspection (call when ready Remarks- 13 i n (SPfor 6/86 and-vl 4t3f] 1(l54 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 'to 41 STATE STREET. ALBANY, NEW YORK 12207 Orate July .5 a 1988 Application No. on file Q 3 p 6 10 / 8 7 A d 7 e: 8 5 5 THIS CERTIFIES THAT oesly the edectricat eggssipsasent as described below ewd introduced by the njapficaat named On the abode eepplieatioss number in the premises of Guyer Builders # 40 Elizabeth Lane Quee:nsbury , New York one family dwelling in the fottorwing location, ❑ ,Basement ❑ tst Fl. ❑ and Ft. Section 12 7etock 4 tat uaA examined on f'> "2 "'$ andfound to be in compliance with the requirements of this Roerd. R%TURE wCU1S SMttTCttES FIXTURES RAP41M COOKING DECKS 11111! DISH WASHERS EXsiAUST FANS i31171ETS INCANDE'SCE►rT H11011ESCENr AMT. E. W. AMT. E. W. "I F-W- AMT. K. W. AMT, M. P. 12 26 1 $ 8 4 1 4 . 6 3 fr DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT TUNE CLOCKS 1I UNIT IlEAtERS MUSVSTE4STIJ TSET DMtIIAERS MI5 AMT. X. W. ou H- a, r>ws M. a. AMr- Ivo. A W. c. AMT- AMa. A MT. AMPS. TRANS. AMr. H. OF. NO. OF !EE t AMT. wwrrs 1 w 1 (7 1 SERVICE MSCONFIECT NO. OF 5 E R M 1 C E METER Na- of ee. I; A. W. G. No. aP rs.uec� A. W.. 3. NO. OF NEum s A. W. c- MP AMT. A - TYPE E44JIF. X a^w 1 X 3w 3 X 3W 3 X •W PER lr OF GC. CONS. OF "1. 4 OF NENTRM 1 150 ob 1 x 4 / 0 2 / 0 OTNEE AFFARwTUSe Elec . Room Heaters : 4 / 2 . 0 , 1 / 1 . 5 , 2 / . 5 1 -post light 3 -gfci i .smoke: detector Guyer Builders Inc . 119 Dunning St . 3 C� i BRAN I MANAGER SalIston Spa , x3Y 12420 # This certificate must not be altered in any manner return to the office of the Sward if incorrect. Inspectors may be identified by their credentials. UNI new = f _ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER_ Own MENT BUILDING and ZONING pEPAFtTBOM 98 Bay and Haviland Road. R.D. Queensbury. New York 12801 BUI L.DING INSPECTOR ' S REPOR.7 NAME cue 41 lce:A 46RJ S' LOCATION Date �►' / permit No . { y r1n * * * * * * * * ✓* APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Back.f ill Framing Roofing Siding Masonry Veneer Dough plumbing Relief Valves Ext . porches Finished Floors Interior Trim Stairs & Railings Cellar grain Tile Ce Floors plbg . Fixtures Gar . Fireproofin Door Closers smoke Detectors ChimneY INSULATION Foundation Floors Walls Ceiling FINAI, FIsECT a AL INSPECTION, DRIVEWAY APPR4 sry" �- Final Building rvey--�� Next scheduled insp ec [ion (call when ret�dy ) Remarks- you* Q"rr,e n A 64 rif N-T 7o t+� n pEP riU1LD��C* and ZC1N`aad, S V) . i gax 9$ Bay and Haviland New York 12801 (]ueensburY, gUS l L7it4G INsPeCTORs hiAMe LOCA' r P+�x t NO 0 �' --- AF'PRQVFD _ VS L3D Footing/pyer Forms Fo-Un da t ron W aterproo£inti3._�-----_"'���---- _- 13ac'k.f i.11 Framing Roof in9. --- S id in9 -- Masol'rl.hmn Rou�3h We Relief Va Ext . Porches F in ished Floo s In for 'Trish �- Cellar Drain T s Concre IO geyxture s l g • FireYrQ'�'fin9 or Closers D o r5 Smoke D,etccta Ch eY Soj',A, TON a Foundation Floors ylalls Zi351'EC'rI Ce it ing YCF.i f,.rtyp,Y, Ei.ECT 13RTVEWAY AF guild TVs SuT"veY -e "eadY h}ex C scheduled inspection C�li en r Ress+arke- Btu, I n9 SnsPector 1NG DEPAR"i T S;JILDING and ZON 180% 9B Bay and Hav"and ROaYo 112801 C)ueensbWY New BUILDING I NS P ECl Ow s LCICA-� ION NO VIES © Fao+c.inE3�pyer Forms Foundation Waterpro 'f in9 �gackfill �aznin�3 goof irt�3 S i<lint3 veneer Nsortr y7.umbin'3 Lr' X e f V alves Ext . Parches Finished Floors terior gram stairs & Railings Cellar S)ra`in Tile Concrete Flocars Pl'tx3 • Fixtures Gar . ._-- Door Clpsers_ - ---- � � -- gtnoke Detcctors Chimney I13 5U LATI ON Foundation Floors Walls Ce it ing CTRI AL IY3SFECTSO _r-- F IN AL EL E UR,iVS1AA3 F►PpR07VAL1��"~ Final 9ui�-dins Survey' ---�"�.�-�. -c-- ---- ~~lam h re y 1 Kexm Scheduled ,inspection (. Rena rks- t R ing nsPector 6/86 and-vl 51ow►r o ( sAeeO3 ""QE¢AR �� j3u%LDyNG and ZON1Nr' Box 98 Bay and Havitand Road. R.B Clueensbury, tfeW12$QI SEPTIC p I SPOSA%- 'SYSTEM INSPECT ION -- c.7ln. J,OC.AT ION PEPr+4IT NO . 3 a41 �-- DATE -Loam �Wo j�o ixed? YSS percolation `r seNfinflncln PercolatiorL ra TYPE of SYSTEM= total pp�oxption ffield . -Length of each Depth of trenches Siy�, of gravel x f --- SEEpAGE ft ,xX �-ft. S j-z ---~~' e e- �--- � Type Orayel Sizezea. g} c1c3 . to tank " G Tank to disc • �-- -v field/ptt NO j-al ppenin9s se p;gp,TSC�3S = ft. Y,G7CA.rxpL3 /S to t2rnk Eoundai,io absorption �--f:t. to .F oundats-o n to lot line -��f t• one ? pbsorp'�i n of pits P,,cPERYY (circle gefara'ti SYSTEM ON _ Riqht side - Xp TICS T,eft Side Front - eax gc- SYSTEM JsF Appg,OVED �' InsPecto���-- pyuilc3 ing Ol/$6 and Vl /own of Qdgeenatury BUILDING and ZONING OEpARTMENT R. Bay Queensbury Ne YorkD 96 12601 BUILDING INSPECTOR ' S REPORT NAME LOCATION _ ' Permit NO , 0 pateLa 601 * APPROVEO YES NO Footinq/pier Forms Foun da t i.o n Waterproofing Backfill Framing Roofing Siding MasonrY Veneer 1ugh Plumbing Relief Valves Ext , porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbg . F ixture s Gar . Fireproof , g ,poor Closers smoke Detecto s ChimneY INSULATION Foundation Floors Walls Ceiling RL INSPECTION��� FINAL ELECTRIC DRIVEWAY APPROV Final Building Survey Next scheduled iT'sp ection (ca3 ] when ready Remarks- � nspector Bui-1 G/B6 and-vi �i.,ieer, s � ur'� i �� �aw►'� '°� EPARTM�P1� Q l gUSLDING and d ZGso , i Box 96 lea', and liavlland S FRoa Yore, i2eoi ' 15 QU,ensbury. New BUILDING INSPEC TCIR ' S 'REPC7RYi NRl l 1-0 CATION �L� J • � � 'ter Pexmi,t No . Date a * * * * * * * * * y APPROVED FOOting�Pier F rms �=iclation WaterPr�f ing E,a cic,f i l l Framing Roof ing S iding _-- -- MasonrY Venee _---- --`" --- Rough Plumber, ----- Belief Valves f Ext - Porches Finished Floor InteriOr Trim it ing ----- Stairs & Pa •Tile Cellar Drain ---- Concrete FloorS Plbg - Fixtures Oar . Fireproofinq Door Clost=rs Smoke Detectors ChimneY I13 SU LA'T I 013 - ti FaundatiOn Floors Walls Ceiling All 114SPECTIc7lN_____-- �-- F Sl3 AL ES,,ECTR1 llR1V WAY AYPFtfI ALL SUrV� �--�- Final Ia011ding Ldext Scheduled inspec tion (call when readyl RemarkG_ Building Inspector far/8C' and-vl a �Jpwn { eteenbury of BU11LE)tNG and ZDNING , RX) , I Box 98 Bay and Havitand New Yop12801 Queensbury, C� OR ' S REPORT BUILDING lt4SP NAME LOCA-T I0r4 permit No . ,YES NO �/* * APPROVED Footing/Pier Forms DpKIInclation Waterproofing �kf ill Framing Roof ing Siding Masonry Veneer g gough �-- �- Relief Va1Ves Ext . PorcF"loor s�_-_ Finished Interior 'Trim Stairs & Railings Cellar Drain Tile ConCrete Floors Plbg - Fixtures Gar . Fireproofin for Closers Smoke Detector Chimney TN SULA'TIOL3 Troundation Floors Walls Ceiling CAL INSPECTICN1__ y FINAL ELEC, RI DRIVt Y APPROVAL Final Building survey Next scheduled insP ect3,on CCall when ready3 Resnarks- i 'peCtor gU,ild 6/$6 and-VI �OfIJ/'Z O� �fRQE'fZ .i �fli'f� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R-D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAMEu LOCAT 110N Date ! '� Permit Pao . APPROVED* -*YES * " ooting/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . 'Porches Finished Floors Interior Trim Stairs & Rat ings Cellar Drain Tile _ --- Concrete Floors plbg , Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling F114AL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey NexC schedul ins e when ready Remarks--D1 �-__-------- C _J _ I � Su lding Inspector 6/86 md-vlb BUILDING D£PT, COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. F1LE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED, P. A DATE j CITY OR Queensbury Worrell VILLAGE Queensbury TOWNSHIP COUNTY STREET AND NO, OR ROAD AND POLE NO. #40 E i 7gbeth Lane POLE NO. BETWEEN WHAT TWO CROSS STREETS IS 1 . ,{. PREMISES LOCAT£DI SECTION ,f BLOCK LOT OCCUPANTS BUILDING NAME ��,�"q� -�� t OCCUPANCY - AND ADDRESS E � ALiUderzv�lws 1 119 �. Streelt. TEL. # �� . ZLU� SUPPLIED i BY FROM THEIR OFFICE DEFECTS Is BUILDING NEW OLD ❑ VIS NEW ADDITIONAL Q REMOVE[? ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS BRAN OFFICE USE Lpca. ONLY ticn Slde Attech't H.P. Watts A.W.G. Caillny Wall RearP' t Switch Pendant Breaker Nm Typo Eeclh Na. E No. Gauge INSPECTION DaN aide Sbw Bev rnent let Fl. 2nd FI, 3rd FI. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE_ DO NOT USE THIS SPACE, This application is intended to corer the above listed equipment to he inspected but if at time of inspacti an there is found additional equipment not above listed, you are authorized to make the inspection and adjust the lee to cover the addiiiional equipment, m provided by the applicant. SIZE OF ELECTRIC SIGN TOTAL MAINS Amm 150FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF WORK ggM& In and >3!ex low CONCEALED TR ANSF ORM ERS OF VA WORK TO BE (NUMBERS (CAPACITYi STARTED CC04WLETED SIZE OF SIGN SERVICE OVERHEAD LONDERGROUND MAKER ENTERS 3= OF SIGN BUILDING INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE W I I cal I mbm moody MEW OLD AVOID OE LAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED, PRINT NAME AN D/+A,ADDRESSNAME OF �EOFy�-,�,�,.,,. .��11 7 987 APPLICANT y{. it Rht4 �lri,b�r B, Tn'r APPLICATION 'S'E'.�1t�� 4� ') "1` - STREET ADOR ESS Q Dugm-1n'g. .Street .a�+TELEPHONE # 8mom �161 (ITY POST OFFICE Bell farl'wl r ba► �T York CIOOF 12M WHEN APP(CABLE 4c UL (wev- lra51 A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING ELIZABETH LANE (C L E A N O U T ".... �r.= TC GRADE 8'-0 DIAMETER 9'-0 DEPTH QUEEN VICTORIA' S GRANT QUEENSBURY , N.Y. 2000 gol REFERENCE DRAWINGS 5 SITE UTILMES SEPTIC WATER VonDUSEN STEVES SURVEY FLAN