1987-699 i
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CERTIFICATE OF C�►CCUPAN��
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YOR`K
September 9 19 88
Date
�1 . �
'l -�q')
87 -699
This is to certify that work requested to be done as shown by Permit No.
has been completed. �� V vaml 1"y)
' j v f a. TWO i'a7rtiyY 17we L 13 g
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1 This structure may be ed an a
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I.ocatiolrt eeit Victoria :� =pant (i.(JGe« 's.:) Z3 isli:zauet i ctrt
Owner (;uve� tx� lrler���
By Order Town Board
TOWN OF QUEENSBURY
Building & 2�oYs£ng inspector
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CRE IiTIVt "IMST n'• •RlRTING GLENS �/•LLS. N Y R2E0� ll�E1S�3'Si IS
- BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87_699
CD
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Queen Victoria i s Grant (Guyer Builders Inc . )
1
OWNER of property located at 28 Elizabeth Lane Street, Road or Ave.
a
in the Town of Queensbury, To Construct or place a 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.
t . OWNER'S Address is Guyer Builders
119 Dunning St .
Ballston Spa , N . Y . 12020
2. CONTRACTOR or BUi LIDE R'S Name
Same
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3. CONTRACTOR or BUILDER 'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by XI a'
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(X) Wood Frame ( ) Masonry ( I Steel ( 1
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7_ PLANS and Specifications MODEL E m
No. 29r x 561 per plot plan , spectficatlons and application including
septic system , attached one car garage & driveway permit .
S. Proposed Use
} of Two Family Dwelling " H
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$5 . 00 C/O R
$ 96 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES �3r 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 Clueensbury before the expiration date,l ro
N
20th October 1987
Dated at the Town of Queensbury this Day of
p rr--,,77 oa
SIGNED BY Gl G Q. `+"�-� for the Town of Queensbury
Building aril Zoning Inspector
Iv UM %. UMr , .^ l"i'.L
Application No . { C U I a j k�
eieel jg"ry Permit Issued 19 i L.t
BUILDING and ZONING DEPARTMENT Permit Expires 19 L% L � CNT 2 1987
Bay and Haviland Road, R.D. 1 Box 98 zoning Designation �7
Clueensbury, New York 12801 Variance N � _ ..' r,3 lii.' r; ; aE � ~"'- t 'EP
Site P1 Review No . /? sy'r.�, ,+! Z4
Ap6pprov kw :
APPLICATION FOR J all
/
BU I W I NG AND ZONING PERMIT '° "' / �
' �
4000
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 : Guyer Builders Inc
P. O. Address 119 Dunning Street Ballston Spa , New York 12020 Tel , ( 518 ) 899-9161
Property Location : 28 Elizabeth Lane Tax Map No . 1 1 4 } 2 ,^
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 :
Ri.chaid H. Guyer III ( 518 ) 899-9161
Napes, P. O. Address Tel . No .
Name of builder Guyer Builders , Inc .Address 119 Dunning Street Tel . ( 518) 899-9161
Name of plumber GOyer FMIcterss nC .Address JL.L9 DWWUH�g Street Tel .
Name of mason yer rs , n'c •Address g ref' Tel .
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
OR DEMOLITION PERMIT , STATE SIZE AND * whether interior or corner lot . Show location
FOR
* of water supply and location and configuration
LOCATION DEMO of STRUCTURES AFFECTED.
of septic disposal area .
*
* COMPLETE INFORMATION REQUIIREDgPE .QW .
seesize of property loot plan ft X 120 ft .
* Existing buildingis) Size ft X��ft .
PROPOSED BUILDING AND USE ; Hof � * Existing buildings ) Use r N/A
Size of new situ a 29 ft X 56 ft
Foundation-pier slab crawl/Partial/full * Proposed buiiding , sdistanceoo lan property line
c role one) 1 * Front yard 30+ ft Rear yard 30+ ft
No & of stories (habitable space)
Haight ( grade to ridge) 17 ' . Q" ft , * Side yards 1 + ft and 1S+ ft
o If on corner , setback from side street ft
If residential, nov of families f 2
No* of rooms (excluding baths) y I * OCCUPANLY INFORMATION
Dios.- nf-£-brooms
P
Nq. of bathYooms * AY BUILDING
One family dwelling one
e y".r
P ry heating system se ar el ectric* ^Two family dwelling
T�e of fuel_ %k Dal
Electric ty * Multiple dwelling / Number of units
No* of fireplaces to be installed * Pew^anent occupancy
Willa wood stove be installed? � Transient occupancy
Central Air conditioning? Na
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
* Other
Ranch Contemporary Lo cabin * If addition , what will use be?
Raised ranch Mansion Duple
split level old style Bungalow
Caps 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/ cane car
r w * rr ar * * * * + * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * .Other.
CONSTRUCTION
INFORMATION ON - BUILD F.0 I TIONS . ON REVERSE SIDE OF THIS SHEET,, TO BE COMPLETED )
Form SPA 4/86 and-vl
WILDING PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe, eteo wood. frame
Will any second-hand or ungraded lumber be used? If so , for what? no
Foundation wall material concrete block Thickness 8" . , f
Depth of foundation below grade (to bottom of footing ) 4801
minimum
Will there be a cellar? no Heated or unheated? Floor sq. footage sq ft
Will there be a basement? no Will any portion be used as living space?
( If so , what por sq. ft . - - Type of use?
Type of roof - sloped lat/shed%other. Material of roof i r ass s ' ngles
Size , wood studs "SC fi " spacing 24 "o . c , length 8fto exterior walls
Joists ( floor beams ) lst . floor N/A "x to spacing- "o . c . span N/A ft .
Joists ( floor beams) 2nd . floor �•'X��" s acing1-"o . c . span N A ft.
Overlays (ceiling beams ) "x '• spacing L'► "O . c . span NI A ft.
Roof rafters 2 "x 10 is space' ng 24 o , c , span 14 ft .
Hoof trusses (,pre-engineered) spacin42+ "o . c . span 42 €t .
Exterior wall finish stained Of what material? 5/8" x 4 ' x 8 ' texture 111
Interior wall finish pa sMietrock
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 garagexnd dwelling? yes 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 Municipal
SEPTIC SYSTEM Distance from ANY private well ( including adjoining properties ft .
(A separate application is necessary for re air or new installation of septic system)
See S . P. E. D. S . � 020 t # 25H _
Town of Queensbury County of Warren AF F I D A V I T STATE OF NEW YORK
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
Owner �wxeKr N eta -- rcnlrect, contractor
�r.._�Y Qf fi, flr. ` ciC lg �"7 Notary Public. State of New York
No- 4862001 f
OUelified in Sara(c)ca-County
Wotaxy� arren County, N . Y . p t5rrl;SiDi : ExUrr«, . N 1 , ? 9 +
• • * • IF ! i Jr k _ • !. ft at * * i * It ie ! it * • tk it i. • it Or f A It * it ilr Ar Ar * tit i 7t Y. ye # M
S8'=4f%L CONDITIONS OF THE PERMIT :
12 70 -
288
Square foot ,garage - one stall
1558 @ $7 . 00/100'_'7 or part of
$5 . 00 One stall ,garage
$ S . Oo C/o permit
Total
TOWN OF QUEENSBURY •*gf
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 .
A�iSMIt.R ALL of the following =
Groom floor area. 1270 S . F.
29 Type of heat Baseboard electric
3 . Is the building mechanically cooled ? No
40 Percentage of area of windows and doors 13 . 3%
A . Over 16 • Only
1 . UQ value of gross area of walls , roof /ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
Am Are foundation walls insulated ? YES NO
1 . If YES , what is the R value ?
3 . Slab on grade YES N.p
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
H . Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions_
R-38 (u . =0 . 026)
20 R value of exterior walls gQ R-23 . 5 U. 0 . 04
3 e R value of glazed area U0 =0 • 30
4 . R value of doors R-14 . 9 01w. O . 06)
L
5 . R value of floors over unheated apaces 4/A
G . 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 ) N/A
90 R value of heated basement/ cellar walls ( below grade ) N/A
106 Type of insulation Fiberglass
C . Controls
1 . Thermostat maximum heat setting
D . Duct Systems N/A
1 . Is duct system installed in unheated spaces ? YES NO
a . If YES , R value of duct installation
b . I. 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
re Service Water Heating
1 . Performance efficiency NIA
2 . Temperature control setting maximum
G . For SwimA�mmwmmmmming Pool Only
10 Maximum heating N/A
Telephone No . ( 518) 899-9161
( applicant ' s i ture )
own of "aw6ovy
APPLICATION FOR SEPTIC DISPOSAL PERMIT
Ref : S . P . E. D . S .
DATE September 23 / 87 permit #
New York - 0202525
MODEL E of
LOCATION OF PROPERTY FOR INSTALLATION 28 Elizabeth Lane
Owner's Name: Guyer Builders , Inc . Telephones ( 518) 899-9161
Address: 119 Dunning Street , Ballston Spa. , New York 12020
Guyer Builders Inc ( 518) 899-9161
Installers Name er. ' Telephone.
2 A, C , E , 11 J , K0 L, M
,Number of bedrooms (residential only) 2 _ 3 F , G , H
Total daily flow (compute @ 150 gal per bedroom) 300
Tapoggraipby: circle one. Flat Roiling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depths $ ' feet +
Ground Water: At what depth? unknown` 8 feet +
Bedrreack or Impervious Materials At what depth? unknown feet
Percolation test: circle one: not require required / rate min. inch.
Domestic water mgWlyaw 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 N/A feet / Total system length N/A feet
* SEEPAGE PIT(S): Number of / Size each feet by feet
* Size of stone to be used # / Depth or Thickness feet
IMPORTANT * See S . P . E. D . S .
...Please...LIST NEW EQUIPMENT TO BE INSTALLED permit & attached
s * ss * * * * * * ss * ss * ss * * s * * * s * ss * * * * e * +e # sss * map .
(over)
Section II §Setic 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:
l.) the propoised .location of the gystem
2.) location and distance to lot lines
3.) location and distance to structures
4.) location and distance to any water supply
SO size and dimensions of all tanks, distribution
boxes, the 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 $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 shore and agree to abide by these and adl requirements
of the Town of Queensbury Sanitary Sewage Dispaeal Ck% in&E=e.
Signature of.responsible person:
Date:
t
Town of Queensbury
Building and Code Department
Say at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME 0F NATURAL BEAUTY A GOOD. PLACE TO L. 1VE
BUILDING and ZONING OEPARTMENT
Bay and Haviiand Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S 'REPORT
NAME
LOCAT I ON
Date./ _.._ Permit N04
APPROVED - YES/ NO
Footing/Pier Forms
Foundation '
Waterproofing
Backf i
Framing
Roofing
Siding
Masonry Verteer�
Rough. Plumbing ,,• _
Relief Valves�.^�._
Ext . Porches
Finished. Floor
Interior Trim d
Stairs & Rani g
Cellar Drain Tile
Concrete Floors
plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors;
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELEC CAL INSPECTION
DRIVEWAY PRC3VA1 .
Final Bui ng Survey
Next ache uled inspection �(cal�l when ready )
Remarks- A415D r ' 114c' GAle,
Bui ing InsP for
6/86 and-v1
4001054 THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
�ta 41 STATE STREET, ALBANY, NEW YORK 12207 Date September 16 s 1988 Application 'Va. an file 030326/87 A 7 2 7 `�• 8 3
THIS CERTIFIES THAT
arsiy the electrical egtsipment ae dsscs�ibed 6efpso and lntradescced by the apvW cone named on the abetw application number in the premtees of
Guyer Builders Inc . #28 ElIxabeth Lane Queensbury, New York 11 of two family
� g
in the following location, Basement r =r let Fl. U trnf FY t . garage
01xt 9 Ld @ Swcteaa 121 B[oclr 4 Lot
was examined an 9-2-88 and found to be in compliance with the.f F regairements of this Board.
FIXTURE ACLRS SWITCMS F17CTUR�` RANGES COOKING DECI[S OVENS DISH WASHERS EXHAUST FANS
TLETS INCANDESC1W r1.<XXMSC.EW VAPORAMT. K. W. AMT. K. W. AMT. K_W. AMT_ K. W. //AMT-
18 28 25 13 4 4 � 4 r
DRYERS FURNACE MOTORS FUTURE APPUANCE FERNRS SPEGAL REC'PT TIME CLOCKS NLL UNIT HEATERS` MIILT1.OUTM p�
AµT, K. W. OIL H. ►. OAS H. ►. AMT. NO. A. W. G. AMT. AMP. AMT. AM/$, TRANS. AMT- H, }. SYSTEMS AMT, WATTS
Wp. OF FEET
1 , Q 1
SERIYMCE WSOONNECT O OF S E R V I C E
AMT. AAV. TYPE min RI lr i ar sw 1 i .s' aW 1 s .r sW a.r nW '''o• °F�ER�,callo. of A. COND. No- or HI-LW Of.HWi'u G No. os NELITKA 5 os'I inRAt
15Cs cb L 2/0 1 /C)
OTHER APPARATus$lea . Room Heaters . 3-2 . 0 , I—I . 5 , I-1 . 25 , I-1 . 0s 3- P5
motore 3 1k
2- gfci
1-stroke detector
Guyer Builders Inc .
119 Dunning St .
BalllEton Spa . Now York 12020 239 BRANCH MANAGER
Prr
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their cretlentiols.
COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
._Jowrt o� �ueend �t�rt�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R- D. 1 Box 98
Queensbury. New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ( J � o .
LOCATIONcr�2 un / . pY �x'
DATE } / PERMIT NO.
SOIL TYPE - San - Loam - Clay - {
Percolation Test Required? YES Ncy '
Percolation rate - Min/Inch
TYPE of SYSTEM ;
Absorption fie , total length
Length of each tench
Depth of trench
Size of gravel
SEEPAGE PITS4NL r of) '—
Size- -ft. X ft .
Gravel size
PIPING ; S ze Type
Bldg . to tank
Tank to list . box �r1C
Dist . box to field/ it
rr �rI G
Openings sealed? YE NO Partial
LOCATION/SEFARAT ONS :
iFoundation to t nk ft.
Foundation to bsorption t ,
Absorption to lot line
Separation o pits f
lLOCATION OF YSTEM ON PROPERTY (cirele one )
Front ea - Left side - Right side
COMMENT
SYSTEM USE APPROVED 'yEac NO
B ildan nspector
01/86 and vl
_loavrr o/ Queen -$ " ry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R- D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION t
Date ,,, / Permit No . or i'��'
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
�am i rig
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
Chimney
INSUI,ATI ON
F undation
lours
Walls
Ce i 1 incl
FINAI, ELECTRIC INSPECTION
DRIVEWAY APPRO AL
Final Buildin Survey
Next schedul _d inspection ( call when ready )
Remarks-
- Eau dii9sector
G/86 and-vl
/ �, � �J'own o� o�ueenshurc�
f BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
Ar
NAME
LOCATION
Date, /.�2 / ' Permit No .
�_
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Roofing
Siding
Masonry Veneer
�h Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Doer Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECT ICAL INSPECTION
DRIVEWAY AP ROVAL_
Final Building Survey
Next scheduled inspection (call when ready )
Remarks- lfole-eW
rv"e7 /
Buil ing Inspector
G/8Fi and-vl
i .�J'ouin o� '�ueerr.s6esre�t
BUILDING and ZONING DEPARTMENT
Bay and Hawiland Road, R. D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTORS REPORT
NAME
LOCATION
Date l/ Permit No .
✓ = - YES
Footing/Pier Forms APPROVED N0
Foundation
Waterproofing r
Backfil. l
Framing
Roofing
Siding
Masonry Veneer
Rough. Plumbing
Relief Values
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
�ncrete Floors
Plbg . Fixtures
Gar . Fireproofs. g
Door Closers
Smoke Detect s
Chimney
INSULATION
Foundatio
Floors
Walls
Ceiling
FINAL EI CTRSCAL INSPECTI N
DRIVEWAY APPROVAL _
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks-
d 5 « 4e) 12
B 411dIng Inspect
6/86 and-vl
�osvn o� �i uc�ens � urt�
BUILDING and ZONING DEPARTMENT
Bay and Haviiand Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME /`7c
LOCAT I ON
Date �� / / Permit No . »Yyr
APPROVED - YES NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding r
Ma ry Veneer
ugh 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
Malls
Ceiling
FINAL ELECTRIC L INSPECTION
DRIVEWAY APPRO L
Final Building Survey
Next scheduled Inspection (call when ready
Remarks-
Buil ing inspector
6/86 and-vl
✓ wn O/ Queen3Erury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. I Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 4E �
LOCATION r�.'"
d
r
Date _.� zx-f- Permit No . E .
✓ = APPROVED - YES NO
Footing/Pier Forms
Foundation r7
Wato..rproofinq
%JWc'k
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 . Fireproofin
Door Closers
Smoke Detector
Chimney
INSUTL ATION
Foundation
Floors
walls
Ceiling
FINAL ELEC RICAL INSPECTION
DRIVEWAY A PROVAL
Final Building Survey
Next scheduled inspection (call when ready )
Remarks-
aw
Building Inspector
6/86 and-vl
r f r awn O/ Queerr3heerey
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D, 1 Box 98
dueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
r
LOCATION / T
❑at,9 Permit No .
✓ = APPROVED - YE NO
noting/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Vene\!�
Rough PI biRelie€ VaveExt . Porches
Finished FloInterior TriStairs & RaiCellar DrainConcrete Flo
Plbg . Fixtures
Gar . Fireproofi 06
Door Closers
Smoke Detecto s
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL E CTRICAL INSPECTION
DRIVEWA APPROVAL __,,,,
Final B lding Survey
Next scheduled inspection (call when ready )
Remarks-
Build ' Inspector
and-vl
BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW 'YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH 13UILOING DEPT. WHEN REQUIRED.
TEMP_ nY DATE
CIY OR
VITLLAGE Queenabury
TOWNSHIP QLum sbury
STREET AND NO. OR �y+.feOp � COUNTY Warrm
ROAD AND POLE ND. xR.yf IM12a ]gth
BETWEEN WHAT TWO PdLE NO.
PRES LOCCROSS ATED7
OCCUPANTS LOT
NAME BUILDING
OWNER'S NAME OCCUPANCY . .. .-'
AND ADDRESS Gayer BUIl erg, I19 DLUNLiMA f �99-91fi1
+ rPalr"t TEL. #
B P?LIED
_ FROM THEIR
BUILDING _ .
IS NEW L OLD ❑ WORK dF FICE DEFECTS
IS NEW I_+g ADDITIONAL l_I REMOVED
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No, of Fixtures B
AN
Ltod Lamp Yfaes'Ptaolas MOTORS HEATERS CIRCIj1CH7'$ OFFICE USE
Ceiling Side Attech't ONLY
Wall Racepls Switch Pondalst Braokef No, Type EHicP. No. Wells A.W.6.
Oat-
Eeelt Nn• Onwee INSPECTION
skla
Sub-
base
ft s
ment
In Fl,
2nd Pl.
a.d Fl.
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH AHOVE;
DO NOT USE THIS SPACE,
This application IS intended to cower the above-listed equipmep
V f to be inspected Wet if at time of inVisoare authorized to make the innllea;tjon and adjust the foe to to the addjtja bs ui maul, as inspection there is found additional Opuipmeltt not abawe listed,
SIZE OF 'A p Provided by the applicant.
MAINS FEEDERS ELECTRIC SIGN TOTAL
CHARACTER
LAMPS WATTS
OF WORK ' �yr3,rlw,� CONCEALED EXPED GAS TUBE SIGN
TA A NSF ORM E RS OF
WORK TO BE s yq
STkATEM COWLETED (NUMBER) (CAPAC(TYY
i WY ff rSYERHEAU SIZE OF SIGN
ENTERS UNDERGROUND MAKER
BUILDING OF SIGN
fNSPECTION REQUESTED
P iBLE NEAR AS *as.J-�l.W 7 7 call
NEW � OLD Ej
AVOID DELAY BY GIViNO FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF
APPLICANT DATE OF
APP L I CATION__ Fetsltiear
STREET ADDRESS _ l _ TELEPHONE #
CITY OR
POST OFFICE Bausta aS-Vae Neff York ZIP 12020 LICENSE NO.
CODE WHEN APPLICABLE
ae EL (REV. 1185) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
REFERENCE DRAWINGS
5 SITE UTIUTLES
SEPTIC WATER
VanDUSEN STEVES
SURVEY PLAN
ELIZABETH LANE
4s.00t
gS.Oc Q
�-SHU OFF ® 100.00 `
cr � T 1 N 1"pi
"Oui
QI I I 1
i 28
18 3� Irn
� LOT
20 LOT M ( I LOT ��'
22 I I 2 26
o
i.
27-
2 5' _17
r o� OK
L
i
� f
� N
b
110 48
r
108.55'
I I6.2.7 _
C L E A N OU T
--- TO GRADE
2000 qol
8'-0 DIAMETER
9'-0 DEPTH
QUEEN VICTORIA S GRANT
QUEENSBURY N.Y.
16, 20, 22, 2a,26, 28
ELIZABETH LANE
PLOT PLAN 4 SEPTIC SYSTEM
GUYER BUILDERS INC. QV 7
DWN ; 1 "- 20'- O