1987-900 y ! x
CERTIFICATE OF OCCUPANCY
TOWN OF +QUEENSBURY
WARREN {COUNTY, NEW YORK
/ •� Date February 16 , 19 88
"Mis is to certify that*work requested to be clone as shown by Permit No, 87-900
has been completed.
}This structure may be occupied as a of Two Family Dwelling
l ocaticm 13 Elizabeth Lane — Queen Victoria ' s Grant
Owner Guyer Builders , Inc .
By Order Town Board
TOWN OF QUEENSBURY
Building. & Zoning inspector
BUILDING PERMIT �
TOWN OF QUEENSBURY �
No. $7--900
WARREN COUNTY, NEW YORK C>
PERMISSION is hereby granted to Queen Victoria ' s Grant
1
OWNER of property located at 13 Elizabeth Lane Street, Road or Ave. 1
in the Town of Queensbury, To Construct or place a j 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.
1 . OWNER'S Address is Guyer Builders Inc .
119 Running St .
Ballston Spa , N . Y . 12020
n
rt
2. CONTRACTOR or BUILDERS Name H
Same w
to
3. CONTRACTOR or BUILDER'S Address
Same
4, ARCHITECT'S Name
W
5. ARCHITECT'S Address rly
t�
N
N
cY
to
6. TYPE of Construction — (Please indicate by X)
(X ) wood Frame { ) Masonry I } Steel [ I
is
7. PLANS and Specifications
No. 31 ' x 46 ' -6" as per plot plan , specifications and application 'k
Including septic system and attached one car garage . MODEL J
nY
8. Proposed Use
} of Two Family Dwelling
E
O
$5 . 00 C /O w
R
$ 89 . 00 PERMIT FEE PAID — THIS PERMIT 'EXPIRES July 1 , 19 8 i
Of 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 29th Day of December 19 $7
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector XM _
/ Application No .
✓�riwPt o " Nl+��rn3#r► ber� Permit Issued 19 U
BUiLDINO and ZONING DEPARTMENT permit Expires 19 �
10
Bay and Hawiiand Road, R.D. 1 Box 98 Zoning Resignation t]
Uueensbury, New York 12801 Variance No . _ ir
Site Plan Rev o
Approved by Lyle -r-� OV
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 ise Guyer Builders Inc
P . a. Address 119 Dunning Street Ballston Spa , New York 12020 Tel . ( 518 ) 899-9161
Property Location : 13 Elizabeth Lane Tax Map No . 121 /,jeee/ 2
Street number or building lot number
subdivision name Cif applicable) Queen Victoria ' s Grant
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Richard He Gayer III ( 518) 899-9161
Name P. O. Address Tel . No .
Name of builder Guyer Builders , Inc .Address 119 Dunning Street Tel . ( 518) 899-9161
Name of plumber Guyer Buildersq, nc •AddressStreet Tel . -
Name of mason Guyer rs . nc •Address $ ree 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) setback dimensions from property lines . Give
* street and number or lot number and indicate
FOR DEMOLITION PERMI , STATE SIZE AND * whether interior or corner lot . Show location
LOCATION OF STRUCTURES AFFECTED. * of water supply and location and configuration
of septic disposal area .
*
* COMPLETE INFORMATION REQUIRED BUELL+�W .
* Size of property 100-t PIanp ft X 120 ft .
" Existing buildings ) Size ft X�—ft .
Model
PROPOSED BUILDING AND USE : of * Existing buildings ) U
Si" se NIA
of new strut a 31 ft X �t
Foundation-pier slab crawl/partial/full * Proposed building , sdiistonnctep om property line
an
castle one ) * Front yard 30+ ft Rear yard 30+ ft
No # of stories (habitable space) 1 �j+—ft and 15+ ft
Height (grade to ridge ) 19 ' -61' ft . * Side yards
If residential, noo of families of 2 * If on corner , setback from side street ft
Now of rooms (excluding baths )_ * OCCUPANCY INFORMATION
No f bedrooms
PRIMARY BUILDING -
No.. bathrooms One family dwelling Trig t e Qr
Primary heating system se r e ectric* -X'-Two family dwelling on& a �i � t}•
Type 'cif fuel Electricity _— * Multiple dwelling / Number of units
No * of fireplaces to be Installs d permanent occupancy
Will a wood stove be installed? No
Transient occupancy
Central Air conditioning? No *
* Business
BUILDING, STYLE, PRIMARY STRUCTURE Industrial
Ranch Contemporary Lo cabin * Other
Raised ranch Mansion Duple * If addition , what will use be?
Split level Old style Bungalow
Cape Cod Cottage Other * ACCESSORY SUILDING-
Colonial Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ] * _Attached garage/one car/ two car/ one car
• * • * w * w * * * * * * * * * '� Private storage building
ESTIMATED MARKET VALUE OF , ,r * 'Other
CONSTRUCTION j
INFLORMATION ON . BUILDING SPECI ICATIONSr ON REVERSE SIDE OF THIS SHEET, To BE COMPLETECII
Form SPA 4/86 and-vl
WILDING PERMIT APPLICATION CONTINUED
PUIL.DING SPECIFICATIONS :
Type of canstrtaction, 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 ) $" Fnininx=
Will there be a cellar? 'no Heated or unheated? 'Floor sq. footage sq. ft
Will there be a basement? no Will any portion be used as living space?
( If so, what por . sq. ft . - - Type of use?
Type of roof - sloped flat/shed/other Material of roof Fiberglass s cas
Size , wood studs "x 6 " spacing 24 "o . c . length 8 fte exterior walls
Joists ( floor beams ) 1st . floor N/A�six' r' spacing! r'o . c . span N/A ft .
Joists ( floor beam s ) 2nd . floor ` "x q' �� spacing : _"o . c . span N Aft .
Overlays (ceiling beams ) "x at spacing 24 "o . c . span N/A ft .
Roof rafters "X '• spacing 2�i o . c . span N/A f t .
Roof trusses (pre-engineered) spaci.n�g "o . c . span42 r 4-6Tt .
Exterior wall finish stained Of what material? 5 /$" x 4 ' x U ' texture 111
Interior wall finish pain 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 Aand dwelling? 'yes If so will a Fire-rated
door, enclosure , and self-closing device be provided? YPS
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 muuzicipal
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)
See S . P . E . D . S . permit # 0202525
Town of A F F I D A V I T STATE OF NEW YORK
eensbury
Warren County off 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 .
•'` /� � _ fie'
SWORN To BEFORE ME THIS Signature _ -- —��_--- _ -
Owner , owner ` s ag n , rcnxruect . contractor
D161 day of �'� , t l9$1 EUZA,SETH K. LANDR1f' t
Notary Publicp state of New York )
Saratoga
No. ogl
Qualifie d in Saratoga County
Notary ellub 'Warren County, commission Expires June 3.15, 192i
sr # # • ♦ * it w fr sr sr tk * Is or to * tr tit tor * tr w is tt tr tt sr * is it it * tk sr * sr sr a * >k is it Is
1123 Square feet living
240 Square foot
Sq garage one stall
1363 @ $7 . 00/ 100 ar part of
_ $5 . 00, .�.�� One stalk. garage
$5 . 00 C/O permit
Total
Ry...._________.._-.......
TOWN OF QUEENSHURY
ee�u
WARREN COUNTY . NEW YORK
Application fors BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE I .
A permit must be obtained before beginning work .
iU$WSit ALL of the following :
�. Grossfloor area 1123 S . F .
2 Type of heat Baseboard electric
3 . Is the building mechanically cooled ? NO
4 . Varcentage of area of windows and doors 1108%
A . Over 16a 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 ?
3 . Slab on grade YES N.Q
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
so Type - of insulation
a . Under 161 Only
1 . R value of roof and floors exposed to ambient conditions.
R-38
2 . R value of exterior walls sr X= R-23 . 5 U. -0wG4+ )
3 . R value of glazed area U- =O • 30
4 . R value of doors R-14 . 9 (U. =0 . 06)
5 . R value Of floors over unheated spaces 333 IX R-730
6 . R value of slab edge insulation - unheated slab NIA
7 . R value of slab insulation - heated slab 12 . 5
Q . R value of heated basement/ cellar walls ( above grade ) N A
9 . R value of heated basement /cellar walls ( below grade ) N/A
10 . Type of insulation Fiberglass
C . Controls
1 . Thermostat maximum heat setting
D . Duct Systems NIA
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
LP Service Water Keating
10 Performance efficiency NIA
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating NIA
'telephone No . ( 518) 899-9161
( applicant ' s s nature )
APPL.i.CAMON FOR SEPTIC DISPOSAL PERMIT
Ref : S . P. E. D . S .
DATE September 23 87 permit #
New York - 0202525
MODEL of
LOCATION OF PROPERTY FOR INSTALLATION 13 Elizabeth Lane
Owner's Name: Guyer Builders , Inc * Telephone% ( 518 ) 899-9161
Address. 119 purming Street , Ballston Spa , New York. 12020
Installer's Name: 'Guyer Builders , Inc Telephone: ( 518) 899-9161
2 A, C , E , i , .T , K., L, M
Number of bedrooms (residential only) 2 3 F , G , H
Total daily flow (compute Q 160 gal per bedroom) 300
Topogrtp6y: circle one: Flat Roiling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: 8 ' feet +
Ground Water: At what depth? "nkrlOwn 8 feet +
Bedrock or Imperviom Material: At what depth? unknown feet
Pes+colatiaan test: circle one: not requirelc required / rate min. inch.
Domestic water =apply: circle one: qj2nicipal) 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 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 .
...Pleause...LLST NEW X QUIP°iMENT TO BE INSTALLED permit & attached
# * s * * * * * a * s * a« * * * * ss * * s * * * s * s * * ss * * * a * * ar * map .
(over)
Section Il Se=tic System Inspectionsa
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:
1.) the propoped .location of 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, the fields and/or drywells
Be 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.
Co. 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 bawe read the regulations above and agree to abide by tLeae and all requirements
of the Tow= of Queensbury Sanitary Sewage Mapowd Ordinance.
Signature of.responsible person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEA A GOOD. PLACE TO LI VE
'Que� rzshure�t
BUILDING and ZONING DEPARTMENT
!I Bay and Haviland Road, R. D. 1 Box 98
Queensbu Y New York 12801
jo
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION r/
Q" G1i
Date f� / �? Permit NO �� Ana
/✓ APPROVED - YES NO
Footing/Pier Formms,
Foundation
waterproofing
Backfill
Framing
Roof ing
Siding
Masonry veneer
Rough Plumbing
Relief valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete floors
P ixtures
ar . Fireproof ' g
Boor Closers
Smoke Detect S
Chimney
INSULATION :
Foundation
Floors
walls
Ceiling
FINAL E ^CTRICAL INSPECTION.
DRIVEWAY APPROVAL,
Final Bui ding, Survey
Next scheduled inspectican ( call wizen ready )
Remarks--
04
guy. nspector
G/86 and-vl
4001054 z
THE NEW YORK BOARD OF FIRE UNDERWRITERS
�
`' BUREAU OF ELECTRICITY
A 41 STATE STRE ET, ALB ANY, NEW YORK 12207
Date February 26 . 1988 Application Ne. on file 002666/33 w r
THIS CERTIFIES THAT •� 055
�
only the electrical equipment as described bohno ward iwtroduced by the applicant named on the above application number in the prensisee of
Guyer }Builders Inc . P7r13 Elizabeth Lane Queenjsbury , New Vokk Rs of 169IIiDrfatnily
in the following location; ❑ Basement ❑ lot FT. ❑ 8nd Ff. Section 121 Block 4 Lot _
4' Loos examined on 2- 11 -N38 and found to be in compliance with the requirements of this Board.
FIXTURE RECIIFIXTURES RANGES COOKING DRCKS OVTrNS OISIH WASHERS EXHAiKT FANS —
OUTLETS AC.1E3 SWITCHES INCANDESCENTI FLUOMSCEHT I AMT, K. W. AMT- K. W. AMT. K.W. ANT, —KW, AMT. N. P. -.
1G ?8 24 12 4 r
DRYERS FURNACE MOTORS FUTURE APPLIANCE PEROERs SPECIAL RECt TIME CLOCKS HyL UNIT HEATERS MULTI.OUTLET CNMMERS
AMT. K. W. On W P. GAS K P. T. No. .. a. AMT- AMP. AMT- AMPS. TRANS. AMT, K P. TiaTRMS AMT, WATTS
pp NO. of III
er O 1
SERVICE O15CONNECT No. CTF S E R Y 1 C E _
AMT. AMP- I TYPE ECMI 4 .4r S'W 1 X a1v 3 A' sW 1 ] 1' IW NO. OF%CCrrQI OF C GOIJD. NO. OF 111-LEG Os'XLEGc` No. OF MUTMLS OFN W. G.IIII I
1 150 cb 1 X 2 0
OTHER APPARATUS:
Elec . Boom ;Neater : 3/2 . O , 1 / 1 . 5P 2 / 1 . 0 „ 2 / . 5
Motors : 1'g
2-gfci
1 -smoke detector
G'�'er Builders Inc .
119 bunntn,E Street BRANCH MANAGER
Ballston Spa , New York 12020
Per
This certificate must not be altered 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.
/own of Queenj " ry
1 I ' BUILDING and ZONING DEPARTMENT
! gay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date / Permit No . _ qC�'
* w * * * * * * See NO
Footing/Pier Forms _
Founda ti.on
waterproofing
Backfill
Framing
Roof In
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 ELECT CAL INSPECTION_ /
DRIvF,wAY AP ROYAL
Final Build ng Survey
Next scheduled inspection (call when ready )
Remarks-
ly
i;1nInspe for
6/86 and-vl
_Jcreun o/ Queenig"r y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. I Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION t �l !/.cl�rsrs r'cxS ,�CtTJ�tc.y 7r
DATE I .2v to PERMIT NO. / 4/,?d
SOIL TYPE - - Loam - Clay -
Percolation Test Required? YES -"=0
Percolation rate - Min/Inch
TYPE of SYSTEM :
Absorption field , total length
Length of each trench
Depth of trenches
-
Size of gravel
SEEPAGE PITS{Number of) _ 49/
Size- 6ft. X ,jL -ft .
Gravel size �+k .3
PIPING : Si a Type
Bldg . to tank �PL/c.
Tank to dirt . box �jI C.
Dist . box to fief pi Iw'C
Openings sealed? Y S NO Partial
LOCATION/SEPARATI
Foundation to t ft.
Foundation to a orpt on ft .
Absorption to t line ft.
Separation of its �G ft.
LOCATION OF STEM ON P OPERTY (circle one)
Front - Rea - Left std - Right side -
CCIKMENTS ¢ fw7[�+V �raZI/
A
Llh1 S t3 / ✓ /7 -/ ?
SYSTEM USE APPROVED 4.� S NO
B ldi Inspector
01/86 and vl
_.1vwn n� �ueens � urt�
suILDING and ZONING DEPARTMENT �C-yam
Say and Havifand Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION , }
Date :_/ Z �— Permit No .
APPROVED - YES N[3
Footing/Fier Forms
Foundation
Waterproofing
Backfili
Framing
Roo f i.ng
Siding
Masonry Veneer
Rough Plumbing_�.��_...
Relief Valves _
F:xt . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain "file
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
C:h imn ey
�13 SU LAT I ON -
Foundation
Floors
Walls
Ceiling_
FINAL EI ECTRIC L INSPECTIONS_
DRIVEWAY APPROVAL.,,_
Final Building Survey
Next scheduled inspection (call when ready }
Remarks-
Ruiidi &pe
6/86 and-vl
awn n� �ueerrsfiurt�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
Date /, Permit No . _ �V
APPROVED YES NO
Footing/Fier Forxne. _ __.,,__�
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Tough plumbing
Relief Valves
1?xt . Porches
Finished Floors
Interior Trim
Stairs & Railing
Cellar brain T ' er—
Concrete Floo —
Plbg . Fixtur
Gar . Firepro fing
Door Closer
Smoke Dete tors
chimney
I N SU LAT Ii O
Foundat0
Floors
walls
Ceiling_
FINAL EI ECTRICAL INSPECTION
DRIVEWAY APpROVAL.,.
Final Building Survey _...�
Next scheduled inspectie3n ( call when ready )
Remarks-
r /
B ld Ins ect
Fi/sG and-vl
. ,►ou�n o �ueenyctrc�
BUILDING and ZONING DEPARTMENT
Bay and Havifand Road, R.L3 , 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION
oo�l Permit Ncy . - 00
Date
* * * * * * * * * ✓* APPROVED - YES No
Footing/pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneet
Rough plumbing
Relief Valves
Ext . porches
Finished Floors
Interior Trim
Stairs & Railing
Cellar Drain Ti
Concrete Floor
plbg . Fixture
Gar . Fireproo ing
Door Closers
Smoke Detec ors
Chimney
INSULATIC)
Foundati
Floors
Walls
Ceilin
FINAL LECTRICAL INSPECTION �--
DRIVE AY APPROVAL
Final Building Survey _ --
Next scheduled insp
action (call when ready )
Remarks-
Building Inspector
6/86 and-vl
gown Of u�+ert � hurr�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.D. 1 Box 98
Queensbury, New 'Work 12801
BUILDING IINSSPECTOR ' S REPORT
DAME -. (A
LOCAT ION F •'"
Permit PIc] . �IIJ0
Date�/
APPROVED ^* YES* NO
Footing/Pier Forms
Foundat lo--
Waterproofing
Backfill
Framing
Roofing
Siding
Fl
onry Venee
gh Plumbin
ief 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 ELECT CAL INspECTION
DRIVEWAY AP ROVAL— -�—
Final Build ng Survey
Next ached led inspection call wttien ready
Remarks-
,..
Building Inspector
6/86 and-vl
own of Qeeeen ,tbury
BUILDING and .ZONING DEPARTMENT
Say and Haviiand Road, R.D. 1 Sox 98
pueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION� �/ ^ �• r
/_.cy_. Permit No . �7 �'C7
APPROVED YE NO
-
Lp6o�ting/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
siding
Masonry Venee
Rough Plumbing
Relief Valves
Ext . Porches
Finished Floors
interior Trim
Stairs & Railing
Cellar Drain T ' e
Concrete P100 _
Plbg . Fixtur
Gar . Firepr ofing
Door Close s
Smoke Det ctors
Chimney
IL3SULAT N
Foundat on
Floors
Walls
Ceiling
FINAL. ELECTRICA'I, INSPECTION _ _....,
DRIVEWAY APPROVAT -
Final Building Survey
Next scheduled inspection ( call when ready )
Remarks-
Building Inspector
6/86 and-vl
....!Dour+' o� �tteen3 +burs�
BUILDING and 2CUNING DEPARTMENT
Bay and Haviland Road, R.i?. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME _M, I/?- �
LOCATION f 3 Z'
Date 2 Permit No *
APPROVED* -* YFS* No
0F ting/Pier Forms
opundation
Waterproofing
Backfill
Framing
Roof ing
Siding
Masonry Veneer
Rough Plumbing
Relief valves
Ext . Porches
Finished. Floors
Interior "Trim
Stairs & Railing
Cellar Drain 'Ti e
Concrete Floor --
Plbg . Fixture
Gar . Firepro ing
Door Closers
Smoke Detec ors '
Chimney
INSULATION
Foundatio
Floors
Walls
Ceiling
FINAL F,L SRICAL IL3SPECTION�
DRIVEWAY A PRCIVAL
Final Bull. g Survey
Next scheduled inspection (call when ready )
Remarks-
Building inspector
6/86 and-vl
BUILDING DEPT. COPY OF APPLICATION FORM 46-ELr NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED.
TEMP 0 DATE CI an .
VILLAGE QI ' TOWNSHIP � COUNTY - .
STREET AND NO- OR #13 II"- A zabeth Lame
ROAD AND POLE NO. POLE NO.
BETWEENWHAT TWO
CROSS STREETS IS
PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANT'S BUILDING
NAME OCCUPANCY
OWNERS NAME TEL, *
AND ADDRESS BuLld@rg! � ! 119 D arit,,iM Street
CURRENT
fly - FROM THEIR - / OFFICE
SUPPLIED
BUILDING l WORK ,. - DEFECTS
k$ ? NEW OLD Q IS NEW ADDITIONAL ❑ REMOVED
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No. of Fkxtums $ BRANCH OFFICE USE
NUIi18ER OF OUTLETS Lamp Rpeptadss MOTORS HEATERS CIRCUITS ONLY
Loos
f c"' Side AtLaWt H.P. Wnfa A,W.O.
i?silin6 Wrll Rrey'Is Switch Pendent Bracket No- Type Eaah No' Each No- Oauye INSPECTION
Ode
Sub-
beM
BMa•
IlrNlf
1st Fl.
2nd Ft.
3rd FI,
R EMAR ICS! I,IST OTHER ELECTRICAL DEV ICES NOT SET FORTH ABOVE: IDO NOT USE THIS SPACE.
t
This application .s intended to cover the above-listed equipment to be inspected buI it at time of inspection there is found additional equipment not above intact,
you ara authorized to make the Inwaction and adjust the fee to cover the additional equipment, as provided tsy the applicant
SIZE Of _^ ELECTRIC SIGN TOTAL
MAINS 50 �e FEEDERS LAMPS WATTS
TUBE SIGN
OF WORK CHARACTERRICOt3lift >Illi/R.i COMC EALCC) ED ED GAS YRANTUBEJON
SFORMERS OF VA
WORK TO BE INUMSERI ICAPACITYI
STARTED COb�LETED SIZE OF SIGGN
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS OF SIGN
BUILDING
INSPECTION R@OLIESTED
ON 004 AS
POSSIBLE NEAR AS J,�,��
L R:iRi NEW OLD
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION- ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS h
NAME OF �r Bkdlxle.S$r DATE OF t i. #. � ��
APPLICANT. Q APPL 1 CA T ION y
STREET ADDRESS 119 �' Street- �T/E�rL}EPPHONE # i61
CITY OR L7�4d lst�. NowYork COD£ ��� WH£N APPENSE LICABLE
POST OFFICE _ --
36 EL (Key. 1I95) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
QUEEN VICTORIA' S GRANT
QUEENSSURY, N.Y.
CLEANOUT.�•-
TO GRADE
Q'-0 DIAMETER
6-0 DEPTH
REFERENCE DRAWINGS
5 5A SITE UTILITIES
SEPTIC � WATER
VanDUSEN g STEVES
SURVEY PLAN
13,15,17,19
ELIZABETH LANE
PLOT PLAN C SEPTIC SYSTEM
GUYER BUILDERS, INC
DWN ' *jAj q_7+-81 I Scale , I"= 20'- 0
Qv- 2