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1989-070 .Twwa�r- ♦ f CER'"nFICATE O. F.F . OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK This is to certify that work requested to be dome as shown by permit No. ;; a — 'I [7 has been completed. This structure may be occupied as a L*cation 14 D Day u L i d u I ) 6C C 1 e.Y�. u ! td er Owner V a l iz � � I3 L u s By Order Town Board TOWN OF QUEENSBURY (z �° Director of Bldg. & Cade Enforcement y BUILDING PERMIT H 74 TOWN OF QUEENSBURY No. WARREN COUNTY, NEW YORK z PERMISSION is hereby granted to bra ] Pni- e 3111 ; 1 ri4pbrc O OWNER of property located at 1 4 D Ra ybr i ri gs Street, Road or Ave. I in the Town of Queensbury, To Construct or place a 3g of >~nurp l�ex tv at the above location in accordance to application together with plot plans and other information hereto filed and 1 approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is 60 Sweet Road Queensbury , NmY . 12804 2. CONTRACTOR or BUILDER 'S Name C r' Same ' fi 3. CONTRACTOR or BUILDER'S Address tFJ G Same r-� 4. ARCHITECT'S Name tl) 5. ARCHITECT'S Address F� B. TYPE of Construction — (Please indicate by X) b E]d IKK Wood Frame [ ) Masonry i I Steel f ) �^G LT' F-{ 7. PLANS and Specifications F'- �:L No. 30r x 56 ' 4 of fourplex as per plot plan , specifications , t., and application , including attached one car garage . r $. Proposed Use 14 of Fourplex 0 25 . 00 c/o $ _]_ta -I nn PERMIT FEE PAID — THIS PERMIT EXPIRES (lf a longer period is required an application for an extension must be rnade to the Building and Zoning inspector of the O town of Queensbury before the expiration date_) n r Dated at the Town of Queensbury � Ray of 79$_9__._. m x SIGNED BY far the Town of Queensbury Building and ing l nspector TOWN OF QUEENSI3URY IIPPI. ICATTCIN FORRTITI.AIilG AND Z(INTNC PERMIT Ir, ' P.c cv eil Reui ed C� y � P y Fee Fa.%d 5 2 a WILDING AN❑ CODES Ul :l xAi:TP+T?.A"f Date 74.6 ued tAY and 11AS 14AND ROADS RA I BOX 98 � i0 ()UEENSBVRY0 NEIV Y0jRK 12804 PeJI NO Tot . ( 5I8 ) 792-5832 Ext 209 .i w w t 1 ae ;w w I w w w w w w al w w w a w w w w w r w Y r w r r w w A • w A PI:RmIIIr MUST B4 OBTAINED BEFORE BEGINNING CONSTRUCTIONI, NO INSPECTIONS WILL 131 AIADT: UNTIL APPLICAMT HAS RECEIVED A VALID 1UIII.DINC PCR1t1IT . All a1 ) 1 3l , Cakilc spaces on this application must be C0111pleted and the ^+ I� ll .ttare icant must appear o Of t11e ;1ltpl n tile reverie sicic of this sheet . I X k X •1' Itie owner of this ,property is : A c� �1 r u fa 57 t► e�z.,.-� A .) L 2 b 4' P. Y. . 5,? - S n f /yIF 'TAX M AP N& l / t /' -A-f JL Property location 1�cscr { ca r -o �4� llas there 1� een any split oe this property since October 1 , 198S ? Yeses no if yes , Planning Board Review is necessary . LOT NO , SUBDIVISION NAMUS IF APPLICARLE - '11he person responsikale for :: uporV1siOn of work as regards Lsuildincj Codes is : NAM1 F . O . ADtaR1 vS `Su1L �`2494"w flame of Lauildc r rx _ 6 �c Address 4 5 �° C s^�- `� flume of Plu[nL. r fYLbY�ca to P Iddress -�'1 �GI+. +°"c... 52d} . CLe -F�. - Pra.z' 'Ye1 37 Name of Mca-On fi'"! F. Yti'Z C.o .�--S i` Address 'Tc l 11 �i 14 '1TURE OF PROPO:CD WJRVI: Gt]tJIt� C: 1N101tA1h'1' iC1k+! 10rrsc4 use only ) Con ;truCtion Of a rteu buildinrl ZONING DESIGNATION Or PROPERTY AdJiGio » to a 1-)uilJi1tCI ' PERMITTED PRINCIPAL PERMTT'TED ACCESSORY �Altut + t ion to a IiUildir:g } REVIEW REQUIRED -- PLANNING BOARD 'ZONING BOARD_ tit4 Cta:a[��I .: Ct1 ♦:xL" .tr1CIC CIi[ACns' ian� ] other %' urk (a a nCriLI&. ) " SITE PLAN RtVIEW 0 APPROV4D DATE r AREA Gll' 1' !'tOL' OSCD. ; '1'ItUC '1' Utt1; VARIANCE # GROSS AR APPROVCD DATE sq f t , " Remarks : 1st Floor " r 2 nd r 1OO r sq f t , # COf"tPLUTC . l;4POf:l4xrION 1(1;f)UIUED 141:UjW . Size Of praiaurty 2. � c� i e 1i o rJ ft . Other Floora sq t t + l itliti[tc� luua l.! tr [ 7 t : ] as : u l L x IIIIIIIIr C . toot cellar or tans : [n . rtc ] t 'DOTAL FLOOR AItGA S sq ft . " Lxiatirtg t�t+ ilJin4� I:; k UMW L i4o Of new :. truct"r� a tt } s ' ft ` l•sstx,r�d:. tion-Iiior/ s1aL craw ti3rtial/ toll ' Yro,pai4d louilcting , di:; Cancc: rrou[ L.Iraal�urty sine tcirclu ont 1 ,� Front yard { ^ ' ft Rear yard 5� ft NJo of wtorlc:: (haltiC:.blo space ) � " Side yards _• tC :and �4-1 rC tluight turada to ridge: ) 22.- ft . It on Corner , ::t: tiatcic .from V6,I .snout re 1 t r0!;idL:Ar ial , no * of familiar / w OCCUPANCY IMFCICJnAT1Llf�1 tla. of roout:a ( a:xaiuding b"ch ti ) '- 110. of bucir000nr: ' " PIiIMARY fsUILDItdL` NQ. Of baCj%raQutn: One. Lai[tily dwelling i�ritrLary ltu:aGiaui �y:.' G.:u[_ /-�- a'�` A-��- -- rt "1'yrp t':�mily dw5�llinal Typ" of fu. dwelling / tiumber of units Na . of fireiSlacu» to 1uu irt :t:tlletl I1'e3n[t;.t0cnt oacupwicy Will .t I.Iciaia.l suravt;; Jj irast:.11cd? '-E '1'r:trtsivrat or:CulY;af[c y CUALZal Air cor�tli tianir[ra ? [ c i " isusinr:s tiujl_DltZ STYi-E. PRIMARY STRUCTURE . lrtdustrial �, OGYtur ltrnctt Contu+[�1 x :.rY t-{+`-� c `bin Yf .adicion , wl'aut will u :u LIU? R 11!*.ai ::4w;d r:.uiCYt ManU1. 0ttyl liplit luv%=i Clad styla_: UuaaaJalow " Lieu Cod COCt q » QC a s,�— ACL`I:SwCSLZY LIUTLDIIIG - ♦ 'C]MIIL liouEe " L)s.; Ca.Chaa CjI ACIaCxe/Gne Cµr,/ LL+t) Carp car Col ani:1l LILOW citt ( two CXRCLW ON PLEALL: ] " �1tCtcaChult tl,sratjuf IIw' Ciar car/� r w r r • r w a r . r r IN w SLOrusa kith LnCc, _ter k4s*rI. MATI1on _MARKET VA1. Ur Or r OChur C o M «'i" tt U C 't' I u 93 # yNCaOfLtR'rTritl ON pLlYLDTNC Sf�f'CII' rCATYONS , ON REVNfLSE SIDE OF 'TIIIS ctic »"r, '1't} Br. COMtPLVTC04 FaOrw BPA 20/88 v1 J r . i. BUILDING', Ijk'PMZT APPLICATION CONTINUED - BUILDING: SP CI1= ICATIONS , Type o1: Cc.r , �rtruction , wood frame , fire safe , etc . 'o Will an; -: t pond-hand or ungraded lumber be used? If so , for what ? / r} Z� Foundar ic;rL wall material v c z.s- Thickness g- " Depth of roundation below rode ( to bottom of footirtq.) rr Will tl'Oru be a cellar ? Eieated or unheated? 1142 - Floor sq . footage C:_r'� s Will thcrt � he a basement? 0 Will any portion be used as living space? -- ( If so , whal portion ? sq . ft . - - Type f use? 'Type of rc)taf sloped flat/sheet/other .Ce' .Material of roof .'712e , wc)c)�E ::: turfs ' }�' " spacing - ems- --_-+�r? Zk ,�o . c . length !s ft . Joists ( i. lt,rar teams ) lst . floor c� " x-/ e? _" spacing s"o . c . span e' .P " ft . Joists ( i is >or beams ) 2nd . floor —" "� �7 " spacing "a . c . Span �F ft . RoofOver rzA ° ( -_ CSZing beams ) _4 � spacing" o . c , span Roof r . t t _ rs Dix -" sp� cing�o . c . span ft . Rnof tr us c: s (pre-engineered) spy singZ " o . cl span ft . Exterior wail finish r o pG�y �f,7 �' Of what material ? Interior.- wa 11 finish �. [ r- t-r' ' 1 :� /.If a guracle is to e attache , escribe material to be used forF�IRF' SEPARATION : G-c.-��s uG . ' rs Is there 10 be an opening bqeween garage and al ing? If so will a lire-rated door , enclosure , and salf-closing device be provided? Will a flue- lined chimney be installed? oar Height above roof �=T e ft . Depth of chimney foundation below gr$de r ft . Depth of rireplace hearth___ ft . q in . r Water supply - Municipal or private well y�� U ry r z. 0 {� c SEPTIC :;YS`[`EM _ Distance from ANY private well ( including adjog properties _ ft . (A separ:, te application is necessyq.ry for any repair or new installation of septic system) D E C L A R A T 1 0 N 110 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, TILE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether specified orm not , and that such work is authorized by the ow . ri Signature ZZ owner, owner's ag nt , arc ritect, contipactor SPECIAL CONDITIONS OF THE PERMIT : By TOWN OF QUEENSEURY 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 *o 1 . Gross floor area / / ` r 2 . Type of heat 3 . is the building mechanically cooled. ? 4 * percentage of area of windows and doors A . Over 16 % On1Y 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 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 B . under 16 % Onlr 1 . R value of roof and floors exposed to ambient conditions. 2 . R value of exterior walls 3 . R value of glazed area rC''G 1 �► 4 . R value of doors Z S . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab Be R value of heated basement/ cellar walls ( above grade )T1 9 . R value of heated basement / cellar walls (below grade ) 1 10 . Type of insulation '�Cm Controls Controls � c� 1 . Thermostat maximum heat setting D _ Duct. Systems 1 . Is duct system installed in unheated spaces ? YES T1O 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 1. Performance efficiency 2 . 'Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating A I xeo�� Telephone No . P ( appliC nty s signature ) ` THE STATE INSURANCE FUND FILE COPY 199 CHURCH STREET, NEW YoaK4 N, Y. 10007 (212) 962-8900 CERTIFICATE OF WORKERS" COMPENSATION INSURANCE EMPLOYER CERTIFICATE HOLDER 4 PCIWCY Numisell Valente Builders inc Town of Queensbury 749 283-8 b0 Sweet Rd Attn : Dave Haden i Queensbury N Y 12804 Bay Rd 1 Queensbury , NY 12804 � UNIT PERIOD COVERED CERTIFICATE NUMBER DATE ISSUED Alb . 2 /1 /88 - 2 /1/90 1' r , 3/2 /89 �� f THIS IS TO CERTIFY THAT THE EMPLOYER NAMED ABOVE IS INSURED WITH THE STATE INSURANCE FUND UNDER THE ABOVE NUMBERED POLICY COVERING THE ENTIRE OBLIGATION OF THIS EMPLOYER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS` COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, IF SAID POLICY 1S CANCELLED OR CHANGED IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 5 DAYS WRITTEN NOTICE OF SUCH CANCELLATION OR CHANGE WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. Tsbte2 1GxA]c8 x p1S tstMkc Gcta!id�d3��c'��Li4C7rSc �`[blM�Ex�cbl�"'r1�iR�3dsd�T�YxBdzc�tSc��Y.r��+1t�c+Rfc�Fs£slk4+f rl3c i`arc'y4.�xftiaSsrifiz�]k�.�c14"�Fx THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITIO144 /6 H. JACOBS DIRECTOR INSURANCE FUND UNDERWRITING U•2e.3 ( 1977) — Y C E R T I F I C A 'T IK O F S l.I R A N C L•' DATE : 01 / 2 �3 / 89 -- ...........-................._-------- _____-------------r_____-___-__ PRODUCER -- ; THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS ; NO RIGHT UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, ; Kinner ' s Insurance Agency ; EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW ; 202 8raaduaqq ------___-------------_-- ; P .O. box 139 ; --------COMPANIES AFFORDING COVERAGE Whitehall , NY 1288] (518) 499-0456 i COMPANY A National Grange Mutual Ins . Cc 1 ; LETTER ------____ � -r------- --- ---- ------------------ ---- ----- COMPANY B ^ - A 6 INSURED LETTER ' William Martell & Gary Manell DBA ; COMPANY C t M A M Construction ; LETTER 27 Blinn St . Whitehall , N. Y . 12887 ; COMPANY D , LETTER ' COMPANY E 1 LETTER ---- COUERAGEs" -------------------------------------------------------------------------------------- --------------- - ------ -- ; THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE^POLICY-PERIOD ; INDICATED. NOTWITHSTAHDIHG ANY REQUIREMENT TERM DR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ; CERTIFICATE MAY BE ISSUED OR #SAY PERTAIN HE INSURANCE AFFORDED BY. THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ; EXCLUSIONS , MiU CONDITION: OF SUCH POLICIES . ------------- ----------------------------------- ..............------- ' POLICY ; POLICY ; EFFECTIVE. ; EXPIRATION ; tLTk ; TYPE OF INSURANCE POLICY NUMBER ; DATE ; DATE ; ALL LIMITS IN THOUSANDS ; GENERAL LIABILITY ; ; F GENERAL AGGREGATE 56om'. 06 ; A ; [A COMMERCIAL GENERAL LIABILITY a MP N35 580 ; 04/11/89 04/11/90 ; PRODUCTS-CAMP/OPS AGGREGATE 5600000 ; [ ] 14 CLAIMS" MADE (x] OCCURREI{CE PERSONAL & ADVERTISING INJURY $300000 1 ; C 3 OWNER ' S A CONTRACTORS PROTECTIVE ; ; EACH OCCURRENCE $3i*06f10 ; FIRE DAMAGE (ANY ONE FIRE) 550006 ; [ ] ; ; MEDICAL EXPEHSE (ANY ONE PERSOMIS500-0 ; AUTOMOBILE LIABILITY ' CSL S C I ANY AUTO _ . -------------- ' C I ALL OWNED AUTOS BODILY INJURY t i C ] SCHEDULED AUTOS {PER-PERSON) 5 C ] HIRED AUTOS i --------- -------------- ; C I NON-OWHED AUTOS ; ; BODILY INJURY ! C ] GARAGE LIABILITY ( ( (PER ACCIDENT) ; S ; ; ; ---- ----------- ; --_ --- - i I I ; PROPERTY DAMAGE __=_5-_ ' ------------------------------------- ; --------------------- ------ - - ---- -- -------------- ------ ^--------- «- � EXCESS LIABILITY f EACH OCCURRENCE t AGGREGATE [ ] UMBRELLA FORM 1 ; ---------------- , _______-----«---- A y C I OTHER THAN UMBRELLA $ $' : STATUTORY -- ; A ; WORKERS ' COMPENSATION WC F99 780 ; 06/21/89 06/21/90 1 ---'- ; 51N6000 ----- (EACH.ACCIDENT) ^----- EMPLOYERSNDLIABILITY $506000 (DISEASE-POLICY ]LIMIT) ; 5100000 (DISEASE-EACH EMPLOYEE) ; --- ' ----------------------- --- ------«-- ---------------- ----- h ---------- ---- -- _-_------ - - -_------ -------- OTHER ' e , Y _ _ 1 DESCRIPTION OF OPERATIONS/LOCATIOHS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER _____________________________________v== CANCELLATION =______--_____---_____-_-_____==_____==______,_____ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- Tcxwn or queensbury PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ; Bay Road ( 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Glens Falls, H.Y . I28fsi LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLTGATIOH OR LIABILITY OF ANY HIND UPON THE-COMPANY , -ITS-AGENTS^OR-REPRESENTATIVES . ; ATTN: Dane Hatian ; ---------^------------r___r____ -- Y —^-------r--_AUTHORIZJp+]/,y�)R}EPRESENTATIVE e { 1 . 0�r'-J � � .. .. .. ,. �r.��.-.�_ � � ,wmy� �.y� r •�� �.y � V-a3- aJli.. I .i w >- :. IfL ' ' • . f: ,_.Y.Ky! .: 1. �1 I ISSUE DATE (MM+UDIYY) Pfi1JDUCEI� CLti7ia'lC:x1C lS 4 .SUtD AS A +. .:-i -i is tt t.r id.C=Gi.::4:=.TiOH ONLY AND COfyFER'S . COO l_ X NtilJf2 L NG4 ACsI :N C: Y Nc NO "IU4U 15 Ur'OI': 'I + .E Gcii !`4r+CAT� r,C [-L r:. 4 rx!a Ci,r, f4riCATE Uiii ti N07 A vsLND, f=;'. l t,r.L: :.:rl ..LI ,li« Lt-. f rt._ C:>V..=4iAC:.., i c�.- =i] c.:Y Tri.i POLICIES BEFF 1 ba l WESTERN AVENUE LJr:: t .'-„vsCS r .: :i ._, . i Cor,WaNNr _ TRAVF. LF_RS INS CO fit . EiANY NY 112f8 :i + LET T-r. I y 4r•.sLar;En , lOREAUS PLUMING ?3 cl.':r 23 CANVASBACK RIDGE: _ WATER' ORD , NY 1 21 b8 --- ' -'- ------- -- - -- __ . .. . _ __— Lf: 1 i t.7 Tril5 Ij T 0 CEr4T3 FY THAT POLICIES OF $SSURAN:-,c LISTED &FLOW HAVE ULEN i ULD -(U 11 +1= II'I51,1 it:D Nr, . .::- + +t'- rOLICY PEri4u^f7414blCATED. r:.�'f`rY ti F.�. I ..rr Ui,rG ANY R��L'JrJAiica.I l:.4iY. T tl'4i.s 'L+, <.- .,.t:IT I+�+K i,.+1= .ilr V L:+...':. a +'. 4' U 1 s, +i ::L+..U ,1�1 I + i +r.� T:^. .... IiCii THIS CERTIFIOAT€ MAY U. i.: ::.3LU Op 4.r..Y AERTAi+{. Ti-lf: 113:IUx7.ANCE r,rr-.�r .bZ t.Y THE POLICIL.`.. L:i- ,:..f.l...: i-> r:._ x.�iN I:i SuDJ t-L i -1 J .->_L r e.... EACLLIS101Y;:r H"u CONDL. . r ur-i._..Uli.n^vC l- _ .. I .. .,t_.r c.ur, : L. 11I1 C Ll ,I-'oP A L.1.- LII. .ITY 1 x' r'I L : . ,.'+-Ia1NTIJr:.]' ✓r,i. k .,,'.`.rY --- 4; CtA L.AP;L IIA,-CAf HI X V,4�Oly :,.t'.iILD Liarc'r . I r x (I di X Ir.cL.rl'LtliJ 4, f :(,:. fh %; TG>i - - - --- �.. X Larh..'.0 F„Ir:.44 I noh nl f r r� ...i',`'. .I_ INJURY } (p I :,L� a41.aiJ F.Ll:GS (UT r,f UTr,f r". lrl..:v1 1 L iLCu a LI k.+LI rY LJ 5[ L1 fI. TA v.l 'I tL1 V, nlr a ltl''r. l 111r;fL1 fcf1:;, d '"Yi,:. ,.tiLrl:: L U,m I'E r,S:+, L1Or. ..a4D .,- -. _ _-.—^ lu La Li%SZIJLICY—L31_.i — t:.r..rLUfG149' LIw.731Lr7"Y 1 -- rC i SL•L.,C i1 EIAr'L'JY LEr . A c=l"v12Ok>F'wI. Y - -- 650288JU204 i �OEiJ ? 0Jt313 � ra �i / 20 / !3 '3 —` ! UESGtj 11'X'IU r{ Cii' ul'k:IiA71P}ra CILC.CIR'IE!:1`3� i OPFRA'rIONS OF INSURED a E OWN or QUL-CNSHURY SHOULD .15J J C. X+.i' Af ¢Yt Or" l rt+:. U i : C' CANCELLED EicFO iE TiR - ! ,I PLHATI:,w D T _ IHLri EOF 1IIIr l U rv.. i,�+,+4•ANY WILL ENDL AYOR T'O 4� A7l N 1) A V E. F ip17 F_ N [ ,4 mA1L 3 LA r : Y7 rrIT"]'L.M NO S lCE t ..l 1 ro r.: Ccr. fl+ rC e\7 L: HOLDER f{A[r4 k:6 TO THE 1 . ! LEFT, LUT F JLU;LL TO t.LAIL SUCK 7'!ii f li.L: ::F+..L-L- u.,rGS£ N¢ Oi3 LIGAT'EON ¢R LIPtFSiLITY ! E - r �`iii:cyIt Pi_SE1TAlVE .T4itiY � I3AY IWAC OF faYClirJ sn— • r�i QUFCN`-;DURY NY j iw Hot, v I THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 47 STATE STREET. ALBANY. NEW YORK 12207 rl Applical in 'o. nn file .^�• : 1 I �., ':i `? " �' r, s - . ,[fate , 1 [ L 3 '1 1 _ THIS CERTIFIES THAT r+ nansed on the alnooe application namber in the premiset of only the electrical egraipment as described below and in t' ; d`FL lci .1' R '. `.: . ' . 4. i::y:` '4if t 1..:',*=F r }3i,i . ' . A L Section Block 1 f+ l at in tlaejallou+inglocasiort.; ❑ Basement I—?s )st Fl• ❑ 2rLd Ff. was examined oaz and found to be in consplionce with the regnirernenta of this Board. pXTURES RANGES CAD( 1 JNG DECKS OVENS DISH WASHERS EXHAUST FANS HXTURE ACLEf FL DGIMCENT OTHER NMI.InICANPlSCEhrT K. W- NMT. K. W- AMT. K.W. AMT. K. W. AMT. }t. P. SWITCME'S OUTLETS ^ r� � � • u , T 1 r., DRYERS FURNACE MOTORS ANTURENU AAPICE FEEDERS SFEC'tAt RRC'FT TEME CLOCKS y UNtT HEATERS tY1YLTFX'NJTLET DIMMERS fTSTEINS N„�r WArra AMT. K- W. all.". P. GAB' rt, P. AMr. NG, A- W. G. AMT. AMP. AMr. AAVS- TRATtS. NMT. H. P. Rtt>.# FEET i 1 i S E R V 1 C E SERVICE DISCONNECT NO, O F F w. G. No. aF NEUTRALS A• w.c:. _ METER NCk OF CC, CflND. A. W. G. nK]. Gr NI-uEG OF M.LEG or WeLrM^L AMT. AMP- TYPE Raw. T X 2W 1 .�' TW S X 9W 8 JU' 4w PER YCaND. OTHER APPARATUS* id x BRANCH (MANAGER i n Pet $ office of the Beard if incorrect. Inspectors may be identified by their credentials. This certificate mast not be mitered in any manner, return to the MUST NOT E ALTERED 1N ANY Copy FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE B fT TOIM! Of QUERY 531 BAY ROAD QUEENSBURY , NEW YORK 12804 mqoMmlfto TELEPHONE ( SIB ) 792-5832 BUILDING 111SPECTOR`S REPOIrr FINAL INSPECTION REQUEST FOR INSPECTION RECEIVEDI +� NAME,'�L� 1 .^4'ti' ~P �. .► 4 F^J C.K`S LOCATI OMITS Lril1.3J .. __PERMITi TYPE OF STRUCIl1RE I RECHECK F FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE) OTING FOUNDATION BACKFILt ILFRAMING UGH PLMING FINAr�ELECTRICAL SEPTIC ;P[INSULATION WODDSTOVE/FIREPLACE IE PLAN/VARIX CE REQUIREMENTS YES NO REMARKS fV0 Qf'c, N/A YES WO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING f DECK/P / _. , RELIEF VALVES FURNACE/HOT WATER OPERATING BASEMENT INSULATION/DUCTWOR k INTERIOR TRIM/PRIVACY DOORS FINISH FLOORS : BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED er _ STAIR CLEARANCE/RAILINGS---� HANDICAPPED ACCESS I SMOKE DETECTORS Le BATHROOM FANS/WHO SFANS! ALL PLUMBING FIXTURES OPERATIIM GARAGE FIRE PROOFING DOOR CLOSERS _.,.. OTHER FIRE SECTION FIRE/DEMISE WALLS DUM PSTER FINAL EL I ECTRICXL OK TO ISSUE C/O 0 CNMENTS • li� �' © qb ARRIVE- a / 3P DEPART h�G] TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURYo NEW12 TELEPHONE ( 518)0RK 792- 58324 r t BUILDING INSPECTOR' S REPORT i REQUEST FOR INSPECTION RRCEIYED NAME i LOCATION DATE ERMI ! TYPE OF STRUCTURE RECHECK APPROVED N/A IYES1 NO FO TIN S/ IERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONS1 E FOR PROVIDING PROTECTION F FREEZING FOR 48 HOURS FOLLO 16 THE PLACEMENT OF THE CONCRE MATERIALS FOR THIS PURPOSE SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VEN S IN 'LAC PLUMBING UNDER SLAB FRAMING : JACK S /HEAD RS_ _ BRACING/BRIDGING _. JOIST HANGERS JACK POSTS/'MAIN BEAM HEATING ROUGH— IN INSULATION : FOUNDATION AL I TE — FOUNDATION WALLS EXTERI R— FLOORS R— WALLS R— CEILING ` DUCT WORK O PIPING IN NHEA ED SPACES R r- 51A ARRIVE. J'/% /5 DEPART INSPECTOR TOM OF QUEENSSURY FIRE MARSHAL QUEENS8URY , NEW YORK 12804 TELEPHONE ( 518) 792- 5832 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED - 1 NAME 51 LOCATION ` DATECjPERMIT#M e � �..' k 'r NtC_.2.�7 APPYES NO EXITS AISLE WID HS EXIT SIGNS EMERGENCY LIG TING FIRE EXTINGUISH S __ AUTO . EXTINGUISH GG SYSTEM- HOOD _ HOOD INSTALLATION AUTO . SPRINKLER S TEM ALARM SYSTEM INTERIOR FINISHES STORAGE : CLEARANCE TO SPRIN RS CLEARANCE TO HEATI UNITS REQUIRED SIGNAGE CHIMNEY WOODSTOVE FIREPLACE-mw-MASONRT IL FIREPLACE- FACTO TUIL REMARKS : Llool J4 ARRIVE �1 DEPART L ti INSP CTOR TOME OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY NEW12 TELEPHONE ( 518)0RK 792- 58324 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED__� 1� _ NAME_ t 1c� r�- - � ► Is LOCATION } DATE, �PERMIT _ .'S 1 70 TYPE OF STRUCTURE C RECHECK APPROVED N!A YES NO FOOTINGS/PIE S MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPO SISLE f FOR PROVIDING PROTECTI FROM FREEZING FOR 48 HOURS F LOWING THE PLACEMENT OF THE CO TE . MATERIALS FOR THIS PURPOS ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT VENTS IN PLACE PLUMBING UNDER SLAB FRAMING : JACKS D /HEADER BRA C G/BRIDGING JO T HANGERS CK POSTS/NW H M TING ROUGH- IN NSULATION : FOUNDATION WALLS E I R- FOUNDATION WALLS EKTERIO R- FLOORS R- WALLS R` CEILING R- DUCT WOR PI ING IN U HEA ED SPACES R ARRIVE DEPART INSPE OR TOWN OF QUEENSBURY E , BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2804 TELEPHONE (5I8) 792-5832 BU I LI7I NG INSPECTOR ' S REPORT REQUEST FOR/IJNS/_�PECCTION RECEIVED / i 2G NAME �. _ F/� /gr- r"-C orr. 1ze-.l LOCATION , y p µ DATE r + 7{r PERMIT # / /7o APPROVED YES NO FOOTING/PIERS, MONOLITHIC PO R FORMS FOUNDATION/D —PROOFXN B4CXPXLL Al RO AL lopeROUGH PLUMBING FRAMING ELECTRICAL ROUG —IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE /S EPS STAIRS—CLEARAN E & ILS PLUMBING FIXTU ES/R IEF VALVE INTERIOR TRIM/ RIVAC DOORS FINISHED FLOG S GARAGE FIREPR FIND DOOR CLOSERS .SMOKE DETECT S FINAL ELECTRIC L INSPECTIO FINAL APPROVAL OF CONSTRUC ON s A SIGNED CERTIFICATE OF OCCUP%NCY MUST BE OBTAINED FROM THE BUILDING DEAARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: t INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK -1 TELEPHONE ( 518 ) 792- 5832 BUILDING INSPECTOR' S REPORT q G ,r REQUEST FOR INSPECTION - NAME L[)CATION gf4( DATE ,APPROVED YES iNO (/FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/D P-PROOFING BACKFILL APPR AL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH- ,N INSULATION. ; FOUNDATION FLOORS WALLS 5 CEILING FINAL INSPECTION: '•, y;' CHIMNEY HEIGHT ROOFING ' SILTING ' EXTERNAL PORCHES, EPS -----�- STAIRS-CLEARANCE & RAIL PLUMBING FIXTUR4S/RELIEF ALIVE INTERIOR TRIM/ RIVACY DOOA9 FINISHED PLOD S GARAGE FIREP OOFING DOOR CLOSE S) SMOKE DETE TORS FINAL ELECT ICAL INSPECTION FINAL APPR VAL OF CONSTRUCTION A SIGNER CIE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ! r •^;'''y� �L REMARKS : r r I �q INSPECTOR YOU .ARE HERESY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED SY r / THE UNDERSIGNED TEMP R DAM 1r o h♦ ,�L cGI.INT"! 'fOWNeur11P ♦--�lJ #A Q (2 .C-,.�e.r CITY OR OL E F7 ' POLE NUMBER SrRE" Na OR Roan ✓ . ,y �"" L.- i { LOT B 'rS PREMISES L.00"AT'EI>•7 +.. iJ,(�, BOD N WHAT SECTION TIO 1. f�4 IT -1 J BUIL.UNG Or:I I'NGY OGC NAME C,.L^ �- �e..� S .^♦+' C � y 7 /� RO^M^E�TEELEP(H2ONExNUM _y ER"B NAME R \^ }. LI 0- '� / / E7 �l i:•�'r ©FEIGE W�JjR.I�i EP(I',I.p�E NUMBER THEIR /S CURRENT SUPPLIES 61' 'i'L/6./_ BUILDING IS N ADDITIONLN- DEFECT'S REMOVED L, OLD � WORK IS NEW LIST Ot-1 V ALL E UIPME.NT WHICH YC71.-1 INSTALLEBRANCH OFFICE USE NUMBER OF OUTLETS No. DT Fixtures & MOTORS HEATERS CIRCUITS ONLY LOca- tamp Receptatlea H.P. watts A.. - INSPECTION swe f Is ttmh Switch Pendant Bradlat Na Type Each No. £ach No- Gauge CaXiR9 OUT- SOF SUtY BASE BASE• M£NT '1st FL. 2nd FL. 3rd FL. REMARKS- LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE' THIS APPLICATION IS INTENDED To COWER THE ABOVE-t_ISTED EQUIPMENT TO BE INSPECTED, BUT IF AT TIME OF INSPECTION, THERE IS FOUND ADDITIONAL I EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDIT%ONAL FQUIPMEN7 AS PROVIDED BY THE APPLICANT. mTAL +we-rs FEEDERS ELEGrRIG SIGNSILAMPS SIZE OF MAINS l c VA � EXPOSE6 GYIi TUBE SIGNRRAN SFCJRMERS OF CHAFLI OF WORK F-1 CC . ALES 1',JaPACITY DATE GOMPLETEp SIZE OF SIGN INUMSER) DATE WORK TO BE STARTED MANUFACTU EIS OF SIGN SERVICE ENTERS BULLRING ❑ UNDERGROUND yn 44 L� OVERHEADMUST OFrE INSPECTION REQUESTED ON{OR AS NERH AS POSSIOI-E) 1©111 MBER.' l V A1FUN'1 DELAYS III IVI Q RULL AND ACCURATE WNFORMATION- A1.1L. g,, ST SE.FILL OR APPLI 710N IIMAY BE RETURNED. PRINT NAME AND ADORESS DATE OF APPLICATION -„ NAME OF APPLICANT TE PH ENO. 57RE£T ADDRESS ZI P CQDE C} B LICENSE N WHEN APPLICABLE CLTV OR POST OFF LCE Aven E] 85 John Street Cl 41 State Street ` d 584 Delaware Avenue �1 RO HE TERr N ❑ 202 Arterial Road NEW YORK, NY 10038 l ALBANY, NY 1220( 1 BUFFALO), NY 14202 FIpCHESTER, NY 14648 SYRACUSE, NY 13206 THE NEW YORK BOARD . OF FIRE UNDERWRITERS TOWN OF QUEENSBURY � BUILDING AND CODES DEPARTMENT y7 BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1290 - TELEPHONE (518 ) 792. 5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE � _i-f� PERMIT # APPROVED YES NO L,fKOOTXNG/PIERS ,MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAINING ELECTRICAL ROUGH-#IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING r" EXTERNAL PORC SISTEPS STAIRS-CLEAR CE & RAILS _.. PLUMBING FI ES/RELIEF VALVE INTERIOR T f IVACY DOORS FINISHED F RS GARAGE VI PROOFING DOOR CLOS R (S) SMOKE DET CTORS FINAL ELECT ICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION . A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS : - INSPECTOR