1989-064 -* .. -..x.• .z .. .. ^ , ;aY y ..,i� ' .le[+y,'w' „� . . .-r,, :yp ,G r �,ry,. m. x = ov*: .
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CERTIFICATE bF OCCUPANCY
Y
TOWN OF OUEENSBURY
WARREN COUNTY, NEW YORK
Date January 2 " i990
This is to certify that work requested to be done as shown by Permit No.
has been completed. Vt4 o P Ft? i p(4
This structure may be occupied as a ? (JIJL+Ey `
Location 7 C a
l Ly i l
'
Owner Val € nY � %3txilcic �
BY Order Town Board
TOWN OF QUEENSDURY
I t
Director of Bldg. BSc Code Enf r ement
BUILDING PERMIT
TOWN OF QUEENSBURY No. JqA - l7d 1-0
,•
WARREN COUNTY, NEW YORK �
c�
PERMISSION is hereby granted to Valente 1113 i 1c1erS a
F-
OWNER of property located at 17C Sayhl- iage Street. Road or Ave. r
I
in the Town of Queensbury, To Construct or place a z ❑ t ie �
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 , 0 WNER'S Address is
60 Sweet. Road
Queenbury , N . Y . 12804 g"
F�
ro
2. CONTRACTOR or BUILDER'S Name
P"r
M
Same
to
r•
3. CONTRACTOR or BUILDER'S Address F-
Same (
n
4. ARCHITECT'S Name
5. ARCHITECT'S Address I"
tz
6_ TYPE of Construction — (Please indicate by X) G
Hk
H
X)j wood Frame ( I Masonry t I Steel ( )
LO
ro
]. PLANS and Specifications
No. 29 ` x 42 ' 14 of Fourplex as per plot plan , specifications ,
and application including attached one car garage . A
8. Proposed Use
4 of F'ourplex 0
25 . 00 c/o
$ 219 nn PERMIT FEE PAID — THIS PERMIT EXPIRES C1ct laer 1 199S) ra
I I f a longer period is required an app Iicat ion for an extension must be made to the Build Ing and Zoning inspector of the
town of Queenshury before the expiration date.)
?C
Dated at the Town of Queensbury this 8th D y of March 19 89
SIGNED BY 4,I�.� for the Town of Queensbury
$uiiding and Zvnirvg lnspectvr
"FOV. N OF QUEENSBURY APP14TCATTON FOR BUILDrMG AND ZONTNC PERAITT
Pate-
Rev
��1 l?ec.i.e.v eel
Fee Paid
WILDING AND CODES U1 .1'AP.TPfEl. ,T Date I,a.o#xed
BAY and IIAVILAND ROA40S RU .1 Box 93
OUEENSBURY, NEIJ YORK 12804 PenmZt No
Tel . (510 ) 792--5832 Ext 204 _
A PE- 101IT MUST B4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPI3CTi6NS
t, ILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT .
All applicable spaces on this application must be completed and the
s -; 6vuature of the applicant must appear on the reverse sick of this sheet .
7l' Ic
The owner of this property iS :
PlO . Address 2C� Ce * �e J�SC � Q , a �ycirzh � s lZ TEL .
P r o per t y l o c a t i o n 4r 1 ej Ll�cu /.C• d 52.- T A]t MAP N G].� - 1---/ 1 / f
lias there been any split of this property since October 1 , 19e0l> k"
If yes , Planning Board Review is necessary . yes no
SUE3DIVISION NAME , IF APPLICABLE � LOT NOW
The person responsible for supervision of work as regards Building Codes is :
NAML _ P . O . ADDRESS d TEL . NO .
Name of builder )Jauw'&^' to c Rl} Address Qt7 ..Su.u� '1>' l � L TelWoo
-� -a ae42 • p L.<.c rr, F37%�-•( Pidd re s S b s`'- L".Qat.++ Y'�r C.t r-',--r1 `. F Tel_ ti
tdamc. of Plurnb�r=yLc, ,4 3 . . _._
Name of Masan rn ge ryX C.o� e'- - Address 2� +3uevpJ e. O ll * t. Ng Eifel -'-A C19 c ' O:z
"ATURE or I_TWPOSED bARA'. : FZONING
INFORmA`1' ION ( Ofrica use only )
.2Lronwcruccion of a new building SIGNATION OF PROPERTYa 1�uil .liiig PRINCIPAL PERMITTED ACCESSORY
( Ito clio-InQu to QXL: rior climonsionu) `� QUIRED - PLANNING BOARD ZONING BOARD
0t1+4,! r wort: SITE PLAN REVIEW # APPROVED DATE
{
GROSS ARIE A OE' PROPOSVOD STRUCTURE
# VARIANCE # APPROVED DATE
1st Floors - _sq ft . ; Remarks
2 net Floor. .5 sq f t . w COMPL1?TC I,r1E'OSQvLA'E'1ON le1:r1UIU130 UE::LU64 .
other Floors sq ft . Si. a of propurcy 2 rs Ca fe x 2 n c7 ft: .
( not cellar ar b4s +:mentl "istIng L X ft .
'DOTAL FLOOR AREA ,l! (-& sq f t . w lrxi::cing builriiny ( w I.1�i fir'
Liza Uf new structur.: _;;L`3 f t X ( 2 -ft `
E'Ouald;ation-riier/ slala/ aw parcial/ full pcopo::ed lauiluinga dlstunca: from property lino
(oirclu one ) :L Na . of Front urd .� ft Rear aird� c�'0 ft
r.torie. (Vtaljlr able
height ( tirade to rtdr� u ) space )
y ft . • Sida yard:: ..t✓� ft and y �S" rt
1f rauicl�ntial , no . of families w It on eornor , t;ut1irtLk .Groin Side: sercc:t r' c
Noo of rooter ( excluding btath4l , ' _:7 ' OCCUPANCY INFOWAATION
Ito. of La4Lmdrao1ns .3
No. of "0%roo3rt:: PRIMARY LUILDINC
mom
vriuury Iruaci trrl ::yr tam t� of » one ramilly dwelling
y kwo family dwulliny
1'Y1I�= of fu. l ram , _ {�i�tultil+la Jwullinc.1 / Number or units/
NO. of fireplacus to 134 inscallwd j
will :. wood ::Loves bu ittisL llud? r i�ertnancnt occuri:utcy
a
a * 01`r:an::ie:rtc cat�culi;ar�cy
L•untral Air cOJka!tianing : �f c $ 13u5inas5
BUILDING STYLE PRIMARY STRUCTURE lnduwtrial
1; arrcft Cont. mj c,r.,ry LGn cabin w C7ttter
i:.Aisad ranch M:ansi.c..tt Dulalux . If uddision , wl;:►t will u: [ 1�a "l
t4pLi.t Old yeylQ 1au, 4.l.alow
CWA'I.au Cod Cott;aga +Del " ACCESSORY BUILDING—
L'uiani:il lcow t'owr� He+u5e '" Wc:cached gart;cjo/one car/ two car/.Car
( CIRCLL Ohm: PLEASE ,� „Act:achod g,:arwu u/ 41a ca two Car/ l _ Wooloocuc•
• R • WWWW
+ W x ■ * It • * IN x a ■ '� ilriv" to storage bul ding .
L•: .'. TIMATED MARKi:'1' VAI. Ur: OF ' �Ochor
C O N t:'E' !t U C'1• I U t4 // d ti
INPOP41A.TTON ON BUILDING SPP.CIFTCATIONS , ON REVERSE: SID2 OF `PEITS SOtIECr, `1'O BE COMPLE"rVal
Farm FPA 10/88 Vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc .
Will any second-hand or ungraded lumber be used? If so , for what ? / 0
/ fihiThickness � t {
Foundation wall material.( {7 ,� C�sw�
e �
Depth of foundation below grade ( to bottom of footrin .� cc ,
Will there be a cellar?�I-3eated or unheated? /y42,er..�� Floor sq . £oatage �t
Will there be a basement? will any portion be used as living space? 0
[ I£ so , what portion? sq . ft . - - Type of use? --
Type of roof - slope flat/shed/other ua7 � Material of roof ' I 45'6r C"A sr
size , wood studs " x spacing " o . c . length � ft .
Joists ( floor beams ) lst . floor ��_"X spacing�,/ 6 "o . c . span / ft .
joists ( floor beams ) 2ndo floor cq,= -_"X�" spacing Z 0 O O . C . span J ft .
Overlays ( c: e .iling beams ) _---,lx ,3 11 spacing/ " o . c . span f'4/ ft .
Roof rafters " 3C spaci +ng_ & o _ o . span / £t .
Roof trusses (pre- engineered) spacings" o - c . span_ljft .
Exterior wall finish�r'yh 6� 09� Of what material? C [ 1py� f�•
Interior wall finish
If a garage is to be ate/ ached de X, _,yhe, materials tom+ be u* l for /FI SEP/ARATION :
L.c.7 L--=-� t ..f':??..y�`"'' `�/✓/�-' c�"r^—�L� chJ Sa
""- �g..i[:-.-.,I
Is thereto be an opening between d�arage and dwel3zn . � I £ so will a Fire rated
door , enclosure , and self-closing device be provided?
Will a flue-lined chimney be installed? c_, Height above of ft .
Depth of chimney foundation below gr4o � - ft -
Depth of fireplace hearth__Z ft . 4 in .
Water :supply - Municipal or private well / 91 ', AV e, �!
SEPTIC SYSTEM _ Distance from ANY private well ( inclu fig adjoining properties ft -
(A separate. application is necessary €or any repair or new installation of septic system)
G=-X r ' S -7 e .--
D E C L A R A T I O N
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.
Signature
Owner, owner's agent, architect, contractor
SPECIAL CONDITIONS OF THE PERMIT :
By._-_.............---^--------
TOWN OF QiUEENS .BURY
WARREN COUNTY , NEW YORK
Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
ANSWER ALL of the following :
1 . Gross floor area
2 . Type of heat
3 * is the building mechanically cooled ? / &7s
_ -
4 . Percentage of area of windows and doors
A . Over 16 % Only
1 . U . 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
5 . Type of insulation
B . under 16 % Only
1 . R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls � l
3 . R value of glazed area c It QZ .
4 . R value of doors
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
8 , R value of heated basement/cellar walls ( above grade ) rah . )
90 R value of heated basement/cellar walls ( below grade ) $ # 3
lO . Type of insulation ) r i
C . Controls
1 . Thermostat maximum heat setting
D . Duct Systems
1 . Is duct system installed in unheated spaces ? YES NO
a . If YES , R value of duct installation
b . R value of duct in other areas
E . Pilling 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
Telephone No . Zt7-G1
applica is signature )
THE STATE INSURANCE FUND FILE Copy
199 CHURCH STREET, NEW YORKO NL Y. 10007
(212) 962-8900
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
EMPLOYER CERTIFICATE HOLDER k POLICY NVMUEIt
Valente Builders Inc Town of Queensbury i 749 283-8
60 Sweet Rd Attn : Dave Hatien
Queensbury N Y 12804 Bay Rd
Queensbury , NY 12804
I
UNIT PERIOD COVERED CERTIFICATE NUMBER DATE ISSUED
Alb . 2/1 /88 — 2 /1 /90 U 1 =. 3/2 /89
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 YOHK.
IF SAID POLICY IS CANCELLED OR CHANGED IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 6 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. Mbthi
l�Cx]r ks X Qt8 m�clx 4d Idf�t�fc 5[yN!'x-6t fe.u"k�IS.Lk1aExRt @!3f�/�did�d�'�iC3'tisk6c>�r1rSGAk-Gcr3{C rf`x xi Lc4�G fic�F�c'Su3r�X�i�!"rri:lr,tik;2�c44'x�x
THIS CERTIFICATE DOES NOT APPLY TO BUILDINC DEMOLITION ,
/Y •.Pao
H- JACOBS
DIRECTOR INSURANCE:
i.J-25.3 ( 1977) FUND UNDERWRITING
a :.Ic;9UF DATE (M DDfYy).
PRODUCER Trll; CL i"i is"rC 7L kS 4'3UcD Az h Ai Al t h Or 1=v1-G 'trnAT1C7lJ ONLY AND CONFF= s
1 1 COOL INSURING AGF N Y INC N. .) rilCa i ! : Ur Cra 11E CLH fIF4CA r a l.,--l..c.tt. ; ral L.LkcYWICA rE UOE:i NOT AI,IElto, i
t_:�T�r.L J:.ai ..Ll L:, I'Fi.- COVEstAC:.: i:.. YVaiL.LO UY THE POLICIES BELOW.
1801 Wt_' STCF2N AV[: NUK
E".i+::+i-'. i1 .:� i•.Lyrc;.:•. .1-.;. i�:�..' COVERAGE �.
' ALOANY NY 12103
LFTFrr Fl - - TF2AVF . L. F_ Fi5 INS CO
INSURED
MOREAU:7 P L UMIJ I NG 1 LiV
23 CANVA HACK RIDGE: � :- •:.:; .,;_ '
fC
WATEFif ORD , NY J ;? 18f3
Lil 4t Fli
THIS la TO CFATIFY THAT POLICIES Or lN:.iUR LL:;! i_fl L�LUrJ rlAV E L+ikrr 1.,::U" TO I Fad. irtt:U"LLT f...,.a�.� ,-�i �: rl.:, i -! !sz !'OLICY P't3iLOO 4"jGICATED.
;.JT'sllfF,S7AN:�1r.C, ANY flLuUlai.,,.�a. l aEr7n, L.. I =�i_-a.::1"i 1GI,J 61: :.;J'a` G�v:< I = 1 r :."Crs..:ra ::+C)C Ur.�i I:T :':l i: . Ir,.:: _ :'T ifi 4�liACki THIS CEH7liFICa7F h.IAY
Li. i-:-:UC-O UrZ ,.a,..Y Pf-HTAif i. Y'rti'_ 1rLiJr 1.-.nCE ..==r,:l„Li i:U L1Y Tr;c YCa L;i:;L� Ui..:.:iir.:.:�t1 rlul . IEi `.i UiXJ�[' I ; L... ..�. ; "i ixCLu:�If3+t::. AND L'ur.ul- ,
TIOI:S Or SUCH i�OLICIES. '
I. a •:'I ri r . . . '. l,a�' f Y L!f !l l Jt kYa.JU adu r
,r> Lar,_.L LI uu 1Tv
A . j 6api? fi8 ,1 €i2f84 0fi1i" U1 / EiB 41G4e216 / Esy
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cn.YL'; Ia JL:lJ a L`JLLFYSL Fif-J_AjAO —
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r k1iS Ur%AL IfrJJri1( rr%'ONAL INJUPY 1 } tb r0 (a
a U I6 6ii1LL LJAWLITY
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ALI. v,hrwNtD JTOS filrriPRiLEH Pn THS:,iJv
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L)THFET THAN HfA lift-LA FOIirA
'.JOruCEJ-t::' COrn Ptri SA71Ofw IJ �i ..a _ .,
AND sL L. w rt Ll-I . : 11 '
Y
EIePLOYERS' LIABILITY a Ls tiL'Jt it ! YLi 'LY LII L J �l.
A "T'!f'f;ZOP ARTY 65028BJ6204 i 06 / 201b ti / 2 (o ts9
� fD I
U._:�Cr�i41'71ON OF 4YEIZATI01,1 SJLCiCFTICSf.Sr'V EI"iICLc.`.,:`,;P4 ClFtL 11i=:,1'a
OPFRAT J: ONE OF I NSURV U
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' W a -k ,i. l ,I M i 'i.. .i k •� ...I-.:.r k� I.. ....-:W.....�
TOWN OF Q11 L:I NSk3lIi2Y sHOULU ..r.Y Or THi_ :..'r:.OVL Oe-- bs i:s :iJ e. _ICILS L:1. CANCELLEDFiEF00E THE E1i-
_ FIRAT10N O: TL: T"Eli E.f7F, fr{L' f:�::U;r..� CtL,,,o�:.NY WILL ENDEAVOR TO
AT T N : UA VE' 1 !A l 1 E N f !'.I: LL 30 GAY;: W,"li 1-TEN NO-I .l:E 'I J i rrr= CEttl arrCATE HOLMcA NAMED TO THE
S 13AY ROAM Lcf-T ;�u7 �AaLU,iE TO f.IA1L SUCei IJ:?l'1c:is `:r l..LL fi.,rt.� NO OBLIGATION Of] LJARMTY �
-i OF ANY ={i,vU •''Ci it THE COMPA=y Y. r 'art 1 :: r'�rl Fi1_P!'S E:.kft7a 71VES.
QUE- F=NC�- FAURY . NY I f? ti Ql A r i , av
.- .
C E R T I F I C A T E O F S N S U R A N C E
DATE : 01 / 23 / 89
--------------- --------------------------------------------________------...............-..........____________ ___-----------_--
PRODUCER ) THIS CERTIFICATE IS ISSUER AS A MATTER OF INFORMATION ONLY AND CONFERS ;
NO RIGHT UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES HOT AMEND ;
Kinner ' s Insurance Agency t EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW ' ;
202 broadway ; ______________ _______________________________________________
P .O. Box 175 COMPANIES AFFORDING COVERAGE ;
Whitehall , NY 12887 ; _____________ _____......_............____________________________________ )
t (518) 499-0458 ; COMPANY A National Grange Mutual Ins. Co
f LETTER ;
-------------------- ---- ------ --------------- -- - ---- --- ; COMPANY 8 ;
INSURED ; LETTER
------------------------ -------- -- - - --------------------------^---- ;
William Marvell & Gary Manell DBA COMPANY C i
t M A M Construction ; LETTER ;
27 Blinn 5t . l -------- ------------------- ---_____________________________________--_-_- 1
Whitehall , N. Y . 12897 ; COMPANY D ;
LETTER
COMPANY E
LETTER ;
1 --------- COVERAGES za==- =_____________ ------ ,=a,====-___-_______________---------^ ;
- -^-------
THIS 15 TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ' >
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY HE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED L+Y. THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , i
EXCLUSIONS , AND CONDITIONS OF SUCH POLICIES. ;
---------------------------^- __- - ^------ ------------ ------------- -- -_ ___ ------ --------------------------- P
1 ; POLICY ; POLICY
; CO ; ; ; EFFECTIVE ; EXPIRATION ; ;
; LTR ; TYPE OF INSURANCE ; POLICY NUMBER p DATE DATE ALL LIMITS IN THOUSANDS ;
----_------ 1 _..._._...-.-........ 1 1 .........--------------------...............
----- '
1 --- 1 ------__..-.__ .----- .------------------ ---- --- ---
GENERAL LIABILITY ; r GENERAL AGGREGATE $600000 ;
A ( (A COMMERCIAL GENERAL LIABILITY ; MF N35 560 ; 04/11/89 04/11/90 ; PRODUCTS--COMP/UPS AGGREGATE $6004100
( ; ( 3 13 CLAIMS MADE Ixl OCCURRENCE ; ; ; t PERSONAL & ADVERTISING INJURY S300000 ;
t ; C 3 OWNER ' S F CONTRACTORS PROTECTIVE ; t ! EACH OCCURRENCE $300000 i
; ; FIRE DAMAGE (ANY ONE FIRE) 550wo
MEDICAL EXPENSE (ANY ONE PERSON) 55000
AUTOMOBILE LIABILITY ; y ;
1 1 1 F ! 1 LOL 1 S 1 1
1 3 ANY AUTO ; _ 1
1 ! 1
I I ALL UAHED AUTOS ; t ; BODILY INJURY
13 SCHEDULED AUTOS ; ; ; (PER PERSON) ; S ) ;
# ; 13 HIRED AUTOS ; A I
f ; C 3 NUN-OWNED AUTOS ; ; ; ; BODILY INJURY ; 6 (
; I I GARAGE LIABILITY k (PER ACCIDENT) ; 5 ;
_..._..._s__......-.___._.. _.-__._..r_..__.-. A
1 0 i
PROPERTY
t ; DAMAGE ; 5 ;
--- ; ------------------------------------- t --------------------- ; ---------- ; ---------- -------- ------------------------------------ ;
EXCESS LIABILITY ; t ; ; EACH OCCURRENCE AGGREGATE ;
13 UMBRELLA FORM t ; ; t ----------------- : ----------------
- ;
I I OTHER THAN UMBRELLA
t p ; STATUTORY ; ;
A ; WORKERS ' COMPENSATION Fay 780 ; 06/21/83 ; 06/?1/90 , -------------------------------------------- p
AHD ; ; 51t�c000 (EACH ACCIDENT) ;
t EMPLOYERS ' LIABILITY ; ; ; 6 ; $500000 (DISEASE-POLICY LIMIT) ;
( ; t $IOIN300 (DISEASE-EACH EMPLOYEE) ;
1 _.._ , _ 1 1 _ 1
OTHER p ;
I 1 !
1 1 1 1 1 1 1
1 1 L 1
1 1 1 A ! 1
DESCRIPTIOA OF OPERATIUHS/LOCATIUTES /tPEHICLES/SPECIAL ITEMS ;
----- CERTIFICATE HOLDER ________________________________________ CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- ;
Town of Queensbury t PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Bay Road ; 240 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Glens Falls , N . Y. 12801 ; LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR ;
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES . i
ATTN: Dave Nation ) -------------------------------------------------------^--------- ----
AUTHORIZ REPRESENTATIVE
1 A) /7A
1 _
________ _______________-----_-__--__-_-__ ------------------------------------
TOWN OF +QUEENISBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
[3UEENSBURY, NEW YORK 12809%
TELEPHONE {518 ) 792-5832
BUILDING INSPECTOR' S REPORT J/
REQUEST FOR SPECTION RECEIVED , / �7 {7 Afl
NAME
LOCATION
DA
T$ ARMxlr #
APPROVED
YES NO
FOOTINGIPIERS
MONOLITHIC PO U FORMS_
FOUNDATiPf#fDAMP PROOFING _
BACKFI-.l. 'hPPROV
ROUGH PLUMBING
FRAMING
ELECtrRICAL ROUGH- N
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
PFINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST S
STAIRS-CLEARANCE & LS
PLUMBING FIXTURES) L F VALVE !/ _. ......�
INTERIOR TRIM/PRIV Y OORS v
FINISHED FLOORS
GARAGE FIREPROOFIN
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INS TION �-� .., .........�
FINAL APPROVAL OF CO STRUCTI
A .SIGNED CERTIFICATE OF OCCUPAN MUST BE
OBTAINED FROM THE BU LDING DEPAR ENT BEFORE
THESE PREMISES ARE O CUPIED!
REMARKS :
10-43
t o 2,
INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS €' `
BUREAU OF ELECTRICITY
41 STATE STREETrAItBAMY. NEW YQRK 12207
Ian to F 17 :l F f F: '; 1eee� Application No. on fife; ,/
;^" ' r. ; 1 THIS CERTIFIES THAT F €- #• ' ! € 1 J
only the electrical equipment es deacribed below end int��` 'tFy--elie�sppliea�silcnanaed an the O&MM epplicetion n"&fther in she prom Ieea of
1 €,T TF. F; f I; P; , . F: II s Fsi II;-; .l�-y f A.
r ,
in the following locati7 ni_I- -- ` ,lflWr �}ernf. �` lat Fl. LJ' 8nd Fl. Section Black Lot
was examined an 11 "� .' and found to be in compliance with the requirements of this Board.
FIXTURE xculs FIXT%MS RANGES COOKING DOCKS OVEN
SWITCHES S DISH YYASMlRS E'XNAYST FANS
OUTLETS INCANMSCENT I FUK AESCENT OTHER AMT. R. W. AMT, K. W- AMT- K-W. AMIlT. K. W. AMT- H. Pe
> d ! ,
[MYERS FURNACE MOTORS FUTURE APtPUAN CE POWERS SPECIAL RECOPY TIME CLOCKS I &SU, UNIT HATERS mum-OUTLET C&% MRRS
SYSTEMS
C}I{ H. P, GAttS H_ P. AMY. Na. A- W. G. AMT. AMP, *,MT- AMPS, TRANS. AMT. H. P. No. OF FEET AMT, WATTS
d i T
SERVICE IxSCONNECT No. OF S E 1I V I C E
mono
AMT. AMP. TYPE EOLIIP. 1 .d 2W 1 0 3W 3 0 3W 3 0 4W MO, UR CA. CONo, of CC COF10. NO. Of HI-uE[i O W%V- GG NO. OF h1EUTAA{5 O MMAL
OTHER APPARATUS:
. T1 F' 1 . .
€ . ' . l I
BRANCH MANAGER
Per
This certificate must not be altered in any manner; return to the office of the Boord if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURye 5 YO9 128 $
TELEPHONE { 87
2-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME eeI A
LOCATION
DATE 2 PERMIT # T - -
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
nACKFILL APPROVAL
LJROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH—
INSULATION:
FOUNDATION
FLOURS
WALLS
CEILING �>
FINAL INSPECTION%
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPSSTAIRS—CLEARANCE & RAT
PLUMBING FIXTURES/RELIE V LVE --..•
INTERIOR TRIM/PRIVACY RS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPEC IONS _
FINAL APPROVAL OF CONS UCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED'
REMARKS:
INSP TOR
TOWN OF QUEENSBURY ` '
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801--
TELEPHONE (518) 792-5832
BUILDING INspECTOR ' S REPORT
REQUEST FOR INSPECTION RE'CETVEDI OLf
NAME � �t
LOCATION
DATE o -2 PERMIT # ^
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORM .
FOUNDATION/DAMP-PROOkI Nf
BACKFILL APPROVAL <
ROUGH PLUMBING t� -
PRAMING
,E EcTRICAL ROUGH-IN
INSL'1LA"1"IONx �` p
FOUNDATION
FLOORS x
WALLS
CEILING <-
FINAL INSPECTION: x�
CHIMNEY HEIGHT
ROOFING '
SIDING
EXTERNAL PORCH S/STEPS
,STAIRS-CLEARA E & RAI _
PLUMBING FIXT ES/RELIE VALVE _........�
INTERIOR TRIM PRIVACY D RS
FINISHED FLOORS
GARAGE FIREPR FIND
DOOR CLOSER (S
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QURY �
BUILDING ANTSD CODES CODES DEPARTMENT
BAY & L HAVIAND ROADS o -
QUEENSBURY, NEW YORK 2280ln
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED S
NAME !i
LOCATION z 7C
DATE _ PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL, INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCH /STEPS
STAIRS-CLEARA CE & RAIL
PLUMBING FIX URES/RELIEF ALVE
INTERIOR TR MJPRIVACY DOOfS
FINISHED F PS '
GARAGE FI PROOFING °
DOOR CLOS R (S)
SMOKE DETPCTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
- INSPECT R
1
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 22807
TELEPHONE (518) 792_5832
BUILDING INSPECTORrS REPORT
REQUEST INSPECTION RECEIVED
-- - NAME v
LOCATION y — ----- - --
r
DATE �^ PERMIT # S"
' APPROVED
YES I NO
1OTING/PIERS n�
NOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURESIRELIEF VALVE
INTERXOR TR-rX1PRIVACY DOORS
FINISHED FLOORS
GARAGE FIRha*PROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELEC9YRICAL INSPECTION
FINAL APPR VAL OF CONSTRUCTION
f
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS.—
�f
YOU ARE HEREBY REQUESTED TD
INSPECT AND ISSUE CERTIrfCATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED �f TEMP pP
f7
DALE /! � ! E„'"r
CITY OR"WtAGE 7,.rU / l>;WANBY.IIR ✓:2"'/l " COUNTY
i A ^'�-^r �- - A(OrTa'" f � °.l.t-c�` /tn+rt� If.i � '� t�L..�.�"'7/s?`tG n.✓
STREET NO. OR POLE NUMBER
BETVV /f RAL TW C7SS STREETS MISES LOCATED? SECTON + BLOCK I-Or
1 "' •yt "f I ..�
OCCUPPINTPMAME —� BUILDINGOCCUPANCY �—
ONTLER'S A NA/M�E ND ESS
L� r jot
HOME TELfE,��HIPME NUMBER . f
GUAR NT SUPPLIED BYTHE OFF! NRJRK TELEPHONE NUMBER
Aj R. C-A,..
BUILDING IS
Rime
OLD ❑ V"K IS NEW ADOMICINAL ❑ DEFECT'S REMOVED Li
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No. of Fixtures & BRANCH OFFICE USE
fion Lamp Receptacles MOTORS HEATERS CIRCUITS ONLY
tion Side Artach.t N.P. W%te R.W.G.
Coiling Wan Recep'Is SWltch Pendant SNicket No. Type Each Na. Each No. C+auge fNSPF=CnON
OUT.
SIOE
BUR-
EWSE
BASE-
MENT
1st
FL.
2nd
FL.
3rd
FL.
REMARKS: LAST CTTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED. BUT IF AT TIME OF INSPECTION, THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT, AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS ELECTRIC SIGN&LAMPS TOTAL V4NITS
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGNrURANSFORMERS OF W
L~e CONCEALED
DATE WORK TO BE STARTED GATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING �—I MANUFACTURER OF SIGN
❑ OVERHEAD u UNBERGROUND J
DATE WSPEC TION REQUESTED ON TOR AS AS NEAR POSSIBLEY % ='IFS IGJ�TIO�1 NI�BE�R. . - �/ I 614q I f I 3I.3�Cr
ID I]ELAYS BY GIVING FULL AND ACIDURATE INFORMATION. ALL SPACES MUST BE FILLIFO IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICAnoN mmoruse amp it
STREET ADDRESS T EVEPHME NCL
CITY On POST OFFICE ZIP CODE LICENSE NO, WHEN APPLICABLE
L.' 85 Jahn Street ❑ 41 State Street ❑ 584 Delaware Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK, NY 10038 ALBANY, NY 12207 I BUFFALO, NY 14202 ROCHESTER, NY 14606 1 SYRACUSE, NY 13206
THE NEW YORK BOARD OF FIRE UNDERWRITERS
TOWN OF QUEENSBURX
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12809.
TELEPHONE (518) 792-58.32
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE ERMIT #� ►
D
-. YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING _-
FRA MI NG
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
i
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURESIRELIEF VALVE
INTERIOR TRIMfPRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
.DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL' INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED ,
i
REMARKS:
lie
INSPECTOR
TOWN OF QUEENSBUR.Y
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY0 NEW YORK 12804t
TELEPHONE (518) 792- 5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME ' _ ' . ` y • — __
LOCATION
DATE /� tPERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING —
BACKFILL APPROVAL
X ROUGH PLUMBING
MING
ELECTRICAL ROUGH—IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCE & RAILS
PLUMBING FIXTUeRES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS _
FINISHED FLOORS
GARAGE FIRo&PROOFING
DOOR CLOSER (S)
SMOKE DEFECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDI
REMARKS:
INS TOR -� �'