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1989-386 . r r CERTIFICATE - OF &CUPAN%C.%0IL7 01 TOWN OF QUEENSBIJRY WARREN COUNTY, NEW YORK pate August 8 lq 9!� This is to certify that work requested to be done as shown by Permit No. 89-386 has been completed. This structure may be occupied as a Single Fami 1 y Dwelling A7 IL Locadon Haney Holes - - - Owner George Gore By Girder Town Board TOWN OF QUEENSBURY Director of Bldg. & Cade Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 89-386 WARREN COUNTY, NEW YORK 1 c�n PERMISSION is hereby granted to Georfie Gore_ kc OWNER of property located at 1 nt 109 Honey Hollow Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a Single Family Dwelling at the above location in accordance to application together with plot plans and otherf information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. �zz 1 . OWNER'S Address is Y 45 helen Drive Queensbury, N . Y . 12804 ^' c x c 2. CONTRACTOR or BUILDER'S Name rn Self 3_ CONTRACTOR or BUILDERS Address Same f.. C 4. ARCHITECT'S Name r;. S. ARCHITECT'S Address C r^ r. 6. TYPE of Construction — (Please indicate by X) px XX) Wood Frame [ 1 Masonry f 1 Steel [ I p 7. PLANS and Specifications No. 89 . 4 ' x 42 ' Single family dwelling as per plot plan , specifications , and application , including septic , attached three car garage and driveway S. Proposed Use � Single Family Dwelling rr -r $ -.a9G_pp PERMIT FEE PAID - THIS PERMIT EXPIRES January 1 19 90 -~r. (If 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.) rr r' _ Dated at the Town of Queensbury this Day of _ !2une 19 89 G SIGNED BY for the Town of Queensbury Bull ing and Zoning I rf4kctor TOWN OF QUEENSBURY APPI. TCATTON r © R BUILnTNc ANT) ZO NINC, rrF.NITT vurt - s %'Cc.i.evert Fee ra i_ci • -- e BUILDING AND CODES i_ I .PART IF.Mr Va..te Ses.aued ailY and HAVILAND ROADS RD I Box 93 nuEEnsBURY . NEW YORK 1 �"1180 -J Penmit NU . Tel . ( 518 ) 792-5833 Exr 204 ! w w t t w "w ■ C ! w w w r w w ! w r r w w w ■ ■ ■ w ` w K ! . w w r ! ! ■ A 11MMIT MUST B13 OBTAINED BE17ORE BEGINNING CONSTRUCTIONR, NO INSPECTIONS 1�' ILL BE MADE UNTIL APPLICANT HAS RE- CE- IVED A VALID BL; ILI) INC PERMIT . All applicabl .: spaces on this application must be completed and the �% -inuature of the applicant mus-t appear on the reverse sick of this sheet * L - 'i' lze owner of this property is : l�f� ��" � may- --- y t' . o . Address :.f� r '.•' '1r : I �c TEL iAroperty location _ l � / '7 !, Lo H +�(7 ` TAX MAP NO ./w� �' / nas there been any split of this property since October 1 , 1988 ? yes no If yes , Planning Board Review is nerc-' essary . r SUBDIVISION NAME , IF APPLICABLE - ` .! � J . � r i ` r . LOT NO . � y - v 'i' he person responsible for supervision of work as regards Building Codes is : NAME F . G . ADDRESS TEL . NO , tiame of builder 640 e s�or+2 Address Tel s� I.ddress Tel NaMe'. of Plumber �[ r� Name of Mason o �r_ Acidross Tel r 14ATURe OF PROPOSED 4.QRK : 70NING INI 'ORPI.A.'I` ION ( Ofrlca LS40 only ) nnitruction of a nQw building ; ZONING DESIGNATION OF PROPERTY Ad..lition to a building PERMITTED PRINCIPAL. PERMITTED ACCESSORY �AlLwr"Lian to a IUilding � kto cEt�., u1..: to a:xc � rior dimanuions ) w REVIEW REQUIRED PLANNING BOARD ZONING BOARD_ i7iii4 a: inC3i is (M1J 4a.''.{w i' i"Lia: 1 S.. � i'L.f' 14 REN .i. Ee % to A P R3 ri'0 OAT" j L: ROSS AREA OL' PROPOSC: D, !L; 'rI. UL:'I' UEiE " VARIANCE # APPROVED DATE 1st Floor ri sq ft . f'rp * Remarks : nd Floor l Cofo 'T sq f t . / � co�•tir'r_c � IjNpOr:ru►'VlORN JcL( )U1lRiXp us:LAJ . Other Flours ---- sq . ft . 3ir.+a of 1srol�urty � z14 ft x doss hfc . * E:xi;itirrcj 1:�4 ils ilrI ( :: ) ji ::w !.` L: x ft . ( not cellar or bas ; ment ) a TOTAL FLOOR AREA 4/1100 .sq ft 0Exi .ti[lg boil.tiny {:: } Usv :.• i4Q of new itruCturu ; ]n4� ft 7: -66iF0UUId.acion-pier/ slab/cr:aw1/parti:al full; ' Yro1w::Cd building , di:: t:ancu from 1.rulJurty sin.: (circl.Q one ) - _ft Front yP"rd / Jam© rt (tear yard fcro S NO . of ,toriera (h:al�ic:.nlo il)aca ) tluight ( grade to ridge : ) ft ■ „ If on corner ,, 4 '� ft and1 5� is Sida yards � rback from 5idu itruuc r' c 1 f rCi �.d.:ntial , n0 . of [;am11iG5 Noa of roo4n:a ( excLudin� b:.ths OCCUPANLY INFORMATION [to, of budroomu '4 _ Roo NGlm of h:aLkarOouSiRRRRRR SIR P X)4ARY LUILDINC • ! 0 "no family dwelling Vrimary lr.:+acijvj `UYUL �rtr A"t" ftkMg. * ,1'wa f:anx.Lly dwulliny Typ" uF fuel RRR, Multil.+la: "wQlling / Number of units NO . of flru1 al .]c.::: to 1'." 1n�t.alli d = Will :a wuu.Y tilava3 b,: irtUt�,ll •r1? rJ . parimanent occupwicy Luntr.►L Air cofa.4itiunirag:* % 400 1'run: ] u[rt ra.:aula.aias y OR 13usin.:ss BUILDING STYLC, PRIMARY STRUCTURE w Tradustrial rt.arrch Contuuglwr"Rry 1,409 cabin ■ Ocher t:.ai :.aod ranch M;anai.+n flulalux . It .addition , wkt.at wi11 u::c: bu? �Islit laay. l Old scylQ la14taaj..a1QW ' 60�".. ar Cod COLC" %2 Ockwr ' ACCESSORY UUILgIHC- / 'oloni■al kaow 'I'owrr Houise AVRRRRRp y:ar.ago/one cur/ two c:ar/ _oar { CIRCL►: C*iL: PLkASE 1 CraCttad g +ria[ju/0+1.: Car/ tiro [ .rr/ .Crac' w r w w a w f t . ■ a ■ r a a a 1lriv at4z £tor"90 building L: STIMATIiD MARXroll VA1. UE OF ' Oth+= S - ._ } _ 3 jrQ3. _ - INFORMhTTON ON AUTLOINC SPrCIFTCATIQNS , ON REVERSE: SIDI: OF THIS SHEET„ 41'0 BE COMPLICTLO ( Form DPA 1018e v1 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 , fay what ? �n r Foundation wall material i "; w, r;' • Thickness Depth of foundation below grade ( to bott f footing ) r V will there be a cellar? Heated or unheateO Floor sq . footage sq ft Will there be a basement? rjgA.Will any. portion be used as living space ? Q ( If so , what por n? sq . ft . - Type of use ? Type of roof - slo ec /flat/shed/otiher'�' r2 Material of roof size , wood stud " X { spacing "o . c . length ft . «, Joists ( floor beams ) 1st . floor spacing "o . c . span/45�0 KM ft . 7} Joists ( floor beams ) 2nd . frloor X��j -" spacing"o . c$span , /-T'tt . Overlays ( ceiling beams ) � "X G ' spacing � '" o . c . span f��ft . Roof rafters gig s,pacing�-a . c . span�7??.sueft . Roof trusses (,pre-engineered) spacing.----- "o . c . span ft . Exterior wall finish r Of what material ? &5S r4A. e. er.7 Interior wall finishb4 _ If a garage is to be atta hed , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? If so will a Fire- rated door , enclosure , and self-closing device be provided" Will a flue-lined chimney be installed? Height above roof. ft . (� � Depth of chimney foundation below grade_' . Depth of fireplaceft . L' in . water supply - unicipal r private well SEPTIC SYSTEM _ ce from ANY private well { including adjoining properties i,Dit> ft . ' fA separate application is necessary for any repair or new installation of septic system ) DECLARATI0N To the best of my knowledge and belief the statements contained in this application, together with the plans and spec '. fications 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, I'HE ZONING ORDINANCE, and all other laws pertaining to the proposed work shag : be complied with, whether specified or not, and that such work is authorized by the oLvner. Signature Owner, �er's agen ar itect, contractor * r * * ► IF * SPECIAL CONDITIONS OF THE PERMIT : By. -----____------___----_- -_____---- -_ TOWN OF QUEENSHURY 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 : I. LJ 1 . Gross floor area // 7 V CC> 2 . Type of heat fa rer. a( I�o7� f7r'r ' fsCoJn 7l� JrCa Zj P✓.st y, � 3 . Is the building mechanically cooled ? ire 4 . Percentage of area of windows and doors f Ve 3 74c7 A . Over 16 % 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 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 amb4ent conditions` 2 . R value of exterior walls [ 3 . R value of glazed area 4 , R value of doors , 5 . 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 ) Al 9 . R value of heated basement /cellar walls ( below grade ) 10 . Type of insulation x 5 Co Controls 1 . Thermostat maximum heat setting $Q �' D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES NO a . If YES * LR value of duct installation b . R value of duct in other areas _ _ _ .4e. E . Piping insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation - Q F . Service Water Heating 1 . Performance efficiency 2 . Temperature control setting maximum /CI+LJ G . For Swimming Pool Only 1 . Maximum heating Telephone No . ( ' �`� o &�Lf ) ( ap is ' s s ' n ure ) WN or• UEENNS13yrY APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE ' LOCATION OF PROPERTY FOR INSTALLATION_ /34e() ,rjoj o G' . Owner's Name: Telephone: Address:—.._.._ C( 0 113f) Ft4( N cLGS _ Installer's blame: r+ = — Telephone:'/ � Number of bedrooms (residential only) q --e' Total daily flow {compute (a 150 gal per bedroom ) Topography: Circle one: at olling Steep Slope % of Slope Soil Nature: Circle one: nd Loam lay Other ko +_ /Depth : Feet Ground 'Water: At what depth? R090 Feet Bedrock or Impervious R7aterial: At what depth ? t4 Feet Percolation test: Circle one: t required r uired rate min. inch. Domestic water supply: circle on unicipal 11 Other If domestic water supply is a Separation: Water supply from septic absorption _� e�� feet PROPOSED SYSTEM: Septic Tank_ 1 X pp gal. ( minimum size: 1 . 00n gal. ) TILE FIELD : Each Trench feet/Total system length ; 3 :n:)o feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used #� /Depth or Thickness_ feet I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary S` ew} a Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: 1� DATE : r 7i' UU U OVER Septic System Inspections : A , All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submirted to the Building Department at least 24 hours before start of construction and shall include a plat plan showing : l . ) the proposed location of the system _' . ) 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 , mile fields and / or drywells B , Nu system shall be covered before inspection and approval by the l; uiiding liispc= ctor . Failure to comply with this„ requiremept may result in [ he uncovering of tha system by the installer and a fine of up to $2150 . 00 . C . An approved copy of the plot plan shall be available on the construction sire . Failure to produce said plot plan at time of inspection may rusulC in an immediate work stoppage . D . Should unforeseen problems during construction prevent proper installa- tion , alteration or repair of an approved system . a new proposal must fu submittud to the Quuunsbury Building Department 'before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queunsbury , New York 12804 litzit:srks ; , SSE DA-E +.!•.! C_ ag PRODUCER ^�S CEATIF'CA`c 5 SS�.ED AS a S1a'�ER 'OF NFr]RMA7iDN ONLY AND CONFERS N=.; R!M-rS uP;;N -"E :£R` F'CA-E ^CL:.Ea THIS CERTIFICATE DOES NOT AMEND- 4 FF ^.REED BY "HE POLICIES BELOW. 0 L e WrIf �f`i7kNCA '1 l3iJ `�r 'T RE: ! ' 1 " ? F' A �fiES Af=FC7F JihIG COVERAGE I 1 fill- fill-:: i`..i . -- INSURED -AiZ- ! -. (lI' r}IfT7V1. IIIdfi%5 `1 11Wj t ;i.3 4ll.11.) ;.i€.Ill 1=' fll -;... :: ; €•!'r" i. '•' .-'. ;4 '? D E THIS IS TO CERTIFY THAT POLICIES OF INSURANCE BE'.. N -,A . E 3E7N .SE .. EL, `•^E -:5'.:RED wAME^_ ASO`.E =OR *HE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONQI" -ih ^� =4` " -'ti'� '._4 " "� = '•acR ,:C. -!NiE�,'• N"H 'a ESPEC'- TO WHICH "HIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 8`+ uES;_,P S&` ALL `HE TERMS £%CLUSiCNS. AND CONDI- TIONS OF SUCH POLICIES. R TY P£ OF IN Si.RANCE ALI M IN GENERAL LIABILITY ! !ii'' :i :i .•' {} ,4 ,,"' �: l) �" ...fy i_% {:! � i . .�'. {? S'' / S) 3 / iit! .. . ' � () {? ,;f CONIMERCIAL G£NER L ._ A61.. Tr $ +;)4+ �1 AUTOMOBILE LIABILITY 1... E311 ;`E 's ,' ,4 � - ;� C� .:i SGHEC+JL=_'J auTOS •,BRED ;u7pj .z..."... . GARAGE _1Ae.,.T`, I x . E%CESS LIABILITY - - S $ OTHER THA% 6Pt -._'' - - •; ,I. :#. i{�, �w 11 {} WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY OTHER -- DESCRIPTION OF OPERAT'ONS! L(DCATIONS + 'dEHICLE= SHr1lr'_u DF `'"E BE CANCELLED BEFORE THE E% - ` -1ERE ,J) '+-IE SSI; •NG COMPANY WILL ENDEAVOR TO TOWN y.� €.� I'- I.:�i t..l i.:.4.#4'i �::] I.34■11-{ ^5' 'A A. I. �) .. �.�';��"FN N0 ICE '10 T"E CER?IFICATE MOLDER NAMED 70 THE " .3 {+i " 1... I ci . ��EP .1. �-r_FT -3, ` F "^- It-vR£ TO MA,L SI.+CN 'JJT'CE SMALL IMPOSE NO QBLIi'aATiON OR + , Af31�. ' r .:F ANY RIND JPON THE COMPAN '� ITS AGENTS OR REPRESENTATIVES. fat=t 't` tri, � I 3r"•5 � l: #"•. (:13+lI) i�E1"lf ,i.) ':i _ _ _.__.. {Jl-IE. FNliH III FEY INY 1. «' �, E) r� hAINL N.F.F.A. & r,,a.E.i. E(ectrtcal� erti icate ATLANTIC - INLAND, INC, NEW YORK +� ,,,�i gq" 5gb Electrical and Fire Inspec[ion-Enforcing !i Cons Wring Service 997 McLean Road. Cortland, NY 13045 ' -� DATE: CERTIFICATE NO. : OWNER: I AS APPROVED FOR: ADDRESS: . ELECTRICIAN : r. T ., ADDRESS- • :.. Fly The cnntlitiors rallo wing governetl the iss rr r.ance of this certil cafe. an any cen rti cate prev IOUSIY Issue[ is cancel led: a This cer trf ca[e only cowers the elee[NCaI equipm ern listed and rnsta labpn conditions as or Gain. UpOr the introduction of addlt,onal equipment o, alterat4on5. application s4all be promptly mace fpr irsoection. Inspectors of this Company shall have the privilege of making inspections at any !ime. And if its rues am violated. the Company Shall have the right to revoke lhie certificate. Al 27 � Ami It MAIN OFFICE ° ^ 1` ATLANTIC-INLANDo INC. 4:: 997 Mclean Rd. NEW YORIC Cortland, New York 13045 -MEMSEPrOF N.FPA,- AND IAE„1I--. PnDn6: (607) 753-7118 FIRE UNDERWRITERS //�''''�� (607) 753-13967W9 (Electrical and Fire Inspection-Enforcing and Consulting Service) C 54859 (6(}7) 753-1396 ICI"f3(Incorporated,in the State Of New York) oeelrinl} certificate of Approval, application is rnade for I)lspectlon of slectrical.instailetion in the premises described below. On demand Applicant &CIrees to pay for Inspection service in accord with schedule of charges. APPLICATION FOR ELECTRICAL INSPECTION —'PLEASE PRINT OR TYPE THIS SECTION TO BE COMPLETED BY APPLICANT DATE OPAPPLICAIMN CITY.TOWN.VILLAGE .C l +-r Dieun4nis �+?rs I ! ' Gktc~� 6 t PoLe No. + '' 6r 'G f" —• OCCUPI AS J r _k- - i RANT �' `•v' wALDING- NeW❑ Old F*—New © Acwktiouw ❑ . - SS APP.FOR =.Rot IGN mmNa4drmTuFqear3oR .READY FOR iNSP _6k .J 191 �i ,, . . { FEE REIAI'►7'ED �,e,f.'�.�-�. - BY.CHECK t] C:rtSd•l 0 MONEY B#Q `MAKE PAYABLE TaA .-1 LMMANI'llM; 0 — NEVYI YORK - -'�1 Nu~01' V19ri Oupela Flserrea :_. - Add i .< �,, .• S i"Ch #.%V Recap. • .I W � t ul . . SSO 750 1 1250 -1 sga i 2S0D 2750 3000 . Elea. Heat is _ - +� I, [3:: ...• .i +LnP.,i�lerribe ':' �' C,.. yyatir Mltr. � +�U:'.. ' ..Horner Air Cond. Surface Urm Oven Ranee � ' Gr. GialL 1 - r.,=� Dleh W. . . Dryer M.P. "P Ex. Asti' ,!. hiooa , j - - OTHER EOUNMIN 4T (Specify Typo A Ce0eci0ee) f a y `�' _ � . i TYPE OF r,. - a" OF �;^� Sty- r BRANCHES No. OF . .WIFII.NG - t r•re+r`e p _ MAIN -..A:) : = Ii�BCM�i ' C7RCUr1'�8 i 4 � � APPLICANT'S .� PERMr)',B' .yam, .r"} N"E OF ... .r' - ADDiI .$- Of sL aK. U[1LiTY ,/ L.j / ek / f �! rtnRlNo f KW.SURFACE. k EoulPMair UNn' i � SIMTCHEB .,: ,2J! AMP SORVIM KW, c>vEni copD ` r -..... ., :• .. H.P.GARBAGE 4 y L WHIT W. 340 .dli+' - .."Otwila - .-,:.y 1 is MLW. . �.e. , /- ..�OI.S.IiWASHER.,�r•/.;,!/ .y �1'JCT1iRR1[E HTJi'rFJi 4S! �'f "" 'IGW. RANOE�i Gar/ • FLUORESCENT H.P.AOR AMP. RECEPT FgMIMIES c6N ER °r S kmasicumt VAPOR OR IIMFOlN3 a Cc 4TRCH.S POA ,,.,,,�,,�rr R SMpKE FRAC, H.P. 3 OIlAR.72 FIMURES -f . •} DETECTORS VENT F MOTOAB. HP. 1/20 IM2 11to 1/4 1/e-' 1/4 1/3 1/2 3/4 i% 2 1 $ 1 S 7Nr 10 15 20 '25 30 a0 50 75 life ` MARK NUMBER - - j OF EACH Sam j - Soo 750 1000 .1250irrabo 1750 2dd5 *150 2a00 I 2750 I MO I :APPARATUS' 6 Elect. How I 1 _ 6.66 ._ ,�G INFO. Received lnspoclad 'r .� FEE PAID { - TOTAL $ ".- o DaFECTIVE } ,A 2..- .. - Q Rough Wiring CartlScera Chock No. ` . . C3 Teialiorary Service Morley Order I FINAL CERTIFICATE cash j ouP Can. Raq. 13 MUNICIPAL . Charge DOW ATTM T}alp Cut-in Card NR. Fine! Opt.-in Card No. 1 6InINPOCkrr _Jore. rs ,�� �uepna6 "I'll-DING and 3 �?� ZONING DEPARTMENT Bay and Haviland Road, R. D. i Box 98 Oueenst,urY, New York 1280t SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION "�---� DATE / J � Y/4 PERMIT No, r SOIL TYP S SandLoam ~� Percolation Tes - Clay Percolat ionRequXred ? YES - rate - MIn/Inch TYPE of SYSTEM ; Absorption field, total Ien9k Length of each trench ' Depth of trenches Size of t3ravel SEEPSize-GE ;?ITS�Nt�e f%) Gravel size PIPING : _ Bldg . to tank SizeJe Type -�-� Tank to d1st . box ';, - Distv bo-1. to field Openings sealed? Y i NO Partial LOCATI'oN/SEPARAT ONS ; Eoundaticn to t F Oundat is n to k �G _f t Absorption to SCrptlOn Separation of its of line ft . N OF STEM ON ft. Rear _ Left PROPERTY (circle one) ;-�ON5 ENTS : side - Right side - SYSTEM USE APPROVED-" YES O i Build g In J ctor 01/86 and vl TOWN OF QUBENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS OUEENSBURYr NEW YORK 128OLL. TELEPHONE (518) 792-5832 BUILDINC, INSPECTOR ' S REPORT HEpUEST FOR INSPECTION RECEIVED NAME _ LOCATION T - / u J DATEPBRmrT rT APPROVED FOOTING/PIERS YES NO MONOLITHIC FOUR FORMS FOUNDA TIO Nl DAMP-PRO[7F'ING BACKF.TLL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH. INSULATION: FOUJVLyATION ', FLOORS WALLS CEILING FINAL INSPECTION CHIMNEY HEIGHT . ROOFING SIDING EXTERNAL PORC &S/` TEPS STAIRS-CLRA NCR &\RAI r PLUMBING FI TURES TNTER201? T IM/PRIV LXEF VALVE - FINISHED RS GARAGE F EPRWFSNG DOOR CLO RR(s) SMOKE D TECTORS FINAL EL TRICAL INSP- y`- FINAL AP ROVAL OF COIVSTRUCT "_�---- 4 } A SIGNE7 CERTIFICATE OF OBTAIN9,D FROM THE OCCUPAN&Y MUS REMISES A T BE THESE P BU'TLDING DEPART MENT "PORE RE OCCUPT.&DI REMARKSIr Of I+tVSPECTOR Tol"N OF QU'EENsnuRY BUILDING AND CODES DEPA J 13AY & HAVTZAND ROADS RTMENT QUEElVSBLrRY, NEW YORK 1280S, TELEPHONE (518) ?92-58'.32 AIDING INSPECr©R ' S REPORT RE�rUEST FOfEC N, M46 TrpN R cExVFD r` rAocATxON DATE ��-- �'FRMxT AFOOT rN 3i PFRpVED MDNO�,r xT'HxC ERS YES NO FOUND 1011R FO g A TxON/DAMp_pR rNG .$AC)k7VXZ Z APPROVA Z - ~ Ro Gli PyllMBING ~ RAMxNG ELECT?22CAZ ROUGH-rN N: T E -STAxRS- L PORCIIES STEPS PL MB-I CLRAPAjxvC & RA�TL S xNTERxOR 2"R1M/R �VAyx ~` F.SN3SHED FOR GARAGE F2REFR D0OR cussER FxNG SMOKE (s): DeTE`CToms FrNA,.T E"LE'C7"RxCAL xNSF FSNAL ApPROVAZ ECTxON OF CONSTRUCT'xON A SrGNED CERTrFrcATE O$TAxNED FROM THE $ e or �CUFANcY SST 8E Tf E PREM SES DrA'C DEFART'MENr BEFO ARE OCCUPrEDr RE �^RE1�fARFS: v 6 t4 f/4 Tr4L 3 wooa, carem � it _,, G 4—SIC. 71 r4vpzc R TozvN of u $U.rrnxlVG Q EENS B UR Y ' -- DCI$ENt1RYAn 44ND RCaADSEp7MENT TErEp1YON1y� ' fs1 YORK .2249oA J 792--593x ry') BU LDZAFG INSPECT OR P S ► 1 RsfJv.�sa , NAME 1Yu^PEC?'xC)N RECErvR ZOCA2'xoly �'•.'Krir # M© px1Y►G/p2EW APP�7C1yEb zrjvxc 4'ss N© Poug"A2*roV/ RBA jtpxrz 4Ppnvo �N TRxCAZ .4R �rN �2'xoN: �'ovNraAT-rC'�N WAZZ4 /,( csxxl-Nc F 1NSP�2'xolV: a1NF y NZ 'Gsr R'�F'I'NG srrxNG SX4.z. AL PORCs s 'AxRs-cam TEpr �� Es rN�s�zraR Tex R�x..rEx GARAxiv S`r La p r 2'Rr CY booms��& �AGF' s mp } FrNAL DZ2BC Rs �'�'N4'#L Ap��"X` E .rnrsps xoN OR TO x SSU� C OF "may G+B7AINE� $R IF'tCg2'E OE THAasjg PRE�J 7'FIL^ eL7I£,LrIN U ANCY ,�17jS2� E -� s ARE OCCUP�.E' .L)b'P,,�T'MENT BEFORE Z&AJ? rsapRx : vz bRp,��n .2"Ns R'G'2'oR d xorvN aF --��........, J'ur�rNG AQ EENSBURY I _ ' CQVEs D3EP AR NSXIJRY jVD I l? 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ANT 415, ORE r P �j !y ,�t rj Uotr,DING 'QUEEI+►SBURY BAY & HAVI CODE'S DE'PA,�pTMEN2'QIIEENSBURY NIJ Rt34Ds 2"ELE'.FH0 NB (S2$ YORX 128o_* l T92-5832 BUILDING INSPECTOR ' S FORT IIZQUES27 N R IN.SPEC'TIC}N AMA zeCE'IVE� DA2"E m . �'Qf3TI11rG/PI,�2�, APP}�i trEl� MO1VQ, x.r..HIC ES So POVC&DA1 -vzo �NAMp�pR glyr Ap-pj OVA NG RAAfXIVG 2'R TCA Ty ROITGH�IN r CZILING XIMN117y �`�'EIGH2' "S-rDING S RCH S/ E ��MB'ING .fiS..Tf RE'S. & �L�-r.'"__'r..�. rslj.&R 2'RI vA IE'F i`'1"NI.SErur'L7 ,g. /tR.7"i�AC DOORSROARAG IRE RajFT D00 Sr"rQS�R SJ F'22VALLEC7'RC ORS 2aTNAL ` VA AQRxCOAIS2"R�rjc2,1 `� SIGNED C 2`HE5& NDoM 2'HRAB �rOCCUp1g1VCY Mfj.ST �. .SE'S ARE CC3P21C' -D 4PAR2'M,�N2' BEPQRE L9ii �� i ✓ ToltrIv of `"`i`""�.. sUx.r,.,D-rwC Ad QD EEIVSB UIZ Y �'�... hr.R Vx,t COD APS �pND R '9C7 Ds `Zvewr ' PIJ,E'E'N.S' R'.k", N?SzEPyONE f'S ' YO92 5632 B(Jj ITJI,NG R�r'ss7w .FOR INSPE�R ,S GRT NARE xNSPFCs^xo�r _ REC�^xVED _ ZCCCA oriojv j DA mom. PoorXArGXpX 4 POVArnA2 rO ty/D ZrR Fp Reys YE" 41VO Pr,u)v8 F'RA)txnrc x1+rc UZA xoly*, -� P'r"�RS xoN.. WAZtAs TIVAZ s O, xNc xR 5. �4 VAf`c�-t�"F r'A LV•,R Ta CA&4F I OO P7 FRS Px t 1 SEC? Fx z APP4ROV or xNSP L 3P�C7N , C'OlIr.5'�RLrC2xON 2'xONED CAR rr�Fs�°''zSDr� �-r�o1y R FREry� SCR zIRE DOCD L?EPA Rfie�1E�Z, gL�FORE �RFcs: OWN OF QUEEAFSaURY BA Y ND co'DES AR PUIs`BNSBIIRy ND R ADSRP TAM&T AVBW T�LEPNONE j � �"92- 583,80j& J3UlrazA(C z) rspc AQUEST I`OR �'NSPECTI[a�r REPO DA TR + - -.pERMt21 �C T 21yS�fF'IERS AP•pRpt,Nl] L1'T,yIC C Y QUNZDATS POUR F RMS NO ��rCz CAPP�j L RC�DF�NG PRR.M?NG L4UN440TMN NSLJ !T AD` - N: FOUNDA� 2ON PZOOI?S CETZ ROOFING CAT r STAZ-&,S�CLP�____Aa P�`MB ��RANCE RAI ING X2'U � RI LRIOR TRIM/ AC y V44vz CARAGR RD FLOORS 'FRS rR`EPROO .DOOR R CDOS'RR "7'NG SMCaNE JD f S) FINAL A-dRp V x L INSP ON O CONST,R'I7CTIO_-N-�-_. -----_- OBTA r,V,6 F.4© T1"F CA OF Tfs SR PRRM1 S A BUbI� I,G PANCY 1iZSq, OCCUI�Z&D .. ARTMENT "BEPORR 46 a dor NSPE'CTOR T0i9N OF QUEENS}3URY auxrnrNG AND Cons n �, rr -Nr lY & &AVX Xtr �ADS �r .PUE1iNSATJI7Y, �r YDlgx 126OtTi TE p,SGNE (516) 792- gg32 BUILDING rNSPE �vssT �oR � S REPORT xNspcTra NA.niZ �►'' ,�zscsxrr,�v 3_ �A2'-i'aN DATE 9 TxNG/�°xERS APPRV7G".u�n MoAV0ZX2'NIC poZR p YS9 No FOUNDATxoA VInA�jl ? G* 1 S Rd x Z ApPRO�rALR- �tK �1VG �`PRAN&G LT I B?NG SLECTR-I ROI7Gy�21y zNsoz,gTroly �'ovn►�iTx,a,N pz0ows r+'ALLS ; c�'xzxNG YxNAL x1VSpTxf7N: { C.Y.TMNF.'Y FI.&'IG�yT 4ROo 'xNG SrD.rNG ST,?xqS- PORCHES/ST Q PLaptar S 2vERRIOp NG X227R.&S REI I CJ T PTNISHE'n Ti7xM/p VACY FRs c� GARAGE DOOR czcassR t.s �'xNG ✓ P-rN xs PxNAL q AL xN Ec L op CONSTI A SIGNOB2IED �'C--"-r.,^'�' op MESS Np�RS A RO&x?'ffEAS ZZ02 A1?,R -Yl i�7xStiS s >`L I INNERI'`RAjrA RKS� " fZ NSP 20R �J YOU ARE HEREBY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED SY MP. THE UNDERSIGNED TE a Jim CITY"DR VILLAGE _,ter ,.�'/r i !uf r f yp TL�'NVSNIP STREET AND NO O� r_ �!/� N K /,�-.ryy �L+ l'� y' -r / K BETYY'E NE�iyyn _ i F✓ C. i//V 4 I� POLE NUMBER de rig IS 5 PREMIF,ES l,prA1-E_ryr OCCUPMTT'S N /T BLOCK LOT .w 05 Ae fS/J BUILDING OIJGUPANC'/ OWNER'S NAyE pp�� "IC 19C,r��GLwRENT${i/✓PfirIFO BYb�/�•� G- V .,r W7M 111 i E N 7 /I►�j .'IF;y/') T+r L., $r1 v.i / i.,^�I C OFFICE ',KJRK TEL�E,(}RI PONE NUMBER BUILDING IS ��r�r� rJ ' � NEW I__N�' OLD El J�'''�.�^ LIST BELOW ALL Ek]UlPMEN WHICH YOU IhISTpLLEp T�L EJ Loca- NUMBER OF OUTLETS No. W FilRures & 11111111 DEFECTS.RFMOVEo C] tion Lamp Receptacles MOTORS HEATERS BRANCH OFFICE USE OUT. Ceiling wai rT p s Switch Pendant Bracket NO, Type CIRCUAt7, ONLY H,P Each Na WG SIDE Each '"° Gauge IlVSF'EL"']70N SUB BASE BASE- MENT let FL. 2nd FL. 3Ri FL. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH Aat7VE. THIS APPLICATION INTENDED TO COVER THE ABOVE-LISTED EOUIPMENT TO BE INSPECTED, BUT IF AT TIME OF INSPECTION, THERE IS FOUND ADDITIONALL EQUIPMENT NOT ABOVE LISTED, You ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER TH£ ADDITIONAL EC]UIPMEN T, AS PROVIDED BY THE APPLICANT. SIZE OF MAINS FEEDERS ELFCIIR7C SIGNSILAAIPS OLI+4RKTER OF WORT( TOTAL ""m EXPOSEa GAS TUBE SIC.NFTpgN SFORMERS DF dPE WORK TO BE 5'W'i7'Ea ❑ COIJCEALED WN WTE COMPLETED SIZE OF S"(NUMBER) SERVICE ENTERS BUILDING CAPACITY MANUFACTURER OF SKiN DATE McSPECRON � OYERHEAa � UNOERGFIOUND REOUESTEO ON(Gr+ AS NEAP A4 POSSIBLEI ON BER ■• I I I I I I R1V0lD DE BY IN6 A RATE !NIF T . A PRINT NAME AND ADDRESS Y '!'� NIL UR A/PP TI MAY OF RE'TIIRN:ED. NAMEQFAPPLIt-•,e,N7' K//,G�I f0►' DATE OF APPLICATION of STREET A�D+DFIESS �j LEP NE CITY OR POST OFFICEjr2 ' * -ZIP CODE LICEN NO. HEN APPLICABLE 1111 85 John Street 47 State Street G 570 Delaware Avenue 217 Lake Avenue NEW PORK, NY 10038 ALBANY. NY 12207 f ❑ 202Arterial Road BUFFALO, NY .Y4202 f F�OCHESTEF{, NY y480& ! S,YRACUSE, NY 13206 THE NEW YORK BOARD OF FIRE UNDERWRITERS IVf..• _ ^ 7 -------------------- 7� n� .10 v z Jo rr� to J �C t ill