1989-622 S
i
CERTIFICATE OF OCCU ''AM.0
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
i
Late klr r cb 90 19 a s
sThis is to certify than work requested to be dame as shown by Permit No.
j has been completed.
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� This structure may be occupied as a Single Family with Alterations
lAck
j location _ Sherman Avenue
i
j Owner John Cardinale
s
By Order Town Board
I
TOWN OF QUEENS$URY
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! Director of Bldg. ac Code Enforcement
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BUILDING PERMIT X
TOWN OF QUEENSBURY No. 89-1;22
WARREN COUNTY, NEW YORK r 3
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PERMISSION is hereby granted to John Cardinale
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OWNER of property located at BOX 150 Upper Sherman Avenue Streetr Road or Ave.
in the Town of Queensbury, To Construct or place a Alterations , to Building
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t , OwNE WS Address is
Same
2_ CONTRACTOR or BUILDER'S Name p
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Self
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3. CONTRACTOR or BUILDER'S Address
G
x
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Same
d_ ARCHITECT'S Name
5. ARCHITECT'S Address W
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x
cn
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6. TYPE of Construction — (Please indicate by X) G
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{ 3 wood Frame { ) Masonry ( 1 Steel ( ? m
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i. PLANS and Specifications m
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No. 640 sq . ft . Alterations to building as per plot plan , specifications ,
and applciation .
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8. Proposed Use m
Alterations to Dwelling m
$ —. 48 00 PERMIT FEE PAID — THIS PERMIT EXPIRES March 1 18 90
(If a tonger 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.)
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Dated at the Town of Queensb S9 is _ 14th Day of August Ig �
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SIGNED BY far the Town of Queensbury �*
8 u 1 Rd i Kirand oniny I nspector o
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va
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TOW1X6rQLrEEXSBURY
REVTE W ED BY ,. �� a
FEE PAID
PERMIT NO,
BUILDING PERMIT APPLICATION
A PERNUT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION_ NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
* * * * * * * * * * * * * s�� *yy * * * r s * * * * * * * * * * * * * s * * s s s s *
The owner of this property is % In 1 CIA �-
P.O. Address C)� n Tel.
Property Location f�� Tax Map No,
Has there been any split of this property since October 1 , 1988 ? /�_
If yes Planning Board Review is necessary , yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
*
NATURE OF PROPOSED WORK : Esr.vMATED MARKET VALUE OF
"�3 . ems
Construction of a new building * CONSTRUCTION: $ J_
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x ft.
Alteration to a building
(no change to exterior dimensions) Existing Buildings( 3) Size w2f,3 ft. x 2`ft.
* Proposed building - distance from property line:
Other work (Describe)
Front yards _ft. Rear yard �� ' .. ft.
- _- �(C-V JGED ,,6/.�r c * Side yards ft* and 47 fx.
GROSS AREA OF PROPOSED STRUCTURE If on corner, setback from side street ft,
1st Floor _ _ _� .�sq. fte * OCCUPANCY INFORMATION
*
2nd Floor sq. ft. Primary Building -
Other Floors sq. ft. . : One Family Dwelling
(not cellar or basement) Two Family Dwelling
TOTAL FLOOR AREA &40 sq. ft. * Multiple Dwelling/Number of units
Size of new structure ft x fte * Business
ier/slab/crawl/ ' Industrial
Foundatia
n-p partial/fruli
(circle one) ' Other
*
No* of stories (habitable space) I
Height (grade to ridge) JJ4 ft* * If addition, what will use be?.
If residential, no. of families_
No. of rooms(excluding baths) • Accessory Building
No. of bedrooms ,.
Detached Garage ONE/TWO Car
No. of bathrooms f
Primary heating systems0 + Attached Garage ONE/TWO Car
Type of fuel Private storage building
No* of fireplaces to be installed `
„Will a wand stove be installed Other
Central Air conditioning
OV* ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING +PECIFICATIONS:
Type of construction, wood frame, fire safe, etc.
Will any second-hand or upgraded lumberbe used ? If so, for what ?
cc
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing) �r
Will there be a cellar ? Heated or unheated? Floor sq. footage sq ft.
Will there be a basement ? Will any portion be used as living space?
(if so, what portion? sq ft . Type of use?
Type of roof - sloped/ flat/shed/other Material of roof
Size, wood studs"x �" spacing��" o. c. length A ft.
Joists (floor beams) 1st floor spacing(w-, "o.c. span[ft.
Joist (Haar beams) 2nd floor " spacing "o.c. span ft.
Overlays (ceiling beams) "x " spacing " o. c. span ft,
Roof rafters `� "x (p " spacing o. c. spanC! ft.
Roof trusses (pre-engineered) spacing " o.c. span ft .
Exterior wall finish of what material? u ^rrivi
Interior wall finish / t�
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to he an opening between garage and dwelling? If so will a Fire-rated door, enclosure,
self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof fte
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft, in.
Water supply - Municipal or private well
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties ft.
(A separation application is necessary for any repair or new installation of septic system)
NAME OF BUILDER { 4Q„ ADDRESS TEL. NO.
NAME OF PLUMBER ( ADDRESS TEL, NO,
NAME OF MASON ADDRESS TEL. NO.
NAME OF ELECTRICIAN ADDRESS TEL. NO,
DEC LARA77ON
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
xll other laws pertaining to the proposed work shall be complied withl whether specified or not, and that
ouch work is authorized by the owner.
Signature Q� n
O r, owner's agent, architect, contractor
31'ECL9►L COND1TiONS OF THE PERMIT:
BY
APPLICATION FOR
PORCHES - DECKS �Q�� Ofi {�11��,�lSl�jligY
DOCKS do BOATHOUSES rLrZ
AUi
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL
OF THE FOLLOWING:
BLL7Q. & CODE pEi3T,
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the permit.
The Owner of this property is: (~
P.O .
Address: -
Property Location.
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR. SUPER`TISION OF WORK AS REGARDS TO BUILDING
CODES* , -(Z_
Address: Tel.
BUILDING SPEC ICATIONS: J� �4�� 1
Type of work to be done: Poreh eck Dock Boathouse {circle one)
Size of structure to be built (square ootage) 1
Foundation Material Width ��+. { " - Thickness t2oLA
J__-
Depth of footing below grade
Size of posts or studs Z��xV2 x Long
Size of floor joist x Fog x [ C? Span
Decking or flooring material
How will porch or deck be fastenbd to building? i6Nolmc 41 1
IF ROOF WILL BE INSTALLED ANSWER QUESTIONS BELOW:
Size of posts or studs x x Long
Roof Rafters x Spacing Span
Roof Trusses Pre-Engineered spacing)
Span
Type of Roof - Sloped - Flat - Shed - Other
Material of Roof
Type of siding (if any
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale
and attached hereto, showing clearly and distinctly all buildings, whether existing or
proposed.and indicate all set back dimensions from property lines. Give street and number
or lot number and indicate whether interior or corner lot. Show location of water supply
and location and configuration of septic disposal area.
COMPLETE INFORMATION REQUIRED BELOW :
Size of property kc �ft. x 1E] C7 ft.
Existing building(s) Size ,7,p ft. x ZLk ft.
Existing building(s) use
Proposed building, distance from property line.
Front yard :Y& ft. Rear yard ,o4 ,-/ ft.
Side yards " -Z ft. and �+� ft.
If on corner setback from side street ft.
DECLARATION
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.
SIGXALTURE.Qa, o�-
Own Owners Agent, Architect,ec , n rac or
TOWN OF QUEENSBURY
•
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 ? 43 (f)
4 . Percentage of area of windows and doors
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 ambient 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 L6
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 ) /
9 . R value of heated basement /cellar walls ( below gradee )
10 W Type of insulation
C . Controls
1 . Thermostat maximum heat setting
D . Duct Systems ` y
Y. Is duct system installed in unheated spaces ? ES NO
a . If YES , R value of duct installation {, rye�
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
Telephone No . '"�
A/applicant ' s signature ?
THE NEW YORK BOARD OF FIRE UNDERWRITERS '
1 ' BUREAU OF ELECTRICITY
41 STATE STREET. ALBANY, NEW YORK 12207
•1 : j.: ,- fl . , 7. flpplication .'V �,AYe� : y : . ': it
Hate �l-IErA. ., .
THIS CEfI'TIFIES THAT
arrsly the electrical equipmaoat as descrifped bedoee and intradnced by the used two the above application number in the pwrmieea aj
=WMIM[wom
in the following location; ❑ Ampernegent Q 1st Fl. ❑ $nd Ft. Section Block ,Got
was examined on 'A"r r • ' ' and founel to be in cornpliance with the requiremerats of this Board.
q%TURE FIXTURES I RANGIES COOKING pEC1f5 OVENS dISH WASHERS E%NAUST FANS
OUTLETS FTACLES SWITCHES tNCANDESCEN7 FLUCA&SCENT OTHEP AMT. K. W. AMT. K. W_ AM
T_ K.W. AMT. K. W. AMY. H. V.
9 it 8 1 .1 1 F -
PRYERS FURNACE MOTORS FUTURE APFLIAMCE FEERIERS SFECIALREC'FT TLMECIOCKS MI1[�l UNIT HEATERS AWLTI-OUTLET DVAMERS
AMT_ K. W. CHL H. P. GAS H. P. AMT. NO. A. W. G. AMT_ AM►, AMT. AMPS. TRANS. AMT. N, p. SYSTEMS
OF AMi_ WATIS
SERVICE DISC OI MIMECT HO OF S E R V I C E
AMT. AMP_ Kw
rYpt EpWF. 1 ,1' YW t 11 3w 8 / 3W 3} •Vr �' optRC,t' D. OF cC. COND. No. OF HI-LEG OF'XI AEG +�O. OF NtUTRA15 OF Pau"t
Asa Its
OTHER AFTARATUS.
Geer. c, x:—!x
Swxz�r bglsc3may- I
�'rrFw Y���• F e�+��
p7rt7E►V��i1LRi �� A►ray,..rr9}..�"."..
ARANC:H MANAGER
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.
L ' 3
TOWN OF QUEENSBURY
BUILDING AND CODE'S DEPARTMENT
BAY & HAVXLAND ROADS
QUEENSBURY. NEW YORK I280&
TELEPHONE (5I8) 792~5832
BUILDING INSPECTOR' S REPORT
REQUES R INSPEC ON RECEIVED. 1_�'r �
NAME
LOCAT
i
DATE PERMIT #
APPROVED
YES NO
f
FOOTING/PIERS
MONOLITHIC POUR RMS
FOUNDATION/DAMP- OOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-
INSULATION:
FOUNDATION
FLOORS.
WALLS x
CEILING
FINAL INSPECTION: $
CHIMNEY HEIGHT
ROOFING
SIDINGEXTE ° r
EPS
STASRS-CLEARANCE `RCHES T RAI V
PLUMBING FIXTURE RELI F VALVE
INTERIOR TRIM/PRI ACY 11ORS ✓
FINISHED FLOORS ' ✓ _
GARAGE FXREPROOFING—. _
DOOR CLOSER (S) _._...... ... .
SMOKE DETECTORS
FINAL ELECTRICAL IN TION
_ FINAL APPROVAL OF CON TRUCTION
OK To I SSUE C/O OR C
A SIGNED CERTIFICAT O OCCUPANCY MUST BE
OBTAINED FROM THE B ILD NG DEPARTMENT BEFORE
THESE PREMISES ARE CCU EW
REMARKS:
ARRIVE
DEPAR -
INSPECTOR
TOWN OF QUEENSIiURY
BUILDING AND CODES DEPARTMENT !
BAY & HA'VILAND ROADS
QUEENSBURYNEW yoRK
p
TELEPHONE , ( 518 ) 792"5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED f c
NAME ti
rpCATION �. �Ic,3
PERMIT " �-
DATE c# ##
APPROVED
YES NO
FOOTINGIPXERS
MONOLITHIC POUR
FING
F+OUNDATIONIDAMP—
Bp1CK L FIL APPROVAL ._
L .ROUGH FLUMBING
RAINING
ELECTRICAL ROUGH—IN
INS ULA x"ION: , `Y
FOUNDATION
. FLOORS
WALLS
CEILING
FINAL INSPECTION :
CHIMNEY HEIGHT
ROOFING
,SIDING STEPS
EXTERNAL PORCHE I
STAIRS—CLEARANC & RAILS
PLTIM,S.TNG FI.X'TU ESIRELIEF VALVE
INTERIOR TRIM RIVACY DOORS
FINISHED FLOG S
GARAGE FLREP OOFING
DOOR CLOSER (
SMOKE DETEC RS
FINAL ELECTRI AL INSPECTION
FINAL APPROVA OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUEtTEDot
REMARKS-*
ram'
INSPECTOR
TOWN OF QUEENSBURY_
BUILDING AND CODES DEPARTMENT
gAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12$0k
TELEPHONE ( 518 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION �y
DATE 4 - PERMIT
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROV
UGH PLUMBI G
4 .40RAMING
ELECTRICAL OUCH-I .
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ TEPS
STAIRS-CLEARANCE & RAILS �-
PLUMBING FIXTUR /RELIEF`, VA E
INTERIOR TRIM/P IVACY DOORS
FINISHED FLOOR
GARAGE FIREPR PING
DOOR CLOSERS _
SMOKE DETECTO S
FINAL ELECTRIC INSPECTION � .. -
FINAL APPROVAL F CONSTRUCTION --
A SIGNED CERTIF OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
T
� f
111,5F'ECTOR
TOIVN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAP, & Hp1VILAND ROADS
QUEENSBURY, NEW YORK 1280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST INSpECTZON RECEIVED
NAME (r rC If7_L"-'^'
LOCATION
DATE � PERMIT'DATE
APPROVED
YES NO
FOOTING/PIERS
MONOL.I POUR FORMS
FOUNDATIOMIDAMPP-PROOFING
BACKFILL A�!PROVAL
ROUGH PLUMO
FRAMING
gzJR&TRICAL R
NSULATION:
FOUNDATION '•
FLOORS
WALLS ` dd
CEILING
FINAL .INSPSCTIO
CHIMNEY HEIGHT"
ROOFING
SIDING
EXTERNAL PORCHES/S Pr.�
STAr.RS-CLEARANCE RAILS �
PLUMBING FIXTURES .RELIEir F VALVE
INTERIOR TRIM/PR VACY DOORS
F.rNSSHED FLOORS
GARAGE FIREPR ING
DOOR CLOSERS)
SMOKE DETECTO S -
FINAL ELECTRICA rNSPECTXON
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERT FICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDTXG DEPARTMENT BEFORE
THESE PREMIS ARE OCCUPrEDI
,_
REMARKS: di
L.r
L
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY. NEW YORK I280&
TELEPHONE (5I8) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR SPECTXON CEIVED
NAME f hJ J%j
LOCATION
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 PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIX2'URXS/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/O OR C/C
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT ,BEFORE
THESE PREMISES ARE OCCUPIEDI
REMARKS:
ARRIVE
DEPART
.INSPECTOR
YOU ARE HEREBY REQUESTED TQ
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INST.AL.LEC1 BY
THE UNDERSIGNED -.
TEMP e CITY Gq 7) 11
,.�,y\RISE y/' �"7 L��!
TOWNSHIP
STF T AND NO OR So D J �. t COUNTY
�`. 7♦ _ F .� '= . 4 �*f. f I] PDI..E NUMBER
aErIAIEEN WFfA1'TWO CROS 3rREETS IS PREMIBE$ LpC�p'Epq t -_..
3EC=rk7N
OCCVF'NJTSN E BLOCK
7p �{ LOT
��`-�- \'�,�,• �✓ L 4-..� { 1;� BUILDING 6=UPANGY
OWNER'S NAIyE AND AppRESS 1 �.-L.-
HOME TELl:pFtCMlE NUMBER CURgENT 3UPPLIEp BY
FROM THEIR
E 1vOR1C TELEPI-ONE NUM6a7 BUILDING I$ T �
NEW ❑ OLD rBu/
WOW Is
LIST BELOW ALL E UIPMEN WHICH YWUNIbfS ADDrrEw. El DNAL EFFECTS REMOVED
I M^_ NUMBER OF OUTLETS ND. of Fixtures & TALLED
lion Lamp Receptacles MOTORS HEATERS BRANNGH OFFICE USE
Ceiling mep''r YPa CIRCUITS ONLY
Wall RecaP'Is Swkch PbnUarit Bracket Na T �h Na W0M A.W_G.
SIDE Eecn No GaLigs INSPECTION
sue-
BASE
BASE-
MENT
Ist
FL
FL-
PL.
30
FL_
REMARKS; LI SIT OTH ER ELECTRICAL DEVICES NOT SET FORTH ABOVE
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTFCD EQUIPMENT TO BE IOSPEGTED, BUT IF AT TIME OF INSPECTION,
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED YOU ARE AUTHORIZED TU
THE ADDITIONAL EQUIPMENT, AS PROVIDED BY THE INSPECTION AND ADJUST THE FEE TTHERE IS
O COVER
THE APPLICANT
SIZE OF MAINS _ � : _
!� M1 FEEDERS C SIGN31t_AiMpg
yqr . TOTAL VM{fiS
CI'IARACTER OF WISR,r' •" .-' Y'I,ir 4�T Ex SUB GAS TUBE SIGN?RANSFOgMERS OF
LATE WADSK 10 BE S7AgTED CONCEALED 1N
LATE COMPLETES ^RE Or WON INUMBER}
SERVICE ENTERS BUILDING -v CAPACITl
MANUFACTURER OF SqN
ERHEAD
PATE INSPECT UNDERGROUND
IP!Y R1 ON OF NEAR AS POSSIBLE) -
rIII
DWI; TIDENTIEF1CJrl10N liU� II I ll II
PRINT NAME AND ADDRESS — 7 H' ALL SPACE M BE ,�y
MAY 81E RE7UR
NAME dP APPLIChNT
Lc DATE OE APPUCAnON (�
ITY PHONE NO,
C UM
LICENSE No WHEN APPLICABLE
❑ 85 John Street ❑ 41 State Street ❑ 570 Delaware Avenue ❑ 2T7 Lake Avenue
NEW YORK, NY 10038 f ALBANY, NY 12207 ❑ 202 Arterial Road
BUFFALO, NY Y42d2 ROCHESTER, NY 14608 SYRACUSE, NY 13206
THE NEW YORK BOARD OF FIRE UNDERWRITERS