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1989-666 � , •.s =s. , , ,y r _r y.y. , .. _ . f r +CERTIFICATE & . CIF OCCUPANCY r TOWN OF +QUEENSBURY 1 WARREN COUNTY, NEW YORK October 1 €� l9 89 DateThis is to certify that work requested to be done as shown by Permit No. 89- 666 has been completed. I This structure may be occupied as a _ Single >=am i l y dwe l l i ag Location 9Z Cohn ry M {ah Road I Owner James Brown By Order Town Board TOWN OF QUEENSHURY I i .r" i Director of Bldg. do Code Enforcement I BUILDING PERMIT TOWN OF QUEENSSURY Na 89- 666 � WARREN COUNTY, NEW YORK � . r 1� PERMISSION is hereby granted to XXMMX James Brown rn r.3 OWNER of property located at 97 CountryC111h Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a SiniUlp KMXZlt Family Modu1 ar at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is 14 Terrace Avenue Warrensburg , N . Y . 12885 c sw R3 IrD 2. CONTRACTOR or BUI LDER'S Name �+ Lamplighter Homes 3. CONTRACTOR or BUILDER 'S Address RD#2 Fort Edward , N . Y . 12828 4. ARCHITECT'S Name 4 !u r� S. ARCHITECT'S Address 4z C3 G. TYPE of Construction — (Please indicate by X1 C_ XKA Wood Frame 11 Masonry 13 Steel i 1 7. PLANS and Specifications No 26 ' x 4W Single 'Family Modular as per plot plan , specifications , and application , including septic and driveway . 8_ Proposed Use c.� Single Family Modular 3' un min $ 144 * 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES march 1 19_�� � I I f a longer period is required an application for an extension must be mad to the Building and Zoning inspector of the town of Queensbury before the expiration date.) s O 2 Dated at the Town of Queensbury this 2t Day of ativ 19 SIGNED BY for the Town of Queensbury Building and Zonidgq nspector TOWN OF QUEE:tiSBURY � , r - . , � � . r ,� T , . - ,. .; r, ' ' � v ; t, r � �+ • �; TOWN OF QiJE �fSBURY RECEIVED Fee Pao,4d t / +' AUG ? I WIL.DINC AND CODES U1 .i ARDfE3+rr Ja-La Iasued - T�$� AY and HAVILAND ROADS RD I BOX 9d >aCnmi.t Nu . �7 BLDG. B CODE []EPT, PaUEENSBURY . N,EfJ YORK 12d0 l Tel f5161 792- 5493 . Exc 204 ■ 1 a f t r r 0 . 0 a • a f f • . ■ ■ ■ ■ ■ f f f • f ■ f f ■ f ■ ■ N s A PCIWIT MUST DO OBTAINED 1 EFORE LECINNINC+ CONSTRUCTION . NO INSPECTIONS VILL BL HADIr UNTIL AP1' LIC.tr! T HAS RECEIVED A VALID I3L: ILDINC PCRNIIT . All applicable spaces On this application must be conrl+ Ieted and the , ir* nature of the applicant must appear on the reverse side of this sheet ■ e k r w * r n * AM k x r x a k * x * * * w r r * w t ![ w 7i a if Ofh x fe Millie owner of this rroperty is : .� A-F+2e s +2-+•� .] L1 . 0 . �.1l1,eE /l nS �, ec2��iylr TEL , " roperty location 7 7 TAx MAP NO . / / alas there been any split of this property since October 1 , 1988 ? yews no If yes , Planning Board Review is necessary . .� uaDIVIS' ION NAME , Ir P% PPLTCARLE LOT NO , Phe person responsible for supervision of work as regards Building Codes is : G P /e L Al tt ... hote- " sQ d lZ Di .F- A { eel c w,0-ok cI„_ ,+- • - 7 1r' 3 — 3 9 t~ NAME fr , 0 . ADDRCES TEL , NO . :jame of builder4eA3c& Prt. CMC& wc Address {z D e. ArMd- T' K " ILr` TeL � !`3 773 ;r 2_ ri"ffkQ of Plumber r+ l.3nress Tel r+ rrame of Me►san r AJdreay Tel ,ATuRE Or PrOPOCLD V4)R% : : � � 0NINGo INI ORPI,+ TION ( office use only ) nnwtructior of u ir+tw builalr,7 • ZONIN`° AI;SICNA":ION OF PROPERTY Adj &, cion to :3 liuilJing PERMITTED PRINCIPAL PERMITTED ACCESSORY �Altk ae"Lion to a Ieuilding ` � ( s &Q to exc .; rior cllrncnsLonal • REVIEW REQUIRED — PLANNING BOARD ZONING DOARD� _Uclatir work i "1 .::scrie0.: 1 ■ SITE PLAN REV-I/"E�,WW 0 APPROVED DATE y� ity55 AFlL ,1 O1 ` L' ROPC} 5yL' C1. : 'SI� LiL'I' LikE • VARIANCE # -- -�'� APPROVED yl '''- DATE�/�� . st Floor 4ow sq ft . Remarks : 2nd floor sq ft . CQ-4PI.L'in Q IMi 'r31.hu' TION 1cur ul1.6:0 UL' L1.+rrr . ' Sisu of pros+wrty rs7 '7Me `? fe x364/• fare . Other Floors sq ft , „ 6 x r" c ( not cellar or bssem �anc ) ICxi�tir[cl 1:ual.li++•] ICY 5i . 0 r . TOTAL FLOOR AREA ft a ■ ixi s++g s3.. . 1JLn�1l - 1 uau !may `" L"1.kj of nGw ::C1ructurti eft N.Y t r 1`04+kd:■ tion-pier/ s13L/Crawl/pares.w ull/ ` Yrorr : u irs o .cci bll " g , dl:. c "Acc: irow E. r.YxJerty lsrti � icirclu oneY ; Front yard 02 sir r' t naar y:+r. d� (P33 ft Na . of .tories ( YwLtiic:.t�l.: sl�occY / rr4ighc ( Uradu to riclq+s ) — ft . Side yard : 3 `. 7 fr. sncl If rauiduntial, no . of famLlicx ,oe ■ If on corndr . :,amok Cross siriu arr:cut�-ct Noe of roorax ( axcludincl br.thu ) ` OCCUPANLY INFOR)oHTICN 1$o, of badroosaas. _ . PRIMARY L UILDINC AWN No . or b:aclsrooluz; f■tiau.ly dwelling 1riu►ary I[watir[cI sry�rL.w ` Aryl+" [af fu.a1 .� 1 C' T;m . c., Mal iple"ly Qx1ei1my No . of lira slacua: L" 1i.c ina:cwllc:d ,. » Multiple" .lrrsslling / N,asat>cr of units ball a W0424 ,,:Levu 6W inscAl14AUM? ea `7 • l�urna.rneaxt occu[s:aucy f.:nsriCJCrI AiC CO[&.11,.L J.rJf►�.ng:' ,/a+'" [? "j•t':arr:.i1:[+ C Cirr'CYj0.i■+rslL"f Ilusinr.srY BUILDING STYLE, PRIMARY STRUCTURE Tncius;cri31 c I L.oc3 czLblen Oth,sr It .■dditisan , wl �.►t +will u :.s b.e71 �� ��.. 1vr66wR1 ras►Clr M:►r►xic.0 G+aj,lux 1lhl4c l .ewsi Gld aseyla U4A4k.j044Low ' C..pu Cod Coc#."c1a Ock"Me r ACCESSORY UUILDINC— Cr+ s oni .l scow TOW91 Ho"Se uucachau y..rc.golone C"C/ two cat/ czar cznc -• ONL Pr WALE Y ' ACC44. hu.1 cj :+rar] u./o,++i C&CI two ■ • a r ■ r r ■ r a a r r s r r a * 1+riY:aCu rL4C:�g3 builrlin+g L: STIMATED MARKET VALUE OF Ochur -- CON :; Tkucz Ium ,r Ly • IMPORHATTON ON DUTLOINC SPECIFICATIONS , ON peeVERSE CIGC OF "SKIS CHUET, 1'O BE COMPLCTLOI Form HPA I0/88 v1 Milk PERMIT ^A-. IPLICn Su I 11%4G SPEC. I F I CAT IONS : t_ e cr constructione wood fraxe , r sofa , etc . �iJe .� .ir !2• FZ -t7 _ e ' 11 a:.y se :end-hand or ungrada? i :` er bz u3ad ? sc , for wk ac ? FoLLr,dation wall material L" ry .,� r . f2 ^e Ihi•- kress r.,epch of Foundation below grade tc bottom of fooclnq ) � r Will there be a cellar ? yes ? gated or un^ete ? ¢ Vploo sq . footage ^ t Will there be a basement ? i Will any portion be used as living space ? ( if so , what portion? _sq . ft . _ - TN ' type of roof - of use ? sl pe flat/ shed/czner Material of roof S' ,� _ .. wood stud " X�� " spacinc, � .�`" a . c . lt .^.gtri 7 � Lo fc . Joists ( floor beams ) 1st . floor " Y rG)� IN spacir&aY" IONIC . span f 3 ft . Joists ( floor beams ) 2nd . floor ' X " spa CIng " o . C , span ft . % verla^ys ( ceiling beams ) � NIX T6" spacing�e" oI c . span f 3 ft . Roof rafters " X " spacing o . c " span ft . Roof trusses ( pre- engineered) spacr g Z } " o . c . scan / ,,I:_ft . Exterior wall finish dA0J 9_ :J G Of what -via. terial ? Not u / Interior wall finish 14Z L2 w a If a garage is to be attached , descrn.be materials to be used for FIRE SEPARATiCN : Is there to be an opening between garage and dwelling? If so will a Fire- rated door , enclosure , and self-closing device be provjdaci ? will a flue-lined chimney be installed? Height above root ft . Depth of chimney foundation below grade ft , Depth of fireplace hearth ft . in , Water supply - Municipal or ,private well p*1 " A4& C E SEPTIC SYSTL:M _ Distance from ANY private well ( including adjoining properties 7' ,C70 Et . ( A separate application is necessary for any repair or new installation of septic system ) DEC LA RA T [ 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 pt'emises 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. Signatur 4 Zee000l000•�._ Caw r, owner's agent , chitect , co trac 11F AN SPECIAL CONDITIONS OF THE PERMIT : TOWN OF QUEENSBURX j f4 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 17 2 , Type of heat. C,Xp e-. y"/2 G '�0 '6 '0 3 , is the building mechanically cooled ? 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 _ 20 R value of exterior walls 3 . R value of glazed area 4 . R value of doors 51 R value of floors over unheated spaces 6 , R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab s , R value of heated basement/ cellar walls ( above grade ) 90 R value of heated basement /cellar walls ( below grade ) 100 Type of insulation Co 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 , 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 . 7 [ 1p � 2 *5 00e L ' > applicant ` ' s1gna�� AM Tafnn of Oussnsfrurg c 4i 4fVaU1V �e}�txrt ierrt Bay at Haviiand Roads Office Rhone 515-793-7771 Queensbury, New York 12601 PAJL H. NAYLOR FiICHARD R. MlSSJTR Suparin7endurlr Mighwa Dep 001)tendanr ,Highways DRIVEWAY PERMIT i�rx?l LE ::. 1 P T. ICAN 'T' NAME : 'I1 - I-. x PHONP NO . 0/ r^. i UIZESS T(D BE INSPECTEDL' 7; �. ,/', 00&�'Oda CnK i< 1 ' I' L'RivT ADDRESS rI licant must show exact location and width of drivewav ( s ) c � :)e connected to the highway by placing stakes at tha s -.- -1- c.: if ieci location . iia Superintendent of Highways , Town of Queensbury , has reviewed the application of the above named resident to connect a driveway to the Town road . The following action has been taken : STEP l ; { } Preliminary Approval , NEED : ( ) Slight Swail ( } Level With The Road ( } Deep Swail L) .ize Pipe to be used ( if necessary ) ( ) 121" ( ) 15 " ( ) 18 " ( ) 24 " ( ) 36 " Preliminary inspection by DATE � l�proval by Highway Supt . Depty . Supt , After receiving the Preliminary Approval , submit the permit to the Town of Queensbury , Highway Department upon completion .for a Final Approval , STEP 2 : ( } Final Approval ( ) Rejected DATE : Paul H . Naylor Superintendent of highways Town of Queensbury TOWN OF QUEENSPURY APPLICATION FOR v SEPTIC DISPOSAL PERMIT DATE 4c" a ,� .- 'Y LOCATION OF PROPERTY FOR INSTALLATION 22 dv} Owner's Name: „„ - �, , L, , ,� Telephone : j!5sQ 3 3f 0, Installer's Name:_f rJ tal /s � 14 , l/ Telephone : y — o c> Number of bedrooms (residential only) 3 Total daily flow (compute Cd. 150 gal per bedroom) 4�5� Topography: Circle one: ja .J1 Rolling Steep Slope a6 of Slope Soil Nature: Circle one: Sand oa . 1 y they /Depth: Feet Ground Water : At what depth? Feet Bedrock or Impervious Material: At what depth ? Feet Percolation test: Circle one* ot required r quired rate min. inch. Domestic water supply: circle one�unic p 1 well (ether If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank Z e1 gal. ( minimum size: 1 , 000 gal.) TILE FIELD: Each Trench 56)p feet/Total system length 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 Qlueensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON . DATE: dF- OVER Septic System Inspectians : A . Ail applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing : 1 . ) the proposed location of the system 3 . ) 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 , tile fields and /or drywells B . No ;system shall be covered before inspection and approval by the Building Inspector . Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine of up to $ 250 . 00 . C . An approved copy of the plot plan shall be available on the construction. site . Failure to produce said plot plan at time of inspection may result in an immediate work stoppage . D . Should unforeseen problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal roust be submitted to the Queensbury Building Department before further construction . Town of Queensbury BUILDTNG and CODES DEPARTMENT Bay and Haviland Poads Queensbury , New York 12804 MIDDLE DEPART RZ'y!7N ACaENCY, INC. 9oq_t+ai�'� In i�roac1"Fl. :'9Deyoe r; WW"_a 6aitj October 20 , 1989 Certcfleg that th lectr9c�Ll equipment listed has been examined an&kapproved as being in accord with the National Electra Code, applicable governmental , utility and ,Agency rules. .,fames Brown :��i.• ,� r` = [`� �s `m.,r: du '': �i . , s �. Dwe] ling : , Owner: Same Occupant: / Ocarfon: 97 Country C ub Road , see . urp L ..,�,� Thia Ge rtlficata c� frw`aieatlir[.pl' U�pmpnt and MSCBYahOn inspected This } date. I1 adddionpl ar]Uip[1Tpn[ ah be inlrad uGetl or alteranpns made to exiah ng system trig car($jcppa t10 null and v4�d, and applrcation tor Equipment: 9 Outlets ; Receptacles ; S F4.xturl3$ " _ napactipn mould ee au6mutetl p dy to ImsABpncy- : .1 >� ,..� :..r7� d �„, +�;� ,",'�}dld pr p} this GerdTicafp anduld. nt aame to hie r �+' � 'Amp �er� ,.hl la9ent orcpm P apprty insurance earner pAtfyl as evid;prlc ilicatiPn of eFpghicpl Equipment approvpd -,� pa aPEcoliEtl...' rM Elec � � Applicant. Michaelichael NNE '1$ Road 3 a • 15-029412 t Ft Edward , NY 12E128 ����n��� ./w"n..1/x' ✓"`. &+n'�hi85✓n'��Lk,f'.:: rt!?eA\!�!,An'�+GE+a:riZ�R�r:" F'h.Z.+ ,4"1�' 1N��.`tti 'e•i, .Down o 4eeitjheere�r BUILDING and ZONINk DEPARTMENT Bay and Haviiand Fioa 3.D. 1 Box 98 C04eensbury, Nevw k 12801 BUILDING INSPECTOR ' S REPORT NAME LOCAT ION Ls Date © / permit Now ✓ = APPROVED - . 'YES NO Footing/Pier Farms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches - "! Finished Floors Interior Trim Stairs & Railings _.._ Cellar Drain Til Concrete Floors Plbg . Fixtures Gar . Fireproof ng Y Door Closers Smoke Detect rs 5 Chimney. INSULATION : Foundation Floors Walls Ceiling FINAL ELXgTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Rema�r ks-{ Quild- "� g I s ector 6/86 and-vl _Down o/ Q" een3E+ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Sox 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION _P DATE Z PERM I T NO. SOIL TYPE - Sand - Loam - Clay -- Percolation Test Required? YES Percolation rate - Min/Inch TYPE of SYSTEM : Absorption field , total length Length of each trench Depth of trenches Size of +Travel_ SEEPAGE i?ITS{Nuinber of) Size- ft. X - ft . Gravel size PIPING : S ' e I T'Ypra Bldgm to tank Tank to list. box Dista boy: to field Openings sealed? r'YEST O Partial LOCATTON�'SEPARATIONS : Foundation to tank ft. Foundation to abserpt ' n ft . Absorption to lot 11 ft. Separation of pits .ft. ION OF SYSTEM PROPER (circle one ) rant - Rear - Lef side - Ri t side - C TS : , ' I SYSTEM USE APPROVED YE O Build i ig n pector 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2$0fl- TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED �— NAME a� LOCATION jo0e Y7 ( DATE /��} - ,rr4L PERMIT 40 � C ►� APPROVED NO YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: f FOUNDATION 0 FLOORS W LS LING FINAL INSPECT. CHIMNEY HEI T ROOFING SIDING EXTERNAL RCHES/STEPS �. STAIRS--C EARANCE & RAILS,N PLUMB.TN FIXTURES/RELIEF VALVE INTERIO TRIM/PRIVACY DOORS FINISHE FLOORS _ GARAGE IREPROOFING 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 OCCUPIEDI REMARKS: I PECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I28ok TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED !— NAME DATEPERMIT #i` �` ` 46; APPROVED NO YES NO FOOTINGIPXERS MONOLITHIC R FORMS _ FOUN,DATION/D P-PROOFING �KFILL APP AL _ ROUGH PLUMBING FRAMING ELECTRICAL ROUGH IN oz INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH SISTEPS STAIRS-CLEARA CE & RAILS PLUMBING FIX URESIRELIEF, VALVE INTERIOR TR MIPRIVACY DOORS FINISHED F ORS GARAGE FI EPROOFING DOOR CLO R (S) SMOKE DE ECTORS FINAL ELE TRICAL INSPECTION FINAL APP OVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: 4. INS ECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY 6 HAVXLAND ROADS QUEENSBURYr NEW YORK 1280k ""^+ TELEPHONE (516) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEXVED NAME LGCATSOv DATE PERMIT APPROVED YES NO "FOOTING/PIERS MONOLXTHIC POUR FORMS FOUNDATXON/DAMP-PROOFING BACKFXZ.L APPROVAL ROUGH PLUMBXNG FRAMING ELECTRICAL ROUGH-IN XNSULATXON: FOUNDATXON FLOORS WALLS CEILING FINAL INSPECTION: CHXMNEY HEIGHT ROOFING SIDXNG EXTERNAL PORCHES/ST S STAIRS-CLEARANCE & ILS PLUMBING FXXTURES/ . LIEF LVE XNTERXOR TRXM/PRX CY DOO _._ FINXSHED FLOORS GARAGE FIREPROOF NG DOOR CLOSERS) SMOKE DETECTORS F.TNAL ELECTRICAL lXNS� PECTXON FINAL APPROVAL or CONSTRUCTION Y A .SIGNED CERTSFtrCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMXSES 'ARE OCCUPIED: REMARKSc INSPECTOR P. .tea,.. . . ,Nation -" H•eadckuarters - 91Ufll Hidnn 'FVL , 1llngsin/6od, N J " Date: �#F [atV, Town or Township 1 r , r C aisJ �.► unty js,0�/ 1f�+ - State Location/Address Located i njrRural Area Please. Attach;010_4=19 Y • :-. PP Is. # _Owner PteC i�t,#' Occupied F., ! _ y y = , " t'Wi6i ig '. w Old O pant .. . x. _-.. .,--- Wo� "!area in Build! (Flow # etc. . for: Ilrin Service on a. for Ins an: ' Tee .Remitted ' - ' " Cash [� Cheak c. :: O. hllalce Pa ab tl 1Vl.D. I.A. l ROO' 7" 1 ITiq �04 ''i'ile4 2TSO bee0 Number of Rough Wiring t7utlets Elect. Heat Switches ` Amp. Seritiiaz mace Unit f3ishvinnr<iier. :' Range Lighting Water Heater Alf ConditionerAmL Dry" ! ` -Pump Receptacles ~ Numbs tkr61j -- f figal Contrail for Burner Disposal Y� . ^a`a AdS' IOtlt Fens Other Equipment: ' = lNL]T{1RS Yi.P. :. '• Ili?. '}1:I 1fLf' 1/5 1Je 1!4 1/3 1/2 3/4 '1 Ills 2 3_. .F• T4x 1G 15 20 as 36 4o. 50 Mark NunU* - - i of Each Size Applicant' Signature ' license T/A l�tbli#Y: H Appl• : (CitY) ' ` (State). �. l -+ S —�" Service Request phcu►e. Electrician: �:, O;kf RECEIVED: _ �. ` DATE INSP-E -1 orrect 'on: ` same as Above : . or: gyp` Red Notice Label Lj Rough Wiring Outlets Surface Unit ven Switches Range rb ' Disposal" Receptacles Water Heater hwasher - 'Fixtures `AIr Condi ioner' D r Amp. Service Equipment Burner, Wiring $r Colitrols for :Anyl�p"Receptscle ' Amp. Service Conductors Pump Vent Fans MOTORS H.P_ 1/20 1/12 1/i0 3/9 1/6 i/4 1/3 1/2 3/4 I . 11lr $ 3 5 "74s 10 1S 20 25 3 ' 4D 5 5 l0U Mark Number . . - of Each Size .-; 500 760 14Pe 1@SO 1S1)O IT50 2i100 2260 $5 2730 3OAD ._ Elect. Heat E] RW Progress: Inc, '' LKD b ry Contractor �C"" CFT Violation : Work Comp. O Inc. E-1 f CASH [] L/A Owner Fee dddd CHIC #t C}_ L/A - - Due MO [3. IPA Municipalid . Date: Other Side's Utiiit�M .00d Al�pltcant Cllwrler Cut in Card Temp Data r {� Final t1k' Date EC N ` t41 Fib .: . APPLICATION FORM NO. "a EL IRS 'SELECT euSINESS praRMS (609) 220-7775 APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES } ` MIDDLE DEPARTMENT INSPECTION AGENCY, INC. — National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 SECTION _ ,fr Date : City, Town or Township� u & F+ 7 ` County +� G2 0 �^ State C4u 1 Location/Address (lf Located in Rural Area - Please Attach Directions) Pole a4t Owner. :�` .0Q a _ Permit # Occupied Building: NewO OIdO Occupant �r`>B. _ Work Area in Buildin Floor #, etc. ) : for: Wirin Service or: Ready for Inspection : Fee Remitted rCash Check [] M.O. Make Payable To: M.D. I A. Number of Rough Wiring Outlets Elect, }{fat 5aa 75a ;pa4 125a SSaa 1]5a 2aaa 2ZDD 25a0 2754 3aaa Switches Lighting Amp. Service Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number!oof Fixtures 'Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles Fractional H.P, Vent Fans Other Equipment: MOTORS H.P. 1J2 1/12 1710 1/S 1/6 1/4 1/3 2/2 3/4 1 14s 2 3 5 Tilx 16 15 20 25 36 40or 50 75 LOo MarkMOTORS H.Number of Each Size Applicant's Signature LAeLA6 ? +A_ r� r e. License # Permit # T/A Applicant's Address : � . .n Utility: NAME $` FF1C LOCATIO (City) LI" (State)0&24EyQ A of Phone -- (Zip? Service Request # Electrician : DATE RECEIVED: DATE INSPECTED: Carre! Location : Same as Above Q or: Red Native Label Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner, Wiring & Controls for Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 11/201/12 1J1D 1/a 1/6 1/4 1/3 1/2 3/4 1 1V2 2 3 5 Mark Number 7U7 14 15 20 25 30 40 50 75 100 of Each Size Elect, Heat saa lea loan ;250 1500 1750 2ono zz5o 2500 275a a000 G] �, ' .. F41111 f1111TtAf.'Vf>it'trl(,,7 I ,i+.r -4' �' 074TLzT: FEE PAID 0 RW Progress: Inc. LKD Q Contractor ED CFT Violation : Work Comp. 0 Inc. Q 0 L/A Owner CASH Q C] L/A Fee CHK # IPA . Due MO # Municipal INV # Other Side Utility Appli'", . r� Temp ale Date M ORSE EMOINEERINGi 99 LOWER DIX AVENUE 9LENS FALLS, NY 12801 October 10 , 1989 Queensbury Building and Codes Department Queensbury Town Offices Bay Road , Box 98 Queensbury , NY 12804 RE : Modular House Inspection - Brown. Gentlemen : Please be advised -that Morse Engineering -conducted an on--site inspection of a one- story modular dwelling on October lot 1989 at the James Brown property , 97 Country Club Road , Town of Queensbury , Building Permit No . 89- 666 . The inspection included visual examination of the foundation for possible damage during placement of the modular sections , center support beam connections and vertical column support . FOUNDATION: O*Ko - 8" poured concrete ; hairline crack middle of rear wall repaired , no chips or spalling . CENTER BEAM : O.R. - Level and straight ; all connections tight with 9116 " bolts at 5 ft . O . C . COLUMNS : O .K . RRIII 3 " steel columns at 8 fto O. C . , with steel plates top and bottom of each column . N . Y . S . D . H . C . R . .Model Approval Data : INSIGNIA SERIAL NO . 35954 PLAN APPROVAL NO . NY 0182 MFR . NAME : RITZCRAFT OF PENNSYLVANIA MODEL : 260 X 489 CLASSIC MFR . SERIAL NO : 01089010024B DATE MFG . 8/23/ 89 Should you have any questions regarding this inspection, please contact me at Morse Engineering . Yours truly , NOR E ENG NE Mack A . Dean Codes Specialist HAD : pl cc : Mr . Jack Liberty , Lamplighter Homes , Inc . RICHARD S. MORSE * PIE. Pfiarte + ( '318) 792 - 'S3$2 1 Cyt rf I t � � 1 1 � .1•_, I i ! i I I i (. 1 I i 1 r 1 1 l i 1 t 1 t f i flf 1 C k 1 ` . <F I I I I Ji � � ! I -_...L- - �.._.. ! I � Vj Lee- 101k {�Il .__�-- _. T 1 C C 4 f F i C K I I I i f 1 1 I w r i I 7 I i I I 1 1 C 4-71 ❑+1 aa] itii fDr u)I 71 Mr CY PROPOSED PLOT PLAN FOR PROPERTY LOCATED AT 97 COUNTRY CLUB RD , OWNED BY NAMES T . and BRENDA A . BROWN ; Prepared by BRENDA A . BROWN an JULY Twentteth, Niknteen 'Hundred Etgftty Nine , SCALE= 7 " 400 -roA Y BRAY TERMrNAL rNc . l �► sS . z r23 #4 *40 OF QUEIE t �1t tTo lY"1A!'Ib do, nNt�"21t c DM POND JAMES T . & BRENDA A . R BROWN GLENS FALLS MP CLARENCE A. & MARY BROWN COUNTRY CLUB f=run-o Carat PURL io 11% n d TO a.7 • PROPOSE . * 04 DECK f * aa� C . BROWN PROPOSED •']' S IF-15r OSED . F !or i DNS FALLS COON Y GA�AG J B STORAGE SHE 7 U BARN BEING ' DE40LISHED o . � a- E'.CIHNTRV E'! IR POAn