Loading...
1989-754 ' .. i : .1.. .. '/' t .. !vt. u ..f�i M�y*.}?�,: i'.::. Tl"'q_""M. ^"o�T['.'�'rw.v ..��i.. ._. . . .- _ -. :�yt. .. . .. •�1.,'e.�•J CERTIFICATE OF 0CCUF'"ANC TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK i)nte December 15 _ _ t9 89 This is to certify that work requested to be clone as shown by Permit No, 89-7 54 has been cotupieted. This structure may be occupied as a_ Single Family Dwelling lAwmtion �—_ ' Q S free Ci rc ! e Orvnlr D7 i nP� Tcr Ire�r By Order Town Board TOWN OF QUBBNSSURY Director of Bldg. do Code Eno ement BUILDING PERMIT x TOWN OF � QUEENSBURY No WARREN COUNTY, NEW YORK w cst PERMISSION is hereby granted to Pl i npy Tucker s OWNER of property located at lot 143 Qa k Trpp Cirr.1p 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 other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is Sox 425 RD#4 Division Road Queensbury , N . Y . 12804 C- 2. CONTRACTOR or BUILDER 'S Name M �a 'X? Self 3. CONTRACTOR or BUILDER 'S Address Same 4. ARCHITECT'S Name C7 5. ARCHITECT'S Address -P cam: C !y 5. TYPE of Construction — (Planse indicate by X) .c +*x) Wood Frame I ) Masonry I 1 Steel I ) r 7. PLANS and Specifications J r� No. 28 ' x 68 ' Single Family Dwelling as per plot plan , specifications , an4d ra application , including septic attached two car garage and driveway . 8_ Proposed Use ,,.. Single Family Dwelling $ 191 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES April 1 19 90 'c (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbu ry before the axpirati on date.) Dated at the Town of Queensbury this 25th Day of September 19 E4 ra SIGNED BY for the Town of Queensbury — Building and Ta.o ng Inspector ciG TOWN OF QU MNSBURY REViE W ED BY FEE PAis! # I q i -''ter-- 7"C7WP,1 OF PERKM NO. � JF � , RECEIVED SBt�R`r BUILDING PERMIT APPLICATION q9t SEP 2 1989 19L00% & CODE DEPT; A PERIQT MUST BE OBTAXNED BEFORE BEGINN1XG CONSTRUCTION. NO OFSPEC IM014S WELL 88 MADE UI4T L APPUCANT HAS RECEIVED A VALID BUILDING PERM All applicants spaces on this application NIUST be completed and the signature of the applicant MUST appear an the reverse side of this application. The owner of this property is: r:2 P.O. Address r .r .rr...&Zze-+ y Tel. Property Location T- .wr Tax .Map No. �;13 S1lr'5 Has there been any split of this property since October 1 . 1988 ? f� If yes Planning Board Review is necessary . yes no SUBDIVISION NAME• IF APPLICABLE 1-L 4"WM.C,, LOT NO. THE PERSOt4 RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: NATURE OF PROPOSED WORK: Esr.MATED MARKET VALUE OF # _Construction of a new building „ CONSTRUCTION: S `��v .. Addition to a building ' COMPLETE INFORMATION REQUIRED BELOW: " Size of property s' c�� ft x f �rt. Alteration to a building " Existing Buildings( 3 ) Size ft. x (no change to exterior dimensions) /y 1�rft . • proposed building - distance from property line: Other work (Describe) " Front yard'.ZAZ-.ft. Rear yard r ft. • Side yards ft. and GROSS AREA OF PROPOSED STRUCTURE ,� If on carnet. setback from side street ft. Ist Floor l 3 4/ sq. ft. /'5( * _- * OCCUPANCY INFORMATION Znd Floor sq* fto f cE . Primary Building Other Flows sq. !t. . ( On* Family Dwelling (not: aetleHar+ar or� r� Two Famfly DererlllesE "L'd' A& F AMS AMA. ft, • Awultivpaw D"0112wwNumbow of uutits S180 at waisaSUR46ftWo Xr�!�_ ' I�iira■■, IF+sooir�isaEi■�r assailw4w at +E?1! " i ._w I • ._w..r a ice.�i - - H*iglu 'CL't'a r to rift ` " f1L • If addltlov4 what wUl U" bel, - If resldrn Uds ea* of families r' + No. Accosaary Ong No* of brdrooKers D� 4arago tyN>!J'I`M • O Car No* of badwoonla a Primary heatiig s�ataMs� ; `"�r , • '" Att �¢! t+ll G1f ,1'1"M�O Car .m Type of ft ate -, 4e e �Prhrate stoeater buUdbq No. of Hreplaces to be install3ed� • WIU a wood sWve be Installed // • Otltel��_ - cantsal Air condttiemiag -_ OV• L►S BL7ILDIVG PERMIT APPLICATION ( C] v T tti F � BUILDING 3PECIFICATIO %JS: Type of con,;true#ofi, wood frame, fire safe. etc_ fti' ill any br rgWaded ltim "rt�e used? If ;o, for what ' Foundation wall Material Thickness ,ica Depth of foundation below grade (to bottom of footing) "�<3 Will there be a cellar? 4!!? Heated or unheated? 4 q age_ -. / 3 Sr r 3q ft . Floor s . foox Will there be a basement ? . Will any portions be used as living space ? xty, ... (If so, what portion? 10ZdL sq ft . Type of use? Type of roof slope flat/shed/other Material of roof 'i.,,, -- tE; 2, 1.s ���z Size, wood studs. ''? "xII000IIi / to spacing�l�."• o. c. length 5?` ft. Joists (floor bcants)olst floor ` "x zv Or ;paring 2�"o.c. span X31 ft. Joist (floor beams) 2nd floor."x ' spacing "o. c, span ft. Overlays (ceiling beams) FIX to Spacing Of o.c. span ft. Roof rafters "x Of spacing floc. span ft, Roof trusses (pre-engineered) spacing ww o. c. span 4KII ft, Exterior wall finish C� ou .,.-/ r* of what material? P/F`rV i c Interior wall. finish /,:;p_ PY If a garage ft to be attached, describe materials to be used for FIRE SEPARATION: , . Y«►� �.L� �],- Is there to he an opening between garage and dwelling? V .e 5 If so will a Fire-rated door, enclosure. self-closing device be provided? V Will aflue-lined chimney be installed?J Height above roof. ft. Depth of chimney foundation below grade IIIto — f Depth of fireplace heartt+�fta /t/ Water supply - Municipal or private well SEPTIC SYSTEM Distance from ANY private well (including adjoining properties X ft. (A separation application is necessary for any repair or new installation of septic system) NAME OF BUILDER / r ,tr ,, .-;:- f ,/ ADDRESS y � �• � / NAME OF PLUMBER ..�z �•,-, ADDRESS -- - - -�- TEL. NO. r NAME OF MASON ,st dl A oie, "ADDRESS TEL. NO., NAME CW V LEIZ!t"!!'IC'tA N� � _v,. ADDI.EW '1`E i.. 1wi+G#. / f TO 4he �lwt +rrg sir! arm irr! o #!lrsil� �sY11. ice' WM apMt �� arm �Irr11a Itted, o" a, try arrQ �:� � an arraie I* i* desra an the eMirscribed peeeMoas and that AU previsions of the BUILDWO CODE. T#RE Zawma O RDQVANCEr O1 kU othw laws 90rtainrt t0 the peglasod work shah be coerpi ed with, whotAw ■Ilra�affisevp nal, and that MACh work is autharf"d try the ownar. ......-rw.w StgIIR . ... r. t]a►aar, owner"; arm*, eGWb*etW ' ,. By TOWN OF QUE - NSPUR . 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 10 Gross floor area 1 r - 2 . Type of heath 3 . is the building mechanically cooled ? [ems 4 . Percentage of area of windows and doors A . Over 16 % Only 10 WO value of s area of walls , roof / ceiling and fl exposed ambient conditio VW 2o loor over heat paces YES a . Are found on walls insula YES 1 . if S . what is the slue ? 3 . Slab n grade YES ,�0 ! a If YES , wh . t the R value of insulation and perimeter floor ? 4 . Is basem heated ? YES NQ�/ a . R alue of insulation 5 . Type of insulation 13L 8 . Under 16 % Only i . R value of roof and floors exposed to ambient conditions_ }" 13 2 . R value of exterior walls 3 . R value of glazed area r.r 4 . R value of doors 5 . R value of floors over unheated spaces _ Vag" 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab / 8 . R value of ed basem t/ cel r s ( abov del ! L / z b� ent dOilar wall s0( t+�l0w 4r } -x 9 , R value of tea / �j lo . Type of insulation Co Controls 2 i . 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 valu* of duct in other areas Plying Insulation 1 , Size of hot water or cooling carrying agent ;sip* 2 . R value of pipe insulation F 0 service Plater Heating 1 . Performance efficiency ' 2 . T*mperatur* control setting maximum G , For Swimming Pool only 1 . Maximum heating --- Telephone goo � icant a signatur * } TOWN OF 1QUEENSB LIP Y CI APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION Owner's Name: / r 4j6 ee ,c� �Telephone: /�' ' ' �s y Z / �+ Address: �5v.+C r / rc gn2 AZ (sloes 7diy w, Ar , e% Installer's Name: / ,r / - i Telephone: Number of bedrooms (residential only) Total daily flow (compute (a 150 gal per bedroom) L,,c ,r-r3 Topography: Circle one: kFlat Rolling Steep Slope % of Slope Soil Nature: Circle one; an Loam Clay Other. /Depth: Feet Ground Water: At what depth? Feet Bedrock or Impervious Material: At whha�t- -d..,epth ? Feet Percolation test: Circle one: Ct— equired rate min. inch. Domestic water supply: circle one: 6:uni:c:1paP Well Other If domestic water supply is a well: Separation: Water supply from septic absorptionf r� feet PROPOSED SYSTEM : Septic Tank d gal. ( minimum size: 1 ,000 gal. ) TILE FIELD: Each Trench .S�L� feet/Total system length f 9 p 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 Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: DATE: 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 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 2 . ) location and distance to lot lines 3 . ) location and distance to structures F 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 iuilding 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 must ht.: submitted co the Queansbury Building Department before further construction . Town of Queensbury BUILDING and CORES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 Kom" rks tY 51 111 11 IIVIKI IUI MIDDLE DEPARTM9 T- INSPECTION AGENCY, INC. 9" kia!ddatill, * Ual. Cio flngawood, N-J. 08108 I I . Dat; December 15 , 1989 GC 1 CCtlfl � that till etectrjgCal .equlpment listed has been examined and is approved as being in accord with the National Elects coil Code; applicable governmental , utility and Agency rules. c Owner: P 1 iney Tucker Occupancy: Dwelling Occupant: Single Family ¢�b-y ,�, l f Location: Lot 143 OakT-r ,, ; c-rcle a PueensburY.ekj,�'arxen �'�q} ;I iicate covers the eleclrical 6gvrpm ant antl ensta l4al on inspected to s C 'x 1, date It additional equipment .should be mlroduced or allerancr--s made 10 �a't t exisb mg system tnis carlitrCate sham be nut( and void. and appliCal.on tarin 9 4,rww Cy Equipment: 120 Outlets SO Receptacles .30 C i1Ct L1r L' $ 3 Hola el:on should be Submrould 04 pmsent iame t hisge properly '7,^ � � MlbltlOr o' im5 4e riilr�g;e should present same to hiS properly In su raACC Ca rne� 200 Amp Service. ;. 8 Appliances (agent or company I as"idori of certification of electriCal edu3pment approved as specilied Applicant: Box 425 R '' Pliney Tucker �:.. Day I] iVi lt�i1 Rci . : . e � Queenshury , NY 12804 � , � � , : NO . 15 -030325 Fans No. 703 E4 f,83 TOWN OF QUEENSBURY BUILDING AND COMES DEPARTMENT BAY & HAV.ILAND ROADS QUEENSBURY, NEW YORK I2801- TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST INSPECTION RECEIV D NAME LpOCATION -t* 2 tkr DATE ' PERMIT #F APPROVED YES I NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIONJDAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING ,'YNAL INSPECTION: CHIMNEY HEIGHT ROOFING y SIDING Syr EXTERNAL PORCHES/STEPS STAIRS—CLEARANCE & RASLS PLUMBING FIXTURES/RELIEF ..VAL _ v INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) lop SMOKE ,DETECTORS FINAL ELECTRICAL 2NSPE TION FINAL APPROVAL OF CO TRUCTION A SIGNED CERTIF ATE OF OCCUPANCY MU.;T BE OBTAINED FROM E BUILDING DEPARTMENT`, BEFORE THESE PREMIS ARE OCCUPIEDI REMARKS: 44 INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 128D41- TELEPHONE (538) 792-5832 ,f� BUILIING INSPECT ' S REPORT 1 fir{ REQUEST FOR INSPECTION RE EIVED NAME AL LOCATION DATE tom- ERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORM FOUNDATION/DAMP- R F.ING BACKFILL APPROVA ROUGH PLUMBING ! FRAMING ELECTRICAL ROUGH-I ✓XNSULATION: FOUNDATION FLOORS WALLS CEILING + FINAL INSPECTION CHIMNEY HEIGHT ROOFING 1 SIDING EXTERNAL PORC ES/STEPS STAIRS-CLEARAOCE & RAILS _ PLUMBING FIXTURES/RELIEF VA L E_ INTERIOR TRIM/PRIVACY DOORS FINISHED FLOQRS _ GARAGE FIREPROOFING DOOR CLOSER ($) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL ' OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUS BE OBTAINED FROM THE BUILDING DEPARTMENT EFORE THESE PREMISES ARE OCCUPIED! ----------------- REMARKS: INSPECTOR BUILDING and ZONING DEPARTMENT + L Bay and Haviland Road, R, D. 1 BOX 98 Queensbury. New York 12801 SEPT jI SPOSAL SYST r, INSPECTION NAME LOCAT I Ole! DATE i L PERMIT NO , Q} CI- SOIL TYPE - and Loam - Clay Percolation Test Required? YES NO Percolation rate - Min/Inch TYPE of SYS + Absorption fie total le gth Length of each ench Depth of trenche Size of 4Iravel --- SEEPAGE i�PITS{Numbe O Size- ft. X _ to Gravelsize PIPING : Size Type Bldg * to tank. -- Tank to (List_ bo Dist_ boy: to fi ld/p ' Openings Seale ? ES ) NO Partial LOCATION/'SER TIONS : Foundation t tank f t- Foundation o absc rpti.on f t Absorption o lot line t . Separation of pits LOCATION YSTEM ON PROPERTY ((. ' de one? Front - R ar Left side - Rightjide - COMMENTS . SYSTEM USE APPROVED ES NO Build ng In ector 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURYt NEW YORK I280k TELEPHONE (5I8) 792-5832 BUILDING INSPECTOR ' S REPORT REQUESTIPPR INSPE. CTTON RECEIVED.. � ^s NAME `` ►t p,, ��}) LOCRTIO DATE PERMIT # APPROVED YES NO FOOTING/PIERS MONOLITHIC PO FORMS FOUNDATION/D -PROOFING BACKFILL APPRO L ROUGH PLUMBING FRAMING ELECTRICAL ROUGH- N INSULATION: FOUNDATION FLOORS r WALLS CEILING FINAL INSPECTION: AF CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE STEPS S'TAIRS~CLEARAN & RAILS PLUMBING FIXT ESfRELIEF. VALVE INTERIOR TRI (PRIVACY DOORS FINISHED F RS GARAGE FIR ROOFING DOOR CLOS (S) SMOKE DE CTORS FINAL ELEC ICAL INSPECTION FINAL APP OVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDl REMARKS: (�� -r�, FECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVXLAND ROADS YORK QUEENSBURY, NEW PORK 12$0¢ TELEPHONE (518) 792-5832 BU I LI}I NG INSPECTOR ' S REPORT REQUEST FOR IN PECTION RECEIVED NAME 'J LOCATION -~J DATE / PER.MIT ;"#� C �j APPROVED — --- YES NO FOOTING/PIERS MONOLITHIC PO FORMS_ F"OUNDATXON/27 -PROOFI�pG -- S.�3CKFILL APPR AL ROUGH PLUM$IN a t.�AMI NG ELECTRICAL ROU H--SN. INSULATION: 11 < FOUNDATION `; i FLOORS r WALLS CEILING FINAL INSPECTXQ& 6 CHIMNEY HEIG11T ROOFING SIDING ) EXTERNAL P RCHES/ TEPS STAIRS-CL RANCE RAILS - PLUMBING IXTURESI ELIEF VALVE .INTERIOR RIM/PRI VA Y DOORS FINISHED )FLOORS GARAGE F EPROOFING DOOR CLO ER (S) SMOKE DE ECTORS FINAL ELEC ICAL INSPECTS �N FINAL APPR VAL OF CONSTRUCjxoN A SIGNED C RTIFICATE OF OCCUPANCY MUST BE OBTAINED F M THE BUILDING ,DEPARTMENT BEFORE THESE PREM ES ARE OCCUPIED! REMARKS: sPECTC7R TOWN RY UXLD OF QD CODESLDE BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS , QUEENSBURY, NEW YORK 72$0d- TELEPHONE (518) 792-5832 i3 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE J PERMIT A PROVED YES NO OOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING .BACKFILL APPROVAL ROUGH PLUMI4.TNG FRAMING ELECTRICAL ROUGH-XN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING 1. SIDING EXTERNAL PORCH /ST S STAIRS—CLEARA E & RA LS PLUMBING FIX RES/REL F VALVE INTERIOR TR /PRIVACY QORS FINISHED F RS GARAGE FIR PROOFING DOOR CZOS (S) SMOKE DST CTORS FINAL ELECT ICAL INSPECTION _ FINAL APPR AL OF CONSTRUCTIO A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT ,BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: c 4XNSPECTOR __ ._ TOWN OF QUEENSEURY BUILDING AND CODES DEPARTMENT BAY & HAVXZAND ROADS QUEENSBURY, NEW YORK 12804- TEZRPHONE (518) 792-5832 BUILDING INSPFO fJR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION 1 C7 �-�1 p DATE PERMIT # CS 1 APPROVED YES NO FOOTING/PIE Y MONOLITHIC R FORMS t�POUNDATXON/D -PROOFING i �ACKFILL APPRO V PLUMBING ROUGH PLUMB FRAMING ELECTRICAL ROUGH- INSULATION: Y• FOUNDATION ' FLOORS WAL.IS' r CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING f SIDING EXTERNALYFRS S/STEP S STAIRS-CE & RAILS PLUMBINGES/RELIEF VA ' VE INTERIORRIVACY DOORS FINISHEDGARAGE FFINGDOOR CLOSMOKE DEFINAL ELECINSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBuRYe NEW YORK 1280+4- TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED .— NAME LOCATION,r DATE y - y7 PERMIT # _ APPROVED YES NO TING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDAT N FLOORS WALLA CEILING FINAL INSPECT Nc CHIMNEY HEIG ROOFING y SIDING EXTERNAL PORCH ' STEPS STAIRS—CLEARA E RAILS PLUMBING FIX RES ELIEF VALVE INTERIOR TR /PRIVA Y DOORS FINISHED F RS GARAGE FT PROOFING ____ DOOR CLOS R (S) ` SMOKE DE ECTORS FINAL EL EC RICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE .BUILDING DEPARTMENT" BEFORE THESE PREMISES ARE OCCUPIED ! /7 `REMARKS: , J I SPECTOR SELECT BuSI rV ESS F0AMS (6091 22e-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 Date City, Town or Township = oe 00 ME T, = (2ce n!t / County g .I ✓- ar-,y.2 _State--. �� Location/Address A- 4977 (if Located in Rural Area - Please Attach Directions) Pole aA Owner Permit # — Occupiers As S' • .r1 .s +�- @K^� sty f r �✓ Building: New Old Occupant Work Area in Building Floor #, etc.]: for: Wiring Service or; Ready. for Inspection : Fee Remitted - $ Cash © Check 0 - M.Q. c:] Make Payable To : M.D. 4.P goo 750 1000 12g0 15" 1750 zoos 2xao xaaa x7so x000 Number of Rough Wiring Outlets. Elect_ Heat Switches Amp. Service Surface Unit Dishwasher Range Lighting Water Heater Air Conditioner Dryer Pump Receptacles pen Garbage Disposal Wiring and Controls for Burner Number of Fixtures Amp Receptacles Fractional H.F. Vent Fans Other Equipment: MOTORS H.P. 1/2 1/1 1/l0 1/a 1/6 1/d 1/3 1/2 3/4 1 1Vz 2 3 5 7=l 10 15 30 20 2S 40 50 75 100 Mark Number of Each Size Applicant's License # Permit` #_ Signature f *l C�+u .r��I�" Utility : �J/,r► .rAroy �+sfard/sera �'� it !j Ng T/A ,, t �,3 + I?A► {NAM Applicant"s Address:._ "�` � '� ���'�� �'�'� (City) (State} I !_Y+^ (Zip) Zaa Service Request # Phone # Electrician : DATE RECEIVED: DATE INSPECTED: Correct Location : Same as Above Q or: Red Notice Label Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Race las Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner. Wiring & Controls for Amp. Receptacle A Service Conductors Pump Vent Fans MOTORS H-P. 1/20 1/12 1/10 1/6 1/6 1/4 1/3 112 3/4 1 1Va 2 3 5 7Ve 10 15 20 25 30 a0 50 T5 100 Mark plumber of Each Si" 5 00 ISO10000 1250 15DO 1750 2000 2250 2500 2750 5000 - Elect. Heat [] Ryy Progress: 7nc. C] LKO Q Contractor CFT Violation: k Comp. F1 lnc. CASH [� LIA Owner Fee C14K # LfA Due MO # lPA�.. .. Municipal INV # Applicant Date,. . _ Other Sid* Utility Owner C Date .�„ . Lilt in Fsari!'. � -romp �; - - . National Haadrtlarters �: . • .. w . 900 Hadltlor5 Aye:; Colllrigswovd of ns ,. Date. City, Town.or Township e!;> oe .a► ww„✓3 AA-Aw County 452- ef %ee a ' 4p o •Slate 2 t ocation/AMress •A *�• +r Mw Air + k ; (if Located in Rural Area • Please Attach Qirections) PAIe # Occupied AS E'iuilding _ Occ3lpan t. a 4 ryYir f f 1Nbrk AArea in Buildi Floor #, a. r !'s for: Whin Service or: Rea for Ins ' ' Fee Remitted' -'$ -'' : Cash � Check da 7Sa i 32;!10 1750 2000 2256 2ebD 270 7t1aa 1 t ,. Number of Rough Wring Outlets Elect. Heat - Swvitches ...- Lighting Amp. Serwlce. $C+¢far�a Unit . < Receptacles Water Heater Air Conditioner Pump NumEies�" Overt , , c rp riuen.�...> { 1NQ' d: Controls for } filorw -..�14eint Fahs _ 41•. . . : 9.�': Other Equipment-: AiA - MOT4 'k1.P. /2 1/1 ljflb 1/e 1!fi 1/4 i/3 If2 3f4 1 1�Fx 2 3 . 5 _: 71h 10. 15 20 25. 30 .SA, Mark Numbar st of Each $ 6. iza - Applicant's +, . x .{. Signature . _„ / _ r .�.+* - L�osnse-# iPe it�dl� Tf ► .. _ 4lLlity i1J r:> _ . a a .Na '<'., f!�^r+r 'S .w , Apiicant's Address ss,��r d/' ,'� r !'mow Js7 �7 r IJ r s Sri+ I' 6. tCitY1— c itirr •r a 3,gs : le •" (State) ' +i ' ' Z+/ S@f trice Request # / Z} Phone .. „Electrician: :':sy F RECEIVED: �I - ^ 5 - DATE INSPE&M9 s Q ' Correct Lddetion: Same as Abowe or: .}"� -t2 �: z . Red Notice Label L . Rough Wiring Outlets Surface Unit - Otiren Switches Ran ' " I Rece tacles . Water Heater Fixtures Ali Conditioner r i Amp. Service Equipment Burner, Mri SI-CoMrols for Amp: c!e Aing►. Service Conductors Pula Vent Fans , MOTORS H.P.- jumj= 1!6 1!4 1/3 1/ 3J4 4s 30 15 20 25 5 k Mark Nuinher r '�- .f •�7.; Jci3 - ' ,?�' of Each Size - - Elect Heat soo. rsa 1000 12aa 15 x7ea 2»aa 22sa ` . saaa ;i, . . 6. .�., �,I : 0 RW Progress: Inc.' LkD � Contractor -- [] LfA Violation : Work .CoMPLQ ink} � ,'.-. - ner CASE# Fee L/A `` _ �:f�ue . . CHK 0 IPA } Mun 106t*,.. Ima MO, r. I*VDate: 16 Othsr-Side � Utility v' . % . Cut in Card Q. Temp # k?ate . . _ ,�, ; f rc'� [] Final 4* Date : z - 4 _ _ _ .Jf . . .. . . _ _.. APPL ICATION .FORM Z. 250`EJa A"'-.., ' • .. .- C4 MAP fills"F A'RENCF' HIDDEN HILLS SUBDIV 1.310N MADE FOR RALPH &e MICHAEL WOODBURY Bl' VanDusen, &c Steves DATED MARCH 26, 1986 FILED SEPTF.,MBER 22, 1986 IN MAP C"ADINET A SLIDE 44 TOWN of QU E.NSBUft4` Cam, LOT 144 �1 honing Administrator L0T' 145 � �� b. iata . ants s 38�r Ta r 1,5.00 4�t3 sq, ft0-60 acres /"t � w�, "IIrJaUTNflftl.7t i)a 1k.ItA 7t)hl 7H A17UI"YfrM r(,a SI IH VE V' E. —11 8FARIMC A IICFN'.I:U AND ;URAYOR VAL I':,A �OLA'noN OF SFCnnm 72CI9, ,LR-Irlw mN 2 OF Txe U NE.YORX STATE'F,UUCALION LAW.' I i 1;C)T 146 i GAR D ,;D. Y'YAf II A 'D kL 4 Y IHADf (I IR 'may 00A' ra /�.°-'`may T /'J�\J'�" �"/�' � /�"'(�^''y /��'(�,1�'' /�^^'�"'y' `��✓+ I - TOWN of QUF(rY�;t?i1k'T' _. . � fEJlJ --- -. __..NEY t7E WACl°2E IV N.Y. i SC:.Iq 1 -."0' ( I7ATE:I JU(_Y 7, 1E35Sb 1,07' 14.E V(f loDuscn 1�cves LOT 147 LAND S'IJit VC:YE]F.> i,l f.Ns f N,I P.t::'wt Y[7F;K N.Y. ST4TE::: LNC, NCI. 395,1/ 93 5-14 88 84'A; (HS 458 1)