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1989-874 ,, ram. ..... . • 4W 1?7T"n! #-i': g I 4 { NNEMMMMMMON 'I CERTIFICATE OF O CCUPA C"Y TOWN OF QUEENSBURY l WARREN COUNTY, NEW YORK s j Dace March 9 19 90 I i I i ! r , { This is to i1 xhat work rcquated to be done as shown by Permit Pao. 89- 874 jhas been completed. I j Thu structure maybe occupied as a Single FaMily Dwelling 's Location ' "` 04 Maol a Drive I 'i Owner FOREST WOOD HOMES i By Order Town Board TOWN OF QUEENSHURY 4 Director of Bldg. & Code E orcement i BUILDING PERMIT x TOWN OF QUEENSBURY No. 89-87 4 WARREN COUNTY, NEW YORK c? u w PERMISSION is hereby granted to FOREST WOOD HOMES ire I OWNER of property located at Lot #46 - Mapl a Drive Street, Road or Ave. ON in the Town of Oueensbury, To Construct or place a Single Family ❑wwl 1 i n 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_ OWNER'S Address is -r� HC- 01 - Box 286P � Warrensburg , New York 12885 ,m 2. CONTRACTOR or BUI LDE R'S Name Self b 0 x 3. CONTRACTOR or BUILDER% Address O 117 4, ARCHITECT'S Name r- 0 S. ARCHITECT'S Address C1+ qk -ia rn 6. TYPE of Construction — (Please indicate by X) 'a (X) Wood Frame i 1 Masonry f ? Steel l 1 rrrm C7 z 7. PLANS and Specifications �--� C Crt No. 32 ' x 46 ' xxx single family dwelling with septic system and drivewa as per plot plan , application and specifications . S. Proposed Use t to Single Family Dwelling m r $ 213 . 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES June 1 19�p_ ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the r town of Queensbury before the expiration date_) -rC L7 rn rn Dated at the Town of Queensbury this d Day of November 19fira _ H SIGNED BY ' for the Town of Oueensbury Building and 2VIh ing I nspector TOWN or QUEENSHURY REViEwE17 BY FEE PAID # '` ..` TOWN OF Q(jEENSBi Ry PERMTr NO. - c DECEIVED 4EL BUILDING PERMrr APPLICATION NOV 2 7989 CODE DEPT. A PERiYEIT MUST BE OBTADMD BEFORE BEGINNING CONSTRUCTION, NO INSPECTIONS WILL BB MADE UNTIL APPLICANT HAS RECEIVED A VALID BUELr)[MG PERMrr. 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 s s a . . * : • . +r . . . • s . r : . : . . * . . . r a . : ■ >+ : . . s ■ The owner of this property is: L 1, P.O. Address Tel. !'Property Location � ,. i Tax Map No, ate; /' 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 PERSO$ RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING "CODES IS. NATURE OF PROPOSED WORK. * ESMMATED MARKET VALUE OF +✓ Construction of a new building ,. CONSTRUCTION: S Addition to a building ' COMPLETE INFORMATION REQUIRED BELOW: ' Size of property ft x ft, Alteration to a building * Existing Buildings( 3 ) Site ft. x ft, (no change to exterior dimensions) Proposed building - distance from property line: Other work (Describe) " Front yard. eft . Rear yard fte w * Side yards fto and ft, GROSS AREA OF PROPOSED STRUCTURE✓ If on corner, setback from side street ft. 1st Floor sq, ft. IG3U * OCCUPANCY INFORMATION 2nd Floor sq. ft, * Primary Building - Other Floors �J . One Family Dwelling (not ceLiar or sew emi f w Two Family Dwelling TOTAL FLOOR AREA 1 + Multiple Dwelling/Number of units 81ae of now structure��� t ft. " Business wmmmmFoundationmVor/slab/crawl,}[IiaFii,i3/fuu * Industrial (circle one) ` • Other I Noo of stories (habitable space),i}L.., . .�= �r Height (grade to ridge) `, ,. ft. If addition, what wil Use bed If residential, no, of families _ • No& of rooms(escluding baths) 7 •Noo of bedrooms Accessory Building �� � ~� • Detached Garage UkNEI"I'WO Car Now of bathrooms_ • ~� Primaryr' • Attachod Gar C hooting sy►stem 1, . � ago ONE�'I'WO� Type of fael� � �`Privato storog* building No* of flroplaces to be inatalled �' ,., Other Will a wood stove be installed Central Air conditioning OV* ER BUfLpfNG PERN11T APPLIC .ATIa :v CONTINUED SC' ILDING SPIEC' IFICA. TIONS: T %, pe of con.Struction, wood frame, fire safe. etc . Will any second-hand or upgraded lumberbe used ? If so, for what ? Foundation wall material Thickness Depth of foundation below grade (to bottom of footing ) 1 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 -Qloped/ flat /shed/other Material of roof Size, wood studs ""x " .spacing " o. c. length ft & Joists ( floor beams ) ist floor "x "" spacing "o. c. span ft. Joist (floor beams) 2nd floor "x " spacing '"o.c. span ft, Overlays (ceiling beams ) "'x "" spacing." o,c, span ft. Roof rafters ""x it spacing o. c, span ft. Roof trusses (pre-engineered) spacing ? o. c. span ft, Exterior wall finish of what material? Interior wall finish If a garage is to be attached, 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, self-closing device be provided? Will a flue-lined chimney be installed? 'Height above roof ft. 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 separate application is necessary for any repair or new installation of septic system) NAME OF BUILDER ADDRESS FIC TEL. NO. NAME OF PLUMBER ADDRESS TEL. NOo NAME OF MASON _ ADDRESS TEL. NOa NAME OF ELECTRICIAN x ADDRESS TEL,. NO. fV -------------- DEC LA RA' MON To the best of my knowledge and belief the statements coast,^ :Y,-,sad in this application, together wIt'h the Plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that ail provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complioo with, whether "cified or not, and, that such work is authorized by the owner. Signature " Owner, owner's aft, architect, contractor SPECIAL CONDITIONS OF THE PERMIT: BY y. WARREN COUNTY , NEW Y RK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW PORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work , ANSWER ALL of the following : 1 . Gross floor area ) S41"r 2 . Type of heat C 1 , ' J 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 heat 3 spaces YES NO a . Are foundat 3n walls insulated ? YES NO i . If YES , what is the R value ? 3 . Slam on grade YES NO a , If YES , wh . t 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 Be, Under 16 % Only i , R value of roof and floors exposed to ambient conditions ' 3 2 , R value of exterior walls F "� 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 ) 90 R value of heated basement/ cellar walls ( below grade ) 100 Type of insulation ? C . Controls 1 . Thermostat maximum heat setting c ' D . Duct SYc. "-�ms 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 rnpulation 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 oftmmomms 1 . Maximum heating Telephone No . . % -- ( app cant ' s signature ) F { t TOWN OF QUEENSBURY GOWN OF QUEENSSURN o ca APPLICATION FOR RECEIVED SEPTIC DISPOSAL PERMIT JQN 1 1990 BLDG. & CODE DEPT. DATE I / % - /C� O LOCATION OF PROPERTY FOR INSTALLATIONcz � Owner's Name: ,G- Telephone: Address: c�1 . Installer's Name: 4 xf �i r '/y •-�,�, Telephone: :2 C ;' 2 Number of bedrooms (residential only) Total daily flow (compute (d 150 gal per bedroom) Topography: Circle one: Flat Rolling ' Steep Slope % of Slope Soil Nature: Circle one Sand Loam Clay Other /Depth: Feet Ground Water: At what depth? Feet Bedrock or Impervious Material: At what depth ? Feet Percolation test: Circle one: not required required rate min. inch, Domestic water supply: circle one: Municipal Well Other. If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank /6; & C�2 gal. ( minimum size: 1 . 000 gal.) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of ,.�. / Size each feet by � feet Size of stone to be used #..,./Depth or Thickness fee# 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 age Disposal Ordinance. SIGNAT E_�P RESPONSIBL.E-^� PERSON: DATE ��..a=-�.•. / � ! ! OVER MIDDLE DEPART AGENCY* INC, (i{}f G� Q �+ D i1VSP�C o$W March 11 , 1990 4Cfrtitteg that fi6oQbA� equipment listed has been writ approved as being in accord with the National Elect iC plicable governmental, utility an S. Owner: Forest:wood I y p i Occupant: Single I?aml7. C) �» Location: Lot 46 Maple r � 'i , u S � . ceryficela i�leC YC uipment and Insiellation inspected this ,mow pale. lr atldilY nrfal ui n1 ih be rntre}d Lr ed W ells rri rbna made to -Y 'G+' a:iBCinQ ayslam Ihi YCe�s Em nutl and void, and application for Equipment: 9 .5 Outlets ; eceptacles ; �� ���� /ss >1-;+.,apaCtion ahauld sll6ml[tpflp i 4y fa th is Agency. `� V ■'iJ 1f Solder of this oe ricale sh M eM same to his property insu*ance Carrier .� 1173I7 SeTV1 4 �l pp �ance5j 8Tl't a.',t7,8 Sagan70r cornP y>af av4 artiricauon of aYaetncak egvipmanl approved as apec4rY�a.' Applicant: 31 Tenth Avenue - - ' o. 15 -03177 2 � Hudson Falls , NY 12 Faun No. M EL 1-03 .. TOWN OF QUEENSBUR'Y BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280k TELEPHONE 18) 792-5832 BUI ING INSPECTOR' S ORT REQUEST TNS ECTIC7N RECEIVED NAME . 'q4, fJ LOCATION DATEI�/ f PERMIT - APPROVED YES NO FOOTING/PIERS 21 MONOLITHIC POUR PO S _ FOUNDATTON/.DAMP-PROOFING_ BA+CKF.TLL APPROVAL ROUGH PLUMBING ? ,r FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS, WALLS CEII.ING INAL INSPECTION: CHIMNEY HEIGHT lox ROOFING SIDING EXTERNAL PORCHES/S P STAIRS-CLEARANCE & LS _.. PLUMBING FACTURES/RE EF VALVE INTERIOR TRIM/PRIVAC RS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSERS} SMOKE DETECTORS FINAL ELECTRICAL INSPE TIO FINAL APPROVAL OF CONS UCT N - OK TO ISSUE C/o OR C/ A SIGNED CERTIFICATE OCCUPANCY MUST BE OBTAINED FROM THE BUItrNG DEPARTMENT BEFORE THESE PREMISES ARE OCdFPIED! REMARKS: 09 ARRIVE �'i INSPECTOR _Down a/ Queen a "ry EIUILDING and ZONING DEPARTMENT A . Bay and Haviiand Road, R. D. 1 Box 9$ Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM IpN�SPECTION NAME ( , LOC4T I CCU DATE � p../JjQ PERMIT NO, SOIL TYPE - Sand - Loam - clay - Percolation Test Required? YES - Percolation rate - Min/inch TYPE of 310TEM: Absorption eld , total lengt Length of each trench Depth of trench Size of gravel_ SEEPAGE P ITS4Nuinb of) Size' �ft_ X ft. Gravel s:i ze PIPING : `, _ e Tape Bldg . to tank Tank to list . box r / Dist. bon to field/ �t car Openings sealed? ES NO Faxtial LOCATION/SEPARATI S : Foundaticin to t /c2 ft. Foundation to a crption ft . Absorption to t line / ft. Separation of its ft. LOCATION OF S STEM ON PROPE (circle one ) Front Rear eft side - Rlght side - CC IMMEN-1 S SYSTEM USE APPROVED . YE O Building Inspect r 01/86 and v1 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVXLAND ROADS C.)UEENSBURYr NEW YORK I280!%m TELEPHONE (528) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED v _ lv NAME � �- ! /// f �lkQL- LrL3 LOCATION Ce 4' DATE / o c PERMXT // 7 CI APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR RMS FOUNDATIONIDAMP-P OOFXNG BACKFXLL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL. ROUGH-I ✓INSULATXON: FOUNDAT-TON FLOORS WALLS CEILING FINAL INSPECTI N: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/S E ,STAIRS^CLEARANCE & RA FLUMBING FIXTURES/ ELI F VALVE INTERIOR TRXM/PRT ACY RS FINISHED FLOORS GARAGE FIREPROOF NG DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL 41VSPECTXO FINAL APPROVAL OF I CONSTRUCT ON A SIGNED CERTTFI TE OF OCCU NCY MUST BE OBTAINED FROM TH BUILDING DE ARTMENT BEFORE THESE PREMISES A E OCCUPIED: REMARKS: TrIspECTOR TOWN OF QU.EENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS jo� ,��464j QUEENSBURY, NEW YORK 12802. OAr �G•c TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED ,i 4 I NAME J LOCA T IO DATE r / PERMIT # - j APPROVED - YES NO FOOTING/PIERS MONOLITHIC POUR FO S FOUNDATION/DAMP-PR FING BACKFTEZ APPROVAL UGH PLUMBING Lpf?AMING ELECTRICAL ROUGH- INSULATION. FOUNDATION I FLOORS WALLS CEILING FINAL INSPECTION: I CHIMNEY HEIGHT 1 ROOFING .SIDING EXTERNAL PORCHES/ST S STAIRS-CLEARANCE & ILS PLUMBING FIXTURES/ E IEF VALVE - INTERIOR TRIM/PRI C DOORS FINISHED FLOORS GARAGE FIREPROOF G DOOR CLOSERS) .SMOKE DETECTORS FINAL ELECTRICAL NSPECTS N FINAL APPROVAL OF CONSTRUC ION A SIGNED CERTIFI ATE OF OCCU ANCY MUST BE OBTAINED FROM T BUILDING D ARTMENT BEFORE THESE PREMISES RE OCCUPIEDP REMARKS: INSPECTOR r 1 TOWN OF QUEENSBURY Jy BUILDING AND CODES DEPARTMENT ' I3AY & HAVXzAND ROADS � QUEENSBURYr NEW YORK 22809E- TELEPHONE ( 5I8 ) 792--5832 BU I LD ING INSPECTOR ' S REP_OR,/T �.� REQUEST FOR INSPECTION RECEIVED / '-yG� NAME T LOCATIO /y DATE PERMIT" # � / APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOF G KFILL APPROVAL UGH PLUMBING MING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STE S ,STAIRS--CLEARANCE & ILS PLUMBING FIXTURES/R LIEF"" LVE INTERIOR TRIM/PRIVA Y DOOR ' FINISHED FLOORS GARAGE FIREPROOFIN DOOR CLOSERS) _. SMOKE DETECTORS FINAL ELECTRICAL IN PECTION FINAL APPROVAL OF NSTRUCTION A SIGNED CERTIFICATE OF OCCUPAN Y MUST BE OBTAINED FROM THE BUILDING DEPAR MENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS : C -- INSPECTOR i. TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEEN,SBURYf NEW YORK 12809+ TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED _ NAME /4 LOCATION Ail. r� r DATE / PERM T #� +� APPROVE YES TING/PIERS Va MONOLITHIC POU FORMS FOUNDATION/DAMP-PROOF G BACKPXLL APPROVAL T ROUGH PLUMBING FRAMING ELECTRICAL R GH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT x� ROOFING SIDING EXTERNAL PORCHESISTEPS . STAIRS-CLEARANCE & RAI _ PLUMBING FIXTURESIREL F VALVE INTERIOR TRIM/PRIVAC'V DOORS• FINISHED FLOORS -- GARAGE FIREPROOFING` DOOR CLOSER(S) SMOKE DETECTORS FINAL ELECTRICAL tNSPECTION FINAL APPROVAL OF CONSTRUCTION r i A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT ,BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: `fie /Get 40 /` " + �`'�, .► ._ + .� 00* _akee NSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT / BAY & HAVILAND ROADS / QUEENSBURYr NEW YORK 1280!- ;f TELEPHONE (518) 792-5B32 BUILDING INSPECTOR ' S REPORT / 7 REQUEST FOR XNSPEC;PTXON RECEIVED NAME LOCATION DATE - �'1 PERMIT # j APPROVED YES NO FOOTING/PIERS MONOLXTHXC POUR FORMS FO NDATION/DAMP-pROOFXNG CKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN *' INSULATION: r . FOUNDATION FLVORS WALLS CEILING FINAL INSPECTION: CHXMNEY HEIGHT ROOFING t SIDING EXTERNAL PORC ES/STEPS_ STAIRS-CLEA NCE & RAILS PLUMBING FX TURESIRELIEF V LV.E .INTERIOR T XM/PRIVACY DOORS FINISHED LGIORS GARAGE F EPROOFXNG DOOR C ER(s) SMOKE D TECTORS FINAL EL TRICAL INSPECTION FINAL AP OVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUXLDING DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: J f � r INSPECTOR C TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280!& TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR NSPECTXON RECE ED NAME f L4'.7C'A TXON , DATE FERMI # 6 ! f APPROVED YES NO OOTXNG/PIERS moNOLXTHIC POUR FORMS FOUNDATION AMP—PROOFING BACKFXLL API*OVAL ROUGH PLUMBX* FRAMING ELECTRICAL ROUG IN INSULATION: FOUNDATION FLOORS WALLS E CEILING FINAL INSPECTION: s CHIMNEY HEIGHT ROOFING SIDING ,EXTERNAL. PORCHES TEPS STAIRS—CLEARANC & RAILS , , PLUMBING FIXTUR S/RELIEF VALVE INTERIOR TRIM/ IVACY DOORS`. FINISHED FLOO GARAGE FIREPR PING DOOR CLOSER ( SMOKE DETEC RS FINAL ELECTRIC L INSPECTION FINAL APPROVA OF CONSTRUCTION A SIGNED CERT FXCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: " ^ ]� 1 4 r rz' �pQ r/ fXr.S ��� Ce.•� 'i�'.E. G�'ercr # 3 �r�ri ,�io�.�rs C. T If AJ f rt I.�V G 2: 7© � < INSP OR MID13LE 0W?ARTIItfEN f Prr,!CTW, 1� WCY, IN r National Headquarters 900 HaddoneAve:� Collirlgswrood, N.J. O131U$ ?. Date : L k C A N'T C(07)N71P L 7 IN ,.A 'k: air. County b { ,f' j State ty, Town or Township ocation/Address E4 if Located An Rural Area - Please Attach Directions) Pale # ' Y"f .) �+► �hj�f � +"wC� S Permit l}wner _ suliding: NevvlQ OId Q 'Occupied As Occupant Work Area in BMilding tFloor #0 etc.): s Ready, for' lns ' ion- A for: Wiri Q Service Q or: r4jake Payable To: M.D. I.A. C [� Check ihM1:O_ Fee Remitted - ash $04 7" 1 1259 1= 750 soon z25o 2500 27 9eoo. Number of Rough Wiring Outlets Elect. Heat 7 Dishwasher. ` Switches Amp. Service. --- urface Unit �Pum�p Lighting Water Heater Alr Conditioner Dryer ' Receptacles Oven .Garbage Disposal Wiring and Controls for Burner Num r of Fixtures '__'� Amp,' Receptacles Fractional H.P. Vent Fans Other Equipment: 1/2" j,/1 1/14 1/8 1/6 1/4 1/3 1/2 3/4 ILL 2 3 $ 7 10 15 20 25 3- MOTORS H.P. 40 50 F5 100 Mark Nurnber .. of Each Size License # Permit # APPl icant.'s ' Signature Utility : CA IN FF L 1 N .T/A Appli.0ll t' dress: (State) ' {Zipl ce ce quest # {City) Electrtician: Phone # __ DATE INSPECTED0 DATE RECEIVED. Correct Location: Same as Above or: Red Notice Label Rough Wiring Outlets Surface Unit Gar aW Disposal Switches Ran pis . washer Pr Rece tacies ater Hea r Dr�et Fixtures 'conditioner ' - -� p,mrts. ;l3eC�P*acle Amp, Service Equipment Burner, Wiring gI`Contrals far Vent Fans Amp. Service Cod nuctors Pump 4v . sti 75 1 ' 5 • 7�/z 10 15 24 25 -34. MOTORS H.P. 1/20 1/12 1/10 1/a 1/6 114 113 1/2 /4 1 - 1 lair r,- Mark Number of Each Size soo 750 1va0 12so 1500 17 2aoo 22so 250o s760 aooa Elect. Heat i 1 RW Progress: inc, � KDQ Contractor .� _ CASH [� CFT violation : Work Comp. Q Inc, 0 'Owner Fea.. ;Cole, # Q L/A _ Due MO- fik- Q L/A Municipal 11 r1p r r. r rlP1V # IPA pipllcarst Other Side Q. UtiIIty Owner Date Cut in Card Temp # + 9SiCyNAUHE• Date r de Q Final # q :W. APPLICATION FORM NO, i }} li I cl 10 f Ifff rl J) ;2 � 1 p 11 I 7 i � I I Gr ++ I � II rj p rvwN OF OOEENSBURY RECq!VED JAN 1 ; 1990 . I BLDG & CjJDE DEPT. TOWN OF- Quc=NS URY ZDnlng Administrator rr .. i IA � . M44- - - 4FAj opa - - i .r .a w1� ,��' ,