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1992-041
7 TOWN Of QUEENSSURY WARREN COUNTY , NEW YORK Date ADY'i 1 17 __14 92 92-041 This is to certify that [work requested to be done as shown by Permit Na. has been completed. u icd as a Single Fermi 1 f)we71 i 11 This structure may be` occ p Heresford Lane Loeation Michael J_ Vasiliou Inc . Owner By C7rder Town Board TOyNfi OF Q%JEENSBUR'Y' Director of Bldg. Code Enforcement fr BUILDING PERMIT TCJ'MIV' N OF QUEENSBURY No. g2-041 WARREN COUNTY. NEW YORK p r PERMISSION is hereby granted to Michael J v Yasi 1 i ou Inc . Street, Road or Ave. CAA OWNER of property located at Lot #33 Heresford Lane in the Town of Queensbury, To Construct or place a Si nbl a Farm l Y DWel l 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 fig t. OWI+IER*S Address is aT 14 Stone Pine Lane a Queensbury, NY 12804 2_ CONTRACTOR or BUILDER'S Name Sam a e>5 rr 3 CONTRACTOR or BUILDER'S Address 1't 1✓ 4_ ARCHITECT'S Name W W 5. ARCHITECT'S Address tri �h Os 6. TYPE of Construction — (Please indicate by XI ( x3 Wood Frame l ? Masonry l ? Steel ( f tro 7. PLANS and Specifications No. 1378 sq ft Single Family Dwelling as per plot plan specifications and application a. Proposed Use Single Family Dfwel l i ng 19 93 $ 193. 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 7 , (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,} : 7 / Day February is 92 Dated at the Town of Queensbury this for the Town of Queensbury SIGNED BY Building arx! zoniry 1 ctor TOWN OF QUItENSBUR Y j,,S 4 o VLA A-1 r� REVIEWED BY : 411il TOWN OF QUEENSBURY FEE PAID : 14" RECEi V Ed PERMIT NO . : - } } FEB 5 1992 SLOG. & CODE DEPT. BUILDING PERMIT APPLICATION A PERMIT 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 . * * * * * * * * * * * * * * * * * * * * * *,r* * * * * -& * * * * * * * * * * * * * r � Owner of Property : � V 4- P . O . Address : ¢_. PHONE Property Location : , � �i /�-•�` 1 � -' Tax Map No . Has there been any split of this property since October 1 , 1988 ? Yes No If yes , Planning Board Review is necessary . 1 ,ram Subdivision Name , if applicable : B-el, ? Lot No . 33 THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS : NATURE OF PROPOSED WORK : * ESTIMATED MARKET VALUE OF THE [7�7 f _ Construction of new building As CONSTRUCTION : $ Le: Ls Addition to building Alteration to building Is COMPLETE INFORMATION REQUIRED BELOW * ( no change to exterior dimensions ) Is Size of Property . ZL� ft . x `,�''_ ft . Other work ( describe ) * Existing Building Size : * Proposed buiT�d Tng - distance from GROSS AREA OF PROPOSED STRUCTURE : eja)� * T property line . rjrl* 1st Floor Sq . Ft . � * Front Yard ft . Rear and ft . Side Yards ft . and ft . 2nd Floor Sq . Ft . � **, If on corner , setback from side street- ft . Other Floors Sq . Ft . W * (not cellar or basementT� f Is OCCUPANCY INFORMATION : TOTAL FLOOR AREA : lam= Sq . Ft . Or Pri ry Building * One Family Dwelling Size of New Structure : ft . x - ft . * Two Family Dwelling Foundation : * Multiple Dwelling/No . of Units Pier/Slab/Crawl /Part /Full cle One ) * Business Or Industrial No . of stories ( Habitable space ) Other Height ( grade to ridge) 4'2 . ft . If residential , no. of fam esee * If addition , what will use be ? No . of rooms ( excluding baths ) : No . of bedrooms : " No . of bathrooms : * Accessory Building : Primary heating system: / As Detached Garage - One/Two-.Car Type of fuel : .-_ * Attached Garage - One wo ar No . of fireplaces to be installed : -- — * Private Storage Building Will a woodstove be installed? : Other Central Air Conditioning : Yes ( OVER ) BUILDING PERMIT APPLICATION CONTINUED : BUILDING SPECIFICATIONS : Type of construction ; wood fram fire safe , etc . Will any second- hand or ungraded lumber be used ? If so , for what ? Foundation Wall Material : C r 7 .. Thickness : ( to bottom of footing ) : Depth of Foundation below grade / Will there be a cellar ? ,�. Heated or Unheated ? Will there be a basement ? �� Will any Sq . Footage : y portion be used as living space ?If sop what portion ? _ Sq . Ft . Type of Ilse ? - Type of aloof : C``S o�lat/Shed/Other Material of Roof �t��c �C , � -_ Size , wood studs ��"' � Z " ; spacing 9 �" o . c . ; length � ft . ,foists ( floor beams ) : Ist Floor x ID spacing ,�''� Joists ( fluor beams ) * �— "� o • c • : span Z/L_ ft . 2nd Floor '" x %Cl_ " ; spacin �, 9 o . c . ; span _ , ft . Overlays ( ceiling beams ) : x spacingr i� - - o . c . ; span l�G ft . Roof rafters : � " ; spacing v . c . ; span /� fIt Roof trusses ( pre-enginee spacing a . c . ; span ft . � Exterior Wall Finish : YN ;� U 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 ng ? enclosure , self- closing device be provided? and dwelling ? If sv , will a Fire- Rated door , Will a flue- lined chimney be installed ? Heig t above roof Depth of chimney foundation below ft ` grade : �--- ft , Depth of fireplace rth : ft . in . Water supply - Municipal r private well : SEPTIC SYSTEM : Distance from any private well ( including adjoining properties : (A separate application is necessary for any repair or new installation of septic system . ) NAME OF BUILDER & ADDRESS : -- NAME OF PLUMBER & ADDRESS ; „ IIIIIIIIIIHIIIIIIIIIIIII�PHONE /Z,J� 5�� NAME OF MASON & ADDRESS : yf,, PHONE :2 rz/ NAME OF ELECTRICIAN & ADDRESS : ]`� T _ PHONE— Z,12 PHONE III 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 belCompliedOEs THE ZONING withs whether specirfiedror and nottlandother thatlaws suchewtrknisg to the authorixhrapo5 d work shall y own Signature . Iorptper : owner agent , arc tec retractor .lii. By: o e orcement cer ENERGY CODE COMPLIANCE APPLICATION TOM OF QIJEENSBURYv WARREN COUNTY - 9000 HEATING DEGREE DAYS TOWN OF QUEENSOURY C=Wj lance Methods : RECEIVED PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings ( ONLY ) FEB 5 1992 PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings ; Multi - Family Owe 1 i nWDG. & CODE DEPT. ( 3 Stories or Less ) PART 4 - Design By Component Performance - Commercial Buildings - Hi - Rise Residential PART 4 & 6 - Compliance Methods Require Submission of worksheets Zo ON AP LIGANT ME FROPE TY L � � PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE4 1 . Gross Floor Area - Sq . Ft . 2 . Type of Heat - Elec . Base Board Other All -- 3 . Is Building Mechanically Cooled ? YES NO 4 . Percentage of Area of windows and Doors Over 17 % - /Y Under 17 % THE ReVALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D THE R-VALUES SHOWN ON PLANS SUB14I11TU10 Baseboard 5 . Insulation Values * Actual Shown�i Elec . Heat Other A . Roof & Floors exposed to ambient temperatures R Be Exterior Walls R— -�— C . Glazed Area R D . Exterior Doors R E . Floors over unheated spaces R F . Edge of Slab on Grade ( Heated Building ) R G . Basement/Cellar walls (Above Grade ) R r !f H . Basement/Cellar walls ( Below Grade ) R r i . Heating/Cooling - Ducts - Piping in Unheated Space R 6 . Service (Domestic ) Not !later Heatinq Device A . Conforms to minimum efficiency per code YES NO TE14PERATURE CONTROL MAXI NU14 SETTING 140' WILL NOT BE EXCEEDED 2-11 ' E T Ci� I NS PECTOR ' S REMARKS : /4 i S "l ITT e�� S Aj 0 TOWN OF QUEENSBURY RECEIVED TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PEIREts �9g2 Permit # Fee Paid r BLDG. & CODE DEPT. Date : 2 Reviewed By / LOCATION OF P OPER Y FOR INSTALLATION : � z ,�e1_3'fz /� Owner ' s Name : Owner ' s Mailing Address : !, C `7� C CiQ /` � F" ,•� • . =�-- Installer ' s Name : * .rY2 Phone # : Number of bedrooms ( if residential ) : Total daily flow ( residential - compute @ 150 gal . per bedroom ) : Topography- Circle One : Flat Rolling Steep Slope % of Slope Soil Nature-Circle One : Sa Loam Clay Other /Depth : Ground Water-At What Depth? Feet Bedrock or Impervious Material -At What Depth? Feet Percolation Test-Circle One : of Require squired/ Rate Min . Per Inch Domestic Water Supply- Circle One : unici Well Other If domestic water supply is a we - Separation : Water supply from any septic absorption feet PROPOSED SYSTEM / = Septic Tank ,r' gal . ( Minimum size : 1 , 000 gal . ) Tile Field : Each Trench feet//Total System Length feet Seepage Pit ( s ) : Number of Size each : _ ft * x ft . Size of Stone to be used : # Depth or Thickness feet HOLDING TANK SYSTEM IF REQUIRED No . of Tanks Size of Each Gal . Alarm system and associated electrical work to be inspected by a certified agency_ 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 : S2Ptic 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 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 installation , alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further construction . Town of Queensbury Building & Code Enforcement Department 531 Bay Road Queensbury NY 12804 Remarks : TOE OF QUEENSBURY 531 BAY ROAD QUEENSBURY . NEW YORK 12804 TELEPHONE fS TOR $ REPORT LDIN6 �FIMAL INSPECT TVED_,r�f/� r REQUEST FO ,Z1 "C �'T� NME t LOCATION nn4e, DATE PERMIT# TYPE OF TRUCTURE RECHECK FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE ) FOOTING FOUNDATION BACKFILL �f RAMING IIROUGH NSULATIONBING M SEPTIC WOODSTOVE/ FIREPLLACEL REMARKS APPROVAL N/A YEs NO CHIMNEY HEIGHT/LOCATION v B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PO CH/S EPS/RAILINGS RELIEF VALVES FURNACE/HOT WA ER OPE A IN BASEMENT INSULATION/DU WOR INTERIOR TRIM/ PRIVACY OORS FINISH FLOORS : BATH/KITCHEN WATE IGHT OTHER FLOORS SWE ABLE OTHER FLOORS CA ETED STAIR CLEARANCE/ ILINGS HANDICAPPED ACC S SMOKE DETECTOR BATHRALL GARAGEUMMBINGS/FIRE OOFINGS OPE TIi�G ~� DOOR CLOSER OTHER FIRE SEPARA ION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/V ANC REQUIREMEN S FINAL ELECTRICAL OK TO ISSUE C /O 0 /C COMMENTS : ARRIV .l � DEPART..,� OF QU ENS URY 531 BAY ROAD Q Y �TELEPHONE ( 518 )NEW 0R45- 4447 BUILDING INSpEC`IOR' S REPORT FINAL INSpEolt+DN REQUEST FOR INSPECTION RECEIVED 4 NAME. LOCATION DATE _l .__PERHIT!11 TYPE 0 S�TURE c RECHECK FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE ) FOOTING FOUNDATION SAC FILL FRAMING ROUGH PLUMBING _FINAL ELE TRICAL�-SEPTIC - INSULATION WOOLIBTOVE/FIRE LACE REMARKS P OVAL N YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/ pORCHJSTEPS/RAILINGS RELIEF VALVES FURNACE/HOT WA ER OPERA NG BASEMENT INSULATION/D TWOR INTERIOR TRIM/ PRIVA DOORS FINISH FLOORS : BATH/KITCHEN ERTIGH T OTHER FLOOR WEEPABLE OTHER FLO CARPETED STAIR CLEA NCE/RAILINGS HANDICAPP ACCESS SMOKE DETECTORS BATHROOM FANS/WHOLEH U E FANS ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARA ION FIRE/DEMISE WALLS DUMPSTER SITE PLAN VA IANCE REQUI EM NTS FINAL ELECTRICAL OK TO ISSUE C/O OR C/G COMMENTS ; ARRIVE DEPART �ou�n a� �ueen36�re� BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. 'I Box 98 Oueensbury, New York 12801 SEPTIC DISEOSAL SYST INSPECTION NAME LOCATION DATE ! +D PERMIT NOVV SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption f field , total length Length of each trench Depth of trenches - -_ Size of gravel- SEEPAGE PITS{Numbe of) Size- ft. X _ ft. Gravel size _ _ �— PIPING : a.ze Type Bldg . to tank Tank to list. box Fist . box to field/p ` openings sealed? Y S NO Partial LOCATION/SEPARATION Foundation to tank ft- Foundation to abs tion ft. Absorption to lot line x ft. Separation of pi - -£t• LOCATION OF SYST ON PROPEL TY (circle one) Front - Rear - L ft side - R4 11 side - COMMENTS : a � 4 SYSTEM. USE APP YES B i g Inspector 01/86 and vl � Jntv," o ueens ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME V A5- ( L i C20 LOCATION �3 . ghluzs ry Loral ' DATE '-i f 1 I Lft PERMIT NO. Ch, -a 7 � - SOIL TYPE - Sand ' - Loam - Clay Percolation Test Required? YES Pl �) — Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total length Q C7 Length of each trench Depth of trenches - '-5 J Size of grave] Z�- SEEPAG'.E P ITS-*,Number of Size- t. Gra a size -- _ PIPING : size Type Bldg . to tank Tank to list. box Dist . box to field/p t Openings sealed? Y NO Partial LOCATION/SEPARATION Foundation to tan ftw Foundation to ab orptia ft . Absorption to t line ft. Separation of its ft. LOCATION OF STEM ON PROPI TY {Circle one) Front - Re - Left side ght side - COMMENTS #0�r 1 L . t (gt ,) l' ' ef4a+e�-- €� i SYSTEM USE APPROVED YES N f B d ng lin 8c or r 01/86 and vl TOWN OF Q1iEENS BUILDING AND CODES DEPARTMENT 531 BAY ROAD 12804 4 NEW YORK TELEPHONE � ( 518) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION R£.CEIVED_ .uff/.d NAME LOCATIUI .+ "` DATE �� PERMIT # r, TYPE OF STRUCTURE APPROVED RECHECK N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM _ -- REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTI FROM FREEZING FOR 48 HOURS LLOWING THE PLACEMENT OF THE C CRETE . MATERIALS FOR THIS PURPO E ON SIT FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/V NTS IN PLAC PLUMBING UNDER SLAB FRAMING : JACK ST D /HEAD R BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH- IN XINSULATION : FOUNDATION WAL S I TERIO R - FOUNDATION WALLS TERIOR RR= FLOORS RT WALLS R_ CEILING DUCT WORK OR PI ING IN UNHEATED SPACES REMARKS ; + 2� ARRIVE' �� DEPART 2� r INSPECT TOMI OF QUEERSBURY BUILDING 5 AND CODES31 ROAD PARTMEN7 QU£ENSBURY , NEW YORK 12804 TELEPHONE ( 518) 7921111` 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR IN CTI REC ED }MIME LOCATION 00 DATE PERNIT TYPE OF STRUCTURE APPROVED RECHECK N/A YES NO F00 INGS/PIERS MONOLITHIC POUR FO M REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONS- IB E FOR PROVIDING PZING FOR 48ROTECTION FROM FREmOURS FOLLOWING THE PLACEMENT OF THE CONCRETE- MATERIALS FOR THIS PURPOSE ON SITE FOUNDATiION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VEN S IN LA E PLUMBING UNDER SLAB FRAMING : JACK STUDS /HEADERS BRACING/BRIDGING - JOIST HANGERS JACK POSTS /MAIN BEAM FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN INSULATION : FOUNDATION MALLS IN IOR R- FOUNDATION WALLS EX RIOR RR_ FLOORS R- WALLS R_ CEILING DUCT WORK OR PI ING IN U HEA ED SPACES REMA K ARRIVE DEPART � I TES PE TAR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURYI, NEW 0 TELEPHONE ( 518 ) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED MANE — LOCATiUN -�� DATE '- _ PERMIT TYPE OF STRUCTURE_„ a � RECHECK APPROVED N/A YE NO FOOTINGS/PIERS �— MONOLITHIC POUR RM REINFORCEMENT IN PLACE THE CONTRACTOR IS RE ONSIBLE FOR PROVIDING PROTEC ION FROM FREEZING. FOR 48 HOU FOLLOWING THE PLACEW—NT OF THE ONCRETE . MATERIALS FOR THIS PU POSE ON. SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLAC k FOUNDATION/DAMPROOFING` BACKFILL APPROVAL ROUGH PLUMBING ` PLUMBING VENT/VENTS IN , E PLUMBING UNDER SLAB FRAMING : JACK S D /HEADER BRACING/BRIDGING, _ — JOIST HANGERS -- — JACK POSTS/MA' N S Arid HEATING ROUGH— IN INSULATION : FOUNDATION ALL INTE I R R— FOUNDATION WALLS EXTERIOR R— FLOORS R— WALLS R— CEILING R— DUCT WORK OR PI ING IN UNHEATED SPACES REMARKS f !, ,, / ARRIVE ---- / DEPART I SPECTOR TOWN OF QUEENSBURY y"Y1 BUILDING AND CODES DEPARTMENT 531 BAY ROAD 4TELEPHONE # NEW 0( 518) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED �J{.NAME LOCATION DATE_ �PERHIT # C TYPE OF STRUCTURE -•,� RECHECK APPROV N/A Y NO FOOTINGSIPIERS MONOLITHIC POUR FORM -• -- REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE . MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE _ FOUNDATION/DAMPROOFINP_ BACKFILL APPROVAL __ ROUGH PLUMBING ---- PLUMBING VENT/VENTS PL E PLUMBING UNDER SLAB FRAMING : JACK S UDS/HEADER BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN B HEATING ROUGH- IN INSULATION : FOUNDATION W LT INTERI R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WO OR PIPING IN UNHEATED SPACES - REMARKS : ARRIVE _ DEPART I SPECTO TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY , NEW YORK 128( TELEPHONE ( 518 ) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTI0,14 RECEIVED NAME LOCATION , DATE y��/�/°� �` PERMIT # TYPE OF STRUCTURE �JI' RECHECK APPROVED NIA YESI NO OOTINGS/PIE S MONOLITHIC POUR FORM HE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF T E T RIALS FOR THIS PURP SE_ONN S4TE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/V NTS IN PLA PLUMBING UNDER SLAB. _ JACK 5 DS HEADERS BRACING/BRIDGING JOIST HANGERS _ JACK POSTS/MA-rff BE .......................... ........................ ......... HEATING ROUGH— IN INSULATION : FOUNDATION WALLS INTERIOR FOUNDATION 'WALLS LTERIOR R— FLOORS R— WALLS R— CEILING R— DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS : « r ARRIVE DEPART - G re4eZ2A� IN EC OR �, ational I�rlaclquartera 133.7 Wl ith ter Pil ', ilfesx CiM�ster, PA=; 19380 Date: City; Town or Township 116 Q1 4U4 County__ , State Location/Address { If Lo}c ad in Rural Area - Please Attach Directions) Pole # Owner i . e$ 5 . a.*ate j . . : : . . .f",IJra * Permit # Occupied As -Building: NewO - Older Occupant — °WoFk ''rArea in Suildin Floor #, etc. I : App, for: Wirin O Service E3 or: Ready for Inspection : Fee Remitted - $ Cash 0 Check © M.O. 0 Make Pay>ilble f! M.D. I.A. Number of Rough Wiring Outlets Elect. Heat -aao- 75p 1 1000 170 =50 2000122501250012750130001 Switches Amp. cServiee —,.t—Surface Unit Dishwasher flange Lighting Water Heater Air Conditioner Dryer "Pump Receptacles Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp" Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P. 1/201/1 1/1f5 1/8 1 1/6 I 1/4 1 1/3 1 112 1 3/4 1 1 l+lx 1 2 3 5 . 71h I 111 1 15 1 20 1 25 1 34 1 44 1 50 1 75 100 Mark Number of Each Size Applicant's Signature ticense # 'Permit # T/A Utility : Applicant's Address: (NAME) OFFIC3 L CATI, , (City) (State) [?ipy Service Request -V Phone # JEiectr•cian : 11ATE RECEIVED: DATE INSPECTED:' Correct Location : . Same as Above or: Red Notice Label Rough Wiring Outlets Surface Unit Oven Switches Range GaattilUe DisposaP Receptacles Water Heater DishwissKer Fixtures Air CGnditi.oner C tiyer`" + . . Amp. Service Equipment Burner, 1 ing Ec Controls for Ampr fteCeptia a `• ` Amp. Service Conductors Pump Vent Fans (MOTORS H.P. 1/20 1112 1/10 1/a 1/5 1/4 113 1/ a 742 10 15 1 20 1 25 1 a,Mj$Z3b 50 7 l00 Mark Number -of Each Size . Elect. Heat 500 750 1000 1850 1500 1T5D ZOQ6 Y25D $500 $750 3000 sa sc ED RW Progress : Inc. KD fl Contractor E CPT Violation : Work Comp, 0 Inc. 0 ' El © L/A Owner CASH Fee CHK # [] L/A Due IPA Municipal MO # INV # Date : s:... Other Side Q Uf i I ity Appl icaint Owner Cut in Card Q Temp # Date. 0 Final # a Date - ;NSPECTORS SIGNATURE APPLICATION FORM N0- 259°Li ' 1 e9 �r k" TOWN OF Q UEENS B UR Y Bay at Haviland Road, Queensbury, NY 12804-9726 (57a) 7r5400 74 5 4447 Building Permit # 92 - 041 These building plans are copies of those reviewed for a previous permit . Please note that additional " HI - R" insuiation was specified on exterior walls and on the sloped portions of the ceilings . We would expect that this building will be the same . If there are to be changes from these plans for this structure , please notify us previous to the work being clone . TOWN OF +QUEEN 0U Yo Thank you , BU �bLDIIIJG CO E- E' ;` f , o7p Vic Lefebvre C . E . O . REVlCVx' ct7 LY _ .. GC - -- Feb 6 , 1992 FATE FILE COPY AdO3 3113 "HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE" SETTLED 1763 rn m-n rr 00 m rn i �z z CA +ry j