8373 C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date July 1P, 19 This is to certify that work requested to be done as shown by Permit No. 2373
has been completed.
One-Family Dwelling
This structure may be occupied as a
Lot 32 Brickoven Road (Bedford Close)
Location
David and Patricia Johanson
Owner
By Order Town Board
TOWN OF QUEENSBURY
-•;, `--**7
• -
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Building et Zoning Inspector
CREATIVE -MST A" PRINTING. GLENS FALLS. N V 12801 1518)793-S858
•
„ BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8373
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to David and Patricia Johanson
Lot 82 Brickoven Road
OWNER of property located at Street, Road or Ave. 0J'
in the Town of Queensbury,To Construct or place a One—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.
rt
1. OWNER'S Address is Camas, Washington
2. CONTRACTOR or BUILDER'S Name
Martin C. Mosher
0
3. CONTRACTOR or BUILDER'S Address
15 Greenway North
Glens Falls, New York
4. ARCHITECT'S Name ti
O
by rt
PJ CO
1-h NJ
5. ARCHITECT'S Address 1 IS
N.
O 0
N
O O-
6. TYPE of Construction—(Please indicate by X) En <
(D (D
(x)Wood Frame ( ) Masonry ( ) Steel ( )
0
7. PLANS and Specifications
28 'x68 ' per plot plan, specifications and
No. application submitted including two—car attached garage
and sewage system.
8. Proposed Use
One—Family Dwelling
CD
$5. 00 C/O Paid lv
$ 1 97_ no PERMIT FEE PAID —THIS PERMIT EXPIRES November 1 1g 84 5
N-
(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.)
CJ
Dated at the Town of Queensbury this 3rd Day of April. 19 84 (�D
SIGNED BY Ctdvt . for the Town of Queensbury
Building and Zoning Inspector
,.-.TOWN OF QUEENSBUR'11
(Space inside block to Ix. filled in by
- WARREN COUNTY, NEW YORK Building Inspector)
Alication for 1l,irlication No.
PP Permit Issued l'i. .
BUILDING AND ZONING PERMIT l'erniit Expires PI
/,'iiiii I)c,tri<t
:I I I I< ()i Work ' . . . . . . . . . . . . . . . . . . . .
THREE (3) Copies of a PLOT PLAN, Drawn to scale '\l't ""'rl by
showing the actual dimensions of the lot to be built k,'m:irl.
upon, The exact site, and location on the lot of the
building to be erected or altered MUST BE SUB- _=
MITTED WITH THIS APPLICATION.
(y T,P, N.MEGEM
OFQLBEENSBURY
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ,1i�? :y _
ANSWER ALL OF THE FOLLOWING. aI RA. /��
The undersigned hereby applies for a permit to do the following work 4761
7 g 1 11 P.M.
which will be done in accordance with the description, plans and specifi- ' �' .�' i�� 0® 12�31�I�I6
cations, and such special conditions as may be indicated on the permit. C
The owner of this property is:
(NA''E) {P 0 ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the ZoningOrdinance apply is:
(NAME) 9P G.ADDRESS)
Name of Builder �G�1�1� (i).J e. • L7-1.vr:'1----/`-u., Address . . . 1.--v
Name of Plumber. . . 4/m.c.� Address lvv.✓�
Name of Mason � L' c., Address
Lot Number#f Unit Estimated value of proposed work S .7 a, --o , /(✓p
Name of Village_. ,,C-a( n.4(+. . .[., -cr. . . . .‹ . Ltr1-/-4 14"iS
Name of Street ��j' Lw— , Side of street: north 0, east , south ❑, west 0
Nearest Cross Street . . �'C-L.ta,lJ1...c.-. . . 1. C-(� . . . . . . . Distance from this cross street ,9 Ft.
Property is north "0,south ❑,east i i,west ❑from Cross Street
If on Corner, which corner, northeast ❑, northwest 0, southeast ❑, southwest
(Designate by marking with an "X" in the correct space.) .
NATURE OF PROPOSED WORK OCCUPANCY
AConstruction of a new building. Main Bttiing '
ElAddition to a building. One-family dwelling
❑ Alteration to a building. Two family dwelling CI
❑. Demolition of a building. -family apartment house ❑
Store building El
-car attached garage Z
Other:
• Accessory Building
. One-car detached garage ❑
0 Other work. Describe: Two-car detached garage ❑
Private chicken house • ❑
Private storage building ❑
Other:
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building,or a change of occupancy.
J Indicate on the plot plan sweet'names, the location and
i size of the property, the location, site and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed buildings) in dotted line and existing
/,t;c/c_A — je« L huilding(s) in solid line.
. Size of property . . . .L47..O. . . . . ft. x ' ft-
i �7` Size and use of existing buildings, if any
62 '
s w Size of proposed building . . . c c • ft.x • •/.7• . • • ft.
Height(from grade to ridge) ' 0 i ft.
• Front yard Li �- ' ft.
Side yards &Q ft. and . . . --6' ft.
Rear yard / / ft.
SOUTH If on corner,setback from side street ft.. ..
Note: All distances are net, as measured from street side
line'to nearest part of building.
(OVER)
:
(cont'd.)
BUILDING SPECIFICATIONS., ..
...; -
Kind of construction: Wood frame, fire safe, etc.?. . . .‘N.--: /. .1."-:-.175‹.-. . ...... ./1.-:(4-:71-1..,c-..,
Will any second-hand lumber be used? 1/4-/-1.'0" If so, for what;
Material of foundation walls /e' " ,,&,--1-4--r-i.-/ , Thickness /t)
Depth of foundation walls below de 0 " Continuous foundation?
Will there be a cellar? u7.s -J-..--
i,Afr. a
If so, material of cellar floor. 2/ ' elze../-e..z._ c._/
Type of roof: Sloped or flit? . ./. .--41...<.-s-L." Material of roof /frtz.-e---1- L.---Wi-le-a-)
Size,wood studs "x '`7/ ", spacing /40 ,,,,,_
"o.c., length. . . . . ,,,d(... . . . . ft. -
Size, floor beams, 1st floor ,,,..2 " x / 0 ",spacing /4 "o.c.,span III ft.
Size,floor beams,2nd floor 6>Z- " x i 0 ", spacing / ( "o.c., span . . . . /. .1"./. . . . . . ft. '
Size,ceiling beams " x 6 ", spacing / C "o.c., span / 17/ ft.
Site, roof rafters or beams G,2- " x . ", spacing / "o.c., span /// ft.
Exterior finish ----7)-1--k-a--/---)2 . f With what material? - A.2.d_..z....m...c_Z--4.2-
Finish of interior walls /,,A "
If garage is to be attached, of what material is wall between garage and main bulging to be constructed?
ita'1` ,5A-L.c.,•-e7r—A--/-,e'
Is there to be an opening between garage and building? L---124--
Kind of heating system . . . . . Oil burner or coal?
Will a flue-lined chimney be provided! . . .y-i:-.4:- . . . . • Depth of chimney foundation below grade 60 " ,
Height of chimney above roo
Will there be a fireplace? . . . . .--a-"
- , Depth of fireplace hearth /4
Will a toilet be installed) '--( ---"
Will a kitchen sink be installed and connected to water supply? ---/f—(2
Water supply(public water supply or pump) ,0 e-(..‘664%e,--
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
AFFIDAVIT
Town of Queensbury
County of Warren 1 SS. .
State of New York
I swear that to the best of my knowledge and belief the statements contained in this application,togedmr with the plans and specifications sub-
mitted, are a true and complete statement of all proposed work to be done on the described premises end that all inovisiona of the BUILD-
ING 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.
.
Sworn to before me this Signature 4-1-21 ,- e•- •
OWNER,OWNER'S AGENT,ARCHITECT,CONTRACTOR
day of 19 . •
NOTARY PUBLIC, WARREN COUNTY. N.Y.
. .. ....—.,
SPECIAL CONDITIONS OF THE PERMIT:
• .
•
' .
• • ,
. ,
• . .
•
•
By . • ,
•-
-•.•-= ,--7---,7"-- ,' - ,-• ,„
TOWN OF QUEENSBURY
Mcs..x:k";;-Thiol YORK I'�uu
WARREN COUNTY, NEW
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 C 6
2 . Type of heat . 1E -e-
3 . Is the building mechanically cooled?
4 . Peicentage of area of windows and doors /3 . i/ 7;
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
bo _
` b - 3g -R. tR �leo�n
2 . R value of exterior walls n e
3 . R value of glazed area 7.. . 0C)
4 . R value of doors A .
5. R value of floors over 'heated spaces tq/}A
6. R value of slab edge insulation - unheated slab N/W
• 7 . R value of slab insulation - heated slab /6
8. R value of heated basement/cellar walls (above grade) 1 }q
9 . R value of heated basement/cellar walls (below grade) WA
10 . Type of insulation .. ot.ANN.AA . VNte- Lho.M�
C. Controls D
1. Thermostat maximum heat setting '1S
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 9....2- / .:2„i-0
(applicant ' s signature)
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1. Owner ' s Name i9 02-1,... �, ���,mot ,✓
Address C�(i►,Z<co/ �i/� �,�2/�.i� � � U
� 4
Telephone No.
2. Property location Kim f � Z i�cr�L� � J /,/• . , „(,/,,./
3 . Name of person or firm responsible for installing system
41)
Telephone No.
Address
4. Number of bedrooms (residential buildings only) 1
. 5. Daily flow gallons/day
6: Septic tank capacity /, gallons
7 . Topography: flat, rolling, steep
% of slope
8 . Nature of soil and depth /a/�,.,� �t,.-
a
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
B is not required
C If required what is the rate minutes/inch.
11. Water supply: municipal, well, other
12. Type of system proposed: drywell, tile field, other ,
7/
Any contractor, corporation, individual, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date ,2 - �� /"1"l:l 5 2-7,1v (i •
signature of applicant
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any' 'structure, . distance from
property line and domestic water supply, etc. 'Include all dimensions of
the system itself.
Form 3-82
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
,� IJ
CITY OR
VILLAGE TOWNSHIP �/� �•„ � �, COUNTY
STREET AND NO.OR if
ROAD AND POLE NO. 7,�I: -" 4! }.-:'; , /-'/.,j is `? 1i , POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS
PREMISES LOCATED? r< `- SECTION BLOCK LOT
OCCUPANTS BUILDING
NAME i��':`[:, '�. _.t r 7 4•' i ! 4i::/7:rri�f OCCUPANCY �� , - 177
OWNER'S NAME
AND ADDRESS
CURRENT
SUPPLIED
BY .�V�!!-a ..Jp-; /. -/ FROM THEIR ( - „� i�L{l-- 1 __ OFFICE
BUILDINGI-'r'NEW OLD❑ REMODELED El IS
IS NEW I / DEFECTS
ADDITIONAL❑ REMOVED Li
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures e MOTORS HEATERS BRANCH LAMPS
Lamp Receptacles CIRCUITS
Loca-
tion Side Attach't H.P. Watts tall WATTS
Ceiling Wall Recept'Is Switch Pendent Bracket No. Type Each No. Each No. Gauge NO. EACH
Out-
side
Sub-
base
Base-
ment
1st Fl.
2nd Fl.
3rd Fl.
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN
SERVICE MAKER
ENTERS OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS Ill�1i, i„ / - i�_ �__, NEW OLD
•
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
DATE OF
APPLICANT //•V i / ,�� !-•-i L%!-?/r�J'2'L N I;==h APPLICATION
STREET ADDRESS 7'f✓i Pf l ) ,%!, c✓ / !1- l I•! 71-7
CITY OR — ;��'. `, CODE /;1/, LICENSE NO.
POST OFFICE 7.--/ /�_� /-�/9l!-J (:'I WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
-To Levi, sO O 37
z �±4,J_.n".._.....l�_Ca,I,A .a/A�C;,,J.. ,ICJ_...1,.41..lJ_I. /-J.AA.CJ_�.I.4C1,,P,.U..l3..Ca! I.J-.!.A k.1.c-1,9,1 .•.C).•.1,•�lI•!.J.%.J.9.V.•.lJ.•tiJ.��J.•�J.%),..,, •.."..aka•.l) �,14••a�a�J.•[.a..4 Aa(, ...
c.
E 4000304 THE NEW' YORK BOARD. OF FIRE UNDERWRITERS • r ._
tZ �i ;Y�
1, � BUREAU OF ELECTRICITY Y ri
rm. cit1 1-C 41 STATE STREET,ALBANY,NEW YORK 12207 ,411. r�
Date July 27 � 1-0u4 Application No.on file 0523 6-Lf,•OVr
A r
THIS CERTIFIES THAT ;r ,
., . only the electrical equipment'as described below and introduced by the applicant named on the above application number in the premises of !r --
I' e tin Mosher Cont . , B;_i.ckovert Road , Qucensbu y, New York
r
,4
❑ Basement in the following location; 'El 1st Fl. '❑ 2nd FL. Outs�"''T � Section Block Lot ?
r
•D was examined on 7 r 8 /f?j� and found to be in compliance with the requirements of this Board. :P.eaj J~ i
FIXTURE RECEPTACLES SWITCHES FIXTURES MERCURY RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS '
c•�. OUTLETS INCANDESCENT FLUORESCENT VAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P.
s}
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS .r
GGGAAA '
'AMT. K.W. OIL ' H.P. GAS H.P. AMT. •-,NO. A.W.G AMT. AMP. AMT. .AMPS. TRANS. AMT. H.P. NO.OF FEET 'AMT• WATTS ,r,
n.
ilk SERVICE DISCONNECT NO.OF 7 lawL S 71-4uE R V I C E •
AMT. AMP. TYPE EQUIP. 2W 1 if 3W 3 if 3W 3,B'4W NO,OFER%COND. OF CC.COND. NO.OF HI-LEG OF.HI.LEG NO.OF NEUTRALS A.OF NEUTRAL 'r
r
7. z 00 CD 1 ..: �• °� elfo
OTHER APPARATUS:
r
Ti,�'� t r c Room i G'£ a - a .�i` 1 W, 5 p 7� �;® ,j r 7 J ,°; 1..W
-- 1 Smoke Datecc or r ir
' 15 ��1 mp CFI 17LoaLtr T _
h-Tb j York
+ r� • J
-, 'J-L L:',P d F a l l , New 41 J r k 12 Li!,.,e i -
-._ BRANCH MANAGER •.
Per .
"-iti'l Iii"iii-lele 5ii-74feiii"i'iii-7ii-i'ai-iiii-iii-iiii-iiri47riiria-iei" Yl'iYYiY iieie lii- Y Y*YYiY Yiriii'l YYZ'iii-i CYO'CYii7 iii-ii 7e'iii'iiYilsYYirYeY Y�i-ieIiYYiY9iiYYaYYiii-ie'iai-i/Y'ie3.
-- COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF-QUEENS-BURY
Building Department
Inspectors Report Date -7 /, f f
Name _1 O H . eD 9 f
Location3 ;,fcea/ dv
Permit No. .*�'-3 777 Weather
5. emarks .
Exca{7a tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor /f',OLD
Interior Trim G''
Stairs & Railings ((''�/'
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing I/' 0-
Door Closers L,/,
Chimney
Water Meter Inst.
Septic Approval
Floors '
Insulation Foundation
Walls
Ceiling
OM-
. L Bui ding Inspector
REMARKS
•
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date 6 /2 3/
Name /lJ/)4 7?k) /n a Y f7"e&
Location L r a-) h/cj44_
Permit No. K3 73 Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves //;Y\''
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst. �
Septic Approval
Floors
Insulation
Foundation
Walls '
Ceiling
Building Inspector
REMARKS
� �� b0�.
TOWN OF•QUEENSBURY •
Building Department
Inspectors Report Date C,17 1
Name 010 i.j) .1�1���19 S ✓1y T
Location L•o i - 3 e0 C!0 5 t' eciczt 4
. Permit No. Weather
Remarks
Excatia tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches 1:;//\\
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation
Foundation
Walls '
Ceiling
2,-(
Building Inspector
REMARKS
� ,7e_,
/00 L e_e_cH
TOWN OF QUEENSBURY
Building Department /
Inspect ,5 s Report Date . ,���-,/ ,
Name
Location e R.-ic.k:cr)v.rY 4../
Permit No. g' Weather
✓�
,,�'' �'G}_�� of-L/leouq5 Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing •
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
'Ceiling
Building Inspector
REMARKS
•
%WN OF QUEENSBURY
Building Department
Inspectors Report Date ..: //4L-
Name X1 .5->e/"r
Location f = ' /1,Glr 0,//. 4/
Permit No. 3 7 3 Weather
Remarks
Excatja on
Footing Forms
Footing & Piers
Foundation .�
Cement Coat
Waterproofing
Backfill
Final Survey /
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation '
Walls
"Ceiling " '
'
Buildin nspector
REMARKS
•
TOWN OF QUEENSBURY
Building Department'�� ,�J
Inspectors Report Date rl/ �"9
Name � �! �!_to_ . C
Location r„ • 5d w,Aewi L:14c Z
Permit No. Weather
• 3ijRemarks
Excatra ti on
Footing Forms ,......--/_,,, k_
Footing & Piers' g
Foundation
Cement Coat
Waterproofing
Backfill
. Final Survey
Framing I •
Sheathing
Roof Felt
Roofing /
Siding ,/'
Masonry Veneer ,/'
Rough Plbg. ,'
Relief Valves
Wall Board
Ext. Porches /'
Finished Floor/
Interior Trim
Stairs & Rail • gs -
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
• Insulation Foundation
Walls
"Ceilin -
Building Inspector
REMARKS
.e•—•
1
1.....17/0 "
.e.C°
> •
j.„ •
,
63 73