1984-8629 i
BUILDING PERMIT
TOWN OF QUEENSBURY No. 8629
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Ken Mattson
Street No. 3 n
OWNER of property located at Lot 24 Pine Wood Hollow Road Street,Road or Ave. X
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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 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'SAddressis 64 Blind Rock Road-
Glens Falls, New York
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2. CONTRACTOR or BUILDERS None
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3. CONTRACTOR or BUILDERS Address M
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Same
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4. ARCHITECT%Neme O x
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6. ARCHITECT'S Address
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6. TYPE of Construction—(Phase indicate by X)
(A Wood Frame ( )Masonry ( )Steel ( )
7. PLANS and Specifications
53 'x3 6 n per plot plan, specifications and
No. application submitted including two-car attached
garage and sewage system-
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8. Proposed Use
One-Family Dwelling
$5. 00 C/O Paid February 19 85
$108. 00 PERMIT FEE PAID -THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the A
town of Queensbury before the expiration date.) M
Dated at the Town of Queensbury this 10th Day of duly 1984
SIGNED BY Q. �C,� for the Town of Queensbury
Building and Zoning Inspector
,,..C/o Paid
CERnFICKM
A
To Cif f URY
WARMN +CEQUWY, I*W YORK
Dace December 5 19 8 4v
This is to cerdh thu work requested to be done as shoat► by Pernsit No
-
has has been r kmwd•
This stnw�mft any be owu�d as a
one-Family Dwelling
don Lot 24 Pine Wood Hollow Road (Street No. 3)
Lea
Ow►ndr Ken Mattson
By Order Town Board
TOWN OF QUEENSBURY
Bn"09 Ql &aeig respect
i. GIR�A7IYE '"1!l�TA r�,►�.rtN4 -OLtR]R; nwets M M ttlOt IStel)R]5{RR s ,�...,.. l .s... ...._..._......,...__........_.,..y._..-...v' 's....--
THE NEW
YORK BOARD. OF FIRE UNDERWRITERS '
4046458 BUREAU OF ELECTRICITY a
(— 41 STATE STREET,ALBANY,NEW YORK 12207
Date January 16, 1985 Application No.on file 463268-84 A 633365
THIS CERTIFIES THAT application number in thepremiees of
ones the electrical equipment as described below and in&odaced by the applicant named on the above
Ken Mattson, Pinovood 90110w, Glans Fails, Now York
in the following location; zi Basement 1st Fi. ❑ 2nd Fl. outside Section Block Lot _
12/3/84 and found to be in compliance with the requirements of this Board.
was examined on ,r
FIXTU RANGES COOKMld DEGAS OISM WASN�S EXHAUST FANS
RX1UM AMI SINK CM NCANDESCEM FLUORESCENT AMT. K.W. MAT. K.W. AMT. K.W. T. K.W. AMT. K P.
28 45 27 26 2
REE i sKpAt"CTT TUM ass E!<l UNIT HEATERS t11111TF OUTIET DIMMERS
{ DR1f�s MMACE MOTORS MAN AMANC! f1fSTEMi .AMT.- wATrs
K.W. OIL •.M.P. GAS R.P. AMT. NO. I A.W.G. MAT. MA►. AMT. AM►S. TRANS. AMT. N.P. NO,OF FNT
f
f
i 1 ange 6
S E R V 1 C E
i�AETER 1/4W 1 �SW S d 3W S 14W NO.F C.CONO. OF CC COND.
NO.OF WLEG OF�wqA ; NO.OF I�UTRAtS Of I�NRAI
MAT. MAP. TYPE EQ111F.
'. 1 200 CS 1 s
1 4/0
OTMER AKARATUS:
Electric Heaters: 4- 2.0 k.w.
1- 4. I.W.— Water Heater 3- 1.5 k.w.
1- G.F.C.i.
1- Smoke Detector 2- 1..0 k.w.
2- .75 k.a.
2- .5 k.w.
L A. X* Dion 11*CtriC 239,
104 Mt, View Drive GER
South Glens Falls, Now York 12801
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COPY FOR BUILDING DEPARTMENT_TH1SCOPY OF CEIRTiFtCATEMUST NOT BE ALTERED N ANY N R._