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1987-183 BUILDING PERMIT TOWN OF QUEENSBURY No 87-183 cr WARREN COUNTY, NEW YORK w E� PERMISSION is hereby granted to Abraham Rudnick a OWNER of property located at Angel Lane — Building H Street,Road or Ave. x in the Town of Queensbury,To Construct or place a 4 Unit Apartment Building 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 Rudley Place Queensbury, New York 00 2. CONTRACTOR or BUILDERS Name M same r r w m 3. CONTRACTOR or BUILDERS Address bd same w a w 4. ARCHITECT'S Name OQ x 5. ARCHITECTS Address 6. TYPE of Construction—(Pieria indicate by XI (K)Wood From ( 1 Masonry ( 1 steel ( 1 7. PLANS and Specifications No 214'x32' per plot plan, specifications and application submitted and Var. 1156 including 4 one-car attached garages and sewage system. x S. Proposed Use w 4 Unit Apartment Building b w K rt $20.00 4 C/Os M $ 280.00 PERMIT FEE PAID—THIS PERMIT EXPIRES November 1 19 87 :3 rt (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the to town of Oueenabury before the expiration date.) O t+ r Dated at the Town of Queensbury this 21st Day of Agril 19 87 o0 SIGNED BY //l� [I° —� for the Town of Queensbury Building and Zoning fnspesxor C��J To BE COMPLETED BY BLDG . DEPT . c� Application No . _Down o/ Queen3iurry Permit Issued 19 TOWN OF QUEcIISBURY BUILDING and ZONING DEPARTMENT Permit Expires 19 t Bay and Hauiland Road, R.D. 1 Box 98 zoning Designation Queensbury, New York 12801 variance No . 4 f � � APR Site Plan Review No . i _ Approved bye �BUILDING Bc CODE DEPT. APPLICATION FOR 4KC+ ¢a EU I LD I NG AND ZONING PERMIT A PERMIT MUST BE [OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER. ALL OF THE FOLLOWING . The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description , plans and specifications submitted, and such special conditions as may be indicated on the Permit . The owner of-this property is *. Q&ez2 i i.4 '7 f ' � FA N ' C�2 'r'� I e1 . ?�1 P. O. Address-�-L�L�It..G.y �fZ,�4�`�Ey..��� � 1 Tax Map No Property Location : Street number or building lot 'number Subdivision name ( if applicable) ��F +,� " " " 14jvnF w! S THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O . Address Tel . No . Nae of builde „ �,,! _Address ' , AC/ PL F Tel . m r .7 � j 5c: Name of plumber g02,4d4,m '7A, nAh !a Address_ nL€k— 1 F Tel • TIA - Name of mason Address jLiA joI Iy d0 Tel NATURE OF PROPOSED WORK : * ZONING INFORMATION : Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , _Addition to a building drawn reasonably to scale and attached hereto . Alteration to a building showing clearly and distinctly all buildings , (no change to exterior dimensions ) whether existing or proposed and indicate all OtJner work (describe) * set-back dimensions from property lines . Give street and number or lot number and indicate whether interior or corner lot . Show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area . COMPLETE INFORMATION REQUIRED BELOW . Size of property `]'�'/� £t X-&�-ft . " Existing building ( s) Size ft X ft . PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structures r wl—£t X �� x Foundation-pied slab/crawl/partial ull * Proposed building , distance from property line (circle one ) ft * Front yard �� ft Rear yard No . of stories (habitable space) 1 * Side yards ft and _,��ft ft Height (grade to ridge ) 'ft . if on corner , setback from side street -� If residential , no . of families No . of rooms ( excluding baths ) , OCCUPANCY INFORMATION No . of bedrooms ; nova .wi �,.,,�__���4.�._�� �, PRIMARY BUILDING - No . of bathrooms One family dwelling Primarys heating YstemRS ...h6037 A4R Two family dwelling Type of fuel Multiple dwelling / Number of units-4. No . of firepl ces to be installed WE- Permanent occupancy : f / C ea. , Will a wood stove be installed?AJ �_ * Transient occupancy `T Central Air conditioning? _ Business * BUILDING STYLE, PRIMARY STRUCTURE * Industrial Other Ranch Contemporary Log cabin * If addition , what will use be? �- Raised ranch Mansion Duplex Split level old style Bungalow Cape Cod c�tage Other * ACCESSORY BUILDING- Colonial Raw Town House * Detached garage/o r/ two car/ car ( CIRCL ONE PLEASE ) Attached garage one car two car/ gx * * * * * * + * * * * Private storage bui ing ESTIMATED MARKET VALUE OF 12 ZV Other CONSTRUCTION f INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI Form BPA 4/66 and-vl BUILDING PERMIT APPLICATION CONTINUES] - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc , woe),D 1=je4M Z Will any second-hand or ungraded lumber be used? If so , for what ? kin Foundation wall material � EMn/7 Thickness Depth of foundation below grade g { to bottom of footing ) Will there be a cellar? Heated or unheate Floor sq. footage 5 ft Will there be a bion? t? ,a,c_ Will any portion be used as living space? q ( If so , what portion? sq . ft . - - Type of use ? Type of roof - sloped flat/shed/other_ Material of roof _ l � E. Size , wood stud s " x _" spacing. , o . co length ft . Joists ( floor beams) lst . floor �_" x _„ spacing / I "o . e _ span ft . Joists ( floor beams ) 2nd . floor — "x spacing "o . c . span ft . Overlays (ceiling beams ) — "X " spacing o . c . span ft . Roof rafters "x spacing o . c . span - � ft . Roof trusses (pre-engineered) spacing 24 "o . c . span ft . Exterior wall finish_ j: 7 Of what material ? Interior wall finish ;1H A6� If garage is to be attached , describe materials to be used for FIRE SEPARATION : 5 r� Is there to be an opening between garage and dwelling? If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? i L Height above roof_ _ _ _ / ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . in , Water supply - Municipal or private wall MGe �rs ► C•, 1r�� 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) Town of Queensbury County of Warren R F F I D R V I T STATE OF NEW YORK I swear that 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 BUILDING 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 Signatur _, owner ' s age , arcniLect , contractor ,,4f!�P day of Notary Public , Warren County , N. Y . * * * * * * * * * * * If SPECIAL CONDITIONS OF THE PERMIT : By TOWN OF QUEENSBURY WARREN COUNTYf 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. 0 Gross floor area Fr 2 . Type of heat 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors Zza f© A . Over 16 % Only 1 . U value of gross area of walls , roof / ceiling and floors o 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 e000YES NO a . if YES , what s the R value of insulation around perimeter of floor ? - 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation Jr� IdA. Ze �"__1, B . Under 16 % Only 1 . R value of root and floors exposed to ambient conditions, 2 . R value of exterior walls 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 a . R value of heated basement / cellar walls ( above grade ) 9 . R value of heated basement/ cellar walls ( below grade ) 10 . Type of insulation c . Controls 4,5 1 . Thermostat maximum heat setting D . Duct Systems 10 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 }ripe _ 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 . i � applicant ' s :: igstiature } APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE � /� �+f LOCATION OF PROPERTY FOR INSTALLATION Owner's Name: qg„''',, ^ ' rn ,"�,"3 4'fJ laf�I G k' Telephone: Address: " 24 ry o= ' Installer's Name: 461W .", DAJ bLk Telephone: Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) J � ------ 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: feet Separation: Watersupply from Septic absorption _ PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1 ,000 gal.) 45�es> TILE FIELD: Each Trench ,�- feet / Total system length �00 feet SEEPAGE PIT(S) : Number of / Size each ssfeet by £eet Size of stone to be used # / Depth or Thickness s� feet IMPORTANT ,_jpIease_..LiST NEW EQUIPMENT TO BE INSTALLED (over) Section I1 Se tie 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, the 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 $250.00. C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further construction. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Cwdju..nce. Signature of responsible person: rL�5� Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-583 2 SETTLED 1763 . „ „ HOME OF NATURAL BEAUTY . . . A GOOD, PLACE TO LIVE TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS ] 28Q 28 QUEENS.BURY, NEW 792—S 11- TELEPHONE f 8-32 BUILDING INSPECTOR' S REPORT REi?Z1ES �F7 C,]�R PECTION ,RECEIVEDW? NAME L =� �• 7 E C yam [ r !2, �I ,JLLLc4.GiF + LOCATION PERMIT # DATE APPROVED YES NO FOOTIN+GI PIERS MONOLITHIC POUR FORMS FOUNDATIONI DAMP—PPROOFING BACKFILL APPROVAL ROUGH pLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: , FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING L,,OXTERNAL PORCHESISTEPS_^_ STATRS^-CLEARANCE & RAILS PLUMBING FIXTUgESIRELtI VALVE .INTERIOR TRINIPRIVACY 60ORS FINISHED FLCKRS GAP AGE FIRE$ROOFING �OOR CLOSERJS) SMOKE DETEITORLS FINAL ELECT INSPECTION _ qT FINAL APPROVAL OF CONSTRUCTION i A SIGNED C RTIFICATE OF OCCUPANCY MUST BE DEPARTMENT BEFORE OBTAINED F OM THE BUILDING THESE PREMYgES ARE OCCUPIED !' REMARKS: •-" � '� . - �" INSPECTOR THE NEW YORK BOARD CIF FIRE Ufi�II) ERINRITERSff,2 �jj' 3 r R4} BUREAU AL ELECTRICITY NEW Y t V 41 STATE STREET. ALEIANY. IVEW YORK 122t77 �f3 gplFlicTLtian ,Vo. on file I.t ,'': � + } i K5i " ' :i ' i f€ + 14iii ' iI • ; Date ; f'F: S T 1 ! -W3 THIS CERTIFIES THAT theppplicent nartsedon the MbIw " np "t Fli ntarnbersn the pro sCf only the electrical egssipment ea deserif►ed fFelore eFssf intradesced Y tI' T 4 Ili T `. section Block Lot It lilt ' IT `i ] 1 '3 . , }� �pserrseni lat Fl, L__l 8nd Fl. :; ;? in the following lacarron; 3 oral farsnd to be in compliance wiCh the regw8rements of this Boa - was examined on [ I I'3;€ ' � z`. ' R 1 EXHAUST FANS pXTURES RANtiES wCppKLNCit?EGKS [iVENS DIS1f1NASHElS AMT. K. W. AMT. K.W. AMT. K- W. AMT. N. r. FIXTURE ECJEFTACUFS ;yWTCHES INC SCR FLIJOKESCEW {]T%GR AMT. I[. W. t7VTlLtTS ! ,tiY UNIT MRATERS R17T,tRE APMANCE }EEbERS SFIK€AL Mrprr TLME CLACKS EEL.L AMT. WATTS DRYERS FURNACE MOTORS T""S, AAVL K P. No. OF PE" AMT- K. W. CMl N. T. GAS H. P. AMT. Ald. A. W, G. AMT. AMP. AMT. AMrS. I 1 Y I C E NO.of S E R A. W. G. lei. GF NEUTRAI•S Of eirtliAt SERVICE tmS iNECT *!R NO, aF CC Ci7Nb. A. W.G. OF HI.LEG pF W. G. TTvt LBOUIF. t e Tov t 1 aw a ,r sW a A sw FEK r GF cc. comb. AMT, AMP. � } E1if OTHER AF►ARATUS- •}�;l r;I, • ; ; I T it . 3 ' . P.Y, l F1 v f 4:l 111 , W i BRANCH MANAGER Par This cpq ettificote must not lea ahered 'in any manner~ return to the office of the Board if incorrect. Inspectors may he identified by their credentiahl. COPY FOR BUILDING DEPARTMENT* THis COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. � �- TOWN OF QU £ENSBURY BUILDING AND CODES DEPARTMENT HAY & HAVILAND ROADS QUEENSBURORK T Y TELEPHONE Y) 792- 5832D BUILDING INSPECTOR' S REPORT ��,/ REQUEST FOR INSPECT ON RECEIVED .. 2 �" NAME LOCATION ��t^,r - DATE � :r',I ` ---�PERMI'T #14 Ad�r"PPROVED YES NO � FOOTINGIFIERS MONOLITHIC POUR FORMS_—�-- -^�— FOUNDATION/DAMP—PROOFING��_ ,BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING ,/FINAL INSP TION: i/ CHIMNEY HE GHQ" ROOFING SIDING EXTERNAL T RC SST PS STAIRS—CLI4AN RAILS—� PLUMBING XTUR /RELIEF VALVE ✓ INTERIOR TRIMIF ACY DOORS FINISHED FLOG GARAGE FIRED r FING DOOR CLOSER {, � SMOKE DETECi'ORS FINAL ELECTRICAL INSPECTS FINAL APPROVAL OF CONSTRUCT RN A SIGNED CERTIFSCATV OF OCCUPANCY. MUST BE OBTAINED FROM THE BUSLDSNG DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED? REMARKS : F"-' ► via -u C� �yF sc S 1.1a`t" SST INS CTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2809 TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED— - , NAME . LOCATION DATE PERMIT # � APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUIVING FRAMING ELECTRICAL R UGH-IN INSULATION: > FOUNDATION FLOORS WALLS CEILING L�NAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ST STIRS-CLEARANCE & I UMBING FIXTURES/ ELIEF ALVE INTERIOR TRIM/PRI ACY DOa FINISHED FLOORS GARAGE FIREPROOF NG C,,,ovoR CLOSER (S) SMOKE DETECTOR FINAL ELECTRICAL INSPECTION — FINAL APPROVAL CONSTRUCTION A SIGNED CERTI ICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE .PREMISES ARE OCCUPIED! REMARKS: NSPECTaR ElUILDING ueen3� r� and ZONINGC)Epo + TMENr BaY and Haviland Road, R.D. 1 Box 98 /� r} Q "'nsburY, New York 728ox s��rrC DxsPas,,,L sy,,, INSPECTION NAME eel LOCATION F Z)ATE r/ �-.• PERMIT SOIL TYPE percolation Test Re Loam _ clay _ Percolation rate 1n/in ? YES " Min/Inch TYPE of SYSTEM: �pt L ion ffie$c eld, total length Lengthngth of h trench Depth of Size o tr riches �-- f gra - SEEPAGE PITS Size- t umber of Gravel size „rt p�p3`NG Bldg% to tank Size T` nk to diet. _ bi.st. box to bc' Y eninQS Seale d it ES No Na Partial LOCAT IaN/SETA � xoNS - o nda Foundation t - tank Absorptzon t absorpt -' i n - Et• Separation lot line rT f pits �Ft• SYSTEM _��ft. rout - RE+ r C11V PR ERTY BENTS ; Left side (circle one i (]' Right side SYSTEM USE APPFtavED,/ No Buildi g n e ator 01/86 and vZ RI-III- DING anc7 `Y"�a�E'r7sfiu�,•� ZCINIIVG DEPARTMENT Bay and Haviland Road, R. D.ue 1 8ax 98 ,y7 QensburY. New York 728d7 BUILDING INSPECT NAME ORr S REPORT LOCATrO :ee � " ---- aLe * * * Permit TVo . polA da tion er Forms APPROVED _ *YES * � Wa terpr� frog NO "ackf-1 prarni n g Roofgng Siding Masonry Vene'e ReI f PVal bin9 ves Ext. X)orch es Finished pZaor In te1.ior 7'rj.m s StaIrs Cel a-r & Railings Co Jar arairl Ti .Ze ncrete plocars Plbg . pi ctj2res Door F� rel,roofj rIg Closes s Smoke Detectors �mney 3NS(3TA?'ION ; 4arzn�3ation I' loors Walls Cell in�I FINAL f?LI3CT Ih1Sp Y 2 ')RXVEWAY ,qp �� Ecrlo `` ---- -- __ FinalBuild n C11rgL�� f� Survey Next scltecluleci 3 Re Ina rks, z�spectiorr {call wl7en readY3 ` Hui 6/$6 m@- vz Id1ri Inspector r ° UI '� - fL 7pfyw Gn a$aY any nd�Z'3 N�+NuG'EDE nDpsA Que + fRlr T �y. T nsburyNew York 1Box98 LDINGI 2801 N� E NSPEOTOR ! S REPORT L OCA -r ] ON p ep-,•.,�..� _ ,s�� Permzt Nc7 pc>oting/Pi I c �n da do e r Form APPIRoVEL] 13 ck f I�r c�f j n 9 ______.___�___'_'_ --- YES NC7 � Il G 3*r irig �- FtcOFing S.iding t RO I Lzr`rb n g Ext . orcl�e�s o zs nt he`q �Iei�rs er �Qr St Tr� rri airs & Cellar pra clings �ngcrc to filoors l e "e C Ire ep of'ing r se Chi e etectors TNSLIFT"TgN . P Lin ds tz 1 ocn Walls ceiling FIN AT, EGY_'TRIC, FRIVEWAY APpROVA ItvSPEC rJI N----_. - � ---- na I Building $ r-�- y Net se-----_ d [ dole inspe [ion keMark4 Cca1I po 6/86 nzc3�vl g�3 zng Ins ",otor i I r` SUILDING and �itQerr � �ur ZONING i]L�Vgftr44Y BaY and Hravrland Road 1 g Queens bury, INeW York 1.2. R, D i 801 x 38 ' WILDING INSP C rDR ' S NAME REPpR 1 LOCA Jr Date oundati n ar orx ✓ `* 'PRpV+EIa -*�-~* LOOLterAroofin- g---� _��"� it No Fr gamin ~~~� g Roofing Siding Masonry Veneer R gh Plumbing ief Val Rxt ' Porches Finished Ploor Interistair,sor Trims c Ilar Rail . concrete Floors to PZbq ' Fixture" DQo Fi rePrao.f,in z Closers g Smoke L�etectors C}3imney, XNSULATranl, Foun da t.ion Floors walls ceiling FI'gA-L Z-LEC ,Rxc�� DRiVEWAY APPRQVA IN SP POTION Final Building Survey Next Scheduled inepecdo Remarks. n Ccall when ready 6/85 md-vZ Bualding rnspect ' --''�►cer.r o , b BUILDING ana� 8aY and ZONING DEPAR ME T Havifand +Road, R. D.C3creensburY. New York T2T Bcsx 98 8U1 BUILDING INSPECTORFS NAME REPORT LOCATIOIy go Da I- t No 4X00 tsn9/Pier ✓ �* Eaundatio �QI"ms A RoVED Waterprooin YE Np Back fiZ ]. Fr`�mi n 9 -Roofing Siding Rough R I ie irnb n9 f 11ves Ext . Porches P'nishedTn teri' o Tr oars cellar ) xngs conc f Z b� r F F.1 Ors t -rain Z e Ixtures Cs�Or. Cl reF�roofi.ng Sz"c3k e Chimney ors r1VSUr gTImom fiounc3ation F2 oo rs Walls ceiiinq FINAL ELECTI2SCAr BRTVEW INSPECTSdN AY F'ir�s-r] APPRC)VAL Rxtilrt�[ n , survey text scfieCrIll sPect Reinarks. ready) 6/86 mc3_ n�x i I� r vx nspector a8tj1L [?INC, 'C 'kPB ►�3b and ZOiVNnI ttr� BY and I favilanq Rva 4EaART44 Queens bury, Nevi, 1'k1 280 ox 98 $ vrLr� rnrG N4Mj6q I F'ECT(}R $ S REPORT LOCATION . 00.ATrpN Av xt octin9/p ' er N' *- * atndatio W Far7rrs ei"Proo � Y8 � Back. i 1 I tr rtg_ -�. Np Fra�zn9 Rootring Sid-ing R u9h p veneer F xn zshe Umbingr rches In St ��O d er xtn Ploors Cellar & R`� i� ing~~ s-"--- -r � bq coneratea1Qo Tile Car. �i'ttures for ry10 offing r�h p ra �QY Detect ors 7IVSEly IC1TT: F'1 oc r.s �+'aiPs Ccilin� FXIVAL EI CT 2RICAh TIVSpbCCCT Final Hill , ding pR V�r�,eY Tom text gcliif tiledn Reinarlts_ spectI" (call '"'hen ready 6/86 md`v3 Rui z dzn� , c��� 4r BUILDING DEPT_ COPY OF APPLICATION FORM 46-1 NEW PORK BOARD OF F FILE THIS COPY WITH BUILDING DEPT_ WHEN REQUIRED UNDERWRITERS. . C TRIP # L �NINE STREE 1 AND NO. OR TOWNSHIP �r ROAD AND POLE NO. F_: '1�' iC.I rC�: BETWEEN W T HA TWO It . CROSS STREETS III �. PREMISE' L TE 7 pp� Poo . OCCUPANNAMET" I ' y �� rION+OW R N BLOCK NE 'S AME C" BUILDING LOT AND ADDRESS e--; =UPANCY U M 'I AI C01 BSylPPLIED III'� Is FROM THEIR NEW OLD ❑ WORK OFFICE LOST BELOW ALL. EQUIPMEN I M T WHlCFf YOU IH�AL�IDONAL Q DEFECTS Q ew LcI NUBER OF OUTLETS No. of Fhlturpp RENIDVEam tAgl Ship A Lanni RapapMplss NbTORS HEATERS BRANpi CfRCUITg Diming Wan R = Swiseh /MnWmt Broo@n No. T H P. OFFAL USE 101IYPr Elrsh Na Na A.IM. AmiallGallw INSPECTION Sub- lamas III ulaltf IH Fl. 2nd Ft. 3rd Fl. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. Do NOT I.LriE THIS SPACE. This aPPliyCion is '"landed to ctI Cba ;bows-IisMsl erFiiPmonC to by 1 You aye aodlorixed t8 make the o006 Ties and adlust the fop to C so ndditit d but if at tirn♦ of ilbPaotion H� MAINS OF tfy addHipnN o4uiWClanl, s ors a f000d addiCiprlal MAINS Proridad by t11a ;ppfjoaClf. o�MprrwrnC not abooa listed, CHARACTER FEEDERS ELECTRIC SIGN OF WORK LAMPS TOTAL NARK EXPOSED GAS TUBE SIGN WATTS STARTED D BE CONNCEALCEAL ED TRANSFORMERS OF SERVICE OVERHEAD COMPLETED CNUMSERI VA ENTERS UNDERGROUND SIZE OF SIGN iCAPACITYI I DI INSPECTION REQUESTED MAKER ON OR AS NEAR AS OF SIGN POSSIBLE AVOID DELAY BY GIYING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY SE RETURNED. NEW O OLD PRINT NAME AND ADDRESS NAME OF DATE OF APPLICANT APPLICATION SIGNATURE STREET AOiaRESS OF APPLICANT P CITY OR - TELEPHONE # Y OET OFFNCE ns EL (REV. ,i86) A SEPARATE CODELICENSE NO. 1 � --� APPLICATION MUST BE FILED FOR EACIJ SEPARATE BUILDING