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92-506 litak TOWN OF QUE E NSB URY 10,0 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. 92506 Date Issued: Friday, January 12, 2007 This is to certify that work requested to be done as shown by Permit Number 92506 has been completed. Tax Map Number: 523400-252-000-0001-049-000-0000 Location: 1899 BAY Rd Owner. GARY & CAROL ZIBRO Applicant GARY & CAROL ZIBRO This structure may be occupied as a: Single Family Dwelling By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the (‘DJ.,/ property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code nforc ment Planning Board or Zoning Board of Appeals. CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date + /.f .i'k 19 L. This is to certify that work requested to be done as shown by Permit No.92=506 has been completed. This structure may be occupied as a single family dwelling Location Bay Road Carol Zibro and Gary Zibro Owner t i 5 a F-©U R °C( .t Pi4N'G y ONLy By Order Town Board TOWN OF QUEENSBURY f�+Yt.4N d 7✓Ct list. r9 Director of Bldg. do Code Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY 92506 TAX MAP NO. 23. -1-36. 22 No. WARREN COUNTY, NEW YORK ZIBRO, GARY & CAROL PERMISSION is hereby granted to 1899 BAY RD. OWNER of property located at Street,Road or Ave. SINGLE FAMILY DWELLING in the Town of Queensbury,To Construct or place a 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 2. CONTRACTOR or BUILDER'S Name SAME . . 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name MDIA 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) SINGLE FAMILY DWELLING ( )Wood Frame ( )Masonry ( )Steel ( 7. PLANS and Specifications COMBLETE 2ND FLOOR OF SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS. PAID $25.00 TO RENEW PERMIT 11/8/95 8. Proposed Use SINGLE FAMILY DWELLING 25 August 20 96 $ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 (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.) 8 November 95 Dated at the Town of Queensbury this Day of 19 SIGNED BY for the Town of Queensbury ding and Zoning Inspector x BUILDING PERMIT TOWN OF QUEENSBURY No92-506 WARREN COUNTY, NEW YORK w rn N PERMISSION is hereby granted to CAROL ZIBRO & GARY ZIBRO ^� OWNER of property located at Bay Road Street,Road or Ave. in the Town of Queensbury,To Construct or place a Single 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. IV I-1 1. OWNER'S Address is t7o 70 RR1 Box 1380A Bay Rd Lake George NY 12845 Q-, 2. CONTRACTOR or BUILDER'S Name �G 52* self z 0 3. CONTRACTOR or BUILDER'S Address — 4. ARCHITECT'S Name t7o 5. ARCHITECT'S Address Cu 0 0) 0_ 6. TYPE of Construction—(Please indicate by X) (x 1 Wood Frame ( ) Masonry ( 1 Steel ( ) 7. PLANS and Specifications No•54'x40' Single family dwelling (2-story) as per plot plan, specifications and application including septic system. .-5 8. Proposed Use !D —11 Single family dwelling co $ 264.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 21 19 93 (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.) c0 Dated at the Town of Queensbury this 21St.D 'of August 1Y2 SIGNED BY for the Town of Queensbury Building a oni Inspector TOWN OF QUEENSBURY • REVIEWED BY: rt.,AAA ,OWN OF QUEENSBU. si&i FEE PAID: 1ALA f -:f oso9 RECEIVED PERMIT NO. : 60- 566 AUG 1 , 1992 BLDG. & 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. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Owner of Property: Carol_ + ,ni"-,/,ro ''76-4-4 , P.O. Address: :. - . r , • . e "a NE 3 4 Property Location: Ray eat Tax Map No. .3 / / / 36, Has there been any split of this property since October 1, 1988? Yes No If yes, Planning Board Review is necessary. t Subdivision Name, if applicable: Lot No. THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: CfP.y Z 1,..6q 0 NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE Construction of new building * CONSTRUCTION: $ //0/0"N),Cfp Addition to building * Alteration to building * COMPLETE INFORMATION REQUIRED BELOW: (no change to exterior dimensions) * Size of Property: 4 Lh) ft. x ' /-) ft. Other work (describe) * Existing Building Size: . * ft. x ft. * Proposed building - distance from GROSS AREA OF PROPOSED STRUCTURE: * property line: % v * 1st Floor / t Sq. Ft. �i� * Front Yard }(5;D ft. Rear yard ,2. ft. ` / L\ *0 Side Yards /3/ ft. and, . ft. 2nd Floor '- /a.'fQ Sq. Ft. /// tA4,* If on corner, setback from side street- ft.' Other Floors Sq. Ft. ,,$ (not cellar or basement) - v * OCCUPANCY INFORMATION: * TOTAL FLOOR AREA: 9 D Sq. Ft. * Prirrlary Building - X One Family Dwelling Size of New Structure: ft. x ft. * Two Family Dwelling Foundation: * Multiple Dwelling/No. of Units _ Pier/Slab/Crawl/Partial/Full (Circle One) * Business r-� * Industrial No. of stories (Habitable space) c?' * Other Height (grade to ridge) ., ® ft. * ` If residential , no. of families: * If addition, what will use be? No. of rooms (excluding�iaths) : (p * No. of bedrooms: „i * No. of bathrooms: * Accessory Building: Primary heating system: s * Detached Ga"rage - One/Two Car Type of fuel : Attached Garage - One/Two Car No. of fireplaces to be ins ailed: 9„ Private Storage Building BUILDING PERMIT APPLICATION CONTINUED: • BUILDING SPECIFICATIONS: Type of construction: wood frame, fire safe, etc. LjI19- 1- :?6,41-e Will any second-hand or ungraded lumber be used? If so, for what? VC Foundation Wall Material : . t [.. Thickness: 15440 ej' Jo "6 ck Depth of Foundation below grade (to bottom of footing): 6 / 6 Y ) Will there be a cellar? Heated or Unheated? e Floor S . F�- q ootage: 4,14c) Will there be a basement? Will any portion be used as living space? ,bfe) If so, what portion? Sq. Ft. Type of Use? Type of Roof: Sloped/Flat/Shed/Other Material of Roof's Size, wood studs x y " ; spacing A o.c. ; length 1 ft. Joists (floor beams) : 1st Floor " x 1.-a "; spacing " o.c. ; span ft. Joists (floor beams) : 2nd Floor '1 " x J "; spacing / , " o.c. ; span/?c ft. Overlays (ceiling beams) : " x "; spacing " o.c. ; span ft. Roof rafters: _ " x "; spacing / o.c. ; span /2) ft. Roof trusses (pre-engineered): spacing " o.c. ; spank ft. Exterior Wall Finish: s -)) of what material ? ! 2W 1 Interior Wall Finish: �/.��,st, .,— - L RA 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 : /zfiIc1 i,pJ SEPTIC SYSTEM: Distance from any. private well (including adjoining properties: //0 ft. (A separate application is necessary for any repair or new installation of septic system. ) 6-70 —kwei NAME OF BUILDER & ADDRESS: ( Z'4445 ;MOO/ /3Zf4 ONE_4•Sij►—�9/.7- NAME OF PLUMBER & ADDRESS: PHONE NAME OF MASON & ADDRESS: PHONE NAME OF ELECTRICIAN & ADDRESS: PHONE 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 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 thorized by the owner. Signature s ?:4:1:10 0 r —.i n ' agent, architect o tractor SPECIAL CONDITIONS OF THE PERMIT: ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS Compliance Methods: .OWN OF QUEENSBu, PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) RECEIVED PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings; A U G 1 3 1992 Multi-Family Dwellings (3 Stories or Less) BLDG. & CODEDEPT. PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential PART 4 & 6 - Compliance Methods Require Submission of Worksheets 6aAo cA.Z;) Tel PLI AN S N Plk1C LOCATIOg PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: ? 1. Gross Floor Area - V ewe) Sq. Ft. 2. Type of Heat - Elec. Base Board Other 0/ ( Aft iL th ie 3. Is Building Mechanically Cooled? YES 4. Percentage of Area of Windows and Doors Over 17% Under 17% THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED THE R-VALUES SHOWN ON PLANS SUBMITTED! Baseboard 5. Insulation Values: Actual Shown Elec. Heat Other A. Roof & Floors exposed to ambient temperatures R 3C) __ B. Exterior Walls RC—P C. Glazed Area R 3 , 7 D. Exterior Doors Vgag E. Floors over unheated spaces RJVA F. Edge of Slab on Grade (Heated Building) R__ZP74 G. Basement/Cellar Walls (Above Grade) R / / H. Basement/Cellar Walls (Below Grade) R I. Heating/Cooling - Ducts - Piping in Unheated Space R 1 6. Service (Domestic) Hot Water Heating Device A. Conforms to minimum efficiency per code YES NO TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED APPLICA S ATU DA E TEL PHONE NUMBE TOWN OF QUEENSBURY 531 Bay Rd., Qussnabury, NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date lin. ,19 Permit No. ;S.Q APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws,ordinances,regulations,and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. Please fill out additional form if more than one appliance and/or chimney. Applicant ( e ZA€ APPLIANCE (check a propriate boxes) Address 7 I30 2.114J ESTOVE: ood o Coal o Pellet ❑ FIEPLACE INSERT jaiz eQzct A). . Zip /r V 915-- i#IREPLACE, FA�i ORY-BUILT: 'mot Mvood o Gas Phone 66, ' 70- 1.7 -2 f - /` 61 0'FIREPLACE, MASONRY: Wood Gas Owner ID/FURNACE: o Wood o Gas uk#4011 Address IF NON-MASONRY: Manufacturer: Zip Model: Outlet: inches Listed By: Number: Phone CHIMNEY (check appropriate boxes) Exact address of proposed construction 0 MASONRY: 0 Block 0 Brick 0 Stone `ramie. as c , , FLUE: ❑ Tile 0 Steel Size: inches CONSTRUCTION/INSTALLATION MUST 0 FACTORY-BUILT: CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model: BUILDING CODE. CONSULT TOWN OF Listed By: Number: QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall 0 Triple Wall REGARDING REQUIRED INSPECTIONS. in Insulated Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Received Code Number Title A 173 3389 (190)Public Safety A 233 2655. (230)Minor Sales FekQllecteliEzonriir Refunded to: CI { (l .�,`-- f 4 t Address: Dated: Town Clerk or Deputy:- -,(", :. (.4 e1 White:Applicant Green:Fire Marshal Yellow:Bldg. Dept. Pink& Golden d Cashier's Dept. ,OWN OF QUEENSBu, A' PECEWED WEIR'a TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit Al1G_1 3 1q92 Fee Paid BLDG. & CODE DEPT, Date: C , -- Reviewed By LOCATION OF ROPERTY FOR INSTALLATION: �. ♦ Owner' s Name: , r, Ur- Ca, -- Owner' s Mailing Address: 21,e = ?c(L,1-1 % 6tkit/ . , Installer's Name: ,51,71, /14,,4,,, A i r 2'4 s- Phone #: (, 5�x,�- `g9 Number of bedrooms (if residential ): Total daily flow (residential-compute @ 150 gal . per bedroom): 41,E Topography-Circle One: Flat;;) Rolling Steep Slope % of Slope Soil Nature-Circle One: Sand Loam,) Clay Other /Depth: 6 1- / Ground Water-At What Depth? - r Feet Bedrock or Impervious Material-At What Depth? / Feet Percolation Test-Circle One: Not Requiredaequir /Rate Min. Per Inch Domestic Water Supply-Circle One: Municipal Other If domestic water supply is a well - Separation: Water supply from any septic absorption 1/.2 O feet PROPOSED SYSTEM: Septic Tank ,f, gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench i f) feet//Total System Length 0/) feet Seepage Pit(s): Number of / Size each: ft. x ft. Size of Stone to be used: # / Depth or Thickness 1 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. r SIGNATURE OF RESPONSIBLE PERSON: I DATE: 1 Septic System Inspections: A. All applications for septic system installation, alteration or repair, as requires, 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: Queensbury Building & Code Enforcement - Residential Final Inspection Office No.(518)761-8256 Arrive: /JiGt am/ Depart: am/pm Date Inspection request received: // Inspector's Initials: NAME: �.lF PERMIT#: Z- -- LOCATION: /J � ir4 _ DATE: fJ7& TYPE OF STRUCTURE: 7 Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Guards at stairs,decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Interior Handrails @ stairs 2 or more risers Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors: Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum%:"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/'/.hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance required / Cf 1/ C Flood Plain Certification,if required Okay to issue C/C or C/O[Temporary Permanent L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc t Queensbury Building & Code Enforcement - Residential Final Inspection Office No.(518)761-8256 Arrive: 3:c'' am/p epart: am/pm Date Inspection request received: A Inspector's Initials: _ �___ NAME: 2 i k rp PERMIT#: _ LOCATION: , b q ci I�Ft) / ' DATE: TYPE OF STRUCTURE: 5 f f U7 Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 .inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Guards at stairs,decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Interior Handrails @ stairs 2 or more risers Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors: Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum'/2"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/3/4 hour fire door/door closer / Duct work Sealed properly L. DJ� 74— Gas Logs in Sealed or Glass Enclosure / n/0)A;,, c -4/_/0;ref Final Electrical i/' �" Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance re Flood Plain Certificr requ1 ed Okay to issue C/CO mporary/Permanent] ���!!! L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc RESIDENTIAL FINAL.INSPECTION REPORT 1/ Office No. (518) 761-8256 / Building &Code Enforcment •Arrive:( Insp: 1.,1t Dept. of Community Development Town of Queensbury Date Inspection Request Received: 742 Bay Road Queensbury, NY 12804 NAME Z..16/20 PERMIT NO. 92- ova LOCATION te53.77 649 !c Q DATE 16,/27/Q 7 TYPE OF STRUCTURE 6P N/A YES NO COMMENTS Chimney Height/"B" Vent/Direct Vent Location Fresh Air Intake Plumb Vent Through Roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30" to " Exterior Handrails, Balconi , ding'_18 in. or more Interior Handrails Stairs oth Sides 3 or More Risers Grade 2% Away Fro 'foundation 8" Clearance To Sill' fate Gas Valve Shut-Off Exposed/Regulator 18" Above Grade Gas Furnace Shut-Off within 30 Feet or within Line of Site Oil Furnace Shut-Off at Entrance to Furnace Area Furnace/Hot Water Heater Operating Relief Valve(s) Installed ` Headroom 6 ft. 6 in. On Stairs ✓/ Basement Stairs 6 ft. 4 in. t�Handrail Exterior Stairs Both Sides More Than 3 Risers / Interior Privacy/Trim/Doors/Main Entrance 36" 1/ Floor Finish /I/ Bathroom/Kitchen Watertight Interior Handrails Balconies/Landing 18 in. or more Railing Across Window in Stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom Fans Plumbing Fixtures Foundation Insulation 3/4 Hour Fire Door/Door Closer Garage Fireproofing Garage Penetrations Sealed Furnace In Separate Room Protected (In Garage) Light Ventilation Per Room Safety Glazing 18" or Less From Floor Final Electrical Site Plan/Variance Required Final Survey Plot Plan /436 6© fl i0A 7/Z 7/' As Built Septic System Layout Okay to Issue Temp C/Oor- t� .cie-b 11/2g f er3 co e • 0 /A. TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 BAY RD., QUEENSBURY NY 12804 ur INSPECTOR'S REPORT: ARR W`) DEPART VIIAd ppr , REQUEST FOR INSPECTION RECEIVED: NAME _ AI. `..C, LOCATION ACt /2jy� (�i ,-h/DATE 7 \` (0 PERMIT # C$?-- 0 TYPE OF STRUCTURE: .6 FD RECHECK APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTE TION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACE- MENT OF THE CONCRETE. MATERIALS FOR THIS PURPO: ON SITE FOUNDATION/WALLPOUR REINFORCEMENT IN ' ACE FOUNDATION/DAMPPROOFING BACKFILL APPROVAL PLUMBING VENT7ENTS IN PLACE ROUGH PLUMBI141 PLUMBING UNDE SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM AIR INFILTRATION BARRIER HEATING ROUGH-IN leNSULATION: FOUNDATION WALLS INTERIOR R- _ FOUNDATION WALLS EXTERIOR R FALLSS R- WALLS R_27 CEILING R-*0/- -1";WORK OR PIPING IN UNHEATED SPACES R- - CALF--- A 'EtA — s-N, v_ c r kZ TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4424 --7 i ` C.= t 3 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED a I / NAME -Z t hrC I �9� LOCATION of-v DATE 1 ' i`�� J PERMIT# qr9'5 ' APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS ft` AUTO. EXTINGUISHING SYSTEM HOOD INSTALLATION t AUTO. SPRINKLER SYSTEM ALARM SYSTEM INTERIOR FINISHES 1 STORAGE: /3 CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNI REQUIRED SIGNAGE HIMNEY 27' 'WOODSTOVE /1 , FIREPLACE-MASONRY / f, FIREPLACE-FACTORY BUI ''T 11 REMARKS: ( L(OK TO THIS DATE -"4-1 / 441/ off ft 2/015 (rI SPECTOR TOWN OF QUEENSBURY 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED NAME LOCATION j • DATE /7/,/trfr PERMITO TYPE OF STRUCTURE �J RECHECK FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) FOOTING FOUNDATION BACKFILL FRAMING - ROUGH PLUMBING FINAL ELECTRICAL SEPTIC - INSULATION WOODSTOVE/FIREPLACE REMARKS ^J� ��/ /:f !/4/a 4 fc e 4 APPROVAL N/A YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILINGS RELIEF VALVES FURNACE/HOT WATER OP ATM BASEMENT INSULATION/D CTWORK INTERIOR TRIM/PRIVACY ORS FINISH FLOORS: BATH/KITCHEN WATERT G}IT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS HANDICAPPED ACCESS ; SMOKE DETECTORS BATHROOM FANS/WHOREHOUSE FANS ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARATION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL OK TO ISSUE C/O OR C/C COMMENTS: Cd /fd- / kw' 6'14 ARRIVE /. 'f DEPART hatt� � IN.T. T.. TOWN OF QUEENSBURYPLIII) AAk 531 BAY ROAD , QUEENSBURY, NEW YORK 12804 T TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED NAME (41i , le ,LOCATION y,z/ l�i , DATE /.�.7 /Q PERMIT/ 92-so4 TYPE OF STRUCTURE S RECHECK . FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) t/FOOTING vFOUNDATION t--BACKFILL 1NG athapLROUGH PLUMBING FINAL ELECTRICAL +-&EPTIC L-F SULATION _WOODSTOVE/FIREPLACE REMARKS W4c)CI.5+Ovc?. +v be r.'1st-al(..@.P.i C--- (CART d.L4Qr: ft.r LA, j --i+e' cLit.1 1 APPROVAL N/A YES NO CHIMNEY HEIGHT/LOCATION ,/ B VENT/LOCATION ;/ PLUMBING VENT pf ROOFING SIDING DECK/PORCH/STEPS/RAILING}S a/ RELIEF VALVES I/ FURNACE/HOT WATtR OPERATING BASEMENT INSULA ION/DUCTWORK INTERIOR TRIM/PR` VACY DOORS I" FINISH FLOORS: ;' BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEOABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS ✓ HANDICAPPE ACCESS SMOKE DETECTORS , V BATHROOM FANS/WHOLEHOUSE\ FANS V ,- ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING ✓ DOOR CLOSERS OTHER FIRE SEPARATION FIRE/DEMISE WALLS idi DUMPS TER ✓' SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL /p/c fL— /3,1:4, f/� OK TO ISSUE C/O OR C/C COMMENTS: V / l e,V /.A44i:, //H. re via/e- v, .40,4- ARRIVE 3.'3 0 DEPART 3ii" I ECTOR TOWN OF QUEENSBURY 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED �* .ti NAME LOCATION —'' '~ DATE /1//4 1T j i PERMIT# -9 -5 0 TYPE OF STRUCTURE RECHECK 41/ 1' -; t FIRE MARSHAL APPROVAL C MERCIAL VULTURE) .OUTING ! UNDATION BACKFILL °'FRAMING ROUGH PLUMBING FINAL ELECTRICAL SEPTIC fNSULATION WOODSTOVE/FIREPLACE _ REMARKS APPROVAL CHIMNEY HEIGHT/LOCATION N/A/YES NO B VENT/LOCATION ✓ ./ PLUMBING VENT ./ ROOFING ✓ SIDING f DECK/PORCH/STEPS/RAILING . "/ RELIEF VALVES f FURNACE/HOT WATER OPERATING ✓ ✓ BASEMENT INSULATION/DUCTWORK INTERIOR TRIM/PRIVACY DOORS 46. FINISH FLOORS: BATH/KITCHEN WAT TIGHT OTHER FLOORS SW BLE " 4,...... to......'OTHER FLOORS CAPED ,/— STAIR CLEARANCE/fAILI1GS HANDICAPPED ACCESS ✓ SMOKE DETECTORS' BATHROOM FANS/ HOLEHOUSE FANS ALL PLUMBING IXTURES OPERATING ......-- GARAGE FIRE OOFING ....- DOOR CLOSERS ---- OTHER FIRE PARATION FIRE/DEMIS WALLS ✓' DUMPSTER SITE PLAN/ ARIANCE REQUIREMENTS ----- FINAL ELE TRICAL 1 OK TO ISS E C/O OR C/C ' ./ COMMENTS: ARRIVE 42 OS ,1 I DEPART /c ' 30 II r INSP To' . - 11 p , TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT '? 531 BAY ROAD QUEENSBURY, NEW YORK 12804 7,211/4 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATIONS �°� (' DATE ,== '' 3 PERMIT # TYPE OF STRUCTURE ,, 6-4 RECHECK APPROVED N/A YES NO FOOTINGS/PIERS 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 r FOUNDATION/DAMPROOFING' BACKFILL APPROVAL ROUGH PLUMBING a PLUMBING VENT/VENTS IN PLAC PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM X HEATING ROUGH-IN 'INSULATION: i b- FOUNDATION"WALLS INtERIOR'. R- FOUNDATION WALLS ETERIOR R- FLOORS 3 R- ✓i WALLS R-.25 CEILING / R--Jo v' DUCT WORK OR PIPANG IN UNHEATED SPACES REMARKS: ' ARRIVE / r' DEPART -;2° �`w SPECTOR 1414 awn of Queenitur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL//SYSTEM INSPECTION NAME 6 ZFy -Z:iKo LOCATION 0, eie 07 A? DATE /9yb / 7Z PERMIT NO. 90.7 _52,‘ SOIL TYPE - Sand - Loam:=- Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length ._TO Length of each trench ,e-) Depth of trenches S Size of gravel w a, SEEPAGE PITS{Number of) Size- ft. X _ ft. /Gravel size PIPING: Size Type Y Bldg. to tank ' ',r C. Tank to dist. box 4 Dist. box to field/pit 4 `,j`ld Openings sealed? < YES' "ENO Partial f LOCATION/SEPARATIONS: Foundation to tankA)/ft. Foundation to absorption 1t ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROERTY(circle one) ( Front - Rear - Left side,- Right, side - COMMENTS: it _ .- i ,-i Ti t SYSTEM USE APPROVED ; YES ,NO lam } Building Inspector 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED l'4A NAME :Aug[ g F l'G.l f�/- LOCATION /DATE %6/ /lvy PERMIT # S(jC TYPE OF STRUCTURE sfD 0 7/ RECHECK APPROVED N/A YES NO FOOTINGS/PIERS 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 ,a. ` REINFORCEMENT IN PLACE } / FOUNDATION/DAMPROOFING j BACKFILL APPROVAL r'3' V ROUGH PLUMBING PLUMBING VENT/VENTS IN PL4E PLUMBING UNDER SLAB ' 1 iFRAMING: JACK STUDS/HEADERS ,: \ BRACING/BRIDGING / JOIST HANGERS JACK POSTS/MAIN BE'AM HEATING ROUGH-IN (` INSULATION: / { p L FOUNDATION , LLB INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS ;` R- WALLS I R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: ARRIVE DEPART I PECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT i6))/( 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 14 d NAME ( ,p(4.6 LOCATION Oa Ay DATE 2_..lv/g . PERMIT TYPE OF STRUCTURE ,,5c- - RECHECK APPROVED N/A YES, NO FOOTINGS/PIERS - ide2) 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 0 1 SITE FOUNDATION/WALL POUR' 1 • REINFORCEMENT IN PLACE r� FOUNDATION/DAMPROOFING 1/ BACKFILL APPROVAL °.� j ROUGH PLUMBING 1 PLUMBING VENT/VENTS IN\ ACE PLUMBING UNDER SLAB FRAMING: )c, � JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN INSULATION: FOUNDATION WALLS NTERIOR R FOUNDATION WALLS XTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: 'r , - j (Axa #4/ Cal/ Faf 6: ,4344e ARRIVE DEPART TNSPFCTM /640/4i TOWN OF QUEENSBURY --Prq BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 4/, 2/ 3 NAME 0),A _ 3apu LOCATION RC DATE , r q PERMIT I 99-5-06 TYPE OF STRUCTURE orD co , RECHECK /� APPROVED N/A YES NO FOOTINGS/PIERS 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/DAMPROOFING BACKFILL APPROVAL j ( ROUGH PLUMBING DY12 ai �/ PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN ?(INSULATION: pGVttii FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS \* c1oeit R .1/7 - WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: ARRIVE 3 •cr9 DEPART :30 ; INSPE TOR Aft-ort /19k4R TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME 62aAW-7, 2 LOCATION DATE 6 ,'' PERMIT # TYPE OF STRUCTURE RECHECK APPROVED N/A YES NO FOOTINGS/PIERS 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/DAMPROOFNG I BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS I.4 PLACE PLUMBING UNDER SLAB *FRAMING: / JACK STUDS/HEADERS \ BRACING/BRIDGING JOIST HANGERS / JACK POSTS/MA? BEAM HEATING ROUGH-0 INSULATION: if FOUNDATIONALLS INTERIOR R- FOUNDATION/WALLSt EXTERIOR R- FLOORS R- WALLS / R- CEILING r R- DUCT WOK OR PIPING IN UNHEATED SPACES/ REMARKS:! ARRIVE ;:60 DEPART ); i5 IN ECTOR TOW OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTIPS REPORT REQUEST FOR INSPECTION RECEIVED , NAM LOCATION /u/ /6/ / DATE e/7/412- PERMIT # 9.47 _,)-2)e TYPE OF STRUCTURE RECHECK APPROVED N/A YES NO pOOTINGS/PIERS MONOLITHIC POUR FORM UNE. REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING I THE PLACEMENT OF THE CONCRETE. 1 MATERIALS FOR THIS PURPOSE ON SITE I FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING 1111111 BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VEN 'S IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEAD 'S 11111 BRACING/BRIDGING JOIST HANGERS 11.11111.11 JACK POSTS/MAIN BEAM HEATING ROUGH-IN MEM INSULATION: FOUNDATION WALLS INTERIOR R- MEN FOUNDATION WALLS EXTERIOR R- 1111111.0 FLOORS R- WALLS R- 111111 CEILING R- il11.1111 DUCT WORK IR PIPING IN UNHEATED SPACES REMARK : 47>j, / / ARRIVE DEPART INSPECTOR LAKE GEORGE (518)668-4676 STONE SCHOOLHOUSE LANE cxEsrEnm pm wwm �w � » msrOFFICE BOX mm nmwosnoax (nm)��smm wxEucuxoE. wv 1ems'u�m ����Nr ����NNN�N����]� -- �m^ �r rcLcpxx (518)668'46/6 oEww/xL. ommwsuw ps /L« SURVEYORS ° ENGINEERS ° LAND CONSULTANTS �VVN OF QUEENSBU% RECE\VED NOV = '--- November 3, 1992 pL��&. & CODE DEPT Mr . David Hatin Building Inspector Queensbury Building Department _ Queensbury T'own 8uilding Bay and Haviland Roads Queensbury , N.Y. 12804 Re: Gary Zibro Mouse Plans Bay Road , Dear Dave: I have enclosed an "as built" sectional view of Gary Zibro ' s foundation showing the R values of the insulation he used . If you should have any questions please do not hesitate to contact my office. �cerely , ~'~ . � Dennis L . Dickinson, encls . ' - '' STONE SCHOOLHOUSE LANE ` LAKE GEORGE (518)668-4676 POST OFFICE BOX 388 �ICI]'� SON CHESTERTOWN (518)494-7803 LAKE GEORGE,NY 12845-0388 ASMW,11111j1N TICONDEROGA (518)585-9865 DENNIS L. DICKINSON, P.E.JL.S. TELEFAX (518)668-4676 SURVEYORS • ENGINEERS • LAND CONSULTANTS G-' o Garc, Z c b ro Hia..1�c_ c _...... 1 pa cod 4 4 A3 i (-{- }-ac_c nd Q-f-ron , fa.... WQ i ( l' _ __ ___ I P(Q.6-hc , g , .. 11 F_ i" Foam in - ki+ion - R 7. a 111 0 -I AZ'' Cemen4 `tatocK - R I^2-8 43*" Vermicu( 14e, - Is 1 • x c R 2,2 per 'Inch) o liK-Ti l`ki 'Plbrr C 0* 4 *- a , - • i 0 44 tom? n c ra i n P 0 - tow »ri , ,....,....7..._ 1cin c5C,C 4-i ono i Vi ew See ai-ed P Tl ove c(1 der- 3 1 ODa '°' MIDDLE DEPARTMENT INSPP � ON AGE cY,INC. f °" National fteadquarters 900 HAtini-Ave./tollingswoo,1V.J 08108 APPLICANT COMPLETES THIS SECTION - Date: City Tov ►or Townshiip ,_ _ _ County WA State Location/Address �� 4 , k � � j f Located in Rural Area-PI�ase.Attach D ections) P-1e# Owner .ry _ (z w1 Z rt;3 P'er_ � - 6 Occupied A s Building 1;w Olaf Occupant t _ 1e _ Work Area in Building (Floor #,etc.): App.for: Wiring ] Service or: Ready for I-nspection, Fee Remitted-S „` Cashes Check[] <1- M.O. Make Payable To: M.D.I.A. -" - - 500)750,;1000 1250 1500 1750 2000 2250 2500.2750 3000 Number of Rough Wiring'Outlets Elect. Heat Switches Li tin Amp. Service Surface Unit DishwasherRange g Water Heater,; Air Conditioner Dryer- Receptacles Pump.. Number of-fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp, Receptacles Fractional H.P. Vent Fans Other Equipment: _ MOTORS H.P. 1/201/12 2/10,1./$ 1/6 1/4 1/3 1/2 3/4 1 11/2 . 2 3 5 71/2 10 15 20 25 30 -40 50, 75 100 ,Mark Number - :., of Each Size Applicant's Signature License# - Permit # TJAi. Utility: 1NAME) (OFFICE LOCATION) C ) ' ' _ (State) (Zip) Service Request # Electrician: i '' o.,S-- — i {3 TE:RECEIVED: - - DATE INSPECTED: _. - cruet . vatic -` Same as Above 1 I or: died-Notice Label_ [�] K _Rough Wring Outlets Surface:Unit Oven Switiheix Range Garbage•Disposal Receptacles r. - Water Heater '- bishwasher fixtures Air Conditioner Dryer Amp. r+rice Equipment Burner,Wiring&Cniitrals for Amp. Receptacle -- Amp.Service Conductors Pump _ Vent Fans � -c' 1/25 3/12 0 1/S 1/6 1/4 1/3 1/2 3/4 1 `1 2 -3 5 71/2 10= 15 20 .25 30 40 50_'7 100 k f fackr rzr ` 500 750 I000 1250 1500 1750 2000 2250:2500 275¢3000-, Elect;Heat - I 1 ftliu Prowess Inc.n LKD[� Contractor 0'cFl Violation; Work Comp.E] Inc. LJ cAsL/A: " Owner N . L/A i-Jue Mfl # IPAMunicipal N Date: Other Side - Utility . Owner - Cut in Card _ Fi Temp-*-- Date Q Final # Date EC,-, 1N�-SP SIGNATURE MIDOtE T PA ENT PEC 'T N AG Y, INC NATAL H DQUARTERS 9001-laddowAve. tollingswobd, N.J.`08108(609) 8 • DEtAWARE NEW 4RSEY • 1815 l wportGAa Pake - 1030 K ngs Highway Nord+ _1 5 Cyr Cliff flr: Mar�ton,'Del, 19808 = Suite 310 Camp Hi11, Pa, I7t111 (302) 999-0243 Cherry Hill, N.J.08034 ` (717) 76 - - (609) 667-9200 203N.E. Front Street 1542 Bristol Pike PAD,:Box 306 350 Grove Street U.S. Route 13 Suite 105 Rear Entrances ' Grove XXII Corner Bensalem,Pa, 19020 Milford, Del. 19963 _ Bridgewater., N.J.08807 (215) 244-191.9 (302) 422-5729 (201)526-088{} (302)=856-2218 Route 19,North 26 S. State Street P.O. Box 136 Hackensack, N.J. 07602 Wexford, Pa. 15D9i) ... - MARYLAND (201) 487-5373 (412) 931-3028 (412)935-1558 Milford Professional Bldg. Route 9 36-10 Milford Mill Road Marmora N.J. 08223 Baltimore,Md. 21207 (609) 390..igitto VIRGINIA (301) 922-1122 3076 Shawnee Drive BurchOil.Co. Bldg. NEW YORK- • Winchester, Va. 22601 US Route 5 (703) 667-8484 Charlotte Hail,Md, 20622 803 Utfc Street • (301) 645-2219 P.O. Box 145 (301) 884-4547 Oriskany,N.Y. 13424 (315) 337-3480 Washington Co. Office B 460 State Street:, 33 W. Washington Ave, Suite 3( Hagerstown, ki-21740 Rochester, 14608 (301) 791-31 0 (716) 454 193 Hitch 'Sidi Room 203 ," 243 Margaret Street 636 S. Salisbury Blvd. Plattsburgh, N.Y. 12901 • Md. 21801 (518) 563--2835 Mit 74-0641 PENNSYLVANIA Room IMMain Street Court-House Coun-House 121 W.Tenth Street Elks Md 21921 Erie Pa 16501 ,- 1J} (814) 45 -4004 Routes 404&662 18 N. Wyoming Ave. - Wye Mills, Md,21679 Room 204 0)1 -022 83 Kingston,Pa. 18704 (301)758095$. ` R._ (717) 288-4906 NOTICE TO APPLICANTS; Final inspection and approval may be required by law before electrical current may energized for use of occupants The Agency undertakes to provide inspections until firatcertification is granted if such requests are made.within in days from date Orthethe last inspection: Upon expiration raation of 120 days from the date of the most recent inspection, all duties and.obligations owed by the Agency shall be deemed completed,and all fees paid by applicant shall be deemed consideration for services performed. No further inspections shall be undertaken by the Agency without filing of a new application,and the payment of relevant inspection fees. No final certification shall Pe implied or inferred without issuance of a duly executed certificate, The Agency in accepting application for inspection cannot assume responsibility for unavoidable delays in inspection. "100 YEARS"PROTECTING THE CONTRACTOR ANE)THE CEN Al"1MFtq ` - THE NEW YORK BOARD OF FIRE UNDERWRITERS "L;f: 1 • 80304 i,.) • BUREAU OF ELECTRICITY • .1 41 STATE STREET,ALBANY,NEW YORK 12207 APRIL•:,. Date 34.1, Ic Application pITliTca tion l • • THIS CERTIFIES THAT 1 • only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of •: CAW31.3 1-4( GhPY .111R.). BitY PEI, oitFum31-9 WV H.y ii . in the following location; El Basement E let Fl. El 2nd Fl. Section Block Lot APPiL 7-',. . was examined on and found to be in compliance with the National Electrical Code. li‘, 4) FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS i OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. ii. DRYERS FURNACE MOTORS • FUTURE APPLIANCE FEEDERS SPECIAL RECPT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ' 4! SYSTEMS MAT. 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 6 SERVICE DISCONNECT .NO.OP _ _ _ S _ E _R -V- - I - -C - E - oi. AMT. AMP. TYPE Liam 1 0 2W 1 0 3W 3 0 3W 3 0 4W NO.OReEiCirCOND. OF Ac-aAko, NO.OF HI-LEG ot•ale NO.OF NEUTRALS °FA:it G. L 'I!!, i 2 :'(X) CB 1 X I 500 I 504,1 , I. , • OTHER APPARATUS: , : itoyorw,. t F H. F . , G f-'„C•, r, -4 • SI JOKE DETECTOR: • 4'Nr./TE.,, TILIS t S :t I-Art i di i I,,c. a , • oll.I o,i ,..,,. (''4--,-r I 1 1 t ----) - ii, UAW( ;,:i fiRO P P,H., BOX•-29 ! \I r •:' E.I IV li AVE BRANCH MANAGER tiY. I ii., Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. PADV CAD DI III ntiun ACDADTRACKIT TUIC PADV AC PCDTICIPATC MI IT NAT RF Al TFRE171 IN ANY MANNER.