AST-0365-2022 /
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TOWN
CV FH OCT 13 2022 Office Use OnIV
742 Bay Road,Queensbuqy,NY 12804 Invoice#:
P:518'761-82S6
Flood Zonejgo viewed By:
���� Quaker �n�� V�m�� �� �
' u_u� ^���m�r Road - Hoffman .����V��/ .
Project Location:
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Tax 0�s� [��#� ' �o��h�si�m �aoue�
PROJECT INFORMATION:
�� Wash
TYPE: [] Residential 9Commercial,, Proposed Use: .���r v v��/ .
El Boathouse(with or w/o sundeck) El Canopy El Carport El Cell Tower El Deck
El Detached Garage(>300x.t) El Dock El Gazebo El Pavilion 0 Pole Born El Porch [] Ramp
��
El Shed («3D0s.[) El Solar Paneb (w/o rafter upgrades) El 3-SeasonPorch �� Other:' Vacuums
SQUARE FOOTAGE OFSTRUCTURE:
1st floor:
%""floor
Total square feet:
Brief description of scope ofproject:
The applicant existing is proposing to the �x8bng aaK-aen/e vacuums with new vacuums at the existing Car Wash &Car Service Facility. No additional pavement mrimpervious surfaces
will be added to the site. The site currently has 12 self-service vacuum spaces and the proposed site will have
13 self-service vacuum spaces. A 12'x Q'thnaa-aided block surround enclosure is proposed to house the vacuum
equipment.
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Accessory Structure Application Revised June 2022
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ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction:$50,000
2. Are there any structures not shown on the plot plan? ❑ YES 0 NO Explain:
3. Are there any easements on the property? ❑ YES ❑ NO
DECLARATION:
1. 1 acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans,additional reviews and re-approval.
2. If,for any reason,the building permit application is withdrawn,30%of the fee is retained by the Town of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certify that the application, plans and supporting materials are a true and a complete statement and/or description
of the work proposed,that all work will be performed in accordance with the NYS Building Codes, local building laws
and ordinances, and in conformance with local zoning regulations.
5. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. 1 also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: Joshua Hogan
SIGNATURE: DATE: 1 0.1 2.2022
Accessory Structure Application Revised June 2022
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Hoffman Development Corp
Mailing Address, C/S/Z: 16 Kairnes Street,Albany, NY 12205
Cell Phone: Land Line: (518)862.1658 x507
Email: jhogan@hoffman-development.com
• Primary Owner(s):
Name(s): T. Hoffman Realty, LLC
Mailing Address, C/S/Z: 16 Kairnes Street,Albany, NY 12205
Cell Phone: Land Line:
Email:
❑ Check if all work will be performed by property owner only
• Contractor(s): (List all additional contractors on the back of this form)
Contractor Name(s): Hoffman Development Corp.
Contractor Trade: General Construction
Mailing Address, C/S/Z: 16 Kairnes Street Albany, NY 12205
Cell Phone: 518.369.3153 Land Line:
Email: Pmatthews@hoffman-development.com
"Workers' Comp documentation must be submitted with this application"
• Architect(s)/Engineer(s):
Business Name: C.T Male
Contact Name(s). Frank Palumbo
Mailing Address, C/S/Z: 50 Century Hill Drive Latham, NY 12110
Cell Phone: (518)786-7400 Land Line:
Email: f.palumbo@ctmale.com
Contact Person for any questions regarding this project: Joshua Hogan
Cell Phone: 518.505.2082 Land Line: 518.862.1658 x507
Email: jhogan@hoffman-development.com
Accessory Structure Application Revised June 2022
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): Machnick Builders LTD
Contractor Trade: General construction
Mailing Address, C/S/Z: 1 West Street Green Island, NY 12183
Cell Phone: Land Line: 518-272.8220 x30
Email: kgrennon@machnickbuilders.com
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
- • Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: Land Line:
Email:
Accessory Structure Application Revised June 2022
THINK SECURE. This email has come from an external source. Do not click on links or open
attachments unless you recognize the sender.
***Please forward any phishing emails to Phishin c-7hoffman-development.com, or click the
Phish Alert Button.***
Laura,
I visited the Hoffman's Quaker Road site today. I found that the site work is substantially complete and
consistent with the approved plans. Small disturbed areas adjacent to the new black top have been
topsoiled and seeded. It is my understanding that an electrical inspection of the vacuums is being
conducted tomorrow.
Please let me know if you need anything further from us. If nothing else is required, please inform the
Building Department that the Planning Department will sign off on this for their CO.
Thank you for your consideration.
Frank Palumbo, RLA
Business Development Manager, Land Services
Tel 518.786.7658
f.pal umboa-ctmale.com
C.T. MALE ASSOCIATES
Engineering,Surveying,Architecture&Landscape Architecture, D.P.C.
50 Century Hill Drive
Latham, NY 12110
Tel 518.786.7400
Fax 518.786.7299
www.ctmale.com
2
XREFS: NONE
EXISTING CONDITIONS AND DEMOLITION PLAN
BAR SCALE
30 0 15 30 60
1 inch = 30 ft.
SITE LAYOUT PLAN
OWNER:
T. HOFFMAN REALTY, LLC
16 KAIRNES STREET
ALBANY, NY 12205
OWNER:
HOFFMAN DEVELOPMENT CORP
16 KAIRNES STREET
ALBANY, NY 12205
SITE STATISTICS FOR NEW CONSTRUCTION
1. AREA OF BUILDING TO BE USED - 15,700f SF CAR WASH/ CAR SERVICE
BUILDING
2. MAXIMUM NUMBER OF EMPLOYEES - 16 EMPLOYEES PER SHIFT
3. MAXIMUM SEATING CAPACITY - N/A
4. NUMBER OR PARKING SPACES EXISTING AND REQUIRED FOR THE INTENDED
USE - 25 EMPLOYEES SPACES, 1 ACCESSIBLE SPACE AND 23 STACKING
SPACES.
FRANCIS G. PALUMBO DATE REVISIONS RECORD/DESCRIPTION
R.L.A NO. 001226
8/29/22 1 _A1 REVISED PER TOWN PRE -SUBMISSION REVIEW
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PROJECT NUMBER: 20.1302
NORT
1 TOWN OF
QUEENSBURY
NEW YORK STATE
SITE LOCATION MAP
N.T.S.
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SITEeq TAT��T Y
ZONE COMMRCIA
Tuo
REQUIRED
EXISTING
PROPOSED
43,560 SF
214,315f SF
214,315f SF
MIN. LOT AREA
(1.00 ACRES)
(4.92f ACRES)
(4.92f ACRES)
MIN. LOT WIDTH
150 FEET
430t FEET
430f FEET
MIN. LOT ROAD
FRONTAGE
50 FEET
0 FEET
UNCHANGED
MIN. LOT DEPTH
200 FEET
400f FEET
400f FEET
FRONT YARD
75 FEET
84.0± FEET
84.0t FEET
SIDE YARD
20 FEET MIN.
97t FEET
97f FEET
50 FEET TOTAL
244f FEET
244f FEET
REAR YARD 1
25 FEET
120f FEET
120f FEET
SHORELINE
75 FEET
75f FEET
75f FEET
GREENSPACE
30.0% MIN.
65.9%
65.9%
IMPERVIOUS AREA
70.0% MAX.
34.1% (73,100t SF)
34.1% (73,100f SF)
BUILDING HEIGHT
MAX. 40 FEET
—25 FEET
—25 FEET
,FLOOR AREA RATIO
0.3 (64,294) SF)
0.07 (15,700 SF)
0.07 (15,800 SF)
BUILDING AREA
-
15,700f SF (7.3%)
15,800f SF (7.4%)
79 SPACES
PARKING
(5 PER 1,000 SF)
85 SPACES
86 SPACES*
STACKING SPACES
36 SPACES
46 SPACES
46 SPACES
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* INCLUDES 13 SELF-SER �.„RC�+S�J4T1RPlY ARKING SPACES,
O TOWN OF QUEEN SOLWCESSI B LE PARKING LFrA STAT
,..r ftAA"a1 BUILDING DEPARTI��IjDD TIONAL STACKI SHAL'S OFFICE
rD qi our limited examination, compliance
comments shall not be construed as REVIEWED BY
o I the plans and specifications are in DATE �o�;� ���
Aance with the Building Codes of OCT 1
State. COMMENTS®��
CD
c
PERMIT REVIE TOE 8U, °°..
DRAFTER CHECK APPR. UNAUTHORIZED ALTERATION OR
ADDITION TO THIS DOCUMENT IS A
VIOLATION OF THE NEW YORK STATE
OKS FGP I FGP EDUCATION LAW.
Q 2022
C.T. MALE ASSOCIATES
DESIGNED: OKS
DRAFTED : OKS
CHECKED : FGP
PROJ. NO : 21.1302
SCALE : 1"=30'
DATE : JULY 15, 2022
O TOWN OF QUEENSBURY
U VACUUM REPLACEMENT PIANiNG & CODES DEPI
4u / Reviewed B
4
�� HOFFMAN CARWASH Date: ��
265 QUAKER ROAD
TOWN OF QUEENSBURY
C.T. MALE ASSOCIATES
Engineering, Surveying, Architecture, Landscape Architecture & Geology, D.P.C.
50 CENTURY HILL DRIVE, LATHAM, NY 12110 PH 518.786.7400
COBLESKILL, NY • GLENS FALLS, NY POUGHKEEPSIE, NY
JOHNSTOWN, NY • RED HOOK, NY SYRACUSE, NY
WARREN COUNTY, NEW YORK
ARE C401
1�b.12�[4 SHEET 1 OF 2
www.ctmale.com DWG. NO: 22.0506
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PROJECT NUMBER: 21.1302
1-1/2" COURSE HOT MIX ASPHALT,
NYSDOT SPEC 402.0983QR
3" COURSE HOT MIX ASPHALT,
NYSDOT SPEC 402.2583QR
12" COURSE SUBBASE COURSE,
NYSDOT SPEC SECTION 304, TYPE2
1-1/2" COURSE HOT MIX ASPHALT,
NYSDOT SPEC 402.0983QR
2-1/2" COURSE HOT MIX ASPHALT,
NYSDOT SPEC 402.2583QR
8" COURSE SUBBASE COURSE, FLOW
NYSDOT SPEC SECTION 304, TYPE2 f-
�' GEOTEXTILE MIRAFI 180N, 1-PLY 18" OVERLAP, `- GEOTEXTILE MIRAFI 180N, 1-PLY 18" OVERLAP,
NYSDOT SPEC SECTION 207 OR EQUIVALENT NYSDOT SPEC SECTION 207 OR EQUIVALENT
PROOFROLLED SUBGRADE PROOFROLLED SUBGRADE
(SEE NOTE BELOW) (SEE NOTE BELOW)
HEAVY DUTY PAVEMENT LIGHT DUTY PAVEMENT
(CAR WASH ACCESS/TRAVEL (PARKING LOTS, EMPLOYEE PARKING,
LANE AND VACUUM AREAS) BYPASS LANE, TRAVEL LANES)
NOTES:
1. THE NEW YORK STATE DEPARTMENT OF TRANSPORTATION STANDARD SPECIFICATIONS FOR
CONSTRUCTION AND MATERIALS, DATED JANUARY 1, 2019 AND ALL ADDENDA THERETO;
SPECIFICALLY SECTIONS 200, 300, AND 400.
2. THE LIGHT DUTY PAVEMENT SECTION SHALL BE UTILIZED ONLY FOR AUTOMOBILE PARKING
AREAS. ALL REMAINING PROPOSED PAVED AREAS (SUBJECT TO TRUCK AS WELL AS
AUTOMOBILE TRAFFIC) SHALL BE HEAVY DUTY PAVEMENT.
3. PRIOR TO PLACING THE SUBBASE, THE SUBGRADE SHALL BE PROOFROLLED AND COMPACTED
USING A SMOOTH DRUM VIBRATORY ROLLER WITH A STATIC WEIGHT OF AT LEAST TEN (10)
TONS. THE ROLLER SHALL COMPLETE AT LEAST SIX (6) PASSES ACROSS THE SUBGRADE AT A
SPEED NO GREATER THAN THREE (3) FEET PER SECOND. ANY AREA WHICH PUMPS OR WEAVES
UNDER THE PASSING ROLLER SHALL BE UNDERCUT AND STABILIZED THROUGH THE
PLACEMENT OF SELECT STRUCTURAL FILL CONFORMING WITH THE REQUIREMENTS OF
NYSDOT ITEM NO. 203.21.
HOT MIX ASPHALT PAVEMENT SECTION
SCALE: NONE
CROSS REFERENCE: NONE
ADDITIONAL PIPE ZONE BACKFILL
CAREFULLY PLACED AND COMPACTED
TO 95% STANDARD PROCTOR DENSITY
Bd
TRENCH
BACKFILL
1'-0" OVERLAP (EXCAVATED MATERIAL)
j JwWu-
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m
SPRING LINE c m z ZOO
OF PIPE Y
`"
Luu
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za
Bc/4, 4"MIN.
,_ 6" MIN. IN ROCK
CRUSHED STONE BEDDING AND INITIAL PIPE ZONE BACKFILL
OPTIONAL EXTRA BEDDING
GEOTEXTILE-GEOTEX 401 OR EQUIVALENT
NOTES:
1. CRUSHED STONE BEDDING AND PIPE ZONE BACKFILL SHALL BE
NO. 1 CRUSHED STONE CONFORMING WITH SECTION 703-02,
COARSE AGGREGATE OF THE NYSDOT STANDARD
SPECIFICATIONS FOR CONSTRUCTION AND MATERIALS, DATED
MAY 1, 2008, AND ALL ADDENDA THERETO.
2. OVER EXCAVATE AT BELLS TO PROVIDE FOR PLACEMENT OF 4"
OF BEDDING BELOW BELLS.
AASHTO M294 TYPE 5 CORRUGATED HDPE PIPE
PIPE DIMENSIONS
TRENCH DIMENSIONS
NOMINAL
SIZE
BARREL
OD
Bc
Bc/4
Bd
ROCK
EXCAVATION
BELOW PIPE
4"
4.8"
2"
28"
6"
6"
6.9"
2"
30"
6"
8"
9.1"
3"
32"
6"
10"
11.4"
3"
34"
6"
12"
14.5"
4"
36"
6"
15"
18.0"
5"
39"
6"
18"
21.0"
5"
42"
6"
24"
28.0"
6"
48"
6"
1. STORM SEWER PIPE SHALL BE SMOOTH INTERIOR WALL.
2. ALL SLEEVES SHALL BE WATERTIGHT.
3. GASKETS SHALL CONFORM TO ASTM F477.
4. GASKETS AND SLEEVES SHALL BE LUBRICATED AS RECOMMENDED BY THE MANUFACTURER.
5. FITTINGS SHALL BE IN CONFORMANCE WITH AASHTO M294.
6. PIPE SHALL BE HANCOR, ADS, OR APPROVED EQUIVALENT.
7. BARREL OD VALUES ARE PROVIDED FOR REFRENCE PURPOSES ONLY. VALUES PRESENTED FOR
12-INCH THROUGH 60-INCH ARE f 1-INCH.
STORM SYSTEM - CORRUGATED HDPE
2 PIPE BEDDING AND BACKFILL
SCALE: NONE
CROSS REFERENCE: NONE
A SECTION
CONCRETE GRADE ADJUSTMENTS
RINGS
FINISHED GRA
> ih
.ra
2'-6" SQ.
2" MAX (TYP.)-
CEMENT MORTAR S6
FIAROUND PIPE
FLOW LOWEST PIPE
INVERT
INSTALL NON -WOVEN
GOETEXTILE SEPARATION
FABRIC (GEOTEX 401 OR
EQUIVALENT) TO PREVENT
MIGRATION OF FINES INTO
THE FOUNDATION CW[S-TURBED EARTH OR ROCA
TYPICAL SECTION
FLOW STEPS AT 12"OC REQD
�- WHEN MANHOLE DEPTH \
EXCEEDS T-0" �� \
FRAME AND GRATE
INSIDE JOINTS
NEATLY STRUCK
AND POINTED
,
PORTLAND CEMENT
OR PARGE
V!'
24"x42" KNOCKOUT
PANELS CENTERED ON
ALL FOUR SIDEWALLS
FLOW
I
(TYP. )
2'-6" x 2'-6" x 4'-0"
.;"•:r INSIDE DIMENSION CATCH
BASIN AS MANUFACTURED
BY "THE FORT MILLER CO.,
INC.", OR EQUIVALENT
- CRUSHED STONE FOUNDATION COURSE
12" MIN. ON EARTH
6" MIN. ON ROCK
(SEE NOTE NO. 7)
NOTES:
1. CONCRETE SHALL HAVE A 28-DAY COMPRESSIVE STRENGTH (f'c) OF 4,000 PSI AND HAVE BETWEEN 5%
AND 8% ENTRAINED AIR.
2. STRUCTURES SHALL BE WET CAST ONLY.
3. PIPES SHALL BE SET IN UPPER PORTION OF KNOCKOUT IN ORDER TO PROVIDE A 12" SUMP FOR A 12"
DIAMETER PIPE AND A 9" SUMP FOR A 15" DIAMETER PIPE, FOR LARGER PIPES, USE A PRECAST
CONCRETE ROUND CATCH BASIN.
4. UNLESS OTHERWISE INDICATED, THE MAXIMUM HEIGHT OF THIS CATCH BASIN SHALL BE 4'-3" AS
MEASURED FROM THE FINISHED TOP OF FRAME AND GRATE (RIM) ELEVATION TO THE INVERT OUT
ELEVATION. WITHIN THE ABOVE STATED MAXIMUM HEIGHT LIMITATION, A SINGLE PRECAST CONCRETE
INTERMEDIATE SECTION MAY BE UTILIZED IF NECESSARY TO PROVIDE THE SUMP DEPTHS CALLED FOR
IN NOTE NO. 4. FOR DEEPER STRUCTURES, A PRECAST CONCRETE ROUND CATCH BASIN SHALL BE
USED.
5. PRECAST CONCRETE SQUARE CATCH BASIN SHALL BE REINFORCED TO WITHSTAND HS 20-44 LOAD IN
TRAFFIC AREAS.
6. CRUSHED STONE FOUNDATION COURSE SHALL BE NO. 2 CRUSHED STONE CONFORMING WITH SECTION
703-02, COARSE AGGREGATE, OF THE NYSDOT STANDARD SPECIFICATIONS FOR CONSTRUCTION AND
MATERIALS, DATED MAY 1, 2008, AND ALL ADDENDA THERETO.
i
PRECAST CONCRETE SQUARE CATCH BASIN
SCALE: NONE
CROSS REFERENCE: NONE
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
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FRAME AND GRATE PATTERN NO. 2816-B AS
MANUFACTURED BY "SYRACUSE CASTINGS",
CICERO, NEW YORK, OR EQUIVALENT.
-OR-
FRAME AND GRATE PATTERN NO. R-3561 AS
MANUFACTURED BY "NEENAH FOUNDRY COMPANY"
NEENAH, WISCONSIN, OR EQUIVALENT.
STANDARD SQUARE FRAME AND GRATE ON
@-CROSS
PRECAST CONCRETE SQUARE CATCH BASIN
CALE: NONE
REFERENCE: NONE
NOTE:
PRECAST LID TO BE DESIGNED TO
WITHSTAND MAX AASHTO H2O TRUCK
LOADINGS (MAX WHEEL LOADING
16,000LBS)
\-STORM SEWER PIPE OF
SIZE AND TYPE REQ'D
8" PRECAST LID WITH APPROPRIATE SHAPE
PAN AND SIZE HOLE CAST IN BY SUPPLIER (SEE
A FRAME AND COVER TYPE FOR HOLE DIM)
1/2" DIA THREADED ROD - 5"
24" DIA CAST IRON COVER EMBEDMENT. NUT AND WASHER
(4 REQ'D)
co HILTI HY EPDXY ADHESIVE
-H _
8" PRECAST LID
N t-
26" DIA HOLE FINISHED GRADE
BUTYL ROPE
GASKET
6" 1 1 5'-0" DIA
CEMENT MORTAR
SEAL AROUND PIPE
MIN 4
UNDISTURBED SI
EARTH OR ROCK
�-LOWEST PIPE
iv g INVERT
T-4Ln
BBASE: CRUSHED STONE 6"-12" DEEP V
MIN LARGER ALL AROUND THAN
SECTION CATCH BASIN OUTSIDE DIA
PRECAST CONCRETE DRAINAGE MANHOLE
SCALE: NONE
CROSS REFERENCE: NONE
? : v . • L 8" COURSE OF NYSDOT ITEM NO.
`; cr 304.12 SUBBASE, TYPE 2
.' ' 4 D CONTINUOUS 8" THICK CONCRETE FOUNDATION
° ° WALL BENEATH CONCRETE BLOCK
o.p!d•
#4 BARS VERTICAL @ 16" O.C. MAX.
2x4 KEY #4 BARS HORIZ. @ 12" O.C. MAX.
(TYP. )
:6 10" HIGH X 18" WIDE CONTINUOUS CONCRETE
FOOTING REINFORCED WITH (3) #4 BARS
'� �� •, o v ACI STD. HOOK ALTERNATE HOOKS
EVERY OTHER BAR
3" CLEAR (TYP.) 3" CLEAR (TYP. )
VACUUM ENCLOSURE FOOTING DETAIL
�O2 SCALE: NONE
CROSS REFERENCE: NONE
..,,, lhlrTklP "SIGHT
PROVIDE SQUARE BASE
COVER AS FURNISHED
BY POLE MFG.
I h---
$
4
411
FINISHED GRADE
____
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-
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II4
-
SQUARE, STRAIGHT STEEL
POLE WITH BRONZE FACTORY
APPLIED FINISH
HAND HOLE ASSEMBLY
-4-4# RE -BARS VERT.
#3 TIES @ 12" O.0
BURNDY'S COMPRESSION
CONNECTOR CAT. NO.
YGHC34C26
BOLT SIZE, LAYOI
7 MOUNTING PROCEDUI
�T AS PER MFG. SPEC
-SCHEDULE 40 PVC
CONDUIT CONTINUOUS
2" MIN.
3,000 PSI CONCRETE
VIBRATE CONCRETE TO
ENSURE
SMOOTH FORM FINISH
ABOVE GRADE
PRECAST BASE OR CAST
IN PLACE SONOTUBE
REMOVED TO 6" BELOW
GRADE.
COMPACTED BASE ORS 24" DIA. MIN
UNDISTURBED SUBGRADE
LIGHT BASE SHALL BE INCREASED IN SIZE SECTION VIEW
AND
REINFORCED AS REQUIRED, TO
ACCOMMODATE SITE SPECIFIC SOIL
BEARING CAPACITIES AND ANTICIPATED
WIND LOADING PER ANSI A58.1-1982
7 LIGHT POLE BASE
C-501 SCALE:
CROSS REFERENCE: NONE
PERMIT REVIEW
PLAN VIEW
THE INSPECTOR
5390 State Route 11, Burke, NY 12917
1-800-487-0535 www.theelectricalinspector.com
Date: June 9, 2023 Application No. On File: 176936
THIS CERTIFIES THAT Hoffman Car Wash
Only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of:
265 Quaker Road Town of Queensbury
In the following location: Basement 1stFloor X 2nd Floor No. of Apt Garage Attic Outside X Commercial X Residence
Was examined on 6/6/23 and found to be in compliance with the requirements of the National Electric Code.
GFCI Fixture Outlets Receptacles Switches Fixtures Ranges Cooking Decks Ovens Dish Washers Exhaust Fans Smoke/Heat
Detectors Incandescent Fluorescent Other Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W.
1 14
Dryers Furnace Motors Dimmers Water Heaters Unit Heaters Multi Outlet Sys. Electric Heaters
Amt. K.W. Oil H.P. Gas H.P. Amt. Watt Electric Oil Gas Amt. Rating No. of Feet Amt. K.w. Amt. K.W. Amt. K.W. Amt. K.W.
Transformers Alarm Systems Special Receptacle Panels Motors Signs Track Lighting Disposal
Amt. KVA A/V PS Det. Panel Amt. K.W. Amt. No. of circuits Rating Amt. H.P. Amt. No. of Lamps No. of Heads Amt. H.P.
2 3 40 A
2 3 90
Service Disconnect Equipment
Meter
Service
Amt. Amp. Type 1 Phase
2W
1 Phase
3W
3 Phase
3W
3 Phase
4W
No. of CC. AWG. No. of AWG. of No. of AWG of
Cond./phase CC. cond. Neutrals Neutrals HI-Legs HI-Legs
Other Apparatus
3 Pole lights
Manager
This certificate must not be altered in any manner; return to the office of THE INSPECTOR if incorrect. Inspector’s credentials can be verified.