Loading...
1987-015 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSOURY WARREN COUNTY, NEW YORK 19 This is to terxifl► that work requested to be done as shown by Permit No. has bee.. Ties strucMM may be occupied as a s wh kle� I !rt By Order Town Board TOWN OF QUEENSBI]RY Building & Zoning Inspector C Iyi/ITIMt "IM fit," ♦Iy{M1NG. GLCN6 FALIy. N Y Y00! {y { }}.y�ye r BUILDING PERMIT TOWN OF QUEENSBURY No. 87-15 r WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Michael Johnson OWNER of property located at lot 74 White Pine Road ( St No 11) Street, Road or Ave, 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 n w approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. m t . OwNE WS address is 7 Sycamore Drive v Queensbury , NY 12801 =r a m a 3. CONTRACTOR or BUI LOERS Name Joe Roulter 3. CONTRACTOR or BUILDER'S Address C/] Cleverdale , NY 12820 ^ o a v 4. ARCHITECT'S Name F Y• I rr m H S. ARCHITECT'S Address �U fo .^J N 0 Gn A7 6. TYPE of Construction — {Please indicate by X1 a rn A 1 'Woad Frame l I Masonry { 1 Steel { I O m 7_ PLANS and Specifications CJ 27 ' x84 ' per plot plan , specifications and application submitted No. including sewage system and two-car attached garage . ro r a. Proposed Use One-Family Dwelling IY �C $5 . 00 C/O $ 220 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES August 1 rtR� (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.) Dated at the Town of Queensbury this /27th Day of January 19 87 SIGNED BY -for the Town of Clueensbury Building and Zoning Inspecto TO BE COMPLETED BY BLDG , DEFT . r Application No , 7o"in of Q"ee4n39"4ry Permit Issued l9 BUILDING and ZONING DEPARTMENT Permit Expires l9 Bay and Haviland Road, R. D_ 1 Box 98 Zoning Designation t ►r" Oueensbury, New York 12$01 variance No .or r� Site Plan Review No . i [RECEIVED JAN 2 3 19M � n " f Approved by : i APPLICATION FOR i iff BUILDING 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 : - .c .mac o `+ a P , O. Address S Cr-airy,,.c. . c Tel Property Location : .{ .r ' "� r / r k Tax Map Street number or building lot numb r Subdivision name ( if applicable) . c � +� THE PERSON RESPONSIBLE FOR SUPERVISION OF WO �.A+�S REGARDSBUILD / N'GG/ CODES IS : a . {rro Cs G Name PoO , Address Tel . No . Name of builder 4 c. Address +rs - Tel . Name of plumber �' � Address Name of mason Address r W � Tel . NATURE OF PROPOSED WOR : * ZONING INFORMATION : ,J '✓ 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 Other 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 /".30 ft x 740 ft ' Existing building ( s) Size ft x £te PROPOSED BUILDING AND USE : * Existing building (s ) Use Size of new structure ��_ft X f't Foundation-pier/slab/crawl/partial/full * Proposed building , distance from property Line (circle one ) * ft Ir Front yard * r & 0 ft Rear yard !F No . of storie's (habitable space )� �- * Side yards eft and •. .2 ft Height ( grade to ridge ) / ft , * If on corner , setback from side street -.. ft If residential , no , of families / Noe bf rooms ( excluding baths ) OCCUPANCY INFORMATION No , of bedrooms_ Y * PR RY BUILDING - No , of bathrooms .e'er ..� * xe family dwelling Primary heating system �t,� r �« * I• ,3 family dwelling Type of fuel * Multiple dwelling / Number of units No , of fireplaces to be installed permanent occupancy Will a wood stove be installed? ,� Transient occupancy 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 mod Cottage Other " ACCESSORY BUILDING- olonial Row Town House '� Detached garage/one car/ twD� / ._.mar ( CIRCLE ONE PLEASE ) * ,:Llttached garage/one caretwo car ,,,--1 car * + * * c * * * * * * Private storage building ESTIMATES] MARKET VALUE OF 'Other CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONSr ON REVERSE SIDE OF THIS SHEETr TO BE COMPLETED ! worm BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - �r BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . Aaaa Will any second-hand or ungraded lumber be used? If so , for what'? ,r /0 Foundation wall material 4= rO ,.Pc ,.c r c Thickness -- C Depth of foundation below grade (to bottom of footing ) :7dr" Will there be a cellar? 1J0 Heated or unheated? Floor sq. footage sq ft Will there be a basement? Csy Will any portion be used as living space ? ( Tf so , what portiom2^ lat/s sq . ft . - - Type of use? Type of roof �slapedhed/other Material of roof �• �ss S �s {c Size , wood studs_ cry „"X /—"' sp,acing ... + a . C . length ' ft. / Joists ( floor beams ) lst . floor "X s acin Joists ( floor beams ) 2nd . floor X� —' P g'4; "o . c . Span 4 ,� /c s acin / �" p eft . Overlays ( ceiling beams ) �7 _"X- -�y � �� spacing,-"o _ c . spaxxft . Roof rafters ""X " spacing o . c . span ft . Roof trusses (pre-engine'/eered) s acing � $ "o . c . span _ft . Exterior wall finish /1 �� veC _ Of what material? Interior wall finish i S' :2; 0. r --�" If a garage is to be ttached , descr ' be materials to be used for FIRE SEPARATION : .i- ' e Is there to be an opening between garage and dwelling? if so will a Fire-rated door , enclosure , and self-closing device be provided? e c Will a flue-lined chimney be installed? 5 Height above roof ft _ Depth of chimney foundation below grade �ft . Depth of fireplace-_ ft . -in . Water supply7unic3_ o.�' r private well 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 f Warren p F F r D n V I T STATE OF NEW YORK County of warren 1-i t I-i Y 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 BUIT,DING 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_day of 19 � -er , owner ' s age , arcritrecntractor - r•G'""� ' �� Notary Public , Warren County, N . Y . * * * * * * * * * * * * * For * * For * * * * * ;t tk For * * * * * 9r * * * ak rr * For * it w * * It SPECIAL CONDITIONS OF THE PERMIT : r TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application fors BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY COUSERVA'TIOM CODE A permit must be obtained before beginning work . ANSWER ALL of the following : i . Gross floor area 2 . Type of heat C ec- r 3 . Is the building mechanically cooled ? -AL/v Percentage of area of windows and doors A . Over 16 % Only 1 . Uo valve 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 �a 2 . R value of exterior walls ooc --- / 3 . R value of glazed area e 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 4 a * R value of heated basement/ cellar walls ( above grac3 "e' ) ���� 9 . R value of heated basement/ cellar walls ( below grade ) 10 . Type of insulation C . Controls 1 . Thermostat maximum heat setting � o D . Duct SX13tems 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 t"a (a07(5 2 . Temperature control setting maximum_ jylp G . For Swimming Pool only 1 . Maximum heating Telephone No . �'3� G' �'Gr - 3� - ,�/ /•r ( applicant ' signature ) ,,,Yearn of QWZVW40V APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE /F / _ of�; LOCATION OF PROPERTY FOR INSTALLATION ,,� i I& Owner's Name: ,/ c ,x- "Telephone: Address: ,�sr'c'.� c • e rr �� c- , s �M . Installer's Name: ,c1yFCi v* c .r.0 c Telephone: ^' Number of bedrooms (residential only) _< _ Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: tf la Rolling Steep Slope & of slope Soil Nature: circle on Sa Loam Clay rather / Depth: feet Ground Water: At what depth? feet Bedrock or Impervious Material: At what depth? _ feet --------------- Percolation test: circle one not require required / rate min. inch. Domestic water supply: circle on unicipal ell Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ -- feet PROPOSED SYSTEM* Septic Tank ,ea gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench 5'' O feet j Total system length 9 s 'd feet SEEPAGE PIT(S) : Number of .r n / Size each feet by feet Size of stone to be used # / Depth or Thickness / feet IMPORTANT ....Please...LIST NEW EQUIPMENT TO BE INSTALLED (over) / Section II Septic 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 fours 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 dryweils Be 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. Co. 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.. 1 have read the regulations above and agree to abide by these and all requirements of the Town of Queensbtn-y Sanitary Sewage Disposal. Ordinance. Signature of responsible person: Date: f ;s _ Town of Queensbury Building and Code Department Bay at Fiaviiand Road Queensbury, New York I280I (518) 79Z-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY A GOOD- PLACE TO LiVE THE NEW YORK BOARD OF FIRE UNDERWRITERS 4057381 BUREAU OF ELECTRICITY F j f 41 STATE STREET, ALBANY. NEW YORK 12207 Q Q Q om* Late July 27 . 1987 Application No. on file 007419�-87 A U U 9 8 9 U � THIS CERTIFIES THAT only the electrical egwt pment as described balow and intreds.ced by the 009dicamt na+nadan the «liana wpplTucstswa number i» the premises aJ Rovlier Crops-to Co . Umt 74. Ldt e PIAe Rd . . C1eTxs Bells , I section Block Lot . in thefallosaing location; Rosemont lot and out g ide was examined on 6r29/87 astd found to be in compleance with the regtxirementm of this Board. MIXTURE FIXTURES RANGES COCIK6ING DECKS OVENS DISH WASHER5 EXHAUST FANS s CE OUTLETS EPTACIES SWITCHES HCANDE5CENT Pt4K:ME5C'EN7 AMT_ K_ W. 23 46 21 22 1 PRYERS FURNACE MOTORS RMER APPUANCE MEMOS SI'ECl/LL tLECttT' TIME CLOCKS HELL. UNtT HEATERS $STMRSI.ET pIMMERS TRANS. AMT. H- P. AMT, WATTS AMT. K. W. CXF W P. GAS X. P. AMT. ND. A. W. G. AMT. AM►. AMT- AXWS. NCI. of IEEr J. I ran 319 6 It SERVICE DI50ON"ec'! No. OP S E R V C E ZF METER NG. vF cc. ctallo. A. W. No. W �-tEG A.W,a. NG, as NEUTRALS OF My R�L �t AMT. AMP, rrpt ROW. r 0 2W t 0 3W 8 0 3W a 1 .sW PER .e OF cc. c�i+o. GF M-UG � 1 200 cb OTHER A"ARATUS: 2-gfci 2-wmoke detector . S 00004 Ers Electric Co . BRANCH MANAGER 7 Birch Lane Glues Falles NY 12801 Par 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. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST PLOT BE ALTERED !N ANY MANNER. - - — �./'Otfllt Ci� �K�p17 l�+E!►'� BUILDING and Z+DNiNG DEPARTMENT gay and liaviland Road. R.D. 98 Queensbury. New York 12801 BUILDING INSPECTOR ' S REPORT � NAME I ' d' f�.y `V LOCATION / f7dr "' /•�7' �" permit Nov Date APPRO�7EI7 - NO Footing/Pier For" FoUndatlon Waterproofing Sackf!I l Framing Roofing `a'idin i Masonry Veneer Ftaucjh Plumbing�� --�--� Relief Valves East . Porches Finished Floors Interior Trim stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures ----� -- Gar . Fireproofing -� Door closers�_ --�~ smoke Detectors Chimney 7.N s1u.,ATI0N Foundation Floors walls Ceiling FINAL ELECT AL INSpECTIC7N DRIVEWAY APP OVAL Final Building Survey Next scheduled inspectto" (call when ready Remarks-- ! a Oil f Building Inspector 6/86 and-vl a ;10414V" V/ Q"ee"'J '"ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. I Box $8 oueensbury, New York 12801 BUILDING I NSPECTOR ' S REPORT NAME ` 70 h 3 6-4 LOCATION Date f p T Permit No . r' APPROVED - 'YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Brain Tile concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL N SPECTION DRIVEWAY AI'PROV Lwr1nal Building S rvey Ne>Et scheduled inspection (call when ready) Remarks-- Building inspector 6f86 and-vl ff _Dawn a/ Queenshury BUILDING and ZONING DEPARTMENT Say and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME f C h 4 0. 1 �To 11 h s o rs ON .L a ?`` `7 At ICJ i r-a /�. n -e, 1 � � D ! ^. PERMIT NO. n! 7---` / SCIL TYPE - Sand - Loam - Clay - Percolation "Pest Required? YES Percolation rate - Min/Inch TYPE of SYSTEM: 46 Absorption f i.eld , total. length Length of each trench S� Depth of trenches r � Size of gravel SEEPAGE PITS-(Number of) Size- to X Gravel size PIPING : SiZ T �p Bldg . to tank +�f Tank to dist . box V Dist.. box to field/p ' Al _ 1/G Openings sealed? ES NO Partial LOCATION/SEPARATIC EIS : Foundation to tank to ft. Foundation to absorption U fta Absorption to lot line (,Lfto Separation of pits ft. 013 OF SYSTEM CN PROPERTY (circle one) Front - Rear - Left side - Right side - S : SYSTEM USE APPROV YES NO Building Inspector 01/86 and vl 11 _ 014vn of Quee►t _f ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.O. 1 Box 98 oueensbury, New York 12801 BUILDING INSPECTTOR ' S REPORT NAME LOCATION W JT� f� / A/ ' Date � £�_/ Permit Noe � �1 - ✓ APPROVED - y S NO Footing/Pier Forms a + _- Foundation waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors interior Trim stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures - Gar . Fireproofing Door Door Closers Smoke Detectors Chimney INSULATION - Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION _ � ....... I)RIVEWA'Y APPRCIVAL _ -- Final Building Survey Next scheduled inspection (Call when ready ) Remarks- 8uiiding Inspector 6/86 and-VI _701vre v/ Queen3hury BUILDING and ZONING DEPARTMENT Bay and Havikand Road, R .D. 1 Box 98 Queensbury, New 'Fork 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date /_?- permit Now ✓ = APPROVED - YES NO Footing/Pier Forms IF6un da t ion &ogla`terproofing j.p4ickfi11 Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Doerr Closers Smoke Detectors Chimney INSULATION : Foundation. Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPR(WAT Final Building Survey Next scheduled inspection (call when ready ) Remarks- Rui ding Inspector 6/86 and-vl Ilk J .JoWn O/ ueert3 �+rer BUILDING, and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New 'York 12801 BUILDING INSPECTOR ' S /REPORT NAME LOCATION e7legg " l! 4fe; /G /r - Date__ Permit No . ✓ = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing ackfill Framing Roofing Siding Masonry Veneer. Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAI. Final Building Survey Next scheduled inspection (call when ready ) Remarks- r z Building Inspector 6/86 and-vl C 1 �lvwn o ueenJIur 193 BUILDING and ZONING DEPARTMENT Bay and Haviland 'Road, R.D_ 1 Box 98 Oueensbury, New York 12801 BUILDINGINSPECTOR ' S REPORT NAME �ry� 1 Cit1 A + �' I h LOCATION �^� T �.t V e Datej,622_/ 7_ Permit No . ✓ = APPROVED - YES N0 X Footing/Pier Forms I Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plum'bing Relief Valves Ext , Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection. ( call when ready ) Remarks-- RI 41j e,, .[r"Owtrw -t o%- AtAIOLCT ti Z' PL.- Aa6 66ST- 6ui � 014t' p&"*tAe 1 r Buildi g Insp to 6/$6 and-ul BUILDING DEPT. COPY OF APPLICATION FORM 445-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING, DEPT. WHEN REQUIRED. TEMP. i' DATE jw VILLAGE r..fir rowNSHIP .._, STREET AND NO. on - -` ROAD AND POLE NO: BETWEEN "MAT TWO CROSS STREETS IS PREMISES LO ""�g.T._Ed7�-+'k+��rryn/' f."`." r r's' '�j ✓C /� �'(1 ' +++. SECTION / B K LOT OCCUPANT'S / /' -�_ BUILDING NAME � f4 r4C G - .Y .s f OCCUPANCY { iJ - f-v / .•+ OWNER'S NAME AND ADDRESS �,f''~ / / TEL_ # CURRENT SUPPLIED r,r,� `. r, a ,. FROM THEIR +, ! -" ''r /f OFFICE SUPPLIED BUILDING NEW OLD ❑ Its RK DEFECTS ( NEW ADDITIONAL ❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED sk BRANCH NUMBER Of OLYTLETS LLeomp Racept eMs MOTORS HEATERS CIRCUITS OFFICE USE Leas, ONLY per" Side Atalah t switdr Pendant Bracket No, Type EH,iePf, No, C� No. A.W.G. INSPECTION f?eilktp well Rccelvl, Oltt- eid. bs" 1 Baer • {.. � meat tet Fla w Zed fl. f' t 3rd FI_ r . REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE, This application it ontanded to cover the above-listed equipment to be inspected but it at time of inspection there is found additional equipment not above fisted. you are authorized to make the impeetion and adjust the tee to vcvar the additional equipment. m 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 (NUMBERI (CAPACITYF STARTED /ra r _ ^ryepLET.�O / I' SIZE OF SIGN SERVICE JOVERNMO UND��E�R SiROU„ ND ter, MAKER ILDINENTERS OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW ❑ OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION PRINT NAME AND ALDb&RESS 1V ..�' NAME OF X OF APPUCANT - APPLICANT '� "� - STR£ET ADDRESS CITY OR / ,,,s TELEPHONE #L�f Cr '" -I .. $ �7 T LICENSE NO POST OFFICE �..+'e�IC { l"CF CODE,4e4,s -2 a WHEN AP LPL ICA BLE 46 EL (REV. 1/66) A SEPARATE APPLICATION MUST BE FILED FOR EACH 'SEPARATE BUILDING OE o OULIER - Home improvements and Maintenance BOX 301 CLEVERDALE, N.Y. 12820 (518) 656-3544 ?y + "4 r� C � r . .ti • f i /0 Ne Jr K.3 4. a.� x