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1987-204 � 4 7 OF %Mx0.II%MI TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Sept . 29 19 87 Late 3C :)I - (R ~ — '"� S91. GCSLA This is to certify that work requested to be done ss shown by Permit N©. 87 -�Ci4 has been completed. Ut V M 1� � olie- Fami..lY Bing Old as This structure may 'be671 t 1 f 6 �" Noe $) Lot 28 k inion Yiise I.Fnc ( St . [�re �o �CUs struction� C? Mer By Order Town Board TOWN OF QUEENSDURY C Huild'rna & Zoning inspector i 1 T E r p o p yy ,T CER.'T�`I._ +_CATS CIF �'� V P.�►Z'*T�'�' :k TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Sept . 222 19 87 Date j This is to certify that work requested to be dome as shown by Permit No. 87-2d4 has been completed. i one--Family Dwelli.r>g This structure may be occupied as a Location Lot 28 Pinion P1112 Lane Gregoire ConsC'Suctian Cawner Hy Order Town Hoard TEv,,PC)RARY C-10 ISSUEII PENDING SOWN OF QfJEEI3SBURY 'I FINAL ELECTRICAL FOR 3t3 DAYS { Building & Zoning Inspector k I BUILDING PERMIT IIIIP TOWN OF QUEE14SBURY No. 87-204 CI WARREN COUNITY, NEW YORK ro 4 Gregoire Construction @ PERMISSION is hereby granted to c-} Lot 28 Pinion Pine Lane (St . N© • $) Street, Road orAve. OWNER of property located at � One—Family Dwelling in the Town of Queensbury, To Construct or place a rt at the above location in accordance to application together with plot plans and other information hereto filed and n Building and Zoning Ordinance. 0' approved and in compliance with the Town of Queensbury y i . OWNER'S Address is 64 Burgoyne Road Saratoga , NY 12866 r O 2. CONTRACTOR or BUILDER'S Name same < r* 03 00 CYJ x o �a 3. CONTRACTOR or BUILDER'S Address 0 same m m rS f b rt w rn m d. ARCHITECT"S Name C, ro 5. ARCHITECT'S Address 0 oa 6. TYPE of Construction — {Please indicate by X) ixi Wood Frame i t Masonry i t Steel l i 7. PLANS and Specifications 26 ' x74 ' per plot plan , sp eclflcations and application submitted 6 No. system and two—car attached garage including sewage `i W S. Proposed Use One-Family Dwelling r �e ro $ 5 . OQ C /O 19 87 ~ 164 . 00 PTovember 1 PERMIT FEE PAID - THIS PERMIT EXPIRES actor of the � lit a longer period is required an applicationthe expiration date extension must be made to the Building and Zoning inspector town of ousensburY before Dated at the Town of Queensbury this 27th Day of A ril 19 87 for the Town of 4ueensbury SIGNED BY ,, auitcling and Zoning Inspector TO BE COMPLETED BY BLDG . DEPT . cam■ Application No . floev T o/ Ql eV 4" j 1"rV Permit Issued lg # BUILDING and ZONING DEPARTMENT Permit Expires 19 Zoning Designation OF QUEEINSS` Bay and F Road, R. D. 1 Sox 98 pueensbusbury, New York 12801 Variance 130 . Site PI Rev ' ew Approv by • ! APR 2 71987 APPLICATION FOR BUILDING & CC)DE DEPT. 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 . --J_- --- -------------------------^----------- ___- _______-......... `__--------__^ C? 9-01P The owner of this property is : �G P . O. Address Ga ` GJ G7 &�L Tel . �7- G e13 Tax Map No . Property Location : n ! � / Street number or building lot number Subdivision name (if applicable) C9 THE PERSON ESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : CYGL E *044 Name P . O. dcd ss Tel . No . L Ad ress �{e . d s+^� .a5el . /j -C? b� Name o£ builder �+' Tel . ' Name of plumber Address Name of mason Address _ 1 � � NATURE OF PROPOSED WORK. : ZONING INFORMATION : A PLOT PLAN MUST BE PREPARED AND SUBMITTED , Addition to a building drawn reasonably to scale and attached hereto , * Alteration to e building existing clearly and distinctly all buildings , � (no Change to exterior dimensions) � whether xisting 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 � £t X ft . Existing buildings ) Size.ft X� ft . PROPOSED BUILDING AND USE : * Existing buildings ) Use r/ � Size of new structure c ft X ft Foundation-pied slab/crawl/partia /full Proposed building , distance from property line * _1� ft (circle one ) Front yard �,�._ft Rear yard �^/� No . of stories (habitablertspace} . Side yards /G ft and _ I ft Height ( grade to ridge ) ft . � if on corner , setback from side street ft If residential , no . of familis OCCUPANCY INFORMATION No . of rooms ( excluding baths ) e No. of bedrooms _ * PRIMARY BUILDING No . of bathrooms � , __ * One family dwelling Primary heating system rr __ Two family dwelling Type of fuel 42 ' * Multiple dwelling / Number of units No . of fireplaces to be nstalled I * permanent occupancy Will a wood stove be installed?�V, Transient occupancy Central Air conditioning?��iv _ * Business BUILDING STYLE, PRIMARY STRU URE Industrial * Other Ranch Contemporary Log Cabin if addition , what will use be? Raised ranch Mansion 'Duplex Split level Old style Bungalow Cape Cod Cottage Other ACCESSORY BUILDTNG- Town House '� Detached garage/one car,/ two car/ Car olonial RowAttached garage/one car/ two car/_ car _ ( CIRCLE ONE PLEASE ) � ._�. I. * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIRE OF THIS SHEET , To BE COMPLETEDI Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type Of construction , wood frame fire safe , etc . Will any second-hand or r ieJd lumber be used? If so , for what? i'Qr Foundation wall material. Th �1Y'I• LG ickness Depth of foundation below grade (to bottom of food g ) 00 Will there be a cellar ? ' Heated, or unheated? Floor sq. footage Will there be a baseme sq ft � Will any portion be used as living space? 01>1p ( If so, what. port ' ona 4P_sq . ft . - - Type of use? Type of roof sloped lat/shed/other Material of roof Size , wood studsu '•x /�._ • spacingl "'o , c . length £t . Joists ( floor beams) 1st , floor VL to /p spacing ", P �3_��� o . C .. span fi .Joists ( floor beams ) 2nd . floor 1�"X�r spacing _ 'Io o . span f ft . Overlays {ceili.n beams ) `�, "X z spacing "'Owe , span_ ft . Roof rafters 4eK� X spaci 9�o . c . span 2..''9 ft . Roof trusses (pre-engineered) " �spacing - "o . c . span TV_ft . Exterior wall finishOF ,'. what material ?Interior "� Interior wall finish Q , 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 , and self-closing device be provided? Will a flue-lined chimney be installedl> Height a ve roof _ Depth of chimney foundation below grade ft . ft Depth of fireplace hearthAwwww� _ / eft . f�,' �eln . Water supply - unicipa�l oar private well SEPTIC SYSTEM _ Distance from ANY private well { including adjoining properties�Q ( ft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury � l T County of Warren A F F I D A V I I 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 OR.DSNANCE , 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 _ _ y� - __- - day of 19 Owner , owner ' s agent rcnitect, contractor Notary Public , Warren County, N . Y . * * * * * * * * * * * * * * * * * ar * * * * * * * * * * It * * * : * * * * * * IF * It * yt SPECIAL CONDITIONS OF THE PERMIT : BUILDING DEPT. COPY OF AI Copy ITFi ICATION FDRIA 48-EL. NEW YORK BOARD OF FIRE fJIMDERVYRITERS. FILE THIS COPY V BUILDING DEPT. WHEN REQUIRED. TEMP.11 # '. "DA c� f COUNTY `;V�v'...t: ' `+✓'~Ei �"1 CITY OR TOWNSHIP VILLAGE i POLE NO• STREET ANd f18. OR an ROAD AND POLE NO.. � " BLOCK LO7 BETWEEN VIHAT TWO SECTION PH�SES EETS ISLOQATE BUILDING OCCUPANT'S !! r.. �_ OCCUPANCY NAME '!•.' :.F 1•.: f�.'i � F /"• I"" 4_. �s �. , r TEL_ # OWNER'S NAME ;`�.. }-- ; -� + i-r -- AND ADDRESS • / K M T OFFICE f f" i FROH TIME 'w- : � .f, -".d i. ��.. j •... DEFECTS SUPPLIED r. WORK REMOVED ❑ . . ."-• OLO © IS NEW Irt ADDITIONAL ❑ BUILDING IS NEW LIST SE LOIN ALL EQUIPMENT WHICH YOU INSTALLEDBRANIT OFF ME USE .: 01 of Fixtures A MOTORS HEATERS CIRCUITS ONLY NUVA36R Of OUTLETS Lamp Replptocbm A.W-O. INSPECTION lion ,Side AtIoWl Switch Pendell Bracket No. TYPa M.P. No. Eoeh No. G+rto. bgkv YIsaN Roomwia Dut- side Sob- below Bate- wnom let Fl. Znd FI. aid Co. DO NOT USE THIS SPACE. REMARKS: LIST OTHER ELECTRICAL DEV ICES NOT SET FORTH ABOVE: tt:ortM puipmertt not abode listed. [ to be :rtspeicsed but if as tints of :rovide on titer apPl+Grrt. she fee to cower the additional equipment, as provided 6w This appliws:on it :nlarrdad to cower the shove-listed egtriPm'�t TOTAL you are autlttxited to make the Ito ELECTRIC and adjustELECTRIC SIGN W AYTS . LAMPS SIZE OF FEEDERS MAINS EXPOSED GAS TUBE 51 GN VA CONCEALED TRANSFORMERS Of C}l,ARACTER ICAPAC17Y1 OF WORK INUMBERi WORK TO BE COMPLETED SIZE OF SIGN STARTED UNDERGROUND MAKER SERVICE OVERHEAD Of SIGN ENTERS 31 BUI NE-Ma OLD INSPILDECTION REQUESTED ON OR AS NEAR AS GATE OF dp .i +i "s 'S•e� �+ POSSIBLE APPLICATION AVOID DELI V MUST BE F LLED IN i OR APPLICATION MAY BEERETURNEDT1ON. ALL SPACE11 �[ SIGNATURE .. PRIN7 NAME AND ADDRESS ' ' OF APPLICANT'IrII; NAOIE OF 1t/ 1 I1 a's' -r^ J . s.. . APPLICANT £ IIIp TELEPOONE # ` - STREET AOD LICENSE NO.IRESS --Y-'---' 'f J., J CODE N APPLICABLE CITY DR r CODE POST OFFICE +t A SEPARATE APPLIGATAPPLICATIONIyyUST BE FILED FQR EACHEACHSEPARATE BUILD ING at, EL (REV. 1/86} TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for % BUILDING CONSERVATION PERMIT ANCE WITH THE NEW YORK STATE A permit must be obtained before beginning work . ANSWER ALL of the following - t� 1 . Gross floor area - � / 2 . Type of heat LT L� 3 . is the building mechanically cooled ?_7 A rim 4 . percentage Of area of windows and doors A . Over 16 % Only and floors 1 . U value of gross area o of walls , roa £ /ceiling exposed to ambient conditions 2 . Floor over heated spaces YES NO NO a . Are foundation walls insulated ? YES 1 , if YES , what is the R value ? 3 . Slab on grade YES 140 a . If YES , what is the R value of insulation around perimeter of flao377 4 . Is basement heated ? YES NO a . R value of insulation 5 , Type of insulation B . Under 16 % Only to ambient conditions 1 . R value of roof and floors exposed 2 . R value of exterior walls 11 3 _ R value of glazed area I( 4 . R, value of doors [ ` • ' `a 5 . R value of floors over unheated spaces, 6 . R value of slab edge insulation - unheated slab -� 7 . R value of slab insulation imm, heated slab r walls ( above grade ) B . R value of heated ]basement/ cella 9 , R value of heated basement/cellar walls ( below grade } IV 10 , Type of insulation C . Controls 1 . Thermostat maximum heat setting D , Duct Systems ages ? YES 1`SO 1a is duct system installed in unheated sp a . If YES . R value of duct installation b . R value of duct in other areas E . piping insulation agent pipe-- 1 . Size of hot water or coaling carrying g 2 . R value of pipe insulation F . Service Water Heatin 1. Performance efficiency Jh� Cl. 2 . Temperature control setting maximum G . For Swimming pool Only_ 1 . Maximum heating Telephone Na . + qr mom xxatre ! applicant ' s g . d f "eeAd&tPP APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLAT10N � �' ��'^ t �I Owner's Name:/ � _ G'�'tT'n'" r / Telephone* ' ! J' q 3 Address: iC 's—° / '� t�`LL' G 'LlCl� �[7 Installer's Name: ,; Telephone: - � Number of bedrooms (residential only) 411 _ Total daily flow {compute (sD 150 gal per bedroom) ' Topography: circle one: lye Rolling Steep Slope % of slope Soil Nature: circle one: an Loam Clay Other f Depth: feet Ground Water: At what depth? feet Bedrock or Impervious Material: At what depth? ----- feet Percolation test: circle one: not required ) required f rate min. inch. Domestic water supply= circle one: ici Well Other IF domestic water supply is a Weil: Separation: Watersupply from Septic absorption _/{.#:) 4 feet PROPOSED SYSTEM: Septic Tank / gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench r Y4) feet f Total system length '� r� _ feet SEEPAGE PIT(S) : Number of / Size each feet by feet Size of stone to be used # cap- / Depth or Thickness al feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLED (over) Section lI 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 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 $2500000 C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system , a new proposal must be submitted to the Queensbur-y Building Department before further construction. I have .read the reg,cations above and ague to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal C kNjinance, Signature of responsible person: r? /�-„� tiy . � ,r 5E a Date. tj� P4 / �'G'�7" Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY A GOOD- PLACE TO LIVE gown of Qesc�ena6ezrct BUILCIING and ZONING DFPARTgox T bay and Haviiand Road, FI_C1. 98 Queensbufy, New York i28oi E3UIUDING INSPEcTOR ' S REPORT sr� NAME �"" Y LOCATION �� �' f Date' Permit NO . - YES iNo APPROVED Footing/Pier Forms Foundation Waterproofing I3ackfill tWF aming cofing ding Masonry Veneer Rough plumbing I'Welief Valves L,7Mt , porches fr'-inished Floors L-Mter for Trim �tairs & Railings -� Cellar 1]rain Tile Concrete Floors Fixtures Fireproofing closers t ,E2sno]ce Detectors Chimney &4SUI.ATI013 �undation Floors 10 walls 'LEeiling FINAL LECTRICAL f3 xP15PECTZo � SIItIV ,wAY APPRovAL final Building Survey NextscYteduled inspection C en ready ) call wh Remarks- F3uilding spector (,/f36 and-vl kd00532, THE NEW YORK BOARD OF FIRE UNDERWRITERS - G' 4 f BUREAU OF ELECTRICITY 41 STATE STREET. ALBANYv NEW2�? AnteCLA'r7�.r g R 1 '�17 Application :Yo. on file d f._.,/ _&. `7 THIS CERTIFIES THAT / only the electrical equipment as described below and Introduced by the rypltcawt nerved an. the above ap Ucation number in the prom"" of Ivan Grenc+ire 2$ „Pinion Pine , Glens '!'alley trY �K X, auts3de 28 in the follasning to cationy} / �sement U l at Fl* fJ end Fl. Section Block Lot tawa examined on andjound to be In compliance with the reguirements of this Board. NMLIRE APES SWITCHES "XTIJRE9 RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST fANS OUTLETS INCAMNSCENT FLUa11ESCINT y AMT. K. W. AMT. K. W. AMT. K.w. AMT. K. W. ,MAT. H_ 43 33 _ DRYERS FURNACE MOTt7RS FUTURE ^WUANCE FEEDERS SlrlCIAL RECO" TIME CLOCKS EgL UNIT HEATERS MULT943VILET DIMMERS AMT. K. W. dL N. ►. CSAS N, R. AMT- AMR. AMT. AMrS_ TERN& AT, M.P. M OF MT AMT. WATT$ _ i I hwt 3# 1 SMVICE 015CONNKT NO. OF S E R V I C E AMT. AMR. TYRE 1 „r sW 1 .e SW S X SW 3 0 AW �' �RER�.fCC�� OF GC . . RKi.Of H4LEG Oi�IN�IEG N4. Gr FIEUTRALS OF NW l EU� E 200 cis ! x 4/0 2 /p OTHER APPARATUS, I-131Xoke deE..ector s s Sam W* Ct3>ChOUSe 7 11 Potter F-d . � (') BRANCH MANAGER GaneeVOOrt , Per This certificate must not be offered 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 NOT BE ALTERED IN ANY MANNER. BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R .D. 1 Box 98 Q Oueensbury, New York 12801 tl SEPTIC DISPOSAL SYSTEM I NSPECT I(W4 LOCAT ION �7 � DATE6? 5- / / PERMIT NO . SOIL TYPE Sand - Loam - clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch - TYPE of SYSTEM: Absorption field , total lend Length of each trench Depth of trench �__.... Size of gravel__ �..- SEEPAGE P ITS-FNumbe Of ) _size- f t. x _ t. Gravel size a Type PIPING : Bldg . to tank Tank to dirt _ box Dist. box to field openings sealed? 'PaE LOCATION/SEPARATION Foundation to tank t' Foundation to absor tion € - Absorption to lot 1 ne Se ation of pits T OF SYST ON PROPERTY (cit a one) ront Rear - lie side - Right 5i CKM TS SYSTEM USE nppROVEDO NQ Duildin Inspector 01/85 and vl AA flown ©f Queen -IIA "ry BUILDING and ZONING DEPARTMENT Bay R.D . 98 Q eensbury. New Yo k12801 BUILDING INSPECTOR ' S REPORT NAME C i ilia LOCATION �-- � ' r j r. __r e� permit No . � to 4' DateA « * * * * * * * * * * - APPROVELI* -* YES NO Footing/Pier Forms Foundation Waterproofing Backf ill }tF raining Roofing Siding Masonry Veneer � -- ,IRough 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 ELECTRI L INSPECTION DRIVEWAY APP VAL Final Buildi g Survey Next scheduled inspection (call when ready Remarks- Bu ding n pector � E/BE and-VI flown a/ Q+eeensiuryt BUILDING and ,ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Gueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME Y V a LOCATION L'_ i r oF? � �'in i Date 1 / Jr 7 Permit Now APPROVED YES NO Footing/Pier Forms 5C Foundation ( Waterproof 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 Closers Smoke Detectors Chimney INSULATION Foundation Floors walls Ceiling FINAL, ELECTRICAL INSPECTION DRIVEWAY APPROV►+L Final Building Survey, Next scheduled in,spieetion (call when ready Remarks- Building Inspector 6/86 and-VI t1 / I -- C Lf/ Cc��r r [4rP /ou.n of Queen -i "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUTLDI�N-G INSPECTOR ' S REPORT NAME LOCATION } Date / �457 7 Permit No . 's - 4204 //y APPROVED - Y .* NO Footing/Pier Forms ' ---. Foundation waterproofing Backfill Framing Roca f ing 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 „ 1)RIVEWAY APPROVAi - Final Building Survey Next scheduled inspectirrn (call when ready ) Remarks- Building Inspector Fi/86 and-vl _Jowst o� �ueens � urc� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME V c? L.QCAT ION Date/Z ? Permit No L1 ✓ APPROVED - YES No 1K Footing/Pier Forms Foundation Waterproofing Backfiil Framing Roofing Siding Masonry Veneer Rough Plumbing Relief ValvesX 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- /` I f Building Inspector 6/86 and-vl M IYN t ��1 Ko o �d Js Gn .�„ ISO