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1987-649 i ,t CERTIFICATE +�3F OCCUPANCY i TOWN OF QUEENSBURY WARREN COUNTY, NEW Y©RK Date January 2 6 Yq R 9 DvlY - ✓ This IS to certify that work requested to be don as shown by Permit No. 7-049 has been completed. This structure may be occupied as a One-Fam L Zy Dwe l l In g f LG Location Glenmar Uri.ve ( Stonehurar ) Clifford & ..Taaet ?nelson Owner By Order Town Board TOWN OF QUEENSSURY I Building & Zoning inspector I BUILDING PERMIT � TOWN OF QUEENSBURY No. 87- 649 � WARREN COUNTY, NEW YORK C' Clifford & Janet Nelson PERMISSION is hereby granted to I V -- 1 OWNER of property located at Lot 10 Glenmar Dr . Stonehurst Street, Road or Ave. in the Town of Oueensbury, 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 approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is 6 Reservoir Dr . w r� Glens Falls , N . Y . 12801 rn 0 ri a. 2. CONTRACTOR or BUI LDER"S Name Ir John Mills ro rt 3. CONTRACTOR or BUILDER'S Address 4 Haviland Dr . f° t~ Glens Falls , N . Y . 12801 w 0 4_ ARCHITECT'S Name t-' rt rt rt 0 5. ARCHITECT'S Address I'D Q � 4'a rt 10 r- m rr � 6_ TYPE of Construction — (Please indicate by XI ri tv ( 2j Wood Frame I ) Masonry ( ) Steel 7. PLANS and Specifications No 45 ' x 77 ' per plot plan , specifications and application including Septic System and attached Itc>: mxx two car garage . 8_ Proposed Used One—Family Dwelling f° I� B ri $5 . 00 $ 150 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES _ April 1 79__fi�i E (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 'ro town of Quearnsbury before the expiration date.) Dated at the Town of Queensbury this 7,28th Day of Sept . 19 87 aka SIGNED BY G.G.!r�for the Town of Queensbury Buildi and Zoning Inspector � To BE COMPLETED BY BLDG - DEPT - c-�■ / Application No . 701V" p/ Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 f C11 ! a !- } �z Bay and HavilSnd Road, R. D. 1 Box 98 Zoning Designation �' L� � i `� Queensbury, New York 12801 Variance No . LJ Site Plan Review No . SEP 2 O �I{+107 Approved by - y JJ L .+ ." 4_,lilt l il4_.i. . ; .. 1 P . Vie.-. f . .+ . l APPLICATION FOR HILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCT-ION* ANSWER ALL OF THE FOLLOWING , Theundersigned 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 Ze _ �' _-40 vrw 7 �-^ P . O, Address Ir� '�O I Tel . ,n wp. Property Location : l.Cz/� �''1 /� •� ytoe, q g: . +r o I / �+tJl�lsr4►+C�! Tax Map Leo . Street number or building lot number �wwfi� Subdivision name Cif applicable} sr ^j € THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS ; 1 L. �o *c v €. G c. J a - �-,� �.c a o . .ic cl de G t f 1 7 9 .�- Name P . O. Address Tel - No . Name of builder �OPAJ 14e4t6a Address �4AweC. oro '"�'� Gce"'.� Tel _ �" Name of plumber_ [,+ ,/`+re.°1�L.t al w7 Address i7 Gee".! Tel . 7 r S,f G N Name of mason---" 'Cll�.lw/ MsLG .S Address Gf hl/4J* (" & " Tel _a G:tQE/ qS°r `- NATURE OF PROPOSED WORK : ZONING INFORMATION : e 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 ) e 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 e 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 , �r COMPLETE INFORMATION REQUIRED BELOW , e, Size of property .ZmZ ,� !a1 ft X 1 +��� ft - Existing buildings) Size ft X ft rt PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structure s(j, f t X` t Foundation-pier/slab/crawl/partial fu Proposed building , distance from property line (circle one ) * Front yard ft Rear yard ft ft No . of stories (habitable space) .�� * Side yards Vr 'L ft and 9 F' Height ( grade to ridge ) _ / ft - if on corner , setback from side street �— ft If residential , no . of families / OCCUPANc:Y INFORMATION No . of rooms ( excluding baths ) No. of bedrooms PRIMARY BUILDING No , of bathrooms ! One family dwelling Primary heating system_.�'" GJ�T OF= Two family dwelling Type of fuel 49 4e Multiple dwelling / Number of units No . of fireplaces to be installed / permanent occupancy Will a wood stove be installed? e✓ d Transient occupancy Central Air conditioning? Business BUILDING STYLE, PRIMARY STRUCTURE Industrial other ' Rant Contemporary Log cabin a If additi Ra on , what will use be? ised ranch Mansion Duplex split level old style Bungalow ACCESSORY BUILDING- Cape Cod Cottage other car colonial Row Town house Detached garage/one car/ two car/ Attached garage/one car/ two car/_ L✓4O car CIRCLE ONE PLEASE rL C } - * * * * * Or * * * x * * private storage building ESTIMATED MARKET VALUE OF * Other >t• CONSTRUCTION $ '�� �- - - - _ - - - INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl BUILDING PERMIT ,A,PPLICATION CONTINUED BUILDING SPECIFICATIONS : Type of construction , wood frame , , fire safe , etc , f�JOG Ij /�/C ,�l{ ry Will any second-hand or ungraded lumber be used.? if so , for what ? Aj0 Foundation wall material COA.. G"IGG, t Mg' rt400 later ickness �? df6 Depth of foundation below grade (to bottom of footing) +� Will there be a cellar? V Heated or unheated? Floor sq. footage %r4 s ft Will there be a basement? g , I-- Will any portion be used as living space? ( If so , what portion? sq - ft Type of use? Type of roof - sloped/flat/shed/othek Material of roof ,f ,Hr/y Size , wood studs 4Xmm ""X spacing .eC "O . c . length g ft . Joists ( floor be lst - floor 2.0 "X iC> spacing '6 r o - c . span t 2+ ft . Joists ( floor beams ) 2nd . floor "X '" spacing "o . c . span.ft . Overlays ( ceiling beams ) "X spacing " O - c . span ft . Roof rafters "% "' spacing o . c . span ft , Roof trusses (pre-engineered) s acin y p g V +' o - c .o span yLi" _f t . Exterior wall finish �iwlis/�S'L. ufT"I c.-of what ffimaterial Interior' wall finish y- f Ai�a'"Vr ,,fro, � If a garage is to be attached , describe materials .to be u�edofor FIRE .SEPARATION : roema� rEae"Jrw r a.wrr- or WqCOC466 ~ s there to be an opening between garage and dwelling? +/}^y .W* If so will a Eire-rated V door , enclosure , and self-closing device be provided? S4rgo Will a flue-lined chimney be installed? y994 Height above roof. ft _ Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . - in , Water supply - Municipal or private well +FsjAFT $i SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining '© ft . properties/ (A separate application is necessary for any repair or new installation of septic system ) Town of Queensbury A L� I �V f T County of Warren A l F D A 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 done ,- provisions of the BUILDING CODE , THE ZONING ORDINACE , and all other laws pertaining to the .proposed work shall be complied with, whether specified or not , and that such work is authorized by they owner . SWORN TO BEFORE ME THIS Signature — Owner , er ' s agent , arcnicect , contractor - �" c/ day of 19 � WILI,i. S 11. CAUL, JR. {Vgtitryot)G Public„ State of New _ .� � L 'Y� �uellftad in Saratopgag fi�,�a�p,= Notary public , Warren County , t V �°ya laaien £zpirea , * _ * * * * * * * st * * * * * * * * it * arc * * * * et ar * * ye * * * It * * st SPECIAL CONDITIONS OF THE PERMIT : By------- --- ........ --- --------- TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for ! BUILDING COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following : 1 . Gross floor area e o f heat a t GJ!G. .r4t3 Y G+.J ear7 i�i��C- 2 . Type _ 3 , Is the building mechanically cooled ? A0040 4 . Percentage Of area of windows and doors fI ! 40 A . over 16 % Only 1 . Uo value 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 fleor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation B . Under 16 % Only 19 R value of roof and floors exposed to ambient conditions . ,, 3 J2 jC I � P & / ,A✓ 0&7J40 2 . R value of exterior walls 0AF 6� iE4"7'e+/* � "'C• � ? 3 , R value of glazed area 04eoo Zoo 33 t meet* .► L� �+ ��l,f 4 , R value of d o o r s & d L i'� I" armalm M 7 wallow e2 a 6 aw Vw it 50 R value of floors over unheated spaces X0 0 Q F 6 . R value of slab edge insulation - unheated slab "" 7 . R value of slab insulation - heated slab a . R value of heated basement/ cellar walls ( above grade ) 90 R value of heated basement /cellar walls ( below grade ) 10 . Type of insulation I' rGG f4 �" ci x4r7owAo6 P6A/ V Co Controls 1 . Thermostat maximum heat setting p , Duct Systems_ 10 Is duct system installed in unheated spaces ? YES NO a , if YES , R value of duct installation �-- b , R value of duct in other areas E , Piping Insulation agent pipe 1 , size of hot water or gaoling carrying 2 . R value of pipe insulation ooei F . Service Water Heating g.r. � 1 . Performance efficiency 2 . Temperature control setting maximum G , For Swimming pool Only 10 Maximum heating Telephone No , ! / '� '� � ( ap ant ' s signature ) Itilyetton a( Qeoew4ov APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE J ' .Z LOCATION OF PROPERTY FOR INSTALLATION .�'d ?` �/' d -��'G�•ti"� � �3 2 Owner's Name : wr VAOAt6 i A /C+ /. ,roA kelephone: /�/�' ,IrC�/C[! e► ! �C. !/ .�+C . �ii Gam,*-� .f rO Address: Installer's Name: ,Ort/ Telephone: �7 `7 2 6 '7 C Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography; circle one: Flat ( olli Steep Slope % of slope Soil Nature: circle one: Sand oa Clay Other / Depth* feet Ground Water: At what depth? A:d v r oe4' f eet Bedrock or Impervious Material: At what depth? � .3+1^ feet Percolation test: circle one: not required required / rate a.r min. inch. Domestic water supply: circle one* Municipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ feet PROPOSED SYSTEM : Septic Tank / gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench 4V 7 feet / Total system length l " feet SEEPAGE PIT(S): Number of / 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 hours before start of construction and shall include a plot plan showing. 1.} the proposed location of the system 2.) location and distance to lot lines 3.) location and distance to structures 4.) location and distance to any water supply 5.) size and dimensions of all tanks, distribution boxes, the fields and/or drywells B, No system shall be covered before inspection and approval by the building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine of up to $250.00. 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. I have read the regulations above and agree to abide by these and ail requirements of the Town of Queensbury Sanitary Sewage Disposal CArdinance. Signature of responsible person: Date: `� z, 3/ Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SE fTLED 1763 . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE ti THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY �d 41 STATE STRE ET, ALBANY, NE W YORK 12207 bate July 60 1988 Application .No. on file 028166--87 /� /� THIS CERTIFIESA 17 THAT t� n 9 7 4 only the electrical equiPmOnt ae described below and intro4saced by the applicant rsansed ass the above application number in the promises of Clifford E Nelson , Gleumar Avenues Glens Falls , New York in thefollofuing location; ® Basement EJE let FY, ❑ $nd Fl. (>Ut Section 54Block 7 Lot 10 was examined on J6 r24 r,3$ and found to be in compliance with the requirements of this Board. FIXTURES. ECE"ACLES SWITCHES AXTIIRf s RANGES Of.IOKtNCi DECKS OVENS DISH WASHERS EXHAUST FANS +� INCANDESCENT FtlN7KE5CEAIT INT.A K. W. 18 5-r 1I DRYERS FURNACE MOTORS MUM All"JANCE PEEUERs srECliu EEC ►T TIEEE cuacKs ESBI� UNIT HEATEES +LEutrr DururT DIMMERS AMT. K. W. COOL M. P. GAS N. P. AMT. NO. A. a. AMT. AM►. A/qT, AAW$- TRANS. AA4f. N, ►. SYSTEMS AMT. WATTS 1 Drye 3010 SERVICE DISCtMNECT No. Os S E R V I C E AMT. Ar,7►. TYPEEICAI Amen 1 .0 'TW 1 }�' ]W S I' �W 3-ff AW ►so. OF CC. COND. A. W, a_ NO. OF HI•LEG OF NtiLEG NO. W NEUT1lAls Of NlllfRAi PER OF CG. COND. 1 200 CB 1 � 1 4 rO � rn OTHER A"ARATUS: 2- SFC1 2 Smoke Detector CLIFFORD E NELSON 6 RESERVOIR DRIVE GLENS FALLS NY 12801 239 BRANCH MANAGER 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 NOT BE ALTERED IN ANY MANNER. i BUILDING and ZONING DEPARTMENT Bay and Hawiland Road, R.D. 1 Box 98 Oueensbury, Ne York 12801 14 IING INSP CTOR ' S RE DRT NAME ez - '�/� 9 LOCATION Dateii Permit No . ✓ = APPROVED - YES Footing/Pier Forms Foundation Waterproofing Backfill wfFraming /\Roofing siding Masonry Veneer Rough Plumbing elief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings _ Cellar Drain Tile Concrete Floors Plbg _ Fixtures Gar . Fi. reproofi Door Closers Smoke Detector Chimney INSULATION : r. Foundation Floors Walls Ceiling FINAL ELECT ICAL INSPECTION DRIVEWAY APPROVAL final Building Survey Next scheduled inspection (call when ready Remkarks-_,I 1r 'ter as 71 71 4rlJ/ /mac'✓ ""C. f Building Insp t r 6/86 and-Vl p I ' _Jr�wri cr Queen3f� ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S ,REPORT NAME LOCATION i7ate —le r M 3-Ot ermi't SIC) ✓ = APPROVED - YES NO Footing/Pier- Forms Foundatian Waterproofing Backfill Framing Roof ing Siding Masonry Veneer L ugh P umbing Relief V Ives Ext . Porc s Finished F OrS Tnterior Tr Stairs & Rai ngs Cellar. Drain 1 Concrete floor Plbg . Fixtures Gar . Fi. reproo in Door Closers Smoke Detec ors Chimney INSUI.ATIO Foundati floors Walls Ceilins FINAL LECTRICAL INSPECTION DRIVEWA APPROVAL_� 7 Final. Building Survey Next scheduled inspection ( call when ready ) Remarks- Building Inspector EifE3E� and-vl � rrcc�� ,r ! +t/11 _JawrR 01 Queexts1ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING /INSPECTOR ' S REPORT NAME ( t X, LOCATION ,1 r f e � ,7r Date f/ ^ _Y Permit N. P°� lacy ice' = APPROVED — YES NO F'ocatinq/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry V eer Rough Plum ng Relief Valve Fxt . Porches Finished Floor Interior Trim Stairs & Rai-Ia. gs _ Cellar Drain Ile Concrete F1 rs Plbq . Fixt es Gar . Fire oofing Door Clos rs � ,,S.moke De ectors }C3~himney Yv I""NSUI.AT ON : Foun da ion oars qp �Ce i 1 i ntI ^'- FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks Buil*tnsp=ector G/86 and- vl _Jvurrt IQ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R, D. 1 Box 98 Queensbury, New York 12801 BU ] IDIING INSPECTOR ' S REPORT NAME ,// G'm& L 0 C A T 10 N� ,E/� .,�- �,� Z �,7e /Y e Date �,.''�_�" �- — Permit No . /� ' ✓ = APPROVED — 'YES NO Footing/Pier Forms Foundation Waterproofing Backfill rami ng Roofing Siding Masonry V neer Rough Plum ing Relief Valy s F.Xt . Porches Finished F1oo Interior "Trim Stairs & Railing Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers :,make Detectors Chimney INSUTxATION , Foundation Floors Wa I l s_ Ceilinq FINAI, ELECTRI AL INSPECTION DRIVEWAY APPR VAL FiTial Builds Survey. _ Next scheduled inspection (call when ready ) Rema rks-- B wilding Inspector G/86 and-vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY,, NEW YORK I2804-- TELEPHONE (538) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME d y� LOCATION/ , / DATE _ / Y � PERMST iE_pmq� 'fpq - APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUG -IN r INSULATION: FOUNDATION FLOORS WALLS CEILING LprxAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING ,XEXTERNAL PORCHES/S EPS STAIRS-CLEARANCE RAILS PLUMBING FIXTURE /RELIEF ALVE INTERIOR TRIM /P VACY DOO FINISHED FLOORS GARAGE FIREPR FIND _ — DOOR CLOSER (S) SMOKE DETECTO S FINAL ELECTRIC L INSPECTION FINAL APPROVAL OF CONSTRUCTION _ A SIGNED CERTIFICATE OF OCCUPANCY Mt$T BE OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPIED; REMARKS: 44PECIR /� �u'een .l6urr� BUILDING and ZONING DEPARTMENT Bay and Hfaviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME rS d LOCAT I ON DATE ! PERMIT NO, SOIL TYPE - Sand - Loam _ Clay Percolation Test Required? YES - N Percolation rate - Min/Inch TYPE of SYSTEM. Absorption fiel total lengtS Length of each t nch S Depth of trenches Size of gravel � - SEEPAGE PITS#Number f) Size- ft. X Gravel Size - PIPING : ' ze Type Bldg . to tank Gf . Tank to d-ISt. box , Dist . }lox to feel Openings sealed? ES O Partial LOCATION/SEPA IONS : Foundation to ank 7,-ft. Foundation to absorption ft . Absorption t lot line ft. Separation o pits LOCATION O STEM ON PROPER'iY (circle one ) Front - e Left side Rid -� a CCHMENTS SYSTEM USE APPROVES] YES "s NO Bui ing Inspector 01/86 and vl 3 ^ ._J`awrr o� �uQQn3 urt� r y" BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 i BUILDING INSPECTOR ' S REPORT NAME ' LOCATION""' Date / t7 / Permit No . q ✓ = APPRWED - YE NO �'c�oting/Pier Forms Foundation Waterproofing I3ackfiII Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile — Concrete Floors 11lbg . Fixtures Gar . Fireproofing - Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls e Ceiling_ FINAL EIECTRIC L INSPECTION DRIVEWAY APPROVAL Final. Building Survey Next scheduled inspection ( call when ready ) Remarks- 10 Building Inspector 6/86 and-vl �7OW407 a/ ueens6urt�r E3UILDING and ZONING DEPARTMENT Bay and Haviland Road, S. D. 1 Box 96 Queenshury, New York 12801 BUIIDfNG PECTOR ' S REPORT NAME r � LOCATION 7` A2 Date � Permit No . � Footing/PierAPPROVED - 'yES NO Forms / �Egaun da tion 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 Closers Smoke I]etectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICA INSPECTION "- DRIVEWAY APPROV Final. Building Survey Next scheduled inspection (call when reads ) Remarks- a I✓l 6/86 and-vl Building Inspector aX04��Lgsdt urn a/ �ie+een sheer BUILDING and ZONING DEPARTMENT Say and Haviland Road, R. [?_ 1 Box ga Queensbury, New York 12801 BUILDING INSPECTORPS REPORT NAME LOCATION r Date/�,/AL';�- Permit No .C;; 1" = - Doting/Pier FormsAPPROiIED NO 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 Closers smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling )FINA-L ELECTRIC INSPECTION DRIVEWAY APPRC?VAI`__ Final Building Survey Next scheduled Inspectlop call when ready 1� Gry1110 4y Remarks-- / / ago Building Inspector 6/66 and-vl 13UILOING DEPT. COPY OF APPLICATION FORM 46.EL, NEW YORK BOARD OF 'FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. TEMP. A DATE ` r CITY OR VILLAGE 4 40 tJ +�' /7 (,,. '�. ,� TOWVNSHIP �l�L...I C' [: .e.� 1 %-j Gf .d'� �' COUNTY ? .✓ !>I tc' �L:� e; STREET A140 No, OF% ROAD AND POLE NO, C t•= +'L✓,/ ,.t.. f iy-:r i BETWEEN WHAT TWO C•• POLE NO. CROSS STREETS IS l,�r` �4r �'�y .A.JC ode: C/ . PREMISE OCATE ? '� SECTION r BLOCK LOT OCCUPANT'S BUILDING _' NAME OCCLIPANCY % , ! -- OWNER"$ NAME // �, - 1[ f .. . AND ADDRESS Lam.. j " ir'l✓ 4 ! �L] By- rU �` _ / �C]tc l �,= TEL- FROM THEIR CLG OFFICE BUILDING �" �r DEFECTS IS MEW L 04D is OLD NEW ADDITIONAL ❑_ REMOVED LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No. M Fircturas A BRANCH Lov imp Reeaptadaa MOTORS HEATERS CIRCUITS OFFICE USE [ion Orrlklp Bid* Attsah't H.P. limns A.W.G. ONLY WaN Reeap'Is SVA*ch Pendant Breekst lilo. TV" Each No. Each No, pauea ONLY out- Vida sub- b*" peas Ist Fl.. / 2 REMARKS: LIST OTHER ELECTRICAL, DEVICES NOT SET FORTH ABOVE: OD NOT USE THIS SPACE. This aPPlicaNas is intended to corer the abore-listed equipment to be ingp tad but to at time of inapactirat there is found additional i You are &Uff a ixod to make the irgtbction end adjust the T squ pmint not ahrsva listed, pp 1 M t0 cover the adEitional lquipn}eM,. q preVidM.# by The eppl/Capt. SIZE OF L, a jF ELECTRIC SIGN MAINS FEEDERS J 0 rqA M##O LAMPS TOTAL WATTS CHARACTER - GAS TUBE SIGN OF WORK G . J .�``' .�� fs t r .0 / �� ONCEAL TRANSFORMERS OF VA WORK TO BE r- (NUMBERI STARTED '0 COMPLETED 7SIZE OF SIGN ICAPACLTY) SERVICE OVERHEAD UNDERGROUND SUi ENTOFNG f/' MAKER 4F SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID DELAY BY GIVING FULL ANO ACCURATE INFGRMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICA ON PRINT NAME DD ESS � / NAME OF /"` AG '{ , JL.r C� f: .' J-0 APPLICANT ' OF APPLICANT PT RE ICA (/ f�Gq _i^ OF APPLICANT -ar STREET ADDRESS "-� C' J 4. -ee o go or -e f2 TELEPHON #CITY O • 3 - POST OFFICE �' L" 'r Y /* ZIP 2.' (y !I LICENSE NO_ CODE WHEN APPLICABLE we EL (REV. t/Ba) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING 0 7 ` IW / 0 e;2 ar, 470 O Q! - 0. E a. w CI C L &Aj /vA7fg r 4 06,04r F10 gC I6 76Z cw. 400 k Fy i C A 4t 4r F!/6 20 L u-r 2 4 a. t.a sf LOT ss - 490 mcq. waft lip ap b a ! @ JF a I / f4a SAL- rS Yam* Ml + J 1 t3Aj ` {fir.^�1 : H,4H �,�n •.so vAA�t rtix 0 1 ! /�p� r i � 1 -37`! At 2 Cie a � / a lb N / vgo As r d. 10 1 Ai �f f /r `•n L a" r / r + a _ lop } r % 207- 15- A . do 1'�r ; - +4 /'t• rw o a, 7`rs ]06" p ' �g1`4"6 `, ",+► -� 'l. ESk` �'! 4t ] too .` `�i $+�• � - � ! � � '�.""'�•7,r1^"`--•_ �y--" `� T