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1987-796 l CERTIFICATE OF C3CCU'I�•�►iN C "JL r TOWN OF QUEENS13URY 7 WARREN COUNTY, NEW YORK Date May 24 , 19 88 87-- 796 This is to certify that work requested to be dome as shown by Permit No. s has been completed. This structure may be occupied as a of a two family dwelling i.ocation 10 Elizabeth Lane, Queen Victoria's Grant: Model E i C}wner Guyer Builders Inc. By Order Town Board TOWN OF QUEENSSURY OAS= Suildind & Zoning Inspector BUILDING PERMIT TOWN OF +QUEENSBURY No. $7_79,6 � WARREN COUNTY, NEW YORK z PERMISSION is hereby granted to Queen Victoria ' s Grant OWNER of property located at 10 Elizabeth Pane Street, Road or Ave. in the Town of Queensbury, To Construct or place a of Two Family Dwelling 4� 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. T. OWNER'S Address is a 119 Dunning Street �a Ballston. Spa , N . y . 12020 ro 2_ CONTRACTOR or BUILDER 'S Name c F�• n Guyer Builders c rt 3. CONTRACTOR or BUILDER'S Address p' Same u'x ry w 4_ ARCHITECT'S Name 5. ARCHITECT'S Address p ts7 Y• N 6. TYPE of Construction — (Please indicate by X) m rr be I Wood Frame I ) masonry f I Steel r pa 7. PLANS and Specifications 't No. 32 ' x 37 ' as per plot plan , specifications and application including - septic system and attached one car garage . MODEL E a. Proposed Use of Two Family Dwelling D $5wUU C /O M 96 . 00 $ PERMIT FEE PAID — THIS PERMIT 'EXPIRES June 1 19_ 88 0 (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.] H• �c Dated at the Town of Queen 27th November sbury this Day of 19 87 t7 . . ' m SIGNED BY for the Town of Queensbury F , Building and Zoning Inspector Uc7 .. .l l BriA 4V/{.y/i ♦/iii/ iii L1MYV • YYF � • / , f � / ApplicationNo . �vn v sans ary Permit Issued 19 .tU1` BUILDING And ZONING DEPARTMENT Permit Expires Bay and Haviiand Road, R.D. 1 Box 98 Zoning De signatpo Q. COT 2 1987 Queensbury, New York 12801 Variance No. Site Plana Re ew Approved 9eyor�l APPLICATION FOR I 1: � BUILDING AND Z©N I NG 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 ; 2yyer Builders Inc P. O. Address 119 Dunning Street Ballston Spa , New York 12020 Tel . ( 518) 899-9161 Property Location: 10 Elizabeth an r Tax Map No .121 / 2 Street number or building lot number Subdivision name (if applicable) Queen Victoria ' s Grant THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK. AS REGARDS BUILDING CODES IS : Richard H. Guyer III ( 518) 899-9161 Name ' P . O. Address Tel . No . Name of builder Guyer Builders , Inc .Address 119 Dunning Street Tel , ( 518) 899-9161 Name of plumber GUyer MXICTdrSo nc .Address 119 D&Wffrig- Street Tel . - 9161 Name of mason Guyer Bullders2 nTC7Address__F19 IY&Mng SEreet Tel . NATURE OF PROPOSED WORK : * ZONING INFORMATION : X 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 FOR DEMOLITION PERMIT , STATE SIZE AND of interior or corner lot . Show location LOCATION OF STRUCTURES AFFECTED . * of water supply and location and configuration of septic disposal area . * COMPLETE INFORMATION REQUIR.EDJEHL W . * 40 Size of property 100- pgau1p ft X 120 ft . Existing building ( s ) Size L41A ft X��`ft . Model PROPOSED BUILDING AND USE : of * Existing buildings ) Use NL Size of new struc a 32 ft X 37 ft Foundation-pier slab crawl/partial/full Proposed building, distance from property line circle one ) * see plat pan No * of stories (habitable space ) 2 * Front yard 30 ft Rear yard 3a+ ft Height (grade to ridge) 21 " - 6" ft , * Side yards -.ft and 15+� ft If residential . no * of families Of 2 * If on corner , setback from side street ft No. of rooms (excluding baths ) ^ " OCCUPANc:Y INFORMATION No. of be�,roarrxs 2 " NG. of brooms „ PRIMARY BUILDING se ar a ectric* One family dwelling one re%k p,eiri "r Primaryaeating system * one family dwelling t5 slide 6ui Type of fuel ElectricityMultiple dwelling / Humber of units No , of fireplaces to be installed Will a wood stove be installed? N[a * Permanent occupancy * Transient occupancy Central Air conditioning? No Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial ,� Other Ranch contemporary Lo cabin If addition, what will use be? Raised ranch Mansion Duple " split level Old style Bungalow " Cape Cod Cottage Other '" ACCESSORY BUILDING,,, Colonial Row Town House " Detached garage/one car/ two car/ car { CIRCLE ONE PLEASE ) - Attached garage/one car/ two car/ on�car w * # r * * * w w * w * * * + * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION � zqrz INFORMATION ON BUILDING SPECIx'IGI',C�/ ONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED ! Form SPA 4/86 and-vl E 'U` $UILDING PERMIT APPLICATION CONTINUED WILDING SPECIFICATIONS : Type of construction , wood frame , fire safe etc . wood frame Will any second-hand or ungraded lumber be used? If so , for what? no Foundation wall material concrete block Thickness 8,0 Depth of foundation below grade Ito bottom of footing ? '" minimum Will there be a cellar? 'no Heated or unheated? Floor sq, footage sq ft Will there be a basement? no Will any portion be used as living space? ( If so, what por � �sq. ft . - - Type of use? Type of roof - sloped flat/shed/other Material of roof Fiberglass shin es Size , wood studs "X b "' spacing 24 "o . c . length 8 ft* exterior walls Joists ( floor beams ) I.st . floor N/A "X "" spacing "o . c . span N/A ft . Joists ( floor beams) 2nd . floor "x�-" spacing��"o . c . span-13=61rtV Overlays (ceiling beams ) 2 "x '" spacing 24 "o . c . span 16 ft . Roof rafters "x 1 " spacing'24 o . c . spaa ' -31 t . Roof trusses (pre-engineered) spacing flowco span N/A ft . Exterior wall finish stained Of what material? 5 /80" x 4 ' x 8 ' texture 111 Interior wall finish palnE 112 s eetrock If a garage is to be attached , describe materials to be used for FIRE sEPARATION * 1 /2" type "X." sheetrock Is there to be an opening between garage 4ind dwelling? yes If so will a Fire-rated door , enclosure , and self-closing device be provided? es Will a flue-lined chimney be installed? No Height above roof NIA ft . Depth of chimney foundation below grade N/A ft . Depth of fireplace hearth N A ft . in . water supply - Municipal or private well municipal SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft . (A separate application is necessary for an re air or new installation of septic system) See S . P. E. D. S . iperm.t �� 020252 Town of Queensbury County of warren A F F I Q A V I T------ 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 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 _ -- ---��—�--____-- �:-7' Own r , owner ' s ag t rcnisect , contractor day of g�S.r 19 U 4 ELIZABETH K. LANDRY Notary Public, State of New York No. 4862001 .( Oualified in Saratoga County rr-,r.- •,, �•-- ,.,�r �+rnirr ft ' r," 1Es, 19.` 5K Notary Warren County, N . Y . `-'---_ w • s Am r r s _ , * s +r rF ik * +r ie * * is sr sr * * sr * f is * f * # * t # ■U * f * ♦ A A4 # SPECIAL CONDITIONS OF THE PERMIT * 1270 Square feet living 288 Square foot garage - one stall 1558 @ $7 . 00/100427 or part of � 5 . 00 One stall garage $5 . 00 C/O permit Total By_---__-.. . _--___- --- _ _ .. _ On x _ _mo, . .. _ .. __ _ , E,. WARREN COUNTY , NEW YORK Application for . BUILDING PERMIT IN COMPLIANCE WITH TIME NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . >NGWER ALL of the followings 1 . Gross floor area 1270 S . F. 2 . Typo of heat Baseboard electric 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors 13 . 3% 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 N0 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 s • Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions R-38 (U . =O . 026) 2 . R value of exterior walls gg= R-23 . 5 UeO . 04 3 . R value of glazed area U • =0 . 30 4 . R value of doors R-14 . 9 (U. . 06) 5 . R value of floors over unheated spaces 9/A 6 . R value of slab edge insulation no unheated slab N/A 7 . R value of slab insulation - heated slab 12 . 5 8 . R value of heated basement/cellar walls ( above grade ) N A 90 R value of heated basement/cellar walls ( below grade ) NIA 10 . Type of insulation Fiberglass Co Controls 1 . Thermostat maximum heat setting D . Duct Systems N/A ann 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 N/A 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulations F . _Service Water Heating is Performance efficiency NIA Z . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating NIA Telephone- No . ( 518) 899-9161 ( applicant ' s gnaturs ) • F n APPLICAT70N FOR SEP77C DISPOSAL PERMIT Ref . S . P . E . D. S . DATE September 23 87 permit; # New York - 0202525 MODEL E of LOCATION OF PROPERTY FOR INSTALLA77ON 10 Elizabeth Lane Owner's Name: Guyer Builders , Inc . Telephone: ( 518 ) 899-9161 Address: _- 119 Dunning Street , Ballston Spa , New York 12020 Installer's Name; Guyer Builders , Inc Telephone:. ( 518) 899--9161 2 A, C , E, I , J , K, L, M Number of bedrooms (residential only) 2 i 3 F , G, H Total daily flow (compute @ 150 gal per bedroom) 300 Topography: circle one: Iat Rolling Steep Slope % of slope Soil Nature: circle one: Sand Loam Clay Other / .Depth: 8 ' feet + Ground Water: At what depth? unknown 8 feet + Bedrock or Impervious Material: At what depth? unknown feet Percolation test: circle one: not requires required / rate min. inch. Domes Uc water supply: circle cane: Municipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption N/A feet * PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1,000 gal.) TILE FIELD: Each Trench N/A feet / Total system length N/A feet * SEEPAGE PIT(S); Number of / Size each feet by feet -` * Size of stone to be used # / Depth or Tbickness feet IMPORTANT * See S . P . E. D. S . ...Please ..LIST NEW EQUIPMENT TO BE INSTALLED permit & attached * * * as * * * * * * * * * * * as * * * * ass * * * * * as * * * s * essss * syla map . (over) a Section U Septic Sntem 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 propoped ,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 8. 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 roust be submitted to the Queensbury Building Department before further construction. l have read the regulations above :a" agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Eduposal Ordinance. Signature of.responsible person: Date; ti Town of Queensbury Building and Code Department Bay at Haviland Road Queensburys New York 12801 (518) 79Z-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE oW, a� SUILDING and ZONIN G DEPARTMENT 88 say and liayiland Soad. Fi.[7. 1280i pueensbury. New York OR ' S REPORT BUILDING INSPECT NAME LOCATION ..00ATIC1N 0 Co Permit Nc - Date APPROVED* YES NO gootingfpiex Forms Foundation waterproofing B ackf I l l Framing L/ Roof ing siding Masonry Veneer Enough plumbl- Relief Valves Ext . Porches Finished Floors �— Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors P1b,q - Fixtures Gar . Fireproof ing Door closers Smnoxe Detectors Chimney 114SUL LTTONO Foundation Floors Walls Ceiling CAL 3I35PECTI014 F�p,i, ELECT pRIVEWAY AP OVAL._--------'� Final Build ng Survey�----�-� i3ext ached led insp ection (call w en ready) Remarks- uilcling Inspector 6/86 mug-VI THE NEW YORK BOARD OF FIRE UNDERWRITERS Gv�110 F4 9UREAU OF ELE+CTRIC•ITY ,— 41 STATE STREET. ALBANY. NEW YORK 12/207 � r� L 9 3 T» 3 � :.Fk 1 � 5 application 7Vo. on file C}34290 8 wh.F 11hate February 26 , THIS CERTIFIES THAT an the abare appucation number in the prvrn►is+s of only the efeetrical equ.ipnsent ae described below and introduce_. �. the �applicarLt N,aPned .= eensbur New York zl of ewa� family Guyer Builders Inew � 10 �lixtlbettt lane � Yr Section 12 �Iock !; Lot in thefaliowirag Location, ❑ gp�rrsent � Ist Fl. � Snd fI. garage Qutsid�e uirerraerxts of thin Board. and found to be in co+++pLiance with the reg was exansined are. 1- So WSM WAS�11�R5 EXHAUST FANS "XTURE AMT K.s RANGES cR)ORTNa ttECKS - K- W AMT. K W. AMT. FIXTUSE ACIFS SWATCHES 1NCANLESCtw FLuostSCtrr'r v AMT- K. w. AMT. K. W. . H. r• OUTLETS 4 '�r le 27 075 13 5 IMUtTI-+D~F vIFA�MME1es = RITtlRIE APPLIANCE FElRSR9 SEAL SWTT TAMS CLOCKS lieLl UNIT HSATSSS SyTrTHMS FURNACfi MOTORS MANS. AMT. ti. P. NO.OF FflT AMT. WATTS DRYERS t, W, 6. AMT. AMP. AMT. AMrS. ^PAT_ K. W. a:L w P. GAS H. P. AMT. Np. tr PV5 E S E R y 1 C aAier`IiAL SwRVKE pISCONNECT No, OF A. W.G »a. OF watG of KY-UG IIIJ. aP MEUTRAI5 !IIlTlR rro OF Cc. CoPLD. AMT. AMP. TV� SCRIP. } ^� 2W 1 Jt. SW 9 I SW 9 Je 1w ! OF CC. CORD. 1 150 c1T 1 OTmW APPARATUS: Z3.ec _ Room Reatiere : 3f2 . 0 . 1f1 . 5r 1f1 • 'S + Lf1 . G , 3f . 5 1-a.014e detector 239 Guyer Tiuil3era , Inc . RRANCH MANAGER 119 TCfulMlUg Street Ar33a11_staci Spa , 33Y 12020 prr This certificate muat rent be altered in any manner; return to the office of the Board if incorrect. Mspectars may be identified by their crederLNalt. NN — - - - • - COPY 1111_DING DEPARTMENT. THIS CO" t)F CERTIFICATE FOR g MUST NOT BE ALTERED 1N ANY MA �� eensfiiart� 4S113G DE PARTMEN� BUftt74NG and ZG R (3 i Box 9a Say and HaviSand Road, pueensburY. New York 128Di BUILDING INSPECTOR t 5 REPORT L NAME LCYCFaT l rJN No 1 '=- *t APPRc7Vi:L1 - YES 13C7 l ootingfi' yer Forte l.auncia'��Sf ing WaterF 15acx E i l l 3. Kamistg hoofing :, ie3 inc] vuneerr— pi,asonrY ---- S uc;it plumbing ---- V alVEs i to l i e f _ �.._.- lorcltes ' l' istisltu(A floor -' �- .�-- Interior 'trim_ irs Tile cellar 1]r:i i n Concrete Floors 1t�g - Fixtures comar C10" r Closers T.mUke pet-Oct ry {'lt irnneY �t3�,U1.11'i'IDf1 1'c ultc3ation 1' loor5 r wlall ^� -- - r C ei ]. istg_ S.C�U I13SPEGTI013___ �--- � FI.Nf�L L:I ►:C:'TR 17RIV SWAY APPIitS'U AL�'�'r~ Final Building teduled dy ) inspecrI-on CGaI 1 when rea iyext i i itemark:s-' { iitxi l ng Inspector G/ifs and-vl ke / M S 91),w #I f x OWT40 � .fl 1 go an 96 (]U ,p+pRrt ORs � Re � 50 C6 * * Fox^ 1'oc'ta�'t3��on x �:o n�aca af �n�3 ,�atexpxo �Oo irtr3 SIL a 'On't T fie] �oxcy'ea� _ ter cellaY Qx v)-oox5 `oncxet x `sxo5 max I" ox 5 ;'y Door Qe ecv Or5 Qtaee +n3 LgrLj p O Ep AF tT M f7 Z pt ttt4G t7 i ,Box cis B 11Ld1G �,nd a.wilain Road � � Ray oue sbur`ll tAew York 12�IC11 INS ? ECNORI S REPOF`Y [ , Np,q+1e LOCAT "' I myt -00 r �/ P'e pates * * * * x Pier �or�ns RC>O f 3*.n14a9 _ _--- - Son Relief Valve Ln 7ntr e 3-or Stairs graie Cs n Tile Concrete tu4s l' '3 xeProof s"; CYtitt� e Tloll INSUi..A �ounaation �,lr�t31'S v3alls IN5EEG'TSON_ -- 1 � � - 1 n9 i Ge i 3 AS.. F IN F.. AL I ECTR A� R V �~ ti3AI Apt' 151xve7T Fjn� l Bv1 lain ^.__.r ill w e r dye Next 5o eduled ros a /1 p of rtMIErA vWK g gLL.D 511NG and 2Ot4lt4 ' fl . l 6ox 9 P1aY and "avlland R �.{ork 1280t Queens+purY • Ke "' upF ` 5 St��'t3i2rt gLyILl7L1 � LT3SPEG r GOGp-' FexYtt��14c) S AS,-2ROVEi1 - YE t3C7 Footin9l pierQrms Founder zoof On 3.n9 wa erP Ba,,c}cf ill Frasc,inC3 Roof in9 Si�in9 Veneer _ _ - - MaSonr Plt5Ln9 -- Qu9r` yes iteliti f dal - - E-At orc ed F ),oars .Cinis In'terjor gailinqs Cella e e ain�• e loa s ConC"r Y iscL'res PI . -F .% , f in9 Gar * rs Dooxe 117et eGtprS Chime e r1013 IN SV LR E•ounda'trc'n F1-00rs yaalls__- SyEC'�x Ceiling cN NL xe der S�� Ftnateall when in necktivn Remarks- i i v 1 i F Q4Aeen jI r _. 91a `vn crt4kNG 01EP and Z pp.C1- 1 BOX 9t3 BUILLIVNC+ oad. y28U1 Bay and Hawiland t4ew .Cerk C]ueensC+ury. fdSP BUILDING I �C, O R w 5 REPf7RI pate ! * * * * S NC7 pppRCFV8D YE Footin�3fpier Forms E.c,,an lotion mat r,roof irV33 ckf ill. Framing goof ing Siding veneer r---- �.-•-- pluxnbiT ef Rel i el . porches Finished Floors interior& i ri-M , l}ngs Stai.�cs Drain Til Cellar Floors concrete Pl. F i 3 - -Xture 5 p Gaz • Fire�,rt3of g poor Closers s Smol�e De :tec to Chimney Id 7N5�3S ''�T C313 = Foundation Floors Walls CeilingCAT+ It35T�'ECTIC?13� --- c.r F TN AL 'LV ©V Aim-�".rr 3)RIV V';o'Y AFF` survey�~ -Filial- Duildi _ (call ready ( Nex scheled InsP'�ction � al] t [�emarlK-5'" �u� :nspector~ g © �eeeens � esrs� f7vwn °1 f,� BULLDING and ZONING DI<PARTgox 984S ?o Bay and "a"and Ne YoBr� 12801 lLsar� i Queensbury. BUILDING INS Pa CTOR ' S REPORT NAME .. Gf LOCAT ION 1 permit i30 [ NO "PROVED I, Qoti.ng/Fier Forms ' Q F[>undation Waterproofing Bacicf ill F ramirig f. Roofing Siding y Ve bie g Masonr Rough Plum Relief 'Valves Ext . "Porches Finished Floors Interi©r Trim Stairs & Railings cellar Drain 'Tile Concrete Floors Plbg - Fixtures Gar . Fireproofing Door Closers Smolce Detectors Chimney IN SU j,m.T 10N Foundation Floors Walls Ceilln(3 TC RIC L INSPECTI'DL`��--� F Ii3 RL I]l1VFWgildin8 survey Finalu ~ ection (call when► ready ) h I3 sceduled insp Remarks- i a ding � lnsp ector p+ai. l 6/B6 and-vl BUILDING DEPT- COPY OF APPLICATION FORM 464ELr NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. DATE TEMP. * CITY OR Irby xisbury TOWNSHIP COUNTY ���� VILLAGE 'r{��"�a"'�'�7 STREET TR Ei TT.N�AND NO. No. #10 E Vieth I•� POLE NO. CROSS STREETS (SW4 SE 714N --'"'/ BLOC% LDT PREMISE L TED'+ - �` BUILDING " ,+` OCCUPANTS OCCUPANCY NAME AO YE L. ADDRESS Guyer B € r$ 1 "w ! iip Z > Stet y 1 ' T � OFFICE DEFECTS BUILDING r NEW P OLD '0 is NEW ADDITIONAL REMOVED 15 LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No. of Fixtures 8 BRANCH OFFICE USE NUMBER OF OUTLETS Lamp Receptacles MOTORS RS HEATERS CIRCUITS ONLY Loeb' N.P. wars A.W.G. INSPECTION tiara Slde Attash't Switch Pandam Bracket No. TV" Each No. Each No. Gauge Calling WaII Recep'bt Out- akin Sub- been Bass- m+nrt lot Ft. 2nd f1. 9pd FI, REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is intended to cover the above-listed equipment M be inspected but it at time of inspection there is Found additional +quipr"o"t not aboaa listed' you are authorized to make the inspection and adjust the far to covor the add itionst equipment, as provided by the applicant. TOTAL ELECTRIC SIGN TOTAL SIZE 4F y C�y/]� " FEEDERS LAMPS MAINS 150 + EXPOSED GAS TURF SIGN VA CH CONGEALED TRANSFORMER54F (NUMBER) (CAPACITY) WORK TO BE COMPLETED SIZE OF SIGN STARTED SERVICE OVERHEAD UNDERGROUND MAKER ENTERS OF SIGN BUILDING ON OR AS NN EAR AS REQUESTED win Cal y � � NE,W � OLD POSSIBLE C:�J.i AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS -,� �s ,�� _ September '21 1987 NAME OF �r iDf.LJJ1atR'Il-g5! Ism*r APPLICATION ! APPLICANT 1�ts �t ��ii Jt.L7 � "�����' y� TELEPHONE # STREET ADDRESS t��e,� YIP y.ton �I�+�p�a NY LfJIJ1.1 LICENSE APPLICABLE CITY OR � a+1�i CODE I POST OFFCE (F rnsa A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING ELIZABETH 125.00 --r-- w %-L-C nIV t-iV I TO GRALE QUEEN VICTORI A' S GRANT QUEENSBURY , N.Y. 2000 qa I . 0 DIAMETER !'-C DEPTH 2,4,6,8,10,12 ELIZABETH LANE PLOT PLAN � SEPTICSYSTEM GUYER BUILDERS, INC QV - 5 CWN;i Q-Z4-87 FS c�le I': 20'-0