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1987-927 f_^_.;_ —..vas �a� r: -r`.•'. . . r ?. S CERTIFICATE OF Co CCUPAl`�TC'J TOWN Of +QUEENSBURY WARREN COUNTY, NEW YORK Bate 14 IV 'f ` This is to certify that work requested to be donne as shown by Permit No. S _g ` 7 i has been completed. } of Two Family Dwelli.zg This structure may be occupied as a 1cs[ atior+ 23 Queen Anne Court Queen Victoria ' s Grant Guyer Builders , Inc . Owner I By Order Town Board IrOWN OF QUEENSBURY i I � Building & ZADimingi l pector k V ' BUILDING PERMIT y TOWN OF QUEENSBURY � No. 87-927 WARREN COUNTY, NEW YORK o PERMISSION is hereby granted to Queen Victoria ' s Grant n 1 OWNER of property located at 23 Queen Anne Court Street, Road or Ave. in the Town of Queensbury, To Construct or place a j of Two 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 `a Guyer Builders Inc . ro 119 Dunning Street :j Ballston Spa , N . Y . 12020 r 2. CONTRACTOR or BUI LDE R'S Name rt Sameos F+• N m 3. €ONTRACTOR or BUILDER'S Address C7 Same w rr 4. ARCHITECT'S Name N w 5_ ARCHITECT'S Address A ro a a 6. TYPE of Construction — (Please indicate by ?(} ro xi Wood Frame I i Masonry 1 I steel { } tt rt 7. PLANS and Specifications No. 31 ' x 46 ' -6" as per plot plan , specifications and application includi g septic system and attached one car garage . MODEL I S. Proposed Use ra•• of Two Family Dwelling 0 r., H E $5a00 C/O 0 $ 82 " 00 PERMIT FEE PAID - THIS PERMIT EXPIRES July 1 , 19 $$ (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the G town of Queensbury before the expiration date.) C7 fA Dated at the Town of Queensbury this 31st Day of December 79 $7 r SIGNED BY for the Town of Queensbury 44 Building and Zoning Inspector // Application No* r ei7fJ1� OIse�elt96ler Permit Issued 19 6UiLD1NG and ZONING DEPARTMENT Permit Expires 19 Say and Harviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York 12801 variance No . } r CT {Z 1937 Site Plan Review No . Approved by : _' i APPLICATION FOR 7 r a 0 BUILDING AND ZONING PERM I T A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING . The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description , plans and specifications submitted, and such special conditions as may be indicated on the Permit . The owner of this property is : Gu er Builders Inc . P. O. Address 119 Dunning Street Ballston Spa , New York 12020 Tel . (0518 ) 899-9161 Property Location : #23 en Acme Court Tax Map No . 121 /.L2 2 Street number or building lot number subdivision name (if applicable) Queen. Victoria ' s Grant THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Richard H . Guyer III ( 51$) 899-9161 Name P. o. Address Tel . No . Name of builder Guyer Builders , Inc -Address 119 Dunning Street Tel . ( 516) 899-9161 Name of Plumber yer ers , nc =Address 119 Dunning StreetTel . - Name of mason Guyer rs , ne .Address g -StreetTel . - 9161 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 * whether anterior 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 * Size of property 100t plan ft ,g 120 ft . " Existing building ( s) Size ft x�—ft . Model PROPOSED BUILDING AND USE : Of * Existing building (s ) Use N/A 46 ' _�� Size of new strut a 31 ft x - - Foundation-pier slab crawl/partial/full * Proposed buildings diispaonctepf om Property line see lan circle one ) * Front yard 30+ 00000ft Rear yard 30+ ft No . of stories (habitable space) l 19 ' -6" ft . � 'Side yards�`r' ft and 15+ ft Height ( grade to ridge ) * if on corner , setback from side street ft If residential, no . of .families of 2 No 4 of rooms ( excluding baths) " OCCUPANCY INFORMATION No. of bedrooms * PRIMARY BUILDING - Nol of bathrooms one family dwelling This t e r Primary heating system se ar a ectrl& -Two family dwelling one s �i i ' Type of fuels Electricity _ dwell / Number of units No. of fireplaces to be installed AtMulta le permanent well occupancy will a wood stove be installed? No 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/ One 1 . car * * • * At ,� * . * At It * +. * * At Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION INFORMATION ON � BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETEDI Form BPA 4/86 and-vl .: J ' BUILDING PERMIT APPLICATION CONTINUED — BUILDING SPECIFICATICNS . 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 wail material concrete block Thickness 8" Depth of foundation below grade (to bottom of footing ) $" minimwn Will there be a cellar? TTio Heated or unheated? Floor sq. footage sq ft Will there be a basement? T10 Will any portion be used as living space? ( If so, what por 7 _sq. ft . - - Type of use? Type of roof - sloped flat/shed/other Material of roof Fiberglass shing es llnft�Size , wood studs "x 6 " spacing 24 "o . c . length 8ft . exterior walls Jolatz ( floor beams ) lat . floor N/A "x _" spacing"o . c . span N/A ft . Joists ( floor beams) 2nd . floor _ "X " spacing "o . c . span N A ft . Overlays (ceiling beams ) "X " spacing 2f+ "o . c . span N/A £t . Roof rafters "X is spacing 4 o . c . span N/A ft . Roof trusses (pre-engineered) spacing 2 "o . c . sparY42 ' =6'ft . Exterior wall finish ataine-d Of what material? 5 /8" x 4 ' x 81 texture 111 Interior wail finish paInt 17ZT, sFRFetrock 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 Jand dwelling? yes If so will a Fire--rated door , enclosure , and self-closing device be provided? yes Will a flue-lined chimney be installed? No Height above roof N A ft . Depth of chimney foundation below grade N/A £t . Depth of fireplace hearth N A ft . in . Water supply on Municipal or private well municipal 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) See S . P . E . D . S . rk t # 0202525 Town of Queensbury County of Warren A F F I D A V I T STATE OF NEW YORE 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 s cified or not , nd that such work is authorized by the -owner . �„ - r SWORN TO BEFORE ME THIS Signature r�✓�7 er , owner ' s agent , c ect, contractor day of lg PATmCIA E . FURPHY ` f ? to-u Public. State of New York �{ - -r,,� Qua%j0ied +n SchenectadY County " �' ► 4717048 Notary Public , N . Y • Commission Expires Sept. is SPECJ?a,b CONDITIONS OF THE PERMIT : 1040 Square feet living 240 Square foot ,garage - one stall 1280 @ $7 . 00/ 100 or part of k5 . 00 One stall ,garage $5 . 00 _ C/0 permit Total By_...... TOWN OF QUEENSBURY !•1!! WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . AN4WXR ALL of the following : ; . Cross floor area 1040 S . F. 2 . Type of heat Baseboard electric 3 . Is the building mechanically cooled ? No 4 . Percentage of area of windo ws and doors 14 . 3% A . over 16s 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 NP 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 R . Under 16 * Only 1 . R value of roof and floors exposed to ambient conditions R-38 (U. =0 . 026) 2 . R value of exterior walls R- 23 . 5 (U6 =0 , 04+ ) 3 . R value of glazed area U. =O . 30 4 . R value of doors R- 14 . 9 (Uo =0 * 06) 5 . R value of floors over unheated spaces R-30 6 . R value of slab edge insulation - unheated slab NIA 7 . R value of slab insulation _ heated slab 12 . 5 S . R value of heated basement/cellar walls ( above grade ) N A 9 . R value of heated basement/cellar walls ( below grade ) N/A 100 Type of insulation Fiberglass C . Controls. 1 . Thermostat maximum heat setting p . Duct Systems N/A 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 N/A 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating 1 . Performance efficiency NIA 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating N/A Telephone No . ( 518) 899-9161 ( applicant ' s s n re ) F APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref : S . P. E . D. S . DATE September 29 / 87 permit # New York - 0202525 MODEL I of I M LOCATION OF PROPERTY FOR INSTALLATION 23 Queen Anne Court Owner's Name. Guyer Builders , Inc . Telephonet ( 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 3 F , G, H r Total daily flow (compute Q ISO gal per bedroom) 300 TaFographyt circle one: QLat Rolling Steep Slope 96 of slope Soil Naturet 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 required! required / rate min. inch. Domestic water supply: circle one: 14unicipa, Well Other IF domestic water supply is a Well: Separations 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 feel * Size of stone to be used # / Depth or Thickness feet * * * * * ss * sir * * * ss rrs * * s +s +rigsrslesllit +lks * * risacss IMPORTANT * See S . P .E. D. S. ...Please...LJST NEW EQUIPMENT 70 BE INSTALLED percoit & attached rar * r �r * rs +r * iesrs +rir �tar * irsrar * sssve �rss� a� �trar7r +r * arar * mad, . (over) w 7t Section Il 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 propoped .location of the gystem 2.) location and distance to lot lines 3.) location and distance to structures 4.) location and distance to any water supply S.) 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 $Z50.00. Co An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted to the Queensbury Building Department before further construction, l bave read the regulations above and agree to abide by the aril all requirements of the Town of Queeasber-yr Sanitary Sewage Diapo"I C k% iiiaxiee. Signature of.responsible person: Date: Town of Queensbury Building and Code Departini ent Bay at Haviland road Queensbury, New York 12801 (518) 792-5832 "' TTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD- PLACE TO LIVE Tativt� OF QvEEIr1SBLiRY9Gr BUILDING AND CODES DEPARTMENT BAY & HAVXLAND ROADS 1280 " f QUEENSBURyf NEW YORK { 5J8 ) 792- 5832 TELEPHONE BUILDING INSPECTOR" S REPO g -----_'� -- .RECEIVED REQUEST F INSPECTION NAME r f CATION J PERMIT � PROVED DATE YES NO FOOTING/PIERS FORMS MONOLITHICPo PROOFING t FOUNDATION/DAM BACKFILL APPROV x�---�--' -�- 4 ROUGH PLUMBXNG FRAMING L ROUGH N } ELECTRICA INSULATION : ` FOUNDATION FLOORS WALLS CBr NG TION : FINAL xNSPEC I CHI By HEIGHT i ,ROOF-T NG i SIDING POSCHES STE i EXTERNAL & RA LS STAIRS^CLEARANC EF VALVE PLUME FIXTUR IREL RS INTERIOR TRIMIE' IVACY FINISHED FLOOR G GARAGE FIRBPR FING DOOR CLOSER {SJ �s SMOKE DETECIO S INSPECT N__��-----J __— FINAL ELECTRXC OF CONSTIM TION 4 -FINAL APPROVAL OR CIC OK TO ISSUE cI Pp1NCY MUST BE ASIGNED CER , TCA BUILDING EPAI4TMENT BEFORE OBTAINED FRO S ARE OCCUPIEDi THESE PREMI REMARKS " { e } PjEFAR'�: P�� INSPECTOR MIDDLE DEPARTME14T jr4SpECTION AGENCY, INC. soo .Knodon-+bn enue, CotllAga rood, WA-0610S 67, 1 `::.,. oe:v May 20" 1990 SP n l�rtl [ �P$ that t#"Tot " iectrlcal equipment lis#ed has bean examined and"IS approved as being in accord #ifity and Agency rules. with the National Electricaj Code, applicable governmental, u x's nc Owner: Guyer Butlde ., Occupance _ Dwelling Occupant: Slagle Family: - 23 Queen Anne -Court Queensbury (walren co) �i6 Ce rt.a rC ite careers qp aht Scat d t)a l +dnt and rn stall aeon inen eaten the3 �x date. n aadtem al eq uepment should be nuliaand Ya or and. aappl Cats ne to Location: :. existing syslem rats cerrilicate shll} 1>e T, ins Dectron should be subrrhttad pr"W"Ptly to Ibis Agency Molder Pt th rS cerbt i Cate Show la Vtogant same to his property insurance corner 70 Outlets ; '30 Receptacles ; 20 FLXtur8s ; event or cam PanYl as evi yar ca bf6e tilicahon of erect r teal equipmenl aPprdvetl Equipment: �� 150 Amp Service ; A. Appliances ; 1 Vent Fan as SPeCOied. Guyer Builders G' �O . 16 -022976 pprrcant_ Ba Dunning ,g NY 3 Mvl Ballston Spa , DIY 1201'1'" a @4WM Mo. Tel EL 41 41W Tp43N ()E Q�ECODES 0S TMENT BUILDING AND CODES DEPAR URVIZAND ROADS x280&- sw YORK(2USE;NSBURY . ( 8 ) 742_ 5832 TEZZpgONE N R�EIVED_�r�� REQUEST NAME rC�2 T.00ATION PLRml -� APPROVED BATE 'YES FOOTING/PxERs MONGILITHIC POUR PO S P_PR FZNG IODA FOUNDA' APpRGVAlt BACKFrLL ROUGH PLUMBING OUG x ELING TRICAL R H- NSULATZON : FOUNDATION FLOORS WALL-' - CEILING TION FINAL INSPECTION : HFXGxT ROOFING SIDING AL SE /IS EX,Tl"sRN VALVE STAIR EF S^CLEAft�NCE PUIMBING FIXTURES/ DOORS�-�'- ..�--- rNTERIOR T1aIM/PRIVAC FINISHED FLOORS FING GARAGE C LOSER (S ) ---� �-- SD DETECTORS INPE ��-- ICAL ION FINAL ELSC AL OF CONS U FINAL APPR C 0 OR Cf dK 'ro TSstT CI C ANCY MUST $EFORE CER A SIGNED �TFIg G ABiJrLD PARTMENT OBTAINED M ES prEtE OCCU ED# �� --- THESE PREMISES � 1. 1 REMARKS = 1 ,t INSPECTOR } nEI" ,j ()Wt3 pp QUEENSBUR'! BUILDING AND COVES DEPARTMENT BAY & HAVILAXV ADSQUENOV 128Q TELEPHONE 4 E PHONE . f5I8 ) 792-5832 PORT B -U Lj)-jNG INSPECT(]R` S L za- REQUEST FOR INSPECTION RECEIVED NAME LOCATION _ PERMIT # BATE APPROVED YES NO FOOTING f PIE S UR FORMS MONOLITHIC P'PROOFING��-- FOUND ILL APPROVAL ROUGBAC H MBING ROUGH 1'� RAMING -IN ELECTRICAL ROUG INSULATION : FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION = CHIMNEY HEIGHT ROOFING SXDXNG�.___ CHBS/ TEP EXTERNAL PORCHE RAII�S_�_�--- STAIRS-CLEAR U S/RELIEF VALVE_�� PLUMBING TRIMIVA RCY DOiRRS_,------- INTERIOR S FINISHED FLO OOFING GARAGE FIRE DOOR CL�75E {S 7 SMOKE DETE TORS FINAL ELEC AL OF CONSTRUCTION FINAL APPR TE OF OCCUPANCY MUST BE A SIGNED CERfiIFICA BUILDING DEPARTMENT BEFORE OBTAINED FROM THE OCCUPIED ! THESE PREMISES ARE REMARKS : INSPE TOR T) Lp�{ _luu++s o ueenSrieRrl� Y � and ZCJivIFJG DEPAR7M N7 p;, ,,DtNG i Box 96 Bay and � auifand Roa(ark 52801 1y, pueensbury, LL7 l NG I NSPECT0R ' 5 NAME Permit No • -�___��'-'-* Clef. tt' /o21, � YES NC =]t. in=7/Pier Forms i� taate r�ronf ing �3ackf i l l y, raming 1�0o f ing Siding t �asonrY Itelie £ valves l;act Porclies t' inishesa Floors Intirior TriTn C; t.airs 6 [z � ilings Cellar Brain "rile concrete Floors ,,,,bcq . Fixtures car - F iroproof in smoke Detector t 'himnev r (J1'ti IC7N �,unclation L' loors Walls Ceiling_ 'TIC)N� �---- 1;1 t3C RIC7\L ItgSpF FIN vii A g,4V AL 1)IiIVEWP.Y 5 Yrvey ~-- Final Build ---�;ckYeduled insP ection (call ea Dlext kG Remar ii , r] in=3 Irzsiat.ctor C3f�3Ci rn3- vl r f 1 y f1W I t u BUILDING and ZONING DEPARTMENT ✓ gay and Hav+land Road , R , Q. 1 Box 96 aueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION 4? 1A"/ ( [ lp --- � Permit f�O * c��+ Date � r � ihF'PRC7V 1=:D — YES r oca t in�l/Pier Fo'rms pourlda t iosz t9a to rproof ing Back f i 11 Framing Roofing :; icli.ng masonry Veneer ltoti.x;h Ylurnbin(j Relief Valves 1;xt . Porches finished floors Inturi.or Trim t, tairs & in Cellar Ilra3.n Ti Concrete Floor f'lhg . Fix Lure Car . I•' i repro ring Door Closcr smoke Dete tos'a chimney INSLII .T T-'O Poundati n J�' Joors wails Ceiling_ FINAL E, ECTIZIC74L It3S'PECTIC7N i)R1VFWAY APPRoV S ey Final Building NexZcduied insPection (call when ready ) .4C1 Remarks- ftuildit+ra 1r�=;I3e, ctor t..,�f3Ca m i-vI flown of Queen i4tdry BUILDING and ZONING r)FPARTNIENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION ' S ze t,/ r Permit No . * * * * * * * * * * * + * * YES NO APPRC7V Footing/Pier Farms Foundation Waterproofing Sackf ill Framing Roofing siding Masonry Veneer Rotigh Plumbing Relief Valves E.xt . parches Finished F100 s� - - Interior Tri - �` - Stairs & Rai ings� Cellar Drain Tile L.,,. oncrete plbq . Fixtu es Gar . Firepr offing 17cx7r c,ioser Sjncake Detcc cars chimney INSULA'ri0N Foundation Floors Walls Ceiling FINAL ELEC TRICAL INSPECTION 1)RiVEWAy "pROVA,L Final Building Survey Next scheduled inspection (ca1_l when ready ) Remarks- n Inspector E /86 and-vl BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YOHK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED, TEMP. # DATE r f CITY OR V VILLAGE Queevwbtwy TOWNSHIP Queensbury COUNTY TolglrJCen STREET AND NO. OR ry,.,,,,,,,,,,,,� 1� ROAD AND POLE NO. 23 t rme Ccftwt POLE NO BETWEEN WHAT TWO " "— CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S BUILDING NAME OCCUPANCY OWNER'S NAME AND ADDRESS Guyer b4ildexa X,r 119 DmwxiOg Street TEL. # eg161 CURRENT SUPPLIED BY E FROM THEIR ppryI _ - OFFICE DEFECTS S BUILDING NEW ® OLD L...__I IS NEW I6J ADDITIONAL © REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No. of Flxturea & BRANCH Lamp Fl ceptacba MOTORS HEATERS CIRCUITS OFFICE: USE Lam+ ONLY don Side Altar' i t H-P_ Watts A.W.O. calling Side Reeap'Is 'S"Ni' Arndant Bracket No. Type Each No. Each Na. Gntpa INSPECTION out tida Bob- be" Basin moot tat Fe. 2nd Fl. 3rd Fl. Fj REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is inteoded to corer the above-listed equipment to be iMPect"d but if at time Of inspectioni there s found additional equipment not abouro listed,you are authorised to make the inspection and adjust the fee to corer the additional equipment, es provided by the applicant. SIZE S 150 a ELECTRIC SIGN TOTAL MAINS r FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OF WORK EDUS33 11000NCEALED TRANSFORMERS OF VA WORK TO BE (NUMBER) ICAPACITY$ STARTED iy COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER MIL ENTERS DING OF SIGN INSPECTION REQUESTED ON OR B� NEAR AS FOSS will l call vtmm reed NEW O OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS NAME OF DATE OF APPLICANTGuyer19s -xnea APPLICATION STREET ADDRESS TELEPHONE til CITY OR ZIP ryt�t LICENSE NO. POST OFFICE CODE 1 'drtJ WHEN APPLICABLE <e EL (REV_ "Fa3) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING �q 4 , a, 0 OOP 0 O o �s oe QUEEN VICTORIA'S GRANT QUEENSBURY, N.Y. ANNE f f f LT f f 3.5 8'-0 DIAMETER 9'- 0 DEPTH �T 0 o 35' �yof ,y5 100, looll M 87.71' 2000 9a I 1000, .101 120.0� .r- REFERENCE DRAWINGS SA SITE UTILITIES sEpfIC A WATER Von©usEN 4 STEVES SURVEY PLAN