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1987-914 ....:. -vimw-Y.. .�-s'A^_ w•,a¢x —. y,y ..._.: • .�, r.,. r •-rx :•s . .:z. L ,.,-F,�X: ..- dd 1 ` Y CERTIFICATE OF OCCUPANCY TOWN OF +QUEENSSURY WARREN COUNTY, NEW YORK May 31 , 88 Date 19 _ This is to certify that work requested to be done as shown by Permit No. 8 i- ` 14 1 has been completed. This structure may be occupied as a of Two Family Dwelling Y y LAipeation 41 Elizabeth Lane - Queen Victoria ' s Grant f Guyer SuIlders , Inc . Owner By Order Town Board i i OrOVVN OF QUEENSHURY D1,4 Z/ Building & Zoning Inspector i I I I i BUILDING PERMIT � TOWN OF +QU EENSBURY No. 87-914 WARREN COUNTY, NEW YORK r� PERMISSION is hereby granted to Queen Victoria ' s Grant a OWNER of property located at 41 Elizabeth Lane Street, Road or Ave_ in the Town of Queensbury, To Construct or place a 6, of Two Family Dwip 1 1 ; ng 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 Clueensbury Building and Zoning Ordinance. nu t. OWNER'S Address is Guyer Builders Inc . � 119 Dunning St . Ballston Spa , N . Y . 12020 0 2- CONTRACTOR or BUI LDE R'S Name w_ m Same w 3. CONTRACTOR or SUi LDER'S Address r� Same #_ ARCHITECT•$ Name A r 5. ARCHITECT'S Address N W cY rt S. TYPE of Construction — (Please indicate by X) It03 Q ro {K } Wood Frame I Masonry ( ) Steel I } 7. PLANS and Specifications No. 30 ' x 30 ' as per plot plan , specifications and application including septic system and attached one car garage . MODEL C - o rn S• Proposed Use � OF TWO FAMILY $5 . 00 C/O 75 . 00 $ PERMIT FEE PAID - Thll& PERMIT EXPIRES July 1 , .I988 (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.) ~` r• d December Dated at the Town of Queensbury this tyy-�30th Day of 19 87 qq SIGNED BY /r / 6 _ for the Town of Queensbury Building and Zoning Inspector ilJ DCI 1rVi4GiiYi7:+ir ari aa.r...rvr rw • r Ag // Application No. # ` ; 1�►a. QItf�@It� 61tI' t Permit Issued 19 ., J + ' BUILDING and ZONING DEPARTMENT permit Expires 19 UL Bay and Haviland Road, R,D. 1 Box 98 zoning Designati %,T 193r Oueenabury, New York 12001 Variance Ni r--> Site Plan Rev No . `.". ' " �; •} ; L+ /p Ne'o Approved by : �yrv�rr' 1� 'V APPLICATION FOR BU I W I NG AND ZONING PERMIT r 0 * it a * 0 * it * * * * +r it �► +r a► w it it +r +r �r e * +r ii it ar ar s s e * � it a :�• 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 an the Permit . The owner of this property is :_ gLiy r Builders Inc . - p , q, Address 119 Dunning Street Ballston Spa , New York. 12020 Tel . ( 518 ) 899-9161 Property Location : 41 Elizabeth Lane Tax 'Map N0 .121 ,/ 4 / 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 He Guyer ITI ( 518) 899-9161 Name P . O . Address Tel . No . Name of builder Guyer Builders , InceAddress 119 Dunning Street Tel . ( 518) 899-9161 Name of plumber Guyer Duillcters2 C •Address ng SfreeE Tel . - 9161 Name of mason Guyer IkIllc1ers , ncrAddress ree Tel , - NATURE OF PROPOSED WORK : * ZONING INFORMATION : X Qonstruotion of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , Addition to a building * drawn reasonably to scale and attached hereto , Alteration t0 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 * whether interior or corner lot . Show location * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED . of septic disposal area . * * COMPLETE INFORMATION REQUIREL7 $E�W . * Size of property 100± PTAp ft x 120 ft . * Existing building ( s) Size ft X�� �ft Mode PROPOSEL3 BUILDING AND USE : Of l * Existing building ( s ) Use N/A Size of new strut laba aft X•_,_aQftFoundation-pier scrawl/partial/full * Proposed building , distance from property line castle one ) * see plot plan Noe of stories (habitable space) 2 * Front yard 30+ ft Rear yard 30t ft height (grade to ridge ) 22 ' - 6" * side yards 5+ ft and 15+ ft g g ft . If on corner , setback from side street ft If residential, no . of families of 2 No* of rooms ( excluding baths ) 4 * OCCUPANCY INFORMATION No* of bedrooms * PRIMARY BUILDING - No . of bathrooms 2 One family dwelling Primary heating system Baseboard a ,ectric* =Two family dwelling ohe, g "� `���` Type cif fuel Electricity * Multiple dwelling / Number of units Nor Of fireplaces to be installed * Permanent occupancy Will wood stove be installed? No Transient occupancy Centra;L Air conditioning? kk 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 BUILDIN+G- Colonial Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * _Attached garage/one car/ two car/ o car w * * * * rr w w w * * * * * * * Private storage building ESTIMATED MARKET VALUE OF',Cfi * Other CONSTRUCTION ' $ .�_ - � INFORMATION ON , BUILDING SPECIFICATIONSr ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETEDI Form $PA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - allILDING SPECIFICATIONS , Type of construction , woad 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 $" Depth of foundation below grade (to bottom of footing ) 4 E" RUXUBnim 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 par,; ' ? sq. ft . - - Type of use? Type of roof - sloped lat/shed/other. Material of roof Fiberglass s g es Size , wood studs "X 6 spacings_"o . c . length 8 ft . exter ' or walls Joists ( floor beams ) lst . floor N/A "X " spacing "o . c . spanN/A ft . Joists ( floor beams) 2nd . floor �-"x��" spacing—T6--"o . c . span'='ft . Overlays (ceiling beams ) 2 inx spacing 24 "o . c . span 14 ft . Roof rafters 2 "x 10 " spacing 24 o . c . span 4 ft . Roof trusses (pre-engineered) spacing "o . c , span N/A ft . Extarior wall finish stained of what material? 5/8" x 4 ' x 8 ' texture 111 Interior wall finish pain 5 etrock If a garage is to be attached , describe materials to be used for FIRE SEPARATION . 1/2" type "X" sheetroek Is there to be an opening between garage Aand 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 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 uninic1pa.1 SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties NIA ft . (A separate application is necessary for an re air or new installation of septic system) See S . P. E . D . S . permit ;rig 026252 * T _ Town of f Warren A F F T D A V I i STATE OF NEW YORK County of Warren I swear that to the best of my knowledge and belief the statements contained in this 4lipplicati.on , 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 r , owner s agen , a izect , contractor d 0�� rrtr day o f7 3i � 19 �[ EUZAB ETH K. LANDRY Notary Public, State of New York j No. 4862001 :1 Lana Qualified in Saratoga County !io>}:ary iC , Warren County , Fx�rirn. .! i ; nr iC9 # # # # ! # # # # # # # • # # # # # # # # # # # tr # # # ilk # # # # # # # # # # # # # # t 7k # SPUCTAb COt4 ITIONS OF THE PERMIT : 975 Square feet living 264 Square foot garage one stall 1239 @ $7 . 00/100'�'l or part of 5 . 00 One stall garage ----- $5 . 00 C/O permit Total " TOWN OF QUEENSBURY r*c^ 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. . ANSWER ALL of the following : 1 . Gross floor area 975 S . F , 2 . Type of heat Baseboard electric 3 . Is the building mechanically coaled ? No 4 . Percentage of area of windows and doors 11 . 1% 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 floor ? 4v is basement heated ? YES NO a . R value of insulation s , Type of insulation Be Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions_ R-38 2 . R value of exterior walls A R . 23 . 5 U. =0n04 3 . R value of glazed area U=O * 30 4 . R value of doors R.-14 . 9 (U. =0 . 60) s . R value of floors over unheated spaces R=19 6 . R value of slab edge insulation - 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 9 . 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 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 insulation F . Service Water Heating 1 . Performance efficiency N/A 2 . Temperature control setting maximum G . For Swimming Pool Only_ 1 . Maximum heating N/A Telephone No . ( 518 ) 899^9161 e� ( applicant * s si nature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref : S . P . E . D. S . DATE September 23 I 87 permit # New York - 0202525 MODEL C of C/K LOCATION OF PROPERTY FOR INSTALLATION 41 Elizabeth Lane Owner's Name: Guyer Builders , Inc . Telephones ( 518 ) 899-9161 Address: 119 Dunnins Street , Ballston Spa , New York 12020 lastaller's Name: Guyer Builders , Inc Telephone: ( 518) 899-9161 2 A, C , E, I , J : Ks L, M Number of bedrooms (residential only) 2 3 F , G, H Total daily flow (compute Q 150 gal per bedroom) 300 Topograpbyo circle one: Flat Rolling Steep Slope 96 of slope Sail Nature: circle ones Sand Loam Clay Other / Depths 8 ' feet + Ground Watered At what depth? unknown 8 feet + Bedrock or Impervious Material: At what depth? un1mown feet PexvAAation test: circle one: not requi required / rate min. inch. Domestic water oupply: circle one: Municipal W ell 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 Thickness feet IMPORTANT * See S . P. E . D. S . »..Please...L1ST NEW EQUIPMENT TQ BE INSTALLED permit & attached map . (over) Section 1I 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: IL the propo$ed .location of the gystem Z.) 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 $Z50.00. 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 must be submitted. . to the Queensbury Building Department before further construction. 1 have read the regulations above and agree to abide by tbese and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of.responsibie person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 79Z-583Z SETTLER 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOO. PLACE TO LIVE 4001054 THE NEW YORK BOARD OF FIRE UNDERWRITERS M �``� BUREAU OF ELECTRICITY to 41 STATE STREET, ALBANY. NEW YORK 12207 Date June 8 , 1988 Application No. on file yy � THIS CERTIFIES THAT O 4 16 2 4 / Q B A 7 f` 54 q `'y 3 only she electrical equiprn arst a describedi�ete,e Oilsntradsaced by the .ppltcwns named an the abases applicw[aLarF nerrwsber in the prerPsises of Guyer Builders iNco # 41 Elixal Lane cueenskauryr mew Yarkl,,, tII , family in the ollowin location; garage C3Llts?' f C IE f g ❑ Basement '� rat 1w'l. � 2nst Fl. smetian.�. 2lir�rcYe 4 Lot waa examined on 5 � 2 7, 8 8 and found to be in compliance with she requirements of this $ew.rd. FIXTURE EffACIEL SWITCHES FIXTURES RANGES COORINGI DECKS CSVENS N DISH WASHERS EXHAUST FAS OUTLETS INCANDESCENT RUCRESCIEW AMT, K. W. uwT. K. W_ a T. K.w, I AMT. K. W. All H. P. 1s 28 25 51 4 . 6 DRYERS FURNACE MOTCIRS FUTURE AFFUANCR FEEDERS SFECTAL REC'FT TUNE CLOCKS I Ell I UNIT HEATERS I MULTI-OUTLET DIM AWM AMT. K. W. OAK H_ P. GAS M. P. T. %% G. AMT. AMP. AMT. AVI TRANS. STSI'EARS AMr. WATTS PIM OF FEET SERVICE WSCONNECT NO. Of S E It C, V I C E AMT. AMP. TYM T 0 2W 1 X 7W 7 X SW S 0 4W �• OF CC. OF CC. COhW. NO. OF HI-LEG OF-F0 Q.W. No- Or MEUMAIS OF ih EUAAL 1 150 Cb 1 x 2 / 0 OTHER AFFARATU& E l eC . ROOM fl e a t it a 3 / 2 . 0 P 1 / l e 5 i 1 / 1 . 2 5 r 1 / 1 . O r Motora is 4 / fr P 11% 1 - poat light 2 , gfci 1 - smoke detector Guyer Builders Inc . 119 Dunning St o Ballston Spa , "JY 12020 239 BRANCH MANAGGR Per This certificate must not be akered in any manner. return to the office of the Board if incorrect. Inspectors may be identified 6y their credentials. COPY FOR BUILVING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT 5E ALTERED IN ANY MANNER. BUILDING and ZONING DEPARTMENT Bay and Mavfland Road, R.D. 1 Box 98 Oueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 1+3 LOCAL' ION7;4, tA,,\ Date ) / Permit NO .s () —C[_ ✓ = APPROVED - 'YES NO Footing/Pier Forms Foundation waterproofing Backfill Framing X Roof Ing 7t Siding MasonrjFlo r. Rough g Relief 7CExt . P ;( FinishrsInteri Stairs & Rail gs Cellar Drain T le Concrete Floors Plbg . Fixtures Gar . Fireproof ' g Door Closers Smoke Detect rs Chimney INSULATION Foundatio Floors walls Ceiling FINAL E ECTRICAL INSPECTION _ DR A APPROV Z,Fft'ial B iiding Survey Next scheduled Inspection (Call when ready ) Remarks- 000 Building Inspector 6/86 and-vl .JOW01 v/ Queep1J1 eery BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Sox 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 'G �f LOCATION f _ � Date 4 Permit No . r = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing 8ackfill y Framing Roofing Siding MasonrI ee Rough in Reliefes Ext . Ps Finishoor Interiim Stairsiling Cellarn Tile ConcreloorsPlbg . resGar . FroofingDoor CsSmoke ctorsChimne INSULATION : Foundation Floors Walls Ceiling FINAL ELECT CAL INSPECTION_ „� DRIVEWAY APP OVAL Final Build g Survey. Next schedu ed inspection ( c l when ready ) Remarks- 4 uil ga:Trnsph6tor 6/86 and-vl ._,Jown o� �ueena � eert� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 96 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME -� LOCATION 4leT , } Date Permit No . ✓ = APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valve Ext , Porches Finished Floo s Interior Trim Stairs & Rsilin s Cellar Drain Til Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers Smoke Detectors Chimney IN SULAT I Orgy Foundation Floors Walls 4 ' Ceiling FINAL ELE RICAL INSPEiCT N- DRIVEWAY PPROVAI Final Bui ding Survey Next scheduled in P.s P.pection (c ll when ready ) Remarks- Bui ding Inspector 6/86 and-vl / f ?l7wn 0/ Q14eFIi3 l2Py BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D, 1 BOX 98 {Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME--ooze LOC.AT I ON / Date 'oe Peymit No . APPROVED - 'YES NO Footing/Pier Forms Foundation Waterproofing Back flll 1 ng Roofing Siding Masonry Veneer ugh Plumbing Relief Values 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 ELECTRIC INSPECTION — DRIVEWAY APPRO A?•�� Final Building Survey Next scheduled inspection (call when ready ) Remarks. rnc �r Building in eGtor 6/86 and-vl ._.lnu.n v�' �ueana+fyure� 13UILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Clueensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION_ /��5 _ Perm-it No . ' 1 1714 ✓ = - Footing/Pier Forms APPROVED YES NO Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing�� Relief Valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile l�ncrete > rrs 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- Building n ctor 6/86 and-vl _.Journ n/ Q" eeni6ury Bu1LDiNG and .ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME rrc.sez1E"Q 64e z� j6lf`'C t....Qr- .r LOCATION �v�'. yrrs�h}-5 3,3, 3.577" y/` Sr _'3 DATE 476c) f_ PERMIT NO qf `/ SOIL TYPE San - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total length Length of each trench Depth of trenc es Size of gravel_ _ SEEPAGE PITS{N er of) Size- _{ ' fto X ft . Gravel size PIPING : Size Type Bldgo, to tank �+- 4' �!�✓C Tank to dxsto box v Dist* box to fi d/pi y " 64 ,.�C. Openings seale ES NO Partial OCATION/SEF TIONS : Foundation tank ft. Foundation o absorption £t. Absorption to lot line t. Separatio of pits f . LOCATION F SYSTEM ON PROPERTY (c ' rcle one ) Front ay Left side - Flight side - COMMENTS : �jSys 1 d 77 I5- I � JtL J'epl<< 4 + �"T'•e"� ,/�iWr 7S Jam' _ ✓�.+ + - SYSTEM USE APPROVED YES NO Building Inspector 01/86 and vl l ot<iI1 D/ Queenshury &I BUILDING and ZONING DEPARThAENT Bay and Haviland Road, A .D. 1 8ax 98 f Queensbury, New York 12801 BUILDING INSPECTOR ' S RESORT NAME LOCATION Date ���G ��� Permit N04 ✓ s APPROVED - YES NO footing/Pier FoMIys Foundation waterproofing Backf ill Framing Roof ing Siding Masonry Veneer jkRough Plumbing F4 Relief Valves k.xt . Porches Finished floors Interior Trim Stairs & Ra.ili s Cellar Drain le e5e-o�ncrete Flo s 111bg , Fixtur s Gar . Firepr ofing Door Close s Smoke Det tors Chimney '7' IN Su I+AT I y. a undati eloors Walls ceiling FINAL EI.VFC:TRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection fcal. l when ready ) Remarks- eV Cdinq n Insp ' tor C %HFi mr9-vl _../otu,rt O� �ue8st3hfere� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.0 . 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION " Date //r / f ermit No . ✓ = APPR(YVED - YES NO Foo ing/Pier Forms undation Waterproofing Backf±11 Framing Roofing Siding Masonry Veneer ,. Rough Plumbing Relief valves Ext . Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Til Concrete Floors Plbg , Fixtures Gar . Fireproof ng Door Closers Smoke Detect rs Chimney I N SU I.A,T I ON Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION- DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready ) Remarks- Building Inspector 6/86 and-vl awrl o/ QUeeolit "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 'Sox 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME rf LOCATION i � + youDate rl? / .__ Permit No . I / APPROVED - S NO Lpi5ating/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext . 'Porches Finished Floors Interior Trim Stairs & Railing Cellar Drain Ti e Concrete Floors Plbg . Fixtures Gar _ Fireproof ng Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION_ DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call wtsen ready ) Remarks- Building Inspector 6/86 and-V1 BUILDING DEPT. COPY OF APPLICATION FORM 4B-EL. NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REOUIRED- TBfIN' tr 0AtE CITY VML rOWNS"11P ry �� COUNTY VILLAGE GE S ET AND NO. OR #43 E '{ +.lam Beth lame ROAD AND POLE NO. POLE Mo- BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S BUILDING NAME OCCUPAAICY OWNER'S NAME r BT{�� Disyn-InW AND ADDRESS ""7'� x • : j 19 ---- — �a-t�ee� TEL. �99�9161 CURRENT SUPPLIED . .BY _ FROM THEIR OFFICE DEFECTS Is NEW OLD El (WORK NEW ADDITIONAL ❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS Laamp ReXA es MOTORS HEATERS. CIRCXXVS OFFICE USE LLo ONLY Ition Side con" rV"II p op'Ie Swirtah P..�a■w.e B..ek r No, Tree M.P. Ne. � Ile. �� INSPECTION Out- Bub. bean Bat► anam 1st Fl. 2nd Ft. 8nd Fl. REMARK$: LIST OTHER ELECTRICAL pEV10ES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is intended to corer the above-listed etpsipm mt to ba inspMud but if at rinse e1 i.epeetio.a der* is f4WW additianel O4uiprnent not aMva listed, rou are authorized m make the irapection and adjust the IM to cover the additkmai rquipnywf, as Ittoei I by dae applicant. Sl2E OF y �I'+s . ELECTRpC SIGN TOTAL MAINS ��1y,��.,�+,��yy�� FEEDERS LAMPS WATTS CHARACTOF WORK ER A*+ • 3-L CONCEALED CAS TIME TRANS SIGN FORMIERS OF VA WORK TO BE fNLiABERI iCAPACITYI STARTED COMPLETED SITE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS OF SIGN B UILDING INSPECTION REQUESTED ON OR AES #TEAR ASr2ftLet NEW O OLD El AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES 21 19�87 MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION `�Y p PRINT NAME AND ADDRESS ANEOFP�PL CANT �� ders �1'�L-♦ x SIGNATURE of 1 OF APPLICANT STREET ADDRESS 119 PmplM gtgeet TELEPHONE CITY OR Ba 7 III-�.1• f�.,o S �, York CCODE '� ''�(]'�[� LNiEN AIrLICABLE POST OFFICE `'',y,.y 20 46 EL {RE , 1/861 A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING QUEEN d VICTCRIA'S GRANT QUEENSBURY, NY. CO-T.G. i CLEANOUT TO GRADE) .1� _ NMEMO 100. SC/ cU / 18' _4-- LCT 1 33 Lu cr 3 'D lm N 1 � M SHUTOFF 1 105.00' 1 ELIZABETH 0 i 2000 gol 102.001 08 52 i O 7 LOT � I 1 (V 1 1 1 ►02.00/ 1 LOT 41 I m � 1 1 92.00 LANE C.O.T. G. i LOT I 43 I REFERENCE DRAWINGS S SITE UTILITIES SEPTIC E~ WATER VanDUSEN $ STEVES SURVEY PLAN 8'- 0 DIAMETER 9'- 0 DEPTH