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987-948 I CERTIFICATE CIF C C UPAN+C X � TOWN OF +QUEENSBURY i WARREN COUNTY, NEW YORK i Dote August 19__ __lq 88 i This is to certify that 87-948 work requested to be done as shown by Permit No. has been completed. This structure may be occupied as a of Two F am i i y 41 Margaret Drive -- Queen 'Victoria ' s Grant 1 E Location 1 �k Owner Guyer Builders , Inc. By Order 'Town Hoard i 'l`OV1►!V OF QL3EBNsBURY Building d► zilftiei inspector s I ,s NINE BUILDING PERMIT y TOWN OF +QUEEN5BURY � No. 87- 948 WARREN COUNTY, NEW YORK - o PERMISSION is hereby granted to Queen Victoria ' s Grant ra r OWNER of property located at 41 Margaret Drive Street, Road or Ave_ in the Town of Queensbury, To Construct or place a f of Two Family dwelling at the above location in accordance to application together with plot plans and other information hereto filed and 4 approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. .cam f. OWNER'S Address is Guyer Builders Inc . ro 119 Bunning St . Ballston Spa , N . Y . 12020 f� rr 2, CONTRACTOR or BUILDER 'S Name O ri Same w m c� 3. CONTRACTOR or BUILDER 'S Address !v Same :3 r-r d. ARCHITECT'S Name S. ARCHITECT'S Address �-i nv w rt m rr 6_ TYPE of Construction — (Please indicate ri (x) Wood Frame ( ) Masonry { ) Steel ( y c m 7. PLANS and Specifications No. 31 ' x 46 ' -6" as per plot plan , specifications and application including septic system and attached one car ,garage . MODEL 1 � 8_ Proposed Use o Of Two Family .Dwelling E 0 $5a00 C/O $ 82 . 00 F, PERMIT FEE PAID — THIS PERMIT EXPIRES duly- 1 , 19 88 (If a longer period is required an application for an extension must be made to the Building and 'Zoning inspector of the town of C2ueensbury before the expiration date.) ro I� Dated at the Town of Queensbury this Slat December Day of yg 87 SIGNED BY for the Town of Queensbury Bu ildl ng and Zoning inspector 61V ME UL~Kaxw" sx i . :, L Application No . IQ Permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 } 6 � Bay and IHawiland Road, R.D, 1 Box 98 zoning Designation I Queensbury, New York 12801 Variance No . Site Plan Review No . .rt Approved by : + oP ~ 7 7, APPLICATION FOR 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 submittede and such special conditions as may be indicated on the Permit . The owner of this property is : Guyer Builders , Inc . P* O& Address 119 Dunning Street Ballston Spa , New York 12020 Tel . ( 518) 899=9161 Property Location : 41 Margaret Drive 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 Alders , Inc .Address 119 I)Luu ing Street Tel . ( 518) 899~91+61 Name of plumber yer Wildersp nfcoAddress JL9 mwining SfreeU Name of mason Wyer BUIders , c •Address 1119 Da&ang StreeE 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 * whether interior or corner lot , Show location * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. of septic disposal area . * COMPLETE INFORMATION REQUIRED PE4OW . * Size of property 100i' plant' ft X 120 ft . * Existing building ( a) Size ft X ^ft . PROPOSED BUILDING AND USE : oft * Existing buildings ) Use NIA 4b ' - Size of new strut a 31 ft Xt Foundation-pier slab crawl/partial/full * Proposed building , disc nee £fram property line circle one } * set'- p�4t plan 1 * Pront yard 30+ ft Rear yard 30+ ft No . of stories (habitable space ) Height (grade to ridge ) 1 * Side yards 10+ ft and 15+ ft If residential, no . of f amilies Of 2 liies ft . If on corner , setback from side street ft Noo of rooms ( exclud.ing baths) OCCUPANCY INFORMATION No. of bedrooms Z PRIMARY BUILDING No . of bathrooms „ = Primary heating system Baseboard a ectric* One family dwelling oilss �ik bti3�r Type of fuel Electrxcxty * T�Two family dwelling bum * Multiple dwelling / Number of Noo of fireplaces to be installed units Will a wood stove be installed? No Permanent occupancy Central Air conditioning'? No * Transient occupancy * Business BUILDING STYLE, PRIMARY STRUCTURE Industrial Ranch contemporary Loucabin Other Raised ranch Mansion If,. If addition, what will use be? 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 car * w : # • * * « * * �r + * +► * * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION sj�q , ! 00 ) INFORMATION ON . BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS 'SHEET, TO BE COMPLETEDI Form BPA 4/8+6 ma-vl UUILDING PERMIT" APPLICATION CONTINUkL] - BUILDING SPECIFICATIONS : wood frame Type of constructions wood frame , fire safe , etc . Mkk 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 ) $" fninimum 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 port ' sq. ft . - - Type of use? 'Type of roof - sloped lat/shed/other Material of roof Fi rg ass shingles Size , wood studs "X E] '" spacing 24 '"o . c . length 8 ft. exterior walls do Joist:.s ( floor beams) 1st . floor NIA sox spacing "'o " c . span N/A ft . Joists ( floor beams ) 2nd . floor _" x spacing "o . e . span N Aft . overlays (ceiling beams ) lox i i spacng 24 "o . c . span N/A ft . Roof rafters '"x '" spacing 24 o ,, c . span N/A ft . Roof trusses (Pre-engineered) spacing 2 "o . c . spa2 ' !6Tt . Exterior wall finish stained Of what material? 5/8" x 4 ' x $ ' texture 111 Interior wall finish pain 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 -6nd 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 ft . Depth of fireplace hearth NIA 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 per nit # 026252� Town of Queensbury A F F 'I D A V I T STATE of NEW YORK County of Warren 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 spAcified or not , and that such work is authorized by the owner . AO SWORN TO BEFORE ME THIS Signature --- ------ --- -- __ � -owner , owner ' s agent , ar rect, contractor 2� 1f�T day of ! "ukf F-:LE-. ' 19 ge) PAULA CHRISTOPHER S, Notary Public, State of New York Qualified in Schenectady County No. 4B64727 Notary Public , Warren County, N . Y . Commission Expires July 7 19 L9 ♦ a * * r • s � , w * : * * s. : * w * * * * Or * * * ,r * t * * * w re * * w SVECIA4 CONDITIONS OF THE PERMIT : , . 1040 Sgxiare feat living 240 Square foot garage one Stall 1280 @ $7 .001100 or part of S5 00 one stull garuse $5 . ao C/o permit ..�,� r4 " Total . 4 Aw " By_________________ -- TOWN OF QU99NSBURY J WARREN COUNTY , NEW YORK Application fors BUILDING PERHIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . AM$WRR ALL of the followings � . Gross floor area 1040 S . F . . 2 . Type of heat Baseboard electric 3 . Is the building mmechanically � cooled ? No 40 percentage of area of windows and doors 14 . 3% A . Over 16g OplY 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 N.0 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 be Under 16 % OnlY 1 . R value of roof and floors exposed to ambient conditions . R-38 M. =0 . 026) 2 . R value of exterior walls CK R-23 . 5 (U. =0 . 04+ ) 3 . R value of glassed area U. =0 & 30 4 . R value of doors R-14 . 9 (U. =3 . 06) S . R value of floors over unheated spaces *OAKK R-30 6 . R value of slab edge insulation - unheated slab N/A 7 . R value of slab insulation - h'eated slab 12 . 5 8 . R value of heated basement/ cellar walls ( above grade ) N/A 96 R value of heated basement/cellar wallas ( below grade ) NIA 10 . Type of insulation Fiberglass Co Controls 1 . Thermostat maximum heat setting p , 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 Insulations N/A 1. Size of hot water or cooling carrying agent pipe Z . R value of pipe insulation we Service Water Heating. _ 1 . Performance efficiency. NIA -- 2 . Temperature control setting maximum G . For Swimming pool Only 1 . Maximus heating N/A J � Telephone Na . ( 518) 899-9161 ( appii nt ' s sig a e ) APPL4CAT1ON FOR SEPTIC DISPOSAL PERMIT AATR October. 7 8ref: S* P.E.D.S. 87 L of I/j New York - 0202525 LOCATION OF PROPERTY FOR INSTALLA770H 41 Margar,etDr-jVe owner's Names Guyer Builders , Inc . Telephones ( S18) 899-9151 Address: 119 DunninR Street , Ballston Spa , New York 12020 l"taller'ss Name: Gu:Yex Builders, Inc Telephones ( 518) 899-9161 2 A, C, E, I , Jo IC, L, M , "umber of bedrooms (resideutial wily) 2 3 Fs Go H + Total daily flow (compute +9 150 gal per bedroom) 300 TQp08 rapbys circle owes let Rolling Steep Slope % of slope Soil Natures circle ones (9i Loam Clay Other Depths. 81 feet + GWOUnd WAters At what depth? unknown 8 feet + I3ods+s�cls or jm i "&tcrials At what depth? unknown feet motion test: circle one: not require required / rate In" inch. D"estic ■rau r sarpplgx circle ones Municipal Well Other IF domestic water supply is a Well; Separation: Watersupply from Septic absorptio. N/A feet * PROPOSED SYSTEMS Septic Tank ,gal. (minimum size* 1,0+�0 gal.) TILE FIELD: Each Trench N/A gale feet / Total system length N/A feet * SEEPAGE PIT(S): Number of / Sias each feet by feek. * Size of stone to be used � / Depth or Thickness feet * +s * * * * * �► s * eeeaes +s * * * * s * * e * ee * * * e * ss * * * * * * IMPORTANT ,r ...Please"w"ST NEW EQUJPMUNT TO BE INSTALLED See S . P. E. D. S. * ass * es * ass * s * * * sees * * * * * sees * ses * s • �rss * es s permit & attached map. • (over) Section 1I Se tic system Ins ectimist III. All applications for septic system installationp alteration or repairr as required by the Town of Queensbury Sanitary Sewage Ordinances, shall at least 24 to the buildin Deartment of consmtruct op and shall mclude A of plan showing hours before start 1.) the p roposed ,location of the system 2.) location and distance to lot lUes 3.) location and distance to structures 4.) location and distance to any water supply S.) size and dimensions of all tanks@ distribution boxes. tUP fields and./or drywells 8. No system shall be cowered before inspection and approval by the building Inspector. Failure to comply with this requirement may result in �e uncovering of the system by the installer and a fine of up ��� 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 systemo a new proposal must be submitted to the Queensberry Building Department before further construction, • 4 • 1 bavee read the regulatums above aced agreei to &&"a by tbese and ail regairememts of the Town Of Qom' SaultarY Sewage Maposal 'Ckmliaance. Signature of.responsible person: Da#et Town of Quee"bury Building and Code Department Bay at Haviland Road Queensburys New York 12801 (518) 792-5832 ~ - MIDDLE DEPARTMENT INSPECTION AGENCY, INC. rid, SON Had Wan "Umie, C,411npaatood, N:J. *alas Date August 17 , 1988 Certifiez that the electrical equipment listed has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules. Owner: Guyer Builders Occupancy: Dwelling Occupant. Same Location:q l Margaret Drives Queensbury ( Warren Co ) t This cor flcate cowers the electncaY date. If edditkonal d be introduced and in OF alhon 'OnS mad this egpipment should a il dv or and atipns mane to 7 Bx POCliiting n shouSFVMld Chia certificate shall y 1 null Aga void, and applicaupn for Equipment: 52 - Outlets ; 40- Receptacles ; 7- Fixtures inspecAlort should be au6m�tted promptly to this Agency. t-t l 5 0-Amp . Service ; 7—A p p 1 i a n c e s ; oldar of this certi}icata Should P+e am m n sent name to e Property insurance earer agent Of company)a a evideriCe or earti fipation of Qlactr icel eq uk pmen l approved as sPecrfled. rGuyer Builders Applicant: -No . 1 5- 02 2 3 95 119 Dunning Street `' % s L.Bal l ston Spa , New Yurk 1 ZO�C? a )v 1 :90w" of Q"eer -31 "ry ENT BtilLUMNG and ZQPNNG OEPAFtTgox 9E3 Say and Haviland fRo � 12801 Queensbury, e dcBUILDING INSPECT OR + S REPORT NAME L� LOcAT I ON f, permit I30 ijatE '� * * * * �` * * * NO * * * * * * * " * *}„r s APPROVED - YES Footing/Fier Forms Foundation Waterproof inc3 Backfill Framing Roof ing S:.ding Masonry Veneer._—J_ -�-- _ Rough plumbinig Belie€ Valves �----- Ext . Porches Finished Floors Interior Trim Stairs & gailings Cellar Drain Tile Concre-te Floors Plbg - Fixtures Gar , Firepmoof ing Door Closers Smoke Detectors Chimney IN SuL ATION Foundation Floors - Walls Ceiling INSPECTION F I J_INA'L ELECTRICAI+ DR-IV Rw y AP'�n RIDvAz SuIrvey _-_-- pinal I3ext scheduled 3nsp ection Ccall wtxen ready ) Remarks-- �/410 �f i Inspec'tor g/86 and-vl _ /ourn Of Q"eenjbury BUILDING and ZONING DEPARTBMox 9E3 Bay and Hayiland New York 12801 pueensbury, SEPTIC DISPOSAL SYSTEM INSPECTION LOCAT ION /^� 1 PERMIT NO - rjATE .,�=--ram`--' TYPE - sand - Loam Clay SCSIL ired? Y - NO percolation Test Req►iE percolation rate - Mi.n,/lnch TYpE of SYSTEM% tote ngth Pbsorption field each e..0 Length of es Depth of txen �.�---� - size of 91, 1 of) SEEPAGE PI Number f t t}. X � f . size~ -----�� Gravel ze size ` T I'e p 1p T.NG t�o tank Tank 331dg - Tank to disc . ' eld/Pit ial IB Dt- IDOX to YES Openings seal d Pa ? �� t.0CATrCN/SEp Pj'TlcNs : (213 ft. tank FoundatioYJ0 n o absarption Fonndatian lot line �-�-ft. Absorption e) Separation of1Fits pRQpE }+,T=ON OF SYSTEM ON ircle - Rig Front side - - Rear - Left side ti CCMXLP4TS vr - - , r ED SYSTEM USE App'f� YE Bui i Inspector 01/86 and v1 o urn OfDFPART11AF BUILDINGand ypt+lfNG 1 Box 96 Bay and Haviland Y(O kk 12$0i Queensbury, BUILDING I NS PE.C� OR ` 5 R�POI2T NAME 1_OCfkT ION / F2SlI1z-1~ * * * * « * * 6e, . AppRovBD - YES Footing/pi er Farms goondation waterproofing Bacxf it l Framing Roofing Siding masonry veneer_--- Roug rj Plumbing Valves Re 1 ie f ..._-�---�- Ext . Parches Finished Floors Inter icar 1I'r im stairs & Railings Cellar Drain 'I Ll concrete floors ,,I bK3 . I' fixture s Gar . Fireproof ' �3 losers time e Detoctc s ( imney r3 SU I,AT 7 '�N Faundatian Floor's walls_ CeilinFI,FGTR L I_I35PEC"T'10N�___ F IN AL -- 01kTvEWNN APPROVAL Final Building 5ur�eY..� —�—� �" Next scheduled insP ection (ca3.l led w1neT' ready Rcmarlcs_ pu Insp ctor 6/66 and-VI mommommumm '7']awn nf� Queen3t tdry l BlliLplNG and Zdh1iNC, LIEPAFtT�O% $$ Bay and Hauiiand Road, R.,:) . p�eensbury. New Yank 12801 f3U1 LD I NG IN SPhCTOR ' S WEPORT NAME L.00AT I ON �� 'T — � Perm t No Al YES Footing/pier Forms Foundation Waterproof '" ,aackf ill . Er�,min"3 Raof ing Sidin19 Veneer ascr ry plumbing ugly [xeljef Valve LXt , Porches Finished Floors interior Trirn Stairs & ,Railing .r cellar Drain ,T i �- Concrete F1'os plbg - F ixtur es Gar . E•' ireprao ing c> r Closers smoke Detec rs C YSirnno"I I'SuI.ATION Foundation 'Floors Walls t ink] - L3SpFC"TI ON Cili J FL CTRICAL f pAk'FR0v& DRIVEWAYurVe��--- Flnal guildin� ed iecCion call whey+ re nsp ady, Next schedul i3uiiding Inspector 6/�S6 and-vl J_ ` �pwre of Queere �� urY !fi U11-0tNG and ZOmING DEPAFiT�ItE�I"f �r /- ` - p, 1 BOX 98 Bay and Fieviland N a York i2BOi ©ueensburY. �Y UI LDIMG INSPECTOR ' S REPORT NAME LOCATION f f a f 0' _ Permit Pao . .O Date * * * * * * * * * see * "PROVED - YES No Footing/Pier Forms Foundation Waterproofing Back-fill Framinj Roofing Siding Masonry Veneer Rough Plumbing -- Relief Valves �---- Ext . Porches Finished Floors Interior Trim stairs & Railings Cellar ,,in Tile Concrete Plbg . Fixtures Gar . Fireproofin Door Closers Smoke Detector ChImneY 114 S[1 LATION Foundation Floors Walls Ceiling CAE IN SpECTION FINPJL ELEC DRYVEWAY APPROVAL Final Building Survey Next scheduled insP ectivn (call when ready3 Remarks- Bui.l rig Inspector f�,f 86 and-vl EfU%LDtNG and ZONING DEPARTMENT J Bay and Havitand Raacl, R.D. i Box 98 aueensbury, New York 12801 B +, V1 DING INSPECTOR " S REPORTT NAME f LOCATION yy�� / Permit N'Q - Ike 140 YF5 ,'o© ring/Pier Forms �ndation Waterproofing �3ackf i11 Framing Roof inq Siding Masonry Veneer R0,4ac , Plumining ,relief Val`jes S:xt . porches finished Flcaors Interior ourirn stairs a Rai, 4 g ^� - ------ Cellar 'Drazr'` ile Concrete Fl ors_���_.-- --' �-- I'Ibg . Fi,t res Gar . Tire pof ing ...-..--- Door Clos rs Smoke Det ctors Chimney i INSuIATlo F�unc3�atia floors Walls Ce it ing_ FI'NtL FI I CTRI.C� L It35E'ECTIC]I3 �_�_�_. pAIVEWAY APPRCIVA prinal Huildln; SixrveY Next scheduled inspectfox, t call when ready ) &, I nns11L)uC for C, fRC" rn6 -vl !! J u w+e Q � r Bl}tLD1NG and ZONING p R�Box 9$ Bay and 1 I'll, and �� York 12801 Queensbury • REPt7ftT INSP75 EC SC3R ' S V 14 B Lf I L C1 I t�S G / NAME Lr] CA� ; ON 13o . x Dat 2 _* YTuS No ROvla) �ating/T'ier Fax�'� ,Foundation v ate rProo f iog aackfi11 Framing goof 3-ng 5 id ln'cj --- -'—_. �-- mason 'Jf'rieer_- -- ,F,ough Pltuabin9 �-- Re1 ie V aLlves Ext . Porches Finished Floors Interior Trim Stairs & Rai] in�3 Cellar Dra"-n rile__ - Concrete Floors _ -- Plbq . Fixtures Gar . Fireproofing poor Closers Smoke Detectors Ch3.mne3' IN SULAT-1 ON Foundat ion Flours 4 walls Ceiling TRI AD INSPECTIor1�,_- IN ELEC t���� DR-S.T�TE`�^�AY AYPFt0 •-�'� i ilding,Final Bu urvey 1 n (call when ready scheduled insp;ctio �3 1 Next %20 �. 1: AJ r- x t__ �-- � i 1 i i Inspector f,/86 and-v1 9 BUILDING DEPT• COPY OF APPLICATION FORM 46-ELo NEW YORK BOARD OF FIRE UNDERVYRITERS. FILL_ THIS COPY WITH BUILDING DEPT. WHEN REOUIRED. DATE I . TEMP. � CITY OR '�- TOWNSHIP _ VILLAGE ;! : r: POLE N STREET ANkOC R 'ROADANDD. ' .. . BL K LOT BETWEEN WHAT TWO SECTION PREM gTRE£TSTE t BUILDING OCCUPANT'S OCCUPANCY - NAME OWNER`S NA AND ADORE ! :�� .• :f. t _ _ .._�r �_:;:_,.,,• OFFICE FROM THEIR DEFECTS SUPPLIED PPLIED . WORK �-y REMOVED ❑ .. 11--}� IS N£W LJ ADDITIONAL BUILDING f .' NEW OLD LJ IS LIST BELOW ALL 'UUIPMENT WHICH YOU INSTALLEDBRANCH or-I E USE Na. of Fl:turaa 8 MOTORS HEATERS CIRCUITS ONLY NUMBER OF OUTLETS Lamp namicapowassm, A,W-0- INSPECTION H.P. No• melt No. Gees ben Side Atw'A't Swtsdt Pendant* 'Bria"ll No, TVPa Each Cellbg Well Rmc h OA b Br► want *st Ft. 2trd F1. 3rd F1, DO NOT USE THIS SPACE. REMARKS: UST OTHER £LECTR ICAL DEVICES NOT SET FORTH ABOVE: x.d but if at tdme of ioaFoction awl e a found adtldtlonal ar*niPrrre^x rwt all Idsted, to carer *Inn adC—e tad equipment to be insOec ridad hY "" applicant. This appil"tion is intended on and -Illst 7lre faa to Corer the additiof�ll erWiPment, O Mo TOTAL you are aatllorieed to Mere the infpeCv - ELECTRIC SA G WATTS S12E OF j FEEDERS 4 CSEALED MAINS V ,GAS TUBE SIGN VA RACTER ! // POSED TRANSFORMERS OF {CAPACITY} CHA �i �l1O INt,MMERl OF WORK WORK TO B COMPLETED SIZE OF SIGN STARTED UND BOUND MAKER SERVICE OVERHEAD OF SIGN ENTERS 1 DI OLD INSPECTION RE', � Y� #.. ..M. '..Ir' r i` NOW I . ON OR AS NEAR AS (., DATE OF IMF*RATEAPPLICATfON AVOID Dt; y By MUST Be FILLED ll OR APPLICATION MAY BE BETVRNED?ION A SPACES SIGNATURE PR114T NANyE A 4.ND A [Q� SS a OP APPLICANT NAME 1 CANT d"' �..-. G.. { y_fir_ } p, y' . � F ' !✓ TELEPHONE f c.' LICENSE NO. STREET ADORE -: J' Yi I¢_ LL)�votEN APPLICAall CITY OR - !{1rFL C,�fP ST OFFICE ae EL itaL�+. �Is�1 A SEPARATE APPLICATION MUST BE FILED FOREAEACH gEPARATE BUILDING 8� 0 DIAMETER .9' 0 DEPTH LOT 33 w1 3 SHUTW MARGARET QUEEN VICTQRWS GRANT QUE-ENSBURY, N.Y. Vito REFERENCE DRAWINGS 5A SITE UTILITIES SEPTIC B WATER VpDUSEN 4 STEVES SURVEY PLAN 0 it 3303St37,39,41,43 MARGARET DRIVE PLOT PLAN 4 SEPTIC SYSTEM GUYER BUILMS, INC. Q.V-17 DWN �-� t Scale : I y W o