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1987-945 .. • �1 w ,prq..'q,.a ..�+ti'n✓!}S� s �, yfT.N[ :r .. 'F+. .j:v IF .Z,. ". -F .. . . 1 4 CERTIFICATE OF OCCUPANC1V s TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK s i Date_ A,uauSt 2A �19 _B3 This is to certify that work requested to be done as shown by Permit No. 87-945 I has been completed. This structure may be occupied as a of Two Family Dwelling i Location 35 Margaret Drive Queer Victoria ' s Grant I OwnerGuyer Builders , Inca By Order Town Board BrOW'N OF QUEENSBURY Building & Zoning-' Inspector ` BUILDING PERMIT � TOWN OF QUEENSBURY No. 87- 945 WARREN COUNTY, NEW YORK a PERMISSION is hereby granted to Queen Victoria ' s Grant: n Drive Margaret OWNER of property located at 35 Mar g Street, Road or Ave, in the Town of Queensbury, To Construct or place a 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. t_ OWNEROS Address is Guyer Builders Inc . 119 Dunning St . Ballston Spa , N . Y , t32fig* 12020 .o ra 2. CONTRACTOR or BUtLD6R"S Name Same n rr 3. CONTRACTOR or BUILDER'S Address I gamimm Same m m Gi �s A. ARCHITECT'S Name n 5. ARCHITECT'S Address w u~ 6. TYPE of Construction — (Please indicate by X) My W (K ) Wood Frame I ) Masonry ( ) Steel n ra 7. PLANS and Specifications r' No 32 ' x 37 ' as per plot plan , specifications and application including septic system and attached one car garage . MODEL E th S. Proposed Use OF TWO FAMILY ..a.- $5a0a C/o q July 1 , 88 $ 96 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES 19 01 a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of C]ueensbury before the expiration date_) w 31st December 87 Dated at the Town of Queensbury this ` ��y Day of —19 SIGNED BY 'Y/ /G� �r rCs/_ �� for the Town of Queensbury Building and Zoning Inspector ,� r� +� Application No . M ..Ji7wn o/ Q"een3l"ry Permit Issued BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Hawiland Road, R. D. 1 Box 98 'zoning Designation %T lei ' i Queensbury, New York 12801 Variance No. Site Plan Review No . Approved by : APPLICATION FOR �/ j° ' �+�e.Gi � �' v 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 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 . ( 518) 899r9161 Property Location: 35 Margaret Drive Tax Map No .121 /_J 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 N&MO P . O. Address Tel . No . Name of builder Guyer Builders , Inc .Addresa 119 Dunning Street Tel . ( 518 ) 899-9161 Name of plumber Wyer 1SX11ders , c .Addrasa g ree Tel . - 91151 N-mmm of mason Guyer rs , c •Address ng ree Tel . - NATURE OF PROPOSED WDRK * * 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 LOCATION OF STRUCTURES AFFECTED . of water supply and location and configuration * of septic disposal area . * COMPLETE INFORMATION REQUIIREEDpVi$OT.QW . ' Size of property 100± plan lft X 120 ft . * Existing building ( $) Size ft x��`ft . Mod PROPOSED BUILDING .AND USE : of Z� » Existing build1.ing ( s ) Use � N/ a Size of new strupslab 32 ft x 37 ft '* Foundation-pier crawl/partial/fu11 * Proposed building , distance from property line 3e one } * see p of plan Nom of stories (habitable space) 2 * Front yard 30+ ft Rear yard 30t ft Height ( grade to ridge) 21 ' - 6" ft . * Side yards i ft and 15+ ft If residential , no . of families Of 2 * If on corner * setback from side street ft Rio* of rooms (excluding baths) �� �` OCCUPANCY INFORMATION No. of bedrooms 2 NO. Of bathrooms * PRIMARY One BUILDING - Prima heating system se ar a ectric" Two family dwelling Tt-dsone sag%j bei r]+ r3 y * -'11ao family dwelling one i D Type of fuel Electricity * Multiple dwelling / Number of units No . of fireplaces to be installed * Permanent 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 XAttached garage/one car/ two car/ One car * • • * w r * w « # * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF ,L� * 'Other COli $TRUCTIONl���s I ORMATION ON SPECIFICATIONS , ON REVERSE SIDE OF THIS 'SHEET, TO BE COMPLETEDI Form BPA 4/66 and-vl $WILDING PERMIT APPLICATION CONTINUED — BUILDING SPECIFICATIONS : Type of construction , wood frame , fire sa€e , etc . wood fraaae Will any second-hand or ungraded lumber be used? If so , for what ? no Foundation wall material concrete block Thickness 8" Depth of foundation below grade (to bottom of footing) mirLi.ffXXi Will there be a cellar? "rio Heated or unheated? Floor squ footage sq ft Will there be a basement? no Will any portion be used as living space? ( If so , what pore sq .pt . -g- Type of use? Type of roof sloLped0ffl-a—tf-s'hed/other Material of roof Fiberglass s rl ley Size , wood studs X 6 spacing 24 o . c . length $ ft . exterior walls Joists ( floor beams ) lst . floor N/A "X " spacing "o . e . span N/A ft . Joists ( floor beams) 2nd . floor 2 "X�^ " spacing 16 'o . c . spanTNT-�(#"t. Overlays (ceiling beams ) 2 '•X '" spacing 24 "o . c . span 16 ft . Roof rafters 2 "X 1 "' spacing �4 o _ c . spaa ' -3"k't . Roof trusses (pre-engineered) spacing 24 "o . c . span N/A ft . 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 and dwelling? yes If so will a Fire-rated door , enclosure , and swlf-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 N Aft . in . Water supply - Municipal or private well municipal SEPTIC SYSTEM Distance from ANY private well ( including adjoining properties WX ft . (A separate application is necessary for an re air or new installation of septic system) See S . F . E . D. S . permit # 02M252 Town of Queensbury T County of 'Warren l 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 s fi or not nd that such work is authorized by the owner . m SWORN TO BEFORE ME THIS Signature___ - iOwner, owner ' s agent arc rect, contractor 410�f day of Ll CSC �_-tadx 19rL PAU A C1- RISTOPHER Notary Public, State of New York AW- ��i �_} �r Qualified in Schenectady County No. 4864727 !Notary Public , Warren County, N , Y . Commission Expires July 7 19ff SPECIAL CONDITIONS OF THE PERMIT ; Square feat I;LVU 1270 288 Square Boot ,garage - one Stall 1558 0 $7 .00/ IOOr4 or part of $5000 one stall garage Tavel Hl'........._________... TOWN OF QUEENSSURY WARREN COUNTY . NEW YORK application tor : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . &NSYSR ALL of the followings l3 . Gross floor wrea 1270 S . F. 2 . Type of heat Baseboard electric 3 . Is the building mechanically cooled . No 4 * percentage of area of windows and doors 13 . 3X & . over 16ti Only } . u0 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 ? 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, =] . 026) 2 . . R value of exterior walls 20= R-23 . 5 'U. OoO4 3 . R value of glazed area U. =0 . 30 46 R value of doors R- 14 . 9 (U. =C] . 06) 5 . R value of floors over unheated +spaces WA 6 . R value of slab edge insulation on unheated slab NIA 7 . R value of slab insulation - heated slab 12 . 5 A . R value of heated basement/ cellar walls ( above grade ) N A 9 . R value of heated basement/cellar walls ( below grade ) NIA Los Type of insulation Fiberglass C . Controls 1 . Thermostat maximum heat ,setting V * Duct Systems N/A 1 . is duct system installed in unheated spaces ? YES no a . 2f YES , R value of duct installation b . -. R value of duct in other areas go Piping insulation N/A om 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation y . 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) 89"161 ( applicant ' s signs ref APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref; S. PeEeD. S. VATS October& 7 / 87 permit # New York ea 0202525 ' MOM E of L/E LOCATION OF PROPERTY FOR INSTALLATION 5 Margaret Drive Owa+sr''s Names Guyer Sunders , Iwo • . Telephones (518) 899-91b1 Address: 119 RanrfLM Street , Ballston Spa , New York 12020 lastaller's Name: Guyer Builders , Inc Telephoner ( 518) 899- 9161 2 A, C, E, I , J, K.r I.., M Number of bedrooms bre+sidential only) 2 3 Fs G, H Total daily flow (compute +Q ISO gal per bedroom) 300 Topography' circle mat lot Rolling Steep Slope % of slope SoU Natures circle one: ��."'==-^' Loam Clay Other j Depths: 8 ' feet + Cowl Waters At what depth? town 8 feet + Bedrock, or Impervious Materials At what depth? unknown feet Pea+colation test: circle one: not require required / rate mine inch. Domestic water swpplys circle oaes Municipal Well Other IF domestic water supply is a Wells Sepasation: Watersupply from Septic absorption NIA feet * PROPOSED SYSTEMS Septic Tank gale (minimum sizes 10000 gale) TILE FIEL.L1s Each Trench N/A feet / Total system length NIA feet * SEEPAGE PIT(S)s Nlarnber of Waal Size each feet by took * Size of stone to be used # / Depth or Thickness feat * * * ss * sssssssssassssss * * * sss * sssssss * sss * * �re� IMPORTANT * See °S . P.E.D.S. ...Pl�easeeeaUST NSW SQUIPMSNT TO I'!S INSTALLED permit & attached * * * * * * sssssss * sssssss * sssssssssssss * * * * ss map. (over) t Section II Seletic 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 *ball include a plot plan showing: 1.) the propoped .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 tar►ks, distribution boxes, tills fields and/or drywells S. No system shall be covered before inspection and approval by the building Lspector. Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine of up to S250.00. Co An approved copy of the plot plan *ball be available on the construction site. Failure to produce said plot plain 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 bare read the regulatums above and agree to abide by Mess and all s'eyuirrames►tse of the Town of Queensbury Sanitary ry Sewage Disposal 4dinaace. Signature of.responsible person: Date; r Town of Quemmbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (618) 792-6832 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT fpN - BAY & HAVILAND ROADS L QuEENSBURY, NEW YORE-5832C1 TELEPHONE ( 518 ) BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE t PE IT (f7/` i �I ,i APPROVED YES NO FOC)TINGJPIERS MONOI,rTxrC POUR FORMS FOUNDATIO /DAMP-PROOFING BACKFILL A PROVAL ROUGH PLUM NG FRAMING BLECTRICAL R INSULATION: FOUNDATION FLOORS WALLS CErLING [/'FINAL INSPECTION CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES S�TES RAILS STAIRS-CLEARANC PLUMBING FIXTU Sj9REL'EF VALVE -- INTERIOR TRIM PRIVACY DOORS FINISHED F RS GARAGE FIRE ROOFING DOOR CLOSE (S) SMOKE DE T CTORS FINAL ELEC ICAL INSPE ION FINAL APPf OVAL OF CON S2 iUCTION f A SIGN CERfiIFICATE OF (�CUPANCY MUST BE OBTAIN D FROM THE BUILDIN(J DEPARTMENT BEFORE THESEpREMISES ARE OCCUPIED! RE KS: INSP TOR flown Of Q"een31 ttr BUILDING and ZONING DFPASTME 98 Bay and Haviyand 1Ro�a � ��i2BOi C3ueensbury, BUILDING INSPEECTORwS RepORT NAME �f LDCAT I DN �, 4�r _ Permit NO . __L F pate 0 * * * * * * * * * APPRC)VFT) Footing/pier Forms Foundation waterprOo ing Sackf ill �'aming Roof ing Siding r Mas ry Ven h Pl gum'bi _�---�- _--- gglief valves Ext , porches Finished Floors -Interior Trim Stairs & gallings Cellar Drain Tile Concrete Floors plbq . Fixtures Gar . Fireproofing Door Closers SmoXe 'Detectors Chimney IN SU 1,AT I ON : Foundation Floors Walls CeitinELECTRICA TNSPECTI013 F IN Al+ B V uIlding Vjnal survey inal call when ready )Next sch+zduled inspection. E Remarks- guild 9 Spector 6/8E' and-vl 'f ollN OF QUEENSBURY 13vrI,DINGROADS AND CODES DEPARTMENT BAY & HAVI NEW YYORK I28L1g- C)UEENSBURY � 518 ) 792-5832 - E LSPHONE pxFPORT WLDINO I It3SPECTDR � " REQUEST FOR rNSPBCTXON RECEIVED�� ._--'�-- NAME �- r ! J CATION C "I vRMIT # r I APPROVED DATE YES NO FOOTI UR FORMS MONOLXT i P_pROOFSNO_�" SACX 7AT APPRO L SACICFILL M`BING . ,ROUGH pLV FRAMING ELECTRICAL ROUGH- INSULAIXONr FOUNDATION j FLOORS WALLS CEILING TION : Fy FINAL INSPHXGHT CHIMNEY ROOFING SIDING PORCHES/STEPS �- - EXTERNAL STAIRS-CLEARANCE & E VALVE_ PLUMBING FIXTURESIRE DO INTERIOR TRIMIPRIVA FINXSHED FLOORS FING GARAGE FIREPROO DOOR CLOSERfs ) SMOKE DETECTORS C INSPECTION FINAL ELETRICAL T FINAL APPROVAL OF CONS2RVCION OF OCCUPANCY T BE THE FORE A SIGNED CERTI A BUILDING DEPARTM OBTAINED FROM OCCUPXED ! THESE PREMISES ARE REMARKS : - k INSPECTOR �ourn o� '�eteens � ur� BUILDING and ZONING DF A PTME 98 Bay and Has➢land Ne dy' ork 12801 ,�Ueensbury, SEPTIC DISPOSAL SYSTEM It4SPECTI0t3 LOCAT IGNb PERMIT NO . '�- t)ATE g - Sand, - Loam - Clay NO SOIL TYPE Test g;equired? Y Percolation _ Min/Inch Percolation rate TYPE of Y STEM z total engtts A�bsOrpti f field r Length of aeh trench hes Depth of tr oI Size of gran _ er f7 SEEPAGE P= ft"E fit. Size Gravel ze Size Type P IP ING to tan}c r/ ~ Bldg . -- Tanlc to disc. f f d/'p o 'Partial --- -� pi.sta box to YE5 ,openings sealed L0CATj0N/SEP'A :EONS , Foundation to tank Foundation to absorption t. tion t Absorp lot line t. separation O pits PROPS J irclt one) LpGATIOI3 OF ySTEM Right Side Left side Front - Rea z d , SY STEP usE PiPPROVF 4Ui Bi Inspector 01/66 and v1 1.11NG C?EPAR�PA�NT l j3Ut 0%NG and 20 R p, 1 8oX 9$ Say and Hawi%and Road, i28�1 {� Dueensbury. tyew E.C. C)Re S REPdR� BUI L DINC INSP I CM Dat@ *..� * * * * * pppRt]VED Y NC see s Y s Foo4tin3/Pier Foxms ro,�dation Waterpr'�of i.n+3 R,acicf ill Frawi.ng Roof In9 Siding �- Masanry Veneer Rough plumbs n9 Re porches EXt - C7iSrs vl F in ishc d Interior � -� � i.l in�3s .._-----. Stairs Cellar vrain Concrete -Flooxs��--� pl - F fixture sl1 Fireproofing Gar - Door Closers Smoke Detectors Chimney Foundation rloo'rs Walls --- eil , ELF:C�L xl35PECTIC143� FIN RClV �---- DR1VEWAY ding Su Vey1"-�~"~~ Final arsil �+h,en ready action (call �C Next sched�u] ecl L3 Remarks_ I� _?7 C M 1 . VA, 3L ' gu5 dinginspector, 6/S6 mt}_vi [3E104S-I TMENT � ! OF Q NG g ,CODES DEPAR SUILDx HAVILANV ROADS NEW YORK R28ak SA SgURYr 5832 QtjEEN ( 518 ) 792~ i1�S53?EC"mR' s g�ORT 'TELEPHONE BZ3i'IIN� --~�� pEC 10.5cErvEn,��---��. RES?UES 7 NAME LOCATxON RMIT APPROVED DATE YES NO FOOTINGIPIE POUR FORMS_ -- MONOLTTHIC P_PROOFINGJ--�' FOUNDA` XONIDAM �AL���r--�"�� '--� --- KF I LL APPRO BAC PLUMB' ROUGH FRAMING,RIC+�+L o�-INS EL SULATION' FOUNDATION FLOOR$ WALL-' CEILING P ECTFINAL _�-- CHIMNEY HEIGHT ROOFIN'G_ --�-"Jf; STEPS P -� - - -�" SIDINGORCHE & pAxLS� EXTERNAL N S1RELXgF 'VALVE STAIRS-'C LEARA C PLUMBING TRIM RIVACY DOORS S Fr xSHED FL p FING �~�~ GARAGE FIRE DOOOR CLOSER ( g SMOKE DETEC L INSPECTIONS - FINAL EL OF CON 5TRUCTxON r.. rf FINAL APPROVA .__-� OCCUPANCY' MUST BE T FICATE OF DEPARTMENT BEFORE ED cER BUILDING p SIGNED FROM THE O8TAINED OCCUPxED - THESE PREMISES ARE�, REMARKS = .aM to ee +Ye T Sa w" d DEPf*RTM�t� OUtLVNG and XOf11NG Bay and Hav'"nd New o vD 12801 Queensbury. B LJI LU Vt4G Ih1SPECTOR i s REFOR N pj1E. _. .. f L..DCAT S ON ! per",, t PCs r 1r * * * * * L3C? Da z,e YEra FoQtln��pler Forms Wat.erPro n .�gackfill F rami-n9 Roof in9 5id5Ln(3 Veneer M y asonr i.n9 --- --"_ _ -- p lusY' �- -- " Relief Ext k'orbC's ors fl-o F �Lni-sbed Trjm Interior& Rarlr stairs Drain Tr]. -----_'"'- Concrett,e F © es c s plb • F rr - Flrerc�of Gar n`3 o Clser poors s c -,, c'ni Ley�xQ� : ' Fo�dabrori Fl�xs Geilin c_ F 1N P,'J, 'ELE TP. L�iR1VEWAY Survey r--�r�� Final Rnlldir+S wl,er� ready) e,a ll 1Y.sPe �tlon - , 0 led lie-At �' �ueerr 3 Wria aZ OWNG C3�PARThM1�I3T B►3l�D1NG d, SR O - t Box11 98 0 taay and Havi%and Boa Y©rk 12801,40 Queensbury. New is REPORT BUILD F ING I115P }CNOR aS , NAtAE �OCATi I ON ! . . ~,� f Pe -- rsni L3 a t t3 * YES LV 0 * ° * r/ r oC,tin9fl'�eK Fox'sY�s �.,dation WaterPr�'of ing Bacicfi31 f ra=tling Roof ing Siding Veneer tiasonry Ven elief valve R s------'-__�__� ell porches---_ "�-- xt:,0m ed Floors F in jLvn -Inter for TK& gail5ngs Stairs ,Cellar Drain `Tile Floors Cencret"e Plbg - F ixture S Gar , FixePxt'a 11g or Closers Same Detect rs ChimneY '+ xr�sos..Rx�or� Fo�aatian flC)OK$ Walls ceiling n9 IL3�aPEGTxOS3^ �__---- F -114A-i EI. FC°TRl Dl1lVEWAY P.I'PR()V?.L�r--- Final Building du,led ins3jec +�i+can call Zyexe SChe 8 ' IYI r-+�eC tOK Building FILE THIS COPY WITH BUILDING UEPT. yy KEN RE[YISIRED. ;. . .. BUILDING DEPT. COPY OF APPLICATION FORM EI NEW YOR1C BOARD OF FIRE UNDERWRITE TEMP. • i TOvv%SHIP CITY OR /, •j � .. � , STREET AND NO. OR i +'� f t ROAD AND POLE MO. - BL % L[7F BETWEEN yiR1AT T'MO S TIOI,i . CROSS STRf ETS tS Btl UPlV'ACV AND ADORE F..• FROM THEIR - DEFECTS SUPPLIED PPLIED WORK REMOVED 5J �—y Is NEW ADDITIONAL ❑ BUILDING NE,�, . ` ol.D L3 Is LIST SELOW ALL EQUIPMENT WHICH YOU INSTALLED dRWITS OFFICE USE NLri+O F MOTORS HEATERS ONLY NUMBER OF OUTLETS A.W.O. INSPECTION d o Side Att*dt$CW `t S..,Wh Petedetat Bracket No- TYW Each Na Eeth Ne. Oetryr 0116100 WaII RaMetp� CAW Is" Sub- team Beer rrleatt 4st FI- 9rtt1 Ft. 3rd FL DO NOT USE THIS SPACE. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: there 's 4m1n+4 edditirsnet ewiyrrteat not abs *IIi; Iieled. ted but if at tkl o4 IMPeCtio" rH. This application is intended to cower etts >+ a sed�the ,pirpimmit to be lf"m4es to corer the aM1E'tt'°iial as M'e`I " tits aPPI TOTAL you are awtheri:ed to make afie ingfeetie ELECTRIC SIGN WATTS SIZE OF FEEDERS MAINS xpOSED 43A5 TUBE SIGN VA { /f � f ¢,¢ NCEAL£d TRANSFORMERS OF (CAPACITY) C%4ARACTER J _# -^t -.,"' INUMBERI '- OF WORK SIZE OF SIGN WORK TO BE COMPLETED STARTED UN GROUND MAKER OF SIGN SERVICE OVERHEAD , ENI OIS } E { Q y *t /" "f] „(,. New m oLD ON GOER AS NEAR AS STEq i r ,(. L,"k.^�""'_ < 1 f� POSSIBLE 1 DATE OF AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES APPLICATION ,r _ �.' r SIGNATURE MUST Be FILLED IN OR APPLICATION MAY Be RETURN SI APPLICANT PRINT NA NO ADORE. S { f/_ t+. t � , ,IIt . - LD NAME OF APPLICANT ' , TELEPHONE # � ~i r CIIIII' Od � LICENSE NO. STREET ADDRESS 4 yY1.IE94 APPLICABLE CITY OR f `' 'e" POST OFFICE . AS EL (REV, ,1��1 A PARATE APPLICATION MUST BE FILED FOR EACH SEPARATE SUILDIN 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