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1989-077 i I 4 Ip I CERTIFICATE (3*0 +i UPAN'i C�' TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK j pare Sgntem er89-77 ?his is to certify that work requested to be done as shown by Permit No. has been c 3mpleaed. This structure may be occupied as • Clne r'amily Dwelling L4DC*ty0n fi F3roo oo I��u -�- y Chwner Gary Decesere By Order Town Board TOWN OF QUEENSBURY 1 Director of Bldg. & Cade Enforcement k BUILDING PERMIT TOWN OF +QUEENSBURY 89_77 WARREN COUNTY, NEW YORK No. ,Ls 0 PERMISSION is hereby granted to Crary IDeCesare r OWNER of property located at 6 Brookfield Dr. Street, Road or Ave. W cn in the Town of Queensbury, To Construct or place a One Famt_l-V 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. [2. OWNER'S Address is 691 Glen St. Queensbury, N.Y. 12801 CONTRACTOR or BUILDERS Name tc C7 m NKMKX Peter Dickens m M mD 3. CONTRACTOR or BUILDER'S Address rD 2-13 Cramer Dr. Ballston Spa, N.Y. 4. ARCHITECT'S Name :: 5. ARCHITECTS Address rn CCI n 0 0 T. 5. TYPE of Construction — (Please indicate 6y }() � Inaf xl Wood Frame f ) Masonry f I Steel f l Ina r7. PLANS and Specifications No• 75' x 27' single familyr dwelling as per plat plan, specifications and a lication includin se tic stem, two car attached ar a and driveway permit.Proposed Use m One Family Dwelling M sr , E3 $25.00 C/O `'e d $ 313a00 PERMIT FEE PAID — THIS PERMIT EXPIRES October 1 19 89 m (If a longer period is required an application for an to extension must 6a made to the Building and Zoning h town of Queensbury before the expiration date.) g inspector of the � aq Dated at the Town of Queensbury this 7th Day of March_ 19 89 SIGNED BY / for the Town of Queensbury uilding and Zoni nspeotor TC 44 OFUEENSBUR APP14TCATTON FOR BUILDING AND ZONTNG PERMIT C C /, Y �;3f6 Reviesu -7 - RFcFIVED . � Fee FaZd 13WILDING AND CODES UI TARPIEVIl' Bate I.64ued -7 - FSLDC, & CODE DEF'.,�u 1AY and HAVSLAJVD ROADS RD I Box 9a c 0UEENSBVRY, JVEW Y04RK 12804 Pe.►e3rizt No .�{ Tel . (518 ) 792-58.32 Ext •204 -a a k k k * •k a R ik • k k x It tt f k k ai k k a a► ■ 'i k . s a k k A PERMIT MUST 114 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS WILL BE MADE UNTIL API' LICAMT HAS RECEIVED A VALID UVILDINC PERMIT . All applicable spaces on tills application inust be completed and the siffDature of the applicant must apV ear on the reverse side of this sheet . The owner of this property � ^is : t�1A/ft/ �Y+� 'W': J Ozer P . O . Address ff / �}$a r_7 _ < c t/ TEL . .,.." MAP N �_ � property location r TA C 11as there been any split of this property since October 1 , 19887 ��/,r /� [l yes no If yes , Planning Board Review is necessary . SUBDIVISION NAME , IF APPLICABLE ��/.k� LOT NO . The person res onsilale for supervision of work as regards Building Codes is : 01 NAME s, II P . O . ADDRESS TEL . NO * tdarne of builder A : ,v+ S Address � ! t r f / Tel�'e�' 7 — N"me of Plumber jCqern f—e Aaldress Name of Mason ,( Tolw-" ��.�ruRt or rr:ano� L� war. : ZONING INFORMA 410N ( office us only ) Con ;tructior► of a era w buildincj ZONING DESICHATION OF PROPERTY' �� Addition to :a building PERMITTED PRINCIPAL ✓ PERMITTED ACCESSORY nit. t:+cion to a Luilding T (no cik"Ilcju to a:xt4: rior climcns• ions ) REVIEW REQUIRED - PLANNING BOARD ZONING LiOARD� OLkiur work i+lasrriLi+ : ) # SITE PLAN REVIEW # APPROVED DATE -- W C14OSS AREA Oe /PR, OPO/ SCDA STRUCTURE-! ; VARIANCE # APPROVED DATE Floor / / ! sq ft . /'!d � Remarks : 2nd Floor ! /L' sq ft . /! 1 COMi' LUTE . SNI'©Ytht.M1'i`IC1N St1C�UIIcL'i1 11� LCHra . Other Floors sq ft . SiVVQ of property ft % ft . 3� 7VW ( not cellar or basa:ment ) Lxi»Haig builalin.] ( ::) Si: u-- -- -LL ?C rt . TOTAL FLOOR AREA 12aa�f � sq ft . * �Exi::ti3zg building (:.: ) UAl Li4ab of new structuro ft X 7' f ! `u►u�danon-picr,/,laL+/cr�rwl/X�artiu full " Yrapa:;ecl building , dlt;tancu from property lina (circlu one: ) CAl ft Na . of . tarie:. (3►ia]�it:ahla lYace ) , ,r Front yard rr !'t near yard t sf livighc turadu to xidgL: ) 19 ft . # 5ida: yard; _ e+.3 _ rt snd w /[�^C -�•ft If ra � 3rdantaal , no . car f:unilitr5 �/ ■ If on cornar , uutb►ack from aide scrQQC o�+=fc Na . of rooma ( excluding Laaths) ,Z� , „f' " 4CC1.lP}�fti1t Y 1NFQI21N4T1C31f No. of bodrooms � PRIMARY DUILDINC - No. at b:ac!►rao+iw * Ono family dwelling 11rilwAry h+jacinrs »y»L uru ,�{� ^r X1.t,� family dwullintj 6ryp" o f f ua= 1 TG7 C f ` ommmompokm No* of fixa: �lacas to b+ xrailcd . Multil4la: dwelling / Number of units _+ Will f wuudl acua Lu it►ssi :.11u�i?_ � � i'exu►ancsr�t occup"l►ey ,� 'rran�ia4nt occupancy contr:.l Air cor4altloning?, �" a llusincs;zs WILDING STYLC, PRIMARY STRUCTURE , Induscria1 i::airch Con"&LlpQr:,ry Log cabin • Other 1c:ai"d rancl► Mans",& 0LApl::x . Ir µddition , wilut will uuc tau? :3plit 14Va l Old ratyla: Lsunyalow C:+ Cod Cott:ay,: otla.:r ACCESSORY" BUTUDINCON` oionia uOW Towla Clouse ' U.::tachad yariagolonaa curl t rl car { LW CIRCL u ONE PLEASE I " ACtacttud gurwqu/onu c:ar/ two c:►t "�/ • c. a a k k s s as k •+ . ■ a v yr a s '�' Privuta: sLor:aye building . 14SWIMATI: 0 MARK T VAI. UIZ OF # "Ocher 7NF01kIATION ON BUIL.UINC SPECIFICATIONS , ON REVERSE SIDE OF T11TS .''.Fll:lr`i', FlXo RC COMPLETE-01 Form ]PA 10/88 V2 BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS ; Type of construction , woad frappe , fire safe , etc . Will any second-hand or ungraded lumber be used? If so , for what ? MO ��' Foundation wall material /,r C� o)re 12nc e& Thickness c3 Depth of foundation below grade (to bottom of footing ) Will there be a cellar? y 'S Heated or unheated? Top , c�e+�� — '�Floor sq. footage ,j'Y 7 sq ft Will there be a basement? Will any portion be usgd as living space? JlG' ( If so , what portion? sq . ft _ - - Type of use? Type of roof - to ed flat/shed/other Material of roof G haq ,L 7 P, ' v Size , wood studs " X " spacing. /G "o . c . length _ " �ft . Joists ( floor beams ) 1st . floor "X -" spaoing "ro . c . span ft . Joists ( floor beams ) 2 floor "X1(�"' spacing span�ft . overlays ( ceiling beamss )) _ _"X r " spacing�..�__"o . c , span�,Wt . Roof rafters "X spacing -- o . c , span — ft . Roof trusses (pre-engineprVd) s acing tL/ "o _ c _ span�_ft . ,. �► �^ Exterior wall finish � �'T 1,� . ' of what material? i pZ r� QQ �r� _ �,7+, J c r�•sr, Interior wall finish J If a garage is to be attached , describe material to be used for FIRE SEPARATION : � YC i Is there to be an opening between garage and dwelling? f` If so will a Fire-rated door , enclosure, and self-closing device be provided? zes Will a flue-lined chimney be installed? Y g= Height above roof ft , Depth of chimney foundation below grade ft . Depth of fireplace hearth ft , in . Water supply - Municipal or private well _ SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties_22S ' ft . (A separate application is necessary for any repair or new installation of septic system) D E C L A R A T I O N 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. Signature Owner, owns agent , architect, contractor It SPECIAL CONDITIONS OF THE PERMIT : TOWN OF QUEZ14SOURY �.r0 WARREN CODUTYo NEW YORK Application for : BUILDING 'PERMIT IN COmPLIANCV WITH Ttig NEW YORK STATE ENERGY CQN59RVA'16TON CODE. A permit roust be obc" lened bafore beginning work . ANSWER ALL. of the following : ] . , Cross floor :, r .: aoeft ram] raf� +�J 1f [/� ' whom 0 • Type: of heia c -3 . Is the building urachanieally cooled ? A . Percentage of area of windows and do4rw + A . Over 16 Only 1 . U v :a-luu of gross area of walk , roof/" c61l1n9 and floors a: xpotiud so ambient condi Giona 2 . ' Floor over heated spaces YES No a . Ara foundation walls insulated ? YES No 1m, If YR: S , what is the:. It value: ? 3 . Slab on grade: YES NO a . If YES , what is the R value of insulation around ,poriuiezer of :floor ? A . Is basement heated ? YES NO a . a value: of insulation s . Type of insulation Be Under 16 � Only 10 is v .alu .: or root and floors axpgped to ambient conditions zplr y r 2 . Rvalue of rsxterior wiills 3 . R value of glazed area. /r q . Rt value: of doorsmom 5 . R value of floors over unheu,r.ed spaces 6 . R value of slab edge insulation -• unheated slab 7 . R value of slab insulation an heated slab fl . R value of heated basement/ cellar walls, ( wbove ' grade ) G 9 . R values of heated basement/cell/as' walls ( below/ grade ) V 10 . Type of insulation_ Co Controls 1 . ite: rmostat maximum heat setting C7 D . Duct systems. 1 . , Ts elute system installed in unheated spaces ? YES < NO a . if YES , R value of duct installation Rome A . 11 value of duct in other areas E . Pi +Ring Insulationmmo '• 1 . Sixu of hot water or cooling carrying agent pipe =' . a value of pipes insulation- -F . service Water treating 1 . 1> " r f orui .ancu L; e .e . ciency 2 . `ruwpuracur4 control setting waxi. ururra Co ror Swimming Pool. Only ol 1 . hluxiruuur �rll.: ac/in{<�3C} A ~ TalepYrone No . ! f / (7 c3 ( �„rsplic ' is signature: ) TOWN U' F QUEENSB UP Y APPLICATION FOR =v N� SEPTIC DISPOSAL PERMIT DATEe / r, r G3'� LOCATION OF PROPERTY FOR INSTALLATION ( ,y (G'JGC1 ► /erlClOz! . '— G7 � 452AP? l/ 5. Owner's Name//: C,�7e zy_ _ Si l� +/� -- Telephone: 7 �CSr[-t� tiJ 4✓� Address: C9 r��^^'l C33lew.7 �a1 c_k'CJ4ns�ZILO� 1' Installer's Name: Son, kAox ,�/ .�e4ler _ ) 6/f/IGd° Telephone: Number of bedrooms (residential only) / Total daily now (compute (d 150 gal per bedroom) a4 {_ Topography: Circle one: Flat Rolling teep Slope % of Slope Soil Nature: Circle one(Sand Loam ,.+CllacyOther./Depth: Feet Ground water: At what depth? ,,/ e < i _Feet Bedrock or Impervious Material: At what depth? / j ,$ Feet Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one: Municipal well Other If domestic water supply is a well: --7 Separation: water supply from septic absorption /�a�s feet PROPOSED SYSTEM : Septic 'Tank h , r O gal. (minimum size: 1 ,000 gal.) TILE FIELD : Each Trench (60_ feet/Total system length ?(:90 feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # /Depth or Thickness f:�' ter— feet I have read the regulation on the reverse side of this sheet and agre to abi y these and all requirements of the "Town of Rueensbury Sanit Sew I Di pos O finance. SI+GNA'T'UR.E .OF RESPONSIBLE PERSON: DATE: OVER Septic system Inspections : A All applicacions .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 proposed 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 B , No system shall be covered before inspection and approval by the Building Inspector . Failure to comply with this requirement may result in Clio uncovering; of the System by the installer and a fine ul 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 nn i.mmudiate work stoppage . D . Should unforeseen problems during construction prevent proper installa- tion , alteration or repair of an approved system , a new proposal must be submitted to the Quuensbury Building Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 Rumarks : it �; TTFICATE CF I N S U R A N C E ISSUE DATE ' 0271/221/59 PRODUCER _____ ___ _ __________ __ ___ I ___-- -THIS-CERTIFICATE� IS- TSSUCIi AS-A ' -f-IATTERROF INFGRMATIG���OWL" AND CONFER` MCAVOY & {WILLItlM} AGENCY I NO RIGHTS UPON THE CER°TTFICATE HOLDER . THIS CERTIFICATE DOES NOT AisEND , CASE ST , I EXTEND OR ALTER THE COVERAGE AFFORTIFD RY THE POLICIES BELOW . SARATOGA SPRINUS I N Y I COMPANIES AFFORDING ; -VER40E ZIP CODE 12866 ] COMPANY LETTER A AETNA L & C CID ? COMPANY LETTER L AETNA L 6 C CID INSURED i JOHN TRAV'ER j COMPANY LETTER C RD ` ROWLEY RD BALL6TON SP,A, N } 1 CDMF'"NY LETTER U I ZIP CODE 12020 � C.OMPAH`f LETTER E COVERAGES THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN''URED 14AMED ABOVE FOR THE POLICY PERIOD INIDTCATFD , NOTWITHSTANDING ANY PECIUIRE i£NT , TEF'i+ OR CONDITION OF MANYCONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH 'THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE I0Si7R:ANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNS , EXCLUSIONS , AND CONDITIONS C+F SUCH POLICIESM CO Fj:3LICY POLICY LTR TYPE OF INSURANCE POLICY NUMBER EFF . DATE EXP. DAYE ALL LIMITS IN THOUSANDS =TjGENERAL LIABILITY~==4==µ==== Al ( X ) COMMERCIAL GENERAL LIABILITY' _ F 379901+ CA = yl 0=1.9===_01120194Y GENERAL—AGGREGATE _________ S __ I t ) CLAIMS !'MADE t 7 OCCURRENCE ! � PRODUCT—CiOMP/OPS AGGREGATE $300 ( ) OWNERS CONTRACTORS PROTECTIVE ] F'rk".)O+A,L 6 ADVE.RTIISIR?G Tiit'jU ;Y ;-3Ct{) ( ? ! f EACH OCCURRENCE =300 t ) ! FIM,E DAMAGE ( ANY ONCE FIRE ) v ii i MEDICAL EXPENSE ( ANY ONE PERSON ) � _____________________________________________________ _____ __. -- __________—____________—____ ____—_ IAUTOMOBILE LIABILITY J II t ) ANY AUTO { I CSL $ { 1 ALL OWNED MUTOS 1 ! BODILY IN--ifiRY C ) SCHEDULER AUTOS I I (PER PERSON) t t ) HIRED AUTOS I I FODILY INJURY ( ) NON—OWNED AUTOS I ! ( PER ACCIDENT } � ( 5 GARAGE LIABILITY PROPERTY l I ! Dir;ACE 3 EACH EXCESS LIABILITY j I OCCURRENCE AGGREGATE t ) UMBRELLA FORM ! ! t ) OTHER THAN UMBRELLA FORM I i -------- __ _�- ---------------------- ---- - -------------------- ----------------------------- _ ----- ---------- ! ! I STATUTORY AIWORKERS ' COMPENSATION � JB9090772212CX 10/01 /88 10/01189 ¢ 100 ( EACH ACCIDENT ) I AND *500 ( DiSEASE-POLICY LIhIT ) lEMPLOYERS ' LIABILITY ! I $ 100 CDISEA:;E-EHCH EMPLOYEE ) - IIIIII---------------------- ---------------------- -- --------------------------------------- ----------------------------- 0THER ! M ! I I DESCRIPTION OF ITEMS ........................ CERTIFICATE HOLDER 1 CANCELLATION I GARY DECEASARE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX— , 2981 LYDIUS ST PIRA T ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 210 DAYS SCHENECTADY , NY WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAH D TO THE LEFT , BUT FAILURE TO NOTICE � Is?D ZIP CODE 12303 ! UPON THE SUCH SHALL IMPOSE P OR LIABILITY THECiOMPA JYj ITSAGENTSORRERESENTATIVES OF ANY ; I AUTHORIZED REPRESENTATIVE ':1�`�. ' .:�• AiH F3i y�.';�'%;� . �� ,- t �I��v + I � 4 �'�. . - _ • - • � s' r * lid L. ISSUE DnI E {MM.'DL11YY) ��� 4/R91m PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS JARDINE EMETT & CHANDLER., INC . NO RIGHTS UPON THE CERTIFICATE. HOLQrR. THIS CERTIFICATE DOES IYOT AMEND, Center City Plaza EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 433 State street COMPANIES AFFORDING COVERAGE Schenectady, N . Y . 12305 COMPANY Telephone : ( 518 ) 381-1600 LETTER Hanover Insurance Co . COMPANY INSURED LETTER Robert Santorelli COMPANY 3675 Carmen Road LETTER Schenectady, N . Y . 12303 COMPANY L) LETTER COMPANY LETTER < ; dill L kid THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. CO -- POLICY EFFECTIVE POLICY ExPIHAILi}r. LIABILITY LIMITS 1N THOUSANDS - LTA TYPE OF INSURANCE POLICY NUMBER LiAIE jhii,LIxU+WI Lu1TE (r,LI4tfO NY10 EACrI A(iCiREC.ATE ncCut+� ce GENERAL LIABILITY .u.� BODILY X COMPREHENSIVE FORM L269-76-28 4/25/88 4/25 f89 INJURY .X PREMNSMOPERATIONS PROPERTY UNDERGROUND DAh5Ak)C- $ $ EXPLOSION rs COLLAPSE HAZARD X PRODUCTSiCOMPLETED OPERATIONS 131 oll CONTRACTUAL ODMIDI3ED $ $ INDEPENDENT CONTRACTORS 1 1 a 000 1 0doo BROAD FOHMI PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY BOA V Ft* P ANY AUTO jPH EiLDry ALL OWNED AUTOS (PRIV- PASS.) bui,Lr :. OTHER KHAN .._[ N ALL OWNED AUTOS PRIV- PASy. IPER .sa:IOEr.rt HIRED AUTOS pFi['iYERIY NON-OWNED AUTOS DAMAGE $ GARAGE LkaILITY I]I m PD EXCESS LIASILLTY . OMBRELL.A F.iRIA eL:l rvin•NtD $ $ A" OTHER THAN UMBRELLA FGH:,f ......_�---I WORKERS' COMPENSATION y AND $ (GIStASE-POLICY LIItiITI EMPLOYERS' LIABILITY (DISLASE EAU EMPLOYEE OTHER a rho , Lid ii -- ` DESCRIPTION OF OPERATIONSILC•CAT1ONSfVEHICLESISPECIAL ITEMS r5HOULD d id G$ DeCesare Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO6 Brook.fleld Drive DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE AILURE TO MAIL SUCH NOVICE SHALL IMPOSE NO OBLIGATION OR LIABILITYGlens F' alls , N . Y . 12804 O UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. -REPRESENTATIVE , . L Lk .:a I . .. w r • LIr H :..[q.' i a. - Y � i s I .e Pii . 4 . r. s^ _r ..v+.' �e ~ Yd"W 'i . ' j "F'' f;r i s cI. ✓ yT y.E f' {.+ _ - 'i ;--#• z I r; : . .'•",T' 17'1 i:.# , ;'♦'�• xs.., C ; ' Y r � . p, a . y ' e I. - 10 LLd . VTP` 7 is too 1t -ti .� r f I,01 yJ 2/ $ 94r ir: lL",1YY) 4TYj PRODUCER ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF IFIFOHjAATION ONLY AND CONFERS NO AdGPITS UPON THL- CERTIFICATE HOLDIEH.. THIa CERTIFICATE DOES NO E AMEIIO, ` � +F. 1 l e r , Ha r C i E & Greco , l n C . EX TcND OR AL I EH THt COVERAGE AFFOkOED UY THE POLICIES BELOW- Id ' ' ' 2621 Guilder Land Avenue _. Schenectady , IVY 12306 COMPANIES AFFC RDIt4G COVERAGE e COMPANY r: Tr ave l e r $ LETTER 't COMPANY INSURED LETTER CMPAN .tf-* LETTER Y K'+ ROCCO kescelo , Jr . 55 <?' . 1605 Rutgers St . COMPANY Schenectady , MY 12303 LETTER COMPANY LETTER I ' VGEINERAL CERTIFY THAT POLICIES OF INSURANCE LIjTED BELOW HAVE BEEN ISSULD TO THE INSURED NAMED AaDVE FOR THE POLICY PERIOD 114OiCATivO. TAfJOING ANY pEGilirltr.ir�1:1`, Tc.1M GI• C:OI,i L]ITION OF ANY COMTiTAC E Gri C1 HLR DOCUMENT WITH HWI�IPECT TO WHICH THIS CERTIFICATE MiaY OR MAY PERTAIN, THE INSURANCE AFFORDED ITV THk POLICIES UL$C.RI6ED HEREIN la SUEJECT TO s,L4 -hf TEFinnj, EXCLUSIONS', AND CONDi-SUCH POLICIES. E OF lN,`.+URANCE POLI.:.Y 11UMSER I �7: �i;r III I ;:11vE POLICY Far.hf,rrur: LABILII Y LIMITS iN THOUSANDS I!mi;AuW'Yrl ❑ATE 1%•v1.:06i fI tp At,H LIABILITY BODILY �-' �— _ COMPREHENSIVC FORM rr.,IUr<Y 650 - 599Jr607 - 8 -COr - 8 t / 27 / S9 1 / 27 / 9c1 PREMISESIOPERATIONS rd U NO EAGROU ND P P 40PE RTY - EXPLO:.iIC1N 8 COLLAPSE HAZARD $ $_ x PRCIDUCTSICOMPLETEO OPERATiarxs CONTRACTUAL [:O�rf rry yED $ 1 , 000 $ ! ' ,r INOCPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAUE -` PERSONAL INJURY PERSONAL INJUFIV . 'F"' AUTOMOBILE LIABILITY ItA;wir ANY AUTO IN r+ Pen::ur,f $ ALL DYMED AU10S (PRIV. PASS.) e:;.,lsr Irr,.;lrif ALL DINNED AUTOS OTHER THAN PRIV, PASS. I+'LF :L41411 rri, $ HIRED AUTOS ii' � PROPE1i1Y $ NON-OWNED AUTOS GARAGE LIABILITY i �"�'{ C:lJA1 E4rNED $ F : EXCESS LIABILITY _ UMBRELLA FORM el a PC) + :_ I'•a° OTHER THAN UMBRELLA FORM COMBINED $ $+ WORKERS' COMPENSATION SI AT UYOHY AND `.S (EACH ACGDENI) EMPLOYERS' LIABILITY Is {DISEASE-POLICY LIMIT) OTHER $ (DISEASE EACH £MPLOYEE) - $•; Y~ DESCRIPTION OF OPEFtATIONS)LOCATIONSNEHICLESISPECIAL ITEMS Work to be done at 6 Brookfield Drive , Queensburg , NY 12804 ddd ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Ex. Gary Il @ C e 8 a re ^J PIRAT" DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 2 _ y, u $ Cu t MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE ;i LE FT,.ELU'T„FAI LURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR UAB1UTY NY2 3 L7 3 Schenectady , OP ANY KINp_}{P_ON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. A U THORIZ E gjRE PA E SE NTAT)V E P r �� :.. yF y y �w -.4 v r ':.[i . S �r�{ x w �I �iYf�` .•:.""r' .,,>. yF y' �-.'�"^� :_ K k }' ;5. Y . . .��e>h'8 nr -,�F• ; �.,Iyk�: ISSUE DATE (MMIQDMYy CERTIFICATE OF INSURANCE PRODUCER 2f 20/89 fl THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Fr C ni NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Ass-`--i ate5 Inc . EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW RD 5 , Broadway Saratoga Springs , NY 12866 COMPANIES AFFORDING COVERAGE COMPANY A CODE SUB-CODEETTER ODE Covenant Mns . CO. COMPANY INSURED LETTER 13 All City Ins . Co. Pete Dickens LETTER COMPANY C 2B, Ctamer s Dr• rt�y r1 COMPANY Bal.lstimi Spa, NY 12020 LETTER D COMPANY E LETTER COVERAGES . _ ..--. .. - - - --. _ ....._ . ._ . ... _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TA TYPE OF INSURANCE POLICY NUl1BER POLICY EFFECTIVE POLICY EXPIRATION DATE (MWDDJYY) DATE (MWDDIYY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY COMMERCIAL, GENERAL AGGREGATE COMMERCIAL, GENERAL LIABILITY PRODUCTS-CDMPIOPS AGGREGATE S 11000 CLAIMS MADE x OCCUR. BP 304 25 38 11/30/88 11/30/89 PERSONAI. A ADVER71 SING INJURY S 1 00d OWNER'S & COmTRACTOR'8 PROT. EACH OCCURRENCE s 1 , 00d FIRE DAMAGE (Any one tire) Sra. 0 MEDICAL EXPENSE (Any one person) S 1 AUTOMOBILE LIABILITY COMBINED ANY AUTO SINGLE S ALL OWNED AUTOS LIMITBODILY SCHEDULED AUTOS INJURY $ HIRED AUTOS (Per parson) BODILY NON-OWNED AUTOS INJURY S GARAGE LIABILITY (Par accident) PROPERTY DAMAGE s EXCESS LIABILITY EACH AGGREGATE OCCURRENCE S OTHER THAN UMBRELLA FORM $ WORKER'S COMPENSATION STATUTORY B AND 2510066497 9/30/88 9/30/89 s 100 (EACH ACCIDENT) EMPLOYERS' LUIBlLtTV S 5dd (DISEASE—POLICY LIMIT} OTHER S 100 (DISEASE—EACH EMPLOYEE DESCRIPTION OF DPERATiONB/LOCATIONSIVEN CLA6L ITEMS �F'+ 7".'Ymi ng,, resldenti a 7 CERTIFICATE HOLDER CANCELLATION - _--- -_._..- --- .. Gary DeCesale SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 2981 Lydius St. EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO Schenectady, NY 12303 MAIL 3_ DAYS WRITTEN NOTICE TO THE CERTIFICATE 1-104DER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY K[ND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. /r w � a. a► . AUTHORIZED qFS dBSENrAnvF7 . �a'/ r I t.. - LACORO 25 S—(3/88� r • y ©ACORD CORPORATION 7 S88 TOWN OF QUEENSBURY BUXLDXNG AND CODES DEPARTMENT BAY & HAVX LAND ROADS QUEENSBURY,, NEW YORK 128ok TELEPHONE (518) 792-5832 BUILDING INSPECTOW S REPORT REJ2UEST PO'R rNSPECTXON RECEIVED - 3 _ fey'-T NAME LOCATXON - -- DATE - `j PERMXT # ` 7 APPROVED YES NO FOOTXIVGfPX.$RS MONOLITHIC POUR FORMS FOUNDAT2'OltvIbA IP-PROOFrIVG BACXFXZL APP�OVAL ROUGH PLUMBXI4�9 FR.AMXNG EZECTRXCAL ROU XN XNSULATXON. FOUNDATION 4' FLOORS WALLS CEXLXNG Z-- x'TNAL rNSPECTZON: CHXMNEY HEXGHT ROOFING SIDrNG EXTERNAL PORCHES/ TEPS V' S'TA.IRS-CLEARANCE & RAXLS PLUMBXNG FXXTUR /RELIEF V VE XNTERIOR TRIM/P IVACY DOORS -- FXNrSHED FLOO,F{ GARAGE FXREPR FXNG DOOR CLOSERS — t SMOKE DETECT° RS FXNAL ELECTRrC L INS.PECTXCyN FXNAL APPROVA OF CONSTRUCTION A S NED CER OBTAX rFXCATE OF OCCUPANCY MUST BE NED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISVS ARE OCCUPIED! REMARKS XNSPECTOR � - LR TOWN OF QUEENSBURY BUILDrNG AND CODES DEPARTMENT BAY & HAVSLAND ROADS QUEENSBURY, NEW YORK 12g �g -J,r'i�7 TELEPHONE (518) 792-5832 BUILDING INSPECTOR " S REPORT ---- REQUEST FOR N PECT_roN RECEIVED NAME LOCAfiIO1V DATE ` PEF2MIT # f APPROVED FOOTrn1G1PIERS YES NO MONOLITHIC POUR ORMS FOUNDAT1` DAMP- OOFING BACKFrLL APPROVAL ROUGH PWMBrNG FRAMING ELECTRICAL ROUGH-r rNSULAT-rON: FOUN7DAT-I FLOORS WALLS CEILING 6,P:fAFAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESfSTE S `� STAIRS-CLEARANCE & PLUMBING rrXTUREs I.IE ;r -INTERIOR TRIM/PR.i Cy VALVE � FINISHED FLOORS GARAGE FIREPROOF NG DOOR CLOSER (S� SMOKE DETECTORS FINAL ELECTRTCAL A7SPECTrON ` t- FINAL APPROVAL O CONSTRU C T ION A SIGNED CERTI ICATE OF OBTAINED FROM THE OCCUPANCY MUST BE BUrLDXNG DEPARTMENT PARTMENT BEFFORE THESE PRENrSES ARE OCCUPIED ! Ile le'j, INSPEC TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280.tZ- TELEPHONE (518) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION CEIVED NAME LOCATION / DATE - caF4, PERMIT #,A6C-e& � ROVED YES NO P0021XNGIPXERS MONOLITHIC .POUR FORMS FOUNDATIONfDAMP-PROOFING BAC"Xr' L ..APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION.: FOUNDATION FLOORS WALLS CEILING FSNA1; INSPECTION: CHIMNEY HEIGHT ROOF I'NG SIDING EXTERNAL PORCHESI$rEP.S STAIRS-CLEARANCH zzpq L PLUMBING FXXTUjR8S1RELXkW VALVE INTERIOR TR-TMfPRXVACY DdORS FINISHED FLOORS GARAGE FIREPROOFING - DOOR CLOSER (S) SMOKE DETECTORS --- FINAL ELECTRICAL Z'NSPECTSON FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST Be OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR - � _ . TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- �. TELEPHONE (518) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATEtx ERMST # A PROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDAVZON/DAMP—PROOF2NG BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICA4 ROUGH—.TN INSULATIO FOUNDATx (�� jIsw FLOORS WALLS ILING c. 4 .�XNAZ INSPECT N: CHIMNEY HEIG ROOFTNG SIDING EXTERNAL PORCHE /STE STAIRS—CLEARANCE' & I PLUMBING FIXTURE IEF, VALVE INTERIOR TRIM/PRIT1 CY DOORS PXNTSHED FLOORS GARAGE FIREPROOF G — DOOR CLOSER (S) '—� SMOKE DETECTORS � r- FINAL ELECTRICAL INSPECTION FINAL APPROVAL F CONSTRU6TION .r A SIGNED CER SFTCATE OF OCCUPANCY MUST BE OBTATNED F THE BUILDING DEPARTMENT BEFORE THESE PREM SES ARE OCCFJPTED! REMARKS: /;N[} I /� f C S t r � ,25 IN PEC R ^ TOWN OF QUEENSBURY� BUILDING AND CODES DEPARTMENT 41C� ! BAY & HAVILAND ROADS QUEENSBURY� NEW YORK 22804L TELEPHONE (528) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST INSPECTION RECEIVED NAME LOCATION DATE ERMIT #I° APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRA,MXAIG EL RICAL ROUGH-IN S'ULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING � SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE' & PG4ZLS PLUMBING FIX77 R�S/REL Elr VALVE INTERXOR TRSMIpRIVACY 19OORg FINISHED FLOOiS GARAGE FIREPROOFING DOOR CLOSERIS) SMOKE DETE TORS FINAL ELECT CAL INSPECTION FINAL APPRO. AL OF CONSTRUCTION J A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED ,ROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS - r} QUEENSBURY, NEW YORK 128pg 4• TELEPHONE (518) 792-58.32 BUILDING I NSPECi'OR ' S REPORT REQUEST FOR XNSPECTXON RBCEXVED NAME LOCATTON DATE - � T #/_ �L2 YES NO FOOTTNG/PIERS MONOLITHIC POUR FORMS F0UN,i7ATTON/,fir MP—PROOFING BACKFTLL APPR�XVAL ROUGH PLUMBTNG�l. FRAMING .ELECTRICAL ROUG TN INSULATION: 's FOUNDATION i FLOORS WALLS CETLTNG FINAL INSPECTION t CHIMNEY HETG ROOFING SIDING EXTERNAL CUES STEP STAIRS—C ARANCE & RA1j4S PLUMBIN FTXTURES/RELI VALVE -TNTERX TR.TM/PRTVACY Di*JORS FINTSH D FLOORS GARAG FIREPROOFING DOOR LOSER (S) SMO DETECTORS FINAL ELECTRICAL INSPECTION . FINA APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: Y 1 INSPECTOR Lar T �vVc -�atG4� L="Jk �T ^ k'� C, LF L �� hZ 17A. s'-S,O. 6 4,,C 7 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280!& TELEPYONE (518) 792-5832 BUILDING INSP'ECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED <—/ NAME LOCATION ' DATE .� c3 APPROVED YES NO FOOTXNG/PIERS MONOLXTHXC POUR FORMS FOUNDATSON/DAMP—PROOF.ZNG BACKF.tLL APPROVAL 6.dt`CJUGH PLUMBING. [,,FRAMING ELECTRICAL ROUG IN INSULATTQN: FOUNDATION FLOORS " WALLS Y CEXLXNG FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS .STAIRS—CLEARANCE & RAIIfSr PLUMBING FIXTURES/RELrEF VALVE INTERIOR TRXM/PRXVACy DOORS FXNXSHED FLOORS f GARAGE FIREPROOFXN0 DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRXCAL NSPECTXON FINAL APPROVAL O CONSTRUCTION A SIGNED CERTX XCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUXLDING DEPARTMENT BEFORE THESE PREMIS S ARE OCCUPIED! REMARKS: k r l XNSPECTOR �4®r wn n/ Queen31urey BUILDING and ZONING DEPARTMENT `�y �� Bay and Haviland Road, R. D. 1 Box 98 "' / Queensbury, New York 128( d /00 SEPTIC DISPOSAL SYSTEM INSPECT NAME; LOCATION DATF / L PE T NO3 - - SOIL TYKE - Sand ftg7 ? Clay - Percolation Teat Required ? YES - Nj Percolation rate - Min/Inch _ TYPE of SYSTEM: f r Absorption field , total length Length of each trench � — Depth of :trenches - Size of gavel: SEEPAGE P*TS{Number of) _ Size- Ift. X ft. u PIPING : zePe Bldg. to tan Tank to dirt . box Disto box to ' eld/ iti openings seale S No Partial LOCATION/SEPARATlT S ^� Foundation to t k ft. Foundation to rorp ion ft. Absorption to .jot lin -- ft* separation ofr'vlts ft. LOCATION ' SYSTEM CST PR ERTY (circle one) Front - Rear> - Left side - s3cTe COMMENTS : ,. SYSTEM! USE APPROVED �.YE O Bull ng Inspector 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT �r BAY & HAVILAND ROADS QUEENS,BURY, NEW YORK 12809. if ' TELEPHONE (518) 792--58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION 1 DATE `3`- FE IT # r APPROVED .YES 4/�OOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING .SIDING EXTERNAL PORCHE /,STEPS STAI .G RS-CF.ARANCk & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TR_"!/PRIVACY DOORS FZN.r,SHEI7 FLOORS GARAGE PXJt 'PROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE or OCCUPANCY MUST BE OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! INSPECTOR mmmmmmmomm TOWN OF QUEENFSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12801 TELEPHONE" (518) 792-5B.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR IN .+S '�PECTION RECEIVED NAME _ .5�� .�_ LOCATION 45p L ( (� DATE `r _ PERMIT #_ tS % ^ 2/ 7j APPROVED YES NO OOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIODAMP-PROO,F'XNG BACKFTLL A PROVAL ROUGH PLUMVTNG FRAMING FLECTR.TCAL R6vGHLXN INSULATION: FOUNDATION FLOORS ILL' L WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHTRp , ROOFING SIDTNG EXTERNAL PORCHESI TE STAIRS-CLEARANCE,'& 4S PLUMBING FIXTUR S/REL£ VALVE' INTERIOR TRIM/ IVACY �RS FINISHED FLOO GARAGE FIRED FXNG -- DOOR CLOSER ( ) SMOKE DETEC RS FINAL ELECTRI AL INSPECTION FINAL APPROV L OF CONSTRUCTION A SIGNED CE TIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED.+ REMARKS: ' r' INSP v St Lt1.: l h{U`S IN t,7 rl,J KNla l4uti) CGn-! ! Ia APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. \ .•• •� r National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 • • Date : -y! !(fr City, Town or Township �'E�va {r/" ` County Grp '"- State /L Location/Address /GCJ l r I y f -located in Rural Area - P$ease Attach Directions) Pole # ` Owner (� / De- JH5 �� Permit # Occupied As r'/ e /"4AWI Building : NeWA Oid Occupant Work Area in Building Floor #, etc. ) -* App. for: Wiring Service or: Ready for Inspection . Fee Remitted - $ Cash Q Check Cf M.O. Make Payable To : M. D. I.A. 544 754 1000 1250 1500 1750 2000 2250 2500 2750 34en Number of Rough Wiring Outlet,5r Elect, Heat Switches i6vt + Lighting — Amp. Service Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner ..Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles FractionarH.P. Vent Fans Other Equipment: MOTORS H.P. 112 1112 1/10 1/a I 1/6 1/a 1/3 1 112 1 3/4 11 1 1 1 '12 1 2 1 3 1 s 1 7112 1 111 1 15 1 20 25 30 40 5❑ 75 100 Mark Number of Each Size Applicant's Signature "ter~ License # Permit # T/A S Utility : / Applicant's Iddre s ' NAME (OFFICE L[]CAT14N (City) Sew S! '—� (State? ! (Zip) Service Request # Phone #� _�S 7 ` / �� Electrician ; I C/✓1 �'l -� 2 GAG • • DATE RECEIVED: DATE INSPECTED: Correct Location : Same as Above Q or: Red Notice Label Q Hough Wiring Outlets Surface Unit Oven Switches Flange Garbage Disposal Rece tacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner, Wiring & Controls for Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 11/2011/1.211,n011/811/6 1/4 1/3 1/2 3/4 1 l+vx 1 2 1 3 5 171/2110 115 24 25 34 4q 50 75 1t10 Mark Number of Each Size lect. Heat See 754 100a 1256 1500 1754 2004 2250 2400 2750 300D Fj Patrick J Dashaaw FFpp 12839 Hudser7 $=34 3 ELECTRICAL INSPECT132 CORRECT CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE FEE FEE PAID 0 RW Progress:' Inc. [] LKD Q Contractor Q CFT Violation : Work Comp_ Inc. {� L/A Owner CASH 0 Fee CHK # [] L/A Due MO # Q IPA Municipal INV # Date: Other Side ED Utility Applicant Owner Cut in Card Temp # Date I—I Final it r)�tw INSPECTORS SIGNATURE TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVSLAND ROADS QUEENSBURY, NEW YORK 1280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECON RECEIVED NAME LOCATION 40 DATE PERMIT # APPROVED YES NO FOOTING/PXERS MONOLITHIC POUR FORMS FOUNDATION/DA.MP�apROOFING - +' BACKFILL APPROVAL. ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN'l: INSULATION: ; a FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHEjPI STEPS STAXRS—CLEARANgi & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOO�FS GARAGE FIREPI;ftX7FING DOOR CLOSER ( ) .SMOKE DETEC RS FINAL ELECTRICAL INSPECTION FINAL APPROVAL 'OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS: AD INSPECTOR m co N N 0 0 iN OR ANY OTHER PURPOSE WITHOUT WRITTEN PERMISSION FROM NORTHERN HOMES INC. IS PROHIBITED. THE USE OF THESE PLANS FOR CONSTRUCTICr NOT BE TO EXACT SCALE. USE ONLY THE DIMENSIONS SHOWN. DO NOT SCALE THESE DRAWINGS. THEY MANT APPLICABLE BUILDING CODES TO INSURE THAT PLANS AND DETAILS CONFORM TO.ALL REOUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH OWNER AND CONTRACTORS SHALL: CONSUaORTHERN HOMES DRAFTING DEPARTMENT OF ANY DISCREPANCIES BEFORE WORK IS PERFORMED. CONSTRUCTION WORK AND SHALL NOTIFY aOLE FOR ANY ADDITIONAL COST 04 STRUCTURAL PROBLEMS RESULTING FROM THE FAILURE TO FOLLOW THESE -PLANS AND THE DETAILS AS OUTLINED IN THE NORTHERN HOMES SHALL NOT BE RESPONSI NORTHERN HOMES CONSTRUCTION GUIDE.