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1989-092 s M1 S + Irv4 "l, y y 1 I CERTIFICATE CUPA.N(ownNONYL I TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date June 19 tq 90 { a I This is to certify that work requested to be done as shown by Perxnix No. I � has been completed. nW k ~✓ 'This structure may be occupied as a Owt er $y Order "Town Hoard orowW of QUEENSSURY 0 4 Director of Bldg. do Code Enforcement i l H X BUILDING PERMIT TOWN OF QUEENSBURY No. 89 - 92 0 WARREN COUNTY, NEW YORK a PERMISSION is hereby granted to I c 0 i Street. Road or Ave. �V OWNER of property located at � in the Town of Queensbury, To Construct or place a IV nvrP l 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 Queensbury Building and .Zoning Ordinance. t =OWNEIRI'S ddress is �d 21 Mohawk. Avenue s✓ Latham , N . Y . H rr 2. CONTRACTOR or BUILDER 'S Name yy Iona Development o [4. CONTRACTOR ACTOR or BU I L❑E R'S Address iv p . c3 . BOX 912 Saratoga Springs , N . Y . 12166 RCHITECT'S NameARCHITECT'S Address p m ts� 00 B. TYPE of Construction — (Please indicate by X) H �C ( I Wood Frame ! 1 Masonry i I Steel ( i tD E O 7. PLANS and Specifications 0 No. 52 ' x 36 ' single family dwelling as per plot plan , f� specifications , and appliCation , including septic , and attach d a. Proposed Use r Single Family Dwelling U 25aOO 1989 $ 28 PERMIT FEE PAID I THIS PERMIT EXPIRES OCtOber 1 R (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.T F Dated at the Town of Queensbury this 21 Day Y of Mar ch ig89 t for the Town of Queensbury z SIGNED BY o Building a on! Inspector i F r U TOWN c� UEEhTSI3URY APPI. TCATTON FOR RUTLDiNG AN ZONING rr: lxri� rx Rec.i.evedJ /�' T[!Wt4 OF QUEENSBURY RECEIVED > . Rev.Cewed Y F,_ MAR Fee Pa %d $ , t;�! (� WJILDING MD CODES Lt141'AMMI`T Date Ieaued BLDG. & +CODE DEPT. BAY and ItAv.rLAND ROADS RD 1 BOX 98 pUEENSDVRy, NEW yopK 12804 PeAmit No p 1 Tel . ( 518 ) 792-5832 Ext 204 .. '■ � * ■ x Ur .■ tr i I r, 1t '■ * ♦ t► Y Yr * ■ 1t k r ■ • 1r 'i ,. A ■r t s • ,t M ,� x A 1' I:RIAIT musT D4 OBTAINED BEFORE LEGINrIING CONSTRUCTION , NO INSPECTIONS li' ILL B HADE UNTIL ,I+,,PI' LICANT I1AS RECEIVED A VALID ]3LII.i7INC PERnIIT . All a ;al l icat� Ic spaces on this application tnust be completed and the � -1 ,niti ature of the appi-Icant 11.1u k appear ° n the reverse side ° this 51* c * t The owner of this Property is : Francis A . Purritano t O . Address 21 Mohawk Avenue Latham N APONOO .. 1 221 $� 9 Part of 922 troperty location Lot 58 T n TAX MAP / _ / ttas there been any split of this proPert since October 1 , 1989 ? �� NO ]r yes no if yes , Planning 13oard Review is necessary . LOT HOo 58 UIIDIVISION L3AME . IF APPLICABLE jyn0c; nnrJ Fc-- at- Q9 The Person responsible tar supervision of work as regards Building Codes is : ZONA DEVELOPMENT P . O , - Box 912, Saratoga Springs, NY 12166 NRtYtE L✓ . o . ADDRESS Tkl N 3 tSame of builder ZONA DE'VI A.ddressPO Box 912, Saratoga SeringSLel 58 3- 2 339/ 42 3- 01 36 a one Faun at."J aeess Troy, NY NY Tel 2 35- 1877 Name of Plumber cJ Tel Name of Ma Son Acidrass La,1TURt; Or P�:c]f 4Srp w[71�t 2O—JlI tJG INVORMATION ( Uxr.i ca use Only ) X coo:; cr'uctior& of a now building ZONING DESIGNATION OF PROPERTY Additio1l to :t l�ui1Ji11t2 s PERMITTED PRINCIPAL pERMITIED ACCESSORY r �Alt�iation to a LLIildinij , REVIEW REQUIRED - PLANNING BOARD ZONING DOARD� — ( 114 ClLciWja to .:xcu. r .loc CIierion: !On:;l OtL :ur wr� rk ( aescriU.e} ' SITE PLAN REVIEW # APPROVED DATE ,r VARIANCE # APPROVED DATE GROSS AKEA OF 11ROPoseD% STRUCTURC Remarks 1st Floor 1148 s+q ft • + —`'� T�'� # A OjQ-iA'Y"LOH 1(L:QUII'LED IA1:WW , ? nd Floor 1218 sq f t . Compfmc'i'1 Ipl. ' Sile of Y�roiac.: rty 150 ft x 149 ft . Other Floors sg ft ' + iaci :tincj 17u11+1i111 ( :: } 5i : c . ( not cellar or basament ) TOTAL FLOOR AREA 2 366 sq f t . ■ ) xi sc Lnrj ❑uiLdifatj ( :> } Use: one '' ix� of new :�-tructur.: 52 ft x 36 f Iatsl,datian-Pier/slat/crawl/L�arti�.l tuZ 1'rOl�O +cd building , d"ta"C: from L.rol.+urty lino ( circle one: ) 2 Front and 82 Pt Rear yard 39 ft • y" N3o of stories (}uIJ4. c ihla :99ace) Side yards 75 ft and 35 ft 11..:ic1hG { tjradc to ridcYcl ft . If on Corner , surb;;LCk .from wide str,u," ,�o,.,,_r` t If r0ssi.dQntial, no . of falnilies w OCCUPANCY INFOf:MAT1pV No . of raom.&; ( QxcludinLj baths) tio. of budroom�: PItTMA►FiY IfUILDINL: No . of "throoms X Ctria family dwelling PCil :ary hL.:" Cinq uy:.• L , 111 Hot Air Two family dwelint3 •rylau Qf r%Aol Oil hultiple dwelling] / Number of units_ No . of firupplaed4a; tO ka.: .in::talle:ct 1 � Pcrinane:nt oCcuparlCy Will :a wood staVa: L, in:; tu114d ' Yes '1'ra»::iurtl~ oc;:cup"11C=y L•.:ntC:al Air ConditiunirLrj Na (iusi»c:5s BUILDING STYL-CI PRIMARY STRUCTURE „ Industrial � QcYcar i.:.111Ch Contului;or.cry Lcoq cabin 3t .addicilaa , w1l&tt will u: a tea 1.. ais+:cl ranch mansic.n D"JAL:x :Iplit 14.!Vcl Old scylo Uu+ 1'J.alow Co,I- a/ d Catt:ic� a Octc� r " ACCESSORY kiUILDINC^ C oni cl lcaw Yaw1� ]louse ' L L-Machad 9 "ragolono Cyr/ twn cur/ Car { CIRCLU cNI PLEASE } beta:k►uel rj.:aragu/ailo car/ two cart Cut• w a ■ • : w x ■ . a ■ ■ W + " itorugo }wilding L•: .`+ "1' IMA"Y' K [] N1ARKf:'1' V14i. Uli OL•' Ocher None Cott :: 'rttuC t xc� H .�' �.~l60a_000w00 1NFORNATION ON RUTLDTHC SPECIFTCATTONS , ON REVERSE SIDE: OF T"S wFIG;] , "1O Br; COMPL.C'rLD3 Form DPA 20/ 88 vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc _ Will any second-hand or ungraded lumber be used? If so , for what ? No Foundation wall material Concrete Thickness 8 " poured Depth of foundation below grade (to bottom of footing ) Will there be a cellar? YES Heated or unheated? lleatedFloor sq , footage 2 366 sq ft Will there be a basement? NO Will any portion be used as living space ? NO ( If So , what portion ? sq . ft . - - Type of use? Type of roof - sloped/flat/shed/other Material of roof Shingle Size , wood studs 2 "X 6 No spacing 16 " o . c . length 8 ft . J _ Joists ( floor beams ) lst . floor 2 " X 10 " spacing 16 "o . c , span 14 ft . Joists ( floor beams ) 2nd . floor 2 " X 10 " spacing 16 "a . c . span 14 ft . Overlays ( ceiling beams ) "X " spacing "o . c . span ft . Trusses Roof rafters "X60spacing o . c , span ft . Trusses Roof trusses (pre-engineered) spacing 24 "o . c . span 36 ft . Exterior wall finish Cedar Of what material ? Interior wall finish _ '�" Sheetrock If a garage is to be attached , describe materials to be used for FIRE SEPARATION : 5/ 8 " Fire Code Sheet:rock Is there to be an opening between garage and dwelling? Yes If so will a Fire-rated door , enclosure , and self-closing device be provided? S tee l Door Will a flue -lined chimney be installer'!? No Height above roof ft . Depth of chimney foundation below grade ft . Zero Clearance Depth of fireplace hearth 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 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 C'' ��.� - Owner, owner's agent', architett, contractor lor SPECIAL CONDITIONS OF THE PERMIT : _----- -- -------------- TOWN OF QUEENSBURY WARREN COUNTY * NEW YORK Application for : BUILDING pERAIIT IN COmPLIANCC WITH THE NEW YORK STATR ENE.RCY CONSEwRHATION CODE. A permit Must be obcai. ned before beginning wank . ANSWER ALL of tha following : 1 . _ Cross floor area 2 366 2 . Oil Type of heat 3 . is the building mechanically cooled ? No q . Percentage of area of windows and doors 15 % A . Over 16 % Only 1 , uo v :aluas of gross area of walls , roof/ ceiling and floors expasud to 4HLbient 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 yuS . what is the R value of insulation around parimer— : r of Floor ? a . Is bascu►ent heated ? YES NO a , ft value of insulation s . 'Type of ln :sulation Ei . Under 16 % OnLy i, it v .. lu .: os roof and Moors exposed to ambient eonditiana R 38 2 . R value of cxt " rior walls 19 -3 . R value: of glazed area 1 . 97 value of doors 11 . 5 ( Front Door ) steel 14 - 15 . 5 S . R value of floors over unheated spaces 6 . Ft value of slab edge insulation - unheated slab_ 7 . R Value of slab insulation - heated slab f) . R value of heated basemuAt/ cellar walls. tabove ' gradel � 9 . It value of heated baseMent/ cellar"" walls ( below grade ) 10 . Type of insulation Fiberglass C . Controls 800 1 . Thermostat maximum heat setting D . Duct Systems 1 . . I7 duce system installed in unheated spaces ? YES NO a . If YES , R value of duct installaition b . R value of duct in other areas ' E . pi +piney Insulation 1 , Size of hot water or cooling carrying agent pipe 2 . R values of pipe insulation F . Service Water Heating 1 . l' . rforux .anc .: eciiciesncy 87 % 2 . 'Peuw[sstraCura: control s; .: tting uk"x1ukusu 140 -0 - G . ror Swimming Pool Only 1 . Maximum h .: acing Telephone No . 583'- 2339 423- 0136 •. L " Sdpplicanto Igna re ) 's atiu�v car- QUEENSBURY APPLICATION FOR > ! SEPTIC DISPOSAL PERMIT DATE March 15, 1989 LOCATION OF PROPERTY FOR INSTALLATION Lot 58 Tyneswood Estates Owner's Name: Francis A . Purritano Telephone: 785- 5219 Address: 21 Mohawk Avenue, Latham, NY Installer's Name: ZONA DEVELOPMENT Telephone: 5 8 3— 2 3 39 4 2 3-- O 1 36 Number of bedrooms (residential only) 4 Total daily flow (compute (4 150 gal per bedroom) 600 Topography: Circle o Flat Rolling Steep Slope 96 of Slope Flat Soil Nature: Circle on :. Sand oam Clay Other /Depth: Feet Ground Water: At what depth? NI A Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one( ne Munic 1 Well Other If domestic water supply is a we Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank 1, 000 gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench 54 feet/Total system length 250 feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # 2 /Depth or Thickness 2 feet I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury. Sanitary Sewage Disposal Ordii3ance. SIGNATURE OF RESPONSIBLE PERSON: DATE: OVER Septic System Inspections : A . All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing : 1 . ) the 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 , Lila 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 $ 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 an immediate work stoppage . D . Should unforeseen problems during construction prevent proper installa— tion . alteration or repair of an approved systeiii , a new proposal must be submitted to the Queonsbury Building Department before further Construction & . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 k4suarks : , THE STATE INSURANCE FUND 199 CHURCH STREET, NEW YORK, N. Y. 10007 (212) 962-8900 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE EMPLOYER CERTIFICATE HOLDER I POLICY NUMBS Fi Y ZONA DEVELOPMENT INC . TOWN OF QUEENSBURY j 935 564--5 P . O . Box 912 Bay St . I Saratoga Springs . N .Y . 12166 Queensbury , N .Y . 12804 l UNIT PERIOD COVERED CERTIFICATE NUM13ER BATE. ISSUED 311fiIR9 to � - t. ."S 3/15/89 1 _. THIS IS TO CERTIFY THAT THE EMPLOYER NAMED ABOVE IS INSURED WITH THE STATE INSURANCE FUND UNDER THE ABOVE NUMBERED POLICY COVERING THE ENTIRE OBLIGATION OF THIS EMPLOYER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK- IF SAID POLICY IS CANCELLED OR CHANGED IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 5 DAYS WRITTEN NOTICE OF SUCH CANCELLATION OR CHANGE WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. ltt-*ic THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION . H. JACOBS DIRECTOR INSURANCE FUND UNDERWRITING U-26.3 (1904) ISSUE DATE (MMIOOfYY) A46w, moo CERTIFICATE OF INSURANCE PRODUCER DEC. . 14 , 1988 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW RYAN & O ' E3A1R.E AGENCY, INC* 1819 Fifth Avenue COMPANIES AFFORDING COVERAGE Troy , New York 12180 CODE SUB-CODESETTER Y A FEDERAL INSURANCE COMPANY B INSURED �y�, /� T- 7�+ p LETTER RAGONE- i'OUNDATIONS 11I� . []C COMPANY C ANDR.EW J . RAOONE 53 Wetsel Road COMPANY L�E-EI'ER B Troy ,New York 12182 ., 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' 93Y 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 7R DATE (MWDDIYY) DATE (MMIDDIYY) ALL LIMITS 199'l�I�Q�CrK GENERAL LIABILITY _ GENERAL AGGREGATE $ 1 rDl'111 X COMMERCIAL GENERAL LIABILITY g ` (� /yry Jp p /r-y /�}�y PRODUCTS-COMPIOPS AGGREGATE . y ' �00 DDQ . . CLAIMS MADE. x OCCUR. : 3527-62-92 5/ 7J 88 5J 9/ 89 PERSONAL & ADVERTISING INJURY S11 , 0L6 , 00 A OWNER'S A CONTRACTOR'S PACT, EACH OCCURRENCE $ 1 y 000 } 00 FIRE DAMAGE (Any one file) S . 1000 00 - MEDICAL EXPENSE (Any one person) S 10 , AUTOMOBILE LIABILITY COMBINED 4' ANY AUTO SINGLE $ 500 ,00000 LIMIT r x ALL OWNED AUTOS BODILY A SCHEDULED AUTOS 7�t� !l/ 7 (� /OO Cf pr NJURY 5 X 73016-O4-41 5�9/ 88 5/9/89 : Seer Person} X HIRED AUTOS BODILY X . NON OWNED AUTOS INJURY $(Per accident) GARAGE LIABILITY PROPERTY S DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE . A . x 7965-46-30 6/6/88 5/9/89 = 170w %0009 . OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION �7 / /t� p / / STATUTORY A AND 7021-22-25 S/ 9/ 88 5J 9/ 89 S' 100 y 000 (EACH ACCIDENT) EMPLOYERS' LIABILITY S 500lo 000. (DISEASE.POLICY LIMIT) $ 100300000 (DISEASE—EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIYEHICLESIRESTRICTIONSISPECIA.L ITEMS Limits shown may have been reduced by paid. claims . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Art Beauldegard EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO P . 0 . BOX 1093 MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Troy , New York 12180 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABI KIN N THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUT SENT E ACORD 25-S (3188) (DACOYRD CORPORATION -1988 dfL NSBOR lVT QF 4uEE DEPARTMENT 'j3vx N AND COD E5 suxL�rNG DS 1 �� BAY & HAVILAND 'R LW Y RK 128Q4 1 f ( 518 ) 92-5832 �TELEpHONEX. N �.3ILi37� INSPECT©B S R84?UES . FOR loop Io R�CExvEn s s NAM LOCATION pE xT # AppROVED .. DATE YES NO FOOTING/pl UR FO S MONOLITHIC p�PR FIND .ram .�..�-- FOUND+ATIONf D� HACK xLL APPROVAL" --�� ROUGH PwMSING FRAMING OUGH-xN F;LEC LATION :p` rNsv FOUNDATION FOUNDA FLOORS WALLS CEILrNG N : F.L NAL INSPECTxO CHIMNEY HEIGHT ROOFING SIDING pDRCRE61STO EXTERNAL A NCE & L F VAL� STAIRS-CL�IXTURESf pL,U,M.SING INTER-TOR 'TRI RSV FINISHED FLOO GARAGE FIREPROOFI LSO©R CLOSER (S ) SMOKE DETECTOR S x SPEC TI ELECTR OITa�TRU rON�� FINAL r FINAL APPROVAL OF CIC L55LTE C/o d MUST BS atc TO OF pANCY RE A SIGNET] OHH7CIFI BIJXLDING EPARTMENT gTsFO OBTAINED FROM TH RE OCCUPXVp THESE PREMxSES y REMARXS ' i k a ARE•I�JE JJ�,-� Grc�` INSPECTOR Ly�pA� TOWN OF QUEENS BURY BCILDING AND CODES DEPARTMENT BAY & HAVILA DDS 28[79L- QUEENSBURYo YO I792-5$28 TELEPHONE (518 ) 32 BUILDING INISPEC£ORI S REPORT R QUEST FOR I NSPECTJ.ON RECEIVED -^ NAME LOCATION A C} / PERMIT # DATE � -- -� AppgOVED YES NO FOOTING/PIERS MONOLITHIC POUR FOIWS FOUNDATIONjDAMP-rpWFING��_ �r BACKFII.L APPROVAL -� ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-INi INSULATION : FOUNDATION FLOORS WALLS t CEILING INAL INSPECTION : :y CHIMNEY HEIGHT �. ROOFING SIDING EXTERNAL PORCHES/ Psi----�- STAIRS-CLEARANCE 41RLIEF VALVE PLUMBING FIXTUREN INTERIOR TRIM/PR VA Y DOORS FINISHED FLOORS GARAGE FIREPROO ING DOOR CLOSER (S) i SMOKE DETECTOR FINAL ELECTRICA INSPE ION FINAL APPROVAL F CONS T UCTION CUPA�NCY MUST BE A SIGNED CERTI ICATE OF DEPARTMENT BEFORE OBTAINED FROM HE BUIL.DI THESE PREMISES ARE OCCUPI REMARKS: C�,a�o& INS TOR THE NEW YORK BOARD OF FIRE UNDERWRITER BUREAU C)F ELECTRICITY 41 STATE STREET. ALBANY. NEW YORK 1220 f Application No. on file 00 1� Date ,'.3. .. . E: `� ILl THIS CERTIFIES THAT rsmber in the premises R/ OMY the electrical equipment ss described below and introduced by the applicant narraed sat the above application n T 'i f . :'. + 1-�r Section Block Lot in th.ejalj~ing location: L�._ Baserraerat fat Fl. 2rtd Ft. 1 `F "[:'l1tF [' 1 1 `; •" " aced found to be in compliance with the req■sirernenta of this Board. UNIS examined on pxTURE FIXTIJEES RANGES C�pO1CiNr# DICKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECWTACLES SWITCHES IFICANOts "T FL OKSCEW OTHER AMT, K. W. AMT. K. W. AMT, K.W- AMT- K- W. AMT. H. P. i ! $*ULT"Wn" orwunl�!Is MOM FURNACE MpTORS FUTURE APPUAMM MV*RS SPECIAL REC'FT TIMECTOCKS EEU, I/WIT HEATERS SYSTEMS AMT wAns AMT_ K- W, dI H. P. GAS A. W. G. AMT. AMP. AMT, ARMS, TRANS- No. AMT. H. }. TtQ.OP FEET i Z SEEVICE dSCONNECT 4P S METER hID- OF CC. COND. A- W. G. 7r0- OF H4LEG A. W- G. Nil- OF HLIITRALS OF NEUTRAL AMT. AMP. TYR owmas 1 .r RW 1 X 9w S 0 ]W S.e Iw PER a OF CC- CaMD. Of HI-LEG O?HER APPARATUS: F' €. T 1%- Tyr; l � T r UP BRANCH MANAGER Par_ •t� This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. - COPY FOR BUILDING DEPARTMENT_THIS COPY OF CE TI_ICA E MU5 NOT E ALTE ED 1N ANY MANNER_ THE NEW YORK BOARD , OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ("'� q ,q 42. If41 STATE .STREET. ALBANY, NEW YORK 12207 T4"/-1 F Bate .I ' ', ` ' '. }"< - # . , Application No. om file , , , .•, s, . . , . THIS CERTIFIES THAT only the electrical equipmeme as described below and introdracod by the applicant named an the above application number in the premises of r, s; •Z . l' , 4�"+,i, l : .i - }- r-"' " i � S.. t . in the following location. Q Basement lst F7. 2nd Fl. P Section Block Lat was examined on J 'V ?-' i 1tl' (' I # I "-' " " and found to be in compliance with the requirements of this Board. NxTURE El�TACLES SYMITt9tEs FIXTURES RANGES COCWW40 DECKS OVENS DISH WASHERS EXHAUST FANS OUTIATS INC U DESCENTt KV00E5CE147 OTHER ANT. K. W, ANT. K. W. AMT, K.W, AMT. K. W, AMT. H. F. DRYERS FURNACE MOTORS RiTUE! AFFUANGE FEEDERS SPECIAL RWTT TIME CLOCKS EELL UNIT HEATERS MVIIILT�-OYTLET D�A6MER5 AMT. K, W" CAL H. F. GAS H. F. ANT. NG. A. W. G. AMT- ^Mpd AMT" ARMS. TRANS. AMT, H" r. S. STEMS AMT. WATM No. t3P FEET SERVICE. DISCONNECT No.oP S E R V I C E AMr, AAhP. TYPE MEQiNP. r /r sw k x avr s 1 sW s x rw No. coNn. ar cc ciiNo. r+o. GF w.LL� i s No. ar HEurnxLs CW NEUTRAL # k v 4 1 CMHS* APPARATM r . 1. I,# [ I .rr 9 ` ... . # . , - } BRANCH MANA09R This certificate mast not be altered in any manner; return to the office of The Board if incorrect. Inspectors may be identified by their credent0i61s. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT (1 BAY & HAVILAND ROADS QUEENSBURYP NEW YORK 12804� TELEPHONE ( 5-18 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST F R INSPECTION RECEIVED NAME! /J LOCATION ` DATE APPROVED YES I NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP'-PR FING BACKFILL APPROVAL ROUGH PLUMBING .FRAMING ELECTRICAL ROUGH-IN IIOSS U,LAT ION FOUNDATION `� O FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STE ILS STAIRS.CLEARANCE & PLUMBING FIXTURES/ LIEF VALV INTERIOR TRIM/PRIV CY ,DOORS FINISHED FLOORS -�- GARAGE FIREPROOFI G DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL I SPECTSON FINAL APPROVAL OF CONSTRUCTION -- A SIGNED CERTIFICA E OF OCCUPANCY MUST OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS : b Alt f A✓ LrS' - mn e ► € 77� INSPECT R af �pllJ �O �VnEPARYFAENI suILDINO and ZONING D } 'Box 98 gay and Hav+4and Road. R-D' pueensburY , New York 12801 NSPECTION SEPTIC DISPOSAL I } LcacAT ION q—� 2- / � I SEND DATE � � Clay - 1-- -�' E Sand - Loam Clay SOIL TYPE Test Req► ire Percolatio _ Min/ ch - Perc alatio rate TYPE of Sys ld . tote length AbSOrpt lOri Length Of eac iCCench Depth of trenc s S1ze of gr8,vel� ) SEEPAGE PITS�414 er . ft. x - size- -- TyPe Gravel size Size PIPING : �---� -Bldg • to tank Tank to disc' boy box to field YES 140 Partial I]ist . seal ed? opening s LOCA'I`x�fSEPA'1�AT ft. k ft . Foundation to t earPtivn £t . Foundation to �t line ft. Absorption its ane) P T (circle separation of h side Lk)CATTpN OF T ft side oo ig Fro�n�t��- Rear L. p VNTS ,- jL / 1 YES 0 SYSTEM USE pPPTtOV Inspector 01/13r' 'md vl _../own o� �ueen �beer+�{ BUILDYNG and ZONING pEpARTBox 98 Bay and Haviland Roadl R'D,ork I pueensbu(Y. New 2801 SEPTIC DISPOSAL SYSTEIM INSPECTION NA+E f � � PERMIT CIYY SOIL TYPE - San$ NO Percolation Test: Required? YES Min/Inch _ Percolation rate ``•- TYPE of SYSSE,Mt t' tal len Absorption field . Length of each trenc Depth of trenches Size of gravel SEEPAGE P ITS-(NW%ber Sire- ft. X ft. Gravel size S TU^[r PIPING : - ---- Bldg . to tan7G Tank to dirtw box rt Disto box to field/Pi D partial Openings sealed? L0CxTx0N/SEPARATI0II .Fo.undation to tank ft. Foundation,datian to abs t.ion line f t Absorption to to y -- t. 5eps.-I ti.orr of pi s PROPERTY circle one) ON Op SYST _ Rih side - _ gear - Left side g Fron TS : SYSTEM USE AFPPO*JED YES &NO S,aildingxspector 01/86 ind vl TOWN OF QlJEENSBURY BUILDING AND CODES DS PARTMENT BA & HAVXLANEW YORK ]. 280ar QUEENSBURYP 518 ) 792-5832 TELEPHONE f BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED a s 041 NAME f. irC� LOCI 11 PERMIT # DATE ��-�--- APPROVED YES NO FOOTrNGIPXERS FORMS MONOLITHIC POUR PROOFING FOUNDATIONAL L BACKFILL pRpVA ROUGH PLUMBI on G y� ."ING SIN ,ELECTRICAL OUGH INSULATION: FOUNDATION FLOORS WALLS CEILXNG FINAL rPlSPECTION : ' CHIMNE'l HEIGHT ROOFING SIDING STEPS EXTERNAL PORCHESL & RAILS MSTAXRS-CLEARA�SLRELXEF VALVE PLUMBING FIXT INTERIOR TRI PRIVACY DC7OR'S_-----�' FINISHED FLORS GARAGE FIRE ROOFING DOOR CLOSE (S) SMOKE OST ITORS L INrPECTION��_�-- FINAL ELEC FINAL APPR AL OF CONSTRVCTION��_ y OCCUPANCY MUST BE A SIGNED CERTIFICATE RTIFCATE OF BEFORE OBTAINED FROM THE BUILDING OCCu IEDIEPARTMENT THESE PREMISES ARE t REMARKS : _�Z C� i INSP TOR TOWjP OF QUEENSBURY BUILDING AND CODES DEPAR2MENT BAY & HAVILAND ROADS ORKI2$ 0 QVEENSBURY, E $ ? 792-5832 TELEPHONE 5 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION ,RECEIVED - s oil NAME ' LOCATION pERMIT ## f5 f DATE e~ d APPROVED tip�.•� YES Z40 FOOTINGIpIERS FORMS MONOLITHIC POUR FOUNDATIONIDAMP-PROOFING BACKFILL APPROVxlL ROUGH PLUMBING FRAMING ' ELECTRICAL ROUGH-- INSULATION: � F FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION ; CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESISTEPS STAIRS�CLEARANCE & RATLS pLUMBING FIXTURESIRELIEF VA VE INTERIOR TRIMIPRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOI° ,DOOR CLOSFR (S) ' SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCT A SIGNED CERTIFICATE OF OCCUPANCY MUST BE THESE PRE ROM TARE OCCUPIED3EpARTMENT BEFORE OBTAINED ISE REMARKS f 14 S i NSPECTOR I TOW RY BUILDING G AND CODES DE BUILDING AND CODES DEPARTMENT SAY & HAVILAND ROADS QUEENSBURY, NEW YORK ] 28+3¢ TELEPHONE ( 518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEXV ,ED NAME c� 7o LOCATION ae DATE �,��'?—.d_.•�`'� PE IT #� FJ *', � f APPROVED YES NO FOOTING/PIERS ' MONOLITHIC POUR FORMS FDUNDATXO N/D�P-PROOFI NG BACKFILL APP VAL ROUGH PLUMBING FRAMI N ELECTRICAL ROUGI}T-IN ULATION: FOUNDATION FURS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL POR HES/STEPS STAIRS-CLEA NICE & RAILS PLUMBING F TURES/RELIEF LVE INTERIOR T IMIPRIVACY DOOR FINISHED RS GARAGE FI EPROOFING DOOR CLOS R (S) -- -�— SMOKE DE CTORS FINAL ELEC RICAL INSPECTION FINAL APPR VAL OF CONSTRUCTION A SIGNED CE IFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BE THESE PREMISES ARE OCCUPIED' REMARKS: (I � 7 ~ ' �� � i�-•.� /'}.D �T N 4rriPEC R TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT DAY & HAVILAND ROADS NEWQUEENSBURY, EW DK 22805E TELEPHONE ( 518 ) 792-5832 BUILDING INSPECTOR' S REPORT (�!� REQUEST FOR INSP IQN RECE VED L�f NAME ` lA �' Sry co J LOCATION DATE PERA7 I APPROVED . YES NO FOOTINGIPIERS MONOLITHIC POUR FnRMS FOUNDATIO IDAMP`PROOFING _ _ BACKFILL A PROVAL ,RQ P'LUM ING MING i ELECTRICAL R UGH—IN { INSULATION: lee FOUNDATION F.T'.Qn'RS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH SISTEPS STAIRSS'CLEARA E & RAILS PLUMBING FIX RESIRELI F VALVE INTERIOR TRI IPRIVACY D&ORS FINISHED F ORS GARAGE FIR PROOFING DOOR CLOS (S) SMOKE DET CTORS _ FINAL ELEC ICAL IN,SPECTI0IV__ _� FINAL APPR VAL OF CONSTRUCTION y SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS : ,y 644 � INSPECTOR TOWS QU EEN S'BURY ND BAY, D BUILDING A r,�]�)yD ROADS CODES DEPARTMENT QUEENSBURY0 NEW YORK 1280s- TELEPHONE (518 ) 792- 5832 BUILDING INSPECTOR' S REPORT � RES?r1E FOR INSPECTION RECEIVED "T NAME LOCATIO`N� PERMIT #i DATE "1 I C7 APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR .FORMS V FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ' ELECTRICAL. ROUGH IA7�_ .INSULATION-. FOUNDATION. FLOORS WALLS CEILING FINAL INSPECTIO CHIMNEY HEIGHT ROOFING ,STRING EXTERNAL PORCHES/STS� - STAIRS,CLEARANCE & RAI°�,S PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PF[IVACY DOORS FINISHED FLOORS: GARAGE FIREPROOFING DOUR CLOSER (S)i SMOKE DETECTOkOS,INSPECTION FINAL ELECTRI"CA� FINAL APPROVAL `OF CONSTRUCTION A ,SIGNED CERT FICATE OF OCCUPANCY MUST BE OBTAINED FROMTHE ARE OCCUPIED ! EPARTMENT BEFORE PIED ? THESE PREMISE / REMARKS : 4 E f INSPECTOR TOWN OF QUEENSBURY ��,►j /� BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS /J QUE£NSBURY, NEW YORK 1280& d� � - TELEPHONE ( 518 ) 792- 5832 BUILDING INSPEC TOR' S REPORT VFQU+EST FOR INSPECTION RECEIVED NAME �y LOCATIO1V �'_ PERMIT # DATE APPROVED NO , pTINGf IERS r MONOLITHT POUR FORMS FOUNDATION AMP-PROOFING��, BACKFILL AP OVAL ROUGH PLUMBI -�—�- - FRAMING ELECTRICAL ROUG FN INSULATION: FOUNDATION FLOORS WALLS ti CEILING FINAL INSPECTION= J CHIMNEY ,HEIGHT ROOFING SIDING EXTERNAL PORCHES%`STEPS STAIRS-CLEARANC* & RAILS PLUMBING FIXTUfiES/RELIEF VALV S INTERIOR TRIM PRIVACY DOORS FINISHED FLOORS GARAGE FIRE ROOFING DOOR CLOSE (s) SMOKE DETECTORS FINAL ELFC'!RTCAL INSPECTION��� FINAL APPROVAL OF CONSTRUCTXON_�^_� A SIGNED CERTIFICATE CIF OCCUPANCY MUST EF OBTAINED FROM THE BUILDING DEPARTMENT BORF THESE PREMISES ARE OCCUPIED: REMARKS : I INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURYr NEW YORK � 28Oe� TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT RE<.)UEST FOR INSPECTION RECEIVED _ NAME LOCATION DATE S PERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING�_� BACKFILL APPROVAL ROUGH PLUMBING )FRAMING &6 ELECTRICAL ROUG —IN INSULATION: FOUNDATION f FLOORS r WALLS CEILING FINAL INSPECTION - CHIMNEY HEIGH ROOFING SIDING EXTERNAL PO CHES/STE STAIRS—CLE RANGE & RA S�.� PLUMBING IXTURES/RELI F VALVE INTERIOR RIM/PRIVACY R.5 FINISHED FLOORS GARAGE IREPROOFING ` t DOOR C SER (S) SMOKE ETECTORS FINAL EL CTRICAL INSPECTION FINAL A ROVAL OF CONSTRUCTION A SIGNE CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING .DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ? REMARKS: NSPECTOR ------------- s YOU ARE HEREBY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY THE UNDERSIGNED f r� TEMP N DATE COUNTY CRY OR VILLAGE TD�MJ5NIP fl I, J.. +3 f I ti POLE NUMBER STREET AND NO OR f iL [J f .�'r1 ./7) , ` " ..s s✓ /i' / N BLOCKLaT BETWEEN WHAT TWO CROSS STREETS IS PREMISES I.00ATcur SECTION BBILDING OCGUPAHCY OCGUPAMIT3 FLAME HOME TELEPHONE NUMBER GN'NER"S NAME AND AOpr1E`-t,-4 /1 --`�3 4 CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER BUILDING IS ADDITIONAL ❑ DEFECTS REMOVED p NEW OLD ❑ WORK 13 NEW LIST BELOW ALL EQUIPMENT W}#1CH YOU INSTALLED ND. of FlxtUMS & BRANCH DFFICE USE 4_Lxa- "*t-NUMBER OF OUTLETS MOTORS HEATERS CIRCUITS ONLY Lamp Receptacles tion Side Anwh'i H'c No. Each No. Gau9 a INSPECTION Ceiling Side ReceP'Is Switch penearn Bracket Na. Type Each OUT- SIDE SUB- BASE BASE- MENT T5[ FL. FL. FL. 3rd FL. REMAFIKS.: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ASCIVE: THIS APPLICATION IS INTENDED TD COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED, BUT IF AT TIME OF INSPECTION, THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT, AS PROVIDED BY THE APPLICANT FEEDERS ELECTRIC SIGNSILAMPS TOTAL VihTTS SIZE 4F MAINS � ,i �.� .4'. . Cr S TUBE SIGNnI NSFORMERS OF CHARACTER OF WORK ❑ EXPOSED ! '�.•-'��/ IwJ L-7 CONCEALED DATE COMPLETEO SIZE O SIGN INUMBER) ' GPAGITY E p4TE WORK TO BE STARTED _y MANUFK:I"I.IRER OE SIGN SERVICE ENTERS BUILDING n U CNERHEAD NDERC'RGl1NU kI GATE INSPECTION REQUESTED ON lOR AS NEAR AS PO531BLE1 jDEwENTiF�YC TION NTM hB LUMT R ID DELAYS BY +RIYINQ FULL AND RATE INFO TION- ALL PACE MU Be FILLED IN OR APPLICATION URNED. PRINT NAME AND ADDRESS DATE OF APPUCATkON •� N�1ME..QF APPLICANT`!1 /_- r i : r r' • .s a/ k . C i/1 n l < _+ C' c: : , , C:n 4 T PHONE ^-STREET AD/DRESS ZIP DOLE LICENSE NO. WHEN APPLICABLE CITY OR PO OFFICE. 0 85 John Street 41 State Street Il 584 Delaware Avenue ❑ 217 Lake Avenue 2Q2 Arterial Road NEW YORK, NY 10038 i ALBANY, NY 122D7 � BUFFALO, NY 14202 l ROCHESTER, NY 14606 � SYRACUSE, NY 1320E THE NEW YORK BOARD OF FIRE UNDERWRITERS