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1989-277 . . ,'�:S�.c."'yz ,�C:.�h-'�•�� r: 'ws',��ii xy ,� • ^- ..,..,��:rt'Yi;_.�, �: r r- t :.sy. c ;.yz .. -,..,. .. A i� CERTIFICATE OIF OCCUPANCY f TOWN OF iQUEENSBURY 4 I WARREN COUNTY, NEW YORK L)atre July 12 19 89 I Th��• certify •that work requested to be done as shown by Permit No, 89- 277 has been completed. 'This structure- may be occupied as a S i n g le Family Dwelling f Location Wtff Tr����rc I e j [7wner Rich Schermerhorn By Order Town Board TOWN OF QUEENSSURY Director of Bldg. do Code Enforcement 1 BUILDING PERMIT TOWN OF QUEENSBURY _ -Q No. WARREN COUNTY, NEW YOR K w w � cri t ko PERMISSION! is hereby granted to Rich Schey+ mar-hnrn coo OWNER of property located at Lot 411-0 Da 4 Tree Circle — Street, Road or Ave. in the Town of Queensbury, To Construct or place a ! i ngl a Family Dwelling at the above location in accordance to application together wlth plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is CIO 33 Harrison Avenue c� Glens Falls , N . Y . 12801 3C rn 2. CONTRACTOR or BUILDER S Norne 0 Self z a CONTRACTOR or BUILDERS Address SAME 4. ARCHITECT'S Name 5. ARCHITECT'S Address r c+ r-t 6. TYPE of Construction — (Please indicate by X) O XX ) Wood Frame { ) Masonry ( I Steel [ I o w x- 7. PLANS and Specifications - "1 No. 24 ' x 32 ' Single family dwelling as per plot plan , specifications , and application including septic and attached one car garage . & Driveway . Y -x S. Proposed Use r1a Single Family Dwelling rn 25 . 00 c/o $ 154 , 00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 1 19 89 �o 011 a longer par iod isrequired an application for an extension must be made to the Builds town of Queensbury before the expiration date_1 ng and Zonis 9 inspector of the 1r Dated at the Town of Queensbury this 101;h Day of May _ 19 89 SIGNED BY for the Town of O.ueensbury ui ding aril Zoning I vNpector e4 TOWN OF QUEENSBURY APPI, ICATTON FOR BUTLDINC AND ZONING PERMIT R e c.i ev eat u f'/ TOWN OF QUEENSBURY �- Reviewed eared �7' RECEIVED i+WA. fly Fee Paid fi { `� MAY 5 _ 1989 BUILDING AND CODES DJ ]1 A `l*f1ENfr Date I.aaued l'� BAY and trrlvsr.ANra rtoslDs R.o ,t Box 93 BLDG. & CODE ©EPT, PUEENSBUR r, NEIr YDIZK .228D4 PenrrlZt No . ' l ��l�I Tel " ( 51 B) 792-5832 Ex t 204 : A * r r « 'r * i r . • r r * : s se r a ,. r r a 7r * . x . ■ w s a : w * • A 1"FiRPIIT MUST Do OBTAINED BEFORE BEGINNING CONSTRUCTIONO NO INSPI:C"rIClNS VILL BE HADE UNTIL APPLICANT HAS RECEIVED A VAL3D BUILDINC PERMIT . All applicable spaces can this application must be completed and the �+ � Rllatute of the applicant must appear on the reverse side Of this s }Zcet . * A A A A it it is aL x % A A i� 9l k A The owner of this property is : Ric lard 2 sch !° � 02er bo col J r .I1 . 0o Address Avenue 1� f TCL . qp 5�! j1 ' 06 Property locationC. TAX MAP NOm � fa isas there )aeon any split of this property since October 1 , 1988 ? / N If yes , Planning Board Review is nelcyessaMr�y . ` i yes r ` Ito SUBDIVISION NAME. , IP APPLICABLE Flad Eva i11 � i5 E bduzISIM LOT NO . �I © H The person responsible for supervision of work as regards nuilding Codes is : ' Jr . - _ NAM1 P . t} . A DItLSS � ' RoI TEL . NO . Marne of }builder ^ Address Tel O clarass Tel Name of Pluantaer Y1 T. N:a�ne of Mason (' �rt �l rr�"I,,�I drew `rel. t 4 FAATURC Of r��:or �aw�1L zr.: rl „ ZONING INJ 'ORr�� TION ( uf fl cea use only ) Cnrt : Lructiar+ of " JLuw buildirr7 ArZONING DESIGNATION OF PROPERTY AdJitioet to a larailJijtg r PERMITTED PRINCIPAL PERMITTED ACCESSORY �Altvr"Lion to ;a, Luilding ( a &o cli:.nq. to oxr . rior climonsions ) REVIEW REQUIRED - PLANNING BOARD ZONING BOARD [1cY �wr work laor4cr .i bol ; SITE PLAN REVIEW # APPROVED DATE t (; DOSS ARLA OP PROPOSED, 1; TrtUCTUNi " VARIANCE # APPROVED RATE l s t Floor q 3_g sq f t . R Remarks : 2 nd Floor 2 37 sq f t . w COmPLETC 1nli'0144ATION RCQUIULD IAL LUW & Other Floors Kim sq ft . + Sizo of property /6-0r` ft x�_rt . ( not cellar or basc! utencl Lxi :tirug LuilJink] ( ::) Siuu !` c X ! t . q TOTAL FLOOR AREA sq f t " + Lxi�ting OwilJifkV (s) UZ of new scructuro I q ft Sc.3jLft roLuidaL ion-pi er/ ::late/crawl/partial/ full ; proposv.4 builuiag , disl:ance from I,ropurty lieu {+circles Oise ) Front y� rd f*t Rear yyj�d fit NJ . of stories Il4aI? iL:ahly' a:I�accl r ' -- ' 11uight ( shade to rid" ": ) Or Side yards _rt s nd rt �t r If on cc,rnur, :.:c: th"ck lfrolu Si du sc ruet C C 1 f r.: :: identiul , no . of f:.u�ilic: s Ito * of roatnu( oxcludinq ta"thsl 7 OCCUPAt4CY INFOI'MATION 110 . of 1>c droout No . at b:acltroouu.: 1 . PIi.2t471FiY AUTLD1lJC l',�•iu:. ry huati� �ra sys4 �u� y + �onc faiuily dwelling !'ylr.: of fu. l aa 4r 1wo f� auly dvelli.ny u:: to Lki int:CallvCi r lM1btlGilala: �iwi:lling / Number of writs NO . of fir.:L>lac Will :. WQQ J � L:aV� bu iet � t:. iiu+l ' �M1,�� S'urinanant occupastcy C#.:YLtral Air caaxditiun:i.etg? j n • Pra3ns:iurrc raicuiaancry ,� iiusiric:as BUILDING STYLC, PRIMARY 1TRUCTuj E � laclusc rial l..vitch Cont. �t�l:.'r.,ry Lcia c slain . Othar If "ddiziait , ulwt will ua:u bu? s;.ai ::ud rands Man::ic.�� Dul�l �x .3YaliL l .:vel old ;: Lyles Uux ���.xlaw L`"Vu Cod COLt: QL2 Otltu:r " ACCL3::G112Y 13UILDINC- u l orr a ls.ow Town 11ou. e ` DL; Cach%::d c- r/ two car/ c" r ( CIRCL2 ONLZ PLXA:OL l elaraciu i1a car two K:ar/ cal" s / w r ■ W • w w a ■ if x t r I'riv" Lct stor;A building V TXHATED _MhRKrT VALUE O/}!'/''� � �-Other ra t: ON `.:4111tUC"1' ICJN �' L ►�.,.as.c. 7Nr•'Or'.MATTON ON DUIL3TNC vPRC1PICATTONS , ON RCVERSV SIDE OF TliTS t.}il:CTO TO SO COMPLETUD ! Form BPA 10/88 v1 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 ? Wn Foundation wall material n n (& i"dQ Thickness Depth of foundation below grade ( to bottom of footing ) x , in + Will there be a cellar? Heated or <�iheated? Floor sq. footage �i Y sq fC Will there be a basement? )tLS'Will any portion be used as living space? 0 ( If so , what portion? sq . ft . _ Type of use? Type of roof - sloped flat/shed/otherSJ° Material . of roof VV Q " ic byi# - C& <6 �► �cS f Size , wood studs '" }x "' spacing "o . c . length ft . J Joists ( floor beams ) lst . floor "K_ �01" spacingjli:"o . c . span £t . Joists ( floor beams ) 2nd . floor "x `" spacing-_LJa_"o . c . span ft . Overlays ( ceiling beams ) Dix "' spacing "O . c . span ft . Roof rafters '"x '" spacing O . C . span ft . Roof trusses (pre-engineered) • spacingl�"' o . c . span ft . Exterior wall finish 'y' n +� ` q � - - Of what material? V I � � � C� � ,y� � J vy�� . Interior wall finish Da If a garage is to be attached , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue--lined chimney be installed? � ' Height above roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth..N..tLft , in . Hater supply - Municipal or private well 1p t JaCA ! SEPTIC SYSTEM _ Distance from ANY private well ( inc uding adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) DECLARAT10dN 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 speoified or not, and that such work is authorized by the owners. Signature Own , owner's agent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT : Dy --_ _-- -- TOWN OF QUEENSBURY WARREN COUNTY , NEW YOR1C Application for : BUILDING PERMIT IN COMPLIANC9 WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A ,permit must be obtained before beginning work . ANSWER ALL of the following : 10 . Gross floor area_ I to 2 . Type of heat 3 . Is the building mechanically cooled ? N) G A . Percentage of area of windows and doors_ „_ A . Over 16 % Only. 1 . Uo value of gross area of walls , roof/ ceiling and Floors exposud to ambient aondlutOns 2 . Floor over heated spaces YE NO a . Are foundation walls insu ated ? YES NO 1 . If yes , what is the R value ? 3 . Slab on grade < YES NO a . If yEss what is the R value of insulation around parimater of floor ? 4 . Is basement heated ? YES NO a , R value of insulation ,+ 1 5 . Type of insulation . �Jfsx D6 Under 16 % Only 10 st value of ro f and floors exposed to ambient conditions, 2 . R value of exterior walls -3 . R value of glazed area dq 44 R value of doors 5 . R value of floors over unheated spaces_ ? Ir Iy CIA � �-�--- 6 . R value of slab edge insulation -- unheated ? . R valu f slab ' n ulation he ted slab " 04 R al e f he ed seme t/ calla is ( abov grade ) 1 g . R a us f eared basement/cellar walls low r 10 . Ty of insulation 1 bf, r Lri fius' C . Controls 0 IV T11j.4rmostat maximum heat setting D , Duct. Systems l . . Is duct system installed in unheated spaces ? NO If YES , R value of duct installation law b . R value of duct in other areas E . Pining Insulation JI 1 . Size of hoc water or cooling carrying agent pipe_ 3 2 " R value of pipe insulation ^ 11A, --- r . Service Water heating 1 . Performance c: fficlency 2 . Temperature control setting maxlmu G . For Swimming Pool - Only I maximum heating "}� ~ Telephone No . ( applicant ' s signature ) TOWN OF QUEENSBURY APPLICATION FOR._ SEPTIC DISPOSAL PERMIT ry'C� DATE LOCATION OF PROPERTY FOR. INSTALLATION L J__ r-{ L 1 n tf \.i ye o& N r Owner ' s Name : cl ( y Telephone : L I � Address : ?' Installer ' s Name : ( } �° ►�lJ Telephone : q j 2 Number of bedrooms ( residential only ) �� ii / � Total daily flow (compute @ 150 gal per bedroom) '"I S o Topography : circle one : lot Rolling Steep slope X of slope Soil Nature : circle one : Sand Loam Clay Other / Depth : feet Ground Water : At what depth ? AZA feet Bedrock or Impervious Material : At what depth? _ dZAV feet Percolation test : circle one : not require required / rate min . inch . Domestic water supply : circle one ; Municipal Well Other If domestic water supply is a Well : Separation : Watersupply from Septic absorption Ar feet PROPOSED SYSTEM : Septic Tank jj"-Cr ' gal . (minimum size : 1 , 000 ,gal . ) TILE FIELD : Each Trench feet / Total system length feet SEEPAGE PIT ( S ) : Number of _ ^/ Size each _feet by feet Size of stone to be used # /Depth or Thickness feet Ik *1k 9k*at* *9r ik �t ye**ik is*ir iF it* * Ik ie 94 ok ik dr****�t**tt�r�e ik***Ye 9e 3k ok*1k k �Ir*ir** 1 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 Ordinance . Signature of responsible person : Date : (OVER) Septic System Indvpctions : A. All 9 r pplicationa for septic system installation : alteration or repair , as requited 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 . ) Ythe proposed location of the system 2 . ) - location and distahee to lot lines 3 . ) location and distance to structures 4 . ) - location and distance to any water supply SO size tend dimensions of all tankst distribution boxes , tile , €ields and /or drywells B , No system shall ;be covered before inspection and approval by the: Ruildin Inspector . Failure to comply with this requirement may result n 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 . V#ilure 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- tionf Alteration or repair of an approved system , a new proposal must be submitted to the �Oueensbury Building Department before further Construction . Town of Queensbury V4 BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 Remarks : wlrl// f * " !SSLiE D M ATE rMrpDlti'vl �. PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMFI4 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, COOL IPJ t R T, NG AGENC V I rNI PC BOX 2074 — -- COMPANIES AFFORDING COVERAGE -aL ENS FALLS NY 12901 CCII A AETNA L & C GF — — LETTEP COMPA'.Y INSURED —.�..v Lc-TcR B YR ZICHARD SCHERMERF OR'' N CGMAA^J'✓ 121A CRIANDALI STREET _ETTE C GLENS FALLS . NY 12801 cvMaaNv -E TEFI D ti,aar, E r THIS IS TO CERTIFY THAT 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 MA '+' BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS. AND CON01- TIONS OF SUCH POLICIES. -IA 3iL " - 'N 4 iH C US,i ",.CS CO TYPE OF INSURANCE j 'COLIC-v NuMBER LTR GENERAL. LIABILITY j � J CD41PRf iiEN51`dE =ORM i i i _ � _-.��--_- I� PRE III ES,0P€F ";S I Er(P 9XPO 0GROUND DAala.3E j C,� LOSIQN 8 COLL:,RSt rrlL=ARD I _ PRQDUGTS/CQMPLETED 'Q°ERA'IUNS jCONTRAti T;.:.Al ! B a: �u ,y $ '—�'I I i ^.firs a:.,=-• I IN0EPEND€VT CQNTRAC"'QRS BROAC -URfA PRpPERTf ::Ah1AGE ------- —�- —._. . PERSONAL !"+.;UR'r �--I AUTOMOBILE LIABILITY - ' i—�, ._----- — --- —.. - --� 'LL 'J'JI AUTi)S 'PRIV l PRIJ PASS �i H!I ED AUTQS —i i r' 014141ED a 'OS GARAGE _:ABL!T•� _ T J! .Y . s EXCESS LIABILITY UMBRELA 'ORM j I� OTHER 'BAN I.JMBRE_LA i A WORKERS' COMPENSATION {'� 1 C}JC 0@44J % C88G x"'. 6 / 0 1 / 88 L G6 / Q 1 / 89 i,-' ..� AND 1 Ct[•1 ------ ----- ' EMPLOYERS' LIABILITY 1- ='---�C) -------- - OTHER I j DESCRIPTION OF OPEe ATIONS:LOCATIC]NSN£HICLE S;SPECiAL 17'c".1$ CiiJEEhlSI3LJF2 Y BUILDING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- PIRATION DATE THEREOF. THE ISSUING. COMPANY WILL ENDEAVOR TO DER "I• _ MAIL , j DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE �, �.T ROBERTS � .�S LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY JII UPON THE COMPANY TS AGENTS OR REPRESENTATIVES. DAY ROAD AUTHOR E¢RESENT GLENS FArLLS , NY 12901IIIII If —�gEoTS ■ a DIY iL BBE x * x #SS UE DATE (MMroYJ PRODUCER 08 03 88 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Edward C . Hu he$ A eflC I nC , NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE ODES NOT AMEND, 9 Y s EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 152 Main Street Hudson Falls , New York 12839 COMPANIES AFFORDING COVERAGE COMPANY A EXCHANGE MUTUAL INSURANCE COMPANY LETTER INSURED LEnERNY $ PENNSYLVANIA GENERAL INSURANCE COMPANY Steven Allen COMPANY RD #2 , Box 2021 LETTER C Fort Edward , New York 12828 COMPANY LETTER COMPANY E LETTER THIS IS TO CER I W V THAT POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MOICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IS8UEDr OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TI•E TERMS, EXCLUSIONS, AND CONDI. Tk1N8 GF SUCH POLICIES. cc LTTS OF F I POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIM#TS IN THOUSANDS INSURANCE POLICY NUMBER DATE IMM4 DATE IMIIIDDIYYI EA MI AGGREflATE GENERAL LIABILITY OCCURRENCE A X DOAIPgEHENSNE FORM 119-2-67003 11 / 19/87 11 / 19/88 BODILY $ $ INJURY PREMrASIOMRATIOHS UNDERGROUNID PROPERTY EXPLOSION 6 COLLAPSE HAZARD DAMAGE $ $ X PRMUCT&CCMPLETEO OPERATIONS CONTRACTUAL eI a PD INDEPENDENT CONTRACTORS COMRYNEO $ 300 $ 300 BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY WMY B ANY AUTO BA 0023843 02 06/ 18/88 06/ 18/89 ftAAW 1PEF1 PE FISM $, r ALL OWNED AUTOS IPRN. PASS i r1I711r ALL OWNED AUTOS ( TH RPTASS ) IK r (PER ACME" $ HIRED AUTOS NON-OWNED AUTOS PROPERTY oAMApE $ GARAGE LIABILITY f, Spec i ' d A { O BI & PD 4r - COMBINED �' 1 ryri!'A EXCESS LIABILITY 000 UMBRELLA FORM coMR MEp $ F OTHER THAN UMBRELLA FORM A ))PORKERS' COMPENSATION 119- 3-67024 04/ 28/§8 04/28/89 STATUTORY AND $ (EACH ACCIDENT) EMPLOYERS' LIABILITY $ (DISEASE-POL{CY LIMIT) OTHER gFI no (DISEASE-EACH EMPLOYEE) DESCRIPTION OF OPERA TX4NS&C)CATIO"SJVEHICLESISPECIAL ITEMS • r Rico Schermerharn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX_ PIRATION D £ THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 112-1 / 2 Crandall Street MAIL �[] rs M/RTTTEN NOTICE TO THE CER IYFICATE HOLDER NAMED TO THE Glens Falls ,, New York 12$Ol LEFT. I FA TO MAIL SUCH NOTICE,SHALL IMPOSE NO DBLK?ATKMOR L ^DX.ITY OF ANY KI THE COMPANY GENTS OR REPRESENTATIVES. AU I D ESENTAnVE A0i►01 Ms CERTIFICATE OF INSURANCE ISSUE DATE iMM1DOJYY) 3/22/89 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS f NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, 11I NC)R 'I IN TNSUFaNG A6GE 1CY1 INC . EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW PO BOX 90 f Tn7E;Trr -rar.r.l NY 1288? COMPANIES AFFORDING COVERAGE I COMMPANY A CODE suB CODE UNITED STAVES E'Il7ELSTY & CRpIy COMPANY INSURED LETTER B F+'I '� I S FUND GR.ANVILT MASCNFLY 013N AC'TIORS 1 INC. COMPANLETTERY C & Tumu%IEM ` Ha BOX 33 COMPANY D MIDDLE GPjUw1Tx or NY 12839 COMPANY LETTERi COVERAGES 1 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 JS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. I €CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS LTR DATE (MMIDDIYY) DATE {MMIDDfYY} GENERAL LIABILITY GENERAL AGGREGATE $ 600 r A X COMMERCIAL GENERAL LIABILITY 1MP077482306 01 8/8/88 g/8/89 PRODUCTS-COMPIO'PS AGGREGATE S600 f CLAIMS MADE x OCCUR. PERSONAL 6 ADVERTISING INJURY S 300 1 OWNER'S B. CONTRACTOR'S PROT, EACH OCCURRENCE $ 3O ry I FIRE DAMAGE {Any one }ire) S V r Sol I MEDICAL EXPENSE (Any one person) $ 5 3 AUTOMOBILE LIABILITY COMBINED 1 3 SINGLE $ ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per Person) HIRED AUTOS BODILY NON�OWNED AUTOS INJURY $ (Per accident) GARAGE LIABILJTY ! PROPERTY S I DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM STATUTORY WORKER'S COMPENSATION �p p �y AND 2 38 WP 803'54461 8/Sf 88 8/8/89 $ 100 / (EACH ACCIDENT) S (DISEASE—POLICY LIMIT) ! EMPLOYERS' LIABILITY 50O I $ 100 (DISEASE—EACH EMPLOYEE)I 1 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIRESTRICTIONWSPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION TOM OF QLIMNSBUE1 Y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BUILDINGS D= , EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO BAY AND HAVEI.AIM ICAD MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 1 QC]EMSBUR'Yl NY 12$04 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIA81LITY OF ANY KIND UPON'6r0WRQWA*ry" I f+ T� cP.E1ESENTATIVES. AUTHORIZED REPRESENTATIVE �[`LL_ Sys ACORD 25-S (3188) OACORD CORPORATION 1988 TOWN OF QUEENSBURY C60 BUILDING AND CODES DEPARTMENT BAY & HAVILAN ROADS QUEENSBURY, NEW YORK 3280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR IINNSPECT N RECEIVED _ NAME /S 1� s/� 1 ,� �^' ""�� LOCATION f —►i_(re� / GGC ff DATE 'vPERMIT ## J APPROVED YES I NO FOOTING/PIERS MONOLITHIC POUR FORMJ\ FOUNDATXON/DAMP -PROOF. G BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN } INSULATION. L. F+auNDATI 1t FLOORS ILING INAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING " EXTERNAL POR ES/STEPS STAIRS--CLEA NCE & RAILS L _ PLUMBING F TURES/RELIEF VALV INTERIOR IM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSERS) .SMOKE DETECTORS FINAL ELECTRICAL INSPECTION — FINAL APPROVAL OF CONSTRUCTION A SIGNET) CERTIFICATE OF OCCUPANCY MUSTXE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: c'G INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS k / QUEENSBURY, NEW YORK 2 28 dji� +/ff TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED �r NAME LOCATION DATE .PERMIT ## ,APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR ORMS FOUNDATION/DAMP— OOFING BACKFILL APPROVAL ' ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION ' FLOORS WALLS GTkN LPeN'AL INSPECTION: CHIMNEY HEIGHT ROOFING x SIDING L. EXTERNAL PORCHES/ST$PS STAIRS--CLEARANCE & .RAILS PLUMBING FIXTURES/ ELIEF VALVE INTERIOR TRIM/PRI-)3rACY DOORS FINISHED FLOORS + GARAGE FIREPROOA NG DOOR CLOSER (S) SMOKE DETECTOR FINAL ELECTRICAV INSPECTION FINAL APPROVAL OF CONSTRUCTION i A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED: REMARKS: s'G f 4 INSPECTOR awn 0/ BUILDING and ZONING DEPARTMEN �T Bay and Haviland Road, R. D. I Box 980571`� Queensbury, New York 12801 SEPTIC ❑ISPOSAL SYSTEM INSPECTION NE1ME a LOCATIONr-7� I1ATI � PERMIT NO. F9 -,-S ^' 2/ SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch - TYPE of SYS Absorption ' eld , total length Length of ea h trench ZS 'Depth of tren hes Size of gravel- SEEPAGE PITS4N er/of) Size- ft. X` _ ft. Gravel size PIPING : Siz Tvr3e Bldg to tank �� Tank to disc. 3'lox G` Fisto box to ifieldy openings sealed? -,YES NOf artial Ls LOCATION/SPARATIONA; Foundatio to tank �t. Foundati n to absorptonft . Absorpt ' n to lnt line Separa on of pits "" ft. LOCATI YSTEM ON PR6PERTY (circle one) Front er Left side — Right side - r ■ � f lee 7 SYSTEM USE APPROVED YES / NO } Building Inspector 01/86 and vl TOW RY BUILDING OF QD CODES DE Bt1ILDING AND CODES DEPARTMENT �- BAY & HAVILAND ROADS QUEENSBURYt NEW YORK 12809- TELEPHONE (518) 792-5832 z4 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED r NAME LOCATION DATE -- / PERMIT # APPROVED YES NO OTING/PIERS ONOLITHIC POUR FORMS 24�0UNDATION/DAMP-PROOFING XBACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS! STAIRS-CLEARANCE & RAXLS PLUMBING FIXTURES/REk'XEF • VALVE INTERIOR TR.IMIPRIVAOY DOORS FINISHED FLOORS GARAGE FIREPROOFI DOOR CLOSERS} SMOKE DETECTORS T FINAL ELECTRICAL INSPECTION -- - - FINAL APPROVAL O j CONSTRUCTION r .t A ,SIGNED CERTIF LATE OF OCCUPANCY MUST BE OBTAINED FROM E BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: � Ail � 04 X INSPECTOR TOW RY BUILDING OF QD CODES DE BUILDING AND CODES ,DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809- TELEPHONE (5181 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR NSP TION RECEIVED NAME LOCATION IJATE PERMIT # jam- r /� APPRbVED YBS NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BAC FILL APPROVAL UGH PLUMBING virfRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: 4k CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH (STEPS STAIRS-CLEARAN E & RAILS PLUMBING FIXT RES/RELIEF VALVE INTERIOR TRI IPRIVACY DOORS FINISHED F RS GARAGE FIRE ROOFING DOOR CLOSE (S) SMOKE DETE TORS FINAL ELECT TORTS FINAL APPRO L OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!' REMARKS: r IN TOR _.. ivrx o/ Qeeeerrs eerey BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 4ueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME moo. r �c � LOCATION / s�3a�GG�ti ctft ' DATE f�/ PERMIT NO . w ! S TYPE - Sand - Loam - Cl Per lation Test Required? ES - NO Perco ation rate - Min/In TYPE of YMTEM: Absorpti fjel , tot len% h Length of ach rent Depth of tr nch s Size of grav 1 SEEPAGE PITS4NufabAr of Size= ft, _ f 3 Gravel size PIPING : d Size Type Bldg . to tan Tank to dis X Dist , box a ied it Openings eal d S NO Partial T M Li?GATI /SEP TIONS Founda. ion t tank f t. Found ion absorpti ft, Absor Lion It lot line fto Separation/ o pits ft. LOCATIONS' SYSTEM ON PRO TY (circle one) Front ear - Left side - Right side - C C MMENT S SYSTEM USE APPROVED YES NO Buj- d i Inspector 01/86 and vl TOWN RY BUILD G QD CODES DE BUILDING AND CDDES DEPARTMENT BAY & HAVILAND ROADS E t4C1¢ENSBURYr NEW YORK I2 T TELLEPHONE (.536) 792--5832 / BUILDING INSPECTOR ' S ORT REQUEST FOR IIVSPECTX04 REC 2V.ED NAME .LOCATION DATE / PERMIT # - � APPROVED YES NO L-- OOTING/PIERS MONOLITHIC POUR FORMS FOUNDA TSON/DAMP-PRO0PXNG .BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN ' INSULATION. Id FOUNDATION FLOORS 'f WALLS CEILING FINAL INSPECTION: �{ CHIMNEY HEIGHT r ROOFING ; SIDING EXTERNAL PORCHES/ST E STAIRS-CLEARANCE & ILS PLUMBING FIXTURES/R LIEF VALVE INTERIOR TRIMfPRIV Y DOORS FINISHED FI,OORS GARAGE FIREPROOFI DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL I SPECTION FINAL APPROVAL OF ONSTRUCTION A SIGNED CERTIFICA E OF OCCUPANCY MUST BE OBTAINED FROM THE 'aILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED: REMARKS to INSPaTR 00 to Cr 1151 OF WEENSF-"