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1989-435 �s R +r CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Llate 19 _ This is to certify that work requested to be done as shown by Permit No. 89- 435 has been completed. This structure may be occupied as�a umbty Location U e owner Higgs Ar C`. rsaUfnrri' Tuir- Hy Order Town Hoard TOWN OF QUEENSSURY Director of Bldg. do Code Enforcement BUILDING PERMIT 90 TOWN OF QUEENSBURY No. R9-4.15 40 WARREN COUNTY, NEW YORK I PERMISSION is hereby granted to 'a h OWNER of property located at Street, 'Road or Ave. in the Town of Queensbury, To Construct or place a 1110 1!at the above location in accordance to application together ;'h 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 Box232 bits Hudson Falls, N.Y. 12839 2. CONTRACTOR or BUk LDE R 'S Name G� rr4"D Self 0 "ra 3_ CONTRACTOR or BUILDER 'S Address Same 4. ARCHITECT'S Name C 5. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) C b (XKVood Frame { I Masonry { l Steel 1 I ]_ PLANS and Specifications No_ 261 x 361 Single Family Dwelling as per plot plan, specifications, and application, includingseptic, attached two car garage and driveway tz 8. Proposed Use Single Family Dwelling z tt� $ 213.00 PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 19 90 , (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.} C Dated at the Town of Queensbury this 24pd Day of 19 $9 SIGNED BY for the Town of Queensbury Build irg Zoning I nsgfe&or }'d d fti r h-i �" APPI. TCATTCIN FOR BUILDING, ANTI ZONING, 1' T: Ithli '!' C; LVI°',I OF QUEENSB URY Pee.tev TOWN OF QUEENSBURY 'e ^` Revez RECEIVED Fly r Fee Paid JUN 1 3 7989 tWILDINC MCI CODES U13"JUtT1'�erf yuCe Ieaued BLDG. & CODE DEPTw JAY land HAVSi.AND ROADS RD 1 DOD 9d pUEENSI3LRyJJJ, JJRI11 y0ill 12804 Pennlit No . Tejo (518) 792-w-I Ext .204 w x w r R w ar * rw w I s iw at u ■ A w ■ }r ze w f A at A A A w w r ! w w w w A 1' Eltl=tl '1 hIUS'I' lil pi31'AIN1iD I31; 1 CI1tE EL' GINTIINC CONSTRUCTION . NO INSP' 1= C'i` IC7iJ5 3E h111DE UNTIL APPLICANT IIAS 1:LCEIV]2D A VALID BUILDINC PERNIIT . WILL 1 All HADElicablc spaces on this application must be completed and the �; -i Rua ture Of Elie upl7l icant must al,pcar On tl� c reverse sick Of ttlis slacet . -Ax * * * * * * * h * * * * x x �: * * * x k * * * * * x * x x is The owner of this property is ! ! S +ll 6ille [' . O . Address A Ao /4s?ooFW W J r`� .SrG�.t+� G.4 GGAll T C L. 3 III _f. =- C' i�.H I'�s E TAX MAP 4 0 . z,,. / 13raperty 1acaian �+�' vo/ I,S7 7',ge ' iv o c9 fs+ T eSf . tlas there . been any split or the s prapert since Oc1Ma er 1 , 19Bi7 ? yesf a o if yes , 'Planning Board Review is necessary . LOT NO . SUBDIVISION WAML , IP APPLICABLE ' The person responsible for Supervision of work as regards Building ��f es isz �GH.4 r2.9 O•i'r7 /�i+.Y ..?�?- f L/y+93 Jill— f . O . A131] ItLSS R' 1 L . Na . NllMli !/C7Sl1JJ &.S.Cx'e1 ,Jame of builder / iS A itb fAcidress 5 � Tr�v 9cIII TG / r �,� Tel ?P,.l - "Z - Namo of Plulrabera�ES r.ddress rQJ %Eac/ /fy1LG Name of Maason ew Address 1'�/rG /3rP I "Cl�' !+/° f+ 'c --rc 1 .�YUf2 � Cif' 1'f:J7f'f]:4�(7 I,UI.I: : # 2 (INIPIC. LN1101tPllyTION ( 0f -I use an1. SJ ) 13 ZONING DLSIGNATION OF PROPI;R'1'Y SIc — Cnnatructiarr of anuw builcfir,aj * PERMITTED ACCESSORY AdJit ian to :a I.'suilaing PERMITTED PRINCIPAL r � Axtur:a � ion to :a 14uildi.ncj ,� REVIEW REQUIRED - PLANNING BOARD ?.OtIINC C3aA � ( fto ch, t 111 to exLL: rioc 41imQn4; ions ) SITE PLAN R3:VIGW 11 APPROVED DATE: UGlaur . Nark (+] u .crib�:l _ # VARIANCE N APPROVED DATE L; ItOSS ARL•' h �/ l :� t x' loor sri f t . 16 13 W Rcrnar}c5 nd F l oo r� 7 f rCJ s i t � e0iolV I.L'"1'1: , 1{Jl CSlt1a!►'P] ON 1tL:J1U13tI D L1L LULJ . _._ � * . : it of prolaarty / col tc x�`fC . OChCr Floors ft . l } isei ,acJ ( not collar or boondt ) .r TOTAL Fi.00R AIIUh. d sq ft . ` L: x.i:: tinq ouiLJintJ ,� ica of new : tructura _ yft tl roil di:: 4a.nCu J rou, �,ra7i u = tY line E'uu, sd:ation - icrJ+tS1aLJ/crawl/laarCital YAolao :;ec1 _ -- � P ft ( circle One ) Front y `_i r itc r �=� 11u . of Static :. 4xraUi>ralwlc :1lat: c ) � Side y;Ards rt :a is ltuirjklC ( tJracic. to ridqul s1 / ft • I.f on corner , :;u ;4, lc froin So dU : cr y It re :.1dL:nLial , no . u t` t ;unilia± :; 1_—_ 0CCUPANCY INFOTJ• ATICtN .5 ; tea , of room. Ta:at11 : ) _ rT - lk� G , 110 . of k�c:drrlo,nS # PR,I.MAj�Y IaLlILDIIJL: low � t„u� . .�k' ea . of I�:at=larCaaut :� ��_ - _one. rel,nily dwallioa t r . { r' L' x.•imary 1 w"LineJ �y :: srvns LtG'f'� 13h� "L'wo ivanily dwtyllin'J ✓ . •rylrc of ICual 1 C Multipla: �lwulli[>cl / tiur,daer J' urxit� [Jc] . of fi.r ilalacu :: tts b� ira It alla�cl Gl -- ' Painn"nualc act:up:uaCy aeill a ws�oal :; toV � k,u in : t:allu►l? ,+✓o 'Lransictac ca{ cul>srle y 6, Co.:ntr:al Air cot,I.xitiunir,cJ;'� � �° llusinua ; 3-RuCTURE Induce rial LiU 1 Li] 1 tVG STYLC, r+Rll1Al2Y 1 gt]aLr 1:_.c,latl Cony LG., cabin + IP .,d3itiiuea . wYlu'C will uc: c k,t:'l 1t..ai :.:ud ranch rtarissic„l Dili r sol.l Old scyl. uurtcj .. law OGlLil 1 " ACCL 3 .OfeY [SIJILDIHG -- car Cad Cot'C.:acj .: r Co cl[ai:.l i:ow 1'a . tl ] louse Lutachari cjsr:age,/anc cur / two ca r/ Ciaa' hccuchec:l cjurarJu,/'a,la: cur/ tua car { C1gCL2 DNE PLh LSI: 1 + - - w x • R a ■ '� x • • + w w x w �� 1' r .iv"t. o storage t�uilajinq l 1' 31•1A 'l• l: D M RK YK. L?',' U J� L. L, rilloomooloo 14 U C'L' I 0 N _. ,lc? _ _ _ _ Map No, - - , •ra 13I CaMrr.>r"rEDf LNF'ORNATTON ON BUILDING Sprcii' YCATTONs , ON Ri2vLR.SE: SIDE OP `TliiS 1klLl.. P , Form BPA 10/88 V2 TOWN OF QUEEN573UPY APPl. ICAIlrroN Foiz nuiL`DIHG AND ZONING PERMIT , 1�tz.ce- �" Peeieved Rev-Zewcd Fee Fcu:d fi WILDING MID CODES DEPA1117"�1'1' Date. I.00ued Ay III NAVTLAND ROADS RD I Fox 9d PUEENSDIIRY N hL , EI>r YORK 1 ?. 604 Pe/tY7kd.0 No . Tc1 . (51O ) ?02-58 ]2 ExC -204 .s +l R R R 'R +R R l R • YY '/r R • ■ R 1R llk R fil w • 4 R R # R w R w r ■ w' w K w A PERMIT NIUST Dq OBTAINED BEFORE BL•.CINNING CONST1tUC:TION . No INSPI:C'rIONS WILL BE 1.1ADE UNTIL APPLICANT HAS 1:liCEIVhD A VALID BUILDINC PERMIT . All applicable spaces an this application must be completed and the �; I* azure of the applicant ukust appear on the reverie side of this Sheet . &' k A u c o yt fc �c Y: l Y: �: Yt k k d: is !t ik * :t Yt is :k yt k �k fc is X * Millie owner of this property is : ,! /C.G .S /- G.e.s' L' . o . Address _ /3-ep w �.7. s+ roperLy location `TAX MAP No . r2/ / J etas there been any split oC thIs propertf since ❑ eto er 1 , 198II ? yes Ito if yos , Planning Hoard Review is necessarY . LOT No . 45 SULIDIVISION 14AMEO IF APPLICABLE The person responsible for supervision of work as regards Building Codes is : TEL * Not N1tNtL Plot ADDRESS �! �fb '� Address S"� /iiv ,¢c T6�+L' lS+f t dia me of k3uilder I' S / G'+'i r5 " �' r�'/Pi r chtl /y!/t G s J °'L:' +L� r P4 S Tel - c 5cs 7 N ut� or Plumberj:::� 7 fdf Tel 4 2 Ly Narne of Mason d.tJ Acldrass r'3� 1.tTUrts� OF I'rar+C�:t D rvCrl:f , : ZCINlr1r: J N1 oltH TION ( 0 -f - ce u5 � an1aJ " t^nn ; trucGioft of a nuw building ZONING DESIGNATION OF PROPERTY Ad:IiGion to alauila3ilig PERMITTED PRINCIPAL PERMITTED ACCESSORY + �nIL%jC : io» to :a building at REVIEW REQUIRED - PLANNING UOARD 7.oNING L3C7A1tD � ( rro clt:trsrj ..: to t:xt � rior clitrnonsionz; ) ; APPROVED D11TL'. Otlr� r _ Work ( de:Criut= ) SITE PLAN REVIEW i1 . W VARIANCE H APPROVED DATE -; k45s AREA .OP PHOL' 051I :; '1' LtUC 'I1Utt� It y f sq f t . ; Remarks IsL Floor �i 4� _ 2 nd Floor / - sq i t . w C(3tiPI.L''L'L - I�l1'f71:711►'i`loN Itf r„st11lcI�D !1L L ULI . Sipe oP lzralrurty / S.l- tit x re . Et . rG . aLhor Flaars tizl sq Exi�tinq )�u11Jiit•] I :: 1 Si: 1.' t ?t — ( not cellar or basement ) ,t _ 'L" o 'TA L F L.00 R AREA s �L f t ' ExiI bui ldintj GA List: �' ie car' new :: trucrure ft f L'x:urrdration-picrf�`.laL,�/ erawl/L>ar i tul " f'ruYso:; ed building . clir anc/f}}• traru L,rus�ue ty Sina p a- f pptLAcar yourd Et ( Citrelo onr: ) Front yard f Not, of sLariesi (hubitablo s"11�+ICC ] 'Z-I � side y+:.rduc _-_- _42 -Lit ft :and Iluit] Ilt ( yrada• to ]ClGltaul e ! Lit • II on corner , :jutback 1`rolA S1Llu : L" fi ( C r4 If reaiduntial , no . of Causiiie :: 1 oCCUPX4CY 1NFow*IICN ttoe of motor. ( excluding bL& r11:31 ^ - . - tlo . of budroosa�: _ - 1'RlMA12Y L. DUID114C Illt tlat of b Ljtroorsss �. ��-� — ,r �'`i_©nc �taruily dwalling t+ atury IIt ;aGiittJ :; y :: v~ eur GLGG� . i3rtSEf�o +Lwr� j"Ifti.ly dwullin+l ` - iIiiu of fu. i L<<C7 Multilalu dwt:lling / flutr,bar of tau . of fi.ruialaGc:4 LO la+. iis:;"Ilucl - do --� " * 1'crtin:anutrt accup;utcy i? will a wood :;Lova: L� ira : t«allec �d * +L+runsiurrt of cul�artc y L:"ntr:ai Air corttlitiranirt`3':� � UU4inuss LIUILDINC STYLE,, ('RIKA.IRY STRUC'l'UR „ lnclus4rial C1r.T7er is tnclt L ❑» Ge+�+I:• ,t.xry Lo`_' c:al3irt 3 f adrlitic�ia , wlrus will usi b. 7 s .ass. tl rant It !• an:.alGrt oul: l . x tJ sli ' luveI Cold acyi� UuiitialoN + ACCLSsaf y BUIL.DING '' Co Co Ltacj .•: OGltu a' C.1K 'I'or+rt Mousy Uutac}t.:.d y :arrrt� [:/one curl two c;ar/ Co oni"I l:ow � - two C*:tr/R._ 2� =cat' * AcLuchLtd t carat u �4,1� car/ ( CIRClI 014is PLl;TtSL ) - t- w ■ s w a R • ,. w w w R • iY :tC� =• GOriat� C 17t1ildin9 L ; l' IttA'1• I: D MnRr: r'r uA ►. vi, or • �'�l]Claur Lorl ::•rttuC 1 ZUNi �7c� C? .. _ INf•OPt7•sATTON ON uUILpING SpECI1' 1CATIONS , Oil REVERSE S10ro OF PHIS IILLC , L' Farm DPA I0f88 V1 BUILDING PERMIT APPLICATION CONTINUED - r BUILDING SPECIFICATIONS : Type of construction , wood framep fire safe , etc . Will any second-hand or ungraded lumber be used? If so , for what ? ekZ 0 - Foundation wall material prerG,cc 1E azaere Thickness_ /2, Depth of foundation below grade ( to bottom of footing ) ,:;Pr'"r Will there be a cellar ?Heated or unheated? Floor sq . footage sq ft will there be a basement? Will any portion be used as living space ? , ,d/ ( if so , what portion? sq . ft . - - 'Type of use? Type of roof - s ope flat,/shed/'other Material of roof ,r9. rV+PI size , wood studs_,x__"" X spacing .<,44 "o . c . length e ft . Joists ( floor beams ) lst . floor _ '" X "' spaainq "o . c . span / ft . .joists ( floor beams ) 2nd . floor - '"x ! o_ " spacing f& "o . c . spank ft . Overlays ( ceiling beams ) "X " spacing "o . c _ span ft . Roof rafters " x spacing O . C . span f t . Roof trusses (pre-engineered) spacing " o . c . span ft . Exterior wall finish what material? ,O65G '�'1441/ interior wall finish klr9CL - f1 .� � r �i If a garage is to be att ched , describe materials to be used for FIRE SE/BA RATION : Is there to be an opening between garage and dwelling? �S If so will a Fire- rated door , enclosure , and self-closing device be provided? Ves Will a flue-lined chimney be installed? 620 Height above roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . in . Water supply - Municipal or private well i(.1'iJ ! ! 91 . 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) DE +CLARATI0N rVo 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, TI-I13o 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, owner's agent , archijoi,061 , contractor SPECIAL CONDITIONS OF THE PERMIT : TOWN OF QUEFNSBURY Cr'4f- -^ .,�--_ APPLICATION FOR .� SEPTICDISPOSAL PERMIT LOCATION OF PROPERTY FOR INSTALLATION��.tw '��" Owner's Name: .g Telephone: %$�r� � t:;l � r,__ Address* Installer's Name: Telephone: Number of bedrooms (residential only) Total daily flow (compute (c3 150 gal per bedroom)_ 'r Topography: Circle one Flat Rolling Steep Slope 1% of Slope Soil Nature: Circle one Sand Loam Clay Other /Depth: Feet Ground Water: At what depth? 4 /n!!:!(- Feet4L7, /.7 Bedrock or Impervious Material: At what depth ? //, Percolation test : Circle one: not required equired rate min. inch. Domestic water supply: circle one• . unicipal> Well Other If domestic water supply is a we Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank �/oreT--yt.J gal. ( minimum size: 1 , 000 gal.) TILE. FTELD: Each Trench r feet/Total system length feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # 2- /Depth or Thickness / Z Z¢ 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 Ordinance. SIGNATURE OF RESPONSIBLE PERSON: DATE: OVER :'upti.c S ystt'1l1 Inspections : A 1111 applications for septic systew installation , alteration or repair , as required by Ciao Town of Queensbury Sanitary Sewage Ord finance , r:hall b � �. ubmitted to the Building Departruent at least 24 hours; before start of c .anscruction and ;: 1a:sll include a pleat plan showing : 1 . ) the proposed location of the system 2 . ) location and distance to lot lines 3 . ) locaton and di:; tance to L. rrucrures 4 . ) locaauloa and distance to any water supply S . ) r. zce and dime nsions of all tauk' s , distribution boxes , till fit. lIds rind / or drywulls h . Nc, r; ystelu oIlail be covered before inspection and approval by the liuiid :ing litspuctor , Failure to comply witti this requiromesat play in the uncuverini; of the sysrom by the installer and a fine uL Lila to T'2115 } . uo . C . Ail .approved copy of tiie plot plan shall be available on the construction Site . failure to produce said plot plan at time of inspt< ction may r� 5ulc in an immediate work stoppage . 1) , Should unforeseen problttms during construction prevent proper installa— tiora , alteration or repair of an approved system , a new proposal must 1)t �; ubiuittt! d to the QUu unsbury 13ulldirtg Department before further ruc t iiin . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and llaviland Road:; Queensbury , New York 12804 THE STATE INSURANCE FUND 199 CHURCH STREET, NEW YORK, N. V. IOOG7 (212) 962-8900 CERTIFICATE OF WORKERS* COMPENSATION INSURANCE EMPLOYER CERTIFICATE HOLDER i P01.1cv NUMBER Higgs & Crayford Inc 836 317--8 Raymond J Storms Contractor Inc 35 Martindale Terrace RD #4 Box 554 Hudson falls . NY 12839 Glens Falls NY 12801 I UNIT PERIOD COVERED CERTIFICATE NUMBER DATE ISSUED Albany 8/1/88 - 8I1I89 U- 543301 9 /2/88 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. THE STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION . H. JACOSS DIRECTOR INSURANCE FUND UNDERWRITING CERTIFICATE :-OF. INSURANCE ISSu 4 ATE DOrvYy 11189 PRODUCER i THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Edward C . enc Hughes A NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, g g I, InC . EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 152 Main Street — Htxdscln Falls , New York 12839 COMPANIES AFFORDING COVERAGE ---- .. .- -- - ------------ -. ....-..-. ..-._ COMPANY CODE LETTER ..A.. ... .. . . ...............EXCHANGE MUTUAL .INSURANCE COMPANY 119 SUB-CODE - . . ..._...... .... . . _. . ...- .-- - .............. _ -- ...-.-._.-.- - .. .. .. - . . ..-.- - .- ....- .. .... COMPANY B INSURED ' LETTER Kenneth F. Celeste Plumb-Ing & Heating. -T.nWMiPEANY C RD##1 , Patten Mills Road — G1enS pal Zs 4f New York 12801 COMPANY D LETTER l ......... ....... ..... .......... ........ . . .. .......... . ._ -. . .. .. COMPANY E LETTER CC7VERAGES : f <s, ' 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 DESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ _------. ._. __._. -T CO POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS TYPE OF INSURANCE POLICY NUMBER TA : DATE (MM/DDIYY) DATE (MMIDDIYY) .... .- - .-.. .. . : GENERA UABiUTY E GENERAL AGGREGATE $ 1 , 000 A X COMMERCIAL GENERAL LIABILITY 119-8-50042 4/1/89 4/I190 PRODUCTS.COMPIOPS AGGREGATE S 1 , Q8G CLAIMS MADE 1s OCCUR. ' 1 PERSONAL & ADVERTISING INJURY S OWNER"S A CONTRACTOR'S PROT. i EACH OCCURRENCE $ 50 FIRE DAMAGE (Any one }irel S —� MEDICAL EXPENSE NS (Any one person) S .--- ............ . . .. . ... .... . ... - - _. ... _.... . ; _ .. . ._.. _,.._.. ---- . . .. E AUTOMOBILE LIABILITY . COMBINED . 500 : ANY AUTO 119--8-80042 4/�2 /89 i 411190 LIMITLE S A X 3 X ' ALL OWNED AUTOS 3 NJO ILY $ x N SCHEDULED AUTOS (Per person) HIRED AUTOS _ BODILY I 7 INJURY $ X NON-OWNED AUTOS t (Per accident): GARAGE LIABILITY ' ' PROPERTY S : DAMAGE _______ . . . .. _._ _. . .. .. -.. . .. .. .. ... .. .. _.._........_ ._--..L . . .. .. _ ... .. EACH AGGREGATE EXCESS LIABILITY OCCURRENCE i i s s I OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION i _ STATUTORY A 119-8-60042 s 4/1/89 4/l/90 s ; 100 (EACH ACCIDENT) AND 500 i S i (DISEASE—POLICY LIMIT) EMPLOYERS' LIABILITY I 5 .. .1 0Q (DISEASE—EACH EMPLOYEE OTHER - I I I DESCRIPTION OF OPERATIONS)LOCATIONSIVEHICLESIRESTRICTIONSISPECIAL ITEMS CERTIFICATE BOLDER CANCELLATION Higgis & Crawford, .Inc . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 35 Mart-indale Terrace EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Hudson Falls , New York 12839 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE `. LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LL R 10 �� j; LiAMLITY OF ANY KIND UPON THE COMPANY, ITS AGENTS CAR REPRESENTATIVES. RECEITRID f17 ;zj AVT RIZED R EftNTATI 9 Y ACORD 25-S (3108) (CA CORD CO ON 1988 E R T I F I C A T E G F I N S U R A N C E ISSUE DATE (hH/DD/YYYY) : 11/23/1988 - ------- ------- .........................-...........................................-................... ---------- PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO I Jack Robinson Assoc. , Inc. 1 RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AT1Eh9q T PO BOX 47491, 116 Aviation I EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DELON. # Oueensbury, N. Y. , 12804 1 ----------—----—-------------—_______ _________________...._______ .......... CODE SUB-CODE I COMPANIES AFFORDI NG COVERAGE k ...............................__I ..........-------____ -__ _-_------- IN5URED ! COMPANY LETTER A: FIREMAN' S FUND INS. CU. 1 Higgs 8 Crayyford, Inc. I COMPANY LETTER Be k 35 Rartindale Terrace # COMPANY LETTER Co T Hudson Falls NY 12839 - 1 COMPANY LETTER D: 1 COMPANY LETTER E: I I COVERAGES =_____��___________________ _'______________-=-=--==-_ ............................... THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED RBUVE FOR THE POLICY # PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CUR➢ITION OF ANY CONTRACT OR DINER DOCUMENT WITH RESPECT i TO WHICH THIS CERTIFICATE MAY RE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREi"A IS I SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS O SUCH PULICIES. LIMITS SHOWN MAY HAVE BEEN RLOWED BY PAID CLA10169 I ____------------___ _____------------___ __ .. ................................___--------------------_--- I CG I TYPE OF INSURANCE I POLICY NUMBER I POLICY [POLICY EXPIR-I ALL LIMITS IN THOUSANDS I LTR1 I IEFFECT. DATEI ATION DATE i 1 I I I MMIDDIYYYY I MN/DD/YYYY # I --- I ----------------------------------1 --------------------------1 ------------I ------------- I -------------------------------- - k IGENERAL LIABILITY I I I 16LNERRL AGGREGAIE I >` I IC ]COMMERCIAL GENERAL LIABILITY I I E IPRGDUCTS-COMPiOPS I r I I I k I I AGGREGATE 1 t I I C ]claims made C ]occurrence I E I 1PERS. d ADVERTISING # # I { k I I INJURY I t I IC ]OWNERS 8 CONTRACTORS PROTECTIVEI 1 I 1 I # k I I I IEACH OCCURRENCE I t [ IC ] f I I I F IHE DAhAGt (ANY ONE I T { I k I I FIRE) I f I 10 ] ] 1 I IHEDICAL EXPENbE (AN ( I I I I I I I ONE PtRSUN) I f T --------------------------------E --------------------------1 ...---...---E -_----------_ I ----------------------I -----------I IAUTOMOBILE LIABILITY - k k I ICOMBINED SINGLE LIMIT 1 L I EC ] ANY AUTO 1 1 I IBUDILY iNJURY # 1 1 [ ] ALL OWNED AUTOS I I I I (PER PERSON) 1 f # IC I SCHEDULED AUTOS # I I IBUDILY INJURY I # 11 ] HIRED AUTOS I E I # (RER AuCIDENE) 1 t # IC ] NON-OWNED AUTOS( { I { I i # 11 ] GARAGE LIABILITY k E I iPROPERTY ➢kMAGE I i ! # C ] I I 1 I I I #EXCESS LIABILITY I I I I EACH OCCURRENCE AGUREGAIE I { C ] 1 E I # I IE ] OTHER THAN UMBRELLA FORM I --_I ---------------------------------I .....___-------------------i ------------ I ------------- I ---------------------------------- { A I WORKERS' COMPENSATION 1238MHX80298399 k 5/02/1938 1 5/02/1989 ISTATUTURY I I AND 1 I I 1 S 100 (EACH ACCIDEN' ) I t I EMPLOYERS' LIABILITY I # k 13 5vo (0ISE.ASc-POLICY Li+dill I I 1 I 1 $ 100 (DISEASE-EACH EMPLOY'. ) # _ { ----------------------------------I ----_ ...................__ I ------------ k ------------- k ------------------___------------ I I OTHER I I I I # I l I # 1 --------------------........----------------------------_____-...........................-.............------------- ------- --- i DESCRIPTIONS OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS I I # l = CERTIFICATE HOLDER =______= ___-_==___= CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE # TOWN OF OUEENSBURY I EXPIRikTIOH DATE THEREOF, THE ISSUING COMPANY WILL PIDEAVOR iU ?tAIL i TOWN OFFICES # 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, I ,DAY RD., k BUT FAILURE TO MAIL SUCH NOTICE SHALL INPObE fIO UT3LIGATIUN UR LIA81L- 1 QUEENSDURY NY 12804 1 ITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVESm I # -------------------------------------------------- __ ---- ...... I AUTHORIZED REPRESENTATIVE 1 ----..........-...... ---------- ____------I -------------------------- _--------- -�_-cam"-�� * �---------------- -# CORD 25-S (3/88) ACOkD is a reni5tered trademark of ACURD Corporation TOWN OF QUEENsBURY BUILDING AND CODES DEPARTMENT BAY & aAVIrAN'D ROADS QUEENSBURY, NEW YORK 22803- TELEPHONE ( 518) 792-5832 BL3IIJ7ING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE / 7 � �-PERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FO'J`NDATIONf DAMP-PROOFING BACKFILL APPROVAL ROUGH PNMBING FRAMING ELECTRICAL`. ROUGH-IN (,INSULAT-ION L.w -FOUNDA 2'ION FLOORS WALLS CEILING FINAL INSPECTION**, CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ /yF5 STAIRS-CLEARANCE RAID PLUMBING FIXTURE fRELIEF VALVE INTERIOR TRIM/F IVACY DOORS FINISHED FLOOR GARAGE FIRE RR FING DOOR CLOSER ( SMOKE DETEC RS FINAL ELECTRI AL INSPECTION FINAL APPROV OF CONSTRUCTION ' A SIGNED CE TIFICATE OF OCCUPANCY MUST BE OBTAINED FR THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS : NSPECTOR TOWN OF QUEENSBURY � .BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS { ' QiUEENSBURY, NEW YORK 3280k TELEPHONE (518) 792-5832 BU I LL`1ING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION, DATE " P - IT # L_ c J APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL .APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—I INSULATION: '}FOUNDATION FLOORS WALLS ZILING ✓f IN' AL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORC ES/STEP STAIRS—CLEA NCE & .RAILS_ ' PLUMBING FI TURES/RELIEF VALVE INTERIOR T MfL'RIVACY DOORS FINISHED F RS GARAGE F .PROOFING DOOR CLOSR (S) SMOKE DETECTORS —.— 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: IN PECTOR 1 MIDDLE QEPARTM N AGENCY, INC. 904. � f QiYloo ; 1p8 oft August zl, 1989 Ctrfif ie5 that 1 qt is a quipment fisted has s been xamined and is approved as being in accord with the National Elect d, plicabie governmental, utility and g$1 r s. Owner: Higgs & Cray Id 4CP Dwell Occupant. Single Fami Q upper Sherman- e>'6 ens u a en o Lmlion: de t¢,cate ca a these prent and installalion inspected thta date. If additional equipiPfentIshou 4e introduced or alterations made to existing system II46 caocalla WMI he null and vald, and applicator for inspectiEquipment' 100 Outlets ' BeCeptaCle$ •1� xt S" lderothiscdlicalamdtedp. entsaneptly tohdnoy. } .f cider of this oecr�ficate shs�uW ent same to nis property insurance carries 2� Amp SerYic AlplYanceB Sagentor company)nevi eftificationof electrical equipment approved as spec lied. F Bill Coleman Si CE 1983 Applicant; Box 512 O• 15425977 L Hudson Falls, NY 12839 x a TOWN OF +QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUFiEN.SBURY NEW YORK 1280$ TELEPHONE (518) 792-5832 --� BUILDING INSPECTOR ' S REPORT REQUEST FOR .INSPECTION RECEIVED NAME LOCATION a ry DATE _�'j .__.� _._—PE T {E_ % APPROVED YES NO FOOTING PIERS MONOLITH C POUR FORMS FOUNDATIO DAMP-PROOFXNG BACKFILL A PROVAL ROUGH PLUMB NG FRAMING ELECTRICAL R GH-IN INSULATION; FOUNDATION FLOORS WALLS CEILING i = 7 2r t _ FINAL INSPECTION. CHIMNEY HEIGHT ROOFING SI DXNG EXTERNAL PORCHES PS STAIRS-CLEARANCE RAILS PLUMBING FIXTURE LIEF VALVE INTERIOR TRIM/P VA DOORS FINISHED FLOORS GARAGE FIREPR FING - DOOR CLOSER (S SMOKE DETEC S FINAL ELECTRIC L INSPECT . N — FINAL APPROVA OF CONSTRU ION A SIGNED CER IFICATE OF OCCU. NCY MUST BE OBfiAINED FROM THE BUILDING DE RTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: }Y I sPECTOR awn o/ Qte ee n s 6 ee r y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. O] 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 241e A6602 , LOCATION 4(5� r� yy- l..,a .• �Ae DATE L �r— PEWIT NO . eqo- SOIL T - Sand - Loam - Clay - Percolat n Test Required? YES - NO Percolate rate - Min/Inch TYPE of SY EM: Absorption eld , total lth y � u Length of ea h trench Depth of tren hes ' 73 Size of grave SEEPAGE PITS#N er of) Size-- ft. X ft. Gravel size - PIPING : Size Tyke Bldg . to tank Tank, to diet. box Dist . box to field/ t. openings sealed? s NO rpartial LOCATION/SEPARATION Foundation to tank f ft. Foundation to absor io ft. Absorption to lot ne ��ft_ separation of pit " ft. ON OF SXS ON PRO RTY (circle one) Front Rear - L ft side - ight side - SYSTEM USE APPROVED ES NO Bui ng Insp ctor 01/86 and vl TOWN OF QUEENSBBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURYr NEW YORK 1280AE TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME =+1- LCCATION DATE �j / PERMIT APPROVED YES NO FOOTING/PIER MONOLITHIC R FORMS FOUNDATION/D —PROOFING BACKFILL APPRO L 4��OUGH PLUMBING AZI FRAMING ELECTRICAL ROUGH N INSULATION: Ir FOUNDATION FLOORS d' WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE /STEPS STAIRS—CLEARAN & RAILS PLUMBING FIXTUPES/RFL-TFF \\VALVE INTERIOR TRIM PRIVACY DOOA9 FINISHED FLoOdRS GARAGE FIREPROOFING DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: It ow" INSPECTOR TOWN OF QUEENSBURY LUILDXNG AND CODES DEPARTMENT BAY & HAVILAND ROADS t` QUEENSBURY,, NEW YORK I280!I& TELEPHONE (5I8) 792-5832 BUILDING; INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME _ LOCATION DATE PERMIT # - APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOF"X NG BACKF.1'LL . APPROVAL e.+ROUGH PLUMBING L/PRAMXNG ELECTRICAL ROUGH-IN INSULATION. FOUNDATION FLOORS WALLS CEXLXNG i FINAL INSPECTION. CHIMNEY HEIGHT ROOFING i SIDING EXTERNAL PORCIMS/STEPS STAIRS-CLEARAACE & RAILS PLUMBING FIX URES/RELIEF Vj4LVE INTERIOR TRI /PRIVACY DOORS ' FINISHED FL4 RS GARAGE FIR ROOFING DOOR CLOSRO (S) SMOKE DETELTORS FINAL ELECTIfICAL XNSPECTXON FINAL PROtA.L Oyu CONSTRUCTION A .SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUpXED! REMARKS: S 2. `/J9 0 �. �f� [�' � UAIJAA ECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT lC~�1 BAY & HAVILAND ROADS QUEENSBURY, NEW YORK .22804- TELEPHONE (5I8) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED _ NAME - LOCATION c? 1G y DATE" IT # APPROVED YES NO FOOTING f PI ERSS MO LITHIC POUR FORMS jiv DATION/DAMP—PROOF2NG BACKFILL APP . ,VAL ROUGH PLUMBIN FRAMING ELECTRICAL ROU --IN INSULATION a FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ E STAIRS—CLEARANCE & RA PLUMBING FIKTUR IRE= VALVE INTERIOR TRIM/ IVACY RS FINISHED FLOG ti GARAGE FIRED FING E _ DOOR CLOSER { ) SMOKE DETEC RS FINAL EIXCTR CAL INSPECTION z FINAL APPRO L OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: / INSPECTOR TOWN OF QUEENSBUR'Y BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS / QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSP CTION RECEIVED NAME T LOCATION DATE 2 7.PERMIT APPROVED YES NO OOTSNG/P-rERS t" 4► MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING --- BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGffi4jN INSULATION.- FOUNDATION FLOORS r WALLS Nd CEILZNG r FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/S PS ' STAIRS-CLEARANCE & RAILS _ PLUMBING FIXTURES RELIEF VALVE INTERIOR TRIMIPR ACY DOOtj$ FINISHED FLOORS GARAGE FSREPROO ING DOOR CLOSERS) SMOKE DETECTOR FINAL ELECTRICAL INSPECTION ......................... FINAL APPROVAL O CONSTRUCTION A SIGNED CERTIF ATE OF OCCUPANCY MUST BE OBTAINED FROM TH BUILDING DEPARTMENT BEFORE THESE PREMISES A E OCCUPIED! REMARKS: r` INSPECTOR - SELECT 6USINESS FORMS (609) a4a-5203 APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 Date City, Town or Township .{�'.d fe w-+� �f++/c� y�r County_ . 4o4e<e1 ' +T +2 State Location/Address CXGf (If Located in Mural Area - Please Atfach Directions) Pole # ( ! Owner_- [r& �� OI --c- Permit # Occupied As Building: NewK Old 0 Occupant Work Area in Building Floor #, etcj : for: Wiring ® Service ar: Ready for Inspection : Fee Remitted - $ Cash Check 0 M.O. Make Payable To: M_D_ i.A_ Number of Rough Wiring Outlets Elect_ Heat 500 xso 100 1250 150o also x000 2x5o xsoo x75o 3000 Switches 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 Fractional H.P. Vent Fans Other Equipment: MOTORS H.P. 1/2 1/12 1/10 1/a 1 1/6 1 1/4 1/3 1 1/2 3/4 1 1 l4x 1 2 3 5 71k 10 15 20 25 30 41, 50 75 11110 Mark Number of Each Size s .. Applicant's Signature A or or License # Permit # T/A Utility : AMEj (OFFICE LOCATION) Applicant Address : AX (City) �y filrfr� (State) - (Zip)4 ;2"-�r7 'Service Request # Phone # G7 'Electrician : DATE RECEIVED: DATE INSPECTED: Correct Location : Same as Above [] or: Red Notice Label Q Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles 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, 1/20 1/12 1/10 1/B 1/6 1/4 1/3 1/2 3/4 1 l�Ix 2 3 5 7Yz 10 15 20 25 30 40 50 75 100 Mark Number of Each Size 500 750 1000 1250 1500 1750 2004 2254 2504 2750 3004 El Patrick J DasMais :t. Heat ; ;tiM1<4} Iiudsf��i8i79�-3�312g39 ELECTRICAL INSPECTOR .TIPICAUSE FOR IIMfTIJIiL VfS1Tf411lf "I 4M NOTIFIED DATE CORRECTPESO FEE t P 0 RW Progress; Inc. 71 LKD 0 Contractor CFT Violation : Work Comp. E:3 Inc. 0 © L/A Owner CASH = L/A Fee due CHK #[] IPA Municipal MO # INV # Date: Other Side © Utility Applicant Owner Cut in Card 0 Temp # Date P.O. Box 232 35 Martindale Terraee Gy�s � ]l Hudsonon Falls, NY 12538 [576] 747-0631 MICHAEL CRAYFORD Webster Management Associates President ANN LAREAU Project Coordinator DAVID L. HIGGS Secretary-Treasurer Queensbury Building Department Town Hall Queensbuiy , NY 12804 Gentlemen : This is to certify that I have in my possession plans for the house at AUKe0 //rra ` '. ram' ,el f//i"a v *r %.Pr r/ + + which bear an original stamp of George Kurosaka dated 3/7/j:� indicating his review and approval . This plan is available for public inspection during normal business hours by calling 747-0631 . S eerely , David L . Higgs Secretary/Treasurer WEBSTER MANAGEMENT ASSOCIATES