1994-614 - - '____.'= 1
CERTIFICATE OF COMPLIANCE
TOWN Of QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
'44614
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be used as a RT(7F BUILDING , 24 BY 10 "!'.—
Location
Owner
By Order of Town Board
TOW O F �►1►t
Director of Building & Code Enforcement
BUILDING PERMIT '�1
TOWN OF QUEENSBURY _/,,f['
No. v/` 7
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to A'tQLl r`! C"'. Lehi. ui, +z
R3
OWNER of property located at Phod jzo nd Ave I C'ir1/1 / Street,Road or Ave.
n i ) y, �
in the Town of Queensbury,To Construct or place a L ,•)a 1 6tOr'Q gP_
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.
1. OWNER'S Address is
t�
2. CONTRACTOR or BUILDER'S Name e'
Doll Ward
3. CONTRACTOR or BUILDER'S Address /"
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
(x)Wood Frame ( )Masonry ( )Steel ( )
7. PLANS and Specifications/� L
No. O'q fT i 10 t f 7-' 5 r q-e bui(dt✓ c1 06 per- pIof plan
5 peu f►•ems.-�;o ovtd Q pp! ccs-,vvt
8. Proposed Use
goal- 6.4-crcit-e 61 Id` '1 7
$ 15.00
PERMIT FEE PAID—THIS PERMIT EXPIRES OdObc 3/ 19 95
(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.)
Dated at the Town of Queensbury this '3k+ Day of AC4 ober 19 91i
SIGNED BY aft for the Town of Queensbury
Building and Zoning I ctor .j.
S.
TOWN OF QUEENSBURY
DEPARTMENT OF COMMUNITY DEVELOPMENT "' '_.:, "
w o APE' '
P • r Application
P BUILDING PPRMIT NUMBER l ` z OC
2
III qq_ uy okra
T
V-p-tcf . 0 ,
N a I. BASIC/BUILDING PERMIT INFORMATION: A "
a. Applicant/Name & Address Agent/Name & Addres7',/.4.,
applicant agent
A. rr �
0 n �. -;Grcil
0
n :1 H
IliMiiil
i.'uer's Nauic Address M
N /�au.ri'6e/-- t z Pro ,erty Address
R11 - . ',.� / ,t- w
�`, 6 ri,- --2(s tl AO
2. PROJECT DESCRIPTION:
b(C + 3_ -e _bi _1ci,.) plot plan (2 copies)
_ / 0 building plan (2)
75 ❑ sewage disposal
Li energy code
3. PROPERTY INFORMATION: Delectrical inspection
Ddriveway permit
ENZEIMERIENIErill Ocotnpleted/signed
ErFEE PAID
I rant Yard 3O�CD
� Front ( if co r) 3U' l i.•-,e..Side Yard (I) D NEW CONSTRUCTION
)�d ^ ,U, 3-6 - a ADDITION
Rear Yard 1 U' qU
a ALTERATION
Width a MCDIPICATION
Depth 0 SINN
YES NO N/A
in PROPERTY IS IN APPROVED SUBDIVISION
n auie
MEMeets depth, width & square footage requirements
_`I Preexisting, nonconforming lot with proper setbacks
_`rd equired road frontage on public road
-- Has required off-street parking
-- Permeable area is adequate / Required: 34) ?70
Mil -- Building does not exceed maximum height / Max. yo ft.
I. Required setbacks from stream, lake and/or travel corridor
meets requirement
M- Buffer zones required
NW Is lot in a Flood Plain Zone?
OVER
4. STAFF DETERMINATION:
As per Section(s) I n-1,
of the Zoning ❑ Sign Subdivision
Ordinance Ordinance Regulations
0
0
2
2
o= 5. REVIEW REQUIRED BY ZONING BOARD OF APPEALS:
ACTION FILE NUMBER RESOLUTION DATE
❑ Use Variance
❑ Area Variance
❑ Sign Variance
❑ Other
Comments:
6. REVIEW REQUIRED BY PLANNING BOARD:
ACTION FILE NUMBER RESOLUTION DATE
El Site Plan Review
Cl Subdivision
❑ Planned Unit Dev.
❑ Other
Comments:
REVIEWED BY STAFF DATE COMMENTS
I3 /6 Z6 S
10 21 �l
6r Co z, 94-
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THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY' C
i
111 WASHINGTON AVENUE,SUITE 704,ALBANY, NY 12210 .�
i' Date ProRtifi 'p I - Application No.on file / :'•
s; THIS CERTIFIES THAT
'• only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of .'
i' :
, • ''014Z1111';: Pi) .. I:. i�111,! 1 11 '
. 111 •
�
� :
:. in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
$: was examined on , d'.13'10FIP I I" • and found to be in compliance with the National Electrical Code. ':
is '.
►' FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS :':
OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. MAT. K.W. AMT. K.W. AMT. H.P. .-
.i.
-.. DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BEu UNIT HEATERS MULTI-OUTLET DIMMERS •-
:"
�' AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. MAT. AMPS. TRANS. AMT. H.P. NSYSTEMS
of FET AMT. WATTS I'
i' 'i
i' '-i
�: SERVICE DISCONNECT NO.OF S E R V I C E 'i
.4. METER
AMT. MMP. TYPE EQUIP. Ix 2W 1 J/3W 3 if 3W 3 A 4W NO.OF„,EirCOND. OF CC COMD. NO.OF HI.LEG •H•& NO.°F NEUTRALS OF NEUGRAL •ii
:
' 'i
i• OTHER APPARATUS:
i' :
i' ':
i' _ '!
i' ►
i' ;,
DAN WARD
I{D BOX 222
(_-.. .,
d
l� .
.ii:' I:OR PATH ROAD BRANCH MANAGER
OUE ;N 3BUR f. N': I.-!:()l
is Per •
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. `:
`; •� •;.,�i.;•�.,•;.:o'.;s .;.';�L.;•i;.�.;.`.;•:..;•`.;�`;.`.;....;`...;•,,;•`.;�;.;•;..;��'i��-la'.'s;-;s:":•i;�(.y;.r�;.;�C.yC;��',�(y2'y!'4i'ref;if.;s. .........-•:'ss 4'.;.. .•..;.•..;•-..... s,.:e,..o. .a �_..
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
AA, No,. • . ,
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TOWN OF QUEENSBURY
n"ILDeL"IG CODj
x DEPT.
1...)v.d g a v '
REVIEWED BY mill/Asit
DATE 43,
. ,
/
6---;9
( OCT 1994
y 1
!
(,.;• ReipoweniVofed :::(:',,
_
1/ 03:,t4:4.:6;1 11:1191:71'
4:"7,1 Bldg. Dept.
,
1 VI j3;6.1 I 47 ,
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6 74-1-US
TOWN OF QUEENSBURY
ttfA� BUILDING & CODE ENFORCEMENT
3 742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:\I�i
�
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTIOON REQUEST RECEIVED:
NAME (,-)ARID DO
n)
LOCATION }�}'1!7 / �`�y ' 2-
��j � �+
DATE ? (e // 7 PERMIT ( /2!f
` cii
TYPE OF STRUCTURE
13.T3Rt66. g4.60C' •
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING _ SEPTIC _ INSULATION _
FINAL ELECTRICAL _ WOODSTOVE OR FIREPLACE
- N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT -
PLUMBING VENT
ROOFING
P
EXTERIOR FIN SH
DECK PORCH ST• 'S , LINGS -
RELIEF VALVES
FURNACE/HOT WATER S •ERATING
INTERIOR 'PRIM/PRIVA Y DOORS
FINISH FLOORS:
BATH/KITCHEN WATE• IGHT
OTHER FLOORS 'SWE'•ABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR 12 0 7R 15
FINA, E,EC CAL
SITE PLAN/VARIANCE-REQ•
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR a
C/
0
/1)66-0 FIRE PA-leSfe AP/'ee. . . _
7210
/;;)(4.49-49 ZaAid d" Oe //1-A/
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TOWN OF QUEENSBURY
Ate• . BUILDING & CODE ENFORCEMENT
, ' , 742 BAY ROAD
�' ' ` QUEENSBURY NY 12804
(518)745-4447 /
01 -
�V DEPART: 1Y-
1"`l� IN +.
FINAL INSPECTION REPORT - RESI'E ' IAL
L
DATE INSPECTION REQUEST RECEIVED:
1
NAME LuTfV
1
7 ` /Y�A- SZO)
LOCATION k--\00E__ `
DATE ,Z �� � PERMIT I
TYPE OF STR CTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/NEIGH
PLUMBING VENT
ROOFING /27
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERT HT
OTHER FLOORS SWE 'ABLE
OTHER FLOORS RPETED
STAIR CLEARA 'E/RAILINGS
SMOKE DETE' ORS
BATHROO FANS
PLUM: NG FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO. _
FINAL SURVEY PLOT PLAN /
OK TO ISSUE C/O OR CJC �� `V/
t ptP \R`-� ID 0 Vs-
I HE NEW YORK BOARD OF FIRE UNDERWRITERS CERTIFICATE NO.
DO NOT WRITE HERE-FOR OFFICE USE ONLY
BUILDING PERMIT NO.
TEMP.N DATE
CITY OR VILLAGE I ZIP CODE I TOW NSHIP COUNTY
STREET AND NO.OR ROAD `- '. I
E NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED. SECTION BLOCK
LOT
OCCUPANT'S NAME BUILDING OCCUPANCY
K,
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER'
BUILDING IS
NEW❑ OLD❑ WORK IS NEW❑ ADOITIONAL❑ DEFECTS REMOVED 0
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETSNo.of Fixtures& BRANCH OFFICE USE
Loca- Lamp Receptacles MOTORS HEATERS CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT •
151
FL.
2nd
FL.
3rd
FL. (06/8/OW081
::3-37/7 Z y31V0—� 3dSNI
/'^ `� Z2 NOINJOI
REMARKS:LIST OTHER ELECTRIC
ON NOLLVOrlddd
M0139 ORLON NOIlVOIlddv NV NI
03U3A00 SV NOI1V11VJSNI 1V3Iki10313
THIS APPLICATION IS INTEND 3H1 I flS 3ONVIld d0 31VNSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
JIdl.La30
FOUND ADDITIONAL EQUIPM V`JNIr1SSl d0 SS30O1:Id 3H1 NI 3H ,KE THE INSPECTION AND ADJUST THE FEE TO COVERV 3M
THE ADDITIONAL EQUIPMENSk1311HMH3GNf3HI4AOOHVO8NHOAM3NMIL
SIZE OF MAINS iNSA.AMPS TOTAL WATTS
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
❑ CONCEALED
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
0 OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REOUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS . I
I 11111
IDENTIFICATION NUMBER
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF.APPLICANT DATE OF APPLICATION SIWJAtyRE OF APPLICANT
STREET,ADDRESS TELEPHONE NO.
CITY OR POST OFFICE' ZIP CODE LICENSE NO.WHEN APPLICABLE
•
❑ 85 John Street ❑ 111 Washington Ave. ❑ 3291 Lake Shore Road ❑ 217 Lake Avenue ❑ 202R Arterial Road
NEW YORK,
10038 I ALBANY,NY 12210 BU6)8201N55 4219 I 7016)254-0141TNY 146081 315A463 8552 13206
(518)46 -2122
THE NEW YORK BOARD OF-FIRE
outt_uttvcavLrl. vrTvr Ft-rU ,mu-vv ucrivvrti 1 t r% �
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K.' TOWN OF QUEENSBURY
+�1j�i�;: '- BUILDING & CODE ENFORCEMENT
x� 742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
' - ( ':
=IV;,:::: 2.40) DEPART: 2: ~, 1NSB:: . .1...,./
FINAL INSPECTION REPORT - RESIDEN•TIAIj'
DATE INSPECTION REQUEST RECEIVED:
NAME I'lI'NOR tCIE_ LFPBou TZ
LOCATION f"lVAcrW- -X1I1LI\ cr'A:,1{�l�Hl OD
DATE ‘71 \c5 PERMIT A 9�--�g1ik
TYPE OFSTRUCTURE (T\� �H1
1,3() 1 tJ O ION ��
FOOTINGS FO A ION ACKFILL FRAMING _
ROUGH PLUMBING SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
' N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT ‘ /
ROOFING
\ '4/
EXTERIOR FINISH iC
DECK/PORCH/STEPS/RAILINGS,
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS •
FINISH FLOORS: f
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
J4OKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
/
DOOR CLOSERS f
FINAL ELECTRICAL )
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE• C/O OR C/C