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1992-525 w.. y CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK • Date -8 19 • This is to certify that work requested to be done as shown by Permit No. 92-525 has been completed. This structure may be occupied as a single family dwelling with two-car attached garage Location Meadowbrook Road Owner Marvin and Janet Hautala By Order Town Board TOWN OF QUEENSBURY 61d h �. t Director of Bldg. & Code Enforcement • • .. • _ --I BUILDING PERMIT TOWN OF QUEENSBURY No. 92 - 525 . • WARREN COUNTY, NEW YORK 03 PERMISSION is hereby granted to MARIVN & JANET HAUTALA OWNER of property located at Meadowbrook Road - Street,Road or Ave. in the Town of Queensbury,To Construct or place a Single family dwelling at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is PO Box 2613 Glens Falls NY 12801 r 2. CONTRACTOR or BUILDER'S Name 0) 3. CONTRACTOR or BUILDER'S Address v A) CD 4. ARCHITECT'S Name `t Wind River Design Inc. 5. ARCHITECT'S Address PO Bx 946 Glens Falls NY 12801 a� 6. TYPE of Construction—(Please indicate by X) ,f. CC )Wood Frame ( ) Masonry ( )Steel ( ) • O CT 7. PLANS and Specifications O 0 No. 50'x52' Single family two story dwelling as per plot plan, speci- fications and application. 0 8. Proposed Use O Single family dwleling with 2-car attached garage $ 285.00 PERMIT FEE PAID—THIS PERMIT EXPIRES September 1 19 93 cQ. (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the CD town of Queensbury before the expiration date.) -h iu a Dated at the Town of Queensbury this 1st D y o ? Se tember 19 92 Q SIGNED BY for the Town of Queensbury CD Building and Zoni Inspector r c0 TOWN OF QUEENSBURY • V REVIEWED BY: i • idir— - ' 1 'v - . lip--$1 FEE PAID: C9 az) C3-5. Y .o of PERMIT NO. : C3 - 5; r BUILDING PERMIT APPLICATION #to o .X A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTII ''•S WILL BE Iii$5 UNTIL = APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. r '914 0 All applicants spaces on this application MUST. be completed and the signature of the applicant MUST appear on the_ reverse side of this application. * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * Owner of Property: rAAVJi r _f A l-4U j k(4 P.O. Address': _ _ PHONE 7 .it O Property Location: M '[xa COV.__ Tax Map No vIOR / / / y, l Has there been any split of this property since October; l, 1988? Yes No 1._ If yes, Planning Board, Review is necessary. 4 Subdivision Name, if applicable: • Lot No. . THE RE N. RESPON LE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE • )( Construction of new building * CONSTRUCTION: $ 17' , c7COQ Addition to building * Alteration to building * - COMPLETE INFORMATION REQUIRED BELOW: (no change to exterior dimensions) * Size of Property: ft. x ft. Other work (describe) _ .a * ' Existing Building Size: * ' ' ft. x ft. * Proposed building - distance from GROSS AREA OF PROPOSED STRUCTURE: * property line: . 1st Floor l4 SO Sq. Ft. / 'O * Front Yard 15 ft. Rear yyard l0C0 ft. Pl C) * Side Yards /.4.Ic ft. and LI&5 ft. 2nd Floor (0 6o Sq. Ft. 35 * If on corner, setback from side street- * ft. Other Floors '"" Sq. Ft. '3S * . (not cellar or basement) * OCCUPANCY INFORMATION: * TOTAL FLOOR AREA: 17,400 Sq. Ft. * Primary Building - _ * )( One Family Dwelling Size of New Structure: 60 ft. x 62_ ft. * Two Family Dwelling Foundation: * Multiple Dwelling/No. of Units_ Pier/Slab/Crawl/Partial/Full (Circle One) * Business * Industrial No. of stories (Habitable space) 2 * Other Height (grade to ridge) j ft. * ' Of residential , no. of families: I * If addition, what will use be? No. of rooms' ( xcludi'ng baths) : '7 * No. of bedrooms: * No. of bathrooms: 2 , 5 * Accessory Building: • Primary heating system: rcrecrer, 1-br AID'_. * Detached Garage - One/Two Car Type of fuel : 64,66 * X Attached Garage - Oneewo Car No. of fireplaces to be installed: i * Private Storage Building Will a woodstove be installed?: hit) * Other Central Air Conditioning: Yes No )1( * } (OVER f _ Application i r AMB28 1992 Mr.onin a riai g Administrator P.4 OF•UEENSBURY BUILDING PERMIT APPLICATION CONTINUED: BUILDING SPECIFICATIONS: Type of construction: wood frame, fire safe, etc. \%D1 -Fp-ANA Will any seOgianIgupgraded lumber be used? If so, for what? '1•1 0l1. ` 1��Z Thickness:Wall ter�i Foundatiron al 'Depth of`f oun c h i©A b.,, ow B ade (to bottom of footing) : Will therex,be ace Ala-`'� BAN© Heated or Unheated? Floor Sq. Footage: Will there b e a basement?* )(4S Will any portion be used as living space? 7\I If so, what po�rti:ot ?.' Sq. Ft. Type of Use? Type of Roof: Sloped/Flat/Shed/Other 5 LOB Material of Roof Size, wood studs 2 " x (0 " ; spacing 1(a o.c. ; length S ft. Joists (floor beams) : 1st Floor • "' x 10 "; spacing 1 (0 " o.c. ; span ft. Joists (floor beams) : 2nd Floor 2. " x 10 " ; spacing f (0 " o.c. ; span 1 ft. Overlays (ceiling .beams) : ' " x ( " ; spacing ( (P " o.c. ; span ( ft. Roof rafters: 'Z " x It " ; spacing i (p o.c. ; span Roof trusses (pre-engineered): spacing NJ jfc " o.c. ; span ft. Exterior Wall- Finish: 61- 13nAT " of what material ? 0. 74c.. Interior Wall Finish: If a garage is to be attached, describe materials to be used for FIRE SEPARATION: qe"-Typt 24( (0 WALL W( W coD Is there to be an opening between garage and dwelling? I3 If so, will a Fire-Rated door, enclosure, self-closing device be provided? Y.V.S w L ` j - ` A2•A .-- Will a flue-lined. chimney be installed? \ .S Height above roof 44 - ft. Depth of chimney foundation below grade: t.JIA ft. Depth of fireplace hearth: ft. in. Water supply - Municipal or private well : MUIJ tc.-I 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. ) NAME OF BUILDER &• ADDRESS: :• PHONE NAME OF PLUMBER & ADDRESS: PHONE NAME OF MASON & ADDRESS: PHONE NAME OF ELECTRICIAN & ADDRESS: PHONE DECLARATION 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 W/rvSIGN /h e.. wner, owner's agent, architect contractor. SPECIAL CONDITIONS OF THE PERMIT: By: Code Enforcement Officer s MfiMkrIW+ Qi f{ P b`. r:PIDKd'M`7's- TOWN OF QUEENSBURY 531 Bay Rd., Queensbury, NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date At'4 V� 2 / ,19 �''1� Permit No. 255 APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws,ordinances,regulations,and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. Please fill out additional form if more than one appliance and/or chimney. Applicant /44CV/n/ t- ...14Nir /I41/7;11.4 APPLIANCE (check appropriate boxes) Address 7a 130n f(0/3 ❑ STOVE: 0 Wood ❑ Coal o Pellet ❑ FIEPLACE INSERT zL-S N, Zip /2-2/ *FIREPLACE, FACTORY-BUILT: "xWood ❑ Gas Phone 76 - H&c ❑ FIREPLACE, MASONRY: ❑ Wood ❑ Gas Owner ❑ FURNACE: ❑Wood ❑ Gas ❑ Oil Address IF NON-MASOf'i 1: " ,'''. .J Manufacturer: 1°�IA.i. S-rs(- Zip Model: N1v 42 Outlet: inches Listed By: Number: Phone CHIMNEY (check appropriate boxes) Exact address of proposed construction / ./- 4./ 1.c'T "7 ElMASONRY: ElBlock ❑ Brick 0 Stone M /T. A ' 45 d ry s/ 1 )/ FLUE: ❑ Tile 0 Steel Size: inches CONSTRUCTION/INSTALLATION MUST %FACTORY-BUILT: CONFORM TO NYS FIRE PREVENTION & Manufacturer: t'4Ap;T1 t Model: 1,412C42- BUILDING CODE. CONSULT TOWN OF Listed By: Number: QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall XTriple Wall REGARDING REQUIRED INSPECTIONS. 0 Insulated • Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Received Code Number Title , al) A 173 3389 (190)Public Safety „ _ A 233 2655 . (230)Minor Sales fee Collected Fro r Refunded to: �1.�„�) IN� , e i r -,-1 --. d.dress: Dated: Ire q Town Clerk or Deputy: i u 7 White: Applicant Green:Fire Marshal Yellow:Bldg. Dept. Pink& Goldenrod: Cashier's Dept. L TOWN OF QUEENSBURY �' 531 BAY ROAD �' ~�"'�' QUEENSBURY, NEW YORK 5 7 28 r '' , TELEPHONE (518) 74 BUILDING INSPECTOR'S REPORT FINAL INSPECTION f REQUEST FOR INSPECTION RECEIVED 11V /9.4 a MANE .i,P t LL. LOCATION `t(e�f}�1 . At DATE i,�,J, le_ PERNIT# 9 —jay TYPE OF STRUCTURE J i� RECHECK FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE) FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING FINAL ELECTRICAL SEPTIC +INSULATION WOODSTOVE/FIREPLACE REMARKS APPROVAL 'z N/A YES NO CHIMNEY HEIGHT/LOCATION ' B VENT/LOCATION / PLUMBING VENT j �° ROOFING SIDING +, DECK/PORCH/STEPS/RAILINGS RELIEF VALVES XFURNACE/HOT WATER OPERATING c," ;. ; INTERIOR TRIM/PRIVACY DOORS s' FINISH FLOORS: , BATH/KITCHEN WATERTIGHT OTHER FLOORS 5IWEEPABLE f', OTHER FLOORSStARPETED , STAIR CLEARANCE/RAILINGS `` SMOKE DETECTORS DOOR CLOSERS BATHROOM FANS ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING e DOOR CLOSERS OTHER FIRE SEPARATION ''''': FIRE/DEMISE WALLS FINAL ELECTR ' / y', OK TO ISSUE C/O OR C/C is COMMENTS: 3 y xl ARRIYE -5, DEPART 3l/ IN PECTOR a�__ 4�LLy. TOWN OF URY I' �t �'` 531 BAY E ROAD 4 QUNSBURY, NEW YORK 12804 ' . �. .TELEP TONE (518) 745-4447 E it ?*.,,e/e.)BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED I, NAME LOCATION >7,�Ges, n„.fi �� DATE / Z,2,/0_ PERMIT# 94r,A0;15 TYPE OF STRUCTURE, rl ;%' RECHECK FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE) FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING FINAL ELECTRICAL SEPTIC INSULATION WOODSTOVE/FIREPLACE REMARKS APPROVAL N/A YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILINGS '7 .. RELIEF VALVES FURNACE/HOT WATER OPERATING A:INTERIOR TRIM/PRIVACY DOORS /S FINISH FLOORS: i BATH/KITCHEN WATERTIG'HT 3 0R) OTHER FLOORS SWEEPAB'1E k; OTHER FLOORS CARPETED\, STAIR CLEARANCE/RAILINGS':.. SMOKE DETECTORS / k; D68 BATHROOM FANS PALL PLUMBING FIXTU,RES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS I OTHER FIRE SEPARATION `( FIRE/DEMISE WALLS FINAL ELECTRICALLA3a.3 )( OK TO ISSUE C/O OR C/C COMMENTS ;4 ORoViL eZte4►2�'`�l�-�r� Ken-PrP'no zit &X P®-coo--C't`oa;51--Lotci ' UVE'- "Ako Mt BA- i4 CCMP?LTb, 2 w Pit"Ei Rom." 'Fq Puttke L i iZ tiJt't'j :4 1'.11r f�i 51 ctoRO 1 LIG To A4i C f U`;iJ.4.: lCAA"s ARRIVE DEPART t } INSPECTOR TOWN OF QUEENSBURY �- FIRE MARSHAL QUEENSBURY, NEW YORK 12804 /1727 TELEPHONE (518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED /.,1/`%f'f NAME I '�`lti^l; f-Qf IYC��Gl �a1 LOCATION ` (l/ �i �,GLG`r`.� , DATE 204,4/ z,, PERMIT# �.s APPED N/A YESROV NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS AUTO. EXTINGUISHING SYSTEM HOOD INSTALLATION AUTO. SPRINKLER SYSTEM ALARM SYSTEM INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNEY 1 LLf U-t WOODSTOVE FIREPLACE-MASONRY ,/FIREPLACE-FACTORY BUILT v/ REMARKS: U OK TO THIS DATE 2/015 -- INSPECTOR )44 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR`S REPORT REQUEST FOR INSPECT ON RECEIVED /O a "/Xi f 9go)' NAME �k�5 LOCATION ' L lA M DATE it)p/ Ii1) PERMIT # g4'5c TYPE OF STRUCTURE RECHECK APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM JEATING ROUGH-IN NSULATION: FOUNDATION WALLS INTERIOR R= /q,u FOUNDATION WALLS EXTERIOR R- FLOORS R ,+r+` WALLS R-";', '� l CEILING R- sg ✓" DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: ck f2 g„,;ds. dot ARRIVE DEPART I PE TOR TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY, NEW YORK -12804 TELEPHONE (518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED/ '- � J J , � NAME G��- 77Gi!c /�Gc - �� "// 0 LOCATIO, g72 Rt' ©241: . &Ad- DATEd ,/�i t ` ? PERMIT# 99? -1409 67---APPROV= N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING /_. FIRE EXTINGUISHERS AUTO. EXTINGUISHING SYSTEM HOOD INSTALLATION , AUTO. SPRINKLER SYSTEM ALARM SYSTEM INTERIOR FINISHES / STORAGE: CLEARANCE TO SPRINKLERS, CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE / CHIMNEY WOODSTOVE FIREPLACE-MASONRY °FIREPLACE-FACTORY BUILT dr REMARKS: U OK TO THIS DATE / ,/.-r, , 4 f/77/24' . 5--e 2/015 INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTIO?I RECEIVED /6-A6/4- , NAME 4•11- atild74) • LOCATION LA/Ardifi.di,e7-4 DATE /11,61 AZ PERMIT # 9,2 TYPE OF STRUCTURE ,50) te,.//a7r 6Ufrt?/4d_,r..- RECHECK APPROVED N/A YES Ni FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR I REINFORCEMENT IN PLACE: • FOUNDATION/DAMPROOFING,' BACKFILL APPROVAL - )(ROUGH PLUMBING 7- PLUMBING VENT/VENTS4NTLACE PLUMBING UNDER SLAe FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED • SPACES REMARKS: ?IL v44 WIc 0 ie._ ceo S 14(45—r p -F-A-La--,0 Aq--litTrAt-W0 A-T- norfZ_OP A) 1 (-16-S Ri&-e 6c-K. oil )( ARRIVE DEPART Se: 675 INSPECT. R • - - TOWN OF QUEENSBURY A) AaL, (I' BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INS ECTION RECEIVED NAME LOCATION ' ef1,4,,,,( /7/ t DATE /0 .26/1-- PERMIT # F7-- 752s-- TYPE OF STRUCTURE —CAW RECHECK APPROVED ,N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE , FOR PROVIDING PROTECTION FROM FREEZING FOR ,A. HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE \ 4 FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB \„..; .. VYRAMING: ,7\ JACK STUDS/HEADERS s, 1, , BRACING/BRIDGING JOIST HANGERS I JACK POSTS/MAIN BEAM i HEATING ROUGH—IN ; \ INSULATION: / FOUNDATION WALLS INTERIOR R— FOUNDATION WALLS EXTERIOR R— FLOORS R— WALLS R— _ CEILING R— DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: ) .. r-c-I1 -RA I t s ,.1t.- Vt::S 7-t..; LC),,v,:rfiL._1-coat. .....-------- --.._........ ..-- ,--1 r\--z)--'A/A 1 tuf 6 co„ve6../rz.il 1) i c us 5c I-) 14/ T IA (-C3AiTru)e'ro/C__ „ tihcc_ Go a Acit i-ti PLUM 1311-16? W5 Vee-ve-v ITI-1(7, ARRIVE - DEPART ,?:-., Li 4---- ' rNSDECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT /A2 • 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 IUMDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 9A42-- NAME b4/46,6 LOCATION 1?-7 7y74i4-7-/J .0 - DATE 402-- PERMIT # TYPE OF STRUCTURE RECHECK APPROVED . N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONPCTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE./ MATERIALS FOR THIS PURPOSE ON/SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE 5.'FOUNDATION/DAMPROOFING / $( KBACKFILL APPROVAL )e, ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE kPLUMBING -UNDER SLAB FRAMING: JACK STUDS/HEADERS / BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- - FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: 116(ozioW -h *Nc--C OP-1,1Pepteiff:(46 • r-C4)\•-;:j CA) c'DZ-Arf tAdr -SLA- ARRIVE ra,LIT-- DEPART t5-- • . SPFCr TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT ," f,7 531 BAY ROAD QUEENSBURY, NEW. YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 9 /9 l4, NAME i7/b),,,^�/f. LOCATION `7 /,e 4AiA?koi- DATE 042 PERMIT # g77-5.4` - TYPE OF STRUCTURE , ci�� G RECHECK APPROVED N/A YES _1O FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: 4 ARRIVE DEPART TNSPFCTflP f enAtN OFFICE I ATLANTIC-INLAND, INC. — 997 McLean Rd. -- - NEW YORK Cortland,New York 13045 •. MEMBER OF N.F.P.A.AND I.A.E.I. Phone: (607)753-7113_ , _ FIRE:UNDERWRITERS p�+C (607)753-1396 (Electrical and Fire Inspection-Enforcing and ConsultingService) C/ 11 O V J 7 -(60,7)'753-1396 P 9 g (Incorporated in the State of New York) ' •Desiring Certificate of Approval,application is made for inspection of electrical installation in the premises described below.On demand applicant agrees to pay for inspection service in accord with schedule of charges. • APPLICATION FOR ELECTRICAL INSPECTION— PLEASE PRINT OR TYPE THIS SECTION TO BE COMPLETED BY APPLICANT DATE OF APPLICATION - `v�`,�/, 'f�'>- CITY,TOWN,VILLAGE i._}:'x_, .'7,—/ ''..:-C• f'- if COUNTY 441 l`, +'V STATE 'ff Y • STREET I',,.,0,,,,,, Fr J +" &- ADDRESS 1 t da J A i f 4=1`t f BUILDG.NO. /e*i --• -s-.�� . RURAL 1.F ` DIRECTIONS POLE NO. OWNER'S ifa 4y J ,y t a.- 1�, ,rg rr' t` "� NAME s `. �'T f v��,� lf ,/`, ��C,'. ' '. ,!'"' OCCUPIED AS f i 1^'`A d f ,4 : ' OCCUPANT ry''r)'Y•I ic7 -4-',..,' Cr Vle BUILDING-New,©Old 0 WORK-New❑Additional 0 , OWNER'S P.O. rt f .- �/ / ADDRESS .. . ',- .,, * 't`:i`...�.."'..'',---" e°"` sa ,Y ./ �T <a'`"C°``st APP.FOR-ROUGH WIRINGeLJ FIXTURESAl7 OR READY FOR INSPECTION 19 FEE REMITTED-$ BY CHECK❑CASH❑•MONEY ORDER❑ MAKE PAYABLE TO ATLANTIC-INLAND,INC—NEW YORK • Number of Rough Wiring Outlets Fixtures Add Installation Swtch Li'tng Recep. KW Med. Mogul Fluor. 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 Heat Base Base Elect.Heat Amp.Service Water Htr. Burner . Air Cond. Surface Unit Oven Range Gr.Disp. Dish W. Dryer H.P.Pump Ex.Fan Hood . • OTHER EQUIPMENT(Specify Type&Capacities) • TYPE OF SIZE OF - SUB- BRANCHES NO.OF WIRING OPEN❑ CONCEALED❑ OTHER MAIN MAIN CIRCUITS APPLICANT'S ,' -'9-• r - E ,h'd SIGNATURE X:l- .!--;:-//�' f f +( (za .-. LICENSE# PERMIT# APPLICANT'S f`- �"`s J` }� NAME OF ADDRESS °' T•-"�'' ''..� G � `£ ice" ! UTILITY OFFICE TO CITY STATE ZIP CODE BE NOTIFIED SPACE BELOW FOR USE OF INSPECTORS ONLY ` ROUGH WIRING AMP SERVICE K.W.SURFACE OUTLETS EQUIPMENT UNIT • SWITCHES AMP SERVICE K.W.OVEN CONDUCTORS • H.P.GARBAGE RECEPTACLES H.P.PUMP DISPOSAL UNIT MEDIUM BASE K.W. FIXTURES K.W.DRYER DISHWASHER MOGUL BASE K.W.WATER • FIXTURES HEATER KW.RANGE FLUORESCENT H.P.AIR AMP. RECEPTACLES FIXTURES CONDITIONER • MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER SMOKE FRAC.H.P. QUARTZ FIXTURES DETECTORS VENT FANS • MOTORS,H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 I1/2 3/4 1 11/2 2 3 5 I 71/2 10 15 20 25 I 30 40 50 75 100 MARK NUMBER OF EACH SIZE 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 APPARATUS Elect.Heat MISC.INFO. Received Inspected FEE PAID • 0 PROGRESS TOTAL$ ' • (?.� / Al /r ❑DEFECTIVE -}✓ #iL-e 1 roa Check No. //�� ❑Rough Wiring Certificate f`•.z. ' 2, ,goo; 50 ❑Temporary Service • Money Order ❑FINAL CERTIFICATE gh.-£e ,,.✓Gu •l� . Alf.L/ 12I�'4 Cash ❑Dup.Cert.Req. Mon.-Fr). 6-7'3QA•M+ 0 MUNICIPAL Charge 518-692-9295 518-638-5339 MUN.ADDRESS ATTN: . Temp.Cut-in Card No. Final Cut-in Card No. . Inspector . . •...n .. . e" .:;Des i: -..p; n INC ORLD: BUILDING SYSTEMS P.O. BOX 946; GLENS FALLS, NY 12801 : : , .: : ..'„TEL., 818•587•0173 FAX 5184587•0686 . • • ., 3. -.-. - ----T_ _ p;t_:_w_ 3--,e70=_ETT.Aati-iL:. . 7:1±a2 bt, -- . •, , ,. ,. . . , , . . . .1.. . .. ......--- - , ,t• 1 1 -' I 1 i ) I 1 _ , .. , c.1 1 iTOWN OF QUEENSBURYINDINCIOVARIVINT _., .... I 444,4 1-o" 0,e/i • :: KT: Based on our limited essminatian, compliance wiments ON ... a. . • -: 1 th our ccom --:(_ e , —1; 3 • not be construed as indicating the - -v r--H . plans and spectficitions min id Plf04110 arab Abel** -*4& Ts —69"0e-, ' • 091 2•013Th 1• •• -1 ' h i . A : • 2. S" ••!‘. —Psve5L . .1, ' ' 5e,se t 4r 1 '' • X N • • „. - 1 11 • _-- :do , -- ..:. • _ — — — __ __, CP___O 6 g•-a-r-5. wa,t.-____ R t Kie)i2,Gik_1( t;) -..-r-4,„-i 1_ : S-c- .L.s 1-. •I/ : - '" -, , . H . • .u fli:tii -4;4,4,7-P** .vl COPY • Rtvtgw .rirr!ii '1A1.6.1.it,. . : ' ' FILE LIUry 0.41,E . main ! i , h y y 6. NEP YORK STATE ENERGY CONSERVATION. CONSTRUCTION CODE 3/91 GK Jr PART 6 COMPLIANCE FORM - Building Design by Thermal Rating Method BUILDING ADDRESS: Me bvO\:::,ropk. liZel. DATE: ' 25- .9_10 - 92 , „. 01)P.E'h S10,0rtA ' etA..) Yoe k e .:r t COUNTY: War-rel.') , 1 ENGINEEER: GEORGE KUROSAKA JR., P.E. PHONE: (518) 793-7190 PERMIT APPLICANT:lAwry Z-n,h ri aui`a la PHONE: ,. .1, HEATING DEGREE-DAYS: 9 D O C7 Degree-days HEATING SYSTEM: _ Gas-fired wOil-fired _Heat-pump — Electric I SUMMARY OF TOTAL THERMAL RATING: THERMAL TABLE AREA U-VALUE RATING USED A. ROOF/CEILING 15227 w o (p 14p to-! B. NET WALL 2161 .b Fj�1 '2 0{ (a- z. C. GLAZING ,I Windows 12,.' .32. -�Tr� (i- 2 Entrance Doors 'A-D 1_ 2, 4-2 Skylights - - - D D. FLOORS 14 4 O I O S& - -j \j es -3 D2 BASEMENT/CELLAR WALLS Wall Perimeter )1O Feet Exposure Ab-grd , 4011 Feet Wall U-Value 'A Depth U-Value N/A Below-grade D3 SLAB INSULATION Slab Perimeter N/A. Feet Insultn R-Value N iA. , - INFILTRATION CONTROL lekeN0 All windows less than 0.35 cfm/lf operable crack t , 1 i t _t t t U NO All red areas. -w/infiltration barrier , , "w TOTAL THERMAL RATING '1~" /.70 WASSIOR 490ROsgrF• f 4? 9 �� v t� ; °C CyEC CIRCLE S '..r:. : 4:�., P.E. t A, i BUILDiJ.0 St-,•�.... ..L..•3ULTANT" o " 13 ARBUTUS DRIVE - - �- -_--- _ -_/, 3586a- <�-- --_-------�� --- ..-- a, CUEENSEURY, N.Y. 12809 TE tj#� O N.Y.S. P.E. Lic. No. 35869 '• ' I-1 AUi 4-L,A• . ;J :OC9 : ''' ...._ 1 Sr , _ . /74 :r." .. .:. ,.4....o- .''''.-;;,:;;. '.114.: 41):: .::'::: 1:17:NI' ' ;- 4 '' : I NC. - ORLD BUILDING;:SYSTE - .. P.O. BOX 946;;GLEN.S FALLS, NY.;1.28.01 -....• • • • ;:•;TEL.. 81840587.0173 ` FAX. 518•587.0686 • ' , fah f.i : .: . • - • : vi-. ' ,:. •:'6'.7:6‘((st:) '.. 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