1991-465 „.
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date hu 2 ) 19 e/.2—
v-
-
This, is to certify that work requested to be done as shown by Permit No. 91465
has been completed.
This structure may be occupied as a V V V Single Family Dwelling
Location Gurney Lane
Owner Nelmon & Joanne Miller
• By Order Town Board
TOWN OF QUEENSBURY
e/11_ ig,
,
Director of Bldg. & Code Enforcement
;;-,-;:;;'. • , ;• ; • ;
--I
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-465
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Dr. Nelson & JoAnn Miller
OWNER of property located at Gurney Lane Street, Road or Ave.
V▪I
O
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 S2v
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
a
1. OWNER'S Address is
Hest Mountain Road
r▪o
2. CONTRACTOR or BUILDER'S Name -s
Tony Marciano
PO Box 2254
Queensbury, NY 12804
3. CONTRACTOR or BUILDER'S Address �G
CD
4. ARCHITECT'S Name
to
CD
'r1
5. ARCHITECT'S Address
.d.
6. TYPE of Construction—(Please indicate by X) ro
In)Wood Frame ( ) Masonry ( )Steel ( ) —▪a'
LA
7. PLANS and Specifications
No.4,242 sq ft Single Family Dwelling as per plot plan specifications
and application
8. Proposed Use
Single Family Dwelling
$ 574.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 2, 19 92
(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 thjs 2nd ; Day f, July 19 91
SIGNED BY for the Town of Queensbury
Building and Z i'ng Inspector
TOWN OF QUEENSBURY Oh A l'OWN OF QUEENSBUR'r
0,101 RECENED
REVIEWED BY: = JUN 2 71991
9 , 5fP� s�
1011$1, FEE PAID: n ®e1, & GOUT ®EPl'o
PERMIT NO. : 0-45'
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
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 �k/,-, / er
,, ,,,,,,,e ,/izw,,,
P.O. Address: ‘' ei--,./y2OG,,v/fi,,y1 /��. a.,,,,,„.V?e,,,,e7, PHONE Mt)/is? d
Property Location: /p,y9y ,�, e,n,e 1 0e/e,o vsau ep Tax Map No. , ?A/ A( /37
Has there been any split of this property since October 1, 1988? Yes No 2/
If yes, Planning Board .Review is necessary.
Subdivision Name, if applicable: Lot No.
THE PERSON RESPONSIBLE FOR_§IJPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
o/fy ,2G/,,,f/
795;57oo - ?'1.s-.56- 3
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
i,/ Construction of new building * CONSTRUCTION: $ - ,1
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: ft. x ft.
Other work (describe) * Existing Building Size:
• * ft. x ft.
* Proposed building - distance from 2)
GROSS AREA OF PROPOSED STRUCTURE: , a(P*t) ,-property line: �CC%L�s
0
1st Floor � 2/c- Sq. Ft. U p.J* Front Yard ft. Rear yard ft.
(i&r d. * Side Yards ft. and ft.
2nd Floor ,2 y ,3 Gj Sq. Ft. ,JL * If on corner, setback from side street-
*
ft. /e2
Other Floors Sq. Ft. �� G� - �e� ez ��� _`�
(not cellar or basement) G .5� OCCUPANCY INFORMATION:
TOTAL FLOOR AREA: ,C12 L Sq. Ft. � `() *vPrimary Building -
,, 1 d/ One Family Dwelling
Size of New Structure: C/eft. x J Y fft:*� Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial/ ul (Circle One) * ' Business
* Industrial
No. of stories (Habitable space) ,2- * Other
Height (grade to ridge) 30 ft. *
If residential , no. of families: / * If addition, what will use be?
No. of rooms (excluding baths) : /L.. *
No. of bedrooms: ', *
No. of bathrooms: ,3 jy * Accessory Building:
Primary heating system: / 7-2 i c,� r * Detached Garage - One/Two Car
Type of fuel : i,p/,o 4 5,v,/,re r P/�F fe.� .&a 1/ Attached Garage - One/ Car :
No. of fireplaces to be installed: / * v Private Storage Building ,t,10 ,7gbii(1
Will a woodstove be installed?: cp * Other
Central Air Conditioning: Yes t/' No *
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: ` d frame fire safe, etc.
Will any second-hand or ungraded lumber be used? If so, for what? �L,I5
Foundation Wall Material : eehe,e.-e_, Thickness:
Depth of Foundation below grade (to bottom of footing) :
Will there be a cellar? 5 Heated or Unheated? 17/.,,,, ,Aae Floor Sq. FootageyPe,W,p
Will there be a basement? /P,S Will any portion be used as living space? AID
If so, what portion? Sq. Ft. Type of Use?
Type of Roof: 1 ope Flat/Shed/Other Material of Roof ;be ,N7/es
Size, wood studs `Z _x ; spacing / 11 o.c. ; length g ft. /
Joists (floor beams) : 1st Floor ,. " x // " ; spacing /(o " o.c. ; span /& ft. Poor
Joists (floor beams) : 2nd Floor 3Xz, " x / `" "; spacing / . " o.c. ; span / ft. 71.4 $
Overlays (ceiling beams) : Z " x g "; spacing / " o.c. ; span /y ft.
Roof rafters: Z. " x /U " ; spacing / 22 o.c. ; span / ft.
Roof trusses (pre-engineered) : spacing " o.c. ; span --- ft.
Exterior Wall Finish: UJoo of of what material ? c Ia,r &ems, 'd,S
Interior Wall Finish:
Z n Dr.1 LA,�
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
0 i-;,.e. 6aei. . 3- e,,e�, dc%
Is there to be an opening between garage and dwelling? 7e'4 , If so, will a Fire-Rated door,
enclosure, self-closing device be provided?
Will a flue-lined chimney be installed? 1/?5- Height above roofg/4, eede, ft.
Depth of chimney foundation below grade:. , /ir ft. l�
Depth of fireplace hearth: ft. in.
Water supply - Municipal or private well : ,. „,, ,e%,e,y,,
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: /6 6 ft.
9 (A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS:�`� ,.. PHONE Z93_,5/ ,--D
NAME OF PLUMBER & ADDRESS: -,a Gil��� PHONE 7rz--a2- 8-
NAME OF MASON & ADDRESS: e ���-7�.11 PHONE7Z2/ J/
NAME OF ELECTRICIAN & ADDRESS: . ,3a _ HONE 7 3-/9/Zj
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 wor is authorized by the,owner.
Signatur
wner, wner s agen ar hi ect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
,/, TOWN OF QUEENSBUR`e
`r � TOWN OF QUEENSBURY RECEIVED
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee PaidJUN 271991
Date: / ,2/q// Rev i eweg41j9° & CODE DEFT.
LOCATION OF PROPERTY FOR INSTALLATION: � 'e,e oG,9,zJP , a%./ee//s&m!r
Owner' s Name: /✓&/srw �o v.�e ��yre___
Owner's Mailing Address: ��G'_S fW7 -z//ii7 ;zy/t/ // /�ePy.z/5/ �%�?,.
25-
Installer' s Name: Phone #:
Number of bedrooms (if residential ) : 4
Total daily flow (residential-compute @ 150 gal . per bedroom): 4 ;eJe
Topography-Circle One: 411111, Rolling Steep Slope % o Slo c7a 2„
/ri 49Y7......7 cC/776Gsw79�
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? ei gfp C /5"--- Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal ell Other
If domestic water supply is a well
Separation: Water supply from any septic absorption /40 f feet
PROPOSED SYSTEM: Septic Tank / gg 2 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench s2 feet//Total System Length 00, feet
Seepage Pit(s): Number of / Size each: ft. x ft.
Size of Stone to be used: # ,2 / .Depth or Thickness / feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
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:, 'C /�' ,4.6 DATE:
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. ' Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE 3/91 GK Jr
PART 6 :. COMPLIANCE FORM - Building Design by Thermal. RatingMethod
N/f z/Q-9(
•
BUILDING ADDRESS: DATE: _6/z-6- / _ .
• C;711 � 'r fd r/ s Al COUNTY: ....iil/41--/Iiiz__ _)
•
ENGINEEER: GEORGE KUROSAKA JR., P.E. PHONE: (518) 793-7190 '
PERMIT APPLICANT: f.L/,�fnr/actd"-�w1,�'• PHONE:
HEATING DEGREE-DAYS: '. ,eoet) C) Degree-days -
HEATING SYSTEM: Gas-fired Oil-fired )<Heat-pump _ Electric -
SUMMARY OF TOTAL THERMAL RATING: THERMAL TABLE
AREA U-VALUE
a RATING USED
A. ROOF/CEILING £. 2 2.C7 O_o Z 'I-. g.:' ''i4
B. NET WALL rJ384- 0.os/ -1'33/ -- Z-..
C. GLAZING
Windows '3 7 0.363 — 7 6--- Z_
— ) I"
Entrance Doors i IVC I.- —
Skylights . 7 0.303 2!..2._ 6 -
D D. FLOORS AA _ .--- ...
D2 BASEMENT/CELLAR WALLS
Wall Perimeter 24...-5---. Feet
Exposure Ab-grd / Feet
Wall U-Value p.e 23?
:'epth U-Value li -74‘g 4. ^-.
Below-gradeel
D3 SLAB INSULATION �p
Slab Perimeter xf Feet
Insultn R-Value - -
INFILTRATION CONTROL
CD/NO All windows less than 0.35 cfm/lf operable crack
YNO All req'd areas -w/infiltration barrier
TOTAL THERMAL RATING Yi-329
.,---7`1 --
4
N'K - 4e
..* ..5,.- ,,,,f ..,.\ .-, f
r,"0 /M -
'f� G e` C .. .
' ' (-(C), '
u ::LI ANT'
9 ' kt:3Ua: u IVE
UEENSBURY, N.Y. 1464
927
'� _ � _ ' •�
_ N.Y.S. P.E. Lic. No. 35869
N4 CO"WN OF QUEENSEUH',
RECEIVED
JUN 271991
BLDG. & CODE DEPT.
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings;
Multi-Family Dwellings
(3 Stories or Less)
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
Ala,5- w < �wd uc ley///e2 C �),eN'e y�.we,
APPLICANTS NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 7 a Sq. Ft.
2. Type of Heat - Elec. Base Board Other /9/17 9'A ,/>;� /ldi srie4ScrUzee)
3. Is Building Mechanically Cooled? V YES NO
4. Percentage of Area of Windows and Doors Over 17% ✓ Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 30 3 0
B. Exterior Walls R /9
C. Glazed Area R 3, 3
D. Exterior Doors R
E. Floors over unheated spaces R /VAI
F. Edge of Slab on Grade (Heated Building) R /101-
G. Basement/Cellar Walls (Above Grade) R /0,g / r�
H. Basement/Cellar Walls (Below Grade) R /0-8 /0,g
I. Heating/Cooling - Ducts - Piping in Unheated Space R NO
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code 1-''YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
i/4
/9Y
APPLICANT S SIGNATURE ETELEPHONE NUMBER
INSPECTOR'S REMARKS:
RE IEWED B
�'.. ,., •Yv., .. „ • v �, J.. .., h , ._. M ...�-.... ,ny..;t,Y".'"`vlr ., '1,..t. r„ .. . ., �r...Y r..--.a.."w. n- ry ,, ,t•y_•Y•-r-•,..•P ^'p,�ti
. TOWN OF Q UEENSB RY
. • ,. Bay at.Haviland Roads, ueensbury,N:Y,12801-9725 .
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date , P3 Permit No.9/ l ._
i
APPLICATION IS HEREBY MADE to the Building Department 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
inspectdrs to enter premises for the required inspections.
.
Applicarit's Name 7%;�JG' % S -/ ��. APPLIANCE TYPE ..
/. � . _
Stove Coal Wood
Address; Furnace Hot Air • Boiler
Zero Clearance Circulating Unit
• Zip .
Phone • If Non-Masonry:
Owner's Name g/.5-,„kj ec /��/v."vP /27///,®2 Manufacturer
Adress �.v s�l7��iiti� �i�� / Model Outlet Size`
(,---/ ee:frJsxu� K_, L/ . Zip /ate/ Listed by Number
/ / .
Phone
CHIMNEY TYPE
Masonry: Block 1/ Brick t/ Stone
Property location of proposed construction Flue: Tile ✓ . Steel
Cl/ie hi -.e .J , KOf>���rO y Size:AS ,' 2/ ee/,/;' c% 4, /7.
Factory Built: Gc ---c•-. •
• Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS.IS. Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES • Type: Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $ id -Z)
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$ r�5"
SONRY FIREPLACES AND CHIMNEYS.
CASHIERS DEPARTMENT f ', ,@
TOWN OF QUEENSBURY, NEW YORK t ,, 1 f'
Department: Fire Marshal Amount Collected Amount Refunded a:"�:'` I
r c
) -Code Number Title G
A173 3389 (190)Public Safety l , ;1�,
r
A233 2655 (230) Minor Sales !-'
k.
Fec-�-e Ue!fror o" Refunded_ to: /7p1eelern 'IL t✓ `f/_/1-4(.. � /�I_-e
Address:Dated: 4/47/9/ Town Clerk or Deputy �% 9. 1 --)-- . 'I'D , .
1 ,
U
U � CA• I`
While:Applicant. Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal / I /l C
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
l337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Dma` /_� /'/''/'y
�� ^��' / State
(]t� Town orTownship ' /'�'' � // -' ' / / ' count/ - ' /
/Addm on Looato
. -- /
(If L6vmodin Rural Area ' �oaeA�aoh Directions) Pole ** -
(�o���'� Permit #
Ooouc�odAs-
Occupant Building: New[F] O���
\NoMk Area in 6ui|ding (Floor #, etc.):
for: VWh ��ring Sor�ooFT or: '' Ready for Inspection:Fee' Remitted $ Cash F� CheokF-1 K8.[l1 l /'/ ' - . � . /' ' '�MakoPayubleTo: M.D1A.
am rm 1000 /25015001750200 22502500e750300
Number of Rough Wiring Outlets Elect. Heat
Switches Amp. Service Surface Unit Dishwasher Range
U0ht»Q Water Heater Aj,Conditiunor Dryer Pump
Receptacles - n Garbage Disposal Wiring and Controls for. 8«'»»'
Number of Fixtures
Amp. Ronoptuo|oo Fractional H.P. Vont Fans
Other Equipment:MOTORS �
z/cuz/1cvm vo' zm 1/4 1/31/23/4 z 1m u o , r* m z, uo ex so «v 50 rx nm
NumberMark
of Each Size
Applicant's--' - Uoomm # p«nn� #
Signature-- ,{
T/A � Utility: (m
mme) (opr/os� �oo��mm>
� r' '
App �anttAddmo :'f/ '--- `
(City) / / / � ' ` � ' ' ^ '',,,(State) ,/ ''�' (zip)) �� '' ` �// Service Request #
Phone # //f �� �~! ' Electrician:
N1D|/\ USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above F-1 o,:
Red Notice Label | |
Rough Wiring Outlets Surface Unit ' ' Oven
Switches Range Garbage Disposal
Rmmpmu|vo Water Heater Dishwasher
Fixtures Air Conditioner _ dryer
Amp. Service Equipment . Burner, Wiring &Controls for Amp. R000ptoo|o
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. veo zue zuv z/a z/o 1/4 z/o vu a/* z z* e a , r* m zs co 25 oo 40 so r, zvv
Mark Number
_ Each Size
-
',00 ,,o moo 1�5" ao" 1750 ,000 ,,,o 2500 2750 3000
Elect. Heat
.�
-
CERTIFICATIONS USE\UneFOR INITIAL VISIT ONLY moT/r/eo ours CORRECT FEE
FEE PAID
_ -
`^ El RVV Progress: inc.El LKD|| Contractor
' [:]'CFT Violation: Work Comp. Inc. CASH F-1
F-1 L/A »w»»' Fee CHK #
L� 4A Du* M0 #
�-1 IPA � Muni�pu| '
|NV #
Applicant | |
Date: 0ther.Sido| I Utility -Owner
Cut in Card Temp # Date
INSPECTORS SIGNATURE
F-] Final # Date -
S.. • TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED ( �! C'
11
-
LOCATION 1 5k>\r OArN___P
DATE (..pIa 97 )- PERMIT# CO -- 65
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
3
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM /
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM? /
ALARM SYSTEM ;; "
e /
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPR/NKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE /
I '
CHIMNEY
WOODSTOVE '
FIREPLACE—MASONRY
FIREPLACE—FACTORY BUILT
REMARKS: U OK TO THIS DATE
2/015 INSPECTOR
c . \ a- 1°111
TOWN OF QUEENSBURY
BUILDING AND CODS DEPARTMENT
531 BAY ROAD
. QUEENSBURg NEW YORK 12804
TELEPHONE (518) 745-4447 '
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED L(// 2-9 I C 2
NAME c A/,A\• M€ \ .(a'V\'�'rNC) Ah fir\
LOCATION -- ) ,v� �- v`�
DATE -1) PERMIT ## ci I — U (Uyj
TYPE OF STRUCTURE \Ekx _ CK. O A. ){ ,
RECHECK APPROVED
• N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE /
THE CONTRACTOR IS RESPONSIBLE /
FOR PROVIDING PROTECTION FROM r!
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE`.; CONCR= E.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR ;/
REINFORCEMENT IN PLACE,
FOUNDATION/DAMPROOF d�G\,
BACKFILL APPROVAL ,, `,
ROUGH PLUMBING / ',,
PLUMBING VENT/VrNTS IN PLACE
PLUMBING UNDER/SLAB
FRAMING: /
JACK STUDS//HEADERS_
BRACING/ RIDGING
JOIST H GERS
JACK PO TS/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:
faa/pvy‘ 6e,--72Zie- C4f---e____ G--r-e--,
7.).e&-..-4-pj/ .
ARRIVE /// •
DEPART 74/ c.
INSPECTOR
TOWN OF QUEENSBURY Pc)/1
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
3F TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME 7j1,I 3/ f 04 (Ite/,),a
LOCATION h J/)L2'
DATE ///���;2_ PERMIT# 9/-��.5
TYPE OF STRUCTURE �5A� ;„ ey .+4-t/ - ,
RECHECK 4;7,
FIRE MARSHAL APPROVAL (COMMERCIAL.STRUCTURE)
7 -FOOTING LFOUNDATION /—BACKFILL /FRAMING
ROUGH PLUMBING ANAL ELECTRICAL iSEPTIC
��INSULATION WOODSTOVE/F REPLACE _
P
REMARKS `
+t'
r APPROVAL
/r N/A YESS NO
CHIMNEY HEIGHT/LOCATION ,f ✓
B VENT/LOCATION / I
PLUMBING VENT / i ✓�
ROOFING / t �✓
SIDING
DECK/PORCH/STEPS/RAILINGS $: ✓
RELIEF VALVES f' ✓
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY/DOORS t/
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE t f
OTHER FLOORS CARPETED
STAIR CLEARANCE/R'AILINGS ✓'
HANDICAPPED ACCESS
SMOKE DETECTORS/ ✓
BATHROOM FANS/WHOLEHOUSE FANS ✓
ALL PLUMBING F,�IXTURES OPERATING
GARAGE FIRE PROOFING ✓
DOOR CLOSERS ,
OTHER FIRE SEPARATION
FIRE/DEMISE .WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS ✓ _ _
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS: 4iRi7 43y Tack,
Z ;- a-7/ a z s' /g'a�v�
ARRIVE
DEPART
INSP T
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804 7
t,�.&;)?W, TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME "77.%C'�J 7 O /1V/21 v /2/_tie(
LOCATION 0/ e,. ��
DATE G/j/�% PERMIT#
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING /
FIRE EXTINGUISHERS
AUTO. EXTINGUISHINGjSYSTEM/
HOOD INSTALLATION 1 /
AUTO. SPRINKLER SYSTEM /
ALARM SYSTEM
/
INTERIOR FINISHES ' /
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEAVING UNITS
REQUIRED SIGNAGE /
i3
CHIMNEY ,r
WOODSTOVE /
FIREPLACE-MASONRY
FIREPLACE-FAC ORY BUILT
REMARKS: OK TO THIS DATE
///9 g 614 h>te-7,1 -
2/015 INSP TOR
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. 45-
Owner Di2• /1). /LL57
Occupant
Location u/2 /V
No. Street
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable codes.
Installed by 2-5 f u ti2 / H"f1 •
_ G � {f /QJJ O'(�
Date V /)' Z� �� C jA"-gC(.Lt ---Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.19 EL. 900 Haddon Ave.,Collingswood, NJ 08108
3 6. R• OUGH WIRING OUTLETS - H.P.AIR CONDITIONER
/"3 ,- /7 ( -- WIRING &CONTROLS FOR BURNER
/ 3 R• ECEPTACLES / H.P.PUMP
7 FIXTURES / K.W.OVEN
L/6Q AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
_-4-ye), A• MP.SERVICE CONDUCTORS K.W. DISHWASHER
r K• .W.SURFACE UNIT /. K.W. DRYER
K.W.RANGE /..- n AMP. RECEPTACLE
i K.W.WATER HEATER 5 FRAC. H.P.VENT FANS
rY SYS. _
%u Q I ' (�1-`i-
MOTORS H.P. 1/20 1/12 1/10 % % / 'h 14 ' 1 11/4 2 3 5 7%z 10 15 20 25 30 40 50' 75 100J
MARK NUMBER
OF EACH SIZE
APPARATUS
-171/TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPOR
REQUEST FOR INSPECTION RECEIVED 6/ i)
NAME RkI I ) ! e Sk'�
LOCATION -0(11,Q2) '-( 4
DATE),;)- a PERMIT # C /, G/_5
TYPE OF STR CTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FOR
REINFORCEMENT IN PL''CE
THE CONTRACTOR IS R: PONSI--LE
FOR PROVIDING PROTEITION RO9
FREEZING FOR 48 HOU' LOWING
THE PLACEMENT OF TH: 5'NCRETE.
MATERIALS FOR THIS ' 'POSE ON SITE
FOUNDATION/WALL POU?
REINFORCEMENT IN P E
FOUNDATION/DAMPReIFING
BACKFILL APPRO. 'L
ROUGH PLUMBIN►.
PLUMBING VE /VENTS IN PLACE
PLUMBING U DER SLAB
FRAMING:
JACK ,MDS/HEADERS
BRA ING/BRIDGING
JO ST HANGERS
ACK POSTS/MAIN BEAM
RESTOPP ING ■
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
NSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- 11 t�
FLOORS R-
WALLS
CEILING
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE/l)
DEPART // f
INSP TOR
TOW OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /VZ/.�/`e/
NAME /1Z/O,,
LOCATION 61,r,ey
DATE // 44( PERMIT # W
TYPE OF STRUCTURE SFP
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 . k I
ROUGH PLUMBING /
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB \
RAMING: / t/
JACK STUDS/HEADERS ', /
BRACING/BRIDGING /
JOIST HANGERS `,/ 1,//
JACK POSTS/MAIN BEAM /, ✓
FIRESTOPPING \
WALLS �
CEILING
FIREWALLS /
HEATING ROUGH-IN / �a
INSULATION: /
FOUNDATION WAL INTERIOR R-
FOUNDATION WA S EXTERIOR R- \
FLOORS R- \.
WALLS R-
CEILING R-
DUCT WORK R PIPING IN UNHEATED \
SPACES ti
REMARKS:
ARRIVE / '
DEPART //� 99d04-‘41/
I NS PEC)OR
•
Jown of Que?nJur/
BUILDING and ZONINCy DEPARTMENT /117
Bay and Haviland Road, R.D. 1 Box 98 .
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME �-l1.Q-..( Z C �/d� ./ t_i
LOCAT ION O'�.(l/�irl,GL/
DATE %//V/ V --PERMIT NO. g/-/y"
SOIL TYPE - Sand oam -\;Clay -
Percolation Test Required?I YES - NO
Percolation rate - "Min/Inch -
TYPE of SYSTEM:
Absorption field, total length _� ( C)
Length of each trench • /b()
Depth of trenches ' \ O. or- •
Size of gravel SEEPAGE PITS{Number r-21—.
) _ '
Size- ft. X . f .-----4/✓_1
Gravel 'size ,
PIPING: Eize`-- Type
Bldg. to tank � \1 5-iil i(C ir1
1 PIA
-
Tank to dist. box 1 /ci..
Dist. box to field/pit \'M ,;;
Openings sealed? Partial
LOCATION/SEPARATION :
Foundation to tank 31> ft.f- -
Foundation to absorption 5-0 .t.•4-
.Absorption to lot lice fl)00 f t--
Separation of pits ,,_/.1.-ft
•
LOCATION OF SYSTEM ON PROPERTY(ci cle one)
Front -CRea - - Left side - Right s'de -
COMMENTS:
9QL`j C 1.(-? i?i ; i i
mac! r O1 .;d/
r
`► ) t j ii( C- - uA• L . ter.' ( 4:/
c+' ( ilicic U Zf\ IOU -- ,\
SYSTEM USE APPROVED OS N0 .
!•!'
j:
� ° /�a -fit;-=�N L-ll. ,
Building Inspector
r
01/86 and vl
Ouin of QUJUrty
BUILDING and ZONING DEPARTMENT /4
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME `i?17�90A/IL rl „__. )4:/X�ef
LOCATION` ,r,(,j/j4.'0/ 44L-e--- •
DATE 9//7/ 0 PERMIT NO. 0- 46 5-
SOIL TYPE - Sand ,_- Loam - Clay - r
Percolation Test Required? YES -ENO
Percolation rate _ Min/Inch /
1
TYPE of SYSTEM:
Absorption field, total length/
Length of each trench
Depth of trenches I
Size of gravel \ 1
SEEPAGE PITS{Number\of) f
Size- ft. X �ft. /
Gravel size "
PIPING: `,Size Type
Bldg. to tank 111;/ ` Pt/Q
Tank to dist. box if t;_
Dist. box to field/pint \,
Openings sealed? Y ES \NO Partial
LOCATION/SEPARATIONS:
Foundation to tank Xl f t.
Foundation to absorption ‘ ft.
. Absorption to 1/ot line \ ft.
Separation of/pits \ft.
LOCATION OF SYSTEM ON PROPERTY\(circle one)
Front - Rear - Left side Right side -
COMMENTS: /J
yJ - 4 i rip. ,
a� �a ti
. .10-674- e,),„-c . ..,
• '\
..
..
.,
SYSTEM USE APPROVED YES NO
410,,yk01,14
B I ding Insp ctor
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPEE /•'/,CTIOI RECEIVED�
NAME / ✓r- /(er
LOCATION
DATE 6A/ PERMIT # %/ 41..5
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 G
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS /
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM e�
FIRESTOPPING /
WALLS
CEILING /
FIREWALLS
HEATING ROUGH-IN I'
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS f R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
sei , /
641 ,71K/JOi /6616414)ar
ARRIVE
DEPART 40.' f44/
(;;I NS PECTO
TOWN OF QUEENSBURY / 6f�
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT ,,
REQUEST FOR INSPECTION RECEIVED /r?lvyv
NAME ' 7e,t/P.r12, I )0-le---7/--re-‹ ���C C%1�/ILOCATION "ha ✓i1f rC
DATE J/VA PERMIT # g%4/65
TYPE OF STRUCTURE ,r- 0/1/76 61%P-at d/(.44/
RECHECK / APPROVED
N/A YES NO
1 FOOTINGS/PIERS 40,e.t JeJTGPC'f.e_
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 THISPURPOSE 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
FIRESTOPPING
WALLS
CEILING '
FIREWALLS
HEATING ROUGH-IN .•'
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALL'S EXTERIOR R-
FLOORS ' R-
WALLS R-
CEILING ', R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARK
()' c � J a �,U S �,I f
z�t'eUn -:7 T-co )AT.
ARRIVE ; _______
=
INSPEC OR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 'ete. k,,- tth )
L 0
LOCATION I //�/
DATE 0 E/(plq/ PERMIT # �� 61&J`-
TYPE OF STRUCTURE,4(747, <
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 I
REINFORCEMENT IN PACE t'
XBACKFFILLOAPPROVALL OF\Gii" /
ROUGH PLUMBING f d
PLUMBING VENT/VENTS IV PLACE
PLUMBING UNDER SLAB ti l
FRAMING: /I 1
JACK STUDS/HEADERS' \
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN BEAM \
FIRESTOPPING %
WALLS
CEILING .
FIREWALLS
HEATING ROUGH-IN "4
INSULATION: /
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS j R- 1
WALLS R-
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
f �
REMARKS:
ARRIVE 9 �
r ,f
DEPART J 411110
/ INSPECTOR
TOWN OF QUEENSBURY P6-1-" iaT
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT ll
REQUEST FOR INSPECTION RECEIVED / 3 O 1, I
NAME 1�, ` A IN V P.l& , .'(vYLJ`''._-i
LOCATION (-4VN Ta )-42✓)-4---' 'I
DATE 9, PERMIT it ` I --/ -
TYPE OF TRUC URE q3- Ro ,C-cki,,,LD_A__b
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 ,,"'
FIRESTOPPING
WALLS . I
CEILING
FIREWALLS ,;"
HEATING ROUGH-IN I
INSULATION: /
FOUNDATION WALLS INTERIOR R=
FOUNDATION WALLS EXTERIOR R-
FLOORS IR-
WALLS / R-
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
. SPACES ;�
/ \
REMARKS•' ` /I) �', �,( 7,
(ç1i-eh (• 4''`r�i( -' r-OD
c< <' [1 ;91 � (2Q/a f 7—
itz.r_i D cj,ji( ___. pi_if2A/(7
ARRIVE - 7- ____._-.__._\__ _ __
DEPART `�(�i /i(i /-- �-
/ 2- _
INSP TO /
TOWN OF QUEENSBURY /rate A7
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME `ipio,,4-i1 4 /I/.44 e_ *Lim)
LOCATION 4,../h'22rl
DATE /(n/9/ PERMIT # f/- 4 5
TYPE OF STRUCTURE ,(f(f 4
j Ae b' diggyibna
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 O THE'CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL ',POUR \
REINFORCEMENT IN`'TJ.LAC — /
FOUNDATION/DAMPROOFING 1 /
BACKFILL APPROVAL . \ /
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PL#CE
PLUMBING UNDER SLAB 1
FRAMING: / !, 1
JACK STUDS/HEADERS / 1
BRACING/BRIDGING s,
JOIST HANGERS .
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING ' ,
FIREWALLS Y`,
HEATING ROUGH-IN / Fk
INSULATION: a
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / R- °;.
WALLS / R-
CEILING / R-
DUCT WORK,/OR PIPING IN UNHEATED
SPACES /
A
REMARKS:
619
ARRIVE
DEPART ci
INSPEC
�ae�o T„ SALES REPRESENTATIVE
Come
CLAUDE ROULEAU
,_Come o °°°°"
qu� v,-6°�' 46 WASHINGTON RD.
jjidersen SCOTIA, N.Y. 12302
518-370-0004
DATE: JOB:
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