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91-349 E CERTIFICATE OF' QCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date_ "�1�✓��YrIAm, 2 I 19 This is to certify that work requested to be done as shown by Permit No. 91-349 has been completed. This structure may be occupied as a Commrcial Bldg Office Building) A Location Lot 7 Baywood Drive Owner John Hughes Tenants ' Dr. David Sherlock By Order Town Board TOWN-OF QUEENSBURY c� f - Director of Bldg. & Code Enforcement s—� BUILDING PERMIT TOWN OF QUEENSBURY No. ci-349 WARREN COUNTY, NEW YORK c c I PERMISSION is hereby granted to John Hughes F " OWNER of property located at Baywood Drive Street, Road or Ave. " in the Town of Queensbury,To Construct or place a Commercial Bui l chin® at the above location in accordance to application together with plot plans and other information hereto filed and c C approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is C 375 Bay Road Queensbury, MY 12804 � u c 2. CONTRACTOR or BUI LDER'S Name Sane c C C e 3. CONTRACTOR or BUILDER'S Address e n C C 4. ARCHITECT'S Name e C C 5. ARCHITECT'S Address e C u< 6. TYPE of Construction—(Please indicate by X) ( X Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications No. 2,234 sq ft Commercial Building as per plot plan specifications and application 8. Proposed Use Office Bldg. $ 330.00 PERMIT FEE PAID —THIS PERMIT EXPIRES JUNE 4, 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 this 4yh Day of JUNE 19 91 k SIGNED BY ( / —1J(.��� for the Town of Queensbury Building and Zoning InSP4Y r TOWN OF QUEENSBURY REVIEWED BY ��� 'rOWN OF "'::"N88UAv FEE PAID $ �j C) B PERMIT NO. M AY9�� BUILDING PERMIT APPLICATION KDO. 8� CODE DEP.!..P A PERK" MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UN71L APPLICANT HAS RECEIVED A VALID BUELDING 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. The owner of this property is: P.O. Address ? 7� z?,g Tel. Property Location- / 47P. Tax Map No. . A/0/ 7/// / Has there been--any split of this property since October 1, 1988? f,/� / 11 _�S_9Q es no If yes Planning Board Review is necessary. SUBDIVISION NAME, IF APPLICABLE LOT NO. THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES-IS: * NATURE OF PROPOSED WORK: * ESf;MATED MARKET VALUE OF V- Construction of a new building * CONSTRUCTION: $ - D Addition to a building * COMPLETE INFORMATION REQUIRED BELOW: * Size of property _� d '/ ft x eft. Alteration to a building * Existing Buildings(3) Size ft. x ft. (no change to exterior dimensions) * Proposed building - distance from property line: Other work (Describe) * Front and y ft. Rear yard sd ft. * Side yards ft. and ft. * GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft. 1st Floor �sq. ft. * OCCUPANCY INFORMATION * 2nd Floor sq. ft. * Primary Building - Other Floors sq. ft. * One Family Dwelling (not c--:!ar or basement) Two Family Dwelling TOTAL FLOOR AREA_= sq. ft. * Multiple Dwelling/Number of units Size of new structure__aft x ft. * Business Foundation-pier/slab/c- --'i�drtiai/full " Industrial (circle Other • .:o. of stories (habitable space) l Height (grade to ridge) _ 2 ft. , If addition, what will use be? If residential, no. of families , No. of rooms(excluding baths) w Accessory Building No. of bedrooms ' __Detached Garage ONE/TWO Cat' No. of bathrooms • Primacy heating system o?s gyp. _,_Attached Garage ONE/TWO Cam' Type of fuel * _Private storage building No. of fireplaces installed __ Will a wood stove be installed Other Central Air conditioning -_ - OV* ER BUILDING PERMIT APPLICATION CONTINUED - BUILDING iPF.CIFICATIONS: Type of construction, wood frame, fire safe, etc. �mo.l ."";.',- Will any second-hand or upgraded limber be used? If so, for what? hVo Foundation wall material ('e ,Q,, b/mei� Thickness /o f( Depth of foundation below grade (to bottom of footing) Will there be a cellar? e�/ S Heated or unheated?_(_,, Floor sq. footage sq ft. Will there be a basement?? Will any portion be used as living space? (If so, what portion? sq ft. Type of use? Type of roof - sloped/flat/shed/other,S Material of roof �soti��i7 �Sh.NgJ�s Size, wood studs ,"x spacing__" o.c. length V ' ft. Joists (floor beams) 1st floor _A"x )-'I " spacing /L"o.c. span ft. Joist (floor beams) 2nd floor "x it spacing "o.c. span ft. Overlays (ceiling beams) "x " spacing " o.c.'span ft. Roof rafters "x—Z---',- " spacing )6 o.c. span /i Roof trusses (pre-engineered) spacing j� " o.c. span_ 'ft. Exterior wall finish eY% s.ol•� n of what material? Interior wall finish If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure, self-closing device be provided? Will a flue-lined chimney be installed? Height above roof ft. Depth of chimney foundation below grade ft. Depth of fireplace hearth ft. in. Water supply - Municipal or private well 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 q 2 TEL. NO. 7 Qa q 20 (, NAME OF PLUMBER �,g,y, Cr9Y/�v�.S a ADDRESS ('�tise doo�� TEL. NO. 9a5a 7 0 NAME OF MASON �2 r !��9/eS ADDRESS TEL. NO. NAME OF ELECTRICIAN Sin, C,,, h,,vre-ADDRESS TEL. NO. 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 ?�ner, owns 's agent, architect, contractor SPECIAL CONDMONS OF THE PERMIT: BY 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 AP LICANT' AME PROPERHMTION AA Old S PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area - Sq. Ft. 2. Type of Heat - Elec. Base Board Other 3. Is Building Mechanically Cooled? YES NO 4. Percentage of Area of Windows and Doors Over 17% Under 17% THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E. Q U I R E D THE R-VALUES SHOWN ON PLANS SUBMITTED! Baseboard 5. Insulation Values: Actual Shown Elec. Heat Other A. Roof & Floors exposed to ambient temperatures- R B. Exterior Walls R C. Glazed Area R D. Exterior Doors R E. Floors over unheated spaces R F. Edge of Slab on Grade (Heated Building) R G. Basement/Cellar Walls (Above Grade) R H. Basement/Cellar Walls (Below Grade) R I. Heating/Cooling - Ducts - Piping in Unheated Space R 6. Service (Domestic) Hot Water Heating Device A. Conforms to minimum efficiency per code YES NO TEMPERATURE CONTROL- MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED APPLICANT'S SIGNATURE DATE TELEPHONE NUMBER, INSPECTOR'S REMARKS : Forvr(p Sa"rrvfi • �s /VOf /4P�t 8WILa 1,04 W 1 tL CbiV$::M A4 rO Phcfr 4 OWL 34 I TJe4 f Raymond Maloney Enterprises LTD. President �'j�i�� p For Complete Michael Pucunas P.O. BOX 2136 Sales/Service T1. �C� SCOM, NY 12302 Sales di Service Geoffrey Searl (518) 399-0281 of Medical and Dental Equipment Operations Manager 8/6/90 MEMO To : '-Mr . John Hughes • From : Mr . Ray -Maloney Re : Dental Office waste line considerations . ' 1 To Whom It May Concern : As regards the use of a Cast Iron Drain Line , the Was.te Line required on the Automatic Film Processor , Manual Film - Developing Tank, and the sink in the Dark-Room area should be of a material impervious to the chemical action of Film Developer and Film Fixer components . (I.E. - CPVC, PVc , or glass ) . Any copper , brass , -and or iron fittings must be avoided , as they are reacted upon by, and decomposed by, Film Development Chemicals . Yours _.Truly, Ray Maloney President , Med-Tech TOWN OF QUEENSBURY APPLICATION,,FOR SEPTIC DISPOSAL PERMIT DATE: LOCATION OF PROPERTY FOR INSTALLATION— Owner' s Name: ���,� Address:_ Installer' s Name: --?',91) ��Q,�es Telephone: pga42o 6 Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography: Circle one: Flat Rolling Steep Slope_ % of Slope Soil Nature: Circle one: Sa Loam Clay Other /Depth: Ground Water: At what depth? Feet Bedrock or Impervious Material : At what depth? Feet Percolation test: Circle one: not required required Rate - 1 110 /S Min. Per Inch Domestic water supply: Circle one: unici Well Other If domestic water supply is a, wel Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank y gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench L D feet/Total system length Z 6 y feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used #. /Depth or Thickness /1) feet ***************************** HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks Size of Each Gal . *Alarm system and associated electrical work to be inspected by an approved 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: DATE: Septic Syste■ 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 co any water supply 5.) size and dimensions of all tanks, distribution boxes, rile fields and/or drywells B. No system shall be covered before inspection and approval by the Uuilding Inspuctor. Failure to comply with this requirement may ruault 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 tine of inspection may - result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper inscalla— cion, alteration or repair of an approved system, a new proposal must be submitted to the Queensbury Building Department before further construction. Town of Queensbury BUILDTNC and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 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 _ k/0" NAME (WX-., .d' I LOCATIO � p DATE (p PERMIT # TYPE OF STRUCTURE RECHECK APPROVED N/A YE5et 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 `11 REINFORCEMENT IN PLACE 'i, FOUNDATION/DAMPROOFING BACKFILL APPROVAL ` ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS f JACK POSTS/MAIN BEAM FIRESTOPP ING WALLS CEILING FIREWALLS HEATING ROUGH—IN ` INSULATION: FOUNDATION WALLS INTERIOR R— FOUNDATION WALLS EXZ'ERIOR R— FLOORS k' R— WALLS I R— CEILING R— DUCT WORK OR PIPING IN UNHEATED S PAC ES REMARKS: ARRIVE DEPART I NS PEC TOR TOWN OF QUEENSBURv BUILDING AND CODES DEPARTMENT X 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RE E/IYED - NAME I 464J LOCATION �L cure L o DATE Y f/ PERMITT f TYPE OF STRUCTURE O q,c RECHECK APPROVED N/A YESI 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 r� FOUNDATION/WALL POUR ! REINFORCEMENT IN PLACE �ZUNDATION/DAMPROOFING f BACKFILL APPROVAL / ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: 4 / JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM FIRESTOPPING WALLS CEILING E FIREWALLS 4 HEATING ROUGH-IN 1 INSULATION: A FOUNDATION WALLS INTERI Rr R- FOUNDATION WALLS EXTER OR��R- FLOORS WALLS I R- CEILING R`,, DUCT WORK OR PIPING N UNHEATED SPACES REMARKS: I i \ lv ARRIVE DEPART INS P CTOR TOWN OF QUEENSBURV BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR°S REPORT REQUEST FOR INSPECTION RECEIVED NA14E LOCATION DATE 7 a< PERMIT f TYPE OF STRUCTURE RECHECK APPROVED N/A YEtj NO FOOTINGS/PIERS I MONOLITHIC POUR FORM l 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 i FOUNDATION/DAMPROOFING BACKFILL APPROVAL I ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE r PLUMBING UNDER SLAB FRAMING: I t JACK STUDS/HEADERS a� BRACING/BRIDGING I,f JOIST HANGERS JACK POSTS/MAIN BEAM / FIRESTOPP ING WALLS ' a CEILING I' FIREWALLS / HEATING ROUGH—IN INSULATION: / FOUNDATION WALLS I TERIOR R—;I FOUNDATION WALLS TERIOR R—, FLOORS R WALLS L R— CEILING R— DUCT WORK OR PIPING IN UNHEATED SPACES i REMARKS: ! fY 1�J ARRIVE T* DEPART Ab 05 INS PEC TOR 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 LOCATION DATE E;tMIT # -- TYPE OF STRUCTURE RECHECK APPROVED N/A YESI 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 p' REINFORCEMENT IN PLACE FOUNDATION/DAMPROOF,ING BACKFILL APPROVAL I �-''-ROUGH-PLUMBING.., PLUMBING VENT/VENTS4IN 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 WALLS EXTERIOR R- FLOORS R- WA LLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: ARRIVEq DEPART _?4-M` SPECTO a ,ir TOWN OF QUEENSBURT BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR°S REPORT �+ REQUEST FOR INSPECTION RECEIVED lJ NAME ZP.� LOCATION DATE k PERMIT fjo TYPE OF STRUCTURE RECHECK APPROVED N/A YESI NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENTiOF THE CONCRETE. MATERIALS FOR`'.THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE F FOUNDATION/DAMP.ROOFING ;! BACKFILL APPROVAL � ROUGH,PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: J JACK STUDS/HEADE BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM\ FIRES TOPPING WALLS CEILING , FIREWALLS HEATING ROUGH-IN INSULATION:: FOUNDATION WALLS INTERIOR\R- FOUNDATION WALLS EXTERIOR `R- FLOORS' R WALLS' R_, CEILING R- 3 DUCTWORK OR PIPING IN UNHEATED, SPACES REMARKS: U ARRIVE u& v DEPART INSPEC OR TOW,, OF QUEENSBURY 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL IIISPECTIOFd �� J REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE g / PERMIT# TYPE OF STRUCTURE_ �e RECHECK i _FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE), SOOTING tiFOUNDATION Ji�ACKFILL _4,FRAMING, �ODUGH PLUMBING FrINAL ELECTRICAL _SEPTIC L,--SULATION _WOODSTOVE/FIREPLACE REMARKS / ` 1 ! ° APPROVAL t N/Af YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION ^s PLUMBING VENT N '{ ROOFING SIDING DECK/PORCH/STEPS/RAILINGS'~, RELIEF VALVES ' FURNACE/HOT WATER OPERATING/ BASEMENT INSULATION/DUCTWOR•K INTERIOR TRIM/PRIVACY DO AS\ FINISH FLOORS: BATH/KITCHEN WATERTI T �, OTHER FLOORS SWEEPA E OTHER FLOORS CARPE ED STAIR CLEARANCE/RAI NGS HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/ 15 = 5 ALL PLUMBING FI fURES OPERATING GARAGE FIRE PR OFING DOOR CLOSERS OTHER FIRE S PARATION FIRE/DEMISE ALLS DUMPS TER SITE PLAN VARIANCE REQUIREMENTS FINAL EL CTRICAL OK TO ISSUE C/O OR C/C COMMENTS: ARRIVE ` DEPART- 1 N S P T _locun o� QueenJlLry BUILDING and ZONING DEPARTMENT ' Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION 7"— DATE 0/-ZL PERMIT NO. SOIL TYPE - Sand - Loam - Clay,. -_ Percolation Test Required? YES - NO Percolation rate - Min/Inch j' TYPE of SYSTEM: r Absorption field, total lengt17X0 Length of each trench '; nS0,' Depth of trenches ' r Size of gravel_ Zt;f SEEPAGE PITS{Number of)'{, J' Size- ft. X Grave ,' PIPING: Size Type Bldg. to tank ,� J L/ P(,/i— Tank to dist. box C— ti Dist. box to field/pit Openings sealed? 1jYES NO Partial LOCATION/SEPARATIONS: Foundation to tan;k ft. Foundation to absorption 'eft. Absorption to lot line eft. Separation of ]tits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear Left side - Right`: side - ( �. COMMENTS: ( ' /V 0 To r—lf 6-c�iL`1�� t�C7"K SYSTEM USE APPROVED fW Buildi g InsI c t o r ` 01/86 and vl 11�TOWN OF QUEENSBURY -e7 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE / / ( PERMITS TYPE OF STRUCTURE RECHECK FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) FOOTING LFOUNDATION vB-CCKFILL /FRAMING Z�ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC .4_I.NSULATION _WOODSTOVE/FIREPLACE REMARKS `APPROVAL N,/ r YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT i ROOFING 7/ SIDING L/ DECK/PORCH/STEPS/RAI NGS RELIEF VALVES `, r FURNACE/HOT WATER OPERATING ✓ BASEMENT INSULATION/DUC,TWORK INTERIOR TRIM/PRIVACY DOORS FINISH FLOORS: BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED % STAIR CLEARANCE/R'AILINGS�. HANDICAPPED ACC�SS �. SMOKE DETECTORS BATHROOM FANS/WHOLEHOUSE FANS ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING DOOR CLOSER OTHER FIRE' SEPARATION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL OK TO ISSUE C/O OR C/C COMMENTS: ARRIVE DEPART IN3PECTOR TOWN OF QUEENSBURY FIRE MARSHAL s QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED / NAME ()I& v a LOCATION ` ja DATE PERMIT# APPROVED EXITS N/A YES NO j AISLE WIDTHS / 1� EXIT SIGNS EMERGENCY LIGHTING t FIRE EXTINGUISHERS AUTO. EXTINGUISHING SYSTEM J ,� HOOD INSTALLATION AUTO. SPRINKLER SYSTEM /11 ALARM SYSTEM / INTERIOR FINISHES STORAGE: / CLEARANCE TO SPRINKLERS ✓ CLEARANCE TO HEATING UNITS ✓ REQUIRED SIGNAGE w t CHIMNEY / WOODSTOVE / FIREPLACE-MASONRYf FIREPLACE-FACTO Y BUILT REMARKS: WOK TO THIS DATE J nb ln.� ARRIVE /Q DEPART 12 INSPECTOR ELECTRICAL.INSPECTIONS DUPLICATE MUNICIPAL RECORD Permit No. Owner ``� m-Aj 1,+. v c Occupant 11 Location No. Sheet t iU "�; j-:3 01 Z' Town or City State Installation as itemized on reverse side has been visually inspected pursuant to applicable Codes. Installed by Sc�JLt. Ce 2%Aaa:5— n o Date //" L / l r r %('%� Inspector MIDDLE DEPARTMENT INSPECTION AGENCY INC. FORM NO.18 EL. 900 Haddon Ave., Collingswood, NJ 08108 6 ROUGH WIRING OUTLETS H.P.AIR CONDITIONER S, OUTLETS WIRING &CONTROLS FOR 6 5 BURNER �U U RECEPTACLES H.P.PUMP FIXTURES K.W.OVEN Q AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT t AMP.SERVICE CONDUCTORS K.W.DISHWASHER K.W.SURFACE UNIT K.W. DRYER K.W.RANGE AMP. RECEPTACLE K.W.WATER HEATER FRAC.H.P.VENT FANS //2C- F 567-Ctk r 7` S --m 2 /,/iNs 7'&-S OTORS H.P. 1/20 1/12 1/10 � i/s V Y! % Y. 1� 2 3 5 7h 10 115 120125.130140 150175 1101 IARK NUMBER F EACH SIZE APPARATUS