2001-107 011K
Aiwa TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010107 Date Issued: Friday, December 06, 2002
This is to certify that work requested to be done as shown by Permit Number P20010107
has been completed.
Tax Map Number: 523400-308-008-0001-037-000-0000
Location: 19 KYLIANS Way
Owner: DKC HOLDING, INC.
Applicant: CLUTE ENTERPRISES
This structure may be occupied as a:
By Order of Town Board
Garage - 2 Cars Attached TOWN OF QUEENSBURY
Single Family Dwelling
t*SEE—ATTACHEELE.OR CON6=T=ON->
Director of Building&Co.e Enforcement
'-r TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010107 Application Number: A20010107
Tax Map No: 523400-093-000-0002-020-001-0000
Permission is hereby granted to: CLUTE ENTERPRISES
For property located at: 486 SHERMAN Ave
in the Town of Queensbury, to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: DKC HOLDING, INC. Single Family Dwelling 90,000.00
13 DAWN Rd Garage-2 Cars Attached
QUEENSBURY,NY 12804 Total Value 90,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
CLUTE ENTERPRISES
13 DAWN Rd
OUEENSBURY,NY 12804
Plans & Specifications
2001-107 _
1248 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT-PLAN
SPECIFICATION -
$178.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,March 26,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.) -
Dated at the To ueenslAry;,q Mr�lla March 26,2001
SIGNED BY 407,k (j ,z 5 for the Town of Queensbury.
r
Director of Building&Code Enforcement
""___ " Buildin Permit Application
Town of Queensl7uly - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 1761-82561
-0 • BUILDING ct CODE ENFORCEMENT
NOTICERequirements prior to issuance r �/� l;•
tr- 1 of this permit: PERMIT FILE NO9 2 t)(- 10 ,
A permit must be obtained before
beginning construction. No inspections 1 b
will be made until applicant has received n Zoning Board Action PERMIT FEE PAID$1 (t ,
a VALID BUILDING PERMIT. AU Area /Use RECREATION FE PAID$
applicants' spaoea on this application
MUST be completed and•the signature
1:::1 Planning Board Action REVIEWED UY.•‹r Kv
of the applicant must appear on tho SPR / Subdivision /Other
Building Imperial.
replication form. J Recreation Fee Payment
Applicant: L-.0 re t Cam, Owner: c4.A-4t1
. ' Address: ‘,'Dcw-a1ZA CU'l e? -c1 Address:
Phone # ( ) S- `7D7 7 Phone # ( ) -
. Property Location: " I kQ S cr N i
• Tax Map Number 9" / , D°- 1
Subdivision Name: Section Block Int
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
^ New Building: CONSTRUCTION: $ 10 070
residence / commercial r
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: 13_ripary Building -
' residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwel i
Office r 6a,aI
Other Work (describe below) Mercantile g MAR 1 2001
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE: •Zo? • .TOWN OF QUEENSBURY
D-Y . t, BUi tari A: D CODE •
1st Floor (� • sq. ft .
If ADDITION, what Vial--trs-e
2nd ,Floor. . ., --- sq. ft of now, addition be? :
Other Fluuts a-'1 sq f t.
(not unfinished cellar or baseme t` ACCESSORY BUILDINGS:
`�D�'C� �
/ � Detached Garage 1, --car
TOTAL FLOOR AREA: 7 SQ. F-r- Attached Garage 1, 2 car
Private Storage Bui ain•g-"-
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
:)C.= FEET X .X, FEET
1
Foundation Type: t- .A Will any second-hand or ungraded
' Number of Stories : • D. lumber be used bso, for what?
(habitable space only)
Height (grade to ridge) : DS feet TYPE of HEATING SYSTEM:
Number of fireplaCe>g d/or woodstove ( circle all whic• .lies)
to be installed:_ - e ' fe i Wood
Forced Hot Air Baseboard / Other
Person responsible for supervision of work as regards to building
codes i s : LOS r C1 f�z.,`R, `i '7 i 7
Name Add'resss Phone
Builder: •
Plumber:
. Mason: L..A.‘.__tie _ '- ' NL.o
Electrician:
•
DECLARATION: Please sign below after you have carefully read the statement.
To the best of my knowledge the statements contained in this application, together with the plans
and specifications submitted, arc a true and complete statement of all proposed work to be done on
the described premises and that . )rovisions of the Building Ccxlc, the Zoning Ordinance and all
other laws pertaining to tl roposci work shall be corn)lied with, whether specified or noted, and
that such work is antis rzed by the weer, Further, is u:u erstood that I/we shall submit prior to a
Certificate of Occ •ancy'or Cert. .tc of Compliar a bcin: issued, an AS BUILT PLOT PLAN by
a licensed s •yor; drawn t• • . ing actu. locati, 1 of project on premises.
Signatur-. Aim.
owner, owner's ,, chitect, ontractor)
•
' Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
• Office Use
Location of installation: Cs't-�cu-N vE •
a /
File Permit No.p�U/ -/6 7
Tax Map No. 9 /
Owner's Name:
• Fee Paid
Address:
2. ••INSTALLER'S NAME : < , � p � 5 PHONE NO. 7�7 3 7a77
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate #bedroom(s) and multiply II of
bedrooms with applicable gallons per bedroom to equal total daily flow)
• Year of House: No. of Bedrooms x Computation = Total Daily Flow
•
1980 or older x 150 gal/bdnn
1980- 1991 x 130 gal/bdrm =
1991 -present x 110 gal/bdrm = • •
•
• Garbage Grinder Installed yes` / no >5
Spa or Whirlpool Installed yes / no X •
4. PARCEL INFORMATION: (circle applicable information &indicate measurements) •
IQpograD is G.�vund afgr.�_B9d.roek oUmpvri9us_MntQritl_ D. . a1.4r_Supply
'Int sat at what depth• at what depth ASYMMO_
Rolling loam feet feet well
' Steep slope clay if well; water supply
_%slope other • from any septic-system
depth: absorption is ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect) •
Rate: minute per Inch
•
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by it licensed
professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size
of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: 100 cC gallon (min. size 1,000 gal.)
Tile Field: each trench 5-0 ft. Total System Length: ft.
Seepage Pit(s): number of size of each: fl. by . fl.
Size of Stone to be used: II / depth or thickness
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
•
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
• For your protection, please note that pursuant to Section 136-29 of the.Code of the Town
of Queensbury, any permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation or failure to make a material fact or
.circumstance known by or on behalf of an applicant, shall be void.
•
I have read . . regulations with respect to this application and agree to abide by these and all
require is of the V. of Queensbury Sai 'A ry Sewage Disposal Ordinance.
idipifiyak
•
• • (o(
Signature (Responsible person- Date
(7_,.6 /6 7
-
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
_ -_ 9000 HEATING DEGREE DAYS
Comoli ance Methods: P?RT 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 'Family .Dwellings; Multi-Fatly
Dwellings (3 stories or less)
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission : of worksheets
APPLICANT' S NA_ME: PROPERTY LOCATION:
•
PART _5 M5TEOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - square feet
•
2 . T- e of Heat - El nr- "1c Oi 1 "Gas Other
3 . Is building mec_ani daliv cooled? Yes No
4 . 7:1=r-ce ntace of area of windows and doors Over
171 ›e Under i 7 s
5 . R-VALt E S FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VAIL S AS
S_OWN ON PLANS ITIS_ ITT_D.
a . Roof R 3v
b . Exterior wails R tar
c . Glazed areas R 4S
d . Exterior dcC_s R
e . 7rloors over unheated Spaces R ,cj
Edge of slay on grade (heated- building) R
c . Basement/cellar wails (above c=ade) R . ---
. 3asement/c= walls (below c=ade) R .--
. _:eating/coc__:g-dLc:_-pT pi:c i__ unheated space R -
6 . Service (domestic) hot water heat i__c device \
Co-:cr to Minimum efficiency war code Yes No
T E 2-S=ERA LIRE CON IF li .AI=MTJM SETTING ?400 - WILL NOT BE EICEEDED
L-3-Taleol Phcz= Nur'-er
_ S R77}47-1RK:.
Inspector's No
Date _ 20
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
(Consulting and Fire Inspection Services)
(Incorporated in the states of Maryland,New York,Pennsylvania,Delaware and West Virginia)
Desiring Certification 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.
PLEASE PRINT -
r--
Owner s, _' ", u s. f "' , ,. - Type.Bldg. ❑DWG 0 Other
Occupant Building Permit No.
Job Location --L t>''.' City l State 1.
County ,,; q ` •- Twp. M/C# Swimming Pool—New❑Old
Directions to Job Site
N• •
Application For Rough.Wiring Fixtures❑ Serviced or
Work—New ' 7: Additional Cl Bldg. —New,L Old❑ Ready for Inspection
APPLICANT'S -
SIGNATURE - ,. ! — - LICENSE s PERMIT S
` PLEASE -
PRINT NAME V. ' — •_• s. PHONE 1$
APPLICANT'S NAME OF
ADDRESS UTILITY
CITY' , . - a STATE ZIP CODE II ram.
_ . BE NOTIFIED
ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS AMP SERVICE PUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE DISHWASHER
FIXTURES _
MOGUL BASE ' V WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
Inspector's Comments:
OFFICE USE ONLY WORK INSPECTED REPOR- �' o
NOTIFIED TED rc 3 FEE PAID
SERVICE DATE CON- TOTAL $
Date Received: TRACTOR TOTAL
R.W.DATE OWNER CHECK NO.
FINAL DATE OCCUPANT CHARGE
Certificate No.:
CERTIFICATE NEEDED AGENT CASH
Date Sent: DYES ❑DUP ELEC.
LT.CO.
Progress 0 INSPECTOR
THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.I.S.INC.
\
WHITE/OFFICE PINK/INSPECTOR YELLOW/OFFICER GOLD/CUSTOMER
1........xii _
Town of Queensbury
Fire Marshal's Office YID®---'
., ..,,' 742 Bay Road y
Queensbury, NY 12804 e
Phone (518) 761-8205 Fax(518) 745-4437
1
Fire Marshal's Inspection Report
Request SCHEDULE
Received: Permit# : Gt7 i- I f)'7 INSPECTION ON: 2`7-6 - -_
Name: (..AtAP, ` Aroag_l 7;p1 _ AM PM ANYTIME
Location: Ki 11 WO A kt y ,
APPROVED
N/A YES NO COMMENTS �L
EXITS
WIDTHS Le/4 OA *' MFP ,,5 o M 6I k
AISLENORMAL
f
EXIT SIGNS-BATTERY -5 eZi-c1e Ck& jtj-; D`lEMERGENCY LIGHTIN r
FIRE EXTINGUISHER
FIRE ALARM SYST 1(FIRE SPRINKLER STE1FIRE Yz
HOOD N TALLAO'N A0_,36,0,L YST M ( � t<04-= t�
J-
STORAGE
1 -
COMPRESSED GAS / I"i ,r "`
CLEARANCE TO SPR NKLERS 1 . am
u
CLEARANCE TOME{ NG.
UNITS (�
CLEARANCE TO ELEC ICAL - `; t1 - I/vJ sect `-�N
REQUIRED SIGNAGE v
EMERGENCY PLAN �f
MAXIMUM OCCUPANCY S.GN -_ \i b'L`f �,�J f.1 ..�� --1 OIC
CHIMNEY
MASONRY ROU‘H IN II
F`,AL - 614- 0111-4 Ck - ffg1Q-1�\e ^�` '�" t
CHIMNEY
f
FACTORY BUILT ROUG IN �� 7 j�
C'-�l'i it�AV -
FIN LWOOD
STOVE ROUGH I�! y'" \I ekk- kel
WI IAA- 1 N)
FINAL _ ,
VENTED GAS .)1A--,IA-
APPLIANCE ROUGH IN /1,
f A Ctl<
FINAL IFIREPLACE V ,�, p( i 41,. (R.Vi4lL2
MASONRY ROUGH IN 1
OK THIS DAT OK FOR CO NOT OK
FINAL , 1
FIREPLACE C.)",'e\t - \ _,-
FACTORY BUILT ROUGH IN INSP D BY
FINAL
COMDEV/CHRISJ/WORDILETTERS200 UFIRE MARSHALINSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
60.4, U4 t, 40 ' Con ce...1-e 1.1,i t")40.R ed., a_
1 I. i A..- 91A e7
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545 z6-0/" 107
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVALA
Permit No2 0 j—/6 `j Cert. No 81847 Cut-in Card No.! 1.a 2. I Q.9i
Owner c.L...0 7'er
Location °I. 14...y Y-.S r
Installation Consisting of G I L) 2..%z...c-) 3 0 ai.6,
„,2...3 i....T...SI .2...`,9 /1'7oJC ny� -
Installed By....0_,...B e746-4°- Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
rules are violated,the Company shall have the right to revoke this certificate.
Date / - 0
Member N.F.P.A.,I.A.E.1.
!^h, 1.+• `- v` .- -. ... -, rr sy r cam^ v. �,,'�-.f 't-{N .2.i(
-.7 .._, , ?
' .. ICY 0 0 iki
RESIDENTIAL-FINAL INSPECTION'REPORT,
Office No.(518)'761 8256; Date inspection request received:f z-/7/o
Building&Cod'e,Enforcement /,;� 2-7�
Dept.of Community Development Arrive am/pm Depart ) -6'"Iai p 3
Town of Queensbury ; , Inspector's Initials - 4'f r •
742 Bay Road .z,r, j LEii ri i,`'i,"}! �`
Queensbury,New York 12804 . ..
NAME . .. 1 _11 i.-A .i PERMIT# f' � ^
LOCATION /`7 VI 1Ceat,> C O`. ►14)CiM.- ,.DATE f Z/ /.i) 7_... d
TYPE OF STRUCTURE /i 1" A , ` ' --.
`% N/A YES/NO COMMENTS i i ` x
Chimney Height/"B"Vent/Direct Vent Location v��,/'
Fresh Air Intake - '''/
Plumb Vent through roof V/
Roof Complete V/ ,
Exterior Finish Complete v/ ,, - /%
Interior/Exterior Railings 30"to 36" u / /
Exterior Handrails,balconies,landing 18 in.or more v./ ` �/ /'
Interior Handrails stairs both sides 3 or more risers 1// 7 /,. /``
Grade 2%away from foundation '// // /
8"clearance to sill plate t�/ \' ,ram-
Gas Valve shut-off exposed/regulator 18"above grade /`-' � / /�,
Gas Furnace shut-off within 30 feet or within line of site ( • i; V / '
Oil Furnace shut-off at entrance to furnace area \ V \ /' /
Furnace/Hot Water Heater operating \ \i� !/
Relief Valve(s)installed \ \-'�4 / t,_ C
Headroom,6 ft.6 in.on stairs \ A./' /
Basement stairs,6 ft.4 in. \ "fir' / • 0 :(AL/ F( ✓4 L- R if..J
Handrail exterior stairs both sides more than 3 risers Vi
k/
Interior privacy/trim/doors/main entrance 36" /VA,
Floor Finish /`'\ \ V
Bathroom/Kitchen watertight 1 V \\
Interior Handrails Balconies/Landing 18 in.or more / / '/I v+
Railing across window in stairwells V i 1.' \\
Smoke Detectors: 4/
every level 'if , '
every bedroom ' `V
outside every bedroom a i I,
inter connected VA
Bathroom fans ✓7.,
Plumbing fixtures - i V ',
Foundation insulation V ,,, '
3/4 hour fire door/door closer 'f'
Garage fireproofing �' LL'S lad— rt r ' "
xkl-r
Garage penetrations sealed / V r
Furnace in separate room protected(in garage) V .f'
Light ventilation per room `'r ;
Safety glazing 18"or less from floor �4 t''///4/„.- �L
Final Electrical 0 'S-ee
Site Plan/Variance required `' / �!_ 7 = ; ���►=, f C r
Final Survey Plot Plan `/ /
As Built Septic System layout required
Okay to issue C/C(Certif:of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_ /
Okay to issue permanent CIO(Certif.of Occupancy) V 7 -7 ''- (155-
r
rt61-417:7711#17
RESIDENTIAL FINAL INSPECTION REPORT /Y o a v q
Office No.(518)761-8256 'Date inspection request received: Z
Building&Code Enforcement 777
Dept.of Community Development Arrive am/pm Depart amlpmom ' �
Town of Queensbury Inspector's Initials ,j`C / •34,t . ' �;
742 Bay Road
Queensbury,New York 12804
NAME CI PERMIT#
LOCATION jj' vo U DATE _' . " hdatir_
TYPE OF STRIJ TLTR is CPrvs F.6
N/A YES
NO COMMENTS
Chimney Height/'B"Vent/Direct Vent Location e/
Fresh Air Intake
Plumb Vent through roof �//
Roof Complete �/�f
Exterior Finish Complete- ✓//
Interior/Exterior Railings 30"to 36" /
Exterior Handrails,balconies,landing 18 in.or more ✓
Interior Handrails stairs both sides 3 or more risers /
Grade 2%away from foundation t�
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site /
Oil Furnace shut-off at entrance to furnace area .f/
Furnace/Hot Water Heater operating
Relief Valve(s)installed ✓/
Headroom,6 ft.6 in.on stairs // . ' k i 1A)
Basement stairs,6 ft.4 in. !// .!7.S` ' F, K� �
Handrail exterior stairs both sides more than 3 risers V Interior privacy/trim/doors/main entrance 36" /
Floor Finish if/
Bathroom/Kitchen watertight 1//
Interior Handrails Balconies/Landing 18 in.or more / ✓
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom •
outside every bedroom t//
inter connected
Bathroom fans /�
Plumbing fixtures ,/
Foundation insulation
3/a hour fire door/door closer
Garage fireproofing trj
Garage penetrations sealed / f/
Furnace in separate room protected(in garage) i/
Light ventilation per room - d/Safety glazing 18"or less from floor 471.,iy.4. F ./ � z-�[ -
Final Electrical ,
Site Plan/Variance required /
Final Survey Plot Plan �/
As Built Septic System layout required
Okay to issue C/C(Certif of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy) A-� - j 2 7 — l 5-5.
TOWN OF QUEENSBURY
.; ' '� BUILDING & CODE ENFORCEMENT
r t 742 BAY ROAD
nc� ,; . QUEENSBURY NY 12804
" (518) 761-8256
ARRIVE: DEPART: INSP: `L
FINAL INSPECTION REPORT
COMMERCIAL MULTIPLE DWELLING
(hotel, motel, apt. complex)
DATE INSPECTION RE UEST RECEIVED:
NAME cj; /
LOCATION Kciii,
DATE V 4 4- PIERMIT H Z&O 1 /O
TYPE OF STRUCTURE SPIJ
FOOTINGS BACKFILL FRAMING PLUMBING
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT/FIXTURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES
FLOORS •
FOUNDATION INSULATION
/
INTERIOR STAIRS/RAILINGS
STOCKROOM ENCLOSURE
FIRE/DEMISE WALLS PENETRATION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT DOOR HARDWARE
t
1
EXIT STAIRS/RAILS
PLATFORM/ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS
HANDICAPPED PARKING
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
\ FINAL SURVEY PLOT PLAN, IF REQ 03
OK TO ISSUE C/O OR C/C
•
-GENERAL INSPECTION REPORT Inspector:Office Use
Town of Queensbuiy Ready at time:
Dept. of Community Development Request received: l0/I /D" Meet:
Building& Code En Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPARTC7/1` m/pm Not- 1-/ 1/�,
(518) 761-8256 Inspector's Initials
NAME: L kg-r2-1 PERMIT# Z(7 U I 6 G7
LOCATION: `7 (Q S Rye-- INSPECT ON(date): 1 I f' jtf
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
•
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/Wallpour
Reinforcement in Place
Foundation/D amppro offing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In V
ins aion --
Fo atio W ls' L terior R-
Foundation Walls Exterior R- i
Floors R-
Walls R- lq (/
Ceiling R- 4)0 V
Duct work or piping in
unheated spaces R- </,
P oper Vent,Attic Vent /
'a u i o 1/ •
Jacl Studs/Ileaders
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed / .
tall T ,4 ho ram:_
topping CAC/•41"6 t/
L:1SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
(411111-V,-"nl
Town of Queensbury
i
Fire Marshal's Office
, , 742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
1
Fire Marshal's Inspection Report
Request /SCHEDULE
Received: Permit# U 1 1 o7 INSPECTION ON: ` 0 /62j
Name: C_LU s(—C AM PM ANYTIME
Location:
APPROVED
N/A YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN
CHIMNEY
MASONRY ROUGH IN Z
. j
FINAL
CHIMNEY tp,4<-i
FACTORY BUILT ROUGH IN
FINAL
WOOD . .
STOVE ROUGH IN
FINAL
VENTED GAS
APPLIANCE • ROUGH IN
FINAL �� \
FIREPLACE ("OK
}
• MASONRY ROUGH IN THIS DATA c_Sr. OK FOR CO NOT OK
.! FINAL
'REPLACE t_C'1JNO)C
`V FACTORY��fLT R UGH IN'1�� INSPECTED BY
�
�' O C n1�r. -
„A o L o FINAL _
COMDEV/CHRISJIWORD/LETTERS2001)FIREMARSHALINSPECTIONREPOR 11022001
YELLOW-OCCUPANT COPY
WHITE-BUILDING DEPARTMENT COPY
Office Use
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GENERAL INSPECTION REPORT Inspector: .
Ready at time:s 5 • �3'Town of Queensbury
Dept. of Community Development Request received: Id ii‘..162_
Meet:
Building& Code Enforcement At time:
742 Bay Road f
Queensbury, NY 12804 ARRIVE am/pm: DEPART • e am/pm Notes:
(518) 761-8256 Inspector's Initials C -(-
NAME: v( i4. PERMIT# �GC1 I —101
LOCATION: Li 661 f 1 4/C. (ici INSPECT ON(date): /D//t' /ô2_
TYPE OF STRUCTURE: S F 14k , )•
RECHECK 14.v C
N/A YES NO COMMENTS
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/W allpour
Reinforcement in Place
Foundati o n/D amppro offing
Backfill Approval .
Plumbing Under Slab ,(;-/..
Plumbing Vent/Vents in Place
4r0 ough Pl mb
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 R-
oper exit,Attic Vent
/ . ----
`ranvng /
Jack Studs/Headers / / / �� / / ��C. 4 � 4 6,4ec
Bracing/Bridging / / \/ ak()U L L: V U /l
Joist Hangers /
Jac 2',osts ain Beam
1.0t In'li atigiilarrier
ire Separation 1,2,3,hour
Penetration Sealed
Fire Wa.112,�r4�hhour 1 (�e //, -tL t - o�c�c 4IG
� nepstopprn
L:\SueHemingway\Bui]ding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: II�/l(� Meet:
Building& Code Enforcement
.f At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPAR7I i Li am/pm Notes:
(518) 761-8256 Inspector's Initials---E
NAME: CJ PERMIT# 0 / — / O7
LOCATION:LA `e. _ � AV-- INSPECT ON(date): G ( ZZj7 a- 4a--
TYPE OF STRUCTURE: Pa 1'CyL
RECHECK
N/A YE NO COMMENTS
Footings 1'
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/Wallpour
Reinforcement in Place
Foundation/D amppro o fing
Backfill Approval _
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
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 R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour_
Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REP,ORT.doc
TOWN OF QUEENSBURY .
BUILDING- &.CODE ENFORCEMENT e n
742 Bay Road
Queensbuvy NY 12804 .
,,,,,A4
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Ct k --- L V e 5 em a- A-tic
Location 1/1400te ! _AN Permit # Of-/07
SOIL TYPE:li r
Loam-Clay-
Results of 'ercol ati on Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: ,, AJ
ABSORPTION FIELD: Total Length/. 40
Length of each trench l -'E
Depth of trenche 2-Size
Size of stone . #7i
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Lize Type
Bldg. to Tank lj 6
Tank to Dist. Box a jc
Dist. Box to Field/Pit 0 kil
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank g! feet
Foundation to Absorption feet . '
Separation of Pits _ fe
Conforms as per Plot Plan es
LOCATION OF SYSTEM ON PROPERT .
(circle ��tL
.�5-
Front - Re. - Left Side - Right Side
Middle ront - Middle Rear
COMMENTS:
' SYSTEM USE APPROVED: YES
Arrived: / ell
Departed:
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Office Use
GENERAL INSPECTION REPORT Inspector: //�j
Town of Queensbu�y
Ready at timed ''/`�i j
Dept. of Community Development Request received: )C1 0 Meet:
Building& Code Enforcement At time:
742 Bay Road --.7
Queensbury, NY 12804 ARRIVE am/pm: DEPART? am/pm Notes:'
(518) 761-8256 Inspector's Initials \S rz---
,,,
Cii4(
-61\11-14
NAME: PERMIT# D' r 0
LOCATION: 1/0- . il- 4)---C------- INSPECT ON(date): < 0
72
TYPE OF STRUCTURE: C�w
RECHECK
N/A YES NO COMMENTS .
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 / 4 p
Foundation/Wallpour / D r' ilu"S( Ate'
Reinforcement in Place
_ Foundation/Di ampproofmg
Bac fil ' pproal
Plumbing nder Slab
Plumbing Vent/Vents in Place
ugh Plumbing
eating Rou -In
Insulation � L____
1 / .
Foundation alls Interior R-
Foundation Walls Exterior R- `0 /
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour .
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
•
GENERAL INSPECTION REPORT Inspector:Office Use
— to: � ,�
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Si Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPART") dAm/pm Notes:
•
(518) 761-8256 Inspector's Initials V12t1
NAME: L i r1.J C L VT(T PERMIT# c O 0 r-- )61
LOCATION: / �' cAt M U INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
• N/A YES O COMMENTS •
ootings/Piers
Monolithic Pour Foim
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/Wallpour •
Reinforcement in Place •
Foundati on/D amppro ofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
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 R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour_
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:\.SueHemingway\Building.Codes.Inspcction.FORMS\GENERAL INSPECTION REPORT.doc
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