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2001-350 TOWN OF QUEENSBURY Fir#0 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 ?=`73 "43 Community Development - Building& Codes (518) 761-8256 y � CERTIFICATE OF OCCUPANCY Permit Number: P20010350 Date Issued: Tuesday; July 30, 2002 - This is to certify that_work requested to be done as shown byPermit Number - P20010350 has been completed. \' Tax Map Number: 523400-296-058-0001-027-000-0000 Location: 29 GENTRY Ln Owner: VALEN'I E BUILDERS INC Applicant: This structure may be occupied as a: By Order of Town Board Fireplace TOWN OF QUEENSBURY Garage - 2 Cars Attached Single Family Dwelling ‘, J 4 Director of Building&Code E orcement Alb TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 .4y Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010350 Application Number: A20010350 Tax Map No: 523400-061-000-0002-071-000-0000 Permission is hereby granted to: For property located at: 9 GENTRY Ln 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: VALENTE BUILDERS INC Single Family Dwelling 120,000.00 153 SWEET Rd Garage-2 Cars Attached QUEENSBURY,NY 12804 iFoireplaue ipso Total Value ) k 120,000.00 _ Contractor or Builder's Name/ Address Electrical Inspection Agency ecihc •ons 2001-35 1350 S SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN CIFICATIONS $206.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,June 05,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the T s. s of luee T i s.;:5 ,June 05,2001 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Building Permit Application Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-82561 BUILDING & . CODE ENFORCEMENT 'NOTICE Requirements prior to issuance r ' )) . A permit must be obtained before of this permit: PERMIT FILE NO��T ,41 _54 beginning construction. No inspections will be made until applicant has received 1-1Zoning Board Action PERMIT FEE PAID$ a VALID BUILDING PERMIT. All Area /Use, cP31 RECREA77ON FEE PAID applicants' spaces on this application MUST be completed and.the signature 0 Planning Board Actai � Ei'ED BY: \,) of the applicant.must appear on the �" Building Inspector / Subdivision /Other implication form. Thank y,,. J/ MFb� Recreation Fee Payment MAY 2 2001 . Vf3 !Y7 Applicant: . , Owl:M e: LA;3 DU ri r BUILDING AND CODE Address: 50 C��s C(��� Address: • Phone # ( 5j e3 ) �N - _EZo O. Phone # ( ) • - • Property Location: Lork '6 664-. 1 i "72 Subdivision Name:. PL 7 3"1p�5 fax Map Number __ (�I / / 7j Section Block T cat NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE XNew Bui] ' : CONSTRUCTION: $ f'Zo,onO residenc / commercial Addition uilding: residence / commercial OCCUPANCY INFORMATION: Alteration to Building: P ary Building - • residence / commercial Single Family Dwelling Residence / Commercial Two Family Dwelling no change to exterior size Family Dwelling Office Other Work (describe below) Mercantile Manufacturing . Other GROSS AREA OF PROPOSED STRUCTURE: / • 1st Floor 07 sq. If ADDITION, what will uf,.., se 2nd •F1'oor. . .,. . . . . sq. f of new addition be? : Other Flouts sq. ft. (not unfinished cellar or basement) ACC• ESSORY BUILDINGS: c20 f Detached Garage 1, 2 car TOTAL FLOOR AREA: 110 SQ. FT. X Attached Garage 1,40rnio Na Private Storage Bui. .in.g SIZE OF NEW STRUCTURE: Commercial Storage Building 40 '313 FEET X Other )� FEET Foundation Type: t'rx7/L21 CcsA Will any second-hand or ungraded ' Number of Stories : . lumber be used? If so, for what? (habitable space only) Height (grade to ridge) : feet TYPE OF HEATING SYSTEM: Number of fireplaCe?t; and/or woodstove (circle all which a. .lies) to be installed:_ , ,/ Electric Oil Rep/ Wood (D. `orced Hot' r, / taseboard / Other Person responsible for supervision of work as regards to building codes i s : Vi i-t.5.i, 5c7 6:9 T(L L fv6 a-D Name Addresss Phone Builder: 0/ t tZvi 1- 4•1 ,5`c CC0i.cv ' ,3- 10 '-- 5-zob Plumber: P4V4 ik - ) �'/1i-5 � — c sGoiu-t '-24'f3 - 44315 Mason: Electrician: 1 t-+J-God 6?x,11 , by,.t ,y,/ (yy-Z3,�- 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, 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 tl e proposed work shall be complied with, whether specified Or noted, and that such work is author'• - by the owne . Further, it is understood that I/we shall submit prior to a Certificate of Occupant IT Certificat /Compliance being issued, an AS BUILT PLOT PLAN by a licensed surveyor; c i to sc le, 1 i g actual location of project on premises. Signature: ' (owner, owner's agent, architect, contractor) Application for Permit—Septic Disposal System Town of Queensbuly 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: ' • Location of installation: / / Office.Use • Tax Map No. 61 / 2 / `71 , File Permit No. • . Owner's Name: IVAWIrhi tci7E5 -n,c., Fee Paid Address: ...0 Co Tlz i GLur. M. • 1 • INSTALLER'S NAME : V4 U1ITTv. M w _>,6 PHONE NO. 75i(2—SZccc 3. RESIDENCE INFORMATION'.• (circle year of dwelling; indicate #bedroom(s) and multiply !! 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/bdrm' 1980— 1991 x 130 gal/bdrm = 1991 —present • Z . x 110 gal/bdrm = 2zo Garbage Grinder Installed yes_ / no .)q Spa or Whirlpool Installed yes /. no yo 4. PARCEL INFORMATION: (circle applicable information &indicate measurements) • Iop9.griwhy SQiLNntlJc9 Q.t_O.und_!4!at.91_.___ .951.rock.or_hpperyj9_l!S Meteri.al__Uomcstic Watcr_S!ipply Mat sand at what depth al what depth municipal Rolling loam fret feet well Steep slope : clay if well; water supply %slope other ' from any.septic-system depth: absorption is fl. other Percolation Test: (To be completed by licensed professional engineer or architect) • Rate; minute per!nch • 5, PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by n 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 cads Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: o gallon (min. size 1,000 gal.) 7:::, o 1 xrIV `Th' 1-414cii- R..k . Tile Field: each trench ft. Total System Length: fl. Seepage Pit(s): number of' • size of each: ft. by fi. Size of Stone to be used: II / depth or thickness __________fret . . 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 S.ystem.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 the rogt 'ions with respect to this application and agree to abide by those and all requirements of th, 'wn of Queen ry Sanitary Sewage Disposal Ordinance. DY9 k . (I • ' - • 517.fib Signature of responsible person Date • 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 *Requires submission of worksheets APPLICANT' S NAME: PROPERTY LOCATION: U Rivi ry Gorr gf- PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area - ' )•5 0 square feet • 2 . Type of . Heat - Electric Oil X Gas Other 3 . Is building mechanically cooled? Yes X No 4 . Percentage of area of, windows and doors Over 17% 7Q Under 17% 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED: a . Roof Rg b . Exterior walls R. 1 c . Glazed areas R rZg, d . Exterior doors R y e . Floors over unheated spaces R N/4 f . Edge of slab on grade (heated building) R ,v g. Basement/cellar walls (above grade) ' R I I h . Basement/cellar walls (below grade) R b/ i . Heating/cooling-ducts-piping in unheated space R L'$ 6 . Service (domestic) hot water heating devic Apo Conforms to minimum efficiency per code Yes No MPERA -E CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED can _ ure Date Phone Number `� ,�✓ or 1 5 ZIJO / 7g46-57-0o INS?EC=OR' S REMARKS : RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept.of Community Development Arrive am/pm Depart am/pm Town of Queensbury Inspector's Initials �//J 742 Bay Road ����/% Queensbury,New York 12804 vs-0 NAME l _ L�/3�� PERMIT# LOCATION (fGC,'-,u j v? Li) r DATE 7 t� TYPE OF STRUCTURE N/A YES NO COMMENTS Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies,landing 8 in.or mo. Interior Handrails stairs both sides 3 or ore risers \ Grade 2%away from foundation 8"clearance to sill plate Gas Valve shut-off exposed/regulator 18' bove grade Gas Furnace shut-off within 30 feet or withi line of site Oil Furnace shut-off at entrance to furnace ar Furnace/Hot Water Heater operating Relief Valve(s)installed Headroom,6 ft.6 in.on stairs Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/trim/doors/main entrance 36" 1 Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or more Railing across window in stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected(in garage) Light ventilation per room S ty glazing 18"or less from floor 1 Electrical Site Plan/Variance required Final Survey Plot Plan (J As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) Okay to issue temp.C/O(Certi£of Occupancy)_ Okay to issue permanent C/O(Certif.of Occupancy) • GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart p• Inspector's Initi. / NAME: PERMIT# +��• LOCATION: (2,e4 Tg-`t Else DATE : • i TYPE OF STRUCTURE: Al RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is re ••nsib e for providing protection `rom •eezing for 48 hours followin:th- placement of the concrete. Materials for this pu ••,e in site Foundat'on/Wallpour Reinforce -nt in Plac Foundation/Dampproo'ng Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in 'lace Rough Plumbing Heating Rough-In Insulation Foundation Walls Intent r R- Foundation Walls Exteri ir R- Floors - Walls I'- Ceiling ''- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framing �C ��STI� �c ,�C-` }� t-�.��� 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 fak PARADOX September 20,2001 DESIGNS John O'Brien,Assistant.Building Inspector Town Of Queensbury Building Department ARCHITECTURE TOWnCenter Queensbury,NY 12804 INTERIORS PLANNING RE: Baybridge Development 6 Gentry Lane,Wakefield Model 1 Dear John. This letter will serve as an amendmenttto the building permit documents for the above referenced project. The following items were changed or added to the project during construction,which are different from or added to the drawings as submitted for the building permit. Charles Johnson - • 1. At three locations a window header in excess of 6-0'-'does not have the minimum (3")bearing dimension as stated on the drawings. A bearing dimension of 2"is provided at each end of the.header. This is adequate for these locations. Should you have any questions or comments please do not hesitate to contact nie. Best regards, • ADIRONDACK OFFICE Charles`4hnson wy '�T:) 14 West Notre Dame Street ° ` Glens Falls, NY 12801 Tel 518.798.8129 @ye'. P�� �i, f Fax 518.798.2851 p CifI I � ,- �' 1? ,y 1 v — L r^ NZ,1 o.9 r OF N'EV4 FINGER LAKES OFFICE • 245 East Street, Suite 408 Honeoye Falls, NY 14472 • Tel/Fax 716.624.5930. GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive VAC) Depart itty ctor's Initial + NAME:\ I eAil P, PERMIT# - 350 LOCATION: ,7L�.- (f;*)-yv2,2 ir��^ c-10l-su DATE: — — TYPE OF STRUCTURE: SJC RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is respo ble for providing protection fro freezing for 48 hours following placement of the concrete. Materials for this purpose o site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Under S Plumbing Vent/Vents in P1 Rou Plumbing He ng Rough-In ulation Foundation Walls Interi r R- Foundation Walls Exte4ar R • - Floors g- Walls R- �q Ceiling R- 3 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 J 7; e\ 17.2.0D 'tee, GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive 9 L 3 D a p epart spector's Initials _ ,�- i NAME: ( QlY1 \r,1O'+-L) PERMIT# CY A dr LOCATION. (rp ������� DATE: TYPE OF STRUCTURE: E C) RECHECK N/A YES NO COMMENTS Footings/Piers I 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/Dampproofing Backfill Approval Plumbing Under Slab Plu bing Vent/Vents in r •ce ough Plumbing ,f Heating Rough-In Insulation Foundatio ""allsInt rior R- Foundation Walls E erior R- Floors R- Walls R- Ceiling R- Duct work or piping n unheated spaces R- Proper Vent,Attic Ve$ / .v'""�ng ✓✓ Jack Studs/Headers Bracing/Bridging tri ✓ Joist Hangers ., jack Posts/Main Beam Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour 'stopping Dec_ CF TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name S Location / � � v�r/k- O Date 'ermi t # ^ 55(,) SOIL TYPE: Sang-Loa -Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total ength Length of each t -nch Depth of trenche• Size of stone SEEPAGE PITS: N mber- Size - f . x ft. Stone size PIPING: / Size Type Bldg. to Tan. Ot, Tank to Dist. Box Dist. Box to Fiel •/' Openings Sealed? No Partial LOCATION/SEPARATI i, Foundation to Tan feet Foundation to Abs+ rption . _ .feet . Separation of Pit- feet Conforms as per Mgt Plan No LOCATION e SYSTE. ON PROPERT (circleon.•) Front Rea, - Left Side - Right Side Middle " •nt - Middle Rearn, COMMENTS: 7 — jfv I G V"\-N► . SYSTEM USE APPROV D: YES NO Arrived: Departed: C.� Building Inspector RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: V 1 Building&Code Enforcement Dept.of Community Development Arrive am/pm Depart! `` ai p Town of Queensbury Inspector's Initials 742 Bay Road . Queensbury,New York 12804 NAME 1J0 jJ PERMIT i On/ v LOCATION J:14 DATE % ' At,/ TYPE OF STRUCTURE V adIA-c-t-y-pk.) ) N/A Y ES NO COMMENTS Chimney HeightP'B"Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete 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 /� c( \ Grade 2%away from foundation 8"clearance to sill plate Gas Valve shut-off exposed/regula.r 1:"above grade Gas Furnace shut-off within 30 fee or wi' in line of site ,`,\\ C Oil Furnace shut-off at entrance to ace.. ea ( &lit V V S J C I P Furnace/Hot Water Heater operating Relief Valve(s)installed Headroom,6 ft.6 in.on stairs Basement stairs,6 ft.4 in. Handrail exterior stairs both sides m e 1. 3 risers Interior privacy/trim/doors/main en 36" Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 1 in.or more Railing across window in stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected(in garage) Light ventilation per room Safety glazing 18"or less from floor Final Electrical Site Plan/Variance required Final Survey Plot Plan As Built Septic System layout required '. Okay to issue C/C(Certi£of Compliance) Okay to issue temp.C/O(Certif.of Occupancy)_ Okay to issue permanent C/O(Certif.of Occupancy) w«• 04_ J�,r,Y rtiv.. 1/2L ttistf,:t_ RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: ' r.•?S Building&Code Enforcement g:X • Dept.of Community Development Arrive- a 1. T•01! •part Town of Queensbury 'ector's Initi 742 Bay Road Queensbury,New York 12804 r• NAME 2)01/14,IL PE # 0766/`35-'6 LOCATION re,r •Fn2./ ?Le — DATE 7/„t'f, dam TYPE OF STRUC / N/A YES NO COMMENTS i Chimney Height/'B"Vent/Direct Vent Location 1 ti%/ ' Fresh Air Intake �J Plumb Vent through roof _ Roof Complete Exterior Finish Compl e Interior/Exterior Railin s 30"to 36" \. Exterior Handrails,bal nies,landing 18 in.or mom. Interior Handrails stairs th sides 3 or more risers N .7 Grade 2%away from four tion \ �/� 8"clearance to sill plate \\ ;// Gas Valve shut-off exposed/re t .tor 18"above grade Gas Furnace shut-off within 30 feet Q within line of site , \ Oil Furnace shut-off at entrance to fum: e area Furnace/Hot Water Heater operating Relief Valve(s)installed / f,) Headroom,6 ft.6 in.on stairs J L� Fi iiz6? Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers I / Interior privacy/trim/doors/main entrance 36" �{� ,CA Floor Finish NI �1`� � l�Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or more !/ ��7 Railing across window in stairwells ,/ \ , Smoke Detectors: f ';�•''r_J every level •J l� �•�� every bedroom /� outside every bedroom J inter connected •/ Bathroom fans / Plumbing fixtures ,l/ Foundation insulation J/ 3/4 hour fire door/door closer J/ Garage fireproofing ✓/ Garage penetrations sealed ,/ Furnace in separate room protected(in garage) / / Light ventilation per room J ,/I \\\ Safety glazing 18"or less from floor ✓� Final Ellan/V calria \ Site Plan/Variance required , 1� 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) cxPw 6 GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart Inspector's Initials 0 NAME: Ck\ PERMIT# I 5V LOCATION: Lem( rr_ _ DATE : TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is re $•nsible f r providing protectio I from freez g for 48 hours folio ng the place ent of the concrete. Materials for this p i'se on site Foundation/Wallpour Reinforcement in Pla Foundation D.1 r i roo• g 11 Approval Plumbing Under Slab Plumbing Vent/Vents i +Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Inte or R- Foundation Walls Exte or 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 -x 70 ry\ GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive 4: a .m Depart 1'' \I 1 , pector's Initial ' NAME: �9 PERMIT# 50 LOCATION: ATE: O TYPE OF S C . RECHECK N/A YE O COMMENTS tings/Piers Monolithic Pour Form Reinforcement in Place \/ The contractor is responsible for providing protection fr. freezing for 48 hours followi _the . acement of the concrete. Materials for this pu .•se on •to Foundation/Wallpour Reinforcement in Pl. Foundation/D..r .prt ofing Backfill Approval Plumbing Under Sla Plumbing Vent/Ven in Place Rough Plumbing Heating Rough-In Insulation Foundation Wall Interior R- Foundation Wall 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 THE NEW YORK K BOARD OF FIRE 'UNDERWRITERS. - CERTIFICATE NO., ,. .DO NOT WRITE HERE-FOR OFFICE USE ONLY ' BUILDING PERMIT NO. TEMP.# DATE ,.. /- ✓ r, ) ,„;-. CITY OR VILLAGE 5 ,= ZIP CODE;-Z Q 4 `TOWNSHIP COUarz STREET AND`NNO.OR ROAD }y .POLE NUMBER l,VA T 1 &-Aik'1( - - If —s j BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? )) ECJION- \- ' BLOCK l ( LOT - \1�lL(�t(3ycbf �t . 4:1,t 6 i (3'1" . f:" 7' — '// . OCCUPANTS NAME BUILDING OCCUPANCY / OWNER'S NAME AND ADDRESS - i , \ Y { i C HOMETELEPHONE 57-00 Via_ ,,, + . CURRENT SUPPLY D BYi,,..i. ' FROM THEIR OFFICE WORK TELEPHONE NUMBER BUILDING IS NEW❑ OLD ❑ WORK IS NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH ' OFFICE USE Loca- Lamp Receptacles CIRCUITS ONLY tion Side Attach't H.P. Watts A.W.G. Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each NO' Gauge INSPECTION OUT- . SIDE • SUB- BASE BASE- .. MENT 1st FL ' 2nd , FL. 3rd FL • REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. - THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT. SIZE OF MAINS FEEDERS . 1 O if"f P • Applicant affirms that there is not an application for electrical I CHARACTER OF WORK ❑EXPOSED inspection pending with aqualified electrical inspection CONCEALED P P 9 P DATE ORK TOBE STARTED DATE CQMPLETED authority, for the installation listed herein. li 4i!✓11 This application is valid for a period not exceeding one year SERVICE ENTERS BUILDING from the date received by the Board. ❑ OVERHEAD' UNDERGROUND • DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER.APPLICANT'S IDENTIFICATION NUMBER> AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS • NAME OF APPLICAN DATE OF APPLICATION SIGN APP ANT Tz\� 14)- GOB; X i 1FD ., ' STREET ADDRESS ( TE HO 17i,1.)-)- 4111.17. 1-4' ' 6C-i9—Z-gS CITY OR POST OFFICE ZIP CODE, LICENSE NO.WHEN APPLICABLE ('-:01inn..-' .L/;A.Z>t^-c.., (v--c'I(-f ❑40 Fulton Street ❑ 111 Washington Ave. ❑3291 Lake Shore Road ❑ 803 West Avenue ❑202 Arterial Road • NEW YORK, NY 10038 SUITE 704 BUFFALO, NY 14219 SUITE 106 SYRACUSE,NY 13206 (212) 227-3700 ALBANY, NY 12210 (716)827-1155 ROCHESTER,NY 14611 (315)463-8552 • (518)463-2122 (716)436-4460 THE NEW YORK BOARD OF FIRE UNDERWRITERS � oars : co,,e icc,,,,1�c.s, �if sFE.. n. lv 1 h 77 r--'`z�„, : 1 _ Gi ' si# jp-i 6„I ,...1- 1 ,, . , #$ �. 7 " ' --r-r Zoe1 ..3-7 1 , 4 K . #11Sio N.N.,. .si.....\I a I . : al _______T 4 • ,„ , tik' ,,,, 7 have r J ' I Lr ► [1-rH all objects seen observed, believe �2 T SG �Qrsnn e�i this document t Saw evidence Z,s o ally me P+Ql1T ; dance of, 1Q1 1�'� 'L measured t -?1ST rc fences, f1 present 3ree4 S, e tlisr' ,?�� forth toe SlGI� r�RE � `�°l the diagram „ a�� " 31 �_, MAY 21 2001 TOWN OF QUEEN sBURY BUILDING AND CODE MAP REFERENCE: BAYBRIDGE PHASE - 3 DATED: JUNE 29, 1987 BY: COULTER & McCORMACK FILED: MAY 24, 1988 M� osv ly£gSr OP ORN� 22 �L RN 0 io N q O 0 UTY TIE5 CP 71 I STORY WOOD FRAME HOUSE ASPHALT DRIVE 1, 897 sq. ft. ' *�.�� � f� O.G? acres oJPV io I MEREDY CERTIFY THAT THIS MAP WAS PREPARED FROM AN ACTUAL FOLD SURVEY. THIS CERTIFICATION SMALL RUN ONLY TO THE PERSONS FOR WHOM THE 5URVEY WA5 PREPARED. AND ON THER BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION USTED HEREON. CERTMATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SMSEG LIENT OWNERS. CERTM TO• VALENTE HOMES GLIB 1 rILL w� 4 V MATTHEW C. 5TEVir 5..5 y NY 1$5 ' DATEDI MAY 14. 2002 \ 4 0(-7,,570 UTUTes 4 an S J-� . t e v e Land Surveyors, LLC 169 Haviland Road Queensbury, New York 12801 (518) 792-8474 New York Lic. No. 50135 UW NCOM ALIMAION CR AW WN M A StRWY YAP KAWW A LIID WO VAtWV= WX IS A WOIATICII OF SECr#QN 72M SIA-ON" $ OF AE KW V MK STATE EOUCATIOR U%%' MW® AU. 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