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1992-520 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Dace govembe�: 217 95 19 j This is to certify that work requested to be done as shown by Permit No. 9 2 5 i 0 1 has been completed. SINGLE FAMILY DWELLING This structure may be occupied as a LUZERNE RE). Location Owner BARBER , TIt-90'rUY G . T RX HAP NO. .t: 5 --I-4. 1 By Order Town Board TOWN OF QUEENSBURY ,4 Director of Bldg. & Code Enforcement � � a BUILDING PERMIT TOWN OF QUEENSBURY No. 92-520 ' WARREN COUNTY, NEW YORK 41 PERMISSION is hereby granted to TIMOTHY G. BARBER OWNER of property located at Luzerne Road Street, Road or Ave. in the Town of Queensbury,To Constructor place a Single family dwelling at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. w 1. OWNER'S Address is X PO Box 4323 m Queensbury NY 12804 Y d. 2. CONTRACTOR or BUI LDER'S Name 9 O Nu Tech Construction C* s 3. CONTRACTOR or BUILDER'S Address ' 4. ARCHITECT'S Name 5. ARCHITECT'S Address r C N O M 6. TYPE of Construction—(Please indicate by X) X O (x)Wood Frame ( ) Masonry ( ) Steel ( ) d 7. PLANS and Specifications No. 72'x4O' two-story Single family dwelling as per plot plan, specifi- cations and application including septic system. 8. Proposed Use Single family dwelling N M $ 439.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept 9 1S3_ (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.) —+ a Dated at the Town of Queensbury this to Da September 192 SIGNED BY for the Town of Queensbury Building and Zo t Inspector TOWN OF QUEENSBURY 6VIN OF QUEENRBijE- REVIEWED BY: RE�.EIVED FEE PAID: AUG 2, 1992 PERMIT NO. : q�� ss��) DL.DC. & C©DE DEP', 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 sid of this application. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Owner of Property: P.O. Address: _ �s (��T` �I�Z , ��,�� _ ���.Jr PHONE Property Location: �_� a :►V, ,� - Tax Map No. Has there been any split of this property since October 1, 1988? Yes 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: '4 1 4, NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE Construction of new building * CONSTRUCTION: $ 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 GROSS AREA OF PROPOSED STRUCTURE: * property line: * 1st Floor 'Zr��� Sq. Ft. * Front Yard ft. Rear yard 33� ft. * Side Yards ft. and S r ft. 2nd Floor I y C�C0 Sq. Ft. * If on corner, setback from side street- ft. Other Floors 9� Sq. Ft. (not cellar or basement) OCCUPANCY INFORMATION: * TOTAL FLOOR AREA: Sq. Ft. * Primary Building - * One Family Dwelling Size of New Structure: -77 ft. x 91�) ft. * Two Family Dwelling Foundation: * Multiple Dwelling/No. of Units _ Pier/Slab/Crawl/Partial/Full (Circle One) * Business * Industrial No. of stories (Habitable space) * Other Height (grade to ridge) ft. If residential , no. of families: * If addition, what will use be? No. of rooms (excluding baths) : 1 No. of bedrooms: .L\ No. of bathrooms: * Acce sor Building: Primary heating system: L'. * ted ed Garage - One/Two Car Type of fuel : �1\ * Garage - One/Two Car No. of fireplaces to be installed: * Private Storage Building Will a woodstove be installed?: �./'_� * Other Central Air Conditioning: Yes No BUILDING PERMIT APPLICATION CONTINUED: BUILDING SPECIFICATIONS: Type of construction: wood frame, fire safe, etc. ��� �Cd KI Will any second-hand or ungraded lumber be used? If so, for what? Foundation Wall Material : ��� �c5c�t� �' Thickness: Depth of Foundation below grade (to bottom of footing) : ' Will there be a cellar? �— Heated or Unheated? I ey Floor Sq. Footage: '29 YO Will there be a basement? A/c� Will any portion be used as living space? If so, what portion? Sq. Ft. Type f Use? Type of Roof: Sloped/Flat/Shed/Other Is 6 Material of Roof S Size I,._, wood studs Z. x � " ; spacing o.c. ; length � ft. Joists floor beams 1st Floor x / Z ]( ) : spacing /(p o.c. ; span ' _ Ift. Joists (floor beams) : 2nd Floor x _� " ; spacing _ o.c. ; span Overlays (ceiling beams) : \4d"�c�w�'�- - spacing o.c. ; span Roof rafters: Z x N� �" ; spacing ' �D o.c. ; span rft. Nuti Roof trusses (pre-engineered) •I spacing o.c. ; span N-M Exterior Wall Finish: �'l�A .Sa 6L� of what material ? C.LJ-ibbkz�y Interior Wall Finish: C- } If a garage is to be attached, scri a materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? QS- 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: 1� ft. Depth of fireplace hearth: ft. in. Water supply - Municipal or private well : �f 1V SEPTIC SYSTEM: Distance from any private well (including adjoining properties: ft. (A separate application is necessary for any repair or new installation of septic system. ) NAME OF BUILDER & ADDRESS: PHONE NAME OF PLUMBER & ADDRESS: J U 3 PHONE NAME OF MASON & ADDRESS: Zu PHONE NAME OF ELECTRICIAN & ADDRESS: PHONE DECLARATION To the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the pro osed r h ' be complied with, whether specified or not, and that such work is au on b Signature - wner),Zo e s age chitect con ra -------------------------------------------------------------------------------------------- SPECIAL CONDITIONS OF THE PERMIT: i 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) J VVN OF QUEENSBL, PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings; �-�EC;Fr9.,EdD Multi-Family Dwellings BUG 2� '992 (3 Stories or Less) PART 4 - Design By Component Performance - Commercial Buildings - Hi-Risd3MS%d#?r6ftlE DEPT. PART 4 & 6 - Compliance Methods Require Submission of Worksheets APPLICANT'S NAME PROPERTY LOCATION 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 Z_(0 C. Glazed Area R D. Exterior Doors . R E. Floors over unheated spaces R ZO F. Edge of Slab on Grade (Heated Building) R N\),, zs, G. Basement/Cellar Walls (Above Grade) R l� H. Basement/Cellar Walls (Below Grade) R_ )S I. Heating/Cooling - Ducts - Piping in Unheated Space R �"f - 6. Service (Domestic) Hot Water Heating Device A. Conforms to minimum effi -iency per code YES NO T MO—E TU ONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED APPLICA 'S IG ATURE DA E TELEPHONE NUMBER INSPECTOR'S REMARKS : tf: OF QUEENSBU . TOWN OF QUEENSBURY 1-1��CHIVED APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # Fete LP& Revi)e Date: Wed9®E DEPT. LOCATION OF PROPERTY FOR INSTALLATION: r-, Owner' s Name: Lvv` Owner' s Mailing Address: U ��, Installer' s Name: Phone #: G Z' 7Lo" Number of bedrooms (if residential ): Total daily flow (residential-compute @ 150 gal . per bedroom): Topography-Circle One: Flat Rolling Steep Slope Y of Slope Soil Nature-Circle One: Sand Loam Clay Other /Depth: Ground Water-At What Depth? sz�,,J ' Feet `, �. Bedrock or Impervious Material-At What Depth? \� Feet Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch Domestic Water Supply-Circle One: Municipa Well Other If domestic water supply is a well - Separation: Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank (7� gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench feet//Total System Length feet Seepage Pit(s): Number of / Size each: ft. x ft. Size of Stone to be used: # / Depth or Thickness 3 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 thi s e and agree to abide by these and all requirements of the T wn of e ury S nitary Sewage Disposal Ordinance. �-/ SIGNATURE OF RESPONSIBLE PERSON: DATE: i _ 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 an water supply 5) size and dimensions of alanks, 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: TOWN OF QUEENSBURY 531 Bay Rd., Queensbury, NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Dater ,19 Permit No. APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws,ordinances,regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. Please fill out additional form if more then one appliance and/or chimney. Applicant ., �{, t� ? �r; ,� ` APPLIANCE (check appropriate boxes) Address t~ , . �! '�'S ❑ STOVE: ❑ Wood ❑ Coal ❑ Pe I let ❑ REPLACE INSERT Zip ! 3` ❑ FIREPLACE, FACTORY-BUILT: ❑ Wood ❑ Gas Phone l 7 - >;�: f_' �[D FIREPLACE, MASONRY: ❑ Wood ❑ Gas Owner ,��` r / ,, ¢. ❑ FURNACE: ❑Wood ❑ Gas ❑ Oil Address �' ,� ' L,,- 1F NON-MASONRY: Manufacturer: Zip Model: Outlet: inches Listed By: Number: Phone CHIMNEY (check appropriate boxes) Exact address of proposed construction 1 n p'MASONRY: ❑ Block ro Brick ❑ Stone FLUE: moo. Tile ❑ Steel ' Size: inches CONSTRUCTION/INSTALLATION MUST ❑ FACTORY-BUILT: CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model: BUILDING CODE. CONSULT TOWN OF Listed By: Number: QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall ❑Triple Wall REGARDING REQUIRED INSPECTIONS. ❑ Insulated Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Received Code Number Title A 173 3389 (190)Public Safety A 233 2655 (230)Minor Sales Fee Collected From or Refunded to: Address: Dated: Town Clerk or Deputy: fMte:Applicant Green:Fire Marshal Yellow:Bldg. Dept. Pink ch Goldenrod: Cashier's Dept. N U- TECH • DESIGN BUILD • • CONSTRUCTION MANAGERS - • CONTRACTORS - INDUSTRIESC ++i F NOV 22 1995 j TCAVINI November 22, 1995 Town of Queensbury 42 Bay Road Queensbury, NY 12804 To Whom It May Concern: I, Timothy F. Barber, certify that the fireplace located in my home at 635 Luzerne Road, Queensbury, NY was constructed as shown on Plan View provided and all clearances from combustible construction are equal to or greater than the required code separations. Sincerelye;erx T' othy F PO BOX 917 GLENS FALLS, NY 12801 PHONE (518) 746-1577 FAX (518) 746-1824 A MERIT SHOP FIRM 0WOU01W FILE# DATE A Division of Nucor Corporation P.O. Box 70, Waterloo, IN 46793 Phone: 219/837-7891 • Fax: 219/837-7384 PAGE OF ADDITIONAL ITEMS TO BE IDENTIFIED ON SKETCH BUILDING ORIENTATION All bays available for wall bracing. LEW All wall deletions. All factory located framed openings. FSW BSW Locations of all concentrated roof loads. Location of crane runways. Locations of any canopies. roof • FSW=FRONT SIDEWALL extensions, or fascias. Location of mezzanines. BSW=BACK SID X Location of adjacent existing buildings. LEW=LEFT ENDWALL LL AL Direction of down slope. * Locate =RIGHT EN ewall f Locate low sidewall for i single slopes. Ci -e z v t� U A10 V 22 7g95 _ly j i3iJlLjJln; �1�.:' '��NY to ' � a 7< T n _� + X 27 J C n� I c v _ Y � N 5 xQQ E N i 00 ' ►0 ell 9 'J U If T / O / -J x ? a 5 i � 0 --s 0 s J � f -l. M nQ -1 %3v V, ' R X � 4 FILE# DATE A Division of Nucor Corporation P.O. Box 70, Waterloo, IN 46793 Phone: 219/837-7891 Fax: 219/837-7384 PAGE OF i ADDITIONAL ITEMS TO BE IDENTIFIED ON SKETCH i BUILDING ORIENTATION All bays available for wall bracing. LEW All wall deletions. All factory located framed openings. FSW BSW Locations of all concentrated roof loads. Location of crane runways. Locations of any canopies, roof extensions, or fascias. * FSW=FRONTSIDEWALL Location of mezzanines. BSW=BACK SIDEWALL X Location of adjacent existing buildings. LEW=LEFT ENDWALL nn Direction of down slope. * PEW=RIGHT ENDWALL Locate low sidewall for single slopes. J bo ^f? q O V 221995. J n� � v 0 n N 12 xx 00 10 q n � DY - J a Inn ND _ s d > z n a 9 0 0 x v i �� rn 0 0 s i l I ' yy, co - nQ 1 n x� a N `1 �n �c.4- TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 BAY ROAD QUEENSBURY NY 12804 (518)745-4447 i ARRIVE: DEPART: 1 INSP/ FINAL INSPECTION REPORT - RESID NT 'AL DATE INSPECTION REQUEST RECEIVED: NAME 1 %M C-,R V-� LOCATION k) -i��i DATE q, PERMIT A r r TYPE OF S RUCTURE ,� E I J W1 GA�, FOOTINGS FOUNDATION BACKFILL FRAMING _ ROUGH PLUMBING SEPTIC INSULATION _ FINAL ELECTRICAL WOODSTOVE OR FIREPLACE N/A YES NO CHIMNEY HEIGHT B VENT HEIGHT PLUMBING VENT ROOFING EXTERIOR FINISH DECK PORCH STEPS RA LINGS RELIEF VALVES , FURNACE HOT WATER 0 ERAT G INTERIOR TRIM PRIVAII D4ORS FINISH FLOORS: BATH KITCHEN WAT IGHT OTHER FLOORS S EEPA LE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINIS SMOKE DETECTORS 1` BATHROOM FANS 1 PLUMBING FIXTURES FOUNDATION INSULATION GARAGE FIRE PROOFING DOOR CLOSERS FINAL ELECTRICAL SITE PLAN VARIANCE REQ. FINAL SURVEY PLOT PLAN K TO ISSUE C/O OR C C A�'�- TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEnnI--V--ED NAME LOCATIONL /once.. DATE 7I&A3 PERMIT# APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS AUTO. EXTINGUISHING SYSTEM i HOOD INSTALLATION , AUTO. SPRINKLER SYST� ALARM SYSTEM INTERIOR FINISHES STORAGE: CLEARANCE .TO SPRINKLERS CLEARANCE TOE�EA*NG UNITS REQUIRED SIGNAG, YCHI NEY W DSTOVE IREPLACE-MASONRY FIREPLACE-FACTORY BUILT REMARKS: U OK TO THIS DATE 2/015 INSPECTOR TOWN OF QUEENSBURY Aj 531 BAY ROAD QUEENSBURY, NEW YORK 12804 ' TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE 1 l� l PERMIT# q 04 TYPE OF STRUCTURE ECNE _FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) _FOOTING FOUNDATION BACKFILL FRAMING _ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC INSULATION WOODSTOVE/FIREPLACE REMARKS APPROVAL CHIMNEY HEIGHT/LOCATION NIA YES NO B VENT/LOCATION PLUMBING VENT i ROOFING SIDING 'DECK/PORCH/STEP RAILINGSlJ RELIEF VALVES j 1 FURNACE/HOT WATER OPERATING ,! BASEMENT INSULATION/DUCTWpRKi INTERIOR TRIM/PRIVACY DOOgS' FINISH FLOORS: BATH/KITCHEN WATERTIbU OTHER FLOORS SWEEPABUE �•. OTHER FLOORS CARPETED STAIR CLEARANCE/RAILPA GS 1• HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/WHOoEHOUSE FANS \ALL PLUMBING FIXT RES OPERATING ARAGE FIRE PROD ING � OOR CLOSERS OTHER FIRE SEPA(ATION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL OK TO ISSUE C/O OR C/C COMMENTS: ARRIVE DEPART ys INSP T r TOWN OF QUEENSBURY 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION FREQUEST FOR INSPECTION RECEIVED _ 3 NAME i1ry1 B�f� i3�S/J-�f LOCATION�����_ DATE PERM9IT# TYPE OF STRUCTURE RECHECK FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) �F OTING -FOUNDATIONvB'A'CKFILL FRAMING OUGH PLUD4BING FINAL ELECTRICAL t--3EPTIC :,: MSULATION _WOODSTOVE/FIREPLACE REMARKS ����' APPROVAL N/A YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PORCH/STEP/RAILINGS RELIEF VALVES FURNACE/HOT WAT OPERATING BASEMENT INSULAT ON/DUC,TWOl`K INTERIOR TRIM/PR VACY L FINISH FLOORS: BATH/KITCHEN WA AT OTHER FLOORS SWE PA OTHER FLOORS CARP ED STAIR CLEARANCE/RAIL NGS HANDICAPPED ACCESS_ SMOKE DETECTORS BATHROOM FANS/WHOL NS ALL PLUMBING FIXTU ES +PERATING GARAGE FIRE PROOFI G DOOR CLOSERS u OTHER FIRE SEPARAT ON FIRE/DEMISE WALLS DUMPSTER I v SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL/ OK TO ISSUE C/O OR C/C COMMENTS: a `'tc�,ll7v� c gVL 51 85 AtCLOQ11 ARRIVE 10 : O qj DEPART : o I �k" I)S P T ELECTRICAL INSPECTIONS DUPLICATE MUNICIPAL RECORD PermitNo. .......--1A---'.�-�-t................................. Owner ------ -/! - Occupant.----------•---------------y---•---------------pv-------•--•-------•----------••-----....---....----------------------------- Location - .......................G.--................. Cs z----� /- /-------------------------scrccc Installation as itemized on reverse side has been visually inspected pursuant to appfcable codes. Installed b 4 Date t! 1� --Inspector MIDDLE DEPARTMENT INSPECTION AGENCY INC. FORM NO.18 EL. 0 e. 0611i ? KVU N —KIN 9 UUILtlb N.V.AIH cury UI llVrvtH 7V11 WIRING &CONTROLS FOR BURNER fj RECEPTACLES H.P.PUMP FIXTURES K.W.OVEN Z;eCIAMP.SERVICE EQUIPMENT H.P. GARBAGE DISPOSAL UNIT AMP.SERVICE CONDUCTORS Z K.W. DISHWASHER K.W.SURFACE UNIT K.W. DRYER r'- K.W. RANGE AMP. RECEPTACLE K.W. WATER HEATER FRAC. H.P. VENT FANS )TORS H.P. 1/20 1/12 I/10 V. '/c 'A % 1 1'/i 2 3 1 5 7%t 10 15 120125130140 50175 1100 'RK NUMBER j I EACH SIZE PPARATUS TOH-H OF QUEE ISBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12304 510--745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name �c Location Date Permit # q,?-J& SOIL TYPE: �am-Cl ay- Results of Percolation Test- (if applicable) .Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Number- / Size - 9�_ ft. x <^/ft. Stone size PIPING: Sri/ze Type Bldg. to Tank 3, 13 Tank to Dist. Box ' ,3 y Dist. Box to Field/Pit 3 cr Openings Sealed? �`� s No Partial LOCATION/SEPARATICH Foundation to Tank ray feet Foundation to Ab rpt'on %0 feet Separation of Pi Cs .3. feet Conforms as pe Plot Pl n Yes No LOCATION CF S TF-14 ON PR PERTY: (circle one) ron - Rea - Left Side - Ri ht S' e Fro, - Middle Rear COMMENTS: SYSTEM USE APPROVED: ES NO Arrived: 3 C,30 Departed: Buildi Inspector Pm TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED �5 3 NAME CcT- 0 LOCATION DATE 3 PERMIT # �-S TYPE OF STRUCTURE _ r F?—ti�lCK t-1 j� APPROVED z rv. N/A IYES NO OTINGS PIERS MONOLITHI UR RM— 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 POOR REINFORCEMENT IN ;PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING,/' PLUMBING VENT VENTS IN PLACE PLUMBING UNDR SLAB FRAMING: JACK STUDS/HEADERS BRACING//BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING//ROUGH—IN INSULATION: FOUNDATION WALLS INTERIOR,R— FOU�DATION WALLS EXTERIOR ,R— FLOORS R— WALLS R— C_E,ILING R— DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: r pf ARRIVE / DEPART I SP TOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR IN�SSPECTIOpN RECEIVED NAME LOCATION —y' u DATE 2 / �3 PERMIT TYPE OF STRUCTURE 30 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 FOLLOIWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SIT',E 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 cr' , JOIST HANGERS ? ' JACK POSTS/MAIN BEAM F„ HEATING ROUGH—IN ( INSULATION: {� FOUNDATION WALLS INTERIOR R— FOUNDATION WALLS EXTERIOR; R— FLOORS r? R— WALLS i;R— CEILING 'R— DUCT WORK OR PIPING IN UNHEA ED SPACES RE KS L \sf, 0j, L o 3 l-viA � uj a-L cNu_rwagm 3lz_z_ %dtz 3&L.AA"e, ARRIVE DEPART —3%/ J IN PEC OR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT (� 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR IN/SPECTION RECEIVED NAME LOCATIONE: DATE__,3�1I PERMIT I 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 r REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING Y PLUMBING VENT/VENTS IN PLACE ' PLUMBING UNDER SLAB FRAMING: :f JACK STUDS/HEADERS BRACING/BRIDGING �y JOIST HANGERS JACK POSTS/MAIN BEAM/ HEATING ROUGH-IN y >(INSULATION: Cr/x FOUNDATION WALLS 'INT RIOR R- FOUNDATION WALL EXT RIOR R- FLOORS , R- WALLS R- CEILING / R- DUCT WORK OR' PIPING IN\UNHEATED SPACES REMARKS: ' ARRIVE DEPART 43 INSPECTOR 42� TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED j S 9 NAME ir}? 7 LOCATION DATE / 3 PERKIT iff TYPE OF STRUCTURE �,/,?�� & 4 1& 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 REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL (ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB AFRAMING: JACK STU HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN \ XINSULATION: ; FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: p I ARRIVE DEPART INSPECTORf TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 5 NAME �(/�}'��yj6ux&- LOCATION DATE PERUMIT 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. 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