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2000-049 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: 2000049 Date Issued: Tuesday,March 14, 2006 This is to certify that work requested to be done as shown by Permit Number 2000049 has been completed. Tax Map Number: 523400-308-018-0002-042-000-0000 Location: 123 SHERMAN ISLAND Rd Owner: THOMAS&MAY FITZGERALD Applicant: THOMAS&MAY FITZGERALD This structure may be occupied as a: Unknown By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: 2000049 Application Numb r: 2000049 Tax Map No: 523400-308-018-0002-042-000-0000 Permission is hereby granted to: THOMAS &MAY FITZGERALD For property located at: 123 SHERMANt ISLAND Rd in the Town of Queensbury,to construmor:plac& ,N- 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: THOMAS, &MAY.FITZGERALD,, . > Unknown' . . _ $15,000.00 123 SHERMAN ISLAND Rd Total Value ; QUEENSB, BURY, NY 12804 �is,000.00 Contractor or Builder's Name/Address i''t ' I : :Electrical Inspection Agency FITZGERALD, THOMAS 123 SHERMAN•ISLAND'ROAD QUEENSBURY NEW YORK ,,r, a i; Plans&Specifications RESIDENTIAL ADDITION, 400 SQ. FT. /RESIDENTIAL'ADDITION(400 SQ. FT.) AS PER PLOT PLAN ANDSPECIFICATIONS $32.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,February 17, 2002 (If a longer period is required,au lapplication fo'r'an extension must ue Made to the code Enforcement Officer of the Town of Queensb,,y hefo et 6' expiration date.): i S Dated at the Town of Queensbury; T�hursday,,,Feb ifuary 17, 2000 " SIGNED BY for the Town of Queensbury. Director'of Building&Code n£orcement. i r; i .:wilding Permit TOWn Of QLL�E'JZ,S�jLlyy - Dept. of Community Development, 742 Btry Road, Queensbuty, NY 12804 [761-82561 NOT RI BUILDING & . CODE. ENFORCEMENT Requirements prior to issuance A permit must be obtained before of this permit: LT LE NO. c �?v"d beginning construction. No inspections 3. will be made until applicant has received Zoning Boa dj nl� E PAID a VALID BUILDING PERMIT. All Area /Use ON FEE $ applicants spaces on this application EP 1 ZQ�� MUST be completed oAd•the signature 0 Planning Board etiOn BY. of the applicant-must appear anti the ,m a 4r r SPR / Subdi�slon:r/,O[liei:c,'-e i'a ;L Building InspectorRecreationF _ Applicant. ' Owne Address: 1a.3 -f;L o'22 ' 1 s /'� �c eer�Jbu�S Address: _-za-"e��y Phone # ( S��_} 7 S�F-5�a 7 -- Phone # Property Location: .S�hez��,9,> ems. .2c>,� '- --- Subdivision Name: �G7�hee�r �K�paJ us2e ( � y Tax Map Number z Section Block T nt NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE New Building: CONSTRUCTION: $ / residence / commercial 4, Addition to •Building: residence / commercial OCCUPANCY INFORMATION: Alterat-Lon to Building: Pri-r9ary 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., If ADDITION, what will use 1st Flac,r.--. .:-.-. . -- yam,___sq._ ft-. of nevi addition be? 2nd .Floor.-. . . . . . . sq. ft. ��,�. S� - Other Floors. . . • sq. ft. (not unfinished cellar or basement) ACCESSORY BUILDINGS: Detached Garage 1, 2 car TOTAL FLOOR AREA: SQ. FT. Attached Garage- 1, 2 car Private Storage Building SIZE OF NEW STRUCTURE: Commercial Storage Building .y ' d--t.� FEET X FEET Other Foundation Type: 71,11, � 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 fireplaces and/or woodstove (circle all whichGas lies) to be installed: % Electric / Oil J / Wood arc / seboard J Other Person responsible for supervision of wg5rk as regards to building codes is : 727e-,g"1 .r le_ �%�zcl �u !c� 1d3 3hee�innfTtCad Name c/ Addresss Phone Builder: Plumber: Mason: Electrician: DECLARATION- Please sign belmv 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 the proposed work shall be complied with, whether specified or noted, and that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a Certificate of Occupancy'or Certificate of Compliance being issued, an AS BLTILT PLOT PLAN by a licensed surveyor; drawn to scale,showing actual location of project on premises, Signature: "- (owner, owner's agent, architect, contractor) Fire Marsh:A's 01,11ce Town of*Qtjeensbur.y, 742 11:iy Roid,Queenshury, Ny (5 18) 701-8205 Application for Fuel Burning Appliances &-Chimneys . applicable to solid fuel & vented gas appliances Date "120 Penult No. Am)licafion is hereb),made to the Buildilia Code. Wcefi)r the i*s-vii(i.ii(--e .o1,'tt-Biti'lttiitg,,iii(I Use Permit it Pursuant to the New Yorl, State Fire Prevc,11tioll (III(/1311iiieli , I ng(,.o(u.. j7he 41,pplicant oil owner agrees to comply with a/I applicable laws, ordiliances, ivgIllatiz)II that are purl raj these r&juirenzews ail also will allow all ill'slye*ciol-s,i.o"ei'ztei.Pre,III I,ses to pej:fbrin required inspections, NOTE to applicant: Roucr h-"I , n and Final Inspections are required. Applicant Information Fuel Burning Appliance'Information .WOW (circle appropriate words) Name: Stove: wood coal pellet gas Fireplace insert Address: Fireplace, factory-built: wood try Fireplace, masonry wood gas �_Jb(-I,�8_ Furnace: wood -cis g oil Phone: If non-inasonary app.licance, please provide ONvnet;:_ Manut'acturer Name .T1 Address: Model-Number: Chimney Information Phone: rat (cil-cle appropriate w-ords) Masonry block - brick stone Flue the steel size: Inches Exact Address: OfCO14truction or installation Factory-Built C., I Manufacturer name: Model NuMbe y Listed BY: v1Vumber: Const;-tiction lInstallation mast conforin to NYS Fh-e Prevention &Building Indicate (circl&) chimney. material: Cocle. Consult available Town of Queensbun; Handouts regarding i-equii-ed inspections. Double wall Triple wall Insulated Chininev Liner Fireillars'hal Code W S Collected S Re fimded R address,- .4 /7-3 3389 (190) Public Safest- .4 233 2655 (230)Alino r Sales White(Applicai t) ; Green(Fii-e Mai-Mial) f Nellow(131do. Dept,) Pink&Goldenrod(Cashier's Dept.) ENERGY CODE COMPLIANCE 'APPLICATION TOWN OF' QUEENSBURY, WAREDAYS N COUNTY 9000 HEATING bEGRER ,. FEB 16 2000 P Compliance Methods: PART 5 Acceptable Practice Method 1&2 Family Dwellings (only) PART 6* Thermal Rating - Component Trade Offs 1&2 Fdmily 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: PART 5 METHOD OF COMPLIANCE BY .ACCEPTABLE TABLE PRACTICE: 1 . Gross Floor Area - 1110-6 sauare feet 2 . Tyke o.f Heat - Electric Oil CI Gas Other 3 . 7s; building mechanidally cooled? Yes 4 . Percentage of area of windows and doors Over 17% Under 17% 5 . R-VA-LUES FOR INSULATION, GIVEN BELOW MUST CORRESPOND TO R-VALUE.S AS SH-OW"INT ON PLANS SUBMITTED: a . Roof R b . Exterior wails R 19 C . Glazed areas R d. Exterior doors R e . Floors over unheated spaces R f . Edge of slab on grade (heated building) R C. Basement/cellar walls (above grade) R Basement/cellar wails (below grade) R Heating/cooling-ducts-piping ng in unheated space R 6 . Service (domestic) hot water heating device Con-fforms to m-i:.,-,--7,um efficiency per code ✓Y e s No TEMPERATURE CONTROL MAXIMUM SETTING 1400 WILL NOT BE EXCEEDED S * atu-r.e Date Phone Numbe'r /Isf 0160rz 79,r-,5-�a 7 T jSp=-�0R' S REMARKS: 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. A3rrivr✓' a ►1nm Dept p spectar's Ini NAME: ,-i Zc�C� _, i) PERMIT# LOCATION: _ i s� Q, DATE : "z 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 pla t of the concrete. Materials for this purpose on ite Foundation/WalI ur Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in lac Rough Plumbing g stin gRough In ion Foundation Walls Int riar R Foundation Walls E erior R Floors R- _ �alls ►— R xe�g Rt—e, R Duct work or piping in unheated spaces R- Proper Vent,Attic Ve Framing Jack StudstHeade BracingBridgin Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour irestoppin oc�o 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 in Inspector's Initials NAME: { A � � PERMIT LOCATION P irv,2 TE TYPE OF STRL7CTi TRE. RECHECK NIA YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from f vezing for 48 hours following the placeinne t of the concrete. Materials for this purpose on E'te Foundation/Wallpour Reinforcement in lace Foundation/Dampp ofing Backfill Approval Plumbing Under Slab Plumbing VentlVents in Place Rough Plumbing He _.g.Rough-In / n� � �`t�,%,1 1T1 atio l d�rAZ4--� t/A1'�`�j FoundationValls Interior R Foundation Walls Exterior R- Floors R fPv ©�`d 1` Walls R- Ceiling R- <-�- Duct work or piping in - unheated spaces R- laper Vent, Attic Vent n7 A'(� G wco . *PwoogL-- tom'" cJLSc t ink 31ftUds/Headers_ Bracing/Bridging— Joist Hangers Jack Posts/Main Beam Ai Alt atio` MB4)Mer Fire eparation_l 2; P tration Sealed ire Wall 2,3,4 hour Fiep7> MARSHAL TOWN C)F C)UF=1=NSE3UR,'7ir 41 (:ZlUE=-IE-N:SElUFZ"`Y% NY 12804- 41F.7 b (518) 701 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED NAME LOCATION SCHEDULE INSPECTION Od""-- AM PM APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINkt&lEkSYSTEM SYS FIRE SUPPRESS[6NZ HOOD INSTALLATION INTERIOR FINISHES STORAC3E: CLEARANCE TO SPRIN LERS CLEARANCE TO HEATI C3 UNITS REQUIRED SIONAC3E CHIMNEY :lD f- 000 STOVE tz FIREP MASor4Ry E!j�ACTORY BLT- RQUQH-IN = FINAL REMARKS: CA OK TO THIS DATE rRR r-> Ali ci "o 0 0--4 INSPSLIP.PUB INSPECTOR r-( tOG RESIDENTIAL REPORT r Office No.(518)761-8256 Date inspection request received: Building& Code Enforcement Dept. of Community Development Arrive !, Town of Queensbury Inspector's Ini 742 Bay Road Queensbury,New York 12804 NAME E T 1—��` RLD PERMIT# Z7C:0—�` -tQ LOCATION �A"r,-Pkkl;�h DATE (. —1-4 — TYPE OF STRUCTURE N/A YES 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.9more Interior Handrails stairs both sides 3 or mo rise s Grade 2%away from foundation 8"clearance to sill plate Gas Valve shut-off ex+in. gulator 1 "above de Gas Furnace shut-off feet or thin li of site Oil Furnace shut-off ae to ace ar Furnace/Hot Water rating Relief Valve(s)install Headroom,6 ft.6 in. P,t�Mt�C- Basement stairs,6 ft.Handrail exterior stairdes ore than 3 risersInterior privacy/trim/d ance 36" V Floor Finish ` j r Bathroom/Kitchen watertight �? Interior Handrails Balconies/U Wig 1$in. or more Railing across window in stairwe s Smoke Detectors: 6�tc`� every level � � every bedroom L k---)t � 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(Certif. of Compliance) Okay to issue temp. C/O(Certif. 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 12844. Arrive am/pm Depar�J z m Inspector's Initials 1 NAME: � �C G` PERMIT# M '� -` u C LOCATION: ��__� G'^�O ,�1� Mt`d DATE: Q- TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS _.._...... -F 1 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 # r Reinforcemed'in,Place 1,-, Foundation/Dampproo dig ' Vag6giil Approval l Plumbing Under Slab :I Plumbing Vent/Vents i Place Rough Plumbing Heating Rough In Insulation Foundation Wall I 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 t t GENERAL INSPECTION REPORT (518) 762-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement L 742 Bay Road Queensbury,NY12804. Arrive am/pm Depart ai �Inspector's Initials NAME: rJ PERMIT LOCATION: ATE: — - (-D TYPE OF STRUCTURE: RECHECK N/A YE O COMMENTS VFings�ers /t Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 4$hours following the place. t of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in P ace Foundation/Dampp oofing Backfill Approval Plumbing Under Slab Plumbing VentlVents in Place Rough Plumbing Heating Rough In Insulation Foundation Walls Interior R- _ L d Foundation Walls Exterio R- �/�G!G�i-f/l) •p J v�G6iiy� 1 Floors c� Walls OFF I L Ceiling /R- Duct work or pipinunheated spaces - Proper Vent, Attic Ve Framin Jack Studs/Headeri 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 Queensbury Building & Code Enforcement - Residential Final Inspection IP Office No.(518)761-8256 Arrive: _ami/p D—epart: am/pm Date Inspection request received: Inspector's Initials: 5T NAME: PERMIT LOCATION: I- A DATE: TYPE OF STRUCTURE: Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Guards at stairs,decks,patios more than 30 inches above Rade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Interior Handrails @ stairs 2 or more risers Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors: Every level: Every Bedroom: Outside every bedroom area: Inter Connected:� Battery backup: Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, I sq.1-150 sq.ft.vents Bathroom Fans,if no window oundation insulation !:IT�o ping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valves)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum 1/2"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/1/4 hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance re aired Flood Plain Certifica r6 red Okay to issue C [ ;bm orary/Permanent] L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form—revised—100405.doc Queensbury Building & Code Enforcement - Resi tial inal Inspection -2,�\C> Wesitiallri Office No. (518)761-8256 1 Arrive: grt: a s� (10 M Date Inspection request received: Inspector's Initials: NAME: - IT M 6 00 P LOCATION: f-- I AJ t lq-�Alj fE: TYPE OF STRUCTURE: Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake V 3 inch Plumbing Vent through roof minimum 6 inches A Roof Complete/Exterior Finish Complete Platform at all exterior doors Guards at stairs,decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Interior Handrails @ stairs 2 or more risers Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors: Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battely backup: Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(hei&t)in accessible area Crawl Spaces IS inch x 24 inch access, I sq.ft,150 sq.ft.vents Bathroom Fans,if no window Plumbing fixtures 7 Foundation insulation Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum V2"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/3/4hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required 7 gtray to issue C/C or C/0[Temporary/Permanent L:\Building&Codes Forms\Building&Codes\Inspection Formsaesidential Final Inspection Form revised1 00405.doc RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: c - Building&Code Enforcement Dept.of Community Development Arrivem Depart Town of Queensbury Inspector's Initial - 742 Bay Road Queensbury,.New York'12804 / NAME PERMTI # d 'Q LOCATION DATE TYPE OF STRUCTURE N/A YES NO COMMENTS Chimney Height/"B"Vent/Direct Vent Location j �� �O Fresh Air Intake V Plumb Vent through roof \ � _ -�►�3� Roof Completec�l Exterior Finish Compiet \ \ \1 Interior/Exterior Railin s 30"to 36" Exterior Handrails,b conies, anding 18 in.or more w `� Interior Handrails sta s both 'des 3 or more risers E � Grade 20%away fro founds on 8"clearance to ss`1l late Gras Valve shut-off exposefi/regulator 18"above grade Gas Furnace withih 30 feet or within line of site Oil Furnace shut-o at entrance to furnace area Fiuuace/Hot Wate Heater operating Red Valve(s)ins lead Headroom,6 ft. on stairs Basement stairs,6 .4 in. -- -� Handrail exterior' ' s both sides more than 3 risers Interior privacy! oors/main entrance 36" Floor Finish Yt Bathroom/Kitchen wa rtight Interior Handrails Bale nies/Landing 18 in.or more Railing across window. stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3l4 hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protect (in garage) Light ventilation per room Safety glazing 18"or less from.fl r 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) COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. � Main Office 176 Doe Run Road AS Manheim, PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPRO L 'Po f NOD 70827 "�� c}Panel �Oard l�1o11l,HI}iflllirlii!!11!llii}lf���i �t �nCard �Yii�Itfi//filiafififttiflffrri{iiNi� Owner Locatic ]!1!!f!!1!!i!!!llrrrll!!lulr#f4l1!!r1!!if!!Ir #lflRrl 1if#1liRffr!!!!!lirffilfifliffrlif!!#f{fifff,itflff #iffiiitll#i Iffif!liff{Ir114#Iffr4f Iff1}ffrrRrfl!!!f!! ! ! �'��� ,}'�I 1(�� 1 ljT�f`i j{'�t}''�j (J�� InstallationConsisting �+ff1 Iif1 iili/ffllif ifi{fi}•{f}i Nii{/iliiiffi!! {i}i}i i}Il lii lr! lf+ifiii+!!s+!} #+i!}#ff!!i{tiii{fi{lNii{iHfl/tiitH1f 4111 t! 1f4#}fitlNlltt+IHli!ltrrl11rf4/tf!!1lifiN4FtffHiH1111lIIHINIli11l IINIIl41f!!llff!lifffiffrfri!!itfliflflfl#filfffli!!!!Nltiil!!!#4iir4ilriffilf#llitf 4rf44111tliiliil141!! t e 1lff11l4!!!!M{+if4+#!1!itRilHl4f4f4!l444Nlt4!!!4lHi!lifi!!lllf!•4111NflINI{ffilif Mi4t4f4ifplf44ftiflffili{!if{!f 4{tiflit{f4t{Nffli4ii{Iif Nlfitf lt!HlffH4lftlf4lifiiilf! 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No. !l4f4fir}41i}11}}!,litai�{!lfii The conditions following governed the issuance of this certificate, and any certificate previously issue 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 he promptly made for inspection, 5 Inspectors of this Company shall have the privilege of making ins ections at any time, and if its rules are violated, the Company shall have the right to rev a this c e �r tel Date, 1 +{jam,/ -' Ilfi i ir}11r11f{il/i EiiN if+iflfiii4if}fi1}i I NSP ECTOR , 1 fit #If41rH1frlfR{ff � 111W' �.b {44{t4llif iffilff!lRtlf l}ii!!il ifll{fl ifil4 .. . .. w w • a +w t FIRE MARSH^t- T'OWN OF QUEENSOURY QUEENS€3URY, NY 12804 (51 B) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED NAME 7'- `T =1- LOCATION _ PERMIT SCHEDULE INSPECTION ON —AM M APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPR NKLERS CLEARANCE TO HEA ING UNITS REQUIRED SIGNAOE CH NEY _ De Y?oc-e- - - OOD STOVE FIREPL%e � MASONRY ACTORY BLT. ROUGH-IN E:l FINAL REMARKS: OK TO THIS DATE INSPSLIP.PUB INSPE WIR �Q TOWN OF QUE I in I AN ; rqo,o g".Admhs to Dat O 4 °e Mon "An go JOB 11 vim IT: �-� ICI � to ".,n �fw W� S7� pC �, Sf o ,Y, ; ?rzomas ar t 4 H (/f���//J�,(71'', �■/��l ly'�1/!I�!'!/��/��t� �(Y�((y''��j� (F)+ �('/�}t � I,t�+l,,,, � � �'i�µ(/�[yJV'j�(s�aid ��o���s�la��laa Was�ad�°��am an,�fuAl '��,,l ��k i �Q'��V 1��1 �Y��i••T�IR"��M��I���IFP�i ,t� /) � rNJ r� I gllk�i.�'�yuL'�I MAL pacordan �o f„1. J IS t yhtt � l r, r z� she�aa �on o � audrf�s yh `ftpror�tfs "� ! t r2mfs�s �h Mere ar'1 no 61n� d&tW8fs r her 1 n� 1��/y Ar'�^d`6'dl� t 1,Yr g4«YA,,Y!✓;wV,U1 $�1i,G f .r ..��,