2000-174 TOWN OF QUEEN.SBURY
742 BayRoad,Queensbury,NY 12804.5902 (518)761.8201
Community Development- Building&Codes (518),761.8256
CERTIFICATE �A` 0 ' ry
CCUPANkil
PennitNumber. 2000174 Date Issued; Frida December 08 �2000�
y,„ .
This is to certify that work requested to be done as shown by Permit Number 2000174
has been completed,
Tax Map Number. 523400-074-000=0002-068-*000-0000
Location:, SARA=JEN Dt House No. 32 Sara Jen' Drive..
Qwnen: GUIDO PASSARELLI (Michaels Group),
This structure'may be occupied as a;
Single Family Dwelling
By Order of Town Board,
TOWN-OF QUEENSBURY
. Director of Building&Code Enforcement
BUIL-DING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 176900 Building Permit No. 2060174
TAX MAP NO. 74 . -2-68
Permission is hereby granted to MICHAELS GROUP, THE
Owner of property located at LOT 6 8#3 2 SARA-JEN DR.
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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
10 BLACKSMITH DR.
MALTA, NY 12020
Contractor or Builder's Name:
_ MICHAELS GROUP, INC.
Contractor or Builder's Address:
JIM CHANDLER, PROJECT MGR 10 BALCKSMITH DR
MALTA, NY . 1,2020
Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK- BOARD OF FIRE UNDERWRITERS
Type of Construction:
SINGLE FAMILY DWELLING
Plans and Specifications:
2573 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATION
Proposed Use:
SINGLE FAMILY DWELLING
$ 311 PERMIT FEE PAID—TIHS PE€t:NUT EXPIRES April 12 2002
(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 wn of Queensbury this 12 Day of Ap r i 1 2000
SIGNED Y for the Town of Queensbury
Code Enforcement Officer
Building Permit Application
Town Of'Qlleensj7i'•lIy - Dept, of Conunwdfy Deevelopmelit, 742 Bay Road, Queensbwy, NY I2SO4 176/-82561
NaTIC�]( BUILDING & . COD,E ENFORCEMENT
E Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE mo,91�7��
beginning construction. No inspections PERMIT FEE PAIDQ-
will be made until applicant has received = Zoning Board Action
a VALID BUILDING PERMIT. All Area /Use RECREATION FE
applicants" spaces on tWs.application
MUST be completed arid-the signature Q Planning .board.ruction REVIEWED BY.-
of the applicant-must appear on the SPR ! Subdivision /Other trts tril�l;n,q �ecror
kapplication form. n,-t>— Recreation Fee Payment
Applicant: I-VAS mtclnbt�5 COVZ^. A Owner'
Address:1C) C tCTr��IR. yt• .T�2C�26 Address:
Phone # - j`�_, Pltone # { ) -
Property Location: � Y '�'T�� -_--- _--_^ ___--�?y
� `F�C3
Subdivision Name:' --
StJ Secio Tax Map Number _
n nl0ck- iris
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
�c New Building: CONSTRUCTION: $
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial �_ Single Family Dwelling
Residence / Commercial Two Family Dwelling�
no change to exterior size Familrty Is, l- 'ng/Y
Office
Other Work (describe below) Mercantile $PR 0 2000
Manufacturin
IO�Z'i�
GROSS AREA OF PROPOSED STRUCTURE.* Other OF O;.I`t:.t� BURY
�`s� R1 M ratty Ah-,IQ r:0ADE
1st Floor.. . f sq ft. �O If ADDITION, what will use
2nd .Floor. . . . . . . of new, addition be? :
Other Floors . . . . . sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS;
Detached Garage 1, 2 car
TOTAL FLOOR AREA: S Q. F �C_ Attached Garage 1 2 car
S ` Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
�7 FEET X FEET j Other
Foundation Type: Will any second-hand,'or ungraded
Number of Stories : lumber be used? I-f so, for what?
(habitable space only) Ko
Height (grade to ridge) : ,3p feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or`woodstove (circle all which a plies
to be installed: Electric / Oil j as j Wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
codes i s :
Na e A dre s Phone
Builder: ell Cal
ZQ
Plumber: '2 b
Mason., Vz 1 Ca tcaCo -
E1.pctri-f as-r
DEG'L.ARATION- Please sign below q?er 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 BUILT PLOT PLAN by
a licensed surveyor; 4iVwn to rlc, o . actual location of project on premises.
Signature:
(owner, owner's agent, arctitect, contractor)
Application for Permit—Septic Disposal System'
yi�nvn Of Qlfvlenshwy 742 Hay Road Quvemvbury, NY 12804 18) 761-3256
1. OWNER INFORMATION:
01ficc Use
Location of installation:
File Permit No;Dp o6
Tax Map No.
Fee Paid
Owner's Name:
.................... ........................................
Address:
2., INSTALLER'S NAME
PHONE NO..(,2
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 9 bedrooih.(s) and multiply,/1 of
bedrooms with applicable gallons per bedroom to equal total daily iv)
Year of House: No. of Bedrooms x Computation. Total Daily Flow
1980 or older x 150 gaUbdrih
1980- 1991
x 130 gal/bdriii
1991 —present _IX x 110 gal/bdrni ---yk 0
APR 0 2000
Garbage Grinder Installed yes no X
Spa or NMI irlp ool,llista lled yes no X 40L
4. PARCEL INFORMATION- (circle applicable information & indicate measurements)
Soil Nature Ground Water Bedrock or Impervious Material Domes.tic Water Su
pper
d a 117 at what clepth
Rolling loam
Steel.)slope clay ij*well; water Supply
slope other ftotn wty septic4)"VIVIn
depth: Cabs6iptiotz is
other
Percolation Test:
arctect)Rate: -L.In/17111c,Per inch
5. PROPOSED SYSTEM' For New Construction: All individual sewage disposal systems must be designed by .licensed
professional engineer or nrchitect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size
of(lie septic tank and leach field for cacti Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: gallon (min. size 1,000 gal)
Tile Field: each trench. Total System Length: 2140
Seepage Pit(s): number of SIZO QJ'CaCh: __J1. by_jj.
Size of Stone to be used: # depth or thickness
Bed,Systein Size: X
Alternative System: length andlor size
6. HOLDING TANK SYSTEM: (if required)
Number oftanks: Size of each:_gallons /TOTAL C i apacity: _gallons
Note:- Alarm System and associated electrical work must be inspected by sj.TQ_wki a
electrical inspection agency.
7. SIGNATURE & INFORMATION'FOR RESPONSIBLE PERSON(please read)
For your protection,, please note that pursuant to Section136-29 ofthe Code of the Town
of Quecnsbur�y, 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 regulations with respect to this application and agree to abide by these and all
-requirements of the Town cif Quee,nsbU Sanitary Sewage Disposal Ordinance.
Signature of responsible person Date
Fire Alilrs)Ial's office TOW11 Of(lueensburv, 742 B,,i\- Rwid,Qtieejjst)jjr\-, N;y
(518)7o 1-8205
Application for Fuel Burning Appliances & Chimneys,,
applicable to solid fuel & vented gas' appliances
Date lay 20 Permit
.Application is hereb)l made to the 13iii1ding& Codes Q/fic efi)r the issualice of CI Building and I Use
Per n,it pursuant to the New York State' Fire Pre I veliji(
)"I11dB"ildiJ79C0(&% 77lecll)l3lict-liziol-oiviiei-
agrees to comply with all applicable Jalt'S, Ot-dillallces-1 regulations, and all conditions that are p (f,
these requirenzents and also will allow call iiupeciors o enter pre
"'I PliseS to pe1:1b1'i1 required inspections.
Va
NOTE to applicant: Roucyli-in and Final Inspections are required.
Applicant Informatioll Fuel Burning Appliance lifforination
Name: pAiCjjAf�5, Stove: (circle appropriate words)
wood coal pellet gas
Fireplace insert
Address: O WA-1 19Le W Fireplace, factoty-built- wood If
Fireplace, masonry: Wood a-is
Furnace- wood gar—,Ow.I
Phone:
If non-masonary applicance, please provide
el,
Owner:_W-Wiflr" Manufacturer Dame:
Addres�s_L --Model NW111ber—
Chimney Information
Phone: = W 1 (circle appropriate words)
Masonry block brick stone
3o-1 Flue tile
( feel" size.- —inches
Exact Address:Jft 5tAiCA- OtZ
ofconstraction or inswItation Factory-Built
Manufacturer name:
Note: Model Number
Listed By: Number:*
Construction lInstallation must
C077f01-177 to A1YSFb-e Pi-evention &Building Indicate(circle) chimney material:
Cocle. Consult aiailable Towirof Queensbiti7,
Handouts regal-ding i-eqlfb-ed inspectiolls. Double hall Triple wall Insulated Direct veIjji/ja
Chininev Liner
Fire Alorshal CodeCec e , ,
S olleS Rfinded Reciived fiom (re1de IWci
Wu A
CY -Idth-ess'.
,
.4 1733389 (190) Public Safety
A 233 2655 (230)Alinor Sales
16n/lfl-02 '0
White(Applicant) I Green(Fit-e Marshal) Yellow(131cfg. Dept.) Nnk&Goldenrod(Cashier's Dept.)
i
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE, 1
0287 BUREAU OF ELECTRICITY
F 40 FULTON STREET, NEW PORK; NY 10038
Date ��CL14t 3. �?t1(3 Application No. on fcle 't68`�7�;`�f�U/00 .155558
THIS CERTIFIES THAT2ed
uceje�l1 hcant on the above a lication number is in the remises oonly the electrical equipment as described below and antrad y pppp p f
r�pp��;; y ii,pp��ii,, �j 1ryr �p �s p �f p�q� t i I'
T t!1 141 t l'k�,�.h i GROIJI)p 32 SARA tl IN i�41 p 1 II NN►�RUR- 1 MY
641 ,
in the following location; D Basement [31st Fl. 1 2nd Fl. li R Sec on Block Lot
was examined on i���14Rfj1R 07,2000 and found to be in compliance with the National Electrical Code..
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. I K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
40 T) 48- 3
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT, TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL N.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP: AMT. I AMPS. TRANS. AMT. H.P. NO,OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OP +S E - - R w w -V- -_. I C_,_ E
METER NO. CC COND. A.W.G. A W.G. A W G.
AMT. AMP. TYPE EQUIP, 10 2W 10 3W 30 3W 30 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HKEG NO,OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
POSIT L1 .`...2
G,1"P,C4./�i.*�7k�`�M,�4
VORMTER KIA121H EL Fiat s
VIRIJAM D M y N
� '1'° 3'�V `'� GENERAL MANAGER
SC1 MAMIW)Y DIY¢ '12309
Per
This cerfllicate must not be altered In any manner;return to the office of the Board If Incorrect.Inspectors may be identified by their credentials.
nn0v Crno 01 ui NKIf-_ PICDADTHr-KIT Tuic r%npv nr! r.PPTII=Ir.ATF FBI i.�T NOT RP AI TFAFD IN ANY MANNER.
i
}0}
z
..
W W
Z za
H '
t H W
� aaw
PA
O��H �• W ��
Nza � ago'• c a WHO
W µ
Z H U Paz
�}
+ � U0 H N H 0 + k"
0� r�z H0 W 0 H 0 z W 4
r� H 0 W z A t7 ,A
0 m 04 H a w 4 H 7 W
N p a 0 0 H W d 0 u W W H U
HW > I M E1 E+ H W
w + 0
ryn O D 1 `' V? W �� z W w U D UJ QJi U H
V 0 V U
H Uk�.N 2 H '* H t11 " W [� ' z 0 ( z a H (� U
y>,H,�.,.•'' 0 z z � w H a «'", 0 0 H Z X H
U � r+ H W H H 0 U 0 0 U H W a H > W W
z �+ z U w > z a 0 �+ 0 H a a W W z w U
H w 0 w z U z a H W w W H 0 H cn W Z tE
w z �aa 0 a > w a w U H w 0 a 4 0 cn
z 0 wUNW � zu00 w0 as� c� a0zH 4waV1H
W H H 0 z W H Z H N W U H 0H W U W
P H x a iQ H ( W H M W W a ca a a 0
H Cl W W w H0 c� w H z W H H H H x a w H
H 2 U H W OOz H U 0 H U a a H z 0 0 0 H 0 0 0 z H
A q .�+ U W p a H W I �� W A w +I 0
2
MAP REFERENCE:
LEHLAND ESTATES SUBDIVISION
MODIFICATION PLAN — PHASE 2
DATED: DECEMBER 22, 1998
REVISED: DECEMBER 29, 1998
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
.v an. D us el:l
8c
Stever
Land Surveyors, LLC
169 HavHand Road Queensbury, New York 128
'518) 792-8474 New York lAc. No. 50135
`UNAUTHORIZED ALYM71ON OR ADDITION TO A SURVEY
MAP REARING A LICENSED LAND SURVEY= SEAL 13 A
VIOATION OF ECRON 720% DUG-WASKI N 2. OF THE
NEW YORIL STATE EDUCATION LAW
'MY COPIES FROM THE ORIGINAL OF " SURVEY
NARKED WAIN AN ORIGINAL OF THE LAND SLIMY=
SEAL SHALL E CONSDERED 10 E VALID TRUE COFIEA'
CERTRIOATIONS NOICA70 IEIKON SGIRFT THAT
THIS SURVEY VMS PREPARED N ACCORDANCE WITH THE
MONG OWE OF PRACTICE FOR LAID SIRVMM ADO%ED
BY THE NEW YORIL STATE ASSDDIARON OF PROFESSONAL
LAND SURVrdRSL SAID Cgn*XAMM MALL RUN ONLY
TO THE PERSON FOR WON THE ROVEY IS PREPARD, AND
ON WS BEHALF TO THE RILE COMPANY. GOVERNMENTAL
AOEICY AND LENDING NS71TUMON UPW HEREON. AND
TO THE A=M= OF THE LOON NSRTUUON.'
F rl�
Map of a Survey made for
Francis & Victoria Sweenor
Town of Queensbury, Warren County, New York
NO. I DATE
FILE COPY
RECEIVE®
DEC 0 2000
0
9
100
CERTIFY THAT THIS MAP WAS PREPARED
ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF 1*0 THE TITLE COMPANY, GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIEC TO: FRANCIS do VICTORIA SWEENOR
CENDANT MORTGAGE,
IT'S SUCCESSORS AND\OR ASSIGNS
CHICAGO TITLE INSURANCE COMPANY
Comm BY:
MATTHEW C. STEVES. LLS NYS 50135
DATED: )ECEMBER 6. 2000
DESCRIPTION
:: Uecember b, 2C
e 1"=30'
S-1
SI$T 1 OF 1
NAME
DWG. NO. lehland-68
............
44
-r(Z>VVM CUr-=F=Nr-3E3UF,'")r
N!"Y 12804 4L >r-= 4=t(518) 761-8205
FIRE MARSHAL INSPECTION REPC)RT
REQUEST REC:EWEIDt —,7 a—z> PERMITO
NAME
LOCATION
SCHEDULE INSPECTI(DN C)N >f`
<�PM ANYTIME
APPR40VED
N/A YES N40
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERC3ENCY LIC31—ITINC3
it
FIRE EXTI N+�U[IS HERS
FIRE ALARM SYSTEM
FIRE SPfzlINKLEf::?,, SYSTEM
FIRE SUPPRESSION SYS -E
HC>C>D INS-FALLATIC3N
INTERIC:)F;Z FINISHES
ST,C>RAC3E:
CLEARANCEIfTC) SPRINKL ,---
CLEARANCE I PT HEATINC3 ' NITS
F:ZE—=C:IUIF:Z-ED Sf(:3NAC3F-
41
X1.1
0 H I M N F—:'Y' tail,,
W(:>C>D STOVE
FIREPLACE — MACC)NF:;,,Y
FIREPLACE — FACT(DRY BUILT
REMARKS: MC>K�TC> THIS DATE
INSPE�r�, O
`iced a o'�---
t t
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement 111
Dept.of Community Development Arrive m Depart t
Town of Queensbury ector's Initial
742 Bay Road P
Queensbury,New York,12804
NAl1r1E 1� `� # C)666—
LOCATION
TYPE OF STRUCTURE C >
rNIA YES NO COMMENTS
C'vChimney Heightf`B"Vent/Direct Vent Location
Fresh Air Intake i
Plumb Vent through roof '
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 3G"to 36" 4
Exterior Handrails,balconies,landing 18 in.or more ,r
Interior Handrails stairs both sides 3 or more risers s
Grade 2%away from foundation
8"clearance to sill plate s
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 34 feet or within line of site
Oil Furnace shut-off at entrance to furnace area\ .�
FurnacelFIot Water Heater operating
Relief Valve(s)installed k
Headroom,6 ft.6 in.on stairs `i
Basement stairs,6 ft.4 in. '`v°
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36" ,
Floor Finish / a
BathroomtKitchen watertight
Interior Handrails BalconieslLanding 18 in.or ore
Railing across window in stairwells r�
Smoke Detectors:
every level /
every bedroom
outside every bedroom
inter connected3,
Bathroom fans V/ I l+W
t�
Plumbing fixtures %t
Foundation insulation '1
s/a hour fire doorldoor closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room pr tected(in garage)
Light ventilation per room ,,--'' 4 1
Safety glazing 18"or less fronfIfloor
Final Electrical $
Site Plan/Variance required
Final Survey Plot Plan ` 1
As Built Septic System layout required
Okay to issue C1C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent CIO(Certif.of Occupancy)
FlF;ZE= r%A^F;Z,<3",ikL-
TOWN (::>I= CD-UaafqSE3UFVY
ClUaaM,-3BUF;---V-, "-v- IP-804
(518) 7151-8;?05
FIRE MARSHAL INSP TION ORT
REQUEST RECEIVED
NAME
LOCATION
SCHEDULE INSRE04ION ON
AM (f!IVI NYTIME
APPROVED
1 N/A YES NO
ITS t�
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING ',
is
FIRE EXT(N(3UISHER.S
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYS M
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANC TO SPRINKLER�S
OLEARAN -TO HEATING UNArs
REQUIRED SI(3NA E
CHIMNEY
W aD STOVE
REPLACE — M SONRY Als,
FIREPLACE — F CTOR-v- BUIL-T
REMARKS: OkNTO, THIS DATE
AN,
I NSPECTOR
QV
RESIDENTIAL FINAL WSPECTIO PORT
Office No.(518)761-8256 Date inspection request receiv)t-,
Building&Code Enforcement tg
Dept.of Community Development Arrivert am/pm Depa M pm
Town of Queensbury Inspector's Initials
742 Bay Road !�
Queensbury,New York 12804- e - 7-j/
/
NAME WtMaA PERMIT#
LOCATIOR DATE f
TYPE OF STRUCTURE 4rr')
NIA. YES O CO
al,
Chimney Heightr'Vent/Dir'ect Vent Location
Fresh Air Intake All
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
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above gra e
Gas Furnace shut-off within 30 feet or within line o site
Oil Furnace shut-off at entrance to fiirnace area s � {'IFurnace/Hot Water Heater operatin 1 L �cxe�✓� /�
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 fit,4 in.
Handrail exterior stairs both sides more than rises.
Interior privacy/t imldoors/main entrance 36'
Floor Finish �.
BathroornXitchen watertight tfi!Q
Interior Handrails Balconies/Landing 18 m ,or more
Railing across window in stairwells '
Smoke Detectors.
every leveIV4-taz
�Nf�
every bedroom
outside every bedroom a
utter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected( n garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required f
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)
! ENERAL 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 al �
Inspector's Initia s �l
NAME: PERMIT# "
LOCATION: DATE:
TYPE OF STR CTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers ;�
Monolithic Pour Form
Reinforcement in Place
The contractor is responsib for
providing protection from ing
for 48 hours following the lace mIt'
of the concrete.
Materials for this purpose o site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Sl
Plumbing VentJVents in P ace
Rough Plumbing
Head"b Ron In
ulation�
Foundation Walls Irate 'or R
Foundation Walls Ext rior R-
Floors R
Walls R-
Ceiling R
Duct work or piping i
unheate&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
wWall 2,3; ouropping
Z
GENERAL dNSPECTI(7N 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- n/p
Inspector's Initials 1�
NAME: r PERMIT# —1314 DATE :
TYPE OF STR
RECHECK
N/A YES NO COMMENTS
Footings/Piers � l
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible foz �l
providing protection from freezing
for 48 hours following the placIrnent j
of the concrete. tr!
Materials for this purpose on sitet
Foundation/Wallpour z
Reinforcement in place
Foundation/Dampproofing i
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place r'
Rough Plumbing '
Hea ough In
ulafiay�
burr Walls Interior R ,p
Foundation Walls Extetior R-
Floors i` R
Walls R
Ceiling ,f R
Duct work or piping in
unheated spaces R-
Proper Ve Attic f'ent
Jac -SfudslFleaders
Bracing/Bridging
Joist Hangers
Jack PostsftvWn Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
e Wa11.2 7 4 hour
f -
stcijing� �`` 1�I`�CL� F't f +ta)c�c
FIRE MARSHAL _
-FC>W" OF (::)UEEElN,4:3E3LJl:;Z'*lr
NY 12804
4SEL (518) 7el -8205
FIRE MARSHAL INSPECTION REPORT -
REQUEST RECEIVED
NAME !kw, x
LOCATION 7 PERMIT A
SCHEDULE INSPECTION ON Lo-k Ck......
�P-
--
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
>4
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYST
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SP EATKERS
CLEARANCE TO H IN UNITS
REQUIRED SIONAGE
CHIMNEY
WOOD STOVE
FIREPI-Ag�E = MASONRY �CT14�CDRY BLT.
Z VROUQH-IN
= FINAL
REMARKS: 'OK TO THIS DATE
INSPSLIP.PUB INSPECTO
77/
1: SPREPORT
( 518) 761.-8256�r
Town of Queensbury
Dept,of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804, A.rrive�UVspector's
Depart
Initials
NAME: , PERMIT It _ h LOCATION. DATE : — C�
TYPE OF STRUCTURE: �(�
RECHECK.
NIA YES NO COMMENTS
Footings/Piers
Monolithic Pour Form \ T
Reinforcement in Place
The contractor is responsi le for
providing protection from ezing
for 48 hours following the lacement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement' lace
Foundation/Dampproo
Backfill Approval
Plumbing Under Slab
�Hea7tingRough-ln
ug Vent/Vents in Place
olumbing ��h
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
_�hg
Jack Studs/Headers'?
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam "ro' CSC) h5TOV fir '- MiC Atr� �AQ1�
Air Infiltration Barrier
Fire Separation 1,2,3,hours
Penetration Sealed
Fire Wail,a,3,4 hour
V opping �'
tD . 0 ro 0 0 0*0 -1- a -JH0 -1- M-I,ro (D 0-4 .,- ro 0 �, 0
' (/� 0.0 -�� n 0`0 C 11.1 (D V) 0 CL 14 0 N M N R3 0 (AU `b 0 ri' 0 RI
.+, 0. 3 - fia 3 7rtfitaM� (D (D00Cm C r
tC a N rt G7 0 0' no 0,0
3 0 0 cr 4 WO Cit .- to M-h 0 11,0 0 4
y "S X 0 0 0 0 's k 0 N LA �h1'.4
0 .1- 0 M Q ,C b
m 00 oa � � 0.cncn �� � ro H(+ C+ 0 -h to H 20
�C na � '�10 mro00a .40. .Iro Na 0 0
;fro , t0 '0 (D :3 0 Hm*4ro a r^ CD
f1 b ' • � t . pro ro `rl � � 0" m3fD � � 0 � N �
o � r -aco0 fiz roc+ 0 >
a.ro rortcn H -4x C+ W �� � r r 0 �0
m 0. -h 3 -jU) 077p (D as 0
H ,, p 0 -s ` rr -� (+ a v � � n1C
0 a w+ �: ro 0 0 ro .rt (D
�^ mmm
ro WO (D a n 0 z z
a (Dz r (D
- 1 "0 tD ct 0 1 0 .00
N to \
ti
CL z m m
ro 0 rt ct ct ►
( , rd 4J4� -P 0 0
{ r -r-. 0 0 o Z ro
0 4J
C s� 4J
*M
W M N 0 ,v r
00
� � J � 4J
4J ( C C ro 0 m u
w «r r ►r r �, � A r� I� �1 A: � 4�
W W Q' a� u C E zl I (A (0
1 0 1 4J -C S. 4 N 0 ul
W V� N r
'r N 0. �% 0 "
z A a 4J N C �. S- WO 0 w
it N � TJ �.1 0 N r- 'a UPI
*-' �
U. U 0 a4-) () 4- a s 0 .0 ,r h ,, , 0 C
O N u 3 U,-% J , ,C M ,r "D 9�- d I s- y) s r
0 y C i. ai w z U U. 4I ; 0 >"
C� 0) r-ICI M U C 4J 1 1 - r• 0' C? �i� f3. P.L o
0 0 COC 4J a ro 4J 4-'
0Z 00 0 I. 0 (0 N4J 0)� �,ro
~ ®' 0 .0 � P +J a) �-- ,r U) L C C C rob C 0 � W � 0
Q � /W 0 r V) t4 Q. N C+ x \ 0 0 0 0 W � U1
CL r" 0 T If. 0 0 0 !t--r or
0 � Q� OILZ f F 4J 0 CO M 4J � aJ
-P 0)Z P'r 1' 'f b � 0 U 0 r�dll a
a W 0 O��N U L Q1 CH Q).� � C'� C C (C 4�- � S- C O p �#
�1J U P 1q 0 A. 000LNwN0C. -0C (� Q1t+ a3aCU ,r- 0'0
�4N4l-rW ,r. +-)HrVrQ,000000U » �r0 '
z ix.-4- 4 .icacnvicnc mF- 0c . �. u, cnu � u. U v� t�
GENERAL INSPECTION REPORT
(51.8) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 32804. Arrive am/pm Depart m
Inspector's Initials
NAME: 1" G PERMIT#dZXW
LOCATION: VDATE:
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respons' le for
providing protection fr fr ing
for 48 hours followin a pla ment
of the concrete.
Materials for this pu se on site
Foundation/Wallpour
Reinforcement in Plac
jF o u n 11ramppro fing
1 A raval
Plumbing Un Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough In
Insulation
Foundation Walls I terior R
Foundation Walls. erior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping i
unheated spaces R-
Proper Vent, Attic Vent
Framing f
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
600
GENERAL INSPECTION REPORT
(518) 761-8256
Town of Queensbury
Dept.of Community.Development Date inspection request received: S 3
Building&Code Enforcement
742 Bay Road
ucensbury,NY 12804. Arrive am/pm Depad
Inspector's Initials
NAME: PERMIT#
LOCATION: DATE: s-7,3 Ajjyt
TYPE OF STRUCTURE:
RECHECK
--N/A YES COMMENTS
Monolithic
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from fike, fig
for 48 hours following the a6ement n r
'/site
of the concrete.
Materials for this purpose n site
Foundation/Wallp,pur
Reinforcement in a
Foundation/Dam
Backfill Approval
Plumbing Under Sla
Plumbing Vent/Ve is in Place
Rough Plumbing
Heating Rough-
Insulation
Foundation ails Interior R-
Foundatio Walls. I/ terior R-
Floors R-
Walls R-
Ceiling R-
Duct rk or pi *ng in
u eated spaces R-
Proper ent, Attu Vent
Fra *
Jack Studs/Headers
Bracin
Joist Hangers._
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
-
Firestopping_—
fiCtiG A /wt •• -
p WITH A TOTAL OF 30' t .
tC3 *- �. 21 584 'sq.f
21 584 (s q.ft. .. �..: :
r- w 0.50 acre
0.50 • :acres
20 _J Z.
142.0
142.00
113,666 }S85'4
�lQa E.LJ
..
2..
ft.
1to
lE , 0 'Y
I have seen or observed, o believe I saw evidence of,
, , ,
I objects such as houses, ells treesE -ences,
-z---�� etc. �•. � � Q���r��. V own on this document. I , so represent that I have
--` - rsdnally meal red the distances set forth on the di '� R = 2000
TP
SIGNATURE --��., rP��,� s�lCa c:�j� �
IAT£ s: L
85`41'20"W
BAR
JEM }RIE
'20"E: CONC. MO �"27�
:. S85 41-
N
t 100.00 38.10 L==93,
00.00 -
p WITH A TOTAL OF-30"
Ca63
r 21584
�. 21 ,! 84 sq.ft �., 0.50 s r:-i=e
0.50 acres o
"I ha a seen or observed,or believe�l saw evidence of.
oo cx� 7 :
all o4ects such as houses,wells,trees.fences.etc.,
show on this document I also represent that l have { d- 9E
tiers o a I WSIGNAT
netforth an the diagram: O �'R �
O __. Z A :
`TOWN OF O jE NO :�BY
DATE SueLDIN ANJO r.�DE 142000
136
6 885'4
It 66
411
- l Lit
0 2�
r _
_j
3 z
SAAA AA
AA
r � t
W41'20"W
S AH
JEN 'DRIVE
S85 41 20
"E C. MON R=27;
100.00 38.10 - 64,
00.00 -