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2001-619 01.11aki TOWN OF QUEENSBURY Foiro 12804-5902 (518) 761-8201 742 Bay Road,Queensbury,NY Community Development - Building & Codes (518) 761-8256 • CERTIFICATE OF OCCUPANCY Permit Number: P20010619 Date Issued: Tuesday, February 12, 2002 This is to certify that work requested to be done as shown by Permit Number P20010619 has been completed. Tax Map Number: 523400-316-013-0001-003-000-0000 Location: 141 BIG BAY Rd Owner: TODD JORGENSEN Applicant: TODD JORGENSEN This structure may be occupied as a: By Order of Town Board Single Family Dwelling TOWN OF QUEENSBURY Garage - 2 Cars Attached Fireplace ( (Condition) Do not use Fireplace on Basement level till completed and inspected Director of Building&C n ment TOWN OF QUEENSBURY fw 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010619 Application Number: A20010619 Tax Map No: 523400-316-013-0001-003-000-0000 Permission is hereby granted to: TODD JORGENSEN For property located at: BIG BAY Rd 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: J. ROBERT LA PANN TRUST Single Family Dwelling 225,000.00 G.F.N'TL BANK& TRUST CO Garage-2 Cars Attached AATT: JOHN CORCORAN Fireplace PO BOX 2161 Total Value 225,000.00 GLENS FALLS,NY 12801 Contractor or Builder's Name/ Address Electrical Inspection Agency INSPECTOR, THE 543 EASTLINE Rd BALLSTON SPA.NY,NY 12020 Plans &Specifications 2001-619 1832 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AND 2 FIREPLACES AS PER PLOT PLAN SPECIFICATIONS $273.44 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,August 22, 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 Town ueensb ; Wednesday,August 22,2001 SIGNED BY 41, for the Town of Queensbury. Director of Building& �de N forcement Building Permit Application Town of Queensbury—Dept of Community Development, 742 Bay Road, Queensbury,NY (518) 761-8256 A permit must be obtained before beginning construction. Permit File No. ( 11(J(Q No inspection will be made until applicant has received a Fee Paid S 1 3. o/i,5 {� valid building permit. All applicants' spaces on this Rec. Fee Paid S �j' application must be completed and must appear on the Reviewed By: application form. I'll V . , AU ,. , Applicant: Owner: Accig c-uul Address: 572 /iZpf ) ,4ve. Address: 5-6-7 I i. per'„. Phone#(���) 496 Phone#(c5 J ,-)b - £/ Property Location: Lot Number: I House Number //f/ Subdivision Name: Tax Map Num er /., , ' New Building: residence /commercial Estimated Market Value of Construction: S S oco- ❑ Addition: residence/ commercial If an Addition,what will use of new addition be? ❑ Alteration: residence/ commercial ❑ No change to exterior size: residence/com'l ❑ Other work(describe ) Check Occupancylnformation 15`Floor 2"d Floor Other floor Total Below sq.ft. sq.ft. sq.ft. Square Feet . Single family dwelling M 7a 36,6 ❑ Two family dwelling o Townhouse o Multifamily dwelling #of units ❑ Office o Mercantile o Manufacturing o 1 car detached garage o 2 car detached garage ❑ 3 car detached garage ❑ 1 car attached garage 2 car attached garage ❑ 3 car attached garage ❑ Storage building- commercial ❑ Storage building- residential ❑ Other • What is the proposed height of the structure feet inches Will any second-hand or ungraded lumber be used? If so, for what? t"o Type of Heating System: electric/ oil / '/wood / orced hot ai / baseboard/other: Number of Fireplaces to be installed Number of Woodstoves to be installed List below the person(s)responsible for supervision of work as regards to building codes: Name I Address Phone Number - Builder . r�� r���l�- 35 668?stat - Plumber 0 4.2“Yc Mason. Electrician Declaration: please sign below after you have carefully read the statement: To the best of my knowledge the statements contained in this application,together with the plans and specifications submitted,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,as requested by the Zoning Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual )ion of all new truction. 1.7 Signature: -� owner,owner's agent,architect,contractor ii�J� c›.266 /- - ENERGY CODE COMPLIANCE APPLICATION TOWN OF-QUEENSBURY, WARREN COUNTY 9000 HEATING DEGREE DAYS a_ Compliance Methods : PART 5 - Acceptable Practice Met 1&2 Family Dwellings (o 3 4 20�� PART 6* Thermal Rating - Component T ..•. fs 1&2 Family DwellingiPifif#D 1 DE Dwellings (3 stories._g-ig -- PART 4* - Design by Component Performance Commercial Buildings-Hi Rise Residential *Requires submission of worksheets APPLICANT'SPP/ NAME: PROPERTY LOCATION: /add- r ii3_ PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area - /Ma square feet 2 . Type of Heat - Electric Oil X Gas Other 3 . Is building mechanically cooled? X Yes No 4 . Percentage of area of windows and doors %4" Over 17% Under 17% 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED: • .�,�- a. Roof R b. Exterior walls R 17 c. Glazed areas R 3��2 d. Exterior doors .R Cc' e. Floors over unheated spaces R f. Edge of slab on grade (heated building) R g. Basement/cellar walls (above grade) R // h. Basement/cellar walls (below grade) R i. Heating/cooling-ducts-piping in unheated space R N A. 6 . Service (domestic) hot water heating device Conforms to minimum efficiency per code /\( Yes No TEMPERATURE CONTROL MAXIMUM SETTING 140° .- WILL NOT BE EXCEEDED Applica s Signature pate Phone Number _a• Wei/0i 79 0767 IN ECTOR'S REMARKS : - Porch, Deck, Dock, or Boathouse Permit Application Town of Queensbury—Dept of Community Development,742 Bay Road, Queensbury,NY (518)761-8256 . A permit must be obtained before beginning construction. No Permit File No.C O L(0 ‘`--" inspection will be made until applicant has received a valid Fee Paid $-- , cc) building permit. All applicants'spaces on this application must be Reviewed By: completed and must appear on the application form. Applicant: t �-r--y Owner: Sa--'+�. Address: /L(' T.3r ' 7 Address: O kJr Phone#(S18 ) 798" - 076.7 Phone#( ) - Email Address: 7�1d 5.rdiens c .l phn�•r Email Address: Person Responsible for Supervision of Work as Regards to Building Codes: `� Name% e-lin Address: $ 1 Phone Property Location: Lot Number: / House Number /`/1 / el p``9' Subdivision Name: Tax.Map Number: Estimated Market Value of Construction: $ 'y C t OC) ❑ Porch • AL Deck , ❑ Dock ❑ Boathouse ❑ Other work(describe , Size of structure to be built 'y Q e 0 square feet Submit along with this application: 1. Two plot plans drawn to scale,preferably using a survey map. Indicate proposed -,� structure showing setback dimensions from all property lines. Show location of water supply and location and configuration of septic disposal area. 2. Two sets of structural drawings. Indicate size of posts or studs, floor joists, decking or flooring material to be used. Show how the porch or deck will be fastened to the building. If a roof will be constructed, indicate the size of posts or studs,roof rafter spacing and span. Indicate type of roof: sloped, flat, shed, or other. Indicate the type of material being used for the roof. 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 the proposed work shall be complied with,whether specified or noted,and that such work is authorized by the owner. i i?2 Applicant's signature: ,w, -- Date: 3/27 Q3 L:\SueHemingway\Building.Permit.FORMS\Porch.Porch.Permit.doc 8/13/02 revised per DH 517-----41- 1 /'/3--/—/1/ Fire Marshal's Office Town of Queensbury. 742 Bad' Road,Queensburv,NY (518) 761-8205 • Application for Fuel Burning Appliances &.Chimneys.: / c4 � applicable to •_ +Ei1. ::,s appliances Date qi 3 f, 20 � AUG 14 2001 Permit No. UVI-( t q Application is hereby made to the Bt rltldtb'eUnyjnr the issuance of a Building and Use Permit pursuant to the New York State r � '• �� Uct (1y1�Er 7 Code. 77w applicant or owner ail;'. . agrees to comply with all applicable law, s t� �tr atious, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to per form required inspections. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information • Fuel Burning Appliance Information • (circle appropriate words) Name:1 ve�- `�� P� 11 Stove: wood coal pellet gas Fireplace insert Address: 56 7 t?/e_ Ave— _ • rep ace, factor '-b '' . wood 0.as 9 � � � AN166 trep ace, masonry: wood gcr Furnace: wood gas oil Phone: ,c-1t- 'c-3 zL • . . If non-masonary applicance, please provide • Owner: �; �e PA.e Manufacturer Name: S .''ire�'" t) 7 Address: rtm‘.� C Model Number: - 3: • • Chimney Information Phone: (circle appropriate words) Masonry block brick stone / tt , tile see ' size: %� inches Exact Address: • of constr•uctio r installa n Factory-Built Manufacturer name: •Jcr..tp2r, .r" Model Number: C -` s, Note: Listed By: Number: ..._:.. Constr•Itction/Instcallatiort ttittst , ._- . ---,_,:__,A.. ;;. ... _ -_ _ --,-,-'---- conform to NYS Fire Prevention &Building ' _ Indicate(circle)chimney material: ode:C44suh available-rou:uu..of Quee{tsbtr+�, --:. . -.- _ ?4.,- ;;-'; --.-.,., -' . : y77.,-,,,,._, . Handouts regarding required inspections. Doable wal / Triple wall / Insulated / Direct venting Chimney Liner 1 40a16thieIr°E1 Depsz meant—Morsivzi. of Queepuak ury, _brew Yorllc- - 1 . l Fire Marshal Code# S Collected S Refunded eceit•ed from (re nderl to): Of/ JUT el 4b . "L- address: 1 173 3389 (190) Public Safetr .4 233 2655 (230)Minor Sales • . lit 1 • • ...„.a wte. - Iow.,. ce.44 02 fai. . White(Applicant) i Green(Fire Marshal) ! . 'Yellow(Bldg. Dept.) link&Goldenrod(Cashier's Dept.) . c7:4-"%xi. N3 -V- 4 X • Fire Marshal's Office Town of Queensburv. 742 Bad' Road,Qucensburv, NV (518) 761-8205 Application for Fuel Burning A• lia 6.Chimneys: 6 : • applicable to solid fuel :" •'- 'r.p�''• ces Date /i 3 20 1 AUG 14 2004 mit No. — Application is hereby made to the Building,d� fsJ9.u4ZErWERIYtance qf a Building and Use Permit pursuant to the New York State Fire PreventirAW: �1 '' • (.. ,e 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 per form required inspections. ^; NOTE to applicant: Rough-in and Final Inspections are required. • Applicant Information Fuel Burning Appliance Information �---, �-� (circle appropriate words) Name: �d �}�-r-- p� Stove: wood coal pellet gas Fire lace ins- r Address: 5'6_ ' k. r/ems Fire lace 'factor ,-bu' •• woo gas6 Q .14-7�� : AN jam . Fireplace, masonry: wood gas dD1� Furnace: wood gas oil Phone: .'t - 5 -- % • If non-masonary applicance, please provide Owner: 7i' 3,,.f- S'esel Manufacturer Name: Ma-i e 4i G Address: .,. ...,....tine..._ Model Number: g. zio. . Chimney Information Phone: (circle appropriate words) Masonry block brick stone F e tile WA size: a inches Exact Address: • /t of construction 'nstallat• r Factory-Built Manufacturer name: 1`p5f1.� Model Number: A Imo- Note.. Listed By: Number: • _ - - -- Construction/Installation.unest.-. , : - -- conform to NYSFire Prevention &Building Indicate (circle) chimney material: • - - - Code.:ConsulLPailableJown,afQueeusbtu :--: - _. . - _ 4,.. _ - Handouts regarding required inspections. Double wall / Triple wall / Insulated / Direct venting . Chimney Liner Ca,echiFer'or Departure nt t—T wirsz of Que ;ifziebri -y, New York • I . • Fire Marshal Code# S Collected S Ref,u,ded eccriyed fi rn, ( efunded to): r,�t', �d rjeiSeki • - f , address: / dam .-i 173 3389 (190) Public Safety g� — — • .: --- — .4 233 2655 (230)Minor Sales • v ylArt•a 14,1-6 — /own. 6161.4 oi. .2.061.,141.• . White(Applicant) i Green(Fire Marshal) t . Yellow(Bldg. Dept.) I Pink&Goldenrod(Cashier's Dept.) ► 1 . . Application_foaermit—Septic Disposal System Town of Queeitsbtiry 742 UayRoad Queensbury,NY 12804 (518) 761-8256 1. OWNER.INFORMATION: . Office'Use of installation: ti R�!�zi . [ �C File rormit No. I • '?. Tax Map No. t / 1 / , Owner's Name:.mQ /GGF� • Fee Paid ���c Address: )> - . 1*.' '1. Q EWE* 2. INSTALLER'S NAME : E 1l et ' PHO - 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate #•bedroom(s) and multiii414 2001 - bedrooms with applicable gallons per bedroom to equalI total dailyJlOn) . TOWN OF C UEENSBURV D13 ING AND CODE Year of House: •. No, of Bedrooms x Computation = Total, 1980 or older_ x 150 gal/bdrm = . '1980— 1991 . - x 130.gal/bdrm = 1991 present_ , x 110 gal/bdrm = mac) 6, • Garbage Grinder Installed yes / no X Spa or Whirlpool Installed yes / no y 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) • . xtap1 th. tuxc Q.roimci W.nt.er. _Dcd1.ock..v!::9,pct_vw.u.$ 0.1,9011_._t► . is Wat.cr.Su1'ply plat at u'l(rt depth al whrr depth . Rolling , oam / —feet 14/ fret we 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: ' - mIntite perinch 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 sulxlivision). Add 2511 gallons to the,size of the septic lank and leach Held for each Garbage Grinder, Spa or WhiiIpool Tub. . _Septic Tank: J45) gallon (min. size 1,000 gal.) Tile Field: each trench '17`v5TO ft. Total'System Length:. 610b " ft. . • Se ge-piit(s : number of size of each: fl. by . ft. . t Size-of Stone to be used: II 4- • / depth or thickness,__.__•_•_ __ .;fret Bed System Size: A h- x • Alternative System: P'/ - •length and/or size' - . 6, HOLDING TANK SYSTEM: (if required) , • • . Number of tanks: * / Size of each: ' gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be.inspected by a Town approved electrical inspection agency. • 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON (pleas©_read) For your protection, pions°note that pursuant to Section 136-29 of the Code of the Town - of Quoonsbury, 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 road the regulations with respect to this application and agree to abide by those and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. S) Inntfrb of responsible person - Date a Town of Queensbury Fire Marshal ' ,. 742 Bay Road •. ;y. �� Queensbury,NY 12804 '. , 54'T; 761-8205/761-8206 V. +•4,,' +,:: `; fax 745-4437 Factory Built Wood Burning Fireplace/Stove Inspection Report Notice: New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's instructions o spe iiications is allowed. Permit# 0/00 - Schedule Inspection I2 7q 0)L Time l :00 am F anytime Inspector55 f�f Name 1o( t)1` Address /'4 1 �7 i 6 1311 fa Rough In Final Appliance Manufacturer Ma) e, rh(._ Model# Si-)R-7 -Z., Masonry Chimney Factory Built Chimney Flue Size Double Wall Triple Wall_Insulated -Yes No N/A Comments Floor Protection 'IQLUtI4\ .b4Vkliinfl i 5 (1,04.,*VCild Clearances to Combustibles (all sides) o 00 Lv to Safety Strip Installation (fireplaces only) 130dji ���'`d (hy yfilbye)? ,,r Firestop(s) Vertical Chase I v 6 =!V CO1 t by i i! 1. Chimney Clearances to Combustibles 5.bak • iL4 {,X u, '14/ Chimney Termination 15 614. 0, l_;vxV ZL off 3 feet above roof penetration;2 feet above any combustible construction within 10 feet Combustion Air • A)0 Co i6c( e, undo ii,etr/(7 . Hearth Extension f )(• 0 a 5 6 b� , Mantel(height above f/p opening) Gitt t ` a-4 ' Fireplace Doors/Screen (required) 5,,,,;1- 1z4/6 i White—Building Dept. Yellow—Customer Pink—Fire Marshal Town of Queensbniry Fire Marshal 1G, 742 Bay Road Queensbury,NY 12804 ,Artirt;‘,. ' 761-8205/761-8206 fax 745-4437 klk. Factory ;;:wilt Wood Burning Fireplace/Stove Inspection Report Notice: New York State requires that all IJL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance. No deviation from the manufacturer's instructions or s ifications is allowed. Permit# A0(�`— C61 t1 Schedule Inspection l Z- Time 3 2-0 amO anytime Inspector 55 Name NJO 1 j,1� Address f l (%� Rough In Final Appliance Manufacturer \C `' ' Y Model# 3 J.-CA I-- J � CC Masonry Chimney Factory Built Chimney Flue Size Double Wall.-_-Triple Wall_Insulated Yes No N/A Comments Floor Protectio is Clearances to Combustibles (all sides) Safety Strip Installation (fireplaces only) b kYt01.0 tOVl fA,1211,kV6 el/-4/1:Aftek Firestop(s) Vertical Chase l _ Wall Penetration ` A h6/1 I/ h V� ..JJJ"'���Ill„ �\a,Ve- ka. 1 'ii Chimney Clearances to Combustibles Chimney Termination penetration; at 1 '4'!i 3 feet above roof penetration;2 feet above /\ � ,9 l any combustible construction within 10 feet l� L/I.e/ 4(e • Combustion Air �- t'kctk cLivike' e c e d earth Extension j'1 Tfr, Wid3Z.1 kti ht. above- Mantel(height above f/p opening) eKCo I Ok Fireplace,Doors J,5 r✓ o s /Screen(required) (a-U White—Building Dept. Yellow—Customer Pink—Fire Marshal COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INCO Main Office 176 Doe Run Road-Manheim,PA 17545 � MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL 4 Panel Board No Cert. N2 . 70457 Cut-in Card No. �.lt ' � Owner 1).0. Location .1 V.../ ��Ll..../g...L? c.t.7.,s..h v•Q Installation Consisting of..g046,.,(J,C,... 3 e-jay}.0 -s.. .j a A e .) (9 ri3. Qt S rr1 1,24/.3 It!u a y p.zy eP_v , /c-) .f as.hcutshcry Installed By...Q.u/a:i...i.Ty....A.L.L.cj(.L..R e Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issued h cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of making inspections at any time, and if its rules are violated,the Company shall have the right to revoke this certificate. Date...c�—1 3 -0 INSPECTOR...,]P i/t {.r✓7 TOWN OF QUEENSBURY Er .' BUILDING & CODE ENFORCEMENT �•,7r 742 BAY ROAD QUEENSBURY NY 12804 '"_ "-' (518) 761-8256 �l ARRIVE: DEPART: INSP: FINAL INSPECTION REPORT COMMERCIAL MULTIPLE DWELLING (hotel, motel, apt. complex) DATE INSPECTION REQUEST RECEIVED: NAME I & G 7I� LOCATION L q , DATE ` -OPERMIT H 1 • TYPE OF STRUCTURE FOOTINGS _BACKFILL_ FRAMING PLUMBING INSULATION N/A YES NO CHIMNEY/"B" VENT/HEIGHT PLUMBING VENT/FIXTURES ROOFING EXTERIOR FINISH HEATING/HOT WATER RELIEF VALVES FLOORS • FOUNDATION INSULATION _ INTERIOR STAIRS/RAILINGS STOCKROOM ENCLOSURE FIRE/DEMISE WALLS PENETRATION FIRE DAMPERS CEILING FIRE STOPPING FIRE DOORS/CLOSERS EXIT DOOR HARDWARE _ EXIT STAIRS/RAILS PLATFORM/ELEVATOR • • HANDICAPPED ACCESS HANDICAPPED BATHS HANDICAPPED PARKING FINAL ELECTRICAL SITE PLAN/VARIANCE REQ. FINAL SURVEY PLOT PLAN, IF REQ a, OK TO ISSUE C/O OR C/C PM illMk . RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept.of Community Development Arrive .j r epart < � Town of Queensbury Inspector's Initi . Bay Road Queensbury,NewYork 12804 � � NAME �C'Y ^�—✓��— l PERMIT ii O I — (0 / LOCATION Pi 1-\;) e.,'( ,_ P' DATE TYPE OF STRUCTURE N/A YES NO COMMENTS Chimney Height/"B"Vent/Direct Vent • ation z/ i Fresh Air Intake �� Plumb Vent through roof Roof Complete ✓ Exterior Finish Complete Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies,landing 18' or mor= / 1)64k Interior Handrails stairs both-hies 3 or mor• 'sea— ./� D Grade 2%away from foundatio ulko,;1"7,7* 8"clearance to sill plate C.,, e 70 c lUIJ7 Gas Valve shut-off exposed/regula. : above•, ade Gas Furnace shut-off within 30 feet or within line a site f Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating V 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" V Floor Finish Bathroom/Kitchen watertight �/ Interior Handrails Balconies/Landing 18 in.or more a/ Railing across window in stairwells • / Smoke Detectors: J 1/ every level every bedroom outside every bedroom inter connected A// Bathroom fans ,J" / Plumbing fixtures X Foundation insulation 3/4 hour fire door/door closer V Garage fireproofing Garage penetrations sealed Furnace in separate room protected(in garage) Light ventilation per room iS Safety glazing 18"or less from floor �/ j Final Electrical Site Plan/Variance required I / I 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) FIRE MARSHAL TOWN OF QUEENSBURY chi QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED PERMIT#0/1/26 NAME ---- LOCATION ` SCHEDULE INSPECTION ON �-©c a 1� Id IQ I;pQ AM C*M. ANYTIME APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTIIyG I FIRE EXTINGUISHERS\ FIRE ALARM SYSTEM \, !' FIRE SPRINKLER SYST-EN1; FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE:, CLEARANCE TO SPRINKLERS CLEARANCE TO HEAT\NG UNITS REQUIRED SIGNAGE i CHIMNEY WOOD STOVE � FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT ESL ✓ • REMARKS: OK TO THIS DATE i�c oo 6Jr ‘OE> FoE?UtC� 1► • (7/2 .7 INSPSLIP.PUB /, .INSPECT v FIRE MARSHAL TOWN OF QUEENSBURY 1x QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED PERMIT# O(-C/9 NAME J2G46,) LOCATION 616, 646, '9 SCHEDULE INSPECTION ON Ce O G/ 6 , AM PM ANYTIME r 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 SPRINKLERS CLEARANCE TO HEATING UNIT REQUIRED SIGNAGE CHIMNEY V WOOD STOVE FIREPLACE-MASONRY N FIREPLACE-FACTORY BUILT PO K. ✓ 3L'/R C( Cl-{D 36 REMARKS:*1e l0 Z ( 3 0 OK TO THIS DATE f-- INSPSUUP.PUB INSPECTOR 1V1r) FIRE MARSHAL TOWN OF QUEENSBURY j QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED PERMIT 1` 9 NAME LOCATION SCHEDULE INSPECTION ON I,, -3 a-/ AM nANYTIME ROVED IA 5 NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM \\N..,� FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE / CHIMNEY a rz_6-A-f2_ • WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT ixt-1-k . ��✓ i/ c),f)6-e(DK °b&L- C I'1D/'3U REMARKS: [] OK TO THIS DATE 1 Na6-PL - ;Do ✓�?a r Co n-) LC— � Qc-°LAY( PA-VAk6 ] ,� ioc-c6 Jr.0 INSPSLUP.PUB INSPECTOR 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 ` n am/pm Inspector's Initials NAME: p� t�p PERMIT# to 11 LOCATION: i g c • DATE : z— d I TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers —1I Monolithic Pour Fo Reinforcement in PI ce The gntractor is spons ble for providing protecti. fro freezing for 48 hours folio ng t e placement of the concrete. Materials'br 's pu .. • on site Foundation!Wallpour Reinforcement in Place, Foundation/Dampproo ng Backfill Approval Plumbing Under Slab Plumbing Vent/Vents i Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Int prior R- Foundation Walls Ext rior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R= r Vent,Attic Vent raming Studs/Headers racingBridginc u , Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2, 3,4 hour Firestopping lO a 69): • , n, I GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: laicX,l Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive Depart E n 1 ('� ,,A Inspector's Initials NAME: f L9CG1 Q / JL< Q� PERMIT# • 1 CA LOCATION: \L-A ' ►�(� \a tec DATE : TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers 17-7 I Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the Ihcement of the concrete. Materials for this purpose o site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval , Plumbing Under Slab Plumbing Vent/Vents in Plaid Rough Plumbing Heating Rough-In / L---4sulation �; � I�a-I Foundation Walls Interi.r R Foundation Walls Exte '*r R- Floors R- Walls R- © .y\k Ceiling R- Duct work or piping i 1Q unheated spaces R- Proper Vent,Attic Ven Framing Jack Studs/Header. BracingBridgin.. Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping 3 GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road 711 Queensbury,NY 12804 Arrive I . a m Depart • it'+ Inspector's Initial �, NAME: ) PERMIT# 1101 7 y) LOCATION: \c��(ay� 1 DATE : J 10 — TYPE OF STRUCTURE: v RECHECK N/A YES NO COMMENTS Footings/Piers I I I Monolithic Pour Form Reinforcement in Place ' The contractor is responsiLle fo providing protection from freezi g for 48 hours following the place ent of the concrete. Materials for this purpose oi}site Foundation/Wallpour Reinforcement itillae Foundation/Dampproofing ~� Backfill Approval Plumbing Under Slab (� Plumbing Vent/Vents in Na e Rough Plumbing viir Heating Rough-In • Insulation Foundation Walls Interio R- Foundation Walls Exterio R- Floors R Walls R Ceiling R Duct w or piping in u eated spaces R Pro r Vent, Attic Vent F ming \( Ft,no,4.4' Jack Studs/Headers Bracin /r doming 1� ��D 6`tG ‘c Joist Hangers—. Jack Posts/Main Beam Air Infiltration Barrier EA Fire eparation 1,2,3,hourtNI jWall23 ration Sealed ,/ -- � v y..-r`Z �1h..i 7 F. 4 hour ` �topP g in N • ::<\ ulj�(� F-6--�C4 ��. N � � _ _ ,„np9). se GENERAL INSPECTION REPO iT ( 518 ) 761-8256 Town of Queensbury Dept. of Community Development Date inspection request received: ! ' Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arri.veV,-.' 7�1m/pm Depart ', a Se_ Inspector's Initi NAME: �,� e�3 n PERMIT# /.- 6q LOCATION: ( /41 ( ' ATE : T / TYPE OF STRUCTURE:.- RECHECK N/A YES NO COMMENTS Footings/Piers I 1 I Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placemen of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing / Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place C-ROT-4115-1umbing Fug_ I r r 6A0C. Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- . Floors R- Walls Q1lkC�`�ai"1� �� �C 1cJ� R- Ceiling R- Duct work or piping in unheated spaces R- Pro r Vent,Attic Vent / raming 16' c F LCC.R LCFI (L� �/ --F3 V-v_ 5 S Jack Studs/Headers Bracing/Bridging V7V-Agc iaL �F Joist Hangers �/ J ��L ����,� Jack Posts/Main Beam �/ �JJ4 =aJ Air Infiltration Barrier ` A� ' RP-sl vv� - � ��.LO 6 Fire Separation 1,2, 3,hour C r>L0 Penetration Sealed ti,c ��� Fire Wall 2,3,4 hour Q( 1� �� Firestopping 1�`�`�AL L t % TLC_ Couoti\I � h TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 6'26(10 Ott) Location / / 6/6 4f A, Date // ?/I �// Permit # 4f- 6/? SOIL TYPE: Sand-Lo." - ay- Results of Perco ation est- (if applicable) ',ate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Tota Length Length of each tre -ch Depth of trenches Size of stone SEEPAGE PITS: Nu ''•e - Size - . x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes No Parta LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorptio _ feet Separation of Pits __ feet Conforms as per Plot P1 an Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: oUGZA— /0. -7 O4) --4/74 • pallid/cl iq¢-c-- �)4-rz2 SYSTEM USE APPROVED: ES NO Arrived: Departed: i c -,ge Building Inspector . . . • 410, TOWN OF QUEENSBURY BUILDING & CODE EWFORCEME 742 Bay Road Queensbury NY 12804 / ,_---- (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name . Jo r of a =, Location /4/ 1 bx Rd-- Date it c 1 Permit # d7-567_6/� SOIL TYPE: and- oam-Clay- Results of Percolati .' Test- (if applicable) R.te-Mi 'ute/Inch J TYPE OF SYSTEM: ABSORPTION FIELD: l otal en•tb) aiR)_ Length of each tre ch .' Depth of trenches 3 , Size of stone ". \ SEEPAGE PITS: NumbeT Size - ft. x ft. Stone size PIPING: S '- 9z Type ,/ Bldg. to Tank Grp r Tank to Dist. Box b, 4 Dist. Box to Field/' >' it • Openings Sealed? ' No . :Partial LOCATION/SEPARATIO' . Foundation to Tank 7— .feet • Foundation to Absorption . .feet . . Separation of Pits - eet )-- 10 onforms as per Plot Plan NoCI LO ION OF SYSTEM ON PROPE'�T , .' one) Fran - Rear - Left Side - R ght Side 1 dle Front - Middle Rear COMMENTS: 172- UIG•j Co,k.w I gip._ &Lc_ lJ6.00.. IN SYSTEM.USE APPROVED: • to Arrived: 04 Departed: ; • f)-6---' . Building Inspec or TOWN OF QUEENSBURY (OW ti-t- BUILDING & CODE ENFORCEMENT 531 BAY ROAD QUEENSBURY NY 12804 (518)745-4447 ARRIVE: DEPART: INSP: 0k FINAL INSPECTION REPORT DATE INSSPEECCT_�ON REQUEST RECEIVED: 1, NAME (7(- C (-17 /y. O�j1,� LOCATION o�, \;11 DATE/[7 r C ) PERMIT # (D `o 1 TYPE OF STRUCTURE , SR.X7) FOOTINGS BACKFILL_ FRAMING_ PLUMBING INSULATION N/A YES NO CHIMNEY/"B" VENT/HEI HT PLUMBING VENT/FIXTURE" ROOFING EXTERIOR FINISH HEATING/HOT WATER RELIEF VALVES FLOORS FOUNDATION INSULATION INTERIOR STAIRS/RAILINGS STOCKROOM ENCLOSURE FIRE/DEMISE WALLS PENETRATION FIRE DAMPERS CEILING FIRE STOPPING FIRE DOORS/CLOSERS 1 1 EXIT DOOR HARDWARE EXIT STAIRS/RAILS PLATFORM/ELEVATOR HANDICAPPED ACCESS HANDICAPPED BATHS HANDICAPPED PARKING FINAL ELECTRICALEL� SITE,A<N/VARIANCE REQ. NAL SURVEY PLOT PLAN, IF REQ a(b OK TO ISSUE C/O OR C/C 1- s GENERAL INSPECTION REPORT ''� �---- ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: 1 l "Di Building& Code Enforcement 742 Bay Road t), V7 Queensbury,NY12804 u �,y u, am/pm Depart ' /V V Inspector's Initials ji " NAME: (c1 ekksoki PERMIT# V/'6/7 f � LOCATION: DATE : TYPE OF STRUCTURE: ✓ � RECHECK N/A YES NO COMMENTS Footings/Piers_ Monolithic Pour Fo Reinforcement in Pla e The contractor is r-sponsible for providing protectio from freezing for 48 hours folio g the placement of the concrete. Materials for this pu .s se on site Foundation/Wallpour Reinforcement in Place Foundation m proofi g - Plumbing Uiider-SlaV'l Plumbing Vent/Vents in 'lace Rough Plumbing seating Ro -In �/In tao''n sisc Z i l -ounda Walls Inte .r R- Foundation Walls Exte gar R- Floors '- Walls ''- Ceiling 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 d %,‘ rk Vklj'UL) GENERAL INSPECTION REPORT ( 518 ) 761-8256 (/45- Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive%) Depart __ _ •m In1111. sp or's Initi ' NAMES i-r C � PERMIT • LOCATION: 1 C - DATE: / �� .i�/ TYPE OF STRUC :� 1 \) RECHECK N/A YE O COMMENTS F tings/Piers 1 onolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection o eezing for 48 hours followin the p ment of the concrete. Materials for this purpos on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Un Slab Plumbing Ven ents in P1 Rough Plumbing Heating Rough-In Insulation Foundation Walls Interi r 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 Be Air Infiltration Barrier Fire Separation 1,2,3, our Penetration Sealed Fire Wall 2,3,4 hour Firestopping S 8252%010 E. 0 _J + FOUND IRON ROO • FOUND IRON MARKER O SET IRON ROD W TH CAP O POINT —E- POWER LINE -c— STONE WALL -_-_- FENCE 77 5• 76.7' LANDS OF AUDREY KIERNAN AND JEFFREY RUMPH 663-355 FOUND IRON ROD U) Q4 0 ul �C '0 o w U > N j W d r, m� V W J_ P4 swum FOUND IRON ROD no on �.� sm 82 J't?'r Sje• 99' FOUND IRON � ROD 604 N 83230SO• W FOUND ❑ ROD TREE HOUSE ONLY COPIES FROW 7HE ORIGINAL OF THIS SURVEY MARKED WITH AN ORNG1NAL OF THE LAND SURVEMIS EMBOSSED SEAL OR INKED STAMP SHALL BE CONSIDERED TO BE VAUD TRUE COPIES Unauthorized Alteration to this map is o violation of Section 7209, Subdivision 2 of the New York State Education Low. SEP77C TANK *VVEN-WIRE FENCE AROUND GARDEN a POWER POLE ke P P P DIRT DRIVEWAY LOT 5.0 ACRES am.ROD 601 i7*1 ft A', FOUND IRON ROD anaftnaN a�350. W "UNUMM593.56' fta an 4 - Gyp4 �2 �R/►.Zr LANDS OF DA WD AND MARCIN ROZELLE 1043-233 <� Alt ��sFc LAND SVP� 602 603 FOUND IRON ROD q Q MAP OF SURVEY OF LANDS OF TODD R. JORGENSEN TOWN OF QUEENSBURY, WARREN COUNTY, NEW YORK SCALE.- 1 " = 60' MAY 25, 2001 a LAND SURVEYOR NO. 49098 MAP REFERENCE 1. MAP OF SURVEY PREPARED FOR 71801? TOTH BY R/CHARD BENNETT DATED AUG. 19, 1985 CERTIFICATION I HEREBY CERTIFY TO TODD R. JORGENSEN, HUDSON RIVER BANK AND TRUST, ITS SUCCESSORS AND/OR ASSIGNS AND OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY THAT THIS MAP HAS BEEN PREPARED IN ACCORDANCE WITH THE EXISTING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED BY THE NEW YORK ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, AS LAST REVISED. MAY 24 2001 OCT. 18, 2001 WILLIAM J. RdeLS 49098 W 41 R ASSOaA 1ES Lk.wwod Land Surw)wv t=4 Sarotvo Rook( P.Q Box t43# South teem Faf, N.Y. 12OW JOB Na w ti WILUAM J. Q4 W O A LANDS N \F AUDREY KIERNAN AND JEFFREY RUMPH FOUND IRON Roo E 79. 00' �, FOUND IRON _ ROD --\ mmm"�\ • 6'•. 99' _ FOUND IRON ROD LOT old 5.0 ACRES 1 a r FOUND IRON r ROD 73 00 IN imp W FOUND /R Q. TREE HOUSE LEGEND: • FOUND IRON MARKER O SET IRON ROD WITH CAP O POINT —E— POWER LINE ---o STONE WALL —x—x-FENCE ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF 7HE LAND SURVEYOR'S EMBOSSED SEAL OR INKED STAMP SHALL BE CONSIDERED TO BE VAUD TRUE COPIES Unauthorized Alteration to this map is a violation of Section 7209, Subdivision 2 of the New York State Education Law. WVVEN—WIRE FENCE AROUND GARDEN Q. POWER POLE 18 LANDS N \F TIBOR TOTH no N8.323aftommommomm50- W offoom 593.56� �4ft GRq � J. R0G v� , -F,` No.49D98 SFO LAND ROO •'�'� o :Vo o• Q� FOUND IRON ROO MAP OF SURVEY TODD R. JORGENSEN WN OF QUEENSBUR Y, WARREN COUNTY, NEW YORK SCALE.• 1 " = 60' MAY 25, 2001 A` 44646�— !2100'c� — WILLIAM J. ROURKE, LICENSED LAND SURVEYOR NO. 49098 I MAP REFERENCE. 1. MAP OF SURVEY PREPARED FOR 7/BOR 707H BY RICHARD BENNETT DATED AUG. 19, 1985 Or o=served, or believe I saw evidence of, s `oLses, Voe ls, trees, dJcL`':nt. I 3119 represent that I have the distances set forth on the diagram." SIG, ATU E DATE AUG 14 2001 TOWN OF QUEENSBURY BUILDING AND CODE �b W. 4L ROM& ASMA WS LAmwd Land &ww)wv tom Sanatow Roa4 P.Q &x ws South Glen* Fall&, N.Y. t28+01.3 JOB NO. 01-89 JOB NO. W h 0