97-037 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Hay 22
19 a7
31c9 lit,' -5,
This is to certify that work requested to done as shown by Permit No. 97t S '
has been completed.
SINGLE FAHT-LY DWELLING
This structure may be occupied as a
LOT 3 MEADOWBROOIC RD.
Location
Owner SCHERHERHORN CONSTRUCTION
TAX HAP NO. 60. -2-7 . 8 By Order Town Board
TOWN OF QUEENSBURY
le
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No.
VALUE $ 62000 97037
TAX MAP NO. 60. —2-7 . 8 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to SCHERMER41OR-N CONS-R-UCTION
OWNER of property located at LOT 3 MEADOWBR- OK RD. Street,Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMILY 17WELLIfw
at the above location in accordance to application together with plot p ans an m other orma ion hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
CORP. 79 MASTERS COMMON NORTH
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
SCHERMERHORN CONSTRUCTION
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
COMMONWEALTH ELECTRICAL AGENCY
5. ARCHITECT'S Address
PO BOX 706
HAGUE , NY 12836
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( !Steel gIINGLE FAMILY DWELLING
7. PLANS and Specifications
SINCE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
$ 80 PERMIT FEE PAID —THIS PERMIT EXPIRES March 3 19 99
(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.)
Dated at the Town of Queensbury this 3 Day of March 19 97
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
+ ,Aa -IUWN UN QULENJl3UKY
14.7 APPLICATION FOR SEPTIC DISPOSAL PERMIT
�r am✓ S6 ewe.
DATE` IZ. ? 7 - - f
LOCATION OF PROPERTY FOR INSTALLATION L !�e��1��b✓'� Li,
Owner' s Name: f ;cN" SG1"ar,.4e 4,0r 3 •
Address:
Installer' s Name: Telephone:
Number of bedrooms (residential only) Y` "
FEB 15 19"
Total daily flow (compute @ 150 gal per bedroom) 'j--
Topography: Circle one: Flat Rolling Steep Slope % of S1oprTPl �E�1i `¢``tf: : =
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? 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: Municipal Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. /Depth or Thickness feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE:
•
•
Ali 'ti'tia JsNI!tIIGY. cool" ti6111'LI11N i 11E'F'LICI1'J'IQ.fJ.• • i
TOWN or OUI':I"NSI-tllltY W11RItISN CO
91100 I.1liitiltJLI!i 'LAYS
• 13 "97
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!met I I ttyg ( 3 el:o.r-i-ee or .l.eren )
PART 'I * Uen.l.ytt I,y Cc�inpotteid: Perl:ot-ttttttiec
C:onitiier:t+i.rt.l. 13u3.J.diitytl-III R113e Roc i.dent: 1;ra
Itec.lu i-t•ei; did/1 i.l.t n. 0rt of wor.ktilieel:n
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PART S t1LTIlob UI'' COtiL'b111tlC8 13Y11cCLY'I'I1ULL i iu e'tict :
1 . t,r•onn IPloor- Area - �.5 ngi.ttir:e ,feet
2 . Type oJ: IIetit -- _—..•._. M.Lr.r.l:t:.i.c' _.._.. Oi_.I. - -- (;tee - - - t1I:Iret:
3 . iii building tnr_cltniiIc,n.1..ty coo.l.rd7 Yen XC No
4 . J.ier.•cetLnye o1: Oren or w-i.nclowr-i and doom X _ Over .11% Under: 171
5 . It-VALUESl''(JIt .[t•IS01.,11'.t'.I.U11 ( .LVI!:u LII!,L,UW HUS'T CORRESPOND TO R•-VALUi?:S AS
SIKiwli ON Pith IS 8UIMi.1-'1"J.'l!:D !
ROWJ
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c. : E,l.ttzod tiJ:thin
t1: Isx( er. .l.or duct It -z,S
e . 1°'.l.00re elver Unheated irl.rnerl J • •
f . I"dye .. ol: e.1.iib c11t grade ( hotted Lrlt).l.d.i.ny) _
I3ntienteiiL/cel.l.rt.r wni..I n (nbtiVe grade) R [
_ _
hi tincitiprietiL/enJ..l.itt: wd.I..Ln (I_ir.l.ow tli:ttde ) R
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.ItISPI(...J.Uit' Ill'I111111t S ' •
v .
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-8256]
-Or BUILDING & CODE. ENFORCEMENT
NOTICERequirements prior to issuance - r.
( of this permit: PERMIT FILE NO.
A permit must be obtained before
beginning construction. No inspections PERMIT FEE PAID$�(� ��
will be made until applicant has received n Zoning Board Action '
a VALID BUILDING PERMIT. All Area /Use RECREATION FEE D$
applicants' spaces on this application
MUST be completed and•the signature n Planning Board Action REVIEWED BE
of the applicant must appear on the SPR / Subdivision /Other Building Inspector
4pplication form. Thank you. J Recreation Fee Payment
Applicant: j cbk e< v^w F r 1,10 t. i o s, ::oc1}LL, i aip Owner: ?---jr $c l-;a.on c stiff a t`'J
. ' Address: -7 j Iflil AS/-e:r-S 0,t i4 co c',&.' /14 r/A Address:
•
Phone # -.( 5 la ) 2 9s_ - 06,7y Phone # ( sip _) ? _ - 6( 7`/
Property Location: go i--3 oft e„.G.tou)b t tva k P el - —
-
Subdivision Name: Tax Map Number_1�1.
Section Block Lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
V New Building CONSTRUCTION: $ (p: . oeo
�esidence�/ 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 Fames Dwelling
Office i p=7 .:: . 7.. : _ .t
'Other Work (describe below) Mercantile !:.y. , � ^ `_' i
Manufacturing
•
Other FEB 1 3 1997
GROSS AREA OF PROPOSED STRUCTURE: PO - I
If ADDITION ftwhalr `w'iil '=`:6% i
1st Floor 74'9' sq. ft� of new additio° be?':� ' u LvI)E
2nd .Floor32.sq. ft. �
Other Floors sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
• Detached Garage 1, 2 car
TOTAL FLOOR AREA: g32 SQ. FT. K Attached Garage9l 2 car
Private Storage-Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
3 o`L FEET X Y FEET
Foundation Type: concl'e-jr Will any second-hand or ungraded
' Number of Stories : ,"/2 lumber be used? If so, for what?
(habitable space only) /4/0
Height (grade to ridge) : /0 feet TYPE OF. HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which a..l' es)
to be installed: P Electric • ' !1. m'/Wood
�.s- B.seboard / Other
Person responsible for supervision of work as regards to building
codes is : k.Sc_1,�!',,,,k, (-):,.eA) 77g- Oeri`j .
Name Addresss Phone
Builder: P�, sr_:w:e:„i„,, 4-1 ,alp • 7n3--06,-)9
Plumber: Stc.J& lI/flA,, 717--54,9?
. Mason: 0ca_Le. ball\u- &? %9Z,-I3 i 1
Electrician: • m;kH , tin.,: e-j 41/71/-376 5
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, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: , i P, -14_0,-1--
(owner, owner's agent, architect, contractor)
FLOOD DAMAGE PREVENTION
BUILDING PERMIT # ?7 37
Floodplain Development Permit Application 7-7L07
Town of Queensbury, New York
(bZA—)
This form is to be filled out in duplicate.
SECTION 1: GENERAL PROVISIONS (APPLICANT to read and sign) :
1 . No work may start until a permit is issued.
2 . The permit may be revoked if any false statements are made
herein.
3 . If revoked, all work must cease until permit is re-issued.
4 . Development shall not be used or occupied until a Certificate
of Compliance is issued.
5 . The permit will expire if no work is commenced within six
months of issuance.
6 . Applicant is hereby informed that other permits may be
required to fulfill local, state and federal regulatory
requirements .
7 . Applicant hereby gives consent to the local administrator or
his/her representative to make reasonable inspections required
to verify compliance.
8 . I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN
ATTACHMENTS TO THIS APPLICATION /
ARE, TO THE BEST OF MY
KNOWLEDGE, TRUE AND ACCURA, � �L/��o---/t f yV��
(APPLICANT'S SIGNATURE) DATE .
SECTION 2 : PROPOSED DEVELOPMENT (To be completed by APPLICANT)
NAME qc'I" Sc.11e r ef yopn/ ADDRESS 79Mtsjeia mo.v TELEPHONE 79f-o675'
APPLICANT
BUILDER
ENGINEER
PROJECT LOCATION:
To avoid delay in processing the application, please provide enough
information to easily identify the project location. Provide the
street address, lot number or legal description (attach) and,
outside urban areas, the distance to the nearest intersecting road
or well-known landmark. A sketch attached to this application
showing the project location would be helpful .
LoT 3 14 roe.foof oe.
DESCRIPTION OF WORK (Circle applicable activity and structural
type) :
A. STRUCTURAL DEVELOPMENT
ACTIVITY STRUCTURE TYPE
New Struct R ria (-1-4—F-am ly
Residential (More than 4 Family)
Alteration Non-residential (Floodproofing?)
yes)
4. }
+ i
{ l
Relocation Combined Use (Residential &
Commercial)
Demolition Manufactured (Mobile) Home
(In Manufactured Home Park? Yes
No
ESTIMATED COST OF PROJECT $ 6 Z7S
B. OTHER DEVELOPMENT ACTIVITIES: (Check Appropriate Activities)
X Fill Mining Drilling k Grading
Excavation, (Except for Structural Development Checked
Above) -
Watercourse Alteration (Including Dredging and Channel
Modifications)
Drainage Improvements (Including Culvert Work)
Road, Street or Bridge Construction
3/ Subdivision a or Expansion)
Individual Water or Sewer System
Other (Please specify)
After completing SECTION 2, APPLICANT should submit form to local
administrator.
SECTION 3 : FLOODPLAIN DETERMINATION (To be completed by LOCAL
ADMINISTRATOR)
The propose d velopment is located on FIRM Panel No. 3(�Oh-oZ��l3
Dated 7/(,
The Proposed Development :
Is NOT located in a Special Flood Hazard Area (Notify the
applicant that the applicant review is complete and NO
FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED) .
Is located in a Special Flood Hazard Area.
FIRM zone designation is a e .
100-Year flood elevation at the site is : an- FT.
NGVD (MSL)
Unavailable
The proposed development is located in a floodway.
FBFM Panel No. Dated
See Section 4 for additional instructions .
SIGNED DATE
SECTION 4: ADDITIONAL INFORMATION REQUIRED (To be completed by
LOCAL ADMINISTRATOR)
The applicant must submit the documents checked below before the
applicatii can be processed:
V A site plan showing the location of all existing
structures, water bodies, adjacent roads, lot dimensions
and proposed development . S'J,6c4,„"oh imp 6,4
/
Development plans, drawn to scale, and specifications,
including where applicable: details for anchoring
structures, proposed elevation of lowest floor (including
basement) , types of water resistant materials used below
the first floor, details of floodproofing of utilities
located below the first floor and details of enclosures
below the first floor..
Also,
Subdivision or other development plans (If the
subdivision or other development exceeds 50 lots or 5.
acres, whichever is the lesser, the applicant must
provide 100-year flood elevations if they are not
otherwise available) .
Plans showing the extent of watercourse relocation and/or
landform alterations .
Top of new fill elevation Ft. NGVD (MSL) .
Floodproofing protection level (nonresidential only)
Ft. NGVD (MSL) . For floodproofed structures,
applicant must attach certification from registered
engineer or architect .
Certification from a registered engineer that the
proposed activity in a regulatory floodway will not
result in any increase in the height of the 100-year
flood. A copy of all data and calculations supporting
this finding must also be submitted.
Other:
SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL
ADMINISTRATOR)
I have determined that the property activity: A. L/ s
B. Is not
in conformance with provisions of Local Law #2, 1996 .
The permit is issued subject to the conditions attached to and made
part of this 717,, o/SIGNED fr % , DATE �o
If BOX A is checked, the Local Administrator may issue a
Development Permit .
If BOX B is checked, the Local Administrator will provide a written
summary of deficiencies . Applicant may revise and resubmit an
application to the Administrator or may request a hearing from the
Board of Appeals.
APPEALS: Appealed to Board of Appeals? Yes No
Hearing date:
Appeals Board Decision Approved? Yes No
Conditions
SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT
before Certificate of Compliance is issued)
The following information must be provided for project structures .
This section must be completed by a registered professional
engineer or a licensed land surveyor (or attach a certification to
this application) . Complete 1 or 2 below.
1 . A) Actual (As-Built) Elevation of the top of the lowest
floor, including basement (in Coastal High Hazard Areas,
bottom of lowest structural member of the lowest floor,
excluding piling and columns ) is :
3a S' 7 s FT. NGVD (MSL) .
•
1. B) Licensed Engineer or Surveyor signature and seal .
0a
• .
, . 't OF 1v ` . .
Y
�,EW c.STF®�D .
2 . Actual (As-Built) Elevation of floodpro&g Ovtection is
FT. NGVD (MSL) .
NOTE: Any work performed prior to submittal of the above
information is at the risk of the Applicant .
SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL
ADMINISTRATOR)
The LOCAL ADMINISTRATOR will complete this section as applicable
based on inspection of the project to ensure compliance with the
community' s local law for flood damage prevention.
INSPECTION •
DATE Y DEFICIENCIES? YES JNO
DATE BY DEFICIENCIES? YES NO
DATE BY DEFICIENCIES? YES NO
SECTION 8: CERTIFICATE OF COMPLIANCE (To be completed by LOCAL
ADMINISTRATOR)
Certificate of Compliance issued: DATE 9 7 BY:
•
FLOOD DAMAGE PREVENTION
Appendix B
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD
HAZARD AREA
Town of Queensbury, New York
(Owner Must Retain This Certificate)
Premises located at : /6/ 3 44.aedevzi
Owner:
Address : 7 4 4,- olne."14 /1.Lk
Permit No. 77-032 Permit Date: 3/3 .2
Check One: /
New Building
Existing Building
Fill
Other:
The Local Floodplain Administrator is to complete a. or b.
below:
a. Compliance is hereby certified with the requirements of
Local Law No 19
Signed: DATED: 41
b. Compliance is hereby certified with the requirements of
Local Law No. 2, 1996, as modified by variance no.
, dated
Signed: Dated:
05/22/1997 1e45 5187454437 DEPT OF COMM DEVEL PAGE 03
1.
FLOOD DAMAGE PREVENTION
a
Appendix B d rD
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD
HAZARD AREA MAY 22. 7997
Town of Queensbury, New York
TOWNOPQUEDJSIURY
(Owner Must Retain This Certificate) BUILDING AND 60
Premises located at: 4_3 "44/�.ckayte, -W
Owner: Cif 1 MC'rflJrr 64 fr h (
Address: 7 Ad'
Permit No. (7-193) Permit Date: 33 51
Check One:
J New Building
Existing Building
Fill
Other:
The Local Floodplain Administrator is to complete a. or b.
below:
a. Compliance is hereby rtified with the requirements of
Local Law o. 2, 19
Signed: DATED: e/ ZZ2/cA
b. Compliance is hereby certified with the requirements of
Local Law No. 2, 1996, as modified by variance no.
, dated
Signed: Dated:
05/22/1997 10:45 5197454437 DEPT OF COMM DEVEL PAGE 01
Subdivision or other development plans (If the subdivision or or other development exceeds 50 lots or 5
acres, whichever is the lesser, the applicant must ek
d�
provide 100-year flood elevations if they are not A•,
otherwise available) . MAY 1997
Plans showing the extent of watercourse relocation and/or
landform alterations. �BV`O'° 'QuEr
--
� NG 4►,!D CdD
Top of new fill elevation Ft. NGVD (MSL) .
Floodproofing protection level (nonresidential only)
Ft. NGVD (MSL) . For floodproofed structures,
applicant must attach certification from registered
engineer or architect.
Certification from a registered engineer that the
proposed activity in a regulatory floodway will not
result in any increase in the height of the 100-year
flood. A copy of all data and calculations supporting
this finding must also be submitted.
other:
SECTION 5: PERMIT DETERMINATION (To be completed by LOCAL
ADMINISTRATOR)
I have determined that the property activity: A. Is
B. Is not
in conformance with provisions of Local Law #2, 1996.
The permit is issued s •..ect to the conditions attached to and made
::::
f 1e t����/� DATE 7�?i S
If BOX A is. checked, the Local Administrator may issue a
Development Permit.
If BOX"B is checked, the Local Administrator will provide a written
summary of deficiencies. Applicant may revise and resubmit an
application to the Administrator or may request a hearing from the
Board of Appeals.
APPEALS: Appealed to Board of Appeals? Yes No
Hearing date: —"
Appeals Board Decision Approved? Yes No
Conditions
SECTION 6: AS-BUILT ELEVATIONS (To be submitted by APPLICANT
before Certificate of Compliance is issued)
The following information must be provided for project structures.
This section must be completed by a registered professional
engineer or a licensed land surveyor (or attach a certification to
this application) . Complete 1 or 2 below.
1. A) Actual (As-Built) Elevation of the top of the lowest
floor, including basement (in Coastal High Hazard Areas,
bottom of lowest structural member of the lowest floor,
excluding piling and columns) is :
S• 7 S� FT. NGVD (MSL) .
05/22/1997 10:45 5187454437 DEPT OF COMM DEVEL PAGE 02
•
YYsF`
• 1. B) Licensed Engineer or Surveyor signature and seal. jpikeilb d0.4 ibroa.•
"c`n J. bet M
t(
4444 P, • O NEI�jy�
••Co EW c,srF 'per .
ASIR W
•
:• ifIAY 22. 7997
2. Actual (As-Built) Elevation of floodprootin. p -ct' . as TQIy4 C)J`
FT. NGVD (MSL) . 500 • ir= -
• seo LAND DIN BU�IJG AND,l4cO Ry
NOTE: Any work performed prior.. to submittal .o ' theme above
information is at the risk of the Applicant.
SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL
ADMINISTRATOR)
The LOCAL ADMINISTRATOR will complete this section as applicable
based on inspection of the project to ensure compliance with the
community's local law for flood damage prevention. •
INSPECTION
DATE6- t BY 2S/- DEFICIENCIES? YES
DATE BY ' DEFICIENCIES? YES �O
DATE BY DEFICIENCIES? YES NO
SECTION 9: CERTIFICATE OF COMPLIANCE (TO be completed by LOCAL
ADMINISTRATOR) •
Certificate of Compliance issued: DATE S 1/9/ BY: '
TOWN OF QUEENSBURY
*,/J� BUILDING & CODE ENFORCEMENT
742 BAY ROAD
2... QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: 'w DEPART: ( N INS .
FINAL INSPECTION REPORT - RESID T L
DATE INSPECTION REQUEST RECEIVED:
NAME `)i't-4. FfIljI,C')P--,�
LOCATION �> � r ` - -1CTh
DATE _ � q 7 PERMIT H (17-o3 f
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL _ FRAMING
ROUGH PLUMBING SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A _ YES NO
CHIMNEY HEIGHT/B VENT/!lEIGHT
PLUMBING VENT •
ROOFING 1
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
• FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE P NL'F�
FINAL SURVEY PLOT PLAN /
OK TO ISSUE C/O OR C/C
9
t
�e TOWN OF QUEENSBURY
' w. BUILDING & CODE ENFORCEMENT
`ay.F i �[' 742 BAY ROAD
� " QUEENSBURY NY 12804
T' (518) 761-8256
ARRIVE: `\c,, DEPART: k\V~ IN '9`- t"
FINAL INSPECTION REPORT - RES ENT AL
DATE INSPECTION REQUEST RECEIVED: /
`
NAME t-Ak,l__-el r6c-t-kCaK1-i i-- 1fe_.K ,
LOCATION � z ��� NL
�{_`� � 7 {v1���,•t�l���� ter
DATE C� Z7��'i PERMIT # CI (-O2)(�_
TYPE OF STR CTURE c')�"O
FOOTINGS FOUNDATION BACKFILL _ FRAMING _
ROUGH PLUMBING SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT ` z
ROOFING Y/
EXTERIOR FINIS '0!/
DECK/PORCH/STEP IL NGS '�;9 ,
-
RELIEF VALVES //
FURNACE/HOT W TER OPERATING V
INTERIOR TRI /PRIVACY DOORS
• FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE '
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS _ V
SMOKE DETECTORS
BATHROOM FANS t�
PLUMBING FIXTURES t/
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL CO:- V I/
SITE PLAN/VARIANC REQ.
/:/;FINAL SURVEY PLOT PLAN V
OK TO ISSUE C/O OR C/C "
D €cc v e 1 v--113e6IA I-ti-L '. CEO:
f{7_0A-1 jev e � Cam ' ‘1--L woe-t ret
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 Q 7 e 3 7
MUNICIPAL CERTIFICATE ELECTRICAL APPROVAL
Panel Board No. Cert. 4 3 2 3 9 I[f -in Card No.
Owner e. ,s' C..,4-6.-4%11f ohee.m
Occupant �y► _ Q �/p
Location.J..�t.7.3...i!r1.�r.g.CCw y' ac.O/C CJ.I u,e-&-7�P�c
Install lion Consistingof / <' cw /i 4—2 p I Sre't 72,7
37/k)t 5e i. ... deLi
Installed By Z C C LZ&—eI Lic. #
The conditions following governed the issuance of this certificate,and any certificate previously
issued 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 be promptly made for
inspection.
Inspectors of this Company shall have the privilege of makin. inspect' sat any time,and if its
rules are violated,the Company shall have the right to revoke-hiiii rtific• e.
Date Jr-7. 9 7 INSPECTOR.
Member N.F.P.A.,I.A.E.1.
•
JT 72
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 , ,
r
INSPECTOR'S REPORT: ARR2c��EPART V INT` 1'
V
REQUEST FO INSPECTIONp1�►`�� ' RECEIVED)
NAME
,-/// 1y /v/=-f/
NAME `/� i/
LOCATION Lei 3 /fievga,A,OK
DATE ii77 y/f�7 PERMIT A 97 0 37
TYPE OF STRUCTURE:
RECHECK _ APPROVED
N/A YES NO
FOOTINGS/PIERS _
MONOLITHIC POUR FORM
REINFORCEMEN\ IN PLACE 1
THE CONTRACTOR\ S RE- ONS BLE FOR
PROVIDING PROTF + IO: FROM REEZING
FOR 48 HOURS FOLL• ING THE PLACE-
MENT OF THE CONC•,
MATERIALS FOR Adill• IOSE ON SITE
N
FOUNDATION •ALLPOUR
REINFO' EMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
-__/_////
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
V-Ck.C) C 1 V 0 (518) 761-8256
,
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ;•r.
I'? /Z:�� `ll'�
INSPECTOR'S REPORT: ARfI) DEPART, INT
REQUEST FOR I ,SPECTION RECEIV D: L. —,
NAME _ Q I\ l -Q ' E ' l r,,,
6 A SA Afir
LOCATION .�`1j-� _
DATEci: - - �P�ERRMIIT i 3
TYPE OF STRUCTUR.: S 1 1 //
' RECHECK i APPROVED
N/A YES NO
FOOTINGS/PIERS t
MONOLITHIC POUR FOAM
REINFORCEMENT IN PUCE 1
'
THE CONTRACTOR IS REa PONSIBLEjFOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWI G THE PLACE-
MENT OF THE CONCRETE 4
MATERIALS FOR THIS PURPOSE+ ON SITE
FOUNDATION/WALLPOUR \\
REINFORCEMENT IN PLACEtg �
rt -
_
FOUNDATION/DAMPPROOFINCtE
_
BACKFILL APPROVAL ,I t
G ,
PLUMBING VENT/VENTS Itt PLA E
k
ROUGH PLUMBING I
I
PLUMBING UNDER SLAB,
FRAMING:
JACK STUDS/HEADERS 1
BRACING/BR:tDGING 1 _
JOIST HANGERS ;
JACK POSTS MAIN BEAM \
AIR INFILTRATION !BARRIER \
H ATING ROUGH-IN/
..INSULATION: . ‘ i
FOUNDATION WALLS INTERIOR R-/I
FOUNDATION {WALLS EXTERIOR R- i
FLOORS ,I R-
WALLS 1 R
CEILING d R-jc
DUCT WORK pR PIPING IN
U HEATED ?PACES R-
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.,. 4-4_ F i gc c sec-ram
0 K 1 ov '
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ."
742 BAY RD., QUEENSBURY NY 12804 ='= ,,.
1
INSPECTOR'S REPORT: ARR DEPART,, INIV F"t
REQUEST FORsOR INSPECTIONPE �, RECEIIV'ED�: _, !�_
NAME f"G/f�[��/r ` �424600"yY��J/
LOCAT •N hin 3 �,�J�5/�/�/lti"lf ? ��
DATE + ///j i`J PERMIT ilAi q7.-c 7
TYPE OFI STRUCTURE: /
t
RECHECK\ I APPROVED
N/A I
YES NO
' /
FOOTINGS' PIERS H
7
MONOLITHIC POUR FORM ,4 - ,
REINFORCE NT IN PLACE I
THE CONTRAoTOR IS RESPONSIBLE FOR
PROVIDING P'OTE TION FROM/FREEZING
FOR 48 HOUR FOLLOWING THE PLACE-
MENT OF THEY ONCRETE. 6
b�
MATERIALS FOR' THIS PURPOSE ON SITE
i'
FOUNDATION WALLPOUR I _
REINFORCEMENT I PLACE ----__
FOUNDATION DAMPP•'OF NG _
BACKFILL APPROVAL TS\� /
LUMBING VENT/VENIN PLACE
ROUGH PLUMBING i?
PLUMBING UNDER SLAB
FRAMING: /'
JACK STUDS/HEADE
BRACING/BRIDGING
JOIST :HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:-
rr
t
FOUNDAT ON WALLS INTERIOR R-
FOUNDA ION WALLS EXTERIOR R-
FLOORS; R-
WALLS R-
CEILIN R-
DUCT K OR PIPING IN
UNHEATED SPACES R- •
•
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 r
zJ e�
DEPART INSPECTOR'S REPORT: AR7 �j S
REQUEST FO INSPECTION RECEEIVED: "/ /
NAME Gr e- : 42 �, �
LOCATION �,( n 9 k(.{' k y
) r ( l(4
DATE 7 / ,7/77 PERMIT # rL -63 7
TYPE OF STRUCTURE: `) 6 /
RECHECK . APPROVED
a 4 N/A YES , NO
FOOTINGS/PIERS ,�
MONOLITHIC POUR FORM /,/
REINFORCEMENT IN PLACE �j` _ __
THE CONTRACTOR IS RESPONSIBLE/IF/
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS1FOLLOWING THE PI:ACE-
MENT OF THE ONCRETE. !,`'
MATERIALS FOR\, HIS PURPOSE»/ON SITE
FOUNDATION/WALL' OUR li
REINFORCEMENT IN\ PLACE �_
FOUNDATION/DAMPPR OFING.
BACKFILL APPROVAL
PLUMBING VENT/VENTS .N PLACE _
ROUGH PLUMBING
y, \
LUMBING UNDER SLAB''
J'
FRAMING: r' .�
JACK STUDS/HEADER ,
BRACING/BRIDGING ,�
JOIST HANGERS
JACK POSTS/MAIN BEAM ,,/�
AIR INFILTRATIO4 -BARRIER _
HEATING ROUGH-/IN \
INSULATION: / \
I
FOUNDATION WALLS INTERIOR R- \
FOUNDATION WALLS EXTERIOR R-
FLOORS I, R- \
WALLS J(/ R-
CEILING' R-
DUCT WORK OR PIPING IN
UNHEA ED SPACES R- •
/1/14\ (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT '`
742 BAY RD., "
QUEENSBURY
? NY 12804 -.:
WI
INSPECTOR'S REPORT: ARR�"' DEPART C' L'v INT"'
REQUEST FOR INSPECTION RECEIVED:,�� �/ =/ S / 7
NAME (
(�' 2�;1 1 mil' 1 '
LOCATION -
DATE 0-"1 -/ (p--el 7 PERMIT 0 -L )-» 7
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS \`
MONOLITHIC POUR .FO`
REINFORCEMENT I . PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB _
` LAMING: _
JACK STUDS/HEADERS
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R- •
•
P6-61( 61‹
A 4-'s%.-C'.C-1O
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ;ri
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR DEPART G7✓` OIN'ty
REQUEST FOR NSPECTION R CEIVED: C -! 5<1i
NAME i
LOCATION
DATE _l PE IT A 97-03-7
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
REINFORCEMENT I PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE _
UGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS -
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
(518) 761-8256
>
TOWN OF QUEENSBURY µ �
BUILDING & CODE ENFORCEMENT ' `�
742 BAY RD., .QUEENSBURY NY 12804 '"V�� :..
INSPECTOR'S REPORT: ARF �DEPART00- / /,
REQUEST FOR
�INSPECTION
�7RECEIVED: r
NAME `J'..G'B,E4_9-R _R1�CAa v
LOCATION _OTC `'-) E c
DATE \3 ®I�;l1` PERMIT fl 9-7 -• 7
TYPE OF STRUCTURE: -3 4F-U)
RECHECK APPROVED_
N/A YES NO
i
FOOTINGS/PIE S
MONOLITHIC P UR FORM -
REINFORCEMENT LACE
THE SQH CTOR IS•.,RESPO SIDLE FOR f
PROVIDING PROTE TION.FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE- /,
MENT OF THE CONCRETE. /
1
MATERIALS FOR THIS PURPOSE ON SITE J
�7
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE _ { +__
/
FOUNDATION/DAMPPROOFING /
BACKFILL APPROVAL I/
PLUMBING VENT/VENTS IN PLACE _
ROUGH PLUMBING
PLUMBING UNDER SLAB J
FRAMING: / - 4
JACK STUDS/HEADERS
BRACING/BRIDGING'
JOIST HANGERS I
JACK POSTS/MAIN(BEAM
AIR INFILTRATION BARRIEE( _
HEATING ROUGH-IN /
INSULATION: 1
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EiTERIOR R-
FLOORS R-
WALLS ) R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R- •
•
DBoP o� - oEtZ - EN\-g
Fro
(518) 761-8256
TOWN OF QUEENSBURY j'
BUILDING & CODE ENFORCEMENT 47= ,
742 BAY RD., QUEENSBURY NY 12804 ., !
Ar
INSPECTOR'S REPORT: AR DEPART )011'
REQUEST FOR INSPECTION REECEIVED::
NAME , C-1-kk \E.
E �gF[EI-3003
LOCATION c'7 ► Ll(,9 .)
DATE t3 17 J9-7 PEERMIT i 9.7-0 7
TYPE OF STRUCTURE: t-J F-!'(
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHI POUR RM ,
REINFORCE NT N PLACE
t
THE CONTRAC R IS RESPONSIBLE FOR
PROVIDING TE T ON FROM FREEZING
FOR 48 HO RS L OWING THE PLACE-
MENT OF HE CON RETE.
MATE ALS FOR THIS PURPOSE ON SITE
i�
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE l \f/
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS _
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- _
FLOORS R- -
WALLS R-
CEILING R- _
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
ika \AL\..b 4-1" 0v- 6EFoe.E
17,i) (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT h' OJ
742 BAY RD., QUEENSBURY NY 12804
TrINSPECTOR'S REPORT: AR i EPART2rdJ'h) I T
REQUEST OR INSPECTION� RECEI D: "INC
J
NAME 1;1\QA / f YZ Q/ / " II)
LOCATI A—, 3 \ "eon. ,-r or
DATE 3-„.LI-00 PERMIT A -7-037
TYPE OF STRUCTURE: S—C (D
RECHECK APPROVED
�
� N/A YES NQ
fIFOOTINGS/PIERS _
MONOLITHIC POUR FORM /
REINFORCEMENT IN PLACE 7 l _ V
THE CONTRACTOR IS RESP NSIBL FO
PROVIDING PROTE TIO ROM FR EZ NG
FOR 48 HOURS FOLLO NG 'iHE P C —
MENT OF THE CONC TE.
MATERIALS FOR THIS PURPOSE 0 SITE
FOUNDATION/WALLPOUR _
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB _
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING _ ._
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH—IN
INSULATION:
FOUNDATION WALLS INTERIOR R— _
FOUNDATION WALLS EXTERIOR R—
FLOORS R—
WALLS R— —
CEILING R—
DUCT WORK OR PIPING IN
UNHEATED SPACES R—
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ication TOWN;or.,-.), ..:•••••-.. .
-- - .
. suiLoitvie,,,..yi•-•--. ..•• • ;
• ..
. . . . MAR —3 1997
. .
.,..,, , rAtr:,...
' ..,,,,-,,,,-..' •• Zoning Administrator --'. • •
TOWN OF QUEENSBURY
or
ZONING sl INT", (1..)/11?111//1 ".1 :
)1; ).•
MIN. WIT !l'll.)N..
c_1..„ , __„ r- int..-."^'Li (3-43-v-tS'tr.),-_4."el AJ c 1 714 A(..it',.(;
FA
\
112.50'
LOT 3
20,250 sq. ft.
0.46 acres
O
O
O
00
117,50'
W
^
LOT 2
0
100M
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r-
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100' SE78ACK FROU VV&-T ANDS -
SE -^
LOT 4
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28.28'
HOUSE
52.30'
/ POROH
2' SECOND STORY
�y OVERHANG
38.08'
112.502
AfEAlDOWBROOK s �06-4
a-
ROAD
FILE
MAP REFERENCE:
MAP OF A PROPOSED SUBDIVISION
MADE FOR RICHARD SCHERMERHORN
BY VAN DUSEN & STEVES
DATED MARCH 28, 1995
LAST REVISED MAY 25, 1995
FLOODWAY INFORMATION:
PROPERTY IS LOCATED
WITHIN FLOODWAY &
100 YEAR FLOOD BOUNDARY
AS PER FEDERAL EMERGENCY
MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
COMMUNITY PANEL NUMBER 360879 0026
EFFECTIVE DATE JULY 16, 1984
BASE FLOOD ELEVATION FOR LOT 3 305.30
LOWEST FINISH FLOOR ELEVATION 305.75
DEIV D
MAY 2 21997
TOW-
BUILDING AND CODE
NEkvY
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SMALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED TO: JAMON H.\. & TINA D. STONE
M&T MORTGAGE CORPORATION,
IrS SUCCESSORS AND\OR ASSIGNS
STATE OF NEW YORK MORTGAGE AGENCY,
IT'S SUCCESSORS AND\OR ASSIGNS
CHICAGO TITLE INSURANCE COMPANY
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: MAY 19, 1997
'UNAWHORIZED ALTERATION OR AD017M TO A SURVEY
MAP BEARING A LICENSED LAND SURVEYORS SEAL IS A
VKOLA710101 OF SECIKON 720% SUB -DI VISION Z OF THE
NEW YORK STALE EDUCATION LAMB'
'ONLY COPIES FROM THE ORI I N& OF THIS SURVEY
MARKED WH AN ORIGINAL OF THE LAND SURVEYORS
SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES.'
'CERTIFICATIONS N DICA70 HEREON SIGNIFY THAT
7HIS SURVEY WAS PREPARED IN ACCORDANCE MATH THE
OWING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED
BY 7HE NEW YOM STALE ASSOCIA7KIN OF PROFESSIONAL
LAND SURVEYORS. SAID CERTIFICAMNS SMALL RUN ONLY
TO THE PERSON FOR MANOM THE SURVEY IS PREPARED, AND
ON HIS BEHALF TO TFE TITLE COMPANY, GOVERNMENTAL
AGENCY AND LENDING INS717U7KON LWI D HEREON. AND
TO THE ASSIGNEES OF THE LOOM V47I1UTNON.'
( UV--1- (.O 1 1 ...�..... %. '