97-130 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date September 11 19 97
CsicIN It \
This is to-certify that work requested, to be done as shown by Permit No. 97130
has been completed.
2 100 SQ. FT. SINGLE FAMILY DWELLING ..
This'structure may be occupied as a
180 ROCK WELL ROAD
Location
Owner HOWE, KEZIA N.
•
TAX MAP NO. 54. --3-16 By Order Town Board
TOWN OF QUEENSBURY
/f
Director,of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 1810RDWN OF QUEENSBURY No 97130
TAX MAP NO. 54 . -3-16 . WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
HOWE , KEZIA W.
OWNER of property located at
20 HOWE DRIVE Street,Road or Ave.
in the Town of Queensbury,To Construct or place a 2 , 100 SQ. FT. SINGLE FAMILY DWELLING
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
20 HOWE DR.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
IMPERIAL, PETER
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
COMMONWEALTH ELECTRICAL
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by XI SINGLE FAMILY DWELLING
( 1 Wood Frame ( 1 Masonry ( )Steel ( 1
7. PLANS and Specifications
2 , 01810 SQ . FT. SINGLE FAMILY DWELLING W/ 2 CAR ATTACHED GARAGE
AND 1 FIREPLACE AS PER PLOT PLAN AND SPECIFICATIONS .
8. Proposed Use
2 , 100 SQ. FT. SINGLE FAMILY DWELLING
287 May 16 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES .19
(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.)
16 May 97
Dated at the Town of Queensbury this Day of 19
SIGNED BY Z)WeiNder:N^ for the Town of Queensbury
lding aZoning Inspector
• , -/
TOWN OF QUEENSBURY iv E
742 Bay Rd., Queensbury, NY 12804 APR 1
1 1997
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AN HHIiMNEYS
BUILDINtGyAND CODE
Date 4-f/// ,19 9' 2 Permit No. / _/
l
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant fie 1--rog_ APPLIANCE (check appropriate boxes)
AdCiress ,3� ivo2 Jfj/k Jo4'/De cype6 ❑ STOVE: ❑Wood ❑ Coal o Pellet ❑ Gas
0 FIREPLACE INSERT
L(,ee3(USbc/ Ay Zip /0/_,F-0 y a FIREPLACE, FACTORY-BUILT:
i6od ❑ Gas
Phone 7 9,p-5 O 9. Z ❑ FIREPLACE, MASONRY:
❑ Wood ❑ Gas
Owner K7 i f4 7--76Gtl e ( cis' ) URNACE: ❑ Wood ❑ Gas -eii-
Address 1-1-d(4e l i2 IF NON-MASONRY APPLIANCE:
Manufacturer: c"
(TcLcENSb c(/Ly Zip /t&0 �' Model:
Phone 7 901_ = 4 C)
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
-q. , D 0 MASONRY: 0 Block 0 Br' ❑ Stone
az. e) 0LOG t l� FLUE: ❑ Tile teel
Size: " inches
CONSTRUCTION / INSTALLATION MUST 0 FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS ❑ D��ble Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS. D' nsulated 0 Direct Venting
❑ Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title C>3,S— G
A 173 3389 (190) Public Safety JJ
A 233 2655 (230) Minor Sales
Fee Collect;d _rf, ' efunded to:
Address:
Dated: 1//Ig7 Town Clerk or Deputy:
White: Applicant` Green: Fire Marshal Yellow: Bldg. Dept. Pink& Goldenrod: Cashier's Dept.
' nutcaing rernut Application
Town of Queensbury - Dept. of Community Development,' 742 Bay Road, Queensbuy, t=B256J
BUILDING & . CODE ENFORCEMENT f#.,
NOTICERequirements prior to issuance ��q
A permit must be obtained before of this permit: P: or, t hh1E .7 �7-/ ,a9
beginning construction. No inspections t-i,;••iE..,ti 5~ •J D
ZoningBoard Action ll�c t
will be made until applicant has received n
a VALID BUILDING PERMIT. All Area / Use
applicants' spaces on this application RECREATION FEE PAID
MUST be completed and•the signature n Planning Board Action REVIEWED B
of the applicant must appear on the SPR / Subdivision /Other
Building Inspector application form. Thank
�W. Recreation Fee Payment 1
Applicant: -e /2 KS uC�e 2 / e Owner: KZ.E( IA 1- C-t-tS /J
Address: -�8 Mc N ( N 5.C'( 0 e e t e-e(e Address: (4 O� -� -0 L2 /
Phone # (Si?) 79P - (5-09 2_ Phone # ( 5( ) 75 . - P39O
Properly l,ocalion: 64,i-e % J27>)-r___.-
Tax Map Number C/ / / /6
Subdivision Name: — Section Block Tnt
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
//UR New Building: CONSTRUCTION: $ /y/ con
residence / commercial /
Addition to Building: - .
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Prima.ry Building -
residence / commercial //Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
alK /� If ADDITION, what will use
1st Floor
i UO sq. ft. of new addition be? :
2nd .Floor sq. ft. �5
Other Floors sq. ft. ---
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, 2 car J.,
TOTAL FLOOR AREA: . ,...2.too SQ. FT. r — Attached Garage 1, )car a if
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
—
O FEET X 3 FEET Other
Foundation Type: pO(Q2 Ef . Will any second-hand or ungraded
Number of Stories : I lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : I - feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or wood stove (circle all ich appli s)
to be installed: ( Electric / Oil )/ Gas ood
-
Forced Hot r Baseboar f/ th6r
) r
Person responsible for supervision of work as regards to building
codes is : I e�-e l2 Z1(),1 p1 (ai al c
Name Addr,esss Phone
Builder: P-��etr2_ Try,p�ILI a/p
Plumber:
. Mason: :-e FP fl la ry
Electrician: QA
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 Uwe shall submit prior to a
Certificate of Occupancior Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale,al) showing actual location of project on premises.
Signature: P01(7,4.__, ,—�/J M c
(owner, owner's aggfit, architect, contractor)
, .
/r /
T:S WN 'S E I UEENS ► U , Y
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
•
Date C.;' f'`/ - ,19 (7, 7 Perm No. t ,.r
t
APPLICATION IS HEREBY MA 1,E to the Building Dept. for the issuance of,a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditions;.that are;part of these requirements and also will allow
all inspectors to enter premises to perform required inspections. .
Please fill out additional form if more.than one ap pliance and/or chimney.
Applicant lir 1-P��. � r �'re i �i� r- APPLIANCE (check appropriate boxes)
?
Address ., r, '7G.,z 111l U q--�'f:Jp' C'I2 't!ti STOVE: ❑Wood o •Coal"-- ❑ Pellet ❑ Gas
0 FIREPLACE INSERT
k-_--%C/ V 9/0.5,r c_/ /i.., Zip f;.t -G (/ - ❑.FIREPLACE, FACTORY-BUILT:
p..Wood ❑ Gas
Phone .T2 G" `5-a 9 L. 0 FIREPLACE, MASONRY:
❑ Wood ❑ Gas
Owner of la A/(pie ./ (is j ;, ) 0-FURNACE: ❑ Wood ❑ Gas 0-Oil
j
Address ,�--�d C�i�, f�
j ) ' . ' IF NON-MASONRY APPLIANCE:
- -.--- ----- - _ _ Manufacturer:_. . '� =(-',/��.0 rrr�ft..ac?
(� if •c�e� � c( /C"cx✓ Zip / - G ` -t Model:
Phone J 2;1. OCI3 r 0
:.. ., , CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction 0 MASONRY: 0 Block ❑ Bri.ek' 0 Stone
,� k .. ...... f � `� ? ! ; ; FLUE: o Tile oSteel
��y� _, - _ {_.-r�° `- inches
- Size: ��
CONSTRUCTION I INSTALLATION MUST ❑ FACTORY-BUILT:
"-CONFORM TO NYS FIRE PREVENTION & Manufacturer: Number:
BUILDING CODE. CONSULT AVAILABLE Listed By:
TOWN OF QUEENSBURY HANDOUTS 0 Double Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS. D'Insulated 0 Direct Venting
❑ Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title Fes;). ,=?.='
A 173 3389 (190) Public Safety ..1
A 233 2655 (230) Minor Sales --_-.
Fee Collected Fro ._mo. l'Refun _�. , .., ,r.`': '--`=
Address: . = c::. i:,.<4, f, . -7 N, 7 .
Dated: .-,'/ /,- /�;';3 Town Clerk or Deputy:
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept.. Pink & Goldenrod: Cashier's Dept.
Application for SEPTIC DISPOSALERMIT
RECEIVED ' `� �j Town of Queensbury Permit No. O// ' `-�
Dept. of Community Development APR 11 1997
Building &Codes Office
742 Bay Road TOWN OF' ..iOE r.ii :i:;CRY 1 Fee Paid $
Queensbury, NY 12804 BU TPS__ I.F�O CODE
Location of property for installation: gy.t. ..e.....
be.,-.4-,_
Property Owner's Name: 12<ae I (4. 1--1 a uj e. d)(-LS 7k
Property Owner's Mailing Address: i ot.oe , )e4 •
Installer's Name: 67 f hl /J alta_pc Phone # 7 77 5--7
Number of bedrooms (if residential): 3 Total daily flow: /fa
(residential - compute @ 150 gal./bdrm.)
Topography: //t, rolling, steep slope % of slope
Soil Nature: sand, :loam, may, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? — feet
Percolation test: &knot required, 6� required [rate JO min. per inch ]
Domestic water supply: municipal, wll,' other
If domestic water supply is a WELL, water supply from any septic absorption is /GC) feet. .
PROPOSED SYSTEM
Septic tank: /,O adgallon (minimum size: 1,000 gal.)
Tile field: each trench � 0 feet / Total system length: ) GC) feet
Seepage pit(s): number of / size each: - ft. by ft.
Size of stone to be used: # / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm system and associated electrical work to be inspected by a certified agency.J
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, 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 of
Queensbury Sanitary Sewage Disposal Ordinance. /
Signature of responsible person: .A `/0 J'YL cc __ Date: 4-// //79
r
/� TOWN OF QUEENSBURY '
'v.2411 11. BUILDING & CODE ENFORCEMENTi �� 742 BAY ROAD
.. , QUEENSBURY NY 12804
(518) 761-8256
1
ARRIVE: //"'/,5'DEPART: kW INSP: ` I
FINAL INSPECTION REPORT -RESIDENTIAL
DATE INSPEC ON REQUEST RECEIVED:
WEQ
G _
NAME �
LOCATION /QO�'_Z4 jc- :-- / ) :[� `�,��
DATE 911 - PERMIT 1 % 7 ` i C�L-�
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING _ SEPTIC _ INSULATION _
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
- N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT \l /
R OFING
XTERIOR FINISH I
DECK/PORCfi/STEPS/RAI NGS -07
RELIEF VALVES
FURNACE/HOT WATER OP TING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS •SWEEPABLE
OTHER FLOORS CARPETED
0///:
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING , /
1/1//;j/
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ. . --1 /://-----
FINAL SURVEY PLOT PLAN 9/1/107
OK TO ISSUE C/O OR C/C VVV
\ I ) () DIPC\
,/� TOWN OF QUEENSBURY
{„/f� .• BUILDING & CODE ENFORCEMENT
'"'" 742 BAY ROAD
� � QUEENSBURY NY 12804
(518)v 761-8256J l JJ /
ARRIVE: ,v DEPART: 1/V , V f INSP:``�Jt
FINAL INSPECTION REPORT - 'RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED: 9iOd17
NAME ` _ J d 2�\ C.
LOCATION c- :tt'��O I�trube �jft (lQ,
DATE C- 1 \--R1 PERMIT 1 9 !-/CJ`./
TYPE OF STRUCTURE 5 ,�
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING _ SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
- N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINIS
,1ECK/PORCH/STEPS/•'' , I,, !•S
LIEF VALVES
FURNACE/HOT WATER OPERA NG
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
I
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED
JS/�TAIR CLEARANCE/RAILINGS Vil
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
-•FOUNDATION INSULATION
GARAGE FIRE PROOFING
.10/1
_:4/DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
/
6INAL SURVEY .• OT PLAN ` /
OK TO ISSU' • OR C/C V/
tk.9 I L`r IJAIL 1DeGly IAPtiv6Gia
TOWN OF QUEENSBURY
4 ,/"!� [� : BUILDING & CODE ENFORCEMENT
`f
� •
742 BAY ROAD
� QUEENSBURY NY 12804
(518) 761-8256 (1,�I�,�,
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPErCj ION REQUEST RECEIVED:
NAME '/'[Oral--
LOCATION LOCATION/ D4)6G� e I�jO�
DATE 7/ J(/1-'
7 PERMIT I 774340
3
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC _ INSULATION _
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
- N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILING
RELIEF VALVES
FURNACE/HOT WATER OPERATI
INTERIOR TRIM/PRIVACY OOR
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
S TE PLAN/VARIANCE RED.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
A.• TOWN OF QUEENSBURY
FIRE MARSHAL.
5`� QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 9
NAME .\\‹-tasc„,
LOCATION Q-{J Jop, - u
• DATE PERMIT # 13 D - -14 -9 7
APPROVED
/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTE
HOOD INSTALLATION l
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLER
CLEARANCE TO HEATING NITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FEPLACE-MASONRY
✓FIREPLACE- FACTORY BUILT `✓
REMARKS: ❑ OK TO IS DATE
•
INSPSLIP.PUB S E TO
"2/ .v
f- TOWN OF QUEENSBURY
,,, f�;1W BUILDING & CODE ENFORCEMENT
o 7+,;. 7421 BAY ROAD
Jay ' QUEENSBURY NY 12804
• Y.;" (518)745-4447
ARRIVE: I " . DEPART: ` ter/ (' INSP /`/
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPEC ION REQUEST RECEIVED: --1/
NAME D I Z_1 D\
LOCATION Z f \OCK CLR0
DATE 11yl / ' PERMIT 0 7l I: LJ
TYPE OF III STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC _ INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A 71 NO
CHIMNEY HEIGHT/: VENT/HEIGHT V
PLUMBING VENT
ROOFING �
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPE'oTING
INTERIOR TRIM/PRIVACY ',ORS
\.7711/ /
• 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 CL SE
FINAL L T I AL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C Lef
Aro,y1"5-( qou 6,cSDoc
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COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. y�Main Office 357 Elwyn Terrace — Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. Cert. 5 3 2 8 o Cut-in Card No.
Owner 4 /14 %
Occupant r
Location /GV-e.ea,/et Ce Ao '_- x
�
Installation Consisting of v S2a i "re-4.!6i ee 5 /'�0__&-E Li 7 Z
I-g. .1/-2 r4 f +_0.0c� A s�a �x �pP�Y ,.
Installed By..:P' -1 PE',/�'i/#'(.."ci: 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 maki• inspec o-s at an time,and if its
rules are violated,the Company shall have the right to revoke t 0 ertific•te.
.r/
Date g"‘'%f 7 INSPECTOR I
Member N.F.P.A.,I.A.E.I.
TOWN OF QUEENSBURY (;
BUILDING & CODE ENFORCEMENT -
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name �1JZJ�
Location l'iocAWC c IQ►o •
Date '7/4 /7 l Permit # F7`" /3-0
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FI LD: ot..1 Length
Length of each ' - ch
Depth of trenches
Size of stone
SEEPAGE PITS: Numbe -
Size - ft. x ft.
Stone size
PIPING: Size ype
Bldg. to Tank '=-J
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION SYSTEM ON PROPERTY:
(circle
Front - ear Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YES daj
Arrived: c : /(9,_
Departed: 7J r
Ar
` \ cc
Building Inspector
(518) 761-8256
.,w
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ,
INSPECTOR'S REPORT: ARR DEPAN0(
REQUEST FOR INSPECTION RECEIVED:
NAME - (,J
LOCATION -dc L - -'- je-`._) ���j
DATE "7/2- 9-7 PERMITA 7`7 r /1� "-
TYPE OF STRUCTURE:
RECHECK APPROVE
N/A YE I NO
FOOTINGS a .=C
MONOLITHI OUR FORM
REINFORCEMENT IN P Allik
THE CONTRACTO R SPON'IBLE FOR
PROVIDING PROTE T 4N_F•6, FREEZING
FOR 48 HOURS FOLLOWI'.G 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
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-
fyuir8da.
TOWN OF QUE BURY
FIRE MARSHAL
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED 0 G 17
NAME e2 20
LOCATION C� 97-130DATE PERMIT 9 3 - /7
APPROVED
N/A YES NO
EXITS _,_ .
AISLE WIDT S
EXIT SIGNS
EMERGENCY LIGHT N--1
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE- FACTO (BUILT
REMARKS: 0 OK TO THIS DATE
(11049:ktize,
+/A die
INSPSLIP.PUB INSPECT
f58 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT t
724 BAY RD., QUEENSBURY NY .12804 . --t,
INSPECTOR'S REPORT: ARR(/' tivDEPARRe •J INTS.4"lk
REQUEST FOR I SPECTION RECEIVED: (0- t i ��//
NAMED!y )-ems \e ? rA
LOCATION (C-- ( . ...(3.0) . ,1
DATE (- ��"---9 / PERMIT A [rl,l 0
TYPE OF STRUCTURE: SC
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO"
lk
REINFORCEMENT•IN PLpa
`,
THE CONTRACTOR IA, RE•PONSI:LE FOR
PROVIDING PROTE TION FROM :REEZING
FOR 48 HOURS FOLLO -4e TH . PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURI•OSE ON 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 /
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TOWN OF QUEENSBURY
BUILDING E. CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
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REQUEST FOR INSPECTIOON RECEIVED: ( (/ l 7- 7
NAME \.. e 1 C -tl \<
LOCATION
DATE PERMIT A ! ./ —/c c)
TYPE OF STRUCTURE:
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THE CONTRACT'' IS RESrONSI:LE FOR
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MATERIALS FOR THIS PUR'OSE ON SITE,_ _
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
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INSPECTOR'S REPORT: ARR _ DEPAR'}3r ZS I142.-C/
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REQUEST FOR INSPECTION RECEIVED:
NAME rlOL)
LOCATION �c7�KLt1G'CL i2o [•
DATE 6,/jj' l`Z/5/2 PERMIT i 6 /3'
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NQ
FOOTINGS/PIERS
MONOLITHIC Pi R FO' 1111W
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THE CONTRACTOR IS PO', .IDLE FOR
PROVIDING PROTE TON FROM FREEZING
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MATERIALS FOR T S PURPOSE ON SITE
FOUNDATION/WALLPOUR
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FOUNDATION WALLS EXTERIOR R-
FLOORS R-
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CEILING R-
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UNHEATED SPACES R- •
3 19/h (518) 761=8256
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT °"
742 BAY RD., QUEENSBURY NY .12804
INSPECTOR'S REPORT: ARE.,' DEPART 2),i i0 INT<,t- 1/
REQUEST FOR INSPECTION RECEIVED: C ` f 7 1 1
NAME \ ;1)\. �
LOCATI N (\(' '1-\.5-2-2 lJ\Cq��
DATE L - 7 7 SEMIT A 17-/l
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS _
MONOLITH C POUR FORM .
REINFORCEMENT I PLACE
THE CONTRACTOR IS RE- ''BIBLE FOR
PROVIDING PROTE TION F'OM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE. _
MATERIALS FOR THIS PUR•ISE ON SITE,_
FOUNDATION/WALLPOUR
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FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL /
PLUMBING VENT/VENTS IN PLACE
t OUGH PLUMBING
PLUMBING UNDER SLAB
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JACK STUDS/HEADERS _
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- _
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ,T 1+
742 BAY RD., QUEENSBURY NY 12804 ls"r��.
INSPECTOR'S REPORT: ARR/Z" EPART/2 f"—_
REQUEST FOR INS ECTION RECEIVED:
NAME U i �'J k
LOCATION / U� GL /
DATE 6�1/L 7 PERMIT $ ,G ` /3o
TYPE OF STRUCTURE:
RECHECK APPROVE
w N/A YE NO
FOOTINGS/PIERS al-4 •
MONOLIHIC POUR FORM
REINFOR M IN PLACE
THE CONT TOR IS RESPONSIBLE FOR
PROVIDIN PROTE TION FROM FREEZING
FOR 48 U S FOLLOWING THE PLACE—
MENT 7 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
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
1IR 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—
4 06,4
(518) 761-8256
TOWN OF QUEENSBURY �
BUILDING b CODE ENFORCEMENT
742 BAY RD., QUEENSBURYY5 NY 12804// //
INSPECTOR'S REPORT: ARR 'l/ EPART I/1 S. iNI./4
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REQUEST FOR INSPECTION RECEIVED:
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NAME 62"
LOCATION Xa'6(,✓ /:2 - 7
DATE (�t/f�`,,, PERMIT 0 r( -/ 4
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PROVIDING PROTE TION FROM FREEZING
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MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
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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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TOWN OF QUEENSBURY \i3c
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
°✓ r-16pY roma no •
Location AMMON U0-12
Date — -9 Permit # (")\ --1 -13 0
SOIL TYPE: n.'-LoaO lay-
Results of Percl` tio Test-
(if applicable) .t_ Minute/Inch
TYPE OF SYSTEM: f e
ABSORPTION FIE- 1: Total Length
Length of e. trench d `5
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size _
PIPING: Size— Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pi u
Openings Sealed? No Partial
LOCATION/SEPARATION .
Foundation to Tank /5j feet
Foundation to Absorption !)-O feet
Separation of Pits •.feet
Conforms as per Plot Plan No
LOCATION OF SYSTEM ON PROPER "
(circle s-.
Front gear Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
•
014 ro
SYSTEM USE APPROVE YES a ''
Arrived: f
Departed: f/ .
1/2(/V
Building Inspector
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
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INSPECTOR'S REPORT: AR v DEPART 2 INTO-
REQUEST FOR INN PECTION RECEIVED: CA/97
NAME /`GVg-
LOCATION f`OCK a - Au -
DATE ‘/5/1?, PERMIT # 7f b 5r,
TYPE OF STRUCTURE:
R HECK APPROVED
N/A YES9/ NQ
,FOOTINGS/ 1 {/
RMONOLITHIC OUR FORM
EINFORCEMENT IN PLACE
f
THE CONTRACTOR IS RESPONSIBLE FOR
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MENT OF THE CONCRETE.
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MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION WALLPOUR i \
REINFORCEMENT IN PLA E
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FOUNDATION DAMPPRO ING / _
BACKFILL APPROV
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PLUMBING UNDER SLAB _
FRAMING:_
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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
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY12804 �6 -
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INSPECTOR'S REPORT: ARRO '�VDEPAR6 INT'J/REQUEST FOR INSPECTION RECEIVED: C)� 7
NAME .i� � ;),/LOCATION �\ (,,a
DATE 5—3Q r ( 7 PERMIT a 9 7 - /✓r)
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE - - --
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOL ,'I %' THE PLACE-
MENT OF THE CONC 1TE.
MATERIALS FOR AROSE ON SITE
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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 ,.
BUILDING E. CODE ENFORCEMENT .••F3
742 BAY RD., 'QUEENSBURY NY .12804 /A ` ,/��. /
INSPECTOR'S REPORT: ARRI 9DEPAR •0" INi`''V
REQUEST FOR IN PECTION RECEIVED:
NAME f`S-X
LOCATION 4c/ ' & -
6 o /
DATE /�` /77 PERMIT A r/�l
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESP ;ID t' FOR
PROVIDING PROTE TION FR FREZING
FOR 48 HOURS FOLLOWING T P CE-
MENT OF THE CONCRETE. ,
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
F NDATION/DAMPPROOFFIING-�r q /
BACKFILL APPROVAL / 10!.. l✓/ li V/
PLUMBING VENT/VENTS IN PLACE _
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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- -
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT 45 '
742 BAY RD., QUEENSBURY NY 12804 /��� l
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INSPECTOR'S REPORT: AR�.' AC--
INSPECTOR'S PART' °((,,.dNT Cv �7
REQUEST FOR INSPECTION RECEIVED:
NAME � 'Lp`:all____ fXtX<•�
LOCATION - 6_ '
DATE S c7 r�-C1) t PER IT A �J"0
TYPE OF ST'UCTURE:
RECHECK APPROVED
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MATERIALS FOR THIS PURPOS ON SITE
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FOUNDATION/DAMPPROOFING
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JACK STUDS/HEADERS
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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
BUILDING & CODE ENFORCEMENT ,y
.e,.742 BAY RD., QUEENSBURY NY 12804 �•1. 4-..r,
INSPECTOR'S REPORT: AR DEPARTA' /V -61NTV& 1
REQUEST FOR IN/��7PECTION RECEIVED:
NAME /ZIG'
LOCATION /6 `�(I.1L .
DATE PERMIT A
TYPE OF STRU TORE:
RECHECK APPROVED
.'FOOTINGS
` N/A YES NO
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MONOLITHIC POUR FORM I 1�
REINFORCEMENT IN PLACES,
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
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-
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UNHEATED SPACES R- •
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BUILDING & CODE ENFORCEMENT ` xo
742 BAY RD., QUEENSBURY NY 12804 ,�., , ., 3
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i V INSPECTOR'S REPORT: AR�F�-'—,�_ -EPAR �N
REQUEST FOR IT!TION RECEIVED:
NAME {S . 011,-7"C
LOCATIOr C-t'awt , O/J L (L
DATE LI 1 PERMIT I
TYPE OF STRUCTURE: 77
RECHECK APPROV D
N/A Y S NO
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MONOLITHIC UR FORM
REINFORCE NT IN PLACE g -
THE CON CTO IS RESPONSIBLE FOR
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MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
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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-
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT .
531 Bay,Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name / G' -
Location £cXcf6 / , ® _
Date s--//���i7 Permit # 7 7--13°
SOIL TYPE: Sand-'loam-Clay-
Results of Percoh on ' est-
(if applicable) °.te-Mi.nute/Inch
TYPE OF SYST `
ABSORPTION : IELD: Total Length _
Length of each tr:nc.h
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: • Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption _ feet
Separation of Pits feet
.Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear .- Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
s-ra,si A5ug.j 5 `
sr
.un 20,) 6 u
SYSTEM USE APPROVED: YES .
Arrived: /, ,s16
Departed: i e) .
Building Inspector -
:/! • "- (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT av :
742 BAY RD., QUEENSBURY
lNNY 12804JE • ,{�
INSPECTOR'S REPORT: ARR DEPARTI( •L "INT
REQUEST FOR INSPECTION RECEIVED:
NAME ff
LOCATION , ECG �®
DATE f 7 PERMIT e 97r//3/0
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR F RM
REINFORCEMENT IN P CE
THE CONTRACTOR IS RE PON IDLE FOR
PROVIDING PROTE TIO RO FREEZING
FOR 48 HOURS FOLLO N T E PLACE-
MENT OF THE CONC TE.
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
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-
r - //i e
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 tom'. - q
INSPECTOR'S REPORT: ARR DEPAR :62)INT\M
REQUEST FOR INSPECTION RECEIVED:
NAME 1,O WC-•.
LOCATION i CC'.ta��C� 4.�(3
DATE / /( /' PERMIT y
t q7—/X
TYPE OF TRUCTURr: I
RECHECK APPROVED
)11____ N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO•\ / -
REINFORCEMENT IN PUCE // _
THE CONTRACTOR IS RE•PONS BLE FOR
PROVIDING PROTE TION FROM/FREEZING
FOR 48 HOURS FOLLOWI' e TIC PLACE-
MENT OF THE CONCRETE.' !/y
MATERIALS FOR THIS PURaiSE ON SITE
FOUNDATION/WALLPOUR i
REINFORCEMENT IN PLACd
FOUNDATION/DAMPPROOF G
BACKFILL APPROVAL
PLUMBING VENT/VENTS, IN PLA'
z
ROUGH PLUMBING
PLUMBING UNDER SLA
FRAMING:
JACK STUD./HEADERS
BRACING :RIDGING _ _
JOIST HA''GERS
JACK POSTS MAIN BEAM
AIR INFILTRATIO' BARRIER
HEATING ROUGH-L
INSULATION: '.
FOUNDATION i ALLS INTERIOR R-
FOUNDATION ALLS EXTERIOR R- - _
FLOORS R-
WALLS R-
CEILING R-
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UNHEATED -PACES R-
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