97-172 - -
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
August, 21 97
Date 19
gLe, 11/- 1
97172
• This is to certify that work requested to be done as shown by Permit No.
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied u a
LOT 2 HEADOWBROOK RD.
Location
SCHERMERHORN CONSTRUCTION
Owner
TAX MAP NO, 60. -2-7. 7 By Order'Town Board
.TOWN OF QUEENSBURY,
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 62501OWN OF QUEENSBURY No. 97172
TAX MAP NO. 60. —2-7 . 7 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to SCHERMERHORN CONSTRUCTION
OWNER of property located at LOT 2 MEADOWBROOK RD. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMILY DWELLING
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the 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 BUILDERS 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)
SINGLE FAMILY DWELLING
( 1 Wood Frame ( )Masonry ( 1 Steel 1 1
7. PLANS and Specifications
S]'NGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
80 May 8 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.)
8 May 97
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
Building and Zoning Inspecto _
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, IVY 12804 [761-82561
NOTICE BUILDING & .CODE ENFORCEMENT
Requirements prior to issuance
M of this permit: PERMIT FILE NO. --
A permit must be obtained before O
beginning construction. No inspections • PERMIT FEE PAID$
will be made until applicant has received 1-7Zoning Board Action
a VALID BUILDING PERMIT. All Area /Use RECREATION FEE P D
applicants' spaces on this application
MUST be completed and the signature n Planning Board Action REVIEWED BY: ,'
of the applicant must appear on the SPR / Subdivision /Other Building nspector
\pplication form. rtanx,mt. J Recreation Fee Payment
Applicant: Cc1n e f vv%Q.(')nc t Ai Q S-Ff t?t L) Owner: —
Cori •
. • Address: 1 ' 't,MaS}-e rS 0 ,+rweJ• frt) (H, Address:
•
Phone # ( 5 l Q, ) 248 - O?y Phone # ( ) -
Property Location: ,oaf A 1'lil ec cIc 1.....4 rec, k 7c --
Tax Map Number --1—/---
Subdivision Name: g - Section Block Lot
NATURE OF ,PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
)( New B ' ldin : CONSTRUCTION: $ (po,5co
residenc - / commercial
Addition to Building: ,
residence. / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial y Single Famil •
Residence / Commercial Two Family D el 4. I V
no change to exterior size Family Dwelling
Office APR 29 7997
Other Work (describe below) Mercantile
Manufactur• nTpWli4C7FC UEE.nIS6URY
Other BUILDING AND CODS
GROSS' AREA OF PROPOSED STRUCTURE: -4?() - -
1st Floor 2 sq. ft. If ADDITION, what will use
2nd .Floor sq. ft. of new addition be? :
Other Floors . . .,. . sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
�,,�� Detached Garage 1, 2 car
TOTAL FLOOR AREA: �.> Q. FT. r ./ Attached Garage 1, 2 car
' Private Storage Building
SIZE OF NEWSTRUCTURE: Commercial Storage Building
Other
32 - FEET X 214 FEET
Foundation Type: C,o"cI'tA•Q._ Will any second-hand or ungraded
' Number of Stories: li lumber be used? If so, for what?
(habitable space only) !l/
Height (grade to ridge) : 17 feet TYPE OF_ HEATING SYSTEM:
Number of fireplaces nd/or woodstove (circle all which a••l' es)
to be installed: is ' Gas ' Wood
Forced Hot Ai / Baseboard / Other
Person responsible for supervision of work as regards to building
codes is : F,• stN,k_:vv,2s1^►ol'J--) 778-067 i.
p Nam Addresss Phone
Builder: i\-, •C r�,,{L..@t^horst-) - `75'5)-0(0W
Plumber: Steve ,41)e•N 147 36
Mason: - Olc,LA , LIAt..A.J:_U -772.-L7)
Electrician: ii/t I K0 C'pvw,-S t•LA
Anti-3 9 a 0=1
DECLARATION: Please sign below after fou 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 r Certificate of Co 'Hance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; dra to cale, ow' •• al • ation of project on premises.
Signature: r
(owner, owner's agent, architect, contractor)
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No.(I—17c)—
Dept. of Community Development it.;
Building &Codes Office
742 Bay Road r Fee Paid $
Queensbury, NY 12804 C/v
Location of property for installation:
Property Owner's Name:
Property Owner's Mailing Address:
Installer's Name: Phone #
•
Number of bedrooms (if residential): Total daily flow:
(residential - compute @ 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: not required, required [rate min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank: gallon (minimum size: 1,000 gal.)
Tile field: each trench feet / Total system length: feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: it / 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.)
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: Date:
4
FLOOD DAMAGE PREVENTION
BUILDING PERMIT # %7-/7Z_
Floodplain Development Permit .Application
Town of Queensbury, New York
e. This form is to bfilled out in duplicate.
i
SECTION le GENERAL PROVISIONS (APPLICANT to read and sign) :
1. No work may 'tart 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 all 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 i ' 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 repr�'sentative to make reasonable inspections required
to verify co�ipliance.
8 . I, THE APPLICANT, CERTIFY T T ALL STATEMENTS HEREIN AND IN
ATTACHMENTS iTO THIS APPLIfCI I 1 R , TO THE BEST OF MY
KNOWLEDGE, T°UE AND ACCURAT . 9�
(APPLICANT S! SIGNATURE) VA Y y . DATE a, i 7
SECTION 2 :' PROPOSED DEVELOPMENT (To be completed by APPLICANT)
NAME Ant--04 at ✓her, ry�-jov{Sf c.r.+'J.S CreADDRESS 7C1 i1/1.4tic am.,,,,,,.--TELEPHONE 2ff-oc 7y
APPLICANT 1,
• BUILDER
ii
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.
ip. /nil ct•cia t ikd o 0 41„
•
Ii
DESCRIPTION OF WORK (Circle applicable activity and structural
type) :
,; .
A. STRUCTURAL DEVELOPMENT
l
ACTIVITY I' STRUCTURE TYPE '
Chew Structure Residential (1-4 Family)
Addition '' � )
R side-nt--a3'(11ore than Family)
Alteration i{ Non-residential (Floodproofing?)
yes)
1
is
I,
•
Relocation I Combined Use (Residential &
Commercial)
Demolition Manufactured (Mobile) Home
• (In Manufactured Home Park? Yes
No
ESTIMATED COST OF PROJECT $ 6% 0ds
B. OTHER DEVELOPMENT ACTIVITIES: (Check Appropriate Activities)
Fill Mining Drilling Sf Grading
Excavation (Except for Structural Development Checked
•
Above)
Watercourse Alteration (Including Dredging and Channel
Modifications)
DrainageiImprovements (Including Culvert Work)
Road, .St eet or Bridge . Construction
Subdivision (New or,,Expansion)
Individullal Water o4 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 proposed eyelopment is located on FIRM Panel No. 3 C O17? -cog
Dated 1//W9Y
The Proposed Development :
Is NOT located in a Special Flood Hazard Area (Notify the
applicant jthat the applicant review is complete and NO
FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED) .
Ar Is located in a Special Flood Hazarj.0 Area.
FIRM zone; designation is 7,(5).-c_
100-Year ,flood elevation at the site is: 3C .3i FT.
NGVD (MS :;)
Unavailable
The propoised development is located in a floodway.
FBFM Panel No. Dated
See Section 4 for additional instructions .
SIGNED • DATE
I
SECTION 4: ADDITIONAL INFORMATION REQUIRED (To be completed by
LOCAL ADMINISTRATOR)
The applicant must submit the documents checked below before the
application can be processed:
iA site plan showing the location of all existing
structues, water bodies, adjacent roads, lot dimensions
and proposed development.
Development plans, drawn to scale, and specifications,
• including where applicable: details for anchoring
111
structures, proposed elevation of lowest floor (including
basement4) , 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,
•
I
ii
it
li
•
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 3o6 70 Ft. NGVD (MSL) .
•
Floodproofing protection level (nonresidential only)
F't. NGVD (MSL) . For f loodproofed 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) j
I have determined" that the property activity: A. . )0 Is
B. Is not
in conformance wi h. provisions of Local Law #2, 1996 :
The permit is issued subject to the conditions attached to and made
part of this 4Lt. . r
SIGNED CI , DATE Of-1/6
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 t:h : 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 infcrmation 'muet 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 ;l(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 :
FT. NGVD (MSL) . -
1
ll
1
aj
Z
1. B) Licensed Engineer or Surveyor signature and seal.
11
I;
m Q 9 O O
�eY ''z N e
,
�t
s
4
' as�l D� '
2 . Actual (As-Built) Elevation of floodproofing .protection is
FT. NGVD (MSL) .
NOTE: Any work , performed prior to submittal of the above
information is at the risk of the Applicant.
!I
SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL
ADMINISTRATOR) i
,
The LOCAL ADMINISTRATOR will complete this section as applicable
based on inspection of the project to ensure compliance with the
community' s local aw for flood damage prevention.
INSPECTION : .
DATE / BY 'Oik DEFICIENCIES? YES
DATE . BY ' DEFICIENCIES? YES NO
DATE BY {i DEFICIENCIES? YES NO
SECTION 8: CERTIFICATE OF COMPLIANCE (To be completed by LOCAL
ADMINISTRATOR)
Certificate of Compliance issued: DATE (01,/ 1 7BY: (-7:4-01 �/Y
II
ij
Ij
'i
1
ij
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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: �1 a Lc 40,h ,~ea c
CJvEe.rLSbur:.j, .N•S'. / .8c /
Owner: bo4'caQ.G..o Sc
Address : ()0.0-0o rho rcok- 4
•
Permit No. 15 7 '17Z Permit Date: 5- 9 r,7
Check One:
New Building
Existing Building
I Fill
II Other:
r
The Local FloOdplain. Administrator is to complete a. or b.
below: �!
a. Compliance is hereby certified with the requirements of
Local Law No , 19 6.
Signed: 1 / ' A407' DATED: ____ ?
JJ 1
b. Compliancle is hereby certified with the requirements of
Local Law No. 2, 1996, as modified by variance no.
, dated
Signed: Dated:
'!I
1
[ CE;VED
RECEI
MAY 121997
r BUILDINGAN®ODES
"-Jz � g7
Dave Hatin, Director
Town of Queensbury
742 Bay Road
Queensbury, New York 12804
RE: '—Footing Verification/Placement of Footings
Dear Dave:At the following location: 264- 02 Meac-LE., l 'oo A l
footings to be formed with 10 inch form boards and frost walls to
be a minimum of 46 inches .
Rich Schermerhorn
- U
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF . QUEENSBURy, WARREN COUNTY
• 9000 HEATING DEGREE DAYS '
Comcliance Methods : PART 5 - Acceptable Practice Method -
l&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* - Design -by Component Performance -'
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
AP/PLICANNT`' S NAME: PROPERTY LOCATrION: J J
Os1'v+•t,e rho C•11-) 2.4 A @,a 0/0�,b,A30
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
•
1 . Gross Floor Area - 76 8 • scuare feet
2 . Type of Heat - Electric Oil $< Gas Other •
3 . Is building mechanically cooled? Yes Se No
4 . Percentage of area of windows and doors - 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 19
c _ Glazed areas R
d. Exterior doors • R .S
e . Floors over unheated spaces R
f . Edge of slab on grade (heated building) R . i�
g. Basement/cellar walls (above grade) R /9
h . Basement/cellar walls (below grade) R 11
i. Heating/cooling-ducts-piping in unheated space R if. (,
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code k • Yes_ No
•
EMPERA UR ON OL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
App c t' Si n to e Date Phone Number
98-063754
INSPECTOR' S REMARKS:
•
./11404. TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(! (518) 761-8256
ARRIVE: DEPART: c- INSP
FINAL INSPECTION REPORT - RESIDENTIAL.
. DATE I-NSPEGTIQN REQUEST RECEIVED: '
NAME 0
1,tukcy\
LOCATION
DATE PERMIT' # O-Pra,'
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 •
ECK PORC TEPS RAILIN S
RELIEF VALVES
-FURNACE/HOT WATER OPE TING
INTERIOR TRIM/PRIVA DOORS
FINISR,FLOORS: / - —7-
-BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED •
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL _
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
•
r
• I eP
h' . TOWN OF QUEENSBURY
I'w 1lko. , BUILDING & CODE ENFORCEMENT
. � r 742 BAY ROAD
`.- QUEENSBURY NY 12804
4fl' (' (518) 761-8256
ARRIVE: kn`Q0 DEPART: 1017.E INSP
FINAL INSPECTION REPORT - RESID TI '
DATE INS 10 EQUEST RECEIV D: _- 7
NAME
LOCATION
DATE ` 7 ' PERMIT ICf''/7g
TYPE OF STRUCTURE c;CI
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 Y`
EXTERIOR FINISH l/
PECK/PORCH/STEPS/RAIL NGS ,V/
RELIEF VALVES V/
FURNACE/HOT WATER OPERATING V
INTERIOR TRIM/PRIVACY DOORS
'T'INISH FLOORS: -- _ _ _-_
- - � f
BATH/KITCHEN WATERTIGHT V
OTHER FLOORS SWEEPABLE %
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
PATHROOM FANS V/
PLUMBING FIXTURES ./
FOUNDATION INSULATION "V
GARAGE FIRE PROOFING V
POOR CLOSERS V
FINAL ELECTRICAL V
'"' -- Q \°•�1Jc l
SITE PLAN/VARIA CE REQ. J
FINAL SPVEY?LOT PLAN 1 V
OK TO ISSUE C/O OR C/C
TOWN OF QUEENSBURY
w� IIIII.IL , BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
• (518) 761-8256
ARRIVE: i
DEPART: LNSP:
FINAL INSPECTION REPORT - RESIDENTIA
DATE INSPECTION %REQUEST RECEIVED: 0
NAME S.0 Of-rail '1 1 i r ice(
LOCATION MOD ,C�?, ® f ( 0
'7
DATE f1 — PERMIT 19 1 %] / d
TYPE OF STRUCTURE S
FOOTINGS FOUND TION BACKFILL FRAMING ROUGH PLUMBING t SEPTIC INSULATION •
_
FINAL ELECTRICAL 1 WOODSTOVE OR FIREPLACE
/+ N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT g,!
PLUMBING VENT P'
IROOFING
EXTERIOR FINISH }
DECK/PORCH/STEPS/RAI INGS I
i r
RELIEF VALVES
FURNACE/HOT WATER OP TIG
INTERIOR TRIM/PRITY DO RS
FINISH FLOORS: ,
BATH/KITCHEN WATERTI/ T '
OTHER FLOORSSWEEPABE
OTHER FLOORS CARPETED i,
STAIR CLEARANCE/RAILIINGS Ar
SMOKE DETECTORS r6 i,
BATHROOM FANS /
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING +
DOOR CLOSERS / y
FINAL ELECTRIC L
SITE PLAN/VARI/ANCE REQ. \
NAL SURVEY :;LOT PLAN \
OK TO ISSUE C/O OR C/C \
I
'w TOWN OF QUEENSBURY
VliNgli BUILDING & CODE ENFORCEMENT
W `^, 742 BAY ROAD
QUEENSBURY NY 12804
' h ( (518) 761-8256.
ARRIVE: U.:m DEPART: 1Z(-L INS
it
FINAL INSPECTION REPORT -IRESIDEN IAf
DATE INSPECTION REQUEST RECEIVED J
NAME `)Cli,N -NA N0,c ,k)
LOCATION V17.,C7c 4PL, A F.Nnf,t 6_c2.)K,C`#i
DATE (4 11 q7 1 PERMIT # CI -117_
TYPE OF STRUCTURE 6R{)
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING'_ SEPTIC INSULATION
FINAL ELECTRIC L _ WOODS;TOVE OR FIREPLACE _
,
N/A YES NO
CHIMNEY HEIGHT/ +. VENT/HEIGHT
PLUMBING VENT
ROOFING
. EXTERIOR FINISH \.
DECK/PORCH/STEPS/RISINGS ,_
RELIEF VALVES
CoO 1—D A 1 R R l'I' sCV/--'
FURNACE/HOT WATER P RATING
INTERIOR TRIM/PRIMACY\DOORS
FINISH FLOORS:
BATH/KITCHEN ATERTIG T
OTHER FLOORS WEEPABLD
OTHER FLOORS CARPETED
STAIR CLEARAN E/RAILINGS
SMOKE_DETECT RS
DATHROOM FAN k /
PLUMBING FI TURES 1
FOUNDATION INSULATION i
GARAGE FI - PROOFING
DOOR CLOS RS
c
FINAL EL CTRICAL
�CRJCi�l�,`�
SITE PLA /VARIANCEo REO• -FIPMC
FINAL S RVEY PLOT PLAN I V I
OK TO I ,SUE C/O OR C/C
J
COMMONWEALTH ELECTRICAL INSPECTION.SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 9 7— / 7 2,--
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. Cert. 5 3 2_ 9 66 Cut-in Card No.
Owner 5°C.1-1-67-4441.972/1-1/2-A-/ MU 97,
Occupant
y
Location Lora- ine-ADIMO it)PAOtv
I 5- zu e re II cf/2-e /6 (1-17-95
Installs ion Consisting of
-1>iiku 13ieve-LI vAfs
t
t vs
I_5-0 A s e—afiee-E
I.Ai -C eiert
Installed By 7,c 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 any time,and if its
rules are violated,the Company shall have the right to revo e th rtific t .
Date. --(c- INSPECTOR/
Member N.F.P.A.,I.A.E.I.
P'Iv)\16.'\Q__-- (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 °cam ;,.
INSPECTOR'S REPORT: ARF SU DEPAR(V 5 INN 2- -
_ £/ i
REQUEST FOR INS CTION /R/E�CE')I�VER. (, ) ! L
NAME `y� ) , 1 lY 1.� `-0 �� //
LOCATIO J J 1- i (�c_ / r �'` �l
DATE / / ( PERMIT A 4-7 "` Ora
TYPE OF STRUCTURE: —S
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS `1
MONOLITHIC POUR FORM
REINFORCEMENT IN PLA E _
THE CONTRACTOR IS RE PONSIBLE 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
IR INFILTRATION BARRIER
HEATING ROUGH-IN _
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- _
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LANDS N\F OF
MACDONALD
MAP REFERENCE:
MAP OF A PROPOSED SUBDIVISION
MADE FOR RICHARD SCHERMERHORN
BY VAN DUSEN & STEVES
DATED MARCH 28, 1995
LAST REVISED MAY 25, 1996
N 60 49'43" E
112.50
LOT 2 I
20,215 sq. ft.
0.46 acres 1211'
O
0
0
00
0
z I-,- -, .
- -
48.60'
34.5'
i 12.50'
S 06#49'43" W
i
0
O
0
00
w
AAl
31.5'
a
0
H t
UNDE GROUND
UTILITIES FROM POLE
AfEADOWBROOK
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 = 305.78
10°
LOT 3
ROAD
�o
I
tiiDr NEIFjI,' ,
1997
_ aJ
c>vI -- � -1 "3\
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL 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: JON M. BORDEAU do CATHY J. WEATHERWAX
GLENS FALLS NATIONAL BANK AND TRUST COMPANY,
IT'S SUCCESSORS AND\OR ASSIGNS
FIRST AMERICAN TITLE INSURANCE OF NEW YORK
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: AUGUST 20, 1997
'UNAUTHO11M ALTERATION OR ADDITION TO A SURVEY
MAP BEARING A LICENSED LAND SURVEYORS SEAL IS A
VIOLATION OF SECTION 7201L sus-D 010N $ OF T11E
NEW YORK STATE EDUCA710N LAVC
'ONLY COPIES FROM THE ORIOMNAL OF 1HIS SURVEY
MARKED 1M7H AN ORKII NAL OF THE LAND SURVEYORS
SEAL SHALL K CONSIDERED TO BE VALID TRUE COPIES.'
'CER7WICA104 INDICATED HEREON SIGNIFY THAT
THIS SURVEY WAS PREPARED IN AOOORDANCE NTH THE
DUSTING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED
BY THE NEW PORK STALE ASSOCIATION OF PROFESSIONAL
LAND SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND
ON HIS BEHALF TO THE TITLE COMPANY, WYERNIENTAL
AGENCY AND LENDING INSRTU710N LISTED HEREON. AND
TO THE ASSIGNEES OF THE LEND" INSTITUTION