98-506 PER.TIFic A►.TE C7F CJ P't l"�TCY
TOWN OF +QUEENSBURY
WARREN COUNTY, NEW YORK
November 24 98
Otte 19
- 98506
This is to certify that work requested to be done as shown by Permit No4
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied a. a
Lar 54 # 51 LEHLAND DRIVE
w
LpCitf61X
MICHAELS GROUP , INC *
Owner
TAX MAP NO , 7 4 . - 2 - 5 4 By Order Town Board
_TOWN of QUEENSSSURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
VALUE $ 154900 OWN OF QUEENSg'URY No gFt �t7ts__
TAX MAP NO . 74 . - 2 - 54 WARREN COUNT,'', NEW YORK
PERMISSION is hereby granted to
TvjlF- Street, Road or Ave.
OWNER of property located at LOT 54 5
In the Town of Queensbury. To Construct or place a
at the above location in accordance to application together with plot pians and other information hall filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t. OWNER"S Address is
1810 ROUTE 9
LAKE GEORGEr NY 12$ 45
2. CONTRACTOR or BUILDERS Name
MICHAELS GROUPr INC .
IIIII
WIN
J CONTRACTOR or SUILOERS Address
JIM CHANDLER , PROJECT 14GR 1810 ROUTE 9
LAKE GEORGEe NY 12845
A. ARCHITECT'S Name
NEW YORK ]BOARD
AWL 7W*11jnARD OF FIRE UNDERWRITERS
B. TYPE of Construction — (Please indicate by X$ SINGLE FAMILY DWELLING
{ 1 Wlood Frame ( F Majority ( ) Stool I 1
V. PLANS and Spacificatlans
228�Q FT SINGLE FAMILY DWELLING WITH 2 -CAR ATTACHED GARAGE
AS PLOT PLAN 'SPECIFICATIONS
a. Proposed Use
SINGLE FAMILY DWELLING
289 August 21 2000
$ PERMIT FEE PAID - THIS PERMIT EXPIRES . 19
;if a longer PK
iod is nquWed an application for an eatendon maast be aide to the Building and Zoning inspector of the
town of (3ueensba+ry before ttw expiration tlat 21 August 1998
Dated at the Town of Queenabury this Daily of
19
Building and 20 aaa nNpaetiw
for the Town of OueenslwrV
SIGNED By _ - -
fI I
I
I
1
Bu olca�itlg pent-hot scatian
Dd f761-82561
rrr+rriry JT + rrrlxrru 742 1ay ROdd, querrubury , NY 12
{ lll crf Qreclrsbr3r jryr. Crrrl:r N "
I) IiV (; tts Cvvr FNF011 f
L1E.I i +l+l ltcelttitelrletlls lrritrr to isslsnncc PERMIT FILE NO.
or this l)crnlil:
A pelrrlil 111110 Ile ohlaillctl I)elirre - � ?Rfff-
17' E� PALV
�eginitillg+ colleltttclion. ' Nu irlsl+acli'ms r �1 jrrrlr,� Bt+*t71"cf Actionwill t ,� S ■
1c lrlado trftlil fillilicrtn! 1rlet rcce hrcivcci t—�1 + I UDC 1V I"L•EVALID 11trlr DIN+Lr 1 I; IM-111'. Alt
n1+r+licnrlRn' kliners etrt Min ropplicntitil+ AVIESwrLy-L iny;•
NRIII lx5 colrrllleted ntld 111c SI�{SIA%RISfC I'lartrrrng /Litxrri[1 llclrOlrnulfrling 1101veror
of (lie nliplicalll slftest nplKnr o11 the MIR I 51r10ivisioll I c User
it+plicalicru fiAful. rw.,lr,� Iteclentiou lice l'aylrletlt Sartre.
,I'11+111ie:lnt: L rre Al.icrlrtCT' n rts'11Uetr.? , Ilrc . C3wncr:
• ,I�,tllltC5S:
I £� r 4 llt?rr t 9 , 1 ulzc f3trrrnc] e? , NY r8 �dclress:
GGft 337f, +stone ( _) _�_..._ _ .�)j _ ..
00
l' 11U11C iy — �i r �� �� —
l+roper (y E crcalioel: Tax Map Number
" sect inn Block 1 A A
:�i111)cTiVISItr11 ldicrllL`: c�
or
rin'rt�ftc of l? nvl�crscu WORK : cF}'olPesrLtUC I STIMATEDMIN 0ARKET . fdGmll
__-�_ rlew Utti. 3_d_i. ttt� : crolt11srercial
res %ciertce / ''
11c1cii t ic7tt l: tr 13tt3 .l.cllrlg t OCCtr *hNCY InroaM.ATION a
r c! rt .clelicc J Catttlltet. cinl r* t: lulatry B" 13-ding -
1► .LIrC` 1: i1t . i. r+ n t:o Ull .i_ ic33. 1+c1 = X Sings+^ Family owell3.ngf .
r. esiclerice t ccrrumcrcial Two FamilyDwelling
Itesi.cTeltce / COltutterrial _ Family Dwelling
rro change to exterior.- rri. zc C)Ifice
16 Mercantile
Other work ( describe below ) manufacturing AUG
Other Q
IF
Gfto ^a5 ri1tC11 OF 111tCrFtJS 17 Sx'litrCi'ViIC : 3f ADDITION ,
will use
} st > ]_oOr . . , . . r; '� of rrem addi tlort be ? t
Other Floors , 0 • .
( riot u1lLinislted cellar: or bas� ertlen ACCESSORY TitlILDIMOS0
Detached Garage 1 c
S4 • T 1' . _K Attached Garagea
TOTAL FLOOR Att};A : Z Private Storage Tau ng
collttnercial Storage Building
s l zTa OF tsllw S'z RuC URE : Other
r FEET
will ally secoltd- 11and or ungraded
C'Oulrel.-tti_ vn 'l'y' t
re lumber: be used? if so , for what: ?
lrttrtlber of Stories S'3?EMS
( 11abiL- able Apace Only ) I era
Ttei lrt ( grade to ridge ) = feet TYPE VP' _ all
Si[ 1,
g circle ail whit =Ctboard./ Woad
Number Or iire [tinces a�nd / orrJwooilsLove Electric I Oil / Othe r
to be ittsl Etllec3 : �_ �/J ___ iror:ced Slot stir /
L?er �sc�tr responsible f .,.- >xt.r,rPrtr3 e loll f work as rcegarde to building
or Eric Rice P
codes ir3 : rt__( .�tatifI - _ Add esss
is�Vrt?2895 sr & - 6G & - 33yG
13ui3.cter : I lse I�liclt�re 5 Grlc�tilr 14c , r utlzgc{ oG eE3A 1:nff-A . kill 17-~ 7XO�51afte 8 - 798 - J3
L' lttltllrer : VrctVct I' It [,Zt.t31�1 p rorl16
yr� furl�l _ NY 1 3f1 � 18 - 3 "1f - 9922
ln%t [r{] Il : �___�J+LLC!-G".Ili '-�-r-.—vLLaL.._` LfClxtL3L3
Llectr1c1art : JLL ' --~
J]L:CLriIt;117C7N.' please .srgrr belary tefTet yell have ctrrefiiily read 1IrS afulerrlerrt'.
le
('O the best vC Illy l ttawledgc isle statcrucnts colnatited is' 111is alylrltcattOtt, stcatl�wa� to ether t Ue�dvnc oil
U1e Zoning +Ordinance and all
.,ills specif"tcations strhltlittecl , nve n true and conrlriete statellrenl of al preps
the cteSctibccl lxcslliaes anti t1►:11 all provisiotts of the r3uilditlg Code,
other lslws lrerlainillglio i el tile l woly tcCe7w1C tk sl'ustlrhawl ber I;its;ul>escrsied loucl ll at ywe shalI, whether l subroh prior and
a
ihnt srlt..11 wof k is :14all AS
Ccttiffcatc of Ocetrfr ,,Icy 'r o Certificate
r C lajillinitco cteal location ofof project a prEc 1Nts~spLC]IT PLAN y
tl licerrscd sut'VCy ,; di w
sigilaturc:
(vwlter, owner's agent, arcllitcCt, contractor)
IN
TOWN O - iEE SIB UR
742 Bay Rd., Cueensbury ,
�
NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
J
Date _.�.-�-,c�� _ , I9 ... .�
Permit Noe
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 it more than one appliance andfor chimney.
��;t appropriate boxes)
Applicant /fig 4bi( �f�l6- , C APPLIANCE (check apP P
Add ress IG 16, 14i, r r 1:3 STOVE: o Wood o Coal o Pellet o Gas
I REPLACE INSERT
��� � rtY zip /leI4LIS ' ( REPLACE, FACTORY UILT:
Owed ❑ Wood Gas
Wood
r - 0 FIREPLACE, MASON
Phone / `� c ❑ Wood ❑ Gas
Owner O FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address t ' ,� r` { IF NONeeMASONRY APPLIANCE;
Manufacturer:
'
Zip Model :
Phone CHIMNEY (check appropriate boxes)
* EXACT ADDRESS of proposed construction 0 MASONRY : ❑ Block ❑ Brick ❑ Stone
FLUE: ❑ Tile ❑ Steel
Size : . inches
CONSTRUCTION 1 INSTALLATIQN MUST 0 ACTDRY-BUILT: Model :
CONFORM TO NYS FIRE PRE & Listed Manufacturer: - Number:_
BUILDING CODE. CONSULT AVAILABLE Listed By :
BULL OF CO ENSBURY HANDOUTS ❑ Double Wall ❑ Trlpte Wall
To
[] Insulated ❑ Direct Venting
REGARDING REQUIRED INSPECT1ONS. ❑ Chimney Liner
Cashier' s Department Town of Queensbury, New 'Fork
Amount Collected Amount Refunded
Dept: Fire Marshal r J
Code plumber Title
A 173 3389 ( 19o ) Public Safety
A 233 2655 (230 ) Minor Sales
Fee Collected Fr Refunded to:
Address: ' {
Dated : Town Clerk or Deputy. "
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Fink & Goldenrod: Cashier's Dept.
1
p ica >oo n o r srnMg rxr cj 1 VUD
S .L.Q.TIC' DIS' .POrSA..L�.� P,E- � MIT
Lac:ttint>E tit property Itrr ittstallaLlat;: - r_ ,L) rj�L'�''���I,.nd Pllf p111zMrt` ttt3Httalrlt
Owner' s Name: Thg. u.i-cfuzvPs Grcou :a LLC Q
o t nhv (sP � k WV t 4 $ .3C; C3
Address: TSiO lZ ttt2 3
Installer' s Nalite:
F1tZedman Excawa.:in 3xt.1: i'hlu
dd
Phone 518 -639�4fJ35�_
Nunt Ile r of bedrOOe]ls (if residential }: �-
'1'nla{ daily now (residantiat - cnsitPule Ci' 150 gal . per L,c�lrcx�tts }:
rm flat r ltuiling = stccl, Stolle ai, srf Slt,l,c
tt��l
l .uant L� C.Iny !�r--1
_] fJlhcr _—Il]cl,4lt:
Soli Natur a: Sand 4�
�� leer
k;, round Water: at What. dci,tlt?
t3edrnck or ltttpervit,us Material: at tvltat delmLO
feet
Ikeatui redllta Le I stu n. 11cr ittch
Percolation 1'cst:
Nol. ltcquircd L'��
Musticipal
Wall � Other
Water 5up{yiy: �-�
if dntucstic water suFl,fy is a Wi °.I _I .: water stslti?ly frt,nt any septic t[,stttl+4ic,n is
{cci
PROPOSED S"Y51433M :
�-� Zi CO
ScIltic tank: Ts UUU gal. (sitinirnunt si�ra: 1.4(1Il 9a1 .)
?e , feet. 1 total system length
'l ite Field: cacti trench —
. Seepage l'il(s}: sturtthcr of
N /A 1 size cncit: ft: c Ct.
2 stone 1 del,4h or thickness
Sizes r,f Stone to be used: # ,
liG�i..1] SN[C; '1'hNiC S`tSlfilvt : (if required)
Number of tanks` _ N /A "Size of Cacti: _ gal.
lllarrrt system tired associated electrical work to be inspected by a certified
For yoter protection ' please note that P14irsurtnt la section 136-29 of tlse Colic of (he Town of
Qreeerxsbury , any perrrtit or approval grareted talricle is based upon or is granted in relietrece rr port
any rrxatery , nlisrepryttit0 Lion or frrilrrre 1'n make a rreaterial fact or circumstance knoll--" by or ore
befxalf0farx applieg, nis 512a11 be void.
f lrers:c rCrxrl the regulrxtiorrs t+ itlx resl+ect to this if p ftliccxrir�rr and rtgree to altirle Fry :here n" d' all
requirtrrtents o f the Tow" of (
]xrrc117ecr rrrt 'tary Sewage 1.7isposrrl Ordinarxce.
Vale:
Sielrrttrere r.• f resltC+n.siftle t3erstsn :
FIRE MARSHAL
TOWN OF clueENSBURY
QUEENSBURY, t4y 12804
8205
(51 a) 761
FIRE MARSHAL INSPECTION REPORT
REQUEST REC VED
PERMIT #
NAME
LOCATION
SCHEDULE INSPECTION ON M TIME
APPROVED
NIA YES NO
EXITS
AISLE WIDTHS
--
EXIT SIGNS
EMERGENCY LIGHT G
FIRE E"NGUIS RS
---
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
-
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TOYHEATING UNITS
RFQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
E - MASONRY
FIREPLAC FIREPLACE - FACTORY BUILT0 K �TO THIS DATE
REMARKS:
INSPECT
CV
i
RESIDENTIAL FINAL INSPECTION REPORT � !'1 '�AYN
Date inspection request received d�
office Na. (518) 761-8256 ��
Building & Code Enforcement e
Dept. of Community Development Arr�v azsn c� Initials
Town of Queensbury
742 Bay Road
Queensbury, N'ew York 1280,4
'PERNHT #
NAME DATE
LOCATLON
TYPE OF STRHC CoN IS
NIA YES NO
Chimney Height/"'$" vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete IntenorlExterior 'R.ailin 30
a to I& ' or more
Exterior Handrails, lcomes, �$ are risers
Interior Handrails rs bo ides 3
Grade 2% away fro fo ti
8" clearance to sill plate
Gas Valve shirt-Off ex $ed/regL�lataf 1 �� above grade �.....
Gas Furnace shut-off Thin 30 feet or within line of site
Oil Furnace shut-off t entrance to furnace area
FurnacelHot water eater a
Relief Valve(s) installed
Headroom, 6 ft. 6 in. on stairs
Basement stairs, 6 fl- 4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/U-,"doors/rrain entrance 36"
Floor Finish
BathroomIK-Itchen watertight
Interior Handrails Balconicsfl. rending l 8 in. or more
Railing, across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire doorldoor closer
Garage fireproofing
Garage penetrations sealed
l,urnace in separate room protected (in garage)
light ventilation per room
Safety glazing 18" or less from floor
Final Electrical
Site Plan/Variance required
Final Survey plot Plan
As Built Septic System layout required
Okay to issue C/C (Certif. of Compliance)__.._�_�—.
(CCI
Okay to issue terrrp_ C/oertif. of Occupancy)
Okay to issue perrnarient C7 (Certif. of occupancy)
TpWN OF QUEENSBURCEMENT
BUILDING & CODE ROAD ROAD
742 BAY p 804
t;}UEENSBUR45N4447
{ 5I$ )
I i4 sr 4..JQ�
pEmaL .1149FECTION REPORT
DATE IVSPVCTION RE SIT RE
VIED % �~
4
NAME
LOCATION PERMIT * u
y7RTE .1.-
OF STRUCTURE FRAMING
TYPE B,ACKFILL ��--
FOOT I'NGS,^___. FOUNDATION 1:7ASULATIC7N �—�-
SEPTIC._- oft FIRgpLAC{3
ROUGH PLUMBING WOOPSiO74
FINAL ELE
CTRTCAL S _ ---
CilIM EY HE GHT VENT
. PL�F,iG V T
Rc)OF IN
EXTERIOR FINISTEP .
ECFC Q CH
S IN S
RE IEF V V
W E
FURNACE S
N ER
TR IV CY
INI FL
O S
BR H K ^pCH W T
OTHER FLO RIG S
E B
OTHER FL40RS C ED
AR ET
'l CLEARRN
E C ILINGS
STAID
E'I'SC S ------
a SMU
f BR HR
pLUMKING----FIX
-----
� ION
FrryUNDA ION INSULA
GARRGE FIRE PROOFING �_�_---
DOOR C SIRS
' VARIANCE RE ._--------
SITE
c L7RV EY PLOT PLAN Jam_
3 Off{ TQCIO
OR £ C
U
MAP REFERENCE:
LEHLAND ESTATES SUBDIVISION
PHASE TWO
DATED: MARCH 27, 1998
REVISED: MAY 1998
BY: VANDUSEN & STEVES, LAND SURVEYORS
52
L\
an- D us e
�I .n
& Steve s
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Lie. No. 50135
I RIAUDIO M ALTERATION Olt AWWN TD A SURVEY
IIAP BEAN" A LICENSED LAND SURVE"M SEAL IS A
MOLATIdt W SEC, ION 72M SUB-MMM 7. OF THE
NEW Y= STATE EDUCATON LAW
'ONLY COMES FROM THE OROKAL OF TNIS SURVEY
NARIISD ON AN ORMOM OF THE LAND SURVEYORS
SEAL VWL BE CONSOE]® 10 BE VALID TRUE COPIES'
'CERTFWATRNS NOICATED HEREON SSIIFY THAT
NHS SURVEY WAS PREPARED N ACCORDANCE VAN THE
EWOSRNB CODE OF PRA = FOR LARD SURVEYORS ADOPTED
BY THE NEW TORN STATE ASSOCLAIM OF PROFESIMAL
LAND SURVEMM SAID CERT6TCANN3 SHALL RUN OILY
TO THE PERSON FOR WNOY THE SURVEY S PREPARED, AM
ON MS BEHALF TO THE TITLE COWAN► OOVE1aRMML
AODWY AND L04M NSOTurnam USED IERKK AND
70 TIE MORES OF THE LEOND NSff U7RX*
53
kv
o�
N
zo
���
N
54
•
Map of a Survey made for
55
MARK A. & MELISSA M. DUNBAR
Town of Queensbury, Warren County, New York
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: Mark A. dt: Melissa M. Dunbar
Evergreen Bank, N.A., its successors
and/or assigns
Fidelity National Title Insurance of New York
19,98
CERTIFIED BY:
MATTHEW C. STEVES. LLS NYS 50135
DATED: November 18, 1998
NO. I DA TE
DESCRIPTION
et NU V LM bLK id,
le 1'=30'
S-1
SHEET 1 OF 1
DUNBAR
DWG. NO. 89423-54
U)
I
74— 2 —54
+GENERAL INSPEG'?'IC?1V RF,� IRT
Town Of Queensbory inspection request received=
Tow Date
Dept. of Community Development
Building & Code Enforcement
742 Bay Road Arrive am/prn Delpart
& In
Queensbury. NY 128" �pector's baitials
PERwr #
NAME: DATE :
LOCATION:
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings+Ners
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 4$ hours fallowing the place t
of the concrete,
Materials for this purpose on site
FoundationlWailpour
Reinforcement in Place
n
Foundatio roofi
BackftU Appro l
Plumbing Under Slab
Plumbing Vent/Vern n Place
Rough Plunibin
14 ugh-
on
Foundati n Wails Interior R-
Founcla on Walls Exterior R-
Floors R
Walls R-
Ceiling R.
Duct work or piping in
unheated spaces R- ------
proper 'Vent, Attic Vent.
Franun
Jack. StudslHeaders
Bracing/Bridgtn'
joist Hangers
Jack Posts/Main
Air Infiltration Barrier_
Fire Separation 1, 2, 31 hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
GENERAL INS 'ECTfO►N REP_ RT
Town of Q►ieensbury Date inapectian req,aest recei•'ede .----
Dept, of Community Development
Building & Code Enforcement
742 Bay Road Arrive ieF�
Queensbury, NY 12804 �spectoes in .
PERMIT 4
NAME: DATE
LOCATION:
TypE OF STpUC
RECHECK
NI YES NO COMMENTS
I
Footm- SOFiers
Monolithic Pour Form
Reinforcement in Place The contractor is responsible fox
,providing protccuon from freezing
for 48 hours following the placement
of the concrete-
Materials for this purpose on site
FoundationlWallpour
Reinforcement in Place
Foundation/Dampproofin
Baclfill Approval
Plumbing Under Slab
Plumbing Vent/VcMs in Place
Rough Plumbin 1
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.� proper '`lent, Attic 'Vent
Framing
Jack Stud&IHeaders �-
BracinglBridging�__�-- --
joist Hangers -
jack Postsf M in Beam
Air Infiltration Barrier
Fire Separation 17 21 3. hour
Penetration Sealed - -
Fire Wall 2. 3, 4 hour
Firestoppin
FAX Pl4. 35513? l -
01
WT-23-S8 'FR1 04 : 56 PM BELL. TRUSS DEP`T, TV
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NOTES i S. Pal le6 sn•ed d.■d lasun C A9Cf 7 03 per lid CAlAKWII5
nwd far qt. wind so was prvuwonat 6y 90 rMh wind* at 34 n above tlra[ar7d IevL n& n0
t1 Two truss fytt oson GltiwGlced for uhe W- ced las Ve rand�[m,+a.
21 Tnle trues not bean dtrrW er• nee sxpesed 16 wlnd. Tits lua++bw II Inurau Ir■ 1 .33, end ti,r plebe G+ip 1ner.asr += i
1l load. 0Tli6atasarmdanNlevera aman9�21li�v are eXV assdrsoM4v1nd9 I Platcch" swatP 1I V to not oin0. of dl{neMiGral 45 It by 2A 11 erl■h expo 1
1.'33 7 5f37 '6 upltlt of leant 2 and 3S7 It upt'�f� sT iainC 1 S. 1
aF Ail Flster aMa i eonrtwc�ao [byne[hs's1 e, Itcussco bear" plate cap
of wlthrtarxi r79
di PSa+Ad0 rn"
51 This InIisra has been dralonad with ANSVl 3H 7 -530G c'+'taal•. ..`
LO SD CA8E;8t .'e„tendaicl 1^t.
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{ September 1S,t998
41I f
V
i
FIRE MARSHAL. V
jernk TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 751-8205
FIRE MARSHAL INS TION REPORT
p !
REQUEST RECEIVE _ PERMIT #
NAM E
LOCATION '
SCHEDULE INSPECTION ON I� c7c) 4�' c rt�
-- -- - AM M NYTIME
APPROVED
ZWA YES NO
E
AISLE WIDTHS _. . _--__ ..--- -- --
EXIT SIGNS --
EMERGENCY LIGHTIN�
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
— - -- --- -
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SY EM
HOOD INSTALLATIO
INTERIOR FI HES
STORAGE. -
CLEARANCE TO SPRINKLERS --
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE ---- -- - - - - - -
FIREPLACE - MASONRY ----- —.-._---- -.. _
FIREPLACE - FACTORY BUILT
REMARKS: Vok,TO THIS DATE
n+sPsuP PUa I NS E TOR
GENERAL INSPECTION REP[7RT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804 Arrive amlprm Depart
,�•^ Inspector's Initi
NAME:
f`�.c-� S {�4"" 3 PERMIT #
LOCATION: DATE : 1.c� * 4
TYPE OF STRUCTURE:
RECHECK
N/A SEES NO COMMENTS
Footings/Piers 1
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible f
providing protection from ing
for 48 hours follow: g the ment
of the concrete_
Materials for this site
FoundationlWallpour
Reinforcement in Plane
Foundation/Dam
Ba'ckFill Atwwoval —_
Plumbing Under S
or
Plumbing Venal is in Place
'ough Plumbin k "`
rHeating 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-
per Vin Attic Vent
.ng _
Jack BraciBridgin
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier k �Ptl �_ '�U [ a�}� t�� Ri•�,,i
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour i
Firestopspin \
GENERAL INSPEG'T'�UN � l
Town of Queensbury Date inspection request 11011 ed �--
Dept. of Commnunity Development
Building & Code Enforcement Depa � pm
742 Bay Road Arrive am/pm
Queensbury, NY 12804 1"pectoes Initials
PRRMIT # �`
NAME: DATE : d
LC)CATION:
~ryP'E OF STRUCTURE:
RECHECK
N/A YES NC3
C. S
1
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
Providing protection from freezing
for 48 hours following the placement
Of the concrete-
Materials for this purposean site
Foundation/Wallp ur
Reinforcement in Place
F on/Dampplr
kfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbin
Heating Rough-In
Insulation
Foundation Walls Interior R- --
Foundation Walls Exterior R-
Floors R"
'Walls R- --
Ceiling R-
Duct work or Piping in
unheated spaoes R-
Proper Vent, Attic Vent
Framin
Jack StudsfHeaciCrs--------~—
Bracing/Bridging�� ----
joist bangers
Jack Posts/Main Bey
Air Infiltration Barrier
hour
Fire Separation 11 2,
3.Penetration Sealed
Fire Wall 2, 31 4 hour
Firestowin
. TOWN OF QUEENSBURY
BUILDING CODE ENFORCEMENT
742 Say Road
s Queensbury NY 12204
1 (S IS) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
i
; J
Name
Locati o If
Date; _ permit #
SOIL TYP Sand am
- ^Clay-
Resul is of percol ati on Test- Inch
if applicable )1Rate-Min t
TYPE OF SYSTEM: al Leng h
i ABSORpTION FIELD : i
Length of each tr
{}epth of trenche
Size of stone
SEEPAGE PITS ' er- ft .
Size - fto x
gtone size size ype
Bldg , to Tank
Tank to Dist . Box --
Dist . Box to Field/Pit o artza
Openings Sealed? s
L.00ATIONISEPARATION feet
Foundation to Tank ti on -- - -- feet
Foundation to Rbsorp et
Separation ai' Pits No
Conforms as per plot Plan
pERTY :
LOCATION OF SYSTEM ON r�
1 ( circle one ) Le 'ht Side
1 Front - Rear ar
Middle Front
COMMENTS
SYSTEM USE APPROVED !
Arri v ed
Departed' � .
ui i ng I p, r
x,.np- r�a.w• c n.x� s�ast;:�tsn :.h�i�:`•:k=
-^-tia :-;r..+_r:, .e+,rtx.�w rRti. r^�� -s�>'.'w:xxsi 4 antbltm• :^+. s ,:...;`a:u•rycr.,'1
1
1
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k 1 Eml
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4
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