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1989-068 CERTIFICATE` OF OCCUPANCY TOWN OF +QUEENSBURY WARREN COUNTY, NEW YORK Date liF v This is to certify that work requested to be dons as shown by Permit No. has been coitspletsd. This structure may be occupied as a LnLocation 4 :3►ya ki cam e 1 l_ cL L. �1� By Order Town Board TOWN OF QUEENSSURY Director of Bldg. do Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY � WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Valente Builders °1 1 OWNER of property located at Street, Road or Ave r a 1 in the Town of Queensbury. To Construct or place a O FO r D P 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 Oueensbury Building and Zoning Ordinance. t_ OWNER'S Address is W 60 Sweet Road Queensbury , N . Y . 12804 ro ffi 2. CONTRACTOR or BUl LDER"S Name Same r [D 3. CONTRACTOR or BUILDER'S Address in Same 4, ARCHITECT'S Name 5. ARCHITECT'S Address tz SD klC i7 M F' 6_ TYPE of Construction — (Please irdicete by X) R XY�4 Wood Frame I I Masonry 11 Steel [ 1 [7,:P:L:At*AS and Specifications No. 29 ' x 42 ' 's of fourplex as per plot plan , specifications ,and application , including attached one. car garage .Prad use C 14 of Fourplex r C 25 . 00 c/o r $ ? l q 00 PERMIT FEE PAID - THIS PERM iT EXPIRES Orf obPr (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbu ry before the axpi ration date.) Dated at the Town of Oueensbury F3th Day of MM arc SIGNED BY for the Town of Oueensbury Bull dirrgand Zo Ong Inspector TOWN 3 = QUEENSIIURY APPP. ICATTON FOR BUILDItPC, AND ZONINC Pr: RrtIT Y I'u.r c ad rFeeRevL Pa td BUILDING AND CUBES UP :)'AXD'FNT Date 1.6aued 3AY and 114AVX LAJVD !ROARS RD I rsox 93 PUrRNSBvRy4NR[1 YOPK 12804 Pe,,,. ..t No . Tel. (518 ) 2-5832 >;xc 2a4 , . .� w t • # w •>t w l w w s w w w w w w w w w w w w ■ w a w w w ■ w * w w w A IIE- R SIT MUST Dq OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS WILL BE, MADE UNTIL APPLICANT HAS 12.I;CI IVED A VALID UUILDiNC PERMIT . All al� Pslicable spaces on this application must be collipleted and the 4- -iilpature of the applicant dust appear on the reverse side o1 this sitcet . �k 'rhe owner of this property -i, s-� : 4&vv7a� l' . O . Address TEL . S ' /�/ /� TAX 1AP No on CA�, C20 too Ilasptherelbeen any y split of this property since October 1 , 19Bf! ? yes , no — 7f yes . Planning Board Review is necessary . LOT NO . SunolVISION NAMEr IF APPLICABLE 'rhe person responsible for supervision of work as regards Pluildinq Codes ':DR srA� 4a t 1 k4. -ter~ NAbtl � P . O . ADDRG ` S TIL . NO . alp 4br Qut Address (oC� �S . ,�. r` - } . ( . ICY Tel ' L' E4ume of builder [.w R4}" y.' , Tel 1 - 33s 1 [4sme of Plurnk,er�Yta 'Ie�?=• PLumF3r t.d:trass 6 Gin .fix rk�• C.� rvL Li . Tel_- `0ic'i Name of Mason rv+ e yv%. C'0^rr / hddrasa l 43Lrwr-} fir- +� t 44ATURL: OF PRQPOSLO 6ORK : 2 NING. 1N1,60101ATION ( 0-f-Clco use only ) Cnrtscructior& of a now building i ZONING DrsicNNrion OF PROPERTY hddicion Co a bui14ir+q + PERMITTED PRINCIPAL ERMITTED ACCESSORY �Altur:.Lion tc, :a L,uildinq ` P _,^ ;rro Cli.,t4qu to .:xt .: ricer c� ixnen:.• ion:: 3 � REVIEW REQUIRED - PLANNING F30ARD ZONING t3oARD 00,ur wort: (<Je.crribo) ; SITE PLAN REVIEW tP APriROVSD HATE r GljosS AUEA of pRoPOSco, t;,rRUCTUk2 6 +. VARIANCE 1t APPROVED BATS 1st Floor f.S `I% I sq f t . Remarks : 2nd Floor S a sq £ t , COltnt.L'1'l IN1'of:f �A'rloN lts=c Ulltetl iilL.Uw . '" Sixo of larolxurty o Cr Lt K .- n fC . other Floors scl ft . * LxisLincJ s>uil.lin;] ( s3 Si=u ft ! not collar Qr basement ) TOTAL F I,OOR hREA ' s9 f t . • L xi :: cisZg louil� lin,J ;:; } U�. do ix. of new structures: foul+lotion-riicrl .lasa! aw+ i:al/ full vxoposed building , di.su"RCu fYout proji4irty lime (CLrralu onc ) # Y'ront yard {t"_5 f c Rear Yard, ' f t NJ . of acorioa (IL"111C4ble sPaCe ) * Sides: yards C--O et :And N�ighC ( clrade to ridq.: ) la ,4 ft • ,� It on cc,rnQr + ::uts):aak .frow side; acr4cuc� rc If residuncial , no . of families_ oCCuPANCY 1NFOP44ATICN No , of roomt4texcluding baths ) '7 ` %Io. of bc:drootns „ p jXjv,6RY BUILDING - No . or b ►t)►roa:u : One Rattily dwelling vritl"ry f"I"ly dwrllin•J 'l'ypc4 us° fuel f+—W'�-3 _ {�ttultil�l.: esswi:11it1sJ ! Number of unit No, of firej�l :ac4a to sac irtsc:a114clRf l�arjn"n" occupWiCy will :► wood =;LQv.: Trtan:;iunt QCCU' p:ar,cy t L.:ntr"1 Air cona,.Lu on:i III[ ': y! c - Liuginc ya tlUILDING STYLE, PRIMARY STRUCTURE , lnduwLrial Ocher tr+:rCh Con CaAllk.e.r..esry I.e.+? CzAbla if .addition. wtLiat will task;: )]es ? )i.ais::d ranch M:ansi4.1t Dural . x uplit luvol Old acyle Uur++J.a1aw " L::4OU Co CI Cotouuq+ Oct ' ACCLiSSCfItY l3UILDIIiC- Caloni:+l t:aw Down llausa U"-c1cha4a CJ:.ttt+ge/O O earl two caC/ c:ar ( CIRCLE QMl PL =:E ) "' ,NCt:aCriuG [J:arta+lcx! tlr: Cia ! testa cart �/ asin' a w a w w ■ w w • w w a w u w w w 't l+rl.V.:aC� zcor"ge nq sw •l• xr+ A•t' t: s� MA xs 'r V A LUU0 OL' 0cher COH ::'1' rtLJC"l' xU �4 _.a..� t 1NC�ORMATTOh Ckl BUTLDINC SprCTVTCATTONS , ON REVRrSV STDC OP "'TS SttC1- r, •sCs ne COMP Lc'r" I Farm DPA 10/88 V1 BUILDING: PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood .frame , fire safe , etc . L"12 Will any second-hand or ungraded lumber be used? If so , for what ? </ C) Foundation wall material C �epe .� . Thickness.-�C.7 sJ C' Depth of foundation below grade ( to bottom of footin x4s " G[ r Will ttc rc be a cellar? a Heated or unheated?_ �+"�2z.• Floor sq , footage t Will there_ be a basement? --- Will any portion be used as living space ? { If so , what portion? "— sq . ft . - Type of use ? Type of roof - s opecT flat/shed/others u--i} . Material of roofr 23G � Size , wooCi studs " X spacing` ,ram "o , c , length S, ft . Joists ( floor beams ) lst . floor 12 _"}CLZ.�a." spacing `! 6 "o , c . span /.41 ft . Joists ( floor beams ) 2nd . floor " ]{- `r 0 " spacing16 "o . c . span ft . Overlays ( coiling beams ) " X Y " spacing."o . c . span /-4 ft . Roof rafters • }� spacing_2�60 . c . span /�/ ft _ Roof trusse.s (pre- engineered) spacing Exterior span ft . Exterior wall finish e� c�9 S ry C Of what material ? CL�,a9.t �. Interior wall finish If a garage is to be attached , de r ' be materials to be u�i for VI SEPARATION : Is there Lo be an opening between Aarage and dweilln y � , If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? u-S Height above ?roof cn!�- to ft . Depth of chimney foundation below grq0e.,ALfft . Depth of fireplace hearth.��_ft . �1 in , r Water suMil y - Municipal or per ivate well ,/i C4 ,our ( ic SEPTIC SYSTEM _ Distance from ANY private well ( inclu ing adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) D E C L A R A T 1 0 N To the hest of my knowledge and belief 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 not, and that such work is authorized by the owner. n Signature Owner, o er's ent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT" ; By TOWN OF QUEENSBUR.Y WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following : 1 , Gross floor area__ �+ 'O 2 . Type of heat " 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors A . Over 16 % Only 1 . U value of gross area of walls , roof/ ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces YES NO a . Are foundation wails insulated ? YES NO 1 , If YES , what is the. R value ? 3 . Slab on grade YES NO a . If YES , what is the R value of insulation around perimeter of floor ? 4 , Is basement heated ? YES NO a . R value of Insulation 5 . Type of insulation B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions 2 , R value of exterior walls � n1 3 . R value of glazed area 2 � � 4 . R value of doors — 5 , R value of floors over unheated spaces 6 , R value of slab edge insulation - unheated slab ~� 76 R value of slab insulation - heated slab 8 . R value of heated basement/ cellar walls ( above grade ) fK 9 . R value of heated basemen��tl/cellars walls ( below grade ) 5 �� 10 . Type Of insulation C . controls 1 . Thermostat maximum heat setting D . Duct Systems_ 1 . Is duct system installed in unheated spaces ? YES NO a . if YES , R value of duct Installation.— b . R value of duct in other areas E . pjVin4 Insulation 1 . Size of hot water or cooling carrying agent pipe 2 , R value of pipe insulation F . Service Water Heatina 1 . performance efficiency r-1 2 . Temperature control setting maximum G . For Swimminq Pool Only 1 . Maximum heating a '.Telephone No . appli. ca tr s signature ) THE STATE INSURANCE FUND 109 CHURCH STREET, NEW PORK, N. Y. 10007 �' L E Cop V (212) 962-8900 CERTIFICATE OF WORKERS* COMPENSATION INSURANCE EMPLOYER EAttn : HOLDER POLICY 1vu7ut6EFt Valente Builders Inc ueensbury i 749 283-8 60 Sweet Rd e Hatien Queensbury N y' 12804 y* , NY 12804 =A-l PERIOD COVERED CERTIFICATE NUMBER DATE ISSUED 2/1/88 2 /1/ 9ia 1: > 'J 3/2 /89 U - THIS IS TO CERTIFY THAT THE EMPLOYER NAMED ABOVE IS INSURED WITH THE STATE INSURANCE FUND UNDER THE ABOVE NUMBERED POLICY COVERING THE ENTIRE OBLIGATION OF THIS EMPLOYER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK. IF SAID POLICY IS CANCELLED OR CHANGED IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 5 DAYS WRITTEN NOTICE OF SUCH CANCELLATION OR CHANGE WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. WR KSCA.Xe�xtWSa4�x�tta{ .jai-cit>Nfxbc3�G�'a5ck�ik}�f�s,Sc@if 3f�i7clt�UBii�d��Y'acllfa�s3tl�k.�c��c7x�tfe�+f-x�kk�R�tx-�:ilc�3c�x�id�S? Q�c!�'�x THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION . .. H. JACOBS DIRECTOR INSURANCE V-26.3 ( 1977) FUND UNDERWRITING . + „-,,.,„,,,v ,.c .--y� ti to L ,I 155UE PATE (haM['L7 DIYY) f PHODUCEH Ti-Ir:; GCi1 xT1,=iCATE I`; tsSUEO AS A hi :'1 1Lk yr rr,r.:(GAATION ONLY AND COt�1FER5: ^j .. E NO rrlCiiT`S Df'ON THE CERTIFICATE ►tC:LGr.R.I Trii i CERTIFICATE DOES NOT AMEND, r 'r COOL. I N'r;UR I NG AGENCY INC Li:TENG GFt x:.LTE" TN4 Cou4rTACL i rrfjriu U Ly l ViL POLICIE5 BELOW. s c 1 1 801 WESTERN AVENUE CL t:�11 r;tVi�:� r.r`r c7e'tLJildu COVERAGE . coi.IP N + ri TRAVE^ LF_ R5 INS CO AL, HANY NY 11P03 IP ' f1ORF /1U1; PLUMING MEAT I NC; R I DGE ---- 23 ( ANVA>f1A( K L ,_ r ., WJ�'C F' F2k C}F�p , IVY 3 SC 1 8 B --- I � Lr� r-rza �, ,; _._ 1 HIa !S TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE E1I:.EN i ' `.U�D l'O THE INSUHcp NAf.,i_u . Lj DJ Ful4 THE POLICY PEFIIDD INDICA TEO. i 334-f WYTHSTANDiF1G ANY REQUIFIEMENT, TERM GH CONDITION OF ANY COri'Flir..i: i vrt Cr-r ry,=F4 GOC U:..�NT vri I n klL:.r r.:. ! 3 U ..r•uC:H THIS GEIITIPiCA l C h1:.Y UE IS$UFU OR MAY PeFITAJ", THE INSURANCE .s.f'FUriiIED by TeiE 130Lr+`iL:.`.^. t)i_:+::r.":Ei ._iN k^`.^a ;;u U.1EC'I' 3-G r.l-I_ T+-tI: 'f Eili.=S, LICCLUSIC}NS, ANQ CCSNgI- TIONS OF SUCH POLICIES. .i . L I sILi7Y LknnITU' kN. THLYUSAt+.0 —� TYPE OF INSURANCE POLICY NLJr lbCR I I� .L r+. . �u rr i :.1 i i� —_____ _��._ _ ---- _.... . c n + „i;r;C r.;`:' ` i•C Lr wr_G..7 E A LI4*x 4 ;%. L4AWLITY f1 .I'f r`wY +� tl �.] +� __�.�. 6 ifs �' (LSI E] a✓ f� f /r r:ti)i.r+ r r Jr( CUI.1F'l9LrtLNS1vL rOitrrf ,•_ " _ .___ '__—__ ___ �...... .......—: YHLhiI:iE�'0±'EIiAiILINS u;JUFIiGROUNO ILE ._ x EXPLOSION & COLLAPSE HAZARO X PfiOOUCTSJS:OR1PLETEO OPERAMNS X eor<TaACTUAL X IfiULPENDENT WNTRACTOSS tiFiuAP FOPIN1 PHOPEATY DAMAGE. j ;'I- r.• 1VF,.�OL II'aJ Uk7Y $ PERSONAL INJURY 1 (d Fd ' AUTOMOt34LE LIABILITY ANY AUTO ALL JVJNt AUTOS (FRIV F'i S5.) OTHER THAN .. , :.. ..__:. . I ,:LL UVi rrrU AUTOS PftiV P:,'a= 1 I ._._..._ ... �. rflriEU AUTOS l pii:.Pe R I'Y "Oli-OVI NED AjTUS CART'+GE LIABILITY L 1G:iELLA Fpl;r>h D ~: OIHk.R rriAiY L.INla RELLA Fuk)o1 ----- r l l 111 r.Y WORKERS' COtAPENSATiON i AND 't; (Dl:JEAS:: POLICY ONILIl , E1,NPLC)YEr75' LIABILITY - A U.:>CHiPTICNTOr Ok'ERAYIONS.l L(X',., Ff : OPERATIONS OF INSURED F: y , ryr s SHOU. _D At4v OF THE AaOVE D✓w::i;t,4.'0 Ic's LIE CANCELLED L3EFOr�E THE E%- I TOWN OF QUEUNSBURY [i! PIETATiON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO i s NtAIL ,310 DAYS WRITTEN NOl�"CtF 10 THE CEii flttGATE HOLDER NAMED TO 7Hr AT T N ' D A V E' f !A l I E N ` Lcr—C, BU1r :=AILURE TO MAIL SUC+-t NDTI"::L t;HALL Ihi+'L`�;E NO OULIGATION ON UAL3iLtTY i BAY ROAD S� � Orr ANY KltaD r '" OC 4 THE COMPANY _I' . ,ENTS OiR REPRESENTATIVES_ . QUF. F,' N::f:IURY , NY 1 cr43414 v ._"PNTIV C R R T Z F C 3 F £ I+I S II R A H C E -- ---------- ------------------------------------------------- --- ..........------- -------------- -^ ^------------------------ I PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS ' I NO RIGHT UPON THE CERTIFICATE HOLDER . THIS CERTIFICATE DOES NOT AMEND, ' I Kinner ' s Insurance Agency I EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW I ------------- 2d26roadwagy ; ---- ----- ---- - ------------------------------------- -- P . D. Box 175 COMPANIES AFFORDING COVERAGE Whitehall , NY 12887 -------- (519) 459-0458 I COMPANY A National Grange Mutual Ins. Co , LETTER ---------- ------ ------------------------------------------ -- --- ------------------------------------- ---- COMPANY B ; I INSURED I LETTER .............____------______....... _______ , I William Manell & Gary Manell DBA I COMPANY C I M & M Construction LETTER ; 27 Blinn t . -_- _ _- _ I Whitehall , N . Y . 12982 COMPANY D LETTER I COMPANY«-`E------- LETTER - COVERAGES =------------------------- ------------===�=r=====_____-=--------- -____-_ ----_ --------- ,______=__ = ---- ---- ' I THIS IS TO CERTIFY-THAT POLICIES-OF INSURANCE LISTED BELOW HAVE BEEN- ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEBIOD I INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS I CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY. THE FOLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , 1 EXCLUSIONS , hHD CONDITIONS OF SUCH POLICIEH. ' ------ ----........ ..------------ - ------.... . ....____------____-------------_-------------------_____---------____-------____---_-- ; POLICY POLICY ; ;CO ; ' EFFECTIVE ' EXPIRATION ' ILTR ' TYPE OF INSURANCE I POLICY NUMBER ' DATE t DATE ALL LIMITS IN THOUSANDS I -------- ---- ' -.............-------------------^ ------ ' I --- ------- -- - --------------- ------ - I ------ ---- --- I GENERAL LIABILITY I I GENERAL AGGREGATE SC60n66 I A I Cx3 COMMERCIAL GENERAL LIABILITY I MP M35 580 ' 04/11/89 04/11/90 PRUDUCTS-COMP AGGREGATE 5£b0 06 t ' C ] C 3 CLAIMS MADE C T OCCURItEiiCE ' i PERSONAL & ADVERTISING INJURY 6300000 I ' C 3 OWNER ' S CONTRACTORS PROTECTIVE ' ' I EACH OCCURRENCE 530"013 I ' FIRE DAMAGE )ANY ONE FIRE) 550(a66 ' MEDICAL EXPENSE(AHY ONE PERSON) sS066 ------- -- - ----------- -- -- -- ------ ' ------- _- ---- -- --------- --- ----- ' - -- ------- --------- _ __---------------- i ' AUTOMOBILE LIABILITY CSL C 3 ANY AUTO ' ' ; ; ___............. ' -------------- I ' ' C I ALL OWNED AUTOS ' ' BODILY INJURY ' ' ' t C I SCHEDULED AUTOS (PER PERSON} $ ' ' C ] HIRED AUTOS ' ...........--_ ; ' ' ' C I NON-GPINED AUTOS ' ' ' ' BODILY INJURY ' ' [ 3 GARAGE LIABILITY ' ' (PER ACCIDENT) ' S PROPERTY ' DAMAGE ' S 4 __....... _.._ _ _ -_ ..- s_.. ... ..___ ___....... --_.._ , EXCESS LIRBTLiTY ' ' ' ' ' EACH OCCURRENCE ' AGGREGATE--- . ' I C I UMBRELLA FORM ' ' ' ' ' ------- ------ - ' ------ ' I C I OTHER THAN UMBRELLA ' ' i i 5 5 I I I STATUTORY S t A ' WORKERS ' COMPENSATION I WC F89 780 ) 66/21/89 66/21/90 I ------- - -- ----_"�'------- -'- ' ' AND I I ' ' $1000043 TEACH ACCIDENT) ; EMPLOYERS ' LIABILITY I ' ' $5tl6000 (DISEASE-POLICY LIMIT} ' $ 1(+M8i+0 (DISEASE-EACH EMPLOYEEIP --- ` --- ---- ' --------- ----------- i --------^ ' ------ --- I -------------- __--------- _---------------- I ' I -OTHER ---------------------- f ; i DESCRIPTIOH OF OPERATIONS/LOCATIOHSjVEHICLES/SPECIAL ITEMS ' CERTIFICATE HOLDER __________________ ________ CANCELLATION -_______-_______._____ ; I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- I ' Town of QueensLury ) PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ' Bay Eoad f 26 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE S I Glens Falls, N. Y . 12861 LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLICATTUH OR ) LIABILITY OF ANY KIND UPON THE C'WANY , ITS AGENTS OR REPRESENTATIVES . - ) ' ATTN. Dave Hatian ; ------^--------____-___-_--..--------------------------------------- - I AUTHORI2 REPRESENTATIVE f xMIMI THE NEW YORK BOARD OF FIRE UNDERWRITERS i BUREAU OF ELECTRICITY 41 STATE STREET. AL SW YORK 12207 Date Apppiica n ,"Vo. on file { k =t ' THIS CERTIFIES THAT only flee electrical equipment an described fie/osn aasd in[rK.shaced by wpp�licrrs mood am date aboee .ppllersion naaarafwer in userprensieee of x_ O : .f .'; It fill i •Fi ;: ltie:' I `: „y *.; { � I {{'e l .ir"? { : , i k. T:'?i :'. jSi ' y'.'s P: " 1 . �# in the folleaoing Location; 1 Baaernent Fat Fl. and FL. i; Section y ! s . Bieck Las x s was exomined on ^} , 'i " ! `: " } andjearMtad Co be in cosnpliance with the requirements of this Board. FIXTURE RXTURES RANGES CQCWIN4 LMECKS OVENS I DISH WASHERS EXHAUST FANS ACUtiS SWITCHES= GMJTLRTS kNCANDESCENt MADWESCENT I OTHER ANT. K- W- AMT. K. w. AMT. K.W- AMT. K. W. MINT. M. ►. _ DRYERS FURNACE A401MOS FUTURE APFUANCE MIMCERS SPECIAL RECPT TIME CLCfCks f:KL UNIT meAlren wATI-OuTm DIMMERS AMT. C W. OM M. R OAS H, P- AMT. N0. A. w. G. AMT. AMP, ANT. AAOS. TRANS. AMT. M. P. N SYSTEMPMAMT. wATTs O. OF F y 1 i l 1 SERVICE DISC0NNt4M< Ji6. OF S E R V I C E AMT, wMr. TYPE i A 2W ; X 3W 3 s 9w a Js +w '�' ERdreoNd. aP cc c d. No. or Mi.Isc CA MI•� r«o. of r+EurEwe s os NEUTRAL s OTHER APPARATUS: OL , . 2 T lt ! ,I'kr ;' _ LrtArjr �.' ;; 's 3•: l: 'E R '.' BRANCH MANA43ER Prt 1 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTlMIENT. THIS COPY O _CERTIFICATE MUST II T BE ALTERED IN ANY MANNE _ _ TooOF 4UE iSBURY BUILDING AN CODES ES DEPARTMENT 531 12804 QU£ENSBURY , NEW 'I TELEPHONE ( 518) 792_ S832 SUILDIN6 INSPECTOR' S REPORT CEIVEU REQUEST FOR 'INSPECTION RE NAME p � LOCATION PERMIT # DATE TYPE OF STRUCTURE APPROVED RECHECK NIA YES NO FOOTINGSIPIERIS MONOLITHIC POUR FORM RE;NFOR EMENT IN PFlACt ESPONSIBLE THE C 0 RRACTOR IS FOR PRO DIMS PRO?ECTIOlI FROM OR 48 HOURS FOLLOIII FREEZING�T OF -THE CONCRE?E SITE THE PLAC R THIS PURPOSE ON MATERIALS PO LL POUR FOUPIDATIONI IN PLACE REINFORCEM'EN FOUNDATIONIDAM"OOFING BACKFLLL APPROV ak ROUGH PLUMBING IN PLACE. PLUMBING VENTIVEN PLUMBING UNDER SLAB FRAMING : JACK ST D }H£AD S�. SRACINGIBRIDGING JOIST HANGERS JACK POSTS /M� B HEATING ROUGH- IN JINSULATION: E FOUNDAT IOTI L 4t FOUNDATION WALLS £7(T£RI R- FL.00RS R- WALLS R- CEILING ; ING IN NHE A E DUCT WORK OR SPACES R. : k kk , �"�. 4 l t ARRIVE ---DEPART --�. / INSPECT ` '/' '�' Tojjj� OF UEEN SBURY BUILDING AND CODES DEPARTMENT �,,y & HAVILAND ROADS QVEENSBURY0 NEW YORK 1280st— TELEPHONE (518 ) 992- 5832 BUILDING INSPECTOR' S REPORT I SPECTION REQUEST FOR RECEIV/ED _J�__— NAME LOCATION _ PERMIT # � DATE' APPROVED YES NO FOOTINGIPIERS RMS MONOLITHIC POUR FXNG FOUNDATION/DAMP P 00 BACKF'ILL APPROVAL �--- ROUGH PLUMBING FRAMING ROUGH�IN ELECTRTCAI LA NSULATION ' FOUNDATION FLOORS WALLS CEILING INSPECTION : FINAL. CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS sM _-- STAIRS—CLEARANCE & R.AIr. __ �--- PLUMBING FIX'TURESIRELIEF 'VALVE INTERIOR TRIM/PRIVACY DOO FINISHED FLOORS GARAGE FIREPROOFING �— DOOR CLOSER SMOKE DETECTORS INSPEC� ION FINAL ELECTRICAL F CONSORVCTION _ FINAL APPROVAL OR C�C _ GK T4 I5$� OIO MUST BE CERTIFICATE CDEpAUpANCY q SIGNED RTIFICATE OF OCM THE BUILDING OBTAINED FRO DEPARTMENT BEFORE OCCUPIED! THESE PREMISES ARE REMARKS: i t? ARRIVE_ � ../ I]EPAR� �1GCJ r P•EC� TOR TOWN Op Qi3EENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS 8C14 QUEENSBURY. NEW YO�RI TELEPHONE f52$ 7 ;`S$228 BUILDING jNSj?FZTOR" 5 !REP0RT REQUEST R INSPE TION RRCEIV �J NAME LOCATION DATE Q PERM APPROVED n YES NO s FOOTING/PIERS MONOLITHIC POUR P�M _ dd FOUNDATION/DAMP—P*OOFIN BACKFILL APPROVAL , OUGH PLUMBING � RAMING ELECTRICAL ROVGH�IN INSULATION: FOUNDATION '€ FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING STEPS EXTERNAL PORCH .�RAN � RAILS STAIRSPLUMBINGLFI tS1RELIEF vALVE INTERIOR TRIM RIVACY DOORS FINISHER GARAGE FIREPR ING DOOR CLOSER { SMOKE RETEC RS S . FINAL ELECTRIC L SPECTION _FINAL APPROVA OF OCNST RUCTION "T OK O ISSUE C O O BE A SIGNED CER TFICA YRE UILDINGE OF C UpANCy T DEPARTMENT OBTAINED FRO 'THESE PREMI ES .ARE CUPIEDI REMARKS : ARRIVE I]EPAFt"5 — IN PECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12B04, TELEPHONE ( 518 ) 792-5832 BUILDING INSPECTOR' S REPORT Y (r REQUEST FOR INSPECTION j RL�'C/EIVE'D �`'"", lele --- NAME /p, ft LOCATION DATE z G FERMI # & APPROVED YESI NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP- ROOFING` BAcKF -rLL APPROVA ROUGH PLUMBING FRAMING ELECTRICAL ROUGH~ INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : r CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHFFS/ST S ,STAIRS-CLEARANCE & ILS PLUMBING FIXTURES/RE EF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FTREP400F.ING_ DOOR CLOSER ($) SMOKE DETECTORS FINAL ELECTRIC L INSPECTTO FINAL APPROVA OF CONSTRUCT ON A SIGNED CERTIFICATE OF OCCUF CY MUST BE OBTAINED FROM THE .BUILDING DR P TMENT BEFORE THESE PREMISES ARE OCCUPIED: REMARKS : I PECTOR TOWN OF QUE'ENSBURY � BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 22804 TELEPHONE ( 518 ) 792 -- 5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION / z DATE APPROVED YES NO L.PooTI NG1 PI ERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACY.FILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING _ DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED: REMARKS : ell eL [ L INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY S HAVILAND ROADS QUEENSBURY, NEW YORK 1280!9- TELEPHONE (518) 792 --58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR XN_aPECTION RECEIVED NAME LOCATION DATE PERMIT # OF APPROVED YES NO OOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRSCA' ROUGH- ZN INSULATIO FOUNDAfir( N FLOORS WALLS CEILING FINAL INSPECT-T O CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PO HESISTEP STAIRS-CLE NCO Sr RAILS PLUMBING F XTURES/RELIEF VA INTERIOR RIM/PRIVACY DOORS FINISHED LOORS GARAGE REPROOFING DOOR C SER (S) SMOKE ETECTORS FINAL E CTRICAL INSPECTION FINAL A PROVAL OF CONSTRUCTION A SIGN CERTIFICATE OF OCCUPANCY MUST BE OBTAIN FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: i INSPECTOR YOU ARE HEREBY REOUESTEP TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY TEMP s THE UNDERSIGNED 1 r coaNrr CITY aR 1 ... /CJ.�r-•"'•' -/ if S,/L'�"� / 15 S7 ~K J+I [,4.R-�.^."vf STREET AN NO OR RC4.61 PG-E NUMBER Le BETWEEN N.{p CROSS STREETS IS PR ISES LOCNED9 SEC7yJN BLOCK LOT OCCUPANT'S AME BUILDING CK:CUPMICY Sri OWNER' NAME AND AD ,/'J� HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM T OFFICE WORK TF No NUMBER BUILOI IS NEW OLD ❑. WORK IS NEW ADOITIONAL ❑ DEFECTS REMCh'ED ❑ LIST BELC7W ALL EQUIPMENT WHICH YOU INSTALLED Luca NUMBER OF OUTLETS � f Fixturrs Receptacles MOTORS HEATERS BRANCH OFFICE USE CIRCUITS ONLY tlOn � Attach'l , h PentlarH Bracket No. Type Each N"s Each N4.H.P waft GaWugGe INSPEC."TION Ceiling Svmlide pecaP'la OUT- SIDE SUB- EASE BASE- MENT 161 FL. 2nd FL. 3rr1 FL. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: TH4S APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED. BUT IF AT TIME OF INSPECTION, THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT, AS PROVIDED BY THE APPLICANT. FCHARACrER FEEDERS ELECTRIC SK➢NSILAMPS TUML �T' LHDRK ❑ EXPOSED GAG TUBE SIGN RANSFORMERS OFCONCEALED BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER CAPACITYRS BUILDING MANUFACTURER OF SIGN OVERHEAD ❑ UNDERGROUND ON REOUESTED ON(OR AS NEAR AS POSSIBLE) !W ST.E.I4TER kPPIyw'"TIS I 1 IOENTIFI[`i►T11 MUM� IsdK11D DELAYS BY RrING FULL ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN RAP L TN7N MAY BE RETURNED_ PRINT NAME AND ADDRESS NAME OF APPLICANT DATE OF APPLICATION WON .d;w STREET ADDRESS TELE HO ND. CITY OR POST OFF bCE ZIP CODE LICENSE NQ WHEN APPUG4BLE E -- ❑ 85 John Street ❑ 41 State Street I=-] 5B4 Delaware Avenue I--] 217 Lake Avenue ❑ 202 Arterial Road NEW YORK, NY 10038 � ALBANY, NY 12207 1 BUFFALO, NY 14202 � ROCHESTER, NY 14608 I SYRACUSE, NY 13206 THE NEW Y©RK BOARD OF FIRE UNDERWRITERS