1993-607 "'.
,� '.A' '
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date CIA,"_ /' 19 Z.1
This is to certify that.work requested to be done as shown by Permit No. 9-z—g n 7'
has been completed.
single family dwelling with
This structure may be occupied as a two chr attached .garage
Meadowbrook Road
Location
Robert and Nancy Murtha
Owner
59-5-19 .21
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 93-607
WARREN COUNTY, NEW YORK b
z
0
PERMISSION is hereby granted to ROBERT AND NANCY MURTHA
OWNER of property located at Meadowbrook Road Street, Road or Ave.
Lri
in the Town of Queensbury,To Construct or place a Completion of Single Family Dwelling
Lo
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
91 Mannis Road
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name
Fuller Construction
0
3. CONTRACTOR or BUILDER'S Address ZS
N
rt
4. ARCHITECT'S Name z
W
0
k<
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
k I Wood Frame ( ) Masonry ( )Steel ( )
fL
pJ
7. PLANS and Specifications °
Complettion of 46 ' x24 ' Two story Single Family Dwelling
11
No. as per plot plan, specifications and application including 0
two car attached garage; original permit issued #86-343 .
8. Proposed Use •
Single Family Dwelling
cn
H- n
178 . 00 OCTOBER 12 94 o
$ 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 fD
town of Queensbury before the expiration date.) CD
� f"r
H-
12th October 93 5 0
Dated at the Town of Queensbury this Day of 19 H
1-C o
SIGNED BY ,h(,/ xd Wa v for the Town of Queensbury t7
/i1d ng and Zoning Inspector
N•
L4
/,,s4564.
'� gTOWN OF QUEENSBURY �,y0 REVIEWED BY:
COMMUNITY DEVELOPMENT A.SPAR tI(,,.Ngng • 'ttrit•-
R9s'( _ ' pv
BUILDING & CODE ENFOR( EMEN ®Ce�jjV��U4 ' FEE PAID: 1, =�531 BAY ROAD co N ed ` .,_
QUEENSBURY, NEW YORK ,1804QTU S ' •ONI of " • PERMIT NO. ��
(518) 745-4447 Ta Bldgg, v
ar
`c' BUDIN ' RMIT APPLICATION
A PERMIT MUST BE OBTAIN eeZORE BEGINNING CONSTRUCTION. I IOPE7C , S
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILD G PE '. IT:p,a�-.
All applicants ' spaces on this application MUST be comp 4` ed and' the
signature of the applicant MUST appear on the applicatik fore 1Qq
73 Town of
OWNER OF PROPERTY: o�E�; NI pi N CV N' UR TH�+ Q •
Mailing Address : q I I'vIARIN I,c olt� , /�„FH\is-rz u-- N Y \' B10 •
Telephone Number(s) : Work 74 3-Igzf 3 Home 7g3-19 l(? her
PROPERTY LOCATION: l/2ad-oa-6,"aO`Pc / •
Tax Map Number: Section 5(1 Block L., Lot/Q, 2/
Subdivision Name: Lot No.
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ 909Q0O
c-e2Ap-e-.()- -iL-
NEW BUILDING: f
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
ADDITION TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL X Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL Family Dwelling
(NO CHANGE TO EXTERIOR SIZE) Office
X OTHER WORK (DESCRIBE BELOW) Mercantile
COrnPLE-rioN or, Euls;,cvc-bw),--)Nq Warehouse
No C'1 ANc,E7-o i ioo_ £,zE. 1---- "slpErucE Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
1ST FLOOR CO9 SQ. FT. !' 16pc/ -
IF ADDITION, USE OF NEW ADDITION:
2ND FLOOR 724 SQ.. FT. I U
OTHER FLOORS SQ. FT. �{{��
(not unfinished cellar or basemen ACCESSORY BUILDINGS:
/ Detached Garage - One Car
TOTAL FLOOR AREA: /(93`'7 SQ. FT. X Attached Garage - One/Two)Car
Private Storage Building
SIZE OF NEW STRUCTURE : Commercial Storage Building
Other
4Cp FEET X - 24 FEET
Foundation Type: CEMENT -LOCK Will any second-hand or ungraded
Number of Stories : 2 _ lumber be used? If so, for what?
(habitable space only) No
Height (grade to ridge) : 2(2 feet Type of Heating System: Gaczs
Number of fireplaces and/or woodstove (circle all whit —a- lies)
to be installed: 0 Electric / Oil ,Gas / Wood
Forced Hot Air / Baseboard / Other
PEON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
/5 ai3£RT /j�URTHA
9 NAME OF BUILDER/ADDRESS/PHONE• FULL c R ('ONSTP.(/CT/oN• 9 J op-N CL faooi, ifs, QWY. '792-2030
?NAME OF PLUMBER/ADDRESS, E) J7ICIC FI VA, f ii po/7 jriz a UsT/Lirtz-•�,102r, Q g y 196- ,',99
?NAME OF MASON/ADDRESS/PHONE: J U1NN SJEE , 1/2R (pemsccA , G, C Vou2T I12 °1 C
NAME OF ELECTRICAN/ADDRESS/PHONE: Ro7E/?T Ili/URTHfi/ inimlo /s , Qe % -79.1 3
DECLARATION
To the best of my knowledge the statements contained in this appli-
cation, together with the plans and specifications submitted, are a true
and complete statement of all proposed work to be done on the described
premises and that all provisions of the Building Code, the Zoning Ordinance
and all other laws pertaining to the proposed work shall be complied with,
whether specified or noted, and that such work is authorized by the owner.
Further it is understood that I/we shall submit prior to a Certificate of
Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN
drawn to scale, showing actual location p_f ro ect on premise .,
Signature ,� ---0-
(Owner, owner' s agent, architect, c ntractor)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
�iAk'�_ ENERGY CODE COMPLIANCE APPLICATION �34a��
� �> TOWN OF QUEENSBURY, WARREN COUNTY N/1 ,8,g
� 9000 HEATING DEGREE DAYS r') * %
gi ' OCT 1993
N
Compliance Methods : PART 5 - Acceptable Practice Method - p ¶oared
wn
1&2 Family Dwellings (only) % ,u bU
ee sal
PART 6* - Thermal Rating - Component Tr 'a e . Fp. ge �1' w
1&2 Family Dwellings; Multi-Fa .1 ''' bN>
Dwellings (3 stories or less) ?eel.ZOZO'S
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME : PROPERTY LOCATION:
h o3 E i- 11.4(2 TH4 ZI /`I g,4000J13ROOX, IQUEENS2 U y
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 163/ square feet
2 . Type of Heat - Electric Oil J\ Gas Other
3 . Is building mechanically cooled? Yes X No 4 . Percentage of area of windows and doors Over 17% X Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R .Jo
b. Exterior walls R /4i
c. Glazed areas R 2.2
d. Exterior doors R fd
e. Floors over unheated spaces R ,Uo;uC
f. Edge of slab on grade (heated building) R iva,UC
g. Basement/cellar walls (above grade) R !'?
h. Basement/cellar walls (below grade) R 47
i. Heating/cooling-ducts-piping in unheated space R Ai iuu
6 . ' Service (domestic) hot water heating device
Conforms to minimum efficiency per code /Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
.kpa1 cant' s Si na e ate Phone Number
'Y J'�“ stZLl 93 7? 3- i �i '�/ ?
r
INSPECTOR'S REMARKS :
1/KlIDIA�: IriuIJLE utrs',,,!IMitn11 iiiSrtt,l Ji Autii , 'RR,.
National Headquarters
1337 West Chester Pike, West Chester, PA 19382-6422
APPLICANT COMPLETES THIS SECTION . Date:9 7 2 q3
City, Town or Township PV P_ehs S. h D P.1 County L.tj r rzrr$.ro State AV
Location/Address #. 21 > CA 4nr.i 'eon �ni &7' ;-,
- e‘m (If L cated in Rural Area - Please Attach Dire•Joct tti's) (;j
` � '`'. Pole #
® r
Owner o U 12 A J�� %►' . Permit # , �
•
Occupied As JM OCT 1993 t� uilding: Newl�f Old
Occupant ple_ J
i W.I Area'in n' p. k1Floor #}}tc.): I Si— -t .2. �i,.
App. for: Wiring Service" or: r-a pue-r�p� for InsF1 fction: L,.-,u l i (.E%
Fee Remitted -$ Cash n Check n M.O. Bldg.Dept .,� Make Payable To: M.D.I.A
500 750 1000 1250115.. .0 2000 2250 25002,6D 000
Number of Rough Wiring Outlets Elect. Heat 25 $
Switches 2S G ZZtZ°
Lighting 7 'Zco Amp. Service Surface ni Dishwasher C14-S Range
Receptacles SO• - Water Heater Air Conditioner s/ Dryer Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for LI'S Burner
Amp. Receptacles ., Fractional H.P. Vent Fans
Other Equipment:
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5- 742 10 15 20 25 30 r 40 50 r 75 100
Mark Number - -
of Each Size
Applicant's
Signature '0 - i t1 Z -C License # Permit #
T/A `1 ,.--3 Pit U a + Ift-,C. Utility: , N, No
Applicant's Address: �� Aruni lcan Y INAME) (OFFICE L ON)
(City) Rueeru-siou24. (State) N )( ( ) )J2-8O i Servi a Re t 9r/6
Phone # 7E1 3 - 1 9 143 lectrician: 1
MDIA USE ONLY DATE RECEIVED: -.- DANEEPECTED� -
Correct Location: Same as Above n or: 1
Red Notice Label ElRough Wiring Outlets Sur e Unit, Oven
Switches Range / ,., Garbage Disposal
Receptacles Water)1/eater Dishwasher
Fixtures Air Conditioner Dryer
Amp. Service Equipm nt rner, Wiring & onfs for Amp. Receptacle
Amp. Service Conduct rs Pump V Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 /4 1/3'1/2 3/4 1 1,/z 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
/
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
• _ s E t. Heat
' y
'' ' .:-." AO
• -V i
CERTIFICATIONS US 0 ITIAL VISIT ONLY' . 1,11WITIFIED DATE .:CORRECT
FEE. - FEE PAID
❑ RW Progress: Inc.El LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
n L/A Owner CASH ❑
1-7 L/A _ Fee CHK #
.
(i IPA Municipal
INV #
Date: Other Side❑ - Utility _ •
Applicant ❑
Owner
Cut in Card n Temp # Date --
Final # • Date - INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 4/93
•
• TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY ROAD
QUEENSBURY NY 12804 •
. (518)745-4447
ARRIVE: 2 'OS---- DEPART: f-( „"I c INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED: (07&/lc4
NAME �� Or�
LOCATION/ ,/ ?frnv1
J �t//� �yDATE rr�am�- PERMIT f 75'7
TYPE OF STRUCTURE C-�1'.J (A) CZ
FOOTINGS FOUNDATION I- ACKFILL L�FRAMING `-�
ROUGH PLUMBING SEPTIC --INSULATION
FINAL ELECTRICAL S. WOODSTOVE OR FIREPLACE
NJA TES NO
CHIMNEY HEIGHT/H VE% EIGIT 7
PLUMBING VENT
EPOFING
IO• FI IS
PECK/PORCH TES ILING
RELIEF VALVES t..///
FURNACE/HOT W. E' ••ERATING
N E•1OR TRIM 'R V;C DOORS ✓/
✓ •
FINISH FLOORS: /
BATH KITC EN WATERTIGI! ®
OTHER FLOORS S E' 'ABLE MOW
OTHER FLOORS C.'PETED 'i\. It J/
smut CLEARANCE RA LING. /
SMOKE DETECLQf(S P/. ' - J/
)lA_,2'HRQQ$ FANS f ✓/
•
✓
PLUMBING FIXTUR•' �I/ VI MI
(WAGE FIRF N RE
pow ppowCLSSEI S ``-W
p NAL EL'CT; C MINN
S TE PLA V.;_AN . ;E• IPA
NAL SURV PLI • AN
OK TO ISSUE C O O' C
\ \ � kU 3I
CC V_1 C
G.•,.
TOWN OF QUEENSBURY
nJ` 531 BAY ROAD
I► ,' TTELEPHONEY9 (518) 745-4447
BUILDING INSPECTOR'S REPORT "
FINAL INSPECTION
REQUEST FOR INSPECTI`'"' RECEIVED
NAME
LOCATION /r,//.. /4
DATE SAIr PERMIT# 573-6p,7
TYPE OF STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION ,/
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING(
INTERIOR TRIM/PRIVACY DOORS';
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE %/
*OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS if \
SMOKE DETECTORS \
D99R- G{$S_ERS
BATHROOM FANS
ALL PLUMBING FIXTURES /OPERATING \
GARAGE FIRE PROOFING `.
*DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS %/
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
�STa v F kc: f_A-
o, COMMENTS: �
i\SCRR C5IVR1 1 tJ611\LIAD
p�c� 5�‘ 1E,G�RPC-v
1\ov5� PD 3 �o C � M65
5VR,1.2..NG, � E
\'` • \‘- Q F .) %.:,PCc-
DEPART tp;3)
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,I C.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 .
MUNICIPAL CERTIFICATE - ELECTRICAL APPRO L
' '45 4701
3 3 3
Panel Board No. Cert.N2 6 6 Cut-in Card No.
Owner *Mu t's 751-11-
Occupant
Location r2--/ M Cifi0 674-3 6/20-6 C2L-077&W
Installation Consisting of 5i-di tett/ istrel° tt( rz--s-
i
le 6 Pi4-NS
< 0.c) At *" ee- •
Installed By Lic. #
The conditions following governed the issuance of this certificate,and any certificate previously
issued is cancelled:-
This certifibate 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 making inspe o §at any time, and if its
rules are violated,the Company shall have the right to revoke ' certi • .
Date -7C1 INSPECTOR
Member N.F.P.A.,I.A.E.I.
w
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME ? AU ii7:7\---ti Pc
LOCATION ¢-./\o Q Lc) BaJD Q )C t--) /--D
DATE /Z .�� PERMIT # 73-6o
TYPE OF STRUCTURE .
RECHECK APPROVED
- N/A YES NO
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 CONCRETT.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR j • 9
REINFORCEMENT IN PLACE 1 .J
FOUNDATION/DAMPROOFING i /
BACKFILL APPROVAL
ROUGH PLUMBING 1
-PLUMBING-VENT/VENTS IN PLACE';'
PLUMBING UNDER SLAB Pa
.nFRAMING: - C,-WIC / \ x
JACK STUDS/HEADERS' I
BRACING/BRIDGING I 5,
JOIST HANGERS /
JACK POSTS/MATN BEAD
HEATING ROUGH-IN
NINSULATION:
FOUNDATION WALLS INTERIOR R- it X
FOUNDATION WALLS EXTERIOR R-
FLOORS di R-
WALLS T.,/ ; y L_ R- _
CEILING R--5 ,
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
17---Z4))141 ,i;(1)61 .10---Wel_ft- 11(W6----
j t1�i /01LiC0/1�1P�d161).—
Ai:&-c-1 itts-feevoti, _ ii,v4-6-_.--
ARRIVE [) 1///:--
DEPART 1,,-0)--
INSPECTO
•
/91
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ////6/9
NAME \ � / /LP.I h tA4-1
LOCATION d.8-7,441 A , .
DATE /// f b/9' PERMIT 'O
TYPE OF STRUCTURE _S
RECHECK APPROVED
- N/A YES NO
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 PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE / [
FOUNDATION/DAMPROOFING /
BACKFILL APPROVAL 1
LOUGH PLUMBING
LUMBING VENT/VENTS IN PLACE if
PLUMBING UNDER SLAB /
FRAMING: /
JACK STUDS/HEADERS I
BRACING/BRIDGING r;/ 7 .
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTE OR R
FOUNDATION WALLS EXT IOR R
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPIN IN UNHEATED
SPACES
REMARKS: ` �y
pL-u Al -I11JvLL P •
is5i \Afel-2S — .
f,
L--//
ARRIVE •
DEPART J
INSPECTOR
( iL1'
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 1 S 3
NAMt> yvj
LOCATION t4'`
DATE Go / (3)ERMIT # eft,
TYPE OF STRUCTURE
RECHECK APPROVED
, N/A YES NO
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 PURPOSE ON SITE
FOUNDATION/WALL POUR \\ !
REINFORCEMENT IN PLACE `{,,
FOUNDATION/DAMPROOFING / ;\
BACKFILL APPROVAL /
_ ROUGH PLUMBING '
PLUMBING VENT/VENTS IN/PLACE \
PLUMBING UNDER SLAB /`` \
AMING:: /
JACK STUDS/HEADERS
BRACING/BRIDGING/`
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-Iff
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
S(c
ARRIVE •
DEPART
IN PE OR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE. (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /,9//4/93
NAME /614M- )21 i,il5 �J
LOCATION
DATE !'07/4/0 [PERMIT it
TYPE OF STRUCTURE Lz'` � ° _5
RECHECK APPROED
R.,N/ANO
NI FOOTING IER�S�
MONOLITHIC OUR 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 PURPOSE ON SITE
FOUNDATION/WALL POUR ,{
REINFORCEMENT IN PLACE °,
FOUNDATION/DAMPROOFING ;'
BACKFILL APPROVAL ,
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE.A
PLUMBING UNDER SLAB ;"
FRAMING: /
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS r
JACK POSTS/MAIN BEAM s'
HEATING ROUGH-IN /
INSULATION: i
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / R-
WALLS 1 R-
CEILING R-
. DUCT WORK OR PIPING IN UNHEATED •
SPACES
REMARKS:
cTh
c \Ub c) (S
CO -TO
ARRIVE r'
DEPART` `,
s
/ SP CTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST OR INSPECTION RECEIVED
NAME ,e, 9/71-77ua��� ?./
LOCATI N
DATE //,/qj PERMIT # cf?�Gi 61
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
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 PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE /
KFOUNDATION/DAMPROOFING �/_ •-r'
BACKFILL APPROVAL l /
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE 1 i
PLUMBING UNDER SLAB I
FRAMING: # /
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS 11
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN /
INSULATION: /
FOUNDATION WALLS INTE 'IOR R-
FOUNDATION WALLS EXTEIOR R-
FLOORS R-
WALLS R-
CEILING
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE \\V
DEPARTS
V 'INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME )a €,I AIL
LOCATION
DATE /c 4/3 PERMIT # f 6' 1,67
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES ,NO
"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 PURPOSE ON SITE
FOUNDATION/W�LL POUR
REINFORCEMENI\IN PLACE
FOUNDATION/DAM OOFING j
BACKFILL APPROVAL
ROUGH PLUMBING ,\
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB, I
FRAMING: \ /
JACK STUDS/HEADERS \
BRACING/BRIDGING \ 1
JOIST HANGERS I
JACK POSTS/MAIN BEAM \J
HEATING ROUGH-IN
INSULATION: /
FOUNDATION WALLS INTERIOR R1
FOUNDATION WALLS EXTERIOR R ',
FLOORS l R-
WALLS J R-
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
(3) .Z y�2 y 'Kr" eft;, -
ARRIVE 7/ ' c�
fj/
DEPART //` 5J '! '
'INSPECTOR
v
S
T
F� Od.
� � ,, � , .ems. �'IJ• � � � �.,
APPRU
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I HEREBY (?ERTIFY TO
ROBERT It:. & NANCY E. MURTHA
TRW TTTLE INSURANCE OF NEW YORK, INC..
THAT THIS MAP WAS MADE FROM AN ACTUAL SURVEY ON
THE GROUND ACCORDING TO RECORD DESCRIPTIONS AND
Lbd�OF BOUNDARIES AND IMPROVEMENTS
4i�FI 44D THERE ARE NO ENCHROACHMENTS
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'UNAUTHORIZED ALTERATION OP ADDITION TO A SURVEY
MAP BEARING A UCENSID LAND SURVEYORS SEAL IS A
VIOLATION OF SECTION 7209. Sue -DIVISION 2 OF THE
NEW YORK STATE EDUCATION LAW
'ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
NARKED WITH AN ORIGINAL OF THE LAND SURVEYORS
SEAL SHALL BE CONSWED TO BE VALID TRUE COPIES.'
'CERTIFICATIONS INDICATED HEREON SWAFY THAT
THIS SURVEY WAS PREPARED IN ACCORDANCE IMTH THE
E)OSTING CODE OF PRACTICE FOR LAND SURVEYORS ADOP
BY THE NEW YORK STATE ASSOCIATION OF PROFE53:JAL
LAND SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONL
To THE PERSON FOR WHOM THE SURVEY IS PREPARED,
ON HIS BEHALF TO THE TITLE COMPANY. GOVERNMENT p
AGENCY AND LENDING tNSTITUTION iU-37M HEREON. AN M
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To THE ASSIGNEES OF THE LENDING INSTITUTION " lip ~
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NAP OF. A SURVEY MADE FOR
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TOWN Or wNOEOLEt.) COUNTY, N.Y.
• SCALE, I "_ $ o ' DATE, r�J 4 30, M 3
( Vadusen k Steves
LAND SURVEYORS,GLENS FALLS,NEV YORK
N.Y. STATE LIC. NO. 35617
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