1989-150 "ar,'. .-.rM ;< ,a-.. � .;,,, ys :, Yra,�,.. 9���°;?�„k„°�',�.�""`s;;�-•`x:: .-.'2,_ k .r.�-��arf
5a sfi
j CER,'T`IFICATE +C3F _ PLTANCE
TOWN OF +QUEENSBURY
WARREN COUNTY, NEW YORK
Ihte Apri 1 6 lq 90
j This is to certify that work requested to be done as shown by Permit No. 89- 150
{
j has been completed.
This structure may be occupied as a Single Family Dwelling w1Ad i tion
Location T-Jtv 'SJL ^1 L ez nr i ve
I
Owner Robert & Susan Hummel
Sy Carder Town Board
TOWN OF QUEENSBURY
I
Director of Bldg. Lit Code Enforcement
a
. BUILDING PERMIT
TOWN OF QUEENSBURY
No. $9- 150
WARREN COUNTY, NEW YORK G
w
PERM1SSlON is hereby granted to Robert & Susan Hummel
1
Lady Slipper Drive Street, Road or Ave. Leo
OWNER of property located at el`
in the Town of Queensbury, To Construct or place a Addition to Dwelli.M
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 . OWNERS Address is
slims
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2. CONTRACTOR or BUILDER 'S Name
S Gortrock Inc . 0
Cr
fd
3_ CONTRACTOR or BUILDER 'S Address rl
25 Alma Avenue
cr
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d. ARCHITECT'S Name
Go
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5. ARCI-IiTEC7'S Address
L]
G
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6. TYPE of Construction — (Please indicate by XD ~
`C
"C
1 Wood Frame ( ) Masonry i } Steel [ } R
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t•
7. PLANS and Specifications
No. 350 sq . ft . addition to building, as per plot plan , , n
speci. ficati+ons , and application
a. Proposed Use
Single Finaily Dwelling w/Addition
10000 c/c
$ 3��� PERMIT FEE PAID — TFi1S PERMIT EXPIRES IiC)VEIB 19 89 I:
IN
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the t
town of Queensbury before the expiration date.?
i
1
Dated at the Town of Queensbury this Day of April 19 $ t
1
t
SIGNED BY for the Town of Queensbury t
Building and Zo i rk I nspector
k
I
1
{
0
TLD N OF UEENSI3URY APPl. TCATTON FOR BUILDING AND ZONING PERMIT v
PatL-
F'ec r evecf J fJD
- 0Z? C G
Rev-Z / F QUEENSBURY
? LUECEIVED
r 'T
FCC F'cli[t S
1AUILDING AND CODES ULPAR111E T 'Date l.aaued APR 7 Z989
DAY and HAVIILAND ROADS RD I pox 98
PUEENSFURYoNEW YORK 12804Penmi.t No . SLOG. 8� CODE DEFT.
Tel . ( 518 ) 792-5832 Ext -204
x ! x a i, a w t x tit * sr * w w se tR ■ s w w w w x w w w w s . ■ s w • x
A 1 ER11IT MUS'C B4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECT IONS
WILL BE HADG UNTIL APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT .
All applicable spaces on this application inust be completed and the
4; puature of the a )aplicant must appear on the reverse side of this sheet *
* W W x x * * * ie w * A k * * x k *
'i' he owner of this property is : �tC3E7Er � r1' SiCS / �� f / � rr, 7rt � � ,+
P . o . Address J A cl Y ' S`/I PPO L l22:-
i' roperty location Pn - a 'TAX MAP NO . 2G2 vw 5
- k{ as there been any split of this property since October 1 , 1988 ? �
yes n_
if yes , Planning 'Board Review is necessary .
SUBDIVISION NAME , IF APPLICABLE LOT NO *
The person responsible for supervision of work as regards Building Codes is :
_5. &0C • ✓ C .0 ?
-o,) 1z
NAML P . O . ADDRESS TkL . NO .
Name of builder Address 7. e1
[Same of Plumber Tddress Tel
Name of Mason Address Tel
r4.1TuRE OF PROPOSED 4.0Rh: . ZONING INFORMATION ( Office use only )
_Cont;cructioe, of a new buildinrj ' ZONING DESIGNATION OF PROPERTY
..j.(Ad.3iGi0n to :a bkAilailig " PERMITTED PRINCIPAL PERMITTED ACCESSORY
A1L4.:ration to a t:uilding �'
(no c1 ,:, izij� to axc � rior Uiinensionu) " REVIEW REQUIRED - PLANNING BOARD ZONING BOARD
Ocksvr work SITE PLAN REVIEW # APPROVED HATE
(; KOSS AREA 01' PStOPOSGO, t: TRUCTUK-E VARIANCE # APPROVED PATE
1st Floor sq ft . 0 Remarks :
2nd Floor sq ft . w C014Pi.isPTIZ 1}+11•40144A1`ION hL:QULhGE) 112t.U64 .
' Si-r.4 of proli� rtY - is�S.�S� ft x 1 lam, ft .
Other Floors sq Ft . + "i�:tineJ builJi ,1.] i : ) yi -•: '?lL X �sJc rc .
( not cellar or basamant )
TOTAL FLOOR AREA sq ft . �r
L•'%1:;G11'ig k�u1l,.lintiJ
Of new !aLructur.: ft X ft
VoLwid:ac ion—,(l-Le f/s1,�L r:,aw Martial/ full " .Proposed builuing , di:: canc4 iro1,, liroljurty lino
Wirclu one ) r ft
Nue of scorieu (h"Ibic:.ble dace ) � ■ Front arils �^ 0 fc Rear yard
ilcighL { iJradc to 1^i.dga: } w ft . r Silo: yard:: .. /ta t7 Ct :and � ,� � l: c
� as „ If on corner , sutb:ack froin side scruc:c� i, C fc
If reuiduatial , noo of families 1
Noe of rooin3texcluding b:.th:� ) . OCCUPANCY 1MFOf:MA7ZOP1
No. of budrooma PRIMARY GUILDING
No * of bathroom:: ,Ono family dwelling
Nriukary lw.atialrf :;ysL �u, 1C- T Y f t "11ro family dwulliny
1'ylw d-f fuel Multipl.: ilwulliny / Number of units
No * of firulilacU4 to lyu iriscallecs� ,� ' &MMMONOW
Porut Aant occupancy
Will :a WQQJziLOV►: k+u ifi� L:rll"d? W
awwwwwwo
'1'rAnZA,Unt c�ucur�:arac y
Coantral Air carirlitiunitig:a '� 13usinuss
BUILDING STYL V,* PRIMARY STRUCTURE „ 3 ndusr.r ial
munch Cont.:iulwrary Lon c:aluin ; Gch=r
lie .addition , wl&"r will u::u b4j?
li.ala.:d ranch r anu.Lcan
!3plic l ,.Vel Old acyla: lsuliyalow
i:;. u Cod CoLUag4: Oclwr " ACCESSORY aUILDIWC-
oloni.al 1iOV 41YQwri Haase ~ pQtachad q ari4ga/ona car,/ two c" r/ car
( CIRCLL•: ONE. PLEASc ) ,Attachad garaqu/onas car/ cue czar/ Cif i'
• w w ■ w r ■ s a x • w w r n w / '�' Vriv" " aS LOC"90 building
14SW I MATED MA RK1?"i• VALUE of " �Orha rrW
r
] NF0R1.IATION ON BUTLOTNCrSPrCIFICATTC.•JS , ON TteVERSE SIDr: OF TNIS SHL•:Lvl', To SE CQMPLC'r .01
Form DPA 10/9a V2
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame fire safe , etc .
Will any second-hand or ungraded lumber be used? If so , for what ? L+
Foundation wall material c Thickness
Depth of foundation below grade (to bottom of footing )
Will there be a cellar?�1 Heated or unheated? Floor sq. footage sq ft
Will there be a basement? 6 .0 _Will any portion be used as living space ?
o , what
sof roof �slo e' flat/shed/other.Type o
f use ?
Type Material of roof
Size , wood studs�" X_�" spacing... "o . c . length ft . I/hs -
Jaists ( floor beams ) lst . floor eo� "X spacing / /. ` o . c • span ft .
ft _
Joists ( floor beams) 2nd . floor "X " spacing "o . c . span £t ,
Overlays ( ceiling beams ) "X " spacing "o . c . span ft ,
Roof rafters 0 krX/CD " spacing Z /ko . C . span -Y_ft .
Roof trusses (pre-engineered) spacing " o . c . span ft ,
Exterior wall finish "/0 e� of what material ?
Interior wall finish f} 49 e i y (L�G/ -If a garage is to be attached , describe materials to he used for FIRE SEPARATION: :
is there to be an opening between garage and dwelling? If so will a Fire-rated
door , enclosure , and self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof ft .
Depth of chimney foundation below grade ft .
Depth of fireplace hearth ft , in .
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private well ( including 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 I O N
To the best 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.
Signature �'2
Owner, owner's agent , archite contractor
SPECIAL CONDITIONS OF THE PERMIT :
By
1 i
TOWN OF QUEEN98URY
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 6J s
2 . Type of heat G ` C_
3 . Is the building mechanically cooled ? �Ll
4 . Percentage of area of windows and doors 1 �7
A . Over 16 % Only
1 . Uo value of gross area of walls , roof / ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a . Are foundation walls 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 ex osed to ambient conditions -
2 . R value of exterior walls
3 . R value of glazed area
4 . R value of doors. Jc
5 . R value of floors over unheated spaces
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab --��
8 . R value of heated basement / cellar walls ( above grade )/
g . R value of heated basement / cellar walls ( below grade )
Ion Type of insulation 0 b Lo r- %y.S
C . Controls
1 . Thermostat maximum heat setting { tii
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 . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F . Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating
Telephone No . [J C> rG cam• c r cy�YYt �' �3 1
( applicant ' s sigr...ure )
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAV'ILAND ROADS
QUEENSBURY, NEW YORK 1280&
TELEPHONE (528 ) 79.2~5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED �J ..............
NAME � —
LOCATIO
DATE -
APPROVED
YES NO
FOOTING1 PIERS
MONOLITHIC POu,� FORMS
FOUNDATION/DAMP—PROOF'I NG
BACKFILL APPRO4L
ROUGH PLUMBING i
FRAMING
ELECTRICAL ROUGH.Xni
INSULATION: `
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION :
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHE
,STAIRS—CLEARANC & ti RAILS
PLUMBING FIXTU ESI LIEF VALVEAA
INTERIOR TRIM/ RIVAkY DOORS
FINISHED FIAO S
GARAGE FIR EP FIND
DOOR CLOSER { )
SMOKE DETEC RS
FINAL ELECTRI AL INSPEC ON
FINAL APPROV L OF CONSTR TION
A SIGNED CE TIFICATE OF O CUPANCY MUST BE
OBTAINED F M THE BUILDIN DEPARTMENT BEFORE
THESE PREM SES ARE OCCUPIE !
REMARKS :
— INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES" DEPARTMENT
BAY & HAVTLAND ROADS
QUEENSBURY, NEW
YORK 92-5832O+I
TELEPHONE (518)
BUILDING INSPECTOR' S REPORT
REQUEST FOR TNSpECTIoN RECEIVED
NAME 4
LOCATION
DATE '/rG7 - PE T # ^/
APPROVED
YES I NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATTONfDAMP-PROOFING
BACKFIL.L XPPROVAL
ROUGH PLUMBING
' FRAMING
ELECTRICAL ROUGH-IN
ELATION: \
FOUNDATION \
FLOORS
WALLS
CEILING
FINAL INSPECTION :
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHESJS S
STAIRS-{CLEARANCE RA LS
PLUMBING FIXTURE /RELI VALVE
INTERIOR TRIM/P VACY D RS
FINISHED FLOORS -
GARAGE FTREPR FING
DOOR CLOSER (S)
SMOKE DETECTO S
FINAL ELECTRIC INSPECTION
FINAL APPROVAL OF CONSTRUCTION
.ry
A SIGNED CERT FICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE ,BUILDING DEPARTMENT BEFORE
THESE PREMISE ARE OCCUPIED !
r
REMARKS :
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HA VILAND ROADS
QUEENSBURY, NEW YORK 1280!&
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUES FOR INSPECTION RECEIVEDJ� Ck
NAME
LOCATTO
DATE PERMIT #
APPROVED
YES NO
FOOTINGIPIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
y FRAMING r'
ELECTRICAL ROUGH-
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL .INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL. PORCHESISTEPS
STAIRS-CLEARANCE •& RAILS
PLUMBING FIXTURE$IRELIEF VA�,VE
INTERIOR TRIM/P14TVACY DOORS
FINISHED FLOORSi
GARAGE FIREPROOFING
DOOR CLOSER (S) ':
SMOKE DETECTORS
FINAL ELECCTRICAZ INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
r
INSPECTOR
TOWN OF QUEENSBURY
BUrLDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURYo NEW YORK 22804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DRTE __Z/// � PERMIT ##
APPROVED
YES O
;'FO0TXNG/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING _
BACK.FILL APPROVAL
ROVG%g PLUMBING
FRAMI�-#VG
ELECT
S �CAL ROUGH-IN
NSULA ON:
FOUN SON
FLOORS
WALLS
CEILING
FINAL INSP TION:
CHIMNEY H GHT
ROOFING
SIDING u
EXTERNAL POR ES/ EPS
STAIRS-CLEARA E & RAILS
PLUMBING FIXTUR /RELIEF VALVE
INTERIOR TRIM/ R IACY DOORS
FINISHED FLOG S
GARAGE FIREP FING
DOOR CLOSER {
SMOKE DETECORS
FINAL ELECTR-�;bAL INSPECT N
FINAL APPROYIL OF CONSTRUC ON
r
A SIGNET CERTTFICATE OF OCCUPANCY MUST BE
OBTAXIVFD FROM THE BUILDING DEPA(zTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
SELECT BUSINESS FORMS (5091 848-5203
APPLICATION FOR ELECTRICAL INSPECTION
PL EASE BEAR DOWN YOU AR E MA I NG (4) COP ES
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
900 Haddon Ave., Collingswood, N.J. 08108
SECTIONAPPLICANT COMPLIETES THIS
Date :
City. To or Township L.0 C� { /l 5 ij.
I/ —County State
Location/Address 00� C!r . s / ,` /O
( If Located in Rural Area - Please Attach Directions) Pofe #
Owner y— r Xvisa
Occupied As nl
Permit #
Occupant '—
Building: NBWQ Old =
Work Area in Buildin Floor #, etc. ) ;
A , for: Wirin Service Q or;Fee Remitted - $ Ready for Inspection :
Cash Q Check Q M.O.
Make Payable To : ISCD, 1,A.
Number of Rough Wiring Outiets Elect. Heat Soo 750 iaoo iz5o c500 i750 20o0 2250 2500 2750 3000
Switches
Lighting Amp, Service Surface Unit Dishwasher Range
Receptacle!boe!0f
Water Heater Air Conditioner Dryer Pump
Nu Fixtures Oven Garbage Disposal Wiring and Controls for Burner
Amp, Receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS H.P. 112 1112 1110 1/8 1/6 1/a 3/3 1/2
Mark Numb 3f4 1 lbx 2 3 5 7+12 16 15 2q 25 30 AO 50 75 ip0
er
of Each Size
A ppl i can is
Signature
T/A License # Permit #
Applicant's Address: Utility : (NAME) OFFICE LOCATION)
(City) (State ) (zip) Service Request #
Phone # Electrician ;
+ •
DATE RECEIVED: DATE INSPECTED :
Correct Location : Same as Above [!] or:
Red Notice Labei 0
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp, Service Equipment Burner, Wiring & Controls for Amp. Receptacle
Amp. Service Conductors Pump Vent Fans
Mark Numb
RS Numb b r ' 1{ 1f12 1/10 1/8 1 /6 1f4 i/3 112 3/4 1 1V2 2 3 5 7br2 10 15 20 25 30 4p 50 �5 100
er
of Each Size
r„ " '_CC_ Heat $00 750 1000 F2S0 1500 1F54 2000 2250 2500 275E Boo0
— - Patrick J Dashreaw
PO Box 32i Hudsorm Fal 12839
FLIECTRICAL INSPECT10R
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT FEE PAID
FEE
0 RW Progress : Inc, 0 LKD E] Contractor
CFT Violation : Work Comp. F Inc.
L/A Owner CASH Q
Q L/A Fee CH K #
Q IPA Municipal Due MO #
1NV #
(:Date; Other Side Utility Applicant H
Owner
Cut in Card Q Temp #
Date
frz
ls�r� CERTIFICATE OF INSURANCEIgs�04,�d�"�'�D`PRR
j THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW EDidARi] Co NLlGNES AGENCY
1521Man Street COMPANIES AFFORDING COVERAGE
f Hudson Falls , IVY 12839 COMPANY
CODE LETTER A GENERAL ACCIDENT
126 i44, suB cadE
j IN COMPANY
SURED
LETTER
' GORTROCK INC . COMPANY
LETTER C
25 Alma Ave .
Hudson Falls . NY 12839 LETTER Y D
COMPANY
LETTER E
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, {I
EXCLUSION'S AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 11
f TR TYPE 4F INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION i
DATE (MMIDD" DATE (MMIDDIYY) ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
j GENERAL AGGREGATE
COMMERCIAL GENERAL LIABILITY PROD UCTS-C OM PLOPS AGGREGATE $
i CLAIMS MADE OCCUR.
PERSONAL 6 ADVERTISING INJURY $
j OWNER'S A CONTRACTOR'S PROT. EACH OCCURRENCE $
I
!{ FIRE DAMAGE (Any one fire) $ j
i MEDICAL EXPENSE (Any one person) $
If AUTOMOBILE LIABILITY COMBINED
ANY AUTO SINGLE $
LIMIT
ALL OWNED AUTOS BODILY
f SCHEDULED AUTOS INJURY y
HIRED AUTOS (Par person)
' BODILY
NON-OWNED AUTOS INJURY ;
(Per accident(
GARAGE LIABILITY r
PROPERTY $ 1
DAMAGE
EXCESS LIABILITY
EACH AGGREGATE f
OCCURRENCE 1
S $
1 �
OTHER THAN UMBRELLA FORM '
WORKER'S COMPENSATION STATUTORY I
A
AND 14C 0133247-00 07/07/98 07/107 /89 g 1009000 (EACH ACCIDENT)
EMPLOYERS' LIABILITY $ 1000000 (DISEASE—POLICY LIMIT)
OTHER $ 500 ,000 (DISEASE—EACH EMPLOYEE)
j
DESCRIPTION OF OPERATIONSILOCATIONSNBHICLEWRESTMWTIOMSISPECIAL 1'TEMS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
"town Of Queensbury EXPIR�N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Bay Road MAIL -� DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Queensbury , IVY 12804 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
A1.11THORI2E0 REPRESENTATIVE
+1e �,�
ACORQ 25-5 (3188) QACORD CORPORATION 1988
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (5I8) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR& 2NSPECTION RECEIVED�
NAME y �1 '1 1�
LOCATION
r
DA TE ERMIT
APPROVED
YES NO
FOOTINGIPIERS
MONOLITHIC POUR FORMS
FOUNDATXON/DAMP-PROOFXNG
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL RO H-XN
.INSULATION:
FOUNDA TXON
FLOORS
WALLS
CEILING
FINAL XNSPECTION:
CHIMNEY HEXGHT
ROOFING
SIDING
EXTERNAL PO CHES/STEP
STAIRS-CL RANCE & RAI
PLUMBING IXTURES/RELIE VALVE
INTERIOR TRIM/PRIVACY S
FXNISHE FLOORS
GARAGE tXREPROOFXNG
DOOR C SER (SJ
MOKE D TECTORS
FINAL ELEC XCAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAXNED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & IYAVILAND ROADS
VUEENSBURY, NEW YORl< 1280$.
TELEPHONE (518) 792-58.32
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSP CTION RECEIVED
NAME � '�
p
LOCATXON
GG{ f t'u'�� :,+�r APPROVED
FOOTING/PIERS f YES NO
MONOLITHIC POUR FORMS
FOUN"DA'TTON/DAMP pROOFING-�''^" ~-
BAC1C1; X-L Z, APPROV L
ROUGH PLUMBING
FRAMING
ELECTRICAL ROI7GH- N
INSULATION:
FOUNDATION /
FLOORS
WALLS
CEILING
FINAL rNSFECTION:
CHIMNEY HEIGHT
ROOFING t
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE ` RAI
PLUMBIlG FIXTUREN/RELIEF VALVE
INTERIOR TRIM/,,pkrVACY D06RS
F'INISHE`D FLOORS �-^----
GARAGE FIRl.pZ{OOFING
DOOR CLOSZ2k (,1
SMOKE DETECTORS
FINAL Ez#tcTR2'CAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE [)F
OBTAINED FROM THE BU3LDING DEPART \MUST BE
THESE PREMISES ARENT BEFORE
OCCUPIEDI
'1
REMARKS:
�.. � op
Aj
Of
I
INSPECTOR
TVWN OF QUEENSBURY F !.
BUILDTNg AND CODES DEPARTMENT
BAY S HA VILAND ROADS
QUEENSBURY, NEW YORK 1280*
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOUR+ INSPECTION /RECEIVED
NAME
LOCATION t
DATE PERMIT #/ -�
APPROVED
YES NO
FOOTINGIPTERS
M,{i,�70La''THIC, POLTR FORMS
NDATXONfD P-PROOFr"W
L'E3ACKFILL APPROVAL
ROUGH PLUMBINq
FRAMING
ELECTRICAL ROUGW-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS ,
PLUMBING FIXTURES/RELI,EF VALVE
INTERIOR TRTM/PRIVACY DOORS ' .
FINISHED FLOORS
GARAGE FIREPROOFIN
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL SPECTION
FINAL APPROVAL O CONSTRUCTION
A SIGNED CERT FICATE OF ON
MUST BE
OBTAINED FRO THE BUILDING DEPARTMENT BEFORE
THESE PREMISE'S ARE OCCUPIEDI
REMARKS: 0L /7
INSPECTOR
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