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1989-267 ! a +CERTIF*IC TT OF ""CU'PANCY TO W'N OF QUEENSBURY WARREN COUNTY, NEW YORK f f Q� Date October 16 l9 89 f 7h18 is to certify that work requested to be done as shaw.n by pertnit No. 89-267 has been completed, fThis structure may be occupied as a Singple EAMJlv Qw 11 i ng Location i1 1 { owner Francis Dingman I I I ti By Order Tpwn Board f TOWN OF QUEBNSHURY /C tll ` f Director of Bldg. Code Enforcement X BUILDING PERMIT TOWN OF QU EENSBURY No. 89-2b7 WARREN COUNTY, NEW YORK 1 too PERMISSION is hereby granted to Francis Dingman III too OWNER of property located at Lot 100 Mohawk Trail Street, Road or Ave. in the Town of Queensbury, To Construct or place a Single Family &wel i i ng 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 Zan ing Ordinance. 1. OWNER'S Address is R04 Box 339E Cnadleberry Drive Queensbury, N . Y . 12804 2. CONTRACTOR or BUI LDER'S Name -rl A.J . Jones r+ 3. CONTRACTOR or BUILDER 'S Address Big Say Road Glens Falls ,N _ Y_ 12801 4. ARCHITECT'S Name r— C e'F CD O 5. ARCHITECT'S Address CI fL 7R' 6_ TYPE of Construction — [Please indicate by X} � XX) wood Frame 1 } Masonry [ Y Steel I } r.J 7. PLANS and Specifications No. 26 ' x 66 ' single family dwelling as per plot plan , specifications , and application , including septic , and attached two car garage . 8. Proposed Use 47 Single Family Dwelling :. tc ttr c/o incl _ -n $ 277 _ 00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 1 1989 (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 axpiration date_l Onr Dated at the Town of Queensbury this Day QJ HaV 1189 SIGNED BY for the Town of Queensbury wilding and Zoni rid Inspector Mae tQ TOWN OF QUEENSBURY APPI. ICATTON FOR BUILDING AND ZONING 'PERMIT Va,tC. >?ec.iev ed 5 ^ �` -S5�`J' --+• f•a -,:" "opt scF.+TM.'1BUfiY Rev.tewed Fee Paid hUILDINO AND CODES 131 "PARODIFN ' Va-te 7adued 8LD©. a CODE DEIST. BAY and f]AVX alvp ROADS RD 1 BOX 98 0UEEM3BURY, AfEiJ YOR?: 12804 PeAuru..t No Tejo ( 518 ) 792ow5832 £xt -204 x x * * x xx x x • x x Yr x x x re x x x x x r x x x x w x w s x x x s A PER?-IIT MUST 1113 OBTAINFD BEFORE LEGINHING CONSTRUCTION . NO INSPE% CTI ©NS I+' iLL BE MADE UNTIL APPLICANT 11AS RECEIVED A VALID BL; ILDINC PERMIT . All applicable spaces on this application must be completed and the sipuature of the applicant must appear on the reverse side of this sheet . 'tile owner of this property is : P . o . Address Q 9� So>( 9 �Q t� Le JJ ez Djv r� TEL 79d 1 .2 fir'' Property location Lpf / Qa /c'1y � GLw is raA �'< f& 00 "l TAX MAP No .r'.�'/'� j �! teas there been any split of this property since October 1 , 1988 ? Z4 yes no If yes , Planning Board Review is necessary . SUBDIVISION NAME , TF APPLTCAnLE t-��C 4" t• 1J_75 _ LOT I O{ -. / The person responsible for supervision of work as regards Building codes is : /3 , &,, k P. ? 31Vol NAM P . O . ADDRESS TE: L . NO . Address s s F lay e'i A- � Tel 7 'y yr` -- � { 9 3 laarne of builder �Ar40 ►`t /'#-fLllc. ' '{ �!. �" ' '- Name of Plumber �Tel Name of Mason opal Address Tel f4ATTURE OF PROPOSCP 6ORK: ZONING INVORHA`1' ION ( Ortice use only ) v ronstructiorr of a etuw building ZONING 02SICNATION OF PROPERTY Addition to .:a building r PERMITTED PRINCIPAL PERMITTED ACCESSORY �ALLer"Li4n to a Luilding r " ( jko ch1 j11qu to .:xc + rior dimenLions ) " REVIEW REQUIRED - PLANNING BOARD ZONING BOARD OCha3r work (,l �,criL>a ) ; SITE PLAN REVIEW # � APPROVED DATE GROSS AREA OV PROPOSED% STRUCTURE " VARIANCE # APPROVED PATE 1st Floor eo :2 z. 6 sq ft . Remarks : 2 n d Floor � y q Z- sq f t . W C014PL Look- 1}+tyaf.LM'L`IGN I(LQU 11tL•;D 11L:L(AJ . ft .Q sqC-zaiL. * SiZQ of property /A/ 0 fL x / 45 Other Floors -[ f Sixu ( not cellar or basement } latistirti;l 1�uil,lil�+] ( :) TOTAL FLOOR AREA Z 'i C& D sq f t . * LxiSLin$ Duildinll (:a ) Use r of now structures 2cP f t h f4(0 ft d:q .A.' l u�sa �daLicrn-liicrjslal./crawl/laarti�.l full It Proposed builring , di:atancu irow pru1-)4rty lino ( circle one: ) NI, Front yurd CsJo ft hear yard CcoC? ft No . of stories ( h:Ab.: t:Ablc space ) Z 3 7 Et :and `7 ft r-------- . Side: yards � lluiclht ( grade to ridge ) 2.{,� r_ ft . If on corner , a:utb:xCk .from Slau :true: If reaiduncial , no . of families No . of rooms ( excludinal b:athsz ) 1 ' OCCUPANLY INFO MAT1CN No, of bedrooms ' �, PRIMARYIsllILLSIN[: - No4 of bachroosus :�.+1't.- * Ono family dwelling tirimary huatitkii sy�tu��4_ GLifOT A-1 �� ,Iwo fam.i.ly dwelling 'ry,lau cif fuel gj ' multiple dwelling / Number of units No . of fireLal3ee4 Lea L�,: in :LialiLd [ r PerltianOnt occu,par►cy Will :a wood sLovu tic; insLalla:d"? w.r.a 'L'rlan::iarwt caccuLuae�c:y C.vnLr:al Air coikditiuni.lkg '? �3�6 � L}usinc:ss BUILDING ;TYLC, PRIMARY STRUCTURE „ Industrial 1"Ikch Cont.ajitpor"ry I..on cabin Ocher 1:... isud ranch Dupla:x . If addition , wl'leat will be? Uplit laV41 Old style Isulky.alow C.a u Cod CoLt:ago Ot1w r " ACCL tiSORY 13L1ILD2NG- CQ Lon L:i Lrt1w 'mown House ' Dtoxachad g"rk4gQ/onC curl two car/ car ( CIRCLE: ONE PLEASE ) " �Atta.:Y14U gar:agu/oily: car/ two czar/ t�i Gia c• • x x • . ,torsago building L: .;TIMATHD MAR'Kr'1' VALUE OF ' .other CDl1 ::'VkUC '1` IUN Now ow NIPS _ � L+2L9l9.4.rAa INPORMATTON ON nUTLDTNC SPECII` ICATIONS , ON REVERSE SI01? OP T111S 5'.HEET4 TO Be COMPLETED ! 'Orm BPR 1D188 Vol } BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . u-P 002 1P0-,0q- 4 t Will any second-hand or ungraded lumber be used? If so , for what ? o -- Foundation wall material C- <� L Thickness �r Depth of foundation below grade ( to bottom of footing ) '- le Will there be a cellar Heated or unheated? .v � Floor sq , footage ft Will there be a basement? �.5Will any portion be used as living space? 4Z ( If so , what portion? sq. ft . - - Type of use? Type of roof - sloped./fiat/shed/rather t Material . of roof tfezt Cp . Size , wood studs "x e, " spacing " o . c , length `gr' ft . }.E .+� 6.) Joists ( floor beams ) lst _ floor 2. " X r O spacing^14 „ "o , c , span.__t_j ft . Joists ( floor beams ) 2nd . floor Z "x pp spacing s^o . c . span Overlays ( ceiling beams ) "X "' spacing "o . c . span ft . Roof rafters "x '" spacing o . c . span ft . Roof trusses (pre-engineered) spacing Zq " o . c . span_eft , Exterior wall finish 14o /t4 ' 'Z _ Of what material ? C4tF 9 - M Interior wall finish C, _ If a garage is to be attached , describe materials to be used for FIRE SEPARATION : � a A Pt&GF aejz ti 7 C2e+sy rL. Le3 owSGC.r— c.E • s rwgz / -YRr" Is there to be an opening between garage and dwelling? If so will a�Fire-rated l2rx/c door , enclosure , and self-closing device be provided? -G $ Will a flue-lined chimney he installed? -+�h Height above roof �� ft . Depth of chimney foundation below grade �t . Depth of fireplace hearth ft , in . Water supply - Municipal or private well 1✓Ir rpv1G, (I) e+ � 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) DECLARATION 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 SIIILDING CODE, THE ZONING ORDINANCE, and all I 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 _ Owner, owner's agent ; archfT­ect/6nt6d1cTbr SPECIAL CONDITIONS OF THE PERMIT : TOWN OF QUEENSBURY 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 2- 7 +-+ t3 5a.., j4vice rt . 2 . Type of heat t*140VV — C: 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors !wS Xo 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 Be Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions /g- II -F- . CSy . 9-= a 55" 2 . R value of exterior wails . C-1 . R = L1 3 . R value of glazed area ,2, . $ rwSL.) 4 . R value of doors f� = tq . g FoAPr F! iC C c p 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab Z " (Zic, 1,;o !z `IN. y 7 . R value of slab insulation - heated slab /Z � I q_ k y Be R value of heated basement / cellar walls ( above grade ) /Z^ !T 5F* "14tC i5o ,^s�`r ouJ 9 . R value of basement/ cellar walls ( below grade ) V 10 . 'Type of insulation lr- C f;^-Cte> ►Z- M A p 'L�fZ. r r , Z1 42 67IL1> C . Controls 1 . Thermostat maximum heat setting - 7 j D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES O 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 I . Performance efficiency 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone No . ( a lican s gnature ) f�f APPLICATION FOR s! � SEPTIC DISPOSAL PERMIT DATE .� - _ 9 LOCATION OF PROPERTY FOR INSTALLATION of ,/d-V //Idh +� Owner's Name: ►C►'ui►G � r ✓ rjr Telephone: d9 �+' Address: /2 © {/ +"' a �C 7.1 9 F f�'QAelff 9-6Y ,� � Yt. C vrc.+ vt �/ Installer's Name: t P Telephone: Number of bedrooms (residential only) ` Total daily flow {compute fd 150 gal per bedroom) Topography: Circle one: z] Rolling Steep Slope of Slope Soil Nature: Circle one: an Loam Clay Other /Depth: Feet Ground Water : At what depth? .ray Fd Feet Bedrock or Impervious Material: At what depth? _. I,!A � Feet Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one: < unicipal Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank Iow V gal. (minimum size: 7 , 000 gal.) TILE FIELD: Each Trench 610 feet/Total system length � ,rr� feet SEEPAGE PIT(S): Number of/ / Size each feet by feet Size of stone to be used # / /Depth or Thickness -y'' feet I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE .PERSON: OVER Septic System Inspections : A . All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing : 1 . ) the proposed location of the system 2 . ) location and distance to 10C lines 3 . ) location and distance to structures 4 . ) location and distance to any water supply 5 . ) size and dimensions of all tanks , distribution boxes , the fields and /or drywells �3 . Nu system shall be covered before inspection and approval by the Building Inspector . Failure to comply with this requirement may result in the uncovering of the systefxi by the installer and a fine of up to $ 250 . 00 . C . An approved copy of the plot plan shall be available on the construction Site . Failure to produce said plot plan at time of inspection may result in an immediate work stoppage . D . Should unforeseen problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further cun ,: tructton . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 h.emarks : , THE STATE INSURANCE FUND 199 CHURCH STREET NEW YORK, N.Y. 10007 ( 212 ) 312 -7627 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ANTHONY JONES D/B/A POLICY NUMBER LANDMARK BUILDERS 866 366-8 RD 4 BOX 536 DATE GLENS FALLS NY 12801 5/03 /89 CERTIFICATE NUMBER 632 - 126 PERIOD COVERED BY THIS CERTIFICATE 4 /11/89 TO 4/11/90 POLICYHOLDER GERITFCATE HOLDER ANTHONY JONES D/B/A TOWN OF QUEENSBURY LANDMARK BUILDERS BAY ROAD RD 4 BOX 536 GLENS FALLS NY 12801 GLENS FALLS NY 12801 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE STATE INSURANCE FUND UNDER POLICY NO . 866 3 +66 - 8 UNTIL 4/11/90 , COWERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS ' COMPENSATION UNDER THE NEW YORK WORK- ERS ' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW PORK , EXCEPT AS INDICATED BELOW . IF SAID POLICY IS CANCELLED , OR CHANGED PRIOR TO 4/11/90 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE , 5 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE , NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION . THIS CERTIFICATE DOES NOT APPLY TO BUILDING DEMOLITION . THE STATE INSURANCE FUND I IC FIG ERT J„C08S DIRECTOR, INSURANCE FUND UNr)ERWRCTfNG TOWN OF QUEENSBURY �� VI BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS -v—v� QUEENSBURY, NEW YORK 1280& TELEPHONE (518) 792-5832 HCJ I i3V �4;� irR' S REPORT rT, : . REQUEST FOR INSPECTION RECEIVED NAME 19 �� yp LOCATION It'90 q G L t (��.i DATE D 1 G> _ I PERMIT #_ e w �' ,2 4;�'p 7 APPROVED YES I NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKF'ILL APPROVAL ROUGH PLUM NG i FRAMING ELECTRICAL RO GH--IN INSULATION: +' FOUNDATION ` FLOORS WALLS CEILING �INAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING Lam' EXTERNAL PORCH S/STEPS STAIRS—CLEA CE s RAI PLUMBING FIX RES/RELISF VALVE INTERIOR TR M/PRIVACY 2700 L' FINISHED F RS GARAGE FI PROOFING !/ DOOR CLOS R (S) I/ SMOKE DE CTORS FINAL ELEC RICAL INSPECTION FINAL API OVAL OF CONSTRUCTION 'ti A ,SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FRaM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!' REMARKS: Xv !l INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT ,BAY & HAVILAND ROADS QUEENSBURY. NEW YORK I280k TELEPHONE ( 5I8) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVEDWIr , NAME �"� LOCATION G'C0 DATE PERMIT ## � ' 7 APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROV L ROUGH PLUMBING FRAMING ELECTRICAL ROUGH- N INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAIL _ PLUMBING FIXTURES/RELIE LVE INTERIOR TRIM/PRIVACY FINISHED FLOORS - GARAGE FIREPROOFING DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL INSPE TION FINAL APPROVAL OF CON RUCTION A SIGNED CERTIFICA OF OCCUPANCY T BE OBTAINED FROM THE UILDING DEPARTMENT EFORE THESE PREMISES A E OCCUPIED! REMARKS: zm jet ( � INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS TELEPHONE Yr NEW Y U� (58) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVE - -- NAME LOCATION N PERMIT DATE IFS P # � APPROVED YES NO . f,. FOOTING/FIERS MONOLITHIC POUR FORMS�� _ i FOUNDATION/DAMP-p9gOQFI NG BACKFILL APFRO AL --^� ROUGH PLUMBING f FRAMING ELECTRICAL ROUG IN 4" ATION: FOUNDATION FLOORS WALLS CEILI G FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EP EXTERNAL PORCHES/ STAIRS-CLEARANCE & RA _�--- -' PLUMBING FIXTUR S/RELI VALVE INTERIOR TRIM/ RIVACY D RS FINISHED FLOG S GARAGE FIRE,, POFING�_J{� DOOR CLOSE S) SMOKE DETE TORS FINAL ELEC ICAL INSPECTION FINAL APPR AL OF CONSTRUCTION A SIGNED ERTIFICATE OF OCCUPANCY MUST BE OBTAINED FJZOM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVSLAND ROADS QUEENSBURYe NEW YORK I280k TELEPHONE (528 ) 592-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME r� LOCATION DATE / ,PERMIT #� APPROVED YES NO FOOTING/PIERS MONOLITHIC ,POUR FORMS FOUNDATIONIDAMP-PROOFING BACKFILL. APPROVAL ROUGH PLUMBING FRAMING 00 ELECTRICAL RO G -IN r� y , INSULATION: %o FOUNDATION FLOORS L/ WALLS CEILING CD FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAT PLUMBING FIXTURES/RELI LVE INTERIOR TRIN/PRIVACY 00Rli FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSP TION FINAL APPROVAL OF CON TRUCTION A .SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BU LDING DEPARTMENT ,BEFORE THESE PREMISES ARE O UPTED ! REMARKS: r c�yr+ INSP R TOW BUXJN OF QD CODES BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURYr NEW YORK I28psb TELEPHONE (538) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIYFD NAME41 , LOCATION / /fJG' DATE !r1 "Jr I PERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIONIDAMP—PROOFING BACKFSLL`` APPROVAL ROUGH pLBSNG _ �y�AMING ELECTRICAL ROUGH -IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION. CHIMNEY HEIGHT . ROOFING SIDING EXTERNAL PORCHES/ EPS STAIRS—CLEARANCE & ILS PLUMBING FZXTURESI IRF VALVE INTERXOR �RSMIPRIVAC DOORS FINISHED /FLOORS GARAGE F EPROOFING DOOR C SER (S) SMOKE TECTORS FINAL E CTRICAL INSPECTION FINAL A ROVAL OF CONSTRUCT/ N A SIGNS CERTIFICATE OF OCCUPANCY MUST BE OBTAINS FROM THE BUILDING DEPARTMENT BEFORE THESE P EMXSES ARE OCCUPIED! REMARKS: a. NSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS fj QUEENSBURY, NEW YORK 1280�R TELEPHONE (518 ) 792 -5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME r LOCATION 7` r DATE PERMIT # _ APPROVED YES NO TING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING . ELECTRICAL ROUGH-IN INSULATIOA[: FOUNDATT01v ° FLOORS WALLS CEILING FINAL INSPECTI CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ST S ,STAIRS-CLEARANCE & RA PLUMBING FIXTURES/RELI VALVE_ INTERIOR TRIM/PRIVACY FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL I C ION FINAL APPROVAL OF CONS RUCTION A SIGNED CERTIFICATE F OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMAR!tS ro 5r `' ' IN PECTOR TOWN OF QUEENSBURY � BUILDING AND CODES DEPARTMENT BAY & HAVIL.AND ROADS QUEENSBURye NEW YORK I28U+I- TELEPHONE (518 ) 792- 58.32 BUILDING INSPECTOR' S REPORT REpUEST FOR INSPECTION RECEIVAD" a NAME LOCATION jP "ram / . � DATE " PERMIT # �e I APPROVER YES NO FOOTING/PIERS MO OLITHIC POUR FORMS �p(}�JNDATIONf DAMPr,PROOFX'VG CKPTIL APPROVAZ ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATIONa FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: 1 CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ EPS STAIRS~CLEARANCE A RAILS_ PLUMBING FIXTURE3�`i/RELIEF VALV T r INTERIOR TRIM/PJ(.TVACY DOORS FINISHED FLOOR GARAGE FIREPR FIND_ , _ ........... DOOR CLOSER (S _.. SMOKE DETEC RS FINAL ELECTRIC L INSPECTION FINAL APPROVALS OF CONSTRUCTION t A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: if INSPECTOR TOWN OF QUEENSIBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY,, NEW YORK I2801-- TELEPHONE (5I8 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR I PECTION RECEIVED . NAME / ] / r , LOCATION / f/ I ,C DATE 1r ! 7 - PERMIT # ! 3 c! APPROVED YES NO TING/PIERS NOLITHIC POUR FORMS UNDATION/DAMP—PROOFING BACKFILL APFROV L ROUGH PLUMBING FRAMING ELECTRICAL ROUGH— N INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: 1p CHIMNEY HEIGHT �� ROOFING SIDING EXTERNAL PORCHES/ TEPS STAIRS—CLEARANC & RAILS PLUMBING FIXTU S/RELIEF VALVE INTERIOR TRIM/ RIVACY DOORS .FINISHED FLO S GARAGE FIRE OOFING _ DOOR CLOSE S) SMOKE DETE TORS �. FINAL ELECT ICAL INSPECTION FINAL APPR AL OF CONSTRUCTION A SIGNED RTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!- REMARKS : INSPECTOR TOWN OF QUEENSBURY 2-� � BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY NEW YORK 128094 TELEPHONE (5138) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEX3rFD NAME ~ �- LOCATION .DATE q PERMIT # � / APPROVED YES NO L,.e• OTING/PIERS / MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROU —IN .INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: ! CHIMNEY HEIGHT ROOFING, SIDING EXTERNAL PORCHESr�STEP STAIRS—CLEARANCE & I PLUMBING FIXTURES/R LIEF ALVE INTERIOR TRIM/PRIV CY DOO FINISHED FLOORS GARAGE FIREPROOF NG DOOR CLOSERS) SMOKE DETECTOR FINAL ELECTRICA INSPECTION FINAL APPROVAL F CONSTRUCTION A SIGNED CERT PXCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS'*: ( EMARKS ( 19�$, �R/ aJ � 7- - ,,di o A&L 1 r1f r C Y�bv jr- ujf rl+ INSP TOR MIDDLE DEPARTME . # ECTtO AG. E cv, IfiIC. National Headquarters .900 Hhddon.Ave., Collingswood, N:.i. 08108 : Date: 5' /~ ' Croy, Town or Township_. z ^ ' r { County ,r 'l �" t ✓ ek State ' Locati on)Acldress a i {}a T C 5 c U u If, rvee f ( If Located Rural Area - Please Attach Directions) Pole Owner n i Permit # '�.. occupied As g C' 41r Building: Newer Old ... Occupant K s� ,=4 .-- - Work Area in Building Floor #, etc.) : r App. for: WiringService or. Read for Inspection: Fee Remitted - $ Cash EJ Check Q' M.fl. Make Pa able To: M.D.I.A. soo 7sa: a000 a2sa isaa z75o 2aao xxsa 25on 27sp aoap - Number of Rough Wiring Outlets Elect, Heat Switches Q p Amp. Service Surface Unit '� Dishwasher - .00 Range , Lighting ✓ Water Heater Air Conditioner r Dryer Pump Receptacles Oven Garbage Disposal Wiring and Controls for ; Burner Number cif fixtures al Amp.. Receptacles Fractional H.P. Vent Fans Other Equipment: MGTTQR$ H.P, 1! 1 1(121/10 1/8 1/6 1{4 1{3 1/2 3/4 11112 2 3 5 71h 2,0 15 20 25 30 40 50 75 q (Mark Number of Each ,Size Applicant'sit Signature License # Per Signature TIA utility : l A ICE L f 10 Applicant's Address:� Of A (City)QV e! !CA h - Age jState) az Y" i2ip) ,re..4 PeLtl Service Request # Phone * Jc+ Electrician: DATE RECEIVED: DATE INSPECTED. Correct Location : Same as Above [] or: Red Notice Label 0 Rough Wiring Outlets Surface Unit oven OD Switches Ran Garbage Disposal ' Receptacles Water Heater D'isliwasher Fixtures Air Conditioner r` Amp: Service Equipment Burner, Wiring & Controls for Arri. Receptacle Amp- SerXj0e Conductors PumpVent Fans . MOOTORS H.P. � jVMj1,n2j1^0j1/8j1/6 1114111/311/21 3/4 k 1 1W 2 � 3' 7�k 10 15 2Q 25 -3Q QA . 5'Q 75 : '1QQ Mark Numiber of Each Size . spo 75v 1aoo 125o asoo 1750 2apa 225a 21,oa a7ea so uI IF Elect. Heat -4 . . [� RW Progress: Inc. LKD Contractor CFT Violation : Work Comp. Q Inc, d C14SIi L/A Owner Fee CHK �- UA Due Mfl # �] IPi4 Municipal INV # Applicant: Dew: other Side UtiIItY -. Owner qut in Card Q v'mp # Date ` AWSPECTOARslC7NATUnt Final # bate APP1 rCA-rioN Foram NO. 250 EL 11/86