1989-349 f u.
f +CER.TIF'ICATEE'' OF O C+CI'PAN%nowY
1
' TOWN OF QUEENSBURY
i
t WARREN COUNTY, NEW YORK
f Date J U l y 4 Z 990
This is to certify that work requested to be done as shown by Permit No_- 89-3� ,
I i
f has been completed.
This ■ re may be occupied s. a Single fa mi 1 y DMe l 7 i nv
i
Laocation l ester Drive
Owner ueil-b Lalwlnra
By Order Town Board
70W N OF QUE$NSBURY
F 7i } i
i
Director of Bldg. de Code Enforcement J
BUILDING PERMIT �
TOWN OF +QUEENSBURY
No. 89- 3414 1^J
WARREN COUNTY, NEW YORK �
r
PERMISSION is hereby granted to KEITH LAMDRA
OWNER of property located at LESTER DRIVE Street, Road or Ave.
in the Town of Queensbury, To Construct or place a SINGLE FAMILY DUELLING
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
Lot 121 Lamplighter Acres
Fort Edward , N . Y 12828
2. CONTRACTOR or BUILDER'S Name
Self
3. CONTRACTOR or BUJ LOE R'S Address
Same
r-
PA
d. ARCHITECT'S Name
rr'!
x
C
70
5. ARCHITECT'S Address Mac
rrl
S. TYPE of Construction — (Please indicate by X)
(UkWood Frame { ) Masonry I } Steel ( i
7. PLANS and Specifications
P=4
No. 26 ' x 40 ' Single family dwelling as per plot plan , specifications ,,
and application . ( 1880 sq . ft . ) Including septic and driveway. ,rr,
S. Proposed Use
r-
Single Family Dwelling
v
c/o incl .
$ 211dD_ 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Decem1mr 1 1989
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the QS
town of Clueensbury before the expiration date_)
Dated at the Town of Queensbury this 25OLtL Day of may 1989
SIGNED BYrVA05 - w for the Town of Queensbury
Building and Zoning In or
TOWN I N +UF � UEENSI3URY APPI, ICATTON FOR BUILL) rHO AND ZONING PrithilT u
1,5 70 jFQ
i�?ecievL'w� sy�* 13 r
Reviewed D . D �FCFLfiF
Fee Pa.l d @ �?'y
BUILDING AN'D COZIES U1 :PAttT>'ff-1v'T Date. 7aeued '� 4 �,�
BAY and HAVXLAND ROADS RD 1 BOX 98 � -,� c '0L'4t: T
PUE'E"NSBUR'Y, NEW YORK 22804 PeA.mit No . rr
Teed . (51. 8 ) 792-5832 Ext •2CI4
-w w ■ w * w �+■ w , w w w w ■ w w w w * ■ w ■ w • w ■ a w w w w w w x x w
A PERMIT MUST D4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPliCTIONS
• WILL BE, MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT .
All applicable spaces on this application must be completed and the
rtkD tkrA of t * e apl iAan� t musk aP* ear * o the reverse side * ok this * Sheet *
The owner of this Property
Address
11� � l �«l. at
--�.a
Property location \ ._.2. � r '0r 'rAX MAP NO . _/ /' � •
teas there been any split of this property since October 1 , 198Ei ? /`,X
"' yes Ito
If yes , Planning Board Review is necessary .
SUBDIVISION NAMna IF APPLICABLE
LOT NO .
The person responsible for supervision of work. as regards Building Codes is :
� } r _
NAME t P . 0 . ADDRESS TEL , NO .
Name of builde Address Tel S � _
Name of Plumber -V-� �r`� r P.ddress �
Tel
er
Name of Mason
1,1.1TuRk OF PROPOSED WORK ` . ZONING INVOftt• ATION ( Of-f ice use Only )
`Xconsrruction of is now building # ZONING DESIGNATION OF PROPERTY
_Addition to a building PERMITTED PRINCIPAL PERMITTED ACCESSORY
AlturaCion to a Luilding '
{no c1M.,,u] u t4 a xcOriar cli,ncn« idnsl " REVIEW REQUIRED - PLANNING BOARD ZONING BOARD
C]tlk+: r work (aa:cril3.cl ' SITE PLAN REVIEW EI APPROVED DATE
VARIANCE # APPROVED DATE
CROSS AKLA OPP ►tOPOSSD. STrtUC•'- UrtE
lst door kQ1 t) s q f t . r Remark
.�f
2 n d Floor ^af� �7 -sq f C w COi•1L' f_L's L I rJi'QrsaA riCstV 1t1:r�u 31cL 1] 1sL l UtiJ .
�"� _�.�sq r' t ` Si.•r..: of PXOV►:rty 3 1 -; ft X
(] they Floors
5i u --'=' ?[ r c .
( not cellar Or basarnentl .
TOTAL FLOOR AREA ^• � sq ft . * xj,ycing DLAi1,6illy (:; 1 U:44^
tal new ::tructur�: cXa.r:a ft S: `��' 'Ft '�
►�aua,d:+ tir�n-[pier/ :laL.fcrawl/paYCliAl ull " Vropo:�Cd building , d.i:: tanco from �sr+alurey
(circlu one ) � Front yutd__...2)C]> ft hear yiAkd ft
Nao of suories (1vabiczLblo c yace ) } Side yy:ardi: to - �fc and ft
IluighC (tarade to ridCjL: ) �� ft . } Tr' on ccrn.:r, ::t ri�ack frola si.dc: strw4t �^ rc
If rcuidential , noo of families L
No . of roows ( excludinq baths ] " OCCUPANCY INFOPNM%TICN
ltoo of bL%drQOJQ .: LA - PR ARY GUILDINC:
No . of b:athrooma One fanu.ly dwelling
1+riu6;&ry I,uaCi+ud •iwo f:auxiiy dwulliny
Y•ylau uC fuel Multil,10 dwelling / Number of units_+_
No . of Cap La:_ install .:d l�erlt►:ai'►Lnt occura:arkcy
Will a woud �L.GVQ b*.: i ,ss " Il+ud7 '�C ' •rr"nNIunC pcculxatu:y
C.:nCral Air ca,«iitionir,cl :} tisc : 13u:,inass
BUILDING STYL_C, PRIMARY STRUCTURE * Industrial
�, Ocher
lut� Ch Cortt.:+G,1�+ .r:.ry L.on t :.t�in Zf "ddition , what will wu+s 43u7
l::ai::u[1 rs.nt:l� Mwa►x3i.c. „ Dial,lux �
a l.:vel Old sryle Liu, «d.alaw W
c .alrru Cod Cottaq.1 Oc14.: r ' ACCL. arty iaUl 0Il
l:al 1tpW 1'[3wrJ� house 17j gCJ�pnr3 Czar/ two caC/ Czar
{ CIRCLL: ONk PLEAS I ' lLttachu rag"/o41u car/ two car/ car
r ■ ■ ■ w s w ■ ■ w ■ ■ w r w w ■i �' IsriVlat ' Staria 13-1Giln�] .
L': .STIMATva MARKPT VALUE OF '" .0r.he
CON :; TRuc •cxON v •
INr••aftigATION ON BUTLDYNC .9PrCIFICATIONS , ON REVERSE SIDI: OF Tills E:ttECP, TO BE COMP[.G•rLDI
Farm DPA 10/88 Vd
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 ?
Foundation wall material / ` �t �� Thickness fr
t, �` y�, �, �
Depth of foundation below grade {to�bcs pg Doting }
gradeWill there be a cellar? y ry Heated or unheated Floor sq. footage_ _0 [) sq ft
Will there be a basement . ,"L Will any ptirtNr
on be used as living spade? fy
( If so , what portiox 0> st . - - Type of use?
Type of roof - ,roped�' Clat Cher Material of roof tyqj x
Size , wood studs (c " spacing f ( "o . c . length _ft .
Joists ( floor beams ) lst . floor _ "X-,.!U " spacing f �.,"o . c . span�ft I
Joists ( floor beams ) 2nd . floor jr "X re spacing iC "o . c . span re ft .
Overlays (ceiling beams ) �"X & Nip pacing O . C ." span , ft _
Roof rafters _- 7_" X �'{' �spacing_41j O . C . spa £t .
Roof trusses (pre-engineered) spacing—"o . c . span t .
Exterior wall finish_ ��t�'I> n what mate al . sp'elK:3E T3. .o
Interior wall finish i/
If a garage is to be attached , describe materials to be used for FIRE SEPARATION :
Is there to be an opening b ween garage and dwelling? f so will a Fire-rated
door , enclosure , and self-closing device be provided? N.,'frx
Will a flue-lined chimney be installed? N Height above root ft ,
Depth of chimney foundation below grade L),a ft ,
Depth of fireplace hearth YJ/A ft . in .
Water supply - unicipa or private well
SEPTIC SYSTEM _ Distance from ANY private well (including adjoining properties 01py ft .
(A separate application is necessary for any repair or new installation of septib system)
D E C L A R A TION
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
Owner, ownergent , architect, cont rector
SPECIAL CONDITIONS OF THE PERMIT :
By
TOWN OF QUEENSSURY
WARREN COUNTYe 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 , ��; �4 ,
2 . Type of heat
3 . Is the building mechanically cooled ? � U
4 . Percentage of area of windows and doors
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
a . Are foundation walls insulated ? YES
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
a . R value Of insulation
5 . Type of insulation
B . Under 16 % Only
1 . R value of roof an-d floors exposed to ambient conditions
2 . R value of exterior walls
3 . R value of glazed area
4 . R value of doors
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 )
9 . R value of heated basement/ cellar walls ( below grade )
10 . Type of insulation
c . Controls
1 . Thermostat maximum heat setting
ftftm
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 C F '
2 . R value of pipe iinsulatiori
F . Service water Heating
1 . Performance efficiency. Cam'
2 . Temperature control setting maximum ,_ _
G . For Swimming Pool Only
1 . Maximum heating_ /+
Telephone No . 1 C'�1 �c - - � C-1
( applicant ' s signature)'
NYS T Ai:[]IT FORM
NAME -: 1 !\ f � y DATE : -
ORDFR #3
INSULATION VALUES
U Value ,.,- 3Walls _ U Value �'- - Ceiling
U Value Ceiling
�., f _ t. �� U Value r Floors
+ d..tP
PART IV - NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE
P.
�.
Uo = Uw Aw + Uri Ag + Ud Ad
Ao
4C> Degree. Days Table 4 - lb
Wall �'[4� Sq . Ft . Dooms Sq - Ft ,
Floor J Q Sq . Ft . Glazing _� ] Sq . Ft .
_ Sq . Ft . Roof - Sq . Ft .
Roof II
Net Wall 1 Sq'. Ft .
Max Allowable Uo .a G64` 4
Wall Roof Floor Glass Doo j j t 5 .S
f ' K 1�2 3)+( tt3 1C +( � D f x �d +C e 3{ f 'S3 }+(, S,� k } CD Qy . 0( 3 Cv S }
Wall , Roof , Floor Sq . Ft .
Actual Residence Uo p
Wall Roo Floor Glass Door
Gail , Roof , Floor Sq . Ft . 73
Uo = 0 (o
* Actual Uo < Max . Allowable Uo n
_ S tiY S :N ER G�
IDE
TOWN OF QUEENsBLlritr
.......... APPLICATION FOR
s } SEPTIC DISPOSAL PERMIT
DATE - - \
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: ,� � i, ,_ 4*V- g, t- f\ Telephone: --Ic.� -Z, -7
Address:
Installer 's Name: Telephone: �+, �
Number of bedrooms (residential only)
Total daily flow {compute (a 150 gal per bedroom)���(�{�
Topography: Circle one Flat Rolling Steep Slope 46 of Slope
Sail Nature: Circle on Sand� Loam Clay Other /Depth:_ Feet:
(Around Water: At what depth ? I C) 4— Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: i47unicipal Well Other f(
If domestic water supply is a wel .
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM : Septic Tank
D `gal. {minimum size: 1 ,OOf1 gal.)
TILT' FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of / Size each,". feet by feet
Size of stone to be used # 4Z /Depth or Thickness - �::a* ■,.C) �f feet
He ae sk * 3k lc :k * * at ak k K k ye �e** � k *# * ox *
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.
SIGNATURE6 OF RESPONSIBLE PERSON _
DATE :
DV1;R
5cptic System Inspections *
A . All appllcziclons for t; ePCic system installation , alteration or repair ,
:As requirod by the Town of Queensbury Sanitary Sewage Ordinance , :; mall
Ijo subinit cud to Elie building Deparrutunt at least 2$ hours before start
ui construction and shill include a plot plan showing :
L . } r. kiu proposed location of the system
? . ) location acid distance to lot lines
3 . ) location acid distance to structures
4 . 3 10cati.an acid dir; Cance Co any water supply
5 . ) size and dimensions of all ranks , distribution boxes ,
rill: fields :-nclfor drywells
Li . N.: :; ysturn shall be cov� rcd before inspection and approval by the
l; uiidilig lAi� pr•ctor . failure to comply with this requirement may
r � -, ult in thu uncover -Lin of the system by the installer and a fine
� i uF} to $ 250 . 00 .
C . Act approved copy of the plot plan shall be available on the construction
failure to produce said plot plan at Cime of inspection may
i'4sulc in an imnicdiace work stoppage .
D . ShoLl ld unforeseen problems during construction prevent proper installa—
tion , alteration or repair of an approved system , a new proposal must
l,v submirred to the Qucunsbury Building Department beforr: further
Uuii �. truccion .
Town of Queensbury
BUILDING and CODLS" DEPARTMENT
Bay and Havi.land Roads
Queensbury , New York 12804
rkl.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
I BUREAU OF ELECTRICITY
I 41 .STATE STREET, ALBANY. NEW YORK 12207
Date I I . I `kc: s
THIS CERTIFIES THAT } ��/I
anry the Ofectricor equipment as deaeribed beloao and insraducaaT by the appolicr�sd t named on the sb~ appricat'iam number in the Premises Of "
}•:1TIT71 L"3.'k�rF.� • 1.I ;; TkI: fr}; , I�--� `: . 5' .
in thejolloToing location, Q�'Basement Dylat Fl. L_i' Sanction Brock Bnd Ff. Lot
,�k"T i �-i y 1 r
was examined an ?i 1•-1
aradjoeend to be in compliance with the requirements of this Board.
FIXTURE E"ACLES SWITCHRS FIXTU"s
OURETS RANGES COOKtNO DECKS OY#NS CASH WASHERS #XHAUST FANS fN[ANbtSCENi FI;J(}tt+,.A:tINT OTHER AMT. K.
1"
DRYERS FURNACE MWORS FLITIJRR APPLIANCE FEEDERS srmAL RRc'HT TUNE CLACKS UNIT HEATERS M4CT1 t711tLET p
AMT, X w- CKl H- F, Gws H. P. AMT. No. A. W- G. AMT. IMF, wMr. AAws. TRANS. wMr. H, ►. STSTEMS wAtt. wwrrs
era VICM 01SCf.1NNECT NO. Qf S E R V 1 C E w q
AMT. AM►. TYFE �P 1 .t` ?W 1 A' SW 9 X Sw 3 JM aYM � �Arc�0. CF CC�. HO. at H6REG A• W. G. M4. OF h1tuTRALS OF ia[1TRI41
Gf fN•lEG
OTMRR rAPPARAnx;
F L E'-
Cow I : 1
BRANCH MAMAGER
Per-
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 DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEEINSBURY
BUILDING AND CODES DEPARTMENT /]
BAY 6 HAVILAND ROADS
J?UEENSBURY, NEW YORK .I2802.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUES24, FOR INSPECTION RECEIVED
NAME
C
r.00ATsoN"
DATE PERMIT # �?
r
'APPROVED
YES I NO
FOOT'INGIPXERS
MONOLITHIC POUR FORMS
FOUNDATSONJDAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROU -IN
INSULATION:
FOUNDATION
FLOORS
WALLS
XNALLING
INAL .I1V.SPECTION;
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PCJRcuss Is4*E
STAIRS-CLEARANCE & RAC
PLUMBING FIXTURESJRE F VALVE �-
INTERIOR TRIN/PRXVACY RS
FINISHED FLOORS
GARAGE FXREPROOFING
DOOR CLosER (S)
SMOKE DETECTORS
FINAL ETzBc2wR2'CAL INS ECTION
FINAL APPROVAL OF C STRUCTI
OK TO ISSUE C/o OR jC
A SIGNED CERTIFICA E OF OCCUPA Cy MUST BE
OBTAINED FROM THE BUILDING DEP TMENT BEFORE
THESE PREMISES A OCCUPIED!'
� r
REMARKS:
► c� v�v G 0
ARRIVE
DEPART s Z Z � 6L -
INSP TOR
TOWN OF QUEENSBURY
BUTLDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YC�RK 128099
TELEPHONE (518) 792-5832
BUIlDI INSPECTOR ' S ORT
REQUEST FOR INSP TION RECEIVED
NAME
LOCATXON
DATE PERMI # gq-
APPROVED
YES NO
FOOTING/PXER.S
MONOLXTHIC POUR FORMS
POU'NDATION/DAMP PROOFXNG -
BACKFILL APPROV L
ROUGH PLUMBING
FRAMING
.ELECTRICAL ROUG XN
INSULATION: /� `rJ40
FOUNDATION
FLOORS
WALLS
CEILING t
FINAL INSPECTION
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCH /STEPS
STAIRS-CLEARAN & RAILS
PLUMBING FIX R S/RELIEF VALVE
INTERXOR TRIM P TVACY DOORS
FINISHED F RS
GARAGE FIRED OO NG
DOOR CLOSER )
SMOKE DETEC ORS
FINAL ELECTR AL X SPECTION
FINAL APPROV L OF NSTRUCTION
OX TO ISS[JE /0 OR /CC
A SIGNED C TIFICAT OF OCCUPANCY MUST BE
OBTAXNED F M THE B XLDING DEPARTMENT .BEFORE
THESE PRE SES ARE CUPIED#
REMARKS:
r �
ARRIVE 4j/% -
DEPAR',T
I NSPEC 2)OR
r
TOWN OF QUEENSBURY
BUILDING AND CODE'S DEPARTMENT 4qk
BAY 6 HAVXZ"D ROADS
QUE'ENS,BURY, NEW YORK 22801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEXvE *44 T_
NAME h
r
LOCATION
DATE 1 { Z°3 PERMI # q 4 q,
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR ORMS
FOUNDATION/DAMP- OOFXNG
BACICFXLL APPROVA
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-
INSULATSON:
FOUNDATION
LOOR
ALLSS
WALLS
17Z -
CEXLXNG
FINAL INSPECTION:
CHIMW Y HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST S
STAIRS-CLEARANCE 6 LS
PLUMBING FIXTURES/ L EF VALVE
INTERIOR TRIM/PRIV CY RS
F.TNI.SHED FLOORS
GARAGE FIREPROOFS
DOOR CLOSERS}
SMOKE DETECTORS
FINAL ELECTRICAL S PECTI
FIIVAL"' APPROVAL OF ONS71 C ION
OK TO ISSUE C/ O OR C/C
A SIGNED CERTIFIC E OF OC PANCY MUST BE
OBTAINED FROM THE UXLDING EPARTMENT BEFORE
THESE PREMISES AR OCCUPIED
REMA141C
LJ �
� I
ARRIVE
DEPAR ' -
INS TOR
BUILDING and ZONING DEPARTMENT
Bay and Havifand Road, R. CI. I Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION ` �1 k jO
DATE PERMIT
SOIL TYPE - and Loam - Clay
Percolation E RRequired ? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM :
Absorption field , tot4l length
Length of each txench !
Depth of trenches �'— --�---
Size of
SEEPAGE a?ITS{Nizmber o } ----
Sixe- _ L ft. X
Gravel size
PIPING : ize ��-
Bldg . to tank Type
Tank to dist . box
Dist. boy: to field/ t �� /
Openings sealed? !E.,
D Partial
LOCATION/SEPARATIONS
Foundat1cm to tank ft.
Foundation to abscrpt '
Absorption to lot 1i + �; � ft.
Separation of ,pits 1 r_-=ft.
LOCATION OF SYSTEM PROPS-R y(c3rcle one )
Front `- Rear - Lef side •- Right side
'COMMENTS :
t.
SYSTEM USE APPROVED . YES- NO 4.
BLk I. la ing �riS�3ECt0`�
Ol/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12809-
TELEPHONE (516) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST F .INSPECTS N R C IVED
NAME
LOCATION
DATE r"�/� +� PERNXT
AZ"OVZD
14'S NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—.PROOF.XNG ._
BACKFILL APPROVA
V4MUGH PLU NG
J
ELECTRICAL ROUGH—IN
INS ULATXON r
FOUNDATION Y f
FLOORS
WALLS
CEILING r
FINAL SNSPECTION.-
CHXMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST PS F
STAIRS—CLEARANCE & .RAILS
PLUMBING FIXTURES ELIEF; VALVE
INTERIOR TRIM/PR CrA DCpRS
FINTSHED FLOORS
GARAGE FIREPROO ING —
DOOR CLOSER (S)
SMOKE DETECTOR
FINAL ELECTRICA INSPmCTTO
FINAL APPROVAL F CONSTRUCT ON
A SIGNED CERyTpxcATE OF OCCUPANCY MUST BE
OBTAINED FROTHEBUILDING Z)EPARTMENT BEFORE
THESE PREMIS ARE OCCUPIED!
REMARKS: ` erg ,r ,v�y
THE CO CTOR IS �NSI'R PROVIDING
PROfECTI FROM FREEZING " 48 HOURS
FOLLOWINGTHE PLACEMENT OF THE CONCRETE.
MATERIALS FOR, THIS PURPOSE ON SITE
ARRIVE. .' ''� YES NO
DEPART}
Gc
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY dr HAVILAND ROADS I/—►
QUEENS,BURY, NEW Y X 1280& r
TELEPHONE (5I8) 92-5832
BUIIDI INSPECTOR ' S UPORT
REQUEST XNSP T N RECEIVED&
MANE
LOCA TXO
DATE Q .PERMIT ,#
APPROVED
YES NO
FOOTXNGIPIERS
MONOLITHIC POUR FO S
FOUNDATION/DAMP-PR PING
BACXFILL APPROVAL
>(M'2OUGH PLUMBING
dd
XRAMXNG
ELEC27RICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS.
WALLS 12 '
CEILING
FINAL INSPECTION: f
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEP
STAIRS-CLEARANCE & RAT
PLUMBING FIXTURES/RELI VAL E
.INTERIOR TRXM/PRIVACY - ----
FXNXSHED FLOORS
GARAGE FIREPROOFING -
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTS
FINAL APPROVAL OF CONSTRU T ON
OK TO =SSUE C/O OR .C/C
A SIGNED CERTIFICATE O OCCU NCY MUST BE
OBTAINED FROM THE BUILIING D ARTMENT BEFORE
THESE PREMISES ARE OCt UP_TED1
C—.n. +C >A
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XN ECTOR
TOWN
BUXZD G N CODES DE
BUILDING AND CODES DEPARTMENT
BAY & HAVYLAND ROADS
QUEENSBURY, NEW YORK 1280!&
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S gEpO/RT
RE-QUEST FaR� ,rNSPE rat ECErvs#.
NAME � I�����C +' +
LacATXON
DATE .r' s PERMIT
f APPROVED
YES I NO
FOOTING/PIERS I
MONOLITHIC POUR FO07MS J
FOUNDATION/DAMP-PIbUOFX NG
BACKFXLL APPROVAL
R
OUGH PLUMBXNGG
ECTRXCAL ROUGH--ZN
INSULATION;
FOUNDATION
FLOORS
WALLS
CEILING
FXNAL INSPECTION: f
CHIMNEY HEIGHT f
ROOFING
SIDING
EXTERNAL PORCHES EPS
STA XRS-CLEARANCE RAILS
PLUMBING FIXTURES gRELXEF VALVE _
INTERIOR TRIM/PR UJCY DOORS
PXNXSHED FLOORS
GARAGE F .zREPRt7p XN
DOOR CLOSER (sl
SMOKE DETECTOR
FINAL ELECTRXCAL r Sp E TION
FXNAL APPROVAL O CONS2�RUCTXON
A SXGNED CERTXF CATE OF CUPANCY MUST BE
OBTAINED FROM HE BUXLDX DEPARTMENT BEFORE
THESE PREMISE'S .ARE OCCUPX D1
REMARKS:
■
&
INS TOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
,SAY & HA VILAND ROADS
QUEENSBURYr NEW YORK 2 28 Q+R
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION ��
DATE ] — {J �G,i�PERMIT # —
APPROVED
YES NO
FOOTING/PXZRS
MONOLITHIC POUR FORMS
FOUNDATIONfDAMP—PROOFING / I
C.J�CKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROVG'H�XN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT .
ROOFING
r
SIDING
EXTERNAL PORCHESItTEPSN
STAIRS—CLEARANCE'S& RAI�—
PLUMBING FIXTUR SCIRELI Ed
VALVE
INTERIOR TRIMfIVACY DOORS
FINISHED FLOOR.$'
GARAGE FIREPROOFING
DOOR CLOSER (Sf
SMOKE DETEC S
FINAL ELECTRIC L INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTI XCATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS.
f
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE +j it PERMIT
�� APPROVED
YES NO
LP60TXNGIPTERS
MONOLITHIC POURIFORMS
FOUNDATION/DAMP:-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS'"
WALLS
CEILING
FINAL INSPECTION: '.
CHINNEY HEIGHT
ROOFING {
SIDING
EXTERNAL PORCHES/ PS
STAIRS--CLEARANC4 & XLS
PLUMB.rNG FIXTU SIRE IEF VALVE
INTERIOR TRIM,rr RIVAC DOORS
FINISHED FLO S
GARAGE FIRE OOFING
DOOR CLOSHJ�r(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTIO
FINAL APPROVAL OF CONSTRUC!'ION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT ,BEFORE
THESE PREMISES ARE OCCUPIED:
REMARKS:
INS ECTOR
MAIN OFFICE ATLANTIC-INLAND INC.
997 McLean 'Rd. +
Cortland, New York 13045 NEW YORK
Phone: (SU7) 753-7118 MEM8CR OF N.F P A. AND I.A.E.1
(607) 7s3-7809 FIRE UNDERWRITERS
(607) 753-T396 (Electrical and Fire Inspection-Enforcing and Consulting Service)
(Incorporated in the State of New York)
Desiring Certificate of Approval. application is made for inspeclion of electrical installation in the premises described below. On demand applicant agrees 10 pay for
inspection service in accord with schedule of chargers.,
APPLICATION FOR ELECTRICAL INSPECTION — PLEASE PRINT OR TYPE I n , 9L 9_ yrr�;
THIS SECTION TO BE COMPLETED BY APPLICANT DATE OF APPOCATIION I4 Q _
CITY. TOWN. VILLAGE �„ COUNTY ) i-w- � �" p,`..,.Y.,� STATE
STREET i
ADDRESSr--
RURAL BUILOG. NO.
DIRECTIONS '�-{a..• �,-}
POLE NO.
OWNER'S `
�+ NAME C- ciii� OCCUPIED AS DP
x
OCCUPANT 0�<eUILDING — New f71d ❑ WORK — New idddrtlonal ❑
OWNER'S P.O.
ADDRESS \ +
A PP. FOR — ROUGH WIRING L7 FLKTU RES O OR READY FOR INSPECTION 19
FEE REMITTED — S BY CHECK 2KCASH 0 MONEY ORDER 0 MAKE PAYABLE TO ATLANTICANLANI], INC. — NEW YORK
Number nl Rough Wiring Ootets Fixtures Add Installation
``----Svnch Li trig Recap, KW Mad Mogul Floor. 500 750 1d00 125o 1 11 1750 2000 2254 25M 1 2750 30D0
Heat ease Base
Elect. Heat
Amp. Service Water Hit. Burner Air Cana.
Surface Unit Owen Range Gr. Disp. Dish W
Dryer N.P. Pump Ex. Fan Hood
OTHER EQUIPMENT (SPaciy Type a Capacrdea) !
TYPE OF Size OF SUB-
WIRING OPEN O CONCEALED O OTHER MAIN MAIN BRANCHES NO. OF
APPLICANT'S CIRCUITS
f S4GNATURE •1 x---� "'- 1+1f4�.t„t LICENSE e
/ PERMIT •
APPLCANT'S _
ADDRESS [. � � ..q�y\ 4 5, NAME OF
{ �� �'- 'C-- ' UTILITY ry
}� s I
OFFICE TO
ZIP GOOF 'Z- �„ SE NOTIFIED
BELOWSPACE • - USE OF • • ONLY
ROUGH WIRING AMP SERVICE
K.W_ 5URFACE
OUTLETS EquIPM ENT UNIT
SWITCHES AMP SERVICE K.W. OVEN
CONDUCTORS
RECEPTACLES H.P GARBAGE
H.I PUMP DISPOSAL UNIT
MEDIUM BASE
FIXTURES K.W. DRYER DISHWASHER
MOGUL SASE DISHWASHER
FIXTURES K.W. WATER
HEATER K.W. RANGE
FLUORESCENT H.P. AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING a CONTROLS FOR BURNER SMOKE FRAG. H.P
QUARTZ FIXTURES DETECTORS VENT FANS
MOTORS. H.P. 1720 I /12 Iflo I /S 1 /6 114 t/3 1/2 3/4 Y IIh 2 3 5 75y 10 15 20 25 30 40 50 75 100
MARK N1IMHER
OF EACH SIZE
600 750 1000 1250 1500 t750 2000 2250 25M 2750 3000
APPARATUS Elect. Heal
MISC. INFO. Received
Inspected FEE PAID
EJ PROGRESS
TOTAL $
❑ DEFECTfVE
� ❑ Rough Wiring CertlliCala Check No,
r ❑ Temporary ServP00 Money order
> �`"EG"`!""'":I, /;_ ,/ -'f ❑ FINAL CERTIFICATE
Cash
fl Dup. CeA. Reg.
❑ (MUNICIPAL Charge
5I $-b3x3-ir339
MUN ADDRESS
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