1989-341 Y:
/ r
CER'TIFICA rrE OF OCCUPANCY
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
Date March 15 19 91
This is to recertify that work requested to be done as shown by Permit No. 89-341
has been completed.
This structure may be occupied as a � Single Family Dwelling
LAAA aX& ion _ f ?� Sharman T r j and Road
Owner Barry Be.? vacs
By Order Town Board
TOWN OF QUEENSBUkRY
Director of Bldg. do Code Enforcement
- 4
BUILDING PERMIT
TOWN OF QUEENSBURY 0
No. 89— 34.1.___._____
WARREN COUNTY, NEW YORK �
n1
PERMISSION is hereby granted to Barry Bel rose /a
iv
OWNER of property located at Lot#4 Sherman Island Road Street, Road or Ave.
in the Town of Clueensbury, To Construct or place a Single Family Dwelling
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 C2ueensbury Building and Zoning Ordinance.
cc
1_ OWNER'S Address is rn
r-
69-B Voshurgh Road o
Mechanicwille , M . Y . 12118 rM
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2. CONTRACTOR or BUILDERS Name
Self -�71
3. CONTRACTOR or BUILDER 'S Address
Same
4. ARCHITECT'S Name
r-1•
N
5, ARCHITECT'S Address
FM
N
6. TYPE of Construction — (Please indicate by X)
O+
Xx ) Wood Frame i I Masonry R I Steel 11 CL
7�0
7. PLAINS and Specifications G
24 ' x 72 ' ( 1536 sq . ft . ) Single family dwelling as per plot plan ,
specifications , and application , including septic , attached two car garage ,
and drivemay
8. Proposed Use
Single Family Dwelling
c/o incl _ o
$ 6Z 207 .09 PERMIT FEE PAID - THIS PERMiT EXPIRES December 1,
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensibury before the expiration date.)
i+C
Dated at the Town of Oueensbury this Day of may 19_..a9___
SIGNED BY � for the Town of Oueensbury
Bui Whig and Zoning (ndpecto,r
TC3`tii�N OF UEENSi3UPY APPLICAIJON FOR BUILDIPI ANC) ZONING+ PERMIT
1'cL.t c
PC TOWN OF OUi ENSBURY
!`¢ _ Rev. a � ' _ _ RECEIVED
/17
� MAY 1 b 199(�)
Fee Paid A
R(.IILDINCe AND CODES D1 PARDT--I�rf Date. Iaaued 91' BLDG. & CODE DEPT.
BAY and IIAVS LAND ROADS RD 1 Dox 9a
pURENSBURY , NEW YORK 12804 PeA11i t NO .
Tel* (518 ) 792-5832 .Exc � 209
.. a w w w w x •w w I w a w to w a w w w w w w w a w w a ■ w s a w • a w w w
A PERHIT htuS'r G11 OBTAINED BEFORE BEGINNING CONSTRUCTIONe NO INSPECTIONS
- 1'' I LL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BL' TLDINC PERMIT ,
All applicable spaces on titis application must be completed and the
sienature of the applicant must al,pear an the reverse side of this sheet .
'1' I'se owner of this PropertY is : 161A iAA e .fS'Et1 h' -
(ses)
11 , 06 Address TEL . Aj4 .'
0 41 r�s
property locationL'oz: $)ACAn.*6J 15LAAlg ,Rex, -_-0t44;, -AlSAuAV TAX MAP NO . 2= /
leas there been any split of this property since October 1 , 1988 ? Yes /� r, o
if yes , Planning Board Review is necessary .
SUBDIVISION NAME , IP APPLICABLE � �Xs'99420Ji LOT NO . �
The Person responsible for supervision of work as regards Building Codes is :
OS
e
NAML P . O . ADDRESS TUL . NO .
14ame of builder ovjmEA Address Tel
t4 me o£ Plumber Address Tel
a
Name of Mason Address Tel
Or PROPOWD lr 1QRK : ZONING I N FO1LriAT I ON ( Ur Fi c e use on1 u )
� _Con ::; truetiare Of " r,ew building � ZONING DESIGNATION OF PROPERTY
Addition to a building # PERMITTED PRINCIPAL PERMITTED ACCESSORY
�Altur:ation to a Luilding
! (1,o clr .rtiqu to oxcvrior clirnen lion a ) REVIEW REQUIRCO - PLANNING BOARD ZONING BOARD
Otler�: r work (pia:Cr"il)Ls ) '" SITE PLAN REVIEW APPROVED DATE
C: kDSS AREA OV Pf'LOj10SCDL 5; T1LUC:'1• Ultr+ r VARIANCE # APPROVED DATE
lst Floor // tf" sq rt . I Remarks :
2 j s q LL-T£ t , k ,� COt ti Irl -
nd Floor ' 1'O1:1tA'1'lOi1 icCr�ullcLi3 Ut iC+y1 .
.; i'!.a O f prol,:u CC . f t .
Ocher Floors sq ft . Lxiitir,g iauiidieel ( 1 ) Sim.: 1 t % rt .
( not cellar or baavnrenc )
TOTAL FLOOR AREA 1536 sq ft • l.xi«ti,zcl bu1lcii1r.3 (:: ) UZ.4j
L' ite or' new : tructurJ .��, ft
trcau„dation-Hier/ :;131i/er:awl/laarci:al/ tul 1'roiaco,;uc1 butluing , dil:canoe moor t.rJlxurty lieu
(circlu orle) , _ Front yard Lo 2 � f t Rear ytard I J ��"- fC
NJ . Of Jtoriu. (tsval�ic:,h1.: �laace ) �Z _ , x /q � l c
Sides srd , 1 . t t ,�ncl 9
Ituight ( grade to ri.dq&4 ) 0 fr , * I1: on corner , "er.J3:aCk from side 2crvec r' t
If reaiduntial, no . Of families
No . of roomy ( excluding barilt l - a " OCCUPANCY 3NF01'.1rtATIGN
11o. of bedroouts
„ PRIMARY rs(IILCeIN+L` aw
Noe of k;:;Ac rrooiu:Jz �000 family dwelling
iarit,ury I,c::aci,u3 ::ysLvW H�Z:,E Irvwo f:aa►i.ly dwQll.i.ng
ory1,au ref fuel o 1 im
MuitjjJl.a dwelling / Number of units
No. of firpuplacu:: to 1a:a ir,st�ail.:d O _�i�crtnanorlt oceura:u,cY
Will :a woJd «trove k,v inJt" llud? U0 ' •1•ran::iurrt [atcup:ar,cy
L'a:ntr:al Air coreCiitienirl9 ? ` O - Ar 13u:,inuss
R
BUILDING STYLE;, PRIMARY STRUCTURE � Irsdustrial
,� Other
1;.a,►cl► Car►.t,,:,u,(:.c.r:ury Lon cabin It sddiCian , whaC will ure bia7
l;aai::o,�d ranCil MUnss.e.ee Duplex
Jpl.ic level Old .scyle uu,uJ.alow '
C_:LP4U Cod cott:agn: Ocyr..:r '" AccassORY BuYLDING�
Colonial ltow Iowr, }louse 1j . Cachecs yrr<+cjc/one cur/ two car/ car
( CIRCLe +Dw1_ PLkASE ) ' _�Attachud 9"r.agulona czar/ twGs car/ czar'
a a a a a w u ■ a r a a a v w w a Vr.iv" C%A ,trorzage building .
L `t '1' TMnR' 1: A r� r+ RIKr'1' uAt. Ul OF W Oah`= r
Co" !;*rk,uCTYVN q
] NVORPoLATTON ON BUILDING sprCIPTCATIiONS O ON R VVRsE SIDE OF THIS MHL•ETe 91�0 RE CO PLG'r9Q J
Form DPA 10/88 VS
BUILDING PERMIT APPLICATION CONTINUED - - .
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc . 1,.y00P
Will any second-hand or ungraded lumber be used? If so , for what ? Al
Foundation wall Thickness material _ �
16 "
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? }�''�: S Heated or unheated? A/p Floor sq. footage J: 1 c� syz sq f *
Will there be a basement? Will any portion be used as living space ? a"L>
( If so , what portion? -- sq . ft . - - Type of use? _
Type of roof - slo ed flat/shed/other. Material of roof ,g -
Size , wood studs ;2., "X spacing. /6 "o . c . length
3oists ( floor beams ) 1st . floor '`"X__k�" spacings "o . c . spank ft .
,joists ( floor beams ) 2nd . floor ; "y� } spacing _ / (G "o . c . span 1 5 T -ft .
RoofOver rafters
beams } "�{ . spacing J6 " o . c . span LZ ft .
Roof rafters ", "3c � _" spacings 'o . c . span_ � ft .
Roof •trusses (pre- engineered) spacing - " o . c . span -- ft .
Exterior wall finis ; ,.) D ) /%,; G Of what material ? V y/,/ 14•
anterior wail finis - yY(p y iH r & 7 .4 r C,, k)
If a garage isoerto b(--. . .iched , describe materials to be used for FIRE SEPARATION :
[]G
Is there to be an opening between garage and dwelling? YES , If so will a Fire-rated
door , enclosure , and salf-closing device be provided? yh� S
Will a flue -.lined chimney be installed? Height above roof Z� ft . �A-AOVAr
Depth of chimney foundation below grade
Depth of fireplace hearth — ft . -- in .
Water supply - Municipal or private well M "hi C ) ! ' l
JL
SEPTIC SYSTL•m _ 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 1 0 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
Owner, owner' agent, architect, contractor ^�
SPECIAL CONDITIONS OF THE PERMIT :
8y
TOWN OF QUEENSBURY w✓ � r yY !� 'SS
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 .
c
ANSWER ALL of the following :
1 . Gross floor areas R
2 . Type of heat
d • , ys
13.. Is the building mechanically cooled ?T
4 . Percentage of area of windows and doors 17 `f ,a
A . over 16 % Onl
Y . Uo value of gross area of walla , ro f/ ceiling and floors
xposed to ambient conditions Ua, Q kAf 's } a C7 0 33C2
o ?- 1
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 d )
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 insulationh } i f;rCA
a . Under 16 % only
1 . R value of roof and 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 - 150 '
1 . Thermostat maximum heat setting [ J
D . Duct Systems
14 is duct system installed in unheated spaces ? YES NO
a . If YES , R value of duct installation = ,C
b . R value of duct in other areas
E . Piping Insulation
10 size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F . Service Water Heating C7 ,+
1 . Performance efficiency I� pn
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating
Telephone No . C `. ' - C> -
( appli ant ' s signature )
APPLICATION FOR SRTrl1C DISPOSAL PERMIT
f� <:7�ry
DATE
LOCATION OF PROPERTY FOR INSTALLATION L 0 2— *' A04- .S/20A9g%VW V 1St,o0Vl._,0 RPe
Owner's Name: Telephone:
Address: gaper 13 V osBuR6s+ 4joo goyj c jz *Alic iiL, z F IV �e I .z S
Installer's Name : Telephone:
Number of bedrooms (residential only) .a,
Total daily flow (compute @ 150 gal per bedroom)
Topography; circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one: San Loam Clay Other Depth; feet
Ground Water; At what depth? At,0 feet
Bedrock. or Impervious Material: At what depth? feet
Percolation test: circle one: of require required / rate mine inch.
Domestic water supply; circle one: Municipa well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank 000_. gal. (minimum size: 1 ,0 00 gale)
TILE FIELD: Each Trench ,50 feet / Total system length �27 00 feet
SEEPAGE PIT(S) : Number of --- /—'3t a each __'___.- eet [ay feet
Size of stone to be used 4- / Depth or Thickness J feet s
IMPORTANT
.v_PleaseeeoIAST NEW EQIYIPh ENT TCO BE INSTALL
(over)
Section II 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 lot lines
3. ) location and distance to structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No 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 system 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 installation,
alteration or repair of an approved system , a new ,proposal must be submitted
to the Queensbury Building Department before further construction.
1 have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: ,/s��
Date: g
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New 'York 12801
(618) 792-5832
" ETTI ; 3 . . . Hr-ME OF NATURAL 9EAUT' GOOD PLACE= TO i_ IYE
TOWN OF QQUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME LL F=.c7.5 ic,
LOCATION p /
DATE I I PERMIT # CJH C
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDAT-rON/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
,ELECTRICAL ROUGH-TN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STE S
STAIRS-CLEARANCE &
PLUMBING FIXTURES/RE F VALVE
.INTERIOR TRXM/PRIVACY RS
X FINISHED FLOORS B
GARAGE FIREPROOFING
DOOR CLOSERS)
SMOKE DETECTORS
XFINAL ELECTRICAL INS ECTI
>(,FI NAL APPROVAL OF CO STRUC ION
OK TO ISSUE C/O OR /C
A SIGNED CERTIFXCA E OF OCCU NCY MUST BE
OBTAINED FROM THE UILDING DE TMENT BEFORE
THESE PREMISES AR OCCUPIED!
REMARKS:
ARRIVE
INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
41 .STATE STREET. ALBANY, NEW YORK 12207
!late '11 R 0fi l { i1l Application on filer I i 1 , . t R 1 F3 )
"PHIS CERTIFIES THAT I'E;I�"11 4i3 , .1 11. �?
only the eltrice! equipnsent as described below and introduced iij*4icons named an the above application Ra�bt�sn the prreaaiaee of
ec
Fi?FtK ISEI.R{):> i . , ^ 11EIVIAN I .; 1 .'.�41) RD .
in the following location; ❑ Basement Q )at Fl. ❑ 2n4 Fl. [i '- ft ; 1"I'`r' C f` Section Block Lot 4
was examined an °1 ItCH r1R r C, +11 and found to be in compliance with the rega.ireaaerrts of thin Board,
FWTNRE EhTAGES SwITCHET. FIXTURES RANEiES COOKING DECKS OVENS DISH WASHERS EXHAUST FANM
ET OUTLS INCANDESCE R.Tf FLIM:EetECEM OTHER AMP, I K. W. AMP, K. W. AMT. K.W- AMT. K. W, AMP. H. P-
1 ' r
DRYERS FURNACE MOTORS RPTURR APPLIAHCE FEEDERTi jsrscm R*CfP`Tj TIME CLOCKS FELL UNIT HEATERS MULTI-,lUTtET DUAMERS
AMT. K' W. CAL H. P, LEAS H. P. AMt. NO. A- W. G. AMP, AMP. AMT. AMPS- I TRANS. AMT. H. P. SYSTEMS AMT- WATTS
NiO. OF PE'E'T
1
SERVICE DISCONNECT HO OF S E R V t C E
0.
AMT. AMP. TYPE METER 1 X hM 1 A' 9W 3 ./' ]W 3 }' �W NO. aF CC. LOND. A. W. G. Na_ 0► HI-LEG A. w. G. FIa. of NEUTRALS A. W. TR
EOUM. PER ■ OF CC. CONd. CIF HI-IEG aF NEUTRAL
OTHER APPARATUS:
%>jk1; ;KV VC'i'F i
a T
' 'li_1'VI n x t,l ,r: 1 BRANCH MANAGER
`r
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 CER !FICA E MUST NOT BE ALTERED IN ANY .r����~
.04
TOWN OF +QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 3280k
TELEPHONE (5I8) 792-5832
BUILDING INSPF OR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME _ E ?� 1_ rosa I E�vfsr, _.
LOCATION Qx mca r, EJ'G o
DATE PERMIT #
rl� PPRaVED
YES NQ
RS
MONOLITHIC POUR FORMS
FOUNDATXON/DAMP-4�'RO0FI NG
BACKFILL APPROVAL' _
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
PIALZ S
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS ,
STAIRS-CLEARANCE & RAIms��
PLUMBING FIXTURES/RELrEF VALVE
INTERIOR TRIM/PRIVAclf DO03tS
FINISHED FLOORS
GARAGE FIREPRQOFI'NG
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INIPECTION "
FINAL APPROVAL OF CENSTRUCTION r,
OK TOO rssrz C/O ORJc/c
LGNED CERTIFICA Cs' QF OCCUPANC ST BE
INED FROM THE3�9UILDING DEPART NT BEFORE
E PREMISES ARf OCCUPIED!
REMARKS:
CLVra . t.,iAC .
ARRIVE_
DEPART.4L.22:::�. 4 r1l
f
NSPECTOR
._ fe7wii 0ueer36urt �
BUILDING and .ZONING DEPARTMENT
Bay and Hauiland Road, R. D. 1 Box g$
Queensbury, New York 128Q1
f
_OA mar�
SEPTIC. DISPOSAL SYSTEM INSPECTICNV
NAME
LOCATI
DATE / Q PERM NO. +'— �.ZZ _
SOIL TYPE - Sand - Lo iam - Clay -
Percolation Test Re _fired? YES - NO
Percolation rate - M n/Inch
TYPE of SYSTEM:
Absorptlon field , to al length
Length of each trenc
Depth of trenches
Size of gravel_
SEEPAGE PITS{Ntuntber )
Size- ft. X f
Gravel size
PIPING : Size Typ
Bldg_ to tank r
Tank to dist . box
Dist , box to field/pi
Openings sealed? ES NO artial
LOCATION/SEPARATIONS :
Foundation to tank pt ,
Foundation to absorpti ft .
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON P PERTY (circle one )
Front - Rear - Left si - Right side -
CCMMENTS : f%
TD 4ous,,z
f
r
SYSTEM USE APPROVED YES No
1 Of Lf s-- - �i�nr�
Bualdi g 4inspeor
01/866 and vl
I
_Jow
►`� �uc'ero.s urt�
BUILDING are ZONING DEPARTMENT
Bay and Havif nd Road, R. D. 1 Box 98
G?ueensb ry, New York 12801
SEPTIC DISPO L SYST INSPECTION
NAME
LOCATION f
DATE / (J P RM I NO .S�{����_
SOIL TYPE - and am - clay -
Percolation Ted fired? YES Np �
Percolation rate n/Inch
TYPE of SYSTEM ;
Absorption field , tal length
Length of each tr ch� "-
Depth of trenches
Size of grave]
SEEPAGE PITS Of ) —
Size- x _
Grave size
PIPING : Size Type
Bldg . to tank ,ZenQjf- Qp
Tanis to dirt , ba &{ �
Dist. box to fie d it
Openings sealed? ES No Partial'
LOCATION/SEPARAT ON
Foundation to t k / /Tj ft..
Foundation to or ion -i �ft ,
Absorption to 1 I e
Separation of p is ,r ,r_ ft.
LC)CATIdN QF Yg PRONE TY (circle one )
Front - 42 eft ide - Right side -
COMMENTS : rL►PrL. F ! /v C J;xz-
h/o �Aotnc7 ,,c:A*
7f. �c!IG Cn PA&:-
r C�n u
rt
SYSTEM USE PROVED YPS NO
S ilding ins ctor
01/86 trod vI
TOWN OF QUEENSBURY Phil
BUILDING AND CODES DEPARTMENT
BAY & VI LAND ROADS
QUEENS" RYA NEW YORK 1280&
TELEPHO (518 ) 792-5832
BUILDING INSPEC R' S REPORT
REQUEST R INSPECTION R EIVED S
NAME
LOCATION B� - SApr
DATE d b P RMIT # /
,APPROVED
YES NO
FOOTING/PIER
MONOLITHIC PO R FORMS
FOUNDATION/D -PRROOF G
BACKFSLL APPR AL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUG -IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ EPS
STAIRS-CLEARANCE RAILS
PLUMBING FIXTURE LIEF VALVE
INTERIOR TRIM/PR VA Y DOORS
F ISHED FLOORS
GARAGE FIREPROOF NG
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL NSPE ON
_FINAL APPROVAL OF CONST UCTSON
OK TO ISSUE C/O d C/C
A SIGNED CERTIFI TE OF CUPANCY MUST BE
OBTAINED FROM TH BUILDIN DEPARTMENT BEFORE
THESE PREMISES A E OCCUPI
REMARKS: *OA + P. p
� c�o xs.
ARRIVE
DEPAFt
SNSPEC R
TOWN OF QUEENSBURY
BUILDING .AND {CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 128024
TELEPHONE (518) 792-5832
r
BUILDING INSPECTCIR' S ORT
REQUEST FOR INSPECTION RECEIVE
NAME ,fr
ATION r
DAT X d�W q PERMI ##
APPROVED
YES NO
FOOTIN PIERS
MONOLIT C POUR FORMS
�DATIO DAMP-PROOFING
CKFILL PROVAL
ROUGH PLUMB G
FRAMING
ELECTRICAL RoO6 u-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ TEPS
STAII4S-CLEARANCE & RAILS
PLUMBING FIXTURE IRELIEF V VE
INTERIOR TRIM/P VACY DOORS
FINISHED FLOORS
GARAGE FIREPROO ING
DOOR CLOSERS)
SMOKE DETECTOR
FINAL ELECTRICAL NSPECTION
FINAL APPROVAL O CONSTRUCTION
A SIGNED CERTIFI ATR OF OCCUPANCY MUST bF
OBTAINED FROM TH BUILDING DEPARTMENT BEFORE
THESE PREMISES A E OCCUPIEDI
REMARKS:
f
INSPECTOR
TOWN OF QULEN5B RY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROA S �}
QUEENSBURY, NEW YO K 1280& J,J
TELEPHONE (518) 7 2-58.32 { LI
$U I LDI NG NSPECTflR' S REPO ����
I
REQUEST FOR NSPECT ON REC IVED Z`rl
NAME
LOCATION
DATE PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORM
FOUNDAT.ZO N/DAMP-PROO ING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERN7F*XXTURESIRE
STEP
STAIRS &
PLUMBING /RE VALVE
INTERIVA RSFINISHGARAGEN
DOOR CLOSERS}
SMOKE DETECTORS _
FINAL ELECTRICAL IN PECTIO
FINAL APPROVAL OF C NSTRUC T__
N
A SIGNED CERTIFIC E OF OCC PANCY MUST BE
OBTAINED FROM THE BUILDING PARTMENT BEFORE
THESE PREMISES A OCCUPIED !
REMARKS:
1 r INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORIC 12801.
TELEPHONE (518) 792-58.32
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION Pic-
DATE �fQI! _ PER #
"T APR+OVED
Y S NO
FOOTING/PIERS r✓
MONOLITHIC POUR FORM
FOUNDATION/DAMP-PROOF NG -
BACKFILL APPROVAL -
ROUGH PLUMBING
�K FRAMING
ELECTRICAL ROUG -IN
'INSULATION:
FOUNDATION
FLOORS
XWALLS * K G V t
oAj T r� 40
FINAL INSPECTION. + ,�
CHIMNEY HEIGHT
ROOFING
SID.rNG
EXTERNAL PORCHES/STEPS -
STAIRS-CLEARANCE & RAT� S
PLUMBING FSXTURESfRE F V VE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING t
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL INS ECTION
FINAL APPROVAL OF C . STRUCTION
OK TO ISSUE C/O OR 6/C
A SIGNED CERTIFICATE OF OCCUPANCY ST BE
OBTAINED FROM THRIBUILDING DEPARTMENT BEFORE
THESE PREMISES AIW OCCUPIEDf
REMARKS:
ARRIVE ! /�
DEPART
INSPEC TOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK .2280¢
TELEPHONE (5I8) 792- 58*
BUILDING INSP CTOR ' S REPORT
REQUEST FOR INSPECTION . ECEIVED
NAME
LOCATION L4 %=3 $
DATE ~J- PERMIT # `�
.APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORM
FOUNDAT^Z-ON/.DAMP-PROO ING
BACKFILL APPROVAL
YROUGH PLUMBING
' FRAMING
ELECTRXCAL ROUGH-IN
INSULATIONa
FOUNDATION
FLOORS
WALLS
CEILING
FINAL XIVSPECTIONr
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL'' PORCHES s EPS
STAIRS-CLEARANCE , & RAILS
PLUMBING FIXTURAt5 ELIEF VALVE
IN2'ERIOR fiRSM/P9IV4CY DO01?S
FINISHED FLOORS
GARAGE FIREPROOF?N
DOOR CLOSER (S) _�...
SMOKE DETECTORS
FINAL E'LECTRICA4 INS C TION
FINAL APPROVAL OF COTRUCTION
OK TO ISSUE C/o OR C/�
A SIGNED CERTIFICATE F OCCUPANCY MUST BE
OBTAINED FROM THE BUDDING DEPARTMENT BEFORE THE,S',E PREMISES ARE OC94UPXED I
,a ►y REMARKS: ILA r l (A �Z4-sJ t' 0A1
'✓
0 Al A— c c r3 t. ' rvc wry
ARRIVE
DEPART ,' t* 4LS ` -
INSP TpR
a..AJ
A4 )Z 5 i C)
i
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & IfAVTLAND ROADS
QUEEIVSBUR,Y. NEW YORK I280+I
TELEPHONE (528) 792-5832
BUILDING INSPECTORrS REpORT
REQUEST FDR INSPECTION RECE-rVED
NAME
100CATION
DATE
APPROVED
A:FOOTIN YES
MOIVOLITHTC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKF.rLL APPROVAL
ROUGH PLUMBING
FRAMING
ELEC'TRXCAL ROUGH-IN
XNSUZATION;
FOUNDATION
FLOORS
WALLS
CETLINc
FSNAL INSPECTION:
CHIMNEY HESGHT
ROOFING
STDXJVG
EXTERNAL PORCHE STEPS
STAIRS-CLEARANG & )ZAXLS
PLUMBING FIXTF! RS/RHZ-rEF VALVE
INTERIOR TRTM PRIVACIADOORS
FTNTSHED F R�
GARAGE FIRE OOF.ING
DOOR CLOSE (S? _
SMOKE DETE TORS
FINAL ELECT ICAL INSPECTION
FINAL APPR AL OF CONSTRUCTION
A SIGNED 0ERTIFXCATE OF OCCUPAIVCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMrSRS ARE OCCUPIED:
REMARKS:
INSPECTOR -�~�
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS f� /
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE PERMIT
T �_ cvr k2 APPROVED
� / YE NO
u"OOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATIONfDAMP-PRppFING
BACKFILL APPROVAL 3
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH- TN 'k
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING s {
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEP
STAIRS-CLEARANCE & SLS_
PLUMBING FIXTURES/R LIEF VALI' "-
INTER-TOR TRIM/PRIV Y DOORS
FINISHED FI.QORS
GARAGE FIREj=2? .FI G
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL NSPECTION
FINAL, APPROVAL O CONSTRUCTION -
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS.
r L�
INSPECTOR