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1989-370 CERTIFICATE +CJF OCCUPANCY TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK Date 14 _ This is to certify that work requested to be done as shown by Permit No. 89-370 has been completed. This structure may be occupied as a Si nal a Fami 1 V Dwel 1 i nQ I ovation Owner Phillip Tucker By Order Town Board TOWN OF QUES14SBURY Director of Bldg. do Code Enforcement -4 BUILDING PERMIT TOWN OF +QUEENSBURY 0 No. 89 370 WARREN COUNTY, NEW YORK w l c� PERMISSION is hereby granted to Phi l l iTn Tucker OWNER of property located at Lot 27 Hidden Hi I I c nvivdx Street, Road or Ave. in the Town of Queensbury, 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 Queensbury Building and Zoning Ordinance. t , OWNER'S Address is i t 38 Dix Avenue ran Queensbury, N . Y . 12W4 b 2_ CONTRACTOR or BUI l_DE R'S Name r Self 3. CONTRACTOR or BUILDER 'S Address Sam 4. ARCHITECT'S Name t-I^ 5. ARCHITECT'S Address x .a. 06 fi tti 8. TYPE of Construction — (Please indicate by X) 'X''X) Wood Frame { ) Masonry f I Steel err tv 7. PLANS and Specifications No. 49 ' x 44 ' Single family dwelling as per plot plan , specifications , an application , including septic , attached two car garage and driveway. 8. Proposed Use Single Family Dwelling to ro $ PERMIT FEE PAID — THIS PERMIT EXPIRES January 1990 n (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 expiration date.) � Dated at the Town of Queensbury this Day of June f'g 89 SIGNED BY for the Town of Queensbury Building and ZoniAWTnspector to Y BUILDING PERMIT VALUE so TOWN OF QUEENSBURY 89370 TAX HAP" NO . 93 . - 5 - 22 Nam' WARREN GC1iJNTY, NEW YIDRK SUCKER . PHILLIP PERMISSION is hereby granted to OWNER of property located at 22 HIDDEN HILLS DR . Street. Road or Ave. CLOSE OUT PERMIT FOR SINGLE FAMILY DWEL in the Town of Oueensbury, To Construct or place a 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 NEW OWNER COLOMMA , THOMAS 35 CEDAR STREET CENTRAL ISLIP . MY 11722 2. CONTRACTOR or BU LDER'S Name 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) { I wood Frame ( I Masonry f I Steel 11 7. PLANS and Specifications Stla,Zua ck salt up for Hay ' 91 SE CLOSE OUT PERMIT AT REQUEST OF OWNER 10/ 13 / 95 S. Proposed Use CLOSE OUT PERMIT FOR SINGLE FAMILY DWELLING 0 January 1 19 90 $ PERMIT FEE PAID — THIS PERMIT EXPIRES (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 expiration date.l Dated at the Town of Queensbury this �, 1 ay of Ocitober 95 SIGNED BY for the Town of Queensbury Building a Zonirg Inspector TO BE COMPLETED BY BLDG . DEFT. �] / Application No . _ JCiwn o ueert�6ttrs� permit Issued 19 ';;?'J OP BUILDING and ZONING DEPARTMENT permit Expires 19 Bay and Haviland Road, R.D, 1 Box 98 zoning Designation Queensbrury, New York 12801 variance No. J }' Site Plaza, Review No . <4� $ 4909 Approved by : Cf3 APPLICATION FOR � qtD,�C� BUILDING AND ZONING PERMIT ,x. # � � .x. � � � � * ,� * * � * � �► * .» � � � .�. so- � � � ,K. � � ,,r ,* � * * � � :�.� A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING . The undersigned hereby applies for a Building Permit to do the following work which wij.l be done in accordance with the description, plans and specifications submitted, and such , special conditions as may be indicated on the Permit . The owner of this property is : ��� ► � fl r} L� P . O. Address Tel . Property Location : ;` ", 'Ack: 1C 13, GIs ) +z , A y � Tax Ma No . / Street number or building lot number Subdivision name (if applicable) " i�1�'ICA16 I b THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARD'S BUILDING CODES IS : Name P. O. Address Tel . No * Name of builder ' scI C7Cc 51 Address `d � , "! ,btL' - Tel . ! 364v Name of plumberAddress 75eje�% Tel . CL Name of mason Address „�.�� Tel * NATURE OF PROPOSED WORK : * ZONING INFORMATION : -�LConstructi.on of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , Addition to a building * drawn reasonably to scale and attached hereto, Alteration to a building showing clearly and distInctly all buildings , (no change to exterior dimensions) whether existing or proposed and ,indicate all other work (describe) " set-back dimensions from property lines . Give * street and number or lot number and indicate * whether interior or corner lot _ Show location FOR DEMOLITION PERMIT, STATE SIZE AND of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. * of septic disposal area . U(K a$ V + 16fi , * COMPLETE INFORMATION REQUIRED BELOW . Size of property ft X. f u S __ft . * Existing I�dilding ( s) Size Aft X ft . PROPOSED BUILDING AND USE : * Existing building ( s ) Use Size of new structure 1 9 ft X , ' t ft * . . . . . . . Poundation-pier/slab/crawl/partial ullT * Proposed building, distance from property line (circle erne ) Front yard '41 ft Rear yard `7 '(if _- ft No . of stories (habitable space ) * Side yards - a .` ft and cti? ft Height ( grade to ridge ) � � ft. * If on corner, setback from side street ft If residential , no . of families r "` No . of rooms ( excluding baths ) * OCCUPANCY INFORMATION No. of bedrooms No . of bathrooms _�1 - * PRIMARY BUILDING Primary heating system - .',/sc * + One family dwelling * Two family dwelling Type of fuel �r �� 5 * Multiple dwelling / Number of units No . of fireplaces to be installed +LiY)c: Permanent Occupancy Will a wood stove be installed? AI (Z> * p y Central Air conditioning? Transient occupancy ,,, Business BUILDING STYLE, PRIMARY STRUCTURE * ' Industrial Ranch ontempor�Log cabin * other Raised ranch nsion Duplex * If addition, what will use be? I� Split level Old style Bungalow Cape Cod Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * Detached garage/one car/ two cart car ( CIRCLE ONE PLEASE =Attached garage/one car/ F,[o ca.JE car Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION INFORMATION ON BUILOTNG SPECTFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLUTEDI Form nPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED — BUILDING SPECIFICATIONS : Type of construction , plod frame , fire safe etc . will any second-hand or ung lumber be used? If so, for what ? Foundation wall material � C"k se,- � Thickness Depth of foundation below grade ( to bottom of footing ) __ Will there be a cellar? Heated or unheated? Floor sq. footage 1345% K sqft. Will there be a basement? Will any portion be used as living space?__ -� t/ - ( If so, what portion? sq. ft . - - Type of ruse? Type of roof - to a /flat/shed/other Material of roof , Size , wood studs " X�� spacing "o. c . length �ft, 7018tS ( floor beams ) 1st . floor "X� (" spacing. "o . c . span��ft . .joists ( floor beams ) 2nd . floor �.�X }C " spacing_ "o . c , span / _3 ft . overlays (ceil).n beams ) "X,, '• spacings/ "a, c . span 1 5 ft. Roof rafters "X "' spacing P . c . spawn ft. Roof trusses (pre-engineer d) spacing "a , c. span ft. Exterior wall finish [� c � �btJ pf what material? Interior wall finishIf a garage is to /b--e attached , describe materials to be used for FIRE SEPARATION : Lr 1 SaC"� c f /Le e07 'lr& Is there to be an opening between garage and dwelling? Ye If so will a Fire-rated door , enclosure , and self-closing device be provided? � * ti Will a flue-lined chimney be installed? L/ ' c� Height above roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft , in , E Water supply - Municipal or private well /n/)cJ SEPTIC SYSTEM _ Distance from ANY private well (IncludIrfig adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury County of warren A F F I D A V I T STATE OF NEW YORK I swear that 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 COOS , 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 . SWORN TO BEFORE ME THIS Signature ------ -------- Owner, owned s t , arcnXr ect , contractor LQ�day of 19 w Notary Public , Warren County, N , Y .. It * re x : : * sr it * it k w * . w w f fr sr a► R w a 9t `: i, w a * * w sr wt !r s se r • x Yr * * t 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 7 � `S F 2 _ Type of heat _ AVk, t.../ k3 7xas t� ti Od -k A c 3 . is the building mechanically cooled ? 4 . Percentage of area of windows and doors A . Over 16 % Only 10 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 insulatio.a, {� B _ Under 1 +6 % On ; + ` 1 . R value of roof and floors ` exp�o`se ambient conditions. f 2 . R value of exterior walls " 3 _ R value of glazed area rY, 4 , R value of doors Li !L 50 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 j� 4z�. e % oc Co Controls �r 1 . Thermostat maximum heat setting c � Do Duct Systems 10 Is duct system installed in unheated spaces ? YES a . if YES , R value of duct installation b , R value of duct in other areas E , Piping Insulation 10 Size of hot water or cooling carrying agent pipe 20 R value of pipe insulations F , Service Water Beating 1 . Performance efficiency GCs 2 . Temperature control setting maximum G , For Swimming pool Only 1 , Maximum heatingg Telephone No . Y 3 Ai " LL L ( app i . ani signature ) .J�r►7� E3 �� iE�`id� APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE r C) / rci LOCATION OF PROPERTY FOR INSTALLATION Owner's Name: _ k ! lit / w '� lrnr Telephone: x' '•� �+ O Address: yA 6 F AJJ Installer's Name: 1 -J 1VA , ic'442 i r Ste' � Telephone: J � (� Number of bedrooms (residential only) :__ Total daily flow (compute @ 150 gal per bedroom) _ Topography: circle one: lat Rolling Steep Slope $O of slope Soil Nature: circle one: C and 1 Loam Clay Other / Depth: _ feet Ground Water: At what depth? feet Bedrock or Impervious Material: At what depth? feet Percolation #est: circle one: of required , required / rate min. inch. b Domestic water supply: circle one: irmunicipa Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption ___ feet PROPOSED SYSTEM: Septic Tank (`yp gal. (minimum size: 1 ,000 gal.) 'PILE FIELD: Each Trench C3- - feet / Total system length _ Ca _ feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # �� / Depth or Thickness �� feet I M P O R T A N T _._P'lease...LIST NEW EQUIPMENT TO BE INSTALLED (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 20) location and distance to lot lines 3.) location and distance to structures 4.) location and distance to any water supply 56) 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. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal C)rdinance. Signature of responsible person: Date: [ 5 Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New 'Fork. 12801 (518) 792-5832 SETTLED 1763 . . HOME OF NATURAL BEAUTY . . A GOOD, PLACE TO LIVE ► ���:� a cER=nFicATE OF INSVFMNCE ISSUE DATES IMMlOD+'YY) Q5 +*J 'aT PRODUCER +-fir TT THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS .J Y11111114&UP& 4AWC+ NO RIGHTS UPON THE CERTIFICATE HOLDER_ THIS CERTIFICATE DOES NOT AMEND, idy4 JC EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 0. &G, .22 COMPANIES AFFORDING COVERAGE �'1 easa 7 l f All Now .9LrrA / ago/ COMPA LETTERNY A XJi64J.' J1H�� coo CODE SUB-CODE COMPANY g INSURED ��1jjj /1 }/ J_ / LETTER w+ ai'a Cl� E�, [J#. !!&A&am YR.S.L4Lj . � COMPANY LETTER .�. .//w���fQ,��IIlix Ave. y�r �/ J laz La NOW .�a^4 tMI COMPANY LETTER D COMPANY LETTER E COVERAGES THIS IS TO CERT FY 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MMlODlYY) DATE IMMIDDIYY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY y ,�! +�g GENERAL AGGREGATE 's /F F./wp COMMERCIAL GENERAL LIABILITY � P+'T �' � � yrI`�„*p {�t� '� PRODUCTS-COMPIOPS AGGREGATE ; CLAIMS MADE OCCUR. PERSONALS ADVERTISING INJURY § OWNER'S S. CONTRACTOR'S PROT. EACH OCCURRENCE S woo FIRE DAMAGE (Any one fire) S ` MEDICAL EXPENSE (Any one person) S Jj �f AUTOMOBILE LIABILITY COMBINED • 4 JM ANY AUTO SINGLE S 66 &4 3-9 5'9� 3 0 1 1 8/8q 01 /2 ksr'g0 BODILY ALL OWNED AUTOS SCHEDULED AUTOS INJURY $(Per person) HIRED AUTOS BODILY NON-OWNED AUTOS INJURY § (Per acciclenf) GARAGE LIABILITY PROPERTY ,§ DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE S S OTHER THAN UMBRELLA FORM STATUTORY riIO RKE R'S COMPENSATION �f�1,r� {1� /� /��Q �yr1� AND wL �-"• � 0/1�f � 01 """"'��Q s /00, (EACH ACCIDENT) EMPLOYERS' LIABILITY S , 3 IOISEASE—POLICY LIMIT) $ /,�r� W (DISEASP—EACH EMPLOYEE OTHER R NY Stern t2dE �73�"Sl Ivt/a8,rdl� 011428190 DESCRIPTION OF OPERATIONWLOCATIONS"EHICLEWRESTRICTIONSJSPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE L3fL4LCGLJtC�I. +G+' "1 . EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 6 a4z Roar7d MAIL M. BAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE QGGC?2JL/1C71L+LCd(,r Ne,,. }`oj& 128104 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY ANY KIND UPON rtE CO ETS AGENTS OR REPRISE TIVES. AUT PR '6 ACORD 2" 3188 R RPORATION 7988 i TOWN OF QrUEENSBURY BUILDING & CODE ENFORCEMENT 531 SAY RD . , QUEENSBURY NY 12804 I INSPECTOR ' S REPORT ' ARR%_�DEPARTJCJ�_ I i REQUEST FOR I*NSPECTION RECEIVED : NAME _-, hCJ' 1.�► 'ti --- LOCATION DATE - PERMIT TYPE OF ST UCTURE ; RECHECK - APPROVED N/A� YES NO FOOTINGS PIERS MONOLITHIC POUR FARM REINFORCEMENT IN PLACE _ THE CONTRACTOR IS RESPONSIBLE OR PROVIDING PROTE TION FROM FREE ING FOR 48 HOURS FOLLOWING THE PLA MENT OF THE CONCRETE„ I _ MATERIALS FOR THIS PURPOSE ON SI E FQUNDATION WALLPOUR REINFORCEMENT IN PLACE FOUNDATION DAMPPR NG BACKFILL VAL PLUMBING VENT/VENTS IN PLACE ROUGH PLUMBING -- --' . PLUi°1BING UNDER SLAB + --- -- --- --. FRAMING : ,JACK STUDS/HEK-DEAS- - ---- - -- -.., SRA!CIMG(BRIf3GING --- JdIST - JACK PO'8T5 /MAIN BEAM - -- -- AIR INFILTRATION BARRIER HEATING ROUGH- IN - - - .`.- ---- - INSULATION - FOUNDATION WALLS INTERIOR R- - _ - -- --�- FOUNDATIO� N WALLS EXTERIOR R- FLOfl S _ WALLS R - CEILING R --_ fJUCT WORK OR R PIPING IN - UNHEATED SPACES R - 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 7 NAME LOCATION DATE / Z PERMIT ! TYPE OF STRUCTURE RECHECK APPROVED N/A IYESI HD FOOTINGS/PIERS MONOLITHIC POUR F RM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONS E FOR PROVIDING PROTECTION F OK FREEZING FOR 48 HOURS TOLL WINi THE PLACEMENT OF THE CONCR TE MATERIALS FOR THIS PURPOSE , ON,7SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTSINZYLACE1 PLUMBING UNDER SLAB FRAMING : JACK S / EAD R BRACING/BRIDGING JOIST HANGERS JACK POSTS/MA IS AM HEATING ROUGH- 1 INSULATION : FOUNDATIONNALLS INTERIOR R-- FOUNDATIOR WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PrPffid IN UNHEATED SPACES REMARK CO/ � INSPECTOR TOWN OF QUEENSBURY Say at HHa andiR�, M,,i DepBC t9mant518-T92-5832 (� t— �•t] INSPECTOR ` S REPORT ]C"-kE& � ►� 1 - J PROPERTY ATIO J-c>E �� mN 1 t kj OWNER OR TENANT BUILDING SEWAGE_ SIGN OTHER REMARKS : 4A ' JJ� aoe f � s CONTACT THIS OFFICE WITHIN EC OR "HOME OF NATURAL BEAUTY . . . A 0000 PLACE TO LIVE" SETTLED 7763 TOWN Op Q L3EENSB[3RY p BUILDING AND CODES DEPARTMENT HAY S RAVILANEW OA©DS 3 281711- QUEENSBURYr pX TELEPHONE ( 518) 792-5832 WILDING INSPECTOR' S REPORT INSPECTION REQUEST rf ¢ 3 NAME vc/Y"er 22 LOCATION ,+D _ PERMIT # + �� DATE APPROVED YES NO r O�,TIrIG/PZERs " MONOLITHIC POUR FORMS FOUNDATXONIU"p.PROOFING -�- BACKFILL APPROVAL �- ROLIGH' PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL XNSPECTION: CHIMNEY HEIGHT ROOFING SXDING EXTERNAL PORCH S/kiP l_._�--- ,STAIRS-CLEARA CE & RAILS PLUMBING FIX RES/RELIEF VA VE XNTVRIOR TRI (PRIVACY DOORS FINISHED FLCPRS NG GARAGE FIREPROOFI DOOR CLOSER(S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION C BE A SIGNED FROM THEAU'zn; Ur BUILDXNDEPARTMENTTBEFORE OBTAINED THESE PREMISES ARE OCCUpIEDI REMARKS : INSPECTOR TOWN OF RY BUILDING AND CODES DEPARTMENT zeq ,BAY & HAVXLAND ROADS QUEENSONEBURY, NEW f51g ) Y�92-5832RK 0 BUILDING INSPECTOR' S REPORT REQUEST IFOPy XNSPECTION RECEIVED NAME r� AI LOCATION � � ! �7 PERMIT #�� ,. � DATEFrG� APPROVED YES O r p9071ING/�PIERS FORMS MONOLITHIC PO FOUNDATION/Dp'PROOFING��— AM BA ILL APPORVAL OUGH PLUMBIN `G FRAMING fr ELECTRICAL ROUGH—XN INSULATION: 3 FOUNDATION ,FLOORS WALLS CEILING FINAL XNSPECTION: CHIMNEY HEIGHT ROOFING d SIDING EXTERNAL PORCHES/STE �----- LS STAIRS—CLEARANCE & x PLUMBXNG FIXTURES/ LIEF VALVE INTERIOR TRXMIPRIV CY DOORS FINXSHED FLOORS GARAGE FIREPROOFI G DOOR CLOSERS) SMOKE DETECTORS' FINAL ELECTRICAL 11NSPECTION FINAL APPROVAL OF, IrCONST.RUCTION A SIGNED CERTIFX ATE OF OCCUPANCY MUST BE OBTAINED FROM THl BUXLDING DEPARTMENT BEFORE THESE PREMISES A E OCCUPIED! REMARKS: `� of f f t f rir4 fU r zN$PECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS �y � QUEENSBURY, NEW YORK 3 28 0k TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION 4? DATE - { - _ ,._� F`ERMIT # APPROVED YES LX,A0rOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIONIDAMP.PROOFING BACKFILL APPROVAL ROUGH PLU KING FRAMING ELECTRICAL OUCH-IN INSULATION: ' FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH S/S EPS STAIRS-CLEARA CE & ILS PLUMBING FIX URES/R IEF VALVE INTERIOR TR /PRIVACDOORS FINISHED F RS - GARAGE FI PROOFING DOOR CLOS R (S) SMOKE DE ECTORS FINAL ELEC ICAL INSPECTION FINAL APP OVAL OF CONSTRUCTION A SIGNED ERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: r �- 4 3 s T INSPECTOR TOWN OF QUEEN3SBUR'Y BUILDING AND CODES DEPARTMENT �? - BAY & HAVILAND ROADS I QUEENSBURY, NEW YORK 12809- + L TELEPHONE (518 ) 792,5832 BuILI)ING INSPECTOR ' S REPORT REQUEST .FOR INSPECTION RECEIVED NAME LOCATION DATE Il PE IT # APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR F RMS FOUNDATION/DAMP- PING BACKFILL APPROVAL UGH PLUMBING �RAMI NG ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS A ILING AL INSPECTION ` CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESIS FPS STAIRS-CLEARANCE RAILS_ PLUMBING FIXTURES RELIEF ALVE INTERIOR TRIM/PR ACY DOO FINISHED FLOORS GARAGE FIREPROO NG DOOR CLOSER (S) .SMOKE DETECTOR FINAL ELECTRICAL INSPECTION FINAL APPROVAL CONSTRUCTION A SIGNED CERTI .LCATE OF OCCUPANCY S7 BE OBTAINED FROM HE BUILDING DEPARTMEN BEFORE THESE PREMISE ARE OCCUPIED! REMARKS : L INSPECTOR MR FGQMS '.OQPORA-Y1w NEW 'C)J h 5 (, KS CQVN-Y LA IWP ELECTRICAL PLEASE BEAR DOWN 66420 P�MEx 1+"'�nrc„q„ MIDDLE DEPARTMENT INSPECTION AGENCY , INC . National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 / APPLICATION FOR ELECTRICAL INSPECTION THIS SECTION TO BE COMPLETED BY APPLICANT DATE. -. � . City, Town or Township = County ir .c F State Al J Location: Lot ��' Block Street Address _ _ _+ � ^1t r � y (If Located in Rural Area - PI ase Attach Directions) Pole No, Owner 1 1 [ tilC kC �^ J? Permit No. Occupied As i.ry + I k + Building - New s7..�'" Old Occupant Work - New ] Additional _ App, for - Rough Wiring ❑ Fixtures ❑ or Ready for inspection 1 9 Fee Remitted - $ By Check ❑ Money Order '-71 Make Payable to A enc RATAFATI=41 I M=OT7M 0 1 Call 24 Hours Prior to Inspection Number of Rough Wiring Outlets Miscellaneous Equipment 500 TSd I Moor r1 554 Switches Elect. Heat +500 IT?SO 2000 1 2250 1 2500 1 2750 3000 Lighting Cs(n Amp, Service Surface Unit Dishwasher Flange Receptacles +Water Heater . Air Conditioner 4T Dryer Pump Number of Fixtures - Oven Garbage Disposal Wiring and Controls for ✓burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTOR H.P. 1120 1i12 vio Us SIB U4 � F13 172 3l4 i 1 bR 2 3 5 7 Yz 10 15 20 25 30 40 50 75 100 Mark Number of Each Size Appticant's Signature License # Permit y T!A Name of Applicant's / i Utility Address Office & Phone to Nptified Cit State Zip Cade O - AGENCY USE ONLY: Date Received Date inspected Rough Wiring cutlets K.W. Surface Unit K.W. Oven Outlets K.W. Range H.P. Garbage Disposal Receptacles K.W. Water Heater K.W. Dishwasher Fixtures H,P, Air Conditioner K.W. p er Amp. Service Equipment Burner, Wiring & Controls for ` Amp. Receptacle Amp. Service Conductors H .P. Pump Frac, H.P. Vent Fans MOTORS H.P. 1i2o 1rt2 1110 11s 116 1 ;4 1!3 1f2 0'4 1 + ^h 2 3 5 T :z 10 15 20 25 30 40 50 75 100 Mark Number of Each Size APPARATUS Elect. Heat 500 1 750 1 1000 1259 1 1500 1 1250 2000 1 225C 2500 2750 3000 Corrected Location CERTIFICATIONS PROGRESS: Inc. ❑ Lkd. ❑ NOTIFIED RE- PORT cnno NEW OLD FEE PAID '71 Rough Wiring ❑ Fixture Approval VIOLATION: Work Comp, ❑ Inc. ❑ Contractor FEE ❑ Elec. Certificate Owner CHECK ❑ Letter of Approval Oecu ant INV. ❑ In-Plant Approval Agent Elec. Lt. Date Issued Other Side ❑ Co. TOWN OF QUEENSBURY 531 SAY ROAD, QUEENSBURY„ V.Y. 12804-9725 (518) 745-4400 October 13 , 1995 Thomas Colonna 35 Cedar Street Central Islip , NY 11722 RE : Permit # 89 -- 370 Lot 22 Hidden Hills .Dear Mr . Colonna : As per our telephone conversation on October 3rd , 1995 you chose to close out permit # 89 - 370 which had. expired . Please be advised , that you are still responsible for maintaining the foundation that was capped off . If you have any questions regarding this matter please do no hesitate to call this office . Sincerely , r�f�^ DAVID HAT N , DIRECTOR BUILDING & CODE ENFORCEMENT od r"C)MIE of- NATURAL BEAUTY . . . A C700D PLACE TO LIVE„ SETT[_ED 1763 MAP REFERENCE. HIDDEN HILLS SUBDIVISION MAD9 FOR RA LPH& MICHAEL WOODBURY BY VanDusen & Steves prup SZPFNAtBRR 22, o86 p t� IN MAP CABINET A SLIDE 44 '30�od (A 0 C) 0?0 LOT 20 LOT 24 OF QUEENWRY C cCO. 0 ya dMin . Zoning A LOT 22 D;i 39,505 sq. 0.90 acres GCS LOT 49 MAP OF A SURVEY MADE FOR PHILLIP J. & DIANE J TUCKER .......... ------- TOWN OF QIJEEXS� COUNTY OF WARREN N.Y. C� Al SCALE, I-m-50' DATE- JUNE 1, 1989 06', VO 6's Valpflusen & steves LO ' 50 LAND SURVEYORS GLENS FALLS,NEW YORK Y N.Y. STATE LTC. NO 35617 93-5--22 88-228 G (85-458 D 27)