1988-914 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
�r y I Date May 26 19 89
\ A3.9)
This is to certify that work requested to be done as shown by Permit No. 88-914
has been completed.
This structure may be occupied aq a 0� Single Family Dwelling
1 1
Location - ' may.
Owner Douglas Burbr3.dge 4
By Order Town Board
TOWN OF QUEENSBURY
_ ,
Director of Bldg. do Code Enforcement
.R H
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-914 °
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Douglas Burbridge °'
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OWNER of property located at Lot 101 Iroquois Drive-Tyneswood 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.
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1. OWNER'S Address is
22 Cedarwood Drive
Ballston Lake, New York 12019
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2. CONTRACTOR or BUILDER'S Name
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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1CX)Wood Frame ( 1 Masonry ( )Steel ( )
7. PLANS and Specifications 1 M
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No. 54' x 49' single family dwelling as per plot plan,specifications,
and application submitted,including septic and driveway.
8. Proposed Use 0
0
a.
Single Family Dwelling
25.00 C/0
$ 277.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 1 1989 N
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the CfQ
town of Queensbury before the expiration date.)
CD
Dated at the Town of Queensbury this 2nd Day of December 1988
,adSIGNED BY L' for the Town of Queensbury ty
Building and Zoning Inspector
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TOIVN OF QuEENSBURY APPI.TCATION FOR BUILDING AND 09FU1 T 61IRV
i� .te- RECEIVED
t,,-" ReC .eyed 11/2./�m •
>< �_ ro: �� >;evi-it , - Q , , Nnv 211988
!I ' Fee. F, '• pZ�®-- - BLDG. & CODE DEPT.
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BUILDING AND CODES U1:PARTMEtr1 Date I44ued
BAY and NAVILAND ROADS RD 1 Box 98 •
PUEENSBURY,NEW YORK 12804 Penrnu t Na• o"9 I L.'
Tel . (518) 792-5832 Ext •209
.. .* * * * * * .e* * 1 * * * * * * * *. * * * * * * * * * *. A * * * * * * * * * .
A PERMIT MUST B1L OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS
1:ILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. -
All applicable spaces on this application must be completed and the
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~mature of the applicant Must appear on the reverse side of this sheet .
* '..t * * * * * * is * * * * * * * * * * * * * * * * * * �: * * * * * * * * *
The owner of this
property is : .pOV6, ' oi//34 /D“.- G
P . O . Addressa� C6D11,e- 1890 AL AelLE-STo� lAg,E, /V�y /2W9 TEL. 8.9y'' /(9/2
Property location /&/ /oi ‘r-/�1Qacc,lS OA TAX MAP NO.a/ / ? //a(
llas there been any split of this , property since October 1 , 1988? 4 -
yes no
] f yes , Planning Board Review is necessary. /
SUBDIVISION NAME, IF APPLICABLE ` (/Vg,Stue-o LOT NO . /O
The person responsible for supervision of work as regards/ Building Codes is :
,l A(-45 /3 /-'i�4��/ e?,C A-e_arvv p ,Pre - gee.c /1,4,-, t- /l),Y/20 l 9 eFf`T- lTi
NAME P .O . ADDRESS TEL. NO.
Name of builder ,4-69`/ ' Address Tel
Name of Plumber//, Aallogj- j Address Jet 9 Cl/I. A ie Tel ,31/ `aaT/
Name of Mason /jow.r`l f-1C,rh." lt.< Address IQu .uS4v-n`r /,-'Y Tel 7g2-- 0z.-Z7—
NATURE OF PROPOSED hORK: A ZONING INFORMATION (Office use only)
✓.Construction of a new building A ZONING DESIGNATION OF PROPERTY
_Addition to a building * PERMITTED PRINCIPAL PERMITTED ACCESSORY
Alteration to a building A
^(no change to exterior dimensions) * REVIEW REQUIRED - PLANNING BOARD ZONING BOARD_
Other work (de crib :) * SITE PLAN REVIEW It APPROVED DATE
CROSS AREA OP PROPOSED, STRUCTURE A VARIANCE It APPROVED •
DATE
1st Floor fie is sq f t . ' Remarks:
f�7
2nd Floor - -)JQ *sq ft . * COMPf.L'1'li INl?Ola•tA'1'1ON REQUIRED BELOW.
1�� f t x ISM r t. �-
Other Floors 0 sq ft .
* Size of property
* Existing building(::) Size ��� X ft.
( not cellar or basement) J ‘)ft . ;
TOTAL FLOOR AREA jK�cr, ' sq �J • Existing building (s) Use �U��.
Size of new structure ,5�--ft.-a-�fy ft A
t'ocsr,dation-pier/slab/crawl/partia1� * Proposed building, distance from prope• rty line
(circle one) • Front yard ft Rear yard SO ft
No. of stories (habitable space) * Side yards 5S' ft and c5'cD ft
Height (grade to ridge) AC ft. * If on corner, setback from side street SO_ft
if residential, no. of families
No. of rooms(excluding baths) CD * OCCUPANCY INFORMATION •
ilo. of bedrooms ill/ • R PRIMARY BUILDING -
No. of bathrooms o2 /-x/ * One family dwelling
Primary heating system n NIJ� * Two family dwelling]
Type of fuel plLfld�/r+�l"- * Multiple dwelling / Number of units
No.. of fireplaces to _be installed Permanent occupancy
Will a wood stove be installed? `155 * '1'ransiurrt occupancy
Central Air conditioning? VD * —
Business •
*
BUILDING STYLE, PRIMARY STRUCTURE * industrial
* Ocher
. lunch Contemporary Lon cabin A If addition, what will use be?
Raised ranch Mansicu Duplex
split level Old style Bungalow A
Cape Cod Cottage Ocher * ACCESSORY BUILDING-
olonial plsol Row 'town House • * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Actached garage/one car/ two car— . cap'
* * A * * * * * * A * Private storage building
—.
ESTIMATED MARKET VALUE OF * Other
CONS•1'RUCTION *
$1 A0 0
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED:
Form BPA 10/88 vl
BUILDING;PERMITAAPPLICATION CONTINUED -
BUILDING:SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc.. °9 l�h44-^4
Will•any. second-hand or ungraded lumber be used? If so, for what? ' ,tfp
Foundation wall material 7 0U 4-40 Ce/A4erTYrCkness pi(
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? do Heated or unheated? Floor sq. footage sq ft
Will there be a basement? c./ 5 Will any portion be used as living space? `(J?
(If so, what portion? sq.ft. - - Type of use?
Type of roof - slope)flat/shed/other Material. of roof // c4,,!� i Siy„fe,._L -
Size, 'wood studs 2�"X (O " spacing /co "o.c. length O ft.
— Joists(floor beams) 1st. floor - "x / 69 " spacing /(, "o.c. span lb ft.
Joists (floor beams) 2nd. floor fj "X /p " spacing /(o "o.c. span fa. ft.
Overlays(ceiling beams) A.0.)1X " spacing "o.c. span ft.
Roof rafters fe--"X " spacing o.c. span ft. •
Roof trusses (pr -engin ered) spacing 2,y "o.c. span ��ft.
Exterior wall finish !2,242 C76:0e12i Of what material?
Interior 'wall finish //a. S17iZrz /1pU✓
If a garage is to be attached, , describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? k7.160 If so will a Fire-rated
door, enclosure, and self..-closing device be provided? '7'
Will a flue-lined chimney be installed? `-/jj Height above roof ft.
Depth of chimney foundation below grade it04- ft. 7,uiLo
Depth of fireplace hearth 2/ft. tl in.
Water supply - Municipal or private well i, -c -
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties //.4.. ft.
(A separate application is necessary for any repair or new installation of septic( system)
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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 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 Own/c1:tv
r's agent, ai itect, contractor
* * * * * * * .* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
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By
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TOWN OF QUEENSBURY
•
WARREN COUNTY, NEW YORK
Application for: BUILDING PERMIT IN COMPLIANC4 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"(9
2 . Type of heat )7joe,- / -zc n r-1,(-^
'3 . Is the building mechanically cooled? /43
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 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
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5. Type of insulation
B. Under 16% Only
1 . It value of roof and floors exposed to ambient conditions.__
23�
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2 . R value of exterior walls /Z 3 fi
3 . R value of glazed area -�
4 . R value of doors l/ /4 •
5. R value of floors over unheated spaces /-///9'
6. R value of slab edge insulation - unheated slab //) `
7 . R value of slab insulation - heated slab /77
8. R value of heated basement/cellar walls (above grade) g-//
9 . R value of heated basement/cellar walls (below grade) P 1/
10. Type of insulation F/6 UrrS.S
C. Controls
1. Thermostat maximum heat setting •
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 Insulationff
1. Size of hot water 'or cooling carrying agent pipe
2 . R value of pipe insulation GLIA4-
F. Service Water Heating o
1 . Performance efficiency • l��/°
2. Temperature control setting maximum •
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G. For Swimming Pool Only l 1 . Maximum heating .v
Telephone No. g/ y ';;.:4
Cap icant ' signature)
I
TOWN OF QUEENSBIIRY
,'51- f'`f—�_• ';µ APPLICATION FOR '
: ''st-— > SEPTIC DISPOSAL PERMIT :
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,F.ct„ ,`-‘k ,.. ,,',".' '',,, '''' 'k/(-: c'— i "
DATE /I/9/Fr
LOCATION OF PROPERTY FOR INSTALLATION 0 71-- A7/ .y7;ve2-° 'IS �'e •
-Owner's Name: 300.,,.441 L,42./,d4 Telephone: O/ .—c1/`v
Address: aZC - tv oo Ode-, /1s re," A# / `K 72-o/
/
Installer's Name: 1-4ciJaieP Gi Ca v/-+'ri Telephone: 2y z oaoa
Number of bedrooms (residential only) `V
Total daily flow (compute (d 150 gal per bedroom) 606.
Topography: Circle one:dflORolling Steep Slope % of Slope
Soil Nature: Circle one Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? P /�. Feet
Bedrock or Impervious Material: At what depth? �i9' Feet
Percolation test: Circle one: not required equired rate min. inch.
Domestic water supply: .circle one: Municipal . Well Other
If domestic water supply is a well: —
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank (/ 00° • gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet/Total system length -• feet
SEEPAGE PIT(S): Number of 3 / Size each F feet by r7 feet
Size of stone to be used # /Depth or.Thickness Z.e feet
*************************
I have read the regulation on the reverse side of this sheet a d agree to abide by these
and all requirements of the Town of Glueensbury Sani ry wa Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: E.4. A
DATE: /(fr/fr
( ( 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 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 installa-
tion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks:
YOU ARE HEREBY REQUESTED TO. • -
, .. INSPECT AND ISSUE-CERTIFICATES
- ' ' • -• ' ' __: FOR'THE FOLLOWING"ELECTRICAL '
EQUIPMENT-TO BE INSTALLED BY
THE UNDERSIGNED' -." •'
TEMP N - DATE _
CITY OR VILLAGEE!� - TOWNSHIP - _" - COUNT -
STREET AND N0.OR ROAD - POLE NUMBER - "
I` 0� (�
. ./ /. " "" '�v
/- , r%/`(2,)./.� -J -. :• -
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? f{ -SECTION - _ BLOCK: - LOT _
•
OCCUPANTS NAME - BUILDING OCCUPANCY - - -
OWNER'S NAME AND ADDRESS • - } ' ' HOME TELEPHONE NUMBER '
rc2. -2 �.' t2/.q/‹.. f v„70 -7• - ' ,Ti L� ,<)/t,�i-;J ./.c,.(•., .--,.(•., .--. ./2.0 - ,/ i-/x ) ','"" f- !;9/7/
- CURRENT SUPPLIED BY FROM THEIR • OFFICE- WORK TELEPHONE NUMBER
r.
.BUILDING IS - . - "
NEW EX :- OLD❑ • - WORK IS NEW - ADDITIONAL❑ - DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU ItSTALLED
NUMBER OF OUTLETS. No.of Fixtures& BRANCH OFFICE USE
Loca- • MOTORS HEATERS
Lamp Receptacles CIRCUITS ONLY
lion -Side Attach't • - H.P. - Watts ' - " A.W.G.,
- Ceiling . Wall - Recep'Is Switch _Pendant Bracket'' -No: Type Each No" Each ' No::•!, Gauge INSPECTION
OUT- •
SIDE . 27. Co
SUB-
BASE _ '..' ' - •
1st FL. - rc 2,- _ - - -
' 2nd
•
• 3rd - • -
FL. . - • - -
•
•
•
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: "
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THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT •
,AS PROVIDED BY THE APPLICANT. . . .
SIZE OF MAINS • )�) . ' FEEDERS ELECTRIC SIGNS/LAMPS- . - TOTAL WATTS
�n-i
• CHARACTER OF WORK • • ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF. - . • - , ' • VA
❑ CONCEALED - . . . '
DATE WORK TO BE STARTED •- - DATE COMPLETED SIZE OF SIGN(NUMBER) - . " . CAPACITY
SERVICE ENTERS BUILDING - . _ _ . " ' MANUFACTURER OF SIGN - - '
• " Cr OVERHEAD jUNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) _ MUST IDENTIFICATION NUMBERS ►
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION/MAY BE RETURNED.
PRINT NAME AND ADDRESS -• / - 'Fj /_. 7�' ��
' NAME OF APPLICANT - DATE'OF PLICATIO SIGNATURE OF APPLICANT/j
•
STREET ADDRESS - / TELEPHON�E'19
n r 'F.>i P 2{.°,/,TO'" 1.��P U • (6(i',% • 'f/7f2.-'. "
CITY OR POST OFFICE •
ZIP CODE. .LICENSE NO.WHEN APPLICABLE
l7Ai i <,-- :.J =/•%,.• ' i�•1 . .. / 2_0/r... .
❑ 85 John Street ❑ 41 State Street - ❑ 584 Delaware Avenue D.217 Lake Avenue.' - ❑ 202 Arterial Road
NEW YORK,NY 10038 ALBANY;NY 12207 BUFFALO,NY 14202 ROCHESTER,NY'14608 SYRACUSE,NY 13206
TuJ M AI vnRV Pfl Pn-n1- IIRI I ininIRWnWRITIRC -
g,a 4. J,A 4 an murk;AK mm
74/ 1jR not mmum>ATnprlpm/Fumcmyall MAR mT>acmnfcmmmmm
41
-1, T:
4. THE NEW YORK BOARD. OF FIRE UNDERWRITERS PAGE 1.
1: "' ` 7`'' BUREAU OF ELECTRICITY y�0 �i�/
0
1: I- 41 STATE STREET,ALBANY.NEW YORK 12207
1' Date I is Li nti,5 . 1. 8 Application No.on file 03517.188 iJ `� II 001630 0
-, THIS CERTIFIES THAT
PERMIT IIT NO. c8.8-`_'1.-1ja
1: only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of 1:
^,
1: DOUGLAS LI RBRIDG E, IRV UOTS M . LOT 101, OUEL:NSBURY N.Y. .
^ in the following location; S '� '❑'Basement ❑ 1st Fl. - ❑ 2nd FL • Section Block Lot � s
1; 22.1989
was examined on and found to 6e in compliance with the requirements of this Board. ® c
1,
-Q
,' FIXTURE I FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS_ EXHAUST FANS
1, OUTLETS ECEPTACLES, SWITCHES INCANDESCENT.FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
-i:' 95 56 16 93 1. 5 1. 1. . 5 I F
..:c' DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ®F
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS -
�,OF FEET AMT. WATTS
. _ C
1 1. F l F 1 600 r
1.
�; SERVICE DISCONNECT NO.OF S E R V 1 C E D.iii
�. AMT. AMP. TYPE EMQEU�F 1.3 2W 1.3 3W 3 0 3W 3 0'4W NO.OF RC.�COND. OF Ad?!AND.. NO.OF HI-LEG OF HI•LEG NO.OF NEUTRALS EUTGRAL ..
�; 1. '0 B 1. `\ 1. 4 i 0 1 '•,i o EI
6 OTHER APPARATUS:
1 ),IO TORS: 1 ..F II. '. -
A.
-1.
DISPOSAL: 1.--F I .F.: F
. C.F.I .I. -10
1�
2 1. SMOKE DETECTOR: -3 .
i .1
-s,
4.
1.
1: DOUC LAS BUP,RIL iE 77e57.‘;'...-...,..4(2,_..7,1....:
1; 22 CEDAR WOOD DR.
1: BALLSTON LANE, Ni 12019 . BRANCH MANAGER
o -
• 1; _:.3 9 7 .. -• . o
1, Per o c
�,' 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. G `
-r- Srtv[turirrlie lit 1111101 Nit IMAM AMstL AU 1111„<lilt Ulf UV vier Auvonirn Ann*Navvy lEf vIvmLirvir-iln ifl trvr(sitlfftWi (111UITIIIIIIIIMMTVIillillIWW El
a
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
F$
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
711
BAY & HAVILAND ROADS !.
QUEENSBURY, NEW YORK 12804.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME cl , dam (G
LOCATION /irr f //)/.�f < 7l'c ,p- / 3y4- :b,.
DATE c��� y /1 f PERMIT # t0F 9/[/
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING .
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
,BALLS •
// CEILING
VINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING V/
EXTERNAL PORCHES/STEPS '>,
STAIRS-CLEARANCE /& RAILS �,
PLUMBING FIXTURES/RELIEF VALVE !%
INTERIOR TRIM/PRIVACY DOORS),
FINISHED FLOORS;'
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION 'r✓
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
•
REMARKS: 4
i6v
INSPECTOR
INFORMATION FOR BUILDING DEPARTMENT
WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE
OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION
AS COVERED IN AN APPLICATION FILED WITH OUR
DISTRICT OFFICE.
THE NEW
�YORKpBOARD OF FIRE UNDERWRITERS
:?
APPLICATION NO. 01 /7 7
to<
CAT ON
DA E CTOR
FORM IRD(RE .I/86(
•
awn of Queeniur1
BUILDING and ZONING DEPARTMENT
• Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC/( DISPOSAL SYSTEM INSPECTION
NAME !( /( 9e-(--(/ f-e,
i� .
LOCATION l /��/� �f�i� I//"'�
DATE_ S r/// / d 9 PERMIT NO. %�-�/L,
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES 7° NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total ,length
Length of\each• trench
Depth of trenches '
Size of gravel_
SEEPAGE PITS{lumber of)
Size- 1,ft. X6 ft.
Gravel size , '7� I
PIPING: v Size N
Bldg. to tank
Tank to dist. box E I 'f /"JfC__
Dist. box to field/p ,✓f�
Openings sealed? ES fO / Partial
LOCATION/SEPARATIONA:
Foundation to tank/ / ft.
Foundation to absorption °2 t. •
Absorption to lot/line ft.
Separation of pits / ',ft.
LOC, TON OF SYSTEM ON P-R{3�ER�Y(circle one)
eront Rear - Left side/ Rig t side -
IMMENTS:
6/7 /
/1/.1
•
•
1
•
•
•
SYSTEM USE APPROVED YES N
fir, O
.
Building Inspector •
•
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS J
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME /1(41 ./'7:G. /9 •
�SC
TAXATION � /Q f .r1�1'jL � /�J✓C��tJ
DATE 37/7 / q PERMIT ��
'# I/"f
I APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING •
ELECTRICAL ROUGH-IN
/INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING 2- j' �-1(j$r200,1
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING N
SIDING •
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS',.
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS,
FINISHED FLOORS •
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS,
FINAL ELECTRICAL/INSPECTION .
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM' THE BUILDING DEPARTMENT BEFORE .
THESE PREMISES ARE OCCUPIED!-
REMARKS:
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TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST F R INSPECTION RECEIVED 3//VFLI
NAME } .�f. / /1f
LOCATION ' ITOPA.s--cttn
DATE .0 / P RMIT # Yf9/f
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BACKFILL APPROVAL
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FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S) I
SMOKE DETECTORS
FINAL ELECTRICAL' INSPECTION •
FINAL APPROVAL pF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
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TOWN OF QUEENSBURY ill"
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 3/A
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NAME ;Jr..41-e
LOCATION _d G./A..)/ �67 C,0if /47,'
DATE 3/�,� PERMIT #/ �G-c''%V
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YES NO
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FRAMING
ELECTRICAL-ROUGH-IN ' '
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DOOR CLOSER(S) 1.,
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION ' 'N+ ' . . . . '
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
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INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT ��
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED . 7 7
NAME -- A a 4Y/.4. /��
LOCATION S/��/J /oj aai -,,/,,.,1 ,,2
DATE /o?`q19(- PERMITA (f f- 9'/ V
APPROVED
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CEILING \ ,
FINAL INSPECTION: °+..
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INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
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DOOR CLOSER(S)
SMOKE DETECTORS \
FINAL ELECTRICAL INSPECTION `,
FINAL APPROVAL OF CONSTRUCTION \,
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A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
REMARKS:
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INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /,2-?/-ri
NAME Cray
LOCATION /12/ U Cr
DATE 1 -a2- J d PERMIT #
APPROVED
YES NO
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FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS`,
PLUMBING FIXTURES/RELIEF ''VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS ,,
GARAGE FIREPROOFING i.
DOOR CLOSER(S)..'
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
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INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /R �
NAME ` ,kw Ii?t _
LOCATION 10/Y 7 %p/�i Lug
DATE j�7// PERMIT # 8 8'-7%y
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YES NO
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DOOR CLOSER(S)
SMOKE DETECTORS m.
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
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A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
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