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1989-441
1 CERTIFICATE OF CSC L/ 1'ANCY TOWN OF QUEENSBURY I I WARREN COUNTY, NEW YORK j i i l I s Date September_ -?6 119 $9. f This is to certify that work requested to be done as shown by Permit No. 89' +�a l i 'I has been completed. 4 This structure may be}�upied as w S i n g3 Family �e 111� t C..� LADcadon L•:rL� Oak Tree Circle j Owner John Burkhardt j By Order Town Sward TO" OF QUEENSSURY x i Director of Bldg. do Code Enforcement s i I a BUILDING PERMIT TOWN OF QUEENSBURY No. _ 441 WARREN COUNTY, NEW YORK , PERMISSION is hereby granted to JOHN BURKHARDT OWNER of property located at LOT 128 OAK TREE CIRCLE 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. 1 . OWNER'S Address is ROXX$88XRRXX Box 528 RR#2 #Xj#KKXXX11XXKXXXXX288I Granvi I l e s N . Y , c 2. CONTRACTOR or BUILDER 'S Name A TO Z DRYWALL 3. CONTRACTOR or BUILDER'S Address C> O BOX 528 RR 2 Granville , N . Y . 4. ARCHITECT'S. Name r- 6. ARCHITECT'S Address r-+ N 6. TYPE of Construction — (Please indicate by X) 9 A+ 11 Wood Frame ( 1 Masonry S 1 steel C I -s r!+ m 7. PLANS and Specifications C") a. No_ 64 ' x 26 ' Single family dwelling as per plot plan , specifications , and application : including , septic , attached two car garage , B. Proposed Use Single family dwelling ' `/) uo $ 777 OO PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 19 90 CD (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the op town of Queensbury before the expiration date.) _ Dated at the Town of Queensbur Qay of June 799 2E 4/ J� m SIGNED BY for the Town of Queensbury Building and o ing Inspector [Ca OF OGEE � SBGIZY " n ' r - , Tr � • r ri purr� Yq t. Nn y4 v *, Nr PTx , rT w w \ , � . , . , . . . . F w i 1Lev TOWN OF RECE y�Ep SBLlRY Fee Frzid JUN 14 1989 I'U I LLB I NCB AeND CODES ui .! 'ARTrfE.1�T pate Iabued BLDG, 8. CODE DEPT. AeLr wind HAVILANA Roans RD i BOX 9a -�p nuEENSBUR Y , NEA1 YORK J. 2 do 4 PC.�rm'it NO . 0 CS I �2 _ Tel ( 518 ) 992-5d32 Exc 204 * It ■ or * ■ r r : . * * ■ * * it ■ Y ■ ■ R r \ . ■ r * s • . . r * • R A PER? SIT MUST D13 OBTAINED LZEFOI1.E DECINNINCY CONSTRUCTIONm NO INSPECTIONS VILL DE HADE UNTIL. APPLiCANT HAS RECEIVED A VALTD BUILDINC PERNITT . All applicable spaces an this application must be contpletcd and the t* uature of the applicant must at,pcar on the reverse side * ° * this sa * e * tl !c X ![ A t t X * * lk(�7■ 7t (]'X The owner of this property {i"]s ,* � N � + � } r � ( t' . Q . Address _ eD +s< z �� i ``. 1 'tc... `cam` TEL . roperty location .fJ GPJ 1w 'CR 0Gi , QEa�I~. 1+�F3s+1 TAX MAP NO . 1/ tlas there been any split of this property since October yeSf n�d If yes , Planning Board 'Review is necessary . w U B O I V I S I O H NAME , I F A P P L I C A n L E I O T N O O. 'llhe (person responsible for sup + rvision Of work as regards Building Codes is : i+1AbtE P . G , ADDRESS TEL . NO , tame of builder i Address +�L '"d �r �I #, G Tel ► ry:,me of Plumber "-<^'o �- T.d,lress r F + r f Tel N.�mE Of Mason . �:�- n M Fa"� A�Id tam + h77 j�'V- 6 (L �"� Tel � ..T W �..._. : 4ATwRE Or PROPQO CD WRK : WOO 0N1NIG IN1 ; OR ` I,l•1' LON ( Orrice use OnIV) �Cnrtatruciicr" of a ��`w builtlin ZOCJIN�, OESICNATION OF PROPERTY AUJLLiOn to a UUil.ling # PERMITTED PRINCIPAL. PERMITTED ACCESSORY �A1L4.rC"Lion to :a L,uilding ■ � t , �o cl "..< <<lu to uxc . rior ulrnansionu ) REVIEW REQUIRED - PLANNING HOARD ZONING BOARD, Urfa� r work IJOvFcribk! ) * SITE PLAN REVIEW # APPROVED DATE � ttOSS ARLA Ol' I� E+ OPOSCD. OT14UL; 'LURa * VARIANCE # APPROVED DATE 16t Floor ft bCa sq ft . / jam * Remarks : nd P 1 oor l L`1 C7 sq f t . r'��„--COc•1T' f.LTL' INVQj tAA'1'SON 1ELQUI1cL D " LOW . -� Si:.0 of prop.: rty i t x rr . Other Floors sq ' ft '� f �j • Lxi:: tiitcj .: fL x r [ . ( not collar or bas4menc ' rr TOTAL FLOOR AREA A bC7 sq E t - ' kx� : Ca�Lg Q" A. 14.La.fu3 ( � ) Ua+: � i ;.;.: uT nGw .itructurw �a ft x'-z.L£t ' L�'u.sa "d:ac ion-pier/ slat+/cr:.wllLiarLl."I/ full ' Yrol�o::cd tau� la�n+y� . dl � c .ncw rroru L.ral�urcy iirtiu (circle one ) * L'ront: yard rt Roar yµrd ft H3 . of .^.curie. ()►:aliic:.ril�, sl�acc ) ■ , s f c and i c Sides ya iArd ltwighc ( Urado to ridq&:) ft . Ix on Corner . :.uU�aCk froca side scr.:Qc ec IC ro4iduntial , no . Qi familie } Noo of rocuas ( axcludinq b:.chs ) • aCCU!"ANL:Y INFDCZMATIQN ttow of badroolas ; PTt Y FiUILaINC - NO * of bacliroousa ` * Ona family dwelling L"riuury I;u.aciLu Ly ::L; w�u -+. , ��`I^�. * Sti„�o r,,,,�,yly dwaslliny '1'yL444 uE fu.: l MulCils141 .]welling / Humber of unics. No . of firuplac"Z; LQ kLw in;:c:+llad� t9� i?eru+,rncuz accun:u,cy w1, 11 :a wuwl scova I:..: 1SLUL . 11wd? * Arun .iwrrL crwCut�:.nc ,r L.sncrwl Air Cos,.liciun:rrq:' © '3usine5x r (iult.DING STYLI:, PRIMARY STRUCTURE * ;ndustrial Ocher lcasrC}t t_Dnewu�L.c.r..ry LGn Cabin It ..ddiciun , w1.6kL will uu.s h..? tv t+ s.:.d rancl► 16;anstir..r► IDuL.l .:x �� uLyk �c lwv.:l Old ycylQ Ls u464J041O r C"P" Cod Coct:agj Gctwr ' ACCESSORY buILDING- CaLoni.rl k46OW wowic douse * laacachad y ariat]ClonO cur/ cwa Q4 _car ( crRCLL OH!» PLYRSE ) AGCAChw�l t} r�trjrs/grlu Crest Wn c.;t1 r- Ctac' ■ * ■ ■ s * V ■ . * ■ ■ * ■ ■ r * Liri.V.. Lw ac.Qr;at3.: building uc 'rIK &TF. Q MARKET VALUC OF,Oh, 4000400 ocher CON !;Ole kWCT I UN ] NPOtt7"LATION ON BUrLOTNC S. PrCIFICATIONS . ON REVERSE SIDE' OF 't`HLS .^.Fr1,ETo RG 8E COMPLETt=ICE Form BPA I0/88 V1 BUDDING PERMIT APPLICATI .:ca BUILDING SPECIFICATIONS : :ype of construction , wood fra.�'e , fire safe , etc . CAI dCY +Jill any second- hand or ungraded iur,.ber be used ? I £ So , tar what ? I " Foundation wall material P00002 � N_� #� Tsickness � lr Depth of foundation below grade ( too bottom of footing ) r rr ,will there be a cellar ? V [F3 Heated or unheated ? Floor sq . footage f! sq £ t Will there be a basement ? 4, LI"S Will any portion be used as li �: i. ng space ? ( If so , what portioxyx _sq . ft . - - Type of use ? - Type of roof - opec flat/shed/other material of root v.,c .ra T ! t Sine , wood stu „ x f�" spacing s _ length rj ft . Joists ( floor beams ) lst . floor `Z " X�" spacing IL o . c . span% IS ft . joists ( floor beams ) end . floor 11X�1 r spaczrg "o .O . C . span 2 ! 3 ft . Uverlays ( ceiling beams ) " X spacing o . c . span ft . Roof rafters " x " spacing O . C . span ft , - Roof trusses ( pre- engineered) spacing�Z " o . c . s_an `77ft , Exterior wall finish U t. w, , i 1 of what material ? r j interior wall finish If a garage is to be attached , describe materials to be used for FIRE SEPARATION : is there to be an opdhing between garage and dwelling? 4 kil. . if so will a Fire - rated ioor , enclosure , and self-closing device ce provided . - art !;!--- will a flue -Lined chimney be installed? �Z Height abovo� r ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft , in , water supply - wif icipaI r private well SEPTIC SYSTEM _ is ance from ANY private well { including adjoining properties £ t . ( A separate application is necessary for any repair or new installation of septic system ) DEC LA RATION 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 wort: shalt be complied with , whether specified or not , and that such work is authorized by the owner. Signature Q "`- Owner owner's regent , arcrutect , contractor SPECIAL CONDITIONS OF THE PERMIT : ay--------_�----------- -- --------- ---� 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 wont . ANSWER ALL of the following ; 1 . Gross floor area 2 . Type of heat� _ C7 3 . Is the building mechanically cooled ? Ns 4 . Percentage of area of windows and doors J ? 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 Nj 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 value of insulation around perimeter of floor ? 4 . Is basement heated ? YES ( NO a . R value of insulation 5 . 'Type of insulation - �JL' C 1. W t- �-- B . Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions 0 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 1 7 . R value of slab insulation - heated slab P.0 8 . R value of heated basement/ cellar walls ( above grade ) &2J2 9 . R value of heated basement / cellar walls ( below grade ) 10 . Type of insulation �3 t2" t-, C . Controls 1 . Thermostat maximum heat setting J D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES 'IN0 a . If YES . R value of duct installation '�•� b . R value of duct in other areas E . Piping Insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation _ F . Service Water Heating STFVY0 1 . Performance efficiency R ;ccpgt::A5 � 2 . Temperature control setting maximum G . For Swimming Pool only 1 . Maximum heating Telephone No . (9 7 ;2 '"" ! 5-3 � �✓ a "t7 ( pplicant ' s signature ) ro WN OF Q UEENs B yr Y APPLICATION FOR ✓.tea SEPTIC DISPOSAL PERMIT BATE LOCATION OF PROPERTY FOR INSTALLATION -T C U k Owner's Name: ,T b N-ft,, A urz H7 a )o Telephone: Address: p `rep-- s ej, 5E vim"_ Installer's Name: L \zr" '7'j+c> _ Telephone: Number of bedrooms (residential only) q Total daily flow (compute (d. 150 gal per bedroom) tc3 o . Topography: Circle one: Flat Rolling Steep Slope % of Slope iE L R Sail Nature: Circle one: Cand) Loam Clay Other /Depth: Feet Ground Water. At what depth? J� a a Feet Bedrock or Impervious Material: At what depth ? ''r 6 Q Feet Percolation test: Circle one: j(ot req ed equired rate min . inch. Domestic water supply: circle one: Municipal Well Gather If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank t o rn p gal. ( minimum size : 1 . 000 gal.) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of / Size each tc> feet by r feet Size of stone to be used # `f /Depth or Thickness f feet i I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: t . - 9' -� DATE: 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 submirted ro 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 5 . ) size and dimensions of all tanks , distribution boxes , rile fields and / or drywells BW Nu system shall be covered before inspection and approval by the iuilding 111spector . 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 sroppage . D . Should unforeseen problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must b4 submitted to the Queensbury Building Department before further c: utistruction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 K{ nkarks TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS -� QUEENSBURY, NEW YORK 1280 TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR _ INSPECTION INSPECTTIOON ,RECEIVED NAME LOCATXOlrb U0, DATE PERMIT # APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOI fNDA T SO N/DAMP-PROOF S NG BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION.: FOUNDATION FLOORS WALLS ING NAL INSPECTION. f' CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORC S/STEPS STAIRS-CLEA CE & RAILS PLUMBINGtR (S) RES/RELIEF VALVE INTERIORPRIVACY DOORS G FINISHEDS GARAGE FOFING DOOR CLOSMOKE DES FINAL ELEC INSPECTION r ,/ FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPIED{ REMARKS: I NS�R ..Jowre n� �teeen3hetrdy �r '[ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box g8 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECT ON NAME � .4' � ''000 -'� + ' ¢ LOCATION DATE / PERM IT NO._._. t? ` eyy I SOIL 'TYPE - Sand - Loam - Clay - Percolation Test Required? YES - N&4 Percolation rate - Min/Inch TYPE of SYSTEM ; Absorption field , total length Length of each trench Depth of trenches ' Size of gravel SEEPAGE�ITS#Number 0 P Size- ft. fir'` Gravel size f' PIPING : Size Type Bldg . to tank Tank to disc_ box Dist. box to flelid/pit Openings sealed?:' YES NO Partial LOCATION/SEPATIONS : Foundation to/tank ft. Foundation toiabsorption ft _ Absorption to lot line ft . Separation of Pits ft. LOCATION OF ,SYSTEM ON PI3.OPERTY (circle one) Front - Rear - Left side - Right side - CCMMENTS ; > R.A v' SYSTEM USE APPROVED NO Build ! g tiSpector 01/86 and vl Down o� �ueens6ure� �� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 SEP,.TryIC DISPOSAL SYSTEM INSPECTION NAME T7 � LA3 eA,. A 1 ! LOCAT IIO�N�� Inc Ock '� DATE 3/ / PERMIT SOIL 'TYYP"- Loam - Clay - Percolati n Test Required ? YES - NO' Percolatio rate - Min/Inch TYPE of SYST Absorption fi Id , total length _ Length of each trench — Depth of trench Size of gravel , SEEPAGE PITS{Ntunb of) Size- _.'sLft. X 1 ft. Gravel size PIPING * ze Type Bldg . to tank Tank to dirt. box f f Dist* box to field/ St Openings sealed? E5 O Partial LOCATION/SEPARAT S : Foundation to t k t. Foundation to sorption c,2a Absorption to of line Separation of pits ft.` \ LOCATION or STEM ON PROPERTY (cirola one ) rant Rear - Left side - Right side - COMMENTS : C SYSTEM USE APPROVED YES NO r i r Bui di g Inspector 01/8+6 and vl TOWN OF QU'EENSBURY BUILDING AND CODES DEPARTMENT BAY & HA V£LAND ROADS QUEENSBURY, NEW PORK 12490¢. TELEPHONE (518) 792-5832 BUILDING INSPECTOR t S REPORT RE£QUE!�OR INSPECTION RECEIVED NAME LOCAT£ON DATE APPROVED YES NO FOOT£NG/PIERS MONOLITHIC POUR FORMS FOUNDAT£ON/DAMP-PROOFING BACKFILL APPROVAL, ROUGH PLUMBING FRAMING ELECTRICAL ROUGH^�TN £NSULATION: 4 FOUNDAT£ON FLOORS WALLS CE£LING ' FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ TRpS STAIRS-CLEARANCJ' RAI PLUMBING F.LXTL7Rts1RELIE VALVE INTERIOR TRIMI fIRIVACY DOORS FINISHED FLOODS GARAGE F£REPRPOFING DOOR CLOSER ( ) SMOKE DETEC RS FINAL ELECTR£ AL INSPECTION FINAL, APPROV OF CONSTRUCTION A S£GNED CER £FICATE OF OCCUPANCY. MUST BE OBTA-TNED FROM THE BUILDING DEPARTMENT BEFORE THESE PREM£SE$ ARE OCCUPIED! REMARKS. INSPECTOR QUEENSBURY . BUILDING TOWN INGG AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280't� TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATX N DAT.F PERMIT APPROVED YES YES NO FOOTING/PIERS' MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL .APPROVAL ROUGH PLUM ING C,�4F RAMING ELECTRICAL ROUGH-IN SULAT.ZON: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT i ROOFING SIDING EXTERNAL PORC ES/STEPS STAIRS-CLEARANCE & RAILS PLUMBING FIXTVRE',S/RELIEF VALVE_ INTERIOR TRI,kIPRIVACY DOORS FINISHED PLC1ORS GARAGE FIREPROOFING DOOR CLOSERS) SMOKE DETEC�rORS FINAL ELECTRICAL INSPECTION' FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE TIIE.SE PRRMI.S'ES ARE OCCUPIED! REM S. 5. ",} :. I f INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280& TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RE VE NAME 9F / LOCATION DATE " - PERMIT # J APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATSON/DAMP-PROOFING f... B KFILL APPROVAL OUGH PLUMBING PRAMXNG .. ELECTRICAL OUGH-IN , INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH S/STEPS STAIRS-CLEARAN E & RAI PLUMBING FIXT ES/RELIEF LVE ry INTERIOR TRIM PRIVACY DOOR FINISHED F S GARAGE FIRED OOFING DOOR CLOSER ( J ` — SMOKE DETEC RS FINAL ELECTRI AL INSPECTION FINAL APPROVA OF CONSTRUCTION A .SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: r'^ ( / / ,q z cad/ C� CTOR T INSP TOWN OF QUEENSBURY BUrLDSNG AND CODES DEPARTMENT BAY & HAVIL.AND ROADS QUEENSBURY, NEW YORK .2280& TELEPHONE (518) 792-5832 &IILDING INSPECTOR ' S REPORT RE=7UEST FO rNSPECTrON RECEIVED LOCATIDNr OAT$ APPROVED YES NO 1.`'C702'INGfPSERS MOMOL.ITHIC POUR FARMS cJp6'UNDATrON DAMP-PRC]OFIN+G BACX:p ROVAL ROUGH PLUMS' NG FRAMrNG ELECTRrCAL R GH-rN rNSULATTON: FOUNDATrON ' FLOORS WALLS CEILr1yG FINAL rNSPECTIO CHrmmEy HErG .l ROOFING SIDING E.YTERNAL RCHESfSTEPV STAIRS-C RANGE & RArtS PLUMBTN FrXTURE'SfRELTEP VALVE TNTERrO TRIMfP ?rVACY DOdRS FYN1sH D FLOORS GARAG FIREPROOFING DOOR LOSER (S) SMO DETECTORS FINAL. ELECTRICAL rVSPECTION FT1VA APPROVAL OF CONSTRUCTION A OBTTAIAXNED FNED CERTIFICATE OF OCCUPANCY MUST BE STGROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIES) REMARKS: r NSPECTOR .�./vtun o� '�teeensburt� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S RE ,P{7RT NAME Gc 2 /4 h'h�✓�1s ,L LOCATION Date � _/ �� _ Permit No . ��--�/ ry�'� *. L` ��-- + = APPROVAL] - YE S✓ NO .�'F'oo t ing/Pier Fo nns ( "" Foundation Waterproofing Back£ill Framing Roofing Siding Masanry Veneer Rough plumbing Relief Valves Ext . porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile _ Concrete Floors Plbg . Fixtures Gar . Fireproo£i Door Closers ; Smoke Detecto Chimney INSULATION : Foundation Floors Walls Ceiling FINAL EL TRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- 6/86 and-vl r 4D"iIdingins ctor TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804 TELEPHONE (528) 792-58.32 BUILDING INSPECTOR ' S REPORT le REQUEST FOR IN PECTION RECEIVE Z Z NAME LOCA TIXON DATE (► 2 3 - Sr c!am+ PERMIT #f APPROVED / YES NO G/FOOTXNG/PXERS MONOLITHIC POUR RMS _ FOUNDATION/DAMP—PR PING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN ' INSULATION: FOUNDATION FLOORS Ilk I WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/fTEPS STAIRS—CLEARANCE A RAILS PLUMBING FIXTURE. /RELIEF VALVE ^' INTERIOR TRIMjPR'rVACY DOORS FINISHED FLOORS "— GARAGE FIREPROOFING DOOR CLOSER (S) _ SMOKE DETECTOR — FSNAL ELECTRICA INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINER FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS J QUTsENSBURY, NEW YORK 1280k 1 TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR NSP TION RECEIVED NAME LOCATION ia DATE — c I - PERMIT # El q APPROVE YES FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFSLL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDA ftON FLOORS WALLS CEILING FINAL INSPECT N: CHIMNEY HEIGH ` ROOFING SIDING EXTERNAL PORCHES/ E S STAIRS--CLEARANCE & ILS PLUMBING FIXTURES/ E EF VALVE INTERIOR TRIM/P ACY OORS FINISHED FLOORS GARAGE" FIREPROO ING DOOR CLOSERS) SMOKE DETECTC] S FINAL ELECTRIC INSPECTION FINAL APPROVAL OF CONSTRUCTr A SIGNED CERT FICATE OF OCCUPANCY MUST BE OBTAINED FRO THE BUILDING DEPARTMENT BEFORE THESE PREMISS ARE OCCUPIED! INSPECTOR SELECT f3osINESs FORMS (6091 849,5203 APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters 900 Haddon Ave., Collingswood, NA, 08108 COMPLETESAPPLICANT • t Date : I, City, Town or Township-0J � M 5U County � IV Iv State Not Y Location/Address L O ":�l R iy 9f _ (If Located in Rural Area - Please Attach Directions} pole # Owner 3 U N As _.. I [7t�► w , T [ G Permit Occupied # Building: New Old Occupant Work Area in BuildingFloor #, etc. ? : A for : Wirin °� Service ® or: Ready for Inspection : Fee Remitted - $ Cash I] Check © M.t), Ej Make Payable To : M.D. I.A. 500 75tl ! 25❑ 15 2790 3000 Number of Rough Wiring Outlets Elect. Heat 00 1750 2000 2250 2500 Switches 3000 �a Lighting Arne• Service A +Q Surface Unit ' Dishwasher Range Water Heater k_w" Air Conditioner r_ n 5 Dryer Pump Receptacles -;—T+�— y p Number of Fixtures —Omft .; — Oven trews Garbage Disposal Wiring and Controls for Surner 1:5 Amp. Receptacles Fractional H.F. Vent Fans Other Equipment: MOTORS N.P. 1/2 1112 1110 1/8 1/6 1/4 1/3 1/2 3/4 .1 1Vz 2 3 5 71/2 10 15 20 25 30 40 50 75 100 Mark Number of Each Size Applicant's .ter Signature _._� dj,t4 . � I'� To License # Permit # T/A Utility: Applicant'sAddress : _US_A�%,'5_2 (Z%Qn�_ (NAME) t3FFIC L CATION 4City) fLArA> Vt (State ) at (2ip)y�y6.� �7- Service Request # Phone # E[ectrician : x DATE RECEIVED: DATE INSPECTED : Correct Location : Same as Above LJ or : Red Notice Label 0 Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp, Service Equipment Burner, Wiring & Controls for Amp_ Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 1/2o 1112 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1Uz 2 3 5 7Vz 10 15 20 25 30 40 50 75 100 Mark Number of Each Size Elect. Heat 500 1 750 1000 125a 1500 1-050 2000 2250 2500 2750 3000 1 —1 [A CERTIFICATKiNS USE FOR INITIAL VJSITONJLV NOTIFIED DATE COFRECT lfEre PAID RW Progress : Inc. �] LKD EJ Contractor 0 CFT Violation : Work Comp. Q Inc, Ll L/A Owner CASH E71 L/A Fee CHK # 0 IPA Municipal due MO # INV # Date: Other Side 0 Utility Applicant Owner Cut in Card 0 Temp Date 1 C7 v Z O T z Total Homes By woodbu SCALE i� _ Z 1 "EVIf10MS DATE z� �, . S I:--L'5'. E P A