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1989-462 .�e.K..T).-.t.r,4p„--.,yw-+.�; .�...w; . .r",�r�S�Y"fY4![`'�r`; .°.fair '. .-.r :,.-•.txhi • yr , r ,�: 7. ,. � •s„_• .r ;`b' -r i t CERTIFICATE OF +�3C+CLJI'AN+CY TOWN OF +QUEENSBURY WARREN COUNTY, NEW YORK i Date z1ve ? f 19 T'h s is to certify that work requested to be done as shown by Permit No. 89- 462 has been completed. i This structure may be occupied as a S i n g l e Family Dwelling 1 24 I rA&.MQak Tree Circle Owner Martin Mosher { By Order Town Board i TOWN OF QUEEMBURY I Director of Bldg. & Code Enforcement sti x ' BUILDING PERMIT _ TOWN OF QUEENSBURY No. 89. 462 r ko WARREN COUNTY, NEW YORK w cn I v7 kn PERMISSION is hereby granted to Martin Mosher ko OWNER of property located at Lot 122 Oak Tree Circle Street, Road or Ave. in the Town of Queensbury, To Construct or place a Sin l a FAmi ly 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 . OVME R'S Address is Cn T 26 Sugar Pine Road M Queensbury , N . Y . 12804 2. CONTRACTOR or BUILDER'S Name SELF 3. CONTRACTOR or BUILDER'S Address SAME 4. ARCHITECT'S Name r— lv ry 5. ARCHITECT'S Address c k m m 6. TYPE of Construction -- {Please indicate by XI t� r-+ W ) Wood Frame { ) Masonry l I Steel r— r+� 7. PLANS and Specifications No. 26 ' x 40 ' Single family dwelling as per plot plan , specifications , and applications , including septic , attached two car garage , and driveway a, Proposed Use rr z SINGLE FAMILY DWELLING r rrt -n $ ps;z; on P P P 4 P 4 PERMIT FEE PAID --- THIS PERMIT EXPIRES January F� (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.) 2= m r r— Dated at the Town of Queensbury this Day 19 A-9--..— Gh SIGNED BY for the Town of Queensbury Building and ZoTford I nspector TOWN OF QUEENSBURY APPI. ICATTON 'FOR BUILDING .AND ZONING PERMIT Va•t e- I TOWN f iF QUEENSg URY X'ec.iev r[ Rev.i. a (e -ate ` RECEIVED Fee i'a f.d •. .yx"�-S',S� -' - MJILDINC AND CODES 1.1k :1 'IV2'T7'1F.hfT Date T -6ued gLDG. � CODE DEPT, DAY and HAVXLAJVD ROADS RD I BOX 9a (1UrrNSBVRY, NE1%I YOAK 12804 PeAm.t.t No . T01 . (528) 792-5832 Ext •204 •• 1* * a a a tie 'a * 1 * a u 1* a a * ■ * w a a a a a a ! x a x a a a a a a s ■ A PERMIT maser u4 OBTAINED BEFORE BEGINNING CONSTRUCTION ., NO INSPEC"CIONS WILL BE MADE UNTIL. APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT . All applicable spaces on this application must be conl-pleted and the i ylaturoc e of * t * c * ap��J�sli * ant must *p* e� r *on � h� *e�o � s � side of �h� s �esl*e* t * oil itie owner of this Property is : 0, P . O . Address troperty location /. R z GpA TEE f �-ra TAX MAP f / 1 s t! e 4 a rN rr ,tr Es- tlas there been any split or thzs property since 5ctober 1 , 1988 ? yes no if yes , Planning Board Review is necessary . SUBDIVISION NAME , IP APPLIC^ DLE mmmmmm LOT NO . The person responsible for supervision of work as regards Building Codes is : gmz NRMk P . O . ADDRESS TEL . HO . Name of builder Address Tel Name of Plumber address Tel Tel Name of Mason Actdress txATURE OF PROVO CD VsORK : ZONING IN1 ,0RHATION ( 0ff1c ,e use on19J p t;onatructiori of a new building " ZONING DCSICNATION OF PROPERTY Addition to ti buildiltig ♦ PERMITTED PRINCIPAL PF U41T"TED ACCESSORY Al tur:at ian to a )4uildin9 ` ( ito or REVIEW REQUIRED — PLANNING BOARD ZONING BOARD clw&i►a]+ to .:xt urior climcn:: lgnsj Gthsxr work (j+=:cri.bLN ) ; SITE PLAN REVIEW # APPROVED. DATE r VARIANCE It APPROVED DATE CROSS AREA OV PROPOSELX STRUCTURE r lst floor C� sq f t . �� G � Remarycs ; / t9 'yt ,/ 2 n d Floor / d " s q f t ./ w Co1-tPLU're . I�1yafl'r1h"L`TON kcL llUlkcr:D Lli»iLn1 . siw.Q of propurty J 4 C7 ft x other Floors sq ft . "r lxiscitzca builsii «J ( ::3 Siva ft x rc • tnot cellar or ba. siament ) TOTAL FLOOR ARnAc22 I� 3 4 ,sq f t . a k:xi«:Ginq b"ImI :iiny (s: 1 Us.: •.: ize of new structure r.? 4' ft X `-14a ft 1'ou,xdat ion-{sier/ slake/crawl/partial ell proposal building , d"raacu crow property iif%41 (circle one ) ; Front yard 5` a ft Rear yard ' ft No * of stprie (k►:,�Ulczablc space ) iktz�. J cf rt and Side yard;; tt4ight ( Uradul to ridge ) a m.AT fte * ie on corner , :u: t:b;4Ck Xrom Sidu szr. QQC -fC if roaidc:ntlal , no* of f alnilies f 1100 of roomataxcludinq bi,thu) A '" QCCUPMit:Y iNF01'J`iATIC1N taom, of budrooma wly # pp Y EtUILDINC - No . of batkaroolnz; � fj �- J One faaxily dwallin9 Primiary lxuatIlLi ,, ::ysVVIJL mop lyfp f;cr�ily dwelling Type of feel .r.'r�. �._ ,r multi ralu glwc:llitng / Number Of Units No . of firQplacag; to iaa nt;m"llud / + Permanent occupaa+cy Will :a wOQJ t:tovQ Li.: if'Ur-allasd? •l"r:ansivnt occur as6cy C tantrial Air coracliCi lining? �i � e- ' � L;usinuss (kUlLfl11VG STYLE, 1'R1MAftY Sl"RUCTURE . lnctustrial mmmmmmWmOcher 1;:auch Cat�ltrsu4Lx1C:ary Len c:..l�in �` if uddicic+r► , wl+:ac will u::4 bps? 14t., is:-a rnr►c1t Hanic+�� l]uylux " aL�lic lu"l old atyla JAUSLLJ.. law `r C:. Cod Cottaga Ot )u r " ACCESSORY DUILDING- L'atanial liow 'Towlti Clouse " Laucachau 94re6go/ono cur/ two aar1� Gar ( CIRCLE' DNii PLEASE ) '" �'httaahud ca;ari►c}u/4JlrZ cwr/ two • a a a a a a s a a a a a r W -6 n 'r PriV;ata stor"90 building L S "1" I MA9` t: Fd MA RKr41% V ALU 1- OF ; Othor co" :;Tf4UC`L' IGN C'a • .. ` l'_ P t2 � _ . .. _ .. .. jHrOrAjoMT7ON ON BUILDINC SPrCIFICATIONS , ON R.G`VURSE Slat OF 'PHIS C^ tEL'T, RYl Be +COHPLE'TVDZ Form DPA 10/88 VI BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe etc . �� '�„�� � �,,,Z�� •_ Will any second-hand or ungraded lumber be used? if so, for What? Foundation wall material Thickness Depth of foundation below grade (to bottom of footing ) _ Will there be a cellar? 'V-4ae'Heated or unheated? w. _FlooY sq. footage Jd14 p �sq ft Will there be a basement? Will any portion be used as living space? ( If so , what portion? sq . ft . - . Type of use? "Type of roof - slo ed lat/shed/other Material . of roof Size , wood studs''X _" spacingR_,,,1 (, "'o . c . length _'.eft , .joists ( floor beams ) 1st . floor *'X_ l p " spacing s"o . c . span_.Zy ft . Joists ( floor beams ) 2nd . floor "X ,. c2 spacing""o . c . spank^ft . Overlays (ceiling beams ) "'X '" spacing "o . c . span ft . Roof rafters "X "' spacing o . c . span ft . Roof trusses (pre-engineered) spacing . 4 "o , c . span 5a "7 _ft . Exterior wall finish �� E'er Of what material? Interior wall If a garage is to be attached , describe materials to be used for FIRE SEPARATION : M L IAP Is there to be an opening between garage and. dwelling? If so will a Fire-rated door , enclosure , and self-closing device be provided? "Z .cd...i' Will a flue-lined chimney be installed? `Z, , , Height above roof ft . Depth of chimney foundation below grade .L�fft . Depth of fireplace hearth ft . in . water supply - Municipal or private well �fv mow' SEPTIC SYSTEM _ Distance from ANY private well ( includi-fig adjoining properties ft . (A separate application is necessary for any repair or new installation of septic system) D E C L A RATIO 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 �x Owner, owner's agent, architect, contractor * * * • * « * * * : : * * * * * * Ar SPECIAL CONDITIONS OF THE PERMIT : Hy TOWN OF QUEENSHURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN CoMp LIANCF 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 2 . Type of heat 3 . Is the building mechanically cooled ?_ 1 4 q , Percentage of area of windows and doors 1 A . over 16 % Only •• 10 U 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 ? 4o Is basement heated ? YES NO z� . R value of insulation so Type of insulation 8 . Under 16 % Only 1 . R value of roof and floor exposed tO, ambient conditions. 2 . R ' value of exterior wa11syz_ V 43 . R value of glazed area � L'7 g . R value of doors ' 5 . R value of floors over unheated spaces lei --------- ' 6 . R value of slab edge insulation. - unheated slab. 7 . R value of slab insulation - heated slab s . 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 V 1 . Thermostat maximum heat setting 'D Duct Systems 1 . Is duct system installed in unheated spaces ? YE NO a . If YES , R value of dust installations b . R value of duct in other areas E . Pining Insulation 1 . Size of hot water 'or cooling carrying agent pipe _ 2 . R value of pipe insulation F . service Water Heating_ 1 . Performance efficiency Zs ► , 2 . 'temperature control setting maximum I `'r G . For swimming Pool one 1 . Maximum heating { Telephone NO * � v'9 �- _ t �-.�v �i` r x r7,,��,._.: �. ' ,-�^,'`i. • �-- - ( applicant ' a signature ) TOWN OF Q UEENSB UR Y APPLICATION FOR ✓ Y �� SEPO"C DISPOSAL PERMIT DATE - / 9 9 LOCATION OF PROPERTY FOR INSTALLATION v�i �t r' '�1.2 � G� Q.,�• T~� �_� [aE_ y, ;�r � Owner's Name: l "r ,,;f `` � L. � Telephone* �9 I�R� ,5Jo Address: Cr ( .�[ M ;•� [ r.i�,_.a_{; �� n �_ i . "� aF • l� ix rS'e) 47e Installer's Name: , , `y Telephone. Number of bedrooms (residential only) Total daily flow (compute fa 150 gal per bedroom) 4 Topography: Circle one Flat Rolling Steep Slope % of Slope Soil Nature: Circle one: Sand Loam Clay Other /Depth : Feet Ground Water: At what depth ? Feet Bedrock or Impervious Material: At what depth ? Feet Percolation test : Circle one: not required required rate min. inch. Domestic water supply : circle on Nunicipa Well Other If domestic water supply is a well: Separation : Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank, 0oo gal. ( minimum size: 1 . 000 gal. ) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S) : Number of 4e� f Size each � feet by feet Size of stone to be used # /Depth or Thickness feet 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: l� 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 submitted to the huiLding 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 . rile fields and / or drywells B . No system shall be covered before inspection and approval by the l: uilding Inspector . Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine Uf 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 rep,iir of an approved system , a new proposal must be submitted to the Cueensbury Building Department before further construction . Town of Queensbury BUILDTNG and CODES DEPARTMENT Bay and Haviland Roads Queunsbury , New York 12804 rt ef�la rl^:a , TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAy & HAVILANp ROADS QUEENSBURYr NEW YORK 12809- TELEPHONE ( 518) 792- 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME _ i o 5 cf LLCATION © �i/�r f / MATE Z Z- PERMIT # O `T � .APPROVED YES I NO FOO,2TING f PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP'�PROOFING BACKFILL APPROVA? ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN I INSULATION: lr FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH S/STEPS STAIRS-CLEARA CE 6 RAILS PLUMBING FIX RESI'RELIFF VALVE INTERIOR TR M/PRIVACY DOORS\.. FINISHED F RS GARAGE FI PROOFING DOOR CLOS R (S) SMOKE DEpvECTORS 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 : Al, NSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2SO4- TELEPHONE (5I8 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION ECEIVED Sf__ NAME LOCATION l� DATE PERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS t WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING ' SIDING EXTERNAL. PORCH /STEPS ,STAIRS-CLEARAWCE & RAILS PLUMBING FIjIURES/R3sLIEF VALVE INTERIOR T IMIPRIVACY DOORS FINISHED ,FLOORS - GARAGE 4XXrREPROOPXNG ,DOOR COSER (S) SMOKE; DETECTORS FINAL ,6LECTRICAL INSPECTION FSNAJ;;' APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: 620) INSPECTOR� _/'ouvxs o� �ieeen .S�+.�re�t $UILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 61Q//�fr � Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 4� LOCATION DATE k'601 j!fq PERMIT NO , � SOIL TYPE - Sand - Loam - Cl Y - Percolatio Test Required? YES - NO Percolatio rate - Min/Inc - TYPE of SYS • Absorption f eld , total ength Length of ea trench Depth of tren hes Size of gravel SEEPAGTS�cI� r oAPM ) Size- ft. X a Gravel size P IP ING : S e Type Bldg . to tank Tank to dist. box Disto box to fie p Openings sealed E NQ Partial LOCATION/SEP'A TION Foundation to tank. k-ftf Foundation t absarpt ' onAbsorption o lot lint. Separation f pits ft. LOCATION YSTEM ON P OPERTY (circle one) Front - ar Left side - Right side +CDMMENT SYSTEM USE APPROVED NQ Bui ding I Spector 01/86 and V1 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1 2804- TELEPHONE (5I8) 792- 58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION REC IVED NAME w AI Al LOCATION I L UL / r7 DATE } PERMIT # .[L APPTROVED S NO FOOTING/PIERS MONOLITHIC POUR FORMS 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 S 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: �- Y ff, t6�� INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809- TELEPHONE (5I8 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE 5 - PERMIT # � ,yG APPROVED YES NO FOOTI NGI PI ERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN AL,.l;NSULATION: L�OUNDA TION FLOORS MALLS CEILING FINAL INSPECTION: I CHIMNEY HEIGHT ROOFING 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 BEFOPE THESE PREMISES ARE OCCUPIED: REMARKS: 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 RECEIVED NAME LOCATION DATE PERMIT # APPROVED YES NO FOOTINGfPXERS MONOLITHIC� POUR FORMS FOUNDATION AMP-PROOFING BACKFILL AP VAL ROUGH PLUMBS FRAMING ELECTRICAL ROU -IN (, "INSULATION: FOUNDATION FLOORS WALLS Wig CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH S/STEPS STAIRS-CLEARA E & RAILS PLUMBING FIX RESfRELIEF LVE INTERIOR TRI /PRIVACY DOORS - FINISHED F RS _ GARAGE FIRE ROOFING DOOR CLOSE S) SMOKE DETE TORS _ FINAL ELECTR CAL INSPECTION FINAL APPRO L OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED+ .REMARKS : ri+rsP R TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT f]_ �� BAY & HAVILAND ROADS �j QUEENSBURY, NEW YORK 12804- TELEPHONE ( 518) 792~ 5832 SU I LT1I NG INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED _ �� NAME LOCATXO,�Ny r�_/�__, /r � DATE L5 r ^ PERMIT #�_ Q- ? APIWZOVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL 6...FR`OUGH PLUMBING ,� XRAMING ELEC!rRlCAL?ROUGH-IN INSULATION: '", FOUNDATIONS FLOORS - WALLS CEILING FINAL INSPECTION: 3 CHIMNEY HEIGHT t ROOFING SIDING EXTERNAL. PORCHES/S STAIRS-CLEARANCE & LS .PLUMBING FIXTURES/ L F VALVE_ INTERIOR TRIM/PRI Cy RS FINISHED FLOORS - GARAGE FIREPROO NG DOOR CLOSER (S) - SMOKE DETECTOR FINAL ELECTRICAL, INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MIDST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED + REMARKS: INSPECTOR It I MIDDLE DEPART F N AGENCY, INC. SIP rrt� n .. . .. o+tom July 25 , 1939 + erfifito that f . e�ulpment lis#ed has been a ''an approved as being in accord with the National Elect 1. plicable governmental, utility anct�,AdX S. Owner., Martin Moshe ! P t ; Occupant: same t Location. 21 Oak Tree C y (QU T15 ceryficate t eciriC uipment and installation inspected this date. 17 additional Ut ant %ah tm introdUoad or alterations made to existing system thif ica�a be null and void. and application for in SpBCtionshould to submItled p tly to this Agency. Equipment: 100 Outlets Re c� t a c le s � � �� ����� Molder o7 [his e�ticafa ahquM ant same io his property insurance car �r 1S �. lie3 ilr�ES rotect ive lagontotcom y} aaeVtdrttC Ritioatian of elBctticai egwpment approved 200 Amp Servz pP r ae speci7 ied.: Signaling Devi. � Sam (Corh se Slvrm �isia __ Applicant: 11 Pouter Road _-._._ _ _. .__ 04 15 - 02570�+ L cansevoort , Nay 1289 Fas Hi 7123 RL t-W TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 3280& TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED _I _ !- NAME LOCATION [ DATE + - PERMIT i4F_8�9 ,� APPROVED YES NO L/F'OOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIO DAMP-PROOFING BACKFILL A PROVAL ROUGH PLUMB NG FRAMING ELECTRICAL R GH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION. ' CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESIST STAIRS-CLEARANCE & I PLUMBING FIXTURES/ LIE VALVE INTERIOR TRIMfPRI. ACY DOO FINISHED FLOORS GARAGE FIREPROO ING DOOR CLOSER (S) SMOKE DETECT S FINAL ELECTRI L INSPECTION FINAL APPROVJfZ OF CONSTRUCTION A ,SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND .ROADS QUEENSBURY, NEW YORK 1280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED .+�- h� - NAME LOCATION DATE - WSJ PERMIT ##_ APPROVED YES I NO FOOTING/PIERS MONOLITHIC POUR FORMS 4,F'OUNDATXO,VI DAMP-PROOFING i,,,�CKF'ILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE /STEPS STAIRS-CLEARAN E & RAILS PLUMBING FIXT ES/RELIEF V VE INTERIOR TRIM PRIVACY DOORS FINISHED F S _ GARAGE FIRE P OOFING DOOR CLOSER S) SMOKE DETEC ORS L FINAL ELECTR AL INSPECTION FINAL APPROV L OF CONSTRUCTION A SIGNED CERT FICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARK --4 INSPECTOR TOWN OF QUEENSBURY � BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURYf NEW YORK 1280& TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED G SW NAME // ��`,,,,.//J/ LOCATION i'i'� �sb ( ]� r'rs � �. DATE PERMIT #i ce OF+ PZ APPROVED YES NO FOOTINGIPIERS SONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STE STAIRS-CLEARANCE & OAI _ PLUMBING FIXTURES/BELT VALVE INTERIOR TRIM/PRIXACY DO RS FINISHED FLOORS GARAGE FIREPROO NG DOOR CLOSER (S) SMOKE DETECTOR FINAL ELECTRICA INSPECTION FINAL APPROVAL F CONSTRUCTION A SIGNED CERTI ICATE OF OCCUPANCY MUST BE OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED : REMARKS: INSPECTOR YOU ARE HEREBY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY THE UNDERSIGNED f _- TEMP A DATE - TOWNSHIP - C" OR VE-LAG'E+�r J POLE NV SER gtF Er 1P NO_.OR1RQ+.p / �` K/R6./ / SA 1_•./4.�a^' BLOCK f l BLOCK SECTION B;-�N,Wm TW �S STREETS. IS 1 REMLSES LCK'.M1TED? BUILDING DOCUPAr K:Y OCCt1PANTS NAME .1..• . • I.LI TELEPHONE N UM OV OWNER-Si NAME AND ADDRESS S.rr 'WORK TELEPHONE><1LIMSER FraEMt THEIR .f CURRENT SUPPLIED BY V�y� , J •�Kf� C.Z. �,/Z..tA.. '""•iC•�' AD01T1ONAL ❑ DFFECIS REMCNEO BUN.DINCa IS W LB NEW NEW 01 ❑ LIST BELUW ALL E UIPMENT WHICH YOU IN BRANCH OFFICE USE - NUMBER OF OUTLETS No. of Fixtures & MOTORS HE+4TERS CIRCUITS ONLY lamp R00e113t0Dle3 AW.G, INSPECTION Loca- H-P. No. Wafts No" Gauge lion Site AtTztch't Switch Pendant Bracket No. 7YPie Each Gelling V4911 ReceP11e OUT- SIDE SBA E 1 BASE- MENT 1st FL. Zed FL. 3(d FL. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. AI EQUIPMENT' NOT ABOVE E ABOVE-LISTED -LI ARE AUUIPt RIIZED To MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THIS APPLICATION IS INTENDED TO COMER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED, BUT IF AT TIME OF INSPECTION, THERE IS FOUND ADDITION TpTAL VW+t-TS THE ADDITIONAL EQUIPMENT, AS P ROW DED BY THE APPLICANT- ELECTRIC SiGNSn.AMPS SIZE OF MAINS W ❑ E%FtilSEb f'a�TUBE SIGN/1 fiAN BF(Jr1MER9 OF CLLARACTSR OF WORT[ ❑ C[NaCE-ALED (;hPAC1T1' Dp'E COrAPI..Ei'ED 312E OF BM'.+N tNPMBER] PATE WORK SO BE STAFTTEP MANUFACTURER OF SIGN SERVICE ENTERS BUILDING ❑ OVERHEAD ❑ UNDERGROUND I I "" `rrulryr�11Io ► f f I I OATS W N R£L7U D ON (OR NEAR AS POSSIBLE? ��• p IN F LL RA INFAFifAATK?N. ALL � iNDRa PRINT NAME AND ADDRESS DATE OF APPLICATION SKYIA7k7RE APP'LT NAME OF APPLICANT STREET ADDRESS ,Y�"��- 'LICENSE NQ WHEN APPLlG48LE GITY OR POST OFFICE / ❑ 202 Arterial Road ❑ d1 State Street h ❑ 570 Delaware Avenue ❑ 217 Lake Avenue _ ❑ 85 John Street h SY NEW Yl7fiK, NY 10038 � ALEiPINY, NY 12207 BUFFALO, NY T a202 ROC SE, NY 1320E THE NEW YORK BOARD OF FIRE UNDERWRITERS A.J FILE Copy wN 3F QUEENSE3URY _ Zoning Admini trator Date r � � cx ro t wAf i 4 � ' s 1 i , vote 1 Gam . i 3 r^l i. � !`C i",�-.� -ems �•�'-�--C.,�_