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1989-558
d d - ------------ CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Mee December 5 19 89 This is to certify that work requested to be done m shown by Permit No. -- 89- 558 has been cA3omplewd, *Phis structure may be occupied as a Sin r_11P Family DwPiling Location Lot 29 Hidden HA-11s Drive 0wner Herbert & Mary Levi By Order Town Board TOWN OF QUEENSBURY .......... Building Zoning Inspector --1 BUILDING PERMIT TOWN OF QUEENSBURY o ' No. __ t3g- 558 WARREN COUNTY, NEW YORRK =M . PERMISSION is hereby granted to HPrhar'f' A 1faE�V 1 eVin r" OWNER of property located at Street, Road or Ave. in the Town of Queensbury, To Construct or place a in le Family Dwellin at the above location in accordance to application togel er with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. r 1 . OWNER'S Address is •—r Glen Lake Y Queensbury , N . Y . 12804 2, CONTRACTOR or BUILDER'S Name Joe Roulier , Inc . e� 3. CONTRACTOR or BUILDER'S Address fis' Box 301 Cleverdale , N . Y . 12820 4. ARCHITECT'S Name S. ARCHITECT'S Address b c-r 6. TYPE of Construction — (Please indicate by XI Q rD I I Wood Frame I ) Masonry { l Steel ( 1 J. 1 7. PLANS and Specifications — + No. 68 ' x 31 ' Single Family Dwelling as per plot plan , specifications , and application , including septic and attached one car gara e , �. ra S. Proposed Use and oriveWay . Single Family Dwelling CIO $ -> 5 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Fohruary an (If a longer period is required an application for an extension must be made to the euisding and Zoning inspector of the town of Queensbury before the expiration date.) -r1 P+ Dated at the Town of Queensbury t of kd V SIGNED BY for the Town of Queensbury 0 Building and Zo Inspector -� J. W TOW O QUEE ��eSLi LrrR r= li * y; ^ t- tir - ' ` K L � r ��v LTO1QUEEhIa°`SuRy RECEIVED Fee F'a,Cd s -5 -r �� FIEC 19$9 t'.UILDINC A14,'fl CODES UI 1 'j%RTtTk.F " Dcz C� IOSu: (a ODE DEPT. Z% Y and HAVILIND ROADS RD I DOX 73 nUEI':YSBURY r NEiJ YORh: 13d(]4 PC�u►t� NU . , _ Tel . ( 51B1 702ll Exc 200 ■ y + + ■ ■ ■ Ole a a /f r ■ ■ ■ ■ ■ ■ e a a a • ■ r • ■ ■ r a R a A IyE }1rtIT MUST Gil OBTAINED U [-: I: 1RE E CINHING CONSTRUCTIONe NO INSpI° C'I` 16NS WILL RC HA1) E- UNTIL API' LIC.' NT HAS R'CICEIVED A. VALID IIL' ILDINC PERMIT . All applicable spaces on this application must be completed and the rvuature of the upplicant must appear on the reverse sick of this sheet . r[ It x a ON 1k t >t * 1• ■ At A * a /A A /r At a IN 7C '* x � 7k 7t Yi 'r' he owner of this/ property is : r' . 0 . Address ! __) ��x-'' ee...Ag [.1 > TEL 71 Proper ty location �` ry ! -��r� � ) I , /�r r� C� � TAX MAP NO � ! > / Ilas there been any split of this property since October -- yes no 3f yes , Planning Board Review is necessary . �. u3DIVISION NAME . { r APPLTCABLE -�'r a r�F � _ LOT NO ' he person responsible tar supervision of work as regards Building Codes is : t/r f �3 n r c/. . Y / a r /:'G ' .3 I .' NAME F , O . ADORCSS TEl NO . :lame oc builder r Address Tell ume of Pum ;lQr I'dares y +C Tel u L s Name of Meson _ Addroa a XXX zJ'. Y Tel 7S4o%' _C [o Ty +. 40%xkc0)n = tructiQlrL or t' WOSCO 6uI.r. . rFREVIEW INI ' 0101A.'rloiI C luiticr? Liao onlw ) of .x r+�w builair„7 rSICNATION OF PROPERTY .Ad4itian to Cx lauilding r PRINCIPAL PERMITTED ACCESSORY :A1cur"Lion to .a l.ulLdlnq + i , ta c11.11tkj, to uxt � rLor cli:nons: ional * QUIRED - PLANNING BOARD ZONING DOARD Uttk,: r r,ork (dQzcriUx ! ] + SITE PLAN REVIEW 0 APPROVED DATE aROSS ARLA Olt PFt © POSCD. ` VARIANCE M APPROVED DATE . tit Floor / ems-- sq Et . � ( '�i..� Remarks : nd riaor zs Sq f t �jr C4t4t`l.L '1'i: SCiI'01JKr1'1'1GN 1cLr�uilcLD L1L' LUkl . ' F t Other Floors ^ sq rt . I not collar or b;asQmenz 1 4 lsari:ataluj L:ua idi+ t } ( � 3 i �u I k x TOTAL FLOOR AR £A��3Q f t • • Laca �carkg Da + l .i ► ft.,1(�f ua.� nCw :cructs+ru art ft f ' ''�'f loaks+ td:, tian-picrf :11Lfcr.►wL/la3res .k r►sll l'rajaG�md 17uaising , 'i� t.ance: trout VC01a4irty 1Lnu ( cLrclW one ) Front ywrd ' 1' t hoar yard7 ft h1aa . of �toriea ( )k:aLaiC:aYalk: sLaocel Side y"rdu /G. ec ana Ilwignc ( yr3.4rs to ridc;u ) �1r' - ft # * Ii on cQrner , y.4j ,l3.ar:1c froca siclu ::crwac _r' c If roi; iduncial , no. call f:.milies .° tin , of rQQm3 ( exCludin4j b:ktha) ' OCCutaalvt.Y INFC][.]MA1T10N Ilo , of budrootns s PRIk TtY DUILDINQ Na. of Lti:k,tlkroowk:: !.� Ono tau►sly dwelling vvis"ry 1kuk,.acikkrj k:ysL �wk�. , t r y� 11ra r:.wily dkrulliny Typta Lie f aka l r'= t no * of >Fisk:Lal3Cuat: to Lk.a ink':t:allk:d . Mu1caL�l.s +lwrilliny / Nwab�er Of units . ----• Per"u"%unc OC%:upru,Cy w. 11 a wks41 stove 1Grk: irks:t;all+sk!"' wrr� ' * 1r;an::ivckt cauculkty �:rrnCidl Air coo k"tiun:.rkg 1 �� uglnvss r UUIL,D( NG STYLE, PRIMARY STRUCTURE r Industrial lukkclx Cane.r.+ki +ac.sy L calaim • Ochar t"iswd ranckk Manrtict,k 0LgAI+ax . 1t rdki; bran . krll kc ,.call u::ka baa7 UPI &c 1■svQ1 old >scyls L►ka,k j., iow coct:kcy%s Olt kwr i AGr C�di�Y UUILOING'a 'aIaniaal uaw 'rowrk Taus• tschad y-+rz4q*/y�.Ioae—c+r:>:�sf two c;arf car III, Clac, QNL: P1WASC ) " �`AQt&Chtti�:l cj:ar ' ka/wlri Car two ca;&XI �� C4+ i' r • r • r ■ * s a a r r r + * � r � 1kriV.ktrs StaC:+g3 d ' clin+g W :ZTIMATK*D MARKF1' VALUL OF ' oth,ar INF'ORA^TTON ON OUTLOINC speclFrcATIONS , ON RjCVERSE SIDr OF TITS SFIl;ETr Z•O Be COmPLCT 01 Form SPA 10/88 v1 NIXON �z - 3� f L�D ING SPE,'� IF f CAT IOt4S cf construction , wood fra:.e , - - _ tc . __ +"+:. li any se .-ond- hand or ungrade3 i ...-.`. ter .^.e ulsed : If- a'C , nor Cs 00 c �r.dation wall material Thickness 7_,epth of foundation below grade _ c bovtora ar foot r.c } .. 7�2 •� Will there be a cellar ? nfo uCFzate �! Floor sq . footage sq t Will there be a basement ? Will any portion be used as living space ? .x/.j ( If so , what port-1 sq , ft . - - 2 e of use ? ape of roofsiopeci/ latfsited, ct er . � r �Saterial of roc, f- i4a , wood stuff x / _ spac ng'�. c . ler gth f t . 'i ;oists ( floor beams ) 1st . floor t,,.2 " { .-cs spacing ..-G " o . c . s an _£ t . Joists ( floor beams ) 2nd . floor �^" X ,rg spacing /C —"o . c , span /fir ft . ,Lverlays ( ceiling beams ), �' �"' X��" spacing�� - - " a . c . span�fr. . Roof rafters " " x /� Isspaczng�,/G c . c . IS ar. ft . Roof trusses (pre- engin red) spac1. n " o . c . scan ft . Exterior wall finish PI fpse what material ? interior wall finish If a garage is to be attached , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage ^.d dwelling ? if so will a Fire - rate3 door , enclosure , and self- closing device ba provided cS Will a flue -lined chimney be installed? '/cs Height above roar Ft . Depth of chimney foundation below graded t . Depth of fireplace hearth _ft . �in . Water supply - Municipal or private well / / . c .� � C SEPTIC SYSTEM _ Distance from ANY private well ( iiNcluding ad7cining properties ft . ( A separate application is necessary for any repair or new installation of septic system ) D ECLA 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 weer, owner's ave architect , contractor r t r r r k r r r r r r r r ,t r k r r !r * r w ,e • +t r : ,r r ,f x ft r r r x +R • * r r r * t • SPECIAL CONDITIONS OF THE PERMIT : sy- ... .. ..... 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 2 , Type of heat e-Z 5 e 3 , Is the building mechanically cooled ?. � 4 , Percentage of area of windows and doors A . Over 16 % Only 1 . U value of gross area of walls , roof / ceiling and floors o 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 so Type of insulation B , Under 16 % Only 1 . R val of ro and floors exposed to ambient conditions _ 2 , R value of exterior walls /'~' 3 . R value of glazed area .�a 4 , R value of doors ' 5 . R value of floors over unheated spaces� i 6 . R value of slab edge insulation - unheated slab :2 7 , R value of slab insulation - heated slab � llnr s . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement/ cellar walls ( below grade ) � +�' '� ^&"� 10 . Type of insuIat1on��C a s s -�r=`s. �f �T !� Co Controls 1 . Thermostat maximum heat setting a D . Duct Systems 10 is duct system installed in unheated spaces ?, Y; �NO 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 cWent pipe 2 . R value of pipe insulation e � F . Service Water Heating 1 . Performance efficiency 2 , Temperature control setting maximum_ � ' � G , For Swimming Pool Only 1 . Maximum heating Telephone No . '�tSL� "' ( applican ' s sign ref OWN OF QUEENSEUPY APPLICATION FOR } SEPTIC DISPOSAL PERMIT DATE 1r ;PP, LOCATION OF PROPERTY FOR INSTALLATION -,<� o Owner's Name: G - f��i 3 , r� .r Telephone: _ �J Address:_ Installer's Name: s' - s f =�r/ { C Telephone*_% Number of bedrooms (residential only) Total daily flow (compute (d 150 gal per bedroom) JfS Topography: Circle one Flat.. Rolling Steep Slope % of Slope Soil Nature: Circle o San Loam Clay Other /Depth: Feet Ground Water: At what depth? - - 1'7 Feet Bedrock or Impervious Material: At what depth? �' 14- Feet Percolation test : Circle one: not required ,- required rate min. inch. Domestic water supply: circle e: Municipal Well Other If domestic water supply is a Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic T/a/1n-k ,,i o-rg v - gal. ( minimum size; 1 , 000 gal.) TILE FIELD: Each Trench r / + Meet/Total system length feet SEEPAGE PIT(S): Number ofr�+ , I Size each 3 feet by 0 feet Size of stone to be used # i /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 R NSIBLE PERSON: -._^_. 1 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 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 , file fields and / or drywells B . No system shall be covered before inspection and approval by the Building Ifxspector . Failure to comply with this requirement may result in the uncoverinb 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 the submitted to the Queensbury Building Department before further construction . Town of Queensbury BVILDTNG and CODES DEPARTMENT Say and Havi.land Roads Queensbury , New York 12804 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809% TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT Cl REQUEST FOR INSPECTION CEIVED NAME — _ 7f GI LOCATION DATE /r �05 - PERMITe4i #li_it APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBIN FRAMING ELECTRICAL RO H-IN INSULATION: FOUNDATION FLOORS IXNA LILING L INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/S±EP,% STAIRS-CLEARANCE & RAIZ�S PLUMBING FIXTURES/RELIE)P VALVE INTERIOR TRIMIPAXVACY D69RS FINISHED FLOORS GARAGE FSREPRgbFING DOOR CLOSER (SAS SMOKE DETECT RS FINAL ELECTRI L INSPECTION FINAL APPROVA OF CONSTRUCTION A SIGNED CERT ICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ! REMARKS: r to c �' INSPECTOR • "~ _Jc+wrr n� Quee" i ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. I Box 98 Queens bu ry, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION f ' HATE // _J PERMIT NO.� �Lc _ _ SOIL TYPE - Sand - Loam. - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM :' Absorption fielp total length Length of each ench Depth of trenche Size of yraveT_ SEEPAGE ;? ITS#Nuinbe of] Size- _ ft . X ft . a , Gravel. size PIPING : Size T pe ... Bldg . to tank y,r Tank to list . box Di st . bom- to field/p ' ! Openings sealed? IN6 rtial LOCAT I OTT f S EPA RATIONS Foundation to tank ft. Foundation to absorption t . Absorption to lot line f . Separation of pits ft. LOCATION OF SYSTEM On PROP RTY (ci le one ) rant - Rear - Left side Right sz e TS : SYSTEM USE APPROVED YES - I ui ng Inspector 01/86 and VI. _Down vj Queens ury .31 410 BUILDING and ZONING DEPARTMENT Say and Haviiand Road, R. Q. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION r NAME a LOCATIONJ ¢ DATE � G PERMIT NO. � L3 SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM : Absorption field , total length Length of each trench Depth of trenches - Size of gravel_ SEEPAGE ; S-(Numlae�r/6f) �_ Size- t. X � ft. 4- �L-- Gravel size, PIPING : ^� Size Type Bldg . to tank Tank to 3.- to field box Dist. bo to eni.ngs sealed? /p�S 10 -Irax-t,-i-al — LOCATION/SEPARATIONS ; Foundation to tank �f t. Foundation to abscrption ft . Absorption to lot line ft. Separation of pits ft . ON OF SYSTEM ON PROPERTY (circla one) imITS, - Rear - Left side - Right side x f J**V SYSTEM USE APPROVED YES NO Buil ng Inspector 01/86 and V1 TOWN OF +QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVTLAND ROADS QUEENSBURY, NEW YORK 2280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR` S REPORT REQUEST FOR, XNSPEC/TION/ RECEIVED NAME .�`'J .y .y w�6'A 'Y� r'7�,-a--•�',�%�- '"_--'' - LOCATION DATE . Q PERMIT # � ' ? 1�Se APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING .BACKFTLL APPROVAL ROUGH PLUMB.TNO 4 1o> k_ FRAMING ELECTRICAL ROU —IN �ULATION: f � ]2'T Gf' FOUNDATION G ' FLOORS WALLS CEILING FINAL INSPECTION: ; CHIMNEY HEIGHT �. ROOFING SIDING EXTERNAL PORCH#wVSTEPS STAIRS— RA LS PLUMBINC�F /RELXEF LVE INTERIOR TRT /PRIVACY DOOR FINISHED F RS GARAGE FIR ROOFING DOOR +CEOs (S) SMOKE DEZICALXNSPECTION TORS FINAL ELI FINAL APPR&AL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE oBTAINED ' FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!' I REMARKS: Po , _ pi lz ",� f TT a�� 11Z /trL� XT 1 y' t3pZe :or Al Arl _ ILISP.&CTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENTf,/fj DAY & HAVILAND ROADS vv ' cL QUEENSBURY, NEW YORK I280& TELEPHONE (518) 792-5832 BUILDING INSPECTORtS REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE" PERMIT fl e , APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL (SOUGH PLUMBING r ." 4r 'rRAMING ELECTRICAL ROUG -IN L.,.kNSULATION: d, f FOUNDATION f FLOORS / WALLS fif CEILING tz 3ay.- FINAL, INSPECTION: CHIMNEY HEIGHT ROOFING SIDING i EXTERNAL PORCHES14f2v PS STAIRS-CLEARANCEr'& RAILS PLUMBING FIXTURE'S/RELIEF VALVE INTERIOR TRIM/P`RIVACY DOORS FINISHED Fidoolo5 GARAGE FIREFTie7C)FING DOOR CLOSER ($') SMOKE DETECTORS FINAL ELECTRI AL INSPECTION FINAL APPROV L OF CONSTRUCTION r l A SIGNED CER" XFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUP£ED! REMARKS . INSPECTOR TOWN OF QUEENSBURY BUTLDTNG AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I280k TELEPHONE (.518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FDR INSPECT-TON RECEIVED NAMEpGL" t' —... LOCATION DATE _ p{ PERMIT —7 APPROV O FOOTrNG/P.TERS YES M0AlOLITHTC POUR FORMS FOUNDATION/DAMP-PROOFXJVG ,BACKFILL APPROVAL IMOUGH PLUMBING FRAMTNG ELECTRrCALROUGH IN �r SNSULATION: 1 FOUNDATION r FLOORS WALLS CEILING FINAL INSPECTION: ¢ CHIMNEY HEIGHT f ROOFING SIDrNG € EXTERNAL PORCHES/S P STATRS-CLEARANCE RAT T PLUMBING Fr1[TURE RELIE� V INTERIOR TRIM/P VACY SLVE FINISHED FLOOR GARAGE FTREFR PING DOOR CLOSERS SMOKE DETEC Rc FINAL ELECTRI AL INSI'ECTTON FINAL APPROV OF CON.STRUCTIO- w A STGNED CE T.IFICATE OF OCCUPANCY MUST BE OBTAINED F M THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: //c/ eel *SPEC - -- --R 17 min M dW gational Headquarters 9W Ald&ry kW, C61I Ingswood; N.J. OEf i t)S Date: City, Town or Township County OB ifL r"t1"CC !j, State Location/Address X tt pC.. a + i ( If ted in Rura a - Please Attach Directions) J�ole # __ Owner Perrttiit Occupied As [ i �tiilding:" .N " +Old 0 Occupant -" k s x . o?& Area in Building Floor #, etr') : for: Wiring Service or: Ready for In eta 611 ° ' ` Fee Remitted CashQ Check _ M.O. M_D:LA: Number of Rsx,ph Wring Cutlets: Elect. Heat F.; d sso 10 125o 15ao 17ao saoo zsav ssoa sv5o aoao ;. Switches Lighting Amp. Service 'Surface Unit Dishw4jibee ":JU IRange Receptacles Water Heater Air Conditioner Dryer 7. °=' ! `pump Oven ?� , . ��Garbage Disposal : ;WIwtrols for y: O-�AM R41ceOudless Fractional-KP. Vent -Fans Other Equipment: MOTORS H.P. /2 1n1 1/10 1/8 1/6 1/4 1/3 1f2 3/4 1 1W 2 3 _ r r, 7V2 10 15 20 25 30 40 . 1SF1 ZS Mark Number Of Each Size _ Appi icant's - n - Signature License ` . f - r. ,r^rj71} - •s `. 40 Appil CarWs Address: r,.. i .. .< . (State.) �ipy Service Request # Phone # Electrician x'':.' `: '. : " • " IATE RECEIVED: DATE INSPECTED: . Correct Location : Same as Above [? or: -: q- Red Notice Labei ..a' Rough Wiring Outlets Surface Unit . €Tweii. . 40 Switches Ran r _ Cis CD . Receptacles Water Heater y Cr' - . . , 40 Fixtures AWConditioner r Amp. Service Equipment Burner, Wiring '& Controls for Amp: fieeeptadfe < Amp. Service Conductors Pum Vent Fans MOTORS H.P. 1/20 1/12 1/10 1/a 1/is 1/4 1/3 1/2 3f4 1 [1% jr'2 3 7W 10 15 20 2 3 50- 75 Mark Number a%."I of Each Size - 's:- C t+ + Elect. Heat Soo Aso 1000 1250 1.500 1sSo @e55 sz50 sxw *Wo RW Progress: Inc. LKb F-1 .Contractor ` [] CF Violation : Work Comp- 0 Inc? CASH Owner © LJ L/A _ Fee CH K Pr -rrr.Flue - [] IPA Mul'#tC4fls91 re{ M4 aUE_.. Date: . . Other Wdrb`0!'"+ Uci(ityi r, A s r Cut in Card 0 Temp,#t Onto , [� Final # Date APPI_ 0W%'WMN .FO R1N 140. 25o Z ♦/}Isl.' " 'v' - - • � - . •. - TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVIFAND ROADS QUEENSBURYr NEW YORK I280+.- TELEPHONE (528) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FORfINSP�EC�T/ION RECEIVED NAME LOCATION 7e DATE %Z PERMIT # APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATIONIDAMP- PROOFING BACKF XLL APPROVAL RO PLUMBING � w ING ELECTRICAL ROUGH—IN ' INSULATION: FOUNDATION FLOORS ' WALLS CEILING FINAL INSPECTIONZ CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ TEPS --- SfiAIRS—CLEARANC 49 ILS _ PLUMBING FIXTUR SIRE EF VALVE INTERIOR TRIMI IVACX OOR.S FINISHED FLOG — GARAGE FIRE PR FING� _ DOOR CLOSER { ) SMOKE DETEC2�RS � FINAL ELECTRICAL INSPECTION FINAL APPROVAZ OF COIVSTRUCTIO A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS. i INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FO INSPEC N R EIVED NAME I A LOCATI N ' E-'�r DATE rd` Sr PERMIT # r' APPROVED YES NO FOOTING/PIE MONOLITHIC UR FORMS FOUNDATION/D P-PROOFING BACKFILL APPR VAL ROUGH PLUMBIN FRAMING ELECTRICAL ROU -..IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION. r� �d r[ CHIMNEY HEIGHT of ROOFING SIDING EXTERNAL PORCHES/S E STAIRS-CLEARANCE RA PLUMBING FIXTURES RELI VALVE INTERIOR fiRTM/PR VACY D RS FINISHED FLOORS GARAGE FTREPROO ING DOOR CLOSER (S'1 .SMOKE DETECTOR FINAL ELECTRICAL INSPECTION FINAL APPROVAL F CONSTRUCTION A .SIGNED CERTI ICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISE ARE OCCUPIED! REMARKS. INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR 11?P7 IXOP RECEI ED NAME LOCATION DATE e5 I f:J i PERMXT # ir S APPROVED YES INO OOTING/PIERS .MONOLITHIC POUR FORMS FOUNDATION/D>bKP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ EPS STAIRS-CLEARANCE RAI PLUMBING FIXTURE /RELIEF LVE INTERIOR TRIM/P VACY DOOR FINISHED FLOORS GARAGE FIREPR FING m DOOR CLOSERS) SMOKE DETECTC7 S FINAL ELECTRICA INSPECTION FINAL APPROVAL F CONSTRUCTION A SIGNED CERTIPTCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS.& INSPECTOR /qN OF QU �EENSBURYING AND CODES DEPARTMENT HAVILAND ROADS LEPHONEyr NEW RK (5I8 ) YQ92-5832128 O� BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTIO RE G VIED NAME LOCATION DATE PERMIT # APPROVED q7' YE NO FOOTINGIPIERS MONOLITHIC FOUR FORMS- -- I FOUNDATIONfDAMP-PROOFING BACXFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN 114SULA TION: 4 FOUNDATION FLOORS 1 WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES SIT STAIRS-C.LEARAN & RAILS pLUMBXNG INTERIOR TRITfPRIVACYIDOORSLVE '-- FINISHED F IRS GARAGE FIR ROOFING DOOR CLOS (S) SMOKE DE CTORS FINAL ELE RICAL INSPECTION FINAL Apj1ROVAL OF CONSTRUCTION A S-TOYED CERTIFICATE LD OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! �l -1"411V45prCTOR TOWN OF QUEENSBUR.Y BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280& TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR .INSPECTION RECEIVED NAME LOCATIO[N� DATE d, — — d�' PERMIT # p / Ss] APPROVED YES NO FOOTS /PIERS MONOLX XC FOUR" FORMS FOUNDAT N/DAMP—PROOFING BACKFI LL PPRO VA L ROUGH PLU KING FRAMING r' ELECTRICAL OUGH—IN ° INSULATION: { FOUNDATION FLOORS WALLS CEILING FINAL INSPECTIO CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE TEPS STAIRS—CLEARAN RAILS PLUMBING FSXTU ES/ LIEF VALVE INTERIOR TRIM PRIVA Y DOORS FINISHED F S GARAGE FXREP OOFXNG DOOR CLOSEFz SMOKE DETEC ORS FINAL, ELECTR AL XNSPECTIO FINAL APPROV L OF CONSTRUCT N A SIGNED CE IFXCATE OF OCCUPANCY MUST BE OBTAINED F THE .BUILDING DEPARTMENT BEFORE THESE PREMI ES ARE OCCUPIED! REMARKS: f INSFECTO' TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 7 BAY & HAVILAND ROADS QUEENSBURYo NEW YORK 328094 TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME .LOCATION . c_� DATE /r PERMIT # �. �c3' APPROVED YES NO FOOTINGJPIERS MO OLITHIC POUR FO OUNDATSON/DAMP�—PROD NG :_;;::::; BACK-FILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION.- FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING a' EXTERNAL PORCHES/STF S STAIRS—CLEARANCE & .;FAILS PLUMBING FIXTURESELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS , GARAGE FIREPR r ING DOOR CLOSER (S) ' SMOKE DETECTOPS 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: uAl 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 r� G, U.D/Yi3�7"7 LOCATION �e'�� 7` e&a;5� - GG a � '�! - DATE PERMIT # �{ � OF APPROVED YES NO ��f3d�'ING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING PRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS r CEILING FINAL INSPECTION. CHIMNEY HEIGHT ROOFING SIDING E.YTERNAL PORC ES/STEPS STAIRS-CLEA CE & RAILS PLUMBING FIX URES/RELIEF VALVE . INTERIOR TR /PRIVACY DOORS FINISHED F RS - GARAGE FIRE ROOFING DOOR CLOSE fsJ SMOKE DETE TORS FINAL ELECTR CAL INSPECTION FINAL APPROV L OF CONSTRUCTION A SIGNED CER IFICATE OF OCCUPANCY MUST BE OBTAINED FROk THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! 11 REMARKS. f: INSPECTOR SELECT BUSINESS FORMS (609) 848-5203 APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters goo Haddon Ave„ Collingswood, N-J. 08106 � - • a Date : City, Town or Township County, -- - State Location/Address f / c-. / 5 G c .ems G�. - Located in Rural Area - Please Attach Dir tions) pole # Owner.Z r- //& . Permit 9x Occupied As Building: NewZlo�' OWED Occupant Work Area in Buildin Floor #, etc. ) : App. for: Wirin Service or: Ready for Inspection : Fee Remitted - $ Cash © Check Q M.O, F-1 Make Payable To : M.D. I .A, 5o0 75a 10001x250 xfi00 1750 2000 2250 2500 2750 3000 Number of Rough Wiring Outlets 'Elect. Heat Switches Lighting Amp. Service Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: Mark Number MOTORS H.P. 1/2 1/12 1/10 1/6 1/6 1/4 1/3 1/2 3/4 1 lux z s s 71.r: iC7 15 za 25 30 40 50 75 1W of Each Size Applicant's Signature •" License # Pe mit # T/A Uti I i ty : +�'� Applicant ddress; s ! (NAM tUFFICE L CATI (City) a -w (State) -'' � (Zip) zZZ— Q _ Service Reque # Phone # L Electrician . • DATE RECEIVED: DATE INSPECTED: Correct Location - Same as Above O or : Red Notice Label = Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Recaptacles 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, 1/20 1/12 1A0 1/8 1 1/6 1 1/4 1/3 1/2 3/4 1 1 .11/21 2 1 S 1 5 171/z 11) 1 15 1 20 1 25 30 40 1 50 75 laa Mark Number of Each Size Elect. Heat soo 7sv xavv x2sv xsoo xzso 2vov 22so 2svv 27sv 3vao w11C1/1L Vow Ig DA fE CCU FED 0 RW Progress: Inc. Q LKD Q. Contractor EA CFT Violation : Work Comp. ED Inc, F7 Q L/A Owner CASH ED El L/A Fee CHK # Due MO # © WA Municipal INV # Dam : Other Side = Utility Applicant H Owner Cut in Card [] -Temp # Date OE o OULIER, INC. (51$) 656-35" BOX 301, CLEVERDALE, N.Y. 12820 IL I 4 i- ]WN OF C. OE.EN.S Ave y ZDni ng Ad " tor 8