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1989-717 .y ..yFIr 4 CER'TI.FICATEi OF C►CCUPAMC JL" TOWN OF QUEENSSURY i WARREN COUNTY, NEW YORK I Date Maech 21 14 9fl j Z A LI �3 _r`7 ' This is to certify that work requested to be done as shows► by Permit No. 89-717 I I has beer+ completed. i This structure may be occupied ss a Si no a Fa mi 1 y Swel 1 i na s � I 'I 1,..ocation �,,,inrl n A rani�a' OwnerDaniel & Charlene Kane k By C rder Town Board I TOWN OF QUEENSBURY f Director of Bldg. is Code Enforcement BUILDING PERMIT x TOWN OF QUEENSBURY = ' a No. 89- 717 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Daniel & Charlene Kane OWNER of property located at Linden Avenue Street. Road or Ave. ry ca in the Town of Queensbury, To Construct or place a Xz X141 11 1* Single Family Dwejjjnq. 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 19 Monument XXXXX Avenue Glens Falls , N . Y 12801 `m 2. CONTRACTOR or BUI LDER'S Name CZY J. ro J 3. CONTRACTOR or BUILDER 'S Address =7 sv 4. ARCHITECT'S Name rR {b 5_ ARCHITECT'S Address 6. TYPE of Construction — {Please indicate by xi r) XtXX Wood Frame I ) Masonry 1 I steel I } 7. PLANS and Specifications rn No, 33 ' X 40 ' Single family dwelling as per plot , plan , specifications , an application , including septic , attached two car garag , S. Proposed Use Single Family Dwelling u, $ 279 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES April 1 19 90 n cu (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 j —• Dated at the Town of Queensbury this 1 *1 ❑a of September Ig 89 SIGNED BY / t for the Town of Queensbury Building and Zoni fig Inspector '� TOWN OF QUIS NSBDNY REVIEWED BY 40t FEE PAID $ PERM T NO. � "OWN RE GEWEr) SBURY '� _ RECEIVED BUILDING PERMIT APPLICATION BLDG. u CODE DEPT, A PERMIT MUST BE OBTAINED BEFORE BEGINNING CC rN uC.'TT+DNo NO INSPECTIONS WELL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. All applicants spaces on this application MUST be completed and the signature of the applicant MUST appear on the reverse side of this application, e r r � s r . : . r . s « . « * « . . « : . : « . . « • s : : . s a . a . « « . : The owner of this /property is: , -49N/45Z ` " �' �5'.�"[f.�•'G` r9rc�'�= P.O. Address / r 'iG'�✓Grr�lG=.cs s052✓L" .�i Property Location ,` �✓�c/%� .y /9L✓G� �T} �'w.r.sv /.F w' o2efGr v 46r,�. Tax Map No. /a/ Has there been any split of this property since October 1 . 1988 ? / �[ If yes Planning Board Review is necessary. yes no SUBDIVISION NAME, IF APPLICABLE LOT NO. THE PERSON RESPONSIBLE FOR SUPERVISION OF WORT{ AS REGARDS TO BUILDING CODES IS: t Y NATURE OF PROPOSED WORK: * ES r.MATED MARKET VALUE OF _Construction of a new building w CONSTRUCTION: $ 1 302000 Addition to a building " COMPLETE INFORMATION REQUIRED BELOWO Size of property ) 2 5 ft x -ft. Alteration to a building " Existing Buiidings0 ) Size ~- ft. x ft. (no change to exterior dimensions) Proposed building - distance from property lines Other work (Describe) Front yard l y £t. Rear yard VY ft. Side yards *:ZD ft. and �. ► eft. GROSS AREA OF PROPOSED STRUCTURE , If on corner, setback from side street ft* 1st Flooresses / ,I' g 49 sqw ft. r OCCUPANCY INFORMATION 2nd Floor 5- sq. ft. / 0 , Primary Building em Other Floors sq. ft. �U • One Family Dwelling (not cellar or basome'n'tT0000eow Two Family Dwelling TOTAL FLOOR AREA sq. ft. + Multiple Dwelling/Number of units � Size of now structure. ft x see� c� fte 0 Bain ess" Industrial Foundatio rr-pierlslab/craw UFNu'tial (circle one) • Other • No. of stories (habitable spece) Height (grade to ridge) 32 !t. . If addition, what will use be* If residential, now of families 1 • Noo of roams(ioxcluding baths) 7 sees # Aceeeisory Building Noe of bedrooms �! • Detached C3arag* ONE/TWO 'Car Mae of bathrooms drA 6�t r Primary heating syst+erre~No� i�Pr +► X �Attachod Gera" ONZA or r Type of fuel_,a�S� Privet* storage building Noe of fireplaces to be Install Other Will a wood stow be installed -- # Central Air conditioning OVER BALDING PERMIT APPLICATION C © NT [ N �' ED BUILDING 3PFCIFIC3TIONS: Type of construction, woo from fire safe. etc. wood -Fro M Will any second-hand or upgraded himt',erbe used? If so, for What ? 11J" 0 Foundation wall material Thickness Depth of foundation below grade (to bottom of footing) Will there be a cellar ? e Heated or unheated? 00 btad'e<( Floor sq. footage f 1 70 sq ft . Will there be a basement ? Will any portion be used as living space? I C! (If so, what portion? — sq £t. Type of use ? Type of roof - sloped/flat/shed/other +Mole Material of roof A5 n , j C, a+ liyr4 (C Size, wood studs 42 "x�"' sfracing 16 "' o. c, length '$ ft. Joists ( floor beams) Ist floor "x ]o ." spacing /6 "o.c. span /6 ft. Joist ( floor beams ) 2nd floor "'x to " spacing /d "o. c. span 14 ft. Overlays (ceiling beams ) r' 'x " spacing.. /d " o. c. span /G ft. Roof rafters "x_ d�7 spacing Z o. c. span /:V ft. Roof trusses (pre-engineered) spacing " o. c. span ft. Exterior wall finish !04:? 0 '4•'' G/c. ,004at ,fit'" of what material? E'de7% Interior wall finish � �7 y 4ma J/ If a garage t to be attached, describe materials to be used for FIRE SEPARATION* �/r�✓ri=.x/,/� 15rl /'r a 4a e A p � Le/ i fI/ .ti"�' C o r/ E"+• f'c# Is there to he an opening between garage and dwelling' ;2 If so will a Fire-rated door, enclosure, self-closing device be provided? 1/25 Will a flue-lined chimney be installed? /yo Height above roof ft. Depth of chimney foundation below grade ft, Depth of fireplace hearth ft. in, Water supply - Municipal or private well I�?'tT/ylc ,petl SEPTIC SYSTEM Distance from ANY private well (including adjoining properties /00 ft. (A separation application is necessary for any repair or new installation of septic system) NAME OF BUILDER &rieeY Spee-1 Go/Y 5f t ADDRESS 2S�oh'4✓ +y7 Atolpe � TEL. NO. 7V 3 215A NAME OF PLUMBER '/.KiY /Yo.�' /f6i"� ADDRESS _ /t",¢ St j!5;yC TEL. NO. NAME OF MASON 00 ADDRESS 15y.`E�,oOp. .a Z.~ "ef TEL. NO. NAME OF ELECTRICIAN ADDRESS TEL. NO, 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 dome an the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and Ali other Laws pertaining to the proposed worse shall be comp ied�wltt�� et �cined or not,, and that such work is authorized the owner. f/ S IgMatu ci111AA f7do 011ie L M J Owner, owner's agent, architect, contractor SPECIAL CONDITIONS OI+ THE PERMIT: BY TOWN OF QUE . NSBUR .. 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 : I 10 Gross floor arear � �L 2 , Type of heat _" "Cl 5 HZ77' 20" 3 . Is the building mechanically cooled ? - 4 . Percentage of area of windows and doors } 7 , A . Over 16 % Only 1 . Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 , Floor over heat - 3 spaces YES NO a . Are foundat on walls insulated ? YES NO 1 . If YES , what is the R value ? 3 , Slab on grade YES NO a , If YES , wh . t is the R value of insulation around perimeter of floor ? 4 , is basement heated ? YES NO a . R value of .insulation 5 . Type of insulation B , Under 16 % Only 1 . R value of roof and floors expos d to ambient conditions. 2 . R value of exterior wails ,, r1 " 3 . R value of glazed area q 4 . R value of doors N 5 . R value of floors over unheated spaces d 6 . R value of slab edge insulation - unheated slab 7 , R value of slab insulation - heated slab_ /� /�• 8 . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement / cellar walls ( be. 11oow- grade ) lU . Type of insulation f � obe Y` Gla S:i � 7 Co Controls 10 Thermostat maximum heat setting D . Duct Systems 1 . in unheated is duct system installed treated spaces ? YES NO a , if YES . R value of duct installation �--- b . R value of duct in other areas E . Pining Insulation 1 . Size of 'hot water or cooling carrying agent pipe1i 2 , R value of pipe insulation F . Service Water Heating 1 . performance efficiency 2 . Temperature control setting maximum / G'' G , ror swimming Fool Only 1 . Maximum heating Telephone No . 1C ( applicant ' s signature ) "1 DWN OF QUEENSB URY APPLICATION FOR SEPTIC DIS'POSA.L PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION- Owner's Name: Telephone: 7Su -r f3 7�/= gyro [.V Address: /` / irvurr� d r9ri°�" �G e.✓s /~f�GLS Installer's Name. Telephone: Number of bedrooms (residential only) Total daily flow {compute (a 150 gal per bedroom) a Topography: Circle one: tat Rolling Steep Slope % of Slope Soil Nature: Circle one: and Loam Clay Other /Depth: Feet Ground Water: At what depth? 7 _ Feet Bedrock or Impervious Material: At what depth :' Feet Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one: 'N unici Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank /0 gal. (minimum size: I ,O0n gal.) TILE FIELD: Each Trench s a feet/Total system length C'' feet SEEPAGE PIT(S): Number of / Size each s 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 nitary ewage Disposal Ordinance. SIGNATURE OF ESPONSIBLE PERSON: � / ' -�'_ 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 Inspuctor . 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 bt2 submitted to the Queensbury Building Department before further construction . Town of Queensbury BUILDING and COZIES DEPARTMENT Say and Haviland Roads Queensbury , New York 12804 h.-[narks elftstt of (IDu eetcshurg Xig4 a nig JBepartment Bay at Haviiand Roads Office Phone 518-793-7771 Oueensbury, Now York 12801 PAUL H. NAYLOR RICHARD A. MISSITA Superintendent Highways Deputy Superintendent Highways DRIVEWA'i PERMIT DATE : APPLICANT NAME : / / /✓�L Y Cf1°r E'L� eve / '/�/✓[ TELEPHONE NO . : 70��25 ADDRESS TO BE INSPECTED : l,/wole / RETURN ADDRESS : Applicant , inert. show .exact locat4,,c and wi&tly bf dr J a ) to be conn*M ac . fro tho. _.highw4y� 51';, PlaEclxyg 8 kets at the specifiedct ► orx .• The Superintendent vg. Rig#4ys Town of - ieen9buryV h4gr ' reviewed the applicatian of the- above r3.atned r4asident to connect a driveway to thy ` Town roaA . The. ,:fol�� a+gsrs has been taken z a , STEP 1 . ( } . ,rreiLiviinaxy, - AApproval , ._ NEED : ( } " . :��`j.ght. Swai 1 1 With The Road Swai 1 Size Pipe to be used ( if necessary ) ( ) 12 " ( ) 15 " ( ) 18 " C ) 24 " ( ) 3501 Preliminary inspection by DATE Approval by Highway Supt . Depty . Supt . After receiving the Preliminary Approval , submit the permit to the Town of Queensbury , Highway Department upon completion for a Final Approval . STEP 2 : ( ) Final Approval ( ) Rejected DATE : Paul He Naylor Superintendent ui highways Town of Queensbury Member N.F.P.A. LfC.L.- ! YI.�L�^'L- Certificate ATLANTIC - INLAND, INC. - NEW YORK Electrical and Fire 1ns,oec00n-Enf0rc109 & ConsuHing Service �y� ..,` 997 McLean Road, Cortland, NY 13045 PATE : i7 4MO CERTIFICATE I`JO.: — — blhni El 1(4riG AS APPROVED FOR : OWNER : L1ri&rit Ave AL]DRESS: t o+ecrsti�lrrya Refideere:e ; ELECTRICIAN: �ryan :+et Ko�rre. '�'-�dKa dtHr . , 14 14anue alk Aptle . {yt ens€ FbO ISS I�( t2wl ADDRESS: •The Conditions fallowing governed the issuance of this cort fiGate and any cernocale previously issue( Is C�Wcelled: This CerliOr of unTy covert :he ent or equipment lispplic ionon4 In'5.11 be pr prompcorlditly ma OS 6t nape. Lon. the mt t of is company ny equipment ve fille rpriv ns application Shall ct praint a made fqr d I it Cron. inspectors d1 this CPm parry shall have the privilege D' making inspections at any 'ime end 1 i[s ruse C opy are violated. the Company shall have the right to revoke this Ca roti Cate -fOWF3 Of QUEENSBURY BUILDING AND CODES DEPARTMENT BAr 4 HAVILAND ROADS 2BOa- gUEENSBURY, NEW YORK 1 �92-5832 TELEPHONE ( 5].S y REPORT �1,3I3.L� 1VG I13SPECTDR S REQUEST:0./ INS ECTION RECrEI,VVEfn-3�� 'r t1aj f i?l� d did t��- kp NAME �r Jt / rri7[�+a� LOCATION / ' /'(G �+ PERMIT # DATE APPROVED YES NO FOOTING/PXBRS FORMS MONOLITHIC POUR FouNDATIONIDA � OOFING BACKFILL AP ROUGH PLUMBING FRAMING r ELECTRICAL ROUGH-XN INSULATION: FOUNDATION FLOORS. WALLS CEILING �'�' INSPECTION . CHIMNEY HEIGHT :ROOFING SIDING E S EXTERNAL PORCHES RAILS STARS' CLEARANCE VALVE PLUMBING FIXT11JR .1 RELIEF INTERIOR TRIM1rP I ACy M)ORS -�--� FLOOR$ �'~~ FINISHED GARAGE FIREPRQOFI DOOR CLOSER (S) SMOKE DETECTli CTION FINAL F;LECTRIC?►L INS —�-�-~� FINAL APPROVAL OF CON TRUCTIONf� OK To I SS f --�---- �- OCCUPANCY MUST BE A SIGNED CE TIFICATE O F M fiHE BUT NG DEPARTMENT BEFORE OBTAINED IED! THESE PREM SES ARE DCC 3 REMARKS : e I S}lR T(E 26 f > i i « i n 1 ARRIVE DEPART. � INSPECTOR TOWN OF QUEEN SBUR p BUILDING AND CODES DE ✓BAY & 14AVILANI7 ROADS � I28Q QU EENSBURY, NEW 792-5832 TELEPHONE (5I8) BUILD NG INSPEC OR' S REPORT REQUEST FOR INS CT ON RECEIVED NAME LOCATIONPERMIT DATE APPROVED YES NO FOOTINGIPXERS MONOLITHIC POUR FORMS FOUNDA TIONIDAMP_PROO F ING SACKFILL APPROVAL ROUGH PLU,M'BING s FRAMING ELECTRICAL ROUGH-IN INSULATION: € FOUNDATION FLOURS WALLS CEILING a FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING �.. EXTERNAL PORC STAIRS-CLEARANCE & RASE { VALVE PLUMBING F IXRES/R0. INTERIOR TAXMIPRIVAPY Do RS FINISHED FLOORS GARAGE FIREPROOFING �V DOOR CLOSER (S) SMOKE DETECTORS 1► FINAL ELECTRICAL dONSTRUCTI N FINAL APPROVAL OF OK TO xSSUE c/o oft° cIc OCCUP NC T BE A SIGNED CERTIFICATE OF RTME T BEFORE OBTAINED FROM THEE BUILDING I1E T 15E PREMISES A4E OCCUPIED!- REMARKS : K� G*AA ) EL aTMxVE DEPARm L� INSPE TOR h TOWN OF QUEENSBURY BUILDING AND CODES ,DEPARTMENT �! z HAY 6 HAVILAND ROADS QUEENSBURY, NEW YORK 1280� TELEPHONE (51 $ ) 792- 5832 --�` BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECCEIrl .D _ NAME LOCATION _ 1 � PERMIT DATE _ J APPROVED YES NO FOOTING/PIERS MONOLITHIC FOUR FORMS F O C I NDA T IO N/DAMP-PROOFING BACKFX,LL APPROVAL RO H PLUMB NG pof'RAMING EL RICAL ROUG$-IN NSULATION. FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORC ESSISTEPS`., STATR.S-CLEA CE 6 RAIL i PLUMBING FIX' URESS/RELIE VALVE INTERIOR TR /PRIVACY FINISHED F ORS GARAGE FIR ROOFING - - DOOR CLOSE (S) ,SMOKE DETE TORS FINAL ELECT CAL TNSPECTION FINAL APPRO AL OF CONSTRUCTION A SIGNED CE TIFICATE OF OCCUPANCY MUST BE OBTAINED FR THE BUILDING DEPARTMENT BEFORE THESE PREMISE`S ARE OCCUPIED! REMARKS.* F(AAS , -- �; 2-a .INS TOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT l,) BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809, f ' �5 7 TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR TNSPFCAfZON RECEIVED NAME L40CATION DATE PERMIT # APPROVED YES INO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIONI AMP- PROOFING BACKFSLL AP VAL -- GH PLUMBI RAMXNG ELECTRICAL" ROU -IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING 4 SIDING EXTERNAL POP C S/STEPS STAIRS-CLEA CE & RAILS_ PLUMBING FI 7VRESIRELIEF VALVE INTERIOR IM/PRI VACY INIORS _..._ FINISHED ZOORS GARAGE F REPROOFSNG DOOR C SER (S) SMOKE ETECT04RS FINAL E ECTRICAL INSPECTION FINAL PPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: Cw _4L kAA kk INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- TELEPHONE (5I8) 792-"5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE PERMIT # Fq_! APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNPATXONIDAMP PROOFING ,,BACILL APPROV. ROUGH PLUMBING FRAMING ELECTRICAL ROUGH— INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORC ESISTEPS ``. STAIRS—CLEA NCE & RAILS PLUMBING PI RES/RELIEF^;WALE'S INTERIOR T M/PRIVACY DO04S FINISHED F ORS GARAGE FI PROOFING DOOR CLOS R (S) SMOKE DETECTORS — FINAL ELECTRICAL INSPECTION a. FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS : ANISPECrop TOWN OF QUEENSBURY ,BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED —� NAME LOCATION DA TE / 1�9 PERMIT # G1 _ ;7/ A ROVED ES NO (_, ,?&TING/PIERS rl- MONOLITHIC POUR F S_ FOUNDATION/DAMP— DOPING BACKFILL APPROVAL ROUGH PLU BING FRAMING ELECTRICAL GH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PO CHES1 EPS STAIRS—CLE RANGE Sa ILS PLUMBING XTURES1 . LIEF VALVE INTERIOR RIMJPRIVA DOORS FINISHE FLOORS GARAGE XREPROOFING " DOOR C SER (S) SMOKE ETECTORS L — FINAL E CTRICAL INSPECTIO FINAL A ROYAL OF CONSTRUCTION A SIGNED RTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!' REMARKS: 1 + � JAS�PECTOR _town o� �ueensErurc� 1 ' ' BUILDING and ZONING DEPARTMENT �� Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SE TIC pISPOSAL SYSTEM INSPECTION NAME LOCAT I019 DATE 107 I PERM 6. IT NC7 . J ■ r - SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - N Percolation rate - Min/Inch _ TYPE of 5Y'STE�: ,ate Absorption fieid , total leng't :ZZiy Length of each trench Depth of trenche$ Size of .3ravel -� T SEEPAGE ? ITS{NuMbe Of) Size- ft. X ft Gravel size PIPING : Si T pe Bldgo to tank Tank to slist. box Dist. boy- to fie / (rG Openings sealed ES t NO Partial LOCATION/SEPA TIONS : Fpuxidation t tank to Foundationabscrpt3.on ft. Absorption o lot line ft. Separatia of pits ft. LOCATION SYSTEM ON PROPERTY'{circle one) Front - a - Left side - Right side - CGIMMENT SYSTEM USE APPROVED YES O Building Inspector 01/86 and vl TOWN OF QUEENSBURY �/ �.'J BUILDING AND CODES DEPARTMENT r ■ 4 BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280& TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST Fi?R,,oLrNSPeCTXON RECEIVED NAME LOCATION DATE PERMIT # — APPROVED � ��^^ YES NO V'FOOTINGjPIERS MONOLITHIC POUR FORMS FOUNDA'S[TZO NI DAMP—PROOFING BACKFrL14, APPROVAL 21. ROUGH PL BING FRAMIN `• ELECTRr L ROUGH—rN XNSULATI FOUNDAT±" )N FLOORS WALLS } CEILrNG FINAL INSPECTIO CHIMNEY HErGH ROOFING SIDING EXTERNAL PO ES/STEPS STAIRS—CLE NCE & RAILS PLUMBING I ES/RELIEF VALVE_ INTERIOR J3frM1PRXVACYC DOORS FZNTSHEDJIF RS GARAGE !�I FiPROOFXNG IL DOOR CL6S R (S) SMOKE AE ECTORS FrNAL ELL4'C ICAL INSPECTION se, FINAL APP VAL OF CONSTRUCTION A .SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPIED: REMARKS: #)9 �I .. Tr INSPECTOR T r M NWW II'm w +rl 1111rt �.F.r.A rwo ui&J. NEW YC?I�K o" sral.srr11 FIRE UNDERWRITERS ', © sJr .�,, 1wn moo l w Cal and Fire lrapecoon_ErOorcing and Cor asultino Service) onCOMOMI 1 in 9M Seaga Of Phw York) *W%400 01% GCCWW wilt w Or Mr irl�p�sCtlOn Of A10Ct"4Cal inH attor m in the WOmiap d'bscribad bNOw. On demand applicant agrees to Pay for APPLICATION FOR ELECTRICAL INSPECTION — PLEASE PRINT OR TYPE q 7*ft SECTION TO BE COMPLETED BY APPLICANT DATE OF APPUCATtON _ _ 4+ go ? - CrrySTAI CGl NTY TowN. v1Le,.oE C1 s C� c1.� VVooV2ZAF^/ / /V+ ^Done" 4/.�AwlliA .R./ �rhC STATE C1iZ N• ! a +f eu+LOG. rwD aR�TI«�s Lo.+t T,�'.E..vt ",.c,�r '�t ,S' q. '�ltf MMEfl s f wit/ POLE NO. �� r OCCUPIED AS OCCUPANT D- OWNERS P.O. ,,r-� ,BUILDING Na. M r O ❑ WORK — New O Aprlilionw yQ ADDRESS �''17d�ciGcpl �.4 J L oo t/� , fo � e ovsp/ APP. FOR — ROUGH M"ING ❑ Ff%TURES C7 OR READY FOR INSPECTION 1 yY FEE REMITTED — 5 BY CHECK p {-,ASH (J MONEY ORDER ❑ MAKE PAYABLE To ATLANTIC-INLAND, INC — NEW YORK Nufnyor of ROuyh VWririg Ouaeft Fixiuroa Swtch Li Add Instsllstlorl �9R. KW Moptll Fluor .+Ci7 T50 10pC 7250 150C 3750 20160 2250 2500 2T50 3000 t'laei Be" BeN Elect Most Amp. S4r'vice Water Htr- Burner Air Co dr SWIAM Unit CJ1ra11 Rwge ef, deP- LtiH1 W. HOW Gri .141✓f,(,te�l l J' /� NAMEOF UTILITY Q� ,� < S 8TATE !'► '` Zip CODE GJQQ f01 OFFICE TO BE NOTIFIED ROUGH WIRING AMP SERVICE OUTLE75 EQUIPMENT K.W. SURFACE SWITCHES UNIT AMP SERVICE K W. OVEN CONDUCTORS RECEPTACLES H.P. PUMP H.P.GARBAGE MEDfUM BASE DISPOSAL UNIT FIXTURES K W MOGUL BASE K.W. DRYER DISHWASHER FL*S TUBES K.W. WATER FLUORESCENT HEATER K-W RANGE Fi%TURFS M.P. A)R AMP.MERCURY VAPOR OR RECEPTACLES CONDITIONER WIRING a CONTROLS FOR BURNER SMOKE OUAAT2 FIXTURES FRAC- H.P. MOTORS, KP. 1l20 1112 1 r 1O 1 f# lea 114 1/3 1/2 31A 1 1 K 2 3 5 DETECTORS VENT FANS Tvs tp 13 20 26 30 40 5p T5 70O .:.,. ._ . ` vZ: : :. L3 r' r .. _R. : Q bit 41011111a5f •. '.Q r . iio r TOWN OF QUEENSBURY .honing Ad istratar Da#e - E i r E `! A � " 1f� fi 1 LIr4IDCr-4 A, VE ck 4 2 .B 9 ' pgL�F'0.5Ep u CLl..i rvr ed q J •r' I>�I i r� Iz4 .°ter' T P L.A. r14 SCALE 1 30' to L E F' -l" E L� VA—r l O ry ; ! _ - - - - SCJ4LE. -"= r •- e] ` rT,'H ayw•• / ORAWN 6Y _D .-VIE -T SCA LE StCNN-� ' Ma cy Y 6 cl As ra 1 t rs