1989-770 CERTIFICATE C.)FF OCCUPANCY
TOWN OF QUEENSOURY
WARREN COUNTY, NEW YORK
October 1 98
Date 19
J 89770
This is to certify that work requested to be clone as shown by Permit No#
has been completed.
2 -- CAR GARAGE WITH HABITAL SPACE
This structure may be occupied as a
16 MICHAELS DR .
Location
WILSON F WILLIAM & VICKIE
Owner
TAX MAP NO . 12 1 . - 7 - 2 6 By Order Town Board
�TO�WW OF QUEEMBURY
Director of Bldg. cRt Cade Enforcement
BUILDING PERMIT
x
TOWN 4F QUEENSBURY �
No. 89- 7 70
z
WARREN COUNTY, NEW YORK o
PERMISSI0N is hereby granted to William J , Wilson r s
OWNER of property located at RD 6 Michael Drive Street, Road or Ave. y
ry
in the Town of Queensbury, 2 Car Gara a with habital space
To Construct or place a g
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
Same
2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
N
4
7
4, ARCHITECT'S Name
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6. ARCHITECT'S Address �.
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6. TYPE of Construction — (Please indicate by X)
( ) Mlood Frame ( ? Masonry l ) Steel L I 1
C•
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7. PLANS and Specifications
No. 22 x 30 2 car garage with habital space on second floor as per plot
plan , specifications and application ,
ry
8. Proposed Use C"�o
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Garage with habital space �s
ua
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eo
$ 75 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
May 1 19 90 E
(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.) c-i-
Dated at the Town of Queensbury this l2th Day of October ig 89 Or
rr
SIGNED BY for the Town of Queensbury �.
cn
Building and Zoning frispector z,S
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m
TOWN OFUEEN5I3UI2Y APPf. ICATTON FOR BUILDING AND ZONING PF: RTIIT
�'ce,.%eu rd
�� ` 'j'QWN C?F r^, UEENSBUIRY
y � R=CEIVEMD
r
Fee Paid SEP r 1989
WILDING AND CODES U1 :IIAR'TMFJt *T Date Ia.aued�j
DAY and HAVSLAND ROADS Rn I Box BLDG. & CODE DEFT,
OUEENSBURY, NE'irr YORK 12804 PeAni t No .
Tel . (51. 8) 792-5832 Ext -204
A PFRMT MUST BLI OBTAINED BE- FORE BEGINNING CONSTRUCTION . NO INSPECTIONS
WILL BE MADE UNTIL AP141LICAMT IIAS RECEIVED A VALID BUILDINC PERMIT .
All applicable spaces on this application must be completed and the
s + nl( ature of the applicant must appear on the reverse side of this sheet .
* * * * e * * * 7r *applicant
��c /t� �i * { W / 7C at 7k �C 7k ak 9k �f '�C 7k Yf iK �i ]k �C YC
'1' lie owner of this property is - I, I /j40' J •r{S01 r 4
Poo . Address �6 -. /,V ' t� lf_ Ally, Id"0. �/
TEL I /�7 y!
Property location /�,N 64A - '�' &wl J V&.r I� 'T'AX MAP Ni - A)Z/
Has there been any split of this property since October 1 , 1988 ? yes n,10
7f yes , Planning Board Review is necessary .
SUBDIVISION NAME , II` APPLICABLELOT NO `
The person responsible for supervision of work as regards Building Codes is :
TEL . NO .
NAME F . O . ADDRCSS
Fuld re s 5 Tel'
Name of builder Tel
,.
Name of Plumber Pddress ----
Tel
Name of Mason '
Address
r4ATURE OF I'ROPC)cSED 1%ORK : ZONING INFORtkl+TION! ( Offl ca esa only )
Construction of a now building + ZONING DESIGNATION OF PROPERTY
::oAd.lition to a building # PERMITTED PRINCIPAL PERMITTED ACCESSORY
AlttjCaLion to a building
( 110 to exc � rior dimensienS ) # REVIEW REQUIRED - PLANNING BOARD ZONING BOARD.
Other work (doficrib*1 SITE PLAN REVIEW APPROVED DATE
VARIANCE APPROVED DATE
GKOS5 AREA OF I� ROPOSED� :; TRUCTURE
#
e.,
w
1st Floor s sq ft :71) Remarks :
2 n d Floor • s ri f t . "{ ,. Col*jp j. r:'PL i Nl'OL:rM'L'ioN 1t1 QU I1cLD LICL.UW1 1
Sire of proLxurt ft x
Other Floors $ g t .f [ t .
. Lxi�ti�krj l3uil+li a��] 1 ::1 Si : u 1. L k 4
( not cellar or basament )
TOTAL FLOOR AREAA,�4> $ q f t . ' k:xistix�g builds" ( 41 U!u
`.' ixu of new ::tructuro a ft x30 ft
t aux,d:xtiort-picr/:;la crawl/partial/ full ' Vropo"d buildsrig , cii:; canae rraur 1�rul�4rty lino
cirelu one ] Front yard �55 rt !tear yard � ft
No . of stories (habi. t,:.hlc s1414clle ) _r ____. Sidle: yards 7 et and rt
Iluic3hG ( yradc to ri1 ZY ft • If on corner , ::utbAck from side scruec
1f residuntial , no . of families
No . of rooms ( excludinq baths ! ' OCCURANLY INFOP,Jr1AkT1CN
IJO , of bedrooms „ PRIMARY BUILDING -
tro * of bL&cj%roosw; t. ""Opts fuuily dwelling
k'rlu6;kry Iivati&Lij ;.:yi: L�:111 Tva fauxily dwelling
LYl,)u of £uci f3 ti2c ! tr Id — multiYxl.s alwu3lirsg } Number of units,
No , of firu131acus to be install�:dT - - " 1'err0an+er►t occup:ukcy
will wood sk:<Qvu bu ixkSL.xllud? 1/rs '1'r:ansia ut occuls;xtkcy
cuaLral Air cotk+liLiunix�g`: /'�v r 13usinc 5s
BUILDING r�TYLC, PRIKkRY STRUCTURE ; Tnduscrial
other
jiasrch Concolulwr"ry L.o;i cabin IY "ddition , wlktat will UUa Yu:?
i .ai :wd ranch Mansl"Nk Duplk:x
J alit iuv.: Old sty !.= isuxkyalcaW '
C"Vu �d CoFt:aye Ottk,ar AcccSSORY 13UILDINC-
Ca 1 rxn i:i 1 Luaw
T'owx� }louse ' Dotachad i;j "ru94'/ono car/ two cuC/ car
( CIRCLti OiCtl: PLFjASG 1 * ir'I+kttachud gurugu/one car/ two c.:kr/ �- cur
• w w r ■ . in w r x • r r # # # '�' PriVaxty Storage building
L : 'l' IMAR'1: i7 MARKET VALUL OF othk: r
CON ::'1' IcUC 'L' IGN ' J .�y'z^. • .
INC'CYRKNT?ON ON BUTLDINC SPECIFICATIONS . ON REVERSE SIDE OF THIS CHUE'T `Y'O Be COMPLCTEDI
Form SPA 10/88 v2
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc . C) fCa w.Ne'
Will any second-hand or ungraded lumber be used? If so , for what ?
Foundation wall material 61 o _. y Thickness�
Depth of foundation below grade (to bottom of footing ) Cyr
Will there be a cellar? Heated, or unheated? Floor sq_ footage sq ft
Will there be a basement . Will any portion be used as iv ' ng space? VeS
( if so , what Lion . csq . ft _ - Type of use? y� 7 -
Type of roof slope flat/shed/other Material . of rroof C � , r r r
Size , wood stu " X spacing "o . c . length _ � ft .
Joists ( floor beams ) + " X spacing "o . c . span ft .
.joists ( £lour beams ) /nd . floor " X_- �� _" s acing_ "o . C . span ft . /� r P-/ r
Overlays ( ceiling beams ) "X spacing "o . c , span ft _
Roof rafters _"X ON spacing /�_ o . c , span (} ft .
Roof trusses (pre-- engineered) spa i g '"o . c , span ft _
Exterior wail finish xvti Se` Vi ., Of what material?
Interior wall finish -- — -SLLP � C -
If a garage is to be attiAched descri_h mat ri_ srt be used for FIRE SEPARATION :
% x r`w V l f J Cl 3 t�S
Is there t?o be an opening between garage and dwelling? F {" If so will a Fire-rated
door , enclosure , and self-closing device be provided? p S
will a flue-lined chimney be installed? Height abov of ft . -
Depth of chimney foundation below grade ft .
Depth of fireplace hearth ft . in .
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private well ( inciuding adjoining properties ft .
(A separate application is necessary for any repair or new installation of septic system)
D E C L A R A T 1 O 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 ore
Owner, owne agent , architect, contractor
Ot
SPECIAL CONDITIONS Or THE PERMIT :
_________________
TOWN OF QCJE . V58UrZ
WARREN COUNTY , NEW YORK
Application for : BUILDING PERMIT IN COMPLIANCE WITH TH %se K
STATE ENERGY CONSERVATION CODE �, \
A permit must be obtained before„
x n9 work .
ANSWER ALL of the following :
1 . Gross floor area
2 . Type of heat G- / fir {_
3 . Is the building mechanically cooled ? /k
4 . Percentage of area of windows and doors
A . Over 16 % Only
1 . Uo value of gross area of walls , roof / ceiling and floors
exposed to ambient conditions
2 . Floor over heat .d 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
S . Type of insul. at *
S . Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions
G
2 . R value of exterior walls
3 . R value of glazed area ,
4 . R value of doors / yy,,�� �r,
5 . R value of floors over unheated spaces 1Z30 -_
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
e . R value of heated basement/ cellar walls ( above grade )
9 . R value of heated basement /cellar walls ( ]below grade )
low Type of 1 n s u 1 a t 1 o n
C . Controls
1 . Thermostat maximum heat setting
D . Duct Systems
1 . Is duct system installed in unheated spaces ? YES " 701
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 Heatin
1 . Performance efficiency_
2 . Temperature control setting maximum
G . F__ar Swimming Pool only
1 . Maximum heating /
Telephone No .
( applican ' s signature )
RESIDENTIAL. FINAL INSP"ECT10N REPORT
Office No, (51s) 761,S256 Date inspection request received:
Building & Code Enforcement a
Dept, of Community Development Arrive �21'?a�ntoes Initimis
Town of Queensbury
742 Bay Road
Queensbury, New York 12804
PERMIT #
NAME DATE
LOCATION
TYPE OF STRUCTURE
N/A YES NO COl!`oAENTS
Chimney HeightP'B" Vent/Direct 'Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Gemplete
InteriorlExtenor littgs 30" to 6"
Exterior Handrails, lcomes, 1 ding 1 in. or more .., .
Interior handrails stair both si 3 or ore risers
Grrade 2% away from to dati
$" clearance to sill plate
Gas Valve shut-off expo ulator 18 above grade _
Gas furnace shut-off within 3 eet or hin line of site
Oil Furnace shutoff at entrap ce area.
Furnacc/Hat Water Heater o t
Relief Valve(s) installed
Headroom, 6 ft. 6 in_ on
Basement stairs, 6 ft. 4 in_
Handrail exterior stairs sides more than 3 risers
Interior privacy/trunldoo main entrance 36"
Floor Finish
Bathrooru/Mtchen watertight
Interior Handrails Balcomes(Landing 1$ in, or more
Railing across window in stairwells
Smoke Detectors
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofs
Garage penetrations sealed
Furnace in separate roam protected (in garage)
Light ventilation per room
Safety glazing 18" or less from flour
Final Electrical
site PlanlVariance required
Final survey Plat Plan
As Built Septic System layout required
Okav to issue CIC (Certif. of Compliance)
Okay to issue temp. CIU (Cortif. of Occupancy)
Okav to issue permanent CIO (Certif of occupancv)
GENERAL LMSEEC ION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804 Arrive QrDepa -
Inspect !
11
NAME: PERMIT # an_:
LOCATION: ngl ATE
TYPE OF STRUCTURE: WL
RECHECK
NIA YE O CO1V11+vIEN'TS
Foo " I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foitndation/Wallpour,
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing,
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1 , 2, 3, hour
Penetration Sealed.
Fire Wall 2, 3, 4 hour.
Firestoppmg
(518) 761-9256
TOWN OF QUEENSSURY
BUILDING & CODE ENFORCEMENT
742 HAY RD . QUEENSBURY NY 12004
INSPECTORS REPORT: AR DEPAR O
REQUEST FOR INSPECTION RECEIVED !
NAME f �y
LOCATION p t �4Q�1�tI►R�CL^_f �{^l+ NJ
DATE "� t { "� � 'C? PERMIT I _
TYPE OF STRUCTURE : 7„____ 'G.A _
p► SE
RECHECK A P V
NIAI YES NO
FOOTINGS/PXERS
MONOLITHIC POUR FPRK� , �-
REINFORCEMENT IN P E
THE CONTRACTOR IS RESPOHSI LE FOR
PROVIDING PROTE TION FROM EEING
FOR 48 HOURS FOLLONIN4 THE P o:
MENT OF THE CQ9CRZTEl
MATERIALS FOR TH S RURPOSE
FOUNDATION/WALLPOUR
R C
FOUNDATION/DAMPPROOFING
I3ACKFILL AP�"RtItLAL
PLUMBING VENT/VENTS IN PLACE_
ROUGL+{ PLUMBING
PLUMBING UNDER SLAB
F I
RACK ST DS HEADERS
FIRACILNG UG N
JOIST HANGERS
JACK POSTSIMAIN BEAM
AIRS„-INFILTRATION BARRIER
HEATING ROUGH- IN
iNS LAT N •
XqjWQajjQN WALLS NTERIOR R-
N WALLtS Ek ERIOR _
RS
CEILING R-
DUCT WORK OR PIPING IN
UNHEA=D SP&
CES R-
i
vV '�w.. j
TOWN OF QUEENSBURY 4l
BUILDING 42CODE
BAY O
ENFORCEMENT
OUEENSOURY NY
804
4447 N
f
FINAL INSPECTION REPORT -- RBSIARN'T
DATE INSPECTION REQUEST RECEIVED ' I
NAME ►
LOCATION
PERMIT 1I
DATE
TYPE OF STRUCTURE
gACKFILL FRAMING
FOOTINGS_,_. FOUNDATIONS6PTIC INSULATION
ROUGH ELECTRIC WOODSTOVE OR FIREPLACE
FINAL ELECTRICAL
p E tt0
C EY IGH V T H I T
U B G E T
ROOF I NG
x E F N
E K R H S N S
F V LVEs
FUR A E HOT WA P T NG
E IO R M P IVA Y DOO
INI H F S '
BATH K TC A E T HT
OTHER FLOORS SWE P LE
OTHER FI_,GORS CAR E
5 AIR CL RANCE LINGS
i S O E 6ET C O S
A HROU N
PLUMBING FIXTUR S
FOUNDATION IN U ON
: ARAGE FIRE PROOF NG
OR CLOSE 'S
FINS LECTRICA
SITE PLANT VARIANCE RED——
FINAL-BEY PLOT PLAN
OK TO ISSUE 'c�()R
TOWN OF QUEENSBURY
BUILDING AND BR DES DEPARTMENT
4TELEPHONE � ( 518)NEW 0745- 4447
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED .�
NAME
Jryt AI4dIJA A
LOCATION
DATE 0PERMIT # `—ems'---
r,
TYPE OF STRUCTURE
ED 0�R
RECHECK N /A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACETHE CONTTOR IS
FOR PROVIDING PROTECTIONSIBLE FROM
FREEZINGTOE S FOLLOWING
PLACEMENT OF THECONCRETEa
MATERIALS FOR THIS PURPOSE ON ITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING _
BACKFILL APPROVAL��_
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING :
JACK ST DS/HEADERS --BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN B AE M
HEATING ROUGH-
INSULATION :
FOUNDATION LLS ERIOR R-
FOUNDATION WALLS ERIOR RR_
FLOORS R_ - i
WALLS R_
CEILING
DUCT WORK OR PI ING IN UNHEATED
SPACES
REMARKS :
Lf ry� c) NSP TO
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY : NEW YORK 12804
TELEPHONE ( 518 ) 792- 5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME i C G'2fr�✓ol&;tz
LOCATIONf
DAT E_4/ '2 PERG?I,,IT #
TYPE OF STRUCTURE S A&a:: 3 r��
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING -FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCR E . '
MATERIALS FOR THIS PURFOS ON SI/T
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/ DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/ VENTS N PL E
PLUMBING UNDER SLAB
FRAMING :
JACK STUDS /HEADERS
BRACING/BRIDGING
JOIST HANGERS - -
JACK POSTS /MAIN
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING RO GH- IN
INSULATION:
FOUNDATION WALLS INTE IOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS :
�I✓� 7/ fqr
7D�
ARRIVE
DEPART j ,�1 � I E R
TOWN OF QUEENSBURY
Bay at Hao'arrd Raasy, UuOmsbury; NY 12804-8725,510-792.5832
Building & Codes Department
/ I,�/ , _ 'y rI SIV.SP£CTOR ".S RE'PCJRT
PROPERTY LOCATION
OSn'N�R OR TENANT
BUILDING SEWAGE IGN OTHER
REMARKS
f
CONTACT THIS OFFICE tti'ITHIi11
IiVSFE TOR `"-
..HOME OF NATL'"L aEAUTY . . . A GOOD PLACE TO 4.IVE"
SE M ED 17o3
. q TOM OF WEMIII1RY
`ram BUILD I NG AND BAY ROAD DEPART "
r�Q 531 I zSO4
gUEENSBURY , NEW VOR92. 5832
TELEPHONE ( 518)
sulLDING I'IISPECTOReS R'EPORl
/,q f — 7 ' -02 CEXVED
REQUEST FOR INSPECTIONRE
NAN� L""fir J .61JY1 ? /"1
LOCATI IG]
DATEf�� PERMIT
R � -
TYPE OF STRUCTURE
N/A YES NO
RECHECK �
ERS
MONOLITHIC POURNF PLACE
REINFORCEMENT SPOK
TRACTOR iSOR
FOR PROVIpING PROTECTION
Iil
FREEZING FOR OF'rHESCORCR
THE PLACElMENT THIS PURPOSE 0 SITE � � ~
MAT $ FOR WALL POUR
UNDATI IN PLACE
REINFORCEMENT OOFING
FOUND IT L APPROVAL tk le
R L Bi IN L E
PLUMBING VENT/V N
PLUMBING UNDER S L ,
)( FRAMING : S HEAD
JACK S
BRACING/BRIDGING
JOIST HANGERS
BE
JACK POSTS/
HEATING ROUGH-,IN
INSULATION : E I
L
FOUNDATION WA
FOUNDATION WALLS EXTERIOR RR-
-
FLOORS R-
WALLS R-
CEILING I ING UNHE E
DUCT WORK
SPACES
�s J Cam ,
ARRIVE
DEPART ' INSP R
,vt.
�-o�
r o�vtaNIN ciF QUEENSBUR.Y
NG AND CODES DEPARTMENT
BUILDDAY & HAVILAND ROADS
QUEENSavRY, NEW PORK 1280�
TELEPHONE (518 ) 792_5832
gUILUING INSPECTOR% S DEPORT
RE�7UEST FOR INSPECTION RECEx VED "�--
w
NAME a
LOCATION PERMIT #
DATE APPROVED
YES NO
FOOTINGIPIERS FORMS
MONOLITHIC � p�PR0010 MG�� -
CFOUNICI -LY APPROVAL
Id
BA
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION,
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION
CHIMNEY HEIGHT
ROOFING
SIDING RCHESIST S
pO
EXTERNAL RCHES RA LS
S TAIRS-CL.EA VALVEI
PLUMBING FIXTURES/ RS
INTERIOR TRIMIPRIVACY
FINISHED FLOORS
GARAGE FIREPROOFING� � �-
DOOR CLOSER (S)
SMOKE DETECTORS
�ICALTNSPET'ION��
FINAL LECT AL ap CONSTRUCTION
FINAL OR C/C
Or, ISSUE c/o OCCUPANCY MUST BE
p SIGNED CERTIFICATE OF ING DEPARTMENT BEFORE
OBTAINED FROM THE BUILD
SES ARE OCCUPIED:
THESE PREMI
60
AEtRI��~ VINSPECTIOFOR
TOWN 6F QUEENSBURY
BUILDING AND CODES
O ESDS PAR'TMENT r
BAY & flAVILAND ORK 3280!!-
QUEENSBURYr NEW
TSLEPHONE (518) 792,5832
BUILDI INSVECI'OR' S PXP
REQUEST Ft INSPE T ON RECEIVED
1
NAME
LOCATION PERMIT #
DATE APPROVED
1 _ -
�' YES NO
f i
;J
FOOTING/ ERS
MONOLITHIC POUR FO
rNG� ..�- -~...
FOUNDATIONR ~-
aACycFXLL APPROVAL
ROUGH PLUMBING
RAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION*
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES /STE c
STAXRS-CLEARANCE &
PLUMBING F'XTURESIR LI F VALVE
INTERIOR TRIMIPRIVA Y
FINISHED FLOORS
GARAGE FIREPROOFIN
,G
DOOR CLOSER (5)
SMOKE DETECTORS
FINAL ELECTRICAL 2NON TIO
RUCT N
FINAL APPROVAL OF
OX TO ISSUE- CPC' pR CIC OC NCY MUST Be
A SIGNED GERTIFXC TE OF NG E TMENT BEFORE
OBTAINED FROM THE B XLDIoCcUP SD3
THESE PREMISES A
REMARKS : h!
DEPAR`L_�r Y I SPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURyo NEW YORK I280&
TELEPHONE (51.8) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECXIQN RECEIVED 1/n
NAME I1� _-'
LOCATION
DATE I I Z [ PERMIT # r r
APPROVED
YES I NO
FOOTING/P RS
MONOLITHIC POUR FORMS,
FOUNDATION/DAMP—PROOFI G _.._
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH—IN '
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEP 1p
STAIRS—CLEARANCE & RA _
PLUMBING FIXTURES/RE E VALVE
INTERIOR TRIM/PRIVAC
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL IN ECTION
FINAL APPROVAL OF C NSTRUCT N
OK TO ISSUE C/O OR /C
A SIGNED CERTIFICA E DF OCCU ANCY MUST BE
OBTAINED FROM THE UILDING D ARTMENT BEFORE
THESE PREMISES A OCCUPIEDt
REMARKS :
F
ARRIVE
4EPAR"LI '� �-�--
SPECTOR
TOWN .DF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
SdUEENSBURYe NEW PORK I280g,
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTIION RECEIVED%
NAME
LOCATION
DATE �, / � PERMIT IV
fy"'y`-�- APPROVED
-` YES NO
�DOTIlVGf PIERS '
MONOLITHIC POUR FORMS
FOUNDATIONf RAMP-PROOFING
BACKF'ILL APPROVAL
ROUGH PLUMBING '
FRAMING
ELECTRICAL ROUG*-IN
INSULATTON..
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHE /STEPS
STAIRS-CLEARAlV$rE & RA 6J,S
PLUMBING FIX RESfRELIL'$' VALVE
INTERIOR TRT (PRIVACY DOORS
FINISHED F RS
GARAGE FIR ROOFING
DOOR CLOS4 (s)
SMOKE DET$CTORS
FINAL EZECJRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ,ARE OCCUPIED!
REMARKS-
INSPECTOR
�'"� NgDDEE DEPARTMENT ENSPECTad is [1N AGENCY, ANC,
' National Headquarters A
-I:i00 Haddon Ave., Collingswood, N.J. 013108
APPLICANT COMPLETES THIS SECTION
Date: '
City, Town or Township `` 1 County.
Location/Address
State
( If Located in Rural Area -, Please Attach Directions) Pole #Owner 1✓ ' J f/,
Occupied As Z. 1 r Permit #
Occupant Building: NevwJ�r pld0
Wo`rk 'Area in Buildin Floor #, etc.): 1�
A for: Winn Service or: Read for Inspection Fee Remitted - $ Q ,, .
CashQ Check MAO, Make Pa able To: M.D. I.A.
Number of Plough Wiring Outlets Elect. Heat bee 750; 1000 1250 15" 1750 2000 2'250 2500 2750 3ap0
Switches
Lighting Amp. Service Surface Unit ._..•_-__,_Dishuvdsher Range
Receptacles Water Heater Dryer Pump
P Air Conditioner
Number of Fixtures ' Oven Garbage Disposal Wiring and Controls for Burner
-..Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
100TORS N-P, 1 1/2 2/12 1/10 1/e 1/6 1/4 1/3 1/2 3/4 1 1 11 3 5 7 !x 10 15 20 25 30 40 50 95 10EI
Mark Number
of Each Size -
Applicant's „""� '7r'r
Signature "ta''
7/A License Permit #
%
1 _ Utility: fN E
A�pplrcant's,Address: F ICE L 7
CATIO
Phone *
h n (State} {Zip'j.w r, �_ Sw�vioe Re Best 4 � t r rr
Phone # Electrician: q
DATE RECEIVED: r' ' DATE INSPECTED:
r`Carnect Location : Same as Above 0 or: s .
Red Notice Label []
Rough Wiring Outlets Surface Unit Oven
SwitchesRan oven #7i
Receptacles Water Heater sposal
Dishwasher
Fixtures AirdddCondd1tio,pne d lei
Amp. Service Equipment Burner.-Wiring'& Cbntroii for -�iyriap Reaeptacl�_
Am , Service Conductors Purnp Vent Fans
MOTORS F1.P, 1/20 1112 1/10 1/a 1/6 1/4 /3 1/2 3/4 1 1 5 7Yx 10 15 20 25 3O #. 0 -9$ 100
Mark Number
of Each Size
EIecY. Heat 5O° 750 1000 1230 130D 1T30 2000 2230 RSOO 275p 3000
t
RW l Progress: Inc. O L' ICD Contractor d.
CFT Violation : Work Comp. Cf Inc. Ed
L/A Owner CASH
�. :I-l^ Fee CHK #
Q IPA , . - Due
Municipal MO #
INV #
Date: Other Side 0 Utility _ Applicant
- . OW e. n r
Cut in Card 0 Temp # Date
ca Final # Date 4 FN5F7irCM IGA A"I"I'FRai
r - -
4i-
'°`*"ay-.UCAT10N FORM NO, 25 «. 74 1.7tsIr - ,:ks_-- -. ... M. , 6 „ .
""0LFCANFT'S COPY