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1989-805 it 7h ' i i CERTIFICATE OF OCCUPANCY � j TOWN OF QUEENSSURY � WARREN COUNTY, NEW YORK Date January 26 19 90 I This is to certify that work requested to be done as shown by Permit No. 89-805 I has been completed. This structure may be occupied as a Two Family- Dwelling l.ocstion Di wrin Road Owner i By Order Town Board TOWN OF QUEENSBURY f C C Director of Bldg. do Code Enforce t i I -t = ` BUILDING PERMIT i TOWN OF QUEENSBURY No. 89_805 }. WARREN COUNTY, NEW YORK r t v PERMISSION is hereby granted to Mi kp Haves t1r r�s OWNER of property located at I of i Dixon Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a two Family DWel l i ng 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 Helen Drive i Queensbury , N . Y . 12804 rn cn 2. CONTRACTOR or BUILDER'S Name Y Rich 5chermerhorn 3. 0ONTRACTOR or BUILDER 'S Address 33 Harrison Avenue Glens Fa17s , N . Y . 12801 4. ARCHITECT'S Name 5. ARCHITECT'S Address r- 4 ci- 6. TYPE of Construction -- (Please indicate by X) O x X(}t+ wood Frame I I Masonry I ) Stool I I o 0 7. PLANS and Specifications ca ra No. 32 ' x 88 ' Two family dwelling as per plot plan , specifications , and XXX application , including septic , attached two car garage and drivew %y . S. Proposed use Two Family Dwelling CD 0 $ 3A3 _ on PERMIT FEE PAID — THIS PERMIT EXPIRES May {If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rC Town of Queensbury before the expiration date_) ME CE Dated at the Town of Queensbury this 16th Day of October 198 SIGNED BY _ 411 lJ� �+ for the Town of Queensbury 8uiftl1ng and Zomry Inspector TOWN OF QUEENSBURY APPLICATION FOR BUILDING AND ZONING PERMIT i'u t e- P ec.i ev ett ; '- ltielv ietued P+1 r Fee. Paid $ BUILDING AND CODES DVj,Ai2TPTwr pate 7aaued HAY "nd ltAVTLAND ROADS RU 1 BOX 9d 0IJFVNSL VRY, NEA1 YORK 1280.1 Peoun it No _ ?'c1 . ( 518) 792-5832 Ext 204 A 1' EIMIT MUST G1� OBTAINED BEFORE BEGINHING CONSTRUCTION . NO INSPl3C'1IONS VILL BE HADE UNTIL APPLICAh!T I1AS RECEIVED A VALID BL: ILDINC PERMIT . All applicable spaces on this application must be completed and the sivuaturc of the applicant must appear on the reverse side of this sheet . * '* * * * * * *' * ti * * * * n 'A it * * * * * * * * * * * * * * Ve * * * * `I` Ite owner of this property is i k' . O . Add re s s ��' L►,"Li'.r^ D Aeyal p C.1 %.l +p ,Ct/1 'c� 6 , r� - TEL . I ' roperty location �. * ! ;,cep! .4 J, TAX MAP No . � �-- r � f �� Ilas there been any split of this property since October 1 , yes rto 7f yes , Planning Roard Review is necessary . :- uuDIVISION I# AML , IF APPI. TCABLE �l _ LOT id0 . / `I` he person responsible for supervision of work as regards Building Codes is : NAME: P , O , ADDRESS TEL . NO . I#etme of !builder Q Sc .p�dlnnt.t`�-�plra++Address w, � <, r.� �lf�$"r Tel 14i5 � Gla'] Came of Plumber 4,0:eAL'R._ A ice_ t%ddress M4sno !a b at" )t Tel -74^7 - 4 (a9 x, Name of Mason . iLr ,,,-+ ►a.a ;h! Address "fwrl��rr � f4+ GG tr.iTuftC Or C'RD1'C1SLD w >i.I. . ZONING INFORPl,l+_TION ( UtFice use on11 ) .Zc'on:itructiort of :a tts w buildir-irj zONING DESIGNATION OF PROPERTY Additiorl to a building r pERMITTED PRINCIPAL PERMITTED ACCESSORY Alteration to a l,uilding ( Ito ch.tn+I+ co axeerior rkiinensiost3) ' REVIEW REQUIRED - PLANNING AOARU ?.ONING UOARD� Utlti: r work (. ancrit3o ) ' SITE PLAN REVIEW 11 APPROVED DATE GROSS AREAOf' L' 1I13POSE 1] =; 'L' IiU + "1' t1itE " VARIANCE Y APPROVED DATE 1 !; t floor s q ft * Remarks : 2 nd f 1 oo r � sq f t , CC]rtl' f.L '1'L I{J!'OWAATION StI=+� UIlis1'0 IJL.LWW . �4 Other Floor s ft . Size Of IsraLterty _ . �- aS' d ft x � -. ft . 1Ll .il _ tT * L:xi:;ting builaingtu) '" k i" L X rc . ( not cellar or baL;%:: T11Cnt ) # " — TOTAL FLOOR AREA h % %, e sq f t , r j.xi;zing builainy { :O uukt '.. i 'G .! of OCW st1ruCtkaro 2LJ ' - ft x IM ft ■ kcru,"dation-pier slab crawl/parti"l/ full ' Yroposcd !building * dint"ncu irow property linu ( ca rely one ) A Front yard +L r Rear yard is % $ ft Nam of stories (lta)Yic .til. !,Lace ) r! a_ � fL and y 2'g Cc kkuight turade to ridge } 0 ft . w Side y�.rd., ; l l' r1= L' �.[i 4.:nt lr] '�. , ri0 . C7I C «nt111c: 5 �, w IL Dii CG'lha_r � =:C C1]:x b.k �1CU111 SLLl 4• :.iC r�CC 1" C IIom of reokncitexcludinil baths ) _ td ' QCCUPAPiI:Y 1NFQ{'.7MATIp4 Ito * of budroo:n:; SI PRIMAL;Y IaUILi]Il# L' Ito . of b:ac)krtaouts Orxa faruily dwelling k"riuury A ..j�rwo family dwulliny `1`ypt of fu.:: l F1C+ Jr.Cb:r ; Multiple dwi:llit►c1 / Number of units 140 . of fi.ruftlact. a: to Lau irtr. talltacl�V�_ L,ertn:artcktt occupaatcy Will :a Wood LmOYa: Lou inutallud? Jt/Q ~ Tr(ansiunt OCCUllartcy Ut:ntr"I Air" Cor"t.titiucting ? AZQ ' lY ll ui.Tt C:'a' S. 111JILDING STYLC, PRIMARY SI-R.UCTURE Industrial kwttch Cprtt. ml c r.�t y Lon cabin . Ocher iwisuQ ranch IVlansit,n vmvbm& � x .. It .addition , wltut will usu Le'l^ Al /A - UI) Iit 1uv41 Old style Uun",l.xlow C: po Cod CoLt.q%a Ocher " ACCESSORY ►IUILDING-- Lulaniul Lcow 'l`ot.rlt house " l]t taehad t,1�trutje/ono curl two czar/ par t CIRCLU ONL° PLEASE: _Actacht:a u ar:arlu/or)0 curl two C4:6r/_,..ram clad w # T T r • x ■ I T ■ a K T T T iQ L' ri.vata! aLOCa94 building L. '_"k' IHATHD MARK. L:'I' VAI. UI? Or �+Otha: r Ik4PORI•tATION ON DUTLDINC SP ?CIPTCATTONS , ON REVEISE STOP_ OF TILTS SItIETO To RE COMPLE TUDI Form RPA 10/88 V1 BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . Lti ! 00 � Will any second-hand or ungraded lumber be used? If so , for what ? roundation wall material Q + IJ/ _ `+ � J 7! 4C11�'! r� Thickness_ _tr� Depth of foundation below grade ( to bottom of footing ) y + Will there be a cellar? Aeo Heated or A3 LJi& 3&a ? Floor sq . footage ,Z , r14 sq ft Will there be a basement? _AYD . _Will any .portion be used as living space ? ^/p ( If so , what porti q . ft . - - Type of use? ,�/ ,✓A Type of roof - sla ed f a"t�/—sh�edfother material—�of #� 6J :,tic -Ve fi[�"�iI S Sl^+ w Size , woad stud s� " X_(�" spacing /�,, "o . c . .length +�_ft . —� "� Joists ( floor beams ) lst . floor ��Do " spacing "o . cm span ft . Joists ( floor beams ) 2�nd . floor ,ZIL " X " spacing "o . c . span ft . Overlays ( ceiling beams ) � "x spacing s_"O , c . span.._52.ft . Roof rafters _ A " x A " spacing_ . __o . c . Roof trusses (pre-engineered) spaQ1n9_q__"o . c . span eft . Exterior wall finish_ :�- Of what material? u„1� Interior wall finish gy„p ?( �. o If a garage is to be attached , describe materials to be used for FIRE SEPARATION : 61 '6 'fir{i'tx ,od v K. ,ate to �No r, Ga0`40.. !I C )- Is there to be an opening between garage and dwelling _ YjS If so will a Fire-rated door , enclosure , and self-closing device be provided? Y !C� er Will a flue-lined chimney be installed? Ala Height above roof ft , Depth of chimney foundation below grade ft . Depth of fireplace hearth� l�-ft , in . Water supply - Municipal or private well +,r 'I,r, � f' Jrlo� SEPTIC SYSTEM _ Distance from ANY private well ( includir(g adjoining properties Z ,00 + ft . (A separate application is necessary for any repair or new installation of septic system) DEC LA RATION To the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether specified or not, and that sucte work is authorized by the owner, f Signature Owner, owner's agent , architect, contractoK SPECIAL CONDITIONS OF THE PERMIT : r � By_ ___._.__----- _____ ______ TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANC$ WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit Rust be obtained before beginning work * ANSWER ALL Of the following : l , . Grass floor area _ 91 2 . Type of heat __. FIIS6A o� r.' ,og.6- 'j. 3w is the building mechanically cooled ? slfC 4 . Percentage of area of Windows and doors /' / A . Over 16 '4 OnlX 10 uo vwlua of gross area of walls , roof/ ceiling and floors exposed to ambient, conditions 2 Floor over heated spaces YES c � � Are foundation walls insulated ? (D + No 1 , If YES , what is the R value ? 3 . Slab on grade ES NO a . if YES $ wha the R Val -d" of nsulation around Y perlmar. or of floor ? ¢ ' 4 . Is basement heated ? YES N0 , a . R value of insulation ���,r(i ,-- t" � SC' �"i 'r �� 5 . Type of insulation B under 161. Only 1 , Si value of roof and floors expOsed to ambient conditions. ,r? 3 *s' '/ Z. "*/ AC epa.Tr t 2 . R value of exterior walls 030 R value of glazed area ��11 4 . R value of doors A +� 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheat 7 , R value of slab insulation - heated slab.,�,,� �_,, - 8 . R value of heated basement/ cellar walls ( above grade ) A 9 . R value of heated basement /cellar walls (below grade ) .7�. 100 Type Of i n s u l a t 10 n , !"" C*';; ++ +� � - f� ►/st .r*�e. Co Controls 0 } Thermostat maximum heat setting D . Duct Systems l . . is duct system installed in unheated spaces ? YES a . if YES , R value of duct installaition b . R value of duct in other areas _ E , Piping Insulation 16 Size of hot water or cooling carrying agent pipe 2 . R Value of pipe insulation 7G - F . Service Hater Pleating - 1 , l� arfar�wana +3 ,Gfriciency x-. 2 . "Tesaperature control setting maximum G . For Swimming Pool OnIY M 1 . Muximum heating -- Z N o . r ,�+ Ga 7 ! U 4 Telephone, ( applicant + s signature ) 'rc)WN OF QUEEN'SBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE 0A d I �� LOCATION OF PROPERTY/ FOR INSTALLATION � � � Owner ' s Name : /,�_ jwk 'L°.,.. {rT^�0`..�► E'i 5 ~jc - Telephone : ' 42_s' -" '�— iFcr f Address : L",41 el,.nee GY Installer ' s Name elepho e : Lt � 4 lea_? Number of bedrooms (residential only ) Total daily flow ( compute @ 150 gal per bedroom) U Topography : circle one : QED 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? AA feet Percolation test : circle one : of requiter required /rate min . inch . Domestic water supply : circle one : Municipal Well Other If domestic water supply is a Well : � Separation : Watersuppiy from Septic absorption feet PROPOSED SYSTEM : Septic Tank /04 ' 92 gal . (minimum size : 1 , 000 ,gal . } TILE FIELD : Each Trench 4; Q _ feet / Total system length . J�' d feet SEEPAGE PIT ( S ) : Number of / `' + / Size each feet by ,/f+�/ feet Size of stone to be used /Diepth or Thickness Zr feet i4 i�*�ek*fit*i�r ak �'t de�k 9r*ir*at*i�*at vk ik*7k ik tk** k Yk i��k ask**1k�k* *k***ak ak i4 Yk ak tk ik do�e 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 : �/ ~ Date : l�r' !ia'' C.✓f (OVER) ems' 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 , tile , fields and /or drywells Be No system shall be covered before inspection and approval by the Building Inspector . 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 . CO 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 inunediate work stoppage . D . Should unforeseen problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 Remarks : ( oton of (Queensbury XiShi aq �epttr#meal# Ray a! Hartland Roads Office Phone 518-793-7771 ©ueensbury, New York 12801 PAUL H. NAYLOR RICHARD A. MISSITA Superintendent Highways Deputy Superintendent Highways DRIVEWAY PERMIT DATE : ,/ 40 or / © S 7 *I APPLICANT NAME : Ate. iGf'Y� TELEPHONE NO * ADDRESS TO BE INSPECTED : V f7L /' r'X 0 -.�.-_ cl� d RETURN ADDRESS : Applicant must show exact location and width , of driveways ) to be connected .to the highway by ', placing stakes , at .; the specified location . The Superintendent of Highways , Town of Queensbury , has reviewed the application of the above named resident to connect a driveway to the 'Town road . The following action has been taken : STEP 1 ; ( ) Preliminary Apa�roval , NEED : { ) Slight Swail ( ) Level With The Road ( ) Deep Swail Size Pipe to be used ( if necessary ) ( ) 12 " ( ) 15 " ( ) 18 " ( ) 24 " ( ) 36o. 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 . STEW 2 : { ) Final Approval ( ) Rejected DATE : Paul H . Naylor Superintendent ox highways Town of Queensbury TOWN OF QUEEI`3SBURY BUILDING AND CODES x}EPARTMENT BAY & HAVILAND ROADS ORK 22$O4' QLIEENSBURY, NEW A/0 5$ ) 792-5$32 TELEPHONE BUILDING INSPECTOR' S REPORT REQUEST FOR IhISPEC SON RECEIVE s NAME LOCATION p,ERMIT # J DATE APPROVED yES NO FOOTINGIF'IERS S MONOLITHIC POUR F F £NG FOUNDATTONIDAMP-PR BACICFILL APPROVAL - -- ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-' INSULATION: FOUNDATION r FLOORS WALLS CEILING FINAL INSPECTION: CHIMN81' HEIGHT ROOFING SIDING EXTERNAL PO RCH+ESIS`TRPS' STAIRS-CLEARANCE & E VALVE PLUMBING FIX INTERIOR E ' L INTERIOR TRIMI PRIVAC _-�--�-� t s FINISHED FIAORS GARAGE FIREPROnFING DOOR CLOSER (S) SMOKE DETECTORS N lJ FINAL ELECTRICAL INSPE , FINAL APPROVAL OF CONS R' TION A SIGNED CERTIFICATE OC PANCY MUST BE OBTAINED THESE PREFROM M SESTHE OC L BUIJ ING EPAI4TMENT BEFORE •REMARKS : '. NSPECTOR TOWS OF QU'EENSBURY fj m BUILDING AND CODES DEPARTMENT � q BAy & HAVILAND OADS YOR1C I280dr I QUEENSBURY, 5I8 } 792-5832 1� � d TELEPHONE BUIi33jNG INSPECTOR' S REPORT REQUEST FOR INSPEC TION RECEIVED ! "� NAME ,LOCATION -- PERMIT # DATE APPROVED YES NO FOOTrNG/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAyp—PROOFT G�� B CKFILL APPROVAL_ ROUGH PLUMBING FRAMING F��r�ECTRICAL ROUGH�IN ✓rNSULATION: FOUNDATION y FLOORS WALLS ' - r CEILING FINAL INSPECTION = CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS LS_ STAIRS,CLEARANCE & RA PLUMBING FIXTURES/REL EF pP1LVE�___ �l— INTERIOR F�� RIVAC DOO FINISHED GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS INS ECTION FINAL ELECTRICAL FINAL APPROVAL OF CO STRUCTIO OF OCCUPA Y MUST BE A SIGNED CE )M THE A U-TLDING DEPA TMSNT BEFORE OBTAINED Fl pCCUPIEDI THESE PREMISES AR REMARKS : - : a F INSPECTOR. ':`7owrn o pEPAftT® BUILDING anti ZONING Ox 98 L'F f Bay and Haviland Road O - I / (]ueensburYq New SEPTIC i7ISPOSAL SYSTEM INSPECTION LOCATION F/ E u PERMIT NO - TATE , r -� Low _ CIaY T Requ it ed? YES - SCXL TYP and Percolation - Min/Snc�x _ y percolation rate ; SYS TYPE of TEM: t field . ta' al Absorption Legth Of each tX ch n =� ID t'h of trencbes Size of ,Iravel� er g �- SEEPAGE IType �5'( 1Xmb vel si i2e jCr1 `{ V P IP IN+G = Bldg - to tan]- , Tank- to ciist - box i i7ist_ b03- to field/ partial openi nqs sealed? ES Loc TTON,/SEFARAT a{y8 : ;p Foundation to Yascrption - -£+t . Foundation to lot line _� - - "sorption one) its / -�� circ separation o ySTE24 ON PROPERTYbt sid I,pGp :EON C F _ ;,eft side Front - ea ti Og1TS USE PPPROVED ' SYSTEM Building nspecta 01/$6 and vl TOWN OF QUEENSBURY BUILDING AND CODES 'DEPARTMENT BAY & HAVILA D ROADS 804• QUEENSSURyp NEW aRK T RK I2 12 2 TELEPHONE ( r)la ) his REPORT B �uu)ING INd REQUEST FOR INSPECTION �gECEIVED NAME CATION ,prRMXT # 29� PATE � APPROVED YES NO FOOTINGIPIERS MONOLITHICPOUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL %PPROVAL ""UGH PL Z4PING pRAMING ECTRICAL !'tIJUGH-^IN INSULATION: FOUNDATION FLOORS WALLS CEILING FXNAL CHIMNEY HEIGHT . ROOFING SIDING PS EXTERNAL B RAN IS E & STAXRS-CLEARAN EF I VA ES/RE LVE PLUMBING FIX PRIVACY INTERIOR TRI RS FINISHED FF2NG GARAGE F DOOR CLOSER S) SMOKE DETE TORS INSPECTION FINAL ELECTR CAL ,FINAL APPRO L dF CONSTRUCTION CER IFICATE OF OCCUPANCY MUST BE A SIGNED OBTAINED FROARE dCCUPIED EPA'ZTMENT BEFORE M THE ou" THESE PREMSSES REMARKS : INSPECTOR TOWS Of Q[.3EENSBU ,E BUILDING AND pORUADSEPTMENT I3AY & 14-1 LANEW 7fORK 2280� QUEENSBURY . NEW 792-5832 TELEPHONE ; BUILD NC, INSPECTOR' S '9"ORT RECEIVED REQUEST FOR INSPECTION NAME fA LOCATION PERMIT DATE +IQ� APPROVED YES NO FOOTINGIFXERS FORMS MONOLITHIC TOUR ~ ~� k FOUNDATIONI,DAMP-PROOFIN BACxFILL APPROVAL i ,XOUGH PLUMBING FRAMING < -IN ELECTF2rCAL ROUGH INSULATION: FOUNDA TION___�---- FLOORS WALLS cEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING -- SIDING ST' ,S`_------- EXTERNAL FORCHE RAILS STAIRS-CLEEARATNeESIRELI_F VALVE PLUMBING INTERIOR TRIM SRIVACY DOORS FINISHED PLO FING GARAGE FIRED OO DOOR CLOSER PIS) SMOKE DETEC.CA S xNSpC7ION_`____- --� FINAL ELECTR OF CONSTRUCTION_ ____�� FINAL APPROVT A SIGNED CERTIFICATE OF OCCUPANCY MOST BE OBTAINED FROM THE BUILDING DEPp�RIMENT BEFOR THESE PREMISES ARE OCCUPIED ? REMARKS : INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES pEPARTIMENT BAY & HAVILA D OO K x28D4 RADS QUEENSBURYO 792— 1432 TE F.FPHONE ( 518 ) BUILDING INSPECTIOI S REPORT 26 REQUEST FOR INSPECTION RECEIVED NAME LOCATION i o PERMIT DATE _I/�G2 — PPROVED YES NO FOOTING/''PIERS MONOLITHIC POUR RMS AFOUNDATION r' BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH"'N INSULATION: FOUNDATION FLOORS WALLS CEILING_�^�—---- "—'---� FINAL INSPECTION = CHIMNEY HEIGHT i ROOFING SIDING ISTEPS EXTERNAL+ PORCH STAIRS CLEARA E & FtAriS�—� PLUMBING FIX pEsIREL I F VA L" INTERIOR TR /PRIVACY FINISHED F ORS Gp1�{AGE FIR PROOFING DOOR CLOS R (S) ,SMOKE DE ECTORS FINAL ELEC RICAL INSPECTION FINAL APP OVAL OF CONSTRUCTION__,__—_ OCCUPANC3' MUST BE A SIGNVDICERTIFICATE OF OBT7iINED FRO S THE OCC[DJPIEDDEPARTMENT BEFORE THESE PRAM REMARKS, (^ 0L1 �t CA �„� !� 12 I lU 40 Ate) INSP OR TOWN OF QUEENSBUR BUILDING AND CORES ARTMENT Jy BAY & HAVILAND ROADS QUEENSBURYBURYr NEW PORK I28aSE- TELEPHONE ( 51.8 ) 792,5832 `J BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION �G/ /�► /d/ `i/ 17�C_ DATE /j '_ — f FERMIT #�� APP VED YE NO TING/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 P[7RCHES/STEPS ,STAIRS.CLEARANCE & RAILS PLUMBING FIXTURE$IRELIEF VALVE� INTERIOR TRIM/PRIVACY D004S FINISHED FLI>C7RS 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 : IDS 4' 3-3 3 33 NSPECTOR YOU ARE HEREBY REQUESTEP TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY THE UNDERSIGNED TEMP- N DATE CITY OR VILLAGE T WNSHIP COUNTY All r -t.- f. 0^400' e � by r' POLE NUMBER STREET AND NO OR FWGAA R AMEM WFMV CR033 Bl e P iv rm IS REMISES LOL.ATED7 -RECIRON BULICK LOT EI OCCU c1ANT•B NAME BUILDING CK;Cl1PANCO p F1OME TELEPHONE NUMBER OWNER'S NAME AND E'SS I . /'` r.,t �{ C V A I^J�, ` K 1.�,�.1: / � 5 . � y[, G I a �i f 'k r/ ! CURRENT SUPPLIED BY OFFICE WORK OF WORK TELEPHONE NUMBER f di BUILDING IS Ned"i CA-D ❑ WpRK IS NEW ADO1TrDNAL ❑ UEF'El:'rS REMOVED El]A4JJ LIST BELOW ALL EQUIPMENT WHICH YOU 1 ALLE NCH .. OFF'10 USE TS No, of ecep MOTORS as R HEATERS Local- NUMBER OF OUTLE Lamp Receptacles CIRCUITS L7NLY lion side Attach t H-P ND. No A>rvD. INSPECTION Ceiling Wall P,,O ,s switch Fbndarrt Ell TYPO Each Each Caauge OIJT- SIDE SUB- BASE BASE- MENT let FL. 2nd FL. 3rd FL. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER T'HE ABOVE-LISTED EOUIPMENT TO BE INSPECTED: BUT IF AT TIME OF INSPECTION, THERE. IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TQ MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT, AS PROVIDED 13Y THE APPLICANT. SUE OF MAINS FEEDERS ELECTRIC SIGNS'LAMPS fO7AL W07S CHARACTER OF WORK ❑ 'EXPOSED GAS TUBE SIGN7TRAN SFORMERS OF r L-1 CONGEALED VArE LwORK TO BE STARTED DATE COMPLETED SUE OF SIGN CNIJMBERI C"APACITV SERVICE ENTERS BUILDING MANUFACTURER OF SIGN ❑ OVERHEAD ❑ UNDERGROUND `` 1 DACE INSPECTION REOUE:iIED ON IOR AS NEAR AS POSSIBLE) MUST ENTER APPtJCANTS IDENTWICATION NUMBER' AVOID DELAYS BY GMI—NG FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FIL ED IN OR APPLI MAY BE RETURN D. PRINT NAME AND ADDRESS NAME OF APPLICANT .•-y DATE OF APPL ION S STREET ADDRESS + 7 J TELEPI E+rNCI. � C , If LICEn1SE NO WHEN APPLICA6LE CITY OR POST OFFICE j � � X/ ❑ 85 John Street Lei 41 State Street ❑ 584 Delaware Avenue ❑ 217 Lake Avenue El202 Arterial Road NEW YORK, NY 1D03B I ALBANY, NY 122W I BUFFALO. NY 14202 1 ROCHESTER, NY 14608 SYRACUSE, NY 13206 THE NEW Y©RK BOARD OF FIRE UNDERWRITERS MAP REFERENCE MAP OF A SUBDIVISION MADE FOR MICHAEL & RA,LPH WOODBURY BY VanDvsen & Steves DATED MARCH 2, 1985 REVISED OCT. 20, 1987 y C5 c3 V O q rr �aj`3 0. �1 5� S Tow"(* QUE84mmy Zo ing mministrato j �kff N I po am MAP OF A PLOT PLAN MADE FOR MICHAEL S. HAYES TOWN OF QUEENSBURY COUNTY OF WARREN N.Y. SCALE: 1 "=40' ATE: OCTOBER 5, 1989 VanDusen & Steves LAND SURVEYORS,—GL--E�-N—S FALLS, NEW YORK .F. = IRON ROD FOUND i N,Y. STATE LIC, NO. 35617 l I 5 = IRON ROD SET r - 93- -2 85-241 DISK 24 )