1990-778 , /,
0,,i II a im i e Its ca a!I!I ek m!MAW la ei IM I ill ill S 1 E I%22 IS MI I I In el 41'I-
..,
CERTIFICATE OF OCCUPANCY . .
TOWN OF OUEENSBURY
- i
WARREN COUNTY, NEW YORK
Date di 4?'//, . 19 .& -
1...
, !
This is-to certify that work requested to be done as shown by Permit No. 90-778 . ..
,. ,.
'3. G has been completed. i
a
This structure may be occupied as a ci ngl family dwelling :
Lot 118 Chippewa Circle i
1,...ocation ,
Owner MICHAEL VASILIOU
By Order Town Board
TOWN OF QUEENSBURY
, t
74///./
i
. !
Director of Bldg. & Code Enforcement
. ,
_. . ,
BUILDING PERMIT
TOWN OF QUEENSBURY s
No. 90-77Fi --v
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MICHAEL VASILIOU
OWNER of property located at Lot •118 Chippewa Circle Street, Road or Ave. co
in the Town of Queensbury,To Construct or place a Single family dwelling co
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
14 Stone Pine Lane
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name n
r-
Same
3. CONTRACTOR or BUILDER'S Address
C7
..T
ly
re
4. ARCHITECT'S Name
5. ARCHITECT'S Address
I-
0
6. TYPE of Construction— (Please indicate by X)
Co
C7
( Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications CD
No. 28'x58' Single family dwelling as per plot plan, specifications
and application including septic system and two-car attached garage.
8. Proposed Use
la)
Single family dwelling
$ 292.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 9 19 91 cn
(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.) cn
CD
Dated at the Town of Queensbury this 9th Day of November 19 90 —h
% /�
SIGNED BY �� �/ice ; /%� for the Town of Queensbury
"—inning and oiling Inspector
CD
(0
T NI. OF QUEENSBURY
—VI— REVIEWED 13,Y e
! — FEE PAID $ f 2 j ��j�
5 _c PERMIT NO. i
o �� t OWN.OF QUEENS—FURY
RECEnt7 •
BUILDING PERMIT APPLICATION
NOV 71990 .
BLDG. & CODE DEPT.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUUJDING 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.
The owner of this property is: M l r:i- E Z.-- V A-Sl G. / oC)
P.O. Address t /1_s7 "i ,p/,yr L4JYE Tel. 793 -73 53
Property Location LO-T # /-/e CfirP°E-WA / (el. Lax Map No. / /
Has there been any split of this property since October 1, 1988? _/ X
It yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE �yAVE& WOOD LOT NO. nIg ,
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
in/CAMEL 57 L/ co I'2E$ /1 /Vlrc/+,4-EL /4-5 acj /1 ,
•
NATURE OF PROPOSED WORK: • ESC:MATED MARKET VALUE OF
X Construction of a new building • CONSTRUCTION: S /6 1 0001-9-
Addition to a building • COMPLETE INFORMATION REQUIRED BELOW:
• Size of property /(o0 ft x An-ft.
Alteration to a building * Existing Buildings(3) Size 2 ft. x 58 ft.
(no change to exterior dimensions) . •
Proposed building - distance from property line:
Other work (Describe) • • Front and
y -S-O ft. Rear yard 8O ft.
•
Side yards 40 ft. and SO ft.
•
GROSS AREA OF PROPOSED STRUCTURE •
If on corner, setback from side street 40 ft.
1st Floor /100 sq. ft.1'• ‘ t,:,1 ' OCCUPANCY INFORMATION
ilV
2nd Floor MOO sq. ft. ) ,. Primary Building -
Other Floors sq. ft.
' XOne Family Dwelling
(not cellar or�asement) . 1 Two Family Dwelling
TOTAL FLOOR AREA.TJOQ se-•' . Multiple Dwelling/Number of units
sq. ft. 7ri;
P,; 7/Size of new structure ft x 5ft. '` Business
'FoundatIon-pl•r/slab/crawl/ ti • Industrial
(circle one) • Other
•
No. of storiee (hobitable space) 2 -
ne!1! (rtvg a to ridge) Zy ft. • If action, what will use be?
Kf residential, no. of families / •
No. of rooms(excluding baths) S •
Accessory Building
No. of bedrooms, 4. •
Detached Garage ONE/TWO Car
No. of bathrooms. 3 •
primary heating system O_ / z f2 • _XAttached Garage ONB�TWO C
Type of fuel CV4.-- •
_Private storage building
K!lo. of fireplaces to be installed / • .
Will a wood stove be installed , • Other—
'V tz11 ai Air 4.MYYtdy liGd.70.... i//' ._�
Oiii ER
•
3LILDINC DER.\TIT .A??`_IC "'`ON -O T `. ED - •
BUILD[NG ;PECIFIC.-kTIOv`S:
Th pe of construction, wood frame, fire safe, etc. (/voo.D F2,E :OWN OF car EENEBU 3Y
Will any second-hand or upgraded lumber be used? If so. for what? /(fo RECEIVED
tiOV 71990
Foundation wall material Co.ve/LE"74E Thickness
Depth of foundation below grade (to bottom of footing) yC$// DLDG. & GODt Dom°
Will there be a cellar? AI Heated or unheated? — Floor sq. footage sq ft.
Will there be a basement? ye' Will any portion be used as living space? Na
(If so, what portion? sq ft. Type of use?
Type of roof slope�fTat/shed/other Material of roof AseHiae'T
Size, wood studs Z. "x ( " spacing /6 " o.c. length 8 ft.
Joists (floor beams) 1st floor Z. "x /d " spacing /G "o.c. span /1 ft.
Joist (floor beams) 2nd floor Z "x /0 " spacing /, ''o.c. span •/9! ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters Z "x $ " spacing /6 o.c. span /6 ft. o2
Roof trusses (pre-engineered) spacing 2 5/ " o.c. span /6 ft.
Exterior wall finish r 2Av7 of what material? et',0•9/2- •
Interior wall finish i, 0v62 S' Ler
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: S/R F/IZE SroP
Is there to he an opening•between garage and dwelling? 514c$ If so will a Fire-rated door, enclosure,
self-closing device be provided? ya-s
Will a flue-lined chimney be installed? Height above roof Z / ft.
Depth of chimney foundation below grade 8 ft.
Depth of fireplace hearth Z ft. 0 in.
Water supply - Municipal or private well 'Prrirg/ /iv A- P'-E'
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties — ft.
(A separate application is necessary for any repair or new installation of septic system)
/¢ STo,v e- P..vr LA,.
'4AME OF BUILDER /Mcr / YhtS iddADDRESS _ TEL. NO. 793-73
'1AME OF PLUMBER JAcK / ,4 ADDRESS S' & - c '' TEL. NO. 79F—'/31c
NAME OF MASON rift P ikquihelp ADDRESS 4Q2,,44./N TEL. NO. 79 -O22 2-
TAME OF ELECTRICIAN t/ZA, ADDRESS ,5- ‘1T TEL. NO. 77i-,S7'2--
DECLARATION
To the best of my knowledge and belief the statements contained in this application. together with the
Mans and specifications submitted. are a true and complete statement of all proposed work to be done on
:he described premises and that all provisions of thw Rt1ILDINC CODE, THE 7n*""• ORD:NANCE, and
Kll other laws pertaining to the proposed :work s^all iae complied with. whether specified or not, and that
gush work is authorized by the owner.
•
Signature - .. / _ J . /
0 ner, owner's / t, architect, contractor
SPECIAL CONDITIONS OP THE PERMIT:
Ft'�'
Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW PORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
ANSWER ALL of the following :
1 . Gross floor area ;2 / QQ �(
2 . Type of heat OtL. PL12 L) 1 EENSRUBY
3 . Is the building mechanically cooled?
s
NOV 7 T990
4 . Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , roof/JVInACCREMLs
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
H . Under 16% Only •
1 . R value of roof and floors exposed to ambient conditions
F3
2 . R value of exterior walls — 1 9
3 . R value of glazed area 3 .
4 . R " value of doors 3. 7
5. R value of floors over unheated spaces
6. A value of slab edge insulation - unheated slab
7. R value of slab insulation - heated slab
S. R value of heated basement/cellar walls ( above grade) R 13
9 . R value of heated basement/cellar walls (below grade) a 1.3
10 . Type of insulation FI 6E2CW 45
C. Controls o
1 . Thermostat maximum heat setting (9 5
D . _Duct Systems •
1 . Is duct system installed in unheated spaces? YES 0
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Pipina Insulation
1 . Size of hot water or cooling carrying agent piper ,
:. value of pipe insulation
F. Service water Heating
1. Performance efficiency f'6-A1 dvrP0T
2. Temperature control setting maximum /3 D • •
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. 79 3 -73,1.3
pplica s signature)
TOV'N OF QUL•ENSBURY
APPLICATION FOft
-=� SEPTIC DISPOSAL PERMIT
war
OWN OF QUEENSBURY
RECEIVED
DATE NOV 7 )9,90
LOCATION OF PROPERTY FOR INSTALLATION L o 0 d/8 iBLDG. & CODE DEPT.
Owner's Name: Vi14. /L ! Oc.) M/C -t.#6e Telephone: 7,3- 735.3
Address: _ 4 SToAv(E I J L&1. (Du e-C�IJSBU2 y
Installer's Name: D?j L/ip /O w,4 2,0 Telephone: 792 022z
Number of bedrooms (residential only)
Total daily flow (compute Cd 150 gal per bedroom) 600
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other SAND /Depth: 20 Feet
Ground Water: At what depth? 20 Feet
Bedrock or Impervious Material: At what depth? NotiE Feet
Percolation test: Circle one: of require required rate min. inch.
Domestic water supply: circle one:(Clunicipa Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet.,
PROPOSED SYSTEM: Septic Tank /OOC gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of 3 / Size each 8 .feet by 7 feet
Size of stone to be used # 2 /Depth or Thickness c :;i feet
I have read the regulation on the reverse side of this sheet and agree to abide by these
and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: 74a v' - -- -
DATE:. .
OVER
. ,1,1 TOWN OF. QUEENSBLTRY
Bay,atlia,Vianii,AO' cls';pulkensOry,144.-I p01-9725 . .
e) '..---, fl/fi•C.I•z-r ,`:,,4 .e. .
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
,.,.
Date NO V S 4 iq 96 .,. ',/,4,,,q2A,.; h./CU 7 0 •
- ..- P / . . ''' ' .19- Perm it/Na.90- iik
, ,
,,,...„ :.
.:„..APPLICATION IS HEREBY MAliElo ti-1813uildikg DeParii(fOr fheissuance of a Building and Use Permit
purswint to the New York State Fire Prevention and Building Code. The applicam or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these itquirements and also will allow all
4ts-
inspectors to enter premises for the required inspections.
APPLIANCE TYPE •
Applicant's NameVA514.)0() i Mc H4-e-i_he
Stove Coal ' - AA/mod
Address /4 riA_liC' R,vp 4/itA1 E Furnace Hot Air / '''•
•q— Boiler ,.
Zero Clearance ,,,..,./ Circulating Unit
i_
Zip .,:,..7.' '',','"•!,,, \
1. %,.:.„-,,,,.-:•"-
Phone 793 -,7s' , •,? . .., .. ,
! . .- ;: '.., . If Non-Masoni'yl:
Owner's Name Achm-6.-....4.... ii,evre
Manufacturer ,
Address Ai -5M-4.4(-7. Role: Z4NF .-'. '-''' . Model
,,:,til.i ie ,iki,v,
ziY2ift/V ' Listed bY...;72-f,- ' .;•Ni1U-Tber
.i
• - Phone
• • • . , .
. .
.,.
., . .
CHIMNEY TYPE,3,,,,,.,,,
Masonry: BlockX BiickX.:',N! Stone
. . .
Properly location.•of,proposed construction . . Flue: Tile >< Steel
, ---rc'A/eY 14zool) Size/,2 ?t 12_
43-r 47//fe elf 60eleil- 0 de i_ it=- Factory Built: .
.. ic,y•
Manufacturer - • Model :, Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
, .
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall ' Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated'
,• ACCORDING TO SPECIFICATIONS. COPY OF
Estimated Cost $
1,1) CONSTRUCTION DETAIL REQUIRED FOR MA- • Fee$
SONRY FIREPLACES AND CHIMNEYS. ' . • '.
•
•
CASHIER'S DEPARTMENT
•
TOWN OF QUEENSBURY, NEW YORK
, .
••
Department: Fire Marshal Amount Collected Amount Refunded
Code Number Title. /C,3
A173 3389 (190)Public Safety • .
A233 2655 (230) Minor Sales
•
, .
. ,
Clc.collected frin or Refunded to: LigGrfiall YazzeiLek
Address:
Dated.//. 9 Town Clerk -,----
or Deiuty , AC)--,- - ..---- •
While:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
1337 West Chester Pike,West Chester, PA 10380 '
APPLICANT COMPLETES THIS SECTION Dvm/�
City, Town orTownship /``'�/ /-��' //'� .��///� >/ County Z-1f /`V /C State
Location/Address
(if Located in Rural Area Please Attach Directions) Pole # '
/7J
Owner A/ / ���� ///� ,J'L /c1 �, /'/� �/ �� -7-~ Ponnit #
�
Oocupio �m . ' - ��~' Building: No"v�~�~'= 0d
Occupant
Work Area in Building (Floor #,otoj:
App. for: VVihnV ^ Service[Z~� or: Ready for Inspection:
Fee Remitted $ Cu hl | ChrckF-1 M.O. 1 I Make Payable To: M.D1A.
Number of R�� �hngOud�� Elect. Heat
� ,� z� 1� z/� 2= 2� u� 2� m�
Switches
Amp. Service Surface Unit Dishwasher Range
Lighting
Water Heater Air Conditioner Dryer Pump
Ro=ptao|ox
0,on Garbage Disposal Wiring and Controls for Burner
Number Fixtures Amp. Receptacles Fractional H.P. Vent Fan,
� Other Equipment:
MOTIYRS H.P. ' 1/201/1e1/10 z/v' 1/6 z^^ z/o zp n/o 1 1112 e a , 71/2 m zo co o, xv ^v ,o r, um
o�E�h`SizeApplicant's -
Signature -- Uoomse # Ponnit #
�A �( ' ��� ������/i//^// ` ��� / L�|i�y�
AppioanttAddmo : ' /� ^�7aA/7 r//,6/�� (mmms> (OFFICE LOCATION)
(city) '°t; 'L.� /7 (State) A/ (]p)_��� \�� �/ Service Request **
Phone # -�'� ��~/ � j 0 Electrician:
K8[U4 USE ONLY DATE RECEIVED: } (— '/ ' ' o��s /mapsurso�
~- ' ' '
Correct Location: Same aoAbove or:
Red Notice Label F�
-
Rough Wiring Outl�, Surface Oven
_ n
Switches —Range Garbage Disposal
R000ptao|oo '---"Water Heater . �~^ Diohvvanho,
Fixtures Air Conditioner _ ~~'D rye r
�z/�c�Amp Service Equipment i/I,Burnor' VVi,ing &Controls for Amp. Receptacle
Amp. Service Conductors Pump i/ Vent Fans
MOTORS H.P. veo zuc 1/10 z/o z/o z/^ z/o z/e 3/4 z 1* o o , r* m ^s ev eu ao 40 no ,, mo
Mark Number
of Each Size
Elect. Heat 500 750 1000 125015001/502000 2250 2500 2750 3000
~r
' �/�
CERTIFICATIONS m oonnsur
oxr/omo _ uo� ron /m �� u/rom�v mor/p/sm oxrs pss FEE PAID
Progress: Inc. LKD ' Contractor
Violation: Work Inc. Fl ��1
— -- CASH �
—[ l L/A Owner. . Rm CHK #
F-1 L/A Duo
' W1O #
� I IPA Municipal '
|NV #
|
Date: Other Side Utility Owner �
/
Cut in Card Temp # Date
/ INSPECTORS SIGNATURE
Final # Date
gi,p' .c4,1nw p"°mwn ,nnpt- ,,x»w
TOWN OF QUEENSBURY
�L
FIRE MARSHAL
QUEENSBURY,TELEPHONE NEW
518)ORK 792-58324 �i
FIRE MARSHAL INSPECTION REPORT /146'
REQUEST FOR INSPECTION RECEIVED le4*
NAME L(.��42P J 7/f.,i i.i../na
LOCATION , //�� �2� /1�/�`/ l�C�-r
DATE 4/ L/ PERMIT# -°- »f
APPROVED
N/A ' YES NO
EXITS
AISLE WIDTHS ,.
EXIT SIGNS
EMERGENCY LIGHTING
i
is
FIRE EXTINGUISHERS ?:,
AUTO. EXTINGUISHING ;.SYSTEM ;
HOOD INSTALLATION /
AUTO. SPRINKLER SYSTEM /
ALARM SYSTEM • /
INTERIOR FINISHES //
STORAGE:
CLEARANCE TO SP INKL,ERS
CLEARANCE TO HEATING, UNITS
REQUIRED SIGNAGE!
I
CHIMNEY t .
WOODSTOVE / f
FIREPLACE-MAS+ONRY - 1/
FIREPLACE-FACTORY BUILT
r
REMARKS: j \
r0%`.)
ARRIVE / /
DEPART • 42z&.1
INS ECTOR
F., TOWN OF QUEENSBURY /i1/;j1/
r 531 QUEENSBURY,BNEW AY RY
OAD
` ORKK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 1040,
NAME ; /,J% /Q /O-d_./
LOCATION ,i//� 7.2; 6 /.//�Li &, " I
1
DATE ,f/ /p I9/ PERMIT/ qD-)2-7J
TYPE OF STRUCTURE
RECHECK , aluo .ems L iW LQ Lbz'
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) j
FOOTING J.FOUNDATION vBACKFILL i�,.RAMING
i-ROUGH PLtHBING .FINAL ELECTRICAL ASEPTIC
.INSULATION WOOSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS ,;YES NO
REMARKS .j",04/2., ,F1.. d,6-per.. nn CJL
(14, .0,1, -ri i /0 /
' APPROVAL
/ N/A x NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION I
PLUMBING VENT "A 5r /
ROOFING U ✓r
SIDING { if i/
DECK/PORCH/STEPS/RAIfINGS
RELIEF VALVES ,/
FURNACE/HOT WATER OP .TING ;
BASEMENT INSULATIONO 'CTWORK /
INTERIOR TRIM/PRIV.; �:�,DOORS V
FINISH FLOORS: ' `_.
BATH/KITCHEN WA ERT.,GHT 4
OTHER FLOORS S EPA: E ✓
OTHER FLOORS ►g1PET;:'
STAIR CLEARANC./RAILI
HANDICAPPED ACCESS
SMOKE DETECTO S - ✓/
BATHROOM FAN%/WHOLEHOUSE FANS /✓
ALL PLUMBIN FIXTURES ITERATING ,/�
GARAGE FIR PROOFING
DOOR CLOS S
OTHER FIR SEPARATION
FIRE/DEM SE WALLS '
DUMPSTE1 '
FINAL ECTRICAL i/'7
OK TO ISSUE C/O OR C/C li P/
COMMENTS: I
•
ARRIVE 0 �
DEPART '`O //�tGt/
INS•
MIDDLE DEPARTMENT INSPECTION AGENCY,INC.
Electrical-BuildingPlumbbing-Fire Inspections.-
_
Label No.500F L I/pFire( .•..
. Rev,8/85. _-. ,
Date ` —2-- Ell Jk .
:..Ty.- tntia�'
..
Ins: or ilt�.tn /fX .)
This 4• -
stitutescertification hattheabove
:installation,:,but not the equipment itself,
has been visually inspected as of_this.date"
`pursuantto the applicable codes: If addi
tional equipment should be:introduced`.or '
alterations made to the existing system or
structure,application for inspection should
be submitted:promptly to this Agency:; <_
ELECTRICAL INSPECTIONS
' s DUP ICATE MUNICIPAL RECORD
(�
Permit No. r O 1 1 U
Owner-._Air K i'/q-Sf4-/ate (PO i/S 7
Occupant
Locat on L C r 8' eft./PPc 1/. Ci2.
t�eZ=]0s ("lay str y
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes. b
Installed by g2��K �/�6�/9-t
N 960
Date
!� 4�_Mah ' Inspector
MIDDLE DEPARTMENT INSPECTION AGE CY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
A.r/ ln,,,,, TS'ac(,ire,IA WIRING &CONTROLS FOR 6446. BURNER
9 . RECEPTACLES H.P.PUMP
c�Y FIXTURES K.W.OVEN '"
p////V��/�0 a AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
( .0 AMP.SERVICE CONDUCTORS K.W. DISHWASHER
as ��K.W.SURFACE UNIT K.W. DRYER
li 7.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
2 S-440(ee';
MOTORS H.P. I/20 I/12 I/10 % % % ' 1 ' 1 11/2 2 3 5 711 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
TOWN OF QUEEMSBURY 4fr /
BUILDING AND CODES DEPARTMENT L/C//1GC �
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME At10
LOCATION 4 • (:41,/�/z
DATE 40/ PERMIT # - 771
TYPE OF STRUCTURE
RECHECK 7ti0.f,Qjid(/yLe_../ D 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 CONCRETE.
MATERIALS FOR THIS `PURPOSE ON SITE
FOUNDATION/WALL POUR,
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING-..
BACKFILL APPROVAL \
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE 1
PLUMBING UNDER SLAB
FRAMING: q :1
JACK STUDS/HEADERS N.1
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM ?i
FIRESTOPPING
WALLS
CEILING (�
FIREWALLS
HEATING ROUGH-IN ' 4
INSULATION: '?
FOUNDATION WALLS INTERIOR R- �.
FOUNDATION WALLS EXTERIOR R-
FLOORS 1 R-
WALLS :! R-
CEILING +; R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: '
�L . r J
ARRIVE , �
DEPART J �
INS CTO
slat y)
TOWN OF QUEENSBURY ' J
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED f//' q)
NAME ��° c, I / r)U j m 1 (Pi
LOCATION o,1)+ f l Ch,cp' q 6--(
DATE CI
/ PERMIT # a/ 7 7O
TYPE OF STRUCTURE l IAlwn -.
0
RECHECK APPROVED
, N/A YES - NO
OOTINGS/PIERS r/
MONOLITHIC 'POUR FORM
REINFORCEMENT IN PLACE '
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING ITOTECTION FROM
FREEZING FOR 48 HOURS FOLLOWI G
THE PLACEMENT OF\ HE CONCRETE/
MATERIALS FOR THIS PURPOSE 014 SITE
FOUNDATION/WALL POU `
REINFORCEMENT IN PLACE r
FOUNDATION/DAMPROOFIN. / .
BACKFILL APPROVAL \ I
ROUGH PLUMBING \ I
PLUMBING VENT/VENTS IN PLCE
PLUMBING UNDER SLAB
FRAMING: ,
JACK STUDS/HEADERS " �
BRACING/BRIDGING I \
JOIST HANGERS I \
JACK POSTS/MAIN BEAM I \
HEATING ROUGH-IN • (' \INSULATION: l
FOUNDATION WALLS INTERIIOR R- 1 , '
FOUNDATION WALLS EXTERIOR R- \
FLOORS I R-
WALLS 1/ R- 1
CEILING f R- \
DUCT WORK OR PIPING#IN UNHEATED
SPACES P �,
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REMARKS: II
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DEPART /J 45
9 -4(-1 1/
INSPE TOR '
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 RECEIVEDii-- //,(0/61/
NAME NGt J} J 11)
LOCATION )! , ,r16 I;P OC\ C\YCP
DATE LII i 7/1/ PERMIT # (9 D 7 7
TYPE OF STRUCTURE S1 (14)e.._
RECHECK \\'ls�' `C. Src�Oi nUS APPROVED
N/A YES NV
FOOTINGS/PIERS d
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE 4 %'
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING I�
THE PLACEMENT OF THE CONCRETE. '
MATERIALS FOR THIS PURPOSE ON SITE Y
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE /
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL t
ROUGH PLUMBING !//
PLUMBING VENT/VENTS IN PLACE (t'
PLUMBING UNDER SLAB c/
FRAMING: ;' \
JACK STUDS/HEADERS r° \
BRACING/BRIDGING I
JOIST HANGERS
JACK POSTS/MAIN BEAM /
HEATING ROUGH-IN ,' \
INSULATION: P \
FOUNDATION WALLS IkNTERIOR R- \
FOUNDATION WALLS EXTERIOR R-
FLOORS 1 R-
WALLS t R-
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
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REMARKS: if
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DEPART _ .% �a
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Jown of Queeniur, he...A
• BUILDING and ZONING DEPARTMENT /,/�.
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME `y/T,/,(9J/f/J hl/ d... (
LOCAT I 0 /- /�0 C.,.//n,4-0--0. (L4i ))
rr
DATE_'}� / 5/ PERMIT NO.r 9,9 4
SOIL TYPE - Sand - Loam .- Clay _' '
Percolation Test Required? YES' - NO
Percolation rate - Min/Inch :
f',
TYPE of SYSTEM: ,r •
Absorption field, total length
Length of each trench',` J.
Depth of trenches ' ;
Size of gravel «'
SEEPAGE PITS4Number o'f) "
Size- g" ft. X ? fft. •
Gravel size it 2 ,if
PIPING: A&,'. a; Size ' pe
Bldg. to tank €'� 'l 4G �1. C
Tank to dist. 46x zi de_
Dist. box to fieldpit (f " P fe./
Openings sealed? `YES NO Partial
LOCATION/SEPARATIONS:
Foundation/to tank t.
Foundation to absorption 720 ft.
Absorption to lot.;line j,„f ft.
Separation of pits' ft.
LOCATION OF SYSTE4 ON PROPERTY(circle one)
ron�f Rear - Left side - Right side -
COMMEfQTS:
,y
G'
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Pr.
•
SYSTEM USE APPROVED NO •
lit
B ifiding In" pector
01/86 and vl
C
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 3/ (cn it
61 (
NAME \)
LOCATION + I v Cil �L Q� 1'C)�
C,{ p
DATE 511.9 ' PERMIT# �7 11
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM l
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS ,'
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
t
CHIMNEY
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS:
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ARRIVE (N b� /
DEPART /°/ Vat l
INSPECTOR
n
TOWN OF QUEENSBURV
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ap3J
NAME .L (5 U j 1(X't eI
LOCATION . ?-fr 1I C__Jl i peuA-"G NirjC
DATE c„Vr yj i PERMIT # 9 0 -7 78
TYPE OF STRUCTURE
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 THECONCRETE.
�
MATERIALS FOR THIS PURPOSE ON SITE/
FOUNDATION/WALL POUR ` /
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING '
BACKFILL APPROVAL iF
ROUGH PLUMBING
PLUMBING VENT/VENTS IN11PLACE /
PLUMBING UNDER SLAB \ /
FRAMING: A /
JACK STUDS/HEADERS 3 /
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN BEAM 'V
HEATING ROUGH-IN
INSULATION: / 1,
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS ;\ R- 14
CEILING \R- 3 e
DUCT WORK OR PIP 'NG IN UNHEATED
SPACES
REMARKS:
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ARRIVE
DEPART 3 - Gf ,/
INSPECT
We
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 REECEIVED /
NAMEVc/ 61 i 0 1) 1 \ \r\i
LOCATION jai"j/,P Ct�r'p ( \+-
DATE � �� 9 / PERMIT k L 7 7 g _
TYPE OF STRUCTURE ( p / -
/ 1�.,41. ,
w/a Ce,A ci�tA1if
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 CONCRETE.
MATERIALS FOR THIS PURPOSES/ONkSITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
'AROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM, I:
HEATING ROUGH-IN I'
INSULATION:
FOUNDATION WALLS INTERIOR R- i.
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS1 R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED.
SPACES
REMARKS:
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ARRIVE /
DEPART if ,g l iwe
/ INSPECT R
TOWN OF QUEENSBURY CM)
BUILDING AND CODES DEPARTMENT
531 BAY ROAD .
QUEENSBURY, NEW YORK 12804
<tril
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ,2- // 6
NAME V C1 v 0 ) 1 Vn I )Cr`A F,(
LOCATION O 11 X ()of_(,()G l ,1vC-'(�
DATE ///C// PERMIT # C7C) - '7 71?
n,�
TYPE OF STRUCTURE S;r��Qp {1F�irn�.�.-;.1� i
Lv �-Caik c c � UUUUUU 7
.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 4,
THE PLACEMENT OF THE CONCRETE. ,;,•
MATERIALS FOR THIS PURPOSE ON SIITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING v}, 1 •
BACKFILL APPROVAL
\ROUGH PLUMBING i;::
PLUMBING VENT/VENTS IN PLACE.v
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN Ct
INSULATION: t:
FOUNDATION WALLS INT'ERIORtR-
FOUNDATION WALLS EXTERIOR -
FLOORS ;` R-
WALLS R`a;
CEILING R=;
DUCT WORK OR PIPING IN UNHEATED
SPACES ;�
REMARKS:
ARRIVE • /
3
DEPART /` 4 -
/
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT -
BAY & HAVILANDROADS
QUEENSBURY, NEW YORK 12840 A17—I
TELEPHONE (518) 792-5832 /�
BUILDING INSPECTOR'S REPORT '//
REQUEST FOR INSPECTION RECEIVED /Gl7%/2f
PE
NAME i i[ °17U.elf /1 /'�-:11-9"'f;
LOCATION "1`)/ //I d.%j.% ,,w0... C
DATE /M/l PERMIT # D-77/
APPROVED
YE NO
42 ?p
/FOOTING/PIERS vf
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING i0
/BACKFILL APPROVAL J
ROUGH PLUMBING 1
FRAMING \ /
ELECTRICAL ROUGH-IN 'S / • . . .
INSULATION: 1
FOUNDATION
FLOORS r
WALLS . 1 . .1
CEILING ' / \
FINAL INSPECTION: I
CHIMNEY HEIGHT /
ROOFING
SIDING
EXTERNAL PORCH k/STEPS >>
STAIRS-CLEARANCE & RAILS \
PLUMBING FIXTfJRES/RELIEF VALVE
INTERIOR TRH/PRIVACY DOORS \
FINISHED FI,.6ORS \
GARAGE FIR 'PROOFING L 0
DOOR CLOS R(S) a
SMOKE DE ECTORS
FINAL ELE TRICAL INSPECTION '
FINAL APPROVAL OF CONSTRUCTION 1
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED! _
REMARKS:
THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING
PROTECTION FROM FREEZING FOR 48 HOURS
FOLLOWING THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
ARRIVE
®t7 YES NO
wr f '
DEPART
i
(-----dte./t/ /1/7"...---"7
INSPECTr
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT -
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801- �2
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED _,"A NO
NAME L /A/? " / -if.if-e.6
LOCATION, \ C,
DATE /.„��' vOlb PERMIT'# 90 ' 77
APPROVED
• YES NO
FOOTING/PIERS ‘\
MONOLITHIC POUR FARMS
FOUNDATION/DAMP-PROOFING ,
BACKFILL APPROVAL
ROUGH PLUMBING A • .J '
FRAMING \
ELECTRICAL ROUGH--IN A I . . . . . . • .
INSULATION: / .
FOUNDATION 0
FLOORS a�
WALLS . . 1 '/
CEILING X
. . . .
FINAL INSPECTION:CHIMNEY HEIGHTROOFING . • I - . .
•
SIDING . i
EXTERNAL PORCHES/S EPS\ •
STAIRS-CLEARANCE RAIL
PLUMBING FIXTURES.RELIEF VALVE
INTERIOR TRIM/PR ACY DOIRS.
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S) I
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION" ' .
FINAL APPROVAL CONSTRUCTION . -
A SIGNED CERTIIIICATE OF OCCUP NCY MUST BE
OBTAINED FROM THE BUILDING DE ARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
ems ` °
REMARKS: ® $d 6 0p 0 12 I}
2,f w.2,4 et E.,,e guzAt,..a, •
, , *
THE CONTRACTOR IS RESPONSIBLE FOR. PROVIDING
PROTECTION FROM FREEZING FOR 48 HOURS
FOLLOWING THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
ARRIVE YES NO
DEPART •
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INS CTOR .
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4.077. * /18
90
i OWN OF QUEENSBURY •
' f�7 i RECEIVED
NOV 71990
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