1991-017 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY; NEW YORK
Date April 119 19 91
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This is to certify that work requested to be done as shown by Permit No. 'Q ®f11 i
has been completed.
This structure may be oc\cupieV a Single Faaiin l y Dwelling
Location Lot 127, 'Chippewa (Ci r'cl e
Owner Rich P® Scher r°hox
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-017 10
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Rich P. Schermerhorn
OWNER of property located at Lot 127, Chippewa Circle Street, Road or Ave.
N
in the Town of Queensbury,To Construct or place a Single Family Dwelling
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
33 Harrison Avenue
2. CONTRACTOR or BUILDER'S Name ry'
Rich P. Schermerhorn
-v
(/)
3. CONTRACTOR or BUILDER'S Address
CD
CD
s--
4. ARCHITECT'S Name 0
5. ARCHITECT'S Address
r
0
6. TYPE of Construction—(Please indicate by X) c'r'
(X)Wood Frame ( ) Masonry ( ) Steel ( )
c')
7. PLANS and Specifications
No. 2,352 sq ft Single FAmily Dwelling as per plot plan specifications
and application
8. Proposed Use J'
n
Single Family Dwelling m
$ 324.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 22, 19 92 rD
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the -n
town of Queensbury before the expiration date.)
C lJ
Dated at the Town of Queensbury this--.22nd Day of ,- January, 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
to
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TOWN OF QUEENSBURY •
IOW REVIEWED BY Ci-d‘
FEE PAID $ ofyy714`,G UN11114111111SB
9 R�i CJVEEED URYI
P rzy-• r PERMIT NO. '-
BUILDING PERMIT APPLICATION JAN 16 1991
• BLDG. & CODE DEPT.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
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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:j;c.1., 13. ScS c,n l..L. ,‘e„r.,v
P.O. Address Na�4,�''; A .A,f - Tel. 79 g- O6-04
Property Location p o b . G;rs.1� `l tk 111 Tax Map No. / /
Has there been any split of this property since October 1, 1988? / ‘/
It yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE T7 ne. 5 wee o LOT NO. pal
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
�;crn Sc.Ne.r`vvti (` o "N
NATURE OF PROPOSED WORK: ESIIMATED MARKET VALUE OF •
✓ Construction of a new building , CONSTRUCTION: $ /qp� DD0
____Addition to a building_~_ * BELOW:
COMPLETE INFORMATION REQUIRED
* Size of property IL 5 ft x
Alteration to a building * Existing Buildings(3) Size ft. x ft.
(no change to exterior dimensions) •
Proposed building - distance from property line:
_Other work (Describe) • Front and
y cO ft. Rear yard 9, ft.
• Side yards isfiaisft. and 5 ft.
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GROSS AREA OF PROPOSED STRUCTURE If on corner, setback from side street ft.
1�
1st Floor in L sq. ft. i �. l?� •
\ _ OCCUPANCY INFORMATION
2nd Floor -I to sq. ft. 1 „0.• [* ' • Primary Building -
• - '✓ One Family Dwelling
Other Floors sq. ft... ..
(not cellar or basement) Q Two Family Dwelling
Multiple Dwelling/Number of units
TOTAL FLOOR AREA a,3S2 sq. ft.
Size of new structure ft x_ft. Business
Foundation-pier/slab/crawl/partial i • industrial •
(circle one) • Other
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No. of stories (habitable space) 2. •
Height (grade to ridge) 17 ft. • If addition, what will use be?
If residential, no. of families 1 •
No.-of rooms(excluding baths) Q • Accessory Building
No. of bedrooms Li _ • Detached Garage ONE/TWO Car
No. of bathrooms, 21/1 •
Primary heating system �r0cno c.e, • ✓ Attached Garage ONE WO Ca!
Type of fuel P crop N e, • Private storage building
No. of fireplaces to be installed I •
• Other
Willa wood stove be instated Alp
Central Air conditioning ,Io •
OVER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe. etc. LAlsaai
Will any second-hand or upgraded lumber be used? If so. for what? AiD
Foundation wall material Pawre,d c,o,,c„r[,t.e.„ Thickness 4 "
Depth of foundation below grade (to bottom of footing) 7
Will there be a cellar? Ycs Heated or(nheatel' Floor sq. footage nub sq ft.
Will there be a basement? Will any portion be used as living space? ^/'p
(If so, what portion? sq ft. Type of use?
Type of roof - loped flat/shed/other 1/1-1,. Material of roof V2, ,e,o x 1Fe \� , F:b„.9 1 s l les
Size, wood studs a "x. ( " spacing ,<. " o.c. length g ft.
Joists (floor beams) 1st floor' � "x jn " spacing /G "o.c. span /9 ft.
Joist (floor beams) 2nd floor 2 "x /p " spacing it "o.c:"span /r ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing Ay " o.c. span -ag ft.
Exterior wall finish c ,a„C GAA,050eurdS of what material? Ge.do..e
Interior wall finish 5yNe,eAd`ac is
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
5/$ c;l' t"or.V_ o,n hovSr_ ..,..)1
Is there to be an opening between garage and dwelling? YG,s If so will a Fire-rated door, enclosure,
self-closing device be provided? ye.s
Will a flue-lined chimney be installed? yr,s Height above roof __ y _ft._ _
Depth of chimney foundation below grade,!, ft. zera G1ea,Pq,Ne.
Depth of fireplace hearth g. ft. in.:
Water supply - Municipal or private well ,yl�r) ,•p a,,L
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties /G o ft.
(A separate application is necessary for any repair or new installation of septic system)
NAME OF BUILDER R. 544e.,1',nht.J'1na'Ai ADDRESS kuL„ vr, TEL. NO. 798-a67y
NAME OF PLUMBER S�-n,q L��nl ADDRESS 61,. J,..ia td TEL. NO. 711 7 =-5 6 Sri
NAME OF MASON iJ Eja.1e w;,A. ADDRESS Al AA /44 A/ TEL. NO. 7 9 2 — I3 7
NAME OF ELECTRICIAN 141,;iz Co.,-,;4. ADDRESS Aran TEL. NO. 99'l -3705
DECLARATION
To the best of my knowledge and belief the statements contained in this application, together with the
rplans 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 / P. ..� .
Owner, owner's agent, architect, contractor
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SPECIAL CONDITIONS OF THE PERMIT:
BY
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
F,1- Q `TE ISBUR1
Compliance Methods:
PART -5 - Acceptable Practice Method - 1. & 2 Family Dwellings (ONLY) JA N �99�
PART 6 - Thermal Rating - Component Trade Offs 1 & 2 Family Dwell & DEFT.
Multi-Family Dwellings
. (3 Stories or Less)
PART 4 - Design By Component -Performance = Commercial Building s- Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
e t' • irjCN � ..
APPLICANT'S NAME PROPERTY LOCATION �� �i ��� ,��
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 91352 Sq. Ft.
2. Type of Heat - GaS Elec. Base Board Other
3. - Is Building Mechanically Cooled? YES ,/ NO
4. Percentage of Area of Windows and Doors Jy/o Over 17% Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual .Shown Elec. Heat Other
. A. Roof & Floors exposed to ambient temperatures • R g-315
B. Exterior Walls - R R-ZS
C. Glazed Area . -Ft Lim
D. Exterior Doors R R-I3
E. Floors over unheated spaces R R-2.5
F. Edge of Slab on Grade (Heated Building) R ,✓/h -
G. Basement/Cellar Walls (Above Grade)
H. Basement/Cellar Walls- (Below Grade) R-ems-j�
I. Heating/Cooling - Ducts - Piping in Unheated- Space R ,✓,A.
6. Service (Domestic) Hot Water Heating Device
A.-. Conforms to minimum efficiency per code YES NO
TEMPERATURE ON OL MAXIMUM SETTING 140* WILL NOT BE EXCEEDED
l; v/6 ,DAT 98 oG 7�
APPLICANT'S SIGNATURE E TELEPHONE NUMBER'
E ONE NU B
INSPECTOR'S REMARKS:
REVIEWED BY
TOWN OF QUEENSBURY`4 j APPLICATION FOR SEPTIC DISPOSAL PERMIT V (4,
Jti/N OF QUB 8.B►J
RECOIL, D
DATE:
//13/9/ _t
LOCATION OF PROPERTY FOR INSTALLATION Lo+ 127 C. .i pp ati,./o-. C: tc.�6 1991
Owner's Name: R ScAN yv►eC4 o r,v rr. 13LDG• & OODE DEPT,
Address: 3; \o.r ' S Ai AJ t. C .F.
Installer' s Name: Q“cti Sc.\'1e-rw+ o t�v Telephone: 798-067L!
Number of bedrooms (residential only) 1]
Total daily flow (compute @ 150 gal per bedroom) K.Oa
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: and Loam Clay Other. /Depth:
Ground Water: At what depth? it/p Feet
Bedrock or Impervious Material : At what depth? ,v /A Feet
Percolation test: Circle one: (not requir_mcD required
Rate - Ai/A Min._ Per Inch
Domestic water supply: Circle one: unicipa Well. Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /bo 0 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench C o . feet/Total system length 3 a o feet
SEEPAGE PIT(S): Number of /Size each feet
by feet .
Size of stone to be used if. ,2 /Depth or Thickness AA 1 3 ' feet
*****************************
HOLDING TANK SYSTEM IF_ EQUTRED
NO. of Tank Size of Each Gal .
arm system and ated electr c 1 Q6rk to inspected by ) approved
agency.
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: , L P. c _ DATE: / i.s /
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lotto 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 houri before start
of construction and shall include a plot plan showing:
1.) the proposed location of the -system
2.) location and discance ..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 drywalls
B. Na system shall be covered before inspection and approval by the
Uuilding Inspector. Failure to comply with this requirement may
rusulc in the uncovering ot-che •syscem by the installer and a fine
of up to $250.00.
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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 nay result in 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
be submitted co the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
R,Imarks: •
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TOWN OF Q LIEENSB LIRY
/ Bay at Haviland Roads,Queensbury,N.Y.12801-9725
i
1
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date T . 15 19 'II Permit NO. qI -0i I
a
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances,regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's>licant's Name APPLIANCE TYPE
ll Pia, S�1� r )nor Stove ,," Coal Wood
Address ',-. i�r. I f' c o nl A e.. Furnace Hot Air \/ Boiler
Zero Clearance / Circulating Unit
1z� .c 115 Zip lAgn I
Phone '7 y k _ a G 1 Li If Non-Masonry:
Owner'st Name 50,,,,,, e�
Manufacturer Alii cui e s 1 C.,
Address Model ,.i 77, a r, ; ( Outlet Size 6 "
Zip Listed by Number
Phone CHIMNEY TYPE
Masonry: Block Brick Stone
Property location of proposed construction Flue: Tile Steel
t_o* iv) c\.; p p,,,,. r.: r�\t_. Size:
Factory Built:
T �^`A^ " Manufacturer iv1c,)e5A-)A mboo,LSize 3L i1
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 $ InmmU 1•15oo
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$ 5
SONRY FIREPLACES AND CHIMNEYS.
CASHIER'S DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department; Fire Marshal Amount Collected Amount Refunded
Code Number Title 'A
A173 3389 (190)Public Safety
A233 2655 (230)Minor Sales
Fee Collected from ►•Refunded to: //.r'' "—A 111_171. 7YL /d��-------
Address: � —u _ ��-- / n
Dated: /� /Qi Town Clerk or Depuf
f y )����-1 )/I ' i� `� �7
/`.
While:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED
TEMP.It DATE /. ! r
CITY OR VII 1 ar'E TOWNSHIP COUNTY
STREET AND NO.OR ROAD POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
,
OCCUPANTS NAME BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS II HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY l FROM THEIR' OFFICE WORK TELEPHONE NUMBER
BUILDING IS)
NEW ILS OLD❑ WORK IS NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
Loca- NUMBER OF OUTLETS Lamp Reo.of lceptacles xtures&
MOTORS HEATERS BRANC RCUIC S H OFFICE
ONLY USE
lion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st
FL.
2nd
FL.
3rd
FL.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
❑ CONCEALED
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER DENT F CATION NUMBERS ►
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION SIGNATURE OF APPLICANT / J
STREET ADDRESS / TELEPHONE NO.
CITY OR POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
- I\ -> i✓ / '`i l 1" 4 /
85 John Street 41 State Street 570 Delaware Avenue ❑ 217 Lake Avenue 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
(212)227-3700 (518)463-2122 (716)884-1155 (716)254-0141 (315)463-8552
THE NFW YnR- K R(ARF) OF FIRE UNDERWRITERS
PO)
TOWN OF QUEENSBURY
4 .. : 531 BAY ROAD
�•�i,' QUEENSBURY, NEW YORK 12804
= TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION 4
REQUEST FOR INSPECTION RECEIVED Viiqq(
LOCATION qAn--i-I
DATE Li'/of 9/ • PER IITO I v/ 7
TYPE OF STRUCTURE
RE7CK
IRE MARSHAL APPROVAL (COMME'AAL STRUCTURE)
,/FOOTING FOUNDATION ,/BAC FILL i/FRAMING
/_ ROUGH PLUMBING FINAL EL RICAL ASEPTIC
✓INSULATION WvMSTOVE/F EPLACE
SITE PLAN/VARIANC: REQUIRENTS YES NO
REMARKS
. "RIVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATiN
B VENT/LOCATION AL mpg
PLUMBING VENT 41111111111111111111122
ROOFING
SIDING
DECK/PARCH/S E•S/l
RELIEF VALVES
FURNACE/HOT WATER OPERA I
BASEMENT INSUL•. ION/DUCTW' ' �l
INTERIOR TRIM/} •IVACY D00
FINISH FLOORS7/
BATH/KITCH / WATERTIGHT
OTHER FL0O' SWEEPABLE
OTHER FLOs;'S CARPETED 11= �
STAIR CLEA-/NCE/RAILINGS =�
HANDICAPPEIrrACCESS $1111
SMOKE DETETORS 11111 �/�/�
BATHROOM `'NS/WHILEHOUSE 'ANS ma
ALL PLUM: NG.FIXTURES OPERATI G
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEP, 1 " IN
FIRE/DEMISE WALLS �
DUMPSTER
FINAL ELECTRI AL nig`
OK TO ISSUE C/O OR C/C 1121
I N..
/1/7 d4/f/D
ARRIVE
ab'
DEPART J
INSPECT
NC-Y -i re—,
TOWN OF QUEENSBURY C?)(V\
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 1-) Ji l 9
NAME , G\AEN-roeAC T('n )
LOCATION )-11-- f;:y7 p p )c, c'ro
DATE 1-1/7/C)I �/ PERMIT# I-6/7
! APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING • '
;
r, h
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING'UNITS
REQUIRED SIGNAGE (s j
CHIMNEY
WOODSTOVE /
FIREPLACE-MASONRY. 1 j,/
FIREPLACE-FACTORY' BUILT
REMARKS: i Li OK TO THIS DATE
q
/ 0/UrtAii
6/vik.,(),e/c7
ARRIVE
DEPART
INS CTOR
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_town o/ Queeniur, •
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BUILDING and ZONING DEPARTMENT ..
Bay and Haviland Road, R.D. 1 Box 98'
Queensbury, New York 12801
SEPTIC DISPOSAL/ SYSTEM,, INSPECTION
NAME �fI 4% t 44/7CG� ,9(e`-k/IrC _
LOCATION Z'f`/,,97 4 ? ,tei�' -
DATE/,%< / �/ PERMIT NO. // /%1�7
/ ,
SOIL TYPE - P- Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch :
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches ' ' ,t
Size of gravel ! 4
SEEPAGE PITS4Numb&r of) _ I`
Size- g-ft. X f' ft. 3 `
Gravel size ir i___.---1
PIPING: Size 1 T pe
Bldg. to tank \ !/
Tank to dist. box , l , //'('�,
Dist. box to field/pit c fay
Openings sealed? Y,ES 1NO Partial
LOCATION/SEPARATION /�
S
Foundation to tank +. nt.
Foundation to absorption ft.
Absorption to lot lines ft.
Separation of pits 1" • 46 ft.
LOCATION OF SYSTEM ONPROPERTY(circle one)
Front - Rear - Leftside - Right side -
COMMENTS: ,
i
. /7 . \
t
i
SYSTEM USE APPROVED YES NO �,
)l
Bu' ing Insp ctor •
01/86 and vl
TOWN OF QUEENSBURY �� t
'FIRE MARSHAL %
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 1/. '//42/
NAME eeh
LOCATION ,f/:V
DATE gh o 9/ PERMIT# ,K)/-'/7
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS 1
EXIT SIGNS
EMERGENCY LIGHTING
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FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM r'
HOOD INSTALLATION + ,F
AUTO. SPRINKLER SYSTEM: I
ALARM SYSTEM
/
INTERIOR FINISHES
STORAGE: jj I
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING(ONITS
REQUIRED SIGNAGE
ffd;,
CHIMNEY 1
WOODSTOVE i
FIREPLACE-MASONRY '
FIREPLACE-FACTORY BUI /7
REMARKS: ( OK TO THIS DATE
Aif f'D ) 1(14\k\
A _. 1.41
0/Y 0 S-#
3 ).9.*Igi
ARRIVE
DEPART 11 I
I SPECTOR
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awn o/ Queensbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
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Queensbury, New York 12801 •
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SEPTIC
DDDISPOSAL SYSTEM INSPECTION
•NAME c►C��'1 C rc\ OY f
LOCATION ) Q 8 7 (- ro ress-
DATE 3 / PERMIT NO. C'I VUI
SOIL TYPE - Sand - Loam - Clay .-
Percolation Test Required? YES - NO
Percolation- rate -\Min/Inch
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TYPE of SYSTEM:
Absorption field, total length
Length of each trench '
Depth of trenches ' .
Size of gravel s _
SEEPAGE PITS{Nuinber of) f
Size- ft. X ,/_ f.t.
Gravel size , „y •
PIPING: \S`ize Type
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Bldg. to tank __
Tank to dist. box l
Dist. box to field/pit
Openings sealed? Y. S NO Partial
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LOCATION/SEPARATIO S: §
Foundation to tan 1 ft.
Foundation to absorption ft.
Absorption to low. line ft.
Separation of pi 's ‘ ' ft.
LOCATION OF SYSG' ON PROPERTY(circle one) •
Front - Rear - 'eft side -\Right side -
COMMENTS:
\,\�^\ A
‘,2a.3
/moo cv- /1 . -A-
SYSTEM USE APPROVED YES I
/00-99
Bu' ding I pector
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01/86 and vl
TOWN OF QUEENSBURY �Q_6L y
BUILDING AND CODES DEPARTMENT /J� / \
531 BAY ROAD iJ/
. QUEENSBURY, NEW YORK 12804 •/
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT /
REQUEST FOR INSPECTION RECEIVED ,�� /�/-
NAME -1 4: 1(0(1 M/C It JLd/ih 1I
LOCATION ✓"i /,)q C'LC.!' /ram/ 4/./,0°,r',
DATE, 1"//49/q/ PERMIT # 9 "D/'7
TYPE OF STRUCTURE ,, , % ;/2s d,/ '�i
/ Ci /
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM 4'
REINFORCEMENT IN PLACE . .v.
THE CONTRACTOR IS RESPONSIBLE 7
FOR PROVIDING PROTECTION ;FROM
FREEZING FOR 48 HOURS FOLLOWING I
THE PLACEMENT OF THE CONCRETE. 47
MATERIALS FOR THIS PURPOSE ON SITE.:'
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE h a"
FOUNDATION/DAMPROOFING Q'"
BACKFILL APPROVAL ' ,.. ,
ROUGH PLUMBING
PLUMBING VENT/VENTS INrPLAC,E /
PLUMBING UNDER SLAB ! I r/
X FRAMING: hP(`1/10,(!Q(i /
JACK STUDS/HEADERS 0', /
BRACING/BRIDGING 4i
JOIST HANGERS l'
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HEATING ROUGH-IN I
Y INSULATION: // k
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / f R-
WALLS A/I/9 -f- S• 3 R- Z-j V/
CEILING fe 3F1, R-3 p/
DUCT WORK :OR PIPING IN UNHEATED
SPACES
A! 7
REMARKS:
ARRIVE
DEPART ) 3
/ " INSPECTdre;i1
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 -'j
NAME c21 .r N O r YZ , 0v
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LOCATION ,� � /� CA% ,pp 41.,k %�%..C.- l� e,
-
DATE 3 AI /q 1'. PERMIT # i� / 0! 7
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TYPE OF STRUCTURE ,-(�� 0{Yh:e 1 , ka,c,)1
RECHECK C1 / � APPROVED
I / . N/A YES NO
FOOTINGS/PIERS >° /
MONOLITHIC POUR FORM : r /
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 A
FOUNDATION/DAMPROOFING Hi,
BACKFILL APPROVAL 1/
ROUGH PLUMBING ,"' t,
PLUMBING VENT/VENTS IN,° PLACE
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FRAMING: , /
JACK STUDS/HEADERS J
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JACK POSTS/MAIN BEAM t, .
HEATING ROUGH-IN • ;
INSULATION:
FOUNDATION WALLS INTERIOR R- '4 '
FOUNDATION WALLS ETERIOR R- \
FLOORS R-
WALLS '\ R-
CEILING R- t
DUCT WORK OR PIPING IN UNHEATED `
SPACES
1
REMARKS:
_0 L.A e.,4 '
ARRIVE
lJ
DEPART-
INSPEC R
CLS a QUSSi191e,
• TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
Q04UEENSBURY,
TELEPHONE (518)NEW OR92-K 5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED // L/ / ` /
NAME `> &X\( J( lrINc3Yn ,i C 1
LOCATION 0 0+ I 1 7 1 , ,p E AA)ck Cir `Jei
DATEV PERMIT # �V 9/ -0/
TYPE OF STRUCTURE S kett,N&A
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 FOLLOWI G
THE PLACEMENT OF THE CONCRETE/.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR jf / -
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL ,{
ROUGH PLUMBING 19 /
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS I ?,
BRACING/BRIDGING t'
JOIST HANGERS
JACK POSTS/MAIN BEAM ) 1.
HEATING ROUGH-IN " 1
INSULATION:
FOUNDATION WALLS INTERIORv';R-
FOUNDATION WALLS EX'TERIOR�R •
-
FLOORS !R-
WALLS § R-
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES I 1
REMARKS:
4)gpLy A2/2/444742/leeJ;--
ARRIVE
DEPART
NSPECTOR
TOWN OF QUEENSBURY ,I}'
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
. QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832 c (JU
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /,6d'/l
NAME ,?/,�h h.rni17`lil h rt u
LOCATION h m 7 (;t?9 ;,ei'.�4n9 Gua
DATE %/0) PERMIT #! j/N 1
TYPE OF STRUCTURE/A ?MI, ('f'ee r
RECHECK I API'ROVED
• N/A/� YES A0
FOOTINGS/PIERS • 1 / i.,/"
MONOLITHIC POUR FORM f
REINFORCEMENT IN PLACE „ /
THE CONTRACTOR IS RESPONSIBLE
7
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR 1
REINFORCEMENT IN PLACE I
FOUNDATION/DAMPROOFING } /
BACKFILL APPROVAL s /
ROUGH PLUMBING l I
PLUMBING VENT/VENTS IN PLACEU
PLUMBING UNDER SLAB Y
FRAMING: A
JACK STUDS/HEADERS /
BRACING/BRIDGING d
JOIST HANGERS /
JACK POSTS/MAIN BEAM / w
HEATING ROUGH-IN / 1,,
INSULATION: /
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS I R- 1.
WALLS / R- ‘
CEILING / R- I
DUCT WORK OR PIPING% IN UNHEATED
SPACES / !
/ \
REMARKS:
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DEPART ft.,(D
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT // �
531 BAY ROAD „G
QUEENSBURY NEW
(518)0792-5832RK 4 ;4'7
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED / d'/�'/
NAME //4, ./'l.'G'>`Y eV. i-A1' -
LOCATI ON, / , d �I.( €%ate % % A'>
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DATE 47/0. PERMIT # 9/-D/7
TYPE OF STRUCTURE i�t/�� (_Llr/ `-G'&e ,
RECHECK i, APPROVED
i' / N/A YES NO
,/FOOTINGS/PIERS I
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE'i
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM •
FREEZING FOR 48 HOURS FOLLOWIN
THE PLACEMENT OF THE CONCRETE.'
MATERIALS FOR THIS PURPOSE ON r ITE
FOUNDATION/WALL POUR 1
REINFORCEMENT IN PLACE ,j
FOUNDATION/DAMPROOFING ;f; ,) ,
BACKFILL APPROVAL +, 1
ROUGH PLUMBING 1
PLUMBING VENT/VENTS IN PLACE'
PLUMBING UNDER SLAB ; ;
FRAMING: `a
JACK STUDS/HEADERS
BRACING/BRIDGING fl,
JOIST HANGERS 1 h
JACK POSTS/MAIN BEAM d1 `;i
HEATING ROUGH-IN s
INSULATION:
FOUNDATION WALLS INTERIOR R
FOUNDATION WALLS EXTERIOR R
FLOORS il R Nz,
WALLS R-%.
CEILING R- '0,
DUCT WORK OR PIPING IN UNHEATED
SPACES `f ''f;
REMARKS:
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