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1991-029 • CERTIFICATE OF ` OCCUPANCY TOWN OF QUEENSBURY r.. WARREN COUNTY, NEW YORK Date June ,23 19 93 This is to certify that work requested to be done as shown by Permit No. 91-0 2 9 has been completed. This structure may be occupied as a s i n cr 1_e family dwe 11_i n cr Location Old West Mountain .Road Jeffrey and Debra A. Foss Owner ' 74-1-2 .1 By Order Town Board TOWN OF QUEENSBURY Director of Bldg. do Code Enforcement S. BUILDING PERMIT TOWN OF QUEENSBURY RE-ISSUE No. 91-029 WARREN COUNTY, NEW YORK v PERMISSION is hereby granted to Jeffrey J & Debra A Foss ' OWNER of property located at Old West Mountain Road Street, Road or Ave. in the Town of Queensbury,To Construct or place a Interior Alterations 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 17 Suger Pine Rd T1 Queensbury NY 12804 to to 2. CONTRACTOR or BUILDER'S Name same fD -n -5 3. CONTRACTOR or BUILDER'S Address 2° rD 4. ARCHITECT'S Name Z 5. ARCHITECT'S Address 6. TYPE of Construction— (Please indicate by X) O ( ) Wood Frame ( ) Masonry ( )Steel ( ) n rp 7. PLANS and Specifications cNt No Interior alterations as per plot plan, specifications and application, 8. Proposed Use Cu Alterations include new windows, doors and siding with a new dormer 0 0_ $ PERMIT FEE PAID —THIS PERMIT EXPIRES February 5 19 94 (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.) CD re-issued to new owners on Dated at the Town of Queensbury this 5thD of V February 19 93 -s / n SIGNED BY for the Town of Queensbury c Building and Zoning spe -5 iv 0 N BUILDING PERMIT TOWN OF QUEENSBURY No. 91-029 .cu WARREN COUNTY, NEW YORK 0 � V PERMISSION is hereby granted to Roy & Jeanne Tonnesen 41. OWNER of property located at Street, Road or Ave. N p p ty Old West Mountain Rd in the Town of Queensbury,To Construct or place a Interior Alterations 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 RD#1 Box 1763A Lake George, NY 12845 0 2. CONTRACTOR or BUILDER'S Name In co Same `0 3. CONTRACTOR or BUILDER'S Address Cr CD 7 4. ARCHITECT'S Name CD 5. ARCHITECT'S Address O a SC rD 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( I Masonry ( I Steel ( ) et. 7. PLANS and Specifications No. Interior alterations to dwelling as per application 8. Proposed Use Interior alterations e+ rD 0 1 $ 65.00 PERMIT FEE PAID —THIS PERMIT EXPIRES February 5, 19 92 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the c town of Queensbury before the expiration date.) e+ Dated at the Town of Queensbury this .. -5th Day of February 19 91 f CA SIGNED BY for the Town of Queensbury Building and Zoning I61pector TOWN OF QUEENSBURYeak / REVIEWED BY �' 4�� FEE PAID $ iI , '7� g � PERMIT NO. 9'/=a29 re. u'G.� BUILDING PERMIT APPLICATION FEB %` 1991 A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A-VALID BUILDING PERMIiT:l D DEPT. 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: /� 4 Jed. e.SeA P.O. Address /C ) I Po), /1634/ L4 on" , `i is Tel. 752 - Z 7� Property Location d (�- m T ,7ei Tax Map No. / / Has there been any split of this property since October 1, 1988? / x If yes Planning Board Review is necessary. yes no SUBDIVISION NAME, IF APPLICABLE LOT NO. THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: gt-( <D l245e&k.._ • NATURE OF PROPOSED WORK: • • ESTIMATED MARKET VALUE OF Construction of a new building „ CONSTRUCTION: $ 75--® o a Addition to a building * COMPLETE INFORMATION REQUIRED BELOW: * Size of property e dekr,e4. ft x ft. - Alteration to a building • Existing Buildings(3) Size a ft. x 34 ft. (no change to exterior dimensions) • Proposed building - distance from property line: Other work (Describe) • Front yard r ft. Rear yard ft. • Side yards ft. and ft. • GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft. 1st Floor sq. ft. • OCCUPANCY INFORMATION • 2nd Floor '— sq. ft. • Primary Building - Other Floors ,► One Family Dwelling sq. ft. (not cellar or base;::ent .• Two Family Dwelling TOTAL FLOOR AREA '— sq. ft. • Multiple Dwelling/Number of units Size of new structure ft x ' ft. ' Business Foundation-pier/slab/c7rtia /full • Industrial (circle Other • i No. of stories (habitable space) • Height (grade to ridge) a ft. • If addition, what will use be? If residential, no. of families / -• N. No. of rooms(excluding baths) • Accessory Building No. of bedrooms 3 _Detached Garage ONE/TWO Car No. of bathrooms .- 2 • Primary heating system (5/ / 0-7t/ -//n • __Attached Garage ONE/TWO Car Type of fuel " Private storage building No. of fireplaces to be installed " • Other Will a wood stove be installed Central Air conditioning Ai© • OV• ER BUILDING PERMIT APPLICATION CONTINUED - BUILDING 3PEC.IFICATIONS: Type of construction, wood frame, fire safe, etc. II Will any second-hand or upgraded lumber be used? If so, for what? Foundation wall material trigs Depth of foundation below grade (to bottom of footing)Will there be a cellar? Heated or e�? \ Floor sq. footage sq ft. Will there be a basement? Will an or •• ► be us,ev d`as liv'%g space? (If so, what portion? • sq ft. Ty of e? Type of roof - sloped/flat/shed/off( Ma erial otr ro•f,/ Size, wood studs "x " s c• g " o.c. lengt / ft. Joists (floor beams) Is o r 'x " spacing ."o.c. •an ft. - Joist (floor beams) n to "x " spacing "o.•. span ft. Overlays (ceiling beams) "x " spac• g o c. span ft. Roof rafters "x " spacing o.c. sp: ft. Roof trusses (pre-engineered) space " o : . span ft. Exterior wall finish of what material? Interior wall finish If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure, self-closing device be provided? Will a flue-lined chimney be installed? Height above roof 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 (including adjoining properties ft. (A separate application is necessary for any repair or new installation of septic system) NAME OF BUILDER ADDRESS . TEL. NO. NAME OF PLUMBER ADDRESS TEL. NO. NAME OF MASON ADDRESS TEL. NO. NAME OF ELECTRICIAN ADDRESS TEL. NO. DECLARATION 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. f Signature ,/ , ' Owner, owner's agent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT: BY . , ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS Compliance Methods: PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) tfrt` OF QUEEN BUH, PART 6 - Thermal Rating Component Trade Offs - 1 & 2 Family Dwellings; Multi-Family Dwellings (3 Stories or Less) FEB 4 1991 PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential & CODE DEFT, PART 4 & 6 - .Compliance Methods Require Submission of Worksheets /W 744c Sew �L // Y APPLICANTS NAME PROPERTY LOCATION PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area - 2. 3'69 9 Sq. Ft. 2. Type of Heat - Elec. Base Board Other 0;7 AX--,2� 3. Is Building Mechanically Cooled? YES y" NO 4. Percentage of Area of Windows and Doors 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 B. Exterior Walls R 2- // �n C. Glazed Area • R D. Exterior Doors R E. Floors over unheated spaces R F. Edge of Slab on Grade (Heated Building) R G. Basement/Cellar Walls (Above Grade) R H. Basement/Cellar Walls (Below Grade) R I. Heating/Cooling - Ducts - Pip'ing in Unheated Space R • 6. Service (Domestic) Hot Water Heating Device A. Conforms to minimum efficiency per code YES NO TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED C;7;;M-I ( 2 APPLICANT'S SIGNATURE NATU ATE �L TELEPHONE NUMBER INSPECTOR'S REMARKS : REVIEWED BY TOWN OP QUEENSBURY REVIEWED BY: YVf'� OF QUEEIVSEU•.. ¶i J FEE PAID: �tECE1VED ��� ��� � aye o�tn0 �� PERMIT NO. : FEB 51993 r l..DG. & CODE ADEPT. BUILDING PERMIT APPLICATION A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. All applicants spaces on this application MUST be completed and the signature of the applicant MUST appear on the reverse side of this application. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Owner of Property: CC r ( P,- rr„ _A- Fr���5 P.O. Address: 11 Cr P) A r� Li PHONE ���-Jrf -IProperty Location: Old �P,S Mis-udL_ d Tax Map No. ."i14/ /-/ , I. Has there been any split of this property since October 1, 1988? Yes No ) If yes, Planning Board Review is necessary. Subdivision Name, if applicable: Lot No. THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE Construction of new building * CONSTRUCTION: $ Addition to building Alteration to building * COMPLETE INFORMATION REQUIRED BELOW: (no change to exterior dimensions) * Size of Property: ft. x ft. Other work (describe) * Existing Building Size: * ft. x ft. * Proposed building - distance from GROSS AREA OF PROPOSED STRUCTURE: * property line: • * 1st Floor Sq. Ft. * Front Yard ft. Rear yard ft. * Side Yards ft. and ft. 2nd Floor Sq. Ft. * If on corner, setback from side street- * ft. Other Floors Sq. Ft. (not cellar or basement) * OCCUPANCY INFORMATION: * TOTAL FLOOR AREA: Sq. Ft. * Primary Building - One Family Dwelling Size of New Structure: ft. x ft. * Two Family Dwelling Foundation: * Multiple Dwelling/No. of Units _ Pier/Slab/Crawl/Partial/Full (Circle One) * Business * Industrial No. of stories (Habitable space) * Other Height (grade to ridge) ft. * If residential , no. of families: * If addition, what will use be? No. of rooms (excluding baths) : No. of bedrooms: * ' No: of bathrooms: * Accessory Building: Primary heating system: * Detached Garage - One/Two Car Type of fuel : * Attached Garage - One/Two Car No. of fireplaces to be installed: * Private Storage Building Will a woodstove be installed?: * Other Central Air Conditioning: Yes No (OVER) BUILDING PERMIT APPLICATION CONTINUED: BUILDING SPECIFICATIONS: Type of construction: wood frame, fire safe, etc. Will any second-.hand .or ungraded lumber be used? If so, for what? Foundation Wall Material : Thickness: Depth of Foundation below grade (to bottom of footing) : Will there be a cellar? Heated or Unheated? Floor Sq. Footage: Will there be a basement? Will any portion be used as living space? If so, what portion? Sq. Ft. Type of Use? Type of Roof: Sloped/Flat/Shed/Other Material of Roof Size, wood studs " x " ; spacing " o.c. ; length ft. Joists (floor beams) : 1st Floor " x " ; spacing " o.c. ; span ft. Joists (floor beams) : 2nd Floor " x " ; spacing " o.c. ; span ft. Overlays (ceiling beams) : " x " ; spacing " o.c. ; span ft. Roof rafters: " x " ; spacing o.c. ; span ft. Roof trusses (pre-engineered) : spacing " o.c. ; span ft. Exterior Wall Finish: of what material ? Interior Wall Finish: If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to be an opening between garage and dwelling? If so, will a Fire-Rated door, enclosure, self-closing device be provided? Will a flue-lined chimney be installed? Height above roof 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 (including adjoining properties: ft. (A separate application is necessary for any repair or new installation of septic system. ) NAME OF BUILDER & ADDRESS: PHONE NAME OF PLUMBER & ADDRESS: PHONE NAME OF MASON & ADDRESS: PHONE NAME OF ELECTRICIAN & ADDRESS: PHONE DECLARATION To the best of my knowledge 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. Further it is understood that I/we shall submit prior to a Certificate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN drawn to scale, showing actual location of project on premises. Signature Owner, owner' s agent, architect contractor SPECIAL CONDITIONS OF THE PERMIT: By: Code Enforcement Officer X TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # a Fee Paid Date: (\.\G )(am 0) -3 Reviewe 2223 aS LOCATION OF PROPERTY FOR INSTALLATION: 4 �i �1. Owner' s Name: ; rp i,�S 013• W Owner' s Mailing Address: es / e 4' v Installer' s Name: �a�,> 'Lp ,J ,-1-� 1, e �-' et�i Phone #: ��dpg'tf T, Number of bedrooms (if residential ): Total daily flow (residential-compute @ 150 gal . per bedroom): Topography-Circle One: Flat Rolling Steep Slope % of Slope I v� Soil Nature-Circle One: Sand Loa Clay Other /Depth: Ground Water-At What Depth? Feet Bedrock or Impervious Material-At What Depth? - Feet Percolation Test-Circle One: Not Required Required/Rate / Min. Per Inch Domestic Water Supply-Circle One( Municip17 Well Other If domestic water supply is a e Separation: Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank 4, f7 gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench $"i feet//Total System Length 2-S--e) feet Seepage Pit(s): Number of / Size each: ft. x ft. Size of Stone to be' used: # / Depth or Thickness I ' feet ************** HOLDING TANK SYSTEM IF REQUIREp No. of Tanks Size\of Each -- -Gal . = Alarm system and associated electrical work to be inspected by a certified 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 / DATE: ( i'Y1� cl3 • a <�w''• Septic System Inspections: loll applications for septic system installation, alteration or repair, a;qf iired;Al;by the Town of Queensbury Sanitary Sewage Ordinance, shall be �•Sbmotted:\to the Building Department at least 24 hours before start of cthi ructio}n and shall include a plot plan showing: Si )- the pr-op.osed location of the system 2) location and distance to lot lines ' '3-) -, .1o,cati on 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 B. 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. C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted —to-the QueensburyBuilding _Dccpartmen4,, .z;fore-'fu=r"et,ftF'r co1lttruction. Town of Queensbury Building & Code Enforcement Department 531 Bay Road Queensbury NY 12804 Remarks: •=-•. a.:-w.--I .' ... ter,,.....+... . -- -, ,.. TOWN OF QUEENSBURY t,AN 531 Bay Rd., Queensbury, NY 12804 yIi '15 ----->' -,: APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date �� n A . O I ct ,19 q 3 Permit No. qi-0 q APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York State Fire Preventipn,,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 to perform required inspections. Please fill out additional form if more than one appliance and/or chimney. Applicant To_ .Q . .r,.,;5-, APPLIANCE (check appropriate boxes) Address CA ti [ z ;-,1 p d ❑ STOVE: ❑ Wood o Coal ❑ Pellet 0 FIEPLACE INSERT r �r , en -�1i 1 ry Zip 1 -) �; ,,-1 ❑ FIREPLACE, FACTORY-BUILT: I - c. r / i ❑ Wood ❑.Gas Phone ()of -,- 5 c11 $R 1 ' I -! - A F\ -)-1\ I t A') 0 FIREPLACE, MASONRY: \---J ❑ Wood ❑ Gas • Owner •J e (•.0 ,,; 0 FURNACE: ❑Wood ❑ Gas . a Oil Address (° �d ( 1-)r` I aj„� a IF NON-MASONRY: Manufacturer: ,f N n 'J__ 1 i ) n A Zip I .,-) R uy_ ,. .- Model: Outlet: inches __! I Listed By: Number: Phone nq - ':, Cir,} ;5 'phi (A 57) CHIMNEY (check appropriate boxes) Exact address of proposed construction 6 MASONRY: 0 Block 'R Brick 0 Stone n,,5)c,ns°e_. FLUE: 0 Tile 9e. Steel Size: • inches CONSTRUCTION/INSTALLATION MUST 0 FACTORY-BUILT: CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model: BUILDING CODE. CONSULT TOWN OF . Listed By: Number: QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall ❑Triple Wall REGARDING REQUIRED INSPECTIONS. 0 Insulated Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected 'Amount Received Code Number Title A 173 3389 (190)Public Safety J S S_ A 233 2655 (230)Minor Sales Fee Collected From or Refunded to: Address: Dated: -,/_.i.� c' Town Clerk or Deputy: ' -----__ White:Applicant Green:Fire Marshal Yellow:Bldg.Dept. Pink'& Goldenrod: Cashier's Dept. J / -tJ' ' ,�°"��� ""6R. MIDDLE DEPARTMENT INSPECTION AGENCY, IN.C• . /• National Headquarters tt` t (�,` l? 1337 West Chester Pike,West Chester, PA 19380 i-..,. ' APPLICANT COMPLETES THIS SECTION _ Date: . . - City, Town or Township -- f /. County ,_.),-/ I ( .-1 State %`'.i• `r'' /. Location/Address h I f I , '�'/t, 1 ; ' -' (If Located in Rural Area - Please Attach Directions) Pole # Owner E L 0_s5 Permit # 9/ --i° 7 Occupied As - Building: New❑ •Old 1�`� ! Occupant Work Area in Building (Floor #,etc.): App. for: Wiring❑,. Service n or: Ready for Inspection: - Fee Remitted-$ Cash n Check n M.O: n Make Payable To: M.D.I.A. 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 Number of Rough Wiring Outlets Elect. Heat • Switches - Lighting Amp. Service Surface Unit - Dishwasher Range - Water Heater Air Conditioner (— Dryer . Pump Receptacles Oven Garbage Disposal Wiring and Controls for •'?, / Burner Number of Fixtures Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100 Mark Number of Each Size . • Applicant's -• Signature _/ - License # Permit # T/A Utility:. Applicant's Address: ', /' ; (NAME) (OFFICE LOCATION) Li — (City) (City) _ - • ,r • -1 (State) i.i. �. (Zip) . ` ' ! ' Service Request # 'Y�4 Phone # f-' Electrician: - MDIA USE ONLY 0 / Z.- j j DATE RECEIVED: DATE INSPECTED: / - F ^ Correct Location: Same as Above n or: Red Notice Label I I • - / 7.-, Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal • Receptacles Water Heater `. Dishwasher Fixtures Air Conditioner Dryer ' Amp. Service Equipment Burner, Wiring &Controls for Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/z 2 •3 5 71/2 10 15 20 25 30 40 50 75 100 Mark Number of Each Size • • 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 Elect. Heat CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT FEE PAID / RW Progress: Inc.❑ LKD❑ - Contractor -7()-~''^ CFT Violation: Work Comp.❑ Inc. ❑ et) --- - • n L/A • Owner CASH n n L/A Fee CHK # 1:�;r.77') Due MO # • n IPA Municipal INV # Applicant Date: •• 1 - • Other Side 0V - Utility � Owner ❑ /. 7- fi r Cut in Card ❑ Temp # Date J f F( /1��-„ /G � ` £ `�J Final # �(` ; t' 4 INSPECTORS SIGNATURE I IDate .11;'.! APPLICATION FORM NO.250 EL 11/89 - • ' - YOU ARE HEREBY REQUESTED TO • • INSPECT AND-ISSUE CERTIFICATES • - FOR THE FOLLOWING ELECTRICAL EQUIPMENT-TO BE INSTALLED BY " THE UNDERSIGNED TEMP.# DATE f f1r CITY OR VILLAGE /\l TOWNSHIP y y{) COUNTY STREET AND "a NO.OR ROAD t { - - POLE NUMBER 0 L- I) ;,r! h r'' jj'1�1 . F-d ' BETWEEN WHAT TWO CROSS/ • TR STREETS IS PREMISES LOCATED? SECTION BLOCK LOT - <9 G;- .I', L, r ,.'e .- flL[°ri r 04 'r (Z 4 OCCUPANTS NAME BUILDING OCCUPANCY r • OWNER' AME AND ADDRESS - HOME TELEPHONE NUMBER/ CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE MMBER A) I vat 'S 1✓s-t BUILDING IS NEW❑ OLD' (' WORK IS NEW❑ ADDmONAL❑ DEFECTS REMOVED)Q� " LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No.of Fixtures& BRANCH OFFICE USE Loca- Lamp Receptacles MOTORS HEATERS CIRCUITS ONLY tion 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 OE•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 APPLICANTS IDENTIFICATION NUMBER I I AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. PRINT NAME AND ADDRESS . NAM„9F APPLICANT . . DATE OF APPLICATION ' SIG RE OF.,A!?AL-ICANT <' /!i d'..9. " Cn— X t !j /7,02.'lzi. - -- STEE RESS • - TELEPHONE NO. l / /fL i /763/7 - 7QZ - '7"73 3 CITY OR POST OFFICE . • - ZIP ODE. LICENSE NO.WHEN APPLICABLE ❑ 85 John Street ❑ 41 State Street 0 570 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 TI-IP NFW vnRK RnAR�_R nF FI"RE"UND RWRITER� l 7� TOWN OF QUEENSBURY. { �A� 531 BAY ROAD QUEENSBURY, NEW YORK 12804 " TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED NAME XLG✓ LOCATION LIRA 2t2 DATE rizi lq i PERRITR 97°2I TYPE OF STRUCTURE RECHECK /7,0 FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC INSULATION WOODSTOVE/FIREPLACE REMARKS APPROVAL N/A 'YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING d/ DECK/PORCH/STEPS/ AILINGS RELIEF VALVES FURNACE/HOT WATER ERATING BASEMENT INSULATION DUCTWORK INTERIOR TRIM/PRIVAC DOORS FINISH FLOORS: // BATH/KITCHEN WATERTI HT / OTHER FLOORS SWEEPABL OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/WHOLEHOUSE A ALL PLUMBING FIXTURES OPE AT k G GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARATION I FIRE/DEMISE WALLS j DUMPSTER SITE PLAN/VARIANCE REQUIREMENTS \ FINAL ELECTRICAL 6 OK TO ISSUE C/O OR C/Ci kN4 COMMENTS: i' S ARRIVE :.:.;z2 //' /4;1 DEPART INSP T TOWN OF QUEENSBURY 4pititk 531 BAY ROAD , QUEENSBURY, NEW YORK. 12804 TELEPHONE ,(518) 745-4447 BUILDING INSPECTOR°S REPORT FINAL INSPECTION REQUEST FOR INSPECTIOO�N RECEIVED l//,4_ NAME 6,�1--4-- �' /i�6o w LOCATION /(04 `r/,Ie4 /7.q$ , 1C d , • DATE 0//9 3 PERM!TO /ZU-9 TYPE OF STRUCTURE /2it�.l- (LiAlicLIT24 RECHECK FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) . FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING FINAL ELECTRICAL SEPTIC INSULATION WOODSTOVE/FIREPLACE REMARKS APPROVAL N/A YES .NO CHIMNEY HEIGHT/LOCATION B .VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILINGS RELIEF VALVES FURNACE/HOT WATER OPERATING BASEMENT INSULATION/DUCTWORK INTERIOR TRIM/PRIV CY DOORS FIBITH FLOORS: it ■■` BATH/KITCHEN WATER GHT OTHER FLOORS SWEEPA E / OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS / HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/WHOLEHOUSE,;FANS ALL PLUMBING FIXTURES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS l ,� OTHER FIRE SEPARATION FIRE/DEMISE WALLS DUMPSTER . SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL /� OK TO ISSUE C/O OR C/C L COMMENTS: ARRIVE DEPART 1 INSPE T Ao TOWN OF QUEENSBURY tl'/-t 531 BAY ROAD fi• ' QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED NAME (Z/4 //e5s LOCATION . (l', G../e-/'A ' • DATE //, / S PERMITil 62,/-Z2 j TYPE OF STRUCTURE RECHECK _FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) _FOOTING FOUNDATION BACKFILL FRAMING _ROUGH PLUMBING FINAL ELECTRICAL SEPTIC _INSULATION _WOODSTOVE/FIREPLACE _ REMARKS \ APPROVAL N/A YES NO CHIMNEY HEIGHT/LOCATION`, B VENT/LOCATION PLUMBING VENT - ,,' ,✓ ROOFING ,i • SIDING DECK/PORCH/STEPS/RAILINGS}; ;•' ,/ RELIEF VALVES a ✓, FURNACE/HOT WATER OPERATING ✓, BASEMENT INSULATION/DUCTWORK ✓ , INTERIOR TRIM/PRIVACY DOORS', ✓ FINISH FLOORS: ' ; / BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED ,/ STAIR CLEARANCE/RAILINGS ✓ HANDICAPPED ACCESS,;' ,- SMOKE DETECTORS y , ✓�/ • BATHROOM FANS/WHOUEHOUS-E-FANS ✓/ ALL PLUMBING FIXTURES OPERATING' ✓ GARAGE FIRE PROOFING ✓ DOOR CLOSERS ,/ OTHER FIRE SEPARATION \-/ FIRE/DEMISE WALLS ,/ DUMPS TER SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTRICAL OK TO ISSUE C/O OR C/C COMMENTS: Tik,d,,i, Ur)) ARRIVE ` III DEPART IA VINSPECTOR ELECTRICAL INSPECTIONS DUPLICATE MUNICIPAL RECORD Permit No. -7‘ Owner ri FC S Occupant , Ttcation g0 We et rAl aa(--&—Ais Street Town or City State Installation as itemized on reverse side has been visually inspected pursuant to applicable ccides. Installed by 51 0o/24o-et Date ‘.--93 1-( 1 Inspector MIDDLE DEPARTMENT INSPECTION AGENCY INC. cniayNfl IR Fl j��//{ ROUGH WIRING OUTLETS�y+ H.P.AIR CONDITIONER T 9 otrre'7 S4.;01 1.4�L WIRING &CONTROLS FOR BURNER E�/� RECEPTACLES H.P.PUMP Lt y FIXTURES K.W.OVEN A MP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT AMP.SERVICE CONDUCTORS / K.W. DISHWASHER K.W.SURFACE UNIT / K.W. DRYER K.W. RANGE AMP. RECEPTACLE `__. / K.W. WATER HEATER FRAC. H.P.VENT FANS • MOTORS M.P. 1/20 I/12 1/10 ' '/s Y. Ih %: Y. 1 1'/: 2 3 5 71/4 10 15 20 25 30 40 50' 75 100 MARK NUMBER OF EACH SIZE APPARATUS TOMS OF QUEENSBURY BUILDING g CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location WW-- /Z Date Permit # 91-O21' SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Number- Size - ft x ft. Stone size A PIPING: / Size Type Bldg. to Tank f Tank to Dist. Bo Dist. Box to Field it� Openings Sealed? ` s No Partial LOCATION/SEPARATIOdS: Foundation to Tank I `ti feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATIO1 OF SYSTEM Og. PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: jpf1 SYSTEM USE APPROVED: NO Arrived: 9So Departed: 5 z i7d�ng nspector /12'fai • TONN OF QUEENSBURY �� � BUILDING & CODE ENFORCEMENT 531 Bay R 2324 Queensbury 1 804 �5-<15' 518-7 447 JAN. SEPTIC DISPOSAL 5YST•. ?,sF C ETION r ' to Name \% - - ctey Location ' (Ji __ Date ,:5',/2/6 Permit # 2/022 rSOIL TYPE-:--Sand_Loa l ay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length „Zs-6 Length of each trench Si Depth of trenches ( ' Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank ' 5.4 _{c) Tank to Dist. Box ti° Sn_ps Dist. Box to Fi Openings Sealed? No Partial LOCATION/SEPARATIONS: Foundation to Tank ,e0 feet Foundation to Absorption ..,z,r feet Separation of iPits feet Conforms as per Plot Plan Yes Nod LOCATION OF SYSTEM ON PROPERTY: (circle one) �Fro'n - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: ' e e /D{ PP r/i/�!- %�'��1 fez- Gce SYSTEM USE APPROVED: YES (0) Arrived: Departed: fiTJ Insector 7 TOWN OF QUEENSBURY ,4 (4 k/ BUILDING AND CODES DEPARTMENT `9/� 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST �FOR INSPECTION RECEIVED NAME LLLCI- Peivi.4... --d.a2 LOCATION (OM 7/V' t AJ l A417(, I l� DATE `I/ `Z,.f l%.q PERMIT # 91-&J2j/ TYPE OF STRUCTURE `At g4/7(jaiz21764 RECHECK APPROVED N/A YES NO FOOTOGS/PIERS MONOLITHIC POUR FORM f REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTDON FROM FREEZING''FOR 48 HOURS .FOLLOWING THE PLACEMENT OF THE ,ONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR p REINFORCEMENT,;, IN PLAC FOUNDATION/DAMPROOFING BACKFILL APPROAL , ROUGH PLUMBING PLUMBING VENT/VENTS Ip PLACE PLUMBING UNDER SLAP FRAMING: \ JACK STUDS/HEADERS' BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN t <: )(INSULATION: k .� r FOUNDATION WALLS I TERIOR 'R- 'z,�t ` ic--� )( FOUNDATION WALLS TERIOR R-�,. FLOORS IUc -t--4,&11 R- __ WALLS I R- I9' 5( CEILING R-3,6 yc DUCT WORK OR PIPING IN UNHEATED SPACES I REMARKS: j ARRIVE 91 DEPART /0..0o INSPEC R 'Ad TOWN OF QUEENSBURV BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED V`C NAME d"C"��1l LOCATION .416, F�/ DATE 4/4y4Y PERMIT # e/,�d Z G TYPE OF STRUCTURE X.— RECHECK APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FbR\48 HOURS FOLLOWING THE PLACEMEN1OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL UR REINFORCEMENT IN PLACE I FOUNDATION/DAMPROOFIN BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM J yEATING ROUGH-IN IJINSULATION: FOUNDATION WALLS INTER OR R- FOUNDATION WALLS EXTER OR R- FLOORS R- WALLS R-/3 CEILING --a- ; s/y R- .� DUCT WORK OR PIPING IN UNHEATED SPACES ti REMARKS: rn f�. G-1o<\, cep (� vs (it ARRIVE `7;€0 DEPART /is Avail 1 INSP TOR TOWN OF QUEENSBURY TLc FIRE MARSHAL QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED /V b3 NAME , i //'? ;i S LOCAT ON O (,( //1,1 DATE ftz-//5-3 PERMIT# G� USG APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS I AUTO. EXTINGUISHINGcSYSTEM// HOOD INSTALLATION 1 AUTO. SPRINKLER SYSTEMyj ALARM SYSTEM r INTERIOR FINIS STORAGE: /` ?� CLEARANC7 SPRINKLERS CLEARAt @ 0 HEATING UNITS REQUIREST NAGE i • CHIMNE�' 7 WOODSTOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT \ REMARKS: U OK TO THIS DATE 2/015 I SPECT R TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT t4)7 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME 91L p./2/ / , G ,/ jX0-1 .1 LOCATION Re/ '1h-di/ /X-/ teq/ DATE ii//..V95 PERMIT I 9 j_o, J 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'\THE CONCRETE. MATERIALS FOR THIS\�PURPOSE ON SI-TE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE',, y FOUNDATION/DAMPROOFING ,X. BACKFILL APPROVAL / N (ROUGH PLUMBING / `\ PLUMBING VENT/VENT/IN PLACE `� PLUMBING UNDER LAB �l )(FRAMING: JACK STUDS FADERS BRACING/BDGING JOIST HANGERS JACK POSTS/MAIN BEAM 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 REMARKS: ARRIVE ®d,`D.S DEPART JO INSPECTOR Onli I�J2 uj TOWN OF QUEENSBURY /1°M BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 3/4/471 NAME c*Le../ yL pap„-„, LOCATION f(9, yap„,/ )lhz DATE 3/2 03 PERMIT # 9/-02q TYPE OF STRUCTURE Ack.. fiLa Z_u 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 PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING 4�� X PLUMBING VENT/VENTS IN PLACES PLUMBING UNDER SLAB FRAMING: �' 5/L-cc_ >C JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERSIV JACK POSTS/MAIN BEAM HEATING ROUGH-INS INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING; IN UNHEATED SPACES • REMARKS: I s G4i-5-s 61) (PCD P -is-LA/6' ARRIVE jr 1 DEPART /-3 INSPECTO / 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 4j, 4Y ?-77w7ii-1-1,,e LOCATION da /2 7'1 ,_ DATE /z,//0 /q/ PERMIT # TYPE OF STRUCTURE -42.4 aje�/z,z 6i_rsZ0 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 PURPOSE ON SITE FOUNDATION/WALL POUR , REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL '; ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE J7 PLUMBING UNDER SLAB FRAMING: <,r' JACK STUDS/HEADERS BRACING/BRIDGING /' JOIST HANGERS p JACK POSTS/MAIN BEAM I FIRESTOPPING 1` WALLS CEILING / FIREWALLS E , HEATING ROUGH-IN ,V INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- h, FLOORS R- WALLS 1 R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: y/ ARRIVE DEPART _INSP 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 RECEIVED NAME el-l/-f 9,edi)(4 .-e, 0f�iit'i_1iJ,( LOCATION 9�� �,�'I �'L/'- DATE C//j6b/ PERMIT I g/-ozf TYPE OF STRUCTURE _/ 4�f�./17:1:41 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 PURPOSE ON/SITE/ FOUNDATION/WALL POUR / REINFORCEMENT IN PLACE i FOUNDATION/DAMPROOFI;NG / BACKFILL APPROVAL l / ROUGH PLUMBING I / PLUMBING VENT/VENTS ;IN PLACE PLUMBING UNDER SLAB// FRAMING: i / JACK STUDS/HEADERS; / BRACING/BRIDGING / JOIST HANGERS JACK POSTS/MAIN BEAM FIRESTOPPING ' WALLS CEILING FIREWALLS 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 REMARKS: A - 7-1 /1;fr 11 -r le 1Jk ARRIVE DEPART INSPECTOR 1)3fP' TOWN OF QUEENSBURY0 BUILDING AND CODES DEPARTMENT tfj7 'TZ 531 BAY ROAD n Y��j' . QUEENSBURY, NEW YORK 12804 a`'- TELEPHONE (518) 792-5832 �� rA, -LkBUILDING INSPECTOR'S REPORT `pil REQUEST FOR INSPECTION RECEIVED NAME �)c VI P, E'xt , 9(�U3.� A e-L? 11 ii It c./ LOCATION D I() Ix)eM- I111 Vl"t ) DATE L/, (/ q/ PERMIT # 9 / — 0,9 TYPE OF STRUCTU E sLAO-e1 j oy «044 RECHECK APPROVED N/A YES NO FOOTINGS/PIERS I MONOLITHIC POUR F RM 1 REINFORCEMENT IN LACE THE CONTRACTOR IS ESPONSisLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HORS FOLOWING THE PLACEMENT OF TFT COCRETE. MATERIALS FOR THIS PUROSE ON SITE FOUNDATION/WALL POU ,1 REINFORCEMENT IN PLACC* FOUNDATION/DAMPROOFI� BACKFILL APPROVAL ROUGH PLUMBING ' PLUMBING VENT/VENT` I ) PLACE PLUMBING UNDER SLIB FRAMING: JACK STUDS/HEADERS 1 BRACING/BRIDGING JOIST HANGERS,; ' JACK POSTS/M*IN BEAM i HEATING ROUGH-'dN INSULATION: FOUNDATION - ALLS INTE'.IOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING i R- DUCT WOR OR PIPING IN UNHEATED SPACES REMARKS: ARRIVE • l ' DEPART / s'd`-- INSPE OR TOWN OF QUEEMBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR°S REPORT REQUEST F INSPECTION RECEIVED NAME 1 1 LOCATION Cl all i -,z e, DATE INf�S PERMIT f 91 ()w TYPE OF STRUCTURE I 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 PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM FIRESTOPP ING WALLS CEILING FIREWALLS 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 REMARKS: Zi:c 44— - (Sr k . ARRIVE DEPART 75 INSPECTOR 49 p 66 s6 :1 °Z -bh -bl- / x V Z W N 0 U ? o j � W 0 F- - N tit 40 — 3 UJ x x �3L o --x — x x x x x— 3 Z `, / i� pp �i it , 0/-gl -b 9J✓ 4 �N - -zs '/f7 o�-ZE-Z/S +k qW� V �I Q` ILL Go. rlGll"kT -oF %#Jj l% Z J J 0) _ od M 0 }" Ot 0 0 J p 7 r � 3 7 t7 OD J � � 0 N Pj r Q F LL Oi N W-Por 4i ° I