1992-029 MM
CERT
HFICATIE OF O UP Y
TOWN, OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date-�`� _19 .
92-029 This is to certify that work requested to be done as Shawn by Permit No.
has been completed.
'Mis structure may be occupied as a
Ag of Fourptex
Location 82 Old Mill Lane
Owner Masul to Brothers/M Real t
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT %�'% Ep
TOWN OF +Q U E E'N S B U RY No. 92-029
WARREN C LINTYr NEW YORK �
w
PERMISSION is hereby granted to _. Masul o Brothers/_ C Real t
1
$2 Old Mill Lane Street. Road or Ave.
OWNER of property located at F.,
in the Town of fQueensbury, To Construct or place a 3A of Fourplex
at the above location in accordance to application together with plat plans and other informs tion hereto filed and
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance.
ka
t. OVMER'S Address is
3049 Broadway
Schenectady, KY 123% °
ea
a
2, CONTRACTOR or B#IILDER S Name r't'
Same "f
vl
3. CONTRACTOR or BUILOERi S Address
Co
fV
4. ARCHITECT'S Name
R7.
a
Jr
�1
6_ ARCHtTECT`S Address
f9
S. TYPE of Construction — (Please indicate by Xi �
I xl Wood Frame ( 1 Masonry l 1 Steel { 1
7, PLANS and Specifications C
No. 1399 sq ft 34 of Fourplex as per plot plan specifications and c
application
8. Proposed Use "r
eo
x
# of Fourplex
183. 00 PERMIT FEE PAID — THIS PERMIT EXPIRES JAnVary , 'g 93 .-
(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.)
Dated at the Town of Queensbury this 31st —
Day of _�. .17n 19— 2
SIGNED BY _ for the Town of Queensbury
' Buiiding and Zoning ! rrspector�� ._,._
TC>'I N t y����
TOWN OF QITEENSBURY ID
REVIEWED B d z+ nn
FEE PAID * JAN 91 .)
� # 41
PER MIT NO. - BUILD11iG CC1DE DEFT*
BUILDING PERMIT APPLICATION
A PERNIff MU'BT BE OBTAHMD BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MAD19 VNTM APPLICANT HAS RECEIWED A VALID BUILDING PERMIT.
All applicants Spaces on this application "v1UST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
The owner of this property is*. 4I /—r] emu`
P.O. Address %v]AV Tel.
_�� ,r
Property Location /f- L- Tax Map No
�/
Has there been any split of this property since October 1 , 1988 ? I
If yes Planning Board Review is necessary. //''�� , J yes no
SUBDIVISION 'NAME, IF APPLICABLE f/►ypiv + ' TS LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS,
Steven M . Masullo or Carmine L . MaSullo
r
NATURE OF PROPOSED WORE{: EsrMATED MARKET VALUE OF
CONSTRUCTION: S 55 , 000 . 00
Construction of a new building
* COMPLETE INFORMATION REQUIRED BELOW ;
Addition to a building • Size of property ft x ft.
Alteration to a building " Existing Buildings( 3) Size A . ft• x tt•
(no change to exterior dimensions) a Proposed building - distance from property line:
M 7
Other work (Describe) Front yard--ft . Rear yard �ft.
» Side yards 23 ft. and �it.
e If on corner, setback from side street ft.
GROSS AREA OF PROPOSED STRUCTURE e
1st Floor 870 sqo ft. r OCCUPANCY INFORMATION
2nd Floor 529 sq. ft. � „ Primary Building
e One Family Dwelling
Other Floors N /A MWEES4. ft._ !� r Two Family Dwelling
(not cellar ar ement
TOTAL FLOOR AREA 1399 Sq. ft. a Multiple Dwelling/Number of units,,_
Business
SIXe of new structure 24 . 5ft x 47 ft. Industrial
Foundatlow 1erlslab/crawI/partWAjSb . Other
(circle one)
Now of stories (habitable space) 2
Height (grade to ridge) 23 ft. * If addition, what will use be?
If residentialt now of families ! •
Nom of rooms(excluding baths) Name • Accessory Building
Na. at bedrooms 3 MENOMINEE ' Detached Garage ONE/TWO Car
Noe of bathrooms 3 a
• X Attached GarON8 WO Car
Primary heating system forced hot a i r
�
Type of fuel kas " Private storage building
Noe of fireplaces to be installed Other
Will a wood stove be installed no
•
Central Air conditioning no OV10 ER
st°Ft .o[r� c r 61 �rtT .app_!(CATt0N Co ;vTIXt: Ep -
I ; • :
+s I ,+
BL- ILD1;t1�,' 3PFCliwA444,VS:
Type of construction, wood frame. fire safe, etc, 2 x 6 exterior 2 "' solid core gyp . wall
Will any second-hand or upgraded 111mberbe used? If so, for what ? No
Foundation wall material 3000 psi cone . Thickness 81" 100" if 32 ' span or greater
Depth of foundation below grade (to bottom of footing) 48 " min .
Will there be a cellar ? yes Heated or unheated? unheated Floor sq, footage ft .
Will there be a basement ? Will an 011tiori ? no sq
y P be used as living space .
(If so, what portion ? sq ft . Type of use?
Type of roof - sloped/ flat /shed/other Material of roof 2351/ fiber lass
Size, wood studs 2 '"x 6 ," spacing 24 " o, c. length 8 ft .
Joists (floor beams ) Ist floor 2 "x 10 " ;pacing 16 "o. c, span 13 fto or less
Joist (floor beams) 2nd Floor 2 "x 10 " spacing 16 "o. c, span 13 ft, or less
Overlays (ceiling beams) 2 "x 6 " spacing 16 if o. c, span 12 ft .
Roof rafters 2 "x 10 " spacing 16 o.c. span 12 ft .
Roof trusses (,pre-engineered) spacing 24 " o, co span ft , see truss certificates
Exterior wall finish horizontal siding of what material ? vinyl -
Interior wail finish " G . Board Taped & Painted
If a garage is to ue attached, describe materials to be used for FIRE SEPARATION:
" Type X Gyp .
Is there to hP an opening between garage and dwelling ? yes If so will a Fire-rated door, enclosure,
self-closing device be provided? yes
Will a flue-lined chimney be installed? no Height above roof
ft.
Depth of chimney foundation below grade ft,
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well Municipal
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties N/A ft.
(A separate application Is necessary for any repair or new installation of septic system)
NAME OF BUILDER I +A-Vi.L,.,p 13-M -MAW. ADDRESS3049 Broadway , Schenqt&1btit4O. 370- 1058
NAME OF PLUMBER 4M4 1 ZVPWj# ADDRESS 88 Newton St , Albany TEL. NO. 459-58 1 1
NAME OF MASON */r- ADDRESS3049 Broadway , SchenectMVL, NO. 370- 1058
NAME OF ELECTRICIAN__ t,+(Ii ►0 )�' `IADDRESS 179 Boxwood I) r , Srhene 355-8 t00
`' i3: NO.
DECLARATION
To the best of my kMwledge and belief the statements contained in this application, together with the
►fans and "cincations submitted, are a true and complete statement of all PrOPased work to be don* on
he described premises and that all provisions of the BUILDING CODE. THE ZONIN
Jl ORDINANCE, and
other laws pertaining to the proproead work shall b* compiled with. whether sp*c
uch work Is authorized by the owner, i[I*d or not, and that
Slgnatur•
Owner, owner's ag*nt, architect, contractor
PECIAL CONDITIONS OF THE PERMIT:
BY
AUI
TOWN OF QUEENSBURY
TOWN OF QUEtr. .
WARRED] COUNTY r NEW YORK
Application for : BUILDING PERMIT IN COMPLIANCE WITH
K
STATE ENERGY CONSERVATION CODE
A permit must be obtained before begkzzni wo � k y
AC] SWER ALL Of the following *
1 . Gross floor area LeIg f ---- - ��
2 . Type of heat GAS HOT AIR
3 . Is the building mechanically cooled ? NO
q , Percentage of area of windows and doors MIN
A , Over 161y
1 . U value of gross
o area of walls , roof / ceiling and floors J
exposed to ambient cvnditions� - �� '
2 . Floor over heated spaces YES NO YES T10
a . Are foundationwhat iswalls
thesRlvalue ?
1 . If YESESP
3 , Slab on grade YES NO
a . If YES , what is the R value of insulation around
perimeter of floor ?
41 Is basement heated ? yE8 NO
a . R value of insulation -
r, , Type of
S . Under 16 % 21n1—
1 . R value of roof and floors exposed to ambient conditions
R -- 30
2 , R value of exterior walls R - 19
3 . R value of glazed area 2 . 25 --
4 . R value of doors z
value Of floors over unheated spaces R 14
Er . R value of slab edge insulation - unheated slab _ na.
7 . R value of slab insulation - heated slab na
ement / cellar walls ( above grade ) na
$ . R value of heated bas
ement / cellar walls ( below grade ) na
g . R value Of heated bas
ip , Type of insulation F IRFR RCS F3- T
C . Controls 90 °
1 , Thermostat maximum heat setting
p . Duct Systems
1 . Is duct system installed itt unheated spaces ? YES
a If YES , R value of duct_ insta 3. la tiOn
b . R value Of duct in other areas
E y _ Insulation
1 . 51aP of }tot water or cooling carrying agent
2 . R value of pipe insulation _
F Service Water }ieatizt
]. . Performance effency
2 , Temperature control setting maximum
GO For Swimming Pool Only
1 . Maximum heating
see Dart si
x NYS ENERGY CODE
Telephone No . ( app3icant ' s signature )
3gOO 1055
APPLICATION FOR SEPTIC DISPOSAL PERM11'
Tpvq,'lrr OF Q�'�N3fu: . L
C VI.
DATE ko . qj, JAN 29 W1
t -
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: I rfta(? fiM . E V1406 J Telephone: ✓ Ie f I� �CJ — - ____ _-----
Address: 5,041
Installer's Name: CA M "� JOH Telephone:
Number of bedrooms (residential only) 4t �3 _
Total daily flow {compute (p 150 gal per bedroom)
Tcpergraphy: circle one: Flat Rolling Steep Slope % of slope `
Soil Nature: circle one! Sand Loam Clay Other / Depth:
Ground 'Water: At what depth? feet
Bedrock. or Impe -vious Material: At what depth? ,I4NA feet
Percolation test! circle one: xot :required required / rate mill. inch.
Domestic water sugaplya circle one: Municipal We]I Other . ...__�
IF* domestic water supply is a Well:
Separation. WatersuppIy from Se�ptti/c} absorption �� feet
PROPOSED SYSTEM: Septic Tank VII[.! gal. (mirximum size: 1 ,UU0 f;s11 .)
TILE FIELD: Each Trench feet / Total system length feat
SEEPAGE PIT(S): Number of / Size each C]~ f✓ feet by fe ^t
Size of stone to be used Depth or '17zickness _ feet
FEET ,s1L .f of AID PIJ3
IMPORTANT
...please...LiST NEW EQUlp"MENT Oro BE INSTALLED
(over)
TOWN OF QUEENSBURY
531 BAY ROAD
TELENSBURY , (5I8)745-44447
TELEPHONE
BUILDING INSPECTOR ' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAMEl1a,
LOCATION d5 D d �.--
DATE jfl= PERMIT#c? �2 9
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL ( COMMERICIAL STRUCTURE )
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
_INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A Y NO
CHIMNEY HEIGHT/LOCA y6N ✓
B VENT/LOCATION
PLUMBING VENT ✓
ROOFING
SIDING ,.r
DECK/P RCH/STEPS/ L NGS
RELIEF VALVES
FURNACE/HOT WATER OPE TING
INTERIOR TRIM/PfaIVACY OORS _
FINISH FLOORS : 1
BATH/KITCHEN � ATERTIGNT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILING—
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE S€PARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C�
COMMENTS :
ARRIVE
DEPART
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518) 745- 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME ZLIJ ->Or—t C) rzcp,>
LOCATION �,I K9 L 7 1 LL �- ,�► v L—
DATE qj ; I c]' Z_ PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS _
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS ROSPONSIBLE
FOR PROVIDING PROTE ION FROM
FREEZING FOR 48 HOU FOLLOWING
THE PLACEMENT OF THE CRETE
MATERIALS FOR THIS PUR SE/ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING �_
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB .
FRAMING :
.TACK ST DS/HEADE
BRACING/BRIDGIN
JOIST HANGERS
JACK POSTS/MAIlf BEAM
HEATING ROUGH- IN/
INSULATION :
FOUNDATION W LS INTERIOR R-
FOUNDATION rLLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS :
ARRIVE_1 �y,
DEPARTI.%
INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS UWE i
6F 1l4)�' BUREAU OF ELECTRICITY
a 41 STATE STREET, ALBANY, NEW YORK 12207
Hate iF;Y"I'IatlFSrifi 14 , IIL4c� 2 Application No. on file
THIS CERTIFIES THATIJy /� M
only the electrical equipment as deecribed below and introduced by the applican w"Id d on above applicatiom number irs [he prerraisr� of
PPYILT)i' , t? t LC) H,T1414 J ANE , 11ASULI/ i }S 0 -.' , 3Uf F i'iiF3I}xt`i , }3 , V .
in thefolloanin,B location; EX *� let Fl. El Brad F!. t, MO soctiors Block Lot
` eras examined ors ':;ra-'r'mRPI.1h 0, , 1 'Y1 1' and found to be in cornpo"nee eoith the requireanenta of this Board.
r
FixTURE PTACLES SWITCHES FIXTURES RA"WS COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
ESItTLETS WCANDESCENT FLUCINSCENT OTHER ANT. K- W. AMT. IC W. AMT. K.W. AMT. K. W. AAtT. I H. r_
tb 32 33 12 3 ! Jos 3 F
DRYERS FURNACE MOTORS FUTURE APPUANCE PGRDII SPECIAL REC*PTJ TOME CUMIts UNIT HEATERS MULTI-OCITLET DIMMERS
r ANT. K. W. CAL H. r. OAS H, r. AMT. NO. A. W. 0. AMT. AMP_ AMT. AMM- TRANS. AMT. H. r. Y STEMSM ANT. WATTS -
SOMI CE DISCONNECT I' dN D. OF S E R Y I C E
AMT_ AMP. TYPE , 1 .e' 2W 1 0 SW ] X 9w S 1 4W NO. OF CC. COMO, A. W. G. N4. Oe Hb1ES# x. W. G. No- OF NEIfiRAILS A. W. O.
PER t OP CC. C OF wwwod OF P&Wmt"
OTHER APPARATUSx
3a �� St���, t Wit, r�I x �r.i''m,yct,t•� - �
Y
AN" ) JONY GM AM M: Aa{} i.t
l �`a I3c1X }QI1 r3f�3.itti trt,J"� A
aL'Fjk;NFC1'i1fJY . N'i' , 1 ' _?« i BRANCH MANAGER
per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BEAN DING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
flown o/ Queendfiury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
. SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION 4 � (J 1 ! f ✓�- [r ' I^ °-`"
DATE f c/ L PEwIT NO .
SOIL TYPE - Sand - 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
Size of gravel:_
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size -
PIPING . Size Type
Bldg . to tank
Tank to dist . box
Dist , box to field/pit
Openings sealed? YES NO Partial
I` s
LOCATION/SEPARATIONS :/ 11
Foundation to tank ! ft.
Foundation. to absor�ition ft .t Absorption to lot } -ine f .
Separation of pa-ts ft.
LOCATION OF SYSTE94 ON PROP'ERTY (circle one)
Front - Rear - Lq6ft side - Right side -
CCt+lMENTS :
� ��� ►.c.A'la 5 t rc.�' 'i`C.� ��;l'2�.,�c_art-a 1�. C-
SeptiC systern o mY on bo
82-84-86-88 Old Mill Lane
Permit NOS : 92-029
92-030
99q2-031
SYSTEM USE APED YES NO
S JR1 (31.1 n I I Is
pe or
01/86 and vl
awn o/ �ueens6ur�r �f�
BUILDING and ZONING DEPARTMENT � -
Bay and Haviland Road, R.b_ 1 Box 98
Queensbury, New York 01
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION
DATE ' / - PERMIT NO.
SOIL TYPE San - 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
Size of gravel _
SEEPAGE PITS{Number of)
Size- ft. X _�ft.
Gravel size -:1.=
PIPING : Six Type
Bldg . to tank - -�`
Tank to diet. box
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/S=�'A RATIONS :
Foundation to tank. � ft .
Foundation to absorption y ft .
Absorption to loot line k ft .
Separation of pitsrft_
LOCATION OF SYSTEM ON PPROPPARTY (circle one )
Front -- Rear Left side - Right sme -
COMMENTS : I
A L. R oL is 3 ,+9 Tr f 1 ----__
SYSTEM USE APPROVED YE NO
Bu dinca Inspeq or -� •`
I 01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
+QUEENSBURY , NEW YORK 12804
TELEPHONE ('518) 745- 4447
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE ,1 /(a PERMIT 0
i
TYPE OF STRUCTURE
RECHECK APPROVED
N A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR F RM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPON ISLE
FOR PROVIDING PROTECTION FROMR
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/VEN S IN PLAC
PLUMBING UNDER SLAB
FRAMING :
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM_
HEATING ROUGH— IN
INSULATION :
FOUNDATION WALLS NTERIO R—
FOUNDATION WALLS EXTERIOR R—
FLOORS R—
WALLS R—
CEILING R—
DUCT WORK OR PIPINVIN UNHEATI&D
SPACES
REMARKS :
ARRIVE
DEPART
SPE OR
f
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 SAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745-- 4447
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVEDIC}
Mill
LOCATION
DATE PERMIT #`�
�~'��
TYPE OF STRUCTURE t� {{!"^sat Q1e ,? �
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 PU OSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLA E
FOUNDATION/DAMPROOF G
BACKFILL APPROVAL.
X ROUGH PLUMBING
kPLUMBING VENT/VEN S IN LAC
PLUMBING UNDER SLAB
',-XFRAM I NG :
JACKS DS/HEAD R
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN
HEATING ROUGH- IN
INSULATION :
FOUNDATION LS IN IOR R-
FOUNDATION ALLS EXTE IOR R-
FLOORS R-
WA LLS R-
CEILING R-
DUCT W RK OR PI ING IN UNHEATED
SPACE
REMARK
ARRIVE 2:ggz)
DEPART �J EX)
NS CTOR
rr
TOWN OF QUEENSBURY ;/��
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
+QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447
UUlLDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED.
NAME
LOCAT I ON_._{a
DATE 15 , / "' ' PERMIT #
TYPE OF STRUCIURE ! (�
RECHECK APPROVED
N/A YES NO
FOOTINGSM ERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE _
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACE"ENT OF THE CONCRETE .
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING�
BACKFILL APPI?OVAL
TROUGH PLUMBING
/ PLUMBING VENT/VENTS IN .,PLAC
PLUMBING UNDER SLAB
. FRAMING :
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS +
JACK POSTS/MAIN BEA
HEATING ROUGH- IN f
INSULATION : ,-
FOUNDATION WALLS I ERIOR -
FOIlNDATION WALLS ,tXTERIOR R-
FLOORS
WALLS R'
CEILING y R-
DUCT WORKtORfPIPING IN UNHEATED
SPACES
I
REMARKS :
76 1
et
ARRIVE-.-
DEPART _ f �
INSPECTOR
�, Dv .z,."c+i 4er4DC Core.- -
9m
T0WN OF QUEENSBURY
BUILDING 53 D BAY ES DEPARTMENT
12804
TELEPHONEQUEENSBURY } ( 518)NEW0RK 745- 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTIOtt RECEIVED_
NAME
LOCATION �" OWN c�
DATE PERMIT
TYPE OF S RUC URE
APPROVED
RECHECK N/A YES Nd
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMELACE
NT IN IS RESPONSIBLE
THE CONTI
FOR PR0YiDIN6 PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACENENT OF THE CO BETE.
FOUNDATION/FOR THIS PURP E ON SI
REINFORCEMENT IN PLACE
FOUNDATION/DAMPFING
ROUUGHGH PLUMBi G
PLUMBING PENT/V N S IN P
PLUMBING UNDER SLAB
FRAMING :
JACK S S/HEAD
BRACING/BRIDGING
JOIST HANGERS �~
JACK P05T5/MA-3N BE
HEATING ROUGH- IN
INSULATION :
FOUNDATION ALLS IN E O R-
FOUNDATION WALLS E ERIOR RR� 1p
FLOORS R-
WALLS R_
CEILING
DUCT WORK OR I I G IN UNDER E
SPACES
REMARK'S
ARRI V E,. ,-
40
DEPART �" �"� I ECTOR
TOWN OF QUEENSBURY �
BUILDING AND O �.
ROAD PARTMEN __
QUEENSBURYTELEPHONE � ( 518)NEW 7451111114447
BUILDING INSPECTOR` S REPORT
REQUEST FOR 114SPECTION RECEIVED�
/ /q2
NAME p
n • I � � env z • .
LOCATION Y -Y�--z- -�
DATE
n// 1f77 PER1'IIT #
TYPE. OF STRUCTURE
APPROVED
RECHECK N/A YES
) .FOOTiNGS/PIEAT
MONOLITHIC POUR FORM dk
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIB °E
AC
FOR PROVIDING PROTECTION FR
FREEZING FOR 48 HOURS FOLLO ING r
THE PLACEMENT OF THE COIICRE E- (TE
MATERIALS FOR THIS PURPOSE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING Id
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/ EN
PLUMBING UNDER SLAB
IN P E
FRAMING :
JACK S UDS HEADE _
BRACING/BRIDGIM�
JOIST HANGERS
JACK POSTS/MAIN BE ���--
HEATING ROUGH- IN
INSULATION :
FOUNDATION L IN E IOR R-
FOUNDATION WALL EXTERIOR R-
FLOORS R-
WALLS R-
CEILING
DUCT 'WORK OR PIPING IN UNHEATED
SPACES
REMARKS :
ARRIVE
DEPART 4NSECTOR
CIE FTrIII NO.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
DO NOT WRITE'HERE . FOR OFFICE USE ONLY I
BUILDING PERMIT No
TEMP F DATE �y
7[/f/IJSHIP UI�LM'+� �" �Ir
CITY OR VILIAC-E IVV1 POLE NUMAER
STRE'E1' A NP OR 1�On.D + � L LOT .+"��F'�
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BETE, NNW 1 VC GROSS .El'S IS PREMISES LOCKED?
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pCCUPANT'S NAME
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ADDRESS Ry / ELEP % }OWNEF.S NA T
OFFICE
FROM 7HE4Fk
CURRENT SUPPLED BY ] f"'�
I1� (�' ppvIT70NPL ❑ BEFCCI':+13EMO�+ED
810IL0WIG IS OLD w'ORK I$
NEW
LIST BELOW ALL EC]UIPMENT WHICH YOU IN ALLEBRANCH CJFFICE USE
NUMBER OF OUTLETS ND. FixtureS & MOTORS HEATERS CIRC %TS ONLY
Lamp FIA eC 3 CIOS wamS AIMPECTIONI
Loca- H.P. No. Each No. Gauge
tion Cele R ene hot Srviucrr Pendant Bracket No. TYPe Each
iling Wa
OUT-
SIDE
SLIB-
BASE
SAI
MENT
1st
FL.
2nd
FL,
3rd
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REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
THIS APPLICATION IS INTENDED To COVER THE ABOVE.LISTED EQUIPMENT TO SE INSPECTED, BUT IF AT TIME OF INSPECTION,TH FEE THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
E s
THE ADDITIONAL EQuiPM.EENT, AS PROVIDED SY THE APPLI ANT- EL+=erRlcslcNs+L+v.+Ps
SIZE OF MAINS &D AMP
RS
fy��/W/�'yJ �•,jl fr}l��1 ��J EXPOSED GA:,TV BE SIGNriRANSFORMERS OF
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f!J MANUFAC7 URER DE SIGN
SEFNICE ENTERS BUILDING F� OVEgNEAD UNDERGROUND
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DATE iNSPEGII6N ReOUESTED ON [OR AS NEAR AS POSS16LE7 ` �1U' I'I !�FrB •R:;. .-
AVOID DELAYS BY GIVING FULL AND A,pCt1RATE INFORIOM0116N. ALL SPAC'E'S M13ST BE FILLED tN OR APPLI'CJ►TION MAY 6E RET'URNEO.
OF
PRINT NAME AND ADDRESS DAT OF pXyp�pLl 7ION
NAME OF APPLICANT
STREET ADDRESS ✓� ! I" �IS.J • ZIP
CODE LICENSE NO. W HEN APPLICABLE
LE
dR POST OFFICE� ,��..�,yT��Y{1}y
IC}IFCmot 10 202 Arterial Road
L� 85 Jahn Street 4- 1 State Street Cj `S Delaware Avenue L7 RO Lake Al+enue fl
NEW YC7'RK, NY 10038 ALBANY, NY 12207 BUFFALO, NY 14202 R"�I 1I $E, NY 13206
THE NEW YORK 'BOARD OF FIRE UNDERWRITERS
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MAP REFERENCE:
DIXON HEIGHTS PHASE III
MADE FOR
MASULLO BROTHERS BUILDERS
BY VANDUSEN & STEVES
LO T 31
95-
MAP L-'� S ,RVEY MADE FOR
I�
MASULLO BROTHERS
TOWN OF QUEENSBURY j COUNTY OF WARREN N.Y.
SCALE:— 1"--20'-----`---`---t-� SErTEMBER 18, 1992 --
e�
Stnes
LAND SURVEYOR f,GLENS FALLS,NEW YORK
N.Y, STATE LIC, NO, 35617
I 30-DH