1992-080 r
y
ATE OF +OCCUPAN+.I
CERTIFIC
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
19
gz-
This is to certify that ork requested to be done as shown by Permit No,
has been completed.
This structure may be o d as a
Single Family Dwelling
4111111111
ie
Location
Lam--;=Mohawk Trail
Owner Frank M. Holman
By Order Town Board
TaJV4*N OF +QUEENSSURY
Director of Bldg. & Code Enforcement
a
BUILDING PERMIT
TOWN OF QUEENSBURY No, 92-0$0CM
WARREN COUNTY, NEW YORK 1
PERMISSION is hereby granted to Frank W. Hoht.an °A s-�
OWNER of property located at Lot f61 Mohawk Trail Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Single Fami 1 v DMIlino
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_
t. OWNER'S Address Is
9990 Arsenal Hill Rd �
Ft Ann , MY
rr
2. CONTRACTOR or BUILDERS Name ac
Herlihy. William
a CONTRACTOR or SUiLDERS Address
29 Fox Hollow Lane a
Queensbury, NY 12804
r
4_ ARCHITECT'S Name a
O
5. ARCHITECT'S Address
N
6. TYPE of Construction — (Please indicate by Xi
I +X Wood Frame I f Masonry I ) Steel f 3 fDl
7. PLANS and Specifications =/+
J
No. 2400 sq ft Single Family Dwelling as per plot plan specifications
and application '
J
a. Proposed Use +-+
Single Farm 1 y Dwelling ref/2 Car Att. Garage A Fireplace ea
$ 326- 00 PERMIT FEE PAID — THIS PERMIT EXPIRES _ March 19+ 79- —
(lf a longer period is required an application for an extension must bra made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date_)
Dated at the Town of Queensh s 19 D�a t. ^��-- March '19_. '92
SIGNED BY for the Town of Queensbury
Sulldi zoning Inspector
r
TOWN OF QUEENSBURY
REVIEWED BYreZiC4
FEE PAQ3
PERMIT NO. `�- rf
TOWN! OF QUEENSBURY
(E4W BUILDING PERMIT APPLICATION RECEIVED
MAR 17 1992
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTIOULDW AMODGIDGM
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.
* * * * * * w ■ w w w w s * « * * s * w • ,� s w s * s w s s * w s • s w * • s s s
The owner of this property is: iLLA&tZ Zj .
P.O. Address !z9g 6 ///// _ ifly_ /7. Tel. . .?el -7
Property Location ,f'r_ -/ iffeS1 fi7oh4t-ok T. ;L ?YlViS � � �� ve� s�acrrcj 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 / f'/ifrr. SGG ')Ij LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
NATURE OF PROPOSED WORK : • ESrIMATED MARKET VALUE OF
Lk Construction of a new building „ CONSTRUCTION: $ 1 /[? , mz)
Addition to a building ' COMPLETE INFORMATION REQUIRED BELOW:
Size of property. 39, ft x 1--ft.
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 yard5(0ft. Rear yard 54-1 ft.
Side yards 30 ft. and H 5 ft.
GROSS AREA OF PROPOSED STRUCTURE If on corner, setback from side street — ft.
1st Floor 1� 3O sq. ft. 1 ! v* OCCUPANCY INFORMATION
2nd Floor d /a Al sq. ft. , , 7, Primary Building -
;; One Family Dwelling
Other Floors --- sq. ft. NX
(rct co3_'ar or em,=t) Two Family Dwelling
TOTAL FLOOR AREA `sq. ft. -* Multiple Dwelling/Number of units
Size of new structure�ft x (0 (g ft. " Business
Industrial
oundatio ier/slab/crawYpsrtial/full *
(circle one) " Other
o. of stories ('habitable space) ,.
Height (grade to ridge) 2.I9 ft. * If addition, what will use be?
If residential, noo of families_
No. of rooms(excluding baths) G * Accessory Building
No* of bedrooms �i ; Detached Garage ONE/TWO Car
Now of bathrooms 'S •
Attached Garage ONE ar
Primary heating system &H a WA-TI w2
„ O
Type of fuel I-- P) " Private storage building
No* of fireplaces to be installed Other
Will a wood stove bo installed ljo
Central Air conditioning .. d w
OV" ER
BUILDING PERMIT" APPLICATloiv C (D %VTFNUED -
BUILDING ;PFCIFIC ATIONS:
Ttpe of construction, and from fire safe, etc.
W ilI any second-hand or upgraded lti m her be used ? [ f so,�for w hat
Foundation wall material 0g::!, Thickness /� ` ,r( lL 0
Depth of foundation below grade ( to bottom of footing) + t�
Will there be a caller ? ti�t9 r unheated . Floor sq. footage. sq ft .
Will there be a basement ?-- sA� t ill any portiorf be used as living space ?
(If so, what portion ? --- sq ft . Type of use ? ,A /!Q
Type of roof - ope /flat/shed/other Material of roof7 ' y {
Size, wood studs "x(L? " spacing ." o. c , length..ft .
Joists ( floor beams ) Ist floor Tr 10 " spacing.-I-{4P."o. c. span—/n( ft.
Joist ( floor beams ) 2nd floor IT &0) I" spacing—(e) "o. c. Span ift.
Overlays (ceiling beams ) - "x — " spacing " o. c. span ft .
Roof rafters '"x IF
spacing o. c. span ft .
Roof trusses (pre-engineered) spacing_�f o. c. span ft.
Exterior wall finish of what material ? �r1Grp1>
interior wall finish
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
r�
Is there to he an opening between garage and dwelling? \- C'5 If so will a Fire-rated door, enclosure,
self-closing device be provided?
Will a flue-lined chimney be installed? `�k�. Height above roof 2 ft,
Depth of chimney foundation below grade ' ft ,
Depth of fireplace hearth 2, ft. CQ in.
Water supply lunici ar private well t
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties A14 ft .
(A separate application is necessary for any repair or new installation of septic system )
NAME OF BUILDER Lj. ; I, A,, /�e�_ADDRESS ,? h fCc X Belly tom.+ TEL. NO, 3- S Zry
NAME OF PLUMBER w e ADDRESS TEL. NOw
NAME OF MASON SA-fl- ADDRESS TEL. NO.
NAME OF ELECTRICIAN r} qv ADDRESS TEL. I+ZO.
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 aL proposed work to be done on
the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
All outer laws pertaining to the proposed work shall be complied with, whether specified or not, and that
such work is authorized by the owner.
Signature-.,.-
Owner, owner's agent, architect, contractor
SPECIAL CONDITIONS OF THE PERMIT:
BY
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY s 'WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings ( ONLY ) TOWN OF CIUEENSBURi
RECEIVED
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings ;
Multi - Family Dwellings MAR 17 199Z
( 3 Stories or Less )
PART 4 - Design By Component 'Performance - Commercial Buildings - Hi - R%P(Xe#i EaDEPT.
PART 4 & 6 ow Compliance Methods Require Submission of Worksheets
rr'iyL �`'" • _ P LOCATION
ro � 1 I
ANTOS NAME
A��LIC
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE :
1 . Gross Floor Area - r +'/f d Sq . Ft .
2 . Type of Heat - . gyp Elec . Base Board Other / , /a Gars /4Z GA1fij Ae�
3 . Is Building Mechanically Cooled ? YES V NO
4 . Percentage of Area of Windows and Doors Over 17 % ✓ Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D
THE R-vALUES SHOtim ON PLANS SUMITM!
Baseboard
5 . Insulation Values ' Actual Shown Elec , Heat Other
A . Roof A Floors exposed to ambient temperatures Rom_
B • Exterior walls R 12
C . Glazed Area R_ 'j ^
D . Exterior Doors R��
E . Floors over unheated spaces R A/oq
F . Edge of Slab on Grade ( Heated Building ) R / Iq
G . Basement/Cellar Walls (Above Grade )
H . Basement/Cellar walls ( Below Grade ) R. .L5
I . Heating/Cooling - Ducts - Piping in Unheated Space R VA
6 . Service ( Domestic ) Hot Water Heating Device A . Conforms to minim m efficiency per code V,/ YES NO
TE104MIIJR;E CONTROL MIkXIM `M SETTING 140' - MILL NOT BE EXCEEDED
�TELEPHOML NUN
INSPECTOR ' S REMARKS
TOWN OF Q +UEENS.B UR Y
531 Bay Road, Queensbury, NY 12804-9725
Inspections Required for Solid Fuel Appliances
MASONRY FIREPLACES
1 . After firebox and smoke chamber are constructed; before face is on and First
flue file is installed. Inspector must also observe clearances to combustibles
(framing, etc.) and combustion air intake.
2. When chimney is partially built and clearances (floe and masonry clearances to
combustibles) may be observed.
3. Upon completion, including hearth extension, mantel, tries,, and when chimney
height may be observed.
FACTORY-BUILT ("ZERO CLEARANCE") FIREPLACES
1. Upon basic installation., when clearances to combustibles, combustion air
ducting, chimney collars/supports, firestop(s) in chase, and chimney height may
be observed and before completely enclosed.
2. When complete., including hearth extension, mantel and trim.
WOOD STOVES & INSERTS
* If new masonry chimney or factory-built chimney - inspection required.
See sheet "Inspections required For Chimneys Serving Solid Fuel Appliances" .
1. Insert - During installation while flue connection can be observed.
2. Wood Stowe - During and/or upon installation when floor protection and stove/
stovepipe clearances to combustibles (walla, ceiling) may be observed.
NOTE: A pre-installation visit by the Fire Marshal may answer your concerns and
help to avoid corrections after installation is underway. Call 7454424.
24 HOUR NOTICE REQUIRED TO SCHEDULE INSPECTIONS CALL 745-4424
Work crust conform to the NY State Fire Prevention and. Building Code,
which has adopted. NFPA Standard 211 on construction/installation of fire-
places„ wood stoves and inserts. An excellent reference for masonry fireplaces
:n accordance with the Code is "tek spec 3" gas
by the NYS Concrete
Masonry Assoc. The Fire Marshal's Office has a limited number of copies.
Factory-built fireplaces and inserts must be installed according to the manu-
facturer's listing and instructions.
+Construadonllan latlon must conform 10 Now York State Fire Prevondon and Hulloing Code
(Saxes. 1005 - Chimneys and Gas Vorrta: 1 OW - fireplaces and Slo vew, 1107 - code Erdorc•mont
QfYlclel Na4ileation) and Town of Gkmenaebury Local Law 10 of 1090. FM INSPSOL.F 1/02
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Pegr(dlill* []F 01LEENSBUR ►
Fee Paid RECEIVE
Date : _ 01 - 1 _ ReviewedMAR 17 1992
LOCATION OF PROPERTY FOR INSTALLATION : rs 62
0§&KdA6:QQnE DEPT.
owner ' s Name *
. 1�.Owner ' s Mailing Address : iqlQ ) 4ysEnV tC f-�,' ( ( 1
i✓ ., �"_ lF z
Installer ' s Name : f L A14e.1i{ Phone
Number of bedrooms ( if residential ) :
Total daily flow ( residential - compute @ 150 gal . per bedroom ) : Ala
Topography-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 Impervious Material -A What Depth ? iA � Feet
Percolation Test-Circle One : of Required equired / Rate Min . Per Inch
Domestic Water Supply- Circle One : uni al Well Other
If domestic water supply is a we ic
Separation : Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank ��0 gal . ( Minimum size : 1 , 000 gal . )
Tile Field : Each Trench rs`p feet//Total System Length ;:t Sa) feet
Seepage Pit ( s ) : Number of / Size each : ft . x ft .
Size of Stone to be used : # _tjh=th== Thickness feet
HOLDING TANK SYSTEM IF REQUIRED
No . of Tanks AX47 Sizelof Each 111,4 ^Gal .
Alarm system and associated electrical work to be inspected by a certified
agency. I
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 : t'r� "y-� tv . . DAITE : 1 - l -
Septic System Inspections :
A . All applications for septic system installation , alteration or repair ,
as required by the Town of Queensbury Sanitary Sewage Ordinance , shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing :
1 ) the proposed location of the system
2 ) location and distance to lot lines
3 ) location and distance to structures
4 ) location and distance to __a_,,__ny water supply
5 ) size and dimensions of all--tanks , distribution boxes , the 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 ,
Co An approved copy of the plot plan shall be available on the construction
site . Failure to produce said plot plan at time of inspection may result
in an 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 Queensbury Building Department before further construction .
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks :
TOWN OF Q UEENS B UR Y
531 Bay Rd'. Oueonabury, NY i2so4
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Bare. , 19 .� `�
t"erdt No.
APPLICATION 'S HEREBY MADE to the Building Dept, for the issuance of a Building and Use Permit
All pursuant to the New York, State Fire Preveation and Building Code, The applicant or owner agrees to oomply y�th
all inspectors
laws, ordinances, tegulatioaa and all oonditions that are part of these requirements and also will snow
to enter premises to perform required inspections.
Plsess All out additional farm if more then one apPlianceF andjor chimney.
Applicant f- ja OK APPLIANCE check appropriate ppropriate boxes)
Address q . OV A4 ❑ STOVE: ❑ Wood ❑ Coal ❑ Pellet
❑ Fi EPLACE INSERT
zip -� � 7 �7 ❑ FIREPLACE, FACTORY-BUILT.
Phone - ? FI REPLACE, MASONRY: Gas
Owner . ❑�a ►�1 �' ,X Wood Gas
A,? 'd 'f/'' ❑ FURNACE: o Wood ❑ Gas ❑ Oil
Address w
IF NON-MASONRY:
Manufacturer:
ZIP Model: Outlet: inches
Phone Listed 8Yi _ Number:
Exact address of proposed construction CHIMNEY (check appropriate boxes)
.MASONRY: d Block Brick ❑ Stave
FLUE: q Tile C7 Steel
FCO�N �STRUCTIONIINSTALLATION MUST GF FACTORY-BUILT: _Sizea Inches
NFORM TO NYS FIRE PREVENITON & Manufacturer:
ILDING +CODE. CONSULT TOWN OF Listed By: _ Nu Model.
EENSBURY HANDOUTS, PROVIDED ❑ Double Wall ❑ Trfple Wall
REGARDING REQUIRED INSPECTIONS, ❑ Insulated
Dept: Fire Marshal Cashier's Departrnsnt Town of Queensbury, New York
Code Number Title Amount Collected ,Amount Received
"
A 173 3389 (190) Public Safety
A 233 2655 (230) Minor Sales .
F Ilected Fro Refunded tea:
AAA Via: �..
Dated: Town Clerk or Dep ty:
WWZC.w Appllaarm Green: Fire Marshal Yellow: Bldg. nept. Pbsk & G Idenrod: cashier's Dept.
ENSBURY
TO 531!ANY ROOAD ,/4J 1
QUEENSBURY , NEw PORK 12804
TELEPHONE (518) 745-4447
SUILDING InSPECTOR' S REPORT
FINAL INSPECTION r
REQUEST FOR INSPECTION RECEIVED.
NAME
LOCATION r'� lyl � o /.rr�i_r. •�>.+•�
DATE PERNI'Tf
TYPE. OF STRUCTUREy` ��3 - � - 1
RECHECK
FIRE MARSHAL APPROVAL ( COMMERICIAL STRUCTURE)
MOOTING z.- OUNDATION y.&SACKFILL FM1ING
ULATION PLUMBING
WO-OSITOVE/EL FI EPLACEL TIC
REMARKS
-APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATIO
8 VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/P CH/S / NG
RELIEF VALVES
FURNACE/HOT WA E E NG
INTERIOR TRIM/PR ACY ORS
FINISH 'FLOORS :
BATH/KITCHEN TERTIGH
OTHER FLOORS WEEPABLE
OTHER FLOORS ARPETED
STAIR CLEARANC /RAILING
SMOKE DETECTOR
BATHROOM FANS
ALL PLUMBING I UR S ERA G
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/OIC � .
! A) �{' - � �
'n
ARRIVE
DEPART 1Q, !( )i' ' -�--^-+
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518) 745- 4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME �' �, / �� tCA�tr
LOCATION --
DATE----' {- _ PERMIT#M .i�^
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO . EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO . SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE :
CLEARANCE TO SPFUNKLE 5 _
CLEARANCE TO HEATING NITS
REQUIRED SIGNAGE
CHIMNEY
�0O'DSTOV E
✓FIREPLACE-MASONR
FIREPLACE- FACTORY B ILT
REMARKS : Lj OK TO THIS DATE
2/015 INSPECTOR
awn 0/ Q"eenji"ry 140
BbILDING and ZONING DEPARTMENT�,J�/�
Bay and Haviland Road, R. D. 1 Sox 38 /
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 44
LOCATION. _ /
DATE �y -�� PERMIT NO.
SOIL TYPE <ESan Lckam - Clay -
Percolation Test Re ' red? YES - NO
Percolation rate - M /Inch
TYPE of SYSTEM: r
Absorption field , to 1 length
Length of each trenc `
Depth of trenchesAl
Size of gravel 2
SEEPAGE PITS4Nuinber }
Size- ft. X _
Gravel size
PIPING : jSjke ,, Type
Bldg . to tank y 04yp' �—
Tank to disc. box ' 00:141
Dist. box to field/p ' 'jl • +r
Openings sealed? S NO Partial
LOCATION/SEPARATIddNS :
Foundation to tank ft.
Foundation to absorptiogj ft.
Absorption to lot line eft.
Separation of pits ft%
OF SYSTEM ON PR ERTY (circle one)
Kilto - Rear - Left side Right sideJAW
-
TS .
Aht
SYSTEM USE APPR ED ES
B ing Spector
01/86 and vl I
TOW OF QUEENS
BURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD [
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447 . .stiff
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION wilt
DATE . . PERMIT f ( +
TYPE OF STRUCTURE >
RECHECK APPROVED
N/A YESI NO
FO T N S/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZINNG 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 x
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING :
JACK STOSPHEAD
BRACING/BRIDGIN
JOIST HANGERS
JACK POSTS! N BEAM ��
HEATING ROUGHz N
NSULATION .
FOUNDATION WALES INTERIOR —
FOUNDATION WALLS EXTERIOR R—
FLOORS R—
WALL.S R—
CEILING
DUCT WORK OR PI ING IN UNHEr E
SPACES
RE K
�J 5 u L.rq l �- I DS p
ARRIVE. r
DEPART : 3 c)
TNSPFCT
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAMEr ��C
LOCATION
DATE PERMIT# ,�Z-C1&0
APPROVED
EXITS N/A YES NO
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO , EXTINGUISHI G SYSTEM
HOOD INSTALLATION
AUTO . SPRINKLER SY TEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE :
CLEARANCE TO SP NKL RS
CLEARANCE TO HE TING NITS
REQUIRED SIGNAGE
CHIMNEY
Jy I REPL0VE
✓FIREPLACE-MASONR
FIREPLACE- FACTORY BUILT
REMARKS : OK TO THIS GATE
2/015 INS EC OR
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447
BUILDING INSPECTOR' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE PERMIT# 9o2 - 62' +C=x
TYPE OF STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE )
FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOODSTOVE/ FIREPLACE
REMARKS
APPROVAL
CHIMNEY HEIGHT/LOCATION N/Al YE5 NO
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS-
RELIEF VALVES
FURNACE/HOT WA ER OPE . ING
BASEMENT INSULATITWORK
INTERIOR TRIM/ PRIVAC DOORS
FINISH FLOORS : - —
BATH/KITCHEN WAT TIjHT
OTHER FLOORS SW PAB
OTHER FLOORS C PETEO
STAIR CLEARANCE/�RAILINGk _
HANDICAPPED ACCESS
SMOKE 'DETECTORS
BATHROOM FANS/WHOL H U E NS
ALL PLUMBING FIXTURES OPER TIN
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS " —
DUMPSTER
SIT£ PLAN/VARIANCE R£ IREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/
COMMENTS :
ARRIVE
DEPART
�INVJYIECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT/W
531 BAY ROAD
QUEENSBURY , NEW YORK 12B04
TELEPHONE ( 518) 745- 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED� ,r
NAME -r'�'/ °'I_+ !
LOCATION
DATE
�`r -PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/Aj YESjA.O
FOOTINGS/PIERS --
/' MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPON IBLE
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/HEAD£ S
BRACING/BRIDGING
JOIST HANGERS _
JACK POSTS/MAIN BEAM
HEATING ROUGH- IN
INSULATION :
FOUNDATION WALLS NTE R-
FOUNDATION WALLS EXT IOR . R-
FLOORS
WALLS -
CEILING
DUCT WORK OR PIP G IN UN HE ED
SPACES
REMARKS .
ARRIVE
DEPART
kCTO
TOWN OF QUEEHSBURY
BUILDING AND CODS DEPARTMENT
531 BAY ROAD
4 �TELEPHONE ( 518 ) 792- 5832 NEW YORK �
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION L-
DATE.5 PERMIT # 'Z]
TYPE OF STRUCTURE
RECHECK APPROVED
N /Al YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE �
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOL OWING
THE PLACEMENT OF THE CO ETE .
MATERIALS FOR THIS PURPO E ON SIT
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
XFOUNDATION/DAMPROOFING
VUACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/ VEN S I PLAC
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 NTER R R-
FOUNDATION WALLS EXTERI R R-
FLOORS R-
WA LLS R-
CEILING R-
DUCT WORK 0 P PfNG IN UN TED
SPACES
REMARKS :
ARRIVE
DEPART
I SP
TOWN OF QUEENSBURY t�,e4r
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY12804
TELEPHONE * ( 518 )NEW0RK 792- 5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATIONS /
DATE,-� "� PER141T !
TYPE OF STRUCTURE. LLJ f
RECHECK APPROVED
N/A YE ' NO
]FOOTINGS/PIERS
ff MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPON ISLE
FOR PROVIDING PROTECTION FRO14
FREEZING -FOIL 48 HORS
FOLLOWING
THE PLACEMENT OF E CONCRETE .
MATERIALS FOR THIS PURPOSE ON SI E
FOUNDATION/WALL PO
REINFORCEMENT IN PL CE
FOUNDATION/DAMPROOF14G
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/ VEN S IN PL E
PLUMBING UNDER SLAB
FRAMING :
JACK STUDS /HEADERS
BRACING/ BRIDGING
JOIST HANGERS
JACK POSTS /MAIN B M
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-
INSULATION :
FOUNDATION AL INTERIOR R-
FOUNDATIO>y WALLS EXTERIOR R-
FLOORS / R-
WA LLS R'
CEILING R'
DUCT WRK OR PI ING IN UNHEATED ;
SPACE
ARRIVE
DEPART
k, "N TOR
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED? BY
THE UNDERSIGNED
CITY OR VILLAGE TOWNSHIP COI.JfSTV
STREET AND NO OR ROAD POLE NUMBER
,1 f r`. .n . f a
r - f - / • L
BETTMEEN WHR'TWO CROSS STREETS 15 PREMISES LOOAIED? SECTION STOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY
OWNER'S rVoAC AND ADDRESS
/ I j .f f :. HOAAE TELEPHONE NUMBER
F fi' Y� l." a / . ;if i !`, s !
CURRENT SUPPLIED BY FROM THEIR OFFICE d ,.. -r NATik TELEPIIOFJE NUMBER
BUILDING IS 11��
NEW �a OLD ❑ VpiRK IS NEW ADDITIONAL ❑ DEFEY::rw REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No. of Fixtures a M01ORS HEATERS BRANCH OFFICE USE
Lorca- Lamp RecaptaCISS CIRCUITS - ONLY
tion Side ,y
Ceiling V II ReDBp'ps Switch ckArldarlt Bracket Na Type Ea l ND' E chh No- Gauggo INSPECrI(M
OUT-
SIDE
SUB-
BASE
BASE-
MENT
let
FL.
2nd
FL.
3rd
FL-
-------------
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
THIS APPLICATION IS INTENDED TO COVER 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
SI+"OF MAINS FEE RS ELECTRIC SIGNSgJGMFS TOTAL Vol-K'
y V I': fs
CHARACTER OF WORK s Exposer) GAS TURF SI GWFRANSFOAMERS OF
CONCEALED
DATE NbRK T7 BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
1
h f !
SERVICE ENTERS BUILDING MANUFACTURER OF SKIN
El OVERHEAD UNDERGROUND
OATS INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE}
! F
6Y QBONG FULL ACCU R S MUST t3E FILLED N OR APPLICATION MAY
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICAnON
STREET ADDRESS TELEPHONE_ NO. _
l I l
CITY OR=POST OFFICE dt ZIP CODE LICENSE N )o]'IVHEN APPLICABLE
85 Jahn Street .. I 41 State Street I 570 Delaware Avenue I ❑ 217 Lake Avenue I El 202 Arterial Road
NEW YORK,. NY 10038 UK�AI LBANY, NY 12207 I BUFFALO, NY 1d202 1 ROCHESTER, NY 14606 ! SYRACUSE, NY 13208
(212) 227.3700 (518) 4"2122 111 (71 B) 884-1155 (716) 254-0141 1 (315) 463-8662
THE NEW YDRK BOARD OF: FIRE UNDERWRITERS
OWN OF QUEENSBui .
RECEIVED
AUG 16 1992
BLDG. & +CODE L?EPT.
tIf
— P.rch
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v P T 4
t
a 5f3
�aT (� rf ,Mt7fIR K `I�IR 1 . �`iel'�A/IC VIA. 40 NR'Ah f
u
TOWN OF +�Ut���� ' °
TOWN OF QUEENSBURI
RECEIVED
Zoning Admini ratOr MAR 17 1992
BLDG. & CODE DEFT.
vs
38 !
i r
r
y
md
,4or4" 61 Mogow►k �TIeAIL rRANK W, 1400#711 1
TYKES W
N
i
TOWN OF QUEENSBURY
AS BUILT PLOT PLM VERIPICAvrom
} Certificate of Occupancy
I . w+ f�rn t ` have verified that the attached Plot Flan is a
(Print Name }( f
true and accurate drawing as to the location of the
(Ty f of structu
for which a Certificate of Occupancy is being submitted .
I understand if the information is false or not accurate , that a
Certificate of Occupancy may be revoked and I will have to file for a variance
to the Zoning Board of Appeals .
3/ 2
( Date Filed) ( g tore } r l
Cl o
A.U-)
351 8
E.
In
CY
7.
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