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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 � M 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. v —----- SL�NEY HADE FOR "OUNly, N"Y' MCA LE, VATS: _c::) anDusen k Steves LAND FfJ-',A'EYUf`S,,GLEN,', FAL.Lr,NEV YCRK ��,Y. srAT-- C. C, ��P.