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1992-092 1� Y �• CERTIFICATE CIF 0 CCUT'AN Cq%jLr TOWN OF QUEENSBURY WARREN COUNTY. NEW YORK t 9 9. This is to certify that work requested to be done as shown by Permit No. has been completed. This structure may be occupied as a Single Family Dwelling - Location LoAAKAIN Lancesti re Sri yn 0weer Michael Yasiliou Inc. By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement Owl BUILDING PERMIT i1c 00 TOWN OF QUEENSBURY92-092 No. WARREN COUNTY, NEW YOR K , ti 1 PERMISSiON is hereby granted to Michael J . Vasi 1 iou INc _ OWNER of property located at Lot #14 Lancestire Drive Street, Road or Ave. in the Town of Queensbury, To Construct or place a Single Family Dwelling .K at the above location in accordance to application together with plot plans and other information hereto filed and W. approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a t. OWNER'S Address is r� 14 Stone Pine Lane 3C Queensbury, NY 12804 n' w tro 2_ CONTRACTOR or BUILDERS Name .r Sam 3. CONTRACTOR or BUILDER 'S Address r C t-r l� 4. ARCHITECTS Name far f� !y th tCi S. ARCHtTECT'S Address eyF 6_ TYPE of Construction — (Please indicate by X) ( XI Wood Frame ( ) Masonry ( ) Steel ( } 7. PLANS and Specifications CI7 No. 1650 sq ft Single Family Dwelling as per plot plan specifications and application 8, Proposed Use -� Single Family Dwelling w�eRi $ 248- 00 PERMIT FEE PAID - THIS PERMIT EXPIRES March 26 ig 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] t0 Dated at the Town of Queensbury this 6t Day o March 19 92 SIGNED BY far the Town of Queensbury Building and Zo ng d nspector TOWN OtV QUEENSSURY REVIEWED B FEE PAID . 42 14945 � Z "'..... ir/ S 7 PERMIT NO . . ` 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 . * * * * * * * * * * * * * * * * * r * * * * * * * * * * * * * * * * * * * * * * Owner of Property : Me Pre- P . O . Address : ,/�y' -:� E" �..rlr2 ,���r+ ?- PHONE ' Property Location : .'Sf, A �7ax Map No . Has there been any split lit this property since 0 tuber 1 , 1988? Yes No If yes , Planning Board Review is necessary . Subdivision Name , if applicable : W THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK ' AS REGARDS TO BUILD G C DES IS : NATURE OF PROPOSED WORK : ESTIMATED MARKET VALUE OF THE d0 Construction of new building * CONSTRUCTION : . <7<� 04V Addition to building Alteration to building * COMPLETE INFORMATION REQUIRED BELOW : ( no change to exterior dimensions ) * Size of Property : ft6 x g -- ft * Other work ( describe ) * Existing Building T1ze : r--, f t . x -- * Proposed building - distance from GROSS AREA OF PROPOSED STRUCTURE : * property line : f C 573 * V.r, Ist Floor r�' �j',/ Sq . Ft . ¢ * Front Yard � ft . Rear yard OT/ ft . * Side Yards „elo ft . and ,�„�_ ft . 2nd Floor 2 .Ft.Sq� � � * If on earner , setback from side street- OF f t . . Other Floors Sq . Ft . / * fL o * - (not cellar or basement ) b * OCCUPANCY INFORMATION : *� -1 d I e L 3 S * - rr �- TOTAL FLOOR AREA : Sq . Ft . * Primary Building - , Air * C One Family Dwelling / xy- Size of New Structure : _ fto x ft . * Two Family Dwelling - Foundation : * Multiple Dwelling/No . of Units` l Pier/Slab/Crawl /Partial /Full ( Circle One ) * Business * Industrial No . of stories ( Habitable space ) * Other Height ( grade to ridge ) 2 _ ft . If residential , no . of families : /'r * If addition , what will use be ? No . - of . rooms" ( excluding baths ) : No . of bedrooms * Noo of bathrooms : Z 35 Accessory Building : Primary heating system Z * Detached Garage - One Type of fuel : * Attached Garage - On Two Car No . of fireplaces to be installed : * Private Storage Building Will a woodstove be installed? : * Other Central Air Conditioning : Yes _ o ( OVER ) BUILDING PERMIT APPLICATION CONTINUED ; BUILDING SPECIFICATIONS : Type of construction : od frame fire safe , etc . Will any second- hand or ungraded lumber be used ? If so , for what ? Foundation Wall Material : — ead! 2 'C. c Thickness : Depth of Foundation below grade ( to bottom of footing ) : Will there be a cellar? eated or Unheated ? Floor Spa . Footage : Will there be a basement ? Will any portion be used as living space ? ace ? If so , what portion ? Sq . Ft . Type of Use ? cz Type of Roof : [,S1vpe at/Shed/Other Material of Roof Size , wood studs _" x spacing "' o . c . ; length ft . � +~ .foists { floor beams } : Ist Floor " x _.Z 40 '° ; spacing o . c . ; span ft . Joists ( floor beams ) : 2nd Floor _ , - " x _ Z8 " , spacing '" o . c . ; spun - ft . Overlays ( ceiling beams ) : �p _ x ' /Q '# ; spacing o . c . ; span o&7p ft . Roof rafters : " x spacing O . C . ; span ft . Roof trusses ( Pre-engineered ) : spacing Z o . c . ; span 240 ft . Exterior Wall Finish : �� — AL 45', a, ,,, 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 ? A If so , will a 'Fire- Rated door , enclosure , self- closing device be provided ? �t*04wez;,�Q_ Will a flue- lined chimney be installed? — Height ab ve 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 : A�)O ft , (A separate application is necessary for any repair or new installation of septic system . ) NAME OF BUILDER F, ADDRESS ; fPH HONE �yy 73s-3 NAME OF PLUMBER & ADDRESS : HONE�ya NAME OF MASON 8 ADDRESS : -� QNE NAME OF ELECTRICIAN A ADDRESS * `' '�" � 2 PHONE `74•Z.�'Z.S'.P DECLARATrON4 . 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 author zed by t owner . Signature Ow owner s ag nt , arc it ct contractor By : ode Enforcement Officer ENERGY CODE COMPLIANCE APPLICATION TWIN OF 99EMSBURyt WARREN COUNTY - 9000 HEATING DEGREE DAYS Cggpl i ance Methods : PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings ( ONLY ) PART 6 we Thermal Rating - Component Trade Offs we 1 S 2 Family Dwellings ; Multi - Family Dwellings ( 3 Stories or Less ) PART 4 - Design By Component Performance on Commercial Buildings • Hi - Elise Residential PART 4 & 6 - Compliance Methods Require Submission of Worksheets � �N- `'' SIG [ +4 ' '• Z rPROPERTY LOCATION "'Ile PART S METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE : 1 . Gross Floor Area ow o0woom � 4 / ry Sq . Ft . �^ 2 . Type of Heat of /'i:El ec e Base Board Other c : 3. Is Building Mechanically Cooled ? YES ._.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 4 U I R E 0 THE R-VALUES SMMOMM ON PLANS SUBMIT TMI Baseboard S . Insulation Values : Actual Shown Elec . Heat Other A . Roof 8 Floors exposed to ambient temperatures R. Be Exterior Walls R� Co Glazed Area D . Exterior Doors RYt Co. Floors over unheated spaces R Fe 'Edge of Slab on Grade ( Heated Building ) R G. Basement/Cellar walls (Above Grade ) R1 — He Basement/Cellar Walls ( Below Grade ) R :E l f I . Heating/Cooling - Ducts - Piping in Unheated Space R 6 . Service Domestic ? Hot Water Heating Device A . Conforms to minimum efficiency per code OYES NO TEMPERATURE CONTROL MAXIMUM SETTING 140" - WILL NOT BE EE=EEOED . .2 efi APPk "NT45 SIGNATURE TELEPHONE NUMBER INSPECTOR ' S REMUS : TOWN OF QUEENS$URY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit A ?'�? Fee Paid i Date : Reviewed By i LOCATION , OF QPERT FOR- INSTALLATION : -A�ZI41 •�1 T/ c" . Owner ' s Name •d . _ - K Owner ' s Mailing Address : or Installer ' s Name : Phone pis Number of bedrooms ( if residential ) : ; . .. r , Total daily flow ( reside -compute @ 150 galm per bedroom ) : Topography-Circle One : .. Fiat Rollin Steep Slope % of Slope Soil Nature-Circle One : and Loam Clay Other /Depths Ground water-At° What ; Depth? Feet ']► Bedrock or Impervious Material -At What Depth ? Feet ~ Percolation Test-Circle One : Not Requir equired/Rate Min . Per Inch Domestic water Supply--Circle One . Municipal dell Other If domestic water supply is a well Separation : hater supply from an septic absorption feet PROPOSED SYSTEM: Septic Tank 'gal . ( Minimum size : 1 .000 gal . ) Tile Field : Each Trench feet//Total System Length feet Seepage Pit ( s ) s Number of / Size each : ft . x ft . Size of Stone to be used : f ! Depth or Thickness feet HOLDING TANK SYSTEM IF REQUIRED No . of Tanks Size\of Each Gal . Alarm system an 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 : lA -A:. %: .. . . _, , . .# i tnr.r ��'] 1 f 1 '+1`��k .1f,:•t �� r ± rt :� r 7 -� -�_, !tf'f y ,+n f t�1' ? f f ,� � 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 dittance to structures 4 4 ) location and distance to any water supply 5 ) size and dimensions of alanks , distribution boxes , the fields and/or- drywells F 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 w?rk stoppage .- I . , . a 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 . d Id i } ; I Tower of Queensbury Building A . Code Enforcement Department ' 531 Bay Road � • , *� }y , , 1 , ; Queensbury,%[ NY 12804 � a i '~ ` t ., 0,1 Remarks 1 3 i 44a. �. f i 'S �� T{� If.lii.�Ss 1 � � � .fSF �• �1 •a1Ft F #.11 { f : �i �l+' . � itt ( . . !*f> ftl+s .q �Fi► , {ya :tt�Ef� � , ,; : 41 ' i 1c�. ^L� iP i . ; , ^[f ?, : ntr 1r `l � � lf SAi # t 4~R , y ++vs f Iax t ocja f [1 = isW r t ) it , . . , � , .4 ri s er + in t ry # r f f 4 � ` # r � f # C f, t � r=y^ ;7 ] r, a e ..e ?fsa riC ^: '':rff.f rrJ 4 n � . : 3f/tt1 �� 't3x. "1. 1 + ' i;, � lstfG:131 _ i�ltf Inxrt� "��# ' t xfdflhSf? i : j r TOWN OF QUEENSBURY Bay at Haviland Roads, Gueensbury. N.Y. 12801-9725 APPLICATION FOR SOLID] FUEL BURNING APPLIANCES AND FIREPLACES Permi Date N 19 -- A 13 1"1 1 C jVVION IS HEREBY MADE to the Building Department for the issuance or a IIuiIding and Usc Pert'liit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with .t11 applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow .111 inspectors to enter premises for the required inspections. nt 's Name 51 t ,�a APPLIANCE TYPE Applica ► C tr W Stove Coal Boiler Address Furnace Hot Air Zero Clearance _ , Circulating Unit Zip PhoneIf Non-Masonry: Owner's Name ��+"+, C; Manufacturer Address �_D = Model (3utlet Size Zip Listed b ' Number si'7` � 4rr /p£' -w +cam* -za,, I'httnc r CHIMNEY TYPE Masonry: Block Brick Stolle Flue: Tile Steel pl-operty location of proposed construction . Sire- ,r / Factory Built: Manufacturer Model Size c0l'Y OF MANUFACTURER SPECIFICATIONS IS Height Listed By Nutnbcr 12I OUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Triple 'Wall A N D C111 MN EYS. MUST BE INSTALLED Insulated ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $ CONSTRUCTION DETAIL REQUIRED FOR MA- Fee $ SONRY FIREPLACES AND CHIMNEYS. CASHIER'S DEPARTMENT TOWN OF QuEENsBu'AY, NEW YORK Amount Collected Amount Refunded 11lilrtment " FilrC Marshal i'cde Nlymbet Title — ^ A 1113389 ( 190) Public Safety A233 21555 (230) Minor Sales Fce Collected frnnl r Refunded to: AcltlreSx: Mate il�l � a�- Town Clerk or Deputy While: AppNeaal VeUow and Pink: Carhieer Department Goldenrod.& Fire Afars ival� � .---- ---- T01iN OF QUEENSBURY 531 BAY ROAD QUEENSBURY ,. JVF YORK 12804 TELEPHONE ( 51`B ) 745- 4447 BUILDING INSPECTOR' S REPORT FINAL INSPECTION REQUEST OR INSPECTION RECEIVED NAME. � LOCATION T I �j ell e 1LS' DATE �Z --- PERMIT# j z- TYPE OF STRUCTURE RECHECK _FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE ) FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING KFINAL ELECTRICAL SEPTIC INSULATION hWOODSTOVE/FIREPLACE REMARKS APPROVAL N/A YES NO CHIMNEY HEIGHT/LOC ION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/ PORCH/STEPS/RA ING _ RELIEF VALVES A — — FURNACE/ HOT WATE PERAII BASEMENT INSULAT N/ INTERIOR TRIM/ PR VACY DOORS FINISH FLOORS : K BATH/KITCHEN ATERTIGHT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILING- HANDICAPPED ACCESS K SMOKE DETECTORS Xt BATHROOM FANS/WHOLEH USE FANS ALL PLUMBING FIXTURES OPERATIN{N GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARA ION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VAR AN REQUI EM NTS r FINAL ELECTRICAL OK TO ISSUE C/O OR C/C COMMENTS tc ,y :'c i ! � . ' � ra s tc u — 0 4C - 1'7 ARRIVE I� DEPART_ INS TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 745- 4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME I .rrdi ,,r :/ pvl � � rl4zr LOCATIONf DATE /�I',4�,f PERMIT# ,1 - 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 T4 SPRIN 'ERS CLEARANCE TO HEAT G UNITS REQUIRED SIGNAGE CHIMNEY WOODSTOVE FIREPLACE—MAS NR tofel REPLACE— FACTORY BUIL REMARKS : OK TO THIS DATE 2/015 Al4PEC TOW" OFQUE URY 531 ROAD B TELEPHONE ( 518 )d745- 444, TELEPHONE � BUILIDI14G INSPECTOR' S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIyEO�, NAME Af LOCATI �/ f �� '°'" 4t;�;l DATE ,�" ,/ l 9 PERMIT# TYPE OF STRUCTURE RECHECK FIRE MAR HAL APPROVAL ( COMMERCIAL STRUCTURE ) FOOTING FOUNDATION K BACKFILL X FRAMING SEPTIC OUGH PLUMBING ` FINAL ELECTRICAL ( INSULATION —WOOUSTOVE/ FIREPLACE REMARKS APPROVAL N/A YES Nd CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/ PORCH/ STEPS/RAILI GS RELIEF VALVES FURNACE/HOT WATE OP RA NG BASEMENT INSULATION/DUC R INTERIOR TRIM/ PRIVACY DOORS FINISH FLOORS : BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABL OTHER FLOORS CARPETS STAIR CLEARANCE/RAILI S HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS /WHOL USE FANS ALL PLUMBING FIX T ES OPERATINt: GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE EPAjlATION FIRE/DEMISE WAgLS DOMPS TER SITE PLAN R; NC RE I EM N S FINAL ELECTRICAL OK TO ISSUE C /O OR C{C COMMENTS : ARRIVE DEPART tINECTOR Ckec BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.Q . 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATE _f PERMIT NO . C ' SOIL TYPE - Sand - Loam - Clay Percolation 'Test Required? YES ~ - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption fielde total ength Length of each trench Depth Of trenches Size of gravel SEEPAGE PITS4Number oft --- Size- ft. X �- Gravel size ---- -- e PIPING . S ' Type Bldg . to tank Tank to list. box Disto box to field/ Openings sealed? ES O Partial LOCATION/SEP^A ONS = £t. Foundation to ank Foundation t absorption ft. Absorption o lot line ft. Separatio of pits LOCATI OF SYSTEM ON PR ERTY (circle one) Front Rear - Left side - Right side - SYSTEM USE APPROVED ES NO } O Buildin In pector 01/86 rnd vl w 0 --- C I P er TOWN OF QUEENSBURY l FIRE MARSHAL � ? t RTELEPHONE � NEW 0 ( 5I8} 745-4424RK 4 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATIO ©ATEuA) I PERMITS 9 APPROVED N/Aj YESI NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS AUTO , EXTINGUISHING SYS --- HOOD INSTALLATION AUTO , SPRINKLER SYSTE ---- ALARM SYSTEM INTERIOR FINISH STORAGE CLEARANCE SPRINKLE CLEARANCE O HEATING NITS REQUIRED S I AGE CHIMNE WOODS VE FIRE ACE-MAS NR FIR LACE-FACTORY SUI T REMARKS : OK TO TIiIS dAT£ � �c� t� tv f; 2/015 INSP CTOR �vax BUILDING and ZONING DEPARTMENT Bay and Havifand Road, R.D. I Sox 98 oueensbury. New York 12601 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT ION � 11 t �A,'n r a ` .4 �► � DATE / PERMIT W .�--F� SOIL TYPE -(San ' - Loam - clay Percolation 'Test Required? YES percolation rat - Min/Inch _ TYPE of SYSTEM: AbSorpti.on field , otal ength_ _ Length of each tre ch Depth of trenches -- Size of gravel SEEPAGE PITS*Number of) Size, ft. X Gravel s PIPING : Size 'Type Bldgo to tank '4+ � � 14~ Tank to dist . x D4 st. box to £field it rPv t openings se ea? YES NO partial LOCATION/ EPARATI S = ft. Foundat n to tan ft � #,,� � Founda on to abs rption ft Absor ion to to line Sepa aton of pi s t. i {circle one) TION OF SYST ON PROP TY F nt - <69r - ft si - Right. si�d/e� - I3T5 : � � M ( lji �jU1t G4SfT '`�}{ SYSTEM USE APPROVED YES COO Building I Spector Ol/86 and vl 4 Z 4� qw WAN t� �• ;:`fix: � I, �, , 22 a , ' r' • 'ti ,dooe 74 �. �' air �Jq ' �� • ss = 33 "- •fir W r© " q�'' ,.` _ .., �,r' � ` �-- --'' L 1 Q ..�"r•� '^'^ ~ ''..^ fit' +' %T Y M vft stomp TOWN OF QUEENSBURY FIRE MARSHAL QTELEPHONE � NEW 0( 518) 745- 4424RK 4 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED 1 f NAME LOCATION_} DATE_ PERMIT# APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHE S AUTO . EXTINGUIS ING SYSTEM HOOD INSTALLATI N AUTO , SPRINKLER SYSTEM ALARM SYSTEM INTERIOR FINISHES STORAGE : CLEARANCE TO SPR LERS CLEARANCE TO HE IN UNITS REQUIRED SIGNAGE CHIMNEY WOODSTOVE FIREPLACE- ONR FIREPLACE- F CTORY BUILT REMARKS : OK TO THIS DATE Cat-- tD C' �-t C * C.ha,2,' o Lvd, 2/015 iNSPEC OR 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 LOCATION_ DATE / ' ��t-PERMIT # TYPE OF STRUCTUREf RECHECK APPROVED N /A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR TS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 46 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 PLAC PLUMBING UNDER SLAB FRAMING : JACK STUDS /HEADERS BRACING/ BRIDGING - .JOIST HANGERS -- JACK POSTS /MAIN BEAN! FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN INSULATION: - FOUNDATION WALL INTERIOR FOUNDATION WAL EXTERIOR FLOORS WALLS CEILING DUCT WO ,R PIPING IN UNH TED SPAC ES REMARKS ARRIVE DEPART INSPECTOR ' J TOWN OF QUEENSSURY FIRE MARSHAL QTELEPHONE � NEW 0 ( 518 ) 745- 4424RK 4 FIRE MARSHAL INSPECTION 'REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE PERMIT# — �� � rJCC's2 _ AA YE S N/ NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING t FIRE EXTINGUISHERS _.. AUTO . EXTINGU SHING SYS sM HOOD INSTALL ION AUTO . SPRINKL R S STEM ALARM SYSTEM INTERIOR FINISHES STORAGE : CLEARANCE TO SP NKLERS� CLEARANCE TO A NG UNITS REQUIRED SIGNAGE CHIMNEY WOODSTUV E FIREPLACE— ON ,,&I REPLACE— F CTORY BUILTi 3 REMARKS : � OK TO THIS DATE AL 2/015 I SPECTOR TOM OF QUEENSBIlRY BUILDING 53 D BCODES AY ROAD DEPARTMENT QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 792~ 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR NSpECTION RECEIVED RA14E LOCATION DATE PERMIT ! �'�-'- --o IZ- TYPE OF STRUCTURE APPROVED RECHECK N/A YES NO F007 NGS/PIERS MONOLITHIC POUR FORM ��- REINFORCEMENT IN PLAN~ THE CONTRACTOR i5 RESPONSE FOR PROVIDING PROTECTIOII FROM FREEZING FOR 48 PLACE"Elff OF HOURS THE FOLLOWING THE CONCRETEw MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALLPOUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING ,� °°°° BACKFILL APPROVAL }ROUGH PLUMBING PLUMBING VENT/VEN S IN LACE _ PLUMBING UNDER SLAB Y >< I( FRAMING : JACK STUDS /HEADERS BRACING/BRIDGING_ JOIST HANGERS - JACK POSTS /MAIN BEAM FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN INSULATION : FOUNDATION WALLS INT I R R- FOUNDATION WALLS EX ERIOR RRi FLOORS R- WALLS CEILING DUCT WORK OR PI NG IN UN EA ED SPACES ARRIVE f. DEPART I ``�C NS E T TOWN OF QUEEN58URY ' ' 1 BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY12804 TELEPHONE } ( 518)NEW0RK 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST F R INSPECTION RECEIVED L NAME ` t � LOCATION 7 DATE � ��PERMIT # -^ TYPE OF STRUCTURE APPROVED RECHECK , r NJA [ YES NO OOTINGSJPIERS ONOLITHIC POUR FOR -- REINFORCEMENT IN PL E THE. CONTRACTOR IS R PdiNSIB FOR PROVIDING 48 HOU OLLO NG R ION FR I FREEZINGZINGFO THE PLACEMENT OF THE -CONCRE7FE . MATERIALS FOR THIS P*POSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE ,. FOUNDATION/DAMPROOFING_ � BACKFILL APPROVAL_ ROUGH PLUMBING ; PLUMBING VENT/VEN S IN PUCE PLUMBING UNDER SLAB FRAMING : JACK STUD /HEADERS -- BRACING/BRIDGING JOIST HANGERS - JACK POSTS/MAIN B AM --�- HEATING ROUGH- IN INSULATION ; FOUNDATION ALL IN ERIO R- FOUNDATION WALL EXTERIOR RR- FLOORS R- WALLS R- CEILING DUCT WORK OR PING IN UNHEATED SPACES REMARKS 1 21-4 , cam — ' �+ rauJ — ,� c DEPART ZAD -6() INSP TOR TOWN OF QUEENS URY BUILDING AND CODES DEPARTMENT 531 BAY ROAD Q � NEW 0 TELEPHONE (518) 745-- 4447 BUILDING INSPECTOR' S REPORT REQUES�FOR INSPECTION RECEIVED NAME ' .LI LOCATION DATEq2 �PERNIT # TYPE OO[F- STRUCTURE RECHECK APPROVED N/A IYES1 NO OOTINGS/PIERS ONOLITHIC POUR FORM -- REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSI$LE 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 , ACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PL CE PLUMBING UNDER SLAB FRAMING : JACK SIUDSJHEADERS -- BRACING/BRIDGING - JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH- IN INSULATION : FOUNDATION WALLS IN ER OR R- ,. FOUNDATION WALLS EXTERIa R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMAR� � S ARRIVE DEPART /L( � IN PE OR TOWN OF QUEEmSh6RY Ira BUILDING AND CODES DEPARTME11 r 531 BAY ROAD r-7 QUEENSBURY , NEW YORK 12804 TELEPHONE (518 ) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST F INSPECTION RECEIVED NAME I LOCATION � ILI n& nC-es %vts tkk', DATE PERMIT # 'r 9 TYPE OF STRU TUBE , --y ) RECHECK APPROV D f OTINGS/PIERS [ N/A E NO ONOLITHIC 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 r ROUGH PLUMBING. PLUMBING VENT/VENTS IN PLAC PLUMBING UNDER SLAB FRAMING • JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN B M HEATING ROUGH- IN INSULATION : FOUNDATION -WA US INTER R R- FOUNDATION WAAS EXTERIOR R- FLOORS R- WALLS CEILING R- DUCT WORK :0R PIPING IN UNHEATED SPACES REMARKS : ; ;t ARRIVE f , DEPART � �1f INSPECTOR MIDDLE [DEPARTMENT INSPECTION AGENCY, INC. ��� F� •, � . - :National: 4u#IrtAkrs . " . , 1337" IYllest Chester Pike, West Chester, PA r10360 Date: City, Town or Township County -� � State Location/Address e E � #1£ orate in Rural Area Please Attach irlectiar } Pole # Owner C. `" f f ,ol Permit # Occupied As r Ag� � '" - Building: New El OWE] .L Occupant `-% +1 brk Araaln Building Floor #. etc.) : App. for: Wiring Service or: i=- e: : Read for Inspection : .' I: " Syr* ' Y Fee Remitted - $ `' . , - � _Cash � Check �] -Nl:l�}: � � Iiiiiak+e,P.ayabte To M:D. I.A. Number of Rough Wiring Cltfttl¢is ' Elect. Heat son 7r 1¢00 12" 1"0 17s¢ z¢¢¢ szso zsao 275111301101 +. Switches Amp. Service surfac Unit Dishwasher Range Lighting Receptacles Water Heater CAI Conditioner Dryer Pump Number of Fixtures Chen - €iartlage Disposal Wiring and Controls .for Burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P, 1/2 vi 1/10 1/8 ,1/6 1/4 1/3 1/2 3/4 1 1+h y , 3 ' 10 15 20 25 30 40 56 75" Idl Mark Number .. t-- - = z'. of Each Size ApiMicant's S4patureA�on. Licence # Permit # T/A ' Utlhty- (NAME) FFIC LOCATION)' -Applicant's (City)- (State). (Zip1 Service Request # Phone # Electrician : DAYS—AiEC'EIVED: DATE INSPECTED: rrrect Location : '`"Fain. as'Above © or: tice Label Rough Wiring Outlets Surface °Unit IOven Switches Range . Garbag a Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Beyer Amp, Service Equ'i resent Burner, Wiring & Controls for Ar lfeeeptac1e " Amp. Service Conductors Pump Vent Fans-" MOTORS H.P. I/ 1 / 1/fi 1/4 1/3 1/2 3/ -4 1 1W 27 " a 4r 16 15 20 25 30 40 so 75 100 Mark Number of Each Size Elect, Ieit ,Qe 750; 14¢¢ 1290 1500 1736 z¢¢O xzSO 2500 2750 30vD Q RW Progress : Inc, ED LKD Contractor = CFT Violation : Work Comp. 0 Inc. ED CASH Q L/A IOwner Fee CHK # i::/A - Clue N10. # D IPA Mucipe! INV #k Applicant Date : Other Side Q Utility - Owner Cut in Card Q Temp # .:. Date _ I SfECTDRS SIGNATURE Fine{ # Data , t f .i'' APPLICATION FORM NO. 250 EL 11/80 4ti a� V a ;. . ` t k ; ;. , S� oe r )Ilk to It IF die r LLLL IF .. l a J 0 � ,, ,,,� .�*�.�+ �� �� � `'�t ��'� f . � • {�� � a`5�� � lit L �• y S, ��s. � • � „ �Y yy al , � � .fir _. 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