1991-230 q} ... . ,. . l� _
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date January 6 19 98
• This is to certify that work requested to be done as shown by Permit No. 1.230
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied,as a
LOT 2 #14 LOREN DRIVE
Location
Owner LEIILAND ESTATES
TAX MAP NO. 74 , -'2-2 • By Order Town Board
TOWN OF QUEENSBURY.f
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91-230
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to LEHLAND ESTATES
OWNER of property located at Lot #2 Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Single family dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
Guido Passarelli
45 Herald Drive
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name
r
Passarelli/Cerrone
r-
3. CONTRACTOR or BUILDER'S Address
same (r'
N
4. ARCHITECT'S Name
5. ARCHITECT'S Address
1-
-
6. TYPE of Construction- (Please indicate by X)
(x)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No- 28')(42' Single family dwelling as per plot plan, specifications and
application including two-car attached garage and septic system.
8. Proposed Use
s
O
Single family dwelling fD
O
$ 324.00 92
PERMIT FEE PAID -THIS PERMIT EXPIRES April 23 19
(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 23rd Day of„ j April 19 91
SIGNED BY �./U) - s i i for the Town of Queensbury
Buildingean'd Zoning Insptor �G
CD
rD
/
'-
/;OWN OF QUEENSBURY f
REVIEWED BY FEE PAID $ , / 45/6",' 3�Oe
QUI_EP+QUEENSBURY
ISQ
RECEIVED
liar
� PERMIT NO. 9/ 5D
2
BUILDING PERMIT APPLICATION
APR 2 1991
BLDG. & CODE DEPT.
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.
• • • • • • • • • * a * a * * * ar. a * * * * * * * * * * • * * * * * * * • *
The owner of this property is: J/�/� T,��,r._64 ,
P.O. Address ..r dZ �/j � ,/�c1 Tel. j jv�
Property Location �67A/ 4 .) /G (aV Tax Map No. /7/ // 997
Has there been any split of this property since October 1, 1988? / a/
If yes Planning Board Review is necessary. ,�/ yes no
SUBDIVISION NAME, IF APPLICABLE //i!.1i -r=-.1/.4 LOT NO. i
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
•
NATURE OF PROPOSED WORK: • ESI'rMATED MARKET VALUE OF •
. Construction •
of a new building * CONSTRUCTION: $ ; n t O?)
/
Addition to a building * COMPLETE INFORMATION•REQUIRE� FIB OW:
• Size of property /s 4 ' ft x /�(� 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 yard 627 ft. Rear yard /yS--- ft.
* Side yards /‘ ft. and S1 ft.
• If on corner, setback from side street 6,5- ft.
GROSS AREA OF PROPOSED STRUCTURE a
1st Floor �2.,xf sq. ft. /C/V •
�J • OCCUPANCY INFORMATION
2nd Floor/ 2 sq. ft. • ' Primarym Building -
9 °/ - • i/ One Family Dwelling
Other Floors sq. ft.�-�
.—
(hot cellar or baset 1 i � * Two Family Dwelling
TOTAL FLOOR AREA24/5Q sq. ft.
• Multiple Dwelling/Number of units
Size of new structure 'r �?ift.
ft x J Business
Foundation-pier/slab/c:=.: / rtitudfull a Industrial
(circle u(i • Other
•
No. of stories (habitable space) 7/ •
Height (grade to ridge) 3/ ft. • If addition, what will use be?
If residential, no. of families / a
No. of rooms(excluding baths) .7 a Accessory Building
No. of bedrooms •
No. of bathrooms a _Detached Garage ONE/TWO Car
Primary heating system c
+ Attached Garage ON WO Car
Type of fuel �- * _Private storage building
No. of fireplaces to be installed / •
• Other
Will a wood stove be installed
Central Air conditioning e'v •
OV• ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING PECIFICATIONS:
Type of construction, wood frame, fire safe, etc. �� 1Will any second-hand or upgraded lumber be used? If so, for what?
Foundation wall material � . � ���-ram Thickness i1/
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft.
Will there be a basement? jam`( Will any portion be used as living space? 4/0
(If so, what portion? sq ft. Type of use?
Type of roof - sloped/flat/shed/otheraMaterial of roof cq, / ,r
Size, wood studs Z. "x " spacing/ " o.c. length7P g t.
Joists (floor beams) 1st floor 2., "x /Q " spacing /'/"o.c. span /y ft.
Joist (floor beams) 2nd floor _ "x /O " spacing IC "o.c. span / ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing " o.c. span ft.
Exterior wall finish ,ei of what material? `
S
Interior wall finish �L "
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
5-/ 7 ae X
Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure,
self-closing device be provided? Cirf.
Will a flue-lined chimney be installed? ,-,; Height above roof 2 ft. 0 "
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private wellv�I/iC•� i
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
NAME OF BUILDEIj� ,14/717.eja/y DDRESS ,�� /� � frz .TEL. NO. /5-'d L�
NAME OF PLUMBEI / ',,46, — ADDRESS /ate/no r TEL. NO. .:69'-'37f7
NAME OF MASON,.,/ /, , ,Ap ADDRESS .�Qir��/�/ - TEL. NO.e*/2 Wei
NAME OF ELECTRICIAN / AV_ ADDRESS / 6 TEL. NO.7j 7-1 9/
DECLARATION
To the best of my knowledge and belief the statements contained in this application, together with the
plans and specifications submitted, are a true and complete statement of all proposed work to be done on
the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
all other laws pertaining to the proposed work shall be complied with, whether specified or not, and that
such work is authorized by the owner.
Signature
Owner, owner's agent, architect, contractor
SPECIAL CONDITIONS OF THE PERMIT:
BY
ENERGY CODE COMPLIANCE APPLICATION'
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
TOWN OF QUEENS-BUM
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) RECEIVED
PART 6 - Thermal Rating - Component Trade Offs - 1. & 2 Family Dwelling 2 2 1991
Multi-Family Dwelling
(3 Stories or Less)
& CODE DEPT.
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
.c2:;?) learg-Cee Zit
APPLICANTS NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - Z D Sq. Ft. .
2. Type of Heat -gid Elec. Base Board Other
3. Is Building Mechanically Cooled? v YES NO
4. Percentage of Area of Windows and Doors Over 17% Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R
B. Exterior Walls R _
C. Glazed Area R
D. Exterior Doors R�
E. Floors over unheated spaces R A/d/./ .
F. Edge of Slab on Grade (Heated Building) . R
G. Basement/Cellar Walls (Above Grade)
H. Basement/Cellar Walls (Below Grade) • R l 3
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device/
A. Conforms to minimum efficiency per code / YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140* WILL.NOT BE EXCEEDED
APPLICANT S SIGNATURE ATE TELEPHONE NUMBER
INSPECTOR'S REMARKS : ~
410.
R i BY
/__ TOWN OF QUEENSBUFADWN OF QUEENSRUR'rl
RECEIVED
alt#ty APPLICATION FOR SEPTIC DISPOSAL PERMIT
� 1.Z 9/ APR 2 21991
DATE:
LOCATION OF PROPERTY FOR INSTALLATION 74 Z eJA/' CODE DEPT.
Owner's Name: 4"," k4ir�/��
Address: do;fed %Z Ozerxee6144
Installer' s Name: A/ el ,� , Telephone: /'(
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) rU
Topography: Circle onedilil) Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: not required required
Rate - Min. Per Inch ri-i—c7rHur ---)
Domestic water supply: Circle one: Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank 4,7) gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 6 feet/Total system length ZY7) feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #.. /Depth or Thickness feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
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: ��/�
1
•
•
lIptiC System Inspections,:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitced to the Building Department at least 24 .hours before start
of construction and shall include a plot plan showing:
1.) the proposed location of tho system
2.) location and distance co lot lines
3.) location and distance to structures
4.) location and distance co any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywells
B. Nu system shall be covered before inspection and approval by the _
uuilding inspuctor. Failure to comply-with this requirement may
result in the uncovering of chd 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 co produce said plot plan at time of inspection may
result in an immediace work stoppage.
D. Should unforeseen problems during construction prevent proper installa-
tion, alteration or repair of an approved system, a new proposal must
bu submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
•
RQmarks:
•
•
•
TOWN OF QUEENSBURT�WN OF QUEENSBUR'1
%.. RECEIVED
APPLICATION FOR SEPTIC DISPOSAL PERMIT
APR 2 21991
DATE: >" 2/,f/
1 / � CODE DEPT,
LO
CATION .OF PROPERTY FOR INSTALLATIONYlJ7 #2 L ��c � 'r-�
Owner's Name:
Address: ledejaZ 77/L. 4.G4W-4k‘U./-
. -Installer' s Name: // (��, .ef722-,--- • Telephone: 7C trp(L/
Number of bedrooms (residential only)_ J .
..f,4
Total daily flow (compute @ 150 ;gal pebedroom) ,(0
Topography: Circle one. Rolling Steep Slope :'% of Slope
Soil Nature: Circle one: Sande Loam ' Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one:. not required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Mug nicipa Well Other
If .domestic water .supply is a well :
_Separation: Water supply from any septic absorption .feet.
PROPOSED SYSTEM: Septic Tank 4n l) gal . (minimum size: 1,000 gal ) -
TILE FIELD: Each Trench 10 feet/Total system length. 'an) feet
SEEPAGE PIT(S): • Number -of /Size . each feet
by feet
Size of stone to be used it.. /Depth or Thickness • feet -
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks • Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
•
• 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 -at DATE:, /"' �� 9f
�
/
' |
/
\
.
'
'
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~_____
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' '-
TOWN OF QUEENSBURY
Bay at Haviland Roads,Queensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date C�/�,P�/ /2/ ' - 19 Permit 1�I0.9/— �, �
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant,to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter prem.i es for the required inspections.
Applicant's Name� 1j ;�.�/Sy,ae'el APPLIANCE TYPE
/ Stove Coal Wood
2JX Cam
Address , C Furnace Hot Air Boiler
Zero Clearance ,/ • Circulating Unit
C �ll/L,'ii�_ Zip - i .
Phone (5Q"— �4./i/ y: . ,
If Non-Masonr
Owner's Name j3.yl o 4h4/47.--
Manufacturer
Address Model Outlet Size
Zip Listed by Number
Phone
CHIMNEY TYPE
Masonry: Block Brick Stone
•
Property�local ion cif proposed construction Flue: Tile Steel
/// �� i .� ���J� ,,J- Size:
,474 ¢ Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall "" Triple Wall
ANI) CHIMNEYS. 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 QUEENSBURY, NEW YORK
.Department: Fire Marshal Amount Collected Amount Refunded
Code Number Title
A173 3389 (190)Public Safety .
A233 2655 (230) Minor Sales
•
I: . Colic (sled from or_Re unded to: ,lifte d �1/ i.(/G�f .0� 7/1,{�/l'4e Nate__
`�- _ 0 7 .
• Address:
Dated: Town Clerk or Deput Cl � � 7----
Dated:
l�p�r�-- 1\(�t o� .
V ) -
White:Applicant Yellow.and Pink:Cashier's Department Goldenrod:Fire Marshal
i'''' `':.- MIDDLE DEPARTMENTINSPECTION AGENCY; INC..
-/ ., National Headquarters
...-••� 1g37 West Chester Pike,West Chester, PA 19380
z
APPLICANT COMPLETES THIS SECTION Date: ;77/� "/
•
�� _ -11 4 " County /S I'A,' ,z State //-� �,
City, Town or Township [��f �� �.f-fi.-
Location/Address rr, -2. .,./ ,•- ,,�f 1 %' ` r- -
�� (If Located in Ural Area Please Attach Directions) .Pole # -
Owner f'c /��-a fr y-7!c /-41, ( r - - , :1,7)
f � �� Permit #
Occupied As ;r,,, r',/-Ja / Building: New❑ .Old❑
Occupant • -
Wok Area in Building (Floor #,etc.):
App. for: Wiring n Service n or: _ Ready for Inspection: _'
Fee Remitted-$ Cash n Check n M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250'1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat
•
Switches
Lighting Amp. Service Surface Unit Dishwasher __ Range
Receptacles 1 Water Heater Air Conditioner Dryer Pump
Number of Fixtures Oven - Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment: ,
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2'3/4 1 1'/z '2 3' 5 , 71/2 10 ' 15 20 25 30 40 50 75 100
Mark Number
of Each Size •
Applicant's : ->�
Signature --.2;-";(-''' �' —-_ ---�- _ License # Permit #
_..� _
T/A Utility:
Applicant's Address: (NAME) (OFFICE LOCATION)
. (City) (State) - (Zip) Service Request #
Phone # Electrician:
•
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED: -
Correct Location: Same as Above pi or: - • - -
Red Notice Label 1 j
Rough Wiring Outlets Surface Unit - Oven ,
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer .
Amp. Service Equipment Burner,Wiring &Controls for Amp. Receptacle
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1,/2 2 3 5 71 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
II500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECTFEE FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
1 1 CFT Violation: Work Comp.❑ Inc. ❑ CASH ❑
n L/A - Owner
• Fee CH K #
L/A
Due MO #
n IPA Municipal ,
INV #
Date: Other Side I I - • Utility - Applicant ❑❑
Owner
Cut in Card n Temp # Date
n Final # Date INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 11/89
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 518-761-8201
January 7, 1998
File: 91-230, Lot 2, #14 Loren Drive
To Whom It May Concern:
It is understood that the factory-built gas fireplace located on the second floor
of the above address is not properly set up at this time and cannot be used until the
installation is properly completed and said fireplace is inspected.
This office will not prevent issuance of a certificate of occupancy providing
such inspection will be scheduled as soon as the fireplace is ready to properly
operate.
C. A. Grant
Fire Marshal
cc: Mike Lamott
/001,1�//EN TO 60 TAKE IRE ALARiL/S SER/0//S/Y REACT FAST TO MT
"HOME OF NATURAL BEAUTY. . .A GOOD PLACE TO LIVE"
SETTLED 1763
TOWN OF QUEENSBURY
l\'5, .},. FIRE MARSHAL
- ;. QUEENSBURY, NY 12804
(518) 761-8205 .
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED OAP
NAME 151/Y/2,14
LOCATION /q2d/`�-')1(
DATE PERMIT # f V 9/-230
APPROVED
N/A YES NO
EXITS
AISLE WIDTH
EXIT SIGNS
EMERGENC LIGHTING
FIRE EXTING ISHERS
AUTO. EXTIN+ UISHING SYSTEM
HOOD INSTA LATION
AUTO. SPRINK ER SYSTEM
ALARM SYSTE
INTERIOR FINISH
STORAGE:
CLEARANCE TO`SPRIN LERS
CLEARANCE TO HEAT) G UNITS
REQUIRED SIGNAGE /
CHIMNEY /
WOODSTOVE / \ / ,
FIREPLACE-MASONRY \
FIREPLACE-E/CTpRY/ BUIhT / G12v� ix
((tea
REMARKS: ar 0 OK TO THIS DATE
A)-kiad thrz. ,-grprce o J-6-9j"
/-1-AC
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drvafrop_-
INSPSLIP.PUB I SPA OR
«'' TOWN OF QUEENSBURY
, ..fww�^' , BUILDIG & CODE ENFORCEMENT
-r 3 742 BAY ROAD
' QUEENSBURY NY 12804
k"- ` ,' } (518)745-4447 a
iv,„: 12° 7DEPART: \2 L1 INS .
FINAL INSPECTION REPORT - RESIDE TIAL
DATE INSPECTION REQUEST RECEIVED:
NAME `'PA,�I-1��}Q __All__I
LOCATION ' _ ii__P rk V P'-T'p ES
DATE t'_19Cr PERMIT # ct t^Z
TYPE OF STRU TURE
FOOTINGS_V FOUN TION ➢ KFILL / ING v1
ROUGH PLUMBING tI SEPTIC i/j INSULATION `/
FINAL ELECT CAL WOODSTWE OR FIREPLACE
l N/A YES HO
CHIMNEY HEIGHT/B VENT/HE GHT
PLUMBING VENT ::////
ROOFING
EXTERIOR FINISH
‘11/;/
DECK/PORCH/STEPS/RAk. INGS
RELIEF VALVES
1. ://:
FURNACE/HOT WATER 'PERA ING
INTERIOR TRIM/PR ACY DOI'RS
FINISH FLOORS:
BATH/KITCHEN ATERTIGHT
OTHER FLOORS WEEPABLE
OTHER FLOORS LARPETED
/1
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS.
/
/////://11/
BATHROOM FANS
J
PLUMBING FIXTURES // //
FOUNDATION INSULATION ✓/
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL `"
SITE PLAN/VARIANCE REQ. �
FINAL SURVEYPLOT PLAN `j//
OK TO ISSUE C/O OR C/C Ek
C j Rc% Ateo t _ UoR L� FOOl fi01
S 0 .-B1-1 o rJ4.1 c3ce x, %t3 L-Ki i3
0 vtty F—arc' . C •
LO 1:;‘ 1)-- vq-kett _v___6 c--- , c_v_k_LPIV-
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p „ C„t\)\T i 1 1UA V' --M201A(--; LFFic
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED / /// / /
NAME
LOCATION )10(...27, '% 4 Q-
DATE / i////�f( PERMIT# 9/ 50
7 `
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM 5 I
a r
r
INTERIOR FINISHES x
STORAGE: • r\
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE . l
C
CHIMNEY ,f
WOODSTOVE
FIREPLACE-MASONRY ! b�
•/FIREPLACE-FACTORY BUILT /• . ) \.
REMARKS: • Li OK TO THIS,.DATE
Cd, 4Z). .&
ARRIVE
DEPART AV-
INSPECTOR-
./97
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME , 17/ cit CaziO
LOCATIONj ,
DATE /(//7./%o PERMIT# 0/-,?,
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS 1
EMERGENCY LIGHTING 1
1
FIRE EXTINGUISHERS /
AUTO. EXTINGUISHING SYSTEM /
HOOD INSTALLATION f
AUTO. SPRINKLER SYSTEM \ /
ALARM SYSTEM /
f,
INTERIOR FINISHES
STORAGE: f
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE/ `1
/
CHIMNEY
WOODSTOVE I
• FIREPLACE-MSONRY
FIREPLACE-FACTORY BUILT
REMARKS: 1X( 0K TO THIS DATE
11`,"
72.-J-3/1 291 c 74/1-N7-'6:14A2
ARRIVE -rb ��
DEPART /O�� �" ' `�
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPO T
REQUEST FOR INSPECTION RECEIVED (/13' Q/
NAME '444110te 0-000
LOCATION Z'
DATE W( � /9/ PERMIT # 7 /-c2-30
TYPE OF STRUCTURE (D
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM .
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE`'
FOUNDATION/WALL POUR ' :t
REINFORCEMENT IN PLACE,
FOUNDATION/DAMPROOFING:
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN. BEAM
FIRESTOPPING
WALLS
CEILING •
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R- //
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE /0
DEPART,/
/0 /414
I NS PEC OR '�
TOWN OF QUEENSBURV
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED g Z32
NAME , -e
LOCATION `a)4p2.
DATE PERMIT # '9,4`0Z
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION!, FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR r'
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING ✓
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM;'
FIRES TOPPING
WALLS ?'
CEILING 1
FIREWALLS 3
HEATING ROUGH-IN ,
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS WALLS R-
CEILING IR-
DUCT WORK OR PIPING IN UNHEATED
SPACES
1\,
REMARKS:
i. lleaI , I/6 y
• 1.erticeti5 'a--7-7 &aril-ad Cht>d---e3
3, ,i&• o •Jo r`d' /9
ARRIVE 6% 30
DEPART
PECTOR
.)e Pm c lh)YS &rIiNz -
•
_/own o f Queen3bur j
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ED,`1r\oVAA iS--ef i 7
LOCATION 4 PA) gr)
DATE S1) / ! ! PERMIT NO. 9 / —3
SOIL TYPE -P-;'Loam - .Clay -
Percolation Test Required,? YES - NO
Percolation rate Min/Inch
i'
TYPE of SYSTEM: 1 �t
Absorption field; total' length U .
Length of each t4nchj 5O'
Depth of trenches` _;.
Size of gravel fi. I '
SEEPAGE PITS{Numbed/of)
Size- ft. X Aft.
Gravel size , / \
PIPING: ) Size Type
Bldg. to tank \, z / GQ .
Tank to dist. box j 2 _
Dist. box to feld/pit .e i
Openings seal? YES;, NO Partial
LOCATION/SEP RATIONS: .i.�
Foundation •o tank Q,ft.
Foundation to absorption „75'ft. •
Absorption: to lot line ID ft.
Separation of pits (0 ft.
LOCATION/OF SYSTEM ON PROPBRT _ -. one)
Front - Rear - Left side - ,•ight side
COMMENTd:
. \\\\' .,
SYSTEM USE APPROVED ® NO \
Bu' ding Insp ctor
01/86 and vl
TOWN OF QUEENSBURV
BUILDING AND CODES DEPARTMENT
531 BAY ROAD / 19
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED 4/U%i/2/h
NAME 'E �.. G(/ P et)
LOCATION 4-,/.0
DATE '0. --///i/ PERMIT # 9/�4'M
TYPE OF STRUCTURE 4 �f/y/).z[ei�f�,.IG). ( .1
RECHECK APPROVED
N/A YES NO
)(FOOTINGS/PIERS �/
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE :1
THE CONTRACTOR IS RESPONSIBLE /
FOR PROVIDING PROTECTION FROM . �,
FREEZING FOR 48 HOURS FOLLOWING / :;
THE PLACEMENT OF THE CONCRETE. /
MATERIALS FOR THIS PURPOSE ON S. TE I
FOUNDATION/WALL POUR .� i�
REINFORCEMENT IN PLACE 4 ts'
FOUNDATION/DAMPROOFING ) P
BACKFILL APPROVAL Y f
ROUGH PLUMBING 1
PLUMBING VENT/VENTS IN PLACES i
PLUMBING UNDER SLAB . ,il /
FRAMING: :1 /
JACK STUDS/HEADERS ,e
BRACING/BRIDGING Y I
JOIST HANGERS 1
JACK POSTS/MAIN BEAM ' /
FIRESTOPPING i,;
WALLS ,fir
CEILING , P
FIREWALLS I i
HEATING ROUGH-IN I V
INSULATION: / A
FOUNDATION WALLS IN,TERI0R R-
FOUNDATION WALLS E.TERIQ1 R-
FLOORS R-
WALLS / R-
CEILING /' 1 R-
DUCT WORK OR PIPING IN UNHEATED
SPACES r "
/
REMARKS: / \ul
ARRIVE
DEPART I - •rig / gyp
INSPECTi' �
!
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 „L—edk 11'1 (1 r -G'�
LOCATION (5 ,
DATE I/06i / PERMIT # /
TYPE OF STRUCTURE
RECHECK � APPROVED
N/A YES NO
FOOTINGS/PIERS `6?, 14fe,t4(�
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWINGi
THE PLACEMENT OF THE\CONCRETE. j
MATERIALS FOR THIS PURPOSE ON SIITE
FOUNDATION/WALL POUR \
REINFORCEMENT IN PLACE \
;' /
FOUNDATION/DAMPROOFING "1 / Vr/
BACKFILL APPROVAL \ / i/
ROUGH PLUMBING \
PLUMBING VENT/VENTS IN PLACE'
PLUMBING UNDER SLAB \,
FRAMING:
JACK STUDS/HEADERS / \
BRACING/BRIDGING I \
JOIST HANGERS
JACK POSTS/MAIN BEAM I
HEATING ROUGH-IN /
INSULATION: ..
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS �' R-
WALLS { R-
CEILING / R-
DUCT WORK OR PIPING, IN UNHEATED ',
SPACES l t
1
REMARKS:
ARRIVE /'0
DEPART / (` /jt, '
(/ INSPECTOR
! i
, .
0 C 2-119 dl
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