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1991-249 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date /.' 19 23, This is to certify that work requested to be done as shown by Permit No. 91-249 has been completed. This structure may be occupied as a Dormer for Bathroom Location 15 Thomas Street Owner John F. Meinrenken By Order Town Board TOWN OF QUEENSBURY V Director.of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 91-249 WARREN COUNTY, NEW YORK 1-4 PERMISSION is hereby granted to John F. Meinrenken ►v w OWNER of property located at 15 Thomas Street Street, Road or Ave. in the Town of Queensbury,To Construct or place a Alteration to dwelling at the above location in accordance to application together with plot plans and other information hereto filed and c approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. T 1. OWNER'S Address is Same rD 1 ro 2. CONTRACTOR or BUILDER'S Name O 7C' Same 3. CONTRACTOR or BUILDER'S Address --I 0 2 N 4. ARCHITECT'S Name ey+ fD rD e+ 5. ARCHITECT'S Address T� rF rD r+ 6. TYPE of Construction—(Please indicate by X) O ( X Wood Frame ( ) Masonry ( )Steel ( ) e+ O 7. PLANS and Specifications =ry No. 70 sg ft Alteration to Dwelling as -per plot plan specifications and application to 8. Proposed Use Dormer for a bathroom $ 50.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 30, 19 92 (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 30th Day of April 19 91 SIGNED BY \ � 14� �n^ for the Town of Queensbury Building and Zoning Inspectors TOWN OF QUEENSBURY REVIEWED B TO �d OF QUEENSBURY �a �''"1 RECEIVED gilla FEE .PAID $ 5() � ,� i � PERMIT NO. q/-24q j � � APR 291991 BUILDING PERMIT APPLICATION 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. * * * • * * * • * * • * *• /• • * �* # * * * * * * * • * * * * * * * * * * * * * * * The owner of this property is: /c7h� F'r h'lF//J/2�i/t)) 71) Ole 7 ---� .442H P.O. Address Tel. -P- 9 ,2 :/0°,72 2 Property Location /5— 01-41 6/J -, 6N7 1 ado Tax Map No. M / 2/ Has there been any split of this property since October 1, 1988? / If yes Planning Board Review is necessary. yes no SUBDIVISION NAME, IF APPLICABLE LOT NO. THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: * NATURE OF PROPOSED WORK: • ESTIMATED MARKET VALUE OF • Construction of a new building CONSTRUCTION: $ ) 0 . 00 Ad ition to a building • COMPLETE INFORMATION REQUIRED BELOW: ���� Size of property )(O2/a ft x �� ft. teration to a building • Existing Buildings(3) Size 30 Ya ft. x (9-P V2- ft. (no change to exterior dimensions) * -lepes-td building - distance from property line: X Other work (Describe) jai /9rd * Front yard g,5- ft. Rear yard 9O ft. �' * Side yards .4P ft. and ? ft. �/ i�r a. D�r�i;K �o �T�, * GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft. 1st Floor sq. ft. ' OCCUPANCY INFORMATION * 2nd Floor sq. ft. * ' Primary Building - Other Floors sq. ft. * )(One Family Dwelling (not cellar or base:-:Mrt ., Two Family Dwelling TOTAL FLOOR AREA ?0 sq. ft. • Multiple Dwelling/Number of units it • Business Size of new structure 9 9 ft x ( ,2 ft. Foundation-pier/slab/craidd/partial/full • Industrial (circle one) • ° Other + No. of stories (habitable space) • Height (grade to ridge) ft. • If addition, what will use be? ( U/ /1) If residential, no. of families * 4-7 /0 1'Ll - No. of,rooms(excluding baths) + Accessory Building No. of bedrooms ' X Detached Garage ONE WO Car No. of bathrooms * Primary heating system • .__Attached Garage ONE/TWO Car Type of fuel * _Private storage building No. of fireplaces to be, installed ' Other Will a wood stove be installed Central Air conditioning ' OV• ER BUILDING PERMIT APPLICATION CONTINUED - BUILDING:SPECIFICATIONS: Type of'Construction, wood frame, fire safe, etc. Will any second-hand or upgraded lumber be used? If so, for what? • Foundation wall material Thickness 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? Will any portion be used as living space? (If so, what portion? • sq ft. Type of use? Type of roof - sloped/flat/shed/other Material of roof Size, wood studs ,"x " spacing " o.c. length ft. Joists (floor beams) 1st floor "x " spacing "o.c. span ft. Joist (floor beams) 2nd floor "x " spacing "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 of what material? Interior wall finish If a garage is to be attached, describe materials to be used for FIRE SEPARATION: Is there to he an opening between garage and dwelling? If so will a Fire-rated door, enclosure, self-closing device be provided? Will a flue-lined chimney be installed? Height above 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 ft. (A separate application is necessary for any repair or new installation of septic system) NAME OF BUILDERcJe1) /'il 1(,) 71), loADDRESS f d '1-40,44o.)l/ QPyTEL. NO. NAME OF PLUMBER ADDRESS /( / TEL. NO. /i NAME OF MASON 1-,�/J ADDRESS TEL. NO. f� NAME OF ELECTRICIAN C�r�— /t r?/A ADDRESS/0//0 G /� Ur7 ) FTEL. NO. 29,2-cP2 DECLARATION To the best of my Imowledge 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 th, whether specified or not, and that such work is authorized by the owner. Signature 4 0 er, owner's agent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT: • BY ENERGY CODE COMPLIANCE APPLICATION I TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS Compliance Methods: APR_z 1991 PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) BLDG. 8. COPE;OEPT. PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings; Multi-Family Dwellings (3 Stories or Less) PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential PART 4 & 6 - Compliance Methods Require Submission of Worksheets . jOA") /r4 ,-JatJ /..) rAo A- --r%� O�y APPLICANT'S NAME PROPERTY LOCATION / PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area - Sq. Ft. 2. Type of Heat - Elec. Base Board Other 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 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 O OIL- /B R / 9 MDT-T-A-1 , . Exterior Walls ©�L C. Glazed Area R D. Exterior Doors R_ E. Floors over unheated spaces R F. Edge of Slab on Grade (Heated Building) R G. Basement/Cellar Walls (Above Grade) R H. Basement/Cellar Walls (Below Grade) R 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 4? TEMPERATURE CONTROL MAXIMUM SETTING 140* - WILL NOT BE EXCEEDED Vh-07 Old- 9 ---ids, _ r APP CANT S SIGNA URE A TELEPHONE NUMBER INSPECTOR'S REMARKS : D BY . YOU ARE HEREBY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY THE UNDERSIGNED TEMP.# DATE _ .1 CITY OR VILLAGE �'''") TOWNSHIP / COUNTY `�to /=r1)l la l°(� W1l_f"('E-� STREET AND NO.0 AD j POLE NUMBER I..5 /1 o/ 4 s T/-fir T BETWEEN HAT 1W0 CROSS srRE ;S/h PREMISES LOCATED?J SECTION BLOCK LOT OCCUPANTS NAME BUILDING OCCUPANCY OWNERF✓SNAM AND ADDRESS r 7- HOMETELEPHONE UITBER CURRENT SUPPLIED BY FROM THEIR OFFICE WOy)�LEPTON MBEa-- , /�2 / BUILDING IS C- Il f L/,/ NEW❑ OLD)Xte WORK IS NEW ADDITIONAL❑ DEFECTS REMOVED❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE Loca- Lamp Receptacles CIRCUITS ONLY lion Side Attach't H.P. Watts A.W.G. Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION OUT- SIDE SUB- BASE BASE- MENT 1st FL. 2nd FL I '� I FL. .7 • 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. SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA ❑ CONCEALED DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY SERVICE ENTERS BUILDING MANUFACTURER OF SIGN ❑ OVERHEAD ❑ UNDERGROUND DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST DENT E CAT ENTER NUMBER AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. I PRINT NAME AND ADDRESS n DATE/_)APPL to ION I UR F "MIT� ,N A I PP LdCAt /`��l,`jfr.''� /�-J !fV 1..`• pip1 �` /'- ST/REr¢ADJDRF Sop, ^ i J /I' / T /. NE//% -- /C! 2 CITY R POSTSS OFFICE o ZIP CODE LICENSE NO.WHEN APPLICABLE N� � � DA._( r=� .��J.bLI Y / / 85 John Street 0 41 State Street D 570 Delaware Avenue 0 217 Lake Avenue 0 202 Arterial Road NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206 (212)227-3700 (518)463-2122 (716)884-1155 (716)254-0141 (315)463-8552 THE NEW YORK BOARD OF FIRE UNDERWRITERS i THE NEW YORK_ BOARD OF FIRE UNDERWRITERS PAGE i so 8017933 _ 1 BUREAU OF ELECTRICITY F 41 STATE STREET,ALBA V.NEW YORK 12207 j Date (TM.' ,Lw2 r'I'99 3 Application N .on file 49t 3i`_'C `.'1./SJ1. Els1�:.3+Y6:-, �c THIS CERTIFIES THAT PERITII' NO. .i:L—`:4l'? only the electrical equipment as described below and introduced by the plicant wed on the above application number in the premises of JOHtd 11SI..ril;r3!1I',EH, 15 TUOMAS ST. F QUf,riP,PSBilRY h N.Y. in the following location; ❑ Basement ❑ 1st Fl. El 2nd Fl. Section Block Lot was examined on i"��ti` 1 • �--• and found to be in compliance with the National Electrical Code. 71 4 .. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS_ OVENS DISH W__WASHERS EXHAUST FANS ': OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 't 1 2 1 3 2 -< DRYERS FURNACE MOTORS RITURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BEu UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO OF FEET AMT. WATTS '• • 1. . 1. ._._ 2,': ...SERVICE_DISCONNECT�_ NO.OF ._ . S E R V I C E ... , AMT. AMP. TYPE EQUIP. 10 2W 1,9 3W 3 a'3W 3 J 4W NO.OPEC irCOND. ^Of CC.CwJD.. No.OF HI•LEG OF•HI•L?o NO.OF NEUTRALS OF EUGNAL F 'p i -r . OTFIER APPARATUS: ' C.7.Fi'.C.it-1 1 . ro 3Oi+Pi F. I-IHI:tlITHEE N 15, Ti-int•A S ST. - (--.. r ,., QtiEEIIS i()R , I%1Y, 12804 BRANCH MANAGER C 2V)C� 'i C i k Per i This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ! ® 00000e ® o000000o e000elNEESE0510eeoeee . 4..}, COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ,,. TOWN OF QUEENSBURY 531 BAY ROAD it-) ''riliv QUEENSBURY, NEW YORK 12BO4-— TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED if NAME /i% , ',7 Q,e/y.�1 0/x J LOCATI+N /, /77-ne1.4 ' . DATE 3/a t/93 PERMITD 9/_7c TYPE OF STRUCTURE (211-- ai d e„..., RECHECK' ' o ��J • . _FIRE MARSHAL .PPRO (COMMERCIAL TRUCTURE) FOOTING FOUNDATION BACKFILL �,gRAMING �UGH PLUMBING FINAL ELECTRICAL SEPTIC 1 ULATION WOODSTOVE/FIREPLACE _ s REMARKS p I ti I r, 1 APPROVAL ! N/A YES NO CHIMNEY HEIGHT/LOCATION , B VENT/LOCATION I —',, PLUMBING VENT ' r ROOFING i —, SIDING , DECK/PORCH/STEPS/RAILINGS RELIEF VALVES 4;1 FURNACE/HOT WATER OPERATING , BASEMENT INSULATION/DUCTWORK INTERIOR TRIM/PRIVACY ODORS yS FINISH FLOORS: BATH/KITCHEN WATER IOI T MI OTHER FLOORS SWEEpABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RA LINGS 4 HANDICAPPED ACCESS' '1w — SMOKE DETECTORS t BATHROOM FANS/WHOLEHOUSE FANS ALL PLUMBING FIXTJJRES OPERATING GARAGE FIRE PROOFING w DOOR CLOSERS OTHER FIRE SEPARATION FIRE/DEMISE WAL/S DUMPSTER . SITE PLAN/VARI, CE REQUIREMENTS FINAL ELECTRICAL OK TO ISSUE C/O OR C/C \ COMMENTS: fi--e-D -•-•"1-t-e--TIZ-1 CA-C_ A/"11-C.- ITS CL0517- cir ARRIVE !d: SC DEPART / (� 05 `— 1N TOWN OF QUEENSBURY ey;:tx_e BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 /lI'As, TELEPHONE (518) 745-4447 BUILDING INSPECTOR°S REPORT REQUEST FOR INSPECTION RECEIVED e/ /91 NAME Q)- LOCATIO " DATE ,}'/ () / 0 PERMIT # 91m?419 TYPE OF STRUCTURE 6 c,LC� o', 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 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 ti>° JACK POSTS/MAIN BEAM +' . EATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- . FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- /7' CEILING R-30 DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: ARRIVE DEPART / ; ////:: Z�� �-- TNSPFCT(1 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE. (518) 745-4447 ' BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTIONTI RECEIVED NAME (J�LZC, Li/ /�/�.(1.1,s (./Z- 'Prid LOCATION l5 , 0 V0,4 .'- DATE %t#2_ PERMIT 0 9/-;#9 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 ? HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR I REINFORCEMENT IN PLACE\ FOUNDATION/DAMPROOFING\ BACKFILL APPROVAL 'PLUMBING PLUMBING / PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB • FRAMING: JACK STUDS/HEADERS / BRACING/BRIDGING_ / JOIST HANGERS / JACK POSTS/MAIN BEAM/ HEATING ROUGH-IN INSULATION: / \ FOUNDATION WALLS INTERIOR R- \ FOUNDATION WALLS :EXTERIOR R- �. • FLOORS / R- WALLS r R- CEILING I R- DUCT WORK OR PIPING IN UNHEATED \� SPACES l REMARKS: ARRIVE 1� DEPART f •"`") INSPE9T R TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPPECTION RECEIVED q1,44/,, NAMET '72/ llcQ/D ) LOCATION / j)7) ,f )4! DATE/,/ f %/ PERMIT 9 /-,/-/% TYPE OF STRUCTURE di, 6 d(,Gi['-L-r/,'ly 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 REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL f' ROUGH PLUMBING ;! PLUMBING VENT/VENTS IN PLACE / PLUMBING UNDER SLAB X FRAMING: (34, J51--/0/91 )J 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: ;9A- ,L 4E„ Gp r�f��&, g//zfilp Gb241-44 moo,0 J `��,J c- ARRIVE fel DEPART /h I SP TOR 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 MAME 9 ,t , Ilie-L/14 1 LOCATION /5 ,. /.17-7-)10,o DATE '( /°L` q/ PERMIT I 9,1 2'q TYPE OF STRUCTURE da o dtvoihw? RECHECK APPROVEDd 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 PUROSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPR OFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS I PLACE PLUMBING UNDER SLAEI\ �- FRAMING: , 2O/y/ ��/ JACK STUDS/HEADE S\ BRACING/BRIDGING ! \ JOIST HANGERS / V 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 DEPART SPECTOR 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 5/ C) ) 9 NAME .�-\ '(\ f e-Y\ k Pam)"\ Y\ LOCATION \5 T1,C�-svu1 <. mac(e4- DATE 'TOP PERMIT # 9 ( - 9L 9 TYPE OF STRUCTURE 1- '( k 4 `-us e l( RECHECK / APPROVED , N/A YES NO FOOTINGS/PIERS • j MONOLITHIC POUR FORM / REINFORCEMENT IN PLACE / THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTIO FROM FREEZING FOR 48 HOURS F LLOWING THE PLACEMENT OF THE C9 CRETE. MATERIALS FOR THIS PURPOSE ON SITE . FOUNDATION/WALL POUR REINFORCEMENT IN PLAC,• / FOUNDATION/DAMPROOFIN I BACKFILL APPROVAL { ROUGH PLUMBING ,! PLUMBING VENT/VENTS ,IN PLACE PLUMBING UNDER SLAB / /IFRAMING: ;i / JACK STUDS/HEADERS / BRACING/BRIDGING i JOIST HANGERS / • JACK POSTS/MAIN BEAM HEATING ROUGH-IN /I INSULATION: 1 ") FOUNDATION WALLS :^INTERIOR R- FOUNDATION WALLS . XTERIOR R- FLOORS R- WALLS ; R- CEILING 'i R- DUCT WORK OR PIPING IN UNHEATED SPACES' 1 REMARKS: %, / \,,,v, ARRIVE i DEPART / '''' — INSPECT -1 OWN OF QUEENSSUR� aECEsaEO APR 2 91991 --- __L G.&CODE DEFT, l� If 117 I1 f"OWN OF QUEENESUR'�, RECEIVED APR 2 91991 BLDG.&CODE DEFT, � J o w—i t;kL r 0^> 9 q Y x 7/0 1/ rdl)I 4L o(,, //01('y jo" ------- .......... TOWN OF QUEEtVSSU,,Y RECEIVED APR 2 9 1991 BLDG.&CODE I)EPT, sgrr �o TOWN OF OIJEENSSIJRY RECEIVED APR 2 91991 BLDG. &CODE DEPT. a I'UW'4 OF GIJEENE�EUH v � l r�, RECEIVED �I APR 2 91991 BLDG. &CODE DEPT I ZZO C-A G +IM�ry d^� ti �r � a t M 04 in