1991-348 1 a
•
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date AV-731/A .4 19 9/
This is to certify that work requested to be done as shown by Permit No. 91-348
has been completed.
This structure may be occupied as a
Single Family Dwelling
Location Lot 37 Herald Drive
Owner Guido Ptssarelli
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. &, Code Enforcement , -
X
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BUILDING PERMIT
d
TOWN OF QUEENSBURY '
No. 91-348 i
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Herald Square
OWNER of property located at Lot 37 Herald Drive Street, Road or Ave.
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a
in the Town of Queensbury,To Construct or place a Single Family Dwelling .r
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.
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1. OWNER'S Address is
1�9
45 Herald Drive
0
2. CONTRACTOR or BUILDER'S Name
Passarelli/Cerrone
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address -�
C7
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6. TYPE of Construction—(Please indicate by X) was
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a
(X)Wood Frame ( ) Masonry ( I Steel ( ) CCD
7. PLANS and Specifications
No. 1,344 sq ft Single Family Dwelling as per plot plan specifications
and application
8. Proposed Use
Single Family Dwelling
$ 179.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 28, 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 28th Day of May 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning In spe r
TOWN OF QUEENSBURY
• APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: Z/ h/ Reviewed -By
LOCATION OF PROPERTY FOR INSTALLATION: tdt /gla
Owner' s Name: C ,r% didG�/lTZZ
Owner' s Mailing Address: .
Installer' s Name: /A(IP �L'��11 Phone #: 7#1- 1/21(
Number of bedrooms (if residential ) :
Total daily flow (residential-compute @ 150 gal . per bedroom) : tit/A)
Topography-Circle On- 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
Domestic Water Supply-Circle One: Municipal . Well Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank . gal . (Minimum size: 1,000 gal . )
Tile Field: . Each Trench e,S-(J feet//Total System Length �,!!"V. feet
Seepage Pit(s): Number of / Size each: ft. x ft.
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 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:.a DATE: ,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 distance to structures
4) location and distance to any water supply
5) size and dimensions of. all tanks, distribution boxes, tile 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.
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 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 QUEENSBURY
REVIEWED .. . �-. , ,<. ,
TOWN OF RECEIVED
j
FEE PAID $, PERMIT NO.I/-3 I-)g MAY 2 41991
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.
* * * *}l * * * * * * * * * it * * * * * * * * * * a * * * * a * * * * * * * * * *
The owner of this property is: ,)Z. Soot
P.O. Address /71/4-r cif. 71 - Tel. 7 ' j---.. Zi
Property Location G Wt .7 � /J�� P✓L /" Ty Map No. 2 /?/ 37
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 �'�.�ra �l-/ ,.,�. LOT NO. 7
7
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
•
NATU E OF PROPOSED WORK: • ESTIMATED MARKET VALUE OF
Construction of a new building * CONSTRUCTION: $ �� �
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property W-3 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 �.C. ft. Rear yard ft.
* Side yards 97 ft. and 4-ft.
•
GROSS AREA OF PROPOSED STRUCTURE • If on corner, setback from side street ft.
1st Floor 67z''.sq. ft. 53 4 •
OCCUPANCY INFORMATION
2nd Floor 67z� •
sq. ft. a * ' PriTary Building -
Other Floors
* / One Family Dwelling
(not cellar or basement) sq. ft. 7 Two Family Dwelling
TOTAL FLOOR AREA/3V7 sq. ft. " Multiple Dwelling/Number of units
Size of new structureft •x ft. ' Business
Foundation-pier/slab/crawl/partial/full * Industrial
- (circle one) - * Other
•
No. of stories (habitable space) 2 -- *
•
Height (grade to ridge) 2 C. ft. * If addition, what will use be?
If residential, no. of families / •
No. of rooms(excluding baths) •
Accessory Building
No. of bedrooms ' Detached Garage ONE/TWO Car
No. of bathrooms /Kv • -
Prim ary heats 'OF/ Rti4 p • '. / Attached Garag ON•/TWO Car
na system
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. AAVI,--
Will any second-hand or upgraded lumber be used? If so. for what? Z. •
Foundation wall material erifizek, Thickness F1/
9 G'a�%
Depth of foundation below grade (to bottom of footing) I I
Will there be a cellar? AA Heated or unheated? Floor sq. footage sq ft.
Will there be a basement? ff ce4 Will any portion be used as living space? /le
(If so, what portion? sq ft. Type of use?
Type of roof -iope)flat/shed/other Material of roof � i Qjh/,�,,r4
Size, wood studs 2j"x 6 " spacing% " o.c. length r ft. ��!!�r
Joists (floor beams) 1st floor 2- "x g " spacing /4 "o.c. span / .
Joist (floor beams) 2nd floor `z,-"x " spacing /6' "o.c. span /�t.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineers ) spacing 2- " o.c. span ft.
Exterior wall finish (/ ,// �� of what material?
Interior wall finish 1 7_ �,l be4e
If a garage is to be attached, escribe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? 't,(' If so will a Fire-rated door, enclosure,
self-closing device be provided? ef..
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 BUILDER /4/ �gfi 'eje,__ADDRESSA-ij� A 7�� f A . TEL. NO. � i/
NAME OF PLUMBER �%'��,% �� �tA_ ,, ADDRESS ' ,124/ TEL. NO. /A-- ?797
NAME OF MASON a? /1767,74v_O ADDRESS <9�.f` iii., TEL. NO. 6%Z--/ CA
NAME OF ELECTRICIAI �,�Of ADDRESS 7r/= .., -/-lO .0 TEL. NO. 7"7-4V15/
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
,,/
Own , 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:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
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
/7r Z/7
APPLICANT'S NAME PROPERTYATION
V
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - / 7/ Sq. Ft.
2. Type of Heat - Elec. Base Board Other of,/ i /" Alt
3. Is Building Mechanically Cooled? YES NO
4. Percentage of Area of Windows and Doors Over 17% r/ 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 �v
B. Exterior Walls R /�/
C. Glazed Area R��J� v7
D. Exterior "Doors R /1
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
TEMPERATURE CONTROL MAXIMUM SETTING 140* - WILL NOT BE EXCEEDED
2 4 , f 2/
APP CANT'S NATURE
�AT� TELEPHONE NUMBE
INSPECTOR'S REMARKS :
4
��.�� MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
-:.��* National Headquarters
• 1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date: / ;
City, Town or Township (___is 4 --,-4-5/Z County --'P^--" State 7 1A, i
L.�
Location/Address 7' �� a [ /� i1 �_�GC /�L
� Located in Ryr,a1,Area - Please A tack Directions) " Pole # •
Owner -7./J ,/,9rr, / ' Permit #
Occupied As . �4-ff e ,.�////' Building: New Old❑
Occupant
• Work Area in Building (Floor #, etc.):
App. for: Wiring❑ 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
Water Heater Air Conditioner Dryer Pump
Receptacles
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,/2 2 3 5 7V2 10 15 20 25 30 40 50 75 100
Mark Number -
• of Each Size i----) �,
Applicant's / /
Signature /_ e' �''�r�^""^' License # Permit #
T/A ,/ Utility:
Applican 'slAddress: �"� /7(S <� f/ / f jf(NAME) (OFFICE LOCATION)
(City) (111.L..�2ifv?� 4-'� (State) ,.>/ • (Zip) / (>0/ Service Request #
Phone # 7c- J " .r4"Z/ Electrician:
MDIA USE ONLY DATE.RECEIVED: DATE INSPECTED:
Correct Location: Same as Above! I or: .
•
Red Notice Label n
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 7,/2 10 15 20 25 30 40 50 75 100
Mark Number `
of Each Size
II 500'750 1000 1250 1500 1750 2000 2250 2500 2750 3000
II Elect. Heat
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CO RECT FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
❑ L/A Owner CASH CI
Fee CHK #
❑ L/A Due ' MO #
7IPA Municipal• INV #
Applicant ❑
Date: Other Side,❑ Utility Owner ❑
Cut in Card n Temp # - Date' -
❑ Final # Date- = INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 11/89
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST YOFOR INSPECTION RECEIVED / ?/
/ 'cd
NAME )GLOP /- J
LOCATION o4) f e 0 l\PP
DATE jcj/j3/91 PERMIT# - 3L/R
TYPE OF STRUCTURE S D
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL SJRUCTURE)
FOOTING FOUNDATI N iBACKFILL }/ FR MING
IOUGH PLUMBING FINAL ELECTRICAL SEPTIC
NSULATION WOODSTOVE/FIREPLACE
REMARKS
rr APPROVAL
N/AI YES NO
CHIMNEY HEIGHT/LOCATION /1 t //
B VENT/LOCATION /,' ✓
PLUMBING VENT ?i f
ROOFING _
SIDING
DECK/PORCH/STEPS/RAILINGS .;)
RELIEF VALVES '.
FURNACE/HOT WATER OPERATING /
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS ' f
FINISH FLOORS: I \ /
BATH/KITCHEN WATERTIGHT ,/
OTHER FLOORS SWEEPAB;LE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS +�
HANDICAPPED ACCESS
SMOKE DETECTORS I
BATHROOM FANS/WHOLE OUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING , y//
DOOR CLOSERS ::El
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
0-V
0/Cli-l-eyJa(,(-4P— Cal0
ARRIVE `U 73
DEPART !a
INSPEC OR
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED /0 /3/1/
NAME /-Iej 5JX7 j) �7 �J
LOCATION n(_01-- 3 1 ! ���� Ic Nrt u.e
DATE PERMIT# l 1 -3 y
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM f
ALARM SYSTEM
INTERIOR FINISHES A
STORAGE: /
CLEARANCE TO SPRINKLERS / 1
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE ,
AHIMNEY / 1�
WOODSTOVE /
FIREPLACE-MASONRY /
FIREPLACE-FACTORY BU LT
REMARKS: I I OK TO THIS DATE
ARRIVE
DEPART
INSPECTOR
ELECTRICAL INSPECTIONS
- DUPLICATE MUNICIPAL RECORD
Permit No.
Owner ii ®- f4Location
` `/ 7 ` �6 t c Y
i.u .J �(
Location
1L -r Street
Town or City C3. State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by lea 6 / `'r'i J 9
Date � for
MIDDLE DEPARTMENT INSPECTION AGENCY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
fROUGH WIRING OUTLETS 4L ilf/i4-9 ,AIR CONDITIONER
, 4 OUTLETS WIRING &CONTROLS FOR . :BURNER
[ RECEPTACLES H.P.PUMP
-( FIXTURES K.W.OVEN
L 672 AMP.SERVICE EQUIPMENT P.GARBAGE DISPOSAL UNIT
e,AMP.SERVICE CONDUCTORS K.W. DISHWASHER
.
.SURFACE UNIT (y K.W. DRYER
K /. RANGE AMP. / RECEPTACLE
v K.W.WATER HEATER / FRAC. H.P.VENT FANS 4
/ /Gc--
MOTORS H.P. 1/20 1/12 1/IO % '% % 'h % '% I 11/2 2 3 5 71 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
awn of ueen3bur/
' BUILDING and ZONING DEPARTMENT j
l
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME Ca-0 SCULAt )
)k)•-r-kA._e__„).
LOCATION oC C 1
DATE /57 PERMIT NO. 10116 /-,
SOIL TYPE - 41ft. Loam - Clay -
Percolation Test Required? YES -- NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length" adD
Length of each trench j(J'
Depth of trenches _ 3 ' r%
•
Size of gravel -P L_, J
SEEPAGE PITS-Number 'of) I
Size- ft. X ft.
Gravel size ,
PIPING: Size Type
Bldg. to tank '/" PA •
Tank to dist. box ?'% y /9U C
Dist. box to field/pitW4 "
Openings sealed? YES \ NO Partial
LOCATION/SEPARATIONS:/
Foundation to tank / gift.
Foundation to absorptions ft.
Absorption to lot line 1 ft. ..
Separation of pits . ft.
LOCATION OF SYSTEMfON PROPE�RTY(circle one)
Front - Rear - Lefrt si - Right side -
COMMENTS:
r
•
S
1 kk
SYSTEM USE APPROVED NO
S
Bu ding In pector
•
01/86 and vl
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 101
ea(
NAME E Y-A,\ (?C�Y{;
LOCATION 3 11�ftruAd Vci V c__,
DATE i;I,9 Op J PERMIT # C7)I--_3 -1
TYPE OF STRUCTURE i (4C cdx,v\i 1,A c)A-ei/
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/DAMPROOF,ING
BACKFILL APPROVAL `,
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING i
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS /°
CEILING 4
FIREWALLS
HEATING ROUGH-IN l
INSULATION:
FOUNDATION WALLS` INTERIOR R- ,
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS / R- /(f'
CEILING R- 3 6
DUCT WORK OR PIPING IN UNHEATED 'a
SPACES
REMARKS:
2_6
ARRIVE '
DEPART 0
INSPECT"(/
.- ( 0 e
- -q1)-
TOWN OF QUEENSBURYi '
FIRE MARSHAL SIAT`% v
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME Saiy, Q_ ____LOCATION e1 3 7 1-\P .�tP ��1 Z•
DATE 7[5/°) 1 PERMIT# 1 1 -31
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 SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY er
WOODSTOVE
FIREPLACE-MASONRY .'
FIREPLACE-FACTORY BUILT;
REMARKS: OK TO THIS DATE
., 1
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ARRIVE 1. JZ.v�.���, M --'f✓ �i-riv--6C4/6•Q
DEPART i/9 44,Are.,(A.
INSPECTOR
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 �1
LOCATION �� ? 1/',���y� Y✓/�
DATE )i f) PERMIT # c 1 3111
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
REINFORCEMENT IN PLIACE
FOUNDATION/DAMPROOF'ING
BACKFILL APPROVAL
ROUGH PLUMBING 1
PLUMBING VENT/VENTSIIN PLACE
PLUMBING UNDER SLAB
FRAMING: q 7 / fri
JACK STUDS/HEADERSI "7 `.
BRACING/BRIDGING 1 /
"I
JOIST HANGERS 1 /
JACK POSTS/MAIN BEAM / v ,
FIRESTOPPINGJ
WALLS
CEILING /
FIREWALLS /
HEATING ROUGH-IN /
INSULATION: /
FOUNDATION WALLS INTERIOR R-
FOUNDATION WAL/LS EXTERIOR R-
FLOORS / R-
WALLS / R-
CEILING ! R-
DUCT WORK OR PIPING IN\UNHEATED
SPACES t,
REMARKS:
ARRIVE
DEPART /y S
INSPECTOR
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 (P)(0
NAME kf�&\rcl r) L ' 0/ra� V e
LOCATION 4-F.- �. 1,/e 1.L) S a.� ,A:
1
0j
DATE 67/3 f / PERMIT # ; 97—.31/R
TYPE OF STRUCTURE Sd c ` I'PA
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 ONCRETE.
MATERIALS FOR THIS PU POSE ON S r E
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFIF+G /
i BACKFI L-.APPROVAL t / J
ROUGH PLUMBING EI I
PLUMBING VENT/VENTS IN PLAC
PLUMBING UNDER SLAB 1
FRAMING: °'
JACK STUDS/HEADERS
BRACING/BRIDGING '4
JOIST HANGERS ,'II
JACK POSTS/MAIN BEAM':
HEATING ROUGH—IN . '
INSULATION:
FOUNDATION WALLS INTERIOR R—
FOUNDATION WALLS EXTERIOR R •
—
FLOORS / `, R—
WALLS / R— _
CEILING / ' ' R—
DUCT WORK OR PIING IN `UNHEATED
SPACES
REMARKS: j
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ARRIVE /U SS
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DEPART // ' .
INSPECT
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TOWN OF QUEENSBURY Al?
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 1Ifr�0--cC < l �
LOCATION + 7 }
() N/A 1 1tsi--
DATE c 9 PERMIT I " I/--)�{-d'
cF
TYPE OF STRUCTURE
RECHECK APPROVED /
N/A YES A0
'MQ:Orli6N GAS/'UE RCS_.
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
ROUGH PLUMBING ✓
PLUMBING VENT/VENTS IN PLACE'
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS.,
BRACING/BRIDGING , I
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN I \
INSULATION: ./
FOUNDATION WALLS INTERIORR-
FOUNDATION" WALLS EXTERIOR R-
FLOORS
WALLS ,j R-,
CEILING 1 R-
DUCT WORK OR PIPING IN UNHEATED,
SPACES
REMARKS:
ARRIVE /f
DEPART JI
NSPECTOR
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