1991-554 i
•
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY,:. NEW YORK
` H
Date October 24 19 91 0
This is to certify that work requested to be done as shown by Permit No. 91®554
has been completed.
This structure may be occupied as a Si ngl Family Dwelling
I nation Lot #1.25 Algonquin Drive
Owner Stephen Kelly
By.Order Town Board
TOWN OF QUEENSBURY
'V
Director of Bldg. ac Code Enforcement
V r.
BUILDING PERMIT -�
TOWN OF QUEENSBURY
No. 91-554
WARREN COUNTY, NEW YORK
N
M.hen
PERMISSION is hereby granted to Stephen Kelly
l
ui n Drive Street, Road or Ave.Lot #125 Algonquin
OWNER of property located at g qcri
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
11 Willow Road
Queensbury, NY 12804
2. CONTRACTOR or BUILDER'S Name N
fD
Same
rD
3. CONTRACTOR or BUILDER'S Address
( l-
0
mliza
4. ARCHITECT'S Name
to
0
5.'ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( ) Masonry ( )Steel ( )
(N
�.
7. PLANS and Specifications =
to
No. 2,416 sq ft Single Family Dwelling as per plot plan specifications fD
and application
8. Proposed Use _,•
1<
Single Family Dwelling with attached 2-Car Garage
rD
$ 324.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 1, 19 92 (a
(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 1st _ Day of August 19 91
( � ��
SIGNED BY � for the Town of Queensbury
Building and Zoning Inspector
TOWN OP QUEENSBURY I.OWN OF OU ENS3U
RECEIVED
Ogg,
� REVIEWED BY:
JUL 31199i�
FEE PAID: 6 J 46-#., 3a/I C/f BLDG. c� CODE DEPT.
PERMIT NO. : c/1-55`�
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.
* * * * * * * * * * * * * * * * * * * * * **ii"�* * * * * * * * * * * * * * * * * * * * * *
Owner of Property: c/ //.P/? /%/ /r //y
P.O. Address: 7/ ,/ (G/ z u A /a OCe-e-ekricry PHONE 719,E":_ c)z
Property Location: /el /2:_c /)047.„fr, wry Tax Map No. / /
Has there been any split of this property( since October 1, 1988? Yes No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: 7474 -2Sia- o/ Lot No. /2.S
THE PERSON RESPONSIBLE FOR SUPERVISION`
� OF WORK AS REGARDS TO BUILDING CODES IS:
F7t7e /
NATURE OF PROPOSED WORK: / * ESTIMATED MARKET VALUE OF THE
V Construction of new building * CONSTRUCTION: $ /37
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: /.2S ft. x /S6 ft.
Other work (describe) * Existing Building Size:
* 06 ft. x 7g ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
L 4' *
1st Floor /�,2�/� Sq. Ft. )?�( w� * Front Yard 64 ft. Rear yard 61( ft.
t.
2nd Floor 42.0 g Sq. Ft. 1 �U d Yardse* Ifoncorner setback afrom side street-
ft.
Other Floors Sq. Ft. -
(not cellar or basement] oN E OCCUPANCY INFORMATION:
TOTAL FLOOR AREA: . z/q./ Sq. Ft. ' )/1/Primary Building -
One Family Dwelling
Size of New Structure: o ft. x 76 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) -7 * Other
Height (grade to ridge) 025 ft. *
If residential , no. of families: / * If addition, what will use be?
No. of rooms (excluding baths) : / 0
No. of bedrooms:
No. of bathrooms: 02 ,/,- * Accessory Building:
Primary heating system: //c4- - eK * Detached Garage - One/T, .
Type of fuel : R,fa / Cif * V Attached Garage - On- wo Car
No. of fireplaces to be installed: / * Private Storage Building
Will a woodstove be installed?: /16 * Other
Central Air Conditioning: Yes No )r\ *
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. /cam einc4
Will any second-hand or ungraded lumber be used? If so, for what? // d
Foundation Wall Material : `04/?e,) CekodE/. _ Thickness: r`(
Depth of Foundation below grade (to bottom of footing) : 4,01(
Will there be a cellar? yeS Heated or Unheated? 6,h Floor Sq. Footage: , 2og
Will there be a basement? Will any portion be used as living space? /Io
If so, what porti ? /j/ Sq. Ft. Type of Use? y��
Type of Roof: hoped/ lat/Shed/Other Material of Roof f�e'r .s /ass ,2627,..c.
Size, wood studs 02 " x /, "; spacing /6 " o.c. ; length S ft.
Joists (floor beams) : 1st Floor " x /O " ; spacing /K " o.c. ; span /6 ft.
Joists (floor beams) : 2nd Floor " x /6 _ " ; spacing /G " o.c. ; span A ft.
Overlays (ceiling beams) : " x " ; spacing " o.c. ; span ft.
Roof rafters: " x " ; spacing o.c. ; span ft.
Roof trusses (pre-engineered) : spacing as/ " o.c. ; span 7' ft.
Exterior Wall Finish: A...,?./--„4 , . coy; of what material ? S'1G9c9C-
Interior Wall Finish: S'/-e .e/- 49,
If a garage is to be at/tached/, describe materials to be used for FIRE SEPARATION: }/ .eS
L �j
Is there to be an opening between garage and dwelling? yes If so, will a Fire-Rated door,
/
enclosure, self-closing device be provided? ye S
Will a flue-lined chimney be installed? /VA Height above roof /i/x ft.
Depth of chimney foundation below grade: ///a ft.
Depth of firepla —h-eearth: A14 ft. /l/, in.
Water supply - nicip 1) 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 & ADDRESS: cs•f.R. 2A" /4 1/>/ PHONE F
NAME OF PLUMBER & ADDRESS: // // // PHONE
NAME OF MASON & ADDRESS: /( // // PHONE
NAME OF ELECTRICIAN & ADDRESS: // ' PHONE
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 pr •visions of the
BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to th. proposed work all
be complied with, whether specified or not, and that such work is au i by the .o f
Signature
• Owner,' o er s age , a itect
contrac or
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
!MN OF QUEENSBUf a
RECEIVED
Compliance Methods:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) AIL 31 1991
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family DwellingSDCL & CODE DEFT.
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
St(12/°/� P� X i /-LS 4/- a4 ��
APPLICANTS 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
B. Exterior Walls
C. Glazed Area R�
D. Exterior Doors
E. Floors over unheated spaces R
F. Edge of Slab on Grade (Heated Building) R q/
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 CO OL MAXIMUM SETTING 140* - WILL NOT BE EXCEEDED
APPLICANT S SIGNATURE 1/ DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS:
RE ED BY
"OWN O' ' f_....",,'SE
ark
Is-)Ca TOWN OF QUEENSBURY fiErx
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit, L, 1
Fee Paid
F3L
ll lGe 8t CODE DEPT.
Date: �3j/�,r Reviewed By
veV
LOCATION OF PROPERTY FOR INSTALLATION: J " /2 /O af uy 24/G 4".
Owner' s Name: s7-107 Jf ek /4/72/
Owner' s Mailing Address:- // OG(ee -S 4,/ /1/
Installer' s Name: �#0 C,e<zA. Phone #:
Number of bedrooms (if residential ) : -S
Total daily flow (residential-compute @ 150 gal . per bedroom) : �5.-Z '
Topography-Circle One: dr Rolling Steep Slope .% of Slope
Soil Nature-Circle One: S.nd Loam Clay Other /Depth:
Ground Water-At What Depth? /Vie Feet
Bedrock or Impervious Material-At What Depth? ,1/0 Feet
Percolation Test-Circle One: 'Not Require. Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: u dici . . 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 66 feet//Total System Length 5d 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 revere side of this sheet and agree to abide
by these and all requirements of the T ti of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: g/4:/
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:
' u n • .__ 1 .. - . I TOWN r ->i ' .:1'a 1 a.. -.i.! • Y _ .1 .•7�(1�i . ..-_ ._ .-. ... . • ! .. . . 1 711
OF Q LIEENSB URY
• Bay at Havlland Roads,Queensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date 7th 19 9/,: Permit No. 9/-554 .
APPLICATION IS HEREBY MADE to the Building.Departinent 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 ate part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's Name , l 7/f)i-en /G4 ,// ' .APPLI:ANCE TYPE
Stove Coal Wood •
Address // Lt///�GG-- ,1 - / Furnace Hot Air Boiler
' Zero Clearance K Circulating Unit
(191(� -e eks b cf Zip �0. ?o
Phone 7 / If Non-Masonry:
Owner's Name ,S,42 -e,
Ad ress �� Manufacturer //e0 /# ' c
`� // !'(//cw Model Outlet Size
LY"-1 -e-ei?l Zggy /0, Y Zip �a2 gG/ Listed by Number
Phone 77�3 ,g /,7__ - CHIMNEY TYPE
Masonry: Block Brick Stone _
Property location of proposed construction Flue: Tile Steel •
Aa' 4 /.2 C iP/ac ,0/pi Size:
CAO -61-LI 6 6( l/ /,2ro ci Factory Built:
Y °�1 j Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height_ Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES-- Type: Double Wall Triple Wall
AND 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
l� ected fron Refunded to: a,_ .P9 7..%0s� i`5 a���L,! •
° i O Address: /Th //
Th •
Dated: (1)
Sf-cl Town Clerk or Deputy (4 _ 1
While:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
1337 West Choom,PU^a'VVeuCho�o,' PA 19380
` `
'
APPLICANT COMPLETES THIS SECTION ' Date: �� ��
. /
City, Town or Township \�~r /' ' ! �//i �/ County/~'/ /' '/ '` State
Location/Address
<\fL �a�16 Ru,a(Amu Please Directions) Pole ��
»« o ~
Permit
Owner
! ^^- ~� ' / Bui|ding� � Old[]
Occupied As ' ' ' / ' ' � ` � ' '`="p^�
-
Occupant
Work Area in Building (Floor #,oto >:
App. for: VNhnn Sor�oo�� or: Ready for Inspection:
Fee Remitted $ -- Cash F-1 Check F-1 W1.O. 1 I . Make Payable To: M.D1/�
a� ,m /mm ,zm ,amnme�o ,�oumoa, s�o
Number of Rough Wiring Outlets Boot Heat _
Switches '
Amp. Service Surface Unit Dbhwu hor Range
ugromg Water Heater Air Conditioner Dryer pump
R»««Pta«|»» Oven Garbage Disposal Wiring and Controls for Burner
Number of Fixtures
Amp. R000ptao|oo Fractional H.P. Vent Fans
Other Equipment: ,
MOTORSp 11201/ovz 1/8- 1/6 zr z/x zp ap` z 11h z a , r* m ,: xo cs nv 40 no 75 um '
Mark Number
of Each Size
/
Applicant's -�? ����\ /> � ' ` / U�o�� � � Ponm� #
Signature _ _
T/A '� ' // Utility:
(NAME) (OFFICE LOCATION)
Appi Address:
(City) ''`/' ' ' ' ' ' '/ (State) /� ,' (5P) Service Request #
Phono ** �� '- '�� '� _ Electrician:
yNOU4 USE ONLY DATE RECEIVED: DATE INSPECTED:'
Correct Location: Same a, Above F� or:
Rod Notice Label | |
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures '� Air Conditioner Dnm,
Amp. Service Equipment' ' Burner, Wiring &Controls for Amp. R000ptao|o '
Amp. Son/ioo Conductors Pump Vent Fans
MOTORS P. vc 1�e z�o 1m z/o 1/4 z/a z/c o�' z 1* e , � 5 ,* m z, eo cs oo ^o no rs mv
��� Number
Each Size
o� ,m ,mm 12� 1awomm�'=m �� om ��
Elect. Ho,�
oenr/FIoAr/omo USE FOR INITIAL m omnnsor FEE PAID
m|r�m�� ��r/p/sm ��rs pss
F-1 RVV Pmomo: Inc. LKD|| Contractor
�-� l CFT Violation: Work |no �l�-^ � ��7�� � �] CASH
�� O
L/A L/A »^»«r Fee Duo --'- .
�-1 � '' ��
�� MO #
F-1 IPA Municipal \NV #
Applicant
L�
Date: O�ho,��do| �� Utility �� ' Owner
Cut in"Cund F-1 Temp # Dam
INSPECTORS SIGNATURE
F-] Final # Date
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME dk've- 07.
LOCATION Lei /G ///Of <r,/i? 4d�d;
DATE /645✓IN PERMIT#
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTIING
FIRE EXTINGUISHER\
AUTO. EXTINGUISHING S TEM
HOOD INSTALLATION
AUTO. SPRINKLER SY M
ALARM SYSTEM �r
1
INTERIOR FINISH S
STORAGE:
CLEARANCE T, SPRIN LERS
CLEARANCE To HEATIN UNITS
REQUIRED SIGN,GE
CHIMNEY
WOODSTOVE
FIREPLACE- ASONRY
(,."FIREPLACE- ACTORY BUILT
REMARKS: 1 1 OK TO THIS DATE
ARRIVE
/
DEPART /2 A/ t(
INSPECTOR
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
f'ELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME ;. e)
LOCATION c640,
DATE , PERNITi
TYPE OF STRU RE
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
- ROUGH PLUMBING FINAL ELECTRICAL--_SEPTIC
- INSULATION WOODSTOVE/FIREPLACE
REMARKS
•
APPROVAL
N/A P YE� NO
CHIMNEY HEIGHT/LOCAT ,N �i///
B VENT/LOCATION ► //
PLUMBING VENT ,!l
ROOFING '+
SIDING ✓/
DECK/PORCH/STEPS/RAIL /, S ✓�
RELIEF VALVES /✓
FURNACE/HOT WATER OP/RA \ING
BASEMENT INSULATIO' DUC ''CORK
INTERIOR TRIM/PRIPCY DOi'S ri
FINISH FLOORS:
BATH/KITCHEN .,TERTIGHT
OTHER FLOORS ;:WEEPABLE ✓/
OTHER FLOOR_ 'CARPETED P/
STAIR CLEARA 'E/RAILINGS ,
HANDICAPPED /CCESS
SMOKE DETEC OIRS '+ /
BATHROOM FA,!S/WHOLEHOUSE FANS', �✓
ALL PLUMBI ! FIXTURES OPERATI a
GARAGE FIRi PROOFING_ 11 Y1
DOOR CLOS t'S T
OTHER FIRS SEPARATION_
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL /
OK TO ISSUE C/O OR C/C
COMMENTS:
/a ..3 4 ,/
c 427
ARRIVE/
DEPART 1
INSP T
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No.
Owner
Occupant
Location L-U T b S 6-6-6.4-(6.(l
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.Installed by /1�j E�C
/ �,r No
Date /a'—l/ - l44-06:9.C_ .�l?/)42_ Spector
MIDDLE DEPARTMENT INSPECTION AGENCY,
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
/ ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
2.---.EwyEETS 5 ,j/ %e el-- WIRING &CONTROLS FOR (4c__ BURNER
3.S7 RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
2C)C.AMP.SERVICE EQUIPMENT /!!lH.P.GARBAGE DISPOSAL UNIT
`,/ AMP.SERVICE CONDUCTORS / %.W. DISHWASHER
,(J� W.SURFACE UNIT • K.W. DRYER
K.W. RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
e)l�C�J
MOTORS H.P. I/20 1/12 1/10 % '/e % '/ 'h '% 1 1/ 2 3 5 71 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
Joeun >0/ Queen.sbuacy 41)(
BUILFING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
(Xeensbury, New York 12801
SEPTIC/ DISPOSAL SYSTEM INSPECTION
NAME zf P e,�e.--1 �' /`" ",r-
LOCAT I ON /4,75 C 2/ .iti4D
DATE /21/ /f/ PERMIT NO. 9/-j,.5/7"
SOIL TYPE Sand Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: �l /
Absorption field, total length?' 300
Length of each trench' ;.1
Depth of trenches -3-
Size of gravel' d t;
SEEPAGE PITS{Number of)
Size- ft. X ft. ;''
Gravel size _ }'.
PIPING: Size P Ty "e
Bldg. to tank SL ?' v
Tank to dist. box `t '� ,
Dist. box to field/pit 9 " f'
Openings sealed? YES NO ' Partial
LOCATION/SEPARATIONS:
Foundation to tank 'O ft.
Foundation to absorption / `' ??U ft. .
Absorption to lot line 17 5 ft.
Separation of pits /
�
LOCATION� OF SYSTEM ON <PROPERTY(circle one) .
`41110 '
Rear - Left s,' de - Right side -
COMMENTS:
/5C7).,tW /
•
SYSTEM USE APPROVED NO •
B lding Ins,.ector
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
NAME ,///p/q
LOCATION - �n! /.fit r,h/fit. Mom.
DATE �1� ;/% PERMIT if ,,�// 517/
I �
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 PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE A
PLUMBING UNDER SLAB
JACKSTUDS/HEADERS U
BRACING/BRIDGING
JOIST HANGERS r
JACK POSTS/MAIN BEAM
FIRESTOPPING
4
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN i
VINSULATION:
r FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXT'ERIOR R-
FLOORS R-
WALLS l� f
/ R- r/
CEILING 4r�E,•2�np; R- V
DUCT WORK OR PIPINN UNHEAT D
SPACES f
REMARKS:
O
ARRIVE
DEPART �s
INSPF,CTOR
.C?. 7;jytg\AL'
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 1 l�/9f
NAME .731-12 C_\V,
•
LOCATION ,21,041- jgcN. I 011)
DATE cj C PERMIT# 9 1 -55•
APPROVED
N/A YES NO
EXITS 71
AISLE WIDTHS /
EXIT SIGNS
EMERGENCY LIGHTING /
/
FIRE EXTINGUISHERS
AUTO. EXTINGUISHIN SYSTEM /
HOOD INSTALLATION /
AUTO. SPRINKLER SYSTEM /
ALARM SYSTEM \ f
5
INTERIOR FINISHES A
,
STORAGE: / 1
CLEARANCE TO SPRI KLERS
CLEARANCE TO HEATING UITS
REQUIRED SIGNAGE
,R
CHIMNEY
WOODSTOVE / N
FIREPLACE-MASONRY \
c.FIREPLACE-FACT/RY BUILT
REMARKS: J�OK TO THIS DATE
. /G-:e.,. ' ,i0aLOCIL--.W-69.,4 eii-,4,
/� A O 1
ARRIVE
DEPART 2� e'11-'
INSPECTO
TOWII OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTORS REPORT
REQUEST FOR INSPECTION RECEIVED
NAME ,9 ,f ► .
LOCATION L - l L C 1 c Gn'� L�
DATECA Do PERMIT # (-5,511
TYPE OF STRUCTURE S f
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 IA S iQ \_
ROUGH PLUMBING\
PLUMBING VENT/VENTS IN PLACE
PLUMBING UN R SLAB
FRAMING: ' �` \
JACK STUD /HEADERS I17/
BRACING/BRIDGING\
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPP ING
WALLS
CEILING
IREWALLS
H ING ROUGH-IN
INSUL SON: \.
FOUNDATION WALLS INTERIOR Pc.
FOUNDATION WALLS EXTERIOR R `...
FLOORS Rj
WALLS R-1 -
CEILING R- 1
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: \Je vN;-CA *S-vos-w•.�
X;Vq- or i/o/1(
ARRIVE /l
DEPART //
I NS PEC R
ACrf-e- ‘Ml
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
- BUILDING INSPECTOR'S REPOR
REQUEST FOR INSPECTION RECEIVED C // J-/ 1i(
NAME \ e)l(..k j S]-e
LOCATION / f��- "�h ()I°/
DATE 10/C1/ PERMIT #
TYPE OF STRUCTURE
RECHECK PPROVED
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 •. f
REINFORCEMENT IN PLACE
'FOUNDATION/DAMPROOFING d
. BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENTAVENTS IN PLACE
PLUMBING UNDER\SLAB /
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS A
JACK POSTS/MAIN'BEAM
FIRESTOPPING
WALLS
CEILING f
FIREWALLS,-
HEATING ROUGH-IN ,i
INSULATION: I
FOUNDATION1WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS ., R-
WALLS R-
CEILING
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE /
DEPART 1,(71,/
INSPECTOR
797
r?
TOWN OF QU EENSBURY n
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORTS/5
REQUEST FOR INSPECTION RECEIVED
NAME6l k )
6
LOCATION lc;) ,f n� ) --
DATE Epp PERMIIT I (' -5S1
TYPE OF STRUCTURE ) ; (\Ge_ C�-
RECHECK ``�� APPROV
N/A YE NO
, OOTINGS/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/WALLI,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 /
JACK POSTS/MAIN BE1M
FIRESTOPPING / 1,
WALLS .I
CEILING ,
FIREWALLS /
HEATING ROUGH-IN'
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / R-
WALLS /
CEILING 2-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 42 --
DEPART %L
NS PEC R
L-91:-`9G¢ M//
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I OWN OF QUEENSBUR
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