1991-741 ' .If7` _' f: ' '{': .Y.I. j 4:'...{, C iV 1.�, •.Y'..(' . - 'n' Y.rs '.
CERTIFICATE OF OCCUPANCY.
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORE
Date December 23, 19 9_1
This is to certify that work requested to be done as shown by Permit No. 91-741
has been completed.
This structure may,.be:occupied as. a Single Fami l N Biel 1 i no
Location Lot #4 Tina Lane
Owner Michael J. Vasi1iou INC.
Do not use. Fire Place until By Order Town. Board
approved by Fire Marshal
TOWN.OF'-QUEENSBURY..
Director of Bldg. do Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-741
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Michael Vasi 1 i ou p�
OWNER of property located hot #4 Tina Lane 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 0
14 Stone Pine Lane
Queensbury, NY 12804
2. CONTRACTOR or BUILDER'S Name
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Same
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0
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name r
fD
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( X Wood Frame ( ) Masonry ( ) Steel ( ) _
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7. PLANS and Specifications —'
No. 1376 sq ft Single family dwelling as per plot plan specifications
and application
8. Proposed Use
Single Family Dwelling w/att 2-CAr Garage
$ 218.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 14, 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 14th Day of • November 19 931
SIGNED BY for the Town of Queensbury
Building and Zoning In ctor
TOWN OF QUEENSBURY i
TOWN OF QUEENSBU1=t~
REVIEWED BY: rr(SEIVED
.011LIIIiik I i F 1 FEE PAID: M A 4,1:� 07/� 6
� � 9 OCT0 uT 1991
PERMIT NO. : ?/- 7'79
BLDG. & CODE DEPT.
' 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.
* * *'* * * * * * * * * * ** * * * * * * * * * * *. :* * * * * * ] * * it * * * * * * * *
Owner of Property: tiIlCe•(-/} j . V/- S /C. ( VV ) �iCse._
P.O. Address: /* Sty /l.P C PHONE 7 37. .
Property Location: ZaT � •j4 0` Tax Map No. / /
Has there been any split of this property since October 1, 1988? Yes No --k--
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: - Lot No.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
M IC NA e L YASrLiou
NATURE OF PROPOSED WORK: . . * ESTIMATED MARKET VALUE OF THE
'� Construction of new building * CONSTRUCTION: $ 70 bO°
Addition to building *
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: ft. x ft.
Other work (describe) * Existing Building Size: 3 0 b 4 s Q F'r
• * ft. x ft. ' �' EGv4-4a-
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
9e/1 . /Dry*
1st Floor Er', 4: Sq. Ft. * Front Yard t: ® ft. Rear yard ft.
��/D D * _... .'. Side Yards ft. and ft.
2nd Floor Sq. Ft. * If on corner, setback from side street-
/
�� '* ft.
Other Floors .. Sq. Ft. �—*
(not cellar or baseme t /* OCCUPANCY INFORMATION:
it
TOTAL FLOOR AREA: Sq. Ft. - 1 * Primary Building -
* 1 One Family Dwelling
Size of New Structure: Z i ft. x ,1 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. 'of Units
Pier/Slab/Crawl/Partial Ful (Circle One) * Business
* Industrial
No. of stories (Habitable space) / A2. * 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: , *
No. of bathrooms: 2. * Accessory Building:
Primary heating ] C
_ system: � .. E) 15. * Detached Garage - One 01...,
Type of fuel : ,'/r_c. * /` Attached Garage - One wo C.
No. of fireplaces to be installed: f * Private Storage Building
Will woodstove be. installed?: Aft, * Other
Central Air Conditioning: Yes • No X *
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: ,od fram fire safe, etc.
Will any second-hand or ungraded lumber be used? If so, for what? p
Foundation
V /
F Wall Material : Abu 2Ei) Thickness:
Depth of Foundation below grade (to bottom of footing) : C
Will there be a cellar? rated or nheate 5 9 G Floor Sq. Footage:
Will there be a basement? ^/t, Will any portion be used as living space?
If so, what portion? -- Sq. Ft. Type of Use?
Type of Roof: l oped,Fl at/Shed/Other Material of Roof Ajpk,9 e.,T SN .q 4.
Size, wood studs Z " x G " ; spacing /c. " o.c. ; length 8 ft.
Joists (floor beams) : 1st Floor _ " x /O spacing /(o " o.c. ; span /f/ ft.
Joists (floor beams) : 2nd Floor Z " x /O" ; spacing /c, o.c. ; span /V ft.
Overlays (ceiling beams) : 2" " x Ali " ; spacing /4, " o.c. ; span /v ft.
Roof rafters: Z u x /U" ; spacing /Cp o.c. ; span 2 $ft.
Roof trusses (pre-engineered) : spacing — " o.c. ; span — ft.
Exterior Wall Finish: Y^/ y L S i r,0►C, of what material ?
Interior Wall Finish: SA,Lee 7 R &G/c.
If a garage is to be attached, describe materials to be used for FIRE" SEPARATION:
®� ,c/R
Is there to be an opening between garage and dwelling? / Xd If so, will a Fire-Rated door,
enclosure, self-closing device be provided? /62"..7
/
Will a flue-lined chimney be installed? )fS' Height above roof .2 ft.
Depth of chimney foundation below grade: *s,v ft.
Depth of fireplace hearth: / ft. in.
Water supply Municipal .r private well :
SEPTIC SYSTEM: Distance from any private well (including adjoining properties:- 20 .ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: Mic cc J. V*s/(,tocJ PHONE 793-73S.3
NAME OF PLUMBER & ADDRESS: FA/A liLL/ 1, 6w PHONE ,fr—vi f f
NAME OF MASON & ADDRESS: Mzu,4 24) PHONE 7,12!CLL2..
NAME OF ELECTRICIAN & ADDRESS: /.dc.+ MO aG, IIG PHONE 'y 2- ig:!y/-
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 authoriz d .y e ow r.
•
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Signature ,
• r, owner .gent, arc itect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
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)
OWN OF QUEENSEUR,
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family DwellinElVED
Multi-Family Dwellings
(3 Stories or Lessbcr 16 1991
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
BLD0. & CODE DEPT.
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
P11-37Z.
APPLICANTS NA /0e/fie--
PROPERTY LOCATIO
r . #14./4 44."."
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - /3 7b Sq. Ft.
2. Type of Heat - arif Base Board Other
3. Is Building Mechanically Cooled? YES NO
4. Percentage of Area of Windows and Doors Over 17% X 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
Other
,_A. Roof & Floors exposed to ambient temperatures R 5d
B. Exterior Walls R 2 S
C. Glazed Area
D. Exterior Doors R 3•
E. Floors over unheated spaces R
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above .Grade)
H. Basement/Cellar Walls (Below Grade) R l/
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 CINTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
. : DM -73 5:-3
APPLI A S SIG A URE DA TELEPHONE NUMBER
INSPECTOR'S REMARKS:
REVIEWED BY
•
..i/�a. TOWN OF QUEENSBURY
� j TOWN OF QUEENSBURY RECEIVED
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee PaiteT 16 1991
Date: -4r(77177 Reviewed' CODE DEFT
LOCATION OF PROPERTY FOR INSTALLATION: 0604. =
Owner' s Name: A<C,N L At/b ) //(1.
Owner' s Mailing Address: �erA /.ivy
Installer' s Name:e7/ft/g Atl/ .D Phone #: 2!2 m-In!Z Z
Number of bedrooms (if residential ) : .3
Total daily flow (residential-compute @ 150 gal . per bedroom) : / ro
Topography-Circle One: 4010 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 Require. Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: unicipal Well Other
If domestic water supply is a we -
Separation: Water supply from any septic absorption "---- feet
PROPOSED SYSTEM: Septic Tank 7 4 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench ri7 feet//Total System Length /Q 7 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 Queen bury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ,tey ___/f2x/r
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 $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department -
531 'Bay Road
Queensbury,-. NY 12804
Remarks:
•a��q' MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
-. �x �, National Headquarters
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date:
r j. /
City, Town or Township `- I. County:/,'�"'ae °`�`
- State / •
/
Location/Address d r' r %,.�r=r i-- -
(!If Located'in Rural Area - Please Attach Directions) Pole #
1, : ,e- �-,-;:`;..../' .r�/ : `, i �,v`-f.� Permit • .7 -
Owner t- # 1
�, . " x-frn . —1 Building: News Old!
Occupied As- ? 4-> ��
Occupant `"'
Work Area in Building (Floor #, etc.):
App. for: WiringVe'"''( Services or: Ready for Inspection:
Fee Remitted -$ Cash n Check n M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250 150b 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets ! Elect. Heat
Switches •'
Lighting !' Amp. Service Surface Unit Dishwasher Range
Receptacles I! Water Heater• Air Conditioner Dryer Pump
Number of Fixtures I' Oven Garbage Disposal Wiring and Controls for Burner
- Amp. Receptacles Fractional H.P. Vent Fans
II Other Equipment:
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number ;l
of Each Size
Applicant's Jr ! } j / ; - ^ l_
Signature ' . sue. ;r 's- ,,, '/ . License # Permit #
T/A Utility:
`Applicant's Address: I! (NAME) (OFFICE LOCATION)
-(City) (State) (Zip) Service Request #
Phone # I • Electrician:
MDIA USE ONLY DATEI•
RECEIVED: DATE INSPECTED:
Correct Location: Same as Above? or:
Red Notice Label n
Rough Wiring Outlets Surface Unit Oven
Switches it Range Garbage Disposal
Receptacles Ii Water Heater Dishwasher
Fixtures li 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 11/2 2 3 5 7'/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size '
500 750 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 1 Contractor
1 1 Inc. I 1
El CFT Violation: Work Comp. CASH
I L/A Owner
Fee CH,K #
L/A l+ Due MO #
n IPA Municipal
1 _ INV #
I
Date: Other Sides Utility Applicant
Owner "
Cut in Card 1 Temp # Date
INSPECTORS SIGNATURE
n Final #II Date
•
APPLICATION FORM NO.250 EL 1'1/89
TOWN OF QUEENSBURY
Bay at Haviland Roads,Ouoensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
a
Date ' ,, i,� 19F Permit No. , fr
•
APPI.,ICATION 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.Btiildirig 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 premises for the required inspections.
i'::
. ii ti- }` ' ,�;` a PPLIANCE TYPE
Applicant's Name - hlil r -_ I; y/` . ,/,.. �A �._ r
.�, *., Stove Coal ' Wood
A`' � T Furnace Hot Air Boiler
5 `_�+�., a.� . i Zero Clearance Circulating Unit
r -
tf �5R '..t d�fd r Zip ofK f.)er'
Phone '¢ s 141; = '; C :4 If Non-Masonry:
Owner's Name 4 i4 N
Manufacturer
Address ")�� a� t"~' Model Outlet Size
Zip Listed by Number
Phone
CHIMNEY TYPE
Masonry: Block Brick . Stone
- Property location of proposed construction Flue: Tile Steel
Size:
/' - ,,. f,, —I Factory Built: � E
manufacturer,�'`d .r �cmodel� Ky,Size 5
('OPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Triple Wall A
AND CHIMNEYS. MUST BE INSTALLED Insulated >?
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$
SONRY FIREPLACES AND CHIMNEYS.
CASHIERS DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department: Fire Marshal Amount Collected -A-mount Refunded
Code Number Title C,
A173 3389 (190)Public.Safety �''
i
A233 2655 (230) Minor Sales
lee Collected from or Refunded to: ?`l J_✓) j :XI_ '_,,.A'. {t ,,,/,,,'r-e, _
Address:
Dated:;. . . •, Town Clerk or Deputy •
White:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
An)
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED /9 %)_ J�J
NAME (ir\r)`11vCt2 X Vg,s ) cf1../�l
LOCATION J(o)? /f4 //i,p, J�LG&e
DATE1 7b/'J/ PERMIT# (2, /. 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
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRI S
CLEARANCE TO H ING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MASONRY
L./FIREPLACE-FACTORY BUILT
REMARKS: OK TO THIS DATE
CA'-'12/. &"64. � i
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DEPART / �- C_L --'%, .-
INSPECTOR
TOWN OF QUEENSBURY AT)
'`jam►' , 531 BAY ROAD
''" � . . QUEENSBURY, NEW YORK 12804
�' TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED J 2/2 37 If
NAME A�6\c 1ce-P Ili c S E' Li 01
LOCAT I ONoilir ij k\N c\_ , /
DATE f„9p3/�j 1 PERMIT# 9 I -- 7�"
TYPE OF STRUCTURE S c
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
AFOOTING \FOUNDATIONBACKFILL FRAMING
ROUGH PLUMBING FI AL ELECTRICAL ' SEPTIC
NSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A I YE$ NO
CHIMNEY HEIGHT/LOCATIO l//
B VENT/LOCATION
PLUMBING VENT
ROOFING /
SIDING
DECK/PORCH/STEPS/RAIL NG1 �/
RELIEF VALVES /
FURNACE/HOT WATER O'ERATI G � //
BASEMENT INSULATIO. /DUCTW RK /
INTERIOR TRIM/PR 'ACY DOO�{}}S I
'FINISH FLOORS:
BATH/KITCO WATERTIGHT
OTHER FLOORS SWEEPABLE ✓ij
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS /
SMOKE DETECTORS fj/
BATHROOM FANS/WHO HDUS-E-FANS ./
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFINGLI DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
STTEIAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL /OK TO ISSUE C/O OR C/C
COMMENTS:
ijelyi J2/i /1
ARRIVE / . /
DEPART is 4=�yv
INSPEC OR
Atigi P
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TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED J /d3//CJ'/
NAME 0 ` TA_ `
1 C C Vs� l , -L
LOCATION ?1_44_7*-/.4 \f0, 4
DATE J,.?/a_./C') PERMIT# / 7y
l APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SY EM
HOOD INSTALLATION
AUTO. SPRINKLER SYST
ALARM SYSTEM
INTERIOR FINIS/ ES
STORAGE: /
CLEARA WE TO SPRINKLERS
CLEA� CE TO HEATING UNITS
QU RELR ED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: ✓/OK TO THIS DATE
AIL;
1pd9-t?A)
ARRIVE -<if/)� G �212G'
DEPART J e,() ��,
INSPECTOR
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No.
r�
Owner / �1 (4,116 gfr/V
Occupant rr
Location' V r/1u h A7/
No.(3 U917z-sws /2 Street
Town or City State
Installation as itemized on reverse side has been isuallyinspected pursuant to applicable codes.
Installed by P. JO/ti64419
Date! i§mgAe(?Q 2L4 pector
MIDDLE DEPARTMENT INSPECTION AGENCY INC. . -
FORM NO.18 EL. 900 Haddon Ave.,Collingswood, NJ 08108
/ ti f ROUGH WIRINGL OUTLETS/ (J H.P.AIR CONDITINER— ''
T li 7. o -r�3('TJt/ / l.6(- WIRING &CONTROLS FOR BURNER
()6, RECEPTACLES - H.P.PUMP
3
' FIXTURES K.W.OVEN
7' AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
C AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT / K.W. DRYER
//J K.W.RANGE AMP. y® RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
st(c:E 1 /2�� , <�
MOTORS H.P. 1/20 1/12 1/to %. % % Ih %_ % I 1 111/2 2 3 5 71 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE -
APPARATUS
, ' '• ;1i
,*, //: �'
_loran of Q ee n 3burcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New YOrk 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME S k L E.C2.� 1 MAC'�!Rr_(, V •
LOCATION 11 n C1 1Q
DATE Id- / I PERMIT NO. CI 141
. J
SOIL TYPE Sai -( Loam = Clay -
Percolation est Required? YES - fNi .
Percolation rate -;Min/Inch
J
TYPE of SYSTEM: •
��Absorption field, total len g,th
Length of each tren5h, 'Gje) y_ JT
Depth of trenches? -3 ' i v
Size of gravel Z, _
SEEPAGE PITS{Number,=of)
r.Size- ft. X r ft .
Gravel size , ,.^'
PIPING: F Size Typ,, .
Bldg. to tank : UG
Tank to dist. box" „Ly.)
d
Dist. box to field/pit S('ai v
Openings sealed?+ • YES NO artial
LOCATION/SEPARATIONS: .
Foundation to tank.' /5.. ft.
Foundation to absorption `,ft.
Absorption to lot line ft.
Separation of pits- ft.
LOCATION F SYSTEM ON PROPERTY(circle one)
Front Rear - Left side - Right side -
COMMENTS:
a .
•
SYSTEM USE APPROVE YE NO
d- /-5- Buil ng Inspe tor
01/86 and vl
/4111(
TOWN OF QUEENSBURY 4. CZ.- ,
' FIRE MARSHAL 1
4r.^
QUEENSBURY, NEW YORK 12804 t.,,;""
TELEPHONE (518) 792-5832 (?s0C)
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
�
NAME \ts) LO } �l e�F = '
LOCATION -°c. N(\ �'',(/VL.'C----
DATE I /Y1/9 / PERMIT# 9 / 714
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS /
EMERGENCY LIGHTING
FIRE EXTINGUISHERS \./
AUTO. EXTINGUISHING SYSTEM A
HOOD INSTALLATION / 't
AUTO. SPRINKLER SYSTEM / '
ALARM SYSTEM I
INTERIOR FINISHES ;
STORAGE: /
CLEARANCE TO SPJRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE!
CHIMNEY /
WOODSTOVE f
REPLACE-M ,SONRY
�.,/FIREPLACE-F CTORY BUILT
REMARKS: Zvi OK TO THIS DATE
ARRIVE ,,//
DEPART /6''�''- 0/ /
/ I-NSP CTOR
//L//'� ; //J�v lel! r
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P ')
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 C C
NAME ‘0\0+ , �fv‘ ()V ' \
LOCATION If \ \ 1\C'.
DATE PERMIT # CAE J - r7 L7'
TYPE OF TRUCTURE
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
•C ROUGH PLUMBING A.
X PLUMBING VENT/VENTS IN PLACE !�
PLUMBING UNDER SLAB
FRAMING: I
JACK STUDS/HEADERS /
BRACING/BRIDGING
JOIST HANGERS x
JACK POSTS/MAIN BEAM
FIRESTOPPING
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CEILING I
FIREWALLS / },
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)\INSULATION:
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FOUNDATION W LLS EXTERIOR R-
FLOORS R- t
WALLS R- ict
CEILING R- 3�
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
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ARRIVE -
DEPART L
INSPECT R
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TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT /
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REQUEST FOR IN$)PECTIO�iRIECEIVED 11�.a�
NAME {1\1 diCLOT
LOCATION ;11 I ). c\ -�
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DATE `) � PERMIT I I _7L/
TYPE OF STRUCTURE r •
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE e'
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS (FOLLOWING
THE PLACEMENT OF THE CONCRETE4
MATERIALS FOR THIS PURPOSE ON ?SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING k
BACKFILL APPROVAL \ I
ROUGH PLUMBING } a`
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
RAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING I
JOIST HANGERS I
JACK POSTS/MAIN BEAM y ‘
FIRESTOPPING I
WALLS P ,
CEILING d 1
FIREWALLS I •1
HEATING ROUGH-IN
INSULATION: I •
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS ----- I R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
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ARRIVE
DEPART dO d�
INSPE OR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT j) C
REQUEST FOR INSPECTION RECEIVED l
NAME /�;(� i /S� � fl C cLOCATION -=. Ga/1L(9_,
DATE , \ C C PERMIT # I --'i g
TYPE OF STRU TURE S_ C') .1
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 FOLLO,IING
THE .PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSEION SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE J
FOUNDATION/DAMPROOFING 1
XBACKFILL APPROVAL ,r"
ROUGH PLUMBING /
PLUMBING VENT/VENTS IN PLACE "
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS ./
BRACING/BRIDGING / 1
JOIST HANGERS /
JACK POSTS/MAIN BEAM/ I
FIRESTOPPING
WALLS
CEILING / 1
FIREWALLS /
HEATING ROUGH-IN /
INSULATION: ,� I
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS � R- •
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE ,I2)
DEPART
INSPECTO
TOWN OF QUEENSBURY RYL''7
BUILDING AND CODES DEPARTMENT
531 BAY ROAD / i
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
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NAME �r�f2Q-e1" laAA.E-(,
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LOCATION X,04-- -f ,
DATE // iS/ / PERMIT # 9/ 741/
TYPE OF STRUCTURE 1 7X)---
RECHECK APPROVE
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS� FOLLOWIN
THE PLACEMENT OF THE CONCRETE.,,
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR j
REINFORCEMENT IN PLACE\
FOUNDATION/DAMPROOFING fi
BACKFILL APPROVAL \ r,
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PEACE
AR
PLUMBING UNDER SLAB
FRAMING: A'+
JACK STUDS/HEADERS / '
BRACING/BRIDGING I
JOIST HANGERS /' 1,,
JACK POSTS/MAIN BEAM 't
FIRESTOPPING
WALLS
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FIREWALLS /
HEATING ROUGH-IN /
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WA/ LLS EXTERIOR R-
FLOORS f R- '
WALLS / R- \,
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES /
REMARKS:
ARRIVE ,�
DEPART IIt5
SPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST OR INSPECTION RECEIVED I ` LI)
NAME P,5 G �ti �
X-. 1 ) _
LOCATION L1
DATE )J ) ) PERMIT #
I
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TYPE OF STRUCTURE
RECHECK APPROVE
N/A; YE NO
`' FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING rI
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR ��,
REINFORCEMENT IN PLACE i r
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL .
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE r,
PLUMBING UNDER SLAB
FRAMING: 1;,
JACK STUDS/HEADERS
BRACING/BRIDGING /;
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS i
CEILING 1�
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R- 1
A
FOUNDATION WALLS EXTERIOR R-
FLOORS }1 R-
WALLS j R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
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DEPART '9J
INSPECTOR
11 •
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RECEFVED
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OCT 16 1991
BLDG. & CODE DEPT.
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