1991-821 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date .A JQ St 20 19 92
2_01s n - 1 -3S
This is to certify that work requested to be done as shown by Permit No. 91—RP1
has been completed. -
This structure may be occupied as a si no1 a fa&i 1 v del 1 i nu
I Stone Pine Lane
Locatio
Owner Michael J. Vasiliou Inc.
By Order Town Board
TOWN OF QUEENSBURY
g/79f ra,"
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-821 17.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Michael J. Vasi l i ou Inc. oo
OWNER of property located at Lot 015 Stone Pine 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. ftc
tv
1. OWNER'S Address is
14 Stone PIne Lane o'
Queensbury, NY 12804
2. CONTRACTOR or BUILDER'S Name —''
Same
ro
3. CONTRACTOR or BUILDER'S Address
r
0
e+
4a
4. ARCHITECT'S Name
N
e*
0
lD
5. ARCHITECT'S Address
CD
lam°
li
6. TYPE of Construction—(Please indicate by X) fD
(X)Wood Frame ( ) Masonry ( )Steel ( )
CM
7. PLANS and Specifications
No. 3,260 sq ft Single Family Dwelling as per plot plan specifications a
and application �.
8. Proposed Use 444
Single Family dwelling with attached 2-Car Garage and fireplace
• J
.d.
$ 426.00 PERMIT•FEE PAID —THIS PERMIT EXPIRES November 25, 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 25t Day of November 19 92
(7.1)
SIGNED BY N) for the Town of Queensbury
Building and oning Inspector
TOWN OF QUEENSBURY •
REVIEWED BY L:. / '_//
.f/, 1 FEE PAID $ /,Li0/ , Oa °�''�-t r,:c ;;r ,^� 60..:
F $ , PERMIT NO. Cy
- -. Win. r.A; -} TV?
f��y p
BUILDING PERMIT APPLICATION L''::'''k,n`� j) 1991 ��,
BUILDING & CODE DEFT.
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: ItI't(C.Hel__ V AS/L
/00 /c.icZ ,
P.O. Address / ,,10AiE SG- •/ Tel. 73 -,3 63
Property Location Zd 7 ._ /9't � E Tax Map No. ,9 '/U / (i
Has there been any split of this property since October 1, 1988? /
If yes Planning Board Review is necessar . yes no '
SUBDIVISION NAME, IF APPLICABLE //VES Af, Z2P-P LOT NO. C
THE PERSON RESPONSIBLE FOR SUPERVIS ON OF WORK AS REGARDS TO BUILDING CODES IS:
� � /793 73.6
•
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF '
* "—
Construction of a new building •. CONSTRUCTION: $ �d�` �Q
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property / • Z heg Ec x ft.
Alteration to a building , •
(no change to exterior dimensions) Existing Buildings(3) Size ft. x ft.
* Proposed building - distance from property line:
Other work (Describe) * Front and -y $S ft. Rear yardft.
•
Side yards 490 ft. and 3 O ft.
•
GROSS AREA OF PROPOSED STRUCTURE * If on cornier, setback from side street ft.
1st Floor / 740 sq. ft. a/lo,
OCCUPANCY INFORMATION
•
2nd Floor 15-00 sq. ft. /3S • Primary Building -
Other Floors it. 4 b j, • 4_One Family Dwelling
(not cellar or basement • . __Two Family Dwelling
TOTAL FLOOR AREA3Z GO.sq. ft. • Multiple Dwelling/Number of units
Size of new structure .ft x ,ft. * . Business
Foundation-pier/slab/crawl/partial/full • Industrial
(circle one) - • Other -
•
No. of stories (habitable space)_ •
Height (grade to ridge) 2 / l ft. • If addition, what will use be?
If residential, no, of families / •
No. of rooms(excluding baths) / • Accessory-Building
• __Detached Garage ONE/TWO Car
No. of bathrooms •
Primary heating system 64.5 hie'r4da. • _Attached Garage ONE WO Car
Type of fuel MO. 4 •
__Private storage building
No. of fireplaces to be installed •/
*
__Other
Will a wood stove be installed /r/lam
Central Air conditioning le_s •
OV• ER
.
1
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING 3PECIFICATIONS:�
Type of construction, wood Pram , fire safe, etc.
Will any second-hand or upgraded lumber be used? If so, for what? A/Q
Foundation wall material fROIOES Thickness E
Depth of foundation below grade (to bottom of footing) 66
Will there be a cellar? )( Heated or unheated? yes Floor sq. footage /7 O 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 - slope• 'flat/shed/other Material of roof AS per.-L T ,c/f-sy /,
Size, wood studs 2_ "x G " spacing !G" o.c. length k ft.
Joists (floor beams) 1st floor Z "x /0" spacing /` "o.c. span /, " ft.
Joist (floor beams) 2nd floor .. "x /6" spacing A, "o.c. span // ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x - " spacing o.c. span ft.
Roof truss s (pre-engineered spacing Zy " o.c. span 31 ft.
Exterior wall finish C P 8C)Ii .D of what material? 06---64-02...
Interior wa11 finish v•Per•NTH- 'jv.t,/
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: y fj, '
Is there to be an opening between garage and dwelling? x, If so will a Fire-rated door, enclosure,
self-closing device be provided? yes
Will a flue-lined chimney be installed? Height above roof / ft.
Depth of chimney foundation below grad a 66 ft.
Depth of fireplace hearth / ft. 8 in,
Water supply - Municipa . private well •
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties /oo ft.
(A separate application is necessary for any repair or new installation of septic system)
NAME OF BUILDER /I fA LJ S/L/ AAA-, /9Sb4EA1t,2" TEL. NO. P.3
NAME OF PLUMBER F 10A ADDRESSgitrree/(!1T TEL. NO. 75f VS ff
NAME OF MASON w/ft.Q ADDRESS/9 ,C'J TEL. NO.XZ—'
NAME OF ELECTRICIANP,44-4/1".) ADDRESSI m, /e TEL. NO. Pf2
DECLARATION
To the best of my knowledge and belief the statements cnn1" '.d 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.
ld
•
Signature
_2/1.4,e
Owner, owner's nt, 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) V
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
•
APPLICANT'S NAME PROPERTY LOCATION V
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 3�6 0 ' Sq. Ft. -
2. Type of Heat - . Elec. Base Board Other
3.- Is Building Mechanically Cooled? x 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 5L
D. Exterior Doors V R 2i
E. Floors over unheated spaces . V R
F. Edge of Slab on Grade (Heated Building) R .
G. Basement/Cellar Walls (Above Grade) ' R V
H. Basement/Cellar Walls (Below Grade) R
I. Heating/Cooling - Ducts - Piping in Unheated Space R -
6. Service (Domestic) Hot Water Heating Device V '
A. Conforms to.minimum. efficiency per code YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140' - WILL NOT BE EXCEEDED
A I • c,r/ .� ////t/ /
` DTELEPHONE NUMBER
INSPECTOR'S REMARKS:
TOWN OF Q UEENSB URY
Bay at Haviland Roads,Queonsbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date t' , : ~ f 19 Permit No. .
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 premises for the required inspections.
Applicant's Name L f ' ', APPLIANCE TYPE
Stove Coal Wood
Address Furnace Hot Air Boiler
Zero Clearance Circulating Unit
! .
Phone
If Non-Masonry:
Owner's Name
Manufacturer
Address ,`' Model Outlet Size
Zip Listed by Number
Phone
CHIMNEY TYPE
Masonry: Block Brick ;'`. Stone
Property location of proposed,:construction Flue: Tile " Steel
Size:
Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Heigh____ 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.
CASHIERS DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department: Fire Marshal Amount Collected Amount Refunded
Code Number Title
A 173 3389 090)Public Safety
A233 265.5 (230)Minor Sales
Fee Collected from or Refunded to:
Address:
i)ated, Town Clerk or Deputy
White:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
c
Nr-F0 TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: `,/ f/ Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: 17- 11'4L .5;11.1,/F ,w.4 /dit rv(
Owner' s Name: h tCN4.c L.,. cif t IIS, 4./aL) i JC .
Owner's Mailing Address: lY ,Stdy„t ?e0/6 /AK'S
Installer' s Name: / Pb(.j cAe,i Phone #: 792 '' Q2 Z 2.
Number of bedrooms (if residential ): Iv
Total daily flow (residential-compute @ 150 gal . per bedroom): eet5
Topography-Circle One: 410 Rolling Steep Slope % of Slope
Soil Nature-Circle One: and Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: of Required Required/Rate Min. Per Inch
Domesti ater Supply-Circle One: Municipal Well Other
If domes is water supp is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /2 S) gal . (Minimum size: 1,000 gal . ) . v
Tile Field: Each Trench Al eet//Total System Length itgagF feet itek
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # 2— / 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: DATE:
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 $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Quei,ns:_ r;� .NY 12804
C.
Remarks:
,,....... MIDDLE DEPARTMENT INSPECTION AGENCY, INC..-
- j National Headquarters
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date: // "* f/
City, Town or Township A County State
Location/Address /6 10 _ 5- ^m ff ,( C `r
(If o ted Rural Area -Please Attach Directions) Pole #
Owner - h e C flT . t�' 44 c ,4/00 �' Permit # �(
Occupied As _-„j �,r , a�� - Building: New Old
Occupant
Work Area in Building (Floor #,.etc.):
App. for: Wiring X Service( or: Ready for Inspection:
Fee Remitted-$ 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 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'/2 2 3 5 7'/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's
Signature License # Permit #
T/A Utility:
Applicant's Address: 1- / (NAME) (OFFICE LOCATION)
(City) 4-[r it' (State) (Zip) 0,0i0 ' Service Request #
Phone # / 735- ? Electrician:
r
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above❑ or:
Red Notice Label n • - -
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
1 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
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❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
1 L/A Owner CASH ❑
n L/A Fee CH K #
Due MO #
n IPA Municipal
INV #
Applicant ❑
Date: Other Side I I Utility Owner ❑
Cut in Card ❑ Temp # ' Date
n Final # Date INSPECTORS SIGNATURE
ADDI Ir-A-rlr,M 'orI195A pin 2Gn FI 11/RO
i TOWN OF QUEENSBURY
i 4 531.13AY ROADs � QUEENSBURY, NEW YORK 12804
" r` TELEPHONE (518) 745-4447
' y" BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME \"f .L._.0('l U -
LOCATION
DATE 2I(7./ PERr1IT# (it^ U 2-1
I/
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
_INSULATION WOODST0VVE/FIREPLACE
REMARKS 2t C c `cIo01ZC., q ,-"-
FtiLAA V6,0 1fi7PtjVPri('!(! 4- 7C#fl1P,.
APPROVAL
N/AI YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VEHT:i
ROOFING G f/
SIDING /'
DECK/PORCH/STEPS/RAIL}'NGS
VALVES ' �'
URNAtEYHOT W TER OPERATING
BASEMENT INSU ATIO /DUCTWORK
INTERIOR TRIMtPRI ACY DOORS
FINISH FLOORS-
BATH/KITCHEN ATERTIGHT
OTHER FLOORSISWEEPABLE
OTHER FLOOR' CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPEDIACCESS
SMOKE DETEPITOR
BATHROOM FANS/ HOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE ,FIRE PROOFING
DOOR CLOSERS k -
OTHER/'FIRE SEPARATION
FIRE/DEMISE WALLS',
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS _
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C `
COMMENTS: oN ac,6 w%,vi',MnuG 0'7'7C 13
11 isr pc7 cm,t to t a DCt ,r' s uM€- rife
Cop`r(103,C1cC toa'L-a Ilk- ai A Aths r VtAr-
0►-I .TZ. PiPL((A);. -r') I$ DiRC:CI-L-p I Ai-
Coe4 E-)c ,e Vg,J-T'T-C-S , (A)3-V 41 �
ARRIVE
DEPART ✓'.-iJ y /L
. INSPEC 0
fi C0 cs -=>n .'A its lie,/ rzod (/JJmekTrceI,&
•
/ -- INSTALLER'S GUIDE
FLUE GAS DEGRADATION .. . JU, IT �;.j,
•
The moisture content of the flue gas may have a detrimental effect that a corrosion resistant shield(24 inches square)be used behind
'on some building materials.This can be avoided by using the roof the vent terminal. This shield can be wood, plastic, sheet metal;
' 'or chimney venting option.When wall venting is to be used on any etc.Also,silicone caulk all cracks;Seams and joints within 3 feet
• :surface that• ,could be affected by this moisture,it is recommended of the vent terminal.
' PVC WALL MOUNT -.
COUPLING PVC WALL MOUNT
i (PLASTIC . N. FLANGE ' , COUPLING ,
i VENTING) STUD (PLASTIC
VENTING) I,•
( 6 IN.MIN. _ ;, 90 ELBOW
(TO JOINT) 12 MIN.111111 •
r 90 ELBOW
• = 12 MIN. 11• 6 IN.MIN.
', (TO JOINT)� t
,
A
: •_• CEMENT •
• --jj�� ,;MORTAR SEAL
. . T ; VE
OUINSTSEIDE
E,, - N1 •MIN.NAORMALLY
EXPECTED
' 12'MIN.ABOVE OUTSIDE_ NORMALLY
NORMALLY EXPECTED SNOW ACCUMULATION
T CLEARANCE III SNOW ACCUMULATION
(AIR SPACE)` ®. ...
Venting Through Combustible Walls Venting Through Non-Combustible Walls
Pitch_1/a Inch Per Ft. Pitch- 1/4 Inch Per Ft.
• ' . ` ;1. Clearance(0"acceptable for •
:., "\PVC vent pipe)(1"acceptable •
for•type 29-4C stainless steel vent pipe).
t 1.
•HORIZONTAL VENTING,THROUGH WALL- •; Avoid'areas where staining,or.:condensate drippage maybe a -• �
problem. •
OPTIONAL SIDE WALL VENT 1 The vent/wind terminal must terminate at least 3' above any
1 ::Milli. '', forced air inlet into the building that is within 10'of the terminal.
s°MAx. The terminal must also teriniriate 4'below;4'horizontal from or 1' .1
45°ELBOW OPTION - --
' above any door,window or other air inlet into building.-r" ,
•
—90°ELBOW The vent/wind terminal shall not terminate over public walkways
' 1 I I I or over an area where condensate or vapor could create a nuisance
OUTSIDE WALL ; 1--.-• 1 ' ' 1
T_�-- 1___1 :L. or hazard or could be detrimental to the operation of regulators,
/ , . I relief valves,or other equipment. :: • - •: , :
The vent/wind terminal shall have a minimum horizontal clear-
, . %z"ARMAPLEx ance of 4'from electric meters,gas meters,regulators;and relief •
INSULATION
OR EQUAL equipment. - - - .
I 1 PITCH—Venting through wall must maintain 1/4"per foot
/ I 1 12"ABOVE NORMALLY ,
/ Z_' EXPECTED SNOW pitched upward to insure that condensate drains back to furnace. .
, .I ACCUMULATION LEVEL •
i:;,•
_I'- COMBUSTIBLE MATERIAL WALL
A minimum clearance of 1" to combustible materials must be
.�1�
maintained when using single;wall stainless steel venting.
Shield material to be a minimum of 24 gauge stainless or alumi-
nized sheet metal.Minimum dimensions are 12"x 12".Shield must
. . • be fastened to both inside and outside of wall.Use screws or anchor
•
type fasteners suited to the outside or inside wall surfaces. i
The vent/wind terminal must be located at least 12" minimum
above normally expected snow accumulation level. NONCOMBUSTIBLE MATERIAL WALL
The terminal must be at least 7'above grade,if it is adjacent to The hole through the wall must be large enough to maintain pitch
, public walkways. of vent and properly seal.
- Use cement mortar seal on inside and outside of wall.
- dwg. no.21X145280 PO4 page 5
TOWN OF QUEENSBURY ''1
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED P,/t/92
NAME 7,rh,_eil �Q'A1.1 7.G
LOCATION 4_4. ,
DATE , //9/ 2 PERMIT# 9/_42i`
TYPE OF STRUCTURE
RECHECK,9 "Z0?. //0-or l/f✓/�l5Qa&69/>
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
FOOTING FOUNDATION kBACKFILL ,FRAMING
j-R9IUGH PLUMBING_ vrINAL ELECTRICAL. ,/SEPTIC
L/INSULATION WOODSTOVE/FIREPLACE
•
REMARKS ! ;p` •
'APPROVAL
jN/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT k„ / Y
ROOFING I/
SIDING -__ - ----- ioe---- X --
DECK/PORCH/STEPS/RAILING .i X
RELIEF VALVES 1;' •
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY/DOORS
FINISH FLOORS: ✓✓
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED ('
STAIR CLEARANCE/RAILINGSc K
SMOKE DETECTORS Du sr St(-i up orJ --
DOOR CLOSERS
BATHROOM FANS x •
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING pc
DOOR CLOSERS fi
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENj '4 T 5 FQ-1i6 Itluu 6& -
L O CSC' c¢1^
t-v evAce V'&,vt' Trt,.A)nt-T- dAJ D
G '1 r-r /''t i,v, f rzm,v. L(J,.urn ow,
ARRIVE
DEPART /0,;I-C`j
I SPE OR
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. 9 l" F 2-1
Owner A-s 0 Tram I !CJ 14
Occupant _ N _ r p�Ate
Location 4-6 7-`�? Sr Q 6
G rj „(� era
,4X Street
4/1Toown on Corr-CJiityl\ 41�'��/` State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes. %�
Installed by F, t� /4)6 f
44-0--ted.
No. (9d
Date ---... Ituector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood,NJ 08108
to OU L 1 7"e .._..
64 WIRING &CONTROLS FOR." BURNER
if 3 RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
261,OAMP.SERVICE EQUIPMENT r H.P.GARBAGE DISPOSAL UNIT
V/AMP.SERVICE CONDUCTORS I K.W.DISHWASHER
C!!
K.W.SURFACE UNIT 1 K.W. DRYER
K.W. RANGE AMP. 7 J RECEPTACLE
1U
• I
K.W.WATER HEATER /„ FRAC. H.P.VENT FANS
9 7' rzi led e
v� u /'ry SY -
OTORS H.P.i 1/20 1/12 1/10 1/8 '/c % 1/4 1/2 % 1 1%= 2 3 5 7%: 10 15 20 25 30 40 50 75 10(
ARK NUMBER
'EACH SIZE
PPARAJ US
c� // ! r � -
Jown o� Queenibur, . ------
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 ,
SEP IC DISPOSAL SYSTEM INSPECTION
NAME t f-5 i L. i n 0
LOCAT I ON L 07 ST-2---cl ' Ai fr
DATE 7 73// PERMIT NO. Cf/" -/
SOIL TYPE - San> Loam - Clay - _
Percolation Test Required? YES -(Nw
Percolation rate - Min/Inch
TYPE of SYSTEM: j /
Absorption field / totals length
Length of each •rench' 4 Q
Depth of trench-s ' G2 43 `"-f
Size of gravel -"z - _
SEEPAGE PITS-EN .er 9E)
Size- ft. x`._ ft. Al _"'
Gravel size ,
PIPING: P Size Type
ll
Bldg. to tank 4# V4/
Tank to dist. boe,, L( f v
Dist. box to f ie'.Ld%pit l( p ft c_
Openings sealed'? \YES NO Partial
i.
LOCATION/SEPA,I®:RATIONS:
Foundation tc� tank \ /0 ft—
Foundation o absorption f ) ft4--
Absorption o lot line (0 ft --
Separation of pits ,vf 4-ft.
LOCATION 0 SYSTEM ON PROPERTY(circle one)
i on - Rear - Left side - Right side -
S' ENTS:{
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SYSTEM USE APPROVED YES NO
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Bu lding ns ector
71. c ) '4
01/86 and vl
Joum o Queenitury
BUILDING and ZONING DEPARTMEN
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM. INSPECTION
L
NAME 774Zei l?i,
LOCATION,; Pc/ �4 /�irre,
DATE 0✓/ 9 PERMIT NO. �d
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field,. total length
Length of each trench
Depth of trenches
Size of gravel_
SEEPAGE PITS{Number of)
Size- ft. X \ ft. 1
Gravel size ,
PIPING: Size Type
Bldg. to tank 11r
Tank to dist. box ` �I
Dist. box to field/pt;F
Openings sealed?' -YES,f NO Partial
f�•
LOCATION/SEPARATIONSfi
:/
Foundation to tank ft.
Foundation to absorption ft.
Absorption to lot line \ ft.
Separation of pits I \ ft.
LOCATION OF SYSTEM/ON PROPERTY(circle one)
Front - Rear - Left side - Right side
COMMENTS: \
5'/6I 6/v JUd k.ls A-c=c e-Z-4D
Piz PLO, �c
A-D Sal' :Uri
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(t)KL ov 2.4 5-r o •
SYSTEM USE APPROVED YE NO
Building I spe or
01/86 and vl -
en)
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED L \ r1f
j•)..
AN, rA
NAME Vas, mi
LOCATION � �' Y1"� � c
j-66k-(
DATE 10),7 9 PERMIT # 9 / O )
TYPE OF STRUCTURE c-
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 11 /
BACKFILL APPROVAL d I
ROUGH PLUMBING a /
PLUMBING VENT/VENTS IN PLC CE /PLUMBING UNDER SLAB \ /
FRAMING: 1Ir
JACK STUDS/HEADERS A
BRACING/BRIDGING /
JOIST HANGERS I
JACK POSTS/MAIN BEAM/
HEATING -ROUGH-IN
5j(�_ NSULATI.ON.:-.
FOUNDATION WALLS INTERIOR R-\
FOUNDATION WALLS/EXTERIOR R- '\
FLOORS // R- ! f
WALLS / R- "q V/-
CEILING / R- 3/3 ✓
DUCT WORK OR/PIPING IN UNHEATED;\
SPACES /
REMARKS: 1
\ ,
ARRIVE t R
DEPART \,
‘---" I SPECTOR
eln
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT (�
REQUEST FOR INSPECTION RECEIVED *)--,)- /'
NAME b e_ Cl al
LOCATION r
DATE ER➢fIT # q I_g f
TYPE 0 STRUCTURE fC---JW C )
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE /
THE CONTRACTOR IS RESPONSIBLE a�
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING ,‘''•
THE PLACEMENT OF THE CONCRETE. I'
MATERIALS FOR THIS PURPOSE ON S<ITE
FOUNDATION/WALL POUR 1 ,.
REINFORCEMENT IN PLACE\ I
FOUNDATION/DAMPROOFING /
BACKFILL APPROVAL '
ROUGH PLUMBING \ ,/
PLUMBING VENT/VENDS IN PLACE J/
PLUMBING U DER AB /1
FRAMING: 2e.---/i, 1
JACK STUDS/HEADERS / l
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN $BEAM I
HEATING ROUGH-IN / 3
INSULATION:
FOUNDATION WA VLS INTERIOR 1R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / R1;
WALLS R _
CEILING R-\,
DUCT WORK R PIPING IN UNHEATED
SPACES \
REMARKS:
\
k
ARRIVE
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•
DEPART ,':/j('
1
‘',SPECTOR
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TOWN OF QUEENSBURY U
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
. QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447 '
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED / pi I q.
NAME v C F l I a* u. nl i CJ tQ1
LOCATION I t_C- S7�/'� traALRO(-PAJk
DATE zip/co PERMIT # 9 ( c(
TYPE OF STR CTURE S . C---t.
RECHECK APPROVED
•N/A YES NO
FOOTINGS/PIERS • I
MONOLITHIC POUR FORM , I' .
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE `
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURSt. FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SMITE
FOUNDATION/WALL POUR \- .1
REINFORCEMENT IN PLACE \ /
FOUNDATION/DAMPROOFING "=,. /
_BACKEI_LL-APPROVAL_ `;, / .
-X-ROUGH PLUMBING 1 ;f
~PLUMBING VENT/VENTS IN PLACE ..
PLUMBING--UNDER SCAB / ''t, ,/
FRAMING: / : - t/
JACK-STUDS/HEADERS I '
BRACING/BRIDGING /
JOIST HANGERS I 'N
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN / • '\
INSULATION: /
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- \. . •
FLOORS R- \
WALLS R- \
CEILING R-
DUCT WORK ORIPING IN UNHEATED
SPACES
REMARKS: N�
I f �
< ( 0P-d/I'e1' C�ea-ie-- J
dc . : C L;C i W 5' o-"i /��idCt24`-lhCr-in S
ARRIVE
DEPART , , Ar
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
i
NAME n51I 41')U
LOCATION f(�"j�I; iQi
DATE LI) pol uf'Z PERMIT #
TYPE OF STRUCTURE
RECHECK . ' APPROVED
IN/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM i
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 1
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL !4;r
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB ,
FRAMING: ;, !!
JACK STUDS/HEADERS W ?,
BRACING/BRIDGING I
JOIST HANGERS
JACK POSTS/MAIN BEAM 1\
FIRESTOPPING pp4'
WALLS H ,.
CEILING 1! .
FIREWALLS t,
HEATING ROUGH-IN Cl
INSULATION: F'
FOUNDATION WALL ' INTERIOR R
FOUNDATION WALL; EXTERIOR R-,
FLOORS R-\.
WALLS ! R- \
CEILING C R-
DUCT WORK OR IPING IN UNHEATED
SPACES
REMARKS: t_
1:147` rU Cry V 1 ti�� s
itl.A1 kd
LI
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ARRIVE 0;5 {O
DEPART I() ,cC. V
INSPLCTO
TOWN OF QUEENSBURY � �
BUILDING AND CODES DEPARTMENT /;7
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED, 9i.�-f,1 //%O/.�j�z
ME ��ll� lG�l i9 7��,f-�zL,
LOCATION, / 6 ,2�G�L -744t ,4:-At
�j�g�
DATE � � PERMIT # 97',f2/
TYPE OF STRUCTURE -,l2 w ; geir.i .
RECHECK APPROVED
N/A YES NO
FOOTINGSLCEP
•
10NOLITHIC POUR FORM
REINFORCEMENT IN PLACE /
THE CONTRACTOR S RESPONSIBLE
FOR PROVIDING\P OTECTION 'FROM
FREEZING FOR OURS FOLLOW G
THE PLACEMENT OF THE CONCRETE .
MATERIALS FOR HI PURPOSE - N SITE
FOUNDATION/WAU P UR /
REINFORCEMENT IN P ACE '
FOUNDATION/DA PROO ING /
BACKFILL APPROVAL i
ROUGH PLUMBIP(°G ' /
PLUMBING VENT/VENTS PLACE
PLUMBING UNDER SLAB
FRAMING: I / '1
JACK STUDS/HEAD , S 1
BRACING/BRIDGI
JOIST,'HANGERS
JACK 'POSTS/ N BEA
FIRES TOPPING
WALLS
CEILING!
FIREWALLS
HEATING OUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WA LL S R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
r
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•
ARRIVE
DEPART
V
\ 1 TOR
'�Q kg 1
r i1 -ST
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT REQUEST OR INSPECTION RECEIVED q 1 5 /J60
NAME S) U, 1 CSk . `•
LOCATION , Lip J,_S Y\-e.cj .,L
DATE 9a PERMIT# 9, I -" Sol
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SY TE
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TOA PRINK ERS
CLEARANCE T, HEATIN UNITS
REQUIRED SIGNAGE
f' Ir-
CHIMNEY 3,,1„4: ` ,;0S- ,oa=
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: U OK TO THIS DATE
p
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2/015 U SINS ECTOR
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 `7/i?" a'Olit4u
LOCATION 43'� 144 &
DATE / /ii/ PERMIT # q/--9
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS P,
MONOLITHIC POUR FORM E'
REINFORCEMENT IN PLACE ; r'
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM/
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE OWN SITE
FOUNDATION/WALL POUR ;'t I J
REINFORCEMENT IN PLACE V
FOUNDATION/DAMPROOFING j, t/ /
BACKFILL APPROVAL j/
ROUGH PLUMBING rY 10
PLUMBING VENT/VENTS IN6PLAC'E
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS/
BRACING/BRIDGING I'
JOIST HANGERS /
JACK POSTS/MAIN /BEAM
FIRESTOPPING �T
WALLS
CEILING
FIREWALLS ( 1
HEATING ROUGH-I,
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R- \,
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE /7
DEPART 1/ •# �.V�'
/ IN PE, OR
• /9/4
TOWN OF QUEE?ISBURY v
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY,
NEW 0 4
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED , , I -(I
NAME \ c I L l mar t
LOCATION V
DATE P-//D/cj/ PERMIT # A--6c±-�
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES/, NO
OOTINGS/PIERS ' f
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 d'
REINFORCEMENT IN PLACE I
FOUNDATION/DAMPROOFING /
BACKFILL APPROVAL , /
ROUGH PLUMBING /
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB I
FRAMING:
JACK STUDS/HEADERS ":
BRACING/BRIDGING t:.
JOIST HANGERS
JACK POSTS/MAIN BEAM `n
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION: ?,
FOUNDATION WALL INTERIOR R-A
FOUNDATION WALL EXTERIOR R-
FLOORS R- '\
WALLS R-
CEILING R-
DUCT WORK OR IPING IN UNHEATED,
SPACES
REMARKS:
ARRIVE 7
DEPART y 4�
/ / INSPECTOR
All1
TOWN OF QUEE1SBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY,
TELEPHONE (518)NEW 07 RK 4 92-5832
BUILDING INSPECTOR°5 REPORT J�
REQUEST OR INSPECTION RECEIVED j
NAME GS; �1 Old- 1 Olja_12_,
LOCATION f 62 Sims__ 81/1e,62,113a
DATE /I/c2//1-1( PERMIT # 611"',g,,Z(�
TYPE OF STRUCTURE E. _
RECHECK APPROV
--- - --- - - .. 1 N/A YE NO
OOTI NGS/P-I.ERS_"
MONOLITHIC POUR FOM
REINFORCEMENT IN P ACE
THE CONTRACTOR IS 4FSPONSIBLE
FOR PROVIDING PROTEgION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF TH CONCRETE.
MATERIALS FOR THIS P RPOSE ON,SITE
FOUNDATION/WALL POUR \ ,'r
REINFORCEMENT IN PLACE h►
FOUNDATION/DAMPROOFIN&
BACKFILL APPROVAL 9 Y
ROUGH PLUMBING i 8
PLUMBING VENT/VENTS IN 'PLAGE
PLUMBING UNDER SLAB 1
FRAMING: A :1
JACK STUDS/HEADERS 1U
BRACING/BRIDGING
JOIST HANGERS irk
JACK POSTS/MAIN BEAM J+ \
FIRESTOPPING F3
WALLS a r
CEILING s' 1, ,
FIREWALLS X'
HEATING ROUGH-IN ,' ‘
INSULATION: 1 \
FOUNDATION WALLS INTERIOR R-),
FOUNDATION WALLS EXTERIOR R- \
FLOORS I R- \!
WALLS ( R-
CEILING 1 R-
DUCT WORK OR PIPING iIN UNHEATED
SPACES
REMARKS:
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ARRIVE
DEPART f t '
INSPECTOR
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