1993-025 �- Q•�,.. /-.pie P - - - - , .> 944
CERTIFICATE OF' OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date January 25 is, 96
This is to.certify that work requested to be done as shown by Permit No. 93025
has been completed.
This structure may be occupied as a
SINGLEWIDE MOBILE HOME
PITCHER RD>
Location
Owner BENW.AY. TIMOTHY & DEBORAH
TAX HAP NO. 125, _i -2 9. 13
By Order Town Board
TOWN OF QUEENSBURY
Ct. .5---tk Olt;
Director of Bldg. & Code Enforcement
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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW Y,..R1(
Date a 1 7 19 ci3
This is to certify that work requested to be done as shown by Permit No. 93-025
has been completed.
This structure may be occupied as a single wide/single family mobile home
i.neation Lot 6 Timber Lane, Forest Park Mobile Home Park
Owner Frank Parillo
Mobile Home Owners: Timothy and Deborah Benway
By Order Town Board
TOWN OF QUEENSBURY
(7,/.),
Director of Bldg. 6: Code Enforcement
--I
BUILDING PERMIT
TOWN OF QUEENSBURY No. 93-025
WARREN COUNTY, NEW YORK0-1
PERMISSION is hereby granted to TIMOTHY & DEBORAH BENWAY ^�
OWNER of property located at Lot 6 Timber Lane Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Si ngl ewi de Mobile Home
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
Forest Park/Frank Parillo
215 Ballard Rd, Gansevoort NY 12831
m
2. CONTRACTOR or BUILDER'S Name
Lamplighter Homes
3. CONTRACTOR or BUILDER'S Address 0
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4. ARCHITECT'S Name fD
tT
0
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
Ol
( )Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications
No 14'x76' Singlewide Mobile Home as per plot plan, specifications w r
and application. CD
8SirnOe gamily/single wide mobile home
to
$ 66.00 PERMIT FEE PAID —THIS PERMIT EXPIRES February 5 19 94 m
(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.) co
Dated at the Town of Queensbury thi SthDay February 19 93 a
SIGNED BY for the Town of Queensbury
Building and Zo Inspector 0
fD
i
TOWN OF Q UEENSB URY
REVIEWED BY: / (�
FEE PAID: $ "' c
PERMIT NO. q3- 001 5
APPLICATION FOR PERMIT
MOBILE HOME OR MODULAR
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED.
The owner of this property i r 147/ E1 ' fie
P.O. Address: i 6 ___ ofie Phone Number
J hh
Property Location �J�?'/- ;�?, Tax Map No/02, / / /o�q./_3
NAME OF APPLICANT: LarlOVAI-i,- 14 r e J c
Address of Applicant: . 4 (;) �� � �� - ���x�,94;,r � 42
All applicants spaces on this application MUST be completed and the
signature of the applicant MUST appear on the reverse side of this application.
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES:
MOBILE HOME INFORMATION APPROXIMATE VALUE OF HOME: $ i? , ''45
New Home Yes No - ZONING INFORMATION:
Replacement Home Yes(9 Size of Property: 0 ft x /(fD ft
Size of mobile home ELI ftx Woft Existing Buildings:
Singlewide /X Doublewide
Proposed building-distance from property line:
No. of rooms (exclude baths) 5 Front Yard ft Rear Yard ft.
r� Side Yards ft and ft.
No. bedrooms
`� Occupancy Informati
No. of bathrooms
Primary dwelling: No
OFireplace
/ Woodstove Accessory Building(s) :
_Detached garage (one car /two car car)
Foundation style and size: Attached garage (one car /two car car)
Piers-No. of Size ft x ft Storage building
Other
Depth below grade ft
* * * * * * * * * * * * * * * * *
Foundation-Footing size " x "
Proposed date of placement:
Wall material
Wall thickness . " Height Water Supply: Well Municipal
Total depth below grade ft. Septic permit required? Alb
Grade to home floor level ft.
FURTHER INFORMATION REQUESTED ON THE -REVERSE SIDE OF THIS SHEET
S•.
NAME OF INSTALLER/MOBILE HOME DEALER: p 4 A /-Ane,N J -
ADDRESS/PHONE 'NUMBER RIb f 2 Q 14-- &-A,),41Y(/ ILO Pea)
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE
1. Insignia serial number // ''
2. Name of Manufacturer 0C.� )40YnedZ
3. Plan Approval Number K-Es i ISO
4. Model or Component Designation
5. Date of Manufacture f La - -
All- the above information is to befound on a plate or sticker which
should be affixed to the Mobile Home. Complete above with that information.
'Town of Qu'eensbury - - State of New York
County of Warren- - _ — -_- - - =
I swear that 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.
ktSignature '="11 . . i
Callo
Owner, owner' s agent, architect, - "
contractor
SPECIAL CONDITIONS OF PERMIT:
By
Code Enforcement Officer
TOWN OF QUEENSBURY
531 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date / 1)9 ,19 93 Permit No. - "Ca-
APPLICATION IS HEREBY MADE to the Building Dept. 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 to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant Limn 4 Ai h 1 , ,,, c-. APPLIANCE (check appropriate boxes)
Address MD ' pule. CI raj-- E ck ❑ STOVE: o Wood o Coal o Pellet
❑ FIEPLACE INSERT
N . `1 . Zip /o 8 2.c p FIREPLACE, FACTORY-BUILT:
g Wood [3
Phone i -- ?Gr 3 m 7, c/ ❑ FIREPLACE, ASONRY:Gas
❑ Wood ❑ Gas
Owner ten.04 Li �± Oe..b a n 4/ &A.)WQ 6.-1 0 FURNACE: ❑Wood ❑ Gas ❑ Oil
Address 56 IF NON-MASONRY:
` Manufacturer:
- t !en , C.CS Y. Zip Model: Outlet: inches
Listed By: Number:
Phone '7?3— .fig 6.3
CHIMNEY (check appropriate boxes)
Exact address of proposed construction
❑ MASONRY: ❑ Block ❑ Brick ❑ Stone
40 IL i, tans f?iet.s/ t., FLUE: ❑ Tile .a! Steel
Size: inches
CONSTRUCTION/INSTALLATION MUST M FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer:FACTORY-BUILT:,
Model:
BUILDING CODE. CONSULT TOWN OF Listed By: Number:
QUEENSBURY HANDOUTS PROVIDED a'Double Wall ❑Triple Wall
REGARDING REQUIRED 'INSPECTIONS. ❑ Insulated
Cashier's Department Town of Queensbury, New York.
Dept:Fire Marshal Amount Collected Amount Received
Code Number Title
A 173 3389 (190)Public Safety
A 233 2655 (230)Minor Sales
Fee Collected Fromco)Refunded to: s .., '%,
Address:- ' %` .� /Fl
Dated: / / Town Clerk or Deputy:7\a,., /I NI n
White:Applicant Green:Fire Marshal Yellow:Bldg. Dept. Pink& Goldenrod: Cashier's Dept.
•
,neV.1/90) THE NEW YORK BOARD OF FIRE UNDERWRITERS
ELECTRICAL DEPARTMENT
A.J. REED, GENERAL MANAGER
RESPOND TO:
❑ 85 John Street ❑ 41 State Street 0 570 Delaware Avenue ❑ 217 Lake Avenue El 202 Arterial Road
NEW YORK,NY 10038 I ALBANY,NY 12207 BUFFALO,NY 14202 I ROCHESTER,NY 14608 I SYRACUSE,NY 13206
(212) 227-3700 (518)463-2122 (716)884-1155 (716)254-0141 (315)463-8552
THIS IS A REPORT OF(SEE BOX CHECKED HEREUNDER)
''
A. ❑ NON-INSPECTION B. C 7NSPECTION C. ❑ ELECTRICAL SURVEY
-
JOB LOCATION: (: T . . ; ' _.t- .✓'-- _�_,
APPLICATION NO.: 1-" , • PERMIT N .: t• - 6"1
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TO: 1,4 ,; r i i 1 e- t, '' '1' i r t; . irc.•.. OWNER/ Vv., .:
rk i i /,,- TENANT f
k.. ..) �. 1„�, �' ADDRESS
i*
elt.4/4. P'61 /AY l-CC 14--- .
A.NON-INSPECTION: We have received your application for an inspection of the electrical installation made-by you at the
premises named herein but we have been unable to make the inspection for the following reason:
LI Floor location and name of tenant not furnished ❑ Premises locked, no entry possible.
❑ Floor location of building'not furnished LI Other .
Inspector's Signature Date
Please provide the necessary information or suggest arrangements for our access to the premises on-the green form
attached and return it to this office.
Applicant's Signature Date
B. __ C.C
INSPECTION OR-ELECTRI.CAL.SURVEY: We have attended at the premises named herein to inspect the electrical
installation,and regret that w`e-can-not-issue-a-cer-tificate-of-compllanee-for the r-eason(*iim• d serewlde —
❑ Concealed work not exposed'sufficiently ❑ Additional electrical work found for which no application
for inspection. - - - for inspection has been.received.
❑ Installation not completed sufficiently ❑Electrical-installation does not comply with National
for inspection. Electrical Code for reasons listed hereunder.
- ' ' (see reverse side far explanation of coding)
KEY TO FORM: Code number printed under BLACK column listed below combined with code number printed under RED column•listed below:
indicates condition. EXAMPLE: BLACK RED = Service Conductor not of proper capacity.
76 45
BLACK RED FLOOR BLACK RED FLOOR BLACK RED FLOOR BLACK RED -FLOOR
il , .
I ' ,,.4
'Z ='_3 - pector's Signature `,ram/ --'/ >' f-
)--- Date �' ` .
i
NOTICE TO APPLICANT: Please=s' ,•.d to and return green,copy of tits
form to request re-inspection when modifications have been made.,,} APPLICANT'S SIGNATURE DATE
iiiiiiiiiiiiiiiiv OF ELECTRICAL SURVEY, A NEW APPLICATION MUST BE MADE FOR RE-INSPECTION.
THE NEW YORK BOARD OF FIRE UNDERWRITERS CERTIFICATE NO.
r- DO NOT WRITE HERE-FOR OFFICE USE ONLY 1 .
, .
BUILDING PERMIT NO.
i
I ,TEMP.ft DATE j /,.... (.41 ',.-/.4j,,, ')
i .
CITY OR VILLAGE TOWNSHIP COUNTY/y.11,ir
STFIEET AND NO.OR ROAD -^ . -
' 317 ' ' I1
.,;./n.1,kr-2,14NUMBER
... I 1112 Li jet F4 in 1
,f
BETWEEIMHAT TWO CROSS STREETS IS PREMISES LOCATED? .1") /1 . ,,,, SECTION i BLOCK /'-''WT.
.. t)(3.(1 (.1..,..rtr..e-,<-724 i-7A,',C.,V• (..... /-s)ri, ,i)epi of. .
OCCUPANTS NAME , BUILDING OCCUPANCY
f
--., s 1 i n ,
,
it, 44-- ) :.csi cf-..-1-;,,( r-,e..--J i,,,A3c,t2i . . . - •
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
s.,....)
CURRENT SUPPLIED BY . , FROM THEIR OFFICE WORK TELEPHONE NUMBER
•
. .
'
• •
. BUILDING IS
. .
NEW IR ' .', OLD 0 ' . WORK IS - .,, NEW D ADDITIONAL 0 DEFECTS REMOVED 0 '
•
-LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED .
..
• NUMBER OF OUTLETS No.of Fixtures& .L MOTORS HEATERS BRANCH ..OFFICE USE
oca- • -
• Lamp Receptacles CIRCUITS ' ONLY ,
,tion Side Attach't H.P. n, Watts ,No.Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each '''). Each Gauge INSPECTION
. .
.. OUT- . , ..
SIDE
.SUB- . • .
,;, . BASE ' ., ' • • .•
. . . •
.
'" MENET •
'
1st .
. • ' -
FL , . .
. •
. 2nd . , . .
. ,
FL ' .
' ,
3rd
• FL '
-
, •
. • • •
•
. '
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
. .
'
'
. .
'THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT. -
-
,
. _ . •
' _SIZE OF MAINS .„, ' . • FEEDERS ELECTRIC SIGNS/LAMPS . TOTAL WAITS • .
, .
. i&D.' It.2;'7'1.-1.- • •
. • ' ,-, •
, CHARACTER OF WORK '' LJ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
' .
D CONCEALED - .
,DATE WORK TO BE STARTED DAM COMPLETED SIZE OF SIGN(NUMBER) , CAPACITY .
. .
,
SERVICE ENTERS BUILDING ' MANUFACTURER OF SIGN
El OVERHEAD .E-UNDERGROUND •
, DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) ' MUST ENTER APPLICANTS LI., ii ,, i i 1 e''' 19 1,'14 1 s-1 . - •IDENTIFICATION NUMBER
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
.PRINT NAME AND ADDRESS . .
s .
i'
MIME OF APPLICANT k > ...-,.. • DATE-OF APPLICATION SIGNFURE,pF APPLRNT/-3 (:. i
) P(41%1-,...,(i__ r-.6-•,,,,.-&-_, ....t.,-;.)-c_:._ . . /,09 fq. ? x :)...iv49,-.7-_-,4:5 t.,... --trt ,,,,,...-__ -1 ;
_
STREET ADDRESS r.-, / „.., . • •'• .TELERHONE.y.0, ....., -.-,.....,,,-, ..
/j_ /..., 4,./
I\,"-.) rr .1'elec.,- 1 ,--V, 6'- :77 •;''''''/707,,,-4
CITY OR POST OFFICE i: ..• . S • ( ZIP CODE.-. - - LICENSE NO.WHEN APPLICABLE '
. ' /--dwAit 61 . • • . , -/i
r..--e-,...2,--s!c. . • . •
. 0 85-John Street 0 41 State Street • -in 570 Delaware Avenue o'217 Lake Avenue -d.202 Arterial Road
NEW-YORK,NY 10038 , 'ALBANY,NY.12207 BUFFALO,NY 14202_ ..RQ.CHESTER,NY 14608 , SYRACUSE,NY 13206 '
(2'12)227-3700 ' .•' (518)463-212,2- • „ (716)-88471.155 ;1. "(716)2.540.141' (315).46.3-8552-
.,
. ..
- •''' .--.-. .•..— . ..—:A B \ /A....111 B'; A,01 A .-.7.-... ........ ,..if i. •n _'':.0- Ifik:I IN:I ..r r••••i-A,1 l 'f'I;;1`"'.1.1 0.1
!(.(t/.1,9 9,,,1•, •{1009/ 19/,19119/19/19(1,9,19/ 19i 19,J•J 19/ ff, 19i P,19/1•(?•,19/ •,19/,_•>,1•,,19)11/ Ilk.j91,k9i 1•t..19 •,.1•i l•)c/9,.)•i •,.j•,;b 39>.1•,,1t, f, t:,•, 1•.}t,,•, C•, ,b.r•/4
11 THE NEW YORK BOARD OF FIRE--UNDERWRITERS ['NAG 1 a
: iL. <J,K.1 b '1
4; BUREAU OF ELECTRICITY
�, tf`g 41 STATE STREET,ALBA NEW YORK 12207
•c, NOVl:i�.1Bi'.�iR 12,.19t- 1 1 ',':'()2 /r:)..: A l.f':04 3
Date Application o.on fi ;:
PEW i T NO. '')ao2.5 / ii
•:<c: THIS CERTIFIES THAT :'i
• only the electrical equipment as described below and introduced by the t named on the above application number in the premises of
!: D[;,:ORRU & TI1'`LOM DENMA.N, TIMER LhN1:;:, 4>UENNSBU} V_ N.V.
•• in the following location= El Basement ❑ Ist Fl. CI 2nd Fl. Section Block Lot �' .�
�' SUMMER I 1 Ed 01, 199J
4:1F: was examined on and found to be in compliance with the National Electrical Code.
l: FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;::
-'• OUTLETS • INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. •�
�: `i
-1: 'i
BELL MULTI-OUTLET DIMMERS ,-'-�' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS UNIT HEATERS
t; SYSTEMS )
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS._TRANS. AMT. H.P. NO.OF FEET AMT. WATTS .,
:
-Si
_ _!:. _SERVICE DISCONNECT__,NO.OF -- _. _ S --- .E_ -- -- R_-- - V I C E .t
AMT. AMP. TYPE EQUIR 1,B'4W 1.�'3W 3,i'3W 9,@'IW �• R a-COND. OF CC.CAD. NO.OF HI-LEG OF•HI•lEG NO.OF NEUTRALS OF NEUTRAL i -
t i
J.
J.
R•
-• OTHER APPARATUS:
1,
14
SERVICE RE DERho-.1 • '•
t:e1 titicE t,4r, This iv d h1 3 1
�; for St' ices Rendered Oni . ,
4ut+d'ti'1,T 11Tlai; HUM'S - . (.. .,
R1'1 2, [ i 9 •- = 2v,77e
.; FORT WARD. NY, 12828 BRANCH MANAGER
i4 i
.-' Per `;
.; This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
i-cr.,--,Af •7 qY-,ert.,",.�" -yi 7• milimairsim 0 mil ® 0 • 4,4,p -i•C-i•i'i•,-i•-7•j 7•i i•;"?.;-;., „ 4 '4-‘-yt✓•1'4 iab •,-4i iN 4i.4- • 4;4. •,):.
COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
/%'ice
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTI RECEIVED
tom--,
NAME ///k �e prl,
LOCATION / P '
DATE -2 A. 9.7 PERMIT 93-G'Z-.S---
TYPE OF STRUCTURE /4 /1r/ X--
RECHECK ccT „=f a Ilec/C/
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATI/ON BACKFILL FRAMING
_ROUGH PLUMBING 1FINAL ELECTRICAL _SEPTIC
_INSULATION WOO STOVE/FIREPLACE
REMARKS 1 if
1
\ / APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCAfl N
B VENT/LOCATION
PLUMBING VENT Y
ROOFING
SIDING i stk
DECK/PORCH/STEPS/RpA'I LI NOS
RELIEF VALVES 4
FURNACE/HOT WATERIOPERATIp G
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/P VACY DO*
FINISH FLOORS:
BATH/KITCHEN ATERTIGHT
OTHER FLOORS SWEEPABLE \
OTHER FLOOR CARPETED \
STAIR CLEARAN E/RAILINGS
HANDICAPPED CCESS \
SMOKE DETECT RS N
BATHROOM FA /WHOLEHOUSE FANS
ALL PLUMBIN FIXTURES OPERATING
GARAGE FIR PROOFING �—
DOOR CLOSE S
OTHER FIRE SEPARATION
FIRE/DEMI E WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
c-PsC- 0-
/Vb cp6- la°AA6
C+�-4-e,Co,+) &tire_ /,04-c__
ARRIVE [:- N.
DEPART j= 36
I SP T
la'ee
TOWN OF QUEENSBURY
jaw,
531 BAY ROAD
, t: QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED� p'�1�'/I q3
j,( �}2 NAME � 4� 1- / Jtii t e/4 \ 41
LOCATION ` L /N R
DATE 911.2 / PERMIT0
TYPE OF STRUCTURE `j f(J,
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS i(,u.ee.
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION I
B VENT/LOCATION .� I
PLUMBING VENT /
ROOFING 1 /
SIDING t . /r
DECK/PORCH/STEPS/RAILINGS'
RELIEF VALVES ,yI �.
FURNACE/HOT WATER\OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCES%RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITEbLAN/VARIANCE REQUIREMENTS
FINAL. ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
AUo L-l�e. .F2(,va-�- � -
i2 Ica L 13o X Le GCS
► -CF 5 703
ARRIVE /: S5�
DEPART 2=007
INS
TOWN OF QUEENSBURY /elaZ
FIRE MARSHAL i)4%97
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED cP/j,�/Cf
NAME �M J 4y i /tL��D'L 4P4T,z.,(/'z
LOCATION 6 , 4�
DATE a//2 f f.8 PERMIT# 9,3-02S-
Lll (4 :gi7d1J t APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS �
AUTO. EXTINGUISHING SYSTM
HOOD INSTALLATION /
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM ,
AINTERIOR FINISHES
STORAGE: n�
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATI 6 UNITS
REQUIRED SIGNAGE
if
CHIMNEY if
WOODSTOVE /
FIREPLACE-MASONRtY
1FIREPLACE-FACTORY BUILT °,///
dYl 2 D 3477 rz'9 sii,3i7-/
REMARKS: 1 1 OK TO THIS DATE
2/015 'INSPECTOR
R ##' TOWN OF QUEENSBURY
s,•• £?
01� BUILDING & CODE ENFORCEMENT
41 742 BAY ROAD
NY 12804
+, 5" 01 (518)745-4447
a
iVc.: r;r) DEPART: PLI INS
FINAL INSPECTION REPORT - RESIDEN L
DATE INSPECTION REQUEST RECEIVED:
NAME I 1 V
LOCATION (S1 1 l [dj _ UNII3� 7
DATE I I •2-, ?�GIST PERMIT l 3—OZj
TYPE OF STRUCTURE PI flat N t E.-
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING SEPTIC INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
' EXTERIOR FINISH
. DECK/PORCH/STEPSALINGS
RELIEF VALVES
FURNACE/HOT WATER O'ERA NG
INTERIOR TRIM/PRIVAIY DOORS /
FINISH FLOORS: /
BATH/KITCHEN "ATERTIGHT /
OTHER FLs4RS SWEEPkBLE
OTHER ,LOORS CARPETED/
STAI• CLEARANCE/RAILIN S
Sv•KE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
CFINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
/
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
•
•
i
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