1993-140 rz
.
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date � G���-�2 c � 199.E
This is to certify that work requested to be done as shown by Permit No. 4 3-14 0
has been completed.
zingte 6amit.y doeU-Lng wLth attached
This structure may be occupied as a uvu cwt. cci- ccicd 8wzay�
Location Ch.ef.�tnwt Ridge Road
Michaek and At ice Cnoi ty
Owner
54-2-15.2 .
Conditional: By Order Town Board
:Use of Bonus Room not approved TOWN OF QUEENSBURY
until receipt of final electrical
inspection approval. -
/7)i,// ,-/
Director of Bldg. do Code Enforcement
>i<
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 93-140
WARREN COUNTY, NEW YORK
� z
PERMISSION is hereby granted to MICHAEL AND ALICE CROTTY
OWNER of property located at Chestnut Ridge Road Street, Road or Ave. ,�, -
in the Town of Queensbury,To Construct or place aS-(.nq-.e AamL.Ly dwe iQing ;''
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
Pex12,(11 Dn i.ve
Hudson i=a,P.Pis NY 12839
H
2. CONTRACTOR or BUILDER'S Name
Kenneth Cotee.e
Cof ette ConitnuctLon Inc.
3. CONTRACTOR or BUILDER'S Address to
Cottette Lane P.
Hud'on Eai.o NY 12839
4. ARCHITECT'S Name
p
5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X) co
c`f•
(A Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
P-
87' 8"x34'4" Two ztony Singte 6amity dweLe i.ng ass put p.2ot p.Ean, z)
No. 4pec,i Utica i.on4 and app.P.%cct i,on including two can attached gaJt.age
and z epic .y4tem.
8. Proposed Use
Singe 6amity dwe.Wing
ram•
$ 309.00 PERMIT FEE PAID —THIS PERMIT EXPIRES MAY 3 1g94
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the �a
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this and Day f May 19 93
SIGNED BY for the Town of Queensbury
Building and Zo ing Inspector
cc)
TOWN OF QUEENSBURY REVIEWED BY: ,d/
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING & CODE ENFORCEMENT FEE PAID: OQ Yj �7
531 BAY ROAD :'.
QUEENSBURY, NEW YORK 12804 PERMIT NO.
(518) 745-4447
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 application form.
OWNER OF PROPERTY: fl1 N-•e ' //t f C-P oTI7
Mailing Address : Pee,k,Ns p,E4Je #UC,</.v f //s A). X • u _ -39
Telephone Number(s) : Work Home 7(/7 •-3-5o9 Other
PROPERTY LOCATION: Uesiivur f? `cO r k ik(
Tax Map Number: Section ,7 4 Block Lot t
Subdivision Name: Lot No.
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ /6o oar)
NEW BUILDING:
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
ADDITION TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL r/ Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL Family Dwelling
(NO CHANGE TO EXTERIOR SIZE) Office
OTHER WORK (DESCRIBE BELOW) Mercantile
Warehouse
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE: ,
1ST FLOOR ..D SQ. FT.
1C `20 O% IF ADDITION, USE OF NEW ADDITION:
2ND FLOOR 7 0 ? SQ. FT.
OTHER FLOORS SQ. FT.
(not unfinished cellar or basement) A ACCESSORY BUILDINGS :
{;a n ,�� . Detached Garage - One/Two Car
TOTAL FLOOR AREA: 23 9 8 SQ. FT. } Attached Garage - One o Ca
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
P7'(-a FEET X 3 4X/ /// FEET
Foundation Type: /-n t12e-c0 Ceovr_./L'e l 1" Will any second-hand or ungraded
Number of Stories : `Z lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : ?b feet Type of Heating System:
Number of fireplaces and/or woodstove (circle all which applies)
to be installed: j Electric / V / Gas / Wood
Forced Hot Air /(aseboaD / Other
fin t
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
Ke it) Co//e]ite
NAME OF BUILDER/ADDRESS/PHONE: (4 ikro Cevo. ( 4//c L,u; ,t f` nin3.3
NAME OF PLUMBER/ADDRESS/PHONE : 5f ut• fl//ram wfesY-/zivon /(cp, -29 7- S 493
NAME OF MASON/ADDRESS/PHONE : Ca 7/e7' �n•u�7-
NAME OF ELECTRICAN/ADDRESS/PHONE : ,von KNQ,0" yPt
DECLARATION
To the best of my knowledge the statements contained in this appli-
cation, 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 noted, and that such work is authorized by the owner.
Further it is understood that I/we shall submit prior to a Certificate of
Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN
drawn to scale, showing actual. location of�roject n e ' ses .
Signature
(Owner, owner' s agent, architect, contractor
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
,,,k4 OF OUEEVSb,.
ENERGY CODE COMPLIANCE APPLICATION
RECEIVED
TOWN OF QUEENSBURY, WARREN COUNTY ,,,, I-
9000 HEATING DEGREE DAYS iPR •l 19JJ
& CODE DEPT.
Compliance Methods : PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT'S NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 2 3 3 ? square feet
2 . Type of Heat - Electric Oil VGas Other
3 . Is building mechanically cooled? Yes y,d/r-No /
4 . •Percentage of area of windows and doors Over 17% ✓ Under 17%.
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R 3S3
b. Exterior walls R /7
c. Glazed areas R
d. Exterior doors R /o
e. Floors over unheated spaces R ^'
f. Edge of slab on grade (heated building) R —
g. Basement/cellar walls (above grade) R //
h. Basement/cellar walls (below grade) R ,/
i. Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Ap��13cantn re Date Phone Number
c/ agi 4 3 7V 7 5"-1 33
INSPECTOR' S REMARKS:
111106. .e\I OF OUEENSb�
� RECEIVED
j TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit R 1993
Fee Paid
Date: e172..6/9 3 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: c44Ps7Zu7' /]4 yr' 7D,
Owner' s Name: k. ko /1//2-12 Cgv
Owner' s Mailing Address: g,e,(!,i,s A. gacesevo / J/ Al )'- / 2 3?
Installer' s Name: k;,� (f/ Phone #: 7(/. ) - 5/ 33
Number of bedrooms (if residential ) :
Total daily flow (residential-compute @ 150 gal . per bedroom): 6 07)
Topography-Circle One: Flat lolling Steep Slope /a% of Slope
Soil Nature-Circle One: Sand oam Clay Other /Depth:
Ground Water-At What Depth? L1 e,vb„, J Feet
Bedrock or Impervious Material-At What Depth? ? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal ell Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption /dco feet
PROPOSED SYSTEM: Septic Tank / o gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 6-0 feet//Total System Length 3 do feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # `Z / 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: 44��9 3
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 $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
., *
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
C ' National Headquarters
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date:5'/,.:r 1 ,
City, Town or Township f County !• State '..
Location/Address • '
(If Located in Rural Area - Please Attach Directions) Pole #
-j
Owner • . ( Permit # r -
Occupied As Building: New❑ Old❑
•
Occupant
Work Area in Building (Floor #,etc.):
App. for: Wiring❑' Service n or: Ready for Inspection: /
Fee Remitted -$ Cash n Check n M.O. ❑ Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat
Switches
Lighting - Amp. Service Surface Unit Dishwasher Range
Water Heater Air Conditioner • Dryer Pump
Receptacles
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
• Amp. Receptacles Fractional H.P. Vent Fans
• Other Equipment: •
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's
Signature License # Permit #
T/A Utility:
• (NAME) (OFFICE LOCATION)
Applicant's Address:
(City) (State) (Zip) Service Request # -
Phone # Electrician: ._
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above n or:
Red Notice Label n
Rough Wiring Outlets Surface Unit Oven
Switches Range _ Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp. Service Equipment Burner, Wiring &Controls for • Amp. Receptacle
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 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.! I LKDI I Contractor
❑ CFT Violation:' Work Comp.n Inc. ❑
n L/A Owner CASH ❑
Fee CHK #
El L/A • _ Due MO #
n IPA Municipal
\ _ INV #
\Date: Other Side Utility Applicant ❑• Owner
and n Temp # Date
n Final # Date INSPECTORS SIGNATURE
ifION FORM NO.250 EL 11/89
•
TOWN OF QUEENSBURY
531 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date ,19 `i , Permit No. (2.1 WO
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 /<(`,...: r:/ ', ,i'jf APPLIANCE (check appropriate boxes)
Address ri / ti . ❑ STOVE: ❑ Wood ❑ Coal ❑ Pellet
❑ FIEPLACE INSERT
ii, y' Zip / P 3 ! ;A FIREPLACE, FACTORY-BUILT:
Wood ❑ Gas
Phone '7 ) :% 0 FIREPLACE, MASONRY:
❑ Wood ❑ Gas.
Owner iij y ;;};,t. ("�{ ;f ; 0 FURNACE: ❑Wood ❑ Gas ❑ Oil
Address ;)e; ;, ; 1, , IF NON-MASONRY: _
Manufacturer: /2/,, r P '
/// Zip % P 3 2 Model: ('r~ ,r= Outlet: 13 `- inches
Listed By: ui Number:
- Phone ti > L r)
CHIMNEY (check appropriate boxes)
Exact address of proposed construction
❑;.MASONRY: ❑ Block ❑ Brick ❑ Stone
FLUE: ❑ Tile ❑ Steel
Size: inches
CONSTRUCTION/INSTALLATION MUST ❑;FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: /i7 ;- Model:
BUILDING CODE. CONSULT TOWN OF Listed By: r z_ Number:
QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall ;o Triple Wall
REGARDING REQUIRED INSPECTIONS. ❑ Insulated
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Received
Code Number Title l
A 173 3389 (190)Public Safety -
A 233 2655 (230)Minor Sales
Fee-Collected From or Refunded to: 4-%'%., .
Address:----:__.___ _._ F 4
Dated: •T`%��i,2/4/ Town Clerk or Deputy: ,� ��: , f.
White:Applicant Green:Fire Marshal Yellow: Bldg. Dept. Pink do Goldenrod: Cashier's Dept.
,r
)( TOWN OF QUEENSBURY
i i `w\ FIRE MARSHAL
�� QUEENSBURY, NEW YORK 12804
r
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTIONN RECEIVED
NAME /2&4/ZL'te/ P--/1 e,^
LOCATION ��z114. Ul ie(6/ ( "d
DATE /d/5/ PERMIT# 93-/51d
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY {' /
WOODSTOVE y
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
i
REMARKS:,! 'i 1 1 OK TO THIS DATE
ti.
i
2/015 INSPECTOR
TOWN OF QUEENSBURY
531 BAY ROAD
dt"'a: QUEENSBURY, NEW YORK 12804
:lowTELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED /D/5-19,3
NAME .//'& / &&%e'- (��1,7
LOCATION (0/.2/12,64 i X 4> &
DATE /0/5/9) PERMIT# 9,j--/ 4
TYPE OF STRUCTURE SI0
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
vFOOTING .—FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING J6FTNAL ELECTRICAL c-SEPTIC
_INSULATION WOODSTOVE/FIREPLACE
REMARKS , jvnid 14( r" Z ii dz 4 1.'Z6-/- 1,-;!,d4C6&
APPROVAL
Y
N/A YES/NO
CHIMNEY HEIGHT/LOCATION ,.,"' ✓
B VENT/LOCATION /
PLUMBING VENT t"/"
ROOFING 1 .."
SIDING / ✓r
DECK/PORCH/STEPS/RA'ILgNGS -Plio E,✓'
RELIEF VALVES / t ,/
FURNACE/HOT WAFER OPERATING 1/
INTERIOR TRIM/PRIVACY L.----
FINISH FLOG,:
BATH/KIjJ /
CHEN WATERTIGHT t
OTHER FLOORS SWEEPAB+LE �'
OTHER/
FLOORS CARPETED,
STAIR ,CLEARANCE/RAILINGS �^
SMOKE DETECTORS ,,,1
DOOR CLOSERS V
BATHROOM FANS ►f
ALL PLUMBING FIXTURES OPERATING t."
GARAGE FIRE PROOFING ✓
DOOR CLOSERS ✓r
OTHER FIRE SEPARATION r/
FIRE/DEMISE WALLS f/ /
FINAL ELECTRICAL ✓'
OK TO ISSUE C/O OR C/C ,/�
COMMENTS:
ARRIVE ?r 933
DEPART
INSP CTOR
TOWN OF QUEENSBURY
531 BAY ROAD
"' ° o Y, NEW YORK 12804
.''�7 TELEPHONE (518) 745-4447
BUILDING INSPECTOR°S REPORT -
FINAL INSPECTION
REQUEST FORU INSPECTION RECEIVED
NAME `J/i'ZL('/?(LL/ q' CLd&C.P Obis-ay
LOCATION (JL/P41- t/a
DATE /0/ / /Q3 PERMITS 93-/4D
TYPE OF STRUCTURE F�
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
L-FOOTING FOUNDATION vBACKFILL GAMING
TROUGH PLUMBING FINAL ELECTRICAL L--SEPTIC
'1INSULATION _WOODSTOVE/FIREPLACE
REMARKS ,Xjp�1i\/e_ ,,jiL� ,A,f
\• APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATIDN ✓J
B VENT/LOCATION �j '� ✓r
PLUMBING VENT
ROOFING
SIDING �'�
DECK/PORCH/STEPS/RA°ILINGS \
RELIEF VALVES
FURNACE/HOT WATER OPERATING \ ✓
INTERIOR TRIM/PRIVACY DOORS ✓
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT ✓
OTHER FLOORS SWEEPABLE I 1./
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS 6 ,i
ALL PLUMBING FIXTURESOPERATING ,%
GARAGE FIRE PROOFING y ,/
DOOR CLOSERS
OTHER FIRE SEPARATION;
FIRE/DEMISE WALLS ✓ '
FINAL ELECTRICAL /ye. A _ cya03
OK TO ISSUE C/O OR C/C. ✓
COMMENTS:
gqI. eArc vap4,1
of CouC2 ct.ceec5 �d���. vnG spite'" 141
G�r_ayf c/o
3 !9aj-4 I tc t5 r?t, t_,{�6 . •
ARRIVE ' I'i
DEPART ') 30
I PECTOR
ELECTRICAL INSPECTIONS
xDUPLICATE MUNICIPAL RECORD
Permit No. q3_)4o
Owner 11-''rz---& m�
Occui)ant J/'_ Q1
Local on C f� TLk -T ./ 06
fl���Z--- street
Town or Ctty
State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes. f�/ t/ /J u-�f��
Installed by ,0 U- / ` / Y"r i
"c(-0
Date Q'i 29— Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
/ (((y ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
7 ---^T^^"r WIRING &CONTROLS FOR -:BURNER
(O y RECEPTACLES / H.P.PUMP
60 FIXTURES K.W.OVEN
//.� MP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
`yMP.SERVICE CONDUCTORS / K.W. DISHWASHER
///bb K.W.SURFACE UNIT / K.W. DRYER
/ K.W. RANGE AMP. RECEPTACLE
7 K.W. WATER HEATER FRAC. H.P.VENT FA(S
Cf /C� / War2G -oc- 7 /rg
MOTORS H.P. I/20 1/12 WO 'A c 'A %3 'A '/. 1 1% 2 '3 5 7%: 10 15 20 25 30 40 50 75 100
MARK NUMBER.
OF EACH SIZE
APPARATUS
Pa L 5 /tJ LI 7 27116tet.6 C; /2'rvt c,rJ/2
•
TOWN OF QUEENSBURY /1M
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED � 7/9'3
NAME ` Lf,(1.//UJ CA-6- -Lcf
LOCATION a( / h „��//r(• £ _
DATE Vk,Qig PERMIT # 93 — /M)
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS . /
MONOLITHIC POUR FORM /
REINFORCEMENT IN PLACE
THE CONTRACTOR IS REOONSIBLE
FOR PROVIDING PROTECTTION FROM
FREEZING FOR 48 HOUR FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR \ /
REINFORCEMENT IN PLACE\/
FOUNDATION/DAMPROOFINGA
BACKFILL APPROVAL /
(ROUGH PLUMBING /
!"PLUMBING VENT/VENTS IN PLAC
PLUMBING UNDER SLAB I
FRAMING:
JACK STUDS/HEADER �.
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN 1
'(INSULATION: /
FOUNDATION WALLS INTERIOR R- j 6'('= 16-/
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS J R- y �,�
CEILING `=p. .a;- R- �'
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 771
DEPART / /.//e/ ,
IN P TOR
141L�L
TO MN OF QUEENSBURY
BUILDIED & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 6- -k- / / ((
Locati on aJ�-�jkk
Date - ' Permit # J-40
SOIL TYPE: and Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length (2.50
Length of each trench ,'l.S")
Depth of trenches 1=,;i r /
Size of stone ,/
SEEPAGE PITS: Nurber= .
Size - ft�. yr` ft.
Stone size V
PIPING: Size Type
Bldg. to Tank A zi A/c--
Tank to Dist. B�oxt, v ,, ��
Dist. Box to 'el o/P ' '( ,e/<
Openings Sealed? Yeti No Partial
LOCATION/SEPARATIONS:
Foundation/to Tank \ la- feet
Foundati orf to Absorption ,.$ feet
Separation of Pits 5 feet
Conform f ass per Plot Plan Yes No
LOCATI A OF SYSTEM; O'1"PROPERTY:
(ci rc en�
Fron - ear)- Left Side,,- Right Side
Midd/ e nt - Middle Rear.
COENTS:
LJJI)
ilTA'rt------
[---- -
SYSTEM USE APPROVED: NO
Arrived:
Departed:
Building bs c-or
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
G'�i�'/r /
NAME ��
' �- r / ,
LOCATION (76-.. '/ *-A a.
DATE Ø7/i? PERMIT i -jVb
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 PURP?SE ON SITE /
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING ,
PLUMBING VENT/VENTS IN PLACE''
PLUMBING UNDER SLAB Id
FRAMING: Z r/ V
JACK STUDS/HEADERS A
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAN \
HEATING ROUGH-IN /
INSULATION:
FOUNDATION WALLS INTERIOR R-\
FOUNDATION WALL EXTERIOR R- \
FLOORS R- �•._
WALLS R- \
CEILING / R-
DUCT WORK OR/PIPING IN UNHEATED
SPACES
REMARKS:
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DEPART i J7) 7, _
\\INSPECTOR
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 7/zVq�
NAME /(.?J L- &- `tl
LOCATION elbl r.ub 6400
DATE i1 2 PERMIT# .
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
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CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE I
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FIREPLACE-FACTORY BUILT
REMARKS: ; OK TO THIS DATE
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FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED } Y
NAME lutt
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DATE ,_ 13 PERMIT# [ I a
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FIREPLACE-FACTORY BUILT
REMARKS: I ] OK TO THIS DATE
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2/015 INSP CTOR
TOWN OF QUEENSBURY 6)/9
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED '7,/141/ J
NAME
LOCATION (,'(.Q�,�1 1piiy , itod
DATE 7///�/lY PERMIT g 93-/2/4
TYPE OF STRUCTURE .,.57ic2)
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 PURPOS E ON SITE
FOUNDATION/WALL POUR / j
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JACK STUDS/HEADERS ,/
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN BEAM
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FOUNDATION WALLS EXTERIOR Rl\
FLOORS 1' R- \
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CEILING r R-
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TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT D
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT )
REQUEST FOR INSPECTION RECEIVED ,) 16Y 3
NAME Al i I(P-
LOCATION CG Ot
DATE PERMIT # 93—/16
TYPE OF TRUCTURE 54=q)
RECHECK APPROVED
N/A YES NO
WOOTINGS/PIERS a`
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
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FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSEON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE j
FOUNDATION/DAMPROOFING j
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TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 2:3
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME r 111/../J /V?ht!_e e
LOCATION 1J i j-,7/jJ /4/( /
DATE .5/ ,5 /q PERMIT # q3_
TYPE OF STRUCTURE
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