1988-692 li ,
.
CERTIFICATE OCCUPANCY UPANCY
TOWN OF QUEENSIBURY
WARREN COUNTY, NEW YORK
Date December 5 19 90
0 1
' is t cetEify that work quested to be done as shown by Permit No. 88 692
has been completed.
This structure may be occupied as a nnc F milt' TwPllirio•
LocationLot 42 Queens Lane (St. No. 18) Van Howe Estates
Classic Home Builders Inc.
Owner
By Order Town Board
TOWN OF QUEENSBURY
t. -
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-692
WARREN COUNTY, NEW YORK
z
O
PERMISSION is hereby granted to Classic Home Builders Inc.
OWNER of property located at 42 Queens T,nne (St. No. 1 8) Van Howe Street,Road or Ave. c�
Estates
in the Town of Queensbury,To Construct or place a One Family i)Welling
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
P.O. Box 14421cn
Albany, N.Y. 12212
_ - x
2. CONTRACTOR or BUILDER'S Name O
td
Same
3. CONTRACTOR or BUILDER'S Address
Same '
4. ARCHITECT'S Name
5. ARCHITECT'S Address
CD
CD
6. TYPE of Construction—(Please indicate by X)
c
t"
(2,)Wood Frame ( ) Masonry ( )Steel ( ) 7 CD
7. PLANS and Specifications
No. 59' x 44' as per plot plan, specifications and application including septic
system and attached two car garage.
CD
8. Proposed Use
One Family Dwelling ,
$5.00 C/O
$ 156.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1, 19 89 fD
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
0q
town of Queensbury before the expiration date.)
Dated at the Town of Queensb this 16th Da f Sept. 19 88
SIGNED BY for the Tow n of Queensbury
Building and o ing Inspector
k
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/auia 0 Qeirr I) Q 1 / Q,lp TOWN Or, C<UE ". L��,�_
BUILDING and ZONING DEPARTMENT. D i, ', O. fr' 1 '."'�
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801 t1 AUG2� 9
Approved :BUILDING &:COD DEPT:
/ '
APPLICATION FOR -'- ,,QQel, 6 -
BUILDING AND ZONING PERMIT s
* * * .* * - * ;.* . * * * * * *. * * * *- * * 4_ * ,* * * * * * *.:.* 'i * * * * it *. * *::*.-
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.. , .
The 'undersigned hereby applies for .a Building Permit to do the following work which will •
be done in accordance with.the description,plans and'specitications'submitted, and such .
special' conditions as may be 'indicated on the Permit.' -,. • -`• '
The owner of this.property is: GL4 3S(C : IO 1 E' ` O,GDE e,s i C', -
P.O. Address PO `BCIC 4
Y Z( •. 4.681W(I
Property Location 4Z ( e1P lS.. e-.4iv E xi-X' /i? Tax Map No / _. /
Street number ornn building lot number -
Subdivision name (if applicable)- Vvtfv a eti d �eS 4,eT '
TIIE PERSON RESPONSIBLE_FOR SUPERVISION OF WORK AS REGARDS BUILDINGCODES IS: :.
FO8E 7S—{4 4e 5Ie..,•. Po. 66c /44(: 46604 q `.i y ='4 6'-0//S
P.O.' Address Tel: No. -
Name of builder CL US!C. Lbw %U ddr.ess Ph .00)0 I(14Z 1 'A(,B4IV L Tel:d 6 of
Name of plumbe ^ ' (�4\V\si�Adddres VL
_, s9�'�t.ttn � �l�Q. r vf��L�cV� e'rel.._ 7
Name. of mason
A �t e MASokilZei Address q(9-ren i4-ye i sCDi-o9 Tel. •
NATURE OF PROPOSED WORK: * ' ZONING INFORMATION: -
X)Construction of a new building .* TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED,
Addition to a building * drawn, reasonably ,to .:scaleand.attached hereto,
Alteration to a building earl showing: clearly y.:and distinctly. all buildings,_; ,.
(no change to exterior dimensions) , - * whether existing or• proposed and,. indicate all,
Other work (describe) . : - - *'..set-back .dimensions from property: lines...Give: '
street and..number or lot number. and..indicate.:
* whether interior or corner lot. Show location:FOR DEMOLITION PERMIT, STATE\ SIZE AND
LOCATION OF STRUCPU 21 S AFFECTED. of• water supply and location and configuration
,,_,_,. `*.,of septic disposal area. , .
: COMPLETE INFORMATION REQUIREDBELOW.,.
'/ , -'. see i2ov rani(
* Size of property l/At 'ft X /77 ft.
* Existing buildings) Size ft X ft: W)9
PROPOSED BUILDING AND USE:.
1 1 *`Existing building(s) Use .
Size of new structure Set ft °X'# / ft * NA
Foandation-pier/slab/crawl/partial ul * Proposed building, distance from property line
(circle one). * Front yard ft Rear yard ft
No. of stories (habitable space) Z
Height (grade to ridge) ZZ ft. * Side yards ft• and ft
IF residential,`,no. of families J * If' on corner,--setback from side street ft, ,
No. of rooms(excluding baths) q' ItOCCUPANLY , INFORMATION
No. of bedrooms *.
No. of..bathrooms Z; 1iz * PRIMARY BUILDING '-
Primary heating system cje J 4.14 . .3o One family dwelling
Type of fuel /IJC;{yiQ�,( Grp. S * Two family dwelling •
No. .of fireplaces :to .be. installed J 4. Multiple dwelling / Number of units `
Will a.wood ..stove. be installed? NO *. Permanent occupancy
Central Air conditioning? NC) t. Transient occupancy
Business
BUILDING STYLE, PRIMARY STRUCTURE '*' Industrial •
Ranch Contemporary Log cabin * Other '
Raised ranch• Mansion • . Duplex * Ifaddition, .what will use be?
Split level Old style Bungalow '*
Cape Cod -' Cottage `. Other . * 'ACCESSORY 'BUILDING-o on a1 '. ''.Row"':' ' Town House '' * ' Detached garage/one "car/ t. - ' ar/ .car‘
( •CIRCLE-ONE'PLEASE;').. . ... .. . : " * ')0 Attached garage/one car/ 'two car car
* * * * *: I ` * *4:* * * * •*' * :* * * * Private storage building
ESTIMATED MARKET VALUE OF . * ' Other: ..
CONSTRUCTION`
q I SO, 060
.
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
r
'LiU1LDIIIC PERMIT Ai PL.LCATI011 'COIITINUCD
BUILDING SPECIFICATIONS: . . _
_
Type of construction, wood •frame fire 'safe,ete. '
Will any =second=hand. or ungraded lumber be used? If so, for what? A/ Q . ..
•
Foundation' wall material CA141C. Bezted4 Thickness /.O NN4!M L cJS2. 8'6.4e4. .--L
Depth of foundation below grads (to butt• i •- . footing) At—on
Will thorn be a cellar?4eS Heated o, unheate• .• Floor sq. footage sq ft .. .
Will there be- a--basement? Lte...5 Will any portion be used as living space? • -/.1Q
(If so, what portion? • sq.ft.• —Type of`use? '
Type of roof sl p /flat/shad/other Material.'ot roof 4sPii4cLr S'4 liver.i'
Size, wood studs 2 "X 6. " spacing 24" "o.c. length9Zsgvit.
Joists.(floor beams) 1st. floor 'Z "X 10 " spacing 16 "o.c. span ft. iii-' Pee. PLku s
Joists (floor beams) . 2nd.. floor Z. "X /0 " .spacing /5 "o.c. span ft.' 4 Pee PC44 S
Overlays(ceiling. beams) . "X .• • " spacing "o.c. span ft: mbri. • .
Boot rafters "X "' spacing ' o.c.- span- • 'ft. N
. ,.Roof '.trusses(pre-engineered) ..spacing 2y '"o..c. span'... . ` ft.., 14S- .Pa. o,C14N' ' ,; '
Lxterior wall finish CEbEi. S1ata to - d 1? Y z '. •44K2ti Q Sr4c4T7 14."
Interior wall finish '/z" b2'1‘..1AGc. OR Vi'i14 13,he Ln:J Ft444
If a garage is to be attached, describe materials to ba used: for FIRE SEPARATION:
s/A D wAcG . ,.
Is there to be an opening' between garage and dwelling? q-e.S If' so will a Fire-rated
door,. enclosure, and self-closing device be: provided? .(.4.&S 1
Will a flue-lined„,chimney Abe installed? WAS Height .above_roof, • 2, ft. G�
Depth of chimney foundation below grade'__ft.. .
Depth or fire') = th 2— ft. D .in.
W.aCuI supply 4111gOror private well' .
SLPTIC :'SYSTEM - ' a ance from ANY private well(including adjoining properties ft.
(A separate application is necessary for any repair or. new installation' of"" septic system)
Town of Queensbury STATE OF NEW YORK
County or Warren 'A. F F. •'I D _A V . I •
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'doneion 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.
0:CZ -
SWORN TO BEFORE ME THIS Signature ,�/`" �� -
Q /� Owner., owner's agent,arcnitect,contractor.. ' .
v - day of NV . 19 .
Notary Public, Warren County, N.Y. .
--.*' * * * * * * *' ai * * -* a '* * a a * * ,* * '* * ..* * a. *. * * * * * * * * * * * * * * *. * * * *
SPECIAL CONDITIONS.OI' T11I: PERMIT:
•
•
. --ay, .
,. .
1
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work.
ANSWER ALL of the following: (� r
1 . Gross floor area , 3 J -1 s� 1"
1-
2 . Type of heat GA S /Gce1D 4/2.
3 . Is the building mechanically cooled? M Q
s
4 . Percentage of area of windows and doors
Duo A. Over 16% Only
1 . U value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
0 Floor over heated spaces ES� NO
Are foundation walls insu ated? E NO
a. �� Q- l�
1 . If YES , what is the R value?
3 . Slab on grade YES NO
a. If YES , what is the R value of insulation around
perimeter of floor?
4 . Is basement heated? YES N®
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
LooP 2 Ullit1E 2— '
2 . R value of exterior walls 1G- 2.4
3 . R value of glazed area p -4. c 1'8 V 0v )
4 . R value of doors dG 2 • v
n.. %Iu Leta iGt� ieS
5 . R value of floors over unheated spacesl� ��
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation- heated slab N A
8. R value of heated basement/cellar walls (above grade) R 1(
9 . R value of heated basement/cellar, walls (below grade)
10 . Type of insulation 2
0 E1,47'eu :Lt Pit Lf gitikeAle
C. Controls• (,�f®��
1 . Thermostat maximum heat setting
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation
1. Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F. Service Water Heating
1 . Performance efficiency
' 2. Temperature control setting maximum
G. For Swimming Pool Only
1 . Maximum heating / /
6 —ter .. Uf,, e a
Telephone No. /
(applicant ' s signature)
AP
OVED
.Jail Of 01 PR
DATED—
.
APPLICATION FOR SEPTIC DISPOSAL PERMIT 2ohIHG 1. IiLD0 CODES Darr.
login OF QUEDUiU kY
LOCATION OP PROPERTY FOR INSTALLATION 42 00E s GQ14E
Owner's Name: CLAss(e ithieveBaeoz/e..s Telephone: 4 c 'etIP
Address: 30x f442 / 468111v4 iV q 12z12 - 44a /
Installer's Name: 64(OS7 4 Telephone: zgf" 2/ S9
Number of bedrooms (residential only) q
Total daily flow (compute @ 150 gal per bedroom) Go®
Topography: circle one: Fla Rolling Steep Slope % of slope 2476
Sail Nature: circle one: der Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? Ai - feet
Less 7'/ N
Percolation test: circle one: not required required / rate Ss min. inch.
Domestic water supply: circle on Well. Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption . IQA- feet
PROPOSED SYSTEM: -Septic Tank WOGS gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench re, feet / Total system length 2S. feet
SEEPAGE PIT(S): Number of AOt / Size each feet by feet
Size of stone to be used -ll "/Jo I//2. / Depth or Thickness/2 xz4 feet
4 * * WV * * 4 44 * * * * * 44F4W4 * * * * * * * 44 * * * * ♦ * * Ir * * * *
IMPORTANT
...P1eas.e...LIST NEW EQUIPMENT TO BE INSTALLED
* * * 4 * * * * 4 .; * ♦ * * * 4 * ♦ 4 * 4 i' * 4 t ♦ 4 } * * ; 4 * 4 4f 4 4 * * *
(over)
Section II Septic System Inspections: •
A. A11 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 2d 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'
•l.) 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.
•
•
I have read the regulations above and agree to abide by these'and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
.Signature of responsible person: -ieriii<511—
A . . .
Date: 61-- 13-&9
Town of Queensbury .
Building and Code_Department •
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832 ••.
•
•
r 1'•.:. 1 I.. r
INTERIM BUILDING PERMIT
Fe-
PERMIT APPLICANT _ 61,46SVC "7"7-t_e
CONSTRUCTION LOCATION 4(02 ace.,,
EFFECTIVE DATE -1-(3/4r42
APPROVED BY 1z7 _
SPECIAL CONDITIONS :
This will certify that all submittals for a Building
Permit have been received and fee has been paid .
During the processing of the Permit , the above named
may begin construction per plans submitted . It is the
responsibility of the applicant to obtain the Permit -
from the Building Department, followi g p c ssing .
POST THIS INTERIM PERMIT IN A CO PICU ! !
s
i ing & Co es Department
TOWN OF QUEENSBURY
•
• - YOU ARE HEREBY REQUESTEP TO -
•
- • - INSPECT AND-ISSUE CERTIFICATES
- - FOR THE FOLLOWING ELECTRICAL - -
-- EQUIPMENT TO.BE INSTALLED BY ,
- THE.UNDERSIGNED- - -
TEMP.#. DATE .,
:7 k%f :.. :_/ i
CITY_OR VILLAG _ TOWNSHIP- COUNTY.
(, til S ^ct, 1S •
. . i1ue<Ns Ltlk L) - L(.1A i'e1e.eA .'. Co..
STREET AND NO.OR ROAD f POLE NUMBER -
• - t {}T ti- Z. .G3U'e P .• ( ,tom-.. . ' -. • -
BETW EN.WHAT TWO CROSS.STREETS S PREMISES LOCATED? ' ,.SECTION- BLOCK • LOT, ,
l . f`Y r- .'
OCCUPANTS NAME - - BUILDING OCCUPANCY V
OWNER'S NAME AND AD I3ESS z - r , .. HOME TELEPHONE NUMBER -R 0
12
CURRENT SUPPLIED BY FROM THEIR - OFFII E- WORK"IELEPHONE NUMBER -
$ f 4 C7r�li- •0 �/4�t.�l�. 6`.Zp . 17- L S
BUILDING IS— -V _ -
NEW❑ V "' - ,' .V OLD-0 - - f WORK IS ' - • ' NEW C ' ADDITIONAL❑ -. ". DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED -
NUMBER OF OUTLETS - ' No.of Fixtures& MOTORS • .HEATERS- ' BRANCH - OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY -
• Lion Side Attach't- H.P. Watts- A.W.G.
Ceiling Wall- Recep'Is Switch Pendant. .Bracket No: Type Each No. Each No. Gauge INSPECTION _
- OUT- '
SIDE ._ - - - - "
. SU&
BASE. • . - -
BASE-
MENT .
1st - .. - - -- - -
FL. - - ..
2nd V -
FL.
3rd
FL. - ' " V V -
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 WATTS -
CHARACTER OF WORK ❑ EXPOSED _ GAS TUBE SIGN/TRANSFORMERS OF :. - VA -
❑ CONCEALED - ..
DATE WORK TO BE STARTED. - - - .DATE COMPLETED SIZE OF SIGN(NUMBER) -CAPACITY•
SERVICE ENTERS BUILDING' ••, - MANUFACTURER OF SIGN - - - . "
❑ OVERHEAD- - - - V - ❑ UNDERGROUND - - -
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) .. . MUST DENT F CAT ENTER NUMBER rl
- AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. - -
PRINT NAME AND ADDRESS -
NAME OF AP, LICANT-- V - - f'+ - '- DATE OFAPPLIC ION SIGNAZ4R F LIC�ANT
C/ SS/ i-ohie '!`�U/6/ S• ' 2 le._- s` X t �.p..-, :`'� _t :,jr`6Pr
. - TELEPHONE NO.t
-'z,STREET ADDRESS' - - -
CITY-OR-POST OFFICE', ,- V - - - -ZIP CODE -., - LIOENSE NO.WHEN APPLICABLE
A)L r /l w ., 1 i,r . . - -- - . .)'-Z 7 I -7_ _
❑ 85 John Street•. ❑.41 State Street ❑ 584 Delaware Avenue ,❑ 217-Lake Avenue-. • ❑ 202 Arterial Road
NEW YORK,NY 10038 . . ALBANY,-NY 12207 . BUFFALO,NY 14202. ROCHESTER,.NY 14608 _SYRACUSE,NY.13206
,-1,1g nl Vn/ Ninny I C Pfl nP PIPP I-INnFRWRITFRS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280� \ /vt_ --
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME !I,ttj YI,CC: d J
LOCATION// � �� �
DATE � s �U PERMIT # Pe-la
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS f
ILING...
�FINAIi-IN:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS'
GARAGE FIREPROOFING
DOOR CLOSER(S)'
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
- OK TO ISSUE C/O OR C/C
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
REMARKS:
f����� / do
ARRIVE /
DEPART � S' (rid'
4.54(
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS �CCJ
QUEENSBURY, NEW YORK 1280k )
TELEPHONE (518) 792-5832 /22
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 111/4/1/U
NAME jJ4DG✓ �1G- _Re0��
LOCATION �-ry
DATE /„�f// PERMIT #
• APPROVED
•
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS •
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH IN •
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING t
FINAL INSPECTION:
CHIMNEY HEIGHT .
ROOFING
SIDING 1 \
EXTERNAL PORCHES/STEPS •
STAIRS-CLEARANCE& RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS �r
FINISHED FLOORS; 8i
GARAGE FIREPROOFING J�
DOOR CLOSER(S) `'t
SMOKE DETECTORS
FINAL ELECTRICAL,'INSPECTION:',
.FINAL APPROVAL OF CONSTRUCTION
- OK TO ISSUE C/O /OR C/C c tT yJ
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
l •
REMARKS: 2 `�� r �.GC .5 L�
1411 4►6Srf S Q L °Ar f l Sere6—
/ ein
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ARRIVE ;4i
DEPART
INSPECTOR
ELECTRICAL INSPECTIONS
(g_ DUPLICATE MUNICIPAL RECORD
Permit No. •
Owner C (42,5.5J.C...- /6 142.1de r--5
Occupant
Location C. 0—1"-- A94ccce "fi
No. / Street
Ca.
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by
I"
Date z7-36 - Fo
Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood,NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
OUTLETS WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT K.W.DRYER
K.W. RANGE AMP. RECEPTACLE
K.W.WATER HEATER PRAC. H.P.VENT FANS
MOTORS H.P. 1/20 1/12 1/10 % % % % '/2 '/a 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
,MARK NUMBER
JF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS /2'07
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR} INSPECTION RECEIVED // kd
/
NAME ( i/i_4!l,
LOCATION
DATE � PERMIT # ? ,--/�
APPROVED
•
YES NO
FOOT G/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
`!FOUNDATION '
FLOORS.
WALLS
"CEILING •
VFINAL INSPECTION:
CHIMNEY HEIGHT •
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY 'DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
.FINAL APPROVAL OF CONSTRUCTION •
OK TO ISSUE C/O OR C/C
A SIGNED CERTIFICATE OF 'OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
•
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t L.!: e ' t�4 �� �� t� J; l •
vJ
i .
•
ARRIVE ' v'
DEPART �) ✓ ✓;�- v"- .rR�; ``iZ
• INSPECT5R
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280c.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST •
Tn FOR INSPECTIONLL RECEIVED
1,Q n Q
NAME ( ll fV
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LOCATION A!L4 LitvkLlmL6 "- irevyL „ v_eiCI Ca,
DATE 41/4/ 70 PERMIT #
J APPROVED
i t .,/c.-fit.Vu L&f YO:.�,iaag� / YES NO
C !
FOOTING/PIERS fi
MONOLITHIC POUR FORMS;
FOUNDATION/DAMP-PROOFfNG
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING 3 • j
ELECTRICAL ROUGH-IN • 1
)(INSULATION: )tt ek
•
X FOUNDATION
FLOORS 1
WALLS /
CEILING /
FINAL INSPECTION: J
CHIMNEY HEIGHT j
ROOFING 1
SIDING it d'
EXTERNAL PORCHES/STEPS.!
STAIRS-CLEARANCE & RA giLS
PLUMBING FIXTURES/REIISkEF VALVE
INTERIOR TRIM/PRIVACY"�DOORS
FINISHED FLOORS s
GARAGE FIREPROOFING/ �.
DOOR CLOSER(S)
SMOKE DETECTORS !
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF }CONSTRUCTION
d 3
1
A SIGNED CERTIFICATE OF OCCUPANCYg MUST BE
OBTAINED FROM THE,! BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPID!
REMARKS: •
r � 1
71
_ 1
4100
614 cLD ftiAA- 0)-°4)°'
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 77/)
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED �J
NAME 1 ' Qf-- n 2 telzq�l�(LOCATION ) ( (� n �p
DATE a-�G/-� PERMIT # E- -6;`,F_,2
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL; �/
ROUGH PLUMBING �( PP,KQ4
FRAMING
ELECTRICAL ROUGH-IN:'
L/INSULATION: \ /
FOUNDATION 1
FLOORS
WALLS ` � 9 3 • _
CEILING �-3-�r • (/-
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS '
STAIRS-CLEARANCE & RAILS '
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS l
GARAGE FIREPROOFING
DOOR CLOSER(S) /
SMOKE DETECTORS :
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
•
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS
A6:
A&A71-IA5 UlATCON.
INSPEC R
kg'4
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 7
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804�
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME — j sew L 4 4%
LOCATION 4-57. 92 ,Fecc,-�
DATE Gl--ofW7-P PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL \
:'ROUGH PLUMBING 2 I/
RAMING 3
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS '
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS \
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION '
A SIGNED CERTIFICATE OF OCCUPANCY',MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
G'4.1
14 l
(I, l` !
4 c " f•
INSPECTOR
awn ot Queenitury
•
• BUILDING and ZONING DEPARTMENT //p4
• Bay and Haviland Road, R.D. 1 Box 98 • - '.
Queensbury, New York 12801
. '
SEPTIC DISPOSAL SYSTEM INSPECTION .
.
NAME a,Z,V.A-e-e'- /4--)i-%-12,.. .--,,'
LOCATION Ze--11-12.-
-14/4DATE. V PERMIT NO.
\
SOIL TYPE -\ Sand - Loam - Clay -
Percolation\Test Required? YES - NO
Percolation 'rate - Min/Inch . .
\ -
/
/ 1
TYPE of SYSTEM:
Absorption fie?_d, total length
Length of each\trench _,,, 1132----46 — 2-6
Depth of trenclis . :W . /
Size of graveI \ L-- ' -/
/ 7
SEEPAGE PITS4NuMber of) ' /
Size- ft. X \ ft. /
Gravel size . \ //
PIPING: \ ize •
Bldg. to tank T
(//-. im
Tank to dist. box
Dist. box to field:Pit ' Al
Openings sealed? / YE' /-77-go Partial
LOCATION/SEPA TIONS:
Foundation t tank / S ft.
Foundation o absorption ft.
Absorptio, -to lot line ft.
Separati -oelpits ft.
LOCATION OF SYSTEM ON• PROPE'IY(circle one)
Fron - Rear -) Left side - Ri6ht side -
COMMENTS: j .
2-1&W iN .
------7.-4
. 1
/
SYSTEM USE APPROVED// YES ) /NO ...
8 fi .
.
Building Inspector •
01/86 md vl
• •
•
awn of Queeniur,
BUILDING and ZONING DEPARTMENT c
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New'York 12801
SEPTIC •
DISPOSAL SYSTEM INSPECTION
•
NAME (�C/�.0. / ~
00-n,yam&-/
LOCATION Z72 in
,��
DATE • PERMIT NO. � 9‘`z
SOIL TYPE -.0mmo Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of 'SYSTEM:
Absorptio\-i field, total length
Length of\each trench' 64:2
Depth of tenches a '
Size of gra4l �o`L
SEEPAGE P ITS umber of) /'I
Size- ft. _ ft.
Gravel size
PIPING: Size) Type
Bldg. to tank 171,1 19
Tank to dist. box
Dist. box to field it /y (-7
Openings sealed? E ' NO Partial •
LOCATION/SEPARATIONS: •
Foundation to tank l02 ft.
•
Foundation to absor tion 3 ft.
Absorption to lot ine /o ft. .
Separation of pit • ft.
LOCATION OF SYST ON PROPE TY(circle one)
Front 7<Re-ex_ Left side - R' ht side -
COMMENTS:
•
•
•
SYSTEM USE APPROVED O
Buil ing Inspector •
01/86 and vl •
•
.own o/ Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC�� DISPOSAL SYSTEM INSPECTION
NAME (_-('J G r /16'� - k' ,d-,-(-
LOCATION //a / 2e//e6 ,o KQiie,e_---
DATE/7-lb, / WIPERMIT NO. . i?� ,p�
SOIL TYPE - Sand - Loam - Clay - j
Percolation Test Required? YES - .NO
Percolation rate - Min/Inch
•
TYPE of SYSTEM: \ '
C,
Absorption field,\ total length 4 , . �
Length of each trench . 07ULI /4)
Depth of trenches �\ `V
Size of gravel \ - "Im: _
SEEPAGE PITS4Number\of)
Size- ft. X t. /
Gravel size .
PIPING: \iize Type
Bldg. to tank 3 T
Tank to dist. box / * )t/L-
Dist. box to field/ Wit\ \ ////C=
Openings sealed? i'ESI NO ` Partial
LOCATION/SEPARATIONS:
Foundation to tank // ft.
Foundation to absorption it: '
Absorption to lot line .
Separation of pits'
LOCATION OF SYSTEM ON PROPERTY( rcle one)
Front - Rear - Left side - Rig t\side -
COMMENTS: 7 Cry, `.
. 1
1,1\i, /2, 0, _ tc,.,
J t
c b
, . .
/ s 7 If'Ji
/L.- .1)
i ,fy ��(,ICJ /,- /, , ,��/�.
T44 -/)
/
SYSTEM USE APPROVED YES //z47.._____ .
�
• Building Inspector •
01/86 and vl
TOWN OF QUEENSBURY �/�
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 1��-7
NAME ,
LOCATION cq GlVe.eay!,,,,--zi`.-2,7��'�`1
DATE /4J rT PERMIT # l( (�'l APPROVED
YES NO
FOOTING/PIERS A.
MONOLITHIC POUR FORS 1)'
FOUNDATION/DAMP-PROOA NG
BACKFILL APPROVAL
ROUGH PLUMBING Y'
FRAMING '
ELECTRICAL ROUGH-IN ' `, ,
INSULATION: '
FOUNDATION ".
FLOORS • 1 ,
WALLS 1
CEILING 1
FINAL INSPECTION: df `
CHIMNEY HEIGHT
ROOFING /
SIDING p
EXTERNAL PORCH ,./STEPS
STAIRS-CLEARAN. E & RAILS
PLUMBING FIXTRES/RELIEF VALVE :,
INTERIOR TRI.'/PRIVACY DOORS r
FINISHED F LIRS
GARAGE FIRE'ROOFING \,.
DOOR CLOSE. (S) N
N.
SMOKE DET CTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: /���
,....
1
l0
9tti .
..
r i .
INSPECTOR
• _own of Queenitur/
BUILDING and ZONING DEPARTMENT
•
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME I YLK-.5)G W1041
LOCATION I 42, �• ( E 5 toe
Date 1O12j / $� Permit No.
* * * * * * * * * *; * * * * * * * * * *, * *
V = APPROVED - YES , NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing !,
Roofing
Siding •
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches •
Finished Floors
Interior Trim 1
Stairs & Railings
Cellar. Drain Tile A
Concrete Floors ?
K
Plbg. Fixtures g'
Gar. Fireproofing /
Door Closers rr
Smoke Detectors ,oy
Chimney p,
INSULATION) a `
Foundation
Floors
Walls /
Ceiling
• FINAL ELECTRICAL INSPECTION \
• DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- &W7---�
•
• Building Inspector
6/86 and-vl
TOWN OF QUEENSBURY .-/ M
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804--
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION �--r, y/ Oil e
DATE 0,7 7/ PERMIT # d cz APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKF ILL yAPPROVAL
ROUGH PLUMBING
›&F'RAMING
ELEC TRICAL\ROUGH-IN
INSULATION: `
FOUNDATION\,
FLOORS
WALLS •
CEILING
FINAL INSPECTION;
CHIMNEY HEIGHT •
ROOFING
SIDING •
EXTERNAL PORCHES/STEPS'
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS `tr
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS!
FINAL ELECTRICAL JINSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM1 THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
It illlyni
/ '
V INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT 111
REQUEST FOR INSPECTION RECEIVED
NAME C J k C 1' M ButLo 5
LOCATION qii,- j 1J AJ&-- * i ` ' Z--
DATE PERMIT #
ice' ►`14- O(L TVI ZC if- APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING • /
BACKFILL APPROVAL
ROUGH PLUMBING •
FRAMING
ELECTRICAL ROUGH-IN ' C.k
INSULATION: S / r c VFOUNDATION A r0 tI / -�'
FLOOR �((/ D
WALLS
CEILING \
FINAL INSPEC ION:
CHIMNEY HEII 1T
ROOFING •
• SIDING
EXTERNAL PORC STEPS
STAIRS-CLEA" CE RAILS
PLUMBING FI 1 RES/ LIEF VALVE
INTERIOR TR.M/PRIVA DOORS
FINISHED F SORS
GARAGE FI'EPROOFING
DOOR CLOS' R(S) .,,
SMOKE DE ECTORS
FINAL ELECTRICAL INSPECTION" 0
FINAL APP;OVAL OF CONSTRUCTION "
11JN t.UCe. `Q &P •
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!•
REMARKS: nn�� r
P�`It �N