96-771 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
•
Date October 5 19 _ 99
This is to certify that work requested to be done as shown by Permit No. 96771
. has been completed.
COMMERCIAL ADDITION (OFFICE)
• This structure may be occupied as a
238 BAY RD.
Location
Owner KUBRICKY CONSTRUCTION
TAX MAP NO. 107 . -2-5
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. Sc Code Enforcement
BUILDING PERMIT
VALUE $ 19000 TOWN OF QUEENSBURY No 96771
TAX MAP NO . 107 . -2--5 WARREN COUNTY, NEW YORK
KUBRICKY CONSTRUCTION
PERMISSION is hereby granted to
OWNER of property located at 238 BAY RD. Street,Road or Ave.
COMMERCIAL ADDITION (OFFICE)
in the Town of Queensbury,
To Construct or place a
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
CORP . P.O . BOX 3202
GLENS FALLS , NY 12801
2. CONTRACTOR or BUILDER'S Name
KUBRICKY CONSTRUCTION CORP
3. CONTRACTOR or BUILDER'S Address
238 BAY ROAD
QUEENSBURY, NY 12804
4. ARCHITECT'S Name
ATLANTIC INLAND
5. ARCHITECT'S Address
RD#2 BOX 60
GREENWICH, NY 12834
6. TYPE of Construction—(Please indicate by X) COMMERCIAL ADDITION
( ►Wood Frame ( I Masonry ( I Steel ( 1
7. PLANS and Specifications
240e°•sa ft COMMERCIAL ADDITION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
COMMERCIAL ADDITION (OFFICE )
January 16 19 99
$ 240 PERMIT FEE PAID —THIS PERMIT EXPIRES
Of a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
16 January 19
SIGNED BY �� 97
Dated at the Town of Queensbury this Day of
` for the Town of Queensbury
cul .ing and Zoning Inspector
,_/ Building Permit Application
Town of Queensbury Dept. of Community Development, 742 Bay Road, Queet J.
-D BUILDING & CODE ENFORCEMENT PF
r i'` tr 4)
NOTICERequirements prior to issuance Syr
6— )7'
r � 1 of this perm' • PE 11�N►�. ' !•
A permit must be obtained before
beginning construction. No inspections a. .��. "
will be made until applicant has received Zoning Board Actions l �'
a VALID BUILDING PERMIT. All Area /Use -k) Pci-7 RECREATION FEE PAID$n ek..d
applicants' spaces on this application
MUST be completed and•the signature Planning Board Action REVIEWED BY:
of the applicant must appear on the SPR / Subdivision /Other Building Inspector
application form. nu„t rm. ) Recreation Fee Payment
Applicant: Kubricky Construction Corp. Owner: Same
Address: 238 Bay St, Oueensbury, N.Y.Address:
Phone # ( 518 ) 792 -5864 Phone # ( ) -
Properly I,oculion: ' 107 / 2 / 5
'I•ax Map Number_
Subdivision Name: n/a Section Block Tnt
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ 1A,000 .
residence / commercial
X Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
rcoidcnce / commercial,' Single Family Dwelling
Residence / Commerial. Two Family Dwelling
no change to exterior size Family Dwelling
X Office
Other Work (describe below) Mercantile
Manufacturing •
Other
GROSS AREA OF PROPOSED STRUCTURE:
If ADDITION, what will use
1st Floor 2,400 sq. ft. of new addition be? :
2nd Floor n/a sq. ft. Office space
Other Floors n/a sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS: N/A
Detached Garage 1, 2 car
TOTAL FLOOR AREA: 2 ,400 SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
40 FEET X 60 FEET
Foundation Type: concrete Will any second-hand or ungraded
Number of Stories: 1 lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : 14 ' -3'feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which a•pli s)
to be installed: 0 Electric / Oil /! as / / ood
geed Hot / :aseboard / Other
Person responsible for supervision of work as regards to building
codes is : Robert Hughes 218 Ray St, Queenhn.ry, N_Y- 792-5864
Name Addresss Phone
Builder: Kubricky Construction . 298 Ray Sd-. - 792-5864
Plumber: n/a
Mason: Kubrirky 664-7316
Electrician: P.J Baker iicrtric, 83 So. Central Ave, Mechanicville, N.Y.
DECLARAT7ON.• Please sign below after you have carefully read the statement.
•
3 •• ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
.-& 9000 HEATING DEGREE DAYS '
Comol i ance 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: •
Kubrickv Construction Corp. 238 Bay St, Queensbury, N.Y.
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
•
1 . Gross Floor Area - 2,4nn scuare feet
2 . Type of Heat - Electric Oil X Gas Other
3 . Is building mechanically cooled? x Yes No
4 . Percentage of area of windows and doors Over 17% X Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R 38
b _ Exterior walls R 19
c Glazed areas R 3 . 3
d _ Exterior doors • R 10
e . Floors over unheated spaces R n/a
f . Edge of slab on grade (heated building) R 10
g_ Basement/cellar walls ( above grade) R n/a
h . Basement/cellar walls (below grade) R n/a
Heating/cooling-ducts-piping in unheated space R h
6 . Service (domestic) hot 'water heating device
Conforms to minimum efficiency per code X• Yes. No
TEMPERAT RE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
A plicant' Signature \' Da. 'e Phone Number
�1� JL /G/ 518-792-5864
INSPECT E S REMARKS
- _ _ - _ _ _
40 EL{REV.1r0() A SEPARATE APPUCAT'ON MUST BE FILED FOR EACH SEPARATE BUILDING ... .. . _ .
THE NEW YORK BOARD OF FIRE UNPERWRITERS
cEaTIF�CAT> Na
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NEW 0 oltLg,. . WORK Is NEW 0 ACDr;. :-•."h.._, DEFECTS firMOVED 0
LIST MAIM ALL EQUIPMENT WHICH YOU INSTALLED —--
NUMBER OF OUTLETS No. ores 14 MOTORS HEATERS BRANCH — OFFICE USE
Loco• tamp Rodoptadas CIRCUITS ONLY .
dolt _'-- Sim� Attach9 H.P. ' itifatts +a't:L K,IS
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THIS APPLICATION
!!! IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TD BE INSPECTED,SUT IF AI•TIME CA tNSPl CTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NIX ABOVE LISTER YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND,u„UST TI IE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVED BY TEUE APPLICANT
sae OPMARLS
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CHRRACYER OF WORK 0 EW'OSED
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PRBIT NAME AND ADDRESS _ 1,•.
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❑ 85 John Street 01; 111 Washington Ave. 0 3281 Lake Shore Road 0 217 Lake Avenue 0 202 Arterial Road
• • NEW YORK NY 10030 ALOANY,NY 12210 BUFFALO,NY 14219 ROCHESTER,NY 14608 SYRACUSE,NY 13206
(212)227-3700 (618)463-2122 . • (716)827-1156 (716)254-0141 (315)483-8652
•
• THE NEW YORK BOARD OF FIRE UNDERWRITERS
'f BUILDING D• EPT COPY OF APPUCAFtO�IORM 46 t.,NEW YORK SOAI OFfFIRE UNDERWRITERS.
FILE THIS COPY WiTPI BUILDING DEPT.WHEN REQUIRED.
)(421 0,0 Vent 9cPt.. Ir\A/SL
COMMERCIAL FINAL INSPECTION REPORT
Building& Code Enforcement Date inspection request received:
Office No. (518)761-8256
Dept. of Community Development
Town of Queensbury Arrive/O/c.) am/pm Depart am/pm
742 Bay Road Inspector's Initial-
Queensbury,NY 12804
NAME PERMIT#
LOCATION DATE /Q-05-9 1
TYPE OF STRUCTURE
N/A YES NO COMMENTS
ChimneyP'B"Vent/Direct Vent location
Plumbing Vent
Roof Complete
Exterior finish grade complete "
Interior/exterior guardrails 42 in.platfo4rvdedcs
Interior/exterior ballasters 4 in.spacing latfi nn/decks
Stair handrail 34 in.-38 in.
Step risers 7 3/4 in.
Main door 44 in.
All others 36 in.
Lever handles
Exits at grade or platform
Canopy to cover req.exit doors
Gas valve shut-off exposed®ular (18 in.)above grade
Floor bathroom watertight
Other floors okay
Hot water relief valve
Boiler/furnace enclosure
<250.000 BTU N/R
250.000 BTU to 1,000.000 B 's(1 hour)
>1.000,000 BTU's(2 hour)
Gas furnace shut off within 30 ft.or(within line of site
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),3/4 hour door
Storage/receiving/shipping room(2 hour), 1 1/2 doors
1 ''.2 hour doors and closers
34 hour corridor doors and closers
Firewalls/fire separation,2 hour,3 hour complete
Fire dampers,2 hour fire wall/separation or greater
Fire door/shutters 1 '/z hour,3 hour
Ceiling fire stopping 3,000/5,000 sq.ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage
Handicapped bathroom grab bars/sinks/toilets
Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space_
Final Electrical
Site Plan/Variance required _Final Survey,new structures
.As-built septic system layout required
Okay to issue temp.C/O(Certif.of Occupancy) ' / (
Okay to issue permanent CIO(Certif.of Occupancy) i
Okay to issue C/C(Certif.of Compliance)
avfirVi
COMMERCIAL FINAL INSPECTION REPORT
Building& Code Enforcement Date inspection request received:
Office No. (518)761-8256
Dept. of Community Development �� Depart ,am/pm
Town of Queensbury Arrive h
742 Bay Road Inspector's Initials)//'s
Queensbury,NY 12804 CA V \ a PERMIT#%0---71
LO �LOCATION `1�j`Z �� � DATE �—
TYPE OF STRUCTURE Rc
N/A YE COMMENTS
CbinmeyP'B"Vent/Direct Vent location
Plumbing Vent
Roof Complete
Exterior fmish grade complete
Interior/exterior guardrails 42 in.platform/decks
Interior/exterior ballasters 4 in.spacing platform/decks
Stair handrail 34 in.-38 in.
Step risers 7 3/4 in.
Main door 44 in.
All others 36 in.
Lever handles
Exits at grade or platform
Canopy to cover req.exit doers
Gas valve shut-off exposed 84 regulat (18 in.)above grade
Floor bathroom watertight
Other floors okay
Hot water relief valve
Boiler/furnace enclosure
<250.000 BTU N/R
250.000 BTU to 1,000.000 : 's(1 hour)
>1,000,000 BTU's(2 hour)
Gas furnace shut off within 30 ' or within line of site
Oil furnace shut off at entrance o furnace area
Stockroom enclosure(1 hour) /4 hour door
Storage/receiving/shipping re. (2 hour),1 '/a doors
1 '4 hour doors and closers
3 4 hour corridor doors and;closers
Firewalls/fire separation,1 hour,3 hour complete
Fire dampers,2 hour fire walUseparation or greater
Fire door/shutters 1 '/2 hour,3 hour
Ceiling fire stopping 3,000/5,000 sq.ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage
Handicapped bathroom grab bars/sinks/toilets
Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space_
Final Electrical
Site Plan/Variance required_
Final Survey,new structures As-built septic system layout required / 40/C
bit tej
Okay to issue temp.C/O(Certif.of Occupancy) tf/
Okay to issue permanent C/O(Certif.of Occupancy)
Okay to issue C/C(Certif.of Compliance)
1 0 1 (518)761-8256
TOWN OF QUEENSBURY
BUILDING F. CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARdALCODEPARTfiliDIN
REQUEST FOR INS ECTION RE EIVED: U� 1�\
NAME r
LOCATION2 --7 "j�
DATE �7 2`^ PER
TYPE OF STRUCTURE:-
)(Ivy)
APPROVED
RECHECK L YES NO
•O I • RS
tONO IT IC POUR F.RM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FO
PROVIDING PROTE TION FROM FREE NG
FOR 48 HOURS FOLLOWING THE P CE
MENT OF THE CONCRETE.
L TE'I S OR THIS PURPOSE ON TE
OUNDATION WALLPOUR
REINFORCEMENT IN PLACE --
FOUNDATION/DAMPPROOFING -
BACKFILL APPROVAL -
LUM N VENT VENTS IN PLACE - -
ROUGH PLUMBING
P MBING UNDER SLAB
FRAMING: ` �"��1�` t•1fiitsl�k+
JACK STUDS/HEADERS Dd4r \
IN
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER --
g! ING ROUGH-IN -----I
NSULATION:
FOUNDATION WALLS INTERIOR R-
___EQUERATION WALLS EXTERIOR RR_
-__FLOORS -
WAlLS R- -
CEILING R
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
C..E-L( 06
(518)761-8256
TOWN OF QUEENSBURY
011
BUILDING
6 CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
n �
INSPECTOR'S REPORT: ARC 6pEPAR j
ir
REQUES
T FOR INS ECTION RECEIVED:
NAME
LOCATION
DATE + PERMIT A `
TYPE OF LSTRUCTURE: �►�tl-Ci1 r U� �[ 4`
APPROVED
RECHECK N/A Y_ N•
FOOTINGS PIERS
OLITHIC POUR FO: Xri
REINFORCEMENT IN PL. '
THE CONTRACTOR IS ". 'SIBLE F.R
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE. -----
MATERIALS FOR THIS PURPOSE ON I E _
FOUNDATION WALLPOUR
REINFORCEMENT IN PLACE -
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB .-
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS ------
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
7-1% 0..16*P1/41 h(:)0
INSULATION: 00S)F
FOUNDATION WALLS INTERIOR R- -
FOUNDATION WALLS EXTERIOR R-
FLOOR -
C
(� WALLS� .. ri a�ti
EILIN "•� .r 1R "
DUCT WORK SR ' '
UNHEATED SPACES R---=-- -'--
1.�FT � bec) V�
1(-- )fr4: 7;
TOWN OF QUEENSBURY
AILif
BUILDING742 CODEB ROAD ENFORCEMENT
QUEENSBURY NY 12804
���. (518) 761-8256
ARRIVE: in= DEPART: INSP:
FINAL INSPECTION
NIRREPORT
TE LIN
COMMERCIAL MUL(hotel, motel, ap ex
DATE INSPECTION REQUEST RECEIVED: 5
NAME
LOCATION 5CC
Q ly���
DATE F PERMIT #
TYPE OF TRUCTURE
FOOTINGS _ BACKFILL FRAMING PLUMBING_
INSULATION
YES NO
CHIMNEB" VENT HEIGHT_--
PLUMBING VENT FIXTURES'
ROOFING A
EXTERIOR FINISH leill
�-
HEATING HOT WATER
ia
RELIEF VALVES
FLOORS • -Mil_____
FOUNDATION INSULATION
INTERIOR STAIRS RAILINGS
STOCKROOM ENCLOSURE
FIRE DEMISE WALLS PENETRATION
IA _____
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT IDIiARDWARE —
EXIT STAIRS RAILS
PLATFORM ELEVATOR
HANDICAPPED ACCESS -
HANDICAPPED BATHS --
FHANDICAPPED PARKING
INAL ELECTRICAL
SITE PLAN/VARIANCE REQ•
FINAVEY PLOT PLAN IF RED
OK TO ISSUE Cf/0(4/
//O-0___ R_LC� 111111
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SPA'
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TOWN OF QUEENSBURY
elite 464
FIRE MARSHAL
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPOR
REQUEST FOR INSPECTION RECEIVED S /7
NAME1D .- 6,se
1 ' `AI-
,
LOCATION
DATE PERMIT # g I0 4 7 g& 7
l-v G ioy—, G.�� E' �., a APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTE
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE - MASONRY
FIREPLACE- FACTORY BUILT
REMARKS: ❑ OK TO THIS DATE
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INSPSLIP.PUB IN Pr/ TOR
13<"i'\T'\ (518)761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
NY 12804
742 BAY RD., QUEENSBURY
I
NSPECTOR'S REPORT: ARAD 5DEPARTAIAInIN„ �a' �,•li
QUEST FOR .INSPECTION RECEIVED: Cam'
• ME
CATION
PERMIT
TE
PE OF STRUCTURE: APPROVED
ECHECK
lr
•0 INGS PIERS A
ON�T—WIC POUR" ; r�►I- -- y
REINFORCEMENT IN PLACE
Ss
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE- --
MENT OF THE CONCRETE.MATERIALS OR THIS •URPOSE ON SITE --
FOUNDATION WALLPOUR
REINFORCEMENT IN PLACE �-
FOUNDATION DAMPPROOFING
D��u=L�pPROVAL
LUMBIN
VENT VENTS N PLACE _ _
_
ROUGH PLUMBING
PLUMBING UNDER SLAB -�-
FRAMING: '---
JACK STUDS lHEPO IS
BRACING BRIDGING
JOIST HANGERS _---
JACK POSTS MAIN BEAM
I�_R INFILTRATION BARRIER
HEATING ROUGH-IN _-_�
INSULATION:
FOUNDATION WALLS INTERIOR R-
TION WALLS EXTERIOR R_
WALLS R- ----`
CEILING
DUCT WORK OR PIPING IN R-
UNHEATED SPACES
(518)761-8256
TOWN OF QUEENSBURY
RCEMENT
742 BAAYY RD. , +�r,�
BUT QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR
04 DEPART INTS -
REQUEST FOR INSPECTION RECEIVED: C�
•
NAME ` 1 C eL Ste"
LOCAT IO /7,7
PERMIT 1
DATE 7/0
TYPE OF T UCTURE: /RECHECK AP•ROVED
Y_ N•
FOOTINGS P ERS
MONQLITHIC '"OUR FORM
REINFORCEME T IN PLACE
THE CONTRACT•R IS RESPONSIB E FOR
PROVIDING SO'FOLLOWING THEON FROM FPLACE EEZId
FORO 48 HOURS CRETE.
MENT OF THE C
MATERIALS FOR
IS PURPOS. ON I E
FOUNDATION WALL -_
REINFORCEMENT IN 'LACE
FOUNDATION DAMPPR''FIN'.'
BACKFILL APPROVAL lir
11
PLUMBING VENT VENTS PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
4=111111 MIL e0dA
4 .CK STUBR DGING
BRACING S Ad
BR DGING
JOIST HAN RS
JACK POST'
AIR INFILTRATION 011011
HEATING ROUGH-IN
INSULATION:
RIOR R-
O--Q ATION ;ALLS EXTERIOR R- -. .----
` ------ ------
FLOORS R-R-
WALLS R-
CEILING •
11110
DUCT WORK a'
UNHEATED
(518)761-8256
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TOWN OF QUEENSBURY
RCEMENT 1111
BUILDING & CODE ENF
742 BAY RD., QUEENSBURY NY 12804 A,
DEPAR _:L' IJ I
INSPECTOR'S REPORT: ARR 1.
REQUEST OR I SPECTION 'ECEIVED: ' `
NAME 1111b 'a r
LOCAT *N
1111111 PERMIT #
DATE ��► � ■ dre�
Si-
TYPE OF STRUCTURE: - .+am.. . ,pPROVED
N•
RECHECK
FOOTINGS PIERS r
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE- --_
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON I E
FOUNDATION WALLPOUR
REINFORCEMENT IN PLACE
FO NDATION DAMPPROOFING -
BACKFILL APPROVAL J
PLUMBING VENT VENTS IN PLACE —"
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS HEADERS
BRACING B/ RIDGING J`--_
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION: qz:A-Ne\
FO' ON WALLS INTERIOR R- t
FOUNDATION WALLS EX ERIOR RR_
FLOORS R_ ----'-
WALLS R_ _---
CEILING
DUCT WORK OR PIPING IN R-
UNHEATED SPACES
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TOWN OF QUEENSBURY
BUILDING 6 CODDE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
�,/f' � DEPART IN
INSPECTOR'S REPORT: ARR i
REQUEST FSR INSPECTION RE EIVED\ r '
LOCATION
0 � ' _ AL. 11
NAME �1III�
-�, ID _
t: PE•MIT -
DATE - k
TYPE OF STRUCTURE: 14+ " -
APPROVED
RECHECK ili
NO
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MOW_ OLITHIC POUR FORM-
REINF RCEMENT I
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
H•TE'IALS OR THIS PURPOSE ON SITE _ --
FOUNDATION WALLPOUR `,
REINFORCEMENT IN PLACE
FOUNDATION DAMPPROOFING - ---
BACKFI_LL APPROVAL
PLUMBING VENT VENTS IN PLACE -
ROUGH PLUMBING .
PLUMBING UNDER SLAB - "
FRAMING:
JRCK STUDS/HEADERS
��gRACING B/ RIDGING
JOIST HANGERS
JACK POSTS MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUND TION WALLS EXTERIOR RR_
LF ORS _
WALLS R_ _. __
CELL NG
DUCT WORK OR PIPING IN R-
UNHEATED SPACES
3
6--1 6/1/A`liacd
(518) 761-8256
TOWN OF ODE ENFORCEMENTE
NSBURY
BUILDING 6 COD
742 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARa DEPARTACL
ik . 0?
Ale
REQUEST FOR INSPECTION REC IVED:
NAME tai --
,---
LOCATION
DATE - PERMIT 1
TYPE OF STRUCTURE:
APPROVED
N!
RECHECK p YES NO
FOOTI S 'IERS
MONOLITH C POUR FORM
REINFQRC ENT IN PLACE .
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE. -
MATERIALS FOR THIS PURPOSE ON SITE _
FOUNDATION WALLPOUR __
REINFORCEMENT IN PLACE
FOUNDATION DAMPPROOFING _
BACKFILL APPROVAL -
PLUMBING VENT VENTS IN PLAC
ROUGH PLUMBING
PLUMBING UNDER SLAB ._—I—
FRAMING:
JACK STUDSlHEAI '
BRACING B/ RIDGI
JOIST HANGERS
JACK POSTS MA
AIR INFILTRATION BA—
HEATING ROUGH-IN .-
INSULATION:
FOUNDATION WA S INTERIOR R-
FOUNDATION WA LS EXTERIOR R-
FLOORS R_
WALLS R-
CEILING
DUCT WORK OR PIPING IN R-
UNHEATED SP. ..ES
1E V 1v3b1\(1'3 tl
b p _ \--t vtv oF- VE4,1 V\
c.AD C -c7 ‘1E
CID - \l6YF.b icy V
FIRE UNDERWRITERS '�'''`'��` ` r
;��/:a�,?.I:?�l?Q:?.(.AQ:S�L.a�,tl,III, �X�tl;}tti At,?g/:�.t:"l•�IA:�.�:) Y
THE NEW YORK BOARD OF
Y
4(..x .11 I,.! BUREAU OF ELECTRIALBANY, NY 12210 !
CITY
T 111 WASHINGTON AVE., SUIT 704, ALB.AN r •, I = , 3 E_:AUG!) 'j' 1-=_ 1 9'Date Ap lication No on file
THIS CERTIFIES THAT on rued on the above application number in the premises of T
only the electrical equ
ipment as described below and introduced by t
� s Y ,' ', , t� };h;t I 1 t. 5°, Block Lot rr �r
' y, y y-CKY CONSTR. t t )�i:,_ , a:,_, Section YI
•
�• 1st Fl. ❑ 2nd Fl.
s<, in the followinged location; ❑ BasP'ReRtRance with the National Electrical Code.
AUG,i39T 11 1 rt9•j and found to be in comp '
was examined on DISH WASHERS ,T
COOKING DECKS OVENS
r
®® ®® :
AMT. ■ •
�' FIXTURE � oTHEn ■ ■ �
-�� ��INCANDESCENT�FLUORESCENT ■ �
�, . OUTLETS � r
�; 24
-■- MULT4OUTLET DIMMERS -
®® TIME CLACKS BELL SYSTEMS �Illill:3'.
,; FURNACE MOTORS FUTURE APPLIANCE FEEDERS ®®TRANS. H•P. NO.OF FEET r
DRYERS ® lealIC� NO. A.W.G. ,
L - -- - --
E
S E R V . .A.W.G. NO.OF NEUTRALS OF NEUTRAL
SERVICE DISCONNECT NO' NO, RCOND. A•W.G. NO.OF HI-LEG OF•HI•LEG
�; METER OF cc.COND.
i` EQUIP. t t Jir 3w a 3w
of !Tfy 11111111111111111111111M
E:it '} ■®■®
r'®
a OTHER APPARATUS:
I'iX r1`/ sl' iRGE`.N "YX LIGHT-4
i;
i.
%,
i'
!...;:k.;11 ; '''''.-- LL
1 -., P.J.
y SOUTH�j j ;y,�yl�`•�p�t AVENUE
p;I}�� BAKER , , pENERAI MANAGER
� .:} ,islt`1'H CENTRAL IlY 1:J LM11�.1 •'!•Ae.�� 1- ay,'
k#F��k�11'IC`t�II,T�r fir. 12118 ,r_q„ K� _� :� "' ',:�9
'= X+ Per ,
manner; return to the office of the Board .`incorrect. Inspectors may
be identified by
their credentials.
This certificate must not be altered in any
- �•''•"•`•'•'' '• _____..'•.,t THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. —
v .
THE NEW YORK BOARD OF FIRE UNDERWRITERS `" ""'
Donor WRITE HERE.-FOR OFFICE USE ONLY
BUILDING PERMIT NO.
»�
7
TEMP* p•eE Jfj
.s - COUNTY
ZIP CODE \TOW HIP
CITY OR VILLAGE POLE NUMBER
STREET AND NO OR ROAD ,. ._ "; - LOT
_ SECTION BLOCK
BETWEEN WHAT TWO CROSS STRE IS PREMISES LOCATED,
BUILDING OCCUPANCY
OCCUPANT'S NAME v r _
�,.OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER_ - � r _ - -
.. i. :: OFFICE t WORK NUMBER
TELEPHONE
-.: -"' `.• FROM THEIR 1 ,I -.. ,. - .
CURRENT SUPPLIED BY
BUILDING IS OLD❑ WORK IS
NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑
" ❑ LIST BELOW ALL EQUIPMENT WHICH YOU YO®ED OFFICE
BRANCHONLY
USE
No.of Fixtures& MOTORS CIRCUITS
NUMBER OF OUTLETS Lamp Receptacles qV,/C,.
bona
- watts
H.P. Each •Gauge INSPECTION
tiOn Side Attach't Switch Pendant Bracket No. � Each -_--_
Cei--ling Wall Rec- MIMI-
SO lAisBi UB- -------
SIDE
ii
B P SE- _----MENTEll ------III IIIIIIIII__
® NI
1E11 ----- MIMI
IIIMI MIMI MINI
NI ----- MIMI
REMARKS: OTHER DEV OT ORTH ABOVE.
THISE INSPECTED,BUT IF AT TIME OF
N,THERE IS
APPLICATION L INTENDED EQUIPMENT N COVER THE ABOVE-LISTED OT ABOVE LISTED,YOU ARE AUTHORIZED UIPMENT TO BMAKE THE INSPECTION AND ADJUST THE FOEE TO COVER
FOUNDH ANEL TOTAL WATTS
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT. ELECTRIC SIGNS/LAMPS FEEDERS
SIZE OF MAINS VA
❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF
CHARACTER OF WORK ❑ CONCEALED CAPACITY
DATE COMPLETED SIZE OF SIGN(NUMBER)
PATE WORK TO BE STARTED
MANUFACTURER OF SIGN
SERVICE ENTERS BUILDING ❑ UNDERGROUND ! I I
❑ OVERHEAD POSSIBLE) MUST
1A! . I _ 1 1_ _ I 1
DATE INSPECTION REQUESTED ON(OR AS NEAR AS T 7 IIII
AVOID a MS 8Y GIVING AND . « • TE INFORMATION:AU. '. S MUST= PILLED IN OR APPLICATION AY e .RETURNER
PRINT NAME AND ADDRESS DATE OF APPLICATION siGNATUPE OF APPLICANT
NAME OF APPLICANT TELEPHONE NO.
STREET ADDRESS LICENSE NO.WHEN APPLICABLE
CITY OR POST OFFICE ZIP CODE
ill Washington Ave. ❑ 3291 Lake Shore Road ❑ 217 Lake Avenue ❑ 202 Arterial Road
❑ 85 NEW YORK,
StreetK,NY ❑ SUITE 704 BUFFALO,NY 14219 ROCHESTER,NY 14608 SYRACUSE,E NY 13206
YORK 10038 ALBANY,NY 12210 (716)827 1155 (716)254-0141(212)227-3700 (518)463-2122
TUC MI W VflRK BOARD OF FIRE UNDERWRITERSi