91-531 CV •
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 41131/"Pird-VL q 19 q
91-531
This is to certify that work requested•to be done as shown by Permit No.
has been completed.
This structure may be occupied as a Sinole Family Dwellino
Location Lot #135 Tomahawk Trail
Owner Michael Vasili4o Inc.
By Order Town Board
TOWN OF QUEENSBURY-
-
(
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-531
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Michael Vasiliou INc.
OWNER of property located at Lot 0135 Tomahawk Trail Street, Road or Ave. I
w
in the Town of Queensbury,To Construct or place a Single Family Dwelling (71
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. to
1. OWNER'S Address is
O
Michael Vasiliou
Lf
14 STone Pine Lane
Queensbury, NY 12804
2. CONTRACTOR or BUILDER'S Name phi
Same CD
I-
3. CONTRACTOR or BUILDER'S Address O
c-F
414
4)
UI
4. ARCHITECT'S Name 0
O
5. ARCHITECT'S Address �{
6. TYPE of Construction— (Please indicate by X)
.a.
O
( X Wood Frame ( ) Masonry ( )Steel ( ) - - - - CO
O
7. PLANS and Specifications
SSr
No. 2,716 sq ft Single Family Dwelling as per plot plan specifications e.
and application
8. Proposed Use 1 `�
rD
Single Family Dwelling
uO
$ 360.00 PERMIT.FEE PAID—THIS PERMIT EXPIRES July 24, ,1992
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 2-4th, D y of /' July 19 91
SIGNED BY • for the Town of Queensbury
Building and Zoning inspector
1 1 a i OWN OF QUEENSBUH b
� j TOWN OF QUEENSBUR`�EOEIVED _
— APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # cJ,5.3/
JUL 2 21991- Fee Paid
Date: BLDG. & OODE OEPR°eviewed By
LOCATION OF PROPERTY FOR INSTALLATION: / 5
Owner' s Name: A.cet-7Y—E---4_' VA-S I(.(c)i . /W ,
Owner' s Mailing Address: G Sr_e"-eJ A 6:Y7 " `
Installer' s Name: /..A,„44PA5s Phone #: 791%402.z` .
.Number of bedrooms (if residential ) :-
Total daily flow (residential-compute @ 150 gal . per bedroom) : 6,3
Topography-Circle One Flat Rolling Steep Slope % of Slope
Soil ,Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Require equired/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal- Well Other
If domestic water supply is a w -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /Odd gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of : L3 . / Size each: S ft. x 7 ft.
Size of Stone to be used: # i / Depth or ThicknessJF--i 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 Queensbu, y Sanitary .Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ' E.:1 • 2- e/
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:
. ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - . 9000 HEATING DEGREE DAYS
Compliance Methods: IOW OF F7-q BL
PART 5 - Acceptable Practice Method - 1 & 2 Family :Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family DwellingsJU L 2 2 1991
Multi.-Family Dwellings
(3 Stories or Less LDG. C-ODE DEPT. -
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
A/( 2ZL_
ANT'S NAME PROPERTY LOCATION . 1
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area c 7 j'(.� Sq. Ft. 17/4-
2. Type ofHeat - Elec. Base Board Other )' /74c5:9
3. Is Building Mechanically Cooled? YES NO
4. Percentage 'of Area of Windows and Doors Over 17% X Under 17%
THE R-VALUES- GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 3 r 30
B. Exterior Walls R 17
C. Glazed Area R �� � 3:2
D. Exterior Doors R 9 0 - 9r a
E. Floors over unheated spaces R
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R /0 -
H. Basement/Cellar Walls (Below Grade)
I. Heating/Cooling - Ducts - Piping in Unheated Space R.
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code YE NO
TEMPERA RE CONTROL MAXIMUM SETTING 140* - WILL NOT BE EXCEEDED
ifI .ANT S S GN URE DAT Tft
NE NUMBER
INSPECTOR'S REMARKS :
TO • • 1 • OF QLIEENSBURY
Bay at Haviland Roads,Queensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date JL 7 19 chf Permit No. 41
kJ of
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's Name hit,„/Aate_ Ad.4e)ci r APPLIANCE TYPEJrw • Stove Coal Wood
Address /a� � , r ,f. , Furnace Hot Air Boiler
06 r Zip Zero Clearance Circulating Unit
OLl
Phone `7 9 7? . If Non-Masonry:
Owner's Name
-_ Manufacturer
Address Model Outlet Size
Zip Listed by _ Number
!'hone •
►� NEY TYPE
Masonry Block X Brick X Stone
Property location of proposed construction Ft.': Tile ° Steel
16 s '7 'nit/ ( .ate Size• /7 It; 7�
Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $ el, 0o0
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$
SONRY FIREPLACES AND CHIMNEYS.
CASHIER'S DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department; Fire Marshal Amount Collected Amount Refunded
Code Number Title
A 173 3389 (190)Public Safety
•
A233 2655 (230) Minor Sales
l•eLS__ rllected from or Refunded to: `1y/,,••r'./7//®./
-
-
Address:
Dated: 7'4.2�C?°"'
/ Town Clerk or Deputy
While:Annlicanl Yellow and Pink!Cn.thler'r Denartment Gnblenrnel•Pi, lifnr.hnl
TOWN OF QUEENSBURY
AIL )1,
REVIEWED BY:
10011, FEE PAID: 6--74- - -36
PERMIT NO. : q/-5-2,
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 reverse side of this application.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Owner of Property: _ A Cf /' '-5./ /(-)u A(v
P.O. Address: _ /y 57 /?,u PHONE 0.i 2.3s3
Property Location: '474/35- ,,old, ,� 774/L Tax Map No.%?// 16 /7325
Has there been any split of this property since October 1, 1988? Yes No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: l y°ti. 1;dcZyp Lot No. "3
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
6 0
pc Construction of new building * CONSTRUCTION: $ ��� Dll�I`�
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: 167 ft. x /,R ft.
Other work (describe) * Existing Building Size:
* ft. x ft. Aide
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:-5`O
1st Floor ,0/4/S 6 Sq. Ft. / * Front Yard _ 90 ft. Rear yard 7,5— ft.
/ U - * Side Yards ft. and ft.
2nd Floor // 6 O Sq. Ft. f * If on corner, setback from side street-
& /..J * 519 ' ft.
Other Floors Ac-=-., Sq. Ft. NJJ
(not cellar or basement * OCCUPANCY INFORMATION:
TOTAL FLOOR AREA: 2 7/C Sq. Ft. >% * Prin ry Building -
, � * �(! One Family Dwelling •
Size of New Structure: 21 ft. x - ` ft. * `, Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial ul L (Circle One) * Business
* Industrial
No. of stories (Habitable space) * Other
Height (grade to ridge) ft. *
If residential , no. of families: _ * If addition, what will use be?
No. of rooms (excluding ths) : *
No. of bedrooms: *
No. of bathrooms: 2_, A * Accessory Building:
Primary heating system: • /1 * Detached Garage - One/T
Type of fuel : �3-i— * — Attached Garage - One/ wo Car
No. of fireplaces to be installed: / * Private Storage Building
Will a woodstove be installed?: 0 * Other
Central Air Conditioning: Yes A' No *
(OVER)
X°
3 7 i'
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc.
Will any second-hand or ungraded lumber be used? If so, for what? 3
Foundation Wall Material : 0J.a-e l Thickness:
Depth of Foundation below grade (to bo .en of footing) :
/f
Will there be a cellar? 4 Heate. .r Unheated? /95'4. Floor Sq. Footage:
Will there be a basement? any portion be used as living space? /C1'P
If so, what portion? Sq. Ft. Type of Use?
Type of Roof: S oped lat/Shed/Other Material of Roof AVsAfityft7-
Size, wood studs 2 x tI " ; spacing 4 " o.c. ; length r ft'.
Joists (floor beams) : 1st Floor ,_ " x L " ; spacing / ,, o.c. ; span /Y. ft.
Joists_ (floor beams) : 2nd Floor 2 " x /0 " ; spacing /. " o.c. ; span />f ft.
Overlays (ceiling beams) : — " x ® " ; spacing " o.c. ; span ft.
Roof rafters: " x " ; spacing o.c. ; span ft.
Roof trusses (pre-engineer d) : spacing fy " o.c. ; span 2 T ft.
e
Exterior Wall Finish: C5-4,_ 5"/ , of what material ?
Interior' Wal 1 Finish: '$
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
l< - ‘.5-'7-
Is there to be an opening between garage and dwelling? If so, will a Fire-Rated door,
enclosure, self-closing device be provided?
Will a flue-lined chimney be installed?, ��� Height above roof c,91 ft.
Depth of chimney foundation below grade: S- / ft.
Depth of fireplace hearth: ft. e in.
Water supply Municipal -)^ private well :
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: ft.
(A separate application is necessary for any repair or new installation of septic system. )
e2 e - r Ic 7/
NAME OF BUILDER & ADDRESS: % V<(C „ ��. tL°Le Ap .. PHONE J
NAME OF PLUMBER & ADDRESS: � �'1�' pu .r.7 PHONE ^�/� f y
NAME OF MASON & ADDRESS: lei-Ala �` J. PHONE 7�2 0 ` .Z
NAME OF ELECTRICIAN & ADDRESS: /47v p Z,l,/ti��sz,A-, J PHONE 79 42 f
DECLARATION
t
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 wor is authorized by th ner.
Signature
r, owner s ag , architect
o tractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
. -11-VN OF OUEE-_:NL.,
q-3,--,,,r- Iir,:n
rt L7.4.-er.::t t!.....1...
SEP 19 1991
. ' Z 0 T ' /J 3 '!.,DG. & CODE DEPT.
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TOWN OF QUEENSBURYi4
531 BAY ROAD ,
�""' NEW YORK 12804
2~. QUEENSBURY,
TELEPHONt n 1518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME ` l /'A2n/ . 5 4 i l/ r/
LOCATION `S / 41 J 1_, ,//f /
DATE `✓//7 /9/ PERMIT# A), ,
TYPE OF STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YE,S NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION /
PLUMBING VENT
ROOFING /
✓✓✓//�
SIDING y / �//
DECK/PORCH/STEPS/RAILINGS �/ /✓
RELIEF VALVES A �J/
FURNACE/HOT WATER OPERATING l\
BASEMENT INSULATION/DUCTWORK / `` V /
INTERIOR TRIM/PRIVACY DOORS / ,!
FINISH FLOORS: / /
BATH/KITCHEN WATERTIGHT ✓
OTHER FLOORS SWEEPABLE / , j
OTHER FLOORS CARPETED / f
STAIR CLEARANCE/RAILINGS /
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS /
ALL PLUMBING FIXTURES OPERATING ✓/
GARAGE FIRE PROOFING j rl/
DOOR CLOSERS V
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
-77/7/ged0472i 4/7/'/
1�
ARRIVE 3
3D
DEPART l
INSPEC�fl
ELECTRICAL INSPECTIONS
/ DUPLICATE MUNICIPAL RECORD
Permit No. 5 1��1 /
1
Owner __ !_ !L /6 U)
Occupant _
Location AU r,'a`c 7 0 01 -,�,C
Street
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by
1-> "Vc 4fJ4. /
Date f / ( 9"- l • /Cake le nspector
MIDDLE DEPARTMENT INSPECTION AGENCY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
/Z Y ROUGH WIRING OUTLETS / H.P.AIR CONDITIONER
0 t*FFEETS 5-c{,r (I C(4- WIRING &CONTROLS FOR / '-1 -.5 BURNER
33 RECEPTACLES H.P.PUMP
$ I FIXTURES / K.W.OVEN
j2 CAMP.SERVICE EQUIPMENT ( H.P.GARBAGE DISPOSAL UNIT
t'6,AMP.SERVICE CONDUCTORS / K.W. DISHWASHER
/Y/ K.W.SURFACE UNIT J K.W. DRYER
K.W. RANGE AMP.( RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
o Div!a. •
MOTORS H.P. 1/20 1/12 1/10 1/4 '/6 % 'h %2 ' 1 11/2 2 3 5 7% 10 15 20 25 30 $0 50 75 100
MARK NUMBER
OF EACH SIZE 1
APPARATUS
71—"XYL)17
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECE�IIVED
NAME 4s2/.2GAZi
LOCATION & /45 --/ ' r r, L /[
DATE f)/ PERMIT# 9/5j)/
APPROVED
Id/J/Q/47)-1 N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION \
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
lr
`\,
INTERIOR FINISHES v
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE /
CHIMNEY 1
,WOODSTOVE 1,
' FIREPLACE—MASONRY
FIREPLACE—FACTORY BUILT
REMARKS: I OK TO THIS DATE
ARRIVE/0
DEPART /f C—
,/ 474
INSPECTOR
kO GAL . \
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
Nair TELEPHONE' (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME , 1)?/2V /G74-d,LMi
LOCATION _,CI J,_5 1,97111Qa24 i
DATE ///11/9/ PERMITS � � f
TYPE OF STRUCTURE
,\ RECHECK
\FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
_
R0 GH PLUMBING FINAL ELECTRICAL _SEPTIC
INS LATION WOODSTOVE/FIREPLACE
REMARKS
•
•
APPROVAL
� N/AI YES NO
CHIMNEY HEIGHTXLOCATION
B VENT/LOCATION\,
PLUMBING VENT \
ROOFING N. i
SIDING �' �. ;"
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES ,,
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK \
• INTERIOR TRIM/PRIVACYt/000RS\..
FINISH FLOORS: ,Y \ '
BATH/KITCHEN WATERTIGHT \
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHO,LEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ilted.,44.>/2.4.4c.Aa
A I
A4.-g /f 470m Am. &41.„,,y
ARRIVE / ( / "
v5 !�
DEPART J �--
INSP R
6/(
TOWN OF QUEENSBURY `'
BUILDING AND CODES DEPARTMENT O
531 BAY ROAD
QUEENSBURY,
NEW 0
TELEPHONE (518) 792-5834 2
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION- 4.65 1,6 t�'�ltsr1�/�ct //�Q� A
DATE ////5A/ PERMIT #
TYPE OF STRUCTURE / ,Oki
RECHECK APPROVED
N/A YES- NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE ?'
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING `
BACKFILL APPROVAL
ROUGH PLUMBING ,c
PLUMBING VENT/VENTS IN PLACE I
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING /;
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS �' A
CEILING �" g
FIREWALLS
HEATING ROUGH-IN /
INSULATION: t
FOUNDATION WALLS' INTERIOR R-
FOUNDATION WALLS EXTERIOR R ,.
FLOORS ,1 R- '
WALLS I R-
CEILING R-
DUCT WORK OR :PIPING IN UNHEATED
SPACES
REMARKS: 1
ARRIVE / - J
S Q
DEPART /
INSPECTOR
a-- p,TOWN OF QUEENSBURY /ea
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY,
NEW 0 4
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 7/G , ..tL.
LOCATION f ,/:5— /
DATE OA/ PERMIT # 9/'63,
TYPE OF STRUCTURE Ay ' 18411.76'1y L ie/eL
RECHECKAPPROVER"
N/A 1 . YES" NO
y FOOTINGS/PIERS E l/
/` MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE.
FOR PROVIDING PROTECTION FROM aN 1
FREEZING FOR 48 HOURS FOLLOWING '
THE PLACEMENT OF THE CONCRETE. '
MATERIALS FOR THIS PURPOSE ON SITE.
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING y'
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB .
FRAMING:
JACK STUDS/HEADERS /
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM /
FIRESTOPPING
WALLS r
CEILING / ,
FIREWALLS • /
HEATING ROUGH-IN y.
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
� so
ARRIVE
DEPART /41
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT .
REQUEST,FOR INSPECTION RECEIVED K /9
l
NAME
LOCATION "— 7 i Ion th4Loi
QI
DATE (�i jl ii PERMIT if / 5 j(
TYPE OF STRUCTURE 5
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING :
c �BACKFILL APPROVAL /
)4,OUGH PLUMBING-- 1 /
PLUMBING VENT/VENTS IN PLACE /
PLUMBING UNDER SLAB 1 /
FRAMING: 3 I
JACK STUDS/HEADERS a /
BRACING/BRIDGING ! /
JOIST HANGERS 1 f
JACK POSTS/MAIN BEAM ,/
FIRESTOPPING
WALLS i
CEILING
FIREWALLS /
HEATING ROUGH—IN /
INSULATION: /
FOUNDATION WALLS INTERIOR R—
FOUNDATION WALLS EXTER'.OR\R—
FLOORS /WALLS R-
CEILING R=,
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
/1/4
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT ti
n
REQUEST FOR INSPECTION RECEIVED /ill
NAME V-6.I L I OA- ,n v,\v(1/\G1�
LOCATION-''' /3 5 /c m c ) (k)ic- --Trz. L
DATE PERMIT # CPI -531
TYPE OF S RUCTURE Gv-eLp .Q
RECHECK APPROVED
-7--- - r. - -- N/A YES NO
'` OOTINGS/PIERS
' --MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE I
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FRON
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE;'ON SITE
FOUNDATION/WALL POUR :'
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING ;2'
BACKFILL APPROVAL R
ROUGH PLUMBING 4
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS (i
BRACING/BRIDGING i
JOIST HANGERS ry
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING / \
FIREWALLS .P
HEATING ROUGH-IN 1
INSULATION: / %
FOUNDATION WALLS INTERIOR R- \
FOUNDATION WALLS EXTERIOR R- \
FLOORS l R-
WALLS c R-
CEILING I R-
DUCT WORK OR PIPING IN UNHEATED ''..
SPACES / \
/ \
REMARKS: � \
f
1.
ARRIVE .-ZJ
l p.- A0—/
DEPART I J
INSPECTO
TOWN OF QUEE1 SBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY,
NEW 0
TELEPHONE (518) 792-5834 2
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 1
LOCATION / 35 --co n1ciiaAi VG'
DATE gi,)-(0191 PERMIT # 6;1'
TYPE OF STRUCTURE S, c,.
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN 'PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVA
ROUGH PLUMBING 1 q`
PLUMBING VENT/VENTS IN PLACE /
PLUMBING UNDER SLAB
0;71WMING
JACK STUDS/HEADERS ;r
BRACING/BRIDGING\
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING /
WALLS
CEILING /
FIREWALLS
HEATING ROUGH-IN
INSULATION: /
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS/XTERIOR R-
FLOORS R-
WALLS J \R-
CEILING l 'R-
DUCT WORK OR PIPING IN UNHEATED
SPACES f `�
REMARKS: /
/ k /
Cal/ Plit44/1 Pitea4 4-5 Co-i>dack
sue _
ARRIVE
DEPART
INSP C OR
Hill
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUESI FOR INSPECTION RECEIVED
NAME Vas i
LOCATION c ifteniudvt,tr -
DATE 3/6i(4?/ PERMIT # Q / �� //
TYPE OF STCTURE •
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE I
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING if
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE/
FOUNDATION/WALL POUR /
REINFORCEMENT IN PLACE , /
FOUNDATION/DAMPROOFING I /
_:BACKFILL APPROVAL I I
ROUGH PLUMBING /
PLUMBING VENT/VENTS IN PLACE ,/
PLUMBING UNDER SLAB ! 1
FRAMING:
JACK STUDS/HEADERS y
BRACING/BRIDGING
JOIST HANGERS / I
JACK POSTS/MAIN BEAM / I
FIRESTOPPING '
WALLS
CEILING /
FIREWALLS
HEATING'ROUGH-IN /
INSULATION: Ii
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR1R_
FLOORS /
WALLS / B-
CEILING / R-
DUCT WORK OR'PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
NSPECTOR
_ .
TOWN OF QUEENSBURY /A
BUILDING AND CODES DEPARTMENT
531 BAY ROAD �P,0/rt
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPOR� l�
REQUEST FOR INSPECTION RECEIVED `J
NAME VaS;J--1‘0-1, ) ►[/
LOCATION' ) 35 I 11'14 CLIk ,' : L
DATE G1 O 11) PERMIT , '-5 31
TYPE OF STRUCTURE '
f�
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING /
PLUMBING VENT/VENTS/IN/PLACE /
PLUMBING UNDER SLAB; /
FRAMING: /C',� /J v/
JACK STUDS/HEADERS/
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAI BEAM
FIRESTOPPING k
WALLS 1
CEILING /
FIREWALLS / t
HEATING ROUGH-IN
INSULATIO
FOUNDA ION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R- /9
CEILING R-3
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
1
1 a
ARRIVE 7.'4/S
DEPART : SS
INS PEC TO,R
•
Jocun of Queen 34ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIIC DISPOSAL SYSTEM INSPECTION
NAME (/16"1/
LOCATION /,3,.- p7e04‹.4(
DATE_ �S / �/ PERMIT NO. Vi'5')
SOIL T E - Sand - oam - Clay -
Perco ation Test 'equired? YE: - NO
Per olation ra - - Min/Inch
PE of SYST' : •
sorption ield, total ength •
Length of each trench '
Depth of trenches • F
Size of gravel
SEEPAG: PITS*Nuinbe. of) f
Size- ft. X ft. f`
Gra el size ,!I
PIPING: Size / pe
B, dg. to tank t
4 ank to dist. box 1 I
Dist. box t. field/pit4' /
Openings s:.led? YES NO Partial
LOCATION/ EPARATIONS: /
Foundat`.n to tank r�''' ft.
Founda ion to absor../±ion f
Absor• ion to lot ine t.
Separation of pi• s t • ft.
LOCK ION OF SY ' EH ON R P TY(circle one)
Frv.nt - Rear Lpft side - Right side -
COMMENTS: �'
F--fr ///Fe. _
das, ,c„,ozeo PL.
\
SYSTEM USE APPROVED YES/ \
•
uil i g Inspector
01/86 and vl
C)' e-
/y0/\
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED L �� I
NAME kc 1 ) ' ,
LOCATION 1 ?J lo mC,�r-,1/4jk
DATE It L` (A I PERMIT# 9) — 3 1;71
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
FIREPLACE-MASONRY 'V
FIREPLACE-FACTORY BUILT
REMARKS: -I-0K TO THIS DATE
12-4“
h`t
ARRIVE J�) /
DEPART f U .r� G"`"2/1'VC4/
9 lT`�1
INSPECTOR
'"\C .\M'-9'L))1rMN OF QUEENSBURY
��BJJILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST =0R INSPECTION RECEIVED
NAME \ 1,,
LOCATION f 3 \on7,4)(VMJA1vc L
DATE l PERMIT # 1 -- 5 3 )
T F S RUCTURE
( RECHECK APPROVED
N/A YES NO
FOOTZNbS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING: !
• JACK STUDS/HEADER
BRACING/BRIDGING
JOIST HANGERS . /
JACK POSTS/MAIN BIM/
FIRESTOPPING i
WALLS
CEILING
FIREWALLS
HEATING ROUGH—IN .
INSULATION: C,
FOUNDATION WALLS INTERIOR R—
FOUNDATION WALLS EXTERIOR R—
FLOORS '. R—
WALLS 1 s R—
CEILING R—
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
LI Roo/LJa)
Lc,vc'
(2, pry ces
3. /ei ,. )=/o0f2-6
ARRIVE F;lc T„ Cc ecL-- l --1--
DEPART ;' ��
N TOR
own o/ Qa ,
DING and ZONING DEPARTMENT 1/7
and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
PTIC DII,SPPOSAAL SYSTEM INSPECTION
rION
9/j,57/ 9/ PERMIT NO. 7---1�%
IL TYPE ___ 1 - Loam - Clay -
Percolation est Required? YES
Percolation rate - Min/Inch / �✓
TYPE of SYSTEM: ! /
Absorption field, total leng h
Length of each trench tp( /_ a -55
Depth of trenches • ,4,1 ' •
Size of gravel' 44
SEEPAGE PITS4Nuinber of) • /
Size- ft. X -
Gravel size A /
PIPING: S'ze T p
Bldg. to tank
Tank to dist. box c'' '
Dist. box to field/pi:q ' ' v(_,
Openings sealed? Y'S . NO Partial
LOCATION/SEPARATIO
Foundation to tan `-t.
Foundation to absorption J ft.
Absorption to lot line 13 ft.
Separation of p s (.
2 ft.
LOCATION OF SYS _ ON PROPERTY(circle one)
cgin` $ - Rear - eft side Right side -
COMMENTS:
77 J •t;°
2? ,1t&d 64)/ A4vt.
SYSTEM USE APPROVED .�i� NO
B i ding I;spec for
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