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87-841 J � CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date November 24 19 89 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 of two amity dwelling Location 48 Queen Anne Court, Queen Victoria's Grant, Model E Owner Guyer Builders, Inc, By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector 911,17BUILDING PERMIT TOWN OF QUEENSBURY ro No. 87-841 0 WARREN COUNTY, NEW YORK PERMISSION is herebyQueen Victoria's Grant granted to I OWNER of property located at 48 Queen Anne Court Street, Road or Ave. in the Town of Queensbury,To Construct or place a of two family dwelling eo 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. CD 1. OWNER'S Address is Guyer Builders Inc. H. 119 Dunning St. �+ Ballston Spa, N.Y. 12020 H. 2. CONTRACTOR or BUILDER'S Name Same 0 rt 3. CONTRACTOR or BUILDER'S Address Same 4. ARCHITECT'S Name co A CD tD 5. ARCHITECT'S Address 0 0 m 6. TYPE of Construction—(Please indicate by X) p Q� )Wood Frame ( ) Masonry ( ) Steel ( ) rti 7. PLANS and Specifications No. 32' x 37' as per plot plan, specifications and application including septic system and attached one car garage. MODEL E N� 8. Proposed Use c of two family 0 $5.00 C/O 5 $ 96.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 1, 19 88 1-6 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the t7 town of Queensbury before the expiration date.) tD I—' Dated at the Town of Queensbury this 9th Day of December 19 87 SIGNED BY %/ L.C, /tY��zJ for the Town of Queensbury Building and Zoning Inspector r`° A lication No. '.e_ +d..�..ti.. ✓own of geueenilur y PP , S �� Permit Issued 19 I �J J � U � CI BUILDING and ZONING DEPARTMENT Permit Expires 19 JJ Bay and Haviland Road, R.D. 1 Box 98 • Zoning Designati • Queensbury, New York 12801 - Variance No. OCT 2 �J� Site Plan Revi . E UILD!NG &.C DE-DEPT, Approved by. ac'�, uO qd� - v�1 • • • APPLICATION FOR • 9• C/O _ r,d0 • EUILDING. AND ZONING PERMIT H - • , * it. * 4 'iv.* '4 * * * * it * * it * it:* * it * * 4- * * •* * .*• *. * * . * * * * * * *N.1F 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 specifications submitted, and such. special conditions as may be indicated on the Permit. ' The owner•of this property is: . Guyer Builders, Inc. " . P.O. Address . 119 Dunning Street Ballston Spa, New York 12020 Tel. (518) 899-9161 Property Location: 48 Queen Anne Court Tax Map No.121 /2L/ 2 ' Street number or building lot number . Subdivision name (if applicable) Queen Victoria's Grant THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: Richard H. Guyer III .(518) 899-9161 Name - P.O. Address . Tel•. No. Name of builder Guyer Builders, Inc.Address 119 Dunning Street Tel. (518) 899-9161 Name of plumber Guyer Builders, 1nc.Address 119 Dunning Street , .Tel. . (516) 899-91b1 Name of mason Guyer Builders, Inc. Address 119 Dunning Street Tel. (5113) 899-9161 NATURE OF PROPOSED WORK: * . ZONING INFORMATION: X Construction of a new building_ * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, Addition to a building ' * drawn reasonably to scale •and attached hereto, Alteration to- a building * showing clearly,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 , . FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location LOCATION OF STRUCTURES AFFECTED. * of water supply and location and configuration of septic disposal area. * -* COMPLETE INFORMATION REQUIRED pBELQW. *• Size of property• • 100± plan ft X 120 ft. E' * Existing buildings) - Size N/A ft X NSA ft. PROPOSED BUILDING AND USE: Model E/L of * Existing building(s) Use N/A Size of new struc e 32 ft 'X 37 ft " * . . • • • ' • • • • Foundation-pier slab crawl/partial/full - * Proposed building, distance from property line circle one) * see plot plan Front yard No. of stories (habitable space) 2 • * 30+ ft Rear yard 30+ ft. Height (grade to ridge) 21' - 6" ft. * Side yards 15+ ft and 15t ft • If residential, no. of families 1' of 2 * If on corner, setback from side street 30+ ft No. of rooms(excluding baths) ' 6 • • * OCCUPANCY INFORMATION No. of bedrooms - • '2 • - * No. of;.bathrooms - 2 * PRIMARY BUILDING - Prima - heatin s stem Baseboard electric* one family dwelling This rmit },ei for U g y * Two family dwelling one sum of oullaing. Type fuel Electricity * "'Multiple dwelling / Number of units • ' No. ob fireplaces to be installed * Permanent occupancy Will a wood stove be installed? No * Transient occupancy Central Air conditioning? No * Business BUILDING. STYLE, PRIMARY STRUCTURE * Industrial •Ranch Contemporary Los cabin * Other • Raised ranch Mansion Duplex If addition, what will use be? Slit level Old style Bungalow. Cape Cod Cottage Other * ACCESSORY BUILDING- ;; • Colonial Row • Town House * Detached garage/one car/ two •car/' car ' ( CIRCLE ONE PLEASE ) * X Attached garage/one car/ two car/ one- car - +r * * * * * * * * * * * * * * * * * Private storage building ESTIMATED MARKET VALUE OF eleer * Other - CONSTRUCTION $�Il fd * . INFORMATION ON .BUILDING SPECIFICATIONS, .ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! . Form EPA 4/86 and-vl .• . • .- • ' WILDING PERMIT APPLICATION CONTINUED - . • BUILDING SPECIFICATIONS; Type of construction, wood frame, fire safe,etc. wood frame Will any second-hand or ungraded lumber be used? If so, for what? no Foundation wall material concrete block - Thickness 8" Depth of foundation below grade (to bottom of footing) 481' minimum . ' Will. there be a 'cellar? nO Heated or unheated? Floor sq. footage sq ft Will there be a basement? no Will any portion be used as living space? (If so, what portion?. sq.ft. - - Type of use? Type of roof -Cloped)flat/shed/other Material .of roof Fiberglass shingles • Size, wood studs 2 "X 6 " spacing 24 "o.c. length 8 ft. exterior walls . Joists(floor beams) 1st. floor N/A-"x " ,-spacing "o.c. span N/A ft. Joists (floor beams) 2nd. floor — "x 10 " spacing t6 "o.c. span 13'-6 't. Overlays(ceiling beams) 2 "X " spacing 24 "o.c. span 16 ft. • Roof rafters 2 "x 1 " spacing 24 o.c. spanl4'-311t. ,Roof trusses(pre-engineered) - spacing. 24 "o.c. span N/A ft. Exterior wall finish • stained Of what material? 5/8" x 4' x 8' texture 111 Interior wall finish paint 1/2" sheetrock • . If a garage is to be attached, describe materials to be used for FIRE SEPARATION: 1/2" type "X" sheetrock Is there to be an opening between garage}and dwelling? yes If so will a Fire-rated door, enclosure, and self-closing device be provided? • yes Will a flue-lined chimney be installed? 'No - Height above .roof N/A ft. Depth of chimney foundation below grade N/A ft.' Depth of fireplace hearth N/A ft. in. Water supply - Municipal or private well municipal SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties N/A ft. (A separate application is necessary for any repair or new installation of septic system) ' See S.P.E.D.S. permit # 0202525 • Town of Queensbury AFFIDAVIT County of Warren STATE OF NEW YORK • I swear that to the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done 'on the described premises and that all . provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether s cified or not, and that such work is authorized by the 'owner. / , e,--A .orf ,..)-2?, .. SWORN TO BEFORE ME THIS Signature .• //�� - er, owner's agen' ,ar itect,contractor Jet day of (Y6 19r a PATRICIA E. FURPHY / '' Notary Public, Mate of New York ,• p �1 r Qualified in Schenectady County Notary Public, W o : ty, N.Y. 4717043 * * * * * * * * *. * * * * * * * * *C9inTis iorttExpir%s apt.SP, T/* * * * * .* * * * * * * * * * * * . SPECMI, CONDITIONS OF THE PERMIT: 1270 Square feet living ._ -- 288 Square foot garage - one stall r' r 1558 @ $7.00/100'or part of . . 1\ 1 . $5.00 One stall garage $5.00 C/O permit Total By 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. £N8WR ALL of the following: • • '1270 S.F. . `. ••„�,, Gross floor area • }• a.. Type of heat Baseboard electric 3. Is the building mechanically cooled? No • 4. percentage of area of windows and doors 13.3% A. Over 16% Only 1. No value of gross area of walls, roof/ceiling and floors exposed to ambient conditions 2. Floor over heated spaces YES NO a. Are foundation walls insulated? YES NO 1. If YES, what is the R value? 3. Slab on grade YES NQ a.. If YES,• what is the R value of insulation around. • perimeter of floor? • 4. Is basement heated? YES NO a. R value of insulation 5. Type of insulation • 0. Under 16% Only 1. R value of roof and floors exposed to ambient conditions R-38 (U.�.026) 2. : R value of exterior walls agQ0C R-23.5 U.0.04 • 3. R value of glazed area U.=0.30 • 4. R value of doors R-14.9 (U...0.06) 5. R value of floors over unheated spaces N/A 6. R value of slab edge insulation - unheated slab N/A 7. R value of slab insulation - heated slab 12.5 6. . R value of heated basement/cellar walls (above grade) -N/A . 9. R value of heated basement/cellar walls (below grade) N/A 10. Type of insulation Fiberglass C. Controls 1. Thermostat maximum heat setting • D. Duct Systems N/A 1. Is duct system installed in unheated spaces? YES NO a. • If YES, R value of duct installation b. K value of duct in other. areas E. Piping Insulation N/A 1. Size of hot water or cooling carrying agent pipe 2. R value of pipe insulation • F. Service Water Heating • 4; •: • 1. Performance efficiency N/A 2. Temperature control setting maximum G. For Swimming Pool Only 1. Maximum heating N/A Telephone No. (518) 899-9161 (applicant's sigrfature) .f APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref: S.P.E.D.S. • DATE September 29 87 permit # New York - 0202525 MODEL E of E/L LOCATION OF PROPERTY FOR INSTALLATION 48 Queen Anne Court Owner's Name: Guyer Builders, Inc. Telephone: (518) 899-9161 • Address: 119 Dunning Street, Ballston Spa, New York 12020 Installer's Name: Guyer Builders, Inc Telephone: (518) 899-9161 2 A, C, E, I, J, K, L, M Number of bedrooms (residential only) 2 • 3 F, G, 11 , . • Total daily flow (compute @ 150 gal per bedroom) 300 Topography: circle one:( la )Rolling Steep.Slope % of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: 8' feet + Ground Water: At what depth? unknown 8 feet + Bedrock or Impervious Material: At what depth? unknown feet Percolation test: circle one: (n-ot require required / rate min. inch. Domestic water supply: circle one: Municipal Well Other IF domestic water supply is a Well: . Separation: Watersupply from Septic absorption N/A feet * PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1,000 gal.) • TILE FIELD: Each Trench N/A feet / Total system length N/A feet * SEEPAGE PIT(S): Number of / Size each feet by feet 1* * Size of stone to be used # / Depth or Thickness feet * * * * * * * * * * * * * * * * a * * * * * * * * * * * * * *.* * * * * * * * - — - - IMPORTANT See S.P.E.D.S. ...Please...LIST NEW EQUIPMENT TO BE INSTALLED permit & attached • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * map. (over) • • Section II 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. 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: Date: -- -- _— Tow n of_Queensbury Building and Code Department - -• Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 • e YTTI eel \7l a uA\le At• Al A TI In AI nr AI1TV .A newt Ell Are TA I I\fr _ wn of Queeni/)ur/ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME C,),1G�! LOCATION 16--FK0 �r Date illy /-7_ Permit No. F'i -f(�/ APPROVED - YES NO noting/Pier Forms .oundation Waterproofing Backfill Framing / Roofing // Siding Masonry Veneer Rough Plumbing • Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar. Drain Tile Concrete Floors F'TTbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney ' , INSULATION: Foundation Floors Walls • Ceiling FINAL ELECT•ICAL INSPECTION DRIVEWAY APP'OVAL Final Buildi .g Survey Next scheduled inspection (call when ready) Remarks- art AJG e,-)90 lnpg,12- Vtr —ioi✓ Buildin nspector 6/86 and-vl • .own of Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT C/ - SAME `� f/t• wr • �fG- (r// � LOCATION���n� C� � oft Date /c7• "/ 7 Permit No. ( "4 -! f ✓ = APPROVED - YES / Footing/Pier Forms F undation Waterproofing . Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext, Porches Finished Floor- Interior Trim Stairs & Railing. Cellar Drain Tile • Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION:. Foundation Floors . "Walls Ceiling FINAL EI•ECTR CAL INSPECTION , DRIVEWAY APP'OVAL Final Building Survey • INJ3 PL-C iOAf Next scheduled inspection (call when ready) Remarl , • 5°1-1A/CoS CA-1.1M 8/: Rw G-6 r & pus rP "toti•/emso . • C,Ro vo-r- 3 Po(424.110 i,v Lnw P,�r2 S 12.&-412 A 'TT) pd a la r Pbv / Building Inspect 6/86 and-vl NMO .own o f Queeniurj A afi BUILDING and ZONING DEPARTMENT 4' Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME Jzv,e}-(9 LOCAT ION f�J v ( � ,(2/' Date /_ Permit No. (-7- r// ' Li iI * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation 6' Waterproofing Backfi 1 Framin. Roofing Siding Masonry V+ neer Rough Pluming Relief Val -s Ext. Porche Finished Flo. s Interior Trim Stairs & Railin;s Cellar Drain Tit- Concrete Floors Plbg. Fixtures Gar. Fireproofi g Door Closers • Smoke Detecto.s � Chimney ►v`IN SU LAT I ON:t0OUndation Floors Walls Ceiling FINAL ELEC RICAL INSPECTION DRIVEWAY A" ' i' , Final Building Survey Next scheduled inspection (call when ready) Remarks— . f • 'Funding ns�hector F,/f1F, mrl- ,1 j/ TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- 114162 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 5--4'-S-J NAME /L 4^J LOCATION Z/ ,N jam{ a ! DATE 5--5 - PERMIT # E-7---c?g/ APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMPSPROOFING BACKFILL APPROVAL ----ROUGH PLUMBING Ik FRAMING f \ ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING , FINAL INSPECTION: ' CHIMNEY HEIGHT / ROOFING ` SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARAJ,CE & 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: / Tt1 PFrmnD TOWN OF QUEENSBURY `�- BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS /7 QUEENSBURY, NEW YORK 12804. 7 /y TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED -s - NAME �� LOCATION �� LplpMc DATE S-%D - 9 PERMIT # D 7 -0 1/ APPROVED YES NO TOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: I 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: T T1(+T Tlm�r • • • awn oI Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 • SEPTIC DISPOSAL SYSTEM INSPECTION NAME ,ftc��/ _P-C_- LOCAT I ON /; rL�a�G DATE '/ PERMIT NO. Y�"( 14) SOIL TYPE//` and Loam. - Clay - Percolati. est Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: • Absorption field, total length Length of each trench Depth of trenches ' Size of gravel SEEPAGE PITS{Number of) _ 9 Size- 'ft. X 5V ft. Gravel size 4/ , PIPING: Size Type Bldg. to tank 6 a 6 Tank to dist. box ry 026 Dist. box to field/ ' �rc> Openings sealed? ES NO Partial LOCATION/SEPARATIONS: Foundation to tank 9� Foundation to absorption ' ft. Absorption to jlot lie ft. Separation of/pits . LOCATION OF SYSTEM ON ••••ERTY(circle one) Front -4ivair Left side - Right side - COMMENT : • SYSTEM USE APPROVE YES NO • Buil ing 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 Ic-5-k 9 NAME LOCATION G a 4( 0041 61 DATE �j - A. r�Y PERMIT # S>7 V ( APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL -OUGH PLUMBING //////'- .FRAMING f -/ ELECTRICAL ROUGH-IN C'f INSULATION: FOUNDATION FLOORS WALLS .\ CEILING \ FINAL INSPECTION: ; CHIMNEY HEIGHT ROOFING }\ / SIDING \a EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE &:RA_LS PLUMBING FIXTURES%RELIEF\ VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS/ `\ GARAGE FIREPROOFING DOOR CLOSER(S)/ \ SMOKE DETECTORS \ FINAL ELECTRICAL INSPECTION FINAL APPROVAL/OF CONSTRUCTION N A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: A14/ INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 (r(.. BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME 11 -1p�lJ • LOCATION DATE (O -'9 PERMIT # ��7 - ' / • APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN Lp ULATION: FOUNDATION FLOORS WALLS . - /( CEILING FINAL INSPECTION: 1 CHIMNEY HEIGHT ROOFING ' SIDING EXTERNAL PORCHES/STEPS•, STAIRS-CLEARANCE &/RAIL$ PLUMBING FIXTURES/RELIEF`:VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS }! GARAGE FIREPROOFING DOOR CLOSER(S) f SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL pF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: • INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 1-67) BAY & HAVILAND ROADS fa QUEENSBURY, NEW YORK 12804- TELEPHONE (518) -792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR N PECTION F ECEIVED NAME ��7/J • LOCATION 4 CCR.,021.41_1 CL(Y C'(-ihIL DATE • `r G� PERMIT # j r APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING . ELECTRICAL ROUGH-IN ' INSULATION: N FOUNDATION `'�e. • FLOORS • WALLS_LLS . /CEILING NAL INSPECTION: JJJJJJ CHIMNEY HEIGHT ,r' • ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS—CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS / ✓ GARAGE FIREPROOFING DOOR CLOSER(S) ✓ 7 SMOKE DETECTO1 S FINAL ELECTRICA2 INSPECTION' • • � FINAL APPROVAL OF CONSTRUCTION — . A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: 1111 II ULA,INSPECTOR • MIDDLE DEPARTMENT INSPECTION AGENCY, INC.- Electrical-Building-Plumbing-Fire Inspections Labe, (4/ .� 500F 5,85 (i ((// • - '�l' ,.� a-teVi Vaa- 1 .-- Date - yuk 17 � t ecto T ',�a�0 T cons itutes certification that the i '. above installation, but not,the equip- ment itself, has been visually inspected as of this date pursuant to, the apmt able codes. If additional= equipment _ should be introduced or alterations made to the existing system or stuc-... ture, application for.inspection should be submitted promptly to this Agency.