92-654 CERTIFICATE -OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Dace December 22 l9 ()2
This is to certify that work requested to be done as shown by Permit No. 92-654
has been completed.
This structure may be occupied as a Single family dwel l6ng
Location Lot 21 Mockingbird Lane, Insoiration Park Subdivision
Owner Ms. Joan C. Loveland
Issued for.lower level only.
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. dt Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY 92654
TAX MAP NO. 148. -2-21 No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to LOVELAND, MS. JOAN C
OWNER of property located at 2 MOCKINGBIRD LANE Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAM DWLG—LOWER LEVEL ONLY
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
2. CONTRACTOR or BUI LDER'S Name
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
MDIA
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
SINGLNP• FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAM DWLG—LOWER LEVEL ONLY
$ f ao(k PERMIT FEE PAID —THIS PERMIT EXPIRES October 23 19 93
(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 23 Day of October 19 92
SIGNED BY � Q for the Town of Queensbury
Buildings d omngInspector
REVIEWED BY: _
FEE PAID:
PERMIT NO. : -OWN OF QUEENSIBUk:
RECEIVED
OCT 161992
BUILDING PERMIT APPLICATION
BLDG. & CODE DEFT.
PERMIT MUST BE OBTAINED BEF RE BEGINNING CONSTRUCTION. NO .INSPECTIONS WILL BE MADE UNTIL
,PPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
01 applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
Iwner .of Property: MS- Joan C. Loveland - Lot #21 - Model IB
1.0. Address: Mockingbird Lane PHONE - -
8.7 1, 7.3 & 7.4
'roperty Location: Queensbury, NY 12804 Tax Map No. 149/ �2_ /
1as there been any split of this..property since October 1, 1988? . Yes x No
If yes, Planning Board Review is necessary. j-1? --)_�1
Subdivision Name, if applicable: Inspiration Park Lat No. 148.7.1,7:3&7.
Lot #21 - Model 1B
fHE PERSON. RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Cushing, Dybas Associates, Architects, P.C.
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
X Construction of new building * CONSTRUCTION': 79,994
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: 100 ft. x 100 ft.
Other work (describe) * Existing Building -Size: None
* _ ft. x ft.
* Proposed building. - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
*
1st Floor 1017 Sq. Ft. d, * Front Yard 30, ft. Rear yard 44 " ft.
D * Side Yards 34 ft. and 26 ft.7d
21d Floor 680 Sq. Ft. * If on corner, setback from se street-..
- ft. .
.Other Floors - Sq. Ft. ���
(not cellar or basement * OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: 1697 Sq. Ft. * Primary Building -
* X One Family Dwelling
Size of New Structure: 40-0 ft. x 25-42 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial ull Circle One) * Business
* Industrial
No. of stories (Habitable space) 2 * Other
Height (grade to ridge) 22 ft.
If residential , no. of fam 1 es: one * If addition, what will use be?
No. of rooms (excluding baths): -.Seven
No. of bedrooms: Four
No. of bathrooms: e- * Accessory Building;
Primary heating system: Baseboard * Detached Garage - One/Two Car
Type of fuel : ElectrIc * Attached Garage - One/Two Car
No. of fireplaces to be installed: None * Private Storage Building
Will. a woodstove be installed?: No * Other
Central Air Conditioning: Yes Ro
(OVER)
IJUILUINb rtKPII I tirrLIUMI lun wiv i III vcv.
BI4ILDIRG 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 : Poured concrete Thickness: s"
Depth of Foundation below grade (to bottom of footing) : Below V-0
Will there be a cellar? Yes Heated or Unheated? unheated Floor Sq. Footage: 1017
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: Sloped/Flat/Shed/Other . Sloped Material of Roof Asphalt Shingles.
Size, .wood studs 2 x 6 " ; spacing 16 o.c. ; length a ft.
Joists (floor beams) : 1st Floor 2 " x 10 spacing 16 " o.C. ; span 13 ft. Max_
Joists (floor beams) : 2nd Floor 2 " x 10 " ; spacing 16 o.c. ; span 12 ft..-Whe'e
Overlays (ceiling beams) : - " x - " ; spacing - " o.c. ; span - f t. Applicable
Roof rafters: - " x - "; spacing - o.c. ; span - ft.
Roof trusses (pre-engineered) : spacing 24 o.c. ; span 13 ft.
Exterior Wall Finish: clapboard Siding of what material ? vinyl
Interior Wall Finish: 1/2- Gypsum Board
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
N/A
Is there to be an opening between garage and dwelling? N/A If so, will a Fire-Rated door,
enclosure, self-closing device be provided? N/A
Will a flue-lined chimney be installed? No Height above roof N/A ft.
Depth of chimney foundation below grade: NIA ft.
Depth of fireplace. hearth: NIA ft. VA in.
Water supply - Municipal or private well : Municipal
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: +100 ft.
(A separate application is -necessary for any repair or new installation of .septic system. )
NAME OF BUILDER & ADDRESS: The Quinn company, Inc. - P.O. Box 6150 - Rutland, VT 05702 PHONE(8o2)747-7010
NAME OF PLUMBER & ADDRESS: same as Above PHONE
NAME OF MASON & ADDRESS: same as Above PHONE
NAME OF ELECTRICIAN & ADDRESS: same as Above PHONE
DECLARATION
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: CODE9 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 nnby the owner.
Signature -I"-Q
0 ner, o er s agent, architect
cont ract
o
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
. PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings;
Multi-Family Dwellings
(3 Stories or Less)
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
Ms. Joan C. Loveland Inspiration Park (Lot #21)
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 1017 Sq. Ft.
2. Type of Heat - x Elec. Base Board Other
3. Is Building Mechanically Cooled? YES x NO
4. Percentage of Area of Windows and Doors Over 17% x Under 17% (10.65%)
(9000 D.D.)
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D
THE R-VALUES SHOWN ON PLANS SUB14ITTE01
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 38 33 24
B. Exterior Walls R 19 23 18
C. Glazed Area R 3.45 2.6 1.7
D. Exterior Doors- R 14.9 2.5 2.5
E. Floors over unheated spaces R 19 24 19
F. Edge of Slab on Grade (Heated Building) R N/A 10 10
G. Basement/Cellar Walls (Above Grade) R N/A 10 10
H.- Basement/Cellar Walls (Below Grade) R N/A - -
I. Heating/Cooling - Ducts - Piping in Unheated Space R N/A - -
6. Service (Domestic) Hot- Water Heating Device
A. Conforms to minimum efficiency per code x YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
(518) 793-5183
APPLICANT'S IGNAT RE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS :
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: 10/16/92 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: Inspiration Park, Queensbury, NY 12804
''e6 #24 Model 7n-)
Owner' s Name: Ms. Joan C. Loveland
Owner' s Mailing Address: Mockingbird Lane, Queensburg, NY 12804
Installer' s Name: The Quinn Company, Inc. Phone #: (802) 747-7010
Number of bedrooms (if residential ): Four
Total dailyflow (residential-compute @ 12s 500 Gals
p gal . per bedroom) :
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle .One: Sand. Loam Clay Other /Depth: +20'
Ground Water-At What Depth? +V-0" Feet
Bedrock or Impervious Material-At What Depth? +20 Feet
Percolation Test-Circle One: Not Required Required/Rate 2 Min. Per Inch
Domestic Water Supply-Circle One. Municipal Well Other
If domestic water supply is a we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 1250 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 36 . feet//Total System Length 216 feet
Seepage Pit(s) : Number of 1 Size each: ft. x ft.
Size of Stone to be used: 1/2° to 1-1/2^ Depth or Thickness 1.0 feet
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Sizelof Each Gal .
Alarm system and associated electrical work to be inspected b certified
agency.
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE:
- I
OWN RE QUEENSEUr.
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OCT 2 21992 TO --GF"-Ql�EEP��SBURY !
BUILDING & CODES ®EPT'.1
REV EWED BY
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DRAWN: ARCHITZ-:C i S, P.C. PLOT PLAN '
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THIS DOCUMENT IS A VIOLATION OF SECTION SuC30IVLS10N
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I certify to the following
that this survey has been
prepared in accordance with
the Code of practice for Land
Surveys adopted by the H.Y.B.
ssocietioa of professional
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and Surveyors as last
revised.
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STATEwlOE_ FUIJOIIJG CARP.
lTS Suc�ESSOR.S Ala o�orL AS516NS
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"ONLY COPIES OF THIS MAP SIGNED IN RED
INK AND EMBOSSED WITH THE SEAL OF AN
1 LL OFFICER OF C. T. MALE ASSOCIATES, P.C.,
OR A DESIGNATED REPRESENTATIVE SHALL
C. J F� OEI IISOFJ PL-S 04g- TEAT E- BE CONSIDERED TO BE A VALID TRUE COPY"
Dote RECORD OF WORK Appr. LOT 2► - N�OcKt tJG81 Rfl LA-.N E.
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C.T. MALE ASSOCIATES, P.C.
6 50 CENTURY HILL DRIVE, P.O. BOX 727, LATHAM, NY 12110 ICU
(518) 786-7400 • FAX (518) 786-72" ZI
Checker: J E) ENGINEERING ► SURVEYING • ARCHITECTURE • LAND PLANNING �cDrOfter. T LANDSCAPE ARCHITECTURE • COMPUTER SERVICES
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Apokation
BUILDING & CODES DEPT.i
KLV!t:WLLJ BY
Zoning Administ,
N OF Ctu!: BRU 1Y
DATE
DAFF: 1 7
CUSHiNG, DY-BAS ASSC)C,'A--F-S,
DRAWN: ARCHIcCTS, P.C. P1,077 KAN
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DIECKM
INS DIRATION PARR
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` TOWS! OF QUEENSBURv
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED l AL-
NAME
LOCATION// 2 f �C1 � cJ
DATE. PERMIT 0
TYPE OF STRUCTURE
RECHECK APPROVED
N/A —YES.1 NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PIROTECTION FRCH
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPRO FIND f
BACKFILL APPROVA /
ROUGH PLUMBING I /
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER HAB
FRAMING: Q
JACK STUDS/HEA,, RS
BRACING/BRIDGI G
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-INS
INSULATION: /
FOUNDATION WALLS ',INTERIOR R-
FOUNDATION"WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
INSPECTOR
TOXIN OF QUEENSBURY /Q
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 1 16 L
NAME
LOCATION j
DATE � PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI 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 URPOSE ON SITE i
xFOUNDATION ALL POU
REINFORCEME LACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL '!
ROUGH PLUMBING I
PLUMBING VENT/VENTS IN PLACE:q
PLUMBING UNDER SLAB l
FRAMING: ! l
JACK STUDS/HEADERS
BRACING/BRIDGING_
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION: y
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR
FLOORS R- �.
WALLS R- ;.
CEILING r' R- `a
DUCT WORK OR PIPIN IN UNHEATED
SPACES ,
REMARKS: `
ARRIVE
DEPART
INSPE TOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE & PERMIT #
TYPE OF STRUCTURE SG/
RECHECK APPROVED
N/A YESI 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 r'
PLUMBING VENT/VENTS IN",PLACE
PLUMBING UNDER SLAB
FRAMING: f
JACK STUDS/HEADERS ;
BRACING/BRIDGING ?
JOIST HANGERS t
JACK POSTS/MAIN BEAM '
HEATING ROUGH-IN
INSULATION: 2
FOUNDATION WALLS INTERIOR R- ;;
FOUNDATION WALLS EXTERIOR R- j
FLOORS R�s
WALLS R
CEILING R='I
DUCT WORK OR PIPING IN UNHEATED
SPACES i
REMARKS:
,f
y t
a
ARRIVE
DEPART
IkspMrOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUQS�7' FOR I SPECT ON RECEIVED
NAME J �
LOCATION , I
DATE 1 1-2-0/-'j-2iPERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI NO
DOTING PIER (00j
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCR -TE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLAC
PLUMBING UNDER SLAB
FRAMING: ,° a
JACK STUDS/HEADERS
BRACING/BRIDGING /
JOIST HANGERS 7°
JACK POSTS/MAIN BEAM s
HEATING ROUGH—IN
INSULATION:
FOUNDATION WALLS INTERIOR R—
FOUNDATION WAL EXTERIOR R—
FLOORS R—
WALLS R—
CEILING R—
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART iL
INSP CTO
d. ,Jown o/ QueenJLry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ,
LOCATION
DATE PERMIT NO. (i/ESL`
SOIL TYPE - .S.a d a Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch _
4
TYPE of SYSTEM:
Absorption field, total length,,. �,
Length of each trendh,. 3(- ;
Depth of trenches ' � '
Size of gravel_
SEEPAGE PITS4Nuinber of,)
Size- ft. X ft!
Gravel size �..
PIPING: S' zei Type
w
Bldg. to tank Y 5- D2 3 5
Tank to dist. box 16X% 5'
Dist. box to field/pit 1/6
_
Openings sealed? ' ES A'; NO Partial
LOCATION/SEPARATIONS: i
Foundation to tank � �:/� ft.
Foundation to absorption LVO ft.
Absorption to lot line Cv ft.
Separation of pits s N ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front �ReT - Left side - Right side COMMENTS:
SYSTEM USE APPROVED 4/ v/
Bui lhg Inspector
01/86 and vl
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK(518) 745-44478
04
TELEPHONE
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
WE—
LOCATION r.,6J'%c�',��,f�'is!1l
DATE .� PERNITO
TYPE OF STRUCTURE ,3'�► jr,✓ %F�r.LG
RECHEC a-
-FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING ;'FINAL ELECTRICAL _SEPTIC
_INSULATION WOODSTOVE/FIREPLACE
REMARKS
N/APPYESALNO
CHIMNEY HEIGHT/COCA ,ION
B VENT/LOCATION +�
PLUMBING VENT
ROOFING a
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES Y'
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART /
INSP CTOR
TOM OF QUEENSBURY
531 BAY ROAD
E QUEEASBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR®S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTI�OpN RECEIVED ,y 7 e
WE
LOCATION �f �r`'� Yy?G(! � � �� WL
DATE /� ' " �'� PERMIT# exy) -� �'
TYPE OF STRUCTURE_
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
:; OflTING J OUNDATION L.�KFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL /,..SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
j N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION J
PLUMBING VENT
ROOFING L
SIDING
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FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER., FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
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DOOR CLOSERS
BATHROOM FANS \
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING\
DOOR CLOSERS v
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART
INSPECTOR
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. Z'
Owner '`-
Occupant ) Y T `�
Location L U l y/� f '7-7
No Street
Town or City State
Installation as itemized on reverse side has been visuallyinns5p-ec�ed pursuant to applicable codes.
Installed by `�—L L �
N
Date /�' LA Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.te EL. 900 Haddon Ave.,Collingswood, NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
^ S 0 /77'14' WIRING &CONTROLS FOR BURNER
�i RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
PCAMP.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
KK..W.WW,A�T,ER HEEAT�ERR FRAC.H.P.VENT FANZil
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PPARATUS
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
_QUE-ENSBURY NY 12804
(518)745-4447
DEPART: v INS
FINAL INSPECTION REPORT - RESID AL
DATE INSPECTION REQUEST RECEIVED: (�
NAME Cd�aA1 w\}F-LA�1 �
LOCATION nn 0 L rr,, E
DATE _1 PERMIT N y7--LEI-Li
TYPE OF STRUCTURE
FOOTINGS_ FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING _ SEPT-IC- INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A TES NO
CHIMNEY HEIGHT B VENT HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK PORCH STEPS RAILINGS
RELIEF VALVES
FURNACE HOT WATER OPERA NG
INTERIOR TRIM PRIVACY DO RS
FINISH FLOORS:
BATH KITCHEN WATERTIG
OTHER FLOORS SWEEP E
OTHER FLOORS CARPAIED
STAIR CLEARANCE ILINGS
SMOKE DETECTOR/
BATHROOM FA
PLUMBING IXTURES
FOUND 'ION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE RE .
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BUILDING & CODE ENFORCEMENT
531 BAY ROAD
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(518)745-4447
ARRIVE: o DEPART: INSP
FINAL INSPECTION REPORT - RESIDENT A
DATE INSPECTION REQUEST RECEIVED:
NAME t pA►Z
LOCATION. .2 MO( 14\t. LGx Pin l AIJF
DATE I I / PERMIT #
TYPE OF STRUCTURE Fn UPPEP� -E�JE�
FOOTINGS_ FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT B VENT HEIGHT
PLUMBING VENT
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FINISH FLOORS:
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STAIR CLEARANCE RAI INGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTU S
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C C
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
:..: 1Vr.: ++-40 DEPART: '�� INS P 4
FINAL INSPECTION REPORT - RESID T L
DATE INSPECTION REQUEST RECEIVED:
NAME 7jbAl�3 l C)'.l v--uA!z
LOCATION 7 C`C' Ihx-,gx��
DATE L �o PERMIT $
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING _
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FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
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CHIMNEY HEIGHT B VENT HEIGHT
PLUMBING VENT
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OTHER FLOORS S PABLE
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SMOKE DETECTORS
BATHROOM FANS
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FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
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FINAL SURVEY PLOT LAN
OK TO ISSUE C/O OR C C