The URL can be used to link to this page

2002-134 � TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-wilding&Codes (518)761.8256 - CERTIFICATE OFOCCUPANCY Permit Number: P20020134 Date Issued: Thursday, October 03,2002 _ This.is.to certify that work requested to be done as shown.by Permit Number P20020134 has beet'completed. Tax Map Number: a . 52340.0-290-000-0001-067.000.0000 Location: 19 BROOKFIELD Run Owner: ROBERT&LORI RODRIQUEZ Applicant: SCBERMERHORN PROPERTIES INC This structure may be occupied as a: By Order oflown Boatd .. . Fireplace TOWN OF QUEENSBURX Garage-2 Cars Attached Single Family Dwelling Diector of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020134 Application.Number: A20020134 Tax Map No: 523400-290-000-0001-067-000-0000 Permission is hereby granted to: SCHERMERHORN PROPERTIES INC For property located at: 19 BROOKFIELD Run in the Townbf Queensbury, to construct or place at the above location in accordance with application-together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. TVe of Construction Value Owner Address: SCHERMERHORN PROPERTIES 12S Single Family Dwelling 180,000.00 15F BIRDIE Dr Garage-2 Cars Attached QUEENSBURY,NY 12084 Fireplace Total Value 180,000.00 Contractor or Builder's Name/ Address Electrical Inspection Agency SCHERMERHORN CONSTRUCTION CO' COMMONWEALTH ELECTRICAL At 15 BIRDIE Dr OUEENSBURY,NY 12804 PO BOX 706 HAGUE,NY Plans &Specifications 2002-134 2282 SQ FT-SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECHFICAT. IONS $326.64 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday,March 08,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at, own o ueensb Friday,March 08,2002 SIGNEDeBY for the Town of Queensbury. 'WIAg Director of B Code Enforcement Building Permit Application Town of Queensbury-Dept of Community Development, 742 Bay Road,Queensbury,NY (518)761-8256 A permit must be obtained before beginning construction. permit File No. No inspection will be made until applicant has received a Fee Paid $ _ Se�� valid building permit. All applicants spaces on this Ree. Fee Paid application must be completed and must appear on the Reviewed By: application form. Applicant: _`j� LI K'�'`vt r cfr,1 C Dry Is/ Owner: _5. Address: Address: Phone# Phone# ( ) - Property Location: Lot Number: / ! House Number Subdivision Name: ��rfro 1�,t'P /c/ Tax Map Number:- . d" New Building: .residence commercial Estimated Market Value'ofConstruction: $ ❑ Addition: residence I commercial If an Addition,what will use of new addition be? ❑ Alteration: residence/ commercial ❑ No change to exterior size: residence/com'1 ,❑. Other work(describe ) Check OccupancyInformation 151 Floor 2d Floor Other floor Total Below sq.ft. sq.ft. sq.ft. Square Feet aa' Single family dwelling X C 7-7- Z ❑ Two family dwelling ❑ Townhouse ❑ Multifamily dwelling MAR 0 5 2002 #of units ❑ Office E9NWURY ❑ Mercantile ❑ Manufacturing ❑ ; i car detached garage �1 ❑ 2 car detached garage ❑ 3 car detached garage ❑ 1 car attached garage u," 2 car attached garage ✓r—Z g ❑ 3 car.attached garage ❑ Storage building- commercial ❑ Storage building- residential ❑ Other What is the proposed height of the structure 28 feet cs inches Will any second-hand or ungraded lumber be used? If so,for what? Type of Heating System: electric/ oil / gas wood ! orced hot;)V baseboard/other: Number of Fireplaces to be-installed / _ Number of Woodstoves to be installed .Iist-relowthe..,Prson(.$)_rpsperzs wrk ding o _ or. . es: Name Address Phone Number Builder e.-.s ti�.�d.d --,1 c>:.s 4, -79 5f'-- o G 7V Plumber 3--7 Mason Electrician Declaration: please sign below after you have carefully read the statement: To the best of my knowledge 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 noted,and that such work is authorized by the owner. Further,it is understood that I/we shall submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning Administrator or Director oilding and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual location of all new co efion. Signature: ,'�' owner,owner's agent,architect,contractor ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY1 WARREN COUNTY _9000-HEATING DEGREE DAYS Comoli ance Methods: PART 5 - Acceptable Practice Method 1&2 Family Dwellings -(only) • PART 6 - Thermal Rating - Component Trade Offs 1&2 Fdm-ily Dwellings; Multi-Family Dwellings (3 stories or less), ' PART 4 Design by Component Performance Commercial Buildings-Hi Rise Residential *Requires submission of worksheets A.PPL1C.A-_N.-.T*'S NAME: PROPERTY LOCATION: t PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gros,s Floor Area - 2-z g7 Z_ sauare f eet 2 . T—.roe of Heat - Electric Oi:1 Gas Other 3 . Is building mechanidally cooled? . Yes t,-' No 4 . Perc.e.ri-tage of a-rea of windows and doors Over 17% t,"Under 17% 5 . R-VA=ES'- FOR INSULATIONGIVEN BELOW MUST CORRESPOND TO R-V;_LUES AS SHOiNTINT ON PLANS SUBMITTED: 'a . Roof R 3c> b . Z-x-4C-erlor walls R _ /2 C . Glazed areas R 2_s� d. Exterior doors R jZ e . Floors over unheated spaces R Edge of slab on grade (heated building) R C. Basement/cellar walls (above grade)' R /0 . Basement/cellar wails (below grade) R /0 . Heating/cooling-duds-piping in up-heated space R -- - 6 . Se=rice (domestic) hot- water heating incr device Co-n-forms to min.i.mum efficiency per code t--' Yes No TEMPERA T EN Y.P ERA URE CONTROL MAXIMUM SETTING 1400 WILL NOT BE EXCEEDED kop , a- S S-ignatu:e Date n e Phone Nu.-mer 7F 7 4/ iNSPECTCR' S REMARKS: Fire IN1.11'shal's Office 'I 1�'MVII OfQUeellsbury, 74.2 13--iy Road,QueelisI)III-N., (5 18) 701-8205 Application for Fuel .Burning 1:`,Appliances &.Chimneys.,, applicable to, solid fuel & vented gas appliances Date 20_0 - Pet t No. � �, -.4PPlication is he)-eb),made to the Building cC C.odes pfficefiw the i. YvIlance(#'a Building(III'd Use Pei-mitpiu-suant to the Nett York State Fire Pi-ev"' ' I, ' 61110 1 iflit? Building Coele. 777e aplVicant o/`o1V11(_II* ag'-Oe�y 10 CORIPly Ivith all applicable Imes, ordinances, 1-V, 111ati0i's, and all conditions that ai-4'.,putt (?f' these requirements and also will alloit,all illsI)ectors to eli,tei-p)-emises to perjbi-w required inspections. NOTE to applicant: Rough-in and Fina�I I lnspe,ctions are.required. Applicant Information Ft,I iel Bui-ning Appliance Information {circle appropriate words) Name: stove.: wood coup pellet gas Fireplace insert Address: /,S— 'Fireplace, factory-built: wood rt_ z;-, /7 s'e Fireplace, masonry: Wood Furnace: wood oil Phone: If non-masonary applicance, please provide Owner, —5—e, Mall L1 factU rer Name: --Address.: Model.Numb_er: Phon'e: Chimney Information le, (Circle appropriate Nvords) Masonry block- brick stone _../-/ F!I tic the steel size: inches Exact Address: ofConstruction or installation Factory-Built M.AnufaCtUl'er nanie: Model Number: Note: i — Listed By: Number: Col'sti-liction!Installation must conform to NYS Fire Prevention &Buildij,'f Indicate" (circle) chininey material: Code,'Consult available Town of Queensbierl, ZI Handouts regarding requi7-ed inspecriolls. Double ivall Triple ivall Insulate4ri " rec III Chimnev Lffiel- Fh-e Alai-shal Code#1 S Collected S RefundedRecei�;Ied ftom o-qIiinded to) oc) .4 17.3 3389 (190). Public Sqfen .4 233 2655 (230)Minor SelicW White(Applicant) Green(Fire Marshal) Dept,) Pink& Goideiii-od(Casliie'r'sDel)t.) Application for Permit-Septic Disposal System TOnwt r?f Qficensbilly 742 Hall,R(wd Qrfeen.vbnijv, NJ' 12804 (518) 7(."1-8256 1. OWNER INFORMATION: ...............*'***............ ....................... Office Use Location of installation: ..Z-,P/- Tax Map No. File Permit No. Fee Paid ............... ........... .......... ............ Address: 2. INSTALLER'S NAME PHONE NO. /7 4 7 5/ 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate #bedrooin(v)and mnitiply If of bedrooms with applicable gallons per bedroom to equal total daililflo,10 Year of House: No. of Bedrooms x Computation Total Daily Flow 1980 orolder x 150 gal/bdrin 1980- 1991 x 130 galibdrin 1991 -present 3 x 110 gal/bdrin -3 c) Garbage'Grinder Installed yes J no Spa or Whirlpool Installed no 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) vrav iv Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply 111 at what depth at what depth 71111nicipal Rolling -75-ain wel Steep slope clay if well; water supply slope other fi-oln any septic-system depth: absorption is -14—f-it. other Percolation Test: (To be completed by licensed professional engineer or architect) Rafe:'- minute per inch 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool'Tub. Septic Tank: /7-5-0 gallon (min. size 1,000 gal.) Tile Field: each trench Total System Length: e-15-c> Seepage:Pit(s): number of___ size qjfeach: _ fl. by___fl. Size of Stone to be used: fl depth or thickness , " -et Bed System Size: X Alternative System: length andlor size 6. HOLDING TANK SYSTEM: (if required) 7- Number of tanks: Size of each: gallons /TOTAL Capacity: _gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any portilit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of all applicant, sliall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of Q the Town o ueensbury Sanitary Sewage Disposal Ordinance. 'a 1 't r,of re, re of responsible person orate COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INCt Main Office 176 Doe Run Road - Manheim, PA 17545 ?oo MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit 7 9 2 9 6 Cut-in Card Not iuflff!!►iltfilffNlfiiliffff111ttf � �{fiffftti!#off ill11I4I1lfr#flfff##lf tiff#itoH{@H#Niftffillfif#it#Nffi off ff#fINNNitli toll i#1MM Off Iflli#iHH{##ff1f11tffiifaHllllflftlHHNIIIIItt#aNffl 660�e14D , I )10 Location,MMIi1H#if##flHlHai#IHffIIf#tiff##lilfffNHfifffNNNNfiltfoffffNiNiHH#Iffffftilftiiifi{ii!l11llllffifff{fulaloes .. llfliflHii fifHHi1lh Installation Consisttn of. ffff#ffiff# Nlff{1••fiffua#ff#lffi Ifitii{If#t#f#IHii#iN11I1 #If#left##tillfH•HffHNffiNff+# HfifilHHi#!N►fIH#M 1 fllfffff IIliifff!# fee66604#ii{##lf toff tl+fiffili Hifiti ii#lH#• i{fffllffN#fiffiff iff #loffff ##i ! #lf Ni f►ili !# i ##fill lHiillffff#loafiNHffil ff off/N #iNNil ii#HiaoffiNit ffffifli!#Hiifi#f/1HHf##lilt ifl#N# ##f###f#i#ail!#Nilt#iH##a#Hoa1!#i#ilifsell loom f!lfo/i a1!!f##lfi##HIli li#MINI##Hf afilillfff#ffifH InstalledBy,,,,, lilt.Dll a## oil losses iN##f#l#IiNt!Yalffi#lH{iHialiii#HNlNHIINi#Licl Not fI#iii#HaiffllflffN#IIIHl1lf!#1!#H#HfiHN#f The conditions following governed the issuance of this certificate, and any certificate previously issued is i cancelled; - This certilcate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations, application shall be promptly made for inspection. Inspectors of this Company shall have the privilege ofpal ,I ` pections at any time, and if its p prules are violated, the Company shall have the right to re kecatel yr f/� o i{ f f111 Hf##ill{ �atefil#NH#Hfffff.tHNHlt #Hi IIVP'ETOR , •#fi##f# ffiff#. i#it#NaN,lil#•Hif#ff#IiitNNlflt f f Miamhpr UAL Town of Queensbury Fire Marshal's Office 742 Bay Road Queensbury, NY 12804 Phone (518) 761-8265 Fax(518) 745-4437 !Fire Marshal's Inspection Report Request SCHEDULE Received: I'D G Permit#� � ,� INSPECTION ON: Name: cl-ko `i, AM PM NYTIME Location: ! APPROVED N/A YES NO COM ENTS EXITS AISLE WIDTHS ^ EXIT SIGNS-NORMAL - BATTERY EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES _ STORAGE COMPRESSED GAS CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS CLEARANCE TO ELECTRICAL REQUIRED SIGNAGE EMERGENCY PLAN MAXIMUM OCCUPANCY SIGN CHIMNEY MASONRY ROUGHIN FINAL CHIMNEY FACTORY BUILT ROUGH IN FINAL WOOD STOVE 'ROUGH IN FINAL VENTED GAS APPLIANCE ROUGH IN FINAL FIREPLACE MASONRY ROUGH IN OK THI7ATEtR29T OK FINAL FIREPLACE FACTORY BUILT ROUGH IN INSICWOY- FINAL COMDEV/CHRISJIWORDILETTERS2001/FIREMARS ALINSPECTIONREPOR 1 022001 WHITE-BUILDING DEPARTMENT COPY ELLOW-OCCUPANT COPY 1 36 RESIDENTIAL,FINAL INSPECTION REPORT Office Na.(518)761-8256 Date inspection request received: 6 6y' Banding&Code Enforcement Dept.of Community Development Arrive am/pm Depart n! Town of Queensbury Inspector's Inn' s 742 Bay Road Queenshury,New York 12804 NAME antPE # LOCATION DATE TYPE OF STRUCTURE N/A YES NO CO1tiUvffi-NTS Chimney Heightf B"Vent/Direct Vent Location � '' ' •��-'C Cr''�.-fie. Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30"to 36" �� Exterior Handrails,balconies,landing 18 in.or more lyt. Interior Handrails stairs both sides 3 or more risers 35 Grade 2%away from foundation -\ 8"clearance to sill plate �� ti C' - �, �- A Gas Valve shut-off exposed/regulator IS"above grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area zJ� Furnace/Hot Water Heater operating Relief Valve(s)installed Headroom,6 ft.6 in.on stairs Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers. Interior privacy/trim/doors/main entrance 36" "Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or more Railing across window in stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation %hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected(in garage) Light ventilation per room Safety glazing 18"or less from floor Final Electrical Site Plan/Variance required Final Survey Plot Plan As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) Okay to issue temp.C/O(Certif.of Occupancy) Okay to issue permanent C/O(Certif.of Occupancy) RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: -~ Building&Code Enforcement Dept of Community Development Arrive am/pm Depart am/pm Town of Queensbury Inspector's Initials 742 Bay Road Queensbury,New York /I 12804 NAME t U ^— PERMIT# LOCATION q 6W7 DATE j 7. TYPE OF STRUCTURE N/A YES NO COMMENTS i f Chimney Height/'`B"Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies,landing 18 in.or more Interior Handrails stairs both sides 3 or more risers Grade 2%away from foundation 8"clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Relief Valve(s)installed Headroom,6 ft.6 in.on stairs Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/ftim/doors/main entrance 36" -Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or more Railing across window in stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected(in garage) Light ventilation per room Safety glazing 18"or less from floor Final Electrical Site Plan/Variance required "`4 Final Survey Plot Plan As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) Okay to issue temp.C/O(Certif.of Occupancy) Okay to issue permanent C/O(Certit of Occupancy} MAP REFERENCE: PHASE II BROOKFIELD ESTATES DATED DECEMBER 7, 1987 LAST REVISED JUNE 7. 1988 BY VAN DUSEN & STEVES LAND SURVEYORS /� /.j./,VV�_ Sieves Land Surveyors, LLC 169 Haviland Road Queeneb ury, New York 12804 (518) 792-8474 New York Uc. No. 50135 W IFA QVM L" 'A W " 0 A MII KMr19 A IlCI " S llJflYEIi01l6 > Of O A MotMIaM n f6DtI0M TIO�. llFaMsaM t a' 1ME I M VW WAU IMUQAM LW 'ONLY OOC! mm w moma, *a MAINLY M&SLUK " l`"TNL M 'RRNICAflpO MDIQ►Tm NLNDOM l01Y TIMT �``�`°°�W`��```t� TM! mW-V I" W@ANFD N AfMOIOMm MI1N 1IN: OO6tIIII LIDO! a maw M LAND Swtw E w ADO/1® LAND swtw dIt I" O4tMATI" W#" " p4Y Imwm" WAR '�°°�'MYIs W*Mo W 11[ MOON fLR w10M TI[ lUNli[T O !IllAll®, AND 0 m MINE W W TIRE WOW QO wm as ""III""°" "" "°" M AI° A0 W NO L' ra mm To A3lOQII w �aviu w- Map of a Survey made for Robert &Lori L. Rodriguez Marren Count Town of Queenebury, , New York y mate, MRKt:H 1t3, duud Scale 1'=50' S 1 �,m, 1 4/27/02 UPDATE SURVEY RODRIGUQ �9 M. No. 86671-�,2�F NO. DATE DESCRIPTION Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: 2 17 Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE a R a Notes: 8_ no 6P t�> a 2 a 17L (518) 761-8256 Inspector's Initi s t NAME: e-3 PERMIT#CPW<� LOCATION: INSPECT ECT ON(date): Z�-elawl TYPE OF STRUCTURE: RECHECK � N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement , COMMENTS of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofmg Backfill Approval tubing Under Slab umbing Vent/Vents in Place Rough Plumbing___ Heatinial Rough-In C��a�Insulation n Walls Interior R- fio 40 Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging-- Joist Hangers Jack Posts/Main Beai/ Air Infiltration Barrier e Separation 1,2,3,hour N dire Sealed 1 re Wall 2,3,4 hour 1restopping_ L:\SueHemingway\Building.Codes.Inspection.FORMS\GFNERAT,INSPECTION REPORT.doe Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received. �d Z Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE at i. PART�p= Hates: (518) 761-8256 Inspector's Initia NAME: S -err^ �-✓ k o r y1 Co- ,,S, t-�F� PERMIT# 2 cv �,3 L�� LOCATION: UO T Ct A"e, INSPECT ON(date): h-7 U �' TYPE OF STRUCTURE: AA,.'f' t RECHECK N/A YES NO COMMENT Footings/Piers C—AR Monolithic Pour Farrn 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/Wallpour p cp,/3 �tTZEPi✓AC�F C Reinforcement in Place Foundation/Dampproofmg Backfill Approval - --f-� Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- 6zcJ�] 1 �iI Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces, R- Proper Vent,Attic Vent Framing J Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main BeaYn Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:\SueHemingway\Bui}ding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept,of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive Depart 1 spector's I utia s / NAME: �tn�d--r PERMIT# LOCATION: Gc�_DATE: lY TYPE OF STRUCTURE: RECHECK NIA YES NO COMMENTS Footings/Piers 1-7-7 Monolithic Pour Form I <QO b!D !KAC\e7. � b o clz>EQ 1j Reinforcement in Place Q V-- V p� p The contractor is responsible for tA providing protection from freezing Ct� cS (Lfl�� -�� g for 48 hours following the placement of the concrete. t Materials for this purpose on site Foundation/Wallpourj � Reinforcement in Place CLZ)M Foundation/Dampproofing Backfill Approval umbing Under Slab _�� Plu ntlVents in Place �� ough Plumbing F Heating Roug -In Insulation Foundation Walls Interior R- _ Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R Prapei nt,Attic Vent ramin .. ac Studs/Headers_ Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation I,2,3,hour Penetration Sealed Fir 3,4 hour iresto in C IPoo Q1 N {U Z "0 V 1�j U #� z w 4- ,4or OPRIO, z I \ N� I Z 0,00 w u m I U) � 4� 1 4JfU C C ro cU 0 u Vf U. W Mq or r �r m /U�1? 0 r L '0 !Y , 0 4j N >- so z V) w w ky pay �S}. {/}lf� 0 +I n, r/� MCI �{ /u�3 'N 1 `of** L6 Ui iri v l �4y ty�l I 0 0 T W Z 4- 0 w y�."y' �16 (0�.0 or. ��x J z 0 M V `0 U^ M 4 Z or 0�' �` �l 1�i. .5t) Ito O�W -C U u. N t 1% to tl 12}*� . ct� 0 I~V9 +� 0 .10-' ;� S. w �? H �Vi 0) 0 rd to 4J (J W W � t�. U ) H • 0 or- NVaCCC Ito C00 w m �r Q 0 -f- 0 4- cn Co, N C x `w 0 0 0 0 tx �• �� 1 Vj J CI r N 0 4- -r 0 0 In �r*r ,,� � Is. 0 t 0 � W 04-W 0 4) 0M0) 4-) 4J E,0 �1 i ti (S tx 4-).0 14 0) Z d t r (*"' *0 - S. 0�* r- W > Warn4-) cu a, aCNv).x4Jc CC (0 101 � ;r0 E U 4j H 04" G.A C aNW N 00- -0 C V) NU :3 :1 CLCU "0 0 � a t 0 M 0 Q)or- �m M 0 0-r W 't- 4J FBI rr 0-w a C 0 0 0) 0 0 1 S- r a > l• N kLL U U) G� "I have seen or observed,or believe.I saw evidence•of, all objects such as houses,wells,trees,fences,etc., . shown on this document. I also represent that I have " personally measured the distances set forth,on.the•diagram" CO CO - � e' SIGNATURE DATE: • nad / Ai. f MAR TOWN OF gUEENSBUR ' AZ_ , BUILDING AND CODE Ts 4 via ME ra• `'. • � � I p I{[p,.• / �r/ .��Y�',y a.. �f1��a��•+ Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: �J Dept, of Community Development Request received: Meet: Building& Code.Enforcement At 11) 7 ' e: 742 Bay.Road Queensbury, NY 12804 ARRII�E f pna PAR ;�a pm (518) 761-8256 Inspector's Init Z 1, `� NAME: 1�� PERMIT# C7"- 1 LOCATION: INSPECT ON(date): ' TYPE OF STRUCTURE: RE ECK N/A YES,,NO COMMENTS ootings/Piers } Monolithic Pour For Reinforcement in Ph ce The contractor is sj6nsi�le for providing protection fro freezing for 48 hours folloi ing t e placement of the concrete. Materials for this pu ose on site Foundation/Wallpou Reinforcement in Pla e � Foundation/Damppro fang v Backfill Approval Plumbing Under Slab / Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls nterior R- Foundation Walls xterior R- _ Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attie Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam _ Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: Meet: Building& Code Enforcement At time: 742 Bay Road Queensbui3,, NY 12804 ARRIVE am/pm: DEPART91_�Ca)mlpm Notes: (518) 761-8256 Inspector's Jnitials_ NAME: S PERMIT# Q LOCATION: N. ) r: INSPECT ON(date): :a -�� Pic TYPE OF STRUCTURE: 6� RECHECK N/A YES NO COMMENTS 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 s,e Foundation/Wallpour- I Reinforcement in Place Foi3pdation/Dampproofing_ \VXckfill Approval Plumbing Under Slab Plumbing Vent/Vents in Plac( Rough Plumbing j_ Heating Rough-In Insulation Foundation Walls Interior I R- Foundation Walls Exterio R Floors Walls R- Ceiling R- Duct work or piping mi unheated spaces R- Proper Vent,Attic Ve t Framing Jack Studs/Header Bracing/Bridging� Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopp M* 9___________________L___j_ L:\Sueffemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury . Ready at time: .Dept. of Community.Development Request received: Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE7* — A ay Notes: (518) 761-8256 Inspecto NAME: PERMIT#a'%004;) ` .ZOCATIO � INSPECT ON(date): TYPE OF STRUCTURE: RECHECK NIA YE i NO COMMENTS F otings/Piers onolithic Pour Forni Reinforcement in Place The contractor is respo 'ble f providing protection fro free ing for 48 hours following the 1 ement of the concrete. Materials for thi` n 'te Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior, R- Foundation Wails'Exterior R- Floors R Walls R Ceiling R- Duct work or piping in , unheated spaces R- Proper Vent,Attic Vent Framing Jack StudslHeadeis BracingBridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L.\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doo Inspector's No. Date "20 COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC. (Consulting and Fire Inspection Services) (Incorporated in the states of Maryland,New York,Pennsylvania,Delaware and West Virginia) Desiring Certification of Approval, application is made for inspection of electrical installation in the premises described below.On demand,applicant agrees to pay for inspection service in accord with schedule of charges. PLEASE PRINT Owner...........:....._ ;.:..;.,...::..:.:'.. ............ ......... :...:... :,.................... Type Bldg. DWG' O Other s t Occupant .............—......................................................,- ............................... ........ .............-.... Building Permit No. JobLocation .........+.:................:.................................._...................—........City., ............ ... ..........:............. State .:. County !.......................... Twp........,..........,....................M/C#-..........,............................ Swimming Pool—New❑Old Directionsto Job Site .........:..::.:......:.................:................:..:............... ......e .............--..........,.............................-—. ................ Application For Rough Wiring❑ Fixtures D Service Q or ........................................ ....................._. ...............—............................ Work—New ❑ Additional Q Bldg. —New❑ Old❑ Ready for Inspection .............:........................—..................... :.....- APPLICANT'S SIGNATURE LICENSE#. PERMIT it PLEASE PRONE# PRINT NAME. APPLICANT'S NAME OF ADDRESS UT}LITY OFFICE TO CITY STATE ZIP CODE BE NOTIFIED ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY OUTLETS AMP SERVICE. PUMP EQUIPMENT SWITCHES HEAT OVEN PUMP RECEPTACLES SURFACE GARBAGE UNIT DISPOSAL UNIT MEDIUM BASE RANGE DISHWASHER FIXTURES MOGUL BASE WATER DRYER FIXTURES HEATER FLUORESCENT AIR AMP. RECEPTACLES FIXTURES CONDITIONER MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P. QUARTZ FIXTURE I VENT FANS MOTORS:H.P. 1L20 1/12 1/10 1/8 1 1/6 1 1/4 113 1/2 1 3/4 1 1 1-1/2 2 1 3 1 5 7-1/2 10 15 20 25 30 40 50 75 100 MARK NUMBER OF EACH SIZE Inspector's Comments: OFFICE USE ONLY WORK INSPECTED REPOR it ❑ NOTIFIED 7Ep ¢ 0FEE PAID U SERVICE DATE CON- TOTAL $ Date Received: TRACTOR R.W.DATE OWNER CHECK NO, FINAL DATE OCCUPANT CHARGE Certificate No.: CERTIFICATE NEEDED AGENT CASH. Date Sent: DYES ODUP, ELEC. LT ca. INSPECTOR Progress ❑ THIS APPLICATIOIN EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.I.S.INC. WHITE/OFFICE PINMNSPECTOR YELLOW/OFFICER GOLD/CUSTOMER "I have seen or observed,or believe.I saw evidence-of, all objects such as houses,wells,trees,fences,'etc., . shown on this document I also represent that I have personally mea red the distances set forth•on the Vagram."co co , GNATURE ATE.. A-0.4 FE r . ._ MAR D 5 2DC2 a r TOWN OF *\ jig AL. r BUILDING AND CODE i s a0 � - - • ram-• �' f ,