2001-071 % TOWN OF QUEENSBURY
742 Ba Road ueensb NY 12 2
T y ,Q ury, 804-590 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010071 Date Issued: Wednesday, September 15, 2004
This is to certify that work requested to be done as shown by Permit Number P20010071
has been completed.
Tax Map Number: 523400-296-013-0001-031-000-0000
Location: 6 WINCREST Dr
Owner: KEN & PATRICIA ZACHARIAS
Applicant: KEN & PATRICIA ZACHARIAS
This structure may be occupied as a:
By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
4
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
1 {
1 - 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010071 Application Number: A20010071
Tax Map No: 523400-296-013-0001-031-000-0000
Permission is hereby granted to: KEN&PATRICIA ZACHARIAS
For property located at: 6 WINCREST Dr
in the Town of 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. Type of Construction Value
Owner Address: KEN&PATRICIA ZACHARIAS Residential Addition $18,000.00
6 WINCREST Dr Total Value $18,000.00
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2001-071
392 SQ FT RESIDENTIAL ADDITION(EXPANDED KITCHEN)
AS PER PLOT PLAN SPECIFICATIONS
$32.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, March 01, 2005
(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 a the T of i/Qiieegsb ..L,,rsday, March 01, 2001
44 ,
SIGNED BY :11("f; for the Town of Queensbury.
I' �a
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
Vice 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010071 Application Number: A20010071
Tax Map No: 523400-069-000-0003-024-000-0000
Permission is hereby granted to: KEN&PATRICIA ZACHARIAS
For property located at: 6 WINCREST Dr
in the Town of 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. Type of Construction Value
Owner Address: KEN &PATRICIA ZACHARIAS Residential Addition 18,000.00
6 WINCREST Dr Total Value 18,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection;Agency
Plans &Specifications
2001-071
392 SQ FT RESIDENTIAL ADDITION (EXPANDED KITCHEN)
AS PER PLOT PLAN SPECIFICATIONS
$32.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday,March 01,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town(1 eensb ; Thu s a ,March 01,2001
SIGNED BY for the Town of Queensbury.
Director of Building& ode Eorcement
4=-- • i With•ng Permit Application . - .
Town of Queensbuty - Dept. of Community Development, 742 Bay Road, Queens•bury, NY 12804 /761-825OJ .
BUILDING & CODE ENFORCEMENT -
NOTICE • Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. t()j-0 '7
beginning construction. No inspections PERMIT FEE PAID$ �'�
will be made until applicant has received 0 Zoning Board Action '
a VALID BUILDING PERMIT. All Area /Use RECREATION FEE P D$
applicants` spaces on this application
MUST be completed add•the signature 0 Planning Board Action REVIEWED BY:
of the applicant must appear an the SPR / Subdivision /Other Building Inspector
application form. Thank y. J Recreation Fee Payment
Applicant: 1<L tJ zievciiA2tP1S Owner: ) 'en, 7CXOIFt0.1 S
Address: 61``/t tvc fcesT D R t Ve Address: Lc w,ti 02es I De.
Phone # (S/B ) '`? - - -106s • Phone # ( s ) ills - 1bbs -
Property Location: to G„Ncees`f DQ,ve
Li-
Subdivision Name: (�'1 PL }l¢ , t,'rS Tax Map Number J /a
Section. Block i.ot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ /• icY0O
residence / commercial
)( Addition to Building:
residence / caratal OCCUPANCY INFORMATION:
Alteration to Building: Pri ary Building -
residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family
-RECU'VED Office
Other Work (describe below) Mercantile FEB 2 1 2001
Manufacturing.
Other • TOWN OF QUEENSBURY
GROSS AREA OF PROPOSED STRUCTURE: • SClILO�?�Q AND CODE
1st Floor If ADDITION, what wi
3 sq. ft .
2n l .Floor.. .. - s ft o net;- arl, .i:t~i o-n.�he?
q' CrX-p ¢d k i"re.1,el.,
Other Flouts ' • sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
• Detached Garage 1, 2 car
TOTAL FLOOR AREA: 3c/ SQ. FT. Attached Garage 1, 2 car
Private-Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
ig FEET X , ,$ FEET Other
Foundation Type: Pta- 2 COt.icce.Te• Will any second-hand- or ungraded
• Number of Stories : • / lumber be used? If so, for what?
(habitable space o ly) NO
Height (grade to ridge) : /7 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which ..lies)
to be installed:, 0 Electric / Oil / alp . .od
. Forced Hot Air / :aseboar. / Other
Person responsible for supervision of work as regards to building
codes is : kety zachorta.S (o La/tomcteesj DR 718--71)-tS
Name Addresss Phone •
Builder: lie,., . 2B-c-l.a".b.3 6 t,,,n,ceo 1- pp 1 4S-7b6s`
Plumber: 1Gei, 'zjc.Aej'AS to w1,.,ce,e_s7 Or'. '1t1S'-70bs
Mason: Ziltc QRla ,ti 62-1 .8,tifel2M,1K Fitt Rd. "1Q9--i3`1
Electrician: i'e r., 7�cha'.63 G L,n,ceosl '0 145-^7063-
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, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: 1 '
(owner,, ow�gent, architect, contractor)
Inspector's No.
Date I9
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. E DWG U Other
Occupant Building Permit No. .......:.....
Job Location City • State
County - ' Twp. M/C# Swimming Pool—New 0 Old Cl
Directions to Job Site
Application For Rough Wiring Ifs' Fixtures U Service❑ or
Work—New 0 Additional U Bldg.—New O Old❑ Ready for Inspection
APPLICANT
SIGNATURE. _ - LICENSE.tt PERMIT It.
PLEASE i ;
PRINT NAME PHONE:I
APPLICANT'S NAME OF
ADDRESS i-.. UTILITY
OFFICE TO
CITY- STATE - ZIP CODE BE NOTIFIED
SPACE BELOW FOR USE OF INSPECTORS ONLY
ROUGH WIRING
OUTLETS AMP SERVICE PUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.R 1/20 1112. 1/10- 118 1/S 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
Inspector's Comments:
DON LOVELAND
Electical Inspector
P.O. 20X To;
i A U , MY12B3x
(GIB)5i..i-S724
1-8 - a2-9234
OFFICE USE ONLY WORK INSPECTED REPOR- 1:1 o
NOTIFIED TED ¢ JO FEE PAID
U
SERVICE DATE CON-
Date Received: TRACTOR TOTAL $
R.W.DATE OWNER CHECK NO.
FINAL DATE OCCUPANT CHARGE
Certificate.No.: •
CERTIFICATE NEEDED AGENT CASH
Date Sent: 0 YES O DUP ELEC.
LT.CO.
INSPECTOR
Progress L
THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.I.S.INC.
WHITE/OFFICE 'PINK/INSPECTOR CANERY/OFFICER GOLD/CUSTOMER
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection reques receive.. J I•.00 anti
Queensbury Building&Code Enforcement Arrive: a p i 9-e.rt: II 4 .
742 Bay Rd., Queensbury,NY 12804 Inspector's Initia a NAME: in�l/ PEY :T� #: UO u r/
LOCATION: -0:00'di
TYPE OF STRUCTURE: latjetu ,
Comments TOSSA-b.
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in. or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Ver r Handrails stairs 2 or more risers •
Grade away from foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
•
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in. ■■
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: / Every Bedroom: _
Outside every bedroom area:
Inter Connected: / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss, draft stopping finished basement 1,000 sf
Emergency egress below grade -
Basement stairs closed rise>4 inches
34 hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 sq, ft,-150 sq. ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Se.tic S stem/Sewer De.t. Ius.ection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C/0(Cert. Of Occupancy)
Okay to issue Permanent C/0(Cert. Of Occupancy)
L:1SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: ui-' /q/iz
Building&Code Enforcement <
Dept.of Community Development Arrive nepa in/
Town of Queensbury Ins ctor's Ini
742 Bay Road
Queensbury,New York 12804 / , '` i
NAME �di a v"1 Cv — PERMIT# -"O -0-7 I 0
[�/�
LOCATION 6-2 ��AN. 1 DATE /Z`zJ/e� 2 rill
TYPE OF STRUCTURE es '. ein'
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof J j
Roof Complete ✓`
Exterior Finish Complete ..//
Interior/Exterior R;.11 s 30"to 36" •f 1
Exterior Handrails, .. co :es,landing 18 in.or more ,,/
Interior Handrails s %irs bo ' sides 3 or more risers
Grade 2%away fro founda n /`
8"clearance to sill pl. • ✓
Gas Valve shut-off e iosed/re;ulator 18"above grade _ V/
Gas Furnace shut-off wi, •n 30 feet or within line of site i �/
Oil Furnace shut-off ate 1an e to furnace area
Fumace/Hot Water Heater. erating
Relief Valve(s)installed ,�
• Headroom,6 ft.6 in.on stair- .//'
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sid,s more than 3 risers j 6 `� 6� 5 A7 b .A �et i
Interior privacy/trim/doors/main -stance 36" Ca)
Floor Finish , Q
// ®2___
Bathroom/Kitchen watertight ,/
Interior Handrails Balconies/Landing 8 in.or more r .1 •
Railing across window in stairwells
Smoke Detectors: AF\\
every level k SiTtLi__ .% V�1�e�
every bedroom \ 4 \\
outside every bedroom \\'3c ‘ -1
inter connected / tU �2�
Bathroom fans ✓ '‘O � 0,
Plumbing fixtures ✓
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage) J
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)
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL /
N 79473 l0
Permit No. C1e/rt. � Cut-in Card No
Owner 4' z Aci t f � �� �r
Location....6 .(...Al CI - I Ls.-a'� X'
Installatio Consisting of �Q 7 Y1 V� } a.2 Lt ?�
., .... t.4- 6:&j
Installed By g.ht',YL C Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon thi
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making ' spections at any time, and if it
rules are violated,the Company shall have the right to rev e this icate
Date /2 /L 0 2 INSPECTOR / ' /
1.A.....{...-U C D A ■ A CI
O�1a(kUY \ 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
Queensbuty, NY 12804 ARRIVE am/pm: DEPART-M' ' rn/pm
(518) 761-8256 Inspector's Initials \('11
U
NAME: \ CAS PERMIT# .o 1
LOCATION: INSPECT ON(date): 4/
TYPE OF STRUCTURE: \ )( ) 1 11
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respgnsi: e for
providing protection om freezing
for 48 hours following the pla,ement
of the concrete.
Materials for this purpose .n site •
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval
unb' Ilntier Slab / /� e4t9 )
+Pxrbing ent/V" rts in Place �/ /jJ "
Rough Plumbing
Heg Rough-In
r°sulatian fic-,Pa VC—le— d
Foun ahon Walls Interior
Foundation Walls Exterior R
Floors R-
Walls R- 1,�
Ceiling R- {�j�
Duct work or piping in
unheated spaces R-
Proper Vent,Attic 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
r 06)
016\
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement }
742 Bay Road t 0 (3
C� v 0` /
Queensbury,NY 12804 Arri.vey i Depar ' C
Inspector's Initia
NAME: -r C S (' , : PERMIT#
‘r-\1)
LOCATION: W`c`CY DATE : Y�2
TYPE OF STRUCTURE: : (�
RECHECK
N/A YES NO COMMENTS
Footings/Piers �— I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection om fr zing
for 48 hours followin the pllaement
of the concrete.
I
Materials for this pu se on site) _
Foundation/Wallpour 1
Reinforcement in Plac
Foundation/Dampproo ng
Backfill Approval
Plumbing Under Slab I
Plumbing Vent/Vents i g Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls s - or R-
Foundation Walls Ext-.'or R-
Floors R-
Walls R-
Ceiling '-
Duct work or piping in
unheated spaces
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetr 'on Sealed
Fire all 2, 3,4 hour
F. stopping
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received: Il 14)D
Building& Code Enforcement
742 Bay Road I
Queensbury,NY 12804 Arrive 1-4(- am/pm Depart - r r
�w^ Inspector's Initials
NAME: l 4 , PERMIT# ? / I
LOCATION: Le DATE :
TYPE OF STRUCTURE:
RECHECK
if
! N/A YES NO COMMENTS
Footings/Piers ° !
Monolithic Pour Form
Reinforcement in Place [ I
The contractor is responsible for /
providing protection from fre zing
for 48 hours following the plaeefnent
of the concrete.
Materials for this purpose on it e
Foundation/Wallpour. \
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab_
Plumbing Vent/Vents in Place P<E-
l_-1 ugh Plumbing q i\g_`--;(\�
Heating Rough-In
Insulation
Foundation Walls Interior R-
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 Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
7 Mi-SZ _t5,-\ in
/ u - /630
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‘0.21Dai3n1 Depart
Inspector's Initi
NAME: 2( ec Q Y t PERMIT# U`" 07 I
LOCATION: p L' \n c,A9 -y u- DATE : ) — eg — D-___
TYPE OF STRUCTURE: („� .\\�-sks.�
RECHECK -_
N/A YES'NO COMMENTS
Footings/Piers I-1 - I
Monolithic Pour Form U \� ft
)rd-tib"
Reinforcement in Place
The contractor is re Bible for
providing protection in freezing
for 48 hours followi g t11,e placement
of the concrete.
Materials for this pu se n site ( - T oJ3?___ Q j i,
Foundation/Wallpour
Reinforcement in Place Q--*PVi NC __. q F T1k(v Foundation/Dampproofi ig
Backfill Approval
Plumbing Under Slab/
Plumbing Vent/Venls in lace
Rough PIumbing /
Heating Rough-id
Foundation Walls Interi r R-
Foundation Walls Exten r R-
Floors -
Walls -
Ceiling -
Du t work or piping in
heated spaces -
Pr Vent,Attic Vent /
ing
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
.szc,.. ---, w_4
GENERAL INSPECTION REPORT • I r
( 518 ) 761-8256 f
Town of Queensbury
Dept.of Community Development Date inspection request received: Or , t—71ti�
Building& Code Enforcement 0
742 Bay Road
Queensbury,NY 12804 Arrive ;Depart fJ �� A 1
Inspector's Initi „_
NAME: r\ q_ PERMIT# IP S
) /
LOCATION: (.4.771-)\r\. J DATE: c-CC /
. TYPE OF STRU (� e Cam\RECHECK
•N/A YES NO COMMENTS
Footings/Piers I
Monolithic P.ar Fo
Reinforcemen in Place
The contrac,•r is respo sible for
providing pr t tection fro freezing
for 48 hours '•flowing placement
of the concret.
Materials for this•.urpose o 1 site
Foundation/Wall.our
Reinforcement in • ace
Foundation/Dampp +offing
Backfill Approval
Plumbing Under Slab
Plu• •'..'Vent/Vents'• Place
' ' umbing
eating Rough- c)(\_ - -
Insulation \ '
Foundation Walls Interi'r R- 1.1,` ): `
Foundation Walls Exteritr R-
Floors =
'- ..
Walls -
Ceiling
Duct work or piping in
un eated spaces R-
Pro Vent,Attic Vent
amting 4i7
Jack Studs/Headers
Bracing/Bridging j . ('
Joist Hangers �/ ��b�Ll
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour .
Firestopping
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Ur
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL 2
Permit No. Cert. N® 73264 Cut-in Card No
Owner ,e6-i Z 414_ r l , ' ,mac
Location 4 tu!dJ e 2e f Dom' ���'tt
Installation Consisting of ...1- ! 6 727'5
Installed By �1 / Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued i;
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon till
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of mak' g inspections at any time, and if it
rules are violated,the Company shall have the right to
/rJgvok= rtificate.
Date 7-Z��/ INSPECTOR..t .�
, A M gat-e-
(-A,.
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury ;/
Dept.of Community Development Date inspection request received: °rt' P
Building&Code Enforcement _ 4.
742 Bay Road �� /�
Queensbury,NY 12804 ,,,,,''' ~^ Arrive n m Depart a
inspector's Initia
NAME: AZ(. PERMIT# /t671
LOCATION: �/ (,c_.A crea r- .: it, :
TYPE OF STRUCTURE: -ix,c 4 6(1 /� -8
RECHECK -P��(, c� 6„,„_
Id' Jr
I N/A YES NO! COMMENTS
Footings/Piers 1
Monolithic Pour Form /
Reinforcement in Place ,'
The contractor is responsible for €t
providing protection from freezing fr
for 48 hours'following the placement A
of the concrete i"
Materials for this purpose on site p
C FoI ndationLWallponr_, ' i
Reinforcement in Place .11 VI/
Foundation/Dampproofing ` /
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place ,
Rough Plumbing
Heating Rough-In 1
Insulation ,/
Foundation Walls Interior R-
Foundation Walls Exterior R- /
Floors R- if `
Walls R- I „
Ceiling R- I
Duct work or piping in r/ '\ .
unheated spaces R- / 1.
Proper Vent, Attic Vent i ''
Framing I
Jack Studs/Headers / .,
Bracing/Bridging I ',
Joist Hangers / '+
Jack Posts/Main Beamt
Air Infiltration Barrier /' \
Fire Separation 1,2,3,hour
Penetration Sealed /
Fire Wall 2, 3,4 hour I ,,
Firestopping I Ny
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development y--Date inspZction request received:
Building&Code Enforcement
742 Bay Road / ';
Queensbury,NY 12804 / Arrive t�/pm Depart
/' - • Inspector's Initial L
NAME: - • , -)1_c)7
,r' '1' PERMIT#
r
LOCATION: ( ) I kkC F T DE, DATE : — I
TYPE OF STRUCTURE: F,)-) <, ADD.
RECHECK s
N/A YE NO COMMENTS
�1F otings/Piers i ~^ I I
onolithic 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 I'
Foundation/Wallpour .1 ,
Reinforcement in Place
Foundation/Dampproofing I _ _ __ _ __
Backfill Approval !
Plumbing Under Slab /
Plumbing Vent/Vents in Place f
Rough Plumbing / '
Heating Rough-In /
Insulation /
Foundation Walls Interior R-
Foundation Walls Exterio R-
Floors '-
Walls R-
Ceiling R-
Duct work or piping i' N
unheated spaces R-
Proper Vent, Attic Ven
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
John P. Kokoletsos
(685/674)
/�PcK/ PIPE
�OUNO `
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Paul & Evelyn Robinson
(377/329)
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DEED REFERENCE:
Karen S. Howard, Exec. of the Last
Will and Testament of
Margaret G. Newcombe, dec.
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