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2002-230 t " TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761.8256 CERT IFICATE OF OCCUPANCY Permit Number: P20020230 Date Issued: Tuesday,November 26,2002 This is to certify that work requested to be done as shown by Permit Number P20020230 has been completed. Tax Map Number: 523400-279.017.0001.020.000-0000 Location: 16 DREAM LAKE RD SOUTH Owner: LEE&BETTY BARTON Applicant: LEE&ELIZABETH BARTON This structure may be occupied as a: By Order of Town Board Garage-2 Cars Attached TOWN OF QUEENSBURY Single Family Dwelling Director 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: P2D020230 Application Number: A20020230 Tax Map.No:' 523400-279-017-0001-020-000-0000 . Permission is hereby granted to: LEE&ELIZABETH BARTON For property located at: 16 DREAM LAKE RD SOUTH in the Town of Queensbury, to construct or place at the above locationin accordance with application together with plot plans and,other information hereto.filed and approved and incompliance with the NYS Uniform-Building Codes and.the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: KIRK&DONNA BARTON Single Family Dwelling 70,000.00 113 SUNNYSIDE NORTH Garage-2 Cars Attached QUEENSBURY,NY 1280470000 Total value 70,000.00 Contractor or Builder's Name/ Address Electrical Inspection Agency COMMONWEALTH ELECTRICAL Ac PO BOX 706 AGUE.NY Plans &Specifications 2002-230 1144 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS , AV 15-2002,7BA approved March 27,2002 $194.88 PERMIT FEE PAID' - THIS.PERMIT EXPIRES: Tuesday,April 15,2003 (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 a e;Town' Queensb 'Monday,April-15,2002 SIGN Y for the Town of Queensbury. Director o ' uildg&Code Enforcement P Building Permit Application Town of Queensbury—Dept of Community Development, 742 Bay Road,Queensbtiry,NY (518)761-8256 A permit must be obtained before beginning construction. Permit File No. U-I-Uc��-�..� No inspection will be made until applicant has received a Fee Paid $ 1__ �f3 valid building permit. All applicants' spaces on this Rec. Fee Paid $ application must be completed and must appear on the Reviewed By_ application form. Q Applicap . >Gi / �_ Owne �� e -Address: Address:,./50 a te -� . Phone#{� ) �9a- 5'/r Phone# 7 ►-7 — C,>/ Property Location: Lot Number: / House Number�1A t Al-Zar:a 1r/7) P Z, � G Subdivision Name: Tax Map Number _ 7- New Buildings resid�ence /commercial Estimated Market Value of.Gonstruction: ❑ Addition: resi�uce/ commercial If an Addition,what will use of new addition be? ❑ Alteration: residence/ commercial ❑ No change to exterior size: residence t com'I o Other work(describe Check OccupancyInformation 1"Floor 2" Floor Other floor Total Below sq.ft. sq.ft. sq.ft. Square Feet Single family dwelling C/ 7/ S- ❑ Two family dwelling ❑ Townhouse ❑ - Multifamily dwelling i #of units ❑ Office ❑ Mercantile ❑ Manufacturing ❑ 1 car detached garage ❑ 2 car detached garage ❑ 3 car detached garage ca 1 car attached garage * 2 car attached garage S' ❑ 3 car attached garage ❑ Storage building- commercial ❑ Storage building- residential ❑ Other What is the proposed height of the structure feet inches Will any second-hand or ungraded lumber be used? If so,for what? 100 Type of Heating System: electric/ of / gas t wood /forced hot air/ baseboard/other: IM"ee"ZG� Number of Fireplaces to be installed 0 Number of Woodstoves to-be installed 0 List below the person(s)responsible for supervision of work as regards to building codes: Name Address Phone Number Builder Plumber, `l9 _ e'er Vr 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 Uwe shall submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning Administrator or Director of Building and Codes,an As Built Survey by a Iicensed surveyor;drawn to scale,showing actual Iodation of all new construction. Signature: � ,� �� .owner,owner's agent,architect,contractor Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: Office Use Location of installation: A" File Permit No. c;OOaZ a3c> Tax Map No. � �� Fee Paid Owners Name e Address: 2. INSTALLER'S NAME : Qi�''Ld-� �Czti PHONE NO 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980—1991 x 130 gaUbdrm = C'T�91-prese .1 x 110 gallbdrm = � Garbage'Grinder Installed yes— / no 4---- Spa or Whirlpool Installed yes / no Y" 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) T000gravhv Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply san at what depth at what depth municipal Rolling foam feet feet IZ Steep slope clay ifwell;water supply _/o slope other from any septic system depth: absorption is/SGft other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: 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: ! 0 gallon(min, size 1,000 gal.) Tile Field: each trench ft. Total System Length: ZOO ft. - r Seepage Pit(s): number of size of each: ft. by`ft. Size of Stone to be used: # t depth or thickness feet Bed System Size: x Alternative System: length andlor size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: I 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 permit 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 an applicant,shall be void. Q�- I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. C sigillature of responsible person Date BLDG. PERMIT NO. 2002-230 APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property located at;, 16 Dream Lake Road South, Queensbury, NY 12804 for the following uses: Single Family Dwelling with attache two-car garage DATEV SIGNWrURE OF APPLICANT TEMPORARY CERTIFICATE OF OCCUPANCY The TEMPORARY CERTIFICATE OF OCCUPANCY is hereby k)APPROVED ( )DISAPPROVED with the following conditions: 1 ) Install radiant heating 2) Install R-19 insulation in first floor - 3 ) Final survey 4 ) As-built septic plot plan 5 ) Cross-section of additional cellar entry TEMPORARY CERTIFICATE OF OCCUPANCY -D.E �.00 received on Y 12::�--t he-2— W P ZO ': Date of I§s&ance Director of Bldg. & Code En'��r ement THIS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES go DAYS FROM THE DATE OF ISSUANCE. NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code Enforcement or his designee. : ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY, WARREN COUNTY 9000 HEATING DEGREE- DAYS Compliance klehhads: PART 5 - Acceptable Practice Method 1&2 Family Dwellings (only) 'eh- ;i" PART 6* Therinal, 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 *Requires submission of worksheets APPLICANT'S ;NAME.: PROPERTY .LOCATION: . PART '5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . .Gross Floor Area Lig. square feet ... 2 . Type of 'Heat - Electric Oil Gas Other 3 . Is . building mechanically cooled? � Yes i/ No 4. Percentage of area of windows and- doors Over 17% Under 17% 5 . R-VALUES FOR :INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SIiOWN ON PLANS SUBMITTED: a. Roof R b. Exterior walls R 19 c. Glazed areas R " � d. Exterior dodrs R 4�----�� 5. .e. Floors over unheated spaces f. Edge of slab on grade (heated building) R . I g: Basement/cellar walls (above :grade) R - h. Basement/cellar walls (below grade) R is Heating/cooling-ducts-piping : in unheated space R b. Service! (domestic) hot water heating device/ Conforms to. minimum efficiency per code Yes No TEMPERATURE CONTROL MAXIMUM SETTING 1400 WILL NOT BE EXCEEDED A ' ant's. Signature Date . Phone Number INSPECTOR' Si REMARKS,: cat el RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building,&Code Enforcement Dept.of Community Development Arrive am/pin Depart a Town of Queensbury Inspector's IniqtWT!�� 742 Bay Road Queensbury,New York,12804 NAME C141 PERMIT 4 Zjo eL— LOCATION rLc z DATE TYPE OF STRUCTURE pis, NIA YES NO COUNIENTS Chimney Height/"&'Vent/Direct Vent Location j 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/him/doorstmain 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 C 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)__!_ �L � �r � '11 n� 7 z z 1 H aUx a 0co a aw a Qw4H H %aWte ww v `zl «w ao4 z ( H H z a 0 N1 W w E H z CD 3urM E H I E 10 0 z z s x z w z u r+H W 0 W z H z 0 W4 0 w �a a H �� 0 a w z x a u H H w a •_"H a � a AHMW H :zE a - a cot w m H UEO ' xx cn aaaNNx E M w a 0 w 9 a 0 w x azo w z x U z w 0 ►a E U1 $ H E+ U E 4 0 0 � E w 4 w 4 9 0 0 4 u 4 9 U H a H U x E H 3rA z U $ a > 4 m w H x u 0 W " W H + > H E u 4 0 Q 0 H > W E z m > Woa zco H 0 xwwwwu W M 0 x 4 0 z H Q,' H w a a+ W z a N cn H 0 > H 0 z 0 9 a W a a 0 z 0 w 0E z 0 0 u H 0 0 w 0 H H H 0 z 9 W H z H z W N H 0 A z Q a N 0 u u u a > H Ha z 0 H H W x H W H H H a 4 0 H w w w w E z z w w E H 0 z W u w w 4 w N E E 0 0 0 w 4 E c H U E a 0W H 0 0 E 4 4, 0 0 H 0 H :4 H H z z z E z 0 4 0 z x 4 0 X w w a 0 z E H H W H X x a 9 4 H H H �1 z 0 E w H U� w 9l w x a w w H W w w u w 14 14 a 41 x NI cn w 0 RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: I C4'��[[�� J O Z, Building&Code Enforcement Dept of Community Development Arrive am/pm Depart rn/pm Town of Queensbury Inspector's initial_sW . 742 Bay Road Queensbury,New York'128804 qq'' NAME r� 6 � PERM[T# Z66 z--Z,3 0 LOCATION 1 ( L dt V y q 6 DATE Lle-G/ TYPE OF STRUCTURE N/A YES NO COMMENTS Chimney Height/"&"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/hun/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 Final Survey Plot Plan s!GO) ) ! C As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) 7 Okay to issue temp.C/O(Certif.of Occupancy) ir t.sfr n Okay to issue permanent C/O(Certif.of Occupancy) / UMSIDF�N'I'IA - FINAT.INSPEC'TTON RRPOWF Office No. (518)761-8256 Date inspection request received. Building.9z Code Enforcement s Dept of Community Development Arrive�L�. ]Depart 47 Town of Queensbury ector's Initi 742 Bay Road Qneensbury, 1'4ew Work 12804 NAME � PERMIT 4 2 - TYPE OQ TRTTC'I'T_II2E p�ss+x L .-� S=C - DATE C7 NJA YES �T0 COA/ftNTS Chimney Heightt"B"Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof = Roof Complete Exterior Finish Complete ` "� i Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies, landing 18 in- or more N Interior Fandrails stairs both sides 3 or more risers Grade 21DZo away from foundation 8"clearance to sill plate3 Gas Valve shut-off exposed/regulator 1 S"above grade Gas Furnace shut-off within 30 feat or within line of site Oil Furnace shut at entrance to furnace area � Furnace/Hot Waterr Heater operating I �J Relfef Valves)installed Headroom,6 ft. 6 in. on stairs Basement stairs,6 ft. 4 in. Handrail exterior stairs both sides more than 3 risers `fin O 1 Interior privacy/trim/doorsimam entrance 36" Floor Finishes Bathroom/Kitchen watertight Interior Handrails Balconiestf-anding 18 in. or more Railing across window in stairwells Smoke Detectors- every level K:> -- every bedroom. outside every bedroom ( inter connected Bathroom fans Plusnbizig€'fixtures Foundation insulation -174 3/4 hour fire door/door closer CN:D cc--5 Garage fireproofing Garage penetrations sealed i Furnace n separate room protected(in garage) Light ventilation per room Safety glazing 18"or less from floor Final Electrical Site PlantVariance required Final Survey Plot PIan As Built Septic System layout required Okay to issue C/O(Cert:if. of Compliance) Okay to issue temp. C/O(Certif. of Occupancy) Okay to issue permanent C/O(Certif. of Occupancy) N I r- I 0 LO 0 z U-466 COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. N12in Ogee 176 Doe Run Road- Manheim, PA 17545 MUNICIPAL CERTIFICATE x ELECTRICAL APPROVAL .o O7 9 3 8 Pennit Not t.R•NNit irrf•;••••• ir111rrNttHi.1 • Cue-in Card � t tr11114p•Ntfl.rtr•i•t•••tlrltlrli {�wner•••i••r..I4trrit.►f•illira••ttt•tlNfrr••.••t•rflltl►Ii411tt.tutplttliritl4t►Ii f1•••it•ftt 1.ti•tRttrt4raltil••••••.nt4iRiu.••tt1►ilil}i}}.i•f►•ti14il►N4itt o#Are f Locat�on ft/6 ittitttltlierrlrrrr••••••411IItI.4••r4 4A� -►•l4Milltiitl•i•t•t•••444rtlIMIt111 !tt►1I44 Rtf••ttft•Ni11N1t1t•••nIlitlrt.!••f••IH1litttt.► 1ltiinttrfitfu • t t /I Installatio Consingatil1t•tR•R1tR}i411}i}„ }lflt}114itlil► 1►R1.•!u ?4g }}}ift}lililfllt.f••t ..}}}}.it}•i•Rt•Rtrl►iittut• r1114!!!}}u1111„i•R••tu WOW Aq t i 1gtN.iftt►iNii4•i••tlfR•t.11iHi►iuRHN!►I4ti/111Hftt}fN111►I41ill feet f•4IiHlNIN1t1►iiit4••tsetse 11►Ii1ltt.r4•t...ft11t111 4••rIN41141RN t614t064 t•oMM 1t►41tl ttt••• ••tllrtititi••4•f•4fgtt•4RR•Ht•f•1 tifo# t44titrtfH.ffHN.ttt 114r1tiN•••N•fu•f.N4lrlitir•fit}f}}}}NMIIii•R}H•gfltttltRlit•.t1f141►}IHflufblM•f.Rf••nM•tf11 ' f InstalledLz No.y•ff•IililtHtinug44tNigpttifii}tflpllt••iuu.Mt}I1Itili11/Nfi•..N}•}44ft1I1i1R•i t tit•►.1►1t14Nii••}1gii1•f}f.iff.}ii•itu•N•..f The conditions followinggoverned 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 th( f inspection, introduction of additional equipment or alterations, application shall be promptly made for Inspectors of this Com an shall have the rivilege of making ' sp bons at any tine, and if it! Company p rules are violated, the Company shall have the right t r oke this e ' ate DateM Mftsft I offset 6000#9004 011#000 1 INSPECTOR tN tt4411Nr•ff}}uR ft plot rtrR•,Met trlllNttRts.ir•itttrtttiit.irtlltrtriiif}tfee0041ur• Uamhar M A 1 A Fi 1 RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept of Community Development Arrive,` -aT�o epa Town of Queensbury is $In, 742 Buy Road Queensbury,New York,12904 7NAMEPERMrr# LOCATION DATE -67 TYPE OF STRUCTURE NIA YES NO COMMENTS - Chimney HeightP'"Vent/Direct Vent Location Fresh Air Intake �7 Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30-to 36' Z V1 -Qeeo Exterior Handrails,balconies,landing 18 in.or more '6 1 oc- Interior Handrails stairs both sides 3 or more risers V Grade 2%away from foundation, 8"clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade- k 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 16 in on stairs Do Lz) Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers. Interior privacy/trim/doors/main entrance 36" -um FLT--ov Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or more Railing across window in stairwells Smoke Detectors: every level 7-0 every bedroom outside every bedroom inter connected Bathroom fans 1 V36 I tza7 I Plumbing fixtures VL�C-Z-^ e Foundation insulation r \t'3" Mu— V--X-Doz- BgADL-o�� 3/4 hour fire door/door closer v// 0 � %66 1 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)_ &ITEMAJ Okay to issue temp.C/O(Certif of Occupancy) Okay to issue permanent C/O(Certif.of Oixupancy)L A V1 I^r no'ITroa � �o��ncncncnvr�-�^� I %1 00 (D 0 0 *0 C+ a. ro tD �� +� (p � 0) 0 cu rt n 0 "S 0. d . ," ro �' tl• A� �-' r� Cp fil4 cD 0 co 01 M z r+ t� � �0 rh J, (h U tJ�0 ~h 0 U1 " 0 0 0 0 `+ X 0 N n1 (D CA S) 3 Z � W W �� (D M r+ r+ •� t� � � � � � lk "rl to M(D r+ 0 a «�0 1 (D '�l J.j > "S ,00 %1 � 'gi0cta V1z (DQ � , tl 0 (b M ro n pit qr �,, r� a � �ro -h � ror>' � o M c Q. rt 0 ct r+ 'd fD All 0 0 022 h1 V a � r C (D ��mC: - 0 0 C+ M (D 0 ci' VV y GENERAL REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queeusbury,NY 12804 ArrivkK.'q0 am/pm Depart = a pm Inspector's W NAME: PERMIT# LOCATION: DR! ,: A,IA Fl�� t> DATE : -7- 1 TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers —�1 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/Wallpour Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing [ Heating Rough-In Insulation (A I 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 Ve t Framing IN Jack Studs/Headers Bracing/Bridgin Joist Hangers Jack Posts/Main Beam Air Infltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INCI 1 Main Office 176 Doe Run Road - Manheim, PA I754 � MUNICIPAL CERTIFICATE Ill ELECTRICAL APPROVAL /�1 T�T1 NO 7 9 117 Cut-in Card No, Penn Nat flf1f11It411rl4Nll4ir4114411r144I1144I"+ +*f ff+rr{ftfffUitlrf/fffrffrtttiltHfl AR ro *�/ }'i• �t itittttltl�/!k1#404011 0 .4tar►ftrrtl4ffilr�tftir�f t++r�ffH lriNlN INtIH/f ff!{rlif{fifffr{!f/Ira/f{/Nfrlt�+ttlt+++r{reef/}rt{/fr}lrtlt tN It1+ 1{{0660+61 Location,/, /a4tttttttt44Mt{tHtrt e11 Itt1I4N1l41$l r114 $/1IIlttttold#$4II4111111NNlitlllll$t+41/144t +uurfffrr,!lfe1144tIt141Hr{tiff fI11I11/1ir$trilrf{!4 Installation Consisting of t. ff414lt4rfl$1/II14{{I141lIrf1lfltl4 if 1$1 $fi$14.II1I1lt1Iti44111/ $tear fr+ 1 t111I4114ri4uili1fi111$il4444H 6i 40 i 41lN441t HItt1$ rr4rf 11IIt44411l111t1r1 rrrfsflisff Intel fH/r4sllNfsltell twill NI414 fill 1I41t1111H4 ++!lHfln11f414 114411 t1H $1lostufrr u 11/r4f4}ot It ir4lHfff4flgiNflllaf{+f/f1fNi erifs1t14114f$!!rN lN4srfllssfiNfrlH{Nlff Hitssffr/1t4teffiifffffir4lltfltflfisi4l$//!/114144l44+a+4{!fl41N/14I1tri/4!//{f41/lftil41N11//e InsialledByloollmi1#1 rf,firt4141f111/$#10#4 Boost!}i!}!1/ f!1 .ellfff1 Ito 1141ffllf4+f11f/f1///ff111 Lie, • !i+/ 1iieHtlf11fr1{Irfflffillttt4lrfffff/{rlfr4ffif$+. The conditions following governed the issuance of this certificate, and any certificate previously issued is cancelled;Inis certificate only covers the electrical equipment and installation conditions as of date, Upon the introduction of additional equipment or alterations, application shall he promptly made for inspection. Inspectors of this Company shall have the privilege of Makin ' pections at any time, and if its p rules are violated, the Company shall have the right t r voke th' e ' icate 200#f Datem be####"##f41t$It }Harr}$}4{r+4fle#Nt4Meet INSPECTOR . 11 1114}01i r... so-11r11f1H4/lt1 It'll tells IIom fit#ffN/4$4$}66}}1}f4444t1et4$IIM Mpmhpr N.F.P'.A..I.A.F.J. Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: r Dept. o Community Development Re uest rereceived: P f �' p q Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE ��' am/ ,PART A� a /p Notes: (518) 761-8256 Inspector's Initi is NAME: , ~ PERMIT# `tbbCQ>7_- LOCATION: tA ___- ))IE INSPECT ON(date): Q "- 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 of the concrete. Materials for this purpose on site Foundation/Wallpour _ Reinforcement in Place oundation/D ampproo fing ack sill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing 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 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.FORMSIGENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury 9 Ready at time: �le ,% .Dept. of Community Development Request received: �b l�'Y Meet: .Building& Code.Enforcement At time: 742.Bay Road Queensbuyy, NY 12804 ARRIVE "r a EP RT ' a In Notes: (518) 761-8256 Inspector's Initi NAME: CW(e�r' (7PERMIT# ;�DO"�-- LOCATION: __ �( INSPECT ON(date): 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 of the concrete. Materials for this purpose on site Foundation/Wallpour _ Reinforcement in Place am roofn Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing 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 raming Jack Studs/Headers Bracing/Bridging Joist Hangers aek Posts/Main Beam nfiltration Barrier Separation 1,2,3,hour \ration Sealed all 2,3,4 hour Ping ngway\Bttiiding.Codes.Inspcetion.FORNfS\GFNERAL INSPECTION REPORT.doo Office Use GENERAL INSPECTION REPORT Inspector: =t�tj Town of Queensbury Ready at time. Dept. of Community Development Request received: 6-Building chi Code Enforcement Meet: 742 Bay Road At time: Queensbury, AT 12804 ARRIVE �b r. EPA a m Notes: (518) 761-8256 Inspector's Initial NAME: ��,(� PERMIT# LOCATION:,} INSPECT ON(date): o� / TYPE OF STRUCTURE: RECHECK N/A YE NO COMMENTS ootin'slPiers . Monolithic Pour Form Reinforcement in Pla e The contractor is re pons'ble for providing protecti0 from eezing for 48 hours follow, the acement of the concrete. Materials for this purpos on s to Foundation/Wallpour Reinforcement in Place Foundation/Dampproofm Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Pla e Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior Foundation Walls Exterior 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 Firestoppnng emingway\Buiiding.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc r t f t STATE of NEW YORK DEPARTMENT R STATE RECEIVED 4 1 STATE STREET AL$ANY, NY 1 223 1-000 APR RANDY A. DANI£Ls SECRETARY OF STATE BUILDING AND CODE March 4, 2002 Mr. Robert Hoffman Muncy Homes, Inc. PO Box 246 - Route 442 East Muncy, PA 17756-0246 Re: Approval No. M 1387-97-024 Manufacturer No. M 1367 Dear Mr. Hoffman: Your request for an extension of the expiration date of Factory Manufactured Home Approval No. M 1387-97-024, applicable to one and two family dwellings, -is hereby granted subject to the conditions of the initial approvals. The manufacturer shall be responsible for assuring that homes or components bearing insignias issued during the extension period also comply with the current'requirements of the NYS Uniform Fire Prevention and Building Code. This extension will expire on April 19, 2002. A copy of this letter shall accompany plans or specifications submitted for a building permit and be deemed a duplicate original. I am hopeful that you will find this extension of assistance. ; ,Very trul yours= George . Cla Direct r,,Codes Division z r 4NW-0CS,5YATE,NY.US EMAIL. INFO@005.STATE:.NY.US cctr t.ro Hatt , t . a ' : r � 4 _ V l ---------- -- ------.--.-.._._... _......... MAP REFERENCE: MAP OF A SURVEY OF LANDS OF LEE & BETTY BARTON DATED DECEMBER 18, 1970 BY JOHN B. VAN DUSEN LAND SURVEYORS LAST REVISED APRIL 15, 1985 BY VAN DUSEN &, STEVES LAND SURVEYORS LOCATION MAP: r-" k w 0 .d a cQ � 0 ow ��► z n w w .W o 4) •y' Mor V 0 ' a �m m� �� D&W scab T. w S ---1 SHWr i CF 1