2001-145 TOWN OF QUEENSBURY
dirzy
Itergir
742 Bay Road, Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010145 Date Issued: Friday, August 31, 2001
This is to certify that work requested to be done as shown by Permit Number P20010145
has been completed.
Tax Map Number: 523400-290-000-0001-071-000-0000
Location: 11 BROOKFIELD Run
Owner: SCHERMERHORN PROPERTIES INC
Applicant: SCHERMERHORN PROPERTIES INC
This structure may be occupied as a:
By Order of Town Board
Fireplace TOWN OF QUEENSBURY
Garage - 2 Cars Attached
Single Family Dwelling
Director of Building&Code Enforcement
1
TOWN OF QUEENSBURY
ao742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
v...--, -
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010145 Application Number: A20010145
Tax Map No: 523400-054-000-0001-035-031-0000
Permission is hereby granted to: SCHERMERHORN PROPERTIES INC
For property located at: 11 BROOKFIELD Run
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: SCHERMERHORN PROPERTIES Ili. Single Family Dwelling 164,000.00
15F BIRDIE Dr Garage-2 Cars Attached
QUEENSBURY,NY 12804 Fireplace
Total Value 164,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
COMMONWEALTH ELECTRICAL A(
PO BOX 706
HAGUE,NY
Plans &Specifications
2001-145
2304 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$304.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,April 17,2003
(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 Queensb ; Tues ay,April 17,2001
for the Town of Queensbury.
SIGNED BY ,
Director of Building& • ode forcement
•
C161-1 ,
/��'_ ENERGY CODE COMPLIANCE APPLIC
�-== TOWN OF QUEENSBURY, WARREN COt E E t
__ 9000 HEATING DEGREE DAYS
APR 0 6 2001
Comoliance Methods: PART 5 - Acceptable Practice ocetZENSSURY
1&2 Family Dwelli I DCODE
• PART 6* - Thermal Rating - Component Trade Orfs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*R oruires submission of worksheets /� L
SG �G✓f.KCt.- i.t ���s��[9��/si ( -. �"( CL40 C<I I del G�ti u
APPLICANT' S NAME: PROPERTY LOCATION:
•
•
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - Z301 square feet
2 . Type of Heat - Electric Oil ) Gas Other
3 . I s building mechanidally cooled? Yes No
4 . Percentage of area of windows and doors Over 17% X Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R 3
b . Exterior walls R >9
c . Glazed areas R Z
d. Exterior doors R f 3
e . Floors over unheated spaces R
. Edge of slab on grade (heated building) R
g. Basement/cellar walls (above grade) R /o
h . Basement/cellar walls (below grade) R- /0
Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heati nc device
Conforms to minimum efficiency per code X- Yes No
•
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
App_-c =- Si�natq=e a e Phone Number
INSPECTOR S REMARKS:
•
Building Permit Application
Town of Queensbuly - Dept. of Community DevelOpment, 742 Bay Road, Queensbury, NY 12804 [761-82561
_f) BUILDING & CODE ENFORCEMENT
NOTICE Requirements prior to issuance r
of this permit: PERMIT FILE NO.c )- .) 145
A permit must be obtained before
beginning construction. No inspections PERMIT FEE PAID$�jri�.+C P
will be made until.applicant has received n Zoning Board Action_
a VALID BUILDING PERMIT. All Area /Use HEC ,1)1
FAD
RECREATION FEE , a
applicants spaces on this application APR 2o�MUST be completed atld.the signature 0 Plying Board Action REVIEWED BY: i
of the applicant must appear on the SPR / Subdivision /ottidDWN OF Ot EENSBURYBuilding �,
Inspector
implication form. n ,,w // Recreation Fee/ Payment BUILDING AND Q:t)t7b J
•
Applicant: SGh�1/ 2 airsi 6otiS114-41o�Owner: �a ^+ e.
Address: / F 13l-'d 1 c. ijiroft, Address: S c_
Phone # ( ).7'11.8. - d 6`7 1 Phone # ( ) -
Property Location: /It erooK-Ft 4,1e/ ►\ uz.l 9/ / / 3�C 21
r 5_
Subdivision Name: vee>Gt�tclef r ova a Tax Map Number Jl
Section Block Tot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ 'l - 1 coo
residence / commercial /
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial }C Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
•
Other
GROSS AREA OF PROPOSED STRUCTURE: G
o
1st Floor p0T— If ADDITION, what will use
/65' sq. ft i of new addition be? :
2nd .Floor. . ., 62.4- sq. ft
Other Flouts 9,,,2,.E sq. ft.
(not unfinished cellar or basemen ACCESSORY BUILDINGS: n "-v.!,Detached Garage 1, 2 car
TOTAL FLOOR AREA: 2- 30et SQ. FT. )C Attached Garage 1,
ldi
Private Storage Buing
SIZE OF NEW STRUCTURE: Commercial Storage Building
FEET X Sg i FEET Other
Foundation Type: oou -<cI cotiCva<-. Will any second-hand or ungraded
Number of Stories: Z lumber be used? If so, for what?
(habitable space orally) JJo
Height (grade to ridge) : feet TYPE OF HEATING SYSTEM:
Number of fireplace$ and/or woods ove (circle all whic)�plies)
to be installed:_ ✓/ Electric / Oil / / Wood
Forced Hot Air / :.seboard / Other
Person responsible for supervision of work as r gards to building .
codes is : A/GA SGC,vL-v-+ct--lrov /5-- RI.-6/t-e� "-- 7'f '—c474f
Name / Add esss Phone
Builder: SC4•r�1.:cc•tiol--- C- 9i 1.5•/"v- -4-td\ •-7 9SS 06774f
Plumber: ti(c-, Ce. c - c_. 44..... 6-",< c Z — 300'
. Mason: 74-/c t?.,/d -ct ref (+ic '772 -- 137/
Electrician: f44) }- PL-k ti C uct.-4; ..7 ?G.o .- 1‘114
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 Occupancyor 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: /77(... -..-----
(owner, owri6r'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: /o- - /� 8 y- ,, {,/,,�
File Permit No.C260 -r 45
Tax Map No. 'G /
R F' > e are :�,� ,
Owners Name: cc Z C6:,S
APR....0...6 2Od1
Address: f 5 F . �t cti<. p�-- Q�tr,t,St,7. -r r
ljjosyytF D CODE
2. INSTALLER'S NAME : 5cL ��;.,c,:.-L c3., 6)LIS PHONE NO. .711'•-CC 71.
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 gal/bdrm =
1991 -present 2_ x 110 gal/bdrm = 2 -
Garbage Grinder Installed yes— / no ?.0
Spa or Whirlpool Installed yes / no ?e
4. PARCEL INFORMATION: (circle applicable information &indicate measurements)
To••graphy S Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
�7at saner at what depth at what depth municipal
o ing oam 0.- feet �04._ feet well
Steep slope clay if well; water supply
%slope other from any septic-system
depth: absorption is/o o ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: ,U44. 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: /2oo. gallon (min. size 1,000 gal)
Tile Field: each trench 5 7 ft. Total System Length: Z. 2.
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # 2- / depth or thickness / feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
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 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.
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.
Signatur of
responsible person ateD
p
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 ❑Other
Occupant Building Permit No. ' •
Job Location . - City State
County Twp. M/C# Swimming Pool New❑Old
Directions to Job Site
Application For Rough Wiring❑ Fixtures❑ Service❑ or
Work—New ID Additional❑ Bldg. —New 0 Old❑ Ready for Inspection
APPLICANT'S SIGNATURE LICENSE# PERMIT a
-
PLEASE `
PRINT NAME _ PHONE#
APPLICANT'S NAME OF
ADDRESS . UTILITY
OFFICE TO
CITY _ - STATE ZIP CODE BE NOTIFIED
ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS E PENT
EQQUUIPMMENT ERVICE PUMP
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 FRAC.H.P.
QUARTZ FIXTURES WIRING&CONTROLS FOR BURNER VENT FANS
MOTORSrH.P. 1/20 1/12 1/10 1/8 1/6 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:
OFFICE USE ONLY WORK INSPECTED REPOR o
NOTIFIED TER ¢ 8 FEE 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: OYES ❑DUP ELEC.
LT.CO.
INSPECTOR
Progress ❑
THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E,I.S.INC.
WHITE/OFFICE PINK/INSPECTOR YELLOW/OFFICER GOLD/CUSTOMER
OW,. TOWN OF QUEENSBURY
_;.+��i1,3 BUILDING & CODE ENFORCEMENT
,� 742 BAY ROAD
`: .=?J9 QUEENSBURY NY 12804
(! (518) 761-8256
ARRIVE: DEPART: 11
INSP: '
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPEC ION REQUEST RECEIVED:
V(i/L
NAME _ OffEQ/F O L •
LOCATION /`'/eMer7i60 'C 4-) -
DATE CI -- -- ® ' PERMIT 0 °(-- 45
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/H, GH
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAIL NGS
RELIEF VALVES
FURNACE/HOT WATER OP ING
INTERIOR TRIM/PS DOORS
FINISH FLOORS:
BATH/KITCHEN WATER IGHT
OTHER FLOORS SWEEP BLE
OTHER FLOORS CARPE ED
STAIR CLEARANCE/RAIL NGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL 7INA
PLAN/VARIANCE REO. r�
L SURVEY PLOT PLAN V�ry�
OK TO ISSUE C/O OR C/C
i
•-eeli f) ___
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: 0 r. l
Building&Code Enforcement i
Dept. of Community Development Arrive am/pm Depart i , p
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New York 12804
NAME ,<L ' II PERMIT# !"'/c(J
LOCATION J j�'I1 Ryurs�,� el DATE
TYPE OF STRUCTURE r'- `
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake //'''
Plumb Vent through roof ✓`
Roof Complete 6/
Exterior Finish Complete 1 /1
Interior/Exterior Railings 30"t i 36" J
Exterior Handrails,balconies, : ding 1: in.or more �/
Interior Handrails stairs both '•es 3 or . ore risers ✓f
Grade 2%away from foundati.n ✓✓
8"clearance to sill plate\ /,,�
Gas Valve shut-off expo d/re t ator 1:"above grade / 47/✓
Gas Furnace shut-of with k 30+eet or • 'thin line of site ✓
Oil Furnace shut-off at entrrah to •.+ ace area ✓✓✓
Furnace/Hot Water Heater oper.ting
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs C�
Basement stairs,6 ft.4 in. /'.
Handrail exterior stairs both sid s more than 3 risers
Interior privacy/trim/doors/main ntrance 36"
Floor Finish • V/
Bathroom/Kitchen watertight t/ (//
Interior Handrails Balconies/L ding 18 in.or more
Railing across window in s ' lls
Smoke Detectors: /
every level s�/
every bedroom ✓
outside every bedroom
inter connected r/ ,
Bathroom fans �///
Plumbing fixtures
Foundation insulation /
3/4hour fire door/door Moser _ /l
Garage fireproofing ,`/
Garage penetrations sealed
Furnace in separate room protected(in garage) //
Light ventilation per r —gJE/�
Safety glazing 18" e ti fro n floor/
Final Electrical G% [ _C`'/ 7 XIPPRe V rr(--
Site Plan/Variance " uir ��
Final Survey Plot Plan — P tG
./As Built Septic System layout required 5 .
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) /.J �(�`�� 19P,
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC..
Main Office 176 Doe Run Road-Manheim,PA 17545 o2-ac)
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No Cert. N2 _ 7 015 7 Cut-in Card No
Owner /..(l5C¢(467vLl426-4 4 c 2,(/ c6Arc(.
Location A /2e't face i(1 d. (
Installation Consisting of 3 / 560 4.z- 6 ....i``l°-3.7 -5
Installed By �/Ai 21'6 CZ,. 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 the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if it:
rules are violated,the Company shall have the right to rev
ke thi err)ficate.
Date J ( INSPECTOR
FIRE MARSHAL
TOWN OF QUEENSBURY
Asti j QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# OI " /y6--
NAME (-- L I-ki-ei3/er P'
LOCATION L7 T I I 3A-i''e=I t�IL /26"11)
SCHEDULE INSPECTION ON l U
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLER
CLEARANCE TO HEATING UNI S
REQUIRED SIGNAGE
CHIMNEY _
WOOD STOVE ) /
FIREPLACE-MASONRY -
FIREPLACE-FACTORY BUILT f 4J4
REMARKS: OK TO THIS DATE
kj/29-
INSPSLIP.PUB INSPECTOR
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received: -2 3/dy- f
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depa
f > 9 Inspector's Initi Is
NAME: `^/ �G.h PERMIT# _GO/-/
LOCATION: t// dy-r it (74/ DATE: 3
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 from freezing
for 48 hours following the -ment
of the concrete.
Materials for this purpose o
.-. Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under S1alz
Plumbing Vent/Vents in Plac;
Rough Plumbing
Hea 'u 'ough-In
C I latipni
Foundation Walls Interior V-
Foundation Walls Exterior -
Floors R /17,'
-
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
ii --/07 '..-3 -----
-= .,46-pec-
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 RA) am/pm Depart pm
Inspector's Initials
NAME: i1\ )� \~� L'/l1>�j 'PERMIT I W F J/ X J
LOCATION: 1 x 5L `�1i� A/tXY DATE: 7/ ..--r3400I
TYPE OF STRUCTURE:
RECHECK
N/A YES•NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is sponsible for
providing pro on om freezing
for 48 hours fo1lo 'ng a placement
of the concrete.
Materials for this purpose o site
Foundation/Wallpoui
Reinforcement in Place
Foundation/Dampprodfing
Backfiill Approval I,
Plumbing Under Slab
\Zbing Vent/Vents in Pla e f
ugh Plumbing ! V
Heating Rou -I-Iri
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
V
ming
Jack Studs/Headers
Bracing/Bridging
Joist Hangers V /
Jack Posts/Main Beam V
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
FireFre Wall 2,3,4 hour / ' '
e i topping
t
/ . i. a
•
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ` �! \(J rn( ' i
Locatiyn rf ) ) Stc(5):scieAd
(jDate `� ) Permit # 1A _,
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length 24g01
Length of each trench c-) a'
Depth of trenches 22_
Size of stone 47
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box /1 'c
Dist. Box to Field/P- ,f P
Openings Sealed? 40000 No . :Partia
LOCATION/SEPARATI4 • :
Foundation to Tank `es,- .feet
Foundation to -Absorption . t_04-. .feet , .
Separation of 'Pits • r fee
Conforms as per Plot Plan Ye No
LOCATION OF SYSTEM ON PROPERTY:
(circle'one)
Front - :-. - Left Si . - Right Side
'iddle Front, •• e ;ear
1. .
1 Z t1-= m GEL_
'Fe-1M 1-EqC A FIELD •
•
"i � � P6-s30\\-\--Aac_
SYSTEM.USE APPROV•4 • ' YES (i)_
Arrived: Elk r�
Degeds. d
par
' Biding In-. '• tor
-Ora,
3.3 r
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�j r rpm I epa r1/2 r p!/
r spector's Init
NAME: i PERMIT# . � /
LOCATION: MIlr. �, : ate, DATE :
TYPE OF STR 1 CTURE: .
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respo i sible or
providing protection fri m free 'ng
for 48 hours following e place 3 ent
of the concrete.
Materials for this purpose 'n site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Cliackfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Mai-
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
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
11 ,3oath
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury —,—__
Dept.of Community Development ~.- Date nspection request received .r.
Building& Code"Inforcement
742 BayRd
Que sbury,NY 128047. ,
--2 Arrive a 4m Depart( \ f�� '•m/
Inspector.s Initi� s—
N : "le'r PERMIT oA f I��
LO TION: e� DATE : AU
TYPE F STRUCTURE:
RECHE ,
/
N/A NO CONIIVIENTS
Oo otings/Piers 1 1
Monolithic Pour Form
Reinforcement in Place "' '�tb
The contractor is responsibl for
providing protection from free 'ng
for 48 hours following the placemei t 7
of the concrete.
Materials for this purpose on site f
Foundation/Wallpour
Reinforcement in Place ".
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place �1
Rough Plumbing
Heating Rough-In / •
Insulation
Foundation Walls Interior R- /
Foundation Walls Exterior R-/
Floors R-
Walls R-
Ceiling R- i
Duct work or piping in
unheated spaces -
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers �'\\
Jack Posts/Maii eam N.
Air Infiltration B 'er ti,
Fire Separation_,2,3,hour
Penetration Sea d
Fire Wall 2, 3,4 hour
Firestopping
•
•
• "I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells, trees, fences•, etc::
.Yr-.. i'YO shown or€ his doct.f•�m t. I .also'repreS�nt that I have
r� I a + . n r s adY¢!f ?'-PFvoeldialr rrtm' • ! v
Ulf( P 4a1 •
3 r�e3 �� \ :j av \• 1 _ �_._._ -
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MAP REFERENCE:
MLJAer 11
E
DA1
LAST
BY
� 0
RECEIVED
SEP 0 5 2001
. • TOWN OF QUEENSBURY
QF NEWk- BUILDING AND CODE
C. s
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED T0: RICHARD E. & KAREN B. CUNNINGHAM
GLENS FALLS NATIONAL BANK AND TRUST COMPANY,
IT'S SUCCESSORS AND/OR ASSIGNS
FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: JUNE 14, 2001
1J
p
OG�
S t e v e s
Land Surveyors , LLC
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York Lie. No. 50135
UAVYHORIZED MITRATM Olt N)OMON TOA 31JRVEY
NAP WARM A UCENSED LAID SIRWAM SEAL 17 A
� MATM OF SOM M 7^ s19-DOW" X of M
NEW "M STAM FDU1DA700M LAW'
'ONLY own FROM THE ORWINAL OF iNS B W-f
MARM " AM "INAL OF THE LAND lIANEI
,E'C � T YNJO IIY COIRi'
COX MYWASTIONS PREPAREDINREM91AN/E=T
MS 91RVEY WAS PREPARED M ACCDIDANQ MI1N 7!E
E70 W CODE OF ►RACIICE FOR LAID SURVEYORS ADOF1Cp
LA nE NEON �M �A,E rWIGAMISDU„OM OWL RUN ONLY
ENALL NMI QlA
LAND E PERSON MD CEA1FlCA Spray
10 WE PERSON FOR wNor TIE et1MMeF K PREPARED. AND
ON W BEHALF ro THE VIE CO PANY. OCVERNIERTAL
AGENCY p1- Or wi HEREON. AND
Map of a Survey made for
Richard E. &Karen B. Cunningham
Town of Queensbury, Warren County, New York
llatel JUNE 14, 200
Scale 1'=50'
S-1
ear , ,
NAME
DWG. NO. 86671-13
NO.
DATE
DESCRIPTION