2001-313 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development -Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010313 Date Issued: Thursday, July 18, 2002
This is to certify that work requested to be done as shown by Permit Number P20010313
has been completed.
Tax Map Number: 523400-290-000-0001-069-000-0000
Location: 15 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 E orceme
TOWN OF QUEENSBURY
41 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010313 Application Number: A20010313
Tax Map No: 523400-054-000-0001-035-035-0000
Permission is hereby granted to: SCHERMERHORN PROPERTIES INC
For property located at: 15 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 IA Single Family Dwelling I55,000.00
I SF BIRDIE Dr Garage-2 Cars Attached
QUEENSBURY, NY 12804 Fireplace
Total Value 155,000.00
Contractor or Builders Name/ Address Electrical Inspection Agency
SCHERMERHORN PROPERTIES INC COMMONWEALTH ELECTRICAL Al
15F BIRDIE Dr
OUEENSBURY.NY
PO BOX 706
HAGUE. NY
Plans & Specifications
2001-313
2436 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$338.52 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,June 11,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T. co uee�.urn; n ne 11,2001
�VJ
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-82561
BUILDING & CODE ENFORCEMENT
NOTICERequirements prior to issuance r
(A permit must be obtained before l of this permit: PERMIT FILE NO
� -,3/
beginning construction. No inspections ��`
will be made until applicant has received n 'Zoning Board Action
:ERII E P.,D$
a VALID BUILDING PERMIT. All Area /Use
applicants' spaces on this application MI01k11Er}TlON FE D
MUST be completed arid the signature PlanningBoard Action Te 4'�J ZUC,
❑ V1EW.ED BY:
of the applicant must appear on the SPR / Subdivision /Other /LG/ ;�,`�`''�44°
._t lication form. D \ (r AM e„+�R dtding Ins czar
J Recreation Fee Payment ®� ,..,rt 0VE.
J
Applicant: 5G"Ici/tnr•v1,,,,,vLN ��tis-1,--ye..-h.`,-\ Owner: tc ( S. ct--tnr,t-,
' Address: / S-F Q1-d t, pL- Qu<<-is lr,--/ Id Y Address: I S" i= gi-cl, c- PP- Q.‘, ,/}/
. /210
i 2 PI
Phone # (Sl8 ) jqff - 66.71 Phone #
pa
Property Location: lo I-- IS El -r<ct( A (AI51-1 /_ 1 /
gv6bt<-1'-i.c,�rr �$��-few Tax Map Number
Subdivision Name: Section Block Tot
NATURE OF PROPOSED WORK: —'�f
ES-TIMATED MARKET VALUE OF THE
X New Building: ONSTRUCTION: $ /
residence / commercial S / ��
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:
1st Floor J$/6 sq. ft. If ADDITION, what will use
of new addition be? :
2nd ,Floor. . ., //2.D sq. ft. Q___G
Other Flouts sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS: ;--/ xp�-�
Detached Garage 1, 2 car
TOTAL FLOOR AREA: 2'1"3 SQ. FT. c Attached Garage 1, 2 car y... .)_ d
�� Private Storage Building Sn
SIZE OF NEW STRUCTURE:/ 402q - Commercial Storage Building
S8 FEET X 35 FEET Other
Foundation Type: Will any second-hand or ungraded
' Number of Stories : . Z lumber be used? If so, for what?
(habitable space on/ly) 00
' Height (grade to rl.dge) : feet TYPE OF HEATING SYSTEM:
Number of fireplaCe?E; and/or woodstove (circle all which .plies)
to be installed:_ c • Oil /e / Wood
Forced Hot Air eboard / Other
Person responsible for supervision of work as regards to building
codes is: RIe-1-1 SG Liu,b.c(.t!:./', -790'-047
Name / t- ddr sss Phone
Builder: Sc,L ,i. ,:-.c,�G,cc‘,, C o ,s frruc oL, (ov . < /3Y. 7 Ter-0672t
Plumber: (etc+-L 6e,1 cs -1-c._ (R gY `79Z- 3CC7
. Mason: -7.1 -. 6 A,c--E- (0,wti, yr//,_ 7.4 O- igo Z
Electrician: i° f- 0/, ,,«t-, c? ray z60— /Lf
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, an AS BUILT PLOT PLAN by
a licensed surveyor; dr n to ale, howi g actual location of project on premises.
Signature: - L
(own r, 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: `o-/ is— 6 i,00 K-rl- l/ ► )
File Permit No. )) -313
Tax Map No. / /
Fee Paid
Owner's Name: $ c4 si tn4 ,-, v/o,
Address: / S- F. •
d�t-�- Y�'7v c,
2. INSTALLER'S NAME : S a4 LVw•cvLtnvti PHONE NO. -7qb'o‘ 7.1
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 x 110 gal/bdrm =
Garbage Grinder Installed yes_ / no >e
Spa or Whirlpool Installed yes / no
4. PARCEL INFORMATION: (circle applicable information &indicate measurements)
To•ography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
a .' at wh t depth at wh t depth mu iicipal
'oiling loam Z{J r-feet 7✓/4 feet
Steep slope clay if well; water supply
_%slope other from any septic-system
depth: absorption is/0o ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: A//1 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: /200 gallon (min. size 1,000 gal)
Tile Field: each trench S7 fl. Total System Length: Z 2 5— ft.
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # Z / depth or thickness I 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 Sani ry Sewage Disposal Ordinance.
/ Zoo /
Signature of responsible erson D to
Fire )larshars Office Town or Qrwenslnure. 742 Bar(load,Quveruhurv, \Y
(5181701-8205
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel & vented gas appliances
Date c iti 70 0l
- Permit No0(10,0/'313
Application it hereby made to the Building& Codes Ol/ice for the issuance ofa Building and Uec
Permit pursuant to the New York Stare Fire Prevention and Building Corte. 7lre applicant or ovner
agrees to comply frith all applicable lass, ordinances, regulations.s. and all conditions that are part of
these requirements and also will allow all inspectors to enter premises to per/man required inspections.
1, NOTE to applicant: Rough-in and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
(circle appropriate words)
Name: Sr e v o-, GONt-fr. (o v/o Stove: wood coal pellet gas
Fire lace insert
Address: is- F 0-- ire.1 factory-built: wood ins
Qvu,a s6.,,.7 [I y /ZYoy- Fireplace, masonry: wood gas
Furnace:
wood gas oil
Phone: -7 Rrp_ OE 7,1.
If non-masonary applicance, please provide
Owner: Cr Manufacturer Name:
Address: /r ): e14v W'�nn✓. Model Number:
qJ G v1)1-7 & ' (2d'oc1
r
Chimney Information
Phone: —7 qg_0F7 t (circle appropriate words)
Masonry block brick stone
Flue tile steel size: 6 inches
Exact Address:id is- f„ co c14 dvL
of construction or installation Factory-Built
Manufacturer name: tl.4j s fro
Model Number: ;4 pV
Note: Listed By: Number:
)
Construction/Installation must umoer:
conform to NYS Fire Prevention &Building Indicate (circle) chimney material:
Code. Consult available Town ofQueensbw-y
Handouts regarding required inspections. Double%ran - Triple vrrll /
N Insulated /
Chimney Linn
Cashier's Departaaeat—Town of Oneeaebury, New York
Fire:I lnrslral Code q S Collected S Rblimded neceirod limn rrrtuuded to):
.4 1 133SJ (190) Public Safetyarid;ee‘Safety
.4 233 2655 (230)Minor Sales
Wy
�.. - 7 .. 0 .o. .D� �,
White(Applicant) Green(Fire:\Iarshal) Yellow(Bid 2. Dept) Pink& Goldenrod(Cashier's Dept.)
_/#��I- -. ENERGY CODE COMPLIANCE APPLICATION
- ��_)- TOWN OF QUEENSBURY, WARREN COUNTY (//7
�i. 9000 HEATING DEGREE DAYS ���/�
Compliance Methods: PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings ( 3 stories or less)
PART a* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Rewires submission of worksheets
APPLICANT' S NAME: PROPERTY LOCATI N:
/' �" / Goo 1 5-- <o�{-�c(cf KJ�
-5c&,�.,L_(t 4bV'. [otis 7vveiliN CovO. �T F P- / -
PART 5 METHOD OF COMPLIANCEl BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 24-36 square feet
2 . Type of Heat - _ Electric _ Oil Gather
3 . Is building mechanically cooled? Yes X. o
4 . Percentage of area of windows and doors _ Over 17% _ Under 17%
5 . R-V__,UES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VLUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R 30
b . Exterior walls R iq
c . Glazed areas R
d . Exterior doors R . _
e . Floors over unheated spaces R 2_
• Edge of slab on grade (heated building) R jO
c. Basement/cellar walls (above grade) R /o
h . Basement/cellar walls (below grade) R to
Eeati ng/coaling-ducts-piping in unheated space R
6 . Service (domestic) hot water heatinc device
Conforms to mmjjinimum efficiency per code C Yes _ No
\ M TE ?E TUREOL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
App__ca _ s .6'i_n D __ Phone Number
/.....____
�r�/� 2oe1 795-067f
INS?ECaCR' S REMARKS:
Fire:Marshal's (mg: Town of Queonsbury. 742 Ray Road, Qucciuburs. N1
(Si81761-82U5
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel & vented gas appliances •
Date T
Applrcat/an id hereby trade to the Building& Codes O//ir. for(he iaanaae e of o Hui/cling and live
Permit puuuant to the New Yin*Stare/Ir. Prevention i end Bui/din Code. 2'he app/iaurl or o r er
agrees to comply with all applicable/a s, ordinances, ntrgillatirms. ungin/l conr6amrs'that are Part a/
these requirements and also will allow all inspectors no utter preen s ro per/ow required inventions.
0 NOTE to applicant: Rough-in and Final inspections are required.
Applicant Information Fuel Burning Appliance Information
/ (c I role appropriate words)
Name: c / /twat Co., vta Sloce'.t „� r v r r� mood coal pellet gas
Fireplace insert
Address, i7 F 17,,,tIie lw. Cr ir ephicn, actory-bulls) mood 001
Ceti((tins _;..._ 01 ( tndf Fi replace. masonry: wood gas
Furnace: wood gas oil
�l �
Phone: / 01777— OF 7c.t
If non-masonary applicance, please provide
Owner: "r (, ,, v_nil,,,,.. " Manufacturer Name:
Address: !; F Cr.'yrt (/v • Model Number: •
rti -ec.)1.“ / N -- lGJp4
Chimney Information
•
Phone: _ -7/7 d-re) 7t (eirdc appropriate words)
Masonry block brick stone ' \
Flue tile steel sire: /o inches
Exact Address: 2.4 is ( - ,k/tlt levh
of construction or installation Factory-Built
Manufacturer name: 0,4 , Itic.
Model Number. 7 G t11/ `
Note: Listed By: li L I
Construction /Installation must Number:
conform to NYS Fire Prevention &Building Indicate(circle) chimney material:
Code. Consult available Town ofQteensbuty •
Handouts regarding required inspections. Double mall ' Triple wall / hu'ulated /
Chinrnrr Linn'
Cashier's Department— Touts of Qneeuabary, 14.7-eur Yorlr
Fire dlaninal Curse# S Co//coed S Refunded Recennd ti•on R /under/mi s r'"I j r ().,.
in .•z allrc+,.
.a 173 3389 (190) Public S&len_'
(230)Minor Sales
� s
l \
•
oy.s,,,.. _ 7ow.. OG..i e,. 'Lr„ay •
White(Applicant) Green(Fire Marshal) , Yellow(13Wg. Dep.) Pink&Goldenrod(Cashier's Dept.)
_ l
. ,
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 end 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 SG.Ln:1"✓ n v rt' ✓MVv1 Ae^rT:4- t✓fa... Type Bldg. g DWG ❑Other p
Occupant . Building Permit No,w47.20-)....3 1)
Job Location .....a4G{.....Lc.........CcAi..i(..tA.f& J?L/n City 4••r e est;..G•may. State 41. Yr
County 4UA VI"t"t. Twp M/C# Swimming Pool-New C Old El
Directions to lab Site Li At.;# .1 “...),
' `"'y ;eft< it " `'K...r.l..c..LI
Application For Rough Wiring C Fixturesg Service 0 or
Work-New40 A itional❑ Bldg.-News Old❑ Ready for Inspection
(q
INA CRT
S rI ! LICENSE• rERMn.
PLEASE CICry i' • :Gin r✓ wf1-Link M PNCTIE II
APPLICANTS NAME OF
AOsn I F Er—do... cw
CITY Ct .r re-1_Lu rY STATE //.y. ZIP CODE l2.^0Y OFFICE
1O
ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS AMP SERVICEPUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE DISHWASHER
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT CONDITIONERAIR AMP. RECEPTACLES
FIXTURES
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.R.
QUARTZ FIXTURES VENT FANS
MOTORS:HP 1/20 1/12 1/10 1/0 1/6 1/4 1/3 1/21 3/4 1 1-1/2 2 3 5 I7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH Sh2E
Inspector's Comments:
DON LOVELAND
E lemhal Impeder
P.O.BOX 706
HAGUE,NY 12636
(516)549-6724
14300462-9934
OFFICE USE ONLY WORK INSPECTED NOTIFIEDR. p FEE PAID
.. /{ SERVICE DATE CON- TOTAL $
Date Received: tk "lj...�-„ '. F TRACTOR
P.W.DATE OWNER CHECK NO.
' FINAL DATE OCCUPANT CHARGE
Certificate No.:
CERTIFICATE NEEDED AGENT CASH
Date Sent: OYES ODUP ELEC.
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
) 7, .30 .
RESIDENTIAL FINAL INSPECTION REPORT Z I N a
Office No. 516 761-8254 J Q/ ¢
( ) Date inspection request received: �— �—,{�/ 7q3 _/rpSl
Building&Code Enforcement n -1/'
Dept.of Community Development Arrive_on/pm Depart rj
Town of Queenabury
742 Bay Road Inspector's hdtiels
Queensbury,New York 12804
NAME 5CAn- &-V k c IJ PERMIT N gook.— (3
LOCATION 6S R ra'K T2.G t t' (Lt."... DATE nµ.t
TYPE OF STRUCTURE, /
N/A YES' NO COMMENTS
Chimney F e gb B"Vent/Direct Vent Location ✓// T/L — gvctC_ �, `- K
Fresh Air Intake ✓ -
it
Plumb Vent through roof
Roof Complete teij
Exterior Finish Complete ✓/
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more di
Interior Handrails stairs both sides 3 or more risers J
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator I S"above grade /
Gas Furnace shnrtroffwithin 30 feet or within line of site J ✓ /
Oil Furnace shut-off at entrance to furnace area
Fumece/Hot Water Heater operating I
Relief Valve(s)installedHeadroom,6 ft.6 in.on stairs
Basement stairs,b ft.4 in. I
Handrail exterior stairs both sides more than 3 risers
Interior privacy/aim/doors/main entrance 36" /
Floor Finish ✓
Bathroom/Kitchen watertight l
Interior Handrails Balconies/Landing 18 in.or more
/✓
Railing across window in stairwells ./
Smoke Detectors. W
every level
every bedroom
outside every bedroom ✓
inter connected
Bathroom fans ✓
Plumbing fixtures
Foundation insulation /
'/�hour fire door/door closer l //
Garage fireproofing ✓
Garage penetrations sealed ✓ r/
Furnace in separate room protected 14 garage)
Light ventilation per
Safety glazing18"or i., �/
Final Electrical '� r� / �! f
Site Plan/Varience u I /
Final Survey Plot Plan J
As Built Septic C/C SystemC layout
Okay to issue (Certif.of Compliance)
y.Okay to issue temp.C/O(Certif.of Occupancy)
'Okay to issue permanent C/O(Certif.of Occupancy) l/ r..4
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 Lb
742 Bay Road
Queensbury,New York 12804
NAME `T>C F(& t&Ek Kett) PERMIT# C 3/
LOCATION iSQOq*'F/E-L0 ,e't Ad DATE 7(/el6Z
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney HeightP'B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof I
ipe
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
Fmnace/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 sera
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing : in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulati.�
%hour fire door/it closer
Garage fireproof g
Garage , , . ons sealed
Furnace in ..v :te room protected(in garage)
Light venti .tion per room
Safetygl:i g18"or lessfrmn floor
Final Elec ria
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System if.oft required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)
Okay to issue permanent C/O(Calif.of Occupancy)
amisposer-
FIRE MARSHAL
It TOWN OF QUEENSBURY
rij QUEENSBURY, NY 12804
(518)781-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED _ PERMIT#
NAME � .,, ww'2144
LOCATION �� e_gPie<,Q ui✓
7 /8 d�—
SCHEDULE INSPECTION ON _. • PM ANYTIME
APPROVED
AA •YES i NO
EXITS _----- �.��
AISLE WIDTHS _-- w=�-
EXIT SIGNS EMERGENCY LIGHTING _—
I
FIRE EXTINGUISHERS __
FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM _ -
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES --
STORAGE
CLEARANCE T• SPRINKLERS MI
CLEARANCE 0 HEATING UNITS 11111
REQUIRED SIGNAG --�
CHIMNEY ,
WOOD STOVE ---
FIREPLACE- •NRY
FIREPLACE-F,CTORY BUILT liar _ Mira
REMARKS: rs TO THIS DATE
r_
INSPECTOR
IN9i11P PUB
��Zr Office Use
GENERAL INSPECTIO RE vp
r� J Inspector: __
Town of Queensbury �]LJ' -'"1 Ready at[ime3(x�3 3()
Dept. of Community Development Request received: Meet:
Building& Code Enforcement I At time:
742 Bay Road
Queensbury, NY 12804 ARRIVES: a e.i j'T'37fOa p./l Notes:
(518) 761-8256 Inspector's�l Initial _ I
jy\Q'V I0Y'n '/\ r k. PERMIT if '3T
LOCATION: t P I� INSPECT ON(date): Q2J3 (
--,
TYPE OF STRUCTURE: S,' C �____Y
RECHECK
N/A YES NO COMMENTS
Footings/Piers r `\ n^ ♦
Monolithic Pour Form D rAtA 1L`L1 Y--lJO t-\ --( JTo G� lFQ1Y�
Reinforcement in Place p F S7ECp1�1 FL o The contractor is responsible for Q- Soy— l' ETT TD
providing protection from freezing UJ 11:Z0A6
for 48 hours following the placement TOT cc
of the concrete. ® F� O C7—JECC LHE)LC_
Materials for this purpose on site
Foundation/Wallpour _
Reinforcement in Place i
Foundation/Dampproofing i
Backfill Approval f
Plumbing Under Slab /
PI iPl Plumbing_
Vent/Vents in Place ✓ i
ough Plumbing_ J
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-
Pr o oVent,Attic Vent _
ranting �h? 7y-'�,��0 (1A0ci, 4,
Jack Studs/Headers _`
Bracing/Bridging Han
Joist Hangers
9 /
Jack Posts/Main Beam
Air Infiltration Ranier
Fire Separation 1,2, 3,hour_
Penetration Sealed ✓
Fire all2,3,4 hour ✓estopping
L:\SueHemingway\Buiiding Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT ,? ,r' e6' ' j'Inspector:
Town of Queensbury � / Ready at time:Dept. of Community Development Request received: / 2 0it Meet:
Building& Code Enforcement At time:
742 Bay Road i
Queensbury, NY 12804 ARRIVE V^bF1am/ E VS a 9 Notes:
(518) 761-8256 Inspector's Initial. -
NAME: Sc,AP r1-MC/8-10R PERMIT# a(OO I— 3/.3
LOCATION: /f /5/200/freL1 INSPECT ON(date): 4/7A2—
TYPE OF STRUCTURE: J
RECHECK
N/A YES NO CO I, S
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 propose on site
Foundation/W allpour_
Reinforcement in Place \
Foundation/Dampproofing
Backfrll Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Heating Rough-In_ — V , �/,(
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R- /•
Floors R- p V/ ja • \ul(b
Walls R- 1 ,`s///�
Ceiling R- ni0
Duct work or piping in
unheated spaces R-
roper Vent,Attic Vent _
Framing_ )./
Jack Studs/Headers
Bracing/Bridging _
Joist Hangers _
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation I,2, 3,hour
Penetration Sealed
ire Wall 2,3,4 hour --- _ /
Firestopping
L:\SueHemingway\Buiiding.Codeslnspec\ion-FORMS\GENERAL INSPECTION REPORT.doc
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U My Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury �/ / Ready at time:
Dept. of Community Development Request received: / ad Meet:
Building& Code Enforcement I At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE 6'^goam/ `A at&Notes: •
(518) 761-8256
-- Inspector IvInitiall.� r
NAME: ✓(j�jeyl.MrJ/4 1//eM PERMIT# 0(00
If BRo(.T /- 3/3
LOCATION: field INSPECT ON(date): 6p/2/ei
TYPE OF STRUC LURE:
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
Foundation/Dampproofing
Backlit'Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough PlumRough-
Heating Rough-Ia Jatrie
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R k ID
// C�arQ�N E \u- LE 1 (a
Walls R-
R-Ceiling R- 410
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 Scaled
Fire Wall 2,3,4 hour
Firestopping ✓
L:VSueHemingway'BuiIding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doe
OI F ��►►`'� J,
T F ENSBURY
BUILDING E CODE ENFORCEMENT
742 Bay Road 0 0,.."
Queensbury NY 12804 Vivo
(518) 761-8256 I^vq/nf
SEPTIC DISPOSAL SYSTEM INSPECTION 1 / /�//
Name C )(1 ry��( JJ
Location .tt/5 Yon hk iP (d K ,
Date Permit # .J
SOIL TYPE: Sal ay-
Results of Percolat'on Test-
(if applicable) R. e- inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tota Length 3Q
Length of each tr:nch
Depth of trenches
Size of stone Mit —.
SEEPAGE PITS; FlU
Size - ft. x� ft.
Stone life--
PIPING: Size -ype
Bldg. to Tank u
Tank to Dist. Box ' N.. lk
Dist. Box to Field/P. 1 (
Openings Sealed? es • PartialTo�6Q.�
LOCATION/SEPARATI, S
Foundation to Tank - feet
Foundation to Absorption ill feet
Separation of Pits -e
Conforms as per Plot Plan 'es o
LOCATION OF SYSTEM ON PROPE• •
(circle one)
' Left Side - Right Side
', ' + - Middle Rear
1.. o
'CCD Fi��� C\\,
<0
\) Nci)\°f �
�`�c \ ‘ 5
\
SYSTEM..USE APPROVED: YES
Arr' , . , 1' .a
D" ' MIA
;LEIflog Inspector
r '
FIRE MARSHAL
`tleis' TOWN OF QUEENSBURY
)' j QUEENSBURY, NY 12804
(518) 761-8205
ARE MARSHAL INSPECTION REPORT
REQUEST RECEIVED G ap PERMIT# deaf'Pi
NAME ///
LOCATION
SCHEDULE INSPECTION ON -.. e __ to--
M P ANYTIME
APPROVED
NIA YES I NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
ARE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM _
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS ,
REQUIRED SIGNAGE 1 \
CHIMNEY J` De �`
er- VtrAl.% ✓//
WOOD STOVE
FIREPLACE-MASONRY
)l 0REPLAC RY BUILT K 0
REMARKS: Alge- a/c_ III OK TOI
ITHIS DATE
3e$(3D1/bite . 8/ &o,562-077 6°
(I c ( C
AW
.mmPUe INSPECTOR
2- \ � 4.�
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received: /6 O/
Building&Code Enforcement
742 Bay Road y,��� �_�
Queensbury,NY 12804 Arrive J62 1° Depart •
Inspector's In'
/Lot'.
LOCATION: r � DATE
: it (3
TYPE OF STRUCTURE: '7�"Jdo
RECHECK_
N 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 site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
13ackfill Approval (-gszs t t t?
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
clnsu tios'v f-G 'l Fpa. 2" FcP.M
Foundation Wall nterior R- In
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
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road /5
Queensbury,NY 12804 Arrive am/pm Depart
Inspector's Initial 2 /1
NAME: N - ^1 PERMIT# D/ /
IACATIO : /� a(0 � n 7 DATE: /O O—BEY)
TYPE OF STRUCTURE:
RECHECK /
N/A YES/NO COMMENTS
dngsgciers I✓✓✓
Monolithic Pour F rm, ✓/
Reinforcement in 'I.•• •
The contractor is respbd§ible for
providing prote on frOm freezing
for 48 hours foil. 'ng file placement
of the concrete. I�
Materials for this pu ••se 4n site
Foundation/Wallpou
Reinforcement in Pla•-
Foundarion/Dampp • n_
Backfill Approval
Plumbing Under Slab
Numbing Venal Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls lute 'or R-
Foundation Walls E - 'or 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 Bather
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
o, ,
GENERAL INSPECTION REPORT
( 518)761-8256 (330
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road „oleo
Queensbury,NY 12804 Arrive : art
, $ �
;.%
Inspector's lni
NACSp�` Ypi\ ` � PERMIT N 3LOAION: j ln3ern
TYPE OF STRUCIURE:RECHECK
N YES.140 COMMENTS
[ings/Piers \*r CA.- 10/
Monolithic Pour Form
{(/
Reinforcement in Place
The contractor is I-ble r
providing protection fi•i • (..:zing
for 48 hours following II- placement
of the concrete.
Materials for ois pu • • on si
Foundation/W4llpour
Reinforcement t .:.:
Foundation/Dampproofi g
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i i Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls I .'or R-
Foundation Walls E 'or R-
Floors It-
Walls R-
Ceiling Ft-
Duct work or piping in
unheated spaces It-
Proper Vent,Attic Vent
Framing
Jack Studs/Headnrs
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
aI . ' <^�
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t .
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SSz�Fsrs r , ? , I I
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se• or ooserved or believe I saw evide ce o1 i
/� - col - "v 77Sitiects such x Aotjusiwells,trees, fences, I
vri on this dot guy ' esent.thaU.4ie i I 4 .
N.
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MAP REFERENCE:
PHASE II
BROOKFIELD ESTATES
DATED DECEMBER 7, 1987
LAST REVISED JUNE 7, 1988
BY VAN DUSEN & STEVES
LAND SURVEYORS
LOT 17
r r%vM mn mo IVA1L T'IGW JVI%vG1.
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 TO: MICHAEL L. & DEBORAH L MCKEE
CENDANT MORTGAGE CORPORATION,
IT'S SUCCESSORS AND/OR ASSIGNS,
AS THEIR INTERESTS MAY APPEAR
CHICAGO TITLE INSURANCE COMPANY
�� �"_ CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: JUNE 28, 2001
nDu s e
Q A
L"%/V-
Steves
Land Surveyors, LL C
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York Lie. No. 50135
UZED ALTERATRN OR ADWYM TO A "VEY
MAP WARM A UCENSED LAND SURVrIM SEAL a A
VIaAIM OF MCTION MA WS-OMBCR 2. OF THE
NEW YM SATE EDUCATICl1 LAW
aRr COPIES FROM THE ORRNIAL CF 71b SURVEY
X& S w,H AN ORmE aF ,NE LAID lURE1W"
CE W CAMIS WWAM MMN awl" THAT
``�`°��V�`�•
7MS SURVEY wts PREPARED N ACCa10ANCE w1N THE
EIOSRNO CODE OF MACML Fat LAND SURVEYORS ADQRD
o ITYTHE NE. TORN STME AS90fA1111ON a Uft"PMES9a1K
LAM SURVEYatS SAq CER7FR.A71dtS 91At1 RUN aLY
10 7HE PEI" Fat IMON THE SURVEY N PREPARED. AND
ON MS gMXj 'M THE TIME OOIPANY. OCYE MEMAL
A°�R`" AND LOOM R�TtRIIDN LISTED MMM. AND
TO THE ASSWEES'S OF THE WOW NST7 UK'
Map of a Survey made for
Michael L. & Deborah L. McKee
Town of Queensbury, Warren County, New York
Dater JUNE 28, 2002
Scale 1'=50'
S - 1
1
SHEET 1 OF 1
McKee
DWG. No. 86671-15
1 NO.
DATE
DESCRIPTION