2002-568 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERLIT IFI
CATS OF OCCUPANCY
Permit Number: P20020568 Date Issued: Thursday, January 02,2003
This is to certify that work requested to be done as shown by Permit Number P20020568
has been completed.
Tax Map Number: 523400-290-014-0001-009-000-0000
Location: 2 CLEARVIEW Ln
Owner: WAYNE&SUSAN PELAK
Applicant: WAYNE&SUSAN PELAK
This structure may be occupied as a:
By Order of Town Board
Fireplace TOWN OF QUEENSBURX
Garage-2 Cars Attached
Single Family Dwelling
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 t
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020568 Application Number: A20020568
Tax Map No: 523400-290-014-0001-009-000-0000
Permission is hereby granted to: WAYNF,& SUSAN PFLAK
For property located at: 2 CLEARVIEW Ln
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 filled
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: WAYNE & SUSAN PELAK
3678 LAKESHORE Dr Fireplace
PO BOX 33 Garage-2 Cars Attached
Single Family Dwelling 90,000.00
DIAMOND POINT,NY 12824 Total value 90,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2002-568
1959 sq. ft. single family dwelling with attached 2 car garage and gas factory built fireplace per plot plan and
specifications.
$235.08 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 06,2003
(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 expir .)
Dated at the Town of Quernsb3u ,):; ay ,2002
SIGNED BY y for the Town of Queensbury.
Director of Building&Code Enforcement
Building Pe-rmit Application
Town,�f Queensbury—Dept of Community Development,742 Bay Road, Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. - Permit File No. -5UV
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By:
application form.
Applicant: Owner:
Address: Address: �J
Phone#(_) - Phone -
Email Address: Email Address:
Property Location_ Lot Number: / House Number_1
Subdivision Name: Tax Map Number:
❑ New Building: residence /commercial Estimated Market Value of Construction: $
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ No change to exterior size: 'residence/com'l
❑ Other work(describe )
Check OccupancyIuformation 16'Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
Single family dwelling - J �J �
❑ Two familydwelling
❑ Townhouse
❑ Multifamily dwelling '
#of units '
❑ Office
❑ Mercantile
❑ Manufacturing
❑ 1 car detached garage
❑ 2 car detached garage
❑ 3 car detached garage
❑ 1 car attached garage
2 car attached garage 02°J x 3,3 5 ,
0 3 car attached garage
❑ Storage building- �-----
commercial
Storage building-
residential ` - 974 I--S-ld / !�
❑ Other `f
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
Type of Beating System: electric/ oil /wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed Number of Moodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
Plumber
Mason
Electrician
Declaration: please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that I/we shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction.
Signature: owner,owner's agent,architect,contractor
Building Permit .application
Town of Queensbury - Dear, efCouuntinity Develolnueut, 742 Bay Road, (Queelrsbury, NY 12804 1761-82561
INDTILJFJI% mrl BUILDING & CODG ''I_%NFORCEMENT
Requirements prior to issuance
rApermit must be obtained before of this permit: PERMIT'FILE NO.ning construction. No inspections . PERMIT F8E PAJt7$�ZI-e made until applicant has received Zoning Board A o)tLID BUILDING PERMIT. All Area /Use
applicants* spaces on this application RGrtT'ION FEE tIID
MUST be completed and,the signature P14W01 ig Board ACUML 02 Dz REVIEWED B _
of the applicant moat appear on the SPR / Sul1(Ilvlfll()L !Other � !lu .1L,x tnat�r
epplication form. 7h_A.._ r ,
Recreation I'ee aUie°iitOfa( �LENS
Applicant: ' nleffliC' .t
Address: t'� ,��r/1 / L�'t j Address: lip—Ae��_xP21 —1A0,6 4.to Eq-
! n'C
Phone # ( _) tC - ` � ��4` Phone #
. Properly Location:
Subdivision Names � 1 ,� jf� i �f�T�iari Tax Map Number _ G!a
t'e Section Blois l.cit
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
_ New Bui] ' n CONSTRUCTION:
esiden commercial
Addit on to Building: -.--
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Pr' ary Building -
residence / commercialSingle 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:3��.
""CC�$$f If ADDITION, what will se
1st Floor. . . . . . . . L42 4j sq. oL- new addition be? :
2nd •F1oor. `!5 sq. ft.
Other Flouts . . sq. ft.
(not unfinished•cellar or basement) tzin4v PUT
AC
TOTAL FLOOR AREA: SQ. FT. Attached Garage 1, 2 cax•�.;
e ge uildi b.
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other -�
FEET X FEET c
Foundation Type: /o�"Okc}}G, Will any second-hand or ungraded
Number of Stories : lumber be used? If so, for what?
( habitable space oryly)
Height (grade to rXdge) : t TYPE OF HEATING SYSTEM:
Number of fireplaCe}i and/o 00 star (circle all w !ch applies)
to be installed:_ cl`-' F vr-t-ri O' Gas / Wood
l e_V'orced HotD1 / Baseboard j Other
Person responsible fo superv' on of work as regards to building
codes is: vvij If
Nam Addresss Phone
Builder: 10VU
Plumber:
Mason:
Electrician:
DECLARA770N.' Please sign belmV 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, area true and complete statement of all prolx)sed 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/wc shalI 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, towing actual location of project on premises.
Signature:
(ow r, owner's agent, architect, contractor)
Application for Permit—Septic Disposal System
Towtt of Queensbury 742 Bay Road Queerrsbury,NY 12804 (518) 7614256
1, OWNER INFORMATION:
.........................................................................................._......
..........................
,..
� �� `-1 r Urric�eeUUs-e-� /
Location of installation:�.... !' ! ice'W � �" C�,�,c�`��'b
~ Tax-Map No. �l —/ -(' .S'? _ File Permit No.
Owner's Name: 44 V Fee Paid-
Address:�_.L�Y.3_3—mil 12PIAloe Aa �--1 2,W(1 ..._........................................... ............._.......................
! RE
2. INSTALLER'S NAME ; -PHONE NO. JUL 0.2 2002
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s)and multiply N�cz ' ®P OtS �i�i; LIR1
'bedrooms with applicable gallons per bellootn to equal Iota!dailyfli3i+f�ILDING AND CC)Ds=
Year of]House: Na of Bedrooms x Computation Total Daily Flow
1980 or older x 150 gal/bdnn =
1980— 1991 x 130 gal/bdriii =
1991 —present =�2-, x 110 gal/bdrm
Garbage Grinder Installed -yes / no V
Spa or Whirlpool Installed yes��/ no
4. PARCEL INFORMATION: (circle applicable information &indicate measurements)
�QD9.d3 _ l_C9 QCQ.tatirl V�aLcr_ .;,,_I3gdroek or�i�ipot'.X!4t1;:MP4'�ri511_UamCstic_Walo_r_$upj?ly
!*Ya c fit what delrth fit tvliert rielrth nnrnicrlpai
uilirr Ivarn feet —feet ' well
Steep slope e ay ifwell• water supply
_%slope other from any septic=systcnr
depth: absorption is ft.
other.
Percolation Test: (To be completed by licensed pi'c fesslotrdl engineer or archlieco
Rate: minide per Inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must-be designed by it licensed
Professional engineer or architect(unless instnUcd in a Planning Board approved subdivision). Add 256 gallons to the size
of(Ile septic litnk and leach Reid for each Gairbagc Grinder,Spa or Wltir-lpool Tub.
Septic Tank: /_1,CL.gallon(min. size I,000 gal
Tile Field: each trench y�—A Total System,Length:._� _fT.
Seepage Pit(s): number of size ofeach: ft. by ft.
Size of Stones to be used: II' delrth or thickness,—f�"_`/let
Bed System Size: x
Altemative 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 oftilo town
of Queonsbury, any permit or approval granted which is"based upon or is granted in
reliance upon any niatorial ntirrepreserrt atiou or failure toy nrako a material fact or
circumstance known by or on behalfofan applicant, shall bo.void
I have read tUP regulations with respect to this application and agree to abide by those and all
requirements of the Town o Queensbury Sanitairy Sewage Disposal Ordinance.
S gn ure o responsible person D to
TOWN OF QUEENSBURY
Richard A.Missita
HIGHWAY Highway Superintendent
DEPARTMENTHome(518)798-5127
742 Bay Road e Queensbury, NY 12804 Michad F. Travis
puty Highway Superintendent
Office Phone: e518) 761-8211 (518)798-0413
Fax: (548) 745-4466 JUL 0 2 2002
#_
DRIVEWAY.PERNULDING A CZf'J"f;tJ W(
DATE: `3v(O'L
APPLICANT NAME: w4wo pKaY
TELEPHONE NO.: (_k2fR_ LR-36
ADDRESS TO BE INSPECTED: a d ex'-" L)I'0 . L A
RETURN ADDRESS: 0- &1(, 33 _DJ()r~AA> I"T MV PJ I
Applicant must show exact location and width of driveway(s)to be connected to the highway by
placing stakes at the specified.location.
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The*
following action has been taken:
STEP 1: O Preliminary Approval.
NEED: )Slight swale
O Level with the road
Deep swale
Size pipe to be used(if necessary)
)12" )15" ( )18" ( )24" )36"
Preliminary inspection completed by —DATE
Approval by Highway Supt. Deputy Supt
Upon completion,please resubmit this approved permit for a final approval.
STEP 2: Final Approval
Rejected
DATE:
Richard A. Missita,Highway Superintendent
ENERGY CODE COMPLIANCE APPLICATION
TOM.; OF QUEENSBURy, WARREN COUNTY'
9000 HEATING DEGREE DAYS
0
Comr)liarnce Methods: R.R 71 5 Acceptable Practice Iiie"v-49
1&2 Famlly. Dwellin y
• PART 6 Thermal Rating *-
1&2 Family Dwellings; M_ult_;__.'
Dwellings (3 stories or less)
P;URT 4* = Design by Component Performance
Commercial Buildings-F.:, Rise Residential
*,Recu_;_T-es submission of worksheets
PPP NAME:
PROPERTY LOCATION:
C;"
PART 5 F_--THOD OF COMPLIANCE BY ACCEPTABLE P'i-kCTICE:
1 . Cross Floor Are=- - sa'U_a' _,-e feet
2 . T—,r=e of Heat - Elec-.ri c 0; 1 Gas
3 . Z s hu_4 Id-- na mec_*__-'id-all y cooled?ed? r/ .Yes No
4 . P c en t a a e o fa ar ea c f2 w
ana Coors Ove.;. _./under 17%
S . R-77.7=ES FOR 7N�-ZU-, , r2, 70N' G7- -_-,N =�. LOW 211-1-UST CO CS Q TO AS
_. - _A L PURE '? R �171:. 0
S_H_0-A__N-_ ON PL.A_NS
a . Ro a f
b . -E x t e-,!-_1 o r ,A r a_;I s R
C . Glazed are=--=
d . F-7xter-ior dcc=s
e . Floors ov-e= spaces
Edge of slc-_*-; on cra _- (heated bu-J", king)
R
=aSe=.e;-1t/ce_*_7a_r (above grade) R
-daIis (belo,;%r grade)
unheated Space
Se_v_-* ce (domest--f*c-) hot Nater heat.1---a device
-1 -"
cc,Mforns to e_;-X.:-clerricy per code Y==
No
Z MP=R,A T URL E• C ON.'-_';0 L MU L C dUM SETTING 1400 WILL NCT BE EXCEEDED
n.
S ca Nu-,
S _R
Fire Marshal's Office Town of Queensbury,742 Bay Road,Queens.bury,NY
(518)761-8205
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel &vented gas.appliances
Date 3�? 20 0'2,'' RFr Nf rmit N
Application is hereby made to the Building& Cgyels free g he issuance of a Building and Use
Permit pursuant to'the New York State fire Prev e i`01 and Building Code. The applicant or owner
agrees to comply with all applicable i f rrm laws, ordinan �s� 1�iYi�ns-°a�r OYonditi ins that are part of
required inspections.
p �1 ' t r=
these requirements and also will allow all ins ec
NOTE to applicant: Rough-in and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
(circle appropriate words)
Name: U) A q jqr P-e-f a.(t' Stove: wood coal pellet
Fireplace insert �-}
Address: C1 ec�y t QL j l— + ' Fireplace, factory-built: wood
OUP-0,,Qr--ice; 4 Fireplace,.masonry: wood gas
Furnace: wood gas oil
Phone:
If non-masonary applicance,please provide
Owner:
Manufacturer Name:
Address: P 0, RbX 2i Model Number:
' Chimney Information
Phone: 433(, (circle appropriate words)
Masonry block rick stone
Flue the ste size: _inches
Exact Address: 9- d o_"Uic-W LA
of construction or installation Factory-Built
Manufacturer name:
Model Number:
Note: Listed By: Number:
Construction IInstallation must
con orrn to NYS Fire Prevention &Building Indicate(circle)chimney material:
Code. Consult available Town of Queensbury
Handouts regarding required inspections. Double i+�aC 1 Triple wall f Insulated t Direct venting
rirnney Liner
t7�,�at,�r',�r.�7►,�sp�arz�Exr�R�eaat.t--�'o�.�. off[''$u��e�r�s�.a-,�,.N"�aRsr�''vz-.�:
oil III
Fire Marshal Code# $Collected $Refunded Received from(refundert to):
�f���Q"!1 address:
A 173 3389 (190) Public Safety `•�
A 233 2655 (23 ) inor Sales
DATE: �-
yia�.,.cc�wto— tOww �i�iiz�c o2 C�ry.•v"t.�
White(Applicant) / Green(Fire Marshal) / Yellow(Bldg.Dept.) / Pink&Goldenrod(Cashier's Dept.)
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Mpf of Community Development Arrive am/pm Depart
Town of Queensbury Inspector's IuitL�
742 Bay Road
Queensbury,New York*12804
NAME R, PERMIT#
LOCATION -?— DATE
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney HeightPV'VentUrect 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-offwithin 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/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight__ I
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors.
every level 14,W tol-r--)
every bedroom co
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
'/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 PlanNariance 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). j
Okay to issue permanent C/O(Certif.of Occupancy)__L I V I
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MAP REFERENCE:
CLEARVIEW ESTATES
OWNED BY
RONALD & MARY SUSAN RAYNOR
DATED OCTOBER 22, 1991
LAST REVISED JUNE 7, 1993
BY NORTHEAST LAND SURVEY &
LAND DEVELOPMENT CONSULTANTS, PC
LEGEND:
UTILITY POLE
Q GIRF = GAPPED IRON ROD FOUND
LOT 2
S82033 35,,E GIRF
t 00 O
Ch
to N
M
U)
PROPANE
TANK
O
97.5G, — 3
O h
_4 I GARAGE h
c� N
h
I N
GRAVEL 91.81'
I 1 1,41 2 STORY DRIVE
WOOD FRAME
LANDS N/F OF DECK HOUSE
CHURCH OF THE LATTER PORCH I
DAY SAINTS LOT 1
76,318 sq.ft. \
1.75 acresWELL
® \
I
W
I
242.70'
HAVILAND ROAD
an D u ,s e
\\
Ste'ves
Land Surve ors, , LL C
169 Haviland Road Queensbury, New York 12804
'UNAU
NATHORIZED ALTERATION OR ADDITION TO A SURVEY
P BEARING A LICENSED LAND SURVEYORS SEAL IS A
VIOLATION OF SECTION 7209. SUB -DIVISION 2, OF THE
NEW YORK STATE EDUCATION LAW.'
INA ORIGINAL N S THIS M'
GNLYC "A ORIGINAL
MARN07 WIfM AN OgGINAL Or T19: IAND'.AIItVCtOR1
SEAL SHALL BE CONSIDERED TO BE VAUD TRUE COPIES."
CERTIFICATIONS INDICATED HEREON SIGNIFY THAT
THIS SURVEY WAS PREPARED N ACCORDANCE WITH THE
TCODE OF PRACTICE FOR LAND SURVEYORS ADOPTED
HE NEW YORK STATE ASSOCIATION OF PROFESSIONAL
BY THE
BY
LAW SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR WHOM THE SURVEY IS PREPARED. AND
ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL
AGENCY AND LENDING EU!NDI ITKN LISTED HEREON. AND
TO me A96K.NR9 ar THE 1LNDING INsmunoNr
(518) 792-8474
New York
Lie. No. 50135
Map of a Survey made for
WAYNE PELAK
Town of Queensbury, Warren County, New York
NO. I DATE
(�o
• i OF�.iF •
9
o �w
DESCRIPTION
e1
W =c;n,
S-1
SFEET 1 OF 1
PELAK
DWG. NO. 02007
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arriv ' Depart + 'n/
Town of Queensbury ector's Ini al
742 Bay Road
Queensbury,New York 12804
NAME K PERMIT# 2-cc-0-, c
LOCATION — DATE !7 " Z T-0
TYPE OF STRUCTURE
N/A YES NO CONDAENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
to • •er32silings 30"to 36"
} erior Handrails,balconies,Ianding 18 in.or more
Interior Handrails stairs both sides 3 or re risers
Grade 2%away from foundation fi
8"clearance to sill plate -
Gas Valve shut-off expose le
ulator 1 'above grade
Gas Furnace shut-off within 30 feet or 'thin line of site
Oil Furnace shut-off at entrance to furna area
Furnace/Hot Water Heater operating1
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs 1
Basement stairs,6 ft.4 in. /
Handrail exterior stairs both sides more th 3 risers
Interior privacy/trim/doors/main entrance 6" V-U FF—
Floor Finish '� /
BathroomMitchen 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 ��Q C_�
Garage fireproofing � � Cam►-���,t��
Garage penetrations sealed � � ,-� 01
Furnace in separate room protected(in garage}
Light ventilation per room 'v �' s����� - -t
Safety glazing 18"or less from floor i)Final Electrical
Site P1anNariance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance) + --�� t
Okay to issue temp.C10(Certif.of Occupancy) ����� �� �'t�-v= �c�
Okay to issue permanent C/O(Certif.of Occupancy)
l Town of Queensbury
Fire Marshal's Office
742 Bay Road c f -p
x Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
Pi Aro_
Fire Marshal's Inspection Report
Request °� "j j? SCHEDULE
Received: Permit# INSPECTION ON: /2c"Z' -02-
Name: 7Fdal< I LI 2-� AM PM ANYTIME
Location: Ck j,a1g0
APPROVED
N/A YES NO COMMENTS
EXITS NI�
AISLE WIDTHS
EXIT SIGNS-NORMAL /^\ P r
- BATTERY 1 h l��i'��1��{r✓"�� (����� l� �U�� Q?
EMERGENCY LIGHTINGe�� °`
FIRE EXTINGUISHERS I
FIRE ALARM SYSTEM ! 1
FIRE SPRINKLER SYSTEM „� 0,0fAit,l-iiy,�a ikJ
FIRE SUPPRESSION SYSTEM s I r V
HOOD INSTALLATION
INTERIOR FINISHES I I i I
STORAGE I / t ri �{-
U
COMPRESSED GAS 1 1.4t1-/1/1 tX12Ait51.d CA'tC 7 �i
CLEARANCE TO SPRINKLERS t/
CLEARANCE TO HEATING ;+ r1
UNITS :' i ,cr lv °°°�(((j
CLEARANCE TO ELECTRICAL N._/ 1 ei, O`
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGNCHIMNEY
I
MASONRY ROUGH IN &at5 Le' r►`I A 0 �� i�`>' 11 4
FINAL 1 w Qiif p �LT/N%&, ow_ 1. tf Qii
CHIMNEY Q e �`1 ( � `
FACTORY BUILT ROUGH IN
FINAL
WOOD
STOVE ROUGH IN 1JL 442,›Zid- 0/6a DA _a
FINAL
VENTED GAS
/
APPLIANCE ROUGH IN ir - fV\aiy /lG �� eC�ir� 0_,D II k
C
FINAL ■
FIREPLACE
MASONRY ROUGH IN OK THIS DATE K FOR CO, NOT OK
FINAL �` ,i'Ia`` _
9. ' o<
FIREPLACE `%i
FACTORY BUILT ROUGH IN -- NS TED BY
FINAL
COMDEV/CHRISJ/WORDILETTERS2001/F IRE MARS HALINSPECTIONREPOR YELLOW-OCCUPANT COPY
WHITE-BUILDING DEPARTMENT COPY
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury
Ready at time:1
Dept. of Community.Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVE a p A T g�-W a pm tes:
(518) 761-8256 Inspector's Initial
NAME: t� ) �fJJ � PERMIT#-Z0-cz -m(01
LOCATION: ,. ( \�l LS� 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/W allpour
Reinforcement in Place
Foundation/Dampproofmg
Backfll Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
eating Rough-In
Irs atlon
floundation-J21 Walls Interior R-
F Fundation Walls Exterior R-
loors R XIA
-
alls 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.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
.GENERA INSPECTION REPORT Inspector:
Town of Queensbury Ready at fime,.
Dept, of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVEtN��, <am f a otes'.
n 16Y
(518) 761-8256 Inspector's Ini
In
A
NAME: PERMIT#-
LOCATION: v- INSPF.CT ON(date):
TYPE OF STRUCTURE:
RECHECK
NIA 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_
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 mi
unheated spaces R-
Proper Vent,Attic Vent
raming
Jack Studs/Headers*
Bracing/Bridgmig-
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Scaled
Fire Wall 2,3,4,hour
V.,firestopping
L:1SueHemiiigwa3�,Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doe
�� Town of Queensbury
�
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
I
Fire Marshal's Inspection Report
Request / aQ I S HEDULE ,
Received: /O/&.) 0 L Permit# INSPECTION ON: (6/311 di_
Name: &/4J - /D AM PM ANYTIME
/� i- aS�'��i�
Location: -7 N ro J r--�-
APPROVED
N/A YES NO COMMENTS EXITS / /
AISLE WIDTHS / CIkkft ix 4rdY or
A
EXIT SIGNS-NORMAL
- BATTERY _! —
EMERGENCY LIGHTING NIP;j 1 V `r 1-0` riotm 6.k5 fr
FIRE EXTINGUISHERS Mode qt 300 PO� � 7
FIRE ALARM SYSTEM 1 loll �/ I`�
FIRE SPRINKLER SYSTEM
FIRE
HOOD INS TPRESSION ALLATIIONYSTE III NM�_ •-`�j �`,l`���41, -C�� �r l oil 7�0-r
INTERIOR FINISHES ],
STORAGE .� p iVIOLCI'�"I� _ of,) � � `�
COMPRESSED GAS 0,9 tl!t C" , t
CLEARANCE TO SPRINKLER` dodv
-
CLEARANCE TO HEATING p1cJf ' '1 OK
UNITS �+ 71 , (7�% --1 ! Ule'
CLEARANCE TO ELECTRIC lik
- . Q cift' c cluclC�,to.4 `- bREQUIRED SIGNAGEEMERGENCY PLAN ■ i l �d Q5. /r � /�
MAXIMUM OCCUPANCY S ����(� J0 C L-' J J
CHIMNEY
MASONRY ROrH IN j , _ (0 i n 0 r,
FINAL \! l "\ i f vp cJ j1�I Q 1 (e c
CHIMNEY — rAa-foc-cy i 1 ! I , , 1, 17 4,,
FACTORY BUILT ROUGH IN (vim {{ 1 ` ,{ �1 ��, s+
FINAL / AI' Ft IZ� 3e D d. -, (0c�( L.
i
�1
WOOD - 5.7 c;��1 c' L l Y'am k ( e l i(IA A*y
STOVE ROUGH IN rI
FINAL 1,l j \icum,b oce e el_I C.A C y i"\rJ a_l(e,r'
VENTED GAS 1 426(
�i� ���� (� �v�APPLIANCE ROUGH IN L-'L�(1 +0 ,/j() t(rii f � ,1. 1 )J
FINAL ■ M. l `� ll ' �UC�LL tit
FIREPLACE Lam! fQ7J
MASONRY ROUGH IN C
OK THIS DATED Olt FOR CO NOT OK
FIREPLACE FINAL .et' i��( �� �
FACTORY BUILT ROUGH IN >(- INS ECTEb Y LL
FINAL
COMDEV/CHRISJIWORD/LETTERS20011F IRE MARSHALINSPECTIONREPOR Y��LOW-OCCUPANT COPY
WHITE-BUILDING DEPARTMENT COPY
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 Notes:
Queensbury, AT 12804 ARRIVE n R
(518) 761-8256 Inspector's Initia
NAME: PERMIT# 7
LOCATION: INSPECT ON(date): 1p P29
07Z--
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
Foundatioh/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In,__
Insulation
Foundation Walls Interior R-
Foundation 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/Bridgmig-
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
e Separation 1,2,3,hour
X
netration Sealed
-/ire Wall 2,3,4 hour 71Q
Firestopping X
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doe
Office Use
GENERAL INSPECTrtI)IN REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 4RRrVEhC2D_ag EPW-1-7—ba In Not s:
nitiiti(518) 761-8256 Inspector's I
NAME: ct, PERMIT# " 2..-
LOCATION: INSPECT ON(date): fd ZC 2
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
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent!Vents in Place
Rough Plumbing_
Heating Rough-In -
Insulation 11 1
4 1'-4-f-k�pj -R&V-
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R- _V!�
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridgmig--
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Are Wall 2,3,4 hour
estopping
L:\SueHemingwayiBuilding.Codes.Inspcction.FORtvfS\GENERAL INSPECTION REPORT.doc
` Office Use
GENERAL, INSPECTION ORT Inspector:
.Town of Queensbury
. Ready at time
Dept. of Community Development Request received. Meet:
.Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVEa / EP a m Notes:
(518) 761-8256 Inspector's Initi
NAME: �(il PERMIT# d -2
LOCATION: 2 11-� "V'� INSPECT ON(date): /0 Z� 6 IL
TYPE OF STRUCTURE: S7
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
Backfill Approval
Plumbing Under Slab
Plumbing VentlVents in Place
/f Rough Plumbing �i 0 ^ - -
Heating Rough-In 6•- -_
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 -
4 Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
ire Wall 2,3,4 hour
Firestopping ���,.1.6 f C.�$-�;:�a�•-� � .��"� 'C"'"�--�
L.\SueHemingway\Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPOR Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE a Notes:
.s
(518) 761-8256 Inspector's Initic s
PE T4
PERMIT#NAME: 06
LOCATION: INSPECT ON(date): VCA 0-7
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
o e concrete.
at� ,ads for this purpose on site
Foundation/Wallpour ej&�MDN-0k,3 1c)I;—
Reinforcement in Place
Foundation/Dampproofing_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing__
Heating Rough-In_
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
gaming
II 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
Firestoppffig
L:\SueHemiiigway\Biiilding.Codes.Inspection.FORMS\GENEP,AL INSPECTION REPORT.doe
Cg & &&S- 4a3(a 4 &J- . l� aIj
u�.r��� d �4 =iL' irw fl � office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: 'Tko Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE % am a: a Notes:
(518) 761-8256 Inspector's Initia
t
NAME: P ##
i
LOCATION: 21
SPE ate):
TYPE OF STRUCTURE:
RECHECK
l
1
N/A YES NO COJ.V`IMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement f
of the concrete. I
Materials for this purpose on site
Foundation/Wallpour f
Reinforcement in Place 1
Foundation/Dampproofmg f
Backfill Approval 1
Plumbing Under Slab °
Plumbing Vent/Vents in Place
Rough Plumbing _
Heating Rough-In
Insulation i
Foundation Walls Interior R- /
Foundation Walls Exterior R- /
Floors R
Walls R-
Ceiling R-
Duct work or piping in _
unheated spaces R-
-,oper
. Vent,Attic?, ntramingack Stu /Hea
Bracin ridg'
Joist H
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
LaSueHemingway\Building.Codes.Inspection.FORMSIGENERAI INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
,
Toxin of Queensbury -
Ready at time: h Yt
Dept. of Community Development Request received: q116 ltf2 Meet:
Building& Code Enforcement At time:
742 Bay Road `
Queensbury, NY 12804 ARRIVE am/pm: DEPART am/pm Notes:.
(518) 761-8256 Inspector'slnnitials�
NAME: PERMIT#� 2-- �6
LOCATION: tom(-e�ilfiJ d } �- INSPECT ON(date): f e
TYPE OF STRUCTURE: '—
Aur ad
RECHECK
N/A YES O COMMENTS
ootings/Piers ,
Monolithic Pour Form
Reinforcement in Place i
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/D amppro o fmg
Backfill Approval
Plumbing Under Slab
Plumbing VentlVents in Place
Rough Plumbing
Pleating 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
Fratnisrg
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
CQ4- 114L9 el q 17""
YOWN OF QUEEKSBURY
BUIUDING A.-CODE ENIFORCEMEN-V
742 Bix_y R"m6
X2804
SEPTIC DISPOSAU SYS-rEM INS I
Name f
Loc-a -tion
Da-tea P o r-fn i t
SORE -ry m _v and- Lo -Cla -
Rt--sul -ts on col a-tion Tos-t-
( i -F applicable ) Ra-tee-Mlnuj:�te-,/I ch
TYPE OF SYSTEM=
ABSORPTION FXEI-D: To-tal Len n h
Length of each trench nch
Dep *th oF trenches
Size o-F s-tone
SEEPAGE P1-rS : N u-Mb E?V--
Size -F-t - X -F-t
St;one size
PXPXNG : S - .Ze pe
Bldg - to -fank-
Tank- -to Dist _ Box
Dist - Box to F-ft--1d/Pj
openings Sealed ? s N 0, Pat--ti al
L-OCA7T-11ON,/SEPARA-r1Ofmd -
Founda-tion to Tank -F c--e-t
Founda -tion to Absorp lon -F e e t
Separate on o-F P -If--s -F e e-t
Con-Forms as per PI t Plan es No
LOCA-FXOH OF Sys-rEm ON
PROPERYY
one )
r-ont , - Rear- - Side - Righ-t Side
e F Y-on -t - ddl e Rea r-
COMMEN-US
SYSTEM USE APPROVED = YES) No
A v-r--f%v 4--cl At w% T- le�
D 17V
Office Use
GENERAL INSPECTION REPOW Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVETUDam- I P T ,' am /Notes:
Z7-- /-6,
(518) 761-8256 Inspector's Initial, 11 1
NAME: PERMIT# 16'Z-AW-
LOCATION: 2— C Lc INSPECT ON(date): 91246 7
TYPE OF STRUCTURE:
RECHECK
NIA 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 ;1Z
Reinforcement in Place
Fo, ati.on/Dampproofing
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
Framing
Jack Studs/Headers
Bracing/Bridgig-
Joist Hangers_
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firesto in
ppn1g-
L:\SueHemingway\Bizilditig.Codes.Inspection.FORMS\GENERAI,INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building chiA Code Enforcement t time:
742 Bay Road
Queensbury, NY 12804 ARRIVE Notes:
(518) 761-8256 Inspector's Initials,
NAME: Pe k, PERMIT#
LOCATION: 0 INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N ESA/A Y NO COMMENTS
t Footrugs/Pl:erDs �-
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
Foundation/Wallpour
Reinforcement in Place
Foundation/Darripproofing
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
Framing
Jack Studs/Headers
Bracing/Bridgmig-
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppmg_
L:\SueHemingway\Bttilding.Codes.Inspection.FORMS\GENERAT,INSPECTION REPORT.doe
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