1999-024 CERTIFICATE OF OCCUPANCY
• TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK , .,
June 7 99
Date .t:9
•
This is to certify that work requested to be'done as shown by'Permit No. 9902.4
has been completed.
SINGLE FAMILY DWELLING-
• This structure may be occupied as a
LOT 52 STONEHURST DR.
Location ; . •
SCHERMER.HORN CONSTRUCTION
Owner
TAX MAP NO. 54 . -7-5 2 By Order.Town Board
' TOWN OF QUEENSBURY
)aet,
Director of Bldg. & Code Enforcement
•
•
. BUILDING PERMIT.
TOWN OF QUEENSBURY
VALUE $ 130500 No. 99024
TAX MAP NO. 54. —7-52 •WARREN COUNTY,_NEW YORK "
•
PERMISSION is hereby granted to SCHERMERHORN CONSTRUCTION
OWNER of property located at •LOT 52 STONEHURST DR. - Street,Road or Ave.
.in the Town of Queensbury,To Construct or place a STNGLF FAMILY DWELLING •
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
•1. OWNER'S Address is
,43H HUNTERBROOK LANE •
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name.. . . r
SCHERMERHORN CONSTRUCTION
3. CONTRACTOR or BUILDERS Address •
- 43 H 'HUNTER BROOK LANE •
• QUEENSBURY, NY 12804
4. ARCHITECT'S Name
.COMMONWEALTH ELECTRICAL AGENCY
5. ARCHITECT'S Address • -
PO BOX 706
HAGUE, NY 12836
6. TYPE of Construction—(Please indicate by X)
SINGLE FAMILY DWELLING
I Wood Frame ( )'Masonry ( )Steel (
. 7. PLANS and Specifications.
•
202e•SQ FT SINGLE FAMILY DWELLING WITH 2—CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use •
•
. SINGLE FAMILY DWELLING
•
•
•
$ 255 PERMIT FEE PAID —THIS PERMIT EXPIRES February 3 19 2001 .
(If a longer period.is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) •
•
•Dated at the Town of Queensbur.y this • 3 Day of February 19 1999
SIGNED BY VithA\CAtiv1e-7,1 • for the Town of Queensbury
Building and Zoning Inspector
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 (761-8256]
NO ° BUILDING & . CODE ENFORCEMENT
TICE Requirements prior to issuance
A permit must be obtained before 1 of this permit: PERMIT FILE NO. `99.04Y
beginning construction. No inspections t
will be made until applicant has received n Zoning Board Action PERMIT FEE PAID , _),..°� -�
a VALID BUILDING PERMIT. All • Area /Use applicants' spaces on this application RECREATION FE 4 ' D/ /
MUST be completed and•the signature n Planning Board Action 41/,,�
of the applicant must appear on theSPR REVIEWED BY /�/,;
pplication form. nit ru Recreation I Subdivision Payment
I' ,.
J Fee Payment
Applicant: SG4ec e_.•!' oPN (11v►S4tvc_.4o'oiJ Owner: 5-.Ae-nni.e,/ ilaifflill,
�3 i1 5or p.
' Address: n�-L�',�!'op Z/✓` Address:
•
Phone # ( Sli3)2.? .0l ' Phone # (5/8 ) 79E3 - OG,7v
Properly lima lion: 4 - 5:2 54 Al e t oaiia'4.7. • .
;Iulullvlalon NnIH l S'i,•ue_A�r,S1- 'I'nK Mop Numlwr i -
MIlon Illoek lot
NiT.92 OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
C'" New ld CONSTRUCTION: $ '3 40 .S'o.,
re idence ommercial ,
Addi ' wilding: _
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary-Building -
residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelli � ��
Office
Other Work (describe below) Mercantile JAN
Manufacturing �j�99
1 Other TOWN®�
GROSS AREA OF PROPOSED STRUCTURE: �U ENSSUR
1st Floor /'o/o sq. ft.
If ADDITION, what will use CODE
2nd .Floor- /c /0 sq,'- f��� of new addition _be? t _
Other Floors y‹ sq. ft. .
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: - 4.. 09o9° SQ. c/ Attached- Garage 1, Qf'r
Private Storage Building
SIZE OF NEW STRUCTURE: C:344 //q Commercial Storage Building
Other •
o V
FEET X '/,2. FEET .
. Foundation Type: ai1Cte Will any second-hand or ungraded
• Number of Stories : 2. lumber be used? If so, for what?
(habitable space only) /Ura
Height (grade to ridge) : 2.4 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which appli s)
to be installed: L Electric / Oil / Gas //Wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of w k as regards to building
codes i s: Sci+e„^wte;, r.✓ 1xr+5-r , /20. 7 9 3-0(075f.
Name Addresss Phone
Builder: Sdt-wg. OXS goo€c .
Plumber: Stwe, 4l •ilk 717-5693 •
Mason: ai-- l k�toi k.) `7727/3 7/
Electrician: A4 e- 040,14r5 . �9�f- 9oS
DECLARATION: Please sign . 4 car read the statement.
below aR you have �y
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 Certificat ompl' n e being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; dr to scale, w' g a u location of project on premises.
Signature: k,1/4-
(own r, owner's agent, architect, contractor)
rt.omOv colw CUMLIAUCE APPLICATIUq
ECEVE
Tom' or QUMMWIDURY , WARREN COUNT:
r.v.c1,11.1Q_PEV REM__DA II-3'.
*. Imre
JAN 2 8 7999
Met.hodu ! •• A n Ed: P r.!n ITRAVOP QUEENs
• 17-4.2 Dw" Ilt"g"4....,T.„rr.n,p.!gY
tilkEDUSA AND
PART ( A Thrum] 101 Ling - Componnn : , 0 I.!,
rnmily Dwellingo;
OwnIllnqn ( 3 ntorlen or lenn )
PART lA - Oenign by Componnnt Pnufoumnucv
Commeroini fluildingo-111 Rinn Rnnidontinl
ARogolunn nulunionl.en TL .
1 .`e.)14 .r./14114%,-)C0(1.54.es,,6011. co fr. 1..ot 59. Sib ne.,141/41eZt
PRoPNRTY IA./CATION !
PART 5 HETROO OF COUPLIAUCE DY ACCEPTADLE PRACTICE !
1 . rftonn rloor Ai-en - nqnnun fret
"2 . Typo of Heat - Oil Con Olhou
I . In bni.iding mehnnicnIly coolnd1 Yon 'i No
'1 Pnrcentnge of nron of wIndown nnd doorn >i Over Ill Undo'. I7T .
5 . R-VAIMES FOR IlIntlhATIOH MUST CURRESPOIID TO R-VAhUr.n
1111(2W1l 0_11_111_,AUS SILOMIYTKILL _
Roof It 30
I . Enterior wnllo R . 11
c . Wont-id nrcnn
11 . Hnter.tor decitm 1•0
e . rloorn over tinhented rp1cer j
C . P.:dge of ninb on oundo ( hflo(:ed building) R - On-
y . lInnementionlinu wolln ( nbovn grndn ) R 407_// . .
h . (Innementionilnr lln wo (bnlow gundn ) it 40141.)1..
I . UnotIng/cooling-ducto-pipIng In nnhentOd nOnne It
6 . nntvion ((Iomentic.! ) hot write,: hunting dnvice
Conformo Lo pui.ittippiipi offlolency per . code w- Yec lbo
TUlIPUI TURE COHTRUL. mnitinuti pETT[NO 14(10 - HOT 11R EXCENDEI)
Applicnn n nig un Untn Phow!
719-4567y
111nPNCTOR' S UNHARKS !
•
• : • .
•
•
• •
..'..n.'.'... ,�::_ mow'. .�.y-.. .. ..1:' .-,_:......:5's F9i1Fli'g�rS,E�AP1�l .•" ' u_;3u^:`.'_'« 9 5'^:l . ��S�u:. C..:`..`..�
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
Dept. of Community Development Permit No. _ _
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: Lot 5a2 s40�e.,fi a75 21' a
Property Owner's Name: �hLgil44w //(I 71r' d t-/ CriU
Property Owner's Mailing Address: N3 �l 8 oc) L iv
Installer's Name: ,ie v v i e,f A4)/,,---��i�Si-✓ Phone # 17% --(- 6 7/
00/9
Number of bedrooms (if residential): _ 1 Total daily flow: OP
(residential - compute @ 150 gal./bdrm.)
Topography: ' flat, rolling, . steep slope o of slope
Soil Nature: u sand, loam, clay, other'/depth:
•
Ground water: at what depth?,tlfi¢ feet / Bedrock or Impervicus Material: at what depth? — feet
Percolation test: 9- not required, required [to' —1 min. per inch ] L-$5 5% p gt
Domestic water supply: municipal, f< well, crer
If domestic water supply is a WELL, water supply from any sepic absorption is Pc feet.
PROPOSED SYSTEM
Septic tank: /025v gallon (minimum size: 1,000 gal.) l
M*o
• Tile field: each trench 50 feet / Total system length: feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # / depth or thickn-cs / feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: - Size of each: gallons
(Alarm system and associated electrical Work to be inspected by a certified agency.)
For your protection, please note that pursuant to Section 136-29 of the Code of 3e Town of Quednebury, 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, . I be void.
I wive rend the regulations with respect to this a.. ._ alto ..,e lame.fse and all requirements of the Town of
it
Queensbury Sanitary Sewage Disposal Ordinanc //
Signature of responsible person: _ ,;/ lvidee Date: /--,2g-- `cy
2
TOWN OF QUEENSBURY
742 Bay Rd., Queensbury, NY 12804 I
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
r
Date 8
i"° ,19 Permit No. -' 1 } Li
Y s
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Iicant r
pp ,,, �a� ,e.Y taa".�'�t1`r` �
A �t<41 APPLIANCE (check appropriate boxes)
Address ii s il S i cc,a 4. 2.6110 0 STOVE: ❑Wood o Coal o Pellet ®"Gas
e 0 FIREPLACE INSERT
I/ t)e Y1s Li f^ ��, Zip 0 atAt ❑ FIREPLACE, FACTORY-BUILT:
❑ Wood Gas
Phone 9e 111 0 FIREPLACE, MASONRY:
0, 4 ❑ Wood .s Gas
Owner y ,i e p,.. et.J LA-A-4;7 ❑ FURNACE: ❑ Wood %Gas ❑ Oil
Address 2) �,1 ) r 4_1_,Ai; IF NON-MASONRY APPLIANCE:
Manufacturer:
(f"A) e.A r�5clt' A Zip j 5o Model:
Phone 06 7
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction _.-.,,:
❑ MASONRY: 0 Block 0 Brick ❑ Stone `.
FLUE: ❑ Tile lzr Steel- "`r' ,
Size: inches
CONSTRUCTION / INSTALLATION MUST Fp'FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION.& Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall 0 Triple Wall
REGARDING REQUIRED INSPECTIONS. 0 Insulated 0 Direct Venting
❑ Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal .. Amount Collected Amount Refunded
Code Number Title _.....
00
A 173 3389 (190) Public Safety c9.5,
A 233 2655 - - .._V(230) Minor Sales
r \ i) ) ---4------t- _
Fee Collected From-or Refunded to: ^-N, �,, ,51.,+` ''�°0.�1.. `4 '�J''1('l , '11r ,,0� L./,x l
``-----Addre"ss -'-" • r� k f ,r
Dated: i :.41 --�"-r� "� Town Clerk or Deputy: =' " - ( } l `;I , -c2
White: Applicant Green: Fire Marshal Yellow, Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
No.
Date 19_
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
(Consulting and Fire Inspection Services)
(Incorporated in the States of MAIN OFFICE:357 Elwyn Terrace,Manheim, PA 17545 • (717)664-2347
New York,Maryland,Pennsylvania,Delaware) 800-732-0043
LOCATION
Please give full and accurate directions in order to avoid delay
(Use back of sheet if needed)
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 DATE
Owner Type Bldg. C DWG ❑Othe>;„ e
Occupant Building Permit No. .. ...
Job Location - - City ° State
County Twp. Swimming Pool—New❑Old
Owner's Address ` Pool Permit No.
Directions to Job Site
Application For Rough Wiring Fixtures El Service❑ or
Work New 0 Additional❑ Bldg.—New, Old❑ Ready for Inspection
Fee Remitted Check El Cash❑ Make Payable To C.E.LS.,Inc.
LIST ALL EQUIPMENT AND WIRING
NUMBER OF ROUGH NUMBER OF ELEC.HEAT-AIR CONDITIONERS-BURNERS-DRYERS-HEATERS-RANGES,FTC_.
WIRING OUTLETS FIXTURES NUMBER TYPE OF DEVICE H.P.OR K.W. NUMBER TYPE OF DEVICE H.R.OR K.W.
SWITCHES MERCURY
LIGHTING SODIUM
RECEPT. FLUORESCENT
ELEC.HEAT QUARTZ
MOTORS:H.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
OTHER EQUIPMENT
APPLICANT'S .£,��. ..� .�,.a
SIGNATURE $�.� u a LICENSE# PERMIT#
PLEASE
PRINT NAME. - ' ' ' '';<v w d ,...v PHONE#
APPLICANTS - -_ NAME OF
ADDRESS - s " UTILITY
ICE
CITY a _ 1 STATE 1't +a ZIP CODE - _ BE OFFNOTIFITO
ED.
ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS AMP SERVICE PUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H,P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.P.. 1/20 1/12 1/10 118 1/6 1/4 1/3 1/2 314 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
MISC.INFO. DATE INSPECTED NOTIFIED POR- FEE PAID
DON LOWLANDTED a a
t Electrical Inspector CON- TOTAL $
P.O.BOX 706 TRACTOR
WORK INSPECTED OWNER CHECK NO.
R.W. SERV
(518)543-6724 0 FINAL OCCUPANT CHARGE
1-800-562-9934
CERTIFICATE NEEDED AGENT CASH
YES C7 DUP ELEC. H.O.
LT.CO.
TEMP CARD# DATE INSPECTOR
FINAL CARD#
BP/9627 Rev.1/95 APPLICATION EXPIRES ONE YEAR FROM DATE.
WHITE/Office CANARY/Officer PINK/Inspector GOLD/Customer
GENERAL INSPECTION REPORT 91-r/
(5n 8) 7 1-8256
een
Town of Queensbury
Dept.of Community Development Date inspection request received: ''''...... J
Building&Code Enforcement
742 Bay Road ,/
Queensbury,NY 12804. Arrive ' m. 9/ Depart ;
ci
Inspector's InitialNAME: K.)G.. PERMIT#
LOCAT N\`� `1. rig-.r DATE: C)
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1. I
Monolithic Pour Foz n
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this p se on site I
Foundation/Wallpour /
Reinforcement in Place /
Foundation/Dampprofi /
Backfill Approval `s
Plumbing Under Slab\
Plumbing Vent/Vents n Place
Rough Plumbing
Heating Rough-In S
Insulation ‘
Foundation Walls Int6rior R-
Foundation Walls Ext.rior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping i
unheated spaces R-
• Proper Vent, Attic Vent
Framing plc a-t t � is�A[.l, V
Jack Studs/Headers
Bracing/Bridging tFFEa1E
Joist Hangers
Jack Posts/Main Beam cbrC)._C \ Nam`
Air Infiltration Barrier
Fire Separation 1,2, 3,hour /21`C\ C
P
Penetration Sealed �
Fire Wall 2,3,4 hour �
Firestopping
4111)
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 am/pm Depart
Inspector's iti 1
NAME: 0 l () d V CX-v�'�, PERMIT# 5
LOCATION: � DATE: ob
/ '
TYPE OF STRUCTURE: - .)
RECHECK t\` ���G�
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Fo .�
Reinforcement in P .ce
The contractor is sponsible for
providing protecti s n from free-ing
for 48 hours folio' g the pla ement
of the concrete.
Materials for this pu u.se on :to
Foundation/Wallpour
Reinforcement • Placr
Foundation/Dampproo ng
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents ' Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls In erior R-
Foundation Walls E erior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces/ R-
Vent, Attic Vent
' ng F-F-A Vc-A-W7C l�R
Jack Studs/Headers
Bracing/Bridging Zj"ee FE 4
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3, hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
,,ry•,. TOWN OF QUEENSBURY
w BUILDING & CODE ENFORCEMENT
i1 742 BAY ROAD
� ,Y, QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP: M
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED:
NAME �C\ Nc\(\_0/1(
LOCATION ` 5cD -
DATE �LQ VScP3ERMIT
9 H 99-0 -1-1
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT B VENT/HEIGHT
PLUMBING VENT
\\
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILI '
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIV CY DOORS
FINISH FLOORS:
BATH/KITCHEN W.TERTIGHT
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECT CAL
SITE PL /VARIANCE REO. �d�
F L SURVEY PLOT PLAN _
OK TO ISSUE C/O OR C/C
TOWN OF QUEENSBURY
1��"+^^ BUILDING & CODE ENFORCEMENT
f' i � 742 BAY ROAD
:„ . QUEENSBURY NY 12804
(1 (518) 761-8256
1
ARRIVE: ``4 ) DEPART: R Z"ib INSP: '-
FINAL INSPECTION REPORT - RESIDENT
DATE INSPECTION REQUEST� � RECEIVED
NAME �C_44�6�t72-\“,1A R13, ,✓
LOCATION 6t1-013 ...-1\i1e,.�
51-
DATE 7 f? -�
_ PERMIT # CFI—OZ.-4
TYPE OF ST UC URE c6 cr v61 / ,c Pg C-.�
FOOTINGS FOUNDATION BACKFILL _ FRAMING
ROUGH PLUMBING SEPTIC INSULATION _
FINAL ELECTRICAL WOOUSTOVE OR FIREPLACE
N/A YES/ NO
CHIMNEY IIEIGHT/B VENT/HEIGHT Ait
/ _
PLUMBING VENT y
ROOFING Vri
• EXTERIOR FINISH '{J
DECK/PORCH/STEPS/RAILINGS y
RELIEF VAL ES 4111 Jl
FURNACE HOT WATER OPE' TIN Vl
INTERIOR TRIM"! DOOR le/
FINISH FLOORS: 1.1 V/
BATH/KITCHEN WATER I 1/
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPE• ED iiiiJJJJ/_
STAIR CLEARANCE RAIL NGS , J
SMOKE DETECTORS / _
BATHROOM FANS V,/l
PLUMBING FIXTURES V
FOUNDATION INSULATION \./ _
/
GARAGE FIRE PROOFING v
DOOR CLOSERS V /
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ. I
FINAL SURVEY PLOT PLAN -
OK TO ISSUE C/O OR C/C
•
'it ID
.T-6 z 0 LDS
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
Main Office 176 Doe Run Road-Manheim,PA 17545 147,6 ay
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No Cert. N2 64557 Cut-in Card No.
Owner .5'e(tee/2406-R 1140/2.4/ 0-0-4.4S77i
Location 4.0r67-• -573W6X41-i2- r -D4 Olarr
Installation Consisting of 3 tel 5tv/ r e g 6-3 Ra-Cerj‘ 3 ‘ CI
i i I
R.A-Ai 6 6.--e c:‘,„,,, 6,4„,,..patv,. ,,,,,,,vo, ,,,. ..P
I i i
3 PA)--At K6-3 Po 0 A- ge7241e •C-C--•
'
Installed By a'07 iC el% 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 i ctions at any time, and if its
rules are violated,the Company shall have the right t re ke th rtifi tpyr2i
Date 6-1- 9 INSPECTOR Vte..-4
1A1A.,1....1\1GPA I A GI
RESIDENTIAL FINAL INSPECTION REPORT �'w-\
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement
Dept. of Community Development Arrive229 e • * 'o.irs,ii!!
Town of Queensbury Inspector's Initi:v.- `
742 Bay Road
Queensbury,New York 12804
.st
NAME 4'Y k.5Y-N 1JXJl1� i'A,,1 —' PERMIT ti ' -00
LOCATION I rk V Q tr Or""" DATE
TYPE OF STRUCTURE < a cc.ic
N/A YES NO COMMENTS
Chimney Heightl"B"Vent/Direct Vent Location I)
Fresh Air Intake
Plumb Vent through roof ✓Roof Complete
Exterior Finish Complete /
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,lan.r ng : in. or more
Interior Handrails stairs both side' 3 or .re risers ✓
Grade 2%away from foundation ✓/
8"clearance to sill plate ✓
Gas Valve shut-off e ..-.sed/reg ator 18'labove grade l
Gas Furnace shut-off wi. . 30 eet or wi in line of site ✓ ,/
Oil Furnace shut-off at en► . 4 to furna area /
Furnace/Hot Water Heater o.'.eating ✓/
Relief Valve(s)installed — ✓`
Headroom,6 ft. 6 in. on stairs ,//
Basement stairs,6 ft.4 in. �
Handrail exterior stairs both ides more than 3 risers /
Interior privacy/trim/doors/ :' entrance 36"
Floor Finish ✓/✓/
Bathroom/Kitchen waterti: ✓
Interior Handrails Balconies anding 18 in. or more
Railing across window in s $. ells /
Smoke Detectors: J/
every level ✓/
every bedroom �/f
outside every bedroom ✓/
inter connected ✓
Bathroom fans
Plumbing fixtures 1J
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing l
Garage penetrations sealed / �/
Furnace in separate room protected(in garage) ti/
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan .k,(//
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy) if
Okay to issue permanent C/O(Certif. of Occupancy)
Ili
°' IUWN uF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name LQ
LocatiomLr, , vkikhb1/
Date " I I- � r�a Permit - L-1
SOIL TYPE: Sand Loam Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length 3b�(
Length of each trench .r,r- Cow'
Depth of trenches Ic "
Size of stone zk Z_
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size \
PIPING: \
ype
Bldg. to Tank \ _ ze c- )
Tank. to Dist. Ek _
Dist. Box to Fie\d/Pi tit
" ��G
Openings Sealed Ye , o Partial
LOCATION/SEPAR4 IO
Foundation to Tank ' _ `T feet
Foundation to Absorption -'� feet
Separation o Pits feet
Conforms as/per Plot Plan Ye No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear Left Sider- Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YES NO
Arrived: r° A.
Dep a r .. gIp` atm --_
Al
. / A. i 1._.....'
Building I p•ctor
GENERAL INSPECTION REPORT
Town of Queensbury CJ
� ry
Dept. off Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive2f-C:am/pm Depart7a m_
Inspector's Initial-
NAME: PERMIT# 1 (
LOCATION: 57, r• 1 DATE : L)—/ (c7—411
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is rel.'nsible f$
providing protection :u --'ing
for 48 hours following the p a -
of the concrete.
Materials for this purpose on si
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Hearing Rugh-In
- on \_,-'-3A— Of 7l FLOC _ ��\t CU6�) . D`c�J� �G T) T B_ 6�U1
Foundation Walls Interior
Orior R- U) ta LL
Foundation Walls Exterior R-
Floors R-
Walls R- 'cl ‘//
Ceiling R- ?,) V
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 REPORT211/11
Town off Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 1•ay Road
Queensbury,NY 12804 Arrive\V-(' am/pm Depart\\
Inspector's Initials. •
NAME: ,riNQ It (\N(\
PERMIT#
LOCATION: y� 5 Q 1A fIJ DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Plac
The contractor is re nsible'for
providing protectio from freezing
for 48 hours followi the placem t
of the concrete.
Materials fortnk.purpo on site
Foundation/Wallik
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
i Plumbing Under Slab
Plumbing Vent/Vents in Place
N'R 151 II Plumbing l
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
4,--11_57.
GENERAL INSPECTION REPORT
Town of Queensbury
Dept, of Community Development Date inspection request received: g
Building& Code Enforcement
742 :,ay Road ' d?)
Queensbury,NY 12804 Arrive am/pm Depart ' pm
Inspector's Initials
NAME: r=� G4.`SQ"/,‘ PERMIT# 7?.1—
LOCATION: ,i S2 5 e.Z r K DATE : 12'
TYPE OF STRUCTURE: 7
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 o site
Foundation/Walur
Reinforcement in Plac.e
Foundation/Damppr.•1 g
Back:ill Approval
Plumbing Under S •b
Plumbing Ven ents in Place /c ?LET _ C `� C cK,
fleatugh Plumbi. V os-rkcf_- � � tOLA_T_ 5
ing
Rout' -In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in 1-6unheated spaces R- K
open Ven Attic Vent n4r
raming 1�z1 ,2�2 S
Jack Stu ers ✓`'
Bracin • ging
Joist Hangers f
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
Town of Queensbury
Dept. of Community Development Date inspection request received: -/l-7t 1
Building& Code Enforcement
742 Day Road
Queensbury,NY 12804 A r•• am/pm Depart- ' pm
Inspecto 's Initials
NAME: -SLI-v2Trt,,.et' k PERMIT • qq—D
LOCATION: ��, n► l. DATE : a-(( -�
TYPE OF STRUCTURE: cceD
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
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 py
Foundation/Dampproofing
/ackfill Approval / �"t
lumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interio R-
Foundation Walls Exte '•r R-
Floors R-
Walls R-
Ceiling R-
Duct work or pi.'ng in
unheated .,; -s R-
Proper Vent, A c 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 P\1Y
` 1
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road 0
Queensbury,NY 12804 Arrive am/pm Depart L.i
Inspector's Initials
NAME: PE' 10 • • 0.9'9
LOCATION: D• :
TYPE OF STRUC _-
RECHECK
N/A NO COMMENTS
'' otingsg 1j 1
Monolithic Pour Form _ lAt)ReinforcementinPlace2 '
The contractor is responsible for V
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 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
•:r, FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
720. r;. (518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT#
NAME A3\ L��
LOCATION
SCHEDULE INSPECTION ON
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTING ISHERS
FIRE ALARM SY ' 1i
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYS+EM
HOOD INSTALLATION
INTERIOR FINISHES __
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO EATING UNITS
REQUIRED SIGNAGE
CHIMNEY
I
WOOD STOVE /
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT cfQW..,
REMARKS: 1OK TO THIS DATE
INSPSLIP.PUB INSPECT
. )ci'e , ,MPr)--10 r,AJ CO,q.5 i r LK)r'C,J,d (Jo c p „
14
'I have seen or observed,or believe I saw evidence of,
all objects such as houses, wells,trees,fences, c
shown on this document. I also..represent I have
onally me sured the distances set forth on the diagram..
•
SIGNATURE DATEF .
. . • • .
60
r
LS
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io
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- F-,00-1 ,A1 ; ,0 6 ° ill' EVE®
i c�e•% 0A ; r✓ / JAN 2 8 1999
d TOWN OF QUEENSBURY
!g ec� r' >M BUILDING AND CODE
i
MAP REFERENCE:
MAP OF SECTION TWO
STONEHURST
DATED: JULY 29, 1987
LAST REVISED: JANUARY 25, 1995
BY: VAN DUSEN & STEVES
LAND SURVEYORS
LOT 54
an D u sF e
.,�
& Steves
Land Surveyors, LIJC
37 Chester Street Glens Falls, New Yo7k 12801
(518) 792-8474 New York TAc. N . 50135
3
M
N
•` 0
04
0 N
Z
U
SST
c�T 01`1E _
'LRIAUMORM ALTERATION 00 ADOMON 70 A SRTVEY
MAP WARM A LICENSED LAND SURVEV01! SBAL IS A
"C A71011 W SOMM 72M. 2111-DM9W 2. OF IM
NO VON STATE EDUCATION LAW
'WILY CWIES FROM VIE MIN& OF TINS SURVEY
MARNED 1MTN ML CRIMINAL. OF 7W LAIN SURVEYORS
SEAL OWL ME COIgIDORD TO S! VALE) TIME COFlES.'
"MVICAMM NDICAIEO HEREON SONY THAT
It" SSVEY MNS PREPARED S ACCORDANCE WIN TIE
EIMIMD CM OF FRAcncE FOI LAND SlIIIMM ADOPIED
BY I E NEW VONL RATE ASIMAYN I OF FROIElMCNAL
LAND SURVEYOR SAID CEWTF1CAINVIS SNARL RUN ONLY
70 1W FETIMN FOR MIIOM 71E SURVEY 0 PREPARED. AND
ON HIS BD MF 70 SE TALE LIOE~A WOMRIMAL
MERCY AND LENIONG O nTMICH LWU NEIIEON. AND
TO TIE AISICNEES OF 71E LE1NR10 RMWIRCII.'
N05' 91 50"E
230.44'
LOT 52
1.23 acres
1-1
OIL TANK
N
LD
�- -21
R_372.01
DRI V.E
.' A NEIy )10,0
p° .
C.
Map of a Survey made for
WELL
— 83.19'
.2
W I
MARK & LORI BLEIBTREY
Town of Queensbury, Warren County, New York
AS PaR MAP RLPBREAWN
NO. I DATE
LOT 50
q�-off.
RE EIVE
JUN 0 7 1999
TOWN OF QUEEN BURY
BUILDING ARID CODE
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 TO: Marts do Lori Blelbtrey
Trustco Bank National Association, Its
successors and/or assigns
First American Title Insurance Company
of New York
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: June 7, 1999
DESCRIPTION
el JUNL /, IVVV
le 1'=30'
S-1
SHEET 1 OF 1
BLEIBTREY
DWG. NO. 83154-52
N
1