2000-248 j
TOWN OF QUtENSBURY,-
742 Bay Road,Queensbuzy,NY 12804-5902 (518)761-8201
Community Development-Building&.Codes {518) 761-8256
CERTIFICATE OF, OCCUPANCY
C/O.Number: 0000248 C/O Date: Wednesday, August 09, poo
Application Number: 2000248
Permit Number: 2000248
This is to certify that work requested to be done as shown by Permit Number 2000248
has,been completed.
This structure may,he occupied as a Single Family Dwelling
Tax Map Number: 523400-048-000-0008-008-000.-0000
.Location: SURREY FIELD Dr
Owner: MICHAELS GROUP,L.H.C., THE.
BY Order of Town Board
TOWN OF QUEENSBURY
D o uil ode Enforcement
BUILDING PERMIT
Town of Queensbury,742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 139900 Building Permit No. 2000248
TAX MAP NO. 4 8 . -8-8
MICHAELS GROUP,THE L.L.C.
Permission is hereby granted to
LOT 8 #52 SURREY FIELD DR.
Owner of property located at
SINGLE FAMILY DWELLING
in the Town of Queensbury,to construct or place a
at the above location in accordance to 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.
1818 r'134APTERT. 9, SUITE 3
LAKE GEORGE, NY 12845
Contractor or Builder's Name:
MICHAELS GROUP, INC.
Contractor or Builder's Address:
JIM CHANDLER, PROJECT MGR 10 BALCKSMITH DR
MALTA, NY 12020
Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK BOARD OF FIRE UNDERWRITERS
Type of Construction: SINGLE FAMILY DWELLING
Plans and Specifications:
1518 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
SINGLE FAMILY DWELLING
215 May 8 2002
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
(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.)
8 May 2000
Dated at the Town of Queensbury this Day of
SIGNED BY -LZA5Z— for the To"of Queensbury
Code Enforcement Officer
Building Permit Application
Town of Queensbury - Dent. of Community Development, 742 Bray Road, Queen.s•buru, NY 12804 1761-82561
�j BUILDING & . CODE ENFORCEMENT
DTCERequirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE No, _q) o- i_
beginning construction. No inspections PE12M/T FEE!'AID
will be made until applicant has received 0 Zoning Board Action
a VALID BUILDING PERMIT. Ali Area /Usc RECREATION FEE P �f�
applicants' spaces on this application
gf57
MUST be completed aftd•the signature Q Planning Board Action REVIEWED BY.- A�
of the applicant-must appear on the SPR / Subdivision /Other I3uikting /ns�ectnr
plieation form, rn�.t Recreation Fee Payment
Applicant: T"'E ti�tlGricit°\S tet�c�p Owner:
Address:� ^CI[ lt �.�a. tXt ��a,�\E �Lt�'2C`� Address:
Phone # ($'Z^) g � - ( ��-- Plronc #
Property Location:
Subdivision Name '
--Tax Map Number
t Section Block I nt
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ 13 9C)b
residence / commercial
Addition to -Building: .
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building --
residence /` commercial X Single Family Dwelling
Residence / Commercial Two Family Dwellin.gm
no change to exterior size Family Dwell!_a4gf � ED
Office
Other Work (describe below) Mercantile APR 2, 7 2000
Manufacturing
Other. f:)',".,Y this'=i ss1=i' y�tJ6�Y
GROSS AREA OF PROPOSED STRUCTURE: '7�0 Bi.fEt_�3ii a F 9:tI3 GO
lst Floor. . . . . . . . Is_/F sq. ft. `3-y 1£ ADDITION, what will use
2nd .Floor. .. . . . . s f.t. of new addition be? :
1--"Other Floors . . . . . sq. ,_
(not unfinished cellar or basemen ACCESSORY BUILDINGS:
Detached Garage 1, r
TOTAL . FLOOR AREA: /�/� SQ. FT. _ZC_ Attached Garage 1, car
Private Storage Buil x g
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
FEET, X FEET
Foundation Type: Will . any. secjond—hand or ungraded
Number of Stories: ) lumber be used? If so, for what?
(habitable space only) Vkc>
Height (grade to ridge) : 15, feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or wooastove• (circle' all which a plies)
to be installed: Electric / Oil / as / Wood
Forced Hot Air j Baseboard / Other
Person r ,, ponsible for supe ision of work as regards to building '
codes s ;
Builde
Na'D e A dregs ` 2�Phone _ ll
O
Plumber: tJ u s _ t • '�2t� �2 ,
Mason: 1
Electrician: �. e GLrL. 27L
DECL.4RAMN.- Please sign below ajler 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, an AS BUILT PLOT PLAN, by
a licensed sin-vey • drawn to scale, sh(owi_ng fp�r-oject on premises.
Signature:
(ow er, owner's agent, architect, contra tor)
Application for Permit—Septic Disposal System
76wit of Qlfeellshilly 742 Ijay Road Queensbury, N)' 12804 (518) 761-8256
1. OWNER INFORMATION:
...............................................
Office Use
Location of installation.: <e r.D4-06 IP9- -(Lc�l B')
Tax Map No.
File Permit No.
Fee Paid
Owner's Name:TE VA�A,Caj 5 Q-11Rn
.......... ......................... ........................... ..............
Address:
2. INSTALLER'S NAME PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 9 bedroom(s) and multiply# of
bedrooms with applicable gallons per bedroom to equal total dailyflovv)
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrin =
1980- 1991 x 130 gal/bdrin =
1991 —present x 110 gal/bdrin
Garbage Grinder Installed yes_ no X
Spa or Whirlpool Installed yes_ no ;<
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
TQ o Yra i Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
447at — 7 at what depth at what cleptI7
Rolling loaln
3Q feet —feet
Steep slope clay }Pater supply
—Vo slope other ,from atry septic-system
depth: absoiption is
other
Percolation Test: (7b be corthpletect by licensed professional ethgitzeer or architect)
Rate: Ininitte Pei,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: I� gallon (min. size 1,000 gal.).
Tile Field: each trel'?ch jt. Total System Length: IC09, - _j?.
Seepage Pit(s): number of size oj'each: fl. by-ft.
Size of Stone to be used: 11 depth or thickness
Bed System Size: X
Alternative System: length and,or size
6, HOLDING TANK SYSTEM: (if.required)
Number oftanks: 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 pert-nit 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 belialfofan applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
--A L6 4��
SigrYature of responsible person ate
TOWN OF UUEENS8URY '
Fee Paid
BUILDING & CODES DEPARTMENT
PORCHAPPLICATION FOR:
ES—DECKS—DOCKS & BOATHOUSES Est' Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF TH[ FOLLOWING:�
The undersigned hereby applies for a Building Permit tn do the follo*ing work which will be
done in accordance with the description, plans and spocifications submitted , and such special
conditions as may be indicated on the per/oit. 'TWO_SETS_Op STRUCTURALLxM3S|/ALL* UE SUBMITTED
WITH THIS ''---�----'
Owner of Prop
P.O, Address
Property Location Tax Maly #
3ubdfvis'ion Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:'
'
.Name Address Phone#________
BUILDING SPECIFICATIONS:
^ Type of work to be done; 1W Dock Boathouse (Circle one)
Size' of Structure to be built (squ-�--
are, footage) : `
Foundation Material : Width Thickness
Depth of Fo0ting, below grade;
Size of Posts or. 3tuds: x _________ p --�--- Long
Size of Floor Joists: ' ��-----
x x ________ Span
Decking or Flooring Material :
How will Porch or Deck be fastened to building?
If Roof Will Be- Installed, Answer rv/ /vx/nO Questions:
Size of Posts or Studs: x '
^ x Long
Roof Rafters: x Spacing Span
Roof Trusses (pre-engineered spacing) : Span
^ Other --------
Type of Roof Sloped Flat Shed 0 / ---- --------
. a e (Circle one)
Material of Roof:
ZONING INFORMATION:
T140 -PLOT PLANS MUST BE PREPARED AND
drawn reasonablyhere -' �� = clearly ~.= " ',^/ox t/yo / / ou� /
to scale and attac
hed
dings, weerexisting or proposed andindicate all set back dimensions from property lines. Show location of water supply andl»catinn and configuration of septic disposal ar�ea,
Size of Property; ft, x ft.
Existing building(o) / Size ft' x ft.
��----�
Size � ft. x ---- ft
Use of Existing buildfng(s) :---- ^ ---- ^
Proposed structure, distance from
-
Front yard ft. R property � �'-'
. Rearr yard ft
Side yards ------' . and . ft
s ft. d ------- ^
n
If on corneT��-setback from '
�ue street� ft.DECLARATION
togetTorthetbest of my knowledge and belief the statements contained in this applicvtion
of al '.eproposedx/ nzneovkans and specificationssubmitted, are a true and complete statement
`
Building tverZozonue0 one on :he described premises and that all provisions of the
.b Code, '' Zoning Ordinance, and all other laws perxuinin9 to the proposed work
he
shall li d specified or n P »
owner, - -` ~'' authorized
DATE'
, SIGNATURE
. '�-� - ''�`.~� , ~' ".. "r�`,� ^vo^r*ctor
REVIEWED BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE
Fire \Icttshal's Office TONN•n ot'Qyee list)ury, 742 Bay Road,Queensburv, NY
(5,18) 701-82ff;;
Application for Fuel Burning Appliances &. Chimneys:
,applicable to solid fuel & vented gas appliances
Pertirit No.
Application is herebl,arcade to the Buildim, Cordes Office f n-the issttence of a Buittlutg anel Use
Peruutpttlsuant•to the Nett, York Stute Fire Prevetitit�lt cute/1311ildijtg(`v{!c. 77tc ctlrpl ccrttt or of+ttcr
rtgl ees to comply irith all applicable'lai*i di is, ornances; t%gitdcai•orts, cuatl r it z011clitions that are part of
these t erltut<entenls curd also will allow calf utspecto s try Mittel'PPe",ises 10 perfvr-nt,r-equired insl7ections.
NOTE to applicant: Rough-in and Final Inspections are required.
ApfAimit Information Ftiel Burning l� 'flaIice II1fo.I'matiotl
(circle appropriate words)
Name: l y� - � Stove:; ttJoocl coal pellet gos
Fireplace insert
Address t � � Fireplace, factory-built: wood �-£ . s
{�/j
° 0•w TYwsr jy`Tk
Fireplace, masonry. wood �is
Furnace: ivoocl ct oil
)~'hone: eq
.
' ""• If volt-rl7asonaryu" lcance; please}provide
Owner: Mattttfacctrer Name:
Address: Model Number:
Chimney Information _
Phone: (circle appropriate words)
t Masonry block' brick stogie
Floe the cel"
size.• inches
Exact Address: e � r ° Ali
ofcorastrtteti°oit of ulst�dlatirtlr NaGtOry-Built
Manufacturer tame:
Model Number:
rVote.: Listed By: -Number:
Construction Ilnstallation mast
con o1-111 to ATS Fire Prevention &Building Indicate (circle) cliinitley material:
Coale. Consult amilable Ton of Queensbu'ry
Handouts,regarding reCjuire' d inspections. Double,ivall Triple it-a/l� I Itrstticlferl /,' Direct ventlrt�*
Chimneu Line
i �'a:,t�be.�er',�.7��,g:a ��t--�."'o�1sr.�t, .�.f Qu+��Bs,�,baa�r-y, N��r-•�E''o.�-dam' n . 1 F
Fiz'cr tl'lnrslicil Corle,rJ S Collected 4 Re Recc tt•erl fi onr l'e jiurrlceJ try): � � �t?1611
,� t
address:
—
.-t 13 3389 (190) .Public Srtfen•
.4 23.3 2655 (230) Milo;,Scales � 4
' ¢1ty �.R't-N:'CG-�(K3.NF>ti L/U S•t'Ll'3'L �G
White(Applicant) Green(Fire?,I irMia 1) 1 - Yeltmv(l31d<g. Dept.) Pink&Goldenrod(Casliier'sDept.)
THE NEW YORK BOARD OF FIRE UNDERWRITERS IIa .c
BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038
Date AI.IGllST 1 ,2M Application Na [ a!r`ro;Jm4! A ! 897
THIS CERTIFIES THAT PERI`LN Nt . ��"� -2411`, '
only the electrical equipment as described below and introduced by t e applicant named on the above application number is in the premises of
14,, I:ITCRAELS GROUP, S2 8041i. I flh'1118 I11".ro r P0,11410 8)
in the following location; rr Basement 0 1st Fl. 0 2nd F). t9 ' Section Block Lot
was examined on AIII(AI4'T 10 r�,Okk and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING OECKS OVENS DISH WASHERS EXHAUST PANS
OUTLETS INCANDESCE FLUORESCENT OTHER • AMT. K.W. AMT, K.W. AMT, K.W, AMT. KX AMT, H.P,
34 4i 311 1
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS M SYSTEMS I-OUTLET
DIMMERS AMT. K.W, OIL H.P. GAS H.P. AMT, NO, A.W,G+ AMT, AMP, AMT, AMPS, TRANS AMT, I H.P. NO.OF FEET AMT. WATTS
SERVICE,DISCONNECT---NO.-OF E_ R�..—__ V—_ __I� C. E -
METER NO,OF CC COND. A.W.G. A W.G. A W.G.
AMT. AMP. TYPE EQUIP. 112W 10 3W 3!3W 3 E 4W pER OF CC.COND. NO. HkEG OF NI�LEG NO, NEUTRALS OF NEUTRAL
OTHER APPARATUS;
SMOKE pETBICTOR r-6
BLIXT, LIC.#20:1, L
VI:UIAH Cl. MCPARTI', M GENERAL MANAGER
246 JAPTTRY ST.
Per 239
This certlfloate must not be altered In any manner;return to the office of the Board If Incorrect.Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depart
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New York'12804 -n
NAME "`�iLH.�K�c.S �iV' PERMIT#
LOCATION DATE
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney Heightl"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation VX
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans'
Plumbing fixtures
Foundation insulation
%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 leK&— ,000r
Final ElectY ical
Site Plan/Variance req red( A
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certi£of Occupancy)
Okay to issue permanent C/O(Certif:of Occupancy)
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MAP REFERENCE:
SURREY FIELD SUBDIVISION
MODIFICATION TO AN APPROVED SUBDIVISION
DATED: OCTOBER 27, 1998
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
� an Du s e
Stever
Land Surveyors, LC
169 Haviland Road Queensbury, New York 12801
'518) 792-8474 New York Lic. No. 50135
�vo
S?8� 7A04„e
105.00A
8
9744.07 sq ft
30.9•
0
Ri
14AS
s
r
UG 0 8 2000
7
w N
6 t A; 1 A
'UNAU7HORIAENSIEDLALTERATION OR ADDITION TO A SURVEY Map of a Survey made for
NAP BEAPoNO A LICENSED LAND SURVEYORS SEAL IS A
VIOLATION OF SECTION 7209. SUS-DMCOI 7. OF THE
NEW TORN STATE EDUCATION LAW
•ONLY COPIES FEW THE DPoOINL OF THIS SURVEY
NARIOD WTIN AN ORIGINAL OF THE LAND SURVEYORS
PIES TEAL SHALL BE CONSIDERED TO VALID TRUE CO• TWI LLIAM B . & SAN D RA R . L4 N GW 4 RT H
CERTIFICATIONS INDICATED NUMM 5N00" THAT
THIS SURVEY WAS PREPARED IN ACCORDANCE VMiH THE
AS FTING DOPE OF PRACTICE FOR LAID SURVEYORS ADOPTED
BY THE
NEW YORK STATE ASSOCIATION OF PROFESSIONAL
LAND SURVEYORS SAID CEATP'ICATIONS SHALL RUN ONLY
TO THE PERSON FOR UM THE SURVEY IS PREPARED. AND
ON HIS BEHALF TO THE TITLE COMPANY, OOVERNME NTAL
TO THE AND LENDING ITHE LENDING
LISTED HEREON, AND Town of Queensbury, Warren County New York
TO THE ASSWEES of THE LENDING INSTITUTION.' T P
NO. I DATE
H.O.A.
VILLAGE
GREEN
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: William B. & Sandra R. Longworth
Chicago Title Insurance Company
Cohoes Savings Bank, its successors
and/or assigns
CERTIFIED BY.• — _
MATTHEW C. STEVES, LLS NYS 50135
DATED: July 26, 2000
DESCRIPTION
Scale 1'=20'
S --1
94W 1 OF 1
LONGWORTH
DWG. NO. 97061-8
TOWN OF QUEENSBURY
QUE!aMSE3UFRY, NY 12804
(51 S) 761-B205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
LOCATION S PERMIT # -a-r->00 -
SCHEDULE INSPECTION ON
AM PM
APPROVED
NIA YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTI G
FIRE EXTINGUISHER
FIRE ALARM SYS TE
FIRE SPRINKLER SY TEM
FIRE SUPPRESSION YSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO S RINKLERS
CLEARANCE TO H TING UN I S
REQUIRED SIGNAGE
CHIMNEY
WOOD STOV E
W-FIREPLACE MASONRY FACT Y BLT.
0 OUGH-IN 04
FINAL
REMARKS: OK TO THIS DATE
INSPSUP.PUB INSPECTOR
GENERAL INSPECTION REPORT
(518) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay-Road /jJ
Queensbury,NY 12804. Arrive am/pm Depaft ` I pm
Inspector's Initials
NAME: L vls PERMIT#
LOCATION: DATE:
TYPE OF STRUCTURE: '
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form 7
Reinforcement in Place �� ;
The contractor is responsible for i
providing protection fromhreezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site {
Foundation/Wallpour '\
Reinforcement in Place .
Foundation/Dampproofing
Backfill Approval p'
Plumbing Under Slab
Plumbing VentlVents in Place
Rough
Heating Rough-In +.
��-,Asulation
Foundation Walls Interior R
Foundation Walls Exterior R
Floors R- f �
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attie 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 REPORT
(51.8) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road ,,
�A-rrive am/�r Depart ax m
Queensbury,NY 12844. / p � p p
inspector's Initials
r'
NAME: iL PERMIT# `
LOCATION: DATE:
TYPE OF STRUCTURE: `
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place t
The contractor is responsible for "k � �
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour ;c-
Reinforcement in Place
Foundation/Dampproofing h
Backfill Approval
Plumbing Under Slab
Plumbing VentlVents in Placeo,
Rough Plumbing
Heating Rough-In. d�
Insulation
Foundation Walls erior R-
Foundation Walls en R
Floors R
Walls R-
Ceiling R-
Duct work or pi ing in
unheated spa es R- ,
Proper Ven A ' ent
rig
Jack
Jack Studs/Headers �
Bracing/Bridging
Joist Hangers
Jack Postsllvlain Beam
Air hifiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Scaled
Fire Wall 2,3,4 hour
Firestopping
FIRE M^F::?.Ic3"^L-
-FCDWN OF C)UlEIENSE3UF;ZY
C;2UE=-E-=N,----E3UF2-Y, M-i- 12804.
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATION 'Aa
SCHEDULE INSPECif.-(C:D:�) q ON
APPROVED
N/A YES : NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMEROENCY LIOHTINC3
FIRE EXTINOUISHERS.
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM""', it
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS-;
CLEARANCE TOw HEATINC3 UNITS
REQUIRED SIC3NA,,GE
CHIMNEY
WOOD STOVE
FIREPLACE F-I MASONRY [FACTORY BLT--� '-.
[TROUGH-IN
FINAL/
REMARKS: tv<VOK TO THIS DATE
INSPSLIP.PUB INSPECTOR
(518) 761—$256 GENEIt4.L INSPECTION REPORT
4
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804. Arrive/4 am/pm Depart am/pm
Inspector's Initials V�
NAME: PERMIT# c .��!✓G� �,
LOCATION: `:� -e� r DXTE:
TYPE OF STRUCTURE:
RECHECK-
N1A YES NO` COMMENTS
Footings/Piers 1 7
Monolithic Pour Form
Reinforcement in Place d,
The contractor is responsible for
providing protection from freezing t .
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
FoundationNallpour t
Reinforcement in Place
'F.oundation/Dampproofing
Ba''ckfill Approval
Plumbiii Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing.
Heating Rough-In"*,
Insulation
Foundation Walls Inte&x R
Foundation Walls Exterior`1Li
Floors R-
Walls R-
Ceiling R-
Duct work or piping in ~� 1
unheated spaces R-
Proper t, Attie,VetXlo 4es) v4
Frpftz
Jack Studsllleaders � �td
Bracing/Bridgiri; , N rlS3 ,f
Joist Hangers C c Ste,
Sack Posts/Main Beam "`'"'�,
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
GENERAL INSFEC'TfON REPORT �U
{51$} 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement \
742 Bay Road 1I
Queensbury,NY 12804, Arrive am/pm Depart
Inspector's Initials
NAME: M PERMIT# "t
LOCATION: DATE:
TYPE OF STRUG'
RECHECK
N/A YF41NO COMMENTS
otings e s 1
Monolitlu our Form?
Reinforcement in Place
The contractor is responsib a for
providing protection from ing
for 48 hours following the place ent
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
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
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GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qlueensbury
Dept.of Community Development Elate inspection request received:
Building& Code Enforcement --r�
742 Bay Road
Qucensbury,NY 12804 Arrive am/pm Depa , am/pm, ,r
Inspector's Initials J O•�-�'"
NAME: PERMIT#
LOCATION: DATE :
TYPE OF STRUCTURE: v V
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pou Form
Reinforcement z Place
The contract r is responsib e for
providing pro ection from fr czing
for 48 hours f Ilowing the p cement
of the concrete
Materials for this urpose on ite
Foundation/Wall ur
Reinforce Ientin lace
iumbing
undat a m Ing
ill Approval
Under SI b
Plumbing Vent/Ven in Place
Rough Plumbing
Healing Rough-In
Insulation
Foundation Walls Int rior. R-
Foundation Walls Ext rior R-
Floars R-
Walls R-
Ceiling -
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
T® i OF QUEEMSBURY
BUILDING & CODE ENFORCEMENT
742 Ba_r Roa 6
Qu4--ennr .-b v-_V MY X2804
(5 18) 76I-82.56
SEPTIC DISPOSA►E SYSTEM INSPECTION
Name
Loca-tion
Date APe rm1 t #�
d
SOIL TYPE : Sand- Loam- Cl ay-
ResuZ -ts of Percol ati on Test-
( 1 -F applicable ) Rate- M`i nu-Ge/ Inch
TYPE OF SYS-rEf4:
A►BSORP-FI OK F1 EED : o t a l [ n g t h
Length o-F each tre ch
Depth of trenches
Size of stone
SEEPAGE PITS: N
Size - f x ft _
Stone size _
PIPING: Size Type
RI clg . to Tank
Tanis to Dist - Bo.
Dist- Sox to Fie d/P -i t
Openings Sealed ? Yes No Party al
LDCATI CW4ZSEPA.RIT OHS :
Foundation -to Ta k -Feet
Foundation to Ab orp t-i on -feet
Separat-ion of" Pik -fee
Conforms as per "P ot" PI an Yes No
t- CA-TION OF S 'S I E91 ON PROPER-FY
( ci rcl e one )
Front - Rear - Left Side -- R-ight Side
Middle Fv-on t - Middle Rea r
CDMMENTS
SYSTEM USE APPROVED ; YES tJ
A r-ra +v ed
Deep a r-U-+ad
Bc1z 3 d� ng I nspector
G)r n\
G`ENDUL 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 � U
t. A Inspector's In'itti s jf
1al .-�-
NAME: W l��G AcGG't,� i PERNUT# v v 2-0
LOCATION: t-s_ DATE:
TYPE OF STRUCTU E f l
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1
Monolithic Pour Form
Reinforcement in Place
The contractor is respo ible fo
providing protection fr freezi g
for 48 hours following a place ent
of the concrete.
Materials for this purpose n site
Foundation/Wallpour
Reinforcement in-Place
Foundation/Dampproofing
Backfill Approval
Plumbing Un er Slab_
g Uen nts,n e......__.. _ _... .
lumbin
o UTnl9in Pc"1 L �J
eough-In
Insulation
Foundation Walls Interio R
Foundation Walls Exterio R-
Floors R
Walls R-
Ceiling R-
Duct work or piping in
unheated.spaces R-
pp�? r.Vent;.Attic Vent
t—
ack Studs/Headers �V�
c�rr � R.
Bracing/Bridging
Joist Hangers
Jack Posts/.Main Beam I
Air Infiltration Barrier I
Fire Separation 1,2, 3,hour -
Penetration Sealed I t�
F' e Wall 2� — hour
oppmg
J
GENERAL INSPECTIQIV REPORT
( 518) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road r
Queensbury,NY 12804. Arrive am/pm Depart.
Inspector's Initials N
NAME: PERMIT#
LOCATION: U{Lp ti�L,� DATE
TYPE OF STRUCTURE: "
RECHECK
N/A YES/NO COMMENTS
/ootings/Picrs I
Monolithic Pour Form
Reinforcement in Place
The contractor is res nsible or
providing protection m f ing
for 48 hours following e pla ment
of the concrete.
Materials for this purpose on sit
Foundati allpour
Reinforcemehon Place
Foundation/Dam
Backiill Approval
Plumbing Under Slab
Plumbing Vent/Vents in lace
Rough Plumbing
Heating Rough In
Insulation
Foundation Walls In erior R-
Foundation Walls E tenor R-
Floors R-
Walls R
Ceiling R-
Duct work or pip' g in
unheated spa s R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
BracingBridgin
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
t
GENERAL INSPECTION REPORT
(518) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement 4 .
742 Bay Road
Queensbury,NY 12804. Arrive am/pm Depart m
Inspector's Initials
NAME: PERMIT#
LOCATION: 4 DATE:
TYPE OF STRUCTURE: J
RECHECK
N/A YES N COMMENTS
-wdmgs/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsibl for
providing protection from ing Q
for 48 hours fol owing the p acem t
of the concrete.
Materials far this pu se on s'
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Back ill Approval
Plumbing Under Slab
Plumbing VentlVents 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/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