2000-318 TOWN OF OUEENS BURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518)761.8256
"PO
CEa"i'IFICAU
E OF OCCUPANCY
Permit Number: 2000318 Date Issued: Thursday, September 28,2000
This is to certify that work requested to be done as shown by Permit Number 2000318
has been completed. k-�+a
Tax Map Number: 523400-074-000-0002.032.000-0000
Location: 5 JACQUELINE Dr
Owner: GUIDO PASSARELLLI
This structure may be occupied as a:
Single Family Dwelling
By Order of Town Board
TOWN OF QUEENSBURY
Director of ' Co e E t
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 169900 Building Permit No. 2000318
TAX MAP NO. 74 . -2-32
MICHAELS GROUP
Permission is hereby granted to
LOT 32 #5 JACQUELINE DR.
Owner of property located at
in the Town of Queensbury,to construct or place a SINGLE 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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
WeB LA Addreg&CK ITH DRIVE
MALTA, NY 12020
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:
2400 SQ FT. SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
SINGLE- FAMILY DWELLING
301. May 19 2002,
$ PERMIT FEE PAID—TFUS PERMIT EXPIRES
(If a longer period is required,an application for an extension must be made to the Code Enforceni6nt
Officer of the Town of Queensbury before the expiration date.)
19 May 2000'
Dated at the Town of Queensbury this Day of
SIGNED BY for the Town of Queensbury
—t—o8e Enforcement Officer
Building Permit .Application
Town Of Qllt."ensbu y - Dept. of,Community Development, 742 B' ay Road, Queeus•b'iuy, NY 12804 1761-8256]
----- 'BUILDING & - CODE, ENFORCEMENT
Requirements prior to issuance
A permit must be obtained before of this permit.- '. PERMIT FILE NO.
beginning.construction. No inspections PERMIT FEE PAID$s �l
will be made until applicant has received :7oning Board Action`
a VALID BUILDING PERMIT. All Area I Use RCCRLA FEE )8'
applicants' spaces on this application r
MUST be completed arid•the signature .Planning Board Action-
of REylEW`BD 13Y
the applicant-must appear on the SPR / Subdivision 1 Other Quiliting /.. rmr
plication form. „„, Recreation Fee Payment
Applicant: T"EtCY1c' �S cwnkzop Owner: Z"mE-
Address:� L� tr� z �\j �2(�2L`� Address:
C 5_l ) �3 _
I hone # �- �� -��,�-- Phone # ( }
Property Location: Q Y L6 i`. Iaa Map Number Tt L 2C -3 oZ
Subdivision Nantc:
J Section 131ock T nt
NATURE OF PROPOSED WORK:
TI TED MARKET }VALUE 'OF THE New Building: CO TRUCTION: $� lO � Z�
residence / commercial
Addition to Building:
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 Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE.
1st Floor, j�2 sq fit+1 1 ADDITION, what will use
2nd .Floor. . . . . . . /o7(p sq. fr�*61' =1 new, addition be?
Other Floors . . . sq. ft. �
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, ?_ _
TOTAL FLOOR AREA: `G' {�(D SQ. FT. _ZC_ Attached Garage 1,1� n-
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
FEET X FEET Other
Foundation Type: Will any second-hand or ungraded
Number of Stories: Z lumber be used? If so, for what?
(habitable space only) `TAo
Height ('grade to ridge) : v feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woo stove (circle all which a plies )
to be installed: J Electric / Oil J as / Wood
r� Forced Hot Air J Baseboard / Other
Person responsible for supervision of work as regards to building
c o d e s i s : mil 4.2�M1CX CAR 8` � K L a ys22E
Nd' e A resss Phone
Builder: O l -u
Plumber: -42p _ __N&V
Mason: tv� Trr a�a.-_�'�1Sa,C� [ -x_e=r�s _ — _ _ _ -
DECEARA770N• 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 Ilwe sliall submit prior to a
Certificate of Occupancy'or Certificate of Compliance Being issued, an AS BLTILT PLOT PLAN by
a licensed surveyor; d wn to scale, s wi tuaI location of project on premises.
Signature:. el
(owner, owner's agent, architect, contractor)
TOWN OF F VUEEN58U8Y Fee Paid
BUILDING & CODES DEPARTMENT
APPLICATION FOR: PORCHES-DECKS- permit y
DOCKS & BOATHOUSES Ent' Cost
A PERMIT MUST DE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FnLLOHlMG:
The undersigned hereby applies for u Building Permit to do thefollowing-
plans and specifications
submitted,
�w»'k which will be
done in accordance with the description ,
nniSETS0F 3T/UCoUk"omic p«`�and s�/c/� special
conditions as may be indicated on the permit.^ TWO �E
---------- STRUCTURAL«L PLANS SHALL DE SUU/1TTT�5
THIS APPLICATION.
Owner of Property:
P.O. Add
Property Location
Subdivision Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF NORK /A REGARDS TO BUILDING CODES: ��--------
Name`
. Address . Phune#_______
BUILDING SPECIFICATIONS:
~ Type of work to be done: Porch Dock Boathouse (Circle one)
Size of Structure to be built (square
u s4uare footage) :
Foundation Material :' Width Thickness
Depth of Fo0ting, below grade: "
Size of Posts orStuds : �___' x x 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 Following Questions:
Size of Po.sts or Studs ` x '
_ x Long
Roof Rafters: x Spacing Span
Roof Trusses (pre-engineered spacing) : Span --------
Type of Roof' Sloped Flat Shed Other (Cirol—e-------
one)
Material of Roof:
ZONING INFORMATION:
TWO -PLOT
here drawn reasonably to scale and attached
' ' -��-�� .'., clearly ".," v .^t/oc:/^y all uui /u/ngo whether -existing
indicate all set back dimensions from property lines ` Show locationfor proposed and
location and configuration of septic disposal a�ea, ` » water supply and
Size of Property: ft' x rt.
Existing' building(s) ' 3i�� ft. » ft �--
' ^
Size �--' ft. x ----' ft
Use of Existing building(s) :--�—' ----- -
rrvposcp structure, 21sta6n �— �--~��_ --- - - ---�~
Front yard ft. Rear '� -'-� ~^ ' '''^ '
. xcu yard ft
Side yards ------ '~ and ' ------- ^
� ". � rx, � rt.
{f on corneT7,-—setback from S'Td7�-s[reeC ft.DECLARATION
toge�Torthetbest of myknowledge and belief the statements contained in this opplication
f l ..o with the plans and specifications submitted, are a true and complete statement '
o a / proposed work to be done on the described promises and that allprovisions
Building Code, the Zoning Ordinance, and all other laws pertaining to tdof the
shall be complied with, whether specified or not and that such work i the pr»pose ` w»rk
owner. � » authorized
the
DATE'
. SIGNATURE
-Owner, Owner.s ..v^..cy` ". ".. ,"`t,-Contractor
REVIEWED BY CODE ENFORCEMENT OFFICER, DATE I
3IGNAT0RE
Application for Permit—Septic Disposal System
Tr�swi of Qiieensbuly 74213ay Road Queensbury. NY 12804 (.518) 76%-3256
1. OWNER INFORMATION:
........... ............. .......... ...............................................................
Office Use
Location of installation;
�7
File Permit N L1 0
Tax Map No.
Fee Paid
Owner's Name: Nl—'-
............ .......... ...............................................-
Address: �
2.. INSTALLER'S NAME PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate A bedrooni(y) and multiply I/ of
bedrooms with applicable gallons per bedroom to equal total daillyflow)
Year of House: No. of Bedrooms x Computation Total Daily Flow
1980 or older x 150 gaUbdrin
1980- 1991 x 130 gal/bdrin
1991 —present x 110gal/bdriii
Garbage Grinder Installed yes_ no X
Spa or Whirlpool Installed yes_ no
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
os-,rat)hv Soil Nature Ground Water, Bedrock or 111IDel-ViOLIS Material Domestic Water Supply
ian at what depth at what depth
Rolling loam _,3Qfeet feet
Steel.'Slope clay ij,wall; .water supply
slope other from crn'y septic-system
depth: absoiption is
other
Percolation Test: ional engineer or architect)
Rate: minute per inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in Planning Board approved subdivision). Add 250 gallons to the size
of the septic lank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: gallon (min. size J,000 gal)
Tile Field: each trench /• Total System Length:
Seepage Pit(s): number of size of each:
Size of Stone to be used: fl clepth or thickness
Bed System Size: X
Alternative System: length andlor size
6. HOLDING TANK SYSTEM: (if required)
Nuniberoftanks: N-X, / Size of each: _gallons /TOTAL Capacity: _gallons
Note.- Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON (please read)
For your Protection, please note that pursuant to Section 136-29 of the Code of the Town
of Queensbury, any permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation or failure to inake n material fact or
circumstance known by or on behalf of an applicant, sliall be void.
I have read the regulations with respect to this application and agree to abide by these and all
-requirements of the Xown of Queensbury Spnitary Sewage Disposal Ordinance.
Signature of responslNe person Date
lire
INI-Irshal's Ofilcc Towilof'Quee Jwrv, 742 Bay Loud,Queensj)jjj-N-, Ny
its
fS 18)7b 1-8205
Application for Fuel Burning Appliances &'Chimneys.
applicable to solid fuel gas appliances
Date.3 Permit No,..-- 31
AI)lVic(Ition is hereby made to the Building Codes Q1.fic�ftw the issitallce qfa Build'ilig(,,id Use
Permitpin-stiala to the New York State T-il-e Preventio'll and Building Code. The uplVicant or 011"nel-
agrees to comply with all applicable laws, ordinances-i regulations, and till condi*
iions that are pul-i qf
these requirentents and also will allow C111 to perform required insy7ections.
NOTE to applicant: Rough-in and Final Inspections are required.
Applicant Informatio'n Fuel Burning Appliance Information
(circle appropriate wordsi
Nam!e:.Tw-M_1Nw1� AkRry I-- Stove: wood coal 1�ellel gas
Fireplace insert
Address: Qjakl mltB pj?lw� Fireplace, factory-built: Wood gas
Fireplace, masonry: wood gas
Furnace: wood- gets oil
Phone:
If non-masonary applicance, please provide
Owner: Cr i Manufacturer Name:
Address: Model Number:
Chimney Information
Phone: (circle appropriate words)
Masonry block- brick- stone
Flue the tsteel .3size.- inches
-Exact Address:
of congy-tiction or installation Factory-Built
LO-T' Manufacturer name-.
Model Number:
1 7 5 4" 1-1
%,ote. f J Listed By: Number:
Construction lInstallation inust
conforin to NYS Fire Prevention &Building Indicate (circle) chimney material:
Code. Consult available Tolviz of Queensbwy
Handouts regarding required inspections. Double it-all Triple wall Insulated f Direct venting
Chimney Liner
71401 VV�M XX 4e 4--XUW
Fire iWarshal Code S Collecied S-Re 'd lo): /bll
funded Rec 0" d'/1*( ;n Orelbinde
.4 1-734 3389 (190) Public Sqfen-
-.4 233 2655 (230)Hinor Sales
White(Applicant) Green(Fire Marshal}
Yellow(Bld,,. Dept.) Pile. (Cashier's Dept.)
THE NEW YORK BOARD OF FIRE UNDERWRITERS �_��
4028189 BUREAU OF ELECTRICITY
40 FULTON STREET, N NY 10038
Date °1'�' 1 � 2s e" 00 Application No,on file ti �. �tp, �i
THIS CERTIFIES THAT �'�:�NIO T 11t! ,�,`f?r >�� .
only the electrical equipment as described below and introduced by the a icant named on the above application number is in the premises of
d H113 GROUP, Jt'SCOUN'111 ME, 1M, , C�� V'!dl�l�J'J ' ���D��i�_'i�l����;�� P
in the following location, Basement El 1st Fl. 0 2nd Fl. 61IR Section Block Lot
was examined on SEPT&SPIR hr,?000 and found to be in compliance with the National Electrical Code..
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W, AMT, I K.W. AMT. N.P.
38 44 4/ 3(
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTI. TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
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._C� �_ _ ___S__ __ .E_ R_ _ V I C E
METER NO,OF CC COND. A.W,0, A W 0, A.W.GS
AMT, AMP. TYPE EQUIP, 10 2W 1 0 3W 3 0 3W C.COND. NO.OF HI-LEG OF H1410 NO.OF NEUTRALS OF NEUTRAL
1 2;0) Chi X J 4/
OTHER APPARATUS.
R �C, GENERAL MANAGER
Per
This certificate 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.
FITSM^F::;;.,SH^L
4EE
-F-C:>W" C:OF (:;lUF-:aNSE3Uf:;Z"vr
(::lUF=-f-=N,->E3UF:Z-)r, NNY12SO4 3L (51 B) Tel -8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
y-Ne-N
NAME
LOCATION-����� �N,ERMIT
SCHEDULE INSPECTION ON
AM PM
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAOE
CHIMNEY
OOD STOVE
FI
REPLACE MASONRY F--t-f:�ACTORY BLT.
R1010QH-IN
F"'F�INAL
REMARKS: E;A<0K TO THIS DATE
INSPSLIP.PUB INSPECTOR
RESIDENTIAL FINAL INSPECTION REPORT
01fice No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept of Community Development Arrive am/pin DepaZ fa ri/�-
Town of Queensbury Inspector's Initiais--;j
742 Buy Road
Queensbury,New York,12804
NAME 01\CA-'a\1 PERMIT 4
LOCATION QC--1., A.)G- (,-)rZ- DATE t 2-A I/?)
TYPE OF STRUCTURE
NIA YES NO COMMENTS
Chimney HeighIPB"VenVDirect Ven[Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18* or more
Interior Handrails stairs both sides 3 or mrre* risers 0
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"a",ve grade
Gas Furnace shut-off within 30 feet or within ti.ne of site
Oil Furnace shut-off at entrance to furnace area.
Furnace/Hot Water Heater operating
Relief Valve(s)installed V
Headroom,6 ft.6 in.on stairs is
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 t
Foundation insulation
'/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed I
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan Apwo(IA- ,
As Built Septic System layout required,_
Okay to issue C/C(Cerdf,of Compliance)__
Okay to issue temp.C/O(Certif.of Occupancy)..
Okay to issue permanent C/O(Certif.of Occupancy) V I
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-9256 Date inspection request received:
Building&Code Enforcement rt/0.1 A)
Dept.of Community Development Arrive am/pm Depa 0 Inspector's V*�J
Town of Queensbury 12ais— IM-
742 Bay Road
Queensbury,New York,12804
NAME PERMIT#
LOCATION DATE
TYPE OF STRUCTURE
141A YE NO NO COMMENTS
Chimney HeightPT"Vent/Direct Vert Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete ttZZ
Exterior Finish Complete- ;yy
Interior/Exterior Railings 30"to 36" Xv.
Exterior Handrails,balconies,landing 18 in.oPlnore VX1,
1�\
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site`
Oil Furnace shut-off at entrance to furnace area
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/Mtelien watertight__
Interior Handrails Balconies/Landing 18 in.or more Z
Railing across window in stairwells
Smoke Detectors. V
every level
every bedroom
outside every bedroom
inter connected 46�41", (su 05
Bathroom fans' tad
Plumbing fixtures
Foundation insulation
'/4 hour fire door/door closer
Garage firepro
Garage penetrations sealed
Furnace in separate room protected(in garage) V/
Light ventilation per room
Safety glazing IS"or S fro or
Final Electrical �/111 te VT161
Site Plan/Variance r4dired I
Final Survey Plot Plan
As Built Septic System layout required_
Okay to issue C/C(Certif of Compliance)_ Ile
Okay to issue temp.C/O(Certif.of Occupancy).
Okay to issue permanent C/O(Certif.of Occupancy)j_ I
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MAP REFERENCE:
LEHLAND PARK
BY: D.L. DICKINSON ASSOCIATES
FILED NOVEMBER 3. 1987
CABINET A SLIDE 128
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Land Sure
veyors, Ll
169 Uvilmd Road I
518) 792-6474 Queensbury, New Yo:
New York Uc. Nc
31
1AIAUlIlORM A.IFRATION OR ADOFIIDti TO A SAW
MAP YEAPWO A IJC6lIIiD LAND MATY4YOIIS SFAL IS A
MAIN W WrAN nW AM-pWILOt 2. OF AIE
NE1r TOIIK tTTAX EDUCATIMI LAW
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ICLRAF1CA11 a MUM Nw" WMRPY INAT
THS SIM WAS FI UWAD M AOOOROMIQ WIN THE
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ETUMNI oam or FMCMIE ra LAID saw= ADWO
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/
LAND MM*N= SAD CFRIFICAMA WALL RUN MLY
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ON NIS KwALF TO INE 'nu OwANY, OpYER AOTAL
p�
12601
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>o THE AMNRIEES OF w w=m RISAAITIML°
50135
JACQUELINE DRIVE
L: 44.569 S85';�V
2
5
20,073 sq ft
0.46 acres
j 100.00,
N85'41_ 0 W
LANDS N/F OF
GUIDO PASSARELU
3 33 O
O •000
00 r�
N
N
..4tOF NEW •
C.
Map of a Survey made for
DEXTER B • JENKINS
ROBIN ROSE-JENKINS
Town of Queens bury.' TwTen County, New York
NO. I DATE
1 HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED. AND ON THEIR
BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED T0: Dexter 8. Jenkins
Robb Rose —Jenkins
Chicago Title Insurance Company
Trusteo Bank. National Association. its
successors and/or assigns
CERTIFIED BY:
MATTHEW C. STEWS, LLS NYS 50135
DATED: August 14, 2000
DESCRIPTION
1*=W
S --1
SHEET 10F 1
JENKINS
DWG. NO. 89423-32
AM-
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 12$04. Arrive am/pm Depart {�Ja o
t (i I Inspector's Initials IC.f[-
NAME: PERMIT#OrM1
LOCATIO DATE: — = }00
TYPE OF STRUCTURE: ,
RECHECK.
NIA YES'NO COMMENTS
Footings/Piers k],
Monolithic Pour Form
Reinforcement in Place '4..
The contractor is responsible for p
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on sitew
Foundation/Wallpour ,
Reinforcement in Place
Foundation/Dampproofing
BackBll Approval
Plumbing Under Slab j
Plumbing VenttVents in Place,
Rough Plumbing
Heating Rough In 4
lalion e
Foundation Walls Interior R
Foundation Walls Exterior R-
Floors R-
Walls R- ?,
Ceiling R- #h
Duct work or piping in
unheated spaces R
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Haugers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation I,2,3,hour
Penetration Seated
Fire 2,3,4 hour
f d
"estoppiri'
GENERAL INSPECTION REPORT
{518) 761--8256 t.
Town of Queensbury
Dept,of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road j
Queensbury,NY 12804. Arrive am/pm Depart
Inspector's Initials 22 J
NAME: } PERMIT#
LOCATION: Ct DATE: — —
TYPE OF STRUCTURE:
RECHECK '
r� �N/A YES NO COMMENTS
Footings/Piers \ I
Monolithic Pour Form �. ,•
Reinforcement in Place t,
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 t�
Backfili Approval !
Plumbing Under Slab
Plumbing Vent/Vents in Place i?
Rough Plumb' g
Heatin ough-In {
atiori � [aV�v� • 19J �— 1 �!1 CCU —
''�-``�'�Foundation Walls Interior R-
Foundation Walls Exterior R- T
Floors R r'
Walls R V 'll
Ceiling R
Duct work or piping in
unheated spaces R
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging I
Joist Hangers
Jack Posts in Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
P netration Sealed
ire Wall 2,3,4 hour
Firestopping - Ptj&
;_. .
W L R C- 0 a5 e
cy-r>
FIRE MARS HAL -
-T-C:)WN OF 4=jUF=aNSaUF:ZY
CZlUr-=f=NSE3UF;Z'*lr, NY 12804
(518) 761 -8205-
1
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATION-4- S PERMIT
SCHEDULE INSPECTION ON
APPROVED
N/A YES NO
1-7-=Xj-rs
AISLE WIDTHS
EXIT SIGNS z
7�
EMERGENCY LIOHTIN
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM f-
FIRE SPRINKLER SYS-17- M
FIRE SUPPRESSION S STEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE SPRINKL\ERS
CLEARANCE T HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD ST VE
FIREPFE = MASONRY FACTORY BLT-
,C
ROUGH-IN
E=] FINAL
REMARKS: OK TO THIS DATE
NS
INSPSLIP.PUB INSPECTVv
,-A
GENERAL aSPECTION REPORT
(518) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay-Road
Queensbury,NY 12844. Arrivkv--Zq&m Depart 1 "
Inspector's Initial
(��
NAME: 1 i t t(-k2C?]i 2u i PERMIT#
LOCATION: 4 S S o-c q ye- DATE ,
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforceinentin Place
The contractor is responsible for
providing protection from fieezi
for 48 hours following the place ent
of the concrete.
Materials for this purpose on site l
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plac
*Rough Plumbing q
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/Header4� L� ��•��
Bracing/Bridging � �
Joist Hangers
Jack Posts/Main Beam
tA.ir lnfiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
• Firestoppin
GENERAL INSPECTION REPORT
(518) 761--$-256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 32804. Arriv = am/� Depart
Inspector's Initia
NAME: PERMIT# -
LOCATION: F 1J DATE: Zl
TYPE OF STRUCTURE:
RECHECK
N/A S NO COMMENTS
Footings/Piers t
Monolithic Pour Form 0
Reinforcement in Place 1
The contractor is responsible f6r
providing protection from freezing
for 48 hours following tAsite ,
of the concrete.
Materials for this purpose
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfiil Approval
Plumbing Under Slab
Plumbing VentlVents in Place
Rough Plumbing
Heating Rough-In
Insulation l 1
Foundation Walls Interior R
Foundation Walls Exterior R 0,
Floors R-
Walls R
Ceiling R
Duct work or piping in �
unheated spaces R-
Proper Vent, Attic Vent
Framing \
Jack Studs/Header
Bracing/Bridging
Joist Hangers �_
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation i,2,3,hour
Penetration Sealed_
Fire Wall 2, 3,4 hour
Firestoppin
TOWN OF QUEEKSBURY
BUIL-DING CODE ENFORCEMENT
42- Ba_y Roa4
NY XZB64
SEP-UIC DISPOSAE SYSYEM INSPECTION
Namc- (AA,* - .5 -
-A A rVA_,r�J
Date Perm i 7t #
SOIL -TYPE: Sand- Laam- Clay-
Re-sul -ts of Per-col a-tion -res"t-
.4�VB( i applicable ) Ra-ta�-Mi e/ Inch
E OF SYSTEM:
EgSORP-rldH FIEIL]Dz T 11 Le-ng h
SP o-t
Length o-F each
n c: h e s
Depth of
Size o-F storm
SEEPAGE PITS 1- Numb j-. -Z_
Size -F-t
Stone size
PIPING: Size Type
Bldg - -to -Tank
-rank to -Dist _ Box
Dist - Box to Field/P -t
Open i ngs Se--al ed Yes s, No - P-av--tial-
L-OCA-rXOffZSEPARAT-I0NS :
- Founda-ti on to Tank -t-
Fc:�unda-tic>n to -Abscy-rp ic>n
Separate on a-F - Pi -ts -f e e-t
Con-Forms as per PI of PI an Yes No
I-OCA-VION OF - SYS-rEV4 O)H PROPERT-Y:
( ci -t-cl e one )
Front - Rear - Le-F/ Side - Righ�t Side
Middle 1=ront� - MiWdle Rear-
COMMEN-rS=
SYS-IFEN . USE APPROVED = D-
YES No
y
>
BuIldino Ins�p+ec-t"v
.r
fr r + 1�l • � �• ,
I have seen.or observed,or believe I'saw evidence of
4 •.
' 1 all objects such'as houses,wells;'trees,fences,
etc, ,
shown on this document'1 also represent thatI have y A
persona Rea sur he,dgances set forth on the diagrarn,"
FSIGDATE
;., 1
1 • �.� • ' • :.. _per c
)gg .
ti � . t�.• �, � !: kyt 1 r. , �t tt �' rlr�i�N ��I
��'1'�'.d}r '' ` "„,I\ .�,: L „ .. - vl�r n.:. •t '4j �y� IwNvh,.�{! f ,,rl0, Iq f
.,. ,t'i hl! �i�,( .� m.,ul1.: r+• .t, v1'S.„1 r;.j'.�.I�'d �1, '.+1{r .'a„'r+4W+' r• S hrt +' '� .�,tr�.dN',r"�� t'6 1 �,7
��•" ! r,;*.qt.rb,�i/�;rili:i!':�.1,�ninw,�i�r{�..tnl. •w14;,y '1 111 ,P JA.+t'7pn; �.i
' "3x'I.za'.i'HnC1tli+J4�il{1kiA' ,rwaw�.,
BUI EDING - & CODE ENFORCEMENT
'T4--::;�--- 8a,y Rcsacl .
Qut--4--nsbu1r_y NY X2804
(518)
SEP7FIC DISPOSAU SYS-TEM INSPEC-rIOM
N am t---
L o c a W� �L,En ..............
P An i -t
SOIL TYPE, Sand Loam-Cl ay-
Resul its er-cola-t-ion -ros-t-
( 1 -F app-, -7 abl - a -tea-Minu-te/Inch
TYPE OF SY BEM--
ABSORP-TY EN D : T tal Len gth
Length of" eac 7tr-enc
Depth of' it-r-enc es
Size o-F stcine Z---7-/-z 10"t-
SEEPAGE PITS : N tltpb e P-
Size - -f-t -Ft_
Stone size
PI PING. Size -Ile P
BI dg . -to Tank i�� -
Tank to Dist - Box
Dis-t - Box to Field/Pi -t
Openings Seal ed ? No - _ Part i al-
L-OCA-FIOMZSEPARAYIOH
- Founda-tion to -rank .
Founda-tion I-c> -Absor-p -tion -F-e-e-t-
Sepa-ra-tion of" Pi -ts -Feet
Con-Forms as per Plot Plan e No
sit
OF - SYS-rEM ON PRO ERY
( ci 1 (314 Paa
Fr-onr'�ct �!a t Le-F-t Side - Right Side
Middle Middle Ptaat-
COF01MEN-US
><---
SYSTEM ..USE APPROVED= YES
D tapia r-t--4--cf
GENERAL MSPECTION REPORT
(518) 761-8256
Town of Queensbury
Dept,of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road Op.
Queensbury,NY 12804. Arrive am/pm Depart ' , pm
Inspector's Initials
NAME: ��� / PERMIT#= 1 3
LOCATION: Y DATE
TYPE OF STRU TUBE:
RECHECK
NIA NO, COMMENTS
ootings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is respJ isible-
or
providing protection fr im freezing
for 48 hours following a placement
of the concrete.
Materials fon,this purpose site
Foundation/Wallpour --— --
Reinforcement in Place
Foundation0ampproofing
Backfill Approval
—"
Plumbing Un er Slab
Plumbing Ven
Rough Plumbing
Heating Rough-In
jH
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
Fimstopping
GENERAL INSPECTION REPORT
( 518 ) 761.-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
Tl/
G
742 Bay Road
Qucensbury,NY 12804 Arrive am/pm Depart` I
Inspector's Initials
I"
PERMIT , �;-31e
NAME: r# 6W-31r
LOCATIONtt:7 Uac- DATE
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsi le for
r
providing protection fro fre ing
for 48 hours following t c place ent
of the concrete.
Materials for this purpose o i site
Foundation/Wallpour—Reinforcement in Place A- I
Foundation/Dampproofing
ckfill Approval
Plumbing Un��-r Slab
Plumbing Vent/W,
Rough Plumbing
Heating 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 Barricr
Fire Separation 1,2, 31 hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Firestopping_