2000-719 TOWN OF OUEENSBURY
742 Bav RoatL Queensbm7, NY 1'8) 4 5()02 (518) 7G1-8241
Community Development - Building & Codes (518) 761-8256
CERTIFICATE CIF OCCUPANCY
Permit Number: P20000719 Date Issued: Wednesday, December 27, 2000
This is to certify that work requested to be done as shown by Permit Number P200007 9
has been completed.
Tax Map Number: 523400-074-000-0002-036-000-0000
Location: 19 3ACQUELINE Dr
Owner: GUIDO PASSARELLLI
This structure may be occupied as a:
Single Family Dwelling
Garage - 2 Cars Attached By Order of Town Board
Fireplace TOWN OF QUEENSBURY
(,Ijw
Director of Building & Code Enforcement
TOWN OF QUEEI`NSBURY
CL 742 Bay Road, Queensbury, NY 12SO4-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20000719 .Application Number: A20000719
Tax Map No: 523400-074-000-0002-03+6-000-0000
Permission is hereby granted to: MICHAELS GROUP
For property located at: f ? o109' JACQUELINE Dr 0 .4
in the Town of Queensbury, to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Tyne of Construction Value
Owner Address: GUIDO PASSARELLLI Single Family Dwelling 1622500.00
465 LAKE Ave Garage - 2 Cars Attached
LAKE LUZERNE, NY 12846 Fireplace
Total 'Value 162,500,00
Contractor or Builder's Name / Address Electrical Inspection Agency
MICHAELS GROUP NEW YORK BOARD OF FIRE UNDER
10 BLACKSMITH DRIVE
QUEENSBURY, NY
Plans & Specifications
2000-719
1800 SQ FT SINGLE FAMILY DWELLING 'WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$251 .00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday, October 05, 2002
(Ifa longer period is required, an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of eensbury; Thursday, October 05, 2000
SIGNED BY for the Town of Queensbury_
Director of ur ing C rcement
Buzzazng Permit Application
Town of Queensbury - Der+t. Of Cmilinfrnity Develap itent, 742 Dirty Rom/, Qrrcrr►.rfrrrrrv, NY I2SO4 1761-82.561
BUILDING do - CODE RNPO" RCEMENT
Requirements prior to issuance
A parmit must be obtained before of this permit: PERMIT F7LE NG)
beginning construction. NO) inspections ��
m e
will be made until applicant has received O Tot#i+ig Ltoard Action PCRANI/T FE0 E PAID }i.� � 4
a 4VA41D BUILDING PERMIT. All Area / Usc C)o
applicants' spaces on this application RECR1sitTION rCE f'AZD
MUST be completed a6dLipp arcs signature Plianning Bogard Action R.CVIELVED BY.,
of the applicant must appear an the
SPR / Subdivision / Other IIrritrllrg Ir�rtxtrnr
3 ptication form. n�„t ) Recreation Pee Payment
Applicant: 141; t �is ti _ Owner:
Address: � l k-^rc �► 2C�
.... Address:
Phone # ( t_J_ `t _) l__ I'hotaa #
Property Loca tion: mom
Biro
Subdivision Name Tax Map NutnUc r ����
Section Mock I rrt
NATURE OF PROPOSED WORK : ESTIMATED MARKET VALUE OF THE
New Building : CONSTRUCTION :
residence / commercial $ + � C
Addition to Building :
residence / commercial OCCUPANCY INFORMATION :
Alteration to Building : Primary Building -
residence / commercial Single Family bwellinc� T
Residence / Commercial Two Familyyfo%#r -1 n' '
no change to exterior size Family"Dvielling
Office
Other Work ( describe below ) Mercantile r 1 8 2000
Ma nufactur3. ng
^., Other
GROSS AREA OF PROPOSED STRUCTURE : `� ' r
1st Floor , . . , . . . . sq . ft . > If ADDITION , what will use
2nd .Floor . . . . . . , . Sq9 ft . " of new addition be ? :
Other Floors . , . , , — t3q . t
( not unfinished cellar or baseme ACCESSORY SUII.IIINGs :
Detached Garage 1 , 2 car
TOTAL FLOOR AREA : SQ . F �_ Attached Garage 1 , car
Private Storage Buis;
SIZE OF NEW STRUCTURE : d Commercial Storage Building
FEET X w FEET Other
Foundation Tyiae : �t�y - y �r-„ Will any second - hand or f: ngraded
Number- of Stories : 1_ - "" lumber be used ? If so , for what ?
( habitable space only ) N, Q
Height ( grade to ridge ) . feet TYPE OF HEATING SYSTEM : _
Number sa fireplaces and/ or woo stove ( circle all which applies )
to be installed : Electric / Oil / as / wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
codes a, s : � zt t,,lb�c •h r cs ' MP%ts+_ %Z y .ate,�rz t77 `nyC emi �.tiN�+caa
Na e A dre s Phone
Builders �.�[, CA
L
Plumber : at
Mason : Ske r&X2 tMatzy 12 t t�
Electrician : Ca 2Z
L?E["t-AR .+ 770N& Please sign Belmv after you luxve carefidly read the statetnert•t.
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 or 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 , anti
that such work is authorized by the owner. Further, it is understood that I/we shall strbrnit Prior to n
Certificate of Occupaticy"or Certificate of Compliance being isstted , nn AS BUILT PLOT PLAN by
a licensed stu-ve r; d wn to scale , sh wing actual location of project on premises .
Signature:
(owner, owner's agent, rciiitect, contractor)
Application for Permit — Septic Disposal System
Torun of Qtic "nsbrwy 74213ay" Road QUeellsbury MY 12804 (.516) 761-8256
1 . OWNER INFORMATION :
Office Uxc
Location of installation:
Tax Map No. / /
File Permit No.
Owner's Name: Tl lAy— Fee Paid
Address: 1G ,1. Y t r � , .(1= s s `�s ,_. a
2. INSTALLER'S NAME yx. c 5Z T �� PHONE NO. LraZ — !� ,\ C9j
3• R.ESIDENCE INFORMATION: (circle year of dwelling, indicate 0 bedrooin(s) and multiply 11 q/
bedrooms with applicable ,gallons per bedroom to equal rural dOilvflow)
Year of H use' No. of Bedrooms x Coniputation — Total Daily Flow
1980 or older x 150 gal/bdrn] =
1980 — 1991 x 130 gal/bdrm =
1991 — present x 110 gal/bdrn] = 33
Garbage Grinder Installed yes . I no
Spa or Whirlpool Installed yes . 1 no
4 . PARCEL INFORMATION: (circle applicable information & indicate measurements)
T� Soil Na re Cround Waft r Bedrock �Sr l�npervious Material Domestic Water Sapp"
1"Yat sand at what depth at what ae"pllt nruryrcipnl i
Rolling loam frier
Steep s•lopc clay ifwell, svater• ,supply
._�Ya slope other fi'onl r111v .scpfic-sy:sicrri
depth: T — cr6.trxr�riicrrr i,s
other
Percolation Test: (1'rr hr cranxl,Jetcal by licc}nsed pru�c".s.siorrer! en1 irtecr , rr arclritcetJ - - _ ._._
Role; — - _ rrrfnrrte pc"r irtclr
5 . PROPOSED SYSTEM: For New Construction. All individual sewage disposal systems ]]lust be designed by a licensed
Professional engineer or architect (tuxicss installed in a Planning Board approved subdivision). Acid 250 gallons to lilc sire
of (tic septic lank and leach Field for cacti Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: I CCC-') ,gallon (inin. .size 1, 000 gal.)
Tile Field: each trench 41 /1. Total System Length :
Seepage Pit(s): number of. .size of•cach: _ ft, by mm ft.
Size of Stonc to be used: 11 • _ l± / depth or ihic',Cne.s's
Bed System Size, x
Alternative System: _ length and/or .size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: N ',�- 1 Size of each: gallons f 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 whici] is based upon or is granted in
reliance upon any material misrepresentation or failure to snake a material Fact or
circumstance known] by or on behalf of as% applicant, slsali be void.
I have read the regulations with respect to this applicatioix and agree to abide by these and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible neon Date
! -rrc cc •I owil o! (�uccltslrur+ , 742) liax- Ruacl, QL1"J1stroue-i , 1, y'
( :+ ) 8) 7tt1 -82or
Application for Fuel Burning Appliances &. Chimneys
applicable to solid fuel & vented gas appliances �}
Date L7 , ?{) - Perillit ?tio.
ril�tllicrttir�tr is here ! rucrcle Irr the f3rtilrfir,� c C rJrlc.s C7Jlir Jr,r nc� i.scurrrtcc nJ �r f3trilrlirzy rzrtd 4usf.'
Pc'r;;til P111-sttaw to the New York Stare Fire Preverlliorr .rrul 13:1'lrliu�r C'udc. 7714V ul�l�lic'retrt r3r nrsrtcr•
€rg!'ce.5' 10 G'Or;tpptY sl irlr all rrPl?licttblc Ir;tr:s, r�r'rlir;al;ces, ;X•,zlhttia.rrt.y, rrrld ell/ ic-011ditiorfs rl;rrf a)-e J)rtr! q1'
rltesrt regreirernerrts evil also twill edlow rill i;rspeCro;s io etttc'r l)r c ;rli.sc.+ Irf laerfvrt;r r'erl;tt l"ed itt Sf)NC't1lJ l;,S'.
NOTE to applicant * Roucyli ,rin and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
\ ame. ( circle appropriate words)
r - Stow-c - tt�ood gcts
�� _ Fireplace insert
Address: lc$ la 40 ., � Fireplace, factory-built: stiood gas
1.._ ` � ,` l- z-S'�2U� Fireplace. masonry: Wood g S
Furnace: snood as oil
If non-iiiasonary appiicance, please provide
Ow4'ner:�..��1-�] Q '%rlattu Fact urer Name:
Address : Model Number:
Chimnev Infol-n-lation
Phot-te : (Circle a ppropriate words)
-Masonry block brick stone
`Exact Address : FlUe the steel size,` iliches
! � � -
ofconsrrttetlo orinstallatlott Factory-Bt1ilt
Manufacturer naive:
Model Number:
.Vote. Listed. By:
Number:
CC717S't1'r1 C'ti L11T / 1rtS1CrllafiOtr t;zrtSf
co;r or-r;t to IVYS Fire Freve;riio;r & Building Indicate ( circle) chininey niaterial :
Corte. Consrtlt assailable Totv;r of t7rreetrsbiety
Hcwdouts regarding required inspecrio;rs. Double Tull 'rrl;l,r itytl! Itr.srrlrrrc r! / Darer 1'V111+r11z
Chirrretrs Gi+rcr•
+�`•B:�E".Z":6i ��Pt3.s.^ftis�. @.]CZ1" r, '�"O]Gis7'.T_! a'�R1�'F. r ,1Iarslertl Corte » S Collected S Rcfrerrrlerl c I (rcfrerreyed rr)/' �C f r'
.'! i 73 3389 l�! 90J PreGltc .S�qfL�71
-4 2J3 635 (? 7/J) Almov Sales c —
P6]s•. /awry Imo& GY. 06 vn.i.y
White (Appiicarn) Greet ( hire Marshal ) VeVovsv 031dhr. De-pr. ) Pilak & Goicierrrn.1 (Cashier's Dept.) J
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761 -8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATIONN ERMI�T #CJ
[!SCHEDULULE71NSPECTION ON / - -
M PM
APPROVED
EXITS
NIA YES NO
_
AISLE WIDTHS
EXIT SIGNS _
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYST
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEIV
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SP INKLERS
CLEARANCE TO H TING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE _
FIREPLACE MASONRY ACTOR BLT.
❑ R
j4GH-iN
L?fINAL
REMARKS: ❑ OK TO THIS DATE
PNWAIRPU13 INSPECTOR
reESIDENTLAL FINAL 1NSPECTI[ON REPORT r
Office No. (518) 761-8256 bate inspection request received:
Building & Code Enforcement � yy
Dept, of Community Development Arrive am/pm Depart�(r ' faa�
Town of Queensbury Inspector's Initials
742 Hay Road
Queensbury, New York 12804
NAME
LOCATION PE UVR E J f
UC
TYPE OF STRIICTIJR.E DATE
NIA YE§I NO COMMENTS
Chimney HcightP 13" VentlDirect Vent Location
Fresh Air Intake
Plumb 'Went through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30" to 36"
Exterior Handrails, balconies, Ianding 18 in. or more
Interior Handrails stairs both sides 3 or more risers
Cn-ade 2% awav from foundation
8" clearance to sill plate
Gas Valve shut-off exposed/regulator 18" above _
Gas Furnace shut-ofTwithin 34 feet or with line of site
Oil Furnace shut-off at entrance to furnace
FUMAIDdHot Water Heater open
Relief Valve(s) installed
Headroom, 6 ft. 6 in. on stairs
Basement stairs, 6 ft. 4 in.
Handrail exterior stairs both sides more tliati3 risers
Interior privaey/trim/doors/rnam enhance 34"
Floor Finish
Bathroom/Kitchen watertight
Interior handrails Balconies/landing 18 in. 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
Garage fuelxoohng
Garage penetrations sealed
Furnace in separate room. protected (in garage)
Light ventilation per
Safety glazing 1$ or l
Final. Electrical 7i
Site Plan/Vanance
Final Survey Plot Plan L OP
As Built Septic System layou
Okay to issue C/C (Certif. of Compliance)
Okay to issue temp. C/O (Certif. of Occupancy)_
Okay to issue permanent C/o (Certif; of Occupancy)
TOWN OF QUgENSBURY
BUILDING & CODE ENVORCEMENT
742 BAY ROAD
QUEENSBURY Y I.28 4
( ' (518) 761-8256
-- ARRIVE ! DEPART: INSP :
FINAL INSPECTION REPORT - RESIn6NTIAL
DATE INSPECTION R VL�'ST El
NAME ' i 4 l .. .
DATE G{ PERMIT I
TYPE OF STRUCTURE
FOOTINGS FOUNDATION RACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULAT20N -"
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
xa ,NO
C. FiIMM i I HT B VENT H
PLUMBItIG VENT
It.00FING
E F N
PECK OR CH S IN
RELIEF VALVES
i
F CE 0 W R T G
INT RIO I P IV C O R
FINXSH F RS :
HAT HEN W H
TH OORS SW E
i
vaks
OTHER FLOORS, $p
FAIR CLEARANCE/ LrNGS
S O E ET C Oft
BL&Tuaoom PANS
YLUM$INS., FIXTURES
fMINVATION U I
A G4L_ZJRA��OOF IN
DOOR CLOSERS
F.JHAL_._p'I�._ECTR I CAL
SITE PLAN/VARIANCE RE(�
L SU VE PLOT P N
I
09 TO ISSUE C/O OR CIC
I
i
MAP REFERENCE:
LEHLAND PARK
BY D.L. DICKINSON ASSOCIATES
FILED NOVEMBER 3, 1987
CABINET A SLIDE 128
35
S84'44'10"E o W
200.00' o
IRF
3
_ N
. ...............
.
00
36
!-►�
20,813 sq.ft.
0.48 acres cn
LO
M
.o
HOUSE
o
z
;
i
t
JED
n
Ii
196.04'
RF'
N84'44'10"W
3'7
-2o)� 71
RECEIVED
DEC 18 20@0
TOWV OF QUEENSBURY
BUILDING AND C(JDE
a D u S
r]^[�[�
�./�/ t e V e
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Lie. No. 50135
MAP" AAUCENS�ED wI mS RVEYORS SEAL 13 A
MOLAVON OF UF.CVON MOB. SUB-OMSION 2. OF THE
NU VOW STAVE EOUCAVON LAW.'
OF ,HIS AN MY
IW ED COPIES CIM NAL OF THE
MARRED WITH AN OIBgCRE OF IHE LAND wRYEr OP
CERTIFICATONS NpGT® RAM SIQYFY THAT
SEAL SHALL BE CCNSIDA IN A YAUD TAUS COPIT'
THIS SURVEY WAS PREPARED N ACCORDAIME wtH INCHE
BY 1NE NEW PORK SPATE A�OCIA710N OF PROFF.SSIp1AL
°` °° � ON
LAND SURVEYORS SAID CERVICAVONS SHALL RUN ONLY
TO THE PERSON FOR VHOM 1HE SURVEY IS PREPARED, AND
ON HIS BEHALF TO INE VILE COMPANY. 0040MANTAL
A084V AND LEND"° INSITUIBON US= H°NE°"' AND
TO VB: ASSIp1EESS OF IHE LENDING INSVIUMN.'
1
Map of a Survey made for
H E M I C HAE LS GROUP, LLC
Town of Queensbury, Warren County, New York
uate: UtC:tMtitK �i, Z000
Scale 1 "=30'
_'
�
%tM 1 1 OF 1
VALENZA
DWG. No. LEHLAND-36
[NO,
DATE
DESCRIPTION
THE NEW YORK BOARD OF FIRE UNDERWRITERS
t}{j �s; 7ri3 BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10088
Date Ii➢. { laMFt3';}: r. } , <'.is+.l(s App&cadon No. onjWe 0 i i '; '•Ii{ ) !r}t} f>. i sx `iV ; f
THIS CERTIFIES THAT
only the electrical eQtuipment as ,described{ *belo(wY,and i(ntrodluc{edf b,,,,iy th1e1 applica+nit[named any the above application number is in the premises o,,,t'
JOE fl )I ('.IIE{r1E.,il l:YS\{ l\ AID ' lL} , I!`Ai�l }{I�l����.lYl"1 i31'1 l !IWI';N )'f9llil 'i 1 61le �""RJVW f/
in the fallowing location; }'❑ Basement ) 0 1st FL d 2nd FL f=;t;1 i / Section Block Lot
was examined on I )" and found to be in compliance with the National Electrical code. .
MIXTURE O RECEPTACLES SWITCHES FIXTURES RANGES COOKING PECKS OVENS DISH WASHERSF EXHAUST FANS
�7 FLUOflrSCElrr OTMER AMT. K.W. AMT. K.W. AMT, K.W. AMT, K.W. AMT. M-P.
10
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
AFAT. K.W. OIL M.P. GAS M-P. AMR. MO- A. W. O. AMT. AMP. AMi. AMPS.. TRANS. AMT. M.r. SYSTEMS
NO. OF FEET ANIt wAtra
SERVICE DISCONNECT FO 1 vOi S. E OFR Cb. V C E
AMT. AMP. YPE M . FOb. HE II • SN S / W • 4W
Mil. of MI-I,Ep ,'w G ND. OF MEVfvwu A. W, e.
Of NEUTRAL
OTHER APPARATUS;
:st'I{?1{F� tTti`7'i�{ "fY7k{ � • ki
E'! ,5.t�1�1•;ft 'I';C.>';f. ' !#3Spr,l' 1 i'�l :5';C" •` I�w,.�.._.._. � `L..e+.�.r�
1.446 jNPFIRply uS'I' , GENERAL MANAGER
Per
This codificafe must not be altered In any manner, return to the office Of the board If Incorrect- Inspectors may be Identified by }hair Credentials.
COPY FOR. BUILDING DEPARTMENT_ THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANitiiffFt.
Zdut,L -
FIRE MARSHAL
AgVnk TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761 -8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATION - PER T
SCHEDULE I SPECTION ON U
At PM
APPROVED
NIA YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS -
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM W
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES -A
STORAGE:
CLEARANCE TO SPRIN ERS
CLEARANCE TO HEAT G UNITS
REQUIRED SIGNAGE
CHIMNEY ' r
OOD ST E
FIREP E ❑MA +SONR 0FACTORY LT.
ROUGH-IN
❑ FINAL 7.
REMARKS: TO THIS TE
2,h
INsws.3P.Pue INSPECTOR
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL I ECTIO REPORT
REQUEST RECEIVED
NAME
LOCATION PE MIT # _ 7/9
SCHEDULE fNSPECTf N ON
PM
APPROVED
EATS NSA YES NO
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE: _
CLEARANCE TO RINKLERS
CLEARANCE TO EATING UNITS
REQUIRED SIGNAGE
CHIMNEY _
V�F�d-STOVE y�
EPLACE MASONR ACTORY BLT.
❑ ROUG---H4N
❑ FINAL0
REMARKS:
❑ OK TO THIS DATE
cloo
`(
INWSLIP.M INSPECTOR
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
eL (518) 761 -8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATION PERMIT r 1
SCHEDULE INSPlCTION ON i if
3
r AkA PM
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS r
EMERGENCY LIGHTING
t
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM ,
a
FIRE SUPPRESSION SYSTEI1 r
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE. TO SPRINKL S
CLEARANCE TO`HEATING ITS
REQUIRED SIGNAGE
CHIMNEY f
WHI D STOVE _
FIREPLAC MASONRY El FACTORY BL .
ZROUGHAN
_ ❑ FINAL
REMARKS: ❑ OK THIS DATE
�A 6 _ wx �
WSPBLIP Pus INSPECTOR
GENERAL INSPECTION REPORT
c518r761 - 8256
Town of Quecusbury
Dept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road {
Queensbury, NY 12MM Arrive am/pm Depart
G ,
/ Inspector's Initials
NAME: PE
�
LOCATION: DATE :
"TYPE OF STRUCTURE: -4
RECHECK
K
NIA YES NNTS
O
Ir
Footings/Piers I
mNm
Monolithic Pour Force
Reinforcement in Place
The contractor is responsible r
providing protection front ng
for 48 hours following the pla Vent
of the concrete.
Materials for this purpose a on site
Foundation/Wallpour
Reinforcement in Place
FoundationlDampptnofittjr
Backftll Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbi
Heat Rough-In
u qn
oundation Walls interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces
Proper Vent, Attic Vent
Framing
Jack StudwIleaders
Bracing/Bridging
Joist Hangers
Jack PosislMain
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Scaled
Fire Wall 2, 3, 4 hour
Fi restoppin
17
GENERAL INSPECTION REPORT
( 518 ) 761 - 8256
'.town. of Queensbury
Dept.. of Community Development Date inspection request received:
Building & Code Enforcement
742 Day Road
Quaensensbury, NY 128o4 Arrive am/pm, Dep
p / Inspector's In}i#isle
NAME: _.. V�k4C Lt� i ( G�rE'f' _ PERMIT # 71
LOCATION: .¢r a u DATE :
TYPE OF STRUC"I'L.JRE-
RECHECK
NIA YES NO COMMENTS
Footings,'I'iers
Monolithic Pour Form
Reinforcement in Place _
The contractor is responsible for
providing protection horn freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofi
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbin
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- _
Walls R-
Ceiling R- /
Duct work or piping in
unheated spades
Vent, Attic Vent
raming.
J Studs/Ileaders
racing/Bridging
Joist Hangers
Jack Posts/Main m
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
P ration rree
Scaled
Wall 2, 31 4 hour
irestom
G"EIYERAL INSPECTION REPORT
( 518 ) 761 -- 8256
Town of Queensbury y�
Dept, of Community Development Date inspection request received: . 4CM16 ►f
Building & Code Enforcement
742 .Bay Road • ! &WWDM
Queensbury, NY 12804 Arrive anVpm Depart
Inspector's Initisls, _ G
NAME: FERM.IT #
LOCATION: rz--�'" DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Fiers 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
FoundationlDampproofin
Backfill Approval
Plumbing Lander Slab
�'Futttbing Vent/TVents in Place
�f gh Plumbing_
�ating Rough-In
Insulation
Foundation Wails Interior -
Foundation Walls Exterior -
Floors
Walls -
C.`eiling R-
Duct work or piping i
unheated spaces R-
Pr t„ Attic `J
rni
Jack Studs/H ,1 �y r�
Bkraci.ng,Bridgin �x .#-G L— do 0 rf� 1', L Oe-4iA t r1C ►�+
Joist Hangers
Jack Pos L3earn
/Air InfUtration Barrier
Fire Separation 1, 2, 3, hour
Penetration Scaled
Fire Wall 2, 3, 4 hour f
Tres -n C�i�C- 7� �r�i • Sfz�' �►�:. .��. . ��, � ���-�.c..
+GENERAL INSPE TIQN �4tEPQRT
( 518 ) 761 - 8256
Town of Queensbury Date inspection request received•
Dept. of Community Development p .
Building & Code Enforcement ,
742 Bay Road Arrive arruprn Depart e
Queensbrxry. NY 12804 Inspector's Initlaia '
NAME: t ' rmeC DATE : �oz7 � .
LOCATION.
TYPE OF STR' U—CTURE:
RECHECK
NIA O COIb NIENTS
—
c r Form
Reinfo nt in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following, the plaoment
of the concrete.
Materials for this purpose on site `
FoundationlWallpaur
Reinforcement in Place
FoundationfDampprOOfin
BaclrfUl Approval
Plumbing Under Slab
Plumbing 'VentlVents in Place
Rough Plumbing
Heating Rough-in
insulation
Foundation Walls Interior R-
Foundation Walls Exterior R- —
Flloors R.-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
proper Vent, Attic 'Vent
Frami
Jack StulieacLers
BracingBtidgin
3oist Hangers
Jack postslMain Beam
Air Infiltration Barrie?
Fire Separation I, 2, 3, hour
Penetration 'Scaled
Fire Wall 2, 3, 4 hour
Firestoppin
TowN of QUEENSBURY
BUILDING _ & CODE ENFORCEFE
742 Bay Road
queensbury IVY I2804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ` 0 GWA
Location Ir
Gate (� " ermi # 0 (]_
SOIL TYP Sand Loam-Clay-
Results of -Percolation Test-
( if applicable ) Rate-Mi u / Inch
TYPE OF SYSTERW
ABSORPTION FIELD : Tot 7 Le h
Length of each trenc
Depth of trenches
Size of stone
SEEPAGE PITS ; mb r-
Size - t .
Stone size
PIPING:
B T dgto Tank ----�-�-"�-'
Tank to Dist . Box
Dist . Sox to Fiel
Openings Sealed? Yes No art a
LOCATION/SEPARAT pi
Foundation to Ta feet
o
Foundation to Ab rption . feet
Separation of Pi s feet
Conforms as per lot Plan a No
LOCATION OF SYS M ON pRopER
{ circle
Front - Rear - Riddle
Side - Right Side
'Middle nt - Rear
COMMENTS
SYSTEM USE APPROVED: yrEr NO
Arrayed:
Departed:-L
Building Inspector
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GENERAL INSPECTION REPORT
( 518 ) 7 +61 -- 8256
Town of Queenshury
Dept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road 1.-- b ��
Queensbury, NY 12804 Arrive `.. epaurf'
-� Inspector's Imt'
NAME: PERMIT # r l
LOCATION: t DATE
TYPE OF STRUCTUP
RECHECK
Z -
NIA YE 4TO CONIWNTS
F tingsoPiers _ ............._ .. i
onolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from ing
for 48 hours following the tent
of the concrete_
Materials for this purpose on ite
Foundation/Wallpour
Reinforcement in Place
Foundation/Dam
Backfill Approval
Plumbing Under Slab — — —
Plumbing Vent/Vents in Place
Rough Plumbing. -
Heating Rough-In
Insulation
Foundation Walls Interior _.
Foundation Wails Exterior R-
Floors R r m-
Walls R
Ceiling I4-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Franu
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack PostslMain Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestoppin
GENERAL I1IISPECTICiN REPORT
( 518 ) 761 -8256
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building & Code Enforcement r
742 Bay Road
Queenshury, NY 12804 Arrive am/pm Deparg
Inspector's Initials
NAME: PERMIT # 7t '= . ., •..
LOCATION: -� /JDATE : I(7 A[,� l>
TYPE OF STRUCTURE:
RECHECK
NIA 'YES NO COMMENTS
Footings/Piers
Monolithic Pour Form _
Reinforcement in Place --
Tlie contractor is responsi for
providing protection front in
for 48 hours following the eem t
Of the concrete.
Materials for this purpose on 'te
FoundationJWalIpour
Reinforcement in P
Four onADampproofi
Approval
Plumbing Under Slab
Plumbing Vent/Vents in P
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls IntIR-
R-
Foundation Walls Extr R-
Floors -
Walls -
Ceiling -
Duct work or piping i
unheated spacesProper Vent,
Attic Vent
Frami
Jack Studs/Readers
Btacing/Bridging
Joist Bangers
Jack Posts/Main Beam
Air infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire 'Wall 2, 37 4 hour.
Firestoppin
GENERAL INSPECTION REPORT
( 518 ) 761 -8256
Town of Quieensbury
Dept. of Community Development Date inspection request received: ! 4 C>- xvz) "
Building & Code Enforcement j • ,�
742 Bay Road
Queensbury, NY 12804 Arrive am/pm Depart m
Inspector's Initial C�
OWN a
N PERMIT # r r r
LOCATION- DATE : '71"L7
TYPE OF STRUCTURE: 07 �}
RECHECK - -
N/A YES N COMMENTS
ootings/I'iers I
nolit to urForm
Reinforcement in Plane *' "
The contractor is responsible
providing protection from ng _
for 48 hours following the p ent
of the concrete- "'•
Materials for this on si
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior It-
Foundation Walls Exlerir R-
Floors
Walls I.
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attie Vent
Framin
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