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98-031 f E MINN CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY r WARREN COUNTY, NEW YORK DateMay 18 19 58 This is to certify that work requested to be done as shown by 17ertnix No. 98031 i j has been completed. INTERIOR ALTERATIONS DUE TO FIRE DPI Gt This structure may be occupied as a 24 JEROME AVE . f 1.ocation Owner DEISLEY , EDWARD J . TAX MAP NO . 101 . - 5 - 1 1 By Order Town Board ], f '}l- 1 14 Y ' 1C?WIV OF QUEE]VS9URY f i irect ,r g farcement BUILDING PERMIT VALUE S se�OTdN OF QUEENSBURY No. ems., � 31 TAX MAP NO . 101 . - S - IWARREN COUNTYO NEW YORK PERMISSION is hereby granted to n3rT,-.T W-V FnLf312if T OWNER of property located at 24 J Street. Road or Ave. in the Town of Oueensbury. To Construct or place a IRE DAMAGE at the above location in accordance to application together with plot plans and tf oter information hereto filed sna approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. 1. OWNERS Address is 24 JEROME AVE , QUEENSBURY , NY 12804 2. CONTRACTOR or SUILDERS Name HARRINGTON , DAVID 3 ooNTR c cSR or T BUILDER Address SARA VENUE SO . GLENS FALLS , NY 12803 4, ARCHITECT'S Name S. ARCHITECT'S Address 6. TYPE of COnuruceion — (Pies" indicate by Xl RESIDENTIAL ALTERATIONS ( I Wood Frame t I Masonry ( I Steer ( 1 7. PLANS and Specifications 37 SQ FT RESIDENTIAL INTERIOR ALTERATIONS DUE TO FIRE DAMAGE PER APPLICATION B. Proposed Use INTERIOR ALTERATIONS DUE TO FIRE DAMAGE 116 February19 2000 S PERMIT FEE PAID — THIS PERMIT EXPIRES (if a longer Period is required an application for an extenaion awaR be made to the Building and Zoning inspector of the town or Ch aansbury before the sapimtion date.l 9 February 19 Dated at the Town of Oueensfwry this Day of �$ A+ SIGNED BY hw., K ~ for the Town of Clueensbury sulfa" and Zoning t Liu t1cl ifIg Pi... "�r l rU A ll ea ti c.�n +ih ,01m 17,f QlleL'nsloIry - 13rfa, rrfCiurrrrrr+n+r?' 1.7e+>rluf)uer +ir, 7!l Ilrry liejrrrl, fJurrrl.rGru + 99 � �, BUILDING & C Cl !l f3 Is` l . Nt" 128U•l I761 -82.56, 1J F� Nto01? C' EAf1: NF { itccluiscntents prior to issu.utcc lterrni[ rrrusl tra utrinirted 1)cfort) of this E1crinit : I'I0-"' "-'* rILC NO. j f ltcgi+tnirrg cc)rrsirlrcli<>:t. !tits! irtslrecliuns _ ~ twill Ixr rnndc erufil nt);ttieaill 11r19 fcce1VC41 G'v►rJ4r�r• UcxTrrl rl[ Ifurt 1'Is'f{Afil"1' 1 LL? I' [!U Jr -J a r✓Af.117 thCltLl?IN[I t'l~RMl'l'. All ++lt[)licnrrls' &[)aces oil Iltia npl)licalient '�'wc'r I Uve MUST t,c CM11111cled nnd- the) signnterrcx y ltGCltl 4'IYfJN fire I'rf!!7 x of Illes nl)plicaut Itrttal nigxmr ors tlr© I larrriheg Ilrxir�f rlelfvrr fire VIEIVCU BY* t tltlicnlil)r, ft)rrrt. rh r SI'il I S1IIHIIVIAli111 101ltcr '',rr ,,r� ltccrcrrl ie)rt 1°ce: I'rrynrcrrl / Anil.rirlR f+cynrerr+r• Owner: Addretcs: 301 1'Elratle # Photo l# f 5 t5 } %y� - . s"f cip, 11ret)terlp l .e>crlliort: ;tu loll lvlallllt Nimio Tnx Mall N11111hl+r Etuul In1I 1111,ak I r,l "ATunn or PltoroaEl) HORK I New Building@ ESTIMATED Mnitrcl✓m vnLula OF THE rcaiclence CONSTRUCTION ; $` fL�acor �Ia. __ I►cJditl. ar, to Du .ildingnLQrc .ial he Alteration t nee / e orlunerc is l OCCUPANCY 1 "IFOMAT' ION r rh to Flullcli =rc� : it vrinrary 11rr11c1irtcJ her; idence / corlterrerciaJ- _ , S1rhCJ1E [ aridly Dwelling) llel� ictence / Iwomlgercial Iho c Two l�arnily DwellingDwellinghange Lo exterior t� lao _ Parttlly Dwelling k lot- lien Wark ( descrlbe below ) Office Me>rcant; ilo t GIs _ HnnufacLuring ' GROSS AREA OF PROPOSED STRUCTVI;� : � OLlher / lot Floor . . . . . . . . la �y+S"� nq F4L VTL 1►U13I 'rIONr what will use 2nri -Floor . . 1 , ray . Ci .4Y1 C news 4�cldi ican 1 �e7 : Ocher Flours ,. . . . . sq . LL- . { noL. unflilisiled cellar or basemetiL ) ACC 5ORY BUILDINGS '1"[7TAL FL001( AREA r' - ached Gar 1 , 2 SQ F'1' . _ _ ALL red "age �, 2 r S I zE or NEW STRUCTURE , ` Prlva - Lorage Duo �X' t ��'� _ Co rcia3. -Orage Bu Id jIg FEET x PC, 13111 tier Foundation Type : 04rk �.Ic .`a�-r -� Will 01-1 neconil-- ltalxcl or u graded Nall'ber or SLorlee� : —�' 1 lulnlrehr �e uoed7 IC so , or whaL- 7 ( habitable apace only ) NO rreiglrL ( grade to r ;.dye ) = � r- cet- ,�� air HrEAT"XHG SYSTEM : Nchlhlluer of fireplaces and /or woodoLove ( c9. rcle all which appl -1 s ) to be installed : �oaoer n +, E10CLvic / / Gas 1 J Forced [ioL lhir / e f Oilier Person reepatteiblO Xo supervision Of work no regardo to building codes is : lv�ev0 ,+'c, r✓ 13 5` 5 Y Ndiht � dclrecss h 7� Phone Builder : Plumbers Or 3fr Electrician : r✓ / � 7�1' c ' r�,r Dh;CL r RA770N.• Please sign below irfle'r yore Iu:ve carefully read !!le .tratelfre/M To !Etc best of my kihowle:dge the statements contained in this alhlrlicalion, logenccr with the plans anct slhecilicatiorls sulnlhil(ed, arc a true and conhtalcta sl.hlcr,eclrt of .111 proix)sccl work to be clone oil lire dcscrilhcd lrrcrltiscs and Eh<h[ 'All 111roVisiorls of the liuilrlirig Ctxle, tlhe Zoning Ordithancc arld all till ter laws lecrlailling to Ilrc 1,, oilosed work shall be coml)liccl with , whether sl)cclflcd or noted, and III-it srrcih work is mitbot-ire(I by tile owner.. [ t,,Irilrcr, it is crnticrsiexxl IIIat Uwe: xlmll snlnnil prior to a Ccrlitic;Ile of occultallcy'"or Ccrli15c:hlc of Contltliarre:e, Icing isslrcci, aIh AS BU1L7' l'l.cyr PLAN by :l licentled surveyor; drawn to sc.Ile, Showing actual icx:arion of lrrcrjcct on lrrerniscs. Signature: - , :•�` y. � r (owner, owner's .1melit, arcEhilect, con(ractor) ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY , WARREN COUNTY 9000 HEATING DEGREE DAYS Compliance Methods : PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings ( only ) PART 6 * - Thermal Rating - Component Trade Offs 1 & 2 Family Dwellings ; Multi - Family Dwellings ( 3 stories or less ) PART 4 * - Design by Component Performance Commercial Buildings -Hi Rise Residential * Requires submission of worksheets APPLICANT ' S NAME : PROPERTY LOCATION : PART 5 METHOD OF COMPLIANCE BY' ACCEPTABLE PRACTICE : 1 . Gross Floor Area - square feet 2 . Type of Heat - Electric ✓roil Gas Other 3 . Is building mechanically cooled ? Yes No 4 . Percentage of area of windows and doors Over 17 % - Under 17 % 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED : am Roof 6f&ej44Z&&*t4e#*-& R b . Exterior walls co Glazed areas �+4s�+, R do Exterior doors 'ot" $#toe(�� v #I R _l e . Floors over unheated spaces R f . Edge of slab on grade ( heated building ) R g . Basement /cellar walls ( above grade ) R h . Basement / cellar walls ( below grade ) R i . Heating/ cooling-ducts -piping in unheated space R 6 . Service ( domestic ) hot water heating device Conforms to minimum efficiency per code ✓ Yes No TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED A Ica tt Signa e Date Phone Number au/f - ,ram" INSPECTOR. ' SS REMARKS : �t2.d�' f f/a.rr4C11-Ipv RESIDENTIAL FINAL pggPECTION REPORT Date inspection request received: Office No. (518) 761-$256 Building 8c Code Enforcement .rrr,,,...� ,,,...nnn DC * arty Dept. of Community Development A`rrive ,s Tltitial Town of Queensbury 742 Bay Road Queensbury, New York 12MM , PER.MTT 11 ��� " 5 NAME: I7A`fE LOCATION 4 J TYPE OF STRUCTURT NIA YES NO CONS Cbunney Heightlt"13>1 Vent/Direct Vent i.ocation Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Extenor 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 S" clearance to sill plate Gras Valve shut-off exposed/re for S" above grade _.. Gas Furnace shut-off wi - feet or in line of site Oil Furnace shut-o a trance to ace area FurnacelN.ot Water Mg. Relief Valve(s) stalled Headroom, 6 . 6 in_ on stairs Basement rs, 6 ft. 4 in. 1 Iandrai Xtenor stairs bath sides more than 3 risers Inten privacyltru-n1dvors/main entrance 36 F1 Finish adwoonlatKitchen watertight 18 or more interior Handrails Balconies/Landing ling across window in stairwells rf Smoke Detectors-- 4very level every bedroom outside every bedroom inter connected Bathroom fans ,Plumbing fixtures Foundation insulation 3/4 hour fire doorldoor closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected ( in garage) Light ventilation Per room Safety glazing 1S" or less from floor Final F.lectrical Site PlanfVariance required Final Survey Plot Plan As Built Septic System layout required Okav to issue C/C (Certif. of Compliance) Okay to issue temp. C!O (€=ertif of Occupancy) Okay to issue Perznanent C/O (Certif. of ()ccupancv) Mahoney P.O. BOX 767 GLENS FALLS, NEW YORK 12801 N oft _;li m P'u s Inc . SIW793-7 F08 FAX: 51a793-4662 May 15, 1998 Mr. Robert Rayno Rayno Electric 41 Thomas Street Glens Falls, NY 12801 RE: Ed Deisley Dear Mr. Rayno: This letter will advise we have completed testing and inspection of the fire and security alarm system at the Ed Deisley home. As at May 15, 1998 our technician tested the fire and security alarm system and found same to be 100% operational. Should you have any questions, please do not hesitate to contact our office. Sincerely, Benjamin P. Chapman Operations Manager RESIDENTIAL FINAL INSPECTION REPORT 1 1 1 Offsce No. (518) 761-$256 Date inspection request received: Building & Code Enforcement Depart Dept_ of Community I7revelopment Arrive In ,s In1tiS1S Town of Queensbury 742 Bay Road Queenshury, New York 12904 ` NAME I]ATE LOCATION TYPE OF STRUCTURE AiIA YE I1Q CO NTS Chimney HeigbtP'B" Vent/Direct Vent tion Fresh Air Intake plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Extenor Railings 30" to 36" y 1 Exterior Handrails, balconies, landing 18 'in- or ore Interior Mandrails stairs both sides 3 or more riser Grade 2% away from foundation 8" clearance to sill plate Gas Valve shut-off expo se&regulator 18" above grade _. Gas Funtace shut-off within 30 feet or within line of site _ Oil Furnace shut-off at entrance to furnace area Funlace/l-Iot Water Heater operating Relief Valve(s) installed Ileadroom, 6 ft. 6 in. on stairs Basement stairs, 6 fl. 4 in. I landrail exterior stairs both sides more than 3 risers Interior privacy/trim/doorslmain entrance 36" Floor Finish BadwoOMIK-itchen watertight 18 e Interior handrails Balcor►ieslLanding or Railing across window in stairwells Smoke Detectors_ every level every bedroom outside every bedroom inter connected l3athroom fans '"` N l cr . plumbing fixtures Foundation insulation 3/4 hour fire dooridoor closer Garage fireproofing Garage penetrations sealed Furnace in separate roo otected f in garage) Light ventilation per in Safety glazing. 18' orliesFl f 6m our C 1 Final Electrical Site plan/Variance regtur Final Survey plot plan As Built Septic System layout required Oka ° to issue C1C (Certif. of Compliance) Okay to issue tcrnp- C/o (Ccrtnf• of occupancy) Okav to issue permanent CIO (Certif. of Occupancy) COMMONWEALTH ELECTRICAL INSPI;UIrlivr4i Z�x nVJL%, .. .ar.7. . Main Office 357 Elwyn Terrace — Manheim. PA 17545 7 C} MUNICIPAL CERTIFICATE ELECTRICAL APPROVAL Panel Board No. . .. . .... .. . ....... Cert. 4,1672 Cut-in Card No. .. ............... ... .... Owner . .. .. ..C�. . !.+'.._.... occupant .......................................... ...... .. . .. . . . �...................,.........,__...; _ {�t,/' <II <..Irk= /�c�nr[- 'C� . .. .... ..................... ...... .... ... ������"" _ rJ Location r....J.._........... ............... rr ~ ' ' Installation Consisting of :. `�. f ..� L' f"6 6. . r. ... . .. .... . . . Installed B 1, .��_. fiL: rT . ..................... ...... ... .... .. Lie. ac.._...._..... .._... .. y ...... The conditions following governed the issuance or this certificate, and any ,:ertiTicatc previoGu y { issued is cancelled: — ] This certificate only covers the electrical equipment and installation conditions o darkcadel tom* the introduction of additional equipment Ur alterations, application shall be promptly it inspection. shall have the privilege of Makin - t, ns aj,'any time, and if its Inspector of this Company - Cf/r� rules are violated, the Co any shall have the right to revoke his r t e- ��. Z ... IN SPECTOR� C1ate . .`.err........ Member N_F.P.A.. S,A.E.f_ i GENERAL IN.SPECTI©N REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive am/pm Depart = S Inspector's Initials NAME: PERMIT # P" LOCATION: DATE : 7,d TYPE OF STRUCTURE: v T RECHECK -- NIA YES NO COMMENTS Footings/Piers Ii Monolithic Pour Form Reinforcement in Place The contractor is respo a for providing protection fro eezi for 48 hours following t place ent of the concrete. Materials for this purpo on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place 7"r Plubing ag Rough-iInsulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ccil ing R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging .foist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1 . 2. 3. hour Penetration Sealed Fire Wall 2. 3, 4 hour Firestoppin r GENERff.L INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 ArriveQ:a�,��} '+- : am/pm DeparP:5 .n pm Inspector's initials +� NAME: b6- 1'S cc--'�L( PERMIT # LOCATION: ••• DATE TYPE OF STRUCTURE: RECHECK NIA YES NO COMMENTS Footmg,%/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpaur Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents, i lace Rough Plumbing Heating Rough-I Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Wal is R- Ceiling R- Duct work or piping in u»heated spaces R- per Ven , ttic Vent ,to aining lG ✓ -z V G Jack Studs/Hcaders 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 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road r �' Queensbury, NY12804 Arrive.+ - 7am/pm Depart �"'` axYUpm inspector's Initials I e?_xf,'' NAME: ..\ ` PERMIT 4 _ O� LOCATION: E [Z c.N&5 '£ �- DATE : 3 TYPE OF STRUCTL E: r4 CC RECHECK N/A YES NO COMMENTS Footings/Piers 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/Wallpau Reinforcement in Place FoundationADa nipproofr n Backfill Approval Plumbing Under SI Plumbing Ven eats in Place Rough Plumbing ring Rough-In 4iisulation Foundation Walls Interior R- ,foundation Wails Exterior R- ✓F'loors R- Walls R- Ceil ing R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridgin Joist Hangers .lack Posts/Main Beam Air Infiltration Barrier Fire Separation 1 . 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Fi restoppin GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building, & Code Enforcement 742 Bay Road , r Queensbury, NY 12804 Arrive 0,e am/pm Departs ,a 1110m Inspector's initials zjlo--&' NAME: J G�-sGG— ' PERMIT # Q� 4 O LOCA11ON: r CPO e- r�iX= DATE TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampprcang 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- Walis R- Ceil ing R- Duct work or piping in unheated spaces R- per Vent L# t Vent Framing Jack Studs/Headers .Il*3raci ng/Bridging Voist Hangers _ JJack Posts[Main Seam Air Infiltration Barrier Fire Separation 1 . 2, 3. hour Penetration Sealed Fire Wall 2. 3. 4 hour Fi restopsping GENERAL INSPECTION REPORT Town of Queensbury DePL of Community Development Date inspection request received: Building & Code Enforcement 742 .Bay Road Queensbury, NY 12804 Arrive am/pm Departs amtpni `� Inspector's Initials _„ / NAME: t SL PERNIIT # 449 3 / LOCATION: SCORgA i67 DATE TYPE OF STRUCTURE: RECHECK NIA YES NO COMMENTS FootingsfNers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement rr of the concrete. ' Materials for this p on si Foundatio nu'W allpour Reinforcement in Place Foundation/Da mpproofi Backfill Approval Pi bing Under Sl ummbing VenVV nts in Place ✓Rough Plumbing_ rG } 5 Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Wai is R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent, Attic Veal Framing Jack Studs/Headers B racing/Bridging Joist Hangers .lack 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: Building ,& Code Enforcement 742 Bay Road r Queensbury, NY 12804 Arrive am/pm Depart' • a,In1 r ► Lrspector°s Initials � G NAME 1 — W PERMIT 4 , LOCATION: DATE : -� - `C�s TYPE OF STRUCTURE: RECHECK NIA YES NO COMMENTS FootingsJl'"iers 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 pur>One Foundation/Wallpour Reinforcement in PlaFoundationtDamppro BaEckfill Approval Plumbing Under S Plumbing Ven ents in Place Rough Plumbing H ling Rough-In Sulation Foundation Walls Interior R- - Foundation Walls Exterior R- 'Fj.V j 0NA JAACALx Floors R- Wal is 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 Firc 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: Building & Code Enforcement 742 Bay Road , cc,, --��' Queensbury, NV 12804 Arrive .�.mfpm Depart Inspector's Initials NAME: 0615 - 4r PERMIT # G? LOCATION: , :oeeo ,rQtjc DATE : '3 o f TYPE OF STRUCTURE: _ G7— RECHECK NIA YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is res*thcent providing protectionfor 48 hours followinof the concrete. Materials for this purpo Foundatio ru'W al 1pour Reinforcement in Place Foundation/©ampproofin Backfill Approval Plumbing Under Slab Piumbing Vent/Vents in Place ough Plumbing: _ I Vol, Heating Rough-In� Insulation Foundation Walls interior R- Foundation Walls Exterior R- Floors R- Wal is R- Ceil ing R- Duct work: or piping, in unheated spaces R- Proper Vent, Attic 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 GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received* Building & Code Enforcement j 742 Bay Road }+ ! Queensbury, NY 12804 Arrive am/pm Depa Mn Inspector's Initials NAME: Dc !'$�'y PERMIT # � 3 LOCATION: CReOJAA ) _ DATE TYPE OF STRtJCTURE: RECHECK NIA YES NO COMMENTS FootingslPiers ' ! Monolithic Pour Form Reinforcement in Place The contractor is respo e f r providing protection fro ing for 48 hours fallowing th is meat of the concrete. Materials for this purpose n site Foundation/W allpour Reinforcement in Place Foundation/Dant ng Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing_ Heating Rough-In Insulation A z_4_ [AA-A) Foundation Walls Interior R- Foundation Walls Exterior R- `JT Floors R- I k l Ar,}6 W, Walls R- p Ceiling R' Duct work or piping in AFraming unheated spaces R- roper Vent, Attic Vent Jack Studs/Headers �-- Bracing/Bridging -- Joist Hangers Jack Posts/Main Beam Air Infiltration Barrio Fire Separation 1 . 2, 31 hour Penetration Sealed Fire Wall 2. 3, 4 hour Firestopping i (518) 761-8256 ,i TOWN of QUEENSBURY BUILDING S CODE ENFORCEMENT 142 SAY RD . , QUEENSBURY NY 12804 • I INSPECTOR' S REPORT: ARR DEPART, .. i REQUEST FOR INSPECTION RECEIVED , NAME f LOCATION � . -.. PERMIT DATE TYPE OF STRUCTURE : PPROV D7 RECHECK -. ram_ Y No 1 TooN S O THE COHT GTOR IS RESPON ISLE FOR VROVIDIR PROTE TIOH FR FREZZXNG FDR 48 H VRB FOLLowl a HE pLACS- H or g C HCRE E . A R T S P E O I FOUNppTI "' AL P U �-- R_EINg{TRCE IN ACE FOUNDATIQNf 00 G sAP KF PPR L U 8 N V V N P A E -- - ROUGH PLUM G _ P U B NG D R SLAG i ING ' S K S U S HE S ANG RS JACK, POSTsr N B AIR N IID,TRATION SA E E G U H- I 3 INS L DUN A I W L H E I R R- 1 O O K O - - R- lEliAl ,� S N _ DUCT WORK OR PIPING IN U HEATE 0 SEA9S I I � r�-�,,oY�- '�cat � t-�► �i �i fib ' ' THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY III WASHINGTON AVE. , SUITE 704, ALBANY, NY 12210 . I e:r�Idllfx lf's _'_L.�' ., l ' "` �`�i ,} ;f}i'�(.�.-? • '' : . " +,-, F;, j _'. `� i tote Application No. on file THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applle-ant named on the above aprpl"tion number in the premises of 1,;$'il AId ksl'; I 'II K'; i 1r1 'ilFl ,ry 'I' Jl1flE34' 'islW 't hi' ' in thefollowiwglocation; ❑ Basement Ins Ft. 0 2nd Fl. Section Blo¢k Lot was exam i nod an '0AjllEfkP'j* I , . i ` 1'?s ; ate, found to be in cornptiance with the Notiarsal .8lectrical Code. FIXTURE TACLIM SWITCHES FIXTURES RANGES COOKINGDRCICS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCEMT I F{ucwsCE7dT oTHER MAT. j K- W. I AMT. I K, W 11wMT. 1 K.W. I AMT. K. W- AMT. H. P. DRYERS FURNACE MOTORS Fuum "MANCE MEMES [SPMALRIC'"I TIM1I CLOCI;S {�, UNIT HEATERS I MULMOUTI.WT DIIMMERS AMT. K. W. alt K ►. CV*A H, p- AMT. NQ. A. W. G- AMT. AMP. wMT. AMPS. TRANS. rn SYSTEMS AMT, WATTS NO. OF FEET SERVICE DISCONNECT NO. IDF $ E R V I E AMt. AMP. TTihE F'. I ,X 2W Ix bW a ,s 3W a.f 4W *b. '� tC. COND, w. W, a. No. OF HI-lfi3 x. W. G. NO. OF NEVTRAlS A. W a- PER AIY as CC.CaPW. # IMLEG OF NEUTRAL OTHER APPARATUS; ': PIiilY1I -Li' P J'h•F`h'l ; 'I ti� [ i+F;S;+% f 3;�'1 ?1'•i l ; fiEElEE'Al Itheir Ir ' +N..: Par This certificate must not be akered in any manner; return to th► office of the Board if incorrect. Inspectors may be identified byredentials. MEN liiiiiii NEW 111� COPY FOR BUILDING DEPARTMENT . THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.