1999-576 . „
Certificate . of Occupancy
Town of Queensbury
Warren County, New York
Date January 19 , 2000- •. _
•
99576
This is to certify that work requested to be done as shown by Permit No.
has been completed..
This structure may be occupied as a SINGLE FAMILY DWELLING
Location LOT 73 #39 SARA-JEN DR.
•
Owner
I, Gr.7.3-U-P
TAX MAP •NO, 74 . -2-73 By Order Town Board
TO QUENSr
Director of Building & Code EnfOrcement
AIMIXIMIMCGAM94.1MMUMI024.1111111EZEMIFI,
BUILDING PERMIT
VALUE $ 0 TOWN OF . QUEENSBURY No. 99576
TAX MAP NO. 74 . —2-73 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MICHAELS GROUP
OWNER of property located at LOT 73 #39 SARA—JEN DR. Street,Road or Ave.
in the Town of Oueensbury,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 Town of Oueensbury Building and Zoning Ordinance.
1. OWNER'S Address is
2. CONTRACTOR or BUILDERS Name
MICHAELS GROUP, INC.
NTRACTOR or BUILDERS Address
IM CHANDLER, PROJECT MGR 282 USHERS. ROAD
CLIFTON PARK, NY 12065
4. ARCHITECTS Name
NEW YORK BOARD
btirTIMPIMWRD. OF. FIRE. UNDERWRITERS
6. TYPE of Construction—(Please indicate by X). SINGLE FAMILY .DWELLING
( )Wood Frame ( )Masonry ( )Steel I )
7. PLANS and Specifications
No.
8. Proposed Use
SINGLE FAMILY DWELLING
0 -. September 1,4 1
. - 200
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbuty before the expiration date.) 1999
14:,` September
Dated at the T 'n o a ueensbury this Day of • 19
SIGNED BY '-� ��®r `
for the Town of Queensbury
u' .ing and Zoning Inspector
THE NEW YORK BOARD OF FIRE UNDERWRITERS CERTIFICATE NO.
DO NOT WRITE HERE-FOR OFFICE USE ONLY
BUILDING PERMIT NO.
lir „,-__-11/
TEMP.# DATE _/ - �i
CITY OR VILLAGE ZIP CODE TOWNSHIP COUNTY 17
STREET AND NO.OR ROAD �.,...� POLE NUMBER
i
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
7
OCCUPANTS NAME 1 ` , k(V q,�� BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS - HOME TELEPHONE NUMBER
ZBa L,Q-..4`-, 'etc
CURRENT SUPPLIED BY `�.y FROM THEIR OFFICE WORK TELEPHONE NUMBER
BUILDING IS -`
NEW g OLD ❑ WORK IS NEW Xs. ADDITIONAL❑- - DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
lion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st
FL.
2nd
FL. .
3rd
FL.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
c ,, 4 E. C .
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS
CHARACTER OF I RK 0 y` `',"S El EXPOSED Applicant affirms that there is not an application for electrical
El CONCEALED inspection pending with a qualified electrical inspection
DATE WORK TO BE STARTED DATE COMPLETED .,-authority, for the installation listed herein.
- This application is valid for a period not exceeding one year
SERVICE ENTERS BUILDING ~>. from the date received by the Board.
❑ OVERHEAD a 0 UUNDE,,EGROUND /�
DATE INSPECTI;ONREOL �IMUST ENTER APPLICANT'S
ESTED ON(OR ASEA1'I AS POSSIBLE) IDENTIFICATION NUMBER> 14101 I Z.
AVOID DELAYS,BY-GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINLNAME AND ADDRESS
NAME OF APPLICANT DATE APir,ILJC,ATION xS G TUBE OLP,L15.ANT
STREET ADDRESS �---' 'TELEPHONE NO.
CITY OR POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
❑ 85 John Street At 11 Washington Ave. ❑ 3291 Lake Shore Road ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK, NY 10038 SUITE 704 BUFFALO, NY 14219 ROCHESTER, NY 14608 SYRACUSE, NY 13206
(212) 227-3700 ALBANY, NY 12210 (716) 827-1155 (716)254-0141 (315)463-8552
(518)463-2122
THE NEW YORK BOARD OF FIRE UNDERWRITERS
TOWN OF QUEENSBURY
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date U 2Permit N,19 `--/ ' a
� a t
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit•
pursuant to the New York State.Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant IVA. Mt3 APPLIANCE (check appropriate boxes)
Address 7 ❑ STOVE: ❑Wood o Coal o Pellet ❑ Gas
0 FIREPLACE INSERT
�t , k. Zip 1 , FIREPLACE, FACTORY-BUILT:
Wood ❑ Gas
Phone 1 ' 0 FIREPLACE',MASONRY:
® Wood ❑ Gas
Owner ❑ FURNACE: ❑ Wood, ❑ Gas ❑ Oil
Address IF NON-MASONRY APPLIANCE:
Manufacturer:
Zip Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: 0 Block 0 Brick 0 Stone
CA° i - cco ..XE,,4 ?eO{ar FLUE: ❑ Tile 0 Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS 0 Double Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS. 0 Insulated 0 Direct Venting
❑ Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title
A 173 3389 (190) Public Safety
A.233 2655 (230)Minor Sales
l/
oI
Fee Collected From Refunded to: ;� ;'� ��r c _��
Address: ='_�_ ./
{ r
Dated: C';f= f 1 ,i Town Clerk or Deputy:
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
Application for SEPTIC:DISPOSA:IPERIVIIT
diTown of Queensbury /
Dept. of Community Development RECEIVED Permit No. hif
Building &Codes Office
742 Bay Road SEp 0 3 1999 Fee Paid $
Queensbury, NY 12804
TOWN OF Q`UEE4'� iF3URY
BUILDING p.lJO COt��
Location of property for instant lion: IC* ' � Sca ,�v.4 ,
Property Owner's Name: Ire_ (Y ii hroj,t,p
Property Owner's Mailing Address: 00 q - 0 ' LjJ
Installer's Name: t(,a& .Faarktihj
Phone # l —oa I oG
Number of bedrooms (if residential): `7 Total daily flow: (1 CC)
(residential - compute @ 150 gal.fbdrm.)
Topography: ✓ flat, rolling, steep slope % of slope
•
- Soil Nature: / sand, loam, clay, other/depth:
Ground water. at what depth? :fit) feet / Bedrock or Impervious Material: at what depth? _feet
Percolation test not required, V. required [rate I min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank laSD gallon (minimum size: 1,000 gal.)
• 'rile field: each trench sit feet / Total system length: 24(t feet
Seepage pit(s): number of / size each: ft.by ft.
Size of stone to be used: #Zs]!c / depth or thiclmess feet •
HOLDING TANK SYSTEM:'. (if required)
Number of tanks: N 1 Size of each: gallons
(Alarm system and associated electrical work to be inspected by a certified agency.) _T;' t ; =-
For your protecfion, please note.that pursuant.to_SectiionJ36.29 of *' eeas o:. f•tiee'own of.Qa �Y;-�Y 1?� '� .�::..fir :.
aPproval granted wlrich is basedupaavr.�:g:a�adidi+elisaoe. auY�atiariala:iarela'esentAtioa�:or-&liue to
material fact or circumstance known by or on behalf of aaai4plicanE,".sal be
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.
Signature of responsible person: Date: /( 7 VI)
��lT1M TOWN OF QUEENSBURY Fee Paid
BUILDING & CODES DEPARTMENT
APPLICATION FOR: PORCHES-DECKS- Permit #
DOCKS & BOATHOUSES Est. Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FOLLOWING:
The undersigned hereby applies fora Building Permit to do the following work which will be
done in accordance with the description, plans and specifications submitted, and such special
conditions as may be indicated on the permit. TWO SETS OF STRUCTURAL PLANS SHALL BE SUBMITTED
WITH THIS APPLICATION.
Owner of Property: �1cJL
P.O. Address Zee 'i?c. z Phone #
Property Location tCsk —13 — rILse Scyt'e �4M Tax Map' #
Subdivision Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name: _JtMgiK� Address Phone#
BUILDING SPECIFICATIONS:
s Type of work to be done: Porch Deck Dock Boathouse 9gQFJeYEL,J
Size of Structure to be built (square footage) : ���•F SEP 0 3 7999
Foundation Material : Width Thickness �'OVilt;l Or Q; H3^ �t�J��,v::��..6FsY
Depth of Footing, below grade: C�EF�G AND CODF
Size of Posts or Studs: 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 Posts or Studs: — x x Long
Roof Rafters: x Spacing Span
Roof Trusses (pre-engineered spacing) : Span
Type of. Roof: Sloped Flat Shed Other (Circle one)
Material of Roof:
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale and attached
hereto, showing clearly and distinctly all buildings, whether existing or proposed and
indicate all set back dimensions from property lines. Show location of water supply and
location and configuration of septic disposal area.
Size of Property: ft. x ft.
Existing building(s) : Size ft. x ft.
Size ft. x ft.
Use of Existing building(s) :
Proposed structure, distance from property line:
Front yard ft. Rear yard ft.
Side yards ft. and ft.
If on corner, setback from side street: ft.
DECLARATION
To the best of my knowledge and belief 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 not, and that such work is authorized by the
owner.
DATE: SIGNATURE
Owner, Owner's Agency, Architect, Contractor
REVIEWED BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE
. .
. .
Bu i/ding PejynE Application • • .
Tully' C7f Que'e'lisbury - Dept. U/`(,f)1niminity Dr'pc'h)/)lllc'n►, 742 Bay Road, Qi eei►.sL:ii j', NY 12801 1761-8256J
_._ __ BUILDING • tc. CODE ENFORCLMGNI
LriitiI ____,
Requirements prior to issuance
rA rntil rnrrst Ire ullMiriccl Ix.linv t)1 Iltis f Icrlttil •
P11Mf1T F1LE NO. ,le—�,ning construction. No Mycelium _ RFC t �\7tt Z onin, 1.7ch)ld JJClioii 11114111'! LL 9$
C utndts until npldit:nrd tors rccr.ivccl t—� g ® � � �.I,Ii.) iJUILIM tl t'IittM r. All Arcrr /Um' • SEP 1 99llrc;llr.I;rxul'✓il:ls l' 5-3Dnuts' rlrncrs un Ihi�r n1'plicntinn..
T bo cum tictetl nntl.the si nature . T j1NOFC l;- '�, yI K U ,1 holing liurtld ' 1 >1EW,GU lilt•npplicnnl must nplx:nr on the �3ll�t_ ii�la f;cif•CC.SI'It I Subdivision /�5i'her Budding lrup ctor•tion Jinn!: le.,:q,,. ____`yy`J itcetention Fee I')tyntcnt •
Applicrutl: IN! Michae0 G)r.onl.), Inc. Owner: Some
•
. ' Adthcss: 1810 Route 9, (.cute Gen). e, NI' 128/ritlress:
!'(torte,t'7 ( 518 ) 668 - 3376. l'hono // ( ) - • .
- Properly Location: tC-'t-IS' a( %21`Z. .12A 2�iD ._.----
'1'n Mnp Number /
Subdivision Name:. _ Section Block molt
1.ghl�nc�. F k1C �'
I(ATURE Or PROPOSED WORK: ESTIMATED tiARKE'L' VALUE OF THE
. New lJu.lJ.ding: • CONSTRUCTION: •$ 1lp1 CM •
r.euidence / commercial
Add.i.L i.on to Building:
residence / ccnimierdial OCCUI'Al1CK Itlr011t•il1'PION:
�� l�.l,Lot:rtt: i.crn tot.ttt 1J.clLncl: Primarytluilcting --
t:ee.ldemce / conunorcial x Single Family Dwelling
Residence / Commercial Two Family Dwelling •
no Change to exterior size . __ Family Dwelling
Uf•fice
Other Work (describe below) , Mercantile
• Manufacturing
•
. Other
GAUSS AREA or VIioPOSEI) STRUC'TvRE4 Z(I •flP .
lsL Floor If DDI'1'.LON, what will use
�'�O^l sq• f t �„�a rt w addition be? :
2nd Floor ' Vi3+ , sq. ftwt t A ' /
Other Floors eq. ft.
(trot unfinished cellar: or basement) ACCESSORY I3UILDYNdS: J�
• ee�� _ Detached Garage 1, 2 ar
TOTAL FLOOR AREA: h14AA SQ. FT. _ . Attached Garage 1,
Private • Storage Bu
SIZE OF NEW STRUCTURE: Conunerciai Storage Building
Other . • . . .
I UT x 4o FEET
Foundation Typo: l'oulte.d / Will any second-!rand or ungraded
' Number of Stories : 5 lumber be used? If so, for what?
( habitable space only) ___An__,______,
ileight (grade to ridge) : feet TYPE OF HEATING 5 STEU:
Number of fireplaces and/or woodstove ( Circle. all whit Rpl ee)
to be :installed! 1 Electric / Oil Las' Wood
Forced not Air / Ba-dc� oard / Other
Person r.e6ponslble . for eupervielon of work as regards to building
cuden in t J]1I_(<[tGU1r1.f pit, 1'/tgj aRag_a or Eric Rice, Proj e' t.
, Willie llddreenn P hone '
iiuiJ.1er. : lite hb:r.lttzebs Gum, Iite. 1810 Rte. 9,Lake Geuft.cie, NY 12845 518-668-3376
PJ.umber: Jl'ctvct i'.fu►,LG.ing,__.LO 1'ajjz Road, G.Ce.it4 1=a.CZ, NY 12801 518-198-4379
Ma rl o n: JJ C.O.I. r lt.eiL,_(3.. 21L8, Gacto i._LL.e.._N Y
E l e c L r.i c i.n n:J_oiLEvslt_ l.mthic, 2446 ' 1ct/f ie y S.t., ache)w iasi y, NY I?.3118 18-3 71-9 9 2
DECLAiMJJON.' Please.sign below after you hate carefully read the sIaIelncat.
To the best of my knowledge the statements contained in this application, together.with the plans
. end specifications submitted, are n true and complete statement of all proposed work to be done on
the described ;itemises end Chet all provisions of the i.loilding Code, the Zoning-Ordinance and all
other Jaws pet raining to the proposed work shell be complied with,- whether specified or noted, and
that such wot k is authorized by the owner. . itot(her, it is understood that I/we shall submit prior to a
Cc'tificetc of Occupnncy'or Cc:til er:le of Compliance being issued, an AS BULL'!' PLOT PLAN by
a licensed surveyor; drawn lrj se,le, showing actual location of project on premises.
' „"s+ r owner's nt?CI11, architect, contractor) '
J__l'J_•_l'J_p_l*_...k.. J_ J_klAt J.o ,,,"A k m trait .".y."l' J_"_l'L!l �_l',,.. .A._lz!l'mi_l N J_�_l !l!,..si 'J_�_oNvA_l l_._l � J_� Aii._l �_l'J__1 �. .1' 0_l':eXJ! ...1' .t:,": ..r..il_l f,
i THE NEW YORK BOARD OF FIRE UNDERWRITERS i:..;U '
028139 BUREAU O ITY i}
111 WASHINGTON AV ., SUITE 704, AL NY, NY 12210 r:
ii 1: B1-RWWRI :�. , 2000 4 .3339.;I�-��9 e l 148641 1Y-
Ar Date Applicat on No. on file
1 THIS CERTIFIES THAT c7c)� jiCi
ji only the electrical equipment as described below and introd by t e zit zz zned on the above application number is in the premises of ift
i THE
n{ j� J } p�} c }� JEN
�l 1 �r�9} }Y( j NY rF
WI THE S'LI HAE t'x`.7 GROUP, 39 SA RA JE DR. LOT 3„ QW.SENSB RY,
r_
Ki in the followinglocation; ® Basement '' GAR ?3 r 1st FL 0 2nd Fl. Section Block Lot ,
'Ai was examined on Jl hltl�I?Y 1 "?@a G> and found to be in compliance with the National Electrical Code.
1 FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS r
it
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
_C
j1 34 39 lc, nq V:-.r
VD
V.
Wt 11 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS r
S 14
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. Mil H.P. NO.OF SYSTEFEET AMT. WATTS iY
IA
=4
SERVICE DISCONNECT NO.OF - S---- -- E - R V I - - C E 'r
=�I AMT. AMP. TYPE EQUIP. 1 0 2W mis3 0 3W 3 0 4W NO.OF C COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G.
PECR 0 OF CC.COND. OF HI-LEG OF NEUTRAL r5:
_•CIX -1 2/0 r7
=G
OTHER APPARATUS: Ir
!(I
ii rOS2' LIGHTiYi -
r_
G.I'.C.I:-4
Al
5 1CDETECTOR:_7 r
r
r
,
Al
�� 1.''., ,,.4-. . r'.. -, r.• i
Cr I .: , 1)=
WI FOREVER EL C .80Lr Er.PCi'.i I =,j - . ���.;, I L w 1�
PiILaINI D. n:CP 1��.I':GtON IKI4 . rsti.tit°_• �a R,%� r
=; 2446 J-+ ET ('Y SqT° i b4;; A"�l�),` �' GENERAL MANAGER
gc�7L22..gv.SV1:rI.:.1AD , NY, 1t230q b, IPf. f'i `7.' ?''"� `.f 3'4
j; ,,. �, + - .• Per I i
r
W; 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. Pr
'0,4Y4YYiYYVYYiYY�Y4YY�YYit4T.4YYiYYiY;IV,Y�Y;Fit Y4YI'iYY�YY`.YY.-YYVilYiYY�YY�YYV-,Y•WeT.5iYYe,4YYiYY�Y4Y4YYkYe,YiYY•Y iiiiI4Y4YYiYYVYYiYY-•YYiiY
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT RE Al TFRFr) 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? ' m
Town of Queensbury Inspector's Initials lZ
742 Bay Road
Queensbury,New York 12804•
NAME V\-k,�Gckft- U3 PERMIT#
LOCATION DATE L 1 1 ci )6b
TYPE OF STRUCTURE
N/A. YES NO COMMENTS
Chimney Height/"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 mare
Interior Handrails stairs both sides 3.or ore risers\
Grade 2%away from foundation
8"clearance to sill plate ,
Gas Valve shut-off expoSed/regulator 1 "above de
Gas Furnace shut-off within 30 feet or thin F ` of site
Oil Furnace shut-off at entran to furna ea
Furnace/Hot Water Heater opera&'
Relief Valve(s)installed
Headroom,6 ft. 6 in. on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more 3 risers
Interior privacy/trim/doors/main entran 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 . or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans �p csK
Plumbing fixtures �' C�✓)2 S
Foundation insulation L r& L.p &1(
3/4 hour fire door/door closer
Garage fireproofmg
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
SJite Plan/Variance required /
'4 final Survey Plot Plan La %if
- As Built Septic System layo t required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy) foT / �Q'+e(� A-frQou-
Okay to issue permanent C/O(Certif. of Occupancy) IY �`y(f U (
2d3 / 4 3
RESIDENTIAL.FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received: Il4/ ail° \,311--�
Building& Code Enforcement
Dept. of Community Development Arrive am/pm Depart `•_.\e)cy/
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury, New York 12804
NAME gd--,e,elsc., 6 PERMIT# —S
-17 ,c
LOCATION A_ -k,S g DATE .c.j/4/ '/6/1 ci `"
TYPE OF STRUCTURE ;.��T�
L)Dy
N/A YES NO COMMENTS
f i'‘fr- 0.---ef�� Q
Chimney Height/'B'Vent/Direct Vent Location ✓
Fresh Air Intake
Plumb Vent through roof ,/v/
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,lan . 8 in. or moreVi
Interior Handrails stairs both sides or \ore risers
Grade 2%away from foundation
8"clearance to sill plate \ i
Gas Valve shut-off ezposed/reg ator 18"labove grade 1.1,
Gas Furnace shut-off within 30 f t or within line of site
Oil Furnace shut-off a entrance o furnacp area /
Furnace/Hot Water Hea oper ting / tJ
Relief Valve(s)installed, ,_
Headroom,6 ft. 6 in.on stairs l ;
Basement stairs,6 ft.4 in.
Handrail exterior stairs both s des more than 3 risers /
Interior privacy/trim/doors/m in entrance 36" .
Floor Finish
Bathroom/Kitchen waterti ✓/
Interior Handrails Balconie /Landing 18 in. or more
Railing across window in .resells
Smoke Detectors: Vi
every level ,/ ] >�
every bedroom jz. O u- ..!,,5 L..E-D 6 Erc 1 6
outside every be m
inter connected ✓ lend
Bathroom fans
Plumbing fixtures V/
`Foundation insulation J ---K5
3/4 hour fire door/door closer7 ✓ '�!v LA-4I Ov�1L 14A"���
Garage fireproofing C_e=4-L..X J TA-1 le 5
Garage penetrations sealed
Furnace in separate room protected(in garage) /
Light ventilation per room 7 �/
Safety glazing 18"o les fr m floor
Final Electrical k �,`ti' Ail.1.3
Site Plan/Variance rc,q . d
Final Survey Plot Plan
As Built Septic System layout required
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) vi
/,'°f1-N
FIRE MARSHAL
• ``* TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
j? 3 dt-s- 39
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED ."--3 D'eful)
N E
S JL---) PERMIT#
SCHEDULE INSPECTION ON T2 -. i' ' D-cfb
i0-6 p AM,
9-2„_, 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 SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE ❑MASONRY ❑FACTORY BLT.
❑ROUGH-IN
❑FINAL
REMARKS: XOK TO THIS DATE
- ) (� �l�}�c- 206 rdm 1°1P cropn
3� G I" - OK1
1-4) bve,c� �!e n I OK-
INSPSLIP.PUB INSPECTOR
FIRE MARSHAL
TOWN OF QUEENSBURY
40, 1; QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# lc/ - 6WO
NAME CAMAS (�� � .
LOCATION ?341 74 Pr '1€ )
SCHEDULE INSPECTION ON I
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS \`
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEIA
FIRE SUPPRESSION SYSTEt
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SP'INKLERS
CLEARANCE TO H ATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
t/9 FIREPLACE-MASO RY
FIREPLACE-FACT.ORY BUILT
REMARKS: OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
17100101k TOWN OF QUEENSBURY
.-AL.
' BUILDING & CODE ENFORCEMENT
� 742 BAY ROAD
`, QUEENSBURY NY 12804
• (518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPE�CC`TION REQUES RECE D:
NAME `\ \\�cC)"\c ( --“_:,C4)1
LOCATION i -2 rC
DATE A —f C- PERMIT b Sr
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N YES NO
CHIMNEY HEIGHT/D VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS / ,
:/
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS/
r'
FINISH FLOORS: /
BATH/KITCHEN WATERTIGHT/
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE RAILIN S
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ. y��
' AL SURVEY PLOT PLAN '"�
OK TO ISSUE C/O OR C/C
1 $ 0 - i t3
lv
GENERAL INSPECTION REPORT
( 518 ) 761-8256 •
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive K lb aim ) Depart
Inspector'slni •
NAME: 9.S.N\\� Ct Q�1\CSV � i7 PERMIT# -
c(cio
LOCATION: `ce\� � .. '� DATE : ll
TYPE OF STRU TURE:
RECHECK
N/A YES COMMENTS
ootin_./Piers � I
Monolit 'our Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the .lace ,ent
of the concrete.
Materials for this purpose of site
Foundation/Wallpour
Reinforcement in Place .
Foundation/Dampproofi n
Backfill Approva
Plumbing Under Slab
Plumbing Vent/Vents in 6 ace
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls In rior R-
Foundation Walls Exerior 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 I, 2, 3, hour
Penetration Scaled •
Fire Wall 2,3, 4 hour
Firestopping
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road ,p t
Queensbury, NY 12804 Arrive am/pm Depart ` • 5�
Inspector's Initialsniiaal
NAME: I/ 1Q AP, PERMIT# `%' �r 6
LOCATION: 3.1 .4 tf VFr� DATE : 2—air
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form a
Reinforcement in Place
The contractor is respon ble for
providing protection fro freerirg
for 48 hours following tl a place lent
of the concrete.
Materials for this'',purpose on site
Foundation/Wallpkur_
Reinforcement in PIK?
Foundation/Dampproof n.
Backfill Approval
P mbing Under Slab _
lumbing Vent/Vents in ''lace/s�
Rough Plumbing Ai4 L.' 1,l�. � •
Heating Rough-In
Insulation
Foundation Walls Intl rior R-
Foundation Walls Ex erior 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 I, 2, 3, hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Firestopping
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Qucensbury,NY 12804 Arrive am/pm Depart c
Inspector's Initialsti�
NAME: L'V��C/{I-&.5 6/2f. PERMIT# q`— 576
LOCATION: DATE : i Z f ci 09
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Picrs —I 1 I
Monolithic Pour Form
Reinforcement in Place •
The contractor is res nsibl for
providinigprotcction rom eezing
for 48 hourS-fQllowi the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour__
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab _._
•
Xo
umbing Vent/Vents i Placesr-
.
ugli Plumbing /L /"d LTG-5 1111`�'�,9—CL �C 9'(�5 I (--_ 6� rrt
Jjeleating Rough-In S Try
sulation
Foundation Walls Interior R- _
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
roper Vent, Attic Vent
-VF Q
raming '\/�rjelQ 5 U;oPd4% - ,
Jack Studs/Headers -r6 t�\ Q
Bracing/Bridging y_U�I l- _
Joist Hangers_ C►4u,5 Lc— &6.K
Jack Posts/Main Beam .
Air Infiltration Barrier
Fire Separation I, 2, 3. hour _
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
45P
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road �/
Quecnsbury,NY 12804 Arrive am/pm Depart , la / m
rr Inspector's Initials �J
iC v�� n PERMIT# `5�
NAME: �C,lrkk(, 5 V
LOCATION: '�c\ �,a(NA, .Jc—tJ DATE : i 2
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsibl .
providing protection from reezin
for 48 hours following the placeme t
of the concrete--
Materials Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproo
Backfill Approval
Plumbing Under Slab
lumbing Vent/Vents in Place_Rough Plumbing _ /N %/1- L /L/41 L iCp
A--r `5 A/ - '0
Heating Rough-In
Insulation
Foundation Walls lnterio R •
-
Foundation Walls Exteri r R-
Floors -
Walls -
Ceiling -
Duct work or piping in /
unheated spaces R- //
?roper Vent, Attic Vent
Oran-ling n
Jack Studs/Headers / (" r
Bracing/Bridging
Joist Hangers_
Jack Posts/Main Beam 1V�
R l O C.- �2 A I:T&a -5 U;oeoeve 7---
Air Infiltration Barrier
,_�. ��
Fire Separation I. 2, 3. hour " �f, �L �
enetration Scaled 0 �`�=�'/��L Lc�n�C
Fire Wall 2. 3,4 hour
iF
- _ I `.
irestopping C -__ n':.. v V►" - �, ..,,a-
� __
,.. ,
iik cf),d,,,,,,f
TOWN OF QUEENSBURY J.?
BUILDING & CODE ENFORCEMENT /(J
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name .C3
Location \ c)QXC \
Date \ 3eit
# l 4-5 /
SOIL TYP Sand- oam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minu .-/Inch
TYPE OF SYSTEM: i
ABSORPTION FIELD: Total Lengt 2.-1 (4?
Length of each trench • .}%, : -j4-7. `, -r
Depth of trenches •-
Size of s ':i - 4
SEEPAGE PITS: Nu .. -r
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank t-r t1)C-4-k(-.ny`li,x) J
Tank to Dist Box q: Q'd L
Dist. Box t. Field/Pit ,3C_i(3 ItA2a.
Openings S-;:led? 40 No Partial
LOCATION/S. PARATI
Foundati o to Tank lLt- feet
Foundation to Absorption 1 feet
Separation of Pits feet
Conforms as per Plot Plan Ye`N�
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front (-,--Middle Rear' _
COMMENTS:
0 - T \ lice.
SYSTEM USE APPROVED: YES CNO
=- L_
Arrived: - f
Depart:.9 /"
4 ,,
/ Building nsp::t®r
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 ay Road -
Quecnsbury, NY 12804 Arrive am/pm Depar 4��t m
Inspector's Initials
NAME: S‘$ �_ PERMIT#LOCATIONDR DATE :
TYPE OF STURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freeing
for 48 hours following the plat emen
of the concrete.
Materials for this purpose on sit
Foundation/Wallpour
Reinforcement.in Place
Foundation/Dampproofi ng
\aCl'cfill Approval 14/1
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior '-
Foundation Walls Exterior '-
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
FIRE MARSHAL
TOWN OF QUEENSBURY
° QUEENSBURY, NY 12804
-`f (518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# 7 7--571P
NAME IkA t ckfiree..6 rer -
LOCATION 1 R -
SCHEDULE INSPECTION ON
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING / }
FIRE EXTINGUISHERS _
FIRE ALARM SYSTEM
FIRE SPRINKLER'SYSTEM
FIRE SUPPRESSIONTSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRI JKLERS
CLEARANCE TO HEAT NG UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT (Z64-(% s�
isc,V1- `(1
REMARKS: ,.Jir,v3 , t f,) MOK`TO THIS DATE
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INSPSUP.PUB INSPECTOR
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MAP REFERENCE:
LE LAND ESTATES SUBDIVISION
MODIFICATION PLAN - PHASE 2
DATED: DECEMBER 22, 1998
RE SED: DECEMBER 29, 1998
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
SARAH JEN DRIVE
S85'41'20"E
ENyg
100.00'
C L
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73
20,000 sq ft
.� 0:46 , acres ..
JAN 1 8, 2000
;... „
I HEREBY
FROM AN
THIS CER
FOR WH
100.00'
10 ft NO CLEAR ZONE ALONG REAR L
T LINES BEHALF T
AND LENDI
- - - - -
�► n- D u s
& Steves
Land Surveyors, LLC
37 Ches er Street Glens Falls, New York 12801
(518) 79 —8474 New York Lie. No. 50135
' NOD 41 YU W 1
' LEHLAND PARK PHASE ONE
%RMffM M ALTMT M OR AMOK TO A MMEY
MAP NENINO A UCONM IIMD WRNEY= NEM. 13 A
MCLA110N K WfM 710k NRI-O MIM % OF W
'awY carts FNa 111E 0R10N& DF " MONEY
"MM w1M AM aNIML OF A1E WC RONEY=
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7MIN ARMY NW PRETAIMiD N ACCONDANfX WM AIE
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CO W NEM#U V I1E Inc COI~' 00YF AwffAI
OF NE
ss ��P�cV►EW C'b�q.
Map of a Survey made for
& PAMELLA T. HASELT4N
TOFINE NI&MAM "° IM LENDommm Mn "°�°'� "'° Town of Queensbury, Warren County, New York
>n n+E ANNIaEEs of I1c U�;oN1D NNn1UIaA• ,
NO. I DATE
CERTIFY THAT THIS MAP WAS PREPARED
ACTUAL FIELD SURVEY.
TIFICATION SHALL RUN ONLY TO THE PERSONS
OM THE SURVEY WAS PREPARED, AND ON THEIR
0 THE TITLE COMPANY, GOVERNMENTAL AGENCY
NG INSTITUTION LISTED HEREON,
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS. OR SUBSEQUENT OWNERS.
CERTIFIED TO: Forrest R. & Pameila T. Haselton
PNC Mortgage Corporation Of America,
its successors and/or assigns
Chicago Title Insurance Company
CERTIFIED BY
MATTHEW C. STEVES, LLS NYS 50135
DATED: January 19, 2000
S-1
BHT 10P 1
HASELTON
DESCRIPTION DWG. NO. 89423-73