1999-595 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date rIca Tn1-141 r ia. 19 9 9
LA/
This is to certify that work requested to be done as shown by Permit No. canco=
has been completed.
• This structure may be occupied as a SINGLE FAMILY DWELLING
LT 3 5 ,#1 5 JACQUELINE DR .
Location
Owner 11/117enT-T7177T rtITO
By Order Town Board
TAX MAP NO . 7 4. 2-3 5
a4:7E U
•I\
Director of Bldg. & Code Enforcement
•
BUILDING . PERMIT
VALUE $ 175000 TOWN OF QUEENSBURY Na 9959�
TAX MAP NO. 74 . —2-35 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MICHAELS GROUP
OWNER of property located at LT 35,#15 JACQUEL INE 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.
aIriR L Miter MGR 282 USHERS ROAD
CLIFTON PARK, NY. :12065
4. ARCHITECTS Name
NEW YORK BOARD
NEfWicVt3R4 ' knit) OF FIRE, UNDERWRITERS
6. TYPE of Construction—(Please indicate by X) SINGLE FAMILY DWELLING
I )Wood Frame ( )Masonry ( I Steel (
7. PLANS and Specifications
2513 S2 FT SINGLE: FAMILY DWELLING WITH 2—CAR ATTACHED GARAGE
AS PER °'LOT PLAN SPECIFICATIONS
8. Proposed Use . .
SINGLE FAMILY. DWELLING
311- September .21: ..: 2001,
$ 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 Oueensbury before the expiration date.)
2.1 .., September 1999 .
Dated at the Town of Oueensbury this Day of 19
SIGNED BY _ for the Town of Oueensbury
Building and Zoning Inspector
Application for SEPTIC DISPOSAL'PERMIT"` '` '':'
Town of Q'ePnsbury
Dept. of Community Development • Permit No.
Building &Codes Office
742 Bay Road , Fee Paid $
Queensbury, NY 12804 .
Location of property for installation: I CA' �a \,n Q Au_Q.
Property Owner's Name: 'fQ ni vica S` hroup
Property Owner's Mailing Address: 1010 1chide q - 0 Ige1386ANA3101.1c
Installer's Name: 1 i,Lc •FaA, Phone # ( a i oq
. Number of bedrooms (if residential): Total daily flow: 1O.C1
(residential -compute @ 150 gal./bdrm.)
Topography: V flat, rolling, steep slope % of slope
Soil Nature: / sand, loam, clay, other /depth:
Ground water. at what depth? 1.) feet / Bedrock or Impervious Material: at what depth? _feet
Percolation test: not required, 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 WO gallon (minimum size: 1,000 gal.) •
Tile field: each trench S4 feet / Total system length: 24 to . feet
Seepage pit(s): number of / size each: • ft. by ft.
Size of stone to be used: #2 / depth or thickness feet
HOLDING TANK SYSTEM:' (if required)
Number of tanks: NIA— . . Size of each: .gallons
• (Alarm system and associated electrical work to be inspected by a certified agency.) .. y.
ease-note: to.-Section136.297of3� Hof.theAownofQueeiosbar9:snypen yr,For your grantedprotection,�Pl P.�� : r'C°da:. .- :...
c 'ae..... :t. y. .k_:.:.1..
aPproval
which ie based: or.is:grsnbed.3a':i+eliazicesupoa. smateial;°mis or•fa>Yure�to makp.� .: ::< *
material fact or circumstance known by or on behalf•of aaapplicant,;shall 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. `
Sib ature of responsible person: Date: 1(- `9 5 •
ull d in't ] erniit Applic ation • • • • .
7b,,,11 of Qll(?eiisbiiiy - Dept. of'Community Development, 742 Boy (load, Queeusbruy, NY 12804 1761-82S6f
n._.-h.-•-i •
UU1L DIN(; • & CUDl ENFORCEMENTN _ _ tluirentcnls prior to issuancePERMIT FILE NO. qcl -ill
- of
this itcrlltil: — S fP
A 'sunlit mil be obtained berme --•--- — �.�-
begiiuting ccnisltaclion. Ni; inspections 1'1:71h1I1'I1sIs 1'�ilU$�T� f
�_) Zoning Board i1Cliort
will Ixr utndo tnilil nl+l+li+�nnt luis tcccivrd
�t VALID uun.ulNcl rliunn r, AllnAwn1 v . 1(Is-lu�.I rruN F
nl+ldienntn' rpnccn on Thin nly,lir.ntiun . _- /71
MUST Ixr con ►Irlc+l nntl•ncn signnlutc Ej ,i'lanning Ilcxud Mellon 1 7V1 rw,sv lll:
of the n)r)tlicnnl um(opium on the hurtling hupeae
St It / .,ubdivisiun /Oilier
►il+)rltenlin linnt, ra•,,t,,,� __ 1 k.
It mention ['cc I'nyn►cnl +
Applicant: I he Al.CCIIi(eC6 Gttunl.r, 'Inc— Owner:
Some
1810 Route. 9 Lake (;c',ultc�e, NV I 281'�t t less: • .
Aticl l css: ' '
('hone,ll ( 518 ) 668 - 3316 . Phone #_(-_ ) . . _. ... ..' .
•
Properly Location: ICA-35— 15 ,ac tr\.c�`U-,`�' 17/. / `7 / 3
I y Tax Map Numbc
Subdivision Name:. 2 ' S1��C ! Section Black Lot '
NATURE or PROPOSED YIORK: I;S7.'IMIt'1't"sU MARKET VALUE OIrO'11E.
Dow Buil.d,ing:. CONSTRUCTION.:
residence / commercial
ndd-i.t.i.crn to Building: . vc:cvE'nNcx IrrrUliMl1'1'IUN!
r:r.ct.i.tleuc;r. / commercial
n1Lerrl cn to Unildlimt Primary Building -
residence / commercial X Single Family Dwellin
g
Residence / Commercial Two :amity , 414� n •
no change to exterior JJ [ratti tt � t
. r
Uffice
Mercantile SEP 13 1999
Other Work (describe below) Mottu£acLurin0 �-�•
Outer TOWN Ol-'O lEF3\1, BiP.Y
— -- F3UtLC1i3�Ci_ `�D CODE
GROSS Floor OF l'I(UL'OSEI) ST1tUC'. ft. 2S If ADDITION, what will use
OD
].st 2 eq. fi: )1 of rtew addition be7 :
2nd .floor ' �� sq. f N/A
Outer Floors _ eq. 1:- 3b
ACCESSOIIY [3UILUINOS:. 2 car
(trot unfinished cellar or basement: _ Detached Garage 1,
Attached Garage 1,
• TOTAL FLOOR 111tL1\: 5V� Su• 11'• private • Storage Bull i g
Commercial Storage BuildingSIZEOF NEW STRUCTURE: Other •. ' _
rj4 FEET r FEET - . .
Willoanyesecon -handso, ungraded
eL7
Number: ot!n tore : I'ou/t . lu b
' Number of Stories : ____N
eightab r create only) , 3C _ feet TYPE OF' NE11TINd Sys'rEI.1:
Height (grade to ridge) : C LrCle all wltLc�--an es)
Number of fireplaces and/or woo stove ( *Circle'
Electric / Oil fag). Wood
to be installed : _ A__ Forced Hot Air / 13a c oard / Other
Person responsible for supervision of worrora peg rds L p building •
codes is I l> (:.hat iffi .,_IUl.0 - u.t�a0.1
Nciiite Addresee • V I tt 28d5 518-GG8-331G
Builder: Zile Mi.chcz.efJS Ghottp_, tile R-t
. 1810_ e 9,_Lake UIUGQ C j
Plumber : _- 'clod I'.Cu►�U�,►itt,__11ZA rah Kgaci, G.C-t?,ItA Fct.C.C4 NY 1280 518-198-43 9
t•tatJvtt : j1 kue.h. .,_3.otL2.6.8 a.auat-iLte.,Ny --- �,18-311-992
E 1 e c I r 1 c 3.a t t- :__Lia/t-c'vs1t._L_�e csUl-c-c:,-21-d lLl ct A A.e.y-S= •- It eae. -asiy.r. —U-3
DECLAKAIIUN:: Meuse sIgrt below uJki you lun'e corefrtlly read the statement.
To the best of my knowledge the statements containd inhis ap oflall licaton, to work tottbo the
plans
one o
. and specifications submitted, are a late and complete statement •
the desct ibed pt effuses and that all provision It ill be co untie tti thing ng cxie, (Itoith, oning•Oifierdinance
err noted, and
other law, pet lainirtg lv the proposed .work s1/we
that such work is authorized by the owner. Cut
rler, l is bciunderstood
an�AS I3USU.:I'1.1:'LOI'submit
i'Lprior
11Nto lJYt
(:ctlificalc of Uccupancy''tr �'�tlificalc cr Compliance b
a licensed sI : ._ 1tvts1huh1
veyo ; • tf , lual location of project on premises.
Signature:
..n,. r nwurr's agent, architect, contractor)
J•
•
,;,:� •-- TOWN OF QUEENSBURY Fee Paid
41F BUILDING & CODES DEPARTMENT Permit #
.APPLICATION FOR: PORCHES-DECKS- �� (5
•
DOCKS & BOATHOUSES Est. Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FOLLOWING:
The undersigned hereby applies for a 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: Thy xc\- .k G cae p
P.O. Address Z82 vs ,- Ro. Phone #
Property Location. 1c* 35 - I5 _. zcrc. ,k, lOvou...A. Tax Map' #
Subdivision Name (If applicable)
•
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name: J W 6\bdv ..4-3. - Address Phone#
BUILDING SPECIFICATIONS:
•
Type of work to be done: Porch ' eck Dock Boathouse (Circle one)
Size of Structure to be built (square ootage) : Iiik-Q S:F
Foundation Material : Width Thickness
Depth of Footing, below grade:
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: ll SIGNATURE
Owner er s Agency, Architect, Contractor
REVIEWED BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE--
i
TOWN OF QUEENS tURY
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date sNIVIAtutr ,19 Permit No. -5 95
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 "TLANe \cVi ,,AS rn 2c APPLIANCE (check appropriate boxes)
Address 4fS Q$ ❑ STOVE: ❑Wood o Coal o Pellet ❑ Gas
0 FIREPLACE INSERT
CV pork_ Zip t ,0G, XFIREPLACE, FACTORY-BUILT:
te) - 5 ▪ Wood .:Gas
Phone -� 0FIREPLACE, MASONRY: .
❑ Wood ❑ Gas
Owner ❑ FURNACE: ❑ Wood ❑ Gas ® Oil
Addresst\ IF NON-MASONRY APPLIANCE:
Manufacturer:
c_ r ture :
Zip _ . - Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: 0 Block 0 Brick 0 Stone
lc* 85 - IS FLUE: o Tile ❑ Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST )i®FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS. 0 Insulated 0 Direct Venting
o 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 bT q 541 G5'06
A 233 2655 (230) Minor Sales
Fee Collected From or Refunded to: i ") C L.
Address:
Dated: qjj. pgii Town Clerk or Deputy: ( °' ") r -V,
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
ti
SLLV: !_LIIM).El''A• J_•.lJ31_Q..A. J_.J_".lJ_•.MILL!'J_• J_• WA'11. LIN:'J_•.l')!_lJ_11_� 4_l'J__lJ_•_M•_l'J:!)."1_•_:A1:1AaLLI'A•� �. 'J_•_l''),,,Q,Amito•)l' •_l' •k)_x: �_.vAt itm.!l l� .m._l•_l' •_:z
=G IY
w, THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 iy
.1 40.28789
j BUREAU OF ELECTRICITY
rsi WASHINGTON AVE., S LBANY, NY 12210
1 T' Cx1�` u'Fi ?2,1111 99 �.6O1O099/9 9 A 147575 4•r. Date Application ,on �/e 4
�1 .F.611TIJ.! V .n95 li
!-K1 THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of i}
4-4 07-
1 THE MICHTAL'LS GROUP, 15 JAOQUELINE DR. LOT 35, QUEENSI3URY, MY 1i
z<1 di 1S 1 GA i Je t` 1�
!(' in the following location• ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
.DErCEMBER 10,1999 Ir
i was examined on and found to be in compliance with the National Electrical Code. I
iii 1
_(1 1}
WI FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS i4
'�1 OUTLETS L INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1
IA
rti
1 JG! J �� 32 --■ ■■■.■.
:1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 'Y
{ AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. 11:2 H.P. NO.OFit nFEET AMT. WATTS '
' SERVICE DISCONNECT NO.OF S E R V I C E
•WC� METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. I
1 AMT. AMP. TYPE EQUIP. 1 0 2WMEM 3 0 3W 3 0 4W pER 0 OF CC.CON D. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL I)=
1 j n f ■ ■■ 31
_- ip
2tfG C 1 /0 1 . /0 1��'
i
---- OTHER APPARATUS: iY
WI POST .L 1t�JIT-'1
�a T DETECTOR: 0.
WI iil4O.fil1 DL:Zylt'CTO :"% I
j I
�(1 (f p
�� 4. •- /L IT' i ` I F,F
FOREVER x'LEC/BOL'L ELECT. r,,4' ,, _....1-' ( • L IY
w; WI L.L Al�d D. MGPARTLO11 ,'% a k+-: •'-"C:a°: L
1 de ._b..4 Wsy I
1 .2446 JA±�FRE Y ST. '` ' i1 1-11T'i GENERAL MANAGER ''
114 5(HI,MECTADY, MY, 12309 a '_ � 4 r.ci b.l.. 4PY tl1. .e:
'1 L.v.• yL,I,'. I Per P
• 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. r
4Y7TiiiliVil'Aitil Y•YY•rizW Y•YY,Y 1'•YYiWiliti%Y YiY YiYYiY YiY Y.Y 5iY Y•Yl'•Y Y4;ii YiY YiYY•Y YeY Y•Y Yii1 5Y YiY Y Y,Y•Y ii-YiY Y•Y4Y YiYziiY Y.Y 4i;5iY;fi YiY Y4Y Y4YY•YY•Y S
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 • Date inspection request received:
Building& Code Enforcement i i j�
Dept. of Community Development Arrive am/pm Dep age_____-
Town of Queensbury Inspector's Initials `�-
742 Bay Road
Queensbury,New York 12804
NAME (MICAS6US COP. PERMIT# 5
LOCATION /-J4 6VJ L(/C}-L DATE /2 /q/(3%
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney HeightP'B"Vent/Direct Vent Location 4/
Fresh Air Intake ty
Plumb Vent through roof
Roof Complete /
Exterior Finish Complete ✓!
Interior/Exterior Railings 30"to 36" �✓`
Exterior Handrails,balconies,1. • 18 in. or more c/
Interior Handrails stairs both sis es 3 o more risers
Grade 2%away from foundation 71/
8"clearance to sill plate
Gas Valve shut-off exposed/reg ator I:"above grade
Gas Furnace shut-off within 30 f:.•t or • 'thin line of site
Oil Furnace shut-off at e trance to • ace area
Furnace/Hot Water Heat:, o. . '2'. /
Relief Valve(s)installed i f'/
Headroom,6 ft. 6 in. on stairs ,///
Basement stairs,6 ft.4 in. /
Handrail exterior stairs both sides mo e than 3 risers ✓
Interior privacy/trim/doors/main entran e 36" /
Floor Finish 1.71
Bathroom/Kitchen watertight 9a,///
Interior Handrails Balconies/Landing 18 in. or more
Railing across window in stairwells /
Smoke Detectors: ✓/
every level cc///
every bedroom V/
outside every bedroom "/ /
inter connected
Bathroom fans
Plumbing fixtures
17
Foundation insulation /
%hour fire door/door closer //
Garage fireproofing //
Garage penetrations sealed ,/
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or 1 ss fr m floor /�
Final Electrical j -• t b C�, /V�.!�
Site PlanNariance re ed
Final Survey Plot Plan l Z Ig cl
As Built Septic System layout retmred
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)
ca1J/Y(
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVE
NAME iN
_
Lei ,.;; ' 3 50/ --5 5
SCHEDULE INSPECTION ON /�/L/
AM PM
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTE
FIRE SUPPRESSION SYS EM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANC' TO SPRINKLERS
CLEARA . E TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE MASONRY FACTORY BLT.
ROUGH-IN
FINAL
REMARKS: OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
TOWN OF QUEENSBURY
;< 1 BUILDING & CODE ENFORCEMENT
� ��� 742 BAY ROAD
r� - QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST ECEI
NAME
LOCATION- 35 / C !_
DATE _ ( -l' -c) PERMIT N
TYPE OF STRUCTURE 0
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
, ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATINS f
INTERIOR TRIM/PRIVACY DOOR
FINISH FLOORS: _
BATH/KITCHEN WERTIGHT
OTHER FLOORS 'SWE ABLE /
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILING.
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATT SN
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO.
F7?�G SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
• Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road _�a
Queensbury, NY 12804 Arrive am/pm Depart a rpm
Inspector's Initials �cc2.-
NAME: c)(' PERMIT If —JCt S
LOCATION: \ \�P S, DATE : l — — G\
TYPE OF STRCTURE: C/
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is re 6onsiblc'for
providing protcctio from frcciing
for 48 hours follo% ing the plac mcnt
of the concrete.
Materials for this pu ..sc on si
Foundation/Wallpot
Reinforcement iti'Pl/cc
Foundation/Damppr I ding
Backfill Approval
Plumbing Under Sla.
Plumbing Vent/Vent. in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls :rierior R-
Foundation Walls :xtcrior 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
Jac Posts/Main Beam
r Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Fircstopping
\\,Aiktr
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 am/pm Depart i f pm
(� Inspector's Initials
NAME: `�,\\�(� O PERMIT#
LOCATION: ` tC �V DATE :TYPE OF STRUCTURE:
RECHECK
N/A YES O COMMENTS
noting Pier HI
Monolit is our Form
Reinforcement in Place
The contractor is respon•ible or
providing protection fr• freizing
for 48 hours followin_ the pl•cement
of the con t rete.
Materials for pis pu ...con S. e
Foundation/Wa ..ur
Reinforcement in
Foundation/Dampproo ing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vent• in Place
Rough Plumbing
Healing Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent_
Framing__
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier_
Fire Separation 1,2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
q
FIRE MARSHAL
OWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST R C IVE L/3 /W9
NAME
3 6 LOCATIO /5 4� �`e `PERMIT#
SCHEDULE INSPECTION ON ,11U'e 1-C7, tqfi
4, AM PM
-c1jL& �_ APPROVED
O" N/A YES NO
EXI
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSFEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO •PRINKLERS
CLEARANCE TO • EATING UNITS
REQUIRED SIGNAGE
CHIMNEY Dt2/`' 1
WOOD STOVE
FIREPLA MASONRY FACTORY BLT.
ROUGH-IN
❑FINAL
REMARKS: o, �;�L k OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Qucensbury,NY 12804 Arrive am/pm Depart- m
Inspector's Initials c
NAME: �` 1��C �C i'L; PERMIT#
LOCATION: -- DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Fonn
Reinforcement in Plac
The contractor is re ponsiblc for
providing protcctiol from freezing
for 48 hours followi g the pl•cement
of the concrete.
Materials for this purpose on itc
Foundation/Wallpour_
Reinforcement in Place
Foundation/Dampproo ► g
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i Place
Rough Plumbing
Lr. sHe' g Rough-In
nsulation
Foundation Walls I tcrior R-
Foundation Walls -terior R-
Floors R-
Walls • R- _19
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
Ji :1L 11-111 -. j. - _ sP
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 am/pm Depart a . ( pm
Inspector's Initials AP-.
NAME: \S SVCVDAG Ap lsl PERMIT# 15
LOCATION: C. )D DATE :
TYPE OF STRUCTURE: \(Th_
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsibl for
providing protection from fr ezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place __
Foundation/Dampproofi ng
Backfill Approval
Plumbing Under Slab //
Plu o,.ing Vent/Vents in Place
-.i,„°ough.riPlummbing
eating Rough_In---. V. FR4 U t 12 l It CL /il'g - lit u5
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
roper Vent, Aµic ent __
Framing )y/ �iv� r
Jack Studs/Headers177
Bracing/Bridging /
Joist Hangers / V
Jack Posts/Main Beam _ ✓ /
VAir Infiltration Barrier it' Coinq(,��'-- 1 y 14 fi—_
RA _ 6dRAU C;i .
"-Fife Separation 1, 2, 3, hour
Penetration Sealed
Fi Wall 2. 3,4 hour _
irestopping Ca P(k IL— f- ig&5rof v sr-
-
r=�►2_ 6,4 l ( , t Li,Jco, -3c--,4tZ 1 Nio C-)
un
•
4 (-12. uC5A--(14 nS6# Z �MMMMX - Ci-t4-5
A 5 ,fie Ag -2- t . C L'5(( 5
GENERAL INSPECTION REPORT
( 518 ) 761-8256
salt)
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart} v 2 m
Inspector's Initials<,' .b/
NAME: k \ J0 l i PERMIT# OC 9 , J
LOCATION: I S SCE / DATE : 1 l —yj —q l
TYPE OF STRUCTURE:
RECHECK
_ N/A YES NO COMMENTS
Footings/Piers —I I I
Monolithic Pour Form
Reinforcement in Place
The contractor is res ms nsible fo
providing protection rom freez ng
for 48 hours following. the pla• ment
of the concrete.
Materials for this purpos on ite
Foundation/WI •••ur
Reinforcement in ' -c
Foundation/Dampproofin
Backfill Approval
Plumbing Under Slab
Plumbing Vent/V is in • cc
ugh PlumbingKpC r _
'Heating Rough-in Auto6 t . t� t;�5
`Insulation �C ��� I bQ" A�
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 5 r
T stopping ��i D&& /x. d-1/4-GC
Alf `'
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 am/pm Depart "G am/ m
Inspector's Initials
�t
NAME: 14'\.� �fr CI"Pe' PERMIT# ��
.3
LOCATION: DATE : II °�`�
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I I
Monolithic Pour Fon
Reinforcement in Pl.' c
The contractor is sponsible or .
providing protecti: from ft.: zing
for 48 hours follow ng the ' acement
of the concrete.
Materials fo this pu c on site
Foundation/Wa •ur
Reinforcement in Place
Foundation/Dampproo 1 g
Backfill Approval
Plu thing Under Slab
P1 robing Vent/Vents in 'lace
rough Plumbing
Heating-_Rough-In '' / .
i`=_
Insulation
Foundation Walls Interi sr R-
Foundation Walls Exter or R-
Floors '-
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 h_our
Firesiopping
ci,/ t_.,/,_____
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury ��� 1��
Dept.of Community Development Date inspection request received: •
Building& Code Enforcement
742 Bay Road 01 i
Queensbury, NY 12804 Arrive am/pm Depart I Jam/pm
/J Inspector's Initial.�( t
NAME: f Pal' PERMIT#Ac_—_ _<9)......r. �� LOCATION: J �„� ( :� DATE : Or,.1,t ���lG�RP
TYPE OF STRUCTURE: ` ��RECHECK s i
t7Lek-6--- eWrk, pki.,-7-,
�7
N/A YE NO COMMENTS
4 otings/ 'er ; GEC L, I
Monolithic ur Form
Reinforcement in Pla
The contractor is espot�sible for
providing prote ion fro freezing
for 48 hours following th placement
of the concrete.
Materials for this purpose of site
Foundation/Wal 1p�ur
Reinforcement in ' ace
Foundation/Damper soling
Backfill Approval
Plumbing Under SI b
Plumbing Vent/Vei is in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Wall Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling i 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
(73 3 Q
- 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, ► �( l epart 7
Inspector's11
o
rr
NAME: L J ) PERMIT#,(�raSq,
LOCATION: = DATE : J n-01 '
f \
TYPE OF STRUCTURE: _ _
RECHECK
N/A YES NO COMMENTS
Footings/Piers � 1
Monolithic Pot, Form
Reinforcement .n Place
The contracto is responsibl for
providing prole tion from f eering
for 48 hours folio ing the .lacement
of the concrete. •
Materials for this pu se4 on site,
Pu
ndation/Wallpour \ r t
Reinforcement in Place •
Foundation/Damppraing
Backfill Approval ‘1(
Plumbing Under Slab •
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation I. 2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name u
Location T O'
Date/0- - Permit # ��
' 916SOIL TYPE: Sand- oam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/I .h
TYPE OF SYSTEM: e ��_
ABSORPTION FIELD: Total Le •th
Length of each trench 4 75�
Depth of trenches fi
Size of stone IA) L -I EEF
SEEPAGE PITS: Nuwber MAW
-
Size - ft. Wit.
Stone size -
PIPING: Size Type
Bldg. to Tank 1/ ®4 51,g 35--
Tank to Dist. Box n 54-o (v
Dist. Box to Field/Pi " 0
Openings Sealed? (Yes' No Partial
LOCATIO 1/SEPARATIO'
Foundation to Tan 1 2— feet
Foundation to Ab .rption 5 feet
Separation of Pi s r eet
Conforms as per Plot Plan — No
LOCATION OF Sy, TEM ON PROPER
(circle >
Front - Rear Left Side - Right Side
Middle F -• - - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: 11,
NO
Arrived: _
Depeparrted.:
Building Inspector
6
GENERAL INSPECTION REPORT U 4,
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive /-bi amn/pm Depart am/ m
Inspector's Initials
NAME: r / PERMIT# ° — 595
LOCATION:SW\CIDO
cc , DATE : 0
TYPE OF STRUCTURE: ¶c��
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I I
Monolithic Pour Fonn
Reinforcement in Place.
The contractor is responsible for
providing protection from freezing
for 48 hours follo ing thc'placement
of the concrete.
Materials for this pu se on itc
Foundation/Wallpour
Reinforcement in Plad /
Foundation/Dampproo{i n
Plumbing Under Slab
Plumbing Vent/Vents it Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inter or R-
Foundation Walls Ext rior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent •
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers •
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
a ' ►c
GENE RAL 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 m Depa °'7 ai pm /
Inspector's Initi
NAME: a\o,QQ,J/ PERMIT# _5 L5
LOCATIC�1 •, DATE : VQ
TYPE OF RUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is r .porilBible for
providing protecti r n fro freezing
for 48 ho irs folio in hg a placement
of the co crete.
Materials fo this p sc on site
Foundation/ a .orir
Reinforcement in 'lace
Foun • 'on/Dam..roofing gill Approval i
Plumbing Under 'lab
Plumbing Vent/V(nts in Place
Rough Plumbing
Healing Rough-I
Insulation
Foundation Walls Interior R- VO
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 I, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Qucensbury,NY 12804 Arrive Depart
Inspector's Initi •
NAME: PERMIT# -S
LOCATION: SAC DATE :
TYPE OF STRUCTURE: S
��.
RECHECK
N/A NO COMMENTS
ootings/Piers � I
Monolithic Pour Form
Reinforcement in Place 'L —49#t h
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 1,
Reinforcement in Plac8 j
Foundation/Dampproof i ng
Backfill Approval '!
Plumbing Under Slab I i
Plumbing Vent/Ven"ts �i.Placc
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Irate for R-
Foundation Walls Exte for 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 Scaled
Fire Wall 2, 3,4 hour
Firestopping
/"-N .... ----m------------
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i1., - i - ,..,4 ell,. o
,_ 7 • W ,,,02,
'U N ` "t have seen Cr observed;cr he,:_
such as hoses, wells, bees. 1 :.:
all objects ....._ � e_ � .., . ve
IP\ \ t shown on this documen�+ 0" U :---•_�-�-
personally • •- tired the distances sei tip �n fine�i`ram. ♦
97_..._ to ,..,... \ c? (3N SA . \
8 It1 RE '0EivEt
......) .------ IGNATURr ..— . ...
[I \ .
,, 1 SEP i 3 1999 \ •
TOWN GFGJE1=NS c.i }— \
45' :17. (
BUILDING AND CODE ^ .
VC°°11.........°°°\n .
MAP REFERENCE:
LEHLAND PARK
BY D.L. DICKINSON ASSOCIATES
FILED NOVEMBER 3, 1987
CABINET A SLIDE 128
33
W
O ..
L fO ro
o00
2
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS -�
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY _ r
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL DEC ..
INSTITUTIONS OR SUBSEQUENT OWNERS. 1999
CERTIFIED TO: William F. & Julie A. Volenza
Mohawk Community Bank, its successors
and/or assigns
Chicago Title Insurance Company
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: December 9, 1999
N an D u s en
8c Steves
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Lie. No. 50135
86.90'
35
20,422 sq ft
0.47 acres
34
.400
2,.E
204•S3M ,
U
W
200.00'
N 84'44' 10"W
?M1
�e a
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nr —
2 STORY
WOOD FRAME 11 cm
HOUSE
a
53.77'
ASPHALT DRIVE
IRF
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Of
"LI"AUTHOROM EANO A N1MAWN IED LAW "VEYM M 13 A Map of a Survey made for
MAP BEANO " uH`ilIED LAND aIRrETaRs SEAL IS "
MMYATTON OF MCI 7M a*aM M % OF THE
NEW YHMN STATE EDUCATION LAB.'
'OIKY COPIES FIEOY TIE pMq ML W THIS SURVEY
MMW MITH AM MOMIAL W THE LAW AWWEMS
SE VALD
� � roAMMANC IN WILLIAM F. & JULIE A. VALENZA
'CGETFMATR7MS lM1 WED HIMN WWY THAT
THIS aShEY WAS PWANW N LAND AMCE w7N 111E
E70SRMC DODE HX PMACTIa Fa LAND ADO►1CD
BY THE NEW YOM STATE AS®OCIAIM OF PROFESS &
LAND 9A\VEXM SAID CERRTFICATMNS SHALL AIM OHLY
TO TEE PERSON FOR WHO THE SURVEY IS PREPARM AND
ON HIS BEHALF TO THE TILE COWANY, OOVENGIFMTAL
� AAM 00TITIRDN LMED HERECK AM Town of Queensbury, Warren County, New York
TO THE ASSI&RES OF THE LEMONO NSRT WL'
NO. I DATE
DESCRIPTION
w
1 "= 30'
S-1
SHEET i OF 1
VALENZA
DWG. NO. 89423-35