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98-369 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK September 30 98 Date !4 98369 This is to certify that work requested to be done as shown by Permit No. has been completed. SINGLE FAMILY DWELLING This structure may be occupied as a 10 JACQUELINE DR . Location C"lwner MICHAELS GROUP , INC . TAX MAP NO . 7 4 . - 2 - 2 4 By Order Town Board 70W-N or QQUEEN BURY L�LS&C 1r .�.. Director of Bldg. & Code Enforcement BUILDING PERMIT VALUE $ 167900 TOWN OF QUEENSBURY No- 9839.4 TAX MAP NO . 74 . - 2 - 24 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to I -, r'itTnn OWNER of property located at 10 JA9QUELI Street, Road or Ave. in the Town of Queensbury, To Construct or place a 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 Uueensbury Building and Zoning Ordinance. 1. OWNER'S Address is 465 LAKE AVE . LAKE LUZERNEr NY 12846 2. CONTRACTOR or BUI LOER'S Name MICHAELS GROUPr INC . 3. CONTRACTOR or BUILDER'S Address JIM CHANDLER . PROJECT M+GR 1810 ROUTE 9 LAKE GEORGEr NY 12845 4, ARCHITECT'S Name NEW YORK BOARD NWTYFbRK 'BOWA.RD OF FIRE UNDERWRITERS B. Type of Construction — IPWase indicate by X1 SINGLE FAMILY DWELLING I I Wood Frame 11 Masonry I } Steel 11 7. PLANS and Spaclfionione 2714 fAQ FT SINGLE FAMILY DWELLING WITH 2 -CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use SINGLE FAMILY DWELLING 333 July 2 2000 $ PERMIT FEE PAID — THIS PERMIT EXPIRES 19 Ilf a longer period is required an application for an eatenslon muse be made to the Building and Zoning inspector of the town or Clueeasbury before the awpirstion lose.) 2 July 1998 Dated at the Town of Queenslbury this Ray of 19 SIGNED BY :Y ' - _ __ for the Town of Oueensbury Buildup and zoning I nQeaer uuil d ing Peyrri-tit Application I a n of QIIG'G'1 sour y - De^#M. rf Crarrrrrlrrrrify 0eveloinnem, 742 Bay Road, Queens-bary, NY 12804 C761-82561 �_-rs-- BUILDING & CODG ENFORCEMENT" ELCClllirelalClilS Ial'lUr to i55LI:la1CC 1��1{MIT FILL' N-C of this pernni : rA ,W,arinit musk Irc oNslincd lx.liarc �roaing constlucliuu. I tar inslrec ticrlr5 PERA T` FEE PAID ac rxxnda unlil nlIIplicalrt has received Zurrirrg 13cxrrtl Actiure LI13 tlta11 .1)ING I"1i1a.Al1f'. AllArc;w I lJsc RCC#iEit77foN tEE � .ltcnnls' sl+ncrs ten Ilri s nlrl+licnlia:n mus, " lee cumlricted nod tlra ssiglanlnre rJa► ning ,Uvrrrrl Action fiEV#GWL£13 !I . of the nirlrlicnrol rrntst nlrlwar un lire 51,11 # Sulldivisiun I Other Buildrerg Irisraecrnr 1lsl�ficnliui} fxrrtn. r� .r r. . Iteclenlion lice leayutent hlrlrlicalrt: Tile r icfraeP_3 GaevuP , Ills . Owner: Same Adxiress: 1 810 iZcrtx.(e 9 Lake. C7eun'ule_ , NY 1 28Ai dress: l'llultc # ( _ 518_) _668 � - _ 3376 __ __ I'roltcrly Location: ' �' �4 1 tJ �Q C �-• '______ ( 'i<-ax Mal) Number.LI 5tllfdivisiarn N .rmc: Section Block Lot ` NATURE OF p toPOSED WORK : ESTIMATED MARKET VALUE OeI�F, UIE New 13ra7_ ]. diTaC� : COI+ STRUCTION : y$�iiy z LJ � residence commercial � Addition too Buildings OCCUPANCY INFOItMATIGN : rcr i. cleitce / ccrnonercial pri .'rry Bui ttt lding AlLerrtl- Cou l: ca i3tailcti. ltclt Single. Faaaaai. ly Dwelling regidenc: e / cortuurrcial ' — Two Family Dwelling Resideticc / CommercialB'amily Dwelling no cliattge l ca exteriax sire Office other Work. ( describe below ) F � Mercant r Man,u �ctur faturing other GROSS AREA OF rROPOSED STRUCTURE * what W3 � L use if ADDITION , lsL Floor 1��.__ aq : ft � Ql newt addition be7 : Zn ed .Floor . . . . . . . - ! tt N/A ` Other I! lours . . . . . _ sq . 1 t . � N ( trot ura Cirrislaed cellar or basemerit X ACCESSORY BUILDINGS * 2 �� , l Detached Garage 1 , SQ* F""1' . Y-- Attached Garage 1 , • TOTAL FLE]L7lL AREA : 2`7 i ' private Storage Bu ding SIZE or NEW STItUCr'URE : Commercial Storage BU.ilding Other R-4LJ ' L FEET X _ TEE"I' I'atcited Will artyy second- hand or ungraded ,Fourld,"ALiota TYPEa : lumber b9 used ? If so , foie what: ? Number Of SL• ories : _ ( iiabitabl.e space only a ieei T7Cl?E OII , HEATING SYSTEM . Height ( grade to ridge ) ! � circle all wlric l p es ) 9 Nulttber oL l fireplaces arari/or woo sl owe Electric / Oil Gas " Woad to be iltsLalled : __ 1_�,_.___ forced Hot: A3*.r / ebvard / Other Person responsible for superuision of work,. as regards to building • rrr codes is . �rp(itLt1n..._._......_,--.---� �1 c� flartte Adc1 ease PI�fYn?284a 518 - 668 - 3376 ; t3ui ],der : 7lxe �i-is►xaeE� G vuA � ` IZvrxdlOGEerlb� > ctL.£� e Yu 280I 518 - 798 - 43 9 plumber : f fiya i'L°t.ttl�#_[E�3 x. 6 L— Maaori : _...1_.1J�+ 1 tr�.•,u 1? l f,r1` 1 - 9922 EIectriciatr : n�+- -ur�r_L#' A ^.a Jr x+ 9$ 4 r IJGCLrl1ZrITTUN. !'lease sign below afler you hove carefully read the staterrrent. 'I"ct llsc best of Isay knowledge Use slaleatrcrrts contained it, this application, together with the Plans and specif+catiolas . ni nutted, are a true and coanl►lete statcrnant Ol all proposed work to be done on the described preauises and lttiat all provisions of lire 13uitciittg code, lire Zeroing Ordinance and all aUter 1 aws perta'asaing to the proposed work shall be; corraplsed with, wlxeUacr specified or noted, and that such work is autiroriged try tlrr owner. uurtlrer, it is understood. tisat I/we shall submit prior to a Ccrlifacatc of C7cct+lahlacy" or CertirCale of Cdalaal-Pliance being, issued, an AS BLIII..T l�WT PLAN by It licensed Sul a U dale, sltowiltg actual location of project Uta prenilses. Signature: (owner, owner's agent, arcilitect, colslraGtor Sep 19 07 12:57p Paragon Engineering, PLLC (518)745-1018 t1.bc.. [n� p.1 r ` P tic CVMPLIFTWU DATIE " I !-'f Ind STAR DATE - PROJRCT �ocs � �l - lBE 77ftE ,ll! 1A dE.© } if 1 -1v`% (steep ` op'a)" a UD�s94 0--eV0) . OF T*I!S ACTMUY FC 1tt V=" A P�#Y " f s St JGH C NOW UN on COMFR :7M r nALCULAWO "I �r I��AII_I4REA 64 r�r. Tpr1-y.AREA OF LAND Fe (d o r at i;�„a,eA4RSC FTIZ TOTAL T AL AIWA {III- • cR .I�i f=F m r.. 5 I..• w .. VOLUME OF VYATtBR � `! r .� �x �pfX tr1�) TOTAL- • •M • a l `f M CF S7 JaTm C 1r Be ll F A"� ! t.c - MAO EUVWM � PLAN Btu PREPAR�D7 �'r� � is 2Eadhed O t�10 �F rxr �yk�'��r C+atu+t�r Svc &11Ya�r�i�o�es Cr�rict for � VWkW Sm p mee�n9 aft ft -- T rnaaF rreeut to wiel�rihts site iar Otte 'Af ir �KE . OF rruezesLatV arI I Pe ""'el to sea�++t[m*such. a 5M �'a yas � no I wmh to be Contacted prior to MW �!#�+ A no ALP �,y,� &W m tntorn oWn oa ttb fo.rn and as +ems ° d trace to time tamest CC ray I Www4edgee�W beVei[ As a corKSWO to Cho P Of 0 O"M tt- OW aPplic * fall) ���� � x � roject descrUmd damd�iect arid kWhOCIL gar Mhaim'aaiure. AWA by r•+e +r su r+ra4 tS* andcoaft of ovum M n ,,a may, andagrees to ir+deanrKy WW riarar>ieas 010 fiaVA■ fi, M a "Ka. ocftmz% DATE SIGNATURE OF AIGBMT ItIf . ' � - - DATE �3 IF Nmmluo alfid am-- .K ..- , ; ErtarwtnneraaRal ltRt tI Iture Iv 6rc*mare as,F or4s ar ove mgwkgd s ewV r» e" � +r�ndca.grad �+ Pr►a�+� y°"r � �, parars�6r e/srf� "Lrb r�4ertrl�t lno�lr t�ther`.�„�--_=`a' a _. _. ,gymW" rer *Mao - tag E 2 of 3 L' �i�r�aA�''4'C"I1i'P'9[7iST�M��•� ama rrr-f7l�DttilY LacaLlon of prtajaerl.v for 'xtistwaiiatican' f d`3 . RL aae; "� _ �+ 4 t'I;tt SIT NZ uM13I;11, Q avttc r s Na ttte: Address : TIZO 2 ^00Fo 0 o r^o � a/ � ,Vu�Sh�![ �1 .7 '{ G : Installer' s L� :line: rr s �w-u.rL �ti vwv�i_�- +�tCtlA irl:?: l'r11I] Photte r tm, vcr or tictiroonrs (if residc.-.0 : l ) : `�'•"` '?'atel daily rlgty (rcnidc:ttial - ct:rettsute r+ t5€a gal. rcr Lictlrt:om ) . TopomrZt,ity: = MaL Relliny Slccr Stulic °er or zlove Sci1 `r; Lure : ! Sand t_ i .csazu Ctay C] ihcr !i] ci:tla: f, r�.und Water- at what do^th? z �j Ccct 13ca4rack ar Inrrer•riotss Awl ateriai ; at twat dcrthl fcct f'cr.::iaticstt 'I'cst: tWtrt ILcquirad ILetluirc311Latc Z tatin. Iicr inc'.t Durtte'stic Water Surriv: hiutsicii�at (+ Wail Q 001cr If uanscstie avatar sur'viy is a `NE.III watar SU17oi v frunt any SCVLic alistsrption is fee ! Scrt'sc tank: 1 '< 1 gal . (sat iran tnuat sirs: ' I.CGO gst .) ITIa f=seld: each trench . `£ fccL. / total slstcttt length 216 feet. Seepage Pi !(:) ; nuntlicr of N /'€ / xizv cac?a; ft. x ft Silt: tir stone to tie usctl: # 2 S'`one. / dcoh or tltickt:css Coat. llrJi i71hlC: 'I'l1rIK S"{Sii�hi : {if rewired) Nunslacr of tanks: N/A Size of each: gal. �s�s /llarrn system and associated electrical work to be inspected by a certifred-ugent:y. For your protection, please norc that pttrsu ant to Section 136-29 oftlre Code oftlte ToWit of Qrteenshury , an permit or a17procaI gratrted which is based upon or is 'granled In reliance ftpolt any rnarerial rrtisrepresentation or frriiure to make a neaterial fact or circuntst'arzee knuxvtr lay or on _ - belralfofait erpplicarit1, slzall he void. I lrarre read (lie regritation.r it-irJh res ect t rr erpplication and agree to entitle by these and all rr:grrirertrerrr.s er f the 7'o +t"r: of (1rrz-eers r y' Sa r ry Sest a llislroserl fJrelirrrrncr. L - Sicrratzrre o � resrJarr.sil77e per.sr� rt: _ !.Jerre: 4 bed hora:2 TOWN OF Q U EJENSB URY 742 Bay Rd., Queensbury , NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date _ iX Yl�" .- , 19 `�- +-- _ Permit No. -' 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 andlor chimney. Applicant APPLIANCE (check appropriate boxes) Address ' STOVE: ❑ Woad ri Coal ❑ Pellet ❑ Gas 0 FIREPLACE INSERT Zip , ,r �t �P �`FI REPLACE, FACTO Y- UI LT: o Wood G as Phone , ❑ FIREPLACE, MASON o Wood ❑ Gas Owner 0 FURNACE: ❑ Wood ❑ Gas ❑ Oil �,l, Address / ! s `�y � .' '-"--` IF N© N-MASQNFtY APPLIANCE_ - . Manu�actur`er: Zip Model: Phone CHIMNEY (checks appropriate boxes) * EXACT ADDRESS of proposed construction # L © MASONRY: q Block Cl Brick ❑ Stone Vf t t -j � — FLUE: ❑ Tile ❑ Steel Size: inches CONSTRUCTION 1 INSTALLATION MUST ❑ FACTORY-BUILT: CONFORM TO N 'YS FIRE PREVENTION & Manufacturer: Model : . BUILDING CODE. CONSULT AVAILABLE Listed By : Number-,- TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall ❑ Triple Wall REGARDING REQUIRED INSPECTIONS, o Insulated ❑ Direct Venting ❑ Chimney Liner Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Refunded Code Number Title ^w A 173 3389 (190) Public Safety A 233 2655 inor Sales - � / Fee Coll led Fr _ r Ref ,; r� `d"-'� * ! t % Address : Dated : ;= . ;; % Town Clerk or Deputy: White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept. .sQWN t3F QUSSOS1F0 RCEMENT QR Bull<DYNG 6 C gAY RQAD gU 4 �SgURY NY ?a QUEEN `!6l-$256 t � �s187 FEPAR'T ' R IORNTIr ARRIVE ° SFECT TOO R'KT` Og'T F xYi AU ECE t V 1f DSyTE INSP vjF IUD FRYING UCTURE 113N OKLrILU -10" TYPE QF STR FOUN4I1TIo -- Z pSt FIRS LAC% �- - lrpOTINGS MBS[3G - - SKgA000S pp`SE R 5 lro Gvt ?Ij CTRS.CNIJ --- Ex_-11i.. - O NGS S K v S G F O T W Q C E s ="' - r pp�� t3 A N 4 i - - U G t3 U NG _--- N V ILht-x .�-�c. 12 k MAP REFERENCE: LEHLAND PARK BY: D.L. DICKINSON ASSOCIATES FILED NOVEMBER 3, 1987 CABINET A SLIDE 128 LOT 25 S JACQUELINE oja D u s en & Steve s Land Surveyors, LLC 37 Chester Street Glens Falls, New York 12801 (518) 792-8474 New York lAc. No. 50135 LEHLAND ESTATES - PHASE TWO RevisrD LOT 24 26,104 sq ft 0.60 acres 3s� ?SV y06 ?'ss. �rO �O ��pp 0`S4 O c1� O 0 %WAI111ONMD AL7E AIM OR ATOITON 10 A 91RVEY MAP EANM A UCEMM LAND SLWYEVM SEAT. 13 A VROLA110N OF ECI 72M 9Is-MMWON 2. OF 14E NEW VOW STATE EXICATON LAR• *ONLY COPES FROM 114E ONOMM. OF TOS 95RVEY MANOR MM AN CNIWNAL OF THE LAND 9ANEYOIQ WEAL SMAIL E CONWERD 10 E PAID ME COPIES.• •CE TIRCATMS SIDICAM HEREON WONIY THAT 7110 SURVEY WAS PREPARED M ACCONDANLT MIN TE OESTEIO COE OF PRACTICE POR LAD 91R1EYON5 ADCP= BY TM NEW VOM STATE ASSOCIATON OF PROFESSIONAL LAN SURVEYM SAID, CO"WICATNINS WALL RUN ONLY 70 TIE PERM FOR MI01 TE &W&'V O PREPARED, AND CN M EHAF m 74E THE 00WANY. GOVERNMENTAL AGENCY AND LM M NQOIUTON LORD 1IE ECK AND TO T4E ASMOEES OF THE LENUMG MSTTITICI • %�f LOT 23 r C 8�'Oyp-: LAND Map of a Survey made for GARY C & ALICE M. DALENA Town of Queensbury, Warren County, New York 0 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 AND LENDING INSTITUTION LISTED HEREON. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. CERTIFIED TO: Gary C. do Alice M. Dolena M do T Mortgage Corporation, its successors and/or assigns Chicago Title Insurance Company CERTIFIED BY: MATTHEW C. STEVES, LLS NYS 50135 DATED: September 30, 1998 NO. I DATE DESCRIPTION 1" =30, S-1 SH9ff 1 OF 1 DALENA DWG. NO. 89423-24 ,OWN 'C)F GUEENSSURY FIRE MAR 12804 QUER 518) R7 61 -8205 FIRE i'+ A RSNP.L lf1SQECTIC) P©RT REQUEST 'FOR iNSPECT4C3N REGEI�ED NAME LOG p�TION DATE PERMIT # P 'PC'ROVEDNO NfA YES EXITS A►SLE WIDTHS EXIT SIGNS EMERGEhiCY LIGHTING FIRE EXTINGUISH S SYSTE AUTO• EXTINGUIS OD INSTALLATI© 'HO - pLITC7. SPRINKLER S STEM P.LARM SYSTEM INTERIOR S-VoRAGE' SPRINKLERS CLEARANCE TO CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNENY \NOODSNON/E NRY --�� FIREPLACE - M#A SO RY aUILT r— ' JE FIRE.PLP.CE FACTO OK TO T"k S C3~A i I�; REMp,C2K5: y a i s SP s. iNSPS�iP,Pll$ l RESIDENTIAL FINAL INSPECTION REPORT Date inspection request received: Office No. (51$) 961-$256 _.�'" Building & Code Enforcement Arrive ��� Depart Dept. of Community Development Inspector's Initials Town. of Queensbury 742 say Read Que+ensbury, New York 12804 _ PFERMlT NAME ~ � DATE. LOCATION TYPE OF STR C N/A YES NO COS Chimney Heighif"B" Vent/Direct vent Location Fresh. Air Intake plumb Vent through roof Roof Complete Exterior Finish Compt „ Intenor/Exterior Railings to more Exterior Handrails, balconie or interior Handrails stairs bo sides 3 or more risers Grade 2% away from to dation V clearance to sill pla ulator 18" above ,grade Gas valve shutoff eagxcl/reS Gas Furnace shut.-off within 30 feet 4r within line of site Oil Furnace shut-off at entrance to furnace Fuinacelllot Water Heater aper Relief Valve(s) installed �, t tr�P+Q !a �� Headroom, 6 ft. 6 in. on stairs Basement stairs, 6 ft- 4 in- Handrail exterior stairs both sides more than 3 risersN73 -It- Interiorprivacyltrirnldoors/mam entrance 36" Floor Finish BathroontlKitchen watertight Interior Handrails Balcorties+'L anding 18 in. or more Railing across window in stairwells Smoke Detectors' every level every bedroom outside ever.,' bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer {;rage fireproofing Garage penetrations sealed Furnace in separate room protected (in garage) Light ventilation per room Safety glazing I V or less from floor Final Electrical Site plan/Variance required Final Survey Plot Plans As Built Septic System layout required Okay to issue Cie (Certif. of Compliance) Okav to issue temp. Cif) (Ccrtif. of C) cupancy) Okav to issue permanent C/O (Ccrtif. of ()ccupancy) RESIDENTIAL FINAL INSPECTION REPORT Date inspection request received_ �-- Office No. (S1$) 761-$256 Building & Code Enforcement ATIrive a��- p� Dept. of Community Development Inspector'9 Initials Town of Queensbury 742 Bay Road Qu,eensbury, New York 12804 PERMfT # NAME DATE LOCATION TYPE OF S"LRTIC'TLyp NIA YES NO cot3TS Chinutey HeightP'D" vent/Direct Vent Location Fresh Air intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings`W' to 36" Exterior Handrails, bal es, landing 18 i are interior Handrails stairs bo sides 3 ore ri (trade 'I% away from faun 8" clearance to sill plate 18" a e grade Gas 'Valve shut-off e & — Gas Furnace shu within 3O feel or line of site Oil Furnace -off at entrance to furnace area - Furnace/Ho ater Heater operating Relief Valve(s) installed Headroom, 6 ft. 6 in. on stairs Basement stairs, 6 ft- 4 in- Handrail exterior stairs both sides more than 3 risers interior privacvArmildoors/main entrance 36" Floor Finish BathroomlKitchLn watertight 18 in- or more Interior Handrails Balconies/l..anding Railing across window in stairwells Smoke Detectors: every level revery bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/darn- closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected (in garage) Light ventilation per room Safety glazing 18" or less from floor Final Electrical Site Plan/Variance required Final Survey flat Plan As Built Septic System layout required 0kav to issue C/C (CerLif. of Compliance) t)kav to issue. temp. C/() (Certif. of Occupancy) Okav to issue permanent CIO (Certif. of Occupancy) THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 4026789 BUREAU OF ELECTRICITY ANY, NY 12210 111 yHp,S}tINCaTON AVE., SUITE 704, ALB 8�J3498f9 � 1366�J`� SEPTEMER 73 . 1998 Application No_ on fide Date THIS CERTIFIES THAT the 11 lican ma only the electrical equipment as described be ed iTn t e a ove application number is in the premises of low and introduced by t{IC�iAELS GROUP , 10 JACC, UELINE DR . » QUE Block ENSBURY , NY Lot AR section in the following location.; Basement ® !st F1, ® 2nd FI. ��. EpTgtigER 18 , 1998 and found to be in compliance with the National Electrical Code. was examined on OVENS DISH WASHERS EXHAUST FANS FIXTURES RANGES COOKING DECKS FIXTURE RECEPTACLES SWITCHES SNCANDf°..CE FWOREE�CENS OTHER AMT. ,W. AMT. K.W- AMT K . K.W. AMC. K.W. A N.P. 4MT. OUTLETS 33 51 51 29 BELL UN17 HEATERS MULTI-OUTLET DIMMER FUTURE APPLIANCE FEEDERS SPECIAL RECTT, TIME CLOCKS SYSTEMS AMT WA"s DRYERS FURNACE MOTORS AMPS. TRANS. AMT, H.r. NO. OF FEET AMT. K.W. OIL H.P- GAw�S Hy.P. A+,MT, 140 A. W. G. AMT. AMP. AMT, 1 - $ E R V I C E A. W. G. NO. OF A. W- G. NO. OF NEUTRALS OF µEL"AL SERVICE DISCONNECT METER NO, OF CCCONV- of ccwCON6- NO. OF HI.LFG OF HIAEG AMT AMP. TYPE E4QUIP. 10 2W 1 0 3W i 3W 3 Tf dW 1 2 f te'1 1 150 CB 1 x OTHER APPARATUS: G . F . C . I : -4 SMOKE DE,TECTORa -6 L FOREVER ELFCfgOEL ELF,CT , WILLIAM D , I4CPARTLON GENERAL MANAGER 2445 ,3AFFRE"Y ST . 239 SCi1Tr�h]ECTAOX : Ny '� Per this certlticate must not be altered in any manner, return to the office of theBoard If Incorrect. Inspectors may be identified by malt credentials. GpQY FL;?R $UILDiNG D'EPARTM1=f'dT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED iN ANY MANNER GENERAL �TVSFE l N RE RT Town of Q'ueensbury Dept. of Community Development Date inspection request received: Building & Cade Enforcement Paz spy Road Arriveam/Pm DeQartsa'sr 2$[ 4Queensbury, NY 1 # torsiti '" �_ �- PERMIT # r NAME: DATE : LOCATION: TYPE OF STRUCTURE: RECHECK N/A YES No CoNevIEN1'S Footings/Ners Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing, for 48 hours following the place of the concretc-� Materials for this site Foundatian/Wallpo Reinforcement in P Foundation/D Backfill ApprovIil.�—�— — plumbing Under Slab plumbing V,ent/Vents in Place Rough Plutnbin Rough-In ation Foundation. walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceihng R- Duct work or piping in unheated spaces R- r Vent, Attic Vent Framin ] ' 5 Jack StudslHeaders Br ngllridgin joist Hangers jack Posts/Main Beans Air infiltration Barrier Fire Separation 1, 2, 311. hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestoppin GENERAL INSPEG'TION REPORT 43 Town of Queensbury - A L, se Dept. of Community Development Date inspection request reties"vcd Building & Code Enforcement 742 Bay Road Depart t Queensbury, NY 12804 Arrive am/pm Inspector's Initials PERMIT # cJ - NAME: •.,,.C_w.-- DATE : 3 * LOCATION: TYPE OF STRUC"T[TRE: RECHECK NIA. YES NO CONOAENTS Footing$ Piers Monolithic Pour Form. Reinforcement in Place The contracto)r is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose tte Foundation/Wallpaur Reinforcement in Foundation/Dam Bacid ppro Pluimbm Un Slab Plumbing V tfvents in Place + UeRough PI bing Heating Rough-In Insulation Foundation Walls lnterior R- _ Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper gent, SAlti Vent Jack Studs/Headers BracinglBridgin�* Joist Hangersc �,� ,� Jack PostslMain Beam ( 6 Air Infiltration Barrier "• -_ f Fire Separation 1, 2, 3. hour Penetration Sealed _. Fire Wall 2. 31 4 hour FiTestopping _— TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY, NY 12804 (518) 761 -8205 FIRE MARSHAL INSPECTION REPORT LREQUEST FOR INSPECTION RECEIVED � ,pp NAME LOCATION DATE PERMIT # <49r t `?did " 3<ve i Fr9oke-C _. APPROVE] N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LI HTING FIRE EXTINGUISHERS AUTO. EXTINGUISHIN SYSTEM HOOD INSTALLATIO AUTO. SPRINKLER STEM ALARM SYSTEM INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNEY �+I4S<c-T tA63 WOODSTOVE FIREPLACE - MASONRY FIREPLACE - FACTORY BUILT REMARKS: OK TO THIS DATE b v ? 3 � INSPSLIP.PUB INSPECTOR rpy�l OF QUEEKS811 SUILpI COUE ENFflRC } 14.2 Bay Road QueensburY NY I280 (518) 761-a256 SEPTIC UIVOSAL SYSTEM IKSPECTION Name Location perm} t # Wee J� Date y oam_cl aye-,-- � SOIL TYPE 't�.=�" Percolation Test' lncri___��— Resul is of Rate eMinutel ( if a,Pl , cable) � I (7 "PE OAF SYSTER= Total Length AgSORPTIOR FIELD = th of each trench Leng Depth Of trenches Size of stone Numb r- ft . SEEPAGE PITS: ft ' Size e& �-- er Stone s1ze _ e PIPI1t6tBldgo Tank w ox Tank. to Di s o IFi el d o art al Dist = Sox ' Seal ed? feet openings Y f Lflr,A'CiOnISEPAM-TION Aw feet Foundation to AbsorPtion - fe� Foundation o,- pits plan Yes Separation per plotTye L�n,,fATIOR OF S'rSTE* flN PROPER ew ( circle o Left Side i ght Si d Front Rea _ Middle Rear Middle rout / pu-Cr' .Syjo NO YES SYSTFX USE Q�partted: ��--��- r�� ector 8ui ding In p y i � .�• , - � I �/\ ! E ' ' �i .. f 444 Vitt /y�■aj f trw�xt i.t7 fr fs.r . .�:r. . .i. f'ENERAL INSPECTION REPpRT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road y Queensbury, NY 12804 Arrive am/pm Depart '' �am/pldn Inspector's Initials NAME: _ '<-AA ( 'W 4 # LOCATION: Prat TE ; / 7 TYPE OF STRUCTURE: RECHECK N/A YES NO COMME S Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for -1 providing 'protection from freezing for 48 hours following the placement T of the concrete. Materials for this purpose on site Foundation/Wallpour Rc'nfforcement in Place iundation/Dampproofin ✓✓✓Hackfill Approval Plumbing, Under Slab Plumbing VenVVents in Place Rough Plumbin Heating Rough4n Insulation Foundation Walls Interior R- Founda.tion Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Frantin Jack Studs/Headers Hracing/Hridging Joist Hangers Jack Posts/Main Hearn Air infiltration Harrier Fire Separation 1, 21 3, ho Penetration Sealed Fire Wall 2. 31 4 hour Firestoppin GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive �� • Depart Inspector's Ini ' NA PERMIT # LOCATION: ' DATE : TYPE OF STRUCTURE: RECHECK N/A YESVfJ0 CONRAENTS %,00lootings/Piers E Monolithic Pour Form 10 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/Wailpnur Reinforcement in Place Foundation/Daiftwiroofing Back&ll Appwval Plumbing Uncicr Slab Plumbing V=c ents i 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 spaces R- Proper Vent, Attic Vent Framin Jack Studs/Headers Bracing/Bridgin Joist Hangers Jack Posts/Main Beams Air Infiltration Barrier. Fire Separation 1, 2, 3, hour Penetration Scaled Fire Wall 2, 3, 4 Hour Firestoppin