97-313 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date September 19 97
19
3 o —
This is• to certify that work requested to be done as shown by Permit. No. 97313
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied as a
LOT 63 LINETTE LANE
Location
oviner PASSARELLI, GUIDO
By Order Town Board
TAX MAP NO. 19-63
OF QUEENSBURY
• Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 9200/OWN OF QUEENSBURY No. 97313
TAX MAP NO. 125 . -9-63 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to PASSARELLI, GUIDO
OWNER of property located at LOT 63 LINETTE LANE Street,Road or Ave.
in the Town of Queensbury,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 Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
RR 2 BOX 34A
LAKE LUZERNE , NY 12846
2. CONTRACTOR or BUILDER'S Name
LAMONT , MIKE
3. CONTRACTOR or BUILDER'S Address
45 HERALD SQUARE
QUEENSBURY, NY 12804
4. ARCHITECT'S Name
NEW YORK BOARD
5. ARCHITECT'S Address
NEW YORK BOARD OF FIRE UNDERWRITERS
6. TYPE of Construction—(Please indicate by X)
SINGLE FAMILY DWELLING
( )Wood Frame ( 1 Masonry ( 1 Steel (
7. PLANS and Specifications
12r96 SQ FT SINGLE FAMILY DWELLING WITH 1—CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
June 20 19 99
$ 167PERMIT FEE PAID —THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
20 June 97
Dated at the Town of Queensbury this Day of 19
SIGNED BY
' � for the Town of Queensbury
( Building and ZonUlnspector
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-8256J t
-Or BUILDING & .CODE ENFORCEMENT
NOTICERequirements prior to issuance -
r -, of this permit: PERMIT FILE NO. 9 7 -30
A permit must be obtained before �}- .-._.� -- ��
beginning construction. No inspections .'3=rPERMIT FEES D : '
will be made until applicant has received n Zoning Board Action
a VALID BUILDING PERMIT. All Area /Use L��N RE
applicants' spaces on this application N FEt P• � �57 1
PP P PP / ,
MUST be completed and.the signature n Planning Board Action TOt, REVIEWED B)'r' ` i
�
of the applicant must appear on the [. ritil�,. ;,
SPR / Subdivision /Other t..C)� Building Inspector
`pplication form. n..x yvu. Recreation Fee Payment
+ t
Applicant: G v t d D . m-s,.s r e 1,1.,l Owner:
Address: "co l�- f>'.1 (h A t,1 Address:
Phone # ( ) f - _ if,2_i Phone # ( ) -
Pro Property location: 4 a T �l'7 ),t noTi e. 1- 1
p Y ff Oc :— Tax Map Numbers `�
Subdivision Name: ie v ,�,c4 ri U,v ye- ,
aq _ c.i*;Q____ Section Block Tnt
NATURE OF,
uPROPOSED WdRK: ESTIMATED MARKET VALUE OF THE
t� New Building: CONSTRUCTION: $ 7,7i0oo
(esidence)/ commercial
Addition to Building:
--
residence. / commercial OCCUPANCY INFORMATION:
Alteration to Building: Prirpry Building -
residence / commercial //Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
la • -� If ADDITION, what will use
1st Floor 64n/ sq. ft.i(7�7''�v of new addition be? :
2nd .Floor (Q 1g sq. ft.
Other Floors sq. ft. �dU
y
(not unfinished cellar or basement)
. ..- ACCESSORY BUILDINGS: J
Detached Garage 2 car 64
TOTAL. FLOOR AREA: /a 9•6 SQ. FT. t7 Attached Garage 1 2 car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
I Other
/,� FEET X c3[ FEET — __-
Foundation Type: Pooled GPY1c.lee,Tei Will any second-hand or ungraded
Number of Stories : a lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : 5 feet TYPE OF_ HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which a plies)
to be installed: / Electric / Oil / Gas Wood
(Forced Hot Ai / aseboard / Other
Person responsible for supervision of work as regards to building
codes is : /"fkJi e.L L,a PI err 71-457-c5//A?/
Name Addresss Phone
Builder: -%erne. /'4 r 5T2c: TYIG. • 71/h 'v a/eV
Plumber: /e T ti -nce ✓ (4/7,,6 �7?7
. Mason: /ien r h0mzs /'ga -*TX,/
Electrician: nva.S `Thonmas 6ISs' -yD,2-7
DECLARATION Please sign below after you have carefully read the statement.
To the best of my knowledge the statements contained in this application, together with the plans
and specifications submitted, are a true and complete statement 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 noted, and
that such work is authorized by the owner. Further, it is understood that Uwe shall submit prior to a
Certificate of Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor;
--d drawn to scale, showing actual location of project on premises.
Signature: gPi.a,4,(1r .� '�/�
(owner, net s agent, architect, contractor)
, t
... ,
TOWN OF.QUEENSBURY
, 742:pay Rd:, Queensbury, NY 12804
1
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date 6 ii,/ ,19 7 I .- , I 2-,
- ' Permit No. 1 ''--), ( --."
/ ,
,.—
APPI(ICATION IS HEREBY MADE to the Building Delt for the issuance of,a'Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The appliC4ntor owner agrees to comply with
all applicable la , 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 andlorChininey.
,
Applicant (-74 iL i e.-4 0 F-71', ,,,:,,„,„es L L,./ APPLIANCE (check appropriate boxes) ,I
Address 7,, pbr,,,,L 4,, ,r),,: .,e, ,ilii.),1, , 0 STOVE: o Wood o Coal o Pellet o Gas
— i •I'' ! ,.• t • .. ''' 0 FIREPLACE INSERT
Zip ,33;,) ilk' a/FIREPLACE, FACTORY-BUILT:
cpWood 0 Gas
Phone —Ili 4".,\cii,..2/. : 0 FIREPLACE, MASONRY:
0 Wood 0 Gas
.
Owner ' 0 FURNACE: 0 Wood 0 Gas 0 Oil
Address
IF NON-MASONRY APPLIANCE:
-- - Manufacturer: --1 -Tt, ,14 -
Zip Model.
Phone
L_ 1 ti:i
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: 0 Block 0 Brick 0 Stone
167 g't(r.:, I LonTre L, vh, 05 Aid a. FLUE: 0 Tile 0 Steel
.......r, - Size: inches
CONSTRUCTION / INSTALLATION MUST afFACTORY-BUILT: ,
CONFORM TO NYS FIRE PREVENTION ,Si lik, Manufacturer: ,eivi,,,,•7, ri Model:
BUILDING CODE. CONSULT AVAILABLE 4'y Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS crboubie Wail °Triple Wall
REGARDING REQUIRED INSPECTIONS. 0 Insulated 0 DireCt Venting
0 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
)
I' __,.--r-., \/„..(....
/1",-. /7'7
• Fee Collected From or Refunded td: '4----_,,,Z,C.6', , oti--0,:ren•-.2- i ,k_c--,
Address: .- , / / , ---, .i•-• tfi• .tc,
Dated: 6,2//), /cri 7 Town Clerk or Deputy:. (,....-43tc,,A_A,
/ /
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Z;liiink & Goldenrod: Cashier's Dept.
• c I 7., 3 1 3
:,, ,
z ,
tip ' O. ENERGY CODE COMPLIANCE APPLICAT ONE[ � ' •, ,
" u''I TOWN or QURENSIIUItY, WARREN CUUNII
{-.: 0 •t . Q09 IIL'A'.CJ.IJG PEGltli E DAYS
.Ie - --- .. -- ... _ JUN 1 1997
Compliance Methods PART _i -- Acceptable Practice ye G,,ir,= )
1.E42 1"aun.i..1.y Dwellings -tm 1,y
I.'AR'1' (i ' -- 'J.I:erma.l. hating - Component: 'Trade Offs
1.&2 Family Dwellings; Multi-Family
Dwellings ( 3 stories or less )
PART 1 * - Design by Component- Performance
CoininerciaJ. 13uildi))ge-IIi Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME : PROPERTY .I-,OCA'1'ION : --
Cr01(1 el F45,5 Y�L i� hI. 3 Ab>CTT� Line_ '
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE :
1 . Gross Floor Area - __/�2 q6�-- - _ square feel
2 . Type of ]Heat -- E.Loc(:ri.c _-` Oil //Gas - Other
3 . In bu.i.l.diug mechanically cooled? _________ Yes kNo
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:
a . Roof R 00
' ' b. Exterior walls It /q
c . . Glazed area's It ,,L_
d. Exterior door's 1t jI. 00
e . Floors over unheated spaces R ! q
f . Edge of slab on grade ( healed building) It
g . Basement/cellar walls (above grade) It
h . Basement/cellar walls (below q.r-ade ) It
1 . Heating/cooling-ducts-piping iii unheated space It _l/.q/
G . Service (domestic ) hot water healing device
Conforms to minimum efficiency per code 1.7' Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
App:licanj;; ' a Pi naLure Date Phone Number
o74-
INSPECTOR' S REMARKS
J
F 4. Application for SEPTIC DISPOSAL PJ .IZMII' 1 O
• - �.SI'AM1' RLCEI Vkl)
J U N •13 1997 O
Location of property for installation: hOT'63
Owner's Name; GV/eir) `..S qS i3yc44,1 L ml 11"N'• 'I nl:ii
Owner's Mailing Address: ��C tiir t,L,e Pi'. Q�<e I , I • rri.
J
PEE PAID Z
Installer's Name: --J--r?•E/ Th.„, Phone #: '7 /29 .
td
Number of bedrooms (if residential): S
Total daily flow (residential -compute rn 150 gal. per bedroom): /45 t✓^ •
- Topography: I><]flat 11 Rolling I1 Steep Slope °b of Slope
. Soil Nature: I Sand n Loam Q Clay n Other /Depth:
Ground Water: at what depth? • feet - .
Bedrock or Impervious Material: at what depth? feet
Percolation Test: J Not Required ri Required/Kate min. per inch
Domestic Water Supply: �, Municipal I-1 Well (-1 Other
If domestic water supply is a WELL: water supply from any septic absorption is feet
PROPOSED SYSTEM: -
•
Septic tank: ./9/10 gal, (minimum size: 1.0(X) gal.)
lilt Field: each trench 5O feet_ / total system length -9Dr7 feet. .
Seepage Pit(s): number of - / size each: ft.x ft.
•
Size of stone to be used: # / depth or thickness feet. .• •
HOLDING TANK SYSTEM: (if required) ,-
Number of tanks: • • Size of each: gal.
Alarm system and associated electrical work to be inspected by ir,certified irgeitcy. '
For your protection, please note that pursuant to Section 136-29 of the Code o f the Town of
Queensbury, any permit or approval granted which is based upon or is granted in.reliance upon
any material misrepresentation or failure to make a material fact or circumstance known by or on •
behalf a fan applicant, shall be void.
I have read the reg«latiorrs moult respect to this application and agree to abide by these and all
requirements o f the •/'onv: o f Queensbury Sanitary Sewage Disposal Ordinance. • .
Signature o f respottsib'e person: �� D ft Date: 6/%/,��97
.�" "1 have seen or observed,or believe t sew evidence ot,
all objects such as houses,was,tunes,tenant Me,,
shown on this document.I also represent taem 1 hive
personally measured the distances set forth on the diagram."
' :.
'11T TURE tATE
PLOT PLAN
SEPTIC SYSTEM
Notice: The following statement must be "stamped" on your plot
plan. This sheet of paper may be used for purposes of drawing your plot plan. After drawing such plot plan, please read the statement
and sign it. If you choose to use other paper for your plot plan,
the office will stamp those plans for your signature.
L IN ET TE LN,
It I'
III , 7 ,
301
11 ,
I I i I y�1ne3
6-b,e.o.
1 •
111)600p31.
I CAR �dl�
1 oyC,
•
lab
•
Zoning Administrator
TOWN OF QUELNSBURY
•
41,./- --1 kJ,•C?L.•••,•,CJ.•.a iCa••J_•.IJJ�J.•,Ca•,Ca•.la•1)_n).N-:••,l_• 7.•�C?94. •.Cx�kx•.C7.f.Cx•_CJ.•R).•ti!.�a�.l�9 l�•tiJ.._C•L11_tti •.C�.I��.L),•_l'A)la&C3.•.C�9�CA•.l')_."._l'?�AJ,W.I:g.±:X91:?9 )•._l'�.1'7.L.lA•ti›•_C.l•.0
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8065695 BUREAU OF ELECTRICITYe.
111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210
►-c; Date E: `'1.1.,i;iB R L 9, 1. ' i Application No.on file 42297697: 1 Fi ' ' ci081_ 1)...
!<, THIS CERTIFIES THAT lY
tc, only the electrical equipment as described below and introduced by the applicant rnamed on the above application number in the premises of Y
'' GU DO PASSAPEf,1.,[`, 63 I,INFiT .E DR, , QUEENSFOR ; N.Y. -�
,.,....
► ,,..„
El in the following location; El Basement 1st Fl. ® 2nd Fl. 1=All Section Block Lot Y
;111, was examined on SEPTEMBERa 1997 and found to be in compliance with the National Electrical Code. ,r
r
►Y(' FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ,r
"ECEPTACLES SWITCHES
4 OUTLETS INCANDESCENT .FLUORESCENT OTHER MAT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 1�
�r . }
-<' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ,r
• AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS.1:2 H.P. NO.OF FEET AMT. WATTS Y
SERVICE DISCONNECT NO.OF S E R V I C E ,�
•.k1 MAT. AMP. TYPE METER 1,0,2W 1 5 3W 3%3W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. 'yY•..
,tiEQUIP. PER b' OF CC.COND. OF HI-LEG OF NEUTRAL
IS-
tv 'Al
.L . CD -1 ■ J2 ■ ::('t`! 1 .1;��} it
OTHER APPARATUS: ,)i-•
T-
ti:, r (( f r'-MS_C
g: F r_}JT LIGET-J
( �
�' (1-I'9.c, F�:__6-, ,,
�i. pp yy�t ff rxSS 11 �vrc r
�' :311 1a1 ,Jl�f.4•f JL. aro1;g'--p'7 i�
r.
�
:' T
R mot,['Jr�C <, 2�_:, •.'.• :�
g' ..�.-.a te Y-, rY
:1i44::i 4'�s t,►
�• 11- a
Y
!: }D') BOX 2262 a 1 •
i.-' LAKEGE RGE, NY, 1.28l? y
j ':;' �?i 'i .� GENERAL MANAGER r'
Y
- 1� . .• �_ ' XI Per
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. ;
,'f'i►i"r.C'i►f1`i{rp 7eY4-,-'ie'i►{'iA{'/i{'ivY'iw{'va-ci►j"iez"/L1'r►{Y►{Y.{ eY►Yle'4Y'ie.'IeY►(Y►(.7ii'YiiY 7►i Y►Yi►i'YaYY►YY.C]►YY►YY.X,71Y,Y►Y,.YsYY►YY►YYaY.iV4Y,7►F]'►YY►Y.Y►Y.Y�Y'%►(`%►Y..Y•Y'40:
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
7/. //, - -
TOWN OF QUEENSBURY
"�'� �#14 FIRE MARSHAL
• ��` QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
0777REQUEST FOR INSPECTION RECEIVED
491717,1/*.k4"
NAME
LOCATION /-671-Kg 2? /the-#/-3
DATE PERMIT # ���7/97 9 7-3/ 3
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYS M
HOOD INSTALLATION
•
AUTO. SPRINKLER SYSTEM/
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
/FIREPLACE-MASONRY
✓FIREPLACE - FACTORY BUILT
REMARKS: El OK TO THIS DATE
INSPSLIP.PUB C R
/
/11111016 TOWN OF QUEENSBURY
ilok BUILDING & CODE ENFORCEMENT
.V 742 BAY ROAD
QUEENSBURY NY 12804
( (518) 761-8256/
ARRIVE: DEPART: CPL)`.[) IN
//����rrf
FINAL INSPECTION REPORT `RESI NT L
DATE INSPECTION REQUEST RECEIVE:
AME ViN-,1?t-1 F_-C-14 ,A
LOCATION ��j L gS r u �yA,t.aE
DI�I,�.TE \19 M 4 PERMIT 1 q-7'3` •
TY E OF STRUC RE
FOOkINGS FOUNDATION / BACKFILL FRAMING
ROUGH PLUMBING SEPTIC; • INSULAT4$N
FINA t R ELECTRICAL _ WOOLSTOVE.-OR
Cr-
P N/A YE NO r{
CHIMNEY HEIGHT/B VENT/HEIGHT / t`C
FLUMBIN . VENT �I V
ROOFING I v
EXTERIOR INISH / ki;
DECK/PORCH/PTEPS/RAILINGS V
RELIEF VALVES I ;
FURNACE/HOT W\TER OPERATING
' _INTERIORTRIM/PRIVACY DOORS
FINISH FLOORS: 'ts� l
I
BATH/KITCHEN WATERTIGHT
OTHER FLOORS S WEE PABLE `
OTHER FLOORS CARPETED
N
STAIR CLEARANC /RAILINGS
$ QKE_DETECTO S R�� 7
r
BATHROOM FAN '
FLUMBING FIX URES
FOUNDATION NSULATION \\
GARAGE FIR PROOFING It
DOOR CLOSERS k
t \ v
FINAL ELECTRICAL �1 of
SITE PLAN/VARIANCE REQ. Wit
A
FINAL S(JRVEY PLOT PLAN f
OK TO/ISSUE C/O OR C/C \
i ,t
" TOWN OF QUEENSBURY
4V BUILDING & CODE ENFORCEMENT
,F.432.11 ,"' 742 BAY ROAD
�" QUEENSBURY NY 12804
( (518) 761-8256
ARRIVE: I o Q) DEPART: 1 uIL.b INSP:
FINAL INSPECTION REPORT - RESIDEN Aj.
DATE INSPECTION REQUEST RECEIVED:
NAME ViNbiAP--L-L-1
LOCATION `. 'SP-) L 1t3c=i\ LIPOK\.)
DATE cl \\:i, 1\c� / PERMIT. #
FA
TYPE OF STRUCTURE c.`) FA) ‘). 1 ` ',r, CA
0 y,
fit•
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING
SEPTIC _ INSULATIONt''
FINAL ELECTRICALWOODSTOVE OR FIREPLACE ?-3/ '
—
N/At`' YES NO
CHIMNEY HEIGHT/8 VENT/HEIGHT
r
PLUMBING VENT
ROOFING k c
EXTERIOR FINISH \ 1
PECK/PORCH/STEPS/RAILINGS 331�' ,-
RELIEF VALVES
FURNACE/HOT WATER OPERATING '9
INTERIOR TRIM/PRIVACY DOORS , 1
FINISH FLOORS: ''d.
e: /
BATH/KITCHEN WATERTIGHT. t
OTHER FLOORS SWEEPABLE . t
OTHER FLOORS CARPETED '"t' ,
STAIR CLEARANCE/RAILINGS
,ef
MOKE DETECTORS a'f. t
' BATHROOM FANS
PLUMBING FIXTURES J
f
FOUNDATION INSULATION
I
GARAGE FIRE PROOFING
DOOR CLOSERS 5' ';•
FINAL ELECTRICAL a) +'�
SITE PLAN/VARIANCE REO.
FINAL SURVEY. PLOT PLAN
OK TO ISSUE ,C/O OR C/C eb w
i \
RESIDENTIAL FINAL .INSPECTION REPORT i
Office No. (518) 761-8256
Building &Code Enforement Arrive: 3(7)Insp. ., (---
Dept. of Community Development
Town of Queensbury Date Inspection Request ' ='eived: q /J 677
742 Bay Road
Queensbury, NY 12804 ����
NAME %(2,e'O - : 5 C-V-e PERMIT NO.g7-,3
LOCATION • , ' -!, n _�. DATE Q/f ',/j( 7
TYPE OF STRUCTURE " 'j,::1,_, ,�
N/A NO COMMENTS
Chimney Height/"B" Vent/Direct Vent Location Y/
Fresh Air Intake V!
Plumb Vent Through Roof V
Roof Complete •,
Exterior Finish ComRlete
Interior/Exterior Railings 0" to 36"
Exterior Handrails, Balc 'es, Lax ding 18 in. or more i
Interior Handrails Stairs o�t i SiSides) or More Risers
Grade 2% Away From F undati8n ' y�
8" Clearance To Sill Pla �'
Gas Valve Shut-Off Ex sed/Regulator 18" Above Grade
Gas Furnace Shut-Off thin 30 Feet or within Line of Site
Oil Furnace Shut-Off at Entrance to Furnace Area �/
Furnace/Hot Water Heater Operating V
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 Privacy/Trim/Doors/Main Entrance 36"
Floor Finish /i(
Bathroom/Kitchen Watertight �
Interior Handrails Balconies/Landing 18 in. or more / ,
Railing Across Window in Stairwells
Smoke Detectors:
every level V
every bedroom
outside every bedroom
inter connected
Bathroom Fans ill/
Plumbing Fixtures -
Foundation Insulation
3/4 Hour Fire Door/Door Closer
Garage Fireproofing I
a Penetrations Sealed •Garage
Furnace In Separate Room Protected (In Garage) I i
Light Ventilation Per Room
Safety Glazing 18" or Less From Floor V;
Final Electrical
Site Plan/Variance Required
Final Survey Plot Plan
As Built Septic System Layout Req. /
_Okay to Issue Temp C/O Vl 6 t‘,,. %o Ps `.s. .E oc- V5 c,
5€p Lc V o.., tTD o F- C k)G. iil i-1
Ft221-31,\c 1, s-D! Tc BE
eEQu\C_cn.
TOWN OF QUEENSBURY
,, `i BUILDING & CODE ENFORCEMENT
�
742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: _ZZ� IN
FINAL INSPECTION REPORT - RES ENT AL
DATE INSPECTION REQUEST RECEIVED:
NAME pAL,-L)AL A
LOCATION (Q^^�� ETA LINO
DATE 9 \ I-) yr.? PERMIT N 97313
TYPE OF STRUCTU
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 r /
DECK/PORCH/STEPS/RAILI GS d/
RELIEF VALVES
/4-
FURNACE/HOT WATER OPERATI G ` /
INTERIOR TRIM/PRIVACY DOORS //
• FINISH FLOORS:
BATH/KITCHEN WATERTIGHT /
OTHER FLOORS 'SWEEPABLE 7.//
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS 1 f
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES V
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL 1
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN /
OK TO ISSUE C/O OR C/C 91 //
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804 •
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ei G(
Location 47' 65 6 Z. )
Date ? �/��'f Permit # CI7-- -7J
l
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone `1
SEEPAGE PITS: Numbe \
Size - ft. x \ ft.
Stone size ‘
PIPING: Siz'e Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit /
Openings Sealed? Yes o Partial
LOCATION/SEPARATI . :
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits _ ,eet
onforms as per Plot Plan No
LOCATION OF SYSTEM ON PROPER
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
MMENTS:
6 o i -% / c /9it/ d4) I U-&
SYSTEM USE APPROVED: YES '+ NO
Arrived: ', - /5
Departed: 3 ;?-40
Building Inspector
. 'mu.moan in mown%OF OINIOVO I$111 011idIMCO Of,
... e.,.—7:Zio
shown on this document.I also represent that I have.
• . personally measured the distances set forth on the di*
. ..
-.., ..,,.../ .,,, , ri p A49;
SIG tr R. -..
g .
1 •
• PLOT PLAN ' -- --
v • . . .
,, . SEPTIC SYSTEM 77 ( 3
•
Notice: The following statement must be "stamped" on your plot
plan. This sheet of paper may be used for purposes of drawing your
' plot plan. After drawing such plot plan, please read the statement
and sign it. If you choose to use other paper for your plot plan,
the office will stamp those plans for your signature.
. . _
' .
•
. .
2.• I i'l E. T 7-E LA',
. . • •
• . .
.:
•
. .
.
•
. .
•
• /0,0_, •
N.,---""7"-----------.__.
, .. , :AL "` • .!
. •
• . ' ',... . . : ' V .
,. •
.L- -------- .
SEP 12 19$17
• ._ '
. •
. ,66"/- •
. .
• •
,....,-.-;. - - TOWN OF.OUEE-NSBURY
,
. .
, •
_,_-.-- - --:
•' BUILDING AND CODE
.,
. •
•
lailless c50aa, . .
• •
• • __ _
. ••
—
• . •
•
0 .
I" - I)- 00 •
• \
/0
I1 / ' l9
•
- . .
' .
,
•
. . .
•
•
•1 .• .
• i V
. IA
•
•
Po Tc•Ii 41 •
• -
. •
• .. • -.
•
. •
•
• •
. . - .
• • .
• • .
,••••,. n
.•
. .
. .
• ,.. . .
. . .
,,,...•
. ..
• • .. • .
•
•
. . .
. . . ,. • •• i a6.-' • - •. . • .• . .
•
. .
. . • .
- . . .
. . , •
. • - I.:0T J . . . ' - . .. . .
• .
•
• . . . .
. . . .
. .•
. .
. ..
. .
. . .• . . . • . . . . .
• • •
. .
. . . • - . • " • . .
. .
- • • . .. .
•
• • • . . . . .. . . .
• . ,
. . . . •• •
. . .
. .
, . . .
. . •
•
- -
•
• • . .
. .•
•
. . • -
• . • •
• .
- .
• . . .
- .
. .
. • . .
. .
• • .
•
• . .
. .
• •
. . . ,
•• . . . .
•
, •
•
•
• . , . . .
, .
_ •
. .
. .
• •
. .. . ..: . ..
•
TOWN OF QUEENSBURY
BUILDING"A CODE ENFORCEMENT An)
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
1
P
Name ��, . 'mil," .
l
Location 13 LI nPL.L/
Date /g q- Permit #Ri -�3 /3
SOIL TYPE EI Loam-Clay-
Resul is of Perco aattr n Test-
(if applicable) Rate Minute/Inch
� PP � )
TYPE OF SYSTEMS I
--__ABSORPTION FIELD: Total Length coZ
Length of each ,tr nchc-)`
Depth of trenches - ) -72'
Size of stone ?
SEEPAGE PITS: Number-
Size - x - _ ft.
Stone size _ _.----
PIPING: Size Type
Bldg. to Tank 141 \
__Tank to _Di st: Box... - _ _ _uAvY
Dist. Box to Field/Pit ut" °`
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank it-4 feet
Foundation to Absorption 7n feet
Separation of Pits feet
Conforms as per Plot Plan . Y- . 'o
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front- Rear - Left .S' - Right Side
Middle Frontlyliddle Rear_
COMMENTS:
1‘,- - 'r V-'--1 Qp6)1 0,,,. ...� 'i
ZOO�-
Lj
11 r 1 /\
f
SYSTEM USEFf : Y NO
Arrim et,C
Depa, it ft
,,wA: Ill_:/i _
B is:dinr n • - ►r.
ft TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPEC p ECEIVED �//`�/g7
NAME �• �� �Ci�`
LOCATION V ' " 3f-�
DATE PERMIT # X /1 /7 / 7jI3
•
[ l� APPROVED
CJ L N/A YES NO
EXITS
AISLE WIDTHS I
EXIT SIGNS
EMERGENCY LIGHTIN
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FI PLACE - MASONRY
IREP CE - ACTORY B I
TB A '/A
REM# KS: K TO THIS DATE
.77-„iiidWit:/71-2, ,e
% a 4
INSPSLIP.PUB INSP CTOR
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ;•._ �;
INSPECTOR'S REPORT: ARR`LLEPART1 , •
REQUEST FOR INSPECTION RECEIVED:
NAME Pt_
LOCATION % — 1 t
DATE q II "1 PERMIT ((yy j
TYPE OF STR CTU E:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO•.
REINFORCEMENT IN PLA
THE CONTRACTOR IS • �.P. S E FORo•
PROVIDING PROTE TI'::" FROM FREEZING
FOR 48 HOURS FOLL' ING THE PLACE—
MENT OF THE CONC•`TE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING: Z?.»
JACK STUDS HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH—IN _
INSULATION:
FOUNDATION WALLS INTERIOR R— _
FOUNDATION WALLS EXTERIOR R— _
FLOORS —
CELLS R)31
-
CEILING
DUCT WORK OR PIPING IN
UNHEATED SPACES R—
\I AJ N \\OftSL- (518) 761-8256
`J
. TOWN OF QUEENSBURY `
BUILDING & CODE ENFORCEMENT
. 742 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARV DEPART\`st5
REQUEST F INSPECTIIcONN RE� E� VED: �
NAME ',via, ; \ J�, lXX
v.
LOCATION +-
DATE ` 7'q -1 PERMIT A 9 31 -3
TYPE OF STRUCTURE: CS(Z-
RECHECK APPROVED
N/A YES , NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM ,_
REINFORCEMENT IN PLAC _.
TILE CONTRACTOR IS RESPO SIBLE FOR
PROVIDING PROTE TION FRO FREEZING
FOR 48 HOURS FOLLOWING T E PLACE-
MENT OF THE CONCRETE. _
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR -
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS ,IN PLACE �C l
ROUGH PLUMBING %5, i/ZQ " o_ Yam` V/
PLUMBING UNDER SLAB 1
1,,�FRAMING: 15T d Fu
JACK STUBS/HEADERS _
BRACING/BRIDGING � AA ��.
JOIST HANGERS 9 0isi L, _
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER +Y/
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- •
•
T ►1EE0 -TL ‘AAK��_ 2 1C-) Ft-00V_
(-+' Chi r.0 s
1C C_ ,NO TE lOb-MI.A t�ikt 1.)(
b*F- 3%1,1- vikt CDE , ' \ Fl002
VAPC _ Fo(2_ 7..:0) Ft g- W '113(3d
Gam ' e (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARr 76 DEPAR
REQUEST FR INSPECZT,ON RECEIVED:
NAME J—'yr- a"dd'�2 ,r
LOCATION IJ / &3�/.- 6q- �J
DATE 7�/ -2 PERMIT I 6f / /.3
TYPE OF STRUCTURE: 45;K,)
Y
RECHECK APPROVED
V I N/A YES NO
FOOTINGS/PIERSt
MONOLITHIC POURh FORM ,f'
1 if REINFORCEMENT INaPLACE
THE CONTRACTOR IS, RESPONSIBLE FOR
PROVIDING PROTE TION FROM F, EEZING
FOR 48 HOURS FOLLOWING THE,PLACE-
MENT OF THE CONCRETE.
1`; I
MATERIALS FOR THIS PURPOSE ON SITE
I`
FOUNDATION/WALLPOUR ',
REINFORCEMENT IN PLACI _
FOUNDATION/I ,G
ii:654pEgitel----- - - - - - -
ACKFILL APPROVAL
PLUMBING VENT/VEN S IN PLACE
ROUGH PLUMBING ��/,F
PLUMBING UNDER/SLAB _
FRAMING: /
JACK/STUDS/HEADERS
BRAG NG/BRIDGING 1
JOI T HANGERS 1
JA POSTS/MAIN BEAM '1
AIR INFIL TION BARRIER t HEATING OUGH-IN
\
INSULAT ON:
FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS EXTERIOR R-
FLOORS R- _
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
f,
1 B 30 (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT x •
742 BAY RD., QUEENSBURY
NY 12804 °
INSPECTOR'S REPORT: ARRJf / DEPAR'' 4 N'I —
REQUEST PECTION VED: -J-j /
NAME (745-e ` ) C7-1,(i4 )-P.„-.7.:--,
LOCATION JZ.-6-7 l S? 3 , A 21L r
DATE1. !l -9 7 PERMIT $ 9;7 :f?
TYPE OF STRUCTURE: S ' !-s__
,--
RECHECK APPROVED ,
yNPA , r' E$ N
P TINGS/PIERS, it
MONOLITHIC POUR FORM f( . I , ,/
REINFORCEMENT IkN PLACE ' '4 1 i \
THE CONTRACTOR S RESPOHSIHLE FORf
If
PROVIDING PROTE 'ION FROM FREEZING' j
FOR 48 HOURS FOL` WING THE PLACE a'
MENT OF THE CONCRETE. F
MATERIALS FOR THIS'. PURPOSE ON SITE,_
FOUNDATION/WALLPOUR
`; i .
REINFORCEMENT IN PLACE i - ,
1 F FOUNDATION/DAMPPROOFING
$ACKFILL APPROVAL \: R
er
PLUMBING VENT/VENTS IN‘P,�LACE
ROUGH PLUMBING A
PLUMBING UNDER SLAB ri \-
FRAMING: • J _
JACK STUDS/HEADERS%
BRACING/BRI+DGING
JOIST HANGERS -
JACK POSTS/MAIN BEAM. .
f ,
t.
AIR INFILTRATIONJBARRIER
1 -
HEATING ROUGH-IN
I \
—
INSULATION: I �r+.
FOUNDATION/WALLS INTERIOR R- '!'
FOUNDATIONN WALLS EXTERIOR R- V+ _
FLOORS R- 4.
WALLS 1 R-
CEILING R- {,
DUCT WORK OR PIPING IN `1
UNHEATED SPACES R- - c
1.