97-666 CERTIFICATE OF OCCUPANCY .
TOWN OF QUEENSBURY V
WARREN COUNTY, NEW. YORK
Date may 4 19 _98
()O — l — 14 fA
This is to certify that work requested to be done as shown by Permit No. 97666
I
has been completed.
SINGLE FAMILY DWELLING (MODULAR
This structure may be occupied as a V
36 EISENHOWER AVENUE
Location
Owner CLUTE, LARRY
TAX MAP NO. 12 0 . -1-6 0 . 6 By Order Town Board _..
TOWN OF QUEENSBURY •
/ �/� <.
•
Director of Bldg. & Code Enforcement
BUILDING Y PERMIT
TOWN OF QUEENSBURY No
VALUE $ 50000 97666
TAX. MAP NO. 120:.-1-60.. WARREN COUNTY, NEW:PORK
PERMISSION is hereby granted to CLUTE, .LARRY
OWNER of property located at RALPH ROAD,OFF EISENHOWER Street,Road or Ave.
in the Town of Queensbury,ToConstruct or place a g - FAMILY_
at the above location in accordance to.application together w F'plot ns-a d� r-tnro 1'atibn-Reret and".
approved and in compliance with the Town of Queensbury Building and-Zoning Ordinance.
1. OWNERS Address is
.13. DAWN ROAD •
QUEENSBURY;.- NY 12.804
2. CONTRACTOR or BUILDERS Name.
CLUTE ENTERPRISES, INC. -
3. CONTRACTOR or BUILDERS Address
QUEENSBURY, NY '-;12804:
4. ARCHITECTS Name
COMMONWEALTH ELECTRICAL AGENCY
5. ARCHITECT'S Address
PO BOX 706;,
p HAGUB > NY:::• 12836
6. TYPE of Construction-(Please indicate by X) ..
( )Wood Frame ( ) Masonry' ....(- -SteeVIIG)LE. FAMILY DWEI,LIN.G.:a_
7. PLANSand Specifications .
No. .
960: Q FT SINGLE. ?FAMILY DWELLING WITH_2CAR.-.DETACHED 4ARAG .
a k sw1�4-0"°p�R 'PL '�T tilS r�.s�nr7Mlr�n�xncs
'r �racxz c.c zrava nai��.
8 Pro sed Use"'po
I SINGLE FAMILY DWELLING MODU3 AR) fl
rr c N `v�a15.5�t' .�PEffN11T�tI�E �i410�-raT+H1�PERMI te`3lPl`Rf S`''L .M w dNovr RbelTu 12 ( #19..;A 5.:•..
(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.)
z
Dated at the Town of Queensbury
KK
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
_ i
.,i suatrt rerinit Application
r �
,l bw,i of Qt eeltsbul y - Dept. r f Community Development, 742 Bay Road, Queensbuiy, NI' 12804 1761-82561
—`O BUILDING & . CODE ENFORCEMENT
NOTICE CNI'Oli' CCMCNT
Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. C1 -1 �(
beginning construction. No inspections
will be mode until applicant has received �� Zoning Board Action PERMIT FEE PAID$ C)-6
n VALID BUILDING PERMIT. All Area /Use 00
applicants' spaces on this application RECREATION Fr IV-(4 `o,
MUST be completed and.the signature
of the applicant must appear on the C7 Planning Board Action REVIEWED Il
`pplication form. tl,.,r),,,. 5PIt / Subdivision /Other / Building Inspector-
-) Recreation I'cc Payment /
Applicant: I t -r£� Li CT-LIP Owner: _A! ;`,
• Address: /
Address: •
•
Phone # ( ) - 7277 Phoneme�#,,``..( ) _
Properly I.ocnlinn: Cor�r�P t� 'cr�IhJc- 1 '1 �=�:J.�!��,.�.i� ' 6:i lidlvlH lI Nitulal but Mnh Num* u�.:,
NINI111ll Illnek I id
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New building: CONSTRUCTION: $ j
residence / commercial .
Addition to Building: ,
residence / commercial OCCUPANCY INFORMATION: '
Alteration to Building: Primary Building - - ; I
residence / commercial Single Family Dwelling —---`�
Residence / Commercial Two Family Dwelling„ no change to exterior size . Family DwellinN®V Q 6 1997
Office
Other Wok (describe below) Mercantile f OWN OF CIUT .Lt°• : RY
o �cc Manufacturing >3UILDING AND CODE
GROSS AREA OF PROPOSED STRUCTURE• f •• Other
1st Floor 94,0 sq. ft:N.c-- If ADDITION, what will use
• of new addition be7 :
2nd .Floor sq. ft. ,
Other Floors sq. ft.
(not unfinished cellar or basement) AC ES50RY BUILDINGS:
Detached Garage 1,(? car)
TOTAL FLOOR AREA:- 4.. t,2 O SQ. FT. Attached Garage 1, 2 car
Private Storage Building •
SIZE OF NEW STRUCTURE; Commercial Storage Building
Other
-aY FEET X `{sb FEET
Foundation Type: Will any second-hand or ungraded
Number of Stories : lumber be used? If so, for what?
(habitable space only) k�
Height (grade to ridge) : Uc, feet TYPE OF HEATING SYSTEM:
Number of fireplaces a d/or woodstove (c' - .11 which appli s)
to be installed: _ / Oil / Gas //Wood
. ed Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
p-
codes is : C — �0.�� ��
Name• Add ease note
Builder: •
Plumber: c, ^� �7
Mason: ' 7 ! `o�!
Electrician:
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 Ccxle, the Zoning Ordinance and all
other laws pertaining to the propo I work shall be complied with, whether specified or noted, and
that such work is authorize iy the o ner. Further, it is understood that I/we shall submit prior to a
Certificate of Occupy • •or Certilic a of Complian being issued, an AS BUILT PLOT PLAN by
a licensed stuvey•• ; drawn to sc , sl in ac 1 ()cation of project on premises.
Signature:
(owner, ner's agent, architect, contractor)
� y
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
Dept. of Community Development
Permit No.)/s(r,(n,51
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: C i-iNer- 7V0 LerN
Property Owner's Name:
Property Owner's Mailing Address: Cr-t,
Installer's Name: ( 1 Phone # ' 7 73:7
Number of bedrooms (if residential): Total daily flow: LA. 0
(residential - compute @ 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? feet
Percolation test: not required, required [rate min. per inch]
Domestic water supply: Vnunicipal, well, other
i1 r.
If domestic water supply is a WELL, water supply from any septic absorption'is vfeet,,
N0 %99'
PROPOSED SYSTEM
acU, cyG'6vha3 c
s't�Atu 1�� j�VGJn�dV GG®6-
Septic tank: (000 gallon (minimum size: 1,000 gal.) jt..���-°�! P�
Tile field: each trench EO feet / Total system length: Z?QO feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # c / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
&larm system and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of 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 be,: :,1•licant, shall be void.
I have read the regulations with respect • +,': application agree t• abid' by :=.e and all requirements of the Town of
Queensbury Sanitary Sewage Dispos: • .',:,ce.Ade
Signature of responsible pe- on• _! Date: \ki(e.//4 "
'jrT)i i' 1' tia,'a1'4D) •
' •Fact-lcai lilspecto No.
P.O.13UX 705 Date 19
-''A ;UE, NY i'''�,_
.. 1&)543-13?2 . COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
' r, `•= ' (Consulting and Fire Inspection Services)
(Incorporated in the States of MAIN OFFICE:357 Elwyn Terrace, Manheim, PA 17545 • (717)664-2347
New York,Maryland,Pennsylvania,Delaware) 800-732-0043
LOCATION
Please give full and accurate directions in order to avoid delay
(Use back of sheet if needed)
Desiring Certification of Approval, application is made for inspection of electrical installation in the premises
described below. On demand,applicant agrees to pay for inspection service in accord with schedule of charges.
PLEASE PRINT - DATE
Owner t 0 Type Bldg. ❑DWG ❑Other ..... ....
Occupant Building Permit No. 7 (Q ,
Job LocatiorLtat—end.' \r-..Z,e: .6-2.03fkCity State ..t C.1
County i--e - Twp. Swimming Pool—New❑Old❑
Owner's Address lS. 4,12,`� Z 7c t?.-er -cy Pool Permit No.
Directions to Job Site ... . .. . ^ . ....4%.!@. - c0..' ^ `E.. .� —
Application For ' s ugh Wiring❑ Fixtures❑ Service K or
Work—New %. Additional❑ Bldg.—New❑ Old❑ Ready for Inspection
Fee Remitted Check ❑ Cash❑ Make Payable To C.E.I.S.,Inc.
LIST ALL EQUIPMENT AND WIRING
NUMBER OF ROUGH NUMBER OF ELEC.HEAT-AIR CONDITIONERS-BURNERS-DRYERS-HEATERS-RANGES,ETC.
WIRING OUTLETS FIXTURES NUMBER TYPE OF DEVICE H.P.OR K.W. NUMBER TYPE OF DEVICE H.P.OR K.W.
SWITCHES MERCURY
LIGHTING SODIUM
RECEPT. FLUORESCENT
ELEC.HEAT QUARTZ
MOTORS:H.P. 1 1 - 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
OTHER EQUIPME
APPLICANT'S
SIGNATURE LICENSE# PERMIT#
PLEASE
PRINT NAME C i(„ PHONE#
APPLICAN ' Q
ADDRESST l L ti_•, '— ]' NAME OF
UTILITY
CITY STATE Jr� ZIP CODE BE NOTIFIIED
ROUGH WIFTING CE BELOW FOR USE OF INSPE TORS ONLY
OUTLETS AMP SERVICE PUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
MISC.INFO. DATE INSPECTED NOTIFIED POR- ¢ w -I FEE PAID
TED U
CON- TOTAL $
TRACTOR
WORK INSPECTED OWNER CHECK NO.
. ❑R.W. ❑SERV
❑FINAL OCCUPANT CHARGE
CERTIFICATE NEEDED AGENT CASH
YES DUP ELEC. H.O.
LT.CO.
TEMP CARD# DATE INSPECTOR
FINAL CARD#
BP/9627 Rev.1/95 APPLICATION EXPIRES ONE YEAR FROM DATE.
•
WHITE/Office CANARY/Officer PINK/Inspector GOLD/Customer
-/ k}° ENERGY CODE COMPLIANCE APPLICATION
V11.41
j !_ TOWN OF QUEENSBURY, WARREN COUNTY
=`� - 9000 HEATING DEGREE DAYS
Compliance Methods : PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings ( 3 stories or less)
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT'S NAME: PROPERTY LOCATION:
LcA-cr-7 Cii-Je__ -6=i- -Je_f.k-).„Jer--/trz_cLirk. c_c_f
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 9(0o square feet
2 . Type of Heat - Electric Oil Gas Other
3 . Is building mechanically cooled? Yes No
4 . Percentage of area of windows and doors Over 17% X Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED: ,
a. Roof cre L-C___ R 7S1-
b. Exterior walls R
c . Glazed areas R
d. Exterior doors M.-op k ( _ — R
e. Floors over unheated spaces R
f . Edge of slab on grade (heated building) R
g. Basement/cellar walls (above grade) R
h. Basement/cellar walls (below grade) R
i. Heating/cooling-ducts-piping in unheated space R
- 6 . Service (domestic) hot water heating device
Conforms - mi imum efficiency per code Yes No
TEM"RATURE ONTRO. •XI SETTING 140° - WILL NOT BE EXCEEDED
Appl: n ' Sgn- II/ 5.7 ` r3 7D77 Da e Phone Number
L (pa �
INSPECTOR' REMARKS :
/� TOWN OF QUEENSBURY
1 ; ` BUILDING & CODE ENFORCEMENT
I 742 BAY ROAD
' ' QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP: ..
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED: 5 ii—A g
NAME bC4-9-A1- --)
LOCATION 3 ( 1 e
syel/— aL(19._
DATE c---- Gam{ —9 gyp-"�(� PERMIT #9 7 LG74
TYPE OF STRUCTURE �� Y
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
PECK/PORCH/STEPS RAILINGS
PELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE N/VARIANCE REQ. )(1)
NAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C •
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement Dept. of Community Development Arrive\.,30 -
/ n Part ;"0 •;,;y„'��
Town of Queensbury Inspector's Initials A
742 Bay Road /
Queensbury,New York 12804 C / ( (6)
PERMIT# i 7 r(0(P
NAME
LOCATIO �
� -- DATE [ —/ ; — cI g
N f�
TYPE OF STRUCTURE S V) / �
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct V t Location
Fresh Air Intake •
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 3 "to 36"
Exterior Handrails,balconi s,landing 18 in. or more /
Interior Handrails stairs bothsides 3 or more risers
. Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/reg ator 18"above grade
Gas Furnace shut-off within 30 fee or within line of site
Oil Furnace shut-off at entrance to ace area
Furnace/Hot Water Heater operating
Relief Valve(s)installed \`
Headroom,6 ft. 6 in.on stairs l
Basement stairs,6 ft.4 in. /
Handrail exterior stairs both sides more than 3 a ers
Interior privacy/trini/doors/main entrance 36"
Floor Finish /
Bathroom/Kitchen watertight / \
Interior Handrails Balconies/Landing 18 `. or more 0
Railing across window in stairwells
Smoke Detectors: / ��
every level ®�a
every bedroom / ��.7`
outside every bedroom /
inter connected ��
Bathroom fans "�
Plumbing fixtures
Foundation insulation
3/a hour fire door/door close/
Garage fireproofing
Garage penetrations cealeld
Furnace in separate roont;preteeted-(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required /
Final Survey Plot Plan a(/
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)
CANAl\CDA,...z.,
RESIDENTIAL FINAL,INSPECTION REPORT '
Office No. (518) 761-8256
Building &Code Enforcment Arrive: Z 1�� In
Dept. of Community Development �,
Town of Queensbury Date Inspection xeques`t eceived:
742 Bay Road
Queensbury, NY 12804
NAME ?,,cNC PERMIT NO. i n( 7
LOCATION C,r,, ��n cZ c,�� DATE 4.i.—S3 95?
TYPE OF STRUCTURE *q---Q \\
N/A YES NO COMMENTS
/
Chimney Height/"B" V-nt/Direct Vent Location /
Fresh Air Intake ',
Plumb Vent Through R•• lie
Roof Complete V
Exterior Finish Complete f
Interior/Exterior Railings 30" o 36" ' / f/'
Exterior Handrails, Balconies, I. ding 18 in. or more - /
Interior Handrails Stairs Both Sid- 3 or More Risers / IGrade 2% Away From Foundation , �
8" Clearance To Sill Plate
Gas Valve Shut-Off Exposed/Regulator :" Above Gra f
Gas Furnace Shut-Off within 30 Feet or wig j Line of ite i
Oil Furnace Shut-Off at Entrance to Furnace • ea
Furnace/Hot Water 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 Thai 3 Risers
Interior Privacy/Trim/Doors/Main Entrance/36"
Floor Finish / \ ;
Bathroom/Kitchen Watertight / /j/
://):\\
Interior Handrails Balconies/Landing 18 in. or more
Railing Across Window in Stairwells
Smoke Detectors: °
every level /
every bedroom /
outside every bedroom/
inter connected /
Bathroom Fans / of/ i
Plumbing Fixtures /
-V Foundation Insulation _,/ _:- F.- \0) F N
3/4 Hour Fire Door/D'ociftloser
Garage Fireproofing' `� \Garage Penetrations Sealed i/ �'
Furnace In Separate Room Protected (In Garage) `�
Light Ventilation Per Room • l 4
Safety Glazing 18".or Less From Floor Y
Final Electrical
Site Plan/Variance Required
Final Survey Plot Plan \///i z
;./r
As Built Septic System Layout Req.
Okay to Issue Temp C/O
t\o T t.*43 i � %b!1 ISAA\ \---t e• G �` QR 1
s- ►� � t,®t� .5 T V � RCS
F' 917 ,ni-,-,_in t
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
'Main Office 357 Elwyn Terrace — Manheim,PA 17545
MUNICIPAL CERTIFICATE pp- ELECTRIICAL APPROVAL
Panel Board No. Cert. 5 2 8 4 4 c-)VCtlt-in Card N
Owner 4A1aI>7 CGGf,f
Occupant �—
Location (,i c7
s5 eu C7Z 0,
Installation Consisting of le SW t r"la,3 29- /
Installed By e 641 0 C G' Lie.#
The conditions following governed the issuance of this certificate,and any certificate previously
issued is cancelled:—
This certificate only covers the electrical equipment and installation conditions as of date. Upon
the introduction of additional equipment or alterations, application shall be promptly made for
inspection.
Inspectors of this Company shall have the privilege of ma.'ng insp ti ns at any time,and if its
rules are violated,the Company shall have the right to revoke .c ti .
Date. .F...0 INSPECTO: ....
Member N.F.P.A.,I.A.E.I.
ipic\ (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT 'K
742 BAY RD., QUEENSBURY NY 12804 a .4i"§° •
INSPECTOR'S REPORT:, ARR\`o 75DEPARTt °41 , i
REQUEST FOR NSPE TI(ON RECEIVED: J2I�yJ i R
NAME Q_ VA /ti J ) (., Y� ff-
Y `r, �� D
LOCATION 13 e , 1 __�/� K,
DATE 3— to-q V PERMIT 0 `) `- /_,N
)(n cn
t �� i
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS i
O ITHIC POUR FO� .
y-C� J/
REINFORCEMENT IN PLACE v
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PR,.TE TION FROM FREEZING
FOR 48 HOURS OLLONINe HE PLACE-
MENT OF THE COCRE�TE
MATERIALS FOR THI`!PURPO.E ON SITE
FOUNDATION/WALLPO R
REINFORCEMENT PLACE
FOUNDATION/D PPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
•
FRAMING:
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 R-
WALLS R •
-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
c-kibitpJy i 1 Avg
. _________,
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804 •
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
NameC \---51d79J:\kT-Q ). d ek�r
Location C Kr)%1
Da te Jd27 Permit #97'(/'10
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length Lfd
Length of each trench 4;:., (-)c
Depth of trench-s ` -
Size of stone leaf
SEEPAGE PITS: Nu -
Size - ft. 1 ft.
Stone size
PIPIN.G.: Size Type
Bldg. to Tank LA"5( c)
Tank to Dist. Bo tL
Dist. Box to Field/Pit " 0. 'Mita
Openings Sealed? Flo Partial •
LOCATION/SEPARATIONS: .
Foundation to Tank 1` feet
Foundation to Absorption O- feet
Separation of Pits feet
Conforms as per Plot Plan _ Ye( NoT ,
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Fron - .ear - eft-. id S - Right Side
Middle rout- Mi die Kear
COMMENTS:
‘( __ . ND-ADVA-T- .!:)E\ \'-‘C_
X'U --\--. WAZ
SYSTEM USE APPROVED: YE NO
Arrived: •,,"-�. -
Depart ,: Ag,'�� '
''_ _ /<< . .
Building I p_c` or
CFIA‘,
(518) 761-8256
TOWN OF QUEENSBURY,
BUILDING & CODE ENFORCEMENT '611,e)
742 BAY RD., QUEENSBURY NY 12804
1.
INSPECTOR'S REPORT: ARRI L EPART ' 116p;• i
Or
REQUEST FOR INSPECTION RECEIVED:.. a;1�
NAME !► "A : 1,
LOCATION e . _,� f Q
DATE 1 ` ' I R 0 PERMIT A f
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES _ NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN ,PLACE /
THE CONTRACTOR IS ESPONS 3.E FOR
PROVIDING PROTE TIO ROM REEZING
FOR 48 HOURS FOLLOWING E PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE N SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
r
F NDATION/DAMPPROOFING _
gACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
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 R-
WALLS R-
CEILING R- 1
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING 5 CODE ENFORCEMENT 'n js.,:
742 BAY RD., QUEENSBURY NY 12804 w �{+v:=
INSPECTOR'S REPORT: ARR EPART L 4,. ........./
REQUEST FOR INSPECTION RECEIVED: Air
NAME C ,V Vil-
LOCATION CZP_c.�� - OF r t tiyEdi epeRli4
DATE IV-Pi-Cif PERMIT fl CIT4(5)(C)
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
i
FOOTINGS/PIER S \plc}
MONOLITHIC POUR FORM
V REINFORCEMENT IN PLACE ?,-' z" '
-
THE CONTRACTOR IS RESPONSIH FOR
PROVIDING ROTE TION FRO REE ING
FOR 48 HOU FOLLOWING 1E PLAC -
MENT OF THE ONCRETE.
MATERIALS FOR T P RPOSE ON TE
FOUNDATION WALLPOU
REINFORCEMENT IN LACE
--FOUNDATION/DAMPPROOFING -
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
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 R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R •
-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 '�
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INSPECTOR'S RETORT: ARR�, DEPARTI.
REQUEST FOR SPECTION • C IVED: -
_
LOCATION I ,_ ? '/ '
NAME v t(lL�.--- tein d-E00
DATE 1 (_` 16, , 7 PERMIT 1 �I �� �
TYPE OF STRUCTURE: t-ie.W>3 gr'' A. 1LiC11I1f
RECHECK t jam( PPROVED
t � /A YES _ NO
Cl/QOTINGS/PIERS Y
MONOLITHIC POUR FORM"
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REINFORCEMENT IN LACE .-444 _
1 I
THE CONTRACTOR IS RpESPONSIBLE FOR
PROVIDING PROTE TIOU FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETEt.
MATERIALS FOR THIS P1RPOSE ON SITE _
FOUNDATION/WALLPOUR ' frT
t'
REINFORCEMENT IN PLACE. :J _
FOUNDATION/DAMPPROOFINE / _
BACKFILL APPROVAL air
PLUMBING VENT/VENTS IN PLACE ..
ROUGH PLUMBING / \ _
PLUMBING UNDER SLAB / \'
FRAMING: P
JACK STUDS/HEADERS \
BRACING/BRI/DGING \ __
JOIST HANG RS \
JACK POSTS/MAIN BEAM \
AIR INFILTRATION BARRIER \`
HEATING ROUGH-IN ` _
i \
INSULATION: n
I
FOUNDATION MALLS INTERIOR R-
FOUNDATION/WALLS EXTERIOR R- \
FLOORS t R- \
WALLS I R- - 1
CEILING ?' R- 1•
DUCT WORK OR PIPING IN
UNHEATED! SPACES R-
I
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT rr'sR.
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR `P) DEPART INT�
REQUEST FOR INSPECION RECE V D:.
NAME LOCATION
DATE PERMIT A
TYPE OF STRUCTURE: / 5eg
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE
MENT OF THE CONCRETE. _,.
MATERIALS FOR THIS P\RPO ON IITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLAC
FOUNDATION/DAMPPROOF G _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB
FRAMING:
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 R—
WALLS R—
CEILING R—
DUCT WORK OR PIPING IN
UNHEATED SPACES R—
- - aev° ® TOM McMANAMAN
N. ` DORSEY MILLWORK, INC.
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36 RAILROAD AVENUE
jjidersen ALBANY, NEW YORK 12205
TEL.: (800) 243-6773 FAX: (800) 231-0199
FAX AVAILABLE 24 HOURS A DAY- 7 DAYS A WEEK
DATE: JOB:
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TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
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plans and specifications are in full , ���®���� �y �� •
compliance with the code. re PTA
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MAP REFERENCE:
MAP OF A SURVEY MADE FOR
LARRY CLUTE
BY VAN DUSEN & STEVES
DATED: SEPTEMBER 23,1997
IRF
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LOT 3
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& Steves
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Lie. No. 50135
GENA'VA
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IRS S84'2191Opp
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CLUTE ENTERPRISES
Town of Queensbury, Warren County, New York
NO. I DATE
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DESCRIPTION
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1'=30'
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CLUTE ENTERPRISES
DWG. NO. 95001-2