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1989-102 � m. w '+'"+%E.','1SR_7.*��;�":E�,w'v,: •"na. ,w.•.t.. , ,�.r.-r.P».'�[�r�'►�'; . v o'�..��a.�.-. q -.�,.,; , f f f SOON +C•ER.TIFICATE ' O OCCUPANCY TOWN OF +QUEENSBURY j WARREN COUNTY, NEW YORK Date ,lung a 19 89 9cl - l09L [ This is to certify that work requested to be done as shown by Pen. it No, 1 �"' y has been completed. Sty\/ Cam Ii�ic This structure may be occupied u C i �' ,ia y Iv' � I i 11 - LfMe �,,� Location .4+0� - � � I•Iarli U1= �vci owner Y'L]:_ G'F.i +... GWoodI Home n ��`•3 I By Order Town Board TOWN OF QUTHNS8VRY i ter-- { �r Director of Bldg. do Code Enforcement I " BUILDING PERMIT TOWN OF QUEENSBURY No. $ 9 - 102 WARREN COUNTY, NEW YORK Cy PERMISSION is hereby granted to Forest Wood Homes r OWNER of property located at Lot 62 Maple Drive Street, Road or Ave. 1 �o in the Town of Queensbu g m ry, To Construct or place a S inclle Farm ly 1JtioE? 11 in �.o 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 HC- 02 Dox 286F Wajrensburg , N . Y . 12885 ITJ 2. CONTRACTOR or BUI LDER'S Name O ;d ts1 Self r-] 3. CONTRACTOR or BUILDER 'S Address O O Same a x 0 4. ARCHITECT'S Name M £i7 S. ARCHITECTS Address 1 " 0 H 6. TYPE of Construction — (Please indicate by X) XK I Wood Frame I I Masonry I } Steel I I tl CrJ 7. PLANS and Specifications 26 ' x 67 ' Single Family Dwelling as per plot plan , No. � Specifications , and applica-tion , including septic and attachei two cal are e . M tTJ B. Proposed Use Single Family Dwelling rn H 25 , 00 c/o 1 $ 211 00 PERMIT FEE PAID — THIS PERMIT EXPIRES oci.ober 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 Queensbury before the expiration date.I , H t~ Dated at the Town of Queensbury this 2 4th Day of March 1989 *C SIGNED BY ~.a c for the Town of Queensbury L J uilding and Zoning Inspector H (i TOWN N OFUEENSI3URY APPLICATION FOR BUILDTHC, AND ZONING PERWITT F ecie+rect_ � TOWN OF QUEENSBURY reviewed RECEIVED Fee Paid fi 2 �`zs` ' MR 2 pl $9 MI LDING AND CODES DI T1ARTliFJ%.`T Date. Taaued BLDG, & CODE DEPT, 13A Y and HAVILAND ROADS .R.D .I Box 9a 01YEEN"SAURY, NEW YORK 12804 PeAmi t No . Tel . (518) 792-5832 Ext -204 .. -s : x t r yr 'r yt : * ar a * r s e Yr • s * * ■ s * *' x w ■ a A PERMIT MUST Bq OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS . k' ILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BVILDIHC PERMIT . All applicable spaces on this application must be completed and the ,; .Iuature of the applicant must al * car on the reverse side of this sheet . 'rha owner of this property is -, f7m -; [w,}pcla #ymeu d^y�.�r -- V . O . Address t& ba �2� + r .P %1nrrrb,s hLA" �� ' �ES1L��_TEI. . � [property location -- 10± &X ►�+^[ +� �br s Avg° ` , TAX MAP NO . [ [ as there been any split of this property since October lx 1988 ? l ✓�'h✓� �' yes no 7f yes , Planning Board Review is necessarys SUBDIVISION NAMEx IF APPLICABLE 1 �{+� F ` tt hL 11A LOT NO . The person responsible for supervision of work as regards Building Codes is : lc ere ,s f C. Q1 lzd )c 2 M P �' " NAME 11 P . O . ADDRESS TEL . NO . 14ame of builder Fbr _L_ ]LSrS?o c� h Add ra,rr^; A-- . .Tel_ 7 4.1 Nance of Plumbers 4. ]u3dress *►"� .4 d Tel 11 Name of Mason u �� 7�ddress �s u 14x1TURE OF PROPOSED 6ORK : ZONING INIOORAIATION ( Offiae use Only ) _✓Conscruction of a ntzw building ; ZONING DESIGNATION OF PROPERTY _Addition to a building PERMITTED PRINCIPAL PERMITTED ACCESSORY AlturatiQn to 4 1:,utlding I " ( 1so Cls.tnt]u to a:xc . riar climcnsions) " REVIEW REQUIRED - PLANNING BOARD ZONING BOARD aclier work ida.crluol ' SITE PLAN REVIEW # APPROVED DATE CHOSS AREA OFPROPOSCD. STRUC 'TUHE VARIANCE APPROVED LATE lst Floor sq ft . Remarks : Jr 2 nd Floor !�b sq ft * Y CUV1E'LL'"1'i: IN,T'Ol:r4A"i'YON 10;QUllc4'D� 11I:WW O jpo 'y�rawT l . 5 ,� Other Floors sq ft . size of propQrty� r � , r^ � �- _ _ft X fs9gk; T.l� t • ( not collar or basement ) ' X rt . LxiutirlcJ 1>yiltlic«] ( : } ai »4 fti w TOTAL FLOOR AREA�� C) ? aq f t . Lxi:: cil7g ra� il.TincJ (:: ) Use E` ixC :of niw structur. ft X ft I`ouatdaci©n-pier/�1a1./crawl/Yyarti�rl�"Et�31 " 1'rc>polr# building , ditzcancu from propurty lint: (circle: one ) . front yard 3l? ft Rear yard ft No * of .torie: (hablLahlO wlyacc) g � side yards ft� ft and _ ��rt I [uighC ( Ura.d►: to ridqu ) ,ant. ft . # if on corner, ::ueb:xck Prow side: acrece fc 1f residential , nos of families I Has of rooms (excluding b:.cths) � 7 '" OCCUPAML:Y YNFL}i2AMT1CnE [ Ito & of bcdroQms 3 # pARY r;UxLDING No . of 't Ono fanri.ly dwelling f'riuu ry IjUa C i11rJ ::y:.t kaLll ..air w '1•wo family dwa:ll my Tytu: of fuel Multiple: dwelling / Number of units NO . of fire,pla U4 to 1Ow inatall ::cs " vaxuu4nont occupancy Will :+ wood =;LQVQ k+.: ia!; L allud? s'ran::iurrt QCCUYsancy Cuntral Air CQirCiLtlCillil«J:' l3u.inuss flUltmOING STYLE;, MiteARY STRUCTURE lnduscrial 1::a1nCh Concogstj")Qr:ary Log cabin � Other , 1<:liaud ranch MansjLc.i► Dulslux . It "dditioca , wh"C; will u:.:e. b%& l t4plic luve:l Old a,cyla 1.luateJ".Low " C:+p.s Otltur ' ACCESSORY BUILDING- (Colonial� stow '1'owtt }OouSE: ` "cached g:ar4ugo/one cFar/� czar CIRCLE C"L PLEASE ) "" �Attach4d ciaragu/osier car// '- o ��r cue' w w w ■ ■ * w f F . w w a w w ♦ x T'rivCa " storage building ESVIMATED MARXE414 VALUE OF '� �Or.hCr 1NF'ORAIATION ON 11L TLOINC SprCIFICATTONS , ON 4tEVERSE STDI- OF THIS ,'..1EEI?ZTa TO Be COMPLVrEDI Form DPA 20/88 V2 $UILDIN.I ; jE MIT APPLICATION CONTINUED - BUILDING 5PECIFICATIONS : Type of cans ruction , wood frame , fire safe , etc . Will any seAnd-hand or ungraded lumber, be used? If so , for what ? inn f • Foundation wall material rlen to�_ Thickness Depth of foundation below grade ( to bottom of footing ) SIZ Ar Will thc_r�s be a cellar?,__Heated or unheated? Floor sq . footage sq ft Will there be a basement? y[C.S�...Will any portion be used as living space? ( If so , what portion? Isg . ft . - - Type of use? Type of roof - swop d latfshed/other Material of roof Size , wood studs_ " X^ �" spacing I (2 "o . c . length ft . 3oists ( floor beams ) 1st * floor _ spacing 1 -'"c . o . spa 'irdwl� ft . Joists ( floor beams) 2nd . floor �` X 1Q spacing-1�"o . c . spar �s ft . Overlays ling beams ) Rix spacing " o . c6 span ft . Roof raft : trs "X to spacing o . c . span ft . Roof trusses (pre- engineered) spacing, __"o .O . C . span. � ft . Exterior wall finish ,,,r ,' K y J ()f what material ? Interior wall finish- —F - k a k` If a garage is to be attached , describe materials to a used for IRE SEPARATION : iYIlITr?+� 1-{ 1 s sa4 � b��rre [ *+ �.ca �Se a .. e� �� ^O%f Slc+ u� � 515 �G laJa Is therm tca be an opening between garage and dwel ng? S If so will a Fire-rated door , E3"1cloL ; ure , and self-closing device be provided.? Will a flu4- lined chimney be installed? �p Height abo e roof. ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . in . f Water 5:upply - Municipal or private well ✓�1.t� IC 'rigo SEPTIC `; Y5_:'1'1 M _ Distance from ANY private well ( including adjoining properties ft . (A separato application is necessary for any repair or new installation of septic system.) 1) ECLARA `FI0N To the best of my knowledge and belief the statements contained in this appliptition, 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 lk}ws pertaining to the proposed work shall be complied with, whether specified or not , and that such work is authorized by the owner. i Signature MAI Owner wn is agent, architect, contractor SPECIAL Cuc]L)I`I'IONS OF THE; PERMIT : TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE + A permit must be obtained before beginning work . ANSWER ALL of the following -. 1 . Gross floor area �� v 2 . Type of heat Ao / 3 . Is the building mechanically cooled ? �} 4 , Percentage of area of windows and doors lu' A . Over 16 % Only 1 . U value of gross area of walls. , roof / ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO 1 . If YES , what is the R value ? 3 . Slab on grade YES NO a . If YES , what is the R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation B . Under 16 % _ Only 1 . R value of roof and floors exposed to ambient conditions. 2 . R value of exterior walls 3 . R value of glazed area 4 . R value of doors 5 . R value of floors over unheated spaces 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab 8 . R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement /cellar walls ( below grade ) 10 . Type of insulation C . Controls 1 . Thermostat maximum heat setting D . Duct Systems 1 . Is duct system installed In unheated spaces ? NO a . If YES , R value of duct installation b . R value of duct in other areas E . Piping Insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating 1 . Performance efficiency 2 . Temperature control setting maximum- G . For Swimming Pool Only 1 . Maximum heating?? I ] r Telephone No . i�L^✓' ��,( ( a p cant s signature ) TOWN OF QUEENSBURY F 9 APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION Mgj�1,' br-i ye. __ Hie��r� t3 Owner's Name. Jrvrr c bad 14b iitA Telephone: Le'214 3979 Address: ff Installer's Name* wr� Telephone: ocQa Number of bedrooms (residential only) Total daily flow (compute (c 150 gal per bedroom) Topography: Circle one: <1212b Rolling Steep Slope % of Slope Soil Nature: Circle one: Loam Clay Other. /Depth: Feet t we 00k* y-h.4k^ Ground Water: At what depth? Feet -¢tsar Bedrock or Impervious Material: At what depth? $ Feet Percolation test: Circle one: of r q ire required rate min. inch. Domestic water supply: circle one<2a p Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank /00 (> gal. (minimum size: 1 , 000 gal.) TILE FIELD: Each Trench feet/Total system length _feet SEEPAGE PIT(S): Number of 3 / Size each. feet by —6—feet Size of stone to be used # /Depth or Thickness feet I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance, SIGNATURE OF RESPONSIBLE PERSON: (_A. Jr DATE . Mate � is- , OVER a #.r, i r 47 E:i 1 • r.«-.- I�+ '�'^ n ! 1 '� i' 1 + ' f .' I.. :UL 1 1 /22 / y , 88 CLEM T HIS CEHYir FC.a-C+- 1`.i ISSUED AS A r,lS:, f rEF# #jf- Iral-C H.,IA-FYON ONLY ,ti+ JJ L.U,.r L+.s �.;haT ]_ L' S W = Merriam & Son Inc . WCH I : deo'ri -1 ki,: (;:i -#TICLC.ATF li3LDLR. r,i,.: c,:_ri'I IFICAIL DUC:. i „O r .ylL u- > FXTEND OR ALT61i THE COVERAGE Af FOHJ6U BY 1HG POLICIES 6VLOV4- . 701 Union Street , Box 1038 Schenectady , NY 12301 CCImP ANIES AEFG&UII%:k'� COVERAGk= COIViHANY LETTER "` Commercial Union Insurance Co . --- .q COMPANY Forest Woad Homes Inc . CJh1PANY E LETTER �+ J c /o Joseph Ammirat i 13 Thunder Run COMPANY �J 4 LE rrER Gansevoort , NY 12831 COMPANY , LErrER �= I TW-: IS TO CERTIFY THAT POLICIES OF INSURANCE LIS1 ED WELOW HAVE IIJTEN IESULD TO THE INSURED NAI.11F❑ ABOV:_ i'414 fr ttr POLICY PiEf"Ci Ll Fr.uFCe: CCo- .i NOTWYTHSTANDING ANY RFOUIHEMENT, TERM GA CONDITION OF ANY CON 1 HACT c: H OTHEI-i DOCUMC14T- WITH I C) +r t Ircri TliIS C;Lfi'f„1IC;A 1 e in..Y "L Vk::ULb UR MAY PERTAIN, THE INS'UA^NCE ACFO1ri•ED BY THi: POLICiC=] ULS C;i ,1..LD Yrc+i3ii" I swjj Ga" r TU . Li- i 1 .._ k :: I:ACLUSi:_i.Ja4 .kha+ j TNONt3 OF SUCH POLICIES. I `"Lri; TY 7F OF IN .0 RANCE PLA NUMBER' -. T lv<:t' r„`c ih11.LUL,' :1 LL,. :, • YY. Us.l, l , I-„ r 1 . — -"` a '��-- GEIak RAI. L1.+.(31L1YY LL-- -'--.�--_•- --__ -..._...- . _�... .--._. .._- ,- _ -_ _.- � . .__ _- —.-.I N , r RA 1107J:a � . — • 1 `—..._ , .. * . ;_hPLUJOf; a l:i1LLAPSE HAZARU I'HCTEII,i;TSiCGPvAPe,.CT ED OPf RADUN: -- C'Gr r 1AAL;I UAL r;c,,.ieslr.L.4.; •`«' ' ;,.utPC.alkhT Cii,THACTORS - - ._ ... -- - -- -- -- Pli,:i;:]IJF.E Ii:,EUf- i i 'r- ri'.;(,7N,i L JtiJ UFIY AU`r CJm001LE LIABILITY r At f 7AJ 10 „c _, U,a`JCU :;UT jr f(7TnEFi IrIAN� PRIV P.1ti., Le�rae...tl 'rk' ef, Jf ItJ AL)i'.J'i !-J EXCESS LIABILITY ,' ufnhrk , N, fGRfJ ' l ..-- - f---- -- --.. . -ii„' .Rf 1 1.A FORM a }}I CQ,APENSATYbr'I _ — 1 A ANa CJ89HO999649 4 /9 /88 /9 /89 ,L LL ' I..r.,r,_GYLI#5 LIABILITY - � 4�. . _ I I-d —• _t7I J I I I i I o - _- - - - ._ ._ - --------- - r'1.7E.S`Ci. P 1 I(i.J . JI L;,ht .I ,A NSl Li yy -�-� F i 67 - - - i Town of ueenstaur ::HOULD A"Y Or' THE Al30VA DESCfiYnC13 rJLI ,c Lc CAiaCcLLFD 61:r A is '1 rrE CX- . +� y { PIRA'flQ fry DATE TRL-.REOF, THC i;>SU17 i COi.WANY klfLL Li.OLAVUii r0 1 7 Building Dept . € MAIL 14 DAYS wHiTYEN NOTICk 1 f_', THE Cc'k RFICATE MOLDER NAME=.D TU TrIE { j LEFT, Bit-I- FAYLUrit TG 61AIL SUCH NOI ICE ai'iALL li*10OSC NO OuLIGATIGN Oil L+,.c+IO-fV i Queensbury , NY t Or ANY_h:Il_J77 UPOiJ THE COMPANY , i L.k-W"S Ok EHE N l f. PSFTATIVES- vAO7-HOF#IZED FIEFaV SF---I I17i_IIVE ,r - -- - - - - - ---- , Brian H . Merriam 'r 1. . 4ilT '_C, offm JV MIDDLE DEPARTME '' S M. T, , AGENCY, INC. 900 dllfwo iial 19iwand; .s. June 'osia8 �T `." .. �ertifirz that tljt3,i eC'Ocal equipment listed has been exarriined and'Is approved as being in accord with the National Electripe� Code, applicable governmental, utility and Agency rules_ # x . Owner: Forestwood Hordes 's, - . bccupancy ` Dwelling � Occupant: Single Family: w # ,�}�Locatjon: Lot 62 Maple Dr iv,e , Hiddq n 1 L L B-4 .816atricef agv�pment and installation inspected this date. It additional aquiprttent ahouid be introduced or atteration9 made Co existing System Inis cw1dicatf shed ITe null and void. and appbcanon !or Equipment: L L 3 Outlets s `•5 r �e c e t a c Les ' nspection Should be SubmtHed npm fl to Ihis Agency. P , ; 3 �.. L',ixtuxes ; c p v 200 Am Servi w 4 Holder of this certificate should prrsent Same io hie progeny insurance Garner Y ?W pp�i .Z% .a.neeS (agent OF companyl approved Joseph Arnett i R- Applicant: RCw023 Box 286P �;., - 15 - 0 224 6 8 _ " ' �� No. Warrensburg , FAY Form ft*. M EL 1 -b3 - . OWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280k TELEPHONE (518) 792-5832 �7 Y BUILDING INSPECTOR' S REPORT REQUEST aF...O�R INSPECTION RECEIVED NAME LOCATION DATE PERMIT # — APPROVED YES NO FOOTING/PXBRS MONOLITHI POUR FORMS FOUNDATION AMP—PROOFING BACKFILL AP VAL ROUGH PLUMB G FRAMING ELECTRICAL RO H—IN INSULATION: FOUNDATION FLOORS r WALLS f`^ ./CEILING L .+ xNAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING f � EXTERNAL PORCHES Sfi S ........ SfiAIRS—CLE,A NC & RA LS PLUMBING FIXTU ES/RE F VALVE INTERIOR TRIM PRIVACY FINISHED F S v GARAGE FIRE OOFING DOOR CLOSE S) SMOKE DET TORS FINAL ELECT ICAL INSPECTION FINAL APPR AL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT" BEFORE THESE PREMISES ARE OCCUPIED# f REMARKSx G' INSPECTOR TOWN OF QUEENSBBURY BUILDING AND CODES DEPARTMENT BAY & HAV2LAND ROADS 2 QUEENS'BURY, NEW YORK 12804- p/� TELEPHONE (518) 792-58.32 BUILDING INSPECMR' S REPORT REQUEST FOR INSP/E�CTXON RECEIVED _/ ] NAME LOCATION �p DATE APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATXON/DAMP—PROOF;XNG BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: `, F FOUNDATION PZOORS WALLS EILING , INAL INSPEICTIO CHIMNFoy HEIGH ROOFING SIDING EXTERNAL PORCHE ST PS STAIRS—CLEARANCE & ILS PLUMBING FIXTURE ELIEF VALVE INTERIOR TRIM/PRI CY Dt7G7RS FINISHED FLOORS GARAGE FIREPROOF G DOOR CLOSERS) SMOKE DETEC'IgORS FINAL ELECTRICAL NSPEC ON FINAL APPROVAL OF CONSTR CTION A SIGNED CERTIFIA TE OF OC UPANCY MUST BEOBTAINED FROM TBUILDINGEPARTMENT BEFORE'THESE PREMISESE OCCUPIED. sa ?4 aXS= y k. (< INSPECTOR BUILDING and ZONING DEPARTMENT 1!� Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME ; If A4e I &2 ,.!`a;r� 7 LOCATION Ae.U7, .��•?f C.' DATE �a - J�_ PERMIT NO. d - SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM:. Absorption field , total length Length of each trench Depth of trenches ' Size of gravel_ SEEPAGE PIT ;,,S 4Nuink3err of) Size- t. X - `�� ft. Gravel size PIPING : Size Tvge Bldg . to tank ri Tank to list. box Dist. box to field/fit Openings sealed? YES `• O Partial LOCATION/SEPARATJeONS : Foundation to t k m*% ft. Foundation to sorption Absorption to of line t . Separation of its t. LOCATION QF, STEM ON PROPERTY (" ircle one) Front - ear Left side - Rightz side - CCMMEf1TS . r t I ( r SYSTEM USE APPROVER 'YES NO Building Inspector 01/86 and v1 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUE.ENSBURYf NEW YORK 12804- TELEPHONE (518 ) 792--5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED rra S� NAME S }r /� 4t; aT LOCATION 2 DATO ]' PERMIT # APPROVED YES NO �, OOTING/PIERS MONOLITHIC POUR FORMS NDATION/DAMP-PA0OFING ACKFILL APPROVAL r" ROUGH PLUMBING FRAMING ° ELECTRICAL ROUGH-IN INSULATION: r` FOUNDATION FLOORS % WALLS #' CEILING FINAL INSPECTION: f CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORC S/STEPS +STAIRS-CLEARA CE & RAILS 4 PLUMBING FIX URES/RELIEF VALVE INTERIOR TR /PRIVACY DOORS FINISHED F RS GARAGE FIR PROOFING DOOR CLOS (S) SMOKE DET CTORS FINAL ELEC_ ICAL INSPECTION FINAL APPR VAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! `. )a4,0 OAAA vo ID INSP OR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUFFNSBURY,r NEW YORK d280dE- TELEPHONE (518 ) 792- 5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR NSPECTIONREC7EIVED - _ NAME t-i_� LOCATION DATE S --�PE IT # APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGE PLUMBING FRAMING ELECTRICAL ROUGH—IN 1,13'NSULATION: / FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ST PS STAIRS—CLEARANCE &;'RAILS PLUMBING FIXTURES,#'RELIEF VALVE .INTERIOR TRIMIPR_yVACY )200RS_ FINISHED FLOORS GARAGE FIREPROO ING DOOR CLOSER (S) SMOKE DETECTORmS FINAL ELECTRICA.4 INSPECTION FINAL APPROVAL J`F CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS : INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT ��� / BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I280&- TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FORIS^ INSPECTION RECEIVED -4 y NAME -- LOCATION DATE i PAMIT 99 C APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BA ILL APPROVAL GH PLUMBING of cr,RAMING ELECTRICAL RQ H—IN INSULATION: FOUNDATION FLOORS ' WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STE S STAIRS--CLEARANCE & ILS PLUMBING FIXTURES/ ELIEF LVE INTERIOR TRIM/PRI ACY DOOR FINISHED FLOORS GARAGE FIREPROO NG DOOR CLOSER (S) SMOKE DETECTOR FINAL ELECTRICA INSPECTION FINAL APPROVAL F CONSTRUCTION A SIGNED CERT FICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS: i d X(O � 7 INSPECTOR TOWN OF +QUEENSBURY BUILDING AND CODES DEPARTMEN 1Y7 BAY & HAVILAND ROADS / / 1 )JI4 QUEENSBURYr NEW YORK 12804- OT TELEPHONE (518 ) 792-5832 J0 BUILDING INSPECTOR' S REFORT /.____�� REQUEST FOR INSPECTION �RECEIVED. NAME LOCATION DATE �_ .{f� PERM T #� 7 APPROVED YES NO DOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAZ ROUGH PLUMBING FRAMING i ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT 1 ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAILS PLUMBING FIXTURESlIRELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ! REMARKS: INSP TOR TOWN C QiLJRY pa BUILDINGG ANDD CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809g TELEPHONE (518) 792- 5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION/' , N RECEIVED � NAME ��, G. a 'Ir7TT �-'� LOCATION �( ,!,l ?ajr- DATE � 'c�. 1 k PERMIT APPROVED -- YES ma L/FODTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ TEPS STAIRS-CLEARANC & RAILS PLUMBING FIXTU S/RELIEF VALVE INTERIOR TRIM] RIVACY DOORS FINISHED FL S GARAGE FIREP iOFING DOOR CLOSER ( ) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: ,+fi r A O INSPEC fi0 SELECT BUSINESS FORMS (609) 228.7775 T APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 TOTHa Date f City, Town or Township � County- OILari�4+ State r Location/Address ]F-7 f ( If Loca d in Rural Area - Please Attach Directions) Pale # Owner FC+rvC".3f "jD+► � jv[ �f Permit # Occupied As Building: New= Old 0 Occupant Work Area in BuildingFloor #, etc. ) : A for: Wirin [� Service or: Ready for Inspection : Fee Remitted - $ Cash [�l Check M M_O_ = Make Payable To: M.D. I_A. Number of Rough Wiring Outlets Elect, Heat 500 750 1000 12so 1500 175a z000 2xso xsoo 275o aooa Switches Lighting Amp. Service Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P, 1/2 141211/10 1/8 1/6 1/4 1/3 1/2 3/4 1 I .lVz 1 2 3 5 74'2 10 15 20 25 30 40 5o 75 100 Mark Number of Each Size Applicant's Signature License # Permit # T/A Utility Applicant's dress' INAME (OFFICE LOCATION) (City) (State) IV (Zip) /aI Ya Service Request # Phone # Electrician ' nomolkYA"o DATE FiECEFVED: DATE INSPECTED: Correct Location : Same as Above © or: Red Notice Label Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner, Wiring $1 Controls for Amp. Receptacle Amp, Service Conductors Pump Vent Fans MOTORS H.P. 1 /3 1/2 3/4 1 1112 2 3 5 7112 10 15 20 25 30 40 50 75 100 Mark Number of Each Size EN Elect. Heat Soo 750 1000 1250 1500 17S0 2000 225p 2500 2750 3000 Pat l+ gk�3 Dash law khldson al ls, 3 12839 518/7158-3473 EUCTRICAL IMSPECTUR CalITIFIf:Jl�'IDIMa iif fl ?M NOTIFIED a 4TE E pas RW Progress . Inc. © LKD Contractor 0 CFT Violation : Work Comp. = Inc. 0 L/A Owner CASH L/A Fee CHK # Due IPA Municipal MO # INV # Applicant Date : ether Side O Utility Owner Cut in Card Temp # Date �L livaa Cf DIFlow ' , ► ' �,q�ir►9 �,ci�rmIr�istY�tor