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1989-143 1PI ---------- O'C"CUPANCY CERTIFICATE' OF khmj� TOWN OF Q' UEENSSURY WARREN COUNTY, NEW YORK Date— jjjj 19 .Sq ?his is to Certify that work requested to be done as shown by Permit Na._ ci has been completed. �� �lmh6* sn%xcture MaY be occupied as a Location O caner ri & Z D r VLv L) By Order Town Board rWN OF QUEENSBUIXY Director of Bldg, & Code Enforcement BUILDING PERMIT a TOWN OF +QUEENSBURY No. 89 - 143 WARREN COUNTY, NEW YORK ua PERMISSION is hereby granted to A & Z Drywall I OWNER of property located at Lot 10 Street, Road or Ave. `g In the Town of 0ueensbury, To Construct or place a 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, OWN R'S Address is RR 2 Box 528 Granville , N . Y . 12832 t:a 2. CONTRACTOR or BUILDER 'SS Name Same r-� r� 3. CONTRACTOR or BUILDER'S Address Same 4. ARCHITECT'S Name t� O �-3 0 5. ARCHITECT'S Address vt O 7C 6. TYPE of Construction — (Please indicate by XI tit { ) Wood Frame { ) Masonry { Steel C7 7_ PLAINS and Specifications .� No. 28 ' x 26 ' single family dwelling as per plot plan , M specifications , and applicat±on , including septic and attached 8. Proposed Use r17 Fi Single Family Dwelling z t 25 . 00c/o � $ 225 • 0p PERMIT 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 O,ueensbu ry before The expiration date_I p.{ C �-C Dated at the Town of Queensbury this 10 th Day of AD-" m SIGNED BY ` for the Town of Queensbury N Building and Zo° ng Inspector H G3 +c ? F LAN �F UEENSBURY APPI. ICATTC}N VOR BUTLDINC AND ZONING PER}�11T peci �'QUEENSBURY Rev i d - RECEIVED Fy Fee Paid fi � -- ` ✓` r Q 19$9 WILDING AND CODES UEPART lEIIII Date Ta.sued BL[]G. 8 CODE DEFT. AY and HAVxL.AND ROAzuS RF 1 Box 93 PUEENS,BURY, NEW .YORK 12BO4 PeJe!?it Na . Tel . (518) 792-5832 Exc -204 . .. Ir ik K * iC 1 SIC i' 1 Yt 1k 1k ♦ lk • ♦ it � M a a ■ it at a► R 7" ,[ r rt t w R 1k • al a A PERMIT MUST 114 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS WILL 13E MADE UNTIL APPLICANT RAS RECEIVED A VALID I311ILDrNC PERMIT . All applicable spaces on this application must be completed and the gipUature of the applicant must appear On the reverse sick of this sheet . * * * K A * * * * * * * * * ,,r* * * * * * * * * * * * * * * * * * X * * * * Titre owner of this property is : ,r r � L OjV71 / rf' N� 11 . o . Address yCt+ r crime .`` 2 ��s' : /1r 'L/'rZ �$-- -7 2. TCLaC,* 'cf-Z 35� I' raperty location !" -at /' � G�r,Gcw. / c ]1 +( see TAX MAP NO *'z -/ `� �� Q leas there been any split of this property since October 1 , 19e8 ? yes Ito If yes , Planning Board. Review is necessary . , / f SUBDIVISION NAME , IF APPLICABLE /�i Cs'� fr�l% f/ LOT NO . lc! &The person respon /siblye� for supervision of work as regards Building Codas is ; l e. 1 V�/' ,�„•�Y` a7 N' LT 1 1 /'G /,j j`^.e.�'. [_e rd' CI 41 t 7 1 / .�+� /�� / — NAME Poo , ADDRESS TEL . NO . Name of builder/ -L .712or1, 4,1 //rfJ e ,iJW ressjg42 4--`' k ' Tel C &#I i � ✓�3.� Ir 14ame of Pluanber j f T.ddress Tel ' Naive of 14"son r Addras!3 Tel / r 14ATTuRE OF PROPQSCR h1712t. : ZONING INFORMATION ( or ice use on .1y ) 1" Crsn ;tx^ucticxrs of a new building or ZONING DESIGNATION OF PROPERTY nddicion to a lauildir►q ; PERMITTED PRINCIPAL PERMITTED ACCESSORY Altur"tlon to a Luilding i ( t►D e1L<Ang..: to exe4I dimensions ) " REVIEW REQUIRED - PLANNING BOARD ZONING BOARD. Octsi:r wort: jaescribe) ' SITE PLAN REVIEW APPROVED DATE GROSS AREA OP CP�ROPOSED6 S rrcUCTURE ; VARIANCE # APPROVED DATE1 � t Floor r �- - -sq ft . * Remarks : 2 n d Floor j .ems �1/ s q f t . eCu trr.l "ri , I;Aio•Or:KATION scl:ti�l x acL D 14t�w41 . Other Floors sq ft . * Sire of proporty /ram' ft XC l e-f f C` t . fc . ( not cellar or bosem� nc } "ItitInra buil.Ji► �•] � :a } ai ::.: ft XC TOTAL FLOOR ARtAe '7Z 0 sq f t • t xi::tLrirj ouilcliny 1:a1 U5u `_.' i ..s or new imructur,: ft .X l'orsaadatian-pier/ :;1st+}crawl/I�aJ tial ull Proposed t>uiluinrl , disc :xnce rrou! proporty lift» (ci ic1� one ) # Front yrµrd__��{',,�5 ft Rear yard �/ ft Na . of stories ()►:abit:.ble �c►Ce ) � d $— ft and � ft Il�ight I ►,Xradc to ridg..a ) :,2 �� c . . Side yards: r i f rot duntial , no . of Families # xf on cornar, uQrPbask from side: 2cr- uce fc No , of room* Cexcludinq n:ath:: y OCCUPANCY INFQP%MATICN No, of be:droo►n5 3 Noo of b:ac)iraolus, �. "r PRAY fxGILDINC - � �-�� ,� /' Ono faauily dwelling 1 rimary 1►uatirwrj Wy `rtunl C-Oo � 4e7oII � + Two family dwelling No. of firuplacu:: to 1}I install. ci -PI • Multiple .1we11%ng / Number of units Will a wood stave k,u ine; talludi? r i erinarrcitiz ace upar►cy cuntral Air coe�+ iitiunie�g ' N d� 'J"ran ;"nc occupancy �. Business BUILDING STYLC, PRIMARY SI-RUCTURE * Industrial la:anct► e +anci ,u.poc"ry Loon cabin Other li.ai ::ud ranch M.rnsic,IL► Dulplux if addition, whaG will uz; c: bc:? :Jpl.i.c 10.:vol old scylo u"Sk&,l:. low C:x a Cod Cott;aq%: Or. t►Qr ACCessoRY UUIL.DxNG- alar►i.a saaw loan douse • U.::cached guraaue/ono c1►rJ' tw car/ car I CIRCLE ON ;' PLEASE ) ' ✓ Actiach�:tId gcaruge/ono car tw cat/ ►' • ■ r a r ■ 71f • .� r v sr ar M '►' J'riVata: star"ga b"ild in 1: .V& TI MA'T ED MAR1: VT VALUE of ' other CON :;'J' 1tUCTTON x' /1wrwr � .. rsrr �� INFORMATION ON 13UrLDTN[2 Spr!cIPTCA'T'TONS , ON REVERSE SJDC OF TNTIS .StIEEL 41 RI BE COMPLETEDJ Farm DPA 10/88 VI c � BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame ,, fire safe , etc , 14?0 - �zz Will any second-hand or ungraded lumber be used? If so , for what ? A.'' Z' Foundation wall material e40 . I r r e� fi Thickness G K Depth of foundation below grade (to bottom of footing ) at� "` r Will there be a cellar? .. Heated or unheated?45f e!yj 40 loor sq. footage sq ft Will there be a basement? yw. ry__will any portion be used as living space?'A � ( If so , what portion? sq . ft . - - 'hype of use? Type of roof - sloped/flat/shed/other 7 # Z Material of r of r S S Size , wood studs 42L "XIS" spacings "o , c . length Joists ( floor beams ) 1st . floor ^" X rG: " spacing / n "'o . c . + spa ' f -to Joists ( floor beams) 2nd . floor "X spacing "o , c , span/ t . Overlays ( ceiling beams ) "x It spacing "o . c . span ft . Roof rafters " X Is spacing o . c , span ft Roof trusses (pre- engineered) spacIng-2.e- c . • sPan�.,. ft , , / Exterior wall finish VI y -i�/ S" Q/A( d Of what material ? V 1 &, L Interior wall finish f'` i l Y ' If a garage is to be at.tached ,,rrdescribe materials to be used for FIRE SEPARATION : Is there to be an ope ing between garage and dwelling? X&> S If so will a Fire-rated door , enclosure , and self-closing device be provided? +xW 5 • will a flue-lined chimney be installed? r(/ C.) Height above roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . in . Water supply - Municipal or private well f [.. 1 AQ SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties_ ft . (A separate application is necessary for any repair or new installation of septic system) D E C L A R A T 1 0 N To the best of my knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work shall be complied with, whether specified or not, and that such work is authorized by the owner. signature / _ � 1^ `V�.'� '� �''�•''_-... Owner, owner's agent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT : By _____ __________._.____-_ __ ------- r TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for ; BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit merit be obtained before beginning work . ANSWER ALL of the following : 1 , Gross floor area./ 4 ?[f 2 . Type of heat , P C ,74 3 . Is the building mechanically cooled ? 4 . Percentage of area of windows and doors 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 4 3 . R value of glazed area f i r 4 , R value of doors 5 . R value of floors over unheated spaces ' ri 6 . R value of slag edge insulation - unheated slab - r � 7 . R value of slab insulation - heated slab e . 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 ? YES 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 Onl 1 . Maximum heating Telephone No . f> � � .� / 0 I ( applicant ' s signature ) JrOWNo OF QUrvE vSBUpv r f^� APPLICATION FOR SEPTIC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION Owner's Name: `� 7 S /i .� �r ,,Telephone: /.� �//Z //r� 3 /S� ^. Address: /�r �� r' _• �.�-.._ S 2S i A r7 ri,/r .�V �� Installer's Name: Telephone: Number of bedrooms (residential only) Total daily flow (compute (a 150 gal per bedroom) � ]C.� �� 4�0 ' Topography: Circle one. Flat Rolling Steep Slope % of Slope Soil Nature: Circle one: an Loam Clay} Other /Depth: S 010 Feet Ground Water: At what depth ? C/ Feet Bedrock or Impervious Material: At what depth ? Feet Percolation test: Circle one: of required required rate min, inch. Domestic water supply: circle on Municipal Well Other If domestic water supply is a we Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank / 0---a—Z) gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet/Total system length I feet SEEPAGE PIT(S): Number of 3/ Size each_ feet by ,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 RE§iPONSIBLE PERSON: DATE: Zrze � ...` OVER MIDDLE DEPART AGENCY, INC. �i �J g S—p` C��[ ,e - D$tl July 26 , lss9 Certffte� that i et;uipment listed has been etra approved as being in accord with the National Elect t� plicable governmental, utility and g�i s_ Owner: A - Z Dry W W p tin Occupant: Single Fall �? Location: Lot 106 Mid it l � ee a rti7lcete I let; It; uipment and Inslallalion inspected thin date. If addillonsl ul nl sh he introduced or slteraflorls made to �y e%Isimg sylorl the ica be null end +told. Ill application for Equipment: 14 0 Outlets l\e c t aC l e S ' ��+qa. � Q in should sUbmntartl P toy to this ngaacy- -'{" ' � M e [r r! fN Solder of Ill uptificata a7�0Uld no same to hIs property insu ranca "Fit f 200 limp Servi �7 ty.pokilanceS (agent orcomaahy] as evi c an lficat tan of electrical eq I pmem approved as apecl��,. r A - Z Drywall ,- A GE 1$ a3 Applicant: RR2110 Box 528 - -- - ----"' 04 15 -025047 Granville , NZ Y 12832 r : Fmen Ne. ELI 1-r] . --------..—r - --.u.----'---- TOWN OF Q 'UEENSBURY .BUILDING AND CODE'S DEPARTMENT BR & HAVXZAND ROADS f7UEElVSBURY, NEW YORK I280!& TELEPHONE (538) 792-5832 BUILDING INSPECTOR I S R PORT "'2UEST FOR INSPECTION RECEIVED NAME _ LOCATION DATE 3'ERMIT # APPROVED FOOTING/PSE,ks YESS NO MONOLITHIC PO jR FORMS FOUNDATIONIrDAN&'_PROOFING BACXFxLL APPROVAL ROUGH PLUMBING FRAMING ELECTRTCAZ ROUGH-_ N INSULATSON: FOUNDATION FLOORS WALLS LP�F,.cErLxrvG , xNAL XNSPECTrON: CHrMNEY HErGHT ; RooprNG SIDING EXTERNAL PORCHES ¢ /�'T'EFS ' STAXRS-CLEARANCE,,4 RAX PLUMBING FIXTURF]S/ INTERTOR TRSM/PR"I REL R9LxEF VALVE ---- fiI)VISHED FLOOR$ GARAGE FIREPI?,QOFING DOOR CLOSER (SJ .SMOKE DETECTORS FINAL ELECTRICAL XNSPECTrON FINAL AP-PROVAL OF CONSTRUCTION A SIGNED CERTrFICATE OF OBTAINED FROM THE OCCUPANCY 'MUST. BE THESE PRE'M-TSES AREH OC�rEY7AFG �EPAR2'MENT BEFORE REMARKS. Y 'FCC sue *IT-lvspzcroRm BUILOING and ZONING DEPARTMENT Bay and Havifand Road, R. D. 1 Box 98 Queensbury. New York 128()l SEPTIC DISPOSAL SYSTEM! It4SP _ C T I OJV NAME LOCAT I ON er' 460 DATE PERMIT NO= SOIL TYPE Sand Percolation Test ReqLoauired?- Clay rate - Percolation quired? YES Min/Inch TYPE of SYSTEM!,: Length Absorption field , total length Lerigtlz of each trench Depth of trenches Size of gr el SEEPAGE P S {Ntlittja�- -- Size- ft. X fto Gravel s ze PIPING : Bldg * to tank Siz Type Tank to dist. box Dist* box to .field/pi �. ,• ,� '~-�-- OPOnings sealed? r r r Partial LOCATION/SEPARATIONS ' „ k Foundation to tank N Foundation to abso tion ft. Absorption to lot ine ft = Separation it £t- LOCATION S I, Front - ear ROPS (CArcl.e one) CCMMENT - E t sidON Pe _ Right fide 4 SYSTEM USE APPROVED X S NO Beiildi ns ector 01/86 and vl Toiv,N OF QUEENSBURY BUXLDTNG AND CODES DEPARTMENT BAY & ffAVXLAND ROADS -QU'EHNSBURY, NEW YORK 128 ok TELEPHONE (578) 792111-15832 BUILDi G 'NSREC7DR I S REPORT REQ4JHST FOR XNSPE`CTrO NAME ECH-rVHD yc�� Z.00'ATXON t'J DATE PERMIT #,~-� C_ A I'ROVHD F0027rNG/PTHI2S YES NO aV0lVOLrT)jrC PCJUR FORMS FOUNDATXON/DAMP-PRCaQPSNG SACKFrZIL APPROVAL ROUGH PLUMBXNG PRAMXNG EZRCTRXCAL aROUG rN rNSULATXON. POUNDATXON PLOORS WALZ.3 CErLrtvG FrNA L rNSPECTTON CHrM.I HE XGH ROOF.I•NO SrDTNG EXTERNAL PO CHES/S2'EPS STA TRS-CLE �----� PLL,MBTNG F NCH & RArLS XTURE's/RELrEr XXTHVA RXOR RIM/PRrVACy -~ '- FrNrSHED LOORS DOORS GARAGE F RHPROOFXNG DOOR CL ER (S) SMOKE D TECTORS PrNAL ELH TRXCAL INSPECTrON FINAL APP VAL OF CONSTRUCTXON A SIGNED CERTrFrCA2. OF OB 2AINED FROM THE BU'rLD-fA?G CY MUST BE ARE THESE PJ?RMTSES TIEE'AR2'MHNT BEFORE OCCUPXED! REMARKS: r rNSPE'C2'OR 50"'" o/ 'Qeteertj6urey BUILDING and ZONING DEPARTMENT Say and Haviland Road, R. D. 1 Sox 98 Queensbury, New York 128D1 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date Perm3t No . Footing/Pier Forms ✓ APPROVED - YES NO Foundation Waterproofing Backfill Framing Roofing- Siding Masonry veneeYr Rough Plumbing'., Relief Valves `f Ext . Porches Finished Floors Interior Trim r Stairs & Railings Cellar Drain Tile Concrete Floors glb9' • Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION Foundation Floors Walls Ceiling FINAL ELECTRIC L � -' DRIVEWAY APPRO IIVSPECTIC7N Final Building Survey Next scheduled inspection (Call when ready ) Remarks- +t ly r 11 ]� VA i 4 f. Building Inspector 6/86 and-vl TOWN OF QUEENSEURy BUILDING AND CODES DEPARTMENT BAY & HAV_rLAND ROADS QUEENSBURY, NEW YORK 121 TELEPHQIVE f518) 792-58.32 BUILD-IM INSPECTORIS REPORT RF'DUEST POR INSPEC27r01y NAME, } a l RECF sVE L7 'ATrON DATE 7 _ F"E'RMrT #�'��c' APPROVED PooTrNG1Pr1s'.$s YES NO MoIvoLITft-rc POUR "ORMS POUNDATSON/i�,R O�rNG BACKFrLZ AT'PROVAL ,R0QjH Grrr nrG �-- MSNG �TRrCAL RQIlGH-2 SULAT�'Oly. FOUNDATION FLOORS WALLS cE•sLrNc FINAL INSPT ION: CHIMNEY HEIGHT RQQPTNG SIDING EX lip PQRCHRS/S7EF}S STArRS-CLEARANCE &pL RArT,,UMBx'NG FIXTURtsS/REL F, 11 VALVE TNTERTQR S TRXMIpR RACY �p� PrNISHED FLOORS GARAGE FIREP,ROQF'I1yG DOOR CLOSER (,S) SMOKE DETECTORS P.TNAL ELECTRXCA,L IN F'sNAL APPROVAL EC2vrON QF C �, TrON A SIGNED CER7'sFrC.AT`E QF' `-4 OBTAI E'D FROM T.HE: B OCCUPANCY MUST' BE THIs'SE PR'EMril UTLDrNG D.E'PARTMENT B ARE' OCCUPrEDJ- E'3'ORE REMARKS: INSPECTOR .✓ w'" ©/ Queert3hure BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION p►'-" ,,_] PetrM± t Nom ✓ APPROVED - YES NO Footing/Pier Forms Foundation Waterproofing Backfill Roofing , Siding Masonry Veneer Cgh Plumbing Relief valves Ext . Porches Finished Floors Interior Trim Stairs & Railin Cellar Drain Tt e Concrete Floor Plbg . Fixture Gar . Fi.reproo ing Door Closers Smoke Detect rs Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELEC CAL INSPECTION DRIVEWAY AP OVAL Final Building Survey Next scheduled inspection (call when ready ) Remarks- Builds g Ins ec r 6/86 and-vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS -1- QUEENSBURY, NEW YORK 12804t TELEPHONE (518) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR .INSPECTION RECEIVED NAME - T LOCATION DATE S- "b . 1 PERMIT # APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATXON/DAMP-RRoOFING BACKFILL .APPROVAL ROUGH PLU� N St, ELECTRICAL ROUGH-IN IN.SULATIONc FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/S EPS STAIRS-CLEARANCE RAILS PLUMBING FIXTURE /RELIEF VALVE .INTERIOR TRIM/PR VACY DOORS FINISHED FLOORSi GARAGE F_i'REPR ING DOOR CLOSERS) SNOKE DETECTO S FINAL ELECTRIC INSPECTION FINAL APPROVAL OF CONSTRUCTION A .SIGNED CERTfFICATE OF OCCUPANCY MUST BE OBTAINED FROM , THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED!' REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVTLAND ROADS QUEENSBURY, NEW YORK I28D+1f TFsLEPRONE (518) 79.2-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME a . DATE S�—C PERMS'T APPROVED YES NO F`OOT�TNG/PIFs'RS MONOLITHIC POUR FORMS FOUNDAT-TON/DAMP—PROOFING BACKFILL AplhROVAL ROUGH PZUMBTZ� FRAMING ELECTRICAZ ROUGV—IN �SULATION: 1 FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS—CLEARANCE & :RAILS PLUMBING FIXTURESIRELIEF VALVE INTERIOR TRIM/PR.I DOOIgS� FINISHED FLOORS ' 'GAGE FIREPROOF" NG DOOR CLOSER (S) .SMOKE DETECTOR FINAL ELECTRICAL �XWSpECT?ON FINAL APPROVAL O}' CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY -MUST BE OBTAINED FROM THE-- BUILDI DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS.: SNSPEC TOR TOWN OF QUEENSSURY BUILDING AND CODES DEPARTMENT BAY & FIAVILAND ROADS f7 QUEENSBURY, NEW YORF[ 22&0q, TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPEgrxOm RECEIVED � NAME ip t LOCATION DATE APPROVED FOOTSNG/PIERS q �y / ONOLITHIC POUR YES NO FO S COUNDAl*r0N/DAMP-PROOp.�NG CKFILL APPROVAL OUGH PLUMBING FRAMING ELECTRICAL ROUG -IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING .SIDING EXTERNAL PORCHES/S2, STAIRS-CLEARANCE & F S PLUMBING FIXTURES/ LIE VALVE INTERIOR TRIM/PRIV CY FINISHED FLOORS GARAGE FIREPROOF G DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL NSPEC27ION FINAL APPROVAL. O CONS2'RUCTION A SIGNED CERTIF CATE OF OCCUPANCY M ' ST BE �- OBTAINED FROM fi E BUILDING DEPARTM T BEFORE THESE PREMISES RE OCCUPIEDP REMARxs: �c INSPzccTo TOWN OF QUEENSBURYf� BUILDING AND CODES DEPARTMENT BAY & HAVI L AND ROADS QUEENSBURY, NEW YORK 12802. TELEPHONE (5I8) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME _ - LAJr I LOCATION �I -- - - BATE � -- f ( � ! PERMIT # .APPROVED YES No FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKF.LLL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INS ON: CHIMNEY' HEI T ROOFING SIDING EXTERNAL PORCHES TEP,S STAIRS-CLEARANCE & ILS r PLUMBING FIXTURES/R IEF}',�VALVE INTERIOR TRIM/PRIVAC DpORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF C62VSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY ST BE OBTAINED FROM TH$' BUILDING DEPARTME BEFORE THESE PREMISES ARE OCCUPIED! REMARKS. i... ,cc [ > qz" R Rjo(>) rNs To SELECT BUSINESS FORMS (609) 849-5203 APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. I —^�-- National Headquarters 900 Haddon Ave., Collingswood, N-J. 08108 a * _� Date : / I J City, Town or Township County ` CL ^} `4 ._.State LocationlAddress —► d .� ( If Located in -Ru al Xrea - Please Attach Directions Pole # Owner. Permit # Occupied A r Building: Newn OWED Occupant Work Area in BuildingFloor #, etc. ) : A , for: Wirin Service 0 or : Ready for Inspection : Fee Remitted - $ Cash 0 Check ' ] M,O. C] 2250 2500 2750 3000 Make Payable To : M.D. I .A. 500 750 1000 1250 1500 1750 2000 Number of Rough Wiring Outlets Elect. Heat Amp. Service Surface unit Dishwasher _____ �Range Lighting Receptacles W Water Heater Air Conditioner Dryer ��. Pump Number of Fixtures C � Oven Garbage Disposal iring and Controls for Burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H, P. 112 1112 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 111: 2 3 5 7L/2 10 15 20 25 30 1 40 50 75 100 Mark Number of Each Si., Applicant's /i ".: Signature "�'" • 'f '"� f -- '"" License # Permit # T/A Utility : Applicanj"s Address : INAMEI IOFFtCE LOCATION (City) (State) (Zip) Service Request # Phone # Eiectrician : a a DATE RECEIVED: DATE tNSPECTEC7 : rRerd ct Location : Same as Above 0 or; otice Label 0 Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner, Wiring & Controls for Amp, Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P, 1120 1/12 1/10 1/8 1 1/6 1/4 1/3 112 3/4 1 1 1112 2 1 3 1 5 7VP 10 15 20 25 30 40 50 1 75 100 Mark Number of Each Size 500 750 lOOd 1250 SSO4 1750 2000 2250 2500 2750 3000 Patrick J DashnairIFO et. Heat ,I.d5a rl -34g ga , ` i2f=i3� ELECTRICAL INSPECTOR CERTIFICATIONS tJSE FOR INITIAL VISIT ONLY NOTIFIED DATE CO RECT FEE PAID FE RW Progress : Inc, 0 LKD [] Contractor 0 CFT Violation : Work Comp, Q Inc, 0 LIA Owner CASH 0 Q LIA Fee MO # Due MO # © IPA Municipal INV # Date : Other Side 0 utility Applicant Owner Cut in Card Q Temp # Date �4