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1989-166 t M If { I ` r r V CERTIFICATE %Yr CCU] ArNCY TOWN OF QUEENSBURY i WARREN COUNTY, NEW YCiRK Date-_ _EP. L rY a 19 9 f This to certify that work requested to be done as shown 8 9 - 16 6 by Permit No. has been completed. f Thu structure may be occupied as a Two car - Garage & Mud Room ' 5 3bk-� na* Location yry-ft- 7 n h n Y v rm a t- Owner Timothy & Antonett: e Weaver I i i j By Order Town Board _TOWN OF QUEENS13URY� E � 1 Director of Bldg. & Ci&de Enforcement a BUILDING PERMIT TOWN OF QUEENSBURY moo. 89 - 166 � WARREN COUNTY, NEW YORK I� n.� PERMISSION is hereby granted to Timothy F Ari o'nette weaver r- F-' Street, Road or Ave. 1 OWNER of property located at _ �F_nhn Street R-' oti in the Town of Queensbury, To Construct or place a Two !Par a 9r & mud room Addition 'to �. 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 Same tx] 2. CONTRACTOR or 8UI LDER'S Name C t'rJ Self H 3. CONTRACTOR or BUILDER'S Address 0 rt Same tr 4. ARCHITECT'S Name f-r GS S. ARCHITECT'S Address (D cr rt fD 6. TYPE of Construction — (Please indicate by X) ( 1 Wood Frame I ) Masonry l 1 Steel ( I E-n [PLANS and Specifications C . No. 22 ' x 30 ' Addition to dwelling two car garage & mud room) 0 as per plot plan specifications , and application - roposed Use Two car garage & mud room +@ (o rt 25 . 00 c / o November 1 1g 89 .-. a $ 51 _ 00 PERMIT FEE PAID - THIS PERMIT EXPIRES i-r p,. (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the O town of Queensbury before the expiration date.) Ct fJ Y- E39 Dated at the Town of Queensbury this 14th Day of April 19 ri � SIGNED BY te� for the Town of Queensbury CFO Building and 2anirg 1 nspector f� 13 t� Y+ ri 0 0 TOWN ,�UEEt�JSELrRY APPLICATTON FOR BUILniNC AND 2nrrxr�c, PERMIT ` t'tz,t c- >~ec i Cv erC TONFQUEENSBURY ' 7 '' E1VED gy Fee Fa,t - , APR 11 1989 WILDING AND CODES UJ :I'ARWENT Date Iaataed / BLDG. & CoE)E DEFTo 13AY and 11AVrLAND ROADS R.D I J30X 98 pUEE'NS VIRY, NEW yOPK 12804 PeAni t No . re*4 /66 Tel , (5.18 ) 792--5832 ExC -204 .. .!C •' } # # x■ } 1 } '} } • Yt } ! # 'at lA< } } x } a ■ } t } 1R } A Pr1RI'.IIT MUST u4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS WILL BE. IIADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT . All applicable spaces on this application must be completed and the 1ptlature of the applicant must apear on the reverse side of this sited . s— p Yr ik sL Yc rL is 7F de * is yt J: �i: st 9c k �: do ik 7k . iC � � 7k i[�/9e ��t� pal• �1e 7c k Mc 71e 7e �k ie 7k The owner of this property is : � `; •"tZ` Trc-- / G� �r�'" V . O . Address _ C7,cltit 57�` TCL . � S G [' roper ty location 'PAX MAP NO ./� � / ttas there been any split of this property since October 1 , 1988 ? yes / na If yes . Planning Board Review is necessary . LOT NO *SuDDIVISION NAME , IF APPLICABLE The person responsible for supervision of work as regards Building Codes is : T NAME �rs t� _ P . O . ADDRESS Tel N . Name of builder nAddress r4- �+ r "`F � J/ Tel 1� `,.ry . SW o-- --- — — Address Tat zywme of Plumber /"t-'� /� f� S Tel,_�,� •"',� Name of Mason i Addres N 12 14ATURE OF PROPOSED L,I izvw ' ZONItiG INFORPIA'I' ION ( otfiee use only ) Conscrucciore of a Ilew building ZONING DESICNATION OF PROPERTY d daiLi.on to a buildirg # PERMITTED PRINCIPAL PERMITTED ACCESSORY Altur:etion to a !;adding „ µREVIEW REQUIRED — PLANNING BOARD ZONING BOARD ( 190 Cle4e1kau VO a:?rCuCiOC [li[1iet7:: i4ri3S Oeiec:: r work (ale.:cribc.$ ) ' SITE PLAN REVIEW # APPROVED DATE GROSS AREA OV NROPOSCD3. :; ` UUCTURE � VARIANCE it APPROVED DATE . 1st Floor f� Cn scI f t . Rt mark 2 nd Floor s q f Ice + Cotli'LL'1't . IFII`Crf;MA'L`COD! Set [„3U I Scl D 1t1 LUti� . 4 Siku of prol}: rty ft x ft . Other Floors sq ft , ' lixi::tileej Luii.. -I ( :: 1 i «e:y C�'f ( not collar or basemenc ) ,r TOTAL. FLOOR AREA.C.00 �r7 �Sq Et . L Xlz:ting bu•ilµlinty U 4z '- OZ4: of nr•w :,:trelCt o�°l ft x - -fIt Fo1aled:., tion-pia :;late awl/Martial/ full rropoz;wd building , di:scc.anca: fratll l,rait:rty lino (circle anc ) !'t !leaf yaid it Front yard _ft Noe of atorieS Okzxbit"bla :pa 0 ) � Side: I, _ rt and tt iluight (grade tc1 ride.: ) / �f � � _ * If an Corner , :i;4I. Uba0k from siel[: :tccyt� �_tt If residuatial , no . of families N 0I OCCUPANCY It+IFOfJ'hFITICN Noe of rooin`n {, excluding] baths) / � 140. . of bodrooms /U •� ._ PRIIMAFtY BUILDING eft I No. of batllroolm; One family dwelling .��+ J1riuury h4:ati6Lg ::y::�1u L� ec .i�"c- ru �7�•y1� * Two r':unLly dwolling Tyla[: of fuel Multiple: awalling / Plumber of units r Na . of firoplacu:: Liu lau in::talled jIIII1'cr1n:►ria1> t ,� occup:accy will :. wou.i :stove: bu ite it:alle;el7 •1'X:an:sit:nc cacculs;arecy + C•e:rltrcel Air caleciition loco.' _, /V Busine:ss UUILDING STYI.C, PRIMARY STRUCTURE . InUustrial ,� Ocher swlicle C:anteuu,iwrefry LaI cabin it .addit ton . wl'eret will u::4 be 4e ' ranch Mans,II LI &I x 4011t li.VQl old style: UuALLJ"low C';Lpa Cod COtt:felu oGlwr " ACCL550RY BUTLDIbIC^ two C Colonial I'Low 'sown House 1►e CachaU Jsria�cfane car/ C� ��► r� oar ( CIRCLt ONl FLkA£.I~ ) �I►ttsache=cl a ara u/onet card^ ` at Cue • ■ y� ■ a a y # 4 a a ■ w r a s ; �.VriVate: Storiage building MhR'10ET VALUE OF oche c CON :;T "uC'rlu" INFORMATTL]N ON BUrLOTNC :SPECIFICATIONS , ON REVERSE SIDE OF Tills SlleE'T, TO BE COMPLE'1'L:DI Farm BPA 20/88 vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction ,[wood frame , fy�re safe etc . Will any second-hand or u' ungrraace� lumbe/r be used? if so , for what? /'U/ C? Foundation wall material_ rl G7 �/o C Thickness Depth of foundation below grade (to bottom of footing ) Will there be a cellar? A)O Heated or unheated? Floor sq , footage sq ft Will there be a basement? _2t..JO Will any portion be used as living space? ( If so , what po Prix sq . ft . - - Type o£ use?'Type of roof loflat/shed/other Material of roof Size , wood studs " spacing "o . c . length ft . �; /Z Joists ( floor beams ) lst . floor "x "' spacing Lk;� _,"o . c . span_4ft , Joists ( floor beams ) 2nd . floor "X " spacing "o . c . span ft . Overlays ( ceiling beams ) "X " spacing "o . c . span ft . Roof rafters "x " spacing o . c . span ft , Roof trusses (pre-engineered) spacing�q o . c . span_.22_ft . Exterior wall finish Of what material ? Interior wall finish S./i Pej' - /�2c+C f< If a garage is to be attache describe materials to be used. for FIRE SEPARATION : 421 L-,t in C.0 F+ I 049q_ -c3 fi rt E C, 0 /r Is there to96y an opening between garage and dwelling? f sa will a Fire rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? I3eight a ve roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . in . Water supply - Municipal or private well 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) DEC LARATIO 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. Signatur Owner owner's atgeiA chits t, contractor IF SPECIAL CONDITIONS OF THE PERMIT : By 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 / c 20 Type of heat. 3 . Is the building mechanically cooled ? r v C� � 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 WO a . Are foundation walls insulated ? YES tjD 1 , If YES , what is the R value ? 3 , Slab on grade YES UO 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 so Type of insulation Be Under 16 % Only 1 . R value of r f_22 d floors exposed to ambient conditions 2 , R value of exterior walls,__� ,r � ^� 3 , R value of glazed area , �7 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 So R value of heated basement/ cellar walls ( above grade ) 90 R value of heated basement/ cellar walls ( below grade ) r 100 Type of insulation / C , Controls 1 . Thermostat maximum heat setting D . Duct Systems i , Is duct system installed in unheated spaces ? YES O a , If YES , R value of duct installation b , R value of duct in other areas E , Fining Insulation 1 , size of hot water or cooling carrying agent pipe 2 , R value of pipe insulation Fe Service Water Heating A.1tc9 ^"s t 1 . Performance efficiency 2 . Temperature control setting maximum +G , For Swimming Fool Only 1 , Maximum heating Telephone Noe Z CO � S -. ( app can " s signature ) SELECT BUSINESS FORMS CGOS1 228-7775 • 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 ' � ' Date ; City, 'Town or Tawnship County �t— - �y'�G` .^" State Location/Address j / ( if Located in Rural Area Please Attach Directions) Pole # Owner_ .a-fvf F 7r- Lam.v E �'f - E___._.rc.1A . Occupied As '�` ' S / 5 r E..� {�, "q I �" Permit # ` : _ Building : New Old 0 Occupant e La in u g Work Area in Building Floor #, etc. ) : for: Wiring 0 Service = or: Ready for Inspection - Fee Remitted - $ Cash Q Check M.O. Q Make Payable To: M.D. I.A. Number of Rough Wiring Outlets Elect. Heat 1 500 750 1000 1256 1504 1 1750 1 2000 1 2250 2500 2750 3004 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: r $ H.P. 1/2 1/12 1/10 1/a 1/5 114 1/3 1f2 3J4 1 I !h 2 3 5 7u2 10 15 20 25 30 40 50 ]S 100 mber Size MOTORS is {�7r�2�.__u License # Permit # Utility : nYs Address: - ] - � JG��1 . J S � (NAME (OFFICE LOCATION4: trK F s Cj � (State)_ r (Zip) Service Request Electrician : a 0 'DATE RECEIVED: DATE INSPECTED : Correct Location : Same as Above or: Red Notice Label Q 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, 1/20 M2 1/10 1/a 1 1/e 114 1 1/3 112 3/4 I Ik4 2 3 S 17st2 10 15 20 25 30 44 1 50 1 75 1100 Mark Number of Each Size Eli Patrick 3 Dgas�hnaw 0 Elect. Heat 500 750 304 254 1504 1750 2004 x25o 2504 2750 3004 liudson9lg7 j_3&1_2834 F ; ELECTRICAL RI CAL INSPECTOR . . J dIRTWWATII"!pt use FFIR INITIAL Vlwr OIIIII:It NOTIFfEID DATE coarse= 11pitiQlIow 0 RW Progress: Inc. Q L K D Q Contractor CFT Violation : Work Comp, Inc, [] Q L/A Owner CASH 0 [] L/A EFeeCHI{ # MO # IPA Municipal INV # Applicant Date : Other Side Utility Owner Cut in Card © Temp # Date t M1lCPCY"Tn GC ClY:M116TI IRF CERTIFICATE OF INSURANCE ISSUE DATE (MMrDDlYY, 4-14-89 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Cool Insuring Agency Inc . EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW P . O . Box 2153 Glens Falls , N. Y. 12801 COMPANIES AFFORDING COVERAGE COMPANY CODE SUB-CODE LETTER A Aetna Ins . Co . COMPANY INSURED LETTER 13 Hartford Ins . Cow CO Richard A . Smaldone DBA LETTERNY C Smaldone Specialties COMPANY 42 Northwinds LETTER D Queensbury , N . Y . 12804 COMPANY E LETTER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MMIDDIYY) DATE (MMIDDIYY) ALL LIMITS 1N_ THOUSANDS GENERAL LIABILITY GENERAL AGGREGATE 5 300 yE COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOPS AGGREGATE S 300 A CLAIMS MADE X OCCUR, Binder 4-11-89 4-11-90 PERSONAL & ADVERTISING INJURY S 300 OWNER'S & CONTRACTOWS PROT, EACH OCCURRENCE $ 300 FIRE DAMAGE (Any one }ire) $ 50 MEDICAL EXPENSE (Any one person) S 5 AUTOMOBILE LIABILITY COMBINED ANY AUTO SINGLE $ LIMIT ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY NON-OWNED AUTOS INJURY 5 (Per accident) GARAGE LIABILITY PROPERTY S DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE S $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY Stoo (EACH ACCIDEN TI A AND Binder 4-11-$9 4' 11 -90 S 500 (DISEASE—POLICY LIMIT) EMPLOYERS' LIABILITY $ IGO (DISEASE—EACH EMPLOYEE) OTHER B N . Y . Disability Binder 4-11-89 4-11-90 Statutory limits I DESCRIPTION OF O PERATIO N SILOCAT ION SAFENICLESIRESTRICTIONS/SPECIAL ITEMS I CERTIFICATE HOLDER CANCELLATION Building Dept . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town Of Queensbury EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Queensbury , N .Y . 12804 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,f�y . LAGORD,25-S_{3188) - . - • -- ___ _ ___ -. - - - OACORD CORPORATION 18881 J� pne) TOWN OF QUEENSBURY 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 792 5832 ` BUILDING INSPECTOR' S FINAL INSPECTION REQUEST FOR INSP'ECTIO,N RECEIVED NAME '!r. LOCATION DATE PERNI T# ' 4? TYPE OF STRUCTUREj aa _aQ& JJ-�p , RECHECK FIRE MARSHAL APPR VAL { CfJMMERICIAL TRUCTURE ) �OOTING rOUNDAT ON BACKFILL RAMING ROUGH PLUMBING FINAL. ELECTRICA SEPTIC 4INSULATION c `�0 TOVE/FIREPLAC REMARKS APPROVAL 'CHIMNEY HEIGHT/LOCATIO N/A YES TVON B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILI2 S RELIEF VALVES FURNACE/HOT WATER OPE TIN, INTERIOR TRIM/PRIYAC DOOR FINISH FLOORS : BATH/KITCHEN WAT TIGHT ' OTHER FLOORS SW FABLE OTHER FLOORS FETED STAIR CLEARANCE/ ILING SMOKE DETECTORS DOOR CLOSERS BATHROOM FAN ALL PLUMBING URES OPERAT N GARAGE FIRE OOFING DOOR CLOSERS OTHER FIRE P ION FIRE/DEMISE WALLS FINAL ELECTRICAL OK TO ISSUE C/O OR COMMENTS : ARRIVE DEPART NSZTOR TOWN OF QUEENSBURY BUI LDSNG AND CODES DEPARTMENT BAY & HAVILAND ROADS ti p QUEENSBURY, NEW YORK 32804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED.1 A& ya?q NAME LOCATION Y] DATE PERMIT # Aw APPROVED YES^ INO QOTING/ IERS MONOLITHIC POUR ORMS FOUNDATION/DAMP- DOPING BACKFILL APPROVA ROUGH PLUMBING FRAMING ELECTRICAL ROUGH- N INSULATION.- FOUNDATION FLOORS WALLS CEILING VFINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ST S STAIRS-CLEARANCE & ILS w+ PLUMBING FIXTURES/R IEF VALVE INTERIOR TRIMIPRIVA DOORS FINISHED FLOORS {GARAGE FSREPROOFIN DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INS ECTI FINAL APPROVAL OF CO STRUC SON A SIGNED CERTIPXCAT OF OCCWbANCY MUST BE OBTAINED FROM THE B ILDING DE*ARTMENT BEFORE THESE PREMISE'S ARE CUPIED! REMARKS: dr400, INSPECTOR TOWN OF QUEENSBURY ,1" ` BUILDING AND CODES DEPARTMENT BAY & HA'VSLAND ROADS QUEENSBURYr NEW YORK I280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST R INSPECTION RECEIVED._. NAME L/ LOCATXON f ,r DATE { PERMIT # r APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN L.,� 7SULATSON: FOUNDATION FLOORS WALLS 5 CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF 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 OCCUPIEDf REMARKS F n [[ INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK Z28O4 TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME G!Yf'i/,. }} / LOCATION r�,. �r �.¢�y DATE /, " ciJ / '/J 7 PERMIT APPROVED YES I NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP.PROOFING BACKFILL APPROVAL ROUGH PLUMBING y,,�RAMT NG ELECTRICAL ROU(W--IN INSULATIONa FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING ExTERNAL PO HESISTEPS STAIRS—CLEA NCE 6 RAI PLUMBING F !rVRES/RELIEF ALVE INTERIOR IM/PRIVACY DOO' FINISHED LOORS GARAGE FI EPROOFING DOOR CLO R (S) SMOKE DE ECTORS i FINAL ELEC ICAL INSPECTION FINAL APPR VAL OF CONSTRUCTION A SIGNED C RTIFICATE OF OCCUPANCY MUST BE OBTAINED F THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BI & HAVILAND ROADS QUEENSBURYr NEW YORK 12809� TELEPHONE (518 ) 792 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME A /ig LOCATION " i DATE6- rS' L -PERMIT # APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS L'' OUNDATION/DAMP .PROOFING (,.•BACKFILL APP VAL �- ROUGH PLUMBIN FRAMING ELECTRICAL ROU H-IN INSULATION: FOUNDATION ,FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ EP STAIRS-CLEARANCE & RAT PLUMBING FIXTUR S/RELIE VALVE INTERIOR TRIM/ IVACY D FINISHED FLOG GARAGE FIRE P FIND DOOR CLOSER { ) r _ SMOKE DETEC ORS-�_ll FINAL ELECTR CAL INSPECTION FINAL APPRO AL OF CONSTRLJCT2�1N - A SIGNED C RTIFICATE OF OCCUPANCY MVSw BE OBTAINED F OM THE BUILDING DEPARTMENT .BEFORE THESE PREMI S ARE +OCCUPIED! , /[} REMARKS:--"{ p g D ,` 1 tp C- ()P AA P S -rcb C3 10 AJ ,Aj-f-IJ AL INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURYF NEW YORK I28ok q + TELEPHONE (5I8 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE PERMIT # 62 APPROVED 1 `) I YES IAvo OOTINL PIERS MONOLIT C POUR FORMS FOUNDATI /DAMP-PROOFING BACIfFILL PROVAL ROUGH PLU ING FRAMING ELECTRICAL GH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PO HES/S PS STAIRS-CLEA NCE & ILS _.. PLUMBING F XTURES/RE EF VALVE INTERIOR RIM/PRIVACY RS FINISHED FLOORS GARAGE IREPROOFING DOOR C SER (S) SMOKE ETECTORS FINAL ECTRICAL INSPECTION _ FINAL PPROVAL OF CONSTRUCTIO A SIGNED CERTIFICATE OF OCCUPANC MUST BE OBTAINED FROM THE BUILDING DEPART149NT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR f IYflLEPEPARTENSPE $�ei ---+� National Headquarters a ` 9W Haddon Ave.,-Coinngswood, N.J. 08108 C3ate' City, Town or Townsh p u '' y County State / f Location/Address (If Located in Rural Area,- Please Attach Directions) Pole # Owner ~rr-ry a it . *` /I r �ar.r L 7 r"—. f„r J� rlFt.+l�t ,' fl Permit Occupied As Building: New Old Occupant Work Area in Build FI etc.} : for: Wiri ".Service or: R or inspection : Fee Remitted . $ Cash 0 Check MO., Make Payable' To: M.D.I.A. 500 754 1400 12`JO 3540 1700 2444 2254 2540 2750 "" Number of Rough Wi ring .Ou efts Effect. Heat Switches d ,Amp. Service . - Surface Unit Dishwasher __ -- , _ Range Lighting Water Heater Air Conditioner Dryer Pump Receptacles Num r of fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles , Fractional H.P. Vent Fans Other Equipment: MOTORSH.P. / ! 1/121/10 1/8 1/e 1/4 1/3 1/2 3/4 1 1+}1 2 3 5 71h 10 15 20 25 .30 4e 50 75 100 Mark Nu ber of Each Size Appfican Signature License # -Permit # T/A {,.lti lity . ...,}�, ,� .qJ -4 - NAME I LOCATION) Appl icanYs Address (City) iv {State} (Zip)_ /d , ' Service Request # Phone ,# Electrician: BATE RECIEMET: i7ATE INSPECTED: Correct Location : Same as Above 0 or: ,Red Notice Label Rough Wiring Outlets Unit Oven Switches lkanW Garbage Disposal Receptacles Water 4-leater Dishwasher Fixtures 'Air Conditioner Dryer Amp. Service Equipment rB4€ner, Wiring' & fior Amp. Receptacle Amp, Service Conductors Pump Vent Fans MOTORS H.P. 1 12/=11/12 1/10 1/8 1/5 1/4 1/3 1/2 3/4 1 life 2 9�Lj3 10 1 15 1 20 25 30 40 50 175 1100 Mark Number of Each Size Elect. Heat I 1 504 1 754 1 3250 15 1754 2000 22 2500 1 2754 30, 0 RW Progress: Inc. LKD 0 Contractor err 0 CFT Violation: Work Comp. © Inc. 0 0 L/A Owner CASH El [] L/A Fee CHIC ## Due MID # Q 'PA _ Municipal INV # Date : Other Sided Utility Appiicant Owner Cut in Card Temp # Date err #. Final # Date INSPECTORS SIGNATURE APPLICATION FORM NOS. 250 EL 12/85 - r„k. Id ,. _y..i r2 m4r� 16Y. i� Yi�F 1. .r:a . ' sf C. at3.•r. . i y y�F: •;�.,�, .r. 6 ,�S: 6 .E�: � ' b � �� -"?.r '�' � a 3Ke �ij f r ' �:�- �: ,'E sx ,y-••' ` ii•F.- . II r¢: - F �`1•. .Y _ i•:.5. ; '� f f^. E t� ?ri N" x ry t ':�{ . ' �.w h .i1. •i: I4 .. 1• 4 ? Y zf �q; _ + t. � Ilo (t• , . 3' � t �,qV^, �.�� r ..� �'" C -�`� .y, ' ' ylYr .�y : :_,r_ ..:'b f rd . irx�c �...t . . �, h' ..{ '.'Sr n'. i! ••.Y ri• I IS � E x Pr .i� Y�. � yet. 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