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1989-290 . 'E;...R.".T-`.�,Y ,_.,. F Imp OL CERTIFI.CA TI " OFOCCUPANCY TOWN OF QUEENSBURY I WARREN COUNTY, NEW YORK JDare ca„+am ht r 2;z 19 . aq f This is to terrify that work requested to be [Ions as shown by Permit 1Va.___81�2'9Q has been completed. This structure may be occupied as a _ Single Family Dwee l l i ng Location Z4 Eux Hallow Lane Owner Will i am iierl i by 1 By Order Town Board TOWN OF QUEENSSURY i Director of Bldg. do Code Enforcement I i I i ��-. _ .. -- - --- -------.. . a BUILDING PERMIT TOWN OF Q►UEENSBURY No. _ R9- 90 WARREN COUNTY, NEW YORK .Y 1 } i PERMISSION is hereby granted to _ _ Nil l i am Herlihy co OWNER of property located at 24 FOX HQl iow 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. t . OWNER'S Address is 1 Dartmore Drive Queensbury, N . Y . 12804 r 2. CONTRACTOR or BUI LdE R S Name +' SELF r.l r 3. CONTRACTOR or BUILDER 'S Address r1 SAM 4. ARCHITECT'S Name 5, ARCHITECT'S Address F'V T X it 6. TYPE of Construction — (Please indicate by X) MR IN XV ) wood Frame ( ) Masonry ( 1 Steel ( i 7. PLANS and Specifications No. 30 ' x 40 ' two story single family dwelling as per plot plan , specifications , and application , including septic , attached two car garage , S. Proposed Use avid driveway. R Single Family Dwelling $ 334 00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 1 1989 U2 If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ..r town of Queensbury before the expiration date_) rp Dated at the Town of Queensbury this Day of Na 1989 r ARC SiGNED BY for the Town of Queensbury Building and Zoning I rMACyor n T J '4 iV L F � UEENS}3URY AP' PP. ICATTON FOR BUIL iNG AND ZONING PERMIT Lla-te- Rec �eued ToWIV op ` Reviewed �Eb s'Bu�Y Fy. Fee Pa l d s Bhp �r 7989 WILDING u LD I Nn VX.LAN CODES ROADS R ADS { •px 943 Date I�►.5 ued �AND / Y 0UEFNSBVRY4rNE(V VORK 12804 PeJern.r:.t No . &� Tel . (518) 792-$B32 Ext •204 A PERHfT MUST D4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPVCTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A "VALID BUILDINC PERMIT . ' " All applicable spaces on this application must be completed and - the- 'the s -ionaLure of the applicant must ap ear on the reverse side of this sheet . The owner of this property is : (_ ( ,a , L�- "4;.2 A /?f r V . O . Address � aE' � r Ca ' s�pp , � r� T E L 0roper ty location CQ �� Gynr w TAX MAP NO .�✓�/ 's' �� llas there been any split of this property since October 1 , 1988 ? / If yese Planning Hoard Review is necessary , yes SUBDIVISION NAMEo IF APPLICABLE LOT NOe 5p? ;7 The person responsible for supervision of work as regards Building Codes is : 9:E .Z 11_�_/ 1 sa e� fi� �d 7 t� r 1' �'B13J NAME J P , O , ADDRESS TEL . NOe Name of 'builder. gt Address Tel Name of Plumber � 4Lee 3��' Address Tel Name of Mason Address Tel NATURE OF PAOPOMCaa 6ORK: ZONING INFORHA•I' iCIN ( OffjCe use only ) —XCon:: cructiori of a new buildinrj '■ ZONING DESIGNATION OF PROPERTY _Addicion to :a building PERMITTER PRINCIPAL PERMITTED ACCESSORY �ALturation to " L.uilding or A (no cl ►~utgu to excurior dimensions) IF REVIEW REQUIRED - PLANNING BOARD ZONING BOARD 91;hvr work (defaCrilas:) SITE PLAN REVIEW # APPROVER 'DATE CkOSS AREA Oe PROPOS .ED, STRUCTURE " VARIANCE # APPROVED DATE 1st Remarks i' loor J ,2' � Q s 4 £ t . r 2 nd Floor 11 2• C- scj f t . 3 0 COMPI.ER`1: IN3 OkJMY•IOH ItL QUIICED UVL.U6J . Other Floors sq ft . " Size of prop rty js5.i`? L'' t x / Ft . ( not cellar or basemenq ) L:at"ting bui.l..l3.ncj ( :+) Si ift: X rt . TOTAL FLOOR AREA . s+q Et . * lrxi::cinrj 1]uiladincj (;; ) U::.: `.: i4o of new uLructuro >;�ft ` lowLdat ion-pier/:;lab/crawl/parti al/rdI25 * l'ropo;:ca building , d1tic;ancu from propurcy lirtu r (circle one ) * F' 0. ront yard j . ft Rear yard £3c) ft Na . of storie.a (I1:alaitziblo :Dace ) � Neigh t ( yradc to ridq L: ) zj f t * SidQ yards yz) et :and 15 r't --- * If on corndr, uutb:ack from sidu scraic.t rc If residuntial , no . of falnilles Nov of rooms texcluding baths) f , ` OCCUPANCY 'INFOP44ATICIN uou of bedroom:.: 0 Nov, of b:athroomL; * PItIMAItY TsUILL1INC aw tlrirnary li" at1rlfj �y:;t ��u r ~I . yLQ»e family dwelling --- ' Z- � •' � — 41vo famlly dwulliny •lylus Uf fuel � Multiple dwolling / Number of units No . of £ircplacu:; to laic irt :t:allud� Will :a Wood stova: to inUL"- llucl7 � �► Permanent accup:utCy y * 'TransivnC occupancy t:.:nte"I Air conalt.ionifig: f r yi�ysin�:5s BUILDING STYLE. PRIMARY STRUCTURE � ' Industrial J"AUClt cabin * Gchcr l.:aie:caal ranch Manst"IL Dulalux * If :addition, wl'�iat will u::4 buT lLnlit luv4al Old style Lju1&Lj"1oW C'aAp a Cod Cott:aq a Oclwr "" ACCESSORY aUILDINC— ani 1 "ow rowrk 130usa '" 1iecached g:arswue/ono czar/ tw car ( CIRCLE: OHJE PLE1rE I " AttachL!a g aragw/oete Car/ two ear cat' w . w r w w • • . . ■ ■ ,. � ,r ■ "�' 1'riY:atd St4r:agw: buildincj . E STIMATI: p MARKrdJ% VALLJ12 OF ' Other coN ::•rltuc•L• xraN � �_ � _ ,r �� cp.��J ` i ' 7NFOR &TTON ON BUTL.OTNC SPCCIPTCATTONSO ON T=VRSV SID0 OF TlilS SHEET„ '1�O 13C COM.PLETEDI Form BPA 10/88 VI BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPErCIFICATIONS : Type of construction , od._] - P fire Safe , etc . Will any second-hand or ungraded lumber be used? If so , for what? � i��^ ! Thickness Fou 2 0ndation wa1 -material ! "� / t1 Cvr�,ryc_ t-,ems" , Depth of foun j�dation below grade (to bottom of footing ) ,L " will there be a cellar? Heated or M eat Floor sq. footage j ,•� sq ft will there be a basement'71 c __will any portion be used as living space? A,20 kAe . ( if so , what portion? sq . ft . - - Type of use? Type of roof - ope flat/shed/other Material, of roof .2vx 12w Size , wood studs`" X "' spaci.ng�"o . c . length/ / s ft . Joistt.s ( floor beams ) 1st . loor ? '"X�T'" spacing / !w "o . c . span �ft . Joists ( floor beams ) 2nd . floor o2- " X I spacing1 / "o - c . spanL.;��fto Overlays ( ceiling beams ) 0:Z "`X ^( � " spaciinng_"o . c . span i £t . Roof rafters e2 " X__LZ " spacing�/4_ 0 . c . span__Z/&�ft . Roof trusses (pre-engineered) spacing " o . c . span ft . Exterior wall finish of what material? Interior wall finish 00 iR +'Af4t--- If a garage is to be attached , describe materials to be used for FIRE SEPARATION : � id5 Is there to be an opening between garage and dwelling? SL, C__ If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue- lined chimney be installed? V_d�C-' - Height a ove roof ft . Depth of chimney foundation below grade Depth of fireplace hearth _ ft . in . Water supply - unicr a or private well SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties &� ft . (A separate application is necessary for any I repair or new installation of septic system) D E C L A R A T I O 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 Owner, owner's agent , ar hitect, cormitractor SPECIAL CONDITIONS OF THE PERMIT : ti 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 2 . Type of heat 3 . Is the building mechanically cooled ? 'VA O 4 . Percentage of area of windows and doors / y"A' A . Over 16 % Only 1 . Uo 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 ? .ZE]k NO l . ` If YES , what is the R value ? Rf3 3 . Slab on grade YES W a . If YES , what is the R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES 40 a . R value of insulation 5 . Type of insulation_ filllrrL' .OSg B . Under 16 % Only 1 . R value of roof and floors a nosed ambient conditions 2 . R value of exterior walls 4RIA 3 . R value of glazed area ,� 4 . R value of doors 5 . R value of floors over heated spaces 6 . R value of slab edge insulation - unheated slab _ RRW 7 - R value of slab insulation - heated slab s . 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 Qo D . Duct Systems 1 . Is duct system installed in unheated spaces ? YES a . If YES , R value of duct installation b . R value of duct in other areas E . Piping Insulation i . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation R A F . Service Water Heating 1 . Performance efficiency 2 . Temperature control setting maximum rz Q G . For Swimming Pool Only 1 . Maximum heating Telephone No . Z23 -5 Zb ( applicant s signs e ) 7'C3lVN OF QUEENSB UR Y APPLICAT'ION FoR. SEPTiC DISPOSAL PERMIT DATE LOCATION OF PROPERTY FOR INSTALLATION e�lw -/ X Owner's Name: _ �L) f j / 4g*5.t 2&P, Y, Telephone:ML Address: d PtU � � Installer's Name: _ C� r E j6vu/ � Telephone:_7V.3 Number of bedrooms (residential only) Total daily flow (compute (4 150 gal per bedroom) Topography: Circle one: 0la Rolling Steep Slope % of Slope Soil Nature: Circle one and Loam Clay Other. /Depth: Feet Ground Water: At what depth? / Feet Bedrock or Impervious Material: At what depth? �Feet Percolation test: Circle one: <Qt require required rate min. inch. Domestic water supply: circle one:( vnic p� Well Other If domestic water supply is a well: Separation: Water supply from septic absorption k) _feet PROPOSED SYSTEM: Septic Tank_ �j �y gal. (minimum size: 1 , 000 gal.) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of / Size each feet by feat Size of stone to be used # G'_/_.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 an4ary Sewage ispo Ordinance. SIGNATURE OF RESPONSIBLE PERSON: 11 - DATE: OVER Septic System Inspections. : A . All applications for septic system installation : alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submitted to the [Wilding Department at least 24 hours before start of construction and shall include a plot plan showing ; 1 . ) the proposed location of the system 2 . ) location and distance to lot lines 3 . ) location and distance to structures 4 . ) location and distance to any water supply 5 . ) size and dimensions of all tanks , distribution boxes , the fields and /or drywells B . No system shall be covered before inspection and approval by the tiuiiding Inspector . Failure to comply with this requirement may result in tl:e uncovering; of the system by the installer and a fine of up to $ 250 . 00 . C . An approved copy of the plot plan shall be available on the construction site . Failure to produce said plot plan at time of inspection may result in an immediate work stoppage . D . Should unforeseed problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must l)� submitted Co the Queensbury Building Department before .Further construction . Y Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Havi.land Roads Queensbury , New York 121304 Remarks - TOWN OF QUE.ENSBURY BUILDING AND CODES DEPARTMENT / BAY & HAVILAND ROADS QUEENSBURY, NEW YOR,K 1280* + TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR ;INSPECTION RECEIVED CJ`- S' 50 NAME LOCATION ' o Ste_ DATE ( /('/ `PERMIT # APPROVED YES NO FOOTINGfPIERS MONOLITHIC POUR ki;ORMS FOUNDATION/DAMP- ROOFING BACKFILL APPROVA - - ROUGH PLUMBING - � FRAMING ELECTRICAL ROUGH- INSULATION. Y FOUNDATION FLOORS WALLS CEILING L.. NAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEP STAIRS-CLEARANCE & LS PLUMBING FIXTURES/RE IEF VA. VE_ INTERIOR TRIMJPRIVAC DOORS FINISHED FLOORS GARAGE FIREPROOFING _ DOOR CLOSER(s) SMOKE DETECTORS FINAL ELECTRICAL IN. ECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUS BE OBTAINED FROM THE BUILDING DEPARTMENT *3.L'FORE THESE PREMISES ARE OCCUPIED! REMARKS: f INSPECTOR TOWN OF QUEENSBURY BU-TLDrIVG AND CODES DEPARTMENT BAY & HAVrLAND ROADS QUEENSBURY0 NEW YORK 12804, TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR TNSPECTION RECEIVED NAME LOCATION DATEPERMIT {# 90 APPROVED FOOTING/PXERS YES NO MONOLrTHXC POUR FORMS f FOUNDATXON/DAMP—PRpOFING BACYPXLL APPROVAL ROUGH PLUMBrNG. FRAMING ELECTRrCAL ROU �rpy rNSULATION: f FOUNDA TrON FLOORS WALLS CESLING F229A L XNSPECTION.- C.FIIMNEY HErGHT ROOFING STDrNG EXTERNAL PORCHES TEPS STArR.S—CLEARANCE RAILS PLUMBING FXXTUR RELTEP VE INTERIOR TRIM/P I ACY DOORSL'^ ~ FINISHED FLOOR GARAGE FIREPR Fr DOOR CLOSER ( SMOKE DETEC RS FINAL RLECTRI AL rNS CTION FINAL APPROV OF CON TRUCTION A SrG'NED C TXFICATE O OBTArNED F OM THE BUI OCCUPANCY MUST EE .THESE PREM�SES ARE JvG DEPARTMENT BEFORE XED! REMARKS: 'V r Q�+�jj v a� INSPECTOR —� ©4U'17 O� �lt[+BI$.3CJiElPlt BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. I Box 98 / ± Queensbury, New York 1280I SEEP�T-IC,r DISPOSAL SYSTEM INSr,PECTION NAME LOCAT I OIV ���t DATE 2 f PERMIT NO. I al::?so SOIL TYPE - Sand - Loam - Clay r :, S~ J' Percolation Test Required? YES Percolation rate - ND-�� � Min/Inch TYPE Of SYSTEM: Absorption field , total len n Length of each trench Depth of trendies ,r Size of gravel: SEEPAGE P T"Number i f) Size- ft. X Gravel s1XZ e PIPING : f Bldg . to tank , z T Tank to dirt . box Dist , box to fief it Openings sealed? ES O Partial, LOCATION/SEPARATX Foundation to t j ' Foundation to ft. Absorption to to olineon '1 t . Separation of p a ft_ It7N OF SYS EM ft. rant Rear ON PROPER (circle one) eft aide - Right side - C ENTS : i SYSTEM USE APPROVED ,' E*S v Buildi. Inspector 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT ] .BAY & HAVILAND ROADS ' / QUEENSBURY,, NEW YORK I280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED 7 - Io NAME oof LOCATION1 DATE -7 J -� �� PERMIT # APPROVED YES NO FOOTING/PTrRS MONOLITHIC `POUR FORMS FOUNDATION AMP-.PROOFING BACKFILL AP ROVAL ROUGH PLUMB G FRAMING ELECTRICAL R GH-IN C,.TNSULATXON: FOUNDATION If FLOORS WALLS CEILING FINAL INSPECTIO ; CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/Sp S STAIRS-CLEARANCE & LS PLUMBING FIXTURES/,i E. F VALVE INTERIOR TRIM/PRT Cy RS FINISHED FLOORS GARAGE FIREPROOF G - DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL NSPECTION _ FINAL APPROVAL O CONSTRUCTION — — A SIGNED CERTIFICATE OF OCCUPANCY MUST ,BE OBTAINED FROM THE BUILDING ,DEPARTMENT BEFORE THESE PREMISE'S ARE OCCUPIED! REMARKS: TN PECTOR �� TOZVN OF QUEENS BURY HUSLDSNG AND CODES D HAY & HAVILAND J4DADSEPARTMENT l2UELcRVSR3URY, NEW YORK 2 2B o-4 TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEsfi FOR SNSr'E'CfiSDN RECEIVED LC1CA2'I—O/N G ''' / 0 IF DATE PERMIfi ## _ Cj sa APPROVED F DOr'rNG/PrE1?S YRS NO MORVDLrTHSC POUR FOIZMS FOUNDA27TON/DAMP—PROOFING HAC"rLL APPROVAL Loo POUGH PLUMSrNG yam~ �'RAMSNG LECTRrCAL ROU H—rN rNSULA27TOI FOUIVI7prON ' FLOORS / WALLS cErLrNG FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EYrERNAL PORC S/STE sTArRs—CLEA PLUMDrNG FS CE & RAI INTERIOR T M RES/RELIC VALVE FINISH,SD p /PRIVAC.Y IS _ GARAGE Fr EPRO(7FrN' �--__ ---__ DOOR CLO R (S) SMOKY DE ECTORS ~ FINAL ELE TRICAL FrNAL 44 'r PECTrON OVAL OF CON.STRUCTTO V -� A SIGNED CERTrFICATR OBTAINED FROM THE OF }� OCCUPANCY MUST HR THESE PREMISES UZZOTNG .DEPARTMENT' B ARE OCCUPrEDf EFORE REMARKS: 2 SPECTOR2 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS OUEENSBURY. NEW YORK I2804 TELEPHONE (51 8) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION - DATE ERMtT" ## l� APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKPXLL APPROVAL ROUGH PLUMBING FRAMING ELECTR.rCAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS 1. CEILING \ FINAL INSPECTION: ; CHIMNEY HEIGHT ROOFING ,^ SIDING EXTERNAL PORCHES/ST S STAIRS-CLEARANCE & ILS PLUMBING FIXTURES/ ELIEF VALVE INTERIOR TRIM/PRX ACY DOORS --- FINISHED FLOORS GARAGE FIREPROO NG DOOR CLOSER (S) SMOKE DETECTOR FINAL ELECTRICAL. INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS: Yf - INSPECTOR TOWN OF QUEENSBURY $ ff.G AND CODES DH TM pARENT / BAYY & HAVrLA1yD ROADS 0 Uff4VSBURY NEW YORK 2 2BOg, TELEPHONE (518) 792- 5832 BUILDING INSPECTOR ' S REPORT 'WUEST FOR INSp Js'CTrQN RECErVRFJ NAME DATA' ---[� -.���,- _� FOOT ApP. OvED ING/PYER+S Yh'S ND MOrvOLrTHrC POUR S FO FOUNDATIO.N/i7AMp- RK Rm ING 8ACXrXZL APAPRov L ROUGH PLUNB2NGg�-�� LING �f---��- ELECTR.rCAL ROUGHirN SNS[TLA2'ION: FOU'NDA2'roV FLOORS WAL.Ls / CEILrNG FINAL I1VSP TrON: CHl.x1NEY HEIGHT f ROOFING ~ SID.ZNG EXTERNAL .F^LIRCHE',S/S EPS STAIR S-CLE44 JVCE PLUNBING FIX R `� rN7ERIl7R 2URES RELIEF LV,E FIXTSHED F LOOKER VACY DOLOR GARAGE FIREPROO ING DOCYR CLOSER Is SMOKE DETECTOR FINAL E'LECTRr,, F LNAL APPROLrA INSPECT3ON COIVSTRVCTrO� ~ A SXG1VED CSRTSF LATE OF LJ E2ArNED FRO�W 2.H C'uPANCY TFfESE LDING SST BE PREMrSES BLTr ARE DEPAR2'MENT OCCUPIED! 8L'FORE RENAF,+ICS: r1VSPBC2voR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS L'/] QUEENSBURY, NEW YORK 12804. TELEPHONE (518) 792-583.2 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTXON�RECEIVED NAME LOCATION DATE APPROVED YES NO FOOTING�r'PIERS MONOLITVzC POUR FORMS �EPtINDATSO'VI DAMP—PROOFING ,. BACKFILL A.AVROVAL ROUGH PLUMBINVa Y FRAMING ELECTRICAL ROU H—IN INSULATION: FOUNDATION 4 f FIRS WALLS CEILING FINAL .INSPECTIONo CHIMNEY HEIGHT ROOFING SID-TNG EXTERNAL PORC ES/STEPS STAIRS—CLEA NCE 6 RAI PLUMBING FIX URESIRELIEF VALVE INTERIOR TRI /PRIVACY S FINISHED F iqg GARAGE FIRE ROOFIN� G - - DOOR CLOSER S) SMOKE DETEC ORS FINAL ELECTRX AL INSPECTION FINAL APPROV OF CONSTRUCTION A SIGNED CER IFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE ,BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR `�� TOWN OF QUEENSBURY � BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS 3 QUEENSBURY, NEW YORK 12804. TELEPHONE (518) 792-58.32 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME j LOCATION DATE 1 PERMIT # �i APPROVED YES O �dOTING/PIERS I�/ MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL AP L ROUGH PLUMBING, FRAMING ELECTRICAL ROUGH- IIVSULATION: Q. FOUNDATION A` FLOORS WALLS CEILING .^ FINAL INSPECTION: CHIMNEY HEIGHT . ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRXMIPRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSERS) 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 : i J• } l INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS , 17/—' QUEEN.S'BURY, NEW YORK 2 28 pghol. /'!+' � TELEPHONE (5.28) 792-5832 BUILDING INSPECTOR ' S RFPORT REQUEST FOR INSPECTION RECEIVED10 NAME z LOCATION DATE g PERMIT APPROVED YES NO OOTINGfPIERS a(/4..° f� MONOLITHIC POUR FORM 4FOUN.UA TSO N/DAMP-PROOF 2NG BACICFILL APP VAL ROUGH PLUMBI FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS X WALLS CEILING FINAL .INSPECTION: CHIMNEY HEIGHT . ROOFING SIDING EXTERIVAL PORC ES/STEWS STAIRS-CLEA CH & RAILS PLUMBING FI RES/RELTEF VALVE INTERIOR T MIPRIVACY DOORS FINISHED F ORS GARAGE FI EPROOFING DOOR CLO RR (s) SMOKE D ECTORS F-TNAL ELE TRICAL INSPECTION FINAL APP OVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED.+ REMARKS: IA)je jK( INSPECTOI{ MIDDLE DEiP►ACRTIaNT INSPECTION AGENCY; National Headquarters "—" 900 Haddon Ave., Collingswood, N.J. 08108 APPLICAN t COMPLETES THIS SECTIONDate : City, Town or Township I t"f - County : 114 k r State Location/Address- ( if Located in Rural Area - Please Attach Directions) pole sc Owner_ _—...._ s-� 1 i c rf _. ��k i )/ - - Permit Occupied As Building: New®. Old 0 Occupant Work Area in Buildin Floor App. for: Wiring ED Service Q or: Ready for Inspection : Fee Remitted - $ Cash Check M.O. 0 Make Payable To: M.D. LA. 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 Number of Rough Wiring Outlets Elect_ Heat Switches Arnp. Service Surface Unit Dishwasher Range Lighting Water Heater Air Conditioner Dryer Pump Receptacles Oven Garbage Disposal Wiring and Controls for Burner Number of Fixtures Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P, 1/2 1/12 1/10 1fa 1/6 1/4 1/3 1/2 3/4 3 11/r 2 3 5 7V a z 10 15 20 25 30 0 50 75 1Sk0 - Mark Number of Each Size Applicant's 1 ) ti Signature `-� • - .� � � ... �%'". License # .� _ Permit T/A Utility : Applicant's Address` {NAME F kCE LOCATI t f•'G� ,r (City) (State) r a� (Zipl�_1— T Service Request # rRed e # �> - Electrician : A LATE RECEIVED: DATE INSPECTED: ct Location : Same as Above [� or: 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 & Controls for Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P, 1/= 1112 1/10 1/9 1/6 1/4 1/3 /4 1/2 3 1 14'2 2 3 5 71/a 10 :IS 20 25 30 40 50 75 100 Mark Number of Each Size Elect, Heat 500 756 1000 125D 1500 1750 2000 2250 2500 2750 3000 t f 0 RW Progress : Inc. F LKD 0 Cbntractor r / 0 CFT Violation : Work Comp. 0 Inc. 0 + / CASH Q L/A Owner124 Fee CHiC# L/A Due m6 L'� IPA r Monicipal INV # -- Applicant Date : Otneir Side E-1 Utility - Owner Cut in Card 0 Temp # Date a INSPECTORS SIGNATURE Final # Date APPLICATI37N FORM NO. 250 EL 11/86 r jM} [{ fff 3 f 1 f r ttj � Q r r r 7tw} i f TOWN OF OUEENSBURY f Zoning Administrator Lmo i