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1989-428 a i i F CER.TIFICAT OF OCCU 'A.N I . TO%W4 OF QUEENSBURY WARREN COUNTY, NEW YORK Date. July 17 1970 Ir This is to certify that work requested to be done as shown by Permit No. - • a sa--4 a sz has been completed.. This structure may be occupied as a _ One. Q..Hr Ciarnge W /j ying SpFiefi Above Location l West_ n9ountain Road Owner David Armstrong 1 III By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement i 4 BUILDING PERMIT TOWN OF +QUEENSBURY _ No. WARREN COUNTY, NEW YORK ��� -C 110r � u PERMISSION is hereby granted to David Armstrong �I OWNER of property located at 279 We,St mcm-antmin, R-clad Street, Road or Ave. in the Town of Queensbury, To Construct or place a Addition Pea at the above location in accordance to application together with plat plans and of er hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t_ OWNER'S Address is Same rn 0 2. CONTRACTOR or BUILDER'S Name z Wes Vey$e'"�' C7 ib G 3. CONTRACTOR or BUILDERS Address sj 61 MacArthur Drive Glens Falls, N.Y. 12801 4. ARCHITECT'S Name w nz� 5. ARCHITECT'S Address U e-P -a ,.a O 6. TYPE of Construction — (Please indicate by XI ac I ) Wood Frame ( ) Masonry I y Steel [ } O C]. i. PLANS and Specifications No. XX 524 sq. ft. first floor,414 sq.ft. second floor addition(one car garage with living area) as per plot plan, specifications, and application. a. Proposed Use M. dditionOne Car Garage With Living Area o' a $ 57_00 PERMIT FEE PAID — THIS PERMIT EXPIRES January t 19�5 90 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the ry town of Gueensbury before the expiration date_) Dated at the Town of Queensbury this Day of .June 19 89 � m SIGNED BY for the Town of Queensbury Building and Zoning I star ,_, C' >b "3 TOWN ©FQUE,ENSBURY � Pn � . rc .� TT , . r P rrTj1 rT ANn 2 �" N ? Vi, P :' Q %ITT TOWN OF QUEENSBURY RECEIVED Fy a JUN 2 1989 f + O F e7 )'a.c { J �-- i kiU I LD I NC AND CODES Li .P 'ARrD 1EP4rI' Date. lea ued BLDG. & CODE DEEPT. SAY 4�tnd ttAVILANU ROADS RD 1 Dox 93 O ` -- 9,veit7� nUEENSBUR Y , NE;i YORK 12 a? 0 4 PcAvw:X Na • �'�� GI/#�` Tel . ( 5I8 ) 792-58 ] ' Exc 204 • ■ a ■ as [ a a a a ■ r or a a a ■ * r a • . s a ■ r ■ . • ■ ■ • • V A I' E32 IIT 14US'r B13 OBTAIr4r-. D BEI" ORE BrCtjN4 fINC CONSTRUCTION . NO INSPECT NS WILL BE MADE UNTIL APPLICAMT HAS RCCLrIVED A VALID BL' ILDINC PERMIT . All applicable spaces on this application must be completed and the oouaturc of the applicant must appear on the reverse sick of this sheet ■ Yt a� x A * 7k 7C * A 4i A A * k A �i;`iky !e 7e 1% * 'Ik` * fi !i 1k t 7K x 7t !c Ye 7�e Ithe owner of this property is : _ ' � ) l� Iryn'!S it" Gryr LI . o . Address `] Z I .JES �C "! � e t'��� tsn^�trlwc .► TEL . ►�`t 7 (a roperty location <G? "r �CAX MAP NO ✓ / / teas there been any split of this property since October yes no zf yes , Planning Board Review is necessary . :; USOIVISION NAME , IF APPLICABLE LOT NO . _ `t` he person responsible for supervision of work as regards Building Codes is * s NAME ,, ]) / i; . G . ADDRESS f TEE . T4 game of builder LGl1 11we S Acidress�(a/ IWOe rwr Y Tel l - �'3� 7 tlumc of Plumber_ " e ! T.ddress et C�fL Tel --� Tel Name of Mason - ile AUdress eL Nap 0-e- O ; 4.% Tuf2 Or FE:OI'OS1:p 4lJI;f_ : 70NIi; C: iN1 RLMA'1" ff' M f0 -f ica use on2Y ) zruccicr of u r4uw buildin7 GONINd 012SICNATION OF PROPERTY � tion to a L}uiloifig � PERMITTED PRINCIPAL PERMITTED ACCESSORY J�. lr .� rC Lion to a Luildinq '" � to 4<xcvrioc Ct ] mCnSiOrla ) ■ REVIEW REQUIRED - PLANNING BOARD ZONING BOARD ( no c1 �.4, jg7 � Ucttvr work ( ate :cr4 U.: ) ` SITE PLAN REVIEW # APPROVED DATE � lt35 $ ARL �S C71' ,, L� FdOi OSLL]. : 'ILcUi. 'L` L1KE VARIANCE # APPROVED] HATE 1st Floor �j��YY sq ft . * Resparks : n d Floor s q f t . „ C014p f_li'1'L i�Nl'01%P%A ION ICLii)U 114L:D U1: L,4APJ . other Floors sq ' ft , 0 Size of proL4� rty 63k • - _fr x ft . ( nor. L',.44i�tirlC} L:u i1.1i, 4jL � ) Si ::v c cellar ar b;aseTne n 1 TOTAL FLOOR AREA .� Sq f t . ` L'xlaci4zg 13uJ L ltf�a} ( :. ) Uav " i : e GC now stru/� ft X € t a ; s 'uua ,dcion-pier �laLA ravel/L�Arts.al/ lull ■ Nropoz:s~d builaLny , ai - cancu trou, L. r,3L,4jrcy ltnu r: xrcl+; one ) a Front yard i t Rear yard 17 ft No , of ,tories (11"bic"- bls 1L)wce ) z-" Side yard:: SW Ifui he ( c rade to ride u ) ` 9 J 1 f t • If on eurn.: r , 1.4.: r.,f>..tck Fro1a siclu sc rvc: c If ra!; iduntial , no . of f..milies W Noo of roa4as ( cxcLudinq b%Aths ) ■ OCCWPp4gL:Y INFO440ATION Itoa of budroomw / 0 No * of b:►tl4raou4:: / ■ PRIh1ARY LUILDINC ✓Ona faau.ly dwelling tiriuury hu.aciwj UVQL �4u *- 'L^wo f"Uu ly dwelling Types of fuel n-Lf ■ MultiYslu Uwulling / Number of units + No * of f1ruplac.x.s to Lao instuil. a� [? La■iT7rl.aalL:4Yt occupajicy W4611 :► W&3 l i tiL' 0VQ X#•- Ill) Tranui4:44t G4_Cujf:ar4t f L"ntr.al Air r:ar4rs+tion: e4g.x _ r44� -- 13u51ricsss r BUILDING STYLE, PfiIMARY STRUCTURE InUuUCriAl lu4►ch Concu44 :ar it "ex c"j6n 1:..ai %iWd ranch M.:►nniir..l4 y Dup1. 0 xerr . It .addiciun , r,t � �t ill u� b,,s? ci-jax 'LL luVG': old uryla Lau4x4}.a14]w '" C"Pu O CGCtaq%! Ocl"r ACCi=5S0Rt UUIL DIHC- C:oLoni.. l 14ow 'i'4w44 }Louse U. Car�hzG1 yaraagC/ona r/ two car/ car ( CIRCLE ONL PLEASE 1 ' Actz&Chua q"ri.►+r " 0JW C4 / two aar/ Ca a ■ ■ ■ . ■ a . ■ ■ s . + ■ ■ s 14r .iv" te & roc ago bul ing L' S 'L' IMATVD MARKrT VAI, Ut: OF ' r—ochur 1Ni'0[:f1ATTDN oN nuILDINc sprcIFIcATIONSe ON TUCVCRSE SIDI_ OF TtITS SHLE'r , TO ge COMPLETUD ! Form BPA 10188 v1 BUILDING PERMIT APPLICATIC:d BUILDING SPECIFICATIONS : Type of construction , wood fraxe , fire safe , etc . q ,lyd8¢ y+r Will a:,y second- hand or ungraded lumber be used ? If so , for what ? ¢/fy oundation wall material (,ice` Thickness depth of foundation helow grade ( to bottom of foot -ingl r /• _- ettNIP Will there be a cellar ?&2 Heated or unheated? Floor sq . footage I'3S/ sq ft will there be a basement ? Will any portion be used as living space ? �e..e0�5 _ ( If so , what ,portion? ,7if sq . ft . - - Type of use ? /jir� Type of roof— s .opedy/ lat/shed/other Material of roof Size , wood studs_ X �" spacing /(✓ '" o . c . length ` _ft , Joists i floor beams ] lst . floor NIX j ,7 IN spacincz Ife " o . c . span /tO ft . Joists ( flo©r beams ) 2nd . floor Z- IN 0`0 IN spacin �+�_" o . c . span__Zo ft . c:verlays ( ceiling beams ) - '"X spacing '" c .� . span ft . Roof rafters aA '" XZZ;> "' spacing sr c . c , spank= t . Roof trusses (pre-engineereAl spacing " o . c . span ft . Exterior wall finish / - ! Of w t er 1 ? r l Interior wall finish - .* _ If a garage is to be attached , describ& materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? ,/1,0 If so will a Fire- raced door , enclosure , and self-closing device be provided ? Will a flue - lined chimney be installed? ,> Height above roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . inq water supply - Municipal or private well [((�p /L� SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties w ft . ( A separate application is necessary for any repair or new installation of septic system ) LDECLA R ATION 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, T E ZONING ORDINANCE , and all other laws pertaining to the proposed work shai e co lie with , whether specified or not, and that such work is authorized by the ner . Signature `2C ^ Own r ner's age , architect , contr or / SPECIAL. CONDITIONS OF THE PERMIT : By______ _____ ______...... .... TOWN OF QUEENSBIIRY 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 : f ,r / 1 , Gross floor area %3U/ T a [ 'fie -,,, )e< } / ,/r�_ 2 . Type of heat ! _� 64/ i r3tC Cj 3 , is the building mechanically cooled ? 4 . Percentage of area of windows and doors Z A . Over 16 % Only 10 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 ? 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 51 Type of insulation Be Under 16 % Only 1 . Ryvalue of roof ..a�nd floors exposed to ambient conditions L� _ � 3� 2 , R value of exterior walls - J 3 . R value of glazed area 4 , R value of doors ! � f 5 , R value of floors over unheated spaces 60 R value of slab edge insulation - unheated slab/ I � 7 , R value of slab insulation - heated slab IVA 8 . R value of heated basement / cellar walls ( above grade ) _ A(4-1- 9 , R value of heated basem ent/ cellar walls ( below grade ) We 10 , Type of insulation ] J �'Lr� 7 rrL < 1t Co Controls a 1 . Thermostat maximum heat setting D , Duct Systems 11 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 1 . Size of hot water or cooling carrying agent pipe 4? 2 , R value of pipe insulation F , Service Water Heating 1 , Performance efficiency r-r AetZt �t �, 29 Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating Telephone No . ( ppli ant ' signature ) TOWN OF QD BUILDING ANDD CODES CODES DE P TMENT BAY & HAVILAND ROADS QUEENSBURYo NEW YORK 2804- TELEPHONE (518) 792-5 32 BUILDING IN EG"fOR' S REPORT REQUEST COR INSPECT ON ECEIVED NAME n LOCATION Ilk I DATE ERMIT # 7 �� / I / I APPROVED E. YES NO FOOTING/PIE MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFI G BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING INAL INSPECTION; CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ST PS STAIRS—CLEARANCE & RAI PLUMBING FIXTURES/ LI VALVE _ INTERIOR TRIM/PRI ACy RS FINISHED FLOORS GARAGE FIREPROOF NG DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL NSPECTIO FINAL APPROVAL OF CONSTRUC ON OK TO ISSUE C/O C/C A SIGNED CERTIFI TE OF OCC FANCY MUST BE OBTAINED FROM T ,BUILDING EPARTMENT BEFORE THESE PREMISES RE OCCUPIED! REMARKS: ARRIVE {" DEPAR fi_ INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW PORK 1280& TELEPHONE lS 81 792-5832 BUI ING INSPE R' S REPORT/ I REQUEST FOR SPECTION CEIVED 1�J �1� NAME LOCATION DATE ERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC PO FORMS FOUNDATION/ -PROD . NG BACKFILL AP P AL ROUGH PLUMBING FRAMING ,ELECTRICAL ROU H-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTIO CHIMNEY HEIGH ROOFING SIDING EXTERNAL PORCH (STEPS STAIRS-CLEARAN & RAILS PLUMBING FIX TU /RELIEF VALVE INTERIOR TRIM( VACY DOORSu �.... FINISHED FFXJL7 GARAGE FIR EPR F G - DOOR CLOSER {S SMOKE DETEC S FINAL ELECTRIC L IN ECTION FINAL. APPROVAL OF C STRUCTION OK Tc► ISSUE C OR C A SIGNED CERT FICATE OCCUPANCY MUST BE OBTAINED FRO THE BUI TNG DEPARTMENT BEFORE THESE PREMIS S ARE OCC IEDI REMARKS: . ARRIVE f DEPART. INSPECTOR TOWN OF +QUEE.NSBURY BUILDING .AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280& fry TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT ,REQUEST FOR INSPECTION RECEIVED NAME LOCATION pr} DATE PERMIT # d 7 APPROVED YES NO FOOTINGIPIE MONOLITHIC R FORMS FOUNDATION/D PROOFING BACKFILL APP AL ROUGH PLUMBIN FRAMING ELECTRICAL RdUG -IN INSULATION: } FOUNDATION FLOORS WALLS CEILING \ /fFINAL INSPECTION : i CHIMNEY HEIGHT PWL ROOFING SIDING EXTERNAL PORCHES/ST PS STAIRS-CLEARANCE & ILS PLUMBING FIXTURES/ ELIEF VALVE INTERIOR TRIMIPRIV CY DOORS FINISHED FLOORS GARAGE FIREPROOFI G DOOR CLOSER(s) �C SMOKE DETECTORS t • FINAL ELECTRICAL I SPECTIONj �- FINAL APPROVAL OF ONSTRUCTION A SIGNED CERTIFIC TE OF OCCUPAN MUST BE OBTAINED FROM TH BUILDING DEPAR ENf[" BEFORE THESE PREMISES A E OCCUPIED!REMARKS , fr .r; ;4c%;Z--u/� ' Pr NSPECTOR U l(� TOWN OF QUEENSBURY "Pm BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENS,BURY, NEW YORK 328p9- TELEPHONE (5I8) 792-5832 BUILDING INSPECTOR' S REPORT REQUES FOR INSPE TION -ARCEXVED4XIqb PNT MANE LOCATION DATE _ PERMIT # i - APPROVED YES NO FOOTING/PIE MONOLITHIC UR FORMS FOUNDATION/ -PROOFING BACKFILL AP VA f ROUGH PLUMBI G FRAMING ELECTRICAL RTGH-XN INSULATION: FOUNDATION FLOORS WALLS CEILING kXNAL INSPECTI N CHIMNEY HEIG . SJ ROOFING SIDING EXTERNAL PORC S/STEPS STAIRS-ClEARAN & RAI PLUMBING FIXTU SIRE VALVE INTERIOR T342M/P VAC Y DOORS FINISHED FLOORS _ GARAGE FIREPROOF NG DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL IN ECTION FINAL APPROVAL OF C STRUCTION OK TO ISSUE C/O OR A SIGNED CERTIFICA E OCCUPANCY MUST BE OBTAINED FROM THE UI NG DEPARTMENT BEFORE THESE PREMISES AR OCC IEDt REMARKS: (a APRIVE �y Altj IDEP INS ECTOR v MIDDLE DEPARTMEP INSBrwCTION AGENCY, INC. goo HIW on Aven deir Cotfingewa id, N.J-.OB100 01, � } , Dalt; January 2 , 1990 h to Certif i CO that tit. electrical equipment listed has been examined and is approved as being in accord wim the !National ElectriGEtl Cone, applicable governmental, utility and Agency males. Owner" David Arstrat g a s m I 0,00UPa17oY 17we1] ing ' O - Same "� 4..+e cal/ ar p _ , d % y+l�� ` rr�t� 1 a'v r, . 'f II Location 3 7 2 West Mt %ca{t ,. . Que ejt bUx' "�"( IY f.1 � ,lt �.�:'. 1Y 1 .:yThls cer4hcate cOVII the eleuriC&OAUiPment and msriallatlon inspected this date 11 additional equiprrdant ahgidld be rnpoduped or alleratrdn5 made ID erisdng system this cerlllicale shall be null and void, and appllca ion for Fq{Jiprnenj: 32 Outlets ,- ' go S Receptacles ; 6 Fixtures inSPeclron should be submitted promptly to this Agency. . . _ Holder of Ihis certificate should present sarne to his property Insurance carrier (Signal or corepanyl as evidence Rr ccrtihca lion of electrical eq m pme fit approved as specified David Arms Apprfcanr: 372 West ML Rtaad ;; ' ::, No . 15 -026639 QueensbLfry , NY 12$04 Flinn No. 703 EL. 1.83 OF Q1L]EE'1, Y BUILTOWDING BUILDING AND CODES DES D DEPARTMENT BAY & HAVILAND ROADS 128 f14- QUEENSBURY, NEWYORK 792-5832 TELEPHONE ( 51.8 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION °�1 � 1 �. � p +� DATE 3 " ri'�!1PERMIT # r7 7 � APPROVED ES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKrXLL PROVAL ROUGH PLU ING FRAMING ECTRICAL OLTGH-IN SULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES ST S STAIRS-CLEARANC & RA LS PLUMBING FIXTU ES/REL F VVAALVIi INTERIOR TRI PRIVACY FINISHED F RS GARAGE FIRE ROOFIhfG DOOR CLOSE (S) SMOKE DET CTORS FINAL ELE ICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CEigTIFICATE 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 QTJEENSBURY, NEW YORK 128Ok TELEPHONE ( 518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST MOR INSP CTION RECEIVED NAME c 7 LOCATION DATE I�4 PERMIT APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL tROUGH PLUMBI tFNG RAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATTON ,FLOORS WALLS CEILING FINAL INSPECTION-6 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 F1,ECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ! REMARKS: I SPECTOR TOWN OF QUEENSBURY BUXLDTNG AND CODES DEPARTMENT BAY & HAVXLAND ROADS QUEENSBURY. NEW YORK 12804, TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR rNSPECTTON RECHXVED NAME LOCATION DATE PERMXT ## .APPROVED YES NO Fy�TTNG/PSERS MONOLrTHIC POUR FORMS FOUNDATSON/DAMP-PROOFXNG BACXFrLL APPROVAL ROUGH PLUMBING FRAMING ELECTRrCAL RO GH-rN XNSULATrON: FOUNDATION FLOORS WALLS CEILING FSNAL INSPECTrON * CHIMNEY HESGHT ROOFING FF. ,SXDXNG EXTERNAL PORCHESfSTER. STAIRS-CLEARANCE & RI PLUMBING FIXTURES1RELXH VALVE XNTERIOR TRIMIPRXVACY D RS FSNrSHED FLOORS_ GARAGE FIREPROOF-T4WG - DOOR CLOSERS) SMOKE DETECTORS FSNAL ELECTRICAL l'NSPECTION FSNAL APPROVAL OF CONSTRUCTION A SIGNED CERTrFI±CATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMXSES;' ARE OCCUPIED: REMARKS: F JYY- ff XN,SPECTOIR `T MIDDLE DEPARTMENT INSPECTION AGENCY, INC. National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 + • • ON Date: (!P * City, Town or Township_ V County State Location/Address 7Z "-el$ �, r� y� (if L ated in Rural Area - Please Attach Directions) Pole # Owner. A [/+ } /T1✓+TI� 449r" Occupied As +r J yE � — Permit # Occupant ✓e yr r : r �s L. f , Building. New© OA[7D P RP Work Area in Buildin Floor #, etc.) : A for: Wirin Q Service or: Read for Inspection : Fee Remitted - $ Cash 0 Check [� M.O. Q Make Payable To: Number of Rough Wiring Outlets Elect. Heat 5pO ise agoq xzsq xspo 175p zpop xxsq zspp 27se apop 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. :Receptapies Fractional H.P. Vent Fans Other Equipment: l- MOTOR$ H.P. 1/2 1/; ;l10 ;/8 1/6 1/4 1!3 1!2 3/4 1 lYr 2 3 57 7�fz 10 15 26 25 3D 40 50 75 . ;DO Mark Number of Each Size Applicant's - Signature T/A License # Permit # . Applicant's Add Utility: ress: NAME 4 ICE CA N (City) (State) (Zip) Service Request # Phone # Electrician.• RIDIA USE ONLY GATE FiECEIVEC: PATE ENSAECTED: Correct Location : Same as Above = or: Red Notice Label Rough Wiring Outlets Surface UnitIjK Oveo 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 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 I 1�/x 2 3 S - 7Yx 30 15 20 25 3 40 50 75 ;Mark Number of Each Size ' Elect. Heat Sop 750 }OOq 1250 1500law }75O 20Oq 22SO 2500 275p 300q Q RW Progress: Inc. ED LKD O Contractor CFT Violation : Work Camp. F] Inc. Q Q L/A Owner CASH 0 L/A Fee CiIK # �] IPA Municipal i]ue _ MO # 1WV # Date : Other Side Utility Applicant" Owner Cut in Card 0 Temp # Date Q Final # Date INSPECTORS.SIGNATURE APPLICATION FORM NO.. 250 EL 11/916 A"L1CANT"S CCWY TOWN OF QUEENSBUR'Y BUILDING AND CODES DEPARTMENy BAY & HAVILAND ROADS / QUEENSBURY, NEW YORK I280k TELEPHONE (5I8) 702-58.32 BUILDINQ INSPECTOR ' S REPORT F REQUEST FOR INSP TION RECEIVEDJ/7 NAME LOCATXON p DATE w PERMIT Add�'� daA l�" 011r- y� -E � APPROVED UU YES NO FOOTING/PIERS MONOLITHIC POUR ORMS FOUNDATION/DAMP DOPING BACKFILL APPROVA ROUGH PLUMBING FRAMING ELECTRICAL ROUGH N INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION* CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE / TEPS STAIRS-CLEARAN RAILS PLUMBING FIXTU ES/ LIEF VALVE .INTERIOR TRIM PRIV CY DOORS - FINISHED F S GARAGE FIR EP OOFIN DOOR CLOSER Sj SMOKE DETEC RS FINAL ELECTR CAL INSP TION FINAL APPRO L OF CON RUCTION OK TO ISSUE C/O OR C/C . A SIGNED C RTIFICATE O OCCUPANCY MUST BE OBTAINED F M THE BUILIJyNG DEPARTMENT BEFORE THESE PRE ISES ARE OCCUPXED1 ARRIVE DEPART INSPECTOR