1990-076 I
CERTIFICATE. OF OCCUPANCY
TOWN OF QUEENSB.URY
WARREN COUNTY, NEW YORK
Date A r►gnst 9. 19
1 (4 - I
This is to certify that work requested to be done as shown by Permit No. 90-76
has been completed.
This structure may be occupied ail a single family dwe'llina'
5 Dixon Road
Location
WILLIAM KOSTECHKO ' 1
OwIIei JOHN HEATH/Constractor
By Order Town Board
TOWN OF QUEENSBURY
�x 01, 4d-17(
• Director of Bldg. & Code Er} o cement
=Y = BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-76
WARREN COUNTY, NEWYORK
PERMISSION is hereby granted to JOHN HEATH t\
i
OWNER of property located at 70 Dixon Road 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.
1. OWNER'S Address is x
William Kostechko1-3
177 Culloden Road
Stanford CT 06092
2. CONTRACTOR or BUILDER'S Name 0
John Heath Jr z
0
ul
3. CONTRACTOR or BUILDER'S Address (1
O
RD#1 Box 1219
Whitehall NY 12887
4. ARCHITECT'S Name
0
5. ARCHITECT'S Address
0
Sy
C1.
6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( ) Masonry ( ) Steel ( )
w
7. PLANS and Specifications acl
0
No. 20' 4" x 40' Single family dwelling as per plot plans, specifications and
application including septic system and one car attached garage.
8. Proposed Use y, `c
Singel family dwelling
z
Uq
1 55-0n PERMIT FEE PAID —THIS PERMIT EXPIRES October 5 19 90
(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.)
Dated at the Town of Queensbury this 5th y of April 19 90
SIGNED BY . for the Town of Queensbury
uilding and Zoning Inspector
r
i
TOWN OF QUEENSBURY APPLICATION FOR. BUILDING AND ZONING PERMIT
y—iir t'u.tc-
FJ <_ Rea e - Z" I Ii;: f- Iq U
,5
"��.i `� F� L
Fee Paid MAR 211990 -
• BUILDI CODES W:PARTP1EI�rI' Date Ieoued �2—'�8 '
NC AND ODC E DES
9AY and HAVILAND ROADS-RD 1 Box. 98
PUEENSBURY,NEW Y0R1: 12804 Permit No. 9 '16, _
Tel . (518) 792-5832 Ext -204
A PERMIT MUST B4 OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL •APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT. •
All applicable spaces on this application must be completed and the
s cTDature of the applicant 'must appear on the reverse side of this sheet .
* * * * * * * * * * * * * * * * * * * * * * * * *r_ * * * * * * * * * * * *
The owner of this property is : \A/1LLii -1✓ ) /' o TecLi 1<o "
P . O. Address /7 7 i l zsGO%D+cam ,a/ 02--/-7 �/�9h�2 V4'O a/r i, TEL. Z/t_75
00^� ��TAX MAP NO. it / /
Property location 0 22f�l� .(/ "e0,1i-/�
iD
Has there been any split of this property since October 1 , 1988? /, ,'✓O 5-
yes no
if yes , Planning Board Review is necessary.
SUBDIVISION NAME, IF APPLICABLE Ii/ DIICI�'�S i� ZOT NO . (pT- `
i
The person responsible for supervision of work/ as regards Building Codes is :
4` c/(Pk /7 ��1 C
NAME • • P .O . ADDRESS TEL. NOT.
Name of builder UN //f i7G, Address 1 Ar 1 Z) , —$ 2
Name of Plumber k L.1 Address Tel
Name of Mason it 1 ( Address Tel i
NATURE OF PROPOSED WORK: . ZONING INFORMATION (Office use only) (
X con::truction of anew building " ZONING DESIGNATION OF PROPERTY
_Addition to a building " PERMITTED PRINCIPAL PERMITTED ACCESSORY
Alteration to a building "
(no change to exterior dimensions) " REVIEW REQUIRED - PLANNING BOARD ZONING BOARD
Other work. (describe) " SITE PLAN REVIEW # APPROVED DATE
r
•
GROSS AREA OF PROPOSED, STRUCTURE/� /; VARIANCE # APPROVED _ DATE
1st Floor �� sq ft . Ej��`� s x Remarks: •
2nd Floor �� 0 •sq ft .(��
(D a. COMPLETEINFORMATION REQUIRED uEL0 d. -__
her Floors -/✓i l- sq ft . UN " Size of property 67 ft X b ft.
/ " Existing building(::) Size 4/74tc X rt.
.;t cellar or basement) "
TOTAL FLOOR AREA/ ` sq ft . • Existing, 1 building (s) Use /1,Z/9
Size of now structure 2J;-H ft x 40 ft
i••oundation-pier/slat,/crawl/partial/full " Proposed building, distance from property line
(circle one) " ft
. Front yard oO ft Rear yard 13
No. of stories (habitable space) 7i " Side yards / S ft and /5- ft
Height. (grade to ridge.) z 7 ft. * If on corner, setback from side street rc
If residential, no. of families i
No. of rooins(excluding baths) " OCCUPANCY INFORMATION •
tJo. of bedrooms ' PRIMARY LUILDINC -
No. of bathrooms Z * One family dwelling
Primary heating system 1_54,G//2i G " Two family dwelling
Type of fuel 4PCi10/ (r " Multiple dwelling / Number of units
No. of fireplaces to be installed] ,nvo Permanent oecup:a►cy
Will :, wood stove be installed? /V0,-/ 7 " Transient occupancy
Central Air conditioning? A/O►✓ o " —Business
BUILDING STYLE, PRIMARY STRUCTURE _ . Industrial
1:anch Contemporary Lon cabin " Ocher
R If addition, what will use be?
Raised ranch Mansion Duplex f?l�
split level Old style Bungalow " t r° .
a'ape Cod • Cottage Other " ACCESSORY BUILDING- A/1,' \ Z'',CQ� I
7:ionic l:ow Crown:House " be ached garage/one cur/ two car/ car i
( CIRCLE ONE PLEASE ) " ' ttached garage/one car/ two car/ car;;
a a a a a tau ea a a a a t t t " _Private storage building •ii
ESTIMATED MARKET V-A1:UE OF --'-- ' Other
CONSTRUCTION r Gfl! ;
]NFORMATION ON BUILDING-Slif:-CIFICAT--IONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 10/88 v1
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe;-etc. VV00.0
Will any second-hand or ungraded lumber be used? If so, for what? 4/0
Foundation wall material COMC/Q-g Oe Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? - Heated or unheated?. Floor sq. footage sq ft
Will there be a basement? any portion be used as living space? ,y 0
(If so, what portion? r sq.ft. - - Type of use?
Type of roof - to ed flat/shed/other Material of roof .25 /r
Size, wood stu s j "X (p " spacing / h "o.c. length S;' ft. '
Joists(floor beams) 1st. floor �c96i� ��`� �
2. "X !Z spacing /k� "o.c. spanZft-J f� �2
Joists (floor beams) 2nd. floor .. "X /7 " spacing / 6 "o.c. span • /z ' ft.
Overlays(ceiling beams) h spacing / b"o.c. span /z ft.
Roof rafters .v"X .$ spacing /lvo.c. span /Z€t.
Roof trusses(pre-engineered) spacing zL "o.c. span7e f ft.
Exterior wall finish /24y- 6 ����/c,v Of what material? ._e. /.�1C-7
Interior wall. finish 7 /fyLL t�
If a garage is to be attached, describmaterials to be used for FIRE SEPARATION:
Is there to be an opening between gara e'and dwelling? /4, ..-If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? ,y c. Height abode roof ft.
Depth of chimney foundation below grade 4/-oft.
Depth of fireplace hearth ,eft. in. _ f
Water supply - Municipal or private well I0(A)r,/ , 6,,v'/C,,'G
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties /p® ft.
(A separate application is necessary for any repair or new installation of septic system)
DECLARATION
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 44- 1LV�
Owner, owner's agent, architect, contractor
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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 .Y�
OF
^ ��{{
ANSWER ALL of the following:
• r - tki
1 . Gross floor area r/
41 I ,4
_ i. 1.. MAR 211990
2 . Type of heat •
HI DING 8: CODE D P
3 . Is the .building mechanically cooled? /1/V
4 . Percentage of' area of windows and doors . .
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? 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 (g
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 /2 c<, Z
4 . R value of doors /
5 . R value of floors over unheated spaces G�
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,e/Pi/_5-- Gore-,1//-7 �i62-74J
C. Controls
1 . Thermostat maximum heat setting
D. Duct Systems
1. Is duct system installed in unheated spaces? YES 4010
• 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 /1,//
Telephone No.2 7.S7 gO90
���/� S (applicant ' s signature)
� c%25o
_ \
0Z'Q4 of aletnodtvitni
APPLICATION FOR SEPTIC DISPOSAL PERMIT 1 Di Lj 1 _J 'pi f / J r.
' Lli ' LJ LJ t�,
MAR 21 1990 3 �F
DATE �V PE. Co / !cliff "L DING & CODE Di PT
LOCATION OF PROPERTY FOR INSTALLATION S.S I DE IC:0101.1 RD, 1 o 'w.0;LIaDE1J Ave:
Owner's Name: \(LL.1 AY► 1OSTt,CW IGO Telephone: 212 75 7 r'e',-;‘,
Address: Ili GU LLO DEN 2D, - s`Y'kL Kt) Coi414, O(, 10Z
Installer's Name: ,I) // 14/9A z x')-- Telephone: ?7? 2/ 7
Number of bedrooms (residential only) _ 3
Total daily flow (compute @ 150 gal per bedroom) _ 4S0 EjAL.
Topography: circle one: Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: 4/...feet
Ground Water: At what depth? feet 5641/Cc& 3,5
1
Bedrock or Impervious Material: At what depth? feet 3'Ec &l 4..5'
Percolation test: circle one: not required. required / rate 2 m
Domestic water supply: circle one: unicipal Well Other min./inch.
IF domestic water supply is a Well: �/�� feet
Separation: Watersupply from Septic absorption
PROPOSED SYSTEM: Septic Tank !coo_ gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 50 feet / Total system length ZOd feet
SEEPAGE PIT(S): Number of fi//4 / Size each feet by feet
Size of stone to be used # C ,:i / Depth or Thickness feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II 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 Building 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, tile fields and/or drywells
B. No system shall be covered before inspection and approval by the building
Inspector. Failure to comply with this requirement may result in the
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 unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
•
Signature of responsible person: 71,4Z
Date: -.3/9/G��
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SFTTI ED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD.PLACE TO LIVE
•
• - YOU ARE HEREBY REQUESTED TO '`j
. - INSPECT AND ISSUE CERTIFICATES -
, FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY •
•
THE UNDERSIGNED %� I�
TEMP.# _ - DATE 0— / '
CITY OR VILLAGE _ TOWNSHIP COUNTY rrr---YYY
STREET AND NO.OR ROAD • j POLE NUMBER
tV iX. /'I Irv/l.J .
BETWEEN WHAT TWO CROSS STREETS IS PREMISE9tOCATED? SECT ON BLOCK • LOT '
ef-vsS (kd' . 1-/ivP/�iv 7/, 7_,
OCCUPAw S NAME BUILDING OCCUPANCY
V////J,' fl '57 6.----4ik2 .
OWNERS tide/, IE AM.)5DRESS i7"vl 4 .f77C '/LoJ �/ !?L? s 9k/Ew-o C M' ,9 �z_ H� � H75 7 � �
CURRENTSUPPLIE BY FROM THEIR FFICE WORK TELEPHONE NUMBER
///9i:91f9 /2i�./, Z.,a' 4/.,4, �ii
BUILDING IS - - -
NEW[ OLD❑ WORK IS • NEW ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- • Lamp Receptacles CIRCUITS ONLY
lion -Side Attach't H.P. Watts AW.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE . -
•
SUB- •
BASE
BASE- -
MENT
1st
FL.
2nd -
FL. . .
3rd
FL-
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS • -
�4 dPc:, /9.4 j' ���—
CHARACTER OF WORK LJ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF - VA
❑ CONCEALED •
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) - CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN •
❑ OVERHEAD UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST DENT F CAT ENTER NUMBER I yI 01 a I ( I I I 2.1
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. -
PRINT NAME AND ADDRESS •
•
NA E OF//A+PPLIC��MyT DATE OF APPLICATION StGNATptE.OP PPLICA- ,,
ITY OR,POST O ICE ZIP jJDD LICENSE NO.WHEN APPLICABLE
i/f�/ 77,4/9G/. hi 7 , . - . 1- +
❑ 85 John Street ❑ 41 State Street ❑ 570 Delaware Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 - ROCHESTER,NY 14608 SYRACUSE,NY 13206
THE NSW YORK BOARD OF FIRE UNDERWRITERS
st-Ivgi,wti.1., n),, ei\1Cati..w:e 1,i.at!_,ati "..1t/:ati;��i"..lt(.",.14a��l?-e.�,AT4.��.a��.��i:a�.a�i��i, �,Nr��i.?�,�• �i. fJ: 1r
ii!
THE NEW YORK BOARD. OF FIRE UNDERWRITERS I'lii! :{;,_1 .1
v; 001121 BUREAU OF 'ELECTRICITY
o
1; I 41 STATE STREET,ALBANY,NEW YORK 12207
1 ,:it 4 l' ile .
✓ Date r_i, U:r.;T ..�- , i990 p (1'7'.�5;:, :)o 1 l:\, .1 ��36256
p ; THIS CERTIFIES THAT P_k?►IT NO;. .90--70 ;
only the electrical equipment as described below int on the above application number in the premises of
9 :ILLIari }.:O :TEC1IFO, DIXONI:D O? EEA� Iit�Ri . `r'. .} .
in the following location; likBasement alst Fl. ❑.;2nd Fl. CAR Section Block Lot
- ,s,„
1
was examined on DTI!L i "5 • 1 9 9 0 and found to be in compliance with the requirements of this Board.
i' .
S FIXTURE RXTURES • RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ':
�' OUTLETS• ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. .,
I 3 ''` ?6 _ 1 5 '? FR -
DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
- AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. . AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO. FEET AMT. WATTS ® '
a 1 ,;
.; SERVICE DISCONNECT NO.OF S E R V • I C E
AM AMP. TYPE EQUIP
T. I. '2W 1 0 3W 3,9'3W 3,B'IW NO.OAR.COND. OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS Op NEUTRAL o
w -`:• 1 200 CB 1 X 1 -1 r0 1 70 4
-' OTHER APPARATUS: '
Fi l l[i
:: ELEC. ?;OO!1 HE\TE : 1--.5 1;. , . ._- , 7 5 1;.1:. . __ -1 1;,;':.
5 • ELEC. I\VOai I-1E .lEliC. _--1 .2r Is..i':.
ELEC. WATER +IL. TER: : 1--4. 5 K.W.
C.F.C'..T : . o
•,• SMNE DETECTOR:-2 o
q .?..7157.4‘21.....d.4(2A
D RD 1. BOX 1219
-=. 'A,
s 1i,ITE I.L1- ;; ? BRANCH MANAGER
1 1^.`;. MEI
a '--tc, Per `,
l,; This certificate must not be altered in any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials. •
pC'ACi4iw're-t i'i•Y • 'i i'ie'i•'Ci6f'i•fY•0iin.Cre'ieei•r'i•14Y4Y4%-tg ral-w 4Y'i1Y7.7ido"a Y'i•C'r•f'iikj 1•i'i•j'i• le'ieW4C'i•VWe'r Ui"i•�'l ,1,-,e'•. .• •. •`'4
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY g`(.17/(1,
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT C
REQUEST FOR INSPECTION REECEIIVED
NAME Nok\ or),
RA-1-.
LOCATION , ,s ,{ ,S it ii q I/ 4_,
DATE l q J PERMIT # 97'\ /''G 7(, 2
TYPE OF STR CTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING -FOR 48 HOURS FOLLOWING
THE PLACEMENT OF 'THE CONCRETE. /
MATERIALS FOR THIS PURPOSE ON SITE'
FOUNDATION/WALL POUR ,''
REINFORCEMENT IN PLACE
, FOUNDATION/DAMPROOFING ,c'
BACKFILL APPROVAL ,P
ROUGH PLUMBING 1
PLUMBING VENT/VENTS IN PLACE /
PLUMBING UNDER SLAB /
FRAMING: ; /
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAM /
FIRESTOPPING /
WALLS '1 I
CEILING /
FIREWALLS
HEATING ROUGH—IN n
INSULATION: Pk
FOUNDATION WALLS/INTERIOR R—
FOUNDATION WALLS EXTERIOR R—
FLOORS / \ R-
WALLS / R—
CEILING / R—
DUCT WORK OR/PIPING IN UNHEATED
SPACES f C
/ E
REMARKS: ` \`
4`
4
ARRIVE
DEPART
/�
INSPECTOR
TOWN OF QUEENSBURY C )/ /`-'
BUILDING AND CODES DEPARTMENT 2:2) 11
BAY & HAVILAND ROADS QUEENSBURY,/ NEW YORK I280 Il, ,d
TELEPHONE (518) 792-5832 N ✓(0) -_
BUILDING INSPECT 1 'S REPOR
REQUEST R INSPEC ION RE,C IVED 2.I q f an,
NAME \i- \f�� al-Li
► (Q - _1� Y .Nt1 f
LOCATION , cad_
DATE r)12 f (l PERMIT # qt)-1 1
1
• ! APPROVED
E r YES NO
FOOTING/PIERS A I
MONOLITHIC POUR FORMS I
FOUNDATION/DAMP-PROOFING;
BACKFILL APPROVAL /
ROUGH PLUMBING f
FRAMING { P
r
ELECTRICAL ROUGH-IN I .
INSULATION: 1 1
FOUNDATION
FLOORS 1
WALLS \
CEILING \,
FINAL INSPECTION: i
CHIMNEY HEIGHT i /V1 -
ROOFING - •
SIDING f
EXTERNAL PORCHES/ TEPS !l
STAIRS-CLEARANCE &VRAILS
PLUMBING FIXTURES/JELIEF VALVE
INTERIOR TRIM/PRIMACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S) I
SMOKE DETECTORS 1 , /
FINAL ELECTRICAL IIVSPEC�TION,,
_FINAL APPROV, - •F CONSTRUc1,i
- OK TO ISSUE C/O SR C/C 0
A SIGNED CERTIFIgATE OF 6CCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES �E OCCUPI' D!
REMARKS:
;/,f:
(dp AitvL 00-g-_, 01. c0-5i-c-v- , gio
L, .
•
41111
. .
ARRIVE ..0000'
//,of
DEPART3 S 1 '
INSPE TOR
INFORMATION FOR BUILDING DEPARTMEN'1
WE ARE IN THE PROCESS OF ISSUING A CERTIFICAI
OF COMPLIANCE FOR THE ELECTRICAL INSTALLATI
•
AS COVERED IN AN APPLICATION FILED WITH 0
DISTRICT OFFICE.
THE NEW YORK BOARD OF FIRE UNDERWRIT
APPLICATION NO. 03 9 5 G`
•
,) LOC TION
1 / t� .
DATE INSPECTOR
FORM IBD(REV.1/86) I1
•
_Town of Queenur, .
BUI,DING and ZONING DEPARTMENT
Bay .1 d Haviland Road, R.D. 1 Box 98 „ig.
s ueensbu.ry, New York 12801
SEPTIC i:'ISPOSAL SYSTEM INSPECTION
NAME /
I►' P
LOCATION 0 g/..,i % r
o ,h
DATE_Alr J / yD PERMIT NO. 901�(/
�
SOIL TYPE - San. - Loam - Clay -
Percolation Tes Required?; YES - NO
Percolation rat:•. - Min/In.r'
TYPE of SYSTEM: • �17
Absorption field, total ength ,l.-7
Length of each tr d.nch ' , j-D
Depth of trenches
•
Size of gravel .
SEEPAGE PITS{Nuinbef, of) ,
Size- ft. X - ft.
Gravel size
PIPING: .ipe Type
Bldg. to tank f -'
Tank to dist. box Li %/U/L-
Dist. box to field/p '. \\ LI ,,,�,,,
Openings sealed? Y • i NO Partial
. t ' /
LOCATION/SEPARATION }
Foundation to tank ; �ft.
r;Foundation to abso •ti,,n "Igft.
Absorption to lot ine '-. . ft.
Separation of pits; — ft.
LOCATION/OF"'SYST ON P'OPERTY(circle one)
Front - Rear/ L-. t sid4 - Right side -
COMMENTS.:__
I / - I r)%i-.y
/6b/
\ I� .
SYSTEM US APPROVED (ES ) 0
• ;, /77: .
Building In•pector
01/86 and vl •
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804. flX/
TELEPHONE ( 18) 792-5832
WI RING INSPECTOR'S REPORT
REQUEST FOR I PECTION RECEIVED / A A
lgNAME
LOCATION
DATE 6 6,?1,1 , PERMIT #, 90 -7 ,
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR '•RMS
FOUNDATION/DAMP- rOOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-I'
( INSULATION:
l FOUNDATION
FLOORS
WALLSq‘_\
r
CEILING -, ) /
FINAL INSPECTION: -
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST '•S
STAIRS-CLEARANCE & ':ILS
PLUMBING FIXTURES/'E t EF VALVE
INTERIOR TRIM/PRI ''CY DOORS
FINISHED FLOORS
GARAGE FIREPROOFr G
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL NSPECTI,.'N
FINAL APPROVAL OF CONSTRUi,TION • '
OK TO ISSUE C/O 1' C/C
A SIGNED CERTIFI ATE OF OC ', FANCY MUST BE
OBTAINED FROM T E BUILDING •EPARTMENT BEFORE
THESE PREMISES .-RE OCCUPIED!
REMARKS:
ARRIVE
DEPART " l . iCi)-1-D
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS /
QUEENSBURY, NEW YORK 1280A.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REP;►RT
REQUEST FOR INSPEC.ION RECEIVED 90
NAME 4r !, 1 /
LOCAT •N 70 I IP/.
DATE 41/1 f qU PERMIT '# 9, - 7(�
/ APPROVED
`dex,v6, l//I�Z/ /.' ( /d�i.0 q YES NO
FOOTING/PIERS •
MONOLITHIC POUR FO' S
FOUNDATION/DAMP-PR4•FING
BACKFILL APPROVAL
ROUGH PLUMBING D C ,0 oft)
FRAMING • ;p�+
ELECTRICAL RO GH-IN,
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
}
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/S, PS
STAIRS-CLEARANCE & '• ILS
PLUMBING FIXTURES ''° LIEF VALVE
INTERIOR TRIM/PRI AY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING';
DOOR CLOSER(S)
SMOKE DETECTORS 1
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL • CON•jTRUCTION
•
OK TO ISSUE C/O OR C/s
A SIGNED CERTI ICATE 0 OCCUPANCY MUST BE
OBTAINED FROM HE BUILDING DEPARTMENT BEFORE
THESE PREMISE,. ARE OCC0PIED!
REMARKS:
ARRIVE / 'r 7>7.
DEPART
f!, I
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804.
TELEPHONE (518) 792-5832
B LDING INSPECTOR'S REPORT
REQUEST FOR 1 SPECTION RECEIVE> (o l i5 J Lt
NAME \ 0 �� Q
LOCATION 7 U i Pi
DATE toJ/��{ q PERMI # yQ- 7(D
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR .L'ORMS
FOUNDATION/DAMP- 'ROOFING
BACKFILL APPROVAA
.(ROUGH PLUMBING
)FRAMING
ELECTRICAL ROUGH- 1
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/.T :•S
STAIRS-CLEARANCE •'ILS
PLUMBING FIXTURE':/REL?EF VALVE
INTERIOR TRIM/PR•- VACY DOORS
FINISHED FLOORS
GARAGE FIREPROO;ING
DOOR CLOSER(S)
SMOKE DETECTOR`
FINAL ELECTRICAL INSPECTI,.
FINAL APPROVAL O. CONSTRUC.ION
OK TO ISSUE C/O R C/C
A SIGNED CERTIF CATE OF OCC FANCY MUST BE
OBTAINED FROM T.E BUILDING DEPARTMENT BEFORE
THESE PREMISES 'RE OCCUPIED!
REMARKS:
ARRIVE
/DEPART ✓ ! '
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1 :I4.
TELEPHONE (518) 792-5832
BUILDING INSPES OR'S REPORT
REQUEST 14' INSPECTION R CEIVED
NAME _ 14 A- ` i,
LOCATION "43 01. `{t)4)
DATE ,�� ' D I
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POU; FORMS
kFOUNDATION/DAMR PROOFING (/y
) BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH IN
xINSULATION: E E, -t0 .rQ,A V
•AFOUNDATION rz it
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES ST PS
STAIRS-CLEARANCE & "•ILS
PLUMBING FIXTUR.S/R IEF VALVE
INTERIOR TRIM/P IVAC DOORS
FINISHED FLOORS
GARAGE FIREPR PING
DOOR CLOSER(S)
SMOKE DETECTOR
FINAL ELECTRICA INSPECTION
FINAL APPROVAL F CONSTRICTION
A SIGNED CERTIF/ICATE OF OCCUPANCY MUST BE
OBTAINED FROM :HE BUILDINi DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIDD!
I
REMARKS: rl
As?Ro,-/.:i o w i,t9-P::1,016, $i6
I INSPECTOR
,: OF QUEENSBURY
_LDING AND CODES DEPARTMENT ,
AY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280�
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT -
REQUEST OR INSPECTION RECEIVED c //�/�a
NAME 4./ 'v 1. (1�(�.Q -gC%ZZe T
LOCATION 70 A ixL Pu
DATE #/)?.., 9,0 PERMIT # (�-
APPROVED
' _ • YES NO
/FOOTING/PIERS `',.
MONOLITUIC POUR FORMS r;:
. FOUNDATION/DAMP-PROOFING-..• . j ,
. BACKFILL APPROVAL 'ra
ROUGH PLUMBING : - tf`:-
FRAMING
ELECTRICAL ROUGH-IN ' i .• .
INSULATION: if - /
FOUNDATION
FLOORS ' . : '
WALLS 1 f .
CEILING s 1
FINAL INSPECTIqN:
CHIMNEY HEIGHT
ROOFING 11 . . .. .
SIDING
EXTERNAL PORGIES/STEPS I
STAIRS-CLEARA10E & RAMS
PLUMBING FIXTURES/RELIrEF VALVE
INTERIOR TRIM/PRIVACY/DOORS
FINISHED FLOORS
GARAGE FIREPROOFING ,4
DOOR CLOSER(S) t /
SMOKE DETECTORS `, a
FINAL ELECTRICAL INSPECTION. ' '
FINAL APPROVAL OF C4NSTRUCTION
t Al . . . .
A SIGNED CERTIFICATE 4 OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCC()PIED! -
/ L E- Lon 5' - tip'ik/VQ
REMARKS:A10 TVS'f [ I w to TO 80 -7-aM
V/3 OF/I-O°T 1J(,S PO 02_,
THE CONTRACTOR IS RESPON IBLE FOR PROVIDING
PROTECTION FROM FREEZING FOR 48 HOURS
FOLLOWINfG THE PLACEMENT F THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE /74
ARRIVE /'Zj YE NO
DEPART l= 30
. I SPECTOR