1989-571 .;s4:
` l
i
f CERTIFICATE +C) OCCUPANCY
!
+CER"TI �� �
TOWN OF +QUEENSBURY
WARREN COUNTY, NEW YORK
December 13 lq 89 1
This is to certify that work requested to be done as shown by Permit No. 89' 7 1
f
,I has been completed.
i
This structure may be occupied as • i na le am i 1 y Dwelling
Location _ l.C� AI gonoui n Drive
0wnerRichard & Jean Guyette
k
k
By Order Town Board
j TOWN OF QUEENSBURY
t
. � .
Director of Bldg. do Code Enf6 rcement
i
P
BUILDING PERMIT
TOWN OF {QUEENSBURY
No_ r O- 571
WARREN COUNTY, NEW YORK .
a�
PERMISSION is hereby granted to Rlti€KKKK Richard & Jean GuyetteCr'.
OWNER of property located at Lot 146 Algonquin Drive Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Si ngl a Fami 1 y Dwe 11 i ng
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
Luzerne (toad c
Queensbury , New York 12804 m
_I
m
2. CONTRACTOR or BUILDER'S Name ..
Boppitts Builders
sue•
3_ CONTRACTOR or BUILDER'S Address >�
36 Boulevard G
Queensbury , N . Y . 12804QJ
4. ARCHITECT'S Name
S. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by XI r
c-t
XlXX wood Frame ( ) Masonry i 1 Steel ( ? F
O`
7. PLANS and Specifications
No 25 ' x 35 ' Single 'Family Dwelling as per plot plan , specifications , o
and application , including septic , attached two car garage ,
and dr4yeway ,
' J
B. Proposed Use
t:
J
Single Faaily Dwelling �
s 299 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 1 19 90
(If a longer period is required an application for an extartsion must be made to the Building and Zoning inspector of vhe
town of Queensbury before the expiration date.l
tG
Dated at the Town of Gueensbury th' 1st Day of July 19 89 �
SIGNED BY for the Town of Queensbury
wilding and Zoni I ctor
n
^ '" — ` `" `: v .^. f 1 7 1 'r" f .• ^ .y, T1 _ , r7 Y' '7 1 T l
TOWN of QUEENSBURY
dd
;,• `�( � . vizwcd /` TOWN OF QUEENSBURY
RECEIVED
q ry q �y
Fee Fa.t 1 I9C39
1:UI LDIN(' AND CORES U1 11ARTtTk.pr rn. iL.th+
AY and Flr1VILAND ROADS RD 1 Box 93 of BLDG. & CODE DEPT.
nUE$NSBURY . NE1i YORr+: 12d04 PCltnttf NU . A) 1
• r r r r r r rr ' r r r r r ■ ■ ■ r r ■ r r r r r r r r r r a r r r r r ,
A I' MitlIT MUST LO OBTAINED BEFORE CECINHING CONSTRUL'TIO ;44 NO INSPECTIONS
VILL BL HADG UNTIL APPLICANT HAS RECEIVED A VALID BI; ILDINC PERMIT .
All arPlicablt-� spaces on this application must be completed and the
ir' nature of the alrplivant must appear on the reversiz sick of this sheet .
,i #e ,c * R * * X * • R u k it R R al * * St f s x{�' * 11t 9t * !e 'k 7e 1[ x f1 le fi fe
I` 1ee owner S
of this Property isIClrlrt .QG�+�—_�J ' iRr' ~C}~+fly
v , 0 . Address TEL
iroperty location Wvc .r
A )C MAP NO . f-42
alas there been any split of this property since October 1 , 1998 ? yeS / o
if yes , Planning Board Review is necessary .
SU30IVISIQN NAME , IF APPLTCAnLE LOT NO .
- ne person respo sible for supervision of work as regards Building Codes is :
Id, 491
�t k IBC P;li S Aq r,-l''!?
NAME F r'� DDRC85 TEL aNl3
:jame of builder s tiTP Address Tel
r;ume of Plumber : J.dclress Tel""-Tel
. � ' A1dro� 5
riam+4 of Mason L PAl�tp•}1 /S�
„% TuRe or PRWOSCO 6QRK : ZONING iNI Oltr' IATION ( O fice use only )
� L":[inatrucCi,:.t of .a sti.:w builclr,"3 * ZONING. DESIGNATION OF PROPERTY
+AddiLian to :► 1]uil .jirtg r PERMITTED PRINCIPAL PERMITTED ACCESSORY
Alteration to .a LuildLnq . REVIEW REQUIRED PLANNING, BOARD ZONING SOARD�
iiiso cls..r <<] � LQ a: XCozri.] r tlilrlCnSiQn:il
QChQr work (J%ar:crLU..-d ) + SITE PLAN REVIEW M APPROVED DATE
feOSS AkL' A 01' l� rt (� P0SGD. :. •rrs. ucoruRX + VARIANCE If APPROVED DATE
: st Floor ] {o j sq ft . r q * Remarks :
tr
? nd t' 1Qo r f f sq f t . � � + COuI• VLL".t"L INI "Oi44%ATION 1suQUI14Lb uLLiaW . ` --
ai:cu Of jsrol..".+ rcy^ S o r t xf C .
Other Floors aq fL Lxi; cirrtj L' uiisi, «jl :: ) 7L �+2rrc .
snot cellar or basgsaenc ) .
TOTAL FLOOR riRCAMNJL � sq fc . + Lxa � cLal; r]4 , L.t�n�ji - 1 u �. - ----- �'"
6: qu nt:w :cructur.: �ft X :us�ft + -
1'tx4t�d;, Lion-riiL' C/ ���L/ Cr.arl/�]3rLL r1� t1311 " pcoj,)Qzowd bkA,6l .1Ln9 , d.6;. c.►nCu trout L.r%)Isurcy IL(te
(cLrclu one ) „ Front yard Cc Ltcar y4rd ft
N6) v of ccoriera (1"Uic;Abla L'I)aCC ) 2 . . [ G ;ancl i fc
• Sidta yaard.:
IlwighG ttlr3d�. GO riGl(Fu ) �_ ft . * If onCGxndr ,�Li....lc Lr41R 51.iYL �tr�t:c fc
i f. raulodixnLial , no . Qf f:atntliou
floo of roomA 1 cxcLudinq b:.Lhsl OCCUPANCY INFORMATION
1l0o of brsdraQtas 3 P'1tZMARY DUILDZNC
No * of bathrocuta + Ono Faa"ly dwelling
vriws,. ry 1us.►cituj yys4wus Two f;+taily dwulLiny
Tiylt.t oaf fuel * Aultslil.+ awwIling / Number of units no . of firel1lac+ua; to 14.e ins:c:.11utx • v4XWrtAQ1Wc occuptu,cy
gill a %Ohio) ,scovu Ir w itts: twll.xi?_�+,� + 1•r;ans:i.xrt>: QuBIALLU" t:y
central Air CQt,.litiunattg? liusinusttt
•
BU l LD l NG STYLC, PRIMARY STR4JCTuRe # 1' ntsus cr is l
lQatialk Concruu 1: Ac"r LGn c:.liin + OL1SQ7c �.�r
Y - * It .addiciurs . rlwC wsll u�.�t k�s'1
146AL *%:d ras►CI Duy,l,sx
uplLL luv,tl (Old v& ry .]I��^ lsu+wjAlQw • �• �•
4' vw CQd .► j-U r M GLl�. r + ACCL�S'DRY YaUILi]Sb1G—
CGiQni.al ttQw rcnw.t� 1iQ+ass • LtcCJChiu y .ari►9Q/0no Curl cwo r/� car
{ CIACLL: ONl: Ptrvoh.:£ l • '�►cLa: hu�1 tj :ar:ag"/Qjva cart w ciaa
r + r • r r s r r . a r r r r ■ + vriv" cit sLor,aLga building
W = WIXAT110 MARKET VALU/C OF ' 4ch.tr
1NFOI*4^TTOH ON OUTLOTNC SPeCIFrCATTONS , ON rtCVCRSe SIDE: OF THIS CkICL'T!' , 1*0 Be CDMPLCTCOS
Form SPA 10/88 vl
5x, fu5lrvG SPECIFIC.= Tf0��5 :
'r: = construction , wood fra:te , . afe , etc .
h it ary se and- hard or ungrada•d i ar ce used ? . _ ao , :or what '
Fou^.lotion wall material Thickness
Depth of foundatior. below gr33a tC :.cttorn of footing )
will there be a cellar ? seated Or unheated .' Floor sq . footage ag ft
Will there be a basement ? WLI 'i ar.y nortian Le used as living space ?
( If so , what portion ? sq . ft , - - ^';.ce of use ?
.ype of roof - sloped/ flat/ shed/oti: er Material of roof
Size , wood studs '" x " lc ^gth fe .
Joiscs ( floor beams ) 1st . floor " x spacing "o , c . span ft .
�oa.sts ( floor beams ) 2nd . floor " x " spacing orO . C . span ft .
:verlays ( ceiling beams ) spacing " o . c . span ft .
,'hoof rafters " x or spatxng c . c . span ft .
Roof trusses ( pre- engineered ) spacLncC "' o . c . span ft .
Exterior wall finish if what material ?
Tntwerlor wall finish
if a garage is to be attached , describe materials to be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling? If so will a Fire - rated
door , enclosure , and self- closing device be provided ?
will a flue -.tined chimney be installed? Height above roof ft .
-aoth of chimney foundation below grade ft ,
_ pth 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 LA R :ATf0 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 thheefowner.
Signature_11 ���?'!
Owner, owner's age , afrcUhitect , contractor
# # # * r # # # # # # # # # # # e fir # # # # # # r • # # # # : # # : # # • # # w w # # # # #
SPECIAL CONDITIONS OF THE PERMIT :
Ry- - -- -- ----
TOWN OF QvEENSBVRY lG'l - ( +� 1^��
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 cy( 0
2 . Type of heat W -
3 . is the building mechanically cooled ? aa--
4 . Percentage of area of windows and doors I )
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 ? S NO
a . R value f in lat ' o Al
5 . Type of insulat � �
Be Under 16 % only
1 . R value of roof and floors exposed to ambient conditions _
yR 3Y 60 [y _
2 . R value of exterior walls /S
3 . R value of glazed area
4 . R value of doors
5 , R value of floors over unheated spaces&3,0
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 )
S . R value of heated basertieffnt/ celllar walls ( below grade )
10 . Type of insulation OP- l� 1 _
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 Only
1 . Maximum heating
Telephone No . � ` !
( applicant ' s signature )
7 O WN OF QUEENSB UR Y
APPLICATION FOR
nr! SEPTIC DISPOSAL PERMIT
DATE j
LOCATION OF PROPERTY FOR INSTALLATION [_. ,,7 �• �
Owner's Name: +' ' € 1, ;4; tf r • z xi> , , 1 Telephone:
Address:
Installer's Name: ,"_ r �l ^ r t; Telephone:
Number of bedrooms (residential only) J
Total daily flow (compute (d 150 gal per bedroom)
Topography: Circle one: la Rolling Steep Slope % of Slope
Soil Nature: Circle one: San Loam Clay Other /Depth: Feet
Ground Water: At what depth? � ee�t
Bedrock or Impervious Material: At what depth ? Feet
Percolation test: Circle one: not required required rate ` min. inch.
Domestic water supply: circle one Municipal yell Other
If domestic water supply is a we 1:
Separation: Water supply from se absorption feet
PROPOSED SYSTEM : Septic Tank t gal. ( minimum size: 1 , 000 gal. )
TILE FIELD: Each Trench feet/Total system egth feet � ; r
SEEPAGE PIT(S): Number of I Size each 1e If
by L.
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 Rueensbury Sanitar w&pge Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:
DATE:
OVER
f
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
? , ) 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 * Nu system shall be covered before inspection and approval by the
Building Inspector . Failure to comply with this requirement may
result in tilt uncovering of the system by the installer and a fine
of up to $ ? 54 . 00 .
co 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 installa—
tion , alteration or repair of an approved system , a new proposal must
l.0 submitted to the Queensbury Building Department before further
construction ,
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
BtiD M#dldlryn''1►wrAtiil Ctl�InpErioodl."NI.��O8i0$ ,
pa,It: December 12, 1489
Certtflle!6 that the electrical equipment listed has been examined arld;l$ approved as being in accord
with the National Electrical Code, applicable governmental, utility and Agency ibles.
Richard Guyette Dwelling .,-
`
Owner. 3' Occrrparrcy
OCCilp$RF: /�
u't"�lme /� ,. :- .�. ' �. •. - i l r,fi,:.
Location Lot 146 Algonquin. Drive , Queensbury (Warren. I" Q)e rt f 1e cpvere trio oPoctriCal iygW pmant and inshs I late on inspected this
date. it additional egutpmentlehpudd be introduced or alteration; made 10
existing system [his c6ttj icate shall he null and void, and application for
Equipment: 110 Outlets ; 50 Receptacles ;. 30 Fixtures , inspect ion should tie submingtl p�lptly to this Agency.
200 Am Service ' S1 Appliances z ' Mader of ihls cerliflaa[e $noelld nl game to his pFope.ty Insurance Carrier
p y pp {agent or company} as eVidallcs bf$erlification of electrical equipment approved
as sPawfied., l;it"
C . .
7Bopp1tt,s Electric � . f
Applicant: 116 Aviation. Road ` t ., N0 . 15 -028611
L Queensbuxy , NY 12804 a
J
Form No. 703 EL 1.03
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY 6 HAVILAND ROADS
QUEENSBURY, NEW YORK 1280& J
TELEPHONE (518) 792-5032
BUILDING INSPECTOR ' S REPORT I
REQUEST F011 INSPECT N RECEI ED
NAME
LOCATION G3/ / SG
DATE PERMI #
APPROVED
YES NO
FOOTING/PIER
MONOLITHIC PO FORMS
FOUNDATION/DAM -.PROOFING W
BACKFILL APPRO L t
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH. N
INSULATION:
FOUNDATION
FLOORS
WALLS
ILIN
i NA INSPECTION: t
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHESISTEP
STAIRS-CLEARANCE & RAI
PLUMBING FIXTURES/RELI VALVE
_. 4
INTERIOR TRIM/PRIVACY RS
FINISHED FLOORS
GARAGE FIREPROOFING ,
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INSP,PCTEON _
FINAL APPROVAL OF CON,'STRUCTI N
A SIGNED CERTIFICATEfOF OCCUPA CY MUST BE
OBTAINED FROM THE BU LDING DEP RTMENT BEFORE
THESE PREMISES ARE CUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT Q
BAY & HAVILAND ROADS
QUEENSBURY,, NEW YORK 1280&
TELEPHONE (518) 792-5832
BU I L.DI NG INSPECTOR ' S REPORT
REQUEST FOpR_ XNSPEC'TI}O pNN/ RECEIVED _
NAME Z�rGf''1 4
LOCATION f
DATE - PERMIT
APPROVED
YES INO
FOOTING/PIERS
MONOLITHIC POUR FORMS
POUNDA TION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION.,
CHIMNEY HEIGHT N.
ROOFING
SIDING
EXTERNAL PORCHE /S PS
STAIRS-CLEARAN E S ILS
PLUMBING FIXT RES/RE IEF VALVE
INTERIOR TR /PRIVACY' DOORS
FINISHED F RS
GARAGE FIOFINGDOOR CLO )
SMOKE D ECTORS
FINAL ELE TRICAL INSPECTION .
FINAL AP ROVAL OF CONSTRUCT-TOV
A SIGNE CERTIFICATE OF OCCUPANCY MUST BE
OBTAINE FROM THE BUILDING DEPARTMENT BEFORE
THESE PRI�MISES ARE OCCUPIED!
REMARKS:
G
INSPECTOR
gown o/ Queervi " ry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. i 'Box 98
Clueensbury. New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ,L'-sd',�1 'C � ]
LCJCAT I ON I
DATE O .
SOIL TYPE - and - , Loam - Clay -
Percolation Required? YES - NO
Percolation rate - Min/inch
TYPE of SYSTEM:
Absorption field , total length
Length of each trench iv ca
Depth of trenches. -�
Size of Travel_ _
SEEPAGE P ITS#Nuir+ber of)
Size- ft. X _ ft .
Gravel size
PIPING . Size Type
Bldg . to tank¢
Tank to d1st . box D-ist, boa: to field/ 1
Openings sealed? ES NO Partial
LCCATION/'SEPARATIONS : oi.
roundatic•n to tank 'Oft.
Foundation to abscrption _�to
Absorption to lot line ft.
Separation of pits - ft.
LOCATIO STEM ON PROPER'T'Y (circle one )
Front Rear Left side' - Right side -
COMMENT
i
r
i
1
f
I
7
SYSTEM USE APPROVED YES No
�, �� Build n I Spector
01/86 and v1
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUE+EN.SBURY, NEW YORK 1280!&
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION REC ED
NAME
LOCATION f L�
DATE
r
APPROVED
YES NO
FOOTINGIPIERS
NOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOY- Nq
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING f
FINAL INSPECTION.
CHIMNEY HEIGHT i
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE RAILS
PLUMBING FXX27URESYRELIEF VALVE
INTERIOR TRIM/PRI�ft JACY DOORS
FINISHED FLOORS
GARAGE FIREPROOF j`NG
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION ' _
FINAL APPROVAL OF CONSTRUCTIOjV
7
A SIGNED CERTIFICATE OF OCCUPANC` MUST BE
OBTAINED FROM THE BUILDING DEPAR % ENT BEFORE
THESE PREMISES ARE OCCUPIED! %•
REMARKS:
fill
INSPECTOR
TOWN Or QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FO INSPEC �ON RECEIVED
NAME
LOCATION Zh
..� n
DATE ) PERMIT #
APPROVED
YES NO
FOOTINGfPIERS
MONOLITHIC POUR FORMS
FOUNDATIONfDAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION: 3x.
FOUNDATION `
FLOORS
WALLS L .
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHESf TEPS I-
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTUR SfRELIEF,�,VE
INTERIOR TRXMIIRIVACY DOORS
FINISHED FLCJp
GARAGE FIREPR FING
DOOR CLOSER ( )
SMOKE DETEC RS
FINAL ELECTRI AL INSPECTION
FINAL APPROVA OF CONSTRUCTION
A SIGNED CERTIFICATE 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
QUEENSBURY. NEW YORK I2809-
TELEPHONE (518) 792-58.32
BUILDING INSPECTOR' S REPORT
REQUEST R INS OECEIVED —
NAME T
LOCATION ) c
DATE PERMIT (#_;R t^ S'
APPROVED
C x I YES I NO
�,,.3�OOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/,DAMP-�PROOFING
BACKFILL APPROVA)
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH—IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION: "y
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES STEPS
STAIRS—CLEARANC & RAI�
PLUMBING FIXTU ESIRELIEF ALVE
INTERIOR TRIM PRIVACY DOOP�6
FINISHED F RSI�r
GARAGE FIRE OOFING
DOOR CLOSER S)
SMOKE DETE TORS
FINAL ELECTR CAL INSPECTION
................. .
FINAL APPRO L OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
L"
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS Y�
QUEENSBURY, NEW YORK 1280&
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED _
NAME
.LOCATION
DATE _ ~"� �^ PERM #
t" k APPROVED
YES NO
FOOTING/PI RS
MONOLITHIC UR FORMS
FOUNDATION/ --PROOFING
BACKFILL APP VAL
1.�OUGH PLUND r
L" .. MING
ELECTRICAL ROU -IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORC ES/STEPS
STAIRS-CLEA NCR & RAIL
PLUMBING FI URES/RELIEF VALVE
INTERIOR T M/PRIVACY D S
FINISHED F RS
GARAGE FS EPROOFING - - -
DOOR CLO R (S) "-
SMOKE DE ECTORS
FINAL ELE TRICAL INSPECTION
FINAL APP OVAL OF CONSTRUCTION
3
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
RRMARKS:
I SPECTOR ` -_
TOWN OF QUEENSBURY
,BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK .2280k
TELEPHONE (5281 792-5832
BUILDING INSPECTOR' S REPORT
/
REQUEST FOR INSPECTTOoe PECEIVED
NAME t-
IXACATION /
DATE RMIT # c 1
APPROVED
YES NO
FOOTINGfPIERS
NONOL.rTHIC PO[jR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL r
RMPLUMBING
ING
ELECTRICAL ROUGH-XN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL TNSPBCTXON:
CHIMNEY HEIGHT
ROOFXNG
SIDING
EXTERNAL PORCH S/STEP$,
STAXRS—CLEARA CE & RAXZS' _
PLUMBING FIX RES/RELXE)'� VALVE
INTERIOR TR N/PRIVACY D09RS
FINISHED F RS
GARAGE FI PROOFING
DOOR CIA R {SJ ,
SMOKE DE ECTORS
FINAL ELE RXCAL INSPECTION 67.
FINAL APP OVAL OF CONSTRUCTION
s
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUrLDING AND CODES DEPARTMENT
BAY & HAVrLAND ROADS ';7
QUE'ENSSURY, NEW YORK I280�& /
TELEPHONE (5I8) 792-5832
.BUILDING INSPECTOR ' S REPORT
REQUEST FOR rNSPECTXON R TV
NAME
LOCATI
DATE E r #- ;�2fl
APPROVED
YES NO
FOOTING/PIE
MONOLITHIC PO FORMS
4 �f UNDATION/DAMP .PROOFrNG .2 e - " —
-�C1{FXLL. APPROVAJk
ROUGH PLUMBING x —
FRAMING
ELECTRICAL ROUGH-X
INSULATION:
FOUNDATrON
FLOORS
WALLS
CErLING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SrDING
EXTERNAL PORCHES STEPS
STASRS-CLEARANC & RAILS
PWMBI'NG FIXTU S/RELIEF VALVE
INTERIOR TRrm1PRIV'ACY DOORS
FXNrSHED FLOORS
GARAGE FIREP$OOFING
DOOR CLOSER (`S)
SMOKE DETECTORS
FINAL ELECTRICAL .INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SrGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDi
REMARKS:
_1-
NSP
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE F RM rT # � y — 6� ( �I
APPROVED
YES NO-
FOOTING/PIERS
MONOLITHIC POUR FORMS
j/FOUNDATION/DAMP—PROOFING
Jj�fIACKFILL APPROVA$
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH—IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING r
EXTERNAL PORCHES/STEPS
STAIRS—cLEARANCE 8 RAID
PLUMBING FIXTURES/RELIE0 VALVE
INTERIOR TRIM/PRrlVACY DOORS
FINISHED FLOORS/
GARAGE FIREPR PING
DOOR CLOSERS)
SMOKE DETECTO S
FINAL ELECTRIC L INSPECTION
FINAL APPROVAL! OF CONSTRUCTION
d
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
RE KS:
I SFECTOR � �
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVXLAND ROADS
QUEENSBURY, NEW YORK I280*
TELEPHONE (528) 992-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR 4IN PECTION RECEIVED
NAME
LOC.ATXON
DATE i t PE'IZMXT
APPROVED
YES NO
l,of'OOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL A PROVAL
ROUGH PLUMF NG
FRAM?NG
ELECTRICAL Rl GH—IN
INSULATION:
FOUNDATION 1.
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/S S
STAIRS—CLEARANCE LS
PLUMBING FIXTURES REL F VALVE
INTERIOR TRXM/PR ACY RS
FINISHED FLOORS
GARAGE FxREpROqPXN4G
DOOR CLOSER (S) .
SMOKE DETEC S
FINAL ELECTRI AL INSPECTION
FINAL APPROVoPfL, OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MhST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED1
REMARKS: —1�FEE
INSPECTOR _�
— � 0c? 5r tl�
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 1+
BAY 6 HAVILAND ROADS
QUEENSBURY, NEW YORK 1280&
TELEPHONE (51 8) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED...
NAME _ a
LOCATION
DATE S;�- ` - PE IT #
APPROVED
YESA NO
00TING/PIERS
MONOLITHIC POUFS FORMS
FOUNDATION/DAMP'4�PROOFING
BACKFXLL APPROVAiI
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-I
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
.SIDING
EXTERNAL PORCHES/STEP
STAIRS—CLEARANCE & RAILS
PLUMBING FIXTURES/RBfLIEF VAL
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 OCCUPIED!
REMARKS:
&� I
jg
INs EGTOR
`- SELECT 13USl NESS FORMS (609) 948-5203
_ . 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
�w Date: f
City. Town or Township r�r-ace
County IJ r"rIlSt-0+ State
Location/Address GI
y ( I Locate Ru Area - Please Attach Directions) Pale #
Owner Permit #
ti
Occupied As Building: New Old
Occupant 5 A t,&
Work Area in BuiWin Floor #, etc. ) :
for: Wiring Service or: Ready for Inspection IW 44
Fee Remitted - $ Cash Check
M.0- 0 Make Payable To: M.D. I,A,
56D 750 1000 1250 1500 I750 2000 2250 2500 2750 3000
Number of ough Wiring Outlets Elect. Heat
Switches i �I
Lighting wr 4: Amp. Service urface Unit &" ishvvasher �� Range
Receptacles Water Piaster ✓Air Conditioner dyer Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for 'Burner
Amp. Recept cles Fractional H.P. Vent Fans
Other Equipment: z;
MOTORS H.P. 1/2 1/12 1/10 1/a 1/6 1/4 1/3 1/2 3/4 1 14z 2 3 5 74s 14 25 26 25 3fl 40 150175110017
Mark Number
of Each Size
Applicant's
Signature Ode License # Permit #
T/A Utility : rdvi"
Applicant's Address: NAMEI D Ic LOCATION
(City) (State) ' (Zip) f-AF, Service Request #
One # � d Electrician : 0
DATE RECEIVED: DATE INSPECTED!
Correct Location : Same as Above or:
Red Notice Label
Rough Wiring Outlets Surface Unit Oven
Switches Ran 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 HIP. 1/20 1/12 1/10 1/8 1/6 1/4
Mark Number 1/3 1/2 3/4 1 l+h 2 3 5 ?I!x 10 15 20 25 30 40 50 75 300
of Each Size
Elect. Heat SOa ]5D 1D00 1250 1500 1750 2000 225D 2500 2750 3000
RW Progress: Inc. O LKD Contractor
' C7 CFT
Violation : Work Comp. � Inc.
0 L/A Owner CASH
0 L/A Fee CHK #
Due. [] IPA Municipal MO #
" INV #
I Da": Other Side Utility Applicant
Owner
Cutin Card Temp # [Date
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