1990-096 • ,
• CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date June 11 19• 90
H1 3
This is to certify that work requested to be done as shown by, Permit No. 90-96
• has been completed.
This structure may be occupied a Eiry-1c family dw.:...1.1iIng •
Ck1CW
Location • L 25 Idavericrtirrve-Ilerald Square
David Oathout / Kathleen Oliver
Owner
• •
• By Order Town Board
TOWN OF QUEENSBURY
• Director of Bldg. & Code Enforcement
1-3
BUILDING PERMIT
Po
4
Po
• TOWN OF QUEENSBURY No. 90-96 z
o
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to DAVID OATHOUT/Kathleen Oliver F'
co
co
OWNER of property located at Lot 25 Herald Drive/Herald S duare Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sing e family dwelling O
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.
0
1. OWNER'S Address is y
1477 Saratoga Road
Ballston Spa NY 12020
2. CONTRACTOR or BUILDER'S Name
Passarelli/Cerrone
m
CD
3. CONTRACTOR or BUILDER'S Address
Lake Luzerne NY
(1)
4. ARCHITECT'S Name L�
cr
CD
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) (�b
(X1 Wood Frame ( ) Masonry ( )Steel ( ) O
CD
7. PLANS and Specifications
•
No. 54'x24' Single famly dwelling as per plot plans, specifications and
application, including septic system and one-car attached garage. 4•
8. Proposed Use CD
"
Singel family dwelling
$ 208.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 0rteber 3 1%0
(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 3rd . Da of April 19 90
SIGNED BY for the Town of Queensbury
Building and Z ning Inspector
TOWN OF QUEENSBURY
jig/ G✓ '(OWN OF QUEENS ,
'REVTEWED BY I r RECEIVED
11 r'Wi A... c,. # FE MPAIID,a:,.R : l'
Eii Ud" iI ERTNO_. o9 '.
h t;\(/11,14R 30 1990
1 J & CODE DEPT".
���l;t�S,i•�,�-BUILD G PE '� PPLICATIO�Y
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
• • • • • • • • • • '• • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • •
The owner of this property is: /' /0•L/.2 /Ckini .` //i
keill (4/6W----
P.O. Address / 77 c5 4 7t__ n , Ne ,Tel. ' ?(9 7
Property Location /16.w *lie— 6/ # ,2_- Tax Map No a7S/// 9 '
Has there been any split of this property since October 1, 1988? / ,,./
If yes Planning Board Review is necessary. yes no se t
SUBDIVISION NAME, IF APPLICABLE J!!,47,o z2 ,Z _ - LOT NO. 26
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
•
NATURE OF PROPOSED WORK: * ESTIMATED MARKET/VALUE OF -
/ CONSTRUCTION: / /7 )
�/ Construction of a new building • // t
Addition to a building
• COMPLETE INFOR`.�MATIO -REQUIRE D BELOW:
/5-®
• Size of property "Z/ ft x
'z— ft.
Alteration to a building * Existing Buildings(3) Size ft. x ft.
(no change to exterior dimensions) • •
• Proposed building - distance from property line:
Other work(Describe) ' Front yard VS- ft. Rear yard PO ft.
• Side yards .30 ft. and 60 ft.
•
GROSS AREA OF PROPOSED STRUCTURE 6, • If on corner, setback from side street ft.
1st Floor 9/ sq. ft. gel `'h 56-,•.. OCCUPANCY INFORMATION
."41 i1fZA-- •
2nd Floor 5,rL'� sq. ft. v' r • Primary Building -
� V_One Family Dwelling
Other Floors SQ. ft. -�`»
i' F"t A(not cellar or basement) .I G'� • e r. Two Family Dwelling .
•D Multiple Dwelling/Number of units
'TOTAL FLOOR AREA/.9rsq. ft. 1 -fA/'-
Size of new structure ft x L ft. ' /ice—Business
Foundation-pier/slab/crawl/partial/full • Industrial
(circle one) • Other
•
No. of stories (habitable.space) / /2/1•-- .
Height (grade to ridge) 2J . . ft. • If addition, what will use be?
If residential, no. of families / •
No. of rooms(excluding baths) 6 ' •
Accessory Building
No. of bedrooms 3 •
__Detached Garage ONE/TWO Car
No. of bathrooms Z •
Primary heating system �,r f'43. ,y0 • /_Attached Garage.ONE WO Car
Type of fuel • Private storage building
No. of fireplaces to be installed_ '
__Other
Willa wood stow.be installed •
Central Air conditioning *
OV• ER
BUILDING PERMIT APPLIC \TIO4 CONTINL.ED -
BUILDING .PECIFICATIOVS:
Type of construction,-wood frame, fire safe. etc. a-AS,
Will any second-hand or upgraded lumber be used? If so, for what? A/o
Foundation wall material Thickness /1
Depth of foundation below grade (to bottom of footing) 6 I
Will there be a cellar? 5-e.S. Heated or unheated? /6194N,1 Floor sq. footage sq ft.
Will there be a basement?s/e,S Will any portion be used as living space? AJO
(If so, what portion? . sq ft. Type of use?
Type of roof - sloped/flat/shed/othe 9 o L_Material of roof ,02,,p4r -
Size, wood studs 7i "x 6 " spacing /6" o.c. length r ft.
Joists (floor beams) 1st floor "x Ii) " spacing "o.c. span /'/ ft.
Joist (floor beams) 2nd floor 7, "x' .r " spacing /6 "o.c. span /3 ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing // o.c. span /7. 'ft.
Roof trusses (pre-engineered) spacing ".o.c. span ft.
Exterior wall finish - A1,4 of what material? UBi1y/
Interior wall finish , , " d
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to he an opening between garage and dwelling? , 7_ ' If so will a Fire-rated door, enclosure,
self-closing device be'provided? 1�5( .�'
;
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties ft.
(A separate application is necessary for'any repair or new installation of septic system)
NAME OF BUILDERI /MA/eeZe# —ADDRESS �„l��� TEL. NO. 6 -3 '77
(��C,�/�-
NAME OF PLUMBER,/ .,� ADDRESS qt,_/4,0A40,,Lei TEL. NO. 79 9D-E,
NAME OF MASON Gem ` &vs- ADDRESS TEL. NO.
NAME OF ELECTRICIAN/��(/�.lLA/ / DDRESS 47.6/g/v/et.44.7 - TEL. NO. 71/-4 9V
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 provisi. -.r,f "'"'..DING CODE, THE ZONINr nRDINANCE, 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 ,a•
Owner owner': ag architect, contractor
SPECIAL CONDITIONS OP THE PERMIT:
BY . . .
TOWN OF QUEENSPURY
IZA APPLICATION FOR lOWN Of�nijr-E�c'" -7'._
"? ; "j=
--v � SEPTIC DISPOSAL PERMIT
MAR 3 0 199u
AMP
BLDG. cc>. ,,::. M t -,,,;PT,
DATEA7ati� z,7 , /99O
LOCATION OF PROPERTY FOR INSTALLATION/7 / 7,e , .6/ 25
Owner's Name/�l/1/C/huT•/&Pheiv iet,Telephone: 9Xrr7
Address: `%77 <14__ a &m- ,1. r e(____-
Installer's Name: A C .t`. c,'L,,__ _ Telephone: wer`��j,0/1
Number of bedrooms (residential only)
Total daily flow (compute (. 150 gal per bedroom)() C .1/ ti
Topography: Circle one:gal) Rolling Steep Slope % of Slope
Soil Nature: Circle one Sand Loam clay Other /Depth: Feet
Ground Water: At what depth? A/4 Feet
Bedrock or Impervious Material: At what depth? 4I.// Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: 1Vlunicipa Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank . at'O gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 5 0 feet/Total system length • ZOO feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # 2/Depth or Thickness ?'aUi,1G a-/if r 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 Sanitary Se age Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ( -Z.
DATE:/ /./.ii_- 7 /19 )
OVER
•
•
' Septic System Inspe'ctions: - •
•
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 linen
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 installa—
tion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building' Department before .further
construction.
•
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay .and Haviland Roads
Queensbury, New York 12804
•
Remarks : .
. 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 :
• . d OWN OF 9 , , -_" _ . -
• ANSWER ALL of the following: �/ RFC r•
' 1 . Gross floor area ,/,� 0 .
2 . Type of• heat �� 1e..4•� .
•
J BLDG. & CODE D.t-.R m
. 3 . Is the building .mechanically cooled? GS
4 . . Percentage- of area. of windows "and doors / O "
- A. Over 16A Only .
1. Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions •
•
2 . Floor over heat spaces . YES NO
• a. Are foundat on walls insulated? YES NO .
. 1 . If YES . what is the R value?
• 3. Slab on . grade YES NO •
a. If YES , wh .t is the R value of_ insulation around -
•
• . perimeter of floor?
4 . Is. basement heated? YES NO
a. R value of .insulation
5. Type of insulation •
•
B. Under 16% Only
1. R value 'of roof and floors exposed' .to ambient conditions •
• *SO
2. R value of exterior walls / /
3 . R value of glazed area ' s- i°41-1A413 .
4 . R value of doors• ,% Zs. 47:0) r
5. R value of floors over unheated spaces
6. R value of slab edge insulation - unheated slab dr// t/
• 7. - R value of. slab insulation - heated slab . ' ®r
8. R value of heated basement/cellar walls (above gra• ) /3
9. R value of heated basement/cellar • walls (below grade) /✓��i
_ /
1-0. Type of insulation_ e24/4r-e,) -
C. Controls Al
1. Thermostat maximum heat setting c'«
D. Duct Systems "1. Is duct system installed in unheated- spaces? YE.S . NO .047()
a. If YES; R value of duct installation
. . b. R. value of duct in other areas
E. Wipe Insulation
1. Size of hot water or cooling carr ing . agent pipe . . .
. - value of pipe insulation �% �lP
F. Service Water Heating
1. Performance efficiency
2. Temperature control setting maximum /cam 6
• G. For Swimming Pool Only
1. Maximum heating -
Telephone No. . 7 -7' ,�Q- a-
(applicant' s signature)
TOWN OF QUEENSBURY
Bay at Haviland Roads,Queensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
•
Date /HIS" 2 7 19 n Permit No.
r r—
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's Name 47L �/ APPLIANCE TYPE
Stove Coal Wood
Address #N 5 ,«71- l u/ Furnace Hot Air Boiler
Zero Clearance Circulating Unit
(2,,ZiktV?1-6z,P/ , zip
Phone 71T- ( ' O / If Non-Masonry:
Owner's Name2a,/iZ, arSa7'- / 'i�tv /3/Peiri?1Manufacturer GT/ ?7
Address //77 34 d4.4
� Model Outlet Size
/Fa h Zip /2-0 7,6 Listed by Number
Phone 9� 7 CHIMNEY TYPE
Masonry: Block Brick Stone
Property location of propose4construction Flue: Tile Steel
/1 /k Size:
, K1/ 14A 2c- Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$Cc
SONRY FIREPLACES AND CHIMNEYS.
CASHIER'S DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department: Fire Marshal Amount Collected Amount Refunded
Code Number Title 4.Z5-
A 173 3389 (190)Public Safety
A233 2655 (230)Minor Sales
Fee ?��ttectc- �d fro or Refunded to: 4,/,{d L 't
Address:
Dated: I/ ho Town Clerk or Deputy - ` C_Q_LV 4T
I — I y
While:Applicant Yellow and Pink:Cashier's Department U Goldenrod:Fire Marshal
&1,....- MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters "
900 Haddon Ave., Collingswood,.N.J. 08108
APPLICANT COMPLETES THIS SECTION / i.
Date: F;-2r
City, Town or Township / /« e-,::-� _i.<✓�" - . County :' ./ -`'e`\ State
r j
Location/Address t' ey f' ,�1✓/ /..1--�-= - f a/ '� 2
;r (If Located in Rural Area - Please Attach Directions) Pole # n.
Owner � , �F 121.--tie-& Permit # qc--Ci
7(42
` /' /;�?�i=zi/ti /_ �' .r" Building: New Old❑
Occupied As y�,�, f ,.�
Occupant -
" P Work Area in Building (Floor #, etc.): .
App. for: Wiring Service( or: Ready for Inspection:
Fee Remitted-$ Cash n Check n M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000,
Number of Rough Wiring Outlets Elect. Heat
Switches ,
Lighting Amp. Service Surface Unit Dishwasher Range
Receptacles Water Heater Air Conditioner Dryer Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1'/z 2 3 5 7,h 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's r'f
Signature ,=`" = r`.{"r='7 License # Permit #
T/A /" C)i r k3�1 r(. )r Utility: /V. :!v c (f (',1"-r ^ (77-- 7,,
"`'� (NAMME) (OFFICE LOCATIO'N)"
Applicant' Address: ,4-- �s-% = � 11�,e ,
(City)` c c,t.,r_ —�,7 '(Stake) /6/-�'" ' (Zip) _`'_�' S,ervice1Request # f
Phone # ' _ ' Ele `r'ician� � f �� 7", .n,-.-- e` 1!,%?/t i
MDIA USE ONLY •
DATE RECEIVED: L7 . DATE INSPECTED: .4/ - r 1._
Correct Location: Same as Above I or:
Red Notice Label
Rough Wiring Outlets Surface Unit Oven
, ' ,r^> Switches / Range Garbage Disposal
4. ,., Receptacles 1 Water Heater i Dishwasher
x— Fixtures Air Conditioner / Dryer
,Th t1 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 1 11h 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number ,
of Each Size /
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
I
I
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CO RECT FEE PAID,
RW Progress: Inc.Q/---- LKD❑ Contractor _
El CFT Violation: Work Comp.El Inc. ❑
I L/A Owner CASH n
Fee CHK #
(7 L/A I Due
IPA Municipal MO #
INV #
Date: � Other Side El Utility • v. / PPlicant
'� - Owner
ti
Cut in Card I Temp # Date 2 f''. i ��,.
��• =; kr
f INSPECTORS SIGNATURE
111/F1-nal # ? Q 7 D(71 Date --/ /- ;-,-,
APPLICATION FORM NO. 250 EL4/89 -
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YO', 12804• ,/1722
TELEPHONE (518) 7'12-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPfECT ION RECEIVED (�,/J1 i/l
NAME �/j.//1� U ,p,eit cc
LOCATION4 2.5- i „fir Y1C! ,I . 1
DATE 611/9t PERMIT #C i
QrQ- 9/
IAPPROVED
YES NO
FOOTING/PIERS /
MONOLITHIC POUR FOP S /
FOUNDATION/DAMP-PR..FING I
BACKFILL APPROVAL /
ROUGH PLUMBING 1 1
FRAMING , "/ •
ELECTRICAL ROUGH-INS /
INSULATION: I
/I _
FOUNDATION
FLOORS
WALLS
CEILING 1
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING \ % . ' i/
SIDING } 1
EXTERNAL PORCHES/ST,PS' i/
STAIRS-CLEARANCE & "• LS A/7 ,
PLUMBING FIXTURES/R: IEF VALVE
INTERIOR TRIM/PRIVA V DOORS /V/
FINISHED FLOORS /I V
GARAGE FIREPROOFING Ir
DOOR CLOSER(S) / I /1h
SMOKE DETECTORS 4/7"--
FINAL ELECTRICAL IN:PEC'ION . . . . . ' .
FINAL APPROV" OF `'NST"UCTION '
OK TO ISSUr C/O O'k6/C
A SIGNED CEP FIC"TE OF OCCUPANCY MUST BE
OBTAINED FROM TH/ BUILDI\ DEPARTMENT BEFORE
THESE PREMISES APE OCCUPI D!
REMARKS: / ,,
_::1: ;? 7111/1 \ ,
I 'i/ \ .
/ .
I ,
ARRIVE / �` ��/
f77
DEPART / Z ( G-
INSPECTOR
,
1v11DDLE DEPARTMENT INSPECTION AGENCY, INC.
Electrical•Building-Plumbing-Fire Inspections
Date • ik
1‘111‘.1 IA&111111
� ►� �� ,
I .=cto
T' constit(tes certification that the
•
above installation, but not the equip-
ment itself,has been visually inspected
as of this date pursuant to the applic-
able codes. If additional equipment.
should be introduced or
. alterationsor struc-
ture,i made to the existing system
application for inspection should
, be submitted promptly to this Agency.
4 TOWN OF QUEENSBURY / 1-1
BUILDING AND CODES DEPARTMENT
BAY & HAVILANDiROADS "11C-
QUEENSBURY, NEW YORK 12801-
TELEPHONE (51 ) 792-5832 l `.---
( ,/f /Q e /(_,W)
BUI ING INSPECTO' S REPORT
REQUEST FOR IN ECTION REC DI VED 6,/3,I HC' P P I
NAME 0 'it
4/3 t t-
LOCATION 2& -._Q0ZCL/d ).//Y
DATE / G/ PE' IT '# 90---qn
/ APPROVED
-^ YES NO
FOOTING/PIERS
MONOLITHIC POUR F RMS
FOUNDATION/DAMP-P OOFIfG
BACKFILL APPROVAL'.
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-I
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/.TE S
STAIRS-CLEARANCE RA LS
PLUMBING FIXTURES REL EF VALVE
INTERIOR TRIM/PRIVACY` OORS
FINISHED FLOORS
GARAGE FIREPROOFI G
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INI'PECTIO
FINAL APPROVAL OF CONSTRUC ION
OK TO ISSUE C/O OR $/C -
A SIGNED CERTIFICAT OF OCCU.ANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE i'CCUPIED!
i
REMARKS:
C CO alLa_Jc_c_
(:,)1 .
ARRIVE
/g,)
DEPART /
l�
INSPECTOR
• c-----e
_Jouin of QueeniLry fl
BUILDING and ZONING DEPARTMEN
Bay and Haviland Road,R.D. 1 Box 98
. Queensbury, New York 12801 •
•
'SEPTIC DISPOSAL SYSTEM INSPECTION
NAME / ,, a
LOCATION c %2j'/ ' R
is
DATE 96 PEwHIT N0.
pia-96
SOIL TYPE - Sand - Loam - Clay I .
Percolation Test Required? YES" - NO
Percolation rate - Mn/Inch - ,I
TYPE of SYSTEM:
Absorption field, total leng '
Length of each trench f
Depth of ,trenches ' 1 1
Size of gra``vel ;
SEEPAGE $TITS-ENumb f) ' I 17
Size- `/(-, ft. X ti . ��
Gravel size _ 1
PIPING: S" le Tye
Bldg. to tank 1/ Y/U L
Tank to dist. box f
Dist. box to field(----P
r° LI
Openings sealed? S �, NO Partial
t LOCATION/SEPARATIONS:v
' Foundation to tank 462ft.
' Foundation to absortion . /A ft.
Absorption to lot line a 4-< ft.
Separation of pits / 1Pft.
ION OF SYSTEM/ON PROPERTY(circle one)
Fron - Rear - Left side Right side -
MMENTS: I i
/ 011 4?f/51/
/ ii ‘;'/A
1
�i N
•SYSTEM USJAPPROVED YES O
�i7
Bu'lding Inspector
01/86 and vl
TOWN OF QUEENSBURY ,
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 61,-3,4q Q PM
NAME OPCLL+ JLa}-( !
DATE l 4.j q D PERMIT # q 0-�1
APPROVED
A-drio,ha d _")h 1 YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS `.
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN '
INSULATION:
FOUNDATION `,
FLOORS
WALLS
CEILING �- =dr�
FINAL INSPECTION: '
CHIMNEY HEIGHT ',
ROOFING
SIDING V.
EXTERNAL PORCHES/STEPS •
STAIRS-CLEARANCE & RAILS '
PLUMBING FIXTURES/RELIEF,;VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION •
FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/O OR C/C ;
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT'BEFORE
THESE PREMISES ARE OCCUPIED!.
•
REMARKS:
•
II
H
ARRIVE tte
DEPART
• INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801.
TELEPHONE (518) 792-5832
•
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION � VE
RECEIVED�
NAME l J �(*i'�, J
LOCATION GSA--y IZ
DATE Cl PERMIT # 1 -q(
8
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL
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A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
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REMARKS: 2NP r_00 R.— 0_G—I c,w( Iti"�C�S
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BUILDING INSPECTOR'S REPORT
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BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
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THESE PREMISES ARE OCCUPIED!
REMARKS:
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BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
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BUILDING INSPECTOR'S REPORT
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