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2014-241 TOWN OF QUEENSBURY woo742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20140241 Date Issued: Friday, June 26, 2015 This is to certify that work requested to be done as shown by Permit Number P20140241 has been completed. Location: 47 BUCKBEE Rd Tax Map Number: 523400-288-000-0001-086-014-0000 Owner: FRANCIS & LAURA COCOZZA Applicant: FRANCIS & LAURA COCOZZA This structure may be occupied as a: Fireplace By Order of Town Board Single Family Dwelling TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property (DJ owner of the responsibility for compliance with Site Plan, Variance, or /� other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement or Zoning Board of Appeals. Temporary Certificate of Occupancy 90 Day Building Permit No. • 2014-241 Property Location : 47 Buckbee Road Property Owner: Laura & Francis Cocozza Approved for the following uses: Single Family Dwelling Conditions of approval: 1. Relocated propane tank (min. 25 ft. from home); 2. Guards at stairs in front porch area; 3. Septic as-built from engineer/architect. 4. Engineer-certified storm water map. II $100 fee received on: March 31, 2015 90 Day Temporary CO expires on: June 30, 2015 *A final inspection for this project must be scheduled before the expiration of this Temporary Certificate of Occupancy — if your project is not complete within this 90 day period you will be subject to additional fees* Signature of Applicant: -/ Printed name of Applicant: LauCo c o7,Z CA-- ' Director of Building & Codes: (-- ,,,P 4 „age- David A. Hatin Town of Queensbury Building & Codes Office Dept. of Community Development 742 Bay Road, Queensbury, NY \. TOWN OF QUEENSBURY ` o 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140241 Application Number. A20140241 Tax Map No: 523400-288-000-0001-086-014-0000 Permission is hereby granted to: FRANCIS & LAURA COCO7.7A For property located at: 47 BUCKBEE Rd in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: FRANCIS & LAURA COCOZZA Fireplace 19 APPLETREE Ln Single Family Dwelling $250,000.00 GANSEVOORT NY 12831-0000 Total Value $250,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency DOUG WEAVER 747-0034 329 DEAN Rd HUDSON FALLS.NY 12839 Plans& Specifications 2014-241 SFD 1st Fir 1680 sf; 2nd Flr 1120 sf 1 Fireplace (woodburning) Cross Ref. SP 33-2014 $560.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, June 23, 2015 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town u nsbui MIL i aj June 23,2014 ��//11 ' SIGNED BY 000 G for the Town of Queensbury. Director of Building& Code Enforcement d ! i 1 ! L YI yd` �jl e.l x ZA 41 777 Won sip ami I,£ ( i'c44 o f ig a 9 • Li Office Use Only ii t `fI 'y Town of Queensbury Building & Codes ._._-.-----� Received: PRINCIPAL STRUCTURE APPLICATION Tax Map ID: 'ut1 17 2014 i Permit No.: 'i--a 41/ A permit must be obtained before beginning construction Permit Fee: . $ �(¢b pGtl Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling *Rec Fee: $ ® 1 units, including single-family dwellings,duplexes or two-family dwellings, multiple family Site Plan No.: dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.: homes,but not including mobile homes. This is in addition to the permit fee. EP�CtSee,Co7-2--41n Date J.oe )(2 ZD) "7 Applicant < 7 Ft)04ea. 1 € d Tax Map ID 3 g, -(` 847. (I Address nJP PAJSi 0!`-( &''( Zoning Phone/E-mail 5I — 90 too e e-z2A> -J �. r Property Owner �►a t)r, C OCoz 2 A- contractor/Agent c�Y i/s > 1, k'Uet_<✓ U--) - Address l'1 4 Me-kfv ' L-420 Address 3?..� eo 4-, / Csaa5etic -, 01 ic?331 14(4.4.0,4 -rd,115 ( - Phone/E-mail - . o 444 Z-aA�c2 • . .?Bone/E-mail 7 yl ) sy Building Street Address: 71 5 JC4‘..ve_o .2OACJ �/ Subdivision Name: /�Lnr•. Lot#: V2 Historic Site: Yes !< No Estimated cost of construction: $ • 025-U CGU • LV 6)e1-1-- 36,5- 33i (7 Type of Construction: Check all that apply Please indicate measurements as required below: c oO d 1st Floor 2nd Floor Other Total Height F ¢ a Single Family aV 26'x 6o' 2. 'x de 27 ' Two-Family /Co g0 / O Multi-Family(#of D;C*9° units ) Townhouse Business Office Retail-Mercantile Factory-Industrial Attached Garages(# ) Other Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 If commercial or industrial indicate name of business Proposed use of building or addition .L Source of heat(circle one) Gas Oil Propane Solar Other Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" /Yes _No Are there structures not shown on plot plan? /ff.) Are their easements on the property? Z, Site Information a. Dimensions or acreage of lot b. Is this a corner lot? c. Will the grade be changed as a result of construction: /Yes _No d. Public water or Private well !�✓ i( e. Sewer or Private Septic System S e-641( Value of all work to be performed(labor and materials) $ 0750/ DO Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and department approval. I certify that the application, plans,and supporting materials are a true and complete statement/description of the work proposed,that all work will be performed in accordance with the NY State Building Codes, local building laws and ordinances,and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a c-u ificate of occupancy. I have read and a•r-- • •-abov- Signed 'l �_ - Date: 67/i FOR OFFICE E ONLY: Operating Permit Issued: _Yes _No Occupancy Type: Construction Classification: Assembly Occupancy Limit: Special Conditions: Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 Town of Queensbury Highway p Hi hwa Department ,!;.1i4 17 2014 1--'0)(1 DRIVEWAY PERMIT Michael F.Travis, Highway Superintendent Thomas R. Van Ness, Deputy Superintendent Home: (518)798-0413 Home: (518)745-0929 Office Phone: (518)761-8211 Office: (518)761-8211 Fax: (518)745-4466 Building Permit#: Date: .77iik )4120/j Tax Map ID: Applicant Name: FR A+Je r'`, Co co?' Address to be inspected: Li 7 1Buck6pe Pc,eltS . a)e('N''DL'1' Return Address: 19 h?cIp44I\€Q_ /4,4c CutnlSc U oo R�, ivy t iF 31 Applicant must show exact location and width of driveway(s)to be connected to the highway by placing stakes at the specified location. The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following action has been taken: Step 1: ( ) Preliminary Approval Need: ( ) Slight swale ( ) Deep swale Level with the road ( ) Level with the top of the paved wing Size culvert pipe to be used(if necessary) ( ) 12" ( ) 15" ( ) 18" ( )24" ( )36" Preliminary inspections completed by: Date: Approved by Highway Supt: Deputy Supt.: Upon completion, please resubmit this approved permit for a final approval. Step 2: ( ) Final Approval ( ) Rejected Date: Michael F.Travis, Highway Superintendent Thomas R.Van Ness, Deputy Highway Superintendent Town of Queensbury Building&Codes Principal Structure Packet .518-761-8256 it Office Ltse Only Town of Queensbury Building & Codes Fit N t Rece fed ` _ :7 : Tax Map ID: �,' FUEL BURNING APPLIANCE & CHIMNEY APPLICATION Permit No.: / �f- <{ Permit Fee: $ Application is hereby made to the Building & Codes Office for the issuance of a Building & Use Permit pursuant to the NYS Fire Prevention & 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 to perform required inspections. Important Note To Applicant: Rouqh-In and Final Inspections Are Required: Date )(JAM I4( ?o / Owner f{ ANA"iS Co CO 2.2_ Installer/Builder 1BU Address ri kbee Zc,ct d Address 6.0e e 0Nj N/ 19g0 Phone Sig - s'B 1— 9 o ro a u ry Phone /� Location of proposed construction and/or installation: '/ 7 BJCA a ee Road Contact Person for Building & Codes Compliance: Subdivision Name: Fuel Burning Appliance Information Wood Coal Pellet Gas Oil Stove Fireplace Insert Fireplace,factory built* Fireplace, Masonry Furnace, (Garage Only) * If Factory Built, Please Provide: Manufacturer Name: 7 BD Model No. -7B Listed By: Number: Chimney Information Masonry** ✓check one _Block _Brick _Stone Flue Vcheck one Tile _Steel Size in Inches Material ✓check one _Double Wall ale Wall iInttrated __Direct Vent _Chimney Liner ** If Non-Masonry, please provide: Manufacturer Name: Model No. ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION & BUILDING CODE AND/OR MANUFACTURER REQUIREMENTS. CONSULT AVAILABLE Town of Queensbury HANDOUTS REGARDING REQUIRED INSPECTIONS. Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 D ;` Office Use Only -orxet a dnuiii Town of Queensbury Building & Codes n Permit No.: / -' 1"t SEPTIC DISPOSAL PERMIT TO',/, Permit Fee: $ A permit must be obtained before beginning construction 6` Approvals: Applicant: /l¢/Lf( S C��(O Z2 A Installer/Builder (fakva;.S Address: a7 vrk1 eo Rya.d Address 32-41 :DPrir fitec1401 Phone: S!g 6-237 ' 90(p D Phone 7407 onsq e (, f Owner: Fief"OrS ©Co 7 Z 1 Location of Installation �14-' .4 c 1`-t'1 Address: as/7' I3+X•l,C6v_ A:20LE) Phone 518 ,57I --T''6,el _ u Contact Person for Building&Code Compliance: Jc�•�y (^%L‘--t 0 Day Phone: 71'6 14/14- Residence Information: Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow 1980 or older x 150 = Garbage Grinder installed? 1981-1991 ----- x 130 = Spa or Hot Tub Installed? /VC, 1992-Present l0 = x 110 = 5.S6 Parcel Information: Topography _Flat Rolling Steep Slope r.) %Slope / Soil Nature Sand _Loam _Clay Other t We Groundwater At what depth? -i Bedrock/Impervious Material At what depth? -I- T' -4 Domestic Water Supply Municipal 1/ Well(if well,water supply from any septic system absorption is 1W ft.) Percolation Test Rate- ;t, per minute per inch(Test to be completed by a licensed professional engineer or architect) Proposed System for New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Tank size BOO gallon (minimum size 1,000 gallons),add 250 gallons to size of septic tank for each garbage grinder,spa or whirlpool tub 1L-( ((4'I%rte 4-1 System Type: Absorption Field(with#2-cte Total length 3 MI ft. Each trench �-' , X Seepage Pit(S)(with#3 stone) How many? Size? Alternative System Bed or other type? Holding Tank System Total required capacity? Tank size? #of tanks? NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form on Town website;2)Effective as of March 23,2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed system must match the septic system layout on file. There will be no exceptions. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury,any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant,shall be void. ✓I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Print Name: Ztxx., Date: ii2ItY Signature: Date: 02,r Town of Queensbury Bui jng&Codes Principal Structure Packet 518-761-8256 Queensbury Building & Code Enforcement - Residential Final Inspection horn_ f ��7j Office No. (518) 761-8256 Arrive: amI'�n Depart: I, ' /)'am/pm Date Inspection request received: 1¢ I � Inspector's Initials: !'` . 1 NAME: l_GC,O Ck PERMIT#: zt-241 LOCATION: £ ' c itkbe Q DATE: i 2-1(1t 2 0A c-) TYPE OF STRUCTURE Comments: Yes No N/A_ 4" Building Number Address visible from road rr -- Chimney Height/"B"Vent/Direct Vent Location T1 W Ni Co GO ata Fresh Air Intake 3 inch Plumbing Vent through roof minimum 18 inches 31c5 Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs,decks, patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck, porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate L �{ f 4-4/3""'Gas Valve shut-off exposed/regulator 18 inches above grade56;. � Interior privacy/trim!doors 1 main entrance 36 inches �� ����il` � � Bathroom/Kitchen watertight ,-'` `� Safety glazing/Window in stairwells safety_glazing Interior Smoke Detectors/Carbon Monoxide Detectors { ;" f1° _ . 14- — Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, 1 sq.ft:150 sq.ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification Floor truss, draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operatihg Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum'/"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/3/4 hour fire door/door closer Gas Logs in Sealed or Glass Enclosure Final Electrical; Energy Saving Light Bulbs 50% Final Survey Plot Plan Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles Flex Gas Pipe Bonding As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C/0[Temporary/Permanent) L:\Building &Codes Forms\Building& CodeslInspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised January 7, 2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11 0 Final Survey Inspection Dept. of Community Development Town of Queensbury 742 Bay Road Queensbury, NY 12804 Date received: 41 t V2-0t5 NAME: C--DC)7. -G LOCATION: ' bl Jet) PERMIT#: � " Final Survey Plot Plan Approved Denied The attached final survey has been received by the Dept. of Community Development. Upon review the survey has been:, Craig B . ' n, Zoning Administrator Notes: L:1Suet-[emingway\Building.Codes.[nspcction.FORMS1Final Survey Zoning Administrator.doc LANDS N/F OF MARK CRONIN BOOK 1257 PAGE 142 SITE LOCATION MAP I \ 7? ROAD culvert L6 I ANT SFTe Z5 N87-12'00'EN85 05 00 E 179.58' Zp o, l A 00 1 - 40 1 at, am bridge o If Iw h IN I w LANDS N/F OF FRANCIS J. COCOZZA rn LAURA A. COCOZZA I w I o BOOK 4961 PAGE 079MI tO ° AREA= 12.111 ACRES culve t m o I �I �� 1 0 1 meter pole x ZI I m 1 /W0041 frame well 1 garage I I I I I I 2 story I wood from house I L — _ poral l I 80.00' — — — — — — 30' REAR SETBACK LINE — _ _ _ _ __ I N87;i4;30'W 528.72' 130.34' A IR S `0 n • ,,, w, .. 159.92' LANDS N/F OF MICHAEL & AMELIA FORTOUNAS BOOK 874 PAGE 43 LEGEND Line Table o IRF Ll 578'10'30 "E 52.29' L2 S644600E 58.19' L3 S5644 OU L 68.82' L4 S583530'L 74.27 L5 S75'11'30"E 64.70' L6 N87'05'30"E 15.29' LANDS N/F OF MICHAEL & AMELIA FORTOUNAS BOOK 874 PAGE 43 LEGEND LANOS N/F OF DAVID BRUNO BOOK 1138 PAGE 160 LANDS N/F OF jI DAVID PARKER BOOK 860 PAGE 262 DEED REFERENCE: 1) JEFFREY BENNETT AND MICHELLE BENNETT TO FRANCIS J. COCOZZA AND LAURA A. COCOZZA, FILED IN THE OFFICE OF THE WARREN COUNTY CLERK IN BOOK 4961 AT PAGE 079, DATED MARCH 28, 2014. i MAP REFERENCE: I 1) 'MAP OF A SURVEY MADE FOR HUNT LAKE HOLDING COMPANY, INC.' DATED APRIL 25, 2000, REVISED ON OCTOBER 31, 2001. PREPARED BY DAVID J. BOLSTER LICENSED LAND SURVEYOR, FILED IN THE OFFICE OF THE WARREN COUNTY CLERK AS PLAT #184. ' I l NOTES: { 1) BASE MAP PREPARED FROM AN OCTOBER 2014 FIELD SURVEY. 2) NORTH ORIENTATION IS BASED ON MAP REFERENCE 1. 3) SUBJECT TO CERTAIN CONDITIONS AS DESCRIBED IN DEED REFERENCE 1. 4) TOGETHER WITH AND SUBJECT TO A RIGHT OF WAY AND U;,IUTY EASEMENT AS DESCRIBED IN DEED REFERENCE 1. 5) THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN", OF TITLE AND IS THEREFORE SUBJECT M ANY EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE. 6) SUB.IFs'r - .:;7 APF+', YVALS OF THE TOWN; COUNTY, AND STATE REGAhDING THE UEVELOPMLN I u1 LAUD. 7) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE NEW YORK STATE EDUCATION LAW. 8) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURF ORS SEAL STALL NE CONSIDERED TO BE VALID TRUE COPIES. 9) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM SURFACE LOCATIONS AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY. THERE MAY BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE, TYPE AND LOCATION OF ALL UTILITIES AND STRUCTURES MUST BE VERIFIED BY PROPER AUTHORITIES PRIOR TO ANY AND ALL CONSTRUCTION. CALL DIG SAFE PRIOR TO ANY EXCAVATION. �+A o IRF IRON ROD FOUNI o IPF IRON PIPE FOUNT o IRS IRON ROD SET 913 UTILITY POLE 000o STONE WALL — x — WIRE FENCE — o — CHAIN LINK FENT — ❑ — WOOD FENCE o POINT F.P. FENCE POST —ohw— OVERHEAD WIRE`. n/f NOW OR FORMEF LANOS N/F OF DAVID BRUNO BOOK 1138 PAGE 160 LANDS N/F OF jI DAVID PARKER BOOK 860 PAGE 262 DEED REFERENCE: 1) JEFFREY BENNETT AND MICHELLE BENNETT TO FRANCIS J. COCOZZA AND LAURA A. COCOZZA, FILED IN THE OFFICE OF THE WARREN COUNTY CLERK IN BOOK 4961 AT PAGE 079, DATED MARCH 28, 2014. i MAP REFERENCE: I 1) 'MAP OF A SURVEY MADE FOR HUNT LAKE HOLDING COMPANY, INC.' DATED APRIL 25, 2000, REVISED ON OCTOBER 31, 2001. PREPARED BY DAVID J. BOLSTER LICENSED LAND SURVEYOR, FILED IN THE OFFICE OF THE WARREN COUNTY CLERK AS PLAT #184. ' I l NOTES: { 1) BASE MAP PREPARED FROM AN OCTOBER 2014 FIELD SURVEY. 2) NORTH ORIENTATION IS BASED ON MAP REFERENCE 1. 3) SUBJECT TO CERTAIN CONDITIONS AS DESCRIBED IN DEED REFERENCE 1. 4) TOGETHER WITH AND SUBJECT TO A RIGHT OF WAY AND U;,IUTY EASEMENT AS DESCRIBED IN DEED REFERENCE 1. 5) THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN", OF TITLE AND IS THEREFORE SUBJECT M ANY EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE. 6) SUB.IFs'r - .:;7 APF+', YVALS OF THE TOWN; COUNTY, AND STATE REGAhDING THE UEVELOPMLN I u1 LAUD. 7) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE NEW YORK STATE EDUCATION LAW. 8) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURF ORS SEAL STALL NE CONSIDERED TO BE VALID TRUE COPIES. 9) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM SURFACE LOCATIONS AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY. THERE MAY BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE, TYPE AND LOCATION OF ALL UTILITIES AND STRUCTURES MUST BE VERIFIED BY PROPER AUTHORITIES PRIOR TO ANY AND ALL CONSTRUCTION. CALL DIG SAFE PRIOR TO ANY EXCAVATION. �+A ._ - �� — fir' i _.� v�._. _ '• _ i_ .-� - �.._ 'K, —�_�_ CERTIFICATION.• I HEREBY CERTIFY TO: _ 1) FRANCIS J. COCOZZA & LAURA A. COCOZZA 2) TRUSTCO BANK - 3) FIRST AMERICAN. TITLE INSURANCE COMPANY - THAT THIS MAP WAS PREPARED FROM AN ACTUAL FIELD SURVEY COMPLETED UNDER MY DIRECT SUPERVISION. THIS SURVEY AND THE CERTIFICATIONS HEREON SHALL BE - VALID ONLY TO THE PARTY OR PARTIES HEREON NAMED AND ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS, OTHER THAN AS MAY BE OR EXPRESSLY - STATED H RUSSELL E. HOWARD NYSPLS# 050540 DATE: 03/24/15 i. GRAPHIC SCALE 100 0 50 100 200. 400 I ( IN FEET ) 1 inch 100 ft. MAP OF A SURVEY PREPARED FOR OF N 116A.�ICI�' . T. COC'OZZA 4EM�n> �. LAURA A` COCOZZA Town of Queensbury County of Warren State of New York °s0s40 BOLSTER TES Al° s PROFESSIONAL LAND "SURVEYORS 342 Alrftr 1"Ireet, Hudspn Falls, New York12839 Russell E. Howard, PLS N.Y.S. Liu. lVo. 50540 Dute:106/03/14 Tax Map #:r88 -r-86.14 Date healed �$ /� Scale: 1 inch 100 feet Revised:03/24/15 Drawing #: 00012 i.),( Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518) 761-8256 Arrive: am/ a i am/pm Date Inspection request received: 3W,•-•I t`� Inspector's Initials: NAME: 61 co at,,. PERMIT#: t q"utt LOCATION: g - ('amu, -►tee DATE: 31-bl -xc�‘5 TYPE OF STRUCTURE: Se-i) Comments: Yes Aki N/A 4" Building Number Address visible from road V/ bCt Chimney Height/"B"Vent/Direct Vent Location ✓ � Fresh Air Intake 'V }c)l,2 - 1111t7-- 3 23 inch Plumbing Vent throygh roof minimum 18 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs, decks,patios more than 30 inches abovejrade 0 ±= ' - Guard at stairwell at 34 inches or more Guard at deck, porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant :ip, Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate • Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim I doors I main entrance 36 inches V;, '\--Z- .-- , '~ Bathroom/Kitchen watertight r,/� , � Safety glazing/Window in stairwells safety glazing l/ ` 4,1}, O Interior Smoke Det ors/Carbon Monoxid etectors Every level: V Ev ry Bedroo : `''/ 0 . 2G•- - Outside every bedroo rea: Inter Connected: Battery backup: ,✓ , � ^- Attic access 30 inches x 22 inches x 30 inches(height)in accessible area ✓ Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents 1/ � A a Bathroom Fans,if no window �J Plumbing fixtures ✓ Foundation insulation to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification Floor truss, draft stopping finished basement 1,000 sq.ft. -� d Emergency egress below grade 1. ct-Yk- =-12._ Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area / Furnace/Hot Water Heater operating ✓ G i� � �` Low water shut-off boiler ��j Relief Valve(s)installed/Heat Trap/Water Temp 110 ‘/"'. p2 i �Lt� Enclosed Stairs Sheetrock Underside minimum l/2"Gypsum �� � Basement stairs closed rise>4 inches Garage Floor Pitched / �--(=Z�� Garage fireproofing/3/4 hour fire door/door closer Gas Logs in Sealed or Glass Enclosure V �S— !d D 'fit 6�-- Final Electrical;Energy Saving Light Bulbs 50% / - Final Survey Plot Plan t/ Arc Fault Breaker Habitable Spaces I Tamper Proof Receptacles k/ , Flex Gas Pise Bonding . Sepis System/Sewer Dept. Inspection Y S icker Site Plan ariance requiredX1-'5 -- - ain Certification,if re. - Okay to issue C/C or C/0 emporary/ 'ermanent] /r C lA, ss VO -Sk-gn411 , ao (6 155,t fee,,_,e r L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised January 7,2008; Revised 6/26/08;Revised 12/22/10, Revised 04/13/11 Queensbury Building & Code Enforcement - Residential Final Inspectio,p Office No. (518) 761-8256 Arrive: am/pm Depart: 1 j , 4)am/pm Date Inspection request received: n Inspector's Initials: 6 NAME: - �r� �-• PERMIT#: 1 � LOCATION: �-'� �!� ` DATE: TA��� TYPE OF STRUCTURE: Comments: Yes No NIA 4" Building Number Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 18 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs, decks, patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck, porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet L 6 inch clearance to sill plate (� f Gas Valve shut-off exposed/regulator 18 inches above grade v 1 Interior privacy 1 trim/doors/main entrance 36 inches _ Bathroomfty /Kchen ing t e ` Safety glazing Window! in stairwells safety glazing Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents Bathroom Fans, if no window Plumbing fixtures Foundation insulation to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum W Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/%hour fire door/door closer Gas Logs in Sealed or Glass Enclosure Final Electrical; Energy Saving Light Bulbs 50% Final Survey Plot Plan Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles tex Gas_Pipe Bonding 01:// :uilt Septic System/ :ewer Dept. Inspection Sticker Si - - _• ..- required Flood Plain Certification, if required Okay to issue C/C or C/0[Temporary/Permanent] Jl r ss `t S kcnaccSe o j l6 6-f ndb Loc.( L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11 Town of Queensbury Fire Marshal �� 1111K 742 Bay Road EV . Queensbury,NY 12804 761-8205/761-8206 fax 745-4437 Factory Built Wood Burning Fireplace/Stove Inspection Report Notice: New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's instructions or specifications is allowed. Permit# aLi Schedule Inspection ,LeI 5 Time am planytime Inspector Name r(D C(722 . Address b -t.- c 0 Rough In X Final Appliance Manufacturer \\)n{-1))9 6-" Model# N.2' Masonry Chimney Factory Built Chimney X Flue Size Double Wall_Triple Wall_Insulated_ Yes No N/A Comments Floor Protection X r Clearances to Combustibles (all sides) (' OIL ~�v L 1 (AO Safety Strip Installation (fireplaces only) / ' Firestop(s) Vertical Chase X 1� Wall Penetration Chimney Clearances to Combustibles 1 Chimney Termination 3 feet above roof penetration; 2 feet above any combustible construction within 10 feet Combustion Air a-' X Hearth Extension .?:`b Mantel(height above f/p opening) Fireplace Doors/Screen (required) Carbon Monoxide Detection White—Building Dept. Yelton—Customer Pink—Fire Marshal ,' Liu j- LL)tt x- d /41°-- "49' Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Ins • do west received: Queensbury Building & Code Enforcement Arrive: a pm 742 Bay Road, Queenshury, NY 12804 Inspecto Initial(s• .►L _ NAME: L'O(26).6-3-4(--- PERMIT #: 1 'I1 LOCATION: -/&' INSPECT ON: / 'r/'i-J5 TYPE OF STRUCTURE: Y N N/A Plumbing under slab Rough Plumbing / Nail Plates Plumbing Vent /Vents in Place 11/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet / change of direction Pressure Test Drain /Vent Air / Head 5 P.S.I. for 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/ Head 50 P.S.I. for for 15 minutes /% / Insulation /43esidential Check/ Commercial Check Window Sealing Tyvek or Similar Exterior Sealant Proper Vent, Attic Vent 7 Door/ Window Sealed (No Insulation) Duct / Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly / No duct tape Blower Door Test Air Sealing i COMMENTS: � 3v "�► Rough Plumbing_Insulatian Inspection_02 05 13 Town of Queensbury Building & Code Enforcement (1U I ' 3 Office No. (518) 761-8256 Framing ! Firestopping Inspection Report Inspection request received: Name: C}.A-6 Inspected on: Location: <1' / CC«n,'{ be- Arrive: t. a.m./p.m. Permit No.: Inspector'sInitials: TYPE OF STRUCTURE: �' r N N/A COMMENTS: Framing Attic Access 22"x 30"minimum Jack Studs/Headers Truss Specification Provided \mac Bracing/Bridging Joist hangers ---- Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft.8 in. C - Stairwells 36 in.or more C.� Exterior Deck Bracing Headroom 6 ft.8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 '/2(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 ft.or less on center Ice and water shield 24 inches from wall Fire separation 1,2,3 hour Fire wall 2,3,4 hour Firestopping: C\/:) Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side 1/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in.(H) 20 in.(W) 5.7 sf above/below grade 5.0 sf grade Design Professional Sign-off,if required Framing / Firestopping Inspection Report Town of Queensbury Building & Code Enforcement 1 1 gyne Office No. (518) 761-8256 Framing / Firestopping Inspection Report Inspection request received: Name: 0 60_4>z z Inspected on: . " A A*- Location: e)(f C k bN& �� Arrive: 4 o Mak a.m.I p.m. Permit No.: Inspector's Initials: _LI� TYPE OF STRUCTURE: S N NIA COMMENTS: 'Paining ' Attic Access 22"x 30"minimum Jack Studs J Headers Truss Specification Provided J Bracing/Bridging ✓/ Joist hangers Jack Posts/Main Beams V Exterior sheeting nailed properly 12"O.C. Headroom 6 ft.8 in. Stairwells 36 in.or more Exterior Deck Bracing Headroom 6 ft.8 in. Notches 1 Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 1/2(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 ft.or less on center Ice and water shield 24 inches from wall Fire separation 1,2,3 hour Fire wall 2, 3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side 1/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in.(H) 20 in.(W) 5.7 sf above/below grade 5.0 sf grade Design Professional Sign-off,if required (ct__3r,„151. V-14—L-4s4--(5-14L— Framing / Firestopping Inspection Report Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256 hul"`3 Framing 1 Firestopping Inspection Report Inspection request received: Name: C Q Co 2. 2 -.- Inspected on: / •_ip— Location: e cta b E Arrive: '' 4 a.m.l p.m. Permit No.: Inspector's Initials: TYPE OF STRUCTURE: s F Q N NIA COMMENTS: Framing Attic Access 22"x 30"minimum Jack Studs 1 Headers Truss Specification Provided Bracing I Bridging Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft.8 in. Stairwells 36 in.or more Exterior Deck Bracing Headroom 6 ft.8 in. Notches/Holes 1 Bearing Walls Metal Strapping for Notches Top Plate 1 1/2(w)16 gauge(8) 16D nails each side Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 ft.or less on center Ice and water shield 24 inches from wall Fire separation 1,2,3 hour Fire wall 2, 3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side 1/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade Design Professional Sign-off, if required Framing/ Firestopping Inspection Report Foundation Inspection Report Office No. (518)761-8256 Date Inspection u-:- - - ed: Queensbury Building&Code Enforcement Arrive: l.7 : i Depart:< ! 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials. - /n NAME: (. C)LoZ _P2 \ ' RMIT#: \IA -ZL LOCATION: %---\—( GVvse c7,:c, INSPECT ON: \p —c\—1IA TYPE OF STRUCTURE: Ot 14 0 ,17. T: 43 ‘ Comments Y N N/A Footings /piPiers Monolithic Slab 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/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofmg Foundation Waterproofing Footing Drain Daylight or Sump Doting Drain Stone: t�\ 12 inch width /�'� 7r 6 inches above footing ` 6 mil poly for wet areas under slab N O/ackfillAPProv:i lab / /Copper -.undation Insulation Interior/Exterior /' Ila R- '1t) 1," c;up.4-0\ v t- QCQrt"7 Rough Grade 6 inch drop within 10 ft. L:\Buftding&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM ft1rn f1' - /4 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Departt 1 r • pm 742 Bay Rd., Queensbury, NY 12804 Inspector's InitialsO ' ! NAME: 2 p�6bOD 2.6- PERMIT#: / �f— I! S F LOCATION: Al "/ ct(! k be e INSPECT ON: /j)"(v TYPE OF STRUCTURE: '5 ) Comments Y N N/A Footings Piers Monolithic Slab 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/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab / Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation.Insulation Interior/Exterior R-� 4l Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: 76 Queensbury Building&Code Enforcement Arrive: am/pm Depart:/ am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial ! ` NAME: C 0 C D ZZ /4 PERMIT#: "k 2' LOCATION: L./ 6./C.. /-t) D INSPECT ON: iJ TYPE OF STRUCTURE: Comments Y N N/A Footings Piers Monolithic Slab 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/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing *Foundation Waterproofing Footing Drain Daylight or SumpItc/ Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building & Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM /V /1 9-11 Foundation Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Dep. •: ' , pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: J Q l., 0 C I f a- PERMIT#: I<n—C/ < f LOCATION: '1 I p Lt AK 1+�ee /Rd INSPECT ON: 9 •- a6,/pi TYPE OF STRUCTURE: 5 r V Comments Y N N/A Footings Piers Monolithic Slab 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/Wallpour Reinforcement in Place V C7it' Footing Dowels or Keyway inplace C Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM --� -11,1)') . Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/p Depart: " pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: 9 NAME: G 0,2 C7 PERMIT#: 001 (i LOCATION: 't{ ( CIA K Vpc e Rd INSPECT ON: -as--/k/ TYPE OF STRUCTURE: S F b Comments Y N N/A Footings Piers Monolithic Slab 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/Wallpour Reinforcement in Place �7 n Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM lo - � Foundation Inspection Report Office No. (518) 761-8256 Date Inspection .0 c-' -.: Queensbury Building&Code Enforcement Arrive: ' .i a P / Depart: b.% s, am!. 742 Bay Rd., Queensbury,NY 12804 Inspector's I ' 'a s NAME: ' 'MIT#: t _ 2-- LOCATION: LOCATION: U 7 Svc le-bee /-1 , INSPECT ON: TYPE OF STRUCTURE: Comments f3Ct ACje AAQ-7•\--r— (CK N N/A Footings Piers Monolithic Slab 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/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM r' icl r Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/ m Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: (2 /)(0 f? Z ZQ., PERMIT#: 17 LOCATION: '9 K b to INSPECT ON: — I TYPE OF STRUCTURE: r Comments Y/ N N/A outings II Aridcy >. Q� ( Gl./ Piers l ;- Monolithic Slab 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/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM iwn of Queensbury Building &Code Enforcement h urs ✓I v Uffice No. (518) 761-8256 Septic Inspection Report Inspection request received: Name: (_T2 ( 2 24 Inspected on: /17 Location: 44 7 8.u(1. K b pto R4 Arrive: I mak a.m./p.m. Permit No.: I ' 1 d J) _ Inspector's Initials: Comments and/or diagram Soil Type: '/ m 1 lay Type of Water: Municipal/ Vell Wa Waterline separation distance left. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NO] Absorption Field: Total length � -c c5 ft. Length of each trenchL, ft. Depth of trenches 2. ft. Size of Stone Z, Seepage Pits: Number _r tPC Size: I� Stone Size: Piping Si • ype Building to tank L\`" Tank to Distribution Box (� '` Gr Distribution Box to Field/Pit Opening Sealed: P1141\1 C End Cap yie5 N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below gradeN [provide extension collar if Yes] N C ry ‘-)/ 5—S �� Yom `, 1 l Location/Separations Foundation to tank 10 ft. Foundation to absorption -eft. Separation of Pits . Conforms as per Plot Plan Y Engineer Report and As-Built Y ETU Maintenance Contract provided _Y N Location of S stem on Prose Front 'ear � Right Side Middle Front Middle Rear System Use Status: pproved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Septic Inspection Report