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2001-271
TOWN OF OUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 a.. Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010271 Date Issued: Thursday, April 25, 2002 This is to certify that work requested to be done as shown by Permit Number P20010271 has been completed. Tax Map Number: 523400-252-000-0001-026-000-0000 Location: 245 LOCKHART Rd Owner: CLAUDIA A JACKSON Applicant: CLAUDIA A JACKSON This structure may be occupied as a: By Order of Town Board Fireplace TOWN OF QUEENSBURY Garage - 2 Cars Detached Single Family Dwelling ijj Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 FON Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010271 Application Number. A20010271 Tax Map No: 523400-023-000-0001-029-241-0000 Permission is hereby granted to: CLAUDIA A JACKSON For property located at: LOCKHART 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: CLAUDIA A JACKSON Single Family Dwelling 170,000.00 227 LOCKHART MOUNTAIN Rd Garage-2 Cars Detached LAKE GEORGE,NY 12845-4905 Fireplace Total Value 170,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency STEVEN JACKSON • COMMONWEALTH ELECTRICAL AG NY PO BOX 706 HAGUE,NY Plans &Specifications 2001-271; 911 Address is 245 Lockhart Mountain Road Lk Geo. 1635 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR DETACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS $258.70 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,May 16,2003 (If a longer period is required, an application for an extension must be made to the code Enforcement Officer Dated at the Town o bury Wednesd y, May 16, 2001 SIGNED BY for the Town of Queensbury. Director of Building&Co E ement liutlaing Permit Application Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 /761-82561 J _o BUILDING & CODE ENFORCEMENT NOTJCEJ Requirementsprior to issuance A permitof this permit: PERMIT FILE NO. � (��'c>.- J must be obtained before G beginning construction. No inspections PERMIT FEE PAID aS g ? S* will be made until applicant has received 1-7 ZoningBoard Action a VALID BUILDING PERMIT. All Area /Use RECREATION FEE P $ applicants' spaces on this application MUST be completed and.the signature ED Planning Board Action REVIEWED BY: of the applicant must appear on the SPR / Suixlivision /Other Building Inspector pplication form. nr.st,ok J . -� Recreation Fee Payment Applicant: &/iziidit( A V C csOii Owner: 0..kzeh&A3—X& n ' Address: £L Xnc 'bni Ar& 'di laii4 Address: ` 9'Adf 41a/1i"ti .eG[, Mire &e,,uie1NV,Wi'5 �/�i "'Phone # ( ) - Ph,Iione # j 8224:3 -,,Property Location:,rdaleip-Ae",93-'/—a1 oqiii © , th /i ,/4 Subdivision Name: Tax Map Number cc q Section Block I nt NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE ,k/ New Building: CONSTRUCTION: $ 1'l0 OW C esidenc) / commercial Addition to Building: residence / commercial OCCUPANCY INFORMATION: Alteration to Building: Primary Building residence / commercial Single FamilREQPIED Residence / Commercial ' Two Family Dwel`� cch� no change to exterior size . Family D I� Vi.g, 2001 Office Other Work (describe below) Mercantile TOWN OF QUEENSBUR`/ Manufacturin$UOLOiPSU A1�0 CC}f-E Other GROSS AREA OF PROPOSED STRUCTURE: /9/,�� 1st Floor /� �O sq. ft (0a If ADDITION, what will use 2nd .Floor. . ., 5 5 sq, a,S,ob of new addition be? : Other Fluuts . . . . , sq. f ta83 �D �- (not unfinished cellar or basement) ACCESSORY BUILDINGS: N _ Detached Garage 1, 2 car 6)a5` TOTAL FLOOR AREA: /6, SQ. FT. Attached Garage 1, 2 car Private Storage Building SIZE OF NEW STRUCTURE: Commercial Storage Building 7b FEET X 38 FEET Other Foundation Type: I ( 11Ci . Will any second-hand or ungraded ' Number of Stories : lumber be used? If so, for what? (habitable space oryly) NO Height (grade to rjdge) : j feet TYPE OF HEATING SYSTEM: Number of fireplace and/or woo stove (circle all lies) to be installed:, / Electric / Oil C,' G_ si / Wood Forced Hot Air / aseboarc / Other Person responsible for su ervision of work as regards to building codes is : ,7 e_v- n Jè/(smi CoJr) 6kr--aa,45 NtiBuilder: C Y mjc�' dreshar` ON' i d e Phone 07g".)64S7—aa11 Plumber: S 'Pk, Jar ,kt,r, ,, f( Mason: 3--ho,ktvm L7Afri 01'j e 2 Electrician:� ,;,fin c S,o El rl DECLARATION: Please sign below after you have carefully read the statement. To the best of my knowledge the statements contained in this application, together with the plans and specifications submitted, arc 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 noted, and that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a Certificate of Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by a licensed surveyor; drawn to scale, showing actual location of project on premises. Signature: Aida __(�,t�f�'� dl1�4,1� (owner, owner's ent, architect, contractor) Fire Marshal's Office Town of QueenSL)urV. 742 Bay Road,Queettshurv, NY (518) 70-8205 Application for Fuel Burning Appliances & Chimneys. applicable to solid fuel & vented gas appliances Date `- 200 t Permit Noc2O L- 2- t Application is hereby made to the Building& Codes Office.for the issuance ofa Building and Use Permit pursuant to the New York State Fire Prevention and 13uilding 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. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information Fuel Burning Appliance Information (circle appropriate words) ; ' �' , Stove: ivood coal pelletC,c7.2) Name:ame: +�'Veitie, t t- t1 fireplace inser Address: ` �; -. g IiI ice,actor}wilt: wood gas f { II'C- ace, I asonr wood oils enlace wood gas/oil Phone: If nonmasonary applicance, please provide Owner: %' Manufacturer Name: /a Address: Model Number: Chimney Information Phone: ( fil & 4 (circle appropriate words) Masonry block brick stone Flue Ae7r, size: inches Exact Address: '" pp f oinstr•ttction or iusta Lion + Factory-Built Aft R r 1(41 M '`/ Manufacturer name: Model Number: :Vote: Listed By: Number: Construction /Installation must conform to NYS Fire Prevention &Building Indicate (circle) chimney material: Code. Consult available Town of Queensbury Handouts regarding required inspections. Double wall Triple wall / insulated I Direct renting Chimney Liner Caurh.ieac*' cp ix'tmearst--Tcyyrdsrzyt of Qzzeexiarbz y, N'xisr York 1 _ • Fire Marshal Code# S Collected S Refunded Received.from (rc.frrnded to): .C1W3 . •(11' } t F`. address: .4 173 3389 (190) Public Safety �� ,�. .4 233 2655 (230)Minor Sales [RzY L. 1 �tsfrti wLfi - ow, Gle.1( White(Applicant) , Green(Fire Marshal) / Yellow(Bldg. Dept.) Pink S.Goldenrod(Cashier's Dept.) Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: � '�// Office Use Location of installation: £ —/oc khad /Z Ent Jed, File Permit No. 09..x1"�7j Tax Map No. 44—ai 4,24/ I Q Fee Paid ( / Owner Owner's Name: � �t�-C/,r j C n ;'pl') Address: 4ar . AAA/74 /it&£1 71/ 46r 2. INSTALLER'S NAME : óhJk PHONE NO. 79 —O,73 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s)and multiply II of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older ? x 150 gal/bdnn = 1980— 1991 x 130 gal/bdrm = 1991 —present 3 x 110 gal/bdrm = 3ao . Garbage Grinder Installed yes / no Spa or Whirlpool Installed yes / no X 4. PARCEL INFORMATION: (circle applicable information &indicate measurements) • DNS) Q11 sls9 Q.l`9Aid Wat.9r Bq r.0_4 QLIMperYl4u4Atakril'1l Doi»pstic Wator.Suphly l7at sand at what depth at what depth nu c:lpal tolltn own C) feet _feet 41, teep slope t well; water supply %slope other from any septic-system depth: absorption is /Q ^fl. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: &gi, minute per inch 5. 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). Add 250 gallons to the size of the septic tank and leach f ld for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: gallon(min. size 1,000 gal.) Tile Field: each trench .C) ft. Total System Length: A00fl. Seepage Pit(s): number of size of each: fl. by fl. Size of Stone to be used: II .M / depth or thickness Bed System Size: x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Quoensbury, 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 those and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of respon le person Date *Z. ta CC CC .,-- 4 .* uo "Z- t.i..• .-- 41.Z. ‘..... 0 ,. . --** 0 (J) .4t• tI) *i.• Z 0 vs** Z 0 0- 0.)- - 4 *%• .....i .4.0 iii (10 40-- Ca T-• f.xl ....., u„. ,., 0) ..i.. ....... co,'‘ 'I. 0-05 00 )..15 ,n ..I 80 cc tec?c, 4 "tf...- CDu- - 00Z0 00 0 La 1.0 ul ti) 0 cl', ....bevc" ti,apv. • ......---- a- 4. v&.• -0 \S") (SN'b 0 .. ?P. 3. . . ...\•\'1>-..,\7;si,k At, %.• 1 ..., _ - _ - \e'y c2 N41' 09 I. \.. .0- " 00e..,, ez- ti,ci. .i.3 z . a ..n ......, z. ,, a„,... _ ......... „,, , . , k ..,(... ,...........------ ... 44 7. - ---- a: 0 cct .c, lit 40 ____.----- i I i ,di laq 4 co co 3.50 q14` tn I -14' Iti 0 c. It 1 0 (4. t(f) ' • 0 t Z" •-- .c.4 ‘121 al 1115 694 4,4, \e'' tr) 1 0 s 0 0 V $ ** 4 C4 1, %it ui co 0* t Vii s°S A a 1, Cl) 0 0 ‘2 < ce• 0 a- us i 6,) 70 vo.% 111011.4.4.1, / S -1 9.1 05101 P 4,f) t o • s 0 cl) 0 •-- txl cooc.> 0.1 0 0 0 0 '* Z.0- 4.0 .. r TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 BAY ROAD QUEENSBURY NY 12804 (518) 761-8256 ARRIVE: DEPART: INSP: 49/ FINAL INSPECTION REPORT Na (hotel, motel, apt. complex) DATE INSPE IO REQUEST RECEI a: NAME C U t (A LOCATION CX4e-t- DATE2i,"-d5A11101?7( PERMIT # g-D0/-01?/ TYPE OF STRUCTURE s•S‘C� FOOTINGS BACKFILL FRAMING PLUMBING INSULATION N/A YES NO CHIMNEY/"B" VENT/HEIGHT PLUMBING VENT/FIXTURES ROOFING EXTERIOR FINISH r\\ HEATING/HOT WATER RELIEF VALVES FLOORS 1 FOUNDATION INSULATION INTERIOR STAIRS/RAILINGS STOCKROOM ENCLOSURE . FIRE/DEMISE WALLS PENETRATION FIRE DAMPERS CEILING FIRE STOPPING FIRE DOORS/CLOSERS EXIT DOOR HARDWARE EXIT STAIRS/RAILS PLATFORM/ELEVATOR HANDICAPPED ACCESS HANDICAPPED BATHS HANDICAPPED PARKING FINAL ELECTRICAL SITE P /VARIANCE REQ. NAL SURVEY PLOT PLAN, IF REO OK TO ISSUE C/O OR C/C FIRE MARSHAL �'� TOWN OF QUEENSBURY QUEENSBURY, NY 12804 (518)761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST REC VED PERMIT# 0/' Z-7) NAME NJA<Oell LOCATION lociektor ib SCHEDULE INSPECTION ON I b_�____ AM PM ANYTIME APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGH NG FIRE EXTINGUISHE' FIRE ALARM SYSTE FIRE SPRINKLER SYS EM FIRE SUPPRESSION S STEM HOOD INSTALLATION INTERIOR FINISHt STORAGE: CLEARANCE TO S'' NKLERS CLEARANCE TO H k TING UNITS REQUIRED SIGNAGE CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT IA'*L— I/ REMARKS: OK TO THIS DATE (NSPSLIP.PUB INSPECTOR , ,, A A) _i--c ,AA,e__ ),--+AA RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: /2 /`l d 7 Building&Code Enforcement Dept.of Community Development Arrive am/pm Depar�� Town of Queensbury Inspector's Initials "� `-' 742 Bay Road Queensbury,New York 12804 (( NAME 4.. G 5(A-k) CI�b I F PERMIT# 2V 0%*. —Z LOCATION TTJ E4 S 6-144 eitrr ANT t (',c{ s DATE i2////(J( TYPE OF STRUC N/A YES O COMMENTS Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake / Plumb Vent through roof ✓ Roof Complete ✓� Exterior Finish Complete +//� Interior/Exterior Railings 30"to 36" +// Exterior Handrails,balconies,landing 1 in.or more ,// Interior Handrails stairs both sides 3 or ore risers / Grade 2%away from foundation ,// 8"clearance to sill plate ,/ Gas Valve shut-off exposed/regulator 18•above grade Gas Furnace shut-off within 30 feet or wi '' line of site y Oil Furnace shut-off at entrance to furnace .1 -: i` Furnace/Hot Water Heater operating ✓/ Relief Valve(s)installed Headroom,6 ft.6 in.on stairs t Basement stairs,6 ft.4 in. _ Handrail exterior stairs both sides more than 3 n.- s � Interior privacy/trim/doors/main entrance 36" Floor Finish Bathroom/Kitchen watertight _ ✓ Interior Handrails Balconies/Landing 18 in.or more /' • Railing across window in stairwells .. i Smoke Detectors: every level /Vy, every bedroom outside every bedroom ✓ inter connected Bathroom fans (7- Plumbing fixtures Foundation insulation1 7 V 3/4 hour fire door/door closer Garage fireproofing // Garage penetrations sealed 7 Furnace in separate room protected(in garage) Light ventilation per r \ ./. Safety glazing 18"or s fi qm ' ' t.7 Final Electrical 1 ' L( 6() Site Plan/Variance r u. ed 6u-tRu6. Final Survey Plot Plan v`a L"� As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) Okay to issue temp.C/O(Certif.of Occupancy)_ C`i C` y UC �j� C � Okay to issue permanent C/O(Certif.of Occupancy) \/ 1 WM1V1V1V WEALI tl ELEC:I KKC:AL INSPECTION SERVICE,INC;.(Jf -, Main Office 176 Doe Run Road-Manheim,PA 17545 ^'k) MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL ermit No. Cert. 7 3 5 5 8 Cut-in Card No. Iwner a Lfra 1 A- J XS', ocation A7 S 1'1 lc A 71-T Ai:Ai:Tv ,2O 8; 4. tst Nation Consisting of �C l I�.t f L 6(/2�'--�-f�, S-L 1 c ° '4 e—,e 'stalled By 5 ` a II Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issues incelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon itroduction of additional equipment or alterations,application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of ma_ki 'nspections at any time, and if Iles are violated,the Company shall have the right r oke t ifica . late/Z -6-0 ( INSPECTOR fi'1 )11 GENERAL INSPECTION REPORT 3 e7))1 ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart pm Inspector's Initials ' ' NAME C) i I Ck , ) PERMIT 06 LOCATION: =� QL i; r-V ,`oi DATE : i U Fpip :9J(. ..)) TYPE OF STR CTURE: RECHECK N/A YES NO COMMENTS Footings/Piers _I I- 1 Monolithic Pour orm Reinforcement i i Place I The contracto is responsib a for providing prot, tion from eezing for 48 hours fol owing the lacement of the concrete. Materials for this p rpose n site Foundation/Wallpo j Reinforcement'On Pla Foundation/Dagrtocfin g Backfill Approval Plumbing Under Slab ;, Plumbing Vent/Vents ii Place Rough lambing H ' g Rough-In sulationi/ Foundation Walls Inteior R- Foundation Walls Extet\ior R- Floors IR- Walls 4R- /9 ir:. Ceiling - 4,.E3 F Duct work or piping in unheated spaces - Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging . Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping 1 t tC?:F_C__----•‘ ‘ )‘,) GENERAL INSPECTION REPORT )--'� ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arriveam/pm Depart y m/ Inspector's Initial N PERMIT# LiI --0'7 / LOCATION: 4 , t �� DATE : ( �T=- �` ) 1 TYPE OF STRUCT'LTRE• AD RECHECK N/A YES NO COMMENTS Footings/Piers - -E i Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection fro zing for 48 hours following t e pla ment of the concrete. Materials for this purpose 3n site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Under Slab Plumbing Vent/Ve n P ce . Rough Plumbing Heating Rough-In , Insulation Foundation Walls Interi r R- Foundation Walls Exteri r R- Floors - Walls - Ceilin R- Duct ork or piping in heated spaces R- Pro r Vent,Attic Vent F ming 1/I ti � 1 w ) Ct o c Jack eade#s iiiStuds/H Bracing/Bridging ✓, Joist Hangers Jack Posts/Main Beam V Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour _ Firestopping ti ��fit,. t�:-A a— �k\ ,� i, OR b VC-0-\\51 CA FIRE MARSHAL ,O TOWN OF QUEENSBURY `� j QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED PERMIT# 1il I NAME CJ CVf T3r1 C-4011/41 LOCATION 2J/ ?ocJiie.1 in A) SCHEDULE INSPECTION ON IO 151 7001 t_30 AM(-NYTIME APPROVED N/A YES NO EXITS 0 AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM � C FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: 1 CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE 1 CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT i: 1/ REMARKS: OK TO THIS DATE Glc5 f P ET CV,._. \) \ \ ♦ lk., Sri► `► IN$PSLIP.PUB INS'i CTO'p GENERAL INSPECTION REPORT ( 518 ) 761-8256 M1 Town of Queensbury Dept.of Community Development Date inspection request received: _/'L_Cc, Building&Code Enforcement 742 Bay Road c7 ) Queensbury,NY 12804 Arrive am/pm Depart a}�p . Inspector's Initials NAME: Ct I.C1 PERMIT i-a7 LOCA DATE: TYPE S CTURE: --� RECHECK N/A YES NO COMMENTS Footings/Piers /16(5 Monolithic Pour Form Reinforcement in Place The contractor is reslionsi a forcNicur-tqael' t,1) providing protection • •m ing for 48 hours following I e r lacement of the concrete. Materials for this purpose ►n ite Foundation/Wallpour Reinforcement in Place Foundation/Dampproofin' Backfill App • Plumbing Under .• Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers 7/ Posts/Main Beam �.,��� 471 I*r Infiltration Bamer k � 1� " � �-� Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping ' P'-'' TOWN OF QUEENSBURY e,Q BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518)761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name CA. Locati on c ) N ;) Date\ '13. N Permit # 0 ) -J-7 / r SOIL TYPE: S nd-Lo -C lay- Results of Percolation Test- (if applicable) Rate-Mi ute/Inch TYPE OF SYSTEM: / ABSORPTION FIELD: T taT Length /c7P Length of each tren h Depth of trenche Size of stone SEEPAGE PITS: Numb= Size - ft. x ft. Stone size PIPING: S`ze Type Bldg. to Tank K 5,h2 I i Tank to Dist. Box X '7iC?Y2 35 Dist. Box to Field/Pit LE -7W1-4, Openings Sealed? Yes No Parti a LOCATION/SEPARATIONS: Foundation to Tank ___,c411: feet Foundation to Absorption feet Separation of Pits fe Conforms as per Plot Plan Yes1/-)ir No LOCATION OF SYSTEM ON PRO'ERTY: (circle one) dope Front - Rear - - Right Side Middle Front - • • e Rear COMMENTS: 4 v 664\t -r- Ae-i— Bci( L-r . , \--,,,,,,,f, , 7 ,,,___L-7 i ---. /Li _ -- ......._ ________- SYSTEM USE APPROVED: YES NO Arrived: Departed: r , \ /2 (....„,,, C Building Inspector W&u- P4M-77 ' — OK . . ) t 3r( TQWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY_12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name0'/*O4/ Location 1 vcLIkf ,2r kv-.. Date i�16/ Permit # c'l - Z7 SOIL TYPE: Sand-Loa -C ay- Results of Percol at'o Test- (if applicable) Ra -- 'inute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: stal Length Length of each en h Depth oftre - es Size of 'ne SEEPAGE PITS: Numb: r- Size - ft. ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box 11 Dist. Box to Field/P e Openings Sealed? - No Parti a LOCATION/SEPARATION` Foundation to Tank feet Foundation to Absorption _____r_ feet /Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle .. -• ,` Front - Rear - of Side - Right Side Middle Front A- Middle Rea \COMMENTS: , - o/cr Dr 4 ;- /7 -Co ./e� I/0 J S .-- OV\ - PcOY f Litik) b Et- APPi?tv> L fo u(k- SYSTEM USE APPROVED: YES #4 + Arrived: .71_2*. Departed: . Lam/ Building Inspector , f w a j. 1 c. LANDS N f F GRANGER � } .7, REC SITE al.- - MAYO r. .-A. \Sip 0 WO 554.24' TO E' O Q#�EEl SB ? ' --j7( on_ %na LANDS N/F =W �� , TOP OF THE I. 1. `� r� ��+ WORLD Lo) N p w �. s'�.� /---1-t5 0(7_7- 2, ' 6 M PROPOSED i\\\\-F3, (251251 li \ itill):P /"- - ,(_-_- 77(____- 0 I AREA = 268,874 f SQ. FT. 70P0� c3► " OR 6.172* ACRES 2 •�M i,�4 40140** ki\ i (0. 117 4?7TH o. .//: >Zvi, \ 0., os ""ate ! \ l WI evidence o is s� v6 SCR Of 0+,"tt ,or f �{Sad ao Inca all objects such - houses,wells,�r h `� rn �' shown an this d{ ume .t also a da a . i n set on the ' personably measured the distances � � �,��, I LANDS N/F dizeilz,•( ,,,444/tf• �,• -.04 v/ JACKSON SIGNATURE / ATE PROPOSED BUILDING LOCATION PLAN LANDS OF CLAUDIA A. JACKSON NOTES: TRUSTEE OF THE 1. BUILDING LOCATION PLAN PREPARED BY JOHN E. QUINN, JR., PLS JACKSON REVOACABLE TRUST 2. SUB, CT To ANY WGHTS, CovENANTS, EASEiriENTS oR RESTRICnONSDEED REF. L. 974 P. 104 OF R� TOWN OF QUEENSBURY COUNTY OF WARREN STATE OF NEW YORK N,..„\ NYS .QUINN, o,2ea 1"=100' 4-23-01 SH 1 OF 1 r r 1 9 aVi" GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury )i\+ Dept.of CommunityDevelopment Date inspection request received: Building&Code Enforcement 742 Bay Road m Queensbury,NY 12804 Arrive am/pm p De p Inspector's Initial �(- NAME: PERMIT#C7) 'a7.) LOCATION: .t.,Ut. ,Z � Y T()? DATE: -"7-'c TYPE OF STRUCTURE: RECHECK N/A YE/NO COMMENTS Ntf, ing a CC�`c'c�, I Monolit our 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/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier , Fire Separation 1,2,3,hour _ Penetration Sealed Fire Wall 2,3,4 hour Firestopping 911 GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart a r o •m Inspector's Initials NAME: PERMIT C.gen) O�7 / LOCATION:• �Z— ,� DATE: `7— 9 'c?-00 J TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers I I Monolithic Pour Form Reinforcement in Place The contractor is 'ble •r providing protection i,'m freez g for 48 hours followin:the places -nt of the concrete. Materials for this purpo•- on site Foundation/Wallpour Reinforcement in Place \;oalatiotiManipproo 11 Approval Plumbing Under Slab Plumbing Vent/Vents in . Rough Plumbing Heating Rough-In Insulation Foundation Walls Interio R- Foundation Walls Exterior R- Floors R Walls It- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Iafiitration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping , 1 CI GENERAL INSPECTION REPORT ( 518 )761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: i G^40 Building&Code Enforcement 742 Bay Road ..10.9A) Queensbury,NY 12804 Arrive am/pmDept�(ppp�Inspector's Initials NAME: ei 1 PERMIT# Z,-1) `D / LOCATION: TE / N TYPE OF STRUC RECHECK `..._._ N/A YE/NO COMMENTS dr tin `ers ce.)Monolithic Pour Form Reinforcement in Place - 1 The contractor is nsib for U OF providing protection from friezing if for 48 hours folio' • the placement i of the concrete. Materials for this purpo on to G'� pA-714- Foundation/Wallpour Reinforcem- , .. r,«- pc-er' Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R Foundation Walls Exterior R- Floors R Walls R Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping