2001-506 TOWN OF QUEENSBURY
Flo/co
742 Ba Road ueensbu NY 12804-5902 518 761-8201
v ,Q rv, ( )
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010506 Date Issued: Thursday, December 20, 2001
This is to certify that work requested to be done as shown by Permit Number P20010506
has been completed.
Tax Map Number: 523400-308-005-0001-026-000-0000
Location: 4 GLEN Ct
Owner: MICHAEL J VASILIOU INC
Applicant: MICHAEL J VASILIOU INC
This structure may be occupied as a:
By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Garage - 2 Cars Attached
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010506 Application Number: A20010506
Tax Map No: 523400-308-005-0001-026-000-0000
Permission is hereby granted to: MICHAEL J VASILIOU INC
For property located at: 4 GLEN Ct
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: MICHAEL J VASILIOU INC Single Family Dwelling 190,000.00
23 SUNNY WEST Ln Garage-2 Cars Attached
LAKE GEORGE,NY 12845 Total Value 190,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2001-506 LOT 9 HSE#4 GLEN COURT
2032 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$291.96 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,July 09,2003
(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 of Queensbury; Monday,July 09,2001
SIGNED BY J — for the Town of Queensbury.
D. .�•�. B g`rr1;"o.\ nforcement
1 ':
101 TOWN OF QUEENSB� f
• +1.,•,c a,1 1, : APPLICATION FOR SEPTIC DISP_OSA R�IS"z001 Permit # oZool-AY,
Fee Paid
d S( ® � eeNSBDR�
AND Co®
Date: ,6 2 6- , eviewed By
LOCATION 0 PROP RTY FOR INSTALLATION: ,_ 9 -i' K'e_tr-
Owner's Name: A4 � -._ = j, V4"5/4_/n cf Aro-Qa c
Owner's Mailing Address: 2 7 ,Zs ,( I,( . -r /4-, Jc_. tk_ 6E13,,
Installer's Name: 47) 11) ` 'f Phone #:Number of bedrooms (if residential ) : 41. 7 w 2_,-2_
Total daily flow (residential-compute @ 150 gal . per bedroom) : 3-0 6
Topography-Circle One. Flat. Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? ' o 4 f kveAD
Bedrock or Impervious Material-At What Depth? AMre- Feet
Percolation Test-Circle One: Not Required quired/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municip— a We1l Other
If domestic water supply is a we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank /ôôô gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench `,57
afeet//Total System Length 4R feet
Seepage Pit(s): Number of / Size each: ft. x ft.
Size of Stone to be used: # Z.- / Depth or Thickness 2., feet
**************
HOLDING TANK SYSTEM IF REQUIREp
• No. of Tanks Size\of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
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 Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE:
Application for Permit-Septic Disposal System.
Town of Queensbuuy 742.Bay Road Queensbury, NY 12804 (518) 761-8256 Ci
1. OWNER INFORMATION:
9 : Office Use
Location of installation: L � �,�/-
3 _E7`1 0 7 I File Permit No. f2*�}uc S
-V
Tax Map No. 00 / (21./ et; F
Feea �
IED
Owner's Name: m C CF7 �-- tl e ( /„ 1&„ 0 f
2001
Address: c�CliCl/11 `r ®�N OF
®VILDIN AND CSgURY
2. INSTALLER'S NAME : "T 0-c {�C PHONE opE
3. RESIDENCE.INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply# 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/bdrm
• 1980- 1991. x 130 gal/bdrm =
1991 -present x 110 gal/bdrm =
Garbage Grinder Installed yes_ / no
Spa or Whirlpool Installed yes, / no
5 4-1c late of
ii 4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
To.o t ra.h e Ground Water Bedrock or Impervious Material Domestic Water Supply
at ; 4 san " at what depth at what depth municipal
•o ling Toam Atom 4 feet itati-.�/feet well
Steep slope clay if well; water supply
slope other from any septic-system
depth: absorption is ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: 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 field for each Garbage Grinder,Spa or Whirlpool Tub.
Septic Tank: G —gallon (min. size 1,000 gal)
Tile Field: each trench b y ft. Total System Length: /or ft.
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # / depth or thickness . feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
I '
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 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.
Sign re of resp sib e person ._ Date
-210-
7
4 5idac L
_s. ENERGY CODE COMPLIANCE APPLICATION
mEe
v0 = TOWN OF QUEENSBURY, WARREN COUNT
:frkm‘
___• 9000 HEATING DEGREE DAYS
L Li
Compliance Methods : PART 5 - Acceptable Practice thud -
® 9 20Di
1&2 Family DwellingsQUE -
• PART 6* - Thermal Rating - Co ,I 1 y
1&2 Family Dwellings; Multi-al • DE
Dwellings (3 stories or less) •
PART 4* Design by Component Performance
- Commercial Buildings_Hi Rise Residential
Ac li.A. 1 ‘j V 111-Si Z_ /CO ii(-)C I 4_6'7'*Reauir s submission pf worksheets
APP ICa T' S NAME : PROPERTY LOCATI N: �� � �
6et
PART 5 t€THOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - /7 7p"-- scuare feet
•
2 . Ty-Pe of Heat - Electric Oil Gas Other
3 . Is building mechani alls. cooled? No _
4 . Percentage of area of windows and doors Over 17= Under 17%
5 . VA ,UES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R 30
b . Exterior walls
c . Glazed areas R 7e y-
d . Exterior doors R
e . Floors over unheated spaces R ---�- -
. Edge of slab on grade (heated building) R
c. Basement/cellar walls (above grade) R
h . Basement/cellar walls (below grade) R
i . Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heati nc device
Conforms to minimum efficiency per code Yes No
TEMPER_3TUREN.CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
App Sign ' u=ems Da- __ _
c,.._(•-____ /-7-40.....„-
-691-..,C) O7 Vo/
TNS?=C-0R' S REMARKS:
. Building Permit Aplice:awn sw0...47'Z.
Town o ueens rr
f Q �u - Dept, of Conutuinity.Development, 742 Bay Road, Queens•bury, NY 12'804 1761-8256J
IN07104
"0 BUILDING & . CODE ENFORCEMENT Requirements, rior to issuance
p r r��
A permit must be obtained before of this permit: PERMIT FILE NO.�N/, S64
�
beginning construction. No inspections
will be made until applicant has received (—I Zoning Board Action PERMIT ! , - •'�. IGS '�
a VAI,ID BUILDING PERMIT. All ;' 09/ '
Area /Use •
,/'
applicants" spaces on this application ",' �'1- ; I rr, .�q
MUST be completed and•the signature '"'
of the applicant-must a Planning Board Action VIEWED.BY PP appear on-use JUL ® 9 z0u1 .
plication form. SPR / Subdivision /Other . Building Inspector
r, J ecreation Fee Pam W /
Applicant: le ci C 0 ..� Diimu-AND 0••• _
. ' Address: 7 ��lU (ARO. . Lts) Address: L« V_ d.
y y'
•
• Phone # '(5 • ). d Phone # ( ) - C�
Property Location: 44.17 # • 9 /c t y•- 396O / Z�� '" �`
Subdivision Name: �/ri L? �, Tax Map Number --__/ l I�`y
Section Block Lot
NATURE� OF PROPOSED WORK: ESTIMATED MARKET V LU OF THE
+�C New Building: CONSTRUCTION:- $ 1 q0 coo
residence / .commercial
Addition to Building: -
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial .Single. Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior -size Family Dwelling .
Office-
Other Work (describe below) Mercantile
Manufacturing
fi Other . .
GROSS AREA OF PROPOSED STRUCTURE: •
/�3°�"� If ADDITION what will use 1st Floor s ft .
2nd .Floor • q of new addition be? ^
sq. ft. �i�
Other Floors
sq.. ft.
(not unfinished cellar or basement),
ACCESSORY BUILDINGS: 0.20 X02.
Detached Garage 1, 2 .car J
TOTAL FLOOR AREA: • SQ. FT.. .Attached Garage 1,1:75
0 3arj Private Storage Building 09
SIZE OF NEW STRUCTURE: r , . Commercial Stora e wilding S
#44 J G
/ FEET X 63 FEET t 566. '' Other
1`�� ,()
Foundation Type: PO UtQ e) Will any second-hand or ungraded
Number of Stories : lumber be used? I so; for what?
(habitable space .only) "to
Height (grade to ridge) : feet TYPE OF HEATING- SYSTEM:
Number of fireplaces and/or woodstove (circle• all which . - s .lies)
to be installed: Electric / / Wood
Forced of Ai / Baseboard / :Other
Person responsible for supervision of 'work as regards to building
codes is :
Name r Addresss • Pho e
Builder: /' G� � ,.J. V14S/‘teitJ ®.�.,�C 4.�. --. 'end
• Plumber: 0! ri�4.�., �,.ttP 9 � ``` 441 9�Marlon: �-J A-•Q Ye.- X n Ar!'il '7"s 7%'? v COL?.
Electrician:�.n L;f�cr�ec 'e -7-YeIC, — 79 - 2-// 7
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, 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 noted, and
• that such work is authorized by the owner. Further, it is understood that Uwe shall submit prior to a
Certificate of Occupancyor Certificate of Compliance being issued;. an AS BUILT PLOT PLAN by
a licensed surveyor; drawn t scale, show'ng-actual location of project on premises.
Signature: . • . •
(owne owner's agent, arc itect, contractor)
TOWN OF QUEENSBURY
,4411110k3,, BUILDING & CODE ENFORCEMENT
742 BAY ROAD
t,, retr` QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT
COMMERCIAL MULTIPLE DWELLING
(hotel, motel, apt. complex)
DATE INSPECFTION REQUEST R CEIVED:
NAME '1 'e �V - d5 \G�
LOCATION, 01-6 I / s,
DATE la--c l O( PERMIT # {/( —SJ(J(.40
• TYPE OF STRUCTURE Scy)
FOOTINGS BACKFILL FRAMING PLUMBING_
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT/FIXTURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES
FLOORS
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 PL /VARIANCE REO.
AL SURVEY PLOT PLAN` IF REO lb
OK TO ISSUE C/O OR C/C
•
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: .II f/
Building&Code Enforcement
Dept.of Community Development Arriv. • •n Depatr• nip
Town of Queensbury spector's Initials /
742 Bay Road 1//
Queensbury,New York
` 1_2804n j - l,,,-� �
NAME Xl"-ti V C.t -Ul,l PERMIT#C /�j u"(0 '
LOCATION `1 -LQ �S Q Q.L. / DATE r `7 J U
TYPE OF STRUCTURE S' � L., 6
tb� `14 SC ,.
YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location 't// '
Fresh Air Intake i/
Plumb Vent through roof ✓,
Roof Complete v//
Exterior Finish Complete V
Interior/Exterior Railings 30"to 36" f
Exterior Handrails,balconies,Ian ' g 8 in.or more f /
Interior Handrails stairs both sides or ore risers V -s�L t�� h7T-N ` A�D �L
Grade 2%away from foundation s�� `��\�d ,, V ,.,5,�\
8"clearance to sill plate ��Z 1.., 'C
Gas Valve shut-off exposed/regulatx 18'l above grade .1
Gas Furnace shut-off within 30 feet or wi in line of site V
Oil Furnace shut-off at entrance to Enna e area 1../
Furnace/Hot Water H ter operating
Relief Valve(s)install I / J
Headroom,6 ft.6 in.on s V
Basement stairs,6 ft.4 in. 7l
•
. Handrail exterior stairs both sides m re than 3 risers
Interior privacy/trim/doors/main en ce 36" i / \)°C'Z 7�� v. vvP � _- D t--k
Floor Finish 1 _
Bathroom/Kitchen watertight ./i \-3tAu_. C5��t' Q CC,p.
Interior Handrails Balconies/Landing 1 in.or more ,/
Railing across window in stairwells V
Smoke Detectors:
every level
every bedroom ,�/ ���_. L�5 _�k'& i
outside every bedroom v�
inter connected V --r'0 l)-i DDT �Q i
Bathroom fans 1"\
Plumbing fixtures /
1 Foundation insulation .
3/4 hour fire door/door closer ! 11 1. (�1L_ p t .Q;C� \`( 1?%
Garage fireproofing �/
Garage penetrations sealed
Furnace in separate room protected(in garage) J — 1 Th -T�l�� ����b �'
Light ventilation per room r
pv
Safety glazing 18"or less from floor t� .
Final Electrical — ����
Site Plan/Variance required l€9 'V' e c vk
mry
~- �sal Built SepticeyPlot SystemPlan
layout required
Okay to issue C/C(Certif.of Compliance) .`"', Si
��� �
Okay to issue temp.C/O(Certif of Occupancy) u ' 6 �
Okay to issue permanent C/O(Certif.of Occupancy) 7bV-C--H
\:)\-,\-3(=, Cr % Ac .
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arrive `: pi psi2 t 'part , ',Pal 1�.t
e?
Town of Queensbury t e- tor's 'A als ` A
742 Bay Road o
Queensbury,New York 12804
NAME
LOCATION A `(�61 L1[ \ � 1 Z 1 Z
T# o ab
►-} c2,L_F 1, G1t if DATE
TYPE OF STRUCTURE -6�'n v.:.)) Z- CAR C.�
N/A YES NO COMMENTS
Chimney Heights"B"Vent/Direct Vent Location V '
Fresh Air Intake
Plumb Vent through roof
Roof Complete /\
Exterior Finish Complete \ v'
Interior/Exterior Railings 30"to 36" \
xterior Handrails,balconies,landing fp in.or more % f
VIntenor Handrails stairs both sides 3 or#core risers �f
Grade 2%away from foundation i1�Tt , ,/
8"clearance to sill plate ! C f-*•,.01 tt', h V
Gas Valve shut-off exposed/regulator 18"above grade , ••/,
Gas Furnace shut-off withini30 feet or/within line of site
/it Furnace shut-off at entrance to furnace area
urnace/Hot Water Heater°f�crating/
Relief Valve(s)installed \ V
Headroom,6 ft.6 in.on staff ---
Basement stairs,6 ft.4 in. r/
)Iandrail exterior stairs both shies more than 3 risers ," /
%Interior privacy/trim/doors/mainyentrance 36" _ RFD Roc)t \ GPiTiN QOo(2.6
Floor Finish `, J
Bathroom/Kitchen watertight i /
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells;
Smoke Detectors:
every level
every bedroom I J/,
outside every bedroom I
inter connected I +/
Bathroom fans_ I ./,
Plumbing fixtures I V`
Foundation insulation / J
hour fire door/door closer ''''.°
/4
arage fireproofmg V
Garage penetrations sealed J
Furnace in separate room protected(in garage) i J
Light ventilation per room
Safety glazing 18"or less from floor V,
Final Electrical / J
ite Plan/Variance required i
mal Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance) f
kay to issue temp.C/O(Certif.of Occupancy)_ `/`
Okay to issue permanent C/O(Certif.of Occupancy)
V 2-�--low
TOWN OF QUEENSBURY .
BUILDING &CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
r
Name \, 61..E
Location G ry
Datel { - /` -JQ� rmit #0/ - ,�n (2
SOIL TYPE: d-Loam-Clay-
Results o' Percolation Test-
(if applicable) ate-Minute/Inch
TYPE OF S TEM:
ABSORPTION FIELD: Total Length
Length of -.ch tre ch
Depth of troches
Size of stop-
SEEPAGE PITS: Nu '.er-
Size - fr. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fi -ld/Pit
Openings Sealed. Yes No Partial
LOCATION/SEPA' , IONS:
Foundation to ank feet
Foundation to Absorption feet
Separation of Pits _ feet
Conforms as p-r Plot Plan Yes No
' LOCATION OF S STEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
-�`v-' Ci??i7 ‘
-- ma c %
SYSTEM USE APPROVED: Y NO
. ,..
Arrived- h�°-3h
Depar ed:
F/
t
Bui ding Ins of or
v
illik i
Q—
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804 A-
(518) 761-8256 iC
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 1 N-e �QIbY),i cr4 . --
Location
Date ,., - ilk - Permit # 0 ) --,c0 6
SOIL TYPE:Aan Toe-Loam-Clay-
Resul is of Perf of a .ion Test-
(if applicable` Rate Minute/Inch
TYPE OF SYSTEM
ABSORPTION FIE D: To al Length . 1 (0-)
Length of each trenc y,—‹
Depth of trenc es ; ‘ - i
Size of stone
SEEPAGE PITS: umb-r-
Size - t. pC ft.
Stone size /
PIPING: Size Type
Bldg. to Tank / i^i'i /-) 44n
Tank to D�ist.�"b /1 INce
Dist. Box 'Fie d/P ' 1-11) 4 Y%
Openings Sealed? Ye No Partial
LOCATION/SEPARATI'6
Foundation to Tan 1---) feet
Foundation to Abssrption )1,_> feet
Separation of Pit _ fee Conforms as per Pict Plan Yes "�.
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Fr ea - Left Side - Right Side
Middle Front Middle Rear
) `1\\ --- ‘n--- 1_ L ',\-) cp36
\ L--t i\) •_S 1 ft5.___Jot-05---
SYSTEM USrW)
D? YES N
Arrive . ti �;' ,
Depa ed: ;_
uii ing Inspect'o
(/
FIRE MARSHAL
`/11111110..
_ TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT#(1I 0(2
NAME \\(\
\ e
LOCATION 7 G.-1 e Y-1 0
SCHEDULE INSPECTION ON ) ) - J3 c )(9O)
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM /
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINK!ERS
CLEARANCE TO HEATING• UNITS
REQUIRED SIGNAGE I
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
F REPLACE-FACTORY BUILT 'CAA- V!
REMARKS•' 2_0gr. OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
FIRE MARSHAL
TOWN OF QUEENSBURY
Fir , QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT �
:l)
REQUEST RECEIVED V/3/0) PERMIT#
NAME �' Cyr-5 (7/- ,5
LDCAT ON✓� _ C���� c�
SCHEDULE INSPECTION ON /i r 3 v/
02-7 e"'`"`)' CTr�(� , DI PM ANYTIME
/'"� �I APPROVED
I� N/A YES NO
EXITS
AISLE WIDTHS \
EXIT SIGNS
EMERGENCY LIGHTING
}
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM I
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION\SYSTE
HOOD INSTALLATION" —
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPR NKLERS
CLEARANCE TO HEA ING UNITS
REQUIRED SIGNAGE
/7
CHIMNEY 1'
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT P611 . /Ai
REMARKS: ❑ OK TO TH ATE
J
>l e OL C /..cJ s— �/}'J/a
60-74A.fr"7 b C'pcL c S c-L-r0•
U �
INSPSLIP.PUB INSPECTOR
4/1)G//O R- OA) r ' (/3 CD
1 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 Arrivg°313� pm epartg.`-y 1..if ,
spector's Initials i�,�,�
• l •
NAME:Va,...),1 }-s _ PERMIT# Oj '1 •
LOCAT ,► (1U..
- Q -7‘Q_&-72,n DATE : 1L- 7 I
TYPE OF STRUCTURE: )
RECHECK •
N/A YES NO COMMENTS
Footings/Piers I—F f
Monolithic Pour Form
Reinforcement in Place
The contractor is responsi.le • r
providing protection fro freez. g
for 48 hours following thi placeuient
of the concrete.
Materials for this p rpose o r site
Foundation/Wall r
Reinforcement in ace
Foundation/Damppr :I-
Backfill Approval
Plumbing Under Slab_
Plumbing Vent/Vents in P ace ,
Rough Plumbing
tang Rough-In
nsulation
Foundation Walls Int 'or R-
Foundation Walls E rior R-
Floors R-
Walls R- !R Z.
Ceiling R-
Duct work or piping i
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 t Q U\C_-
‘\ -DR ‘i6
_ y�'1---�
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. ' 7 da I Depart 164ftle
Inspector's Initia :PM"
NAME: i(Ai)1'I-,t C)L) PERMIT# (Pi —c ,r i, 111
LOCATION: 9 G t<e_la cc) 0 a�T DATE: t'— —•
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible
providing protection from fre zin
for 48 hours following the p1 ceme t
of the concrete.
Materials for this purpose on six
Foundation/Wallpour ' .
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Und Slab
Plumbing Ven is in Pla
Rough Plumbing
Heating Rough-In /
Insulation �/
Foundation Walls Interio R-
Foundation Walls Exteri q r R-
Floors -
Walls '-
Ceiling '-
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 ✓ t.7Z- PEP1S)3
e-cFrEC_V--- t P.K,
Li., -- \ L'-).C. \---- Ain
Y ,},:;J :,qL,-ifl:,
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road 1 t%'.
Queensbury,NY 12804 Arrive Depart -;,-r ttiv g
Inspector's 1k' ' 1.
mil r
NAME: \--,,,\-
t _ PERMIT# v� l
LOCATION: 2 ,C e,r DATE :
TYPE OF STRUC : F'
RECHECK
N/A YES NO COMMENTS
Footings/Piers - I 1
Monolithic Pour Form C-�`��1 DF �!�\ !�b
Reinforcement in Place !J- -�L t ) t� v -,`c
The contractor is responsible fo
providing protection from freez, g A c)V V t c 1,!f--V
for 48 hours following the place nt .-
of the concrete. cOtoo,,j `V6 _c__ 6 v \N X__
1 Materials for this purpose on s - _
Foundation/Wallpour U V-�, 0 �!��7 \
Reinforcement in Place
Foundation/Dampproofing F\ ,A___ Go-' \F)e p3E1 O".
Backfill Approval
Plumbing Under Slab — LVcj- L --- 6 e1L-
Plumbin ent/Vents in Place
Rough umbing �°Hea • g Rough-In1:111 W!1�DC�v3b
I uiation D CD�S-421j ej .V--0V_E___ \ RA t,`
Foundation Walls Interior R- ( y
C
Foundation Walls Exterior R-
Floors
�� S -E \ k�\.
Floors R-
Walls R- 11.
FI
Ceiling R- V ) - ‘060 --
Duct work or piping in sV ( \ �
unheated spaces R- i �� jProper Vent,Attic Vent � f �e � �I . b�
Framing Y' LA Z 1� C a
Jack Studs/Headers
Bracing/Bridging
Joist Hangers t `.3t_i,"Tv t S
Jack Posts/Main Beam \\tJ
Air Infiltration Barrier i _T
Fire Separation 1,2, 3,hour >� G V- '-V- -� �c)
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping V
eres2—AK;k_._ k,\g_ ___ wc:L C
�uv ._ moo; c( }-t
Pr_)c3
\ 0 C-6 t•-\\) ,6,\E.t.-r--e,c_e_ FDF____ (--EAL) 13
/' ca i i _ i,O C7 '1 \ t..--A h/ - c— , _ - ,n: c '3-1-7, 1 i
FIRE MARSHAL 47))7
TOWN OF QUEENSBURY
` :CS QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST,RFCEIVED PERMIT# b 1 - 1)-
NAME Vn i ,��61-A__ ,
LOCATION
SCHEDULE INSPECTION ON )0 ,6' 1
W- r) M P ANYTIME
APPROVED
N/A YES I NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES ci55Y
STORAGE:
CLEARANCE TO SPRI LERS
CLEARANCE TO HE A ING U i
,� 1 j
REQUIRED SIGNAGE \� ` \ /
CHIMNEY 0 �9`
WOOD STOVE c
FIREPLACE-MASONRY , /
FIREPLACE-FACTORY BUILT
REMARKS: ❑ •K TO THIS DATE
F1?,- Th\b 0 k tOST a
\ ti ` %r
INSPSIIP. UB ,: INS ECTOR
1
e)"EIC-1 -(3C1 Alt_ 1(') 1 3 h S
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 ArriveZ,.rat Depart f • p
spector's Initial•
NAME: \,l AIj 1 L1[S) PERMIT# 1 i a •
LOCATION: 9 C e,C:471— DATE : I • t
TYPE OF STRUCTURE: c'J F®
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form 1
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 ton site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slabs '
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
•-• ed spaces R-
o.-r Vent Attic Vent
• Fraariing ,.61— 'Fuuc'V.—
Jack Studs/Headers
Bracing/Bridging 1 a:bTt�t� C_rRTEALq\ eeflCE_ e
Joist Hangers A,L30 0 E ,5e C—
Jack Posts/Main Beam `0 i i\G4\i'‘o l,.ENJ G am"T 0
Air Infiltration Barrier / ��-- -mod
Fire Separation 1,2, 3,hour
JPenetration Sealed
/Fire Wall 2,3,4 hour
J Firestopping6 a^—ei_ �1 L1� 1 �DCR—
L0 c `)-\ \--1E13
pOOI
CAA .To _ tti36 -vl E r— v cue At' PE
Li_ //V
1 1,‘0/17, ---/---.=--
a:
GENERAL-INSPECTION ' Ta
( 518 ) 761-8256
Town of Queensbury
Dept. off Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road "'�
Queensbury,NY 12804 Arrive- ita pepart , r C( •
Inspector's Ini
- l►L�_
•
NAME: (, �� ,� (5) * PERMIT#
LOCATION: 0� Yy�� °, -G-l?rv. DATE : /U-a,,l'-JC O J
TYPE OF STRUCTURE: SFn
RECHECK
N/A YES NO COMMENTS
Footings/Piers Imo- 1
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following t'e .lacement
of the concrete.
Materials for this pu .• e on .ite
1 Foundation/Wallpour
Reinforcement in Pla e
Foundation/Damppr,i ofing
BackfilI Approval
Plumbing Under SI,b
Plumbing Vent/Ve is in : ace
Rough Plumbing
Heating Rough-In
Insulation_
Foundation Wal nterior R-
Foundation W. Exterior R-
Floors _ R-
Walls R-
Ceiling R-
Duct work or pipi k g in
unheated spaces R-
Pro7r Vent,Attic Ve 1
,r ming
Jack Studs/Headers I /
Bracing/Bridging v Y ez f�
Joist Hangers cV"-� � \"'` �e �`� _Ti
Jack Posts/Main Bea .— A� v 4 --\6 C,
Air Infiltration Barrier 7 i tv -‘t Ll_ '�j�Av_`t
Fire Separation 1,2, 3,haur _ t�Li-ci.
Penetration Sealed ' 9=,;(kI.,/ M11. , 1 (.tgV v `
Fire Wall 2,3,4 hour \ ` ��C `bE��
Firestopping ® , Pg 1 !�� RL�. ��� `
�- L -� , \
Ft c e- GI?),
. tc �
i T
FIRE MARSHAL
/ '. TOWN OF QUEENSBURY
c �Y QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# Zoo'
NAME 'O
LOCATION Lt (-Et) CP iL\{
SCHEDULE INSPECTION ON
43b AM M A YTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
F1 4
REMARKS: OK TO THIS DATE
INSPSLIP.PUB INSPECT
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road JO f
Queensbury,NY 12804 Arrive am/pm Depa.v. = ate/ m
Inspector's Initials �J
NAME: 1 i'ct,� ��1 PERMIT
LOCATION: -5-1 Q DATE : ";WO/
TYPE OF STR TURF:
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1-7-1
Monolithic Pour Form
Reinforcement in Place
The contractor is respo sible for
providing protection fr freezing
for 48 hours following t e placement
of the concrete.
Materials for this purpose o site\
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plac-
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inte-*or 1'- ,
Foundation-Wall erior '-
Floors R-
Walls R- _
Ceiling R-
Duct work or piping in
unheated spaces R- (R.
',.•per Vent,,AAtic Vent
L U 6gPrq j fAiv'
„ramit .y.
' Ja is tuds/Headers
Bracing/Bridging
JJoaciskt PHoasntsg/Mersa in Beam
//
1rItnBaTnerI }4 ,�re Separation 1;2,-3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping Cie C_ (mod' e-C l‹
G �
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:_ a /
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart
Inspector's Initials
NAME: . U s [ o�• PERMIT# alp l —D 61-'0�v
LOCATION: /- r) 06, DATE : ;71-7 4)/
TYPE OF STRUCTURE: 7
RECHECK
N/A YE NO COMMENTS
orin s/Pi r I
Monolithic Pour Form
Reinforcement in Place \`J L
The contractor is respo ible�or
providing protection fr m free'ing
for 48 hours following e pl went
of the concrete.
Materials for this purpose n site
Foundation/Wallpo _
Reinforcement in Place
e
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 I,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
GENERAL INSPECTION REPORT
( 518 ) 761-8256 � r
Town of Queensbury r,
Dept.of Community Development Date inspection request received:
Building& Code Enforcement c,}�,�\?
742 Bay Road C,
Queensbury,NY 12804 Arrive G m Depart j ;��
spector's Ini . .!
NAME: 1 `J) i CR�. D1 Cil ll3? PERMIT �� C,)J�0 Ce
LOCATION: I - C"SI e:�� rn:�C DATE: ,v j
TYPE OF STRCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Plac-
The contractor is espo sible for
providing protec h on fron freezing
for 48 hours foll)wing the •lacement
of the concrete.
Materials for this p rpose on Si
Foundation/Wallpo r
Reinforcement in Pl.ce
Fours ion/Damppr.efing
11 Approval \' C-� b �j j 1 LL O
Plumbing U der Slab 1
Plumbing yen►•. - i Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inr-rior R-
Foundation Walls E f erior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping i n
unheated spaces R-
Proper Vent,Attic Ven
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
Firestoppin.
.1111
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
Inspector's Initial C
` PERMIT# 4 0/--`��e
NAME: �kxs-
S�6�!U
LOCATION: ^ --1 DATE : —
TYPE OF STRUCTURE: ��FD
RECHECK
N/A YES N COMMENTS
/ootings/Piers •
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
�'° p C�
providing protection ' om -
for 48 hours followi g the place 'ent ��� k°6-41/4 r
of the concrete.
Materials for this purpo•a on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Damp.
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Pla e
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior -
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
j6, h
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.off Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road fr, 4/ ,�
Queensbury,NY 12804 Arrive am/pm Depart p nv
Inspector's Initials 4
NAME: tt_ PERMIT# t/ �/" e
LOCATION: t KC. 6,cc of DATE : 6 leo ('6
TYPE OF STRUCTURE:
RECHECK
N/A S COMMENTS
Footings/Piers 1 I
Monolithic Pour Form
Reinforcement in Place 2
i
The contractor is responsible or
providing prot- tion-fr 3 m freezing
for 48 hours fo lowing the placement j C/ -02'>
of the concrete.
Materials for this eu se on •ite �' /
Foundation/Wallpo r
Reinforcement in PI 1 ce
Foundation/Damppr'ofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/V-- i Place
Rough Plumbing
Heating Rough-In
Insulation ,
Foundation Walls Inte 'or R-
Foundation Walls Exte 'or R-
Floors -
Walls
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
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax - 518-792-8511
a'CPC)
J 0(.9 December 31, 2001
Job # 46024
Mr. Glen Bruso
New York State Dept. of Health
77 Mohican Street
Glens Falls,NY 12801
RE: Lot#9 —John& Dorothy Schwartz, purchasers
The Glen Subdivision (Vasiliou—off of West Mt. Road)- Queensbury (T)
Dear Glen:
This letter is to inform you that I inspected the completed septic system for the house on Lot #9
in The Glen Subdivision on December 11, 2001. The house being constructed on this lot is a 2
bedroom house with no expansion attic, no garbage grinder and no hot tub/spa.
The septic system as installed consists of a 1,000 gallon septic tank and 165 lineal feet of
absorption trench. The installation conforms with the requirements of the approved subdivision
design drawings.
Please call me if you have any questions or concerns.
Sincerely,
Thomas W. Nace, P.E.
cc: Dave Hatin, Town of Queensbury
Michael Vasiliou—fax 668-5656
/-VJb-LU19 1 :.3urM r KUM J I C V i'ML.5/M 1 LLLK 51 5 /Y2 851 1 P. 2
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MAP REFERENCE:
THE GLEN
A SUBDIVISION BY
MICHAEL J. VASILIOU, INC.
DATED JANUARY 1993
LAST REVISED APRIL 30, 1993
BY VAN DUSEN & STEVES
LAND SURVEYORS
LOT 10 /
40 `\
f
`
i
i yp
LOT 9 G�
o 29,006.98 sq. ft.
ri 0.67 acres
N o
z
_may
88 94'
N733g O'W
i
1 IVA
C:F' ' ENSgpR�
gI�
�rO NG PN
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
LOT 8 AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED TO: JOHN L & DOROTHY J. SCHWARTZ
HUDSON RIVER BANK & TRUST COMPANY,
�r� ITS SUCCESSORS AND\OR ASSIGNS
C ' FIDELITY NATIONAL TITLE INSURANCE COMPANY
1 �
1
" CERTIFIED
BY-`' MATTHEW C. STEVES, LLS NYS 50135
DATED: DECEMBER 18, 2001
a� Du s '� 'UNAUTHORIZED ALTMAnDN OR ADDITION TO A SURVEY
NAP BEARING A LICENSED LAND SURVEYORS SEAL IS A
4 A VIOLATION OF SECTION 7208. BUS-DMRON 2. a THE
V�/`I NEW YOM STATE EDUCATION UAW.'
ONLY COPIES PRDN THE ORIN& OF THIS SURVEY
MAIIIKS SE.Al- WALL
I AN O 20M OF ,IIE LAND SURVEYORS
SEAL SNALL BE CONlDI]lED 10 [i VALID TRUE COPIER'
*CERTIFICATIONS INDICATED HEREON SIGNIFY THAT
THS SURVEY WAS PREPARED IN ACCORDANCE WITH THE
ETOSIING CODE OF PRACTICE FON LAND SURVE^(ONS ADOPTED
Land Surveyors, LLC LBY AND `�"h "n°"°F` '°"LY
LAND 9URVEYORs sA10 [ERIIFTGTIONS SHALL RUN aNLr
TO THE PERSON FOR MOM THE SURVEY IS PREPARED. AND
ON NO OMALF TO THE TITLE COWANY, GOVERNIA NTAL
AGE169 Haviland Road Queensbury, New York 12804 TO
AM LEM O NsnTENON NSMSTED UK' AM
TO THE AS9aiEES OF iNE Lt7LOINc INSTTu110N.'
'518) 792-8474 New York Lie. No. 50135
Map of a Survey made for
John L. & Dorothy J. Schwartz
Town of Queensbury, Barren County, New York
NO. I DATE
DESCRIPTION
.uatel uecemioer lass,
Scale 1'=30'
S-1
SHeUIOFI
NAME
DWG. NO. 92300-9
C-605
Map of a Survey made for
John L. & Dorothy J. Schwartz
Town of Queensbury, Barren County, New York
NO. I DATE
DESCRIPTION
.uatel uecemioer lass,
Scale 1'=30'
S-1
SHeUIOFI
NAME
DWG. NO. 92300-9
C-605
ANUARY 1993
APRIL 30, 1993
JSEN & STEVES
SURVEYORS
RECEIVED
rit'll.lasup II
TOWN 'r- C EENSBURY
BUILDlNg4ND CODE
s
°
C.
�o��i`o N��o cddE
f
i HEREBY CERTFY THAT THIS MAP WAS F
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIRCATION SHALL RUN ONLY TO
FOR ViHOM THE SURVEY WAS PREPARED,
BEHALF TO THE TITLE COMPANY, GOVERN;
AND LENDING INST17UTION LISTED HEREON
CERTIFICATIONS ARE NOT TRANSFERABLE
INSTITUTIONS OR SUBSEQUENT OWERS.
CERTIRED TO. JOHN L do DOR07HY J. SO
HUDSON RIVER BANK do TR
IT'S SUCCESSORS AND\OR
FIDELITY NATIONAL TITLE IN