2001-790 TOWN OF QUEENSBURY
2 Ba Road ueensb NY 12804-5902 518 761-8201
74 Y , Q �9, � ) J.
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010790 Date Issued: Friday, March 22, 2002
This is to certify that work requested to be done as shown by Permit Number P20010790
has been completed.
Tax Map Number: 523400-308-010-0002-046-000-0000
Location: 36 NICOLE Dr
Owner: GUIDO PASSARELLLI
Applicant: GUIDO PASSARELLLI
This structure may be occupied as a:
By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Garage - 2 Cars Attached
(D411104
Director of Building&C•de En:rcement
1ft TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010790 Application Number: A20010790
Tax Map No: 523400-308-010-0002-046-000-0000
Permission is hereby granted to: GUIDO PASSARELLLI
For property located at: 36 NICOLE Dr
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: GUIDO PASSARELLLI Single Family Dwelling 160,000.00
465 LAKE Ave Garage-2 Cars Attached
LAKE LUZERNE,NY 12846 Total Value 160,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
LAMOTT. MICHAEL NEW YORK BOARD OF FIRE UNDEI
92 NICOLE DRIVE
OUEENSBURY,NEW YORK
Plans & Specifications
2001-790 LOT 119 #36 NICOLE DRIVE -Herald Square, Phase 3
1530 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$232.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday, October 26,2002
(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 -, b ; ,'d..y, October 26,2001
SIGNED BYnQue
j4 for the Town of Queensbury.
Director of Building&Co- Enforcement
• , Oblf/qn
•
' �M EtIE'IGY CODE COMPLIANCE APPLICATION R
• �
i!
Ece VED
U6Je1 OF QUEENSBURY, WARREN COUNTY
t ? , , a;.,,, 9000 HEATING DEGREE DAYS
. TT OCT 2Zppl
Compliance MethoUs : PART 5 - Acceptable Practice MethodOWNOFQuE
1&2 Family Dwellings '(onl CpL01NG4 NSURY
• PART 6* - Thermal Rating - Component Trade •�
1&2 Family Dwellings; Multi-Family
•• Dwellings (.3 stories or less)
•
PART 4* -' Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT NAME: PROPERTY LOCATION:
•
7 'e. 1 jesm 'lie., her //7 iJ c, e, V r. ,s.by,
Pll II 73 METIIOI) OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floo : Area - /tg.7,p square feet
•
2 . Type of IIe •iL - - Electric Oil I/ Gas • Other
3 . Is building meclianidally cooled? ✓ Yes No •
4 .. Percentage of area of windows and doors Over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN .ON PLANS SUBMITTED:
a . Roof • R c3®
b . Exterior walls R
c . Glazed areas R a, 3
d . Exterior do')rs R /0#y
e . Floors over unheated spaces R 14
f . Edge of slab on grade (heated building) R _
g . Basement/cellar walls (above grade) R
h . Basement/cellar walls (below grade) R
i . H ating/cooling-ducts-piping in unheated space R y, 7
6 . Servit.e (domestic) hot water heating device •
Conforms to minimum efficiency per code d/ Yes No
T'EML E'•_A.TURI CONTROL MAXIMUM SETTING 140° .WILL NOT BE EXCEEDED
• Appl_caz' i na re Dap • Phone Number
INSPECTOR' S REMARKS .
Building Permit Application lile,6714000,.t%
Town of Queensbury-Dept of Community Development, 742 Bay Road, Queensbury,NY
(518)761-8256 OCI- 4- 4444
L 2001
A permit must be obtained before beginning construction. Permit File No.Cx Fhb elk DI
Q(/�c
No inspection will be made until applicant has received a Fee Paid $ ,Z›j �� NGMOILIS(/R�
valid building permit. All applicants' spaces on this Rec. Fee Paid • $ - ®F
application must be completed and must appear on the Reviewed By:
application form.
Applicant: 7a yeet. /'1tecsT.e., 2-7,G Owner: _ 5
Address: n , L.e., "Dr,/ <Pdhl y, Address
1.
Phone#(t7/&') 7. / - p p/a/ Phone# ( ) -
• *.: -2 ',( /6(a7
Property Location: Lot Number: Jig ./ House Number SQ( / ///004 Dv-,
Subdivision Name: /7i v Ld 6itids ye_ Tax Map Number:
•
New Building: residence commercial Estimated Market Value of Construction: $ /AO(pQ
❑ Addition: residence/ commercial If an Addition, what will use of new addition be?
o Alteration: residence/ commercial
o No change to exterior size: residence/com'l
❑ Other work(describe ) .
•
• Check Oceupaneylnformation Isr Floor . 21111 Floor Other floor Total
Below .• sq.ft. sq.ft. sq. ft. Square Feet
/42
Single family dwelling /eLF 0 V/e D /
❑ Two family dwelling1____!,5,(e°
o Townhouse
o Multifamily dwelling
#of units
❑ Office . .
❑ Mercantile
❑ Manufacturing
o 1 car detached garage
o 2 car detached garage
o 3 car detached garage .'�-J�
o 1 car attached garage 7 bp 1►
�2 car attached garage g/red/ ('q `l
❑ 3 car attached garage
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other
Will any second-hand or ungraded lumber be used? If so, for what? /Yd
Type of Heating System: electric/ oil./at/wood / orced hot air/ baseboard/other:
Number of Fireplaces to be installed Q Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder IV;de, d,av Aar, y!Kr 6 a.i
Plumber /ram/r`l 3eoi_2?--citi f i'o9',/y ® 3797
Mason ties 'rho anv.x 6-Yo7-/4/4G
Electrician nio55a4.•A Themi.shs Gam' a(230
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,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location,f,all new construction.
Signature: ., ,/ ,P . fr744—. . owner,owner's agent,architect,contractor
' Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury, NY 12804 (518) 761-8256 • la1. OWNER INFORMATION: / '-7
i Office Use
Location of installation: ,(o T // /V G D�•N. car, [�,S�7y, O I"E r
// V
File ermi co.Tax Map No. / /
1 }} Fee Paid OCT eS 2001
Owner's Name: Te v Ye- friaj 7 c G , • I
TOWN OFt1EESBl1RY
Address: �,2 /' •
I/ca e. p yr,1 (2,51! e BUILDING AMD CODE
2. INSTALLER'S NAME : Al,/re, flo r y/6,5 at.! PHONE NO. 799 -6 a
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 ,3 x 110 gal/bdrm = CFI®
Garbage Grinder Installed yes— / no 1,...---
Spa or Whirlpool Installed yes / no e -
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
• Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
CO at what depth at what depth nunicipa
o ing oam / feet feel we
Steep slope . clay if well; water supply
_%slope other from any septic-system
depth: absorption is fl.
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.
I. Septic Tank: / Odd gallon (min. size 1,000 gal) --
Tile Field: each trench 0-0 ft.. Total System Length: Q40 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) . .
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. •
00,0 047, /14/Wren
Signatuv (responsible person f Ddte
RESIDENTIAL FINAL.INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depat am/q�t
Town of Queensbury Inspector's Initials C
742 Bay Road
Queensbury,New York 12804 NAME t PA ! r<61 C�( PERMIT# ( —7 `C°°
LOCATION 1 /�•t Cr,C_C— DR— DATE `2,
TYPE OF STRUCTURE G l
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direc• ent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to t 6"
Exterior Handrails,balconies,Ian''i g 1 in.or more
Interior Handrails stairs both side 3 or ore risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off e osed/re la't. 18"above grade
Gas Furnace shut-off within 0 feet o within line of site
Oil Furnace shut-off at entrance to ace area
Furnace/Hot Water Heater operating
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more\than 3 risers
Interior privacy/trim/doors/main entrap 36"
Floor Finish
Bathroom/Kitchen watertight
In or Handrails Bda cconies/Landing 1 in.or more
ailing across window in stairwells
Smoke Detectors:
every level
ev edroom
ide every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
• Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan f ,
As Built Septic System layout required fl&'V(J 7f S Io
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy)
RESIDENTIAL FINAL INSPECTION REPORT il cr2.4_ , 5 q_.,Office No.(518)761-8256 Date inspection request received: h, l
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depart ' pm '
Town of QueensburyInspector's Initials
742 Bay Road
Queensbury,New York 12804 0 (�
NAME C�< � ��}�� PERMIT# C v
LOCATION I 1A SL . DATE � ----
TYPE OF STRUC
k N/A YES NO COMMENTS
Chimney Height/'B"Vent/Dire. ent Location /'
Fresh Air Intake i//
Plumb Vent through roof V/
Roof Complete �//
Exterior Finish Complete ,/
Interior/Exterior Railings 30' to 36" /
Exterior Handrails,balconies,landin 18 in,or more l/
Interior Handrails stairs boil sides 3 r more risers V/
Grade 2%away from founda ion ✓/
8"clearance to sill plate ✓/
Gas Valve shut-off expose. egi}l'ator 18"above grade ✓/
Gas Furnace shut-off within feet or within line of site / ,/'
Oil Furnace shut-off a - .. ce to furnace area
Furnace/Hot Water Heater o.erating J
Relief Valve(s)installed ✓/
Headroom,6 ft.6 in.on sta. :
Basement stairs,6 ft.4 in. ,//
Handrail exterior stairs both .ides more than 3 risers. ✓/
Interior privacy/trim/doors/m:in entrance 36" ,/7/
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconie :.ding 18 in.or more /
Railing across window in s ells ✓ / _ [J �
Smoke Detectors: ✓ C * <s- `j,'l - t 1
every level •
every bedroom
outside every bedroom
inter connected
Bathroom fans ,//
Plumbing fixtures i/
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing ✓/
Garage penetrations sealed , J V
Furnace in separate room protected(in garage)
Light ventilation per room / J
Safety glazing 18"or es Moor
Final Electrical S C/ -ell
Site Plan/Variance equir d J Final Survey Plot Plan
As Built Septic System layout required .
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
/ .
Okay to issue permanent C/O(Certif.of Occupancy)
TOWN OF QUEENSBURY
,Y;��'�w_,.K.'' BUILDING & CODE ENFORCEMENT
"` ' 742 BAY ROAD
h,,_ ,�,r QUEENSBURY NY 12804
r :n , (518) 761-8256
ARRIVE: DEPART: INSP: 69
FINAL INSPECTION REPORT
COMMERCIAL MULTIPLE DWELLING
(hotel, motel, apt. complex)
DATE IN ECTION REQUEST RECEIVED:
NAME S�CA.510 0
LOCATION '4!' i + ` \CAI e.._ l(
E DAT '- H a W -� PERMIT N Or- 7q p
TYPE OF STRUCTURE 53''
FOOTINGS BACKFILL FRAMING PLUMBING
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT/FIXTURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES C
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 REQ.
NAL SURVEY PLOT PLAN, IF REO ()
OK TO ISSUE C/O OR C/C
4.--. , , 4 '-,,i.,' Itt/__- -''-
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement ,\
742 Bay Road /7 fr 7,0
Queensbury,NY 12804 Arrive am/pm Depart" ,pm
Inspector's Initials —i
NAME: PaVeke:L., PERMIT# 0C — ( ( �-/LOCATION: , \ DATE : 0— / I— -0U(--
TYPE OF STRlJCTURE: SC`C)
RECHECK
N/A YES NO COMMENTS
Footings/Piers I. I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection fr• freezing
for 48 hours followin the p •cement
of the concrete.
Materials for this purpo e on site _
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval /
Plumbing Under Slab
Plumbing Vent/Veiits in P1.ce
Rough lumbing
Hea ' g Rough-In
1/1
kz
sii aat onf
r��'K Foundation Walls Interior •-
Foundation Walls Exterior ''-
Floors R- _
Walls R- 1
Ceiling R- v
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
F Wales l 2,_3�f4 hour /
`..II, 0 511PYtg.Lk •• /() L s "L f--,
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 1N167pffi- Depart a
Inspector's Initial A NAME: �j .4. eE(uD Cl PERMIT#
C:)
LOCATION: Il) 1 aO L 1 Del E DATE : 2 7-o T
TYPE OF STRUCTURE: / Z. CAR. OE
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1-7-1
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible f
providing protection from freeing
for 48 hours following the placement
of the concrete. ;
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Pla I /
Foundation/Dampproo ��
Backfill Approval , ��
Plumbing Under Slab j v-`��
Plumbing Vent/Vents in Place I V�
Rough Plumbing
Heating Rough-In
Insulation I
Foundation Walls Interior/R-
Foundation Walls Exterior R-
Floors Ft-
Walls
Ceiling Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent r^
Framing //If 'n'� 0\�N v f'D\4---
Jack Studs/Headers WBracing/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
,_ ,..... /r...ri„eccx:a4
.0,.,),
,,,;, ,,,,f,..,,f,1,1.4,v;_,,„
,a„,:.„., :.:.Q.:,..,:.:4,:... __..._.___________, 7.1
c,...___, ,......„......_
GENERAL INSPECTION REPORT a
( 518 ) 761-8256 3
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road ..-
Queensbury,NY 12804 Arrive c sedg.m Depart
Inspector's Initi
NAME: l PERMIT - / 7'd'
LOCATION: 7 11 q ij,rZd6, n`L _` DATE : / 3/ 0--
TYPE OF STRUCTURE: 3-1
RECHECK
lA6V,00, 3 Aild(e. &vb.--
N/A YES NO !COMMENTS
Footings/Piers 1 I I � Y �7
Monolithic Pour Form �� v d��- `j��?2\�
Reinforcement in Place V �V icD1rw VJ .6., \J �7 r.; /,1
The contractor is responsible for �-- � �
providing protection from freezing �\�ff
for 48 hours following the placeme. ti. ^- 11 '7 _
of the concrete. J - 1 I -.)
Materials for this purpose on site
Foundation/Wallpour — 7 \ Le- L.);\ 0, (�U E_?_ l L J.C.)�t1
Reinforcement in Place C .
6 ' t �LFoundation/Dampproofing t. v �, �
Backfll Approval \\� `�-� :t` <<=-' `(lUc_ -� r\
d...ti- \'Plumbing Under Slab ` ��i17�-1- - �'�v ti
lu V ents in ace `1 �%� 1;\-(. tivw-`-
ough PI mbi i f7���� C�J _
Heating Rough-In ?' -.E1�� r �— L,C' v V�� \1 ..
Insulation l 1 s-- � r E ti>ti�e�\ r; �r_. , -` �
Foundation Walls Interior R- �- I-1,
Foundation Walls Exterior R- ��� --, __
Floors R- C%`� _.,'-- a,,-i f„. rj 1 'r.�--
Walls R-
Ceiling
\ Lh\\r .r- 0,\.
Ceiling R- }.� •
Duct work or piping in Z�yv��
unheated spaces R- ` f
Pro Vent, Attic Vent �� vv.) _
rami
�_ VFr
Jac tuds/Headers \- `�`"'~ ,r u u`;"C \ ;L� \�7 �J
�:.
B_racin ridging '-1 f
angers �.it"�-- !l \w 'fi•:;-. v1 \ 1--4<<J C,{
Jack Posts/Main Beam ,
Air Infiltration Barrier �U' �'l,
ire Separation 1,2, 3,hour
enetration SealedNI \Q-7aQ GABLE 6D b. \�\\ P-et-1L
Fire Wall 2,3,4 hour
IF
k ok.-C_ -T Q:J j_
irestopping
///
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
*(11) -,Sa.j1/2.% C tlt
Location, V
Datel0-q'61Q01 Permit # (/ ) O
SOIL TYPE: Sand-Loam-Clay-
Results of P-rcolation Test-
(if applicabl -) R'a\e-Minute/Inch
TYPE OF SYSTEM
ABSORPTION FIEL1 : Tot 1 Length
Length of each trench
Depth of trenche.
Size of stone
SEEPAGE PITS: Nu ber-
Size - ft. x ft.
Stone size
PIPING: Ilir Size Type
Bldg. to Tank
T nk to Dist. Box
ist. Box to Fi- : ! t)\
Openings Sealed? :s No Partial
LOCATION/SEPARATION
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
_
Conforms as per Plot P1 . Yes No
LOCATION OF SYSTEM ON PRaPERTY:
(circle one)
Front - Rear - Left Side Right Side
Middle Front - Middle Rea \
COMMENTS:
VA-CIA0,9— 40-raiN\ik
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
)---'///////
Building Inspector
3' 7(
TOWN OF QUEENSBURY
BUILDING_ A CODE ENFORCEMENT e„.742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ?c-L-e,..e ("A
Location 3ld J ;�
Date'(' ; / Permit # 4-790
SOIL TYPE: Sand oa =Clay-
Resul is of Percol a do, Test-
(if applicable) Rase-Ainute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tota Length moo'_
Length of each tren h a;,;01
Depth of trenches 7j _ .3
Size of stone rtSEEPAGE PITS: Numbe,Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank /461g(.., cf
Tank to Dist. Box Li " PJr
Dist. Box to Field/Pit ' " '. 11)
Openings Sealed? Ye di IPartial
LOCATION/SEPARATIONS:
Foundation to Tank 10 feet
Foundation to Absorpti o _zip .feet
Separation of Pits feet
Conforms as per Plot P1 a Y No
LOCATION OF SYSTEM ON PR PE .
(circle one)
Front - Rear - Le tight Side
Middle Front iddle Rear
COMMENTS: _ - '
•
Fo kT1p uJ AtL L -
SYSTEM.USE APPROVED: YES N.:._)
Arrived:
Depa 47 `-
//AO. �i
lding Ins,e for
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 Arrive3Ja Depart
spector's dnit'
NAME: C P PERMIT —
LOCATION: =q, 1031 C_ LE_ SD V_ DATE :
TYPE OF STRUCTURE': t). 1 c_fle__ 6 12-<
RECHECK
•
N/A YES NO COMMENTS
Footings/Piers 1 I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsibl for
providing protection from fr zing
for 48 hours following the pl cejnent
of the concrete.
Materials for this purpose on site
Foundation/Wallpour /
Reinforcement in Place _
Foundation/Dampproo ng
Backfill Approval l
Plumbing Under Slab
Plumbing VentNents in Place
Rough Plumbing 1
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
d )
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 ai pi-
Inspector's Initials-)R-
N p/ PERMIT
LOCATION: ' �� N 1(' ,-QC) , DATE : (.(-JQ--- I
TYPE OF STRUCTURE:
RECHECK
N/A YES,../Ifr COMMENTS
F otings/Piers —I V I
onolithic Pour Form /
Reinforcement in Place
The contractor is respo sible f.r
providing protection fro freez' g
for 48 hours following t e place ent
of the concrete.
Materials for this purpose o► site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Undei'S
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 J
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
•
4e1 99/t/ VON/®7l evidence of,
n( o fie
0 fences, etc.,
L��Z n y 1 "I have seen or o\�ser`aed, or believe sa
iNe;ls,trees, , ,�
-1 00 all ot�, .cts suer as houses, resent that! h .
„�11. -, s- ciccumo t. ! also rep < diagram„
. shy e dis ances set for,.I, on th'..
��W Qersu,;ally CI thy,,
•
-iliql-E-19-11-- .
(oar " • AM'ivURE
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2 2 0.56 --- ' 1 41.9�)' 10
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/,y . � \ I- •( 1' aci? -LOT 12.0 rc-; N 20,00C
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o 3,9 ; e sq. ft. `'
r 24,901. sq. ft. ; 0.45
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0.57 acres
--
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LOT 118 \\_ � /
39,72C). sq. ft.
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0.91 acres 97.633 � , 1G� ,\ ....,
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'LjOT 129 \
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I LOT 130 \'''.:--)
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���' '_'�.'.,b32. sq.q. f t. 1 4 / /
I 0.51 ac r-