1999-303MAP REFERENCE
MAP OF A SURVEY MADE FOR
WILLIAM K. & LISA C. GEREAU
DATED APRIL 21, 1998
LAST REVISED NOVEMBER 19, 1998
BY VAN DUSEN & STEVES
LAND SURVEYORS, LLC
L1
S37'01'31 "E
L2
S48'39'59"E
L5
N75'30'18"W
L6
N65'17'18"W
L7
N52'59'18'W
L8
N41'49'18"W
L9
N35'36'23"W
L10
N44'45'01 "W
L11
N48'43'32"W
L12
S05'58'05"E
L13
S11'55'22"E
L14
S20'58'04"E
39.68'
45.17'
45.05'
41.07'
29.63'
50.57'
36.47'
28.35'
72.82'
35.34'
53.18'
19.32'
Ic
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"I have a or observed, or bed � � �
all objects such as houses, wells,, trees►
shovFn on this document. I also t+ _ 0-1-FtIM11110
personally measured the distanM Id1AWWW W
nl ATl tRK
� an Du s eh
8c Steves
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
i518) 792-8474 New York Lie. No. 50135
'UMMJ7 W = ALTERATION OR AOORION TO A SURVEY
NAP EAWC A LL 040 LAND SAWEVORS SEAL 13 A
%CLAIM OF SECTION 72M A16-01VA N $ OF THE
NEW YOLK STATE ED MIM LAST'
'ONLY COPIES FTLOY THE ORaNAL OF THS SURVEY
NARIOD WTN AN OHpNAL OF THE LAND SUIYEICRS
WA. SHALL E WISDEl1ED TO E VALD TRW COPIES'
'CfR1FlCATWNS 90CA70 MEN N HONEY THAT
THS SURVEY WAS PEPARED N ACCORDANCE 101H THE
EGSMS OWE OF PRACRS: FOR LAND SURLEYORS AOOPRD
BY 36 NEW VOW STATE ASISOCALON OF PROFESSMAL
LAND 9ANEYRLSL SAD a0"F1CAT10NS SNAIL. ISM OILY
TO DJE PERSON "M WHM 7FO SURVEY R PI EPARD. AND
ON W EHNF 70 THE VILE CON PW OOMOMENTAL
AGOICY AND LOOM 01SITUM N NSIED NE11EQK AND
TO THE ASMONCES OF AK Lf711IN0 91"AlIOi'
ROAD
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770
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2` 7,969 sq. ft.
5.00 acres
3� 3�>. 590.0,5
36E11i1,.
i �Il /f 750
LOT 1
J
Map made for
CHARLES HUPPERT
Town of Queensbury, Warren County, New York
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NO. I DATE
DESCRIPTION
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HUPPERT
DWG. NO. 96010-2
C-12
MAP REFERENCE
MAP OF A SURVEY MADE FOR
WILLIAM K. & LISA C. GEREAU
DATED APRIL 21, 1998
LAST REVISED NOVEMBER 19, 1998
BY VAN DUSEN & STEVES
LAND SURVEYORS, LLC
5-C
W
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WETLANDS
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00
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2
217,969 sq.ft.
5.00 acres
NO3'S3—'3'-----�--...
-.� 590.03
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L1
S37°01'31 "E
39.68'
L2
S48°39'59"E
45.17'
L5
N 75°30'18" W
45.05'
L6
N65°17'18"W
41.07'
L7
N52°59'18'W
29.63'
L8
N41 °49'18"W
50.57'
L9
N35°36'23"W
36.47'
L10
N44045'01 "W
28.35'
L11
N48°43'32"W
72.82'
L12
S05'58'05"E
35.34'
L13
S11 °55'22"E
53.18'
L14
S20°58'04"E
19.32'
� an D u s eh
8c Steves
Land Surveyors, LLC
37 Chester Street
Glens Falls, New
York
12801
(518) 792-8474
New York TAc.
No.
50135
'{IMOM M AL1DMTON OR AOO M 7O A 7A WT
RM LL-~ A UC04M LOW 91N4EVM WJL b A
VWrON OF =110N 7M 9LO-ONOW ]. OF DE
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'CMFICAMM ADIC W MBIM SM" 1MAT
1MM KWYEY 03 PNE"= M AOOOI MM "'DE
VISM OWE OF FROM FM LAD aIADEYORS A00/I!II
BY 1NE NEW "M 8►A1E AWIOOMYION OF rRRE>a --
LAID SMVEIM !MD COCIFICAIM BALL NN ONLY
10 NE FERSDII FOR YRMM 1W SANY LS FWARM AND
ON m ODIALF 10 7ME im Cm~. OOYERNNF ax
AQDW AND LDDOO MWRRDON UMM MLILEOL NO
LOT 1
Map of a Survey made for
CHARLES H. & ALICE S. HUPPERT
Town of Queensbury, Warren County, New York
Rm
NO. I DATE
R 9 � -3o
GENE®
Aug 16 igg9
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° *of NEW y
AN''L) COf
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20
ENO-
1.=100'
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8HEE?1OF1
HUPPERT
C12
M. NO. 96010-2
4
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19 — 99
This is to certify that work requested to be done as shown by Permit No.
has been completed.
• This structure may be occupied as m SINGLE +NILY DWELLING
CLENDON BOOK P.OAD
Location
Owner HUPPERT, CHARLES & ALICE
TAX eAl? NO, - 12 3 , —1 —2 2 , 2 By Order Town Board
TOWN OF QUEENSBURY
r /,,&,
Director of Bldg. & Code Enforcement
'BUILDING PERMIT
VALUE $ 120000 "TOWN OF QUEENSBURY No. 99303
TAX MAP NO. 123. -1-21 . 2 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HUPPERT, CHARLES & ALICE
OWNER of property located at BUSH ROAD Street. Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMILY DWELLING
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and'Zoning Ordinance.
1. OWNER'S Address is
TRUSTEES 8 HERSEFORD 'LANE
QUEENSBURY, NY : 12804
•
2. CONTRACTOR or BUILDERS Name,
COLLETTE CONSTRUCTION
3. CONTRACTOR or BUILDERS Address
9 COLLETTE LANE.
HUDSON FALLS, NEW YORK 0
4. ARCHITECTS Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X).
SINGLE FAMILY DWELLING
1 1 Wood Frame ( I Masonry ( )Steel ( 1
7. PLANS and Specifications • '
1584 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE' FAMILY DWELLING
211 June 15 2001
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
15 _ June 1999
Dated at the Town of Queensbury this Day of
19
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector ' '
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 /761-82561
_o BUILDING & CODE ENFORCEMENT
NOTICE Requirements prior to issuance Ili ,
of this permit: PERMIT FILE NO. 15•
A permit must be obtained before '
beginning construction. No inspections PERMIT FEE PAID$
will be made until applicant has received n Zoning Board Action
a VALID BUILDING PERMIT. All Area /Use 1
RECREATION FEE ' • a .y F1 ,
applicants' spaces on this application ,
MUST be completed and the signature n Planning Board Action REVIEWED BY
- z _Alt
e.of the applicant must appear on the
SPR / Subdivision /Other Bud ng Inspector
application form, n you. aRecreation Eee Payment
Applicant: �1 v O Owner: A2les. :;; cr / iU/ '•ear
Address: 3�- 7 +t-�'� Sri L 6 ,/ Address: g He/2-Pa a i WV (*(045 0
125
Phone # (51g ) Wg - .calS Phone # ( 512. ) `792 - l3r
Property Location: (OMOA) gI2.0bk I / ��.
Subdivision Name: eTeGI,t,.i�d Gt>1 I,/C• ,t AGE. Tax Map Number
/ Section Block T nt
NATyRE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ / t,QTIVI
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 .
Other
GROSS AREA OF PROPOSED STRUCTURE:
If ADDITION, what will use
1st Floor --_V sq. ft. of new addition be? :
2nd .Floor sq. -t. L C'
Other Floors _ sq. ft. J
(not unfinished cellar or basements
L ACCESSORY BUILDINGS:
Detached Garage 1, 2
TOTAL FLOOR AREA: /t 9 J SQ. 2 Attached Garage 1, .�
C Private Storage Bui •ing
SIZE OF NEW STRUCTURE: ilk
Commercial Storage Building
Other
X FEET X F T ,
Foundation Type: P002 . t Will any second-hand or ungraded
Number of Stories: lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : 22 feet TYPE OF HEATING SYSTEM:
Number of irep ac and/or woodstove (circle all which applies)
to be insta ed: / Electric /`�tr / Gas / Wood
Forced Hot ' ir / t.asebo._ •► / Other
Person responsible for supervision of work as regards to building
codes is : Ve,- Ce f/p
Name 1 Addresss Phon
Builder: (',f/pgio ( 7S 3 $ �2 ' "7c S7F L. IC, • g>SsF C,P,/.S`j
Plumber: JAck FA � Son) 71F W99
Mason: E,0/le Pro
Electrician: Qc,o/;'t 5/oc,72-1c, ft. f. 7't/7 P2c9-7
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 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: y-.� 6,--€0--•°
owner, owner's agent, architect, rac
Application for - ---
SEPTIC DISPOSAL PERMIT STAMP RECEIVED
Location of property for(installation: C>/p 1 Qom, 12Dj
l ,/1A2/'PS PER T NUMBER
Owner's Name;
Address: g (-9,1-1P S frirt.0 AA) a ( ((,riot be/
Installer's Name: Ce)i4/�'' (--eiud; '"c ' FEE PAID
Phone #: ( ) 'CO--ca/S
Number of bedrooms (if residential): 3
Total daily flow (residential - compute @ 150 gal. per bedroom): 9 CC)
Topography: [j Flat Rolling (i Steep Slope % of Slope
Soil Nature: n Sand 151 Loam n Clay n Other Lit/Depth:
Ground Water: at what depth? /0 •
feet
Bedrock or Impervious Material: at what depth? feet
Percolation Test 134 Not Required I i Required/Rate min. per inch
•
Domestic Water Supply: 1-1 Municipal DZ1 Well IJ Other
If domestic water supply is a WELL: water supply from any septic absorption is /6-6 feet
PROPOSED SYSTEM:
•
Septic tank: /OM gal. (minimum size: 1,000 gal.)
Tile Field: each trench S-0 feet. / total system length feet.
Seepage Pit(s): number of. / size each: ft. x ft.
Size of stone to be used: # / depth or thickness feet.
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gal.
Alarm system and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code o f 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 o fan applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all
requirements o f the Town o f Queensbury Sanitary Sewage Disposal Ordinance.
Signature o f responsible. person: Date: 6/2 hi
PLOT PLAN
SEPTIC SYSTEM
Notice: The following statement must be "stamped" on your plot
plan. This sheet of paper may be used for purposes of
drawing your plot plan. After drawing such plot plan,
please read the statement and sign it. If you choose to
use other paper for your plot plan, the office will stamp
those plans for your signature.
va40 5/1 '2 4'
S ee !� A
"I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells, trees, fences, etc.,
shown on this document. I also represent that I have
personally measured the distances set forth on the diagram."
SIGNATURE DATE
• � ENERGY CODE COMPLIANCE APPLICATION
.fr 'TOWN OF QUEENSBURY, WARREN COUNTY
.,a�'` 9000 HEATING DEGREE DAYS
1 .
Compliance Methods : PART 5 - Acceptable Practice Method -
1.&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
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' S NAME: PROPERTY LOCATION:
(10/4/44 6911. • deitda /2,014X
PART 5 METHOD OF COMPLIANCEr BY ACCEPTABLE PRACTICE:
�j 1 . Gross Floor Area - / "6 7 square feet
2 . Type of Heat - Electric Oil Gas Other
3 . Is building mechanically 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 3g'
• b. Exterior walls R
c . Glazed areas R /3• /
d. Exterior doors R
e . Floors over unheated spaces • R --
f . Edge of slab on grade ( heated building) R -
g. Basement/cellar walls (above grade) R //
h . Basement/cellar walls (below grade) R //
i . Heating/cooling-ducts-piping in unheated space R —
G . Service (domestic) hot water heating device
Conforms to minimum efficiency per code V Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
APP i ant ' s i e Datj/� Phone Number
6/3 / 7 46e- S�a�SJ
INSPECTOR' S REMARKS :
TOWN OF-QUEENSBURY
531 Bay Rd., Queensbury, NY 12804
/
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date (', 3 ,19 r Permit No. • s� _
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply-with
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant ( (1e54. 7 APPLIANCE (check appropriate boxes)
Address -2, `y, r'"1r }J a t. ❑ STOVE: ❑Wood o Coal o Pellet ❑ Gas
0 FIREPLACE INSERT
r' c'7 ''7174, Zip I ? "t/e;-- D FIREPLACE, FACTORY-BUILT:
1:16Wood ❑ Gas
Phone ; 462 4'2 /3 0 FIREPLACE, MASONRY:
;j� ❑ Wood ❑ Gas
Owner {' �� ; /, I'is f�!"�N� - 0 FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address / ;, � , IF NON-MASONRY APPLIANCE:
Manufacturer: M d y 5 c
,„,) 1-7, Zip " 1 , s 6/ Model: 'Y 44.: f,(
Phone 7 (.)
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: ❑ Block 0 Brick 0 Stone
-�',=,'t• FLUE: ❑ Tile ❑ Steel
Size: inches
CONSTRUCTION I INSTALLATION MUST CI:FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS otDouble Wall ❑Triple Wall
REGARDING 'REQUIRED INSPECTIONS. 0 Insulated 0 Direct Venting
❑ Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Received
Code Number Title r. i
A 173 3389 (190) Public Safety ,
A 233 2655 (230) Minor Sales �.
� tif .,
Fee Collected From or Refunded to: r,._-.� `.'� /C-'t \ 3 ;
Address: , _? a '', -. r I)
Dated: Town Clerk or Deputy:
t+ y✓. ( .✓ }j -4—r
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
e/c.)
RESIDENTIAL FINAL INSPECTION REPORT
b /�
Office No. (518)761-8256 Date inspection request received: 9 7 9 AifOli
Building& Code Enforcement
Dept. of Community Development • Arrive am/pm Depart/
Town of Queensbury Inspector's Initials i-jh ' ,
742 Bay Road
Queensbury,New York 128I
NAME tC�''�� PERMIT# i3
- �_
LOCATION �fb• �,rL r DATE . D i
TYPE OF STRUCTURE ` ��
N/A YES 0 COMMENTS
Chimney Height/"B"Vent/Direct Vent Location /
Fresh Air Intake i/ I
Plumb Vent through roof V'/,
Roof Complete a�
Exterior Finish Complete i
Interior/Exterior Railings 30"to 36" /
Exterior Handrails,balconies,lane..l'g 18 in. or more
Interior Handrails stairs both sides 3 .r more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"a,•ve grade
Gas Furnace shut-off within 30 feet or within ' e of si ' /
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Relief Valve(s)installed �'
Hea'1room,6 ft. 6 in. on stairs V
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in. or more i 4
Railing across window in stairwells
Smoke Detectors:
every level s
every bedroom
outside every bedroom
inter connected ,/
Bathroom fans �/
Plumbing fixtures
Foundation insulation /
3/4 hour fire door/door closer ✓
Garage fireproofing i /
Garage penetrations sealed / ,/
Furnace in separate room protected(in garage) t/
Light ventilation per room
Safety glazing 18",Tess ess floor
Final Electrical
Site PlanNariance requited /
Final Survey Plot Plan V _ )
vs 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)
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Jo r
Panel Board No Cert. N2 64827 Cut-in Card No.
OW= e-46a ; fe72-7-
Locationh2r2. C-(...-67-4)49'A-)Bea ( /2/0,
Insplation Consist?' of-2 7 stv rc gz) aficer, ? re-S
c4.4.4-P1 4)5 --/nerstr p-0.0/9-Installed
—
Installed By AD/1e-0 C." e-C Lie.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of maki inspections at any time, and if its
rules are violated,the Company shall have the right to r ok th c ificat .
•
Date 36-1 INSPECTOR.
. .
TOWN OF QUEENSBURY
;.` BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED:
NAME `J\Y`
LOCATION \-e\76
DATE '3 `1 lC! PERMIT H 363
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPE• 't'IN'.
INTERIOR TRIM/PRIVACY DOO'S
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS 'SWEEPA:LE
OTHER FLOORS CARPPrED
STAIR CLEARANCE/RA LINGS
SMOKE DETECTORS •
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE LAN/VARIANCE REO.
NAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
.---gif
.„; ,� FIRE MARSHAL
,/, ;: TOWN OF QUEENSBURY
W QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED 6/g
NAME Sz,Y-pi-, ehy
LOCATIOC1f, C)C b 3 rO64-PERMIT# 19-303
SCHEDULE INSPE I N O
a
7 AM
/11) '
APPROVED
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 SP''INKLERS
CLEARANCE TO ,TING UNITS
RE UIRED SIGNAGE
• /I
HIMNEY ►( ft `i) -uiZ►Uk
WOOD STOVE i
FIREPLACE ❑ i.. INRY FACTORY BLT. j
' -0, H-IN
■ FINAL
REMARKS: 11,k of`L ❑ OK TO THI` DATE
-R3C-' ` rblo CD0C\ \9C\879
3 ', OD .Ye-
INSPSLIP.PUB INSPECTOR
APY\
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!'�, ta,,m! m/
Inspector's Initials d Imo(/
NAME: 1\--(> \r1G j PERMIT#
ALA,0
LOCATION: , j� �OUA DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form /
Reinforcement in Place
The contractor is responsible for /
providing protection from freeing /
for 48 hours following the pl• c
of the concrete.
Materials for this purpose o site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproo mg
Backfill Approval
Plumbing Under Sl•b
Plumbing Vent/V nts in Place /.
Rough Plumbin
Heat' lg Rough-In
I lation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R tU1
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
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,aapart
Inspector's Initi s -
NAME: v PERMIT#
LOCATION: ats kr)v},_ DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is r nsible for
providing protecti n om freezing
for 48 hours folio ing the placement
of the concrete.
Materials'or this pu sc n site
Foundation allpour ,
Reinforcemen in Plac
Foundation/Da proo ng
Backfill Approval J
Plumbing Under Slat;'---)
Plumbing Vent/Vents. Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls I terior R-
Foundation Walls xtcrior R-
Floors R-
Walls R-
Ceiling R-
Duct work or pi, ing 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 Wa 1�. 3,4 hour
„ Firestiiving
4/1
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 am/pm Depa am/ m
Inspector's Initials �}
NAME: PERMIT# 5i 3
LOCATION: ATE :
TYPE OF STRUCTURE: (-6,7
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the ac ment
of the concrete.
Materials for this purpose on,itc
Foundation/Wat ••ur
Reinforcement in •lace
Foundation/Damppr•Ming
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 houreA-L ��S ���tt2�5 coik'2 i
irestopping C?, .PC)
PtPe
Ara- Pry I`�LI-IC-GL
TOWN OF QUEENSBURY , C'
BUILDING & CODE ENFORCEMENTc
742 Bay Road
Queensbury NY 12804 113c:
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name h'JQe (' Y�.
Location C`ep(N )c \ e)
Date - I Pe it # CY)30 3
SOIL TYPE: and-Loam lay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIE ,r: otal Len -rh _
Length of eac tren r i
Depth of trenc hes
Size of stone Jt Z
SEEPAGE PI : Number
Size - ft. ft.
Stone size -
PIPING: Sze Type
Bldg. to Tank 52" 1) Y-0
Tank to Dist. •ox e, u
Dist. Box to F eld/P` 11 u '
Openings Seale, ? No PartSal
LOCATION/SEPA' JIONS.
Foundation to ank feet
Foundation to Lbsorption e7 feet
Separation of 'its fe=
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - ight-Sid
Middle Front - Middle Rear
COMMENTS:
> 5--\)(3ci,..cr i/A• — (ZotA,
nK
\() C3vc�/S
SYSTEM USE APPROVED: YES 0
Arrived: 41 -Departed: b
Building Inspector
i
TOkIN OF QUEENSBURY
BUILDING 3 CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name )
Location 1
Date -7 - in Permit # £ �(2
SOIL TYPE: Sand-Loam-Clay-
Results of Percola io Test-
(if applicable) Ra e-Msinute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: otal Length
Length of each tren h
Depth of trenches
Size of stone
SEEPAGE PITS: Numb:
Size - ft.
Stone size
PIPING: Si- Type
Bldg. to Tank Se
Tank to Dist. Box IA
Dist. Box to Field
Openings Sealed? e� No Partial
LOCATION/SEPARATIONS.
Foundation to Tank ) feet
Foundation to Absorption _ 0O feet
Separation of Pits fe
Conforms as per Plot Plan Yes N
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Rght
Side
Middle Front - Middle Rear
COMMENTS: US n
-^j J 0(6 ,c.t1 16 c23 i L;i 1- (A-r)
Ohl K e oK
� D c�rv[�U
SYSTEM USE APPROVED: YES
Arrived:
Departed: 1:—/----<1(2)67
Building Inspector
,. 2\-- 'LP"7 --Q66` -,
GENERAL INSPECTION REPORT f
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road ;1X J
Queensbury,NY 12804 Arrive am/pm Depart • am/pm417
Inspector's Initials -
NAME: \V1 ,0PC j PERMIT#
LOCATION: DATE . , 1\.. i 1r'
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour 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 s'te
Foundation/Wallpour .)
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slabii
ePI bing Vent/Vents in Place
ugl Plumbing' v
eating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- I
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
per Vent, Attic1Vent
_laming L S z U P L.2. ,
Jack Studs/Headers (///
Bracing/BridgingJoist Hangers
Jack Posts/Main Beam /�
"'Air Infiltration Barrier: ,c/
Fire Separation I, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour 7 Obt -A)LL--rL ftR&-rDP A'�-(fie C�C-G� • 4)
'Fires'topping - N. LP14L 2 RCNC- C6&COk i 14SvL •)
GENERAL INSPECTION REPORT ea_cea
Town of Queensbury /4/4Dept. off Community Development Date inspection request received:
Bui➢ding& Code Enforcement '7
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart ( D m
Inspector's Initials
NAME: \ or ,Io , Q \(x PERMIT# _ —
` 1
LOCATION: � 1 Q rv\ psi C�c �� BATE
TYPE OF STRUCTURE: S� '
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place_
The contractor s respo i.ible for
providing protec •n fir, freez''g
for 48 hours follo rn• e -ment
of the concrete.
Materials for this purpo on site
Foundation/Wallpour
Reinforcement in Place
Fours tion/Dampproo g n p
ackfill Approval (,4ft. i 6 g
Plumbing Under Slab
Plumbing Vent/Ven 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
q '30410• ICD
GENERAL INSPECTION REPORT
Town of Queensbury = - - -y°- =_=.: .:,,
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 .Lay Road ,�
Queensbury,NY 12004 . Arrive pm Depart 1°diFr 1j
Inspector's Initial.
NAME: \�V V ! PERMIT# l led.....3
LOCATION: 1 ((c)n-. DATE : OOP ' 1
TYPE OF STRUCTURE: .c0
RECHECK
N/A YE NO COMMENTS
\'Footings/Piers C—n-fhw--c-•.ap_
Monolithic Pour Form O /
Reinforcement in Place / V
The contractor is re ible for
providing protection fro freezin
for 48 hours following the lace ent
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing 11.1
11 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
\ rik\ '-r MrY\ wez)— MouikW/17-1trx-101311C_,-.7,k‘
GENERAL INSPECTION REPORT .N..
gC07.
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 ':•ay Road
Queensbury,NY 12804 Arrive k t c9Car—Depart . � • m
Inspector's Initial. I1 i
NAME: /�`� W \ cAnv----- PERMIT# 1°' l��
LOCATION: qb, _ , DATE : C()
TYPE OF STR C : 1
RECHECK
N/A YE NO COMMENTS
tin \ I I
Monolithic Pour Frm \
Reinforcement in Place i' k 1 I A---> V
The contractor is responsible or
providing protection from ing
•
for 48 hours follow n the pla ment
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place \
Foundation/Dampproofing \. !
Backfill Approval °h.
Plumbing Under Slab I \
Plumbing Vent/Vents in Place / \
Rough Plumbing / \
Heating Rough-In / \
Insulation I \ _
Foundation Walls Interior; R-
Foundation Walls Exterior R-R \�
Floors -
•
Walls -
Ceiling R- \\
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing 9
Jack Studs/Headers 9
Bracing/Bridging 6 ,
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
• (518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RE`qEIVED PERMIT# 617"303
NAME e►21
LOCATION C - go
SCHEDULE INSPECTION ON
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS /'
EXIT SIGNS
EMERGENCY LI e HTING
FIRE EXTINGUISHE•'
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM _
HOOD INSTALLATION
INTERIOR FINISHES _
STORAGE:
CLEARANCE TO SP"INKLERS
CLEARANCE TO HEA'ING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
F}REPLACE-MASONRY
,/FIREPLACE-FACTORY BUILT —
REMARKS: OK TO THIS DATE
Pi7
INSPSLIP.PUB INSPECTOR