1999-594 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date nxNr.m.mhAr 19 —99
This is to certify that work requested to be done as shown by Permit No. mnrelA
has been completed.
• This structure may be occupied as a SINGLE FAMILY DWELLING
LOT 33 #67 SURREY FIELD DR.
Location
Owner lyTTOWAVTC OATTTDMT-Tr L 1. I"
By Order Town Board
TAX MAP NO. 48 . -8-33
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 99594
TAX MAP NO. 48 . —8-33 .
WARREN COUNTY, NEW YORK
MICHAELS GROUP,THE L.L.C.
PERMISSION is hereby granted to
. LOT 33 #67 SURREY FIELD DR. Street,Road or Ave.
OWNER of property located at
in the Town of Oueensbury,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 Oueensbury Building and Zoning Ordinance.
t. OWI9.01S0Xd PlTE RT. 9, SUITE 3
LAKE GEORGE, NY.. 12845
2. CONTRACTOR or BUILDERS Name
MICHAELS GROUP, INC.
acolOMUMMENINIMNPIP4tTECT MGR 282 USHERS- ROAD
CLIFTON -PARK, ..NY . 12065
4. ARCHITECT'S Name
NEW YORK BOARD
5. ARCANE ? •rAUARD..OF. FIRE . UNDERWRITERS
6. TYPE of Construction—(Please indicate by X) SINGLE. FAMILY. DWELLING
( I Wood Frame ( I Masonry ( I Steel ( )
7. PLANS and Specifications
1518 SQ FT SINGLE FAMILY DWELLING WITH 2—CAR ATTACHED GARAGE
AS I➢ R PLOT PLAN SPECIFICATIONS
8. Proposed Use •
SINGLE FAMILY .:DWELLING ..,,
215.. September. 21 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 Oueensbury before the expiration date?
1 September .. 1999
Dated at the Town of Oueensbury this Day of 19
SIGNED BY for the Town of Oueensbury
17— Building and Zoning inspector
Application tor Jt r l lL 1)l k OJ.1iL, rblt1V111 1
r
Town of Queensbury
1-(-.)
j)
Dept. of Community Development Permit No.
.-\
Building &Codes Office .
742 Bay Road Fee Paid $
Queensbury, NY 12804 -
Location of property for installation: ICk 33—tr::71 .\b v-.,
Property Owner's Name: 1 i NI1dIQe.0 emi I n La.. .
Property Owner's Mailing Address: I?)IU aade 4- taite is:tt't ‘
Installer's Name: &ta t_ LM'c j Phone•# (fid3.I n q
. Number of bedrooms (if residential): 3 Total daily flow: L/67..)
(residential - compute @.150 gal./bdrm.)
Topography: ✓ flat, rolling, steep slope To of slope
•
✓sand loam, ,EN
Soil Nature: clay, other /depth:
Ground water: at what depth? 30 feet / Bedrock or Impervious Material: at ilEtPdept11999feet
..;,�::).OF QUEENSBUr°'
Percolation test: not required, ✓required [rate 1 min. per ilc Ii � ,t 1p CON
Domestic water supply: municipal, well, other -
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
•
Septic tank 1ECID gallon (minimum size: 1,000 gal.) 2,1 i 45 fE2 ue/D I V.
Tile field: each trench- 1 feet / Total system length: ti . feet
/
Seepage pit(s): number of I size each: ft.by ft.
Size of stone to be used: #(g tflC. / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: MIA- Size of each: gallons
(Alarm system and associated electrical work to be inspected by a certified agency.
i
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.faiure to make a
material fact or circumstance]mown 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. g((
Sioature of responsible person: Date: 3(34
•
TOWN OF QUEENS tURY
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
5 � :'c c.Li
Date " ,19 Perm t Ni,.
fire ,‹
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of aBuilding 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 vtAr, V..., APPLIANCE (check appropriate boxes)
Address ` 1S s, erarN STOVE: ❑Wood ❑ Coal o Pellet ❑ Gas
0 FIREPLACE INSERT
CAA 42. Zip IL-TA L,,c 'FIREPLACE, FACTORY-BUILT:
❑ Wood %Gas
Phone 6V . 611-i °°S (,0 ❑ FIREPLACE, MASONRY:
❑ Wood Gas
Owner 0 FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address IF NON-MASONRY APPLIANCE...,
Manufacturer:
Zip Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: ❑ Block 0 Brick 0 Stone
t®* -Is- Le m -e6 FLUE: ❑ Tile o Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST , FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS ❑ Double 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 Refunded
Code Number Title c c)')
A 173 3389 (190) Public Safety
A 233 2655 (230) Minor Sales
Fee Collected From or Refunded to: 1
Address: I
Dated: .. k Town Clerk or Deputy: • . V w
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
:'ii TOWN OF QUEENSBURY
Fee Paid
BUILDING O
CODESDEPARTMENTAPPLICATIN FOR: PORCHES-DECKS- Permit # -5q
)/-
DOCKS & BOATHOUSES Est. Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FOLLOWING:
The undersigned hereby applies for a Building Permit to do the following work which will be
done in accordance with the description, plans and specifications submitted, and such special
conditions as may be indicated on the permit. TWO SETS OF STRUCTURAL PLANS SHALL BE SUBMITTED
WITH THIS APPLICATION.
Owner of Property: TL V'6c,S (c,,Qn\4ez, ;
P.O. Address ?&2 0-S\-12- ..rQIL) Phone #
Property Location \�� '33— �'1 ` ' _-‘,6c-) .)-,, Tax Map # ' 33
Subdivision Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name: _itM '''?.?\oac- Address Phone#
BUILDING SPECIFICATIONS:
Type of work to be done: . Porch Deck Dock Boathouse (Circle one)
Size of Structure to be built (square footage) :
Foundation Material : Width Thickness
Depth of Footing, below grade:
Size of Posts or Studs: x x Long
Size of Floor Joists: x x Span
Decking or Flooring Material :
How will Porch or Deck be fastened to building?
If Roof Will Be Installed, Answer Following Questions:
Size of Posts or Studs: x x Long
Roof Rafters: x Spacing Span
Roof Trusses (pre-engineered spacing) : Span
Type of Roof: Sloped Flat Shed Other (Circle one)
Material of Roof:
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale and attached
hereto, showing clearly and distinctly all buildings, whether existing or proposed and
indicate all set back dimensions from property lines. Show location of water supply and
location and configuration of septic disposal area.
Size of Property: ft. x ft.
Existing building(s) : Size ft. x ft.
Size ft. x ft.
Use of Existing building(s) :
Proposed structure, distance from property line:
Front yard ft. Rear yard ft.
Side yards ft. and ft.
If on corner, setback from side street: ft.
DECLARATION
To the best of my knowledge and belief 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 not, and that such work is authorized by the
owner.
e
DATE: 5c, , SIGNATURE / `---------
wner,' Owner' s Agency, Architect, Contractor
REVIEWED BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE
, �
Building • rinl Application • • •l of vii O f.11(.'(:'i,sbill:)t - Dept. of Community iturits+ Development, 742 flay !load, Quccnsbtuy, NY 12804 /761-8256J
11Ull.UlNc; • cF CODE ENFOltCFMLNT' � ,
li[JriiICE cl:Is prior to issuance
-------- . Requirenl---• of this ltcrntil: PERMIT FILE NO. 19-.5g9-
A p a,111 l outs! be uhbtinccl Wine PERMIT FEE PAID$
•
beginning conslrnclion. No inspeeliutts 7�cnrlttp, Ilcxtrc!ildiotl
will ho tondo unlit npplic not Ims teec�ived , I—I !t1` 't : , j'' -Lt!
n VALID IMIL )INU I'URt Il I'. All i Awn /Use r/1L�1TlUN ! V$
nl,I+licnnln' t.Iucccn on Ihin nlq+licntinn . __ , ` a ---
MUST'lxs completed nncl•Ihc sign:time 1771 1'la,,uing 1)val•t1 Action REVIEWED 141:"�
of the applicant most nptienr on the SI% / Subdivision /Oilier
Building lrulxcwr•
fly>licnliuu linen. ra..:.tp --__ -1 Rectcrtlion Fee I'styiitelit
I he Itl.i.chtct�Cat U/tunl.t, IIt Owner:
Same
Applicant: .
• /Cddtcss,
1810 Route 9, Luke c;hu)tje, NV 128Alithcss' .
!'hone /i ( 518 ) 668 - 3316 I'Itutic // ( ) - . _. ... .. .'
Properly l,ucalion: Tau Mop Number_ 42 , 7/ 33
,
Section Block LotSubdivision Nantes _E{ta{�
NATURE or PROPOSED tiOR C: ESTIMATED MARKET T
L E Oer 111;
Hew Building: COrt5'J.'ltUC'.1'ION: •$
`—'� r.eeldonce / cotnnter,c.La1
AdctlL.i.ctn to I.In1J.dincls UCCVE'l1tICX If1I"UItMl1'1'xoNs
r:c(r l.cic:ncr, / commercial Primary ld
r Uu.i l.rlrlty
A.Ll;c.Urtt: i.ort to I.ttt i.Ldt.ttcl: x argt.o ns.ii.J.y Dwelling
• residence / commercial
Residence / Commercial Two Family U, th �
change.. to exterior size latlly J t c
no
_
Office
Mercantile SEP 1 3 1999
Other her Work (describe below) Manufacl:ur3.ny . - +S a-,; ;:
_ — Other 1 _,•,:t°.���1 OF Q..:c��-iJSF�,URY
•
MSS Alt[:A OF PROPOSED STRUCTURE: I ADDITION,. wital: will use
1st FJ.00r 1 \& sq• ft' of new, .addition be? :
2nd .Floor • eq. ft . N A .
Other Floors — eq. ft.
(not unfinished cellar or basement:) ACCESSORY UUILUIt1d5=.
. ... • 2 car
__
TOTAL FLOOR AREA: Detached Garage 1,
1�'1'• Attached Garage 1,
' -1
\ St1• x private . Storage Dui •
Conunercial Storage building
SIZE OF tILW STRUCTURE: Other .
Foundation Type:- roakec[ Willlu><, any
r vsecond-hand
econ -handr3or ungraded
' Number of Sl;ories :� —� S'xCt•i:
(habitable apace only) Za reel TYPE Ul" (I1;11Ittd 8
Nu bier- (grade to ces a) . circle all whit R,PI ee)
Number of fireplaces and/or wood Love Electric / Oil Ga Wood
to be installed: ___�_____ Forced IIoL' Air / R e oard / Other
ards
Per
son re ponslble . far supervision on of work aEri garde t building ng
codes 3.s : ___ja �.haac(.uiL,__�Ul d lresect PI)Rn128d5 518-6G8-331G
Ntinte Iile. 1810 R.L . 9, Lake. Ge.o/u e nY
tiui.J.der: the Cvli.r.haef� G)tuit.p-,
Plumber: I duct (' :utb ln,_1O I'aisk Rgacl, GZeltz f_NY 12801 518-198-939
Mason: _.UL liail`chn lr.,_13.0 2L 21t_8_,_Q(uJ.vi_C.C.e..N Y1— SL8__,i 8-3!1-9 9 2
'_lia _o_v_B_-l:-r'.edit..i_c.,�-41:216.4.A i-C cl- =�-.— f lE1 sy��-1-2.3
Elect r.tc:a.�tn .
DECLAIM:110N: Please slut below Oa you have ganef tlly read the statement.
To the hest of my knowledge the statements contained inhis applil proposeof d work tvlth the
plans
e o
. mid specifications submitted, Mire n true and complete statement
the ilcsctibcd ittctttises and that all provisions of the Building Code, the Zoning•Or to be andon all
d
either laws pet l:ainittg to the proposed work shall be
complied
ct pli with, wherspecified
rorntedn
that such wetk is authorizccl by the owner. ut thor, it is understood shall priord a
ettilicntc of Occupancy'or Cettiftcate of Compliance being issued, an AS BUU 'r PLOT PLAN by
�- + actual location of project on premises.
a licensed surveyor; d ttv' lode, showing
•
Signature:
r..,.n,nr .putter's anetst, architect, contractor)
Se_l'J_e_l'J_-0.._me..l'J.• Jtl''Ae_l •_l'x•_l'itAv.4!1-me.l'3•.lJ_,l'A•_l'.k•l'J_•_lJ_•lJ_•_l'LEIJ_e AUP.II:1" J_,_l' . ILQIM: •09.L15_0_l1_4 ...1:el: •..1,15•1l'J_•_l'e J_._l' e J_•_l'J_• J`.. J•_C .l_'/,
=G IY
` •
-r � THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGEIA
!(1 BUREAU OF ELECTRICITY ,
it 111 WASHINGTON AVE. SUIT ALBANY NY 12210
CEC'E1gf3Fk' ? 3L? 9 4065-.29Q/99 r7 147517 �r
jl Date Alleleon No.. n f'le iA
L1 1riJ, _ 5941;
'Ai THIS CERTIFIES THAT tr
!i only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of I
�CI a c'+ SURREY FIELD LOT y�E r 0i,
', Mr, al.Z'CH..l.1JLS GROUP, 6 7 SURREY ?IELD DR. ,. 3, QU E:NSBUR , 1"Y 1r
•
�i in the following location;
z<t 0 Basement 0 1st FL El 2nd FL G Section Block Lot 3=6 DEC.EME3ER 16,1 999 tj
If(1 was examined on and found to be in compliance with the National Electrical Code. to
:K1 IA
W! FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS 1Y
:, OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. t
•
1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS `
=G SYSTES IY
K; AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. mi H.P. NO.OF FEET AMT. WATTS Y
IA
. -1 1 2 2 — — . ,:
•
1t SERVICE DISCONNECT— NO.OF ______ _ _._ E.E. - _ _ R_.- _ . V — I_,__. C-.-_ --E.._
M
TER
-s1 AMT. AMP. TYPE EQUIP.E 1 0 2Wlam 3 0 3W 3 0 4W NO.OF CC COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. tr
:41PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL 1Y
!Ki IA
170 IY
:<, rill.
-v OTHER APPARATUS: I
• POST LIGHT-1 i i r
WI CEILING FANS-2 . , y �I .
W; MOTORS:1—F HH.P. .IA
W; C.F.C.. :-5
Wi SMOKE DETECTOR:-6 - i IX"
_CI T
it 1 5
11 — 4 _ ^_ IY
-Zt ' Y
V:.
�I FOREVER El /�G. .4.: IJ f. 'C"t'1 1 I ( a ✓ 1WILD;,AMM 9. !ICPARTLON . Fr l._ ,-r .
• r�• �',-H a GENERAL MANAGER •
1 2446 ,.:T7 '. ?EY ST. ?`�` "'e��?1 1
t SCH NECTAD4', NY, 1230_T ^71' . a ; '.e'b .- - Per 239
4-4 This certificate must not be altered in any manner; return to the office of the Board if incorrect.Inspectors may be identified by their credentials. ai
V,YeYY•YY•YY%YY•YYiYI'-•YY.Y.17•YYeYY Y.Vr., Y.YY.Y4YY•Y4Y4YYV114Y4Y474471Y•YY%YY�YY•YY•YY•Y4YY-.YY7.YY•Y4-YY•Y4YY-.YY.YYVa YY•YYeY.V1Y•YY•YY-•Y
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FIRE MARSHAL
;/, ' TOWN OF QUEENSBURY
•VnIr' QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED / 9
NAME /(.. -..Q O
LOCATION _i , - dLPERMIT# r"5 7i/
SCHEDULE INSPECTION ea) i . /1"
3 AM M
' ,f e % %,--4.-- APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS 1 in
EMERGENCY LIGHTING /
\ /
FIRE EXTINGUISiERS / l
TE FIRE ALARM SYS
FIRE SPRINKLER SYST:M
FIRE SUPPRESSION S STEM
HOOD INSTALLATION
INTERIOR FINISHE'
STORAGE:
CLEARA CE TO SPRINKLERS
CLEA FOk
NCE TO HEATING UNITS
REQUIRED Sid
NAGE
CHIMNEY
FIREPLACE • 'MASONRY ❑FACTORY BLT. ,/
❑ GHIN
FINAL
REMARKS: OK TO THIS DATE
"4kIff--- --
INSPSLIP.PUB INSPECTOR
.‘,/-.
RESIDENTIAL FINAL INSPECTION REPORT ,..4 .,
Office No. (518)761-8256 Date inspection request received; 27 lid ,
Building& Code Enforcement
Dept. of Community Development Arrive am/pm DepartlZ dam/
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New York 12804
NAME ' l`Gt.ee(75,-.Z7, ,1 0 /"� PERMIT# WI-5
�
LOCATION -,re 3^ 1,_,-1/_. In,-(o�� d-7-33 DATE
TYPE OF STRUC CS
N/A YES NO COMMENTS
i 1/0/d. ;14'
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 03 in. or m,9ree ✓
Interior Handrails stairs both sides 3 or more risers ` ✓/
Grade 2%away from foundation / V/
8"clearance to sill plate .
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or withiy. n line df site
Oil Furnace shut-off at entrance to furnac-aLea. /
Furnace/Hot Water Heater operating /
t/
Relief Valve(s)installed /
Headroom,6 ft. 6 in.on stairs /
Basement stairs,6 ft. 4 in. f 177.
Handrail exterior stairs both sides more than 3 risers ,/4-
Interior privacy/trim/doors/ma entrance 36" t/
Floor Finish
BathrFinish tchen waterti
/ (.7_,-
Interior Handrails Balconi /Landing 18 in. or more 7 •••
Railing across window in stairwells /
Smoke Detectors: i/
every level
every bedroom
outside every bedroom
inter connected /�
Bathroom fans 1//
Plumbing fixtures ✓
Foundation insulation ,/
3 hour fire door/door closer
Garage fireproofmg I
/r
Garage penetrations sealed �f
Furnace in separate room protected(in garage)
Light ventilation per room /� •
Safety glazing 18" 4ls rm
floorFinal Electrical ! /( t /) V
Site Plan/Variance required r
Final Survey Plot Plan 1-2-it lQdl V
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)
as_A- 4 6
TOWN OF QUEENSBURY
fif.tr„ f� BUILDING & CODE ENFORCEMENT
1"'h� � 742 BAY' ROAD
QUEENSBURY •NY 12-86A
(518) 761-8256
ARRIVE: DEPART: INSP: CA
FINAL INSPECTION REPORT - RESIDEN I
-I ll�-�-u-�- L
DATE INSPECTION RG/FUEST F ECEIVED: /� 1
NAME = J
LOCATIO e/C-
DATE 0I PERMIT H 1�-
11 .
TYPE OF STRUCTURE
FOOTINGS FOUNDAT / BACKFILL FRAMING _
ROUGH PLUMBING SEPTIC INSULAI ON
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILII
RELIEF VALVES /
FURNACE/HOT WATER OPERITING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
1
DOOR CLOSERS
FINAL ELECTRICAL
2 TE PLAN/VARIANCE REQ.FINAL SURVEY PLOT PLAN Gil
OK TO ISSUE C/O OR C/C
l4I141
. TOWN OF QUEENSBURY -
BUILDING & CODE ENFORCEMENT
742. .Bay Road0
Queensbury NY 12804 Q
(518) 761-8256 "gf
D, /1
SEPTIC DISPOSAL SYSTEM INSPECTION
Name UG46-49S 601-V
Locati o ; ;4/-5 _ , -4
Date 4 Permit # s-()-6 .N
SOIL TY . Loam- lay-
7i-LL
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each t ench ' • 1-163(Qkifo,j12
Depth of trenchep 1 Z1 LI_7 j c
Size of stone I :q;, ‘�- i
SEEPAGE--PITS: Number=
Size - _ `/ ft.
Stone size
PIPING: Size Type
Bldg. to Tank P' J, ‘t3,. -g_p
Tank to Dist. Box L_',0 -P\c
Dist. Box to Field/Pit << i T `1)Vt Uo
Openings Sea ed? es� Partial
LOCATION/SEP RATIOç1io
�
Foundation o Tank ityi— feet
Foundation o Absorption 7�-+- feet
Separation f Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPER .
(circle _ G�MMonJ PLEA
Front -- Left Side - Right Side
Middle -rout - fiddlesear
COMMENT§:==111
x1``'(0we,3t w 7cW 173
•
Lei 33
SYSTEM USE APPROVED: YES NO
Arrive, - !-
Dep. ed: '
ANAIIIIIIP
AK
Bui]ding I r_'p•ctor .
Ci
GENERAL INSPECTION REPORT P
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Qucensbury, NY 12804 Arrive`�'1 am/pm Depart am/pm
Inspector's Initials ',1�(./41-
NAME: • (7-h(Z i — ` � PERMIT#
LOCATION: S I;r.(\e 2ekf'J DATE : 1 7
TYPE OF STRUCTURE: i
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is respon for
providing protection tram frc zing
for 48 hours followin r the pl'cement
of th concrete.
Materials, r this pu 6.se on tc_
Foundation%Wal •-.
Reinforcement in P cc_
Foundation/Damp roofing
Backfill Approval
Plumbing Under `.lab_
Plumbing Vent/ ents in Place
gh Plumbin_
Heating Rough- n
Insulation
Foundation ails Interior R-
Foundatio Walls Exterior R-
Floors R •
-
Walls R-
Cei l i ng R-
Duct work or piping in
unheated spaces R- -
Proper ent, Attic Vent _ /
Fr. ling- � L J
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire 2, 3,4 hourA.Th
F. stopping V(8at�1,-
9 A-Yv `
GENERAL INSPECTION REPORT afis �-1�rJ
( 518 ) 761-8256
Town of Queensbury /
Dept.of Community Development Date inspection request received: 1 f C 0/7,
Building& Code Enforcement
742 Bay Road
Queensbury, NY 12804 Arrive TV'am/pm Depart am/pm
Inspector's Initials1
NAME: awl E M R 1_S &(Z-OU PERMIT#
LOCATION: 7 ���P ��e11� (L0T33>ATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection frorfreesc4ig
for 48 hours following t c placer ent
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval
Plumbing Under Slab l f
Plumbing Verdi- its in ace
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interi R-
Foundation Walls Eotcri R-
Floors R - " j,/I 'Jar✓:) y c IFS ,- �,v f.1,,
Walls R-
Ceiling ,fin
R-
Duct LG Gcll JZ`aG % ' .rc'��
work or piping in S
unheated spaces R- -_
Proper Vent, Attic Vent_ _;;�/ _,/'
'Framing -- — /r V' �
Jack Studs/Headers ✓1
Bracing/Bridging
Joist Hangers v'
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2. 3,4 hour
Adfirestopping
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
Inspector's Initials
NAME:
_ 1
Ceti
SIN (' P,c Q C � PERMIT#
LOCATION: S( �� � e\d DATE : I— — Cl
TYPE OF STRU
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor i. res.•nsible for
providing protc•tion fr• i freezing
for 48 hours following tl a placement
of the concrete.
Materials for this •urpose o i site
Foundation/Wall r•ur
Reinforcem nt in 'race
Foundation/ •.ling
Backfill Approval
Plumbing Under Sl•b
Plumbing VenUVen s in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls fterior R-
Foundation Walls .'tcrior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing_
Jack Studs/HeadersPi
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Pciiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Firestopping
FIRE MARSHAL4 1
f '` TOWN OF QUEENSBURY
..ai j. QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT /'
REQUEST RECEIVED // / 4 PERMIT# -S7
NAME V� ' 'me- 6
LOCATION 075/Giv-e/\______ C( Z---i—
SCHEDULE INSPECTION ON ',i1 /-_1' � 9 '
e...9AD ANYTIME
,Ni-el
(r e_ APPROVED
N/A YES-V NO
E S
AISLE WIDTHS
EXIT SIGNS (--- \
EMERGENCY LIGHTING
FIRE EXTINGUISHERS \
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES __
STORAGE:
CLEARANCE TO SPRIN ERS
CLEARANCE TO HEAT! UNITS
REQUIRED SIGNAGE '/� `
CHIMNEY D ��� V
WOOD STOVE
VF REPLACE-MASONRY /
I REPLACE-FACTORY BUILT 1/
REMARKS: KG a, I it) E-OK TO THIS DATE
111-10rIC 'Pa 34, -RA)
INSPSLIP.PUB INSPECTOR
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
" Building& Code Enforcement
742 Bay Road rir 7-
Queensbury,NY 12804 Arrive am/pm Deparf/ a pm
Inspector's Initials-0-
NAME: 1(G1(46S 6 to PERMIT# / "- 67
LOCATION: "6,7 .0e-ye-P-6 lidihV5 DATE : /" /6` /"..
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsibl• for
providing protection from fr ezi
for 48 hours following the . ace tent •
of th oncrete.
Materials o his purpose on •
Foundation/Wal
Reinforcement in Place .
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab •
Plumbing Vent/Vents in ''lace /
R gh Plumbing
eating Rough-In
Insulation
Foundation Walls nterior R-
Foundation Wall• 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
1114r
�u- Mon_ q-at
�61}.•
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location 6 1 5a' l d
Date`O'd-�9 Permit # 11- `;qq
SOIL TYPE: Sand-40-Clay
-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPT IN LD: Total Length
Length of each trench
Depth cf trench s
Size o' stone
SEEPAG' PITS: umber-
Size - _ t. x ft.
Stone si e
PIPING: Size Type
Bldg. 6 nk #" 5o/2 3-
Tank to D 'st. Box
Dist. Box to Field/Pit
Openings S-aled? Yes . No Partial
LOCATION/SE?ARATIONS:
Foundation o Tank J 7- feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot P1 an s o
LOCATION OF SYSTEM ON PROPER
(circle one) )
Front - Rear;- Left Side - Right Side
Middle Front(- Middle Rear
COMMENTS: /;,)/( ,— 6 k
E A-e--- P/Pe- r-e)0&:d04 r li v 604-4c
r- -`i- aPpS-('T �i(C 1) ra-f"
C. A e_r—. ia c cl<
SYSTEM USE APPROVED: YES ONO
Arrived:
Departed: 660 ,
Building Inspector
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name=L/r - '-t-5 G2'
Location L; 0�,�s,1
Date ./06-Af Permit # 9?- 594
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: o 1 Length
Length of each t ench
Depth of trenche
Size of stone
SEEPAGE PITS: N mb6r-
Size - f . x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fiel /Pi
Openings Sealed? No Partial
LOCATION/SEPARATII .
Foundation to Tank \ feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot; Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front,- Middle Rear
COMMENTS: / &ck6--cic — &Q 1 f 6._
u ppikT - K to 6(xiik
SYSTEM USE APPROVED: YES .-N�
Arrived: oL
Departed: �
Building Inspector
GENERAL INSPECTION REPORT r
( 518 ) 761-8256
Town of Qucensbury
Dept.of Community Development Date inspection request received: / — - —47 9 •
Building&Code Enforcement •
742 Bay Road
Qucensbury,NY 12804 Arrive am/pm Depart Aa pm
��
Inspector's
Initials /�
NAME: PERMIT# 59y
LOCATION: DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Fonn
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
FAundation/Dampproolin \\ANN:
`4 cklill Approval
[[[ Plumbing Under Slab
Plumbing VenUVcnts 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
0 Mil -
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury •
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Qucensbury,NY 12804 Arrive am/pm Depart. al pm
Inspector's Initials
NAME: \ PERMIT# —5
LOCATION: '7 �S 6 es.Ce7:1:-,..t-LI
,�\, _ DATE : / -0 7 -
TYPE OF STRUCTURE: 5c v
RECHECK
N/A YE NO COMMENTS
otings/Piers 1 I
Monolithic Pour Form
Reinforcement in Place 4
The contractor is re,:• s 1e for
providing protccti e n fr. freezing
for 48 hours folio ing the placement
of the concrete.
Materials for this p+rpose n site
Foundation/Wall.. r
Reinforcement in "lace
Foundatp. ling
Backlit' Approva
Plumbing Under lab
Plumbing Vent 'cnts in Place
Rough Plumbin..
Heating Rough n
Insulation
Foundatio Walls Interior R-
Foundatio 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 Scaled
Fire Wall 2, 3,4 hour
Firestopping
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