1999-735 . . .
Certificate of Occupancy
Town of Queensbury
Warren-County, New York
Date March 3 , 2000
9975
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a SINGLE FAMILY DWELLING
Location LOT 17 #1:90 SURREY FIELD DR.
Owner ,'141E L L . .
TAX MAP NO. 418 . -8-17 By Order Town Board
Director of Building& Code Enforcement
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 128000 Building Permit No. 997'Li
TAX MAP NO. 48 . -8-17
Permission is hereby granted to MICHAELS GROUP,THE L.L.C.
Owner of property located at T,oT 1 7 #9 0• SURREY' F T F.T,T') nR _
•
in the Town of Queensbury,to construct or place a INGLE FAMILY DW r.T.ING
at the above location in accordance to 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.
Owner's Address:
10 BLACKSMITH DRIVE
MAL TA, NY 12020
Contractor or Builder's Name:
• - ;IIICHAELS GROUP, INC.
Contractor or Builder's Address:
JIM CHANDLER, PROJECT MGR 10 BALCKSMITH DR
MIALTA, NY 12020
Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK BOARD OF FIRE UNDERWRITERS
Type of Construction:
SINGLE FAMILY DWELLING
Plans and Specifications:
1315 SQ FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
SINGLE FAMILY DWELLING
$ 191 PERMIT FEE PAID—TRIS PERMIT EXPIRES December 13 2001
(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 this 13 -Day of December 19 9 9
SIGNED BY -. for the Town of Queensbury
Co Enforcement Officer
1
Application tor Jtr l ll: U16fU611L YtKLV11 I
Town of Queensburyyy �a —���
Dept_ of Community Development R F- fl y E D Permit No.
Building &Codes Office „
742 Bay Road D C V - 2 1999 Fee Paid $ •
Queensburv, NY 12804 (
fC ,r�i OF 01_52El JELA.rl1
BLHL.DiNG AND CODE.
Location of property for installation: 10-k- uli
Property Owner's Name: Midae,LS E u n L C
Property Owner's Mailing Address:. lQ 1:312ckSmtivIDRIvE Maltz �1. t s 9
Installer's Name: atig - fkaai-Tilj Phone I# 1/0-�-a n q
Number of bedrooms (if residential): 3 Total daily flow: 4S7)
(residential - compute @ 150 gal./bdrm.)
Topography: ✓ flat, rolling, steep slope % of slope
• Soil Nature: ✓sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: not required, i/ required [rate I min. per inch]
Domestic water supply: municipal, well, other •
If domestic water supply is a WELL, water supply from any septic absorption is feet.
•
PROPOSED SYSTEM
•
Septic tunic l= gallon (minimum size: 1,000 Qa1 )
Tile field: each trench- Lif feet / Total system length: I(p feet
Seepage pit(s): number of ,�iO / size each: . ft. by ft.
•
Size of stone to be used: #a St u )C., / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Ai IA- Size of each: gallons
Alnffi system and associated electrical aoxi to be inspected by a certified agency. J
-.
For your protection,` please note that pursuant to Section 136=29 of the Code of the.Town of Queeasbury, any per or
approval granted which is based upon or 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 it aj .t to this application and agree to abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Disposal Cl
Signature of responsible person: te'v Date: l.a-iry f-e
Building Permit Application
Town. of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-82561
• ° BUILDING & . CODE ENFORCEMENT
NOTICE Requirements prior to issuance
`
r 1 of this permit: PERMIT FILE NO.
A permit must be obtained before
beginning construction. No inspections QO
PERMIT F PAID$
will be made until applicant has received n Zoning Board Action
a VALID BUILDING PERMIT. All Area /Use RECREA E FEE PAID$ S
applicants" spaces on this application
MUST be completed aftd•the signature El Planning Board Action REVIEWED BY: CA Ik
of the applicant must appear on the SPR / Subdivision /Other Building Inspector
,implication form. nme�,,. J Recreation Fee Payment
Applicant: Tir4E leticirve 1s CagoAlP Owner: G6'rnt•
' Address:16%e(Lnrn*E .tka. 16.vlq.rit526 Address: n r-a�
eL.J..47,ii E,D
Phone # (BIS ) S'n -(p?j1,1 Phone # ( ) Gc,C-��k -ss
Property Location: �- �a�t.Mln��1,2���ii:=0.. .,'�- ',� - - 71V.
/ S) (`-]
Subdivision Name Sutztly Vte�.vs `��`TY1U �.�Dspt4, Tax—Mapp Number, ,—/
- 1 1 �-Section Block Tot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
X New Building: CONSTRUCTION: $ 12eTCc-
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial X Single Family Dwelling (---0
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwellin
Office /�
/ 55
Other Work (describe below) Mercantile (�
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE: lk:-.3p.
1a-Y 13 If ADDITION, what will use
31
1st Floor v5 sq. ft. J
of new addition be? :
2nd .Floor sq. ft. WA.
Other Floors — sq. ft. 7-)Th
(not unfinished cellar or basement) ACCESSORY BUILDINGS:• Detached Garage 1, ‘,T
TOTAL FLOOR AREA: t;45 SQ. FT. A Attached Garage 1, ,,
Private Storage Buil. - g
SIZE OF NEW STRUCTURE: Commercial Storage Building
44 FEET X 5a FEET Other '
Foundation Type: . ?�9REYj Will any second-hand or ungraded
' Number of Stories : ( lumber be used? If so, for what?
(habitable space only) NAp
Height (grade to ridge) : As feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which a.plies)
to be installed: C • Electric / Oil / / Wood
e Hot Baseboard / Other
Person responsible for supervision of work as regards to building
codes i s : 9at k 1.- rn eat CAZ $RA A 1.reeek1A4Z
1NaTe Ap�1dre$$ss Phone
Builder: -[In:...V(tch S eaup. tO ca2�cksektt>1' 4v�. t lk ‘zei -(cat t
Plumber: CAC— leltbrrtic,tru5 l?:t!.C .A\C_' .,eel 2LA‘cPartt% 1220 P 4(4n-2
. Mason: 11 -A.s.-VveNc Conc. 443 tlattx_ IleeN► t�12 2 0(03
Electrician: 'Ekat4tR..� Rod ( -
Cr *.1r4e_t S , gc1nL+. %Z30es 3`1i -9 -z-i-
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 I/we shall submit prior to a
Certificate of Occupancy•or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; awn to scale, showing actu ation of project on premises.
Signature: &-a 0.-I_1 9
(owner, owner's agent, architect, contractor)
THE NEW YORK BOARD OF FIRE UNDERWRITERS CERTIFICATE NO.
DO NOT WRITE HERE-FOR OFFICE USE ONLY
BUILDING PERMIT NO.
TEMPI DATE I , i t- J-. ✓)
CITY OR VILLAGE ZIP CODE TOWNSH P\/ �i �� COUNTY r
STREET AND NO.OR ROAD POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOC ED? SECTION BLOCK LOT
VA
OCCUPANTS NAME 1\ANC-es` ., �\�( BUILDING OCCUPANCY
\ -
OWNER'S NAME AND ADDRESS ` ac.L— ^\�� ` � HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY ````A`v1 \\ FROM THEIR' OFFICE WORK TELEPHONE NUMBER
1\ C\
BUILDING IS 1�y
NEW t� OLD ElWORK IS NEW ADDITIONAL CI DEFECTS REMOVED Elf LIST BELOW ALL EQUIPMENT WHICH YOUINSTALLED
•
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st
FL.
2nd
FL.
3rd
FL. -
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
COS} e`.
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS
� � pS'- Applicant affirms that there is not an application for electrical
CHARACTER OF WORK ` ❑EXPOSED
❑CONCEALED inspection pendingwith a qualified electrical inspection
DATE WORK TO BE STARTED DATE COMPLETED authority, for the installation listed herein.
This application is valid for a period not exceeding one year-
SERVICE ENTERS BUILDING from the date received by the Board.
❑ OVERHEAD 0 UNDERGROUND ,
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANT'S Il� I� I I I �
IDENTIFICATION NUMBER>
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FIL ED IN OR APPLICATION MAY BE RET RNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION XSIGNATURE OF APPLICANT
STREET ADDRESS 24 L . /-(�v _ , y - TELEPHONEiNO. 9/
�CITY OR POST OFFICE �'� C••-k- �J\� ZIP CODE LICENSE NO. APPLICABLE
❑ 85 John Street 111 Washington Ave. NE 3291 Lake Shore Road ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK, NY 10038 SUITE 704 I BUFFALO, NY 14219 I ROCHESTER, NY 14608 SYRACUSE, NY 13206
(212) 227-3700 ALBANY, NY 12210 (716) 827-1155 (716)254-0141 (315)463-8552
(518)463-2122
THE NEW YORK BOARD OF FIRE UNDERWRITERS -
-....11111111111
• •):J,,Q • �6.1'J_�_ ...)•_l'J!ti •� l!').*�!l ._l'5.0.:eA J.0_l'AU' l''AQ'AU AP;'AQ:Cl_l'Al!'AU 5.0_l'A Al''AU Al'Al'5.4 A A:A!5Ak'AII)' :J_.,l 1,Q 5AQ 5A1 J0l''P, ..1 AUUse,Q V,
THE NEW YORK BOARD OF FIRE UNDERWRITERS• ' PM.1I I r
4028789 BUREAU OF ELECTRICITY ,
' 111 WASHINGTON AVE., SUITE 704 ALBANY, NY 12210 •
Wi NARf.'1.1 0il 2000 46.3 ,530i0/0O El 149242 r
(r Date Application No. on a 1.).,,=cr P aRI11T . 0, '.t9'l3!-) ' ,�=
!k$ THIS CERTIFIES THAT i>'
41 only the electrical equipment as described below and introduced by t licant na d on the above application number is in the premises of A
A I:`NE NI G:RO t.1E', 90 SUR1tE;Y F'1 1:;LDSQUEE;i :31, -1t1RY, Y P•
j; in the following location; ® Basement 1S 1st Fl. ❑ 2nd Fl. GAR t Section Block Lot y
zt+ was examined on 1"1'ttiF{lal�l4fY `� •
': O}t3 and found to be in compliance with the National Electrical Code.. 1
zi � :
_4 Ir
c FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
• OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. hi
AI
AI
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
i AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. Cil H.P. NO.OF FEET AMT. WATTS
14
_<' SERVICE DISCONNECT NO.OF S E R V I C E 'r
=G rY:
•
_-' AMT. AMP. TYPE EQUIP. 1 0 2WmEN 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. I
j PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL rY
OTHER APPARATUS: Ir-
r •y-,:
-ir r
SMOKE DE1'!IL'C 1'OH:-•4 4,
1i rY
ij!
i
-(, rY
t(I h
1 — ,. .... Wf
. .r.
��(i • 4 r 4� •r h
1 FOREVER ELEC/B0M ELECT. F j u R"�' tr
U}LL1AU ii. UCPt1RTDO1� a 4. ` .(}�:.t' , '' .1
I 2446 J_AF1.'REY. ST. ('� `�: S- f' N'• GENERAL MANAGER I
•
t! , yt ss I9.
•K, �C.1aEfi>11'�I-.tA1.)"Y, td�,. '1'1.'{ply 7 � r, %:'I'� (}?
►+�d ~`° .` Per '
I IA
j; 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. 5
/,4Y.76Y Y.1�476 Y�Y.Y.Y Y.Y Yir,Y•Y Y.Y,Y•Y Y•Y 4i1:4Y ysY 7�Y Y4ir,Y•764Y Y•Y 46 Y.Y Y�Y Y�Y Y••Y,;Y•Y Y�Yr4Y Y•Y Y•Y 47r,41;47,ri YiY4Y4-t,Y4Y 4Y Y�YI'iY Y.764Y YV4 474YiY 5i.76476S
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
,. ._ .
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement
Dept. of Community Development Arrive am/pm Depart
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New York 12804 �
NAME W k\C14 A-6 L S 1- /PERMIT# ' ` ~73 5...—
LOCATION DATE .-5(9) /a
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location 4 '
Fresh Air Intake V //
Plumb Vent through roof i1/
Roof Complete
Exterior Finish Complete ✓/
Interior/Exterior Railings 30"t 36" i//
Exterior Handrails,balconies,lan • g ; .'. : more �✓
Interior Handrails stairs both sides 3 o more risers /
Grade 2%away from foundation ✓
8"clearance to sill plate ✓
Gas Valve shut-off exposed/reg for 18"above grade /
Gas Furnace shut-off within 30 .-t or within line of site / /
Oil Furnace shut-off at entran • to furnace area /
Furnace/Hot Water Heater o ating J�
Relief Valve(s)installed ` ,/
Headroom,6 ft. 6 in. on .tairs ,/
Basement stairs,6 ft. , in. r
Handrail exterior . s both sides more than 3 risers ✓
Interior privacy/ . doors/main entrance 36" f
Floor Finish
Bathroom/Kitc+,en watertight ,�
Interior Handr ils Balconies/Landing 18 in. or more ../
Railing across window in stairwells I
Smoke Detectors: ✓
every level
every bedroom 11,
outside every bedroom
inter connected ,//
Bathroom fans ,1
Plumbing fixtures /
Foundation insulation „/
%hour fire door/door closer �/
Garage fireproofing �/
Garage penetrations sealed / V
Furnace in separate room protected(in garage) ✓
Light ventilation per room f
Safety glazing 18"or less from floor +✓ ,
Final Electrical
Site Plan/Variance required /
Final Survey Plot Plan /7
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)
t
TOWN OF QUEENSBURY
BUILDING_& CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Mlc t-w 6PIP,
Location &ieeLG;' hrG—c.0
Date ' 5 3 \CO Permit #
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total L- g h
Length of each trench
Depth of trenches
Size of stone Aiiiiir
SEEPAGE PITS: Numb
Size - ft ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box t• Field/Pit
Openings S• .led? Yes No Partial
LOCATION/4EPARATIONS:
Foundat'on to Tank. feet
Founda ion to Absorption feet
Sepa .tion of Pits feet
Con 'orms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
ri&-LD /4_c_y_...riGc__ —
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
Building Inspector
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
A lc Name /"/--/ 6/- �f� �
°Zf/Locati di#' qO -,,
I4 G
Date j/c /atoaPenflitV99- 1 5
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Lengt.
Length of each trench
Depth of trenches
Size of stone
SEEPAGE ' S: Number_
Size - ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. lox
Dist. Box t Field/Pit
Openings S,aled? Yes No Partial
LOCATION/ EPARATIONS:
Foundat'on to Tank feet
Found. ion to Absorption feet
Sepa ation of Pits feet
Co orms as per Plot P1 an Yes No
LO ATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS: . , r---
_ ,„ C
u/i-r G1=r. LPo
CniLic �le Co G RA-oC 00612 F i&c:a
' SYSTEM USE APPROVED: YES NO
Arrived: ` , A
Departed: " ( 1 le,,
Building Inspector
FIRE MARSHAL
TOWN OF QUEENSBURY
ift ,,,
j QUEENSBURY, NY 12804
" , (518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT#It7;
NAME \AN.t tW
LOCATION
SCHEDULE INSPECN
AM PM ANYTIME
APPROVED
NIA YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
,\
FIRE EXTINGUISHERS
FIRE ALARM
FIRE SPRINKLER I EM
FIRE SUPPRESSION SYST'
HOOD INSTALLATION
INTERIOR FINISHE
STORAGE:
CLEA•7'NCE TO SPRINKLERS
CLE: •.NCE TO HEATING UNITS
REQUIRED •IGNAGE
CHIMNr
WOO a STOVE
F r PLACE-MASONRY
FIREPLACE-FACTORY BUILT I,`V
REMARKS: K TO THIS DATE
INSPSLIP.PUB INSPECTOR
TOM OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date 4) d7.) Permit # 99 — 755'
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Te
(if applicable) Rate-Min to/Inc.
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of tre' .hes
Size of stone 111111,
SEEPAGE PITS: ber$PI
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank _
Tank to Dist. Box
Dist. Box to Field/'it
Openings Sealed? Yes No Partial
LOCATION/SEPARATION' :
Foundation to Tank feet
Foundation to Abso tion feet
Separation of Pits feet
Conforms as per Pitt Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
C /4-P ce, it& — ivt)
01+01
SYSTEM USE APPROVED: �0, . - NO
Arrived: `
Departed:
3iZQ-
Building Inspector
-,41' RESIDENTIAL.FINAL INSPECTION REPORT 1.t.K
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement 27,V
•
Dept. of Community Development Arrive am/pm Depart"` ff am/
Town of Queensbury Inspector's Initials %J 12. 1� ` l
742 Bay Road
Queensbury,New York 12804 C� �jy
NAME t—Y�ULCQv ��l`' or, PERMTI # l L �
LOCATION 1NcrseA% DATE i — ,r X•erC i
TYPE OF STRUCTURE • "4- -�
N/A YES NO COMMENTS
Chimney Heightl"B"Vent/Direct Vent Location //- +
Fresh Air Intake Vr-
Plumb Vent through roof VV/
Roof Complete V//
Exterior Finish Complete ,//
Interior/Exterior Railings 30"to 36" ✓/
Exterior Handrails,balconies,1•, •k:•g 18 in. or more ✓
Interior Handrails stairs both Q,des 3 ► more risers
Grade 2%away from founda :on ,//
8"clearance to sill plate �//
Gas Valve shut-off expose'/ regulator 8"above grade ,/
Gas Fi3rnace shut-off wi 30 feet • within line of site
Oil Furnace-shutoff at ei a, -- o furnace area
Furnace/Hot Water Beat;r operating
Relief Valve(s)installe•
Headroom,6 ft. 6 in. o stairs 7 f
Basement stairs,6 ft. , in.
Handrail exterior sta. s both sides more than 3 risers
Interior privacy/trim/ oors/main entrance 36"
Floor Finish /
Bathroom/Kitchen .tertight / l9
Interior Handrail Balconies/Landing 18 in. or more •✓/
Railing across dow in stairwells f
Smoke77-
Detecto s:
every leve
every be• oom
outside,•very bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closervr
Garage fireproofing
7
Garage penetrations sealed /
Furnace in separate room protected(in garage) �f
Light ventilation per room
Safety glazing 18"or le s fro floor /
Final Electrical IS IV /1/j6' �"
Site Plan/Variance re uire
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance) ldl uk. _Ke 46',
Okay to issue temp. C/O(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
1(NQ\reC ) o��' - —. t-vbda, 2c,
r a,, TOWN}OF QUEEN (URY ,,-o�0,,Q'
BUILDING & CODE ENFORCEMENT
742 Bay Road ,
Queensbury NY 12804 '`' ' l V• 3 C
(518)761-8256 G -
SEPTIC DISPOSAL SYSTEM INSPECTION
Name M � O Gi )k,
Location 9c) )c\- '- ,e_A
_., ,
Date -' , t # _�,
AC
SOIL TYPE: Sa; • Loa Cla -
Results of Pe.colation Tes' -
(if applicabl : ) Rate-Minut'/Inch
TYPE OF SYSTE •: Q i
ABSORPTION FIELD: Total Le gtil /(®U _
Length of each rench • . . _
Depth of trencte.,
Size of stone It P L-- l2/2._
SEEPAGE PITS: Giber-
Sizei- f , ft. .
Stone size
PIPING: Size Type
Bldg. to Tank T 3e:13 p
Tank to Dist. Box ' ii Sae_ 3C
Dist. Box to FieldRit iz 5Lr) (90
Openings Sealed? No Partial
LOCATION/SEPARATION ,.
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot P1 an CP No
LOCATION OF SYSTEM ON PROPERT
(circle
Front Rear - Left Side - Right Side
Middle • - •nt •- Middle Rear
COMMENTS:
‘_- A - - elCL-� POi-A)
/Itri�-6 - t e y
Sk,iic o 6Li'5 . L e s IL f /7 11 i,i= 011= Fi6.i-fJ
f.N'iir9-cam[ U 4-7- rh t- 'Tii �� t o iz_067
iSii1-o t3 it,>> 4G e L-'r-r�'t ram.
SYSTEM USE APPROVED: YES NO
Arrived:
Departed: �- `t7
Building Inspector
TOWN OF QUEENSBURY
1!' l,,, ., BUILDING & CODE ENFORCEMENT
742 BAY ROAD
� ' QUEENSBURY NY 12804
(! (518) 761-8256
ARRIVE: DEPART: INSP: v ,
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST ECEIV D:
NAME
LOCATION
DATE �� ''���� PERMIT
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 RAILIN S
RELIEF VALVES
FURNACE/HOT WA .ER OPE TING
INTERIOR TRIM/P IVAC DOO S
FINISH FLOORS: I
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPEETED
STAIR CLEARANCE/ ILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSUL TION
GARAGE FIRE PROO ING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
V L SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
jr—ZAIKA -ta7,
•
GENERAL INSPECTION REPORT .vr
( 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 pm
Inspector's Initials
NAME: c 4 PERMIT#
LOCATION: I = llY DATE :
S
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 freezing
for 48 hours following h ie placement
•
of the concrete.
Materials for this purpose on site
Foundation/Wal(pour_
Reinforcement in Place
•
Foundation/Dampproofiing
Backfill Approval
•
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough PI bing
caU ough-In
.lat""{io
oundation Walls Interior \(-
Foundation Walls Exterior R- /
Floors R-
Walls /
R- ' 1 +t,
Ceili
ng g R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing •
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam _
Air Infiltration Barrier
Fire Separation I, 2, 3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
of rc`stopp�cng
_ :#11111111N13P
:7-9
er'-\-
GENERAL, INSPECTION REPORT
( 518 ) 761-8256 •
Town of Queensbury ( 1? _ „\)
Dept.of Community Development Date inspection request received: C/� t ��"_
Building& Code Enforcement
742 Bay Road z ' /
Queensbury,NY 12804 Arrive am/pm Departs • !�am/t�m /
Inspector's Initials
99-----q,-)
NAME: 6E1-41C;`� PERMIT#
LOCATION: tJ 7 U DATE : `lCe-,_ 'd--
�� TYPE OF STRU URE:
51142 i
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is respons'.le fo .
providing protection fro freezin
for 48 hours following t e placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement if i Place ' -
Foundation/Daneroofi g
Backfill Approval .
Plumbing Under Slab_ /
plumbing Vent/Vents i Place
h1Pl utnbing z
eating RoughtF1 k/
Insulation
Foundation Walls I iterior R-
Foundation Walls t xterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or pi. ng in
unheated spaces R-
. oper Vent, Attic Vent n
. • Jack Studs/Headers /
Bracing/Bridging U
Joist Hangers iJa ck-Posts/MainBeam _
Asir Inf Itration 13a[ricr _
`' Fire Separation I, 2, 3, hour
Penetration Sealed
Fire Wall 2 3,4 hour 4,3.r4a:_4.•Fir€s P i 1"!ts&c. Ajcr 8 — clC—/i 1 , -Li.
Gvi(e_ j.t,cc— �. L u, ;2li.c..
TOWN OF QUEENSBURY
BUILDING.& CODE ENFORCEMENT
742 Bay Road
• Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION •
Name -cVW' C.J26 Gyl
Location ��p 2-M? rSUrir (0)�
• c 2
Date j, '.) /Permit #T •- _
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIEL : Tottl Length
Length of each rench )
Depth of trench s 1
Size of stone / .
SEEPAGE PIT S,•N u t r-
Size - . x ft.
Stone size
PIPING: Size Type
Bldg. to Tank ;..f"-5tArg L-c: -i— ",va)i
Tank to Dist. Boa .
Dist. Box to Field/Pit
Openings Sealed? Yes No _ .Partial
LOCATIOt1/SEPARAT ONS:
Foundation to Tank. V 5 .feet
Foundation to Absorption • feet .
Separation of Pits feet
Conforms as per Plot Plan Yes No
.LOCATION OF SYSTEM ON PROPERTY:
(circle one) •
Front ERear = Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
\ 1 ,: L.
SYSTEM USE APPROVED: YESc ,_O•y......_.,_
Arrived: ,,._ V/' .1 1
Departed•. Ct;0-5_, , )/
// -•�... / "7 �,.7
/.B'uilding Inspector
0-------.,
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
rt/Z 5)Queensbury,NY 12804 Arrive am/pm Depa ' mn/pm
Inspector's Initials
NAME: PERMIT# f \C
LOCATION: �• ( ` e, �� DATE : �
O\
TYPE OF STRUCTURE: 7-2
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I I
Monolithic Pour Form
Reinforcement in Place �`� 1� (j\--
/The contractor is respos'ble for \CG�{�V" ,� 1
providing protection rom freezing Plo% 1
for 48 hours fo11o% th placement
of the concrete.
Materials for this urp9 eon site
Foundation/Wall _ u
Reiitforcomenfli Place
Foundation/Da pproofing_
ill Appro al
Plumbing Under Slab
Plumbing V nt/Vcnts in Place
Rough Plu bing
Heating R ugh-In
Insulatio
Foun lion Walls Interior R-
Fom •lion Walls Exterior R-
Floo s R-
Wal s 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
/01-‘,
6
GENERAL INSPECTION REPORT )
( 518 ) 761-8256
Town of Qucensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road //
Quccnsbury,NY 12804 Arrive am/pm Depart ' a m
Inspector's Initials
NAME: f\S t PERMIT# .(1)q" 7t 1
LOCATION: DATE : i /Co—Ct
TYPE OF STRUCTURE:
RECHECK
•
N/A YE NO COMMENTS
.:F __ings/Piers I •
Monolithic Pour Form •
Reinforcement in Place
The contractor is responsi!le for
providing protection from freezin
for 48 hours following th placcm nt
of the concrete.
Materials for this purpose o i site
Foundation/Wal 1pour
Reinforcement in`'Placc •
Foundation/DampprooF
Backfill Approval
Plumbing Under Slab I
Plumbing Vent/Vents in Place
Rough Plumbing J
Heating Rough-In
Insulation
Foundation Walls Int rior R-
Foundation Walls Est rior 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
FIRE MARSHAL
TOWN OF QUEENSBURY
' QUEENSBURY, NY 12804
• ,,., ,• (518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# co- 736
NAME ,%CAN/t-5 61Z,i'-
LOCATION CO 64062-06' r-l-co $
SCHEDULE INSPECTION ON
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 SYSTE
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE: _
CLEARANCE TO SP INKLERS
CLEARANCE TO HE TING UNITS
REQUIRED SIGNAGE
%N!�
CHIMNEY i�t:e�-i v`'
WOOD STOVE
FIREPLACE-MASONRY
i'FIREPLACE-FACTORY BUILT Rc • 41 1/
f Y4.q-IL- 1 4- tiVR3CGp RA)
REMARKS: r. K TO THIS DATE
.2_v �o
INSPSLIP.PUB INSPECTOR
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