97-021 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
May 30 97
Date 19
l' 1VP 97021
This is to certify that work requested to be done as shown by Permit No. •
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied as a
LOT 4 EAGAN RD.
Location
NEWELL, SCOTT' Sc O'SICK,
Owner
TAX MAP NO. 137 . -2-9. "11 3 By Order Town Board
OWN OF QUEE SBURY
&Y.r
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 65000TOWN OF QUEENSBURY No 97021
TAX MAP NO . 137 . -2-9 . 11WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to NEWELL, SCOTT & O 'SICK,
OWNER of property located at EAGAN RD . 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
MICHAEL 300 BAY RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
NEWELL, SCOTT
3. CONTRACTOR or BUILDER'S Address
357 BAY ROAD
QUEENSBURY, NY 12804
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SINGLE FAMILY DWELLING
( 1 Wood Frame ( ) Masonry ( 1 Steel ( )
7. PLANS and Specifications
140Nb°•SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
January 24 99
$ 193 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.)
Dated at the Town of Queensbury this 24 Day o January 19 97
("Qi),
SIGNED BY for the Town of Queensbury
Building-and Zorii%; nspe
97-.6(2/
-,, ENERGY CODE COMPL2ANCE APPLICATION t ,
- S ' TOWN OF QUEENSBURt, WARREN COUNTY ,. :•-• T4-.i °'.' . 1
• 9000 HEATING DEGREE DAYS '
�AN23199T
Comol i ance Methods : PART 5 - Acceptable Practice MetioT "-'',.vi .i' :.� ,;;•�.
1&2 Family Dwellings (one c.ODE
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 E: PROPERTY LOCATION:
aC1--`W-114///t /,
A))670A/ #60q-Z.. . 00"e..f..1/6-4-7—
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - /V61 ,r ' scuare z et
2 . Type of Heat - Electric OiVA. 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:
b a . Rote R
_ Exterior walls R 4F--:
c _ Glazed areas R S.0
d- Exterior doors - R 7,.2-
e . Floors over unheated spaces R -_---
f: _ Edge of slab on grade (heated building) R ---
g_ Basement/cellar walls (above grade) R jr
h. Basement/cellar walls (below grade) R
i Heating/cooling-ducts-piping in unheated space R "------
6 . Service (domestic) hot 'water heating d i
Conforms to minimum efficiency per cod Yes No
T ERATURE CONTROL MAXIMUM SETTING 140° = WILL NOT BE EXCEEDED
Appli nt's ature \\ Date Phone Number
INSPECTOR' S REMARKS:
� Building Permit Application
Town of Queensbury - Dept. of Community Development,' 742 Bay Road, Queensbu►y, NY 12804 [761-8256]
BUILDING & . CODE ENFORCEMENT
INOTICE Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. 9 7 -D.:-.__I
beginning construction. No inspections )• (� 2 Co
will be made until applicant has received n Zoning Board Action . PERMIT FEE PAID$ 1
a VALID BUILDING PERMIT. All Area /Use f
applicants' spaces on this application RECREATION FEEPA1D$
MUST be completed and the signature (�//�
(� Planitbtg Board Action REVIEWED QN` ��'—�of the applicant must appear on the
SPR / Subdivision /Other Building Inspector application form. rn.ty,,. Recreation Pee Payment r 7 J
40
Applicant: / Owner: Tr / 14 .-/--`"
• Address: 3A� �'�1/ 04' Address: V�P/� Gr ��0 ig4-.) &ec,0
Phone # (71 Z7 - j‘ Phone # (jl( ) W
Property l,ocation:6— rA45i00 I (dU-eo./-roh 137/ G. ` /13
Subdivision Name: A/�/j�L� L.
c axiz. fir Tax Map Number _ •
/
Section Block T.ot
. TU E OF PROPOSED WORK: ESTIMATED MARKET V E OF THE ////�
New Building: CONSTRUCTION: $ c )!JU
• - - / commercial GO, t>
•
Addition to ilding:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: X4Apary Building -
residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwe _ •, , •,c;�
no change to exterior size . Famil D e'6C1;�in ;, •' `. ==
Office
Other Work (describe below) Mercantile �AN 2� 1997
Manufacturi' g '
Other # Y i.': 3iiBY 1
GROSS AREA OF PROPOSED STRUCTURE: ®�J' 't '11 I. "e'siD GOD.
sv-
SCD
1st Floor � � sq. ft. �,j If ADDITION, wh.�will use
2nd .Floor .7/ sq. ft149
of new addition be? :
Other Floors sq. ft.' •
(not unfinished cellar or basement)
ACCESSORY BUILDINGS:
M Detached Gara a 1, 2 car
TOTAL FLOOR AREA: / ;./ a SQ. FT. '' ' "'">5---- -a_c_h-e_d__Cza.r.a..g-e31, scar
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Z e g Z_ Other
FEET X FEET
•
Foundation Type: Pvi-i2ft) &tic,— Will any second-hand or ungraded
' Number of Stories : / lumber be ed? If so, for what?
(habitable space only)
Height (grade to ridge) : Z ,t- feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woo stove (circle all, which a ligs)
to be installed: ,i[l�71.,,el Electric / Oil /Mood
• 'orced Hot Air / Baseboard / Other
Person re'apopSble for supe vision of„work asilregards to building •
codes is : A,401/ SA7 (C aGutr�el, '71>-745 3 .
Mine
m Addresses Phone
Builder:
Plumber: j /2 4
. Mason: �7-.6 PP/P qA` !d nA�^via. �`F:�--9
Electrician: � ;
LA. -
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 audio ed by the owner. Further, it is understood that Uwe shall submit prior to a
Certificate of Occup. cy'••r Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; dra:n to scale, s i i g actual location of project on premises.
� / . i /
Signature: _ .
Crowner's a_-nt, architect, contractor)
Application for SEPTIC DISPOSAL PERMIT
r r�'f//�
Town of Queensburyity Permit No. 9 i /
Dept. of Community Development
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
/�
Location of property for installation: ;J - �e5A 1 ' �A`¢-e--4°6 //4/
Property Owner's Name: c— / /Lie/6-4
Property Owner's Mailing Address: 6 7 &71/.4 / 06Lt---Q /2-d
Installer's Name: 1(4/j/ � Fr5,7-6-'1°V.A7 Phone # 77& -57"7
y
Number of bedrooms (if residential): ,3 Total daily flow: 46-0
(residential - comput @ ' )-gal./bdrm.)
Topography: flat, rolling, steep slope % of slope ,
Soil Nature: sand, loam, clay, other /depth: TOWN.Ok C.
1 BUILDING , -
Ground water: a what depth? feet / Bedroc r Imnervion Material•.at what depifiV feet
Percolation test: not required, required [rate min. per inch]
..?S-
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: gallon (minimum size: 1,000 gal.)
f
CL10 ile field: each trench . eet / Total system length: v2-U rfeet
Seepage pit(s): number of G v / size each: /V ft. by ft.
Size of stone to be used: #____ ___ / depth or thickness Af...67,15feet
HOLDING TANK SYSTEM: (if r ed)
Number of tanks: Size of each: gallons
( 1arm system and associated electrical work 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 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 ' lication and agree abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Disposal
Signature of responsible person C.44 s✓` Date: Z,G�--`- 7
/�— TOWN OF QUEENSBURY
��"f�aily M BUILDING & CODE ENFORCEMENT
$*'i � 742 BAY ROAD
Hr� `,, QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: } \Zei DEPART: t2/41 INSP: G
FINAL INSPECTION REPORT - RESIDEN IAL
DATE INSPECTION REQUEST RECEIVED:
NAME 6\i'VE(�E
LOCATION ZZ) E� \ RV)
-
DATE � /� PERMIT N 97-ail
TYPE OF STRUCTURE cj c) uI Z OV_
FOOTINGS FOUNDATION _ BACKFILL _ FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES, NO
CHIMNEY HEIGHT/B EN /HEI IT
:///
PLUMBING VENT V ROOFING _ 1
EXTERIOR FINISH /
DECK/PORCH/STEPS/RAILINGS /
RELIEF VALVES //
FURNACE/HOT WATER OPERATING J/
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: /
BATH/KITCHEN WATERTIGHT ✓�/�
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS V
SMOKE DETECTORS
BATHROOM FANS (7�
PLUMBING FIXTURES" { `/
FOUNDATION INSULATION `�
GARAGE FIRE PROOFING V
DOOR CLOSERS /
FINAL ELECTRICAL .,(
SITE PLAN/VARIANCE REO. I
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 2
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. Cert. 4 3 2 4 4 Cut-in Card No. ii
Owner Se_o-rr- 4,telce-z.(.....
Occupant
Location 6.-746.4-/Lf /2.0, a6e7ti I-7'
/2-6r0 , 3 rz---5
Installation Consisting of Z $Wirc41/ 43 1-/
i• /
reMitiae./ -0P_A(6,72 /fi:-/4-4i 1 a, s-ifttke-
/
f71-6,6-4-- 0 e--724,1 e 0-6- -,
a tii6X-oreie.--
Installed By Lic.#
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 making inspec:al at any time,and if its
rules are violated,the Company shall have the right to revok- t, •ce tifi ,.
Date 6 -2 - 7 INSPECTO;
Member N.F.P.A.,I.A.E.I.
� TOWN OF QUEENSBURY
.�S��0` BUILDING & CODE ENFORCEMENT
/� •' 742 BAY ROAD
. 'QUEENSBURY NY 12804
(518) 761-8256
r �
ARRIVE: DEPART:. �i4 -4� INS :/ �. G
FINAL INSPECTION REPORT - RESIDEN
DATE INSPECTION REQUEST RECEI ED: c J
NAME GC e.t~7C
L 0 s&-TA-,J 47--d
D J . PERMIT I -7-C01
TYPE OF ST UC �>Q. CMG
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING- _ SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE _
N/A YES NO
CHIMNEY HE I,, HT/B. 'T/HEIGHT ��
PLUMBING VE.T ROOFING ji
EXTERIOR FI SH /
DECK/P.O'CH/STEPS/RAILINGS Nf/
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT 7
OTHER FLOORS •SWEEPABLE \//
i.
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS \_
PLUMBINGFIXTURES
( o
. 11/i///)11(:
FOUNDATION ,I SULATION
GARACaFi,,0 IN
POOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE.RE4}
FINAL SURVEY PLOT- N1
OK TO ISSUE L'�O g1C/C > �f
&Q-+ �:� E `w-i VCOS'�' -l it
tag'4-�J �' -o�F , L.
2ram.r- 1
/ `518) 761-8256
,y�r 4 er,`C..4yJ)
TOWN F QUEENSBURY
BUILDING & CODE ENFORCEMENT .•
742 BAY RD.', QUEENSBURY NY 12804
INS• CTOR'S REPORT: AFg EPART a aNT- z-
REQUES OR INSPECTION RECEIVED: 6
NAME 6, A L.J a
LOCATION r� .
•
DATE "./ /t ' PERMIT
TYPE OF STRUCTURE: - �}� � 74r- Dlr's
RECHECK A.A4-F Q ! aaaan��So�
v [� N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN P
THE CONTRACTOR IS RESPINSIHLE FOR
PROVIDING PROTE TION F.•OM FREEZING
FOR 48 HOURS FOLLONINt THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE r
FOUNDATION/DAMPPROOFING
BACKFILL 'APPROVAL
PLUMBING VENT/VENTS IN PLACE _
II H PLUMBING n ib %F$ _64-6
PLUMBING UNDER LAB
FRAMING: •
JACK STUDS/HEADERS
BRACING/BRIDGING _
JOIST HANGERS _
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN •
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R- L
DUCT WORK OR PIPING IN
UNHEATED SPACES R- ••
ALve7"5 — c5V
(518) 761-8256
,ao-ps e
TOWN OF QUEENSBURYa`
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRlo LI DDEPART
REQUEST FOR INSPECTION RECEIVED: /
��� ��L
NAME i
LOCATION Ito ¶\`
DATE 11-6197 PERMIT gTYPE OFUCTUE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR Fo-•
REINFORCEMENT IN A ACE •
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE—
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
•
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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—
•
1 �ei---T Tott-CT
F1\Cs L\-\-- -To\ k 1-5fliJ
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRDEPART9.e21) I
REQUEST FOR INSPECTION RECEIVED:
NAME 1
LOCATION —h )
ADATE A2:1_519-7 PERMIT fl 9 ( 'C2_(
TYPE OF STRUCTURE: FO )1 z ct42-C-JIR
RECHECK APPROVED
N/A YES NO
f r FOOTINGS/PIERS l,
MONOLITHIC POUR FORM i/
Irri
REINFORCEMENT IN PLACE . F
THE CONTRACTOR I ESPONSIEMR
PROVIDING PRO TION FROM FRE NG
FOR 48 HOURS FOLLOWING THE PLACE—
MENT OF THE CONCRETE. _
/
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR /11
`
REINFORCEMENT IN PLACE f___F____
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL J/
/ 4
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS EADERS
BRACING/BRDGING _
JOIST HANO'ERS
JACK POS /MAIN BEAM
AIR INFILTRATIO BARRIER
HEATING ROUGH— N
INSULATION:FOUNDATIONi/
WALLS INTERIOR R— _
FOUNDATIO WALLS EXTERIOR R— _
FLOORS / R—
WALLS R— _
CEILING R—
DUCT WOK OR PIPING IN
UNHEATE SPACES R—
•
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(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ,• 'y;
742 BAY RD., QUEENSBURY NY 12804 .,
INSPECTOR'S REPORT: ARR DEPART /'(. INT (Jf
REQUEST FOR II SPECCTTION RECEIVED:
NAME 60Gw
LOCATION •TC ii! �b
DATE 15/ 92 PERMIT a 4?/ �. 12/
TYPE OF STRUCTURE:.
RECHECK APPROVED
`� N/A YES NO
FOOTINGS/PIERS f//
/
MONOLITHIC POUR FORM r
/ -
REINFORCEMENT IN PLACE /
/
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE f.___
FOUNDATION/DAMPPROOFING
B//ACKFILL APPROVAL
/LUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _ --
PLUMBING UNDER SLAB
FRAMING: •
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER _
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-
rnow06 i4 Airl— c A-c-b /Af o Fng
Borth 6ilo("' Uq.1-065
4 0 ,,f), j Ccp,,0G6-AL_
518) 761-8256
_ /7 L/
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 cs<.
1
INSPECTOR'S REPORT: ARRf :/5 DEPART INTJIC-
REQUEST FOR INSPECTION RECEIVED:
NAME A)61A.--&-C. .-
LOCATION rut 0(4J) R c-) , �7 -DATE 1.7_0
/c7 7 PERMIT A ' O�+
TYPE OF STRUCTURE:
RECHECK APPROVED
'\ N/A I YES NO
FOOTINGS/PIERS :\A ,
11
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING -
$ACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R- _ _
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS
WALLS R- t//
CEILING R-. 1/
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
(X e 6&16 Z. /46 L L U f
iya&&/ 0A-1-1'6-5
ALI (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURYJ NY 12804 .ar•;.,t� ,
INSPECTOR'S REPORT: ARR/ ZDEPAR3/i• .3-3 INTV/
REQUEST FOR II PECTION RECEIVED: // j
NAME /
�✓C� A+21-i =i/
�
LOCATION �i F �/t�� /e
DATE 3 / �jPERMIT A / / - W-/
TYPE OF STRUCT RE: �( �
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM I _
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RES'•N-IHLE FOR
PROVIDING PROTE TIO • FRO FREEZING
FOR 48 HOURS FOLLO. NG T r PLACE-
MENT OF THE CONC:o- "TE. _
MATERIALS FOR THIS PURPOSE ON SITE _
FOUNDATION/WALLPOUR _
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING -
BACKFILL APPROVAL -
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB
ell/SING: _
JACK STUDS/HEADERS w'
BRACING/BRIDGING V
JOIST HANGERS _ y�
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
A PI-61 ZAVS
1-1)Lc 11 4,11-/1— ALL I/14Z,6/L'S.
4-4/e-HoR ` -/) 40 ode OF /1 4/•t/ /P,'i
I4U51`,4/1-L A&L . d/57- �'�� �?Jv�/� I0(LE7—
(518)761-8256
TOWN OF QUEENSBURY ,,,,O.'',
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 //;)
INSPECTOR'S REPORT: ARR DEPART(/ ` WINT -
REQUEST FOR INSPECTION RECEIVED:
NAME /(9W6'GL.-
LOCATION ei '4'1) A-2
DATE •5�j4/97 PERMIT A ( 7' 62 I
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A I YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
REINFORCEMENT IN P A E
t
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
SACKFILL APPROVAL
7/
f�LUMBING VENT/VENTS IN PLACE
V/ROUGH PLUMBING
PLUMBING UNDER SLAB _
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING -_ _
JOIST HANGERS _
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ;1-. fF..
742 BAY RD., QUEENSBURY NY 12804 ,•., -
INSPECTOR'S REPORT: ARR DEPART:5INTS/W
REQUEST FORA INSPECTIONI RECEIVED:
NAME 'VG G—Lv
LOCATION > e5e9'�D4%)
DATE --- /l///g 7 PERMIT 1 e! 7--Q 2
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES _ NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM /-
REINFORCEMENT IN PLA
THE CONTRACTOR IS ESPONSIBLE FOR
PROVIDING PROTE ON FROM FREEZING
FOR 48 HOURS FO OWING THE PLACE-
MENT OF THE CON RETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR _
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB _ _
FRAMING:
JACK STUDS/HEADERS _
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR IFILTRATION BARRIER
H ING ROUGHIN
INSULATION:ri1"�//7i_
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- _
WALLS R-- _
CEILING R-
,________
DUCT WORK OR PIPING IN
HEATED SPACES R-
TORN OF QUEENSBURY
BUILDING A CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name N" OfiLk_D-e___W )cam,e
Location A—y �0: Gm �
Date—a 5 rL 7Permi t # f tOa
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) .Ra e-M'nute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: To 1 Length
Length of each tren
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Ta to Dist. Box
1st. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
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:
T l i�C /9 L fcsv�10 c?A-t_c_
)1f
SYSTEM USE APPR 1(ED: YES NO
Arrived: 7 ,l
Departed: �. lC
V(
Building
Inspector
�, TOM E
• 4.
OF () E SBJ Y
SOILDIOG A CODE EE3FORCEME !T
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
il
Name ,c,'" New-eCi
Locati ort741- LI �,
1_-t5M2e c �2 a 97 Pe t # q 7-O-- I
.
SOIL TYPE an Loam-Clay •
-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: __.___t
ABSORPTION! FIELD: Total Length
Length of each trendy'
Depth of trenches „
Size of stone
SEEPAGE PITS:. Number-
Size - ft. x ft.
Stone size ,
PIPING:
Bldg. to Tanf Sire
`, L/�
Tank to Dist; Bo', / 9 90
Dist. Box to Fiela/Pit d it
Openings Sealed? Yes 4ip Partial
LOCATI ON1,/SEPARATI(CMS:
Foundation to Tank j feet
Foundation to Absorption '1-lO feet
Separation of Pits m feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM O PROPER'
(circle , ;
Front - e'ar Left Side - Right Side
Middle L - Middle Rear
COMMENTS:
4.)&me._ 4P6-, % (,) 60Avo, CO,q��
icil-e-- , :
SYSTEM USE APPROVED: YES NO
Arrived: /�f j�
l
Departed: a : Z`)
-1/2ir
Building Inspector
1A(,-cp
TO 7i OF QUEEI SBURY
BUILDING E CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name N >@S2 S-(r-it))-
Locatio
(
Date-DS- 9-7�� permit # -Oa '
SOIL TYPE: Sand-Lo -C ay-
Results of Percola n Test-
(if applicable) .R e linute/Inch
TYPE OF S!°STEM:
ABSORPTION) FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
D,i st. Box to Field/P;i•
1/Openings Sealed? No Partial LOCATION/SEPARATIO
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:
•
SYSTEM USE APPROVED: 11111 NO
Arrived: -
Departed: 7' S�
` �l
Building Inspector
(518) 761-8256
41,
TOWN 'OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 `S ` h• ,
INSPECTOR'S REPORT: AR% `/' DEPART/- . � lT
REQUEST FOR
�IINSPECTION RECEIVED:
/NAME 4(-Jr� --
LOCATION e4e ,11 A).
DATE 2i45/7 PERMIT A 77-07- I
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES , NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PU OSE ON SITE
FOUNDATION/WALLPOUR
•
REINFORCEMENT IN PLA
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB •
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING .-
JOIST HANGERS
JACK POSTS/MAIN BEAM _
AIR INFILTRATION BARRIER v/
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 •
-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR/ DEPART INT�
REQUEST FOR INSPECTION ECEIVED:
NAME c) iC�G
LOCATION6/ �ri
DATE 72 2� 72 PERMIT A 92-ozf
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
1\i//(
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLAC
THE CONTRACTOR IS RESPONS BLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
TOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE _
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER -
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-
•
4?? ell ba.tia
r�� (518) 761-8256
OF QUEENSBURY ''
NN!IATIR11115OWN
BUILDING & CODE ENFORCEMENTWAY
742 BAY RD. , QUEENSBURY NY 12804
0
INSPECTOR'S REPORT: AR7455
EPi/O5T
[6REQUEST KiINSPECTION�� � �� � E IVED: _ //{{
NAME / �A,o c ✓ cs / cA
LOCATION Q o
DATE 6)----7—9 7 PERMIT A 9 7--0c21
TYPE OF STRUCTURE: ��.\
RECHECK APPROVE
N/A YES NO
OOTINGS/PIERS
.*
MONOLITHIC PO R F RM - ' / -
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOl
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE. -
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE f
i
FOUNDATION/DAMPPROOFING -
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
—
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION: 4
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
(518) 761-8256
TOWN OF QUEENSBURY ,
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY12804 . " '
INSPECTOR'S REPORT: ARK�',LbEPAR/�/- c INT�/
REQUEST FOR INSPECTION CEE�IIVV D:
NAME /'G/�1�//
LOCATION
/) e- LJ a'
DATE "/" � i U PERMIT A C17''-v 1 f _
TYPE OF STRUCTURE: j[
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR RM
/
REINFORCEMENT N PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
/r
) F/OUNDATION/DAMPPROOFING _ i
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
-
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
761-8256
fin.--,
Le-j
TOWN OF QUEENSBURY ¢
BUILDING & CODE ENFORCEMENT { f(
742 BAY RD., QUEENSBURY NY 12804 '''.11,• ii
INSPECTOR'S REPORT: ARR fZD DEPART` --
REQUEST FOR INSPECTIO RECEIVED: , 4 QI 7
NAME 5�.% ' Ak6.
f� C-
LOCATION -I ( C ex l t
ef-
DATE v! 17 ✓PERMIT L % 7 -d 4 I
l
TYPE OF STRUCTURE: L�11°,�L
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR RM
REINFORCEMENT IN LA _
THE CONTRACTOR I SPONSIHLE FOR
PROVIDING PROTE ION FROM FREEZING
FOR 48 HOURS F L KING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
•
REINFORCEMENT IN PLAC f_______. 4i////7
E
F UND ION/DAMPPROOFING
OCKF� 19PPRO AL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
•
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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- •
G A1,L, tea. ' ch i
(518) 761-8256
TOWN OF QUEENSBURY }'
BUILDING & CODE ENFORCEMENT ;'.'
742 BAY RD., QUEENSBURY NY 12804 -*,,.
INSPECTOR'S REPORT: ARR7:Uv DEPART IN` Ai.'"
REQUEST FOR INSPECTION RECEIVED:
NAME . t ecoG;G7-- /7
LOCATION -e9z .4AJ ✓`b •
DATE /1'3 //y 7 PERMIT It 77- 07-j
TYPE OF STRUCTURE:
RECHECK APPROVE
NIA YE NO
J
FOOTINGS PIE::
bfi0 OLITHIC POUR FORM V")
' 11;///:
EINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTECTION FROM FREEZING
FOR 48 HOURS FO LONING THE PLACE-
MENT OF THE CON T
MATERIALS FOR THI PURPOSE ON SITE
k'OUNDATION/WA POU
REINFORCEMENT IN PLACE __;
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS _
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT �
742 BAY RD., QUEENSBURY NY 12804 �._
i
INSPECTOR'S REPORT: AR/OS DEPART) IN..--.
REQUEST FORK INSPECTION/ RECEIVED:
/1/(�NAME &)&—
LOCATION &'A- gAJ 4 .
DATE Oey/f/ PERMIT fl 77—02-'
TYPE OF STRUCTURE: 5 P-6
RECHECK _ APPROVED
L� N/A YES NO
F OTINGS/ IERS .
V/(
,/MONOLITHIC POUR FORM 2`*I ,
REI EMENT IN PLACE
HE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTECTION FROM FREEZING
FOR 48 HOURS FOLLONING THE PLACE-
MENT OF THE CONCRETE.
TERIALS FOR THIS PURPOSE ON SIT
pm TION/WALLPOUR
REINFORCEMENT IN PLACE L
FOUNDATION DAMPPROOF N
BACKFILL APPROVAL
PLUMBING VENT VE S I '-PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS EXTERIOR R- e _
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
•
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) P`� (518) 761-8256
TOWN OF QUEENSBURY ',n`c
BUILDING & CODE ENFORCEMENT , f
fi
742.BAY RD., QUEENSBURY NY 12804 'ns ,A ', t3,
INSPECTOR'S REPORT: ARF -r ODEPART3 ' IN'I'4Q�'
Q T FOR I /SPECTION RECEIVED: a
AM c�� �/Yil Cl t ,p ae,,, /,f/, 4'o', CJk
LOCATION y� 6e_
DATE --� l/ ERMIT A 0
TYPE OF /STRUCTURE: ��
RECHECK APPROVED
N/A YES NO
0�.'ING /PIERS 2 '- "41
(((. ONOLITHIC POUR FORM 7----
REINFORCEMENT IN PLACE
THE CONTRACTOR IS SP• SIDLE FOR
PROVIDING PROTE TI," rROM FREEZING
FOR 48 HOURS FOLLOH.'•G THE PLACE-
MENT OF THE CONCREa .
MATERIALS FOR THJ URPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB _
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
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i • JAN 2 3 1997
Nb
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Zoning Admini trator
TOWN OF QUEENSBURY
- ' • allummismolowervamemPearowit I
S i WO g fir ' taw evidence of,
1 elidel1t111.0 wells, --- fences, etc.,
Own eft I also r present that I have
Pe , ,rsonaNY eallilared Mans set forth on the diagram "
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