97-529 CERTIFICATE OF OCCUPANCY'
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
August 7 98
Date 19
This is to certify that work requested to be done as shown by Permit No. 97529
has been completed.
SINGLE FAMILY DWELLING
• This structure may be occupied as a
LOT 3 EAGAN RD.
Location
NEWELL, SCOTT & O'SICK,
Owner
TAX MAP NO. 137 . -2-9 . 114 By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 85000 TOWN OF QUEENSBURY No. 97529
TAX MAP NO. 137 . -2-9. 114 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to NEWELL, SCOTT _Sr O 'RTPK
OWNER of property located at LOT 3 EAGAN RD. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a S TNCT.F F AmTLY UWELLIN-C
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 BUILDERS Address
357 BAY ROAD
QUEENSBURY, NY 12804
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
SINGLE FAMILY DWELLING
( 1 Wood Frame ( I Masonry ( )Steel (
7. PLANS and Specifications
1064 IN FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
167 September 22 99
$ 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 22 Day of September 19 97
SIGNED BY 1�� TF�1�cd for the Town of Queensbury
Building and Zoning Inspector
mit Building Permit Applicaijon
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Qu ens`.itticIrrigfiE 'i!?: :^56J
-O BUILDING & . CODE ENFORCEMENT � �NOTICE Requirements prior to issuance
of this permit: �,�R._ FI ENO.
A permit must be obtained before Ti�Tlliiv ul"tAJE N
beginning construction. No inspections B %
will be made until applicant has received ri Zoning Board Action
a VALID BUILDING PERMIT. All Area /Usc RECREATION FE PAI
applicants' spaces on this application
MUST be completed and the signature 1-7 PlanningBoard Action REVIEWED
•of the applicant must appear on the SPR / Subdivision /Other w But ing Inspector
pplication form. vw.sk,.x, Recreation Fee Payment
Applicant: S CO N> (,L Owner: 3Aw«
Address: a ? 13A9 iD ' Q UE' C6vea1 Address: A 046-
Phone # . (5L6 )1 - 76-5"3 Phone # ( )
Property Location: )� P-.3 GA6A3 ic`�A b 12 /� 7 6 1 )G j�
Subdivision Name: MA L1.1'sILDS 1-AN�in Tax Map Number I
Section Block lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET TeAlE OF THE
New : ' o ' - e • CONSTRUCTION: $ l [1•t�-t-"'
residence ' commercial
Addition . = ilding:
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
44 Other
GROSS AREA OF PROPOSED STRUCTURE `F��G�
VP- .' f ADDITION, what will use
1st Floor
64 sq. ft. of new . be? :
2nd .Floor sq. ft.
Other Floors sq. ft. f
(not unfinished cellar or basement)
. ... ACCESSORY BUILDINGS:
/ Detached Garag
/ e 1, 2 a
TOTAL FLOOR AREA: �� SQ. FT. < Attached Garage 1401Pr ar
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
�j ��� FEET Other
FEET X
Foundation Type: RC v0�� Cb e.6r. Will any second-hand or ungraded
Number of Stories : / lumber be used? If so, for what?
(habitable space only) / / /UCS —
Height (grade to ridge) : / feet TYPE OF HEATING SYSTEM:
Number of fireplaces a d/or woodstove (circle all whit lies)
to be installed: EJectrlc / Oil / Wood
(Forced Hot A / Baseboard / Other
Person respo ible for/supervision of work as regards to building
codes is : ,5L5 , ,t/vJ _ C -793 -7,6
Name Addresss Phone
Builder: S' - - - ,t.ItI 'dr4. - As 46cS145
Plumber: A. 14
Mason: R134-z,.J 1, 2i S4-AVOK) ,4-5263
Electrician: .S.' /✓../4,-et/ 4.r A --
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; drawn to scale, showing actual location of project on premises.
Signature: _ - t i I..All.
(o ner, owner's agent, arciut- t, contractor)
• Application for Jt '111: L)1 t"J - L; t'tKMl l-
Town of Queensbury
Dept_ of Community unity Development .Permit No. ?") 2 9
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804 �EC.q
�"' R/Fn
-
Location of property for installation: L 5 ae 1 '1 SEP 12 1997
Property Owner's Name: "JZ- Zr //J , 1Z4_ \ TOWN OF QUEEN 1SBURY
/f�® buiLDINCa AND CODE
_ Property Owner's Mailing Address: 35 7 �7 " z�-e_P�!/l /z60
.
Installer's Name: ?Ll rev (-) A-4-G s Phone # ( ??--W
Number of bedrooms (if residential): Total da7Zv flow: `e
(residential - compute Qa 150 gal./bdrm.)
To h : 'Vat, rolling steepslope o of slope
Po�P Y �,
- Soil Nature: sand, loam, clay, other/depth:
y
Ground water: at what depth? Oeet / Bedrock or Imper icus Material: at what depth? , feet
Percolation test: not required, required [rate min. per inch]
Domestic water supply: 6 i inicipal, well, comer
e
If domestic water supply is a WFT.T water supply from any sec absorption is / feet. .
PROPOSED SYSTEM
Q f
Septic tank /I" gallon (minimum size: 1,CCO p1.) 1
Tile field: each trench '' Feet / Total system! zth: -- ,r.,. feet
,Seepage pit(s): number of A/6 / size each: ft. by ft.
Size of stone to be used: # / depth or thic' s / g el feet
HOLDING TANK SYSTEM: (if r uired)
Number of tanks: Size of each+ gallons
(Alarm system aI associated electrical vovrk to be inspected by:certified agency.)
For your protection, please note that pursuant to Section 136-29 of the Code of Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any matedsi misrepresentation or failure to make a
material fact or circumstance known by or on behalf of an applicant, shall be void..
I have read the regulations with respect to this application and agree to abide by ese and all requirements of the Town of
Queensbury SA.,it4ry Sewage Disposal Ordinance.
Signature of responsible person: Date: 9-1/7-17
l7- s -
: ENERGY CODE COMPLIANCE APPLICATIO �"---� _
3-"- TOWN OF QUEENSBURY, WARREN COUNTY 't Ri{ ` "'�
- 9000 HEATING DEGREE DAYS "�
SEP 12 1997
Compliance Methods : PART 5 - Acceptable Practice MetIltif vF-Qijec;,;, oRy
1&2 Family Dwellings (oDayl .DINGANDCODE
. 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:
S'ce3T Jfw6-L-(, Li7't‘c3 640 /W' Veir_- 4-62UV,.
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 10 6 square feet
2 . Type of Heat - Electric Oil _,(Gas Other
3 . Is building mechanically cooled? Yes >S.' No
4 . Percentage of area of windows and doors Over 17% Under 17%
;-?_1
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R C-EC)
b. Exterior walls R /9
c. Glazed areas R -` .8
d. Exterior doors R 7.2—
e. Floors over unheated spaces R /A-er—.
f. Edge of slab on grade (heated building) R A/
g. Basement/cellar walls (above grade) R //
h. Basement/cellar walls (below grade) R //
i. Heating/cooling-ducts-piping in unheated space R N
6 . Service (domestic) hot water heating device •
Conforms to minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Ap nt' Signature Date Phone Number
./.1,--- 77 713 —,•6r s
SPECTOR' S REMARKS :
'h
RESIDENTIAL FINAL INSPECTION REPORT. `� '
Office No. (518) 761-8256 77 F
Building &Code Enforcment Arrive:" - - Insp' e_ol/
Dept. of Community Development ,� 0
Town of Queensbury Date Inspectiotr R uest Received: /-'?`9a
742 Bay Road
Queensbury. NY 128
NAME / e-G(, �l�'. / PERMIT NO. q7 �/
'LOCATION DATE ,,2-9 .9.(r
TYPE OF STRUCTURE
Chimney Height/"B" Vent/Direct Vent Location Al
Fresh Air Intake �—
Plumb Vent Through Roof
=
IIIIMMINII
Roof Complete
Exterior Finish Complete '
Interior/Exterior Railings 30" to 36" l ;
Exterior Handrails, Balconies, Landing 18 in. or more / NI
Interior Handrails Stairs Both Sides 3 or More Risers
Grade 2% Away From Foundation '
8" Clearance To Sill Plate
Gas Valve Shut-Off Exposed/Regulator 18" Above Grade W
Gas Furnace Shut-Off within 30 Feet or within Line of Site
Oil Furnace Shut-Off at Entrance to Furnace Area
Furnace/Hot Water Heater Operating IF
Relief Valve(s) Installed I�
Headroom 6 ft. 6 in. On Stairs
Basement Stairs 6 ft. 4 in. I
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
Railing Across Window in Stairwells .�
Smoke Detectors: Ilel
every level M_
every bedroom
outside every bedroom IIM
inter connected WI
Bathroom Fans MEM
Plumbing Fixtures IIMIll
��
Fo
In
3/4 Hour
Fire Door/Door
��
3/4 Hour Door/Door Closer
Garage Fireproofing
Garage Penetrations Sealed • MIME
Furnace In Separate Room Protected (In Garage) WIIIM
Light Ventilation Per Room.
Safety Glazing 18" or Less From Floor WWII
INWII r
Final Electrical
Site Plan/Variance Required 11111111,
-.
Final Survey Plot Plan
As Built Septic.System Layout Req.
Okay to Issue Temp C/O 4
Okay to Issue Permanent C/O - --0 b (f e D- i'l rV,rL 644-Z Je'
0 ay to`DIssue cC/C / v
RESIDENTIAL FINAL INSPECTION REPORT.
Office No. (518) 761-8256 t • .
Building &Code Enfoccment Arrive e - " •nsp: "P� C------
Dept. of Community Development -, _ 1
Town of Queensbury Date Inspection Request Received:
742 Bay Road
Queensbury, NY 12804
NAME �e.c:114-
cir-i--. PERMIT NO. _ ,,,,7._
LOCATION --2 ��a� DATE /
TYPE OF STRUCTURE 28
Chimney Height/"B" Vent/Direct Vent Location 1
Fresh Air Intake MN �_
Plumb Vent Through Roof EM. _
Roof Complete -
Exterior Finish Complete AM
Interior/Exterior Railings 30" to 36" A
Exterior Handrails, Balconies, Landing 18 in. or more �. =-
Interior Handrails Stairs Both Sides 3 or More Risers ailliVIEr
Grade 2% Away From Foundation
8" Clearance To Sill Plate AW
AIMIIIMMINIV
Gas Valve Shut-Off Exposed/Regulator 18" Above Grade A�
Gas Furnace Shut-Off within 30 Feet or within Line of Site
Oil Furnace Shut-Off at Entrance to Furnace Area n
Furnace/Hot Water Heater Operating
Relief Valve(s) Installed -
Headroom 6 ft. 6 in. On Stairs
Basement Stairs 6 ft. 4 in. A
Handrail Exterior Stairs Both Sides More Than 3 Risers Al-
Interior Privacy/Trim/Doors/Main Entrance 36" rtr
Floor Finish I;'
Bathroom/Kitchen Watertight ir
Interior Handrails Balconies/Landing 18 in. or more A;_
Railing Across Window in Stairwells i,
Smoke Detectors:
every level ✓/: ,
every bedroom ✓
outside every bedroom
inter connected AI
Bathroom Fans ,
Plumbing Fixtures
Foundation Insulation INV
3/4 Hour Fire Door/Door Closer IW
Garage Fireproofing
Garage Penetrations Sealed In
Furnace In Separate Room Protected (In Garage) MI
Light Ventilation Per Room• WA
Safety Glazing 18" o Less rom Floor
Final Electrical •2- ' O — L INEM-
Site Plan/Variance R-1uir-• lil=�r
Final Survey Plot Plan
As Built Septic System Layout Req. lil
Okay to Issue Temp C/O
Okay to Issue Permanent C/O ,
Okay to Issue C/C Crnu, G
,,r'Lec- 1�r1o5p4.4a St-DcKIA.)62 i
J --,eLy�j' SAIL i 1��t
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL ,•' N
_ )
Panel Board No. Cert. 5 2 5 4 8 Cut-in Card No. .
--r2
' Owner o-e.:0- TT Newez,e---
Occupant
Location .46- t---3 6-71-G4--,ci f
66€.-6----
.• . , /E? i,i) 77E4,4 3 6 Rerer o-ye..
1 "7--cFs
..21 stal ation Consisting of r
i
A-AIC 6 L,)/24067e j 3 , 4-ifiEj 6-57/4-dexv-
1
c:9-co A
Installed
Installed By V° or c----kt.e6-7L. .
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. l /
Inspectors of this CompatiYishall have the privilege of maki g inspigr. at • y time,and if its
rules are violated,the Corriapy shall have,the right to revoke th. certi' :.
Date /— z-6 ---ff 1 )
pr 4_2 INSPECTOR dr
Member N.F.P.A.,I.A.E.I.
i0/1-4
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: AR�t_� DEPARZaui, I }
REQUEST FOR INSPECTIO RECEIVED:: ?/ Jq
P(N
NAMED `J
LOCATION \� hh_
DATE J( _ 0-9 PERMIT
U A"1` fl Cu -✓(T
TYPE OF STRUCTRE: ) I cA�C
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 FOL'LOWING' T4E PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS\•U•PO ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLAC:'
FOUNDATION/DAMPPROOFI`"G
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 HARRIER
HEATING ROUGH-IN _
ULATION• j` I
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R- `
CEILING R_ f 7
DUCT WORK OR PIPING IN
UNHEATED SPACES R- _
, , , -
. Pi8 761-8256
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT -
742 BAY RD., QUEENSBURY NY 12804
4
INSPECTOR'S REPORT: ARj/1 vDEPAR _ I L REQUEST O INSFECTIO EIV C�\. V
NAME -,
LOCATION
DATE \e '1�-r� i PERM A 9 7-5
TYPE OF4 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 PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
r
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING: \/
JACK STUDS/HEADERS - -
BRACING/BRIDGING
JAIKT HANGERS � _
JACK POSTS/MAIN BEAM �/'�
'N'e�
AIR INFILTRATION BARRIER�-)
HEING ROUGH-IN ��✓✓�J _
NSULATION:
FOUNDATION WALLS INTERIOR Rlit/
-
FOUNDATION WALLS EXTERIOR R-
FLOORS - R- /
41 WALLS --� R-
CEILING
CEILING R-•T'-
DUCT WORK OR PIP! IN
UNHEATED SPACES R- •
L A at.k0D
z \N-)v._ cT R `LN
,V--,---w J (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ,'s; .
1
INSPECTOR'S REPORT: ARR DEPART �INT ��_
REQUEST OR IINSPECTI CEIVED:
NAME )PKOPYY ) S
LOCATION s -iTC..e_si:-.,,,„--_, �(�!')
r
DATE \)_ I Lk—9 j PE IT� i 9
TYPE OF STRUCTURE: '
RECHECK ` APPROVED
N/A YES _ NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM\
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPO SIBLE OR
PROVIDING PROTE TION FROM FR ZING
FOR 48 HOURS FOLLOWING THBP CE`
MENT OF THE CONCRETE.
1
MATERIALS FOR THIS PURPOSE 0 SITE _
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
SACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
/
PLUMBING UNDER SLAB
y /R1 � ^
`;PR MINGt V°d /yL6{c
—
JACK STUDS/HEADERS _
BRACING/BRIDGING f
JOIST HANGERS �l
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— •
0-P7-W / (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 .,
INSPECTOR'S REPORT: AR1 -, DEPAR ✓3
T-
REQUEST FOR NSZ0Q--v--)KA
PECTIONIVED: 1�- Lr-�)
NAME v1LOCATION 3 F.�� C\�jG(>J
y
DATE \\~1 L"k 7 PERMIT n 17 ^a9
TYPE OF STRUCTURE: Ste:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IO RESPON ISLE FOR
PROVIDING PROTE T:ION FR MiFREEZING
FOR 48 HOURS FOLLOWING HE PLACE-
MENT OF THE CONCRETE. I
MATERIALS FOR THIS P\RP SEION SITE
FOUNDATION WALLPOUR _
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
HACKFILL APPROVAL
PLUM ING VENT/VENTS IN PLACE
UGH-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= -
fi,,5 97414- 4/4. Pc/4-re-5 e°Lk --cps
ifosoL._
)
f27618256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD.; QUEENSBURY NY 12804 •`. . '; .
t- .
INSPECTOR'S REPORT: ARA EPAR � CINT
REQUEST FO I SPECTION\RECE 1
NAME \�x jP
LOCATION /4� (- 2C74 O
DATE 1''- -97 P IT A
TYPE OF STRUCTURE:
RECHECK 'N A PROVED
N/ YES NO
FOOTINGS/PIERS
1
MONOLITHIC POUR FORM \
REINFORCEMENT IN PLACE \
THE CONTRACTOR IS RESPONSIBLE FO
PROVIDING PROTE TION FROM FREEZI G
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 f/ •
FRAMING: - /
JACK STUDS/HEADERS
RACING/BRIDGING
/ JOIST HANGERS M
JACK POSTS MAIN BEAM
I \
A INFILTRATION BARRIER
I .
HEATING ROUGH-IN {
INSULATION: \ I
FOUNDATION WALLS INTERIOR R- •
FOUNDATION WALLS EXTERIOR R-
FLOORS \ R-
WALLS t R-
CEILING R- 1_
DUCT WORK OR PIPING IN
UNHEATED SPACES R- •
TOWN OF QUEENSBURY
C o e;,k,
BUILDING b CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOS L SYSTEM INSPECTION
Name D ,06/a--e
Location f
V--d •
Date j , Permit # y�Z
SOIL TYP Sand Loam-Clay-
Results of Percolation T st-
(if applicable) Rat- Mi {ute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tots Len P).
Length of each trench t �
Depth of trenches 1
Size of stone
SEEPAGE PITS: NutT6 r
.Size - ft. x ft.
Stone size
PIPING:. iz ype .
Bldg. to Tank 0
Tank to Dist. Box m Si 3
Dist. Box to Fiel /P' 0 , 9 .V
Openings Sealed? T - , No Partial
LOCATION/SEPARATIONS:
Foundation to Tarok j feet
Foundation to Absorption f , feet
Separation of Pifs _ lieet
Conforms as per riot Plan No
LOCATION OF SYSTEM
ON PROPERT`.. .
one)
ron - Rear - Left Side - Right Side
` '•dle Front - Mi1dle Rear
COMMENTS:
SYSTEM USE APPROVED: YES NO
Arrived: /O1
Departed: /0 y (0
Building-Inspector
•
TOWN OF QUEENSBURY
531 Bay Rd. , Queensbury NY 12804
518-745-4447
Building & Code Enforcement
INSPECTOR'S REPORT
k//7 19 77
Lof s 64-6rw Ro /2-6Q6ler 77'
Property Location
4
Owner Te ant
Building Sewage gn ' ' the
r
Remarks:
• - `06 k ttS C— IVCb C(s,l—
.- • , t7i i 4Gov i K of tpvty
d4C;IL IT IC-5
oleo- ® Jo A) ! kwC--lo (4-TEL `/ 10 c0
ci 2 T 6�C k ,1��71 o fu & "2 d r= t cC
•
CONTACT THIS OFFICE WITHIN
c_1 c./6 7 b
Building Inspector
P
P4.,L-i
, TOWN OF QUEENSBURY
BUILDING C CODES DEPARTMENT
Complaint Investigation - Inspector' s Report
* * * * * * * * * * * * * * * * * -*7 * * * * * *
DATE RECEIVED 70 — l 7 _19 ci
COMPLAINANT , E c&e TEL
NATURE OF COMP AINT ^ f? '' ) L-' - i
IN VIO ATION •F:— . 0 11 - LA! l 4 r �i
Lk S
PRO ERTY LOCATION �,��P ��
. O
OWNER/TENANT
INVESTIGATION + / 19 BY
FINDINGS/REMARKS c . 64-;_C
E7 --. * ' 0'6
r0A.ro D
FOLLOW—UP :
DISPOSITION :
NO APPARENT VIOLATION, NO ACTION REQUIRED ❑
ORDER TO REMEDY VIOLATION SENT 19
COURT APPEARANCE TICKET SERVED 19.
COMPLAINT ABATED 19
See reverse side for additional information .
Form CI 1/87 and vl
4t-i
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
AR l7DEPART + "',
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DATE PERMIT A
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THE CONTRACTOR IS -' 'S••0,- HLE FOR
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UNHEATED SPACES R—
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TOWN OF QUEENSBURY * '
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
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742 BAY RD., QUEENSBURY NY 12804
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742 BAY RD., QUEENSBURY NY 12804
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742 BAY RD., QUEENSBURY NY 12804 •4'," •: ',..;
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DATE 71/1-Lt
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TOWN OF QUEENSBURY �+'
BUILDING & CODE ENFORCEMENT K` qj/t
742 BAY RD., QUEENSBURY NY 12804 41 6P 0.Q.9
INSPECTOR'S REPORT: ARR`0 4 • 4/
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TYPE OF STRUCTURE
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OTHER FLOORS SWEEPABLE
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Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Uc. No. 50135
RMAUINORM AL7MTM OR AOMT= M A SUM
W IEAR A LIMAIM L" VJWANM S'M. M A Map of a Survey made for
WOMnaI OF =nm ?uk so-wimm ; OF W
WE YORM WAR IDUCAVOR LAW.'
*QLY MU FM lE aIIO & OF M MOKY
YARIFiD MIN AM MOMAL OF nE LMD SML YM _
>�L MNL OE mma b MD= "MmO K AIM WW' V �f.�' S C O TT N EWE LL, INC.
'OQiMICAifOMS. FDK'AIID � MMM7 7N„T
nq SM U UM FMEPARM M ACCaDANC[ MIN 7K
OOCIIRO OOOE Of F ucm FOR Um W.Wallm MGM
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ON NIs sF W M INE WU CWMY, OOWDMMUL
AM= MD LDMW MMMM L*= HWX AMF, Town of Queensbury, Warren County, New York
NO. I DATE
I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITU71ONS OR SUBSEQUENT OWNERS.
CERTIFIED 70- SCOTT NEWELL, INC.
HOMESTEAD FUNDING,
ITS SUCCESSORS AND\OR ASSIGNS
CERTIFIED BY.
MATTHEW C. STEWS, LLS NYS 50135
DATED: FEBRUARY 2. 1998
DESCRIPTION
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