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1986-571 • . CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date August 31 19 88, This is to certify that work requested to be done as shown by Permit No. 86-571 has been completed This structure may be occupied as a One—Family Dwelling Lot 12 Lady Slipper Drive (St. No. 22) John and Debra Daley Owner By Order Town Board TOWN OF QUEENSBURY ' (,_ c et/le' re/ Building & Zoning Inspector ... A - BUILDING PERMIT TOWN OF QUEENSBURY No. 86-571 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to John and Debra Daley - ? OWNER of property located at Lot 12 Lady Slipper Drive. (St. No. 22) Street, Road or Ave. . in the Town of Queensbury,To Construct or place a One-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 o Lady Slipper Drive Glens Falls, New York w CD 2. CONTRACTOR or BUILDER'S Namero o' - rt same ty _ w 3. CONTRACTOR or BUILDER'S Address ~ m same - • 4. ARCHITECT'S Name 1-d N CD ao 5. ARCHITECT'S Address - gq p,, 0 cJ 0 �d d 6. TYPE of Construction—(Please indicate by X) ( x)Wood Frame- ( .) Masonry ( )Steel ( ) - d N• a. c 7. PLANS and Specifications 1-4.11) 60'x44' per plot plan, specifications and application submitted co' En No. including sewage system and two-car attacehd garage. o' rr 8. Proposed Use One-Family Dwelling N tJ $5.00 C/O m . $ 171.00 PERMIT FEE PAID THIS PERMIT EXPIRES April 1 19 87 9 (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 15th Day of September 19 86 SIGNED BY - )114ael Q.. for the Town of Queensbury Building and Zoning Inspecto pq q�� � 6 TO BE COMPLETED BY BLDG. DEPT. • // Application No. sown of Queensburey Permit Issued 19 TOWN OF QUEENSIBURY BUILDING and ZONING DEPARTMENT Permit Expires 19 REG .EIIVEDBay and Haviland Road, R.D. 1 Box 98 Zoning Designation Queensbury, New York•12801 Variance No. Site Plan—Review No J U L 2 9 1986 2- Appro fl b . A.M. 1 C�f2-6— P.M. �j q�/ _ 71819119.11412)1)213)41516 APPLICATION FOR iJ at -. a'/IL'L"' me • . +4. a a a a e (pa__ FUILDING AND ZONING PERMIT . * * * * * * * * * * * * * * * * * .* * * * * * * * * # # * * * * * * # * # # # A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. 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. The owner of this property/ � is: 37c�1AVI g• 4. 0(°lprek Oq/6 / P.O. Address $11/7 Zaic J n f r PDPr .Or/f.' Tel. ?-7R-72 / 1 ii Property Location: #/� /_Qc L/ S/j er Dr) S];*�Z Tax Map No. / / Street number' or buil ing 0 lot number Subdivision name (if applicable) P3(Z)C./4161A agr.(r THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : \t'O‘f‘C\ )(?ice y Name ) P.O. Address Tel. No. Name of builder 1. 04/,P v Address z:we c,C hove Tel. 79$g 7' / or Name of plumber \I i\ / Address 11 %k '.li Tel. 77 ?7 d Name of mason ]Oil(1;e S-:405t ri4scL, Address LCieJy S,4)1/ter ! iriU,e. Tel. 753 344,3 NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, Addition to a building * drawn reasonably to scale and attached hereto, Alteration to a building * showing clearly and distinctly all buildings,_ (no change to exterior dimensions) * whether existing or proposed and(indicate all Other work (describe) * set-back dimensions from property lines. Give * street and number or lot number and indicate * FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location of water supply and location and configuration LOCATION OF STRU-TURES AFFECTED. * of septic disposal area. * �' * COMPLETE INFORMATION REQUIRED .BELOW. s'- i✓---/ �/ * Size of property '/M _'a= T) ()ft X j7Or;i ) ft. v * Exist-ing—buildings) Size ft X ft. * . . PROPOSED BUILDING AND USE: � * Existing_bu llding_ s) Use (flG C Size of new structure ft X / Y f * Foundation-pier/slab/crawl/partial% * Proposed building, distance from property line (circle one) * Front yard ' �, . ft Rear yard :cif) ft No. of stories (habitable space) A'Side yards ft and :30 ft Height (grade to ridge) a ft. * If on corner, setback from side street ft If residential, no. of families J . . No. of rooms(excluding baths) ' ,6 * OCCUPANCY INFORMATION * No. of bedrooms el. * PRIMARY BUILDING - No. of bathrooms .9 ill,_ * ' one family dwelling Primary heating system pq¢ 1-l' ' c�, , p * Two family dwelling Type of fuel a.' ' 1C *. . Multiple dwelling / Number of units No. of fireplaces to be installed ' I * 1,-Permanent occupancy Will a wood stove be installed? , 1eS T * Transient occupancy Central Air conditioning? J (( Business* BUILDING STYLE, PRIMARY STRUCTURE '" . Industrial Ranch Contemporary Log cabin * Other * If addition, what will use be? Raised ranch ,Mansion Duplex Split level Old style Bungalow * Ca e Cod Cottage Other * ACCESSORY BUILDING- Colonia Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * >( Attached garage/one car/c car ' car * * * * * * * * * * * * * * * * * * * 'Private storage building ESTIMATED MARKET VALUE OF ) *• Other • CONSTRUCTION G' . / * INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - - BUILDING SPECIFICATIONS: Type of construction; wood frame, fire safe,etc. Will any second-hand or ungraded lumber be used? If so, for what? 106 Foundation wall material dIa•j, Thickness /t�O ie A Depth of foundation below grade (to bottom of footing) Will there be a cellar? Heated or unheated? Floor sq. footage sq ft Will there be a basement? dJ S Will any portion be used as living space? , () (If so, what portion? / sq.ft. - Type of use? Type of roof - 440 /flat/shed/other Material.•of roof 4.)4 t• f1i1C1`9/r4'S Size, wood studs 4 "X 4) " spacing // "o.c. length ft. ' Joists(floor beams) 1st. floor "X /() " spacing j(( "o.c. span 3 ft. Joists (floor beams) 2nd. floor a "X //(`} s acing P o.c. span_1 �� ft. Overlays(ceiling beams) "X (3 " spacing /7.. "o.c. span 45 ft.-- Roof rafters -,�7 "X " spacing I('.., o.c.r span („ ft. Roof trusses(pre-engineered) spacing <t7 "o.c. span /,-,j ft. Exterior wall finish -- C� j0 n1(.. Of what material? 7 y���2 j} J�'�C'l' Interior wall finish /-7/ )-ti.," a "9 If a garage is to be attached, describe materials to be used for FIRE SEPARATION: .b ' 1';C. 11 ' rA - Is there to be an ope ing between garage and dwelling? 02;, If so will a Fire-rated door, enclosure, and self-closingdevice be / " 1 provided? ! � l tv i c Will a flue-lined chimney be installed? L/ C Height above roof , X 1 f-t-_ - ;'Depth of chimney foundation below grade J - ft. ,/. '1n Zvi+ 1�,a-1-�� 5 ',\ Depth of fireplace hearth ft. in. I Water supply - Municipal or private well y?_"):(,e.--)ii.."SEPTIC SYSTEM _ Distance from ANY private we (including adjoining properties ` ( ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of Warr„pn -I sw-ar that to the best of my knowledge and belief the statements contained in this application, togAher with the plans and specifications submitted, _are a .true.and complete statement of aril proposed work to be doneion the described premises and that all • provisions • the BUIL/DING 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 o,ener. , / / / i ( A • SWORN TO BEFORE THIS Signatur r rifL - ,r Owne , owner's agent,ar 1 ect,contractor day of 19 / I Notary Public , Warr n County, N.Y. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *; * * * * * * * * * * * SPECIAL CuNDITIONS OF THE PERMIT: • - By . TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work. • ANSWER ALL of the following: 1. Gross floor area - 2 . Type of heat • ' tL€L-C—TE (41\f\k_ 3 . Is the building mechanically cooled? \t Es . 4 . Percentage of area of windows and doors_ A. Over 16% Only 1. Uo value of gross area of walls , roof/ceiling and floors • exposed to ambient conditions 2. Floor over heated spaces YES NO ' a. Are foundation walls insulated? YES NO • 1. If YES , what is the R value? 3 . Slab on grade YES NO a. If YES, what is the R value of insulation around perimeter of floor? • • 4 . Is basement heated? YES NO • a. R value of insulation ' 5. Type of insulation ' A • B. Under 16% Only 1. R value of roof and floors exposed to ambient conditions 2 . R value of exterior walls �" L 3 . R value of glazed area 2- .. 0 4 . R value of doors %, • 5. R value of floors over unheated spaces �;FK 6. R value of slab edge insulation - unheated slab ), 7. R value of slab insulation - heated slab 8. R value of heated basement/cellar walls (above grade) T 9. R value of heated basement/cellar walls (below grade) 10, Type of insulation Cs) Q ,,,,. C. Controls 1 . Thermostat maximum heat setting • D. Duct Systems 1. Is duct system installed in unheated spaces? YES 0 a. If YES , R value of duct installation • b. R value of duct in other areas . E . Piping Insulation 1. Size of hot water or cooling, carrying agent pipe 2 . R value of pipe insulation • F. Service Water Heating ` Gf • 1. Performance efficiency 0 2. Temperature control setting maximum ( (- () G. For Swimming Pool Only 1 . Maximum heating , )/� 1 1 AA) JC,L.,e',M, /Telephone No. /l / (-2/ 7I / �C;� iij �9 I, (applicant ' s si4na"ture) Jown of QUQtU APPLICATION FOR SEPTIC DISPOSAL PERMIT. BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 DATE /,.r./ K4 • LOCATION OF PROPERTY FOR INSTALLATION Qdvck ffer Or/s -/(_:' 75%i OWNER S NAME TUII '1 .. i 0 b ref 1 17 1,-,i , ...,-, ,. (L , . 197 V • ‘-)0 I, c, .., • ADDRESS �p ` /` Grp ,C/ /::2. INSTALLER' S NAME >► 1' /1 RIm TEL 0 4.1/ TEL G&5/-?,f7ae.9 Number of bedrooms (residential only) V Total daily flow(compute @ 150 gal per bedroom) /,•, O(..j Topography: Flat ;'- Rolling - Steep slope - (circle one) % of slope Soil nature: ind Loam - Clay - Other Depth ft. Ground' water -At what depth? S' ) ft. %/2"i' 'c `j • Bed-rock or impervious material - At what depth? ' ft. Percolation test - Not required - Required - -Rate ' L� C'C', ' r-inch. Domestic water supply - 6Municip a-1 - Well - Other - Separation - Watersupply(if well) from Septic absorption _ft9 , Proposed System: Septic tank /D10 gal: ( Minimun size, 1000 gal. ) L'(Tile Field - Each trench' ja. ft. Total system iegnth ' ; 75i ' ft. K . Size of stone to be used Depth or thickness ft. IMP* * *ORTANT* * ! !* ,* * * * * * * * * * * * * * * * * * * * * * * * * * .* *..* * On a separate piece of paper, submit a diagram of the proposed system with• all d jriensions shown; including distance from any structure , distance from property lines and from ANY DOMESTIC WATER SUPPLY or shore-,line of lake, strea'm,pond or wet-lands: Include all dimensions of r the system, itself . * * * * * * * * * * * * * * •* * * * * * . * * * * * *• •* * * .* * * * * * * • I hove read the regulations on . the reverse' side of this sheet and agree to abide by theseand all requirements of The Town of Queensbury • Sanitary .Sewage Disposal Ordinance, . Si...0.gt_ure of responsible• person �� t ;Je.- iY . _ . . . Darr-. : 7, • • 05AiS, and/vl ,I Section II Septic System Inspections: A. All applications- for septid system ilnstallation,. alteration or repair, as required by► the Town of Oueensbury Sanitary Sewage Ordinance, shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing: 1) the proposed location of the system 2) location and distance to lot lines 3) location and distance to structures • 4) location and distance to any water supply 5) size and dimensions of all tanks, distribution boxes, tile fields and/or drywells B. No system shall be covered before inspection and approval by the Building Inspector. Failure to comply with this requirement may result in the uncovering of the system by thetinstaller and .a fine of up to $250.00. C. An approved copy of the plot plan shall he available on the construction site. Failure to produce said plot plan at time off inspection may result in an immediate work stoppage. • D. Should unforeseen problems during construction S prevent proper installation, alteration or repair of an approved system, a new proposal . must be submitted to the Oueensbury Building Department before further construction. • • - i THE NEW YORK BOARD. OF FIRE UNDERWRITERS 13 In NLG • BUREAU OF ELECTRICITY ® 741 STATE STREET.ALBANY.NEW YORK 12207 Date APRIL 19, 1988 Application No.on file 025563/86 A 713143 6 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of mi Et.7 � U �b Le & ��77 . DALEY, LOT 12 L ADYSLIP ER DRIVE, GLENS FAILS, NEW YORK — in the following location; ❑`Basement Er"1st Fl. ❑'2nd Fl. OUTSIDE Section 90 Block 7 Lot 12 CI — 1 was examined on 1/L J!88 and found to be in compliance with the requirements of this Board. '... FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ': OUTLETS INCANDESCENT-FLUORESCENT MEAppY AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 28 47 21 27 1 3 fr DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELt UNIT HEATERS MULTI-OUTLET DIMMERS •.' T_ AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SYSTEMS .i. - SERVICE DISCONNECT NO.OF S E R V I C E ': AMT AMP. TYPE METER 1.$2W 1$.3W 3$3W 3 X IW NO.OF C.COND. A.W.G. NO.OF h EG A.W G. NO.OF NEUTRALS A.W.G. 'i = EQUIP• PER$ OF CC.COND.. OF HI-LEG OF NEUTRAL 1 200 CR 1 x 1 4/0 1 2/0 1_ 4113,OTHER APPARATUS: - 2•- GPCI 1- SMOKE DETECTOR :- 7 c:40111 1 E--- .,-..-. ..4*itYr . F.:- gi. 4:7 . = F_D 2 LADYSL.'PPM DRIVE GLENS laALLS, NEW YORK 12801 239 • BRANCH MANAGER .• �I • Per 1( '`';r�_ o - ^y 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. ® 0 rtilitaniliM ffiffliniMilin ® MOE ® 0 Milii5SEUESMI 0 0 0 ® 0 CIESERENIESNE ® ® = COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. _town of Queenitury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME 7d / LOCATION / -/� � e (A9,4 Date; cif / Permit No. r'� * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill / Framing Roofing a/ Siding t/ Masonry Veneer Rough Plumbing • Relief Valves ✓ Ext. Porches c/ Finished Floors Interior Trim Stairs & Railings (/ Cellar Drain Tile Concrete Floors Plbg. Fixtures \ t ' Gar. Fireproofin. ✓ Door Closers ✓ Smoke Detector- tV Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- d • Bui g Insp ctor 6/86 and-vl (=all�P' �a�/d �� s /M4 awn of Queenitur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME -16 API D Gi y LOCATION �c /Z 1-a--4/ (5li Date y/_c/ /xi Permit No. Y -- 5 7/ * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings / Cellar Drain Tile \, Concrete Floors Plbg. Fixtures / Cs\ Gar. Fireproofing Door Closers Smoke Detectors Chimney (/ INSULATION: Foundation Floors )(Walls i.k„n Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- /J C.Qi1 �fe% i �) )4-aujA j or4j Building(Vfld27 spector 6/86 and-vl _/own of Queeniur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME el,t& • LOCATI P>tr Date 1:,, / y Permit o. ( * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill ('�_ n framing ILL- (24 . Roofing Siding Masonry Veneer ,, ;� ,�� LRough Plumbing Q n —C 0,1( Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile J Concrete Floors i' \\IPlbg. Fixtures i/ Gar. Fireproofing Door Closers Smoke Detectors ;/ \ Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey � z Next scheduled inspection (call when ready) Remarks- 0/0) Building Inspector 6/86 and-vl call,' 3/ 6/r7 Y: as4-iz7 _lown o f Queenáur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME -�G1't ba /E, LOCATION 1-or ��d,.y S/id2 -I. V1( Date 3J 6 /f7 Permit No. ` * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer c l hz iJ ( 9 Rough Plumbing � Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures I Gar. Fireproofing \1\11 Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors I Walls j Ceiling FINAL ELECTRICAL INSPE TION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- L I if a-r. e .n �4 I Yl Rc tJG TY°cc),h 1 Ct j U11Z ✓ .J21/1 tit puo- A,fi 6441/1(3 Building Inspector 6/86 and-vl 11,22( c�-dly`1 Down of Queenitury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME c) 1.1 rTha y LOCATION LOT j z L &chi S i r E, �e� Pr., Date .�1;;t0 / 87 Permit No. � -57/ * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill )` Framing n Roofing W LAin 17 /.f(� Siding C, Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling // FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- ��11 �L ()1/1-44-3 L1 UI//0 SOkC- v t,-)i- Po-mac I-- t3 & M,6-Air- S`, -,r. 0 P i2 A), V4-, • Building I/ispector 6/86 and-vl • C _Jown o1 Queenitur, • BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 . Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME i 2u�_c. 4.V..,c.e re-f, -iAll-d._ g''1 LOCATION /4 -•, _( DATE q/r/5'/ PERMIT NO. S7 6 -5-77 SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS{Number of) _ / Size- ft. X ft. \ / Gravel size ' \ / PIPING: Size 'Type Bldg. to tank ' Tank to dist. box _ Dist. box to field/pit _ •, Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank ft. Foundation to absorption " ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENTS: A- -e-%4 f CA.r c -oiLt � - Ato01SIo!i P© CC.uJ &eo a T-c-bZs TS C L i:rt_ Imo• i/L-c y r'0.41 (2) C'ol4r /0,v c o'Joys& 5 - - SYSTEM USE APPROVED YES NO ak—i-/, 2/ G 41.-Z___-- Building Insp tor 01/86 and vl Jorl o f Qurj BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION „certi.;,_ DATE 9i/K/ Sq,v PERMIT NO. SOIL TYPE - Sa - Loam - Clay • - Percolation Test Required? YES O Percolation rate '- Min/Inch TYPE of SYSTEM: f• Absorption field, total length .fj_C� Length of each trench 5-0' Depth of trenches 1 Size of gravel_ SEEPAGE PITS{Number of) • Size- ft. X ft. Gravel size • PIPING: Size Ty.e Bldg. to tank y/' `, dd Tank to dist. box i '' Ogre,— Dist. box to field/pit zl 4 pv Openings sealed? YES 0 Partial � ,�► �Fio/'o o/ULC LOCATION/SEPARATIONS: Foundation to tank ft.Of Foundation to absorption ft.e'fl/ Absorption to lot line ft.49 e_ SepataLiuii oaf—pits ft LOCATION OF SYSTEM ON PROPERTY(circle one) Front - %V - Left side - Right side - COMMENTS: C.o n4M6c`t C,(4-4.7C-V 010 J5 C� l� t o C vfr 1 ,0 ©0 Cid cis 1,� �1 9�r� !✓1/,/z rD l it l�rf 5 • SYSTEM USE APPROVED S 0 Jr / Building Ins. ector 01/86 and vl Cdt (/ - q( //t/e,, _own of Queen.itury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME teY LOCATION etc/ • h�� Date 9 //o / ,�'(p Permit No. /6-�// * * * * * * * * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms 7c Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call w e ready) Remarks- - cie) 6 L). Bui ding n• .ector 6/86 and-vl �1 '3;c -0 cc��77 _lown of Queenitury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME .°ice ..--ey- LOCATION L�_ %tom .r Date /_ Permit No. 1? 7 - 5 / * * * * * *, * * * * * * * * * * * * * * * * * � � Or = APPROVED - YES / NO Footing/Pier Forms OL Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings \\\/, / . . Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar.. Fireproofing / \ Door Closers r Smoke Detectors 1 Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - Ali4 Build B n Inspector 6/86 and-vl i ✓ ' �; `..- jt 3 i f r� i .. n