1986-840 _
CERTIFICATE OF OCCUPANCY
' TOWN OF QUEENSBURY
•
WARREN COUNTY, NEW YORK
7 --
Date July 29 19 8____
Th" is to certi th t requested to be done as shown by Permit No 86-840.
has been completed.
This structure may be occupied as a One—Family Dwelling
Ak-
Location Lot 20 Candleberry Drive (Ste No. 5)
Frank and Sheila Dingman
Owner
• By Order Town Board
' TOWN OF QUEENSBURY
• (• Building & Zoning Inspector
, • .
BUILDING PERMIT
TOWN OF QUEENSBURY No 86-840
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Frank and Sheila Dingman
OWNER of property located at Lot 20 Candleberry Drive (St. No. 5) Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One—Family Dwelling a)
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. p
a.
1. OWNER'S Address is
22 Sugar Pine Road
Queensbury, NY 12801 1-;
. t7
2. CONTRACTOR or BUI LDER'S Name. C
Paulin Const. 0
C
3. CONTRACTOR or BUILDER'S Address
22 Sugar Pine Road
Queensbury, NY 12801
4. ARCHITECT'S NamefD co 0
W rt rt
rt •
C N
fD O
1-1 O
0' • C]
5. ARCHITECT'S Address I-1 ¢'
o In
o a.
CD
0
CID CD
C n
6. TYPE of Construction—(Please indicate by X) er 1-1
101
( Wood Frame ( ) Masonry ( 1 Steel ( ) Ft
cc N•
r• C
O rD
7. PLANS and Specifications 0
No. 72')(28' per plot plan, specifications and application submitted
including sewage system and two car attached garage.
C
8. Proposed Use (D
One—Family Dwelling
N•
$5.00 C/O Cy
199.00 E
$ PERMIT FEE PAID —THIS PERMIT EXPIRES July 1 1987
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the I~,
town of Queensbury before the expiration date.) 0
04
Dated at the Town of Queensbury this 9th Day of
of December 19 86
SIGNED BY 71 �l =N^ '--'� for the Town of Queensbury
Building and Zoning Inspecto, SE)
...7:urit of aelildviity
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE / 1 2eLl / v
L 6\-
LOCATION OF PROPERTY FOR INSTALLATION 2,0
Owner's Name: �, Telephone: f
Address: �� �• p-��� ' ��
Installer's Name: � ��s.� Telephone: `, <g --- cc_D 3 Z.
�c-a5
Number of bedrooms (residential only) 1
yap
Total daily flow (compute @ 150 gal per bedroom) (Q o
Topography: circle one" lat Rolling Steep Slope % of slope
Soil Nature: circle onerand Loam Clay Other / Depth: feet.
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? 3 E feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one. Municipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank MI gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench G Q feet / Total system length ?_2-(0 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # _ ("1 / Depth or Thickness _ I * feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury 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 the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: ill Q p P(),k, ( Q.k
Date: 1 / %4 J 7 v
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD,PLACE TO LIVE
TO BE COMPLETED BY BLDG. DEPT.
cc�� Application No. j
_/own oi QueenAuryEN: _.
Permit Issued 19 �TOWN CF•%����� �a. ��i.:-; ,
BUILDING and ZONING DEPARTMENT Permit Expires 19 10) [ i; Fr' 11 I, E
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation r�j�y - II
Queensbury, New York 12801 Variance N N . tdi
V , , , >t R,
Site Pla Review No. Pit) �' _0 J
od
Approv ky r 6, -f,;., ;�?y'f2 . f,,:8t-1 ?I, r<
APPLICATION FOR
BUILDING AND ZONING PERMIT ___ .�.
* * * * * * * * * * * * * * * * .* * * * * *. * * * * #V-.* .*
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL. OF THE FOLLOWING.
The undersigned hereby applies fora 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
i is,,:� Q t , r C (v erg, 01--)•--Pr\-.)
C p
P.O. Address ?_ . �- .X.)•( "�.. A \.1N-,J J -11 Tel. 1% -'l.AZa..
Property Location: 4Z.0 ' _ 44 A►{� Tax Map No. / /
Street number or building lot number
Subdivision name (if applicable) -14 -.k
THE PERSON RESPONSIBLE-FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Name P.O. Address Tel. No.
Name of builder �� a�� Address ,p,i __ _ Tel. --
Name of plumber . \4. �1A Address --4k-K Tel.
Name of mason Address Tel.
N URE 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
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property Zito ft X Z ft.
* Existing building(s) Size `1•c., ft X 7_Z ft. -
*
PROPOSED BUILDING AND USE:
* Existing building(s) Use .-----
Size of new structure vie_. ft X ZI ft *
Foundation-pie rq
slab crawl/partial/full * Proposed building, distance from property line
circle one)
No. of stories (habitable space) * Front yard 4j 0 ft Rear yard O ft
(grade to ridge) ft. * Side yards Tin' ft and . 'tom ft
Height
g g ) �`2' * If on corner, setback from side street ft
If residential, no. of families
No. of rooms(excluding baths) * OCCUPANCY INFORMATION
No. of bedrooms LI *
No. of bathrooms ? * PRIMARY BUILDING -
system 'Q • `R ,�,� _ * One family dwelling
Primary heatin
Type of fuel �� �` * Two family dwelling
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed?--- * /Permanent occupancy
Central Air conditioning? * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE ' Industrial
Ranch Contemporary Log cabin * Other " 7
cZaised ranch j Mansion Duplex If addition, what will use be?
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * \/Attached garage/one car/ two car/ z car
* * * * * * * * * * * * * * * * * * 'Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION k
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? (\_)(D N 2_
Foundation wall material c ,K n0-k_ Ca thickness
Depth of foundation below grade (to bottom of footing) � -- (E, )
Will there be a cellar?`4.3 Heated or unheatec?Floor sq. footage \`-1-11-4 sq ft
Will there be a basement? Will any portion be used as living space?
(If so, what portion? L sq.ft. - - Type of use? )Lt ,
Type of roof sloped flat/shed/other Material, of roof , ,i,-,fe�
Size, wood studs ""Z- "X Lo " spacing '7_R,4 "o.c. length ft.
Joists(floor beams) 1st. floor Z "X " spacing 1(p "o.c. span N ft.
- o' floor "X " spacing "o.c. span ft.
' -� s) "X " spacing "o.c. span ft.
Roof rafters "X Le " spacing -7y o.c. span 2,g ft.
Roof trusses (pre-engineered) spacing "Za "o.c. spat ft.
Exterior wall finish tp.ER�,n S• Iv Of what material? Y1oly
Interior wall finish Q,r-`h
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:i4p)
D Q
k
`1
—is there o be an opening between garage and dwelling? If so will a Fire-rated
door, enclosure, and self-closing device be provided? '1/4- a J7
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supplyMunicipa)r private well W .A.)-Nu. A
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ‘03 ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Qbury AFFIDAVIT STATE OF NEW YORK
County off Warren
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a true and
complete statement of all proposed work to be done 'on the described premises and that all
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the proposed work shall be complied with, whether specified or not, and that such work is
authorized by the owner. Q�
SWORN TO BEFORE ME THIS Signature ` ' ,�Uv�9- AG) -
I Owner, owner's agent,architect contracto
Zyff day of \\ 16Kt6
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS 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 "?._(..p g
2 . 'Type of heat ey--- .0 _ )-
3 . Is the building mechanically cooled?
f
4 . Percentage of area of windows :and doorp -- I
A. Over 16% Only
1 . Uo va of gross area of w. ls , roof/ceiling and floors •
exposed to ambient conditions ' �
2 . Floor over he-at.ea spac s YES ,- NO
i
a. Are foundation w. is insulated? YES NO I
1. If YES , wha is the R value?
1j
3 . . Slab on grade S 0
a. If YES , wh is the R alue of insulation around' i
• perimeter of floor?
4 ' Is basement heated? YES NO ,
a.-:- `R' va e of insulation -
f
5. Type ofl/insulation
- B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
t
2 . R value of exterior walls \ } q
3 . R value of glazed area .S `-
4 . R value of. doors '-
5 . R value of floors over unheated spaces IN. °' 13
6. R value of slab edge insulation - unheated slab-V
7 . R value of slab insulation - heated slab o6 c Y--{.,C'..P�`—
8. R value of heated basement/cellar walls (above grade) 9a3
9 . R value of heated basement/cellar walls (below grade) '
t i
10 . Type of 'insulation V�i�L � 1. ) \
C. Controls
1 . Thermostat maximum heat setting T. "3 LL-6-3
rS°J
D. Duct Systems
1 . Is duct ,system installed in unheated spaces? YES cNO
a. If YES , R value of uc installation \ JJ/
d t
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 WaterHeating
1 Per or ancs.e efficiency
' 2---~Temperature control setting maximum
G. For Swimming Pool Only '
1 . Maximum heating • '
Telephone No. \ -- LQ�- _ --nil Ir�� "�"r � �
P
(applicant ' s signature)
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
•
(TEMP.# IDATE
•
CITY OR • r- r l
VILLAGE ar�` 2i2 ..�.: -- .. TOWNSHIP�� COUNTY
STREET AND NO.OR `1
ROAD AND POLE NO. -_ • _. y ii- _%,_•V._•t_ S j -I . , POLE NO. -
BETWEEN WHAT TWO ', ...
CROSS STREETS IS °, ,, - _...? a`�
PREMISES LOCATED? -.- - - - -- • - SECTION BLOCK LOT C_-,S.-.J
OCCUPANT'S BUILDING .
NAME . T_ _--r.. - \_ .V7.-... a`�,i C C., J_N.;e OCCUPANCY
OWNER'S
AND ADDRE SE S 1 TEL.# `li_'•q }` r
CURRENT
SUBYPPLIED \`1 _-,l --:(.,':' FROM THEIR — ? ;� OFFICE
BUILDING NEW OLD[I] IS WORK r
NEW DEFECTS
I/ ADDITIONAL CI REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
o. Fixtures& BRANCH
NUMBER OF OUTLETS LampfReceptacles MOTORS HEATERS CIRCUITS OFFICE USE
Loca- ONLY
Lion Side Attach't H.P. Watts A.W.G.
Coiling Wall Reeep'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: DO NOT USE THIS SPACE.
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 ELECTRIC SIGN TOTAL---
MAINS FEEDERS LAMPS WATTS
CHARACTER. EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN -
SERVICE OVERHEAD UNDERGROUND MAKER '
ENTERS
BUILDING OF SIGN
INSPECTION REQUESTED .
ON OR AS NEAR AS (�( '
POSSIBLE NEW l I OLD -
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION
PRINT NAME AND ADDRESS
NAME OF t ' •T SIGNATURE " -s ) •
APPLICANT �-. ' -\.—''' :Y'--_ ��ti;<< i \-:', d:,'' X OF APPLICANT �, _ :---' • - _5t '`'t ' t r L. -7�
pp i j/ S
STREET ADDRESS [._� -. •
-_. -.-_.i- ( ±._ �.�� �f�:-.1: d \c\'.,� TELEPHONE# i�--? /�
CITY OR ZIP LICENSE NO.
POST OFFICE CODE WHEN APPLICABLE
46 EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
awn o/ Queeni1ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME j���/�,/1 %'//✓l�h?��
LOCATION /l/ ZGJ ( ,/ii o`/''hC/7, t Goa
Date__ /e7 Permit No. Wh^PO
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim h
Stairs & Railings Y
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing )(
Door Closers x.
Smoke Detectors �f
Chimney
INSULATION:
Foundation
Floors
Walls
) (1 >(
Ceiling
FINAL ELECTRICAL INS CTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
,9 --- sr,
e
17d/
I
awn of Queensbur y
I 1 1� BUILDING and ZONING DEPARTMENT
r Bay Haviland Road, R.D. 1 Box 98
�� ��u�ensbury, New York 12801
4;
� 11
:U4' DING INSPECTOR ' S REPORT
LOCAT I ON 0/ 070
Date i'/f /I/ Permit No.
* * A. * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing X
Siding
Masonry Veneer
Rough Plumbing
Relief Valves r�
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures ?�
Gar. Fireproofing ,\
Door Closers j(
Smoke Detectors c�0
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Building Inspector'
6/86 and-vl
_Town of ueen36ur y co/d-r
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME F-64\1C-Se WI071
LOCATION 0 NCO c f
Date � //-? Permit No. ?(p d
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing )1C\
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 w
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
)inal Building Survey
Next scheduled inspection (call when ready)
Remarks-
V/
Building Inspector
6/86 and-vl
Down of Queeniur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC ISPOSAL SYSTEM INSPECTION
NAME C(Gt C`9 Clef S (IZVA/ A OA"
LOCATION # / /J
0/G1o/`.
DATE 4/ / 1'7 PERMIT NO. gi ' P_P- gLio
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 ype
Bldg. to tank /( // -
Tank to dist. box // L G
Dist. box to field/pi /77/�
Openings sealed? 4111, 0 Partial
LOCATION/SEPARATIONS:
Foundation to tank ft.
Foundation to absorption ft.
Absorption to lot line ft.
Separation of pits ft.
L N OF SYSTEM CJN PROP .•TY-(circle one)
rant) Rear - Left sid- - Right side COMMENTS:
SYSTEM USE APPROVE YES NO
/e/7/j
Building Inspector
01//866 and vl
0,1 cy j /U file,h/7l�s" fir, oar -
e,cato D. /101 q i5 thrn
Jown of Queenihur1j
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR` S REPORT
NAME r►- Okn 15 i h vn�c•,
LOCATION mil- 0?.6 (And�e
4014.
Date am / (Y1 Permit No. p(o - vd
* * * * * * * * * * * * * * * * * * * * * * *
f� = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
,(Framing 2.. N V
Roofing �J
Siding.
Masonry Veneer
X Rough Plumbing r,T „ .,
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 when ready)
Remarks- - ( /J
(pee eff-mrptcy 6
led
A/wi3
Building Inspector
6/86 and-vl
Jocun of Queen iur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME. l 1�aI1k p/ n) /11 Gpi
LOCATION G G (A/id/4 e''iy v�.
ate /•�l/c / Permit No. g --
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
terproofing' Q4
Backfill I`
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
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
pa,uVoN Co s .
((//i74/6
Building Inspector
6/86 and-vl
/5 l CP
awn o/ Queeniktry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 1-1-6C4-L 1< P c A31'YL
LOCAT ION Ls]1 ot-e C tid Ic 6 e- ,
g(0- b'Lc
DATE PERMIT NO.
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-fNumber 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�t
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:
aw :1 4 D-6 ZS
SYSTEM USE APPROVED YES 6
(Vi/0
Building Inspector
01/86 and vl
flown of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /4-tiLOr
LOCATION 1 �/2-j ct-N ,6r2(yoki TZO
DATE /2/5 PERMIT NO. V a - ZS `1n
SOIL TYPE Sand Loam - Clay - �
Percolation Test Required? YES i'►►•"
Percolation rate - Min/Inch D
TYPE of SYSTEM:
Absorption field, total length z 3 V
Length of each trench 3e_60' r 301(Gam'10
Depth of trenches .0
Size of gravel2
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:
SYSTEM USE APPROVED YES NO
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Building Inspector
01/86 and vl
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BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME F/-q,i k ,JI n7 vha.y
LOCATION Lot dU ( /id`/e el-b y ,OG
•
Date /l /a,} /'(. Permit No. ��rlr/%1
* * * * * * * * * * * * * * * * * * * * * * *
= 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
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-
((/i/i3
Building Inspector
6/86 and-vl
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