1989-163 y
CERPm ICA'TE OF OCCUPANCY
TOWN OF QUEENSOURY
WARREN COUNTY, NEW YORK
1
,4 Daft August 4 19 €39
1
j This is to certify that work requested to be done as shown by Permit No. 8 9- 16 3
i
E I
ham been completedw
l i
This structure may be occupied as a '-!E OF A DUPLEX
I
Location
i OwnerQUEEN VICTORIA ' S GRANT - GUYER BUILDERS
4
By Order Town Board
TOWN OF QUEENS$URY
jl
Director of Bldg. do Code Enforcement
I
BUILDING PERMIT
S i
TOWN OF QUEENSBURY No. 89 _ 163 x
WARREN COUNTY, NEW YORK
ev
PERMISSION is hereby granted to QUEJZIN VjC:!r0RIA ' S CR--AJNT — G ~
I�
OWNER of property located at Street, Road or Ave.
I
in the Town of Queensbury, To Construct or place 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.
1 . OWNER'S Address as
119 Dunning Street
Ballston Spa , N . Y . 12020 04D
C
2. CONTRACTOR or BUILDER'S Name
Self IWA
3. CONTRACTOR or BUILDER 'S Address
C7
I--I
Same a
Cn
A. ARCHITECT'S Name
H
5, ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X) F^'
CO
XXI Wood Frame I ) Masonry ( 1 Steel a a .0
7. PLANS and Specifications 7r
No_ 42 ' x 26 ' 4 of a duplex as per plot plan , specif3.cation8 1
and application , including septic
I
B. Proposed Use
I--I
OF A DUPLEX
25a00 c/a
s126 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES November 1 tig 89
(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.}
Gated at the Town of Queensbury this 13th Day of April 89-79
tv
SIGNED BY for the Town of Queensbury iv
Building and Z6nirib rnspector
` �- Application No .
✓o�r►� oaeQrt��ur Permit Issued -- 19
BUILDING and ZONING DEPARTMENT Permit Expires l9 rC7yy,
Boy esld Hawilsnd Road. R.D. 1 Box $8 Zoning Designation / Q
Oueensbury. New York 12801 variance No. � [,4 1
G1�"'Q 1'
site Plan Review No .^
jw7v;;r
AppLICATION FOR @�d� ���5.
_
BUILDING AND ZONING PERMIT
�► e +r �r �r • e �► �► w * rr w s a► Ar �r w • s * a • +s a �► �r a` a �r sr �r * * �r w e �► u
BE OBTAINED BEFORE
A PERMIT MUST BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to• do the following work which will
be dons in accordance with the description , Plans and specifications submitted, and such
special conditions as may be indicated on the Permit
�����._I�w..�w/w ..�_���••r�'__r:____._.�.w.__r__r__r�_rr w_::�_�__'n______r_�.�r__�r._ter . .. .
1K
The owner of this property is : am. GUYER. BUILDERS INC .
P. D. Address 11 DUNNINGA�owwwww BALLSTON SPA NEW PORK 12020 Tel . ( 518) 899-9151
Property Location : IS Tax leap No . �
Street number or build rgi lot number
Subdivision name (if applicable) QUEEN VICTORIA' S GRAM
THE ,PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARD.. BUILDING CODES ISt
lC.4kikRD �r�! 17` 1 .R- l ofjoT 6. Clot, �& • �rrG
ease P. O. Address Tel NO .
Name of builder Gi3YER BUILDERS . INC . Address 11�Wnwwn9 DUNNING STREET Tel . ( 518) 899 =9161
Nasss of plumber(�sr+r BJJTJJ F� & TNC . Address 119 DUNNING S"i'R,Et;T _Tel . 518 899-- 1 1
518 89 9161
Name of ason iRJYF t BUILDERS . INC . Address 119 DUNNING STREET Tel . 9-
Mason �
NATLJRE OF PROPOSED WORK : * ZONING INFORMATION :
X construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
WMENNERN
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 STRUCTURES AFFECTED. * of septic disposal area .
0=0 * '�
* COMPLETE INFORMATICi+1 [ see RED HELOW .
* Size of proper ty,,]�i�}++ [ S t X 120 t .
* Existing building ( s) S zs N ft X NIA ft .
PROPOSED BUILDING AND USE : �f l+ * Existing buildings ) Use N A
six* of new structure 42-0 ft x Z6- t
Foundation-pier/slab/crawl/partial/full " Proposed building , cUs�taffeo t Wo�m� property lines
(circle one)
Na. of stories ('habitable space) ft and 15+ ft
1 * Front yard_30+ ft Rear yard�30+ ft .
* Side yards 15+ '�
Height (grads to ridge) _19-6 ft . * If on corner , setback from side street ft
If residential, no. of families
No. of rooms ( excludin ths) 5 * OCCUPANCY INFORMATION
Hoe of bedroc as 1 _._.
' * PRIMARY BUILDING -
No. of bathrooms One family dwelling
Primary heating system BASEBOARD E -ECT X Two family dwelling
Type of fusl F1A["['i7I{CITY * Mult
_ iple dwelling / Number of units
No. of fireplaces to be installed, * Permanent occupancy
Will a wood stove be installed? NO Transient occupancy
central Air conditioning?^ NO
Business
BUILDING STYLE, PRIMARY STRUCTURE „ Industrial
abin �+ Other
Ranch Contemporary Lfl If addition, what will use be? Woo
Raised ranch Mansion Duplex
Split level Old style unga ow "
Cape Cod Cottage Other * ACCESSORY SUILDING-
Cpe Cal ot Town House * Detached garage/one car,/ two car/ car
CIRCLE ONE PLEASE ! Attached garage/one car/ two car/.car
car
( CI
* • i * * w „ * r +r • • * w t w * Private storage building
ESTIMATED MARKET VALUE OF * Other
*
CONSTRUCTION 55K
INFOi1MATION ON BUILDINGiSPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI
porn SPA 4/86 md--vl
> IiILDING PERMIT APPLICATION CONTINUED
13UIL.DIM SPECIFICATIONS :
, . .
Types of construction , wood frame , fire safe, etc , WOOD FRS_
Will any ascond-hand or ungraded lumber be used? if so, for what? No
Foundation wall material CONCRETE BLUC.'K Thickness 8"
Depth of foundation below grade (to bottom of footing) 48" MINIMLIM
Will there be a cellar?_�Meated or unheated? Floor sqo footage sq ft `
Will there be a basement? NO will any portion be used as living apace?
( If so, what porti,�}? sq. ft . - - Type of use?
Type of roof - jlopa flat/shed/other Material •of roof FIBER
Size, wood studs "X b " spacings. c . length • 8 ft. exterior walls
Joists ( floorbeams) into floor NIA"X " spacing "o . c . span ft .
Jaiats (floor beams) grid . floor 2 "X 10 " spacing�l,�'b . c. span ft.
Overlays (ceiling beams ) "X " spacing . 24 "o . co span ft. SEE PLA W
Roof rafters "X " spacing 24 o . ce span ft.
Roof trusses (pre--engineered) spacing L."o . c . span ft. /
Exterior wall finish STAINED Of what material? 5 ! 8" 4 ' x 8 ' 11
" 5I�'l'ROCiC "
Interior wall finish PAIM 112
If a garage is to be attached , describe materials to be used for FIRE sEpAR^TION :___ N'/A
is there to be an opening between garage and dwelling? If so will a Fire-rated
door, enclosure, and self-closing device videed?
Will A flUO� lined chimney be installed? eight above roof N/A ft.
Depth of chimney foundation below grade ft .
Depth of fireplace hearth NIA ft. in .
Water supply on Municipal or private well MUNICIPAL
SEPTIC SYSTEM Distance from ANY private well ( including adjoining properties N A ft.
(A separate application is necessary for any repair or new installation of septic system)
See S P E D S frmir #0202525
County off a
Corsi of bury A F F 'I D A V I T STATE OF NEW YORK
Warren
I swear that to the best of my knowledge and belief the statements contains+
ion this application, together with the plans and specifications submitted, are a true and
ooaiplets 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 .
SWORN TO BEFORE EKE THIS Signature
owner, owner 's agent arcn.t.cect, contractor
day of 19 ADRIENNE J PIN OER
NOU" Public, State of New York
t]uMMed in Sara $ Gout ety
140tary Public, County, N . Y . iN 4�?75 2
Coors �P+lree Oct. 13, 191�
s • s * * • ♦ w , �► • ,r * r • r • * f * * * • w * r * ,r • • * • * * • * r * a a # s !r
SPECIAL CON ZTIONS OF THE PERMIT :
TOWN OF QUEENSSURY
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 Baseboard electric
3 , Is the building mechanically cooled ? /
49 percentage of area of windows and doors 4o— f�
A . Over 16 % only
Uo value of gross area of walls , roof / ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES �+IO �'���
a . Are foundation walls insulated ? `�..'"`_'.�'-" NO
1 . If YES , what is the R value ?
3 , Slab on grade ES NQ
a , if YES , what is the R value of insulation around
perimeter of floor ? e,..e_
4 . Is basement heated ? YES NO „r
a . R value of insulation
so Type of insulation
5 --`� •t-LC"'�
8 . Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions.
R-38
2 . R value of exterior walls R-20
36 R value of glazed area
4 . R value of doors R-14 . 9
5 , R value of floors over unheated spaces- R-19
6 , R value of slab edge insulation -- unheated slab N/A
7 . R value of slab insulation - heated slab 12 , 5
8 . R value of heated basement/ cellar walls ( above grade ) N/A
9 . R value of heated basement/cellar walls ( below grade ) N/A
10 . Type of insulation Fiberglass
C . Controls rf /
1 . Thermostat maximum heat setting W
D . Duct Systems N/A
1 . Is duct system installed in unheated spaces ? YES NO
a , If YES . R value of duct installation
b , IR value of duct in other areas
E . Piping Insulation N/A
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F , Service Water Keating
16 Performance efficiency N/A
2 , Temperature control setting maximum
G . For Swimming Pool Oniy
1 . Maximum heating N/A
a �,.
Telephone No . ( 518 ) 899-9161 +
( applicant ' s signature )
4 Yawn of Q"AJ6.
r
APPLICATION FOR SEPTIC DISPOSAL PERMIT
Ref : S . P.E. D. S*
_ permit #
DAT'I� New York - 0202525'
MODEL �.lam of �I*F C
LOCATION OF PROPERTY FOR INSTALLATION 18 ChJPr�rr mn;r..�:Lvo
Owner's Names Guyer Builders , Inc . ..• Telephones ( 518) 899-9161
Address: 119 Dunning Street , Ballston Spa , New York 12020
'
Guyer Builders Inc Telephones '( 518) 899-9161
Installer's Name. p
2 A, Co. E, I , i , K, L, M.
Number of bedrooms (residential only) 'g' � 3 F, G , H
Total daily flow (compute Q 150 gal per bedroom) 300
Thy: circle one: Mat DORolling Steep Slope 96 of slope
Sail Nature: circle ones Sand Loam Clay Other / Depths . 8 ' feet +
Ground Waters At what depth? ur'RnQwl' 8 feet +
Bedrock or Impervious Material: At what depth? unknown feet
Percalatioa taste, circle ones required / rate min. inch.
Domestic water supply: circle ones M p l Well Other
IF domestic water supply is a Wells
Separation: Watersupply from Septic absorption NIA feet
* PROPOSED SYSTEM: Septic Tank gal. (minimum size; 1 ,000 gal.)
TILE FIELDS Each Trench N/A feet' / Total system length NIA feet
* SEEPAGE PIT(S)s Number of / Size each feet by fe4W
* Size of stone to be used / Depth or Thickness feet
* * * * * At * * * * * * * * * * * * * * *
IMPORTANT * See S . P. E.D. S .
...Please...LIST NEW EQUIPMENT TO BE INSTALLED permit & attached
* * * * * * * * +s * * * * a * * * * * * * * # * yK * * * * * * * * * * * * 1e * * * map .
(over)
y Y
Section Il 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 gystem
aj location and distance to lot lines
3.) location and distance to struptures
4.) location and distance to any *ester supply
So) size and dimensions of all tankso distribution
boxes. tile fields and/or drywella
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.
Co. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time onspec f 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 abider by these sad all r equiremeats
of the Town of Queensbury Sanitary Sewage Disposal Cardinance.
Signature of.responaible person:
Date:
sr
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury. New York 1z$01
(518) 792-5$32
SFT7L_ ED 1763 . . . BONE OF NATURAL BEAUTY A GOOD. PLACE TC
CERTIFICATEE OF II SURF NCE ISSUE DATE {MJMi,D/Dpp1YppY?
PRODUCER Requ611)i burg �y gency' Inc* THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
DES
121 U. Stro� EXTEND OR ALTER THE COVERAGE AFFORDED BY HERTIFICATE POLICIES BELOW NOT AMEND,
P 0 Box 953
Sabanectadyp NY 12301-0953 COMPANIES AFFORDING COVERAGE
372r 564i
LETTER Y A The Automobile Insurance Coo of Hartford., CT
CODE 3340 SUR-CODECOMPA ��yy fir,,, op��� p .
. . . . LET-TER
B iiie Aetna Ca$L�..�.ty` 4r= Surety' Co*
INSURED
COMPANY C.
( �Myper Bu31der$ , I= * LETTER
-1
� 19 DLuI72 izie Street COMPA
Ballston Spa, NY 12020 ETTERNY D
COMPANY E
LETTER
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OG OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSAND$
LTA DATE (MMIOWYY) DATE (MMJRDiYY)
GENERAL LIABILITY Renewal of ^� ,.y GENERAL AGGREGATE i 2,000,
COMMERCIAL GENERAL LIABILITY C0136924 1C3/1AB 10/1/89 PROD UCTS-COMPJO PS AGGREGATE $ 2t (=a
CLAIMS MApF X, OCCUR. PERSONAL & ADVERTISING INJURY S l0000,
OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE S 1,00000
FIRE DAMAGE (Any one Fire) $ 3.00,p
MEDICAL EXPENSE (Any one person) S 50
AUTOMOBILE LIABILITY Renewal of COMBINEDSINGLE S j
x ANY AUTO FJ390995 10/2/68 IOIV69 LIMIT
BODILY 1,U00, - III
ALL OWNED AUTOS INJURY $
SCHEDULED AUTOS - (Per Person)
HIRED AUTOS BODILY
INJURY $
NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY PROPERTY S
DAMAGE
EXCESS LIABILITY Renawal of EACH AGGREGATE
OCC RRENCE
�B x u XS475556 10/l/88 10/l /89 $ .,000,
OTHER THAN UMBRELLA FORM
WORKSR'S COMPENSATION Renewal of STATUTORY
<(I, + 379 10/1A8 10/1/819 $ 100, (EACH ACCIDENT)
AND J ff 77 .
5co.. (p{SEASE—POLICY LIMIT)
EMPLOYERS' LIABILITY
S 100r (DISEASE—EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONS!LOCATIONSIVEHICLESIRESTRICTIONSFSPECIAL ITEMS
CERTIFICATE HOLDER . . ._..,.r _ _ .. .. . . CANCELLATION
Bu lriing & 'Zon g j]epte SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Tom of Queenatiuxy EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Bay & Havlland Road MAIL 'L,U DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
RD #1, Box 98 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Queensbl]. y.p NY 12801 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 2S-S (S!$$) RATION 1900
�
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVIL.AND ROADS �1 /
QUEENSBURYIIr NEW YORK 3280!k
TELEPHONE (528 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME le
LCICAT ION
DATE 7 i - PERMIT #
,APPROVED
YE NO
�OOTINGjPI�%�
MONOLITHIC POUR FORMS
FOUNDATIONIDAMP-PROOFING
BACKFILL APPROVAL
ROUGH PL LIMB-TNG
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT `
ROOFING
SIDING
EXTERNAL PORCHES/ TEPS -
STAIRS-C EARANC & RAITxS
PLUMBING FIXTU ,,Cj,IrRELIEJF' VALVE -
INTERIOR TRIM/ RIVACY D06PS
FINISHED FLOG S_,-,�
GARAGE FIREP FING
DOOR CLOSER ( )
SMOKE DETEC ORS
FINAL ELECTRI AL INSPECTION
FINAL APPROV L OF CONSTRUCTION
A SIGNET] CSRTIF£ ATE OF OCCUPANCY MUST BE
OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS :
1 .
V
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS /f!7
CUEENSBURYt NEW YORK 12sol-
TELEPHONE ( 51.8) 792-5832
BUILDING INSPECTOR' S REPORT cc�yy
REQUEST FOR INSPECTION RECEIVED /
NAME /
LOCATION
DATE PERMIT # q4�
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
6.e rO UNDAT IO N/DA MP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROU -IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION*
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHESIST S����_
STAIRS-CLEARANCE & LS
PLUMBING FIXTURES/ EL F VALVE
INTERIOR TRIMIPRI ACY RS
FINISHED FLOORS
GARAGE FIREPROOF NG
DOOR CLOSER (S)
SMOKE DETECTOR
FINAL ELECTRICA INSPECTION
FINAL APPROVAL F CONSTRUCTIO'
A SIGNED CERTIFICATE OF OCCUPAN Y MUST BE
OBTAINED FROM THE BUILDING- RTMENT .BEFORE
THESE PREMISES ARE OCCUPIED ?
REMARKS :
I SPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12809'
TELEPHONE ( 518 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED -
NAME �.y
LOCAT ION L
DATE PERMITS¢
APPROVED
YES NO
FOOTING/PIERS
ONOLITHIC POUR FORMS
UNDATSON/DAMP�PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION : t.
CHIMNEY HEIGHT I
ROOFING
SIDING
EXTERNAL PORCHES/STE 75
STAIRS-CLEARANCE & ELS
PLUMBING FIXTURES/ LI'1€F VALVE
INTERIOR TRIM/PRIV Cy DFRORS
4
FINISHED FLOORS
GARAGE FIREPROOFI G� -.... ---
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL I SPECTIONJ� --
FINAL APPROVAL OF ONSTRUCTION
A SIGNED CERTIFIC TE OF OCCUPANCY MUS , BE
OBTAINED FROM THE BUILDING DEPARTMENT BORE
THESE PREMISES A OCCUPIED?
REMARKS :
INSPECTOR
TOWN OF QpEENSBUES DEPARTMENT 40;
BUILDING tf
BAY & HAVILAND ROADS I!
QUEENSBURYe NEW YORK
TELEPHONE (518 ) 792-5832
BUILDING INSPEC OR' S PLEPORT
REQUEST FOR INSPECTION RECEIVED
NAME ! 1 I v
LOCATION ►G — �7 t �+ �
DATE -� — I _ PERMIT #
,APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR PR FIN��— _.
FOUNDATION/DAMP— -----^'�
BACKFILL APPROVAL _^
y.�OUGH PLUMBING
ING
g gCTFtICAL 140UGH—IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT '
ROOFING
SIDING
EXTERNAL PORCHES/ TEPS
STAIRS—CLEARANCE f& RAI
PLUMBING FIXTUR /1RELIEF ALIVE
INTERIOR TRIM/�VACY DOO
FINISHED FLOOR
GARAGE FIREPR � FING
DOOR CLOSERS)
SMOKE IJETEC S
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL' OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DE-'ARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMAR KS:
INSP TOR
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.D. i BOX 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME _,_�..e --
LOCATION
DATE 4/ PERMIT NO , � r� I "
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO ,
Percolation rate - Min/Inch -
TYPE of SYSTEM:
Absorption field , 'Ltotal length !
Length of each treipch
Depth of trenches 1 �-
Size of gravel_
SEEPAGE PITS4Number nf)
Size- ft. X _ 't- -
Gravel size .
PIPING : S i " Ty GfG
Bldg * to tank
Tank to disc , box �I(
Dist. box to fs �'1dfi� p Partial
Openings sealed? �,�YES
LOCATION/SEPARAT S = 1, ft,
Foundation to t k ,
sorption #��ft .
Foundation to ft .
Absorption to o't l in'e ^f t .
Separation of its '
LOCATION OF S STEM ON pROPE �ht�side rcle one)
Front - Rear - Left side 9
ComMENTS
SYSTEM USE APPROVED NO
SYSTEM
Buildi Inspector
01/86 and vl
TOWN
RY
BUILD G AND
CODES
DE
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
�'7, UEENSBURY, NEW YORK I280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION C41
DATE ( e7 T c� _ PERMIT #„ —
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC UR FORMS
FOUNDATION AMP—PROOFING
BACKFILL AP VAL
ROUGH PLUM$I
FRAMING
ELECTRICAL ROU —IN
/'`INSULATION
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
Af
SIDING
EXTERNAL PORCHESJST PS
STAIRS—CLEARANCE & . I
PLUMBING FIXTURES ELSEF ALVE
INTERIOR TRIM/P ACY DOO
FINISHED FLOORS
GARAGE FIREPROO ING
DOOR CLOSER (S)
SMOKE DETECTOR
FINAL ELECTRICA INSPECTION
FINAL APPROVAL F CONSTRUCTION
A SIGNED CERTtTFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
�X
a4NSPECTOR
MIDDLE DEPARTMENT INSPECTION AGENCY, INC. �7 .�
goo,t,.d�w A"itt,e, Cafflftyate�I kJ 04108
fat. August 5 , 1989
CFTtif iO that tkt tectrical equipment listed has been examined and is approved as being in accord
with the National Electr Cide; applicable governmental, utility and Agency rules,
Guyer Builder L Inc. Occupancy. Dwelling C
Owner �
Qccuparat: Single Family 1 ttv
Location: 18 Queen Mary; Drive .. Qdeensbuty (Arren CQ s & certficate covers teq electrical equipment and installation Inspected Ihns
p' date If additional equipment should be introtluted or enetat,ons made to
�1 . existing system !Ma certfecata shale be nu+l anO raid, and appt,cahon for
U0 Outlets ; .R'� �.@GeptdCleS ' 20 Fixtures , �nspecndn should besubmitted pro I*llytoth,sAgency.Etaurprngrtt: r holder ofthoscerhhcate should pwrA some!an,a Property,nsurancacartrer
150 Amp Servie' � 7 Appliances r {agent ofcompanyfasevidenceg#rtlficatianelefectncataqupmentapproved
aS Spectiied.
NdnGuyer Sui ``
. .�,.,.
AppOcant.' 119 Dunning Stree
15424927
Ballston Spa, NY 12�2
tg
►eon xo. me EL $43
TOWN OF QUEEENSBBURY
BUILDING AND CODES DEPARTMENT /}
BAY 6 HAVI LAND ROADS
QUEENSBURYf NEW YORK 32809-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED j
NAME
LOCATXO�N
c5
DATE A _ PERMIT #
APPROVED
kES NO
FOOTING/PI S
MONOLITHIC UR FORMS
FOUNDATION/D P—PROCIFING
BACKFTLL APP VAL
ROUGH PLUMBIN
FRAMING
ELECTRICAL ROU —IN
SNSULATION:
FOUNDATION s''
FI.00IRS
WALLS
CEILING
Ce�FXNAL INSPECTION. is
CHIMNEY HEIGHT
ROOFING
STDTNG r'
EXTERNAL PORCH,VS/ST S
STAIRS—CLEARANCE & TLS
PLUMBING FSX*JRES/RE EF VALVE
INTERIOR fiRi/PRIVACY OORS L/
FINISHED F ZOORS
GARAGE FI PROOFING
DOOR CLOSSR (S) IA
SMOKE DE ECTORS
FINAL ELE TRICAL INSPECTTO
FINAL AP OVAL OF CONSTRUCT N
A SIGNED CERTIFICATE OF OCCUP CY MUST BE
OBTAINED FROM THE BUILDING DEP TMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
(4cey
INSPECTOR
SELECT BUSINESS FORMS (609) 848.5203
APPLICATION FOR ELECTRICAL INSPECTION
PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
f ^— National Headquarters
900 Haddon Ave., Collingswood, N-J. 08108
Date : .4 S
` Town or -- e-t' F?'3T 3T County Warrerl State I+IY
Loeati on/Address 1$ Queen Mary Drive
( If Located in Rural Area - Please Attach Directions) Pole #
Owner GUYER BUILDERS , INC . _ _ Permit #
Occupied As Building: NewEM Old Q
Occupant
Work Area in Building Floor **, etc. ) :
A , for: Wiring E3 Service Q Or: Ready for Inspection :
Fee Remitted - $ Cash Q Check Q M.O. 0 Make Payable To: M.D. I.A.
500 750 1000 1250 1500 1750 2000 225a 2500 2754 30a0
Number of Rough Wiring Outlets Elect. !-lest
Switches
Lighting Amp. Service Surface Unit Dishwasher Flange
Receptacles Water Heater Air Conditioner Dryer Pump
Number of Fixtures 'Oven Garbage Disposal Wiring and Controls for Burner
Amp. receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS H, P, 1F2 1/12 1/10 1/a 1/6 1/4 1/3 1/2 3/4 1 IV7 2 3 5 74x 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's
Signature License # Permit #
T/A GINER 'MATT) S— IM Utility :
Applicant's Address: 119 ihinnlTlg Street
(NAME M (OFFICE LOCATION
(City) Ballston Spa (State) NY (zip) 19020 Service Request #
Phone # 899-9161 Electrician :
• 1 USE • NLY DATE RECEJVED: DATE INSPECTED !
Correct Location : Same as Above Q or:
Red Notice Label
Rough Wiring Outlets Surface Unit Oven
Switches ran a Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp, Service Equipment Burner, Wiring & Controls for Amp- Receptacle
Amp_ Service Conductors Pump Vent Fans
MOTORS H.P. 1l2O 1/12 Lfl0 1/8 1/6 1/4 1/3 I/2 3/4 1 1112 2 3 5 7Vx 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Elect. Heat Sao 7so 100o 125a 15aa 175012001 225a 2500 2750 3000
CERTIFICATIONS USE FOR INITIAL, VISIT ONLY NOTIFIED DATE CORRECT PEE pAiD
Q RW Progress: Inc. 0 LKD I1 Contractor
CFT Violation : Work Comp. Q Inc.
[� Q
L/A Owner CASH 0
Q L/A Fee CH K #
Q IPA Municipal Due MO *
INV #
Date : Other Side 0 Utility Applicant
Owner
Gut in Card F-1 Temp # Date
REFERENCE DRAWINGS
5 SITE UTILITIES
QUEEN VI IA' S G SEPTIC 4 WATER
Van DU S E N $ S TEVES
QUEENSBURY , NY
SURVEY PLAN
0-MODEL ROOF PLAN WILL VARY
ACCORDING TO SALE, DRAWING
SHOWS ONE STYLE ONLY.
8`- 0 DIAMETER
9=0 DEPTH
CLEANOUT
/ r...�,.. r........ ...»....... tiF.w..., .......,.,.,,.� .....a.... .,....�.,... .....r.._W .......... .�._....,_ .....�.,... ........... _.......,,.�.. .rrlrw.. ......... ......r.... .r...... _...__•_
TO GRADE ...
129.55'
2000 gal.
/ 3./e
\3rO' LOT M ! _L__
2� /6 0
4
a,
v, 4
2� �o o I
O 0`
Co. 1�
` N 0
129! e _
Sh
pp
j
10
MARY
TOWN F QUEENSBURY
\ Zoning Admi is
�Sr7�i.=.Z4f
QUEEN tRY DRIVE
PLOT PLAN SEATIC SYSTEM
Yf-a gu, LDERS ► I"C.
is kale; { _ % 0