1988-608 .. ,, ,. . .. .. .. a .. .._. _Ai
. ...
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Seot.2004r 27 19 89
This is to certify that work requested eo be done as shown by Permit No. 88-608
has been completed.
This structure may be occupied as a One Family Dwelling
Location Lot 77 Orchard Dr. (St. No. 33) Old Ordhard Subd.
Owner Dou74.as & Jackie Herschleb
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning lnepector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-608 b
WARREN COUNTY, NEW YORK
. gp,L' ! ,\ ,f- L •
Douglas & Jackie Herschleb
PERMISSION is hereby granted to
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Lot 77 Orchard Dr. (St. No. 33)
OWNER of property located at Street, Road or Ave.
Old Orchard Subd.
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.
ty
1. OWNER'S Address is 0
12 Dorset PLace
Glens Falls, N.Y. 12801
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2. CONTRACTOR or BUILDER'S Name (-1
William Herlihy
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3. CONTRACTOR or BUILDER'S Address x
l Dartmore Drive
Glens Falls, N.Y. 12801
4. ARCHITECT'S Name •
0
5. ARCHITECT'S Address rt
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6. TYPE of Construction—(Please indicate by X)
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Ff Wood Frame ( ) Masonry ( I Steel ( )
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7. PLANS and Specifications
No. 81' X 36' as per plot plan, specifications and application
including septic system and attached two—car garage.
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8. Proposed Use ,
One Family Dwelling
6
5.00 C/O
$ 269.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1 19 89
o
(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.) N
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25th August 88 a.
Dated at the Town of Queensbur s Day of 19
SIGNED BY for the Town of f Queensbury •
a'
Building and Zoning nspector
APPROVED
j/txurig. of Oue4aderell
APPLICATION FOR SEPTIC DISPOSAL PERMIT ZONING I.OtDO CODES DCI'L
TOWN Of QUEUiSUUItY
DATE -1 SIC,
LOCATION OF PROPERTY FOR INSTALLATION Lod'— 77 c RcHXI D DR) vie
Owner's Name: gE_( ScJ-/Lpr Telephone: 75 - --a341 O
Address: _ 12 Dr) f?S �% �L/ff
Installer's Name: Telephone:
Number of bedrooms (residential only) _ _ •
Total daily flow (compute @ 150 gal per bedroom) T GOO
Topography: circle one: Fat .,Rolling Steep S1op.e_9% of slope S°, _
Soil Nature: circle ones`-Ss nd Loa Clay Other / Depth: S feet
Ground Water: At what depth? ' 9 feet
liedrock or Impervious Material: At what depth? _ 4f O feet
Percolation test: circle one: of re wire required / rate min. inch.
Domestic water supply: circle one:Nunicip Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank /6'0(2 gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench SO feet / Total system length 42? feet
SEEPAGE PIT(S): Number of / Size each feet liy feet
Size of stone to be used / Depth or Thickness / feet
* * « * « « * * * 4 * * « * * « * * * * * * * * * * * « « * * * * * * « « * * * *
IMPORTANT
...Please—LIST NEW EQUIPMENT TO BE INSTALLED
* * * « *,« « + « * « * « « * * 4 * « « « 4, « 4. « « sa « 3s * * * * « * * *
(over) •
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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
=t.) •location and distance'to any water supply
5..) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells • . •• • •
13. 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.
•
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I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordin:wce.
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Signature of responsible person: i ,�r�l�` '/l •
Date:
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Town of Queensbury
• , Building and Code_Department
Bay at Haviland Road . .
Queensbury, New York 12801
(518) 792-5832 •
TO BE COMPLETED BY BLDG. DEPT. .,.;.ti,e-.: ; N
w,' I. QUA:.:.. TD
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Application No. .'L,`,r`ry O .-1 f� ;.;; t ,
• / un U/ Queeniburti Permit Issued 19 l�' \- ,, `-' -I\
BUILDING and ZONING DEPARTMENT Permit Expires 19 d
Bay and Haviland Road, R.D. 1 Box 98 Zoning Desi nation 1 A .1.549 3
Queensbury, Ne York 12801 Variance 1J EpT.
o A Site ` �n Rev'ew No. W
O G & CODE D
,,t) /-
APPLICATION FOR 4-d ` . ,�; 67
BUILDING AND ZONING PERMIT 'oy ���
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *::*
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.
n
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The owner of this property is: .\---)ocIri -S r PG I E #ER c_hLE1
P.O. Address • `a On R sir `f i q Tel.
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Property Location: Lp /L 77 0(2.r_ ale 17 Dt~V/(z i Tax Map No. / /
Street number or building lot number ��`' 'J �?
Subdivision name (if applicable) V3
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder (21f/I,g-G171—kf2 thV Address \` j-()`�%0/ `t�.{T° t Q ,Tel. 7q 3-.5Z,(o/
Name of plumber J pey gg1/X1- • / Address � ,, e�y)0---211 rfL Tel. 79e-/ 3 %GI .
Name of mason .,1 e - MAW/ Address 3 03 4h'2. T Tel. 793 - J 6 e/
,
NATURE OF PROPOSED Il RK: * ZONING INFORMATION: •
X 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 STRUCTURES AFFECTED. .
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property /7a ft X 37() ft.
* Existing building(s) Size /- ft X / ft.
* T—
PROPOSED BUILDING AND USE:
* Existing building (s) Use
Size of new structure f ft X3(, ft *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one)
No. of stories (habitable space) 2 * Front yard -O ft Rear yard �� ft
* Side yards • 44() ft and ciR N ft
Height (grade to ridge) ,�.(`) ft. * If on corner, setback from side street ft
If residential, no. of families
No. of rooms(excluding baths) 9- * OCCUPANCY INFORMATION .
No. of bedrooms • y *
•
No. of bathrooms 2 /2 * PRIMARY BUILDING - •
*••_One family dwelling
Primary heating system 1.:1-(0=rF R * Two family dwelling
Type of fuel (� S •
.No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? Uo, * Permanent occupancy
Central Air conditioning? A) * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
•
Ranch Contemporary Log cabin * Other
Raised ranch 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/.o c. / car
* * * * * * * * * * * * * * * * * . * _Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
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BUILDING PERMIT APPLICATION CONTINUED -
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BUILDING SPECIFICATIONS: •
Type of construction, wOcd framj, fire safe,etc.
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall material n ow,,R r�P' Thickness
Depth of foundation below grade (to bottom of footing) -f
Will there be a cellar? , Heated oruilheateab Floor sq. footage Ito-0 sq ft
Will there be a basement? Will any portion be used as living space? A}-O
(If so, what portion? sq.ft. - - Type of use?
Type of roof -&-lopc flat/shed/other Material.-of roof
Size, wood studs "X 6 " spacing /l "o.c. length A ft.
Joists(floor beams) 1st. floor "X f2 • " spacing , "o.c. span 12- ft.
Joists (floor beams) 2nd. floor '2 "X / " spacing ) ( "o.c. span 7c ft.
Overlays(ceiling beams) "X E3 " spacing /4, "o.c. span /6 ft.
Roof rafters "X " spacing o.c. span ft.
Roof trusses (pre-engineered) " spacing "o.c. span ft.
Exterior wall finish 0.p..a°I Plzce Of what material? Sy>Qur.
Interior wall finish fz ta2V Loiss44
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: r8 ,tlRsepp�
Is there to be an opening between garage and dwelling? Aj e_s If so will a Fire-rated
door, enclosure, and self-closing device be •provided? v p C •
Will a flue-lined chimney be installed? /E�� Height above roof e) ft.
Depth of chimney foundation below grade (, ft.
Depth of fireplace hearth , ft. Yin. •
Water supply --�Nfunicipal or private well
SEPTIC SYSTEM Distance from ANY private well(including adjoining properties g d 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 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 donelon 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 ME THIS Signature _ // �2k �
Owner, owner's agen ,arcnl.te _ ,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
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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 376-TD
2 . Type of heat P.,t) 1%R_
3 . Is the building mechanically cooled?
4 . Percentage of area of windows and doors Oil 4
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling a d floors
exposed to ambient conditions
/
2 . Floor over heated spaces YES ONO
a. Are foundation walls insulated? qO
1 . If YES, what is the R value? �� IS
3 . Slab on grade YES
a. If YES, what is the 'R value of insulation around
perimeter of floor?
4 . Is basement heated? YES
a. R value of insulation R L3
5. Type of insulation �l13Rr�L ���
B. Under 16% Only
1. R value of roof and floors exposed to bient conditions
2 . R value of exterior walls R — ��
3 . R value of glazed area R - 3• Z,
4 . R value of doors " •
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5. R value of floors over unheated spaces 11-9oz-o 2 .
6. R value of slab edge insulation - unheated slab //) /J'e_-
7 . R value of slab insulation - heated slab YJIA
8 . R value of heated basement/cellar walls (above grade) R1-3
9 . R value of heated basement/cellar walls (below grade) 643
10. Type of insulation FT E_IL ,1-19-SS
C. Controls
1 . Thermostat maximum heat setting •8
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
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 *R
F. Service Water Heating
1 . Performance efficiency
2. Temperature control setting maximum
G. For Swimming Pool Only l
1 . Maximum heating
Telephone ,No. _ 75 3 5-2<o
(applican sslignt re)
- . - _:YOU ARE HEREBY.REQUESTED.TO • '• \ir.'
_ INSPECT AND ISSUE CERTIFICATES •
FOR THE FOLLOWING:ELECTRICAL
•• . - EQUIPMENT:TO BE'INSTALLED BY , _ •
' --THE UNDERSIGNED - ,-i 9 t•
•
Ft -, :
•
TEMI : DATE"- C — t ut •
•
CITY OR VILLAGE ,/7 j / • TOWNSHIP - - - " COUNTY
/ y
STREET AND NO.OR ROAD // /. ? .'--�y� ' :?' �%• �: �,y/) - - POLE NUMBER.
• • ,C- f> / .-1_ / / ( ° f/1(/ /7 i`�:,' / ✓ /7/.:.:
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? - . • "SECTION." BLOCK LOT
OCCUPANT'S NAME • r" i - I . t. / BUILDINC�•6CC NCY ..
7/`, /' , , - r``y- .ej,///_ . - • '
• OWNER'S NAME AND ADDRESS," - '_ ". - HOME TELEPHONE NUMBER •
CURRENT SUPPLIED BY A / /1/) .FROM THEIR. .p� /-1 OFFICE '`,,^ . : ,WORK TELEPHONE NUMBER
t
BUILDING IS - _
NEW - OLD❑ - WORK IS - NEW❑ ADDITIONAL❑ . - DEFECTS REMOVED❑
LIST BELOW ALL-EQUIPMENT WHICH YOU INSTALLED -
NUMBER OF OUTLETS "- No.of Fixtures& MOTORS. HEATERS BRANCH OFFICE USE
Loca- . Lamp Receptacles CIRCUITS ONLY
tion Side Attach't'."- H,P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant -Bracket No. Type Each N9• Each Nc. Gauge INSPECTION
OUT- '
SIDE ' . . - •._ ' - •
.SUB- -. , _
BASE - . -
BASE-
• MENT '
1st - - .•
FL. - • . ,
2nd - '" - "
.FL. _ .
3rd ' .
FL. .- ..
- REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE '
• 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 MAINS .I _FEEDERS _ ELECTRIC SIGNSILAMPS . - TOTAL WATTS
CHARACTER OF WORK ❑ EXPOSED - GAS TUBE SIGNITRANSFORMERS OF VA
•
- . ❑ CONCEALED , - •
- -
DATE WORK TO BE STARTED -•" - • _DATE COMPLETED . SIZE OF SIGN(NUMBER) . _ CAPACITY
•SERVICE ENTERS BUILDING - MANUFACTURER OF SIGN ' (
_ .. - .❑ OVERHEAD. .. ❑ UNDERGROUND ?• •'-
. DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) ' MUST ENTER APPLICANTS ":Pt'
' ,.
IDENTIFICATION NUMBER
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN ORAPPLICATION MAY BE,RE RNED`.
PRINT NAME AND ADDRESS ; i - /
•
NAME OF APPLICANT )/' //' % /,� ' DATE OF APPLICATION �/SIG1jp/�1. ,E,p/APPLICO q r
_ - • / "if -/'`r i - _ /rI/'',/ i r--A - _' _ • " .X sTirribi?.- f ff •I .fy// -
STREETADDRESS'` • /' /'/ , ``" _ TELEPH NE NO.— I j ,.. .
CITY OR POST OFFICE 7) •
Y • ZIP CODE _ LICENSE NO.WHEN APPLICABLE .._,
• ' ❑ 85 John Street 0,41 State Street " ` ❑ 584 Delaware Avenue ❑ 217 Lake Avenue'' _ 0202 Arterial Road ,-'.
NEW YORK,NY 10038 - ALBANY,'"NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
TI—I"P NEW vnRK RnARn nF FIRE UNDERWRITERS
y
INTERIM BUILDING PERMIT
FILE COPY
PERMIT APPLICANT )162
CONSTRUCTION LOCATION to T ' ? 0 m Ci P R 0 0 ft •
EFFECTIVE DATEi?
APPROVED BYjr
SPECIAL CONDITIONS : •
This will certify that all submittals for a Building
Permit have been received and fee has been paid .
During the processing of the Permit, the above named
may begin construction-, per plans submitted . It is the
responsibility of the applicant to obtain the Permit -
from the Building Department, following processing .
POST THIS INTERIM PERMIT IN A Cr ! UOUS,JPA. TION ! !
Building & ' .des Department
. TOWN OF QUEENSBURY
INFORMATION FOR BUILDING DEPARTMENT
WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE
OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION
AS COVERED IN AN APPLICATION FILED WITH OUR
DISTRICT OFFICE.
THE nn
NEW
YORK BOARD OFFIRE UNDERWRITERS
V
APPLICATION NO. C7/ Y
7l 01-ct,c-d P"-
LOC T10N
DA E INSPECTOR
FORM IBD(REV.I/86)
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST F R INSPECTION RECEIVED
NAME Z�GU1 la O
_
LOCATION O1aycA 1'r�,
DATE q 4 J 1 PERMIT # Pt (p )f
• APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DrMP-PROOFING / '
BACKFILL APP OVAL'
ROUGH PLUMBI G ' •
FRAMING • /
ELECTRICAL ROUGH-IN /
INSULATION: \ \ /
FOUNDATION /
FLOORS \
WALLS \ �/
CEILING �'`.
FINAL INSPECTION: /
CHIMNEY HEIGHT ,`''s,,
ROOFING /
SIDING / tV
EXTERNAL PORCHES/STEPS',
STAIRS-CLEA 2ANCE & RAILS 1/
PLUMBING F/ XTURES/RELIEF VALVE q/
INTERIOR/TRIM/PRIVACY DOORS 1/
FINISHED FLOORS
GARAG FIREPROOFING
DOOR CLOSER(S)
SMO E DETECTORS •
FINAI' ELECTRICAL INSPECTION L/
FINAL APPROVAL OF CONSTRUCTION ' • Z/
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: //��
it-t- , Y�DRS 6.4-f)fo4f-
�LL K6 e cHEu y- B
Ofv,,i3c_Y To & ,L,-n -t'E ,
•
,� // /� LE C•r8i c,9c_ •,L-nrs pc2�T7v2t,
�ssc�e 0-/ ��/ .
6K To Uee.,-me.,.c.
ee:2%•
4
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801 /11/77
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /. U'
NAME -- - - .l9C
LOCATION ,, r,7/ 1 / (cl((ht 4� )
DATE /�- PERMIT # (hr- (.2e
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BAC1CFILL APPROVAL
UGH /
PLUMBING ''u V
FRAMING \
ELECTRICAL ROUGH-IN
INSULATION: \\
FOUNDATION
FLOORS
WALLS ��� )0.� V �
CEILING ' ) 2 I5G�
FINAL INSPECTION: .i `
CHIMNEY HEIGHT >f`
ROOFING .4,
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE &,,RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
(1
INSPECTOR
_town of Queeniarj
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAMEk.,c\E.,aS L L�
LOCATION aciAcuu> DA `1
R .
Date \ I\-2-1 / 0° Permit No. Op - -vim
* * * * *' * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation\ /
Waterproofing /
Backfill \ /
gaming \\ /
Roofing \ /
Siding \
Masonry Veneer `\
Rough Plumbing /
Relief Valves '\,
Ext. Porches \/
Finished Floors / \
Interior Trim / \
Stairs & Railings /
Cellar Drain Tile /
Concrete Floors 1 \
Plbg. Fixtures /
Gar. Fireproofirfg
Door Closers \
Smoke Detectos \
Chimney \
INSULATION:/ \
Foundation \
Floors `
Walls \.
Ceiling
FINAL E ECTRICAL INSPECTION
DRIVEW APPROVAL
Final uilding Survey
Next scheduled inspection (call when ready)
Remarks-
. , ,.A, %,
Buil ing Instil tor
6/86 and-vl
Jown of QueepiAury
BUILDING and ZONING DEPARTMENT _
Bay and Haviland Road, R.D. 1 Box 98 . .
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 1 0,e4}`' ,- g&(SCA iE.,h
LOCATION ( ,
DATE /7 /? / G.T PERMIT NO. (0.'1% () '(/
SOIL TYPE - ni),- Loam - Clay .
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
/
TYPE of SYST :
Absorption fi ld, total length ?-D
Length of each trench
Depth of trenches • /-BZ. ' •
Size of gravel 1i 52 /
SEEPAGE PITS{Nutter of)
Size- ft. X \ ft
Gravel size _ \ / .
PIPING: \ / Size Type
Bldg. to tank 1.¢ /G/C
Tank to dist. box \ 4f a •
Dist. box to fiel /pit\ c/
Openings sealed? / ES ' NO Partial
i
LOCATION/SEPAR4TIONS:
Foundation to hank /Alt.
Foundation to///absorption ft.
Absorption ib lot line /k ft.
Separation/of pits `_\ft.
Le 4TION 91' SYSTEM ON PROPERTY`'(circle one)
ront __Rear - Left side - Right, side -
C. i ENTS I
SYSTEM USE APPROVE NO
Bu .1 g Inspec ' r
01/86 and vl
_lown of Queenit ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /fit.Qd,6
LOCAT I ONE ��L(� r'� if�. /UO>)
DATE AVi/ PERMIT NO. S-6- ,yak
SOIL TYPE - and Loam - Clay -
Percolation est Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 6.;2570
Length of each trench cpa
Depth of trenches /--4;2
Size of gravel
SEEPAGE PITS{Number of) •
Size- ft. X _ ft.
Gravel size •
PIPING: Size Type
Bldg. to tank Y
Tank to dist. box 414 11
Dist. box to field/pit f LI
Openings sealed? 4011P NO Partial
LOCATION/SEPARATIONS:
Foundation to tank /02 ft,
Foundation to absorption ola ft. ,
Absorption to lot line /Q ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle 'one)
or1t)- Rear,.•- Left side Right side -
COMMENTS:
SYSTEM USE APPROVED ES
•
B i g n ector
01/86 and vl
awn of Queeniur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCAT I ON ‘9A 77
Date( / /�� Permit No. (O lr>"(
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED YE / NO
L—Fo t ng/Pier Forms .i/
Foundation
Waterproofing
Backfill j
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)
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Building Inspect
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