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1989-363 ki F TOWN OF QUEENSBURY WARREN COUNTY, NEW YQRK Date Ma4, 7 90 This is to certify that work requested to be done as shown by Permit No.__ s:-363 _ has been completed. This structure may be occupied as a Lorarrion Owner Guyer Bui 7ders-oUeen_ Victoria ' s Grant By Order Town Hoard TOWN OF QUEENSBU1ty Director of Bldg, dt Code Enforcement m BUILDING PERMIT TOWN OF QUEENSBURY No. 89-363 WARREN COUNTY, NEW YORK " r PQ ru r PERMISSION is hereby granted to Q_lYER BIJITIIDERS�QIIIEEN VICTORIA ' S AINNAM GRANT W Cm OWNER of property located at 33 QUEEN MARY 00 DRIVE Street, Road or Ave- N in the Town of Queensbury, To Construct or place a 11 A.____SINGLE FANIII Y 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 . 0VVNER'S Address is 1 Hemphill Place Suite 201 rM Ballston Spa , N . Y . 12020 rn •c 2. CONTRACTOR or BUI LDER 'S Name N�7 ^-I Self ' 3. CONTRACTOR or HUILOER"S Address L7 Same s 4, ARCHITECT'S Name 5. ARCHITECT'S Address W +O G In m fi. TYPE of Construction — (Please indicate by X1 P1 wood Frame ( 1 Masonry ) steel v .'b 7. PLANS and Specifications "--� yC No- 42 ' x 26 ' k a single family dwelling as per plot plan , specifications rM and application , including septic and driveway. S. Proposed Use A SINGLE FAMILY DWELLING $ 12 00 PERMIT FEE PAID — THIS PERMIT EXPIRES januaryZiff (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.l rt'# Dated at the Town of Queensbury this Day a June 19�__$� f -c SIGNED BY for the Town of Queensbury Building and Zom Inspector .�N or• �`ytL1�Nsbdu' RY A1' I' I. [ cA [' TCEN tart IiLII :. . . . . . � ,) znNlNc PERMIT TOWN OF QUEENSBURY PCCjaVLod Mir��A �e+� i awed / RECEIVED Fee Iftaa[ •. MAY 2 6 1989 kWILDING AND CURES U, :rNtTrRzt�r 1?a to Iaaued 4DAY dared JdAVZ1 AM0 ROAZks .RJ) I pox 993 � BLDG.DG. & GORE DEPT.. t71J�'JVf.S'EIL1fiY, JYEy�" YORE 3 «8Od Pe.�srni.t NO . �/ `�.� ,� — TEs� 792-583; E'xC 204 . .• .■ wr w ■ ♦ r ■ w � w ■ w * ■ w r w w w � ■ w rt ■ w w ■ ■ • w w ■ ■ w ■ ■ • A PERMIT HUST UP OBTAINED BEFORE EECINMINC CONSTRUCTION . NO INSPECTIONS lw' ILL R1r MADE UNTIL AP14' L. ICANT 11AS RECEIVED A VALID BUILDINC PE MIT . All applicable spaces an tliis application ukust be coulpleted and the s + frnatsre of * the uppli ant *must ill# oar ' on rho yreverse side * Of thiS ShOct * The owner of this ProPurtY is : — C;i] YEItBUTIDERS . Inc p . O . Address I EMIPHILL PukCE-SUITE 20I BALL.STON SPA NY 12020 T c Lr [ 518) 829-21U property location 33 Q1) t $t,(;L4 '7QtVE TAX MAP NO . L21 11ws there been any splic of this property since October 1 , 1980 ? / no yes s►o 7f you , Planning Board Review is necessary . SUDDIVISION NAME . IP APPLIC'AaL.0 QUEIW VICTORIA' S GRANTLOT NO . -SG The porson rosponsitale tar :: upQrvision of work as regards Building Codes iss Richard He Guyer III 1 Hentnhi 11 Place Suite 2CJ_1 B.. 1] store �,3., NY ( 518) 899-9161 - k+lA14L P . O , ADDRESS TE i . NO . 11ww of buildorGuyer Builders , Inc Address I Hemphill Place , Ballston Spa - - Tul ( 518 ) 899-9161 Nz~ of Plumbor -same- 7,ddress - Tel samezL. t4aa►e of MWsan -same- Addtas5 -same- 'rul -same- WNTL" Or PRO,'+OSLD b,f3ltr: : MODEL : "Q" ZONING1NUORl1ATION ( 0. tica3 use oillyJ X (:onr:cruccior4 of :a s►caw buil4ir+q ZONING ❑1:SICNA'PIC7N OF PROPERTY Aci.3icion to :a bwilJing # PERMITTED PRINCIPAL PERMITTED ACCESSORY Altaar:acion to :a 6uilding ■ [a►a clwi►g� to QXCt 2rior * REVIEW REQUIRED - PLANNING BOARD ZONING U ARO Ocisar nark (o.lascribc.) ' SITE PLAN REVIEW # APPROVED DATE r c: MOSS ARL:A Or' PROPOSCOk !;TGUCTURe VARIANCE a APPROVED HATE 1st Floor 9O0 sq f t . w Remarks : 2 nd Floor s q i t . t COLAP L34T4: INI'Oa:rwr►'i'tGtti lcyQU l ULiS ul^. k.r Al . L $ee 100 ' # Other Floors -- a ft . ' Siva of lxrol�erty pnic x . { not collar ar bws .aznunc3 ' 1 ucia:ti►u� lYuilJicw] is: 1 sir.: a 120 ft rc . n lat l rc r:_� r TOT4KL FLOOR AREA� 900 sq ft . " iug la4il.rincJt+� f Lis.: n a «jx" tAe aQw a:tructurs 42 it ]i 26 ft ` Yyaa.dreiort-Iaicir ` la er�►wl/laarci.al/ ruil ' l'rols+a:;,�d ,auiluing , di::cancu craw L+r�3pasrty line (circle one ) , Front yµrd 30+ rt Roar yard 30+ ft *Me Of CctQriea (IL"141"blu 141acc) 1 ,r Sidi: y:ar4:: 15+ m1mtt :an+.l 15+ Ct 14uigtic turada to rjagel 19 . 5 fr . r If on earner, .:aWa.:k .from sides ::cruwc30+ if ro"Wufttial, no. of t:wuilieu rT 2 "It of room" toxcluding b achal P'^'� i QCCUf'ANt:Y INPOf:AWTLkSV Uo. of 1x►droossw I pLLT14A1tY [aUILDINC an No* at b;acltroowa: 1 Ono fasu.ily dwelling tortw4ry hu4CIAtij a:yuL%;&►► gg 94rri F1t=Ir tyic ; ]c Two tally dwullin.J Tye �f fu.:y ericity +` Multiple lwaslling / 'Number of units�� ,,� 1kta. o[ fire Slaccz� tea la:.L lstett:allw4a "� . r•orsa:srtranz oceup:aiccy Will ;a w►]o.1 �toVe k+u iiistallecl'„ No Trun:;i4;i4c uccuiL;ahry cautrux Air cou+litiunis►ca:' No - - t Uouinuua 0uILD1t4C STYLE, PRIMARY STRUCTLAZE f 1►utu crial 1"uch cant►:url:c.r.+ry/ L.c+n cabin Crclwr ii.aia�wd rancli M;ariaiuu Du .l. x . le .►ddiciona wlcwt will uuu be? dot" hovel Old scylo taus►yrLow OWN Cayes Cad CoLu"94 Oslws ' ACCLSSORY UU1101"G-` Caloni:►1 itow Towel house • "-tachaa q:ar"go/ono cur/ two c" C/ ewr [ czar/ two car/ c:a CIriCLL' Cir1l: PLEASE 1 IVActaahuu g"r;agu/osti+a • • w w w w w ■ _ ■ ♦ • w • w ■ • s * I+rivute stara93 building ' 9a 114AT 0 MIARKCOIs VALUE or • Or.hsr COM «'1` 1ttlC'Y' I4N ryryyy'�� • . � �1Farwxs`ar�1r av aulteninc sr+r.Cllarc^TTONS , ON REVRRSK SIDE OP TI1IS ;1i1:i~"r, I BC Ck L1;'r9DI F+Prm DPA 10/88 V.1 ♦.F BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . Rood frame Will ar+y second-hand or ungraded lumber be used? If so , for what ? no Foundation wall material concrete block Thickness $to Depth of foundation below grade ( to bottom of footing ) 48" irri..nimwn Will there be a cellar ? no Heated or unheated? Floor sq. footage sq ft Will there be a basement? no Will any portion be used as living space? ( If so , what portion? sq . ft . - - Type of use? Type of roof - s o a flat/shed/other Material of roof fiberglass shIngles Size , woad studs_"lC�_" spacing 2 '"o . c . length $ ft . Joists ( floor beams ) 1st , floor n/a "x " spacing "o . c . span ft , Joists ( floor beams ) 2nd . floor n/a "'x spacing "'o . c . span ft * Overlays ( ceiling beams ) . n/a "x '" spacing boo , c , span fc . Roof rafters set " x plan $$ spacing 24 " o . c , span ft . Roof trusses (pre- engineered) spacing 24 "o . cm spanvax-y ft , ( see plan) Exterior wall finish stained. Of what material ? 5 /8"x 4 ' x 8 ' TEXTURE 1-11 Interior wall finish painted 1 /2" sheetrock If a garage is to be attached , describe materials to be used for FIRL: SEPARATION : n/a _ Is there to be an opening between garage and dwelling ? n/a If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue- lined chimney be installed? no Height above roof ft . Depth of chimney foundation below grade ft , Depth of fireplace hearth ft . in . Water suppLy - Mwiicip l or private well Munici 1 SEPTIC sY5'1IM _ Distance from ANY private well ( includifig adjoining properties n/a ft . (A separate application is ncccassary for any repair or new installation of septic system) D E C L A R A T 1 0 N 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. 40 Signature .,fir Owl or, owner's agent , a itect , contractor SPECIAL CONDITIONS OF THE PERMIT : 4 ay___-______-s_-- ....... TOWN OF QUEENSOURY WARREN COUNTY + NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORX STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the followings i . Grows floor area See Ej= 2 . Type of heat Baseboard electric 3 . Is the building mechanically cooled ? No 4e Percentage of area of windows and doors See Part 6 A . Over 16 . Only MWOR 1 . Uo value of gross area of walls , roof/ calling and floors exposed to ambient conditions See Part 6 2 . Floor over heated spaces YES a . Are foundation walls insulated ? YE NO 1 . If YES , what is the R value ? See Part 6 3 . Slab on grade YES NO a . If YES ,- what s the R value of insu n around perimeter of floor ? See Plan 4 . Is basement heated ? YES NO a . R value of insulation.nia 5 . Type of insulation Pol St ene Be Under 16s Only 1. R value of roof and floors exposed ambient conditions. R-38 2 . R value of exterior walls R-2 3e R value of glazed area 4 . R value of doors R-14 . 9 4 5 . R value of floors over unheated spaces R=14, _ 6 . R value of slab edge insulation .wo unheated slab N/A 7 . R value of slab insulation - heated slab 1265 8 . R value of heated basement/collar walls ( above grade ) N/A 9 . R value of heated basement/cellar walls ( below grade ) N/A law Type of insulation Fiberglass C . Controls is Thermostat maximum heat setting N/A DO Duct Systems N/A 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 N/A 1 . Size of hot water or cooling carrying agent pipe 2 . 'R value of pipe insulation F . service Water Heating 1 . Performance efficiency. N/A 2e Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating NIA Telephone No . ( 518) $99-9161 k ( applican ' signature ) APPLICATION FOR SEPTIC DISPOSAL PERMIT S Ref: S . P . E. D. S . DATE ! permit # New York - 0202525 ' MODEL dP B? of �* [Q LOCATION OF PROPERTY FOR INSTALLATION Drive Owner's Names Guyer Builders , Inc . Telephonet ( 518) 899-9161 Address: 119 Dunning Street , Ballston Spa , New York 12020 Installees.Name: Guyer Bu lders , Inc Telephones 518) 899-9161 2 A, C , E, is ,I , K, L, M. Number of bedrooms (residential only) dp 3 F , G , H Total daily flow (compute (W 150 gal per bedroom) Thy: circle ones Fiat Rolling Steep Slope Xi of slope Soil Nature: circle one: Sand Loam Clay Other / ,Depth: . 8 " feet + GurouvA Waters At what depth? unknown $ feet + Bedrock or Impervious Material: At what depth? unknown feet Percolation, test" circle one: not require required / rate nt3in. inch. Domestic water supply: circle one« Municipa�Well Other IF domestic water supply is a Wells Separations Watersupply from Septic absorption N/A feet * PROPOSED SYSTEM" Septic Tank gal. (minimum size: 10000 ,gal.) TILE FIELD: Each 'Drench N/A feet I Total system length N/A feet * SEEPAGE PIT(S): Number of I Size each feet by feet' * Size of stone to be used # I Depth or Thickness feet # * * +1 * * * * a► sssss ss * +ss � � * ii * # si +1� a , * +t +� * * * s * * * �i IMPORTANT * See S . P .E.D. S . ...Please...LIST NEW EQUIPMENT TO BE INSTALLED permit & attached y► es * * * s * s * * * rs * as * * * "rsss * ass * s * ar * aye * s * * * * * * map . w (over) Section 11 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 Z4 hours b 6wo to" of construction and shall include a plot plan showing: q 1.) the propooecl ,location of the j4ystem 2.) location and distance to lot lines 3.) location and distance to structures 4.) location and distance to any 'W Ater supply 5.) size and dimensions of all tanks, distribution boxes, the fields and/or drywells Be 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 ir*aller and a fine of up to $250.000 C, An approved of the plot plan shall be available on the construction site. Failure �oduce said plot plan at time of inspection may result in an immediate work stoppage. Do Should unforeseen problems during, construction prevent proper installationo alteration or repair of an approved system, a new proposal must:be submitted to the Queensbury Building Department before further construction. I have read the regulations above and agree to abide by the and all requirement= of the Town of Queensbury Sanitary Sewagq Udsposal O ,.dina nee, Signature of.responsible person: Date. u Town of Queensbury Building and Code Department Hay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 . . . HUM OF NATURAL BEAUTY . . . A GOOD, PL ACE T[ .�.#.�1►� ��►� CERTIFICATE OF INSURANCE ISSUE GATE (MM;pO+vul 1C)/3/88 . PRODUCER HeIqu,gmbQtu,^p' A$'6I1C37', .T31Cr THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS 121 MTB�.�. w�str NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW F 0 Box 953 Schenectady, NY 12301^0953 COMPANIES AFFORDING COVERAGE 37'2-5641 LETTER COMPANY A The Automobile Insurance COr of Hartford, CT CODE 3340 SUB-CODE COMPANY S The Aetna Casualty '.: Surety Co. INSURED y�y- p,�y Tom,�, LETTER Guyer BLti.lderS , Im ■ L OM EARNY 119 Dun=tng StreetCOMP L Ballston Spy N 12020 LETTER NY D LETTE 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 REOU I R EMENT, TERM OR CONDITION OF ANY CONTRACT O'a 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 11 EXCLUSIONS AND CONDITIONS OF SUCH POLICIES- LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- CO NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS TYPE OF INSURANCE POLICY LTR Renewal iMM)DD+YY) DATE IMMIDDIYY) GENERAL LIABILITY Renewal of /�7 c� GENERAL AGGREGATE S 24 000, _ A X COMMERCIAL GENERAL LIABILITY COIJ6924 10/1Ab 10/1/89 PRODUCTS-COMP;OPS AGGREGATE S 2, QW'v CLAIMS MADE X OCCUR. PERSONAL & ADVERTISING INJURY $ 1, ' OWNER'S & CONTRACTOR'S PROT, EACH OCCURRENCE $ 1, owj I FIRE DAMAGE (Any one Iirel S 1, 'pw p MEDICAL EXPENSE (Any one personl $ 5jp I A AUTOMOBILE LIABILITY Renewal o COMBINED A $ ANY AUTO FJ390995 10�/1/g$ ICJ : �QO SINGLE S 10400wo I ALL OWNED AUTOS I ++! V7 BODILY INJURY $ SCHEDULED AUTOS tPer person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per acmdent) GARAGE LIABILITY PROPERTY $ �7 DAMAGE EXCESS LIABILITY Renewal of EACH AGGREGATE 11B x 1 MBRET,ra XS475556 l0/1/8s l0/1/89 °G?,'000, $ 5, 000, i OTHER THAN UMBRELLA FORM Renewal of STATUTORY 14 WORKER'S COMPENSATION KC66379 10 /lAp 1011189 $ IOU,* (EACH ACCIDENT) AND / [•7 -�-/' SJ 4A/ EMPLOYERS' LIABILITY 5 5�, {DISEASE—POLICY LIMIT) S 100, {DISEASE-EACH EMPLOYEE OTHER DESCRIPTION OF OPE RATION WILDCAT ION SP1rEH ICLE SIRE STRICTI©NSISPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION Building Pic Zoning Dept• SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE '],own of Ghueensbury EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Buy & KaYiland Road MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE RD #1, Byg 98 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Queembury, NY 12801 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUT}IOflIZED REPRESENTATIVE ACORa xS-s (31") Tlo+l saeti (70 MIDDLE DEPARTMEK ON AGENCY, INC. 0 -1 _ J gno ° E � INSPecy-f� Datu May 20, 1990 uipment listed ash been Esc i approved as being in accord that S. with the National Elect et, plicable governmental. utility an Owner: Guyer BuLlde 1 ra.,I P 1 SLn le Pami r•d � 1 rfC 3pmerH end Ihsteltation inspected this OcC�i.lpan#: i�,.y ' na eert�litafa t be introduCW m a}terntkcns MOOD to Queen man ,g _ dste- It additional be n&iu and void, end ePPtication for Location: exlal{ng system khi IC 1 to this ApencY. �� speetion mince Dub i III Y InsuxanCe carrier �C tac le$ cider ae mis or ricers Pit same to his property Equip/rent: � '� Outlets let6 agent at cam Y)as"I artiflCatlon al elecvfcal equipxrsent epp+awed 150 Amp SerVi ApP antes ; as specified. FGuyer Builders ' `-- "ICE o1963 01 16=032481 Appifcant: 119 Dunning, 5tre 120 Ballston Spati CC &upFPARTMENT HUSLDING AND D ROADS 2$ 6 �'Y & H URY N yORK 1 NEW QUEErrsB ( 5,S ) '79x�5� sx pR TE ,SPHONB W.jII3G TIySPEOit` S INSPECTION �, ��c�xv��.�.----__`�-- �� FtE�DES � LOCATION PERMIT APPROVED DATE YES Nd FOOTING/P s MONOLITHIC PO NG UP�r'�OOFIN~ FOIJ N DA r:ro N/DAM BAC ILL APPROVAI ROUGH PLUMBING FRI+1`2ING CAL ROUGH�IN f ELECTRI ON - � .�--- --� INS UjjDA TSON FOUNDA Fj,00RS LS CEILING INPECx ION • ��-- FINAL CHIMNEY HESGHT ROOFING S SIDING PORCHES/ST ILS_ EXTERNAL ARpNCE & EF V VE��-- �._-- S,LASRS-CLIXTURES/ ELI R5 TRSM/ pRS C1' DOO PLUMBING INTERIOR FINxGHE ROOF G GE GtjAf7D� CLpSER [s3 SsmolcE Dve ETEC CAL N4,3 STR C ON FINAL ELECT VAL O CONSTRUCTx FINAL APPRO OCCUPAiTC MUST BE CERTIF CATE dF ING DHPART ENT BEFORE A SXGNE D FROI= TffB suT ' ED I. dBTAXN PREMISES ARE OCCDPI THESE ^yj� RK51`i4oj�. R Gis" tf C �iBLP l'FOVYiC1IL`TG REMA *STciE ��I"R. �� ER���Cy15 �T'E��41 1C'�`�' . �Cfi.FC�1,01g'rjs� PLAOEM C� r��'TE�_ t4O E"C7LLkAq S �OgE YES 'T��x VOTL j UEPAFT� 1 _.�mnR Ta��N a QEEENSBUR'y SUILDxNG AND CODES DEPARTMENT UAY g HAVILAND ROADS 12$C} QUEENSBL7RY . NEW YORK TELEPHONE ( 518 ) 792_ 5$32 Bui�x 1KSPEcY s aR � I '�,N EcsxvED� REQUEST R INSPECTi NAME LCcATION PERMIT APPROVED DATE i YES NU 3 FOOTINGIPIERS POUR FORMS`' MONOLITHICp-PROOFIN� FOUNDATIO PR ROUGH OVAL�_-- �---.� BACKS IPLV14BING FRAMING ROUGH-IN ELECTRICAL t, AN5ULATION : "•,. FOUNDATION FLOORS _ . :. WALLS } CEILING TxaN = FINAL INSPEC CHIMNEY HEIGHT ROOFING SIDING PORCHES/STEPS' STAIR5-' TURES/ EXTERNAL ERNA L & I CLEARANCE RELI' F V LVE FIX PLUMBING PRIVACY voo INTERIOR TRIM/ I FINISHED FLAORSFING� � -�-- GARAGE FIREPROO �---- DOOR CLOSER (S ) _-- SMDKE DE2SCTORS INSPE TxON FINAL. EL,ECTRICA OF CONS RUCTION FINAL APPRflVAI. ' s MUST BE F OCCUPANC ENT BEFORE CERTI THE BUx ING DEPAR' A SIGNED FRDM UPIEDI OBTAINED T1iESE PRENISEa ARE OC r REMARKS : 3 INSPECTOR IONgN OF QUEENSBURY TpiENT BUILDING AND CODES DEPAR BAY & HAVILAND ROADS 128D QUEENSBURY . NE yORK TELEPHONE ( 518 ) 792�5832 BUILDING INSPEG'IORT S f3 1 REQUEST $ R XSSPECT20N RECEIVED NAME CATION PERMIT # ci r APPROVED DATE YES NO l FOOT.INGIPIERS E MONOLITHIC POUR FORM ; P-PROO TNG_ �..�. _-- FOUNDATION/+DAM BACKFILL APPROVAL i ROUGH PLUMBING .AMING ELECTRICA ROUGH�IN L IN5 U LA TI ON FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING p(7RCHESIST S EXTERNAL ILS .STAIRS.CLEARANCE IEF VALVE PLUMBING FIXTU pRIVA Y DoOR*9 — INTEXIOR TRIMI �. FINISHED FLOORS GARAGE FIREPROOIIN DOOR CLOSER (S) SMOKE DETECTORS TN pECTION FINAL ELECTRICAL NSTRUCTION FINAL APPROVAL OF E OF i, G , 1PFAI T14 T BEFORE A SIGNED CER'TIF2C BUILDIC' DEPAR OBTAINED FROM THE pCCUP ED ! TFIESE PREMISES AR REMARKS = ' SPECTOR mINSBURY TOWN OF QUEE BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS I28Q QUEENSBURY NEW YORK TELEPHONE ( 518 ) 792- 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR IN PECTION RECEIVED _-- NAME 'e"1' LOCATION PERMIT DATE rQ #' APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DI�MP�PROOFING OUGH PLUMBING , APP VA L ar . DUGH PLUMBING . FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT;_ ROOFING SIDING STEPS EXTERNAL PO HESJ �-�-^ STAIRS-CLE NICE & RAILS PLUMBING F XTURES/RELIEF VALVE INTERIOR RIM/PRIVACY DOORS FINISHEDfFLOORS GARAGE F'XREPROOFING DOOR CLOSER (S) SMOKE DkTECTORS FINAL EL14CTRXCAL INSPECTION FINAL APbROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE ,BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ? REMARKS: / c! / INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT ,BAY & HAVILANI:) ROADS I28011 QUE,ENSBURY. NEW RK TELEPHONE (5I8 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR rINSPECTION RECEIVED NAME LOCATION PERMIT # DATE APPROVED YES NO popTXNGIPXERS ONOLITHIC POUR FORMSf�_ FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL d ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING IiJSPECTSONs FINAL CHIMNEY HEIGHT ROOFING ti SIDING EXTERNAL PORCHES/STEPS STAIRS—CLEARANCE & RAT -�-- PLUMB=NG FIXTURES/RELIL�' JVALVE INTERIOR TRIM/PRIVACY +xS�----- � - FINISHED FLOORS GARAGE FIREPROOFING let DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INON CTIONION_�___ FINAL APPROVAL OF� A SIGNEDING DEPARTM CENT T BE BUILDI BEFORE OBTAINED FROM THE TffESK PREMISES ARE OCCUPIED' REMARKS : INSPECTOR aura o/ Queem4 "ry BUILDING and ZONING DEPARTMENT Say and Haviland Road, R.D. 1 Sox 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LI, LOCAT I ON I rC� DATE `� PERMIT NO . SOIL TYPE - Sand - LoTnClay ays- - NO Percolation Test Required?Inch Percolation rate - Min/ w TYPE Of SYSTEM: Absorption field , total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS4Number o } Size- ft- X - f Gravel Size PIPING : Bldg . to tank Tank to dirt . box ��...... Dist. box to field/pig openings sealed? YES NO Partial LOCATION/sE, pARATIONS : ft. Foundation to tank 9* ft . Foundation to absOrP.4:L � . ft. Absorption to lot line fty Separation Of pits � LOCATION OF SYSTEM £ . PFtOPERT�' (circle One} Front - Rear - Left side - Riot side - COp4MENTS r M1 f SYSTEM USE APPROVED YES f Su Id :Ln Inspector 01/66 and v1 TOWN OF QUEENSBURY 13UILDING AND CODES DEPARTMENT .yam BAY & HAVILAND ROADS S QUEENSBURY, NEW YORK I28D4- 4 TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED I � - NAMEwor LOCATION DATE - f PERMIT 4 APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR F RMS FOUNDATION/DAMP- PING BACKFILL APPROVAL } ROUGH PLUMBING FRAMING ELECTRICAL ROUGH--IN 61--NSULATION0 {FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : j CHIMNEY HEIGHT f ROOFING ` SIDING EXTERNAL PORCHES/STE STAIRS-CLEARANCE & ILS PLUMBING FIXTURESIRE IEF VALVE INTERIOR TRIMIPRIVA Y DOORS FINISHED FLOORS GARAGE FIREPROOFING _ DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL INS ECTION FINAL APPROVAL OF CO STRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BU LDING DEPARTMENT BEFORE THESE PREMISES ARE O CUPIEDS REMARKS. I SPECTOR TOWN OF QUEENSBURX BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION R7ECESVED NAME LOCATION _ ? _e • Ao -- DATE (p - /� PERMIT ## APPROVED YES NO TING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING f EXTERNAL PORCHES/ST S STAIRS-CLEARANCE & ILS PLUMBING FIXTURESf ELIEF VALVE INTERIOR TRIMfPRIyACY DOORS FINISHED FLOORS GARAGE FIREPROOF NG - DOOR CLOSER (S) SMOKE DETECTOR -- FINAL ELECTRXCALI .INSPECTION FINAL APPROVAL O? CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR ' M100LE QEPARTMENT INSPUTIOWAGENCY, INC. \_ National. 1-iead4"rs 90O Haddohi gtia ' Collingswood, N.J. 08108 7Mtion:/Add #?ate� tIll�av _.. .- --... ..._ County zs<� State mress 33 Quilimp Hary Drive (if Located in Rural Area - Please Attach Directions) Pole # Owner f s Permit # -: Occupied A l Irs� f r rat= Building: New ]. Old 0 Occupant I Work Area in Building Floor #, etc.) . App, for: Wirin rvice 03 Rea for Inspection: Fee Remitted - $ Cash Check F1 M.O: Q Make Payable To: M.D.LA. SPO 7SP 1PP0 125P 150P 1�SP PPOP 2250 25aU 275a 3aOl# Number of Rough Wiring Outlets Elect. Heat Switches Amp, Service Surface Unit Dishwasher flange Lighting 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 FI.P. 1/2 1/12 1/10 1/e 3/6 1/4 1/3 1/2 3/4 1 1% 2 3 5 73fs 10 15120 25 30 40 50 75 IM Mark Number of Each Size Appl icant's ' Signature License # Perrrlit •# T/A fi ,� 9s IIT.. Utility. " F" Applicant's Addresc:; � � � NAM OFFIc L 1 (City) -111bal I.Aptyies ,Arimi, (State) wr (Zip) ] Service Request # Phone # 89924aft Electrician: DATE RECEIVED: % „/ • DATE INSPECTED: 7FIed ct Location : Same as Above El or: Notice Label Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater I Dishwasher Fixtures Air Conditioner If Dryer Amp. Service Equipment Burner, Wiring & Controls for Axnp. Receptacle : Amp. Service Conductors Pump Vent Fans MOTORS K,P, 1/20 1/12 1/10 1/8 1/6 1/4 1/3 3/2 3/A 1 15s 2 3 5 F% 10 1 15 1 2e 1, 25 0 1 40 1 50 1 75 1100 Mark Number of Each Size Elect. Meat "Cl �w loco lzso laoo 173P L^aPP zzso 2soo 275P 9ooP mom RW Progress: Inc. � LKD 0 Contractor Q CFT Violation : Work Comp. E] Inc. 0 � 1 0 L/A Owner CASH E L/A � CH Kr # [] IPA Municipal #pal r INV # Date : Other Side © Utility 3 Appl icallt . Owner' LJ Cut in Card 0 Temp # r^ Date [� .Final # >✓� , r Date — � INSPECTORS SIB TUBE APPLI cA-rioN Fro RM NO, 250 EL II/86 QUIT VICTORIA'S GRANT QUEEN MARY DRIVE REFERENCE DRAWINGS: 5 SITE UTILITIES SEPTIC & WATER VQnDUSEN & STEVES SURVEY PLAN Q—MODEL ROOF PLAN WILL VARY ACCORDING TO SALE, DRAWING SHOWS ONE STYLE ONLY 2000 gal MODEL : 25,27,29,31,33,35 QUEEN MARY DRIVE PLOT PLAN do SEPTIC SYSTEM GVYER BUII=, Inc. drawn: KW 5/24/89 1 Scale: 1" = 20'-0