1989-362 CERPnFICATE : %C)IF OCCUPANCY
TOWN OF QUEEMSBURY
WARREN COUNTY, NEW YORK
Upate December 12 -198g
tq r,2 r49
This is to certify that work requested to be done as shown by Permit No. 89-3682.
has been completed.
This structure may be occupied as a A Sia*U
Location ----- 31 asseen l4ary Drive---
Id Qjxer bllj1xjer.S.-.
Queen victarla ' s raraol
By Order Town Board
TOWN OF QUEENSOURY
Director of Bldg. be Code Enforcement
------ -- --
BUILDING PERMIT �
TOWN OF QUEENSBURY No
WARREN COUNTY, NEW YORK
N3
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PERMISSION is hereby granted to GUYER BUILDERS-QUEEN VICTORIA ' S GRANT w
V
OWNER of property located at 31 QUEEN MARY DRIVE Street, Road or Ave. r-•
in the Town of Queensbury, To Construct or place a ih A SINGLE FAMILY
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
1 Hemphill Place Suite 201
Ballston Spa , N . Y . 12020
.o
c
2. CONTRACTOR or BUILDER'S dame Pn
m
ME
Self
3. CONTRACTOR or BUILDER'S Address
A
Same
4. ARCHITECT'S Name
5. ARCHITECT'S Address Omni
�
6. TYPE of Construction — (Please indicate by X)
XXX Wood Frame S ) Masonry I ) Steel C 1 w
r+
7. PLANS and Specifications C=
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M
No. 42 ' x 26 ' 'k a single family dwelling as per plot plan , specifications ,
and application , including septic and driveway.
B. Proposed Use
r
0
A SINGLE FAMILY DWELLING
rr
m
$ G 00 PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 79 90 3r
(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.) V
Dated at the Town of Queensbury this Day of _ June 19 89
r
1'r
T
SIGNED BY for the Town of Queensbury
Building and Zoning I rfteivtor r-
-e
17)WPJ OF QUEEN&-.r URY APPI, TCA TON FOR BUI ., . . . . . . . :41) ZONI O PER1611T r
F.cc.i eue�t TO�iIVN jq OF QUEENSBURY
Reviewed RECEIVED
PSI zo MAY 2 6 1989
Fee. Fcu:d
IIUILDINC AND CA ul :rA11DT;b:r Date. 144"ed BLDGm 8► CODE DEPT.
I11L V aind 0AVJ'A"D ROAYIS RD I Dox 93
()UXZMS49 MVdo ML171 Y04RK .2 2B O 4 Pe4M*4 t NO . 8%'7
Tel (518) 792-5832 exc •204
" .* * w w w w r w i w * • r r * ■ w t w w r r ■ r ■ ■ ♦ w w r w r w w r ! ■
A 11TIV-1IT MUST 164 OBTAINCI3 BLFORE LEGINMING CONSTItUCTION . NO INSPeCTIONS
IKI LL BE HADE UN'CI L API' LICAPIT LLAS RC - IVED A VALID BL' I LDINC PCRbtIT .
All applicahle spacias on this ap.nlication must be completed and the
� � �+ Daturc of the u �+I� licant I�eust appear on the reverse side of this sheet .
* Mc m # R st i a ra -4 W 4 sfa Is a A a * * '*
T L1 a owner of this property is ; TYE:R W TTT TjF'li. F Inc =
P . D . Address 1 H..MHILL PLPC:E—SUITE 201 , BALISTON_SPA, NY 12020 TE L { 518 ) 8`3_9-91.61, 3 �
Iroperty location 31 Q%3r%x%1 told. " DVZIV ... TAX MAP NO . „ %"XI_/
Ilex & there been any split ce this property since October 1 , 19883 / no
if yes , planning Board Review is necessary . yas r►o
SUBDIVISION NAME . 1P APPLICAnLE QUEEN
_ VICTORIA► S GRANT LOT NO
The parson responsitale for :; upQrvision of work as regards nutlding Codes is :
Richard H. r III 1 H hill Place-"tg 20 NY 518 899-9161
NAIKE: F . O . ADDRESS TEL . NO .
14"w of builderGuyer BtL lders :IncAddress 1 Hemphill Place . Ballston Sva Tc:1� 518 ) 899-9161
tu&ma of PlurWD�Qr —Same-- T.ddress —Qy£ ILe— Trsl -car -
Ma oea of rkason -same- Addro45 -same- `Pest -same-
Li,tiTu" or Paopoe.cu L+J i.m * MODEL' "'Q_� ZONING 1 Ni;Ui0LA,1610N ( Ui r i ce us " on.l q )
,X C.ona:cruccicu, of a Itaw building . "� ZONING DESICNATION OF PROPERTY
Adaitian co 4 lauil.lijkq PERMITTED PRINCIPAL PERMITTED ACCESSORY
Al cur"L ion to " l+u i ld inq '
Cabo Cla:aavjw to axt .: rioc oia►cnuiean:: I r REVIEW REQUIRED - PLANNING BOARD ZONING HOARD
OGI►esr work LJarocriLaa:I SITE PLAN REVIEW # APPROVED DATE
IL: k" S AREA OV PRQPOSCD. «: T14UCTUit1: " VARIANCE I APPROVED DATE
let floor 900 sq ft . Remarks
2nd Floor —~ sq f t . t CO&406 .ET" It 'flulILLD UL:LAAI *
sees
Other Floors: -- sq it . r ;i:�u Qe 13toir,:rey 1001t lot lnft x 120 fc .
Lnot cellar or bdb .rruarntl L:xi::tiaay LiuiiJiaa+3L ::I Siru n a re: x nt' t .
TOTAL FLOOR AREA 900 sq f t . ■ L:xl.ti,►g Ja"11Jiny { :: I Ux�.: n a
:Lza of new uLructuru 42 f t a 26 ft `
Ywrv.daciara-pier •�la cr.► ra] JLaarci.al/ roll * Prolxa :4d builaing , di:atanca from vroiurty Al au
(circle onQ ) Front yard 30+ !' t Raar yard 30+ ft
Maa . of :iu3riexu (tw►lult:.bles ;:l3wcc ) 1 „ Sids yaar4u 15+ et :and 15+ I t
1&%mJw9 L tUVadQ to ridg.$) 19 . 5 ft * if on corn.sr, uut"ok frosa uldw ::crwuc 30+ f [
It re:s:irlwntial , no. of cra►uili+au - 2
No* of bcathu 1 "'g, } OCCUPANCY 1 NFORmAT ION
iio. of %marr:► mu 1 40, PRIMARY LUILDINC 'w
LM 0 of b:atlaroora:s 1 � One f" ily dwelling
vrilacary Luzacing sys:w:.w -�L'T+:Iprr,�,c rk X trwo L::wily 4wullinLi
Tylw of f "I edif"ty - multipi3 awaslling / Number of unitaq
Now of firQLalacus to ua imm"lud ( Lscraw:ana►►c oce:ul+:aracy
will :a Wu�a uLo " t..: in:: ta114a? No
f.Atrwl Air cauulitieyniray': No u0siniu:r►e rsucuYswncy
� Ll►.fsinuais
OUILOING STYLC, PRIMARY STRUCTU E ; Tnalustrial
uuscla C:eant.w+l:�r.,ry Lx.�a c:a#ain ,• Other
K;aisuad ranch M ►rldie+ee Dea ,L.:x If ,additioa�, sleet will uas t,as7
UP&ALG l.sW41 Old ucyl.: Lauaey.alaw
4::&Put Cad COGZ"gw Otle.:r • ACCESSORY uuxloozwcC
Calani:al Icow 'Cows► ttouSe ' L:scachda q"C"gCa/ona clan/ two car/ a«►r
{ CIRC" OHL* PLEASE 1 * Acc achija g;ar.ages/01laT c4r/ two cat/ cos•
w ■ w w w ■ a w . w r r w r ■ w 't Iariv" ts sLac"go builaing
Wrd4rTMA'rVD 14XF4KI"a' VALUI: OV r Othaar
caaw :: rlaucrsoa .
THPOAP44TTON CH L'IUILDINC SPrCTF TCATTONS, ON REVERSE. SIDr OP TLISS 6 tI"EIi'I', 'I'O AE COMPLwE ED$
Floras DPA 10/80 Vl
....
,
$UILDIN G PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe etc . wood. fr
Will any second-hand or ungraded lumber be used.? If so , for what? nO
Foundation wall material concrete block Thickness 8to
Depth of foundation below grade ( to bottom of footing ) 48" minimum
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? 0000000 sq . ft - - - Type of use?
Type of roof - s o e flat/shed/other Material of roof fiberglass sh! 5zles
Size , wood studs_" X.�" spacing 2 "o . c . length 8ftv
Joists ( floor beams ) lst . floor n/a "X spacing "o _ c , span ft .
Jolsts ( floor beams ) 2nd . floor n/a " X '" spacing "o , c . span ft .
Overlays (calling beams ) nfa "X spacing O . C . span.ft .
Roof rafters see "X�]Lan " spacing 24" o . c . span ft -
Roof trusses (pre- engineered) spacing 24 "o . c . span Vary ft . ( see plan)
Exterior wall finish stained Of what material? 5 /8"x 41x 8 ' TEXTURE 1-11
Interior wall finish _ painted 1 /2" sheetrock
If a garage is to be attached , describe materials to be used for FIRE SEPARATION : n1a
Is there to be an opening between garage and dwelling? ri 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 to
Depth of fireplace hearth f:t , in .
Water supp Ly - Municipal or private well Munici al
SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining propertius n a ft .
(A separate application is necessary for any rep" ir or new installation of septic system)
DEC LA RATION
To the best of my knowledge and belief the statements contained in this
application, together ► ith 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, TILE 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.
do
Signature
�t
Ow er, owner's agent, a itect, contractor
• t w y r w • • • w Yr yr a ik MI 1r R 1e Je ! M1 A s t • x x . w ■ * `t x • R ■ Ie , Y" + n R x � t :
SPECIAL CONDITIONS OF THE PERMIT :
ay____ ......__........_-_-__ _, ____
TOWN OF QUEENSSURY
WARREN COUNTY , NEW YORK
Application fors BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
AVOWER ALL of the following :
1 , Caroms floor area_ See Plan
nn i � ran
20 Type of heat Baseboard electric
3 . Is the building mechanically cooled ? No
4 . Percentage of area of windows and doors See Part 6
A . Over 16s Onl
1 . Uo value of grows area of walls , roof/ ceiling and floors
exposed to ambient conditions See Part 6
2o rloor 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 insul n around
perimeter of floor ? See Plan
4 . Is basement heated ? YES NO
a . R value of insulation n a
5 . Type of insulation Polystyrene
Be Under 16 . Only
1 . R value of roof and floors expose to ambient conditions
R-38
2 . R value of exterior walls
3 . R value of glazed area
4 . R value of doors R-14 . 9
L
5 . R value of floors over unheated spaces R=414
6 . R value of slab edge insulation an unheated slab NIA
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 ) NIA
10 . Type of insulation Fiberglass
Ce Controls
1 . Thermostat maximum heat setting N/A
D . Duct Systems tems NIA
le Iw duct system installed in unheated spaces ? YES NO
a . If YES , R value of duct Installation
b . I. R value of duct in other areas
E . Piping Insulation N/A
1 . Size of hot water or cooling carrying agent pipe
2 . It value of pipe insulations
P . Service Water Heating
1 . Performance efficiency N/A
2 . Temperature control setting maximum `•'
G . For Swimming Pool Only
1 . Maximum heating
NIA
a Z
Telephone No . ( 5i$) $99-9161 f�
( Applicant" signature )
APPLICATION FOR SEPTIC DISPOSAL PERMIT
Ref : S. P.E. D. S .
DATE /
New York - 0202525 '
MODEL ! tz of Ity
LOCATION OF PROPERTY FOR INSTALLATION _ 31 Queen Mary Drive
Owner's Names Guyer Builders , Inc . ' ..• Telephoner 518) 899-9161
Address: 119 Dunning Street , Ballston Spa , New York 12020
lnstaller'a'Name* Guyer Builders , Inc Telephone: ( 518) 899-9161
2 A, C , E, I , J , K, L, M
Number of bedroom& (residential only) a 1 3 F , G, H
• Total daily flow (compute (9? 150 gal per bedroom) dW 150
TopoWraphy: circle one: let Rolling Steep Slope % of slope
Soil Mature: circle one: Sand ) Loam Clay Other / Depths , 8 " feet +
Caround Water: At what depth? unk"n8 feet +
Bedrock or Impexviaus Material: At what depth? urdmown feet
Percolation tesu circle one: net require required / rate min. inch.
Domestic water su;Wlyow circle ones unicipal Well Other
IF domestic water supply is a 'Well:
Separation: Watersupply from Septic absorption N/A feet
* PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1 ,OOO gal.)
TILE FIELD: Each Trencb N/A feet ' / Total system length NIA feet
* SEEPAGE PIT(S)s Number of / Size each feet by felt'
* Size of stone to be used e / Depth or Thickness feet
* * ssasssss * +s * s sssss * * ssa� s +� * ss �c, s * sssas * ss *
IMPORTANT * See S, . P. E. D. S .
...please...LIST NEW EQUIPMENT TO BE INSTALLED permit & attached
sus * ss * s +K * s * * frss * +s * sa �lts * * * saR7Y ss # ssss s asps maps
(over)
section Il Septic System Inspections:
A. All applications for septic system installationip alteration or repairp as
required by the Town of Queensbury Sanitary Sewage Ordinance. shall
be submitted to the Building Department at least 24 hours ;
of construction and shall include a plot plan slnawing:
Imp U
l.) the proposed location of the gystem
2.) location and distance to lot lines
3.) location and distance to struptures
4.) location and distance to anY - pater supply
5.) size and dimensions of all tanks. distribution
boxes, tile fields and/or drywalls
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 inst*er and a fine of up to $250.00-
C. An approved co� the plot plan shall be available on the construction
site. Failure to uce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installationo,
alteration or repair of an approved system, a new proposal must.-be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Torn of Que sud iry Sanitary Sewage Disposal Ordinance.
Signature of.responsible person:
Date; ,S .
u
Town of Queensbury*
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
w
SETT1_ EO 1163 . . . HOME 0F NATURAL BEAUTY . . . A GOO D. PLACE TCA
1L If
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
SOD Haddon AIVin- Ua, colllnoawoO' N.J. Oslo*
Dater December 12 , 1989
QCPxtIf iC5 that the electrical equipment listed has been examined and is approved as being in accord
with the National Electrical Code, applicable governmental, utility and Agency rules.
Owner- Guyer Builders Inc occupancy Dwelling
Occupant: Single Family
Location 31 Queen Mary Drive , Queensbury (Warren CO) fM certificate cowers the electrical equipmens and rnslallillion inSpected this
dale. If additional equipment -should be introduced or alterations made to
existing system this certlUcafe shall be nut$ and void, and application for
80 Outlets ; 40 Receptacles ; 20 Fixtures ; inspect tan should be submitted protymptiy to this Agency.
Egtlipmenl: Holder or this ca(tlflcste should present same to his property insurance carnet
150 Amp Service ; 8 Appliances ;agent orcompeny) asexidsnceor certification orelactricnl equipment approved
as specilied.
FGuyer Builders Inc
Apprrcanr: 119 Dunning Street No . 15 -03007 2
Ballston Spa , NY 12020 J
Fwse He. 7e8
TOWN OF QUEENSBURY II
BUILDING AND CODES DEpARfiMENT
BAY & HAVXLAND ROADS !
OUEENSBURY, NEW PORK 3280&_
TELEPHONE (528) 792-5832
BUI NG INSPECTOR ' S ORT
REQUEST FOR XNSP TION RECEZVED
NAME
LOCATXON
DATE PERMXT # �
APPROVED
FOOTING/P.T'ERS YES INO
MONOLXTHXC POUR FORMS
-1"OUNDAVZON/DAMP-PRODF3' G
BACKFILL APPROVAL
ROUGH PLUMBXNG
FRANxNa
ELECTRICAL ROUGH-XN
INSULATION:
POUNDATXON
FLOORS
WALLS
CEXLXNG
FINAL. INSPECTION:
CHIMNEY HEXGHT
ROOFING
SIDING
EXTERNAL PORCHESJS EPS
S27AXRS-CLEARANCE & RAX
PLUNBXNG FIXTi1RES/ ELI
VE
INTERXOR TRIM/Pt �yCY RSL - y
FXNXSHED FLOORS
GARAGE PIREPROOF G _
DOOR CLOSER (SJ
SMOKE DETECTORS
FINAL ELECTRXCAL X SPECTXO
FINAL APPROVAL OF CONSTR,UC ION
A .SIGNED CERTIFI TE OF OCC PANCY MUST BE
OBTAINED FROM TH BUILDING EPARTMENT BEFORE
THESE PRENISES A E OCCUPIED
REMARKS:
INSPECTOR -
TOWN OF QUEENSBURY
BUILDING AND CODES DIERARTMENT
BAY & HAV2LAND ROADS
f1UEENSBURY, NEW YORK 12801i-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME LLOCATtat
DA rE ` #
XT
APPROVED
FOOTING/PIERS YES NO
MONOLITHIC POUR PORM,S
FOUNDATION/DAMP-F oC)FING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
E�� CTRICAL ROUGH-IN `
SULATIONs
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT '
ROOFING
SIDING
EXTERNAL PORCHES/Is S
STAIRS-CLEARANCE & T L S- ---
PLUM82NG FIXTURES LXEF V,�1- LV E'
LNTERICJR TRIM/PRI ACY DOORS
FINISHED FLOORS
GARAGE FIREPROO ,LNG
DOOR CLOSER (S)
SMOKE DETECT'O S
FINAL ELECTRIC INSPECTION
FINAL APPROVA OF CONSTRUCTION
A SIGNED CERrSFTCArR OF' OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DIqZVT BEFORE
THESE PREMISES ARE OCCUPIED?
REMARKS:
{
INSPECTOR _._
TOWN OF QUEENSBURY r'r
BUTLDrNG AND CODES 'DEPARTMENT
13AY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280!&
TELEPHONE (516) 792-5832
BUILDING INSPECTOR ' S REPORT
FfES7UEST R INSPECTIO RECEXVHD^_ fo
NAME
LOCATI
DATE 1 lJ PERMST ##
APPROVED
FOOTr1VG/PIERS YES NO
MONOLXTHXC POUR FORMS
FOUNDAfiWN/DAMP-PROOFING
eCKFILL APPROVAL,
✓"ROUGH PLUMBrNG dd
FRAMING
ELE7CTR.ICAL ROT7GH-
TN,SULATrON:
FOUNDATION
FLOORS
WALLS
CEILXNG
FINAL INSPEiCTXON:
CH.T MNEY IYEXGHT
ROOFING
.SIDING ,,
HXTERNAL PORCHES/ EPS
STAIRS-CLEARANCE & RAIL
PLUMBING FIXTUR SIRELIEF VALVE
INTERIOR TRrM/ RXVACY DOORS
FINISHED FI00 S
GARAGE FIRED QOFXNG
DOOR CLOSER Sf
SMOKE DRTE ORS
FINAL ELECTR CAL INSPECTION
FINAL APPRO AL OF CONSTRUCTION
A SIGNED CERTIFICATE OF
OBTAINED FROM THE BUTLDr� DEPARTMENT .BEFORE
MUST B,9
TFIES$ FREMSSRS ARE OCCUPIED:
REMARKS.
NSPECTOR
TOWN
BUILI74VrLD OF QUEENSBURY a -lx
BA SNG AND CODES DZPARfiME'NT
U�' & HAV rLAND ROADS
f�'UEENSBURY, NEW YOR.K 1280g,
TELEPHONE (518) 792-583.2
BUIL.L)' INSPECTOR ' S REPORT
REQUEST FOR NSPECTSC7N
NAME
FtECE2VED
LEA 2 SON
DATE I/3 1. > /.n
PERMIT #�
APpR,pVEb
F0C)T1'NG/PIE&S 1'ES .NO
MON0Z-r271YIC POUR FO S
rou V 44T rcJN/ i z yP_P12e pF'rNG 1
B44CXFZ'LL APPROVAL
L.pUGF! PLUMBING
R.T�MSNG
ELECfiRICAL ROUGH—rN
INSfjLATION:
FOUNDATSON
FLOORS
WALLS
CE2LrNG
FINAL 2NSP TION:
Cats M2VEY FEIGHfi
ROOPTNG
SSDING
EXTERNAL PORCHES/ST S
STAIRS—CZ-eAA jvCE &PLU ILS MBING FIXTU '
INTERIOR RES/ ELSEF V
TRIMIPRS ACY ALV1S
F INI.SHE17 F.TiL7DR,S' DOORS
GARAGE L PR pO NG e ,
DOOR CLOSER (s) ;
SMOksr DETECTOR
FINAL ELEG'fiR2CA
FINAL APPR OVAL
NSPECTrON
F CONSTRUCTION
A SSGNEU CEh'T2ICATE Of pCCCiPANCY
C7BT�LNED FROM THE BUILDSNG
TFlESE PRE1N t SE I2TMENT r BE
S ARE bEPA BEFORE
OCCUPIED
REMA.FtICS:
F PEC2"QR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCCATXOON_ 3
DATE __2 Z- q ` S PERMIT #
APPROVED
YES NO
FOOTING/PXERS
t,AmONOLXTHIC POUR FO S
FOUNDA2 XOX/DAMP-PRoc-kvXNG
BACKFXLL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULA TSON:
FOUNDATION
FLOORS
WALLS
CEXLING
FINAL XNSPECTION:
CHIMNEY HEIGHT 'l
ROOFING
SIDING
EXTERNAL PORCHES/S PS
STAIRS-CLEARANCE RAILS
PLUMBING FIXTURES RELIEF VALV,&..
INTERIOR TRIM/PR ACY DOORS
FINISHED FLOORS
GARAGE FXREPROO SNG -
DOOR CLOSERS)
SMOKE DETECTOR
FINAL ELECTRICA INSPECTION
FINAL APPROVAL CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDL
REMARKS:
ley
SNIP CTOR -
otun oue¢nsh+ure�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. O. I Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION
r7�fl
DATE PERMIT NO .
SOIL TYPE - Sand - Loam - Clary
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 PITS41 umber o )
Size- to .X ftj —
Gravel size -
PIPING : if size
Bldg. to tank "
k. ---y Te
Tan to diet . bos4� '
Dist* box to field/pit
Openings sealed YES No Partial i
LOCATIONI/SEP�A TICNs o
Foundation to ank ft.
Foundation to absorption ft .
Absorption t lot line ft..
Separation o pits f t.
LOCATION OF SYSTEM ON P.ROPERTY (circle one)
Front - Rea - Left side - Right side -
C`CHMENTTS .
f Y�� / t
Ole
SYSTEM USE APPR(WED YES ( N
8 ing Inspector
01/86 and vl
i
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW PORK 12804.
TELEPHONE (518) 792-5832
BUILI]ING INSPECTOR ' S REPORT
REQUEST FOR IN CT-TON RECEIVED
NAME
LOCATIONn .. f
DATE `j /f} C)t' PERMIT #
��---"—r APP VED
YE NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOPING
BACKFILL APPROVAL
L—R UGH PLUMBING
FRAMING pp
ELECTRICAL ROUGH—
INSULATION:
FOUNDATION t
FLOORS
WALLS
CEILING
FINAL INSPECTION: 1s
CHIMNEY HEIGHT
ROOFING
.SIDING
EXTERNAL PORCHES/S BPS
.STAIRS—CLEARANCE RAILS
PLUMBING FIXTURE /RELIEF VALVE
INTERIOR TRIM/P VACY DOORS
FINISHED FLOORS
GARAGE FIREPR ING
DOOR CLOSERS)
SMOKE DETECTO
FINAL ELECTRICA INSPECTION
FINAL APPROVAL F CONSTRUCTION
a
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT ,BEFORE
THESE PREMISES ARE OCCUPIED.
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
my & HAVILAND ROADS -1
(, UEEN.SBURYr NEW YORK 12804 -
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECT.Z�r+-0N RECEIVED
NAME
LOCATION
DATE - } _ PERMITj .
APPROVED
YES INO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPRgVAL
ROUGH PLUMBING '
FRAMING
,.ELECTRICAL ROU IN
d ULATION:
INFOUNDATION
FLOORS
WALLS
CEILING f
FINAL INSPECTION : r'
CHIMNEY HEIGHT
ROOFING
,SIDING
EXTERNAL PORCHttSIST&PS
STAIRSIFS
CE & RxAILS
PLUMBIFTRES/REIEF VALVE
INTERIPRIVACY'-:.DOORS
FINISHOR
rp
GARAGEOFING DOOR C )MOKESFINAL EL INSPECTIONFINAL APOF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE .BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAy & HAVILAND ROADS
QUEENSBUpyTELEPHONE ' (� 518)NEW y oRK 0�
792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
2-h
NAME
LOCATION
DATE
�/ _ PERMIT ## � --
- APPROVED
YES DLO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATXON/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
,ELECTRIC ROUGH-IN
INSULATIO f'
FOUNDATIOlk
FLOORS
WALLS r
CEILING
FINAL INSPECTION : `-_ j
CHIMNEY HEIGHT dd
ROOFING
SIDING
EXTERNAL PORCH% S/ST
STAIRS-CLEARA#±CE & RAXL5�--
PLUMBING FIXAURESIRELIr,�F VALVE
INTERIOR T M/PRXVACY DOORS
FINISHED FAORS - -
GARAGE FIJEPROOFING
DOOR CLO.�ER (S) -.�-�-
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST HE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE'
THESE PREMISES ARE OCCUPIED±
REMARKS:
-
INSPECTOR
CERTIFICATEOF INSURANCE ISSUE DATE (MM7DO7YY)
10/3/88
PRODUCER I'WQueZaboUrg AgeT.1Cyi Ina THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
121 Wall St NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
P Q 953 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
BODCSahenectadys NY 123013 COMPANIES AFFORDING COVERAGE
372-5641
LE ITERNY A The 1,utomobi 7 e Insurance Coo Of Hartfards `
CODE 33},�Q $uB-CODE
INSURED LETTERNY R The Aetna Casualty & Surety Co •
` w er Bu lder,$ i Im • LETTER
COMPANY �w
119 Duinn1mg Street
COMPAN
Aston' Spat NY 12020 LETTER Y 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 Oq 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 THC7USANOS
TR DATE (MM)DDfYY) DATE (MMMOlYY)
GENERAL LIABILITY Renewal of GENERAL AGGREGATE $ 2i '�, 0 i
A Z COMMERCIAL GENERAL
LIABILITY 00236924 IQ/IA8 I,0/3,/89 PRODUCTS•COMP1OPS AGGREGATE $ 2i WOO
CLAIMS MADE OCCUR. PERSONAL & ADVERTISING INJURY $ impow" i
OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 120wi
FIRE DAMAGE (Any one fire) $ IQQi
MEDICAL EXPENSE (Any one person) $ '
�L yArUTOMOBILE LIABILITY �newal Or COMBINED
A i ANY AUTO FJ390995 10 /-1 W ryrn,/-1 „ 89 LIMITSINGLE $ 1i Sys
ALL OWNED AUTOS W -V �'^`� .I.V i✓ L BODILY Vw
INJURY S
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY
NON-OWNED AUTOS INJURY $
)Par accident)
GARAGE LIABILITY
PROPERTY $
DAMAGE
EXCESS LIABILITY Renewal of EACH AGGREGATE
CCVB x UNIBRELLk XS475556 10/1/88 10/2/89 3 5P000.9 $ 5i WOi
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION Renewal of STATUTORY
A AND 379 1013 8 1013,189 $ lW'q (EACH ACCIDENT)
EMPLOYERS" LIABILITY $ „5' W v (DISEASE—POLICY LIMIT)
S lQQi (DISEASE—EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIC SILOCATIONSIVEHIC -EWRESTRICTIONSISPECIAL ITEMS
CERTIFICATE HOLDER CANCELLATION
Building & Zon1 g Dept. SHOULD ANY OF THE ABOVE DESCRIBERS POLICIESBE CANCELLED BEFORE THE
Town Of Queen,sbury CXPIR&T1ON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Bay & Havl1and Road MAIL X(y DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
KD #12 Box 98 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Queeysburyi NY 12801 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 2" (31") TlF3N 19"
SELECT BVS(NESS FORMS (609) 548-5203
APPLICATION FOR ELECTRICAL INSPECTION
PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES
MIDDLE DEPARTMENT INSPECTION AGENCY, INC,
National Headquarters
+d 900 Haddon Ave., Collingswood, N,J, 08108
• ' • kTA I M a= • Date : S 'h
](XL Town orMEKM$. _ Oleenssbury County _ Warren State NY
Location/Address 31 Queen Mary Drive
Cif Located in Rural Area - Please Attach Directions) Pole #
Owner GUYS BUILDERS , INC • Permit ## �r - -
Occupied As Building : Newn Old F7
Occupant
Work Area in Building Floor 0. etc, ) :
App. for- Wiring Service [] or: Ready for Inspection :
Fee Remitted - $ Cash 0 Check 0 1A_0_ = Make Payable To : M.D. I.A.
SOD 750 1 000
1250 1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect, }-lest
Switches
Lighting Amp. Service Surface Unit Dishwasher Range
Receptacles Water Heater Air Conditioner Dryer Pump
Number of Fixtures Oven Garbage Disposai Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS H.P.. 1/2 1/12 1/10 1/8 1/6 1 1/4 1/3 1 112 1 3/4 11 1 1 1112 1 2 1 3 1 5 1 7V2 10 1 15 1 20 1 25 30 4d 50 1 75 LOO
Mark Number
of Each Size
Applicant"s
Signature License # Permit #
T/A Gi1YT:R igumn'FT3:Sr--1 - Utility :
Applicant's Address: 119 DL1TmixX%Z Street (NAME WFFICE LOCATION
Spa(City)—Ballston Sp (State ) NY (Zip) 19020 Service Re uest #
Phone # 899-9161 Electrician : GUYER B�3ILDERSS INc .
• DATE RECEIVED: DATE INSPECTED :
Correct Location : Same as Above [ or:
Red Notice Label 0
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp, Service Equipment - Burnet, Wiring & Controls for Amp. Receptacie
Amp, Service Conductors Pump Vent Fans
MOTORS H P 1/20 1/12 1/10 1/8 1 1/6 11 /4 1 1/3 1/2 3/0. 1 1 lYh 1 2 1 3 1 5 1 7t1x 1 5 30 40 50 1 75 1100
Mark Number
of Each Size
Elect. Heat 500 1 750 1000 1250 1500 1750 2000 2250 2500 2750 1000
USE FOR INITIAL ViSEY_-OHL+Ir NOTIFIED DATE DDFEEDT FEE PAID
Q RW Progress : Inc. 0 LKD Contractor
CFT Violation : Work Comp. Inc,
L/A Owner CASH El
0 L/A Fee CH K #
Due MID #
'� IPA Municipal
INV #
Date: Other Side 0 Utility Applicant
Owner
Cut in Card Temp # Date
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