1990-204 d�, �' i t/4 ..Y}.� fl✓ lr.q "Onl yyl,'•...I,' 1 i•.,.+ >���.-... 1 -�.5-'^,...v,r:_'•'i 4 'i: 41
"�
104
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBU •.Y
WARREN COUNTY, NEW YORK
Date
September 13 19 90
This is to certify that work requested to be done as shown by Permit No. 90-204
has been completed.
This structure may be occupied as a single family dwelling
(7? Dream Lake Roads
"Location
Andy & Holly Serra
Owner-
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg:& Code Enforcement
3
BUILDING PERMIT y
TOWN OF QUEENSBURY
NO. 90-204
WARREN COUNTY, NEW YORK :� o
cri
PERMISSION is hereby granted to ANDY & HOLLY SERRA `i'
ND
OWNER of property located at Bay & Dream Lake Roads Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Single 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.
U)
t�1
1. OWNER'S Address is
49 King Av
Hudson Falls NY 12839
•
2. CONTRACTOR or BUILDER'S Name
Gregg Nelson R°
3. CONTRACTOR or BUILDER'S Address `C
RD#2 Box 291C
Queensbury NY 12804
4. ARCHITECT'S Name
R°
5. ARCHITECT'S Address
ro
6. TYPE of Construction—(Please indicate by X) ro
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 1150 sq. ft. Single family dwelling as per plot plan, specifications
and application, including detached two car garage and septic system
8. Proposed Use
Single 'family dwelling
ro
$ 179.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 27 19 90
(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.)
Q4
Dated at the Town of Queensbury this 27th Day cyf April 19 90
SIGNED BY for the Town of Queensbury
Building and Zoning'Inspector
BLDG. PERMIT NO. 90-204
APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY
A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property
located at; Bay and Dream Lake Road - Andy & Holly Serra
for the following uses: Single Fami 1 y Dwelling
8/21/90
DATE SIGNAT E OF APPLICANT
TEMPORARY CERTIFICATE OF OCCUPANCY
The TEMPORARY CERTIFICATE OF OCCUPANCY is hereby GOAPPROVED
( )DISAPPROVED
with the following conditions: Front steps and kitchen sink and insulation in
basement complete and plot plan of septic system.
TEMPORARY CERTIFICATE OF OCCUPANCY FEE: (X)$10.00 DEPOSIT: (>$100.00
received on 8/21/90 a) ,( 1 C,I ` - d A Code
Date of Issuance Director of Bldg. & Enfor rnent
THIS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES 30 DAYS
FROM THE DATE OF ISSUANCE.
NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code
Enforcement or his designee.
,TOWN OP QUEENSBURY
REVIEWED BY
_JvviV OF ?UEE1\�u: :. ,
.. 1��1,1_111k FEE PAID $ [ �� �� r
i % PERMIT NO. f o le 11 N W LS 9jj '
BUILDING PERMIT. APPLICATION APR 251990 `--.
BUILDING &CODE DEPT.
A PERMIT MUST BE OBTAINED BEFORE.BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
♦ ♦ ♦ ♦ * ♦ * ♦ ♦ ♦ * ♦ * * M * '♦ * * S. * * .♦ * * ♦ ♦ * ♦ * ♦
The owner of this property is: (f�'YY1 LI �` tJ�i Ee, 1�
/1 ?i / 1 /q
P.O. Address . kith ci Y fiodsoyv ils Tel. -7 C( --],-
y((( 1
../ Q
Property Location ,�\v d- PCJo1 I ��f'e P /a (L 1C Tax Map No,S/ /.,9/ z7e
Has there been any split of this property since October 1, 1988? / 41,1,4 CO-Lita 1-
If yes Planning Board Review is necessary.it j � _ yes no -
vL� s'v'
___L ..-
SUBDIVISION NAME, IF APPLICABLE 5"C4.9_,--111,4,,A,,hepri LOT NO. _
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
•
NATURE OF PROPOSED WORK: ESr;MATED MARKET VALUE OF •
•
Construction of a new building „ CONSTRUCTION: $ g�'�Q
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property j yc ft x °ft.
Alteration to a building ' Existing Buildings(3) Size ft. x ft.
(no change to exterior dimensions) . •
Proposed building =distance from property line:
Other work (Describe) ' Front yard 7( ft. Rear yard 1 Q f) ft.
* Side yards T2 a ft. and ft.
•
GROSS AREA OF PROPOSED STRUCTURE ,'(�( *
If on corner, setback from side street 70 ft.
1st Floor / / `�O sq. ft. Itke,( .1 OCCUPANCY INFORMATION
ck/ '
2nd Floor . �� sq. ft. � �`�• ' Pri ary Building -
Other Floors • V One Family Dwelling
sq. ft.
(not cellar or basement * Two Family Dwelling
TOTAL FLOOR AREA /�c(O sq. ft. • Multiple Dwelling/Number of units
Size of new structure ft x ft. ` Business
Foundation-pier/slab/crawl/partial full Industrial
(circle one) �..J ' Other
•
No. of stories (habitable space) I . . •
Height (grade to ridge) / it, ' 4 1 i ft. • If addition, what will use be?
If residential, no. of families I *
No. of rooms(excluding baths) ' Accessory Building
No. of bedrooms ,� • i Detached Garage ONE F at
No. of bathrooms 2; •
Primary heating system el-e(>- f--IC • _Attached Garage ONE/TWO Car
Type of fuel ei P r/5 -t c ' _Private storage building
No. of fireplaces to be.installed '
• Other
Willa wood stove be installed -/c) 0
Central Air conditioning yl O
OV' ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPFCIFICATIONS:
Type of-construction; wood frame, fire safe, etc. tOod f'cvm e
Will any second-hand or upgraded lumber be used? If so, for what? h 0
//
Foundation wall material 12)W-ed e� ('�p Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? j. Q. e Heated or unheated? tiy' r! Floor sq. footage I Z 6-0 sq ft.
Will there be a basement. L/,p Will any portion be used as living space? 11,0
(If so, what portion? sq ft. Type of use? (. Ole"Ol d,
Type of roof sloped at/shed/other Material of roof p/y Ckfa7) _ �� it j,. s h 1i115 )-e�
Size, wood studs "x (n " spacing 6 " o.c. length ' ft. 4
Joists (floor beams) 1st floor 0- "x /O " spacing /(,,, "o.c. span t.:.3 ft.
Joist (floor beams) 2nd floor "x " spacing "o.c. span ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing 24j " o.c. span 1) ft.
Exterior wall finish ( , (-fa plo y.-.r) of what material? }^UP-
Interior wall finish ,C h-pp —(r- --i{
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure,
self-closing device be provided?
Will a flue-lined chimney be installed? f Height above roof ft.
Depth of chimney foundation below grade/ ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well f Y'I VCt4 Lt e-1 1
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
NAME OF BUILDER Cilef /V& co)/ ADDRESS lay> 730,0xc_. TEL. NO. 74.31,---(0cf,r(
Tarmh NAME OF PLUMBER t 1 (Xfl�Ci1,p7 ADDRESS ' '4yent�p A. TEL. NO.
p ' bridit IVr
NAME OF MASON JGyi ADDRESS lilj/Icrinj i kJ TEL. NO.
NAME OF ELECTRICIANClirpyie? ko/ er, ADDRESS 6543e*2,q1 C TEL. NO. -6,11 (�
DECLARATION
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.
'fly I
Signature , �[� C ./1t
f•
Owner, own "'s agent, architect, contractor
SPECIAL CONDITIONS OF THE PERMIT:
BY
WARREN COUNTY ; NEW YCRK-
•
Application for': BUILDING PERMIT IN COMPLIANCE WITH THE NEW PORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginnin work :
ANSWER ALL of the following:
&�. S
1 . Gress floor area � _ _ ____
2 . Type of heat P ( f' ( .
•
BUILDING & COD . utr+.
•
3 . Is the building mechanically cooled? Yl ��
4.. Percentage of area of windows and doors ' 14(70
A. Over 16% Only
1... "Uo value of gross area of .walls , root/ceiling and floors
exposed to ambient conditions
•
•
.2 . Floor over heat.'3 spaces YES NO
a. Are foundat on walls insulated? YES ' NO
•
1 . If YES .. what is the. R value?
• 3 . Slab on grade YES NO
a. If YES, wh .t is the R value of insulation around
perimeter of •floor?
•
4. Is basement heated?' YES NO
• a. R value of insulation
. 5. , Type of insulation
B. . Under 16% Only
1. R value of roof d floors exposed to�iambient conditions_
2. R value of exterior walls C 3
3 . R value of glazed area ,3 1-
4 . R value of doors p-� ,c. o
5. R value of floors over unheated spaces v" -2
6. R value of slab ' edge insulation - unheated slab
7. R value of slab insulation - .heated slab
8. R value of heated basement/cellar- walls (above grade)
9. R value of heated basement/cellar walls (below grade)
10. Type of insulation •
s
. C. Controls 6
' 1. Thermostat maximum heat setting p�6 U •
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. Mina Insulation
1. Size of hot water or cooling carrying agent pipe
2. it value of pipe insult'
.F. Servicm Water Keating - •
1.- Performance efficiency -
2. Temperature control setting maximum f?0°
G. For Swimming Pool Only
1. . Maximum heating
Telephone No. 7 7- V / "
(applicant' signature)
U WN OF QUEENSPLIRY
;. T
APPLICATION FOR
SEPTIC DISPOSAL PERMIT 4-OWN OF QUEE.s• `....
APR 251990
DATE .A... r4 l 2X )C(�l V BUILDING do CUOE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION / C Rd by'- et,fil
Owner's Name: / dy4 1 rra Telephone: 7 l- LI
Address: 11. l E'�j -Ayr, Flu d U Nf Fott
Installer's Name: Telephone:
Number of bedrooms (residential only)
Total daily flow (compute la. 150 gal per bedroom) kc(J
c /
Topography: Circle one: Flat-)Rolling Steep Slope % of Slope
Soil Nature: Circle oneand Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: Municipal Well ther
If domestic water supply is a well:
Separation: Water supply from septic absorption r- 0 () feet
PROPOSED SYSTEM: Septic Tank /OQO gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet/Total system length - feet
SEEPAGE PIT(S): Number of V /-Size each O feet by G feet
Size of stone to be used #_ ? /Depth or Thickness `� feet
*************************
I have read the regulation on the reverse side of this sheet and agree to abide by these
and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: Ak `� lY�1, �'
6d
DATE: —2.q. 5 0
OVER
Septic System Inspections:
• A. All applications for septic system installation, alteration or repair, •
• as .required._,by;;theifT,ownz:•;of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours' before start -
of .construction and shall include a plot plan showing:
1.) the proposed'location 'of the system
2.) location and distance to lot lines
3.) location and distance to structures •
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywells
•
B. No system shall be covered before inspection and approval by the
Building' Inspector. Failure to comply with this requirement may
result in the uncovering of the system by the installer and a fine
of up to $250.00. •
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may •
result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa-
tion, alteration or repair of an approved system, a new proposal must ,,
be submitted to the Queensbury Building Department -before further
construction.
• Town of Queensbury
BUILDING and CODES DEPARTMENT •
Bay and Haviland Roads
Queensbury, New York 12804 •
•
RL:marks:
1.g.e.".!. "In.lm•n,.‘w Ili ez.-)�¢J�....At?w,_l ".aQ, .a�..�{_ap,aw.!.".a ",.�i.�t ati fit,.4, 1� , .
•�
THE NEW YORK BOARD PAGE OF FIRE UNDERWRITERS ,Ar+�^
1
1
1, FL .',BUREAU OF ELECTRICITY ;;
i
41 STATE STREET.ALBANY.NEW YORK 12207 II
•.iate AUGUST 2_, 1990 Applicati No.on ile� I363090/90 F05
ic(; THIS CERTIFIES THAT PERMIT NO. 901-201
'w. sic' only the electrical equipment as described below and int -ed by aiapp scant named on the above application number in the premises of -'
1+ ,'
a 1+ a;T DY/HCLLB SERF1 . 49 KING iT. _ rILE '>FlF„ . N.Y.
' i ;
n the following location; ❑i Basement ❑-::1st Fl. ❑ 2nd Fl. Section Block Lot i
' was examined on r and found to be in compliance with the requirements ofthis Board. `�
' AUGUST `0, 19.90 J P ' 9
f !; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS '
OUTLETS ECEPTACLES SWITCHES •
INCANDESCENT-FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
j' 3-1 37 31 :`-1 4 15 1 1 .5 3 1 l
K. DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS '��
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS •.
'.i
_ 1 :t 1 ;
a SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER �,2W ,B'3W 3/B'3W 3,B'IW NO.OF CC.COND.• A.W.G. NO.OF HI-LEG A•W G' NO.OF NEUTRALS A.W.G. 'Al
'' EQUIP. PER B• OF CC.COND.. OF HI•lEG OF NELRRAL
't
OTHER APPARATUS: ,,
`i •
ELEC. SOON HEATERS: - .5 k.W. . 2-.75 K.W. . 3-1 .5 K.W.
ELEC. ROOM HEATERS: 1-2.5 K.W.
MOTORS:1--F H.P. A.
ELEC. WATER IIEA'TE RS: :1-•1 .5 K.W. •
.F'.C.I:--1 '
SMOKE DETECTOR:-1 :`
ar .
ANDY & HOLLY SERR?S �9 `'
KI
NG I9 I:T��.� ST.
BRANCH MANAGER �
\ ,
3
Per .,. _.'I,' ',
icate must not be altered in any mannerp return to the office of the Board if incorrect. Inspectors may be identified by their credentials. •'
?ii-lei-,.r ® oo ® aoeoME000 ® ® o .;�'<.;s.':: .
,\ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804•
TELEPHONE (518) 792-58.32
Y
BUILDING INSPECTOR'S REPORT
REQUEST FOO INSPECTION,RECEIVED //�)j el
NAME C'/�/ (" jjj
LOCATION � ,1 ,, ! ( i..!(�, /7C d
-� 4—`C7() ( PERMIT #ego —a-(
\ 7 / APPROVED
¢ YES NO
FOOTING/PIERS 1
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL APfROVAII
ROUGH PLUMBING I
FRAMING j d
ELECTRICAL ROUGH—IN '
INSULATION: l
FOUNDATION.Ic i
FLOORS ;; I • . . . .
WALLS .1
CEILING '' I
47FINAL INSPECTIQN:
CHIMNEY HEIGHT
ROOFING j iy, /
SIDING 1 °; d'
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCE & RAILS !/
PLUMBING FIXTURES/RELIEF VALVE (,/
.INTERIOR TRIM/PRIVACY DOORS [//
FINISHED FLOORS r4 �/
GARAGE FIREPROOFING
DOOR CLOSERS) ,¶
SMOKE DETEC 'ORS Y
FINAL ELECTRICAL INSPECTION /
FINAL APPROVAL OF COVSTRUCTION v/
OK TO ISSUE C%O OR C/C ✓
A SIGNED CERTIIIFICATE VOF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISE'S ARE OCCUPIED!
REMARKS: i�,
a
c
\ •
\.:
4s
ARRIVE
DEPART
9 4�
INSP CTOR
TOWN OF QUEENSBURY (:///12///-111.----"
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION ECEIVED tlD/' d A Al
NAME j �'�f /h I� },
LOCATION \/ FI V/:P;(2 1--)(
DATE 9,/0 /Gj { PERMIT
APPROVED
k % YES NO
FOOTING/PIERS ° r
MONOLITHIC POUF FORMS /
FOUNDATION/LAMP-PROOFING
BACKFILL APPROVAL I
ROUGH PLUMBING I,
FRAMING / '
ELECTRICAL ROUGH-IN ' I
INSULATION: `
FOUNDATION
FLOORS tt • t
WALLS ► .
r
CEILING ‘ I
A INAL INSPECTION
11 CHIMNEY HEIGHT
ROOFING 't 1
SIDING \ J
EXTERNAL PORCHES/STEPS '
STAIRS-CLEARANCE &!RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS ,
GARAGE FIREPROOFING
DOOR CLOSER(S) r6
SMOKE DETECTORS /
FINAL ELECTRICAL INSPECTION. . . .
FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/O OR C%C
A SIGNED CERTIFICATE\OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCpUPIED!•
REMARKS:
/2..glee/244d/ 0'4 tip/21e,p emd
„t1v4744,44;
-xlis441) /a144-12Aitc--4797;;) .
ARRIVE m
DEPART/�
INSP CTOR
TOWN OF QUEENSBURY S �,e l�Q._.1/-Q._
BUILDING AND CODES DEPARTMENT 15-�
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
1
REQUES',FOR INSPECTION REC IVED
��
NAME L,ILC (�.:,�, '1 1 4C) __ -n_ _
LOCATI c,1004 `a _) ` Cam! 1)0.-1-.),-__
DATE 4 2 - PE IT (# Cw)-7 \ '
APPROVED
YES NO
FOOTING/'IERS
MONOLITH,C POUR FORMS
FOUNDATIs /DAMP-PROOF NG
BACKFILL PPROVAL
ROUGH PLU BING
FRAMING
ELECTRICAL ROUGH-IN '
INSULATION:
FOUNDATIO,
FLOORS
WALLS
CEILING
FINAL INSPEC ON:
CHIMNEY HEI HT
ROOFING
SIDING ✓
EXTERNAL POR E'/STEPS ► //
STAIRS-CLEARA C. & RAILS J//
PLUMBING FIXT S/RELIEF VALVEiii
INTERIOR TRIM/'•IVACY DOORS /
FINISHED FLOOR' eJ
GARAGE FIREPR.JNG
DOOR CLOSER(S) /
SMOKE DETECTO'S L
FINAL ELECTRICA IN PECTION
FINAL APPROVAL $F CO 'STRUCTION
OK TO ISSUE C/O OR C
A SIGNED CERTI ICATE 0 OCCUPANCY MUST BE
OBTAINED FROM ,HE BUILD NG DEPARTMENT BEFORE
THESE PREMISES ARE OCCU ED!
REMARKS:
,4 p 1,e. t 574995 . n
6-Ai/keel fAvsiL/alga- ���/J^°SEK1kN�
ARRIVEI' v Pr7
DEPART 3,'05' 441 •
I SPECTOR
,. . .. ..i 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 ...
,.,
1
DISTRICT OFFICE.
. •': ,,.-,- .
.. .•
,,./.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
:.,
.,-.,
IAPPLICATION NO.
._..
.'
1
. ... ,
LO
..
1...7::.'
, . .
1 DATZ-E °
. .
FORM 18D(REV.1/86) NSPECTOR .
_
.1',
Jown of Queeni , r,
•
: BUILDING and ZONING DEPA TMENT
Bay and Haviland Road, R.D 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM/INSPECTI N
NAME 5e-,e_,L°Gt. / /
LOCATION �/fr,,,7 ii . C.
DATE_ / / ?O PERMIT N0. ', ,e2o Y
,SOIL TYPE - Sand Lb0Cl ly -
Percolation Test Required? /IES - NO
Percolation rate - Min/ nch
f /TYPE of SYSTEM: i
Absorption field, total }ength o2.c
Length of each trench' ;5o
Depth of trenches ' 62. 7 •
Size of gravel" -* R IA
SEEPAGE PITS{Number of) '
Size- ft. X _ f .
Gravel size. ,
/ I
PIPING: /; Size Type
Bldg. to tank / ;f `r p v.e_
Tank to dist. box / er
Dist. box to field/�lpit Hy" y
Openings sealed? NO Partial
LOCATION/SE �ARATI,DNS:
Foundation to tank ft.
Foundation to absorption 5/oft.
Absorption to It line /p ft.
Separation of pf, is ft.
LOCATION OF SYTEM ON. PROPERTY(circle one) •
Front - Rear --(Left side -\Might side -)
COMMENTS:
/,:
1 ' \
• \
/41/4 & /. •
4 \
SYSTEM USE APPROVED YES .
del ' : .
Building Inspec or
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILANh ROADS
QUEENSBURY, N YORK 12804- I.
'
TELEPHONE (51'F) 792-5832 14 � '
Cb BUI DING � .�INSPECTOR'S i' 'ORT 0 "�'
REQUEST FO IN PECTION RECEIVD r1 / (
NAME i i' I1LK _ 4-� A...._ I)
�: AL1/ /
LOCATION � '
DATE 9 1 1 Z I Oh () PERMI I/ # 0 L-Zb 4-
I APPROVED
YES NO
FOOTING/PIERS ! I
MONOLITHIC POUR FIRMS
FOUNDATION/DAMP-P'IOFING •
BACKFILL APPROVAL , I
ROUGH PLUMBING 1
FRAMING 1
ELECTRICAL ROUGH-I ' f
INSULATION: 11 I
FOUNDATION
FLOORS • , I . . . .
WALLS 1 I R r26- 1j
CEILING
l n -. 3e
FINAL INSPECTION:
CHIMNEY HEIGHT I
- ROOFING
SIDING
EXTERNAL PORCHES/S E'S
STAIRS-CLEARANCE &' ' LS
PLUMBING FIXTURES RELIEF VALVE
INTERIOR TRIM/PRI ACY''DOORS
FINISHED FLOORS
GARAGE FIREPROOF NG
DOOR CLOSER(S)
SMOKE DETECTORSf1
FINAL ELECTRICAL 'NSPECTIi..
FINAL APPROVAL OF/CONSTRUC+ION' '
OK TO ISSUE C/O R C/C '
A SIGNED CERTIF � ATE OF OCC PANCY MUST BE
OBTAINED FROM T'E BUILDING D PARTMENT BEFORE
THESE PREMISES RE OCCUPIED!
REMARKS:
ARRIVE 640
DEPART ao'5 . (11 /
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 1110(1(____
BAY & HAV LAND ROADS
QUEENSBUR NEW YORK 12809-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST OR NSPEC ION RECEIVED rl . ( )C,O
NAME l /l',k_C / %,,,_; )( ��
LOCATIOJ`► (fC LA 1 //
DATE I ( 1 [0.n PERMIT (# r ( 1) —7_0 --
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP ;'ROOFING
BACKFILL APPROVAS /,
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH—`N
INSULATION:
FOUNDATION
FLOORS .
WALLS .
CEILING '
FINAL INSPECTION:
CHIMNEY HEIGHT
t ,
ROOFING
SIDING
EXTERNAL PORCHES/STE??,
STAIRS—CLEARANCE & ' '.LS
PLUMBING FIXTURES/R 0) c F VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL I ,t.PECTIO ' ' ' ' ' '
FINAL APPROVAL OF c ONSTRUCT i.N
OK TO ISSUE C/O 07! C/C .
A SIGNED CERTIFI.''TE OF OCCU•4NCY MUST BE
OBTAINED FROM TH! BUILDING DE"i'RTMENT BEFORE
THESE PREMISES -',frE OCCUPIED!
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REMARKS:
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DEPART-/ ' 75
- INSPECTOR
TOWN OF QUEENSBURY ' 1711.1(1
BUILDING AND CODES DEPARTMENT
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BAY & HAVILAND ROADS f
QUEENSBURY, NEW YORK 112801. /
TELEPHONE (518) 792-5832 {p.
BUILDING INSPECTOR'S REPORT :`'
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REQUEST_ INSPECTION RECEIVE D
NAME ) A 1( A•
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LOCATION 62 r
DATE • � / C1 i() PE IT
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APPROVED
YES NO
FOOTING/PIERS U r
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
kmCKFILL APPROVAL y i�
OUGH PLUMBING 1 ,)'
FRAMING �?
ELECTRICAL ROUGH—IN .1
INSULATION: .a
FOUNDATION 49
FLOORS.
WALLS s�
CEILING p s�
FINAL INSPECTION: /
CHIMNEY HEIGHT as
ROOFING
SIDING ,
EXTERNAL PORCHES%S 'EPS
STAIRS—CLEARANCE/&TRAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOOFINGa
DOOR CLOSERS,
SMOKE DETECTORS
FINAL ELECTRICAL INSPCTION
.FINAL APPROVAL OF CONSFRUCTION
- OK TO ISSUE d/o OR -C/d
D y
A SIGNED CERTIFICATE O. OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
x
THESE PREMISES ARE OCCUIED!'
REMARKS: 1
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ARRIVE /2 6Ct,
DEPART/O�6'`5
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT y�q
BAY & HAVILAND ROADS CO 1'11
QUEENSBURY, NEW YORK 1280� d
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED , 5*f�/Q
NAME (1.41,Ll 1 �Y a -
LOCATION 6ini4 ayi A 11,7j/X, ,p An
DATE ,..441191). PERMIT # 961-440
APPROVED
YES NO
X FOOTING/PIERS
MONOLITHIC POUR FORMS 1
FOUNDATION/DAMP-PROOFING •
I
BACKFILL APPROVAL i
ROUGH PLUMBING } •
FRAMING 4 J
ELECTRICAL ROUGH-IN j {
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING # a
FINAL INSPECTION: f
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS )
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF','VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS it.
GARAGE FIREPROOFING _ l
DOOR CLOSER(S) r
SMOKE DETECTORS 1
FINAL ELECTRICAL INSPECTION; '
_FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/O OR C/Ca - •
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUIeLDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDt t,
t
REMARKS:
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DEPART I �� : 1 i
�'/ INSPECTOR
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Date'a
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DATE OF PRINTING 6 APR 1990