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1989-870 y r'.� . ,�j ., .v<<R` i?xM4 -�."'"_ ';''• ,""' _'a�'�1T°"`a'MWmvp:^.;'a^rd,..., j 1 1 i • �r f # CERTIFICATE 01V CiCCUPA.NCY TOWN OF QUEENSBURY 1 WARREN COUNTY, NEW YORK Date 19 � This is to certify that work requested to be done as shown by Permit No. 89- $7 Q has been completed. This structure tnay be occupied as a Ein g l e family dwelling Location Lot *761 - Maple Drive OwR1Ci Stephen M . Kelly f By Order Town Board TOWN OF QUEENSBURY I Director of Bldg4 do Code Enforlument I I BUILDING PERMIT x TOWN OF QUEENSBURY Na. $q_ F-S]d � WARREN COUNTY, NEW YORK :CD PERMISSION is hereby granted to STEPHEN Ms KELLY c.s, I OWNER of property located at Lot ,#76 - Napl is Rri e Street, Road or Ave. `1 rs, in the Town of Queensbury, To Construct or place a at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is 11 Willow Road m r- r 2. CONTRACTOR or BUI LDERZ Name C/1 rri rn SELF rn 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name Cr cr 6_ ARCHITECT'S Address Gr r 6. TYPE of Construction — (Please indicate by X) b rG KI Wood Frame I } Masonry ( i Steel I I c 7. PLANS and Specifications 1'a No. 26 ' x 50 ' single family dwelling with septic system and driveway as per plot 121an . application and specifications . B. Proposed Use cn Single Family Dwelling CD -n $ 235oOO PERMIT FEE PAIL! — THIS PERMIT EXPIRES _ June 1 1990 ,_.,_, (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_} C3 Dated at the Town of Queensbury this 3rd Day of November 19 89 to SIGNED BY for the Town of Queensbury Building and Zoning Inspector TOWN OF QUEEtiS13URY ' [ • is Review 0. F e C IM11 LD INC AND CODES trk PARTP�FT Date Iaaued ► &44D 0�' :,iY and If,1VIX.4hfg ROAD RD 1 Box 93 Y 5;47 (1UEE'NSBURY . NE1J YOR1i 22d04 PCn1n.I Na . � �'' Tol . e5146 ) 792- 5332 Exc 204 A I) C- ;zt1IT mUST DTI OBTAINED UEFORE aEGINMINC+ CciNSTRUL:Ti (3I•i . NO INSPE C� S 141ILL BI: MADE UNTIL APPLICANT HAS RLCCIVED A VALID BL" ILDINC PI_ RMIT . All applicable spaces on this application must be completed and the ; iouature of the ;applicant must appear on the reverse side of this sheet 'k 7t Ys 'k A A YK yf 7! 7k R * ih 1i at The owner of this property is . O . Address III .Eti� f/FO AI /4'o APO/ ( +' 'G �' �S /r v K s< F�= -----T E L . �? iroperty Location a7` 7d /�P. 900CM .c�elXI� � CAX MAP NO . f S / 11as there been any split of this property since October 1 , 1988 ? / Oi yes no if yes , Planning Board Review is necessary * uU13DIVISION t1AMC , Ir' APPLICABLE 1&44da1e4. Z 1§lellS� LOT NO •s' he person responsible for supervision of work as regards Building Codes is : ,571e , e ellrX - N A14E P . Ca . ADDr16wS TEL . NO . Tel ? A ;flame of builder sApiv a Address /{ .+Cry/�4 �c .*.�-� }i r4,qte of Plumber Tel Name oe Mason Tel 4ATuRE or rr.,c '+ sco h(:ll.r, ZONING iN ! C) ItAl.ti,`I" iC�!~E ( Urfice use On1. y ) 1�17rrn :: crucc iQr, of a rkctw builcliri�l GGNING2 DLSICNATION OF PROPERTY Ad,sicion to a builoI r PERMITTED PRINCIPAL PERMITTED ACCESSORY A1cwr.. Lion to " LuildLng ` ( ; to to %:xcorr.oY axirtQnsion::) • REVIEW REQUIR.CD - PLANNING BOARD 7.ONINC BOARD. Gti+ut work [ J�scriUol SITE PLAN REVIEW # APPROVED DATE r : KLDSS ARLA 41' PROPOSLL�. . orrkUCTUkEr7 • VARIANCE It APPROVED DATE ,. s t Floor /(l� �C, }5r, s q f It � w Remarks . nd r' loorw 7 {Jd sq t t . III, COkaP [ L'i'L LCIi`O[.M.1'L'LON Lck:r�UL1cL:D Other Floors sq Ft . . Siiu of proL.� rty_ }�rst/ et x [ not cellar or basQtnantl �653`+ L:xi tiruj L' uLi.l� � �] ( : ) si �u x' L x r' c . TOTAL FLOOR AREA 54 ft Ua.s G i �a a, a new :truccurs 076 f t x 0 t ' Luksr,d;+ tion-frier/ l.�L}crawl}[aarca ,.l tul ' Yrolso�aa buiLssnq . r1s� c.ank:�: croup 1. rcal�urty isrk4 ( Circle one ) R ft Front y:ard��-� r t near yard .� Na . of ztorica ( )k"it:.blo c13bCC ) Sid. y"rdoo = t .ancl it k[� ighC ( clrada to rid(j.r ) / fIt • If on carn.: r , : c: tLz.kck from uII :cr.:tc��rt I ( reo.; iduntial , no . of famili.as t ' t000 of rocun:s ( axciuding b"tha ) 2OCCUf'ATLk:Y 1NVFC)I',MAT ( CN Itoo of budroorns It 4 P'R.I.N,ARY LUILD1NC amo No . of C"0%raouk:: 1 Y s jOna fan"ly dwelling t•riuury tky.ktilkuj Ly�i .:«k �� Two e"MoLly dwulliny 'rylau of fuul " r Multii�l.s UwQlling / Number of unics�,� No . of firwpj .I cca b" sngtwll .:d / Paztia•ufoiac occupwkcy Nall :a wo" k:l:ovka t.k: ilksst:aii.:k17 C * 'L' l.:ekc ratcuxr;arrLy L'wntr.kl Air coak.liciun..rkg7 V25 13usinc:ss BUILDING STYLE, PRIMARY STRUCTURE 4W1nc[uscri5l L+wI Conc.:utpor.ry Lcn? cZ&Uln . OthKrr # It .rddiciun , wi..rt will ul." bu7 tiow& A a :d raskatt M.4n36iwk U014L 1 WVQl old %6 ry 1Q Uu+k.j•.low ' C..yxt cod catc:+g,: Otkkur ' ACCESSORY UUILDINGr `o Tj 641 111 Mouse ' wucachau y .►r:,gC/anct crar/ cam/ cwr ( CIRCLL:: OWL PLyh C ) ' AccaChtI 9 "C40u/0444 car/ wo t:+ C" L' • ■ r r r r ■ * a . a ■ ■ r r r ■ • L, rsv,I sLor"94 bulll4ing L: STINATI-I MARKET VALUL OF � Orh._ r - INFORmATION ON nUILOINC SPCCIFYCATIONS . ON REVERSE SIDC OF •mils g.%f1UET, 1'+0 BE COmPLETLDL Form &PA 10188 v1 5 [ L :DING 5PECIFIG TrOr4S : . ,tpe cf construction , wood framem re aafa , et ,Lt � 4 �+ ryLll any second- hand or ungraded 1 :per he ; sad ? _ f so , for what ? /tid p . r Fcundataor. wail material D Fa Cc47c T? < <cknass C] Eept :: of Foundation below grade 4 c, hottom cf tooting ] 400W Will there be a cellar ? crated or unheated ' _4 Floor sq . footage 14167 sq rt will there be a basement . ) Will any portion be used as living space ? �t.m ( If so , what portion ? sq . ft . - - Tvne of use ? Type of roof - sloped/ flat/shed/other - material of roof /r"A4 e..P o: A&, % f t�°� L.,�r1/� r Site , wood studs " X 12 " spacing A6 C . C ." length �`ft . Joists ( floor beams ) 15t .. floora� c0& J spacinq /16 " o . c . span ft . .. oists ( floor beams ) 2nd . floor 7Z X�y/ ► spacing"o . C . span f t . Cverlays ( ceiling beams ) "' X " spac �rg " o . c . span ft . Root rafters f�c . c . span '- £ t . Roof trusses (pre-engineered)o?R/spac : r. O . C . span ft . Exterior wall finish la / 4 r ' Of what material ? A'? "r zl ►e ca`" oe/ Interior wall finish -9 .e e7'- 940 if a garage is to be attached , describe materials to be used for FIRE .SEPAFATICN : is there to be an opening between garage and dwelling ? y If so will a Fire - rated door , enclosure , and self- closing device be prouidecl? -e will a flue - lined chimney be installed? ,ems Heighc above roof - ft . Depth of chimney foundation below grade ,21oy ft . Depth of fireplace hearth ft * in . r� C Water supply - Municipal or private well 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 ) D E G 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 ZO %IING ORDINANCE, and All other laws pertaining to the proposed work shai be complied with , whetbgr specified or not, and that such work is authorized 13 the a ner. Signature Owner, owne 's gent, architect/co or Y /e Y Ye ♦ * * * 'le Y * * Y t R R * aC 1! 14 'f * R * < Y * A ♦ R t Y Y * • * 1t * * 14 1k Y Yt 1` * * SFECIAI, CONDITIONS OF THE PERMIT : BY. ... ... TOWN OF QUE . 45SUR .. 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 : r�tt 1 . Gross floor area Z62,9 ��'� �` r� 24 'Type of heat 62,95 �/� � 9/1A 3 . Is the building mechanically cooled ? _�I✓�° � 4 , percentage of area- of windows 'rand doors /s ,,��'' A . Over 16 % Only 1 . Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 . Floor over heat - 3 spaces YES NO a . Are foundatt 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 BW Under 16 % Only 1 . R value of roof and floors exposed to ambient conditions . 2 . R value of exterior walls 3 , R value of glazed area 4 . R value of doors ! 5 . R value of floors over unheated spaces ' 6 . R value of slab edge insulation - unheated slab 7 , R value of slab insulation - heated slab B . R value of heated basement / cellar walls ( above grade ) 9 . R value of heated basement/ cellar walls ( below grade ) 104 Type of insulation 1AZS9 r?� Co Controls -7 �1 d Y . Thermostat. maximum heat setting / 7 D . Duct Systems, 1 . is duct system installed in unheated spaces '? O 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 A 2 . R value of pipe insulation ra Service dater Heating •( 1 . Performance efficiency 2 . Temperature control setting maximum G . £'or swimming Pool Only 1 . Maximum heating Telephone No . � � �' '� � �'" - ( a p icant ' s s gn ure ? TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMrr DATE LOCATION OF PROPERTY [FOR INSTA-LL,�A/''TION ,� . ,� i(� ` /�ZA219 e Owner's Name* rrP_ /! �e d7 // i L�Teleph©ne: / �r- d Address. /r/ 1v ep e' -e, �ril9 •mil !r T .'�S r /f '� Installer's Name: �I /QO C /r p? I- Telephone: ,r� �r �!'•�S Number of bedrooms (residential only) Total daily flow (compute Ca 150 gal per bedroom) ' 67 Topography: Circle one: Flat Rolling Steep Slope 96 of Slope -- 7' Soil Nature: Circle one: Sand Loam Clay Other S AAr"/ /Depth: Feet Ground Water: At what depth? 400 /� 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 Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank /006 gal. ( minimum size: 1 , 000 gal.) TILE FIELD : Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of / Size each feet by C6 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 nitary Sewage Dispo Ordinance. SIGNATURE OF RESPONSIBLE PERSON: DATE: - OVER 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 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 luilding 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 bt submitted to the Queensbury Building Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Havi.land Roads Queensbury , New York 12804 k�no:srks : TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBU'RYo NEW PORK 22809% TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR' S REPOFT REQUEST INSPECTIOY RECEIVED NAME LOCATION DATE PERMIT # APPROVED 1 YES NO FOOTXNG/PIERS MONOLITHIC POUR S FOUNDATION/DAMP— PING BACKFILL APPROVA ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—I INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTIONr CHIMNEY HEIGHT — ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS—CLEARANCE & RAILS PLUMBING FIXTURES/RELIEF LVE INTERIOR TRIMIPRIVACY FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS :.. -- FINAL ELECTRICAL INSPEC4 A FINAL APPROVAL OF CONS T Uit7 ION OK TO ISSUE C/O OR C/C A SIGNED CERTIFICATE D UPANCY ST BE OBTAINED FROM THE BUI IN DEPARTME BEFORE THESE PREMISES ARE OCC PI Df REM�A+'RKKS : ce U ! P,/ ARRIVE DEPART —__'ter+ -- INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YOR 1280k TELEPHONE (518' 99 —583,2 BUILDING INSPECTOR ' S ORT REQUEST FOR INSPEC ON RECEIVE NAME LOCATION DATE PERMIT ffq . I LL� APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFI G BACKFILL ,APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING �_.. EXTERNAL PORCHES/S STAIRS—CLEARANCE RA w -- PLUMBING FIXTURES RELZ zF VALVE — INTERTOR TRIM/PR VACY RS FINISHED FLOORS GARAGE FIREPROO ING DOOR CLOSERS} SMOKE DETECTOR FINAL ELECTRICA INSPECT N FINAL APPROVAL F CONSTR TION � DK TO ISSUE C/ OR C/C A SIGNED CERTI ICATE OF CUPANCY MUST BE OBTAINED FROM HE BUILDIN DEPARTMENT .BEFORE THESE PREMISE ARE OCCUPI d REMARKS: +' p . rri c ARRIVE DEPART INSPECTOR `I'OTVN OF QUEENSEURY BUrXAOrNG AND CODES BAY & HAVXZAND RQABSEPAR7'MEN7' QUEENSBVRY, NEB+ PH TE YC3R3[ 2280e1 ZEPHONE (518) 792-5832 BUILDING INSPECTORPS REPORT RES7UEST FO"R r / C7lV RtsCEIVEli 1VAME ZoOcAT.rON DATE d _-� ERr�rT # c-- APPI?OVET F ooTING/PIERS s. YES ArO M'ONOLITXrc POUR FO F'OUN4A2*2QN/DAMP. WOO aACXFXZ APPROVAL --� PRAMING ELEC27?rCAL I2CJUGhi-IN r .Z'NSIILATzoN: FQUNDATroN FZOQRS. NArLs CEIL 1"NG FTIVAL xNSP�czro�.: *1 CHIMNEY XtsIGNT' RQOFrNG Sr.D2NG EXTF S2 'RNAL PORCAE 7AIRS'- PLi1MBrNGpRANCE & rzs rrvTERTOR 2'RrTU.RE"S/RE SF LVE FIN rSHED F ZOORS GARAGE FZR?sPRC.l"JFTN D004R CLOSER (SJ SMOKE D�EC27!7R,g _ FINAL ELECTR-rCAL IN PECT'rON FINAL APPRQVAL OF ` OXc T'o 1rSSL]E C/O ORC C./C NS2RUc2vXoV A SIGNED CER2*rF2CA OBTArNgD FROM THE OF OCCUPANCYt MUST B rHESE PREMISES U.tLDX&G DEPART E AR OCCtJP�E33i NT B `FORE 40 .`.'z. `�, �✓2 SAC- Ile `wZ. ONVA MIDDLE DEPARTMENT 90o "NSA" F ION AGENCY, INC. per} VL,+Ci' tif[ 1'q that t ,r,> d1 oats March 232 1990 el h- with the National Electr; ectrical equfprnent lister) has been�exar ,e a901 Cade, aPPlfcable governmental, utility and .A Ppra�ed as being in accord Owner S r_ elllielt Ke I ] fir , ?P X es, m x �Occupant: Sillgle kain!] y p i, � l : Location �ir Lot 70 linple - ])ri.ve , (�u`rerlsbu9Cr > .,,. 5 . `'certjfkcate t Equflornent: date. It additional of ! Iprnonf and inetallahon pecrrd this ill) Lilt le ZS r, J 1eCQ ttlCles e.iafln s �6n1 efr be introduced Ina rl yy y- C g system lhl� eed or nlCeraltdna made to �/ L_11i17 J X"�+-1,4' I „ $ '"+ ' l�.' =YF insyeelron snauftl gpa bmltt be n41! and Void. And &Pplication tar s `u' A /WdOF of this oepificrte &h p Y to This ApancY. (agent or com ent name to kdr P+opartY Insurance carrier as apecitied. par+Y1 eselri 41"Ification of electrical i ui 9 pmant rppro*Wd Applicant: 11. 110w Fioa 3 Italr'S : i �lttr?erlsbiii"y , tdY 1 ? 3Qli` � R 0. 15 -03 17 7 6 knrwl atn >n9 FI � e• V . a TOWN OF QUEENSBURY BurLDrNc CODES bEPARTME1yT BAY 6 AND!YA [�rLA,I'VD ROADS' QUEZArSB4VRYr NEW YaR1C 228pg. TELEPIICJNE (528) 792,5832 Bu.Tr W.r rc k�s EcroR s REPORT �uEST .N,SPECT aN RE'CEr[rE"D ,j �-� LIJG'AT3'd � DA20 2'ERMIT # /. +21PPROtisEL7 k'at7T tNG/F�IEIS YES NO M0wor rTHj_C POUN'DATrt7N/Dyp-PAR S AACKF.rLZ APP k'rNG ROUGH p +�vAL FAA 1:C1M8IMG MrNG EZRCTRI"CAL ROUGH-IN rNSUL,A 2"2 ON; FOUNC?ATrON FLOORS WALLS CErLrNG PrNAL rNSPECTIOcy CHrMNEY HE2GHT RaOF2'NG SrDrNG E`Y2'E'RNAL POli'CHE STArRS-CZZARt1N PLUM.B.I'NG FT)r ES RAr�� rnT7'ERrOR ELrEF VALL'ts PrNrSHEb FRrM PRrV CY DOORS GARAGE p s rR'E1' �R CrosEp SOaPrNl SMOKE DET P?NAI. ELECTRF$S CALPrNAZAFpRp L aP rCNaSPIS TroT1v If NRUCr ay�* -' .� A SrGNED c ,RTrFrC OB2�AINED ATE OF OCCUPANCY ROM THE BUrLD * 5T BR THESE PRE�1rSEs ARE G DEPARTMENT BE'PORE aCCU ED1 REMARKS: za .may r'l7 TNISPECTOR TOWN OF QUEENSBURY Dt jy G AND BAY CobE'.S DEPAR!PNENT & HAvrLANb ,ROADS C�CIEENSBCTRY, NEty YI7`RK -I / T'EZEPHONE (518) 792-S � B32 9 to BUILpING INSPEC rpR S REPORT uEsr FOR rNsP NAMErroN RRCErvsb r4CATroN t 'f aa•�s c t'o p . ST # Ff7d2'IN�/AI RS A'd'.Pj?OVEb MONO YES NO LITh*IC POUR F Rms FOUNMAT-ros. PRp Aly VAL p_p lr NG btAC+T{F 1-,T,L, AP ROUGH �'LUMBxlVG PRANZNG �' C7RSCAL JtirCK7GH -1r NSULATrON; E'OUIVmAT2ON FLOORS WALZs cE-rL2NG _ FrNAZ rNSPgCrroNx cHrM+�EY HErGHfi 1''OOE`2'NG SrbrNG E.XrERNAL p0'RC E`.S/ST.&'PS SMA-rRS-CLEAR, CE - ~ ` X'VMBxNG Fx.'Y RAxZS RRs FrNTsH,6D 2'Rr /PRrVACyrEF ALVE SHED I, GARAGE FrREp7FrNG "�-- DOOR cZOSER( J SMOKE b�rEC RS PTI Z, ELEcrRxC L rNSP� FrNAL APP120VAL pF crrl7N C0N.5rRL*CT2G+N SrGNEI� CER2 �FICA2'E PBTASNEIS PR04V rHE .BUrO OCCUPANcY VU,92' rHEBg pR'E'MxSES 1'NG bEPARTMENr BEFp ARE Occur j f RE RS. RK.S•: xNspE•crOR T01VN OF QUEENSBURY RU-rLD1'NG AND CODES DE'F'ARTNzXr BAY & HAVXLA VD ROADS QUEENSBURY0 NEW YORK 128p¢ TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT EEL�UEST FO NSPECTI(71V RE /// NAME EIVED___L /I J , rOCATXON DATE c^ T PERMIT # APPROVED F002'SNG/PSER YES NO MONOLXTHXC UR FORMS F'OUNDA7'XON/D p BACKFTLL APP PRC7DFXNG lltj?6UGH p VAL LUMBX G +-�"RAMXNG ELECTRICAL R GH- XN INSUTVATION: rOUATDAT.TON FX.DORS WALLS CEXL-r FXNAL XNSpECT ON CHIMNEY HEX T ROOPXlVG SXDXNG EXTERNAL PORC ES/SIT FS STAIRS-CLEARA E & I PLUMBING F1 X U LS XNTERIOR ES X/ ELXEF VALVVE TRXM/ ,� -'- FXNXSHED FfpORS Cy DOORS - GARAGE FIREPROOF NG D00R CLOSER (S) SMOKE DETECTOR F'TNAL ELEC'TRX INS CAL `- xXN APPRO AL ECTXON_ VAL F CoN �-y TRUCTTOv A SIGNED cERT `-�---� OBTAXNED FRO, XCATE OF CUPANCY THE BUXLDI MUST $ THESE PREmr s ARE occtrFr C DEPARTMENT BEFORE, Ds REMARKS: �_, r i t YNSPESCTOR �� _Jocun o� �ueen -s6ure� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. O. 1 Box 98 4ueensbury, New York 12801 SEPTIC SPOSAL SYSTEM INSPECTION 4 d NAME LOCAT I ON DATE Z./,52 PERMIT NO. q SOIL TYPE - Sand - Loam - Clay - Percolation Test Required ? YES '- NO' Percolation rate - Min/Inch TYPE of SYSTEM : Absorption field , tal length Length of each tren h Depth of trenches Size of .Travel_ SEEPAGE P TS{Number ) Size- t , X _ f Gravel s�.ze PIPING : - e Bldg . to tanks Tank to ciist . box Dist. boy: to field) Openings sealed? ES O artza LOCATION/sEPARA ON Foundation to k ft. Foundation to bscrption 7. ft. Absorption to of line t , Separation o pits ft. LOCATION OF YSTEM ON PROP (circle one) Front - ea - Left side - Rigbt side - CCM.MENTS : SYSTEM USE APPROVED 'YES N B i n Inspector 01/86 and v1 TOWN OF QUEENSBURY BUXLDXNG AND CODES DEPARTMENT .BAY & HAVILAN 17g- ROADS �� QUEENSBURY, NEW YORK 228 TELEPHONE (518) 792-5832 BUILDING INSPF.CMR' S REPORT REQUEST FOR XNSPECTION RECEXVED NAME LOCAfiXON DATE -,. r - ! F'ERMIfi # APPROVED YES NO FOOTING/PXERS MONOLXTHXC POUR FORMS FOUNDATXON/DAMP—PROOFXNG f,,,gA'CXFX.I.r.L, APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—I XNSULATTON: FOUNDATION Id FLOORS WALLS CEXLXNG FINAL XNSPECTXON: CHIMNEY HEIGHT ;r ROOFING SXDXNG EXTERNAL PORCHESIST PS STAIRS—CLEARANCE & RAILS PLUMBING FIXTURES RELIEF VA VE XNTERIOR TRXM/PRACY DOORS FINISHED FLOORS GARAGE FXREPR C XNG a DOOR CLOSER (s) , SMOKE DETECTO S FINAL ELECTRXC XN'SPECTXON FINAL APPROVAL OF CONSTRUCTION A dSXGNED CERTXFICATE OF OCCUPANCY MUST BE OBTAXNED FROM THE BUXLDXNG DEPARTMENT BEFORE THESE PREMXSES ARE OCCUPIED!- REMARKS: A4NSPBC!MrOR TOWN OF QUEENSBURY 14 BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS ,f QUEENSBURY, NEW YORK 22809, + �` TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INS E TION RECEIVED NAME LOCATION DATE ��� PERMIT # e' ( '/ 6 T^ APPROVED YES NO FOOTING/PIERS lomOLXTHXC POUR FORM FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCH (STEPS STAIRS-CLEARA CE & RAILS PLUMBING FIXTURESIRELIEF 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 U L,T L n IN PECTOR �y MIDdLf-I1IEPAPATP M A INSP>£ CTI l �11 Y, aNC. -»� National Headquarters 900'kadd6n RlCvd.-, Mill ingswood, -NA ooios Date: City, Town or Township U e e 46 County- '' ► £' /G _State Location/Address fa C .R - - 1 Cj�P,,rs (If Located in .Rural Area - Please Attach Directions) Pole O # wner 's '' —. "� Ifs'/yr F�elmit # Occupied As jr Z "-'•_'7'v Building-' • '111ewKj Old © Occupant ' Work Area in Buildkn Floor #, etc.) : for: Wirin Service. or: Ready for Inspection: Fee Remitted - $ Gush Check Q &4*0:" Make Payable To: M.D. I.A. "S40 750" lbp0 124f1 1544 L750 2004 2250 2500 2754 3440 Number of Rough-Wiring Outlets Elect°: Heat1. Switches Lighting Amp. Service Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amer Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.i', 1/2 1/12 1/10 1/8 1/6 1 1/4 1/3 1/2 3/4 1 14z 2 3 5 7% 10 15 20 25 30 40 50 75 1 100 Mark Number of Each Size WIN pilliliplil Pill 11 Applicant's . Signature License # Permit # T/A Utility * Applicant s Ad dress, !� �=•' ?V e4f (NAME) (OFFICE LOCATION) (City) '. i (State) Ad' IZip) " / Service Request # Phone # Electrician: DATE RECEIVED: DATE INSPECTED: Correct Location : Same as Above Q or: Red Notice Label Rough Wiring Outlets Surface Unit Oven.-' Switches Ran Garb :Disposal ' ReceptApeles Water Heater Dishwasher Fixtures Air Conditioner y" er ;' , Amp. Service Equipment Burner; Wlrinil &`Controls for Amp, .Radeprache . Amp, Service Conductors Pump Vent Fans MOTORS FI,P, 1/20 1/12 1/10 1/a 1/S 1/4 1/3 1/2 3/4 1 3 5 7Y2 10 is 20 25 [40- 50 75 -[loo ., Mark Number of Each Size 11 e - Elect. Heat 504 750 1000 5 12" iso4 i750 2004 2250 240 750 3", RW Progress: Inc. Q LKD Q Contractor _ 0 CFT Violation : Work Comp, 0 Inc.. Cp.SH 0 LIA Owner = GQ L!A Fee: CHK # t7ue.Q #IPA Municipal MO : . INV 40 Appl scant Q Date: Other Sided Utility Owner [] Cut in Card Temp # Date aI' 0 Final # Date_ _x '. INS CTORS SIGNATURE s � APPLICATION FORM NO. 250 EL 31/86 ;;ssM�r;`•s: TOWN OF QUEVASBURY Zoning Administrator Date—g!,Z*=�- Ah of 1