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1991-100 J r.1 ---- - CERTIFICATEL ®F OCCUPANCY TOWN OAF QUEENSBURY WARREN COUNTY, —NEW YORK . ,a Date May 20 19 91 ( ct This is to certify that work requested to be done as shown by Permit No. q1-1110 has been completed. This structure may be occupied as a Single Family Dwelling ra Location _ WaltonCourt Owner Forest Wood Homes By Order Town Board TOWN',OF QUEENSBURY Director of Bldg. & Code Enforcement 1 BUILDING PERMIT • P TOWN OF QUEENSBURY No. 91-100 WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to Forest Wood Homes N OWNER of property located at Lot 43 Walton Court Street, Road or Ave. es,, 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. 1. OWNER'S Address is HC-02 286 P Warrensburg, HY ro In 2. CONTRACTOR or BUILDER'S Name Same 0 0. 3. CONTRACTOR or BUILDER'S Address 0 ro N • — 0 r+ 4. ARCHITECT'S Name �1 r+ 5. ARCHITECT'S Address C9 O C r+ 6. TYPE of Construction— (Please indicate by X) (X)Wood Frame ( ) Masonry ( )Steel ( ) • N 7. PLANS and Specifications -+ No. 1,462 sq ft Single Family Dwelling as per plot plan specifications and application a 8. Proposed Use 9, • Single Family Dwelling 4. 4 ro $ 191.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 21, 19 92 (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.) Dated at the Town of Queensbury this 21 Day of March 19 91 SIGNED BY � i'�sz for the Town of Queensbury Building and Zoni spector .,. i , ' ENERGY CODE COMPLIANCE APPLICATION ' I TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS Compliance Methods: PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) AIYANCrn11".= PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings; 19* 1 Multi-Family Dwellings (3 Stories or Less) MAR 1 9 igqi PART 4 - Design By Component Performance - Commercial Buildings - HtttApeRasidential ctLAAuc iarJrr , PART 4 & 6 - Compliance Methods Require Submission of Worksheets FOreA+ WP9r) PDmp,s Ot I/4 A/ 1°A i't Oneetirkfpl forad• APPLICANT'S NAME PROPERTY LOCATION " ' / PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area - 1114d Sq. Ft. 2. Type of Heat - Elec. Base Board Other rf Ad- air 3. Is Building Mechanically Cooled? YES v( NO 4. Percentage of Area of Windows and Doors Over 17% v/' Under 17% THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED THE R-VALUES SHOWN ON PLANS SUBMITTED! Baseboard 5. Insulation Values: Actual Shown Elec. Heat Other A. Roof & Floors exposed to ambient temperatures R 20 B. Exterior Walls R 0 C. Glazed Area R 3 D. Exterior Doors R 11 E. Floors over unheated spaces R /9 F. Edge of Slab on Grade (Heated Building) R, harli 1 G. Basement/Cellar Walls (Above Grade) R. H.H. Basement/Cellar Walls (Below Grade) R . I.I. Heating/Cooling - Ducts - Piping in Unheated Space R 10 6. Service (Domestic) Hot Water Heating Device A. Conforms to minimum efficiency per code v( YES NO TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED af(A ir, ill! 03-3179 APP116Ak'S 'SIGNATURE DATE TELEPHONE NUMBER ' - INSPECTOR'S REMARKS: REVIEWED BY TOWN:OF QUEENSBURY '/ REVIEWED BY FEE PAID $ . TOWN OF i .. 1�� y QI.DE£ItiBI�L1�ly %%SR PERMIT NO. �" RECEIVED BUILDING PERMIT"APPLICATION :MAR 1 9 1991 . BLDG. & 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. * • * * * * * * * * * * * * * * * * .* * * * * * *_ * * * * * * * * * * * * * * * The owner of this property is: focvr) k[t,,,d P.O. Address 1/(- 0 Oa;mpg kva N.Y. Tel. h23"3979 Property Location h f V L Mn (oaf/ Tax Map No./ ///// '/3 Has there been any split of this property since October 1, 1988? / V If yes Planning Board Review is necessary. yes no SUBDIVISION NAME, IF APPLICABLE (Vows kir 1`dr,it LOT NO. 4& THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:.. I D ri,-c1 Iiintsd Homes • NATURE OF PROPOSED WORK: ESCIMATED MARKET VALUE OF - • CONSTRUCTION: $ /�o h�� 1/Construction of a new building » Addition to a building • COMPLETE INFORMATION REQUIRED BELOW: /is- /sb * Size of property tiy,gq ft x 'gam 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 and y 3s— ft. Rear yard 1,73 ft.' * - Side yards 3.s" ft. and 3/� ft. GROSS AREA OF PROPOSED STRUCTURE If on corner, setback from side street ft. 1st Floor $; sq* ft. c' - - *- OCCUPANCY INFORMATION /) ,. 2nd Floor 4p'. sq. ft. �� .i 6� * Primary •Building - �., y One Family Dwelling Other Floors sq. ft. I (not cellar or baset Two Family Dwelling TOTAL FLOOR AREA._= sq. ft. • Multiple Dwelling/Number of units Size"of new structure6t�ft x yg ft. • Business Foundation-pier/slab/c2:_-f_ tia1 full * Industrial (circle r. • Other • No. of stories (habitable space) a • - Height (grade to ridge) fi- ft. • If addition, what will use be? If residential, no. of families / • •No. of rooms(excludin! beths) Accessory Building No. of bedrooms. j • Detached Garage ONE/TWO Car No. of bathrooms a • Primary heating system hot ail • 1/ Attached Garage ONE WO Car Type of fuel ORS ' _Private storage building No. of fireplaces to be installed 110 Other • Will a wood stove be installed 0 Central Air conditioning OV' ER BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS: Type of construction, wood frame, fire safe, etc. sfick by; l� woo c cwwP • Will' any second-hand or upgraded lumber be used? If so, for what? Vln. Foundation wall material ,`„ 'P. Thickness Depth of foundation below grade (to bottom of footing) I/te Will there be a cellar? ho Heated or unheated? Floor sq. footage sq ft. Will there be a basement? Will any portion be:used as living space? no (If so, what sqft. Type portion? � ' T e of use? Type of roof - sloped flat/shed/other Material of.roof Grs,,;4 /J Size, wood studs a- "x " spacing /�, _" o.c. length ft. Joists (floor beams) 1st floor ,2 "x " spacing ./6 "o.c. span /4) ft. Joist (floor beams) 2nd floor � "x " spacing /i, "o.c. span /a ft. Overlays (ceiling beams) "x "spacing " o.c. span ft. Roof rafters "x " spacing o.c. span ft. Roof trusses (pre-engineered) spacing d y o.c. span 3 -ft. Exterior wall finish V,'ti � sr�ha of what material? Interior wall finish silo pi-ro r,fr �r,�r, aa,,d eaiHle sr- If a garage is to be attached, describe materials to be used for FIRE SEPARATION: c(v�-�,-dr L p.b -c rP iIiL,G . sLo,(7-yrnt P.i,-kri' I/Jalf hr-1.APPP,v, hn1A.tr aMcl q<,rmcr S�Ow---1 walic Is there to he an opening between garage and dwelling? 1P , If so will a Fire-rated door, enclosure, self-closing device be provided? yes Will flue-lined chimney be installed? yio Height above roof , ft. Depth of chimney foundation below grade ft. Depth of fireplace hearth ft. in., Water supply -CMunicipa])or private well SEPTIC SYSTEM Distance from ANY private'well (including adjoining properties �' iod ft. (A separate application is necessary for any repair or new installation of septic system) NAME OF BUILDER / �/>7?°(l��dn4� �77114u.,(O,< ADDRESS i/(+-P,1hnxni, blorvarlo,TEL. NO. 6a7 -?979 NAME OF PLUMBER ‘),,t 04,4jy'vi ADDRESS P$4,1;1 S+, alhc , TEL. NO. 7//- DO/y NAME OF MASON die( P/,r/4 oj1,�j ADDRESS NR„ le cf 1ud( f TEL. NO. 7y7- p�a� NAME OF ELECTRICIAN k A/y/ j ADDRESS f awJ-/pIeYn, lob, TEL. NO. 793-/(//t/ 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. Signature �N /I Owner, owner's agent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT: BY TOWN OF QUEENSBURY s`r J APPLICATIOf1 FOR SEPTIC DISPIZIAIMPURMICRJEENSBURY gg RECEIVED DATE: AilikAnpill MAR 19 Nat Y-�9 LOCATION OF PROPERTY FOR INSTALLATION /O 9,3 7, ; CouJ;,F t a as,,n hrh - BC . & CODE.DEPT. Owner's Name:- Fore cf n nrw a.,A Address: UP- (L m) o 110 arrat S intro y © • Installer's Name: dart. ec JTelephone: 1°17- p Number of bedrooms (residential only) L4 3 Total daily flow (compute @ 150 gal per bedroom) 11,(13 Topography: Circle one: Flat �ollin Steep Slope % of Slope Soil Nature: Circle one:'aand Loam Clay Other /Depth: Ground Water: At what depth? -0 Feet Bedrock or Impervious Material : At what depth? Feet Percolation test: Circle one: not required required Rate - Min. Per Inch Domestic water supply: Circle one: Municipal Well Other If domestic water supply is a. well : Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank ton O gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench c) feet/Total system length n r feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used W. /Depth or Thickness / feet ***************************** HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks \ Size of Each Gal . *Alarm system and associated electrical work to be inspected by an approved agency. 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. 91 SIGNATURE OF RESPONSIBLE PERSON: 6441 DATE: 11 14 , ./PF I• • • Seep'Cic 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 co the Building Department at lease 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 co any water supply 5.) size and dimensions of all tanks, distribution boxes. tiles fields anal/or drywalls B. Nu system shall be covered before inspection and approval by the uuilding Inspuctor. Failure to comply with this requirement may • result in the uncovering of the system by the installer and a fine _ uf up to $250.00. • C. An approved copy of chi plot plan shall be available on .the construction' site. Failure co produce said plot plan at tune of inspection may result in an immediate work stoppage. - D. Should unforeseen -problems during construction prevent proper installa— tion, alteration or repair of an approved system, a new proposal must be submitted co the Queensbury Building Department before further construction. Town of Queensbury • BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 kgmarks: • :. I/ _ - MIDDLE DEPARTMENT-INSPECTION AGENCY- I:NC. - . i National Headquarters 1337 West.Chester Pike,West Chester,'PA 19380 - APPLICANT COMPLETES THIS SECTION Date: r a.-. , . City, Town or Township County . . State . Location/Address • . ,� • ? .'' ` - r—r. (If Located in Rural Area-Please Attach Directions) ' Pole # J Owner •":.— i - Permit #. / // / 0 Occupied As - Building: New Old n Occupant Work Area in Building (Floor #, etc.): App. for: Wiring n Service n or: Ready for Inspection: Fee Remitted-$ Cash n Check n " M.O. n Make Payable To: M.D.I.A. 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 - Number of Rough Wiring Outlets Elect. Heat _ Switches . Lighting Amp. Service - Surface Unit Dishwasher .Range Water Heater Air Conditioner Dryer " Pump Receptacles Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: ' MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1'/2 2 3 .5 71/2 10 15 20 25 30 40 50 75 100 Mark Number - of Each Size Applicant's Signature License # Permit # . T/A Utility: Applicant's Address: '' i (NAME) (OFFICE LOCATION) (City) (State) (Zip); : - Service Request # • Phone # - Electrician: . MDIA USE ONLY DATE RECEIVED: DATE INSPECTED: Correct Location: Same as Above n or: _ Red Notice Label n Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures _ Air Conditioner, . Dryer- , Amp. Service Equipment Burner, Wiring &Controls for _ Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1'/z' 2 3 5 7,/z 10 15 20 25 30' 40 50 75 100 Mark Number of Each Size 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 Elect. Heat CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT FEE PAID ❑ RW Progress: Inc.❑ LKD❑ Contractor ❑ CFT Violation: Work Comp.❑ Inc. ❑ - J L/A • Owner CASH ❑ (� L/A Fee CH K # Due MO # n IPA - . Municipal • INV # Date: -- , Other Side Utilit Applicant . Y Owner 1 •Cut in Card n Temp # - Date - . n Final # Date INSPECTORS SIGNATURE APPLICATION FORM NO.250 EL 11/89 • -- S.4 .1,./."��l,?!1".a.4• 4 ,n;14,� i.��i,:���,I,A4!."- 4.t i 0�i". 4?..A 1. ,�r..1�i. 4."a4 ","...1.. aw..,nA�r air n.40aa"J.4, ��,?•.,10!,r 4.: 41 1.414?-14f,4,E 4 ji THE NEW YORK BOARD_ OF FIRE UNDERWRITERS F' ,G_ 1 i!.,, r BUREAU OF ELECTRICITY 1i �17J98 41 STATE STREET,ALBANY,NEW YORK 12207 i' Date Application No.on file - �' MAY 15,1991 06737'�91_/91 H 411366 - '. THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of • FOREST WOOD HOMES, 1 `' TtiALTER rT , OUEF SBURY, _\.`, . - _ - r in the following location; ' Basement 1st Fl. LLJJ 2nd FL Section Block Lot ' . GAR :3 ►; was examined on MAY Y 1 0 1 9 91 and found to be in compliance with the requirements of this Board. - 'ii jFIXTURE. ECEPTACLES SWITCHES FIXTURES `I RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS I OUTLETS INCANDESCENT-FLUORESCENT OTHER I MAT. K.W. MAT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. t! _ i; Ir 4 - iP '0 38 26 19 1 5 1 1.5 2 _ �' DRYERS FURNACE MOTORS FUTURE APPLIANCE 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. mAT. H.P. N SYSTEMSF AMT. WATTS ti . 1 " 3 1 F - 1 __ :' --SERVICE-DISCONNECT NO.OF S .E -- R - - V I _. -- C E - AMT. • AMP. TYPE Kw. 1,0'2W 1,B 3W 3,R'3W 3,0 AW NO.OAnrCOND. OF CG COND. NO.OF HI-LEG OF HI-1 G NO.OF NEUTRALS Op NEUTRAL • i .('to 200 CB 1 X 1 :1,/0 • 1 _2/0 ; OTHER APPARATUS: :� 7. G.F.C.I:-2 . SMOKE DETECTOR:-1 f jr i 1 / = jN . 111... _ . .\N.,§)/ • 1, -ki \X - '. " - .41../i-- •••,1.*-;•• •�`•♦ ate .. • 6 .(o• •,50 . ( . FOREST WOOD HOMES _ tru7 -i C286P . BRANCH MANAGER �. W`ARRENSBI5RG, . NY, 12885 �, 9 , • . - •• Per` This certificate must not be altered in any manner;- return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ': i-i'43 ME ® Mill NW ® WI 0 ® ® 0 0 0 0 B 0 MECMU-Nr- [vr\firvtngt\it�t�tvt', ;�''. , F; TOMN O QUEENSBURY ,/ / x0/41 ' , 531 BAY ROAD :;0, jy: QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING IfSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED ,j//th/ NW YRI, — 6i—e�G -- .� -/ LOCATICA -ii- �7%L . 61 TE Y�/ Cl/0 • PERHIT# 47—/O"--0 TYP STRUCTURE RECHECK .,*tza1 r itc/l_tier J FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) OOTING FOUNDATION yBACKFILL RIMING € -ROJGH PORBING /SAL ELECTRICAL_SEPTIC h.LOSULATION WOODSTOVE/FIREPL `CE ` SITE PLAN/VARIANCE REQUIREMENTS i_YES _ HO REMARKS I I / APPROVAL N/A Y gS NO CHIMNEY HEIGHT/LOCATION J ! B VENT/LOCATION ;. ,/�/j PLUMBING VENT ;k ' ,// ROOFING • J/ SIDING k` 1 DECK/PORCH/STEPS/RAILINGS A / �/ RELIEF VALVES j ✓/ FURNACE/HOT WATER OPERATING i/ ✓ . BASEMENT INSULATION/DUCTWORK/;;' ✓ INTERIOR TRIM/PRIVACY DOORS/ ''. ' , ' FINISH FLOORS: J +' BATH/KITCHEN WATERTIGHT, d OTHER FLOORS SWEEPABL, ` ✓/ OTHER FLOORS CARPETED 1,1 p/ STAIR CLEARANCE/RAILT+�]GS •� HANDICAPPED ACCESS SMOKE DETECTORS J BATHROOM FANS/WHOUEHOUSE FANS ALL PLUMBING .FIXTURES OPERATING J GARAGE FIRE PROOFING h r DOOR CLOSERS / OTHER FIRE SEPARATION , FIRE/DEMISE WALLS DUMPSTER if s: FINAL ELECTRICAL / OK TO ISSUE C/O OR C/C ,! COMMENTS: _/".fife/r2Aliaik 18 2 V - 5'/WT/ . ARRIVE DEPART 1 -o Iy i �/ � / IN'; OR A7i) TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED II )IC)) NAME 1: Y r-5 (Th ` LOCATION )6+ Li 3 boott f c C 1)— DATE ( 110 IC) PERMIT # l —/00 TYPE OF STRUCTURE 5 i'(\o Ou>e Ona/ v RECHECK APPROVED . N/A YES NO FOOTINGS/PIERS if MONOLITHIC POUR FORM P' REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE t FOR PROVIDING PROTECTION FROM n FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE.- MATERIALS FOR THIS PURPOSE ON ,SITE FOUNDATION/WALL POUR / ' REINFORCEMENT IN PLACE b / FOUNDATION/DAMPROOFING p' f BACKFILL APPROVAL ROUGH PLUMBING f PLUMBING VENT/VENTS IN PLACE 6; ,,f PLUMBING UNDER SLAB - -(. /— __ FRAMING: / JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM I/ HEATING ROUGH—IN INSULATION: i FOUNDATION WALLS INTERIOR. R:— X FOUNDATION WALLS EXTERIOR R° FLOORS / RL x. WALLS / RI— 19 ;1C CEILING DUCT WORK OR PIPING I UNHEATED SPACES REMARKS: /// ARRIVE //; DEPART /i:2 .4,e> INSP CTO ) f\r\TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT V 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED /t /9NAME cye � �OC)C es LOCATION )--G-- / ), li 'r.' �ti CNA Ou2e.LSUuv 461,-& Y DATE 2-0 Cj/C] / PERMIT'# c 1- - /on TYPE OF STRUCTURE S 1 n e cvl� CSC 11 RECHECK (/. APPROVED / . N/A YES NO FOOTINGS/PIERS + ,` MONOLITHIC POUR FORM REINFORCEMENT IN PLACE ;' THE CONTRACTOR IS RESPONSIBLE' FOR PROVIDING PROTECTION ,FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ,7 -ROUGH PLUMBING !/ PLUMBING VENT/VENTS INN PLACE PLUMBING UNDER SLAB , )+yFRAMING: I i JACK STUDS/HEADERS BRACING/BRIDGING/ j JOIST HANGERS / JACK POSTS/MAINEBEAM HEATING ROUGH-IN;" INSULATION: 1 FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS ! R- WALLS ! R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES 1 REMARKS: / Z.4 ARRIVE 4f DEPART !�/ ; x/ / INSPECT'• awn o/ Queensbury CT BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98/i�% Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME A-Mea 7/ 1 to LOCATION S - , , f � o= - DATE-I/J / gf PERMIT NO. SOIL TYPE - - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total lenjth ft) Length of each trench 5 A Depth of trenches..—,3' Size of gravel SEEPAGE PITS{Number of) ' Size- ft. X ft Gravel size PIPING: ;Size Type Bldg. to tank a/ ,. Tank to dist. box t !'Y Dist. box to field/pit Openings sealed? YES NO Partial LOCATION/SEPARATIONS:' Foundation to tank Foundation to absorption yj ft. Absorption to lot line ,Td ft. Separation of pits Al' ', �, ft. LOCATION OF SYSTEM/ON PROPERTY(circle one) Front `m % - Left side - Right side - COMMENTS: ,/ �I l SYSTEM USE APPROVED Ifte NO B ding Insp ctor 01/86 and vl TOWN OF.QUEENSBURY ( --e%` • BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 'j/ V NAME :c�Nr-e o r) /-iryT'i -}— LOCATION n DATE,7/ /'9/ PERMIT # 9/ / 00 TYPE OFI STRUCTURE i\0,O,0P, 1-u-i2 O RECHECK APPROVED . N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE ?` THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM / FREEZING FOR 48 HOURS FOLLOWING r d THE PLACEMENT OF THE CONCRETE. , ryr MATERIALS FOR THIS PURPOSE ON S:rTE FOUNDATION/WALL POUR j" REINFORCEMENT IN PLACE , FOUNDATION/DAMPROOFING / / XBACKFILL APPROVAL ,1 / ROUGH PLUMBING 11 1 PLUMBING VENT/VENTS IN PLACE / PLUMBING UNDER SLAB I FRAMING: a/ -JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM 11 HEATING ROUGH-IN / j INSULATION: / FOUNDATION WALLS IfTERIOR R- FOUNDATION WALLS &(TERIOR R- FLOORS / t R- WALLS / R- CEILING / r R- DUCT WORK OR PIPING IN UNHEATED SPACES o / REMARKS: ARRIVE DEPART / � ^�' INSPECTOR cza--rc_, ir) TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED `j r 6/Ci f NAME cif) C� `5+ L90O r i,�Yle-,S LOCATION c, 0+ L/ 3 kAl ( A to DATE v2,51 G / PERMIT # ,� - boo TYPE OF STRUCTURE S j{1cQQ. ç \Tec / RECHECK APPROV D N/A YE NO -XFOOTINGS/PIERS ✓✓✓ MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE / FOUNDATION/WALL POUR 4 REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING / PLUMBING VENT/VENTS IN PLACE . PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM f HEATING ROUGH-IN INSULATION:FOUNDATION WALLS INTERIOR R- ". FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING I R- DUCT WORK OR PIPPNG IN UNHEATED SPACES .� REMARKS: ARRIVE DEPARTC)4*-� , INSPEC4OR TOWN OF QUEENSB IRY RECEIVED MAR 19 1991 10* ']5 kai-l-oh Cowl Oyeeksigy f to BLDG. & CODE DEPT. 11,1,99 A. si(.. SO 1 „ 1 , ao 4._...---36 > �— 3S' I s i TOWN OF QUEENS URY 3i /lf .. , Zoning Adm1nistrr.or Date -Z :r?/ W o Lim Gown"