1991-126 �. CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY,. NEW YORK
Date August 7 19 q l
This is to certify that work requested to be done as shown by Permit No. 91-126
has been completed.
This strucn{rcmay be occupied as a Single Fanii l y Duelling
Location /1.0- 47 Maple Drive
Owner Rich Po Scherinerhorii Br
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-126
WARREN COUNTY, NEW YORK
l0
w
PERMISSION is hereby granted to Rich P_ Sr_hermerhnrn .1r.
OWNER of property located at 1 nt 47 Maple Drive Street, Road or Ave. v
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 n
33 Harrison Avenue
a
rD
1
2. CONTRACTOR or BUILDER'S Name O
Same
3. CONTRACTOR or BUILDER'S Address
0
-1
4. ARCHITECT'S Name
3
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
ro
( X Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 2,120 sq ft Single Family Dwelling as per plot plan specifications
and application
8. Proposed Use ..i.
Single Family Dwelling
$ 265.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 29, 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 29th,- Da/of March 19 91
1P�SIGNED BY � J �1 _�^ 5 for the Town of Queensbury
Bailding and Zonin0 Inspector
r QUEENSBURY
REVIEWED BY
.41111b.1 FEE PAID $ �
g % PERMIT NO. ct I-- 12 0
BUILDING PERMIT APPLICATION
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.
• • • • * • a * * * • * # * * # # * * * # * * * * * * # # * • • # • # * * # # # #
The owner of this property is: R;rin P. S.1Ne,0144e,C' Pnl 't7'C .
P.O. Address Tel. 198 - 04,14
Property Location o+ ." I&. • ? Tax Map No. 93 /Si V7
Has there been any split of this property since October 1, 1988? / ✓
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF.\APPLICABLE }4;d,I& / y;//S LOT NO. 77
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING-CODES IS:
R«�; P. yvl e (` 11 o r nlT r.
*
NATURE OF PROPOSED WORK: ESC:MATED MARKET VALUE OF
* .
Construction of a new building * CONSTRUCTION: $ %3 p o 0 0
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property bao ft x
Alteration to a building • * Existing Buildings(3) Size a ft. x ft.
(no change to exterior dimensions) •
Proposed building - distance from property line:
Other work (Describe) * Front yard 55 ft. Rear yard ,51J ft.
•
Side yards /8 ft. and ft.
• -
GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft.
1st Floor /p y 0 sq. ft. / •
OCCUPANCY INFORMATION
•
2nd Floor /o S d sq. ft. /MHO * ' Primary Building -
Other Floors sq. ft. • ✓ One Family Dwelling
(not cellar or base:-:ent �• Two Family Dwelling
TOTAL FLOOR AREA . O sq. ft. * Multiple Dwelling/Number of units
Size of new structure_y aft x a(o ft. • Business
�-y
Foundation-pier/slab/c? ,'. rtiai/full * Industrial
(circle ur��; ° Other •
•
No. of stories (habitable space)_ *
Height (grade to ridge) jZ, ft. • If addition, what will use be?
If residential, no. of families / •
No. of rooms(excluding baths) $ • Accessory Building
No. of bedrooms y • _Detached Garage ONE/TWO Car
No. of bathrooms g'f 2__ *
Primary heating system ��c6oce. • ,/ Attached Garage ONE�TWO Car, 3)`�
Type of fuel lUo�aral rs * Private storage building
installed of fireplaces to be / • Other
Willa wood stove be installed Atz) •
'
Central Air conditioning Ye,s
OV' ER
BUILDING PERMIT APPLICATION CONTINUED - 1111-A
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe, etc. Wood -�'('o ,.., er
Will any second-hand or upgraded lumber be used? If so, for what? Ns
Foundation wall material 1p,6p;411c
Concre.t e. Thickness a jr /o" !
Depth of foundation below grade (to bottom of footing) 7'
Will there be a cellar? Ye_ 5 Heated or unheated? ii,7 b e a,.fG a/ Floor sq. footage /Q go sq ft.
Will there be a basement? Ye.s Will any portion be used as living space? A/p
(If so, what portion? sq ft. Type of use?
Type of roof - lope flat/shed/other Material of roof '/2. eD x pIy uiooc1/ a� r F;bec',lass
Size, wood studs a "x , " spacing 4, " o.c. length ft. Sh;r Jl e S
Joists (floor beams) 1st floor 2 "x /O " spacing /G "o.c. span /3 ft.
Joist (floor beams) 2nd floor �, "x /p " spacing /G "o.c. span 13.5 ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing Ay " o.c. span ft.
Exterior wall finish Clo.pbaourd of what material? ),(,•nyL Sick',?
She
Interior wall finish e, -i•l`oc,IL a
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: $
lB A•rec.pde,
51,
Is there to he an opening between garage and dwelling? Ye, s If so will a Fire-rated door, enclosure,
self-closing device be provided? y,, s
Will a flue-lined chimney be installed? Ye, S Height above roof 5 ft.
Depth of chimney foundation below grade,✓/A ft. Zc, 'o 01e.o.1`otitic.e..
Depth of fireplace hearth 3 ft. in.
Water supply - Municipal or private well /0 vn:ai`Ja. L.
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties /of, ft.
(A separate application is necessary for any repair or new installation of septic system)
TAME OF BUILDER R. Sc,b►e,ew,e,rbor/vADDRESS 33 tio.Pf�saA) Ave,TEL. NO. 798--067y
ZAME OF PLUMBER 54-e.,/ G Alle,.✓ ADDRESS ilvd 50 fa,//5 TEL. NO. -7'I7--56 9 3
KAME OF MASON ,Dc.Le, , G,./,h,v;NADDRESS ,C7e. i4NA/ TEL. NO. 7?2-)37/
KAME OF ELECTRICIAN alike. (T ,., ,:sky,ADDRESS tan TEL. NO. y4y-3105
DECLARATION
To the best of my knowledge and belief the statements contained in this application, together with the
tans and specifications submitted, are a true and complete statement of all proposed work to be done on
me described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
11 other laws pertaining to the proposed work shall be complied with, whether specified or not, and that
4ch work is authorized by. the owner.
Signature /0.
Owner, owner's agent, architect, contractor
PECIAL CONDITIONS OF THE PERMIT:
BY
411ift TOWN OF QUEENSBURY 1
;Arta
• APPLICATIOtI FOR SEPTIC DISPOSAL PERMIT
DATE: 3)a7 /q
LOCATION OF PROPERTY FOR INSTALLATION Lai' `i1 YY1c�p 00; v e�
Owner's Name:. R ic,1n 9 . sc�..,,n ek_c_k o c' �1
Address: 40.l`c i,o N Ave.
Installer' s Name: Ric.�'l P. cciner �r)noCh Telephone: 7 78 -067 y
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) 0 O
• Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? N/A Feet
Bedrock or Impervious Material : At what depth? N/4 Feet
Percolation test: Circle one: not required) . required
Rate - ,J!A Min. Per Inch
Domestic water supply: Circle one: Municipaj Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption /o 0 feet.
PROPOSED SYSTEM: Septic Tank /c o o gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of 2 /Size each 8 feet
by gib feet
Size of stone to be used #.. 3 /Depth or Thickness o. feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks 0 Size of Each x 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.
SIGNATURE OF RESPONSIBLE PERSON: 4--1 GJ �;�—j`'--��. DATE: 3/27 /9/
•
SeptiC System Inspections:
•
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ord.inance,' shall
be submitted to the building Department at least 24 hours before start
of construction-and shall include a ploc '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 drywalls
B. Nu system shall be covered before inspection and approval by the
Uuilding Inspector. Failure co comply with- this requirement may
rasulc in the' uncovering of the system by the installer and a fine
of up co $250.00.
C. An approved copy of the plot plan shall be available on the construction •
site. Failure co produce said plot plan at cams of inspection may result in 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
bu submitted to the' Queensbury Building Department before further
coeist ruc t ion.
Town of Queensbury
BUILDING and CODES DEPARTMENT
. - Bay and Haviland Roads
Quednsbury, New York 12804
kumarks:
•
•
•
\\'\. , •
' .ENERGY CODE COMPLIANCE APPLICATION. •
TOWN OF QUEENSBURY, WARREN COUNTY -- 9000 HEATING DEGREE DAYS
•
Compliance Methods:
PART 5 - Acceptable Practice Method - ' 1 & 2 Family Dwellings' (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2. Family Dwellings;
Multi-Family Dwellings
(3 Stories or Less)
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
P c,\,‘ P• Sc.h e r,M t'h o r ill r. !-a f`7'7
APPLICANT'S NAME _ PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
. 1. Gross Fl oor Area - d I a O Sq. Ft: .
2. Type of Heat - . Gas Elec. Base Board . Other-
1,o_t
3. Is Building Mechanically Cooled? ✓' YES NO
4. Percentage- of Area of Windows and Doors ' Over 17% Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO ' R E Q U I R E .D .
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
- 5. Insulation Values: Actual Shown . Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 30
B. Exterior Walls R /9
C. Glazed Area R�
D. Exterior Doors R 9, 5
E. Floors over unheated. spaces _ R'_ -
F. Edge of Slab on Grade (Heated Building) - Rom_
G. Basement/Cellar Walls (Above Grade) R 1`j
•
H. Basement/Cellar Walls (Below Grade) R n//A-
I. Heating/Cooling - Ducts - Piping in Unheated Space R q . (o
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code ./ YES NO .
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT. BE EXCEEDED
e ....L. • 3/2 ? /-9 l - 7 9 8--O 6 7 Y
. APPLICANT'S SIGNATURE - - DATE - TELEPHONE NUMBER
INSPECTOR'S REMARKS:
REVIEWED BY
•
TOWN OWN OF QUEENSBLIRY
• Bay at Haviland Roads,Queensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date /Y 2.-7 19 91 Permit No. W"/Z6
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections. •
Applicant's Name j j- p S 1 r. , �- h� �l J- ,APPLIANCE TYPE
Stove ✓. Coal Wood
Address 3 3 N r C s o ti A ' �- Furnace Hot Air ✓ Boiler
Zero Clearance ,/ Circulating Unit
'Pcr l 1 .S it/ . Y . Zip /28 a /
Phone 7 g b_ o G 7 V Iff Non-Masonry: •
Owner's Name 5c a 5 c La ✓ e
Manufacturer /Y1 a, ; G$ 7 c,
Address Model i'Yl'5oc..-5 Outlet Size 8 "
Zip Listed by Number
Phone
CHIMNEY TYPE
Masonry: Block Brick Stone
Property location of proposed construction Flue: Tile Steel ✓
4.6T 9/7 h00.P/e— Size:
Factory Built:
- Manufacturer /4q-ics-f.cModel mm Size
('OPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall i Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $ ,046/Z-0
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$ �S
SONRY FIREPLACES AND CHIMNEYS.
• CASHIER'S DEPARTMENT
•TOWN OF QUEENSBURY, NEW YORK
lepartment: Fire Marshal Amount Collected Amount Refunded
Code Number Title a3, Ott
A173 3389 (190)Public Safety
A233 2655 (230) Minor Sales
Fee Collected from or Refunded to:
Address:
Dated: ?-9 Town Clerk or Deputy (
• •
While:Applicant Yellow and Pink:Cashier's Deparimenl Goldenrod:Fire Marshal
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED
TEMP.N DATE
CITY OR VILLAGE TOWNSHIP COUNTY
STREET AND NO.OR ROAD POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
BUILDING IS
NEW❑ OLD❑ WORK IS NEW LJ ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
lion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB- _
BASE
BASE-
MENT
1st
FL.
2nd
FL.
3rd
FL.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
❑ CONCEALED
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS
IDENTIFICATION NUMBER I`1 f ..! IL I C 1010
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT ^ - DATE OF APPLICATION SIGNATURE OF APPLICANT,
STREET ADDRESS - TELEPHONE NO.
. _ _ •, `,
CITY OR POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE
•
'^hn Street . 4f�State Street ' 570 Delaware Avenue 217 Lake Avenue ❑ 202 Arterial Road
NY 10038 ALBANY.;'NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
(518)163-2122 (716)884-1155 (716)254-0141 (315)463-8552
-1ArvnRK RfAR1) nF FIRE I INDERWRITERS
i
r 4 PAGE 1
THE NEW YOFtI� BOARD. OF FIRE UNDERWRITERS R
, -96600 BUREAU OF ELECTRICITY
-4 I 41 STATE STREET,ALBANY,NEW YORK 12207
Date AUGUST 09,1991 Application N .---on t )66660791/91 A 057019
THIS CERTIFIES THAT PERMIT NO 91126 ® '
1,
only the electrical equipment as described below and introduced b the want named on the above application number in the premises of
_ i.1,: ®`_
E RICH P. SCHERHERHORN JR. , MAPLE DRIVE (HIDDEN HILLS) , GLENS FALLS, N.Y. o
�. in the following location; 4 Basement L-J 1st Fl. 0 2nd Fl. ' GAR Section Block Lot ..7 o
z ; was examined on AUGUST 06,1991 and found to be in compliance with the requirements of this Board.
s
FIXTURE I 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.
11
-4: 43 52 43 33 10 4 F
- t, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT, TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
ii• SYSTEMS
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
1 F 1 600
ii4 SERVICE DISCONNECT NO.OF :S E R V I C E •
AMT. AMP. TYPE E�U�P 1.0 2W 1 3W 3 A'3W 3,B'IW NO.OPERCirCOND. OF CC.COND. NO.OF HI-LEG OF.HI--LEG NO.OF NEUTRALS . OFA NEIJGRAI
i it
1 200 CB X 1 4/0 .-. 1 2/0
if. OTHER APPARATUS: 1-
c•
i'
— G,F.C.I:-9 r
�. SMOKE DETECTOR:-1
..
.
iiP
'mot' RICHARD P. SCHERNERI-IORN .
33 HARRISON AVENUE ~BRANCH MANAGER
Cr u
GLENS FALLS, NY, 12801
.. 239 0
!Ai
.- Per
•
-e
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.
-eY. ?ei-i. -4- ffilifl 51111 r1 MI fl CI !I ri tl !I fl rtifl fl CI WI ri !I II ME ME rl !I !ST 11 am mama ® a ® ®
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
14-44-ev-. )ym
TOWN OF QUEENSBURY
f �� 531 BAY ROAD
QUEENSBURY, NEW YORK 12804
`-I �x TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 31 vc74
LOCATION 0-0,"! 1/7 Mold e br11
DATE g/iVg1 -PERMITO -L
TYPE OF STRUCTURE cA# ���yN,N.t • '
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION .BACKFILL X-P ING
)( ROUGH PLUMBING FINAL ;ELECTRICAL 'SEPTIC
`j_INSULATION _WOODSTOVE%FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION f
B VENT/LOCATION
PLUMBING VENT s,
ROOFING //..
SIDING 'd i /
DECK/PORCH/STEPS/RAILINGS , 1/
RELIEF VALVES
FURNACE/HOT WATER OPERATING '�}.
BASEMENT INSULATION/DUCTWORK; /�J
INTERIOR TRIM/PRIVACY DOORS ,i I
FINISH FLOORS: 'i
BATH/KITCHEN WATERTIGHT y1'
OTHER FLOORS SWEEPABLE A di _
OTHER FLOORS CARPETED /4, //
STAIR CLEARANCE/RAILINGS / i ,/
HANDICAPPED ACCESS 1 V
SMOKE DETECTORS I f:: ll
BATHROOM FANS/WHOLEHOUSE FANS ';r, f
ALL PLUMBING FIXTURES OPERATING ✓�
GARAGE FIRE PROOFING_ /
DOOR CLOSERS / i ,/
OTHER FIRE SEPARATION / '#
FIRE/DEMISE WALLS / 1
DUMPSTER /
SITE PLAN/VARIANCE REQUIREMENTS /FINAL ELECTRICAL i � V
_OK TO ISSUE C/O OR :G/C °
COMMENTS:
,77A/i/r,2d ,De7
ARRIVE / il-
DEPART .. // , / �
/ 'SPE TO'
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED g///61/
NAME Sc e(VY� 1)lOr l glt l
LOCATION 4- J)/7 /7?4 /,,_ i u-e
/7/9 )
DATE PERMIT# APPROVED.,
N/A YES NO
EXITS
AISLE WIDTHS / ,
EXIT SIGNS / .
EMERGENCY LIGHTING /
I
FIRE EXTINGUISHERS /�
AUTO. EXTINGUISHING SYSTEM /
HOOD INSTALLATION /"
AUTO. SPRINKLER SYSTEM, ,/
ALARM SYSTEM i
s
A
INTERIOR FINISHES ,/
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
a
1
CHIMNEY
WOODSTOVE ?,
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
\
REMARKS: OK TO THIS DATE0)- ('‘x \I_A, ' ()
ARRIVE � (i9) h ,
�/
DEPART Or) j -GL /2t
INSPECTOR
•
_loom of Q ee n u rt9
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road:R.D. 1 Box 98
Queensbury, New York 12801
SEPTTIC DISPOSAL SYSTEM' INSPECTION-
NAME �"�G0,9 d l Le107(111. 1c.-9
LOCAT I 4 ( u. f�(
DATE .7//? / 9/ PERMIT NO.
SOIL TYPE San - Loam - Clay -
Percolation t Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: '
Absorption field, total length,,
Length of each trench• 24_ 50' 60
Depth of trenches "3, S/ 'ro I"
Size of graveI2� ,y
SEEPAGE PITS{Number.' of)
Size- ft. X ft. /
Gravel size . ;
PIPING: 1Side Type
Bldg. to tank •
Tank to dist. box 41 '' Plc'
Dist. box to field/pit" iall(L,
Openings sealed? YES it
S 't NO Partial
_��ss •
LOCATION/SEPARATIONS:
Foundation to tank /p ft.
' Foundation to absorption : • 7-) ft.
. Absorption to lot line ft.
Separation of pits ; 6. ft.
LOCATION OF SYSTEM ON PROPERTY(circle• one)
Front1141Mf/- Left side ' Right side -
• COMMENTS:
•
•
is
SYSTEM 'USE APPROVED NO
4tiLl
Buil;iing Insp ctor
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR°S REPOR
REQUEST FOR INSPECTION RECEIVED /I/ - (,
q I
NAME'S )(\€Y r�� f\Mit\ I qi G
LOCATION )-( ? thy le--� u K I'
DATE _7// 1 c/ / PE IT if9 1 -j:1 '
TYPE OF STRUCTURE c,\(1 � �-tv�
RECHECK �1 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
THE PLACEMENT OF THE CONCRETE. //
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR i /
REINFORCEMENT IN PLACE : '
FOUNDATION/DAMPROOFING`;
BACKFILL APPROVAL A
ROUGH PLUMBING I
PLUMBING VENT/VENTS IN PLACE 1.
PLUMBING UNDER SLAB f /
FRAMING:
JACK STUDS/HEADERS \ /
BRACING/BRIDGING ' I
JOIST HANGERS '. /
JACK POSTS/MAIN BEAM ' '
FIRESTOPPING '\
WALLSift
CEILING /
FIREWALLS /"
HEATING ROUGH-IN /
-INSULATION: / 'k
FOUNDATION WALLS INTERIOR R- \
FOUNDATION WALLS XTERIOR R-
FLOORS / R- ',
WALLS / R- 3
CEILING / R-.25 "„ (....----
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REQUEST FOR INSPECTION RECEIVED /41/2/
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