1991-187 riamo
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY,. NEW YORK
\ Date f 1.-/ Z
This is to certify that work requested to be done as shown by Permit No.v91 187
has been completed.
This structure may be occupied as a S a ngi Family Dwelling
Location Lot #29
Owner Robert Elizabeth Dickinson
By Order Town Board
TOWN OF QUEENSBURY
/),
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91-187 0
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Robert & Elizabeth Dickinson
0
OWNER of property located at Lot #29 Heresford Lane Street,Road or Ave. 6'
l0
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 1/1
O
BLD 6 225 Apt 3
Robert Gardens North
Queensbury, NY 0
2. CONTRACTOR or BUILDER'S Name
rh
Mike Dickinson l-
0
rl•
3. CONTRACTOR or BUILDER'S Address
6 Little St. 10
Hudson Falls, NY 12839
m
4. ARCHITECT'S Name
In
G1.
5. ARCHITECT'S Address
ft,
N
6. TYPE of Construction— (Please indicate by X) coy
co
( A Wood Frame ( ) Masonry ( )Steel ( ) w
7. PLANS and Specifications •
. CL
No. 1,176 sq ft Single Family Dwelling w/ 2-Car Garage as per plot plan
specifications and application;" ,
8. Proposed Use
7
Single Family Dwelling 1.0
$ 179.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 16, 1992
(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 16th D y of April 19 91
SIGNED BY for the Town of Queensbury
Building and ning Inspector
'I/: l! i
TOWN OF QUEENSBURY 101 1 -BY i/�'
REVIEWED TO N OF QUEENSBURY
.I 1 FEE PAW $ /7 9 0 ' RECEIVED
g � PERMIT NO. q / —/ g
� APR 12 1991
BUILDING PERMIT APPLICATION
sLOa. & COPE 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.
• * * * * • * a * * * * * * * * * a • * * a • • a a • * • * * * * * * * * * * * *
The owner of this property is: ')/&Z J eVk-) i% jW G Z,/L �
nn , 11/14el.
P.O. Address &I)4 _ ,25 ozez, / moo
� ' 7f3 -2✓S-
Property Location a ,d Zit,/ �v-/ #,„2? Tax Map No.//7 / /G.Y
Has there been any split of this property since October 1, 1988? / y
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
l <GM-e/ biok ids&
*
NATURE OF PROPOSED WORK: * ESrIMATED MARKET VALUE OF
X Construction of a new building * CONSTRUCTION: $ 3dd
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property MO ft x a()-Qft.
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 66"7(j ft. Rear yard / 67 ft.
•
Side yards I ft. and i f ft.
•
3ROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft.
1st Floor /f 76 sq. ft. 1 M'- ,6Q *
35,000 ,*'Is- OCCUPANCY INFORMATION
2nd Floor sq. ft. ! as * ' Primary Building -
Other Floors sq. ft. • . One Family Dwelling
(not cellar or base::.ent .. Two Family Dwelling
ICOTAL FLOOR AREA`_ sq. ft. • Multiple Dwelling/Number of units
'iize of new struc ft x ��vft. •* Business
(Foundation-pier/ a /c7, : rtiai/full * Industrial
(circ a Sri;:; ' Other
a
4o. of stories (habitable space) /
!eight (grade to ridge) ft. • If addition, what will use be?
f residential, no. of families 1 ,
,4o. of rooms(excluding baths) j ' Accessory Building
!10. of bedrooms ! ' Detached Garage ONE/TWO Car
lo. of bathrooms i ' •
Primary heating system, /� /tzv • r Attached Garage ONE WO Car
1rype of fuel *
__Private storage building
No. of fireplaces to be installed WO *
• Other
Will a wood stove be installed d
Central Air conditioning 6 a
OV' ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING >PFCIFICA'TIONS:
Tape of construction, wood frame, fire safe, etc. kleD
Will any second-hand or upgraded lumber be used? If so, for what? /v O •
Foundation wall material 6Ziee Thickness g f I
1 /
Depth of foundation below grade (to bottom of footing Cofo ,1-
11
Will there be a cellar?Heated or unheate Floor sq. footage sq ft.
Will there be a basement? Will any por ion be used as living space? /✓e
(If so, what portio 9 sq ft. Type of use?
Type of roof - € tT /other Material of roof U` el/4,
Size, wood studs "x " spacing /6 " o.c. length y ft. ,j
Joists (floor beams) 1st floor. d— "x /U " spacing l(2 "o.c. span /41 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 s)-d " . . :•an , - 4 ft. ai6
Exterior wall finish /i'6 `0, ,6 of what material?
Interior wall finish
If a garage is to be a taetf d, describe materials to be used for FIRE SEPARATION: f 4-'.ls c 71 -
Is there to he art opening between garage and dwelling? Ii 0 If so will a Fire-rated door, enclosure,
self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in. AtoduLi 4.1
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)
TAME OF BUILDER /1ALAP Il t4 ,1,-- ADDRESS 4 Si hi *rEL. NO. 710 -RCA
TAME OF PLUMBER Elc-A /aICO7 ADDRESS -.- TEL. NO. 7Y7O^t 3'
K
1AME OF MASON "r"1 RPt,cr "'meta; ADDRESS • TEL. NO. 17
'TAME OF .ELECTRICIAN a C .4:4, ADDRESS ' 1411- e,,,,eC; TEL. NO.
DECLARATION
To the best of my knowledge and belief the statements contained in this application, together with the
lans 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
d1 other laws pertaining to the proposed work shall be complied with, whether specified or not, and that
duch work is authorized by, the owner.
Signature t-L 7d )
u.„
Owner, owner's ent, architect, contractor
PECIAL CONDITIONS OF THE PERMIT:
BY
ENERGY CODE COMPLIANCE APPLICATION
9
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methodsi .
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
6 Ia Aso- IL, .i/gee"' faa 2,
APPLICANT'S NAME PROPERTY LOCATION"
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - /1 7& Sq. Ft.
2. Type of Heat - Elec. Base Board Other24At � `-'
3. Is Building Mechanically Cooled? YES NO
4. Percentage of Area of Windows and Doors Over 17% )6 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 3 6 "
B. Exterior Walls R /9
C. Glazed Area" . G . R 185"
D. Exterior Doors V7 R / /' /
E. Floors over unheated spaces R 1 9
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R
H. Basement/Cellar Walls (Below Grade) R
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code g YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - - WILL NOT BE EXCEEDED
/e6i V/I -9 �,3 s
APPLICANT'S G TURE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS:
t.a. awNOt55
9
/O
vol- i . •
9
/ _ TOWN OF QUEENSBURY
41 j APPLICATIcN1 FOR SEPTIC DISPOSAL PERMIT
41*
DATE: /' "
LOCATION OF PROPERTY FOR INSTALLATION cgq de.4.ed/e-teii -
L ly
Owner's Name: ���,/� ,,t&v/ %d e ,,fay ,
Address: A ,D4 „75— 4,5ev/ 2L ?/5 /�l2r; , ,& egh/s, `cy
Installer' s Name: / c L 6,69) Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) . 300
Topography: Circle one: 41110, Rolling Steep Slope % of Slope
Soil Nature: Circle one: /and - Loam Clay Other /Depth:
Ground Water: At what depth? 41- 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: unicipal Well Other
If domestic water supply is a well .
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /1O gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench <=` eet/Total system length / 2 r feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #.. c3--- /Depth or Thickness feet
t****************************
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.
SIGNATURE OF RESPONSIBLE PERSON: �1�� DATE:
•
Septic System Inspections:
•
A. All applications for septic -system installation. alteration or repair,
as required by the:Town• of Qeu ensbury Sanitary,, Sewagt 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 co lot lines
3.) location and distance co structures
4.) location and distance co 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
Building Inspuccor. Failure co comply with this requirement may
result in the uncovsrinb of the system by the installer and a fine
of up co $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure co produce said plot plan at time of ,inspection may
rdsulc in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or repair of an approved system. a new proposal must
bu submitted co the Quaansbury Building Department before further
construction.
Town of Queeasbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roods
Queensbury, New York 12804
remarks: ,
'`' : MIDDLE DEP•ARTMENT,INSPE.CTION AGENC•Y,,INC.
National Headquarters -
// 1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION - Date: i—,,•6 _s,,,.
•
City, Town or Township t-r. , - - t _County /✓-,4 c='.. / State .iti f
Location/Address Y? ' ,7p.--,-/,_,,//l / q, '
(If Located in Rural Area- Please Attach Directions) Pole #
Owner l`I:r Y/i SI.11J i s'7;f14.. ri - i`r r1/ j Permit #
�. .
Occupied As - Building: New Old!
Occupant /
- -.? :Work Area.in Building (Floor.#,e.tc.): • ' - . i
App. for: Wiring Q Service[. or: ' 'Ready for Inspection: ;wit`L ,',-..j 4.,f, i 1
Fee Remitted-$ ' Cash n Check' -M.O. [ Make Payable To: M.D.I.A.
500y 7.50' 1000 1250 1500'1,750'2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat •
Switches - '0 .
Lighting ' 2 ' Amp. Service.' Surface Unit .. Dishwasher Range
Receptacles [f Water Heater Air Conditioner Dryer Pump
Number of Fixtures , t;Oven , Garbage Disposal Wiring and Controls for .A'S Burner
• Amp. Receptacles 2 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 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size -
Applicant's i (•
,
, . -
Signature /t--(17.L.-� , /S r.... .�.ir._— License # Permit #
T/A v , _ -_`- Utility: /\J/rtt;A"Of s�.(0.1•/p;/cskc Rj3 .+=tifc,
Applicant's Address: / / 7 c' its ry-4.,-/(, (NAME) (OFFICE/LO ATION)
(City) (i�,e a•,,1_t; ,-° tom" !j (State)"- •=„3'�-`• _.(Zip) /2 4r1 l - Service Request #
Phone # 74' . ` r? l 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 I 11/2 2 3 5 71/2 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 CO RECT FEE PAID
•
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
1-1L/A Owner CASH ❑
n L/A Fee CHK #
Due MO #
1 I IPA . Municipal
• INV #
Date: Other Side❑ Utility Applicant ❑
Owner
Cut in Card Temp #_ .. Date
n Final # Date INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 11/89
,N-Ae n"..m.), .ne!j .ty.4"a":17I,In"...in }, a?"at(" i"" 1�i.","."."..��i""(..J.�(."."C"-I ".at(""".In"..•,.7i ,,,•.it."."C A ,•,,A1.-e,,
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 ' !,
R01$$Q3 BUREAU OF ELECTRICITY .
I
41 STATE STREET.ALBANY.NEW YORK 12207
I
_ Date JULY 11,1991 Application No.on file07145''9:1/91 H -4:L '2G"1
THIS CERTIFIES THAT G _ j
,,
only the electrical equipment as described below and introduced by the app'icant named on the above application number in the premises of . 1
I
ROBERT & E. DICKINSON, 11 - HERESFORD LANE, QUEENSBURV, N.Y.
' in the following location; 1=1 Basement 1st Fl. ❑ 2nd Fl. GAR Section Block Lot 29 im i
_— was examined on JULY 0$,19 91 and found to be in compliance with the requirements of this Board. • 'i !
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ; '
OUTLETS ECEPTACLESI SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. !
2' �"9 25 24 1 5 1 1 .5 3 F
_ DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS •••-
„g ' 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 SYSTEMS .,
1 3 1 F 1 1 600
' SERVICE DISCONNECT NO.OF S.. E.. .. R V. ..-. .. ICE
E ,1
••. AMT. AMP. TYPE METER id ,9'3W 3,B'3W 3,B•4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG F W.G. NO.OF NEUTRALS A.W.G.
Eau'''. PER B' OF CC.COND.. i Of HI-LEG OF NEUTRAL
ee
! 1 2'00 CB 1 X 1 4/0 1 3/0 •• .,i
[i _. 'I
. OTHER APPARATUS: ;i iI
PADDLE FAN-1 I
�
. G.F.C.I:-7 1
SMOKE DETECTOR:-2
—
WI
�`' ROBERT �J. DICKINSON - ! �E. •
1:
w BED 225, APT. 3 h'
-- <i BRANCH MANAGER j!
ROBERT GARDENS NORTH 'I
• I
OUBENSBUR1 , NY, 12804 '39 !
Per ' :
I " 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.
'II 4 eitivvrmiYtuuutr lie vinierVilaivetistvei iavent[matvinsviVa tii7rlfvvrt [vi[vlawmumnit[v1r ualat[vi[vnitnni etlrnirf_vi rvralSrtvu - .:r
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNE
(7-7-6 6 e-/- CC.i/e c,-0 C a, " ,-- - Z-e"'(-.
0 t� /'2�`
OF C(MiedSBURY
531 BAY ROAD
/,)_O ,a.,� j. QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
/ys I do BUILDING INSPECTOR'S REPORT
FINAL INSPECTION '
REQUEST FOR INSPECTION RECEIVED 0/9/
NAME S { 4. -2/� U � !�('.��/4,:f9�3,
LOCATION A`, .9 r 4ci1It4' �ri�.�,e_L-,
DATE 7/9fr/ • PERMIT! 9//97
TYPE OF STRUCTURE ,/�/ row, L 4e
(
RECHECK.X,tW2C//C Vi-e-1 /" J_[..L/' . *7li I
FIRE MARSHAL APPROVAL (COMMERCIAL S RUCTURE)
/FOOTING FOUNDATION+' LBiktKFILL /-FRAMING
,ROUGH PLUMBING FINAL ELECTRICAL .SEPTIC ,
II1c1SULATION WONSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS ,/ YES NO
REMARKS p CI �— e
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION `:
B VENT/LOCATION / I.
PLUMBING VENT ;
ROOFING
SIDING V. ,/
DECK/PORCH/STEPS/RAILINGSt
RELIEF VALVES I �.
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVALY DOORS, f
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT ✓
OTHER FLOORS S EEPABLE ‘ 1/OTHER FLOORS CARPETED ,,
STAIR CLEARANCE RAILINGS
HANDICAPPED ACCESS
SMOKE DETECT* \ ✓
BATHROOM FANS/ WHOLEHOUSE FANS \ V /
ALL PLUMBING .FIXTURES OPERATING a V
GARAGE FIRE ROOFING ✓
DOOR CLOSER r/
OTHER FIRE EPARATION
FIRE/DEMIS WALLS
DUMPSTER
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C ✓
COMMENTS:
fr .c' a 7/ 56' '
/11_409,4i4e4a(f4A-rel, SallefE:414$44(r
7..e_ie,e,e,atde.de/r/n-ol eg, ,_, / ,
ARRIVE // C 2 _7:72.-Z) ,p f@/i¢'e
DEPARTS A -r 4
ocs-‘€)v 3 ? II\
_____=,__,,,-
TOIPI OF QUEENSBURY
QUEENSBURY.BAY NEWRY AD
YORK 12804
TELEPHONE (518) 792-5832
r-
BUILDING-I CTOR'S REPORT
INSPEC�TT
REQUEST FOR INS OCEIYED �j/�-I c I N-"iO=
NAME ‘C�\N\PWy (21V6a
1.
LOCATION. C e. 5dnuL.,
DATE rJ I )/ (c I . PERMITS 9 1 - I$
TYPE OF +STRUCTURE S'44-C-0,43u6c3,,A.A
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL / FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL' SEPTIC
INSULATION WO USTOVE/FIREPLAC I
SfTE PLAN/VARIANCE REQUIREMENTS YES _ NO
REMARKS 0
/
APPAL
N/A YESROV/ NO
CHIMNEY HEIGHT/LOCATION /
B VENT/LOCATION ✓
PLUMBING VENT 17,
ROOFING / ifr
SIDING
DECK/PORCH/STEPS/RAILINGS grj
RELIEF VALVES /
FURNACE/HOT WATER OPERA T G B Y
BASEMENT INSULATION/DUC ORK
INTERIOR TRIM/PRIVACY D ORS
FINISH FLOORS: 4
BATH/KITCHEN WATERTI HT , 4
OTHER FLOORS SWEEPA LE ✓
OTHER FLOORS CARPET D ‘ 7
STAIR CLEARANCE/RAIL NGG t'
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOL HOUSE FANS ✓/
ALL PLUMBING.FIXT ES OPERATING �/
GARAGE FIRE PROOF NG ✓j
DOOR CLOSERS ti
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINALTER ELECTRICAL )
OK TO ISSUE C/O OR C/C 1/
COMMENTS:
S
ARRIYE
i
DEPART 171 --'
TOWN OF QUEENSBURY /4A)
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED CC )//6)
NAME \ 1 R ,� ( ° `4 ��(?Y)/A-4 01•261)0exl,
LOCATION \- p.s YCJ rr\--e
DATE b l I / 9/ PERMIT # 7>3
d � I
TYPE OF STRUCTURE S"' lS e I 1
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 PURPSE O,N SITE
FOUNDATION/WALL POUR \ ? •
REINFORCEMENT IN PLACE \
FOUNDATION/DAMPROOFING '
BACKFILL APPROVAL ?' /
OUGH PLUMBING / ; V
PLUMBING VENT/VENTS IN' PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS ,
JACK POSTS/MAIN BEAM
HEATING ROUGH/'IN
INSULATION: /
FOUNDATION WALLS INTERIOR R-t
FOUNDATION WALLS EXTERIOR R- 1,,
FLOORS / R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
•
ARRIVE //
� �
DEPART jl cac/ /' /
INSPECTS,'
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
NAME A5./ ,Q� . Ade,A(4,/-x.)
LOCATIO 1 ./4.1 �,
DATE 4p�/)//(' PERMIT # 9l'/O 7
TYPE OF STRUCTURE4�y 4
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
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING yr
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING S'
FIREWALLS
}IEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR
FOUNDATION WALLS EXTERIO RR
FLOORS ,r R-
WALLS { R- j I
CEILING ,/' R-2n
DUCT WORK OR PIPING INwUNHEATED 's'
SPACES 1 �.
REMARKS: i
ARRIVE lD
DEPART f '
I NS PEC TO
. (1.7)&?te)
. _awn' oQ Q . bur
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
4
NAME l yz A: J ..,l//i1�/fiU
•
vLOCAT ION �j�f % �l1/ j/ , 4....___
(DATE �D ,� / % PERMIT NO. 9z/17
i
SOIL TYPE 0►- Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: C I i
t
Absorption field, total length d!_-7'
Length of each trench So i .
Depth of trenches -,-3 - 1
Size of gravel TY2 • _
SEEPAGE PITS{Nuinber !of)
Size- ft. X Ift. w
Gravel size / •
PIPING: °1 Size/ y e
Bldg. to tank 4
Tank to dist. box i- � t!
Dist. box to field/pit `i i5Vej
Openings sealed? YES.. NO Partial •
LOCATION/SEPARATIONS: A
Foundation to tank \ 0-/ft.
Foundation to absorp ion 4 ft. •
. Absorption to lot line \ 1s ft.
Separation -of pits \ ft.
LOCATION OF SYST ON PROPERTY(circle one) •
Front - tab. L ft side - Right side -
COMMENTS:
SYSTEM USE APPROVED 4110 NO
Bui ing Inspec or
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT -/6)
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 2t/C / �%Ci� l/'i r`}'J ` F5%0
LOCATION! jf/;;i9p����Cc
DATE 7 / j� PERMIT # /c/
TYPE OF STRUCTURE A(4i6 41,./1 //
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC PO\R FORM
REINFORCEMENT N PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING OTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT 0 THE CONCRETE.
MATERIALS FOR TH S PURPOSE ON/SITE
FOUNDATION/WALL UR /
REINFORCEMENT IN I\LACE
FOUNDATION/DAMPROO iNG
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS \I N PLACE
PLUMBING UNDER SLAB
)(FRAMING: \ / f
JACK STUDS/HEADERS \ /
BRACING/BRIDGING \/
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS !°
CEILING /
FIREWALLS /
HEATING ROUGH-IN/
INSULATION: /
FOUNDATION WALLS INTERIOR\R-
FOUNDATION MALLS EXTERIOR (i-
FLOORS ,/' R-
WALLS
CEILING,/ R-`;
DUCT WORK OR PIPING IN UNHEATED
SPACESI
REMARKS:
ARRIVE
DEPART <i
I NS PEC TO
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 S/(P J 5
NAME KTY) c ;\5 Om, (2 \i4? )-I
LOCATION n -Q.1\ - �U
DATE 5J (n/ C\ PERMIT # I- I�
TYPE O/F STRUCTURE c>i c)Q�. cc;,rn-. (A. Ot,u 1
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 SIT
FOUNDATION/WALL POUR H
REINFORCEMENT IN PLACE :I
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE 1 i
PLUMBING UNDER SLAB 1
FRAMING:
JACK STUDS/HEADERS y >:
BRACING/BRIDGING ,1.i`
JOIST HANGERS 4
JACK POSTS/MAIN BEAM w .? .
HEATING ROUGH-IN
INSULATION: �' ?
FOUNDATION WALLS INTERIOR R=
FOUNDATION WALLS EXTERIOR
FLOORS /R-
WALLS R- .1
CEILING R-
DUCT WORK OR PIPING IN ,UNHEATED
SPACES
1 1
REMARKS:
•
ARRIVE 1C
DEPART'
INSPE OR
�1 JQ
TOWN OF Q EENSBURY Gycr
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED y/j / /
NAME s.>\C. ,\� N mow\ `
LOCATION ) (2,--A— 1 ) ?.'1`) ' Q.-71-1,s
DATE r9q/ !l PERMIT # ��I --/��7
/ II/
TYPE OF STRUCTURE S kcp_ --r-GLx Nod!,
RECHECK .\ APPROVES'
• N . N/A YES/ NO
-FOOTINGS/PIERS i
MONOLITHIC POUR FORM ./
REINFORCEMENT\IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING kROTECTION FROM
FREEZING FOR 4B HOURS FOLLOWING
THE PLACEMENT iv THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR I
REINFORCEMENT ¢N PLACE /
FOUNDATION/DAMFROOFING
BACKFILL APPROVAL /
ROUGH PLUMBING k :
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SyAB
FRAMING:
JACK STUDS/HEADE .,/S
BRACING/BRIDGING i`
JOIST HANGERS \` `
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN /
INSULATION: / \
FOUNDATION WALLS! INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS I \ R-
WALLS /` ,R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES ' N.
REMARKS:
J
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ARRIVE // -35 ( ,
DEPART - 2J
J INSPECTO
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