1991-194 - frr71.
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 10, 19 92
This is to certify that work requested to be done as shown by Permit No. 91-194
has been completed.
This structure may be occupied as a Single Family Dwelling
Lot 57 Mapldr,Drive
Location
Owner Stephen Kelly
By Order Town Board
TOWN OF QUEENSBURY
\T-LeD
Director of Bldg. & Code Enforcement
s BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-194 x
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Stephen M. Kelly
OWNER of property located at Lot 57 Maple Drive Street, Road or Ave. w
vt
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.
CD
1. OWNER'S Address is 44C
11 Willow Road
Queensbury, NY
CD
2. CONTRACTOR or BUILDER'S Name CD
Same
I-
0
c+
3. CONTRACTOR or BUILDER'S Address
V
a
CD
4. ARCHITECT'S Name
fD
• 5. ARCHITECT'S Address VY
to
co
6. TYPE of Construction— (Please indicate by X)
a
( X Wood Frame ( ) Masonry ( 1 Steel ( )
7. PLANS and Specificationsco
No. 2,120 sq ft Single Family Dwelling as per plot plan specifications �•
and application to
8. Proposed Use
Single Family Dwelling
290.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 16, 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-_J6th Day, Apri 1 19 91
SIGNED BY ) %✓;��fi/ for the Town of Queensbury
• Building and Zoj(ing Inspector
TOWN OF QUEENSBURY `
yREVIEWED B /"'— e D-q
6
ell& FEE PAID $ s
C
OF QU ;ri"r:iEE r r
PERMIT NO. k , T �'a(ip, rti)
�33l111 4 �lf6as�� Gl�i ` 0
BUILDING PERMIT APPLICATION ,
APR151991
GODE DEFT•
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTION& S. ,
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
BUILDING
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: Ste-/- e h 72/ , 1 e//y
P.O. Address // ///A„ 12 6'10 J (T9c, hs ZLe/ 7 / Tel. 7 y3-L?t z.
Property Location ,.<07L .s? /7 P/e Z7,f/c--e- Tax Map No. qLI /5/ 6" 7
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 Ac/dP,, //,//S LOT NO. LS'?
THE PERSON RESPONSIBLE.FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
SrfPie4 4 /1 1/,
•
NATURE OF PROPOSED WORK: * ESC;MATED MARKET VALUE OF -
K Construction of a new building * CONSTRUCTION: $ // 7/Q o D
Addition to a building * COMPLETE INFORMATION'REQUIRED BELOW:
* Size of property / n a _ -ft x /-�y ft.
Alteration to a building * Existing Buildings(3) Size R6 ft. x 6 ft.
(no change to exterior dimensions) •
Proposed building - distance from property line:
Other work (Describe) * Front yard SD ft. Rear yard ft.
* r/d
Side yards j7>� ft. and 7 ft.
•
GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft.
•
1st Floor /G V sq. ft. ) ?--O
* OCCUPANCY INFORMATION
2nd Floor to G sq. ft. * - Primary Building -
r
Other Floors sq. ft. -q "" • - One Family Dwelling
(riot cellar or basement) j 1 0 .. Two Family Dwelling
TOTAL FLOOR AREAjiza_sq• ft. * Multiple Dwelling/Number of units
Size of new structure •ft x * Business
Foundation-pier/slab/c. `:.,._ ' rtiai/full • Industrial
(circled:: • Other
•
No. of stories (habitable space) 2 - •
Height (grade to ridge) r2 Q ' ft. • If addition, what will use be?
If residential, no. of families / •
No. of rooms(excluding baths) •
Accessory Building
No. of bedrooms q • __Detached Garage ONE/TWO -
No. of bathrooms „2 yL •
Primary heating system /k r 4.4 4-6( • Attached Garage ON:/T- 0 C-
Type of fuel 0 PS • Private storage building
No. of fireplaces to be installed / * - -
• Other
Will a wood stove be installed q D
Central Air conditioning n C, •
OV• ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING PECIFICATIONS:
Type ofcobs'tluct[o.n,Wood frame, fire safe, etc. //[/dQ'0.
(�
hill`',tiny: second-hand,or upgraded lumber be used? If so, for what? ///(J'
Foundation wall material'' ' (,in e Thickness r
Depth of foundation below grade (to bottom of footing) /Qo, ,'
Will there be a cellar? 1/-eS Heated or unheated? ((i ti ,`=v2, Floor sq. footage /jyi sq ft.
Will there be a basement? Will any portion' be used as living space?
(If so, what portion? sq ft. Type of use?
Type of roof - sloped/flat/shed/other Material of roof %-�- 75 //1/4 Pr1y /ASS
Size, wood studs "x l " spacing " o.c. length ft.
Joists (floor beams) 1st floor ,o "x ,' " spacing)6 "o.c. span // ft.
Joist (floor beams) 2nd floor ,. "x lG " spacing /‘ "o.c. span ,f ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing /I " o.c. span 9-1 ft.
Exterior wall finish of what material? / 2—
Interior wall finish S'e( e e f ,co c�
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
/' /W e ,5/, e e , /
Is there to he an opening between garage and dwelling? y If so will a Fire-rated door, enclosure,
self-closing device be provided? -y -e.S
Will a flue-lined chimney be installed? , 6 Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well J(,/ /R /
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 //y Ccti s/lefol,n ADDRESS // ,// TEL. NO. J y,3 -� d -
NAME OF PLUMBER ii ADDRESS /i �� TEL. NO. `�
NAME OF MASON // ADDRESS `/ '' TEL. NO. /'
NAME OF ELECTRICIAN if ADDRESS i i / TEL. NO. 7'
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 comp i d with, whether spe ified or not, and that
such work is authorized by the owner.
Signature ,J
Owne , owner's ag t, ar itect, contractor
SPECIAL CONDITIONS OF THE PERMIT:
BY
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
lt)ie /e/ a(a s-2 //.b''j% ae/o -e-
T.CN
AP A T'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 02/Po Sq. Ft.
2. Type of Heat - GlA(' Elec. Base Board Other
3. Is Building Mechanically Cooled? YES
4. Percentage of Area of Windows and Doors i Over 17% 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 33
B. Exterior Walls
C. Glazed Area
D. Exterior Doors
E. Floors over unheated spaces
F. Edge of Slab on Grade (Heated Building) R __ALZ/
G. Basement/Cellar Walls (Above Grade) R (2-5-
H. Basement/Cellar Walls (Below Grade) R // - -
I. Heating/Cooling - Ducts - Piping in Unheated Space R Gf
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code )'A,, YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
APPLICANT'S SIGNATURE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS :
RE D BY
TOWN OF QUEENSBURY '
`s ty APPLICATIOD FOR SEPTIC DISPOSAL PERMIT
DATE:
LOCATION OF PROPERTY FOR INSTALLATION ,/a/ ,<') ,73A//e .0//b,e_
Owner' s Name: ctef74 A A48/
Address: 1/ A,; //i4 �y-d
Installer's Name: Ph CiP,,- 7,— Telephone:
Number of bedrooms. (residential only) 2/
Total daily flow (compute @ 0 gal per bedroom) 19 a 0
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: 110 Loam Clay Other /Depth:
Ground Water: At what depth? 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 /43 0V gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench ,Si) feet/Total system length .—S feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used # /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 revers ide of this sheet and agree to abide
by these and all requirements of the Tow f Queensbury nitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE:
I
\441
SeYstic S stem Inspections:
A. All applications for septic Byers. installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted co 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 to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields anal/or drywells
B. Nu system shall be covered before inspection and approval by the
Building Inspuccor. Failure to comply with this requirement may
rusulc 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
lice. Failure co 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 rupdir of an approved system, a now proposal must
bu submitted co the Queensbury Building Departmonc before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
k.marks: .
•
•
ft
•
•
TOWN OF QUEENSBURY
Bay at Haviland Roads, Quoensbury,N.Y.12801-9725 •
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date 19 Permit No.9/ _ / ! L/
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 ,Cte�/j P% A ,//!/ APPLIANCE TYPE
/��J / Stove Coal Wood
Address // �i///i1. 1i'G c r Furnace Hot Air Boiler
// Zero Clearance K Circulating Unit
s If A? A/. l/ Zip /02 g
Phone. . /. / If Non-Masonry:
Owner's Name g P_—
Address Manufacturer �P /r7J 7/ ir
Model - Outlet Size
Zip Listed by Number
Phone •
CHIMNEY TYPE
Masonry: Block Brick Stone
Properly location of proposed construction Flue: Tile Steel
J6t- Li'-7 Size: .
Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT-APPLIANCES Type: Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$
SONRY FIREPLACES AND CHIMNEYS.
CASHIERS DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department: Fire Marshal Amount Collected Amount Refunded
Code Number Title - 0 cD
A173 3389 (190)Public Safety
A233 2655 (230) Minor Sales
•
Tee Collected from or Refunded to: S eic \lsh. *I L.,
C.)`�
Address: ) . !3'if , 7 N 9\(. _ t ✓c' .
Dated: Town Clerk or Deputy
While:Applicant Yellow and Pink:Cashier's Department Goldenrod:rod:F ire Marshal '
t.
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.:
(.&,..............--,-,
� National Headquarters -
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date:
City, Town or Township J �'r'i /7) �'f ;';� County / i-.54-r-- State �/, k/Y
Location/Address ;/t ;/ stir- .>„ :1) `), ', (I. (r/r"%"-//, ,Zi• /-"c
—(if Located in Rural Area -Please Attach Directions) Po(e #
Owner `^ C.• i•-)r. , 1_, ,.-r%(-. r/ r Permit #
- F.
Occupied As Building: Nevv❑ Old
Occupant
Work Area in Building (Floor #,etc.):
App. for: Wiring❑ Service n or: Ready for Inspection:
Fee Remitted -$ Cash I1 Check Ii M.O. I --I 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
Receptacles Water Heater Air Conditioner Dryer Pump
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'/z 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
' of Each Size
.Applicant's j
Signature '42/, J !A/ License # Permit #
T/A Utility: (NAME) (OFFICE LOCATION)
Applicant's Address: ;"' .' - ,%,>l%
(City) ,7y','r.- : . / , -,/ (State) d, / (Zip) /=% k cc/ Service Request # / !' ,.*/ 71
Phone # Electrician: ./
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above n or: •
Red Notice Label fl - `
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,/2 2 3 5 7'/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 CORRECTFEE FEE PAID
1 I RW Progress: Inc.n LKD❑ Contractor
I 1 CFT Violation: Work Comp.❑ Inc. ❑
n L/A Owner CASH El
�] L/A Fee CH K #
Due MO #
I1 IPA Municipal
_ INV #
Date: Other Side I I Utility Applicant Cl
Owner ❑
Cut in Card I I Temp # . Date
I Final # Date • INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 11/89
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. ,/,
Owner 5 7'a"llL �1Ly
Occupant
Location _to_r• M C'< L` Pie
r7o� Street
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by ____1C � Y e Z
Date 0,11,„.0 _ ector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood,NJ 08108
/ 3 TROUGH WIRING OUTLETS H.P.AIR CONDITIONER
3 I s:__-c v e 1? L, WIRING &CONTROLS FOR �4� .BURNER
C� !
4_,(yam' RECEPTACLES H.P.PUMP
Z i
FIXTURES K.W.OVEN
Z,L3IMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
y/i/ AMP.SERVICE CONDUCTORS J K.W. DISHWASHER
K.W.SURFACE UNIT / K.W. DRYER
K.W. RANGE AMP. RECEPTACLE
K.W. WATER HEATER 9e FRPC. H.P.VENT PANS
MOTORS H.P. 1/20 1/12 1/10IA I A %3 %2 'h 1 11/ 2 3 5 71/ 10 15 20 25 30 40 50, 75 100
MARK NUMBER
.OF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY !)
1: ,01:101:' 531 BAY ROAD
- l� QUEENSBURY, NEW YORK 12804
� 0}'' TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 9:� 'v
NAME Zvir,,,_.„ > ,
LOCATION G7/2 J ,
I `
DATE 1/2/r 2e? PERIIITL q7 79.27/
TYPE OF STRUCTURED «,�� (i
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
,FOOTING 1FOUNDATION yBACKFILL kFRAMING
TROUGH PLUMBING FINAL ELECTRICAL r_iSEPTIC
_INSULATION _WOODSTOVE/FIREPLACE
REMARKS 7 / ,/ � C-tC'
ti
r, APPROVAL
; 1 N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING ,
DECK/PORCH/STEPS/RAILINGS c--
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS.
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT e✓
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS I/
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS //
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL v
OK TO ISSUE C/O OR C/C
COMME
ARRIVE
t
DEPART 3 "2(5- ---
INS ECT
TOWN OF QUEEHSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY9 NEW YORK 12804
TELEPHONE (518) 745-4447 '
BUILDING IPNSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED f1
J
NAME
LOCATION �°,�,-> 7 9 lE. 1---->;1 l IK?
DATE C' C PERMIT 0
TYPE 0 STR CTURE ( F
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR " HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL r
A-ROUGH PLUMBING / 1/
PLUMBING VENT/VENTS ,.IN PLACE
PLUMBING_ UNDER SLAB'`
(FRAMING:
--JACK STUDS/H,,GADERS 4/!
BRACING/BR.IfOGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING"ROUGH-IN
INSjJATION:
0FOUNDATION WALLS.ANTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: / 1
?, :AVjallif/46141
ARRIVE /v -
a
DEPART//
INSPEC)' R
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 �?' � � � \\
,/'
��
LOCATION '67 7421
DATE l� /4Z PERMIT # 9//6Y
TYPE OF STRUCTURE Sf &
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 V
PLUMBING VENT/VENTS IN PLACE '
PLUMBING UNDER SLAB \1 i
FRAMING: 'i+. g
JACK STUDS/HEADERS }1 /
BRACING/BRIDGING V
JOIST HANGERS
JACK POSTS/MAIN BEAM / `a
FIRESTOPPING
WALLS
CEILING /
FIREWALLS
HEATING ROUGH—IN /
INSULATION: !
FOUNDATION WALLS INTERIOR R—
FOUNDATION WALLS EXTERIOR R—
FLOORS f R—
WALLS R—
CEILING R—
DUCT WORK OR PIPItG IN UNHEATED
SPACES
REMARKS: '/
7/44,,,,)2/4)4044-
3a
ARRIVE /l)
DEPART �''
/ INSP CTOR
7:-;•—cs,--utp,111\
•
•
ocun of Queen3Zury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME E ; , "y'`, .
LOCATION J 1 �- t'� %A„ \ t I S
cr\a-Q S •,1v�
DATE j /3 PERMIT NO.
SOIL TYPE - Loam - Clay -
Percolation es Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length biJ
Length of each trench ' 5/)/
Depth of trenches •3-11, ' •
Size of gravel _
SEEPAGE PITS{Number of)
Size- ft. X ft. •
Gravel size
PIPING: Size i T e
Bldg. to tank417-1
Tank to dist. box
Dist. box to field/pit ° ! 1�
Openings sealed? YES *01 Partial
s� k
LOCATION/SEPARATIONS: �! •
Foundation to tank pit ft.
Foundation to absorption R 3v ft.
Absorption to lot line ft.
•
Separation of pits 6 ft.
LOCATION OFF SYSTEM ON PROPERTY(circle one)
Front -Rear - Left side - Right side -
COMMENTS: /
SYSTEM USE APPROVED 6P NO
/ i
Buiiiding I pector
•
01/86 and vl
TOWN OF QUEENSBURY
LRISgIaFT7).
APR 151991
!WILDING & CODE DEPT.
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'MINN OF QUL-b1,,1c,
Zorling,A i _inistrator
- I . .....,
'. Date— -.-- .- -- —
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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 1 Jp yl q/
NAME c`t-�i0 c ��F? l( I /
LOCATION S 7 Mt,vie
DATE I I 15/Cj) PERMIT # 9 ( —
TYPE OF S RUCTURE
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 I'N PLACE
PLUMBING UNDER SLAB "!,
FRAMING:
JACK STUDS/HEADERS ,y:,
BRACING/BRIDGING 4
JOIST HANGERS 1
JACK POSTS/MAIN BEAM
FIRESTOPPING d'
WALLS 7�
CEILING I '
FIREWALLS / `,
HEATING ROUGH-1N
INSULATION:
FOUNDATION MALLS INTERIOR R- "1
FOUNDATION :WALLS EXTERIOR R-
FLOORS R- " .
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE (D ' vO
DEPART t 8%'‹
INSPECTOR
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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 /11 t/ 1
NAMEY.,2,\\. L.,,)
LOCATION j + S 7 `GL 01 L
DATE , PERMIT # Cj '' 9`-fi
TYPE OF TRU TURE :=E> C�
RECHECK APPROVE
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 '
JOIST HANGERS y'}
JACK POSTS/MAIN BEAM .
FIRESTOPPING ?;
WALLS
i
CEILING ,S
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR
FOUNDATION WALLS EXTERIOR
FLOORS
WALLS R- t
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
. SPACES
REMARKS: t
ARRIVES
DEPART S�
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RE,CEEIVED
NAME Ab^ 2iLlilu %
LOCATION dS y .�'7 �/ n�, ' ru,e
DATE PERMIT # /1/—/V
TYPE OF STRUCTURE ,5 _2 Cc��LCc_
RECHECK APPROVED
, N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FR.'y+
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
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
}(INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R •
-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
TNSPFCTf1R
TOWN OF QUEENSBU6 Y
RIF141211F511
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' BUILDING & CODE DEPT.
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