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1992-143' +CEI.TIFICATE +CPF OCCLMAMOMW I TOWN OF +QUEENSBURY WARREN COUNTY, NEW YORK 4 Dated ��fi 14 �� This is to certify that work requested to be done as shown by Permit No, has been completed. This structure may be occupied as a with attached 2-dea garage Location � 3 - Algonquin Drive , 'Tyneswood Subdivision Richard P . Schermerhorn Jr. Owner By Order Town Board TOWN OF QUEENSSURY I [� Director of Bldg. & Code Enforcement BUILDING PERMIT x TOWN OF QUEENSBURY Na 92_ 143 WARREN COUNTY, NEW YORK r.s PERMISSION is hereby granted to Richard P . Schermerhorn J >rw OWNER of property located at Lot 141 Algonquin Drive , Tyneswood S ubd i y Street. Road or Ave. 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_ t.n ' " arrl Son ' y ra Glens Falls NY 12801 2. CONTRACTOR or BUILDER'S Name Q V sameJ. 3_ CONTRACTOR or SUILDEWS Address a Aa d. ARCHITECT'S Name ,S s. ARCHITECTS Address r— Cs Ca. TYPE of Construction — (Please indicate by K) 4- b ( x) Wood Frame I I Masonry { } Steel A 7. PLANS and Specifications yr' p 2 No. 26 ' x66 ' Single family dwelling as per plot plan , application and specifications including two car attached garage and septic system . v S. Proposed Use -5 C Single family dwelling r° u, w $ 277 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRESCD April 16 19 co (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of O.ueensbury before the expiration date,) rn Dated at the Town of Queensbur is 16tb� y of AP ri 1 19 92 r SIGNED BY ` �� ^ for the Town of Queensbury Suilding afed Zoning Inspector TOWN OF QCMENSOURY REVIEWED BY , f ' FEE PAM ; � 7 1 p �, �{Jr�riJ� ��QZ a'i+V'N OF QUEENSBU►l PERMIT NO. - RECEIVED? BUILDING PERMIT APPLICATION APR 14 1992 ` BLDG. & Coce DEPT, A PERMIT MUST BE OBTAMED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. All applicants spaces on this application :MUST " completed and the signature of the applicant MUST appear on the reverse side of this application, * # * 0 • * * * * * * N * * * * a a * * * * a * * * * * * * * • * F * * * * * * * The owner of this property is: rG�, P,O. Address Tel. "79s _o6 -7y Property Location 14 1 �41 o , ,.� rf}t" Tax Map No f ,/ / Has there been any split of this property since October 1 , 1988 ? / It yes Planning Board Review is necessary . yes no SUBDIVISION NAME, IF APPLICABLE aS wo Jf) CZ LOT NO. /� r THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES ISs NATURE OFF PROPOSED WORKS � ESI`14MATED MARKET VALUE OF �Construction of a new building CONSTRUCTION : s ,/50&, ao 0 Addition to a building ' COMPLETE INFORMATION REQUIRED BELOW: " Size of property A5 o ft x /60 ft. Alteration to a building • Existing Buildings( 3 ) Size ft* x ft. (no change to exterior dimensions) * Proposed building - distance from property lines Other work (Describe) " Front yard.ft. Rear yard j1 q ft. Side yards ft* and y3 ft. GROSS AREA OF PROPOSED STRUCTURE „ If on corner, setback from side street ft, 1st Floor ,rc� �sq. ft, " OCCUPANCY INFORMATION tnd Floor ,► l 3 y sq. ft. �; „ Primary Building Other Floors >e sq. fC 2 f One Family Dwelling (not celuur orTsement r ! '-I • Two Family DwoUing TOTAL FLOOR AREA 2,9a & q. ft. .^ ' w Multiple Dwelling/Number of units Six* of new :tructtir. rt x =G it. �' U +► Business Foundatio"er/slab/crawl/partial/full ` Industrial (circle one) ' Other No. of stories (habitable space) Height (grade to Hdro)-2 .` ft. # If addition, what will use bye! If residential, no. of families E • No, of rooms(excluding baths) S s No. of 15edroon�s _ �' . Accessory Building Detached Garage ONE/TwO Car No* of batheoome;I2, _ • Primary heating system 14A : r w ��,,�Attached Garage ONEa C iib Type of ftmd � Private storage building Non of fireplaces to be Installed � Other WIU a wood stow be ln l0 stalled A Central Air conditioning jn/o e OV* ER BC'fLDING PERMIT APPLICATION C (DNTIVUED - BUILDING SPECIFICATIONS: Type of construction wood frame fire safe. etc. Will any second-hand or upgraded lumtrer be used? If so, for what ? a Foundation wall material�1111'1'e ,.P_ 71 a Thickness $,aas •, Depth of foundation below grade (to bottom of footing) Will there be a cellar ? Heated or unheated' Floor sq. footage /r p Z sq £t . Will there be a basement ? Will any portion be used as living space? — (If so, what portion9 sq ft . Type of use ? Type of roof stops flat/shed/other Material of roof '/Z Cgyrr- y� U r� Sine, wood studs—42 spacings" o.c. length!$.ft . Joists (floor beams ) 1st floor !D. "x t cs „ spacing 1�"o. c. span—/3 `ft. Joist (floor beams) 2nd floor.-a.."x , o .,'} spacing 1<.�"o.c. span /Yft. Overlays (ceiling beams ) "x " spacing '} o. c4 span ft. Roof rafters **x " spacing o. c. span ft. Roof trusses (pre-engineered) spacing" o. c. span -:9•7 ft. Exterior wall finish ,-- l p,t 1- 4 4'0'/ , of what material ? Interior wall finish 4 If a garage is to be attached* describe materials to be used for FIRE SEPARATION= ] •1 � � �,a 1� n Is there to ho an opening between garage and dwelling? Y. S If so will a Fire-rated door, enclosure, self-closing device be provided? y� 4 Will a flue- lined chimney be installed? ye, S _Height above roof. ft . Depth of chimney foundation below grade r�,,1A ft. Depth of fireplace hearth -;L ft. ra in. . Water supply - Municipal or private well ,-y�U ,, ,•c ;,pa L 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__. GA1 - r ADDRESS Ac& rf so k`hv& TEL. NO. 9S � © 6 7f' NAME OF PLUMBER :Sr`cve ADDRESS4,/�»- , - TEL. NOS. yZ --6G93 NAME OF MASON 4aL+ - ADDRESS _ r ! . /94. y TEL. NO* "2yam - J,571 NAME OF ELECTRICIAN , .a} , ADDRESS !) caN 6TEL. NO. 6K./ - c35.5 .2 DEC LA RATION plansTo the specifications of my knowledge and belief the statements contained in this application, together with the ,submitted, are a true and cor1plete statement of all Proposed work to be done on the described premises and that all provisions of the BUILDING CODE. THE ZONING ORDINANCE, and such work its authother laws et inIn to the Prod work shall be compiled with, whether specified or not, and that by the owner. r " Signature-Owner,, owner's agent, architect, contractor �� SPECIAL CONDITIONS OF THE PERMns BY ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY , WARREN COUNTY - 9000 HEATING DEGREE DAYS OF QUEENSSuh Compliance Methods : ;' iVED PART 5 - Acceptable Practice Method - 1 & 2 'Family Dwellings ( ONLY ) PR 14 1992 PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings ; Mu ti - Fami I Owe l i ncftLOC3. & CODE DEPT. ( 3 Stories or Less ) PART 4 - Design By Component Performance - Commercial Buildings - Hi - Rise Residential PART 4 & 6 - Compliance Methods Require Submission of Worksheets APPLICANT ' S NAPE PROPERTY ATION PART 5 NETHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE : 1 . Gross Floor Area - ;? a 9quC Sq . Ft . 2 . Type of Heat - Elec . Base Board Other Gols hod aA : c 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 SHOW! ON 'PLANS SUBNI1TEU! Baseboard 5 . Insulation Values : Actual Shown Elec . Heat Other A. Roof & Floors exposed to ambient temperatures R 30 � B . Exterior Walls R AS Co Glazed Area R_ a L5 I r 0 D . Exterior Doors Rom. ._ - = — -- E . Floors over unheated spaces R . 4 - Iq F . Edge of Slab on Grade ( Heated Building ) R IA G . Basement/Cellar Walls (Above Grade ) H. Basement/Cellar Walls ( Below Grade ) Rom, I . Heating/Cooling - Ducts - Piping in Unheated Space R co 6 . Service ( Domestic ) Hot Water Heating Device / A . Conforms to minimum efficiency per code ✓ YES NO / TEMPERATURE CONTROL MAXINJN SETTING 240 WILL NOT BE E=EEDED d' 7� ~J i S S - GaG - LI 1E TELEPHONE INSPECTOR ' S REMARKS : ' Al TC� VAT OF QUEENS �3I.TI�Y 1V Bey at Haviland Roads, ©ueensbury, M.Y. 12801-9726 APPLICATION FOR SOLII3-FUEL BURNING APPLIANCES AND FIREPLACES Date - lg Permit No. L' ;� L / AYP'L.ICA`rION 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 till applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow till inspectors to enter premises for the required inspections. APPLIANCE TYPE Applicant's Name ? }, i'. Strive Coal Wood Address Lf :7% l l 5 r- `� A ./ C:_ ' Furnace Hot Air Bailer Zero Clearance / Circulating; Unit zip Phone -7 _ '� yr If Non-Masonry: Owner's Name � Lx V, Manufacturer *l Address Model r0 Sire Zip Listed by Number Phone CHIMNEY TYPE Masonry: Block Brick Stolle Property location of proposed construction Flue: Tile Steel ✓` 7 �. S ., c rf Size: ,. Factory Built: Manufacturer //I Model Sire 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 $ r CONSTRUCTION DETAIL REQUIRED FOR MA- Fee. SONRY FIREPLACES AND CHIMNEYS, CASHIER'S DEPARTMENT TOWN of Qur=ENSBURY, NEW YORK D Liart ent• Fare Marshal Amount Collected Amount Refunded Code Number y Title e.• M_ A173 3389 (190) Public Safety A233 2655 (230) Minor Sales Fee Collected from or.Refunded to: 1 Address: Dated: •i' '1 Town Clerk or Deput While: Applicant Yellow and Pink: Cashier's Deparhnent Goldenrod: Fire Marshal Ad TOWN OF QUEENSBLTRY APPLICATIO" FOR SEPTIC DISPOSAL 'PERMIT i OWN 4F QUEENSBUH ti RECEIVEn DATE : 41 -- l3 LOCATION OF PROPERTY FOR INSTALLATION L � ;J'="RCw�'ac� Owner ' s Name : rn e r^ I,a R r ' BLDGi & CODE DEEPTI Address : 3 T10e, rP ; Sg .A Au5; K t Installer ' s Name :, :c -+ a Telephone : _ 7?_ & - OG, ? Y Number of bedrooms ( residential only ) y Total daily flow ( compute @h 150 gal per bedroom ) coo Topography : Circle one Flat Rolling Steep Slope % of Slope Soil Nature : Circle one : Sand Loam Clay Other /Depth : Ground Water : At what depth? Feet Bedrock or Impervious Material : At what depth? N/A Feet Percolation test : Circle one : r not requir:e�d_-> required Rate - /� - Min . Per Inch Domestic water supply : Circle on 'At nicipJ- a --7l Well Other If domestic water supply is a, we m -- Separation : Water supply from any septic absorption feet . PROPOSED SYSTEM : Septic Tank J Z-.5' 4> gal . (minimum size : 1 ,0O0 gal ) TILE FIELD : Each Trench o feet/Total system length 4250 feet SEEPAGE PIT( S ) : Number of 51e, /Size each .k feet by feet Size of stone to be used /Depth or Thickness ,/ feet r tyr it* ,►,pry►*it ft * * r4*****r*no-+k,�t,i► k HOLDING TANK SYSTEM IF REQUIRED NO . of Tanks Size of Each *Alarm systm 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 : L' DATE : Santis SrsCem Znsc►:ec�c_ions A . All applications for sepcic system installation , alCrracion or repair , as required by the Tower of Qu■ensbury Sanitary SO wage Ordinance , shall be submitc ■d ca the building Deparcment aC least 24 hours before star[ of construction and shall include a plot plan showing . 1 . ) the proposad location of Cho system 2 . ) locarcion and discanc■ to laC lines 3 . ) location and distance to structures 4 . ) location and distance co say wacer supply 5 . ) size and dimensions of all csnks , dtscribution boxes . cilr fields anJ / or drywalls Be No system shall be covered before inspection end approval by the UQ1ldIng Inspuctor . Failure to comply with this requirement may rwdult in the uncovering of the system by Cho installer, and a fins ui up to $ 250 . 00 . � • An approved copy of the plot plan shall be available an Cho construction Alice . Failure co produce said plot plan at c"" of insprcclon Say result to an immadiace work stoppage . D . Should unforeseen problems during construction prevent proper installs" cton & alteration or rapair of an approved system. a new proposal must b%, submictad to Cho Qudansbury BuiliJing Dopartmenc before further t; onutruccion . Town of QFueeusbury BUILDING and CODES DEPARTMENT Bay and Naviland Roads Qusdnsbury , Now York 12804 k,sai:irk3 ; THE NEW YORK BOAR © OF FIRE UNDERWRITERS PAGE E 191:ar,4 Fs BUREAU OF ELECTRICITY 41 STATE STREET, ALE3A EW YORK 12207 ,Date AUGUST Oci A,ppticatio o. onfile 1 ,4479F1 /92 s 1<�� C THIS CERTIFIES THAT VERt11T 140 i l only the electrical equipment as dmwrlbed below ersd introduced by t treed an the above epplicrtioPQ rsurrsfaer in the prewwiaee of y $ Ft7c'i1 i° �ClkE�clfE�kFIC)Fip1„ Ate {}13+ IN f}L . . i3�r,E3ST3L1R�' . f� . `x in the following location: L`X,J Basernent let Ft, 2nd Ff. GAP Sectewa Block Lot t �'11 ums examined on J ;Ly 300 i 919 and found to be in eompltance .with the requirernenta of this lRoard. t RANGES COOKkMG PECKS OVENS DISH WASHERS E%HALPST FANS RE FIXTU EP WIT TACLES SCHES fl%TIRES OUTLETS INCA"MSCENT FLLIOQSSCENT OTHER AMT. K. W. AMT. K. W. AMT- t f]IRYERS FURNAC! MOTORS FUTURE APPIiANCe FEEBRttS SPECIAL RiC'PT TMAE CLCCICS EulLL LINIr HEATERS MULTIAUTLET NAT. K. W. ok H. P. OAS H. P. AMT. NO. A- W. G. 4MT. NAP. AMT, AMPS. TITANS. AMT. N. F. AMT. WA'rt5 t ti 1 � 1 SERVICE DISCONNECT NO.OF s E R V I C E METER No. OF CC. GOND. A. W. 3. NO. OF rll-lEG A. W. G- NO. OF NEU"ALS OF- W. � AMT. AMP. TYPE 1 ,r 4rV 1 0 3w 3 / 3W 3 JP •W PEQ ► of CC. CONp. OF HI-LEG AL OTHER APPARATUS: 10 '. HARRISON AVENUE BRANCH MANAGER � Par 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. # A ERMD 1N ANY MANNER. TOWN 531 =Eavuy SAY ROAD TELEPHONEY ! (618) 745 4447 SUILUING INSPECTOR' S REPORT FINAL INSPECTION 9 REQUEST FOR INSPECTION RECEIVED MJ1ME LOCATION DATE lym PERNITO .- TYPE OF S RECHECK SIRE MARSHAL APPROVAL ( ERICIAL STRUCTURE ) DOTING ✓✓ FOUNDATION BACKFILL '1,,''"FRAMIHG OUGH PLUMBING FINA ELECTRICALSEPT INSULATIOyoOSTOVE/'FIR PLACE RE RKS APP OVAL 1 N/A YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION PLUMBING VENT !` ROOFING SIDING DECK/P R H/S E S/RAIL S RELIEF VALVES FURNACE INTERIOR TRIM/PRIVAC DOERS FINISH FLOORS ; BATH/KITCHEN WATERTIGHT OTHER FLOORS SWE'EPABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS SMOKE DETECTORS DOOR CLOSERS BATHROOM FAN ALL PLUMBING F X URE OP RA ING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPA ION FIRE/DEMISE WALLS FINAL ELECTRICAL OK TO ISSUE C/O / C OMME N C.] ip o ;v -- ARRIVE DEPART ,fir r1� T TOWN OF QUEENSBURY 40000" FIRE MARSHAL QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 745- 4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED_ ', 1`1Z NAME LOCATION DATE1. ' PERMIT# APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING i FIRE EXTINGUISHERS / AUTO . EXTINGUISHING SYS E- HOOD INSTALLATION AUTO . SPRINKLER SYSTEM ALARM SYSTEM A.lf INTERIOR FINISHES STORAGE . CLEARANCE TO SPRI L RS CLEARANCE TO HEAT' NG UNITS REQUIRED SIGNAGE CHIMNEY WOODSTOVE FIREPLACE-NASD Y •.FIREPLACE- FACT RY BUILT REMARKS : Lj OK TO THIS DATE too/*/�� 2/015 I PEC BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R-0. 1 Box 98 oueensbury. New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION + { NAME LOCAT I ON T l 1 14Z gAl 'S-a.kl DATE �f l �2 -- ERMIT NO . �� ' � SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES - , NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , t0t4l length Length of each trend Depth of trenches Size of graver SEEPAGE PITS4Number t�f) _- f Size- ft_ X f Gravel size �� zz Type P IP INZG : � . B1ag . to tank Tank to disco box v Distm box to field/Pit Partial Openings sealed? YES NO LOCAT I ONI/SEPARAT I ON'!S : f t. Foundation to tank \4 ft . Foundation to absorP ion ft. Absorption to lot 1 ' e ft. separation of pits LOCATION OF SYSTEM PROP TY (ciside one) Front - Rear - Le£ side - grit side - COM.MENITS i r r%,,R-`-" F !�-# ram'' S -TA C_ • JET ` l o C& SYSTEM USE APPROVED YES NO � Building Ins ctor 01/86 and vl 1 TOWN OF QUEENSBURY FIR£ MARSHAL QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECT,pI.ON RECEIVED ,::p NAME LOCATION } /h / DA PERMIT# APPROVED EXITS N/A YES NO AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHER AUTO . EXTINGUISHING SYS EM HOOD INSTALLATION AUTO . SPRINKLERS TEMF ALARM SYSTEM INTERIOR FINISHES STORAGE : CLEARANCE TO S R KLERS CLEARANCE TO A NG UNI S REQUIRED SIGNAG CHIMNEY WOODSTOVE ,F�IIREPLACE-MAS NRY v'FIREPLACE- FACTORY BUILT REMARKS : OK TO THIS DATE JO 2/015 IN PEC OR TOWN OF QUEEHSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE (518 ) 745- 4447 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION 4tl2l t DATE P I PERMIT # — / TYPE OF STRUCTUREowc RECHECK APPROVED N/A YES1 NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RES S LE FOR PROVIDING PROTECTION! F FREEZING FOR 48 HOURS FOLLING r THE PLACEMENT OF THE CONCR E. MATERIALS FOR THIS PURPOSE PN SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE Ir FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLA E PLUMBING UNDER SLjkB FRAMING : JACK STUUS/MEADERS BRACING/BRIDGING _ JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH— IN INSULATION : FOUNDATION LES IbrTE R— FOUNDATION WALLS TERIO R— FLOORS R— WALLS R— CEILING — DUCT WORK OR PYPING IN UN ATED SPACES REMARKS : A"XF ARRIVE DEPART NSPEC OR OF TOWN OF QUEENlSBURY BUILDING AND CODES DEPARTMENT All 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE ('518) 745- 4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION! RECEIVED fi7 NAME LOCATION DATE " I PERMIT TYPE OF STRUCTURE- RECHECK APPROVED - FOOTINGS/PIERS N/A YES NO MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSI LE FOR PROVIDING PROTECTION FREEZING FOR 48 HOURS FOL WING THE PLACEM LENT OF THE CONIC E. MATERIALS FOR THIS PURPOS ON SITE FOUNDATION/WALL POUR -- REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VEN S IN PLA PLUMBING UND R SLAB FRAMING : .TACK ST / EAD RS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN 8 HEATING ROUGH- IN INSULATION . FOUNDATION ALL N R R - FOUNDATION WALLS E ERIOR - FLOORS WALLS CEILING R_ DUCT WORK OR I ING IN UNHEA E SPACES R EMARKS : C' L I Ja WA L-Cs J Cry-V T 1► )OL C. f) Cif s7r 1-4 Fi AJ Co C fz S F-CA2 PZvA4 ARRIVE 1 DEPART INS CTO BLILf)ING a Bay and Havil ! `Crtpprrlfirrr na ZONING 17 Pq Mev i nd Read, fil,p R 9 Q"eensbcarY. Now York 7 281 88 01 SEPTIC NAME > DISPOSAL SY$ri�M INSPECTION LOCAr ION 14 DATERM s' / PERM SOXL TYPE Ir NO -- p'erc and olat .Loam --_ Percolation rest Req :red ? G Y S ��. ate /Inch TYPE of SYS �lbaorption Tea z��~_ Length of field, al 'Depth of each trench leng h Size bf 't2'enches SEEPAGE 9xave S l" Size. {�� umber Gravel size __�-�ft. PIPING Bldg " to tank S xe Tanto dirt. boar ."�,l0#� `ye Qpeni box to field/ ngs sealed? pit, C Y$ � LOCATION /SEPa14AfiXc" . Foundation potarrdatzon t �I Absor r �_ft. Pt,ion to pt on Separa to lin �� ft. tiOn of p F ont IflIV ' SYg3 PRC3P'` f t . S. ear - zeft $ de ERTY (circle one , � Right siege _ ) How SYSTEM USE APPROVE ES Bean d ng InsPe tot Lll/85 and vl 1 oW h1 OF QUEENSBUH . j liEcEIVED V 31~ '1 : ', k l 3 rn ?I l , �� APR 14 1992 13L0i3. & CODE DEFT. tL (A rl U 11 UpWN OF UEEN5BU1-{ . ' REC 4VED 5 APR 16 1992 y ,UE . r} BLDG. & C DE DEFK? c;.-5it ace E: ry 4 f • r T' Vco { ! 1 { rV ,( ` L} K I ;5} L +I (pQ ' "y 4 IwY 4111c .. y k F ) *TOWN OF QUE:ENSBU'Ay� w isirata lolling A�i r y�r //' 1r BUILDITnGVA QUEENSBORY401 NDOF CODES DEPARTMENT QUEENSBURYI BAY ROAD TELEPHONE ' NEW YORK IZ804 ' ( 5I$) 745- 4B f SUILI)INS INSPECTOR 'S REPORT REQUEST FOR INSPECTION RECEIYEB NAME tocArl,npv ,/Z f aarE x--- S RMIT # TYPE OF STRUC U RECHECK j FOOTINGS7p A PROVED I MONOLITHIC POUR N/ YES NO 1 REINFORCEMENT IN PLACETHE + FOR PROVIDING CONTRACTOR IS RESPOMfSis F FREEZING FOR 4 0TECTIQN FROM THE PLAc NOURS FOL.Lo s Q NDA TIONMATERIALS / Q I�POURF THE CONCRETE. REINFORCEMENT in PLACE ON SITE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ,7'MOUGH PLUMBING PLUMBING VENT/VEN IN PLA E PLUMBING UNDER SLAB AFRAIII JACK S D /H15 r �_ BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN $EA HEATING ROUGH- IN INSULATION: FOUNDATION W LL IN E FOUNDATION WALLS R= - -- FLOOR S EXTERIOR R- r WALLS R------ CEILING R_ DUCT WORK oR PI - UNHE ED SPACES ING f 1 R EMARKS r Add Tool f TAmI Is ARRIVE , DEPART CTOR ` ��� Jvwn ©� �ueensLyurr� � ! BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION r DATE / PERMIT NO, SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES NO Percolation rate - Min/Inch _ r TYPE of SYSTEM: / Absorption field , total lengthl Length of each trench .Depth of trenches Size of gravel SEEPAGE PITS#Number of) Size- ft. X _ ft. Gravel size PIPING : Siz Type Bldg . to tank Tank to disc . box Dist. box to field/pit Openings sealed? YES O Partial LOCATION/SEPARATIONS : Foundation to tank ft, Foundation to absor ion ft . Absorption to lot ne ft. Separation of pits ft. LOCATION OF SYST ON PROPER Y (circle one) Front - Rear - L t side - R ght side - CCHMENTS F SYSTEM USE APPROVED YES NO Building Inspector 01/86 rnd V1 BUILDING OF QUjEFjtSI AND CODES DEPARTMENT 531 'QUEENSBURY RAY ROAD TELEPHONE ' NEW YORK IZ804 ( 518) 745- 4447 BUILDING INSPEC7.OR 'S REPORT REQrUE"' FOR INSPEcrrox RECEIYED NAMEf� LOCATION DATE PERMIT f TYPE OF STRUCTURE RECHECK u FOOTINGS/PIERS APPROVED MONOLITHIC POUR FORM N/A YES NO REINFORCEMENT IN PLACE FOR PRovior Is R�sPonrs18L� Ro�xDZNG PROTL CTz �v FRoN FREEZING FOR 48 HOURS FOLLOk¢Ns THE PLACE�T OF THE CONCRETE. MATERIALS FOR THIS PURP05 >' ON SITE FOUNDATION/WALL P A, REINFORCEM UR ENT INLACE +�,�- FOUNDATION,.II PRO FIND ; .^ BACKFILL APPROVAL +ROUGH PLUMBING PLUMBING VENT/VEN IN PLACE PLUMBING UNDER FRAMING : SLA JACK STUDS/HEADS S BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN HEATING ROUGH- IN INSULATTL7iN: FOUNDATION WALL F�OpU�NDATION WALLS W. Ls S TER ' R_ CEILING R_ DUC R T WORK OR SPACES P IPING IN UNHEATED REMARKS : g• , s ARRIVE 'Q� DEPART /( I SP TOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY , NEW YORK 12804 BUILDINGNINSPECTOROSZ- 5832 REPORT REQUEST FOR INSPECTION RECEIVED NAM LOCATION ,rs DATE— / ' /'/`,+�•� ` PERMIT # � �_ TYPE OF STRUCTURE z.- RECHECK APPROVED OOTINGS/PIE S N/A YES NO ONOLITHIC 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 A E _ PLUMBING UNDER SLAB FRAMING : JACK STUDS /HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS /MAIN BEAM FIRE-STOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN INSULATION : FOUNDATION WALLS INT IOR R- ; FOUNDATION WALLS EX T RIOR R- FLOORS WALLS R- R- CEILING R- DUCT WORK OR PIPIN IN UNHEATED SPACES REMARKS : ARRIVE DEPART . ( . INSPE TOR "- LAN Q'5 c, F KE t -r t4 VANESSA EEt45ow i i `0 0 0 9 2 5?oft y WOOD FRAME RE5 % DEis_P_ 0 cN<l I RCN , to �9 d 4 T I � 3 o. ----- ----- —9 ---- I p I t— — — ---- — 13 -- — — — 45) 50' L Ab5z-AlbT'Q N TRENGNE154 PIPE (ZSot..F) 4 a t29. 65, -IN---- LPL Cc�c�l V 1 CjAV,AGr E . , 1 Lo-r ty4 � ►�{ � TY N rG�woov TOWN OF QUEENSSURY Z®ning -Ad Dat® ; TOWN OF QUEENSBUK. RECEIVED APR 14 1992 BLDG. & CODE DEPT. 9 _ ///i A N U)r Z ca < m iZ r CCW W 3 Q }— 7 Jg Q C K a