1991-434 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY'
WARREN COUNTY,- NEW YORK
Date .4 n lrirx_k. -5 19 ✓
301 . r I3 - � - ( 6
This is to certify that work requested to be done as shown by Permit No. 91-434
has been completed.
This structure may be occupied as a EbiiieHe
INDIANA AVENUE
Location
Owner BARBARA MALLANEY
By Order Town Board ,
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
� Y
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-434 31
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Barbara MallaneyCO
OWNER of property located at Indiana Avenue Street, Road or Ave.
.p.
in the Town of Queensbury,To Construct or place a Mobile Home
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
Ri
7 Indiana Av enue
2. CONTRACTOR or BUILDER'S Name
John Mallaney c
3. CONTRACTOR or BUILDER'S Address 0
a
4. ARCHITECT'S Name a
Uv
5. ARCHITECT'S Address .2).
_I.
=
6. TYPE of Construction— (Please indicate by X) . 8
t'1)
( )Wood Frame ( ) Masonry ( )Steel ( ) �1
� 1
7. PLANS and Specifications
No. 70' x 14' Mobile Home as per plot plan specifications and
application
8. Proposed Use
Mobile Home
$ 60.00 PERMIT•FEE PAID —THIS PERMIT EXPIRES June 24, 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 24th Day of June 19 91
SIGNED BY A74!i',. , for the Town of Queensbury
Buildin and ning Inspector
. -_y / 7//
TO BE COMPLETED BY BLDG. DEFT•/-Own 0/ Quee:ailury Application No. /
Permit Issued 19
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road Permit Expires 19 �:..
, R.D. 1 Box 98 Zoning DesignationTOrn `Queensbury, New York 12801 Variance No.. ''t f
Site Plan Review No. ="M�� �f-
APPLICATION FOR Approved by: r !' u N 20 1991
MOBILE HOME •
CpQ { elt7i�
PU I LD I NG AND ZONING PERMIT ®uaulNG & co®E "PIN
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications
special conditions as may be indicated on. the Permit. submitted, and such
The owner of this property is: 06R12hr: ('atlny),Q/P.O. Address 1 - :Tr1 ACY., r0111°. • Tel. Tee6'
Property Location: /ciii9✓lJA Alen - ' Tax Map No.g7 (1/ J4/
Street ::umber or building lot number
Subdivision name (if applicable) /v/09
TILE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING 'CODES IS:
,h.M r71/9//hreeY 7 ,-5 5 3 / - ...
Name P.O. Address - Tel. No.
Name of Installer Address Tel.
Name of plumber • Address Tel..
Name of mason Address Tel.
MOBILE HOME INFORMATION: * ZONING INFORMATION:
New dome Placement ✓ . * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
-' drawn reasonably to scale and attached hereto,
Replacing existing Home • .. . * showing clearly and distinctly all buildings,
Size of new Home 70 ft X /1/ ft . * whether-existing or proposed and indicate all
•�/ * set-back dimensions from property lines. Give
Single w ?e • Y Double wide * street and number or lot number and indicate
•
No. of rooms (excluding baths) *whether interior or corner lot. Show location
of water supply' and location and configuration
No. of bedrooms A, * of septic disposal area. -
*
No. of bathrooms / . * COMPLETE INFORMATION REQUIRED BELOW. •
Fireplace?J.4 Wood stove? /(` * Size of property ' /40 ft X ft.
1/1/ *Foundation style and-size: -
Existing building(s) AO Size � ft X ft.
* .
Piers- No.of Size- ft x ft. * Existing building(s) Use• . �//�
Depth below grade ft.
i* Proposed building, distance from property line
aFOUNDATION - Footing size " X.2( 1
",1` *
* Front yard .. ft Rear yard ft
Wall material * Side yards / ft and 3 J ft
Wall thickness " Height . ft. * If on corner, setback from side street ft
* • OCCUPANCY INFORMATION -
Total depth below grade ft. *
Grade to Home floor level ft. * PRI�NkRY BUILDING
# * * * * * * * * * * * * * * * * * * * One family dwelling • .
* Two family dwelling
Proposed date of placement / / * Multiple dwelling / Number of units
Y * Permanent occupancy
Aprox. Value. of. Home $ Se02, * Transient occupancy
Water supply - Well Municipal {� * Business
* Industrial
Septic Permit required? xe5 * Other -
* If addition, what will use be?
*
FURTHER INFORMATION REQUESTED * ACCESSORY BUILDING-
ON THE REVERSE SIDE OF THIS SHEET.* Detached garage/one car/ two car/ car
* Attached garage/one car/ two car/ car .
- * Private storage building
• * Other
•
*
•
•
•
•
' Form MIIP 5/86 and-vl
APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
. State of New York Division of Housing and Community Renewal
H. INSIGNIA OF:AP.Nt-OVAL OF THE STATE BUILDING CODE
1..- =INSIGN;IA:=SER;IAL NUMBER
2 . NAME OF MANUFACTURER (. 7Ai ilt/t)
3 . PLAN APPROVAL NUMBER Y •
4 . MODEL OR COMPONENT DESIGNATION .
•
•
•
5 . MANUFACTURER'S SERIAL NUMBER 5i' S `- 999 � '7
6. DATE OF MANUFACTURE • / 71
•
All the above information is to be found on a plate or sticker which
should be affixed to the Mobile Home. Complete..above With that information.
* * * 4 * 4 4 * * * * 4 s * .* * 4 4•••* * 4 4 * * * * * 4 4 4 * * 4* 4 * *
•
Town of Queensbury A F F I D A V . I T STATE OF NEW YORK
County of Warren
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a true and
complete statement of all proposed work to be done on the described premises and that all
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the proposed work shall be complied-with, whether specified or not, and that such work is
authorized by the owner.
Signature _ __rsLIL
er, .owner's agent,architect ontractor•
•
•
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * '*
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
•
•
•
•
•
•
. • ' By
• •
� 1.
TOWN OF Q UEENSB UR Y
Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832
SWIMMING POOL PERMIT APPLICATION
FEE PAID
OWNER'S NAME �Pp/�,�/�,g MA///g4ry TEL. 'i 9g-c/a/5 -
LOCATION // _ZAIUr Mtn Am2X1i re
PERSON RESPONSIBLE FOR CODE REQUIREMENTS: J&("w _ mac,\\ ,,,Rey
ADDRESS )1/ 2i1/d,4n,,q TEL. 19,9-499g0
TYPE OF POOL - - y/ in-ground above- ground
SIZE: Length ,qa ft. / Width /0 ft. / Diameter ft. / Depth '/ ft.
APPROXIMATE WATER CAPACITY gallons.
MATERIALS USED IN CONSTRUCTION: (circle one)
Steel vinyl -- Fiberglass -- Gunite -- Poured Concrete -- Other
CONTRACTOR/INSTALLER 30'nn rnca\\avR�4 TEL. kle`9-6,gL(()
ADDRESS // TivC/i>v1', /9116 U"e
IMPORTANT INSTRUCTIONS:
On a separate piece of paper, submit a diagram; drawn to show:
PROPERTY LINES - EXISTING STRUCTURES - PROPOSED OR EXISTING SEPTIC SYSTEM -
LOCATION OF PROPOSED SWIMMING POOL - Show all distances from lot lines to both
the pool and the structures, as well as separations between.
APPLICATION FOR ELECTRICAL INSPECTION IS NECESSARY. A COPY OF THE APPLICATION
IS TO BE FILED WITH THIS OFFICE.
THIS OFFICE IS TO BE NOTIFIED UPON COMPLETION OF CONSTRUCTION; INCLUDING
INSTALLATION OF FENCING. A FINAL INSPECTION WILL BE MADE BEFORE USE OF THE
POOL IS AUTHORIZED.
Signature of Applicant: a44/ i'i/Ceilce/i2 Date:
y
OVER
Section 7.074 Accessory Structures and Uses.
4. Private Swimming Pools. Private swimming pools, permanent and portable,
which shall be accessory to a principal , non-commercial dwelling use
shall be regulated as follows: except that these regulations shall
not apply to portable swimming pools which shall be not more than
three (3) feet in height nor more than fifteen (15) feet in length.
a) May be erected only on the same lot as the principal structure.
b) May be erected only in the rear yard of such structure and shall
be of a distance not less than twenty (20) feet from the rear
lot lines or buffer zone where appropriate nor less than ten (10)
feet from the side lot line, or buffer zone where appropriate
principal structure or attached or detached accessory structure.
c) Such use shall not adversely affect the character of the
neighborhood.
d) All private swimming pools shall be enclosed by a permanent fence
of durable material at least four (4) feet in height.
e) In the case where a lot fronts on two (2) or more public
rights-of-way, a private swimming pool shall be erected only on
that portion of the said lot that is directly adjacent to that
side of the principal building which is directly opposite the
architectural main entrance of said building and the neighboring
side lot line. In no case shall the pool be any nearer to the
lot lines abutting any public right-of-way than the required front
setback for the principal building of the zoning district in which
it is located.
Furthermore, the pool shall be screened from the view of the public
right-of-way and the neighboring property by means of landscaping.
(See "Landscaping" )
FEES:
$25 Fee for Above Ground Swimming Pool
$35 Fee for In-Ground Swimming Pool •
NOTE: ALL POOL PERMIT APPLICATIONS MUST STATE MATERIAL TO BE USED.
41521
inIN
� � TOWN OF QUEENSBURJ. , ; .,.~
APPLICATION FOR SEPTIQr a'CAL9 1 ,A:--.,- Permit #
tfi `-1 1i ‘ �I1tFI t� Fee Paid
1:4
Date: (� ,he'd � 1i JUN 20 19
91 Reviewed By
LOCATION OF. PROPERTY FOR INSTALLATION:B" ^�r�gapot* Dy sgf^D{,p
Owner' s Name: <t }t- �7h�`-1i 11) i,� a°r°�°'
Owner' s Mailing Address: 'I :Ends a a, ,,:ti ,,,_ y\u1R
Installer' s Name: r `��f�+: 0_., ��ar`4,IIt�;�.�r ® t Phone #: �9 -�575/
t
Number of bedrooms (if residential ) : L,
Total daily flow (residential-compute @ 150 gal . per bedroom) : 3C'
Topography-Circle One: lat Rolling Steep Slope % of Slope
Soil Nature-Circle One:, " Sand Loam Clay Other /Depth:
Ground Water-At What Depth? lid Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: No Rt equired Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: I'3 1 c_ipal ' Well Other
If domestic water supply is a we
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank Ain- gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 50 feet//Total System Length /5 0 feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # 1 / 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 a certified
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: , ;., !.°t, .DATE: ``��r0]-, '
� � / ��•�` .
•
4 v... Se,pti c System Inspections:
A. All applications fo,r. , septic system installation, alteration or repair,
as required by the' Town of;: Queensbury Sanitary Sewage 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 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 drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
� ..••r', MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
(f( *t
National Headquarters
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTIO
JN Dater'
.
City, Town or Township C_ - • 1-`j}-h; iL / County / ' -1, '! State • '- /.
Location/Address r• it '(T1 i.4/f� !"--)/r.'ir'/(
(If Located in Rural Area - Please Attach Directions) Pole #
Owner Permit #
Occupied As ) )% • iJ )--.I Jr Building: New❑ Old
Occupant ,
- Work Area in Building (Floor #,etc.):
App. for: Wiring 11 Service n or: Ready for Inspection:
Fee Remitted-$ Cash n Check I I M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat
,_.
Switches
Amp. Service Surface Unit Dishwasher Range
Lighting � ! / Water Heater Air Conditioner Dryer Pump
Receptacles
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment: .
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 r 1 1'/2 ' 2 3 5 7'/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's
Signature . ` License # Permit #
T/A Utility:
' ' (NAME) (OFFICE LOCATION)
Applicant's Address: '':1 '
L
(City) • ; -- '- ``y (State) /J- / • (Zip)�c'`�G' Service Request #
Phone # 7r3�1 W/_, Electrician:
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED: .
Correct Location: Same as Above or:
Red Notice Label n
Rough Wiring Outlets _ Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp. Service Equipment Burner, Wiring &Controls for Amp. Receptacle -
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. '1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1'/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 CORRECT FEE PAID
FE
❑ RW Progress: Inc.❑ LKD❑ Contractor •
❑ CFT Violation: Work Comp.❑ Inc. ❑
n L/A Owner CASH ❑
Fee CHI( #
L/A Due MO #
n IPA Municipal INV #
Date: • Other Side❑ - Utility Applicant ❑Owner
Cut in Card ❑ Temp # Date .
INSPECTORS SIGNATURE
n Final # Date
APPLICATION FORM NO.250 EL 11/89
TOWN OF QUEENSBURY
531 BAY ROAD
N{x' n QUEENSBURY, NEW YORK 12804
r ° f.' TELEPHONE (518) 745-4447
BUILDING INSPECTORS REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED ,p'5C//�/
NAME
LOCATIOW
DATE 9/��/ PER 1ITf �---412
TYPE OF STRUCTURE �- e-
door, a( € , 4X2-e1;
RECHECK (?plyiY (Vey,. 1UTrr', /si X--///O-heoW
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
- FOOTING FOUNDATION : BACKFILL FRAMING
ROUGH PLUMBING L�NAL ELECTRICAL _LS4EPTIC
- INSULATION WOODSTOVE/FIREPLACE
REMARKS
NAPPROVAL
/A 1ES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION i
PLUMBING VENT d'
ROOFING II ✓ .w_�
SIDING 11
DECK/PORCH/STEPS/RAILINGS "
RELIEF VALVES j
FURNACE/HOT WATER OPERATING ,d
BASEMENT INSULATION/DUCTWORK/
INTERIOR TRIM/PRIVACY DOORS/
FINISH FLOORS: /
BATH/KITCHEN WATERTIGHT/ 4'
OTHER FLOORS SWEEPABLE/ f
OTHER FLOORS CARPETED?' /
STAIR CLEARANCE/RAILINGS 1/
HANDICAPPED ACCESS /
SMOKE DETECTORS /
BATHROOM FANS/WHOLEJiOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROD ING ?,
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS: A
CA Am SleAtaf 01, cy€4,
11
ARRIVE 11
41
DEPART.__ _
INSP T'
TOWN Of QUEENSBURY
'"` � 531 BAY ROAD
'1,1` j ,, QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECWRIS REPORT
FINAL INISPECTION i
REQUEST F INSPECTIOf1 RECEIVED
MAME ,,%,-s /',l�/e7
LOCATIO . /. �,v1
DATE c 3e/iV PERMIT# y/- %/
TYPE OF STRUCTURE �4-.6 /e'
RECHECK
{
FIE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
L,TOOTING FOUNQQTION-' BACKFILL FRAMING •
_ROUGH PLURBING �FINAL ELECTRICAL_SEPTIC
INSULATION WOODSTOVE/FIREPLACE
SITE PLAN/VARIANCE R QUIREMENTS YES _ NO
REMARKS /i
• APPROVAL
N/-YES NO
CHIMNEY HEIGHT/LOCATION `i, ✓ ,
B VENT/LOCATION • [ \ :✓
PLUMBING VENT
ROOFING ‘ ✓,
SIDING
DECK/PORCH/STEPS/RAILINGS ✓ ,
RELIEF VALVES :✓
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
-
INTERIOR TRIM/PRIVACY DOORS ,/
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT L .
OTHER FLOORS SWEEPABLE ,✓
OTHER FLOORS CARPETED ,
STAIR CLEARANCE/RAILINGS ,--,----
HANDICAPPED ACCESS
SMOKE DETECTORS --‘----
BATHROOM FANS/WHOLEHOUSE FANS ✓
ALL PLUMBING .FIXTURES OPERATING ✓'
GARAGE FIRE PROOFING ;
DOOR CLOSERS ✓
OTHER FIRE SEPARATION ✓ ,
FIRE/DEMISE WALLS ' - "
DUMPSTER
FINAL ELECT AL- ,/ ,- •
OK TO ISSU C/O' R ;/
COMMENTS_5
7/EE'C/� k P4r vU�/ U/'/.4f.2
0. 4)14'/ q// e C4 LA z� /�
ARRIVE /r.76 ��
DEPART /'i f `/ ),/
INSP,�CT R
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No Vg V
Owner -crb 17/-4) Pt A-A-terfri
Occupant
Location ftOideP-1114— Aucd u.14.197755
No. Street
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by
No.
DateeA:eck4s.peetor
MIDDLE DEPARTMENT I SPECTION AGENCY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA_19380 _
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
OUTLETS WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.
FIXTURES K.W.OVEN
/ MP.SERVICE EQUIPMENT H.P.GARBAGE DIPOSAL UNIT
..0
LAMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
MOTORS M.P. I/20 1/12 1/10 'h '/6 % 'h '/: 'h 1 1' 2 3 5 71/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY /)017ti--
BUILDING AND CODES DEPARTMENT " it���
531 BAY ROAD "Z� e/
QUEENSBURY,
NEW O 3
TELEPHONE (518) 7792-582
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED �!��ft`'/
NAME vrAroc )jM ,
LOCATION /
DATE /Z9/C// PERMIT # 9/-4(34
TYPE OF STRUCTURE ;i5,w;_e4/e, ,�' ) ,i p
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 l
ROUGH PLUMBING
PLUMBING VENT/VENTSpN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS \
BRACING/BRIDGING \
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING /
WALLS
CEILING /
FIREWALLS �.
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: �e_f_
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY /In
:;;�! 531 BAY ROAD
t4l' QUEENSBURY, NEW YORK 12804
,.. "
;. � �, TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
/W-FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVER 04A/
NAME
LOCATION ..e !2 C.Qi'(.,f)4ei
DATE fi `lff _PERNIT5 f/-4(W
TYPE OF STRUCTURE `f?L-L;Z! 42-21...e (QedP/[/�
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL _FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
/
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LO ATION 11
B VENT/LOCATION /
PLUMBING VENT /
ROOFING \ /
SIDING \ I
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES \ I
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/D, CTWORK
INTERIOR TRIM/PRIVAC DOORS
FINISH FLOORS:
BATH/KITCHEN WAT ' TI'GHT
OTHER FLOORS SW PABLE
OTHER FLOORS C PETEA
STAIR CLEARANCE/, AILINGS
HANDICAPPED ACCSS 'I
SMOKE DETECTORS 1
BATHROOM FANS/WHOLEHOUSE\FANS '
ALL PLUMBING-'FIXTURES OPERATING
GARAGE FIRE PROOFING a •
DOOR CLOSERS
OTHER FIRE SEPARATION ''t
FIRE/DEMISE WALLS_
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL '
OK TO ISSUE C/O OR C/C
COMMENTS:/71 j r`ci Chi C WC-V:01. {`0
AY qi+-7-6L.1 5 0 i={z- L-G-/}-iC"S' .
P Po v i D b-/}c-'�J5- Tc� Pou;c=o f—1-k -'4
(A, LZ_ I' `I US &-er i 6,4.1 126-A D -
ARRIVE /0(-- ,/
DEPART4( L([ /cam
` ' INS T
foul
//
_ n of bur /9/7
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME \� iee-C4/ &� 4 -
LOCATION yjdJgj/,/ v�f
DATE7/4 / 11 PERMIT NO. 0—4<V /
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: ;,'
Absorption field, total length
Length of each trench ;{"
Depth of trenches i '
Size of gravel ;i I
SEEPAGE PITS{Number of)
Size- ft. X II ft
Gravel size. 1 /
PIPING: 9 /Size Type
Bldg. to tank i` -
Tank to dist. box_-��_,- -
-- Dist:- box to field%pit
Openings sealed? ;%�@YES NO Partial
'r `t
LOCATION/SEPARATIONSI:
Foundation to tanks ft.
Foundation to absorption ft.
. Absorption to lot line: ft.
Separation offpits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear- Left side;- Right si
COMMENTS: f
�a / '� ef.2) t-QQ it
Uif:3 frio kb_ — .
13
....„_,
SYSTEM USE APPROVED 7 YES 0
i
' 7/40 /---1--
Building nsp"ector
01/86 and vl
Ait,.-4yezcw ew.
,_..tal....e.
_lown o ueendbur
y A/1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road;R.D. 1 Box 98 .
Queensk?ury, New York 12801
eIC DISPOSAL SYSTEM INSPECTION C ION
NAME
LOCATION „��j/jGl� /!,(� /1g'
DATE /% i 9/ PERMIT NO. 9k- z.97
SOIL TYPE - Sand - Loam - Clay.i,'-
Percolation Test Required? YES - NO
Percolation rate - Min/Inch I' •
TYPE of SYSTEM: :i. rl .
Absorption field, total 'lencjth / c.)O
Length of each trench- 5 Cj''
Depth of trenches ' "j...„ r
Size of gravely '
SEEPAGE PITS{Nuinber of) ;
Size- ft. X . if
Gravel siz j
PIPING: ------8- ze Type
Bldg. to tank C�
Tank to dist. box / [' f c.
Dist. box to field/ ' j' /f 7c C—
Openings sealed? YE NO Partial
LOCATION/SEPARATIONS:
Foundation to tank / ft
Foundation to absorption° f . C)1(
Absorption to lot line f
Separation of pits "%V A- ft.
LOCATION OF SYSTEM ON PROP RTY(circle one) •
Front - Rear - Left side - Right side -
COMMENTS:
C 1L - C6 Qi&g. / _ -
SYSTEM i.
USE APPROVED YES NO
c
B ilding ns ector
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 REPORT
REQUEST FOR INSPECTION RECEIVED (ORO' 91
NAME 01'\ y�
)LOCATION S6Y S U l Ile- I 1 O Y
DATE PERMIT # Gj) .��
TYPE OF STRUCTURE
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
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
R EMAR KS:
/. e%
( �
6-dill-7
3 , r CA)Q v
46. all ffcc, Ax1J Afc'ef
!9 7y
ARRIVE
DEPART
INSPECTOR
+ I I I j ! I � i !
I 1
---Ri6tik, si•z‹.. 2_ i v./it...R.
•
i I 1
� I
i_"
i2
I
1 i i f
T
i
�� I I I !� I ��i I I I j= 4 1
r'
i
! I � I i
I
i ! '
1 I. I I I ,
j i I I I I i
I 1
I
j I! , 1 I
I I I I I I r I , .
ff:,..7.,:‘,,,......,‘,.....,, ,...... ,, .
ie . . ,
..,,. h-,„, ..... ,i. ,i , .
. , ,
u.,. ,
..-.. ,,,, ...,..7, . . .
,may I I I
•
I a%4,
I I I
I— itZ4
.44- .2 ,
® t'INN
1' r I I �
•
;,, 1 Ij j i '1\1; \—iih;-
: , I . . u,..),c; ‘,) ,., ,.: ,
4.
q- t 1 rar 4 .r�_ 1
•
ic.._...
•••••-tj I
. ,ii 1 I I I 62 ' , .
I I I 7-9 mo.-._'_' d1
I I I 3i
.\1. . 1
11
- _�.:._ .,ems --- . ..- - ..s _.._.: �..�.,_�.
...„,,,a , ,
s`4 + F" +•f`.*'acorn T-'""'/_ I/ / 71 j` ?4 '•''A
LI
�. �—,! ` , J�