1991-731 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 23, 19 91
This is to certify that work requested to be done as shown by Permit No. " 91-731
has been completed.
•This structure may be occupied as a Sy ngl � ara71 Melling
Location LOt 04 Gerd Pond Rd
Owner Scott and Patricia Veils
By Order Town Board
TOWN OF QUEENSBURY
•
•
Director of Bldg. & Code Enforcement
k
BUILDING PERMIT
TOWN OF Q U E E N S B U RY No 91-731 a
WARREN COUNTY, NEW YORK
0
cn
PERMISSION is hereby granted to Scott and Patricia Wells
OWNER of property located at Lot #4 Mud Pond Rd 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. --'
N
1. OWNER'S Address is
10 2 Olive Street
Hudson Falls, NY 12839 c-f'
sae
2. CONTRACTOR or BUILDER'S Name
'G
Raymond Sherlock—Bldrs
C,
3. CONTRACTOR or BUILDER'S Address
29 Lafayette Street
Hudson FAlls, NY 12839
4. ARCHITECT'S Name
O
5. ARCHITECT'S Address
a
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6. TYPE of Construction—(Please indicate by X)
( X Wood Frame ( ) Masonry ( I Steel ( )
V)
7. PLANS and Specifications
t0
No. 1056 sq ft Single Family Dwelling as per plot plan specifications
and application a
8. Proposed Use
..a
Single Family Dwelling with 1—Car Attached Garage
$ 157.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 15, 19 92
t0
(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 15th Day of October 19 91
SIGNED BY for the Town of Queensbury
Buildi and Zoning ctor
TOWN OP QUEENSBURY
ellill REVIEWED BY: -'
� � FEE PAID: - 'wEp
PERMIT NO. : 9/- 7 / OCT 1 0 1991
BLDG. & CODE DEPT.
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Owner of Property: Scott and Patricia Wells
P.O. Address: 1 p a nl ivP St . Hudson Falls, N.Y. 12839 PHONE 747-6513
Property Location: Lot#4 Mud Pond Rd. Queensbury, N.Y. Tax Map No. / /
Has there been any split of this property since October 1, 1988? Yes No x
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Rainbow Ridge Lot No. 4
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Raymond Sherlock-Bldrs . 29 Lafayette St . Hudson Falls . N.Y. 12839 747-7327
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
X Construction of new building * CONSTRUCTION: $ 80 ,000
Addition to building *
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: 146 ft. x 200 ft.
Other work (describe) * Existing Building Size:
* ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
*
1st Floor 1056 Sq. Ft. i3c` * Front Yard 35 ft. Rear yard 85 ft.
-5 *--_. Side Yards 51 ft. and 91 ft.
2nd Floor Sq. Ft. - 7 .�* If on corner, setback from side street-
* ft.
Other FloorsGarage-308 Sq. Ft. *
(not cellar or basement) * • OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: I 364 Sq. Ft. * Primary Building" -
* X One Family Dwelling
Size of New Structure: 24 ft. x 58 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units
Pier/Slab/Crawl/Partial , (Circle One) * Business —
* . Industrial
No. of stories (Habitable space) 1 * Other
Height (grade to ridge) App. 16 ' ft. *
If residential , no. of families: 1 * If addition, what will use be?
No. of rooms (excluding baths) : 6 *
No. of bedrooms: 3 *
No. of bathrooms: 1 * Accessory Building:
Primary heating system: Forced-Air * Detached Garage - One/Two Car
Type of fuel : oil * 1-Car Attached Garage - One/Two Car
No. of fireplaces to be installed: * Private Storage Building
Will a woodstove be installed?: * Other "
Central Air Conditioning: Yes No X *
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. Wood-Frame
Will any second-hand or ungraded lumber be used? If so, for what? No
Foundation Wall Material : cement Block Thickness: 10"
Depth of Foundatiori :below grade (to bottom of footing) : App . 62 '
Will there be a cellar? yes Heated or Unheated? 4akheated Floor Sq. Footage:1056
Will there be a basement? Will any portion be used as living space? No
If so, what portion? Sq. Ft. Type of Use?
Type of Roof: Si oped/Flat/S ed/Other Gable Material of Roof 0.C . fibre-glass 3-tab
Size, wood studs 2 " x 6 " ; spacing 16 " o.c. ; length 9 25/8ft.
Joists (floor beams): 1st Floor 2 x 10 spacing 16 " o.c. ; span 12 ft.
Joists (floor beams) : 2nd Floor _ " x " ; spacing " o.c. ; span ft.
Overlays (ceiling beams) : T r„SSPg' x "; spacing 24 " o.c. ; span 24 ft.
Roof rafters: " x " ; spacing o.c. ; span ft.
Roof trusses (pre-engineered) : spacing 24 " o.c. ; span 24 ft.
Exterior Wall Finish: Clap-hnard of what material ? Vinyl
Interior Wall Finish: Drywall
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
5/8 Firecode Sheetrock
Is there to be an opening between garage and dwelling? Yes If so, will a Fire-Rated door,
enclosure, self-closing device be provided? Y e s
Will a flue-lined chimney be installed? No Height above roof ft.
Depth of chimney foundation below grade: ft.
Depth of fireplace hearth: ft. in.
Water supply - Municipal or private well : Well
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: min. 1 o o ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: Rey �herinck 29 Lafayette Hudson Falls :'N.fHONE 747-7327
NAME OF PLUMBER & ADDRESS: KPn CP1 estP Glen. Falls , N.Y. PHONE 792-3007
NAME OF MASON & ADDRESS: 11AiP Baldwin Fort Ann, N.Y. PHONE 792-1371
NAME OF ELECTRICIAN & ADDRESS: Scott Wells Hudson Falls N.Y. PHONE 747-6513
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 complied with, whether specified or not, and that such work i authorized by the owner.
Signature o,1 ,, ,J• �j�
Ow r, wn r nt, architect
contr ctor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
°'� ----..,,`\1 MIDDLE DEPARTMENT INSPECTION AGENCY; INC.
/ National Headquarters
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date: fit)/l0/g 1
City, Town or Township i 0112C.r1uhur6 ,_. .7. County i<)cSrren State wl,Y.
Location/Address L0"L ,#ft Mud POn 1 Ix,I . �'��*.e e n bur y, i': .Y
• (If Located in Rural'Area -Please Attach Directions) Pole #
Owner ysntt A'rd' 'PAtrir i F. ',4p11 iti,da0n Falls Rj V Permit # / '- :1/
Occupied As 7, Building: New) ti I Old ElOccupant , , - 7, - I . _ --
Work Area in Building (Floor #, etc.):
App. for: Wiring{ ik,. Service❑ or: Ready for Inspection:
Fee Remitted -$ Cash❑ Check❑ 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
Lighting 70 rt?L1.F:ts 200 Amp. Service Surface Unit Dishwasher Range
1 Water Heater Air Conditioner Dryer I y Pump
Receptacles r. .�sF 1y
N t�et� .Oven Garbage Disposal Wiring and Controls for , Burner
of Fixture
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment: I Ffir; 1v nt ' cm0i:e dnrtPctnrt
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 r- ,
Signature License # • Permit #
T/A J Utility:
Applicant's Address: ni. T �- 7 - ett C t (NAME) (OFFICE LOCATION)
J� dJ Ci�<�
(CO) 17-,c,soll ij s11 e 1? o f (St4tel) _+? (Zip) _ Service Request #
Phone # 1 Electrician: Scott jJe11S
MDIA USE ONLY DATE RECEIVED: DATEINSPECTED:'
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 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.I I LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑ -
I L/A Owner CASH I I
L/A Fee CHK #
IPA Due MO #
Municipal
INV #
Applicant ❑
Date: Other Side I I Utility El
Cut in Card I I Temp # Date
1
Final # Date INSPECTORS SIGNATURE
LICATION FORM NO.250 EL 11/89
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods: TOWN OF GLJEENSSta`-
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) RECEIVED
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings; OCT 1 0 1991
Multi-Family Dwellings
(3 Stories or Less) BLDG. & CODE DEPT
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
Ray Sherlock Bldrs . for
Scott and Patricia Wells Lot #4 Mud Pond Rd. Queenshury, N_Y_
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 1056 Sq. Ft.
2. Type of Heat - Elec. Base Board Other nil fnrrPr1 ai r
3. Is Building Mechanically Cooled? YES x NO
4. Percentage of Area of Windows and Doors Over 17% X 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 38
B. Exterior Walls R 19
C. Glazed Area R 3 . 03
D. Exterior Doors R 12 . 6
E. Floors over unheated spaces R
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R 10
H. Basement/Cellar Walls (Below Grade) R 10
I. Heating/Cooling - Ducts - Piping in Unheated Space R.
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code X YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
APPLI S SIGMA RE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS:
R D BY
` j TOWN OF QUEENSBURY TOWN OF QUE: 'IIISBUR.
APPLICATION FOR SEPTIC DISPOSAL PERMIT Perin-CO/WED
Fee Paid
OCT 10
y
Date: 10/10/91 ReviewedLLU� & C
LOCATION OF PROPERTY FOR INSTALLATION: Lot ' ##4Nud Pond Rd. Queensbury,N.Y.
Owner' s Name: Scott and Patricia We1 1 s
Owner' s Mailing Address: 102 Olive- St . Hudson Falls , N.Y. 12839
Installer' s Name: Dow Construction Phone #: 798-4315
Number of bedrooms (if residential ) : 3
Total daily flow (residential-compute @ 150 gal . per bedroom) : 450
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: 'Sand Loam Clay Other gravel /Depth: h '
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 absorpti ortji n. 100 feet
PROPOSED SYSTEM: Septic Tank loop gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 50 feet//Total System Length 200 feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
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 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: , ?� DATE: I U,/-on)/
Septic System Inspections:
A. All applications for 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:
2it- ( v1')
{^„ TOWN OF QUEENSBURY
531 BAY ROAD
s; ' }
t QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME Lt J l�
LOCATION Ls+ y Wi u1 d Ro
DATE I l ..3 C PERMIT# 9/ "73 ✓
TYPE OF STRUCTURE S i
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
-FOOTING FOUNDATION BACKFILL FRAMING
-ROUGH PLUMBING FINAL •LECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE-
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION t//
PLUMBING VENT ✓
ROOFING vi
SIDING
DECK/PORCH/STEP RAILINGS t/i
RELIEF VALVES V/
FURNACE/HOT 'TER OPERATI G
BASEMENT IN. LATION/DUCT ORK
INTERIOR PIM/PRIVACY DOORS !/
FINISH F IORS:
BATH/'ITCHEN WATERTI T
OTH FLOORS SWEEPAB E
OT, R FLOORS CARPETED
ST, R CLEARANCE/RAILINGS c�
,NDICAPPED ACCESS /
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING t
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION ✓/
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C </
COMMENTS:
/ 4 "
ARRIVE//
DEPART 11 �
NSPC OR
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No.
Owner c e0 yr tt)CLLS
Occupant 1f
Location LD / m 113) Pc) R-40
No. Street
f I_,V
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable codes.
Installed by 5-e-e) CZA---S
Date /2 / ?/ plats Cxt Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood, NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER •
3 0 , f T'e(-/ WIRING &CONTROLS FOR lL BURNER
C.// RECEPTACLES / H.P.PUMP
�/ FIXTURES K.W.OVEN
()QAMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
yt 4 AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT / K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
/ K.W.WATER HEATER 4/ FRAC. H.P.VENT FANS
•
MOTORS H.P. 1/20 1/I2 I/IO 1/4 'h '/ 'h '/z 'h 1 11/2 2 3 5 71 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
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 I c�i°I j 1 (`
NAME ),..) ei1\.c.)) ((LA.:NI_ ����r c 4, Ilia
fl
LOCATION- Lf I`kc)c) \W �()
DATE
J cl I ( PERMIT # f —73(
TYPE OF STRUCTURE S ‘c- c
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
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
-INSULATION: X
FOUNDATION WALLS INTERIOR R- lI '\
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING .IN UNHEATED
SPACES
REMARKS:
/l n rl
ARRIVE r G;(� V.
l ;
DEPART Z.:. /k
INSPECTOR
sown of Queeniturcy
• BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME / ,fiLGt
LOCATION 1/ /7/l /eGL
DATE ff/ PERMIT NO. 97 75/
SOIL TYPE - Sand ca Clay -
Percolation Test Required? YES -�Na)
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench ' 5.0
Depth of trenches '
Size of gravel
SEEPAGE PITS{Number of) ' /
Size- ft. X ; ft.
Gravel size
PIPING: Siz '' Type Bldg. to tank / ,r 5'c1(tle {w(--
Tank to dist. box ctj f76r;`
Dist. box to field/ it' '-1 12j c_
Openings sealed? IYESJ NO Partial
LOCATION/SEPARATIONSI „
Foundation to tank ./ \
Foundation to absorption. 21)ft—
Absorption to lot Line \ %U ft-
Separation of pits Affjr}-ft.
LOCATION OF. SYSTEM ON PROPERTY(circle one)
'tom------ * .
Front - ea - LlOft s-i - R ght side -
COMMENTS:
r
SYSTEM USE APPROVED YES NO,
BuJJding Inspe tor
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 1 � �5)��
Wet�
REQUEST FOR INSPECTION;, I `RECEIVED r f
NAME p SL 0" "
LOCATION LI (flr) KW)
DATE ?S19 J PERMIT # c\
TYPE OF STRUCTURE iS
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 FOLL WING
THE PLACEMENT OF THE CONCR E.
MATERIALS FOR THIS PURPOSE N SITE
FOUNDATION/WALL POUq
REINFORCEMENT IN PL CE
FOUNDATION/DAMPROOF NG !J
BACKFILL APPROVAL I
ROUGH PLUMBING \ I
PLUMBING VENT/VENTS I'N PLACE
PLUMBING UNDER SLAB \ /
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING / 1.
JOIST HANGERS /
JACK POSTS/MAIN BEAM
FIWALLOPPING
\CEILING / \.
FIREWALLS
HEATLNG _ROUGH-IN
_ I°NSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R- O
CEILING R- 5c,i K
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
)l
ARRIVE • f,
DEPART /(;:( �_-
1 INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT -""14.441H
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT%\ ,\
REQUEST FOR INSPECTION RECEIVED
NAME \ \1 C , C t*-t
LOCATION ),,1,(7V S
DATE\\ ' PERMIT # I I - / 3 1
TYPE OF S RUCTURE 'c , T
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE 1
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 is /
kFRAMING: r
JACK STUDS/HEADERS
BRACING/BRIDGING i'
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:
ARRIVE l
DEPART J / dzz) 4 �
/ 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 (tom'-C /"/-0../ezx
LOCATIO 7 L(G(, j4 1i, le
DATE //,�,1 f PERMIT I f'/-
TYPE OF STRUCTURE '
RECHECK /,/1 APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE. /
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE.
x FOUNDATION/DAMPROOFING '' /
X BACKFILL APPROVAL . J 1`
ROUGH PLUMBING
PLUMBING VENT/VENTS IN '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-
FOUNDATIO.N WALLS EXTERIOR R-
FLOORS ) R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
( L��C"°E rociep-Pi('C)1 J
c)PON (\AA P•11-0g)C-'11416,
•
ARRIVE W1'6 '�^
DEPART I( .(?i.'' ;" GL. ,,6/,1
LINSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD P/77
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT /
REQUEST FOR INSPECTION RECEIVED A')/7, ,/
y/
NAME �/t'
n , �GI /2L .ld' Gt//If
LOCATION (' �- 1 AW . 477e/ vid
DATE fQ// 7/97 PERMIT #
TYPE OF STRUCTUREf9
RECHECK APPROVED V
N/A YES ,-NO
FOOTINGS/PIERS I/
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 r°
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING /
JOIST HANGERS
JACK POSTS/MAIN BEAM r'
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: I
ARRIVE
DEPART 5 / . ////// Lam'
I-NS-PE TOR
- - TOWN OF QUEENSB URY
Bay at Haviland.Road, Queensbury, NY 12804-9725-518-792-5832
1 June 4, 1991
TO WHOM IT MAY CONCERN:
RE: Scott and Patricia Wells
Lot 4 Mud Pond Road
The septic system proposed for the single-family dwelling to be built
on the above captioned address does meet minimum requirements of the Town of
Queensbury Sanitary Sewage Ordinance.
Verytruly yours, ,
ACC y
DAVID HATIN, IRECTOR
BUILDING & CODE ENFORCEMENT
DH:lm
"HOME OF NATURAL BEAUTY. . . A GOOD PLACE TO LIVE"
SETTLED 1763
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