1991-849 •
•
�h
l-. _ CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 7//0ZVJ!k /D 19 gg.
tv—
This is to certify that work requested to be done as shown by Permit No. 91-849
has been completed.
Thi' `tru�j�le may be occupied as a Single' Family A �'nn
`anon l��¢ ¢� Herald Square
Location �� �
Owner Guido P::mare&l H
By Order Town Board
TOWN OF QUEENSBURY
(%/-c>
-2
Director of Bldg. & Code Enforcement
r �•�
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-849
WARREN COUNTY, NEW YORK • '�
PERMISSION is hereby granted to Herald Square Vl g.
Cf
I
OWNER of property located at Lot 010 Street, Road or Ave. 4c
rr
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.
rD
1. OWNER'S Address is
a
45 Herald Drive a
Queensbury, NY 12804 .a
2. CONTRACTOR or BUILDER'S Name a
Same f D
ir,
3. CONTRACTOR or BUILDER'S Address
I-
0
4. ARCHITECT'S Name
C
V
5. ARCHITECT'S Address
cG
ID
-r
a
6. TYPE of Construction—(Please indicate by X)
( )(Wood Frame ( 1 Masonry ( 1 Steel ( I _- .4 4G
ro
7. PLANS and Specifications t
No. 1,176 sq ft Single Family dwelling as per plot plan specifications cfl
and application
8. Proposed Use
Single Family Dwelling
$ 179.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 11, 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 tie.— 1 h ay December 19 91
SIGNED BY for the Town of Queensbury
Building and o i Inspector
IF*13
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
JINN OF QUEENSL
tECEIVED
Date: % Reviewed By
LOCATION OF PROPERTY
FOR INSTALLATION:
?� VIL1/0 LAC101991
Owner's Name: AGejA/„; ' �`' e CODE DEFT.
Owner' s Mailing Address: /z • ��{
Installer' s Name: 62/ 6 r'zr Phone. #:
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom): A()
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? 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 _ gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 5-0 feet//Total System Length . feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # 7/ / 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:. a- /mod DATE: 4-24/ '
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:
TOWN OP QLTEEWSBURY
.0 REVIEWED BY: . AIN OF QUEENS:.
FEE- PAID: RECEIVED
PERMIT NO. : f/—AW - Pig C 1 0 1991
:. CODE CREPT_
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: ¢ �
P.O. Address: Agto= ;?;?!.. n qj t.a PHONE 7fV-sz
r r
Prop
erty ty Location: /C7 Tax Map No. / /
Has there been any split of this property since October 1, 1988? Yes No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: cF. Lot No. AO
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
PHONE
NATURE/OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ ,2 �1
Addition to building * - /'
Alteration to building * COMPLETE INFORMATIO REQUIRED BE W:
(no change to exterior dimensions) * Size of Property: /Cj'9 ft. x A9 ft.
Other work (describe) * Existing Building Size:
• * ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
1st Floor //77 Sq. Ft. )( * Front Yard tg..'
ft. Rear yard ) ft.
Side Yards ft. and ft.
2nd Floor Sq. Ft. * If on corner, setback from side street-
* 7.f ft.
Other Floors Sq. Ft.
(not cellar or basement) * OCCUPANCY INFORMATION:
TOTAL FLOOR AREA: //7 Sq. Ft. * Prim ry Building -
/ One Family Dwelling
Size of New Structure: -Wft. x 7 t. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units
Pier/Slab/Crawl/Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) / * Other
Height (grade to ridge) 7 2;7- ft.
If residential , no. of families: / * If addition, what will use be?
No. of rooms (excluding baths): *
No. of bedrooms: *
No. of bathrooms: / * Accessory Building:
Type f healing system: , * , Detached Garage - One/ : - . -
Attached Garage - One Two Car
No. of fireplaces to be installed: * Private Storage Build Iv
Will a woodstove be installed?: * Other
Central Air Conditioning: Yes No *
(OYER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. Ad
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation Wall Material : X,Oej,i2Z- < ! s Thickness: f/.
Depth of Foundation below grade (to bottom of fo 'n ) : /0
Will there be a cellar? (464" Heated o Unheated Floor Sq. Footage:
Will there be a basement? Will any portion be used as living space?
If so, what port' !n? Sq. Ft. Type of Use?
Type of Roof: Sloped lat/Shed/Other Material of Roof /;flp44
Size, wood studs x "; spacing 43 " o.c. ; length er ft.
Joists (floor beams) : 1st Floor 7i " x /0 spacing /A " o.c. ; span /21 ft.
Joists (floor beams) : 2nd Floor " x " ; spacing " o.c. ; span ft.
Overlays (ceiling beams): " x "; spacing " o.c. ; span ft.
Roof rafters: " x " ; spacing o.c. ; span ft.
Roof trusses (pre-engineered): spacing ?. " o.c. ; span 7 (ft.
Exterior Wall Finish: A/ / 52 ie of what material ?
Interior Wall Finish: 5./dee .e
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
..7r I-4Z-- /r
Is there to be an opening between garage and dwelling? y6(' If so, will a Fire-Rated door,
enclosure, self-closing device be provided? e'r
Will a flue-lined -chimney be installed? Height above roof ft.
Depth of chimney foundation below grade: ft.
Depth of fireplace hearth: ft. in.
Water supply - Municipal or private -well : l31 iC.i ___--
SEPTIC SYSTEM: Distance from N.& private well (including adjoining properties: ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: , ' � _ PHONE f-ft L
NAME OF PLUMBER & ADDRESS: ,J' PHON0g- 77
NAME OF MASON & ADDRESS: //'//-y PHONE all-4,1616
NAME OF ELECTRICIAN & ADDRESS: ii / Xeria--- . PHONE 71,--Zf 7o
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 is au horize by the owner.
Signature l
• Owl r, owner gent, architect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code -Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
l�iaN OF QUEENS°_
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) RECEIVED
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings;, 0 1991
Multi-Family Dwelling's-'
(3 Stories or Less)
7)0. & CODEDEFT
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
Z;l4- #/6 Ad/
S NAMEPROPERTY 41,4i/1--
APPLICANT LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - i%7‘ Sq. Ft. 1,
2. Type of Heat - Elec. Base Board Other ,E.f Nit9
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 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 ?t
B. Exterior Walls R 1`y
C. Glazed Area R
D. Exterior Doors R 1I
E. Floors over unheated spaces R -30
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R
H. Basement/Cellar Walls (Below Grade) R /9
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency p er code ✓ YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
C / 4 7 f� (1E/21::43ER
4 PLICANT'S SIGNATURE /DAT,E TELEX
INSPECTOR'S REMARKS:
•
REVIEWED BY
6 MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
.md National Headquarters
1337 West Chester Pike,West Chester, PA -19380 .
APPLICANT COMPLETES THIS SECTION Date: 447
/, j r
City, Town or Township ! tip? ;s - { County ":°/jam State
Location/Address ) :ail?.f _`,r-Ez.,,,ry /!'.,I"�.e_,c _
``� � (If Located in Rural Area-Pie Attach Directions)6. Pole # y/ /
Owner feat,/,-: , �i7%7..^r/E:'1e / rmTt`# Q� ''"l Lf
Occupied As „Si.. /� r7/,lc/ Building: New' I Old❑
Occupant .
Work Area in Building (Floor #,etc.):
App. for: Wiring❑ Service❑ or: Ready for Inspection:
Fee Remitted-$ Cash n Check n 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 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 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's ,_
Signature '�Frig 1 "'" '�`---- License # Permit #
T/A �/, 1 Utility:
Applicant:s>Address: 9/1- ie,. f, ,51--( .??i, (NAME) (OFFICE LOCATION)
(City);• / ,T/-46. 9-tp (State) f1_,/5, (Zip) 729/,t,/ Service Request #
Phone # -7-{/ - CV 2 ,1 Electrician: ffr-/ )'`•�?, `
MI:a.USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above n or:
Red Notice Label n
Rough Wiring Outlets Surface Unit Oven .
Switches Range - - _ Garbage Disposal
Receptacles _ Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp. Service Equipment _ Burner, Wiring &Controls for Amp. Receptacle •
Amp. Service Conductors Pump Il 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 CORRECTFEE FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
L/A Owner CASH II
n L/A Fee CHK #
Due MO #
n IPA Municipal
INV #
Date: Other Side❑ Utility Applicant
Owner ❑
Cut in Card n Temp # Date
7 Final # Date INSPECTORS SIGNATURE
tCYrf
TOWN OF QUEENSBURY
531 BAY ROAD
:--QUEONSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION // -�
REQUEST FOR INSPECTION(c )
RECEIVED NAME )-Je Le
LOCATION #-/U c ddDA- ---
DATE3//O/c7.2 PERMIT# I /74-7
TYPE OF STRUC RE 5
-
RECHECK
FIRE MARSH9-L' APPROVAL (COMMERCIAL STRUCTURE)
FOOTING 1/ OUNDATIJOK BACKFILL \{RAMING
xMUGH PLUMBING INAL ELECTRICAL �3EPTIC
NSULATION WOO STOVE/FIREPLACE
REMARKS
APPROVAL
N/A- YES NO
CHIMNEY HEIGHT/LOCATIO r/
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATINQ,
BASEMENT INSULATION/DUCiTWORK e,
INTERIOR TRIM/PRIVACY DOORS \ !/
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED t/
STAIR CLEARANCE/RAILINGS If
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS •
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING 9/
DOOR CLOSERS
OTHER FIRE SEPARATION ✓,
FIRE/DEMISE WALLS
DUMPSTER /
SITE PLAN/VARIANCE REQUIREME TS
FINAL ELECTRICAL ';":!) 960.
OK TO ISSU /0 IR C/C
COMMENTS:
ARRIVE /2;36 DEPART /O'V� TJ:=)-74(;(!:5-------
'YN. 'P EC TOR
ELECTRICAL INSPECTIONS
�// DUPLICATE MUNICIPAL RECORD
Permit No/( —
61,
Owner 0- ".48.51 - 2 /
Occupant
Location 1-'4, t 16 Al 0121�
No. Street
Town or City State -
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
•
Installed by •�t ?4 A-Lc' No. l '/
`/ � Q
Date � — �7� � 'r sector
MIDDLE DEPARTMENT INSPECTION AGENCY,I .
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
ROUGH WIRING OUTLETS H.P.AIRC.9NDITIONER
O(C� / .ENITtETS �,�^� WIRING &CONTROLS FOR 6 45 — BURNER
7 / RECEPTACLES H.P.PUMP
a3 FIXTURES K.W.OVEN
AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
/�AMP.SERVICE CONDUCTORS / K.W. DISHWASHER
`[/Grp K.W.SURFACE UNIT / K.W. DRYER
K.W. RANGE AMP. RECEPTACLE
/ K.W.WATER HEATER Q FRAC. H.P.VENT FANS
�4t ,
IOTORS M.P. /20 I/12 1/10 1/e 1/s % % 114 % 1 1% 2 3 5 7% 10 15 20 25 30 40 50 75 10
!ARK NUMBER
F EACH SIZE
,PPARATUS
,jba,
TOE! OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804 40,
TELEPHONE (518) 745-4447 '
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /, l 92
NAME llegii f Si-pq r e-
LOCATION 0 Q
DATEr q;1 PERMIT # / -B17
TYPE OF STRUCTURE 5 ,'V"
RECHECK APPROVED
• N/A; YES NO
FOOTINGS/PIERS •
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM a`
FREEZING FOR 48 HOURS FOLLOWING/1
THE PLACEMENT OF THE CONCRETE./
MATERIALS FOR THIS PURPOSE ON,/SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE ct ,Y
FOUNDATION/DAMPROOFING .!
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN(PLACE
PLUMBING UNDER SLAB ,o
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING?
JOIST HANGERS r
JACK POSTS/MAIN BEAM
HEATI.NG__ROUGH-IN
NSULATION: Y hL -
FOUNDATION-WALLS RIOR R- « r/
FOUNDATION WALLS EXTERIOR R- • •
FLOORS R-
WALLS R- J9
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 72/- '
DEPART /2) 4grpwv
INSPE OR
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 %3 .2
NAME /74Z- /21 f
LOCATION // /c'
DATE .R/3/472 PERMIT # q/-U 1
lq
/ /
TYPE OF STRUCTURE 5/;�4 / 7. 7
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 CONC ETE.
MATERIALS FOR THIS PURPOS ON SITE
FOUNDATION/WALL POUR I
REINFORCEMENT IN PLACE 1 /
FOUNDATION/DAMPROOFING 1 J
BACKFILL APPROVAL Y.
ROUGH PLUMBING if,
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB `�,
FRAMING: �'
JACK STUDS/HEADERS A
BRACING/BRIDGING I 1,
JOIST HANGERS
JACK POSTS/MAIN BEAM ;,
FIRES TOPPING I( \
WALLS N,
CEILING \
FIREWALLS
HEATING ROUGH-IN !
INSULATION: J \
FOUNDATION WALLS INTER OR R- \ J-
FOUNDATION WALLS EXTER OR R- \
FLOORS R- L--_—
WALLS j�„-44 J/ R-/, �E--
CEILING I R- 3n \i-----
DUCT WORK OR PIPING I/N UNHEATED \
SPACES / \
REMARKS:
o, 4 L57,tvd6d1 u sitck-c \
04/ Z 7
—OS J/R. Gcf2t,e/�-R a445D79 .(i!/ihI
ARRIVE i
DEPART
I CTOR
TOWN OF QUEEHSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832 6 /d-.
BUILDING INSPECTOR'S REPORT 1;11Ke LZf//,4r
REQUEST FOR INSPECTION RECEIVED lq-,�J- �-`7� g,v7-
NAME a '�',e6el e /V rot e
LOCATION La( JO, //er-A-( kt4t-e //c t
/ E 9'
DATEdAidg7, lg5g PERMIT # /
TYPE OF STRUCTURE 5'mye /tip floLea
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 � e /
>OUGH PLUMBING �✓
PLUMBING VENT/VENTS IN PLACE A
PLUMBING UNDER SLAB
> RAMING: I 1
JACK STUDS/HEADERS r i
BRACING/BRIDGING �' ✓
JOIST HANGERS { 1
JACK POSTS/MAIN BEAM I 4
FIRESTOPPING
WALLS
CEILING
FIREWALLS 1 ',
HEATING ROUGH-IN
INSULATION: I
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS I R-
WALLS ( R-
CEILING I R-
DUCT WORK OR PIPING PN UNHEATED
SPACES
REMARKS:
,4!5 •
ARRIVE
DEPART
SPEC OR
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 RECEIVED // 3 J
NAME - p�q C► uce _
LOCATION J-1,4-
(. �� �Xr I� ��- ' A-►-P
DATE L 3 I q PERMIT
TYPE OF STRUCTURE S
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 V. • .
REINFORCEMENT IN PLACE \
FOUNDATION/DAMPROOFING '\,
BACKFILL APPROV4 ,1
ROUGH PLUMBING !I/Anil)).
PLUMBING VENT/VENTS IN PLACE_,
PLUMBING,_UNDER SLAB '
FRAMING: e'1: )3it- t v4
JACK--STUDS/HEADERS ti ‘,
BRACING/BRIDGING / t.
JOIST HANGERS
JACK POSTS/MAIN BEAM/ I, .
HEATING ROUGH-IN
INSULATION: '
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLyXTERIOR R- 1 • `
FLOORS R- !i
WALLS I R- i
CEILING / R-
DUCT WORK ORIPING IN UNHEATED
SPACES
REMARKS:"To 157- 19 ✓ (i'��?� ,r3?-
r i,F,/1,1 LIS I A..r 0 0 I) :i i? 1-4-
Cif I 11/)Af PyAi G 6i-Z1 P16)
ARRIVE 1 1 1 t 11
f'r )
DEPART I1,?6 I / k
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT /17
531 BAY ROAD ]
QUEENSBURY, NEW YORK 12804 �f
TELEPHONE (518) 745-4447 ' -L
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED /)j/f/
NAME &/. e. ti,"-- l '-CDC-Q _�
LOCATIO /Q (U,2J ,, t.
DATE /,,t/4/�/ PERMIT U 9/-12f,
TYPE OF STRUCTURE LS� /)
RECHECK APPROVED
N/A YES 0
)(FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE.
FOR PROVIDING PROTECT '®N FROM
FREEZING FOR 48 HOUR FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS P RPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL 1
ROUGH PLUMBING 4,
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 EXTERIORR-
FLOORS R-
WALLS R _
CEILING R-\
DUCT WORK OR PIPING IN UNHEATED
SPACES
.1
REMARKS:
ARRIVE �,\
DEPART 41
. �
' INSPECTOR
Oil
awn o/ Queen i ur j
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME \\-eArc () C UCk.r'P
LOCATION I Pe/mid `-j„L{
DATE I //i PERMIT NO. I g L/9
SOIL TYPE -dr- Loam - Clay -
Percolation -st Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 23-0
Length of each trench ' 5o
Depth of trenches 3
Size of gravel
SEEPAGE PITS{Nuiab r o )
Size- ft. X f .
Gravel size
PIPING: Size Type
Bldg. to tank y iZ-'C
Tank to dist. box e
Dist. box to fiel•/pit
Openings sealed? � NO Partial
LOCATION/SEPARATIONS: •
Foundation to tank /a ft.
Foundation to absorption AD ft.
Absorption to lot line /5 ft.
Separation of pits eft.
LOCATION 0 YSTEM ON PROPERTY(circle one)
Front - - Left side - Right side -
COMMENTS:
SYSTEM USE APPROVED YE NO
s B 'ng spector
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01/86 and vl
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