1993-067 ���� .�. - ,. ;_ -„i, f:, ., r ...r•{+{•a 't,:' Sh.l.rur,.f .iu-' ., ;�,�„-.,rq,. , .,z , ._. .- ...,-,
1
CERTIFICATE OF 'OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date ]0.4,/, a..5 19 93
301. )`A' ( _31
This is to certify that work requested to be done as shown by Permit No. 93-067
has been, completed.
single family dwelling with
This structure may be occupied as a L
�.Y n,_.s L
i � 4.bvV Gwp' un u. u,ofLa.. gxa ra-g.'.
nration of 11 AmPthuct nrriv®, Amharchirp Subdivieinn
Owner Forest Wood Homes, Inc.
125-7-33
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. 6c Code Enforcement
X
BUILDING PERMIT
TOWN OF QUEENSBURY No 93-067
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to FOREST WOOn HOMES INC.
OWNER of property located at lot 33 Amethyst Drive 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 m
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
m
1. OWNER'S Address is N
—I
HCO2 Box 286P o
Warrensburg NY 12885 0
2. CONTRACTOR or BUILDER'S Name
m
N
H
3. CONTRACTOR or BUILDER'S Address •
c7
4. ARCHITECT'S Name
I-
0
5. ARCHITECT'S Address w
0
6. TYPE of Construction—(Please indicate by X)
c+
(X)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications CD
No. 62'x31' Single family two-story dwelling as per plot plan, specifica-
tions and application including two car attached garage and septic system.
8. Proposed Use
Single fmaily dwelling
-J
CD
$ 265.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 24 19 94
r,
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 2
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury tbi 24t Da March 19 93
CD
SIGNED BY for the Town of Queensbury
uilding and Z Inspector to
ts1TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permi t OF QUEENSbL
Fee Paid RECEIVED
Date: Reviewed By VAR 2 r 1993
LOCATION OF PROPERTY FOR INSTALLATION: kd 33 GLticcP, e, F & CODE DEFT.
Owner's Name: / nd l{AO j
Owner' s Mailing Address: h&-V %D c2B, /la44460 J `
Installer's Name: 0-st1, /10Aal Phone #: 62_?q7�
Number of bedrooms (if residential ): t
Total daily flow (residential-compute @ 150 gal . per bedroom) : (,06
Topography-Circle One: F a Rolling Steep Slope % of Slope
Soil Nature-Circle One: eril Loam Clay Other /Depth:
Ground Water-At What Depth? ? Feet
Bedrock or Impervious Material-At What Depth? g Feet
Percolation Test-Circle One: Not Require Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal ell Other _
If domestic water supply is a -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank faS b gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 373 feet//Total System Length EZj 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 th .Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: ipLacvs(J ,5
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 OF QUEENSBURY \ REVIEWED BY: /�
COMMUNITY DEVELOPMENT DEPARTMENT .,.4s
BUILDING & CODE ENFORCEMENT FEE PAID: O?IOJ���S� a9�
531 BAY ROAD `' #
. QUEENSBURY, NEW YORK 12804 PERMIT NO.
(518) 745-4447
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 ori': the -application form. .
OWNER OF PROPERTY: .F , • ,
Mailing Address : /10-D nx ,2. P ida,ravoskuArerAIY.
Telephone Number(s)' : Work 423-,3979 j Home Other
PROPERTY LOCATION: Lp V 1dV"�l d- (I l .,
' Tax Map Numbe Section Block Lot
Subdivision Name: Q p, oIT,, .Lot' No.
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE' OF THE
CONSTRUCTION: $ AWI
/
NEW BUILDING:
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
ADDITION TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL `/ Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL ' Family Dwelling
(NO CHANGE TO EXTERIOR SIZE) Office ,
OTHER WORK (DESCRIBE BELOW) Mercantile
Warehouse
Manufacturing
Other
GROSS AREA. OF PROPOSED STRUCTURE:1VO'
1ST FLOOR 1940 SQ. FT. ' s.0
� ® f IF ADDITION, USE OF NEW ADDITION:
2ND FLOOR 117 SQ. FT.
OTHER FLOORS . SQ. FT.
(not unfinished cellar or basement) ACCESSORY BUILDINGS :
Detached Garage - One/
TOTAL FLOOR AREA: a�aD _ SQ. FT.� 1/ Attached Garage - One Two Car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
FEET X .31 FEET
Foundation Type: Gimeedr Will any second-hand or ungraded
Number of Stories : . 4 lumber be'.used? If so, for what?
(habitable space only) D
Height (grade to 'ridge) : �,S' feet Type of Heating System:
Number of fireplaces and/or woodstove (circle all hich applies)
to be installed: . 1 ?et-T. / Gas / Wood
ced Hot Air' / Baseboard / Other
. PERSON RESPON IBLE FOR SUPERVISION OF WORK, AS REGARDS TO BUILDING CODES IS :
Fowl- laird 11-nue,i
NAME OF BUILDER/ADDRESS/PHONE: Frwill1000() C � -� ild,�_ -6W-up 4 #
NAME_OF PLUMBER/ADDRESS/PHONE : it �,u�e+ ILK /.vx DQ1y •
• NAME OF MASON/ADDRESS/PHONE: �fro►4d f,rip ,(�., � Y
NAME OF ELECTRICAN/ADDRESS/PHONE: ,/�pe p Pl�� l�1� ,ypY
•
DECLARATION
To the best of my knowledge the statements contained in this appli- ,
cation, 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''fhat 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 noted, and that such work is author.i_ ed by the owner.'
Further it is understood that I/we shall sul;p4 prior to a - Certificate of
Occupancy or Certificate of Compliance belt- issued, an AS BUILT PLOT _P.LAN
drawn to scale, showing actual location of of t o premises .
, Signature .'
(Owner, owner' agent, architect, contractor)
FOR ANY1SPECIAL PROVISIONS - SEE REVERSE SIDE.
fay OF QUEENSbL
4 jai`" ENERGY CODE COMPLIANCE APPLICATION RECEIVED
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS +f
•
w.. MAR 2 21993
Compliance Methods : PART 5 - Acceptable Practice Methn ®®E DEPT.
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
*Requires submission of worksheets
APPLICANT'S NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - r)(20 square feet
2 . Type of Heat - Electric / Oil Gas Other
3 . Is building mechanically cooled? Yes ,7 No
4 . Percentage of area of windows and doors Over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R 30
b. Exterior walls R
c. Glazed areas R
d. Exterior doors R
e. Floors over unheated spaces R 19
f. Edge of slab on grade (heated building) R
g. Basement/cellar walls (above grade) R
h. Basement/cellar walls (below grade) R
i. Heating/cooling-ducts-piping in unheated space R lO
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code pYes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Ap' lic S' gnature Date Phone Number
INSPEECTOR'S REMARKS:
I�JJ c QA-E o c- / S A—c.U,A—,2--L l k\ r c� 1—A—{ a v L IC �'z,
1�(aP� vc�s /t/tUz toIts )13 sc..)LA--rtiD
TOWN OF,QUEENSBURY
531 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date a M R;°r ' ,19ri 3 Permit No. 0 ;0
17
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant o;downer agrees to comply
all applicable laws,ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if,more than one appliance and/or chimney.
Applicant f ,, / 4 , APPLIANCE (check appropriate boxes)
Address II., . f=' 0 STOVE: INSERT
oWood o Coal ❑ Pellet,
,� �,�r„" _��
0 FIEPLACE
tr:j,' , ,.,j , . :'c vt./V Zip oar`" LT FIREPLACE, FACTORY-BUILT:
0-Wood ❑ Gas
Phone t . 0 FIREPLACE, MASONRY:
❑ Wood ❑ Gas.
Owner ,r , % _ 0 'FURNACE: J ❑Wood ❑ Gas o Oil
Address IF NON-MASONRY:
Manufacturer
Zip Model: ;15-g_ ' Outlet: inches
Listed By: Number:
Phone
-i CHIMNEY (check appropriate boxes)
Exact address of proposed construction
CI MASONRY: ❑ Block 0 Brick ❑ Stone
�di 5 f x/ �{ FLUE: ❑ Tile 0 Steel
Size inches
CONSTRUCTION/INSTALLATION MUST ❑-FACT RY-BUILT
CONFORM TO NYSFIRE PREVENTION & Manufacturer Model: `?
BUILDING CODE. CONSULT TOWN OF - Listed By: Li Number:
QUEENSBURY HANDOUTS PROVIDED LO'Double Wail 0 Triple Wall
REGARDING REQUIRED INSPECTIONS. 0 Insulated
. .y
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Received
Code Number Title
A 173 3389 (190)Public Safety
A 233 2655 (230)'Minor Sales
Fee-Collected From or Refunded to: (1, / /47'.)r 4,17
Address: I' r°
Dated: ,V, ,� Deputy: l- Town Clerk or De u : 'Cr' 4.s . � f` �. A
P
White:Applicant Green:Fire Marshal Yellow:Bldg. Dept. Pink& Goldenrod: Cashier's Dept.
THE NEW YORK BOARD OF FIRE_ UNDERWRITERS CERTIFICATE NO.
DO NOT WRITE HERE-FOR OFFICE USE ONLY -
• BUILDING PERMIT NO.
'TEMP.N DATE ;'F .r t_+rli'a •Fi-
_,
r
CITY OR VILLAGE `:^ ZIP CODE TOWNSHIP COUNTY
STREET AND NO.OR ROAD / "' -' - ,..Z •POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? . SECTION BLOCK LOT
S jj
OCCUPANTS NAME BUILDING OCCUPANCY
tl
ir' :f".
OWNER'S NA1IE`AND ADDRESS j HOME TELEPHONE NUMBER
1 7
. . n i s ),-, ,.-h ( ,,, _ r ,i. .
_ -
CURRENT SUPPLIED BY ` . ." ' - FROM THEIR 1 OFFICE WORK TELEPHONE NUMBER
BUILDING IS r _-
NEW OLD❑ _ WORK IS NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑
2,1m. _LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
S,NUMBER OF OUTLETS', No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- ,., Lamp Receptacles CIRCUITS - ONLY
tion ;Side Attach't \H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. .Type Each NO Each NO Gauge INSPECTION
OUT- L ,
' SIDE "
SUB- •
BASE
BASE-
MENT '
1st
FL. .
2nd
FL. ,-
3rd
FL.
-It,.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
THIS APPLICATION IS INTENDEDlO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS_
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT.
SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF "' VA
❑ CONCEALED - _
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
•
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN_..l .
❑ OVERHEAD ❑ UNDERGROUND - _
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) - APPLICANTSMUST ENTER DENT F CATION NUMBER ►
AVOID DELAYS BY GIVING FULL"AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS _ 4`'',
NAME OF APPLICANT - '• DATE-OF'APPLICATIONT SIGNATUIR OF APPLICANT ,
�`Y�;r!I..,�j„ e�c1
f /1,, i I �.e t: .rC?r. !,;0t is*i�[. s+�' o.,,•>
• ' —
•STREET, y
ADDRESS ' . TELEPHONE NO.
CITY OR POST OFFICE - ZIP CODE LICENSE NO.WHEN APPLICABLE
❑ 85 John Street _0 41 State Street ❑ 570 Delaware Avenue ❑ 217 Lake Avenue 1-1 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 . BUFFALO,NY 14202 ROCI ESTER,NY 14608 SYRACUSE,NY 13206
(212)227-3700 (518)463-2122 ,(716)884-1155. • (716)254-0141 (315)'•z,463-8552
t •_.fi t/. ,!•r\•r . • \1,1 ,,,•r tb t(. b„ •N./• t t 19r \1,!,AL.,\•/ tr.„1•/,OP/ •r•Aj 1.t✓;\•/ \•r. Ai...t,^,kit!„1tt,"\•>"L.A.!" t t•i_ b •r..cb, • • .1tir.!u,_•i...t.r^ • • ,•/, AI.
i' i
',: 4 1Gi;2
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE
�, BUREAU OF ELECTRICITY
41 STATE STREET,ALBANY,NEW YORK 12207
1' Date Application No.on file f i'F764 f�a '
•,: THIS CERTIFIES THAT ° a1il'!f`�Y ?i_t?{?'f ':i9
%' only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of -•
`Of1,Eoa+`9 (100, .' 1119 TIPIf3'f', t (1111ENSTAM 7,, Ni,V
in the on; — 0 1st Fl. E 2nd. Fl. GAR
following B location; Section Block Lot ::
IJA `11. .V.'Basement
was examined on and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ''is
-•'• •ECEPTACLES SWITCHES
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. ..
•, 1f; 50 :s{%t 2.11 1 5 1. 1,!I .1 F' it
�: DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
Ili' AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO OF•FESET _ _AMT. •
WATTS ';.
1'. 1 }' 1 .30 1 .:
J:
'As'; SERVICE DISCONNECT NO.OF S E R V 1 C E -- `e
METER ,
1. AMT. AMP. TYPE EQUIP• l,s'4W 1;9'3W 3 03W 3,8'4W NO.O CR gCOND. OF CC.COMD... NO.OF HI-LEG op•H•�G NO.OF NEUTRALS OF NE 1TRAL •
•
4.' 8 a:{,')tF> CB 1 X 3 u/0 I - - ,.:/0
r, :ti
1' OTHER `A C APPARATUS:t ,,
� G(' .1 . e l.a 2 _ 'la
1, St O1:I DI',TEICTORi; —1 ':
i; _ "5.
J
v
:. APE ET 51,UCTfl C i NC. ` •
ii<f s�;0T1f II` e 1.2302 - ;
BRANCH MANAGER •
.ist
1' Per
"I'
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.
`i.i•-4,-ra f'i•i,/•`.r•1;r•\r•r YV.;4I NO i :r•`.(41\'fti'W r 01 lt,.r•`J•i 7•i`'4 'ill'r•C'vi r• 47'feN'(4°C4 41're i61"7•l •\ NV' •r qY i•N`f/ r•\ • •' •\ 41 1i4?AF 46 '6, •\r•\'41-'A' • • • )in
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED .f/./0,�
NAME Z�Q/J/l oti(9--ozi
LOCATION ��47 4 ,,
DATE -/ `,Y PERMITV 93'40 D�/I
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM /
ALARM SYSTEM /
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY 'N.
WOODSTOVE
FIREPLACE-MASONRY
IREPLACE-FACTORY BUILT
REMARKS: ( 1 OK TO THIS DATE
(7);--4-) /2_.a.4/1,1,4g,‘../e
mat
2/015 �•�r
SPECTOR
TOWN OF QUEENSBURY
lift 531 BAY ROAD
�'M1 QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR°S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME rorert �A�4/4/,-
LOCATION v/ �3944,f/rt •
DATE 5 'f�1 PERMITO 6 1
TYPE OF STRUCTURE J6
RECHECK .
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING . FINAL ELECTRICAL SEPTIC
_INSULATION _WOODSTOVE/FIREPLACE _
REMARKS
APPROVAL
N/A E NO
CHIMNEY HEIGHT/LOCATION
B .VENT/LOCATION
PLUMBING VENT X
ROOFING X
SIDING K
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES _
FURNACE/HOT WATER OPERATING sc
BASEMENT INSULATION%DUCTWORK X
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: .7
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED NL
STAIR CLEARANCE/RAILINGS XN
HANDICAPPED ACCESS
SMOKE DETECTORS;'; •
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS/ ','
OTHER FIRE SEPARATION
FIRE/DEMISE/WALLS
DUMPSTER / .
SITE PLAN/IVARIANCE REQUIREMENTS
FINAL ELECTRICAL; A
OK TO ISSUE C/O OR C/C
COMMENTS:
, s
ARRIVE Ch f
//(7
DEPART P, 7"e ti1----
IN P T
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED I —64?
NAME . /it mo,/ /i
LOCATION l'yJL aya-4
DATE__4/Azd'/9 PERMIT# 9 -0 7
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS )
EMERGENCY LIGHTING i d
FIRE EXTINGUISHERS,
AUTO. EXTINGUISHING SYSTEM,f
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM ;j
ALARM SYSTEM 'a y
INTERIOR FINISHES A
STORAGE: \�,,
CLEARANCE TO SPRINKLER
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MASONRY
/FIREPLACE-FACTORY BUILT
REMARKS: LJ OK TO THIS DATE
174
2/015 - INSPECTO
• TOWN OF QUEENSBURY ' IP%
BUILDING AND CODES DEPARTMENT ,e1-0
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED #'2/A
NAME .fg',,,/GQS / ' 4-
LOCATION 'O. .9.9 0/4/ Aa-
DATE 1/A4/2 PERMIT # 9. G4,7
TYPE OF STRUCTURE J'/ ia?cezzVpkce.
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/DAMPRObFING, r
BACKFILL APPROVAL !'
ROUGH PLUMBING I? A
PLUMBING VENT/VENTS INIPLACE
PLUMBING UNDER SLAB
'. FRAMING: is�a=f(:r.Ci
JACK STUDS/HEADERS f,,{
BRACING/BRIDGING, p
JOIST HANGERS \ ,`
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN ,.
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALL : EXTERIOR\R-
FLOORS I R�
WALLS �`� R- ;C'j�`
CEILING fIW`2 c" 1 R- '3v
DUCT WORK OR P , ING IN UNHEATED
SPACES •
REMARKS:
_., .1 I g, Vt3,1,/-
I � :
ARRIVE ri
DEPART I'C= 0-0 ,. r
jINSPECTOR
/' \
TONA OF QUEENSBURY
BUILDING & CODE ENFORCEMENT r 0
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name t,,We-ej 7//itz .4r' ‘,A,°.
Location c3� % 4 9
Date 1f,,a4/l9 Permit # 93 pa,7
SOIL TYPE: Loam-Clay- /
Results of Percolation Test-/
(if applicable) Rate-Minute/Inch Ail, --
TYPE OF SYSTEM: ,
ABSORPTION FIELD: jotal L ngth 76-0
Length of each trench 570
Depth of trenches L--`5 -
Size of stone "
SEEPAGE PITS: Nu ber-,'r
Size - ft. x PIP- ft.
Stone size
PIPING: i Size Type
Bldg. to Tank 1 4/ S'cr Co /'"
Tank to Dist. Box `-( I'Yl--
Dist. Box to Field/ - `f pv-c--
Openings Sealed? Ye No Partial
LOCATION/SEPARATI4 S:
Foundation to Tan ft feet
Foundation to Ab orp i on feet
Separation of Pi •-s - fcc.t
Conforms as per Plot Plan ka, No
LOCATION OF SYSTEM ON\PROPERTY:
(circle lie `�
Front Rea - eft Sid- - Right Side
Middle Front ' .. e Rear
COMMENTS: \•\,
SYSTEM USE APPROVED: 4110 NO
Arrived: /O;40
Departed: JDtjzp
ij- ,,,,.../....t___,
9.e
Building Inspec i
TOWN OF QUEENSBURY A'?BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /4/(5 ahv
Gt/
NAME ,rnt:S/ c /i7
LOCATION d 33 6rxe A.
DATE .4lA/93 PERMIT I
TYPE OF STRUCTURE L / 9/k
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM 1
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 J
REINFORCEMENT IN PLACE/
FOUNDATION/DAMPROOFIFU
BACKFILL APPROVAL /
ROUGH PLUMBING \,,, ,+c
PLUMBING VENT/VENTS IN PLACE54(
PLUMBING UNDER SLAB '
(FRAMING: '
JACK STUDS/¢¢HEADERS
BRACING/BRIDGING \
JOIST HAPGERS
JACK PO$'TS/MAIN BEAM
HEATING .ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUIVDATION WALLS EXTERIOR R-
Fl4ORS �R-
WALLS
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
7i- S-11)05
pb-riitc6- Pi:, b at) ty& I.7ki
ARRIVE �- U�
DEPART 77 j -
INSPECTOR
Jown o/ Queeniturj
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
•
Queensbury, New York 12801 .
SEPTIC DISPOSAL SYSTEM INSPECTION
e'
NAME t.WaOn .
LOCATION _WC-7 3 • A-l-46 l+11S'i
DATE)/2fJ / a PERMIT NO. 9 5 --0 6 7
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES -1NO
Percolation rate - Min/Inch _
TYPE of SYSTEM: t'
Absorption field, total! length p '
Length of each trench'
. Depth of trenches ' p /
Size of gravel I 1
SEEPAGE PITS{Number of)' '
Size- ft. X - ft l
Gravel size /
PIPING: size / Type
Bldg. to tank
Tank to dist. box I I
Dist. box to field/pit
Openings sealed? YES , NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft.
Foundation to absorptio • ft.
Absorption to lot line ft..
Separation of pits \ ft.
LOCATION OF SYSTEM ON ROPE TY(circle one)
iFront - Rear - Left s'de - Right side -
Ar
COMMENTS:
'ai- pm_p4_ • ,. 1-50\-70,-.•
•
SYSTEM USE APPROVED YES I.•
IL/ _ G
Building r sp,ctor
O1/86 and vl
3;3a -
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTIION RECEIVED
NAME 1reJ1` 74,&/ ', "tei
/LOCATION 6/33 A/1-e41"D:
DATE 4 ..? PERMIT # 734.267
TYPE OF STRUCTURE sRP
RECHECK APPROVED
� C 'n N/A YES NO
�il-OOTINGS/PIERS �• B/�.0(- ' J�
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 PUkPOSE ON •`ITE
FOUNDATION/WALL POUR I /
REINFORCEMENT IN PLAC /
FOUNDATION/DAMPROOFIN
BACKFILL APPROVAL /
ROUGH PLUMBING _ I
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING: /
JACK STUDS/HEADERS/
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN/BEAM 1,
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION W LS EXTERIORq,R-
FLOORS )R-
WALLS R,-
CEILING R2k,
DUCTWORK 0 PIPING IN UNHEATED
SPACES'
REMARKS: / a f
ARRIVE
DEPART 21%
IN ECTOR
A. .01lfr,..- ijiatzw9'el
TOWN OF Q ENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 93
NAME d _ W obc1-/
LOCATION L + 3-S 4 - s 1't 4+-v-,es&,(,,e
DATE S % 3 PERMIT IT 3 --Oca7
/
TYPE OF STRUCTURE SAD
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. f;'
MATERIALS FOR THIS PURPOSE ON SITE i
FOUNDATION/WALL POUR / - :2
REINFORCEMENT IN PLACE j 1
)FOUNDATION/DAMPROOFING_j._ _ I!
CACKFILL APPROVAL 9 ,J
ROUGH PLUMBING ‘ 47
PLUMBING VENT/VENTS IN PLACE A'
PLUMBING UNDER SLAB '\ I
FRAMING: k, t`
JACK STUDS/HEADERS V
BRACING/BRIDGING /!A,,
JOIST HANGERS / '!,
JACK POSTS/MAIN BEAM ,I
HEATING ROUGH-IN / ',,,
INSULATION: I `1\
FOUNDATION WALLS INTERIOR R- .1,
FOUNDATION WALLS EXTERIOR R- \
FLOORS ,I R-
WALLS / R- \. _
CEILING R- ti
DUCT WORK OR PIPING IN UNHEATED ';
SPACES I \
REMARKS:
( \
200 -,(6-0vm.(2 s
. A-,-,Q*Nk„-- ,),,,p- l ‘c2k,,,,-r---,u-co
ARRIVE i;jj •
DEPART P-f6---
I SPEC OR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 3.„U "44
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED J, 0/Q.3
NAME -h J a/0j-0-41 R r9-frxel
LOCATION /fr ,'3 akX/iL - Gl li
DATE ,,�f�(J/9Y PERMIT # 9o-%% 7
TYPE OF STRUCTURE t5;r2� (ar c. ?„(91Xo
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 TH CONCRETE.
MATERIALS FOR THIS URPOSE ON SITE
FOUNDATION/WALL POU
REINFORCEMENT IN PL CE !�
FOUNDATION/DAMPROOF\NG /
BACKFILL APPROVAL I
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN gEAM k
HEATING ROUGH-IN / \i
INSULATION:
FOUNDATION WAL;L'S INTERI,OR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / ` R-
WALLS / b. R-
CEILING / \ R-
DUCT WORK OR PIPING IN UNHEATED
SPACES I
1
REMARKS:
Co,u
pt erts- x -/ Vt
ARRIVE
DEPART c—{ /U.)
INSP CTO
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AME�NY ST
DARL ENE LIVERS
( 855-266 )
30
L EGEND:
• FOUND IRON MARKER
0 SET IRON ROD WITH CAP
0 POIN r
—L— POWER LINE
SrONE WAL L
—�—r— FENCE
ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S
TAsmAL
EMBOSSED CONSIDERED TO BE VALID D TRUE COPIES` BE
Unouthorized Alteration to t giis on
v is a
Violation of Section 7209 ,ubd
CA...-MiAA Law
M A jP
O
M
Xt
r.�
125.00'
S 83°-36'-301 E10,
I 1 v —
1 1 o
14,D1 W 2
1
1
1 c 1
1 c 1
o l
I 1
�1
r 1 Po ch
`1 2 Story
1
a4° 1 Frame
R E F.
LO r 33
0. 668 f A cres
--� N 78°-46'-40'1 W 136.71'
Underground Electric Boxes
nderyround Telephone Box
N
N
N
IN i
N
0
LANDS OF LANDS OF
RONALD d CELINA BUTLER TAAoWY ROJCEWICZ
( 627-730 �g O d
1 MICHAEL CALABRESE
I ( 813-28 )
M A P
( Amber
E F. N 2
Shir 9 Section One J
CERTIFICATION
I hereby certify to David M. and Wendy A.
Ghocko, The First National Bank of Glens
its successors an assigns and Old
Falls, nsurance Company that
Republic National Title Id in accordance with
this map has been preparFtice for Land
the existing code of pra{New York State Assoc.
Surveyors adopted by the,eYars.
of Professional Land Sur
�-,J. Rourke LS 49098
02/2 J/9S William
LANDS OF
FOREST W000 HOMES INC
( 847-258 )
LO
WILLIAM J.
MAP REFERENCES:
1. Amended map of Section Two of Amber Shire,
Town of Queensbury, Dated August 27, 1986,
Amended November 17, 1986 by Coulter &
McCormack L.L.S.
2. Map of a proposed subdivision to be known
as Section One of Amber Shire, Town of
Queensbury, Dated February 19, 1982 by
Chas. T. Nar_y L.L.S.
3. Warren County, Town of Queensbury
Tax Map No. 125-7-33
Liber 833/Page 122
NOTES:
1. No building shall be constructed on any lot
closer than fifty (50) feet to the front
lot line and shall comply in alI respects ,
with the set back lines of the zoning
ordinance of the Town of Queensbury,
effective June 11, 1982, and as amended
from time to time, as per Liber 694/Page
1032 (c)
2. An easement is reserved of five (5) feet in
width over the rear portion of each
building lot which does border upon another
building lot for the installation and
maintenance of sewage, electric, gas,
water, drainage and telephone, as per Liber
694/Page 1032 (L)
* See Liber 694/Page 1032 for complete
Declaration of Covenants, Restrictions,
Easements, Charges and Liens for Amber
Shire Subdivision - Section II
o) �9
co
r MAY 1993
Town oe' Vied
�. Bid,. L, "Mury .
G3�
MAP OF SURVEY
of lands to be conveyed to
DA VID M. WENDY
A . CHO CKO�
TOWN OF QUEENSBURY, WARREN COUNTY, NEW PORK
SCALE: 1" = 40' FEB. 25, 1993
REVISED: APR* IC 1993 - to show ?muse Location
'L LAND SURVEYOR NQ t909B
W. ✓. ROURKE, ASSOCIATES
Licensed Land Surveyors
10264 Saratoga Read, P. 0. Box /434
South Glens Falls, N. r 12803
JOB N°
93-35 B
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