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1993-098 i f 7.0 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date , 9 � q 19 L3 LA This if to certify that work requested to be done as shown by Permit No. 93-098 has been completed. single family dwelling with This structure.tsYay be occupied as a e car att.,. chcd „r�- IAA 1. U m tnn rnurt., toPPncht} i anon P � ry Forest Subdivision Phase III Forest Wood Homes Inca 121-4-13 By.Order-Town Board T WN OF QUEENSBURY Director of,Bldg. do Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 93-098 WARREN COUNTY, NEW YORK F•+ .p PERMISSION is hereby granted to FOREST WOOD HOMFS, INC_ OWNER of property located at Lot 13 Hampton Ct , QuePnshury Forest Met,Road or Ave. T in the Town of Queensbury,To Construct or place a Single family dwelling cmn 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. 0 1. OWNER'S Address is HCO2 Box 286P 3 Warrensburg NY 12885 2. CONTRACTOR or BUILDER'S Name (-) r c-+ 3. CONTRACTOR or BUILDER'S Address 0) 3 R7 c+ 4. ARCHITECT'S Name 0 (-) V^^ 5. ARCHITECT'S Address fD fD N v- c 6. TYPE of Construction—(Please indicate by X) TI ()0 Wood Frame ( ) Masonry ( )Steel ( ) CD tn 7. PLANS and Specifications No. 34'x48' Two-story Single family dwleling as per plot plan, speci- s:u fications and applicaiton including two car attached garage and septic system. CD 8. Proposed Use !y1-1 1-1 Single family dwelling $ 235.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 19 19 94 fD (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.) _J. Dated at the Town of Queensbury this 19th Day of April 19 93 SIGNED BY 47JJf / a/.1.2/ for the Town of Queensbury Building and o n or - '‘' • '' \ 1 TOWN OF QUEENSBURY n'' REVIEWED BY: COMMUNITY DEVELOPMENT DEPARTMENT .'`i Lit ' f� _ BUILDING & CODE ENFORCEMENT �' FEE PAID: l a�35d as A(OC� ,. c 5 31 BAY ROAD :+=>-•:k QUEENSBURY, NEW YORK 12804 PERMIiP NO�� C�l������,� (518) 745-4447 t+� BUILDING PERMIT APPLICATION RECEIVED A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTIONrU N0-' lt:x'ECTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING ' *_ IT. All applicants ' spaces on this application MUST be completed and. the signature of the applicant MUST appear on the applib fic IDD ER°r. OWNER OF PROPERTY: ,, 0 / 4 met' , Mailing Address : fir_D2 hox / rrcb At /,]0d3- • Telephone Number( s) : Work Home ba3-317? Other PROPERTY LOCATION: kr I/a M 0Q b4' toluab ' g phafejir Tax Map Numb r: Section /a/ J Block .y Lot d3 Subdivision Name: OiJkckwy FQyesf p9haY fir Lot No. /.:,, NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE � l�"""' , CONSTRUCTION: $ 'Q',()V //NEW BUILDING: _ RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION: ADDITION TO BUILDING: PRIM RY 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: 1ST FLOOR 1006 SQ. FT. /AO 2ND FLOOR '® IF ADDITION, USE OF NEW ADDITION: 71j1, SQ. FT. 10-0 OTHER FLOORS SQ. FT. t7 • (not unfinished cellar or basement) ACCESSORY BUILDINGS : �?� � Detached Garage - One/Two Car TOTAL FLOOR AREA: )75 SQ. v/ Attached Garage - One/ Car Private Storage Building SIZE OF NEW STRUCTURE : 0-- Commercial Storage Building Other FEET X tiff FEET Foundation Type: 19bui'ecI J COj1& Will any second-hand or ungraded Number of Stories : 1 a - lumber be used? If so, for what? (habitable space only) hr7 Height (grade to ridge) : as feet Type of Heating System: Number of fireplaces and/or woodstove (circle all which plies) to be °installed: ) El / ( . / Wood Forced Hot Air / Baseboard / Other PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS : NAME OF BUILDER/ADDRESS/PHONE : 5,4 Lax,4 _s He.-oa-ixr„.mekawir tsb Val l'a-�s- NAME OF PLUMBER/ADDRESS/PHONE : (,.(� P44.0.0�, 0A s1, ��,��.,r,,,, 64 . _ Nn/ NAME OF MASON/ADDRESS/PHONE : Safi UX41 /:bv+� 1-fermi,, ,f k.p ve-vcAour ra-siJ NAME OF ELECTRICAN/ADDRESS/PHONE : 1446-eig _. Of to.A-ou.to 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 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 noted, and that such work is authorized--by the owner.. Further it is understood that I/we shall submit prior to La Certificate of Occupancy or Certificate of. Compliance being issued, an AS"BUILT PLOT PLAN drawn to scale, showing actual location of project on premises . • Signature (Owner, owner' s agent, architect, con FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE: . \ - Allibmi Ics - � � TOWN OF QUEENSBURY o of QUEEN�Sb. APPLICATION FOR SEPTIC DISPOSAL PERMIT ."'`" RE44 M .D # Fee Paid APR .0 1993 Date: q Reviewed B f j� � iJ. ?: CODE uCP LOCATION OF PROPERTY FOR INSTALLATION: l4 / ' lrly/�JTl1h Uoff UWAS ,� 1� I /44/ AWAY Owner' s Name: FjjrpSf Wood ikN1P.S Owner' s Mailing Address: Ne-oa igx o p idurmfk a WO' Installer's Name: sant As ajkow Phone #: 6 Number of bedrooms (if residential ): Total daily flow (residential-compute @ 150 gal . per bedroom): IJS U Topography-Circle One: CP Rolling Steep Slope % of Slope Soil Nature-Circle One: Sand Loam Clay Other /Depth: 7j'4; Ground Water-At What Depth? �` Feet Bedrock or Impervious Material-At What Depth? ? Feet Percolation Test-Circle One: of Required Required/Rate Min. Per Inch Domestic Water Supply-Circle One: Municipal Well Other _ If domestic water supply is a w- - Separation: Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank 1000 gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench a feet//Total System Length _ I/ feet Seepage Pit(s) : Number of / Size each: ft. x ft. Size of Stone to be used: # .2 / 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 revpyse side of this sheet and agree to abide by these and all requirements of th- rown of Qu nsbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: M A DATE: alm4/49 k(0,,3 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: _vl1 OF QUEENSb. RECEIVED ;;/�� ENERGY CODE COMPLIANCE APPLICATION W, ' TOWN OF QUEENSBURY, WARREN COUNTY APR .i3Y 1993 9000 HEATING DEGREE DAYS 'el, & CODE DEPT. Compliance Methods: PART 5 - Acceptable Practice Method - 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: F)reAl- i,iI0,7d 1vieJ Job- 13 netriOn edif ? .4�,7 Inf1 PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area - =-'" 177i, square feet 2 . Type of Heat - Electric Oil 1,7 Gas Other 3 . Is building mechanically cooled? Yes v/ 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 I1 c. Glazed areas R a d. Exterior doors R W. e. Floors over unheated spaces R 0, 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 p) 6 . Service (domestic) hot water heating device Conforms to minimum efficiency per code 1,7 Yes No TEMPE TURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED Appli ant s Sig, ture Date Phone Number IN E OR'S REVMARKS: Pig a,j`-„"�'2AY tiii}f'�y.•!(} - 17�,{�,., .4 �� h +dZ rF„ .-— 'o -'•{,.r '^-".:, _ 5 l 7Y4 id•i'+� ' "�'( ` �l /�'' +4( - r'rrrp i 1j i`•..,,f M k' TOWN OF QUEENSBURY 531 Bay Rd., ©ueensbury, NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date fiord id ,14 Permit No. •fg `, vie 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 or owner agrees to comply with 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�� � �� & ��� APPLIANCE (check appropriate boxes) • Address fix , , ,� ❑ STOVE: o Wood o Coal o Pellet 0 FIEPLACE INSERT tilkotpd ham WY Zip ow D'Fi REPLACE, FACTORY-BUILT: o-Wood o Gas Phone M 7 0 FIREPLACE, MASONRY ❑ Wood ❑ Gas Owner ,sue 4,s , ,4, : 0 FURNACE: ❑Wood o Gas o Oil Address IF NON-MASONRY: Manufacturer • Zip Model: ,ri' tOutlet: inches Listed By: Number: Phone CHIMNEY (check appropriate boxes) Exact address of proposed construction ,� ❑ MASONRY: o Block 0 Brick 0 Stone bit 111:1 11am/dim (i f l y r.� r� / f FLUE: ❑ Tile ❑ Steel Size: inches CONSTRUCTION/INSTALLATION MUST ❑'FACTORY-BUILT: ' CONFORM TO NYS FIRE PREVENTION & Manufacturer: ,... Model BUILDING CODE. CONSULT TOWN OF Listed By: Number: QUEENSBURY HANDOUTS PROVIDED totouble Wall ❑Triple Wall REGARDING REQUIRED INSPECTIONS. 0 Insulated 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) Refunded to f.",4 , _r�._o 1 'Address: Y . - ..- Dated ..'0:9,4 Town Clerk or Deputy:/ o .r- .r1 a <r� White:Applicant Green:Fire Marshal Yellow: Bldg. Dept. Pink& Goldenrod:Cashier's Dept. • •.THE. NEW YORK:BOARD OF 'FIRE .UNDERWRITERS. .- ... CERTIFICATE"O r DO NOT WRITE HERE-FOR OFFICE USE ONLY _ . BUILDING PERMIT NO.. t ' ii TEMP,# DATE } i 4# .;•f t CITY OR VILLAGE I ZIP C}}ODE 0i_ TOWNSHIP ` { `COUNTY \ , ' •S REET AND NO. ROAD 1 'POLE NUMBER li: t;', Ift r (., e::.ii y� L.• u ;'i`_N +' . BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? / SECTION- - -BLOCK. LOT • 4k :\i'D•.r", a- .. _-1. '`_ ,.._, ally ---- - OCCUPANTS NAME BUILDING OCCUPANCY . a 7~'OWNER'S NAME AND ADDRESS • '.., HOME TELEPHONE NUMBER ' CURRENT SUPPLIED BY • FROM THEIR _ OFFICE WORK TELEPHONE NUMBER • • • BUILDING IS i _ . NEW`❑•7-—r-"-'' OLD❑ - WORK IS NEW❑ ADDmONAL 0 DEFECTS REMOVED❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED - " =NUMBER OF OUTLETS. No.of Fixtures& BRANCH OFFICE USE LGBa - - Lamp Receptacles MOTORS '\ HEATERS CIRCUITS ' - ONLY tion • Side,. Attach't H.P. Watts A.W.G. • • . Ceiling -.. Wall Recep'Is ''Switch Pendant Bracket No. Type Each_ Na. " Each Na Gauge INSPECTION, 1 • SIDE - SUB- , BASE BASE- . MENT" - 1St._ , • ',a FL. - 2nd \ - . " FL. ? . `A. 3rd { s ' FL. •f • 4~ REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. - ; -'.THIS APPLICATION.IS INTENDED TO COVER THE ABOVE LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIMEOF 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 SERVIC- NFBUILDING MANUFACTURER OF SIGN - . 3 0 OVERHEAD .(Q•, ❑ UNDERGROUND .• DATS ._ E INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS I I I - I I I�,-° IDENTIFICATION NUMBER AVOID DELAYS-BY GIVING-FULL AND ACCURATE INFORMATION.ALL SPACES-MUST BE FILLED IN'OR APPLICATION MAY BE RETURNED. - . _- PRINT NAME AND ADDRESS . DATE'OF APPLICATION `SIGNATURE OF APPLICANT NAME. APPLICANT - :- .�. r STREET ADDRESS . -TE{LEPHONE NO T ?'' r "7 2-1"f ' 4t CITY OR POST OFFICE y�'S 5 • ZIP CODE LICENSE NO.WHEN APPLICABLE ' 85 John.Street- J' 41 State Street.. 570 Delaware Avenue • 217-Lake Avenue - • 202 Arterial Road - • . �"NEW YORK;NY 10038 '�'ALBANY,NY 12207- BUFFALO,NY 14202 . ROCHESTER,-NY 14608 SYRACUSE,NY 13206, - - (212)227-3700 (518)463-2122 .. (716)884-1155 -'(716)254-Q141- . - `(315);463-8552 .. - .-... .. . ..r.v-.'....-1 1.1-. r,./.A'1111 -41 1 ' 1 .111-1 '-•1•srw I ri•r,lr t A/11.1-rr-ri-6 --- . _ !(,"",),1 r.90C••{;01r 01,e%fir ..1.9r 1b 1.b le(1,9! 19r VC sir fr ih 1.IPi 1,•rJOi OP/ 1P;?, AP/ke, 11Pi,)h fib." e/,01,%a .ylP4,".ati;?, itr,OP!1ti N Ai")9( h,_1i • t•i„M h 7r_,. Or. b)h.fs 101r�ti2$ THE NEW YORK BOARD OF FIRE UNDERWRITERS i:-'2�sf' • BUREAU OF ELECTRICITY ' r- 41 STATE STREET,ALBANY_NEW YORK 12207 �. .?ONE :1.1.,1°`)9 3 1 . 120 93✓9:f t; OW117L i', Date Application No on file c.! : THIS CERTIFIES THAT PERMIT jlI NO. }� :. ii ' na a, only the electrical equipment as described below and introduced by the plicanynmed on the above application number in the premises of FOREST WO)DS HOME, W 1I}'TON COURT, QUEENSE5Ur . .N,Y. ., .' Y in the following location;_ 3 Basement El lst Fl. E 2nd Fl. t�'� Section Block Lot } I JUNNE 07. 199,i i: was examined on and found to be in compliance with the National Electrical Code. :."ii : FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FAN_S < OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. '' i' i DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HATERS MULTI-OUTLET DIMMERS •' •_' AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS.' AMT. H.P. NSYSTEMS OF FEE AMT.� WATTS ;i' .: I E? 1 ? I , 0: SERVICE DISCONNECT NO.OF S E R V I C E : �. AMT. AMP. TYPE ME ER 1 A 2W 1 p 3W 3 r 3W 3 4W NO.OF CRL COND. of CC.COND.. NO.OF HI-LEG OF HI LEG NO.Of NEUTRALS OF NEII RAL ,,� 1 • 1 :ZOO C13 1 X 1. 4/Cl 1 2/0 R j: OTHER APPARATUS: 4 • CEILING FAZE---1 G,P,C..IT 2 ' :AIM:AIME DETECTORt; 1 • 1: 1+ 'i �: ARK ET .� LECTR.IC. 1-NC a I ' : .-.).v.....„...L. c . �' i,2`7 NOHAUIC AVEC e,• '' SCOTIA, NY, 12302 BRANCH MANAGER • ip �' i4ti :. Per ; 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. :iX ' �('ref_re�..re('r4t.'rei.�e\..re`..,e;.ie\.reC're�lei'r1i Yei'rN"rei 7e�'yi-rei're�'ret'q�.re['q�'lei Y�1'(ei'ie�rer iei'iei r(•f gC'reC ie� rej'r�Y>t�°rej'ieY q� ie('(e�;y� iN,y�C ie�-res y�yes q� ��i..re,..re,,;e`y....}. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ik TOWN OF QUEENSBURY /Vct 531 BAY ROAD _ € QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 ,. rsi• BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED 4/7/9 3 NAME \ 1 W " ,Q o LOCATION 4y--/ ", L/04/),( . DATE (p ( �j PERRIIT#7 93-o TYPE OF STRUCTURE ` ) 4C a21- rt1. /J RECHECK • (/ VAL (COMMERCIAL ) N - OUGHNPGLU INGDATI00INAL LECTRICALSTRUA C YNSULATION _WOODSTOVE/FIREPLACE REMARKS ( IAr- r-ea. is ,T l��✓7 d�iK=/ ma lt- �� (/ APPROVAL N/A YES NO CHIMNEY HEIGHT/LOCATION t� B .VENT/LOCATION PLUMBING VENT \ ROOFING \ SIDING !, DECK/PORCH/STEPS/RAILINGS RELIEF VALVES FURNACE/HOT WATER OPERATING BASEMENT INSULATION/Dt1CTWO K r/ INTERIOR TRIM/PRIVACY DOORS r/ FINISH FLOORS: \/ BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLEk\ OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS j. HANDICAPPED ACCESS 1 SMOKE DETECTORS • f BATHROOM FANS/WHOLEHOUSE FANS. ALL PLUMBING FIXTURESOPERATI GARAGE FIRE PROOFING , // ' DOOR CLOSERS fj ii OTHER FIRE SEPARATION FIRE/DEMISE WALLS lI DUMPSTER 1 . , SITE PLAN/VARIANCE REQUIREMENTS 'k FINAL ELECTRICAL silk, ' ri - OK TO ISSUE C/O OR C%C COMMENTS: %SSui- /o/ a){r-ff H12;1 41-es114.L V �L ARRIVE //O q /7 .,// DEPART W \ TOWN OF QUEENSBURY / ��� FIRE MARSHAL QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED 6/0*5 NAME ,1/4),Aed-A I1I YZ)-ze, ) �Y LOCATION %/� 7,3 g/fzielajow e, - DATE PERMIT# gt5-D I,I �`a APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS AUTO. EXTINGUISHING SYSTEM HOOD INSTALLATION / AUTO. SPRINKLER SYSTEM / ALARM SYSTEM / ,; I 11 d° INTERIOR FINISHES I STORAGE: CLEARANCE TO SPRINF$JERS CLEARANCE TO UNITS REQUIRED SIGNAGE HEAT? 1if CHIMNEY WOODSTOVE Ti, 7 FIREPLACE-MAS RY / '(FIREPLACE-FAC ORY BUILT . 1;, ✓ / REMARKS: L',OK TO THIS DATE ' ;7/ 2/015 IN ECTOR TOIV�OF QUEE6 SBURY BUILDING` & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Ci - Name 1L`c44-0.1kz-kD Location -c' 1 • , �Lu Date 1-7///1 Permit # 9 -Dqf SOIL TYP • -and- lam-Clay- Results of Percolation Test- (if applicable) .Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Lengths Length of each trench S,o Depth of trenches /_rp,/ Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: s: ;;; - Bldg. to Tank Size ;Type Tank to Dist. Box / S'1'� / Dist. Box to Field/Pit y Openings Sealed? Q Nd Partial LOCATIO /SEPP IkTICMS: Foundation to Tank , /0 feet Foundation to Absorpti ,' `: 0Q feet Separation of Pits — feet Conforms as per Plot P,an Yes No LOCATION CF SYSTEM ON OPERTY: (circle one Front -1p. Left Side '- Right Side Middle Front - Middle Rea COMMENTS: J l SYSTEM USE APPROVED: E NO,, Arrived: s,•yc Departed: iisoz, Buil din IPasp ctor TOWN OF QUEENSBURY FIRE MARSHAL QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME . t-c�Z(;-5 l_11)G v-) \4co-‘.G-. LOCATION LO,( re ► A.L4 o,0 CT DATE 5 1 ( c j9 3 PERMIT# 73-O/ APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS I, AUTO. EXTINGUISHING SYSTEM HOOD INSTALLATION AUTO. SPRINKLER SYSTEM u / ALARM SYSTEM , 't, /' INTERIOR FINISHES ��''f k STORAGE: CLEARANCE TO SPRINKLERS .\ CLEARANCE TO HEATING' UNITS . REQUIRED SIGNAGE ,rsi 111 '/ \ CHIMNEY f' WOODSTOVE ;i FIREPLACE-MASONRY.;' \FIREPLACE-FACTORY BUILT REMARKS: Ld'OK TO THIS DATE /271-G?7\. 0://( ' - /W,,,,,tq 2/015 INSPECTOR" TO#; OF QUEENSBURY tAIL i4 �f'1 BUILDING AND CODES DEPARTMENT 531 BAY ROAD • QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR°S REPORT REQUEST FOR INSPECTION RECEIVED NAME I', woo t7 ptin$-S LOCATION Jr (s, i- ti f--cv C-r DATE 5//4 c 5 PERMIT # 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 C ; ROUGH PLUMBING [ PLUMBING VENT/VENTS IN PLACE/ PLUMBING UNDER SLAB - FRAMING: JACK STUDS/HEADERS I BRACING/BRIDGING / JOIST HANGERS / JACK POSTS/MAIN BEAM HEATING ROUGH-IN / k INSULATION: 2t1 ,r ore_ \ FOUNDATION WALLS INTERIOR R- ✓✓�f: � FOUNDATION WALLS EXTERIOR R- FLOORS )(WALLS R-3v KCEILING R- /(e IC DUCT WORK OR PIPING IN UNHEATED • SPACES REMARKS: ARRIVE /DEPART / LI� At I 'PEI TOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT r/�y� 531 BAY ROAD �� lc' , QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED J NAME �p"�l M- (/'c��is- L 9r �aJ LOCATION Xi- /.,f5 #iVYN -w c f DATE 610//1 PERMIT # TYPE OF STRUCTURE ..,5;22 ) c? (»/, RECHECK A PROVED OVE 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 ON4SITE FOUNDATION/WALL POUR f REINFORCEMENT IN PLACE- ,4 FOUNDATION/DAMPROOFING / BACKFILL APPROVAL / ROUGH PLUMBING { ` PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB j `i4-FRAMING:(jjZCit - 0pS114/k-p& g( JACK STUDS/HEADERS '( BRACING/BRIDGING /A JOIST HANGERS I 'A JACK POSTS/MAIN BEAM1 HEATING ROUGH-IN / 4, XINSULATION: /2 (ook/0 1 - FOUNDATION WALLS INTERIOR FOUNDATION WALLS EXTERIOR R- FLOORS / .\. R- WALLS / \ R- /9 CEILING / \ R- DUCT WORK OR PIPING IN UNHEATED SPACES J REMARKS/ /0; so-- ( Kcn2 I A SuUrrro J--O'( — • ARRIVE /a; DEPART l0" S� \ SP CTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD �'L— QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED S`///9_3 NAME Led, - POW jYkacz) LOCATION / ���yj{ �af DATE 01/V93 PERMIT # 9_`D9I TYPE OF STRUCTURE ,562j et, G eta?" �j �/ 2 RECHECK eta?" 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 h/ FOUNDATION/DAMPROOFING 1 BACKFILL APPROVAL / ROUGH PLUMBING 1 PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB XFRAMING: /' \ JACK STUDS/HEADERS / `y, BRACING/BRIDGING / JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN INSULATION: / FOUNDATION WALLS INTERIOR R- FOUNDATION WALL EXTERIOR R- FLOORS R- �. WALLS J R- '. CEILING J R- DUCT WORK OR PIPING IN UNHEATED SPACES i l REMARKS: �2 409 "s �. s-wow o ARRIVE_ DEPART NSPE► OR A-e-fv TOWN OF QUEENSBURY /Q ah- BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED/f NAME ltuu,ai //k'�.�i oia-c— LOCATION , t/3 #j/j 1 DATE 4,/,„ PERMIT I 93-09f TYPE OF STRUCTURE ,Y€J u/p (r dA6 v:6;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 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/MAI`N BEAM HEATING ROUGH—IN INSULATION: FOUNDATION WALLS NTERIOR R— FOUNDATION WALL . XTERIOR R— FLOORS \ R— WALLS \ R— CEILING \ R— DUCT WORK PIPING IN "UNHEATED SPACES \ REMARKS .van al"..edgy ARRIVE /0'( DEPART /eaZu (----)7)4�/ / INSP=CTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD !m QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME ` Q.G luxe 2 r37�t LOCATION /j - /3 Wan j DATE t667,3 PERMIT # CJ J -- 092 TYPE OF STRUCTURE Sfj a C cat pi Vh) RECHECK APPROVED N/A YES /NO l( FOOTINGS/PIERS s� �ctdl� C/ MONOLITHIC POUR FORMf' 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 V BRACING/BRIDGING , 1 JOIST HANGERS / \ JACK POSTS/MAIN BEAM / HEATING ROUGH-IN / INSULATION: /' A FOUNDATION WALLS INTERIOR R-\ FOUNDATION WALLS E TERIOR R- l FLOORS R- \ WALLS / R- \ CEILING r R- DUCT WORK OR PIPING IN UNHEATED \ SPACES , REMARKS: f 0 ARRIVE DEPART Of5 if. / I SPE'TOR TOM. OF QiUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 9E /-&rPy ,1/ 42 .r P. LOCATION 4/ 3 DATE 4 1,,.P f? PERPIT 0 93-0,J> TYPE OF STRUCTURE RECHECK APPROVED N/A YES N( FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONT`':'CTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE P, ,CENENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE IIIIIIIIII G/BACKOLL APPROVAL ROUGH PLUMBING - PLUMBING VENT/VENTS IN PLACE '= PLUM ING UNDER SLAB FRAMI G: JAC STUDS/HEADERS BRAG G/BRIDGING r- JOIST (ANGERS JACK P §TS/MAIN ;EAM HEATING RO INSULATION: FOUNDATION\ AILS INTERIOR R- � FOUNDATION IALLS EXTERIOR R- FLOORS R- 11111 � WALLS R- CEILING R- MIN DUCT W 'K 0 PIPING IN UNHEATED 11111 SPACE .111 REMARKS: ARRIVE //40 DEPART //6/0 IN ACTOR ��' 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 /��9r1 NAME ` 7Pid.G V4—a7Y:Wc.P_e?...) LOCATION �- /� ect/ 1� DATE /////2,3`gj PERMIT I 93'0W TYPE OF STRUCTURE ,,5cD Gv de aLf" RECHECK (/APPROV(EDD ,, N/A YES_,NB' FOOTINGS/PIERS MONOLITHIC POUR1FORM / REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 ''HOURS FOLLOWING THE PLACEMENT OFFTHE CONCRETE. MATERIALS FOR THIS .PURPOSE ON SITE FOUNDATION/WALL OUR REINFORCEMENT INkP VACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING a PLUMBING VENT/VENp IN PLACE PLUMBING UNDER SLAB FRAMING: 4 'F� JACK STUDS/HEADERS BRACING/BRIDGING \\ JOIST HANGERS 11 ?a JACK POSTS/MAIJN BEAM HEATING ROUGH-IN INSULATION: 4 w\ FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS °\ R- WALLS R- CEILING ,J \ R- DUCT WORK OR !PIPING IN UNIVED SPACES REMARKS: ARRIVE p DEPART �f INS' CTOR '44-A k\ce10_ `''`) 27,905.09 sq. ft. ` . cil ® Z - .r3 % 41b \ Z I. S IHC3; \ �, ,v /\.. N+,., ti t \ \ \\ ..\ \ .C#\.‘ . ' \ \ \ .• \ \ \\ 4,, Q'l• f•\ °q 4 L,(1 Ca` _ • w �J� 0 wa - .. GP 4 ,./ co) .N•A ,k,,A, . :4* ()14 v CP .,.• ' ( ' 7/ + 's sh • , .„ 28149V , _ w C661 ; I"de 4 AUfl SN33flO dg NMOJ. mes uluiPtl WIZ is 3o3 M15 1 ddd UORBOilddV L 'a.. %\� A/' G AOHddV. ��r� f zIr Z Q n L EGEND: • FOUND IRON MARKER 0 SET IRON ROD WITH CAP 0 POINT WIM Ewa POWER LINE gyro ONE WAU FENCE OF THIS SURVEY ftnlrc GAOM ORIGIIII. s� SURVEYS 1 i LOT II 1.064 3 ACRES N 82°- 57'-17" I LANDS OF I LANDS OF RI CHARD & SANDRA BAKER I JANE POTTER ( 738-223) (7/3-222 ) CERTIFICATION a and Kathleen M. Ihereby certify to Ted PY-ork and Commonwealth )any that this map has Wilson, Trustca 61" New,ce with the existing Surveyors adapted by e Insurance C(* of Professional Land land Ti tl rda� en prepared forred in Icco Lin r&ctict code of P state Assoc the �Iew Y°r� MAP REFERENCES: 1. Map of a proposed subdivision known as Queensbury Forest Phase III, Town of Queensbury, Dated September 19, 1991 Last Revised April 22, 1992 by VanDusen & Steves L.L.S. 2. Warren County, Town of Queensbury Tax Map No. 121-14-13 Li ber 863/Page 75 MAP OFSURVEY. of lands- to be conveyed to TED M. 8 KA THL EEN M. WIL SON TOWN OF QUEENSBURY, WARREN COUNTY, NEW YORK pF NE.I SCALE: MAY 28, 1993 V 49098 Rece s a `' town ei QI � I -AND 5�k 'oilR o�'o W J. ROURKE, ASSOCIATES Licensed Land Surveyors JOB Ns 23 Z P. 0. Box 1434 93-106 B W I LL IAM J, ROURKE, LICENSED 4 YOR N445 /0264 Saratoga Road, Y �2803 AND SURVE South 6/ens Falls, N. - 09e z Q J Q U O Q Y j L