1993-132 CERTIFICATE' OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date V('./A,4-e . '5 19 ?3
This is to certify that work requested to be done as shown by Permit No. 3-13 2
has been completed.
This structure may be occupied as a z.cngte 6=Ley t&eVAIng/1/4 o6 6o tap.2ex
77 Utd M,(12• Lane, Dixon Ne i.ghti Lot 28
Location
CLReatty
Owner
95-1-28.2
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. (Sc Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 93-132
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CgL REALTY
77 O d MLfi Lane "'
, Dion Nei
OWNER of property located at �� LUG 28 Street, Road or Ave.
in the Town of Queensbury,To Construct or place a 1/4 °4 owcp.tex o0
at the above location in accordance to application together with plot plans and other information hereto filed and ^�
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
3049 Bnoadtay
Schenectady NY 12806
2. CONTRACTOR or BUILDER'S Name r
r
Madu.P.2o Bno.. Btd . czs
G
3. CONTRACTOR or BUILDER'S Address
tTJ
tame
d
4. ARCHITECT'S Name
5. ARCHITECT'S Address
v
6. TYPE of Construction—(Please indicate by X) v
( JWood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications Model.: The Dixon II
22.5' x42' 1/4 o .6ounp.Pex cus peh pto-t plan, 4peci{�ica ionz and apptica-
"ot,Lon inc.adLng one cats attached ga age and zep..%c zyztem common .to P
who 6ounp!ex.
8. Proposed Use
S-.ngYe 6am.uiy dwetUng/1/4 o,6 6ouhptex
$ 207.00 PERMIT FEE PAID —THIS PERMIT EXPIRES APRIL 30 19 94
(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 30h Day of y Apt l e 1g3
SIGNED BY � for the Town of Queensbury
Building and Zoning Inspect
.
TOWN or QUEENSBURY ` , `.aN OF QIJEENSE
RECEIVEb L'.
REVIEWED 81l
O1W FEE PAID $ . , APR , ' •
ciporsil PERMIT NO. , 9�—/9‘
• BUILDING ptnlyit1'APPLICATION . C®D FT°
A FERMI F MUST DR OBTAINED HEPORB BEGINNtNO CONSTRUCTION. NO INSPEC'MONS
I WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID i3UtLbINO PERMIT.
' All applicants seaces oh this epplicetiori Mimi. be completed and the signature of the
, • applicant MUST appear on the reverse side of this application.
• i • • • • i •- • • • #- i .i i a 6 • i • • •1 • • • a • • « .4 i • a a a • • • • • •
The owner of this property 1st 04L PE,114 , •
i P.O. Andress ?649 g8oaiwnv .._Gda/P-rAPY AI , 1 e306 Tel. 3h9-I0
Property Location 1 7 OLD PhIiL, 1 • 1' { ' • Tax Map No. V/1/
S
•
Nat there been any split Of this property since October 'L,,.I988?, . /, X �•4
If yes Planning Board Review is necessary. 4 yes no I
SUBDIVISION NAME, IF APPLICABLE gxeht.. I-ielpill LOT NO:, eh ,
I ,
THE-PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS! '
NATURE OF PROPOSED WORKI , •• , '1:ESCiMATED MARKET VALUE OF . •
X Construction of a new building „ • CONSTRUCTION: $ 7✓/0�U
COMPLETE INFORMATION REQUIRED BELOWt
Addition to a building Z1Z,43
* Size of property 13, 09 , it x ft.
Alteration to a building , M Existing Huildlligs(3) Size �J.1A ft. x . ft. •
. , (no change to ekterior dimensions) *
Proposed building distance from property lines
Other work (Describe) • ;. . . 's�. ,e.
Front yard ' � ft. Rear yard . Ii ft.
F , 1 • ,n t , ri, 'mil. • # • , 0
Side yards 0 It. and . ft.
•
GROSS AREA OF PROPOSED STRUCTURE a ft on corner, setback from side street N/l� ft.
1st Floor 679. . sq. ft. f, '•
OCCUPANCY INFORMATION
a .' i ,
2nd Float G 9
1t sq. ft. i r ' Primary Building -
• aY1 '�Family Dwelling
Other Fluor! aq, ft,. ; ,
': (not cellar or basement) '?! ,i!. .. .i Two Family Dwelling
TTAL FLOOR AREA I V sq.,tt. .. : .
e Multiple Dwelling/Number of unit:
iO
Site of new itfuetute 2Z.5 tt x 42- it. . •
Ruainees
" tnddttiil
Foundation-pier%:lab/crawl/partial/ u�
41 :; Week ono). ..! `.�,•rt >-,I .: a 1'l,1 t; , .Othlf ,
U 1 . . ' . if' r FLL ,�1' ig �'3.1 �, ! :i ii f
Md. of stories thabit*bie toe.) .:2: ' ' i , '' ,y ,. 1•.' 'y .., ' . ' , ,
Height (grad, to tldge) ' Z tt.• • . a ''it addition, whit will up bet • •
it residential, no. at families • • •
Nd. of rootni(exeluding bathe) C . .. ' a i Aceetsoty building •
Nb. alfidrtlohl� ` .: ..1 ,1,, ' e I
....�
a
Car •
He, of bathroottt! . l`h, i Primary kiting whim r.omit . • a X ire
Typo of fuel 60 y ' " • Private Horace building
He. of fr+ptie i to be Inetall.d 0 " • tither ,
Woo i,
I
i Wilt a d steel bi installed
i
• 1
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING a PF.CIFIcATIONs:
Type of construction, wood frame, fire safe. etc., WooDiM11�
Will any second-hand or upgraded lumber be used? if so. for what? /Jp
Foundation wall materiel POOO DNC. - DI�Ps� , Thickness
•Depth of foundation below grade (to botto „of footing). ,4B"m m.IN.
Will there be a cellar? ' 1110 Heated or unheated? • Floor sq. footage - sq ft.
Will there be a basement? . Will any portion be;used as1 living space? • NO .
(If so, what portion? . • sq ft. Type'of use?.;, . .• . ; ;
Type of roof - to ed flat/shed/other Material of root Z ,J
Size, wood studs 'i.. "x " spacing 16 " o.c. length fi' ft. •
Joists (floor beams) 1st floor Z' "x f ) " spacing-16. "o.c. span lb(1_, ft.
Joist (floor beams) 2nd floor Z "x 10 " spacing 1 j) "o.c: span-..1 0:\i2 ft.
Overlays (ceiling beams) 2- "x " spacing /4 ," o.c. spin 12 ft.
Roof rafters 1. "x ) ," spacing l b 0.0. span L It. ' .
Roof trusses (pre-engineered) spacing/ EA " o.c. span .3DL3 ft.
Exterior wall Wilt : I�DRIi?a1+mL gweav 5'9 v _OE What Material? 14NyL
• NV7�j
Interior wall finish. ,, , YZ' 1A o • I, 1 , , . ; .
if a garage Is to be Attached, describe materials to be used for FIRE SEPARATION:
. . "Na' . YZ : 'ALL bvit s t C'la t B-Rezal Der
Is there to hp en bpehihk between `amigo and dwelling? :,YE5 If so will a Fire-rated door, enclosure,
self-closing device be provided? ,,N; . ;.,
Will a flue-lined chimney be installed? No Height above roof ft.
Depth of chimhey below grode ft. "
Depth of fireplace hearth ft. . in.. .
Water supply -Qt1,tthicipal r private Well
SEPTIC SYSTEM Matinee from ANY private well (including adjoining properties %SIN /3 ft.
(A seprrnte appih,etion,is necessary for any repair or new Installation of septic system)
NAME OF BUILDER AixlloA,6, Lobo, ADDRESS d41 40fiplt litlei lid 'EL. NO._ • 320la •
NAME OF PLUMBER gotherzoliN•( ADDRESS34300,-ll ,,uie&opotTEL. NO. Y.S6 3//O
NAME OF MASON Pig/ . .ADDRESS 1joiy gif0ApiUOME1 r' TEL. NO. 39 2 fo1 3
•
NAME OF ELECTRICIAN 6u9zAD, jw12L ADDRESS fl Aeici to P2• �ijiatvitoy . TEL: NO. 3 '00
DECLARATION ` '
To the belt of my knowledge and belief the stetementf Contained in this epplleetlon, together with the
clans and specifications submitted, lire I true end coniplote stetirnent of all ro
p poeed work to be done on
the described premises end that all provisions of the BUILDING CODE, THE-ZONING ORDINANCE, and
ell other I.wrk pertaining to the proposed work shall be.com,lied With, whither specified or not, and that
;Web Work is Cuthorlsed by the owner‘ ' `' ' • " '
SIgnatufe• vfli
Owner, owner's agent, architect, contractor
SPECIAL CONDITIONS OP THE PEAMIT! •
EY , -
•
•
TOWN OF QUEENS$URY
WARREN COUNTY , NEW YORK
Application for : BUILDING
PERMIT
TNINRCOM COMPLIANCE
NCEEWITH THE HEW YORK
STATE ENERGY
CUE NSb._
A permit must be obtained before begin'nittit
ANSWER ALL of the following: APR Lly 1993
1 . Gross floor area _ �3��
l) - - . & CODE DEPT,
/1 M
2 . Type of heat _ ( r- ,q12
3 . Is the building mechanically cooled? AO
4 . Percentage of area of windows and doors_
A. ever 16% Only
1 . Uo value of gross area of walls , roof/ce,tling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? YES NO
1 . If YES, what is the R value?
3 . Slab on grade YES N.O
a. If YES, what is the ft value of insulation around
perimeter of floor?
•
4 . Is basement heated? YES H9
•
a. R value of insulation
5. Type of insulation _ .
R. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls •
3 . R value of glazed area P"Z,/
4 . R value of doors D Q
5. R value of floors over unheated spaces /� i
6. R value of slab edge insulation - unheated slab AO
7. R value of slab insulation - heated slab WA
B. R value of heated basement/cellar walls (above grade) P//
9 . It value of heated basement/cellar walls (below grade) fli
10. Type of insulation igw4Ayf
C. Controle 1 . Thermostat maximum heat setting 90a
D. Duct Systems
1 . Is duct system installed in unheated space.s?. YES 0'
a. If YES , R value of duct installation
b. R value of duct in other areas
E. Piping insulation
1. • Size of hot water or cooling carrying agent pipe -
2. R value of pipe insulation
• F. Service Water Cleating
1. Performance efficiency
2. Temperature control setting maximum
•G. For Swimming Pool Only
1 . Maximum heating /► •
Telephone No. 11O`L0,-b
" (applicant ' s signature)
TOWN OF QUEENSBURY
41,0
APPLICATIOH FOR SEPTIC DISPOSAL PERMIT
DATE: 4-2Z-9'
A OF QUEENSb-
LOCATION OF PROPERTY FOR INSTALLATION Cir) OLD PULL /A - RECEIVED
Owner's Name: 100,90 ,/A/6 App. igq3
Address: 3614q &guy . aiavEzrANy, y
& jra C DEPT
Installer's Name: 4,0//44 /1 . Telephone: z* / ;7- --
Number of bedrooms (residential only) Z
Total daily flow (compute @ 150 gal per bedroom) ,
Topography: Circle one: lip Rolling Steep Slope % of Slope
Soil Nature: Circle one: and Loam Clay Other /Depth:
Ground Water: At what depth?. Ara , Feet
Bedrock or Impervious Material : At what depth? A9ll Feet
Percolation test: Circle one: C-iot required required
Rate - Min. Per inch
Domestic water supply: Circle one: Municipal Well Other
If domestic water supply is a wel
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ao gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPA feet
1-711
Size of stone to be used 11. Z /Depth or Thickness IL sono 56Epayr fir feet
********* *********** VALL-
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Atari systei and associated electrical work to be inspected by an approved
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:
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queenibury Sanitary Sewage Ordinance. shall
by submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan shoving:
1.) thi proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structural,
4.) location and distance to any water supply
5.) size and dimensions Of all tanks, distribution boxes,
tile fields and/or drywalls
B. No system shall be covered before inspection and approval by the
Building Inspuctor. Failure to comply with this requirement may
rusulc in the uncovering of the system by the installer and a fine
ut up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure co produce said plot plan at tin. of inspection may
result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper inscalla—
cion, alteration or repair of an approved system, a new proposal rust
bu submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Rumurks:
.',46 EL(RE\(1/ae) - .A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
THE NEW YORK BOARD OF FIRE�UNDERWRITERS , ,,.,'• .CERTIFICATE NO.
j "DO NOT WRITE HERE FOR OFFICE USE ONLY
•
d 1 h y Y rT.'La •i < .t;UT I: f , - e. -
• BUILDING PERMIT NO.
TEMP.N DATE
CITY OR VILLAGE / TOWNSHIP1. i/
COUNTY
I.CJ4✓2rt/'
STREET AND NO.OR ROAD '
, ^^ V I ( �,�� �6�� ... POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION ! BLOCK LOT
DTFFAirbvooi Dr , OFF QI,kotti t2A Lorizrs
OCCUPANTS NAME -- BUILDING OCCUPANCY . {
OWNER'S NAME AND ADDRESS -HOME TELEPHONE NUMBER ,
IH I(o Ric (-SulIdp4 �3�q "0 1i l � y c�� ice,
CURRENT SUPPLIED BY FROM THEIR; . O ICE WORK TELEPHONE NUMBER
•
BUILDING IS �/ ��� 37O 1D '
NEW L'f I OLD❑ i WORK IS NEW I k 1 ADDITIONAL 0 DEFECTS REMOVED❑ i
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED.
NUMBER OF OUTLETS i No.of Fixtures& BRANCH • OFFICE USE Loca- LampReceptacles MOTORS HEATERS
lion J P CIRCUITS . ONLY
.Ceiling Side Attach't A.W.G. ?
; Wall Recep'Is: Switch Pendant Bracket Na Type Each NO• Each Not Guge INSPECTION
I
OUT- ' •
,SIDE '
SUB- I •
BASE ; •
- 3 •
•
MENT . ' . . ,
{ . .
1st
FL.
2nd . -. • .. _ .. ._.... ,..�.
FL. .. ." •
3rd
FL.
•
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: -
1
THIS APPLICATION IS INTENDED.TO 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 i...... , __ .. • FEEDERS . ELECTRIC SIGNS/LAMPS . - , TOTAL WATTS. •
. 15zD. A-�i P . '
CHAA�RACTER OF/W�ORRKK 1 I GAS TUBE SIGNITRANSFORMERS OF
�P J Q.00)S `-6 C_Y•`{O oii .. ❑1EXPOSED _ VA
�� / ._ IS CONCEALED _
DATE WORK TO BE STARTED - - .DATE COMPLETED ' SIZE OF SIGN(NUMBER) CAPACITY
. . s—,0-5'3 _._
SERVICE ENTERS BUILDING --,�..,��� MANUFACTURER OF SIGN
I ;,❑ OVERHEAD I' • rl.NDERGROUNO
DATE INSPE ION REQUESTED ON(OR AS NEAR AS POSSIBLE) , - - - --
i
/s' I DENT FIJCAT•ION•„MUST ENTER N SUMBER '° i,a. Q , j ,� � , IQI,
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES-MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. .
PRINT NAME AND ADDRESS -
NAME OF APPLICANT t -...-• • - DATE F APPLICATION : SIG ATURE APp ,
• V ZZAt'� t •P cs c ...c_�L—• .. • i�(°2z 53.. ;X
STREET ADDRESS EPHONE yc
17 1 XI ViOnd' : f i-. . . , - l$ 3SS8(on
CITY OR POST OFFICE : I .ZIP CODE LICENSE NO.WHEN APPLICABLE
El85 Jolin Street" ' - tale Street , - ❑'S84 Delaware Avenue ❑'217 Lake Avenue. :`❑ 202 Arterial Road '
NEW YORK,NY.10038 ALBANY,.NY 12207 ' BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
THE NEW YORK BOARD OF FIRE UNDERWRITERS
w, THE NEW YORK BOARD OF FIRE UNDERWRITERS 'ar{', 1.
4001057
1; BUREAU OF ELECTRICITY
41 STATE STREET,ALBANY,NE ORK 12207
14. Date SF,PTE�t1BER 2/1'1.99? No.an i �.{.t; (,` 3/f3 A {'rf1V3.15 •%.
Applicationf
THIS CERTIFIES THAT I'E;�,l fT 1` NO. �3 :_2 `:
' only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of :'
i; ..
HASULLO BROS l L, W S INC 77 OLD HILL LANE, QU.EiENSBURY, N.Y,',
x GAR. ?s� •'
. in the following location; ❑ Basement H 1st FL ❑ 2nd Fl. Section Block Lot
was examined on aL`�`1'F�I f�ti fit I , :19�a and found to be in compliance with the National Electrical Code. 'i.
!�; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT.. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
;::3 38 2 6 '?:1 1 1 :1.5 3 l'
•
-c, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS 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. NO SYSTEMS FEET AMT. WATTS :
'i
►, SERVICE DISCONNECT " _NNO.OF - . . . _.S. E.,. _ _ R' V __I _. _ _C E `
�. METER
. AMT. AMP. TYPE EQUIP l,e'4W 1 F 3W 3%3W 3,6'AW NO.OAR%COND. OF CCiej .COND.• NO.OF HI-LEG of HI-LEG NO.OF NEUTRALS O EUTRAL ••?
F
t, :I. 150 CBX 1 2/0 1 1/0
J
i OTHER APPARATUS:
''.: ( .J'.'.C. E: . %
to SMOEB DETECTOR:-1
,,
Pc1., ':••
•
•
1
' 1
AI aHOUY' (:;112Z�1RDI
L7( BOXWOOD DRIVE . . t/,.-...,-:-..--. (..,- -f Cj
�; SCHENECTADY, NY, 12303 BRANCH MANAGER
': 239
Q: - %
••4• 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.
ii 0 00555555 5101Mirl ® 000 ® DODO WSW 0 Rif MEW ;.:
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
t .
TOWN OF QUEENS ;ii ) -
:,_� ;t 531 BAY ROAD
'� 1_ ; QUEENSBURY, NEW YORK 12804
� -. TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT -
FINAL INSPECTION ` /
REQUEST FOR INSPECTION RECEIVED /e/i( f3
NAME !'���GCd-LC—tL'o / .
LOCATION '7 lJ/L )2( i' 7 ..
DATE jd/5/9, PERMIT# "3-/32
TYPE OF STRUCTURE 4,/,1 irpairiage4,2
RECHECK G
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
1 FOOTING FOUNDATION —BACKFILL 4-FRAMING
‘AOUGH PLUMBING =—FINAL ELECTRICAL ASEPTIC
reINSULATION WOODSTOVE/FIREPLACE
REMARKS
' APPROVAL
CHIMNEY HEIGHT/LOCATION P1/A ES NO
B VENT/LOCATION ' y�✓r
PLUMBING VENT ;� ' ✓'
ROOFING ;y
SIDING , . J�
DECK/PORCH/STEPS/RAILINGS / , ✓'�
RELIEF VALVES I `,
FURNACE/HOT WATER OPERATING/ ✓-
INTERIOR TRIM/PRIVACY DOORS ', ,.. '"--
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT/ \ ;/
OTHER FLOORS SWEEPABLE + ✓
OTHER FLOORS CARPETED' '_, ✓`
STAIR CLEARANCE/RAILINGS `� +f
SMOKE DETECTORS ` \, 1,----
DOOR CLOSERS / ✓
BATHROOM FANS / a
ALL PLUMBING FIXTURES OPERATING ✓'‹
GARAGE FIRE PROOFING -i
DOOR CLOSERS ; , -
OTHER FIRE SEPARATION ,/', /�
FIRE/DEMISE WALLS
FINAL ELECTRICAL 4//�f'
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE IG --
DEPART 0,06
N ECTOR
TONN OF QUEENSBURY ,/,''/
BUILDING A CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name :`l/'s,1 0 7e9
Location ___23 -26__ 27 _ 77
Date 93• .3o, i 3,
�' 0/1 . Permit # ,3a, /33
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inc
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number- +i
Size - _(,, ft. x e2r ft.
Stone size a' j,1rr►.t.
PIPING: t/ Sizg Type
Bldg. to Tank
Tank to Dist. Box -�- 6 )�!1 35
Dist. Box to Field/Pit y - 33
Openings Sealed? (Ye No Partialy
V
LOCATION/SEPARATIONS—
Foundation to Tank (_f feet
Foundation to Absorption ems,_ f/et
Separation of Pits _ .%' feet
Conforms as per Plot Plan / Yes' No
LOCATION OF SYSTEM ON PROPER/TY://
(circle one
Front - ' - Left Side = Right Side
Middle Front - Middle Rear
COMMENTS:
'- i(-)°
I '
\ :
2oa�t
SYSTEM USE APPROVED:. 5
N0
Arrived: �' '\
Departed: . 30 `.
Buildi c or
/1405`-- TV 51LIA h c r4y.1 r/-o 1)1.114-5
J
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 46/tq3
,
NAME L��t 0 VI t lJ(p� ( t1 .0 , Lit t
LOCATION 71 A)/d
DATE £I/,3 f r 3 PERMIT #
TYPE OF STRUCTURE / /--e-6,,,...frev/
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 fN SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL s'
ROUGH PLUMBING /
PLUMBING VENT/VENTS IN PLACjE /
PLUMBING UNDER SLAB \, /
FRAMING: `:;
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAM
HEATING ROUGH—IN
jINSULATION: ` ,('(/L
FOUNDATION WALLS INT RIOR R—
FOUNDATION WALLS E ERIOR R •
—
FLOORS R—
WALLS R—
CEILING R
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
4
ARRIVE i'
DEPART (0;:3) •
SPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT Aat
531 BAY ROAD
QUEENSBURY, NEW YORK 12804 ( 1 ")
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ��/��Jq. 3
NAME �lCl�1 GGL�LJ�d ,e164
LOCATION , �/ itCI�Cd2 )l�-(,�°r
DATE 'i z f( PERMIT # 9 -1.j�,
TYPE OF STRUCTURE (ft itri.tAftey
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 ! r
PLUMBING VENT/VENTS IN PLACE,/
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS \,
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN •BEAM
HEATING ROUGH-IN
}( INSULATION: w.
/- FOUNDATION WALLS INTERIOR R- ',
FOUNDATION WALLS EXTERIOR R- • -
FLOORS R-
WALLS R- Iq
CEILING
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 3"..5 5
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT 2/
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED �//O!
NAME ` l }fit✓1,Liil fiL
LOCATION 1717 aid 7 TL/ 4/(--/U)
DATE f// 3 PERMIT I
TYPE OF STRUCTURE AZ 1 /A-641?-p..-i)_ii
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM J'
FREEZING FOR 48 HOURS FOLLOWING ,/
THE PLACEMENT OF THE CONCRETE. f
MATERIALS FOR THIS PURPOSE/ON SITE
FOUNDATION/WALL POUR • /
REINFORCEMENT IN PLACE /
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL a
) ROUGH PLUMBING -�
/ PLUMBING VENT/VENTS IN PLAC
PLUMBING UNDER SLAB
`(FRAMING:
JACK STUDS/HEADERS /
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN 4BEAM
HEATING ROUGH-IN „+'r
INSULATION: /
FOUNDATION WiNLS INTERIOR R-\
FOUNDATION ALLS EXTERIOR R- \
FLOORS / R- \
WALLS / R- O.
CEILING / R- \
DUCT WOO( OR PIPING IN UNHEATED
SPACES I �\
REMARKS".
ARRIVE JZ':
DEPART 7-
INSPECTOR`
TOWN OF QUEENSBURY /)�4
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%QGLlb /,ytl.JGLiL4J
LOCATION 7/ did `7)j.��'/1 a4 .0
DATE AV M PERMIT I 9,5-/3.2._
TYPE OF STRUCTURE > L V , _thyn eip f,
RECHECK / APPROVED
• N/A YES NO
FOOTINGS/PIERS J
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE , .
THE CONTRACTOR IS RESP NSIBLE
FOR PROVIDING PROTECTION FRO ,
FREEZING FOR 48 HOURS FOLLOW NG
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR /r •
REINFORCEMENT IN PLACE i ;!
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 tBEAM
HEATING ROUGH-IN /
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS i� R-
WALLS R-
CEILING
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
pisP F rz/syt Z.vd%,
ARRIVE /V= 6
DEPART [d
INSP CTOR
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 ,
NAME Zei ,e/ A X--(%L/)
LOCATION ��,� ey 7
DATE / PERMIT I 93-45„2
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
'> ACKFILL APPROVAL `!
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE ,
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM 7A
HEATING ROUGH-IN I
INSULATION:
FOUNDATION WALLS INTERIOF R , _
FOUNDATION WALLS EXTERIOR R-'
FLOORS / R-'
WALLS R—
CEILING R- '
DUCT WORK OR PIPING IN UNHEATED
SPACES
1
REMARKS:
ARRIVE / j
DEPART
NS TOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT �u��/
531 BAY ROAD /4,,?4r
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED S7 1
NAME /� 5s-" ar:f.
LOCATION 47 77 ,�/e/if, _-.4-
DATE ,.5�/s l') PERMIT # g 3.7T Z-
TYPE OF STRUCTURE -y+oub'-L
RECHECK APPROVED
� N/A YES NO
i/rOOTINGS/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 THISPURPOSE ON,;SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING ,, /'
PLUMBING VENT/VENTS IN4lPLACE
PLUMBING UNDER SLAB r
FRAMING:
JACK STUDS/HEADERS ;
BRACING/BRIDGING /
JOIST HANGERS ;
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN /
INSULATION: i
FOUNDATION WALLS INTERIOR' R-
FOUNDATION WALiLS EXTERIOR R-
FLOORS / R-
WALLS / R
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: '
' /IfARRIVE . f,
)EPART ✓j
INSPECTOR
OF OUEENSb,_
RECEIVFD
APR . 1993
tPIXOla 41, •••• CODE DEPT.,
SUMMARY OP TOTAL TRERMAL RATING
I,ulicllng Is itrrttitlipratrirgbwIth gag&
ett.er.the envelope portion of the
TABLE THERMAL
AREA tiVALUE USED RATING
A. WALL ASSEMBLY
Al. Net Welie A 950 . .-z
Awuw
A2. Glazing Ag/ZB U 44 • .• :62Z- • +11
Al. Dove i3L uai.070 o #1_
Ad Lid a
Subtotal Thermal Rating for Stettin A (Al+A2+A3): 10
B. ROOF/CEILING ASSEMBLY
RoOf/Celing Ar .q3j) , 043 6 -4 -c
Ar - .
82. Skylights Ag tin ..12 a. •
• Subtotal Thermal Rating for Section B ( El +B2)! •
C. ENTER DATA AS APPLICABLE (Elitist CI, C2,Or C3)
Ci. nod At .ZZO 1k .;034. • k •
C2. Foundation Wed
Wiii Perimeter 1 o ft.
Above Grade Exposure I ft.
kittultitioti Depth 024 Ut
348Footkig
Perimeter fl-Valuti
c3. Stab Edge liatulatiOn
S •
• Subtotal thermal Rating tot&taw'C(C.1 4-C2+C3):
a tout.titehmAL nktitici (A4-ti+C)
• •
I tasuikmi o
he
Builder , Inca
An49 nroldW4v Schenectady New York i2406: (CHO 470-106R. FAX 115181 ;70-562R
s V RECEIVED S `APR .- 1993
.---, & CODE DEPT.
I
e D,tPd ,pA -7-'1 d iv eti
ki
Za< 4.._ \ Vzs..' ls' ' / AN
N N.
•
\ , �
l>`
M
AppU dtiof. ApPn CA,Eff-1± 1
lkikt
/\ • N —11
\ / s / APR 2 8 1993 /
N •, 6/ f { / t
o /S ' (�` \ \ Zoning Administ ator •
Ni /7 ' �. 1 I \ \ \ ..v ,�®W(V OF QUEENSBUR /' Ai
P -` Z _ ,\b / / '0
',-- , : v\� �` �9s \ �\ /
0' .s N
tit-
l
Y--° I . \ \
\ \ \
flk ;.. 44 .
,i•
s _ _ \ N iki17-4`" a 40 - \ \
?-------7------
'� r r \ `\ `' - 1 \� ' 1
N .r, 1
'.',0/ / -,
--, -_, \ . II. o q. „4.6-- I.:
\ / f r'