2014-203 TOWN OF QUEENSBURY
WOW
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
5rY
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140203 Date Issued: Thursday, October 01, 2015
This is to certify that work requested to be done as shown by Permit Number P20140203
has been completed.
Location: 34 THUNDERBIRD Dr
Tax Map Number: 523400-295-000-0001-003-002-0000
Owner: THOMAS & DEBRA SYLVIA
Applicant: THOMAS & DEBRA SYLVIA
This structure may be occupied as a:
Garage Attached By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property 41
)45't
owner of the responsibility for compliance with Site Plan, Variance, or c ,{
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
Temporary Certificate of Occupancy
90 Day
Building Permit No. : 2014-203
Property Location : 34 Thunderbird Drive
Property Owner: Thomas & Debra Sylvia
Approved for the following uses: Single Family Dwelling
Conditions of approval:
1. Final electric for septic;
2. Site plan certification;V-
3. Septic as-built from engineer/architect;
4. Final electric.G
$100 fee received on: July 30, 2015
90 Day Temporary CO expires on: October 30, 2015
*A final inspection for this project must be scheduled before the expiration of this
Temporary Certificate of Occupancy — if your project is not complete within this
90 day period you will be subject to additional fees*
Signature of Applicant: T77,--t/ cg
Printed name of Applicant: s k . s:`l t.' ' G
k.---.
Director of Building & Codes: (Da.0 4
David A. Hatin
I
Town of Queensbury Building & Codes Office
Dept. of Community Development 742 Bay Road, Queensbury, NY
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20140203 Application Number: A20140203
Tax Map No: 523400-295-000-0001-003-002-0000
Permission is hereby granted to: THOMAS & DEBRA SYLVIA
For property located at: 34 THUNDERBIRD Dr
in the Town of Queensbury, to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: THOMAS & DEBRA SYLVIA Garage Attached
258 FORTSVILLE Rd Single Family Dwelling $175,000.00
GANSEVOORT NY 12831-0000 Total Value $175,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
TOM CASE
793-0153
NY 12804-0000
Plans&Specifications
2014-203
SFD 1,568 sq ft; garage 672 sq ft
SEE BP 2014-110 for Pere Test
$414.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,December 30,2015
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Townu sbuty /jTu a 7/J.1 • .mber 30,2014
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
f !...:1 : -,--'------- Office Use Only
Town of Queensbury Building & Codes l ; '�
y
Received:
PRINCIPAL STRUCTURE APPLICATI01 'A Y 3 Tax Map ID: ��1� ' t- 3 01
AulliPermit No.: /41/"-a0 .
A permit must be obtained before beginning cpns r, ction ��
��� Permit Fee: $ '��'� —
Please read: *TB resolution 86-2013(1-28-2013): $850 recreation f e/for new dwelling:_: Rec Fee: $‘5P37-)
units,including single-family dwellings,duplexes or two-family dwellings, multiple family Site Plari No.:
dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.: •
homes,but not including mobile homes. This is in addition to the permit fee.
Date 43d le1--0 t `'t" Applicant -----1m , 'Pet S '/ / v f `'`/
Tax Map ID Address
Zoning
Phone/E-mail 93e2 -, -C C 2.
Property Owner —77.v, , Dc b 5 11 V/r9 Contractor/Agent I c e a 0-17e-„e-r Z'n r
'j- irt
Address - �,, c"-e- �A- c'/ RaA-O Address / 3 Z /2a•- 17 cj
t , ?.-xre mac.7 r'- t 24-31
Phone/E-mail J 3 a - G Phone/E-mail ,9t:- .. ,7 i-s �c ct,.1o'e4 t.-,c ('c 3
Contact Person for Building&Code Compliance: T, , , <°' A. J i Day Phone: 79 3 ”01 c 3
Building Street Address: 3 Y %'ice h elf hi r r1 . E o A 0
Subdivision Name: Lot#: Historic Site: Yes No
Estimated cost of construction: $ t 11 C -000
Type of Construction:
Check all that apply Please indicate measurements as required below:
c
c, c
d d 1st Floor 2nd Floor Other Total Height
z a a
Single Family >/ ciji
EA-I k
Two-Family 4 5�� il 31 5 �'
Multi-Family(#of
units_)
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garages(# [ ) R -•a sr - 111000�
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business
Proposed use of building or addition $ i \ c M r•,‘ ( r w f (�
Source of heat(circle one) Gas Oil `Propanei Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" Yes >( No
Are there structures not shown on plot plan?
11\iLI
Are their easements on the property?
Site Information
a. Dimensions or acreage of lot
b. Is this a corner lot?
c. Will the grade be changed as a result of construction: je.,Yes No
d. Public water or Private well
e. Sewer or Private Septic System
Trk-vuo–C-
Value of all work to be performed(labor and materials) $$ r S coo
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval. I certify that the application, plans,and supporting materials are a true and complete statement/description of the
work proposed,that all work will be performed in accordance with the NY State Building Codes, local building laws and ordinances, and
in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a
certificate of occupancy. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above.
Print Name: c �„ S �� �•`
Signature: T-71"—s -576— Date:
FOR OFFICE USE ONLY:
Operating Permit Issued: Yes No
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit:
Special Conditions:
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Office Use Only
Received:1 t✓l j i .
Tax Map Ib:
Town of Queensbury Building & Codes Permit No,,: . ,
SEPTIC DISPOSAL PERMIT Permit Fee: $ t•;AY 2014 I
A permit must be obtained before beginning construction Approvals: ,-,7h�ry r'a-, ...._... .! .
, :1 i,;
�5
Applicant: 1 \via 1
/ ACS 1'•0Aft L Installer/Builder 8-16'`e"
Address: 13q� o ti-'re._ C Address 1� .�.`4,0 03 A.)=
oCti� S OLALic t \I \al3'11 S Q,,A4. .01(.&,.5 'CA11_g t kl Java
Phone: S(`ic 1 613 <01, S rj Phone Sk`"d 1q to <6;\3\
Owner: 11 0-.-\._ °+--R �e S Location of Installatio, 3`1 �" Q6. t S? 1(--'^'-
Address: �i
G '1%4
Phone (51cd)9'3 ,D, Ofota
Contact Person for Building&Code Compliance: CkeL `�J1)&-o Day Phone: i9 (o 81_1 I
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow A 1O
1980 or older x 150 = Garbage Grinder installed? !v
1981-1991 x 130 = Spa or Hot Tub Installed? 4/ 0
1992-Present ..3 x 110 = -S56 6 P 0
Parcel Information:
Topography A Flat Rolling Steep Slope %Slope
Soil Nature ) Sand X Loam Clay ic Other
Groundwater At what depth? i apt v f- 'f2., 41,
Bedrock/Impervious Material At what depth? �4 a
Domestic Water Supply Municipal (Well(if well,water supply from any septic system absorption is IOC) ft.)
Percolation Test Rate- per minute per inch(Test to be completed by a licensed professional engineer or
architect)
Proposed System for New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or
architect(unless installed in a Planning Board approved subdivision).
tLe
Tank size d gallon minimum size 1,000 gallons), add 250 gallons to size of septic tank for each garbage grinder,spa or
whirlpool tub. A)
t
System Type: Absorption Field(with#2 stone) Total length al-o ft. Each trench JO X
Seepage Pit(S)(with#3 stone) How many? Size?
Alternative System Bed or other type?
Holding Tank System Total required capacity? Tank size? #of tanks?
NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified
Electrical form on Town website;2)Effective as of March 23,2006 Septic System-As Built Plot Plan: The Building Department will no longer
allow systems to be covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed
system must match the septic system layout on file. There will be no exceptions.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted
which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known
by or on behalf of an applicant,shall be void.
✓I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury
Sanitary Sewage Disposal Ordinance.
ILL
-So I I,LA.11 L4
Print Name: ILL �Ue-`o� Date:
Signature: CALL.-- ^o-c-,_P),,j- Date: 30'✓t u) I L\
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Town of Queensbury Highway Department D Imp La,
DRIVEWAY PERMIT
MAY 3 0 2014 1)
Michael F. Travis, Highway Superintendent Thomas R. Van Ness, Deputy''Supen'h OrQUEErvsguRY
Home: (518)798-0413 Home: (518)745-0929 BUILDING & CODES
Office Phone: (518) 761-8211 Office: (518)761-8211
Fax: (518) 745-4466
Building Permit#:
Date: `3 'M C 19
Tax Map ID: 4AI°
Applicant Name: `1��`�€``) }�����`S
Address to be inspected: (AV). Q,;:, ��C�' 1��3
Return Address: 1373, SZo�� Q (ccv `I
Applicant must show exact location and width of driveway(s) to be connected to the highway by placing stakes at the
specified location.
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following action has
been taken:
Step 1: ( ) Preliminary Approval
Need: ( ) Slight swale
( ) Deep swale
( ) Level with the road
( ) Level with the top of the paved wing
Size culvert pipe to be used (if necessary)
( ) 12" ( ) 15" ( ) 18" ( )24" ( ) 36"
Preliminary inspections completed by: Date:
Approved by Highway Supt: Deputy Supt.:
Upon completion, please resubmit this approved permit for a final approval.
Step 2: ( ) Final Approval
( ) Rejected
Date:
Michael F. Travis, Highway Superintendent Thomas R. Van Ness, Deputy Highway Superintendent
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
s9 0
y%
STING AREA
'8.6 Sq. Feet
.32 Acres
NEW CULVERT
FOR DRAINAGE
SWALE
sir nc SLOT_ S 76030'10" E
I HAVE 5EEN OR OBSERVED ALL OBJECTS
�ti AS i&SES, WELLS, TREES, FENCES, ETC 114.62 '
SHO i`, I ON THIS GOCUMT FORTH ON THIS DIAGRAM.
LY
li�f.
SI E L-�
MINIMUM � Si
I TAKEN - MAY 2014 BY
CINSKI HALL ARCHITECTURE
:D 12 INCHES LESS THAN 10 MIN.
:D 12 INCHES LESS THAN 10 MIN.
1'CHIJtV atV
113-60 '
t \
P -2 0
S 35008'00" E
f
95. 00 '
S 73012'30" E
479 011
DRAINAGE SWALE ALONG \ \�
THIS SIDE OF DRIVEWAY �' \
NEW CULVERT \ -
0 DRIVEi LOCATION
�---
S 87038'40" E
144.27'
A _ _ N 90000'00"
N 86030'00" E
66.58'
i
R 80.00,'
L 66. 77'
R 80.00'
L 40.00'
R 80.00.'
L 18.89'
76.291
I lool "3(l, W IF
USING A DE:_
TOTAL TREK
SYSTEM DF_
USE 5 LATE:
USING THE I
1" IN 5 MINU
RATE OF 1"
THE REQUIR
(330 GPD/G.I
THE SYSTEM'
UTILIZE 5 L,
OF 50% OF
THE TOTAL
TO BE 975
w FI L
SYSTEM WI'f
TOP OF FILI-
TAPER ARE)
THEREFORE
MIN. VOLUMI
MIN VOLUME
MIN. VOLUME
CONS
THE ARCHIT
THE CONSTF
THE TOWN I
PERIODIC OE
THE ARCHIT
1. PRIOR 1
2. AFTER
3. DURING
4. PRIOR 1
5. AFTER I
CONTRACT;
OF ALL KI
ON THE P
Town of Queensbury GIS Viewer Page 1 of 2
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Zoom In
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Parcel Results: More Info Clear ; LC-10A i.. I.
FID 6237
,66l lel
PIN 2950000001003002
NEWNUMBER 295.-1-3.2 / 1\ I��- _ l '1 IJ
GISACRES 6.07815 �.7+ ��,; _-_ -
PRINT_KEY 295.-1-3.2 j WI Municipal Boundaries
AREA 264764.067409653 / f L✓J Town BND
PERIMETER 2696.72204527005
�J Roads
PARCEL ID 295.-1-3.2 -_-
1 ------ IA Queensbury Parcels
PARCADRNUM 0
I\'y' `:z::
icts
1 PARCADRNAM Thunderbird Dr
OWNERl DEREK SLAYTON
OWNERI \\ \ IJ Zoning Districts7.
seweriines
/ ---~
I_ waterlines rl
r-\ LC 10A ,
{_ Waterbodies
\ U streams
♦ II Flood Zones
ilit------------------. I C\ ) ---)
�l r / /'\ jJ EEEE5
/
� -----------______L
�+ M H NWI Wetlands
��_t
�s Li 200S Orthophotos ,.
7 /
....-- -... -1---..-__ / 1"----
--.'-' ,, / ) r ------'-' __=:./
MDF,/
100m
i
400ft
http://toggis.queensbury.netlwebmap/workingwebappapri12012TestPage.html?pid=295.-1-3.2 5/30/2014
Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: am/pm D-tart: am/pm
Date Inspection request received: Inspector's Initials:
NAME: V A PERMIT#:
LOCATION: � `rZ,e)Lraj 2,V) DATE: v I
Manufactured Home
cif
Modular HomeFootings_ Foundation— Backfill Framing
Comments:
Yes No N/A
Foundation support, pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off
Sewer line support @ 4 feet
Heating Crossover[doublewide}off grd_
Dryer vented outside
Skirting ventilated 1 sq. ft.per 1,500 sq.ft.
Hot water relief valve piping outside
Deck, porches, steps, railing
Fumace/hot water operating
Garage Fire proofing
Fire Door/Door closers
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected
Final ElectricalAnia `--
Variance required
Data Plate okay
Manufactured HUD seal okay
Warranty Seal after January 1, 2006 ��
Installers Warranty Seal — - � A'
18"x 24"access or 22°x 30"attic access
Vapor retarder under home 6 mil poly or other +I
911 Street number !�
Okay to issue C/C or C/O[Temp./ erm.] f
Model# Serial#
Manufacturer
Date of Manufacturer
L:1Pam Whiting\2010\Building Codes Forms Manufactured_Modular Final Inspection_03 04 10.doc
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:ei
Name: \ V tG Inspected on: w X29 I7-t
Location: lSYNatXb1✓d Arrive: /Imo a.m.I p.m.
Permit No.: 2.,e 1L\ + " Inspector's Initials: �J�lli
Comments andlor diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: / ft.
Well Casing Length 50'+1/ Y N IA
[150'to well required if NO]
7
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
qC(6\I
Tank to Distribution Box
Distribution Box to Field/Pit
Opening Sealed: _Y N
Jt
End Cap �'_Y_N
Inlet/Outlet Pipes&Baffles _Y N
Manholes 12"or less below grade _Y N
[provide extension collar if Yes] _Y N
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits
Conforms as per Plot Plan
Engineer Report and As-Built
ETU Maintenance Contract provided Y_N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use Sta • :
7 Approve.
. •ial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-851
September 28, 2015
Project#49374
Dave Hatin ..
WECEOVJETI
Code Enforcement Officer fi SEP 2 8 2015 g
Craig Brown
Zoning Enforcement Officer TOWN OF QUEENSBURY
Town of Queensbury BUILDING& CODES
742 Bay Road
Queensbury,NY 12801
Re: Sylvia—34 Thunderbird Drive—New Septic System & Site Plan
Dear Dave & Craig:
This letter is to inform you that we inspected the completed new septic system and site work for the
Sylvia residence located at 34 Thunderbird Drive in the Town of Queensbury on July 27 & August
31, 2015.
The new septic system as installed was for a three bedroom home and consisted of the new 1000
gallon septic tank, new pump station with alarms & force main, new distribution box and a raised
absorption system with 4 — 50 if absorption trenches constructed of 4" diameter perforated pipe &
stone. The system conforms to the requirements of the approved septic system design.
The completed sitework complies with the approved site plan design.
Please call me if you have any questions.
Sincerely,
rl
Thomas R. Center Jr, P.E.
. . .
. . . .
. ii .
: • COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
.•••
Main Office 176 Doe Run Road-Manheim,PA 17545
. :
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MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
. ..
. . .
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2°1 4- -2-1') cert, No 4 2 1 9 3 •
. :
. .
• • • i Permit No. Cut-in Card No
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. .
• Owner............ 7s;J-r, -,Fy 4 la.4 A :
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Location .3...5,........;*.?.111a.0 -/4..6 ..e3a7 3.1,tr.v.cal.4.1? e--,EY . . •
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Installed Ey A: - (-4,,,45:4/7'4- Lic.No.
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.. . Thc conditions following governed the issuance of this certificate,and any certificate previously issued is : • ..
.. .
cancelled:-
.. .
. • This ceniticaic only covers the electrical equipment and installation conditions as of date. Upon the
.
introduction of additional equipment or alterations,application shall be promptly made for inspection-
. ,
• ; .
inspectors of this Cornpany shah have the privilege of making inspections at any time. and if its : •
.• . rules are violated, the Company shall have the right to revoke this certificate, •
. . 1
. 1 paw 5 -i4 —4,:i IN1MCTOR.. wri -47*--Kred.ragyrfi-I-At----'
Member N.F.P.A.,1.A.E.1.
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COMMONWEALTH0111ce ELECTRICAL176DoeRn INSPECTION SERVICE545 ,INC.
Main ttRoad-Manheim,PA 17
MUNICIPPAL CERTIFICATE - ELECTRICAL APPROVAL
: Permit No.Vt•—203 Cert. N° 42190 Cut-in Card No
. Owner .t!..S:t.trm S.-41,.4e..g W
3.4... ...................... L r4„ .Q. sa,,A.1.sds--;/
Location
Installation Consisting oof,,.,,2„Q. 44... , .m. . ,. .r 7 Ric-+ S./..4.41
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.1.3....4,-.7.7-5,...•.•!.:• YXt .j....F?tl.w,...f V r :sR,.�?� (z11. .0a2
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Installed ByI
The conditions f ]iewin governed Lic,1V0. ,„
Cancetted: . the issuancC of this ccrtlfieau,and any c�ifcate grnryN
This certificate only cove's the electrical equipment and installation Plevip�. f ,
: introduction ot'additional equipment or alterations,application$h / n •' ,.o��S
condiri�
ru/csarev a/arca 1hGlOrs of 'COn7pay S S11�1/ A'Q�, II 1S Of (.
hove rhC 1I
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to ��bd x"SrEcro� ala `� 1i���isa� �r►i�spc PoI 0
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Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart I/-3 m/pm
Date Inspection request received: Inspector's Initials: Ci
I
NAME: nIL\A N PERMIT#. 2.., vy- Ze3
-77
LOCATION: b‘ 1\RDATE: 1,Z° I"'h
Manufactured Home
Modular Home
Footings_ Foundation)\ Backfill— Framing
Comments:
Yes No N/A
Foundation support,pier spacing, .
(7 ...
Per manufacturer V
/10
Anchoring per manufacturer 2'from ends Y �
Water line shut off
Sewer line support @ 4 feet Ve e.,0) \-)i`7(1•Ci) -
Heating Crossover[doublewide}off grd. 1/ QG ""
Dryer vented outside �!' `
Skirting ventilated 1 so.ft.Der 1,500 sq.ft. i✓ ?111r/S14- '�
Hot water relief valve piping outside
Deck,porches,steps, railing J ''
Fumace/hot water operating
Garage Fire proofing ✓ . V-ifIt)`''6�c"-'c" 06—{30-Lia
Fire Door/Door closers V ` n-� t
Plumbing Fixture/3"Vent through roof[Modular] U �-
Foundation insulation[if applicable] 1"6"---
Smoke/Carbon Monoxide Detectors/Interconnected
Final Electrical ,.
Variance required ‘7 --2iiR2 c
Data Plate okay /
Manufactured HUD seal okay ,
Warranty Seal after January 1,2006
---2Installers Warranty Seal
18"x 24"access or 22"x 30"attic access "e-
Vapor retarder under home 6 mil poly or other / ��,� Ca•
��i
911 Street number/ f
Okay to issue CIC or C/• [Temp 'erm.]4
v
Model# , F7.) 721, • rial#iCt. D cfii,Manufacturer
.1.
Date of Manufacturer . ti 1 1-4
L:\Pam Whiting120101Building Codes Forms\Manufactured_Modular Final Inspection_03 04 10.doc
Town of Queensbury Building & Code Enforcement ---E
tic
No. (518) 761-8256 tilLC)
Septic Inspection Report
Inspection request received: 4i2-9-12)0\
Name: V 1 CA Inspected on: -4I. ii. 241,
Location: V�,VlaRS\P\Vd D 1( Arrive: 2. r a.m./p.m.
Permit No.: > , \zt- 2-O Inspector's Initials: III
�
Comments and/or diagram
Soil Type:COO/Clay
Type of Water: Municipal/ ell W r
Waterline separation distance r t ft.
Well separation distancer ft. 1 b1.3`
Other wells: !`� Ft.
Well Casing Length 50'+/- __Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft.
Length of each trench ."'5-7 ft.
Depth of trenches ft. ' t--1
2SeepSize of Stone 1472-
Seepage
age Pits: Number �/�
Size: /"Q x
Stone Size:
Piping Size Type
Building to tank 'C - I: 17
Tank to Distribution Box —
C
Distribution Box to Field/Pit -- il.--3 ic-�,C�Z
Opening Sealed: �Y_N
End Cap ✓Y N
Inlet/Outlet Pipes&Baffles NC2RA5")6VrCILICW-A3Manholes 12"or less below grade Y N
[provide extension collar if Yes] _Y N �'��, $
i(1.1.
Location/Separations
Foundation to tank fo.rm...._,C14-6-a„,‘---Qie__.
Foundation to absorption ;74ft. � �'
Separation of Pits l`-} ft. r` �f `plc'eG —1*5-- 3C.-"
Conforms as per Plot Plan
Engineer Report and As-Built _Y_N
ETU Maintenance Contract provided _Y N
Locatioy on Prope
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
proved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
4
Disapproved
Septic Inspection Report
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received: l,291 20\S
Name: 5 �/ ,1 c • Inspected on: }I" 'i 2531
Location: \ &u`b1vd D ✓ Arrive: - 2
a.m.!p.m.
Permit No.:
J \I— 2-5°2 Inspector's Initials: ip- lk
Comments and/or diagram
Soil Type: a Clay
Type of Water: Municipal Iell W r
Waterline separation distance ta:Pr ft.
Well separation distance ft.ft. A1 �, ( — e) 1.b l
Other wells: P ' 1
Well Casing Length 50'+1- Y_N_N/A
[150'to well required if NO]
Absorption Field: Total length ft,
Length of each trench -151f) ft
Depth of trenches ft. f'.1614-39
'1 " /
Size of Stone 2
Seepage Pits: Numberf
Size: JV`-'/ Pr x
Stone Size:
Piping Size Type
Building to tank 4,,
Tank to Distribution Box -g4D -4C)
Distribution Box to Field/Pit `c c -iz,
Opening Sealed: �Y N
End Cap ✓Y N
Inlet/Outlet Pipes&Baffles t4Y N
Manholes 12"or less below grade _Y_N v 1�� 1�'a If
[provide extension collar if Yes] _Y_N ' ��
Location/Separations
Foundation to tankV fd•t1144.--046-8.- 12—Ve„
Foundation to absorption ft. .
Separation of Pits Pv j4 ft. Oj(f'( 2-i*S`"6 .
Conforms as per Plot Plan
Engineer Report and As-Built _Y_N
ETU Maintenance Contract provided _Y_N
i
Location
on Prope :
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
proved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
Town of Queensbury Building&Code Enforcement /
Office No. (518)761-8256
Rough PlumbipgjInsulation Inspection Report
Inspection request received:
C
(7_, -) //
Name: G7 yInspected on:
Location: 3u( ‘./ /Vi V4/1 kCi D r ` Arrive: a.m./ p.m.
Permit No.: 1 u Inspector's Initials:
Type of Structure: �7 r
COMMENTS
Y N NA
Plumbing under slab
eough Plumbing/Nail Plates
It'Plumbing Vent/Vents in Place �V
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I change of direction
Pressure Test
Drain /Vent DAir/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes /7\
Pressure Test
Water Supply Piping
Air/Head
50 P.S.I for 15 minutes
Insulation/Residential Check/Commercial Check
Window Sealing
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
Blower Door Test
Air Sealing
Rough Plumbing/Insulation Inspection Report
6,1c( \ ' �, 1() --; ,
.7)
Foundation Inspect on Report (�, J1 f 4)-- q ro-
Office No. (518) 761-8256 Date Inspection request received: 63 7)))f''/ Sf
Queensbury Building&Code Enforcement Arrive: amp,iya Depart: i 1 r pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials- 4 •
NAME: �\f I Vi ` PERMIT#: Cil-i.4.6 7)
1 � /3/ &t (LOCATION: ,3 Lif G-4,Lkivr�ji c.�i INSPECT ON: Gt iir + (4/3/30
TYPE OF STRUCTURE: �''f`'
Comments
Y N N/A �1 67_xRr
Footings ci
Piers
�' -/`1')—
Monolithic Slab
Reinforcement in Place
, pi , dThe contractor is responsible for ( C rLc4 (3'^
providing protection from freezing Cic ,° /U�yO
for 48 hours following the placement ��'�
of the concrete.
,5 oall ou 2Materials-€er the uurpose on site. /
19- k Le i/l,
4,,_,- undation/W ,4 .� (2--,1\7-
Re�n�orcement in PlaceL j^' r. )
/i Footing Dowels or Keyway in place
Foundation Dampproofmg :lJ a (
Foundation Waterproofing
/s Footing Drain Daylight or Sump iJ
K Footing Drain Stone: l ,
\ 12 inch width
V r 6 orches . ,. - •Ming ��
0+ 0o1 for wet ar:as under slab
C
l :ac 1 A,.ro .
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/9/2014
(l .-
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: •
Queensbury Building&Code Enforcement Arrive: am/p _ Depart:C/ m/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
r G
NAME: �' \�/� � . PERMIT# L: 2V°
LOCATION: �l.l 0 (/
rr;r CG INSPECT ON:
TYPE OF STRUCTURE: '
Comments
N_ NIA
Footings
Piers
AMonolithic Slab G
Reinforcement in 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/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/9/2014
T�
Foundation Inspection Report Io -12—
Office No.(518)761-8256 Date Inspection request received: 5)2-A0115
Queensbury Building&Code Enforcement Arrive: am/pm Depart:/ pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: G
NAME: v�c,� PERMIT#: - 203
LOCATION: z unC ,V INSPECT ON: 5 i Z t2-GA3
TYPE OF STRUC
Comment%
Y N NL �J 2 tdo - lCi 2—
Footings Footings v
Piers
Monolithic Slab
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/Wallpour
Reinforcement in Place ‘.7
Footing Dowels or Keyway in place ‘,/
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L•\Building &Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
8--c)
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: 512\ 15
Queensbury Building&Code Enforcement Arrive: am/pm Depart�� •1 �m/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: &_)`v C� PERMIT#: l4- ZO
LOCATION: 1"--)21 v'CtCv k INSPECT ON: C312`1 113
TYPE OF STRUCTURE:
Comments
N N/A (J YVV\ (G`0 - rig 2.
Footings
Piers
Monolithic Slab
Reinforcement in Place (/.,0`�JY��� wc��1
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing CC.-
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/9/2014