93-755 s " t �; .
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C �A sr
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date September 22 19 94
This is to certify that work requested to be done as shown by Permit No. 9 3—7 5 5
has been completed.
single family dwelling
This structure may be occupied as a
Location Jay Road
Owner Richardw. and. Susan E. Rourke
43-1-15
By Order Town Board
TOWN OF QUEENSBURY
Condition: fireplace not to be used until
approved by the Fire Marshal rD
, v
Director of Bldg. 6c Code Enforcement
_ <� � I
BUILDING PERMIT '
TOWN OF QUEENSBURY No. 93-755 o
WARREN COUNTY, NEW YORK
w I
RICHARD W. AND SUSAN E. ROURKE - 1
PERMISSION is hereby granted to - ~
OWNER of property located at Jay Road _ Street,Road or Ave.
in the Town-of Queensbury,To Construct or place a rngle Family Dwelling
at the above location-in accordance to application together with plot plans and other information hereto filed and p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
x
1. OWNER'S Address is
25 Jackson Av
Glens Falls NY 12801 7
o I
2. CONTRACTOR or BUILDER'S Name
Thayer General Contractor a
� II
3. CONTRACTOR or BUILDER'S Address
PO Box 93
Hudson Falls NY 12839
4. ARCHITECT'S Name
5. ARCHITECT'S Address C
1
O
6. TYPE of Construction—(Please indicate by X)
( $Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
28 ' x50 ' Two story Single Family Dwelling as per plot
No. plan, specifications and application including septic
system and in compliance with Area Variance # 21-1993 . c
N•
8. Proposed Use
4
Single Family Dwelling
� I
sv I
248 . 00 December 20 94 H- ,
$ PERMIT FEE PAID—THIS PERMIT EXPIRES 19
(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.) C7
20th December 93
Dated at the Town of Queensbury this a of 19 N
SIGNED BY for the Town of Queensbury
Building and Zoni spector
�— I
• TOWN OF QUEENSBURY REVIEWED BY:
COMMUNITY DEVELOPMENT DEPARTMENT ,, ,
BUILDING & CODE ENFORCEMENT ` , . FEE PAID: c 4$� I`o3.5' 13
531 BAY ROAD ,��
QUEENSBURY, NEW YORK 12804 PERMIT NO. -) l'7-.
(518) 745-4447
BUILDING PERMIT APPLICATION 13't4.157er„
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ,OkN�Z O IN PECTI0 S
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUIttLDING„.2E- IT. '6
All applicants ' spaces on this application MUST be co M etedlUnMithe ex
signature of the applicant MUST appear on the applica Simon v ol d Town of 1
c� bury
OWNER OF PROPERTY: R1Gy ARD vJ, ow& c As•ArI E. Ro%iR � \�i Dm.Dept l
Mailing Address : 25 'A-cKsorJ AVE, GLEW5 FALL/ N.y. 1280\N,.. ..W
Telephone Number( s) : Work Home 7q3_ iAy� ONY%``;.9'
PROPERTY LOCATION: SAY RD. GLEIJ LigIGE ALv /a8O5"
Tax Map Number: Section /f3 / B16ck .,,2 Lot 4.5
Subdivision Name: N/A . Lot No.
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ /3 S/ Oo o, o o
NEW BUILDING:
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
ADDITION TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL A 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 /c/OO SQ. FT. oAb
z� IF ADDITION, USE OF NEW ADDITION:
2ND FLOOR gtfU SQ, FT. F e N/Pc
/ -
OTHER FLOORS 0 SQ, FT. ;.
(not unfinished cellar 9r basements) 4 ACCESSORY BUILDINGS : 14/f5
v..' Detached Garage - One/Two Car
TOTAL FLOOR AREA: oljA zi O SQ. FT. Attached Garage - One/Two Car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
oZ $ FEET X 50 FEET
Foundation Type: M/iSoa42y Will any second-hand oI Lrayraded-
Number of Stories : 02 lumber be uged? If so, for what?
(habitable space only) Fo2rns, gvmciNell misc.
Height (grade to ridge) : a rJ feetfi Type of Heating System:
Number of fireplaces and/or- woodtc (circle all ich applies)
to be installed: i Electric / Oil / Gas / Wood
Forced Hot Air /(aseboara)/ Other
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
DOLACn OR B R%An) T H-A y Q-- —
4'1-7 0o -
NAME OF BUILDER/ADDRESS/PHONE: 1'1.4AYt1R C�BNeeA -� CONTR.Ac7+�{ P.0.Bb1e013 1-14450ArALe.s'S.y.
NAME OF PLUMBER/ADDRESS/PHONE:
NAME OF MASON/ADDRESS/PHONE:
NAME OF ELECTRICAN/ADDRESS/PHONE :
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 a Certificate of
Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN
drawn to scale, showing actual location of oje on p ises .
Signature _
(Owner, owner' s en t archi ect contractor)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
A 1415i
,s �, TOWN OF QUEENSBURY K.-, i.x APPLICATION FOR SEPTIC DISPOSAL PERMIT Permi, 'z# nrn 1093
Fee Paid uw i
o neueived
0 Town of ,�
Date: Rev iewed\' u
�` Ida.. Denteot.
I
LOCATION OF PROPERTY FOR INSTALLATION: �Itc£--,,- %,- '
Owner's Name: R‘ct-kA(2..0 W. SvA,¢.Ar{ s, {zo, ar—
Owner's Mailing Address: 25 Jokctcso,., AVE. CI,EvtJS ) Li .y. ( Zo 1
Installer' s Name: S..p iztoi? L,/k►ID SeTzvtc, s Phone #: g54-9564
Number of bedrooms (if residential ) : 3
Total daily flow (residential-compute @ 150 gal . per bedroom): 450 4
Topography-Circle One: Flat Rolling Steep Slope' % of Slope
Soil Nature-Circle One: �an� Loam Clay Other ColMe /Depth:
Ground Water-At What Depth? Lo,kn. Level( Feet
Bedrock or Impervious Material-At What Depth? 1 Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption ISO feet
PROPOSED SYSTEM: Septic Tank 10 00 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench , feet//Total System Length feet
Seepage Pit(s) : Number of a / Size each: 8 ft. x g ft.
1
Size of Stone to be used: # 2.,. / Depth or Thickness Ste 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 a d all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: kacrie,„
V?( DATE:
a�1
a y�
.4: •
•
•
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:
left TOWN OF QW ENSBURY Fee Paid _
BUILDING & CODES DEPARTMENT Permit #
• APPLICATION FOR: PORCHES-DECKS-
DOCKS & BOATHOUSES Est. Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FOLLOWING:
The undersigned hereby applies for a Building Permit to do the following work which will be
done in accordance with the description, plans and specifications submitted, and such special
conditions as may be indicated on the permit. TWO SETS OF STRUCTURAL PLANS SHALL BE SUBMITTED'i
WITH THIS APPLICATION.
Owner of Property: ck
P.O. Address Phone #
Property Location Tax Map # 42 —\—\5
Subdivision Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name: �t (' - (��) 9,01304,e_ Address Phone#
BUILDING SPECIFICATIONS:
Type of work to be done: Porch AMMO Dock Boathouse (Circle one)
Size of Structure to be built (square footage) :
Foundation Material : Width Thickness
Depth of Footing, below grade: )c %L ¢c , Q
Size of Posts or Studs: LA x x mcto?Acj, Long p‘0 _ -co
Size of Floor Joists: 7 x x aIk2A S Span 6vItIsz kkA` tz\
Decking or Flooring Material : 71 TAt°05 4
How will Porch or Deck be fastened to building?
� c , )
If Roof Will Be Installed, Answer Following Questions:
Size of P x x
Roof Rafters: Span
Roof Trusses (pre-en tr rc "ed pacing) :
Type of Roof: Sloped Flat Shed Other (Circle ne)
Matera-a' of Roof:
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale and attached
hereto, showing clearly and distinctly all buildings, whether existing or proposed and
indicate all set back dimensions from property lines. Show location of water supply and
location and configuration of septic disposal area.
Size of Property: ft. x ft.
Existing building(s) : Size ft. x ft.
Size ft. x ft.
Use of Existing building(s) :
Proposed structure, distance from property line:
Front yard ft. Rear yard ft.
Side yards ft. and ft.
If on corner, setback from side street: ft.
DECLARATION
To the best of my knowledge and belief the statements contained in this application,
together with the plans and specifications submitted, are a true and complete statement
of all proposed work to be done on the described premises and that all provisions of the
Building Code, the Zoning Ordinance, and all other laws pertaining to the proposed work
shall be complied with, whether specified or not, and that such work is authorized by the
owner.
DATE: SIGNATURE
Owner, Owner' s Agency, Architect, Contractor
REVIEWED BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE
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--_:`_a M. Re.o ait-, Lei ., ,17 114.394 • a• _ - - .
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/ TOWN
Q
THE •
OF NEW YORK BOARD FIRE UNDERWRITERS A;w
DO NOT WRITE HERE-FOR OFFICE USE ONLY
- - - - - BUILDING PERMIT NO.
TEMP.# DATE
CITY OR VILLAGE I ZIP CODE I TOWNSHIP COUNTY
STREET AND NO.OR ROAD POLE NUMBER
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS NAME BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER
BUILDING IS
NEW❑ OLD❑ WORK IS NEW E:' ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
tion Side Attach't H.P. Watts AWG
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st
FL.
2nd
FL.
3rd
FL.
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 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
❑ OVERHEAD ❑ UNDERGROUND
DATE 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.
V PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION /SIGNATURE9FAPPLICANTI
•
STREET ADDRESS :TELERHONENO. _
CITY OR POST OFFICE. ,,, }} F ZIP CODE LICENSE NO.WHEN APPLICABLE
85 John Street 0 41 State Street 570 Delaware Avenue 217 Lake AvenueLJ 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)254-0141 (315)463-8552
TLII_ IftII 1A/ Vrl171l! IDf A ID r t1C =1E1= I.110IrtI IDIA/IDIII I7) •
TOWN OF QUEENSBURY
�. FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 947,
NAME Jfkey'
LOCATION (%y ,E
DATE 9/v/OIL/ PERMIT#/
9 2Xf
� APPROVED
N/A YES NO
EXITS, d`
AISLE `WIDTHS /
EXIT SIGNS r°
EMERGENCY., LIGHTING
r
1 i
FIRE EXTINGUISHERS /
AUTO. EXTINGUI§HING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER S\ STEM
ALARM SYSTEM 'ad
INTERIOR FINISH/ES \\
STORAGE: 1
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGN AGE
I
C MNEY
ODSTOVE/'
FIREPLACE,=MASONRY \.
FIREPLACE—FACTORY BUILT
REMARKS: OK TO THIS DATE
ARRIVE /,.
DEPART f D�— ;%
INS TOR
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
% 531 ROAD
QUEENSBURY NY 12804 ry
/r (518)745-4447
n
ARRIVE: '`2 22 ``^y
0 DEPART: -: �j INS G
FINAL INSPECTION REPORT — RESIDENTl L
DATE INSPECTION/� REQUEST RECEIVEll: q11:I PI
NAME .,1!Jjchutei j �d J
)
LOCATION �" g` U ��/ }
DATE qI�s�.J9q //�� PERMIT # 3-'1 eu
TYPE OF STRUCTURE ,'-"CI
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
Al/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
/ I
PLUMBING VENT 1
ROOFING
EXTERIOR FINISH 1/ 1
DECK/PORCH/STEPS/RAILINGS ! s
RELIEF VALVES / f
FURNACE/HOT WATER OPERATI G I V i
INTERIOR TRIM/PRIVACY DOORS P
FINISH FLOORS: I
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED 1
STAIR CLEARANCE/RAILINGS Y
SMOKE DETECTORS /
\\/
BATHROOM FANS
PLUMBING FIXTURES
1
FOUNDATION INSULATION
GARAGE FIRE PROOFING
I
DOOR CLOSERS qy��
FINAL ELECTRICAL r IONA 1
SITE PLAN/VARIANCE REQ. 1
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C N(//.
i
PI art. - IT In .
TOWN OF QUEENSBURY
• FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT `
REQUEST FOR INSPECTION RECEIVED OW%
NAME 8 t 't (4, . Ma: 4?,a o.
LOCATION . ,,, 4 .
DATE S/c2°� c/ PERMIT# --' 7� / V
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 `f,
t"f
CHIMNEY
WOODSTOVE -
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
•
REMARKS: 4 `1 OO,K TO THIS DATE
2/015 INSPECTOR
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME '_.c,
LOCATION J ciLl Po
DATE ;S(22.IQ4 PERMIT# i - 53`
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 'a
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
J WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: IA OK TO THIS DATE
414
2/015 INSPECTOR
TOWN OF QUEENSBURY
" ' BUILDING & CODE ENFORCEMENT
531 BAY ROAD
rrrn
,.4,41, QUEENSBURY NY 12804
ti (518)745-4447
ARRIVE: DEPART: .) ,,t( INSP:
FINAL SPECTION REPORT - RESIDENTIAL L�
DATE INS ECTION REQUEST RECEIVED: 81iq/cf
NAME it? Ohtz4 s tiI Op 46) i G. "eAee f.t'"C.,
LOCATION 1-/ Rd_
DATE g+ /g 'VI pp--;;�� PERMIT # Q 9 -1,57 1
5-r TYPE OF STRUCTURE .b
FOOTINGS v- FOUNDATION v BACKFILL L- FRAMING
ROUGH PLUMBING i,__. SEPTIC .V- INSULATION .i-
FINAL ELECTRICAL j;.--- WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT X
ROOFING kt
• EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS 7
RELIEF VALVES !+ K
FURNACE/HOT WATER OPERATING/' X
/
INTERIOR TRIM/PRIVAC�a11 Y DOOMS K
FINISH FLOORS: Ji �('
BATH/KITCHEN WATERTIGHT '\
OTHER FLOORS SWEEPABLE 1
OTHER FLOORS CARPETED
STAIR CLEARANCRAILINGS
SMOKE DETECTORS / X
BATHROOM FANS 1
-1.L e e^ (s N6-
PLUMBING FIXTURES L7c-g? -1 q�°
FOUNDATION INSULATION !�►e-S + ,
^no ^-aTRE-PTOUF1NG
FINAL ELECTRICAL a��)1S-
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C 14
Rez,e ,.. 9,A-6,....;,- -X4/,99,e-e-o /kai./Ai, ' ,--(91(
1 '` `
is
TO ;i3 OF QUEENSBURY
BUILDING tt CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name /1(lhdid 1' ' ;lti4dwr c c&
Location , tPd
Date cr/i9/94 Permit # -`734
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box 1
Dist. Box to Field/Pit 1
Openings Sealed? Yes'1. j No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption" feet
Separation of Pits ; feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side — Right Side
Middle Front - Middle Rear
COMMENTS:
0129A/#6-crtra- t-6A/1-4--sr-to
woe
SYSTEM USE APPROVED: is NO
Arrived:
Departed: ;10
Building I f p-cto
TOWN OF QUEENSBURY
ro FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED S/r7/754
NAME ka..-
LOCATION 6)A_
fr-7/€34/
DATE PERMIT# qj3u APPROVED
--�'' N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SyYSTEM /
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM ! :.
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO:HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
./ IREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: kr OK TO THIS DATE
2/015 - L INSPECTOR
=
' - TOWN OF QUEENSBURY f
-..... BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804 .
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name akAy,(4, 12 ,i--/„.....,
Location t7 ,1'./ —7
Date 62'11 -?_)`- Permit # -7 ,..)- 7 3
7(
_ .
SOIL TYPE. an. oam-Clay-
-___.
Results of Percolation Test-
(if applicable) Rate-Minute/Inch --
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length -----
Length of each trench
Depth of trenches ----
Size of stone ----
SEEPAGE PITS: Number- z
Size - t ft. x <6 ft.
Stone size
PIPING: Size Type
Bldg. to Tank --z--"
Tank to Dist. Box " imw
voik._
Dist. Box to Field4Pit . I'L 1111:1 -
Openings Sealed? ' g4Fo Parti-81
LOCATION/SEPARATIONS: /
Foundation to Tank \ —10 feet
Foundation to Absorpti9h — feet
Separation of Pits )1 eet
Conforms as per Plot Plan Yes o
LOCATION OF SYSTEM opi PROPERTY:.
(circle one)
Front - Rear - jeftA Side - Right Side
Middle Front - %liddle Re-iif )
COMMENTS:
\70 01/4V)
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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 ,,94
NAME RCAF R )E..
LOCATION c ) C? {�
DATE cc,)9,p q PERMIT #. =i' )
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
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BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME Rf�0R\Aa.
LOCATION ; ,
DATE (4 91 C1(4 PERMIT
TYPE OF STRUCTURE i)FD
RECHECK APPROVED
,N/A YES NO
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THE CONTRACTOR IS RESPONSIBLE
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BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
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LOCATION le-
DATE 69 PERMIT # 3 / S S
TYPE OF STRUC URE
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FOR PROVIDING PROTECTION FROM
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TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST R INSPECTIO'-, RECEIVED / /5,
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BUILDING AND CODES DEPARTMENT
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QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECT .'N RECEIVED CD 5�
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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 Roo R tA
LOCATION A \'i RDA D
DATE \-719 1) PERMIT
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THE CONTRACTOR IS RESPONSIBLE
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FREEZING FOR 48 HOURS FOLLOWING
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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 . -4//91
NAME
LOCATION 9/ey 4
DATE ,0/ PERnIT # -
TYPE OF STRUCTURE
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N/A YES NO
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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
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BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE" (518) 745-4447
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME !)t. -
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DATE .1,-////4t$ PERMIT I ~Z Y 5 R v
TYPE OF STRUCTURE ,,U
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BUILDING AND CODES DEPARTMENT
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BUILDING INSPECTOR'S REPORT ciowi T '
REQUE R INSPECTION RECEIVED
NAMES `
LOCATION
DATE .5 / PERMIT # 94:5
TYPE OF STRUCTURE
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MONOLITHIC POUR FORM
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FOUNDATION WALLS EXTERIOR R-
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!EMARKS:
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INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR CTION RECEIVED
NAME
LOCATION 14> RO
DATE / 1--J%f y PERMIT # J -7 �
TYPE OF STRUCTURE X/37
RECHECK APPROVED
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MONOLITHIC POUR FORM
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FREEZING FOR 48 HOURS FOLLOWING
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MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
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