1988-658 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date October 19 19 88
This is to certify that work requested to be done as shown by Permit No. 88-658
has been completed.
This structure may be occupied as a One Fnmilv Modninr 1lweliincr
Location Ogden Rd.
Owner Thomas Welch
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
y
TOWN OF QUEENSBURY
No. 88-658
WARREN COUNTY, NEW YORK z
PE ISSION is hereby granted to Thomas Welch
OWNER of property located at l V Ogden Rd. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One Family Modular Dwelling
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.
1-3
1. OWNER'S Address is
O
#92 Homestead Village
Glens Falls, N.Y. 12801 c
CD
2. CONTRACTOR or BUILDER'S Name
Lamplighter Homes
3. CONTRACTOR or BUILDER'S Address
• RD #2
Ft. Edward, N.Y. 0
4. ARCHITECT'S Name a
CD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
(x)Wood Frame .( I Masonry ( )Steel ( 1 p
CD
7. PLANS and Specifications hJ _
¢yyD •r
No. 26'.x 48' as per plot plan, specifications and application including septic
system 4 r "
8. Proposed Use
THE ATTACHMENT OF THE TWO PARTS MUST BE APPROVED BY A
One Family Modular Home LICENSED PROFESSIONAL ENGINEER.
$5.00 C/O
$ 91 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1, 19 R8
(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 Queensbu is. 12th Day of Sept_ 19 RR
SIGNED BY G for the Town of Queensbury
Building and Zoning Inspector
•
r• iJUWi Of ?UaJZur, -
BUILDING and ZONING DEPARTMENT • i lilt 1 n
Bay and Haviland Road, R.D. 1 Box 9.8 AUG v 1903-
Queensbury, New York 12801
I �' APPr e cit.
(1• • 9/ OP
r ' APPLICATION FOR • C l �s�
BUILDING AND ZONING PERMIT. . �'" CV
)
it * * it it * * * * * * * *. * *. *: * * * it * * * * * * * * * * * *, it * * it * * ::
A PERMIT MUST BE OBTAINED BEFORE .BEGINNING CONSTRUCTION. 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.
The owner of this property is: rh o e4 f" -- it /e
P.O. Address °-�_2_ c9,r e S4'4_ 4 -4J. /f,4 G ) 67,e. 4..1' /_,q /ff,,,• Tel. '7 9Z� Y
Property Location: -0el(y'e r4 4Tax Marp No. it.r2/ ( / 60
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
4 Pi, G 4 te ri.- ?grin e gglef f.$, k-2 •it.T 64,4'46 4 !F- f 7 9 2 -7 3 t
Name • P.O. Address l '!'el. No.
Name .of builder Zj{ ,-j P/, 6#7 .r Address 12, p,`Ez tr �- f Tel. -79 2 --7 9 t
Name of plumber 4„.,1 p/ 6F4Teee.- Address sr Tel.
Name of mason e,r4-/„ p j_�1,421-E242.' Address ✓• 0. '
Tel.
NATURE OF PROPOSED. IhORK: - * .ZONING INFORMATION:
(` Construction of"a new building •
* TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED,
_Addition to a building • *'drawn reasonably to scale and attached hereto,.
_Alteration to a' building * showing clearly and distinctly all buildings,
(no change 'to exterior dimensions)'' ' * whether`existing.or proposed and indicate all
_Other 'work (describe) * set-back dimensions from property lines. Give
• * street and number or lot number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED. * of water supply and location and configuration
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property /S-6 ft X • o a ft.
* Existing building(s) Size ft X ft.
*
•
PROPOSED BUILDING AND USE: * Existing building (s) Use -
Size of new structure a 0 ft X Q',fit *
Foundation-pier/slab/crawl/partia a " * Proposed building, distance from property line
- (circle one)
• „• 'Front yard . 3 o ft .Rear yard J'V ft
No, of stories (habitable spa ) * Side_yards ' 1 ft and 3 9. ft .
Height (grade to ridge) / S ft. If on corner, setback from side street ft
If residential, no of families /' A.
No. of rooms(excluding baths) ' * OCCUPANCY INFORMATION
No. of bedrooms 3
* PRIMARY BUILDING - -,
No. of. ba.throoms.''` _One familydwelling
Primary heating system s,n
ai ,, - e_3.igS.c.,4 Two family dwelling
Type of fuel j7 u p r• ,.1 ,
Multiple dwelling ./ Number of units
No. of fireplaces,.to be installed .�✓ *J Permanent occupancy
Will a wood stovebe installed? �✓ * p Transient occupancy
Central Air conditioning? A * Business
. * ,
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
*" Other '
Contemporary Log cabin * If addition, what will use be?
Raised ranch 'Mansion Duplex
Split level ,Old style Bungalow * .
Cape Cod ;Cottage Other - * ACCESSORY BUILDING-
: Colonial Row•:. Town House * Detached garage/one car/ two car/ car
(. CIRCLE ONE PLEASE .) * Attached garage/one car/ two car/ car •
* * * * * * -* * * * * * * * * * * * • Private storage building
ESTIMATED MARKET VALUE OF . * Other
CONSTRUCTION $ d 7 O o *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED:
Form BPA 4/8G and-vl -
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING :SPECIFICAT<IONS:
Type of construction, wood frame, fire safe etc. VOW / -e
Will any secondhand or ungraded lumber be •used?_:If .so, for what? ,cJ v
Foundation':wall_ material [,'a-0._ c f. T e Thickness 1),�
Depth of foundationbelow grade (to bottom of, footing) 7
Will there be a cellar?y eS Heated or.unheated?tbateetee4 Floor sq. footage /a. V2 sq ft
Will there be a basement. 'r) J Will any portion be used as living space?
(If so, what portion' sq.ft. - Type of use?
Type of roof - slope)/flat/shed/other Material..of roof P4 idoo rt - ,„_ /1•0 J
Size, wood studs '' ' "x (;'' " spacing '//y "o.c. _length d- °.ft.
Joists(floor beams)`"1st. floor "X /0'. " spacing /b "o.c. span r3 ft. •
Joists (floor beams);'':2nd. floor "X " spacing" "o.c. span ' ft.
Overlays(ceiling beams) ,j. "X is spacing "o.c. span /3 ft.
Roof rafters "X " spacing o.c. pan ft.
Root trusses(pre-engineered) spacing /6 "o.c. span'.'/ �ft:
Exterior wall finish CA (? £. t; Of what material? ti, y
Interior wall finish c-
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? If so will a Fire-rated
door, enclosure, ands,alf-closing device be provided?
Will a flue-lined chimney be installed? ' _ Height above roof• ft.
Depth of chimney foundation below grade ft.
Depth of fireplace;;hearth. ft. , in..
Water supply -. -Municipal or private well �!�{'o+ ,`.• �. P a. C
SEPTIC SYSTEM._' Distance from ANY private well(including adjoining properties/, ft.
(A separate application is necessary for any repair or new installation of septic system)'
Town of Queensbury ;: TT
County of :Warren A F F• .:1 .� A V I T STATE OF. NEW YORK
I swear that 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,,,1HE ZONING. ORDINANCE, and all other laws pertaining to
the proposed work shall be coiuplied with, whether specified or not, and that such work is
authorized by the., owner..
SWORN `10 BEFORE ME :TUIS •- Signature_ = _- -
er, owner s agent,arcnitect, ntractor
day of 19
Notary Public, Warren County, N.Y.
* * * ;*.'* is * * * * * * * * * ** , - .*' * *- * * * * * * * * * * * * * * * * * * * * * * * *:' *
SPECIAL CONDITIONS OF THE PERMIT:
•
TOWN OFQUEENSBURY
WARREN COUNTY, NEW YORK
Application for: BUILDING PERMIT IN COMPLIANC WITH THE NEW YORK
"• STATE ENERGY CONSERVATION •.CODE,
A permit must be obtained before beginning work.
ANSWER ALL of the following:.
1. Gross floor area / (lc()' �T
•
2 . Type of: heat. -L/,a•" 4)4 ?ems . ��~L n
3 . : ..Is the building mechanically cooled? yi.JO
4: Percentage of area of windows and doors
A. Over 16% Only
1 .;,.,Uo value. of gross area of walls , roof/ceiling 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 NO..
a. If YES , what is the R value of insulation around
perimeter of floor"
4 . Is basement heated? YES NO
a. R value of insulation
5.. Type of insulation
B... . Under 16% Only.
1. R value ,of roof and floors exposed to ambient conditions•
•
2 . R value of exterior walls L• 9
3... R value of glazed area
4 R value of doors
✓. 5 R value' of floors over unheated .spaces s' 9
A ( �
6. R value of slab edge insulation - unheated slab
7 •" R value of slab insulation - heated slab
O 8 +. R value of heated basement/cellar, walls , (above grade)
1t' 9 . R value of heated basement/cellar walls (below grade)
10 Type of insulation ' 1 'P: 6�IFE S "J
C. Controls
1.',. Thermostat maximum heat setting
D. Duct Systems •
1-. , Is duct system installed in unheated spaces? YES NO
a. If. YES,- : R value of 'duct `installation"
b.. Rvalue 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 Heating o
1 ., Performance efficiency ?a
2E.', Temperature:,control setting maximum /y,�
G For Swimming Pool Only,.:
1 `; Maximum heating
Telephone No. "c�-,S ���
(applican ' s signature)
J �:, T
o . A 'Y'?r'L0' ''
arivtt 0 tr tr7
3 i - APPLICA'l7ON FOR SEPTIC DISPOSAL PERMIT ,
2UIiIliG t D1.D0 CODES DUY.
t '..
1 OYrli OF(lUEL/allUIiY
DATE ,kit S / c
LOCA'I'ION OF PROPERTY FOR INSTALLATION. -mod /'e,,,_ . 26 A d
Owner's Name:.ilda m i- S • _ tern C ,� Telephone: _- 7 . .- ccf- y-
Address _902- Ariyi
e.S-1"e 4 0 /14 e - 6 /',. 5 ';1,/l1 vi/ i 7 r ..
Installer's Name: LA), tJ, rvt. IN , //.e. 'Telephone: 7 1 o o F
Number of bedrooms (residential only) 3 "
Total daily flow (compute @ 150 gal per bedroom) V579
Topography circle onedWIP oiling Steep Slope. 9L of slope _
Soil Nature:: circle.one: Loam Clay Other / Depth feet
digr
Ground Water: At what depth? ,/ Al- feet
Bedrock or Impervious Material: At what depth? Al 4- feet
Pcrcohitiou test: circle one: not required required / rate ,1', min. inch.
,
Doiuesticwater supply circle on Municipal; ell Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption. feet.
PROPOSED SYS'TLM: Septic Tank /d d 0 cal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench . _cc) feet / Total system length 6.0 " feet
SEEPAGE PIT(S): Number of / Size each feet by . feet
Size of stone to be used.li - 3 / Depth or Thickness i feet
* 4 4 * 4 + *_4444 * • 4444 4444444 * * 44444444 444 * 444
IMPORTANT
...111ease...LIST NEW L•'QUIPMI:N'1'TO BE INSTALLED
• * * * * 4 4; * 4 44 4 4 4 44 4 4 4 4 4 4 444 4 444 4 4 4 4 4 4 44 4444
(over)'
•
•
•
Section II Septic System Inspections:
A. MI '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
-I.),.locution and distance to any water supply
5.):`.size and dimensions of all tanks, distribution
:boxes, tile fields and/or drywells '
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 .f250.00.
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.
•
•
1 have read the regulations above and agree to abide by these'and all requirements
of the Town of Queembury Sanitary Sewage Disposal Ordinance.
•
Si nature of,responsible person -erson r —���
g P
Date: •
Town of Queensbury
Building and Code.Deprnrtment
•
Bay at Haviland Road
Queensbury, New York 12801
• •
(51 R) 792-5832
•
•
•
i T' . C hI
INTERIM BUILDING PE IT
I�:1
28 ^ 6 sg
PERMIT APPLICANT _ 77ow., l-1 ,
CONSTRUCTION LOCATION 69 .Dell Rc
EFFECTIVE DATE l
APPROVED BY � /I/k /FvE-Ce77
SP
ECIAL CONDITIONS :
•
This will certify that all submittals for a . Building .
Permit have been received and fee has been paid . 1-
During the processing of the Permit, the above named
may begin construction per plans submitted. It is the
responsibility of the applicant to obtain the Permit -
from the Building Department, folio ing processing .
POST .THIS. :.INTERIM PERMIT :_IN A CO SP C i i
Bui ing & Codes Department
. TOWN OF QUEENSBURY
'
~
^ MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
0OOHaddonA,o, C�Uinowvund' NJ� OO108
APPLICANT COMPLETES THIS SECTION D��� '' - -
' \
City, Town orTownship ` ' ~ � ' .\ '� m County .�/^��/ '` ' '� State
`
Looaton/Addmos p ^-
(|f Located in Rural Ama - Ploae.Attaoh Directions) po|o # `
Pon�
Owner
� #
Occupied As ' ^` ° ' "` �/ � /` . ^ // ' � � ` Building: Nevvi Old l
/
Occupant �'(� ^' /" ` ��� ' ' r /
Work Area in Building (F|6or #, etc.):
App. for: Wiring -1 Service 71 or: Ready for Inspection:
Fee Remitted $ Cash F-1 Chock F7 M.O. 7 Make Payable To: M.D14`
� � 1m° 1� 1� om2� z� v� x� a�
Number of Rough Wiring Outlets Elect. Heat
Switche
s
Lighting Amp. ' Su�ao Unit D�hwa hor Range
' -VVu�rHeater Air Conditioner Dryer Pump
R000pt��o- � Oven ' Garbage Disposal Wiring and Controls for Burner- Num�nufF�tuns -~
Amp.-Receptacles Fractional H.P. Vent Fans
' Other Equipment:
.
MOTORS
zpoz�cvm 1/8 1/61/4 1/33/41- * 5- * m a �/z � z e a r zo uo on ao +o no -75 �m
NumberMark '
of Each Size
Ann�uo�,� U n�� *�
Signature � P:
_ '
T/A Utility:
(mmws) (OF pm�LooxrION)
Applicant's Address:
(City) � .�� (State) (Zip) Service Request #
Phono # Electrician:
K8Cl/\USEQNLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same ao Above F7 or: �
Red Notice Label
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
' Fixtures Air Conditioner Dryer
Amp. Service Equipmont Burner, Wiring & Controls for Amp.:Receptacle
Amp. Service Conductors Pump Vent Fans
MOTORSH.P. vc z�ez�o z/o 1/6 z^+ z/o 1/2 n!^ z 1� e -x s rm m 15 uo uo 30 40 ,v' rn zov
Mark Number
o, Each Size
�m rm ,mm z2m /mm1,mu�oe�o �o �� nmr
Elect. Heat
'
-
nnscr
CERTIFICATIONS USE FOR /mnuxLVISIT ONLY moT/p/so oArs copss FEE PAID
RVV Progress: Inc.1:1 LKD| l Contractor
� \ CFT Violation: �] Inc.on� Work Comp. F7 � ' �l
CASH . ^
| L/A Owner. :m CHK #
L/A Duo
MO #
IPA Municipal
|NV #
Applicant
Date: ' 'Other Side Utility Owner �]'
Cut inCard | l Temp # Date ' '
INSPECTORS SIGNATURE
F7 Final # Date
.
APPLICATION FORM NO.eovsLz1/mo
MIDDLE DEPARTMENT INSPECTION"AGENCY,:INC. •
NATIONAL HEADQUARTERS:
900 Haddon Ave:,•Collingswood, N.J. 08108 (609) 858=4400::
•
-- DELAWARE NEW JERSEY
1815 Newport Gap Pike 1030 Kings Highway North 1525 Cedar Cliff Dr. •
Marshallton, Del. 19808 Suite 310 Camp Hill, Pa. 17011
(302) 999-0243 ` Cherry Hill, N.J. 08034 - (717) 761-5340 `. "
(609). 667-9200 _
203 N.E. Front Street ... ..,_- _, " __ 1542 Bristol Pike
P.0-. Box 306 - 350`Grove Street U.S. Route 13. - -
Suite 105 Rear Entrance . Grove XXII Corner Bensalem, Pa. 19020 '
Milford, Del. 19963 . . :Bridgewater; N.J. 08807 ,, '- (215) 244-19.19 ' •�
(302) 422 5729 (201) 526 0880_-
(302) 85.6-2218• _ _
Route 19,-North `
- .;....: ...... 26 S. State Street -. . ' P.O. Box136 - -
. Hackensack; N.J.=07602 --Wexford, Pa. 15090 — -
_ _ MARYLAND_ _ . . (201).487-5373 (412) 931:3028 -
8 _
Milford iPeOfessional Bldg. Route.9 :
3610 Milford Mill Road : .. . __Marmora, N.J. 08223, __
' - Baltimore, Md. 21207 r (609) 390-1940 VIRGINIA -
(301) 922-T122- .. - - - - - -
3076 Shawnee Drive
Burch Oil Co. Bldg. NEW YORK - - Winchester, Va. 22601
E/S Route 5 : . - -: `__ -(703)-667-8484 -. . ..
- Charlotte Hall, Md.:20622 - 803'Utica Street - ' _
. (301:) 645-2219 P.O. Box 145
(301) 884-4547 Oriskany, N.Y. 13424.
(315) 337-3480 =
Washington Co.
Office Bldg, 460 State Street -. - _ -_
33 W. Washington Ave. ' - : Suite 308 - _
Hagerstown, Md: 2.1740 Rochester, N.Y. 14608 - -
(301.).79.1.=3190 - . .
- Hitch:Bldg.,Room 203 243 Margaret Street' _ - - .
636 S. Salisbury Blvd. Plattsburgh, N.Y. 12901
Salisbury, Md. 21801. :: _..:•` (5.1.8) 563-2835 -
(301) 749-0641 : -t ` ' - -- - _ .. _. , ;
PENNSYLVANIA
- " "Room 301 Main Street
Court House " - - 121 W.-Tenth Street "
- Elkton, Md. 21921 - - Erie, Pa. 16501 - _. -
(301) 398-5200 , (814) 452-4604 ' 2
Routes 404 & 662 18 N. Wyoming Ave. . - -
Wye Mills, Md. 21679. Room 204
(301)..822-83.00 _ Kingston Pa. 18704 ;
(301) 758-0958 (717) 288-4906
NOTICE-TO APPLICANTS: Final inspection and approval may be required by law before electrical current may be energized for use of :
-occupants. The Agency undertakes to provide inspections until final certification is granted if such requests are made within 120 days
from date of the last inspection.-Upon expiration off;120 days from the date of the most recent inspection, all duties and obligations
owed by the Agency shall be'deemed completed,and all fees paid by applicant shall be deemed consideration for services performed. No
further inspections shall be undertaken by the Agency without filing of a new application, and the payment of relevant inspection fees.
No final certification shall be implied or inferred without issuance of a duly executed certificate.
The Agency in accepting application for inspection cannot assume responsibility for unavoidable delays in inspection.
"100 YEARS"PROTECTING THE CONTRACTOR AND THE CONSUMER.: •
-\
J��.J'�`\•J"—"N luty \vu'�\v e*-'\vJ�\J/1 JdW\a•�JeGV ' ' -rn /1 /� / J '� J J%�� _.., J/1�A
( _ ' . . MIDDLE DEPARTMENT INSPECTION AGENCY, INC. .
. )
900 Haddon,Avenue,-CollingswoodN:J:08108
y.. �,. - C1
C . �,,...- .~t�i.{ . • Q ', �+ � i ""� '-, _ Date October 10, 1988 e/
cCertif iez that the:electrical e n quipment listed has been exarnined,andis approved as being in accord )
Cwith the National Electrical,Co4de,applicable governmental, utility and,Agency'rules. C
Thomas Welch ' i� tf err' 1 , `~ P r , °`s
2 Owner: ^ i r / ,, ? ,_` / 11. i Occiupancy.\ Dwelling \ \ Cl
' Occupant: .game r %..,/ i ," i \.,� G i - 1/
Road, Queei sbury L (Warren Co) NY" 1
Location: Odgen ) —_-- This.certificate'covers-gtcelec lical equipment and installation inspected this C
I, , t `-� # date. If additional equipmentishould be introduced or alterations made to
'. ' t . existing system this certificate shall be null and void, and application for e
Equipment: 63 Outlets; 45 Receptacles; .8 F.ixtur;es inspection should be submlttedpromptiyto this Agency.
p p ytn ij),u L��it n h f'°r i fl=Holder of this certificate should:present same to his property insurance carrier
ukJ� la gent an pp
( 6 Appliances 'L �� ( g p, Y)esevid�nceolcerti}icationofelectricelequipmenta roved ,
c
as specified./ r' / e
.--�� e
(PI— Lamplighter`Homes -�. i I.q F;a...._..._- " --: ter` C
' Appl►cant: RD#2 y:}. 'iI'�_ NO. 15-025543
CL Fort Edward, NY 12i323 '-2. _ ._„�' -- fJ C.
Form No.703 EL 143
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
0 iv BUILDING INSPECTOR'S REPORT
REQUE FOR INS/EC ION RECEIVED iU/,/ PY�S'^
NAME 6-1-7:7:`17
LOCATION
DATE /O//GJf PERMIT # S V s 1S
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS ,10"^
FOUNDATION/DAMP-PROOFING 7
BACKFILL APPROVAL a%'r
ROUGH PLUMBING gam,
FRAMING
ELECTRICAL UGH-IN
INSULATION:
FOUNDATION .!fa
FLOORS
WALLS (1.
CEILING
FINAL INSPECTION: T,
CHIMNEY HEIGHT
ROOFING }(
SIDING >(
EXTERNAL PORCHES/A'EPS
STAIRS-CLEARANy4E & ILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIR/PRIVAC , DOORS
FINISHED F •ORS
GARAGE FIR ROOFING
DOOR CLOS (S) J-J It
SMOKE DET CTORS
FINAL ELEC ICAL INSPECTION.
'FINAL APPR VAL OF CONSTRUCTI•N �(
A SIGNED C TIFICATE OF OCCUPANCY MUST BE
OBTAINED FR THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
t/C (/
C
INSPfc TOR
Down of Queensbury.
Dn D
BayBUIL and HavilandINGadZONING Road, R.D. 1 BoxEPARTMENT8 9
7-)71
� Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 7A, )
a-, �_{ (
LOCATIONlid2,-&/
DATE_ PERMIT NO. 0-
d 4t-5(f
SOIL TYPE - Sand - Loam - Clay
Percolation Test Required? YES - NO .
Percolation rate - Min/Inch
TYPE of SYSTEM: ,
Absorption field, total length l
Length of each trench ,r'
Depth of trenches ' `" . j
Size of gravel -7_ . •
.
SEEPAGE PITS{Number of) _ `i
Size- ft. a X _ ft. /
Gravel size . /
PIPING: Size_ Ty e
Bldg. to tank '; les:,
Tank to dist. box l�
Dist. box to fie1`d/ L-
Openings sealed? YEg" O Partial
LOCATION/SEPARATION :
Foundation to tank /-ft. •
Foundation to absorption ft.
Absorption to to line .�ft.
Separation of p s -7-= ft.
LOCATION S S EM ON PROPERTY(circle one) •
Front - earr -.Left side, - Right side -
COMMENT :
SYSTEM USE APPROVED A,-/ p.
(----Th .
Build ng Inspector
01/86 and vl
_/own f Queeraury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
e\l.(r/BUILDING INSPECTOR S REPORT
NAME 717D-9/-7 Z-0 Lc 6 v
LOCATION cc- , 6,-- 4-
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0,
Date 9- G / Permit No. fr- �'k7
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED Fo YESS / NO
oting/Pier Forms (/
Foundation
' Waterproofing
Backfill i
Framing .
Roofing
Siding
. Masonry Veneer
�A
Rough Plumbing
Relief Valves
Ext. Porches . •
Finished Floors, JJ.
Interior Trim /
Stairs & Railings` /
Cellar Drain Tile / •
Concrete Floors
Plbg. Fixtures '`'
Gar. Fireproofing f`;,_
Door Closers / \
Smoke Detectors J
Chimney/ / :,
,2NSULATION: /
Foundation /f
Floors /
Walls f
Ceiling j
FINAL ELECTRICALLINSPECTION
DRIVEWAY APPROVAL
Final Building Survey !
Next scheduled inspection (call when ready)
•
Remarks- (� fil � .
r4 •
,(,Li,�,l0 '2°- -z__-- .
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Building. Irector,
6/86 and-vl
_Down o Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUI DING INSPECTOR' S REPORT
NAME
LOCATION
Date L V / Permit No. / ,o, K
✓ = APPROVED - YES /.NO
Footing/Pier Forms f�
Imo dation
''Waterproofing l�
Backfill
Framing f
Roofing ;
Siding /
Masonry Veneer \ ,
Rough Plumbing ,/ •
Relief Valves /
Ext. Porches ,✓
Finished Floors /Y
Interior Trim
Stairs & Railings /
Cellar Drain Tile /
•
Concrete Floors
Plbg. Fixtures j
Gar. Fireproofing •
Door Closers ,'
Smoke Detectors
Chimney ,/
INSULATION:
Foundation
Floors
Walls '
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Buildi g Inspe r
6/86 and-vl
. _ MORSE ENGINEERING
Atin
99 LOWER DIX AVENUE October 19, 1988
GLENS FALLS,NY 12801
Queensbury Building & Codes Department
Queensbury Office Building
Bay at Haviland Road
Box 98
Queensbury, New York 12804
RE: Modular Home Inspection - Welch, Ogden Road, Queensbury
Gentlemen:
Please be advised that Morse Engineering conducted an on-site
inspection of a modular dwelling placed at Ogden Road, Town of
Queensbury, on October 5, 1988, temporary building permit #88-658
issued to Thomas Welch.
Said inspection included the foundation, visible connection of
structural components and means of support of first floor main
beam connection.
All components, connections and supports inspected were acceptable
as per manufacturer recommendation by contractor, as was poured
concrete foundation.
N.Y.S.D.H.C.R. Model Approval Data is listed below as observed on
insignia label attached to modular home.
D.H.C.R. Insignia -
Serial No. : 31955
MFR: RITZCRAFT
Plan Approval No. : N.Y. 0182
MFR. Serial No. : 020889-2647AB
MFG. Date: 8/31/88
Should you have any questions regarding this inspection, please
contact me at our office.
Very truly yours,
MORSE ENGINEERING
Mack A. Dean
MAD:lag
cc: Mr. Jack Liberty
Lamplighter Homes
Route 9
South Glens Falls, NY 12803
RICHARD S. MORSE, P.E. Phone:(518) 792- 5382