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2001-853 4111.a. TOWN OF QUEENSBURY 10,iri$11 742 Bay Road, ueensb NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010853 Date Issued: Tuesday, November 04, 2003 This is to certify that work requested to be done as shown by Permit Number P20010853 has been completed. Tax Map Number: 523400-289-018-0001-008-000-0000 Location: 160 MANNIS Rd Owner: ROBERT HUGHES Applicant: CLAIR HENSLER This structure may be occupied as a: By Order of Town Board Fireplace TOWN OF QUEENSBURY Single Family Dwelling (1--- J 4 r Director of Building&Code Enforcement TOWN OF QUEENSBURY coo 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010853 Application Number: A20010853 Tax Map No: 523400-289-018-0001-008-000-0000 Permission is hereby granted to: CLAIR HENSLER For property located at: 160 MANNIS Rd 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: ROBERT HUGHES Single Family Dwelling 270,000.00 CLAIR HENSLER Fireplace 33 GARRISON Rd Total Value 270,000.00 QUEENSBURY,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency NEW YORK BOARD OF FIRE UNDEI Plans &Specifications 2001-853 2978 SQ FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS. 2-CAR ATTACHED GARAGE UNDER PERMIT#2001-301 $357.36 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday, November 27,2002 (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 Town Que sbury; T esday,November 27,2001 SIGNED BY i/ for the Town of Queensbury. Director of Buildin. &C S e Enforcement Building Permit Application Town of Quecnsbury—Dept of Community Development, 742 Bay Road,Queensbury, NY (518) 761-8256 A permit must be obtained before beginning construction. Permit File No. �v No inspection will be made until applicant has received a Fee Paid $ ` valid building permit. All applicants' spaces on this Rec. Fee Paid application must be completed and must appear on the Reviewed By: application form. Applicant: cmne, Q• : Er Owner: .( Efi5G6/n�-- Address: is 5 FortioNis RD Address: 1 ZS M t S Qua: s y ,N �I C ' 6i q mg1 0 Phone# (Sig' )N -6-13WV Phone# ) Property Location: Lot Number: / House Number / Subdivision Name: _ Tax Map Number: Q—/- '72- `-/ New Building: resident /commercial Estimated Market Value of Construction: $ ?o,,a60 ❑ Addition: residence/ commercial If an Addition, what will use of new addition be? ❑ Alteration: residence/ commercial ❑ No change to exterior size: residence/com'l ❑ Other work(describe • 1—09 Check Occupancylnformation Is Floor 2" Floor Other floor Total Below sq. ft. sq.ft sq.ft. Square Feet Single family dwelling er Db 2 f q 7g ❑ Two family dwelling ❑ Townhouse ❑ Multifamily dwelling /I of units ❑ Office ❑ Mercantile ❑ Manufacturing ❑ 1 car detached garage ❑ 2 car detached garage ❑ 3 car detached garage ❑ 1 car attached garage _ ❑ 2 car attached garage — ❑ 3 car attached garage - ❑ Storage building- commercial _ _ — ❑ Storage building- residential ❑ Other Will any second-hand or ungraded lumber be used? If so, for what? {v Type of Heating System: electric/ oil gas wood /forced hot air/ baseboard/other: RA D/AIJ Number of Fireplaces to be installed C Number of Woodstoves to be installed List below the person(s)responsible for supervision of work as regards to building codes: Name ''-�� � Address Ph, - Number Builder �J�C�L (t�V�_ �'j1 �� , 74 + pAri� Plumber �t �� J 4 Mason D Electrician E V 4q4-2-00 Declaration: please sign below after you have carefully read the statement: To the best of my knowledge the statements contained in this application,together with the plans and specifications submitted,arc 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 he 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 o ccupan or Certi wale of Compliance being issued,as requested by the Zoning Administrator or D. c n c iuildiu ul Cod• ,an its Built Survey by a licensed surveyor;drawn to scale,showing actual location of all n ns ion. • Signature: ____owner,owner's agent,architect,contractor ENERGY CODE COMPLIANCE APPLICATION V = TOWN OF QUEENSBURY, WARREN COUNTY 9000 HEATING DEGREE DAYS Comol i an ce Methods: PART 5 - Acceptable Practice Method - 1&2 Family Dwellings (only) • PART 6* - Thermal Rating - Component Trade Offs 1&2 Family Dwellings; Multi-Family Dwellings ( 3 stories or less) PART 4* Design by Component Performance • Commercial Buildings-Hi Rise Residential *Requires submission of worksheets PDPLIC=NT S NA'� . PROPERTY LOCATION: COAL / � I,)�Js Ro (p c i/ PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area - square feet 2 . T-r e of Heat - Electric Oi 1 Gas Other 3 . Is building mechani sally cooled? Yes )( No g . Percentage of area of windows and doors Over 17% Under 17% 5 . R-V;LUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED: a . Roof R 5 g b . Exterior walls R 410 c . Glazed areas R , S/ d . Exterior doors R e . Floors over unheated soaces R J/ . Edge of slab on grade (heated building) R 'v/A- g. Basement/cellar walls (above grade) R v h . Basement/cellar walls (below grade) R Yo I . Heating/cooling-ducts-piping in unheated space R ti/A 6 . Service (domestic) hot water heat inc nc device/! Conforms to minimum efficiency per code / Yes No TEMPERATU CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED A =-- Signature /D/e,/ Phone Number TNSP S REMARKS: Fire Marshal's Office "Town of Qucensbury. 742 Bay Road,Quccnsburv, \1 (518) 761-8205 Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances , Date I I — I b 20 0) Permit No. "0t /'. &S....3 Application is herelyy made to the Building& Codes Office jor the issuance of a Building awl Use Permit pursuant to the New York State Eire Prevention and 13uilelin,uf Code. 77re applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to pe>,Jorm required inspections. NOTE to applicant: Rough-in and Final Inspections are req uired4 Applicant Information Fuel o pl Burning Appliance Information (circle appropriate words) 6tAttz,Name: tip=-i`� „1, stove: wood coal pellet gas �� Fireplace insert y Ni0 g. i? ' Fireplace, factory-built: voo gas Address: "' ft Fireplace, masonry: wood gas f� rI �� `#— Furnace: wood gas oil Phone: �/ �iF If non-masonary applicance, please provide Owner: Manufacturer Name: 1 CA L i K. 10 Address: ' . .1 it, I Model Number: I L',A. 2 106 Chimney Information Phone: (circle appropriate words) t =1 Masonry block brick Fo�ti Flue tile ,,-.sleeT' size: inches Exact Address: ,fd �t A1,1 . of constru ttou or installation Factory-B ui l t Manufacturer name:; Model Number: -},, -70 f3 :Vote: Listed By: Number: Construction /Installation must conform to NYS Fire Prevention &Building Indicate (circle) chimney material: Code. Consult available Town of Queensbur v Handouts regarding required inspections. ,,Double tt•al Triple wall / Insulated / Direct renting Chimney Liner Csakiler',er De.pz rtzrie. t—Towsrn of¢ueezt«rbwry; Anew-York I i Fire Marshal Code# S Collected S Re/itnded Received from /rclanded to): c 1 ‘ rk, Nie '` CO address: .4 173 3389 (190) Public Safest —T_--` — .a 233 2655 (230)Minor Sales C_____ rows,, G ... ,. Willie(Applicant) Green(Fire Marshal) Yellow(Bldg. Dept.) Pink& Goldenrod(Cashier's Dept.) MIA� Town of Queensbury Fire Marshal 742 Bay Road ^"�-- Queensbury,NY 12804 761-8205 I 761-8206 fax 745-4437 Factory Built Gas Fireplace I Stove Inspection Report Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's instructions or specificatiLonns(is allowed. Permit# (2 C')I-g53 Schedule Inspection /c/3lid 3 Time 6144 am pm ytime Inspector Name " Address ` (d chILLlLM S al----- Rough In_._Final Appliance Manufacturer u ! 1 k"1 V i Model# 7"1'L u o 700 Direct Vent Factory Built Chimney X, Flue Size r 1 Double Wall Triple Wall Insulated Yes No N/A Comments Floor Protection X -- /�1,�,4411es i") 6 " (y C -te 51i 6 Clearances to Combustibles (all sides) ieCi — /JO Ci‘)Ntili4;-‘49 a I t g )/1/4) a I ody(i p frb xiiim 1--tv :ea e pad i i v ��it 1 Q e� Reif J�f QQ,, ` Firestop(s) Vertical Chase X F Wall Penetration /\ re vi100 a pr ct) Vent Clearances to CombustiblesX' \I rirg F re��. a,y��plrLU Vent/Chimney Termination a Chimney height must be 3 feet above roof jj4 �', Q. I�U (�r1 G(��l�G �t- enetration• 2 feet above anycombustibley penetration; )(- J construction within 10 feet Gas Shut-Off Valve ?(, x b u' --,tb & 'j.- Combustion Air X LI 1 ,e. ` 't Liu I-(-- u �l� p Hearth Extension (if any) ^ , / orle Mantel iQO 0 3-le t Height above f/p opening "i' Witness Operation K. )( () K._ Q Li s'- Tank Placement(if LP) t�' White—Building Dept. Yellow-Customer Pink—Fire Marshal 4M - Residential Final Inspection ",, Office No. (518) 761-8256 Date Inspection request received: l0 Queensbury Building&Code Enforcement Arrive: am/p Depart: )b am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: 4/4 - (. PERMIT#: act, -85'3 LOCATION: s_ 4 DATE: 1 a/ %/G `3 TYPE OF STRUCTURE: Cornments VN N/A Chimney Ht./"B"Vent/Direct Vent Location Fresh Air Intake / 3 inch Plumb Vent through roof .// Roof Complete ,// Guard 30 in. or more @a,stairs,decks,patios IJ Guard at stairwell at 34 in. or more Guard at deck,porches 36 in. or more Exterior Finish Complete / Interior/Exterior Railings 34 in.to 38 in. I / /4/fatt- i24'1(-,5 ftA 5 12/5G,vs ¢1d Platform at all exterior doors Interior Handrails stairs 2 or more risers Grade away from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wall 8 inch clearance to sill plate l'/-1 /- Gas Valve shut-off exposed/regulator 18"above grade 17- Gas Furnace shut-off within 30 ft. or within line of site . Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed If; Interior privacy/trim/doors/main entrance 36 in. //VBathroom/Kitchen watertight Safety glazing • / / Window in stairwells safety glazingvInterior Smoke Detectors: 37 Every level: / Every Bedroom: G. 1tC„' J0 Outside every bedroom area:Inter Connected: / Battery backup: Bathroom Fans,if no window Carbon Monoxide detector ' /- Plumbing fixtures _S7,/ Foundation insulation V I_ Floor truss,draft stopping finished basement 1,000 sf Emergency egress below grade / i") �1�G G 7/ R�� �, Basement stairs closed rise>4 inches �J L rJ ,. %hour fire door/door closer ✓ / C'"{ Y Garage fireproofing Duct work Sealed properly Ck 6 p�SU�� Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area / Crawl Spaces 18"x 24"access, 1 sq. ft.-150 sq. ft.vents 17 Fa "6 44.414 5 Building No./Address visible from ad 6 ► "/ Final Electrical ' Site Plan [Variance required Final Survey Plot Plan Y As Built Septic System/Sewer Dept. Inspection Sticker Flood Plain Certification,if required Okay to issue C/C(Cert.Of Compliance) Okay to issue Temporary C/0(Cert. Of Occupancy) / Okay to issue Permanent C/0(Cert. Of Occupancy) L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003 TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 j, 1 , (518)761-8256 �` ;tion Report SEPTIC DISPOSAL SYSTEM INSPECTION ' r .1>36" Inspection request received: • Name 1-1uco Kos :e: am/� � �Dep�rt. 1 pm actor's Initials: -�/ C 3 Location 4- J,)t 5 Q.‘ • PERMIT NO.: 0 I -- g-,. Date 7 17:41-- Permit # d I 85-3INSPECT ON: -7 cj - Q�SOIL PSand-Loam-Clay- Comments and/or diagram Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ft. ABSORPTION FIELD: Total Length ft. Length of each trench ____ft. Depth of trenches ft. Size of stone ft SEEPAGE PITS: Number- �_ Size - ft. x ft. --ft' Ck s f \` — ( Ak) ( D Stone size PIPING: Size Type Bldg. to Tank x v5 Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Yes No Partial T e LOCATION/SEPARATIONS: Foundation to Tank feet ;` Foundation to Absorption feet u N 5 r - I AA)(4 PAIFFikS Separation of Pits _ feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: C C,G-4-G- ID Rkt LA`rG- (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: A\.,,,,p \ ,e..... t lit,) ' SYSTEM USE APPROVED: el NO Arrived: fri5.-- . Departed: •e-inspected,please call the Building&Codes Office Building Inspec or Report.doc January 28,2003 �I t (tlZ 062. t2:9-504/ �"' TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT at 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name altlf,14 Location 0 6o kKhQ Date 1 /1Z(0 b 'LPermit #ajj— 53 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 ' SEEP' E PITS: Number Size ft. ft. Stone 'ze PIPING: Size Type Bldg. to 1 .0 Tank to Dis :ox $1" be Dist. Box to ield/Pit Openings Se.le•? Yes No 'artia �Pal LOCATION/FoundItotis a PARA ONS: fee' `,L/w R Foundati •n to Abs. ption feet Separa on of Pits _ feet Confo ' s as per Plo Plan Yes No LOCAT'ON OF SYSTEM 0 PROPERTY: (circ e one) Front - Rear - Left Side - Right Side Middl : Front - Middle Rear COMMENTS: Am Tots hi I4 O uTLG--� l r= y._ IA) PLA-e_c— roR cC i/Ea Co D 6D: YES NO Arrived: !A Departed: fint , J17& Building Inspector ' -tom TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518)761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 44K44/1 Location �(��6 in - �' Date li//Sle2- emit #1 cldi - 6'1? SOIL TYPE: and oam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: —77` ABSORPTION FIELD: Total Length 7 Length of;each trench ( 3 Z Depth of, trenches 2 Size of stone e L ,J� S -.5 , SEEPA E PITS: Number- Sizhe ft. x ft. Sto' a size PI IfG: Sizee B dg to Tank LID VO T nk to Dist. Box ,y ist. `Box to Fie1d/P' penings Sealed? No P � � q4 LOCATION/SEPARATION Foundation to Tank /) feet Foundation to Absorption S 7feet Separation of Pits eet Conforms as per Plot PlanIlip No OCATION OF SYSTEM ON PROPER (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: oA 1�C— cc& 1A_10(1._.l b D &sJG SYSTEM USE APPROVED: YES NO Arrived: / Departed: T745 _ Building Insp ctor Office Use 9 GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: l///Z/0 2_ Meet: Building& Code Enforcement r At time: 742 Bay Road //'' 7- Queensbury, NY 12804 ARRIVE am/pm: DEPART(U=) am/pm N (518) 761-8256 31-7 Inspector's •Initials v NAME: /16- 6 — PERMIT# 206) i— (Sf 13 LOCATION: f Z C I t c i‘t i SkciC' INSPECT ON(date): I/ /7/0 2. - l - -- TYPE OF STRUCTURE: '- RECHECK N/A YES NO COMMENTS 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/W allpour_ Reinforcement in Place f & k7amppg4j2 " / 4 ;- F ff Approval Atzr(4 ✓ r ' /71 Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing . Heating Rough-In /V� Foundaon Walls Interior R- _ Foundation Walls Exterior. R- Floors R- _ Walls R- eV / Ceiling R- 3 ,. Duct work or piping in unheated spaces R- —_ Proper Vent,Attic Vent_ Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier —_ Fire Separation 1,2,3,hour Pinetration Sealed ire l;p vv t_ - — 1 7 L:\SueHemingway\Building.Codes.Inspection.FORMS'\GENERAL INSPECTION REPORT.doc Office Use i GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: I II 71' Meet: Building& Code Enforcement At time: arigairr,tf 742 Bay Road Queensbury, NY 12804 ARRIVE Z 5i a • D T 1-fb a /p> Notes: (518) 761-8256 Inspector's Initi NAME: lie RS/'(f_ PERMIT# 03 LOCATION: / i S ilti KA • INSPECT ON(date): _ ©z_ ,-i i-t- TYPE OF STRUCTURE: &CO RECHECK N/A YES NO COMMENTS Footings/Piers ___ Monolithic Pour Form Reinforcement in Place ,„ r , 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/W allpour . Reinforcement in Place Foundation/Dampproofmg Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place_ Rough Plumbing • \ Heating Rough-In \\\\ _ _ Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- _ Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers . % �� Jack Posts/Main a l Beam — C �� (-% Air Infiltration Barrier `� Fire Separation 1,2, 3,hour �� ' �dc;*— � Penetration Sealed �,�,( ` 1/ `� ��� Fire Wall Z,3,4 ur __ ' O/ '- irestopping \(\ J I Q� Lp L:\SueHemingway\Building.Codes.Inspection.FORMS\GRNERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT , Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: I( I qc Meet:_ 06 Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE `1 � � 7pm i r ," 0 otes: � (518) 761-8256 Inspector's Initi NAME: E,/ PERMIT# ,o! 03 LOCATION: (42 C) C4A-4-4 t S eck INSPECT ON(date): J j 6 / 6 -- Lestd �TYPE OF STRUCTURE: J TQ�► RECHECK ,• thd1 Py,.. N/A YES NO COMMENTS 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 obi site Foundation/Wallpour " Reinforcement in Place FoundationlDampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing • Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- _ Floors R- Walls It- Ceiling R- Duct work or piping in unheated spaces R- — Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers____ Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed____ Fire Wall 2,3,4 hour Firestopping L:\SueHemingway'Building.Codes.Inspection,FORMS\GENERAL INSPECTION REPORT.doc Residential Final Inspection ja - „VA__ Office No. (518)761-8256 Date Inspection request received: f/— 3 -0 3 Queensbury Building&Code Enforcement Arrive: am/p De art: / ' 5•5am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: r� PERMIT#: / 5 3 LOCATION: j _A-1 "s /2/ DATE: l/9fr j/TYPE OF STRUCTURE: !�/ C(rC zr,s' Comments Y N N/A Chimney Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof Roof Complete Guard 30 in.or more @ stairs,decks,patios Guard at stairwell at 34 in.or more Guard at deck,porches 36 in.or more Exterior Finish Complete Interior/Exterior Railings 34 in.to 38 in. Platform at all exterior doors Interior Handrails stairs 2 or more risers Grade away from foundation 6 in. with 10 ft. Handrail Termination at Newell Post or Wall 8 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30 ft. or within line of site • Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed Interior privacy/trim/doors/main entrance 36 in. Bathroom/Kitchen watertight Safety glazing Window in stairwells safety glazing Interior Smoke Detectors: Every level: / Every Bedroom: Outside every bedroom area: Inter Connected: / Battery backup: Bathroom Fans,if no window Carbon Monoxide detector Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf Emergency egress below grade Basement stairs closed rise>4 inches 3/o hour fire door/door closer Garage fireproofing Duct work Sealed properly Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area Sao- re V/0U5 S G.to Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq.ft.vents Building No./Address visible from road Final Electrical Site Plan /Variance required Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Flood Plain Certification,if required / Okay to issue C/C(Cert.Of Compliance) Okay to issue Temporary C I 0(Cert.Of Occupancy) Okay to issue Permanent C/O(Cert.Of Occupancy) L:\SueHenungway\Building.Codes.Inspection.FORMS\Res.Final Insp.form .doc edited January 28,2003 r �� Town of Queensbury `� Fire Marshal's Office 742 Bay Road Queensbury, NY 12804 Phone(518)761-8205 Fax(518) 745-4437 Fire Marshal's Inspection Report I Request Received: `o `3f c2 Permit# 0'_ �5.'3 INSPECT!SCHEDULE ON: / 62 Name: 41 C t-er ' CP PM ANYTIME �Zc l t ►Iaitti5Y` � . to', an I Location: APPROVED N lA YES NO COMMENTS EXITS AISLE WIDTHS EXIT SIGNS-NORMAL b<C.2J F2) C1b( 7& PC 1,{1 1 EC k1 M' e - BATTERY EMERGENCY UGHTING FIRE EXTINGUISHERS y l �l e (AA( 1 \)0/L-F rife FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYS EM HOOD INSTALLATION 1 �C�n 4 INTERIOR FINISHES �{�(C�© I ✓ f5 STORAGE / . _ COMPRESSED GASH��� CLEARANCE TO SPRINKLERkJ I6. CLEARANCE TO HEATING UNITS CLEARANCEQUIRED TO ECTRI AL - , ,11 C a I ram& 11 /� REQUIRED SIGNAGE `C A��� fri• ��'e . EMERGENCY PLAN MAXIMUM OCCUPANCY IGN je,ik 1:et]CHIMNEY MASONRY ROUGH IN FINAL i I-v(44 - ,,�/� �}, !�CHIMNEY r — 1 tvi Aie I "'6 ! bik 1 FACTORY BUILT ROUGH IN X C� FINAL aQ C.af`3 —� Le OK. WOOD STOVE ROUGH IN �V.` I �i �v� FINAL �f f/F NM- VENTED GAS (/ APPLIANCE ROUGH IN ✓lGt e,i1. Vletl,)f oAt 1 c FINAL p 1 ,, ,_l ^ FIREPLACE II -' - /A) /AY - 1 t�l11 reoiti. MASONRY ROUGH IN OK THI DA K FOR CO NOT OK FINAL FIREPLACE � tj 1 i (� FACTORY BUILT ROUGH IN IN CTED BY FINAL COMDEV/CHRISJIWORDILETTERS2001/FIREMARSHALINSPECTIONREPOR��LLOW-OCCUPANT COPY WHITE-BUILDING DEPARTMENT COPY Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury �� /���0 � Ready at time: Me-rikiel �'1 Dept. of Community Development Request received: Il Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE am/pm: DEPART am/pm Notes: (518) 761-8256 Inspector Initials .�(1l./ P NAME: _ PERMIT# 2o G I LOCATION: L' 11VdYl,tlix INSPECT ON(date): _ l q3// 6 I TYPE OF STRUCTURE: 3-D RECHECK N/A YES NO COMMENTS 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 or ite� 'NPoundationiWallpour____ Reinforcement in Place _ ✓ ..0Foundation/Dampproofmg _W i' Backfill Approval Plumbing Under Slab �_._.._ _ Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In___ _ Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging —_ Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier �__ Fire Separation 1,2, 3,hour Penetration Sealed _ Fire Wall 2,3,4 hour_ Firestopping L:\SueHemingway`;Building.Codes.Inspectioe.FORMS\GENERAL INSPECTION REPORT.doe Office Use GENERAL INSPECTION REPORT r Inspector: Town of Queensbury Ready at time: L.21 Dept. of Community Development Request received: Meet: ) f rp 1 Building& Code Enforcement At time: l 742 Bay Road ii'4 Queensbury, NY 12804 ARRIVE am/pm: DEPAR �� am/pm Notes: r (518) 761-8256 Inspector's Initials U ( '' NAME: ' n)S( 'Y i PERMIT# 0 — S LOCATION: NVA-11/411‘l V) l - INSPECT ON(date): _( 6 1 74 o'(/ TYPE OF STRUCTURE: RECHECK iN/A YByNO COMMENTS sr ers - V v Monolithic Pour Form Reinforcement in Place 1, ----4 i'l / 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/W allpour Reinforcement in Place Foundation/Dampproofing Backfill Approval. Plumbing Under Slab r/ P me VentNe is in Place 1� �¢ � V Plumbing �.e-06 L- f Heating Rough-In Insulation _ Foundation Walls Interior R- _ Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- roper Vent,Attic Vent ° ranung Jack Studs/Headers Bracing/Bridging f Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed _ /J/`r' t F es `Z,3,4 hour stopping A r fiA L:\.SueHemingway\Buiiding.Codes.inspection.FORMS\GENERAL INSPECTION REPORT.doc __________ tI Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time:4iiy i)--kw Dept. of Community Development Request received: q 2-3 C 2- Meet: Building& Code Enforcement / At time: 14/17 p#C. 742 Bay Road �, Queensbury, NY 12804 ARRIVE am/pm: DEPART 7 • �7 am/pm Notes: (518) 761-8256 Inspector's Initials f 2Z/ NAME: (\ie"1'L-S �t. PERMIT LOCATION: �`'�(L/4t1 r jed INSPECT ON(date): i c+_2-ei/C-)2- TG L -- TYPE OF STRUCTURE:— O---eiA-,z-f-e--, RECHECK N/A YES N* / COMMENTS ootings/Piers__-X- ,✓ Monolithic Pour Form / LL k `� j j L3(�Reinforcement in Place ✓ pi3O The contractor is responsible or providing protection from freezing /i NS C \W5 for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/W allpour_ Reinforcement in Place Foundation/Dampproofing Backfill Approval__ Plumbing Under Slab _ _ �` / Plumbing Vent/Vents in Place`___` __ Rough Plumbing__ j' • Heating Rough-In —_ /1 Insulation _ / Foundation Walls Interior R- _ / Foundation Walls Exterior R- , Floors R- Walls R- Ceiling R- _--. � — Duct work or piping in unheated spaces R- _ _ Proper Vent,Attic Vent Framing . Jack Studs/Headers Bracing/Bridging __— Joist Hangers , Jack Posts/Main Beam Air Infiltration Barrier _ Fire Separation 1,2,3,hour_ �, Penetration Sealed — Fire Wall 2,3,4 hour Firestopping -- —_-_� L:\.SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: 161/ 162- Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE am/pm: DEPART( ' am/pm Notes: (518) 761-8256 Inspector's Initials NAME: -- Y j s tt r- PERMIT# ?(�()I � LOCATION: f Z S I ' l&M v( S 61 INSPECT ON(date): i e y Id 2-- TYPE OF STRUCTURE: c f RECHECK N/A YES NO COMMENTS 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/W allpour Reinforcement in Place Foundation/Dampproofmg Backfill Approval Plumbing Under Slab P bing Vent/Vents in Place t// ` i (A-A)7- nue v ' l,o F- ,Aux Bing 1/ /t y/,-LL /V.,4 I L 4-I •6 He: s i g Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- _—_ _ Floors R- / Walls R- _ `�✓ Ceiling R- Duct work or piping r m in unheated spaces R- Proper Vent,Attic Vent *Framing l,, Jack Studs/Headers t//T R O U i 0� t7 Z J ,�C lL �' f ��R . ram"I t Gieci 429-1�11 Bracing/Bridging V Joist Hangers I 1 Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour_ Penetration Sealed ire Wall 2,3,4 hour ---------- Firesttpping , 9/ /c 2 A L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc TOWN OF QUEENSBURY 1111 BUILDING & CODE ENFORCEMENT 1:Ne742 BAY ROAD QUEENSBURY NY 12804 ( (518) 761-8256 Ie ARRIVE: DEPART: INSP: FINAL INSPECTION REPORT - RESIDE IA DATE INSPEC N REQUEST REEIVED: 3 O NAME / LOCATION / D , Q DATE 3 ©F- PERMIT TYPE OF RUCTURE FOOTINGS FOUNDATION BACK LL FRAMING _ ROUGH PLUMBING SEPTIC INSULATION FINAL ELECTRICAL WOODSTOVE OR FIREPLACE N/A YES NO CHIMNEY HEIGHT/B VENT/HEIGHT PLUMBING VENT ROOFING EXTERIOR FINISH DECK/PORCH/STEPS/RAILINGS RELIEF VALVES FURNACE/HOT WATER OPERATIN INTERIOR TRIM/PRIVACY DOORS FINISH FLOORS: BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPAB OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS SMOKE DETECTORS BATHROOM FANS PLUMBING FIXTURES _ FOUNDATION INSULATION GARAGE FIRE PROOFING DOOR CLOSERS FINAL ELECTRICAL SITE PLAN/VARIANCE REO. �` FINAL SURVEY PLOT PLAN OK TO ISSUE C/O OR C/C TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name \\•) Location V•LkfjM Ce7 Date g/11 Q7,/ Permit # 01-- 636 SOIL TYPE: Sand-Loam-Clay- Results of PercolatiTest- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTI FIELD(Total Length Length of ch $'ench Depth of tre es Size of stone SEEPAGE PITS/ Num - Size - ft. x ft. Stone size PIPING: Si e T e Bldg. to lank " 442 /6 Tank to Dist. Box Dist. Box to Field/P. Openings Sealed? Yes No Partial LOCATION/SEPARATI S: Foundation to Tank / 40 feet Foundation to Absorption feet Separation of Pits f et Conforms as per Plot Plan e No LOCATION OF SYSTEM ON PROPER . (circle one) Front - Rear - Left Side - Riot Side ` Middle Front - Middle Re r ` o�✓ COMMENTS: /*06/7/i;//7&' 64-F4L-f-- (1‹: SYSTEM USE APPROVED: YES (4) Arrived: Departed: 3"`Y--- Building Inspector IAJO( ..• aft .� & (Orke, L/ GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: 3/ Building& Code Enforcement / 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart' m�a /p Inspector's Initials '" NAME: Lf1QJL/ )/ r PERMIT# - 53 LOCATION: PleV DATE : ?! TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS 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/Wallpour Reinforcement in Place FoundationfDampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPO AL SYSTEM INSPECTION Name /6 Location _ __it2L_ Date Permit # SOIL Ti' E: Sand-Loam-C]av- SYSTEM USE APPROVED: YES 0.;) Arrived: Departed: -1, INSPECTION REPORT Building Inspector inspection request received: l am/pm Depa t'T Inspector's Initials I ii PERMIT# ON: h JA) b . DATE : 7 8`O?/ TYPE OF STRUCTURE: RECHECK N/A YE O COMMENTS Footings/Piers I Z. 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/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2, 3,4 hour Firestopping Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: Meet: Building& Code Enforcement At time: 641 cy 4Ili 742 Bay Road 2 Queensbury, NY 12804 ARRIVE am/pm: DEPART ) am/pm Notes: (518) 761-8256 Inspector's Initials______ , NAME: lit;Cc, J PERMIT# 0 t — 186. LOCATION: \)\kM'A,5 kp, INSPECT ON(date): _ 7757L____7.---- TYPE OF STRUCTURE: RECHECK N/A YES NO CO TS ootings/Piers Monolithic Pour Form Reinforcement in Place / r -e�c 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/W allpour _ Reinforcement in Place Foundation/D amppro o fmg Backfill Approval_ Plumbing Under Slab Plumbing Vent/Vents in Place _ Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Wails Exterior R- Floors R- Walls R- Ceiling R- _ Duct work or piping in unheated spaces R- Proper Vent,Attic Vent . Framing Jack Studs/Headers Bracing/Bridging_ Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour___ _ Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Ready at time: /l Town of Queensbury m Dept. of Community Development Request received: 7 / Meet: Building& Code Enforcement / At time: 742 Bay Road � Queensbury, NY 12804 ARRIVE am/pm: DEPART 11 • 1,I,dim/pm Notes: , (A).*0 (518) 761-8256 Inspector's Initials(2 / _ / , NAME: filer k,z PERMIT# 07O0/ — 853 LOCATION: J b met l�4,s ��+ INSPECT ON(date): 7 c 7A 26) TYPE OF STRUCTURE: Si.6 RECHECK __ N/A ;Jr ! COMMENTS Footings/Piersir Monolithic Pour orm Reinforcement in Place Z The contractor is responsible for `t providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour____ R nforcement in Place oundation/Dampproo ng z, ackfill Approval VA \\ Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing_ Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent A Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier _ Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:\SueHemingway'Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc if Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: Meet 'vt Building& Code Enforcement At time: /7-An* 742 Bay Road / Queensbury, NY 12804 ARRIVE am/pm: DEPART ' am/pm Notes: (518) 761-8256 Inspector's Initials ' NAME: ` _C J I 4 eiti tzR PERMIT# 0 /' g 3 LOCATION: WILA4 4) . INSPECT ON(date): 6 Z''/'tl " TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS 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/Wallpour _ Re' forcement in Place F dation/Dampproofmg ✓/ ackfill Approval_ 4/ Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In r Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing_ Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping _ I__ L:\SueHemingway\Building.Codes.lospection.FORMS\GENERAL.INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: 0//Vd,u2 Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE i. ,p a .m: I'E'AR ' to; ;.a,/,/.m Notes: (518) 761-8256 Inspector's Init NAME: _____4PERMIT# c 001 —8✓3 IYl6e) LOCATION: a?C /et INSPECT ON(date): 4/,S A'i TYPE OF STRUCTURE: Sc As' RECHECK N/A YES NO ii COMMENTS 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 sjYt,Foundation/Wallpour (.sf4 b '� ✓� Reinforcement in Place kr, Foundation/Dampproofmg _ Backfill Approval Plumbing Under Slab _ Plumbing Vent/Vents in Place_ Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent _ Framing Jack Studs/Headers Bracing/Bridging Joist Hangers — Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: 1'----V- 3/4. -- Dept. of Community Development Request received: Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE , m P R `,f am Notes: (518) 761-825 // ( yector's Initia s NAME: r. tom ' PERMIT# C O 53 LOCATION: l?-/. fv S ,i �/ INSPECT ON(date): 1 TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS 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 op ite r dation/Wallpot \ NA Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing _ Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed _ Fire Wall 2,3,4 hour u_ _ Firestopping L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc :3 T ' MAP REFERENCES: 0 Lo Lo MAP OF A SURVEY MADE FOR ELIZABETH MANNIS SWAN DATED FEBRUARY 5, 1982 Z O ; CL '£ BY VAN DUSEN & S x oc , a TEVES iv LAND SURVEYORS o + Q O �. MAP OF A SURVEY MADE FOR z RICHARD A. HUGHES, JR. a- U DATED APRIL 8, 1986 p BY VAN DUSEN & STEVES LAND SURVEYORS N z, O i O t- O Q 04 1 C"1 N (� N Z GLEN LAIN.V-d00 w 4.1 O a�i / N Z \ /) I.R.F. ram, D,w W +� a'0 \ Ca b SHORE -�14'MAPLE b o 22 5,t MAP O A w /oc Q 9" LE/ E —_42yIWWHE ALOCK GRAVEL DRIVE T 25,00 IE LINE ONLY / 12 N� Oof- G I'.R.F. elRcn —'' 1A LEGEND: N W �00 OODpO f `�� _ „eN O I.P.F. - IRON PIPE FOUND W PUMPHOU5E 1.. I Z" 04 o Q O I.R.F. = IRON ROD FOUND 0 o w� AREA O �, - UTILITY POLE � 5MALLER TEES Q 38.25' 0000 - 5TONE WALL rT, G PORCH I 16'HEMLOCK W 14" IfM. ` C 62 1 STORY ! W ° O f � I18.I a NSTONE HOUSE; r = �p >VGK .i • O .,, b Wpc>v v O O O I o!s _ 5ATELITE D15n �Oo _ LANDS OF ------�s.es o00 APPROX. HUGHES, BRANDT & DANIELS sE I Q GpRpG� ' 'f\`' 6"nEML9GK Q g�g �N 3a� 'a 5109YNpUSE LANDS OF UC110N� $ FRA RICHARD M. & JOYCE 0. WARDA < o MpNg1R r? �r� O V HEMLOCK t 17 O I0'E9RHC 8'HEMLOCK a ' I Q<tx� � O � 0 Z ,7a i 18' I1 I •` • 1 I , 1 U OAK I w ko Co I ► 1 0o I 1 � AREA I 0 -.4 51,799 sq.ft. ko 1.19 acres 1 I I I 1 o I I W I o z I I HEREBY CERTIFY THAT THI5 MAP WAS PREPARED W p I , i FROM AN ACTUAL FIELD SURVEY. THI5 CERTIFICATION SHALL RUN ONLY TO THE PER5ON5 TEM SYS SACK - ,_._-, FOR WHOM THE SURVEY WA5 PREPARED: AND ON THEIR _ \ b Z BEHALF ''O THE TITLE COMPANY. GOVERNMENTAL AGENCY R.F. AND LENDING INSTITUTION L15TED HEREON. n 190,74 CERTIFICkTIONS ARE NOT TRAN5FERA5LE TO ADDITIONAL C7 \ VF O INSTITUTION5 OR 5UB5EQUENT OWNERS. 53.0 100 \ CERTIFIEL' TO, ROBERT H. HUGHE5 GLAIR HEN5LER 1t1A , I GLENS FALLS NATION< ®f�IffM►+ ST COMPAN NNITS SUCCE55OF j�IIS UNITED GENERAL.T •ANY /� v 1�1rMV 0 A� 17 CERTIFIED -- ---- MATTHEW G. a L 5 5 �» I DATED, kUGU5T 29, 2002 4 w C'0 425 ° :C U Dates JAWAFRY 25,im am GRAPHIC SCALE 20 0 10 20 40 so 1 k ( IN FEET ) 1 inch = 20 it. SHEET 1 OF 1 - D181 DWG. NO. 99009 TAX VAD NO. 40-1-42 & 43