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99-757 TOWN OF QUEENSBURY r742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: 99757 Date Issued: Monday, May 12, 2003 This is to certify that work requested to be done as shown by Permit Number 99757 has been completed. Tax Map Number: 523400-289-018-0001-012-000-0000 Location: 99 MANNIS Rd Owner: JAMES UNDERWOOD Applicant: UNDERWOOD, JAMES This structure may be occupied as a: By Order of Town Board Fireplace TOWN OF QUEENSBURY Single Family Dwelling Director of Building&Code Enforcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518) 761-8256 VALUE $ 60000 Building Permit No. 99757 TAX MAP NO. 40 . -1-47 Permission is hereby granted to UNDERWOOD, JAMES Owner of property located at 99 MANN I S RD. in the Town of Queensbury,to construct or place a REBUILD SINGLE FAMILY 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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owner's Address: Contractor or Builder's Name: UNDERWOOD, JAMES Contractor or Builder's Address: Electrical Inspection Agency: Type of Construction: SINGLE FAMILY DWELLING Plans and Specifications: 2300 SQ FT REBUILD SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS Proposed Use: REBUILD SINGLE FAMILY DWELLING $ 2 2 OPERMIT FEE PAID—THIS PERMIT EXPIRES Apr i 1 11 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.) 11 Apr 11 2000 Dated at the To1„„,,of Queensbury this Day of SIGNED BY `1�X.N., FIA/N.,---,_ , for the Town of Queensbury Code Enforcement Officer BLDG. PERMIT NO. ! 9 15 7 APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property located at; 7 1 fi h Ni S Ra. for the following uses: "NI he ca.»,;( bw't /Z2v OZ *! DATE NATURE OF APPLI T TEMPORARY CERTIFICATE OF OCCUPANCY The TEMPORARY CERTIFICATE OF OCCUPANCY is hereby KAPPROVED ( )DISAPPROVED with the following conditions: j 4� S 54. , SP' 1-00 3 , 47) urr Ian h; j base(§ TEMPORARY CERTIFICATE OF OCCUPANCY F • $10.0 DEEPOSIT: $100.00 received on /Z- 0 VV Date of Is uanc2 � Director of `� n C.C&Bldg. cement THIS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES !V DAYS FROM THE DATE OF ISSUANCE. NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code Enforcement or his designee. Building Permit Application Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queenshury, NY 12804 1761-8256J BUILDING & . CODE ENFORCEMENT NOTICERequirements prior to issuance r r,,(, ,r—Ir- A permit must be obtained before of this permit: PERMIT FILE NO. ,� J beginning construction. No inspections / "� will be made until applicant has received I I Zoning Board Action PERMIT FEE PAID$,.. "f, -), a VALID BUILDING PERMIT. All Area /Use applicants" spaces on this application RECREATION FEE/PAID MUST be completed and.the signature l Ping Board Action REVIEWED BY: f -; of the applicant must appear on the SPR / Subdivision /Other f Building Inspector tplication form. 7honk N,,,. . J Recreation Fee Payment J Applicant: tiA1lt&-I?.,,(vvCk.0 / Ji-ttiars Owner: L f 't4`C6,. zobi J 4ii'I tom, Address: q 71 r t) e) Address: /% 414-7i,''v1S. /2l, Phone # ( ) -X& - .3 ,30 Phone # ( ) •7 - -53 Property Location: 2(.t'J = t � ( t Tax Map Number Subdivision Name: --__'� Section Block Tot NATURE OF P K: y �� MATED MARKET VALUE OF THE ,New Building: :7f/ �'j �! ' NSTRUCTION: $ .(1�("" residen / commerc' 1. o Building: iN, 1 residence / commerci ' �� OCCUPANCY INFORMATION: Alteration to Building: Primary Building - residence / commerci Single Family Dwelling Residence / Commercial }, Two Family Dwelling no change to exterior siz ,/ Family Dwelling ,_ IROX ctf Heit ,-<-N c f , i '` VS� ct517i' 1�n*k-w--x X Office t.}s_ f .. 1999 Other Work (describe below) Mercantile Manufacturing • Other GROSS AREA OF PROPOSED STRUCTURE* .-(Q `'i -1 1st Floor %Gr s se)'?( Iq. i�i` (� kf ADDITION, what will use 2nd .Floor i sq. ft. of new addition be? : Other Floors sq. ft. (not unfinished cellar or basement) ACCESSORY BUILDINGS: Detached Garage 1, 2 car TOTAL FLOOR AREA: ff SQ. FT. Attached Garage 1, 2 car Private Storage Building SIZE OF NEW STRUCTURE: Commercial Storage Building Other FEET X FEET Foundation Type: a�-0, -- Will any second-hand or ungraded ' Number of Stories: . - lumber be used? If so, for what? (habitable space only) +� , Height (grade to ridge) : C'(2 feet TYPE OF HEATING SYSTEM: ({f}t�iibvT— Number of fireplaces and/or woodstove (circle all which ..lies) t-;-Lci m. -Lyv) to be installed: // Electric / Oil / G.s / Wood F, tisz— Forced Hot Air / :. eboard / Other Person responsible for supervision of work as regards to building codes is: Name a Ad esss Php.De, , Builder: t`" u �PL ! 'All• '( (? • "7s`^.Sza0/ Plumber: 64 • Mason: 14 Electrician: li 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, 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 Uwe shall submit prior to a Certificate of Occupancy•or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by a licensed yor; drawn to scale, showin actual location of project on premises. Signature: ,k wner, owne ' gent, architect, contractor) Application for Permit—Septic Disposal System 1 own of Queensbury 742 Bay Road Qaeensbuh;y, NY 12804 (518) 761-8256 1. OWNER INFORMATION: q� Office Use Location of installation: ► 1 H A p.p, 1W RC) Filo Poi mit No. Tax Map No. — © / ,/ 141 VK)D ERu300Di I R Vial) Fee Paid Owner's Name: ; Address: 99 M A tQ l0 2. INSTALLER'S NAME : PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate II bedroom(s) and multiply II of bedrooms with applicable gallons per bedroom to equal total daily flow) Your of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980— 1991 x 130 gal/bdrm = 1991 —present L k x /110 gal/bdrm = �4110 Garbage Grinder Installed yes / no �/ Spa or Whirlpool Installed yes / no 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) Topography Soil Nature .Ground Water Bedrock or Impervious Material Domestic Water Supply Flat .sand at what depth at what depth municipal Rolling loam `) fret fret well Steep slope clay 1—Z%slope other if well; water supply from any septic-system • depth: absorption is 15011. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5, 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). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: 1()Ot7 gallon (min. size 1,000 gal) Tile Field: each trench ft. Total System Length: Seepage Pit(s): number of '�. size of each: i, fl. by Size of Stone to be used: II / depth or thickness __fret Bed System Size: x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) 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. O.? 44 ,amtittatt, 3 � nature of responsible person Da / k _^ ENERGY CODE COMPLIANCE APPLICATION 31':= TOWN OF QUEENSBURY, WARREN COUNTY 9000 HEATING DEGREE DAYS Compliance 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 APPLICANT' S NAME : PROPERTY LOCATION: Uj3DEBu so S i .1AN1E.i 99 Z`'i AI,:-,o,A) RL BD PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area - 7-0c: square feet 2 . Type of Heat - Electric Oil I Gas Other 3 . Is building mechanically cooled? Yes Y No 4 . Percentage of area of windows and doors I Over 17% Under 17% 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED: a . Roof R ►-\-Q b . Exterior walls R ? 4- c . Glazed areas R 1,,1 r d . Exterior doors R 2 + e . Floors over unheated spaces R i-40 . Edge of slab on grade (heated building) R g. Basement/cellar walls (above grade) R Z4- h . Basement/cellar walls (below grade) R i . Heating/cooling-ducts-piping in unheated space R 6 . Service (domestic) hot water heating device Conforms to minimum efficiency per code Yes No TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED .0 1:4c J atur e M Phone Number, 2" 1/4/WkilaiLLC A Ci /(3-(1) !Mrs PF_CTOR' S REMARKS : Fire Marshal's Office Town of Queensbury,742 Ray Road,Queensbury,NY (518)761-8205 ., Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances nq5 Date ilao , 20 42,_ Permit No. , 7 Application is hereby made to the Building& Codes Office for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The 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 perform required inspections. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information Fuel Burning Appliance Information (circle appropriate words) Name: � •, 1,111, ;AA }; Stove: insert wood coal pellet gas P Address: f Fireplace, factory-built: wood gas t ' , Fireplace, masonry: wood gas (- ' k)'i j tl i Furnace: wood gas oil Phone: -q .t 9101 tIf non-masonary applicance, please provide Owner: �, Manufacturer Name: a Ls elv i c Address: q /1/1(47\i'M 4 i10 Model Number: at k eo ` u ` Chimney Information Phone: y (circle appropriate words) d Masonry block brick stone Flue tile size: G inches Exact Address: coq M (1�} o nstructiod or'fnstallatidn Factory-Built Manufacturer name: Model Number: Note: Listed By: Number: Construction/Installation must conform to NYS Fire Prevention &Building Indicate(circle) chimney material: Code. Consult available Town of Queensbury Handouts regarding required inspections. Double wall / Triple wall / Insulated / Direct venting Chimney Liner t i II Calsabeier' partm t—To•v s, t of Qzzeeii�etbu tw, 1V'emsr-`lTorlx I Fire Marshal Code# $Collected $Refunded i AReceived fr•orn (r unded\to):_v A r r� address: ..,, `� i '�-. t"r,. iA, '.,7-7 c:,r F.F';/ A 173 3389 (190) Public Safety . .. _ """" / A 233 2655 (230)Minor Sales - DATE: t :` _ \ ` '- ,+.") ' n:/., ..'. - 7 •Yta1 w're r town, VLUUG04, U i� White(Applicant) / Green(Fire Marshal) / Yellow(Bldg. Dept.) / Pink&Goldenrod(Cashier's Dept.) O TOWN OF QUEENSBURY 742 Bay Rd., Queensbury, NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS Date ,19 /9 Permit No. APPLICATIO IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The 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 perform required inspections. Please fill out additional form if more than one appliance and/or chimney. Applicant 0.1061kdar0 _IPMEISAPPLIANCE (check appropriate boxes) Address qti MAIVMS II /) STOVE:' Wood o Coal o Pellet o Gas 0 FIREPLACE INSERT (Qt ) Zu6&)Nty WL( Zip (2 ❑ FIREPLACE, FACTORY-BUILT: ❑ Wood ❑ Gas Phone qb (Y FIREPLACE, MASONRY: ❑ Wood ❑ Gas Owner )P!1V1C D FURNACE: ❑ Wood ❑ Gas ❑ Oil Address IF NON-MASONRY APPLIANCE: Manufacturer: Zip Model: Phone CHI NEY (check appropriate boxes) *EXACT RESS of propose onstruct.ion MASONRY: ❑ ock ❑ Brick 0 Stone � "--"." FLUE: Tile ❑ Steel Size: inches CONSTRUCTION / INSTALLATION MUST 0 FACTORY-BUILT: CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model: BUILDING CODE. CONSULT AVAILABLE Listed By: Number: TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall ❑Triple Wall REGARDING REQUIRED INSPECTIONS. 0 Insulated 0 Direct Venting 0 Chimney Liner Cashier's Department Town of Queensbury, New York Dept: Fire Marshal Amount Collected Amount Refunded Code Number Title A 173 3389 (190) Public Safety A 233 2655 (230 ,Minor Sales Fee Collectei rom-dr Refunded to: Address: Dated: a�fr,-ter '' ' Town Cle Deput : . White: App icant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept. 111.116 Residential Final Inspection Office No. (518) 761-8256 Date Inspection reques eive . Queensbury Building&Code Enforcement Arrive: \111C2 m rt: C 2 . M a p 742 Bay Rd., Queensbury,NY 12804 Inspector's Init. s: NAME: p, IT#: LOCATION: � `J `L_ E: TYPE OF STRUCTURE: 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: `'y k(% Inter Connected: / Battery backup: ), tt< Bathroom Fans,if no windowVt Carbon Monoxide detector ;- Plumbing fixtures v0// Foundation insulationV .� Floor truss,draft stopping finished basement 1,000 sf / l ' Emergency egress below grade Basement stairs closed rise>4 inches 3/4 hour fire door/door closer Garage fireproofing Z Duct work Sealed properly 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 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/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 Y 4 Septic Inspection Report Office No. (518) 761-8256 Date Ins ection request received: Queensbury Building& Code Enforcement Arrive: 7i / am/pm Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: ltir- PERMIT NO.: LOCATION: Ze K, INSPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand/Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: _ ft. Absorption Field: Total length ft. Length of each trench — ft. Depth of trenches ft. Size of Stone Seepage Pits: Number =Z Size: g x g • Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/Pit Opening Sealed: Y/N/Partial Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits CS ft. Conforms as per Plot Plan Y—N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: /)( Approved Partial Approved and needs to be re-inspected,please call the Building&Codes Office - Disapproved L:`\SueHemingway'Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 Piot" PLA4 Rt-1)Ise-9 51q 1 03 Loctenop oe stvrIC 9.6 , .fv;eu 99 At/010S tZt9ft 6200--)43506011 ,.‘V 1 TA-AAcs Uavot'"11.1...)000 /vs re ( 17 45S . 0."4,„5 0-4745 or: ‘., 4... 47/4114mA/4y) „I _ ,_ 4s„tzlti6 , pltiov____ t \:‘,1°\ APpoi. ,0 ''.10t) ---„; (0P4(144c 1;0, %.‘'1•4- a . tklonk -,1*',% .3•-• 00:114:. di * f S• :'‘ 4-- ‘0::::% ....,„ ) \\' ..,‘ • a , , it ieTV\) IS \ \ t; * ..' . , * ... C_Pit40.5 * :,..., it (t c.:\kl / .1 Of . . • viAVI10441) -*4. h3/4 0... . ke ,N4 N (1: 1 ., -. \. Ng/ in 4 ,43 opt, ti fir)K IS * \ 4 .,.. ' N - - 0,,,opz-t Li)Cille-0 1-$CC• flwiv/ ,, ti 4 ... 4, : -1.--- Nw- ( , . ,--, ,.,-ildf ,, rit:',...)' 1-1-cl' ,,.. ' • Writ',> 447.N ArN 0 q X Pr PDAI 0 I 46 LAle14/ ,Ael 1)11 ors\ 5 N. ?.Rom , '0 L I* (Rock 0 °9.t.0941 ).C:rillici _ . pif _.------ -- •t,l NI , 510E C------ , . ------ -- - /air Septic Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Insp tor's Initials: JTDk NAME: tit f -- -. Cr / PERMIT NO.: LOCATION: INSPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand/Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. C1) e I:8 1 Absorption Field: Total length ft. !Per a l 1 Length of each trench ft. _ e /� Q Depth of trenches ft. C1 )t r WI 5 Size of Stone �s Seepage Pits: Number + ~�k� p ets / Size: x , J_ (I) gam' '- UL! Stone Size: _ / /�iP //�J p 1 Bole1 f Jam- cG� CN • Piping Size Type Building to tank eV;s'" 5 7 Tank to Distribution Box Distribution Box to Field/Pit Opening Sealed: Y/N/Partial Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _Y—N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Approved /Partial Approved and needs to be re-inspected,please call the Building&Codes Office i/ Disapproved L:SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003 • Residential Final Inspection Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: /'30 am/) De a • /-° 'IS am m)' 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: S� Wi"ffe iyetc/ PERMIT#: 9/— 7S LOCATION: 7 y / „4 /'r/ DATE: /2 -31--02 TYPE OF STRUCTURE: S /e 1Dii 12,.I//,r. •/ Comments Y N N/A Chimney Ht./"B"Vent/Direct Vent Location if S'_ Qu Fresh Air Intake 3 inch Plumb Vent through roof Roof Complete -- al/ as ��" Qn� Guard 30 in. or more @ stairs,decks,patios 1� Guard at stairwell at 34 in.or more Guard at deck,porches 36 in.or more Au - 2000 Exterior Finish Complete /`Interior/Exterior Railings 34 in.to 38 in. _ Q/� S�f 6pC�cS Platform at all exterior doors Interior Handrails stairs 2 or more risers Grade away from foundation 6 in.with 10 ft. 1 d gr6V O f, Handrail Termination at Newell Post or Wall f/ 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 3/4 hour fire door/door closer Garage fireproofing Duct work Sealed properly Attic access 30 in.x 2 in. x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, 1 sq. ft.-150 sq.ft.vents Building No./Address visible from road / S I Final Electrical /�a Site Plan /Variance required n�ve Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Y S t Flood Pin Certification, Okay olissue C/C(Cert. required Compliance) µCt Okay to issue Temporary C/0(Cert. Of Occupancy) Okay to issue Permanent C/0(Cert. Of Occupancy) X RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: / � Building&Code Enforcement /� Dept.of Community Development Arrive Ca %:�� ... Depart' �Q1 '�' i Town of Queensbury Inspector's Initi: s 'f � 742 Bay Road Queensbury,New York 12804 NAME UC)ER,-0._ CA`>C-) P RMIT# qq 751 LOCATION ' DATE 1°Z. —t 7_ j „, TYPE OF STRUCTURE Q,E � \_\ _._ 1�" N/A YES NO COMMENTS Chimney Height!"B"Ven.i - t Vent Location J Fresh Air Intake V/ Plumb Vent through roo i >i Roof Complete / Exterior Finish Complet d// Interior/Exterior Railing 30"to 3 V d/ Exterior Handrails,bal ill'es,Ian. .: 18 in.or more ✓✓Interior Handrails stairs ..th sides or more risers Grade 2%away from fo ..tion Vic 8"clearance to sill plate di Gas Valve shut-off expo- i •r .ator 18"above grade •,// Gas Furnace shut-off within • eet or within line of site ,/ Oil Furnace shut-off at•.: :,.• to furnace area ./ F Furnace/Hot Water Heater o.- :ting Relief Valve(s)installed Headroom,6 ft.6 in.on stairs d Basement stairs,6 ft.4 in. Handrail exterior stairs both side more than 3 risers Interior privacy/trim/doors/main - 'trance 36"Floor Finish pathroom/Kitchen watertight Interior Handrails Balconies/Lan, i: 18 in.or more Railing across window in stairwe Smoke Detectors: 11. I every level every bedroom di outside every bedroominter connectedBathroom fansPlumbing fixtures Foundation insulation 3/4 hour fire door/door closer ` Garage fireproofmg ii ✓ Garage penetrations sealed / Furnace in separate room protected(in garage) ,/ Light ventilation per room // afety glazing 18"or less from floor Final Electrical / Plan/Variance required / ✓ FiE.� 13}JC�1 C:final Survey Plot Plan ✓Jite z z.B —cZ s Built Septic System layout required Okay to issue C/C(Certif.of Compliance) / Okay to issue temp.C/O(Certif.of Occupancy) CI\ ) Okay to issue permanent C/O(Certif.of Occupancy) ` ✓f Gt D c.ca .,. COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE — ELECTRICAL APPROVAL .7 cs Permit No. Cert. N 2 7 9 4 8 7 Cut-in Card No. Dwner u/UQ b2 W C Ott) Location...? /IM ' S 20- installation Consisting of...Wu tJ C �,t g ,'6 VC)(-/ Installed By 0' „�' ` ix-W-249 Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate 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 Company shall have the privilege of making spections at any time, and if its rules are violated,the Company shall have the right to ev e thi icate. Date /2- v INSPECTOR Member N.F.P.A.,I.A.E.I. Well RESIDENTIAL FINAL INSPECTION REPORT O� Office No.(518)761-8256 Date inspection request received: i 6• Building&Code Enforcement Dept.of Community Development Arrive am/pm Depart Town of Queensbury Inspector's Ini 742 Bay Road Queensbury,New York 12804 � NAME i# ULtx)O od ERMIT# G O- 1J 5 1 LOCATION 4'9 /'►igr)r i S kV . DATE /Z//9 f t) L . .t,1. TYPE OF STRUCTURE '2 A-d..ckt `/J,' N/A YES NO COMMENTS Chimney HeightP'B"Vent/Direct Vent Location ' Fresh Air Intake Plumb Vent through roof ✓/ Roof Complete Exterior Finish Complete f Interior/Exterior Railings 30"to 36" �/f Exterior Handrails,balconies,landing 18 in. • more J Interior Handrails stairs both sides or more .-rs J Grade 2%away from foundation i f/ 8"clearance to sill plate �.,0 . - • NA\Ik // Gas Valve shut-off exposed/regulat r 18":ze gradeGas Furnace shut-off within 30 feet withne of site j �/ Oil Furnace shut-off at entrance to furnace Furnace/Hot Water Heater operating /j, Relief Valve(s)installed , / Headroom,6 ft.6 in.on stairs . / ,// Basement stairs,6 ft.4 in. !/ Handrail exterior stairs both sidoI ill'. 3 risers i/ Interior privacy/trim/doort in entrance:6" ✓ Floor Finish J Bathroom/Kitchen watertight ,/ / Interior Handrails Balconies/Landing 18 in. • more :� I/ e (�1L. \�.c, Railing across window in stairwells � � Smoke Detectors: V-�DD� / `� every level b C�th—A6K every bedroom e 41.094) outside every bedroom ✓/ inter connected ✓` Bathroom fans ✓✓✓/ Plumbing fixtures %/ Foundation insulation 3/4 hour fire door/door closer Garage fireproofing ✓ Garage penetrations sealed ,/ Furnace in separate room protected(in garage) /t Light ventilation per room ✓/ Safety glazing 18"or less from floor // / Final Electrical ✓ Site Plan/Variance required / C ' ,-CA.---. �, 1 i J Final Survey Plot Plan �/ As Built Septic System layout required i c 0 L� Okay to issue C/C(Certif.of Compliance) Okay to issue temp.C/O(Certif.of Occupancy)_ / Okay to issue permanent C/O(Certif.of Occupancy) �/ I ( RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept.of Community Development Arrive 11;-Ipau apart ✓ Town of Queensbury Inspector's Ini 742 Bay Road Queensbury,New York 12804 NAME (Itin- t./l l b6—glAcr PERMIT# LOCATION pCD — DATE TYPE OF STRUCTURE N/A YES NO COMMENTS Chimney Height/"B"Vent/Direct Vent Location /i'G`l al , Gf� t-1( "ki iO Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies,landing 18 in.or more Interior Handrails stairs both sides 3 or more risers Grade 2%away from foundation 8"clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Relief Valve(s)installed Headroom,6 ft.6 in.on stairs Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/trim/doors/main entrance 36" Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or more Railing across window in stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected(in garage) Light ventilation per room Safety glazing 18"or less from floor Final Electrical Site PlanNariance required Final Survey Plot Plan As Built Septic System layout required Okay to issue C/C(Certif of Compliance) Okay to issue temp.C/O(Certif.of Occupancy)_ Okay to issue permanent C/O(Certif.of Occupancy) • GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive A:L*4d Depart Inspector's Initi NAME: � �� w�3O� PERMIT# LOCATION: cil et 1.7\1? Qc) DATE : a 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/Walipour _, Reinforcement in Place Foundation/Dampproofing Backfill Approval /N. Plumbing Under Slab Plumbing Vent/Vents in Place fRough Plumbing Heating Rough-In I Insulation ��'c \m, c.�-�j1 -' Foundation Walls Interior R- Foundation Foundation Walls Exterior R- Floors R- Walls R- ,Ct \\/7 Ceiling R- _'3, '`i1 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 GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 ArriveL{.' j m Depart or's Initial NAME: 1\\OC4)(5CQ PERMIT# LOCATION: klA iR tJ N‘h Q o AQ DATE : TYPE OF STRUCTURE: RECHECK N/A YES NO NTS Footings/Piers f I 1 3 Monolithic Pour Form J 1 U (r'OON\ Reinforcement in Place The contractor is responsible for °R 61- \b VD, providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour t 15\tJ(� ),\- c-c.A.Nrct3 Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab � i"\F►�— fJ C2;c7 Plumbing Vent/Vents in Place f( Rough Plumbing Heating Rough-In LW Insulation Foundation Walls Interior R- Foundation Walls Exterior R- pp Walls R- 1-,� Q \ Ceiling R- ya 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 �( - t q (. Office Use GENERAL INSPECTION REPORT Inspector: Ready at time:n a r Town of Queensbury Dept. of Community Development Request received: 1/24("6- 2 Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE Voyo am/p D RT i Y=2o am/pm Notes: (518) 761-8256 Inspector's Initial NAME: LJt j.k,1/Lt1 0 D 0( PERMIT# Ci(`I LOCATION: 4d_ INSPECT ON(date): 7J24 A ?„ TYPE OF STRUCTURE: c I `J RECHECK N/A i 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/D ampproofing Backfill Approval __ Plumbing Under Slab Pl ...ing Vent/Vents in Place • •ugh Plumbing eating Rough-In _ .sulation 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 jF. Separation 1,2, 3,hour netration Sealed ire 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: CJ ----- Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE am/pm: DEPART31 am/pm Notes: (518) 761-8256 Inspector's Initials NAME: ji h` (k6‘ ,k111G�----- PERMIT# qq- rK7 LOCATION: WAidejth - INSPECT ON(date): �--- TYPE OF STRUCTURE: ' F'D dip. rebi,, (' 02,300 ,sy. RECHECK p 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 i Foundation/Wallpour__ , Reinforcement in Place ,� Foundation/Dampproofing _ Backfill Approval Plumbing Under Slab ti Plumbing Vent/Vents in Place . ugh Plumbing eating Roug n Insulation -- Foundation Walls Interior R- • Foundation Walls Exterior R- `‘ Floors R- j Walls R- i Ceiling R- _ ? Duct work or piping in t --4nb_eated spaces R- (Proper Vent Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam CH(.Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour �! Firestopping L:\SueHemingway\Building.Codes.Inspccticn.FORMS\GENERAL INSPECTION REPORT.doc C 41-\f),NAc , GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive pf Depa + tga Inspector's Imt 5 7 NAME: 1 f�: `r d PERMIT# 7 LOCATION: `c;-NC„r`5�� DATE : TYPE OF STRUC c) RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Forni _ Reinforcement in Plac The contractor is responsible for providing protection from fiyieezing for 48 hours following the acement of the concrete. Materials for this purpose ao site Foundation/Wallpour Reinforcement,in Place Foundation/D ` ng Backfill Approval Plumbing Under Slab P1u bing Vent/Vents in Plac ough Plumbing Heating Rough-In Insulation Foundation Walls Interior iR- Foundation Walls Exterior ;R- Floors R- Walls R-:! Ceiling R- Duct work or piping in unheated spaces It- 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 -0W01 \, • \ - 1, - UJDUA iftWa--- (4,91\c0 I FIRE MARSHAL / TOWN OF QUEENSBURY �,� ., QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSP TION REPORT REQUEST RECEIVED 420 09?PERMIT# y 161 NAME ZANAE5 QA)4j.1¢t &J00 LOCATION 961 Mall A t '7 gel SCHEDULE INSPECTION ON a 0 �AM M ANYTIME APPROVED N/A ;YES NO • s EXITS AISLE WIDTHS EXIT SIGNS ,. EMERGENCY IGHTING FIRE EXTI UISHERS 'Th FIRE ALAR E SYSTEM f FIRE SPRIN . R SYSTEM .0 FIRE SUPPRESS c, SYSTEM _ tom. HOOD INSTALLATION INTERIOR FINISHES STORAGE: . ,-/ CLEARANCE TO SPRINK ='S Z CLEARANCE TO HEATIN ITS REQUIRED SIGNAGE ''1- .' CHIMNEY WOOD STOVE 11111111111 ■ FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT . h. REMA-KS• . ( (' fx .K TO THIS DATE . („ja I c ove ot lie ci - 'y I - ActkAt, 15 I T/z . - tiliwlAey c( l a '- Off to_ ile u4 .i- i&64' : - ie) 49iii AN, at 0 Oar k . OK. ;t NV( ibteChtt1 rel ,t:iiQa I�� -r(cA v a CCi L� NS3L(p f 1 e A�. A , ,, '),- r, L ,_ SPECTOR ,, GENERAL INSPECTION REPORT ( 518 ) 761-8256 ' • Town of Queensbury Dept.of Community Development Date inspection request received: / •� �' Building&Code Enforcement 742 Bay Road U Queensbury,NY 12804 Arrive am/pm Depart 9,nypm Inspector's Initials NAME: C r�G4 ERMIT# - l 45/2 LOCATION: '/ TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers I I 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- PrVeni,Attic Vent anrn�� Sy —Tack Stft'd�rs r Bracing/Bridging t// Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed re Wall 2,3,4 hour '/l/ irestpping t SUS lt& b;LV(WO( `? P/L GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: % / Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive am/pm Depart ` 7 rpm Inspector's Initials Vv NAME: c S fer mi-( PERMIT# ` 9T '77 LOCATION: ems /? L DATE : ) TYPE OF STRUCTURE: ,.-it 1, RECHECK :C<<. 1O N/A YE NO COMMENTS Footin .ers Monoli P Form Reinforcement in Place The contractor is - •• sible for providing protection •m freezing for 48 hours following he placement of the concrete. Materials for this purpose •n site Foundation/Wallpour Reinforcement in Place Foundation/Damppraefitng. Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Pla - Rough Plumbing Heating Rough-In Insulation Foundation Walls Interi• R- Foundation Walls Exteri i r R- Floors '- Walls '- Ceiling '- Duct work or piping in unheated spaces - 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 -2__ 1 t .,_-,\ -\--- )1 GENERAL INSPECTION REPORT eCiDA-l\I (518) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: ;, Building&Code Enforcement 742 Bay Road - Queensbury,NY 12804. Arrive �, m Depart `" is In' ' ,, NAME: U n CJiN( cl CXrU� PERMIT# _±iziL5 LOCATION: -— 'LY�_� S Ro Q) DATE: TYPE OF STRUCTURE: ''c7 RECHECK N/A YES NO COMMENTS Footings/Piers I I I 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 .F / Fo tion/Dampproofing kfi11 Approval Plumbing Under Slab Plumbing Vent/Vents in Place ,'' Rough Plumbing Heating Rough-In Insulation 1..,1' am Foundation Walls Interior R- %l Foundation Walls Exterior R- Floors F R- Walls R- Ceiling R- Duct work or pipi g in unheated spa s R- Proper Vent, AtticlVent 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 GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive C.'!a. S Depart m Inspector's Initia NAME- �C'� � �' SY a,- X- PERMIT# - l LOCATION: C --`, � .� � '��'��=� .j � DATE : TYPE OF STRUCTURE: ` RECHECK N/A YES O COMMENTS tings/Piers � I 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/Dampproofi ng 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' y I / BURY , , - 1 y,-y ._. ...- -. , i - Wit - _ _ _ _ . -_ 4_, z -- - / fl , - - - j / X`, NI • • 1; . . ./ G 2- 6'8' q��� cli!tellsc\L- ' 2 - q).4, „ce.,,t, "--c ' i__)c-;\?c\c" _ _ _ ___ / i _ ‘-‘4,-/,,c\ 1-)1 )— / �� e� L_ �a�cl _ 1�'1acCi �� i It "I have seen or observed, or believe I saw evidence o all objects such as houses, wells, trees, fences, etc., shown on this document. I also represent that I have 1 personally measured the distances set forth on The diagra' ." / /01 ,4-ate-t. ii(h/o9 L SIGNATURE DATE awn o f Queeniiury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME /7/7 LOCATION,,,4/f/4/!5 kb DATE 5A77,67 PERMIT NO. ''7- S . SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: • Absorption field, total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS4Number of) Z. Size- ft. X ft. Gravel size 3 PIPING: Size Type Bldg. to tank Tank to dist. box Dist. box to field/pit Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank ft. Foundation to absorption ft. Absorption to lot line ft. Separation of pits ft. LOCATIOON YST ON PROPERTY(circle one) Front Rea - Left side - Right side - COMMENTS: 2?" SYSTEM USE APPROVED YES NO `4; Building Inspector 01/86 and vl . % of 4 To tr OF QUEENSBur�T APPLICATION FOR SEPTIC DISPOSAL PERMIT D t tnr E D MAR 4 1981 DATE I A $1 BUILDING & CODE DEPT. LOCATION OF PROPERTY FOR INSTALLATION rnc,:m;S (\eR \a_tp Owner's Name: P�u (Y\C c(1 �� Telephone: "(q 3 SR-- 6 40-a ceb Address: 1 Ea5t Aki\ • C\rgnt.:;1kt. C`.)oui ►K Installer's Name: 'Q• k\ Telephone: '1 q 3 - Number of bedrooms (residential only) 1j Total daily flow (compute @ 150 gal per bedroom) LIS0 Topography: circle one: Rolling Steep Slope % of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: feet Ground Water: At what depth? feet Bedrock or Impervious Material: At what depth? feet Percolation test: circle one: not required required / rate min. inch. Domestic water supply: circle one: Municipal Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption I/ C) feet PROPOSED SYSTEM: Septic Tank 11000 gal. (minimum size: 1,000 gal.) FILE FIELD: Each Trench et SEEPAGE PIT(S): Number of 2.__ / Size each feet by feet Size of stone to be used = / Depth or Thickness 7 feet * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLED * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * (over) _ Section II 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. I have read the regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. • Signature of responsible person:,,� tom{j a Date: QS � ff Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 . . . HOME OF NATIIPAI RFAIITY A rrnnn of A G Tn I It