99-620 1
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date t9
November 12 ""-99
This is to certify that work requested to be done as shown by Permit No.
99620
. ham been completed.
This structure may be occupied as a SINGLE FAMILY DWELLING
Location 19 TEE HILL RD. •
Owner LLUTE, LARRY
By Order Town Board
TAX MAP NO. 47 . --3-4 , 1
A
TOWN OF Q ENSBURY
(::— '',7,-, -'' .
Director of Bldg. & Code Enforcement
.ti
BUILDING PERMIT
TOWN OF QUEENSBURY No. 99620
VALUE $ 60000
TAX MAP NO. 47 . —3-4 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CLUTE, LARRY
OWNER of property located at TER HIT•L BD_ Street,Road or Ave.
in the Town of Oueensbury,To Construct or place a 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 Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
13 DAWN RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
CLUTE ENTERPRISES, INC.
3. CONTRACTOR or BUILDERS Address
13 DAWN ROAD
QUEENSBURY, NY 12804
4. ARCHITECTS Name
COMMONWEALTH ELECTRICAL AGENCY
5. ARCHITECTS Address
PO BOX 706
HAGUE, NY 12836
6. TYPE of Construction—(Please indicate by XI
SINGLE FAMILY DWELLING
I 1 Wood Frame ( I Masonry ( 1 Steel ( I
7. PLANS and Specifications
864 SQ FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
108 September 30 2001
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.l
30 September 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY t.,4\7)1-'
I�IvQ�\ �1 �i for the Town of Queensbury
Building and Zoning InspectOr
Isuz1azng Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 1761-82561
o BUILDING & CODE ENFORCEMENT
NOTICL Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. --
beginning construction. No inspections —
Zonin Board Action PERMIT FEE PAID$ /O
will be made until applicant has received n g •-
a VALID BUILDING PERMIT. All Area /Use RECREATION FEE P
applicants' spaces on this application
MUST be completed add•the signature ED Piing Board Action REVIEWED BY.
of the applicant must appear on the SPR / Subdivision /Other uUding Inspector
plieation form. n Recreation Fee Payment J
Applicant: Owner: e_
Address: \' D-A c..1.^� 91 Address:
Phone # ( T753 - 7 D:7 7 Phone # ( ) -
Property Location: ` P_P kt.l k e_V __
(�-7 �.
Subdivision Name: Tax Map Number —J 1
Section Block lot
N7HE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ ( C C00
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Pri ary Building - _ _
residence / commercial Single Family e1ling , -
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwsti9,g4. 1999
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE;
1st Floor �j(a �( sq. ft. of
If , ADDITION, what will use
�6 of n:w addition be? :
2nd .Floor sq. ft.
Other Floors sq. ft
(not unfinished cellar or basemen ACCESSORY B. DINGS:
Detached e-ra• - 1, 2 car
TOTAL FLOOR AREA: SQ. FT. Attached G. . •e 1, 2 car
Private orage :uilding
—
SIZE OF NEW STRUCTURE: Comer, al Storage : ilding
Othe
� '-ci FEET X FEET
Foundation Type: •. Will any second-hand or ungraded
Number of Stories : k lumber be used? If' so, for what?
(habitable space only) \-- 0
Height (grade to ridge) : tCo feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which a lies)
to be installed: ( E / Wood
Forced Hot Air Baseboard / Other
Person responsible for supervision of work as regards to building
codes is : Lam{; C Je —75 3 7D-7 7
Name Adidresss Phone
Builder:
Plumber: (ILL
V---pote..r"--CCAc'
Electrician:
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 authoriz-• .y - owner. Further, it i n•a tood that Uwe shall submit prior to a
Certificate of Occupa , or Ce ' cate of Complianc: being i• ued, an AS BUILT PLOT PLAN by
a licensed survey. , drawn to . : e, showing ac . locatio of project on premises.
Signature: ///1111
o ner, owner's, architect, contractor)
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
62.12
Dept. of Community Development Permit No.
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation:
RFORNIFD
Property Owner's Name:
SEP 2 4 1999
Property Owner's Mailing Address:
Installer's Name: ( A.,.4e. 3e_� Phone #
Number of bedrooms (if residential): Total daily flow:
(residential -compute @ 150 gal./bdrm.)
Topography: /flat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? feet
Percolation test: not required, required [rate min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is (OD'- feet.
PROPOSED SYSTEM
Septic tank• tcpu gallon (minimum size: 1,000 gal.)
Tile field: each trench '5° feet / Total system length: .2 o(3 feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
(Alarm system and associated electrical work to be inspected by a certified agency.J
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbary, 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 pplicati' . and agree to these and an requirements of the Town of
Queensbury Sanitary Sewage Disposal • • .
Signature of responsible pers. Date: ` /D1 F
9'\-ca-e)
vm6k8 .a
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY SEP 2 4 1999
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:
e_- :�
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - v(.a square feet
2 . Type of Heat - Electric Oil X Gas Other
3 . Is` building mechanically cooled? Yes V. No
4 . Percentage of area of windows and doors Over 17% %< Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R 3
b . Exterior walls R
c . Glazed areas R Lj 5
d . Exterior doors R
e . Floors over unheated spaces R is
f . Edge of slab on grade (heated building) R
g. Basement/cellar walls (above grade) R
h . Basement/cellar walls (below grade) R ---
i . Heating/cooling-ducts-piping in unheated space R L(. .5
6 . Service (domestic) hot water heating device
Confo s to minimum efficiency per code Yes No
MPE- • TURE CON -OL • % IMUM SETTING 140° - WILL NOT BE EXCEEDED
• •p' S .•`. - Dp.te Phone Nu er
L � ��-/C 1 --7 X7-7
INSPECTa ' S REMARKS:
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
Okrq
742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED:
NAME G\ \
LOCATION
DATE \\ -(7f' PERMIT N CIP4_
TYPE OF STRUCTURE
FOOTINGS FOUNDATION _ BACKFILL 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 /
-- f
FURNACE/HOT\WATER OPERAT NG
INTERIOR TRIMIPRIVACY D'O':
FINISH FLOORS:
BATH/KITCHEN WATERT' HT
OTHER FLOORS SWEEP• :LE
OTHER FLOORS CARPE ED
STAIR CLEARANCE/RAI INGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
/,FINAL SURVEY PLOT PLAN S
OK TO ISSUE C/O OR C/C
1 i vv
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:Building& Code EnforcementTXDept. of Community Development Arrive arn/pm Departam
Town of Queensbury Inspector's Initial ___�L
742 Bay Road
Queensbury,New York 12804j �`�
NAME CZuTG-
PERMIT# t t^ Lc)
LOCATION 1416- yLL tab . DATE 11,I 2:2-,
TYPE OF STRUCTURE
N/A I
NO COMMENTS
/ininey Height/"B"Vent/Direct Vent Location Lam' / l6�� cc
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,bale es,lan '' g 18 in. or more
Interior Handrails stairs booth sides 3 r more risers
Grade 2%away from foundation
8"clearance to sill plat
Gas Valve shut-off e a sed/re ator 18"above grade
Gas Furnace shut-off 'thin 31 feet or within line of site
Oil Furnace shut-off. . ce to furnace area
Furnace/Hot Water H . er operating
Relief Valve(s)installe.
Broom,6 ft.6 in. on tairs
✓Basement stairs,6 ft. 4 i .
Handrail exterior stairs • ,th sides more than 3 risers
Interior privacy/trim/doo main entrance 36"
Floor Finish
Bathroom/Kitchen waterti t
Interior Handrails Balconi;s/Landing 18 in. or more
Railing across window in s . ells
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
$ite Plan/Variance required
J 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)
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.l'-
Main Office 176 Doe Run Road-Manheim,PA 17545
//
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL /
v
'anel Board No Cert. N2 6 4 914 Cut-in Card No (
���2/t./
)caner e �� (�.-��'"/ �.
TL&.tic
.ocation �j '
nstall ion Consisting of 1 4-1 $�'f �� GP 3- -j 7 7 U 17-675
,i
_D GOt -Pa w .. , ,p d f /. -7 t '
m D f4— S fc G'
nstalled By J✓� Y42.s�_ Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
ancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
itroduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of maki.• inspections at any time, and if its
Iles are violated,the Company shall have the right to yoke t 40.1ficate.
` ` ed
)ate - 4f 9 INSPECTOR /....
Member N.F.P.A.,I.A E.I.
pii
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: /[ 4
445 C)?
Building& Code Enforcement
Dept. of Community Development Arrive am/pm Depart `� a
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury e York 12804
NAME /n PERMIT#
9V--4
LOCATI N / ' !' / DATE if_ !—
l V`�
TYPE OF STRUCTt ;e"
N/A YES I
COMMENTS
Chimney m Hei t/"B"Vent/Direct Vent Location '�Fresh Air Intake `/, 7••• / 1 -C
Plumb Vent through roof ✓/
Roof Complete �
Exterior Finish Complete / /
Interior/Exterior Railings 30"to 36" `1, V. �/
Exterior Handrails,balconies,landing1 in.or more �,f PR
-
Interior Handrails stairs both sides 3 or ore risers u! �'�OU bl06- VA ArN ' ������ ' ~`�
Grade 2%away from foundation , 7 awl TAN L v
8"clearance to sill plate '���
Gas Valve shut-off exposed/regulator 1.8"abovle grade
Gas Furnace shut-off within 3Qfeet or `'thin • e of site
Oil Furnace shut-off at entrance ce
Furnace/Hot Water Heater operating �/
Relief Valve(s)installed / IfHeadroom,6 ft. 6 in. on stairs /p, c,u
Basement stairs,6 ft.4 in. 1 IJ�f C® ' }Ae-A-�Rod.
Handrail exterior stairs both sides ore than 3 risers J Ca",4-,1QS
Interior privacy/trim/doors/main en ance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconie ' g 18 in. or more K kT 1)5 r- i; p /e E
Railing across window in s . ells , /
Smoke Detectors: C4ro
every level /
every bedroom ✓
outside every bedroom 1/,
inter connected ✓,
Bathroom fans Vj
Plumbing fixtures Y//
Foundation insulation / 1/
3/4 hour fire door/door closer li
z.
Garage fireproofmg V
Garage penetrations sealed J
Furnace in separate room protected(in garage) I
Light ventilation per room
Safety glazing 18" les floor /
Final Electrical U. let• co--.7 . ✓
Site Plan/Variance q ed 41/6k
1Final Survey Plot Plan k'j F'�N Pc 4- `�U IQ() E
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy) f
Okay to issue permanent C/O(Certif. of Occupancy) iJ
( AS11O
TOWN OF QUEENSBURY
'h.� t�i1 BUILDING & CODE ENFORCEMENT
' 1, 742 BAY ROAD
���CI QUEENSBURY NY 12804
(518) 761-8256 ��JJQQ,,
ARRIVE: DEPART: INSP: a
FINAL INSPECTION REPORT — RESIDENTIAL
DATE INSPECTI EQUE T RF, VED: f/"../49�1�
NAME �.r- n
LOCATION
DATE -- PERMIT
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL F' _
ROUGH PLUMBING _ SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLA•
- N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/S'PPS/RAILINGS
7-
RELIEF VALVES
FURNACE/HOT WATER's,Q,pERATI
INTERIOR TRIM/PRIVACY DO' S
FINISH FLOORS:
BATH/KITCHEN WATERTI'HT
OTHER FLOORS SWEEPA-LE
OTHER FLOORS CARPE ED
STAIR CLEARANCE/RAI INGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES ,
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SIDE PLAN/VARIANCE REQ. _
FINAL SURVEY PLOT PLAN _
OK TO ISSUE C/O OR C/C
Inco r rtuk m .. ....
a°.1-vA -k.rn k ES S .
/. (
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury ` /
Dept. of Community Development Date inspection request received: 1144- -9
Building& Code Enforcement
742 Bay Road i rj
Queensbury,NY 12804 Arrive am/pm Depart aj pm
Inspector's Initials —�`
NAME: =l #T l -O`0'M
LOCATIO : 2 : /r l 7 l-J stc
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¢n site__ •
Foundation/Wallpour___I _ 1
Reinforcement in Place_
Foundation7Dampproofin,._�=�'
Back fill Approval_
Plumbing Under Slab
Plumbing Vent/Vents in 'lace-__
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls In rior R-
Foundation Walls E.i erior 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
it Infiltration Barrier '
I Fire Separation I, 2, 3, hour
Penetration Scaled
Fire Wall 2, 3, 4 hour
Firestopping
y-
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name C iu
Location _c-
Date L E tol R9 Permit #
SOIL TYPE: Sand-Loam-Clay-
Results o Perco .tion Test-
(if appli able) R.te-Minute/Inch
TYPE OF S STEM:
ABSORPTI' FIELD: Total Length
Length of each tench
Depth of srencFyds
Size of st.nv
SEEPAGE p1' : Number-
Siz� ft. x ft.
Stone size
PIPING: Size Type
Bldg. to T.nk
Tank to Dist.vp4t. Box to Field/' '
Openings Se;led? No Partial
LOCATION/SE'ARATION
Foundation a Tank feet
Foundation t' Absorption feet
Separation oi. Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
PR -iiou6 SLA
fit. fo � �
t(— ;)
SYSTEM USE APPROVED: YES NO
Arrived:
Departed: /, ÷7a
Building Inspector
41111 C.,-qvici 4
TOWN OF QUEENSBURY (
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name \C.J,Kt-Q Le
, X-V4iN6
Location `
Date 1 - Permit #C\C:'l"CQ1CJ
SOIL TYPE• Sand- oam-Clay-
Results of ercolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: 7-7
ABSORPTION FIELD: Tot:lLengttFb Or�
Length of each trenci1 50
Depth of trenches
Size of stone
SEEPAGE PITS: Numb •r-
Size - ft. • ft.
r
Stone size -
PIPING: Size Type
Bldg. to Tank ii
Tank to Dist. Box o ‘‘.
Dist. Box to Fiel /Pit i�
Openings Sealed? Yes 40 Partial
LOCATION/SEPARAT ONS:
Foundation to Ta k 12i feet
Foundation to Assorption feet
Separation of P is -_ eet
Conforms as pe Plot Plan � No
LOCATION OF SY TEM ON PROPERTY:
(circle
Front -% Rea - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
A- AUto.-
1 t t. ,i.A-r<o 6)5 — OK
A-L Pie FocuvoA tc/0
�:-oR. R
SYSTEM USE APPROVED: YES C.../
Arrived:
Departed: 8 ', 46
,li02
Building Inspector
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Ad/o/ner: .n
Joist crane
snee • I •
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North Out Stocked* / -c
Fame (.4' Wail Of LinoAO•r ii -L
q,� swim.'�".'• .. - swim. oat `
1
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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 3'.3Sram/pm Depart am/pm
y Inspector's Initials
NAME: PERMIT# - ��
LOCATION: 'ee ,(((C1 DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I /
Monolithic Pour Form . I"
Reinforcement in Place
The contractor is res•.nsible .r
providing protection ►om f ezing
for 48 hours followi th, placement
of the concrete.
Materials for this.a. ase on site
Foundation/Wallpour
Reinforcement in PI' e
Foundation/Damppr.•fing
Backfill Approval
Plumbing Under SI b
Plumbing Vent/Ve is 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
3 GENERAL INSPECTION REPORT — e3 C)
( 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 am/pm
Inspector's Initials "pki--
NAME: ' \N(' 11 t=-� PERMIT# C,)
LOCATION:
I4 i .i i 1, ` ) _ DATE . A - % / ..671 f,"
TYPE OF STRUCTURE:. \C-)
RECHECK
__ N/A YE NO COMMENTS
otings/Piers —� I
Monolithic Pour Form V f�' )6 /( -44 in Pla
The contractor is re-..nsi e for Lei f
providing protectio -from/reezing
for 48 hours followi g the placement , �r
of the concrete. / , / / d
Materials for this pu •.sc`on site J/
Foundation/Wallpour ,. !1`Zea) 'n-+,.fi r
Reinforcement in PI +
Foundation/Dam/tr.ding_
Backfill Approval
Plumbing Under Slat _
Plumbing Vent/Ven , in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Wa s Interior R-
Foundation W Is 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 I, 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 am/pm Depart 4m/�pm�
Inspector's Initials Il�o��
NAME: e i L'►C--- PERMIT# ! `-6
LOCATION: L-- t tt - _- DATE : <vEM f c'(
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 c 'lacement
of the concrete.
Materials for this purpos, on site _
Foundation/Wal 1pour_
Reinforcement in Place
Foundation/Dampproof o
Backfill Approval
Plumbing Under Slab _
Plumbing Vent/Vents in P ace
Rough Plumbing
ling Rough-In
%Insulation 1 H&kN4 ' RE'4-K
Foundation Walls Interio R-
Fgtndation Walls Ezteri.r R-
loors [t-
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 I, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
,v
4_ 1 _
kfj4
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Quccnsbury / y ,Dept.of Community DevelopmentDate inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart/a `
Inspector's Initials
NAME: I° fi (5' C L E PERMIT# C - � )
LOCATION: ..2 ,, 1 I, DATE : ? z ! 9
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible or
providing protection from fr ezing
for 48 hours following the laceme,it
of the concrete.
Materials for this rposc o site
Foundation!Wallpou -fr '`�~
Reinforcement in Place f
Foundation/Dampprool i nt
kfill Approval
numbing Under Slab - � � n ��
Plumbing Vent/Vents in Place_
Rough Plumbing
ating Rou In
sulation .:t-•/
,,.„oundation Walls Interior R-
`� .undation Walls Exterior R-
Floors UNP6A. 5448 R- f(o 1I (e1 /ZWvt-'- K Q .L 6-
Walls R-
Ceiling R-Duct work or pipingin `'' 4-4- IR--C-("(E'-'-C1�
unheated spaces R- _
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging _ _Joist Hangers
Jack Posts/Main Beam _
Air Infiltration Barrier
Fire Separation I, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
)1
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement ,,,----
742 Bay Road _ ..„Alegi
Queensbury,NY 12804 Arrive V.: �aml}pm Depart ,Fi 't_•,•'ice-
Inspector's Initials-'`'„ /
NAME:
CI `,,kC�1 PERMIT# '
LOCATION: DATE : /0--a i
7`
TYPE OF STRUC URE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers / 1 I
Monolithic Pour Form i
Reinforcement in Place_
The contractgris responsible for 1
providing prot tion from fcezing
for 48 hours fol mg the placemen
of the concrete.
Materials for this purpose onisite
Foundation/Wallpour
Reinforcement in Place `
Foundation/Da m pproofi n
Backfill Approval i
nbing Under Slab ,
Plumbing Vent/Vents i 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
Fircstopping _
00 ik)
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 Arrivee m ai Depart— '1s a
nl spector's I
NAME' PERMIT#
LOCATION: '" \ LL _ DATE : C1 f\
TYPE OF STRUCTURE:
RECHECK
, N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respon 's le for
providing protection from freezing
for 48 hours followin_ the placement
of the concrete.
Materials fsr this pu sse on s' _
Foundation/ .---
Reinforcement in PI ce
Foundation/Dampp oofing
Backfill Approval
Plumbing Under ab
Plumbing Vent/V nts in Place
Rough Plumbing
Heatin ough-I
�I ation 'C7
Foundation Walls Interior
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 I, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
,S, JSp.
GENERAL INSPECTION REPORT " (
( 518 ) 761-8256 /
Town of Queensbury �! �\
Dept.of Community Development Date inspection request received:
Building& Code Enforcement } % J/
742 Bay Road 22 ¢� l
Queensbury,NY 12804 Arrive am/pm Depart`-' am/pm
Inspector's Initials � L!
NAME: Q1 '— PERMIT 9)/0
LOCATION: 1 , DATE : `/� •
TYPE OF STRUCTU E:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor i ..nsible for
providing pr• ection rom freezing
for 48 hour•followin. the placement
of the con ete.
Materials fo this pu 'se on site
Foundation!' allpou
Reinforcement in ace
Foundation P•mpproofing__ __
Backfill Ap•roval___
Plumbing U der Slab
Plumbing V•nt/Vents in Place ✓/
tough Plu sing ✓
',heating Ro gh-In 1/
Insulation
Foundat sn Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
P(oller Vent, Attic Vent
Framing 0 r - &LLi))
Jack Studs/Headers
Bracing/Bridging
✓
Joist Hangers �
vJack Posts/Main Bea
"Air Infiltration Barrier y r /t)r7 6,t
Fire
Separation 1, 2, 3, hour
Penetration Sealed
fire Wall 2, 3, 4 hour
'Fi restopping
` TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
GENERAL INS, -�
( 518 ) 761-8256 Name - -1\\(�.�� .,,'
Town of Queensbury
Dept.of Community Development Date inspt Location � ! .\�- 1 l .\(
Building& Code Enforcement ., :� `,
742 Bay [toad Date/y.7iii 11 Permi t #1 C 1 O--L.
Queensbury,NY 12804 Arrived
a_....) ,4,,,-. SOIL TYPE: Sand-Loam-Clay-
NAME: Results of Percolation - t-
LOCATION: ) 'c i.Z,/. / (if applicable) Rate- inute Inch
TYPE OF STRUCTURE: TYPE OF SYSTEM:
RECHECK ABSORPTION FIELD: T.tal Length
Length of each tre ch
Depth of trenches. ..___.--
N/A YES Size of stone
Footings/Piers —1 SEEPAGE PITS: Nimber-
Monolithic Pour Form Size - t. x f t.
Reinforcement in Place Stone size _
The contractor is responsible for PIPING: Size Type
providing protection from ing Bldg. to Tank _
for 48 hours following th placement Tank to Dist. Box
of the concrete. / Dist. Box to Field/Pit
Materials for this purpose bn site Openings Sealed? Yes No Partial
Foundation/Wallpour 1 LOCATION/SEPARATIONS:
Reinforcement in Place I Foundation to Tank feet
Foundation/Dampprooting___ J� Foundation to Absorption feet
ckfill Approval V Separation ofPits feet
Plumbing Under Slab_-r Conforms as per Plot Plan Yes No
Plumbing Vent/Vents in Place LOCATION OF SYSTEM ON PROPERTY:
Rough Plumbing (circle one)
Heating Rough-in Vi
Front - Rear - Left Side - Right Side
}.lnsulatio .,' '2 C4 t\ Middle Front - Middle Rear
Foun ion Walls Interior R- VT) COMMENTS:
Foundation Walls 4xtcrior R- V L . L J i ,,L4:t 4 t_)16--- 1
Floors I R-
I( R- C ^ \ , . ( ,. C'V , \,��> ` r ti: , Y
Ceiling I R-
r ,
Duct work or piping ins . �� L_ �_ '�-`
unheated spaces R-
Proper Vent, Attic Vent eifie> 4)<- 1°,AiS e- /Ciec$4. . ,it l-<;l/,F► , F7 /e
Framing ou&,e/fc rite41 C,444.3 t A Cca..f�L«ti i
Jack Studs/Headers i-5Z'4^^ L.4-ti ' Ad,Si4tet 6...0, .
Bracing/Bridging SYSTEM USE APPROVED: YES NO
Joist Hangers_
Jack Posts/Main Beam Arrived:
Air Infiltration Barrier Departed:
Fire Separation I, 2, 3, hour ,
Penetration Scaled _ c.
Fire Wall 2, 3,4 hour Building Inspector
Firestopping N0 'j«f,, v#= Ale-/6.,r6o,Q5 &,&-44-
10,THh ,,) Ic�eARc4iPo ,14/e6.%¢. S 19,14- *
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TOWN OF QUEENSBURY
BUILDING AND CODE
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MAP REFERENCE:
COUNTRY COLONY
A HOW—MAC DEVELOPMENT
DATED APRIL 1955
FILED MAY 13, 1955
BY G.C. TRIPP RACWrX
22
23
2A
SN'� / 100 00
I.P.F.
N
' SNEO `O
AREA 00 0
15,000 sq. ft. . 0\ ,
1999
10 -
\p zg� N005E o
Z
14 �\ w` a.
Q
/ xa
LEGEND: -� Q�O
I.P.F It� 1�
/ �(t I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
1 L+ FROM AN ACTUAL FIELD SURVEY.
I.P.F. - IRON PIPE FOUND / �'(j• THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
Y FOR.WHOM THE SURVEY WAS PREPARED, AND ON THEIR
I.R.F. — IRON ROD FOUND / �ALFTDONTHE TITLE
COMPAON NY. GVE ENTAL AGENCY
rQ.). = UTIUTY POLE CE TI FICATIS OR RE NOT TRANSFERAW, TO ADDITIONAL
® = WELL CER11F ED TO: ROBERT L CARPENTER
LORRAINE E. GRANT
.. •,:e,� o. M & T MORTGAGE CORPORATION,
•. IT'S SUCCESSORS AND\OR ASSIGNS
0) ' ' o CHICAGO TITLE INSURANCE COMPANY
4
P
se •
CERTIFIED BY:
MATTHEW C. VMS. LLS NYS 50135
DATED: NOVENBER 17. 1999
Da e' N
•�-� � s, Map o! a Survey made for
''"UFM A ""Q LA ""°a'="A L 10 A Scale 1'=30'
YM W�AIINO A lASl1ED LAW)�IYE1iCIM�q A
>�TMWWI"T>�. &OFW 'ROBERT L. CARPENTER
W!W V=WAR GXM1=LAW.'
YAW®WW1 All gNNlt 6 ll[LAW lUI1tY010 Steves K&ova=
I"COMW
CaTir"11011i 143"=Ng�WOAIT ANT Q_ �� 1
lIM AMY WAS! M N ACC WPW"1K JL7`VrI
Land Surveyors , LLC INWKW°`"" �"�"W°A =
H 111[IEW W>AI BATE ALOCMTON 0/RIW cfWrglAt
`V "�`�`='W `"a`Y
ma COPW QW00NWRAL LORRAINE Ew GRANT
>b>�r�rail wnr ale w�lEr a r�rAiWa AtD
OM Mq W]INf 7p AIE
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New York 12801 A�"��"DN°Mi71�0M""�'�'MD 1 11-1 8-99 SHOW LOT 15 ONLY
37 Chester Street Glens Falls, ,�>�AWICIIEli a nlc►�NtAR17Ot•
518 792-8474 New York Uc. No. 50135 7�own of Queensbury, Warren County, New York GRANT/CARPENTER
t ) NO. DATE DESCRIPTION owc. No. 99250
C-182