92-678 • '^^,Y•:ivk t.f'' ..Y•'Pf Y.•v.� -.Y A._..... - _ Yrr- i r.nra., _
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 22 19 92
This is to certify that work requested to be done as shown�by Permit No.92-678
has been completed.
cture may be occupied as asingle family dwelling (modular)
stru
Location Lot 25 Mockingbird Lane Inspiration Park
Owner Mr. & Mrs. Scott F. Ryan
s Issued for lower level only, By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
X
TOWN OF QUEENSBURY 3
No. 92-678
WARREN COUNTY, NEW YORK z
0
s
PERMISSION is hereby granted to Mr. & Mrs. Scott F. Ryan ,—
OWNER of property located at Lot 25 Mockingbird Lane Street, Road or Ave. N
N
in the Town of Queensbury,To Construct or place a Si ngl a fami 1 y dw� (modul ad
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
2. CONTRACTOR or BUI LDER'S Name .�
n
z
3
3. CONTRACTOR or BUILDER'S Address 3
N
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) N
cal
(X)t Wood Frame ( ) Masonry ( )Steel ( ) 3
O
n
7. PLANS and Specifications Model : 1B
No, 40'x25.42' Modular Single family dwleling as per plot plan, specifi- �- Q
cations and application including septic system. Q
8. Proposed Use r
Single family dwelling CD
120.00 October 27 93 V'
$ 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 (p
town of Queensbury before the expiration date.)
Iv
Dated at the Town of Queensbury this 27th Day of October 19 92
SIGNED BY for the Town of Queensbury
ding and Zoning Inspector ._,
.J
J•
TOWN. OF-QLEj9NS8URY
F OWN OF QUEENSSUh
REVIEWED BY: RECEIVED
FEE PAID: OCT 221992 .
PERMIT NO. : RLDG. & CD®E ,DEPTa
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces- on. this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
* * .*. * * * * * * * * * * * * * * * * * * * * * * * * * * .* * * * * * * *. * * * * * * *
Owner of. Property: Mr. & Mrs. Scott F. Ryan - Lot #25 - Model 1B
P.O. Address: Mockingbird Lane, PHONE -
Property Location: Queensbury, NY _12804 148.7_1, 7_3 & 7_4Tax Map No.
Has there been any split of this property since October 1, 1988? Yes X No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Inspiration Park Lot No. 148.7.1,7.3&7.4
Lot #25 Moe IB
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Cushing, Dybas Associates, Architects, P.C_
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
X Construction of new building * CONSTRUCTION: $ 79.994
Addition to building
,Alteration to building. * COMPLETE INFORMATION RF
10�UIRED BELOW:
(no change to exterior dimensions) * Size of Property: .ft. x 100 ft.
Other work (describe) * Existing Building Size: (None)
* - ft. x - ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
1st Floor 1017 Sq_ Ft. * Front Yard 30 ft. Rear yard 44 ft.
nJ * Side Yards 10 ft. . and 50 ft.
2nd Floor - Sq. Ft. * If on corner, setback from side street-
ft.
Other Floors - Sq. Ft.
(not cellar or basement) OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: 1017 Sq. Ft. * Primary Building -
* , X One Family Dwelling.
Size of New Structure: 40.0 ft. x 25.42 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units
Pier/Slab/Crawl/Partial ACO(Circle One) * Business
* Industrial
No. of stories (Habitable space) one * Other
Height (grade to ridge) Twenty Two ft.
If residential , no. of families: nnP * If addition, what will use be?
No. of rooms (excluding baths): Five
No. of bedrooms: Two
No. of bathrooms: one * Accessory Building:
Primary heating system: Baseboard * Detached Garage - One/Two Car
Type of fuel : Electric * Attached Garage - 'One/Two Car
No. of fireplaces to be installed: None * Private Storage Building
Will a woodstove be installed?: No * Other
Central Air Conditioning: Yes No ff_
(OVER)
BUILDING PERMIT 8NNLIL811UN LUNIINutu;
BUILDING SPECIFICATIONS:
Type of construction: wood frame-, fire safe, etc. wood Frame
Will any .second-hand or ungraded lumber be used? If so, for what? No
Foundation Wall Material : Poured concrete Thickness: 8"
Depth of Foundation below grade (to bottom of footing) : Below V-0
Will there be a cellar? Yes Heated or Unheated? Unheated Floor Sq. Footage: 1017
Will there be a basement? No Will any portion be used as living space? N/A
If so, what portion? N/A Sq. Ft. Type of Use? N/A
Type of Roof: Sloped/Flat/Shed/Other sloped Material of Roof Asphalt shingles
Size, wood studs 2 x 6 " ; spacing 16 o.c. ; length a ft..
Joists (floor beams) : 1st Floor 2 " x 10 " ; spacing 16 o.c:; span 13 ft. max.
Joists (floor beams) : 2nd Floor 2 " x 10 "; spacing 16 " o.c. ; span 12 . ft. whez
Overlays (ceiling beams) : - x - "; spacing - " o.c. ; span - ft.Applicable
Roof rafters: - " x - "; spacing - o.c. ;. span, - ft.
Roof trusses (pre-engineered) : spacing 24 " o.c. ; span 13 ft.
Exterior. Wall Finish: clapboard siding of what material ? vinyl
Interior Wall Finish: 112" Gypsum Board
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
N/A
Is there to be an opening between garage and dwelling? NVA If so, will a Fire-Rated door,
enclosure, self-closing device be provided? N/A
Will a flue-lined chimney be installed? No Height above roof N/A ft.
Depth of chimney foundation below grade: N/A ft.
Depth of fireplace hearth: N/A ft. N/A in.
Water supply - Municipal or private well : Municipal
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: +100 ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: The gLbm Corny, Inc. - P.O. Box 6150-- Rutland, vT 05702 PHONE (802)747-7010
NAME OF PLUMBER & ADDRESS: same as AboVe PHONE
NAME OF MASON & ADDRESS: same as Above PHONE
NAME OF ELECTRICIAN & ADDRESS: same as Above PHONE
DECLARATION
To the best of my knowledge and belief the statements contained in this application,
together with the plans and specificat ions submitted, are a true and complete statement of
all proposed work to be done on the described premises and that all provisions of. the
BUILDING:'CODE, THE ZONING ORDINANCE, and all. other laws pertaining to the proposed, work shall
be complied- with, whether specified or not,, and that such work is authorized by the owner.
Signature V1
0 ner, ner 1 . agent, afVitect
contrac r
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Meihods:
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
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
. Mr. & Mrs. Scott F. Ryan Inspiration Park (Lot #25)
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 1017 Sq. Ft.
2. Type of Heat - x Elec. Base Board Other
3. Is Building Mechanically Cooled? YES x NO
4. Percentage of Area of Windows and Doors Over 17% x Under 17% (10.65%)
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U IRE D
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient- temperatures R 38 33 24
B. Exterior Walls R 19 23 18
C. Glazed Area R 3.45 2.6_ 1.7
D. Exterior Doors - R 14.9 2.5 2.5 -
E. Floors over unheated spaces R 19 24 19-
F. Edge of Slab on Grade (Heated Building) R.N/A 10 -10
G. Basement/Cellar Walls (Above Grade) R N/A 10 10
H.- Basement/Cellar Walls (Below Grade) R N/A - -
I. Heating/Cooling - Ducts - Piping in Unheated Space R N/A - -
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code x YES NO
TE14PERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
(518) 793-5183
APPLICAN S SIGNATURE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS:
• r V
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: 10121192 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: Inspiration Park, Queensbury, NY 12804
.Owner' s Name: Mr. & Mrs. Scott F. Ryan - Lot #25 - Model 1B
Owner' s Mailing Address: Mockingbird Lane, Queensbury, NY 12804
Installer' s Name: The Quinn Company, Inc_ Phone #: (802) 747-7010
Number of bedrooms (if residential ): Three
Total dailyflow (residential-com-compute @ ?25' 1 . 375 Gal.
p ga per bedroom) :
Topography-Circle One t Rolling Steep Slope % of Slope
Soil Nature-Circle One: San Loam Clay Other /Depth: +20'
Ground Water-At What Depth? ._,,.. Feet
Bedrock or Impervious Material-At What Depth? +20 Feet
Percolation Test-Circle One: Not Required Required/Rate 2 Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other
If domestic water supply is a we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 1000 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 27 feet//Total System Length 162 feet
Seepage Pit(s) : Number of ! Size each: ft. x ft.
Size of Stone to be used:1/2" to i-i/2n: Delpth or Thickness 1-0 feet
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size\of Each Gal .
Alarm system and associated electrical Mork to be inspected by a certified
agency.
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of .the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE:
lr. �� •�kED q
I ;Fk1P� O1".QUEENSBU�•h
... Oc ..4J %.�\S �• O
REFIVED
OCT 22 1992
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DATE:10"11•612 ' CUSHING. DYBAS ASSOCIATES,
DRAB,: � ARCHITECTS, P.C. � PLOT PLAN
LOT 25
CHECKED: INSPIRATION PARK
rite i-su-7vs-e7Re
SCALE: 1"-20' 274 ear ROAD.OIEMS FAWL NEW WR%QRUI Mow, -su-ivs-e.e�
UNAUTHORIZED ALTERATION OR ADDITION TO
THIS DOCUMENT IS A VIOLATION OF SECTION "►NSP\KJ.T►oL1 P.��L1c-SuCiDIVLS\olJ 7209 SUBDIVISION 2 OF THE NEW YORK STATE
\ EDUCATION LAW. C.A.ypuT PLAL3� PsL>=D BRED 14Y M/J�1JW
- >=L1Gl V>6ETLLUCS� G.S.M.aLE ASSC>c.. P.G. �
LArtilt'S N/ F HOME OW IJER.S ASSac.tAT l0 tJ
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i aartify to the following
that this survey has been
prepared in aOoordanae with
the Code of Praatiae for Land
Curvays adopted by the X.Y.S.
]lsaoaiatioa of Professional A A Q C-W 1 'IV` /�V Q 1 FL A
Laced Surveyors as last �7� v
ravisad. SC•
SCOTT
ST,►,T EV�t\O E FU/J 1�1 fJ G Go rt-P.
ITS SUGG.E$SO[ZS A►J��oTZ ASSIGI�lS
C.Ft( 4"rL
SUT2AIUC.E. COMPANY
-�/ ^j� C1l� "ONLY COPIES OF THIS MAP SIGNED IN RED
INK AND EMBOSSED WITH THE SEAL OF AN
OFFI
CER OF C. T. MALE ASSOCIATES, P.C.,
G. J EIJ 150 tit PAS 4-q o44 D.yT E OR A DESIGNATED REPRESENTATIVE SMALL
BE CONSIDERED TO BE A VALID TRUE COPY"
Date RECORD OF WORK APPr" LOT 25 - Moc►c� t`w1 G B 1 ROSE LAN E
11.2A•92 Faut.]DAT\oN Loc...,TIoN G O ' N S P I RAT I O ,V (� AR K
co
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L° Tov_i\J of QUEElJS$UR`l L.1A5ZTLEIJ COUNTY, NEW YORK
C.T. MALE ASSOCIATES, P.C.
50 CENTURY HILL DRIVE, P.O. BOX 727, LATHAM. NY 12110 ML
c (518) 786-7400 m FAX (518) 786-7299
Drafter: a F Checker: G.J O ENGINEERING • SURVEYING • ARCHITECTURE • LAND PLANNING m
N
LANDSCAPE ARCHITECTURE • COMPUTER SERVICES �
m
o APPr• bY�_ roj. No. 92 .1-74.5 SCALE: ►" = 3o DATE: Nov . zz", 194Z
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
( (518) 761-8256
ARRIVE: met DEPART: ° INSP:
FINAL INSPECTION REPORT — RESIDEN
DATE INSPECTION REQUEST RECEIVED::
NAME
LOCATION �(t�
DATE ` — Z-A —(C _ PERMIT N
TYPE OF STRUCTURE l) P�U_
FOOTINGS_ FOUNDATION _ BACKFILL _ FRAMING _
ROUGE( PLUMBING SEPTIC INSULATION _
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/11EIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES A,
FURNACE/HOT WATER ' PERATING
INTERIOR TRIM PRIVACY DOORS
FINISH FLOORS:
BAPH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE RRAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
�� Ot�E AT l-koN1� Gf�LL�D
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
�1V DEPART: JZ*-q� INS
FINAL INSPECTION REPORT - RESIDE TI
DATE INSPECTION REQUEST RECEIVED:
NAME
LOCATION IO moC lemn k-, ,leD Lt` r3F—
DATE _ 1•7-2,19 PERMIT 0 g �$
TYPE OF STRUCTURE FD— QMs-=
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
FURNACE HOT WATE OPERATING
INTERIOR TRIM PRI ACY DO ZS
FINISH FLOORS:
BATH KITCHEN WAT YTIGHT
OTHER FLOORS S EE ABLE
OTHER FLOORS CARP ED
STAIR CLEARA CE RAIL NGS
SMOKE DST TORS
BATHROO 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
rl2 �r�QS A J `��u2 Pc�Mr i EZt�i�Ep
EEa P ace �o u, w., �E
HAS FiE�t=� flom�� o� 1 F C�t�1Ql..ErE
THE P��EF ta�S�E�lar�:>� t�>r:bT(3F
I-%
TOWN.OF QUEENSBURY 13PPEQ�
BUILDING & CODE ENFORCEMA,.
_ 531 BAY ROAD
QUEENSBURY NY 12804
2 (518)745-4447
ARRIVE: �.'7 3C� DEPART: �' IFINAL INSPECTION REPORT - RESIDE
DATE INSPECTION REQUEST RECEIVED:
NAME c�--� A k ,'\\
LOCATIONS
DATE �I? 1 PERMIT #
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
FURNACE HOT WATER OPERATIN
INTERIOR TRIM PRIVACY DOOR
FINISH FLOORS:
BATH KITCHEN WATERTIGH
OTHER FLOORS SWEEPABL
OTHER FLOORS CARPETE
STAIR CLEARANCE RAILI S
SMOKE DETECTORS i
BATHROOM FANS4
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS NZ
FINAL ELECTRICAL
SITE PLAN VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C C -e
�i A7U-5
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE ('618) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME y� 7W z �
LOCATION
DATE S PERMIT ff 92
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES - NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 40 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE.
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING �t ..
JOIST HANGERS r°
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIP NG IN UNHEATED
SPACES
REMARKS!
4A 4 ,
J 1Jo ova ��\���_ 3
66J �1- _
\A O
ARRIVE
DEPART = �'
INS CTO�t"
TOXIN OF QUEENSOURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4"7
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED/
MIME
LOCATION
DATE ! PERMIT#
TYPE OF STRUCTURE �.�/�_G� &/yh /Ga/J
RECHECK
_FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
,N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION i
PLUMBING VENT /
ROOFING ,
SIDING i L/
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNA&E/HOT WATER OPERATING ✓
INTERIOR TRIM/PRIVACY DOOR'S',
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS ;
DOOR CLOSERS
BATHROOM FANS d
ALL PLUMBING FIXTURES10PERATING\
GARAGE FIRE PROOFING/
DOOR CLOSERS \ v
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS t/
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART
INSPECTOR
TOM OF Qi� . B'1RY
531 BAY RDAG�,
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 4 ,
NAME /i'� /✓ ,��� -s7it_�
LOCATION 1r—
DATE PERMIT#
TYPE OF STRUCTURE .<7
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
I--E.00TING zfOUNDATION e.BAEKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL _--SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS //717d I X-) a
APPROVAL
-N/A -YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT A f.
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS.,'
RELIEF VALVES "v
SCE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH KITCHEN WATERTGHT
OTHER FLOORS SWEEPABLE \
OTHER FLOORS CARPViED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS / �, �✓
BATHROOM FANS \ ✓
ALL PLUMBING FIXTURES OPERATING,
GARAGE FIRE PROOFING 7
DOOR CLOSERS
OTHER FIRE SEPARATION ✓
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C --
COMMENTS: _
s�
z
ARRIVE
DEPART
INSPECTOR
Jown of QueenjLry �fA'
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION ZJ 75-
DATE PERMIT NO.
SOIL TYPE -(Srand0_- Loam - Clay
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length ,!K R
Length of each trench -2)
Depth of trenches ' L�2.,(
Size of gravel _4�a _
SEEPAGE PITS{Number of) !•
Size- ft. X. ft.
Gravel size,,
PIPING: Size Type
Bldg. to tank _i !S W —�
Tank to dist. box _Y _ �-� 0
Dist. box to field/pit y '5-11)
Openings sealed? ;,YE � NO Partial
LOCATION/SEPARATIONS,-
Foundation to tank eft.
Foundation to absorption o2t- ft.
Absorption to lot ,line " 0 ft.
Separation of pits — ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rea - Left side Right side -
COMMENTS:
� 1
SYSTEM USE APPROVED ES NO
Bui ing pector
01/86 and vl
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. Z (0
Owt er S"•
Occupant
LocationSpiP. ����' h�
No. Street
Town-Or State
Installation as itemized on reverse side has been visually inspected pursuant to applicable codes.
Installed by. �
j No.
Date � z� �f�:Cn � Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM No.18 Et_. 900 Haddon Ave.,Collingswood, NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
<n= r c I:�vv' WIRING &CONTROLS FOR BURNER
-- RECEPTACLES H.P.PUMP
f FIXTURES K.W.OVEN y�
MP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
MP.SERVICE CONDUCTORS K.W. DISHWASHER
0
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC.H.P.VENT FANS
o CG
OTORS M.P. 1/20 1/12 I/10 lYs I h I% 'h %i Y I 1 I I%:1 2 3 1 5 IM110 115 120125130 40 50 75 100
ARK NUMBER
c EACH SIZE
APPARATUS
TOWN OF QUEEWSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATIOP2 r�s
DATE I �Z� PERMIT I
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES
jQ FOOTINGS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM i
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON Sb E
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE a
FOUNDATION/DAMPROOFING a
BACKFILL APPROVAL '
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB "
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING 1,
JOIST HANGERS
JACK POSTS/MAIN BEAM!--
HEATING ROUGH—IN
INSULATION:
FOUNDATION WALLS INTERIOR R—
FOUNDATION WALLS ,'EXTERIOR R—
FLOORS R— r
WALLS R—
CEILING R—
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR®S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME�'�
LOCATION La i
DATE /Y Z; PER19IT
TYPE OF STRUCTURE
RECHECK APPROVED
_ N/A YESI NC
FOOTINGS PIE
MONOLITHI R FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE .
FOR PROVIDING PROTECTION FRO1
FREEZING FOR 48 HOURS FOLLPWING
THE PLACEMENT OF THE CONCi�ETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL + ,'
ROUGH PLUMBING g
PLUMBING VENT/VENTS IN PLAO+E
PLUMBING UNDER SLAB 1'
FRAMING: t
JACK STUDS/HEADERS'
BRACING/BRIDGING
JOIST HANGERS f
JACK POSTS/MAIN BEAM
HEATING ROUGH- N
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATIO WALLS EXTERIOR R-
FLOORS // R-
WALLS f R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
NSP C R
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION L-0
DATE I Z-� C PERNIT ,#
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION IONI
FREEZING FOR 48 HOURS OLG
THE PLACEMENT OF THE ONCMATERIALS FOR THIS PU POSSITE;'
FOUNDATION/WALL POUR
REINFORCEMENT ,iN PLA E I
FOUNDATION/DAh{PROOF G
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/'ENTIS IN PLACE
PLUMBING UNDER VIAB
FRAMING: T
JACK STUDS/HE ,DERS 1
BRACING/BRIDqDpG 1
JOIST HANGS
JACK POSTS
I BEAM l
HEATING ROUG -IN
INSULATION:
FOUNDATION WALLS �TERIOR R-
FOUNDATI�N WALLSTERIOR R-
FLOORS R-
WALLS / R-
CEILINP \ R-
DUCT WORK OR PIPING IN\.UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
INSPE TOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT cl /o"?
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED J1 1 3 /
NAME
LOCATION_
DATE/ 1 PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR JOS PURPOSE ON SITE'
X FOUNDATIO WALL POU
REINFORCEMENT IN PLACE f
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE f
PLUMBING UNDER SLAB �a
FRAMING: k'
JACK STUDS/HEADERS '
BRACING/BRIDGING y
JOIST HANGERS t� ;
JACK POSTS/MAIN BEAM / 4
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTE IOR R-
FOUNDATION WALLS EX CFRIOR R- 4.
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIP NG IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
I SPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT /(/ a/X-
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME >
LOCATION v
DATE PERMIT # 0
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
XFOOTINGS/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 PURPOSEeON SITE
FOUNDATION/WALL POUR a�
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING r
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS;''IP LACE
PLUMBING UNDER SLABt
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS � '�
JACK POSTS/MAIN' BEAM
HEATING ROUGH—I f
INSULATION: ell
FOUNDATION WALLS INTERhOR R—
FOUNDATION 4JALLS EXTERIOR R—
FLOORS ;° . R—
WALLS R-
CEILING ,' R=
DUCT WORKIOR PIPING IN UNHEATED
SPACES `
REMARKS:
ARRIVE
DEPART ! 1 / f
�' INSPECTOR