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2001-399 EE SB RY . TOWN OF QU N U � l 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 76118256 CERTIFICATE OF OCCUPANCY Permit Number: P20010399 Date Issued: Monday, October 15, 2001 This is to certify that work requested to be done as shown by Permit Number P20010399 has been completed. Tax Map Number: 523400-290-000-0001-066-000-0000 Location: 21 BROOKFIELD Run Owner: SCHERMERHORN PROPERTIES INC Applicant: SCHERMERHORN PROPERTIES INC This structure may be occupied as a: By Order of Town Board Fireplace TOWN OF QUEENSBURY Garage - 3 Cars Attached /f .4' Single Family Dwelling /�f Director of Building&Code Enforcement 77-11.11E--\-'' •TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010399 Application Number: A20010399 Tax Map No: 523400-054-000-0001-035-041-0000 Permission is hereby granted to: SCHERMERHORN PROPERTIES INC For property located at: 21 BROOKFIELD Run in the Town of Queensbury, to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value ' Owner Address: SCHERMERHORN PROPERTIES III Single Family Dwelling 165,000.00 15F BIRDIE Dr Garage-3 Cars Attached QUEENSBURY,NY 12804 Fireplace Total Value 165,000.00• Contractor or Builder's Name/ Address Electrical Inspection Agency SCHERMERHORN CONSTRUCTION CO: COMMONWEALTH ELECTRICAL A( 15 BIRDIE Dr OUEENSBURY,NY 12804 • PO BOX 706 HAGUE,NY Plans &Specifications 2001-399 2292 SQ FT SINGLE FAMILY DWELLING WITH 3-CAR ATTACHED GARAGE AS PER PLOT PLAN ' SPECIFICATIONS $358.64 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday,June 14,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of Queensbury; Thursday,June 14,2001 SIGNED B(...* for the Town of Queensbury. Director o B g '`,Code Enforcement ' Building Permit Application Town of Queensbury-Dept of Community Development, 742 Bay Road, Queensbury,NY (518)761-8256 A permit must be obtained before beginning construction. Permit File No06 i-3 3� 6 No inspection will be made until applicant has received a Pee Paid $ i ' valid building permit. All applicants' spaces on this Rec. Fee Paid $ ,,,,w-. application must be completed and must appear on the Reviewed By: • application form. Af 1.1. Applicant: tt c - -- L--' 6r•j 1:6"uc i©.- Owner: -c, ,cf...-- c_ i e h i_, 5 �ti Address: j F O1�0//c. fir-tv-c, Address: S F �t���r � .. It Q , c t cc-,S‘ L,� , A.4,,, )4,44 q )c.c)7Sty,7 /./-c.J Phone# (Si$ ) 7/X - 067t Phone# ( )7yy - 66711 Property Location: Lot Number: 2/ / House Numbe a` / Subdivision Name: gi oefr;..ct cjc4 /f:s ap Number: ANew Building: residence commercial Estimated Market Value of Construction: $ /6 5- 000 o Addition: residence/ commercial If an Addition, what will use of new addition be? ❑ Alteration: residence/ commercial o No change to exterior size: residence/corn'1 ❑ Other work(describe ) . Check Occupancylnformation 1" Floor 2"' Floor • Other floor Total g'-',- J1 1 B low sq.ft. sq.ft. sq.ft. Square Feet } I a� Single family dwelling / 1 qi 2- j( C'p 2 Z g 2-t ❑ Two family dwelling o Townhouse , o Multifamily dwelling #of units • o Office o Mercantile o Manufacturing . o 1 car detached garage o 2 car detached garage o 3 car detached garage o 1 car attached garage /, ❑ 2 car attached garage lY� 34, 3 car attached garage "R 36 ?3 • ` o Storage building- commercial - o Storage building- • residential o Other 1 Will any second-hand or ungraded lumber be used? If so, for what? /V 0 Type of Heating System: electric/ oil / ga /wood /forced hot air/ baseboard/other: / bcr of Fireplaces to be installed / Number of Woodstoves to be installed /ICJ 1st below the person(s) responsible for supervision of work as regards to building codes: Name Address Phone Number Builder 5c. 4 et.--1-,cvl,e,vh Cooc.s �i",Gjca•-, cbcanSt,tt 7 l,--O6 '7474 Plumber wide f t c--4- 440,t -rZ —3 oo7 'G Mason -q"•;YI t!ar�te.�. -I- Cam• .ut/le �6v �9 P Z •....„Lc.) �D'1 Electrician s-� �Jt�.� t;, t c.c.-Ls l,�;,y 2 0 [ 3 6 , d . ... Declaration: please sign below after you have carefully read the statement: (...\l To the best of my knowledge the statements contained in this application,together with the plans and specifications 5 ,,• submitted,are a true and complete statement of all proposed work to be done on the described premises and that all 3 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 1/we shall submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning Administrator or Director of Building and Codes, an As Built Surveil by a licensed surveyor;drawn to scale,showing actual location of all new mst lion. Signature: �' v' . - _ owner,owner's agent,architect,contractor Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: Office Use Location of installation: 2c 2 I fit-60 ( c a( /'��1 File Permit No. ()-06( 39'1 Tax Map No. / I Fee Paid Owner's Name: Sc 4 e-- Kr;Lis�r-vc �to� I tr-s Address: %S F Ou teal 10 y 4'! JUN I.2 200 1 Tom,rO 2. INSTALLER'S NAMESL, Q�� PHONE S-yM7 �& y 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate #bedroom(s) and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year 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 3 x 110 gal/bdrm = 3 3 0 Garbage Grinder Installed yes / no X Spa or Whirlpool Installed yes / no 4. PARCEL INFORMATION: (circle applicable information &indicate measurements) To os;raphv Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply Flat s at what depth at what depth municipal Rolling /oa 1 feet feet MTh* Steep slope c ay if well; water supply _%slope other from any septic-system depth: absorption is ft. 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: 120'O gallon(min. size 1,000 gal) Tile Field: each trench 5?) ft. Total System Length: Z 2 ft. Seepage Pit(s): number of IS3- size of each: ft by ft. Size of Stone to be used: # ,v7fr* / depth or thickness feet Bed System Size: /'- x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: ,(,0/,y / 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 To of Queensbury Sanitary Sewage Disposal Ordinance. 6 /r zoe Signature of responsible person ate Fire Marshal's OfficeTown of Ag o Quecnsbur, -t_ 3a t •,ttsUu N' \�' (51$) 761-3305 • t1 r }�- Application for Fuel Burning Appliances &.ChirlwNtv ` applicable to solid fuel & vented gas applianc&c2;4d Z007 Date // 20 b s� t mit No��Ir� ` i11ee' f/ 1-1F'r` s Application is hereby-made to the Building& �t .,3(�gic2001 the issuance qt.(' Building and lire Permit pursuant to the New York State Fire Prev r, urd Buildinsg Code. %Ire applicant or owner agrees to comply with all applicable laws, ordinanffeh '6rli ti.iA.'l<rt?64173'.orulitiorrs that are part of these requirements and also it•ill allow all inspect It - ) r 1 per.fornr required invectiorrs. NOTE to applicant:. Rough-in and Final Inspections are required. . q Applicant Information Fuel Burning Appliance Information / (circle appropriate words) Name: CCLv.--i,t�fle;.rk Co�S- vc-�i` Stove: wood coal pellet �O e Fireplace insert Address: (r P el-d a-1.:/ . Fireplace, factory-built: wood 'NV ePocct..�L..... t /c/c,,, >ti-v /2-10 f Fireplace, masonry: wood gas _Furnace: wood gas oil Phone: 7V-06 7y . If non-masonary applicance, please provide Owner: .s'-�� Manufacturer Name: ll.. J .c.i f Address: S,--'-c Model Number: P V— 36 • Chimney Information Phone: 5:9-I- c_ (circle appropriate words) Masonry block rick stone L Flue tile teel size: 6 inches Exact Address: bo'f 2./ ri-oct( el' eieti of construction or installation Factory-Built Manufacturer name: t1 -J.u l-c� Model Number: ,V —3 Note: Listed By: U L. Number: Construction/Installation must conform to NYS Fire Prevention &Building .Indicate (circle) chimney material: • Code. Consult available Town of Queensburp Handouts regarding required inspections. Double trail r Triple wall / Insulated / Direct venting Chimney Liner • I Ca.slzier'sii_IONe sz r-t ziezzt—Tc w z of Qzzeea srbzzz�, New York j Fire Marshal Code# 5.24e- `61...4' S Collected S Xefrmded Xccr�ivc d T onr t, totted to): Pam' -----•- • .4 173 3389 (190) Public Safety C arhb'ess: — — — .4 233 655 (230)Minor Sales • r..awta- Iowx Vo o•t vtpavy. White(Applicant) I Green(Fire Marshal) ! . Yellow(Bldg. Dept.) i Pink&Goldenrod(Cashier's Dept.) • oor9q / '-. ENERGY CODE COMPLIANCE APPLICATION '= TOWN OF QUEENSBURY, WARREN COUNTY ' �-'=' _ _ - 9000 HEATING DEGREE DAYS � ti E �`, JUM 1.2 2001 Compliance Methods: PART 5 - Acceptable Practice Het & . 1&2 Family Dwellings (prayaD y,C� JEE'SBURy • PART 6* - Thermal Rating - Componenadg.Offst 1&2 Family Dwellings; Multi-Family Dwellings (3 stories or less) PART 4* = Design by Component Performance • Commercial Buildings-Hi Rise Residential // *Recrui_es submission of worksheets SCC,w;,.,c� h at,ti C...5 +-4,;(..1-A - APPLICaNT' S NAME: PROPERTY LOCATION: PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: I . Gross Floor Area - -2_7_ q Z scruare feet 2 . Type of Heat - Electric Oi 1 Gas Other 3 . Ts building mechani sally cooled? Yes /C No - 4 . P e_c entage of area of windows and doors Over 17% X Under 17% 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SH0c,•IN ON PLANS SUBMITTED: a . Roof R '30 b . Exterior walls R t q c . Glazed areas R z d . Exterior doors R / 3 e . Floors over unheated spaces R •,U/ f . Edge of slab on grade (heated building) R 4,1 c. Basement/cellar walls (above grade) R •o h . Basement/cellar walls (below grade) R i o _ . Heating/cooling-ducts-piping in unheated space R 6 . Service (domestic) hot water heat-inc device Conforms to minimum efficiency per code Yes No TEMPERATURE CONTROL MAXIMUM SETTING 140c - WILL NOT BE EXCEEDED Apoli -t ignat re P' ?o e Number ..."..- r 677(7 2-°1 -7 qr'.6.67? INSPECTOR' S REMARKS: Inspector's No. Date COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC. (Consulting and Fire Inspection Services) (Incorporated in the states of Maryland,New York,Pennsylvania,Delaware and West Virginia) Desiring Certification of Approval, application is made for inspection of electrical installation in the premises described below.On demand,applicant agrees to pay for inspection service in accord with schedule of charges. PLEASE PRINT Owner Type Bldg: ❑DWG ❑Other r' , � , Occupant Building Permit No. ' ' ' Job Location ;,.t City State County t Twp. M/C# Swimming Pool—New❑Old❑ Directions to Job Site Application For Rough Wiring❑ Fixtures❑ Service❑ or Work—New Q. Additional Bldg. —New❑ Old❑ Ready for Inspection APPLICANT'S. SIGNATURE , LICENSE it PERMIT# - PLEASE PRINT NAME. - ._. PHONE# APPLICANT'S NAME OF ADDRESS .. UTILITY OFFICE TO CITY _ STATE ZIP CODE ! BE NOTIFIED ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY OUTLETS AMP SERVICEE PUMP EQUIPMENT SWITCHES HEAT OVEN PUMP RECEPTACLES SURFACE GARBAGE UNIT DISPOSAL UNIT MEDIUM BASE RANGE FIXTURES MOGUL BASE WATER DRYER FIXTURES HEATER. FLUORESCENT AIR AMP. RECEPTACLES FIXTURES CONDITIONER MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P. QUARTZ FIXTURES VENT FANS MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7.1/2 10 15 20 25 30 40 50 75 100 MARK NUMBER OF EACH SIZE Inspector's Comments: OFFICE USE ONLY WORK INSPECTED REPOR- a o NOTIFIED TED 4 B FEE PAID 0 SERVICE DATE CON- Date Received: TRACTOR TOTAL $ R.W.DATE OWNER CHECK NO. FINAL DATE OCCUPANT CHARGE Certificate No.: CERTIFICATE NEEDED AGENT CASH Date Sent: 0 YES 0 DUP ELEC. LT.CO. INSPECTOR Progress ❑ THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.LS.INC. WHITE/OFFICE PINK/INSPECTOR CANERY/OFFICER GOLD/CUSTOMER RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept. of Community Development 've pm Depart am/pm Town of Queensbury ector's Initials C 7 742 Bay Road Queensbury,New York 12804 I,, NAME 'JLQ.C.nLQC. i' !CL PERMIT c& / "3' q LOCATION e21 •�� LQIO¢ � /� 12tLg(. DATE WI I I5 I C TYPE OF STRUCTURE N/A YES N COMMENTS Chimney Heightl'B"Vent/Direct Vent Locatio 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 mo le 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 grad: Gas Furnace shut-off within 30 feet or within line of sit• 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 Plan/Variance required"--..'%`4-Final Survey Plot Plan 1 y 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) FIRE MARSHAL TOWN OF QUEENSBURY • QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT 2 REQUES EI ED 'ERMIT#0 J-3 NAME OACIVmi7A7 r� � LOCATIO d-/ C�c �P 1 SCHEDULE INSPECTION ON /Q —/, 2 ����_ APPROVED N/A YES I NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SP' NKL:'S CLEARANCE TO HE A TING ITS REQUIRED SIGNAGE CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT FiAAL C-D REMARKS: TO THIS DATE INSPSIIP.PUB INSP OR • l ,. 4 RESIDENTIAL FINAL]INSPECTION REPORT �-(C. ly Office No.(518)761-8256 Date inspection request received: C. Building&Code Enforcement Dept.of Community Development Arrive V2:).ccamepart D • Town of Queensbury Inspector's Initial 742 Bay Road Queensbury,New York 12804 NAME 'Q, ,\)-e�/ n PERMIT ::›160) .1 39 LOCATION t DATE 0�/ -. Ol TYPE OF STRUCTURE N%A S NO COMMENTS Chimney Height/'B"Vent/Direct Vent Location , \ ` Fresh Air Intake ' � \ Plumb Vent through roof ;// Roof Complete �i/// Exterior Finish Complete kk 'i \\ Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies,landing 18 in.or mor v // Interior Handrails stairs both sides 3 or more risers .`/ Grade 2%away from foundation ✓/ 8"clearance to sill plate V 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 2,/ Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/trim/doors/main entrance 36" Floor FinishBathroom/Kitchen watertightInterior Handrails Balconies/Landing 18 in.or more / Railing across window in stairwellsSmoke 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 Y Garage penetrations sealed Furnace in separate room protected(in garage) I Light ventilation per room Safety glazing 18"or less from floor7// Final Electrical / Site Plan/Variance required / Final Survey Plot Plan J 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© Main Office 176 Doe Run Road-Manheim,PA 17545 /\ MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL SQ, Permit No. Cert. No 7 3 4 3 R Cut-in Card No. Owner /3e�0A 1 !`�^' 0--e7'S'f Location t�-�.?../.s;l 1'B 1C�jCGP "/j�v"""��9- f Installationta Consisting of.t 3 -f � ( �i s r79)` Y�'t ras5 . )/6,- �i 1ini6 Ca fr2/.3 f is It f/wee-I'av G, 44/A O Installed By `1 •-A /Af 004-1 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 maki in ections at any time, and if its rules are violated,the Company shall have the right t r ke r ificat Date AI '13' O a/ INSPECTOR Member N.F.P.A..I.A.E.I. \ 11\-) GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury %(-7;1-16 Dept.of Community Development Date inspection request received: - Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive /2 t51>am/pm Depart apipm Inspector's Initials NAME: e o,,.Atruc-S``PERMIT# �-L) O C( LOCATION: ry r7 ` 6-C- `�-tie P ' c DATE : �C��/0( ( tA, `TYPE OF STRUCTURE: c I RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is respoi ible '.r providing protection fro free ing for 48 hours following a e pla a-ment of the concrete. Materials for this purpose a n si - Foundation/Wallpour Reinforcement in Place Foundation/Damppmofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Pla - Rough Plumbing Heating Rough-In insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors Walls lc) Ceiling '- 5 !/ 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 FIRE MARSHAL IOW" TOWN OF QUEENSBURY j QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED g/2-1-10( PERMIT# -` 7 NAME c,r vim_ CGnurP��G4�c4 LOCATION LOT- )( (Vote '1-J,e C d 2 SCHEDULE INSPECTION ON Sf/2;3('( n WM— AM PM ANYTIME APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPRI KLERS CLEARANCE TO HEAT NG UNITS REQUIRED SIGNAGE CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT REMARKS: OK TO THIS DATE INSPsuP.Pus INSPECTOR / J Y S 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 b a pm Inspector's Initials NAME: PERMIT# d I LOCATION: ., f t �l L i€ 40 IN DATE : — 1 TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers I Monolithic Pour Form Reinforcement in Place The contractor is responsi ple fo providing protection from eezi g for 48 hours following the placement of the concrete. Materials for this purpose on .ite Foundation/Wallpour Reinforcement in place Foundation/Dampproofing Backill Approval! Plumbing Under Oab Pl ing Vent/Vents in Place /� ough Plumbing �/� 17 klaikati7.033570Th Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in nheated spaces R- Pro r g ent,Attic�'Def F min - I. D�L ✓ - Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam �rAtr, nfil on Berner �/ / Fire Separation 1,2,3,hour Penetration Sealed Fire all 2,-3,4 hour stopping E TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name G��� f '�/�I�Oe ) Location /e zy, �' v/d Date 6(17,1 b1 Permit # 0 ( " 397 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-M. . to/Inch TYPE OF SYSTEM: ABSORPTION FIELD: To al Length _ Length of each tren•h Depth of trenches Size of stone UMW SEEPAGE PITS: Numbe, Size - ft. x =lir ft. Stone size -_ iPPF 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 feet Foundation to Absorption . feet . Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROP RTY: (circle one) Front - Rear - Left Side Right Side Middle Front - Middle Rq.r COMMENTS: I /C u o 0 5 .S 1)u‘K- 60 , • SYSTEM.USE APPROVED: NO Arrived: Departed: • Building Insp ctor -� Q-A/ f(,; , TOWN OF QUEENSBURY BUILDING &_CODE ENFORCEMENT(ec jti 742 Bay Road Queensbury NY 12804 poi/ C( L�!l (518) 761-8256 l v SEPTIC DISPOSAL SYSTEM INSPECTION PM Name ,__ Ce_ f ---- - Locati o ,7) ( Fy-yo-b-kre1PC Date 2)r/ L)/)/ Perrit a- o/ -319 SOIL TYPE Sand-Loam- lay- Results of Percolation Test- (if applicable) °:te-Minute/Inch TYPE OF SYSTEM: ______7 ABSORPTION FIEL' ctal e � EZi gt � ' Length of each 0 Depth of trenche. Size of stone 4- SEEPAGE PITS: N ,Orr- Size - ft ft. Stone size PIPING: Pe Typ- Bldg. to Tank 4-b Tank. to Dist. Box 04 t+ 9. Dist. Box to Field P' « c1 Openings Sealed? Y-s No Partial LOCATION/SEPARATI., N :Foundation to Tank t B v feet Foundation to Absors ti on °z_-7 feet Separation of Pits et �� Conforms as per Pl o, Plan _ ►o4- Ve LOCATION SYSTEM IN PROP''T : �/i) (circle Front - Rea - Left Side Right Sid- ( : ) Middle Front - Middle Rear COMMENTS: /4 —D N L LcPCA-TTO Ai Ca /6 r 'j, ,c.c-C ) SYSTEM USE APPROVED: Iti NO Arrived: ,,j • ; Departed: Building irtspector ••••••••'''''......."".. • i /51.,1 11f/72 ZJ/7k.-,4".' . . .7t f • 00•'50/1 • • / ' ,.. \ /•9.-/Z•Z l:' .id Z•if0•f" i .11 ...--- •Alg - .t t . \-- ..-- NJ VC.;' . '4,'.% 'tf.',... Al) -. i• -----".- . . . _------- . . . . - • • . •\''` 0.---;. -. (5....e. •.... ,......„ i .-•.r . ) ,4-..,.•.,v.- ‘, 2 1,-,.. ....h...,\. ... .1 , . . ,7 t,.../1 t.: tf ts:Li. • 'Y\ ' - . . I. • k . t.1 • .I . , ,...,. ..,..L.___ '.> . ,.'''' • 1 t .1/. N (.' y . .. • 04- I.. ,„, f, •'•••"-- ',%.,,,:;1.;lifi.:,' • . , . , P.,.......-LIJA:. :;.;%1D %.(IDE • (ci . ,.. -..) . ,_.,..„.... ..,-. . - . 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GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: `7 / Do I Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive\ t5-• I pm fart e I 31° spector's Initial NAME: , -G,ll 1 yvd'y,1er PERT# v I- LOCATION: ,I X Jt I C , [)j - DATE : TYPE OF STRUCTURE: RECHECK N/A YE NO COMMENTS otings/Pi s ,, ,� 1 , '` I 1 0 lithic Pouri orm Reinforcement in Place V The contractor•: respo •ble for providing pro ction from zing for 48 hours f.11owing the p cement of the concret•. Materials for thi• purpose on si Foundation/Wall..ur Reinforcement in 'lace Foundation/Damp.,oofi' J ac 11 App vial �J um mgnder SI.. Plumbing Vent/Ven in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Int•rior R- Foundation Walls Ext;rior 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 - 6y))),1 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 c a;_l/ Inspector's Initials ` /f NAME: Y PERMIT# (J 9'q LOCATION: V 1.-DATE: ( TYPE OF STRUCTURE: S� RECHECK N/A YE O COMMENTS tings/Piers Monolithic Pour Form Reinforcement in Place The contractor is re •• 'ble for providing protection, on'• --zing for 48 hours followi g the ?lacement of the concrete. Materials for this pu •.se on .ite Foundation/Wallpour Reinforcement in Place Foundation/Damppro•.e g Backfill Appr. . Plumbing Under Slab Plumbing Vent/Vents in P ace Rough Plumbing Heating Rough-In Insulation Foundation Walls Interi. R- Foundation Walls Exteri r R- Floors '- 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 4,t/ i.1.,t.., . 1 7 1 ".. '-'- ?, :" I, / 1 • '..6 4' r '':4 1 ,',..1ji .' ' • \• STRAr V - ' ;1 •!:., ,i.r . \, it ----- , "I ha ie:„%c' o7VgArved, F believe I saw evidence of, , . ,ruell - all o.wc itich tis-Tiot.F.,..., s, trees, fences, etc., t.,. / shwa or ',his do- .en.CiP also re.present that I have ti .v.. pLrsonally ri 77 :,-..,u .1.-) distances set forth on the diagram." l'e`, A Z. -e o c,/ t, ..:4 ___ -P)P.,1-1:41q.J;46.---4-: e-,--45-&.:•fe,v7 , AfE — • , . i / •i . .4 ............,„„,.........."`"e.,„\ * rl• • ............. "'".-A-11 ee,..50;?, t.• • y t ,------ • .• I ------- ,), ........--."...' . et''Zi: ) ...----.`• \?I c•.e!, Z .) i. .. .. 4 t X$N• .5d/r'.---.. 1 \e' 4 0 21 . 1 1 040 k- 1 ....f>1; ..m....- •1 l 1 .1 (11 °()44 4"\ ---- I .A.4.: .11(11::7:111 L.:::::1-11): --\, - 4 . •I'4. .,0 ...................,DINat ND ODE 1 '44 • zs, ...r UN 2 2001 i/ u /`14- • i 1 ‘, \ <, v ` . , • / / V 6/N /ti'd . . • 1( Y) \ -...--c, • • , 4" - cz-•:,, / •/ ci • 1 /frope ,-* • . s--34. 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