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2002-687 TOWN OF QUEENSBURY 742 Bay Road,Queen&7,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 CE A I ."IFIC111TE OF OCCUPANCY Permit Number: P20020687 Date Issued: 'Thursday,March 06,2003 This is to certify that work requested to be done as shown by Permit Number P20020687 has been completed, Tax Map Number: 523400-307-000-0001-009-000-0000 Location: TUTHILL Rd Owner: THOMAS&KELLY REUKAUF Applicant: THOMAS&KELLY REUKAUF This structure may be occupied as a: By Order of Town Board Fireplace TOWN OF QUEENSBURY Garage-2 Cars Attached Single Family Dwelling Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020687 Application Number: A20020687 Tax Map No: 523400-307-000-0001-009-000-0000 Permission is hereby granted to: THOMAS & KFTI,YRFIJKAIJF For property located at: TUTHILL Rd in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Tue of Construction Value Owner Address: THOMAS &KELLY REUKAUF Fireplace 15B SHERMAN Ave Garage-2 Cars Attached GLENS FALLS,'NY 12801-0000 Single Family Dwelling 150,000.00 Total Value 150,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency TOM MASON& SON PO BOX 361 HADLEY-NY 12804-0000 Plans&Specifications 2002-687 911 Address: 33 Tuthill Road Construction of 2021 sq ft SFD with 728 sq ft attached two-car garage and one fireplace. $315.32 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 29,2003 (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 Queen.16ury; Thursday,August 29,2002 SIGNED BY for the Town of Queensb V - hector of Building Co nforcement Building Permit Application Town of Queensbury—Dept of Coziununity Development,742 Bay Road, Queensbury,NY (518)761-8256 A permit must be obtained before beginning construction. Permit File No. No inspection will be made until applicant has received a Fee Paid $ ,2- valid building permit. All applicants' spaces on this Rec. Fee Paid application must be completed and must appear on the Reviewed By 'O _ application formV^��"'`''�� i'hlaef 5d" �ddress: Wner AUG 1 72 3;?Address: Ro.Box a2-77 //ad/eI✓j/j✓. /SS S'h ermar1 Rue /piers GLueensbor) N;-k' 4 lurl_l rnt Phone#(ilfr ) 6Y6 - ?3 Phone# (s/g- ) ZVS-- D.39D ..... • -_O f�D Email Address:/WaSd,,?J hrcrecl, ur�ron .net �� Email Address: Pro e Lot Number: / H use 101.- er ubdivision Name• Tax - ap' 3 11W New Building: Qesidence commercial Estimated Market Value of Construction: $ /$Olt ' ❑ Addition: residence/ commercial If an Addition,what will use of new addition be? ❑ Alteration: residence/ commercial ❑ No change to exterior size: residence/com'1 ❑ Other work(describe ) Check Qccupancyinformation I't Floor 2n Floor Other floor Total Below sq.ft. sq.ft. sq.ft. Square Feet Single family dwelling p X ❑ Two family dwelling ❑ Townhouse ❑ Multifamily dwelling #of units ❑ Office ❑ Mercantile ❑ Manufacturing ❑ 1 car detached garage ❑ 2 car detached garage ❑ 3 car detached garage ❑ 1 car attached garage J9. 2 car attached garage Z&g- Z �/ ❑ 3 car attached garage d ❑ Storage building- commercial ❑ Storage building- residential ❑ Other What is the proposed height of the structure 'Sy feet 5— inches Will any second-hand or ungraded Iumber be used? If so, for what? NO Type of Heating System: electric/(5) gas/wood /forced hot air/ baseboard 1 other: Number of Fireplaces to be installed l_ Number of Woodstoves to be installed List below the person(s)responsible for supervision of work as regards to building codes: Name Address Phone Number Builder 2am 1wa se f'-�x 6! le 6 7,6 -..?-7W Plumber i i t e t Mason Electrician 1174— (v , 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,as requested by the Zoning Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual location of all new construction. Signature:�� / �o� _ 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: J ..............................................................................................._............................ ........; Office Use Location of installation: '-rvAA,*1/ fl d File Permit No. V Tax Map No. /d3 I / 1 y2_3 JJ �p �`°� Owner's Name: 7'n,v, r ICe!/v l2e e�kceycF ` 't / aid :....................................................................._.............._._..._................. ......................: Address: /5- $-h er,vtas" /:Iwe p�q'y�f�g$pAUG 1�yy2 2002py +{ p O{{ N OF QU �i-4 SBUR 6 2. INSTALLER'S NAME BU1L-D1('E( E NO. 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 gallbdrm = 1991 —present 3 x 110 gallbdrm = 3 3D Garbage Grinder Installed yes_ I no ?c Spa or Whirlpool Installed yes_ I no _.^ 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) Topography Ground Water Bedrock or Impervious Material Domestic Water SuRply sand at what depth at what depth unicipal Rolli oam feet feet well Steep slope clay if well;water supply %slope other �L1 .. from any septic-system depth: absorption is O ft. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inc 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: fjjW gallon (min. size 1,000 gal.) Tile Field: each trench ft. Total System Length: f fF6 ft. Seepage Pit(s): number of size ofeach: ft. by ft. Size of Stone to be used: # / depth or thickness feet Bed System Size: x Alternative System: length andlor size 6. HOLDING TANK SYSTEM: (if required) Number oftanks: I Size of each: gallons I 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. � 7-a fr-d L tgnature of responsible person Date ' '1'<�«%n of t�tscci►attui-y Sewers A1111 sewalte Disposal Cipipfer Alllwtttlix C AI3ti0Iti"I'10N. PI FAAJ � S rftN r.M Pont)• L _ i^!I+I.l._ tN jI/ITF.-R- Wr1 LS'n•! . i �. :�'.`�� /�' tom►sr-.. 7. SIGNATURE &INFORMATION FOR KhSFUfvutni.r-r-r—w— wavoo. Fire Marshal's Office Town of Queensbury,742.Bay Road,Queensbury,NY (518)761-8205 Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances r-Z— Date 20 Permit No. App�cation is hereby made to the Building& Codes Office for the issuance of a Building and Use Pertnitpursua'nt-io the New York State fire Prevention and Building Cod(,'. 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_ NOTEto applicant: Rough-in and Final Inspections are required. Applicant Information Fuel Burning Appliance Information (circle appropriate words) Stove: wood coal pellet gas x Name: "y Fireplace insert Address: X Fireplace, factory built: gas Fireplace, masonry: wood gas Furnace: wood gas oil Phone: Y" If non-masonary applicance,please provide O Manufacturer Name: wner: (mil V Address: Model Number: D A Chimney Information Phone: (circle appropriate words) Masonry block-Z brick stone Flue the /I st el size: inches Exact Address: I % of construction or insiallatiou Factory-Built Manufacturer name: Model Number: Note: Listed By: Number: Construction lInstd1lation must conforin to NYS Fire Prevention &Building Indicate(circle) chimney material: Code. Consult available Town of Queensbury Handouts regarding required inspections, Double wall / Triple wall it Insulated Direct venting Chimney Liner Fire Marshal Code# $Collected $Re ended Receive(61'17Z (refwlded to): address: A 173 3389 (190) Public Safety '4 A 233 2655 (230) inor Sales DA TE: White(Applicant) Green(Fire Marshal) Yellow(Bldg.Dept.) 1 Pink&Goldenrod(Cashier's Dept.) i x z H w U 0 �OAn z W H Mao wwa zi aw �z a u o W H "� z W O Na U W 14U H L� v t A °,�' I tz W H z hm � I a Vi 30 0 � off al w x v, 2 W U A w 1� A rUi 0 a w z tx a U N w H H �" w N 0 Q a A w w w w A N a a N cn UJ H U ' H 0 q x F H w a rn 4 0 w 4 a 0 w x � 4 z 0 E A N O a H Q H H U H 4 a 0 0 , d w w W r4 a 4 M 0 A 4 4 U 4 H H a F z z z W H z 0 W U 4 W q 9 � U U = w H > F w w t� x rn a p A A > w w w f + lz q > � 0 z N 0 w H 0 w w w W w U� > n a 0 q 9' 0 H N N a H a s w z [G N N z WH Y H 0 0 a s A N 44 z 0 �. 0 H >+ z 0 Ol 0 H 0 0 w 0 0 0 E 9 4 w0 w H w H ' H 0 z9 w H Z H z �4 d H A A z A A N 0 U U U G+ > H Ha z LQ H w a A x x H W H H H a 0 H w w ca w E q W w H H 0 z w U w w a w H :� H A A A w 4 E� c� H z U H 0w H A 0 H g O A E 0 H H H 4 z z z Z x ' A z A M U N a w x x, 0 W 14 � c4 w wl N x N 0 " IPF MAP REFERENCES: MAP MADE FOR DONALD L. & ANNE L. BETTERS DATED FEBRUARY 14, 1983 BY VAN DUSEN & STEVES MAP MADE FOR ROBERT & ERICA PRITCHARD DATED NOVEMBER 28, 1990 BY VAN DUSEN & STEVES Rl • • LANDS N/F OF / SEYMOR 1481°40 50'E �j / N 1008.261 0 LANDS N/F OF SMITH AREA .._�, 2 STORY 4r 217,949 sq.ft. WOOD FRAME o 5.00 acres HOUSE g1REaj� ��ERttEN� 1157.96' S87022'00'W LANDS N/F OF EGGLESTON IPF . ;t� Of NEW;.:. Iq a� Dusel ^ /]V[`/`A/ S t e ve S Land SurveTO yors , LLC 169 Haviland Road Queensbury, New York 12804 (518) 792-8474 New York Lie. No. 50135 E0 ALTERATION S RVEYADDITION .S A SURVEY MAP NM BEARING S LICENSED 72 ll1ND SURVEYORS SEAL IS A NO1A710N OF SECTION 740Y, 4�-pNSION 2. OF fl# NEW YM STATE EDUCATION LAW.' 'MY COrIH rRCM THE ORIGINAL Or""MY MA. NT11N AN ORIGINAL Cr TIN: LAW MXV&M �SHALL BECDN�ED�BEYA�TRUE `GP� d7NlNlCA1NNK NNOCATED HEREON SkMFY THAT TINS SURVEY WAS PREPARED H ACCORDANCE WITH THE EXISTING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED LA THE NEW YORORS. AO C A�'"n� � PROFESSIONAL LAND SURVEYORS. SAq CERTIFICATIONS SHALL RUN ONLY THE PERSON FOR 040M THE SURVEY IS PREPARED. AND ON HIS BEHALF THE COMPANY. GOVERNMENTAL AGENCY AM LEN M NNSTnuTION LISTED SON, AND MimAMONMCrTMEL&MMOaTlnnaN.' Map of a Survey made for THOMAS M. & KELLY L. REUKAUF Town of Queensbury, Warren County, New York ate A Y , 1002 Scale 1'=100' S-1 /� SHEET OP 1 REUKAUF C-618 DWG. NO. 0128G NO. DATE DESCRIPTION CV I N 123-1-42.3/307-1-9 At �1A RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept,of Community Development Arrive�L am/ epart I ai pm Town of Queensbury ector's Initia 742 Bay Road Queensbury,New York 12804 NAME P # `�L�—�oj� LOCATION DATE 3--3 —rp,3�_ TYPE OF STRUCTURE N/A YES NO COACOENTS Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30"to 36" Exterior Handrails,balconies,lauding 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 shutoff 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/doorstmain 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 1 Bathroom fans Plumbing fixtures _t 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 roan Electrical Site PlainlVanance 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) COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INCi fain Office 176 Doe Run Road - Manheim, PA 17545 MUNICIPAL CERTIFICATE P. ELECTRICAL APPROVAL Crut-iad ert1 No.Permit Not ,H#+ff,Iif,,,,,,i#Niuf„##,ialiilii �j lf,lilIli.ifplliiiiffrf.Igiififrlflll,Mflfl}iq„1NIYiffi fffliilN,1/1#„!„Mini1lfflNU 79517 1. ffll*"# ', i� 1IM#fi! iiiifff.i,Hr„1#i/i owner$406010141--40010 � 5 � ,it,uli11M1ei/fillpu,ilgrffalllu!lr,11,,.,l.f#Ifffff#f.sf IH„fl11/Ifui//r# a ILI Locationi,iii##„r,i#i#ff.ff.Iili,..rf#gp,f„ ii#ti,ii##„ffpf#H,fff. I,r.,,If„ J(! 1 I {r f ifrl +flirffl/IffrNlNur1111la/�iuffl•Ifff.fillllNfl.gll Installation onating of f..If/II,Iffi,.Nlifr,fil,fiilffl.lii�if ff/ 11/ � 0�00 i1N.0 II.ffN1#i11lf.1/I Iifflwtaoof ffllfl,i,/lllfl.If,uflf/fpff,l.il.,1 �! 111il1i fi/1.1lii1flill l,.1ifflifolloole f/!# f/fu/iHfi!/ll.ilil11i1fi 1/Nl.i HN f *„*too al„I , ,il,M#Itaflff.lth ells,f.If/fffrll.Mi.i##Of off►/fffll�fff,.ilfffff/11.fl.11floose Nlf,f,.111{ serf.Ill,ial, l#,iifl,l,#ffuiffi, raariii # ,/� Ntf�'f 111 ili if l.f#fllffrrlf Ulf i,ffl,i.l,iHIp1Y.N.ff.,Lice •1 V# f.,#i!f}!#IiifNiif,if.IfiN,rl1##f,}„f iiifff ifi. Installed Byloolool.ot'felf f governed the issuance of this certificate, and any certificate previously issued is The conditions following cancelled: - lectricalequipment and installation conditions as of date, Upon tht This certificate only covers the e ' additional equipment or alterations, application shall be promptly made for inspection. introduction of addpp ' hall have the rivile a of rria ' inspections at any time, and if it Inspectors of this Company s p g rules are violated the Company shall have the right r oke rtificate. py i - i Datel�Iflrlf,111NlIp ifffif„f!fl.,fi#.#ifHffflllN INSPECTOR iil ff4!lflff,•1.1 'f feelffli#iIIl,!lIIllffqlNlff„f,11lff.11„,f/#!f!f/fiYiff.ff„/Nlf.l Member N E.P.Ai, IIA.E/I/ Town of Queensbury £- Fire Marshal's Office 742 Ray Road Queensbury, NY 12804 Phone (518) 761-8205 Fax(518)745-4437 Fire Marshal's Inspection Report � Request SCHEDULE Received: Permit# 20C)Z.—(dS7 INSPECTION ON: 7, Z —UU22 Name: 9,1= -'�O AM M ANYTIME Location: T1�T 1�1 L fl APPROVED N fA YES NO COMMENTS EXITS AISLE WIDTHS EXIT SIGNS-NORMAL - BATTERY EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE COMPRESSED GAS CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS CLEARANCE TO ELECTRICAL REQUIRED SIGNAGE EMERGENCY PLAN MAXIMUM OCCUPANCY SIGN CHIMNEY MASONRY ROUGHIN FINAL CHIMNEY FACTORY BUILT ROUGH IN FINAL WOOD STOVE ROUGHIN FINAL VENTED GAS APPLIANCE ROUGHIN FINAL FIREPLACE MASONRY ROUGHIN OK THIS E K C NOT OK FINAL FIREPLACE FACTORY BUILT ROUGHIN INS C ED FINAL COMDEVICHRISJ/WORDILETTERS20011FIREMARS LINSPECTIONREPORT11 001 WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept.of Community Development Arrive epart Town of Queensbury ector's Ini .,r. 742 Bay Road Queensbury,New York 12804 . t NAME # �7 LOCATION t �'� t DATE 7— ""7 TYPE OF STRUCTURE ? �F= N/A YES NO COMIVIE'NTS Chimney HeightP lY'Vent/Direct Vent Location VA 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 fumace area FurnacelHot 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 Bathraom/Mtchen watertight Interior across ils ow inistairw stairwells 1$in.or more ` 1� Railing across window in stairwells `�— Smoke Detectors: every level every bedroom �� /fie outside every bedroom inter connected Bathroom fans Plumbing fixtures VtJ 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/Variarice 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) 0 oc� RESIDENTIAL FINAL INSPECTION REPORT � TAJ Office No.(518)761-8256 Date inspection request receivedOK4y r`. Building&Code Enforcement F Dept.of Community Development Arrive m/pm De'a Town of Queensbury Inspector'sIniti 742 Bay Road Queensbury,New York'12804 / NAME PF1LVa L# _ t LOCATION K'�a T OM411 L. Rnp D DATE — /- O TYPE OF STRUCTUIM N/A YES NO CO NTS Chimney HeightrU'Vent/Direct Vent Location it Fresh Air Intake - Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30"to 36" '\M "� dL`�F\ tJ l`�EiJ Exterior Handrails,balconies,landing 18 in.or more Interior Handrails stairs both sides 3 or more risers Gin Grade 2%away from foundation ` 8"clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade I Gas Furnace shut-off within 30 feet or within line of site 76 t� 1 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. �1 Handrail exterior stairs both sides more than 3 risers Interior privacy/trim/doors/main entrance 36" ��\�c� � •�\� Floor Finish BathroomMtchen watertight Interior Handrails Balconies/Landing 18 in.or more Railing across window in stairwells Smoke Detectors. 5� � every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures _-- Foundation insulation (� �- 3/4 hour fire door/door closer Garage fireproofin Garage penetrations sealed p Furnace in separate room protected(in garage) Light ventilation per room , Safety glazing 18"or less from floor Final Electrical Site Plan/Variance required J � Final Survey Plot Plan `- As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) Q Okay to issue temp.C/O(Certif,of Occupancy) Okay to issue permanent C/O(Certif.of Occupancy) b TOWN OF QUEENSBURY FINAL INSPECTION CERTIFICATE PROPERTY TAX MAP NO. Bob Hayes Excavating PO Box M6 D-Box 105'from Well Lake Luzerne, NY 12846 Well Septic Tank 64'from Well (518)696-7176 Main Structure 18'6' 21«6«r Porch 1000 Ga 5116" 47'6t' 4 X 50'Runs Permit No.P20020687 Thomas&Kelly Reukauf Tuthill Road Queensbury, NY The above sketch shows the locations of the units comprising your sewage disposal System for future reference in case of difficulty. It shows measured distances from Buildings,trees,garage,fence posts,etc., to the components of your sewage disposal System. Constructed by: Bob Hayes Excavating Date Installed:February 25,2003 1 Design Basis 1. Number of Bedrooms 5. Septic Tank Type: 1000 Gal. 2. Daily flow: - GPD 6. Size of Leaching Device: 4 X 50' Leach Lines '3. Undisturbed soil depths: 7. Type of System: (Conventional, A. To Groundwater: fill,etc: B. To Impervious Lens: 4. Percolation Rate: MINAN Approved By: Date: 1 0 (D 0 0 0-0 -r- a W .a. a+(D 0 CC 0 0 a 0 a n :io c c n (D lA :3 A. O a N N 'S :5 a ar 4 'S >-h a 5 :5 )1 :3 r} r(a IM z (D `o(D c+(3 Q rn c r (D a (D �► T ' jct0 �0 1 0.a (D > :rrfi ;S a 0 � M 0) a A) N 0 0 0 zoo 0v rh J' � C 11 rr rF C+ V 0� 0 r� VI. m`h 0.,,t, � Ut 0 w t� ,l %J ;o0 0 0 0 %ill x 0 N Vt o o m I Q � ra t' 0 �+ C+ To 0 rho � oz m � �� all � � I �, � � Q (D a -h z (D rr 0 a in -1 roc a� 0 a (D as ' 0 n m o ,+ (+ V) -h - -, I 1< 00 a m (D (D m �' m 0 rt (+ �F a lF'IF:Za M^F:;Zc3"^L- -r4CDWN OF ClUIHElNSE3UF;Z"lr -(:;lUE-=aN5SE3Uf::;."lr, N)r 1280 (518) 761-820C 5 FIRE MARSHAL INSPECTION R REQUEST RECEIVED NAME LOCATION 715-2-5, PERMIT # SCHEDULE INSPECTION ON — F 2�2 c:>4 M APPRO(%*E� 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 SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAOE CHIMNEY WOOD STOVE FIREPLA��; [—I MASONRY V?l'FACTORY BLT. ROUGH-IN FINAL REMARKS: 0 C:)K TO THIS DATE Jr 77 tl �44 INSPSLIP.PUB INSPECTOR Septic Inspection Report 100) Office No. (518)761-8256 Date Inspection request re ed- Queensbury Building&Code Enforcement Arrive: JfDb a a 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: RMIT NO.: LOCATION- 3 INSPECT ON: RECHECK: Comments and/or diagram Soil Typq:'—Sand = am/Clay , Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance W7 ft. Comments and/or diagram 6 Other wells: Absorption Field: Total length Length of each trench ft. Depth of trenches - ft. Size of Stone Seepage Pits: Number Size: ---x— Stone Size: Piping Size Type Building to tank �All AC-IA-1A0 Tank to Distribution Box LA 1% 9�C Distribution Box!%Field Pit !Awl NN C- Opening Sealed:C)V-N7 Partial Location/Separations Foundation to tank ft. Foundation to absorption. ft. Separation of Pits & Conforms as per Plot Plan Y VN Location of System on Property: (Gj�Rear ( eft 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 Town of Queensbury Fire Marshal's Office 742 Bay Road Queensbury, NY 12804 Phone(518)761-8205 Fax(518) 745-4437 Fire Marshal's Inspection Report Request `7 SCHEDULE Received: Permit l INSPECTION ON: c�� Name: Alit! P /ANYTIME Location: APPROVED N/A YES NO COMMENTS EXITS AISLE WIDTHS EXIT SIGNS-NORMAL - BATTERY EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE COMPRESSED GAS CLEARANCE TO SPRINKLERS CLEARANCE TO HEATING UNITS CLEARANCE TO ELECTRICAL REQUIRED SIGNAGE EMERGENCY PLAN MAXIMUM OCCUPANCY SIGN CHIMNEY MASONRY ROUGHIN FINAL _ CHIMNEY FACTORY BUILT ROUGHIN FINAL Z 7 �'C��J�1 C� I WOOD STOVE G- ROUGHIN VENTED GAS FINAL APPLIANCE ROUGH IN FINAL FIREPLACE MASONRY ROUGH IN OK THIS D OR CO NOT OK FINAL FIREPLACE Locov A . FACTORY BUILT ROUGHIN INSPECTED /13 FINAL COMDEV/CHRISJ/WORD/LETTERS2004/FIREMARS ALINSPECTIONREPORT1102 1 WHITE-BUILDING DEPARTMENT COPY YEL OW-OCCUPANT COPY Office Use .GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time., Dept. of Community)Development Request received; Meet: Building& Code Enforcement At time: 742 Bay Road Notes-, Queensburj; AY 12804 ARRIVE am/pm: DEPART amlpm (518) 761-8256 Inspector's Initials NAME: e�)k rA PERMIT WCA INSPECT ON(date): TQ. LA TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS FootingsMiers 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 -FoundationfWallpour Reinforcement in Place Foundation/Dunpproofing_ Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing_ Heati Rough-in I at ion IV- Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls It- 1c, F j. 1,-A- 1234, 0�:- Ceiling R- 30 C,14,1,1 Duct work or piping in I, unheated spaces R- &lie- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/BridgingJoist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping_ L:\SueHemitigway\Building.Codes.Inspecdon.FORMSkGENERAL INSPECTION REPORT-doc 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 31,t)am/pm Depart am/pm k"A Inspector"s Initials NAME: L, PERMIT# 6 LOCATION: 33 TaX,7142c DATE TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Under Slab Plumbing VentlVents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- f Foundation Walls Exterior R- Floors R Walls R- A Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framin Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping Office Use GENERAL INSPECTION REPORT Inspector: 7;1�0 Town of Queensbuty Ready attime: Ck'-c—'-0 Dept. of Community Development Request received: Meet: Building& Code Enforcement At time: 742 Bay Road Notes: Queensbury, AT 12804 ARRIVEa I I I'Na DEP iti (518) 761-8256 Inspector's 11niti MIT;V —7 -Q r-,7 NAME: PERMIT# 7—Q C, (n LOCATION: MMM VA— gM A� INSPECT ON(date): �7-:—\S-67- TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab— V tmP bing Vent/Vents in Place ulzgh Plumbing t-\ Heating Rough-In Insulation Foundation Walls Interior R- C' Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent --Vol gaming ' ", Jack Studs/kea—derl Bracing/Bridging Joist Hangers 2'n Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed rnre Wall 2,3,4 hour V/Firestoppin Eli V L-.\SueHemingway\]3uilding.Codes.Inspection.FORrvfS\GENERAL INSPECTION REPORT.doc -_7� �� Office Use GENERAL PE TI %P T // Inspector: Town of Queensbury Ready at time: 2: Dept. of Community Development Request received. Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE?, a pr . E A am6!_n otes: (518) 761-8256 Inspector's Initi ►s NAME: PERMIT#_:ZbD 7 -.� LOCATION: �< �. INSPECT ON(date): j t-7js7p TYPE OF STRUCTURE: EQ _kN f 2— 0—CA R 2,f R RECHECK I N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/D ampproofmg Backfill Approval lumbing Under Slab lumbing VentlVents in Place ✓RoughPlumbing � Heating Rough-In Insulation F�J Foundation Walls Interior R- Foundation Walls Exterior R- Floors R Walls R- Ceiling R- Duct work or piping in unheated spaces R- roper Vent Attic Vent Framing_ Jack Studs/Headers Bracing/Bridging Joist Hangers Jack PostslMain Beam Air Infiltration Barrier ire Separation 1,2,3,hour Vt Penetration Sealed /Fire Wall 2,3,4 hour V Firestoppin ao Tlp L:ISueHemingway�Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at ' e Dept. of Community Development Request received: b 16,�— Meet: Building& Code Enforcement / At time: 742 Bay Road` Queensbury,NY 12804 ARRIVE am/pm: DEPAR am/pm Notes: (518) 761-8256 nn Inspector's Iaait'als NAME: �rtS� r PERMIT4 �- � r LOCATION: �J.Xah INSPECT ON(date):40 TYPE OF STRUCTURE: --� RECHECK N/A YE O COMMENTS Monolithic Pour Form Reinforcement in Place The contractor is responsible lor 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/Dampproofmg Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration.Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:ISueHemingway\Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doe ✓~ Office Use G� ob GENERAL INSPE ON REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received. Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE(, ID am/p D AR �: a Notes: (518) 761-8256 Inspector's Initi NAME: _ ��I 1Y,PsI y PERMIT#_oa7 LOCATION: I i.A_ RhEND INSPECT ON(date): Z�=_OZ— TYPE OF STRUCTURE: RECHECK N/A YEV,NO COMMENTS Footings 'ers Z X i l _ ithic 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 enforcement in Place oundation/Dampproofing Backfill Approval Plumbing Under Slab lambing Vent/Vents in Place ough Plumbing ' �rleating Rough-In {� Insulation a' Foundation Walls Interior R- , Foundation Walls Exterior R- Floors $tbFtA�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:1.SueHemingway\Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc Office Use GENERAL MSPECTION REPORT Inspector:-�E Town of Queensbury Ready at time: Dept. of Community Development Request received: Meet: Building& Code Enforcement At time: 742 Bay Road Queensbury, AT 12804 ARRIV Notes: E(518) 761-8256 Inspector's In ia NAME: PERMIT# LOCATION: I AN U— RD-RD INSPECT ON(date): TYPE OF STRUCTURE: c6 n RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour K Reinforcement in Place Foundation/Dampproofin Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing C>t3 Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping mi unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridgmig— Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Scaled Fire Wall 2,3,4 hour Firestopping_ L.\SueHemingway\Building.Codes.Inspeefion.FORMS\GENERAL INSPECTION REPORT.doe Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury Ready at time: Dept. of Community Development Request received: 2— Meet: Building& Code Enforcement At time: 742 Bay Road Z Queensburj; AT 12804 ARRIVE am/pm: .DEPART am/pm Notes: (518) 761-8256 Inspector's Initial Ay- NAME: PERMIT# G' I LOCATION: 1 v! �� U'`-�I INSPECT ON(date): ?A6 67- TYPE OF STRUCTURE: RECHECK MAI YE NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place J The contractor is responsible for providing protection from freezing / r for 48 hours following the placement V of the concrete. Materials for this purpose on site Foundation/Wallpour _ Reinforcement in Place _ Foundation/Dampproofrng Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent,Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping L:\SueHemingway\Building.Codes.Inspection.FORMStGENERAL INSPECTION REPORT.doe "S 0 Q 0 fD 0 0 O"o �+, a N(+ M N a sit N� "S+ C C C�(D CL wO 0 N N -0 to : � c} N "4.a o Z(D (D > :r f+ r' ID a (� rt � � I m o so 0,0 rf r. 0 C+ �M �r � 11 N Q Q .ar "f1 0 tom# �./ T 0) 0 C�' Z 04 (D Ql Cr � .o Y 0rM �7 ID c� 0 ro IU rF I� Spa � 1 0 � '� � I�;1 r c (D C M N C I tD c+ to I ct 0 t a rorom e+ 0 Z O (D (D -J. 0 (+ f �