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2000-247 TOWN OF-QUEENSBURY .742 Bay Road, ueensb ,NY 12804-5902 518)761-8201 Q � Community Development-Building.& Codes (518)761-8256 'CERTIFICA'TE,OF OCCUPANCY C/O Number-: 10000247 CIO Date: Tuesday, August 29, 2000 Application Number: 2000241 Permit Number: 2000247 This is to certify that work requested to be done as shown by Permit Number 2000247 has been completed. This structure may be occupied as a Single Family Dwelling. Tax Map Number: 523400*-048-000-0007-012-000-0000 Location: �j BERRY PATCH Dr Owner: CERRONE BUILDERS, INC. By,Order of Town Board TOWN OF QUEENSBURY Director of tdilding&Code En orcement BUI--LDING PERMIT Town of Queensbury,742 Bay Road, Queensbury,NY 12804 County of Warren (518) 761-8256 VALUE $ 180000 Building Permit No. 2000247 TAX MAP NO. 48 . -7-12 Permission is herebyCERRONE BUILDERS, INC. granted to Owner of property located at LOT 12 BAY RD. in the Town of Queensbury,to constructor 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 NYS Uniform.Building Codes and the Queensbury Zoning Ordinance. Owner's Address: 66 SUNSET TRAIL .QUEENSBURY, NY 12804 - Contractor or Builder's Name: CERRONE BUILDERS Contractor or Builder's Address: 66 SUNSET TRAIL QUEENSBUP,Y, NEW YORK 12804 . Electrical Inspection Agency: COMMONWEALTH ELECTRICAL AGENCY PO BOX 706 HAGUE, NY 12836 Type of Construction: SINGLE FAMILY DWELLING Plans and Specifications: 1818 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS Proposed Use: SINGLE FAMILY DWELLING 251 May 9 2002 $ PERMIT FEE PAID—TES PERMIT EXPIRES (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 T of Queensbury this 9 Day of May 2000 SIGNED BY— for the Town of Queensbury o Enforcement Officer Building . .Peimit Application Town of QGLGensbltl y - Dept. of Comintinity Development, 742 Bay Rocid, Queensbury, NY 12804 j761-8256J' B UIL'DfNG & .G'ODE .ENFORCEMENT NOTICE Requirements prior to issuance f . A•permit must be obtained before of this permit: PERMIT FILE beginning construction. No'inspections PERMIT FEE PAILQ$ will be made until applicant has received 0 Zoning Board Action a VAI,ip BUILDING PERMIT. All Area /Use RECREATION FIE AI' applicants' spaces-on this application MUST be completed-and.the signature - Pkmnin Board Action c.!'. � 0 S REVIEWED BY.• of the applicant must appear on the SPR / subdivision /Other nftaing Inspector _ pplication-form. Recreation Fee Payment Applicant: !J Owner: Address: d i! Address: Phone # tJ 1 _),L -z"aa Phone # ----- -=-- - ' ------- Property Location: Subdivision Name: Tax Map Number -� I _ Section Block Tot NATURE OF PROPOSED 'WORK:. ESTIMATED MARKET VA i '' OF THE r� New B d�dn CONSTRUCTION: $ ,& res % commercial Additionilding.: residence / commercial OCCUPANCY INFORMATION: Alteration to Building: Pr ary Building' - €erg residence / commercial ✓ Single. Family DwellIng� "�'- " � L�' Residence / Commercial Two Family. Dwelling no change to exterior- size Family DwellincAPR 2 6 2000 office Other Work (describe below) Mercantile T01,,V,0FC?iIL-=i=i`,t3-,U ) Manufacturing BL1_1L0i1`13 ANO Cr other GROSS AREA OF PROPOSED STRUCTURE J � 1st Floor. . . . . . . sq. ft. � If ADDITION, what will use of new addition be? : 2nd .Floor.. . . . sq. ft Other Floors. . ... . q. ft (not unfinished cellar. or ba MeQ ACCESSORY BUILDINGS: DetachedGarage 1, 2. car TOTAL FLOOR AREA: / S T. Attached Garage 1, ca Private Storage Building SIZE OF NEW STRUCTURE: Commercial Storage Building FEET X / FEET Other Foundation Type: -ll/LPsL:.. [j, s�T.- Will- any second-hand or ungraded Number of Stories: ,.lumber be., usecl?��If so, for what? (habitable space only) Height (grade to ridge} : 2 feet TYPE OF HEATING SYSTEM: Number of fireplaces and/or woodstove (circle all which._a lies) to be installed: _/ j Gas / Wood Forced Hat Air j aseboard / Other Person responsible. r perv,ision of work as regards to building codes i s : y:! %%_�{ Name Addre ae Builder: Plumber: Mason: i ✓r ,' Z__ Electrician: DECLARATION• Please sign below after-you have curefidly read the statement. To the best of my knowledge the statements contained in this application,.together with the plans and specifications submitted, area 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 I/we shall submit prior to a Certificate of Occupancy"or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by a licensed surveyor; wn to'5evle, showing actual location of project on premises. Signature: (owner, owner's-agent, architect, contractor) ENERGY ,CODE.COMPLIANCE -APPLICATION TOWN OF QUEENS BURY,. WARREN COUNTY- . . - . - 9040- HEATING DEGREE DAYS Coinr)li ' nce .Methods PART .5 -- Acceptable Pract rice' Methoc'Pjj, I -1&2 � Fam'�ily Dwellings,.(only" s� �`C?� ^ a DIP PART: 6* Thermal Rating - Component :Trad`e'}Off§3�" 1&2 Family,.Dwellings; Multi-Fami].y_`� 4 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:, ' PART 5 METHOD OF COMPLIANCE BY 'ACCEPTABLE PRACTICE: 1. Gross Floor Area - square feet -2 .. Tvoe of Heat �,t, Electric Oil Gas' .r�. Other 3 . . -Is building mechanically-" cooled? Yes No a, Percentage of :area,of w,indovws . and. doors Over 175 1 ' Under 17% 5. R-VALUES FOR INSUTATTON GIVEN. BELOW MUST, CORRESPOND TO R-VAILUES 'AS S HOWNr ON PLANS SUBMITTED a . Roof R,. V b.. Exterior.- walls R. C-. Glazed .areas R d . 'Exterior doors R 42 e . Floors, over unheated' spaces R Edge .of slab on :grace (heated building} R a. Basement/cellar, walls. (above grade)" R' h . Basement/cellar walls ,('below '-grade) R'. i , Heating/cool ing-ducts-piping in unheated space R 6 . Service, (domes-ic) hot water heating device .Conforms to min-imum efficiency per code Yes i No TEMPERATURE CONTROL MAXIMUM SETTING 1400 WILL -NOT B,E .EXCEEDED Ap _ aal , Signature �a ie Phone NU.710eer ' T NSP=C OR' S REMARKS Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Dept. of Community Development Permit No. ( L� Building &Codes Office 742 Bay Road Fee Paid Queensbury, NY 12804 Location of property for installation: P� Property Owner's Name: Property Owner's Mailing Address: .�- Installer's Name: � - Phone ## Number of bedrooms (if residential): Total daily flow: oo / (residential - compute rt7i 150 gal./bdrm.) Topography: ✓ fl-at, rolling, steep slope 5r of slope Soil Nature: sand, ! Ioa , clay; other /depth: Ground water: at what depth? feet / Bedrock or Lppervious Material: at what depth. feet Percolation test: not required, :S required [rate6-�Z min. per inch Domestic water supply: municipal, ✓' well, other If domestic water supply is a WELL, water supply from any septic absorption is feet, PROPOSED SYSTEM Septic /� gallon (minimum size: 1,000 gal.) Tile field: each trench �570 feet / Total system Iength: Wak eet Seepage pit(s): number of / size each: . ft. by $. 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 vva&- to t e inspected by a certified agency. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Qwensbury, any permit or approval granted which is based upon or is granted in reliance upon any material miarepresn or failure to mike a material fact or circumstance koovn by or on behalf of an applicant, shall be void. I have readd the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal t� Signature of responsible person: Date: T TOWN OF QUEENSBURY, 742 Bay Rd.,'Queenibury,'NY 12804 j APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS t _ Permit Date Nar- ,19 APPI ICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York_State;Fire Prevention and Building Code, The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. Please fill out'additional form if more than one appliance and/or chimney. Applicant 4 ors APPLIANCE (check appropriate boxes) Address , O STOVE: ❑Wood ❑ Coal ❑ Pellet ❑ Gas 0 FIREPLACE INSERT Zip v ®' FIREPLACE, FACTORY-BUILT: ,. o Wood d'Gas. Phone ❑ FIREPLACE, MASONRY: — ❑ Wood ® Gas Owner E' FURNACE: ❑ Wood if Gas a Oil Address IF NON-MASONRY APPLIANCE: Manufacturer: Zip Model: Phone CHIMNEY (;check appropriate boxes) *EXACT ADDRESS of proposed construction s 0 MASONRY: ❑ Block ❑ B:rick ❑ Stone FLUE: ❑ Tile ❑ Steel Size: inches CONSTRUCTION / INSTALLATION MUST El FACTORY-BUIL CONFORM TO NYS FIRE PREVENTION & Manufacturer r . Model BUILDING CODE. CONSULT AVAILABLE Fisted By: . Number: TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall . 13Triple Wall ' REGARDING.REQUIRED INSPECTIONS. 0 Insulated °Direct Venting ❑ Chimney Liner Cashier's Department Town of Queensbury, New York Dept: Fire Marsh;at Amount Collected Amount Refunded Code Number Title A 173 3389 ,(190) Public Safety A 233 26.55' (2,30) Minor Sales . a A, ii Fee Collecte'd''From" or Refunded to �,p 1,\_.c- Address: 1.> Dated: ""t ` '"" Town Clerk or Deputy: l White: Applicant Green: Fire Marshal Yellow .Bldg. Dept. Pink c& Goldenrod: Cashier's Dept. T LUIVINUIN HAL1 ti ULLIKILAL ONL IVII 0W ILLI 11ILl Main Office 176 Igoe Run Road Of Manheim, PA 17545 Poo PZ MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Panel Board No.tffoMl Hfllf}}++#1MMtf/tit ^=1 Cut-in Card Not i11fq}Ht}}}tt1/It1111t}!/fEtN}I}i Sm- 34 0 Owner,,,,,, }IttlRYt tttRtlf}i/ii}Nttttt111}ti+}}f 0.606#11 Mfiletti} Hu/ttRRN+N!++{t!l11ttltltllltllklllttitf}tf1}flRlft111 61W } :...�_ oton#M###t.t "lot, NfM#1R1f#il}1o#N1/fo f}IMY YIiitfll Mt#Ifftf{tftitf###fIf1MIfNRtloiMtIM11Yi#1tIftM1'f#Rt#it#M#f IIN##1fi11tt}Y#1 .fuM#ltfffif llMt� i Rog q of 1 ,IMIIff g fllH}//o11t1##foflflMlIIRII+M fMIN#tRii#o/tYYiY#RRIMIR#YR#!R#{ttiflflM11M1it#IYRRN Install 10nConsisting q MMMt1 V� 111 }!} ttffi ft/ tifiY{fo1 1oi/11/tN1 f11tYIN/ 1##i P.... llfMf}+,of,iof /1#NM11flt#!H #ftlM1111N }j�*1}i1t/ttf*tlttftlff lflfttfi/i1f/}/Mliti}}I/tf/f}}fffl}111/}fit}I 1*41156I6MID#M!N#11 ooM M IIIof 1/ti1N1}}1f14M 1#Y4+++off Ito too 11t1/#1161M}11/too toll MIMoo1/f1###t#i#1#f}I to fllfi fif fitif/t,o iotlf IIto Ito I f l off m of Miit#61111MIftt Mf IN 5 j� eo + No. Installed By,,,,,,,,Itof�IMitMt4Not#lot iMiM/M}f11MMIMMM1iMt/!##f1/lf o o f o l f l of too i}MiMiM + f11f}t„oMN1fIf#tf111tYMIR#„IIIffMoftRY#fif#fi 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 thison� an shall have the privilege of �nakin ' spectior�s at any time, and if its p Company rules are violated, the Company shall have the righVtor voke th' . cerli sate+ Alk eveo INSPECTOR11 #fflMofllNoflMt{lf#f1MM11ft1}11l}Rf11fIMIf1t#IIIIMtfM1#f14##f1f 111#fooN,1 Member N.F}P#A}, LA El RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement Dept.of Community Development Arrive am/pm Depar --- Torun of Queensbury Inspector's Initials -,.-A 742 Bay Road Queensbury,New York 12804 NAME C14-g C PERMIT# LOCATION DATE TYPE OF STRUCTURE N/A YES NO CON EVIENTS Chimney HeightP'B"Vent/Direct Vent Location Fresh Air Intake%\,,)6` ( Plumb Vent through roof Roof Complete [✓���r/ Exterior Finish Complete InteriorlExterior Railings 30"to 36" erior Handrails,balconies,lauding 1$in. r more, Vinterior Handrails stairs both sides 3 or more 'sers l Grade 2%away from foundation 8"clearance to sill plate Gas Valve shut-off exposed/regulator 18"ab ve grad-b Gas Furnace shut-off within 30 feet or within me of ite Oil Furnace shut-off at entrankc to furnace ar Furnac&Hot Water Heater op in Relief Valve(s)installed I Headroom,6 ft.6 in.on stairs / Basement stairs,6 ft.4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/tFimJdoors/main entrance 3e" Floor Finish Bathroom/Kitchen watertight Interior Handrails BalconieslLanding 18 i.or more Railing across window in stairwells Smoke Detectors: 1 every level I every bedroom I outside every bedroom 1 inter connected Bathroom fans' / Plumbing fixtures Foundation insulation i 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 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) orov, roac� roroccncn � � ro a ron ,ro�m ►� arza ; x w w o } r M [ k X 0 r x wan z x0 ana © 00mz g0CH zGoroyn' n r r 0 a � � � x x �3 � � > t� � H � ro n �q w 0 w n ' ro w z w z 0 H w w �nr r azaun ova O00z N 0 z ua r 0 14 w X m r x ro 0 rr�n z yy N w 0 M r x n xC w a nt� z ro � rr 0 q 0 ro C � n H > n 0 0 n 0 w U} z H O w [ n k ro x 2 0 n a x %to w x wzro n rown x � ncnr� zyy , w t� C n 00 " rod nro w x �H 10 a CH ,n n z 0 z z t� � H m r � y z b x n 0 � c H 0 0p � a z x ©q gzro - c� c�x t� +� G� M. I w q 00 iy o x 0 pp 3 00 n .r o� c Hx N kC vi ONH rn G I pp ► Pmz yy N az� rorr i� Nd0[ MP H H a � to w > z z 1, 0 MAP REFERENCE: SURREY FIELD SUBDIVISION MODIFICATION TO AN APPROVED SUBDIVISION DATED: OCTOBER 27, 1998 BY: VAN DUSEN & STEVES LAND SURVEYORS, LLC � an Du s e Stever Land Surveyors, LC 169 Haviland Road Queensbury, New York 12801 '518) 792-8474 New York Lic. No. 50135 �vo S?8� 7A04„e 105.00A 8 9744.07 sq ft 30.9• 0 Ri 14AS s r UG 0 8 2000 7 w N 6 t A; 1 A 'UNAU7HORIAENSIEDLALTERATION OR ADDITION TO A SURVEY Map of a Survey made for NAP BEAPoNO A LICENSED LAND SURVEYORS SEAL IS A VIOLATION OF SECTION 7209. SUS-DMCOI 7. OF THE NEW TORN STATE EDUCATION LAW •ONLY COPIES FEW THE DPoOINL OF THIS SURVEY NARIOD WTIN AN ORIGINAL OF THE LAND SURVEYORS PIES TEAL SHALL BE CONSIDERED TO VALID TRUE CO• TWI LLIAM B . & SAN D RA R . L4 N GW 4 RT H CERTIFICATIONS INDICATED NUMM 5N00" THAT THIS SURVEY WAS PREPARED IN ACCORDANCE VMiH THE AS FTING DOPE OF PRACTICE FOR LAID SURVEYORS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS SAID CEATP'ICATIONS SHALL RUN ONLY TO THE PERSON FOR UM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLE COMPANY, OOVERNME NTAL TO THE AND LENDING ITHE LENDING LISTED HEREON, AND Town of Queensbury, Warren County New York TO THE ASSWEES of THE LENDING INSTITUTION.' T P NO. I DATE H.O.A. VILLAGE GREEN I HEREBY CERTIFY THAT THIS MAP WAS PREPARED FROM AN ACTUAL FIELD SURVEY. THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. CERTIFIED TO: William B. & Sandra R. Longworth Chicago Title Insurance Company Cohoes Savings Bank, its successors and/or assigns CERTIFIED BY.• — _ MATTHEW C. STEVES, LLS NYS 50135 DATED: July 26, 2000 DESCRIPTION Scale 1'=20' S --1 94W 1 OF 1 LONGWORTH DWG. NO. 97061-8 RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: Building&Code Enforcement a Dept.of Community Development Arrive am/pm Depart ` Town of Queensbury Inspector's Initials_ 742 Bay Road Queensbury,New York 12804 NAME PERMIT# LOCATION y DATE TYPE OF STRUCTURE !S�n N/A YE NO COMMENTS 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,landing 18 in.or more I r� Interior Handrails stairs both sides 3 or mo � - -� Grade 2%away from foundation 8"clearance to sill.plate Gas Valve shut-off exposed/regulato 18"above grade Gas Furnace shut-off within 30 feet o within line of site Oil Furnace shut-off at entrance to ce 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 th 3 risers_ _ ........._...._ Interior privacy/trim/doors/main entrance 3 " Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in.or re 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" ess fr m,�loor Final Electrical QUID// r Site PlanNariance r uir Final Survey Plot Plan As Built Septic System layout required Okay to issue C/C(Certif.of Compliance) Okay to issue temp.C/O(Certi£of Occupancy)_ Okay to issue permanent C/O(Certif.of Occupancy) GJ ! 1 s FIFZZF:= M^FNSH^L_ _FC>WN OF CkUI=_eN,3E3UF:;Z'*vo' (:;kUaar4,4SE3UF:Z'V% M`ir 12SO4 (51 S) 7e 1 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED NAME LOCATION MIT tg� SCHEDULE INSPECTION ON AMC PIVr-- APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM -FIRE SUPPRESSION SYST M 3 HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPRIt'LERS CLEARANCE TO HEAT[ , UNITS REQUIRED SK3NA4GE K CHIMNEY N %PAOOD STOVE V '-�FIREPLACE MASONRY FACTORY BLT. 1= UGH-IN FINAL REMARKS: E__l OK TO THIS [DATE llozie6cf INSPSLIP.PUB INSPECTOR F=IF--',F-= M^F;tZc3HAL- -F-C)WN C:)F= QtUE=—EiNS13LJF:Z,'-v-, NY 12804 %2Q (518) 7151-8205- FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED NAME LOCATION PERMIT # . SCHEDULE INSPECTION ON \ AM PM 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 SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNEY Wg,(2rD STOVE —Fl—REPLACE 1-1 MASONRY C� FlCCETORY BLT. EJ ROUGH—IN � FINAL REMARKS: OK TO THIS DATE INSPSLIP.PUB INSPECTOR -IrOWN IMF Q-U-C-ENSBURY BUILDING b CODE ENFORCEMENT 7 2 -- Bcx_y Rcipad Quo4--nt;buir_y MY M2864 (5 18) -7 CS 1-82-56 SEP-rlC DISPOSAL SYSTEM INSPECTION Name Loca'k-i on D a-t Solt- TYPE: San Resul -ts of Per-cola-tian 'T-,es-t ( -i -f applicable- ) Ra7t4 e4 -M-in� -te-/ Ini-- h t TYPE OF SYSTEM= I ---"b-) 5 e- ; ,o ABSORPTION FIELD : T"d-tal Lqng7th,F ,,7pLengthc:P-F eac -tr- h enl�tj , � Dep-th o-F -trenches Size o-F stone SEEPAGE PITS : N u m b e-v-'-- Size - -F-t x -F-t S-tcma size PIPING: S p e BI dg . to Tank Tank to Dis-t - Box Dist - Box to Field/Fp I Openings Sea-le-d ?, Yes o Part 1 al EOCA-FIOMZSEPARA-1-1 OHS . Founda-tion `to Tank Foundation to Absor-p -tic)n -f e c2t-t Separa -tion 0-f, = pi -ts I et Con-Fo,rms as per, PI o-t PI an Yes No LOCATION OF -SYSTEM ON PROVE r- -f V-C 1 e�= I R - g Front Le FtSide ::Y:: o 0 11 r � t Side Middl e Fv-on.-t Middl e Rear COMMENTS = SYSTEM[ . USE APPROVED = YE: No D C!p c-1 T-t-7ed h 0 SA WO Fz J ^00 � o � ? "I Iaave seen or observed,or believe I saw evidence of, " :)hlucts such as houses,wells,trees,fences,"etc,, on Ihis document. I also represent that I have. ° 1iieasu the distances set forthWe ' " 1 kENERAL MS.P'ECTION.REPORT I (518) 761-8256 Ob Town of Queensbury Dept.of Community Development Date inspection request received: I Q Building&Code Enforcement 742 Bay Road Queensbury,NY 12804. Arrive —a Inspector's Initial NAME: � � � F71VI 0 ( PERMIT LOCATION: DATE: TYPE OF STIrUC G RECHECK NIA YES NO COMMENTS Footings/Piers —� Monolithic Pour Form Reinforcement in Place + The contractor is responsi lc for providing protection from ezing for 48 hours following the lacement of the concrete. Materials for this purpose on si Foundation/Valipour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Hea �ationou r-InIn l d Foundation Walls Interior R 1 Foundation Walls Exterior R- Floors R- Walls R- Ceiling R C) Duct work or piping in unheated spaces R- Proper Vent, Attic Vent f Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack PostsNainn Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Sealed Fire Wall 2,3,4 hour Firestopping GENERAL INSPECTION REPORT (518) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804. Arrive ,-Mu m Depart Inspec or s Initia NAME: PERMIT LOCATION: 1 -_ '`t TC �5�- DATE: 77— 3—c)0 TYPE OF STRUCTURE: 1 RECHECK N/A YES NO COMMENTS Footings/Hers I Monolithic Pour Form Reinforcement in Place The contractor is responsible or providing protection from ing for 48 hours following the pla ement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- _ Walls R Ceiling R- Duct work or piping in unheated spaces R- 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 VIFirestopping ? GENERAL INSPECTION REPORT ( 518) 762-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804. Y Arrive Ii m Depart inspector's Initi NAME: PER1vIIT# O LOCATION: DATE: TYPE OF STRUCTURE: RECHECK NIA 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 placeme of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Baclrfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place ough 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- 00, Proper Vent,Attic Vent �,�:i�ftiing F Jack Studs/Headers Bracing/Bridging 4 Joist Bangers Jack Posts/Main Beam \, id i tration Barrier Fire Separation 1,2,3,hour Penetration Sealed Fire Wall 2,3,4 hour 1.K'mopping �IF,\-A V,,3b Ft Lk GENEIM L 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/.2 am/ m Inspector's Initials OM— NAME: �`f7J7-2_ PERMIT# C � � 41 LOCATIO a- DATE : Z 3 TYPE OF STRUCTURE: RECHECK N/A YE O OMMENTS o ings/ I V1 I Monolithic Pour Form Reinforcement in Place .� The contractor is respo siblie\R providing protection fro freed g for 48 hours following th placecnt of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundation/Dampprool ing Backfill App val___ Plumbing Under Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior - Foundation Walls Exterior 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 Bcam Air Infiltration Barrier_ _ Fire Separation 1,2, 3, hour Penetration Scaled Fire Wall 2, 3,4 hour Firestopping 1% Aly� 4 GENERAL MSPECTION 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 p Inspector's Initials Q NAME: , PERMIT 4 LOCATION: 1`. _ DtATE: - TYPE OF STR RECHECK N/A YES NO COMMENTS FootingslPie 1' I Monolithic Pour Form - f t- Reinforcement in Place. ° The coitractor is responsible for _ providing protection from freezing f for 48 hours following lacement of the.concrete. T, Materials for this purpo on site Foundation/Wallpour ' Reinforcement in Place 1` Foun on/Dampproofin I Approval i Plumbing Linder Slab Plumbing Vent/Vents in PI ce Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior - Foundation Walls Exterior Floors R ?Walls R Ceiling R Duct work or piping in �. unheated spaces R Proper Vent, Attic Vent 1 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 th (518 ) 761-8256 GENERAL IN.VPECTION REPORT �~~� Town of Queensbury Dept.of Community Development Date inspection request received:2 Building& Code Enforcement 742 Bay Road t Queensbury,NY 12804 Arrive am/pm Depa4 a,., am/pm r / Inspector's Initials -�-- C� NAME: +`tl�2 ,(CI t PERMIT# r LOCATION: ( DATE: TYPE OF ST UCTURE: RECHECK WA YE N COMMENTS �- otings/Piers ] Monolithic Pour Form Reinforcement in Place The contractor is responsible f providing protection !rom freezi g for 48 hours fo]lowin tlzc p]acci gent of the concrete. Materials f this purpo c on sit Foundation/ •illpour Reinforcement i`nitl Foundation/Dampproofi g Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in lace Rough Plumbing Heating Rough-In .Insulation Foundation Wails Interi r R- Foundation Walls Exte or R- FIoors R- Walls R- Ceiling R- Duct work or piping i unheated spaces R- Proper Vent, Attic Vent Framing_ Jack Studs/Hcadcrs_ Bracing/Bridging_ Joist Hangers Jack Posts/Main Beam, Air Infiltration Barrier_ Fire Separation 1,2, 3, hour Penetration Sealed Fire Wall 2, 3,4 hour Firestopping GENERAL INSPECTION REPORT (518) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804. Arrive V iu— Depa In Inspector's r / NAME: �S PERMIT LOCATIO t DATE : c TYPE OF STR C RECHECK N/A YES N COMNVIENTS ot�inn,�lPi �:: � I Monolithic Pour Form A Q Reinforcement in Place >r•(� The contractor is responsible for providing protection from freezing for 48 hours following the placern tof the concrete. Materials for this purpose on site Foundation/Wallpour \ Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rougli;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 J000 RECC. r APR 0 2000 ,p � ,Vf"Ad Qy Q PA P•� a� o � f A+ '/ ' Jc � I have seen or observed,or h1eve I saw Wince of, CY, ail obiects such as houses,wells,trees,fences,etc, s„omin on this document. I also represent that I have le, measur the •i n . d sta yes set for on the agra S'i"GN 1TUR;E DOE