2000-305 ' r. .i 'w'1r �' v y T r ,a 1,1' tt iv .� ✓"'i-Tr'VV i I. �.r • •
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erti ate
, I U v% ,
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C fi IIAY
4'
Town of Qu.ecnsbury
Warren.County, New York
Date September 5, 2000
I C�
�
This is to certi fy that work regested to be done as shown by Permit Igo, 2 0 0 0�w
has been completed,
This str cture ii"ay e occupied as a ' single family dwelling
Location 25 Lehland Drive, Lot 4
Owner Michaels Group
By Order Town Board
OF QU ENSBURY
��Djire-(bi of Buafdin & Cade Enforcement
L
BUILDING PERMIT
Town of Queensbury,742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE 167000 200030-9
TAX MAP NO, 74. -2-48 Building I Permit No.
MICHAELS GROUP
Permission is hereby granted to
LOT 48 #25 LEHLAND DR.
Owner of property located at
in the Town of Queensbury,to construct or place a SINGLE FAMILY DWELLING
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
,, Q
CBn A,�ftks,
L K S �1 DRIVE
MALTA, NY 12020
Contractor or Builder's Name:
MICHAELS GROUP, INC.
Contractor or Builder's Address:
JIM CHANDLER, PROJECT MGR 10. BALCKSMITH DR
MALTA, NY 12020
Electrical Inspection Agency:
MEW YORK BOARD
MEW YORK BOARD OFFIRE UNDERWRITERS
Type of Construction- SINGLE FAMILY DWELLING
Plans and Specifications:
2321 SQ,FT, ,SINGLE ..FAMILY DWELLING .WITH 2-CAR ATTACHED GARAGE
kS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
INGLE FAMILY DWELLING
291 . May 17 2002.
PERMIT FEE PAID—THIS 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.)
17, May 2000
Dated at the Town of Queensbury Vs H__L.Day of
SIGNED for the Town of Queensbury:�
Code Enforcement Officer
Building Permit Application
Town Of Queensbury - Dept. of Community Development, 742 Bety Rortrl, Qrtcertsbrrrv, NY 12SO4 17t/-32561
BUILDING & . CODE ENFORCEMENT
Requirements prior to issuance
A permit must be obtained before of this permit: f'EtZrLl1T I/GE NO. Q-
beginning construction. No inspections b FCC PAID S will be made until applicant has received 0 Z PERMIT
Zoning Board Action V
a VALID BUILDING PERMIT. All Area /Use �uw�
applicants' spaces on this application ( RECRIiAT M', E ZIA �$ .-
MUST be completed appea a signature Q plwining BooardtR ��. VIEWED BY.of the applicanf•must appear on.the SPR / Subdivision !Ot
by 1 0 20 lttti4ling rn�/tctnr
plication form, n-a>� Recreation Fee Pay
Applicant: -r"! tt�2G�S Co�k_%)p _ YUtlblk�G►►= ��.. $ --
�� t4 z. eUILDIN;G'AND CODE
Address: Address:
Phanc # CSt�_) a�� - `l__ I1110119 #
Property Location: --��_r-�
Subdivision NanIC: Tax Mal) Number J '1 / 2-
Section Mock I rat
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF T11E
New Building: CONSTRUCTION: $ 1�?, (�0
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY. INFORMATION:
Alteration to Building: Primary Building -
residence / commercial _� Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to .exterzor size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:.
{`l f�q�£3 /5� If ADDITION, what will use
lst Floor. . . . . . .2nd .Floor. . . . . . , took sq. ft.JD�qC of new addition be? :` of
Other Floors . . • sq. f t, l
(not unfinished Cellar or basement) ACCESSORY BUILDINGS :
Detached Garage 1 , 2 ca�
TOTAL FLOOR AREA: 'jZ� S{Q. FT. _�_ Attached Garage
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial-Storage 'Building
�� Other
FEET X ='-6-- FEET
Foundation Type: Will any second-hand or ungraded
Number of Stories : i'' lumber be used? If so, for what?
(habitable space only) V 0
Height (grade to ridge) : 3 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woo stove (circle all which 1pplies)
to be installed: j Electric ./ Oil j as / Wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building *
codes i s :
Builder: Na e O A dre s
QPhone `t
Plumber: 214p - .ate.
Mason: t
E_lectricLan-: ---
DECf lRA7709. Please sign below ajler 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 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 scale, s 1 a t location of project on premises.
Signature:
E�_
(owner, owner's agent, architect, contractor)
Application for Permit-Septic Disposal System
Town of Queell.s bw y 742 Ray Roml 911c ulrshrrl;Y, NY 1280! (.SIN) 76 i-N3,SG
1. OWNER INFORMATION: _...............................
Office Use ?
Location of installation: ®
MA
Tax Map No. / -- ! it Vb','
File Mat No. -�� I
�l-taCB?i' t���►lQUE BURY
Owner's Name:
......... ....................
Address: kC)
2. INSTALLER'S NAME ; � �2� y"c�TtYux PHONE NO. Cv2�- lCpj
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 9 bedroom(y) and multiply It qj'
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/bdrni =
1991 -present lf. x 1 !0 gat/bdrnn = G j y(j
Garbage Grinder Installed yes_ / no
Spa or Whirlpool Installed yes_ / no
a. PARCEL INFORMATION: (circle applicable information & indicate moasuronents)
Sao rrapl1y Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supper
sand at what depth at what debt/t nriuricipa/�
Rolling Imam -23Q feet feet t---"
Steep slope clay ifrvell; svatersupply
—`%slope Other j%CIAr trt7Y.SG'p[tC-System
depth: _ absorption is
other
Percolation Test: (1'a be completed/ry/icensed projessioncrl engineer ur architect)
Rate: - —�— Ininttte per inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems inusl be designed by a licensed
professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the sirc
of the septic tank and leach flcId for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: gallon (Irvin. size ],000 gal.)
Tile Field: each trench .�i�_fI, Total System Length: jl•
Seepage Pit(s): nurrrber of size ofeach: by fl.
Size of Stone to be used: tt , / depth or thickness --_V feet
Bed System Size: x
Alternative System:_ _ ---------- length and/or size ___ -- -__ _-_-_-•---_..--•___-__
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
_ -_ �__-_-___-Note.--A.=bar=nz-Systerii-and-associated-elvcrri'cat-workii�ust be inspects by Town a aproved
electrical inspection agency.
7. SIGNATURE & INFORMATION FOR RESPONSIBLE PERSON (please read)
For your protection, please note that pursuant to Section 136-29 ofthe 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 QuVnsbbpp Sanitary Sewage Disposal Ordinance.
wp ____1(a 1C)6
Signature of responsible person Date ___
Fire 'Al.f.rS1111's Officc To%v11 of, `y. 742 11,1y ko"W'Qtleensbtjn•' N
(518) 701-8205
Application for Fuel Burning Appliances & Chimneys.
ao'okable to solid, f0el & vented'gas-appliances
Date
: 20 ( 0
Permit No.
made to the Bitilding, &Codes Qf -efi)r 1he issitance(?/'(I Building and Use
Permit parsuant to the Nett, York State 1--il-e Preielifioll a;jej Bit
ildijlk Code. The al)I)licant or 011.111ell
agrees to conq)1y itdth all apl2licable knt)s, Itgulations. and 4111 conditions that arc part of
these requirements and also will allow,all insp'e'C'16 i,,s' 103,eliler prenti.ses to perfbi-nt required in.,q)ections,
NOTE to applicant: Rough-in and Final-Inspectioi-is are required.
Applicant Inforniation Fuel Burning Appliance Information
(circle appropriate words)
Name: tic "I"Icog"115 It." Stove:C_ I If 64)o liolood coal pellet gas
Fireplace insert`
Address: Fireplace, factory-built: wood <9777P
0 1,7 u2 b Fireplace, masonry: Wood gas
FUrpace: hood 'C,&Tt oil
Phone:
If non-niasonary applicance, please provide
Manufacturer Name:
Address: Model NUrnber:
Chimney Information
Phone: (circle appropriate words)
Masonry blo&L, _�5ick stone
Flue file steel size: inches
Exact Address:pk 5 _A-c V L—1VE
ofConstraction oi-installation Factory-131filt
I-CT ManUfaCtUrer na "me:
Model.Number:
Alote:
Listed By: Nun ber.
Construction I Installation nnist
con f orin to NYS Fire Prevention &Building Indicate (ci
ircle),chirnn.ey material:
Code,'Consult available Town of Queensburj,
Handouts regarding required inspections. Double it-all Triple wall l Insulated Direct i,entim,
0
Chininev Liner
Fire Alarshal Code# S Collected S Re ded Re inded to):
ad.11"ess:
A17-33389 (190) Public Stifetr C
.4 233 26.55 (230)Minor Sales
White(Applicant) i Greed(Fire mar§jjaj),
Dept.) Goldebrod(Cashicr"'s Dept.)
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MAP REFERENCE:
LEHLAND ESTATES SUBDIVISION
MODIFICATION PLAN — PHASE 2
DATED: DECEMBER 22, 1998
REVISED: DECEMBER 29, 1998
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
� an D u s e
Steves
Land
169 H&Aiand Road
(5181 792-8474
Su�veyors,
Queenebuq, New
New York U0.
A
ork 12801
LANDS N/F OF
JOHN & MELANIE KING
47
'UNNAMED ALTERATION OR ADD17KN TO A SL WY
NAP SEAM A LICE W LAND SURYEYaS SEAL I$ A
VIOLATION OF SFCTIOFI ?M p15-DMSIOF $ OF THE
NEW V= STAR EDUCAT01 LAW
ONLY COPIES FROM TIIE O M40L OF 'SUS "M
NARKED MATH AN ORLOIHAL OF M LAND SURVEYORS
SEAL *HALL BE CON90ERE0 TO s VALID TRUE COPIES.•
CERTIFICATIONS NOICARD MOWN SIfi1MY THAT
TM S VEY WAS PREPARED N A=RDANCE WTII TTN:
MIND OOOE OF PMOIICC FOR LAND SURVEYORS ADOPTED
IFY THE NEW YORR STATE ASSOCIAMON OF PROFESNOFAL
LAND SURVEYORS. SAD CETTWCAIDONS !ULL RUN (PLY
TO THE PEASON FOR SHOP THE SURVEY 6 PREFAB®, AND
CN No SEHAiT To THE TITLE cO1Pw ODYSIS OTAL
Amu AND IFJIDNO S mMMON LISTED HEREON, AND
To THE ASSOM OF TIFF L=W DIS8IT =V
S85'41'20
-- ; 0.
128.5
15'-F'f A0"
48
23,387 sq ft
0.54 acres
4&4Y ---�
128.50'
N85 4 20"W
LEHLAND
VAC
DRIVE
Of IVEW
y�
5 C. STD,
cP °
Map of a Survey made for
WALTER A. X THERESA R. ARNOLD
Town of Quee> bury, 'Warren County, New York
NO. I DATE
FA us
MLIM
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: Waiter A. do Theresa R. Arnold
Chicago Title Insurance Company
Trustco Bank, National Association, its
successors and/or assigns
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
DATED: August 14, 2000
DESCRIPTION
1 "=30'
S-1
01wIOF1
ARNOLD
DWG. NO. 89423-48
1
t�
50135
F=IF:Zr-= M^FtSH/kL-
-rC>WN OF ClUaaM-'3E3UFP,,")r
"-v' -12804
(518) 7G-1 -8205 .
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATION PERMIT
SCHEDULE INSPECTION ON
I CD- (��mm
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 UNIT
REQUIRED SIONAGE
CHIMNEY
WOOD STOVE
FIREPLACE = MASONRY E91FACTORY BLT.
EA UGH-IN
ti FINAL
REMARKS: OK TO THIS DATE
ov
k INSPSLIP.PUB I SPELTo
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept of Community Development Arrive'1,71 Depart v
Town of Queensbury spector's Initial
742 Bay Road
Queensbury,New York 12804
NAME V�\ \- r-1109 Q n (-5 Iq W 1-0, RMIT
LOCATION DATE DATE Mo 0
TYPE OF ST—RL-TT—URE
N/A YES NO COMMENTS
Chimney HeightPB"Vent/Direct Vent Location,
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings,,10"to 16"es,la n a
Exterior Handrails,balec din 18 in. r more
Interior Handrails stairs both sides 3 or more sers
Grade 2%away from foundation
8"clearance to sill plate J/
Gas Valve shut-off exposed/regulaor 18"abov grade
Gas Furnace shut-off within 30 feel or within lin of site V
Oil Furnace shut-off at entrance to ace area
Furnace/Hot Wate)\Heater operatin z
Relief Valve(s)ins ed
4� irs
Headroom,6 ft.6 in. irs
Basement stairs,6 14 in.
Handrail exterior stairs both sides i iore than 3 risers
Interior privacy/trim/doors/main en rance 36" 11/
Floor Finish
BathroomMitchen watertight
Interior Handrails Balcanies/Lan R 18 in.or more
Railing across window -is-
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans I
Plumbing fixtures I iVA
Foundation insulation
'/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 hi
Final Survey Plot Plan V/ I
As Built Septic System layout required
Okay to issue CIC(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy)_
J.•1'�•1;'�•�,';�•�;;?�•�4.�•1;:1.1;;�•!:'.t•i;rl•�l'�•�;:l�l;'�•�;>l•�;!?��?<'.t•1;�,•�?.•�:;�•?.'>l•�;L•J;:l•.�:?.•?;:?.°a;.4•�>l•�l';,l•.��4��;',l�k�iJ;��k�:��L�l•�::1*�S.�J;'J,.•�t�•�:J�•�l�'��;',�•J_::_l•�'.t•�l'�•�l�•�1:'�•.�1�*�':l•�l'/,
=G 1�
t� THE NEW • BOARD • UNDERWRITERS
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all
BUREAU OF
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I Date 20NA0
HIRMIT
Application
II introduced
I t I ��!1 ! ttl applicationt t l I1 r equipment r' t`rt' t and Yr r II�
THIS CERTIFIES THAT
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FURNACE MOTORS FUTURE APPLIANCE FEEDERS
SERVICE DISCONNECT.
•I 1•
(I • .APPARATUS:
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!i i
I*
' !. GENERAL MANAGERThis certificate must not be altered In anyiinannor;return to the office of the Board If Incorrect. Inspectors may be Identified by their credentials
Ir
Per
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.rn( 1%lii1.1....t•I��f lip( lirt 1��( V��(•'!�T liit ia�lll�i,lii.+t 1��1 Veit 1 iY lei/ilil•lii�(i�+i/•lii(•1r-�t Yi�l )ail lei!1��!'1ti liil' �7~�•Yi(•'4iit•�ii�`•'(iit'•7ii�1•l�il•1ii#•7��(•��(���ySii1•lii(•�rr`(llii(•li�(i�il'•'l��
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
Initials
Inspector's Initi &
NAME: kLwrrC_C_!S PERMIT#— A- / ,
LOCATION: Z,'T DATE:
TYPE OF STRUCTURE:
RECBECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsibl for
providing protection from zing
for 48 hours following the pl \ement.
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place.
Foundation/Dampproofin
Backfill Apvzoval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Ro gh Plumbing
acing Ron
Foundations-
Walls Interior R
Foundation Walls Exterior R
Floors Rr
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Vovcr Vent,Attic Vent
I acing/Bridging
V6104i'st Hangers_(,Z_t,)) LAA)CIJAX0
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
���g Eff 2 3 ur
! _ 4h
.1 r,
! 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
Inspector's Initials ------` -"
NAME; jG � L���_ PERMIT#
LOCATION: Oy DATE: 7 3JG�
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers �
Monolithic Pour Form
Reinforcement in Place
The contractor is res nsible for
providing protection m freezing
for 48 hours followin the placement
of the concrete.
Materials for this purp on sit os e
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing VentlVents 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
__. nheated spaces R-
Pro r Vent; Atfiic Vent oe
Jack Studs/Headers
Bracing/Bridging
Joist Hangers _'
Jack Posts/Main Beam
Air Infiltration Barrio
Fire Separation 1,2, 3,hour
Penetration Sealed
F e Wa112,3, hour
:1
g zG$ t l IJ
-T-C�WN C)F= ClUF-=aNSE3UF:?,Nr
CkUIEaN!3E3UF:Z')r. "")r 12BO4
(5I8) 761-8.205 .
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAM E
LOCATION PERMIT #
SCHEDULE INSPECTION ON
AM PM
APPROVED
NIA YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIC3-HTINC3
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLER,4�'-/
CLEARANCE TO HEATING NIT
REQUIRED SIONAC3E
CHiM HEY
D STOVE
IREPLACE MASONRY Ell FACTORY BL.T.
EP OUCH-IN
[--] FINAL
REMARKS: OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
M^FZSI-1^1E
-rC)WN C)F C:kUF-Eit-J,SE3UF?.'-lr
(::kUaa"SE3Ul:Z)r, NY 12804
(518) 781 -8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME
LOCATION
PERMIT #
SCHEDULE I N S P E C ION ON
AM PM
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIC31-ITING',
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
RE IRED SIC3NAC3E
CHIMNEY
WO PD STOVE
Vf!:rrR'EPLACE F-1 MASONRY R? FACTORY BLT.
&a-R-OU4GEJ-IN
FINA t J'�/
REMARKS: OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
� C
GENERAL INSPECTION REPORT
(518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road r
Queensbury,NY 12804. Arrive' am/pm Depart3! n/p
Inspector's Initials �JJ
NAME: rch s' PERMIT# G Q - 30
LOCATION:�a 5 I 6 k rx y, DATE
TYPE OF STRUCTURE: _
RECHECK
N/A YES NO COMMENTS
Footings/Piers C
Monolithic Pour Form �.
Reinforcement in Place
The contractor is responsibl for
providing protection from fre ing
for 48 hours following the plac ent
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Bac1c ll Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough=ln ) _
Insulation
Foundation Walls Interior R- �LC
Foundation Walls Exterior R- _
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
gaming
Jack Studs/Header
,racinglBridging
`1*oist Hangers -
- Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
�re Wall 2,37 4 hour
irestopping
GENERAL INSPELTION REPORT ?�"J.
( 518) 761-8256
Town of Queensbury
Dept of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804. Arrivvi-C—Z—>anyjjm _Depart
Inspector's Initials
NAME: PERMIT as
LOCATION DATE: :z
TYPE OF STRUCTURE:
RECHECK
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
Plum ing Vent/Vents in Place
ugh 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-
ProperVent, Attic Vent
Jack Studs/Headers
Bracing/Bridging_
Joist Hangers
Jack Posts/Main Beam
\,A4rhiffitration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire 12
,3,4 hour stopping ng_
P ID
OF QUEENSBURY -
BUIUDING 'CODE EMPORCEMEW-r
742 Bay Roic-lef -
MY 124304
(518�
SEPTIC DISPOSAL. SYS-FEM IMSPEC-rXOM
Name-
Laca-t-1 on ZIP
X A Z
D a t--e P c-- r-m i -t # -0
SOIE -TYPE: San a-y-
P,t-SUl is a-F P r-Cal a an
( if"' applicabl Rate i nu-te/Inc-- h
-"PE OF SYSTEM
ABSORPTION F=XEU To I Lencrthr
Length of each t enc
Depth of trenches
Size O-F stone
SEEPAGE PI-rS : Num
Size -F-t -f-t
S -tam--- size
PIPING : Si e- Type
Bldg . . to Tank f rL
-Fank- -to Dis-t - Box f�=C1 :2)
Dis-t - Box to Fie-ld/
Ze L r
Openings No Partial
L-OCA-FXONZSEPARA-FjOMS
Faunda-ticm to Tabk: feet
Founda-ticin to Ab scarp tticm feet
Se-par-a ,tion of- Pi is -t
Con-for7ns as per PI of Plan yle-,--% No
OCA-TI 0 F SYS-rEM ON PROPER-F ',�,
( .ci r-cl e n
Fi-on t - lea Left Side - R-ight Side
Middl e Fr Middle Rea r-
COMMEN-FS z
SYSTEM USE APPROVED = YES No
GENERAL dNSPECTI'ON 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 VV6 am/pm Depart am/pm
Inspector's Initials
NAME: PERMIT#
LOCATION:_ 5�� - DATE : UP
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Fo
Reinforcement in Place
The contractor is r sponsible for
providing protecti from freed ing
for 48 hours follo ng the placement
of the concrete.
Materials for this pu se on site
Foundation/Wallpour
Reinforcement in Plac /
Foundation/Dampproo ng
Backfill Approval
Plumbing Under Slab
Plumbing Vent n in lace
Rough Plumbing
Heating Rough In
Insulation
Foundation Walls Interi R- _ _ .._._.........._..
Foundation Walls Exterio 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
! ENERAL INSPEeTlON REPORT
(518) 761-8256
Town of Queeusbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement '
742 Bay Road
Queensbury,NY 12804. Arrive-am/pm Depart am/pm
Inspector's Initials
NAME: 0 Dn G5-ca44P PERMIT# -�
LOCATION: DATE
TYPE OF STR14CT0
RECHECK14
.w - -
NIA YE NO COMMENTS4
tings/Piers �, ( `'
Monolithic Pour Form
Reinforcement in Place V
The contractor is responsible:far
providing protection from freezing '
for 48 hours following the placeriient
of the concrete.
Materials for this purpose on site
Foundation/Wallpour fir,
Reinforcement in Place '
Foundation/Dampproofing
Backfill Approval `}•.
Plumbing Under Slab
Plumbing VentlVents in Place ;
Rough Plumbin
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 =M'
Framing
Jack Studs/Headers .`.
Bracing/Bridging
Joist Hangers
Jack Postsflv.Wn Bea
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
}
GENERAL IN,SP.EGTION 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 1`` am/pm Depart r`am/pm
Inspector's Initials--/.=-
NAME: PERMIT# nU—
LOCATION: D TE
TYPE OF�, C
RECHECKS '�,.
NIA YES N ,r" ..COMMENTS
tings/Piers
Monolithic Pour Forrii '^ r I-
Reinforcement in Place`,,.
The contractor is responsible for
providing protection from.freezing cF r�
for 48 hours following the placement
of the concrete.
Materials for this purpose on site j 1plc. A �zdf
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough In
Insulation r•''`'
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R .. 1
Walls R v
Ceiling R
Duct work or piping in :� ; •;,
unheated spaces
Proper Vent, Attic Vent
Framing
Jack Studs/Headers ,''°•`
Bracing/Bridging>!+;
Joist Hangers
Jack Posts/Main Beam
Air hiffitration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppin
't.# ��.observe ;or belreve'I'saw evidencef,
ail objects such.:as h'* s,-wells, trees, fences
shown on this do cu . nt. I als6:represent that I Dave°
person rheas a the distances set forth-G. -the-diagram 's EI
0 MAY
. 2000
SIG ATURE ON W., QWiq.QE QUEENSBURY ,L
L � �Z�WUILDPNCa e4ND CODE JflHN. &: >I
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