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2000-426 TOWN OF OUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761=8256 CERTIFICATE CIF OCCUP-A-N. CY Permit Number: 2000426 Date Issued: Friday, January 26, 2001 This is to certify that work requested to be done as shown by Permit Number 2000426 has been completed. Tax Map Number, 523400=125=000-0007-020-000-0000 Location: 26 AMETHYST Dr Owner: PETER & JILL VdEI➢MAN Applicant: WEIDMAN, PETER & JILL This structure may be occupied as a. By Order of Town Bo and Single Family Dwelling TOWN OF QUEENSBURY Fireplace Director of Building & Code Enforcement BUILDING PERMIT Town of Queensbury. 742 Bay Road, Queensbury, NY 12804 County of Warren (518) 761-9256 Building Permit No. Permission is hereby granted to --- - -- ----- �11 P" �—k Owner of property located at in the Town of Queensbury, to construct or place a at the above location in accordance to application together with plot plans and other iiiio­rmatton Hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owner's Address: 1P 1 . kLe I k I Contractor or Builder's Name- - �P k Contractor or Builder's Address: Electrical Inspection Agency: I P Type of Construction: Plans and Specifications: I k I r I rd 4 1 Proposed Use: L I PERMIT 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.) Dated at the TVV-o�of Quee s Day of SIGNED B for the Town of Queensbury CZ& Enforcement Officer Buildrrr. � 'c��-tttr' ` aplr.'ealort !b [vtt v tccer1sZ11r y f v Q _ Ue1,l, a e0l111rl+rrllir 1Je1'd(MV11011, 74.2 llay Muclrl, Q+Il't'11.11ilify, NIP 12801 l7G1_t'12.5eiJ NO-�0 11UILDING cat . GOD E7 L , 1 ICE lv 1 01r � L. hr 131V 7r �+ liccitlircliiclits prior [o issu:rlict+ I laanlriR Ilnutl ixx 4atllnincd Iru/rala cal' Ibis 1xe1`1x]ii : IF ERAll?' 1d11 Ni), + IwIilllrrill Cenlerfr4li riirn ✓Jar illeelscucl4lrr#r -~� __.�� will Istx Irtnilo ellrlil nlalaliarslll ill rt:t74iivud JJ ;!nordreg 114Ar-Ie-41 Acllr,rr I l:'leAIt'I !:'181',4Ill 1< G� + -- It VALID lrUl [.. 311l l'L1ilr1v11'r'. All 1 nlaialicnnlrt' birl►cp:l ptt lllry rrlrirll4rrti4lrl Alan ! Uso Masi be cc,Itlple"I "41. ,so sigl,ilritra lnc�lrril77(,N rrs7, l ll1/ ext plea nixirlicnllR xrrlxrtt "ItImear ciao lira j lrrrrrllrrg Tlrx]rrl 44clltrrr ,l,w/1 :rl'It r tirrlr,livislrrrl / rl1lrcr lrldY�l.]Y1i1) 1lr"r r alicirtlitrt riarllr. x�...t r.,a - - -- lri:r L'eihill! i'GaS I'iryrllCrd #rurL!!np In+rrre..r Applicant: ,r- ; � Owner. � I j ( lei Addicts: . l^t ! Addicts: Ii 1►�` G71/ 1'llvrlo # S1 cS'_) `Z ' a ' Propertyf,oclition ; ��° ` � l VAP Stibdivislou Nrlllrc * '['fix h4rill Number JJr25 ';4ciittls lilrx:k lrxl 1Zllr`.L'URIJ or YltolaOSED WoltiC : — / - 14OW l`illl;mil VALUE OF 'i'1113 roel3.tle1lc 'UDNS'i'ItUC:'i'Jlt)N ; $_.. '���rr?[3 n,d4liL: . r� SLe3. lc13. ncll.larc3.rx1 _ trial] i.c Intl c43 / corIII norcira 1. 1:3r C UE'111r[ Y IHF t,rtFtl] Tlotl ! A L Lcaro R 3.ca11 i:o lau3„l,ciran -I- rtc� r r' rintr] ]:Y Itui ,l, c11- ncl 011 C: .i.c) tx It cCx / rnurracx l:clra .l. _`� S .i. rxcal, n i�+sln,i- -1 I I w is ttcx [] .Lcluelctx j Cntxlrrl432: . lcti 'E'wix lI'ain.i -1 Own IIJ. eltl coca clltlt]cJC3 !_:c, rpH, i:4S;j:4xl: f1 ,1- Ic1 I"(411s31, ] Y I,wcx ] 1, l lxcl CIL"itor Work ( describe below )low 6?-T-.x.rn } Medoff iLtur MErRltiiucl'.urirlq GROSS AREA OF PROPOSED STRUCTURE * Other is [: 1! loon . . . . . . 0 � t— c9 • fL . z C 11[lUI'�'Ivtd , what will rise 2nd o loor . -, " a , r . . !V " EL " O irLVli rrcll.i l; lou be ?alwttar >.� loors . . . . . � .__ l! tl JJ ( 110 [: ullf11a3. stled cellar ur: basement) ACCESSORY 11111L[) INGS I l)etacherl [;+Irrte�e l r 7 car 'la'ChL FLOOR IIRL:A : rr ( +rTU t + SQ . rIlia _ lr4 t ctcheci�vGuacage It 2 crl - SIZE QL�' NEW $'.CIt.L.I C`l'tl oil: : l' rA.Vc'r. [: d StOrOgla Mill 11 (� Cornrlle�`cicli SL-aruge 13uiltll.ng Er'la L'E• X ,R, L�ii ls,i• C]L- 11 a >:• i'oun ivn ol. © e t .-._ ils CIO !",r,r yes Will Wily atxcvniE- 11tat]c1 oxr uxlc� rciclQ41 ' Nutlxi3av vL• Stt; or .#. ( 1111abr, i• tbIrl rjpac: n rin .r- v3" � - Eurnlaar �a ltttec.i ? I nv , f.' o1: wreoi: 7 Itix .i.cll] t: ( ij1'rtr,lia i:r.a ItIj' x } i: c± ia1. �_.._ 't-` II l'I: UI"� III•:l1'1' .l tics t+lillllraa L' 01: .t: 1. t• nix .L r�ct3 rr r.l llrl/ca 1,• wvcxdrr L• cx v © ( t: .1. 1.`c. .L cx ' r1 i. .L wltic: ll rt aE, ]. 1 (xxr } f:o late il] ct ctil ©il : $ Isl ii / Gus / Woad • orcecl i o 141 / aseboaril / Other Person reepoll 1 le .for su aervllsion of w :roc rr >: egard " to btlllcilnc� ir N6%iite lltli[ rc)oo l'11c) Ire Bui, ldil Plumber ., CIO- , Malzorl : Elect ricl.atr : t,.) DECLAMA77il Illerlre sigh Le1r�1V eleir yell I1r1fIe crrlcfellly rerrel !hc s1r71e1l1r^Al. �i'U Illcx toed or rosy ketowledge 11to sl;llelnellts c.0111:tincll ill lhis ;Ilxlrlic illicln, tottelller will] like lalitrxs :1nx1 ti}( i ill( :tllrxll4 su1x111iltccl , sill :x titre ix/lii CmIl sleek stirlcelrclxl of 111111 ialixim:sSed caulk In Ile (luiie tier till4I4`.SCIIIILSI llxc111isex trial tlr;tl ;111 Irltxvixi4ms 41I- ✓lux IIr1i141irIl; t-'inlix, llle ;/.4milll; t)IrliII. rrcc.r ;slim oil axllsx r I;r+vS lace 1:aillilll; tO lire larialaru:i:al wiu k nitsmil Ire ct3rxrillii:41 avilh, ♦ her1u:f' Siacr. ilicil <)I' rxuicel, Millxllal ..^.l rixil we.H'k i!i 5111111t 7f IY„cil I,y 1110 4x1V11C1'. I 'UI (1rl:r", it 48 4I114I4_r tiit >4I Iilitl I!\V[ SiIa II SI1lrllrll ial'IUI' lit :x t)e 4Rilie nor ixr v � iI, en:y'exr' C'oxlilic:xle 4,r cr,li,lai:tllt ix twirxl, Iremied, tilt A5 Irrllr_'I' l'I.CYI' txy it rice llsc4E aui'v u1'; ilR., scillc sltuwiug sclu:ll 14x :ltiull u!' irrujixcl cxrx Irrcerrises. Sigllatl]rc: .a c . .a-�-- (owner, owner IS ail archiloctl outracty Application far Permialt — Septic Disposal System 7bivii of QiteeilslJur;y 742 Bay Ropad Queenslrurv,, NY 12804 (518) 761-8256 1 . OWNER. INFORMATION- Location of installation: c [p 'Ain Ufficc Use � -��` F ] I � Files Permit No Tax Map No. CT -► �_. �-�^� ! Fee Paid Owner's Name: r �) ! J We 1 ,rYXg r'! I Address: e 1 jg e. 2. INSTALLER'S NAME : PHONE NO, 3, RESIDENCE INFORMATION: (circle year of dwelling, indicate 1# bedr oonr(s) and multiply 11 of bedraarrrs with applicable gallons per bedrawn to equal total dailyflow) Year of House: No of Bedrooms x Computation - Total Daily Flow 1980 or older x 150 gal/bdnn = 1980 — 1991 x 130 gal/bdnn 1991 -- present x l 10 gal/bdnu 0 Garbage Grinder Installed yes l aao Spa. or Whirlpool Installed yes I no 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) TQp­Q9QP1% .5-Pil Nillw .f,'r_rQuizrl W�tor __F3oclr_ock or [iii pervious fvlatci�ial �I]ogzicstic Waco SuErjrlx flat srurcl rrt IvItal depth <rt rvlrat deptle rrnict xr Rolling aura T feet feer Al / we Sleep slope clay if well; water supply slope other Pram any septic-system depth: absorption is ft. ether Percolation Test: (Fo be completed by licensed prrfessioiral en,girteer at• ar•cIiiiect) Rate: ininure per• ►nett 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless installed ill :1 Planning 13oard al-proved subdivision). Add 250 Wallons to the size of (lie septic tank and leacli field or cacli G3rbjgc G indcr, Spa or Whirllxmi Tub. JZ6�' '4c - Septic Tank: ^, ,A-a gallon (min. size 1, 000 gal.) Tile Field. each trenchQ f1. 'Total System Length: 2L+V� Seepage Pit(s): number of size of each: f1. by fl. �r Size of Strand to be used: t! , X � ! clrptlr or rlrickrress /d;t _ firer Bed System Size: x Alternative System: length andlor .size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each : gallons I TOTAL Capacity: gallons Note: Alarm System and associated electrical work trust 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 ofQueensbury, any permit or approval granted which is based upon or is granted ill reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on belialfof an applicant, shall be void_ I have read the regulations with respect to this application aixd agree to abide by these and all requirements o own of Queensbury Sanitary Sewage Disposal Ordinance. Lam'' _.t✓ „1e.,.�.�.--.----�—�...�` [,9 /'~X, lgnature t�f responsible person —�" Date r-f � PI 44 ° r-I b w d �' lztG1 U "j O U [? I _H Fi In IU ar ctaC4 s4 n �; t7 �.43 .0 iif ' amat ° U-4 t 7V O t .. 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I k IV C I l'il"t' � t.l l'Sll.i l 's OflF i'C � i74\'fi r!I QLl(:E."r11f1U1•\", */ 42. 3 ti• tZ.t};1 a3 f,7114`L'rl!i tl ll l-1'� '� � f5, 18 ) 7fi1 _8:!4^' Applicaf'an for Fuel Burning Appliances & Chimneys aPplicable too ;Solid fuel & vented gas appliances Date 20 Pei-III it L I / ` Application is hereby 111u{le tv the 131r 1c1i,rg• & Crxle.s pflic't'jor thei.s.kltcua�'t• oJ tt Buddingrautl UsePerim( pursararrt to the New }'irk State Dire revewirm and Bl ldi,rt: Ccxtic- ? 7tc �r�{slic'rrlri rar.n„ rrcr "9_ec.s' to catrrply w4111 c111 elly;4ic'able laitS. orclincinces, regideirirtrrs, rt,rtl all conclitlrsats flail are parl r,f thrcc' reyuircntc�nts cartel [also a"i11 ulloit" u11 ituj�ectai:r ry etiiz�rl�reaaai.sc�.ti Irk {rc�,;ftirrlr rcgttrretl itas{yccric,n,r. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information Ftiel Burning Applialice inf`ortt>;atitt<e;l ` ( (circle apl)ropriate words) i*Iaene: •a•-f"' A ear _ Stove: wood coal PCl/er gets pry Fireplace insert Address. �,Ir �- ► . + *:!�t Fireplace, factory-built: wood ` Fireplace", masonry- ,wood ;us ' Furnace: woad gus oil f Phone. 798 If sign-n-iasonary applicance, please provide ¢�t.. Owner: 49i t��..,... Manufacturer Name: '= W� !r: Model Nuta�laer. y Chimney Information ,. Phone: (CIi-cle appropriate words) Masonry Floc Stolle Flue inches Exact Address: +" m ' l �■ - r: . ofcostructiet: orirrsrawa rloaa Factory-Built i Manu €'acturer name. Model Number: A .Note: Listed By, Iti r i uni Ucr: Construction J Mstallarion raatrst corn erm to NYS Fire Prevention & Ba(ilding Indicatr, circle) cllintr-ley material : Code. Consult available Town ofQueensb1co17 Handouts regarding regrdred bispectiolas. < 7r IO „tt11 ! ltisrrlrtretl / Direct ,•e.mllir�cy Chiarrrre+k• Lira"� I d7ru,r'�.�-.�,U,=se-ary, �IrTiBa�► �.''ork I a�t� fire 1 fr , iltl Cade S / e 1c . �u . � tr �•-_�fi _�! ", � f 1 ?3 3389 (190) Pifbiw Safett -----,.- -__ _-.. 1 ?33 655 (230) Rfinor Sales <2:7eOD. _ I "64a White {,41a}aiicatitj Green ( Fire Marshal ) Yello%v ( Bldg, Oept. ) Pink & GO]derirod Waskuer's Dept, ) i i TowN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 BAY ROAD j QUEENSHURY NX 12804 761-8256 ARRIVE : DEPART : INSP : FINAL IN5PECTION REPORT - 'ftEgiI7EN'A'I DATE IN E TI N REQUl3 T ftECE+ IVE NAME LOCATION ^ , DATE ��` A y PERMIT TYPE OF STRUCTURE __ �_a"� FOOTINGS FOUNDATION BACKFII,L FRAMING ROUGH PLUMBING SEPNTOO'LSTOVEIOR FIREPLACE FINAL ELECTRICAL `i N A YES ND CHI kE HE T V NT HE G PLUMD.ING VENT ROOFING V.XT R I OR E N 7 3-N— E OR H S GS RELIE VALV E _ FURNACE W TER OPM G T RI R R V CY RS pINISHl:WORS.." H H C N W IG OTHER rLsOOR SWEEP O I3ER FLOOR C P T STAIR CLAIE NCE FZA I G S O E. DE C O B G I TU E IT9UNDATIP-M N GA IftE P O ING VOID R C OS A C C m P VARIANCE N SURVEY P O K TO I SUE C OR C C I l vn!•s AREq r /.Y Q J f ]n. fdnp N •ri 1:5 Re . lea (4 JAN 2 16 2001 TOWN OF QUEENSBBU Y BUILDING AND CO T q ff3t AREA 29964Sq Ft r a6:r; S sy a . 12 'too Oil ,AMEYH Rnf..owr .., mane to wasrner.f yra•nee! le. hr' 1Neyw. . '^^-.., 'f/.tt, ".� 3 ?` Cnr.sf.]nv n 19Ff5 at 4'1211 an caw rtserdl yarttM InFr�Q+r v '•?mac /. r!.1Qaia Mnt.Awk Pn.,�r c,a rr It 1"9 nl +50 160 and "4N ' ii_ t ies .1,ociiyit Ner1 a162].i 30 .._i'rf- / 8 7. 1)Ef:p REFERENCE: MAP REFERENCE: `"�.,�'. S r `1 L 8 J Enterprises Amended Map Of Section 7uv of Ambe• Shire ^� to made by Coullar $ McCof raCk Licensed Land \ Peter R and Jill E Weidman Survey0eS dated 8 12 71 1 986 amended t 111 i11996 L3 51021200171 and filed In The Warren County Clerk s Office on R 6?0542000 1167/182 1111811 Da5 to plat Cabinet A Slide `,i PramlSes suoJecl to fDeclaralton n} Covenaills Reidle by SI Eesa+nen} Charges and Lens � fT4ld9 by Slppey Enter prises lr]C doled Tpl1114F4i av+d tied In the Warren County Cler$% S CA71C6 r]n 1Uf 1'S119W@ In r Ry%011 rpe,gds) and amended try of a survey of lands of an Arherrde? L7 - -aralrpn of Covenants ReStnClr,,,s Peter R. Jill Weidman Easer*xtms Ch.l';yes arm Liens iAmber Shire Sub- s317C/ /Ill En YY er f{#man dlv,srort SP•:tlnn 111 made by C L 4. J Ernafprfses gated 7PD9i 19A, Arid fired to satd ck" is off vice tin situated In 7115119e1 Deals) Town of Queensbury Warren County New York Scale 1 w = 40' August 1 . 2PD0 1 HEREBY CERTIFY Peter n Wellman Jill E Weidman SOP WOW and Mnp r,r HSBC M00e819e CCa poi atrari (USA) its successors ancvot CHARLE$ T. NACY assigns James F Par+adrrio. and Chicago Tire fnsurance LWi riled I,srp Sy/wrv," 3z ,}tiro, street Company stilt Fod map was rafar7ared by me from an actual owrnahiwy NY 12aa. survey do 1h0 {arpurrd pC%Cpf'dlfNa Id reCwd tnfdrmaCton 8uflusL?. 2p4g Charles T Nacy L S Elate Y Oniv coPrwe irtade hym Nnr rip rental antes N Y S License No 4gi 17 LLL///////// surrey man MtKh ail ma.r.rl .yalsan 4lru tRbnrrlM elver anon M ndrl,twn M a a ray miginat of the larwn furvlyrw a arrrtfaa.tod Map blr wig a NClrNlP rant stir r"nr a teal rs seal Nix! lx,M no erN F,f Mf vw ♦Ni tprnat OIL agfalaXt at Seclrpn 7209 r„ifi}.fis,on 2 ar Ifrc stIIIIIal.e.. ,.l rail Will MnN be aom.aarM IL Nenr ins Stria EPvewe i i..r rNe aM m,e sap.lw RESIDEN'I`MLL FINAL INSPECTION REPORT Office No. (518) 761-8256 Date inspection request received: Building & Code Enforcement � i,�' �-- Dept of Community Development `�rrive�ru in Depart � Town of Queensbury inspector's Initial 742 Bay Road Queensbury, New York 12804 NI1. Fu PERMIT # LOCATIQN BATE _ TYPE OF STRUC NIA YES NO CC31Vf: AE.NT'S Chimney Height/"B" Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete lnterior/Extenor Railings 30" to 36" Exterior Handrails, balconies, landing 18 in. or more Interior Handrails stairs both sides 3 or risers Grade 2% away from foundation 8" clearance to sill plate ve shut�off reg IV G s Furnace shut-off thin 0 f akta withinl a aF Sitev y Oil Furnace shut-off at entrance to ace ar Furnace/Hot Water Heater operat' Relief Valve(s) installed Headroom, 6 ft. 6 in. on s Basement stairs, 6 ft. 4 in. Handrail exterior stairs both sides in than 3 risers Interior privacy/triin/doors/main entr cc 36" Floor Finish Bathroorn[Kitchen watertight Interior Handrails Balconies/landing 8 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/a hour fire door/door closer C:Tarrage 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 Plat Plan As Built Septic System layout required �^ � �, Okay to issue CIC (Certif. of Compliance) '�---'t�- -tl`- vss, 1'� �iz il� t►�s t j 1, C3kav to issue temp. C/O (Certif of-Occupancy) Okay to issue permanent C/O (Certif. of Occupancy) RESIDENTIAL FINAL INSPECTION REPORT Office No. (518) 761-8256 Tate inspection request[ received. Building & Code Enforcement Dept. of Community Development Arrive epa t xL Town of Queensbury Inspector's Initial 742 Bay Road Queensbury, New York 12804 NAME n^ +- - . PERNIIT # ! I_d)CATION DATE TYPE OF STRUCTURE ej N/A YES NO COMMENTS Chimney Height/"B" Vent/Direct Vent Location / Fresh Air Intake J� e •� Y 6 / Plumb Vent through roof Roof Complete Exterior Finish Complete e ` 16 Iuterior/Exterior Railings 30" to 36" Exterior Handrails, balconies, landing 18 in. or more Interior Handrails stairs both sides 3 or mow risers Grade 2°ln away from foundation 8" clearance to sill plate Gas Valve shut-off gulator 1S" above grade Csas Fnnrnace shuts within 3 feet or within line of site. Oil Fur nar + shut-o at entran to furnace area FinrnaceMot Water ter ng Relief Valve(s) ins lied Headroom 6 ft. 6 ' on Basement stairs, 6 4 in. 1landraii exterior . s bo sides more than 3 risers • �+�y .�? Interior privacy/tri in entrance 36 4� ty� � *5� Floor Finish S" Bathroom/Kitchen tertight and_b - Interior Ilandrails B comes/ iris 18 in. or more Railing across wind • in stairwells Smoke Detectors: every level every berh-aom outside every inter connected IL Bathroom fans Plumbing fixtures Foundation insulation 3/a hour fire doorldoor closer Garage fuvproofiin Garage penetrations sealed Furnace in Separate roorn protected (in garage) Mid 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 CIC (Certif of Compliance) Okay to issue temp. C/O (Cerfif of Occupancy)_ �( Okay to issue permanent C/O (Certif. of Occupancy) �-w—�- F IRE MARSHAL TOWN OF QUEENSS RY QUEEN Se) 61 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVE© 0 �r NAME L{)CATIC?N 5C,8EOULEI INSPECTION ON _..__ AM M -" APPROVED Nip, YES NO EXITS AISLE W IDTHS — -- —�� EXIT SIGNS _ --- EMERGENCY LIGHTING _ FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM e - FfRE SUPPRESSION SYSTEM { __ HOOD INSTALLATION INTERIOR FINISHES � STORAGE; ___ CLEARANCE TO SPRI LE UN CLEAFtAf10ETd HEATI G REQUIRED SIGNAGE CHIMNEY ' 'f WOOD STOVE FACTORY BLT, FIRrPIACEzOM ''SONRY C OUCH-IN [� FINAL OK TO THIS DATE REMARKS: DK INSOE TOR 40 TOWN OF iQUEENSBURY BUILDING.--S. CODE ENFORCE)"T 742 Bay Road Queen sbPry NY I2804 SEPTIC DISPOSAL. SYSTE14 INSPECTION Name Location Date Permi t # SOIL TYPE: Sand- Loam-C7ay. Results of of ati Qn Test_ ( if aW icable ) Rate-Min elInch TYPE OF SYSTEM: �/ ABSORPTION FIELD: Tat L Length of each trene Depth of trenches Size of stone SEEPAGE PITS : be Size Stone sYze� ft . x - to -- — __ _ PIPING: '. Bldg, to Tank ype Tank to Dist . Box ---�-- -- 0 4) Dist . Box to Field _=-- �'-�'-��.� L- Openings Sealed? � t + ? a LOCATION/SEPARATI es "" art Foundation to Tank l - � Foundation to Abso feet Separation of Pits ion ' ' feet Conforms as per P7o Plan " re4; Feet LOTION OF SYS es No c(- 4:" e one) TEN PROPEf T1: . -- , (Front .,� Rear - Lef M�dzt?e Front Side - Right Side COIF► NTS: - Mi ddl a Rear i } i i E f SYSTEN USE APPROVED _ YES No t Arrived: Departed_ Bui ding nspector r d 31. SO "I have seen or observed, or bell ve i saw evidence of, I all objects such as houses, wells, Tees, fences, etc., show n this document. I also r present that I have per nal measure the distant s set forth on the diagram . SIGNATURE DATE r L � r OD TOWN OF QUEEMSBURY BUILDINIG & CODE ENFORCEMENT 742 Bay Road Queensbury NIX 1_2804 (518) 761-8256 t SEPTIC DISPOSAL SYSTEM INSPECTION Name tom7t1o�o yy� ° Location A,\ ,,e-rK,. 6-r Date 17, Z'� Permit #�_ SOIL TYPE: and- a Clay- Resul is of P`ercol ti on Test- ( if applicable ) Ra a-Mi ute/ Inch TYPE OF SYSTEM: ABSORPTION FIELD : tal Length Length of each tren h Depth of trenches Size of stone SEEPAGE PITS : N Size - ft . x ft . Stone size PIPING : Size Type Bldg . to Tank Tank to Dist . Sox Dist . Sox to Field/Pit Openings Sealed ? Yes a arti al { LOCATION/SEPARATIONS : Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan �l�f es No i LOCATION OF SYSTEM ON PROPERTY : j ( circle one ) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS : SYSTEM USE APPROVED: YES NO Arrived : Departed : GENERAL LYSPECT'!ON REF DR -- ( 518 ) 761 - sass Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, SPY 12804 Arrive Depart sperptor's Initials NAME:LOCATIC3N: � � � � PPERMI� TX w 't TYPE OF STRUCTURE: RECHECK 7q d . ,r NIA YES NO COMMENTS f f G�•• � �?ru�G �•s FootingslPiers ^� l Monolithic Pour Form Reinforcement in Place The contractor is responsiblc,lbr providing Protection from freezing for 48 hours following the placement •4 of the concrete. x` Materials for this purpose on site ;{ FoundationlWallpour Reinforcement in Place Foundation/Dampproofing. l3ackfill Approval Plumbing Under Slab Plumbing Vent(Vents in Place Rough Plumbing, { Rough4n Insulation Foundation Walls Interior Ft- Foundation Walls Exterior R- Floors R- .' Walls R- Ceiling R. Duct work or piping in unheated spaces R- PProper Vent, Attic Vero Frami ng F Jack St*idstlfers BraJoist Manger gin g. Joist Hangers Jack PostslMain Beam Air Infiltration Barrier Fire Separation I, 2, 3, hour Penetration. Sealed Fire Wall 2, 3, 4 hour Firestoppin ►- ^ . GENEItA.L IIYSPECTIQN REP+f7kRT ( 518 ) 761 - 8256 Town of Queensbury _ Dept. of Community Develo On ection request received: Building & Code Enfo at 742 Bay Road Queensbury, NY 12#64 Arriv Depart is Ium -��}} NAME: PERMIT # �_ "2 LX)CATION: DATE ti TYPE OF STR CT RECHECK NIA NO CON04ENTS Footings/Piers if I Monolithic Pour Form Reinforcement in Place The contractor is responsible AW providing protection from freezl*g for 48 hours following the placensisgt of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place � �.-�^' Foundation/13ampgraroiing BackFill Approval Plumbing Linder Stab f...._ PentlS7ents in P ? ut lace _ bin it Beating Rough-In �— Insulation Foundation WallLEY* R� Foundation WallFloors Walls Ceiling Duct work or pipunheatedVent, Attic ramin Bracing/Brt � Jack PostslOe Mjoist anamI Beam ... v Air Infiltration Barrier Fire Separation I, 22 3. hour Penetration Sealed Fire Wall 2, 3, 4 hourc�� Firestoppi �j' ti tiJ �' �► T� # j 1 2 (':�5 GENERAL IN,SPECTIr01V REPQRT ( 518 ) 761 -8256 "Town of Queenshury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive am/pm Dep Inspector's mill is / NAME: PERMIT # LOCATION: DATE TYPE OF STRUCTURE: RECHECK A NO CC N%4E3+TTS tings/Piers °?. _ # Monolithic Pour Form Reinforcement in Place r The Contractor is respo ible r providing protection from ng for 48 hours following the p nt of the concrete. Materials for this purpose on site Foundation/Walhxmr. Reinforcement in Place FoundationfDanipproafing. Backfill Approval Plumbing Under Slab Plumbing VentfVents in Place Rough Plumbing, Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls .Exterior R- Floors R- Wa.ils I2- Ceiling, R- Duct work or piping in unheated spaces R- Proper Vent, Attie Vent t Framing Jack StudsfHeaders Bracing/Bridging Joist Bangers Jack Posts/Mam Beam Air Infittration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire 'Wall 2, 3, 4 hour Firestopping � o -- -2�fj 77>0 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 Depa pm Inspector's Lutialls NAME: PERMIT # O LOCATION. BATE TYPE OF STRUCTURE- RECHECK NIA YES COMMENTS Foating�''Piess Monolithic Pour Form Reinforcement in 'Place The contractor is responsible for providing protection £tom freezing for 48 hours following the placemen of the concrete. Materials for this purpose on site Foundation/Wallpour Reinfo p&t in Place Fou onll3amppr it Approval Plumbing Under Slab Plumbing VcntfVents 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 Frami lack Studs/Headers Eracing/Bridgi Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation I, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestappin GENER4L INSPECTION REPORT ( 518 ) 763. - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: 7 Building & Code Enforcement 742 Bay Road ✓ Queensbury, NY 12804 Arrive anVpm Depart Inspector's Inittiiaal}s NAME. r07CZG r. PERMIT 4 LOCATION: DATE - TYPE OF STRU RECHECK N/A YES C€7MMENTS Footings/131ers 50499tonolithic Pour Faros ( Reinforcement in Plane The contractor is risible for providing protection freezing for 48 hours following a n19rP..,ent of the concrete. Materials for this purpose o site Foundation/Wallpour Reinforcement in Place Faux�datinnlL3ampproo Backfill Approval Plumbing Under Slab Plumbing Vent'Venls io Plane Rough Plumbing Heating Rough4n Insulation Foundation Walls Interior R- :y Foundation Walls Exterior R- Floors R- Wails R- CeAmg R- Duct work or piping in unheated spaces R- Proper 'Vent, Attic Vent Frami Jack Studs/Readers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Scaled Fire Wall 2, 37 4 hoar Fi GENERAL MSPECTTON 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 a Depart ¢ Inspector's Initials - NAME: PERMIT # "Z LOCATION: DATE : ? !'x"]�� TYPE OF S LTCTURE: RECHECK. N/A. YE O ti COMMENTS Monolithic Pour Form +y�Reinfotoetnent in Place — \ The contractor Id is respo ible for providing protection 6rc>m ing for 48 hours following the nt of the concrete. Materials for this purpose on site t Foundationf WaRpour +i Reinforcement in Place Foundation/I?am } Backfiil 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 Framin Jack Studs/Headers BracingfBri Joist Hangers Jack Posts(Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall Z 3, 4 hour Firestoppi