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2000-705 TOWN OF OUEENSBURY 742I3ay Rf),icl, 42ttc�ciishttry, ICY 128011-5902 {518} 701-S201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANC A Permit Number: 2000-705 Date Issued; June 12 , 2001 This is to certify that work requested to be done as shown by Permit Number has been completed. aq Tax Map Number: 611 - 2 -90 ` ` ) Location: 26 Gentry Lane Owner: VALENTE HOMES , INC . A►ppUCant: VALENTE 110MESt INC . This structure may be occupied as a: SINGLE FAMILY DWELLING By Order of Town Board TOWN OF QUEENSBURY Director of Building & Code Enforcement TOWN OF QUEENSBURY 742 Hay Road, Queensbury, NY 12804-5902 (5 i 8) 761 -8201 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20000705 Application Number: A20000705 Tax Map No: 523400-061-000-0002-090-000-0000 Permission is hereby granted to: VAI.ENTE HOMES, INC. Owner of property located. at: 26 GENTRY Ln in the Town of Queensbury, to construct or place a Single Family Dwelling at the above location and n compliance a lQanee with the NYSaUniform Building tion together with Codlotesland the +Queensbury Zonians and other ng and filed and approve p Ordinance. Owner Address: VALENTE BUILDERS, INC. 153 SWEET Rd QUEENSBURY, NY 12804 Contractor or Builder's Name 1 Address Electrical Inspection Agency V ALENTE HOME11111 S, INC. NEW YORK GUARD OF FIRE UNDER DA.N `JALENTE-798-5200 50 COUNTRY CLUB Rd QUEENSBURY, NY 128()4 Type of Construction: S 1111 ingle Family Dwelling Value : S 1109000.00 Plans & Specifications 1111111 Z00o-705 1300 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS RMIT EXPIRES: Thursday, September 19, 2002 $191.00 PERMIT FEE PAiD - THiS PE de Enforcement Officer (i f a ionger period is required, an application for an extension must be made to the co of the Ti own of Queensbury before the expiration date.) Dated at the Town o ensbu Tuesday September 19, 2000 for ti-le Town of Queensbury. SIGNER B'Y Director of Building & de E rcement Building Permit Application Town of Q,ueensbury -- Demp of 742 BavRrJad, Qifee viniY)r, NY 12804 1761-82561 BUILDING & CODE ENFORCEMENT NOTICE Requirements prior to issuance PL•'HM of this permit: FILE Np. A pormit must be obtained before Iwginning construction. No inspections O Zatyting Board Action PERMIT FL•:ls PAID $ I r will be matte until applicant has received a Vhltt3 13U1L171N[3 PERMIT. A11 Arm ! Use RECREATION FEE applicants` spacers on this application Q MUST be completed and the sigrueture [] Plapuli tg Board Action REVIEWED BY, of the applicant must appear an the SPR ! Subdivision ! Other gr�rl,llrryq Jnvfaerfnr Lication form. nh..rk Ya'+ Recreation Fee Payment Applicant: WA -'FVTF '"'rx ri'u Groner: Address: c> G..e ev-iF�; C L� 91b _ Address: Phone # 57S _ 8 - 5ZC)C> Phone # ( ) - Property Location: I--5T. t'L3t[LG76 Tc�u "^-F c�" r Tax Map Nu tuber --�.-�- Subdivision Name: Section Block t „t t+NaZuRE of PROPOSED WORK : ESTIMATED MARKET V LUE of THE New t3t+ ' ' : CONSTRUCTION : $C. 1 /C1� Dsa�s esidence cotnmerclal ui14 Adds ding * residence / ingcommercial OCCUPANCY INFORMATION : Alteration to Building ; Mary Building - residence / commercial �i� Single Family Dw�.d• l ,� rg . Residence / Commercial Two Faml ly L3we 11 ng' no change to exterior sixes Family Dwelling office Mercantile Other Work ( describe below ) Manufacturing . Other ; GROSS AREA OF PROPOSED STRUCTURE : If ADDITION , what will use Ist floor . . . . . . . 1 a sq • ft I of new addition be ? : 2nd .Floora . .,! ! . . . sq • ft • r / Other 1~ luu7Cs . 4a�� sq . f t . ( not unfinished cellar or basement ) ACCESSORY >BUILDINGS : f �aa Detached Garage 1 , 2 car TOTAL FLOOR AREA : SQ . FT Attached Garage 1 car Private-_ Storage Building SIZE OF NEW STRUCTURESCommercial Storage Building Other c FEET X FEET Foundation 'Type : �ck-7ft� 0 '6 ^ h will an yy second- hand or ungraded Number of Stories ;V . lumber be used ? if so , for what ? ( habitable spade oryly ) height ( grade to ridge ) : feet- TYPE of ftEATINK3 SYSTEM : Number of fireplace$ and/ or woo stove ( circle all which plies ) El il a / Wood to be installed :_ rcedplot O hit / aseboard / other Person responsible for supervision of work as regards to building codes is : Name Address Phone Builder : Plumber : f/ Asti Poe r� Mason : Electrician : - 1 �K. 4tv- Z3S DECI.4RA7y0N.• Please sign below q er ,you have carefully read the statenteltt. To the best of my knowledge the statements contained in this application , together with the plans and specifications sttbilnited, are a true and complete statement of all proposed work to be done on tltie described premises and that all provisions of the Building Ccxle, the Zoning ordinance and all other laws pertaining t le proposed work shall be complied with, whether specified or noted, and that stGch work is null r• ed lay the o ner. Further, it is untlerstood tiyat I/we shall submit prior to a Certificate of Gccu ttc or Certitic of Compliance being issued, an AS BUILT PLOT PLAN I by a licensed surveyor air wrt to al bowing actual location of project on premises, Signature: ( ner, 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: ...... ............_,.,.._........................... ... Oi[ice Use Location of installation: r+c S File Permit Na. Tax Map No. _ 1 - 1 � a Fee Paid Owners Name: - .. .. .. ........................ . ....__,................... Address: _ �` "" '{ PHONE NO. �'� 2. INSTALLER'S NAME : , � � ' 3. RESIDENCE 1NFORMATION: (circle year of dwelling, indicate 0 bedroom(s) and multiply 9 of bedrooms with applicable ,gallons per bedroom to equal total dailyflow) Year of Ho se No of Hedroorris x Computation _ Total Daily Flaw 1980 or older x 150 gallbdrm = 1980 — 1991 x 130 gallbdrm = � 1991 — present 2 - x 110 gallbdrm = Garbage Grinder Installed yes 1 no "3C Spa or Whirlpool Installed yes ! no 4. PARCEL INFORMATION: (circle applicable information +& indicate measurements) Tvnoittatt ��9l1�8t„re �5 41p �tQ __...DSdroCh gr npgfl]Lt4lts_. M$teri-al� _Donl st c Water $ti;PP-1y Sand at what depth at what depth nit►nlc 1"(11 1 yat well Rolling loam ,Jeer feet tfwell; water ,supply Steep slope clay from any septic-system % slope other absorption is Ii• depth. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch aoetryctiaa: All individual sewage. dispersal systems must be designed by a licensed 5. PROPOSED SYSTEM: Far NcRr +�— professional engineer or architect (unless installed in a Planningodi 1ppt �isivn). Add '�5t� gallons to the sue of the septic tank and leach field for each Garbage Grinder, Spatepool �� c. Septic Tank: 15� gallon (mint, size 1, 000 gal.) -- 1 { J Tile Field: each trench ,Jl• Total System Length: Seepage Pit(sy number of size ofeach: �ft by 1/ de pth or thickness _�-�feet Size of stone to be used: t+ Bed System Size: x Abtemative System: length and/or size 5. HOLDING TANK SYSTEM: (if required) Number of tanks; 1 Size of each: gallons / TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE & INFORMATION FOR RESPONSIBLE PERSON (please read) For your protection, please note that pursuant to Section 136-29 of the Code of the Town of +Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact ar circumstance known by or on behalf of an applicant, shall be void. I have reaz1atu:reof =responsible application and agree to abide by these and all requiremetary Sewage Disposal Ordinance. rson O'ate 11 ,a ati to 1P W N H 0t� u1 tt1 H n It! HE !a tft I I, @ (1t o up w w It) I-! ki (,� 1-I Iwo � I1 t 11 0 tD t , . ;t1 I tD to 11 v lit ;1 it 0 11 U 004 in tit 0 I '• n, W W 191 '+1 I n (D N N C1. I- !' 0 to [n to [D 1u In in 1() 0 rt 1u It 0 0 P1 rt H 1-1) H to rt ik tD ro 0 (D N tD rh Z to N !l. to [ .-, HE. -1 �j ti 11 ID 11 lfl Ia. 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Qtiecrisheirv , 'ti' 1 ' � f� lfil7<ar -$?t7� Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances Aplaficaiiorr r. l+crc6y made to the Bwlelhtg & C od(!-Y olfir ,lol .11w i-v.vrrerr ce of tr 13rrelclr`r7,i; (are! (t' c l'cr ntirlarrr:srrurrr to the 'Vew Kw-k ,5'rrrrc I-!rc Pre vewioi; frnd fhiilflr+tz; C 'rrdc 77w U/JlVic'aw or Oil tier cfgrcc'.s' to corrrlaly -ifh all apj� ?ficalalG Ia313s. urdinairc'es, : r r;rrlrrriort.v, ftrul sr11 c ntrrfiriorrs 1/rur er+-elxlrr ul rlae+c> rnrlrrirf>rrrerr�v and also will allow a / ra 1)e car m Ivelrrir-er7 irr.,f3rc'rcc7rr.s . f , NOTE to applicant: Rough -in and Final hispecttons are required_ I Applicant Information Fuci But-niog Appliance Itilot-mation -CIO appropriate words) l Name: E/'j Lr _ 1 �r °_ � ,IPG 51�4'C' Ivood coal 'yeller gets Fireplace insert Address: C�l t''v� �+ I 'r GG Fireplace, factor)-Built: wood gcrs Fireplace, masollry: tvood Zers Furnace: wood gets oil Phone: If t-ton-masonary appiicance, please provide I oNvnet: ,t art S Mattctfactttrer Name: Y ' Address: Model NumbetLL' �? I Chimney Information phone : i.circle appropriate vk-ords) Masonry block brick stone Floe the eel size: I1whes Exact Address: "�'',,4' ._ +> &-r o"I a V L- Ae� � i ofcorrsrr-rrcriorr 00' irrst(rliatinn Factory-Built Matxtlfacturer name; Model Ntimber: :rote: Listed Bv: Number: Coustiwction 1 histallation ratalst con orm to NYS Fii-e Prevention & Building Indicate (circle) chimney material : Code. Consult available Toa+'tr ofQrreensbtei-if Handows regarding reclirired inspecilol s. ' l3ofrble sE'r11l .Cr'il�le iz trll �' Irrserfrrrerl / LJrrrcr i rrrrirr, C J�inarrei' f.iuc +' l F)ve llal-shal Code # xo,rr (velroxrded rr ),- ,-t 1 ,73 .3.389 i 1 90f !q'rrl7lfC .S`Crf PT t' A 233 26.53 (230) Afirrnr- sclk.v I f If While (Applicant) Greell (Fire '+.larslia!) 1"ClroEv' 4l3icl�. Dept. ) Pink (4 Goldirijod Washier's Dept.) TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 SAY ROAD yam 4UERNSHURY NY 12804 (518) 761-8256 - ARRIVE : - DEPART : INSP : FINAL INlSPECTION REPORT - USSIDENTIAL DATE INSPECTION REQUEST RECEIVED : NAME LOCATION /' �G-C-C71 ■ t�� _� '�, ,rt DATE l �:L" � �, ��� � PERMIT TYPE OF STRUCTURE FOOTINGS FOUNDATION SACKFILL FRAMING, ROUGH PLUMBING SEPTIC INSULATION FINAL ELISCTRICAL WOODSTOVE OR FIREPLACE XZA� j 1195 1 NO Y iiE ENT T ING V ROOFING EXTERIOR FINIS DECK/PORCHfSTE -s/AAjL .NG RELIAF VALVES F OX WA TING O DOORS FINISH ,FLOORS : BATH/KITC HEN rf A E HT ER EFL DRS SWEEPAE OTHER FLOORS CARPETE CLEA C LING Smogs DFTEC BATHROOM }FANS _ h PLUMBING FIXTURES FOUNDATION INSULATION rr GARAGE FIBS PROOFING DOOR CLOSERS FINAL MLECTRICAIi - - - - SITE PLAN/VARIANCE REO % _ .'FINAL SURVEY PLOT PLAN V K TO ISSUE Cf0 OR CLC� 0 UTUTIES O 4 0 }L Ico Ln 0 z N c9 ._,.r ri 577— 71737.E GRAVEL IF/ �n •r W4 N Uj try �- O® aw op /., Col U UTUTIes r-1 0 LL H m i MERELY CERTIFY ThAT MIS nap WAS PREPARED MOM AN ACTUAL FIELD SURVEY. „�• •�" D%mmmmm KBE M" OR AWTM " A YJRW WV MOM A LIWNM LAND #I MM" ELL, IB A VW" a: um" ram, as-aw" % W MLw WN STALL LOUD " LAVA' 'OILY IRON L f Steves Wftt w r rig MP ka om NIA MIM AM ORIGYIAI � ILK LAID FIAMYgb iFX awl K OOMgMM YO OE YAUO WK OO W %01111 OAIM Sg MM MOM M *Mkn 1NAY 'MW SUWA'Y W8 FWAMfD a AOGCM MW =1 is Land Surveyor, LLB ° °�`a' K"`A1e pow �Y uc Law wRM sTAa AaeoaAwall as rllarsaoMAL LAIIO aMtYEllab< 4AIp►'110W SNALL MIN aaY W W PERSON rag MMOM W "WX R RIEPARM AIO ON Ma WW M ns I= OOI~AMY. efARMMwTAL 169 Haviland Road Queensbury, New York 12801 AOLMOY " LO WO ON"AM LX= MEM A AM TO W 6560 i or m Lamm Wa+M� (518) 792-8474 New York Lic. No. 50135 Map Showing As -Built Location and Dimensions of uilding No. 90 in Phase-3 BayBridge Town of Queensbury, Warren County, New York 82.• k %E W yr , 3 7. -, �a M�l NO. IDATE W a F=— Q LL a W z a O U V) Q W O 0 N 4 DESCRIPTION MAP REFERENCE: SAYBRIDGE PHASE - 3 DATED: JUNE 29, 1987 BY: COULTER & McCORMACK FILED: MAY 24, 1988 S - 1 SHEET 1 OF 1 VALENTE HOMES DWG. NO. 00319-90 FIRE MARSHAL TOWN OF QUEENSBURY QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST R EIVED - L! p/ PERMIT # NAME �.•, LOCATION SC fEDULE INSPECTION ON AM ANYTIME VED EXITS WA YES NO AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION €€ INTERIOR FINISHES STORAGE: - CLEARANCE TO SPRIN LERS _ CLEARANCE TO HEATIN UNITS REQUIRED SIGNAGE CHIMNEYj�Q t '� WOOD STOVE FIREPLACE - MASONRY _ FIREPLACE - FACTORY BUILT REMARKS: OK TO THIS DATE r r f,r INaptup.pu@ INSPEC i 1:. J/ L/ RESIDENTL4L FINAL INSPECTION REPORT 4f (ye7e No (518) 761-8256 Date inspection request received: 1� f �" Y Building & Code Enforcement Dept. of Community Development Arrive rt Town of Queeusbury s 742 Bay Itosd Queensb , New York 12804 NAME t e / ;A" /"� `� W'% PFIt3III r # e C? LOCATION 1 ATE f( t3E 9 J "TYPE OF S'1 E nl�S NO COMMENTS Chimney Height/"B" Ventn3irect vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railin_ogs, 30" to 36" Exterior Handrails, balconies, landing 1S 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 expo sedhe tar IS" a ve grade Gas Furnace shut-off within 30 or withi line of site Oil Furnace shut-off at entrance furnace Furnac&Hot Water Heater open frog Relief Valve(s) installed Headroom, 6 ft. 6 in. on stairs Basement stairs, 6 ft. 4 in. Handrail exterior stairs oth si s than 3 risers VJ Interior privacy/trim/ trance 36" Floor Finish Bathroom/Kitchen watertight Interior Handrails Bat 18 iVr n. or more Railing across window in s 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 fnreproofin Garage penetrations sealed Furnace in separate roam protected (in garage) Light ventilation per room Safety glazing l8" or less from floor Final Electrical Site Plan/Variance required Final Survey Plot Plan EC.EI �JE�7 As Built Septic System layout required. ' M Okay to issue C/C (Certif. of Compiiance) Okay to issue temp. C/O (Certif. of Occupancy)_ Okay to issue permanent CIO (Ce:rtnf. of Occupancy) FIRE MARSHAL CL TOWN OF QUEENSBURY QUEENSIBURY, NY 12804 (518) 761 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST R ";CEI D PERMI�' NAME _ LOCATION -s� SCHEDUL INSPECTION ON — A. ; rR+f ANYTIME APPROVED N!A ! YES EXITS AISLE WID EXIT SIGNS EMERGENC LIGHTING FIRE EXTING SHERS _ FIRE ALARM S TEM FIRE SPRINKLE SYSTEM FIRE SUPPRESSI N SYST M HOOD 1NSTALLATI N INTERIOR FINISHES STORAGE: _ ~� CLEAR,eNc SPRINKLERS CL E T HEATING UNIT SIGNSREQUIRED SIGN E CHIMNEY WOOD STOVE _ FIREPLACE - SONRY _ FIREPLACE - ACTORY BUILT REMARKS; ' OK TO THIS DATE � 'P' INSPECTO _ 9E.NERA INSPECTI+f iN REPORT ( 518 ) 761 - 8256 - ".� Town of Queensbury DepL of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive atn/pm Depart \� Inspector's Initial NAME: V PERMIT # LOCATION- DATE TYPE OF STRUC RECHECK NIA YES NO COMMENTS Footings/Piers �'"t Monolithic Pour Form _ Reinforcement in Place The contractor is responsibl r providing protection from for 48 hours following the t of the concrete. N1rlateriais for this purpose on to Foundation/Wallpour Reinforcement in Peace Foundatio Z oofrn Back1i11 Approv Plumbing Unde ff Plumbing VentJVents in Plao Rough Plumbing . id Heating. Rough-In Insulation Foundation Walls Interior 7R- FloorsFoundation Walls Extend R Walls Ceiling Duct work or piping in unheated spaces - Proper Vent, Attic Vent Frami Jack Studs/Headcrs BracinglBridgin Joist Hangers eltration Baparation 1, 2, 3, hour Penetration Sealed Fire Wail 2, 3, 4 hour Firestoppin GENERA.I. 1lY,SPECTIPN REPORT r' 0 � ( 518 ) 761 - 8256 00 Town of Queensbury Dept, of Community Development Date inspection request received: Building & Code Enforcement 1 742 Bay Road ^'� r Queensbury, NY 12804 Arrive` pin Depart tor's initial Lam'V NAME: PERMIT # LOCATION: DATE , 1 TYPE OF STRUCTURE: RECHECK _ NIA YES NO COMMENTS FootingPiers Monolithic Pour Form _ Reinforcement in Pi The contractor is re nsible r providing protection m fr ing for 48 houis followi the pl nt of the concrete. Materials for this on si Foundation/Wallpour Reinforcement Iq Foundation/Dampprnon Backfdl Approval Plumbing Under Slab Plumbing, Vent/Vents in ace Rough PI mbinEE Head ugh-In kI on POO Foundation Walls Interior R- Foundation Walls Exterior R- Floors R.- Wails R- Ceiling R- Auct work or piping in unheated spaces R _ Prosper Vent, Attic Vent Framiniz Jack Studs/Headers Bracing/Bridging Joist Hangers Jack PcstsWmn Beam Air Infiltration Barrier. Fire Separation 1, 2, 3. hour Penetration Sealed ire Wall 2, 3, 4 hour Firestoppi f gUME'RAL M6SEECTION REPORT ( 518 ) 761 - 8256 Town of Queensbury Dept, of Community Development Date inspection request received: v r Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive Depart Inspector's Initi NAME: PERMrr # LOCATION- BATE : 1+ TYPE OF STRUC:TI : RECHECK N/A YES NO COMMENTS Footings/Ners Monolithic Pour Form _ ��.E. El� t 't tom` Reinforcement in Place d , L The contractor is responsible for e providing protection from fieezzi for 48 hours following the pl m t r �'Tt ►C p�h of the concrete. `L Materials for this purpose on �`t3T1 u. fi� p 1�L 17 Foundation/Waltpour � '" ALL Reinforcement in Place Foundation/Damppfoofin Q Backfill Approval Plumbing Under Slabj Plumbing Ven nts in Plao Rough Plumbin rj y Heating Rough-ln Insulation Foundation Walls Jnteri r R- Oa U►J1T Foundation Walls E or R- Floors R- Walls R- Ceiling R- {� Duct work or pin in ELL {"o _-.� �� u' I unheated s R- �-y _ = Proper 'Pent, Attic Vent '� Cf L y [}} ] Ft, Framing Jack Studw'Headcrs Bracing/Bridgine. Joist Hangers Jack Posm/Niain. Beam Air infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed 11 2 39 4 hour ire ppin ,,,..��.,.... ... . . ..:,.. *may, � GENERAL MSPECTION REPORT ( 518 ) 761. - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Rosa Queensbury, NY 128U4 Arrive"!VA Depart / Inspector's Iaiti / �y NAME: e \r � PERMIT #Z:Q �J LOCATION. n DATE : U TYPE OF S C RECHECK N/A YES NO COMMENTS Footings/Piers -�- Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection front freezing for 48 hours following the placement Of the concrete. Materials for this purpose on site Foundation/Wallpour.,n -� Reinforcement in Place. , Fou tion/Da rooiin Backfill ApI, Plumbing under Slab PI ng Vent/Vents in Place N to Pluming l=T S Frrs_r•`• ' 1 t �`(� Heating Rough-In Insulation Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- LEuct work or piping in unheated spaces R- r Vent, Attic Vent mi Jack. Studs/Headers BracingMridgin Joist Hangers a'� x *� `i t ►JG r1 ►�Pc t+� t tir ' ft1 � f31ti Jack PostslMain Beam tal^FtPES i l G Air Infiltration Barrier L RVCt�3V Fire Separation 1, 2, 3, hour s Penetration Sealed Fire W'POWI2, 37 4 hourPII�i �-' i j 1C�' , L T1 i TOWN OF QUEENSBURY BUILDING &_ CODE ENFORCEMENT Bay Road Queensbury NY 12804 (5 i s) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Named rc' Location CSC=i�� � /q1) C.,✓ Date x +( Perini t 1M SOIL TYPE : Sand- Loam- Clay- Results of Percolation Test- ( if applicable ) Rate-Minute/ Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS : Number- Size - ftm x ft - Stone size PIPING : Size ype Bldg . to Tanis Tank to Dist . Box Dist . Box to Field/r!Y Openings Sealed? s o a ti a f LOCATIOVSEPARA►TI feet Foundation to Tank Foundation to Absorption feet feet Separation of Pits Conforms as per Plot Plan Ye No LOCATION OF SYSTEM ON PROPER ' ( circle one ) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS : SYSTEM USE APPROVED : (YES NO Arrived: Departed : Building Inspector TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY I2804 (5I8) 761-8256 y SEPTIC DISPOSAL SYSTEM INSPECTION Name 144,� Locate on j,�t+7 Date Fermi t (1(J 0 5 SOIL TYPE: Sand- Loam-Clay- Results of Percolation Test- ( if applicable ) Rate- Minute/ Inch TYPE OF SYSTEM: ABSORPTION FIELD : Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS : �ber- Size - ft . x ft . Stone size PIPING: Size ype Bldg . to Tank i �" 3 Tank to Dist . Box Dist . Sax to Field/Pit . Openings Sealed? Yes No art aT LOCATION/SEPARATIONS : Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: ( circle Front - ear,.) Left Side Right Side Middle Front - Middle Rear COMMENTS : .r� E SYSTEM . USE APPROVED; YES Nib Arrived: 1 ._f Departed : r BuiTd1Aq Inspector t GENERAL LysPECTIO.N REPORT ( 518 ) 751 - 8255 Town of Queensbury Dept. of Community Development Date inspection request received: j� r Building, & Code Enforcement 742 Bay Road 'i t Queensbury, NY 12804 Axrfve amlpin Dep ttt Inspoctor's Initials NAN4E: t PERmff # 77,6 `y LOCATION: BATE : L I atErl�' TYPE OF STRUCTURE: . RECHECK t NIA YES NO'a COMMENTS FooUingslPiars _ _ � Monolithic Pour Form, Reinforcement in PlacO The contractor is responsible for providing protection "m freezing; for 48 hours following the placement of the concrete, , r/ Nlaterials for this purpose on ` 'te Foundation/Wallpour Reinforcement in Place FoundationfDampproofing kfAll Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbi Heating Rough-In insulation Foundation Walls Interior Foundation Wars Exterio R- Floors Walls - Ceiling R- Duct work or piping, unheated spaces R- Proper Vent, Attic V Frami Jack Stucls/Headc BracingBridgin Joist Bangers Jack PostsJMain Air Infiltration Ba Fire Separation 1, 21 3, hour , Penetration Sealed -. Fire Wall 2, 3, 4 hour, Firestoppin V Y.,E,NERAL INSPEC NI REPORT ( 518 ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection retitiest received: Building & Code Enforcement 742 Bay Road J prn Qneensbury, NY 12804 Arrive am/pm Depart [ �G Inspector°s Initials r NAME_ _ PERMIT 0 LCICATIi]N: DATE : — �-(�0 [Q 17ym OF STRucTcaRE_ RECHECK NIA S COMMENTS ngs/Picrs Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection fro ing for 48 hours following t cement of the concrete. Materials for this purpose n si Foundation/Wallpour Reinforreruent " Place Foundatio fill Rackfill Approval Plumbing Under Slab Plumbing Vent/Vents in lave Rough Plumbing. Heating Rough-In Insulation Foundation Wails 1 erior R- Foundation Walls rior R- Floors R- Walls R- Ceiling R- Duct work or piping in untreated spaces R- Proper Vent, Attic Vent Franu 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, 31 4 hour Firestoppin t � Q 4" 240 S .LQ"t Lol 107 l� w� 1 1L O l07 1 AN ISPOW f � 0* 1 all