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2000-683 TOWN OF OUEENSBURY 742 Bay Road, Qucensbw, ICY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761=8256 CERTIFICATE OF OCCUPANCY Pem it Number: P20000683 Date Issued: Friday, January 05, 2001 This is to certify that worm requested to be done as shown by Permit Number P20000683 has been completed. (� I q 1 Tax Map Number. 523400- 48-000-0008-04I-000-0 00 Location. 87 SURREY FIELD Dr Owner. THE NUCHAELS GROUP LLC This structure may be occupied as a: Single Family Dwelling Garage - 2 Cars Attached By Order of Town Board Fireplace TOWN OF QUEENSBURY Director of Building & Cock nforcemew TOWN OF QUEENSBURY CL 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 BUIEDIN+G PERMIT Permit Number: P20000683 Application Number: A20000683 Tax Map No: 523400-048-000-0008-041 -000-0000 Permission is hereby granted to: THE MICHAELS GROUP, L.L.C. Owner of property located at: 87 SURREY FIELD Dr in the Town of Queensbury, to construct or place a Single Family Dwelling at the above location in accordance with application together with plot plans and other information hereto bled and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owner Address: THE MICHAELS GROUP, L.L.C. 10 BLACKSMITH Dr MALTA, NY 12020 Contractor or Buiidei's Name / Address Electrical Inspection Agency MICHAELS GROUP NEW YOR.K BOARD OF FIRE UNDER 10 BLACKSMITH Dr STE 1 MALTA, IVY 12020 Type of Construction: Single Family Dwelling Value : S 159,900.00 Plans & Specifications 2000-683 SINGLE FAMILY DWELLING WITH 2-+CAR. ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS $264.00 PERMIT FEE PAID - THIS PERMIT EXPIRESO Friday, September 13, 2002 (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.) Bated at the Town 415 bu Vyyedn s a Se tember 13, 2000 SIGNED BY ,/V for the Town of Queens6ury. Director of Building & Code Enforcement .Building Permit Application ! 'own of Queensbury - Dept. of Community Develufxrtew, 742 Day Roan, Queeusru oy, NY 12SO4 f 751-82561 n� NOTIBUILDING do . CODE ENFORCEMENT Requirements prior to issuance A pormit must be obtained before of this permit: PERMIT F1LE N beginning construction. No inspections PERMIT FEE PAID will be made until applicant has received � ZZonlrtg Board Action tr a VALID BUILDING PHRmrr. Alt Area f Use: RECREATION FEE 1-1 1D y\ applicants" spaces on this application MUST be completed attd• the signature 0 Planing ,board Action REVIE, WED DY.- of the applicant must appear on the $PR I Subdivision I Other Dreiklin,q hirl+rrmr k,applacation form. rr.m& ,.,.. l �-+ Recreation Fee Payment llpplic,Int, �3-Tt1= lC 8S Ln4enS51 Owner: Address: C��M1 . T ]" a Address: Phone # ( rJi ) to - ��__ Phone # Property I..ocation: t�� f>,a " yihGA�..S 0! L41 Subdivision Name: C.5> 1FL1 kt t �ira , yy%w>s Tax Map i`Tunzt�cr .. -' Section Tiir+ck Tint NATURE OF PROPOSED WQRK : ESTIMATED MARKET VALUE OF THE �{ New Building : CONSTRUCTION * $ 1 * residence / commercial Addition to Building : residence / commercial OCCUPANCY INFORMATION : Alteration to Building : Primary Building - residence / commercial �_ Single Family bwiirt - Residence / Commercial Two Family Dwell no change to exterior size Family Dwellin ; Office ALG Other Work ( describe below ) Mercantile F„ .. . Manufacturing TV . other .' ' GROSS AREA OF PROPOSED STRUCTURE W,,I,, If ADDITION , what: will use 1st Flaor . . . . . . . . l�rl sq . ft . of new, addition be3 : end .Floor . . . . . . . . �SyL _ sq . ft . Other Floors . . . . . sq . ft . ( not unfinished cellar or basement ) ACCESSORY IiUILI] INGS : Detached Garage 1 , 2 car TOTAL FLOOR. AREA : W ;�,;P SQ • F` * Attached Garage 1 , car Private Storage Buie SIZE OF NEW STRUCTURE : Commercial Storage Building Other FEET X FEET Foundation Type : ' will any second- hand or + ingraded Number of Stories : "L Lumber be used ? if so , for what ? ( habitable space only ) -- Height ( ggrade to ridge ) ' feet TYPE OF HEATING SYSTEM : Number of fireplaces and/ or wao stove ( circle all which plies ) to be installed : _ 1 Electric / Oil / as / woad Forced Hot. Air / Baseboard. / Other Person `sponsible fo upervision of work as regards to building codes i s : v -tj 42seL,. vt2 Nd A dre s Phone � l Buil.dertFlk Plumber : 'z Mason : t i C�' Electrician D,EGL,ARA7y0 .* Please sign belmv after you ]lave careftdly read the statelxtenta 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 clone 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. I~urther, it is understoaci titat I/we sliall submit prior to a Certiricate of Occupancy'bor Certificate or Compliance being issued, an AS BUILT PLOT PLAN by a licensed sc drawn to s ale , showing actual lac of project on premises. Signature: r; ` a (lywrier, owticr's agent, architect, contractor) Application for Permit — Septic Disposal System f'<lsul7 Of Q1104n,s1)111 y 742 I3rryRorrel cre'e'n,sfi7rry, NY 12804 (Sly) 761-82.56 I . OWNER INFORMATION : ..................................... ....... ................................ . ......_...........:.......,.....I........... ... Location of installation: �� \� ,s {� orfice ilxc Tax Map No, / / File Pernxi N� oo Owner's Name: �i l �1E Fee Paid C c 1s I ..--......... ........_-..... . _. .: .adds-eSs: � � 2. INSTALLER'S NAME Y PHONE NO. 3 , RESIDENCE INFORMATION; (circle year of dwelling, indicate # bedrooin(v) and 111L)It ip ly 11 Of bedroonss with applicable gallons per bedroom to equal total daily flvi+ ) Year of House: No, of Bedrooms x Computation = Total Da ly Flaw 1980 or older x 150 gaUbdrin 1980 — 1991 x 130 gal/bdnn 1991 present x i 10 gal/bdren Garbage Grinder Installed yes / no Spa or Whirlpool Installer! yes f no 4 . PARCEL INFORMATION: (circle applicable itiformation & indicate tsyoasurements) T�2 o rra [x if N s tare r un Wa er B dr ck or Impervious Materi-tl Domestic Water Su l lolat sarrcf ` Ciollirrg hl� at sul7a1 depth at what deptla irrerrricilrc —� J Steep .slope clay ��lriret feet r— �';/u slope other r1'svell; svaier s,ipply, depth: ftior7r �r��Y' ,sc'l�tic' .ry;ster:r absoey.114m Percolation Test- (7ir be ceimplefed by lie'ela.redlr7`r Ji',s,sirslurl engineer ew architect) other —__- Rate. _�(� r77ilt1rtc� perinch 5 . PROPOSED SYSTEM : For New Construction; All individual scw.igc disposal systcitss nuast be designed by a licensed Professional engineer or architect (unless insialled in a Planning Board approvcd subdivision). Add 250 g,:allcans to ilhc si:fc of (ltc scptic tank and Icackr Geld for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: I QC)0 gallon (min. size 1. 000 gal.) 1 (}�/� p h treirch * - f Are, voe* , 1 L. O):A) Tile Field: eac " t ft. Total System Length : /l Seepage Pit(s); number of size of'each: fl. by --1 Size of Stone to be used: ff , — _ / depllr or thickness Bed System Size: x Alternative System: -+ —�- len),rth aiacL4)r .size 6. HOLDING TANK SYSTEM. (if required) Number of tanks: ±j.9.j " / Size of each : gallons / TOTAL Ca acit P Y: gallons Note: Alarm System and associated electrical work must be insp=ted 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 Cade 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 a [I requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. *, a . -�Sure of responsible person Date Fire 41 :11'till:l ! Office !`u3t'tl rrf ( ltic ilslriirs". 742 11:is Rw.ld, QueenstrtlrV, `Y ( 519 ) 7t> 1 -820 Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances Date i.>I� 20 20 CKwN I'crttsit No. Cz -C_.-''i. 1 " p `� • ..wr 11�pfiC'cttiurt is /iereh} erttarle 1V 11te littiltfirrS d C rrtic.s CJIIit tO fi)P 1hC i N;smemr-4 rrf tt liteiltlrrr ; tall Us'e Pcrll lit lattrsctctta( 14U flee hNely Ye)i k -Stol f irn Pi'evertlitrrr oeid Hidlriitry Code - 7h<! appli€ww or oil,tta r agre'c-s' to comp t, ir'i1h all applica/)h e ltrlk .ti, ordille 11ces, i-cg rlwi«tt5, area cril c'rarrditirarrs tllcri are fader{ raj" thteksc° requirements rartd also will trimly ell/ inspectors to errfarlrrcwi.vc y le.) pcifc,rm rc gtrire'd in.spectioll.s - NOT.E to applicarlt: Rough- In and Final hispections are required . Applicant Information Fuel Burning Appliance Information ( circle appropriate words) Narne : l`'"' 1tC r1 , 5 J (? . s (atic : z,,oacl coal _pellet gas i Fireplace insert Address: ■ + '°►� V,\ 11„J, Fireplace, factory-bunt : slrood Fireplace. masonry: wood acrs Furnace: snood gets j oil If non-masonary applicance, please provide (Jlv3pner: xNv4anufacturer Name: Address< Nlodel Number: Chimney Information Phone: � (circle opprol)riate words) my block ick Stolle ltte rile Q eel sire; inches Exact Address, ofconstnuctiou oriersrrdfla{lair Factory-Built MailLlfacturer name: .Model Number: Note: Listed F3} : Number: Constrtaction f lnsrallariolt louse corn oral to NYS Fire Preventiolt &P Bttildhig Indicate (;circle) chimney material : Code. Cottsrdt available Towiz of Qieeenshttrs Hatldows regardhig required insjiections. Dooble brill Tviple wall f lrtsrrltrfcCl /' Direct vontirtq Clritrtarr�l f.ir7c + Cyrii�3 it�',�r IE:W4e � m -- "sa calQ►rrx+� n �uz.ar-y, 3V xrsr Yca.r r FI 1v :} ends{rrrl Code # Colfc er �r^f�, S Hc_tirtttfc rf 12c c'r it ed-Iirrtrr Ir c}ertrt{ rl trrJ- { 7? .i_� S1 (! 9ll) YtrGl{c ,5trfc i _ -f '3 i 2655 730) Mnol' Sales _..__. �y f //� / rt �'w"t^Y - FGYV+Y f/[�e%' O't White ( Applicant) Green ( fire 'Matsilal ) `>;"riles' { 11ldtr . []edit. } Pink Goldenrod (Casilicr's Dclit. ) J 169 Haviland Road, Queensbury, NY 12804 Phone - 518-745-4400 Fax - 518-792-8511 January 21 , 2002 Mr- Glenn Bruso Job ## 46143 New York State Dept. of Health 77 Mohican Street ��`` �,, Glens Falls, NY 12801 CDOO/ - / IZE- Lot # 14 -- Anthony & Patricia Salvarezza, purchasers Emerald Grove Subdivision - Queensbury (T) Dear Glen: This letter is to inform you that I inspected the completed septic system for the house on Lot # 14 in the Emerald Grove Subdivision on January 14, 2002. The house being constructed on this lot is a 3 bedroom Douse with no expansion attic, no garbage grinder and no hot tub. The septic system as installed consists of a 1 ,250 gallon septic tank and 217 lineal feet of absorption trench. The installation conforms with the requirements of the approved subdivision design drawings. Please call me if you have any questions or concerns. Since ely, w Thomas W. Nace, P.E. cc : Dave Hatin, Town of Queensbury Michael Vasiliou — fax 668-5656 03 Q rfLl 3FC3j MlLI�GI�G�� r�Ll1�[�[�r l<� C I�G�GI-aG� GnC1CfG�LT� GrGr� C.I�� LIrJTJ� Ll� C� BY THIS CERTIFICATE OF COMPLIANCE THE S NEW YORK BOARD OF FIRE UNDERWRITE7,ra;, S S BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORKo NY 10038 S CERTIFIES THAT Upon the application of upon premises owned by S SS SFOREVER ELECIBOEL ELECT. THE MICHAELS GROUP THE MICHAEL: S 5 WILLIAM D. MCPARTLON 10 BLACKSMITH DR, 2446 JAFFREY ST. OUEENSBURY, NY 12804 SCENECTADY, N.Y. 12301 , S Located at 87 SURREY FIELD DR. OUEENSBURY, NY 12804 Application Number: 1000112 Certificate Num 1000112 Section. E3lock: Lot: 41 Building P rmit2000-6$3 DC: A239 occupancy, wherein the re s tem consisting of S Described as a Residential P y P y5 9 electrical devices and wiringr described below, located inton the premises at: SBasement, First Floor, Second Floor, Attached Garage, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was C, found to be in compliance therewith on the sth Day of January 2001 S SName CITY Rate Ra_ tinQ Circuit Tyne ' .� Alarm and Emergency Equipment 6 Smoke Sensor Pj Appliances and Accessories Dish Washer 1 L5 KW Exhaust Fan l F.H.P. S Furnace 1 Gas Future Appliance Feeder 1 15 =°cps S Bell Transformer 1 Wiring and Devices C� 32 Fixture Outlet La Receptacle 49 General Purpose Switch 41 General Purpose Receptacle 1 30 Special Receptacle 1 so Special Receptacle 4 GFCI C Pole/Post Lighting Standard 1 Residential c seat SService �r 1 Phase 3W Service Rating 200 Amperes �7 Continued on Next Page 1 of 2 SThis certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. S OrJ'aeJ�rJ� r rJ� r�r.PrU� cl�15 r rnr� r��n rJrr1 rJsr rJ�:rTJOR rJ"cn�n rJcr� r� T Mr3 �r�rilgil eTefrJ1c.1'efar�rJ� rJe1� rJ�cJ�eJ� cJ�rJ� t1�� efeT p 13Y THIS CERTIFICATE OF COMPLIAIYCE THE S NEW YORK BOARD OF FIRE UNDERWRITERS S CSSJ BUREAU OF ELECTRICITv S 40 FL)LTON STREET - NEW YORK, IVY 10038 CERTIFIES THAT S Upon the application of l� pP upon premises owned by FOREVER ELECIBOEL ELECT, THE MICHAELS GROUP THE MICHAEL, WILLIAM D. MCPARTLON 10 BLACKSMITH DR. S 2446 JAFFREY ST, QUEENSBURY, NY 12804 5 e� SCENECTADY, N.Y. 12301 , �7 Located at 87 SURREY FIELD DR. QUEENSBURY, NY 12804 Application Number, 1000112 Certificate Number: 1000112 S Section: Block: Lot; 41 Building Permit: BDC: g239 2000-683 Described as a Residential occupancy, wherein the premises electrical system consisting of S electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Garage, SS was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 5th Day of January 2001 Nam e MY. Rate Ratine Circuit Tyne C��''•��,,, Service Disconnect: 1 150 MB G5J Meters: 1 7 S S (lr`� seal L' Th; 2 of 2 L_L_L_"""�,,,certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. l�icPrJ3cJ'� cJ�cJ�cl�c.1� rJ�rJ�cJ�t:J�c l� t J�r�i_l�cJ�c I'� rJ�cJ�tJ�rJ�r� rU�cPr�r.l� c rrJ�rJ�r.T cl�rJ�rJ� rJ� FIRE MARSHAL TOWN OF QUEENSBURY QU'EENSBURY, NY 12804 (518) 761 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEI D NAME w LOCATION PE M1 0 SCHEDULE INSPECTION ON r L - A PM APPROVED NIA YE5 NO EXITS .. AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTINiG FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLE SYSTE FIRE SUPPRESSION SYS1 EM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO PRINiKLERS CLEARANCE TO EATING UNITS REQUIRED SIGNAGE CHIMNEY WOOD STOVE FIREPLACE ❑ MASONRY FACTORY BLT. ❑ GH-IN FINAL REMARKS: OK TO THIS DATE o4smi .wm INSPECTO TOWN OF UVEENSBURY HUI;.DItJG & CODE ENFORCEMENT 742 BAY ROAD QUEENSBURY NY 12004 (51$) 7151-$2S6 ARRIV$ : .~o- DEPART : FINAL INSPECTIOK REPORT RESIDE S DATE INSPECTION REQuEsT RECE;VWD : ,r NAME l__ J LOCATION ` DATE PERMIT / TYPE OF STRUCTURE �. FOOTINGS FOUNDATION BACKP• ILL F ROUGH PLUMBING 58P'.CIC RAMING FINAL LLECTRIC)lI; WOpy GTOVEIOROrlRXPLACF M A VES H6 CHIMNEY HEIGH'�'�'� c SNT +'HEIGHT U V N PROOFING 11) .E� I R �'Ih7 H Ff K +'POR H TEY fR_AILr+ BELIEF VALVES F E OT A O E I G INTERIOR rttrMfpnrY�CY S F-INISOO ----.BATIZ IT_g�E�TKRT.IjOH O2'fiEROCiRS SEEP L OTHER Fr0ORS CARPETED S CL A NCE LING ,S�70fCE DETEC S 1'�� E3RC+OM FANS PLUMBING FIXTURES OU D T ON N LATION GARAGE FIRE eapgE mq II DOOR CLOSERS `�f FSN ELg TR CAL S.ITf.; MANZ ARIANCE RE,_ EINA14 SURVEY PLAT PLAN ' �OK TO ;SSJ,�� C/O OR CfC \00� ) opm�\ RESMENTIAL E1NAL INSPECTION REPORT Office No. (518) 761-8256 Date inspection request received: Building & Code Enforcement Dept. of Community Development Arrive Depart ` Town of Queenshury Inspector s . 742 Bay Road Queensbury, New York 12804 CX NANIE _ IACAT I N PERMIT TYPE OF sm CT`URVO DATE NIA YES No COMMENTS Chimney Heightr B" Vent/Direct Vent Location Fresh .Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Railings 30" to 36" ExteriorF-IladraiiIs, balconies, ides it or more Interior Handrails stairs both sides +ear rnarc risers \ Grade 2% away from foundation ��t i � �'C�'�--�� ►r �/ i HcAt.1 8" clearance to sill plate ' Gas Valve shutoff +exposo& ator 18" bove grade ` Gas Furnace shut-off within 30 eet or ' line of site --- Oil Fa*m ace shut-off at en to ce area FurnacC)Hot Water Beater a . Relief Valve(s) installed Headroom, 6 ft. Basement stairs, 6 ft. 4 in. Handrail exterior stairs bot�hsi les more than 3 risers .Interior privacy/trim/doors/ma entrance 36" Floor Finish BathroomlKitchen watertight Interior Handrails Batcomi 18 in_ or more Railing across window in staiv vells Smoke Detectors: every level every bedroom outside every bedmoru inter connected Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofing Garage penetrations sealed l Furnace in separate room protected (in garage)_ — ✓ Light ventilation per room_ _ Safety glazing l 8" or less from floor Final Electrical Site Plan/Variance required Final Survey Plot Plan As Built Septic System layout negnired —" Okay to issue C/C (C:ertif. ofCompliaace)� Okay to issue temp_ C/O (Certif of C)ccupancy)_ Okay to issue permanent C/O (Certif. ofOrrupancy) TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 74 _2 BAY ROAD QUEENSBURY NY 12804 ,`�!, Ent ] _ (518) 761-8256 'ARRIVE : DEPART : INSP : FINAL INSPECTION REPORT - REBIDEN 'IAL DATE INSP TION REQUEST RECEIVED : NAME LOCATION . DATE PE T N TYPE OF S RUC URE FOOTINGS FOUNDATION BACKFILL FRAMING ROUGH PLUMBING SEPTIC INSULA ON '�— FINAL ELECTRICAL- WOODSTOVE OR FIREPLACE N x No CliI�MNEY H�'IrHTlB VENTIIi_^EI�d"'HT PLUMDING VE R G T I F N C O H S NGS RELIEF VALy S F RN E C7T WAT R E G E I O R M IINC i7,S ,LkRFINISH FLQ0RSz -.-AATlJ/KIT9Ajjy WA T GH TH F ppR3 S E PAB 'I'13E F OOR C ED FQj!N _ STA R C EA C LING S OK D E O NG IX ES D O I C,. AUQE FIRE PROD F__ j DOOR CLOSERS F CTVAL 51TE N V RI NC R FINAL_J-„URVEY PLOT p�N K TO Iss OR c i - DEC 2 8 2000 MAP REFERENCE: SURREY FIELD SUBDIVISION MODIFICATION TO AN APPROVED SUBDIVISION DATED: OCTOBER 27, 1998 BY: VAN DUSEN & STEVES LAND SURVEYORS, LLC • r ((����pF NE I+V y�� l N.ai--v D Steves Land Surveyors, LLC 169 Haviland Road Queensbury, New York 12801 (518) 792-8474 New York Lie. No. 50135 'UNAUTHWt= ALIE 11M OR ADDITION TO A SURVEY NAP DARNS A LICDOW UYD SIAWYoR. SEAL 6 A VILLA ICN DF =7100 7901. SN{-01RUM 9. OF IM NEW YORK STAB' MUCAIDN LAM.' 'ON.T GOM PRM M 0MG ML OF THIS SIRVCY PAR= WM AN ORIQML OP M LAND GLRVC/ORS REAL SHALL K C@I9OOM TO K VAtD IRUE CWM* 'CERIVIC UMS NNCATED HEIMON SIM" INAT INS SLNVEY WS PREPARED N A00016ANCE MIN IM DIWING COOS OF PRACIM FUt LAD SIa1KY0115 ADOPM BY THE NEW VOW STATE ASSDCIAAON OF PROFESMOM LAND SURVEYORS. SAD COURIDAWIR SHALL MAI OILY m IHE PERSON FOR WM THE SRWEY 6 FREPARED. AND ON HIS 11119MLF TO THE 1ILE COMPANY, ODVDSROITAL ADENCY AND LDDNB NSRRATION L6&D IIErtEtN. AND TO IM: AGNOWn OP YK LD = NtiflRJROFL' 41 7323.72 sq ft V 0' srov / o00 42 Map of a Survey made for RAYMOND & MARY ANN BENDER Town of Queensbury, Warren County, New York H.O.A. COMMON GREEN SPACE 00 -- a3 RECEIVED DEC 2 g 2000 TOW-N OF OUEENSBURY BUILDING A D CODE 1 HEREBY CERTIFY THAT THIS MAP WAS PREPARED FROM AN ACTUAL FIELD SURVEY. THIS CERTIFICATION SMALL RUN ONLY TO THE PERSONS FOR WHOM THE SURVEY WAS PREPARED. AND ON THEIR BEHALF TO THE TREE COMPANY. GOVERNMENTAL AGENCY AND LENDING NSTITUTION LISTED HEREON. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL NSTMMONS OR SUBSEQUENT OWNERS. CERTIFIED TO* Raymond r- Mary Am Bender CW4W Title hswn" Company GERTrED BYs________� MATTHEW C. STEVES. LL5 NY$ 501W DATM December 21. 2000 S-1 IWEET 1 OF 1 BENDER DWG. NO. 5URREY-41 DESCRIPTION GENERAL INSP. CTION 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 ' sts""� Di9l, Inspector'sNAME: PERMTT' #t f]CATIC7N: �.-Q1DATE : TYPE OF STRIMTOBE; RECHECK NIA YES NO CONDAENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freer_ing far 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Fou ndationlDampproofing Backfill A,ppraval Plumbing Under Slab FI 'ng VenVvents in Place gh Plurnbi Heating Rougli4a Insulation Foundation Walls Interior; R. Foundation Walls Exterio# R- Floors Walls � Ceiling R- Duct work or piping in unheated spaces I R. �Proper Vent, Attic Vent n Jack Studs/Headers Bracing/Bridgi Joist Hangers Jack Posm Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour. G e5 PAT Penetration Sealed r , s Fire all 2, 3, 4 hour ` 3 ] �LA GENERAL rN„ 'EiC"I Tt�►NREPQRT c518f761 - 8256 Town of Queensbury Dept- of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive __Ilepart'� Impector's ijakia NAME: PERM3T # LOCATION: I tigLit DATE TYPE OF STRIJC'rURE: RECHECK NIA "YES NO CONNIMENTS 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/Wallpcsur Reinforcement in Place Foundation/Dampproofin Backfxll Approval Plumbing Under Slab _ Plumbing Vent/Vents in Place_ Rough Plumbing eating Rough-In _ -- Insulation Foundation Walls In rior R- Founda.tion 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 Bracing/Bridgireg Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour _ Penetration Sealed Fire Wall 2, 3, 4 hour Firemoppin FIRE MARSHAL TOWN C)F QUEENSBURY QUEENSBURY, NY 12804 (518) 761 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVEIJ NAME 1+ Q� V LOCATION SCHEDULE INSPECTION ON PERMIT # •� -- A APPROVED EXITS NIA YES NO AISLE WIDTHS i i EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FfRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE; CLEARANCE TO RINKLERS - CLEARANCE T EATING. UNITS REQUIRED SIGNAGE CHIMNEY WOOD STOVE _��--- F'REPLACG� OMASONRY I gCTORY BLT, OUGFIAN C FINAL REMARKS: V _ T-1 OK ToTHIS DATE INSPEcro GEJ VERAL INSPECTI+fJN REPl7RT ( 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 De } �} p J / f �� Inspector's blitirals NAME: f J � PERMIT # LOCATION: DATE TYPE OFSTR RECHECK / Footings/Piers N/A YES No COMMENTS Monolithic Pour Form Reinforcement in Place The contractor is responsibae for prrviding protection from freezing for 48 hours following the placement of the concrete, Materials for this purpose on site Foundation/Wallpour Reinforcement in PIace Foundation/Dampproonn Backfill Approval P m g Under n Slab luntbig Vent/Vents in Place Rough Plumbi n '�Ieating Rough-In Insulation Foundation Walls Interior R.- Foundation Walls Exterior R- Floors R.- Walls R- Ceiling R- Duct work or piping in unheated spaces Proper Vent, Attic Vent Jack StudsMeaders Bracins/Bridginl; _ Joist Hangers / Jack Posts/Main Beam 10440r Infiltration Barrier C Fire Separation 1, 2, 3, hoar Penetration Sealed Fire Wall 2, 3, 4 hour 00'eh toppin i FIRE MARSHAL TOWN OF QUEENSBURY QUEENSBURY, NY 12804 (518) 761 -8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED r� NAME - LOCATION r2y ]:�-+-- PER T �_ ! --- - SCHEDULE INSPECTION N �l ( 7- AM M APPROVED NIA YES NO EXITS _ 1 AISLE WI THS EXIT SIG S. EMERGEfICY LIGHTING -- 1 FIRE EXTIN UISHERS FIRE ALARM YSTEM - FIRE SPRINKL SYSTEM FIRE SUPPRESS N SYSTEM - — HOOD INSTALLATI N INTERIOR FINISHES STORAGE.- ----- -_. CLEARANCE TO INKLERS - CLEARANCE T NG UNITS _ REQUIRED SIGNAGE CHIMNEY Wo"6STOVE`— - - --- - - -- IREPLAC ONRY FACTORY LT. _OUGH- -- ❑ FINAL REMARKS: ❑ TO THIS DATE f IMSPSUPPUB INSPECTOR Irk /G7r� TOiIN[ OF VEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY I2804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date ZE: Pe it #SOIL San - Loa Clay_ Results of Percolation Test_ ( if applicable ) Rate- Minute/ In TYPE OF SYSTEM: ABSORPTION FIELD: Total Len Length of each trench ;K:tf r Depth of trenches MA (A/ , Size of stone SEEPAGE PITS : �5umb e r- ' Size -Stone size _` ft . x �.� ft . �� PIPING: S 'ze Bldg* to rank ype Tank to Dist . Sox ar Dist . Sox to Fiel / t ac Openings Sealed ? �ti LOCATIINI,/'SEPARAT Yes No a rt a a Foundation to T nk Foundation to sorption -Feet Separation of its feet Conforms as P r Plot Plan 'Feet LOCATION OF STEM ON PROPER s No circle Front - ea Left Side - Right Side Middle I - Middle Rear COMMENTS : i1�2L7 +1 rC k 1 fi_ 7 7 'Jc�[_ SYSTEM USE 'APPROVED: YES NO Arrived;Departed: Bui ? ding Inspector GENERAL IMS CTI N? REPORT ( 518 ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay .woad Queensbury, NY 12804 Arrive auxfpru Dep PM �.� Inspector's Initials ') NAME: i � PERMIT # LOCATION: DATE : �Q TYPE OF STRU cz�4ry') RECHECK t N/A. YES NO COMMENTS FootingwPiers Monolithic Pour Form Reinforcer jent in Place The contractor is respnns' or Providing protection from for 48 hours following the t of the concrete. Materials for this purpose on site Nf FoundationlWallpour R.einfomement in Place F onlDamPPtno l 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 , Wails R- Ceiling R- Duct work or Piping in unheated shoes R- Proper Vent, Attic Vent Framing, Jack Studs/Headers Bracing/Bridging Joist Hangers Jack PpstslMain 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 flute inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive3k26 am/pm Tor: Initials NA „i � PERN 41T 4 ei060 21 LC7CATION: 11e-&sdr - DATE TYPE OF STRUCTURE: RECHECK N/A YE NO COMMENTS Footings/PiersNs i Monolithic Pour Form �. Reinforc:ement in Place ' The contractor is respo for providing protection from ing > for 48 hours foilowing the p cot of the concrete_ Materials for this purpose on site Foundation/Wallpour Reinforcement in Place _ Foundation/Dam Backfiil Approval Plumbing Under slab 3 Plumbing Vent/Vents in Pla ae Rough Plumbing, Heating Rough In Insulation Foundation 'Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiiing R- Duct work or pipmng in unheated spaces R- Proper Vent, Attic Vent Framin Jack StudslHeaders Bracing/Bridging, Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 37 4 hour Firestoppia MMONWASEMrs OF 8UI1 DING A CODEE�f 58URY 742 ENFORCO"T ga Queensbur Y Road .Y NY 12804 (S18) 761 -8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date Permit Ae SOIL TYPE: Sand- Loam- Clay. of ( if { if al5 Results is Percolation Test- �fiable ) Rate-Minute/Inch TYPE YSTEM: ABSORPTION FIELD : Total Length Length of each trench Depth of trenches .size of stone SEEPAGE p TS: Number- Size Stone Siz-e ft . x PIPING., -----�- f t . B ' dg- to Tank Size .__ yp Tank to D ' Ype Dist . Dist t . Box -------_ Bo.x to Field P ' Openings / r t`-�'�-- LOCATIIN/SEPARATI Yes No a rrt T Foundation to Tank�S Foundation to Absorption ---____, feet Separation of pits __ y_ feet Conforms as per Prot Plan f LOCRTION( c OF SYSTEM OIR PROPERTY s NO ircle one) Front - Rear -Middle Front Left Side - Right Side - Middle Rear C'O044ENTS 14A;ram, C, 47 ► � L'ey.7- qo SYSTEM USE APPROVED; YES NO Arrived: Departed.- Buz ding nspector .raj l41- SEPTIC DISP SYS EC&I ta"r Name Luca t i an �,r-0"7 '47���"' Date /Z rMit # -- SOIL TYPE: Sand Loam- lay_ ~� Results of percolation Test_ ( if applicable ) Rate-N�inute/Inch TYPE OF SYSTER. .� ABSORPTION FIELD: Total Len th Length of each trenc4 • - Depth of trenc -- Size of stone SEEPAG PITS; Numb 4c 147-0 Size 5tane ' ft ` x ft ..s 'ze ,00 PIPING: _ Sldg, to n. �` Size Type Tank to Dis Box Opening "-- a� "4� Ole Dist . Box to ield/p - ee Seale 7 e ''>c LOCATIOIr/SEPARA a N o a rt i s Foundation to Tank Foundation to Abs feet Separation o;, ion feet Conforms as pePit at Pl LOCATION — -- feet OF :CYST M ON p Yes rci role one) R RTY: �- �- Front . Bear - eft Side Middle Front Rig t Side COMMENTS: M� ddl a Rear T:: _ AX Ar r l s Arrived: Din a r-rr+�rl: z - z TOM OF QUEENSBURY BUILDING A CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-825+5 SEPTIC DISPOSAL SYSTEM INSPJName Location L ' Date 7� Perma # SOIL TYPE: and oam la _ Results of ercolation Te t- ( if applicab e ) Rate-Mine a/Inch TYPE OF SYS ABSORPTION FI LD : Total L nygth Length of each trench -- Depth of trench s Size of stone !74 r© SEEPAGE PITS : Nu ' er- Size - ft . Stone size - ft . PIPING: Size e Bldg . to rank Tank to Dist . BOX ----__ Dist . Box to Field) it Openings Sealed ? Yes No Partia LOCATION/SEPARAT S . Foundation to T nk Foundation to bsorption et Separation pr its eet eat Conforms as er Plot Plan f LOCATION OF _ YSTEM ON PROPERTY: s No { circle on Front - R r - Left Side - Right - de Middle Fr nt - Middle Rear COMMENTS - r/ &C o cv SYSTEM USE APPROVED: YES Arrived.- Departed: Binding Inspector I)r l..ot-fill 5F7 A;:,1 F c� mov car 94 Q _ a - AUG p3 `l_Qt10 / \ � 1!t.-- "I have seen or observed,or believef saw evidence of, all objects such as houses,wells,trees,fences,etc., shown on this document.I also represent that I have personallY measured the distance set forth o the diagram:' 5sNo DA E x, < SIGNATURE 7f"iS U f _1N3N3S:3 t CO