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2000-711 TOWN OF QUEENSBURY 742 Bay Road, Qucrnsbury, NY 12804.5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE �F �C��CY Pertn%t Number. �'20p�07i i Date Issued: Thursday, April 19, 2001 This is to certify that work requested to be done as shown by Permit Number P20000711 has been completed. Tax Ma Number: aLk, � f �� p 523400-027-000-40 -040-0400 Location. 10 BOULDERWOOD Dr Owner. CHRISTOPHER & MARY BAUDER Applicant: CHRISTOPHER & MARY BAUDER This structure may be occupied as a. By Order of Town Hoard Single Family Dwelling TOWN OF QUEENSBURY Garage - 2 Cars Attached Fireplace Director of Building & Code nforcement ti TOWN N OF Q►UEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761 -8201 r Community Development - Building & Codes (518) 761-8256 BUIEDIN+G PERMIT Permit Number: P20000711 Application Number: A20000711 Tax Nlap No: 523400-027-000-0004-028-000-0000 Permission is hereby granted to: CHRISTOPHER. & MARY BAUDER For property located at: 10 BOULDERWOOD Dr in the Town of Queensbury, to construct or place at the above location in accordance with 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. Type of Construction Value Owner Address; CHRISTOPHER & MARY BAUDER 32 $ARBER Rd Single Family Dwelling 200,000.00 Garage - 2 Cars Attached QUEENSBURY, NY 12804 Fireplace Total Value 200,000.00 OWL Contractor or Builder's Name / Address Electrical Inspection Agency V & H CONSTRUCTION NEW YORK BOARr DON VALENTINE-746- 1520 , y Plans & Specifications 2450 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIO 4S F $312,00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday, September 26, 2002 (Ifa longer period is requited, 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 Town nsbu Tuesday, September 26, 2000 SIGNED BY for the Town of Queerisbury. W or Director of Building & C e E rcement --------------- Building Permit Application �- Town ofQueensbury - Dept. .f cerrrrrrrurtEry Urvelulirr+cerl, 742 Arn, Road. Quee► v1surt+, NY 12804 /761-82561 NOTICE BUILDING & COD , ENFORCEMENT Requirements prior to issuance ,r -F1 A parrrsit rnrietl lio atataina+l liefiira of this permit: 1'GRMIT FILE' NO. Ixsginni:rg conntructlwt. No inslinctitine 1'LiRM1T ILli I'AIIJ will lxi mxdu until applicant loos received © ►+ tg Ord Activrs A Vhl, D BUILL INO PERMIT. All Arta / Use L11LLLCR4PEAj770N FEE I'applicants` spwcros on this, ap ,plicatioqMUST be cvmplaWct s[sd tlra sigrusluroPlarueing B arertd Action WD BY.• of ills applicant moot appear <xu thn SPR I Strlr,Jivi4on I Other ,. tr„a In+It rlrw Boat farm. rrwt r... Recreation Feu Payment Applicant: OA s )ZPPIP' rta *ZV Owner: rl � Address: __ � r1� 5r 'Y c LeirL•L �' _ Address: Phone # .� iE� one Property Location: Cte R4k)7.. Tax Map Nusuber _ Subdivision Name: G2i7 cce - �fiirt5t= o � - � Scatirirt ltirick tRit oo- N31TUFtE OF PROPOSED WORK : ESTIMATED MARKET VALUE OF THE New Building * CON7STRUCTION ; $ residence / commercial Addition to Building : residence / commercial OCCUP"CY xNrORMATION : Alteration to Building : Primary Building - residence / commercial Single Family Wej~],;i-.rrg- Residence / Commercial Two Family Dwnrl"iiit(A . : no change to exterior size Fal"lly Dwelling 2000 Other Work ( descelbe below ) Mercantile `} Ei Manufacturinq .` Other GROSS AREA OF PROPOSED STRUCTUREC If ADDITION , what will use 1st Floor . . . . . . . a t6o4c) sq . ft . of new addition be ? : 2nd ,Ffoor . . w4lP . . . e�Ib aq . ft . Other r uut's . . . . . — sq . ft , ( not unfinished cellar or basement ) ,ACCESSORY SUILDXNGS : Detached Garage 1 , 2 car TOTAL FLOOR AREA : SQ . FT . —rk-- Attached Garage le Q. car Private'. Storage Building SIZE or NEW STRUCTURE : Commercial storage Building + r Other FCET X CrrC - FEET Foundation Type : L'C �'tr�{c ------ - - will any]/' second- hand or ungraded Nuiii oar of Stories : z lusnber be used ? if so , for what ? ( Itabitable space orgly ) A17 Height ( grade to rYdge ) • �rI feet TYPE or HEATING sysrrEms Number of fireplaCeO and/ or woo stove ( circle all 1ch applies ) to be installed :_ 1 Electric j �i / Gas WoOd Forced Hot it / ass oar j Other 4- Parson responsible for supervision of work as regards to building codes is . cam > r ra,�- t �G 15 2-0 Name - ddresse Phone Builder : Plumber : Mason : Electrician : DECr r1RAT70M Please sign belmv gfter you have carefully read the statement. 'ro the: best of my knowledge the statements contained in this applicalian , together with ilia plans and spec ilicaUiorta sulirrtittcct, are a true and complete statement cif all proliosed work to be done out the described premises and that all provisions of the Buiiding Ccxle , the toning Ordinance and all other laws pertaining; to tlic proposed work shall be complied with, whether spgcified or noted, and that such work is cttnhorized by the owner. Further, it is understrxxl that I/we sli:tll submit prior to a Certificate of Occupancy or Certificate of Conipllance being; issued , an AS BUILT' PLOT PLAN by a licensed surveyor; drawn to scale, lio 'n,g a ual location or project on premises. Signature: ` Q_ cncr, a ner's agent, architect, contractor) Application for Permit - Septic Disposal System Town of Queensbury 742 Bay Road Queensbury, NY 12804 (518) 761-8256 I . OWNER INFORMATION: _..._....._........_ ........... .,. ............................................................_..__.. .m3 Location of installation: _ 00/l t.T OcC c c-; - LZ`T Z .._...0[Fite Use Tax Map No. File Permit No. I l Owner's Name: Fee Paid Leff,?, dc �( rr� „ sr.�►� y ' Address: 212 I--L% 9T_ � G E_ t f=Vl C 2 2. INSTALLER'S NAME : V I-tI t' PpjV 5Tk�,,(t CZ-2 CrtCU PHONENO. 74 !�2 - 626 3 , RESIDENCE INFORMATION: (circle year of dwelling, indicate # bedroom(s) and multiply # of bedrooms with applicable ,gallons per bedroom to equal total dolly flow) Year of House,• No of Bedrooms x Comput.a ion = Total Daily Flow 1980 or older x 150 gal/bdnn = 1980 - 1991 _ x 130 gaVbdrm = 1991 - present x 110 gallbdrm C> Garbage Grinder Installed yes no Spa or Whirlpool Installed yes l no t� 4, PARCEL INFORMATION: (circle applicable information &. indicate measurements) 12hX Sail 1t4 C'arQunc _tiVato Bedrock or linpe �Ns Materia_1 Dom$stic_Wator_5uppiy 1 7at at what depth at what depth )al ng loam feet _ feet well Steep slope c ay t well; water .supply slope other from any septic-system depth: absorption is ft. other + Percolation Test: (To be completed by licensed professional engineer or architect) Role: 2� 30 t»InUte per inch M,_ suss 0tvtse.n..+ TVsr Og �- 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless install to a Planning Board approved subdivision). Add 25(�1'.&jilIoits to the si-1c of the septic tank and leach field for each Car- c (jrii Spa or Whirlpool Tub. Septic Tank: 11 S' C� C. gallon (min. sta4` 1, 000 gal-) Tile Field: each trench fi'. Total System Length: spa-P ): number of size ofeach: fl- by J?. 4i Size of Stone to be used: 0 depth C>r thickness _� _—feet x length and/or size fi. (if required) Number of tanks: 1 Size of each: gallons l 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 l 36-29 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 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 Queensbury Sanitary Sewage Disposal Ordinance. 2e aturii of responsible person Date . W�s.. . ; ;. 1, iry IN Iarsl t.11 's 0ft`icc '1'rrW11 of Q LJe•e k IS I)airs , 741 11:1 %' tLoad , (Yueei is l]Lll'1', � -820ce Application for Fuel Burning Appliances & Chimneys 3 applicable to solid fuel & vented gas appliances Date 1 20 Permit No . J r{l-)Irlicutiofi is hef'eh}- rrlttdc io the l3rrddiiiV & C'crdc o. O. ii -to Jrrr the {ssll££FI{'e (xl cr 13161ding r£rld t"'3c Pef"flF!£ IJ£tiSF{Ctfit to llle h'csv Yorh State P'ire PretrelWorr, and 13!££ltllrl,Sr Code- 7be ul'iJili( Gill fli" oklo,ilvi' 1 agives to L'{afillaly xr ith all aplViccrhle lali•s, Cl i'c1irFClf tees, ri'gr£dt£titails, tdfld till collel{ odis 111ut al`C' l?or{ of { those f`equiretiiews and also svill allow till iliS`)eclors to crlier l7r'G'l it r.l e.} to lit t_J[Jr'ili reepfired irl.5`k7)ecl{C/ns. NOTE to applicant: Roungh-in and Final Inspections are required- 1 Applieaiit Information Fuel Burning Appliaiiee Inforornation (ck3-cle appropriate .cords) "tame: It Stove: Wood coal pellet ;tts Fireplace insert Address: Fii ace, factory-built : VV00d gas i Ffireplace, masonry: I'Vood aus 4 FUMaCC: wood gas oil I If non-masonary applicance, please provide Owner: %lanufacturer Name: k Address : - . _ - Modc4 Number: Chimney Information Phone: owl (circle appropriate words) Masonry hloc'k brick stone ' Flue rile steel size: inches Exact Address : l C- i =' # 'f i /ic , ' - { of constrtecrtait Or histaltatiorr Factorv-Built MatzufactUl-er 11a11-€e: Model Number: :'More: Listed Bv: Number: Construction / Installation Hurst con ortii to N S Fire Prevention & B£iddiiig Indicate (circle) chininey material : Code. Consult available Town of Qteeenshui-lr Handouts regarding required inspections. Double ii•all Triple lleall / Ira-Sulated / Di)- >ct vewi)i`f,+ Ctrr£rilrev Liner I i k �z-"lW <3s Q��[�+ra rt /bu >ry'� 3V►'� `�'vz-l�[ l ; I l I a F'ri'c> A lei rsheiI Code ;4 3 Collected Re ielidert l2cc't>it` ^tT ti`r rlr rr c-/cruder fo/; ! IS2 f ' {= - %c e Ui C .-I 1 E3 3389 (190) Public Safcoi f .3 233 ?Ga 5 l?30) Alinor Stiles 1 \\Ihile (Applicalit) Green ( Sire Marshal) Yeliiva 031dst. Dept. ) Phik '& Goldenrod (Cashier's Dept. ) ENERGY CODE COMPT,XANCE APPLICATION TOWN OF QUEENSBURY , WARREN COUNTY 9000 HEATING DEGREE DAYS Comcl i an ce Methods : PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings ( only ) PART 6 * - Thermal Rating - Component Trade Offs 1 & 2 Family Dwellings ; Multi-FarLj= 1y Dwellings ( 3 stories or less ) PART 4 * - Design by Component Performance Commercial Buildings -Hi Rise Residential *R.eau.=res submission of worksheets A.PPL1C.=LVk T ' S N.ZL%IE : PROPERTY LOCATION & . PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE : 16 Goss Floor Area - sauare feet 2 . TTrne cf Heat - Electric }t" 041 Gas Other 3 . _ s buildwng mechanidally cool ea. ? �X Yes No Pe ;ee :ztage of area of urindows and doors Over i7 $ Under 17Rj 5 _ R-V.A=ES FOR I.iSULATZON GIVEN SELOiri MUST CORRESPOND TO R-V_�UES AS Sr C7W-.Njj ON PLANS 5U$LM7TF I=D : a EtO 4 R CJ b . Exterior wails R c _ Glazed areas R d . �xte�for doors R tQ e . * loors over u:heated spaces R " _ . Fdce +o f slag or. grace ( heated h: =_ * lding ) R _L� L c _ Sasement/ ce= iar wa " s ( above grade ) R 1— ?� . Basement/ ce ' iar walls ( below cr ad.e ) R i . H eat lag/ coo !ing-ducts -pin ir_g in unheated space R 6 . S e r-rice ( domes ;`c ) hot water head =g device Co .-: = arms to minimum e =iciezacy per code Yes No T MPERATURE CONTROL MAXIMUM SETTING 3 400 - WILL NOT BE 'EXCEEDED re Date _T':ode N=Ltbe= I `•+' S ? EC7GF ` S REM_R � : • cy RESIDENTIAL FINAL INSPECTION REPORT ()Rice No (518) 761-8256 E]atr map can nest received: Building & Code Enforcement Dept. of Community Development Arrive �am/pni Depart 'Town of Queensbuty In 's Initials 742 Bay Road - Queensbury, New York 1, 804 IVEiME h PEPJVIIT LOCATIONR c3 E? CE 1"1fU t1 RATE 'l"YPE OFFS 'RT [IC RE 1 N A NOCOMMENTS Chimney HeightrB" Vent/13wect Vent Location (! Fresh Air Intake Plumb 'Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior.Railings 30" to 36" Exterior Handrails, balconies, landing IS in. or more Interior Handrails stars both sides 3 or more risers Grade 2% away from foundation 8" clearance to sill plate Gas Valve shut-off exposed/regt3 gtor 1 S" above gra Gas Furnace shut-ofTwithin 30 feet or within line of Oil Furnace shut-off at entrance to ftrri aw area FurnaceMot Water Heater Relief Valve(s) installed Headroorn, 6 fl. 6 in. on stairs Basement stairs, 6 ft. 4 in. Handrail exterior stairs both sides more than 3 sers, Interior privacy/trim/doors/main entrance 36" Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 in, more hauling across window in stairwells j Smoke Detectors: �' - � ��/`/c t✓ f ""d� r we` r� every level � .� to Go �n r- ,,A 6 every outside every bedroom inter connected Bathroom fans �. Plumbing fixtures Foundation insulation 3/4 hour fire door/door closer Garage fireproofinglPA�e.L>� .� rrsrrs Garage penetrations sealed Furnace in separate roorn (in garage) Light ventilation per room_ A J/OAAW r Safety glazing 1$" or less fmrn fl � �a,.. fL Final Electrical Site Plan/Variance required Final Survey Plat Plain As Built Septic System layout req Okay to issue C/C (C'.ertif. of C o npliaRee) Okay to issue temp, C/O (Certif: of Occupancy)_ Okay to issue pern7a ncut C;/O (Certif of K ccupancy) RESIDENTIAL FINAL INSPECTION REPORT Office No. (518) 761-8256 Date inspection request received: Building & Code Enforcement 17ept. of Community Development Arrive anVpm Depart 'Town of Queensbury Inspector's Initials r=S�aPm 742 Bay Road Queensbury. New York 12804/] jo NAME r1 r [ aocCr PERMIT # ) LOCATION 40 .r Ljo.,e DATE TYPE OF STRUCTURE NIA YES NO COMMENTS Chimney HeightP B" Ventll'i7irect Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete Interior/Exterior Failings 30" to 36" Exterior Handrails, balconies, landing 18 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 exposed/regulator 18" above grade _.. Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnac /Hot Water Heater operating. ^' Relief Valve(s) installed Headroom, 6 ft. 6 in. on stairs Basement stairs, 6 ft. 4 in. Handrail exterior stairs both sides more than 3 risers Interior privacy/trim/doors/main entrance 36" Floor Finish Bathroom/Kitchen watertight Interior Handrails Balconies/Landing 18 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 3/4 hour fire decor/door closer Garage fireproofing Garage penetrations sealed Furnace in separate room protected (in garage) Light ventilation per room Safety glazing 18" or less from floor Final Electrical Site Plan/Variance required Final Survey Plot Plan As Built Septic System layout required Okay to issue CIC (C:ertif. of Compliance) Okay to issue temp. C/O (Certif. of Occupancy) Okay to issue permanent CIO (Certif. of Occupancy) TOWN OF QUEENSBURY BUILDING & COD9 ENFORCEMENT 742 BAY ROAD QUEBNSBURY NY 12804 t (518) 761-8256 ARRIVE : DEPART : INSP : FINAL IIiSPOCTION REPORT - RE$IIJBNTIAL DATE IN 'TION R QUESY' ECEIVE" , NAME _ LOCATION On ` f";2 r .S. . PERMIT # TYPE OF STRUCTURE _S�a y r{l l FOOTINGS FOUNDATION BACXFILL FRAMING ROUGH PLUMBING SIEPTIC INSULATION FINAL ELECTRICAL WOODST VE OR FIREPLACE n - — N A x s o CHIMNEY HEIGHT/H V NT/HEIGHT p'LUMSING V NT - R0�7FING _ EXTERIOR FIN C OR H s NG LIES+' VALVES FURNACE O WA PE -LUTERIORT IM R VAC D R F S F S T 1 E IG T OTHER FLOOgS SW, EF�pA OTHER Fpp RS g STAIR CLE CE LINGS SHQKR DETECTOO S PLUMBrNG FIXTURES FOUNDATION IN§UL�TION gARAGE FIR - PROOFING DOOR CLOSERS FINAL ELECTRICAli SITE PLANIVARIA_NiC_E REO E.INAL SURVEY PLOT PLAN ~� 09 TO ISSUD C O OR C C � (SV�4tiboA MAP REFERENCE: MAP OF PHASE ONE GRANT ACRES A SUBDIVISION MADE FOR EDWARD GRANT DATED DECEMBER 29, 1976 REVISED MAY 4, 1977 BY JOHN B. VAN DUSEN LAND SURVEYORS —4Lb1 xZ, S e,,'UNAUTHORIZED ALTERATION'S OR ADDITION TO A SURVEY MAPBF�10 A LICENSED LAND SURVEYORS SEA. IS A Map of a Survey made for Q A VIOLATION OF SECTION 7200, SUB-OMSION 2. DE THE /L`%/V NEW MIX STATE EDUCAnON LAW 'ONLY COPIES FROM THE ORIGINAL DF THIS SURVEY S t e v e s NARKED METH AN ORIGINAL OF THE LAND SURVEYORS COPIES' CERTMATIONS NOICAn� HEREON SONNY THAT TO A VALID ACCORDANCE � BE S PREPARED THIS WAS PREPARED N ACCORDANCE NITS THE C H R I S T Q P HE R Sc MARY BAUDER E]tlSI1N0 000E OF PRACTICE FOR LAND SURVEYORS ADOPTED ING Land Surveyors, L L C OF LL RUN S NEW OR& SAISTAD CERTIFICATIONS LAND SURVEYORS SAID CEAlF1CAnON3 SHAL RUN ONLY LAND TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INsmumoN US= HEREON. AND Town of Queensbury, Warren County, New York 169 Haviland Road Queensbury, New York 12804 To THE Assam OF THE wow NSnTUTION.- ,518) 792-8474 New York lie. No. 50135 NO. I DATE MAR 21 2001 TOWN OF QUEENSBURY BUILDING AND CODE 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 117LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. CERTIFIED TO: CHRISTOPHER do MARY BAUDER CHARTER ONE BANK FSB, IT'S SUCCESSORS AND\OR ASSIGNS COMMONWEALTH LAND. TITLE INSURANCE COMPANY 48 CERTIFIED BY; NIATiHEW C. DATED: NOVEMBER 21, 2001 DESCRIPTION el NU V LMbLK el, le 1'=50' S-1. SHW I OF I BAUDER DWG. NO. 00298 � -390 1 ti HUDSON ENVIRONMENTAL SERVICES, INC. Mail: 22 Hudson Falls Rd., So. Glens Fails. NY 12803 Delivery. 211 Ferry Blvd., So. Glens Falls, NY 12803 HE s Phone: 5l8l747-1060 Fax: 51W747- 1062 ANALYTICAL TEST RESULTS `4rJ � 1400; N . Y . S . D . O . H . LAB ID# 11140 CLIENT : Christopher Bauder SAMPLED : 02 / 09/01 SAMPLE DESCRIPTION : Piping from well TIME SAMPLED : 11 : 00 am MATRIX : Drinking Water DATE SAMPLE RECD : 02 / 09/ 01 LOCATION : 10 Boulderwood, Queensbury, NY TYPE SAMPLE : Grab H . E . S . # : 010209HOI SAMPLER : Client N . Y . S . D . O . H . DRINKING WATER PARAMETER METHOD RESULT UNITS TEST DATE LIMITS Total Coliform SM18 9222B [1 . 0 # / 100ml 02ZO9/01 <1 . 0 Approval IBy : h o Date : %XAC>% Hudson Environmental Services . Inc . certifies that the services provided were performed in accordance with the New York State Department of Health, Environmental Laboratory Approval Program certification manual . In the event of an error, HES' s sole responsibility will be to perform reanalysis at its own expense . HES , Inc . assumes no other liability for damages incurred from the interpretation or use of the analysis provided . HUDSON ENVIRONMENTAL SERVICES, INC. CHAIN OF CUSTODY RECORD/ Gab Work Re ue�t Mail: 22 Hudson Falls Road; South Glens Fails, NY 12803 G Delivery: 211 Ferry Blvd-tSouth Glens Falls, NY 12803 j HES Phone: 518/747-1060 Fax: 518/747-1062 Client - Mail Address HES Client Contact/Person # - _. — K/l 1I2IIL t CAY — use Only Project Location l r' p � t � f'�'ur� '!1 :;� � its v V, Samples Were: r� Lry ' ��G ryj 1. Shippetior Purchase Order 1^ A6 Phone # ( Nand Delivered HES Contacts _ 76 1 �7 97 F l/l ter P -e _PLE TYPE 2. Ambient Chided { HES LJSe Only I Date TIME MCampositeTSS+ Lab ID Sample 1D ( Description Collected A=a.m. G=Grab Conts. ANALYSIS REQUIRED 3. Received Bmlient P=p.m.` MATRIX C G Leaking (Irnpropedy h, Scale �+ n �/ { 1 �/ 1J(, F f C(l ( J i-� � j `� �i P �'� ► t I �'o Y N NOTE A F 4. Praper�preserved NOTES Y 1 N A �J P 5. Received Within A 'Mo ding Times r N ; P N N s: II A y P A C Tape was: p 1. Pr ent an uuter A Pac ge Y N I P 2. Unb ken on Outer A Pack e Y N P 3. Present n Sample 1 L rix SL - Sludge SW -Surface Water DS • Drum Solids Special Instructions: Y N Soil O - Oil L - Leachate DL- Drum Liquids -Sediment DW- Drinking Water A • Air X - Other 4. Unbroken nSample -Solid GW- Ground Water WI -Wipe WW- Waste Water NOTES: N Sampled by: paatur Date Im Rece` by ignature) D ime r 30 p Relinquis by: (Sipnatilre) date/Time Received by: (Signature) 0ate ime COG Record Was: G�{ r �• ` r1 ' :) l h 1. Pres tl upo li Receipt of Satnf ns Y 1 N 'Minqulshed by: (SI mature) ()file[]ime Received by: (Signature) Date(Time I 'w: (Signature) Method of Shipment: 0atelTime Discrepancies Between 0 e/fi e ; L ( 0 k� Turnaround Time: � Lab Approval: Sample Labels and COC . Record? Y N NOTES: Copy YELLOW -Sampler Copy PINK -Generator Copy i OOOS GENEVA4CAL E618ECT QN REPQRT — ----- ( Sl $ ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Flood Queensbury, NY 12804 Arrive am/pm Depart ` G°" ( Inspector's Initials -y NAME: Ao tc)4, PERMIT # CFO LOCATION: DATE : cs TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS FoolingsJPiem Monolithic Pour Form _ Reinforcement in Place The oontractor is respomaibl for Providing; protection from ng for 48 hours following the to of the concrete. Materials for thus purpose on s to Foundation/Wallpour Reinforcement in Place Foundation/Dampproofi Backfhtl Approval Pltpubing Under Slab Vt/ utn Pl bing Vent/Vents in Place ough Plumbing. Healing Rough4 Insulation Foundation Walls InteJRFoundation Walls Ext Floors Walls Ceiling Duct work or piping iunheated Spaces Proper Vent, Attic Vent Frami Jack Studs/Headers Bracing/Bridging- -Joist Hangers Jack Posts/Main Beath Air Infiltration Barrier Fire Separation 1, 2, 3, hour on Sealed z : , c l hour rtoppi !L//� 1l ' 60 IN r GENERAL EVSPECTION .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/pin Depart `e Irrspectoes Initials NAME-. A}'U PERMIT # LOCATION- DATE : �~ - � ..¢•� TYPE OF STRUCTURE: RECHECK NIA YES NO COMMENTS Footings/Piem M� j 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 o site Foundation/Wallpo Reinforcement in PI Foundatio _ Backfxll Approval t xng Under S ng VentfV in P &WesC� Rough Plumbi ,*Wing Rou%ln Imaulatia ' Foundation Walls I terior R- Foundation Walls E •or R- Floors R- Walls R- Ceiling R- Duct work or piping unheated spaces R- Proper Vent, Attic Vent Framing Jack Studs/lleaders Bracing/Bridgmg _. . = Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Pen tion Sealed ' F; Wall 2, 3, 4 hour -r GENERAL "SPECTION REPORT ( 518 ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Rbxd Queensbury, NY 12804 Arrive am/pm Depa Inspector's Initials NAME: J -]w' _ PERAC T # i LADCATION: DATE TYPE OF STRUCTURE: RECHECK NIA YES N4 CONMENTS FootingslPiCis Monolithic Pour Form. Reinforcement in Place — The contr:icwr is responsi to fcr providing protection fro freezing for 48 hours following placement of the concrete. IL Materials for this purpose o site Foundation/Wallpour Reinforcement in place Foundationfl]ht rip proofin Backfill Approvat v�li Uruier Stab Vent►'3Temts•in Place R Plumbing VEg Rough-In rmdation Foundation Walls Interior R Foundation Walls Exterior R Floors R- Walls R- Ceiling R- Duct work or piping in unheated spaces R- Proper Vent, Atxic Vent Frami Jack Studsl leaders BracinglBridgi Joist Hangers Jack Posts/Main Beam. Air Infiltration Barrier Fire Separation t, 2, 3, hour Penetration Sealed F- Wall 2, 3, 4 hour zrestoppi kE ERAL INSPECTION REPORT ( 518 ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 128" Arrive am/pm Depart Inspector's Initials NAME; PERMIT # 5 e I DCA.TION: DATE : TYPE OF STRUC'1`IJRE= RECHECK N/A YES NO MMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from i for 48 hours following the M t of the concrete. Materials for this purpose Site Foundation/Wallpour Reinforcement in Place Foundation/Dainpproolinal Backfill Approval Plumbing VentUnder Slab f<X��/ V� _ t A�` Pl ng Vent/Vents in 7 f^� Plunibing. Heating Rough- Foudation Walls Iriteri R- �� �' c �,g 'o ' R i2 . /} 4 /vG c r✓r t Foundation Walls Extcri r R- WallFloors �� Walls Ceiling, Duct work or piping in unheated spaces R PtcVr Vent, Attic Vent. ack StudslHeaders 2 r'Bracing/Bridgin joist Hangs ,eJack Posts/Main aeam Air Infiltration Barrier Fire Separation 1, 2, 3, Hour Penetration Sealed V Firestoppi ng 3, 4 hour GENERAL I7VSPECTION .REI'1DRT ( 518 ) 71a1. - 8256 Town of Queensbury Dept. of Community Development .Date inspection request received: Building & Code Enforcement 742 Bay Road 1 t +Queensbury, NY 12804 Arrive am/pm Depart[ „ Y/pxa Inspector's lnintials ti (� { .p NAME: 3�� PERMIT ## L430CAI ION• � ,f.���� iC1 DATE , TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Food ers + Monolithic Pour Form Reinforcement in Place The contractor is responsible 11 providing protection from i g for 48 hours following the plicqinew of the concrete. Materials for this purpose on Feu harem nl t in our Place F 1/ (�6a W� 64 <- r(O A) Reinforcement in Place Foundation/Dampproofi Backfili Approval Plumbin 1-1. V , L T / Tx i G., Plumbing VentlVents in P Rough Plumbs ,[� Heating Rough-In J`. L l? i lc rG74 r 7r /L1 -�� Insulation . /(1 � Foundation Walls I r R- � J ' Foundation Walls Exte 'or R. Floors PP R- Ceiling R- Duct work or piping, in unheated spaces R- Proper Vent, Attic Vent Framin Jack Studs44caders Bracmg/Bridgin Joist Hangers Jack PostsINWn Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Aetration Sealed Wall 2, 3, 4 hour restoppin GENERAL I1Y.SPECTICIN RF_PC1RT w „;:, """ ( 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: fS'4� �"� PERMIT 4 LOCATION: l (2 st � e r c. t o0 � �� DATI? : TYPE OF STRUCTURE?: RECHECK (� N/A YES NO CON064ENTS Footings/Piers j Monolithic Four Form lR Reinforcement in Flare � � The contractor isMh responsible , providing protectio for 48 hours follow of the concrete. Materials for this purFoundatioxv Wan ur Reinforcement in PlaFoundatiowDarappro Backfill Approval Plumbing Under Slab vougbing h Plumbi Vent/Vents in Place /� 43 Heating Rough-In ,/1/ !{ Insulation Foundation Walls Interior Foundation Walls Exterior f / Floors R y f nJ`.� j u- +& `i RP A +eq�cc 7 Walls Ceiling Duct work or piping in unheated spaces R- Prva ramipern Vent, Attic Vent 74 Jack Studs/Headers Ci Bracing/Bridging, - ' Joist Hangers cd'- , PLC— Tc 106 ( A7C� Jack Poston a rBeam /4 �GF(Q�{ I cJ '� C"E � t�+o Air Infiltration Barrier .- Fire Separation I, 2, 3, hour Penetration Sealed =i2, 3, 4 hourn .,.'L.• U �. TOXIN OF QUEEMSSURY c . ILDING A CODE ENFORCEMENT 742 Bay Road Queensbyry NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTIONY � Name . � --' Location © Date] Permit # SOIL TYPE: Sand- Loam�tl a,y- Results of Percolation Te t- ( if applicable ) Rate- Min to/ Inch TYPE OF SYSTEM: ABSORPTION FIELD : Tota Len h ' Length of each trenc Depth of trenches Size of stone SEEPAGE PITS : umb Size - ft . ft , Stone size PIPING : 7zee` Bldg . to Tank Tank to Dist . Ho Dist . Box to Fie d/P,�' ----�-40 -��"' Openings Sealed '�'es_ o aria a '� LOCATION/SEP Foundation to ante �_ feet Foundation to bsorption feet Separation of Pits f Conforms as p r Plot Plan Yes LOCATION OF STEM ON PROPERTY: , circle Front - e - Left Side - Right Side Middle on - Middle Rear COMIKENTS : SYSTEM . USE APPROVED. YES ND Arrived: Departed: J � Building nspectcrr OtE Rev Descri tion— v / ---------- l l / LOT 28 j "1 h ve�Iseen or observed,or believe I saw eviden a of, ! i all o�plec,,ts such as houses,wells trees.f _ /.---r— goes et % sho n n this document.I also represent that I ha e pers�na lY measured the distances set forth on th diagram."i IOC'EPT CS END / /� � (GNAT RE' TE 42 -0' 60._0. I' Ij I I I I D.(i.D.PL I I IDO'-0' LUS I -D- I I 06 i ADJA-Lbi WELL /y/ "`w. !- -/ I 1 I L 46'-0' •� I / I PRbPOSED WELL ' I I 123-0' STRUCTURE SETBACK(50'07 BOULDERWOOD DRIVE I s•-o' Au auENsrous aRE INCHES MATERIAL: UM£S 011ICRW SKCIIIED. TOIEW,NOES IXCFFf AS NOTED C.I t 001 DESCRIPTION:CHRIS AND MARY SAUCER'S 34'D' DEC.DI .�* /-DI PART Bf.NUMR — +-005 PLOT PLAN DRN A +%-T Dea._ LOT 28 GRANT ACRES_ 8i WEIGHT CHK'D BY � ��DATE DRAWING NUMBER R ( 518 ) 761 - 8256 +C:ENERAL INSPECTION REPORT �'i" ► Town of QFueenxbury •._.-.•---P'Dept- of Community Development - bate inspection request receiv f J Building & Code Enforcement.-- 742 Bay Road Queeushury, NY 12$04 Arrive amlpni Dep m �1, Inspector's I . Lials NAME: 1. " PERMIT LOCATION- ATE : I .�.2 o2cr'p TYPE. OF STRUCTURE: ,;o ri RECHECK tin Piers MM.N/A YES O COENTS gs/ Monolithic Pour Fonn Reinforcement in Place- " ter The contractor is responsible providing protection from freezi-he for 48 hours following the piaccmwC%N 01' the concrete. , Materials for this purpose on site Foundation/Wall pour_ --- - -- - Reinforcement in Place Fou ndation/Dampproofi ng Backfill Approval_.___ Plumbing Undcr Slab_ Plumbing Vent/Vents in Place Rough Plumbing; - Heating Rough-ln Insulation —__ - Foundation Walls In rior R- Foundation Walls xterior R- Floors R- �- Walls R- Ceiling R- Duct work or iping in ----- V unhcat ' Paces R- Proper Vent. ttic Vent Framing_ __ Jack S dslllcaders Braci Bridging— — T- - -- foist angers _ Jack Posts/Main Bcam_ _ Air lntiltration Barrier Fire Separation 1 , 2. 3, hour Penetration Scaled_ Fire Wall 2, 3, 4 hour`- — - - Firestopping_ __ -- . � o - 7/ �� OF NEyy jp fit, KE,r,yt �1, o ``• ` . 23 October 2000 )A 06675 � GL+a Mr_ Chris Bauder �`�'��SSt ONf'� 32 Barber Road Queensbury, New York 12804 REGEIVED Re: Bauder Single Family Residence NOV 0 12M Drazdnas Sealed 011 inn TOWN OF QUE 6UlLDING AND CODE Y Dear Mr. Bauder: Regarding the above referenced project, the following structural changes are acceptable: 1 ) Replace the 3 1 /2" x 9 114" parallam shown an the foundation plan running back to front with a W8x35 steel girder 18' clear span. Omit the lally column and footing associated with the parallam. Please feel free to contact me if you have any questions or comments. ere[ Edwa pint, P. E. PO Box 190 Cleverdale, New York 12820 518-656-3059 4 R e M tsQ f- Tl-tt is S I-^tD pc 2T {.%E s2xa IT"H - 7STVUC�T Isr" L f3Ez/701 cvEx3 �' �co I t irCow:G . Lh $ 4 f 0 R 0 CS� ` t-s Z V 1 0 o ST nJ E,y Bah Ix.11•ir„� k ¢ ( 518 ) 761 -8256 GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road fi 1 Queensbury, NY 12804 Arrive am/pm Dept flf/ ( Inspector's Initials f-- p7 NAME- L CkY� n PERN41T # � O - f LC)CATION: C\ DATE TYPE OF STR C' 'URE-- 'c4= �3 REC1 E+CK r` _,. N/A NO CONRAENTS 1.-xngs./Piers- Et Z7 a Monolithic Pour Form , Reinforcement in Puce The contractor is respo i fo -� � providing protection in ing for 48 hours followin the p ent of the concrete. Materials for this p on site Foundati 1pour Reinforce t in PI Foundatio n Backl-all Appmva Plumbing Under Slab �I� Plumbing Vent/Vents inPlace c,` i� V -> Rough Plumbing Heating Rough-in Insulation Foundation Wail$ Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- I>uct work or piping in unheated spaces R- Proper Vent, Attic Vent Framin Jack Studs/Headers BracinglBridging Joist Hangers Jack Pbsts/Miain Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire 'Wall 2, 3, 4 hoar Firestoppin