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2000-811 TOWN OF OUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761=8256 CERTIFICATE OF OCCUPANCY Permit Number: P20000811 Date Issued; Friday, January 19, 2001 This is to certify that work requested to be done as shown by Permit Number P20000811 has been completed. Tax Map Number: 523400-137-000-0002-009-103-OOOO Location: 50 EAGAN Rd Owners ROSEMARY THREW Applicant: BILL THREW This structure may be occupied as a: By Order of Town Board Single Family Dwelling TOWN OF QUEENSBURY A7 Director of Building & Code Enforcement TOWN OF +QUEENSBURY i 742 Bay Road, Queenshury, NY 12804-5902 (518) 761-8201 I Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P2000081. 1 Application. Number: A20000811 Tax Map No: 523400- 137-000-0002-009- 103-0000 Permission is hereby granted to: BILL THREW Vor property located at: 50 EAGAN Rd 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 filled and approved and in compliance with the NYS Uniform Building Codes and the Queensbury= Zoning ordinance. Type of Construction Yalue Owner Address. ROSEMARY THREW 46 EAGAN Rd Single Family Dwelling 652000.04 QUEENSBURY, NY 12804 Total value 65,000.00 Contractor or Builder's Name / Address Electrical Inspection Agency CLUTE ENTERPRISES INC. COMMONWEALTH ELECTRICAL Ac 13 DAWTI Rd OUEENSBURY, NY 12804 PO BOX. 706 + HAGUE, NY Plans &z Specifications 2000-811 1008 sq ft SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS, 50 Eagan Road $126.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday, October 31, 2002 (ifa longer period is required, an application for an extension must be made to the code Enforcement Officer of the Town of Cueensbury before the expiration date.) Dated at the To o eens ryy T I d ober 31, 2000 SIGNED BY for the 'Town of Queensbury_ Director of Building &c Cade Enforcement Building Permit Application ToWn of QUeenSbUry - DeO, of Canrmu+uty Develaprrre"t, 742 Bav Rend, Queensbury, NY 128o4 1761-82.561 BUILDING & CODE ENFORCEMENT NO Requirements prior to issuance A ,permit must be oTICE btained befaTe of this permit: PERMIT FILE NO. "« beginning conalrttction. g pect17PERMIT FEE PAIDwill be tnado until applica received F-] T.�tg Board Al.'#fott $ a VA14D BUILDING PE . All Area 1Use applicants' spaeas oon this ation REC'REA77ON FEE PAID $ MUST be completed mad the aignature Q PlrxrVtbsg Board Action Of the applicant must appear an the REVIEWED BY.• _ Orm, rt � trm1werarlicatiet f SPR Subdivision Other Recreation Fee Payment Applicant: �. , c3i t-"�-r _ �i f �._ [hurter: Address: ��~+ �s.+^. r~-•- Q address: Phone # ( -_) ' _ - ?-� Phone # Property Location: Subdivision Name: _ Tax Map Number �' �''� 1. __l Q Section Block T lot NZLTURE OF PROPOSED WORK : ESTIMATED MARKET VALUE OF THE New Building : CONSTRUCTION : $ Ce>s.C;!,2 residence / commercial Addition to Building : residence / commercial OCCUPANCY INFORMATION : Alteration to Building : Pr ary Building - residence / commercial. Single Family Dwelling Residence / Commercial Two Family Dwelling no change to exterior size Family Dwelling Office Other Work ( describe below ) Mercantile Manufacturing Other GROSS AREA OF PROPOSED STRUCTUREe 0 p�) 1st Floor . . . . . 'g sq . ft , If ADD; ON , wh will use 2nd .F1o+�r . . ... . . . sq . f.t of new adda e ? ; Other F1crvtsl . . sq . ft . ( not unfinished cellar or basement ) ACCE7et St1ILDINTGS : ed Garage car TOTAL FLOOR AktEA : C>C>"r SQ . FT . he a e I , 2 car te S ge Building SIZE OF NEW STRUCTURE : rc ' 1 Sto a Building FEET X "(,G+ FEET .� Foundation Type : Pe, I-r- Will any second- hand or ungraded Number of Stories : lumber be used? If so , for what ? ( habitable space orslly ) Height ( grade to rjtdge ) : -' -C> feet TYPE OF HEATING SYSTEM : Number of fireplace( arid/or woo stave ( circle all which applies ) to be installed :_ CD E rac as Wood arced Hot/ Air board, / Other Person responsible for supervision of war as regards to building codes is : k, C., r-r- t`.. ti �. S.► =Z11r {. 7�� 7 Builder : Name kkdd_resss Phone Plumber : Masone Electriciane - 01 DEC7,4RATION.• Please sign below after you have care dly read the statenwnt. To the best of my knowledge the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the Building Code, the Zoning Ordinance and all other laws pertaining to the pro sed work shall be complied with, whether specified or noted, and that such work is autho ' by a owner. Further, it is derstood that Ilwe shall submit prior to a Certificate of Occ ncy or Ce �cate of Compliance b in issued, an AS BUILT PLAT PLAN by a licensed sury ar; drawn to ale ng actual 1 tion of project on premises. Signatur (owner, owner's agen chitect, c tractor) Application for Permit — Septic Disposal System T014+11 of Quee►tsbury 742 Bay Road Queensbury, NY 12804 (318) 761-8256 1 . OWNER INFORMATION: Location of installation: _ .-. . �, _ Office Use _ a Tax Map No. t 15�7 ! File Permit No. PS Owner's Flame: C"r r � � � Fee Paid Address: 2. INSTALLER'S NAME _ PHONE NO. 3. RESIDENCE INFORMATION; (circle year of dwelling, indicate # bedroom(s) and multiply N of bedrooms with applicable gallons per bedroom to equal total dailyflow) Bedir 8 m n — T 1 Dail FIo 1980 or older 2 x 150 gaVbdnn = -- 1980 - 1991 x 130 gaVbdrm 1991 — present x 110 gaVbdrm Garbage Grinder Installed yes . t no Spa or Whirlpool Installed yes / no 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) 4 Q_t�our_td�atpt:. �CSlrock.ar I+nl7orii.Rus l+vl$_tQrial �ars�4st.+�tor Sup;ply at sa►rd tit whirl delrth cif what depilr , r+ ng 7rs`rnsr...._ _ feet feet x,e .._ Steep slope clay if well; water srrppJy �36 slope ether from any .septic-system depth: absorption is ,{?, other Percolation Test: (To be completed by 11censed,prt feorslonal engineer or architect) Rate: minute ,per inch 5. PROPOSED SYSTEM: For Nor Construct,ign: All individual sewage disposal systems must be designed by n licensed professional engineer orarclhilect (unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and ]each Cold for each Garbage Grinder, Spa or Whirlpool Tub, Septic Tank: 1 t3 J O gallon (min. size 1, 000 ,gal.) Tile Field: each trench . 'c� ft Total System Length. Seepage Pit(s): "umber of size ofeach: ft. by Size of Stone to be used. li / depth or thickness _ Peer Bed System Size: x Alternative Syvt m: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: I Size of each. gallons I 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, p lease 'late that pursuant to Section 136-29 of tile Code of the Towl't of Quoensbury, any permit or approval granted which is based upon or is granted in reliance "Per', any material misrepresentation or failure to make a material fact or circurnstance known by or on behalf of an applicant, shall be void. I have rm, a regulations with respect to this application and agree to abide by these and all requir ants of the To of Queensbu Mary Sewage Disposal Ordinance. Signature of a onsible person ©,sue, ENERGY CODE APPLICATIONS F ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY , WARREN COUNTY 9000 HEATING DEGREE DAYS Compliance hods : PART 5 - Acceptable Practice Method - I & 2 Family Dwellings ( only ) , PART G * - Therittal Rating -- Component Trade Offs I & 2 Family Dwellings ; Multi-Family o Dwellings ( 3 stories or less ) PART 4 * Design. by Component Performance Commercial. Buildings - Hi. Rise Residential * Requires submission of worksheets APPLICANT ' S NAME : PROPERTY LOCATIONP e - PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE : 1 . Gross Floor Area - WO �F- square feet 2 . Type of Heat - Electric oil Gas Other 3 . Is building mechanically cooled ? _ Yes No 4 . Percentage of area of windows and. doors Over 17 % >..< Under 17 % 5 . R- VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED : a : Roof R b . Exterior walls R c . Glazed areas R IL4 d . Exterior doors R 1:7 e . Floors over unheated spaces R - ' f . Edge of slab on grade ( heated building ) R -- g . Basement / cellar walls ( above grade ) R y h . Basement / cellar walls ( below grade ) R i . Heating/ cooling-ducts -piping in unheated space R G . Service ( domestic ) hot water heating devic Conform o minimum efficiency per code Yes No T'EM RATU CONTROL MA I M SETTING 1401� - WILL NOT BE EXCEEDED APPlp Sig at a Da a Phone Number I SPECTOR ` S RE KS : RESIDENTIAL FINAL INSPECTION REPORT f?Pllee No. (518) 761-8256 Date inspection request received: Building & Code Enforcement Dept. of Community Development Arrive art ° Town of QQueensbury or's 742 Bay Road Queensbury, New York 12804 c fl hlAh+lE DA LOCATION TYPE OF STRU NIA YES NO CONIMEI*US Chimney HeightPWt Vent/13irect Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete InteriarlExterior Railings 30" 36' Exterior handrails, balconies, ending in, or more -- Intenor Handrails stairs both 'des 3 or ore risers Grade 2°/a away froant foundat n $" clearance to sill plate Gas Valve shut-off exPogad/ l ' above grade. c�'x��LLa{{ off s Furnace shut within 3 feet or 'thin line of site V Furnace shut-off at to ar'� FurnaccAlot Water Heater o Relief Valve(s) installed Headroom, 6 ft. 6 inn. on stairs Basement stairs, 6 ft. 4 in. Handrail ,exterior stairs both sides in than 3 risers Interior privacy/trim/doors/main en 36" Floor Finish Bathroom/Kih:hen watertight interior Handrails BalconiesiTmuling 18 or more Railing across window in stairwells Smoke Detectors: every level every bcxlroonn outside every bedraonn inter connected Bathroom fans plumbing fixtures Foundation insulation 3/4 hour fire doorldoor closer Garage fireproofing Garage penetrations scaled Furnace in separate room protected (in garage) Light ventilation per room Safety glazing IS" or less from floor Final Electrical Site Plan/Varianoe required Final Survey Plat Plan As Built Septic System layout required Okay to issue CIC (Certif. of Compliance) Okay to issue temp. CIO (Cmlif. of Occupancy), Okay to issue permanent CIO (Certif: of Occupancy) TORN OF QUEENSSURY BUILDING & CODE ENFORCEMENT 742 HAY ROAD lamp QUEENSBURY NY 12604 ( ' (518) 761-8256 ARRIVE : DEPART : INSPr FINAL INSPECTIO" REPORT - RESIDENTIAL DATE INSPECTION REQUEST RECEIVED : NAME LOCATION CA C-) DATE PERMIT , LJJ TYPE OF STRUCTURE FOOTINGS FOUNDATION HACKFILL FRAMING ROUGH PLUMBING SEPTIC INSULATION FINAL ELECTRICAL WOODSTOVE OR FIREPLACE H A 28S No CHIMNEY HEIGHT/6 VENTIHEIGHT -- PLUt4V T ROOFING XTERI99 FINISH PECKIPORCH/STEPS/RAILINGS RELIEF VALVES .� FURNACXZUQT WAT TING T RI I RIVAL EXNI$R FLOORS _BATH EN AT OTHER FLOORg -SWEEPABLFs OTHER ORS CARPETED STAIR CLEARANCRJRAILINGS SMOKE TECTO S PL!IMBING FIXTURES ._._ rOVNDAj;KON I ON GA GE FI PROO IN DOOR CLOSERS INALELECT I CAL SI P7�j�W +�VRRI�WCE REO 5U VEY P T N OF TO ISSUE, C/O OR C C MAP REFERENCE: MAP MADE FOR CLUTE ENTERPRISES DATED: JANUARY 25, 2000 BY. VAN DUSEN & STEVES LOT 1B VA POAD moo - ill RFCEIVED JAN 2 3 2001 TOWN OF QUEENSBURY BUILDING AND GOOF an- D s' e & Steve s Land Surveyors, LLC 37 Chester Street Glens Falls, New York 12801 518 792-8474 New York Uc. No. 50135 IMAI IMMM ALIMAIM OT AOOHION M A SLIM YAP BEAM A LKSM LAND SLOMORS SIX 5 A MMAT= OF WPM 72W 91D-DIVISM Z OF THE NEW YOIBL STAIE MUCATON LAW.' 'oLY DOPEs neon T< OHU7ML OF TM am" KW= TRM AN COW" Or THE LAND SLI=YORs VOL SHALL. K C01 wMw M K MILD Mg COPIES., *CMRCA7KM INWAIM HHEADDN SIGWY THAT TSS SRREY WAS PREPMED IN AOCMANCE MM THE H7IM= OME OF PRACRLL FOR LAMB SIMVE"M ADOPTED BY TE NM MW STAIE ASSWATDN OF PROFESSIONAL LAID 91Rwmm SAD COITFIenm SHALL RUN ONLY TO THE PEAM FOR MHOY TE SLO EY IS PREPARED, ANO ON HIS BEHALF TO TE THE COWAIM 0DYETM0ffAL AGOMY AND MOM INW"Xn N LISTED NEREM AND TO THE ASSOMS Or IFE LOOM NSTIrUMC Do - Nj LOT I 31,344 sq.ft. 0.72 acres Ag Map of a Survey made for THOMAS J. LINEHAN Town of Queensbury, Warren County, New York NO. I DATE I HEREBY GERWY TMAT 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 THER BEHALF TO THE TITLE GOMPANY. GOVERNMENTAL AGENCY AND LENDNG INSTITUTION LISTED HEREON. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. CERTIFIED TOv Thomas J. Llnehan . State of New York Mortgage Agency. its successors and/or assign Fleet Mortgage Corporation. Its successorsm and/or assigns Chicago Title Insurance Company GERTIFIED BY•---- MATTHEW G. STEVE$. LLS NY$ 50135 DATED December 21. 2000 DESCRIPTION Scate 1 S-1 G EET 1 OF 1 THREW C400 DWG. NO. 881C13-10 TOWN OF QUEENSSURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queens bury NY _12$04 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 11 e �l � 41.' Location � ELf-A Date Permit #7 SOIL TYPE: Sand- Loam-Clay- Results of Percol atirinute/ ( if applicable ) 'RatenchTYPE OF SYSTEM:ABSORPTION FIELD : Toh Length of each tr�nc Depth of trenches Size of stone SEEPAGE PITS : Numb Size - ft , ft . Stone size PIPING: Size Type Bldg , to Tank Tank to Dist , Box Dist . Sox to Field/P t Openings Sealed ? es No Partial LOCATION/SEPARATIONS Foundation to Tank feet Foundation to Absorp ion feet Separation of Pits et Conforms as per Plot Plan Y~ LOCATION OF SYSTEM PROPER : ( circle one ) Front - Rear - Lef Side - Might Side Middle Front - Mid le Rear COMMENTS: VNIn SYSTEM USE APPROY Y ND Arri Depa AABSUI 7n pector 11► ELLRNO BROS•r IN'C• 518-785-5537 Water Sewer Municipal Supplies RW'3424855 7 Hemlock Street Latham, New York 12110 TOLL FREE Yellano Or., P.U. Box 837 6708 Townline Rd. 4401 Walden Ave. P.aJ. Box 372 - Route 342 Beacon, NY Mattydale, NY Lancaster, NY Slack River, NY (914) 838-1010 (315) 455-2995 (716) 684-7222 (315) 77 '5130 406 Commerce Rd, 795 Beahan Rd. 3 Otter Rd. 3 B Driv Vestal, NY 'Rochester, NY Raymond, NH W. Br' gewat , MA (607) 770-4005 (716) 328-8270 (603) "! have dh obsery , or believe ! saw evidence of, #! objects as ho es, wells, tr %nces, +etcc , J'^ gun on is docum t. I also represent that I have so"aily measured e di 4n[was� ,s> - hfth on the diagram.pr cc SIGfR .[�A E #Ly Your sM90a source for p►ve, equWn&W for u"OOrWourvd ~hw, yewvier and dralnllne syare.na Featuring �r � ��� Drainage Products RESIDENTIAL FINAL INSPECTION REPORT Of'Pice No. (518) 761-8256 Late inspection request received.- Building & +Code Enforcement Dept, of Community Development Arrive Depart Town of Queensbury tees Ini s 742 Bay Road Queensbury, New 'York. 12804 NAME LOCATION DATE TYPE OF STRUC"1`C"TItF. NIA 'YES NO COMMENTS Chimney Height!"B" Vent/Direct Vent - Fresh Air Intake t�, [ �. t ► ; 3 ` Plumb Vent through roof Roof Complete a Exterior Finish Complete lnterior/Exterior Railings 30" to 36" Exterior Handrails, balconies, landing IS in. mare Interior Handrails stairs both sides 3 or more s Grade 2% away froth foundation S" clearance to sill plate y" Gas Valve shut-off exposed/regulatoi 18" abo ade Gas Furnace: shut-off within 30 feet or-umthin i of site Lail Furnace shut-off at entrance to firmacc area I Ftanacefilot Water Heater operating_ - Relief Valve(s) installed Headroom, 6 ti. 6 in. on stairs i3,aae'_-icnt stairs, 6 ft. 4 in. Handrail ail exterior stairs both sides more than 3 r1sers Interior privacy/trim/doors/main entrance 36" Floor Fetish Bathroom/Kitchen watertight Interior l iandrails 13 iniesAi anding IS in. arm e hailing across window in stairwells Smoke E%eteotor& every level every bedroom outside every bedroom inter catutectecl Bathroom fans Plumbing fixtures Foundation insulation 3/4 hour Fire door/door closer Garage fireproofing___. _ Garage penetrations sealed Furnace in separate room protected fin garage) Light ventilation per room. Safety glazing 1 S" or less from floor Final Electrical Site PlanfVariance required Final Survey Plot Plan As Built Septic System layout required Okay to issue C/C (Certf. of Compliance) Okay to issue temp. C/o (Certif. of Occupancy)_ Okay to issue permanent C/O (Certif, of C3ccupancr) t - � 3 / �k Y � k GENERAL V SPEC7'ION 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 amlpm Depart Inspector's Initials , NAME: PERM:1'I' 4 � I,C7CATLON`2 +2 DATE - rpmmL711i TYPE OF STRU RECHECK NIA YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection firm freezing for 48 hours E placement Of the =c Materials for on site Foundation/W l Reinforcement 'nFoundationMa n Backfrll Approv 4,,,,,.Ffunthing Under lab 1 r{� R Plumbing Ven is in lace 11 v 'Rough Plumbing Heating Rough-Insulation Foundation al Foundation FloorsWallsCeilingDuct work o unheatedP� Vent. A Jack StuclslIcaclers Bracing/Bri dgm Joist Hangers Jack. Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour. Firestoppin +GENERAL IN,SPECTI+f3N REPORT Town of Q 51 — bury 8256 Town. of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 128Q4 Arrive _. Depart am/pm ram{* , In is Initials N PERMIT I I.QCA ION: DATE : TYPE OF STR + ! RECHECK f NIP. YES NO C+OMMEN'i S Footings/Piers � Monolithic Pour Form Reinforcement in PlaceAA The contractor is responsible"or providing Protection from ing " for 48 hours following the nt ' of the concrete- Materials for this purpose on sine _ Foundation/Wailpour Reinforcement in Place Foundation/Dampproafin Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place ' Rough Pluming ing Rough-In„ laiion lion Walls Interior R- _.., Foundation Walls Exterior R.- _ Floors R- t Walls R- Ceiling R- Duct work or piping in unheated. spaces R- Proper Vent, Attic Vent Frarnin Jack Studs/Headers Bracing/Bridging ing Joist Hangers Jack Posts/M,am Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 37 4 hour Firestoppin S ` Y eti GENERAL INSPECTION REPORT" ( 518 ) 761 - 8256 Town of Qiueensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 44 742 Bay Road / ~~ Queensbury, IVY 12904 Arrive arulprn Depsrt� Inspector's Initials ! NAME: L 7 tr `! L t�1 PERMIT # �G� I LOCATION: MATE awe" TYPE OF STRUC7 RRE: NIA YES NCl COMMENTS Foot ersT Monolit Pour Forth Reinfaroe in Place The cu ctor is responsible for providing ection from freezing for 48 hou ollowing the placement of the concre Materials for th' se on site Foundation/Wal r Reinforcement in P Fotmdatio in Backtill Approval Plumbing Linder Slab Plumbing Vent/Vents in P v dough Plumbing Heating Rough-In Insulation Foundation. Walls Interior R Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping in unheaVed spades R- Proper Veal, Attic Vent anti Jac)eStudwHeaders Bracing/Bridging Joist Hangers f Jack Posts/Main Beam -- r Infiltration Barrier ✓ / [ L' ► � " Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 31 4 hour Lf' / / Gf ' lA�9 kvc�),o GENERAL VVSPECTION REPORT ( 518 ) 761 -8256 Town of Queensbury DepiL of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive am/pm Dep inspector's In' isle NAME: LV `G' __ PERMIT # LOCATION+ 6 lhd�2A � DATE : Z� 1' OF STRUCTURE: RECHECK N/A YES N COMMENTS Footings/Piers I Monolithic four Form Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete_ r/ Materials for this purpose on site Foundation/Walipour Reinforcement in Place Foundationll?ampproofsn Backfill Approval Plumbing Linder Slab Plumbing Vent/Vents in Place Rough Plumbin Heating Rough-ln Insulation Foundation Walls EII RR- Floors Wails xt 'or R- wal is R- Ceiling R- Duct work or pi gin unheated S R- Proper Vent, Attic ent Frarnine Jack S rs Bracing/Bri /Joist klang ,/'f Jack Po 'n Heam Air InFiltratio Barrier Fire Separati n 1, 2, 3, Dour etration ed Wall 2, 3, 4 hour Firestcrpping i/ TOWN OF QUEEKSBURY BEiILDIM6. S CODE ENFORCEMENT 411 Road Queensbur$,y` My 12804 (5I8) 761-9256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date Perms SOIL Sa Clay_ Results of Pp`rcolation Tes { if applicable ) TYPE OF SYSTOM: Rate Minute Inch ABSORPTION FIELD: Total Len th Length of ea4h trench ! Depth of trenches " Size of stone SEEPAGE PITS : .Size Numb F - F Stone size� ` x ft . PIPING: Bldg . to Tank zze ,Ype Tank to Dist . Box '`; ti'� Dist . Box to Fieldxpit Openings Sealed? � a LOC.ATIOM/SEPARATI Foundation to Tank Foundation to Absorp n —f' -� feet Separation of Pits -- ._ feet Conforms as per Pl o pl} feat LfK;ATIlyIiM OF SYSTEM n ~"ems ..No -� t { circle one) P PERTY: Front - Rear - Lef S Middle Front zste .- fight Side CENTS: _ dT a Rear lu --�- �1, SYS7EIi . USE APPROV&D] � Arrived: 9► �.S�J p `-- Dep a uz2d ng Inspe r AltjGENERAL VVSPECTION REPORT ( 518 ) 76Z -- 8256 Town of Queensbury Dept. of Community Development Date ins. . pection request received: l Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrivel t It Depart spectoes Initials L Z� �"ERMlT' # xAMI= LOCATION: JDATE TYPE OF STRU � RECHECK NIA YES Q CQM4vMNTS Footings Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from. ' Ing for 48 hours following the pI'hc ment of the concrete. Materials for this purpose on site Foundation/Wallpour 'nforcementin Place Foundation/D n I u ng Under Slam Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation Foundation Walls Interior Foundation Walls Exterior Floors R Wails Ceiling Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framin Jack Studs/Headers Bracing/Bridgin Joist Bangers Jack Posts/Mai n Air Infiltration Barri Fire Separation 1, 2, 31 Penetration Sealed Fire 'Wall 21 31 4 hour " Firestoppin . / Id f:E1VEJ"L IN8PECTION REPORT ( 5t8 ) 76 ]_ - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 Arrive amlprn Depa �' Inspector's Initials / NAME: -� " J PER-MIT # G � ! LOCATION: � DATE : TYPE OF STRUCTURE: RECHECK NIA YXI COMMENTS lingsJPiers onolilhic Pour Form Reinfotwrpo, ent in Place _Theractor is res nsibl forprov prolecl,o from f zingfor 4urs foliow' g the accmenlof thncrete.Materir this pu sc o siteFoundWallpou _--_ __ ... . _ _.Reinfoent in PI ce _FaundE7ampp fng _�Back Iproves __��-_. _Plumbcr Sl bPlumbentfVc is in Place_RoughbingHeatinugh-In Insulation Foundation Wal Is Interior R-��� Foundation Wal Is Exterior R- Floors R- Walls R- Cciling R- _ - -- Duct work or pi ing in unheated spa cs R- Proper Vent, Attic ent - - _ - Jack Studs/1"ders Braci ng/Bridgi nb._ . .......... - - Joist Hangers.---—. Jack Posts/Main Beam Air Infiltration Barrier Fire Separation I , 2, 3, hour. Penetration Scaled _ Fire Wall 2. 31 4 hour Firestopping—_- ! I ! 1 {. i I have seei'i w dbar"d, or be0m I $m aNide nce pt. ! i I �;, nhrects such as houses, well , trim fences, 4rtc.vl ! in on t ' o merit t olso'reptesehtMet UhavO i ;,.:;; meal rid the d' arrce fo!rtx on ,the Ora ram~ 1 ' I 1 I I f- _. SiG�!1 ! ,tRE DAZE; t r Woo i � I I i I i I I 1 I ' f I I , LD i l - 1 . . I Yd , ' I � I I I • j i I I l I