1999-372 - - •
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW Y'ORK
Date clot rNhfr 1 9 19 a9
This is to certify that work requested to be done as shown by Permit No.
has been completed.
• This structure may be occupied as a SINGLE FAMILY DWELLING
LOT 12 *68 SURREY FIELD DR. • '
Location
Owner m-rrliun t7po1J1? 11T-TV. T, T. r
By Order Town Board
TAX MAP NO. 48 . -8-12
TOWN OF QUEENSBURY
Director of Bldg. dc Code Enforcement
BUILDING PERMIT
VALUE $: 136900_.. TOWN OF QUEENSBURY No 99372 .
TAX MAP NO. 48 . —8-12 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MICHAELS 'GROUP,THE L.L..C_
OWNER of property located at LOT 12 #68 SURREY FIELD 1D _ Street.Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMTI.Y fW1 LLING
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
1810 STATE RT. 9, SUITE 3 .
LAKE GEORGE, NY. 12845.
2. CONTRACTOR or BUILDER'S Name
MICHAELS GROUP, INC.
3. CONTRACTOR or BUILDERS Address
JIM CHANDLER, PROJECT MGR .1810 ROUTE 9
LAKE GEORGE, NY 12.845
4. ARCHITECT'S Name .
NEW YORK BOARD
5. ARCHITECT'S Address
NEW. YORK. BOARD OF FIRE UNDERWRITERS
6. TYPE of Construction—(Please indicate by X)
- SINGLE .FAMILY DWELLING
( )Wood Frame 1 ) Masonry ( )Steel ( 1
7. PLANS and Specifications •
1518 SQIoFE. SINGLE.. FAMILY DWELLING. WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
- SINGLE. FAMILY DWELLING
215.. • July .7 4001
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
• 7...; July . , • 1999.
Dated at the Town of Queensbury:this Day of 19'
SIGNED BY _ for the Town of Queensbury
Building and Zoning Inspector
- f .. -- •
BuildThwart's Fenna. Application •
ToIIWU of QueclishU1:)1 - Dept. ofCommunity Uerrloinnent, 742 flay•total, Quecnrbuty, NY 12804 1761-8256J •
•
.n__---- nUII DIN(; & COUls ENFORCEMENT
•
IVUTIC _- Requirements prior' to issuance 1'GKAI!'1'r1LL NO.
--� ol. Iltis pernlil:
h Ix;Inlil II1%%l Ix ohblincd Ixaino ' - ---~ pL"[ lMmn.raEr $ )L �
beginning con,ltuclkm. No iiispccliuns Zoning Board Action ®� c�
will be ntntle until nlgdicnnt (its icecivetl J—) g
n VAL II.) Inn WINO chant I. All Ana /use • nEcnE.ttruN rLYs MI
'MIJSTtb completed nntl•limo�sti.'nnhue --� 1'Jtt,,,,1ng 1Jcxrrd Acrlvn REVIEWED RD •
of the nitplic:unl nus)n Ixnr on the SIt I Subdivision I Ulhcr DuIlding hurxctar
nigtlicnlion !Mtn. u,.,:,t),,_ ,i ItccionIkin Fee Payment
AEilrlic:ut I: I he. Aliclul,e f..b G1tUtil.1, I itc. • Owner:
Same
Addlcss:
I810 Route 9, takefi(',Ultgt'.r NVI28Adtess:
.
!'bone.it ( !i r 8 ) 668 - 3316 Phone if ( ) ... . -. - .. •.
IC* a (oS �+..�,�� ke tlt rt." • ._J.___--J
I'rvllcrly l,ucalion: - ---=---� Tax Mnp Number
„ , , r r r Section , Block beet •
Subdivision mime:: `-'°
t111'1 Ulll;• OF E'IIUE'U5CU YIUILIC: F57.'.Lt-tll'T'EU Mf1ItKE'1' VALUE OF VIE
Mew Building l CONSTRUCTION: •$ 13 ___
� residence / commercial
Addition to Building: OCCUE'11flCX ItrronFtn'�t'ltoNs
residence / commercialpt:3.mrary Ltui.l.ding -
Alter ul: Lcln I:v Lt .i..lillnclt X Single Family Dwelling
residence // commercialTwo Family Dwell iv Eper,
Residence / commercial _ Family Uwe! � r
no change to exterior size Uf .ce
Other Work (describe below) MercantileManufacturing JUN 2 2 1g99•
— — Other TOWN OF Qai::--NS•B a=P:,,
___ 1�� d3lJILDi�Ir�it,� rr try
• GROSS AREA OF E'IIUE'U5I;El s'clwc'runt: l I f AUDITION, what will use
1st lr i.00r • k5\8 . sq• �
. S of flew addition be? :
2.nd .Floor • eq. ft.
Other Ir loor.a ncg. f t' •
(not unfinished cellar or u' emelrl: �S ACCESSORY UUILUINOS:. 2 Car
. ... . .._S Detached Garage 1, z Car
• A: 15�� SQ. K . Attached Garage 1,TOTAL FLOOR I11tL — private ' SL-orage Dui ing
� Commercial Storage Building
SIZE OF HEW STRUCTURE: uCJ,D _ Other 49,
r�c'rx1 ��'L'
Will art second-hand or ungraded
I'ouberti.on tType: I'uttk lumber be used? If so, fo1 what?
(habitable
of Stories ! 1 _�
(habhtab.l.e space only) , g5+/' feet '.CX1?E OF' IIEATItIO sysTEi3•i•,es)
Ile"iglu (grade to r�.ctye) • circle all wltic Rp /'�
Number of fireplaces and/or woodstove (Circle.
/ Oil Gras b ardWood/ Other
to be Installed:a.iJ ect: Ot�� Forced Hot Air /
a on r.es onsible for. supervision of work as regards ti p building
Person r fief or Er ,
codes i.s : �LtJ!!_c�(laIlrlCell.,�ltv� -�� (�
Ntiiile 1lddresso Ph4ott12845 518-668-3316
11u 1l.de r: 1 Ite M i.ckg.(f� Gr 0.LW, I lle. 18 I 0 R.te 9 r_ Lake Geuftc e
G.0 JI fCL 4� NY 12801 518-198-4399
Plumber : -Lava P .1.tat6-00,-_16A Pak Ilgac(. :--
Marren: AL-ktte.lig1[. 66 21L8_,—Gatu>.vj.ftee.. Ny I , ►v r 3a ;,I s-31I-v92z
Electrician:_1_r21t.Ev_eh_E-Cet'_Uuc.,_114.62/ufal/iey .-.—� � 1'-�—
1)ECL lRAlION: Please slgti below r flcr you have carefully read the statement.
h
ns
To the best of my knowledge the statements cottla'llted in anl ofis lall IlroposedT work totlbotdono on
and •sllccitiealions submitted, ate a true and complete
slalem
the desclilied pmctulises and that all provisions of the Building Ctxle, the Zoning Ordinance and all
ed
other laws petlaining to the proposed work shall be
complied 1is with,t he.ther t t/vro shall or ntted, and
d a
that such wilt k is authorized by the owner. I'm ,
Certificate of Occupancyor lificate of Conllrliancc being issued, an AS BU1J-.T PLOT PLAN by
a licensed surveyor; elf vt e6a)\:, sho actual location of project on premises.
Sig11atut'C:
, r rswnrr'R :went. architect, contractor)
TOWN OF QUEENSBURY
•
• 531 Bay Rd., Queensbury, NY 12804
•
.APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date o 1' ,19 S9 Permit No.'
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant-to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations; and all conditions that are part of these requirements arI 1 also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant Tlt-e.' ,8Aae_\s C _ _1 APPLIANCE (check appropriate boxes)
Address OS\Jurs 0 STOVE: ❑Wood c Coal ❑ Pellet ❑ Gas
��� Zip0 FIREPLACE INSERT
I2tL FIREPLACE, FACTORY-BUILT:
8— os�1, -- a WcO
cd
Phone S1Gs
0 FIREPLACE, MASN^
❑ Wood ❑ Gas
Owner
0 FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address . - IF NON-MASONRY APPLIANCE:
Manufacturer:
Zip Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
• ` - 1 — R 110 0 MASONRY: CI Block El Brick CI Stone
t1 FLUE: ❑ Tile ❑ Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST FACTORY-BUILT:
- CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE:. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall ❑Triple Wall
. REGARDING REQUIRED INSPECTIONS. - ❑.Insulated • ❑ Direct Venting
❑ Chimney Liner - = y:
•
Cashier's Department Town of Queensbury, New York
Dept:Fire Marshal Amount Collected Amount Received
Code Number Title _:.
A 173 3389 _ (190) Public Safety
A 233.2655 (230) Minor Sales '
Fee Collected From or Refunded to: •
Address: . .
Dated: •. Town Clerk or Deputy:
White:Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
TOWN OF QUEENSBURY
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
.l
Date ' 11,r % / 19 q '. Permit No. C\q, * -.‘ ;.
APPLICATION IS HEREBY MADE to the Building Dept.for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant , d / r t i, -, c, 6 1 c:cr,iy APPLIANCE (check appropriate boxes)
Address 2.r,ld ---/,/ j lit( _.) 61 0 STOVE: ❑Wood o Coal o Pellet ❑ Gas
,' 0 FIREPLACE INSERT
( (. // C. '..,', j c- - f'( Zip ��i o ( , '/ ti,FIREPLACE, FACTORY-BUILT:
❑ Wood ❑,Gas
Phone ` CF } , j , ❑ FIREPLACE, MASONRY:
❑ Wood ❑ Gas
Owner 0 FURNACE: ❑Wood p Gas ❑ Oil
Address IF NON-MASONRY APPLIANCE:
Manufacturer:
Zip Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
DI1ASONRY: ❑. Block 0 Brick 0 Stone
LcT I /A <1,4 , i 4 Q , -,, (/'''. FLUE: ❑ Tile 0 Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST \I;� CTORY-BUILT:
CONFORM TO INS FIRE PREVENTION & ;! Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS . . 0 Double Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS. 0 Insulated 0 Direct Venting
0 Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title C .;N 7
A 173 3389 (190) Public Safety w •
A 233 2655 (230) Minor Sales
Fee Collected From or\Refunded to: .._ '-,. 't ' ' t �,�- ;a f'1 t.:i
Address:- _ _...__ ```: .r '11— t 4
ated: I a :,,,... ! -c-1 C a Town Clerk or Deputy: `.-, `T"' .
White:Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
\ ,
Application tor .JtY-1.1L DIJYUJAL Y�1t1V111
Town of Queensbury
Dept. of Community Development Permit No. C/1 J,
.Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: t k. — Cog Sv2db , -
Property Owner's Name: 1T m id etS ii u
Property Owner's Mailing Address: 'bit) acuJe G— (Q&Q ga_4 _ '
Installer's Name: alkali 60L ah Phone-# 1ic) a Ia'7
. Number of bedrooms (if residential): 3 Total daily flow: LISZ)
(residential -compute @ 150 gal./bdrm.)
Topography: ✓ fat, rolling, steep slope To of slope
• Soil Nature: ✓sand, loam, clay, other /depth:
Ground water: at what depth? O feet / Bedrock or Impervious Material: at what depth?• feet
Percolation test: not required, r/ required [rate 1 min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WET.T,, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank l= gallon (minimum size: 1,000 g✓al.)
Tile field:, each trench feet / Total system length: feet
Seepage pit(s): number of / size each: ft. by ft. •
Size of stone to be used: # SfixV. / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Ai IA- Size of each: gallons
(iann system and associated electrical work-to be inspected by a certified agency.) J
For your protection, please note that pursuant to Section.136-29 of the Code of the Town of Qmensbary, 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 this application and agree to abide by these and an requirements of the Town of
Queensbury Sonitary Sewage Disposal
Signature of responsible perso : Date:
Ait l0 :),•_(::).•.Q J� ":.A4l Pik J_tl'":J'C •_l'J_'l J_tl' A J!_l 1, J`._l'Div J_.•.Q..ow,":'J_•_l' A_1 tw J_sl"1,,,,l•_l':l.,l J.•_C J_•Anle_l J_,•AvAme._l'o.o.. ltl".lol'J_it e.w. _;..A1'J__l' K:lo_l' ti:z
�' 4028789'
THE NEW YORK BOARD OF FIRE UNDERWRITERS 'AGE 2 r
•.,; BUREAU OF EL-ECT-RLCITY r
il I- 111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210 r
_(, OCTOBER 12,1999 43'05599/99 A 145836 Ir'
r Date Application
p lica ',o, p on ale , q I�•
• THIS CERTIFIES THAT cr
• only the electrical equipment as described below and introduced by t pplicant-na zed on the above application number is in the premises of hr
ii6 r
• THE MIC.HAELS GROUP, 68 SURREYFIE'LD .DR. LOT 12, • UEENSBURY, NY
=Si tx 6x is GBR 12 )4-
!<, in the following location; ❑ Basement ❑ 1st FL ❑ 2nd FL. Section Block Lot ,)
(OCTOBER 07,1999 r}
'-mac, was examined on and found to be in compliance with the National Electrical Code.. I4.
r
P IA
• FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
W OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT., K.W. AMT. K.W. AMT. K.W. AMT. H.P. Irr.0 IA
j 26 37 29 26 1 1.5 3 r ry,
' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS M LTI-OE TS ET DIMMERS
-, AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO:11 .OF FEET AMT. WATTS }
•
!r !T:
2 -•
.2
r r•
j' SERVICE DISCONNECT NO.OF S &- R V a I C E' .. .. J
i r}'
"� AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W NO.OF CC COND. A.W.G. NO.OF HI-LEG A'W'G' ,NO.OF NEUTRALS A.W.G. Ir
711 PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL ,
r
2 150 CB 1 X 1 2/0,,- 1 1t/0 ZI 6 ,
t•
-`• OTHER APPARATUS:
POST LITE-1 ., r'
G.F.C.I:—4 1
• SMOKE DETEC'TO?:—6 r
r
r Si,
y
•
_�- r
.cr ) .X.
.t INi i ti
FOREV•
ER ELEC/BOEL ELECT. r -4. . l al
�, WILLIAM D. lrCPARTLON• . ::; $�.. ,�e,. .
CI F�I 1! _,.t-'0.
'w H+ 1 GENET
W, 2446 JAFFREY ST.
�Ir SCHE1VECTADY, NY, 12309 e?„+°�. �[' �,` i._ 239
• •
-fie aat� •,_
•
-. Per
�C�
4i; This certificate must not be altered In any manner; return to the office of the Board if incorrect. Inspectors may be identified k
L,Y'.Y Y4Y 7•1;YdY 4YI'4,Y YeY,YeY Y..Y Y•Y Y•Y .Y 7•Y Yiii;Y�Y Y�Y Y�Y Yi'(Y•Y,4Y 4..YiY Y�Y,iiiY Y•Y Y�Y,7.Y Y Y YiY 4Y Y.Y;T'iitY•Y 4Y 4Y Y.Y Y�Y Y..Y f:Y YilY
nnPY FC R BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MP_'.
,
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name M
GY0)/( 0 \\
Location pU r\ -e--K7
Date/O-/ 1° Permi t Rq
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Tes' -
(if applicable) Rate-Minute/I .ch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total L-ngt
Length of each trench
Depth of trenche
Size of stone
SEEPAGE PITS: Numb- -
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/P t
Openings Sealed? es No Partial
LOCATIONI/SEPARATION: :
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Ye No
LOCATION OF SYSTEM ON PROPE .
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: 4101P .I
Arrived:
Depar /
Bu' ing Ins to
r. r
._
, ,,.4
Clemente Latham
v, Concrete Corp.
40 River St., P.O. Box 448 Bus. Ofc. 270-1767
Troy, NY 12181-0448 Dispatch 272-5750
6
a..C3 ....t. 1 11
•
it
•
c t::11/
c .)C lcv.i. 4" 0
(0
V ‘C5D ,
cit5:e - Ve-j k Sitt
�4�®CY V-'^,OC)
'\ c,,c 4
1 IV
a[ IN
VA
TOWN OF QUEENSBURY
,, BUILDING & CODE ENFORCEMENT
� � 742 BAY ROAD
�/' QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP: C3
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION R.QUEST .CEI ,D:
-Ift
NAME / l _ /?
LOCATIONi ].10 .12 l) (�
DATE I0 5 -CV\ PERMIT
TYPE OF STRUCTURE g
FOOTINGS FOUNDATION BACKFILL _ FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
- N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISHI
DECK/PORCH/STEPS RAILINGS
RELIEF VALVES
FURNACE/HOT WATER O\RATI G
INTERIOR TRIM/PRIVACY D S
......-)
FINISH FLOORS:
BATH/KITCHEN WATERTIGLIT
OTHER FLOORS .SWEEPABIL
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAIL GS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULAT ON
GARAGE FIRE PROOF NG
DOOR CLOSERS
FINAL ELECTRICAL
SI PLAN/VARIANCE REO.
1.4
INAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
•. _ p_iti
. ,
',•,,_
�� RESIDENTIAL FINAL.INS'ECTION REPORT
Office No. (518)761-8256 Date inspection request received: 17Th 1
Building& Code Enforcement I
Dept. of Community Development Arrive am/pm Depart ILI am/_pmm
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New York 12804
NAME ktf dila 6 PERMIT# 3 7 —
LOCATION (ta? G-re-4 eL�e4 r2-09L l a-- /i -
DAThIa / i K57
TYPE OF STRUCTURE Sk-irj
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof f
Roof Complete
Exterior Finish Complete 1 V
Interior/Exterior Railings 30' to 6"
Exterior Handrails,balconie ,1 ding 18 in. or more �f
Interior Handrails 'rs bo sid s 3 or more risers .
Grade 2%away from oun tion J
8"clearance to sill pla e
Gas Valve shut-off e s re ulator 18"above grade
Gas Furnace shut-off wi feet or within line of site ✓
Oil Furnace shut-off at ce to furnace area /�
Furnace/Hot Water Heat dr operating c//
Relief Valve(s)installe�d(( / �/
Headroom,6 ft. 6 in. o stairs .. ,/
Basement stairs,6 ft. in. /17,/'
Handrail exterior sta' s both sides more than 3 risers
Interior privacy/trim/ oors/main entrance 36"
Floor Finish ✓ 1
Bathroom/Kitchen atertight as
Interior Handrails alconies/Landing 18 in. or more t
Railing across window in stairwells
Smoke Detectors: /s
every level
every bedroom
outside every bedroom I
inter connected
Bathroom fans /'�
Plumbing fixtures • .
Foundation insulation Y �cJv
3/4 hour fire door/door closer 1;,(,,,
i
Garage fireproofing
Garage penetrations sealed ,
Furnace in separate room protected(in garage) 7./.
Light ventilation per r n
Safety glazing 18" r le s from17 i
Final Electrical ( x.. ,J 'b
Site Plan/Variance eq . ed a/J /
Final Survey Plot Plan "Y)®J J l U At167 4 4 77G
As Built Septic System layout required A-6 6;1iL r
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy)
I
Okay to issue permanent C/O(Certif. of Occupancy)
CL )I- tW
TOWN OF QUEENSBURY /4
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name \\VI:A\O-Qk) (3)(6V4
Location o f ,P- 31/Y irf4))e-`d
Date`0-06 19ermi t # t- /
SOIL TYPE: Sa -Loam- ay-
Results of Percolation Test-
(if applicable) Rate-r'nute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tcy Length
Length of each tren• • „AR . T
Depth of trenches
Size of store- it_e_a •• 6
SEEPAGE PITS: Numb.r-
Size - ft. ft.
Stone size
PIPING: Size Type
Bldg. to Tank QRFO • -C-FEC
Tank to Dist. Box y"QvC a
Dist. Box to Field/Pit 1-4"M Tn WIC
Openings Sealed? 4114212. No Partial
LOCATION/SEPARATIONS:
Foundation to Tank I () feet
Foundation to Absorption _yam _ feet
Separation of Pits feet
Conforms as per Plot Plan Yes No t3EF
LOCATION OF SYSTEM ON PROPERTY: T-U EftF
(circle o
Fro - Rear - Left Side - Right Side
Middle •ron - Middle
C0MMENTS
SYSTEM USE APPROVED: YES NO
Arrived: 411
G
Depar - : 2,244
-\
//j
/ ui ding Ins or
TOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name IALC_Riti c-5 (RAP
Location Ls lig c
Date &( c( Peit # l7' Z
SOIL TYPE: Sand-loa -Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:- ----
ABSORPTION` FIELD: Total-Length
Length of ach trench
Depth of tr nches \
Size of ston \
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size IType
Bldg. to Tank ''` - 0,
Tank to Dist. Box
Dist. Box to Field 'it
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank 0 feet
Foundation to Absorptio, feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON P'JP.'TY:
(circle :,..:�.
Front - Re. - Left S '.e Ri .ht Side
Middle Front - Middl : Rear
COMMENTS: I�C9,t(A-
I P-N K c,Nc-y — /N L c,--r 64FFL6-
({
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
A
Building Inspector
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road '
Quecnsbury,NY 12804 Arrive am/pm Depart/0m
Inspector's Initials
NAME: 11\•c-RI & -`? PERMIT# 99— 7 2---
LOCATION: DATE : Ve...75/9,
TYPE OF STRUCTURE: _
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placeme
of the concrete.
Materials for thi purpose on site
Foundation/Walls.ur
Reinforcement in cc
Foundation/Damppro 6
Backfill Approval
Plumbing Under Slab •
PIu thing Vent/Vents in 'lace
R gh Plumbing
eating Rough-In
ti
Insulation C_8.- E G!J00_2 1./.
Foundation Wal Interior R-
Foundation W•;'s Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing •
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation I, 2, 3. hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
KO N • ...,
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury ,
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury, NY 12804 Arrive am/pm Depar '� m/pm
Inspector's Initials
NAME: ' mot, -S o - PERMIT# 7 2---
LOCATIO ' v:212C {I---t6Z05_ DATE : "ifiSO
VFi
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is re:ponsiblr for
providing protecti,,n from f cezing
for ,8 hours foil► ing th, placement
of 11 concrete.
Materials • 1 purpose on site
Foundation/Wa pour
Reinforceme in Place
Foundation/►ampproofing
Backfill A!•royal
Plumbing ndcr Slab
Plumbing,Vent/Vents in Place
Ro gh Plumbing
fring
Rough-Inlation AU F- I/1/43S,0 y ` _ A (01,01 -tc), ‘
Foundation Walls Interior R- p,e<-(2r` ; 4) fRA)Y - �,(�
Foundation Walls Exterior R-
Floors '
Floors R-
Walls R- 19_ V`
Ceiling R- 7
Duct work or piping in
unheated spaces R-
Proper Vent;Attic Vent
Framing .
Jack Studs/Headers
Bracing/Bridging _
Joist Hangers
Jack Posts/Main Beam
f
Air Infiltration Barrier
Fire Separation 1, 2, 3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
FIRE MARSHAL
TOWN OF QUEENSBURY
j QUEENSBURY, NY 12804
YY, (5.18) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST
NAME \` C12\ctf2j2
LOCATION (et. PERMIT#
SCHEDULE INSPECTIO W-
AM PM
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENC IGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTE'
FIRE SUPPRESSION SY',TEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
H'C I ;11 EY DLikE-r
WOOD STOVE
tEFREPLACV❑MASONRY FACTORY BLT. _
ROUGH-IN
❑FINAL
REMARKS: M./A-466-1.1c PV g3 OK TO THIS DATE
iu
O60.7 636
°Jif
INSPSLIP.PUB INSPECTOR
,6,-------,---e-. \\Wcys)
f 1"Ar":' " _
GENERAL INSPECTION REPORT
( 5 1 8 ) 7 6 1—8 2 5 6
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury, NY 12804 . Arrive am/pm Depart it
Inspector's Initials
NAME: PERMIT# 3-2
LOCATIO : DATE : —)0
TYPE OF STRUCTURE: 1
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1 I
Monolithic Pour Form _
Reinforcement in Place
The contractor is respo i for
providing protection f m fre ..ing
for 48 hours following the playment
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforccm nt in Place_
Foundation/ ampproofin�;
Backfill Appro
Plumbi Under S
Plu ing VenUVents in Place ir.
ough Plumbing ✓
Heating Rough-In
Insulation
Foundation Walls Int rior R-
Foundation Walls Ext rior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Atti Vent _ �J,r
Jack Studs/Headers
Bracing/Bridging
Joist Hangers V .
Jack Posts/Main Beam •
ir Infiltration Barrier
Fire Separation I, 2 3,hour •
Penetration Sealed
Fire Wall 2, 3, 4 hour �
restopping . _ it Q_:01N—P ` 1C� Ti-k&etnl.D ^ F"1 /�
I 0 NY1
GENERAL INSPECTION REPORT
(518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart -
pm
Inspector's Initials
NAME:M ( 51çWtC) PERMITLOCATION: i.P\ '3 DATE : - (-14
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is res nsible for ��� �K(Itk( ,( 6
providing protection from freezi g
for 48 hors followi g the plac meat
of the cone lc.
Materials for this pu se on site
Foundation/Wallpou
Reinforcement in Pl ce
Foundation/Dampp oofing
s .B __i11 Approval
Plumbing Under ab
Plumbing VenU ents in Place
Rough Plumbi
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
GENERAL INSPECTION REPORT J J r�
( 518 ) 761-8256
Town of Queensbury J�
Dept.of Community Development Date inspection request received:
Building& Code Enforcement /
742 Bay Road `b
Queensbury, NY 12804 Arrive am/pm Depart'" pJp/m
Inspector's i 'als
NAME: PERMIT
LOCATION: c\c) S DATE : —
TYPE OF STRUCTURE:
RECHECK
N/A Y NO COMMENTS
ootings/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 oi ' e
Foundation/Wal 1pour_
Reinforcement in Place
Foundation/. ampproofng
Backfill App val
Plumbing Un Slab
Plumbing Vent/ nts in P ace
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls In erior R-
Foundation Walls , terior R-
Floors R-
Walls R-
Ceiling R-
Duct work or pi ,ing in
unheated spaces R-
Proper Vent, Attic Vent
Framing
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, 3,4 hour
Firestopping
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
• 4 (518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT#
NAME G44(,L5 6/P-e
LOCATION 6S '/eGv
SCHEDULE INSPECTION ON
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO S' INKLERS
CLEARANCE TO H'ATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT hAM-t-
REMARKS: OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
MAP REFERENCE:
SURREY FIELD SUBDIVISION
MODIFICATION TO AN APPROVED SUBDIVISION
DATED: OCTOBER 27, 1998
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
2'7
a D us �
SIC S teve S
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Lie. No. 50135
'UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY
MAP BEARING A UCENSED LAND SURVEYORS SEAL IS A
VIOLATION DE SECTION 7205, 918-DMsa 2, OF THE
NEV YORK STATE EDUCATION LAW
'ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
MARKED VATH AN ORIGINAL OF THE LAID SURVEYORS
SEAL SMALL BE CONSIDERED TO BE VALID TRUE COPIES.'
'CERTIFICATIONS INDICATED HEREON SIGNIFY THAT
THIS SURVEY WAS PREPARED INACCORDANCE NTH THE
EKISONO CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED
BY THE NEW YOM STATE ASSOCIATION OF PROFESSIONAL
LAND SURVEYORS SAID GRTFICATIONS SHALL RUN ONLY
70 THE PERSON FOR VIHOM THE SURVEY IS PREPARED. AND
ON HIS BEHALF TO THE TITLE COMPANY, GOVERHNDNTAL
AGENCY AND LENDING INSTITUITION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTITUTION.'
N�2 ha
1D5 O0,
9729.35 sq ft
�6
i
0
"�
0
t�
Map of a Survey made for
R,FCF7-IVED
OCT 12 1999
H.O.A.
moo. VILLAGE
s. Qom+ GREEN
F
-110
Irp.
THE MICHAELS GROUP
Town of Queensbury, Warren County, New York
90
\I
OCT 13 1999
T3rtlKK=k.
!4
�liatei
=30'
S-1
I7
SFEET1OF1
MICHAELS GROUP (SURREY FIELD)
NO. DATE DESCRIPTION DWG. NO. 97061
N r\ a
I.-- ---1 Z
\ .;_,,,,_: ,,;_i 3 -r. s,t . . — _
Z
-�0 ,312.46 sq. f t, N —7c``•.
�--^ 4 L, 67.23 L�7.
� 4. L�5•931
v
3,4k f R=7 25.0v
/ . s� . 675-D
�•r3� •50 ' L:76.35 L=7E
y ' o
� • ._,.. . ..., -r~w . C o O
,
.t • , c.1, .3
� 3 j 13
IN
, . . • • • ,,.,.... . . \ . ,, „t,- .
„‘,....,. .::z11: t if: 01 iNI.00 CI
. t•>001 • ':)1,4:).\71._,...,;...i.1-7-----7-7.,,..,..-,.j...i .‘ 4C7:2 r.-c71 /108.82 sq. f.t.L. 7'1°8'82 4
:r . • . I 0 • ' • • \ ' t --:-1.-:':-- .
__ S 6,�:SD __ 6��
y --� 3 S $4191°4 W N 8972%
\, \
' ' ' ' ' ' ' ' ' ' \ • k•- ,H;) .--- • *
�'�' `� mot •' S ?4 . •
�� rf ti- 's' ;: 1' ' �; or believe I saw evidence of,
I have seen �r asshou es, wells,trees,fences, etc.,
�- ��3 (0• � all objects such
shown on this document• I also represent that I have
• 1 so ally measured the distances set forth on the diagram:'
. - per
:. • • • Ai • 11_ - -
-412*-----'
SIGNATURE
.. '....,:6,,, c;)
. REDV� �®
. / c1, b LOT L 1E� TO t' DELETt�
JUN 2 2 1999
. .
TOWN OF QUEE�av13URY
BUILDING AND CODE H.Li
I N LOT I�tCO#FIC„A7lC 1 V JAGE
c DELETE LUT 11 Aun .,.__ - _
___
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