1999-589 . .
Certificate of Occupancy
Town of Queensbury
Warren County, New York
Date plarch 24 • 2000
fl
his is to certify that work requested to be done as shown by Permit No. 99589
has been completed.
This structure may be occupied as a qTM(7,P1 VAMTLV MIRLLINP: 2 CAR ATT. GARAGE
Location LOT 76 FAWN LANE
•
Owner
-SCHERAEITHORN CO&STisiun
TAX MAP NO. 121 . -15-76 By Order Town Board
OF QUEEN B Y
.(c744/1"
Director of Buil ing & Code_Enforcement
BUILDING PERMIT
VALUE $ 100000 TOWN OF . QUEENSBURY No 99589
TAX MAP NO. 121 . —15-76, . WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to SCHERMERHORN CONSTRUCTION
OWNER of property located at LOT 76 FAWN LANE Street.Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE- FAMILY DWELLING., 2 CAR ATT. GARA
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.
t. OWNER'S Address is
CORP. 43 H HUNTER BROOK LANE:.:.
QUEENSBURY,.•NY_ >.12 8.0,4....
2. CONTRACTOR or BUILDERS Name.
SCHERMERHORN CONSTRUCTION. - _
34 grWIRTF20311E6PEAir
QUEENSBURY., NEW YORK 1280.4.
4. ARCHITECT'S Name
COMMONWEALTH. ELECTRICAL
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) SINGLE ,FAMILY DWELLING
I )Wood Frame 1 I Masonry ( I Steel 1 I
7. PLANS end Specifications
SINGLU FAMILY. DWELLING, 2 .CAR ATTACHED. .GARAGE AS PER
PLOT PLAN AND SPECIFICATIONS
B. Proposed Use
SINGLE FAMILY . DWELLING., 2 CAR ATT GARAGE
211 ... September 14 2001
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for en extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) 1999
..14 .. .:, September
Dated at the Tow Qu •nsbury this Day of 19
SIGNED BY
for the Town of Queensbury
�"
`'� ng and Zoning.)minder
Building Permit App licat�ion
Town of Queensbu y - Dept. t f Contttutnily Developnr'nl, 742 Bay Row!, Queensbnly, NI' 12&)4 l761•32W
, TT1,1Jr • BUILDING ..Q . CODE ENFORCEMENT.,
/— of
Requirements prior to issuance
A permit must be obtained bororo 1 Uf this permit: PERMITnix NU.
boginnlog construction. No Inspections PERMIT FCC PAID �%/ dZ
will bo made until applicant tins received F 1 Zoning Board Action
a VAI,ID BUILDING PBRMIT. All Arco /Use a�,
applicants' spaces on Ibis application ItLs"C/ZC�17�9�1'it! a ��
CZ ,
MUST bo completed and We signature ri Plannlug Board Action
of the applicant must appear cat the /iliVlli II'/iU Dr:.
SI% / subdivision /other '"' I ding Imitator
eplicnlion form. ro..oi,.. l Recreation Pee Payment
Applicant ce,har'Wtie.rk0tA.)CoAsi-ric 4o/J Owner: < gef
. ' Address: 93 a 0,erie f iroo k LAW" Address:
SEP O 19
Phone # ( 5/8 ) /7J8 - 6 6 7y Phone # ( T �i" Q�=.Ot ar--ff
Cs IV e=,v� b+>�Y
IL
Properly Location: L.6-t In, cAw� �Nf -
' Tux Mnp Number. /� ' /-/ S/ .
Subdivision Mu : 51i e.r✓yl a �V P'dv 6S . section Block I al
• NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
X New. 40.4.1diadi CONSTRUCTION: $ /ap doe
'residence / commercial
Additio:n`:'t;o.,,auilding:
'r.eel:dan.ce / conunercial oCCU1i'ANCX INFORMATION:
Alteration to building: primary Building -
residence / commercial X , Single Family Dwelling
Residence / Commercial •• Two Family Dwelling
no change to exterior size Family Dwelling
Off ice
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS i AREA OF PROPOSED STRUCT• Et jcp •
$' ' If • ADDITION what will UGC
let Floor 768 sq, ft. of new, addition be7 :
2nd .?loot: 768 eq. EL. f"4
Other Floors eq. ft. -
(not uniirliehed cellar or basement) ACCESSORY BUILDINGS:
• Detached Garage 1, 2 cal'
•• TOTAL FLOOR AREA: /536) SQ. F'I'. x Attached Garage 1, (T-car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
ail FEET X 5-2- FEET Other
•
Foundation Typo: 004.'re11E'- Will any second-hand or ungraded
' Number of Stories : .,. lumber be used? If so, for what?
(habitable space only) _ 1yo..---_. _.._-•-
height (grade to ridge) : a.S feet ii PE bi. iii n'T1UU sYSTrrt:
Number of fireplaces and/or woodsLovo (circle all which lies)
to be installed: ® Prase / ell Gas / Wood
Greed riot Aar)/ Baseboard / Other
Person reupoi:sible foi: supervision of work as regards to building
codes is :
Heine ltddress° Phone
Builder: Sell a Pen acAor.4/ . • 749-067Y
Plumber: 5/eve- 4i/e,/i • 117-$e23
, Mason: A_AAS. Act/clwi4./ 79a-/37/
Electrician: /Nilre_ (-20„, ,'c,C% Y9y-39®5
DECLARATION: Please sign below after you have carefully read the statement.
To the best of my knowledge the statements contained in this application, together with the plans
and specilicntions submitted, nt'o a true and complete statement or nil proposed work to be done on
the described premises and that nil provisions or the Building C.xlc, the Zoning ordinance :vul all
other Inws pertaining to the proposed work stunt be complied with, whether specified or notch, and
that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a
Certificate of Occupancy'•ur Ccrtilicate of Cuntpli,ntee being issued, mu AS BUILT PLOT CLAN by
a licensed surveyor; tlr n to ss le, wing stclual location of project on premises.
I Signature: t„„, .
(owner, owner's agent, architect, contractor) .
.
09/09/1999 11:12 5187454437 TOWN OF QUEENSBURY P PAGE 01
••
r r�
Application for SEPTIC.DISPOSAL _PERMIT
Tower of Que nsbury Y� f4.5 I�.� Pk.i.) 0A)
Dept_ of Co poirY Development ment Perrntt No. ��
P •• �'�j J
8uildizig &Codes Office cI 1).� ; � �-%1C i3
742 Bay Road 0 Fen Paid $
Queeusbury, NY 12804
1/4_ REOFIVED
Location of property for instillation: . •1 o 17 74 .' Fa.u.Ji� L.N
iiBUI
` /); SEP ®U9�®1999
Property Owner's Name: �c l�e rs44.e r�a rig/ _0 n5-1.r✓�T oft./ tV OF
• IL®t1V Q� ,CODE 1
Property Owner's Mailing Address: '�1 #..—_/-krifer'.5roo z L •
Installer's Name: . re: -r_- C'o,u7. . jtC.c2v i;n.et Phone #
Number of bedrooms (if residential):• . . . Total daily flow: eyD
(residential -compute IV 150 galdbdrm.)
Topography: x fiat, rolling, • steep.•slope % of slope
•
• Soil Nature: 7L sand, loam, clay,' _ other /depth:.-�.
Ground water: at what depth?A' eet• / Bedrock or ttpervious Material: at what depth?_ feet
Percolation test: not requirredd, . rescp4rt4. f rate min. per inch.J
Domestic water supply: -X ..municipal, well,. other
If domestic water supply is,a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM • . •
Septic tank h250gallon•(minimum .size: 1,000 gal_)
Tile field: each trench feet .I Ttytat system length: feet
Seepage pit(s): number of . •/ size each; ft.by . ft.
Size of stone to be used: # _ • % .depth or thickness feet
HOLDING TANK SYSTEM: (if required) .
Number of tams: : . ' Size of each.:• pions
(Alarm system cad associated electrical work to be inspected by a certified a,:mecy.)
For your protection, please note that pursuant to.5.ectioa 136-29 of the Code of the Town of Qneetisbtrrh any pormsit or
approval;ranted which is based upon or is granted is r cv:ttpva gay material miareprese ion or failure to roa/ce a
material fart or circumstance known by.or on behalf of ari ipplicst..shall be void.
I bays read the regulations with respect to this•applicati sad' to a by these and an requirements of the Town of
Qoeerzsbcry Sanitary Sewage Disposal Ozdinence. .
Signarzre of responsible person: • Date: ? ?`J /
0:04p?
. /��_ ENERGY CODE COMPLIANCE APPLICATION
�
�`r�J_: : TOWN OF QUEENSBURY, WARREN COUNTY
.�� -. 9000 HEATING DEGREE DAYS yrz
Compliance Methods: PART 5 - Acceptable Practice Method - SEP O. `� aggq
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component W Obf sEN,S Ry
1&2 Family Dwellings; Multi- COOS_
Dwellings (3 stories or less)
PART 4* -' Design by Component Performance
- Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
I . Gross Floor Area - /536 square feet
2 . T-v e of Heat - Electric Oil X Gas Other •
3 . Is building mechanidally cooled? Yes x No
4 . Percentage of area of windows and doors ‘NI Over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R 3.61
b . Exterior walls R / 9
c . Glazed areas R /.8
d. Exterior doors R 9,_5
e . Floors over unheated spaces R 17
_ . Edge of slab on grade (heated building) R //
g. Basement/cellar walls (above grade) R /
h . Basement/cellar oia1ls (below grade) R //7
i . Heating/cooling-ducts-piping in unheated space R //to
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code x Yes No
- T E M RAT E C NT OL MA IMUM SETTING 140° - WILL NOT BE EXCEEDED
Appl_ __w ' Si t e Date Phone Number
,�.�. 1-9 - g g 798- d679
INSPECTOR' S REMARKS:
,'I---O,J(-(6
/� TOWN OF QUEENSBURY
+�1#"il BUILDING & CODE ENFORCEMENT
s � 742 BAY ROAD
;� ��4 QUEENSBURY NY 12804
( (518) 761-8256
'
ARRIVE: DEPART: INSP: (.LJ
I
FINAL INSPECTIONAIER7 — RESIDENTIAL
DATE PECTION REQUEST RECEIVFD: 3 c9/5‘. a ,
NAM. i. 1
LOCAT I 71.- -----
i
'✓ip �1 1 �Y-2�
DATE . �f �/oD PERMIT 0
�;1 Pr
TYPE OF STRUCTURE f.
FOOTINGS FOUNDATION BACKFILL _ FRAMING _
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL _ WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT s
PLUMBING VENT i
ROOFING 4ir
EXTERIOR FINISH ''a (
f`
DECK/PORCH/STEPS/RAIILINGS if
RELIEF VALVES ‘2 A
FURNACE/HOT WATER OPERATING(
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT`,
I
OTHER FLOORS SWEEPABLE ',•.
OTHER FLOORS CARPETEDr .
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS F
BATHROOM FANS
N
b
g
PLUMBING FIXTURES / k
I °v
FOUNDATION INSULATION '11,
f'
GARAGE FIRE PROOFING
DOOR CLOSERS t
FINAL ELECTRICAL {
SITE PLAN/VARIANCE REQ. ,
/
�E` AL SURVEY PLOT PLAN �/
OK TO ISSUE C/O OR C/C
- fib/ —
// —
RESIDENTIAL FINAL INSPECTION REPORT
PI ee
Office No.(518)761-8256 Date inspection request received: 3 c 3/,a-9uc 2 ./ eu1
Building&Code Enforcement 7 7 Dept.of Community Development Arrive P pm, Depart t 7
Town of Queensbury Inspector's Initial✓r
742 Bay Road -
Queensbury,Ne ork 12804 - - ,\\ Q
NAME Lk\ ,5 -mot r<' e /NU f-- PERMIT ii i',/ - ✓ "
LOCATION %(!:' / 'w1� ,A/,.7/ DATE Z 3/ e i
TYPE OF STRUCTURE c :�� /
U�
' N/A YES NO 4COMMENTS
Chimney Height/"B"Vent/Direct,VentLocation I V/ ' ,0( Lv— G
Fresh Air Intake V /
r '
Plumb Vent throughroof j
Roof Complete i� �'
Exterior Finish Complete . i// , 9 �`
Interior/Exterior Railings 30"to 36" / �/ .,
Exterior Handrails,balconies,landing 18 in.or more �/ if
Interior Handrails stairs both sides 3 or morre_riser ciA°'> \/, • /'
Grade 2%away from foundation ,-. PNr- N �/�
8"clearance to sill plate ✓I c -
Gas Valve shut-off exposed/regulator 18"above grade 4'
Gas Furnace shut-off within 30 feet or within line of site �•�'
Oil Furnace sljt-off at entr can epfurnace area / / t/
Furnace Water Heater operatmy .+{I
Relief Valve(s)insc f
Headroom,6 ft.6 in.on stairs Basement stairs,6 ft.4 in. / a�/
/
•
Handrail exterior stairs both sides more than 3 risers / /
Interior privacy/trim/doors/main entrance 36" / 1
Floor Finish ) /
Bathroom/Kitchen watertight / / V
Interior Handrails Balconies/Landing 18 in.or more / V
Railing across window in stairwells /
Smoke Detectors: / V/
every level / /
every bedroom / c///// ,�
outside every bedroom / �.
/ ''
inter connected / h
Bathroom fans / ,,,
,,
Plumbing fixtures ,• / _ ,
Foundation insulation / O U�l���C I0I tjl a !tl3 L t a. tosit-
3/4 hour fire door/door closer / 7-16KC' l-k It C,
Garage fireproofing /
Garage penetrations sealed ! /"-5..�L iN JD O Va V .9'
Furnace in separate room protected(in garage) �/
Light ventilation per room /
Safety glazing 18"or less from floor e/f
Final Electrical `` ,/
Site Plan/Variance required 51
Final Survey Plot Plan /
As Built Septic System layout required V
Okay to issue C/C(Certif.of Compliance) COS Q?E C ? CX%s.
Okay to issue temp.C/O(Certif.of Occupancy)_ ‘.- L -31C7 `a`3E \\"J
Okay to issue permanent C/O(Certif.of Occupancy) V — �AIL..._ R utz)V 6PttZt 1 Pte_I
ii5Pt\--1.._
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement
Dept. of Community Development Arrive/TO-Ain/pm Depart Mile
Town ofQueensburyInspector's lnitia , .p.—
,� ,
742 Bay Road
Queensbury,New York 12804
NAME I C r\ t- 1 PERMIT#_99-
LOCATION 7CO A-1Z1\ E. DATE .-'Z= -a-)
TYPE OF STRUCTURE A PP
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location �'
Fresh Air Intake 1/
Plumb Vent through roof '//
Roof Complete
Exterior Finish Complete tifj
Interior/Exterior Railings 30"to 36" L/
Exterior Handrails,balconies,lane.1 : in. or more • Z
Interior Handrails stairs bath sides , or mire risers
Grade 2%away from foundation /�
8"clearance to sill plate
Gas Valve shut-off exposed/reg .tor 18"above grade /
Gas Furnace shut-off within 30 feet or wi in line of site ✓ /
Oil Furnace shut-off at entrance to furna'a area /
Furnace/Hot Water Heater operating ,�/
Relief Valve(s)installed / ///
Headroom,6 ft. 6 in. on stairs / ✓�
Basement stairs,6 ftt�irt.- i
Handrail exterior stairs both side more than 3 risers
Interior privacy/trim/doors/main entrance 36" ✓/
Floor Finish
V
Bathroom/Kitchen watertight
Interior Handrails Balconies/Lan g 18 in. or more I
Railing across window in stairwel s
Smoke Detectors: /4
every level
every bedroom
outside every bedroom
inter connected i /
Bathroom fans I ✓/
Plumbing fixtures 1 if/
Foundation insulation .✓
3/4 hour fire door/door closer ///V
Garage fireproofing a/
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 1
Final Survey Plot Plan //
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance) � �`
Okay to issue temp. C/O(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy) 10,...)k'�Z 6�NE,)
COMMONWEALTH ELECTRICAL INSPECTION SERVISE4NC.
Main Office 176 Doe Run Road-Manheim,PA 17545 c// y
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No Cert.
Ng 6 7 6 0 8 Cut-in Card No.
Owner SC 2/- e /2 Ai e
4-6 r 7 G � u /J £ ,V.
Location '/ �.�p
Install/ation Consisting of 37 j4. I C Y4 r�-1 1�!G / 7 £4 `7 s
�A-2810/SP � ave— �G v�s�
5'c�/2'Q c-G%
Installed By 114 t 1 S K Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of makin inspections at any time, and if its
rules are violated,the Company shall have the right to r oke ific e.
Date 3-2 0 -0--0 INSPECTOR
T.1.....1...-1U CD A TAVI
„4/1-7
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development ' Date inspection request receive
Building& Code Enforcement
742 Bay Road
Quecnsbury,NY 12804 Arrive am/pm Depart <
4
/ Inspector's Initials
NAME: GiG //le../s ' PERMIT# '5;99
LOCATION: DATE : Gf v C
TYPE OF STRU TURF: - 1 J 3
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is rest.. sible for
providing protectio from ezing
for 48 hours folio% ing the plat ment
of the concrete.
Materials for this pi rpose on site
Foundation/Wall.t ur
Reinforcem-. in place
Foundation/I. .,.rot g
Backfill Approval
Plumbing Under '.lab
Plumbing Vent/ nts in Place
Rough Plumbing
Heating Rough-I
Insulation
Foundation Wills Interior R-
Foundation W lls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work o piping in
unheated .paces R-
oper Vent, tic Vent
raming
Jack Stud./Headers
Bracing/7;ridging
Joist Ha gcrs
Jack Pots/Main Beam
Air Infiltra ion Barrier
Fire Separation 1, 2, 3, hour
Penetration Scaled
Fire Wall 2,3,4 hour
Firestopping
s -."---.}- -74-rgel, - Aill'. t<e74c;" 6-4-." ,
GENERAL INSPECTION REPORT I a00M
( 518 ) 761-8256
Town of Queensbury ,, /
Dept.of Community Development ' Date inspection request received: .ofr- L2�
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart ' 1_• am,/p%
'Inspector's Initial le
NAME: (,."----" SGkz''C-t„-z: „tv� Q
'' //
PERMIT#
LOCATION: ' 6 !' i DATE : B - L)
TYPE OF STRUCTURE: „_�7
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I I
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/Wallpour
RIKReinforcement in Place O K .'w 'S`i fal S c -
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab •
Plumbing Vent/Vents in Place ,
Rough Plumbing .
Heating Rough-1n
kir 7 IVion Walls Interior R-
Foundation Walls Exterior R- F
Floors R- /
Walls R-
Ceiling R- 7
Duct work or piping in
unheated spaces R- r''
/ "
Proper Vent, Attic Vent ,, v"
, F' nib- :/ •
Jack Studs/Headers 1 \ nn
vracing/Bridgingt� PJ ���C��,, -R R I�q t j>t�(1o6 it e'e e�J TRY
oist Hangers V
Jack Posts/Main Beain 1 . >Y4' 0CL,/{-(`
Air Infiltration Barrie
Fire Separation I, 2, 3;hour
Penetration Scaled Cam. g -c. i-k4e,K
Fire Wall 2, 3,4 hour /
fearf pftt r
GENERAL INSPECTION REPORT
; , s
/ ; '
Town of Queensbury Dept. of Community Development Date inspection request received: 17 U,� Al
/-----
Building& Code Enforcement ~-" —
742 Bay Road - ,i)
Queensbury,NY 12804 ; Arrive am/pm Dep\arti.� am/pm
,, Inspector's In teals :) g v
NAME:
z) , "`L�,:�f !)-1-� PERMIT# o p
LOCATION: ^��.� ��/f7ATE : l R de.52) --(
TYPE OF STRUCTURE: ,6) E�
RECHECK '
\4
N/A YES NO CO `1 I NTS
Footings/Piers :
I
Monolithic Pour Form \a
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 R
Foundation!Wallpour \
Reinforcement in Place _ C�
Foundation/Dampproofing '�
Backfill Approval �'/ '1�
Plumbing Under Slab J Plumbing Vent/Vents in Place 4- \II \
/° : g ggesfi g vr
i \
Insulation
Foundation Walls Interior R- ' \\,
Foundation Walls Exterior R-
Floors R-
Walls R / \
-
Ceiling R /' \
-
Duct work or piping in
/ unheated spaces R- „\
oiler Vent, Attic Vent
rarmTg ivi - 7 4 &, 471i° \` 1d,Kc 1 oR ,
ack Studs/Headers /--- . \
V f
Bracing/Bridging ,/6°144 1L� Elite f)(A/V(7 e,DO UCH 6-ti i n 1
Joist Hangers Co .PL(1"C IAt mac--Pa A)f1,-jp j.)& C 2_ F.12.5`%`
iJack Posts/Main Beam
sAlillMfrAtirtarrier FLti- , C"u r 1�`v-17,\
Fire Separation 1, 2, 3, hour �''�,
Penetration Sealed
Fire Wall 2, , 4 hour
ppuig: / 6.pric., 1,. 1 Pc-,oc. i 4k 0 V►prz , ge4k(.Kc;l lrL,L vi:N,eciZ t.iJ s
60 (4-6L r< <�61 � 6 - u6-A)
1111
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518)761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ,(4.7e/41_
Location 4
4596 ,4 Z '
Date /00c Permit # Q9-S5'
SOIL TYPE:/ Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Lengthil "E —
Length of each trench . 21 -
Depth of trenches -.'/
Size of stone 2—
SEEPAGE PITS: Number jr
-
Size - ft. x t.
Stone size - ( _ /
PIPING: maize Type
Bldg. to Tank y " Pic
Tank to Dist. Box
Dist. Box to Field/Pi SDa
Openings Sealed? es No , Partial
LOCATION/SEPARATIONS:
Foundation to Tank. - b1 . feet
Foundation to Absorption q[1 feet
Separation of Pits _ feet
Conforms as per Plot Pla CAR No
LOCATION OF SYSTEM ON PRfiPERTY:
(circle on )
Front - ea - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
fee P42--
SYSTEM.USE APPROVED: E NO
Arrived: 2''3 e
Departed:
Building Inspector
egg*wrsrrrr TOWN OF QUEENSBURY •Ah
BUILDING 8 CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name - (` Q(l
Location Val() ik F'Q
Date 1I-J4-9 Permi # -5
SOIL TY S am-O'l ay-
Results of Percolation Test-
(if applicable) Rate-tinute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Totai Len th
Length of each trench /
Depth of trenches k /
Size of stone �, /
SEEPAGE PITS: Number- V
Size - ft. x /\ ft.
Stone size \,
PIPING: SIze Type
Bldg. to Tank 1-41 v °->C.4 �C
Tank to Dist. Box \
Dist. Box to Field/Pit
Openings Sealed? Yes Ntlartial J
LOCATION/SEPARATIONS: , �-.5 c4,pE
Foundation to Tank ID... feet
Foundation to °bsorpti on .A feet
Separation of feet
Conforms as per Plot P1 an Ye No
LOCATION OF/SYSTEM ON PROPERTY:
(circle one
Front - Rear - Left Side - Right Si e .
Middle Front - Middle Rear '
COMMENTS:
` v c • \ E \ \
pLA; j D oE5 tJ�� VEVISZ
\3 \ �
•
SYSTEM USE APPROVED: YES NO
Arrived: \7-7 t
Depart : _
wilding In a or
\s- 1-414,_.11- 1
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lily /
!RECE \IED
40 SEP 0 9" 1999
14 I•JILD'ti2 AND COOT
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1.114 it'7 14) -,.„.
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cellQr.M QX1r1C) rJJ CVAS Let,d:L,0
CNECKEfS: SCALE: DRAWING NO.: . P r 1'
R.S M. 1 =100' SHEET OF
SHEETS - MOBE P.O.
DATE: PRO.,ECT N0„ pm '�RY00 LOW R DO(AV o O( .N.Y.12004
8-31-92 89-121 3
ze.
r
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury r
•
Dept.of Community Development Date inspection request received: I /2 I q
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm DeparO- Jam/p
Inspector's Initials
NAME: 4 ,rpm 6 ptJ� PERMIT#
LOCATION: ,� �, 1 p / of 71� DATE :
TYPE OF STRUCTURE: r
RECHECK
e-7
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is respgnsible for
providing'protection f om freezing ?"601".71
for 48 hours followin the placement �� (416>
of the concrete. r
Materials for this purpo a on site
Foundation/WalOo r f
Reinforcement in Plac /
Foundation/Dampproyei frog �/j
ackfill Approval ✓
Plumbing Under Sla
Plumbing Vent/Ven in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Wal s Interior R-
Foundation Wale 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 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
\ Pry)
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\e,lgai Depart
Inspector's Ink
NAME: t PERMIT#
LOCATION: JyG.,\-6�' DATE : —�1I
TYPE OF STRUCTURE: c NO •
RECHECK
N/A YES O COMMENTS
‘Ittings/Piers —I ✓1 I
Monolithic Pour Form
Reinforcement in Place '"7_,— L6
The contractor is responsible for
providing protection from freeing
for 48 hours following the placement
of the concrete.
Materials for this purpo,'se on site
Foundation/_Wal 1pour- ''�
Reinforcement in Place_
Foundation/Dampproof ng
Backfill Approval :A
Plumbing Under Slab ".
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In t'
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Cei l ing 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
CP--/(51 -) 1
---_____-_-:.,_____,s.2.
,
• \\'..." lA....--/-*/
4111%, iiiiii 1 4 RECEIVE II
40 • _ SEP 09 1999
� � -,/ --
42
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. 114
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Fro A+ vv�1IJ 36 S
' r . 't Si A e-,S ,nn ./0 15
.
75
' I 1( p1
SG1<LC,"Q--rk0(Ai anS i eJ .-u0
CHEM D: SCALE: DRAWING NO.: G 0�'
R.S.M. 1'=100' SHEET OF
SHEETS MOF1 HVC 11Q P, .
DATE PROJECT No.: ) jr4 —1ooaoc�vzOl1��dl1FiY.N.Y.ffisO41151
8-31-s2 89-121
I