97-020 •- _ , _ ,
CERTIFICATE- OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
July 17 97
Date 19 _____
This is to certify that work requested to be done as shown by Permit No. 97(320
has been completed.
SINGLE FAMILY DWELLING
This -structure may be occupied as a
LOT 46 PEACHTREE LANE
Location
SCHERMERHORN CONSTRUCTION
Owner -
TAX MAP NO. 121. -15-46 By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 9000IOWN OF QUEENSBURY No. 97020
TAX MAP NO. 121 . -15-46WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to SCHERMERHORN CONSTRTJCTT(AT
OWNER of property located at
LOT 46 FAWN LANE Street,Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMTIvv nWELLT*TC
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
CORP. 9 MASTERS COMMON NORTH
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
SCHERMERHORN CONSTRUCTION
3. CONTRACTOR or BUILDER'S Address
79 MASTERS COMMON NORTH
QUEENSBURY, NY 12804
4. ARCHITECT'S Name
COMMONWEALTH ELECTRICAL AGENCY
5. ARCHITECT'S Address
PO BOX 706
HAGUE , NY 12836
6. TYPE of Construction—(Please indicate by X)
SINGLE FAMILY DWELLING
( ►Wood Frame ( I Masonry ( I Steel ( I
7. PLANS and Specifications
1536o•SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATTn?`TC
8. Proposed Use
SINGLE FAMILY DWELLING
211 PERMIT FEE PAID -THIS PERMIT EXPIRES January 30 )9 99
$ (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 30 Day of January 19 97
SIGNED BY �, )�,��— A.r+' for the Town of Queensbury
Buildin and Zoning Inspector
��� ! OWN Ut• QUEENS/JURY '
'' - ii-' ; APPLICATION FOR SEPTIC DISPOSAL_PERMIT 7 0 2_d
DATE! - � �' - n s� k�
/- 2g. 77 [`l ,✓ o f Qcie-Qn,5ip(i _...,. : 1 '_ ''
r;
LOCATION OF PROPERTY FOR INSTALLATION AO� '1c9 ,4.ctc.k/re-e. /,,j W 221997
Owner' s Name: .5&1 e r✓►•t e..t" a -A' ,Hs/ .,C_JL • . _; :_i'ZE...,F_?v
Address: 79 V loskrs Cn,N►,nno."--) , or'14.. f
Installer' s Name: Y"t . c_,�•eyr\AneI-korA) Telephone: 7 7 B-0( ) y
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) 95°
Topography: Circle one: 0 Rolling Steep Slope % of Slope
Soil Nature: Circle one: and Loam Clay Other /Depth:
Ground Water: At what depth? //1-/ /A- Feet
Bedrock or Impervious Material : At what depth? 41,/f9 Feet
Percolation test: Circle one: not r-e uir required
Rate - Min. Per Inch
Domestic water supply: Circle one: unicip Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ie"c gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. /Depth or Thickness feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: 41------DATE:_/— zz.47
• v •
•
JM 2 2 1997
ENERUY. CoDE COMPLIANCE APPLICATION
•-v
TOWN or oOMMNSRUR RN N
Yi WARE COUTY\ 170,, , ,.Au--, ‘ ,
ti; 9.90/_10mW10_Pm0ABOLID4v$ ..tt_ALD04c: AND
•
c.otilpilunce_PpOodpt OMIT 5 - Accept:0111n PrecLICO MeLhod
• . Mhifilly bwellinge (only )
PART 61, - Mervin]. Rnting COMponent Tundo Oljn
• I t romily DwellIngni MulLI-Mnmlly
Dwellingn ( 3 !It:orlon or .tern )
PART 4 ', - Deolgn by Cutoponenb Perfoumnnce
ComMerOlnl Unilding0=-Iii Rine Resident:lel
ARequires mnbmieelon of workeheets
_
APPLICANT' S NAME ! PROPERTY LOCATION !
P rQ,E,
e.0 e..4"0 ClovNsi-ava:t5A.)Cppe•
PART ti tiEthuN or coMPLIANCO HY ACCEPTABLE PRACTICE !
1 . GrOnn rioot Area - /536 dgnare .feet
2 . Type of Rent - Mlocitic 011 Utiu • OLhou
3 . In mechnnIcnIly cooled? Yen ,S( No
4 . Peri:end:bye of dren of windown and doOtn Over 17% Under 171
5 . S.-VALUES rot( INSULATION OIVER OrLoW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUUMITTED !
n : ROOf
I.). . Mitioriot wnllo R
c . Clnzed riterin
NAlletior docito
ei ribOrd Over dnheoLed Opnce0 It
Ndy6JJE Oldb On grode ( hentod hnIldIng) R ii
• c.) ;. Dailement:/eefint wollo (01JOVei yrnde) R
h . OnOewentioelint wnlIn (below qtnde) //
I . _
Nealing/doiiiing-dneto-plping in unhenied epee° R AKC
6 . SetVice (dotildolio ) hot wnLer heciLlfig device
• CblifOrnin Lci ii.ti1inuiim OfflOiency per code w tee Ito
ledlOgnATORig CONTROL NAxitinti SitTiNti 1400 - HiLL NOT RE EXCEEDED
Ap1,11WinlYn Si hd 'ilre • DnLe Phone Number
fq •
INSPNCTOR' f; IMHARRSt
• , •
•
•
• •
•
. .
•.
• • •
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-82561
BUILDING & .CODE ENFORCEMENT
NOTICE Requirements prior to issuance r W -
of this permit: PERMIT FILE NO. 1 -O&,,,
A permit must be obtained before -
o
beginning construction. No inspections PERMIT FEE PAID$ �1/�
will be made until applicant has received 1-1 ZoningBoard Action
a VALID BUILDING PERMIT. All • Area /Use RECREATION FEE PAID$
applicants' spaces on this application
MUST be completed and the signature n Planning Board Action REVIEWED BY: (Ill
of the applicant must appear on the UUU
SPR / Subdivision /Other Building Inspector
Opplication form. Thank you - J Recreation Fee Payment
Applicant: Sc.,14e.r'vvierhorA) sEr.rt; CT rp. Owner: I(• Sat e r alloy Irk)rN _
' Address: 7() >14e15 Fors Owe. 0.4-1/14/"I.1 Address: (2rie�MsLa/0,1_
•
Phone # ( 5/s ) 7 98 - o fo")`l Phone # ( ) -
Property Location: J 0 f gto /mac acL,i,r e i/iJ• - l 5/te ,�,
Tax Map Number es2J
Subdivision Name: srvt�:J - ,',cJ/� S —_ Section Block Lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
X New Building: CONSTRUCTION: $ 9V ooc
a:esi cp / commercial
Addition to Building:
--
residence. / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -r.-. _ -
residence / commercial x Single Family (Dw II='rg;�''P't'y:. 0 I
Residence / Commercial Two Family Dwelling-
no change to exterior size Family twe11,3rig
Office d AA 22 1997
Il
Other Work (describe below) Mercantile r
Manufacturin TOVWr-�Oi .��•'--,-Jodu
Other BUILDI A.ND CODE
GROSS AREA OF PROPOSED STRUCTURE: ��o ti
1st Floor 7(v8 sq. f . 0 If ADDITION, what will use
2nd .Floor -7(d,f _ sq. ft of new addition be?
Other Floors sq. ft. /✓
(not unfinished cellar or basement) , ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: /5 3(r SQ. FT. x Attached Garage 1, C2 i)
Private Storage Buil3caing
SIZE OF NEW STRUCTURE: Commercial Storage Building
52 FEET X LI. V FEET Other
Foundation Type: r-onctale, Will any second-hand or ungraded
' Number of Stories : l lumber be used? If so, for what?
(habitable space only) A/a
Height (grade to ridge) : V. feet TYPE OF_ HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which aRpl' es)
yan /
to be installed: 0 Electric Oil /( Wood
orced Hot Ai / Baseboard / Other
Person responsibe for supervision of work as regards to building
codes is: 1 :u1., Sc.,14Qrw►@ r 1me r.a
Name Addresss Phone
Builder: K-Sclne.d`w,.Q.rI+o.rJ�/ 7" iVic.sfirc Csy:z,o...11"• h• 798-067,
Plumber: S}r_vp_ r4l/en/ 797-.SG, 9 3
Mason: aet..1—. Eti1du./:A) 7 cia -/37/
Electrician: ), :.V-P _Oy :sIf ,' 1-3yo-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 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 proposed work shall be complied with, whether specified or noted, and
that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a
Certificate of Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: I`- "-
(owner, owner's agent, architect, contractor)
' TOWN OF QUEENSBURY�� BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART:. INSP:
FINAL INSPECTION REPORT - RESIDENTIA
DATE INSPECTION
`REQUEST RECEIVED:
NAME 6 `' I
LOCATIO '� cap ! V �
DATE 9' PERMIT 1 1 -600
TYPE OF STRUCTURE 53(` T
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
- _. N/A YES NO
CHIMNEY HEIGHT/B VENT/H.' GH
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS 'SWEEPABLE
OTHER FLOORS CARPETED ,
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE AN VARIANCE RE .
AL SURVEY PLOT PLAN 3>
OK TO ISSUE C/O OR C/C
TOWN OF QUEENSBURY
j��� BUILDING & CODE ENFORCEMENT
s +Y 742 BAY ROAD
� J QUEENSBURY NY 12804
(518) 761-8256
`,aI-
ARRIVE: ■ _ DEPART: 12.- IN
FINAL INSPECTION REPORT - RES�IJD r , 7 DATE INS TIO REEQ�UESST,�RE(�CE ED: �/�/ J
NAME C�' 3111/1 V 4 lU� 1
LOCATION 1r, -'"} ar ) ` YP
DATE 1 — d (I, `9 / PERMIT 1 'A-�
TYPE OF STRUCTURE rGLl._J
FOOTINGS FOUNDATION BACKFILL ' FRAMING
ROUGH PLUMBING i SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YE NO
CHIMNEY HEIGH B V NT/H IGHT /
PLUMBING VENT Iv
ROOFING .
EXTERIOR FINISH
DECK/PORCH/STEPS/ ILINGS
RELIEF VALVES ��
'V-4.3t4-1-__, 7.4_, - /
Nam PCT �---• '-
FURNACE/HOT WATER OPERATING `�Q
INTERIOR TRIM/PRIVACY DOORS C
�
`FINISH FLOORS: V �
/ /
BATH/KITCHEN WATERTIGHT V
/
OTHER FLOORS 'SWEEPABLE V
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS :
SMOKE DETECTORS
BATHROOM FANS V/
PLUMBING FIXTURES !(
FOUNDATION INSULATION :/:
MHEETV cc v ThV - Oa.�)EP.�!
GARAGE FIRE PROD ING F?IFL- ems?
tiag-k__, ‘.7
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO•
FINAL SURVEY PLOT PLAN I I
OK TO ISSUE C/O OR C/C
•
•
•
��7A TOWN OF QUEENSBURY •
iww BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
ARRIVE: o DEPART: (34 IN /' .
• FINAL INSPECTION REPORT- RESIDENr, iL
DATE INSPECTION REQUEST RECEIVED::
NAMEN
LOCATION 1410-. IAEK7
DATE I.cQI\q7 PERMIT, A _. Z:g202)
TYPE OF STRUC URE FD' 1 Z- . tw
. FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION •
FINAL ELECTRICAL WOODSTOVE'OR FIREPLACE
N/A TES( NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT ;///l;
ROOFING
EXTERIOR FINISH
•DECK/PORCH/STEPS/ LINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING •
INTERIOR' TRIM/PRIVACY DOORS
• FINISH FLOORS:
BATH/KITCHEN WATERTIGHT - "
OTHER FLOORS -SWEEPABLE 1_- V•
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS .
- BATHROOM FANS
PLUMBING .FIXTURES
FOUNDATION INSULATION V
- GARAGE FIRE PROOFING
, DOOR CLOSERS •
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO. -
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 `% 2
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. Cert. N° 4 9 9 5 9 Cut-in Card No.
Owner 501-6—A
Occupant ,,,, n ��yy �f
Location/0 '46 f 4j#2i ai z `t /••
Installation Consistin of.2. .. /�0� 'et c
_ e- bias DIET 6- J 501 cCc s,
./6Q11- (/.y eC f ~Srr
Installed By frit cows � Lic.#
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 maki ins Ion, at any time, and if its
rules are violated,the Corpny shall have the right to revok h' ert Irate.
Date. INSPECTOR
tuber N.F.P.A.,I.A.E.I..
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ,t1...`ti ri,, k,
INSPECTOR'S REPORT: ARR/ h EPART ' NT��a
1
REQUEST FOR NSPECTION/ rR/ECEEIVED:
NAME 2Y/ 1 �FfG/L
LOCATION / �/9Ci v
DATE /(/" PERMIT A f7-1)26)
TYPE OF STRUCTURE:
RECHECK ` APPROVED_
N/A YES NO
FOOTINGS/PIERS
IV
MONOLITHIC POUR FORM 11 ,
-REINFORCEMENT IN P,SCE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON $ITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE ,
ROUGH PLUMBING _
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER _
EATING ROUGH-IN _
INSULATION: a3 dl/l. lLk./9 N 1kii
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
t, .
742 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT:' AR ,''d'�DEPARI"
REQUEST FO'R}'INSPEJ'CTTIION RECEIVED:/��y �✓
NAME %%J�'����"`i`/��G/��/zlU
LOCATION ,�(j}�f ��n✓����C DATE 1 8/97 PERMIT I 1,7 v4 0
TYPE OF STRUCTUR :
RECHECK APPROVED
N/A 1 YES NO
FOOTINGS/PIERS _
MONOLITHIC POUR FAii I _
REINFORCEMENTCE
THE CONTRA OR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE _.
ROUGH PLUMBING _
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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- •
e (29t1A%11-)Ci//0 (518) 761-8256
TOWN OF QUEENSBURY •
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 :
INSPECTOR'S REPORT: ARR/G•el DEPART INT
REQUEST FOR INSPECTTInON�RECEIV D: 3 - U 9, �/
NAME �;/U`
LOCATION 'I
I DATE Li ` -9 -1 PERMIT {I 97 e
TYPE OF STRUCTURE:
RECHECK APPROVED
V I
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM /f
REINFORCEMENT IN P ACE ! /
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE -
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
ZING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- '
WALLS R- 1 -
CEILING R- .
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
•
64,g 1.4' /Areife,
(itirtfzokG•
Js,L
0/ Jar
°(.3-Ik.){��� (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT # .
742 BAY RD., QUEENSBURY NY 12804 .,,4*,�1 ,
INSPECTOR'S REPORT: ARR DEPARO , ' NT`0 4„
REQUEST OR I SPECTION RECEIVED: '2 _ �i7
5NAME r\�; 1 Cam,- \ 1
LOCATION SL (r LPCl.G r ee______
DATEZe 1 1) PERMITM1 A 9 / �'"( �2 o
1D
TYPE OF STRUCTURE: i Sq.
RECHECK _ APPROVED
N/A YES NO
FOOTINGS/PIER
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
k'OUNDATION/WALLPOUR
REINFORCEMENT IN PLACE L
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PL MBING VENT/VENTS IN PLACE _ If
✓ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS v
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM ,
AIR INFILTRATION BARRIER
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-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING G CODE ENFORCEMENT t ~~,
742 BAY RD., QUEENSBURY NY 12804 ",,,ern:',
INSPECTOR'S REPORT: ARR DEPAR //' (-)INT `./121 -
REQUEST FOR INSPECTION�/ � �R� � r
ECE; 2 VED: - ()
✓1 \
NAME W L '�X J ) J 1{
LOCATION `r V G� y:Q�
DATE 2-0.- PERMIT A OZ
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC P. R FORM
REINFORCEMENT IN PLACE •
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOMING THE PLACE-
MENT OF THE CONCRETE. _
MATERIALS FOR THIS PURPOSE ON SITE,_ _
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE 1
FOUNDATION/DAMPPROOFING
BACKFILL -APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS_
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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- •
TONN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Ci
Location
Date /z41 f 77 Permit # 9 7-v?-0
SOIL TYPE: Sand-Loam-Clay-
Results of Percol ti n' Test-
(if applicable) Ra -Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: o al Length
Length of each tr nc
Depth of trenche
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
•
SYSTEM USE APPROVED: YES NO
Arrived: 1/5--
Departed: / '2 0
Jac-
Building Inspector
3
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT .j±ry
742 BAY RD., QUEENSBURY NY 12804 .E
INSPECTOR'S REPORT: ARR DEPART INT s-
REQUEST FORei gPECTION RECEIVED: ;a/2 / ! 7
NAME (1" a ,_X,4`mo `//�o,/ i vim_
LOCATION 4-it 4(,
•
DATE 2 PERMITA -�
TYPE OF STRUCTU E:
RECHECK _ APPROVED
N/A YES/ NO
WOTINGS/PIERS kir
/ MONOLITHIC POUR FORM
i
REINFORCEMENT. IN PLACE~�-
THE CONTRACTOR IS SPONSIBLE FOR
PROVIDING PROTE ION FROM FREEZING
FOR 48 HOURS L OWING THE PLACE-
MENT OF THE NC TE.
MATERIALS F R THI PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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- •
TOM CF QOEERSBURY
BUILDING S, CODE ENFORCEMENT
531 Bay Road
Queensbury ANY I2804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location Lc?1 '`/ ' cp/
Date � � �j 'Permit # 97co
SOIL TYP : San -Loam-Cla -
Results o ercolati ` fest-
(if applicable) ute/Inch
TYPE OF SYSTEM: ' pi,2C-D
ABSORPTION FIELD: Total Length S 15T&
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Si Type
• Bldg. to Tank L)Lh 21-0
Tank to' Dist. Box, ;� r
Dist. Box to Field/!? ; �`/"- 35
Openings Sealed? ( Yes No Partial
LOCATION/SEpARATIO'�S.
Foundation to Tank /0 feet
Foundation to Absorption ,05 feet
Separation of Pits
Conforms as per Plot Plan Yes No
. LOCATIOFfl OF SYSTEM C PROPERTe.
(circle�
Front -�R - Left Side - Right Side
Middle(Fr o t - Middle Rear
COMMENTS:
C'Lc,��J-��'i t '
SYSTEM USE APPROVED: ' YES NO
Arrived: 3�0
\__}
Departed: 4)
Building Inspector
Ca) (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD. , QUEENSBURY NY 12804 '
INSPECTOR'S REPORT: ARR DEPARi ll4 NT
REQUEST FOR INSPECTION RECEIVED: 1
NAME er- /k,aVn
LOCATION 7' L1 t /
DATE / PPERRMIT A —02 0
TYPE OF ST CTURE: S \` )
RECHECK PPROVED
A YES NO
✓ FOOTINGS/PIERS C�•Y'Pi.
MONOLITHIC iUR FORM —
REINFORCEME IN PLACE j
THE CONTRACTOR IS RESPONSIBLE FOI1
PROVIDING PRO E TION FROM FREE^Z;NG
FOR 48 HOURS tOLLOWING THE PLACE—
MENT OF THE CONCRETE. I
THIS
MATERIALS FOR IS PURPOSE ON RITE
FOUNDATION/WALL OUR Jr
REINFORCEMENT INA PLACE < _
FOUNDATION/DAMPPIOOFING
BACKFILL APPROVAL /
.
PLUMBING VENT/VENTS IN MACE
ROUGH PLUMBING
PLUMBING UNDER SLAB ,,,
/q
FRAMING: t� • r
JACK STUDS/H- AD.RS
BRACING/BRI1 GINe\
JOIST HANGgRS
JACK POSTS/MAIN B'..AM
AIR INFILTRATION ARRIER
HEATING ROUGH—IN \
\
INSULATION: I \
FOUNDATION 6/ALLS INTERIOR R—\
FOUNDATION ALLS EXTERIOR R—
FLOORS R_ —
WALLS / R— \ -
CEILING 1 R—
DUCT WORK OR PIPING IN t'
UNHEATED PACES R— ,
•
Or ,mob'
Cr V. O i)-) (518) 761-8256
TOWN OF QUEENSBURY ;R
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ;�
o
INSPECTOR'S REPORT: ARY `q DEPAR `, `7 INT V
REQUEST FR I PECTION RECEIVED: //-i 7
�
NAME 4J1 O XIM P (WY�E , 61,C R
If
LOCATION/ \\ � i C
DATE — PERMIT A 9 - 1 '1 !
TYPE OF STRUCTURE: sc-f-' _J
RECHEC AP°ROVED
N/A/ YES J NO
FOOTINGS\PIERS /'
MONOLITHI�1 POUR FORM /
REINFORCEMENT IN PLACE /
THE CONTRAC OR IS RESPONSIBLE FO•i
PROVIDING PRATE TION FROM FREEZ < G
FOR 48 HOURS 'OLLOWING THE PLAC'--
MENT OF THE CONCRETE.
MATERIALS FOR IS PURPOSE 0 'SITE
\ I
r
FOUNDATION/WALLPoUR
REINFORCEMENT IN 'LACE /
//;;:----
FOUNDATION/DAMPPRO• ING _ V
ACKFILL APPROVAL L ' v
PLUMBING VENT/VENTS ,, PLACE
ROUGH PLUMBING _
PLUMBING UNDER SL.:' \ _
/ \FRAMING:
JACK STUDS HEADERS \ _
BRACING ,BRIDGING \
JOIST .LAGERS
JACK PISTS/MAIN BEAM \
AIR INFILTRA ON BARRIER `\
HEATING ROUT —IN
/
INSULATION
FOUND' ION WALLS INTERIOR R—
FOUND.TION WALLS EXTERIOR R—
FLOO.S R— -
WAL R—
CEI ING R—
DU( . WORK OR PIPING IN
U. •EATED SPACES R— •
/1319- f
REA I
)kL3
7\22) (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR` DEPART e ' R
REQUEST FOR IN PECTION RECEEIIVED: I Adii
00 NAME 1C�' '`.�,1 / � k' 1 ' ' ! L 9^o
LOCATION .,I L� ( ip, ' , 411F V
il
DATE 3 -- 1 1— 91 PERMIT .�"k"l"��l".''r
TYPE OF STRUCTURE:S ,�� 9 1 /-no (
RE HECK APPROVED
N/A Y`ESS NO
OOTINGS/PIERS `- t, ) �!
MONOLITHIC AUR FORM
REINFORCEMENT PLA •7` Al,
THE CONT 0 IS RESPONSIBLE FOR
PROVIDIN PROT TION/FROM FREEZING
FOR OURS F LOWING THE PLACE-
MENT OF THE CON ETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
SACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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- ,
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MAP REFERENCE:
SHERMAN PINES SUBDIVISION
BY MORSE ENGINEERING P.C.
FILED IN THE WARREN COUNTY
CLERK'S OFFICE ON JANUARY 29, 1993
IN PLAT CABINET A SLIDE 197
p
0
LOT 45
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 TITLE COMPANY, GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED TO: ROBERT C. STONE
FLEET MORTGAGE CORPORATION,
IT'S SUCCESSORS AND\OR ASSIGNS
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
N S� DATED: JULY 10, 1997
7
I0*
.h�� ', am 0 00 , F
a
2
LOT 46
10, 341.36 sq. ft.
YOU
r- cOHs� CT/ p R
II H
IN cW3�
1-1 �.
O- h
V,
S 2S 8) SO-
�� 70 FCE
LOT 47
,( OF NEW
ca
• i�
• �d>
• �� 5 `
ystD LAND S�6 .
•UNAU7HOR12ED ALTERATION OR ADDITION TO A SURVEY
MAP BEARING A LICENSED LAW SURVEYORS SEAL IS A
VIOLATION OF SECTION 7209, SU9-01WOON 2, OF THE
NEW PORK STATE EDUCATION LANL•
*ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
MARKED IM7H AN ORIGINAL OF THE LAND SURVEYORS
SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES.•
*CERTIFICATIONS INDICATED HEREON SIGNIFY THAT
THIS SURREY WAS PREPARED IN ACCORDANCE MATH THE
EXISTING CODE OF PRACTICE FOR LAND SUR%V= ADOPTED
BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL
LAND SURVEYORS, SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR MHIOM THE SURVEY IS PREPARED, AND
ON HIS BEHALF 70 THE 717LE COMPANY, 00VE3ftENTAL
AGENCY AND LENDING 9=71.1ITKIN LISTED HEREON, AND
TO THE ASSMM OF THE LENDING INSTITUTION."