97-086 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
June 4 97 -
Date 19 _
311O-( - ..
This is to certify that work requested to be done as shown by Permit No. 97086
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied as a
LOT 1 #8 RALPH RD.
Location
Owner CLUTE, LARRY
TAX MAP NO. 120. —1-1 . 6 . - By Order Town Board
TOWN OF QUEENSBURY
•
1 �
ti -50e"""nnel.".."4"."
R
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 55000 No. 97086
TAX MAP NO. 120. —1-1 . 6 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CLUTE, LARRY
OWNER of property located at TcOT 1 RALE-H END Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMILY DWELLING
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
13 DAWN ROAD
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
CLUTE ENTERPRISES, INC.
3. CONTRACTOR or BUILDER'S Address
13 DAWN ROAD
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 ( )Steel
7. PLANS and Specifications
832°SQ FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
$ 96 PERMIT FEE PAID —THIS PERMIT EXPIRES March 25 19 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 Oueensbury before the expiration date.)
Dated at the Town of Queensbury this 2 5Day of March 19 97
SIGNED BY r for the Town of Queensbury
Building and -onindlrispect
nuilaing Permit Application
-Town of Queensbury - Dept. of Community Development,' 742 Bay Road, Queensbury, NY 12804 [761-82561
INOTJCj
O BUILDING & . CODE ENFORCEMENT
Requirements prior to issuance
A permit must be obtained before
of this permit: • PERMIT FILE NO.
beginning construction. No inspections Q� '1 0 C
will be made until applicant has received n Zoning Board Action PERMIT FEE PAID$ f
a VALID BUILDING PERMIT. All Arca /Use
applicants' spaces on this application RECREATION FEE PAID$
MUST be completed and.the signature n Planning Board Action REVIEWED BY.
of the applicant must appear on the
application form. n wE 3„u. SPR / Subdivision /Other Building Inspecvor
J Recreation Fee Payment
Applicant: =t-1 C Owner: 1.- _
' Address: � v.` l n_Je---(- Address:
.
Phone # ( ) �
- 3? . . Phone # ( ) -
Properly I.tx:alion: � �
Subdivision Name: kc4- I [ G/r '
., ice-� ,,
_ �Tax Map Number t '
Section Block Lot
NATURE OF PROPOSED WORK: 9 ESTIMATED MARKET VALUE OF THE
V New Building: CONSTRUCTION: $ S Lx.�0
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building *-'- '
residence / commercial . <Single Fami yF.tgrekng : _._.1l •
Residence / Commercial Two Family welling
t
no change to exterior size . Famil Dukdi2g 1997 y
Office tVt Ff
Other Work (describe below) Mercantile - r
:OR?r S
9'e-p,i:c Lit '•...�r--..: .:._,,'- I
Manufacturing �., yeiit;, ,_ t,d.)m
Other --4)" --
-
GROSS AREA OF PROPOSED STRUCTURE: •
1st Floor If , ADDITION, what will use
�,��. sq. ft. of new addition be? :
2nd .Floor sq. ft.
Other Floors sq. ft.
(not unfinished cellar or basement) A ESSORY BUILDINGS:
etached Garage -, 2 car
TOTAL FLOOR AREA: - ' 3 -- - SQ. FT. At ed G ge 1, 2 car
Priva orage Building
SIZE OF NEW STRUCTURE: Co ercial age Building
�fe, FEET X 3 - FEET her
Foundation Type: C t eC- aWill any second-hand' or ungraded
Number of Stories: � 1 lumber be used? If 'so, -.for what?
(habitable 'space only) ,
Height (grade to ridge) : VI feet TYPE OF HEATING SYSTEM:
Number of . fireplaces a d/or woodstove (circle all which appli s)
to be installed: 1 Electric / Oil / Gas // ood
Forced Hot Air / Baseboard / Other
Person responsible (:)1. supervision of work as regards to building
codes is : c C -
. Name Addresss Phone
Builder: -
Plumber: x-p �a t' 3 -7377
. Mason: G
Electrician:
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 authorize y the owner. Further, it is understood that I/we shall submit prior to a
Certificate of Occup or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surve ; drawn to scale, showi _• al location of project on premises.
Signature: 7' �='
(owner, o er's agent, architect, contractor)
No.
Date 19
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
(Consulting and Fire Inspection Services)
(Incorporated in the States of MAIN OFFICE:357 Elwyn Terrace, Manheim, PA 17545 • (717)664-2347
New York,Maryland,Pennsylvania,Delaware) 800-732-0043
LOCATION
Please give full and accurate directions in order to avoid delay
(Use back of sheet if needed)
Desiring Certification of Approval, application is made for inspection of electrical installation in the premises
described below.On demand,applicant agrees to pay for inspection service in accord with schedule of charges. 7
PLEASE PRINT ..
DATE ''
Owner � ..Gr V s - • � {� Type Bldg. ❑DWG ❑Other ]1...�1
Occupant Building Permit No. r ! C i�51!1
Job Location (,Q 4 -4t 4c. '-`a.City e (.' State 1"---)
County C C r e k Twp. Swimming Pool-New❑Old❑
Owner's Address 1 ........C3t-A '-f Pool Permit No.
Directions to Job Site 4-ke.,;-..t.et.r.:<.,- ..f ., P /� �c 1 �•
Application For Rough Wiring❑ Fixtures,Service❑ or
Work-New)" Additional❑ Bldg.-New❑ Old❑ Ready for Inspection
Fee Remitted Check ❑ Cash❑ Make Payable To C.E.I.S.,Inc.
LIST ALL EQUIPMENT AND WIRING
NUMBER OF ROUGH NUMBER OF ELEC.HEAT-AIR CONDITIONERS-BURNERS-DRYERS-HEATERS-RANGES,ETC.
WIRING OUTLETS FIXTURES NUMBER TYPE OF DEVICE H.P.OR K.W. NUMBER TYPE OF DEVICE H.P.OR K.W.
SWITCHES MERCURY
LIGHTING SODIUM •
RECEPT. FLUORESCENT
ELEC.HEAT QUARTZ
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE i
OTHER EQUIPMENT l -r, f ✓' ,r
APPLICANT'S /
SIGNATURE i `� 4[)J -r"- (� LICENSE# PERMIT#
PLASE
PRINT NAMEf ` 7C r r '- C t('�� 1C PHONE#
GI tb!'-\ C UTIL TOF
CITY 7 (( L OFFICE TO
�\3�(�P�urk�^wt.9 k.e-v/Il STATE T L.`l ZIP CODE 1 , .>i') /BE NOTIFIED
ROUGH WIFfING SPACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS AMP SERVICE PUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
MISC.INFO. DATE INSPECTED RE- n
NOTIFIED POR- ¢ w -J FEE PAID
TED U
CON- TOTAL $
TRACTOR
WORK INSPECTED OWNER CHECK NO.
❑ R.W. ❑SERV
❑ FINAL OCCUPANT CHARGE
CERTIFICATE NEEDED AGENT CASH
YES ❑DUP ELEC. H.O.
LT.CO.
TEMP CARD# DATE INSPECTOR
FINAL CARD#
BP/9627 Rev.1/95 APPLICATION EXPIRES ONE YEAR FROM DATE.
WHITE/Office CANARY/Officer PINK/Inspector GOLD/Customer
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury ---0
782)Dept. of Community Development Permit No.
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: c3 -41 I
Property Owner's Name: ���-� C Le
Property Owner's Mailing Address: re--A
Installer's Name: ,pr- 6 Phone # '?4 � '70 7 7
Number of bedrooms (if residential): Q Total daily flow: 3
(residential - compute @ 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: ><"sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: T not required, required [rate min. per inch]
Domestic water supply: ',A"'municipal, well, other:
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank: (00o gallon (minimum size: 1,000 gal.)
Tile field: each trench feet / Total system lenggth: )o 0 feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # a / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm system and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fact or circumstance known by or on behalf of an applicant, shall be void_
I have read the regulations with respect to this a cati and agree to abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Disposal ce.
Signature of responsible perso . Date: � I !c
.._,
'_ rocz'• ENERGY CODE COMPLIANCE APPLICATION 'S�z _ �_��0�/
S ' TOWN OF QUEENSBURY, WARREN COUNTY' ,.: j_- ' N��
- 9000 HEATING DEGREE DAYS ` BAR 2Q 1997.
Coro ance Met -
1 i hods • PART Practice Methclid `"
I&2 Family Dwellings (only) ---- --` = _
PART 6* - Thermal Rating - Component Trade Offs
&2 Family Dwellings; Multi-Family
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 - Zak- scuare feet
2 . T oe 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 3
b _ Exterior walls R la
c _ Glazed areas R L s
d_ Exterior doors - R a
e . Floors over unheated spaces - R C6
f _ Edge of slab on grade (heated building) R vN.fr-.._ -
g. Basement/cellar walls (above grade) R 1,9
h _ Basement/cellar walls (below grade) R i(
1. Heating/cooling-ducts-piping in unheated space R Li,c-
6 . Service (domestic) hot water heating device •
Conforms to minimum efficiency per code >Yes• No
-
T E TURE CONT L MAXIMUM SETTING 1400 = WILL NOT BE EXCEEDED
App Sig ture \' D to Phone Number
3��5�57 `?5-3 7a�7
INSPECT R'S REMARKS:
•
TOWN OF QUEENSBURY
41111
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
• (518) 761-8256
�/ji
ARRIVE: DEPART: INSP: 0Ji
FINAL INSPECTION REPORT - RESIDENTIA
DATE INSPECTION REQUEST RECEIVED: (C1 U - 7
NAME (/ '�\r\C C/
LOCATION \k,k_ gC�1 q
DATE (0 L) PERMIT 1 1
TYPE OF STRUCTURE
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 FINISH ,
DECK/PORCH/STEPS/RA LINGS
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 PLAN/VARIANCE REQ.
L�T710.L SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
#"� 1 TOWN OF QUEENSBURY
w BUILDING & CODE ENFORCEMENT
T` 742 BAY ROAD
,�� QUEENSBURY NY 12804
•,{, (518)745-4447
6 �
ARRIVE: 'lJ� DEPART: INSP(,112L
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPEC ON REQUEST RECEIVED:
NAME Z
LOCATION hi- / `r�,')/ ?.
DATE 3/ /07 PERMIT A /C `.
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC INSULATION •
FINAL ELECTRICAL- WOODSTOVE OR FIREPLACE
N/A ; YL ES/ NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING •
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES " /
FURNACE/HOT WATER OPERATING V
INTERIOR TRIM/PRIVACY DOORS
• FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS •SWEEPABLE •
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS /V/
PLUMBING FIXTURES • V////
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR C O E // Y
FINAL EC' C'A
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
l �s0e, to AVM.
u &d=y I1 p,&o vJC_
i
-'
TOWN OF QUEENSBURY �. �
Cok c BUILDING & CODE ENFORCEMENT742 BAY ROAD
5., QUEENSBURY NY 12804 A.
00
(518) 761-8256
[�ARRIVE: 0 DEPART: e:'q-
INSP:
'O S
FINAL INSPECTION REPORT - RES DENTIAL
DATE INSP(ECCT ON REQUEST RECEIVED:
NAME `,
LOCATION " f l ta ci{ Vr? — .DATE ` Z 7 7- /_ PERMIT 171., 45/96
61
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING _ SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
- N/• YES NO
CHIMNEY HEIGHT B VENT HEIGHT
PLUMBING VENT
ROOFING i
-'(i !'
EXTERIOR FINISH
DECK PORCH STEPS RAILINGS
RELIEF VALVES C�.
rI
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 PLAN/VARIANCE REQ. f
FINAL SURVEY PLOT PLAN
OK TO ISSUE C 0 OR C C
g,,G„ . 1-0(21416-6 CALL .--re
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ,,1 '
742 BAY RD., QUEENSBURY NY 12804 ...7.e4 y
r
INSPECTOR'S REPORT: ARRR\•4' DEPART`1`.0 IN
REQUEST FOR INSPECTION RECEIVED:?,, �(//c d
NAME CA , , � ��
LOCATION 0LA_'
DATE S~g.,2-- k'7 �ERMIT A C\7—OS.7
TYPE OF STRUCTURE: AM\ \`G'Y-)
RECHECK _ APPROVED
N/A YES NO
FOOTINGS/PIERS r`, _
MONOLITHIC POUR FORM` 1i
REINFORCEMENT IN PLACE /
P `,. .
THE CONTRACTOR IS RESPONSIBLE FOR
X
PROVIDING PROTE TION FROM FREEZING
e
FOR 48 HOURS FOLLOrING THE PLACE—
MENT OF THE CONCRETE. _
MATERIALS FOR THISIPURPOSE ON SITE _
u
FOUNDATION/WALLPOUR _.
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE _
ROUGH PLUMBING _
PL BING UNDER SLAB
r�
RAMING: 1ST' _ Z_
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— •
CI) ---C41C3k:•— \�G-Er4—�iU L4i 66~ ctiii C�
0 Cot evL vE_- 1 t.:,1-_51 N l c - 14: L•=
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 9 7-6
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. Cert./y 43 2 3 8 Cut-in Card No.
Owner LA-4'g.V au
7-4--
Occupant
Location/-0
r
Installation Consisting of../ o/ C 2ECe C° �
''
n_ Ssdf!" C
Installed By ' A D6 e Lie.#
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 inspe ion, at any time,and if its
rules are violated,the Com any shall have the right to revoke t s tit t
Date 5-- 9 INSPECTOR.. . ... ...
Member N.F.P.A.,I.A.E.I.
(518) 761-8256
tr
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ,
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARE 11C DEPART\`�2 • =I
REQUEST FOR INSPECTION RECEIVED: Air
NAME aw• i� (� 11- V
LOCATION ,p`r - gopin r
DATE 4 _Q-97 PERMIT e 9 7�O9
TYPE OF STRUCTURE:U
RECHECK APPROVED
N/A YES NO _
FOOTINGS/PIERS
MONOLITHIC POUR FO' _ -
IIIREINFORCEMENT IN P -,�( --
THE CONTRACTO: S RES'ONSI: E FOR
PROVIDING'-PROTE TION F''M REEZING
FOR 48 HOURS FOLLOWING - 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
H ATING ROUGH-IN
INSULATION• — `)
FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS EXTERIOR R-
FLOORSR-
WALLS �/
R-4y �J/
CEILING R-,"3 )
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
3 J) ) (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT V��°.
742 BAY RD., QUEENSBURY NY 12804
3-f
INSPECTOR'S REPORT: ARR DEPAR 4' �
REQUEST FOR 7yY,�•'�'Q'PECTION RECEIVED: i /
NAME +'�� d--aRA
i
LOCATION 1 , ( c (7)
DATE 1 --7 Cl PERMIT A 7`0 c C
TYPE OF STRUCTURE: 6
RECHECK _ APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
REINFORCEMENT IN PLAC
THE CONTRACTOR IS RE PONSIBLE 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
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE _\./://
7OUGH 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- •
Fir)
(518) 761-8256
' TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT ar,�7+1��l
742 BAY RD., QUEENSBURY NY 12804 .•r,enA;�° i'
Ilir
:Fyn
INSPECTOR'S REPORT: . ARR�^ (TEPAR1?`J,4CU ow --
REQUEST F PEC ION RECEIVED: 9
NAME
LOCATION
DATE A 7 4 k'
,1 PERMIT t1 97O
6c--
TYPE OF STRUCTURE: "WA:;)
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
•
REINFORCEMENT IN P ACE \1
THE CONTRACTOR I RESPONSIILE 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
PLUM NG UNDER SLAB
JACK STUDS/HEADERS
JOSINHANGIRSING /
JOIST HANGERS V y�/
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER i
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 •
-
�� � U-31 7.TT
iiirekle
Z:36
(518) 761-8256
10 al& -
TOWN OF QUEENSBURY a+
BUILDING & CODE ENFORCEMENT NV
742 BAY RD., QUEENSBURY NY 12804 "%•F:.;,:0. :.
INSPECTOR'S REPORT: ARR ' F7- DEPARP2" INT/-�
REQUEST FOR IN ECTION RECEIVED: 9
NAME L U I G
LOCATION R
` � -�-// ,eO . C
DATE 'fj y/�7 PERMIT it / /7-v �
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
-fONOLITHIC POUR FO
REINFORCEMENT IN 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
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 •
-
TOSN OF QUEENSBURY —
BUILDING & CODE ENFORCEMENT 2p
531 Bay Road ��
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location R;)
��' ,,�1 ,-�
Date — Permit # NG:2
SOIL TYPE: Sand-, oam-Clay-
Results of Percolation Test-
(if appli able) Rate-Minute/Inch
TYPE OF Si STEM-
ABSORPTI I F: , 'I : Total Lep. .t 40)
Length of -.ch trenchI �jU
Depth o ,renc es tr
Siz= . st. e 'L
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank . 1' 5 1
Tank to Dist. Box k u
Dist. Box to Field/Pit ii it • 0
Openings Sealed? No Partial
LOCATION/SEPARATIONS
Foundation to Tank /0 feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan , No
LOCATIONt OF SYSTEM ON PROPER .
(circle Fr - q
Front e ., - Right Side
Middle Front - i•i .: - Rear
COMMENTS:
SYSTEM USE APPROVED: NO
Arrived: 4;��
Departed: •
Building Inspector
0
v (518) 761-8256
cD_:
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT ./. '
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRDEPAR
REQUEST FOR INSPEC I
ION RECEIVE -C 'T'
NAME �/ 1
LOCATION ( 1' J ' .A
DATE s 7-9 PERMIT # CV-0de (I)
TYPE OF STRUCTURE: ._)
RECHECK APPROVED
A N/A YES NO
FOOTINGS/PIERS r -
MONOLITHIC-POUR FORK/
REINFORCEMENT IN PLAC -
THE CONTRACTOR I 'ESPONSIBLE FOR
PROVIDING 'P•• E 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 _
I;- K:F3LL 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-
�1
, ) ;(2) —� 18' 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR3M DEPART?- �Ix
AiginnamREQUEST F• Il .PECTION RECEIVED• '/
NAME 1t! J �__ !b ] _�J
411111
LOCATION r
DATE 1-- c o`� Cyl
PERMIT A o c+/
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
e� tr•
vo4OOTINGS/PIERS
MONOLITHIC POUR FORM -
REINFORCEMENT IN PLACE "y15 _
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM F EZING
FOR 48 HOURS FOLLOWING THE P C ,
MENT OF THE CONCRETE. I _
� �
MATERIALS FOR THIS PUfiPOSE N 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: 4
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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Application PPR OV ED ':
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. MR 2 .5997 •
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—. _ T Zoning Ad rnis:v or.. •.
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f 01�VN OFQUE) NSBURY Ve
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_-- _-:. _ • a.- seen or observed,or believe I saw evidence of,
__s _ _ — objects-such-as-houses;w
_ • - - etl`• ells;: f
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than anthis d ument p�setrt t!m!11ve
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-. - - - - � 7nameasuredfli h set forth on'the di:�am:'
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I hereby certify that this sap was prepared from an
actual field survey. This certification shall run only
to the persons for whom the survey was prepared, and on
his behalf to the Title Company, Governmental Agency and
Lending Institution listed hereon. Certifications ale
not transferable to additional institutions or
subsequent owners.
certified To: Pamela M. LaBrum
Fleet Mortgage Corp., its successors and/or assigns
Stewart Title 1 urapce'CN,' any
:~
9
•
Certified BY: • t
Leon M. ste es5617
June 2, 1997 ``Y �`
Date:
Lr tY:.
1JNAU7HORHSED ALMATM OR ADDIIHON 70 A WNCY
YA7 NEANNO A LJCDIgD LAND SAt*- ORS SEAL 9 A
WLADON OF SE 71ON 720Y. 9UIP--DIM" 2. OF THE
NLW VOW STATE EDUCATION LAM.'
'ONLY =40 FROM THE OMMAL OF TH/S SAMY
MjUA D WM AN ORHOSUL OF THE LAIC SUR%C QRS
WAL 9IMl E CONSIDERED m E VALD 7" OOPEL
CUUM1CAW NS POCA7ED HEREON 99SEY THAT
TIsiS SURWY W PWARED N ACMIDA"CE WM TIE
06700 CODE OF PRACTICE FOR LAID 9IRIEYORS ADOPTED
r, THE HErr im STATE ASMOIATM OF PROFES9MAL
Ut4o 5Xt% jWM SAP CUtWICA704 SHALL NO ONLY
,M THE PE1lSCh FOR W" THE lLWACY Hi PIEPAIIM AND
OHH neS SEHALf 70 TIE IM OOEMAIfY.4VAW UWAL
AGENL.'Y AND LE)DW Ns'R7IA" UffIED WWOK AND
W1 THE AlSoM OF THE 10IR I NSITRrWH.'
at
41997
t"Ir.3JVN
MAP Ofi A SURVEY MDE FOR
M. L.N,&rz-ucn
TM OF QvEEN SBv fL`l W A.tt¢E N COUNTY, N . Y .
SCALE H I': 3o DATE I 2 . \`',91
Vadusen k I Steves
LAND SURVEYORS,GLENS FALLS,NEV YORK
N.Y. STATE LIC. NO. 35617
95:0o I -15
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