97-452 CERTIFICATE OF OCCUPANCY
• TOWN OF QUEENSBURY
• WARREN COUNTY, NEW YORK
October 14
Date 19 9 7
r 1
This is to certify that work requested to be done aa shown by Permit No. 97452
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied as a
LOT 5 FIELDVIEW SOUTH
Location
owner CERRONE BUILDERS
By Order Town Board
T .X. MAP NO. 48. -7-5 •
• TOWN OF QUEENSBURY
af/W
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE $ 122000TOWN OF QUEENSBURY No. 97/.52
TAX MAP NO. 48. —7-5 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to_ CERRONF WJIS
OWNER of property located at _ LOT 5 FTFIT )VIEW OUT i Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SINGLE FAMILY i3WELLINC
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
66 SUNSET TRAIL 637 BAY RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
CERRONE BUILDERS
3. CONTRACTOR or BUILDERS Address
66 SUNSET TRAIL
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
1786Ng.qft SINGLE FAMILY DWELLING WITH 2—CAR ATTACHED GARAGE
AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SINGLE FAMILY DWELLING
$ 233 PERMIT FEE PAID —THIS PERMIT EXPIRES August 12 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 Queensbury before the expiration date.)
Dated at the Town of Queensbury this 12 Day of August 19 97
SIGNED BY Noe_ cL Y for the Town of Queensbury
Building and Zoning Inspector
�' t„1,��„, t "7.+ ".:,__.�---..._
;c e aituiertl o f Community Deveio pinerrt ,, Yl 1;;, ,, ; T ; TI'�,ev-iewed By: `� re_____-----
.
Building & Code Enforcement : : uYt�ll„g us, ctor
Tvwrr of Quecnsbury r+1,,,i .�,.w�,. G li,j , Permit No. 7 '
742 Bay Road �',r ISG;'
•
v� 22 �
Queen,s.bury, New York 12804 a ,"` )<+e,e Paid,$ r'(_IJ
(518) 761-8256 ' ..: _. _ �f�; �r�e 7 �i
. Building Fermi . - hcation ® -s .
1�1
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants ' spaces on this application MUST be completed and the
signature of the applicant MUST appear on the application form.
Applicant: /'.�1�///`� 'G - Owner:
Address: //� / " L a �
Properly Locvi
ation: S i�2/
�. Tax Map Number
Subdivision N:untc /` / Addy ki.4.//J
efc: .. . . . • , ..4., ..:g)- ______,_3.:. ,. .... •
_ Scclioii Block Jet
atNATU E OF PROPOSED WORK:
ESTIMATED MARKET V U OF THE
New B ' 1 ' CONSTRUCTION: $ ,;i' T .
residence / commercial
Addition . o ttiiding: • ---
residence / commercial OCCUPANCY INFORMATION: . `
Alteration to Building: Pri}rary Building -
residence / commercial :/ Single Family Dwelling MAWED0N,
Residence / Commercial Two Family Dwelling SI/Rpl AP
no change to exterior size Family Dwelling DATE 7 q
Office mix
7
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCT Iate`Uh E::� ; f S N ' .
r0D 7f ADDITION, • what will use
v.;.,-
1st Floor a ' ,, sq. ft .i17}C� , of new additi .n be? :
2nd .Floor �` _ sq. ft. ,/
Other Floors ' sq. ft. f� ��
(not unfinished cellar or basement)
ACCESSORY BUILDINGS: ,4"� -69
�;
- r Detached Garage 1 , r
TOTAL FLOOR AREA: /7t te
SQ. FT. ,/ Attached Garage 1, 2. car ----- --
Private Storage Bui ing •
SIZE OF NEW . STRUCTURE: Commercial Storage Building
Other
� — FEET X �� FEET .
Foundation Type : • , Will any second-hand or ungraded
Number of Stories : 7j lumber be used�?�� / If so, for what?
(habitable space only) /i/P
Height (grade to ridge) : 27 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodsl-ove ( circle all which lies )
to be installed: / _ � / Gas / Wood
Forced Hot Air / seboard / Other
•
Person responsible for supervision of work as regards to building
codes is :
Name Addr- . _ ''Phone "
Builder `�=J�. _. i 1.i � J!/vr/ � f��/ � '� 6 ..
Plumber:
/ �// a G�
Mason : �,- • i; � •
Electrician : ' 2 -If6
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; d n to sc• le, showing actual location of project on premises.
Signature: 4' �--- ::.>. :
(owner, owner's agent, architect, contractor) .
. •\CYO:.... . .
Application for SEPTIC DISPOSAL PERMIT
.
T_._.. s�s�-
Town of Queensbury '' -' ' Permit No.
• Dept. of Community Development
Building &Codes Office
742 Bay Road AUG 07 1997 Fee Paid $
Queensbury, NY 12804
� ae-
Location of property for installation:Gt)/ Rir
�_/1,2t /P/� �{//,f'
�
Property Owner's Name: &P.-fe.e?',&e,__25__/2:&M_,a1______'
Property Owner's Mailing Address: Al‘ c txre/ Tii/
oh 0 _
Installer's Name:,, � J��J 4 Phone # Z— /2'1
Number of bedrooms (if residential): Total daily flow: //a
(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: not required, req/well,
ired [min min. per inch]
Domestic water supply: municipal, other
If domestic water supply is a WELL, water supply from any septic absorption is /07 feet. .
PROPOSED SYSTEM
Septic tanlc:jaOgallon (minimum size: 1,000 gal.)
' Tile field: each trench 6 .7 feet / Total system Iengtth: 'TOO 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 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, shed be void.
I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queensbury Simitnry Sewage.Disposal •
Signature of responsible person:40, g.,/,1"1. � Date: c� "l
TOWN OF QUEENSBURY
742 Bay Rd., Queensbury, NY, 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
677 411:- a-
Date 7: 7
,19 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 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 ,80,,,,t ,7,r,, , ,4.,_ [P . APPLIANCE (check appropriate boxes)
Address ,,I lad/ El STOVE: ❑Wood o Coal o Pellet ❑ Gas
/ ,'� 0 FIREPLACE INSERT
I °lt Zip 0 FIREPLACE, FACTORYUI LT:
if ❑ Wood p G as
Phone 794--- . 0 FIREPLACE, MASONRY:
❑ Wood ❑ Gas
Owner 0 FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address ,. IF NON-MASONRY PL+ANCE:
-- w, L.,,_ - - --- -Manufactur-er-:- - : =- -- - -- ---- -
Zip. . Modelj '
Phone,? -.cc-, -
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
.-� ' 0 MASONRY: 0 Block 0 Brick 0 Stone
)/ :) '" `,;� 1.- .' -�. �/�-7�1 c./ �;,.r FLUE: ❑ Tile 0 Steel
Size: inches
CONSTRUCTION / INStALLATION MUST 0 FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS 0 Double Wall ❑ . tiple Wall
'
REGARDING REQUIRED INSPECTIONS. 0 Insulated re Direct Venting '
❑ Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire.Marshal Amount Collected Amount Refunded
Code Number Title " ' '•~• . .. ,
A 173 3389 (190) Public Safety '
A 233 2655 (230) Minor Sales
0 I' �2
�
Fe&Coll.ected FrOm or Refunded to: L. •( "-i- 1,t L ti` `--
Address:`'{ ,� --' in , r i
Dated: i -7 ( `) Town Clerk or Deputy: ` k�- . °.�,e.. V.�! A-�','
I 17.1
,
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
RESIDEINILAL FINAL INSPECTION REPORT
Office No. (518) 761-8256 ��
Building &Code Enforement Arrive:J :2�!Insp:--Jt�e----
Dept. of Community Development
Town of Queensbury Date Inspection Request Received:
742 Bay Road
Queensbury, NY 12804
NAME a atOd C' PERMIT NO. ,-- v
LOCATION Laf 5 4,'' itR'' DATE p
TYPE OF STRUCTURE 4( 17
N/A YES •NO COMMENTS
ChimneyHeight/"B" Vent/Direct Vent Location i 4/
g /
Fresh Air Intake ✓
Plumb Vent Through Roof dtiiiii
Roof Complete
Exterior Finish Complete
Interior/Exterior ilings 30" to 36"
‘ixteri Handra s, alconies, Landing 18 in. or more ,v/
itenor drail Stairs Both Sides 3 or More Risers
Grade 2% A ay From\Foundation
8" Clearance To ill Plate /
Gas Valve Shut- sed/Regulator 18" Above Grade i
Gas Furnace Shu-Off within 30 Feet or within Line of Site I
Oil Furnace Shut Off at Entrance to Furnace Area
Furnace/Hot W ter Heater Operating I
Relief Valve(s) Installed - - ✓
Headroom 6 ft. 6 in. On Stairs
Basement Stairs 6 ft. 4 in. l
Handrail Exterior Stairs Both Sides More Than 3 RisersVII
Interior Privacy/Trim/Doors/Main Entrance 36"
Floor Finish
Bathroom/Kitchen Watertight
Interior Handrails Balconies/Landing 18 in. or more �'
41/
Railing Across Window in Stairwells r
Smoke Detectors: ti/
every level
every bedroom
outside every bedroom f
inter connected 11.71:.1/
Bathroom Fans
Plumbing Fixtures
Foundation Insulation `
3/4 Hour Fire Door/Door Closer ,//
Garage Fireproofing 1�
Garage Penetrations Sealed / i /
Furnace In Separate Room Protected (In Garage)
Light Ventilation Per Room
Safety Glazing 18" or Less From Floor j
Final Electrical j
J
Site Plan/Variance Required
Final Survey Plot Plan /
As Built Septic System Layout Req. J
Okay to Issue Temp C/O
-
RESIDE1VI7AL F7NAL .INSPECTION REPORT
Office No. (518) 761-8256 rr
Building &Code Enforcment Arrive:` 3 Insp: J�
Dept. of Community Development �^
Town of Queensbury Date Inspection Request Received: /U/9fy7
742 Bay Road
Queensbury, NY 12804
NAME (16%g/20,4.tC PERMIT NO.
LOCATION Ler ,64M6iele9 Maio - DATE AD / o
TYPE OF STRUCTURE 5F/5
N/A YES NO COMMENTS
Chimney Height/"B" Vent/Direct Vent Location �1
Fresh Air Intake
://://f
Plumb Vent Through Roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railin s 30" to 36"
Exterior Handrails, Bal onies ding 18 in. or more _ �r
Interior Handrails Stairs Sides r More Risers f 1�5 f 4C km,C iZA.)( ig e'er(
Grade 2% Away From undation
8" Clearance To S• late
Gas Valve Shut-Off Exposed egulato 18" Above Grade
Gas Furnace Shut-Off within 30 eet or within Line of Site
Oil Furnace Shut-Off at Entrance to Furnace Area
Furnace/Hot Water Heater Operating
__ Relief Valve(s) Installed
Headroom 6 ft. 6 in. On Stairs
Basement Stairs 6 ft. 4 in.
Handrail Exterior Stairs Both Sides More Than 3 Risers � `
Interior Privacy/Trim/Doors/Main Entrance 36"
Floor Finish
Bathroom/Kitchen Watertight
Interior Handrails Balconies/Landing 18 in. or more
Railing Across Window in Stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom Fans
Plumbing Fixtures i/V
Foundation Insulation
3/4 Hour Fire Door/Door Closer
Garage Fireproofing
Garage Penetrations Sealed
Furnace In Separate Room Protected (In Garage) /r
Light Ventilation Per Room
Safety Glazing 18" or tsprom Floor
Final Electrical /O f f'7 (i
Site Plan/Variance Required
Final Survey Plot Plan 1
As Built Septic System Layout Req.
Okay to Issue Temp C/O
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NY 12804
- (51 8) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED LU-i(97
NAME
LOCATION
._S
D Ti4�RMIT # t° -S7
hl APPROVED
N/A YES NO
EXITS I
AISLE WIDTHS
EXIT SIGNS /
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHIN SYSTEM
HOOD INSTALLATION(
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
ZREPLACE-MASONRY
EPLACE- FACTORY BUILT
REMARKS: ❑ OK TO THIS DATE
•
INSPSLIP.PUB I P 0
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545 ql- cic
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. Cert. 5 0 2 2 2 Cut-in Card No.
Owner C67-12 laa A16--- atA4'c 0672-S
Occupant
Location 4.0 T efria3672-,--V i71e-74-06W S atir&-4,17/
Li6 SlAn 'ir- A/ 6 t ie6reri3 (fit,/ tZ'
Instal ation Consisting of 1 Si
j /cu -P6iAti e Y )..s•/
1
e / 5 mo 66e—
Installed By ie` 190 4-1110, 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 ma ' g in sectIons at any time,and if its
rules are violated,the Company shall have the right to revok: t: •cer icate.
ill
Date 4%) -/e1-77 INSPECTO• ....
ember N.F.P.A.,I.A.E.I.
j
TOWN OF QUEENSBURY
4 !!!1 BUILDING & CODE ENFORCEMENT
VWW 742 BAY ROAD
QUEENSBURY NY 12804
1' (518) 761-8256
ARRIVE: r`VV DEPART: II` V 0 INSP: "t
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST,p RECEIVED:
NAME CC''-9ele6A)6
LOCATION /fir eel—Me/NC( /40eLi�g +�
DATE d PERMIT I
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/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
pATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
L� c& - I Y, K
. et-tiZt5
t TOWN OF QUEENSBURY
.�(/; .!" BUILDING & CODE ENFORCEMENT
:`,�s �� 742 BAY ROAD
� .` QUEENSBURY NY 12f304
(518) 761-8256 Ott
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPE IONN REQUESTST RECEIVED:
NAME -/�- e/L
LOCATION if V / 76- & - 6 -
DATE O G' PERMIT 1 97-y6-2--
TYPE OF STR CTURE
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC _ INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VE T/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
ii /
DECK/PORCH/STEPS/RAIL GSA
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
FI L ELECTRICAL
S TE PLAN/VARIANCE REO. �1
FINAL SURVEY PLOT PLAN 11�/
OK TO ISSUE C/O OR C/C
Cr'(\)-FIYY`--(L).
TOWN OF QUEENSBURY
;3. 1 FIRE MARSHAL
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED 1 `-1(n^-J
NAME 2S' J5- Q_ A .61 A Q
LOCATION \`P ��1 SC-4-`
DATE PERMIT # l ��,�a -/(0-q7
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE- FEA TORY BU,
REMARKS: GrOK TO THIS DATE
----- /14
t' mPit7/
INSPSLIP.PUB INSP CT
i A
• p/ti
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT -
742 BAY RD., QUEENSBURY NY 12804
a
INSPECTOR'S REPORT: ARR"� DEPAR " I
REQUEST FOR INSP CTION RECEIVED: 9 /3 1
NAME , C �I
LOCATION /O�-�fc j /�7:ea e
DATE 9 /.S /Q- ( PERMIITvfi • /` t e_
TYPE OF S RUCTURE:
•
RECHECK - APPROVED
N/A YES _ NO
•
FOOTINGS/PIERS
MONOLITHIC POUR FORM -
REINFORCEMENT IN PLACE
THE CONTRACTOR S RESPONSIBLE FOR
PROVIDING PROTE TIO'N FROM FREEZING
FOR 48 HO. RS FO OWI'.G THE PLACE-
MENT OF THE CONC 'ETE
MATERIALS FOR + _W'POSE ON SITE
FOUNDATION/WALLPO �
REINFORCEMENT IN PLATE
FOUNDATION/DAMPPROOFING
BACKFILI;IAPPROVAL`
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
SULATION• - f
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- --
FLOORS -- R-
WALLS vj'r 41 243D fL --R- V f
CEILING tc ec k R-' . V
DUCT WORK OR PIPING IN
UNHEATED SPACES R •
-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT y, '•
742 BAY RD., QUEENSBURY NY 12604 r ,
INSPECTOR'S REPORT: ARR DEPAR
REQUEST FOR IN/SPnECTION RECEIVED: / I/
011 NAME
LOCATION
�+'Cry �J
DATE P.RMIT fl /
TYPE OF ST UCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS l
MONOLITHIC POUR ? • '_
REINFORCEMENT IN PAIM
THE CONT • •-' !R IS RESPONS :LE FOR
PROVIDING PRO FREEZING
FOR 48 HOURS FOLL'WING THE PLACE-
MENT OF THE CONC.- TE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING& c(k4?2
ER SLAB
. c//
ING: ` 1 M14911161112 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- •
„2;4."--; /-1
. .
-(518) 761-8256
i1V>, 1-T.. ... .,
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 ;,1 =--
INSPECTOR'S REPORT: ARO)/OjDEPAR ' 5 T tP1
REQUEST FOR INSPECTION RECEIVED: i 1
NAME &." qPi _ 1�--�__/_� 7
LOCAT ION r-f C�� LP
DATE //514 r PE T H "/ (( .A
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR F
REINFORCEMENT IN PLA E
THE CONTRACTOR IS RESPON ISLE FOR
PROVIDING PROTE TION F M FREEZING
FOR 48 HOURS FOLLOWIN THE PLACE-
MENT OF THE CONCRETE _
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR _
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
LUMBING VENT/VENTS IN PLACE = /
.t OUGH PLUMBING •1!//
r��P UMBING 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 •
-
sr�-� CAP 40 L i 106 C &/04,;74-‘4 /t,),Avw._ /161_115).S Q ? 114.- Fi.,4
l3 4;i-4 4) . • ct,R,oeic veer
��fm IT
(518) 761-8256
`
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 '
e 4� a aa,, , c I
INSPECTOR'S REPORT: AR44-'�5 DEPAR'N'Z- INTO C
REQUEST FOR INSPECTION RECEIVED:
NAME C E fel o4)
LOCATION L, 7 1 ( 4-b v /C4) •
DATE 91/d/q7 PERMIT e ,7 7-4
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES , NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
1 -
REINFORCEMENT IN PLACE __
THE CONTRACTOR I RES'•NSIBL FOR
PROVIDING PROTE ON -ROM FR:EZING
FOR 48 HOURS FOLLO ., e THE ; 'CE-
MENT OF THE CONCRETE. _
MATERIALS FOR THIS PURPLSE ON SITE
FOUNDATION/WALLPOUR _
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE _
ROUGH PLUMBING _
PL MBING UNDER SLAB _
RAMING• /�
JACK STUDS/HEADERS
BOSINHANGIRSING _ y
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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(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 `<
INSPECTOR'S REPORT: ARR DEPART/•/J NT��
REQUEST FO�NSPECT,IJONNN RECEIVED:
L NAME l. 0-0/1/"
LOCATION 6-4'4e'PEP //6- ./S
DATE 7 2/ 97 PERMIT #
TYPE OF STRUCTURE:
RECHECK . APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOL WINO HE PLACE-
MENT OF THE CONCR TE.
MATERIALS F IS P POSE 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-
•
as thi-ce- kov r1v6 r)ie 4-44e
4-0 .4026:4 r 'V 0T 060 nJ 0 4
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road . .
Queensbury NY 12804 ,
518-745-4447 -
SEPTIC DISPOSAL SYSTEM_ INSPECTION
Name .V-Revie
Location RelAtleer ,1j�oc)S •
Date +317? Permit #�`� 7- �v
SOIL TYPE: Sand-Loam-Clay
•
Results of. Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total'' Length
Length of each trench
Depth of trenches
Size of stone '
SEEPAGE PITS: ;,Number-
Size - ft. x;' ft.
Stone size
PIPING: f. Size Type •
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/,Pr
Openings Sealed? , 'al- No Partial
LOCATION/SEPARATI.ON
Foundation to Tank feet
Foundation to Ab,,sorpti,on _ feet
Separation of Pits \ feet
.Conforms as perf'Plof Pl\,an Yes No .
LOCATION OF SYSTEM ON PROPERTY:
(circle one) I
Front - Rear .-1/ Left Side Right Side
Middle Front v Middle Rea
COMMENTS:
�6-t�c ��� ' /o:v
C:MihertO 4/
SYSTEM USE APPROVED: • NO
Arrived: 8
Departed: " U
Building Inspector
WI
TOWN OF QUEENSBURY
,- BUADING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
ti,• f,.
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 11 -4{Oh -f::
i
Location �-I---i'' � �"?� ���d-
Date �' , _ 'ermit#' '' 5
SOIL TYPE: Sa . -Loa 1 Clay-
Resul is of Percol ati on :Test-
(if applicable) 1t,ate-Minute/Inch
TYPE OF SYSTEM: r, I p., _,/
ABSORPTION FIELD:;; Total Length i-10
Length of each. trench i 5"�
Z
Depth of trenches\' ,
Size of tone
2.---
SEEPA PITS: Number--
Siz ft.,{,x ft.
one size ?
PIPING: , �' Si e Type
Bldg. to Tank it
Tank. to Dist. Box
Dist. Box to Field/ ' • +t 4
Openings Sealed? . Yes No Partial
LOCATION/SEPARATI
Foundation to Tank "V feet
Foundation to 4bsorptio9 - feet
Separation of its ,\ _ fee,
Conforms as peer Plot Plap Yes o
LOCATION OF S`-STEM ON PRIPERTY:
(circle -_
Front - Rea. Left Side Right Side
Middle Front - Middle Rea,
COMMENTS:
Sep 14 .- & ;�r
OF - Ca 0
6,-c 1_, .ems B K'
Cict 2A• & -lt(
. \
SYSTEM US APPROVED: YES ti,
Arrived: / r
Departed: MEM.
cIPt/
Building Inspector
(518)761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT - :V
742 BAY RD.,-QUEENSBURY NY 12804 '' ,/Yp,�'�'t4,•.:
INSPECTOR'S REPORT: ARR Vr� PARTCI S�INT`fr
REQUEST FOR }NSPECTION RECEiIVED:
NAMEL t :Red/Jf-' ,•r
a
LOCAT11ON /L---L • _//-D-,
DATE t 2. PERMIT a
TYPE OI STRUCTURE:
RECHECK\ `t APPROVED
N/A YES NO
1'OOTINGS)PIERS
1ONOLITHIC.POUR FORM i)y
.
REINFORCEMENT IN PLACE
THE CONTRAC&OR IS RESPONSIBLE FOR
PROVIDING PR bbbb TE TION FROM FREEZING
FOR 48 HOURS\FOLLONINc/THE PLACE-
MENT OF THE C 7NCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
YM
FOUNDATION/WALLPOUR )
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOF1NG
BACKFILL APPROVAL Jv.
PLUMBING VENT/VENTS41N, PLACE _
ROUGH PLUMBING I \ _
PLUMBING UNDER SLAB E�
-
y.
FRAMING: I EN
JACK STUDS/HEADERS ;;
BRACING/BRIDGING
JOIST HANGERS •
JACK POStS/MAIN BEAM ;
AIR INFILTRATION BARRIER
HEATING ROUGH-IN `` _
1
INSULATION: 1
FOUNDATION JALLS INTERIOR R i.
-
FOUNDATION WALLS EXTERIOR R-
FLOORS , R-
WALLS I R-
CEILING I R-
DUCT WORK/OR PIPING IN
UNHEATED SPACES R-
'
L(/ L. LJ J (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NYNY 12804 /
INSPECTOR'S REPORT: ARAI-. DEPART ' ' N V(-"_
REQUEST R INSPECTION R CEI ': /
NAME AC� (�Y`sZ_ %�
LOCATION ) A c�e V VC A.1 (]
� �kT
DATE g v O ) 97 PERMIT A f -"1 a
TYPE OF STRUCTURE:
RECHECK APPROVED_
• N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE,TION FROM FREEZING
FOR 48 HOURS FOL OWING THE PLACE-
MENT OF THE CONCR TE.
MATERIALS FOR THIS UR OSE ON S TE
FOUNDATION/WALLPOUR
REINFORCEMENT IN P CE
FOUR TION/DAMPP OF G
GKFS1.4B APTPR. AL \�l/
PLUMBING /VR T/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- • ,
731. OC)
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR 12AEPAR ( /. INT‘,)N'
REQUEST FOR INSPECTION`` MRECEIVED: �I L�{--
NAME �� � ' 1 ` }6 Q ( )) ) 6CAT
LOCATION e A C)',./ 1 PA Ai )�_
DATE 5<-'1
TYPE OF STRUCTURE: c
RECHECK / APPROVE
N/A YE NQ
\F TINGS/PIERS
MONOLITHIC POUR FORM /• . •_
REINFORCEMENT IN PLACE (4\
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 WALLPO R _
REINFORCEMENT IN PL 1
FOUNDATION DAMPPROOF
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN LACE
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- i
FLOORS R-
WALLS R- _
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
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"I have seen or observed,or believe I saw evidence of, �' @ \� '° `''
all objects such as houses,wells,trees,fences,etc., L661, v g „nV
shown on this d ment. I also represent that I have -
personally red th istances set forth on the iagrom.' 1/ _ r__vet=
/ 7
- /, '`jir.
SIGNATURE - t •DATE°' ,a, !
OS,
I(' ' V '
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Ily RECEIVED
OCT 0 81997
TOWN OF QUE&4SBURY
BUILDING AND CODE
NEIII
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V4 C.0 Datw
scaie r
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