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1987-847 ? , , w�e�+r � ; } i ✓. ..�9h.4; 'Y. -tea .. ya� 9k" uyF » iF 71; 5kFF. $, . yl 5 � a ': r - x 1� y{ . r l , I k CERTIFICATE OF OCCUPANCY TOWN OF QUEENSSURY f WARREN COUNTY, NEW YORK a i Date 4> 9 1Q� This is to certify that work requested to be done as shown by Permit No. k has been completed. i jThis structure may be occupied as a '/: of a two family dwelling Location 36 Queen Anne Court, Queen Victoria's Grant, Model J owner Guyer Builders Inc. f ,i By Order Town Board TOIRPN OF QUEENSBURY - Building dr Zoning Inspector Y BUILDING PERMIT � TOWN OF QUEENSBURY No 87-847 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Queen Victoria ' s Grant I OWNER of property located at 36 Queen Anne Court Street, Road or Ave_ in the Town of Queensbury, To Construct or place a of Two Family Dwelling at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Clueensbury Building and Zoning Ordinance. 1 . OWNER'S Addressis Guyer Builders Inc . ��.. 119 Dunning St . n Ballston Spa , N. Y . 12020 n F� A� 2_ CONTRACTOR or BUILDER'S Name no Same C, rt r+ 3. CONTRACTOR or BUILDER 'S Address Same 4. ARCHITECT'S Name w rn m ro 5. ARCHITECT'S Addrew .FJ sro C] 6. TYPE of Construction — {Please indicate by X} C r- ri Ix$Wood Frame 1 } Masonry I I Steel ( ) 7. PLANS and Specifications No, 32 ' x 48 ' as per plot plan , specifications and application including septic system and attached one car garage . B. Proposed Use o of Two Family Dwelling 0 $5 . 00 C/O g $ $ ' CG PERMIT FEE PAID — THIS PERMIT EXPIRES July 1 19 88 �c (if a longer period is required an application far an extension must be made to the Building and Zoning inspector of the �y town of Ctueensbury before the expiration date.) � F-' Dated at the Town of Queensbury this 9th Day of December 19 87 �y -�� , Oro SIGNED BY / / r'G G �-4ate-- �� ^--"" ' for the Town of Queensbury Building and Zoning Inspector TO BE COMPLETED BY BLDG . DEFT O f,;t J; ;,, '� .• . . Application No . a LL, JOt!/J� 0/ Q690ed"J ►"PJ4 Permit Issued 19 j; L �' �b t`' BUILDING and ZONING DEPARTMENT Permit Expires 19 L��- D CT 2 3 1987 Bay and Havitand Road, R.D. i Box 98 Zoning Dt__ i.r IJ(7 Oueensbury, New York 12801 Variance Site Pla .Approved '!eAPPLICATION FOR BU I LD I NG AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWINGS The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description, plans and specifications submitted, and such spacial conditions as may be indicated on the Permit . w Mlw.w.w.w—w.w r.w wwww wrrrwi�.w oaf www—r.r s---Wwww—.—w.w.w.--www �. ww r.rs---wi�w--irr—n..n.r—www--wwww w The owner of this property is : Gu er Builders Inc . P. O. Address 119 Dunning Street Ballston Spa , New York 12020 Tel . ( 518 ) 899-9161 Property Location : 36 Queen Anne Court Tax Map tyo .121 ,,+ 2 Street number or building lot number Subdivision name ( if applicable) Queen Victoria ' s Grant THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Richard H . Guyer III ( 51E3) 899-9161 Name P . O. Address Tel . No . Name of builder Guyer Builders , Inc -Address 119 Dunning Street Tel . ( 518 ) 899-9161 Name of plumber E3Wer millaersi, nC .Address 119 LX1r1nXng Street Tel . - 9151 Name of mason Guyer rs , nC .Address n$ ree Tel . NATURE OF PROPOSED WORK : * ZONING INFORMATIC]N * X construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED , Addition to a building drawn reasonably to scale and attached hereto , Alteration to a building * showing clearly and distinctly all buildings # (no change to exterior dimensions ) * whether existing or proposed and indicate all Other work (describe) * set-'back dimensions from property lines . Give * street and number or lot number and indicate * whether interior or corner lot . show location FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED . * of septic disposal area . * COMPLETE INFORMATION REQUIREDp$F� . " size of property, 100t QTan ft X 120 ft . * Existing buildings) Size ft X NjX�ft . PRQPOSED BUILDING AND USE : M000fl * Existing building ( s ) use _ _ N/ A -- Size of new strut e 32 ft X 48 ft Foundationwp:Ler slab crawl/partial/full * Proposed building , see ddiisttannceplan fr property line cIrcle one ) * Front yard 30+ ft Rear yard 30+ ft No * of stories (habitable 1yae} 1 Height ( grade to ridge ) * Side yards�l +�r ft and 15+ £t g g ft . * If on corner , setback from side street ft If residential, no . of families * i . of roome ( excluding baths ) OCCUPANCY INFORMATION 2 IP of bedrooms • * PRIMARY BUILDINGTo of bathrooms 2 One family dwelling Th ' s •e' f r Primary heating system se ar a ectric* �- o family dwelling O s Type of fuel Electricity * Multiple dwelling / Number of units No * of fireplaces to be installed * Permanent occupancy will a wood stove be installed? �� Transient occupancy Central Air conditioning? No " * Business BUILDING STYLE, PRIMARY STRUCTURE: * Industrial * Other Ranch Contemporary Lo cabin If addition, what will use be? Raised ranch Mansion Duple Split level Old style Bungalow " Cape Cod Cottage Other * ACCESSORY BUILDING- colonial Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE } * _.Attached garage/one car/ two +car/ One car Private storage building ESTIMATED MARKET VALUE OF * ' Other CONSTRUCTION rp INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED ! Form SPA 4/BG and-vl 4 BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction, wood frame , fire safe, etc . wood frame Will any second-hand or ungraded lumber be used? If so , for what ? no Foundation wall material concrete block Thickness 8" Depth of foundation below grade (to bottom of footing ) 4814 minimum Will there be a cellar? no Heated or unheated? Floor sq. footage sq €t Will there be a basement? no Will any portion be used as living space? ( If so, what part ' ? �sq . ft . - - Type of use? Type of roof - sloped flat/shed/other Material of roof Fi rg ass s angles Site , wood studs "X C7 spacing 24 "o . c . length 8 ft. exterior Walls Joists ( floor beams ) 1st . floor NIA "X " spacing. �"o . c . span N/A ft . Joists ( floor beams) 2nd . floor -` �"X j '' spacing "o . c . span N A ft , Overlays (ceiling beams ) lox " spacing 24 ,o . co span N/A ft . Roof rafters 2 "X " spaci— n- g 24 o . c , span 14 ft . Roof trusses (pre-engineered) -� spa4=1;g 2 "o . c . span 42 ' ft . Exterior wall finish stained of what material? 5 / 8" x 4 ' x $ ' texture 111 Interior wall finish pain s eetrock If a garage Ls to be attached. , describe materials to be used for FIRE SEPARATION : 1 /2" type "X" sheetrock Is there to be an opening between garage -&nd dwelling? yes If so will a Fire-rated door , enclosure , and self-closing device be provided? yes Will a flue-lined chimney be installed? No Height above roof N/A ft . Depth of chimney foundation below grade N A ft . Depth of fireplace hearth N A ft . in . Water supply - Municipal or private well municipal SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties ft . (A separate application is necessary . for an re air or new installation of septic system) See S . P . E . D . S . permit # 026252� Town of Queensbury County of Warren F F I D A V I T STATE OF NEW Yt]Rx I swear that to the best of my knowledge and belief 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 90ecIflied or po o and that such work is authorized by the 'owner . 1 / SWORN To BEFORE ME THIS Signature V;z ---_ -� --- --- - - -�~ =_-- Owner , owners agent , cnitect , contractor day of 6 l9 pp,TftiC4A E. FtiJRPNY y Wit} -- /� r . ,•,,ic. State 01 New York ectadY County Notary Public , 4I1,1048 t ry 19 SPECIAL CONDITIONS OF THE PERMIT : 1123 Square feet living 240 Square foot garage - one ,stall 1363 @ $7 . 00/ 100 or part of $ 5 * 00 One stall garage $5 . 00 C/O permit Total H'Y----------------- ._- --____ _ TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE I . A permit must be obtained before beginning work . ,►1 gVElt ALL of the following : } . rjrasa floor area1123 S . F . �. 3 . Typ a of heat Baseboard electric 30 is the building mechanically cooled ? No 4e Percentage of area of windows and doors 11 . 8% A . Over 16 % Only 1 . Ua value of gross area of walls , roof /ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces YES NO a . Are foundation walls insulated ? YES NO 1 . If YES , what is the R value ? 3 . Slab an grade YES N,p a . If YES , what is the R value of insulation around perimeter of floor ? 4 . Is basement heated ? YES NO a . R value of insulation 5 . Type of insulation So under 16 % Only 1 . R value of roof and floors exposed to ambient conditions„ R-38 2 . R value of exterior walls R-23 . 5 (U. =0 . 04+) 3 . R value of glazed area U. =1 . 30 4 . R value of doors R-14 . 9 M =0 . 06) 5 . R value of floors over unheated spaces._ R�0 6 . R value of slab edge insulation - unheated slab N/A 7 . R value of slab insulation - heated slab 12 . 5 e . R value of heated basement/ cellar walls ( above grade ) N A 9 . R value of heated basement /cellar walls ( below grade ) N/A 10 . Type of insulation Fiberglass Co Controls 1 . Thermostat maximum heat setting Do Duct systems N/A 1 . Is duct system installed in unheated spaces ? YES NO a . If YES . R value of duct installation b . R value of duct in other areas E . Pipa. ngg Insulation N/A 1. Size of hot water or cooling carrying agent pipes 2 . R value of pipe insulations ro Service Water Heating 1 . Performance efficiency N/A 2 . Temperature control setting maximum G . For Swimming Pool Only 1 . Maximum heating N/A Telephone No . ( 518) 899-9161 ( ppltcant " e signat e ) APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref : S . P . E . D. S . DATE September 29 / 87 permit # New York - 0202525 MODEL J of J/A LOCATION OF PROPERTY FOR INSTALLATION 36 Queen Anne Court Owner's Name: Guyer Builders , Inc . Telephone: ( 518 ) 899-9151 Address: 119 Dunning Street , Ballston Spa , New York 12020 "taller's Name: Guyer Builders , Inc Telephone: ( 518 ) 899--9161 2 A, C , E , I , J , K, L, M dumber of bedrooms (residential only) 2 3 F, G , H Total daily flow (compute (Q 160 gal per bedroom) 300 TopoWaphy: circle one: Fiat Rolling Steep, Slope 9b of slope Soil Nature: circle one: Loam Clay Other J Depth: 8 ' feet + GaNumd Water: At what depth? unknown 8 feet + lkmkvck or Impervious Material: At what depth? in-Amown feet 34wcolation test: circle one: not require required / rate min. inch. Domestic water &UPP17: circle one. trlunicipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption N/A feet * PROPOSED SYSTEM: Septic Tank gal. (minimum size: LOW gal.) TILE FIELD: Each Trench N/A feet / Total system length N/A feet * SEEPAGE PIT(S) : Number of / Size each feet by feet * Size of stone to be used # / Depth or Thickness feet I M P O R T A N T * See S . P. E. D. S . ...Please...LIST NEW EQUIPMENT TO BE INSTALLED permit & attached * * * i • * s * s ys # * * ik aR s * * * * * * * * * * * i +� * s # s # * ye yc * s * map ` (over) f ' Section II Septic System Inspections: A. All applications for septic system installation. alteration or repair, as required by the Town of Queensbury Sanitary Sewage Ordinance, shall be submitted to the Building Department at least 24 hours before start of construction and shall include a plot plan showing: 1.) the proposed .location of the +lystem 2.) location and distance to lot lines 3.) location and distance to structures 4.) location and distance to any water supply 5.) size and dimensions of all tanks. distribution boxes, tile fields and/or drywells B. No system shall be covered before inspection and approval by the building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the installer and a fine of up to $250.00. C. An approved copy of the plot plan shall be available on the construction site. Failure to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during. construction prevent proper installation, alteration or repair of an approved system, a new proposal must be submitted to the Queensbury Building Department before further construction. I have read the regulatuaw above and agree to abide by the and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of.responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 , . . HOME of NATURAL BEAUTY . . A GOnr+ PLACE To LIVE MIDDLE DEPART AGENCY, INC. t 199 May 20, O Foccupant: rtiftle� that Ias Al eRUipment listed has been exams s¢ anti approved as being in accord ational Elect applicable governmental , utility and A"pcy s- r $ui,lder. / pan le Farmi8 , r� 12 f Ocali©r1- Qu&e OL3l �, 4 Lts caryhcase i t aCtriG uipment and ;ns[allation inam3ctad th a 36 data H ao�tlitlonal aqunt 'ah De introduced or alto rat+ona made to eriBaing aYa,Cem thin C +Cat! be null and VI?io, and BP PI+Caxton For ' .� tt- 9irtgpeczian snaultl t1�a submm W p uy to Lhia Agency. equipment.. ](� Outlet:8 s �,''�$�ECCptaC leB ; `.c,�+'_ 3li madder o1 ln+s Canfificata shqultl nt same to his praperiY insurance cerr+er 150 Amp S,eTvla `PPI an em " (agent or comPllnYY aaeri artificaeian oteiecencal equiPmenf aPpror d 0.\\\+\\\ as apamlietl;r�` r' Guyer BULLder Applicant. 11g Dunning Stree O " 16�032492 �Ballotan Spa, NY 120 rents No. res EL 1-ii TOWN OF QUEENSBI BUILDING AND CODES DEPARTMENT BAY & yAVILAnEW OADS YORK I280k QUEENSBURY, 792- 5$32 TELEPHONE C 51.8 ) BUILDING INSPECTOR' S REPORT p REQUEST FOR INSPECTION RECEIVED 7G� — -- NAME LOCATION # / !� PERMIT DATE APPROVED YES NO ,FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL AppROV L ROUGH PLUMBING FRAMING ELECTRICAL ROUG IN INSULATION: FITION ,FLOORS WALLS CEILING FINAL INSPECTION: ,1 C'H_rMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/S . 't'S STAIRS- CLEARANCE &. RAILS___ PLUMBING FIXTURES/REEF VALVE I I INTERIOR TRIM/PRVAC3' DOORS FINISHED FLOOR$FING GARAGE FIREP -� DOOR CLOSERTORS ) �_ SMOKE DETEICAL INSPECTION FINAL ELEC FINAL APP VAL OF CONSTRUCTId 1 ,A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESErPREMISES ARE OCCUPIED! REMARKS : ~' INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT DAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2801- TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME � ��'+ LOCATION DATE PERMIT APPROVED YES NO FOOTINGIPTERS MONOLITHIC POUR ':FORMS 3` ,FOUNDATIONIDAMP '..PROOF TNG BACKFILL APPROVAL ROUGH PLUMBING 'FRAMING ELECTRICAL ROUGH-IN )(INSULATION: FOUNDATION FLOORS )( WALLS 'CEILING FINAL INSPECTION-4 j CHIMNEY HEIGHT P ROOFING SIDING EXTERNAL PORCHESIS PS_�- �- STAIRS-CLEARANCE & ILS__�--�- PLUMBING FIXTURES R IEF VALVE INTERIOR TRIMe+'PR :. AC� DOORS FINISHED FLOORS T GARAGE FIREPROO INGJ DOOR CLOSER {S) �- SMOKE DETECTORS N PELT ---. FINAL ELECTRICAL: -� FINAL.. APPROVAL {bF CONSTRU TION r A SIGNET) CERTIFICATE OF OCCVPANCY MUST BE OBTAINED FROG THE BUILDING bEPARTMENT BEFORE THESE PREMISkS ARE OCCUP.TED! '', REMARKS - ,' yvr_�,9f L bL� k E COI ple X INSPECTOR TOWN OF QL3EHNSSllR'Y i BUILDING AND CODES DEPARTMENT 33Ay & HAVILAND ROAD'S QuEENSBUI NEW YORK 32SOl- TELEPHONE (528 ) 792-5532 BUILDING INSPECTOR' S REPORT REQUEST R INSPECTION RECETVED� NAME -Ir AiL toe LOCATION NIi T= DATE �- —1 PERMIT # APPRO ED YES I NO FOOTING/PIERS MONOLITHIC POUZ FORMS FOUNDATION/DAM:'-PROOFING_J_^ BACKFILL APP AL t� - �„RGUGH PLUMBIN +.+FRAMING ELECTRICAL R H-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECT N : CHIMNEY HEIG T ROOFING SIDING EXTERNAL PORC ES/STEP L_��_ STAIRS-CLEARA E & PLUMBING FIKTU ES/RE TEF VALVE INTERIOR TRIM/ IVA Y DOORS FINISHED FLOORS GARAGE FTREPROO DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL N PECTION� FINAL APPROVAL a CdgSTRUCTIONN A SIGNED CERTI ICATE OCCUPANCY MUST BE OBTAINEDFROM HE BUT ING DEPARTMENT BEFORE THESE PREMISS ARE OCC IEDd REMARKS : s 1 Lam : IZj Ifs rr�f INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT ,BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1 320&' TELEPHONE BUILDING INSPECTOR' S REPORT REQUEST FOR INSP TION RECEIVED NAME CAa�,IOffN Lp de Z�l DATE PERMIT APPROVED YES NO FOOTXNGIPTERS ONOLITHIC POUR FORMS FOUNDATION/nAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH—IN SNSULATTON : f FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORC SfSTEPS STAIRS—CLEA CE & i�2AILS PLUMBING FI RES/RETIEF VALVE INTERIOR TR MIPRIVACY ;POURS .FINISHED F RS - GARAGE FI EPROOFING nOOR eLo ER (S) _ SM(7XE D TECTORS FINAL EL iTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION . A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED ? REMARKS : INSP CTOR '` `L-E_...- L•- �� "_ �� +,--�+ ram/ ,� �o ura►� o� �is ae n a� Er+ri► BUILDING and ZONING DEPARTME i Bay and Haviiand Road, R. D. 1 Box Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME " _.4 I LOCATION . Date / Permit No .74 ` ✓ = APPROVED - YES NO Footing/pier Forans Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer ( _.Iough Plumbing XzX Relief Valves Ext . Porches Finished Floors Interior Trim �^ Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers .Smoke Detectors Chimney INSULATION . Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- $ it dl g Insp afar 6/86 and-vl 0w" Of Qtdoe" Jt "ry BUIL.E)$NG and ZON'NG PEPARTME $8 Bay and Haviland Flora Yo ki280i ()ueensbury. New OR ' S REPORT SUILDING INSPECT NAME LOCATION Permit Na .CI ;] P p pPROVEi]* _ YES No Footing/Pier Forms /'oun dat ion waterproof In 8ack.f i11 Framing Roofing Siding Masonry Veneer Rough Plumbi Relief Values V:xt . porches Finished Floors Interior Trim Stcllra & Railings cellar oral-n Til Concrete Floors rlbq . Fixtures riq Gar . Fireproof Door C'l. C)S erB e detect rs zN SU LAT z ON ,0FG andat.ion Floors walls ce i l inq ^tR?CAS INS ECTION �---� F?NAL ELE�{ PROVP�L DRIVEWAY A Survey -----� ~� Final guildlnS lyext scheduled insP action {,call w n ready ) Remarks' Build Inspector G/sE, md�vl BUILDING and ZONING DEPARTMENT Bay and Haviiand N YarkUI28�x 98 Queensbury, 9UILOING INSPECTORwS REPORT NAME `z1C� 42 LOCATION /_ - l l Permit No . Da-te APPROVED - YES No [ „6oti.ng/pier Forms Foundation Waterproofing Backfill Framing Roofing Siding ty,asonry Venee _ -- Rough plumbing .. Relief Valves Ext . porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors plbg . Fixtures Gar , Fireproofing Door Closers Smoke Detectors Chimney IK SULAT-ION Foundation Floors walls Ceiling C L INSPECTIOi3_�� �- FIN ELECTRI DR-1VEWAY APPRO Su eY Final Building ready) 27ext scheduled inspection all when Remarks- Building Inspe t L� 6/86 and-vl ,J'own o� ��e�nAbtere�. BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R.D. i Box 98 Queensbury, New York 12801 BUILDING INSPECTOM S REPORT NAME LQCAT I4N Date^ to Permit No . ! " APPRaV ED - YES ting/pier Forms Foundation �- Foundation waterproofing Back£ill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext , Porches Finished Floors interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg . Fixtures Gar . Fireproofing Door Closers smoke Detectors ChimneY INSULATION Foundation Floors walls Ceiling FILIAL ELECT CAL INSPECTION DRIvEiAV APP OVAIi Final Build g Surveys -�- Next scheduled inspection Ccall when ready ) Remarks- /"� j -7'r A / � , -�- !41,jk Ale. M' Building InsP ctor .J'ocure o�' �ueen.� l�ur� BUILDING and ZONING DEPARTMENT Bay and Hawiland Road, R.D. i Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT I,ON.si� DATE / PERMIT NO . �— 7� _ _ Loam _ Clay SOIL TYPE Sand percolation Test Required? YES - NO Percolation rate ^ Min/inch TYPE of SYSTEM: Absorption field , total length Length of each trench Depth of trenches Size of gravel_ SEEPAGE PITS#bIumbeX' C; Size_ ft. X '' ft. Gravel size P IP S13G : ;,. 5,,,• ,,1�ze.." Type pt'cr Bidg . to tank. : �-. Tank to list , bo — Dist_ box to fia d/pitE ` Hp Partial openings sealed. EOCATION/SEpA TJONS Foundation t tank Foundation a(bsorP Absorption a lot l Separation f pits wmTIC]N SYSTEM .rcle one} Front - R r - Leftside CCMMENTS : 4 SYSTEM USE APPFJDV'E%663:nspetctor g 01/e6 and vl �GiL+fi/t ©C "�C '�FFJYl3fiLtr SUlLDlNG and ZONING C)EPARTMEENT BaY and Haviland Road, R+D. 1 8ox 98 QueensburY. New York 128Q1 5EF!TIC DISPOSAL SYSTEM INSPECTION NAME , LOCATION � , 1 DATE PERMIT No. 1 SOIL TYPE - Sand _ Percolation Test R Loam Clay Percolation e4in/Incred ? YES rate - Min/Inch TYPE of SYSTEMe Absorp Length of field , total length Length of each trench Depth of trenchers Size of gravel. SEEPAGE PITS{NUtnbEr of) Size- Gravel size PIPING : Bldg . to tank Size Type Wank to dist . box "---� Dist . box to Eleld/pj:—� Openings sealed ? YES O Partial LOCATION/SEVARATIONS , POUnda't.ion to tank Foundation to absor ft. .Absorption to ption � ft . 7eparation lot line pits .00ATION Op SYSTEM ON pROpERTYft. front - Rear - teft side (circle one) 'OMMENTS6 - Right side La f4c% IL tTEhg USE APPROVED ES NO Bu ] ding Spector 6 and vl BUILDING DEPT, COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED. 7IEIwp # OATS CITY OR I VILLAGE Queenshlivy STREET TOWNSHIP 91 I'I�7i�.7i.t>ry C4MMTY WarrenROAD ANo FOLF C NO. 36 'Queen Ain-le court BETWEEN WHAT TWO POLE jy . pRR� STREETS IS ' TE67 OCCUPANT'S SE TIDN BLOCK LOT NAME BUILDING NAME T�y.,,,,..;; �7 ``�� OCCUPANCY RAND ADDRESS Guyer�+e'r �t�L tiers �I1C. U f jig �Ll SCCF_E+'t TEL 1I�` 89"161. SUPPLIED BY BUILDING FROM THEIR OFFICE � �—+� . IS NEW I_'I` OLo El WORK sItppyy DEFECTS NEW 9I AIDDi TIONAL Q REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS Nw at Fdahttae a LtKf LanMt ReeepttpNa MOTORS HEATERS CIRCUd7M OFFICE USE ti an ONLY Otilinll vlall R 'y Switch Rwttlant Bracket No. Tyjla H'P• Illtats A.W.B. Et'd" Pow Eaeb Nt"- INSPECTION Gate- aldt sub- Piano Beer "mo tat FF. 2nd Fl. 3*d FL REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE- This aPPlitation IS intaintlad to ,O " the ab jistetl a<Iu1Plnent to M in you are autheriked to make tht ! �Peeted but H at iiwMt e1 i{ tjen IIMY! 4 found idditiontl apuiprnent not abeyt Pitied, nlPeCtien and adjust the hH to mtw LM atltl#ienal Nlyjptneryl. as jrrevided by the aPPldeant. 512E S ELECTR IC SIGN MAINS �.lV r FEEDERS L.AIIPS TOTAL CHARACTER a WATTS ,0. OF WORK 3'3T .I�y� CONCEALED EXPOSED GAS TRANSFORMERS OF usE SIGN WORK TO BE VA STARTED Cf.MIPLETEO (NUIMSERI (CAPACITYI S12E OF SION SERVICE OVERHEAR UNDERGROUND ENTERS MAKER ILDI ' OF SIGN INSPECTION ION AR AS TEO PONSSOtsLe NEAR AS M 11 call whm Xamay NEW OLD E] AVOID DELAY BY GIVING FULL AND ACCURATE IN F OR MATZO N. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. DATE OF �ry(T�Drj PRINT NAME AND ADDRESS APPLICATION ■ NAME OF APPLICANT SIGNATURE yy OF APPLICANT p�yt� STREET ADDRESS i TELEPHONE III 8996mg l CITY OR _ POST OFFICE NY ZIP LICENSE LICENSE NO. CODEy�, VIVIEN APPLICABLE �� EL Clxev. cool A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING 8=0 DIAMETER 9'-0 DEPTH CLEANOUT TO GRADE c y�o QUEEN VICTORIA'S GRANT QUEENSBURY , KY nc�. REFERENCE DRAWINGS 5A SITE UTILITIES SEPTIC $ WATER VonDUSEN 4 STEVES SURVEY PLAN