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1989-165 {Y [ 4� !^�� +DER i IF�'ICATE OF C �UI'AN�Y �+ TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK This is to certify that work y� requested to be dare su shown b Ptrrtsit No. $9 - 16 5 4 has been completed. I ,l This structure may be occupied sus a 4 OF A DUPLEX I Location 22 QUEEN MARY DRIVE { QUEEN VICTORIA ' S GRANT - GUYER BUILDER'S IOwner By Carder Town Board TOWN OF QUEENSBURY Director of Bldg. do Code Enforcement i Y i i ima BUILDING PERMIT TOWN OF QUEENSBURY - � No. 89-165 WARREN COUNTY, NEW YORK r PERMISSION is hereby granted to QUEEN V I CTORIA ' S GRANT - GUYER BUILDERS � I OWNER of property located at 22 QUEEN MARY DRIVE ~ Street, Road or Ave- in the Town of Queensbury, To Construct or place a Aj OF A DUPLEX u 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, OWNE WS Address is 119 Dunning Street c xxxxxxonIR tt Ballston spa , N' . Y . 12020 V i 2_ CONTRACTOR or BUILDER'S Name i- Self c 3_ CONTRACTOR or BUILDER'S Address r Same G G 4. ARCHITECT'S Name r r- S. ARCHITECT'S Address h h 6. TYPE of Construction — (Please indicate by X) A XX] Wood Frame I 1 Masonry I ) steel [ 1 n A C 7. PLANS and Specifications R No. 42 ' x 26 ' of a duplex as per plot plan , specifications , and application , including septic `■ t 8_ Proposed Use i~ OF A DUPLEX � 25 . 00 c /o s 126 a OO PERMIT FEE PAID — THIS PERMIT EXPIRES Nd%:% (lf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the I� town of Queensbury before the expiration date.) { t Dated at the Town of Queensbury this 13 th Day of A' r 3l. 1 19 89 7y C SIGNED BY cl. J for the Town of Queensbury "C Building and Zoning In or R pM G� Application Noe 0*0 y own a/ Qtswasb"ry Permit Issued 19 r /G'c 9 4 BUILDING and ZONING DEPARTMENT Permit Expires 19 /� � Cry Bay and Hawiland Roan, R.D. 1 Box 98 Zoning Designation � c�j�,�b, � Oueensbury, Now York 12801 Variance No. CCj ( , Site Plan Review No . Approved bye � � ^FPLICATION FOR BUILDING AND ZONING PERMIT * . Me 10 z ' * 0 • : NO * • * * Or 10 ON M M r r • * i * � r �r � • i � « :s• A PERMIT MIDST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING. 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 special conditions as may be indicated on the Permit . The owner of this property is : GUYER BUIL.DERSj INC . P. o. Address 119 DUNNING STREET R67 .T .�N SPA, NEW YORK 12020 Tel . � ( 518) 899 9161 Property Location : 022 g2olelslwi MgIJC Tax Map Street number or building lot number Subdivision name (if applicable) QUEEN VICTORIA" S GRANI' THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES ISs Maine P . O. Address oral . No . Name of builder GUYER BUILDERS, INC . Address 119 DUNNING STRE"T` Tel . ( 518) 899-9161 Naar of plumber GUYER BUTT=& INQ . Address 119 nUMING STREET 'eel . 518 899- 191 Name of Mason GUYIII BUILDIIZ.S . Ili . Address119 DUNNING STREET Tel 518) 899-9161 NATURE OF PROPOSED WORK : ,. ZONING INFORMATION 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, mmanumm 61teration 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 FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot . Show location F F . * of water supply and location and configuration OR DEM IT STRUCTURES AFFECTED of septic disposal area . * COMPLETE, INFORMATION R,EQeUe RED BELOW * * Sias of property _44�] t X �ft . *. Ixisting buildings) SiseN ft X NJA ft . PROPOSED BUILDING AND USE. : I * Existing buildings ) Use N/A Size of new structure 42-0ft x 26 t " Foundation-,pier/slab/crawl/partial/full * Proposed building , cUst f om property line ce (circle one ) * bee of an No . of stories (habitable space) 1 * Front yard 30+ ft Rear yard 30+ ft . Height (grade to ridge ) 19-6 ft . * Side yards ft and 15+ ft — If residential, no* of families - * if an corner , setback from side street ft Noe of rooms (excluding baths ) ' S * OCCUPANCY INFORMATION Noe of bedrooms 1 NOe of bathrooms 1 ' � PRIMARY BUILDING Primary heating system BASEBOARD R'r-Fi'.TR1C One family dwelling * X Two family dwelling Fd Type of fuel .EMICITY• _ * Multiple dwelling / Number of units Now of fireplaces to be installek� * Permanent occupancy Will a wood stove be installed'?_ NO Transient occupancy Central Air conditioning? NO ' * Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial Ranch Contemporary Lo bin * Other ' Raised ranch Mansion Dupleac * if addition, what will use be? Split level Old style unga ow 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/ car k * r * • • * * + r r w * • r r * * Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION $ r_ 55K IWOMATION ON BUILDING SPECIFICATIONSr ON REVERSE. SIDE. OF THIS SHEET, TO BE COMPLETED ) Foos BUPA 4/86 md-vl SUxL )ZNG PERMIT APPLICATION CONTINUED allILDING SPECIFICATIONS . - Type of construction , wood frame , fire safe , etc . WOOD - FI AME Will any second-hared or ungraded lumber be used? If so , for what? NO Foundation wail material CQNCRETE BLACK Thickness all Depth of foundation below grade (to bottom of footing) 48" MINA Will there be a cellar? NO wwwwwwwwHeated or unheated? Floor sq. footage sq fit Will there be a basement? NO Will any portion be used as living space? ( If so, what ports ? sq. €t. - - Type of use? Type of roof - lope flat/shed/other Material of roof FI Size , wood studs "x 6 " spacing�. c . length - 8 ft. exterior walls Joiats ( floor beams ) 1st . floor NIA"X spacing "o . c . span ft . Joiatz ( floor beams) 2nd . floor 2 "X 10 " spacing. span ft. overlays (ceiling beams ) "X " spacing'.. 24 "o . c . span ft . SEE PLAN Roof rafters "x " spacing 24 o . c . spanowoowww ft . Roof trusses (pre-engineered) spaclnq. 4 'O . c . span ft . Exterior wall finish STAINED of what material? _ 51819 x 41 x 8 ' TENURE 111 Interior wall finish PAINT 1 /2" SBEETROCK If a garage is to be attached , describe materials to be used for FIRE SEPARATIONS " NIA Is there to be an opening between garage and dwelling? If so will a Fire-rated door, enclosure , and self-closing device be provided? 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 NIA Water supply - Municipal or private well M[7NICIPAL SEPTIC SYSTEM _ Distance from ANY private well (including adjoining properties N/A ft . (A separate application is necessary for any repair or new installation of septic system) See S P E D S 'Permit #0202525 Town of Queensbury County of warren A F F I I} A V I T STATE OF NEW PORK I swear that to the best of my knowledge and belief the statements containea is this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be donepon 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 not, and that such work is authorized by the owner . ~� SWQitM TO BEFORE ME THIS SignatureM-zow �,,,,_ M Owner # owner ' s agent rcnizect, contractor day of :2c-/ 19'7 ADRiENNE Jo PINOER notary Putgio, State of Now York ous Med in Sarnvga County je No. 4907692 Notary Public , XW4 Ca ty, N. Y . C9wn 1**&on Eviree Oot. 13, 19iw9J SPECIAL CONDITIONS OF THE PERMITS TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION CODE A permit must be obtained before beginning work . ANSWER ALL of the following : 1 . Gross floor area � � �- Lei' &j 2 . Type of heat Baseboard electric 3 . Is the building mechanically cooled ? No 4 , Percentage of area of windows and doors -c.•c� ��1� �4 A . Over 16 % Only 1 . Uo value of gross area of walls , roof/ ceiling and floors exposed to ambient conditions 2 , Floor over heated spaces YES a . Are foundation walls insulated ? YES NO 1 . if YES , what is the R value ? 3 . Slab on grade ES NQ a . If YES , what s the R value of insulation around perimeter of floor ? 4 , Is basement heated ? YES NO a . R value of insulation s . Type of i n s u l a t i o n iLt_'r'.� ?C+- - C cXS7ot_._.___ Do Under 16 % Only 1 , R value of roof and floors exposed to ambient conditions_ R-38 2 . R value of exterior walls R- 20 3 , R value of glazed area 4 , R value of doors R-14a9 ti 5 , R value of floors over unheated spaces - 419 6 . R value of slab edge insulation - unheated slab N/A ? , R value of slab insulation - heated slab 12 . 5 8 . R value of heated basement/ cellar walls ( above grade ) N/A 9 . R value of heated basement/cellar walls ( below grade ) N/A 100 Type of insulation Fiberglass Co Controls / I . 'Thermostat maximum heat setting D . Duct Systems N/A 1 , Is duct system installed in unheated spaces ? YES N i a . If YES , R value of duct installation b , - R value of duct in other areas E . Piping Insulation N/A 14 Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation ro Service Water Beating 1 . Performance efficiency N/A 29 Temperature control setting maximum G . For swimming Pool Only 1 . Maximum heating N/A eu Telephone No . ( 51$ ) 899-9161 .��.- ! K ( appl cant ' s s nature ) �� of Q' 4oy APPLICATION FOR SEPTIC DISPOSAL PERMIT Ref : S. P. E.D. S * DATE permit �# I � . New York - 0202525 ' MODEL �jp� of -` !�1 4� LOCATION OF PROPERTY FOR INSTALLATION 22 Queen Mary Drive Owner's Names ammom Guyer Builders , Inc • Telephones ( 518) 899-9161 Address: 119 Dunning Street. , Ballston Spa . New York. 12020 Installer's Name: Guyer Builders , Inc Telephone: ( 518) 899-9161 2 A. Co Es I . Ji Ks L. M Number of bedrooms (residential only) 3 F . G, H a Total daily flow (compute @ 150 gal per bedroom) 300 Topography: circle ones lat Rolling Steep Slope % of slope Sail Nature: circle one: Sand Loam Clay Other / Depths . 8 ' feet + Ckround Water: At what depth? unknowri 8 feet + Bedrock or Impervious )Material: At what depth? unknown feet Percaa�lation test: circle one: not requir required / rate mina. inch. Domestic water ,wapplyx, circle ones Municipal W ell Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption NIA feet * PROPOSER SYSTEM: Septic Tank gal. (minimum size: 1.000 gal.) TILE FIELD: Each Trench N/A feet / Total system length N/A feet * SEEPAGE PIT(S)s Number of / Size each feet by feet' * Size of stone to be used # / Depth or Thickness feet sic * e �ss �s * +� e * * * as +re +s * * ar * sssssssas, #� �s �sssss * �s * s I M P O R T A N T * See S . P.E.D. S . ...Please...LIST NEW EQUIPMENT 713 BE INSTALL. permit & attached asss s * s * +► ss * * * * * * * * +IMIk * * * sus * * * * s * * s * * * i * i * map,. (over) section II Septic System lanections: A. All applications for septic system installation, alteration or repair, as required by the flown 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: IV) the propooed ,location of the glystem 2.) location and distance to lot lies 3.) location and distance to structures 4.) location and distance to any vi ater supply 5.) size and dimensions of all taiiks, 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 QQueensbury Building Department before further construction. I have read the regulations above algid agree to abide by these and all requireaseats of the Torun of Quueensbury' Sanitary ScwagV Disposal Signature of.responsible person: Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensburys New York 12801 (518) 792-5832 TTLED 1763 . . . hOME 0P NATURAL HEAUTV . . . A GOOD. PLACE TG CERTIFICATE OF INSURANCE ISSUE DATE (MMiDprYY) 10/3/88 PRODuDER uembour F�Og, g Agency., Inc . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS 121 Wall at NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE GOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW F 0 sox 953 Schenectady, NY 12301-0 53 COMPANIES AFFORDING COVERAGE CTTER COMPANY A The Automobile S.l'7siL7.'anoe Go. Of Hartford d, CT CODE 3340 SUB-CODE COMPANY $t; La$INSURED LETTER Unit y & S tv Co . COMPANY puUdersp IncA LETTER C T�1 �1 n,+�xu i g Stryeeet} r�/-y Yry/� J.HW.Rla oon '��pap J.4i. 1202E OMPANY D COMPANY E LETTER ..I ... _- ........__.-...-_-.« f.-_.._.--..-.... ..-.-.. ..__ .-........_._..-....._............._....-.- _......_�..�_...�.._. ., COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING, ANY REGUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13L ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MMIDDIYY) DATE (MMIDDIYY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY Renewal of GENERAL AGGREGATE x 2 (]00 .6 .Y COMMERCIAL GENERAL LIABILITY C0 3692l4 10/1/86 ,10/1/89 PRODUCTS-COMPIOPS AGGREGATE $ 2 J WOi CLAIMS MADE X OCCUR. PERSONAL & ADVERTISING INJURY $ 110 woo OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE 11 S 1, 000io FIRE DAMAGE (Any one fire) S 1W40 MEDICAL EXPENSE (Any *no person) S ' IIII AUTOMOBILE LIABILITY y� -7�p/'Renewal of of pQ /ry. fQp COMBINED SINGANY AUTO i J390995 10/2/6 .T :LOI I v/ LIMIT $ ALL OWNED AUTOS BODILY SCHEDULED AUTOS INJURY S(per person) HIRED AUTOS BODILY NON-OWNED AUTOS INJURY S; Per aoeident) GARAGE LIABILITY PROPERTY S -{ ,,p DAMAGE EXCESS LIABILITY vRFeJ,{n.,�1 al of p D / p EACH AGGREGATE H X U�?ELI XS47,�, 1556 10/1/88 1011189 SCC RRENCE OTHER THAN UMBAELLA FORM ,OD{), � �CP S WORKER'S COMPENSATION Renewal e ewa of /� J-� STATUTORY j AND 379 10 2Ap B 1011189 s 1000 ;EACH ACCIDENT) EMPLOYERS' LIABILITY S -500, {DISEASE-POLICY LIMIT) .. - S 100* (DISEASE-EACH EMPLOYEE OTHER DESCRIPTION OF OP£RATIONSILOCATIONSiVEHI CLESIRESTRICTION Sig PECIAL ITEMS CERTIFICATE HOLDER CANCELLATION Building & Zoning Dept * SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of Queembux7 EXPIR TLON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO Hay & Haviland Road MAIL lU DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE RD #l, Box 98 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Queensb=y,p NY 12801 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE NOT ACORD 25-S (9/88) MPA Ak RATION 1988 MIDDLE DEPARTME j=N AGENCY, 1NC. S ��"" ►+lC *,? , oae� July 19 , 1989 r�- � Wi.erfifIC� that le equipment listed has been e)car�ti a a4 approved as being in accord with the National Elect Cr�r� ,applicable governmental, utility anc � d+jr S. Owner- Guyer Suild�e 1�� %r p I7 li Occupant: Single Fami Location: 22 Queen Ma ri ire +[S(/ Seri r cer4fl ale Ip % � lecfrlc uipment and installation irnXP*csed ihis S date. If 8416ilibnal uI nt ish be introduced or allerauons made in k r existing system fill Vice be null and void. and application for 9 s Ou t l e t: s ; (�l, hC a Q' 7 � 1 @ S a C} c` ? Y,L ' $ inspection should Fitr nubmnt�d p tly to this Agency. Equipment: 1 , + rko der of th s carfflcata ahquld ni same to his property insurance carrior ]- 51�i Amp `u e ry L l iN.�,Y �. f.eti3 Tl C 2 S (agent or companyI as evitlNlc erliiicallon of electrical equipment appro+ed r as specified. : r Guyer Builcle ` � .. if 119 Dunni�zg St + 11 (, r- ` fA ' . 4IVo . Applicant: NY Z 1.5 -023201. Ballston Spa , f!,"'� !�re/n'R•4�,rn",3.slkn`R�. s�'nrn��le�"�!{�3r''. '.i'.�'�'Cibs"n"�'�.'ris.`4Z'"Abe".+i$fi'l�IS'"'.n,.`�CC'rri'��`e� '/s`{ TOW BUILDING G QD E CODES BUILDING AND C©DES DEPARTMENT BAY 6P HAVILAND ROADS QUEENSBURY. NEW YORK�2-5 280q- TELEPHONE ( 518) 32 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME 1i t LOCATION C OD DATE - I - r5 PERMIT # �'% -- �— APPROVED YES I NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIONfDAMP-PROOFING BACKFILL A[ PROVAL ROUGH PLUMB NG FRAMING ELECTRICAL R GH-IN INSULATION: t/ FOUNDATION FLOORS WALLS CEILING c/ FINAL INSPECTION CHIMNEY HEIGH , ROOFING SIDING EXTERNAL P RCHESISTEPS STAXRS-CL RANCE & RAILS PLUMBING IXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHE FLOORS p , f GARAGE IREPROOFING . DOOR C SER (S) , SMOKE ETECTORS FINAL EL CTRICAL TIVSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE T]YESE PREMISES ARE OCCUPIED' REMARKS: 4 INSPECTOR /aura aueeashurt� Pilo) BUILDING and ZONING DEPARTMENT Bay and Haviiand Road, R. D. 1 Box 98 Oueensbury. New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME ra LOCATION d4%�)� ( � 1 � Qj7.yv•, ,ram/ ^- ' LATE � PERMIT NCI . / fo420 SOIL TYPE - Sand - Loam - Clay - Percolation. Test Required? YES - NO Percolation rate Min/'Inch TYPE of SYSTEM: Absorption field , total lengtbL. Length of each trench Depth of trenches ' Size of gravel SEEPAGE PITS#Nurfl:ier of) Size- ft. X _ ft . 1` Gravel size PIPING : iz Y e Bldg * to tank -- Tank to list . box rr Dist. box to field/Ajit Openings Sealed? YES NO Partial LOCATION/SEPARATONS :`i Foundation to ty nk ft• Foundation to gtbsorptiNOn ft- Absorption to lot line ft- Separation o to/lot ft • LOATION OFYSTEM ON PROPERTY (circle one) Front - Ream - Left Side --:, Right side COMMENTS Al 0�4 r SYSTEM USE APPROVED YE N ! f ildin Inspector 01/86 Md vl TOWN OF Q SUILDrNG ANDD CODES CODES DEPARTMENT BAY & HAVXLAND ROADS /f QUEENSBURBURY, NEW PORK 128Ok TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR WPECTIONV RECEIVED NAME LOCATION{{ DATE !0" PERMIT # APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING EL&9TRXCATo ROUGH—IN kal;FSULATxO FOUNDATIO FLOORS WALLS CEILING FINAL INSPECTS CHIMNEY HEIGH ROOFING SIDING EXTERNAL PORCHES , TEPS STAIRS—CLEARANCEC RAILS PLUMBING FIXTURES/ ELIEF VALVE INTERIOR TRIMJPRIVA Y DOORS FINISHED FLOORS - GARAGE FIREPROOFING DOOR CLOSERS) SMOKE DETECTORS FINAL ELECTRICAL INSPECTIO FINAL APPROVAL OF CONSTRUCT N 4 A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS-& INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT SAY & HAVILAND ROADS QUEENSBURY, NEW YORK 128 C3& TELEPHONE (518) 792-5832 BUILDING INSPECI"OR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE / PERMIT #Z APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING B,�ICKFILL APPROVAL GH PLUMBING LePRAMING ELECTRICAL ROUGH—IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS—CLEARANCE Co RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORSx FINAL ELECTRICAL INSPECTION FINAL .APPROVAL OF CONSTRUCTION- -A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED_+ REMARKS.& INSPECTOR TOWN OF QUEENSHURY BUILDING AND CODES DEPARTMENT BAY S HAVILAND ROADS QUEENSBURY, NEW YORK 128096 TELEPHONE (5I8) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST F NSPECTION RECEIVED.. NAME LOCATION DATE PERMIT # APPROVED YES NO FO TING/PIERS NOLITHIC POUR FORMS FOUNDATIONIDAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS r , WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE 6 RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PR_TVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL- OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR 70WO? o/ 'Quee4n3 "ry BUILDING and ZONING DEPARTMENT Bay and Haviland Read, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION ' DATEtiS P / ?f (? PERMIT NO . SOIL TYPE - Sand - Loam - Clay Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total length Length of each rench Depth of trenche Size of gravel SEEPAGE PITS4NumbNoksk Size- ft. X t. Gravel size -� PIPING : :Sizgf Type Bldg . to tars Tank to list . Dist . box to 1 /pit Openings sealed . YE NO Partial 1,0C AT ION/SEF A RAT I GN - Foundation to tan ft. Foundation to an rption ft" Absorption to to line ft . Separation of p ' ts ft. LOCATION OF SY EM ON PROPERTY (circle one) Front - Rear -- Left side - Right side - COMMENTS : SYSTEM USE APPROVED YE Hu g Inspector 01/86 and vl TOWN RY BUILD G QD CODS DE BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 2280!& TELEPHONE (518) 792-5832 BUILDINIG INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME r a r( LOCATXON� F DATE PERMIT # / APPROVED.- " YES NO FOOTING/PIERS MONOLITHIC POUR FORMS L. OUNDA T SO N/DAMP-PROOFING BACKFSLL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL GH-SN INSULATION: FOUNDATION FLOORS WALLS CESLING FINAL INSPECTION: r CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STE S STASRS-CLEARANCE & LS PLUMBING FIXTURES/ LI F VALVE _ INTERIOR TRIMIPRIV CY RS FINISHED FLOORS GARAGE FIREPROOFI G DOOR CLOSERS) \ SMOKE DETECTORS FINAL ELF.C3'RICAL NSPECTION FINAL APPROVAL O CONSTRUCTION A SIGNED CERTIFI ATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR TOWN OF QUEENSBURY BUILDING ING AND CODES DEPARTMENT BA Y & HA VILAND ROADS QUEENSBURYr NEW YORK 1280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE _ -�/ �" PERMIT # I fr1, APPROVED ES NO LOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-Xff INSULATION: FOUNDATION FLOORS WALLS CEILING r" FINAL IN,SPECTIONe CHIMNEY HEIGHT r ROOFING SIDING w EXTERNAL PORCHESIST PS SfiAS—CLEARANC IR E & RAILS . PLUMBING FIXTURES ELSEF VA VE INTERIOR TRIMIPRI ACY DOORS FINISHED FLOORS GARAGE FSREPROO ING DOOR CLOSER (S) SMOKE DETECTOR FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: INSPECTOR SELECT BUSINESS FORMS (509) 848.5203 APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY. INC. --- -- National Headquarters 900 Haddon Ave., Collingswood, NA. 08108 e e Clete Town or � C;IIIPenshur3r County Warred State NY Location/Address 7 ( if Located in Rural Area - Please Attach Directions) Pole # Owner i lnM RfTTF TS , + I jNC Permit Occupied As Building: NewX` Oid M Occupant Work Area in Buildin F400r #, etc. ) : _A pp, for: Wiring 0 Service 0 or. Ready for Inspection : Fee Remitted - $ Cash Check C] mo. Make Payable To. M. D. I.A, 500 750 1000 1250 1500 1T50 2000 2250 2540 2x5o 3000 Number of Rough Wiring Outlets Elect. Heat Switches Lighting Amp. Service Sur#ace Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner Amp, Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P. 1/201112 1/10 1/8 1/6 1 1/4 1/3 1/2 1 3/4 1 1 1 1112 1 2 3 5 71/x 10 1 15 1 20 25 30 40 50 75 100 Mark NurnFaer of Each Size Applicant's Signature License # Permit # T/A G YER BUTT,DER. Se TI C _ Utility : Applicant's Address : 119 Dluln-ing Street INAMC (OFFICE LOCATION (City) Ballston stpn Spa (State)— NY (Zip) I ?.h90 Service Request # Phone # 899-9161 Electrician : DATE RECEIVED: DATE INSPECTED: Correct Location : Some as Above 0 or: Red Notice Label 0 Rough Wiring Outlets Surface Unit Oven Switches Mange Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner, Wiring & Controls for Amp. Receptacle Amp_ Service Conductors Pump Vent Fans MOTORS H.P, I/20 1fl2 1f10 1/8 1/6 1/4 113 1/2 3/4 1 lifx 2 3 5 74z 10 15L213f 30 40 50 75Ll0 Mark Number of Each Size Elect_ Heat 500 71 1000 1250 1500 1250 2000 2250 2500 2750 300p CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT PEE PAID 0 RW Progress : Inc-0 LKD [] Contractor CFT Violation : Work Comp Inc. 0 L/A Owner CASH [] L/A Fee CH K # IPA Municipal Due MO INV # QDate : Other Side 71 ty ApplicantOwner Cut in Card C] Temp # Date REFERENCE DRAWINGS 5 SITE UTILITIES QUEEN VI IA' S G SEPTIC 4 WATER Van DU S E N $ S TEVES QUEENSBURY , NY SURVEY PLAN 0-MODEL ROOF PLAN WILL VARY ACCORDING TO SALE, DRAWING SHOWS ONE STYLE ONLY. 8`- 0 DIAMETER 9=0 DEPTH CLEANOUT / r...�,.. r........ ...»....... tiF.w..., .......,.,.,,.� .....a.... .,....�.,... .....r.._W .......... .�._....,_ .....�.,... ........... _.......,,.�.. .rrlrw.. ......... ......r.... .r...... _...__•_ TO GRADE ... 129.55' 2000 gal. / 3./e \3rO' LOT M ! _L__ 2� /6 0 4 a, v, 4 2� �o o I O 0` Co. 1� ` N 0 129! e _ Sh pp j 10 MARY TOWN F QUEENSBURY \ Zoning Admi is �Sr7�i.=.Z4f QUEEN tRY DRIVE PLOT PLAN SEATIC SYSTEM Yf-a gu, LDERS ► I"C. is kale; { _ % 0