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1988-608 .. ,, ,. . .. .. .. a .. .._. _Ai . ... CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date Seot.2004r 27 19 89 This is to certify that work requested eo be done as shown by Permit No. 88-608 has been completed. This structure may be occupied as a One Family Dwelling Location Lot 77 Orchard Dr. (St. No. 33) Old Ordhard Subd. Owner Dou74.as & Jackie Herschleb By Order Town Board TOWN OF QUEENSBURY Building & Zoning lnepector BUILDING PERMIT TOWN OF QUEENSBURY No. 88-608 b WARREN COUNTY, NEW YORK . gp,L' ! ,\ ,f- L • Douglas & Jackie Herschleb PERMISSION is hereby granted to rn Lot 77 Orchard Dr. (St. No. 33) OWNER of property located at Street, Road or Ave. Old Orchard Subd. in the Town of Queensbury,To Construct or place a One 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. ty 1. OWNER'S Address is 0 12 Dorset PLace Glens Falls, N.Y. 12801 sZn 2. CONTRACTOR or BUILDER'S Name (-1 William Herlihy r• 3. CONTRACTOR or BUILDER'S Address x l Dartmore Drive Glens Falls, N.Y. 12801 4. ARCHITECT'S Name • 0 5. ARCHITECT'S Address rt O ri 6. TYPE of Construction—(Please indicate by X) w ri Ff Wood Frame ( ) Masonry ( I Steel ( ) r•i 7. PLANS and Specifications No. 81' X 36' as per plot plan, specifications and application including septic system and attached two—car garage. 0 8. Proposed Use , One Family Dwelling 6 5.00 C/O $ 269.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1 19 89 o (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.) N � w 25th August 88 a. Dated at the Town of Queensbur s Day of 19 SIGNED BY for the Town of f Queensbury • a' Building and Zoning nspector APPROVED j/txurig. of Oue4aderell APPLICATION FOR SEPTIC DISPOSAL PERMIT ZONING I.OtDO CODES DCI'L TOWN Of QUEUiSUUItY DATE -1 SIC, LOCATION OF PROPERTY FOR INSTALLATION Lod'— 77 c RcHXI D DR) vie Owner's Name: gE_( ScJ-/Lpr Telephone: 75 - --a341 O Address: _ 12 Dr) f?S �% �L/ff Installer's Name: Telephone: Number of bedrooms (residential only) _ _ • Total daily flow (compute @ 150 gal per bedroom) T GOO Topography: circle one: Fat .,Rolling Steep S1op.e_9% of slope S°, _ Soil Nature: circle ones`-Ss nd Loa Clay Other / Depth: S feet Ground Water: At what depth? ' 9 feet liedrock or Impervious Material: At what depth? _ 4f O feet Percolation test: circle one: of re wire required / rate min. inch. Domestic water supply: circle one:Nunicip Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM: Septic Tank /6'0(2 gal. (minimum size: 1,000 gal.) TILE FIELD: Each Trench SO feet / Total system length 42? feet SEEPAGE PIT(S): Number of / Size each feet liy feet Size of stone to be used / Depth or Thickness / feet * * « * « « * * * 4 * * « * * « * * * * * * * * * * * « « * * * * * * « « * * * * IMPORTANT ...Please—LIST NEW EQUIPMENT TO BE INSTALLED * * * « *,« « + « * « * « « * * 4 * « « « 4, « 4. « « sa « 3s * * * * « * * * (over) • { • • • • • 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 system • 2.) location and distance to lot lines • ' 3.) location and distance to structures =t.) •location and distance'to any water supply 5..) size and dimensions of all tanks, distribution boxes, tile fields and/or drywells • . •• • • 13. 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 regulations above and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordin:wce. • Signature of responsible person: i ,�r�l�` '/l • Date: • • • Town of Queensbury • , Building and Code_Department Bay at Haviland Road . . Queensbury, New York 12801 (518) 792-5832 • TO BE COMPLETED BY BLDG. DEPT. .,.;.ti,e-.: ; N w,' I. QUA:.:.. TD / Application No. .'L,`,r`ry O .-1 f� ;.;; t , • / un U/ Queeniburti Permit Issued 19 l�' \- ,, `-' -I\ BUILDING and ZONING DEPARTMENT Permit Expires 19 d Bay and Haviland Road, R.D. 1 Box 98 Zoning Desi nation 1 A .1.549 3 Queensbury, Ne York 12801 Variance 1J EpT. o A Site ` �n Rev'ew No. W O G & CODE D ,,t) /- APPLICATION FOR 4-d ` . ,�; 67 BUILDING AND ZONING PERMIT 'oy ��� * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *::* A PERMIT MUST 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. n • The owner of this property is: .\---)ocIri -S r PG I E #ER c_hLE1 P.O. Address • `a On R sir `f i q Tel. - Property Location: Lp /L 77 0(2.r_ ale 17 Dt~V/(z i Tax Map No. / / Street number or building lot number ��`' 'J �? Subdivision name (if applicable) V3 THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: Name P.O. Address Tel. No. Name of builder (21f/I,g-G171—kf2 thV Address \` j-()`�%0/ `t�.{T° t Q ,Tel. 7q 3-.5Z,(o/ Name of plumber J pey gg1/X1- • / Address � ,, e�y)0---211 rfL Tel. 79e-/ 3 %GI . Name of mason .,1 e - MAW/ Address 3 03 4h'2. T Tel. 793 - J 6 e/ , NATURE OF PROPOSED Il RK: * 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, _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 FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location. of water supply and location and configuration LOCATION OF STRUCTURES AFFECTED. . * of septic disposal area. * * COMPLETE INFORMATION REQUIRED BELOW. * Size of property /7a ft X 37() ft. * Existing building(s) Size /- ft X / ft. * T— PROPOSED BUILDING AND USE: * Existing building (s) Use Size of new structure f ft X3(, ft * Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line * (circle one) No. of stories (habitable space) 2 * Front yard -O ft Rear yard �� ft * Side yards • 44() ft and ciR N ft Height (grade to ridge) ,�.(`) ft. * If on corner, setback from side street ft If residential, no. of families No. of rooms(excluding baths) 9- * OCCUPANCY INFORMATION . No. of bedrooms • y * • No. of bathrooms 2 /2 * PRIMARY BUILDING - • *••_One family dwelling Primary heating system 1.:1-(0=rF R * Two family dwelling Type of fuel (� S • .No. of fireplaces to be installed * Multiple dwelling / Number of units Will a wood stove be installed? Uo, * Permanent occupancy Central Air conditioning? A) * Transient occupancy * Business BUILDING STYLE, PRIMARY STRUCTURE *' Industrial • Ranch Contemporary Log cabin * Other Raised ranch Mansion Duplex * If addition, what will use be? 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/.o c. / car * * * * * * * * * * * * * * * * * . * _Private storage building ESTIMATED MARKET VALUE OF * Other CONSTRUCTION * INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl • BUILDING PERMIT APPLICATION CONTINUED - • BUILDING SPECIFICATIONS: • Type of construction, wOcd framj, fire safe,etc. Will any second-hand or ungraded lumber be used? If so, for what? Foundation wall material n ow,,R r�P' Thickness Depth of foundation below grade (to bottom of footing) -f Will there be a cellar? , Heated oruilheateab Floor sq. footage Ito-0 sq ft Will there be a basement? Will any portion be used as living space? A}-O (If so, what portion? sq.ft. - - Type of use? Type of roof -&-lopc flat/shed/other Material.-of roof Size, wood studs "X 6 " spacing /l "o.c. length A ft. Joists(floor beams) 1st. floor "X f2 • " spacing , "o.c. span 12- ft. Joists (floor beams) 2nd. floor '2 "X / " spacing ) ( "o.c. span 7c ft. Overlays(ceiling beams) "X E3 " spacing /4, "o.c. span /6 ft. Roof rafters "X " spacing o.c. span ft. Roof trusses (pre-engineered) " spacing "o.c. span ft. Exterior wall finish 0.p..a°I Plzce Of what material? Sy>Qur. Interior wall finish fz ta2V Loiss44 If a garage is to be attached, describe materials to be used for FIRE SEPARATION: r8 ,tlRsepp� Is there to be an opening between garage and dwelling? Aj e_s If so will a Fire-rated door, enclosure, and self-closing device be •provided? v p C • Will a flue-lined chimney be installed? /E�� Height above roof e) ft. Depth of chimney foundation below grade (, ft. Depth of fireplace hearth , ft. Yin. • Water supply --�Nfunicipal or private well SEPTIC SYSTEM Distance from ANY private well(including adjoining properties g d ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of Warren 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 donelon 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. / SWORN TO BEFORE ME THIS Signature _ // �2k � Owner, owner's agen ,arcnl.te _ ,contractor day of 19 Notary Public, Warren County, N.Y. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: • • By 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 376-TD 2 . Type of heat P.,t) 1%R_ 3 . Is the building mechanically cooled? 4 . Percentage of area of windows and doors Oil 4 A. Over 16% Only 1 . Uo value of gross area of walls , roof/ceiling a d floors exposed to ambient conditions / 2 . Floor over heated spaces YES ONO a. Are foundation walls insulated? qO 1 . If YES, what is the R value? �� IS 3 . Slab on grade YES a. If YES, what is the 'R value of insulation around perimeter of floor? 4 . Is basement heated? YES a. R value of insulation R L3 5. Type of insulation �l13Rr�L ��� B. Under 16% Only 1. R value of roof and floors exposed to bient conditions 2 . R value of exterior walls R — �� 3 . R value of glazed area R - 3• Z, 4 . R value of doors " • �� 5. R value of floors over unheated spaces 11-9oz-o 2 . 6. R value of slab edge insulation - unheated slab //) /J'e_- 7 . R value of slab insulation - heated slab YJIA 8 . R value of heated basement/cellar walls (above grade) R1-3 9 . R value of heated basement/cellar walls (below grade) 643 10. Type of insulation FT E_IL ,1-19-SS C. Controls 1 . Thermostat maximum heat setting •8 D. Duct Systems 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 . Piping Insulation 1. Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation *R F. Service Water Heating 1 . Performance efficiency 2. Temperature control setting maximum G. For Swimming Pool Only l 1 . Maximum heating Telephone ,No. _ 75 3 5-2<o (applican sslignt re) - . - _:YOU ARE HEREBY.REQUESTED.TO • '• \ir.' _ INSPECT AND ISSUE CERTIFICATES • FOR THE FOLLOWING:ELECTRICAL •• . - EQUIPMENT:TO BE'INSTALLED BY , _ • ' --THE UNDERSIGNED - ,-i 9 t• • Ft -, : • TEMI : DATE"- C — t ut • • CITY OR VILLAGE ,/7 j / • TOWNSHIP - - - " COUNTY / y STREET AND NO.OR ROAD // /. ? .'--�y� ' :?' �%• �: �,y/) - - POLE NUMBER. • • ,C- f> / .-1_ / / ( ° f/1(/ /7 i`�:,' / ✓ /7/.:.: BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? - . • "SECTION." BLOCK LOT OCCUPANT'S NAME • r" i - I . t. / BUILDINC�•6CC NCY .. 7/`, /' , , - r``y- .ej,///_ . - • ' • OWNER'S NAME AND ADDRESS," - '_ ". - HOME TELEPHONE NUMBER • CURRENT SUPPLIED BY A / /1/) .FROM THEIR. .p� /-1 OFFICE '`,,^ . : ,WORK TELEPHONE NUMBER t BUILDING IS - _ NEW - OLD❑ - WORK IS - NEW❑ ADDITIONAL❑ . - DEFECTS REMOVED❑ LIST BELOW ALL-EQUIPMENT WHICH YOU INSTALLED - NUMBER OF OUTLETS "- No.of Fixtures& MOTORS. HEATERS BRANCH OFFICE USE Loca- . Lamp Receptacles CIRCUITS ONLY tion Side Attach't'."- H,P. Watts A.W.G. Ceiling Wall Recep'Is Switch Pendant -Bracket No. Type Each N9• Each Nc. Gauge INSPECTION OUT- ' SIDE ' . . - •._ ' - • .SUB- -. , _ BASE - . - BASE- • MENT ' 1st - - .• FL. - • . , 2nd - '" - " .FL. _ . 3rd ' . FL. .- .. - REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE ' • THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO'BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT , . _ - SIZE OF MAINS .I _FEEDERS _ ELECTRIC SIGNSILAMPS . - TOTAL WATTS CHARACTER OF WORK ❑ EXPOSED - GAS TUBE SIGNITRANSFORMERS OF VA • - . ❑ CONCEALED , - • - - DATE WORK TO BE STARTED -•" - • _DATE COMPLETED . SIZE OF SIGN(NUMBER) . _ CAPACITY •SERVICE ENTERS BUILDING - MANUFACTURER OF SIGN ' ( _ .. - .❑ OVERHEAD. .. ❑ UNDERGROUND ?• •'- . DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) ' MUST ENTER APPLICANTS ":Pt' ' ,. IDENTIFICATION NUMBER AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN ORAPPLICATION MAY BE,RE RNED`. PRINT NAME AND ADDRESS ; i - / • NAME OF APPLICANT )/' //' % /,� ' DATE OF APPLICATION �/SIG1jp/�1. ,E,p/APPLICO q r _ - • / "if -/'`r i - _ /rI/'',/ i r--A - _' _ • " .X sTirribi?.- f ff •I .fy// - STREETADDRESS'` • /' /'/ , ``" _ TELEPH NE NO.— I j ,.. . CITY OR POST OFFICE 7) • Y • ZIP CODE _ LICENSE NO.WHEN APPLICABLE .._, • ' ❑ 85 John Street 0,41 State Street " ` ❑ 584 Delaware Avenue ❑ 217 Lake Avenue'' _ 0202 Arterial Road ,-'. NEW YORK,NY 10038 - ALBANY,'"NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206 TI—I"P NEW vnRK RnARn nF FIRE UNDERWRITERS y INTERIM BUILDING PERMIT FILE COPY PERMIT APPLICANT )162 CONSTRUCTION LOCATION to T ' ? 0 m Ci P R 0 0 ft • EFFECTIVE DATEi? APPROVED BYjr SPECIAL CONDITIONS : • This will certify that all submittals for a Building Permit have been received and fee has been paid . During the processing of the Permit, the above named may begin construction-, per plans submitted . It is the responsibility of the applicant to obtain the Permit - from the Building Department, following processing . POST THIS INTERIM PERMIT IN A Cr ! UOUS,JPA. TION ! ! Building & ' .des Department . TOWN OF QUEENSBURY INFORMATION FOR BUILDING DEPARTMENT WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION AS COVERED IN AN APPLICATION FILED WITH OUR DISTRICT OFFICE. THE nn NEW YORK BOARD OFFIRE UNDERWRITERS V APPLICATION NO. C7/ Y 7l 01-ct,c-d P"- LOC T10N DA E INSPECTOR FORM IBD(REV.I/86) TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12804- TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST F R INSPECTION RECEIVED NAME Z�GU1 la O _ LOCATION O1aycA 1'r�, DATE q 4 J 1 PERMIT # Pt (p )f • APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DrMP-PROOFING / ' BACKFILL APP OVAL' ROUGH PLUMBI G ' • FRAMING • / ELECTRICAL ROUGH-IN / INSULATION: \ \ / FOUNDATION / FLOORS \ WALLS \ �/ CEILING �'`. FINAL INSPECTION: / CHIMNEY HEIGHT ,`''s,, ROOFING / SIDING / tV EXTERNAL PORCHES/STEPS', STAIRS-CLEA 2ANCE & RAILS 1/ PLUMBING F/ XTURES/RELIEF VALVE q/ INTERIOR/TRIM/PRIVACY DOORS 1/ FINISHED FLOORS GARAG FIREPROOFING DOOR CLOSER(S) SMO E DETECTORS • FINAI' ELECTRICAL INSPECTION L/ FINAL APPROVAL OF CONSTRUCTION ' • Z/ A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: //�� it-t- , Y�DRS 6.4-f)fo4f- �LL K6 e cHEu y- B Ofv,,i3c_Y To & ,L,-n -t'E , • ,� // /� LE C•r8i c,9c_ •,L-nrs pc2�T7v2t, �ssc�e 0-/ ��/ . 6K To Uee.,-me.,.c. ee:2%• 4 INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12801 /11/77 TELEPHONE (518) 792-5832 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED /. U' NAME -- - - .l9C LOCATION ,, r,7/ 1 / (cl((ht 4� ) DATE /�- PERMIT # (hr- (.2e APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BAC1CFILL APPROVAL UGH / PLUMBING ''u V FRAMING \ ELECTRICAL ROUGH-IN INSULATION: \\ FOUNDATION FLOORS WALLS ��� )0.� V � CEILING ' ) 2 I5G� FINAL INSPECTION: .i ` CHIMNEY HEIGHT >f` ROOFING .4, SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCE &,,RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY 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: (1 INSPECTOR _town of Queeniarj BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAMEk.,c\E.,aS L L� LOCATION aciAcuu> DA `1 R . Date \ I\-2-1 / 0° Permit No. Op - -vim * * * * *' * * * * * * * * * * * * * * * * ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation\ / Waterproofing / Backfill \ / gaming \\ / Roofing \ / Siding \ Masonry Veneer `\ Rough Plumbing / Relief Valves '\, Ext. Porches \/ Finished Floors / \ Interior Trim / \ Stairs & Railings / Cellar Drain Tile / Concrete Floors 1 \ Plbg. Fixtures / Gar. Fireproofirfg Door Closers \ Smoke Detectos \ Chimney \ INSULATION:/ \ Foundation \ Floors ` Walls \. Ceiling FINAL E ECTRICAL INSPECTION DRIVEW APPROVAL Final uilding Survey Next scheduled inspection (call when ready) Remarks- . , ,.A, %, Buil ing Instil tor 6/86 and-vl Jown of QueepiAury BUILDING and ZONING DEPARTMENT _ Bay and Haviland Road, R.D. 1 Box 98 . . Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 1 0,e4}`' ,- g&(SCA iE.,h LOCATION ( , DATE /7 /? / G.T PERMIT NO. (0.'1% () '(/ SOIL TYPE - ni),- Loam - Clay . Percolation Test Required? YES - NO Percolation rate - Min/Inch / TYPE of SYST : Absorption fi ld, total length ?-D Length of each trench Depth of trenches • /-BZ. ' • Size of gravel 1i 52 / SEEPAGE PITS{Nutter of) Size- ft. X \ ft Gravel size _ \ / . PIPING: \ / Size Type Bldg. to tank 1.¢ /G/C Tank to dist. box \ 4f a • Dist. box to fiel /pit\ c/ Openings sealed? / ES ' NO Partial i LOCATION/SEPAR4TIONS: Foundation to hank /Alt. Foundation to///absorption ft. Absorption ib lot line /k ft. Separation/of pits `_\ft. Le 4TION 91' SYSTEM ON PROPERTY`'(circle one) ront __Rear - Left side - Right, side - C. i ENTS I SYSTEM USE APPROVE NO Bu .1 g Inspec ' r 01/86 and vl _lown of Queenit ur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME /fit.Qd,6 LOCAT I ONE ��L(� r'� if�. /UO>) DATE AVi/ PERMIT NO. S-6- ,yak SOIL TYPE - and Loam - Clay - Percolation est Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length 6.;2570 Length of each trench cpa Depth of trenches /--4;2 Size of gravel SEEPAGE PITS{Number of) • Size- ft. X _ ft. Gravel size • PIPING: Size Type Bldg. to tank Y Tank to dist. box 414 11 Dist. box to field/pit f LI Openings sealed? 4011P NO Partial LOCATION/SEPARATIONS: Foundation to tank /02 ft, Foundation to absorption ola ft. , Absorption to lot line /Q ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle 'one) or1t)- Rear,.•- Left side Right side - COMMENTS: SYSTEM USE APPROVED ES • B i g n ector 01/86 and vl awn of Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCAT I ON ‘9A 77 Date( / /�� Permit No. (O lr>"( * * * * * * * * * * * * * * * * * * * * * * * = APPROVED YE / NO L—Fo t ng/Pier Forms .i/ Foundation Waterproofing Backfill j 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 FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection (call when ready) Remarks- R76 /0 7ecia - '/ S.Secr 4&)1-/e- t'1 /47j Building Inspect 6/86 and-vl 170. S 7\1 ' . i i i i { • • n . n1 ; f N -1 i ' j -. CI i . { I ( ,VI, • { 1 ai a i I o I . • 9) No as G. . 'fog LL '6u Z \*' 6wRp6E i. ! — — �,�1 . 1 • 9 tab 1 LoT" - 77 s -yt)y 4�i1( fr kL;h�/ 0RC..Ht}F-D TDR‘V1=- • booGh-i- 4-TActct� 792-5?ro1 LL1=0.Cr..:i 1 IZ