2006-677 ../ . TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
dab
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20060677 Date Issued: Wednesday, March 25, 2009
This is to certify that work requested to be done as shown by Permit Number P20060677
has been completed.
Location: 83 GLEN LAKE Rd
Tax Map Number: 523400-288-020-0001-013-000-0000
Owner: GIUSEPPE & ANNA CHIARAVALLE
Applicant: GIUSEPPE & ANNA CHIARAVALLE
This structure may be occupied as a:
Fireplace By Order of Town Board
Garage - 2 Cars Attached TOWN OF QUEENSBURY
Single Family Dwelling
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, y
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Fir.. • .17
Community Development- Building &Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060677 Application Number: A20060677
Tax Map No: 523400-288-020-0001-013-000-0000
Permission is hereby granted to: GIUSEPPE & ANNA CHIARAVALLE
For property located at: 83 GLEN LAKE Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information9I ereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zo 'i
Ordinance. Type of Construction Value
Owner Address: GIUSEPPE &ANNA CHIARAVALL
337 C.t •, • 1 • , Fireplace
L• 4 GEORGE NY 12845-0000 GSin gge-2 Cars • 'i hed
le Family Dling $450,000.00
Total Value $450,000.00
/
Contractor Builder's Name/Ad• ss t ' 1 Ins re Age.-
RICHA POCK
37 ORCHARD r
OUEENSBUR NY 1280
Plans &Specifications
2006-677 83 Glen Lak Road /A e George, NY 12845
2812 SQ FT SINGLE F IL DWELLING, 705 SQ FT ATTACHED 2 CAR GARAGE AND 1
FIREPLACE
$407.94 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday, October 25, 2009
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the TQuee ury + .;nes i ay, October 25, 2006
SIGNED BY t," >etAr ft-stf)
for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
Mi
742 Bay Road,Queensbury NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060677 Application Number. A20060677
Tax Map No: 523400-288-020-0001-013-000-0000
Permission is hereby granted to: GIUSEPPE &ANNA CHIARAVALLE
For property located at: 83 GLEN LAKE Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with .r.lication together with plot plans and '.t - ;f ormation hereto filed
and approved and in compliance wi • e S Uniform Building Codes and t - f eensbury Zoning
Ordinance. Typr instruction Value
Owner Address: GI . EPPE ANNA CHIARAVA`L
/57 CANAD St / 1 Fireplace
KE GEO GE,NY 12845-000 Gat-age-2 Cars Att. ed
ogle Family D ,elling
('\ Total Value $450,000.00
Contractor or Builder's Nam / ddress ` Elect-.cal Inspection Agency $450,000.00
RICHARD PENNOCK
37 ORCHARD Dr
QUEENSBURY, NY 1280
Plans &Specifications
2006-677 83 Glen Lake Road, Lake George, NY 12845
2812 SQ FT SINGLE FAMILY DWELLING, 705 SQ FT ATTACHED 2 CAR GARAGE AND 1
FIREPLACE
$407.94 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, October 25, 2008
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration pte1)
Dated at theIf6cpn oeu �,'.,nesday, October 25, 2006
SIGNED BY c/ for the Town of Queensbury.
Director of Building&Code Enforcement
.4.00k4 TOWN OF QUE E NSBURY
742 Bay Road,Quccnsbuiy,NY 12804-5902 (518)761-8201
IF.r.. • ..y
Community Development- Building &Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060677 Application Number: A20060677
Tax Map No: 523400-288-020-0001-013-000-0000
Permission is hereby granted to: GIUSEPPE & ANNA CHIARAVALLE
For property located at: GLEN LAKE Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: GIUSEPPE&ANNA CHIARAVALL
337 CANADA St Fireplace
LAKE GEORGE,NY 12845-0000 Garage-2 Cars Attached
Single Family Dwelling $450,000.00
Total Value 5450,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
RICHARD PENNOCK
37 ORCHARD Dr
QUEENSBURY, NY 12804
Plans &Specifications
2006-677
2812 SQ FT SINGLE FAMILY DWELLING, 705 SQ FT ATTACHED 2 CAR GARAGE AND 1
FIREPLACE
$407.94 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, October 25, 2007
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensb/ before the expiration date.)
Dated at the Tow(of Qyie nsb ,� /. :-. 1,, October 25, 2006
c r
SIGNED BY .. for the Town of Queensbury.
Director of Building&Code Enforcement
Community Development Office
Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 pbt.ems Stamp
Marilyn Ryba, Executive Director• David Hatin, Director of Building&Codes LJ
Craig Brown, Zoning Administrator•Michael I. Palmer, Fire Marshal
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building &Codes Office for the issuance of a Building & Use Permit
pursuant to the New York State Fire Prevention & 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.
IMPORTANT NOTE TO APPLICANT: ROUGH-IN" AND FINAL INSPECTIONS ARE REQUIRED.RE
OWNER: �ji) SSS/ 1 �,//,4IL/�.��4 INSTALLER/BUILDER: '7_f 2 /G � r j v/1
ADDRESS:/v/4' if (DDRESS: �-C U r � S -41-1( 7 f
PHONE NOS. '2 0 — C-"6 PHONE NOS.
LOCATION OF PROPERTY: az c.4/ h! SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION:
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE:
✓ FUEL BURNING APPLIANCE WOOD COAL PELLET GAS OIL
INFORMATION
STOVE
FIREPLACE INSERT
FIREPLACE,FACTORY BUILT* !�
FIREPLACE, MASONRY
FURNACE(GARAGE ONLY)
*IF FACTORY BUILT,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
LISTED BY: NUMBER:
QUESTIONS?
CALL 761-8205 or 761-8206
CHIMNEY INFORMATION BLOCK BRICK STONE OR EMAIL:
firemarshal anqueensbury.net
MASONRY** CHECK ONE ✓ VISIT OUR WEBSITE
TILE STEEL SIZE:IN. FOR MORE INFORMATION
•
INCHES www.queensbury.net
FLUE CHECK ONE ✓
DOUBLE TRIPLE WALL INSULATED DIRECT VENT CHIMNEY
WALL LINER
CHIMNEY MATERIAL CHECK ONE ✓
**IF NON-MASONRY, PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION &BUILDING CODE AND/OR
MANUFACTURERS REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED
INSPECTIONS.
C6 77
-TOWN OF.QUEENSBURY ._
-IIG HWAY Richard A. Missita
Highway Superintendent
DEPARTMENT Home(518)798-5127
742 Bay Road *Queensbury, NY. 12804 Michael F. Travis
Deputy Highway Superintendent
Office Phone: (518) 761-8211 (518)798-0413
Fax: (518) 745-4466
DRIVEWAY PERMIT
DATE:
APPLICANT NAME: /
TELEPHONE NO.: -
ADDRESS TO BE INSPECTED: a
RETURN ADDRESS: MEI=
Applicant must show exact location and width of driveway(s) to be connected to the highway by
placing stakes at the specified location.
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The
following action has been taken:
S I EP 1: ( ) Preliminary Approval
NEED: ( ) Slight swale
( ) Level with the road
( ) Deep swale
Size pipe to be used (if necessary)
( )12" ( )15" ( )18" ( )24" ( )36"
Preliminary inspection completed by DATE
Approval by Highway Supt. Deputy Supt
Upon completion, please resubmit this approved permit for a final approval.
S I EP 2: ( ) Final Approval
( ) Rejected
DATE:
Richard A. Missita, Highway Superintendent
E-mail:highway@queensbury.net
OFFICE USE ONLY
7'
2
TAX MAP NO. � '
�r� 11/ PERMIT NO. a (€:.) � .i l ti;',
FEES: PERMIT / 7 RECREATION ENGINEERING ��,
-j Zpr4e-c. (If applicable) 3 P
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION.APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUAN('c (' A VALID PERMIT FOR CONSTRUCTION. r ( -�aJa1��
APPLICANT/BUILDER:Jf°Gj �4,/IJ OL.i /� C v 't
OWNER:coc,�.S£`oP�' w I#4�F►'J/rUc.c
ADDRESS:3 _ ORCd1Q-_ a____. ADDRESS:
��PHONE NOS. 7Zf
0121'
/7y,3,, i �S.--Z PHONE NOS.
7,s(57
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE:A /! C b-4 PHONE:
4..1.9'
LOCATION OF PROPERTY: C�,_ tA) 1,A t4).c._ AP(
SUBDIVISION NAME:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT Z
APPLY TO YOUR z o IX cC g 0
PROJECT o o w
o w _ E � L w Q a = =
l- u. _ O C2 z
z Q Q i- CO NCO Ouu_ O � a. = ots
SINGLE FAMILY 25 / ..7
2,4>/.7 •
TWO-FAMILY
tSI) '-- 4
MULTI-FAMILY (it ,51 /31,
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE /� --�
FACTORY OR f
INDUSTRIAL /, )
ATTACHE7 V
GARAG 1,)\.:,),41 /
.7°4 Sc' ' 4 4 0 1 .7 .z/
. 7/OTHER '
(..___________________________________,.
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: A ` 0 / ♦e __ FUEL TYPE: ,/#5-
HEAT TYPE: RAD,.v xw-v-
HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS a THIS SITE? tt)J
IS THIS A HISTORIC SITE? Ad
PROPOSED USE OF BUILDING OR ADDITION: /Jc)fit e-
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
B 3-LGL l l-05
ta, Town of Queensbury• Communihy Development Office • 742 Bay Road, Queensbury, NY 12804
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? IJ
ARE THERE EASEMENTS ON PROPERTY? 0 0
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above.
Signed !}�
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction
codes or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
‘ (\-4 .--- 5,4._) -
B DI G &CODES APPROVAL ZONING APPROVAL
c;2
DAT DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codesaqueensbury.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury,net
s:., . Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
OFFICE USE ONLY
TAX MAP NO. PERMIT NO. C/i:J —(j73ERMIT FEE
APPROVALS: ZONING
TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT;
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. /
OWNER: Or: SE//t C_ �t.9,L/LJpsi44' INSTALLER: 11 'c,�A Pf.v�J��L.0 Ste--
�ADDRESS: QST Zr' f fd+efl ADDRESS: & 6`f -�L2 �� z ✓ � ��}AA.rv�.?� (
PHONE NOS. 7- ..7, ? PHONE OS. -2 TY- P 3D o
LOCATION OF INSTALLATION: Ct... f-) 1.....4/1" Q
YEAR BUILT ! i RESIDENCE INFORMATION:
BEDROOMS X } COMPUTATION= = ` TOTAL DAILY FLOW
•
1980 or older I X 150 gallon per bedroom s I GARBAGE GRINDER
_ I INSTALLED?
1981 -1991 I X 130 gallon per bedroom : = i I
resent i a ? 3 SPA OR HOT TUB
1992-
P } i X 110 gallon per bedroom = INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING K STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL V. WELL
•
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH (TEST TO BE
COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by
a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). Add 250
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
✓ SEPTIC TANK: /071-4? GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH 3? FT.
✓ TOTAL SYSTEM LENGTH: /S FT. SEEPAGE PIT(S): HOW MANY?
SIZE OF EACH 7 ' FT. X / 1r FT.
✓ SIZE OF STONE TO BE USED: # dL /DEPTH OR THICKNESS /r2 rr FT.
✓ BED SYSTEM SIZE: X
✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
✓ HOLDING TANK SYSTEM:(If required) NO. OF TANKS: /SIZE OF EACH
✓ GALLONS. /TOTAL CAPACITY• GAL.
I NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. i`
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any
permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or
failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void,
I have read the regulations with respect to this application and
agree to abide by these and all requirements of the Town of QUESTIONS? CALL 761-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. codes@aueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburY.net
Signature of Person Responsible Date
114 Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 322
/ .
•
NAME: / orAVAlif.
LOCATION: 23_77At_ t
PERMIT#: 7/7/.
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has been:
Craig Brown, Zoning Administrator
•
Notes:
•
L:\SudHemingway\Building.Codes.lnspection.FORMS\Final Survey
Zoning Administrator.doc
WiWASUMON"'
/ --S Ci /i'-
Queensbury
Building & Code Enforcement - Resid ial Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart:2 " 3U am/pm
Date Inspection request received: inspector's Initials:
NAME: L/C� PER IT#. . 6 - .......
LOCATION: (- a1I DATE: -
TYPE OF STRUCT E: -- -V-1)
Comments:
Ye No N/A
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches C"
Roof Complete/Exterior Finish Complete
Platform at all exterior doors V/ . _ CJ\�c_ `�Zj �
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade V
Guard at stairwell at 34 inches or more C— 1/`"'
Guard at deck, porches 36 inches or more
Handrail Termination at Newell Post or Wall V ,
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 8 inches with 10 feet �� ,' ,,� 7._
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy I trim I doors I main entrance 36 inches
Bathroom/Kitchen watertight
Safe •lazin_ /WI dow in stairwells s-fe •l- in•
Interior Smoke 6' ectors/ arbonM•• oxid: Detectors
Every level: Ev Bedro• : �_ /
Outside every bedroom rea: �//
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area /
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents r/
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification //
Floor truss,draft stopping finished basement 1,000 sq.ft. v
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site / /
Oil Furnace shut-off at entrance to furnace area / �/
Furnace/Hot Water Heater operating u /
Low water shut-off boiler �/
Relief Valve(s)installed/Heat Trap/Water Temp 110 v /i.
y.
Enclosed Stairs Sheetrock Underside minimum 1/2"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched /�
Garage fireproofing/%hour fire door/door closer �/�
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical I.LI-0-1.5e). V
/ .
Final Survey Plot Plan7
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker /
Site Plan /Variance required 1/
Flood Plain Certification,if required /
Okay to issue C/C or C I 0[Temporary/Permanent] 0..1}
L:\Building&Codes Forms\Building&Codes\lnspection Forms\Residential Final Inspection Form_revised 100405.doc; Revised
January 7,2008; Revised 6/26/08
? i/ ��c l(10co
Queensbury Buil ing & Code Enforcement - Re ential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: 10' /)`Jam/pm
Date Inspection request received: Inspector's Initials:
NAME: .. ,k 6 PERMIT#: �, ` • .
LOCATION: :Varilail �.Jlsi DATE: 1.
TYPE OF STRUCTURE: — .. 71111 •
Comments:
7Yes /A
4" Building Number Address visible from road / PC
Chimney Height/"B"Vent/Direct Vent Location �1 KC r I f _-j
Fresh Air Intake -- Ce ti -
3 inch Plumbing Vent through roof minimum 6 inches / _*
Roof Complete/Exterior Finish Complete \/ 7 -‘-s.- ?viz/
Platform at all exterior doors \/ / ?J i
Handrail 4 or more risers �/ , p/a (,�/ /Z
Guards at stairs,decks,patios more than 30 inches above grade J
Guard at stairwell at 34 inches or more
1oi _ y0 J
Guard at deck,porches 36 inches or more /400r
Handrail Termination at Newell Post or Wall r 'lit
Interior/Exterior Railings 34 inches to 38 inchesC-X 11eci u • /`t€
Deck Bracing/Handicapped Ramp Compliant / ✓ ?
Grade away from foundation 6 inches with 10 feet V � ��� � C�i�ir'/e•-• Sc�- Pf
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade l// h`p �,- so sL`€
Interior privacy/trim/doors/main entrance 36 inches �� rr�d�,- _.
Bathroom/Kitchen watertight
Safety glazing/Win•• in stairwells safeglazing
‘/ = _--.
Interior Smoke II, ectors/Carbon M oxide ectors ��
Every level: Every Bedroo : / V r, ) -- lCFIZ_\i`
Outside every bedroom arc: / ���Zs:J � �-� _
Inter Connected: , /Battery backup: ���,,,///_
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area //:
\ �',_,-
IC v �
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents / �u Y ' �
Bathroom Fans, if no window 't /V
Plumbing fixtures �/ I
Foundation insulation I Insulation Certification AO �` Th;may`
Floor truss,draft stopping finished basement 1,000 sq.ft. Dtrio ,,,
Emergency :•ress below grades —
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area V
Furnace/Hot Water Heater operatingA - o-P. {v'"
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 40e� `'F- i..- t7c
Enclosed Stairs Sheetrock Underside minimum'/:"Gypsum 9 ' �
Basement stairs closed rise>4 inches
11; -yv
Garage Floor Pitched
Garage fireproofing/'/.hour fire door I door closer f, �,L�. �-1��
Ductwork Sealed properly :'�,. '� „ , �, ti,� 3�
Gas Logs in Sealed or Glass Enclosure _ ,+/ j:(n.
Final Electrical \.\ 1
FArcauSurvey Plot Plan / 1
Arc Fault Breaker in Bedrooms �`
Flex Gas Pipe Bonding � ��l
As Built Septic System/Sewer Dept. inspection Sticker \[ "1
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C I 0[Temporary/Permanent] 0 ----------
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008;Revised 6/26/08
INSPECTOR'S REPORT
Dept. of Community Development
Building & Code Enforcement
Town of Queensbury (518) 761-8256
742 Bay Road
Queensbury, New York 12804 -1#0
Date: 8 ,-221/4-\0-e-e)
Property Location: B3 _
Owner/Tenant: (%4QZi ^-
BUILDING — SEWAGE SIGN
OTHER
1
REMARKS: Tax Map No.
L 1
CONTACT THIS OFFICE WITHIN
Building Inspector
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: C-V-At I `ZAV A-1•44 PERMIT#: OCQ
LOCATION: Pi ) (49 L- �,, L 12�'� - INSPECT ON: A ` k,
TYPE OF STRUCTURE: S� — 1
Comments
Y N N/A
Footings
Piers "� -l� C
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezi g
for 48 hours following the place ent
of the concrete. �C \f
Materials for this purpose on site.,
1)`` ,-r-e__ 1
Foundation/Wallpour
Reinforcement in Place 01 eN M.' `1
Footing Dowels or Keyway in place ' � i :
Foundation Dampproofing �_SX
Foundation Waterproofing
Footing Drain Daylight or Sump S01)
Footing Drain Stone: ����` —
12 inch width r V->P z1K r., /
r �
6 inches above footing �� �-`
6 mil poly for wet areas under slab J Vs✓i .—....
Backfill Approval �--
Plumbing Under Slab
PVC/Cast/Copper r1 �
Foundation Insulation Interior/Exte '•r
R- — B-zC71
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
T- ii
. 74,5-707
Inspection Report
Plumbing I Insulationp
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm Depart: C' °.T a In/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: _4_, 9
NAME: arlargivalf,e, • PERMIT #: 400FLOCATION: SS 3 fit, A kt go( . INSPECT ON: , 0-.
TYPE OF STRUCTURE: ' -�
Y N N/A 7 Is 1 i.
Rough Plumbing / Nail Plates
Plumbing Vent/ Vents in Place •/- ) Sirrcic
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I change of direction
Pressure Test C
Drain / Vent
Air / Head
5 P.S.I, or 10 ft. above highest connection for 15 minutes -. 1)\A-1 (-17--r' '
Pressure Test
Water Supply Piping
ead ' '
l
50S�I t�J 15 minutes . .
e,
�
Insulation / esidential Check / Commercial Check (,147(.. '<R_ ,
nt Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace R-2- t
Duct work sealed properly / No duct tape 0,--k,_*-5
o
---
COMMENTS: i2%. �..`� <�j / CU �� L <,��G ecu
! "`�\cL�� cv
,0---moi- t-m t69 i -L _
ei,N.45z-, �',,,,_3-1 “..0- __,\-2,1,, 4 ,\s5 -�
— �. �, ca t
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L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Numbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
/2j/27 cZ _ :.
Rough Plumbing / In;ation Inspe tion Report
Office No. (518) 761-8256 [nspection request received: 7 Z—'
Queensbury Building & Code Enforcement rive: am/pm Depart: OP am/pm
742 Bay Road, Queensbury, NY 12804 ;pectoris Initials:
NAME: L �R - PERMIT #: 1 J t 7
LOCATION: ala INSPECT ON: a'
TYPE OF STRUCTURE:
Y N N/A
Rough Plumbing / Nail Plates
Plumbing Vent / Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout eve 100 feet / change of direction
Pressure Test
Drain / Vent
Air/ Head
5 P.S.I. or 10 ft. above highest connection for 15 m:es
Pressure Test
Water Supply Piping
0 P.S. or 5 minutes
Insulation 'esidential Check / Commercial Checl
Piro p- rent, Attic-Vent
eruct/ Hot Water Piping Insulation
If required unheated s.aces
Combustion Air Su..l for Furnace
Duct work sealed 'roger! / No duct ta•e
COMMENTS: D -ARRA---t Fet3t-dc,-rokcarz-€--
1.
L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
""4 \ 0-0 . •••••
Framing / Firestopping Inspection Report
Office No.(518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p part \Zc0 am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: /'
NAME: t. 2 ('" '�- PERMIT#: / '~ ,
LOCATION: - RZ INSPECT ON: OM ,.
TYPE OF STRUCT
Y pa/A_ COMMENTS
Framing
Attic Access 22"x 30"minimum
Jack Studs/Headers eR,C"\tteV/��
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly i _ ` L r'
12"O.C. �� �
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate 6K_ � I
1 'A(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1,2, 3 hour
Fire wall 2, 3,4 hour V
Firestopping _
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side ''A inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in.(W)
5.7 sf above/below grade
5.0 sf grade
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Ins ectio request received: (214
Queensbury Building&Code Enforcement Arrive:2\ am/pm Depart:7W am/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:/)
NAME: (`� I t RA PERMIT#:
LOCATION: �9 dt-3 1 R ) INSPECT ON: p3---/
TYPE OF STRUCTURE:
Y N N/A COMMENTS
Framing
Attic Access 22"x 30"minimum `Ft--1Z-
Jack
Jack Studs/Headers (1,)
Bracing/Bridging
Joist hangers o "ChA C _
Jack Posts/Main Beams
Exterior sheeting nailed properly �~ f�
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in. P
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate Vr\-Lti 95 ¶W
1 'A(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft.floor trusses `
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall -k At--xt=
Fire separation 1, 2,3 hour t: -0.,'1/4 -+ -�-S '-'
Fire wall 2,3,4 hour
Firestopping v
Penetration sealed a0)
16 inch insulation in cavity min.
Garage Fire Separation 4 ``\\
House side I/2 inch or 5/8 inch Type X - .� !" - �"A -
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms I 's
24 in. (H) ¶ tt4tc <)
20 in. (W)
5.7 sf above/below grade v' , '" �-
'g
5.0 sf grade �y��
1 -
t,
Rough Plumbing / Insulation Inspection Repo
Office No. (518) 761-8256 Date Inspection request received: c
Queensbury Building & Code Enforcement Arrive: am/pm Depart: a am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: okAk)
NAME: C/1-� i(2, 4 vA I t -c- PERMIT #:
LOCATION: ' 6---L4,-) Z./V--c- itc f INSPECT ON: 17111/
TYPE OF STRUCTURE:
.122eY N N/A ch ec k
Rough Plumbing / Nail Plates VC_
Plumbing Vent / Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction
Pressure Test
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head
50 P.S.I for 15 minutes
Insulation / Residential Check / Commercial Check _
Proper Vent, Attic Vent
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape
COMMENTS:
L:\Pam Whiting\Building&Codes\Inspection Formts\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm D art: �I_ am`.m
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:ej/LA� `any
NAME: its ii vx 0 c M V3/) ERMIT #: � "67
LOCATION: g3 (tom L ,a k e (t-)_ INSPECT ON: BY
TYPE OF STRUCTURE:
VN N/A
*Rough Plumbing / Nail Plates
Plumbing Vent/ Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction
Pressure Test
Drain / Vent ���
Air / Header
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test 6
Water Supply Piping
Air / Head
50 P.S.I for 15 minutes
Insulation / Residential Check/ Commercial Check
Proper Vent, Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Air
Combustion Supply for Furnace
b pP Y
Duct work sealed properly / No duct tape
COMMENTS:
L:1Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report-revised Nov 17 2003.doc Revised February 15,2005
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: (-0// �•'
Queensbury Building & Code Enforcement Arrive: am/pm Departam/pm %
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ._6 . /
NAME: Chlravolle_. PERMIT #: o 6 — 77
LOCATION: ,'.3 Glen 1 /jam INSPECT ON: 6//3/U (0
TYPE OF STRUCTURE: 6F6
9 4 x/44(
Y N N/A
Rough Plumbing / Nail Plates
Plumbing Vent/ Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet / change of direction
Pressure Test 6
1\) (3Drain / Vent
Air/ Head _
P.S.I. or 10 ft. above highest connection for 15 minutes elz)(35 .
Pressure Test
Water Supply Piping \/
Air / Head -4A)--t---
50
._50 P.S.I for 15 minutes
Insulation / Residential Check / Commercial Check _ A--a'
11
Proper Vent, Attic Vent i'gtik-k),'('
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS: c ` k, kD-
-1/41 . C7 ' ---. (._ (/--(- L-Q-FN)
L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received: &' //
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
NAME: 0 G. a h l,A rG`" ✓a l/ PERMIT#:
��r 6 6.- 77
LOCATION: 03 & /en Lr,_ INSPECT ON: (1//L0-7
TYPE OF STRUCTURE: ,k-r,
Y N N/A COMMENTS
rmng
Attic Access 22"x 30"minimum //
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams 5�
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls `-KK C2
Metal Strapping for Notches Top Plate
1 '/(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1,2, 3 hour ¶ cf
Fire wall 2, 3,4 hour
- � �
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side Y2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
Rough Plumbing I Insulation Inspection Repoil(i
Office No. (518) 761-8256 Date Inspection request received: .5
Queensbury Building & Code Enforcement Arrive: am/pm Depart: 4,4a
, am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: Mck ( Gyee PERMIT #:
LOCATION: R/('fl AC /fir /0 INSPECT ON: 1 o�
TYPE OF STRUCTURE:
Y N N/A
V'Rough Plumbing / Nail Plates
Plumbing Vent/ Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction
Pressure Test
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head
50 P.S.I for 15 minutes
Insulation / Residential Check / Commercial Check _
Proper Vent, Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS: rka.14A)
I
VQ i i
L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
fi/o/ -- 4//z:361
Rough Plumbing / Insulation/Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/p Depart:313E9. am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: C11 a qkifik_ PERMIT #: (3C77
LOCATION: /sac - /!. 6?) INSPECT ON:
TYPE OF STRUCTURE:
Roughumbing / flail Plates
s V- • Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet / change of direction
Pressure Test INK-71
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head •
50 P.S.I for 15 minutes
Insulation / Residential Check/ Commercial Check
Proper Vent, Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS: Q, /Cf L V`� ) v -4 ®
&O"A"-_ 1--z2TAA)-1
L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003,doc Revised February 15,2005
- z/?/7
V Framing/ Firestopping InspectioniZeport
Office No. (518)761-8256 Date ction quest received:
Queensbury Building&Code Enforcement Arrive. , am/pin Depart: _ am/pm
742 Bay Road,Queensbury,NY 12804 Inspect 's Initials:---117--C--"
NAME: f C�l/�/L �C • PERMIT#:
LOCATION: - P., - INSPECT ON:
TYPE OF STRUCTURE:
Y N NIA COMMENTS
Framing
Attic Access 22"x 30"minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate r lam/
1 Y2(w) 16 gauge(8) 16D nails each side '13.4. 1)(
Draft stopping 1,000 sq. ft. floor trusses
neB . or less on center
Ice and water shield 24 in• es from wall
-• - - .. . ion , 2, 3hour
Fire wall 2, 3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min. I
Garage Fire Separation
House side 1/2.inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade �
5.0 sf grade
Framing/ Firestopping Inspection Report
Office No.(518) 761-8256 Date Ins ectt}',o,n Lsquest received:
Queensbury Building&Code Enforcement Arrive: .6..I-am/pm Depart am/pm
742 Bay Road,Queensbury,NY 12804 Inspecto s Initial '�
NAME: OA.i r IPERMIT#: �/�"� 77 •
LOCATION: 3 �-,/ ,c—� -e � INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A COMMENTS
Framing
Attic Access 22"x 30"minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 V2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft. floor trusses
c • :0 `. • s on center
Ice and water shield 24 in• es from wall
.-.. . •. , hour
•
Fire wall 2, 3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side Y2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart:''_z. r am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: 6 - l
NAME: " PERMIT NO.:
LOC""`/ INSPECT ON:
CHECK:
Comments and/or diagram
Soil Type: Sand/ Loam / Clay
Type of Water: Municipal / Well Water
Waterline separation distance ft.
Well separation distance ft. 12.c,
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft. r4F'(-4
—
Size of Stone
Seepage Pits: Number
Size: x ...
Stone Size:
tri'
Piping Size Type
Building to tank Y3 L-k Chi) ✓� '�' �, acs
Tank to Distribution Box y vim'
Distribution Box to Field / Pit
Opening Sealed: Y Partial
End Cap
Inlet/Outlet Pipes &Baffles Y N 'CP#501
Location/ Separations
Foundation to tank / Zr ft.
Foundation to absorption . _?Z- ft.
Separation of Pits A ft.
Conforms as per Plot Pla Y Y N
Engineer Report and As-Built Y._.._.,N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
-m U - tatus-
Approved
Y Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05
'S - 4 —
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received: i i 2 0
Queensbury Building &Code Enforcement Arrive: am/pm Depart: - *'''i am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ![ •
NAME: Gt �rd+4\4l- PERMIT NO.: Er� C
LOit. P'Zt
►; ` rt/-rL4-'-ce . R{ INSPECT ON: �li
digESO
C. _____.j Comments and/or diagram
Soil Type: band) Loam/ Clay
Type of Water: Municipal / Well Water
Waterline separation distance _ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ftft. � ,�j�
Depth of trenches �'L�.v
Size of Stone
Seepage Pits: Number
Rif4r-C2C) --
Size: x-^- ---
Stone Size: ")
Piping Size Type `� per' t
Building to tank t l 4 ` �� -�c��
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: Y/ N/ Partial Gl�_ '- ij 1�Lt
End Cap C- _.
FLa--.-/,,i) .__
Inlet/ uti Pipes&Baffles N
‘i
Location/ Separations .(- V-4--3-2,31/4
_Foundation to tank ft. ) J. 34 _. )
�'�-�
Foundation to absorption ft. i � "
Separation of Pits _ _ft. !�
Conforms as per Plot Plan Y—N "�
Engineer Report and As-Built T Y^N r1 Q LA-)- -9 Y? "---A-+�7
Location of System on Property:
Front Rear Left Side Right Side )
Middle Front Middle Rea -_____------
/
S -mU - .: .
Approved
V Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05
Ij<- s rim-" ��..�.- - -
77.1USD 1`, i1110
Septic ns ion fie
pest port
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: ' !!r 1:_am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: (i tvtlJ I� 1i'
NAME: pir---Lxidi,_,,r` vk PERMIT NO.: 0 —R� -
LOCATION:6j �- / .- • INSPECT ON: '' r
-'�RECH ,
Comments and/or diagram
Soil Type:/50,40.Loam/Clay rs
Typeof Water:i Munici 1j Well Water; i ; - ` r r
arline separation distance ` ft. t) f>� �� k�:�,-j.�:--2..�
Well separation distance t ft. y\JC'gl,ft. r ) �_. s ...\C`1 Cj, �-t--i.f-)
Other wells: •
Absorption Field: Total length � ` , '/ -k- j v.',, j c
Length of each trench ` ft. �.� o!!�� N E
Depth of trenches 1„... ft. `2�'% "-'0•J \ 1 f c' --
Size of Stone `i r' ` �
Seepage Pits: Number )1 IY_ r,-- � t` 'f ,ry { v ri- E.-E.
Size. x 11c N ,r.
Stone Size: o,:t.-A---Ia' )
Piping Size Type
Building to tank -" *1:•/1-11---1) j-
Tank to Distribution Box �•,�" ;r jE' ��,
Distribution Box to Fiel / Pit i j i` S 3r
Opening Sealed: Y Pa ial
CLQ/ •
End Cap ____
I
Inlet/Outlet Pipes&Baffles __Y,. 11
N ,__— 1
Location/ Separations k)(. - ' '-
_Foundation to tank /7• ' ft. '
Foundation to absorption . . .� ft r� ;Cin
Separation of Pits i\v i;i- ft. r,,J ��iit,
Y
Conforms as per Plot Plan _ A N , t-
Engineer Report and As-Built Y ''. N
Location of System on Property: �____
Front Rear Left Side Right Side 1.4 (.:.l ,;,:-1:. r c_..._ ! Q.--k. —
Middle Front Middle Rear
S emU - •.. s:
Approved ----- _
:J-PartlatApmved and needs to be re-inspected, please call the Building &Codes Office
Disapproved ...______-- '_
L ,A-1„ti, 1--014, R.,,,,--, -__ ,_,A .11.:- (_1---(-_
Last revised 021006
Last revised 1/6/05
-- '1
s!.( Foundation Inspection Report , /
PO I
^ ,,
dd
Office No. (518) 761-8256 Date Inspection request received: ►v L lit < 3 - v g-
Queensbury Building&Code Enforcement Arrive: _am/pm Depart: ! f '4icamlpm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 1 Jin
NAME: On l G ir-C,Ii PERMIT#: (e"(4077
LOCATION: r INSPECT ON: U 13 c.).(wC,..
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg //
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 nu ly for wet areas under slab
(BacJixkroval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
I
P Po
Office No. (518) 761-8256Date Ins ectionuest received: I 1/c(cirnaj
Queensbury Building&Code Enforcement Arrive: 2 am/pm I Depart: pm
742 Bay Rd.,Queensbury,NY 12804 Inspec or's Initials: J
NAME: C1 13 1 A g-P‘14 PERMIT#: U�Q ` 4-7 7
LOCATION: L (24-‘ L 4►L i2- . INSPECT ON: ( jj UC
TYPE OF STRUCTURE: l
Comments
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
'oundation/Wallpour
Reinfor - in Place
Footing Towels or Keyway in place
Foundation I ampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
-/o 44aubArk-7 /off
Foundation Inspection Report
Office No. (518)761-8256 Date Inspectigwr uest received:
Queensbury Building&Code Enforcement ArriveQ /' _am/p Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspectdr's Initials( J
NAME: L PERMIT#: —�j 77
LOCATION: le� �� _ INSPECT ON:
TYPE OF STRUCT :
Comments
Y N N/A
Footings '
Monolithic Slab v 7 ` �'47)
Reinforcement in Place Z iV '
The contractor is responsible fol
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofmg
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Bullding&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
21/ . 11/ /06
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: ' /pri De art: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's itials:
NAME: Gln ](� I� / ,„jf( PERMIT#: 06 -677
LOCATION: ( '/€i— ! a-ne. INSPECT ON:
TYPE OF STRUCTURE:
Comments
N N/A
outings
Pie
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
uzier _.
Town of Queensbury • 742 Bay Rd.
Queensbury, New York •12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines. ••
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all objects such as houses, wells, trees, fences, etc of,
shown on this document. I also representti
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SIGNATURE -�� '`
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Total __ - I:�tiTE C
RECEIVE c
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(Area
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cres to JAN 0 3
/ r Center road}
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or nbservec�, or believe __________`�"�
all objects °
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.7:-)acres to Center road �'
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