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2010-107 ..4111" TOWN OFQ UEENSBURY F4ro742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100107 Date Issued: Thursday, September 08, 2011 This is to certify that work requested to be done as shown by Permit Number P20100107 has been completed. Location: 11 CHARLTON Ln Tax Map Number: 523400-308-006-0002-004-000-0000 Owner: BROOKVIEW PLACID INC. Applicant: CLUTE ENTERPRISES, INC. This structure may be oc&tif,VMI:VENTURES, LLC Garage Attached By Order of Town Board Single Family Dwelling TOWN OF QUEENSBURY i Issuance of this Certificate of Occupancy DOES NOT relieve the ,P 41 /1/4/At �, property owner of the responsibility for compliance with Site Plan, `'�" 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 Fiffr,co 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100107 Application Number. A20100107 Tax Map No: 523400-308-006-0002-004-000-0000 Permission is hereby granted to: LUZERNE VENTURES, LLC CLUTE ENTERPRISES, INC. For property located at: 11 CHARLTON Ln 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: LUZERNE VENTURES, LLC 22 SULLIVAN Pky Garage Attached FT. EDWARD,NY 12828-0000 Single Family Dwelling $160,000.00 Total Value $160,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-107 1280 SQ FT SINGLE FAMILY DWELLING WITH 400 SQ FT ATTACHED GARAGE $193.60 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,April 08, 2011 (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 T ee ury -,April 08,2010 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement • 30g, Cj -2 - 4OFFICEUSEONLY TAX MAP NO. PERMIT NO. 20 _,-, /o 7 � I.a,_._.� ,.�n—�r T.w I FEES: PERMIT / L� RECREATION �weENGINEERING r LS ' M R 3 i 2U10 (If applicable) ; ; L — BUILLING & ;.�tal_1�. . PRINCIPAL STRUCTURE: -,...k __y: .._.. .._ APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION. APPLICANT/BUILDER: - ^ - cam ` f '.,LOWNER: ce r-v.estse 7 C....A3\e_ ADDRESS: ( , -( c _\ e_ L( ADDRESS: PHONE NOS. "-/ -/3 "n77 PHONE NOS. CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: Ve., PHONE: 15 0t `t, LOCATION OF PROPERTY: 1\ �,-•cu4 . Lo HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? cES 0 NO IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL: 04`"�;(�J . )().-4 5/1_. Cht/ii--)Lr)-• PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT z APPLY TO YOUR z x a o I-- PROJECT O 00 1.-- w u_ w ow -J U- U- � w -' O = = Z Q Q i- N O F. 0 F- W IX Z I- U. a = 06 SINGLE FAMILY 06 5-7 n-- 1 253 0 02(0 TWO-FAMILY MULTI-FAMILY (NO. of UNITS ) TOWNHOUSE BUSINESS OFFICE RETAIL- MERCANTILE FACTORY OR INDUSTRIAL ATTACHED GARAGE( ) 'S tII LI 00 ,0 0 1 ; , OTHER �i IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: ESTIMATED CONSTRUCTION COST: klco01 COO FUEL TYPE: q a' O B 3-LGL 11-05 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? ARE THERE EASEMENTS ON PROPERTY? c 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 • • ovl• : an as-built survey by a licensed land surveyor of all newly constructed facilif- prior to is'. -nce o certificate of occupancy. I have rea. -nd agree t• abo Signe. 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: BUILDING & CODES APPROVAL ZONING APPROVAL DATE DATE QUESTIONS? CALL 761-8256 OR EMAIL codes(c queensburv.net Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION OFFICE USE ONLY lb) . .---.._,. .._,` ,1 TAX MAP NO. PERMIT NO.20`O/0 ERMIT FEE MAR i 2010 .J APPROVALS: ZONING TOWN CLERK OF OtiL { pp\ i 44fl rluc- r _ 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: �Z�+—rte' ( INSTALLER: > J••� . ADDRESS: ADDRESS: }�a� -� ��J'� C.�/ 7 PHONE NOS. PHONE NOS. �c, TS ft 7 1 LOCATION OF INSTALLATION: k A= LS NO.OF RESIDENCE INFORMATION: YEAR BUILT BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW GARBAGE GRINDER 1980 or older X 150 gallon per bedroom = INSTALLED? No 1981 -1991 X 130 gallon per bedroom = SPA OR HOT TUB 1992-present X 110 gallon per bedroom = -;3‘ INSTALLED? �,o PARCEL INFORMATION: ✓ TOPOGRAPHY: Flat rolling >< Steep slope %Slope ✓ SOIL NATURE: Sand >( Loam Clay Other ✓ GROUNDWATER: At what depth? ✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth? ✓ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic system absorption is ft.) ✓ PERCOLATION TEST: Rate is minutes per inch [MPI] (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). TANK SIZE: \©z D GALLON (MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for each garbage grinder, spa or whirlpool tub. SYSTEM TYPE: ABSORPTION FIELD (WITH NO. 2 STONE) Total length 15o ft. Each trench D. x So ❑ SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size? ❑ ALTERNATIVE SYSTEM Bed or other type? ❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks? NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. 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. 11\ /p-sjZ-- /A r sd QueensburY Building & Code Enforcement - Resid�tial Final Inspection Office No. (518) 761-8256 Arrive: am/pm Depart: 1 1 _ Oam/pm Date Inspection reque r ceived: Inspector's Initials: 611/4.AX) NAME: PERMIT#: _ 10 LOCATION: 1 1�t r 16'1 — (_._v - DATE: 4.. TYPE OF STRUCTURE: Comments: Yes/No N/A 4" Building Number Address visible from road V e Chimney Height/"B"Vent/Direct Vent Location /:,. Fresh Air Intake 3 inch Plumbing Vent through roof minimum 18 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risersIs,,\/- Guards at stairs,decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more V Guard at deck,porches 36 inches or more 1 / Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches 1:1"; Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate V Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy I trim/doors I main entrance 36 inches Bathroom/Kitchen watertight /r Safety glazing/VVinp6w in stairwells safety g 'ng Interior Smoke De ors/Carbon onoxi• Detectors Every level: V Ev Bedr m: 7/ 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 Bathroom Fans,if no window tli":"; 7 Plumbing fixtures Foundation insulation to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification Floor truss,draft stopping finished basement 1,000 sq.ft. 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 Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 V/Enclosed Stairs Sheetrock Underside minimum/2"Gypsum Basement stairs dosed rise>4 inches Garage Floor Pitched Garage fireproofing 1%hour fire door/door closer G •• i r sled or Glass Enclosure aminal lectrical; ergy Saving Light Bulbs 50% Fina u - of Plan Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles ,• Flex Gas Pipe Bonding V As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required y Flood Plain Certification,if required Okay to issue C/C or C/O[Temporary/Permanent I Li) ' L:1Building&Codes Forms\Building&Codesklnspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08; Revised 12/22/10,Revised 04/13/11 Ii i /f ' ^1" Town of Queensbury Fire Marshal 742 Bay Road � ` Queensbury,NY 12804 761-8205/761-8206 fax 745-4437 Factory Built Gas Fireplace/Stove Inspection Report Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's instructions or specifications is allowed. Permit# ft`� Schedule Inspection '1 / "t'1 Time C lani pm anytime Inspector �.M) a Name �, ` , , Address f' ;� ,`,<<1 ` 1 t �'�.� Rough In Final • _ Appliance Manu cturer i-"'ON giSAj Model# C J 3C 1, "1 IA- Direct Vent Factory Built Chimney Flue Size DoubleWall Triple Wall Insulated Yes No N/A Comments Floor Protection G I) p ( 7a Clearances to Combustibles(all sides) 4 Firestop(s) Vertical Chase / Wall Penetration 6 1 s24 Vent Clearances to Combustibles i . Vent/Chimney Termination Chimney height must be 3 feet above roof penetration;2 feet above any combustible construction within 10 feet Gas Shut-Off Valve Combustion Air V Hearth Extension(if any) I Mantel V Height above f/p opening Witness Operation V Tank Placement(if LP) Y CO Detection l/„ CSST Bonding White—Building Dept. Yellow—Customer Pink—Fire Marshal Rough Plumbing I Insulation Inspect.On 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: (,tYc PERMIT#: /(1---/(7 LOCATION: j (1/ INSPECT ON: ; TYPE OF STRUCTURE: Y P1 N/A Rough Plumbing/Nail Plates Plumbing Vent/Vents in Place 1 %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 - - . 0 P,S.l for 1 inutes lation/Residential Check/Commercial Check T • •: •• =r Exterior Sealant Proper Vent, Attic Vent Door/Window Sealed (No Insulation) r/ Duct/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly 1 No duct tape COMMENTS: c'-`k1-)`1•' — Rough Plumbing Insulation Reportrevised Nov 17 2003,revised February 15,2005, revised January 7,2008 C c -r-C S"— 6--t. Framing / Firestopping Inspection Report Office No. (518)761-8256 Date Inspection request received: 2-724 Queensbury Building&Code Enforcement Arrive: am/pm Depart- • pm 742 Bay Road, Queensbury, NY 12804 Inspector's initials: /kT) NAME: ( L ( �, PERMIT#: — 107 LOCATION: c,lti '( L A) , INSPECT ON: kW I TYPE OF STRUCTURE: Ittra ming Y N COMMENTS: Attic Access 22"x 30" inimum ^ \ •---� ,fir Jack '/ • Bracing = ,Ing Joist hangers I- c'..).\.1 Jack Posts/Main Beams V Exterior sheeting nailed properly 12"O.C. Headroom 8 ft. 8 in. Stairwells 36 in. or more Exterior Deck Bracing Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 16(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 wail Fire separation 1, 2, 3 hour Fire wall 2, 3, 4 hour Wapping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side's 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 L:\Buitding&Codes Fortes-OLIABuUding&Codes taspection FomnVFreming FfnstApping lnspedion Report doc Revised January 7,2000 Rough PlumbingI Insulatin ns ec t in Report "' 9 p Office No. (518)761-8256 Date Inspection request received: 271Z-7-/ Queensbury Building &Code Enforcement Arrive: am/pm Depart: i am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: �� NAME: CL r E PERMIT#: 10 -l6 LOCATION: I [ a,7-71-m-m t,, INSPECT ON: AMPT TYPE OF STRUCTURE: -->JA) r , _ Y `' N/A (Tiough Plumbing /Nail Plates Plumbing Vent/Vents in Place V 1 %inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet I change of direction Pressure Test Grain/Vent Air/Heady 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 T @r-$tmilar Exterior Sealant P r Vent�Attic Vent ‘41.Z;Liff Door TWindaw Sealed (No Insulation) Duct/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly I No duct tape COMMENTS: Rough Plumbing Insulation Report-revised Nov 17 2003,revised February 15,2005, revised January 7,2008 Rough Plumbing I Insulation Inspection Report Office No. (518) 761-8256 Date Inspection • r - - •: Queensbury Building &Code Enforcement Arrive: ,i C. •m ' : pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initia -. P' RANT#: I [ —107 LOCATION: I C-WARI " `Pt.iJ I PECT ON: \ —11 TYPE OF STRUCTURE: Y N N/A Rough Plumbing/Nail Plates Plumbing Vent/Vents in Place 1 %inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout eve 100 feet/cha !e 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 I Commercial Check T • Similar Exterior Sealant co gECT1 b Proper Vent, Attic Vent \ • EVTh Door/Window Sealed (No Insulation) O� � Duct/Hot Water Piping Insulation l\) \reCI\ if required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape COMMFNTS: Rough Plumbing insulation Reportrevised Nov 17 2003,remised February 15,2005, revised January 7,2008 oo Rough PlumbingI Insulation In Ction Report Office No. (518)761-8256 Date inspection request ec>lriv" : Queensbury Building &Code Enforcement Arrive: -1Z&L a /- rt: 4j 1,17(arn/pm./-� 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: • (./ NAME: 0,-/_< PERMIt#: //9-/0/- LOCATION: // CAA c/ ,,> INSPECT ON: TYPE OF STRUCTURE: Y N N/A1 Rough Plumbing/Nail Plates Plumbing Vent/Vents in Place P ► 1 %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 , Tyvek or Similar Exterior Sealant - � Door/Window Sealed (No nsulation) Duct/Hot Water F.'•' , sulation ! required un = :ted spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape COMMENTS: Rough Plumbing Insulation Report.revised Nov 17 2003,revised February 15,2005, revised January 7,2008 Final Survey Inspection Dept. of Community Development Town of Queensbury 742 Bay Road Queensbury,NY 12804 Date received: /0-2tc/7 NAME: CAA', LOCATION: // c/IQY'✓/ fr PERMIT#: /D '" /O7 . Final Survey Plot Plan Approved Denied The attached final survey has been received by the Dept.of Community Development. { Upon review the survey has b : Craig Brown, Zoning Administrator Notes: L:\SueHemingway\Building.Codes.Inspection.FORMSWina1 Survey Zoning Administrator.doc MAP REFERENCE SUBDIVISION PLAN MADE FOR HA YES AND HA YES BY., VAN DUSEN & STEVES DATED: JUNE 15, 2007 LAST REVISED. NOVEMBER 5, 2007 5 tih_ do / / / / t i 1 / 1 / 1 / / / 1 I I/ LOT4 LOT AREA 14,602.92 sq. ff. 0.34 acres LOT2 n � r n u W N 6 0 0 0 0 GRU5HED 5TONE DRIVE se.a UTILITIE5 A A �Z. u s fff►►►///�� VS. S t e v e s Surveyors 169 Haviland Road Queensbury,New York 12804 (518) 792-8474 New York Lic. No. 50135 11NAUT10RRED ALTERATION pt ATW70N A SURYEr YAP BEARING A LICENSED LAID SllRA-MW SEAL IS A VIOLATION OF SECTION n%. Sue -DIVISION 2 OF THE NEW YORK STATE EDUCATION LAW SLY "A FROM THE OF THE OF THIS SURVEY MARKED MIM AN OILIONK OF THE LAND SURVEYORS SELL SHALL � COMICATD ro BE N 9 TLUE Comm* TING IOM W PIA CATFD NEAEON SKiMFY THAT SURIEYWASPREPAREDwACCORDANCEMITNTHELand �`��P'�"��°�`�°THE NEW YOKK STATE ASSOOAioN OF pROFE.S50NAL RANDSURVEYORS SAID CFRTFICAIKwS SHALL RIM ONLY TO THE PERSON FOR WHOP THE SURVEY IS PREPARED, AND ON MS BEHALF TO THE TITLE COMPANY, OOrflB WAL "`� A"° `EES OF THE LEMNI "�° RW' "'° ro THE A551<N{ES a THE IErroINc RISTINTIOFL' Map of a Survey made for C l u t e Enterprises Town of Queensbury, Warren County, New York Date, August 30, 010 Scate 1'=20' S —1 pL�.*. �i3 � GUte DWG. NO. 04007-3 NO. DATE DESCRIPTION 3 -U0 Wed'he-54 Framing / Firestopping Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/pm part: f� am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: 4 3 G' ,A NAME: , PERMIT#: 0- _,. LOCATION: /1 r yo INSPECT ON: / r. TYPE OF STRUCTURE: W4) Y1! 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 Exterior Deck Bracing Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 %(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq. ft. floor trusses • Bolts ; . or less on center Ice and water sh = • 24 inches from wall fiNi Fire separatii• 1, 2, 3 hour _ 2, 3, 4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side%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 L:1Building&Codes Forms-OLDSulIding&CodesUrapec ion FonnsTrammng Firestopping Inspection Report.doc Revised January 7,2008 Septic Inspection Report Office No. (518) 761-8256 Date Ins.- son-_ - *►' • Queensbury Building &Code Enforcement Arrive: O° "RM. -part: \a- ettiOr 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: (fu '' IT NO.: V - 07- LOCATION: I/ C� r-I' ► PELT ON: — i RECHECK: Comments and/or diagram Soil Ty•: ..n oam/ Clay Type of Water. Municipal Well Water Waterline separation distance ft. Well separation distance ft. Other wells: _ft. Well Casing Length 50' +/ - Y_ N N/A [150'to well required if NO] Absorption Field: Total length k5 O ft. Length of each trench • ?i ft. Depth of trenches - Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank '+ 3c1.1 LID Tank to Distribution Box L(it P il Distribution Box to Field/ Pit z 4" c' C - b Opening Sealed: ✓Y N End Cap ✓�( N Inlet/Outlet Pipes&Baffles ✓Y N Manholes 12"or less below grade t N [provide extension collar if Yes] Y N Location/ Separations Foundation to tank 1O ft. Foundation to absorption VD ft. Separation of Pits e,eC) P4%,-27j\) Conforms as per Plot Plan T Y N Engineer Report and As-Built Y_ N ETU Maintenance Contract _Y N provided Location of System on Property: Fron, Re.r Left Side Right Side Middle F t Middle Rea; stem Use Sta -s: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010\Building Codes Forms\Inspection Forrns\Septic Inspection Repor _03 29 10.doc ZO/O-/07 s i 5.0 / I_ 1 f 1tJ GG' sk, `® G� G 1 ``e�e�sa e , ,r�s�e ��a0 led, \s, 5e, 0 zs �c.As ,Aw \3 I F��, c,- r c„ f 0!�eta$ �0",i. s� , - ` ' 1 '-'�•, k / �, { SO 1 99O i i 0y p P°/ \VCr 6.r ii [..\- 1:-: A 1 . r---------- ,.....______;,,,.. .. i , ‘ 1 w . 6 4 (/cdemshdkc ) 2- Foundation Inspec ' Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: .3f pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials- ` NAME: PERMIT#: /(J-/6 LOCATION: J ,p r.I;INSPECT ON: /,"— s 2—/ C 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 (Th', Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width - bove footing 6 mil poly or wet areas under slab Backfill App,•val Plumb' nder Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection FormsWoundatIon Inspection Report.doc Last printed 12/20/2005 9:24:00 AM ,i Aibe Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: ,9- )/�l Queensbury Building&Code Enforcement Arrive: am/pm Dep: : am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: • PERMIT#: 16 -1 C' 7 LOCATION: 1 (j1L';--f / h a INSPECT ON: f` }C /�I TYPE OF STRUCTURE: Comments Y N N/A Footings 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 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:\Buliding&Codes Forms\Building&Codes\Inspectton Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM 2O/0 707- t May 21 10 03:38p p.2 • Chckol. Lo4IS c:4) pR e_R-Ey „\\:\t 0 dd <- 40`t- 4 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Yq Permit No..... . .)..— Cert. N2 1 9 s Cut-in Card No................... Owner............ :. � ...... :.�`.... . . . .................. ........ .............. J � Y t ` Location....,-.- a-:: �" ,.. t -rc , Installation Consisting of..g,... 'f..:.............tl-.. ?:r... .....:......... :` :.. . .'',�?.......... ........................................................................................ .................................................................................................................. ............................................................... InstalledBy..... . :'L.. ......``. ,:. . ........................................Lic.No................................................... The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be raptly made for inspection. Inspectors of this Company shall have the privil e makin ins ections at any time, and if its rules are violated,the Company shall have the right to re ok thi i icat� Date...... f f ... INSPECTOR . C�� r Member N.F.P.A.,I.A.E.I.