2012-154 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 518 761-8201
} Q rl, � )
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120154 Date Issued: Friday, August 17, 2012
This is to certify that work requested to be done as shown by Permit Number P20120154
has been completed.
Location: 15 HONEY HOLLOW Rd
Tax Map Number: 523400-308-018-0001-021-000-0000
Owner: FRED & PAMELA SCIALABBA
Applicant:
This structure may be occupied as a:
Fireplace By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property t;14,P,47 /
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
1
00k*
ellAffli TOWN OF QUEENSBURY
Fivertf 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120154 Application Number: A20120154
Tax Map No: 523400-308-018-0001-021-000-0000
Permission is hereby granted to:
For property located at: 15 HONEY HOLLOW 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: FRED & PAMELA SCIALABBA Fireplace
15 HONEY HOLLOW Rd Residential Addition $68,500.00
QUEENSBURY,NY 12804 Total value $68,500.00
Contractor or Builder's Name /Address Electrical Inspection Agency
COLLETTE CONSTRUCTION
38 COLLETTE Ln
HUDSON FALLS.NY 12839-0000
Plans&Specifications
2012-154
440sf Res. Addition w/fireplace
$150.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 26,2013
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town Quee bury hu i a. A ril 26,2012
SIGNED BY "r \ for the Town of Queensbury.
Director of Building&Code Enforcement
R 7 :I�,
i� r
OFFICE USE ONLY L, __
TAX MAP NO. 30 .( ! c ) �i !
PERMIT NO. 15t ; APR 2012 1J
FEES: PERMIT /00 RECREATION ENGINEERING r
-To -,re i � (If applicable) ;TOVV ! l g
, BUILDING &CODES ,
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION. /�
APPLICANT/BUILDER: 6, //p C��,s Prue OWNER: OR - FRO SGI A(IA nA
ADDRESS: 7r- (4,5(A,I1 p l- ii, I b f, ADDRESS: / �on;� /46/4/6 JJ
PHONE NOS. 7(/l I I.?-o 3 ($ ckJ- - PHONE NOS.
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: e,v C/IP7r PHONE: 3�� 5 �
LOCATION OF PROPERTY: / f4rN� ��IIOr� ��` , cPf<-, c:f�c-9
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION
� APPROVAL? OYES El NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL: f p�V ftcLrp (--,6f•a
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z
APPLY TO YOUR z pLU LL
PROJECT 0 g 0 0 • J O 1-
z Q Q :- cn N co 0 u_ O � C = oo
SINGLE FAMILY Iqi/Oi
TWO-FAMILY
MULTI-FAMILY
(NO. of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
IF COMMERCIAL OR INDUSTRIAL- NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: C�i 577) FUEL TYPE: 2/1.5-
HEAT
/r/sHEAT TYPE: 1107A6? *HOW MANY FIREPLACE(S): / c- AND/OR WOODSTOVES(S):
ZONING CATEGORY: jq,--t-447ARE THERE WETLANDS ON THIS SITE? NO
IS THIS A HISTORIC SITE? A)C.)
PROPOSED USE OF BUILDING OR ADDITION: /7-1—'1h;
/� £—
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
B 3-LGL 11-05
ftp' •
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? NO
ARE THERE EASEMENTS ON PROPERTY? Ah?
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 (-2.„)f- eteA0
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
codesAqueensbury.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
Operating Permit Issued: Yes No
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
di
,2. 6i; —, 5
Revised 4/14/2010
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: Rouqh-ln and Final Inspections Are Required:
Owner:: Q/z• Fj cD SGIa /I,6d Installer/Builder:
Address: /s /X OAtp. /7 d 15h) Address: 3 Ccs/�/ (—AJ '
Phone Nos.: / Phone Nos.: 7 q(• //a-c7 ' sg
Location of Property: e41--,--)0 Subdivision Name: RQrPtiO (io(,P
Location of Proposed Construction and/or Installation: /S //r)iv i /4//6z,i
Contact Person for Building & Codes Compliance: /6/3
Fuel Burning Applicance Wood .Coal Pellet Gas Oil
Information
Stove
Fireplace Insert
Fireplace, factory built* +✓
Fireplace, Masonry
Furnace, (Garage Only)
* If Factory Built, Please Provide: Manufacturer Name: Va(Z.41;<kyuf C.45--kTodel No. 3 1)i,/
Listed By: Number:
Chimney Information BLOCK BRICK STONE
Masonry** Check One✓
TILE STEEL SIZE IN
INCHES
Flue Check One ✓
i
DOUBLE WALL TRIPLE WALL INSULATED DIRECT CHMNEY
VEN LINER
Chimney Material Check One✓
** If Non-Masonry, please provide: Manufacturer Name: u/et2 r*✓ C 1 df J Model No. 3( 0 V
ADDITIONAL NOTE: CONSTRUCTION / INSTALLATION MUST CONFORM TO NYS FIRE
PREVENTION & BUILDING CODE AND/OR MANUFACTURER REQUIREMENTS. CONSULT
AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED INSPECTIONS
Town of Queensbury* Community Development Office* 742 Bay Road, Queensbury NY 12804
h (AM cct ck 1 •-3
Queensbury Building & Code Enforcement - Residential Final Inspect on
Office No. (518) 761-8256 Arrive: am/pm Depart: < I am/pm
Date Inspection request received: Inspector's Initials: --)
LL,,
NAME: S C, f O 10 .b bC — PERMIT#: 9 t/
LOCATION: , •. witDATE: fl
TYPE OF STRUCTURE:
Comments:
Yes 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 18 inches ‘\v/70./
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers C�C51\-42
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy I trim/doors I main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
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
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
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum Y2"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched r
Garage fireproofing I%hour fire door/door closer J f\)- J
Gas Logs in Sealed or Glass Enclosure
€,A) .$(
Final Electrical; Energy Saving Light Bulbs 50%
inal Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
A.,Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker LiSite Plan /Variance required
Flood Plain Certification, if required
Okay to issue C/C or C/O[Temporary/Permanent]
L:1Building&Codes Forms\Building&Codesllnspection Forms\Residential Final Inspection Form_revised_I 00405.doc;Revised
January 7, 2008; Revised 6/26/08; Revised 12/22/10,Revised 04/13/11
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: am/pm
Date Inspection request received: 7 A (,--/t. Inspector's Initials: ,I
NAME: S C Oc hr--t- PERMIT#: / (--1"—11
7
LOCATION: «- 6 _ 1 DATE: `7— f)--/A
TYPE OF STRUCTURE: R a.- ct,--f/n,i
Comments:
Yes No N/A 11 /� �Jj
4" Building Number Address visible from road W
Chimney Height/"B"Vent/Direct Vent Location ,(1.�C4�-�
Fresh Air Intake /�"
3 inch Plumbing Vent through roof minimum 18 inches
i
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers :o>(2 0 k). ---6"<-
Guards
-Q"<-
Guards at stairs,decks,patios more than 30 inches above grade -y�--'�"
Guard at stairwell at 34 inches or more 11(4-1) --i)� C - "r
Guard at deck, porches 36 inches or more ""��``11 �
Handrail Termination at Newell Post or Wall 1.%k w0') —
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant v��C2z-r_vkai\ 0-Z14)4.0(&—
.
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Eve Bedroom:
Outside every bedroom ea: / I/
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
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel /
Duct work sealed properly/Blower Door Test Certification /J
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade _. cLt
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
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 C. fAsS sP\ `"- -L s--
Enclosed Stairs Sheetrock Underside minimum Y2"Gypsum �c- �f��^
Basement stairs closed rise>4 inches (e_.5_ 1-
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure / (1' F ^
Final Electrical; Energy Saving Light Bulbs 50% in-
>��1�--C,
Final Survey Plot Plan �` '�
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
kir Flex Gas Pipe Bonding •--------
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification, if required
Okay to issue C/C or C/0[Temporary/Permanent]
L:1Building&Codes Forms\Building&Codesllnspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11
011111K Town of Queensbury Fire Marshal
742 Bay Road
Vr 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.
1
Permit# /,-)—r 'L' Schedule Inspection Time / 2 R am pm anytime Inspecto
Name f (,fee.Q_01560!—• Address I t TI p /X° -f'1 c, f l b l D Rough In Final_
Appliance Manu acturer `. I ` V Model# //�- CL,'
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated
Yes No N/ Comments
Floor Protection �, L
Clearances to Combustibles (all sides)
Firestop(s) Vertical Chase
Wall Penetrations
Vent Clearances to Combustibles
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
Hearth Extension (if any) I
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if LP)
p
CO Detection � _ �����
CSST Bonding
White—Building Dept. Yellow—Cust,mer Pink—Fire Marshal
frid� s . 117
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p Depart: r am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: <S la. PERMIT ##: /
LOCATION: /5. f}-t n Nv lb INSPECT ON: I
TYPE OF STRUCTURE:
Y N N/A I
Rough Plumbing /Nail Plates
Plumbing Vent I Vents in Place
1 'A 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 _
"Y( Insulation/Residential Check/Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape
COMMENTS: k "`J- AIJ\11/4.51.-2
faktA &/'
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
Framing / Firestopping Inspection Report S (4H
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: amlpm part: d am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
•
PERMIT#: / . -i J T
LOCATION: - - r o • 11 ),1 INSPECT ON: ' -la.-
TYPE OF STRUCTURE: (- S AAc .
1P IV , NIA COMMENTS:
Framing
Attic Access 22" x 30" minimum
Jack Studs/ Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams Vti �
Exterior sheeting nailed properly
12"O.C. a��\ �`�-
Headroom 6 ft. 8 in.
Stairwells 36 in. or more • "2` Cz�' -
Exterior Deck Bracing
Headroom 6 ft. 8 in. •
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '/2 (w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Botts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire , , ur
Firestoppink � —
Penetration sealed _
16 inch insulation in cavity min.
Garage Fire Separation
House side '/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space 1 Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:1Building&Codes Forms-OLD\Building&Code&Unspection Forms\Framing Firestopping Inspection Report.doc Revised January 7,2008
Rough Plumbing I Insulation Inspection Report
Office No. (518) 761-8256 Date ins ectio - • = t r. �- -e�: 5
Queensbury Building &Code Enforcement Arrive: - 7a •,• ► - • -rt: ilneWry
742 Bay Road, Queensbury, NY 12804 Inspector's
NAME: ;(.- t4► 121P 'MIT #: 17- -
LOCATION: ( t (v_.o L),‘ INSPECT ON: 57Z 7 Z
TYPE OF STRUCTURE:
_ Y N N/AJ
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
1 '/s inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I 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
nsulation / Residential Check/Commercial Check
ek or Similar Exterior Sealant -r�F�2
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct I Hot Water Piping Insulation
If required unheated spaces _
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape
COMMENTS:
Rough Plumbing Insulation Reportrevised Nov 17 2003, revised February 15,2005, revised January 7,2008
NNo i_
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection - = •-' •
Queensbury Building &Code Enforcement Arrive: [':.L,y - • %' I�►.rt: r i am/ m
742 Bay Road, Queensbury, NY 12804 Inspector's Initial . „do A._
NAME: ►Jai •ERMIT#: / /6V
LOCATIONE INSPECT ON:
TYPE OF STRUCTURE: e% 6, .1.�-1-'� ,—�'� �,•,
wA COMMENTS:
Framing S.
j
Attic Access 22" x 30" minimum
Jack Studs/ Headers
Bracing I 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) 160 nails each side
(\ )?raft stopping 1,000 sq. ft. floor trusses
.->)//Anchor Botts 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
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
L:1Building&Codes Fomes-OLD\Building&Codes\Inspection Fomts\Framing Firestopping Inspection Report.doc Revised January 7,2008
Me, cMe -3 h PlumbingI Insulation Inspection Ri or
Office No. (518) 761-8256 Date Ins ectio re :-= r F-' •i:
Queensbury Building &Code Enforcement Arrive: VD a p 2- • - : 'n a pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initial:0- .9
NAME: S Goal Q,\A PE* .. IT #: / a.- 15
LOCATION: J 5 A ) INSPECT ON: 5--7 t -1 z—
•
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 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
\\EY
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation) 1,; \
Duct 1 Hot Water Piping Insulation
If required unheated spaces ,
Combustion Air Supply for Furnace _
Duct work sealed properly I No duct Jape
COMMENTS:
Rough Plumbing insulation Report.revised Nov 17 2003, revised February 15, 2005, revised January 7, 2008
(05 v C (
Foundation Inspection Report ( _
Office No.(518)761-8256 Date Inspection request received: .5/7/1
Queensbury Building&Code Enforcement Arrive: am/pm Depart:(`3 am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's s Initials: 6
NAME: cC1n (I-) )7/2>A _
PERMIT j — r (�^
LOCATION: 15 H c— ` i-t u i 1 Cu _ INSPECT ON: 51-1//
TYPE OF STRUCTURE: kV—atIv t11
II 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 Dampproofing
Foundation Waterproofing
Footing Drain Daylight or SumpE7)
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
:ackfill 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
My cat. 1 ..(2e �o
Foundation Inspection Report -Le:W-QA
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p Depart: /�/ am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 'WM
NAME: S G PLI a. at-) PERMIT#:
LOCATION: / 5 a v ��, Lr ) INSPECT ON:
TYPE OF STRUCTURE: N
Comments
VN 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 4 ,C
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