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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