2014-392 v
TOWN OF QUEENSBURY
acs742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140392 Date Issued: Wednesday, December 30, 2015
This is to certify that work requested to be done as shown by Permit Number P20140392
has been completed.
Location: 9 GLEN HALL Dr
Tax Map Number: 523400-289-011-0001-033-000-0000
Owner: RONALD & CYNTHIA MACKOWIAK
Applicant: RONALD & CYNTHIA MACKOWIAK
This structure may be occupied as a:
Residential Addition By Order of Town Board
Residential Alteration TOWNOFQUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property
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.
TOWN OF QUEENSBURY
*O 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140392 Application Number: A20140392
Tax Map No: 523400-289-011-0001-033-000-0000
Permission is hereby granted to: RONALD & CYNTHIA MACKOWIAK
For property located at: 9 GLEN HALL Dr
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: RONALD & CYNTHIA MACKOWIE Residential Addition
14 STONEWALL Dr Residential Alteration $150,000.00
WAPPINGERS FALLS,NY 12590-0( Total Value
$150,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2014-392
Res. Addition 250 sq ft/Res. Alteration 727 sq ft.
SEE AV 8-2014 and SP 9-2014
$209.05 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,September 10,2015
(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 of • eensbury• Wet .s y y, September 10,2014
SIGNED BY4 for the Town of Queensbury.
Director of Building&Co.e Enforcement
•
PRINCIPAL STRUCTURE APPLICATION Office Use Only
DATE g"../. 5-1/ Received
Tax Map ID 0.,1-med
TAX MAP ID 50234/00-2f/-G//- 0 3,�- !�G(, - Permit No. ,g I
oeY� Permit Fee 7 aDe. pai
ZONING PI/2 Rec Fee N/,}
Site Plan# cf.9-o2,41 el t✓edE/'it
HISTORIC SITE Yes V"No Subdivision #
SUBDIVISION NAME Lot#
TOWN BD.RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS,INCLUDING SINGLE FAMILY DWEWNGS,DUPLEXES
OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR MANUFACTURED &
MODULAR HOMES, BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE. //J
APPLICANT /' •vA✓ ' / Gf�Gltl�:f/G ' )Ot42 OWNER {' 44,7T+ N G ot✓ik"'�
ADDRESS /`7 `S44e4-4¢� . - • ADDRESS 9 cC/��/ /�/a-// LJr
a/4,,o ivGG'1 S n'//S/AP/ 4.eeh5 ur(-7/ /1/`l /.2 f+y
4 S5O
PHONE/E-MAIL 2°]-SG5-4-7,9C 1 OHONE/E-MAIL
0-/n4 GKO Nf top/on /tnc• neC rrn s.0 ca-siT ! >i ,we./!G
CONTRACTOR 17aaAde-obricips5 C./Pr COST OF CONSTRUCTION(ESTIMATED): $ 4957en 43 fl
ADDRESS: PO ecac le,9 BUILDING ADDRESS: 'P aVW 44.// UY
11�U.ttr S�j yr /4/Y/2 o
n�;�e,�.i/ ,ty /also y
PHONE/E-MAIL ;Das en-rdea //[/-‘,:;2/-no 02
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: wr74 /07i6 c 5 PHONE s7t�4
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
> New Addition Alteration 13t floor sq. ft. 2nd floor sq.ft. Total sq.ft. Height
Single Family I/ V 977 /53-0 a7
Two-Family (P02( a-6 CAM tic
Multi-Family wqo5
(#of units ) '7a4'b U of
Townhouse
Business Office
Retail - Mercantile
Factory- Industrial
Attached Garage
(# of_)
Other
1
Town of Queensbury Building&Codes Principal Structure Application July 2014
If commercial or industrial indicate name of business it/zA
Proposed use of building or addition .CS--pe.vcE-frill/2 scree-t
Source of heat (circle one) Gas Oil Pro•an- Solar Other
Fireplace: complete a separate application for Fuel Burning Appliances &
Chimneys Ciic,'s/ �5
Are there structures not shown on plot plan? //p
Are there easements on the property? n/p
Site Information SCE /-I/7E,s fie 4•vcc
a. Dimensions or acreage of lot
a- -1-e/y s/.,/'y
b. Is this a corner lot? /LY,
c. Will the grade be changed as a result of construction ✓ Yes No /
d. Public water or Private well Lya /'w
see ,.--wan-7, C' ?G/re,/$ •
e. Sewer or Private Septic System sr�� Io.� v pc/I1
Value of all work to be performed (labor or materials) $ //S oz-O' /57,i
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed,subject to fees and department
approval.
3. 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.
• 4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy.
5. I also understand that I 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 certificateofoccupancy.
I have read and agree to the above: PRINT NAME: / "'Are '«' $/ DATE 5/fir/ r
`
SIGNATURE: /�� `4/1- g :_/G DATE e s7
FOR OFFICE USE ONLY
Operating Permit Issued: Yes _No
Occupancy Type •
Construction Classification
Assembly Occupancy Limit
Special Conditions
2
Town of Queensbury Building&Codes Principal Structure Application July 2014
4:441
Fi_ Survey Inspection
A n
Dept. of Come, city Development
Town of Queensl ury
742 Bay Road
Queensbury, NY 12804
Date received: It zq zc1=
•
NAME: NlOCkm W IQIL
LOCATION: >z
PERMIT#: 20 Ig ?G L
NORIO icritij ;
frigtmeptiO. 33
Final Survey Plot Plan
A. 'roved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
surve has been:
Air
Craig own Zoning Administrator
Notes: �nJl� SVEc/
7
B - t6cac, ,v, •
I
L:\SueHemingway1Buildmg.Codesdnspection FORMS\Final Survey
Zoning Administrator.doc
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O MR = MAGNETIC REACTION
O DSF = DOCK SPIKE FOUND
c�
"O"IPF ,= IRON PIPE FOUND '
Cry
m
CMF = CONCRETE
Nl
"= UTILITY
POLE'
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z - x =' = WIRE FENCE REMAINS
(9).=SEPTIC. COVER `
Date:
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O DSF = DOCK SPIKE FOUND
"O"IPF ,= IRON PIPE FOUND '
O CIRF =CAPPED. IRON ROD FOUND
CMF = CONCRETE
MONUMENT FOUND
"= UTILITY
POLE'
z - x =' = WIRE FENCE REMAINS
(9).=SEPTIC. COVER `
Date:
�00000'= To WALL
# LAMPPOST
Scale
1 -3
Rough Plumbing / Insulation Inspection Report
Inspection request received
Name MW6 Inspected on
Location q .A} r24)
Arrive . 5 am/pm
Permit No. '7 €514- 3cIZ Inspector's Initials 1
Type of Structure
COMMENTS
Y N NA
Plumbing under slab
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 V2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every TOO 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
indow Sealing
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
Blower Door Test
Air Sealing
to-i-Lucc —
u4AcA,L R tee--t
Town of Queensbury Building & Code Enforcement Office No.(518)761-8256
6-iic
Rough Plumbing I Insulation Inspection Report
Inspection request received 9\30. ISS
Name MaCACD Inspected on in t ti 1 Zfc Is —
Location 9 `-v, i l Arrive _ 81C-0 am J pm
Permit No. 2a >,(� _ 6oi Z Inspector's Initials C
Type of Structure kitsl f-rack
t COMMENTS
Y N NA
Plumbing under slab Q—`J�,,, 932 (a ZZ t,cp
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 Y2 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 �.
i Insulation /Residential Check/Commercial Check ?Nal _ zl t.�% '�-1*-5
Window Sealing ��� 2 ` 3s -\s?
Tyvek or Similar Exterior Sealant
Proper Vent,Attic Vent - 3 0 IT e S k-CPh
Door/Window Sealed(No Insulation) �
Duct/Hot Water Piping Insulation \l S `-"6t/a[ J .
If required unheated spaces -Cr0 iMpa-`�\`rcc ,
Combustion Air Supply for Furnace J
Duct work sealed properly/No duct tape
Blower Door Test
Air Sealing
Town of Queensbury Building & Code Enforcement Office No.(518)761-8256 � �
Mo ry
/0 _12_
Rough Plumbing ! Insulation Inspection Report
Inspection request received '12 i(24-115
Name Maciccivg1J Inspected on 2e5I,L5
Location (A ,l t Arrive C2 am/pm
Permit No. 201 t} - j Z Inspector's Initials
Type of Structure 124s odd
COMMENTS
Y N NA n
Plumbing under slab _ (' q 32-- �,ZZkp
Rough Plumbing/Nail Plates ``J1
Plumbing Vent /Vents in Place
I V2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test � ���p
Drain/Vent \ elik� i
Air/Head
5 P.S.I.or 10 ft.above highest connection for 15 minutes �t
Pressure Test
/
Water Supply Piping
ti Air/Head
50 P.S.I for 15 minutes
Insulation/ Residential Check/ Commercial Check
Window Sealing � ¶ �f 7
Tyvek or Similar Exterior Sealant 6 v �—
Proper Vent,Attic Vent (? c'- CI ' ±._Q-.c
Door/Window Sealed (No Insulation) ��t
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly /No duct tape
Blower Door Test
Air Sealing
Town of Queensbury Building& Code Enforcement Office No. (518)761-8256
Rough Plumbing I Insulation Inspection Report
Inspection request received 1/1-2-h-5
Name Th 4r /Vow ha V Inspected on ric<_c —
Location G1,e� NAl Dr. Arrive1am!pm
Permit No. i ` - 3q2 Inspector's Initials ddiCCA
Type of Structure
COMMENTS
Y N NA
Plumbing under slab
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 V2 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.5.1 for 15 minutes
Insulation /Residential Check/ Commercial Check
Window Sealing / ,
iTyvek or Similar Exterior Sealant I b ,'/
Proper Vent.Attic Vent
l.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
Blower Door Test
Air Sealing
fts - •i I r \. ._.
tj
CI
Town of Queensbury Building & Code Enforcement Office No. (518)761-8256
z_3
Rough Plumbing ! Insulation Inspection Report
Inspection request received `112-zj‘25
Name MaCk10 .)'1030, Inspected on 912-51�S
Location CA 6114 In 16( •Pre& Arrive �� am/pm
Permit No. 2o l- Z Inspector's Initials
Type of Structure Q,25. P1-aa -I A-1-1-.
COMMENTS
Y N NA
Plumbing under slab
th Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 14 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain/Vent V/
Air/Head w
5 P.S.I.or 10 ft.above highest connection for 15 minutes I r
5-2-C12‘01
Pressure
Pere up
Water Supply
Piping
Air/Head
50 P.5.1 for 15 minutes
Insulation/Residential Check/ Commercial Check
Window Sealing
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
Blower Door Test
Air Sealing
Town of Queensbury Building & Code Enforcement Office No.(518)761-8256
Town of Queensbury Building &Code Enforcement i ?�
Office No. (518) 761-8256
Framing I Firestopping Inspection Report
Inspection request received:iv912-5\T-CAS.-)
ec
Name: ' XCX.F)W alt., Inspected on: 9 1 25)20AS
Location: I Oit k1 t6A fci Arrive: °Z,". a.m./p.m.
Permit No.: - 2- Inspector's Initials:
TYPE OF STRUCTURE: kC. d • P'Yr •
Y / N NIA COMMENTS:
t Attic Accng
ess Access 22°x 30"minimum
Jack Studs/Headers
Truss Specification Provided ° / ►/ ,r
Bracing lBridging
�// --7"0`1\9C-0\ (,,,o�.-fV �
Joist hangers `/ /
Jack Posts I Main Beams V/ t4
Exterior sheeting nailed properly
12°O.C. r` • ` �1�2
Headroom 6 ft.8 in. — V
Stairwells 36 in.or more
Exterior Deck Bracing
Headroom 6 ft.8 in.
Notches/Holes I 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
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 /
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
Design Professional Sign-off, if required
Framing/Firestopping Inspection Report
'It
I—3
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 1- 22 10 5
Queensbury Building& Code Enforcement Arrive: am/pm Depa pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: 1°-
MSW1PERMIT#: Z
LOCATION: 9 CLtN 1A-Pc1--` �nv ,(— INSPECT ON: 1122 1 2J5
TYPE OF STRUCTURE: 2ts . ALA-
Comments
Y N N/A Q�p �v2 6i2A0
Footings ^�U
Piers
Monolithlfb
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 tea v4
Foundation Dampproofmg DAR—
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 12/9/2014 `\
Town of Queensbury Building&Code Enforcement ---1--
Office No.(518)761-8256
Rough Plumbing ! Insulation Inspection Report ckvacif -o (CJ
Inspection request received: 1129`1S
Name: 1V\aCk-00AN x0,)cInspected on: \\ZQAB
Location: 61\r.tata‘l v'v - 9'- �'.m.
• cJ Arrive:
Permitbi-
No.: li— 61� Inspector's Initials:
Type of Structure:
COMMENTS
Y N NA
Plumbing under slab
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 Y inch minimum Drain Size
ashing Machine Drain 2 inch minimum
leanout every 100 feet/change of direction
Pressure Test J
Drain 4
Air :/
5/•.-. . o 10 ftrove highest connection for 15 minutes
Pressure -
Water Supply Piping
Air/Head
50 P.S.Ifor 15 minutes
Insulation/Residential Check/Commercial Check
Window Sealing
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
Blower Door Test
Air Sealing
Rough Plumbing/Insulation Inspection Report
Town of Queensbury Building&Code Enforcement
Office No. (518)761-8256
Rough Plumbing I Insulation Inspection Report
Inspection request received: ( Z0/t5 7/ /5
Name: (71 kQ Fi R Inspected on:
Location: G-Linxhu1. Arrive: tgiumwory.'ter
/ p.m.
Permit No.: . ci 3 Inspector's Initials: a
Type of Structure: 1�c5 4�r. it
COMMENTS
A.umbing Y N iNA under slab `/J
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 Yz inch minimum Drain Size tom[—p C
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test r5
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
Window Sealing
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door I 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
Blower Door Test
Air Sealing
Rough Plumbing/Insulation Inspection Report
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: � l r f
Queensbury Building& Code Enforcement Arrive: am/pm Depart: l m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initia .
NAME: �
LIMA/gc,ci � �
iAle) PERMIT ) ' )--
J /
LOCATION: q t ' -II i ^^ INSPECT ON: J /<
TYPE OF STRUCTURE: jtL\ A-Jd
Comments
Y N N/A
FootingsCREs,(1 .
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
Coundati ^ roofmg is
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 12/9/2014
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: / /;
Queensbury Building&Code Enforcement Arrive: am/pm Depart: .m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials. tJY '
NAME: r''1 ThC KOWi A PERMIT#: _`
�� —3 92
LOCATION: _l &1€Jnl /4"1/ bC INSPECT ON: 7/L / S
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 s)te.
�y �
Foundation/Wallpour � N5
r Reinforcement in Place ` `1
Footing Dowels or Keyway in place V� / (2_4
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump "r
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 12/9/2014
V
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 1+51 20 15
Queensbury Building& Code Enforcement Arrive: am/pm Depart: \ am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials.
`
NAME: M ack b W kak, PERMIT#: L
LOCATION: ` (.3\Ln11"f \I''b rt yd.-) INSPECT ON: 11 e 17-0 (5
Q.L.C.OF STRUCTURE: (Cks. Baa.•I
Comments , 7
•
Y N N/A Qp I I 932,- 6L2—Lo
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
ofthe concrete.
Materials for this purpose on site. ,\///
Foundation/Wallpour t-,YA ,J
Reinforcement in Place T
Footing Dowels or Keyway in place ✓
Foundation Dampproofing
Foundation Waterproofing d\Vr
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 12/9/2014
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building& Code Enforcement Arrive: am/pm Depart. \ oam/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: `�q
NAME: Mrs_ t PERMIT#: ^J 14
Wi
LOCATION: INSPECT ON: _
TYPE OF STRUCTURE: !(at A1sV7
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 c -- 4v
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 12/18/2013 2:44:00 PM
`1ltI;S
9-11
Foundation Inspection Report
Office No. (518)761-8256 Date Insperction ue,;,.j:ceived: �lZ&11.S
Queensbury Building&Code Enforcement Arrive: �; ar iv,
Depart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initial' '
NAME: MPt-W .i IM" (MIT#: i2
LOCATION: 9 CTLs-- INSPECT ON: la 12-9 17 ox
TYPE OF STRUCTURE: QQ. • A .
n Comments
Y N N/A
Footings r"`^'O(2 f✓' 9i 52 - 226
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/WallpourD1 • , h�
Reinforcement in Place wC
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 12/9/2014
CI a
Foundation Inspection Report � 1,1"75
Office No.(518)761-8256 Date Inspection request received: `c'JZ.S 7S
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: M icrigatt, Icvk PERMIT#: ,
LOCATION: `� (_ 2 U 1-4-<.. 1/ ?-01/44 D INSPECT ON: n/%��!��.
TYPE OF STRUCTURE:
Comments
N N/A
7 ootmgs
Piers - prcuA ,--
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:\BufidIng&Codes Forms\Bullding&Codes\Inspectfon forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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