1992-718Certificate of Occupancy
Town of Queensbury
Warren County, New York
Date
February 4,
2000
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a
Location
25 MOCKINGBIRD LANE
92718
SINGLE FAMILY DWELLING (LOWER LEVEL)
Owner .13.0140.1.1C,„.14/M—STEPHFN R _
TAX MAP NO. 148.-2-41 By Order Town Board
TO OF QUEENSB RY
Director of Building/8z, Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY
TAX MAP NO. 148.-2-41
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
BOLDUC, M/M STEPHEN R.
No.
92718
25 MOCKINGBIRD LANE
OWNER of property located at Street, Road or Ave.
SNGL FAM DWLG-UPPER LEVEL ONLY
in the Town of Queensbury, To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
MDIA
5. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
( ) Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
PAIDN$25.00 TO RENEW PERMIT ON
FAMILY DWELLING
2/15/96
FOR LOWER LEVEL OF
SINGLE
8. Proposed Use
SNGL FAM DWLG-UPPER LEVEL ONLY
0 February 15
PERMIT FEE PAID — THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 9 Day of
SIGNED BY
November
Building and Zoning Inspector
19
92
98
for the Town of Queensbury
TOWN OF QUEEHSBURY
f
REVIEWED BY:
FEE PAID:
PERMIT NO.:
9,?- 7/.5
BUILDING PERMIT APPLICATION
-.4VN OF QUEENSBUr
RECEIVED
NOV 41992
F'LDG. & CODE DEPT.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Owner of Property: Mr. & Mrs. Stephen R. Balduc - Lot #41 - Model 3B
P.O. Address:
Mockingbird Lane
PHONE
148.7.1, 7.3 & 7.4
Property Location: Queensbury, NY 12804 Tax Map No. / /.
Has there been any split of this property since October 1, 1988? Yes X No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Inspiration Park
Lot No. 148.7.1,7.3&
Lot 141 - Model 31
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Cushing, Dybas Associates, Architects, P.C.
NATURE OF PROPOSED WORK:
X Construction of new building
Addition to building
Alteration to building
(no change to exterior dimensions)
Other work (describe)
GROSS AREA OF PROPOSED STRUCTURE:
1st Floor 1017 Sq. Ft.
2.1d Floor - Sq. Ft.
Other Floors - Sq. Ft.
(not cellar or basement)
TOTAL FLOOR AREA: 1017 Sq. Ft.
Size of New Structure:
Foundation:
Pier/Slab/Crawl/Parti Circle One)
No. of stories (Habitable space) 1
Height (grade to ridge)
40.0 ft. x
If residential, no. of families:
No. of rooms (excluding baths):
No. of bedrooms: Three
No. of bathrooms: One
Primary heating system:
22 ft.
One
Baseboard
ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $
77,592
COMPLETE INFORMATION REQUIRED BELOW:
Size of Property: ft. x ;g ft.
Existing Building Size: (None)
- ft. x - ft.
Proposed building - distance from
property line:
Front Yard 3o ft. Rear yard 43 ft.
Side Yards 20 ft. and 39 ft.
If on corner, setback from side street-
- ft.
OCCUPANCY INFORMATION:
Primary Building -
X One Family Dwelling
Two Family Dwelling
Multiple Dwelling/No. of Units _
Business
Industrial
Other
* If addition, what will use be?
Six
*
Tyne of fuel! 727a..4 -r;,-
* Accessory Building;
* Detached Garage - One/Two Car
* Attarh04 (:arano - (lno/Tmn rar
SUILU1PIU rEnni u nrr LaI.n, avn wig 1w� v.
3U4LDIi 3 SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc.
Wood Frame
4111 any second-hand or ungraded lumber be used? If so, for what?
No
Foundation Wall Material: Poured Concrete
Thickness:
depth of Foundation below grade (to bottom of footing):
4111 there be a cellar? No
Will there be a basement?
If so, what portion? N/A
Yes
R"
Below 5'-0
Heated or Unheated? Unheatea Floor Sq. Footage: 96
Will any portion be used as living space? No
Sq. Ft. Type of Use? NIA
Type of Roof: Sloped/Flat/Shed/Other Sloped
Size, wood studs 2 " X 6 11; spacing 16
Joists (floor beams): 1st Floor
Joists (floor beams): 2nd Floor
Overlays (ceiling beams): -
Roof rafters: - " x
Material of Roof Asphalt Shingles
o.c.; length 8 ft.
2 " X 10 spacing 16 o.c.; span 13 ft.p
- x - ", spacing - " o.c.; span - ft.
" x H.
- spacing - " o.c.; span - ft.
- "; spacing - o.c.; span - ft.
Roof trusses (pre-engineered): spacing 24 " o.c.; span 13 ft.
Exterior Wall Finish: Clapboard Siding of what material? Vinyl
Interior Wall Finish:
1/2" Gypsum Board
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
N/A
Is there to be an opening between garage and dwelling? N/A If so, will a Fire -Rated dol
enclosure, self-closing device be provided? N/A
Will a flue -lined chimney be installed? No
Depth of chimney foundation below grade:
Depth of fireplace hearth: N/A ft. N/A in.
Water supply - Municipal or private well: Municipal
Height above roof N/A ft.
N/A f t .
SEPTIC SYSTEM: Distance from any private well (including adjoining properties:
+100
(A separate application is necessary for any repair or new installation of septic
system.
NAME OF BUILDER & ADDRESS: The Quinn COY. Inc -
- P.O. Box 6150 - Rutland, VT 05702
NAME OF PLUMBER & ADDRESS:
NAME OF MASON & ADDRESS:
NAME OF ELECTRICIAN & ADDRESS:
Same as Above
Same as Above
Same as Above
PHONE (802)747-i
PHONE
PHONE
PHONE
DECLARATION
To the best of my knowledge and belief the statements contained in this application,
together with the plans and specifications submitted, are a true and complete statement
all proposed work to be done on the described premises and that all provisions of the
BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to the proposed work
be complied with, whether specified or not, and that such work is authorized by the owne
Signature
0 ner,Oner, s agent, archi
contractor
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings;
Multi -Family Dwellings
(3 Stories or Less)
PART 4 - Design By Component Performance - Commercial Buildings - Hi -Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
Mr. & Mrs. Stephen R. Balduc Inspiration Park (Lot #41)
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 1017 Sq. Ft.
2. Type of Heat - x Elec. Base Board Other
3. Is Building Mechanically Cooled?
4. Percentage of Area of Windows and Doors
YES x NO
THE R -VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO
THE R -VALUES SHOWN ON PLANS SUBMITTED!
Over 17% x Under 17% (1o.9%)
REQUIRED
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 38 33 24
B. Exterior Walls R 19 23 18
C. Glazed Area R 3.45 2.6 1.7
D. Exterior Doors R 14.9 2.5 2.5
E. Floors over unheated spaces R 19 24 19
F. Edge of Slab on Grade (Heated Building) R N/A 10 10
G. Basement/Cellar Walls (Above Grade) R N/A 10 10
H. Basement/Cellar Walls (Below Grade) R N/A
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code x YES
N/A
NO
TEMPERATURE CONTROL MAXIMUM SETTING 140" - WILL NOT BE EXCEEDED
I F tfl1 -7n �_c Ifl
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT
Date: 10/23/92
Permit #
Fee Paid
Reviewed By _
LOCATION OF PROPERTY FOR INSTALLATION: Inspiration Park, Queensbury, NY 12804
Owner's Name: Mr. & Mrs. Stephen R. Balduc -
Lot #41 - Model 3B
Owner's Mailing Address:
Installer's Name:
Mockingbird Lane, Queensbury, NY 12804
The Quinn Company, Inc.
Number of bedrooms (if residential):
Three
Phone #: (802) 747-7010
Total daily flow (residential -compute @ 125 gal. per bedroom):
Topography -Circle One: Flat . Rolling Steep Slope % of Slope
375 Gals.
Soil Nature -Circle One: Sand Loam Clay Other /Depth:
Ground Water -At What Depth? +6'-o" Feet
+20
Bedrock or Impervious Material -At What Depth?
Feet
+20'
Percolation Test -Circle One: Not Required Required/Rate 2 Min. Per Inch
Domestic Water Supply -Circle One: •. Well Other
If domestic water supply is a well -
Separation: Water supply from an,. septic absorption feet
PROPOSED SYSTEM: Septic Tank loon gal. (Minimum size: 1,000 gal.)
Tile Field: Each Trench
27
feet//Total System Length 162 feet
Seepage Pit(s): Number of / Size each: ft. x ft.
Size of Stone to be used: 1/2" to 1-1/2" Depth or Thickness i.o feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Sizeiof Each Gal.
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:
1(1 O , /92 {
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518) 761-8256
Building & Code Enforcement
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury, New York 12804
NAME c4z-Fpv\EI>
Date inspection request received.
Arrivam/pm Dep
Inspector's Initial
GOL
LOCATION Zytj t-\ c (Lt ti.Rtes) 1 .i\JE_
TYPE OF STRUCTURE
Chimney Hei
Fresh Air In
Plumb Vent
Roof Comple
Exterior Finis
Interior/Exteri
Exterior Han
Interior Handr
Grade 2% aw
8" clearance t
Gas Valve sh
Gas Furnace s
Oil Furnace s
Furnace/Hot
Relief Valve(
Headroom, 6
Basement s
Handrail e
Interior privac
Floor Finish
Bathroom/Kit
Interior Flan
Railing across
Smoke Detect
every leve]
every bedr
outside eve
rater conn
Bathroom fan
Plumbing frit
jk Foundation in
Ir 3/4 hour fire d
Garage fireprc
Garage penetl
Furnace in sel
Light ventilate
Safety glazing
Final Electric
Site Plan/Var
Final Survey ]
As Built Sept
Okay to issue
Okay to issue
'Jkav to issue
N/A YES NO
PERMIT # ci7 - T14:6
DATE 2 — t_} __ )
ht/"B" Vent/Direct Vent Location
take
through
to
h
drails,
ay
o
ut-off
but
Water
s)
tarns,
xterior
dr
i
roof
Complete
or Railings 30" to 36"
balconies, landing 18 M. • more
ails stairs both sides 3 or mor• ri -
from foundation
s
sill plate
exposed/regulator 18"
but -off within 30 feet or wi
-off at entrance to furna :
Heater operating
. bove
• I . .
area
grade
of site
installed
t. 6 in. on stairs
6 ft. 4 in.
stairs both sides more
y/trim/doors/main entrance
. 3 risers
t 6"
:hen watertight
ails Balconies/Landing 18 i
window in stairwells
. or more
ors:
Dom
my bedroom
cted
3
ores
r?
sulation KRP►
Dor/door closer
)ofmg
ations sealed
karate room protected (in garage)
ion per room
; 18" or less from floor
31
iance required
'lot Plan
is System layout required
C/C (Certif. of Compliance)
temp. C/O (Certif. of Occupancy)
permanent C/O (Certif of
Occunancv)
COMMENTS
00.k 06VED hE
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
' Vb DEPART:
^ ,r) INSP
FINAL INSPECTION REPORT - RESIDE
DATE INS TII REQUEST RECEIVED:
NAME
LOCATION
-(-
DATE
TYPE OF STRUCTURE
PERM M 1 11L1�
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
CHIMNEY HEIGHT/B VENT/HEIGHT
N/A
YES
NO
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAI INGS
RELIEF VALVES
FURNACE/HOT WATER OPE ,TING
/
INTERIOR TRIM/PRIVACY DIORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGH
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPET 1
STAIR CLEARANCE/RA INGS
SMOKE DETECTORS
BATHROOM FAN
PLUMBING P`IXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL, ELECTRICAL
SITE PLAN/VARIANCE REQ.
/
1
i
--
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C (I)
�/
VyI:5TOWN OF QU. ENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY ROAD
ARRIVE: 'Li
QUEENSBURY NY 12804
(518)745-4447
DEPART: T11.6 INSP
FINAL INSPECTION REPORT - RESIDEN
DATE INSPECTION REQUEST RECEIVED:
NAME bTE P 4E►,� c2)a Loo
LOCATION 1 H(x 10C- ,w ) 1�P1JE
DATE 7_1 1-1
PERMIT #
TYPE OF STRUCTURE :_.6Pc) (Lo&ER IAEA)
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATIN _
FINAL ELECTRICAL WOODSTOVE OR FIRE LACE
CHIMNEY HEIGHT/B VENT/HEIGHT
�� �
N/
YES
NO
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPE" ING
INTERIOR TRIM/PRIVAC DOORS
FINISH FLOORS:
BATH/KITCHEN W• ERTIGHT
OTHER FLOORS .WEEPABLE
OTHER FLO0•. CARPETED
STAIR CLEA NCE/RAILINGS
SMOKE DET TORS
BATHROOM FANS
PLUMBIN- FIXTURES
FOUND ION INSULATION
GARAfE FIRE PROOFING
DOO CLOSERS
FIAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
ORAL- 'SZ) �F_
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, �518� 745-4047
TELEPHONE
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME Atm/ i� it ti. azde,/,--
LOCATION 411/ ,/326,,,,,,,,,- ��}�i� h6/Lfr4
DATE //// /A? 4 PERMIT# % - /r/l
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
APPROVAL
N//YES NO
L/
tyi
l
COMMENTS:
ARRIVE
DEPART
r-eket ( elle ! G 3
Permit No.
Owner
Occupant
Location
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
qZ-7/ 7
s , /¢C..
Lo j" Y( .,7riL s P,,(*7 �c oc/P<
No. / Street
(
u. � S
Town or City State
Installation as itemized on reverse sidelhas been visuallyinspectedpursuant to applicable codes.
In/fstalled by t.( t / 7 L l
Date
Inspector
MIDDLE DEPARTMENTINSPECTIO AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave., Collingswood, NJ 08108
ROUGH WIRING OUTLETS
H.P. AIR CONDITIONER
.- T44__._
Z.-
WIRING & CONTROLS FOR BURNER
RECEPTACLES
H.P. PUMP
L FIXTURES
K.W. OVEN
MP. SERVICE EQUIPMENT
H.P. GARBAGE DISPOSAL UNIT
/CAMP. SERVICE CONDUCTORS
K.W. DISHWASHER
K.W. SURFACE UNIT
f K.W. DRYER
K.W. RANGE
AMP. RECEPTACLE
/ K.W. WATER HEATER
FRAC. H.P. VENT FANS
2.j
/ CJ /C <
t,
)TORS H.P.
1RK NUMBER
EACH SIZE
1/20
1/12
1/10
%G
h
%
15
A
A
1
1A)
2
3
5
715
10
15
20
25
30
40
50
75
100
PPARATUS
NAME
1901)
.awn o/ Queensbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
cOet-( G(21,c
LOCATION )_ofzj t ra.A si. `F'k
DATE / / PERMIT NO. C10)_-7)
SOIL TYPE - San Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length /
Length of each trench &7
Depth of trenches v?/
Size of gravel 1iy z
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING:
Bldg. to tank
Tank to dist. box
Size /Type
S .re)
Dist. box to field/pit /i SCJ
Openings sealed? (1) -NO Partial
LOCATION/SEPARATIONS:
Foundation to tank !ii ft.
Foundation to absorption ft.
Absorption to lot line c, ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front -j - Left side - Right side
COMMENT :
SYSTEM USE APPROVED
01/86 and vl
Building Inspector
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ,/�//J/9' .
NAME Alibitte/
'/ 4/ 2 41, ,
y- �
DATE /U�/�'�' PERMIT # 9 - 7/4f
TYPE OF STRUCTURE 6 (�yyZ Q )
RECHECK APPROVED
N/A YES flO
FOOTING' 'IERS.
MONOLITHIC FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH -IN
INSULATION: d
FOUNDATION WALLS INRIOR R -
FOUNDATION WALLS E,)(TERIOR R -
FLOORS R -
WALLS R -
CEILING R -
DUCT WORK ORPIPINGIN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART f
! '
0)/
I NSf'ECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR`S REPORT
REQUEST FOR INSPECTION RECEIVED -';0'
NAME --LP.,-/P 10'2/ Li?
LOCATION 4l "ry/
DATE /2, 2 PERMIT
TYPE OF STRUCTURE
RECHECK
APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH -IN
INSULATION:
FOUNDATION WALLS INTERIOR R -
FOUNDATION WALLS EXTERIOR R -
FLOORS R -
WALLS R -
CEILING R -
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
-AU,/
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION - 4/ ' /I44C'61/797d 1
DATE gAi ////92PERMIT # -- 7i!
TYPE OF STRUCTURE.
RECHECK
APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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
X FOUNDATIO
REINFORCEM ` ' 'CE
FOUNDATION/D*MPROOFING
BACKFILL APP OVAL
ROUGH PLUMBI G
PLUMBING VEN VENTS IN PLACE
PLUMBING UNDESLAB
FRAMING:
JACK STUDS/HADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIM BEAM
HEATING ROUGH -IN
INSULATION:
FOUNDATION WALLS INTERIOR R -
FOUNDATION WALLS EXTERIOR R -
FLOORS R -
WALLS R -
CEILING R -
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 35 30
DEPART
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED //,�L/4-`
A477
NAME
LOCATION
>2cliettoL
iad
'%/�'
DATE /060/A PERMIT #
TYPE OF STRUCTURE Jcf) (/fl_Jj)
RECHECK APPROVED
YES
N/A
XFOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH -IN
INSULATION:
FOUNDATION WALLS INTERIOR 4,
FOUNDATION WALLS EXTERIOR R;,
FLOORS R
WALLS R -
CEILING R -
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
Oce Bruning. Inc 70996 Form 8847
UNAUTHORIZED ALTERATION OR ADDITION TO
THIS DOCUMENT IS A VIOLATION OF SECTION
7209 SUBDMSION 2 OF THE NEW YORK STATE
EDUCATION LAW.
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Proj. No, 92 176,5
C.T. MALE ASSOCIATES, P.C.
50 CENTURY HILL DRIVE, P.O. BOX 727, LATHAM, NY 12110
(518) 786-7400 • FAX (518) 786-7299
ENGINEERING • SURVEYING • ARCHITECTURE • LAND PLANNING
LANDSCAPE ARCHITECTURE • COMPUTER SERVICES
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DATE: Dec. 23, Ict9 .
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