2008-669 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTI F I CAT E OF OCCUP AN CY
Pennit Number. P20080669 Date Issued: Monday, February 09, 2009
This is to certify that work requested to be done as shown by Permit Number P20080669
has been completed.
Location: 819 STATE ROUTE 9
Tax Map Number. 523400-302-006-0001-049-000-0000
Owner: MICHAEL & WILLIAM FREEBERN
Applicant: MC DONALD'S
This structure may be occupied as a:
Commercial Alteration By Order of Town Board
TOWN OF QUEENSBURY
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 Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080669 Application Number. A20080669
Tax Map No: 523400-302-006-0001-049-000-0000
Permission is hereby granted to: MC DONALD'S
For property located at: 819 STATE ROUTE 9
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: MICHAEL& WILLIAM FREEBER
ROBERT, DOUGLAS &GEOFFRE Commercial Alteration $40,000. 0
C/O RENEE REARDON Total value $40,00000
PO BOX 4510
QUEENSBURY, NY 12845-0000
Contractor or Builder's Name/ Address Electrical Inspection Agency
HILLSON CONTRACTORS
1032 ROUTE 119
RINGE,NH 03461-0000
Plans &Specifications
2008-669
72 sq ft commercial alteration
$50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,January 16,2010
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To of Qu ensbu FdAy,January 16, 2009
SIGNED BY / s�J for the Town of Queensbury.
Director of Building&Ede korcement
i; _a___.____r____ _________ IC US> 2008-669 ------
Off
TAX MAP NO. 5�' PEI
FFFS. PERMIT RECREATION
F
(11 applicable) i
-aa______..__-__ aee___.-P-__-_a____-_____..-____._ __,.______--P_f___a�._
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION.APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER: jq J l So" OWNER:Qs vt< e_ Or ao-otd✓►
ADDRESS: fo 2. 2 T !!9_ .Ild s t- ,v H oYNG l ADDRESS: Ib i3,.x a37a . Qce'r e."s�x.r
PHONE NOS. (pol It- 3/! PHONE NOS.r,$ - het Y -&5-.r.T
CONTACT PERSON FOR BUILDktjG&CODES COMPLIANCE:U1d s si c.+.��T PHONE:
vj C Csof-J61-G7N9
LOCATION OF PROPERTY: 12 7' -9 4hdiee, nG.ld-h t%
SUBDIVISION NAME: /" c-b o� l at .� /2 s Tim,u K T
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW.
CHECK ALL THAT z
APPLY TO YOUR Z O0 a O dCl) UJ u w
PROJECT O 00 p w ¢ 2=m
o
z ¢ Q :-rii Nv�i Ori �LL aics
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY(NO.^,
TOWNHOUSE
BUSINESS OFFICE
RETAIL- ✓ �� C
MERCANTILE J
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
A
Town of QI eensbury ° Cc,lttll unit:t Decelopment Office ° 742 Bay Door, Qateenslj o°I!r N1r' 12804 r
f•q�Y;. ,.�+���i Z _1 1�� n-.. ^. ^W"
�+. _s'X�[.t+};4;J.� t.31�.',�a�•,C:{.,F1 �:�1,�L'7 ,t"i �..). .1 f�U d•�]1 {�i; )., �.• �.',
.q. -� y ♦y.a 11,� < i1
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:_
ESTIMATED CONSTRUCTION COST: `P th , FUEL TYPE:_1V/�J
HEAT TYPE? -HOW MANY FIREPLACE(S)—e,/d AND/OR WOODSTOVES(S): 4-'bj--
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
iS THIS A HISTORIC SITE? &Q
PROPOSED USE OF BUILDING OR ADDITION: Ta ilr4 ft c. K« sney :e- 17-v l-4 44-- 1-llc,t,;,v
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?
ARE THERE EASEMENTS ON PROPERTY? /
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 faciiities 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 constricted facilities prior to issuance of a certificate of
occupancy.
I have read and agr o the ab ve.
Signed
17
Director of Building & Codes: 61-8256 (for questions -�
QUESTIONS? CALL 7614266 OR EMAIL
regarding Building Permits, construction codes or septic
systems)
VISIT OUR WEBSITE FOR MORE INFORMATION
Zoning Administrator. 761-8218 (far questions regarding MTML-gueensbua-net �f
required permits, the permit process, application requirements or to
schedule an appointment)
a--a a----a--aria---r--------------a--r-------t ---r-----------a-----a-------r-s a---------
This application/proposed action described Permission is hereby granted to the above
a herein is found to be in accordance with the Applicant to erect or alter the building described
zoning Laws of the Town of Queensbury. herein in accordance with said Application:
4 t t d
f ¢ a
1 p
a e d
i ' t
a ZONING APPROVAL DATE r BUILDIN C S APPROVAL
i d
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—---------I---- ----a-a-------r-a- .tea-? ------------ a .. ..-. . d
?o-U,n trNut'ens�m-u �.o€.'tmun'�y Dev lt�t��'?ent Office 742 Bay jloa �, t?f'<'1tS�11. jy, L ���, !�:c���^3`
1
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
2008 669
McDonalds— Rt9
1/16/2009
I have reviewed the submitted drawings for the above project, and offer the
following comments
1) Fire extinguisher locations to be discussed
2) Any exit signs or emergency lights displaced shall be replaced.
3) Owner to verify with fire alarm contractor that all devices are still in the
proper locations.
4) Contractor to provide for maintaining operation of fire alarm system during
construction, without contaminating devices.
5) Any changes / modifications to cooking lines will require submittal of new
layout and an inspection by Ansul certified agency to verify the suppression
system.
Fire Marshal
Michael J Palmer
742 Bay Road
Queensbury NY 12804
518 761 8206
firemarshal@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 • Fax: 518-745-4437
-flrentarshal@queensbuitt.net • wzuzu.queensbury.net
---- ant una%,nLLL GUMPANIES 191002
I
2008-669
IMPORTANT---------- ------
If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endors M.A statement
on this Certificate does not confer rights to the certificate holder in lieu of such endon::ement(s).
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may
require an endorsement.A statement on this certiflcate does not confer rights to the ceMcate
holder in fieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a co itract between
i the issuing insurer(s),authorized representative or producer,and the certificate holds^r,nor does it
affirmatively or negatively amend,extend or alter the coverage afforded by the polici+is listed thereon.
1
I
` ACORD 25(2001/08)
I
i
CERTIFICATE OF L i 23`"
PRO MxeR (978)897-7773 FAX (978)897-153 MAA110N
TM GeuMll Companies Insurance Services. ] 2008-669
973 Great Road. Suite 102 T�°OR
PO Box 844
Stow, NA 01775 _ -- - - - Am a
Iwom Hillson Contractors Inc - - - - LWER A. St Paul Travelt::rs 0060
70K Striping. LLC 8'
2032 Route 119 INSURER C.
Rindge, NH 03461 WSUAERD:
�(Nl16R E'
i THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO_iCY PERIOD INDICATED.NOTWITHSTANDING
ANY REGUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W PTM RESPECT TO W HIO THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM a",EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
I SR ADWL TYPI of INSURAWA POLICY NUMBER POLICY EXPIRATW LHNTB
GENERALLIASILIrr DT-0-0916L649-IM-08 03/02/2008 08/01/2009 EACHOCCIIRRENCE s 21000.0001
X. COMMERCIAL GOOK LaelLm GAMA.GE
TO ROM s 300.0001
CLAIMS MADE XX OCCUR MED V(P(Any a.r PAN i 5.004
A PERSONAL A ADV NAM S 1.000.
r3ENERAL AGGREGATE 3 2 000
GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPW AGG s 2 000.
POLICY I LOC
AWOMOAI.ELAKORM DT -810-7S60L281-00E-08 08/01/2008 08/0wZ008 =NWOMMEUmIT
x AaYAUTO "ammem)
l o00
ALL OWNED AUTOS 80DILY INJURY s
SCHEOUL6U AUTOS IrNn PIINwni
A X HIRIID AUTOS BODILY INJURY $
)( NON-OWNED AUTOS IPNKscddwb
PROPSRTY DAMAGE _
(PIISaidgnq
GARAGE CRY AUTO ONLY-EA ACCIOENT S
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCHSWUMBRELLAUASILITT DT -CUP-7560L293-TXL-08 08/01/2008 08/0l/2OOS EAcHOCCURR0x4 a 1,000
x OCCUR Q CLAIMS MADE A0GREGAT6 $ 2.000.000
A s
DEDUCTIBLE
s
1 X RETENTION s 10,000I
wDRIwIa COMP@IIATpM aNS WC sTATu- x
OMPIAM11MLIAeanr DTNUB-S708868-2-0S 08/07./2008 05/01/2009 E.L.EACHAcOMW S 500,004
p ANY Lv c11TME E.L.DISEASE-eA EMPLOVEE s S00 0
M �F30 3 , ILL DISEASE-POLICY LIMIT s S00.
OTHER
DESCRIPTION OF OPUMTIONS I LOCATIONS I VEHICLES I E=L.UIIONS AM=IY UNCOMIIIIIIINT N SPECIAL PROVISIONS
SHOULD ANY OF THE MOVE MCI MEG POLICIES OE CANCELLED 11"ORe THE
W~T1O1 DATE THEREOF,THE ILI3U NG NNIURER WILL®pF.AVOR TO MAIL
10 oAYs woTTEN Nomca ro Tm cjiRT rATI:HOLDM NAM PTO THE LEFT-
ToMm of Quuensbury LIT S FAILURE TO MAIL SUCH NOTNG:SHA616IAPOW NO OBLIGATION OR LIA KITY
Attn: Building DepartMent or Any Rwo UPON THR*W)RS"L"-zAGENT11ORI W$EwATWr m
Queensbury. NY 12901 RSPRESERTAiA1e
�1 `�7
ACORD 26(20010e) GACORD C0 TON 19ee
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection st ecei
Queensbury Building&Code Enforcement Arrive: Depart: am/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initi s:
NAME: McD .�J PERMIT. : �'j�--(Q�
LOCATION: DATE:
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks _
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 sq. ft.
All Doors 36 in.w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36(w)x 44"(1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator 18" Above Grade
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/z doors
> 10%> 1000 s .ft.
3/a Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping,3,000 s . ft. Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Si a e/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Si na e
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond[Both sides]
Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides b 20' /Driveable Surface 20'wide
Oka To Issue Temp, r Permanent C/
Okay To Issue C/C
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc
F 1 0 �.
Inspection for Permit to Occupy
Fire Marshcd's Office Request Rec'd d�2 I(-) 9 Permit No. 669
Town of Queensbury
742 Bay Road Q
Queensbury,NY 12804 Scheduled Inspection Date: S / Time:
Phone: (518)761-8206 Business Name:
Fax: (518)745-4437 Location: G"e C f T
T of 111UPOC&M N/A US No
EXITS:
Exit Access
Exit Enclosure COMMENTS
Exit Discharge
AISLES:
Main Aisle Width
Secondary Aisle Width
EXIT SIGNAGE
Si -normal /
Sign-battery
EVAC signs in rooms !
TRUSS ID SIGNAGE
EMERGENCY LIGHTING
FIRE EXTINGUISHER:
Hun
inspection of extinguisher
FIRE ALARM SYSTEM ,
Fan Shutdown
Fire Sprinkler System
Fire Suppression-kitchen
Fire Suppression-Gas Isiah
Generator
Hood Installation
Elevator
Interior Finishes
Storage
Compressed Gas
Clearance to Sprinklers
Clearance to Electrical
Electric Wiring Enclosed/Labeled
Combustible Waste
Vehicle impact Protection
Knox Box
F.D.Si na e-Wility Rooms
No Smoking Signs
Maximum Occupancy Sign
Emergency Evacuation Plan
Approved (If no other approvals apply,the B&C Office will is et Certi at of Occupancy)
Li Denied / call for Recheck
Inspected By:
L:\FireMarshal\New Folder\permitto occupyform.doc
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection re s �.eceiv : _
Queensbury Building&Code Enforcement Arrive: epart: Z / n
742 Bay Road,Queensbury,NY 12804 Inspector's Initia
NAME: �G��o PE T —CO
LOCATION: 2J`�=�i'f'AT'rE q DA —
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Throug Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in. /Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 s . ft.
All Doors 36 in.w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36(w)x 44" 1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site �A�► \�L�
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 %z doors
> 10%> 1000 s .ft. ���-/1
3/4 Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping,3,000 s . ft.Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan,if required
Elevator Operation and Si a e/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Si na e
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous!12 in.Beyond[Both sides]
Active Listening System and Signage Assembly SpaceA�
Final Electrical lJ _
Site Plan/Variance required Jb
Final Survey,New Structure/Flood Plain certification,if req. � 4
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides by 20' /Driveable Surface 20'wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C 91 1
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc
Commercial Final Inspection Rep
Office No.: (518) 761-8256 Date Inspection r ue t r cc' e
Queensbury Building& Code Enforcement Arrive: �epart: am/
742 Bay Road, Queensbury,NY 12804 Inspector's Initia s:
NAME: A V _ Q PERMIT#: —
LOCATION: _ 1 DATE: --�
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6"in 10' or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Ballisters 4 in. Spacing Platform/Decks
Stair Handrail 34 in.—38 in. /Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 s . ft.
All Doors 36 in. w/Lever Handles/Panic Hardware,if required
Exits At Grade Or Platform 36 w)x 44" 1)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator 18")Above Grade
Floor Bathroom Watertight/Other Floors Oka
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum l�
Boiler/Furnace Enclosure 1 hr. or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For BoilersO
Gas Furnace Shut Off Within 30 ft. or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 '/2 doors
> 10%> 1000 s . ft.
3/a Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 s . ft. Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Si a e/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets
Handicapped Bath/Parking Lot Si na e
Public Toilet Room Handicapped Accessible
Handicapped Service Counters, 34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond [Both sides]
Active Listening System and Signage Assembly Space
Final Electrical
Site Plan/Variance required
Final Survey,New Structure/Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway
Water Fountain or Cooler
Building Access All Sides b Surface 20'wide
Okay To Issue Temp. ermane
Okay To Issue C/C
LABuilding&Codes Forms\Building&Codes\Inspection Forms\Commercial Final Inspection Report.doc
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection req
Queensbury Building&Code Enforcement Arrive:j1, J-f a rt:
742 Bay Road, Queensbury, NY 12804 inspector's Initials
NAME: ��:� ,�``� _
ERMIT#:
LOCATION. _ INSPECT ON: --
TYPE OF STRUCTURE:
Framing Y N WA COMMENTS•
AM-Kc-cess,22' x 30" minimum
Jadc Studs/Headers
Bracing/Bridging
Joist hangers
Jadc 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 h 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's inch or 518 inch Type X
Garage side 5/8 inch Type X
Ceiling1wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. eM
5.7 sf above/below grade
5.0 sf grade
LABuiiding&Codes Form9-=\8ui1dN&CodesWnspec ion FomisTraming Firedoppinq Inspecxion Report.doc Revised January 7,2006
. ,
.,
�- _ _�, ?L
— .-. <. . , a _ .. _.__ _ _— __ .
Rough Plumbing / insulation kTioection Report
Office No. (518) 761-8256 Date Inspection reques eceived:
Queensbury Building &Code Enforcement Arrive: 12�DD a _a pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials
NAME: '�° PER t i
LOCATION: r INSPECT ON:
TYPE OF STRUCTURE:
Y44 NIA
Rough Plumbing/ ail Plates
/Vents in Place
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet 1 change of direction
P eT t
e rai nt
/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
Proper Vent, Attic Vent
Door/Window Sealed No Insulation
Duct/Hot Water Piping Insulation
If r uired unheated 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
Rough Plumbing / Insulation Inspecti n Report
Office No. (518) 761-8256 Date Ins ecti r s ived: ,�„
Queensbury Building &Code Enforcement Arrive:�a f art: • an��
742 Bay Road, Queensbury, NY 12804 Inspector's Initial
i
t
M C� �1� PER I e #:
NAME:
LOCATION: _ �t��h � �.ST�—�. INSPECT ON: Z—L-—tit
TYPE OF STRUCTURE:
Y N N/A
Rough Plumbing /Nail Plates
Plumbin Vent/Vents in Place
1 Y2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
leanout every 100 feet/change of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.I. or 10 ft. above h' hest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
50 P.S.I for 15 minutes
Insulation J Residential Check/Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed No Insulation
Dud/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Dud work sealed properly/No duct tape
COMMENTS:
Rough Plumbing insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008