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92-150 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date ,4d/ J 2&19 This is to certify that work requested to be done as shown by Permit No. 92-150 has been completed. This structure may be occupied as a Single Family Dwelling Location Lot #1 Hall Road Owner Daniel Barber -� 21.. 22.2 '� 2 By Order Town Board TOWN OF QUEENSBURY 4a1}(li Vigibit-7 Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY • o No. 92-150 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Daniel R. Barber N OWNER of property located at Lot #1 Hall Rd Street,Road or Ave. N in the Town of Queensbury,To Construct or place a Single Family Dwelling op at the above location in accordance to application together with plot plans and other information hereto filed and a approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. • C • 1. OWNER'S Address is v RD5 Box 119 Queensbury, NY 12804 2. CONTRACTOR or BUILDER'S Name Same I- 0 3. CONTRACTOR or BUILDER'S Address S 4. ARCHITECT'S Name O. 5. ARCHITECT'S Address Nf iG 6. TYPE of Construction—(Please indicate by X) fD ( X Wood Frame ( I Masonry ( )Steel ( ) a 7. PLANS and Specifications No. 1040 sq ft Single Family Dwelling as per plot plan specifications g and application r� 8. Proposed Use Single Family Dwelling with Att. 2-Car Garage $ 155.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 5, 19 93 (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 5 pay pf 9 May 1992 SIGNED BY 14, for the Town of Queensbury Building and Z ing I ctor 4 s TOWN OF QUEENSBURY ,- OF :A , ; �A REVIEWED BY: 1031$1 FEE PAID: )5[- `T----2_ APR 15 04 PERMIT NO. : Cl a _ J .`.a C) 3LD(, & CODE ®Ept BUILDING PERMIT APPLICATION 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 rever side of this a lication. * * * * * * * * * * * * * * * * * * * * * * * * * * * Owner of Property: � a P.O. Address: i(( P 5 ' .c7.751 I ( PHONE )i)P Property Location: )c& o_,_ A24; Tax Map No.2 �/ y' _ yam- ay��c. Has there been any split of this property since October 1, 1988? Yes No If yes, Planning Board Review is necessary. Subdivision Name, if applicable: Lot No.4/ THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: , D Ai)-l '\ 1 f.. L . S A F. K , NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE _ K Construction of new building * CONSTRUCTION: $ 5o c o d Addition to building Alteration to building * COMPLETE INFORMATION Rf QUIRED BELOW: (no change to exterior dimensions) * Size of Property: f(a'-f'ft. x / 2'ft. Other work (describe) * E isting Buil . Size: * 0/6 ft. x -� ft. * Proposed building - distance from GROSS AREA OF PROPOSED STRUCTURE: * property line: 1st Floor / b 1f® Sq. Ft. /V * Front Yard 3'7 ft. Rear y rd /D ! ft. * Side Yards a5ft. and ft. 2nd Floor Sq. Ft. ' 'J * If n c9orner, setback from side street- * (p�ta ft. Other Floors Sq. Ft. * (not cellar or basement) * OCCUPANCY INFORMATION: * TOTAL FLOOR AREA: / 0 416 Sq. Ft. * Primary Building - * One Family Dwelling Size of New Structure: 6 ft. x 7 ft. * Two Family Dwelling Foundation: *, Multiple Dwelling/No. of Units — Pier/Slab/Crawl/Partial/Full (Circle One) * Business * Industrial No. of stories (Habitable space) / * Other Height (grade to ridge) /Z, ft. * If residential , no. of families: c-r._ * If addition, what will use be? No. of rooms (excluding baths) : S---1 * No. of bedrooms: * No. of bathrooms: * Accessory Building: Primary heating system: * Detached Garage - One/Two Car Type of fuel : _ * . Attached Garage - One/To Car No. of fireplaces to be instal ed: ----- * Private Storage Building Will a woodstove be installed?: * Other Central Air Conditioning: Yes No * (OVER) BUILDING PERMIT APPLICATION CONTINUA: BUILDING SPECIFICATIONS: A ‘4.0 '� t Type of construction: wood frame fire sa `e, etc. Will any second-hand or ungraded lumber be used? If so, for what? Foundation Wall Material :. 1P thickness: R/��-,,�,,. Depth of Foundation below grade (to bottom of footing) : — Will there be a cellar? Heated or Unheated? Floor Sq. Footage: Will there be a basement? ..Will any portion be used as living space? 2 If so, what por tion? Sq. Ft. Type of Use? - . Type of Roof Sloped Flat/Shed/Other Material offf Roof Size, wood studs x " ; spacing 116" o.c. ; length 645 ft. Joists (floor beams) : 1st Floor " x `( " ; spacing d/4 " o.c. ; span / 3 ft. Joists (floor beams) : 2nd Floor " x " ; spacing " o.c. ; span ft. Overlays (ceiling beams) : " x " ; spacing " o.c. ; span ft. Roof rafters: " x " ; spacing o.c. ; span ft. Roof trusses (pre-engineer ): acing c " o.c. ; span 'C 6et. Exterior Wall Finish: o what teri al ? 's � .� Interior Wall Finish: / ( o If a garage is to be attached, describe materi s to be used for FIRE ARATION: Is there to be an opening between garage and dwelling? If so, will a Fire-Rated door, enclosure, self-closing device be provided? ' 7 Will a flue-lined chimney be installed? Height above roof ft. Depth of chimney foundation below grade: ft. Depth of fireplace hearth: in. Water supply - Municipal or rivate well : SEPTIC SYSTEM: Distance from any private well (including adjoining properties: /6, 5 ft. (A separate application is necessary for any repair or new installation of septic system. ) NAME OF BUILDER & ADDRESS: „ -L 2 C,..a62 PHONE )) 2'9-,52 NAME OF PLUMBER & ADDRESS: _ / PHONE t l NAME OF MASON & ADDRESS: if PHONE I r NAME OF ELECTRICIAN & ADDRESS: r ( PHONE r f 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 of 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 p 'ning to th proposed work shall be complied with, whether specified or not, and that such wo is au ize by the owner. Signature '): Owner, owner s agent, architect contractor SPECIAL CONDITIONS OF THE PERMIT: By: Code Enforcement Officer 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 APPLICANT'S NAME PROPERTY LOCATION PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area - /p 44 cD Sq. Ft. 2. Type of Heat - IEle ) Base Board Other 3. Is Building Mechanically Cooled? YES \/"NO 4. Percentage of Area of Windows and Doors Over 17% ' Under 17% THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED THE R-VALUES SHOWN ON PLANS SUBMITTE! Baseboard 5. Insulation Values: Actual Shown Elec. Heat Other A. Roof & Floors exposed to ambient temperatures R —3 , 4 B. Exterior Walls R______ C. Glazed Area R 1 , 1.a D. Exterior Doors R /0 /b E. Floors over unheated spaces R F. Edge of Slab on Grade (Heated Building) R '—' "----5 G. Basement/Cellar Walls (Above Grade) R / 9 / /✓ H. Basement/Cellar Walls (Below Grade) R_ 7 --/-2-✓ I. Heating/Cooling - Ducts - Piping in Unheated Space R 6. Service (Domestic) Hot Water Heating Device A. Conforms to minimum efficiency per code YES NO ZUT 0L MAXIMUM SETTING 140• - WILL NOT BE EXCEEDED 1) 9_ g. 9, ,.c-c APPLI NT'S S GNA EL NE NUMBER INSPECTOR'S REMARKS: el, 140).5; .:. . . AiiilliP 45457k ti___ rbiTiitir tr --- . - iiE�BT Pew �1M . ilift ` tg � TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # Fee Paid Date: Reviewed By LOCATION OF PROPERTY FOR INSTALLATION: Owner' s Name: a_ r ? en_&).x. Owner's Mailing Address: F Ds- ger—fi it / k )( / 2'6 Installer' s Name: q�, ,,L c.., () Phone #: � 1 �� ;. Number of bedrooms (if residential ): Total daily flow (residential-compute @ 150 gal . per bedroom) : 1,s Topography-Circle One Flat) Rolling Steep Slope % . lope Soil Nature-Circle One: Sand Loam Clay Other „ j,,. i,epth: Ground Water-At What Depth? Feet Bedrock or Impervious Material-At What Depth? Feet Percolation Test-Circle One. Not Require Required/Rate Min. Per Inch Domestic Water Supply-Circle One: Municipal 0 Other If domestic water supply is a well - Separation: Water supply from any septic absorption l G Ofeet PROPOSED SYSTEM: Septic Tank /0 0 cJ gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench feet//Total System Length l feet Seepage Pit(s): Number of '14 / Size each: ft. x Sift. Size of Stone to be used: # '3 / Depth or Thickness feet ************** HOLDING TANK SYSTEM IF REQUIRED No. of Tanks Size\of 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 o e Town of ueensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: TE: 9` TOWN OF QUEENSBURY 531 BAY ROAD QUEENSBURY, NEW YORK 12804 IMO TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR PECTION RECEIVED NAME ',c e/ 71-5_ LOCATION 497 ,/—i,7 0 DATE C 2 '.,? PERMITI rgA • /j TYPE OF STRUCTURE S rD RECHECK _FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) _FOOTING FOUNDATION BACKFILL FRAMING _ROUGH PLUMBING FINAL ELECTRICAL SEPTIC _INSULATION _WOODSTOVE/FIREPLACE _ REMARKS APPROVAL CHIMNEY HEIGHT/LOCATION N/A YES NO B VENT/LOCATION PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILINGS RELIEF VALVES FURNACE/HOT WATER OPERATIN' BASEMENT INSULATION/DUCTW,'K` INTERIOR TRIM/PRIVACY DOI'S FINISH FLOORS: \ BATH/KITCHEN WATERTI T OTHER FLOORS SWEEPA: E OTHER FLOORS CARPET D STAIR CLEARANCE/RAIL GS HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/WHO HOUSE FANS ALL PLUMBING FIXT RES OPERATING GARAGE FIRE PROD NG -': �/ DOOR CLOSERS OTHER FIRE SEPARATION FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VARIANCE REQUIREMENTS FINAL ELECTR L OK TO ISSUE4sR C/C ✓i COMMENTS: ARRIVE 3` 27 DEPART 221 IN T TOWN Of _QUEENSBURY P/-1 531 BAY ROAD QUEENSBURY, NE# YORK 12804 �%- TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION� RECEIVED 9//'/J NAME �LYI/12-al 4C7IZ€A LOCATION `3 f / )04/ . £ DATE 9//4/9.3 PERMITS 72- /5l) TYPE OF STRUCTURE , l2}j a2,e RECHECK FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE) FOOTING t.FOUNDATION t-BACKFILL L—FRAMING TROUGH PLUMBING FINAL ELECTRICAL SEPTIC INSULATION WOODSTOVE/FIREPLACE REMARKS Ai. /Q- ' APPROVAL N/A; YES NO CHIMNEY HEIGHT/LOCATION B VENT/LOCATION ' PLUMBING VENT ROOFING ✓ SIDING r DECK/PORCH/STEPS/RAILINGS ✓ RELIEF VALVES ✓ FURNACE/HOT WATER OPERATING INTERIOR TRIM/PRIVACY DOORS FINISH FLOORS: BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLE ° '>; ✓� OTHER FLOORS CARPETED +� / STAIR CLEARANCE/RAILINGSr v/ SMOKE DETECTORS DOOR CLOSERS / BATHROOM FANS ✓ ALL PLUMBING FIXTURES OPERATING t/ GARAGE FIRE PROOFING v' DOOR CLOSERS OTHER FIRE SEPARATION /v."' FIRE/DEMISE WALLS ✓ z FINAL ELECTRICAL ✓ OK TO ISSUE C/O OR C/C t/ COMMENTS: %fVie , , ARRIVE 31/0 DEPART -312c <� \ I C ELECTRICAL INSPECTIONS DUPLICATE MUNICIPAL RECORD Permit No. o?' /5-4 /� Owner /3 ,C/� /,4,C/ 23,/L JG Occupant Lqcation )L M- <` /2 Installation as itemized on reverse side has been visually inspected pursuant to applicable codes. Installed by g' t 12 T H, N27 g ._ Inspector 1 6 '� Date '7!1 ..�� MIDDLE DEPARTMENT INSPECTION AGENCY INC. FORM NO.18 EL. /.. ")C?) ROUGH WIRING OUTLETS H.P.AIR CONDITIONER L/ 7 Q...ETTS WIRING &CONTROLS FOR BURNER Sy RECEPTACLES / H.P.PUMP Y FIXTURES J K.W.OVEN f Y )AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT y °AMP. SERVICE CONDUCTORS / K.W. DISHWASHER. 7 j-- V K.W.SURFACE UNIT K.W. DRYER / K.W. RANGE AMP. RECEPTACLE / K.W. W�ATE�R HEATER � FRAC. H.P.VENT FANS , MOTORS M.P. 1/20 1/12 I/10 Ye '/ '/. 1/2 1/2 '% 1 112 2 3 5 71/2 10 15 20 25 30 40 50 75 1( MARK NUMBER OF EACH SIZE APPARATUS TOWN OF QUEENSBURY BUILDIikNG & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name bmizi Location )150-/ 94/4/4 Date Permit # 90?—/?0 SOIL TYPE:Swan Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length ___-- Length of each trench__.. Depth of rn:&es__ —? Size o stone SEEPAGE PITS: er- Size - ft. x ft. Stone size '' PIPING: � Sige Type Bldg. to Tank r--/ig VQ Tank to Dist. Box Dist. Box to Field/P ,, Openings Sealed? (Yes) No Partial LOCATION/SEPARATIONST Foundation to Tank feet Foundation to Absorption feet Separation of Pits z°' feet Conforms as per Pltt Plan es No LOCATION OF SYST7A ON PROPERTY: (circle one) Front eater - •eft Sides Right Side Middle F '-#M�, dear COMMENTS: , 6-4'\ SYSTEM USE APPROVED: (!ESSES j) NO Arrived: Departed: , Building nspec or TO OF QUEENSBURY BUILDING A D BAY ROAD CODES DEPARTMENT 53 QUEENSBURY, N W YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED N /9/4g NAME *4't Zafic J LOCATION ////- 7 .0 _11 DATE 4/177 /?;:? PERMIT # 907"11/45-d TYPE OF STRUCTURE JFJ ki C fi Xi/L./ 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- ( 9 FOUNDATION WALLS EXTERIOR R- FLOORS R- CEILINGt� I, vro� R- + DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: �% ARRIVE :2: \_____,// DEPART Z: diAL- SP OR TOWN OF QUEENSBURY 4tit BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED , /h1/1/3 /911(.. NAME LOCATION k / PG1� DATE ,:gici f q3 PERMIT # 9 '-/54) TYPE OF STRUCTURE ,?1 RECHECK APVROVED 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 SIT4 FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFIN ,BACKFILL APPROVAL ,ROUGH PLUMBING e PLUMBING VENT/VENTS IN LACE PLUMBING UNDER SLAB FRAMING: L--� JACK STUDS/HEADERS \vi BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM ; , HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERI R d FOUNDATION WALLS EXTERI R R- FLOORS R- 'l WALLS 1 R- CEILING R- DUCT WORK OR PIPING IIi' UNHEATED SPACES REMARKS: v. ARRIVE 11' io DEPART rWECTOR TOWN OF QUEENSBURY 7 BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 (<1-2/ ) TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 4 A9 am- LOCATION , l 4 '/ DATE 4/l W PERMIT I y -/,5 TYPE OF STRUCTURE 5 ,7) We. Gl C�:deep .e 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 PLAC PLUMBING UNDER SLAB ,(FRAMING: ili.odc_ �-ebi Q hil4 '\ JACK STUDS/HE4ERS U BRACING/BRIDGING a JOIST HANGERS t JACK POSTS/MAIN BEAM HEATING ROUGH-IN (INSULATION: r7'NA e n a FOUNDATION WALLS INTEFIO FOUNDATION WALLS EXTERI R- FLOORS R- WALLS AA- CEILING !k- DUCT WORK OR PIPINGIN UNHEATED SPACES REMARKS: ve PLN ,L ARRIVE DEPART I PE OR / TOWN OF QUEEMSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD �t QUEENSBURY, NEW YORK 12804 ,1 �/� ., TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME /L'i,'f L-C c-i t.- A -C--- LOCATION ] Q'/LL Li ti DATE q,,, z- PERMIT # 9 / 5-0 TYPE OF STRUCTURE _S/'-7) 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 r FOUNDATION/DAMPROOFINEG ?/ ini x __BACKFILL APPROVAL _ ROUGH PLUMBING PLUMBING VENT/VENTS IN` PUCE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING_ _ JOIST HANGERS i JACK POSTS/MAIN BEAM HEATING ROUGH-IN / INSULATION: / FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS I R- WALLS 1 R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: vr1) %,4"te5 r 11 -5-rf,1 i=-T -- /-) / / - . wkif.)12.(/' ..... ARRIVE DEPART �-- INSPE 0 TOWN OF QUEENSBURY jgeadBUILDING AND CODES DEPARTMENT 531 BAY ROAD /9r21 QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING IXSPECT'W S REPORT REQUEST FOR I SPECTION RECEIVED 0/Yel?d,A, NAME 1 LOCATION / 9 L/ DATE ����/f�� PERMIT # ra%..co TYPE OF STRUCTURE RECHECK APPROVED - N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR F .M REINFORCEMENT IN PLACE THE CONTRACTOR IS R4SPONSIBLE FOR PROVIDING PROTECTIt „ FROM FREEZING FOR 48 HORS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR I r REINFORCEMENT IN PLACE------------- X 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: `Q—tv Faas, 0., (1,.s.d f 5'% 20 icn Wad. ARRIVE DEPART /�14( [NSPECTOR TO k? OF QUEEMSB3JRY BUILDING AND CODES DEPARTMENT 4: <--�A 5M BAY ROAD QUEENSBURY9 NEW YORK 12804 I;/77 TELEPHONE (518) 745-4447 BUILDING INSPECTIY S REPORT REQUEST FOR INSPECTION RECEIVED NAME /4 0 L.4r! ,� i‘4�- LOCATION / r/ f DATE q//c/92 PERMIIT y,2 -/ TYPE OF STRUCTURE 1 c� C !t'' '/5 J RECHECK APPROVE 1 N/A YE NO ( FOOTINGS/PIERS MONOLITHIC POUR FORM j REINFORCEMENT IN PLACE [ THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING P'TECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. 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