1992-749 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Janijary 11 19 9.1
This is to certify that work requested to be done as shown by Permit No.92-749
has been completed.
This structure may be occupied as a single family dwelling (modular)
Location Lot 42 Mockingbird Lane. Insniration Park
Owner Mr. & Mrs. Daniel D. Demeter
Issued for upper level only with By Order Town Board
two car attached garage.
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
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BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 92-749 r
WARREN COUNTY, NEW YORK 00
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PERMISSION is hereby granted to MR. & MRS. DANIEL D. DEWER ^'
OWNER of property located at Lot 42 Mockingbird Lane Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Single family dwelling(modular)
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. o
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1. OWNER'S Address is 3
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2. CONTRACTOR or BUI LDER'S Name
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address 4--
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6. TYPE of Construction-(Please indicate by X)
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( X)Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications Model : O l le r—
No. 44'x23.42' Single family dwelling (Modular) as per plot plan,
specifications and application including two-car attached garage and septic
85AX996 Use
Single family dwleling r
255.00 November 25 93
$ 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.) �G
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25 November 92 rD
Dated at the Town of Queensbury this y of 19 fD
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SIGNED BY for the Town of Queensbury `n
Building and oning Inspect
UNAUTHORIZED ALTERATION OR ADDITION TO Map R elpC r e n1 e-
THIS DOCUMENT IS A VIOLATION OF SECTION "1-spir cat;an Subdivision
7209 SUBDIVISION 2 OF THE NEW YORK STATE Layou-+ Plo,n" F repQred by Hacar,on
EDUCATION LAW.
Eno��naerinoJ c.T. Ma1e_ Assoc. Pc.
DcktGd DGC. 19go. nrs 29
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5 14 0 55 00"\N 1 00.o o ✓I
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Y certify to the following
that this survey has been
prepared in accordance with
the Code of Practice for Land
surveys adopted by the R.Y.B.
Association of Professional
Land surveyors as last
revised. 6� v
DCInie1 D. Deme FGr (50' R.o.\Q.)
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1�S Su cc e 55or5 And/Or f\S S 19r�5
cl-�iccT�o T��le Insurance ComPan�
/ ;,ONLY COPIES OF THIS MAP SIGNED IN RED
INK AND EMBOSSED WITH THE SEAL OF AN
( OFFICER OF C. T. MALE ASSOCIATES, P.C.,
c. JeF r c �er11 SO n f L5 4g 0 -44 Dade. BE CONSEDEREDTTO BE A VALIED D TRUE COPY"ATIVE LL
Dote RECORD OF WORK Appr• LOT 42 - M ocK i rl GBi RD LP%rfE
1228•`12 Founder-lion Locgtior� G 1 { � S� 1 R A ` , ® 'V ��►�
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-To LJn of oUGen5bur Warren COUNTY, NEW YORK
C.T. MALE ASSOCIATES, P.C. F
50 CENTURY HILL DRIVE, P.O. BOX 727, LATHAM, NY 12110 l�s I -�-
(518) 786-7400 • FAX (518) 786-7299
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Drafter: LPN Checker: G � ENGINEERING • SURVEI'ING • ARCHITECTURE • LAND PLANNING
LANDSCAPE ARCHITECTURE • COMPUTER SERVICES 0-
Appr, by. _ Proj. No. 92 17665 SCALE: i"=30' DATE: Dec. 28,199-2
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REVIEWED BY:
FEE PAID: S dv i F QU�ENSBU-.
RECEIVED
PERMIT NO. : 9 - 26L.
tgov.2 31992
BUILDING PERMIT APPLICATION BLDG. & CODE DEPT
PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
'PLICANT HAS RECEIVED A VALID BUILDING PERMIT.
'1 applicants spaces on this application MUST be completed and the signature of the
iplicant MUST appear on the reverse side of this application.
finer of Property: Mr. & Mrs. Daniel .D. Demeter - Lot #42. - Model Modified 3A
0. Address: Mockingbird Lane PHONE
Queensbury, NY 12804 148.7. , 7.3 & 7_
�operty Location: Tax Map No. )1/9'/ �2
is there been any split of this property since October 1, .1988? Yes x No
Yes, Planning Board Review is necessary.
ibdivision Name, if applicable: Inspiration Park Lot .No. 14$.7.1,7.3&7.4
Lot #42 - Model 3A
iE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Cushing, Dybas Associates, Architects, P.C.
ITURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
x Construction of new building * CONSTRUCTION: $ 91,952
Addition to building
Alteration to building . * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: 100 ft, �c 100 ft.
Other work (describe) * Existing Building Size: None
* - ft. x .- ft.
* Proposed building - distance from
ROSS AREA OF PROPOSED STRUCTURE: * property line:
st Floor 1030 Sq. Ft. / ' *•. Front Yard 30 ft. Rear yard 46 ft.
Side Yards 22 ft. and 34 ft.
id Floor - Sq. Ft. -W; *' If on corner, setback from side street-
''" * - ft.
ther Floors - Sq. Ft*
not cellar or basement 1J.° * OCCUPANCY INFORMATION:
OTAL FLOOR AREA: 103o Sq. Ft. * Primary Building -
* x One Family Dwelling
ize of New Structure: 44 ft. x 23:42 ft. * Two Family Dwelling
oundation: * Multiple Dwelling/No. of Units
ier/Slab/Crawl/Partial ull Circle One) * Business _
* Industrial
o. of stories (Habitable space) 1 * Other
leight (grade to ridge). 22 1 ft.
f residential , no. of families: one * If addition, what will use be?
loi, of rooms (excluding baths) : six
lo. of bedrooms: Three
lo. of bathrooms: 1-3 4 * Accessory Building;
'rimary heating system: Baseboard . * Detached Garage - One/Two Car
.ype of fuel : B ec r c * V Attached Garage - One/wo Ca,r
lo., of fireplaces to be installed: None * Private Storage Building
lill a woodstove be installed?: No * Other
:entral Air Conditioning: Yes No
(OVER)
BUILDING PERMIT ANNL1CA-rION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. wood Frame
Will any second-hand or ungraded lumber be used? If so, for what? No
Foundation Wall Material : Poured. concrete Thickness: 8"
Depth of Foundation below grade (to bottom of footing) : Belot' V-o
Will there .be a cellar? No Heated or Unheated? Unheated Floor Sq. Footage: 972
Will there be a basement? yes Will any portion be used as living space? No
If so, what portion? N/A Sq. Ft. Type of Use? NIA
Type of Roof: Sloped/Flat/Shed/Other sloped Material of Roof Asphalt shingles
Size, wood studs 2. x 6 " ; spacing 16 " o.c. ; length s ft.
Joists (floor beams) : 1st Floor 2 " x so " ; spacing 16 " o.c:; span 13 ft. Ka2
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-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:
5/8 Type x Gypsum board, fire taped - full height and length of garage
Is there to be an opening between garage and dwelling? Yes If so, will a Fire-Rated door
enclosure, self-closing device be provided? Yes
Will a flue-lined chimney be installed? No Height above roof - ft.
Depth of chimney foundation below grade: - ft.
Depth of fireplace hearth: _ ft. _ in.
Water supply - Municipal or private well : Municipal
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: +100 ft
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: The Quinn Company, Inc.. - P.O. Box 6150-- Rutland, VT 05702 PHONE (802)747-701
NAME OF PLUMBER & ADDRESS: same as Above PHONE
NAME OF MASON & ADDRESS: Same as AbOVe PHONE.
NAME OF ELECTRICIAN & ADDRESS: same as AbOVe 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 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 pertaining to the proposed. work sh
be complied with, whether specified or not, and that such work is authorized by the owner.
Signature
OQ7ner, er s agent, arc ite
contractor
- -------------------------------------------------------------------------------------------
SPECI L CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
ENERGY. CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
a
Compliance Mkfiods:
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 ofWorksheets
Mr. & Mrs. Daniel D. Demeter Inspiration Park (Lot #42)
..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? YES x NO
4. Percentage of Area of Windows and Doors Over. 17% x Under 17% (1o.9%)
THE R-VALUES GIVEN ON THIS, SHEET MUST CORRESPOND TO R E Q U I R E D
THE R-VALUES SHOWN ON PLANS SUBMITTED!
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. to
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 N/A - -
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code x YES NO
TEMPERATURE. CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
' � i► 1� i2'L .
APPLI ANTS IGNATURE ' DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS :
Y
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
' r
Date: 10123192 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: Inspiration Park, Queensbury, NY 12804
Owner's Name: Mr. & Mrs. Daniel D. Demeter- - Lot #42 - Model Modified 3A
Owner' s Mailing Address: Mockingbird Lane - Queensbury, NY 12804
Installer' s Name: The Quinn Company, Inc. Phone #: (802) 747-7010
Number of bedrooms (if residential ): Three
Total daily flow (residential-compute @ 12s gal . per bedroom): 375
Topography-Circle On lat Rolling Steep Slope % of Slope
Soil Nature-Circle One: San Loam Clay Other /Depth: +20'
Ground Water-At What Depth? +6'-0#1 Feet
Bedrock or Impervious Material-At What Depth? +20 Feet
Percolation Test-Circle One: Not Required Required/Rate 2 Min. Per Inch
Domestic Water Supply-Circle. One: Munici ell Other
If domestic water supply is a well . -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank loon gal . (Minimum size: 1,000 gal . )
Tile Field:. Each Trench 27 feet//Total System Length 15____�___ feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: 1/2- to i-i z- Depth or Thickness 1.0 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 of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE;
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: AR DEPARTj.2�I/
REQUEST FOR INSPECTION RECEIVED:
NAME C'
LOCATION I<Al-`r c i �\
L- �__ �
DATE PERMIT # `
TYPE OF S'i'RUCTURE: � J
RECHECK APPROVED _
N/A YES NO
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM F EEZING
FOR M, OURS FOLLOWING THE LACE-
MENT OF HE CONCRETE.
MATERIALS - R THIS PURPOS ON SITE
FOUNDATION WA POUR
REINFORCEMENT I PLACE
FOUNDATION DAMPPR0 ING
BACKFILL APPROVAL
PLUMBING VENT/VENTJIN LACE
ROUGH PLUMBING
PLUMBING UNDER SLA
FRAMING:
JACK STUDS EADERS
BRACING/BRIDGING PE
JOIST�A_N -RS
JACK POST MAIN BEAM
AIR INFILTRATION BARRIER
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 R-
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY ROAD
QUEENSBURY NY 1280AIAL
(518)745-4447
�
ARRIVE: - 6 DEPART: 'l7
FINAL INSPECTION REPORT - RESI
DATE INSPEC(TTIIOON'REQUEST RECEIVED::
NAME
LOCATION P) L I\JX.—
DATE Z-1 I (� PE`RM_IT N q z—•7L49
TYPE OF STRUCTURE
FOOTINGS_ FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N A YES NO
CHIMNEY HEIGHTJB VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK PORCH STEPS RAILING
RELIEF VALVES
FURNACE HOT WATER OPERAT
INTERIOR TRIM PRIVACY D ORS
FINISH FLOORS:
BATH KITCHEN WATER IGHT
OTHER FLOORS SWEE ABLE
OTHER FLOORS CAR ETED
STAIR CLEARANCE ICINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN VARIANCE RE .
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C C
bJlL1—
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TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME ADO%s'-w L-Z�—
LOCATION ` ¢ 17 �
®ATE PERNITO
TYPE OF STRUCTURE ,c.c�
,�tECF�ECK,
FIRE MARSHAtPPR&L (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLLMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
,
CHIMNEY HEIGHT/LOCATION N/A YES NO
B VENT/LOCATION
PLUMBING VENT
ROOFING f
SIDING
DECK/PORCH/STEPS/RAILINGS,
RELIEF VALVES
F�/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY,,DOOR$
FINISH FLOORS: r
BATH/KITCHEN WATERTIGHT �s
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED �, ✓
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS I
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
COMMENTS:
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, VIEW YORK 12804
TELEPHI'uNE- - �518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR
FOR INSPECTION RECEIVED
NAME/.l�///11
LOCATIO�f— �� Meg
DATE ( PERMIT#
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION /
B VENT/LOCATION /
PLUMBING VENT
ROOFING /
SIDING l /
DECK/PORCH/STEPS/RAILIN S
RELIEF VALVES /,
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT',
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCVRAILINGS
SMOKE DETECT098
DOOR CLOSERSr�
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOS RS
OTHER FIR SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART
NSPECTOR
Jown o/ QuvenjLry
BUILDING and ZONING DEPARTMENT
Bay and Hav+land Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME �a4k7lr,- -
LOCATION L e! Z-
DATE /b/ PERMIT NO. /�-7��
SOIL TYPE - Sand -(Loam)- Clay -
Percolation Test Required? YES - NO —
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length L,) e:n�2
Length of each trench -27'
Depth of trenches ' I
Size of gravel_ 21 —
SEEPAGE PITS{Nuinber of)
Size- ft. X /ft
Gravel size
PIPING: Size Type
Bldg. to tank �✓�� b` '
Tank to dist. box - '�'�
Dist. box to'field/pit
Openings sealed? YES 0 Partial
LOCATION/SEPARATIONS:
Foundation to tank jb ft.
Foundation to absorptio Z10 ft.
Absorption to lot line (,eft.
Separation of pitsift.
LOCATION 9F- YSTEM ON �PROPERTY�(%circle one)
Front - Rear Left s'de - Righ side COMMENTS: �llic�GlL
'3
SYSTEM USE APPROVED YFf�S) NO v I'
Building Inspe $or
01/86 and vl
ELECTRICAL INSPECTIONS In Clc-c-es
DUPLICATE MUNICIPAL RECORD 9GLirCCC��
Permit No. 2- / n
Owner 17
Occupant / e /�
Location L7�l r 7— 1 lei �✓ ��/�
No. Street
C i c u:Z:`��S
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable codes.
Installed by U hLic t T esel01 11 -
z
No. Q
J
Date Inspector
4
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NOAG EL. 900 Haddon Ave.,Collingswood, NJ 08108
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ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
�`r 0t-m-em y—tu _ WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
<%AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
L , K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
i
� r
]TORS N.P. 11/20 1/12 1/10 V. % Y. 1/11 I 1%1 2 3 1 5 lye 10 115 120125130140150175 1100
\RK NUMBER
EACH SIZE
PPARATUS
AP- I
T0WN OF QUEENSBUR7
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED -a - �
NAME �I
LOCATIOFd !�� 4 "(� tr�
DATE
TYPE OF STRUCTURE_
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTP.ACTOR IS SPONSIBLE
FOR PROVIDING PRO(HE
TION FROM
FREEZING FOR 48 HS FOLLOWING
THE PLACEMENT OF CONCRETE.
MATERIALS FOR THIURPOSE/ON SITE
FOUNDATION/WALL P
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOkING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLA,'
FRAMING:
JACK STUDS/HE aERS
BRACING/BRIDG NG
JOIST HANGER
JACK POSTS/. IN BEAM
HEATING ROUG�-IN Y
INSULATION:/+.
FOUNDATI N WALLS INTERIOR R-
FOUNDAT �N WALLS EXTERIOR, R-
FLOORS R-
WALLS R-
CEILI. G R
DUCT (IRK OR PIPING IN UNHEATED
SPACES
REMARKS:
0
1
ARRIVE
DEPART
L' 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
NAME
LOCATION
DATE j 9-Z--PERMIT # 7 6
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI 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
YBACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS INY�LACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS 4
BRACING/BRIDGING r,
JOIST HANGERS
JACK POSTS/MAIN BEAM "z
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS E�JTERIOR R`-.
FLOORS R
WALLS f R-
CEILING J R-
DUCT WORK OR PIWING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPARTZ?j '
NSPr CTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST OR INSPECTIO14 RECEIVEDNAME
LOCATION.
LOCATION
DATE-0 PERE9IT i —
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI 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 �—f
ROUGH PLUMBING F '
PLUMBING VENT/VENTS IN PLACE l
PLUMBING UNDER SLAB /
FRAMING:
JACK STUDS/HEADERS 7
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAM "
HEATING ROUGH—IN y
INSULATION:
FOUNDATION WALLS INTE IOR R—
FOUNDATION WALLS EXTtRIOR R—
FLOORS d' R—
WALLS R—
CEILING R—
DUCT WORK OR PIPPNG IN UNHEATED
SPACES
r
REMARKS:
ARRIVE vil
DEPART /
w41 �1 CTOR ��
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
NAME
LOCATION
DAT �PEP141T 9
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES1 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
/;�COUNDATIO )_
REINFORCE `NT-��E
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING: A
JACK STUDS/HEADERS 4
BRACING/BRIDGING
JOIST HANGERS °� r
JACK. POSTS/MAIN BEAMS t'
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTER'I,OR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING `R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
R EMA R KS:
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY `o2�/�
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FO ECTION RECEIVED
NAME
LOCATION
DATE PERMIT # � � '79
TYPE OF STRUCTURE STD
RECHECK APPROVED
N/A YES
FOOTING /P ER
MONOLITH OUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FO L!LP OU S PURPOSE ON SITE
FOUNDATION A
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- I
FLOORS R-
WALLS R- I
CEILING R- I
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: %
ARRIVE �f '
DEPART
SPECTOR
s ,
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
/nRECEIVED
NAME
LOCATIOPd
DATE atl PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES N
A
OOTINGS/PIERS
ONOLITHIC 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 PLACEi
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS s
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM `
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R!;,
FOUNDATION WALLS EXTERIOR R-`i
FLOORS f R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
i
REMARKS:
ARRIVE
DEPART V _
INSPECTOR