94-651 BUILDING PERMIT
TOWN OF QUEENSBURY No W.
L�WARREN COUNTY, NE�WvYORK /� b
PERMISSION is hereby granted to J-�+7y�M bR (j / kC:�d/-1 c�_42P
OWNER of property located at zp� r'_kA1n1y/� Street, Road or Ave.
in the Town of Queensbury,To Construct or place a �o^ & i<A4Z6a6t7
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
CA 41a,0
2. CONTRACTOR or BUI LOERS Name
3. CONTRACTOR or BUILDER'SAddres
�25 �ra1 cr1 �o2Tiff-
4. ARCHITECT'S Name Q
(A 1\.
5. ARCHITECTS Address
1
6. TYPE of Construction—(Please indicate by XI T
1/ Wood Frame 1 1 Masonry 1 1 Steel ( ) `
7. PLANS and Specifications
No.:!�CaG_
8. Proposed Use
c5p6c
$e?A Dp PERMIT FEE PAID —THIS PERMIT EXPIRES /V ! 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 Day of 19
r
SIGNED BY for the Town of Queensbury
Building and Zoni nspector
r
.I
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date March 1 , 19y5
This is to certify that work requested to be done as shown by Permit No. 9 4—6 5 1
has been completed.
This structure may be occupied as a Single Family Dwelling, with two car
attached garage as per pmot plan and specifications .
Location Lot 53 , Autumn Lane
Owner Schermernorn Construction Corp.
1.21-15—5 3 By Order Town Board
TOWN OF QUEENS URY
Director of Bldg. do Code Enforcement
TOWN OF QUEENSBURY REVI#WED BY:
COMMUNITY DEVELOPMENT DEPARTMENT d/ %/00
BUILDING & CODE ENFORCEMENT FERV4XID
531 BAY ROAD (�j{ qq
QUEENSBURY, NEW YORK 12804 ��eNO.
( 518 ) 745-4447 nsbury
BUILDING PERMIT APPtxCAuee Mept
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 I�UST appear on the application form.
OWNER OF PROPERTY: t.^Hc ti Cr'('P^
Mailing Address : c c orfY+
Telephone Number(s ) : Wor �y � -ce �v Home � vs -ac7d Otter
PROPERTY LOCATION: /c A✓t✓ " A,' AA1 C CCIL• T. H, J .
Tax Map Number:/� Section i_ _ loc I Lot
Subdivision Name : S�eCvho r� 0:,/J .S Lot No.
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ `1I 9c•o
NEW BUILDING:
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
ADDITION TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL Family Dwelling
(NO CHANGE TO EXTERIOR SIZE) Office
OTHER WORK (DESCRIBE BELOW) Mercantile
Warehouse
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
1ST FLOOR 790 SQ. FT.
IF ADDITION, USE OF NEW ADDITION:
2ND FLOOR 79 D SQ. FT.
OTHER FLOORS S/ SQ. FT.
(not unfinished cellar or basement) ACCESSORY BUILDINGS :
Detached Garage - One/T�_C
TOTAL FLOOR AREA: /S�a SQ. FT. Attached Garage - One wo Car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
S-0 FEET X 27 FEET
Foundation Type: plj%,� Will any second-hand or ungraded
Number of Stories : OL lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : 28 feet TyVe of Heating System:
Number of fireplaces and/orrwoo-dstove (circle all which applies)
to be installed: O Electric / Oil / Gas / Wood
Forced Hot Air / Baseboard / Other
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
NAME OF BUILDER/ADDRESS/PHONE : Acy% S<.I �rwe .^hc^ � 72F -o67y
NAME OF PLUMBER/ADDRESS/PHONE: S+e- �`, Ake v7-5
NAME OF MASON/ADDRESS/PHONE: 01 - 7
NAME OF ELECTRICAN/ADDRESS/PHONE: cM ' �Y -3yr S
DECLARATION
To the best of my knowledge the statements contained in this appli-
cation, 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 shall be complied with,
whether specified or noted, and that such work is authorized by the owner.
Further it is understood that I/we shall submit prior to a Certificate of
Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN
drawn to scale, showing actual location of p�p-�ec� on T sea .
Signature
114i
(Owner, owner' s agent, architect, contractor)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
I,
ENERGY CODE COMPLIANCE APPLICATION
'DOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance Methods : PART 5 - Acceptable Practice Method -
1F2 Family Dwe.11i-ngs (only)
PART 6* - Thermal Rating - Compoaent Trade Offs
1k2 Family Dwellings; 'Multi-Family
Dwellings ( 3 stories or less )
PART 4* - Design by Component Performance
Commercial Buildings-Ili Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME : PROPERTY LOCATION!
1 SCy v,C v✓ I.-JNufti ��t 53 AJ'1otn7J LAJ ' —
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 150 square feet
2 . Type of Ileat - ___ Electric __ oil ✓ Gas Other
3 . Is building mechanically cooled? _ Yes ✓ No
4 . Percentage of area of windows and doors ✓ Over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . .. Roof R 30
b. Exterior walls R 19
C . Glazed areas R ;k-5
d . Exterior doors R ;a•S
e . Floors over unheated spaces R 11
f . Edge of slab on grade (heated building) R j I JA
g. Basement/cellar walls (above grade) R _ Ali/
h . Basement/cellar. walls (below grade) R - IIA
i . heating/cooling-ducts-piping in unheated space R H.t.
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code ✓ Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
A ca t Si n ur Date Phone Number
PP ` -- c-15 '44f. —t>E1y )Y� 33 `s3
INSPECTOR' S REMARKS :
TOWN UEENSBURY
APPLICATION FOR SEPT CF DISPOSAL PERMIT Permit #
Fee Paid
Date: is-05- 9y Reviewed By
LOCATION OF PROPERTY/ FOR INSTALLATION: Lo-I 53 A L) vU � nl 6 ,V
Owner's Name: LA, SG},ec wee �hornl
Owner's Mailing Address: 9 UYloeiefs �c �t9or+1,
Installer's Name: Akc Phone #: abjS 067y y�-33si
Number of bedrooms (if residential ): 3
Total daily flow (residential-compute @ 150 gal . per bedroom): �2S0
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? Al �A Feet
Bedrock or Impervious Material-At What Depth? N /A Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Munici a Well Other
If domestic water supply is a we
Separation: Water supply from any septic absorption nn feet
C See. S%.}e, 91c ,A1 1�0r Shec wnti Aj N.J-7eS Subdr.,;Ste:nl J
PROPOSED SYSTEM: Septic Tank coo gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # / 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 of the Town of Queensbury Sanitary Sewage Disposal
Ordinance. n (�
SIGNATURE OF RESPONSIBLE PERSON: Q JH DATE: /c-� 5- g
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
TOWN OF QUEENSBURY
531 BAY ROAD,QUEENSBURY, N.Y. 12804-9725 (518) 745-4400
Memo
Re: Sherman Pines Septic installations
Date /(
Inspection made of seepage bed developed per specifications,
but built on existing soils. All previous systems required soils
to be ammended to slow pert rate . Original engineering by
Morse Engineering indicated the soils throughout the entire
subdivision to be medium to fine sands to depths up to 120"
and the percolation rates of these existing soils were observed
at less than 15 sec. per inch. -
The results of the perc tests received this date showed the
soils to be sandy loam to a depth of 18 inches and the perc rate
at over one inch per minute at three locations. These tests were
taken by a representative of VanDusen & Stoves, licensed Land
Surveyors.
The engineering specifications for the original Subdivision
are considerably different than those we are being asked to accept .
Without ammending any soils, the recent percolation tests seem to
be acceptable. If we are to accept these; I believe that some one
should make that determination before a number of system ` are in
place.
Vic Lefebvre
115195 �..:
David Hatin called the office of the professionals that did the
percolation tests . A copy of those results will be on file for
each of the systems. Mr . Steves states that he is qualified of
do this testing and will stand by the reports .
"HOME OF NATURAL BEAUTY. . A GOOD PLACE TO LIVE"
SETTLED 1763
VAN DUSEN & STEVES
LICENSED LAND SURVEYORS
37 CHESTER STREET
GLENS FALLS , NEW YORK 12801
(518) 792-8474
Owners Name : cNE#tfAISeC1t%%LM
Location S#tX*%#jt4
PERCOLATION TEST HOLES DEEP TEST HOLES
TOTAL DEPTH OF HOLE 18 TOTAL DEPTH OF HOLE "
SOIL DESCRIPTION SOIL DESCRIPTION
„-(a SANv C..AW „
„— „ „_ if
N „ „
„-
it—
PERCOLATION RATE 1 " — I min /L" MOTTLING if GROUNDWATER "
TOTAL DEPTH OF HOLE " TOTAL DEPTH OF HOLE "
SOIL DESCRIPTION SOIL DESCRIPTION
PERCOLATION RATE 1 " — min Z MOTTLING " GROUNDWATER "
TOTAL DEPTH OF HOLE Ir " TOTAL DEPTH OF HOLE
SOIL DESCRIPTION SOIL DESCRIPTION
O „- r. of -T.Osu
—We,
if „
„— It
PERCOLATION RATE 1" — min G¢'7 MOTTLING GROUNDWATER "
ur r . it. a. , ,
DATE: is 1•. TESTS MADE BY : /yINN
1,
U TOWN OF QUEENSBURY
/ BUILDING E CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSALSYSTEM INSPECTION
Name _J�prm��pr� �,C-�
Location j-Q5+- rj
Date Permit R 94—
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench I. _ I
Depth of t enches TL7'n"`--
Size of st e
SEEPAGE PIT : N er-
Size - t:"z" t.
Stone size
PIPING: Size Type
Bldg. to T k
Tank to D st. B x
Dist. B to Fie d/Pit _ f
Openin s Sealed? Yes No Partial
LOCAT ON/SEPARAT S:
Fou ation to Tan feet
Fo dation to Abs rption feet
S aration of Pit feet
onforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
Building I ctor
TOWN OF QUEENSBURY
BUILDING E CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Sche+,- lMo� kioy-n
Location L
Date permit #
SOIL TYPE: S -nd-Loam-Clay-
Results of Pe colation Test-
(if applicabl ) Rate-Minute/Inch
TYPE OF SYS
ABSORPTION FIE : Total Length
Length of each rench
Depth of trenche
Size of stone
SEEPAGE PITS: Nu ber-
Size - ft x ft.
Stone size 00
PIPING: Si-e Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/P't
Openings Sealed? s No —Pa rtia
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorptio feet
Separation of Pits feet
Conforms as per Plot Pla Yes No
LOCATION OF SYSTEM ON RO ERTY:
(circle one) i
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
5�
K
j1J5I/fLS'y� iVr1 �/T�
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
Building I pector
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
531 SAY RD., QUEENSBURY NY 128y0y4,
INSPECTOR'S REPORT: ARR DEPAR7/ _k TINT
REQUEST FOR INSPECTION RECEIVED:
NAME SC,-�dUn A4, %(21, C)
LOCATION C Q-\ V I
DATE �'1 ^R' PERMIT A '`P
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS[HEADE S
BRACING BRIDGING
JOI"T HANGERS
JACK POSTS MAIN BEAN
AIR INFILTRATION BARRIER
f1EATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERI f R- �
FOUNDATION WALLS EXTE OR R-
FLOORS R-
WALLS R-
CEILING R_
DUCT WORK OR PIPING IN
UNHEATED SPACES / R-
j
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
531 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR DEPART!3LZa INT
REQUEST FOR INSPECTI N RECEIVED: _
NAME
LOCATION /'
DATE t , PERMIT A g l{ E
TYPE OF STRUCTURE:
RECHECK APPROVED _
A YES _NO
A FOOTINGS PIERS
'MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBL FOR
PROVIDING PROTE TION FROM FR EEING
FOR 48 HOURS FOLLOWING THE P CE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS __ -_- -
BRACING BRIDGING _ - - --
JOIST HANGERS ----- - -- -
JACX POSTS/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-
F - --- _
TOWN OF QUEENSBURY %v
BUILDING F CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRJZ _�EPAR IN i
REQUEST FOR NSPECTION RECEIVEEDD: y
NAME '� eY h.< i kc( k/l-C1.S N ,
LOCATION/
DATE J � PERMIT N
TYPE OF'STRUCTURE:
RECHECK APPROVED
NIA YES NO
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSI LE FOR
PROVIDING PROTE TION FROM •REEZING
FOR 48 HOURS FOLLOWING TH PLACE-
MENT OF THE CONCRETE
MATERIALS FOR THIS PURPO E ON SITE
FOUNDATION/WALLPOU
REINFORCEMENT IN PL \CE
FOUNDATION/DAMPPROOF
ACKFILL APPROVAL
PLUMBING VENT VENTS IN LACE
ROUGH PLUMBING
PLUMBING UNDER S AB
FRAMING:
JACK S UDS[HEADERS
BRACI /BRIDGING
JOIST HANGERS
JACK POSTS MAIN BEAM _
AIR INFILTI TION BARRIER _
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R_
WALLS
CEILING R_
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
531 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRAt-_�LQ DEPART 1
REQUEST OR INSPECTI N��_��_REyyyyyyC��/��/EIVED: _
NAME � (l�
LOCATION
DATE �_ PEER,M�I'T\ -._-
'TYPE OF RUCTURE:
RECHECK APPROVED
N/A YES NO�
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS REEPONSI LE F R I
PROVIDING PROTE TION FROM RE ING
FOR 48 HOURS FOLLOWING THE CE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE N SITE
FOUNDATION WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION DAMPPROOF G
BACKFILL APPROVAL _ -
PLUMBING VENT VE S IN PLAC
OUGH PLUMBING /
PLUMBING UND SLAB
FRAMING:
J K STUDS HEADERS -
CING BRIDGING ----
GIST HANGERS - - ---
JACK POSTS MAIN BE
AIR I ILTRATI0 BARRIER
HEAT NG ROUGH-IN
IN LATION:
.FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS_E_XTERIOR R-
FLOORS ---
WALLS R`
CEILING R_ -
DUCT WORK OR PIPING IN ----
UNHEATED SPACES R-
P'AS)iL�wft
c Jock �Oc.A MR :77E
14' I
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY RD. , QUEENSBURY NY 12604
INSPECTOR'S REPORT: ARRLDD DEPART,% IN
REQUEST FOR INS/PECT�IONNRRE�CEIVED:
NAME _ L1�.o��c'3'1� ,�^' p� /--t•�
LOCATION
DATE �j GrPERMIT A
-�/
TYPE OF STRUCTURE: Oro,
RECHECK APPROVED
N A YES NO
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESP NSIBLE OR
PROVIDING PROTE TION F OM FRE ZING
FOR 48 HOURS FOLLOWING HE P CE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURP S ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLAC
FOUNDATION DAMPPROOF NG
BACKFILL APPROVAL
PLUMBING VENT VE S IN P ACE
ROUGH PLUMBING
PLUMBING UNDE SLAB _
ING•
JAC STUDS/HEADE S
B ING BRIDGING _
RA
JO ST HANGERS - -
J K POSTS MAIN EAM �
AIR INFI RATION BARRIER
HEATING ROUGH-IN
INSULA ION:
FO NDATION WALLS INTERIOR R-
F NDATION WALLS EXTERIOR R-
OORS R_ -- --- -
ALLS R_ - ---
CEILING g_ ---
DUCT WORK OR PIPING IN --
UNHEATED SPACES R-
Roots �Eo�, PRoPE1Z cDLu-�� S
� t3oT�-i dEa��,� Fb�I�rS
FLoo4Z Joist '4 '�E
P,5 PEA oOQ
1JEF_q Tp V�E C�ULA,VE\FZ)
P�� uJc�O CA-0ED 1 REu�E.D
PAST O F N uJH Fco
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
531 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR DEPART/bV�'INT
REQUEST FOR INSPECCTIION RECEIVED:
NAME _ vV A1e�v /\O Y Yn
LOCATIONv�-WyVvy�-.�,g./w,,,`i_
DATE ,— )�' _ PERMIT LI# 9 W
TYPE OF STRUCTURE: _
RECHECK APPROVED _
N/A YES NO
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE _
THE CONTRACTOR IS RESPONSIBLE FOR f
PROVIDING PROTE TION FROM FREEEINC
FOR 48 HOURS FOLLOWING THE PLACE
I4ENT OF THE CONCRETE. _
MATERIALSS' FOR THIS PURPOSE O SITE
FOUNDATION V LPOUR
REINFORCEMENT PLACE 4
FOUNDATION/DAMPPR FIN /
BACKFILL APPROVAL
`PLUMBING VENT VENT ' IN LACE
1 ROUGH PLUMBING /
PLUMBING UNDER ALAB
FRAMING:
JAC STUDS/HEADERS
BRA ING BRIDGING
JO ST HANGERS
JACK POSTS/MAIN BEAM -
AIR INFILTRATION BARRIER
HEATINy;'ROUGH-IN _
INSULATION:
FOUNDATION WALLS INTERIOR R- _
_FOUNDATION WALLS EXTERIOR R R-
FLOORS R- ---- --
WALLS R_ --
CEILING
DUCT WORK OR PIPING IN
At
P�T5 M
UNHEATEDnSPACES R-
(SS(/t/6
VE#r P( PI)/6 Pr-6c Pcrea.
TOWN OF QUEENSBURY
BUILDING S CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR DEPART�614-% INT
REQUEST FOR INSPECTION RECEIVED:
NAME _ ` Y' r C-z M VLX
LOCATION 1 ��
DATE PERMIT N
TYPE OF STRUCTURE!
-'Y'7��
ECHECK APPROVED
N/A YES NO
FOOTINGS PIERS
MONOL THIC POUR FORM
REINFOR 6EMENT IN PLACE-
/
THE CONT` CTOR IS RESP�l NSIBLE FOR
PROVIDING ROTE ;ION
FROM FREEZING
FOR 48 HOUR FOLLONIti THE PLACE-
MENT OF THE NCRETE
MATERIALS FOR IS URPOSE ON SITE
FOUNDATION WALLP
REINFORCEMENT IN L CE _
FOUNDATION/DAMPP OOFI G
BACKFILL APPROV L
PLUMBING VENT EN7'S IN P CE
ROUGH PLUMBIN _.
PLUMBING UNDIR SLAB
FRAMING:
JA K STUDS/HEADERS
4B CING BRIDGING
J IST HANGERS
J CK POSTS MAIN BEAM --
AIR INFI TRATION BARRIER
HEAT UGH-IN _
6I4SULA7'ION: -4
FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS EXTERIOR R-
_FLOORS R_ --- --- ------
WALLS R_ _--
CEILING R_ - -- --.
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
U Wiz-` -1 C
mc�
TOWN OF QUEENSBURY �-
BUILDING S CODE ENFORCEMENT
531 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR_ DEPART__ INT_jU
REQUEST FOR INSPECTION RECEIVED: i P -ci j
NAME _ _CY\EiY(tir-k,iJ 1
�(yT'J_A_�_y-)1-�
LOCATION -J 3
DATE �-7(�i -�� _ PERMIT A L4-/'
TYPE OF STRUCTURE: ��
RECHECK APPROVED w
N A YES NO
FOOTINGS PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRE
MATERIALS FOR THIS LRPOSE ON SITE
FOUNDATION WALLPOUR '
REINFORCEMENT IN PLAC
FOUNDATION DAMPPROOFIN
BACKFILL APPROVAL
PLUMBING VENT VENTS I LACE
' ROUGH PLUMBING
PLUMBING UNDER SLA
FRAMING:
JACK STU S HEAD RS
BRACING BRIDGINq
JOIST NGERS 7
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FOUND TION WALLS INTERIOR R-
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TOWN OF QUEENSBURY � -
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531 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR DEPARII"'�'_ N
REQUEST I�N/�/SPEC�ONN RECEIVED: r �
NAME C.G� •�G�h `
LOCATIONN �1
DATE ( 3 ). PERMIT #
TYPE OF STRUC URE:
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N/A YES -NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RES ONSIBLE FO
PROVIDING PROTE TION ROM FREEZ G
FOR 48 HOURS FOLLONIN THE PLA -
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MATERIALS FOR THIS PURP SE SITE
FOUNDATION WALLPOUR
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531 BAY RD. , QUEENSBURY NY 12804
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LOCATION
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MATERIALS FOR THIS PURP SE 7 SITE
FOUNDATION WALLPOUR
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TOWN OF QUEENSBURY
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531 BAY RD., QUEENSBURY NY 128004
INSPECTOR'S REPORT: ARR DEPARIL'-?4INT
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NAME
LOCATION
C
DATE D _ I I c� PERMIT N
TYPE OF STRUCTURE:
RECHECK APPROVED
N A YES NO
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MONOLITHIC POUR FORM
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PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS OR THIS PURP E ON SITE
FOUNDATION IALLPOUR
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'r 531 BAY ROAD ,^_
QUEENSBURY NY 12804
(518)745-4447 /i�G7A'��
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENT
DATE //INy//yL��ppE/CTIOONN REQUEST RECCJEIVED: ( �J
NAMELOCATION
DATE
DATE 15 PERMIT N /
TYPE OF STRUCTURE =
FOOTINGS FOUNDATION BACKFILL FRAMI
ROUGH PLUMBING SEPTIC INSULATION
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PLUMBING VENT
ROOFING T
EXTERIOR FINISH
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OTHER FLOORS SWE PABLE`
OTHER FLOORS ZRPETED
STAIR CLEARA E RAILING
SMOKE DE CTORS
BATHROOM FANS _
PLUMBING FIXTURES
FOUNDATION INSULATION OK
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL S(Tc
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FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C C F R
TOWN OF QUEENSBURY
BUILDING 6 CODE ENFORCEMENT
531 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
ARRIVE: DEPART: loctio INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
( /
DATE INSPECTION REQUEST RECEIVED: /S
NAME ,,(G)'1C'/2 o'�'�$—ho2 Mi 12 rCh
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FURNACE HOT WATER OPE TING
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531 BAY ROAD
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(518)745-4447
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FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECrTIIOON REQUEST RECEIVEDD:
NAME , '(1
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