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2002-099 TOWN OF QUEENSBURY
742,Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERT IFICATE OF OCCUPANCY
: LL Permit Number: :P20020099 Date Issued: Wednesday,August 27,2003
This is to zerti£y thatwork requested to.,be done as shown by Permit Number P20020099
has been completed, }
Tax Map.Number: , _ 523400-295-017-0001-005-000.0000
Location: 27' VERANDA Ln
Owner:. FREDERICK&SUSAN ZM ERMAN.
Applicant: HAROLD T RAVEN
This structure may be occupied as a:
By Order of Town Board
Fireplace TOWN 0F_QVEENSBVRY-
Garage.-2 Cars Attached
Single Fatnily`Dwelling" .. ._.. . . . / ..
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020099 Application Number: A20020099
Tax Map No: 523400-295-017-0001-005-000-0000
Permission is hereby granted to: HAROLD T RAVEN
For property located at: VERANDA -Ln
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: HAROLD T RAVEN Single Family Dwelling 200,000.00
70 MC CORMACK Dr Garage-2 Cars Attached
LAKE GEORGE,NY 12845 Fireplace
Total Value 200,000.00
Contractor or Builder's Name Address Electrical Inspection Agency
RAVEN INDUSTRIES
70 MCCORMACK ROAD
LAKE GEORGE.NY
Plans &Specifications
2002-099
2700 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$391.20 PERMIT FEE PAID- THIS PERMIT EXPIRES- Wednesday,February 12,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date)
Dated at die T fQueembyry; Ti4esday,February 12,2002
1
SIGNED BY —for the Town of Queensbury.
Director of Blin7&Co Enforcement
Building Permit Application
Town of Queu'tZS`bu y - Dept. of Community Developneerrt, 742 Baja Road, Qttc eirsbtuy, NY 12804 1761-8256J
BUILDING & . CODE ENFORCEMENT
1�OTICE Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. ��j� � , 0
beginning construction. No inspections PERMIT FEE PAID$
will be made until.applicant has received ® Zoning' Board Action `s
a VALID BUILDING PERMT'. All Area /Use RECREA770117 FEE jAID applicants` spaces on this application
SPR / Subdivision /Other
MUST, completed ae a signature 0 Planning Board Action REVIEWED BY.-
of the applicant-must appear on the
IieatiOn form. 7nm�k ion. .. &� iRS tec ar
Recreation Fee Payment
Applicant:' fr''� ,''�- i� -
�-•� Owner: •-
Address, —`� Address:
/N"'j Phone # ( } ` ,�-, Phone # ( ) 7Pz_ --�
Property Location: . -_�
� �, .-" Tax Map Number1
Subdivision Name: fS —
Section Block int
NA/T N OF B PROPOSED WORK: ESTIMATED MARKET VA THE
"mow iYTg`�s CONSTRUCTION: $_ �
UE OF
commercial
Ad ion to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Prima v- Building -
residence / commercial L==-- Q`ingle Family Dwe _ng�®
Residence / Commercial, Two Family ,
no change to exterior size Fami 1.�1`3
Office
Other Work (describe below) Mercantile FEB U 8 2002
Manufacturing
Other TOWN OF QUEENSBURY
GROSS AREA OF PROPOSED STRUCTURE: BUILDING AND CODE
If ADDITION, what will use
lst Floor. . . . . . . sq. ft. of new, addition be?:
2nd .Floor. . . . . . . - sq. ft.
Other Floors . . . • sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS: ]
Detached Garage 1, 2 car
TOTAL FLOOR AREA: SQ. FT. u attached Garage 1,
•Vrivate Storage Build
SIZ'EE OF NEW STRUCTURE: Commercial Storage Building
- G-� Other. '
FEET X FEET
Foundation Type: �v'r r'- Will any second-hand or ungraded
Number of Stories : �� lumber be u e �f so, for what?
(habitable space only)
Height (grade to ridge) : feet TYPE OF. HEATING SYSTEM:
Number of fireplaces a d/or woodstove (circle all which applies)
to be installed: '� Electric / Oil ¢- "'��Wood
Ho_t__A-i_T== Baseboard / Other
Person responsible fo supervision of work as re ar s o building
codes is: � /� ��/�_ :, ' V :7•7--
Name Addresss Phone
Builder:
Plumber: t
Mason:
Electrician:_ -
DECLARA770N. Please sign below after you have carefully read the statement.
To the best of:my knowledge 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 shall be complied with, whether specified or noted, and
that such work is authorized by the owner_ Further, it is understood that Uwe shall submit prior to a
Certificate of Occupancy-'or Certificate of Compliance being issued, an AS BIJIL.T PLOT PLAN by
a licensed surveyor; dr to sca1g,.s ing actual location of project on premises.
Signature:
er, owner's agent, architect, contractor)
Application for Permit_Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION: . f-- -- ;
OfFce Use
Locations of installation.,
File Permit No.
Tax Map No.
I Fee Paid {
Owner's Name:
Address:
2. INSTALLER'S NAME PHONE NO.
3. RESIDENCE INFORMATION: -(circle year of dwelling,.indicate#bedroom(s)and multiply# of
bedrooms with applicable gallons per Bedroom to equal total datly flow)
Year of House No of Bedrooms x Computation = Total Daily Flow
1980 or-older x 150 gal/bdrm =
1980—1991 x 130 gailbdrm =
x 110 gal/bdrm =
Garbage`Grinder Installed yes_ 410=
Spa or Whirlpool Installed yes
4. PARCEL'INFORMATION: (circle applicable information&indicate measurements) -
Too H ' Soil N r Ground ater Bed_rock or I ervious-Material Domestic Water S 1
Flat s at what depth at what depth municipal
of oam feet feet
Steep slope clay if well,water supply
%slope other from any septic-system
depth: absorption fs Z.�-
other
Percolation Test- (To be-completed by licensed professional engineer or ahitect)
Rate; MtJc�1�-minute per inch �����i•�i!'
r;
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be.designeiiby a licensed
professional engineer or architect_(unless installed in a Planning.Board approved subdivision). Add 250 gallons to the size
of the septic tank and leach field for each Garbage Grinder,Spa or Whirlpool Tub.
Septic Tank: gallon (min.size 1,00 gal.)
Tile Field: each trenc ! _ft Total System Length:
Seepage Pit(s): number,of-- size of each: 1i By i
l " feet
Size of Stone to be used: #. depth or thickness f
Bed System Size: x ;
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if reguired)'
Number oftanks: / Size of each: gallons /TOTAL Capacity: gallons
Notes Alarm System and associated electrical,work must be inspected by a Town approved
electrical inspection agency.
7• SIGNATURE 8c INFORMATION FOR RESPONSIBLE PERSON(please read)
Far your protection,-please note thatpursuantto Section 136-29 ofthe Code ofthe Town
i of Queensbury,any permit or approval granted-which is based-upon or is granted in
reliance upon any material misrepresentation or failure to make a material fact or
circumstance known by or on behalf of an applicant,shall be void.
I have read the regulations,with respect to this application and.agree to abide by these and all
requirements ofthe Town of Queensbury Sanitary Sewage Disposal Ordinance.
S gnature�of responsible person
BLDG. PERMIT NO.
2002-099 ,�G �
APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY
A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property
located at; Lot G, House No. 27 Ve%anda Lane
for the following uses: SingZe-Aa►niZy duct;t; ing with 2-can attached garage
Tvr Fekr zu 13, W03
DATE SIGNATURE OF APPLICANT
TEMPORARY CERTIFICATE OF OCCUPANCY
The TEMPORARY CERTIFICATE OF OCCUPANCY is hereby ()QAPPROVED
( )DISAPPROVED
with the following conditions: 1. eomptete siding
2. comp'ete nait inge
3. dubbin .6uxvey
TEMPORARY CERTIFICATE OF OCCUPANCY F $10.00 EPOSIT:)(X)$100.00
received on Febnuany 13, 2003
, /_4�__
Date of Issuance Director of Bldg. & Co of ement
THIS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES 90 DAYS
FROM THE DATE OF ISSUANCE.
NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code
Enforcement or his designee.
'"WN OF QUEENSBURY
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date 2 Permit No.r_XY)')
_
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Buildin,&�,,
o4 UsetP,&rxnit/
t' ,
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with.
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to-enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant APPLIANCE (check appropriate boxes)
Ad d ress ,�A/ 13 STONE:ciWood r3Coal c3 Pellet c3Gas
0 FIREPLACE INSERT
Zip lle_?? 0-FIREPLACE, FACTORY-BUILT:
d rj G as
Phone 0 FIREPLACE, MASONRY:
[3 Wood E3 Gas
Owner 0 FURNACE: [3 Wood o Gas [3 Oil
Ad d ress IF NON-MASONRY APPLIANCE:
-_-...Manufacturer:
Zip Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
7fl > 0 MASONRY: 13 Block 0 Brick 13 Stone
FLUE: 13 Tile w�gtfeel
Size: sr inches
CONSTRUCTION / INSTALLATION MUST [3 FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS tdo' uble Wall 13 Triple Wall
REGARDING REQUIRED INSPECTIONS. [I Insulated o Direct Venting
c3 Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title
A 173 3389 (190) Public Safety
A 233 2655 Minor Sales
t,;_eCollected From
0 efunded to: [4c
Dated: Town Clerk or Deputy-L—c-i V
White: Applicant Green:Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
ENERGY COD;:* COMPLIANCE APPLICATION
TOWN OF QUEE:NsBURy, WARREN COUNTY
9000 ?.*E:ATTNG DEGREE DAYS
Colmollance Methods : PART 5 — Accept-able Practice Method
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Farally Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* - Design -by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APgLZCA2 T' S 'NA214E:
PROPERTY LOCATION:
7Z
4�K
PART 5 METHOD OF COMPLIANCE ;BY ACCEPTABLE PRACTICE:
I . Grots Floor Area scuare feet..
2 . Tv-oe o'_F Heat - - .Electric 041 ��C_as__ Other
3 . 1s building mechanically cooled? Yes
4 . Percentage. of area of windo;qs and doors Over 17 nder 17z--
5 . F.-VALUES FOR INSULATION G7-V=P IN M-EL07,-T MUST COR]RESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTEED:
a . 'Roof R-
b I Exter-Jor walls
C Glazed areas R ;_P
d- Exterior doors
. e . Floors over unheated spaces P
f . Edge �of slab on grade (heated building)I R g. Basement/cellar walls ( above grade) R
h- Basement/cellar, walls (below g=ade) R
1. Heating/cooling-ducts-piping In unheated space R
6 . Service (domestic) hot 'water heating device
Conforms to minimum efficiency per code �Y e s No
TEMPERATURE CONTROL MAXIMUM SETTING 1400 = WILL NOT BE EXCEEDED
Applic s tuts Date Phone Number
5
INSPECTOR' S REMARKS:
Application for SEPTIC DISPOSAL PERMIT
Town of Queen'sbury
Dept. of Community Development Permit No. 60
Building &Codes Office
742 Bay Road Fee Paid
Queensbury, NY 12804
Location of property for installation: ........ Z%� 7,24
/A.1
Property Owner's Name:
Property Owner's Mailing Address:
Installer's Name: Phone #
Number of bedrooms (if residential): Total daily flow:
(residential - compute @ 150gal./bdrm.)
,
Topography: flat, 4.,rollling, steep slope
Soil Nature: sand, loam, 7, of slope
loarn, clay, other /depth:
Ground water: at what depth? feet J Bedrock or jxpervious Material: at what depth?
feet
Percolation test: �ot required, _ required [rate- min. per inch
Domestic water supply: _ municipal,
well, - other
If domestic water supply is a WELL, water supply from any septic absorption is
PROPOSED SYSTEjyf
Septic tank: gallon (minimum size: 1,000 gal.)
Tile field: each trench 31Z' feet Total system length: feet
Seepage pit(s): number of I size each: fL by ft.
Size of stone to be used: de*pth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm system associated�elo-tr�icaI v���to b,�i,,��by,�,..tffid certified
For your protection, please note that pursuant to section 136-29 of the Code of the Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any material misrepewntation or failure to make a
material fact or circumstance known by or on behalf of an applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Disposal
Signature of responsible person: Date:
t I
�'��,J i Residential Final Inspection ItAl
Office No. (518)761-8256 ~i '� Date Inspection requ ceiv 4pnspector's
Queensbury Building&Code Enforcement Arrive: p art: `- „a742 Bay Rd.,Queensbury,NY 12804 .I Initial : . �
NAME: ' V Mom' T#: � `�
LOCATION: 27
TYPE OF STRUCTURE: E Val' 1
Comments
L4 j cQ
ChimneyHt.1"B"Vent/Direct Vent Location Y N N/A '
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in.or more1��
Exterior Finish Complete
Interior/Exterior Railizi s 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating.
-Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safet lazing
Window in stairwells safely glazing
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: 1 Battery backup:
Bathroom Fans,if no window }
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
'1 hour fire door/door closer
Garage fireproofing
Ductwork Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s .ft.-150 s . ft.vents
Building No./Address visible from road
Final Electrical .
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C Cert.Of Compliance)
Okay to issue Temporary C 10(Cert.Of Occupancy)
Okay to issue Pezmanent C 1 O(Cert. Of Occupancy
L:ISueHemingtvay\Building.Codes.Inspection.FORMSIRes.Final Insp.form 2.doe edited January 28,2003
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Residential Final hispection
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: an,/Dm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#.
LOCATION: DATE:
TYPE OF STRUCTURE:
Comments
Y N NIA
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof 67
Roof Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
uard at deck,porches 36,in.or more
Pxterior Finish Complete
V—Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in,with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operating
-Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: _ / Every Bedroom:
Outside every bedroom area: .
Inter Connected: — / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
%hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, I sq. ft.-150 sq.ft.vents
Building No./Address visible from road
Final Electrical
/Site Plan [Variance required
V Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C 0(Cert. Of Occupancy)
Okay to issue Permanent C 0(Cert. Of Occupancy
L:\SueHeningway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept,of,Community Development Arrive am/pm Depart ain/pm
Town of•Queensbury Inspector's Initials
742 BayRoad
Queensbury,New York,12804
NAME ���A. AJJ [TE
LOCATION :71-1 P
TYPE OF STRUCTURE
N/A YES NCO
Chimney HeightF B" ent/Direct Vent Location
Fresh Air Intake.
Plumb Vent through roa
€Complete
xteroor Finish Complete
InteriortExteriorRailings 30" 36" Cd'�„�/�LCt�
xteroor Handrails,balconies,I 18 in.or more 1L
Interior Handrails stairs both sides or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposedlregulator 18' bove.grade
Gas Furnace shut-off within 30 feet or wi line of site
Oil Furnace shut-off at entrance to furnace ar
FwmacetHot Water Heater operatin
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 n
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balcomes/Landmg in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroo
inter connected
Bathroom fans 1
Plumbing fixtures
Foundatio ation
3/a b0 fJre door/door closer
Garage f#eproofmg
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18".or less from floor
Final Electrical
to Plan/Variance required
mat Survey Plot Plan DY
As Built septic System layout required Okay to issue C/C(Certif.of Compliance) CID ® yT
Okay to issue temp.C/O(Certif.of Occupancy)_ /
Okay to issue permanent C/O(Certif.of Occupancy)
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518 ho ) 761-8205 Fax(518)745-4437
Fire Marshal's Inspection Report
Request SCHEDULE
�2� —0
Received: Permit# INSPECTION ON:
Name, 118,iAc-pebu A-A) AM PM ANYTIME
Location:
APPROVED
N/A YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIG
CHIMNEY
MASONRY ROUGHIN
FINAL
CHIMNEY
FACTORY BUILT ROUGH IN
FINAL
WOOD
STOVE ROUGHIN
FINAL
VENTED GAS
APPLIANCE ROUGHIN
zFINAL,
.VFIREPLACE
MASONRY ROUG IN OK THIS DATE OK FOR C NOT OK
U IN
FIREPLACE ---RO/'FINAL
FACTORY BUILT ROUGHIN ----INS-ECTED BY
FINAL
COMDEV/CHRISJfWORD/LETTERS2001/FIREMARSHALINSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INCe
Main Office 176 Doe Run Road*Manheim, PA 1754
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
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The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelledI -
This certificate only avers the electrical equipment and installation conditions as of date} Upon the
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making F
ns at any tune, and if its
rules are violated, the Company shall have the right to v e this c
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Datei! .IR.NiRi141►4■lilM11+!!!4 INSPECTOR •.../ #f•##►f rifil.ir R/iN1.►i l..........f .!!M
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Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPART0, amApm Notes:
761-8256 Inspector's Initials
NAME: PERMIT#
LOCATION: Qc-t-wt zp,- o-- INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
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
FoundationiWallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
]�,,�ea ig R ugkh�---,,:,-1
m u u su 0
sulation-
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
olls R-
Ceiling R- e2 0 V
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging_
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
lr W`511,2,,3,4�bour
p"'estbppm
L:\SueHemingway\Building.Codes.Inspecdon.FORMS\GENERAL INSPECTION REPORTAOC
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbuty Ready at time:
Dept. of Community Development Request received:
Building& Code Enforcement Meet:
742 Bay Road
Queensbuiy, NY 12804 ARRIVE_am/pm: DEPART P. N
L
(518) 761-8256 Inspector's Initials�44�1 I
NAME: PERMIT#
LOCATION: INSPECT ON(date): vi &310-2-
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
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/Wallpour
Reinforcement in Place
Foundation/Dampproofing_
Backfill Approval
Plqmbing Under Slab
Pg','entl, � is in PlaceX-
Hearing Rough-In
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- -------------
Walls R-
Ceiling R- WA
Duct work or piping in
unheated spaces R-
?zdper Vent.&gic Vent
TM,19—E09-:17-4
—
ac kStuds/Headers oC-e-
14—
Bracing/Bridgmig—
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
�e etration Sealed
Wald
3,j re 2�4're
F topp J�
L:\SueHemingway\Btiilding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT-doe
Office Use
GENERAL INSPECTION REPORT Inspector:
Ready at time: -�A
Town of Queensbury
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE aml P&I am/pm Notes-
pm: DEPART /Pm
(518) 761-8256 Inspector's Initials 4&
NAME: aft,Khlleit'�y w- Q.1J PERMIT#
LOCATIOM-W71, INSPECT ON(date): '16
TYPE OF STRUCTURE:
RECHECK
N/A YES i NO COMMENTS
Footings/Pier
Monolithic Pour Form N
Reinforcement in Place
The contractor is respo ible for 20L
fro providing protection freez' g
for 48 hours following the lac meatof the concrete.
se
Materials for this purpose on si
Foundation/Wallpour—
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plu bmig Under Slab
P bing ent/Vents
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-
raper ent, Vent
L
zck Studs/Headers 1,A)6-1&t1 4TU05
Bracing/Bridgin U,5�:�6-5 I A /7
Joist Hangers 7-4 C I <
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
L-.\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doe
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbuty Ready at time:
Dept. of Community Development Request received: Meet: C-14 4
Building& Code Enforcement At time:
742 Bay Road
Queensbui�� AT, 12804 ARRIVE am/pm: DEPART� am/pm Notes;
0- 1-001w—01
(518) 761-8256 Inspector's Initials,
NAME: PERMIT# (9
LOCATION: \6&A:r,,A— P9, INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
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/Wallpour
Reinforcement in Place
Foundation/Dampproofmg__
Backfill,Approval
Plplilbing Under Slab_
,Kumbing Vent/Vents in Place
Rough Plumbing_
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-
en ttic Vent�___
0 e V
ra
rin g
Jack S tudslHeaders_ t .
Bracing/Bridging C.li> bly-o Ck
Joist Hangers
Jac s earn
fir io arrier
-Fire Separation 1,2,3,hour
Penetration Sealed
re Wall 2,3,4 hour
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Residential Final Inspection T
Office No. (518)761-8256. Date Inspection'request received: 1001*
Queensbury Building&Code Enforcement Arrive: am/ m Depart: am/pm
742 Bay Rd.,-Queensbury,NY 12804 Inspector's Initials:
NAME: lYQA1'fY\9VV_"-,PERMIT#:
LOCATION: CK DATE: -= 3
TYPE OF STRUCTURE: �1
Comments .
Y N N/A.
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete _
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
uard at deck,porches 36 in.or more
xterior Finish Complete (5
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to"sill plate
Gas Valve-shut-of e used/regulator 18"abov6"grade
Gas Furnace shut-off within 30.ft.or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shutoff boiler
Relief Valves installed
Interior privag/trim/doors 1 main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety
glazing
Interior Smoke Detectors:.
Every level: 1 Every Bedroom: '
Outside every bedroom area:
Inter Connected:j' ! Battery backup.
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency Enjergency egress below grade
Basement stairs closed rise>4 inches
3/4 hour fire door/door closer -
Gara e fire roofm
Duct work Sealed ppoperly
Attic aCCCSS 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s .ft,-150 s ,ft.vents
Building No./Address Visible from road
F'nal Electrical j
ite Plan /-Variance re uired.
Final Survey Plot Plan
As Built Septic System Z Sewer Dept.-Ins ection Sticker
Flood Plain Certification,if re aired
Okay to issue C/C Cert.Of.Compliance)
Okay to issue Temporary' C/O Cert.Of Occit anc
Okay to issue Permanent C 1 O Cert. Of Occupancy)
L:\SueHemingway\Building.Codes.Inspeetion.FORMS\Res.Final Insp.form 2.doe,edited January 28,2003
Office Use
G
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time: G
.Dept. of Community.Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE 1Z5, a m:, EPA Notes:
(518) 761-8256 Inspector's Initials f
I
NAME: PERMIT
LOCATION: r />�5 V �~o INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES i NO COMMENTS
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/W allpour
Reinforcement in Place `
oun a ron/Dampproofmg
Backfrll Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-lr
Insulation
Foundation Walls Interior R '
Foundation Walls Exterior R /
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing /
Jack Studs/Headers /
BracingBridging: `
Joist Hangers {
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
LASueHemingway\Building.Cod es.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
GENERAL INSPECTION REPORT
(518 ) 761-8256
Town of Queensbury
Dept.of Community Development hate inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NV 12804 Arrive tLpeCtOr's
Depart
Initi
NAME: P\aPERMIT# O'�--OCV:1)
LOCATION: DATE : - -12 -
TYPE OF STRUCTURE:
RECHECK
N/A YE SINO COMMENTS
tings/Piers [
Monolithic Pour Farm
Reinforcement in Pla
The contractor is r sponsibI for
providing protectio from fr ing
for 48 hours follotivi g the lacement
of the concrete.
Materials for this purpo e n site
Foundatio all ur
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in PI cc
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inte 'or R-
Foundation Walls Ext 'or R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping