2002-159 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICAT E OF OCCUPANCY
Permit Number: P20020159 Date Issued: Monday,August 26,2002
This is to certify that work requested to be done as shown by Permit Number P20020159
has been completed.
Tax Map Number: 523400-309-005-0001-061-000-0000
Location: 36 MAPLE Dr
Owner: ALYSSA IRELAND
nY
Applicant:. '
ALYSSA&MICHAEL PARK. a
This structure may be occupied as a:
By Order-of Town Board
Residential Addition TOWN OF QUEENSBURY
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': P20020159 Application Number: A20020159
Tax Map No; 523400-3 09-005-0001-061-000-0000
Permission ishe-tebv granted to: ALYSSA&MICHAEL PARK
For property located,at: 36 MAPLE Dr
it, the Town of Queensbury, to construct or place
at the above 1p' cation 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: . ALYSSA IRELAND Residential Addition 35,000.00
36 MAPLE Dr Total Value 35,000.00
OUEENSBURY,NY 12804
Contractor or,Builder"s Name Address Electrical Inspection Agency
MICHAEL PARK .
36 MAPLE Dr
OUEENSBURY.NY 12804-0000
Plans &Specifications
2002-159 ALYSSA& MICHAEL PARK
460 SQ FT RESIDENTIAL ADDITION(MASTER BEDROOM)AS PER PLOT PLAN
SPECIFICATIONS
$75.00": PERMIT FEE PAID-THIS PERMIT EXPIRES- Friday,March 21,2003
(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 the T(7;Vb7;, day,March 21,2002,
SIGNED BY for the Town of Queensbury.
N Director of Building&Co c e Enforcement
Building--Permit Application
Town of Queensbury-Dept of Community Development, 742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File N
No inspection will be made until applicant has received a Fee Paid $-7 5, cad
valid building permit. All applicants' spaces on this Rec.Fee Paid
application must be completed and must appear on the Reviewed By:
application form.
Applicant: . Aklb y,, *-fntJACteA 1pcp/K Owner:
Address: 310, -meo 1 e- -'br"oe- Address:
E I
ED
Phone#Q41,L Phone#
MAR 1 4 2002
Property Location: Lot Number: 25-1 House Number 3116
Tr1W\'C &G.WEEENSBURY
Subdivision Name: WAA-e,,,3 )+l It Tax Map Number: 9-q3tJfk61#W;,1AJ\1n CODE
13 New Building: residence /commercial Estimated Market Value of Construction: $
Addition: idence commercial 0� If an Addition,what will use of new addition be?
L3 Alteration: residence/ commercial
E3 No change to exterior size: residence com'l
E3 Other work(describe
Che'ck OccupancyInformation I I"Floor 2 Ed Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
��k Single family dwelling
,E3 Two family.dwelling;
U Townhouse
❑ Multifamily dwelling
#of units
E3 Office h A
E3 Mercantile
U Manufacturing
U 1 car detached garage
U 2 car detached garage
0 3 car detached garage V
q I car attached garage
2 car attached garage
U 3 car attached garage
0 Storage building-
commercial
U Storage building-
residential
❑ Other
What is the proposed height of the structure feet -'5 inches
Will any second-hand or ungraded lumber be used? If so,for what? r130
Type of Heating System: electric/ oil wood /forced hot air other:
Number of.Fireylaces to be installed Number of Woodstoves to be installed—�
List below,the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder M,c-kxm-\
Plumber e\11-1&C11-\ VIl< t
Mason M D.-O e-
Electrician M"On uc-\ Vti Y,<
Declaration: 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 I/we shall
submit,prior to a Certificatf,of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all;;�tructi 6,v�k
Signature: ov.,ner,owner's agent,architect,contractor
ENERGY CODE COMPLIANCE APPLICA• 4ho) 15
TOWN OF QUEENSBURYr WARREN COUNTY
9000 HEATING DEGREE DAYS
Como?i an c:e Methods: P;-RT 5 - Acceptable Practice Met-hod
1&2 Family Dwellings
• P.kRT 6 - Thermal Rating - Componeat Trade Offs
1&2 Fdmi ly Dwellings; Multi-Family
Dwellings (3 stories or less)
P;01" 4* -* Design by Component- Performance
Commercial Buildings-Hi Rise Residential
*Recrui res submission of worksheets
AID P L 1 C.;4-N.-T S NAB:
PROPERTY LOCATION:
PH'J,-4,6C, 4-MIC,64CA ?WKI
31. MtWo-- biNc-
PART 5 tE TEO D OF COMPLIANCE BY ACCEPTABLE P.R.ICTICE:
1 . C-r-oss Floor Area - scr-,a--r-e feet
2 . e or Heat Eiect---ric 041
X Gas 0 th e r
3 . 7S ldinc mec"=---'-daliv Cooled? Yes No
*- -
'
4 . Percentage of a=ea of w`ndows and doors Over -17%
Under 17%
5 . R--,,72:-IUES FOR IN4ZU-,.:LTT NT G71VEN NM U S T CORRESPONTID r- R-VILUEES AS
0' B'77.0W -0
S 1 Z-0 N- ON PLANS SU-ZyITTTED:
a . -R 0 o f` R'
b . E x t er-- o r ways s P,
C . Glazed areas R
d . Exterior dco!-,-s R PIA
e . Floors ove: unheated soaces R III
=dce of s12^ an crade (heated bu-ild-incr) R
MIA
=as-e.-nent./ce2--,-=7- we-Tis (above grade) R %ri JA
h . ��a s e m e n t-/c-e 111,a Z, wells (below grrade) R rj'IR
ur-seated eated suace 6 . Se=-.rice (domes 1,-,!.c) hot waver heat.ina device
confo-Z-1-LIS to min-.-um efffIciency per code Yes No
TEXPE'RATURE CONTROL M-U-IMUM SETTING 1400 WILL NOT BE EXCEEDED
A= S
D a t e
TN.-S R S
Fire Marshal's Ol'tjee Town of,Queensbun-. 742 INy Ro,.I(I,Qtlec w, NY
{518) 701-8205
Application for Fuel Burning Appliances & Chimneys.
applicable,to solid fuel & vented gas appliances
Date 20CX ,
Permit No.
Application is hercbj,made to the Building d. Codes pf he jssjjcj/j -e ql'a Buildim'T Wid Use
Pei-mitpin-suant. to the New York Slate 1--ire Prevention and Building ("ode. 77te applicant 01,01141el*
agmes.to Comply with all applicable laws, 01-difiances., I-Vgldations, and till conditions that are pw-i of
theseand also will allow a . 0 Inspe 01-.;�,to
NOTE to applicaiat: Rough-Iii aiid Final hispectioiis are required,.
Applicant Information Fuel Burning Appliance 1xiformatiou
(circle appropriate words)
Na me. j �j:j + St,O'V'c: wood coal I)ellet
cas
' Fl re ]ace insert
Address Mci C ie Pace�Fa c t o r��L�i�l t wood as
fireplace, masonry: wood gets
Furnace- wood gas, oil
Phone: � ,l <1
If non-masonary applicance, please provide
Owner: Kt 01 e_ Mall U facturer Name:
Address: Model Number: VI/ 6P\jLW
Phone: Chimney Information
(circle appropriate words)
Masonry block- brick stone
Flue the steel size.- inches
Exact Address: Ott fn c
ofconstruction or installation Factory-Built
Manufacturer name:
Model Number:
Note: Listed By- Nurnber:
Constrile'tion lInstallation must
conform to Alys.Fire Pre'vention &Building Indicate (circle) chimney material:
Code.'Consult available Town of Queensbui-1,
Handouts regarding i-equired inspections. Double wall / Triple wall I '111sillcited <D�irect Direct
Chimnev Litter
Fire Attu hal Code 4 • S Collected eel fioln,0*4�fimded to).
S Re Receii-
address.,
.4 173 3389 (190), Public Safer'
.4 233 2655 (230)Alinor Sej&v
_Z7
While(Applicant) Green{Fire Marshal) Yellow(Bld. Deptj Pink&Goldenrod(Cashier's Dept.)
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received.
Building&Code Enforcement
Dept.of Community Development Arrive_am/pm Depart�JAI�ai'p2-
Town of Queensbury Inspector's Initials (2
742 Bay Road
Queensbury,New York-12804
NAME A it '% ✓ P'P"T 4 6)Z'
LOCAT1014 :36 DATE
TYPE OF STRUCTURE A-a I t44 4-yN
N/A YES NO COADAENTS
Chimney HeightPB"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more
Interior.Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade�_
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating_
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 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom V
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing_
Garage penetrations sealed V�4
Furnace in separate room protected(in garage)
Light ventilation per room. I
Safety glazing 18" elssn'Poor--L—
Final Electrical
Site Plan/Variance uirdd
Final Survey Plot Plan
As Built Septic System layout required,-_
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy).
Okay to issue permanent C/O(Certif:of Occupancy)
F=ff:;ZF= MAFR4B"^I
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ClUaaM,cSE3UF;Z'Y', r-Pir 12-804
(518) 761-8P-05
FIRE MARSHAL INSPECTION REPORT
REQUEST REqE&VED PERMIT -*
NAME
LOCATION
SCHEDULE INSPECTION ON
AM PM ANY-lFIME
APPROVED
NIA YESES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIIGH C3
FIRE EXTINGUISHERS
FIRE ALARM SYSTE
M
FIRE SPRINKLER SY'STE
FIRE SUPPRESSION S)YrST
HOOD INSTALLATION
INTERIOR FINISHES'
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE-TO HEATING UNITS
REQUIRED SI(3NAC3F=
CHIMNEY
WOOD STOVE
FIREPLACE - MASONRY .04o
FIREPLACE - FACTORY BUILT
REMARKS: OK TO THIS DATE
(NSPSLIP.pula INSPECTOR
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC
1 b Doe Run load - Manheim PA 1754�Math Office7 , .
6 Zoo 4'
MUNICIPAL CE ATE a ELECTRICAL APPROVAI;�01�
RPM
Permit No. NO 79380� Cut-in Card ■ ,�li#flllH4t##rriinr+iif+t4#i4iiirfii
Owner......,mMM Ann, {r4lrii toes I4444##riffiM i •#4#4 #irrrgrr#rr#f41
Location ilfiittitiifN4iffti M1401HEIN}t!}}}}/t!!}}t}ffrffrrrri4lfiff!!flaHfltl}irfrir}rtfr!lif11#1111NIilr4tr7"C4
ti44tiilifi#}tirtrttii44flfiltt4t„4rruirtiU
!
Installation Consisting of.rrf rrrfif44lii!liilirfffrrfrrf rfrfrf! rrltif4Ntil}}4ilfi}riirirrriNfrr• !i ff4lri„rr,rrtlfi4li,i rfrriirrl+Iliirrirrrrir
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iliftlrfNrrliiifillliili#iritliritrirrltitlf}r/rp iirirr Nffiltlrri#iiN+H Hrrii rrrtiifgr/141 ill Ntiif lif rri ii#pif rrtf4i4lfi#Nrlrifrrlirl!!ii}}rirrrigNNi4rrrH+HirlfitH!
Installedifl#lilt}}iririrrrrfif it/!flit/rirrrrfiirrtfiiiiri iilf#rifHl4rffifiriiifff ifirHiiNifillll��c! No, ii„#+ii+irfirirrillNiiirf}Nfffrf4riii}#}ffirir
The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelled.This certificate only covers the electrical equipment and installation conditions as of date} Upon n.thc
introduction of additional equipment or alterations application shall he promptly made for inspection.
Inspectors of this Company shall have the privilege of ma �+ g ins ctions at any time, and if it;,
p
rules are violated, the Company shall have the rigW
ke t is c " scat r
Itrfl iNrrifi}rrrrlfiiri iriirifNNrfHMNlil i4l INSPECT`+ rrir rifrlirfliifitHilfifrriiilfN#triiiirriiiHif#frplrri!liirftt+ilifr4if
�/1�rwL wr�1 ,,n , it'
Office Use
GENERAL INSPECTION REPORT Inspector""
Town of Queensbury •
Ready at time:�m
Dept. of Community Development Request received: Meet:
Building& Code Enforcement ,� At time:
742 Bay Road LV5ainIpm
Queensbury, NY 12804 ARRIVE am/pm: DEPART Note
a
(518) 761-8256 ' Inspector's Initials
NAME: PERMIT# 2—
LOCATION: Vr ' ASPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
NIA 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/Wallpoui
Reinforcement in Place
Foundation/Da4proofing
Backfill Approval r
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
He ou
aundatz"'o'n Walls nterior' R-
Foundation Walls Exterior R-
Floors R-
Walls R`-
Ceiling 4 .Pk? 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
Firestoppmg
L:4SueHemingway\Bui]ding:Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:A+Ihl
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVE amlpm: DEPARTe-2
amlpm N
(518) 761-8256 Inspector's Initials
NAME: Q PERMIT#
LOCATION:, mo,r� to , INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is re
providing protection
ftez9
for 48 hours following the p ace ent
of the concrete.
Materials for this purpose on si e
Foundation/Wallpour_
Reinforcement in Place
Foundation/Dampproofl g—�
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough lumbing
Hea i g Rough-In
I elation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in I L A)
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
L:\SueHemingway\Building.Codes.I-nspection.FORMS\GENERAL INSPECTION REPORT.doc
_ — e—��-- Office Use
GENERAL INSPECTION REP(JR.T .ry_ :_..ry.�- Inspector:
ti Town of Queensbuzy Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIV i a : D RT z Notes:
(518) 761-8256 Inspector's Initi l
NAME: La 1 C Q PERMIT#
LOCATION: J or\ { INSPECT ON(date): t-CT
TYPE OF STRUCTURE: 1�
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is resp sib for
providing protection fr m fr ezing
for 48 hours following he pl ement
of the concrete.
Materials for this purpose n sit
FoundationfWallpour
Reinforcement in Place
Foundation/Dampproo
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing 41
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-
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 all 2,3,4 hour
estopping
L:\SueHemingwaylBuilding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
F=IF:ZF= rvjAkf:2,4z3f-jAL-
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CZP-UaaM,<3E3UF;,"Y, fq"'ir 1.7804
(51S) 7e1--8205
FIRE MARSHAL INSPECTI<DN REPORT
REQUEST RECMED Q;Z PERMIT jJ
NAME QK
LOCATION
-C;TIQN NON
SCHEDULE INSPE
5NI\4rPf�>ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT S[G1NIS
EMERC3ENCY LIGHTING f
FIRE EXTINGUISHERS I
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION
HOOD INSTALLATION
INTERIOR FINISHES
STO RAG E:
CLEARANCE TO SPRIN LERS
CLEARANCE TO, HEA7TI UNITS
REQUIRED SIC3NAC3]—=
CHIMNEY
WOOD STOVE
FIREPLACE - MASONRY
IRtEPL-ACE — FACTORY BUILT
REMARKS: OK TO THIS DATE
cnq<-
errs ��.c3ur3
INSPEC-TOF;Z
FIRE MARSI--IAL
-rC:)VVf*4 OF ClUE-=F-=NI4SE3UF:Z"'r
(:;lUaaNlSE3UF:Z-)r-, M-V- 112004
(518) 761-8:205
FIRE MARSHAL INSPECTIC)N REPC:)RT
REQUEST RECEIVED PERMITO
NAME
LOCATION
SCHEDULE INSPECTI(DN (DN
AM PM ANYTIME
APPROVED
N/A JYES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMER(3ENC'Y LIGHTING
FIRE EXTINC3UISHERS
FIRE ALARM SYSTF-=M--..
FIRE SPRINKLER SYSTEM i--A
FIRE SUPPRESSION SYSTEM
HOOD INSTALL-A-rION
INTERIOR FINISHES
STORAGE
CLEARANCE TO SPRINKLER�
CLEARANCE TO HEATI NO UN Ts
REQUIRED SfG,NA<3E
..ZCMIMNEY
WOOD- STOVE
VIREPLACE - MASONRY
FIREPLACE - FACTOR'YBUIL-F
REMARKS: OK TO THIS DATE
0 -7
t
INSPECTOR
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 1
Queensbury, NY 12804 ARRIVE am/pm: DEPART mtpm Notes:
(518) 761-8256 ; Inspector's Initials '
NAME: PERMIT# �2-` j`J q
LOCATION: �j VvLQ<-CY~. �QoE' INSPECT ON(date): a --
TYPE OF STRUCTURE:
RECHECK
NIA YES NO COMMENTS
Footings/Piers _
Monolithic Pour Form`
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours followin a acement
of the concrete.
Materials for this purpo a on site
Foundation/Wallpour. -
Reinforcement in Place
Foundation/Dampproofi.
_..._
Backfill Approval
Plumbing Under Slab_
Plumbing Vent/Vents in Pla e
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior -
Foundation Walls Exterior -
Floors R-
Walls :R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
B cing/Bridging
oist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAI.INSPECTION REPORT.doe
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 t f
Queensbury, NY 12804 ARRIVE am/pm: DEPf1RT = limlpm Notes:
(518) 761-8256 Inspector's Initials 3P 61
.)NAME: PERMIT# rr�Cr—_
LOCATION: � � �� INSPECT ON(date): t
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respRplac
providing protection
for 48 hours followinnt
of the concrete.
Materials for this purpo
Foundation/Wallpour _
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval
Plumbing UndefSia _
Plumbing Vent/Vents in P ace
Rough Plumbing _
Heating Rough-In
Insulation
Foundation Walls Interi r R-
Foundation Walls Exter or R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Prop ent,Attic Vent
r'ng
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
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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