2002-214 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development.Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20020214 Date Issued: Tuesday, July 30,2002
This is-to certify that work requested to be done as shown by Permit Number P20020214
has been completed.
Tax Map Number; - 523400.301.013-0001.038.000-0000
Location: 27 BRONK Dr
Owner: ANNE LOCASCIO
Applicant: ANN LO CASCIO
This structure may be occupied as a:
By Order of Town Board
Garage 2 Cars Attached TOWN OF QUEENSBURY
Single Family Dwelling:
Direct r f g o went
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
PermifNimber: P20020214 Application Number: A20020214
Tax Map No: 523400-301-013-0001-038-000-0000
Permission is hereby granted to: ANN LO CASCIO
For property located.at: BRONK Dr lot 16
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: ARTHUR&ROSE ANNA FREY Single Family Dwelling 85,000.00
2.5 BUENA VISTA Dr Garage-2 Cars Attached
QUEENSBURY,NY 12804 Total Value 85,000.00
Contractor or Builder's Name Address Electrical Inspection Agency
AJS ENTERPRISES.INC.'
TONY LOCASCIO
6 HIGHLAND AVENUE
QUEENSBORY.NY
Plans &Specifications
2002-214 ANN LO CASCIO
1562 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$235.84 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,April 03,2003
(If a longer period is required,an application for.an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Tp*n-�Qluee b d esday,April 03,2002
SIGNED BY for the Town of Queensbury.
IV
Director of Building&Code Enforcement
-Bu lding P Application of Q1lE'G't1SlJlll y - Dept. of Co►nrnWury P.rve101,7111ent, 742 Day Road, Queensbury, NY 12804 1761-8256
BUILDING do , C€' rz, ENFORCEMENT ,
NOTICE - Requirements Prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. +(��'
beginning construction. No inspections
will be made until applicant has received [-1 Zoning Board Aeflvti .PERMIT FEE PAID$ oD-�j� j,
a VALID 13UILDING PERMIT. All Area /Use
applicants' spaces on this application RECREA77ON FEE PAIDD$
MUST be completed appear signature F Plcuailtig Board Action � f�- �of the applicant:must appear on the REVIEWED IiY.•_
application for 3PR / Subdivision /Other BwUdt»g Insi,rcror,`;`;
Recreation Fee Payment
Applicant: !� TS � y!/-%S�.f ��
Owner: __4'fft is
Address: Address: 1- /( -
r6
7
.`f. • _�.�`3�� I bt�no tit ( �S'7_�');^?��- „Y���'
1'rulturly I:uuniltutl F-a�!/�
,
Subdivision.Nne: � f'S� r7
tu iLt Cl•,� � 'I'aa Map,Numbor
Section Block Irtll
NA'1'UItN w uitlding I HOI' i ESTIMATED MARKET VALUE OF THE
x New Building t CONSTRUCTION;
residence j commercial
Addition to Building:
? residence / commercial OCCUPANCY INFORMATIONS
Alteration to' Building: Primary Building -
residence / commercial X Single Family Dw
Residence / Commercial Two. Family Dwell g � V=RVELJ
no change, to exterior size Family Dwelling
Office APR 0 " 2002
other Work (describe below) Mercantile
Manufacturing TOWN OF.QUEENSBURY°
GROSS
Other Eat 99t_t7fP�9r AND.Onn''
AREA OF 1°ROPOSED STRUCTURES — -
18t Floor. . . . . . . . sq. •ft. If ADDITION, what will use
2nd .Floor.'. . . . . . . sq. ft. of nevus addition be? :
Other Floors. . . . . sq. ft..
(not unfinished cellar or basement)
ACCESSORY BUILDINGS: .
Detached Garage 1, 2 car
TOTAL FLOOR AREA; :c:. l -62 SQ. FT. Attached Garage 1, <I�b
Private Storage Building
SIZE OF NEW ;STRUCTURE: � Commercial Storage Building2
FEET X .Z FEET Other
Foundation Type: __P6V!-fef. Ac- r Ste Will any second-hand- or ungraded
Number of Stories: '— lumber be used? If so, for what?
(habitable space only)
Height ;(grade to ridge) : Cl'� feet TYPE OF HEATNG SYSTEMS .
Number of fireplaces and/or c
woo stove (circle all whicWas5eboard
" igs)
to be installed: Axelr, El et c Oil j /�+Iood
owed itot j / Other
Person responsible for
,pupervislon of work as regards to building'
codes is: 7`G5etc, . L-,a I- 6 793- 7-T-es, /
Builder: emeE� "-resss 9 -Phone
Plumber: 6'
Mason:
Electrician: 4.0
DEGLARAHOM Please sign belmv gfie)•you leave carefully read the staten#ent.
r
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, tine 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 BUILT PLOT PLAN by
a licensed surveyor; drawn to scale. ssJr�►owing actual location of project on premises.
Signature: -
(owne , owner's agent, architect, contractor) .
as EL(REV.tr88) .. A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING -
CERTIFICATE NO.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
( D0 N07�WRITE HERE FOR OFFICE USE'ONLY f��;; 4
-. )J N.ft, } h �'ttr f ti a o Y�('rt. r y �� �y �s}f �f �y }� .. , . ,!)', :+. ;;i q ., •
t 1 f-'\ l i i t i v
�F t ` '; �z••t t _L w� t<..i r�'. "i' : r � BUILDING PERMIT NO
{ TEMP.# DATE
.CITY OR VIL .,.... ,- - TOWNSHIP%•'`
STREET AN4 0,OR SO ; .., ._,.,.. .. ...POLE NUMBER BETWEEN WHAT TWO SS IS PR ISES D? A
- SECTION BLOCK. LOT:}- '.
OCCUPANTS ME BUILDING OCCUPANCY - •- _ --
OWNER-SN EAND DORESS-[' ..:. '. .. HOME TELEJ-HCIN7MBER ... -..
CURRENT SUPPLIED BY FROM THEIR' OFFICE ? VVORK TELEP E NUI,
BUILDING IS
NEW OLD❑ LVOAK IS N ADDRiONAL❑ DEFECTS REMOVED❑ '
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& BRANCH- ; rt OFFICE USEp
MOTORS HEATERS ,
Laca• Lamp Receptacles j CIRCUITS: )la:` }. E O14 11, T i
t10R Side Attach't H.P. Watts + A.W.G. }. "'z `"v'rc�:s• fia 'f
.Celling Wall Recep'Is 'Switch .Pendant Bracket No. Type' Each No. Each NO.' Gauge j ,41��N.SSPEUI}ON 'i= ,_
OUT- j LA u rFt)
SIDE. - - f a. :i.'�1%r :%1.. a„r w�i zt.•
SUB- -
G�: h
EASE
BASE-
MENT ) nxW t)da,. •, -fr7 7. i ,
1St ) rt '"'S
F�
3rd t• t 1Y i ?.I4 ti .,�{a'
' a 'w H 3. ! •t
t .. � .'.. t. . .•: s' _ .'!" .. .. .. ,: Z!v 4d;;a�n-cz" 1;''i�+x}}'1,,'�F.S�'�sk,Kf ,
_ F '
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:,
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS f t
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED„YOU ARE AUTHORIZED TO•MAKE,THE INSPECTION ANDADJUST:THE FEE TO COVER `-
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT:.''
• SIZE OF MAINS' f "••• FEEDERS •.I ELECTRIC SIGNStLAMPS_ _T.•.,, •TOTAL WARS
CHARACTER OF WORK. �J GA;TUBE SIGNITRANSFORMERS OF
�1/ OSED', _
Ld,CONCEALE4'i
DATE WORK TO BE STARTED. - :4 DArF COMPLETED _ SIZE OF SIGN(NUMBER): CAPACITY
SERVICE ENTERS BUILDING + .• ,MANUFACTURER OF SIGN -
. ! '_❑ OVERHEAD':.
DArEINSPECTI•N REOLM ON AR As Nym ybss1BUEj. " ' s;MUSVEiJT'Ef#APpL'ICAN1'S".• '�5°-I'' '1 '' yM.
- c.IDENTtICi4TtO :NMBEEai !a,V� !x& I °
'$:^AVOID'.DELAY 8Y'GIV! G VyLVAND ACCURATE INFORMATION:AL•L'SPACEVMUST BE FILLP-DPI 'ORAPPLECATIObf MAYBE RETURNED:
PRINT NAME AND ADDRESS.
NAME OF.AP LI—Q�qN / DATE OF APPLICATION 4,81 A I,LCAN--$ p t
I STREU DR TELEPHONE'NO.,
CITY PO ICE ZIP CQDE LICENSE NO WHEN APPLICABLE
C� 85, 1 Street ❑'41 3 ate Street. ❑ 584;Detawafe Avenue 1�:.217,.t ake Avenue�,4=:.M,T 202'Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 I' 'ROCHESTER,NY 146081 '' SYRACUSE,•NY 13206
• .._ CG CibV4:;flat:
THE NEW-YORK BOARD.OF,FIRE UNDERWRITERS.:
Application for Permit—Septic Disposal System
Town of Queensbury 742 Rqy Road Queensbury,NY 12804 (518) 761-8256
1._OWNER INFORMATION: �---
��� ��� Office Use
Location of installation:
1 File Permit N "�(r
Tax Map 2--- / r
Fee Paid €
Owner's Name: GL y' 4 ���"
Address:
2. INSTALLER'S NAME 4Q-A 4a v . �- PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s)and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gaUbdrm =
1990—1991 x 130 gallbdrm = —
1991—present x 110 gallbdrm =
Garbage Grinder Installed yes_ I no
Spa or Whirlpool Installed yes_ t no >
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
Too h So' ature Ground Water Bedrock or ervious Material Domestic Water Su 1
at) --s-5ii2d at what depth at what depth municipal
olling —Toam feet feet well
Steep slope clay ifwell;water supply
_%slope 'other from any septic-system
depth: absorption is ft.
other
Percolation Test: (To be completed by licensed professs 1 engineer or architect)
Rate: minute per inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by 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: f = gallon(min. size I,000 gal.)
Tile Field: each trench S`r7 ft. Total System Length: c `Z 1 ft
Seepage,Pit(s): number of size of each: ft by ft
Size of Stone to be used: # �? / depth or thickness feet
Bed System Site: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: I Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE ,&INFORMATION FOR RESPONSIBLE PERSON(please read)
*For your protection,please note that pursuantto Section 136 29 ofthe Code of the Town
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.
Sig u e o respo�.ttsibi pe Date
c5pl, �14
ENERGY CODE COMPLIANCE APPLICATION
TOWN. OF QUEENSB.URY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Complance: Methods : PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or- less)
PART 4* -- Design by Component- Performance
Commercial Buildings-Hi Rise Residential
*,Requires submission of worksheets
APPLICANT'S- NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross F2ooV Area - / J �o.Z square feet
2 . Type of " Heat - 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 3 d
b. Exterior wall-s R
c. Glazed areas R ,L,
d. Exterior doors R /I.
e. -Floors over unheated spaces R
f. -Edge: of slab on grade (heated building) R
g. Basement/cellar walls (above grade) - R
h. Basement/cellar walls (below grade) R �--
i. Heating/coolifig-ducts-piping in unheated space R
6. Service (domestic) hot water heating device
Conforms to minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL -NOT BE EXCEEDED
App-1 t' !gnature;, Dat Phone Number-
7
ZfZ /
INSPECTOR'S REMARKS.:
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LEGEND:
9 O IPF = IRON PIPE FOUND
15 M., = UTILITY POLE
— o = WOOD FENCE LINE
QF S74°24'00'E a
150.00' PF
N
X
- �7 �JED
— JUL 3 Q 2002 �►
STONE DRIVE
TOVvi\40` CfvL_-L_GBURy
W AIJ' "E MAP REFERENCE:
8 o s4za - WOOD FRAME ; - " MAP SHOWING LANDS OF
�co o HOUSE c o FRANK K. BRONK &
16 o m ROYAL J. BRAYDON °°
AREA a a SUBDIVISION TO BE KNOWN AS
14,995 sq.ft. roan co MOUNTAINPARK '
r7
0.34 acres —
DATED: OCTOBER 7, 1959
BY: A.J. LANFEAR
— O I
i N
M n� 00
- N F•i'� D v �
PF 150.00'
N74024'00NW
ti
IPF
I OT
1 HEREBY CERTIFY THAT THIS MAP WAS PREPARED
FROM AN ACTUAL FIELD SURVEY. i`01r'V.1THIS CERTIFICATION SHALL RUN ONLY TO THE PERS �, FOR WHOM THE SURVEY WAS PREPARED, AND ON 17)I`�
17 I BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
�7 AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
% INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED TO: ANNE C. LOCASC 0
HSBC MORTPAGE CORPORATION (USA),
IT'S SUCC SS+Q�r`i+�N9/OR ASSIGNS
CHICAGQ�.MISURANCE COMPANY
� tro
CERTIFIED
MATTHEW C. STEVES, LLS NYS 50735
DATED: MAY 21, 2002
JULY 24, 2002
a e� MAY 1 , 20
a� Us e„� ""M'L OR AM" '°""AVWY Map of a Survey made for Scate 1'=20'
NAP ■J1NN0 A LN:ENlED LOW }lRVEYOR! S.PL 17 A
A.7E. NOLAYM ff N rrM M% "—W" 4. OF THE
XI^��
�.7�. NEW YM STATE EDUC Mm L&X*
Stoves .�Y��TN�°�.`aT��.
NIMFm 1NR1 AN =N= TfR IA E SI1RYtlW -_
�> ft . ,14ACC � E_. ANNE C. LOCASCIo
QRiMAMNS N MIM HMM SOAPY '*AT
'MIS SAh�EY MV PIEPANFD N ACOAlDANQ MPiN 7NE
Land Surveyors, LLC V7WMFM?" °� E�'�° �°
BY 1NE NEN Tdllf STATE ASSOM110N OK pllOFi39O10L
'M X MMSONs SAID me7HE WW4s IS NUN D, 2 7-24-02 CHANGE IN CERTS. dG DRIVE LOC.
TO THE PERSON raN E VI THE VMY, rs PREPARED. At0 �T t OF I
ON Nl1 BEHALF To THE TTI.E COI�PANr, ODVFAIINpiTAL
169 Haviland Road 'ANZ' A'° ""°"°'"�""""°" "�° "°�°" ""° Town of
Queensbury, New York 12804 IOTTliC06rlDOrltA:lEiaNGN71BI1110N• Queenebury, Warren County, New York 1 5-22-02 CHANGE IN CERTS.
LocAsclo C704
(518) 792-8474 New York lAc. No. 50135 1 NO. DATE DESCRIPTION DWG. NO. 02069
89-2-4.3/301.13-1-38
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept of Community Development Arrive am/pm Depart'0
Town of Queensbury Inspector's i 'als
742 Bay Road
Queensbury,New York 12804
NAME Lc, Cvse-i o PERM# 2J
LOCATION eog. R- DATE 7/-M
TYPE OF STRUCTURE V
N/A YES NO COMMENTS
Chimney Heightf'B"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 I*me site
Oil Furnace shut-off at entrance to furnace area
Furnacefflot 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
Ba oom)Kitchen watertight
or Handrails Balconies/Landing 18 in.,or more
ailingacross window in stairwells A
I ----
Smoke Detectors:
every.,level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing_
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room.
Safety,glazing 18"or less from floor
""y
Fi Electrical
S* Plan/Variance required
- PI V Safety
Survey Plot Plan 10
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)
Xale M&,
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:4*' n/
-
Building&Code Enforcement 1
Dept.-of Community Development Arrive am/pm DepartpmTown of Queensbury Inspector's Initi
742 Bay Road
Queensbury,New York 12804
NAME koctur i a' PERMIT
LOCATION ,a t 16 &X40,1-k tZk DATE
TYPE OF STRUCTURE SF!>
N/A YES/NO COMMENTS
Chimney HeightP'B"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 1 "above de
Gas Furnace shut-off within 30 feet or ti 'thin line site
Oil Furnace shut-off at entrance to furna 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 'sers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
BathroomlKitchen watertight
Interior Handrails BalconiestLanding 18 in.or more
Railing across window in stairwells n
Smoke Detectors: � %&e_TC V. JA,) �kk&.e,-
every level every bedroom /4"'J-!, j
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or/less fr in floor
Final Electrical ' e2- o Zs
Site PlanNarian&lrequfrid ,.--
Final Survey Plot PlanGx.
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)
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
4
Queensbury, AT 12804 ARRIVE am/pm:WDEPA T 4m/pm Notes,
I 1
(518) 761-8256 Inspector's Initials.
NAME: 410 �Odsc!,,j PERMIT#
LOCATION: ---Tq-S'PECT 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. B,,
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough lumbing
eating RoughgInw—,q—,i�p,
Insulation
Faun anon 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
oist Hangers
Jac eam
xirIn�filtrattun -a TrE,i e.
Dire Separation'1,2, Tlfo—tir
Penetration Sealed
—
FJ�fre Wall 2,1, ur,etop L:\SueHemingwaylBuilding.Codes.inspection.rORMS\GENERAL INSPECTION REPORT.doc
ice Use
GENERAL INSPECTION REPORT pector:
AY/
Town of Queensbury
Ready at ofiffiek:
.Dept. of Community Development Request received. Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbuy3,1 NY 12804 ARRIY ', a pm: �C�im6ni �kes:
(518) 761-8256 Inspector's Initial 1
NAME: 4y�. �"�� _ PERMIT
LOCATION: ` INSPECT ON(date): - yt
TYPE OF STRUCTURE:_
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protect from freezing
for 48 hours foll in the placement
of the concrete.
Materials for this p ose on site
Foundation/Wallpo r
Reinforcement in P ce -
Foundation/Damppr ofIn
Backfill Approval
Plumbing Under Slab �p
Plumbing Vent/Vent Place
Rough Plumb'
He ' Rough-In
ion '
) �idation Walls
a s Interi R-
Foundation Walls Exten R-
Floors R
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Pro "Veittic Vent ��
Jack Studs/Headers
BracingBridging
Joi angers
ck Posts/Main Beam
Infiltration Barrier
ire Separation 1,2,3,hour
enetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:1.SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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
Notes:
Queensbury, ATY 12804 ARRIVE��,Db am air, dam
(518) 761-8256 Inspector's Initia s
NAME: PERMIT#
—10
LOCATION: INSPECT ON(date): (a, '
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respons b)ler
'om
r
providing protection from freez g
for 48 hours following)the lace ent
of the concrete.
jte
Materials for this purpose on ite
Foundation/WaRpour-
Reinforcement in Place
Foundation/Dampproofi,19—"
Backfill Approval
Plumbing Under Slab_
Plumbing Vent/Vents in Place Y
Rough Plumbing—
Heatin Rough-In
'neanny
,InW 6tion
Foundation Walls Interior R- V3 RLL-J-j Y-� E Y-CE—P-1—
Foundation Walls Exterior R- I
L—F-1 -)
Floors R- 10D OK
Walls R- Iry �3OT"O-
q- P-1 EK
Ceiling R-
Duct
V
Duct work or piping in \�iNybo
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
Firestoppiing_
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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t? ce Use
GEN-RAL INSPECTION REPORT Inspec �--
Town of Queensbur y Ready at time:
Dept. of Community Development Request received: Meet:
Building c& Code Enforcement At time:
742 Bay Road '
Queensbury, NY 12804 ARRIVE am/pm: DEPART f am/pm °t J
(518) 761-8256 Inspector's Initials `r k<f--
NAME: C_(j Lit ICJ PERMIT# c�,)OW—J
lv
LOCATION: r V IarL F-� n1 �----TNSfE' CT ON(date): C} --
TYPE OF STRUCTURE: -
RECHECK
NIA YES NO COMMENTS
Footings/Piers
Monolithic Pour Forni
Reinforcement in Place
The contractor is responsible for -V,,,r7� jT V
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site q
Foundation/Wallpour A)
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbm' Uen�nls-in Place
60-ough PIuI .
�ng�In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R
Floors R
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Prop_e Vent ttic Vent
� ^1 G
5; Jack Studs/lieaTexS
BracingBndgm' (tom 2 7765
Joist Hangers 12U-$s _Ajo _ bvq( LL
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
j
etration Sealed
Wa112,3,4�Yraus ii �-+_.� u
L:\SueHemingway\Buitding.Codes.Inspection,FORMS\GENERAL INSPECTION REPORT.doc
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.: DEPART' b am/pm Not
(518) 761-8256 Inspector's Initials.
NAME: l,J PERMIT# C
LOCATION: � Y ��( Y INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YE O COMMENTS
f'ngstPers
onolithic Pour Form
Reinforcement in Place
The contractor is esp able for
providing protect, fro freezing
for 48 hours follow g the lacement
of the concrete..
Materials for this purpo eons
to
Foundation/Wallpour�
Remf cement in Place
F dation/Dampproofin
ac ftl _ ppro
`Plum xng -nder S5F
Plumbing Vent/Vents in Pl e
Rough Plumbing j
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 Wall 2,3,4 hour
Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc
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: DEPART - l am/pm Notes:
(518) 761-8256 .Inspector's Initials
NAME: t PERMIT#a-Ooa-
LOCCAT ON: 2Dairs-yINSPECT ON(date):
TYPE OF STRUCTURE:
"RECH CK
N/A YES N COMMENTS
ootings/Piers
Monolithic Pour Farm
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
0
Materials for this purpose on site
Foundation/W allpour
Reinforcement in Place
Foundation/Dampproofmg
Backfill Approval
Plumbing Under Slab
Plumbing 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-
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
L:\SueHemingway\Buildfng.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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