2002-327 1 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: P20020327 Date Issued: Monday, September 30, 2002
This is.to,certify that work requested to be done as shown.by Permit Number P20020327
has been completed.
Tax Map Number: 523400-290-013-0001-015-000-0000
Location: 87 MASTERS COMMON NORTH ''
�n ?s
Owner MICHAELS GROUP LLC THE w
Applicant:
MICHAELS GROUP LLC THE
This structure may be occupied as a:
By Order of Town,Board ,..
Fireplace TOWN OF QUEENSBURY
Garage-3 Cars Attached
,Single Family 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: P20020327 Application Number: A20020327
Tax Map No: 523400-290-013-0001-015-000-0000
Permission is hereby granted to: MICHAELS GROUP LLC THE
For property located at: 87 MASTERS CON IM40N NORTH
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: MICHAELS GROUP LLC THE. Single Family Dwelling 279,000.00
10 BLACKSMITH Dr Garage-3 Cars Attached
MALTA,NY 12020 Fireplace
Total Value 279,000.00
Contractor or Builder's Name f Address Electrical Inspection Agency
MICHAELS'-GROUP
10 BLACK SMITH DR
MALTA.'NY
Plans &Specificationis
2002-327 LOT 43 HSE#87 MASTER COMMON NO.
3142 SQ FT SINGLE FAMILY DWELLING WITH 3-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$440.24 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,May 08,2003
(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 To of Q ensb ; Wed d ,May 08,2002
SIGNED BY '(}� for the Town of Queensbury.
Director of Building&6de E orcement
Building Permit Application
Town of Qucensbury—Dept of Conununity Development, 742 Bay Road, Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No.�
No inspection will be made until applicant has received a fee Paid 2 ,aL) °� a
valid building permit. All applicants' spaces on this Rec. l�cc Paid $
application must be completed and must appear on the Reviewed By
application form.
Applicarit:-TIAE �� Owner: 'C`(l�
Address: `p �� 1Lr(iittraTZt3 5 Address:
Phone#(5e)eA'% - C-ZN fl Phone#
Property Location: Lot Number: / House Number , / �`✓'(2+ +(^ t <`(1MCM �
Subdivision Name: T[\F. 1_k?�wvc>S Tax Map Number: :2 clo n 13 ` 1 -f S"
XNew Building: residence /commercial Estimated Market Value of Construction: $
❑ Addition: residence I commercial If an Addition,what will use of new addition be?
❑ Alteration: residence t commercial
❑ No change to exterior size: residence/com'l
❑ Other work(describe )
Clieck Occulmncylnformation I"Floor 2H"Floor Other floor Total
Below sq.ft. sq.fL sq.I't, Square Feet
3 Single farnily dwelling
Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units EF 1 �
❑ Office rll
❑ Mercatitile UUZ
❑ Manufacturing t - Vlf1V 01'-[
❑ 1 car detached garage Z® ` !�'If= a�'r p
❑ 2 car detached garage
❑ 3 car detached garage
❑ I car attached garage
❑ 2 car attached garage
3 car attached garage
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other
Will any second-hand or ungraded lumber be used? If so,for what? ,� .
Type of Ideating System: electric/ oil / gas wood /forced hot air/ baseboard/other:
Number of Tirgrntaces to be installed iKi=i_ Number of Woodstows to be installed _
--List bolo«,- tic-pc rson!s)-responsiUle-for super-vfsiola of--work as regards-lo-building-ctJdes: - ---- -I - -
Name Address Phone Number
Builder TIAF- 1AIChor-As w itc>3t-�c_srn� I7 �
Plumber ,_ C
Mason �.Q. -- 3 Aak- 1�9t'JZ_)
Electrician QAAJ _� ��i l—C_�0_32Z
Declaration: please sign below ancr you.havc carefully read the slatement:
To the best of my knowledge tlic s"tatenicliis contained in-this application,together with the plans and specifications
submitted,are a true and complete-slatement of all proposed work to be done on the described premises and that all
provisions of the 011ilding Code, the Zoning Ordinance and all other laws pertaining to the proposed work sliall he complied
witli, whether SpCCIt1Cd.Ot'110(ed, and(lint such work is atitlrorized by the owner. further, it is understood that I/we shall
submit,prior to h Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
ilclrninis(ralor or Director of Building and Codes,an As Built Survet by a licensed surveyor;drawn to scale,showing actual
loc�aiiori'of a21 new construction.
Sib atuX-C- owner's agent,archftecl,contractor
.y
- Fire i•Tstt-slral's Office 1' •11 t}1'QuccnsbUry, 742 13a}'Road,Qtleensburv, .Ny
(518) 761-8205
Application for Fuel Burning Appliances &.Chimneys
applicable to solid fuel & vented gas appliances
Date TC�k 20 Cat Pet tzt t No.
Aj-)plication is her•eb),made to the Building C)de. //ic•c Jet the lsrrTnnce of'cr l311iltlisrg and Use
Permit pursuant to the New York-State 1--h-e Pi-evelttk)rr and Building- Code. The applicant or ou tter
agl-ees to comply with all applicable lcmt s, orelinalleel,f'Gtllations, and all conditions that w-e pell't ()f
these recluirenzents and also will allot: irll ittspecta.s to'c�itier l�rentiti<es to per/vi-m requit-ed inspections.
NOTE to applicant: Rough-in and Filial Ins ections are re aired_
P q
Applicant Information Fuel Burling Appliance Information
� - ��g (Circle appropriate Nvords)
Name: ` k'�1tC. Q � + - stove:, ivood coal 1,,)ellet gas
` Fireplace insert
Address: 4 t�sr Firepl<i ce, factory-built: ivood gas
Fireplace masonry:' wood! gas
Furnace-. wood gets oil
Phone:
If non-masonary applicance, please provide
Owner: Manufacturer Name:
Address: Model Number:
Chimney Information
Phone: (circle appropriate v.-ords) -
Masonry block b -ick stone
Flue rile tee! Si
3e:- inches
Exact Address: -1 IsAe
ofcorrstr•uction or irtsrallation Factory-Built
Manufacturer name:
Model Number:
Note: Listed By- Number:
Construction IInstallation ntztst
con ortlt to AT S Fite Prevention &Buildirt; Indicate (circle) chimney material:
Cocle. Consult available Town of Queensbul-11,
Handouts regarding required inspections. Double,roll / Triple wall I 11rsulated / Direct veirtilt
Chimney Liner
• j Ca���r'rs 33e��zne��— To�crxs o�Qu�ea��erb�-y, �T��r Yorl�r
Fire,Tlciislxtl Coyle S Collected S ltefirndc:d Recei:•ccifi•oltr (i•efirn(jerl to):
00
rtdrb c.+s.
.a 1 f:.i3s9 (190). Public Safety �. ,.`��• "
.d 233 655 (230)Minor Sales
While(Applicant] Green(Fire�.larsha}) Yellow(Bldg. Den.. rr `
( Dept.,) 1h C.61denrod(Cashier's Dept.)
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: Ij
Building&Code Enforcement
received:
Dept.of Community Development Arrive D Depa a
C,
Town of QueensburyInspector's Ini
742 Bay Road
Queensbury,New York,12804
NAME PERMIT g 2-02--3 2,77
LOCATION DATE "JjXrl+ PM
TYPE OF STRUCTURE
N/A Y7 NO COMMENTS
00—
Chimney HeightPT"Vent/Direct Vent Location 14�
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 J/ 1
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
OilFurnace 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. 41
Handrail exterior stairs both sides more than 3 risers 14/1
Interior privacy/trim/doordmain 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
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing V/
Garage penetrations sealed V
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor V1
Final Electrical
Site Plan/Variance required
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)__L
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depart am/pm
Town of Queensbury Inspector's Initialsr
742 Bay Road
Queensbury,New ttYork,12804
NAME U + Z S G / PERMIT# 6 2
LOCATION y-7 fi5. cv�.. r DATE r
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterioi 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-tiff within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot 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 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconiesllanding 18 in.or more
Railing across window in stairwells
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 fireproofin
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
rie
lectricalan/Variance requiurvey 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)
MAP REFERENCE:
MASTER'S COMMON NORTH
DATED: AUGUST 26, 1987
BY: VAN DUSEN & STEVES
FILED: MARCH 10, 1988
DRAWER 17 FOLDER 1
� an Dus e�
Steves
Land Surveyors, LLC
169 Haviland Road Queensbury, New York 12804
'518) 792-8474 New York Lic. No. 50135
11UNAUUT401 D ALTERATION Olt AODFIION TO A SURVEY
MAP BEARING A UCEMSED LAND SURVEYORS SEAL IS A
MOLAMON OF S MM nW SUS -WAS IN % OF TINE
NEW YORR STATE EDUCADOM LAW
MY Ca16 R110LM M ORI611ML Q 1FRS'JAPT/
W JM;; 1 AN ONI NALOr M LAND SURVEtM
VEAL SAIL BE CONSIDERED TO BE VALID TRUE CORES'
•CERTMMIONS MIMED HTMON SIGWY THAT
THIS "VEY WAS PREPARED INACCOICANCE MLTH THE
EX8TNS CODE OF PRACTICE FM LAW SURVEYORS ADOPTED
BY THE NEW YON STATE ASSOCTA7100I OF PROFESSION&
LAND S RVEYMS. SAID CERTFICATIOIS SMALL RUM ONLY
TO THE PERSON FOR WHOM THE SURVEY S PREPARED. AM
ON M BEHALF TO DIE 7I7LE COMPANY, AOVERN11 TAL
AODMCY AND LOOM NSTITUDOM LWO HEREOM. AND
TO M A5510 M OF M OVNO NSMUT100
rnxtMON NORTH
r
X
r`
Map of a Survey made for
MICHAEL & AMBER PALLESCHI
Town of Queensbury, Warren County, New York
NO. i DATE
W WAS PREPARED
FROM AN ACTUAL FIELD SURVEY.
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED. AND ON THEIR
BEHALF TO THE TITLE COMPANY. GOVERNMENTAL AGENCY
AND LENDING INSTITUTION LISTED HEREON.
CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
CERTIFIED TOR MICHAEL PALLE"
AMBER PALLE"
ABN AMRO MORTGAGE GROUP. INC.. ITS
SUCCESSORS AND/OR ASSIGNS
MONROE TITLE NSUIt-"E COMPANY
CERTIFIED BY ----------
MATTHEW C. STEVES. LLS NYS 50135
DATED SEPTEMBER 25. 2002
DESCRIPTION
el �,tr i LmbtK czi,
le 1'=30'
S-1
SHEET IOF1
PALLE 5CHI
DWG. NO. MCN-3
yb -)-3
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, AT 12804 ARRIVE am/pm: DEPART 00i m1pm Notes:
(518) 761-8256 Inspector's Initials
NAME: 1M,tC,1AA6—(1-5 eg Rp. PERMIT# - 6&' '37-7
LOCATION: �7 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/Dampproofing_
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-
Coiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridgig-
Joist Hangers
Jack Posts/Main Beam
it Infiltration Arrier
47i ' 2,3,hour
U
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping_
L-\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: J7,,"Yn
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE amlpm: DEPART am/pm Notes:
(518) 761-8256 Inspector's Initials
NAME. — -7.
Q�3� 11#jCjM,6 5 PERMIT# 02--3Z-'
LOCATION: r I nUS4-4-5 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/Dampproofi.ng_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing_
Heating Rough-In
XInsulation
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/Bridgmig—
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Scaled
Fire Wall 2,3,4 hour
Firestopping_
L:\Sueffemingway\Building.Codes.Inspection.FORMS\GENERAT,INSPECTION REPORT.doc
FIRE MARSHAL
TOWN OF QUEENSBURY FIRE MARSHAL
QUEENSBURY, NY 12804 TOWN OF QUEENSBURY
(518)761-8205 QUEENSBURY, NY 12804
(518)761-8205
FIRE MARSHAL INSPECT16N REPORT
REQUEST RECEIVED PERMIT#41-*"3z-7 FIRE MARSHAL INSPECTION REPORT -L7
NAME REQUEST RECEIVED ERMIT#
LOCATION NAME
1A 4 1 atAv W�6- iow
SCHEDULE INSPECTION ON LOCATION
M PM ANYTIME SCHEDULE INSPECTION ON
APPROVED AM M ANYTIME
N/A YES NO
EXITS APPROVED
NIA YES NO
AISLE WIDTHS
EXITS
EXIT SIGNS
EMERGENC LIGHTING AISLE WIDTHS
EXIT SIGNS
F EXT EMERGENCY LIGHTING
IRE , INGUIS 8
FIRE ALARM SYSTEM FIRE EXTINGUISHERS
FIRE SPRINKLER SYSTEM
FIRE ALARM SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR;FINISHES
STORAGE:
TOSPEI
TING
T
NCE INTERIOR FINISHES
CLEARANCETO SP NKLERS
NCE10 H CLEARANCE TO H ING UNITS STORAGE'
CLEARANGE To SPRINKLERS
REQUIRED SIGNAGE CLEARANCETO HEATING UNITS
CHIMNEY i REQUIRED SIGNAGE
WOOD STOVE
7
CHIMNEY
FIREPLACE-MASONRY 0 Y WOOD STOVE
'T lxfd -v .-
FIREPLACE-FACTORY ABUILT i
M4 ORT16 kt9l A V FIREPLACE-MASONRY
REMARKS, Ce"OK TO THIS DATE FIREPLACE-FACTORY BUILT
REMARKS: OK TO THIS DATE
INSPSURPUB .INSPECTOR
INSPECTOR
impsup-PIA3
Office Use
GENERAL INSPECTION REPORT y Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet: Ji-kA
Building& Code Enfbreement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE�ja aml am- DEPART�am m otes:
(518) 761-8256 Inspector's Initials,
NAME: MICetvah, &W PERMIT# 706 2-- 3 2-7
LOCATION: 7 7 hwI4-Vl%L C�m aAA- A( INSPECT ON(date): 6
TYPE OF STRUCTURE: Vy
--��RECHEC
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
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 I
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
4Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Torn of Queensbury Ready at time:
Dept. of Community.Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE arn/ a Notes:
(518) 761-8256 Inspector's Initial
NAME: � � oh�,�p 11 h�dJR Sr PERMIT# 2A0Z —3 2-:7
LOCATION: 7- .jig C 0�n t-,t-CA-A-' INSPECT ON(date):
TYPE OF STRUCTURE: S
RECHECK
N/A YES NO COMMENTS
Footings/Piers _
Monolithic Pour Form --
Reinforcement in Place
The contractor is responsible for
providing protection from freezing 9jD�--vt T'D 6\Q -�
for 48 hours following the placement
of the concrete.
Materials for this purpose on site f.
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofmg
Backfill Approval
Y-lumbing Under Slab
�lumbing Vent/Vents in Place /
ough Plumbing
Heating Rough-In
Insulation
l
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- �.
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
4roper Vent,Attic Vent
rammg_
Jack Studs/Headers
BracingBridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Pire Separation 1,2,3,hour
VPenetration Sealed
Ire Wall 2,3,4 hour
' irestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT,doc
c
�-Y7 Office Use
GENERA C)�S L INSPECTION REPORT Inspector: ,e:!N
Town of Queensbury Ready at time._30
Dept. of Community Development Request received:
Meet.
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIV, a D Notes:
(518) 761-8256 - Inspector's 11niti
NAME: PERMIT#
LOCATION: 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 freezin\
<Z— ,
for 48 hours following the placem t
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
on/Dampproo g .............
Foundpe' ..........
kjBatlrXill 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
Bracing/BridgingJoist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppin
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
,
Town of Queensbury
Read y at time:
Dept. of Community Development Request received: Meet: "I
Building& Code Enforcement 44 At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE ' RI' Notes:
VD , - �m ,
(518) 761-8256 Inspector's 1-Thitia
NAME: C PERMIT# 3:Z?
LOCATION: 1��&MMOj INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YE NO COMME,
(Footings/Piers 01 Pour I
no I is Pour Form
Reinforcement in Place N/
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
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
Bracing/Bridgmig-
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.doe
MASTERS COMMON NORTH
a N06' E:-;O-E
173.00' 1 1
,54i _ v
r7 J 0 L �f1C1
i
I have seen or observed,or believe 1 saw evidence of, ji udil;hu�
co ~ �v, I Id objects such as houses,wells,trees,fences,etc.,
z - --'_ own on this document.I also represent that I have
I
personal! easured the distances set forth on the diagram."
a. --
tG SIGNATURE DATE
LJ
L � 0
MAP REFER 4ENCE:
MASTER'S COMMON NORTH
bl
DATED: AUGUST 26, 1987 �I
BY: VAN DUSEN & STEVES 73 95 t
FILED: MARCH 10, 1988 S72'73.95'W <7
DRAWER 17 FOLDER 1
S-1