2002-450 TOWN OFQUEUNSBURY742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20020450 Date Issued: Thursday,May 06, 2004
This is to certify that work requested to be done as shown.by Permit,Number P2002.0450
has been completed.
Tax Map Number: 523400.253-003-0001-040-000-0000
Location: 12 KNOLLS Dr
Owner: SCOT&DEBORAH SMITH
Applicant: } SCOT&DEBORAH SMITH
This structure may be occupied as a
By Order of Town Board
Fireplace TOWN OF QUEENSBURY
Residential Addition
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 7
tytE cop
BUILDING PERMIT
Permit Number: P20020450 Application Number: A20020450
Tax Map No: 523400-253-003-0001-040-000-0000
Permission is hereby granted to: SCOT&DFBORAT4 SMTT14
For property located at: 12 KNOLLS Dr
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: SCOT&DEBORAH SMITH
12 KNOLLS Dr Fireplace
Residential Addition 20,000.00
QUEENSBURY,NY 12804 Total Value 20,000.00
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
2002-450
340 SQ FT RESIDENTIAL ADDITION AS PER PLOT PLAN SPECIFICATIONS
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 20,2003
(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 of the Town of Q(eenZb -JT irs 2002
SIGNED BY OM for the Town of Queensbury.
Director of Building&Code 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 No.<9-00,3- zY57
No inspection will be made until applicant has received a Fee Paid $
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: SC_-_.�c Q,:--) Y-" Owner:S::�C_, s- . \_6 Y11 I
Address: Address: .
Uyn
Phone#(_)?QVcA-��S7 n Phone#
Property Location: Lot Number: / House Numberj�_/ ho �5 /✓��
Subdivision Name: Tax Map Number_._
❑ New Building: residence 1 commercial Estimated Market Value'of.Construction: $ X el d G Q
Addition: rest ence If at commercial an Addition,w will"tse of new addition be?"
❑ Alteration: residence/ commercial Cd7 p �'
Cl No change to exterior size: residence/com'i
❑ Other work(describe )
Check OceupaneyInformation 1"Floor 2° Floor owenoor o al
Below sq.ft. sq.ft. sq, t.0 y Squa Fe Feet
oW/p/1".y O
Single family dwelling
J2 Zf U
❑ Two family dwelling
❑ Townhouse 1
❑ Multifamily dwelling
#-of units
❑ Office
❑ Mercantile
❑ Manufacturing
❑ 1 car detached garage
❑ 2 car detached garage
❑ 3-car detached gara,ge
❑ 1-car attached garage }
❑ 2 car attached garage
❑ 3 car attached garage
❑ Storage building-
commercial
❑ Storage building- $
residential
❑ Other
What is the proposed height of the structure. Z feet inches
Will any second-hand or ungraded lumber be used? If so,for what? � ' r3 E'-
Type of Heating System: electric/ oil /(gas wood. /forced hot air/ baseboard/other:
Number of Fireplaces to be installed CI° �- 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
�� -O /TdBuilder
Plumber --
- Mason 1(4
Electrician
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 Uwe shall
submit,prior to a Certificate 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 now c on.
Signature: t^'`G a � l`��wner's agent,architect,caatractor #
ENERGY CODE COMPLIANCE APPLICATION - 5V
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance Methods: PART 5 - Acceptable Practice Method
w 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:
!S_' � S �C, /-�. Y"--
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
_ .i._,__`ia.:Cis-s-Fl oo A-re -
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 -76
b. Exterior walls R
C. Glazed areas
d. Exterior doors R
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/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heating device
Conforms to: minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXfMUM-- SETTING 1400 - WILIJ790T BE EXCEEDED
Appl' c n ' gn ej Date Phone Number
INSPECTOR' S REMARKS:
Fire Marshal's Office Town of-Queensbury,742 Bay Road,:Queensbury,NY
(518)761-8205
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel & vented gas appliances
Date. 20 Permit No.r o 0"1—
r.
Application is hereby made to the Building& Codes Off
ice the issuance of Building and Use
Permit pursuantto 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 preinises to per form required inspections"
NOTEto applicant: Rough-in and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
(circle appropriate words)
Name: Zi
Stove: wood coal pellet :121s
/ ,
. 11 Fireplace insert
Address:
& Fireplace, factory-built: wood g,da'
Fireplace, masonry: wood, gas
Furnace: wood - gas oil
Phone: • 'If non-masonary applicance, please provide
Manufacturer Name* w 'Iff 1, ''
Model Number:
Address: -7cz 2 Aj
4
Chimney Information
7e
Phone: ✓ 79 (circle appro"'priate words),i f-
Masonry block brick stone
Flue the sted size: inches,
Exact Address:
construction:or installation Factory-Built
Manufacturer name: '
Model Number:
Note: Listed By: Number:
Construction I Installation must
con f grin to NYS Fire Prevention &Building Indicate (circle) chimney material:
Code. Consult available Town of Queensbur),
Handouts regarding required inspections. Double wall / Triple wall Insulated Direct vent",
Chimney Liner
Fire Marshal Code# $Collected S Refunded Receivedfi-onz (refunded to) r
address:
0
A 173 3389 (190) Public Safety
A 233 2655 (230)Minor Sales
DA TE: �(ol o'R f
White(Applicant) Green(Fire Marshal) Yellow(Bldg.Dept.) Pink&Goldenrod(Cashim's Dept.)
Town of Queensbury Fire Marshal
742 Day Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Fireplace! tove Inspection Re Dort
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying;the appliance.No deviation from the manufacturer's
instructions ar sp .ii»n bane is allowed.
Permit# �� f __ Schedule Inspection Time -_- am icon anytime Inspecto
Name �G�a.,j Address, Z- ` ^.),occ's R Y) +_ Rough In_,_,Final_
Appliance Manufacturer Model#
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides)
Firestop(s) Vertical Chase
Wall Penetration
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Old'Valve
Combustion Air
Hearth Extension(if any)
Mantel
Height above fIp opening
Witness Operation
Tank Placement{if LP)
Whfte—Suflding Dept �� i'ella>wCft mer Pink—Fire Marshal
Residential Final Inspection
Office No. (518)761-8256 Date Inspection reque t received:
Queensbury Building&Code Enforcement Arrive: aR-
Depart: T am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION! N d DATE:
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete V
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete
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
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
Safety glazing
Window in stairwells safety glazigg
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, 1 sq, ft.-150 sq. ft.vents
Building No./Address visible from road
Final Electrical
Site Plan Wariance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept. Inspection Sticker
Flood Plain Certification,if requi ired
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C 1 0(Cert. Of Occiipanc
Okay to issue Permanent C t 0(Cert. Of Occupancy
L:\SueHeniingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2443
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
Main Office 176 Doe Run Road - Manheim, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Pennit No, ffiffiRfffR•ifRtR4ilifiHN1.1!•ii1lR•fCert. 0 8 2 5 0 2 Cut-in Card No,ffnlf411/4RRriifff.tffRRtffIR44Rf1
n �INf41#11R1 /44I4rR4f} 0f11019414411116111 IM lt#.#1I I111►Ili#4111i lot/#fii#fI4f1lfRIoff Move II off fi/ltfift l l.f#1#Ni.f4i R.pfMfll#f 141#iftll#IlRIf#t4#Rr#ff1•.lfl
i
Locationm/wmmislf##4f#ft0# 114.f1601 01408104141 H#III 1146IfA19I ffff ffff Nfff•fff tl##11#IIfRR off fff N/Rlf•ft t f *###$offif#tiff#f f• fill I Rio#914##1!••lf 1006#11
Installation Consisting of,,, •}/}. t...ffl.ft#Hi.#i#,it1If 1i#fi ii#f 1l.ffff4i11fiifitlf i4 !toff ifft##iNlff4fff#I• Y4#1/YIIfi4tflf#••1#llff offii•Ii•!
•lit.iittllt.fftf#Ff#lllf/f#IF1Y4#4#.i}ififff.It#f#f#lfRf#itfflif R}Iitl4fltt4to 11#ill#11Nif4fllllfifi#ifflRlfl#1ifiR#f Rf lRttillNl44#f#t1!#Igff!/If tt4f#41iiiNHi.Itltlffi##/NI
ffl#11lt}}iiiN.iitif#tfiRflifNffffofff141ffi•f.t4#44ft4M###Off IIN##•11f4RflomIs ifiiN#!!##I##t##1#fi#4l11.11!#ff#1!#itftt/iilttit#Ifllflllttll441iftlfflltt41tlt04181011#41
t �
InstalledBytf#4 P0#6ob#01f#ff! /f 44111Y/f!}f IirH!•4#flNiNffilllNlt#tf•If 1#It/!•ltff•IiiY##i.i#It Lie, No. IfIIfllttff111iffili.gYfffftfl.tf Rf tfttittitiffl
The conditions following.governed the issuance of this certificate, and any certificate previously issued i
cancelled; -
This certificate only covers the electrical equipment and installation conditions as of date. Upon th(
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the priviie e f makin i pections at any time, and if itl�
rules are violated, the Company shall have the right to re o e this ' icat
1
Date,,fttl• r1u•!•!•#!•!1lfl• INSPECTOR#1##1#II4NNRr/r1.111 f.ffl14Rf111f#•##11 i1\tf#lfffltflfliff/fif11114R1/#11.ff#.t# ff•ffffffftl.fR41YRRiff#tfitfi
Member N.F.P'.A.,LAiE.Y}
F=lR,'F-= rv%AFZ-<3FUkt-
-rC:)N/Vfq OF C;lUEiar4SE3LJF2-)r
C>-UaE=-M-c3E3UF;Z"')r, MY' 12804
Mks"& (518) 701-8205
FIRE MARSHAL INSPECTION REPORT
-Z
REQUEST RECEIVED PERMIT 0 /5
NAME
LOCATION
SCHEDULE INSPECTION ON
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WlEffHS
EXIT SIGNS
EMERGENCY LIC3HTI
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED S[4:3NAC3E
CHIMNEY 77C
WOOD STOVE
FIREPLACE - MASONRY
_.5�E PLACE - FAC,&TORY BUILT LZ
1 0 %-�5 --.:;s I
REMARKS: - EVOK TO THIS DATE,
x
INSPECTOR
FIRE MARSHAL
TC)WhJ CIF CtUEENSBURY
QLJEENSBURY, MY 12B04
(51 8) 761-8ZO5
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT # 0
NAME
LOCATION
SCI-IEDULE INSPECTION C)N
AM PM ANYTIME
APPR.aVED
NIA YES NCB
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERC3ENCY LIGI-ITINC3
FIRE EXTINGU[SHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SVlGj.TEM
HC]OD INSTALLATIC3N
INTERIC)R FINISHES
STO RAGE: ''-
CLEARANCE TO SP f INKLERS
CLEARANCE TC? HBMTING;s UNITS
REQUIRED SIGNAGE '
i
CI-41MNEY a
W9,00 STOVE
F EPLACE — MASOI+ i Y,
[REPLACE — FACTORY'BUILT
REMARKS: 0 OK TO THIS DATF
�n�sps��p_�us INSPECTOR
Office Use
GENERAL IIeTSPECTION REPORT Inspector:
at time:-
Town of Queensbury Ready�
Dept. of Community Development Request received. 0�
Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPAR am/pm Notes:
(518) 761-8256 Inspector's Initials .
NAME: PERMIT#
LOCATION: INSPECT ON(date):
TYPE OF STRUCTURE: � ��� u--
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 t
Backfill Approval f
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
He -In ,
:su a.I. -
0 11 _ tenor 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
lo,
' e Wall 2,3,4 hour '
L:\SueHemingway\Building.Codes.Inspection.'FORMS\GENERAL.INSPECTION REPORT.doc
Office Use
GENERAL E16PECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Roadff-
FA
Queensbury, NY 12804 am/pm: DEPART In Notes.:ARRIVE RWI Mir
P P�;'
(518) 761-8256 Inspector's Initials
NAME: PERMIT# -07—
LOCATION: �ijlf 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
PI bi Vent/Vents in Place
Ing
R gh Plumbing
IT_it
1i/Zeatin RVill"r-04 r 4u g
u 41_a 11 i o Kn.
F
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
enetration Sealed
L:\SueHemingway\Bziilding.Codes.Inspection.FORlvfS\GE,NERAL INSPECTION REPORT.doc
F=IRE r%AA.F,','S".okL-
-T(Z:>Xr%f" CW 4C;lUE=E=NIE3E3Uf:;,"`lr
ClUr-=E=",4=-:-E3UF,w7*)r, N'Y 12804
(5 18) 7G I -8ZOS
FIRE MARSHAI- INSPECTION REPOR
REQUEST RECEIVED PERMIT
NAME
LC:)CATIC)N
SCHEDULE INSPECTION C)N
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMER(DENCY LI(3HTINGw'
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM/
HaC313 tNSTAELATION
INTERIOR FINISHES
ST10RACDE:
CLEARANCE TO S RINKLERS
CLEARANCE TO EATINC3 UNITS
REQUIRED SICaNAC33=
CHIMNEY
W<>C)kD STOVE
FIREPLACE - MASC)N I 4F;-"
FIREPLACE - FACTOR BUILT
REMARKS-. C>K TO THIS DATE
INSPECTC)R
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
Queensbuy3l, AT 12804 ARRIVE am/pm: DEPART m/pm Note
(518) 761-8256 Inspector's Initials
NAME: 4 SA:rA PERMIT# 02—
LOCATION: k/tt9 6 e--&!5 INSPECT ON(date): 7/x hxz—
TYPE OF STRUCTURE:
RECHECK �� G -
:0�1
N/A YES NO 0 4ENTS
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
eated spaces R-
Z JZ
P er Vent,-Attic Vent
irw
-47a—ek Studs/Headers-
Bracing/Bridging_�
Joist Hangers
J�—o Eo sts fMain Bea
Fir u711 titian Barrier
Fire Separation 1,2,3,hour
'10
Penetration Sealed
4.eWall 2,�34 o)
�-'14 L
PP n 4)A-e-4- 11?,*F7-eX
U1101
q&&6-15
L:\SueHemingway\Building.Codes.hispection.FORMS\GE,NERAL INSPECTION REPORT.doe
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY i280.4 bck��r ve am/pm Depart
Inspector's Initials
NAME: n
sl4e �1;n, T
LOCATION: DATE
TYPE OF STRUCTURE: 44
RECHECK ,J-
7 &P
N/A.YES NO COMMENTS
Footings 'efs
Mon
on r
Reinfo—rcement�inace�
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 Z
Insulation
Foundation Walls Inte R-
Foundation Walls Exte or R-
Floors R-
Walls R-
Ceilm* g R-
Duct work or P ing in
unheated ces R-
Proper Vent, is Vent
Framing
Jack S enders
Braci ridging_
Joist
oist
Jac Posts/Main Beam
Ja
B
o
rc a i
k s
ci t
S
angers
ridg
ing
angers
Jac Posts/Main
Air I ltration Barrier
Fi Separation 1,2, 3,hour
/P
I I
P et . S
P etration Scaled
W 11
W 2 3 4 r
ire all 2,3,4 hour
Firestopping_
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury I Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVE amlpm: DEPART Z III Notes:
LAM/Pm
(518) 761-8256 Inspector's Initials
NAME: 4/i 412W PERMIT#
LOCATIONff_!!!&6!S YJ INSPECT ON(date): 1-2-;Teo�
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/Dampproofin
9
vIlackfill 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
Firestoppin
L:\SueHemingway\I3uilding.Codes.Inspection.FORMS\GENERAT,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
Queensbury, AT 12804 ARRIVE am/pm: DEPART J_�- am/pm Notes:
(518) 761-8256 Inspector's Initials
NAME.. 6-\TK PERMIT#
LOCATION: K-A)(5CC-!5 90 INSPECT ON(date):
TYPE OF STRUCTURE:
ZR REC CK EC N/A YES 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/DampprooPing
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
� 5
.v
J
co
OD
O t p
0
p 356 0
`sf
9 170.0' 162.99' Ln �
N co 30' L 491.07' ;
C 6� O.
KNOt .1~.5 YE;
49.99' O
vM 5 6'o 30, yY- 4
171
X' yti 148.46' 180.0' . 21 jzf/
,t �. "; O
z
�b 360 CD
Ut
N 1 °
cb OCD _
r -z- t't
O w o N
ra
4 M � �' �- N 85�17YY~+86
t I 180.0'
Cl i °~35 -1319.79' N roll- 3o' r, 3oo.o' N 6°-30'r- -- 150.0' N 6°~ � r~
I
s
_ ly
°a
e� 0
-� 0 o SO o O
y p
O I I
po t