2001-456 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: P20010456 Date Issued: Wednesday, October 10, 2001
This is to certify that work requested to be done as shown by Permit Number P20010456
has been completed.
Tax Map Number: 523400-301-005-0001-005-000-0000
Location: 777 WEST MT. Rd
Owner: ROBERT &PATRICIA DI STEFANO
Applicant: ROBERT DIS'IEFANO
This structure may be occupied as a:
By Order of Town Board
Single Family Dwelling 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: P20010456 Application Number: A20010456
Tax Map No: 523400-301-005-0001-005-000-0000
Permission is hereby granted to: ROBERT DISTEFANO
For property located at: WEST MT. Rd
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: ALAN& SHARON HOMES Single Family Dwelling 99,000.00
17837 BEAUJOLAIS Dr Total Value 99,000.00
EAGLE RIVER, AK 99577
Contractor or Builder's Name/ Address Electrical Inspection Agency
ACE HOMES, INC.
3A SARATOGA ROAD
FAX 793-1994
GANSEVOORT,NY
Plans &Specifications
2001-456
1456 SQ FT SINGLE FAMILY DWELLING(MODULAR)WITH SEPTIC SYSTEM AS PER PLOT
PLAN SPECIFICATIONS
$174.72 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday,July 13,2002
(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 Tow Queens ry; Fr' y July 13,2001
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement
06/25/2001 10:08 518-793-1994 ACE HOMES INC PAGE 02
06/21/2001 16:44 518-793-1994 ACE HOMES INC PAGE 02
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-
/
tql4tw TOWN OF QUEENSBURY
REVIEWED BY:
\--C2C' C\-3 )0\RO FEE PAID: $ 1 £4 j d
EMIT NO. O P R � 4-5(a,
APPLICATION FOR PERMIT
MOBILE HOME OR MODULAR
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISS ED.
The owner of this property i s.: ;4/--iz1 `� -x/A ti /�u•�S �SGUC of �d�cwni�
/2-1o2• P.O. Address: ,-)So�al ST. C/P 7.5 ki/75Prhone Number 79 z���
Property Location We574 /770ecr7Xtl� ,i ' . Tax Map No. b''7/
NAME OF APPLICANT: �o6ec--f'D s zv10 (A'crchasev) p/t 1q 0 5.?
Address of Applicant: 671;jzi2c5 re. aezegirri cry /l1
All applicants spaces on this application MUST be completed a EIC EIV
signature of the applicant MUST appear on the reverse side of this applicatio st
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING
C D N 2 zoos
N 0 ,J II ^ QUEEIVSgURY
NV�4/aioivd ec(-) `Nn oOpE
�iZoOLtG.�% nii
MOB-ILE HOME INFORMATION APPROXIMATE VALUE OF HOME: $ 4'9,oeo
New Home4/1110 No /y% ZONING INFORMATION:
Replacement Home Yes No Size of Property: . / 5 i2 ft x 30a ft
Size of ettabite home 2(o ftxSCft Existing Buildings: l2vi�e�
Die
Proposed building-distance from property line:
No. of rooms (exclude baths) _ Front Yard S'O ' ft Rear Yard /7 5 1 ft.
No. bedrooms Side Yards rf9 ft and ft.
No. of bathrooms G I/L Occupancy Informatio
Primary dwelling: Yes No
Fireplace fI4 Woodstove /4 Accessory Building(s) :
,,r AD et (o /to car car)
Foundation style and size: Attached hed garage garage (one ne carwocar w
car car)
Piers-No. of Size ft x ft Storage building
_Other
("Depth below grade ft
* * * * * * * * * * * * * * * * *
Foundation-Footing size " x "
Proposed date/of placement:
Wall material pou.ra(cop,Cre'fe. Wid-c)0/
Wall thickness r" Height ( " Water Supply: Well Municipal I/
Total depth below grade lift. Septic permit required?
Grade to home floor level ft.
FURTHER INFORMATION REQUESTED ON THE •REVERSE SIDE OF THIS SHEET
1
/ZddL/y
-3
NA
ME OF INSTALLER/MOB—FEE HOME DEALER: CIF d �� 6Y?1Q3O'S
ADDRESS/PHONE NUMBER
7:-P6-/9' /6g ( ;;; A-4. .6.71.404,e4r /11(//2-fg /
, STATE OF NEW
O HOUSING
STATEAND
BUI�DMNGICODERENEWAL
. INSIGNIA OF APPROVAL OF THE
1. Insignia serial number ive aa-d/ereL . •
2. Name of Manufacturer //22uye y )/1-,6s- cy
3. Plan Approval Number rYll3
V/—6/7- 02-V /(— il/44,19/L'e
4. Model or Component Designation in / 3 y'`7
5. Date of Manufacture the0/
All the above information is to be found on a plate or sticker which
should be affixed to the Mcb41- 'Home. Complete above with that information.
Town of QueensburY State of New York
County of Warren AFFIDAVIT
I swear that to the best of my knowledge and belief 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 not, and that such work is authorized
by the owner.
Signature ' tI
Owner, owner' s agent, architect,
contractor
SPECIAL CONDITIONS OF PERMIT:
By
Code Enforcement Officer
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(! (518) 761-8256
ARRIVE: DEPART: INSP:
v!')
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVEDD:;
NAME i/� / (C�(%r=/-i
LOCATION C/" c �+ �T" . e'U ---v-/
DATE b /070 } PERMIT #
TYPE OF STRUCTURE I 1AKOk9 jLA� 4 6-
FOOTINGS FOUNDATION _ BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING /�
EXTERIOR FINISH / 1
DECK/PORCH/STEPS/RAILINcLS
RELIEF VALVES
//f
FURNACE/HOT WATER OPERA TAG
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: �A
BATH/KITCHEN WATERTIGHT
I (�
OTHER FLOORS SWEEPA/LE 1 I
OTHER FLOORS CARPETED 1
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS'
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL I
S TE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
TOWN OF QUEENSBURY
BUILDING_ & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Di 7 F/n1O
Location CV, tiir'_ RR
Date lvlq d:•; Permit # 01— 6-Ce
SOIL TYPE: Sang Loam-Clay-
Results of ' colation Test-
(if appli ;ble. Rate-Minute/Inch
TYPE OF S STEM:, —�
ABSORPTI' FIELD. Total Length
Length of :-ach trench e'. j�
Depth of t enches�
Size of stone •
SEEPAGE PI `, : Numb.r-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. i,ox MU N .ct7 Ao
Dist. Box to Fi -1 d/P--e, =4 0
Openings Sealed. Yes' No _ ,Partial
LOCATION/SEPARATY,ONS:
Foundation to Tan ' feet •
Foundation to Abso ptio ..feet .
Separation of Pits • -- feet
Conforms as per Plo Plan No
ION OF SYSTEM O '. ROPERTY.
(cir 1 one)
Fro - Rear - Left Si.. - Right Side
iddle Front - Middle , e:r
COMMENTS: L - �I.� b. R -
- 'k l v d
}- ' L-�, - 8�0,• \
0F1r ..-i j
Fog () 5 T&f IA, 41� r cY<
SYSTEM.USE APPROVED: /YES NO
Arrived:
Departed: /D'/
Dr
. Building Inspector
FINAL INSPECTION REPORT -
MOBILE: 0 MODULAR
Town of Queensbury
Building & Code Enforcement
742,Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART:fO'URiNSP:"JP-
DATE INSPECTION REQUEST RECEIVED:
� 1
NAME: I ST G—�=F fr/0d
LOCATION: w , Vim,i Pb
DATE: ( D 1 / 0 i PERMIT# CV—jS `L
l[[
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION BACKFILL FRAMING
N/A YES NO
1. foundation support, pie spa,ing
per manuf. _
2. anchoring per manuf. /
3. water line shut off
4. sewer line support 4 f•:t f _
5. heating crossover (dblewi.: iff grd.
6. dryer vented outside
7. skirting ventilated _
8. hot water relief valve piping,• tsio: \
9. deck, porches, steps, railin; .. �l ) _-
10. furnace/hot water operating _
11. garage fire proofing
12. door closers _
13. plumbing fixture V
14. foundation insulation (if appl.)
15. smoke detectors u r �J
_ //
16. final electrical
17. variance required
18. data plate okay —
19. mobile HUD seal okay `
Model # y 461Z1I?Serial #®I— 0 c 7
Manufacturer V D G 5 5
rate of Manufacturer g in 0(
OKAY TO ISSUE C/O YES NO
Comments�,� Rl4lL 13i L 4 •
Rt= ►iSF- Ins o
�� TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name BrIES . t %C-di=f, A9O
7 Location ,z-'- SO 2 G R
Date 6'0 ; e J Permit # Z--,33 Li
SOIL TYPE: Sand-Lo.u-Clay- 1\:—
Results of Percola ion Test-
(if applicable) Ra 'e-M nute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: T.ta Length
Length of each tren, h .
Depth of trenches
Size of ston-
SEEPAGE PITS: Numbe -
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No . .Partia
LOCATION/SEPARATIONS:
Foundation to Tank .feet •
Foundation to Absorption . — feet . .
o�' •Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF.SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS: , . .
/ Lo-,/f C- , -/-f Fie�,�
t
17 F---Ro,,� &ii,-1-6,Zug.4r& .
C - -c.Ke�J
SYSTEM.USE APPROVED: • YES 0
Arrived: it
Departed: j o /.
Building Iris ector
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name D i 5M6=r-74.00
Location 60 , I/A - _ go ,
Date /OAS)I Permi t # ()/ `/
SOIL TYPE: Sand-L m--Clay- _
Results of Percol at Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: l
ABSORPTION FIELD: Total Length
Length of each tre ch .
Depth of trenches ,
Size of stone
SEEPAGE PITS: Numb-r'
Size - ft. x1 ft.
Stone size . ____./
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pi
Openings Sealed? Y s No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet •
Foundation to Absorptio . — feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON P 1PERTY:
(circle one)
Front - Rear - Left Sid - Right Side
Middle Front - Middle Rear
COMMENTS:
4/7?-:- Ci-V. F;.4 (k) 4 rc-2
Li1ic GoC-- ;
SYSTEM.USE APPROVED: YES 0NO
Arrived:
Departed:
VP
. Building Inspector
FINAL INSPECTION REPORT I '"
MOBILE / MODULAR,
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8251, F
ARRIVE: DEPART. � INSP.
DATE INSPECTION REQUEST RECEIVED:'
NAME: /edG� a c/GFf',✓3rd
LOCATION: 01; Mr, n0 -
DATE: ld �,,,0 I' PERMIT# 0( _10'
MOBILE HOME - MODULAR HOME V
FOOTINGS _ FOUNDATION BACKFILL FRAMING_
N/A YES NO
1. foundation su...rt, .ier spacing
per manuf. _
2. anchoring per . uf.
3. water line shut o , _ _
4. sewer line support @ 4 ••t _ _ _
5. heating crossover(•ble .de) off grd.
6. dryer vented outsi•- _
7. skirting ventilated .. .... _ _
8. hot water relief valve I.'Mg outside
9. deck, porches, te. -.fling _ _
10. furnace/hot water oper:ting _ _ _
11. garage fire proofing
12. door closers _ _ _
13. plumbing fixture
14. foundation insulation (if%ppl.) _ _
15. smoke detectors _ _
16. final electrical _
17. variance required _ _
18. data plate okay _ — —
19. mobile HUD seal oka, _ _
Model # Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O . YES NO
Comments: Cr7o )S _ b1" .
b) 3 0 kv&c, Artko vfr(--
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAi b2 f
Panel Board No,„ Cert. N2 70180 Cut-in Card No
Owner (W 6 'r 9 c9
Location iU . 44. /41'i R C.
Installation Consisting of.....3-to I rc- / zec 'c 2 G/-Zoo 56724fie-G-
Installed By A-5 LfL o S i ' Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued b
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon thf
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of makin• inspections at any time, and if it:
rules are violated,theCompany shall have the right t r ok- thA0 tific, te.
Date 9�/9-6 `/ INSPECTOR
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT iqlln\l)
742 Bay Road
Queensbury NY 12864
(518) 761-8256 U
SEPTIC DISPOSAL SYSTEM INSPECTION
• Na'1 +e
Location777 WC rk`�
Date- ", Permit O)'95(C)
SOIL TYPE: Sane-L.,am-Clay-
Results of Perc•la ion Test-
(if applicable) Ra e-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIEL otal Length
Length of each t nch
Depth of tench
Size of st
SEEPAGE PITS: Nu ber-
Size - ft x ft.
Stone size .�
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field Pit
Openings Sealed? Yes No . :Partial
LOCATION/SEPARATIO S:
Foundation to Tank feet
Foundation to 'Abso ption .feet . .
Separation of Pits • feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one) •
Front - Rear - Left Side - Right Side
Middle Front. - Middle Rear
COMMENTS:
• U
or
SYSTEM.USE APPROVED: YES (:;!;)
Arrived:
Departed: ,� �
. Building Inspector
TOWN OF QUEENSBURY
. BUILDING & CODE ENFORCEMENT
r , ¢; 742 BAY ROAD
i.4, QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: Z° INSP: it
INSPECTION REPO:
OMMERCIAL - -- MULTIPLE I •LLING
(hotel, motel, ..t. complex)
DATE INSPECTION REQUEST' RECEIVED: _
NAME 4 -IE FI� ` '6 ,`
LOCATION Zzt C-021 0 r-\ ropo
DATE { "-1 '-(-,1 PERMIT It
TYPE OF STRUCTURE
FOOTINGS BACKFILL FRAMING PLUMBING_
INSULATION
N/A YES NO
CHIMNEY/"B" VEN1 HEIGHT
PLUMBING VENT/Fl TURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES
FLOORS •
FOUNDATION INSULATION
INTERIOR STAIRS/RAILINLS
STOCKROOM ENCLOSURE
FIRE/DEMISE WALLS PENET' TION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT DOOR HARDWARE
EXIT STAIRS/RAILS
PLATFORM/ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS _
HANDICAPPED PARKING
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN, IF REQ
OK TO ISSUE C/O OR C/C
1 : 6
j= ' ,.„..TOWN OF QUEENSAIRY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name "Di q,TC-`-4:41/d
Location _ f"-, k .
Date (17!) N ..Permit # d/4
SOIL TYPE:di,
. Loam-Clay-
Resul is of Pert of ati on `Test-
(if applicable) Rate-Minute/Inch___
TYPE OF SYSTEM: \
ABSORPTION FIELI: Total Lenth
Length of each rench 1 \
Depth of trench, s Z
Size of stone " J
SEEPAGE PITS: N mber-
Size - f . '\x ft.
Stone size
PIPING: Size Type �U
Bldg. to Tank . `8"s Se-3
Tank to Dist. Box i^ , '�53,
Dist. Box to Field/Pig VL to
Openings Sealed? 'es No . Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption . •e .feet. .
Separation of Pits _._`, feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERT .
one)
Front Rear - Left Side - Right Side
le 1 rout Middle Rear
<.
COMMENTS 6 '„"t::
t
j
11 Q U\VS ( 'ie 11 Ov,0
SYSTEM USE APPROVED: YES NO
Arrived: ,
Departed:
C:'s 'P- .
Building Inspector
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r^1=1'IEWED BY # __ __Arir
DATE .• 4./4•
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Sideyard �t. s�
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GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Quecnsbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive.°>,titan Depart n
Inspector's Initial
NAME: V)137-F F 160 PERMIT# ' r 1- 1-1Q
LOCATION: ta)I:F•5T HOUl.,'T/)IN Rip DATE : / —
TYPE OF STRUCTURE: c/)F 0
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is respo • ble fo
providing protection fro freez ng
for 48 hours fo lowing t a e pla ment
of the concrete.
Materials for this urpose i n s' e
Foundation/Wall ur
Reinforcement in P sew
.oundation/Dampproofing f
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/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
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 12804 Arrive m Depart •
�r's Lnitia:.i'.
4 I
N \4 0 ,PO�Q,11+ PERMIT# "�G 3)- Li (p
LOCA ON: T\ C\5 A DATE : g`— U X7 I
TYPE OF STRUCTURE: > \'h
RECHECK
N/A YES NO COMMENTS
ooti s/Piers
Mo lithic Pour Form
enforcement in Place
The contractor is respons ble for
providing protection fro freezing
for 48 hours following th placem: t
of the concrete.
teria is for this purpose o site
/oundation/Wallpourt\i/
ti/Reinforcemen in Place
Foundation/D proofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plac.
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
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
08A4/2001 12:56 5186953655 GARRY ROBINSON, PE " PAGE 01
FAX TRANSMISSION
GARRY ROBINSON, RE.
CONSULTING ENGINEER
114 Monument Drive
Schuylerville,New York 12871
Phone and Pax: (518) 695-3655
DATE: V/#6/ TIME: J 50 A.M. cr.M.D —
A-OA—AGES
NOTE: If you did not receive all of the pages, please contact us at the above phone number.
TO: FROM: _
CO.NAME: NAME: GARRY ROBINSON
ADORLiidib
SUBJE - �1
yrier7 �E'Tk6 i
ATTENTION: 1 C i
FAX NO.: q3
REMARKS:
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�'"'} ~ '� H ` ' • INSPECTION REPORT i Alon,--\
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request receiv• 1•
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive\ depart ., . �.�1�,�!
is1ector's —
NAME: N, (2 --U PERMIT# �� I ' 5 .42
LOCATION: DATE : 4,410 j
TYPE OF STRUCTURE: S
RECHECK
N/A Yyti NO COMMENTS
ootings/Piers ~1. I
4onolithic Pour Fo
Reinforcement in PI ce
The contractor is r sponsi1 le for
providing protectio from fezing
for 48 hours followi the p cement
of the concrete.
Materials for this purpos on s•
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin _
Backfill Appr'val..
Plumbing Unde
Plumbing Vent/Vents in PI ice
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interi3r R-
. Foundation Walls Exter.or R- _
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces
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
Cr A^-^--
GENERAL INSPECTION REPORT j Iik '^ 0
( 518 ) 761-8256
Town of Queensbury �-./
Dept.of Community Development Date inspection request received: �C
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive"�I p a Depart
Inspector's Initi
NAME: e,,S r an U PERMIT# -2, 512
LOCATION: L Z/-c-(- .NYVT- P-Etv4 DATE:
TYPE OF STRUCTURE:
RECHECK
N/A YES N COMMENTS
Footings/Piers ---, 1 1
Monolithic Pour Form 1�.Y�`--
\-\\‘4 , V2F____kb,
Reinforcement in Place \ '\
The contractor is responsible'tor `\
providing protection from freezing\
for 48 hours following the placement
of the concrete. ,j
Materials for this purpose on site 1 Vl_._z_ k6 _Foundation/Wallpour 03----\—‘:-
Reinforcement in Place
Foundation/Dampproofpig
Backfill Approval ` i E .
Plumbing Under Slab 1 RP--. .\ -‘2----
��
Plumbing Vent/Vents in P1
Rough Plumbing S)
Heating Rough-In _ .k\--\--7
Insulation I � .
Foundation Walls Interior R-
Foundation Walls Exterior R •
-
Floors R
Walls R- 1
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
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 12804 Arrive Depart`L=tO '� �mipm
I Inspector's Initials
NAM( - ` PERMIT# i,♦ — J
LOCATIO /ADZIA—
N: -2 4-r DATE : R—3
TYPE OF STRUCTURE:
RECHECK
N/A YES-N COMMENTS
F ngs/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is re •.nsible .r
providing protection fr I m freez g
for 48 hours following e place ent
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 PI.+e
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interio R-
Foundation Walls Exterio R-
Floors '
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
_ r 41e._
';')6/7/4-/ -6 .
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,/ _
"I have seen or observed, or believe I saw evidence of, 661.514" /(ki°cc�`l •� r'
5
all objects such as houses,wells,trees,fences, etc., RECEIVED•
shown on this document. I also represent 1ha� ve
personally'measured the distances set forth on the diagram."
• JUN 2 5 2001 '
•SIGNATURE DATE TOWN OF QUEENS URA" •
BUILDING AND CoDE
Rear Line - •
f t.
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n. J .
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S /
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RECEIVED
JUN 2 5 2001
TOWN OF QUEEN .RF
BUILDING AND W....,,
•
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: ti5iST•7—
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10.7 $
10.6 I 2 go
2.40 AC.
2.12AC. 1. hi. •
10.5 I. I6AC LW
(4) (3)
2..93 AC 3
10.1
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06/28/2001 14:24 518-793-1994 ACE HOMES INC PAGE 02
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DATE • I .
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