2000-043 ".J l i In},.,,r,r ��- y"k-4 I"A'"I a..d nlp A'
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Town of Queensbury
Warren County,New York
„t d
Date June 9 , 2000 0
J:i�I;;9 tt�I`i W�,��r Y��a nl�f?dry�i'"Y(r"r'W'u►'°°R'°`""""""""""�1"
This is to certify that work reg Y
ested to be done as shown� Penuit No, 2600043
has been completed.. M
This structure inay be occupied as a SINGLE FAMILY DWELLING
:location LOT 79 #51 SARA-JEN DR
Owner
TAX NAP NO. 7 4. -2-7 9 By Order Town Board
TO QUEEN BURY
Director of Ming&,`Cade Enforcement
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of"Warren (518)761-8256
VALUE $ 189000 Building Permit No. 2000 A3
TAX MAP NO. 74 . -2-79
Permission is hereby granted to MI CHAEL S GROUP
Owner of property located at LOT 7 9 #5 1 SARA-TEN DR.
in the Town of Queensbury,to constructor place a ;T Nr T r x a mjj y nWp_i T 1XG
at the above location in accordance to 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.
Owner's Address:
10 BLACKSMITH DRIVE
MALTA, NY 12020
Contractor or Builder's Name:
MICHAELS GROUP, INC.
Contractor or Builder's Address:
JIM CHANDLER, PROJECT MGR 10 BAACKSMITH DR
MALTA, NY. 12020
Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK BOARD -OF FIRE UNDERWRITERS
Type of Construction:
SINGLE FAMILY DWELLING
Plans and Specifications:
Proposed Use:
SINGLE FAMILY DWELLING
$ 319 PERMIT FEE PAIL)--TEAS PERMIT EXPIRES February 17 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 Town eensbury this 17 Day of February 2 0 00
SIGNED BY j for the Town of Queensbury
ode EnforctTffent Officer
Building Permit Application
Town of Queensbury - Dept. of Ccnnnuuity Development, 742 Bay Road, Queensbrny, NY 12804 1761-82561
r_[u B-UILDING & . CODE ENFORCEMENT
NOTICE Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. care�7yv` t�
beginning construction. No inspections PERMIT $
will be made until applicant has received Z FEE P !D
oning Board Action �
a VAIrID BUILDING PERMIT. All Area /Use �,a�
applicants' spaces on this application RECREA71AWq E PAID$
MUST be completed afid•the signature Planning Board Action REVIEWED BY.-
of the applicant-must appear on the SPR / Subdivision /Other Brrttdin� tru�ecrnr
t plicakion form, Recreation Fee Payment
Applicant: "'E t'r\If IBAs Owner:
Address: - T t - y �i�2. Address:
Phone # (5mZ ) Phone #.C -----)
Property Location: 'J^ _ -
Tax Map Number--
Subdivision Name: 5" —
- Section 131ocEc lot
r
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
_ New Building: CONSTRUCTION:
residence / commercial $
Addition to Building: T
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building "-
residence / commercial _� Single Family Dwelling
Residence / Commercial Two Family Dwe -
- no change to exterior size F i m i 1 D��l°xa n=g��EE
Office
Other Work (describe below) Mercantile FEB 1 0 2000
Manufacturing
Other TOWN OF
GROSS AREA OF PROPOSED STRUCTURE: 1 BYJ9t_DIR1 :6�1� O�JI? _
lst Floor. . . . . . . . 1Z tla-
' (�-- sq ft. t � f ADDITION, what will use
2nd .Floor. ... . . . . ._j�l;( sq.. ft DU<I ' G f new. addition be? :
Other Floors . . . sq. ft. �`
(not unfinished cellar or basement) ACCESSORY BUILDINGS: 13
Detached Garage 1, 2 car
TOTAL, FLOOR AREA: �(pS' SQ. FT. _ CA Attached Garage 1, Q
car
Private Storage Bu11 i g,
SIZE OF NEW STRUCTURE: Commercial Storage Building
FEET X VZ7 FEET Other
Foundation Type: Will any second-hand or ungraded
Number of Stories : 2 lumber be used? If so, for what?
(habitable space only) INA0
Height (grade to ridge) : 30 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or wooastove (circle• all which a plies
to be installed: ( Electric / Oil / as J Woad
Forced Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
c o d e s i s L4F_% rt c`�q
Na e A dresss Phone
Builder: e% chi _CsZs
Plumber:
Mason: 1 l Caal
Electrician:
DECLARATION Please sign below after you have carefrdly 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
Certificate of Occupaneyor Certificate of Compliance being issued, an AS BLTLLT PLOT PLAN by
a licensed surveyor; dra to scaliq s ing actual location of project on premises.
Signature:
(ow er, owner's agent; architect, contractor)
Application for Permit—Septic Disposal System
Town of Queensbiny 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
........... ........... .............................................. ..............
office Use
Location of installation:
I SMAil Delve-
File Permit No.
Tax Map No.
Fee Paid
Owner's Narne:
............... ................................................................
Address:
2. INSTALLER'S NAME PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate gbedroom(y) and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: --No. ofBedrooms x Computation Total Daily Flow
1980 or older x 150 gaUbdrin
1980- 1991 x 130 gal/bdrm
1991 -present x 110g.11/bdriii Flt%
R
Garbage Grinder Installed yes no PT
Spa or Whirlpool Installed yes 1 no FEB 1 0 2000
4. PARCEL INFORMATION: (circle applicable information &indicate measu`r.e'm"65Aiyz,,
Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Sut)t)lv
Ciflal(Lao ell what depth at what depth I::�W,1-11 We_71-1-11
Rolling loam feet —feet
Steep slope clay if well; water supply
slope other from any septic-system
depth: absorption is_ft.
other
Percolation Test: (To be completed by licensed pi-c?fcssional engineer ol-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: gallon (min. size 1,000 gal.) -DL-AU
Tile Field: ejch Q;; • fl. Total System Length: ID52:__ ft.
Seepage Pit(s): number of_ size oj*each: _ft. by__fl.
Size of Stone to be used: 11 depth or thickness v __ftet
Bed System Size:
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: 'WA 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 pursuant to Section 136-29 of the 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 of the Town of Que isbury Sanitary Sewage Disposal Ordinance.
Signature of re`s�ipon ible person 15ate
TOWN OF QUEENSBURY
142 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date Permit No :p
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the Now 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 re I quirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant Jim- mialm-Is bwcvp APPLIANCE (check appropriate boxes)
Address �LJVF E3STOVE: oWood oCoal oPellet-oGas
0 FIREPLACE INSERT
111-1111-44 )J Li zip 102 10 FIREPLACE, FACTORY-BUILT:
[3 Wood 1�r Gas
Phone 0 FIREPLACE, MASONRY:
r:3 Wood rj Gas
Owner 0 FURNACE: [3 Wood o Gas [3 Oil
Address IF NON-MASONRY APPLIANCE:
Manufacturer:
Zip Model:
Phone •
CHIMNEY (check appropriate boxes),
*EXACT ADDRESS of proposed construction 0 MASONRY: 0 Block 11 B I rick 11 Stone
5 1 � AP-A -NEo 1�p_ FLUE: o Tile El Steel
Size: inches
CONSTRUCTION / INSTALLATION MUSTf FACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE, Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS i3Double Wall 13Triple Wall
REGARDING REQUIRED INSPECTIONS. [I Insulated [i Direct Venting
a Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title
* 173 3389 (190) Public Safety
*233 2655 (239, Minor Sales
Fee Col ed Fro_M__o)Refunded to:
Address: r.
Dated: C:j� LLR-1 tRJ) Town Clerk or Deputy:
White: Applicant Green: Fire Marshal Yellow Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
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MAP REFERENCE:
LEHLAND ESTATES SUBDIVISION
FINAL LAYOUT PLAN - PHASE 3
DATED: APRIL 27, 1999
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
SARAH JEN DRIVE
CC'.��T�G f
JUN 0 9 2000
TOWN OF �5JEENSBURY
BUILDING AND CODE
f
i/
I HEREBY CERTIFY THAT THIS MAP 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 TO. -Kathryn M. do Arthur R. Troisi, 11
Chicago Title Insurance Company
Cendant Mortgage Corporation, its
successors and/or assigns
CERTIFIED BY:
MATTHEW C. STEVES, LLS NYS 50135
t� • DATED:
• June 8, 2000
A �r D's e „n
&CSC.
Steves
Land Surveyors, LLC
169 Haviland Road Queensbu�p New York 12801
ry!
(518) 792-8474 New York Lie. No. 50135
,�'�"�° u.Tnanal OR "°°„'°" To A RJRVEY
� A �D S � IS A
VIOLATION OF SECUM rIM SUG-WASM ; of THE
NEW TOM STATE i1nQ1 LAW
ONLY DOPE FO THE ORS OF 91
WEAL S I AN ORNRNN. OF W LAND SLRVEYORS
�KCOMMIED >oEEVAD
CERINICATM NNQAIED P19M SIONP , TUT
iHS SURVEY WAS PREPARED N ACCpFDMIOE 1711N TIE
°yT'"DDDDEa STATE M O AD&
91' iNE MEW YdN STATE ASlOpAllpl of PROfE7lOFI/�L
LAND SURVEYORS. SAX CERMCATIONS SNAIL. MM ONLY
TO THE PERSON FOR Oft THE SURVEY 3 PREPARED, AND
m FRS BEHALF TO m 1171E COMPANY, ODVERMMTAL
701W ANDSS `�"° "HE LEMO" INSTM�°" "'°
1b T11E ASSNNEES OF mu
tDFOwc INS717U110N.'
Map of a Survey made for
KATHRYN M. & ARTHUR R. TROISI, II
Town of Queensbury, Marren County, New York
Date: , 2000
Scale 1 ~=30'
S 1
TROISI
DWG. No. 89423-79
NO.
DATE
DESCRIPTION
EaL
F I R T M,fi FZS I-IAL.
4
TOWN OF QUEENSBURY
QUEENSBURY. NY '12804 -
(51 8) 761 -8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED
NAME N&
LOCATION PERMIT #
SCHEDULE INSPECTION- l .�
AM PM
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIONS
EMEROENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEAT NO UNITS
;H�Q
IRTD SIGNAOE
IMNEY
W OD STOVE
IRFPt_ACE MASONRY ACTORY BLT. _
EA R Ohl-IN
FINAL
REMARKS: OK TO THIS DATE
rrwsPSLIP.Pue INSPECTOR
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received. —/I'—
Building&Code Enforcement q,,p)
Dept.of Community Development Arrive am/pin Depart arrilmil
Town of Queenshury Inspector's Initials
742 Bay Road
Queensbury,New York,12804
NAME "IN J-1k PMVRT
Mil In —LOCATIOIS? DATE
TYPE OF STRUCTURE %!5py-Nn-
N/A YES NO CONINIENTS
Chimney Height/79'Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete V1,
Interior/Exterior Railings 30"to 36
Exterior Handrails,balconies,Ian g 18 or more 111//
nt
Interior Handrails stairs both side 3 or risers
Grade 2%away from foundation 1110)r
8"clearance' ill'plate
ed/re4atopf8"above grade Gas Valve s expos
Gas Fm�nmmmace s t or within line of site
Oil Furnace shut- at trance o furnace area
Furnace/Hot Water Heater open ting
Relief Valve(s)installed
Headroom;6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both si es more than 3 risers
Interior privacy/trim/doors/mai entrance36?'
Floor Finish
Bathroom/Kitchen watertight
ding
Interior Handrails Balconie ding 18 in.or more
Railing across window in sll� ells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected V
Bathroom fans
Plumbing fixtures
Foundation insulation
'/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed V
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"o les om fl9or
Final Electrical.5-12 74 a?
Site Plan/Varian ct reqdired
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). Vp
Okay to issue permanent C/O(Certif.of Occupancy) V
4028789 OF l
r FULTON STREET, e - ' NY 10038ii
M(I Date i F 2WO Application No 1 r •. .
THIS CERTIFIES THAT • i
a 1 1?^
WI t r equipment r described t^.l and introduced by rrt rr ^t I rrt applicationr premises Of 1
GROUPmil, mcwt's MUMMYNY
a
1in thefollowing location; Basement ® IFl. .1Section Block 1
�I
K' wasexamined on IM 22,2ft and found to be r r rNationalr ►r^
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GENERAL MANAGER A
{ ► ,(� y^ ►
tiSCHENETTADYj NY, 12309 :,, f , ., s; 239l�
{iPer
ficate must notbe alteredInany • tothe office of :•• • If Incorrect. e beidentified by :•: ♦ri I�
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N' N I• :51 wor, e �• i M
GENERAL INSPECTION REPORT
(518 ) 761-8256
Town of+Quecnsbury
Dept.of Community Development Date inspection request received:
t Building&Code Enforcement
742 Bay Road 2,
� \cn5bury, (�Ii' 12804 Arrive am/pm Dcpart'' am/Win
Inspector's Initials �v
NAME: �,.%1"53�. _ PERMIT# c (7C��U
LOCATION: �_� � �G.�rG�P DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers --� —j
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection fro reexing
for 48 hours followin the placemen
of the concrete.
Materials for this p se oil site
Foundation/Wall ur_
Reinforceiaacnt in Plac
Foundation/Da pproofing
Backfill Approv 1
Plumbing Und r Slab
Plumbing Ve /Vents in Place
Rough PIu ing
Heating R ugh-In
Insulatio
Fo lotion Walls Interior R-
oundation Wails 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
Jac. Posts/Main Beam
iiGi tratpi Ba`rricr
Fire epara' on I,2, 3, hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Firestopping
i
l
REPORT
GENERAL.�NSPE�`TIUN.��EPG►
(518) 761-8256
Town of Queensbury I
Dept,of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road r
Queensbury,NY 12804. Arrive am/pm Depart 5a,,,�pIn
Inspectors Initials ` (/
NAME: _ G,' �, � PERMIT#
LOCATION: DATE
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form_
Reinforcement in Place
The contractor is responsib a fo
providing protection from zin
for 48 hours following the laceme t
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement.
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in P ce
Rough Plumbing
Heating Rou - In
ul aon
.Foaadation Walls In riar R-
Foundation Walls E erior R-
Floors R- ,
Walls R- 1
Ceiling R- C�
Duct work or piping in
unheated s aces. R-
Proper Vent, : .c ,ent
xannn! . �cL
it ac Studs/Headers
Bracing/Bridging5. o<J ��� '� �• -��r t�(t�J
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
r
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Day Road
Queensbury,NY 12804 Arrive am/pm Depart l ' n
Inspector's Initials
NAME: ��� =-`c:
l (� PERMIT#
LOCATION: l h�, DATE : jt .L
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsib for
providing protection fro freezin
for 48 hours following a place ent
of the concrete.
Materials for this purpo o to
Foundati
i all
Reinforcement in PI
Foundation/Da mppr fing
Backfill Approval
Plumbing Under Sl
Plumbing Vent/Ve is in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation ails Interior R- _
Foundation alls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
oper Vent, Attic Vent
Fra 'ng
ck Studs/Headers
racing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestoppmg
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 1280* Arrive am/pm Depzzt, In
Inspector's Initial
NAME: C PERMIT# '1 043
LOCATION: .- G ` ► _� DATE:
TYPE OF STRUCTURE:
RECHECK,
NIA YES NO COMMENTS
Footings/Piers E
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezin
for 48 hours following the place ent
of the,concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
FoundationA:)amp roofing_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Pla e _
1'rl binaft.
ea g Rough_
Insulation
Foundation Walls Inte or R
Foundation-Walls E 'or R-
Floors , R- 1�<l
Walls
illing R-
Duct work or pi;e-nt
unheated R-
Fro Vent,Attic
'PROo
�k Studs/Headers / •
11
Bracing/Bridging
Joist Hangersv-�
Jack Posts Beam
Ai tratio Ba,-'er
F' Separation 1,2, 3,hour
�. �;�i' ?
Penetration Sealed
Fir all 3,47hour
� slppittg
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I / "I have see
�_ _.. . _ _._ .�. .�... ._.. ....� ��.. lieve l saw evidence of,
noses, wells, frees, fences, etc.,
shown on this documeft l also-represent, tr Personally flneasurPd tl that! have
Cr Jstances set forth-on the diagram.}} i
SIGNATU z 2 1
DATI
100.00
SO 5O V'
o
o a C4
r
i MM�
rJUTY EASEMENT N051550
' � "E R�3T5.0
.
4' TYP. 2000043
TYP. MICHAEL'S GROUP
LOT 79 -#5 I SARA—JEN" DR.
SIKGLE FAXILY.DWELLING
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road Iii
Qucensbury,NY 12804 Arrive am/pm Depart-- am/prn
Inspector's Initials
NAME: PERMIT
LOCATION:' DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respons/iblel
providing protection from fire ing
,p
for 48 hours following the pl cement
of the concrete.
Materials for this purpose on itc V
Foundation/Wall�ir
"-h cc Reinforcement in Place
Foundation/Damt)t)roofi
� 11-Approval--
Plumbing Under Slab
Plumbing Vent/Vent in Place,/n;;
Rough Plumbing_
Heating Rough-li
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/Hcadcrs
Bracing/Bridging_
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
tJ 1 GENERAL INP.ECTIQN REPQRT
Town of Queensbury
Dept.of Community Development Date inspection request receivedr
Building-&Code Enforcement
742 Bay Road
Queens4ury,NY 12804 Arrive am/pm Depart am/pm
Inspector's Initials
PERMIT
NAME: 1 # '�' �
LOCATION: �'1 � c p,, DATE :
s C.1)�` �
TYPE OF STRUCTURE:
RECHECK
N/A YES N ..COMMENTS
F g/Pi
M ers
asiolitbic Pour Farm p� t�
Reinforcement in Place
The contractor is responsible for .
providing protection from freezing
for 48 hours following the placeme
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
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 I, 2; 3, hour__
Penetration Sealed
Fire Wall'2, 3,4 hour
Firestbpping
GENERAL INSPECTION REPORT
(51 8 ) 76].-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road lr
Queensbury, NY 12804 Arrive am/pm Depart a pm
t , Inspector's initials
NAME: 1 ,\C(.p 6 =t-S r" ', PERMIT#
LOCATION: DATE : LIZ�
TYPE OF STRUCTURE:
RECHECK
N/A YES INOV COMMENTS
/00tings/Picrs
Monolithic Pour Form
Reinforcement in Place The contractor is responsible for
providing protection from freezing
for 48 hours following the placeme t
of the concrete.
Materials for this purpose on site
Foundation%Wailpour_
Reinforcement in Place
Foundation/D mpproofing
Backfill Approval
Plumbing Under Slab_
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-in
Insulation
Foundation Walls/in
R-
Foundation Walls R-
Floors -
Walls -
Ceiling -
Duct work or pipiunheated space -
Proper Vent, Attic Vent
Framing_
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Bcam
Air Infiltration Barrier_ _
Fire Separation 1,2, 3, hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Firestopping
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FILE
Rum a
100.00
01
. atYM 1l.m►l�.0fti9 h`Lt4.li �lis�� IllOf." I�leeY OMS60 4415'W dab403mm
s a ��
� X D
_ q FEB 0 200
Mo .
0.46 acres 14- cv00
e t
r
.»-
f r _
I have see r Elie ve 1 saw evidence of,
o6ses, wells, trees, fences, etc.
shown on this docume t 1 also re
Personally easur d t Present that I have
!stances set forth on the diagram.,,
SIGNATU Z14L_.
DAT
100.00
SOh5�t5o"W
flnUTY EASEMENT N0501 '50a�E R1=32b
4' r(P. 2000043 :7f4.
MTCHP,ELS GROUP
` TYF°. LOT: 7.9 #5,1..SARA—JEN, DR
SINGL& FAtdILY'WELLING
--__
LLJ
cc
I5 r �
f
�77_
1all
have seen or observed, or believe I saw evidence of,
objects such as houses, wells,trees, fences,etc.,
shown on this document. I also represent that i have
personally measured the dis noes set forth on th di gram."
SIGNATURE DATE'