98-628 CE ]RCA 1 ,C. OF V U L` AN"'
L1► 1
TOWN Of QUEENSBURY
WARREN COUNTY, NEW YORK
January 15 99
Este #4
p L4 98528
This is to certify that work requested to be done as shown by Permit No.
has been completed.
SINGLE FAMILY DWELLING
This structure may be occupied as a
BIG BOOM RD .
l ccation
CLUTE , LARRY
C']tivner
TAX MAP NO . 14 5 . - 1 - 1 . 3 By Order Town Board
"TOWN OF QUEEt4SBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
VALUE S � 5000TQWN OF +QUEENSSURY No, af4F7 >L
TAX MAP NO . 145 . - 1 - 1 . 3 WARREN COUNTY. NEW YORK
PERMISSION is 'hereby granted to CLUTE
OWNER of property located at
BIG BOOM RD Street, Road or Ave.
in the Town of Queensbury, To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Oveensbury Building and Zoning Ordinance.
rC0C)?,N4TRACT0R
d001s is
WN ROAD
CT34
SBURYr NY 12804
OR or BUILDERS Name
ENTERPRISESr INC .
WN rRC7ADR SAddressSBURYr NY 12804
4. ARCHITEGI Nsme
COMMONWEALTH ELECTRICAL AGENCY
S. A I>F81 TE,f r�"S As ft%s
HAGUEr NY 12836
FPLANS
f Construction — IPpease indlootaby X) SINGLE FAMILY DWELLING
i ) wood Frame l 1 Masonry i t Steel 11
and Specification
3a, SQ FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIO S
ed Use
NGLE FAMILY DWELLING
144 October 8 2000
PERMIT FEE PAID - THIS PERMIT EXPIRES
$
19
tit a IcI Period is required a thialxpaliun #Of an data Ixtem� must � made to the Barlldlnp and Zoning inspector of the
town of oueenso ury 1998
Dated at the Town of QueensburY this 8 October
Day of 19
Lr for the Town of tlueensbury
SIGNED BY Buildarg atW Zoni I rptor
B using .F'ermt A�ap►licrxt�ion
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-82561
BUILDING & . CODE ENFORCEMENT
NQi ICE Requirements prior to issuance
of this permit: PERMIT FILE NU.
A permit must be obtained before no
beginning construction. No inspections PERMIT FEE PAIR $ _ Q
will be made, until applicant has received 0 Zoning Board Action
a vALID BUILD1.No PERmrr. All Area I Use RECREA77ON FEE PAID $
applicants' spaces on this application
MUST be completed and the signature Q Phuming Board Action REVIEWED BY:
of the applicant must appear an the SPR I Subdivision I other Ruilding Inspector
lication farm. 7h..t 3 . Recreation Fee Payment
Applicant: Owner:
Address: ` �����^ �� Address:
Phone # ( ) "j - _ �? Phone # ( ) --__._.. ' ____...—
Property Location: , _ �
Tax Map Number _
Subdivision Name: Section Block lint
NATORE OF PROPOSED 'WORK : ESTIMATED MARKET VALLJ OF THE
New Building : CONSTRUCTION : $ C7 �
residence / commercial
Addition to Building :
residence / commercial t]CCUPANCY INFORMATION :
Alteration to Building : r ary Building -
residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work ( describe below ) Mercantile
Manufacturing OCT 67 1998
Other
GROSS AREA OF PROPOSED STRUCTURE : /le. r
7 If ADDITION , what will use
1st Floor , . . . . . . 0 sq • ft • of new addition be ? : 1 f
2nd .Floor * V . 11 . 0 sqm ft4 h-f ✓
other Floors . . 0 * 0 sq • ft •
( not unfinished cellar or basement ) ACCESSORY BUILDINGS :
a Detached Garage It 2 car
TOTAL FLOOR AREA : Q-3 % SQ .- FT . Attached Garage It 2 car
Private Storage Building
SIZE OF NEW STRUCTURE : Commercial Storage Building
f Other
FEET X "�G FEET
Foundation Type : Will any second-hand or ungraded
- Number of Stories : _ lumber be us d? If so , for what ?
( habitable space only )
Height ( grade to ridge ) : � _ feet TYPE OF BEATING SYSTEM :
Number of fireplaces d/ or woodstove ( csrcle al h applies )
to be installed : Ele 1 Gas / Wood
orced Hot Baseboard / Other
Person responsible for supervision of work as regards to budin
codes is :
Name Address Phone
Builder :
Plumber :
Mason :
Electrician :
DEC'L.ARATTON.• Please sign below after you have carefully read the statentent.
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 ner. Further, it is understood that Uwe shall submit prior to a
Certificate of Occupan or Certifi to of Compliance being issued, an AS BL1I.LT PIADT PLAN by
a licensed surveyor- yawn to s e, showi ac l loc n of project on premises.
Signature-
caner, ow is agent, architect, contractor)
Application for SEPTIC DISPOSAL PERMIT
"town of Q=ensbury
Dept_ of Community Development Permit No.
Building & Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
a
Location of property for installation:
Property Owner's Name:
Property Owner's Mailing Address:
Installer's Name: (`ACvt � , `;« _., Phone # .._?r �`'i�
Number of bedrooms (if residential): Total daily flow: U
/ (residential - compute g 150 gal./bdrm.)
Topography: e flat, rolling. steep slope % of slope
Sail Nature: sand, loam, clay, other / depth:
Ground water: at what depth? feet f Bedrock or Impervious Material: at what depth? . feet
Percolation test: not required, required. [ rate min, per inch ]
Domestic water supply: >f municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorpticn is feet.
PROPOSED SYSTEM
Septic tank_ (COO gallon (m nimum size: Is000 gal.)
Tile field: each trench feet / Total system length: �`!~ feet
Seepage pit(s): number of I size each: ft. by ft.
Size of stone to be used: # I depth or thickness feet
HOLDING TANK SYSTEM.: (if required)
Number of tanks: Size of each: gallons
Alarm sys and associated electrical work to be inspected by a certified agency.
For your protection, please now that pursuant to Section 136r29 of the Code of the Town of Queeusbxuy, any permit or
approval granted which is based ngt�nl,,,o,r in m: ,w,s;..,..._ upon any material mis�u or failure to make a
material fact Cyr ci-a zustanc$ known by halfLiofan applican t, shallbe void.
I have react the regulations wit}: to this c and by these and all requiremerna of the Town of
Queenebw7 Sanitary Sewage al
r /
Signature of respon ' I r n: _r Date: I ID `7 I
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURYt WARREN COUNTY
9000 HEATING DEGREE DAYS
ComrSliance Methods : PART 5 - Acceptable Practice Method -
i 07 1998
1 & 2 Family Dwellings ( only )
PART 6 - Thermal Rating - Component Trade offs
1 & 2 Family Dwellingsto 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 :
Grass Floor Area - e feet
2 . Type of Heat - Electri O :V7" Gas Other
3 . Is building mechanically coaled ? Yes > No
4 . Percentage of area of windows and doors Over 17 % eUnder 17 %
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SriOT4N ON PLANS SUBMITTED :
a . Roof R _3 z)
b . Exterior walls R
C . Glazed areas R —
d . Exterior doors R 5 :2
e . Floors over unheated spaces R _
- . Edge of slab on grade ( heated building ) R
g . Basement/ cellar walls ( above grade ) R 1cj
h . Basement /cellar walls ( below grade ) R it
i . Heating/cooling-ducts piping in unheated space R
6 . Service ( domestic ) hot water heating device
Conforms to minimum efficiency per code Yes No
T PERA LIRE CONTIROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
Ap _ i c - , ' {� at Y Da e Phone Number
/e�INSP ,.;" Cr,rC;,.4FS REMARKS :
TOWN OF QUEENSBURY
BUILDING 6+� CODE ENFORCEMENT
CL 7i42 BAY ROAD
QUEENSBURY NY 12004
( 518 ) 745- 4447
Pk RR IVE: T7 P.L'.""..R'I' : IIdSF : "'"L.J
FINAL INSPECTION REPORT — RESID7ffWl �L�
DATE INSPEIPTION REQUEST R • CEIVED : !!rr
ND A
NAME OeO
LOCATIONQcxnns
DATE CN PERMIT K
TYPE OF STRUCTUR
FOOTINGS FOU DATI N BACKFILL FRAMING
ROUGH PLUMBING S TIC INSULATION
FINAL ELECTRICA OODSTOVE OR FIREPLACE
N A IRS NO
CHIMNEY HEIGHT VENT 4EIGHT
PLUMBING VENT
RODE I NG
EXTERIOR FINISH
DECKfPORCiI STEPS IL NGS
RELIEF VALVES
FURNACEZ OT WATER ONRATING
INTERIQR. TR RIVACADOORS
FINISH FLOORS :
BATH/KITCHEN WATH TIG
OTHER FLOORS -SW FABLE
OTHER FLOG S CA PETED
STAIR CLEARANCE ILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXT ES
FOUNDAT3PN SULATION
GARAGE FIDE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SIT P' l ARIANCE REO .
Aro SURVEY PLbT PLAN
QK TO ISSilE CfQ OR CfC p pqp cA
.�
t
MAP REFERENCE:
MAP OF A SURVEY MADE FOR
DANIEL D. GOODRICH
DATED: SEPTEMBER 2, 1992
BY: VANDUSEN & STEVES
LAND SURVEYORS LANDS N/F LANGDON `
P3
00N •
o IRF
oCONC. MON.
x
LEGEND:
= IRON ROD FOUND
= CONCRETE MONUMENT
= UTILITY POLE
= CHAIN LINK FENCE
� an D us eh
8c Steves
Land Surveyors, LLC
37 Chester Street Glens Falls, New York 12801
(518) 792-8474 New York Lic. No. 50135
30.1 j 33"E
509 1j.
ARAE
128,943 sq fi
2.96 acres
,07.3V
LANDS OF
STATE OF NEW YORK
w
10
pR•
CON, MON
A
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: JON do CYNTHIA LUSSIER
NORWEST MORTGAGE, INC., its successors
and/or assigns
OLD REPUBLIC NATIONAL TITLE
INSURANCE COMPANY
CERTIFIED BY: _
MATTHEW C. STEVES, LLS NYS 50135
DATED: JANUARY 14. 1999
Dwtel JANUARY 14,
'u Aurmz D ALTERATION OR ADDITION TO A SURVEY
NAP BEARNo A LICENSED LAND SURVEYORS SEAL IS A
NCLAMCN OF SECTION 720% SUB -DIVISION 2. OF THE
NEW YORK STATE EDUCATION LAW.'
'ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
Map
of a Survey made
for
Scale 1'=50'
NARKED VTTH AN ORIGINAL OF THE LAND SURVEYORS
SEAL SHALL BE TO VALID TRUE COPIER'
'CERTIFICATIONS INDICATED HEREON SIWIFT THAT
S -1
SCONSIDEREDPARE
SURVEY ACCORDANCE THE
THIS SURVEY WAS PREPARED N LANDSU SURVEYORS
EXISTING CODE OF PRACTICE FOR lAFO SURVEYORS ADOPTED
BY THE NEW YORK STATE ASSOCA71ON OF PROFESSIONAL
LAND SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR TWNON THE SURVEY IS PREPARED, AND
W HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL
AGENCY AND LENDING INSTITUITION LISTED HEREON, AND
TO THE ASSONEES OF THE LENDING INSTITUTION.'
J O N
Town of
&
Queensbury,
C YN T H IA LU S S I E R
Warren County, New York
145-1-1.
NO. I DATE
DESCRIPTION
LUSSIER
DWG. NO. 92239C
r
oil have seen of ho4, ;
all object ,,
Shp o this mar
sonally it
T 07
4 ) I /
5 �r
L C7�
t
� RESIDENTIAL FINAL INSPECTIOrN REPORT
Office No. (518) 761-8256 Date inspection request received:
Building & Code Enforcement
Dept. of Community Development Arrive am/pm Depart
Town of Queensbury Inspector's Ini ' s
742 Bay Road
Queensbury, New York 12804
NAME X. F'ERh+IIT' #
LC7CA N t DATE
TYPE OF STRiJC I [.1RE
N Y4P NO CONDAENI"S
Chimney Heightr" 13" VentMirect Vent Location
Fresh Air Intake
Plumb Vent through roof
Root'Complete
Exterior Finish Complete
Intertor/Exterior Railings 30" to 36" kAe
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 he of site
Oil Furnace shut-off at entrance to furnace area
FurnacelHot Water Heater operating
Relief Valve(s) installed
Headroom, 6 ft. 6 in. on stairs
Basement stairs, 6 ft. 4 in. .00
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Fixuish
Bathrootn/Kitchen watertight
Interior Handrails Balconics(L anding 18 in. or mor
Railing across window in stairwells
Smoke Detectors:
every level woe
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer.
Gar-age fireproofing
Garage penetrations seald
e
Furnace in separate room pro ted (in garage)
Light ventilation per room
} Eety glazing 18" ir
or es
F _ floor
d rtal Electrical
tte YIanlVariance reytured
4ma] Survey Plot Plan �' glwl A FI A I eI t--
As Built 'Septic System layout required e� r` t 64&Pv&
Okav to issue CIC (Certif. of Compliance)
Okav to issue: temp. CIO (Certif of Occupancy)
Okay to issue permanent C/O (Certif. of Occupancy) � V, tI & Uj iro
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
Main Office 176 Rue Run Road - Manheim, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICA14 APPROVAL
Panel Board No. .............................Cert.
/ p� ,� N_ 66734 Cut-in Card Na- .........
.._.................. _,_�}
Owner.......^>.P4.�c. ` 7 ...... �L', ZC-.............. �T
....&.....................................................u
Location ......... _ ,6. 61C rJ..7$!C......�LJ.................. ............ .......-
,f
Ins a1, Consisting of..-.,,. ... Fr. 1 t� q�
% . 1.... ....................... /..................................
..........
Installed By........... ............ l� �_. ^'...........,..... .
Lic. No, ...... ................................. ....
The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelled: -
This cenificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of Ma inspections at any time, and if its
rules are
violatte,ed.,�, the Company shall have the right `oke rtiPpj,�atte..[�'y
Date....
. ..... .... INSPECTOR
-Member N.R.P.A., LA E.I.
GENERAL rN,S',PE+CTIO�''V' REPORT
Town. of Queensbury
Dept. of Community Development Date inspection request recelm*d:
Building & Code Enforcement ll/
742 Bay Road Arrive am/pm Depsir#���'��Pm
Queensbury, NY 12804 Inspector's Initials 'y1
} ,� •'� c' 7, C9
NAME: DATE : #
LOCATION:
TYPE OF STRUCTURE:
RECHECK
NIA YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freI
for 48 hours following the meet
of the concrete.
Materials for this n site
FoundaUonlWallpour
Reinforcement in Pi
Foundation/Dam n
Backfill Approval
Plumbing Under S
Plumbing VentN nts in Place
Rough Plumbin
HeatingRoughmIn m.
LAmilfation
Foundation Walls I R-
Foundation Walls Exterior R-
Floors R'
Walls R"
Ceiling, R- f
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
BracinglBridgin
Joist Bangers
Jack PostslMain Bean'
Air infiltration Barrier
Fire Separation 1, 2. 3, hour
Penetration Sealed
Fire Wall 2. 3, 4 hour
Firestopping
GENERAL I56SPEf77G►N REFaDRT
Town of Queensbury
DepL of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road `
Queensbury, NY 12804 Arrive am/pm Dep& r� � � am/pm
Inspector's Initials
NAME: PFR1VL[T W
LOCATION: DATE : �.
TYPE OF STRU
RECHECK
NIA YES NOCO14�Q1+IENTS
Footings/Piers �
Monolithic ur Form
Reinforoeme in Place
The coon is responsi for
providing pro 'on fro free ing
for 48 hours fo110 a plac:exn
of the concrete.
Materials for this se on site
Foundation/Wall
Reinforcement in
Foundation/Dam oofin
Backfill
Plumbing Un r Slab
Plumbing V ntNents in Place
Rough PI g
Heatin Rou -In
on
Foundation Walls Interior R-
Foiun+dation Walls Exterior R-
Floors R-
Walls R-
Ceiling R.
kv
Duct work or piping, in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridgix�
joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1 , 21 3. hour
Penetration Sealed -
Fire Wall 2. 3, 4 hour _ —
Firestoppin
i
GENERAL IN pE 'IpN REPURT J
Town of Queensbury 1 f
Dept, of Community Development Date inspection request received:
Building. & Code Enforcement
742 Bay Read „
Queensbury, NY 12804 Arrive Alt
Inspector's Initials Q
NAME: G _ PERMIT # t� `
LOCATION: DATE :
TYPE OF STRUCTURE: cAae
RECHECK
N/A. YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible f
providing protection from ing
for 48 hours following place t
of the concrete.
Materials for this on si
FoundationlWall
Reinforcement in
Foundation/D roofing.
Backf ll 1
Plumbing Under Slab
pl ent/Vents in Place
gh Plum +
Heating Rough-ln
insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiking R-
Duck work or piping in
unheated spaces R-
Pro Vent, Attic Vent
Jack Studls/Heaciers
Bracing/Bridging
Joist
Jack Posts/Main Beam
Air infiltration Barrier _
Fire Separation 1, 2, 3, hour
penetration Sealed
Fire Wall 2. 3, 4 hour
Firestoppin
TOWN OF t2lJEEMSBl1RY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Qtueensbury MY 12804
(518) 761-8256
SEPTIC DISPOSALSYSTEM INSPECTION
I
Name _CwZ 4
Location
Date 1aX i Sf Permit # 'L2 °
SOIL Tl Sand am- Clay-
Results of Per of ati on T vtl -
( if applicable ) ate- Min'ut#,/ nch
TYPE OF SYSTEMS y
ABSORPTION FIELD : tal Le th 2
Length of each trench
Depth of trenches 77
Size of stone __
SEEPAGE PITS : um
Size - ft . x ft .
Stone size f
PIPING : 4�Size ype L
Bldg . to Tank -
Tank to Dist. Box
Dist . Sox to Field/Pit
Openings Sealed ? <2 artia
LOCATION/SEPARATIONS :
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yesc $] � �
LOCATION OF SYSTEM ON PROPERTY:
( circle one )
Front - Rear - fr s ; ea Might Side
Middle Front a lie r�]
COMMENTS:
SYSTEM USE APPROVED .
Arrived -
Depa
i di tar
GENERAL RNSPECTION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received: 1 l �! _ rUS✓ .
Building & Code Enforcement
742 Bay .Road
Qrueendwry, NY 12804 Arrive am/pm Depart 'Am/Mm
Inspector's Initials
NAME: � VJA4_ A-- C- k4 jai G-fE- PERM1717 # ,
LOCATION: r2C+. DATE : - - '
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respon4ble for
providing pro on
for 48 hours llowin t
of the can
Materials for this on "
Foundation/Wall
Reinforcement in
Foundati ppmo
Backfill l
lumbing U r Slab
Plumbing Vont/Vents in Places
Rough P1
Heating Rou -In
f'f A� Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors eke) R. /t>
Walls R-
ce't� R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framin
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
Fi
GENERAL IN PE N REPQRT
Town of Queenslaary
Dept. of Community Development Date inspection request receKred: —
Building & Code Enforcement
742 Bay Road
Queens6ury, NY 12804 Arrive am/pm Depaurt � 'I_T`
J �f 6 4-�^ ,,CA .+�` I nspector°s Initials
NAME: I f n l � PERNUT #
LOCA'nON: DATE
TYPE OF STRUCTURE:
RECHECK
NIA YES NO COMMENTS
Footings/Piers I
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 purpo site
Foundation/Wallpour.
Reinforcement in Place
F undation/Darnpproafing
ackfill Approval
Plumbing Under Stab
Plumbing Vent/Vents in Place
Rough Plurnbin
Heating Rau In
ton I
Foundation Walls Interior R- L7
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling, R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic "Vent
Framin
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. 31 4 hour
Firestoppin
C'EIVERAL s�EN Y-3 043YI
Town of Queensbory
Dept. of Cflmmnai won rimed.
tY Development Date
Building & Code Enforcement
742 say Road
Qhueeusbury, NY 12804 Arrive;
�� �
Imp�eCirDe'*
NAME: 'v�Y PERZVIIT # C
LCfCATION: DATE
TYPE OF STRUCTURE:
RECHECK
N/A YES A40 COMMENTS
r
Monolithic Pour Farm
Reinfat. inn Place
The cantra�ctor is reslaansiblc
p��n8 an frarn
far 48 fallowing
of the
Materials for this on site
Foundation/Wall
Reinforcement
Faundati
Back ill
Plumbing Under Stab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Wags Interior R-
Foundation Walls Exterior R-
Floors R_
Walls R
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
F
Jack Spa
Bracing/Bri,dVin
Joist Hangers
Jade PostslMiain Beam.
Air Infiltration Bander
Fire Separation 1, 29 3, lour
Penetration Sealed
Fire Wall 2, 37 4 hour
Fi