97-586 •
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
{
WARREN COUNTY, NEW YORK
Date June 12 19 98
13—{
This is to certify that work requested to be done as shown by Permit No. 97586
has been,completed.
SINGLE FAMILY DWELLING
This structure may be occupied as a
129 BIG BAY RD.
Location
Owner ROZELLE, DAVID & MARCIA
TAX MAP NO. 14 3 ,-1-1 . 6 By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING . PERMIT .
VALUE $ se000TOWN OF QUEENSBURY
No. 97586
TAX MAP NO. 143.-1-1..6 WARREN COUNTY, NEW YORK.
PERMISSION is hereby granted to ROZELLE,. DAVID
OWNER of property located at BIG BAY RD. Street.Road or Ave.
in the Town.of Queensbury,To Construct or place a (ANGLE FM.J. -L Pj;LLING
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 Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is.
4HAVILAND ROAD
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
ROZELLE, DAVID
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
NEW YORK BOARD
5. ARCHITECT'S Address
NEW YORK BOARD OF FIRE .UNDERWRITERS
6. TYPE of Construction—(Please indicate by X)
( )wood Frame ( )Masonry ( )SteePI{NLE FAMILY DWELLING.
7. PLANS.and Specifications
1232NS.Q FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS A :
8. Proposed Use
Ygi SINGLE, FAMILY; DWELLING
144$ PERMIT FEE PAID —THIS PERMIT EXPIRES :- October:: 3] 19 99
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
•
Dated at the Town of Queensbury this `- "' :z31 a f .;:pay:af� :....- October.-
SIGNED BY '�- •
for the Town of Queensbury
Building and Zoning Inspector . .
Application tor Jt1'11C 1i1JYVJAL t't1<M11
Town of Queensbury Permit No.- �'n cg(40.
Dept. of Community Development
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804 •
Location of property for installation: (3 f 5 ec , j')
Property Owner's Name: Oar v:of fflo z. e l i e
5 P
Property Owner's Mailing Address: Ho ; L r A ,A Y e, G 1.t çJV, D
OCT a 8 199(
Installer's Name: l _. r e& > Phone #
BUILDING p,�a CODE
TO
Number of bedrooms (if residential): 3 Total daily flow:
(residential - compute @ 150 gal./bdrm.)
Topography: ✓ flat, rolling, steep slope % of slope
- Soil Nature: V sand, loam, clay, o± /depth:
Ground water: at what depth? set / Bedrock or Impervious Material: at what depth? _feet
Percolation test: not required, required [rate min. per inch ]
Domestic water supply: V municipal, well, a:r
If domestic water supply is a WFT , water supply from any szc absorption is feet.
PROPOSED SYSTEM
Septic tank lice gallon (minimum size: 1,CCO
Tile field: each trench 6b feet I Total system TQth: f-,2o a feet
Seepage pit(s): number of / size each: ft. by ft.
•
Size of stone to be used: # 2— / depth or thickness 1 feet •
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
1
Alarm system andassociated electrical work to be inspected by z certified agency.J
For your protection, please note that pursuant to Section 136-29 of the Code of Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any materiii misrepresentation or failure to make a
material fact or circumstance known by or on behalf of an applicant, shall be'r .
I have read the regulations with respect to this application and agree to abide by bese and all requirements of the Town of
Queensbury Sanitary Sewage Disposal Ordinance.
Sigiature of responsible person: Date:
• . Molding Permit Application
'Own O QueensbwyDept. o Community Development, 742 BayRoad,/ Y 1 QueensGury, NI' 12804 /761 825GJ
NO1114.
BUILDING & . CODE ENFORCEMENT
Requirements prior to issuance • r ,
r l of this permit: PERMIT FILE NO. 11 5-$�.p
A permit must be obtained before
beginning construction. No inspections . t�O
will be made until applicant has received n Zoning Board Action PERMIT FEE PAID$/ `T I.
a VALID BUILDING PERMIT. All • Area /Use
applicants' spaces on this application: RECREATION FEE PAID$.
MUST be completed and•the signature n Planning Board Action REVIEWED BY: •
•
of the applicant must appear on the
`pplicalion form. . SPR / Subdivision /Other ` Building Inspector J
Die.)-or l Recreation Fee Payment
. Applicant: 1?6 a I e I e Owner: D av i o4 60 Z. e lie
' Address: 4 ri vi Lc-c( AYt . 1"e S.I„rhi Address: S4",, e .
Phone # (Sit( ) 70; 2 - 9,5J- Phone # ( ) -
Properly Location: a rS L3c j floc (5,'aeehs.ic,,r�
iulullvlalun Nnnlul Tim Mnit Numhpr a.--._f�
. .. Ntn tllun Illnek I of
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF TILE
X New Bui ng: CONSTRUCTION: $ •10 s D-e
rest ence ./ commercial
Addition o Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building •
-
residence / commercial X Single Family Dwelling
• Residence / Commercial Two Family D e
no change to exterior size . Family D WED
Office
Other Work (describe below) Mercantile '
Manufacturing OCT 08 1997
Other TOWN Of F U_ a
GROSS AREA OF PROPOSED STRUCTURE: CODE
If ADDITION, whal will use
1st Floor 12 3 2 sq. ft. of new addition be? :
• 2nd .Floor sq. ft.
Other Floors sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: " I.12 3 `Z•- SQ. FT. Attached, Garage 1, 2 car
Private Storage Building
—
SIZE OF NEW STRUCTURE: Commercial Storage Building
I Other ,
2 Sr' FEET X 9 y FEET .
Foundation Type: PaiA1{Cat Will any second-hand or ungraded
Number of Stories : / lumber be used? If so, for what?
(habitable space only) , „
Height (grade to ridge) : 18 / feet TYPE OF HEATING SYSTEM:
• Number of fireplaces and/or woodstove (circle al • 4ich appli s)
to be installed: 0 Electric / Oi / Gas ood ,
Forced Hot / aseboar / Other
Person responsible for supervision of work as regards to building
codes is : DGvlat (t!ozelje . y HG 'l.,�dt AYt. 7 e, 2 rti. Y .
Name . Addresse Phone •
• Builder: OG►v.d 1202.ennt ••
Plumber: alter, Ro2.eIIP
• Mason: 0Al. e SaldW I`,
Electrician: ()avid 662,el]r
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 I/we shall submit prior to a
Certificate of Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: DOA-AL
(owner, owner's agent, architect, contractor)
).?_l)_.V'AV'At!'_l. J_V.I...,C 21.!'e_l J_...QIL l.41C!It!'Al!'_IW I,..,'l4_l':INl'J_._l J6.1::I C J_i.1•AltOPl')At!'')... :l•_l'J_Q IAI, ;IN::J.•_l'J1.l J_tl'!Al'IAQ IA•_l'A ..,ft A::SQ'.l 4!l'zV%_,t),e_OtI'Ae ./,
_6 rY
'AiTHE NEW YORK BOARD OF FIRE UNDERWRITERS .eAGE1 4
W; 8067793 BUREAU OF ELECTRICITY tYz
K,, F 111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210
1/2
I 5EPTr�1-1BER 22 t999 ,i 78:2397,,,,g7 H 456335 �:
•j, Date + Application No. on file r
-41
THIS CERTIFIES THAT �'BRP2' ��• 7-�BCi
ji only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of r
! Ai
(I I:
', DAViD ROZELLB, BIG BAY RD. , c11 JEENSBURY. NY
i in the following location; 0 Basement 0 1st Fl. ❑ 2nd Fl. Section Block Lot ;y
Kit was examined on JUNE 11.1998 and found to be in compliance with the National Electrical Code. I}
=p rY
�(I I}
:4 FIXTURE.koRECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS r
=CI OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. I}•
i cum 1.0 25 1 -■-■■■.■. ty tN
iI Ii
•I DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS Iy_
=ci iY
AMT. K.W.// OIL rrH.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. cli H.P. NO.OF AMT. WATTS I
WI
III
.<1
-- I-SERVICE-DISCONNECT— METER - — — S— - --E- — R- V I _ C--- —E-.- -- - -- ----- ,
ii,
_CI AMT. AMP. TYPE EQUIP. 1 0 2W ma 3 0 3W 3 0 4W NO.OFPER CC0 OF CC.COND. OF HI-LEG r
COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. Ir
.(I OF NEUTRAL ,
'Al IA
'C "VolCB 1. 1 4 r'e+ 1 �!! T
1" OTHER APPARATUS: tY
?<I I)!
'I CEILING FAN-1 A
'At DISPOSAL:1-f K.W. 'r
=G
'(I TRACE LIGHTING:-8 I
K1 :_ii
cI - 14
I�
•,r .,-ram?; ,'" ,: "`rz `r
DAVID ROZELT.^ .r• a ''9 '; `;; GENERAL MANAGER li
.--mac, 121 BIG BAYiYi RD. X✓..:, r�°y;,ti ' vim /J Ir
�Ci FNSBUR�'J .�YT „ .E�''.7 ® .b4.I:„ . INY t I �... 1 I}
.I .,, r�I �e Per 5
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. r
'/,Y.Y YiY Y%Y YeYYWr Y-•Y%s-r,.VraWrYeY,%Y Y-.T.VI�Y,%Y;fie.4:?.YiY Y YY-.Y Y•YY•Y YiY YiYY.Y YiY YiYYeY 47r.Y.-Y Y?;6iii�Y YiYYoY YiY Y"Y,WYY:Y Y-Y YEY;WI Y•Y;Tiii;Y-•Y,V1;Tit S
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
. L.:, V `(.,
RESIDENTIAL FINAL INSPECTION REPORT / ir
�
Office No. (518)761-8256
Date inspection request received: /
Building& Code Enforcement
Dept.of Community Development Arrivearnep p� stials
Town of Queensbury
742 Bay Road
Queensbury,New York 12804 (�,
t. Z - „e ,r PERMIT
--7
NAME ��� -
LOCATION Q7\ a . ,i �, DATE
TYPE OF STRUCTURE S F
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
y
I .
Fresh Air Intake
Plumb Vent through roc(
Roof Complete
Exterior Finish Complete N
Interior/Exterior Railings 30" 36"
Exterior Handrails,balconies,lan � g 18 in more
JInterior Handrails stairs both sides 3 r re 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 line of site
Oil Furnace shut-off at entrance to furnace area J
Furnace/Hot Water Heater operating Relief Valve(s)installed
Yii
edroom,6 ft. 6 in. on stairs asement stairs,6 ft.4 in.Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36" �//
Floor Finish J
Bathroom/Kitchen watertight ji
Interior Handrails Balconies/Landing 18 in. or more
Railing across window in stairwells .. /
Smoke Detectors:
AO
every level
every bedroom V
outside every bedroom /
inter connected ✓
Bathroom fans J/
Plumbing fixtures V
Foundation insulation /
3/4 hour fire door/door closer //
Garage fireproofing ,//
Garage penetrations sealed /
Furnace in separate room protected(in garage) J 1
Light ventilation per room /i
Safety glazing 18"or less from floor.
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan I/
As Built Septic System layout required v
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)
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement Dept. of Community Development Arrive 2 J44- epart y
Town of Queensbury
Inspector's Ini • s
742 Bay Road
Queensbury,New York 1280\4 1 ��s ��
illP
NAME �� \ --(>� `a, , ' PERMIT#
(p
LOCATION Vj�`e , . DATE Q—) (7-CI z
TYPE OF STRUC _�
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct • t Location V
Fresh Air Intake
Plumb Vent through roof
Roof Complete V
ExteriorFinish Complete `� it:,‘,.Interior/Exterior Railings 30"to 36" /
v(cc1 ?$.. �'i��
Exterior Handrails,balconies,landing 8 in. or ore ✓ /f !&CP\ i- p 1� h`�V1_
Interior Handrails stairs both sides 3 or ore .sers �(t�
Grade 2%away from foundation \//
8"clearance to sill plate v
Gas Valve shut-off exposed/regulator 18 a ve grade
Gas Furnace shut-off within 30 feet or wi e . line of site ji
/ -�
Oil Furnace shut-off at entrance to furnace ea Eu-T� p� hi Ft
Furnace/Hot Water Heater operating
Relief Valve(s)installed „. / BE_ V/4i l o N mop.it 12_+ E_
Headroom,6 ft. 6 in. on stairs
Basement stairs,6 ft.4 in. EQ A
Handrail exterior stairs both sides more than risers I://Interior privacy/trim/doors/main entr. ce 36'
Floor Finish ,f
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landin 18 in. or ore J
Railing across window in stairwells
Smoke Detectors:
every level
Vi
every bedroom
outside every bedroom
11/
inter connected I
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer 1/
Garage fireproofing
Garage penetrations sealed e
Furnace in separate room . otected(in garage) i }/f
Light ventilation per roo 1
Safety glazing 18"or less from floor J
Final Electrical / i ,
VVV
Site PlanNariance required
Final Survey Plot Plan I
As Built Septic System ayout required ' lw
Okay to issue C/C(Cert.if. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy) J
Okay to issue permanent C/O(Certif. of Occupancy)
TOWN OF QUEENSBURY
3. BUILDING & CODE ENFORCEMENT
� J 742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECCE`IVVEED`: ( -• �9,
NAME ��� v�,`( C.✓A1'070
LOCATION \� \ lI 1
DATE (p ` 1 _ ERMIT / p -5
TYPE OF STRUCTURE 888���
%
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
PECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPE TING
INTERIOR TRIM/PRIVACY D ORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGH,
OTHER FLOORS SWEEP. : E
OTHER`FLOORS •ETED
STAIR CLEARANCE/RAILINGS
•
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
POOR CLOSERS
FINAL.ELECTRICAL •
SITE PLAN/VARIANCE REO.
INAL'SURVEY PLOT PLAN 110
OK TO ISSUE C/O OR C/C
oLA o-D 3 \ -.L —p;(-,p )p
1. ,._,13.312
TOWN OF QUEENSBURY
V
a i '� M
BUILDING & CODE ENFORCEMENT
e,e_olx-ThQuee7n4s2b:ify:12804
otA l e (518) 761-8256 es,e...,2- -
SEPTIC DISPOSAL SYSTEM INSPECTION
Name c-- k,\Iii (l Rn______ \2„..e...., se'Location Q j byQcJ
Date -95 Permit #9 `59A)
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenchd's
Size of stone
SEEPAGE PITS: N b-
Size - ft ft.
Stone size
PIPING: 'ize Type
Bldg. tort
Tank to—Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan —<---ALi7 No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
t\k COMMENTS:
— P�-4-.‘ ? ka \ 1—Flu VD o�
Pr\--I,
caL o __.--- \z:kl ___
SYSTEM USE APPROVED: < N®`�
Arrived: clA
Depar _ti,r K:j
v
A Building o' ,p-ctor
b Q�n 'Cc
1V` PV
Aeze-
n yv
vr
,fir r
gxC 1+,
z-"a.c e r.e_
3f N)
'- -� TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Cb61c) CP-.C)
Location j% aotk.,6 `�
Date -/-Cj Permit Pn--
SOIL TYPE: oam-Clay-
Results of Percola 'ion Test-
(if applicable) Ra e`Minute/Inch
TYPE OF SYSTEM:
ABSORPTION ELD: btal Length
Length of each r
Depth of trenc {
Size of s e
SEEPAGE PUS: . NumI
Size - ft.f x ft.
Stone size / .22
PIPING: Size Type
Bldg. to Tank L.1I't }\ LAD
Tank. to Dist. Box 4' C.
Dist. Box to Fi el 'i - _ 4" WqC_-
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan es
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front -ar -ft Side - Right Side
Middle Front - Middle Rear
COMMENTS:
— 1.3 EED P►i3--eo wzr- �C
—6 EN__ 3,i
TO ‘3PICYFILL
caEsnEsv- cr 7 Q 0t- Fgo
YSTEM USE APPROVED: YES NO •
Arrived:
Depart
" wilding actor •
o
GENERAL INSPECTION REPORT
Town of Queensbury -
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive 2 a Depa ' °L a m
Inspector's Initi
NAME: 0;010 V\C"7 L PERMIT# ` (0 .
LOCATION: VAC- t3H 1 PAl l L- T) DATE : j—t 9?,
TYPE OF STRUCTURE: 0
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is re nsible for
providing protection fr freezi g
for 48 hours following - place en
of the concrete.
Materials for this purpose on -'te
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing- /
Backfill Approval
Plumbing Under Slab /
vPlumbing Vent/Vents in Place (-1i-i ��c)0 ✓
Rough Plumbing__
eating Rough-In •
nsulation C -\\,-4-k 6
Foundation Walls Interior R- .
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R- ,t-.6 /
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 c);' ??—
U
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive r' i Depart` ; nr;� 1, .►
Inspector's Initials p.
NAME: !,- ,\I C RCS C 1 PERMIT# r‘
LOCATION: P)i DATE : 3 - / (-9 1
TYPE OF STRUCTURE. :
RECHECK
N/A YES NO COMMENTS
Footings/Piers F I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the pl. ement
of the concrete.
Materials for this purpose on .ite
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin. --�
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents ' Place Q•1VIA.%'�z l WA Z)VC c-i7l=LD
ougt1i lumbing 0,V c c.t •l - \' �,�C CGS \iv?�i;'�.�\1 G�vJ u
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 h��� �v
Vent, Attic Vent / �
mng. J/
Jack.Studs/Headers ,/
Bracing/Bridging
Joist Hangers J
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3.. hour
Penetration Sealed
Fire Wall 2, 3, 4 hour �`-�✓ '1V
Firestopping
GENERAL INSPECTION REPORT -
Town of Queensbury •
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive V'G C am/pm Depart
Inspector's Initial" -NAME: � - i PERMIT# x' "
LOCATION: fkoxfk, " DATE :
TYPE OF STRUCTURE 1�
RECHECK
frT/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/Dampproofxng
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
Ceiling R-
Duct work or pipin in
unheated spa s R-
Pro r Vent, Att(c Vent
turning V' cvk ZNZI
Jack Studs/Headers •
Bracing/Bridging Cl\EP- .L_ 4q7.CAL '
Joist Hangers fe p.�i �.� 4 L► �u�1 b .
�
Jack Posts/Main Beam Ct�°t-A vJh
Air Infiltration Barrier % R t`l
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
' --51
co (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT IP
742 BAY RD., QUEENSBURY NY 12804 •
INSPECTOR'S REPORT: AR r ,2 DEPAR a � -2-REQUEST FO INSPECTION RECEIV j I
NAME U-4__/ I5 7
LOCATION 0 4MY, ock_r)
DATE `I-a. l � - T CA-F SWr 7
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE _
THE CONTRACTOR IS R PONSIBLE FOR
PROVIDING PROTE TION ROM FRE ZING
FOR 48 HOURS FOLLOWIN THE P CE-
MENT OF THE CONCRETE. _
MATERIALS FOR THIS PURPOSE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE _ /
BAFOUNDATION/DAMPPROOFING _ +.- /
CKFILL APPROVAL Vv
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING _
PLUMBING UNDER SLAB _ _
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- _
FLOORS R-
WALLS R-
CEILING R- 4
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
v„.____ ____7-_---y-,----v----
(, wv .__
.,,.,,,, ,
co,,,,i\a-,),,
f �i'-} (518) 761-8256
TOWN OF QUEENSBURY ci
BUILDING & CODE ENFORCEMENT �L1�I .
742 BAY RD. , QUEENSBURY NY 12804 •_ .
INSPECTOR'S REPORT: ARRDEPART M t� t
REQUEST FOR INSPECTION RECEIVED: A
NAME ___`�) 0 1/�.7 c- ' V.,) I,
.� l
LOCATION 16 f7� i�1-:-:
DATE a PERMIT 0 (11 \591Q
TYPE OF RUCTURE:
RECHECK APPROVED)
KON/A YES NO
OTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE Z " __
THE CONTRACTOR`fIS RESP E FOR
PROVIDING PROTE TION F OM FR EZIHG
FOR 48 HOUR OLLOWIN THE P CE-
MENT OF THE C CRETE.
MATERIALS FOR THI UR OSE ON SITE -
FOUNDATION/WALLPOUR _.
1
REINFORCEMENT IN PLACE _ _
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN P ACE ..
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT 1..
742 BAY RD., QUEENSBURY NY 12804 '" �:
011/
INSPECTOR'S REPORT: ARE3:3O DEPART'® I 0
REQUEST FOR INSPECTION RECEIVED:
NAME 7: OD •/�ZLL Or
-
LOCATION 1'1c1 V371 C� v)P\1 zoP�rD-
DATE \o1/-A IV PERMIT I C1-7-c7c4
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES ; NO
FOOTINGS/PIERS ,
MONOLITHIC POUR FORM ,
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
PROVIDING PROTE TION FROM FREEZI• y
FOR 48 HOURS FOLLOWING THE PLACE-
MENT
OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SI,E
FOUNDATION/WALLPOUR
•
REINFORCEMENT IN PLACE _
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN P ACE _.
ROUGH PLUMBING _
PLUMBING UNDER SLAB •_
FRAMING:
JACK STUDS/H:ADERS
BRACING/BRID ING
JOIST HANGE:S
JACK POSTS/ ',IN BEAM
r
AIR INFILTRATION B'RRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK 'R PIPING IN
UNHEATED 'ACES R- •
L1 t 13 LFvCk\1 L5
O b� (6,`v-2cov_tv, c_ .
lz ALL .c-6`` _ ' , r-( 6—u
i ►fE TR g,o 0,
7s e
4.t's') .1\_,___92—5-X
-9 ( /:?CrEIM, r)
% —7; OCT 081997
TOti�i� OFQUEEN$BURY'-
B�+�i. ING AND CODE
• 3v 8
117, 5 el_p
r.
e_ v cars-f i &J-,o'- 6 Qx
k/ �`
1
..
Aso®_ ,( on __ _ _ _ _ _ _ _____ /r-i/
_____,, _
� . ..,_, ,
..Have i saw evidence of,
all objects such as houses,wells,trees, fences, etc.,
97/.-"- own on this document. I also represent that I have
sonally measured the distances set forth on the diagram"
k7''‘ c-SIGNAT / /‘ ‘ ' "i - ' att--/ -
—1\ 0 Iiiiilite,
P
APPRV- E \
' ta 6 199-1 \ c-
__-_\ 9
Zoning AdminisArator
TOWNOF O.UECEN^BURY. -,�.M.--k
i
.. r.. .4..-. ,-- . .. \/ \ **C" . .
; (1 : .- 0 LI:\® 'Pri
M q V
Q
,\•Tj Q a
d
M 2q2°
✓ V 94 a \p
� N
M 0-1
Q
O
S
^7
Z y'
o � SO'C• Q�.
Q Q
w bJ �P OAP
�P
/ c
� I