1987-267 +�ER.TIFICATE CIF OCCUP CY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
S m r a , '9 rl
September 11 , 19 87
Lori
871~267
This is to certify chat work requested to be done as shown by Permit No.
has been completed. L/ 1 ll., in -n i w\.J
1
()Tie" .'35Y1i�..}T �.�- 1IS'g
This structure may be occupied as a
11
Location Lot �43 Stonehurst Drive — Stonehurst SubdIvisiun
Owner Robert Labrim
By Order Town Board
'GOWN OF QUEEIVSBURY
., Building !I► Zor►in� Inspector
BUILDING PERMIT
TOWN OF QUEENSBUR`'M' No, 87-267
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Robert Labrum
OWNER of property located at Lot 43 Stonehurst Drive Street, Road or Ave.
( Stone5urstu v s on
fine—Family Dwelling a
in the Town of Queensbury, To Construct or place a cr
at the above location in accordance to application together with plot plans and other information hereto filed and ro
,y
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. rt
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71 . OWNE WS Address is 12 Clark St .
South Glens Falls , NY
2. CONTRACTOR or BUI LDEWS Name Town and Country +Const .
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3. CONTRACTOR or BUILDER'S Address Box 1642 r*
Fort Edward , New York 12828 w
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4. ARCHITECT'S Namo
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5. ARCHITECT'S Address
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F71.
TYPE of Construction — {Please indicate by X)
( x} wood Frame I ) Masonry I ) Steel I S
PLANS and Specifications
No. 31 ' x66 ' per plot plan , specifications and application submitted
including sewage system and two-car attached ,garage .
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m
B. Proposed Use I
One.-Family Dwelling
W
1—•
$5 . 00 C /O tY
$ 157 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES December 1 19 87 ro
r-
Ilf alonger 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.)
OR
Dated at the Town of Queensbury this ' —y18th Day oof' May 19 87
SIGNED BY / ! I Cif c` L t� - ~ for the Town of Queensbury
Building and Zoning Inspactor
TO BE COMPLETED BY BLDG . DEPT .
CC Application No .
�lowr! o/ �uee" J19"ry Permit Issued 19 TOWIJ 4
��
BUILDING and ZONING DEPARTMENT Permit Expires 19 I �-;
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation J E
Queensbury, New York 128011 Variance No . y_ MAY 14 1987 �U
Site Plan Review No .
_ l (a J� � -� pry*
41- 3 Approved bX: UIL-DI NG & C01 E DEPT
APPLICATION FORi��
}
PUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CC7NSTRUCTION . ANSWER ALL OF THE FOLLOWING .
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the descriptions plans and specifications submitted , and such
special
-conditions-as-may-be-indicated-on`the-Pere[tit//^---............
.............The owner of this property is : lz} ;—a L
P. O. Address _ ----
yG 4-.r Tel . / 3 2 _�
___ /�. r+�rl, �,e�v�,r---tfi � „�,, r.�..�f�.ee�'�,�',
Property Location : i Jam_ r„G - � s , [��5 L� ' r� .. �`E y1 3t1 t Tax Map No .
Street number or building lot number
Subdivision name ( if applicable) 17 + n/ rC`` I cG f4
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORM. AS REGARDS BUILDING CODES IS :
Name P . O. Address Tel . o .
Name of builder To u v �# G ,�nxR r Cc - a, Address f� L-c A + Tel .
Name of plumber"V7 T4-✓t- / L f_ Address af3TT- '---�'A14' 0 A' 91 Tel 'i i F' >1 �
Name of mason -1-0 .- :,L c' Address� Tel .
NATURE OF PROPOSED WORK : ,� ZONING INFORMATION :
/
V Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
_Addition to a building drawn reasonably to scale and attached hereto ,
Alteration to a building showing clearly and distinctly all buildings ,
(no change to exterior dimensions ) * whether existing or proposed and indicate all
_Other work (describe) set-back dimensions from property lines . Give
* street and number or lot number and indicate
* whether interior or corner lot . Show location
FOR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED . * of septic disposal area .
*
* COMPLETE INFORMATION REQUIRED BELOW .
Size of property f r; O ft X ft .
Existing buildings) Size ft X ft .
PROPOSED BUILDING AND USE : Existing building ( s ) Use
Size of new structure ) ft Xft
Foundation-pier/slab/crawl/partial Proposed Proposed building , distance from property line
( circle one) _
i * Front yard 60 ft Rear yard & S f t Now of stories (habitable space ) * Side yards -;7 5- ft and
Height ( grade to ridge ) r ft . If on corner , setback from side street ft
if residential , no . of families '( r
No . of rooms ( excluding baths ) OCCUPANCY INFORMATION
No * of bedrooms_
No _ of bathrooms * PRIMARY BUILDING -
No . of bathrooms
system * + wone family dwelling
y g �=F Gi' 'yc Two family dwelling
Type of fuel ry G -c ; !.}�N �. - - * Multiple dwelling / Number of units
No * of fireplaces to be installed. � Permanent occupancy
Will a wood stove be installed? /y ow_ Transient occupancy
Central Air conditioning? ,r+/ r s
�. Business
BUILDING STYLEo PRIMARY STRUCTURE Industrial
Ranch Contemporary Log cabin * Other
If addition , what:
Raised ranch Mansion Duplex * t will use be?
Split level Old style Bungalow
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonia Row Town House Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other
—
CONSTRUCTION $ _0 a - � s - s - - "
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED !
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc . f,, V0 U /� /3 ✓�JL
Will any second-hand or ungraded lumber be used? If so , for what ?
Foundation wall material � . vG � t 7 ,- Thicknesses s �
Depth of foundation below grade (to bottom of footing) '
Will there be a cellar? �- H ated or unheated? E � /�u. � , . Floor s footage�`-- [3�( q. g 1 � 7� �1 sq ft
Will there be a basement? Jfar _Will any portion be used as living space?
( If so , what portion? sq . ft . - - Type of use? _
Type of roof - sloped/flat/shed/other Material of roof
Size , wood stuff " " s acin o . c . len thft .
Joists ( floor beams ) 1st . floor Qt= �_'F spacing / J "o . c . span .L,
.foists ( floor beams) 2nd . floor 3= "X � p ' spacings j."o . c . span �� ft .
Overlays (ceiling beams ) "X '" spacing "O . c . span ft .
Roof rafters ""X to spacing o . c . span ft .
Roof trusses (pre-engineered) spacing"o . c . span $ ft .
Exterior wall finish_L; , 1 Of what material?
��
Interior wall finish -�sc � �� [ � -
mate
If a garage is to be attached ,
Cached , detib e rials to be used .for FIRE SEPARATION :
Is there to be an ape ng between garage and dwelling? If so will a Fire-rated
door , enclosure , and self-closing device be provided? ar-.s
Will a flue-lined chimney be installed? Height aboxfe roof j ft .
Depth of chimney foundation below grade G-S ft .
Depth of fireplace hearth ft . � in .
Water supply - Municipal or private well
SEPTIC SYSTEM i Distance from ANY private well ( including adjoining properties CIO ft .
(A separate application is necessary for any repair or new installation of septic system)
Town Of A F F I D A V I T STATE OF NEW YORK
m .
Warren
County off Warren
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
authorised by the owner . T� -_----
SWORN TO BEFORE ME THIS Signature . !.vz day of 19 _----_---
Owner , owner ' s agent , arcnitect, contractor
Notary Public , Warren County , N. Y .
* * * It * * * * * * * * At At It * * * * * It It * * At At * * * Ar
SPECIAL CONDITIONS OF THE PERMIT :
BY
TOWN OF QUEENSBURY
WARREN COUNTY , NEW 'YORK
Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
ANSWER ALL of the following :
10 Gross floor area �c7 'd
2 , Type of heat
3 , is the building mechanically cooled ? ✓
4 , Percentage of area of windows and doors
A . over 16 % Only
1 . Uo value of gross area of walls * roof / ceiling and floors
exposed to ambient conditions KI 0 Ifi --
2 . Floor over heated spaces ES NO
a . Are foundation walls insu aced ? YES NO
1 . If YES , what is the R value ? / If
3 . Slab on grade YES NO
a . If YES , what is the value of insulation around
perimeter of floor ?
4 , Is basement heated ? YES ND
a . R value of insulation_ L✓ l .� 12 � [ %� � �✓�
5 . Type of insulation
B . Under 16 % Only
1 , R value of roof and floors exposed to ambient conditions.
R _ C� ;
2 , R value of exterior walls V 5
3 , R value of glazed area off "
4 . R value of doors_` ["I OKI
5 , R value of floors over unheated spaces
6 . R value of slab edge insulation - unheated slab _
7 , R value of slab insulation - heated slab
s , R value of heated basement/ cellar walls ( above grade ) " 1
9 . R value of heated basement / cellar walls ( below grade ) L
10 0 Type of insulation f7jF_E CjLh
C . Controls o
1 . Thermostat maximum heat setting k�p
Do Duct Systems
1 . Is duct system installed in unheated spaces ? YES O
a . if YES , R value of duct installation
b , R value of duct in other areas
E . Piping Insulation
10 Size of hot water or cooling carrying agent pipe
2 , R value of pipe insulation.
F , Service Water Heating a
10 performance efficiency 6
2 . Temperature control setting maximum
G . For Swimming Fool only
1 . Maximum heating
Telephone No .
( applicant ' s signa ure )
APPEICATION FOR SEPTIC DISPOSAL PERMIT
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: ~l .3 ? f �n 1 Telephone:
Address:
Installer's Name: Telephone: '7
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) G
Topngmphq: circle ones Flat ollin Steep Slope So of4sirope
Soil Nature: circle ane: Sand Lo .
a Clay Other *'STY / Depth: feet
Ground Water: At what depth? — feet
Bedrock or Impervious Material: At what depth? "� feet
Percolation test: circle one: not required required / rate ./ ,o ^ min. inch.
Domestic water supply: circle one: Municipal C-iW eli 2 Other
IF domestic water supply is a Well:
Separation: W atersupply from Septic absorption _ _ /� p o feet
PROPOSED SYSTEM: Septic Tank �� c gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench S� Q feet / 'Total system length c 5' C5 feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
_ -2. P Size of stone to be used # +�� ! / Depth or Thickness �_ feet
IMPORTANT
...Pl.ease..,.LIST NEW EQUIPMENT TO BE INSTALI.EI]
(over)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
l .) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and approval by the building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $Z50.0o.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage,
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Quc*asburq Sanitary Sewage Disposal Ordinance.
Signature of responsible person:
Date: r�r
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD. pLACE TO LIVE
,,rr,�� f/ 1 � Jnwr+ o� '�uee►ts �+�re�t
"1 E BUILDING and ZONING DEPARTMENT
![ Bay and Mavlland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME L� Ir
LOCATA M1- cam°' d{ S ✓
Date/ '� Permit No . % � •fie° r�
* * * * * * * * �✓ APPROVED* *YES* NO
Footing/Pier Forms
Foundation
Waterproofing
Sackfill
Framing
Roofing
Siding
Masonry Venee
Rough Plumbing
Relief Valves
Ext . 'Porches
",> Finished Flavors
Interior Trim
Stairs & Railings ----�—
Cellar Drain Tile �-
Concrete Floors
1pg . Fixtures
ar . Fireproofin
vor Closers
ll Smoke Detectars
"'chimney u •, ew
r ' xW;ULATION :
Foundation
floors
wail l s
ceiling
FINAL ELECT CAL INSPECTION
TiRIVEWAY APP QV
nal Building Survey
Next scheduled inspection (call when ready
Remarks-
Build ' inspector
6/86 and-vl
THE NEW YORK BOARD OF FIRE UNDERWRITERS &
4208090 BUREAU OF ELECTRICITY
41 STATE STREET. ALBANY. NEW YORK 12207
A * YDoer Septemba7r 24s 1987 Application Na. 023173 / 87 A 694644 r.
THIS CERTIFIES THAT
only the electrical equipment an described below and introduced by the applicant named an the ebowe opplicocien number in the premises dv —
Robert LaBrums Stonehurst Dr . , +Queensburg . New York
in the following Iodation; ❑ Basement lot Fl. ❑ .2nd FT. Section Black Lot 43
was examined an andfound to be in compliance with the requirements of this Hoard.
9I9I87
NXt/JtlE �TACLEI SIMLTCHES NXTURES RANGES 1GOOKINO DECKS OVENS DISH WASHERS EXHAUST FANS
QUTIRTS INCANot'$CtMT FL COESCIE14T v AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT.
DRYERS FURNACE MOTORS FUTURE APTUAWA PlEDERS SPECIAL RIWTT TLMR QOCKS R141 UMT' ATERS MUL'I OUTLET dYMMERS
MMSM'r. K. W. OIL H. A. G $ M. P. AMT, NO. A. W. G. AMT. AMP, AM NO. OF FE
T. AMPS. TRANS. AMT. H- r_ SY
ZZ
AA MET AMT_ WATTS
1 angs 6
SERVICE DISCXMR�EGT ND. OP S E R V I C E
AMT. AMP. TYRE �P 1 X 21ry 1 0 SW 3 X 1W 9 A' ♦W N4_ i PC�,CGND. OP CC CCINQ. NO- Or H611G Of��� NO. CK NEUTRALS OF NEUTRAL
OTHER APPARATUS:
E
Electric Room Eastern - 1 -- 2 . O KW G . F aC a 2 . - 3
11 1 . 5 KW _ 2 - ,Smoke Detectors
2 - 1 . 25 KW
1 - . 75 KW
1 — . 5 KW
Town & Country Coast . '
RR # 1 r Box 1642 BRANCH MANAGER �
Rt . 196
Fort Edward , N * Y . 12828 Prr
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. �
✓own O� �eeeen3 +[s�ulr+�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
pueensbury, New York 12801
BUILDING I NSPECTOR � S REPORT
NAME
LOCATION ��^^rAs /
Date Permit NO . �iT♦♦ ~ z(!
* * * * * * * ow' NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
woof ing
L,,B"sdi.ng
Masonry Venee
Rough Plumbing
4'Meli_ef Valves
�t . Porches
Finished Floors
/iornterlor Trim
e.rr airs & Railings
Cellar Drain Tile
Concrete Floors
I.. ibg . Fixtures
ar . Fireproofing
Z.Deor Closers
Smoke Detectors
L.r�znrney
INSULATION :
telF-oundat ion
Floors
walls
Ceiling
t f'�INAL ELECTRICAL I135PECTION
DRIVEWAY APPROVbT .
FFjoal Building Survey
Next scheduled inspection (call when ready
Remarks-
Building Inspector
6/86 and-vl
_Down aJ/ Queen31urY
13u1LDING and ZONING DEPARTMENT
Bay and Haviland Road. R. 0 • I Box 98
Queensbury, Nevv York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME / !r
LOCATION
/DATEPERMIT G"wL9
Sand - Loam - Cl
SOIL T PE } E N(
Percolation Test R percolation rate -
TYPE of SYSTEM: to th�
Absorption f elr3 , ,JJJf
Length of lea tren
Depth of tren es
Size of gravel ........ —
SEEPAGE PITS4N er ft) —
Size- ft.
Gravel size Size Type
PIPING :
Bldg . to t 'k
Tank to d ' t- box
vist. Igo to field Partial
opening sealed? YES
LCfCATI ISEFARATSCYL3S : ft.
Found ion to tank. ft .
Found ion to absorption f t.
Absorp n to lot line ft.
Separation of pits
of SYSTEM ON PROPERTY (Circle one)
. rant -
ear - Left side - Right side
00
SYSTEM USE APPROVED
Building Inspector
pl fg6 and vl
1 �.lown o� '�ueen .� bsir+�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. Ri D, 1 Box 98
Oueensbury. New York 12801
BUILDING INSPECTOR ' S REPORT
NAME �2���/Zl/ r'.�`ll � •� '7
LOCAT I O �
Date /1/� Permit No . / �f
* *
* ,r * * * * * * ✓* * APPROVED* - YES NO
Footing,/`pier Forms
Foundation
waterproofing
Backfill
Framing
Roofing
Siding
,XM��33sonry Veneer
ugh Plumbing
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRIC INSPECTION _
DRIVEWAY APPRO L
Final Building Survey
Next scheduled Inspection when
Remarks- X::
CO
�Bu lilddIng Inspector
6/86 and-vl
.Jowre arueer� shurr
y BUILDINGik
zoNiNG DEPARTMENT
0 { ] Say and Haviland Road, R.D. 1 Sox 98
u oueensbury. New York 12801
BUILDING INSPECTOR ' S REPORT
NAME.
LOCATION 11
permit No " �Lr
Dates & z-/ ri
APPROVED s NO
Footing/pier Arms
Foundation
Waterproofing
8ackf it l
gaming
Roofing
siding
Masonry veneer
Rough Plumbing
Relief Valves
Ext . Porches
Finished Floors
interior 'Prim
stairs & Railings � �-
Cellar 'Drain Tile
Concrete Floor's
Plbg - Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY API"ROVAL
Survey
~-
Final 'Building
duled -Inspection '(call when ready
Next sche
Remarks-
$ -*O*N
{
Building Inspects
6/g6 and-vl
. ._../mare crI �u�+�nshur
1 /► ' suiuDING and ZONING DEPARTMENT
Bay and Haviland Road. R#0- 1 Sox 96
[C * Queensbury, New York 12801
i �
BUILDING INSPECTOR ' S REPORT
NAME r/�+
LOCATION/
I7ateJ� Permit No .
* ,r r * * * * • * ✓yr * * * * YES LSO
APPROVED
Footing/Pier Forms
Foundation
waterproofing
Backfill [
s.�fram.ing
Roo f ixng
Siding
t4asonry Veneer
Rough Plumbing
Relief valves
Ext . Porches
Finished Floors
interior Trim
stairs & Raili_ngs_
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar , Fireproofin
Door Closers
smoke Detectors
Chimney
INSULATION -0
Foundation
Floors
walls
Ceiling
FINAL ELECT ICAL II3SPECTIOi3� _
DRIVEWAY AP ROV urvey��—
Final Building
Next Schedu led inspection (call when ready )
Remarks-
zt-
Building Inspector
6/86 and-vl
Mourn o�' �ieeQn3� re+"+�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.D. 1 Box 98
pueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION �pr� y� 'S � ,+
Date ' /�-�- Permit No . l� {i
AppROVED -' YES NO
Footing/Pier Forms
xFoundati.on
X waterproofing
+x Backfill
Framing
Roof ing
Siding
Masonry Veneer
ljough plumbing
Relief Valves
Ext . porches
Finished Floors
Interior 'Trim
stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg , Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULAT-ION
Iroundation
Floors
Walls
ceiling
F3I3AI ELECT'RTCAL Il3^aPECT3ON
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready
Remarks-
guildi g or
6/86 and-vl
awn o/ Quee"JI"ry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. i Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME +?, eetE 4 CL AS
1QrATIQ N �r j" 413 5)On Edi r-J ' s
Permit Noe _��,2 6 7
r'' APPROVED - YES NO
)CFooting/Pi_er Forms�0?4 in "7
Foundation
Waterproofing
Sackfill
Framing
Roofing
Siding
Masonry Veneer.
Rough Plumbing
Relief Valves
Exte Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar . Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION :
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTS
DRIVEWAY A3P'PROVAT-
Final Building. Survey*
Next sch duled inspection (call when ready
Remarks-
�pe,
Huilding Inspector
86 and-vl
t
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41
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