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1992-050 rt ' MEMO RTIF`ICATE OF CJCCU�'AI`�+ ,Y TOWN OF QUEENSSURY WARREN COUNTY , NEW YORK Dote � Permit No. 92'050'is ss to Certify that work requested toasbe done ' shown by has been completed, twor This structure may be occupied as a single attached garage Amethyst Drive , Ambershire Subdivision Location Forest Wood Homes Owner BY Order Town Sward �T�OVA%4 OF QUEENSSURY Director of Bldg. do Code Enforcement BUILDING PERMIT p TOWN OF +QUEENSBUR Y"' No. 92- 050 � WARREN COUNTY, NEW YORK 0 anted to Forest Wood Homes PERMISSION is hereby granted c�rr OWNER of property located at . Lot 31 Amethyst Dr /Ambershi re Subdivision street, Road or Ave. w in the Town of Queensbury, To Construct or place a Single family dwelling with 2- car attached garage` at the alcove location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. t . OWNER'S Address is same HC-02 Box 236P o Warrensburg FEY 12885UFA m C+ 2. CONTRACTOR or BUILDERS Name C+ Same Q 3. CONTRACTOR or BUtLDER'S Address z fO N 4. ARCHITECT'S Name S. ARCHITECT'S Address r— c+ w 8. TYPE of Construction — (Please indicate by XI 1 xl Wood Frame f } Masonry ( } Steel l 1 r+ 7_ PLANS and Specifications c+ No. Single family dwelling with two- car attached garage and septic system as per plot plan and application . S. Proposed Use co Single family dwelling with two- car attached garage , M -h 265 , 00 February 13 19 93 THIS PERMIT EXPIRES (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.) u7 Dated at the Town of Clueenstrury this 13th Day of , February tg 92 t r'x SIGNED BY for the Town of Queensbury car Building a Inspector u7 ru =p M rp TOWN or QQEENSOURY REVIEWED BY : FEE PAID : �r G s`' �f �s�/ TOWN DF QUEENSBURY �1L�2 �" " - - RECEIVEL7 EEL PERMIT NO . : — FEa I2 1992 BUILDING PERMIT APPLICATION BLDG• 8 CODE DEPT. A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT . All applicants spaces on this application MUST be completed and the signature of the applicant MUST appear on the reverse side of this application . * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * � * Owner of Property : rr S P . O . Address : A4 Yr lc ° PHONE Property Location : f �3 j ax Map No ./ f 3 /zr; dt; t T Has there been any split of this property since October 1 , 1988? Yes No - _---- If yes , Planning Board Review is necessary . Subdivision Name , if applicable : g"� '�� rr'( Lot No . THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS : PHONE NATURE OF PROPOSED WORK : * ESTIMATED MARKET VALUE OF THE ye, Construction of new building * CONSTRUCTION : E Addition to building Alteration to building * COMPLETE INFORMATION REQUIRED BELOW : ( no change to exterior dimensions ) * Size of Property : _ ft . x " a ft . Other work (describe ) * Existing Building Size : * ft . x ft . * Vroposed bui ding - distance from GROSS AREA OF PROPOSED STRUCTURE : * property line : 1 * Ist Floor 1 07 "' Z> Sq . Ft . * Front Yard 5y ft . Rear yard 1 ' ' ft . * Side Yards �7�� ft . and tom'. 2nd Floor log . Sq * Ft . r * If on corner , setback from side street- . *Other Floors Sq . Fte s r, ft . (not cellar or basement OCCUPANCY INFORMATION : * TOTAL FLOOR AREA : a ) 4N C) 5q . Ft . * Primary Building - * One Family Dwelling Size of New Structure : (04 ft * x s p ft . * Two Family Dwelling Foundation : ,� ;� * Multiple Dwelling/No . of Units Fier/Slab/Craw] /Partialkfull.77� Circle One ) * Business * Industrial Noe of stories ( Habitable space ) * Other Height ( grade to ridge) a 5 ft . If residential , no. of families : s * If addition , what will use be? No* of rooms (excluding baths ) : - - g Noe of bedrooms : I No. of bathrooms : �4' * Accessory Building : Primary heating systm. 11'V . * Detached Garage - One/Two Car Type of fuel : * Attached Garage - One/tZ*o Cij No* of fireplaces to nsta ed : f * Private Storage Building Will a woodstove be installed? : * Other Central Air Conditioning . Yes No .. ( OVER ) BUILDING PERMIT APPLICATION CONTINUED : BUILDING SPECIFICATIONS : Type of construction : wood frame , fire safe , etc . Si , Will any second- hand or ungraded lumber be used ? If so , for what ? Foundation Wall Material : n ,:� Thickness : .;0 . , Depth of Foundation below grade ( to bottom of footing ) : Will there be a cellar ? ,- Heated or Unheated ? Floor Sq . Footage : Will there be a basement ? 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 studs . 01 x 'r ; spacing o . c . ; length _ ft . _ Joists ( floor beams ) : Ist Floor r rr X spacing ,r " � �� o . c . ; span ft . Joists ( floor beams ) : 2rtd Floor spacing p g o . c . ; span _ ft . " s Overlays ( ceiling beams ) : It x � rr ; spacing " o . c . ; span ft , 11 Roof rafters : x spacing o . c . ; span ft . Roof trusses ( pre-engineered ) : spacing , p o . c . ; span ft . Exterior Wall Finish : , of what material ? Interior Wall Finish : -41s • ? If a garage is to be attached , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling ? jeS If so , will a Fire-Rated door , enclosure , self-closing device be provided ? _ ye, s Will a flue- lined chimney be installed ? Height above roof ftV. Depth of chimney foundation below grade : ft , Depth of fireplace hearth . ft . in , Water supply - Municipaat- or private well : SEPTIC SYSTEM: Distance from AM private well ( including adjoining properties : 32, ft . (A separate application is necessary for any repair or new installation of septic system. ) NAME OF BUILDER & ADDRESS : t ,? TY fi.} ; : s � , �. • r K ,epler PHONE NAME OF PLUMBER 3 ADDRESS : PHONE NAME OF MASON & ADDRESS : _ I�e3 NAME OF ELECTRICIAN & ADDRESS : ° ' ' xC PHONE DECLARATION To the best of my knowledge and belief the statements contained in this application , together with the ,plans and specifications submitteds are a true and complete stateme all provis nt of all proposed work to be done on the described premises and that ions of the BUILDING CODES THE ZONING ORDINANCES and all other laws pertaining to the proposed work shall be complied with , whether specified or not , and that such work%, is aq0prfted by the owner, '1 Y - Signature ; 3 4 , SC FIp ers owner s agen , Marc itect contractor ____---r--r___--_---- �) SPECIAL CMDITINS OF PENRITO +.rr+rr.rrry.r r._rr�wr r.rrr�.r:.ter rr_n._.rrrr�.�rr+ rr�rrr.Mrwrr Byft Cod* rnforcemen cer ENERGY CODE COMPLIANCE APPLICATION TOM OF QUEENSBURY , WARREN COUNTY — gODO HEATING DEGREE DAYS TOWN OF QUEENSBURY CoMliance Methods: RECEIVED PART 5 - Acceptable Practice Method - I A 2 Family Dwellings ( ONLY ) F E B 12 1992 PART 6 - Thermal Rating - Component Trade Offs - I A 2 Family Dwellin s • Mul ti - Fami 1y Owel 1 i n#&' bG. a CODE DEPT. ( 3 Stories or Less ) PART 4 - Design By Component Performance - Commercial Buildings - Hi - Rise Residential PART 4 A 6 - Compliance Methods Require Submission of Worksheets _ ----------------------- AP NA PROPERTY LOCATION PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE : 1 . Gross Floor Area - * F' Sq . Ft . E . Type of Heat - Elec . Base Board Other r:O ; • ° ` 3 . is Building Mechanically Cooled ? YES s;` NO 4 . Percentage of Area of Windows and Doors Over 17 % 4 Under 17% THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D THE R-YALIUES SHow ON PLANS SUBMIT! Baseboard 5 . Insulation Values • Actual Shown Elec . Heat Other A . Roof A Floors exposed to ambient temperatures B . Exterior Walls Ry C . Glazed Area R f D . Exterior Doors R00000000k E . Floors over unheated spaces R F . Edge of Slab on Grade ( Heated Building ) R G . Basement/Cellar Walls (Above Grade ) R H . Basement/Cellar Walls ( Below Grade ) R i . Heating/Cooling - Ducts - Piping in Unheated Space R J ' 6o, Service Domestic Hot Water , Heating Device A . Conforms to minimum efficiency per code 1LL YES HO TEP04MlATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EBGEEUEsD T C TELEP NUMBER INSPECTOR " S REWRKS : TOWN OF Qk6 YQUEENSSURV APPLICATION FOR SEPTIC D SPOSAkAgMW M Permit # fir -U5y Fee Paid �k FEB 12 1992 Date : _�: _ <_ Reviewed By LOCATION OF PROPERTY FOR INSTALLATION : Owner ' s Name : Owner ' s Mailing Address : e'` Installer ' s Name : . . ^ ' i ' rr `' F x .* ` Phone # : z Number of bedrooms ( if residential ) : ' Total daily flow ( residential - compute @ 150 gal . per bedroom ) * Topography- Circle One : Flat Rolling Steep Slope % of Slope • x . Soil Nature- Circle One : Sand Loam Clay Other /Depth : Ground Water-At What Depth ? 8 Feet Bedrock or Impervious Material -At What Depth? Feet Percolation Test-Circle One : :.Not Requi red`' Required/ Rate Min . Per Inch Domestic Water Supply-Circle One . ' , unicia&V Well Other If domestic water supply is a well - Separation : Water supply from 1!y septic absorption feet PROPOSED SYSTEM: Septic Tank y = gal . ( Minimum size : 1 , 000 gal . ) Tile Field : Each Trench feet//Total System Length a _; ; feet Seepage Pit ( s ) : Number of / Size each : ft . x ft . Size of Stone to be used : # / Depth or Thickness feet HOLDING TANK SYSTEM IF REQUIRED No . of Tanks Sizelof Each Gal . Alarm system and associated electrical work to be inspected by a certified agency_ * * I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance . SIGNATURE OF RESPONSIBLE PERSON : = f DATE ; 1 : x `" � 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 : 1 ) 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 alT tanks , distribution boxes , the fields and/or drywel l s 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 $ 250 . 00 , 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 . Town of Queensbury Building A Code Enforcement Department 531 Bay Road Queensbury NY 12804 Remarks : .\ t �sf•-'H+±r"a" s ; Bay at Havilantl fioads. nsburys My, 12901-9725 APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES N o. De :Y Permit �. rl, i'i'1..1cKrit)l [ IS HEREBY MADE to the Building Department for the issuance of a Building anti Use Pertnit [mrsuant to the New 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 requirements and also will allow all inspectors to enter premises for the required inspections. - x APPLIANCE TYPE Applicant 's Name � •>g F'P_i �" " #r4i 1: Stove Coal Wood s_.. Furnace Hot Air - ��Boller Address - Circulating Unit Zero Clearance ---�---- em^ Zip r Phone If Non-Masonry: Owner's Name j Manufacturer Address Mode!_, Outlet Size r zip Listed by Number Phone CHIMNEY TYPE ,. Masonry: Bloch Brick Sterne nwrty .tocation of proposed construction Flue: Tile Steel SizeV 9 " r Factory Built. Manufacturer Model S1Je COPY OF MANUFACTURER SPECIFICATIONS IS Height.__ Listed By � � Number REOUiRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Trsple,wall AND CHIMNEYS. MUST HE INSTALLED Insulated ACCORDING TO SPECIF'ICA3MONS. COPY OF Estimated Cost $ CONSTRUCTION DETA EL REQUIRED FOR M Fee $ SONRY FIREPLACES ANg] CHIMNEYS. CASHIER'S DEPARTMENT - TowN oB QUMNSB;a YORK t)etrstrlm nt•. Fire Marshal Amount Collected Amount Refunded 11 Clade N mher Title A 173 3389 (190) Public Safety A233 2655 (230) Minor Sales k"ce Collected frq�e�..a�r'Refunded to. Addre%s` x , Town Clerk or Deput ►1 hbeu Appkarwl Yall�w lax/I nR:CpA�i�r"I WM w1 Croldenrod: F1+x 11fQrtJw! TOWN OF QUEENSBURY FIRE MARSHAL -xQTELEPHONE � ( 518)NEW 0745-4424RK 4 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION �• f DAT E PERMIT# S�� �`n — APPROVED N/Al YESI NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS�� AUTO . EXTINGUISHIN SYSTEM HOOD INSTALLATION AUTO . SPRINKLER SY TEM ALARM SYSTEM 3 S 4h 1 �. INTERIOR FINISHES Y STORAGE: CLEARANCE TO SPRINKL CLEARANCE TO HEATINGf NI S REQUIRED SIGNAGE i CHIMNEY �. wo ODSTOVE FIREPLACE- gSONR FIREPLACE-FACTOR B ILT OK TO HIS DATE REMARKS : W .f TINSECTOR 2/015 TOUIN OF QUEENSBURY 192 531 BAY ROAD QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518) 745- 4447 BUILDING INSPECTOR' S REPORT FINAL INSPECTION REQUEST FOR ImSPECTION RECEIVED lIA14E LOCATI f/ DATE ,i ,r'fl.� PERMIT# � TYPE OF STRUCTURE 6 RECFIECK FIRE MARSHAL APPROVAL (C_OMM'ERCIAL STRUCTURE) -VFOOTING &FOUNDATION BACKFILL YC FRAMIN ROUGHFI AL IINSULATIONBINGWb DSTOVE/ FIREPLACEL -SEPTIC REMARKS APPROVAL N/A YE NO CHIMNEY HEIGHT/COCA ION 8 VENT/LOCATION PLUMBING VE14T ROOFING SIDING DECK/PORCH / IL RELIEF VALVES FURNACE/HOT WATER D IN _ BASEMENT N/D TRIM/ PRIVACY YU INTERIORD FINISH FLOORS : X BATH/KITCHEN WATERTIGH ' OTHER FLOORS SWEEPABLE R FLOORS CARPETED STAIR ECLEARANCE/ RAILINGS ��_ HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS ALL PLUMBING FIXTURES OPERATING�R GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARA I N FIRE/DEMISE WALLS DUMPSTER SITE PLAN/VARIANCE REQ4 REM N S FINAL ELECTRI CAL SL1W � AJ �� OK TO ISSUE C /O OR C/ COMMENTS : ARRIVE DEPART �� $ g --------------- Ll THE NEW YORK BOARD OF FIRE UNDERWRITERS d ; i f fi BUREAU OF ELECTRICITY +41 STATE STREET, ALBANY, NEW YORK 12207 ;.I :: y Applicatio . pace THIS CERTIFIES THAT only the electrical egrs.ipEnent as described before and intnndaced by t rimmed om taut rbaoe Nppfscs[iwa Fwmber iPE tFae premises of . +lye RI'.. fi ? � }'i �{i •e' . . wii ir . � N�l•? .. �' !; � . . Yi .1 in thefollowing location: Basement 0 !st Fl. 3ftd Fl. Suction Block Lot was examined on YI 4L .f { ' .-T, „ and found to be in compliance with the "uirements of this Board, _ F4xTU" FIXTURES RANGES gOOKIM4 DRCKS OVENS DISH WASHERS EXHA LE UST FANS OUTTS EFTAS * � INCANEIESCENT FL{IORESCENT OTHER ¢ DRYERS FURNACE MOTORS filTURE APKIAN[E FEEDERS SPECIAL RECFT TIME CL4CR5 UNIT HEATlRS Mu►TI-iDLtTLIet ip1iMUMiIRS _ SYSTEMS AMT WATTS AMT, K. W- OIL H. P. GAS If. P. ANT. No. A. w. G. ANT- AMP. ANT. AMPS. TRANS. ANY. H. T. FIG. OF FEET �S{ SERVKX DISCONNECT No_ OF S E R V i C E METER Na, aF CC. COND. IL W.G. Na.11 aF M4LEG A. W. G. ND. OF NEUTRALS A- W. G. AMT. AMP. TTPE EOYIP. 1 ,0 INN F 1 9W 3 ®r 9w 9,A' aW PER :II' # IN-IEG # NEUTRAL f l} it t OTHER APPARATUS: .' �. 1 ri V I't A BRANCH MANAGER Per This certificate must not be ahered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. I A T N BE ALTERED iN AINY DMNNER. - -- - - TOWN OF QUEENSSURY 141n FIRE MARSHAL QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518) 745-4424 FIRE MARSHAL INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED /aZL NAMED >�-,� LOCATION DATE--'" 9 PERMITS APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS AUTO . EXTINGUISHING SY TEM _ HOOD INSTALLATION -- AUTO . SPRINKLER SYSTE ALARM SYSTEM INTERIOR FINISHES STORAGE : CLEARANCE TO SPRINKLE S CLEARANCE TO HEATING ITS REQUIRED SIGNAGE CHIMNEY WOODSTOVE F,,,-iI.REPLACE-MAS NRY ,/FIREPLACE- FAOTORY SOIL REMARKS : 4K O THIS DATE 2/015 INSPECTOR TOWN OF QUEENSBURY BUILDING 53 D CODES ROAD DEPARTMENTfl QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 792- 5832 BUILDING INSPECTOR' S REPOR. REQUEST FO.R/"INSPECTION , RECEIVED NAME, ._ _ LOCATION DATE q �PERNIT� TYPE OF STRUCTURE APPROVE© RECHECK NIA YES NO 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/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/ VENTS IN P C PLUMBING UNDER SLAB FRAMING : JACK STUDS /HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS /MAIN BEAM - FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN ('INSULATION : FOUNDATION WALLS INTERIO R- FOUNDATION WALLS EXTERIO RRM FLOORS WALLS R- CEILING R DUCT WORK OR PIPING I UNHEA ED SPACES REMARKS : ARRIVE DEPART NSP£CTOR TOWN OF QUEENSBURY BUILDING 53D BCOES AY ROADPARTMENT QUEENSBURY , NEW YORK 12$64 TELEPHONE ( 518 ) 742- 5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME J '� l+ DCZ�'12Z'7Jl LOCATION GATE_ � �PER"IT # Z TYPE OF STRUCTURE APPROVED RECHECK N /A YES. NO FOOTINGS/ PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE IS RES FOR PROVIDINGRPROTECT ONSIBLE FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE . MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/ DAMPROOFING BACKFILL APPROVAL ;ROUGH PLUMBING PLUMBING VENT/VENT P ACE` PLUMBING UNDER SLAB XFRAMING JACK BRACINGIBRIDGING ---- JOIST HANGERS JACK POSTS /MAIN BEA FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN INSULATION : FOUNDATION W LS IN ERIOR R- FOUNDATION ALLS EXTERIOR RR- FLOORS R- WALLS R- CEILING DUCT WORK OR PIPING IN UNHEA ED SPACES REMARKS : ARRIVE 3 DEPART INSPECT flown o/ Queens " ry BUILDING and ZONING OEPARTMENT Bay and Haviland Road, R. DI 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME L.00AT ION DATE � � PERMIT NO ., SOIL TYPE - Sand _ Loam � Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TYPE of SYSTEM: �. Absorption field , total length Length of each trench Depth of trenches ' - Size of gravel_ $0 SEEPAGE PITS-(Number f) size- ft. x _ to Gravel size PIPING : Size pe Bldg , to tank Ce - Tank to disc. box Dist. box to field/pit openings sealed? YES NO Partial LOCATION/SEPARATIONS : ft. Foundation to tank Foundation to abso tion ft. Absorption to lot ine ft . separation of pi s ft. _L�O.-C- ATION OF SYS ON PROPER Y (circle one) <�t - Rear - ft side - Ri ht. side COMMENTS : SYSTEM usE APPROVED,.�- S NO g ..... ding Insp ctor f 01/86 and V1 TOM OF QUEEKSBURY BUILDING 53 BA D COES Y ROAD DEPARTMENT `' QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 792- 5832 BUILDIW. INSPECTOR' S REPORT �' - REQUEST FOR INSPECTION RECEIVED MANE LOCATION �+'" _ DAT PERMIT i - TYPE OF STRUCTUR APP OVE RECHECK N/A YES NO O N / ER MONOLITHIC POUR-1'rU REINFORCEMENT IN PLAN—��—~ FOR P'ROV110INf RiOTECTION. FROM FREEZING FC* 48 HOURS FOLLOWING THE PLACM]NENT OF THE CONCRETE . MATERIALS FOR THIS PURP E ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLAC FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/V N IN CE PLUMBING UNDER SLAB FRAMING : JACK STUD /HEADERS �- BRAC I NG/BRIDGING — -...... JOIST HANGERS JACK POSTS /MAIN BE J FIRESTOPPING WALLS CEILING FIREWALLS HEATING R UGH— IN INSULATION : FOUNDATION WALLS IN E IOR FOUNDATION WALLS EXTERIOR RR~ FLOORS WALLS R- DUCT WORK PI ING N UNHEA ED DUCT SPACES REMARKS ; ARRIVE . ra — DEPART `+ NS C R TOM OF QUUEENSBMY 6 BUILDING 53 ��,,r}.-�_ 0 SCODES AY ROAD DEPARTMENT QUEENSBURY , NEW YORK 12804 TELEPHONE ( 518 ) 792- 5832 BUILDING INSPECTOR' S REPORT REQUEST yFOR INSPECTION RECEIVEO!_ 4Z; Z. NAME LOCATION ,r C �PE1gMIIT f r.�' DATE .'�' rl TYPE OF STRUCTURE APPROVED RECHECK N/A YES NO FOO INGS/PIERS MONOLITHIC POUR FARM REINFORCEMENT IN PLACE THE CONTWICTOR IS RESPONI LE FOR PROVIDING PROTECTION FROM FREEZING FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE . MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING y� BACKFILL APPROVAL / ' ROUGH PLUMBING PLUMBING VENT/ VEN S IN PLACEr� PLUMBING UNDER SLAB FRAMING : JACK STUDS /HEADERS BRACING/BRIDGI JOIST HANGERS I — JACK POSTS /MAI SEAM F1RESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN INSULATION : FOUNDATION WALL IN 0 - FOUNDATION WAL EXTE OR R- FLOORS WALLS CEILING DUCT WORK d PI ING IN UN ED SPACES REMA KS : ARRIYE_�� DEPART � I P C r' NWADOOESEAARBUILDIGN CD DTM531 BAY ROAD ENT QUEENSBURY , NEW YORK 12804 02.� / TELEPHONE ( 518 ) 745- 4447 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED D� NAME _�1����—� LOCATror DATE` .2 PERMIT # _ TYPE OF STRUCTURE RECHECK APPROVED FOOTINGS/PIERS N/A YES -NQ MONOLITHIC POUR FOF2`�M �— REINFORCEMENT IN PL E �~ THE CONTRACTOR IS R SPONSIB FOR PROVIDING PROTE TION F$Om FREEZING FOR 4$ HOU FOLk�WING THE PLACEMENT OF TH C ETE MATERIALS FOR THIS P R ONo P� SITE FOUNDATION/WALL POUR REINFORCEMENT IN PL FOUNDATION/DAMPROO NG BACKFILL APPROVA ROUGH PLUMBING PLUMBING VENT/ N S IN PLA _ PLUMBING UNDE SLAB FRAMING : ---------- JACK S lNEADE S"�" BRACING/' RIDGING JOIST NGERS JACK P STS/MA N BEAM H EATING 'ROUGH— IN INSULATION : FOUNDATION AL N ERI R _ FOUNDATION WALLS EXTERIOR R— FLOORS WALLS R— CEILING R— DUCT WORK OR PI ING IN UNHR— £D SPACES REMARKS : k S ARRIVE DEPART � INSPEG R_ t f 4 yl Y ,j L 1 f }a f h a ys 20 5� or r � OWN OF DUEENSBUh . ".�. RECEIVED c� MAY 8 1992 f CODE DEPTi / '