1992-097 C
ERrn]FICATE OF OCCUPANCY
TOWN OF QUEENSBUR'11"'
WARREN COUNTY , NEW YORK
921111111097
This is to certify that work requested to be dome as shown by Permit No.
has been completed.
This structure st+yay be occupied as a Single FamUl y 71 i ng
L ocatian ' Carolina Court
owner Stephen M. Kell
By Order Town Board
III OF QUEENSBURY
Director of Bldg. 'Code Enforcement
�• . -
BUILDING PERMIT
TOWN OF QUEENSBURY No 92-097 ,� o
WARREN COUNTY, NEW YORK
ro
PER MISS EON is hereby granted to Stephen N. Kelly ry
OWNER of property located at Lot #3 Cardinal Court Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a Single Family Dwelling
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. fop
W
t. OWNER'S Address is rC
11 Willow Road w►
Queensbury, NY IM04 tv
a
2, CONTRACTOR or BUILDERS Name �
Same
3. CONTRACTOR or BUILDER'S Address
a
r*
w
4. ARCHITECT'S Name W
W
W
S. ARC"ITECT'S Address
C
r•M
6. TYPE of Construction — (Please indicate by X)
( ry Wood Frame ( ) masonry i ) Steel f I ► N
.d.
7. PLANS and Specifications ;
to
fC
No. 25b2 sq ft Single Family Dwelling as per plot plan specifications Tl
and application '
B. Proposed Use
4•c
Single Family Dwelling '
W
W
$ 338' 00 PERMIT FEE PAID — THIS PERMIT EXPIRES March 2 s i9 93 �
(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.l
Dated at the Town of Queenshur 7th Day March i9 92
SIGNED BY for the Town of Queensbury
Build'erg and ing Inspector
TOWN OF QLXEEKSBUR Y
REVIEWED BY : ' r ��t•�-�'r
1 � ?
FEE PAID : e- ? Whit 0F duFEA1SBUlj ,
REGF+VED
PERMIT NO . : ',�� - �I �,%
MAR 2 {; 1992
BUILDING PERMIT APPLICATION BLDG, a, 0001E g)r;pTn
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 :
P . O . Address : // 4 llle-=v PHONE
Property Location : hru � _ : C � rr�r /, /, f ct> � n f _ Tax Map No . A , 2 / J
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 : 1-21[ 0 �c� u %� Lot No .
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
/S-' 4'
NATURE OF PROPOSED WORK : * ESTIMATED MARKET 'VALUE OF THE
Construction of new building * CONSTRUCTION : $ / 7z perd
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW :
( no change to exterior dimensions ) * Size of Property : Sir ft * x '�?,rs- ft .
Other work ( describe ) * Existing Building Size :
* & _ ft . x 0 ft .
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE : * property line :
1st Floor Sq . Ft . ' * C Front Yard f Rear yard 4�<19 fte
Side Yards �_
f ands ft .
2nd Floor // . Sq . Ft . - * If on corner , setback from side street-
ft .
Other Floors Sq . Fta
( not cellar or basement ) OCCUPANCY INFORMATION :
TOTAL FLOOR AREA : C�?Sr6 �2- Sq , Ft , ,7 * Primary Building
* � One Family Dwelling
Size of New Structure : ft . x by .,A - ft . * Two Family Dwelling
Foundation : * Multiple Dwelling/No . of Units
Pier/Slab/Crawl /Partial /Full ( Circle One ) * Business
* Industrial
No * of stories ( Habitable space ) * Other
Height ( grade to ridge ) z z— ft .
If residential , no . of families : / * If addition , what will use be?
No . of rooms ( excludin baths ) : l'ca
No . of bedrooms :
No * of bathrooms : i/= * Accessory Building :
Primary heating system : 1:z4f Afk? * Detached Garage - One/Two Car
Type of fuel : Grp * � tA� Attached Garage - One/lwc�r
No , of fireplaces to be installed : r * Private Storage Building
Will a woodstove be installed ? : A�e * Other
Central Air Conditioning : Yes i No
( OVER )
BUILDING PERMIT APPLICATION CONTINUED :
BUILDING SPECIFICATIONS :
Type of construction : wood frame , fire safe , etc . 0/
Will any second- hand or ungraded lumber be used ? If so , for what ?
Foundation Wall Material : 'vr? C ,p Thickness :
Depth of Foundation below grade ( to bottom of footing ) :
Will there be a cellar? Heated or Unheated ? 140e1119 Floor Sq . Footage : i y3
Will there be a basement? Will any portion be used as living space ? ,filar n
If so , what portion ? Sq . Ft . Type of Use ?
Type of Roof : o ed Flat/Shed/Other Material of Roof a?S
Sizes wood studs .2- " x � spacing 1" o . c . ; length N' ft .
.foists ( floor beams ) : Ist Floor z x o�,7 '" ; spacing Z46 o . c . ; span �7 ft .
Joists ( floor beams ) : 2nd Floor " x /e; " ; spacing /Oz ' " o . c . ; span f�-? ft .
Overlays ( ceiling beams ) : x " ; spacing o . c . ; span ft .
Roof rafters : _c5k itx _ " ; spacing o . c . ; span ft .
Roof trusses ( pre-engineered ) : spacing "' o . c . ; span ft .
Exterior Wall Finish : 1/2 P C of what material ? 1 4. a
Interior Wall Finish : !'•/,.e er�- /? cc. k/ ^�
If a garage is to be attached , describe materials to be used for FIRE SEPARATION : �S
Is there to be an opening between garage and dwelling? If so , will a Fire- Rated door ,
enclosure , self- closing device be provided ? ye-3
-_
Will a flue- lined chimney be installed? Height above roof ft .
Depth of chimney foundation below grade : AM- ft .
Depth of fireplace hearth : ft . in .
Water supply - Municipal or private well :
SEPTIC SYSTEM : Distance from any private well ( including adjoining properties : ft .
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS : / '4e PHONE 2 f g -.�6 � z
NAME OF PLUMBER & ADDRESS : i ' PHONE
NAME OF MASON & ADDRESS : PHONE
NAME OF ELECTRICIAN & ADDRESS : °" PHONE
DECLARATION
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 au prized by the pwner ,
Signature
ner , weer s ag nt , Sw6hitect
contractor
SPECIAL CONDITIONS OF THEPERMIT :
By:
Code Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEERSBURY , MARREIN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods : TOWN OF Q VE[3 SBUH ,
CE
PART 5 - Acceptable 'Practice Method an 1 & 2 Family Dwellings ( ONLY )
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings ; MAR 2 192
Multi - Family Owe 1 1 i ng1SLDG. $ CODE DEPT�
( 3 Stories or Less )
PART 4 - Design By Component Performance - Commercial Buildings - Hi - Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
S PROPERTY rr�PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE :
1 . Gross Floor Area - 4�2 --�` 4� -2— Sq . Ft .
2 . Type of Heat - 6 ,Vg, Elec . Base Board Other
3 . Is Building Mechanically Cooled ? �YES NO�
4 . Percentage of Area of Windows and Doors Over 17% " , Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5 . Insulation Valves : Actual Shown Elec . Heat Other
A . Roof & Floors exposed to ambient temperatures R.Z2
Be Exterior Walls R,`„>'
Co Glazed Area R
D . Exterior Doors R
E . Floors over unheated spaces R
F . 'Edge of Slab on Grade ( Heated Building ) R, _
G . Basement/Cellar Walls (Above Grade ) R 2
H. Basement/Cellar walls ( Below Grade ) R
I . Heating/Cooling - Ducts - Piping in Unheated Space R
6 . Service ( Domestic ) Not 'Water Heating Device
A . Conforms to mini 11 efficiency per code Y_YES NO
TEMPERA?URE CONTROL mMXIMUM SE uts moo - WILL NOT BE EXCEEDED
' ' � Ly / 1 mot..-[,. �'"•- �{
1! B
INSPECTOR ' S REMRK,.S
"REV rrum-OT 0/
AV 1k
TOWN OF QUEENSSURY TOWN OF OUEENSB06 ,
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit O E'CEIVED
Fee Paid
M 619 2
Date : Review d
B�DGi. $ p7 ,
LOCATION OF PROPERTY FOR INSTALLATION :
Owner ' s Name :
Owner ' s Mailing Address :
Installer ' s Name : _ � � ,c=� Phone # :
Number of bedrooms ( if residential ) :
Total daily flow ( residential - compute @ 160 gal . per bedroom ) :
Topography-Circle One '' Rolling Steep Slope % of Slope
Soil Nature-Circle One San Loam Clay Other /Depth :
Ground Water-At What Depth ? � 4Z Feet
Bedrock or Impervious Material -At What Depth? _ Feet
Percolation Test- Circle One : Not Required Required/Rate Min . Per Inch
Domestic Water Supply- Circle One : Municipal Well other
If domestic water supply is a well
Separation : Water supply from AnX septic absorption feet
PROPOSED SYSTEM: Septic Tank /��'G gal . ( Minimum size : 1 ,000 gal . )
Tile Field : Each Trench �_ feet//Total System Length C 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 RE+QUIREP
No . of Tanks Size \of 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 Tow of Queensbur `Sanitary Sewage Disposal
Ordinance .
SIGNATURE OF RESPONSIBLE PERSON :
C ; DATE :
oo
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 an water supply
5 ) size and dimensions of all tanks , distribution boxes , the 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 $250 . 00 .
Co An approved copy of the plot plan shall be available on the construction
site . Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage .
D . Should unforeseen problems during construction prevent proper installation ,
alteration or repair of an approved system , a new proposal must be submitted
to the Queensbury Building Department before further construction .
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks :
TOWN OF QUEENSBURY
5si Bay Rd., (]ueoratdury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date ,.' .2 / ,19 ..E Permit No.
APPLICATION IS HF.RR$Y MA►IaE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire P revention and Building Code. The applicant or owner agrees to comply with
all applicable taws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance andW chimney.
Applicant 574p r- 0-> 7 , -12 }.` APPLIANCE (check appropriate boxes)
Ad d roes ,� / �� , / d ,- ` ,r o STOVE: ❑ Wood ❑ Coal ❑ Pellet
❑ FIEPLACE INSERT
r lr elsr' z . /4x Zip ❑ FIREPLACE, FACTORY BUILT:
❑ Wood ta �"'.�as
Phoney' ' - 3 e ❑ FIREPLACE, MASONRY:
❑ Wood ❑ Gas
Owner ❑ FURNACE: ❑ Wood ❑ Gas ❑ Oil '
t Address c IF NON-MASONRY:
Manufacturer: h( eA l-„ r' `' ._
Zip , � . : c
Model: Out Number: inches
Listed
Phone
CHIMNEY (check appropriate boxes)
Exact address of proposed construction
❑ MASONRY: ❑ Block ❑ Brick ❑ Stone
FLUE: ❑ Tile ❑ Steel
Size* Inches
CONSTRUCTION/INSTALLATION MUST ❑ FACTORY BUILT:
CONFORM TO NYS FIRE PREVENTION 8c Manufacturer: Model:
BUILDING CODE. CONSULT TOWN OF Listed By: Number:
+QUEENSBURY HANDOUTS PROVIDED ❑ Double Wall N,Triple Wall
REGARDING REQUIRED INSPECTIONS. ❑ Insulated
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Received
Code Number Title Z
A 173 3389 (190) Public Safety
A 233 2655 (230) Minor Sales
F Ieoted Fro Refunded to:
A
Dated.: Town Clark or Deputy:
Wk#e: Applicant Green: Fire Marshal Yellow: Bldg. Dept Pink dk Goldenrod: Cashier's Dept.
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518) 745-4447
BUILDING INSPECTOR' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIyED � ^.
NAME
LOCATION/ /
DATE /,,011 d i� PERMIT#
TYPE. OF STRUCTURE ,,`3�*�
RECHECKilQ2 '
FIRE MARSHAL APPROVAL ( COKMERICIAL STRUCTURE )E )
Aw FOOTING A PDUNDTIQNJ:r
KFILL AFRAMING
-,ROUGH PLUMBING ICTRICAL� SEPTIC
iINSULATION �Wa� EPLACE REMARKS +
A PROVAL
N/A YE5 NO
CHIMNEY HEIGHT/L+OCAT N
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DE CK/PORCR/STEPS/ LINGS
RELIEF VALVES
FURNACE/HOT WATER ER ING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS :
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILING
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FAN
ALL PLUMBING FIXTURES OP R ING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/0 OR C/C�
caMMENTs ,
ARRIVE
DEPART
ISPECTOR
TOWN OF QUEENSBURY �
FIRE MARSHAL
QUEENSBURYv NEW YORK 12804
TELEPHONE ( 518 ) 745- 4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED_.,3r
NAME
7A�� 41�ZL 4!
LOCA ION 2
DATE_._. ' ri PERMIT#__
APPR VED
EXITS
V
E
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO . EXTINGUISHING !SYSTEM
HOOD INSTALLATION
AUTO . SPRINKLER S STEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE :
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNIT
REQUIRED SIGNAGE
z
MNEY
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE- FACTORY BUIL
REMARKS : OK TO THIS DATE
2/015 4rNSPECTOR
�1 A?
61 o, eertsbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME � tP�'rf23ry` , 7
LOCATION �'`
ID
ATF PERMIT NO.
SOIL TYPE Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inds
TYPE of SYSTEM.:
Absorption field , total lengthJ�
Length of each trench . p7
Depth of trenches
Size of gravel_
SEEPAGE PITS{Number of)
Size- ft* X
Gravel size
PIPING : ize Pe
Bldg . to tank
Tank to dist . box
Dist, box to field
Openings sealed? Y NO martial
LOCATION/SEPARATIONS :
Foundation to tank 5 ft.
Foundation to absorption ft.
Absorption to lot line G+ ft.
Separation of pits ft.
�LOCATION OF SYSTEM ON OPE (circle one)
Rear - Left s e - R ' ght side COMMENTS :
i
SYSTEM USE �AP/P� RQVED,�y YEySS NO
Buildintf Itispector
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE (518) 745- 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOOR, INSPECTION RECEIVE :�
NAME
LOCAT ION !�_...g G GLJCc 441 ez7 , � _
DATE 2 PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIER
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RE5 SIDLE
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 PLAC
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL '
ROUGH PLUMBING
70L-
PLUMBING VENT/VENTS IN LACE
PLUMBING UNDER SLAB
FRAMING :
', JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH— IN
( INSULATION :
f FOUNDATION LLS INTERIOR R—
FOUNDATION WALLS EXTERIOR R—
FLOORS R—
WALLS R—
CEILING R— T
DUCT WORK OR PIPING IN UNHEA E
SPACES
REMARKS :
F
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745~ 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSP TTQN RECEIVED IR
NAME [[
LOCATION . 5--�--
DATE� PERJNIT #
TYPE OF STRUC URE ��
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE ;
THE CONTRACTOR IS RES STBLE
FOR PROVIDING PROTECTI FR011
FREEZING FOR 48 HOURS PPLLOWIN
THE PLACEMENT OF THE CCIMCRETF49
MATERIALS FOR THIS PURP SE 0$ SITE
FOUNDATION/MALL POUR �_ -
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING —
BACKFILL APPROVAL
j OUGH PLUMBING
PLUMBING VENT/VENTS IN CE
PLUMBING UNDER SLAB
4 FRAMING :
JACK STUDSMEAD
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEA
HEATING ROUGH— IN /
INSULATION : e
FOUNDATION W LS INTERIOR —
FOUNDATION LLS EXTERIOR R�
FLOORS R
WALLS !—
CEILING R—
DUCT WORK <OR PIPING IN UNH£AT D
SPACES
REMARKS :
dO
�� Li ve •may Ko�'��
QkrnScXd
ARRIVE n,
DEPART
INSPECTOR
TOWN OF QUEENSBIIRY
FIRE MARSHAL
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 792- 5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPE TION RECEIVED
NAME
LOCATION
DATE S- ' L-'1 PERMIT#
APPROVED
EXITS N/A YES NO
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO . EXTINGUISHING SYSTEM
HOOD INSTALLATION _
AUTO . SPRINKLER SYSTEM -
ALARM SYSTEM -r-- .......� ..
INTERIOR FINISHES '
STORAGE :
CLEARANCE TO SPRIXY4.ERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
t.
CHIMNEY
WOODSTOVE
FIREPLACE,MAS MI
u/ FIREPLACE- FACTORY BUILT
REMARKS : OK TO THIS D E
ARRIVE
DEPART
NSP CTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE (518 ) 745-4447
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION EiYED �LUA
MANE
LOCATIQNt;?�]I• r. J1� rXCz �—A7�
DATE L4 1 ,2 PERMIT
TYPE OF STRUCTURE
RECHECK APPROVED
N/A 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 � ITE
FOUNDATION/WALL Poug I
REINFORCEMENT IN PLACE
"— t"UNDAT ION/DAMP ROQF.ING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/'VENTS ALA E
PLUMBING UNDER SLAB /
FRAMING : L
JACK 5 UDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEA
HEATING ROUGH— IN
INSULATION :
FOUNDATION WALLS I ER R—
FOUNDATION WALLS TERIOR R—
FLOORS
WALLS
CEILING R_
DUCT WORK OR PI ING IN UNHEATIED
SPACES
R EMEAR KS :
i
f
ARRIVE car ! t r
DEPART /
PECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE (518 ) 745-4447
BUILDING INSPECTOR ' S REPORT
REQUEST OR INSPECTION RECEIVED
NAME
LOCATION
DATE ~ PERMIT # Ic 097
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES#1 NO
FOOTINGS/PIERS Loe
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS ' FOLLOWING
THE PLACEMENT OF THE ONCRETE .
MATERIALS FOR THIS PU POSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLAC
FOUNDATION/DAMPROOFIN
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS I LACE
PLUMBING UNDER SLAB
FRAMING :
JACK STUDS/HEADERS.
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN AM.
HEATING ROUGH- IN
INSULATION :
FOUNDATION WA S N E ;R-
FOUNDATION WA LS EXTERIOR ( -
FLOORS Ro-
WALLS R-
CEILING R-
DUCT WORK PIPING IN UNHEATED" '
SPACES
REMARKS :
1
ARRIVE cr
DEPART
INSPE R
,'OWN OF QUEENSBUI
RECEIVED
JUL Q 1992
BLDG, & CODE DEPTo
rV
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t c r
r
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TOWN OF OUEENSBU
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W ' o Zoning AdVnistrator
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�
+ LOT J
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MAP Of
W�RDƒNAL COURT
■#` ? - S1.160 e» e KELLYm_CTION
» 7saar ! , LW1 a# _ E OUEENSBURT COUNTY OF _a AIJ,
SCALE I"mi@n. 2TEMB_ Rm
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LAND sEY6L_ ma YORK
# STATE 2 NO. 35617
�0�' ' ' LOT 8
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Lll�` TOWN OF QUc�i {. Dui.
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