1992-117 N -
+CERTIFi+CATE OF OCCUPN'
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORR
Date_ /—.
a - L� 92. 117
This is to certify that work requested to be done as shown by Permit No.
has laeen completed.
Single Familhis structure may be oecupied as a
Dw llin
'P
oca�tion Shal l oM Creek Road
owner Donal d Kruger
Hy order Town Hoard
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
: ,� :.
ac
BUILDING PERMIT
0
TOWN OF QUEENSBURY No 92- 117
WARREN COUNTY, NEW YORK
I
IV
W
r
PERMISSION is hereby granted to Donald Kruger
OWNER of property located at Lot 17 Shallow Creek Rd Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Si nQ1 Family Dwe11 ins
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. to
ell
-s
t . OWNER'S Address is
12 Shallow Creek Road
Queensbury, NY 12804
w
iz
2. CONTRACTOR or 8U1 LDE R 'S Name
Salve
r
3, CONTRACTOR or BUILDER 'S Address
VF
tJ7
4. ARCHITECT'S Name
C'!
5. ARCHITECT'S Address
ro
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a
S. TYPE of Construction — (Please indicate by X)
i x} Wood Frame I } Masonry ( I Steel i I
♦. _ fn
wr
7_ PLANS and Specifications
fR9
N6, 2. 120 sq ft Single Family Dwelling as per plot plan specifications a r�
and application .
8. Proposed Use
Single Family Dwelling w/Att 2 Gar Gar.
Transferred fray # p91-825 A ri l 9, 19 93 to ES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of she
town of Queensbury before the expiration date,)
Dated at the Town of Queensbury this 9th # _ April 1992
::::J
SIGNED BY for the Town of Queensbury
Building and 4pfning Inspector
TOWN OF QUBENSBURY � Lk
REVIEWED BY :
�
4EJ FEE PAID : Qnsferred f
PERMIT NO . : 92-117 APR 1992 L
BUILDING & CODE DEPT,
BUILDING PERMIT APPLICATION
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 : Ronald Kruger
P . O . Address : 12 Shallow Creek Road PHONE 793- 5707
Property Location : Lot #7 Shallow Creek Road Tax Map No . 75 / 1 ! 23 . 7
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 : Shallow Creek Lot No . #7
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
NATURE OF PROPOSED WORK : * ESTIMATED MARKET VALUE OF THE
X Construction of new building * CONSTRUCTION : $ 1109000 .
Addition to building
Alteration to building COMPLETE INFORMATION REQUIRED BELOW :
( no change to exterior dimensions ) * Size of Property : / G+S ft , x /en/ ft .
Other work ( describe ) * Existing Building Size : 40 ,, 790
* 2-`1 ft . x ram'', cp ft .
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE , * property line :
1st 'Floor 1 ,040 Sq . Ft . * Front Yard -3 ft . Rear yard � ft ,
* Side Yards tz� ft . and ft .
2nd Floor 1 .080 Sq . Ft . * If on corner , setback from side street-
* ft .
Other Floors 1 ,040 Sq . Ft .
( not cellar or basement ) OCCUPANCY INFORMATION :
*
TOTAL FLOOR AREA : 2 , 120 Sq . Ft , * Primary Building -
* X One Family Dwelling
Size of New Structure : 26 ft . x z2o ft . * Two Family Dwelling
Foundation : * Multiple Dwelling/No , of Units
Pier/Slab/Crawl /Partial /Full ( Circle One ) Business
* Industrial
No . of stories ( Habitable space ) 2 * Other
Height ( grade to ridge ) 24 ft .
If residential , no . of families : 1 * If addition , what will use be ?
No . of rooms ( excluding baths ) : 6
, No . of bedrooms ; 3
No . of bathrooms : 2 Accessory Building :
Primary heating system : Wm Air * Detached Garage - One/Two Car
Type of fuel : Gas * X Attached Garage - One/Two Car
No . of fireplaces to be installed : * Private Storage Building
Will a woodstove be installed ? : NO * Other
Central Air Conditioning : Yes No X
( OVER )
BUILDING PERMIT APPLICATION CONTINUED :
BUILDING SPECIFICATIONS :
Type of construction : wood frame., fire safe , etc . Wood 'Frame
Will any second- hand or ungraded lumber be used ? If so , for what ?
Foundation Wall Material : Concrete Thickness : 8"
Depth of Foundation below grade ( to bottom of footing ) : 6 '
Will there be a cellar? Heated or Unheated ? Floor Sq . Footage :
Will there be a basement ? Yes Will any portion be used as living space ? No
If so , what portion ? Sq . Ft . Type of Use ?
Type of Roof : Sloped/Flat/Shed/Other Sloped Material of Roof Fiberglass
Size , wood studs 2 "' x 6 " ; spacing 16 " o . c . ; length a ft .
Joists ( floor beams ) : 1st Floor 2 x 10 " ; spacing 16 " o . c . ; span 14 ft .
Joists ( floor beams ) : 2nd Floor 2 x 10 " ; spacing 16 it o . c . ; span 14 ft .
Overlays ( ceiling beams ) : x " ; spacing " o . c . ; span ft .
Roof rafters : x " ; spacing o . c . ; span ft .
Roof trusses ( pre-engineered ) : spacing 24 o . c . ; span 27 ft .
Exterior Wall Finish : Yinal siding _ _ of what material ?
Interior Wall Finish : Sheetrock
If a garage is to be attached , describe materials to be used for FIRE SEPARATION :
5/8 fire code
Is there to be an opening between garage and dwelling ? Yes If so , will a Fire- Rated door ,
enclosure , self- closing device be provided ? Yes
Will a flue- lined chimney be installed ? Yes Height above roof 2 ft .
Depth of chimney foundation below grade : 6 ft .
Depth of fireplace hearth : 3 ft . 0 in .
Water supply - Municipal or private well : Town
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 : Donald Kruger PHONE 793-5707
NAME OF PLUMBER & ADDRESS : Same PHONE
NAME OF MASON & ADDRESS : Same PHONE
NAME OF ELECTRICIAN & ADDRESS : Peter Weidman PHONE
DECLARATIOR
To the best of my knowledge and belief the statements cant ine in this ap licati n ,
together with the plans and specifications submitted , are a tru an c plete tatem t of
all proposed work to be done on the described premises and that all pr ision of t e
BUILDING CODE , THE ZONING ORDINANCE , and all other laws pertain g to t ' pr os work shall
be complied with , whether specified or not , and that such work uthori , ed the owner .
ti
Signature
Own r , o er s Ogent , architect
contractor
SPECIAL CONDITIONS OF THE PERMIT :
By :
ode nforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOMB OF QUEENSBURY , MARREN COUNTY - 90M HEATING DEGREE DAYS
Cowl iance Methods:
PART 5 - Acceptable Practice Method on 1 b 2 Family Dwellings ( ONLY )
PART 6 no Thermal Rating - Component Trade Offs on 16 2 Family Dwellings ;
Multi - Family Dwellings
( 3 Stories or Less )
PART 4 - Design By Component Performance - Commercial Buildings - Hi - Rise Residential
PART 4 6 on Compliance Methods Require Submission of Worksheets
Donald Kruger Lot #7 Shallow Creek Road
APPLICAWNS KANE PROPERTYLOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE :
on
1 . Gross Floor Area - 29140 Sq . Ft .
2 . Type of Heat no Elec . Base Board Other Gas WW Air
3 . Is Building Mechanically Cooled ? YES X NO
4 . Percentage of Area of Windows and Doors Over 17% X Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D
THE R-VALUES SHOW ON PLANS SUBMITMI
Baseboard
5 . Insulation Values ; Actual Shown Elec . Heat Other
A . Roof & Floors exposed to ambient temperatures R 36
Be Exterior 'Walls R 21
C . Glazed Area R 5
On Exterior Doors R 4
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� ft
i . Heating/Cooling no Ducts - Piping in Unheated Space R 5
6 . Service ( Domestic ) Hot Water Heating Device
ANNUMEN
A . Coni icy per code X YES NO
1. MRXIMlM SETTING 140a on WILL *NGT BE ENCEEM
�`- v April 6 , 1992 793- 5707
APPLI ONE
INSPECT( -
4�
R
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # 92- 117
Fee Paid
Date : 4/6/92 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION : Lot #7 Shallow Creek Rd .
Owner ' s Name : Donald Kruger
Owner ' s Mailing Address : 12 Shallow Creek Road
Installer ' s Name : Same Phone # :
Number of bedrooms ( if residential ) : 3
Total daily flow ( residential - compute @ 150 gal . per bedroom ) :
Topography-Circle One : Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One : Sand Loam Clay Other /Depth :
Ground Water-At What Depth? 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 wfel T -
Separation : Water supply from an septic absorption feet
PROPOSED SYSTEM: Septic Tank 1 ,, � gal . ( Minimum size : 1 , 000 gal . )
Tile Field : Each Trench feet//Total System Length feet
Seepage Pit ( s ) : Number of / Size each : ft . x 6 ft .
Size of Stone to be used : # - / Depth or Thickness feet y
HOLDING TANK STEM IF REQUIRE
No . of Tanks Size of Each Gal .
Alarm system and associated elec ric 1 work to b petted by a certified
agency. yrr * ***
I have read the regulation on the reve se side of thi sheet and agree to abide
by these and all requirements of t e T wn of Quee ry Sanitary Sewage 'Disposal
Ordinance .
SIGNATURE OF RESPONSIBLE PERSON : DATE : y— -
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 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 .
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 & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks :
- ._ ::.... h,+ .. _ .r. :... .'+,"'9+4C•'aF':.,iR�T.�i1S{I¢•_-.•:.• yl'd' :1' rT.. : _.j. .. __
[]WW OF QUEENS.BLIMY �
Say at Maviland Roads, Gueenasbury, N.Y. 12WI1 9725 �
APPLICATION OR SOLID-FUEL BURNING APPLIANCES AND FIREPLLAC
,
Date 19
Permit No.
A1'in..wxriON IS HEREBY MADE to the Building Department for the issuance of a Building <tnd Use l'ennit
t pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrecs to comply with all
applicable haws, ordinances., regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter remises for a required inspections,
Applicant 's Nam &� ,,&. * .9... _r APPLIANCE TYPE
Stove Coal Wood
Add `✓ x..-1 +� Furnace Hot Air Boiler
Zero Clearance Circulating Unit
If Nop-Masonry:
Phone
Owner's Name ,., . .„, ,
Manufacturer
Address Model Outlet Size
Zip Listed by Number
Phone `;p if Ir " 15` '70 7 CHIMNEY TYPE
Masonry: Block Brick y . . Stone
l'reoperly location of proposed construction Flue: Tile k_ Steel �6
Size: V k AWx
�f ��- jrx jt6z cot„ r le Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number.
REQUIRED FOR FACTORY-BUILT APPLIANCES Type` Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost $
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee $
SONRY FIREPLACES AND CHIMNEYS.
CASHIEWs DEpAlrtm r
TOWN c)F QuEeNswIwY, NEW YORK
Denarlmeszte. Fire Marshal Amount Collected Amount Itefanded
(,udp N amber Til1e
A173 3389 (190) Public Safety
A233 2WS (230) Minor Sales
Fee Collected from or Refunded for
Address
Mated. Town clack or llepa
WAffe: ,fppfierwe Ysffmr+�re/PMk:+C+r�rr"s Wprrpwewf Gafdew�ad: Ftar AlarsAat _ .
T011N OF QUEEXS8k Ry
531 SAY ROAD
TELEPHONE (518 O 745,3 4"7
SUIL91ps INSPECTOR` S *.0T
FINAL INSPECTION
REQIJEST FOR INSPECTION RECEIVED
MAKE
LOCATION
DATE.--���PERMIT#
TYPE OF STRUCTURE_ !i►
v
RECHECK
FIRE MARSHAL APPROVAL ( COMM EFILL L S, T RUCTURE )
FAQTINGUPIOATIOINA�LECTRICAL �EP`TIC
ROUGH PL MBINGWOZDSTOVE/FIREPLAC'E
INSULATION
REMARKS
PROVA
N/A YES NO
CHIMNEY HEIGHT/L06ATION
B VENT/LOCATION
PLUMBING VENT x
ROOFING
SIDING INGS
DECK/PQR H/STE / ,
RELIEF VALVES I
ING�
FURNACE/HOT WA ER P '
INTERIOR TRIM/PRI ACY OORS
FINISH FLOORS : K
BATH/ KITCHEN ATERTIG'I{T
OTHER FLOORS WEEPABL K.
OTHER FLOORS CARPETED �
STAIR CLEARANiCE/ RAILINGS � K.
SMOKE DETECTORS
DOOR CLOSER, ?C-
BATHROOM FA 5
ALL PLUMBING FI TURES OPERA I G
GARAGE FIRE PROOFING�� � x
DOOR CLOSERS
OTHER FIRE SEPARA ON
FIRE/DEMISE WALLS
FINAL
ELECTRICAL
OK R /
Lf
COMMENTS '
A{ ,�,, C1 .ti1�-F M
ARRIVE �.
DEPARTT�� I E 0 ~�
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY , NEW ORK 128 44
TELEPHO
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME_,--r 11i
LOCAT I ON-044 --'`� �
DATE /Cy ' PERMIT## '
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO . EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO . SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR 'FINISHFS
STORAGE :
CLEARANCE TO SPRINKLERS
CLEARANCE. TO HEATING UNITS
REQUIRLD SIGNAGE
CHIMNEY
WOpDSTOVE
Fri"REPLACE-MASONRY
,f IREPLAC£-FACTORY BUILT
REMARKS : OK TO THIS 'DATE
2/0I5 SPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS
411 BUREAU OF EL CITY
` F— 41 STATE STREET, AL Y, NEW YOR 12207
Date OC.'Te ?v III 2 43 ' . S '+`3 4ppiicat' No. on file t� 23r+ +�3 : F1 4) i 5 t 143
THIS CERTIFIES THAT F'F.Iikfl'I` f , :' - :1. 1
only the electrical equip
'ment " deacribed below and in raeksoed the named on the above application number in the premises of
t
in thefallowing iocati ; Basement let Ft. 2nd Fi. ee!k Section Blvck lout
i ums examined on -drT1i a andfound to be in compliance with the requirements of this Board.
{ FXTURE RXTtMM RAMM COOKING DECKS OVENS DISH WASHIPRS EXHAUST PANS
CUTLETS WEPTACIAS SWITCHIS tW.ANDES(:FF0f KUOPANCENT I OTHER AMT. K. W. AMT. K- W. AMT- K-W- 14MT. C W. AMT- N. ►.
*435 Api'
DRYERS FU*NACE MOTORS FUTURE APPUAHCE FtEDRRS SMOAL REC'PT TIMECIOCKS WWL UNIT NEATENS MULT"WILET DUM 111R5
AMT. K. w_ O1L M, P. OAS N. ►. AMT. NO. A. W. G. AMT. AMP. A NMT. AM►!F. TRANS. AMT. H. t. 00 fm AMT. WATTS
SRRYMCE DISCONNECT NO. OF S R R V I C E
AMT. AAhP. TYPE ++ 1 OW 7WI 1 0 2w 2 X 2w 2 0 4w NO. 0rP ER*COND. Cw CC ela&o. NO. OF I-WUM Of IW-UG6 NO-`Or NtVTEALS I Of NWE- a-
' OTHER APPARATUS:
5 '
t;I�L1GFIi t�c')I1�a'1'I2UC'T1.UN � F
DON KRUGER
12 SHA-lalk)Fi t'ItFIEK [:OAD BRANCH MANAGER
' Per w
This certificate must not be altered in any mannerr return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. TMS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
�� own-�� '�seeen3Eretr�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTETI INSPECTION
NAME .0 r
LOCAT I ON o 9 F=- `61k, i ir L 2- lee 2.i'C
DATE /� PERMIT NO.
SOIL TYPE - nd - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch _
TYPE of SYSTEM:
Absorption field , total length ZOE
Length of each trench
Depth of trenches
Size of gravel_ ;
SEEPAGE PITS# r of)
size-ize- X ft. ft.*
Gravel size
PIPING : S1 Type
Bldg . to tank
Tank to diet . box 4y � r
Dist. box to field/ y
Openings sealed? - Y NO Partial
LOCATION/SEPARATI
Foundation to tan ft.
Foundation to orpt on Q-2V €t .
Absorption to t line �€t .
Separation of its -- ft.
LOCATION OF STEM ON P PERTY ( circle one)
Front - ea Left side Right side -
CC MMENTS :
`Q.
CSC SYSTEM USE APPROVE YES O
1 g ns ctor
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 FOR INSPECTIOM RECEIVED(
NAME —' C7``''fftr_k �r
LOCATION ` ka I s ? L.Ng'o J
DATE PERMIT # 9 ,2 — ,/ /
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPOROBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FO LOMIING
THE PLACEMENT OF THE GON BETE .
MATERIALS FOR THIS PURPOS ON SIT
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING :
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH— IN
INSULATION :
FOUNDATION WALLS IrflERIOR R—
FOUNDATION WALLS TERIOR R—
FLOORS R—
WALLS R—
CEILING R-3
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS :
f
ARRIVE
DEPART
INSPECTOR
TOWN Of QUEENSBI.IRY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED `.2 _
NAME f
LOCATION
DATE T2 PERINIT
TYPE OF STRUCTURE �'th CX0 E II,`az
RECHECK APPROVED CJ
N/A YESI NO
FOOTINGS/PIERS _
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPOHSIBL
FOR PROVIDING PROTECTION FR
FREEZING FOR 48 HOURS FOLL ING
THE PLACEMENT OF THE CONC E .
MATERIALS FOR THIS PURPOSE, ON SITE
FOUNDATION/WALL POUR o
REINFORCEMENT IN PLACE ;
FOUNDATION/DAMPROOFING `
BACKFILL APPROVAL
—;ROUGH PLUMBING 5
PLUMBING VENT/VEN S , N PLACE
PLUMBING UNDER SLAB'
FRAMING :
JACK S UDS HEAD S
BRACING/BRIDGI G
JOIST HANGER
JACK POSTS/TRAIN BEAM __
HEATING ROUGH— IN
INSULATION :
FOUNDATIQ W LLS INTERIOR R—
FOUNDATION WALLS EXTERIOR R--
FLOORS R—
WALLS R—
CEILING R—
DUCT WORK OR PI ING TN UNHEATED
r
SPACES
REMARKS : '7
IZC✓
cl
ARRIVE
DEPART L '
EPA _ �I„?�
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447
BUILDING INSPECTOR' S REPORT �y
REQUEST FOR INSPECTION RECEIVEDX� C c+ --
NAME r-�
LOCATION f r
DATE PERIMIT / _ '
TYPE OF STRUC URE
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE _
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FQLLOWING
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 PLAC
PLUMBING UNDER SLAB
>\44;RAMING :
JACK STUDS/HEADERS
BRACING/BRIDGING i
JOIST HANGERS
JACK POSTS/MAIN BEAM
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
REMARKS :
ARRIVE 4INS
DEPART
OR
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECi"ION RECEIVED
NAME S: ~
LOCATION
DATE _ PERMIT# -�I j ?
APPROVED
EXITS NIA YES NO
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO . EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO . SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE :
CLEARANCE TO SPRINKLERS_
CLEARANCE TO HEATING U IT
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MAS NR
,,,FIREPLACE-FACTORY BUI
i
REMARKS : OK TO THIS DATE
2/015 INSPECT
� M
TOW
N OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE (51$ ) 745- 4447
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED f
NAME {,� W
LOCATION
DATE PERMIT # _f
TYPE OF STRUCTURE
RECHECK APPROVED
FOOTINGS/PIERS N/A YES NO
MONOLITHIC POUR FO M
REINFORCEMENT IN P CE
THE CONTRACTOR IS R SPONSI
FOR PROVIDING PRATE TION F
FREEZING FOR 48 HOU FOLL WING
THE PLACEMENT OF TH CONC ETE.
MATERIALS FOR THIS P RPO E ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLA ---
F XWW"NPRQOF
'PILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VEN I PLACE
PLUMBING UNDER S AB
FRAMING •
JACK STU S/ ADERS
BRACING/BR DING
JOIST HAN RS
JACK POS /MAIN BEAM����......
HEATING R GH- INN
INSULATI
FOUND ION ALLS INTE Ip R-
FOUN TION WALLS EXTERIOR R-
FL S R-
WA LS R-
CEILING Rw
DUCT WORK pR PIPING IN UNHEATED
SPACES
REMARKS :
a
ARRIVE %
DEPART � .
x SPECTOR
� � 11
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ('518) 745- 4447
BUILDING INSPECTORS REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DA7_ I aL PERMIT 0
TYPE
O ST IfCTURE
' RECHECK
APPROVED
FOOTIN N/A YES NO
GS{PIERS
MONOLITHIC POUR ORM
REINFORCEMENT IN PLACE
THE CONTRACTOR ISfECT
SIBLE
FOR PROVIDING PRO FROM
FREEZING FOR 48 HFOLLOWING
T14E PLACEMENT OFCONCRETE.
MATERIALS FOR THIS RPOSE ON SITE
FOUNDATION/WALL PO
REINFORCEMENT IN P CE
FOUNDATION/OAMPRO I�VG
BACKFILL APPROVA
ROUGH PLUMBING
PLUMBING VENT/V TS IN PLACE
PLUMBING UNDER LAB
FRAMING :
JACK STUDS ADERS
$RACING/GRID ING
JOIST HANGS
JACK POSTS/ IN BE
HEATING ROUGH IN
INSULATION :
FOUNDATION ALLS IN ERIOR R-
FOUNDATION 'WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS :
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DEPART
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