1991-229 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date July 19 91
This is to certify that work requested to be done as shown by Permit No. 91-229
has been completed.
This structure may be occupied as a Si nal a Family Modular Dwel l i n i
Location Van Dusen Road
Owner William and Autumn Kennedy
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
ti t
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-229
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to WILLIAM & AUTUMN KENNEDY 1\3
OWNER of property located at Van Dusen Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Single family Modular Home
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
RD#3 Box 273 Luzerne Rd
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name
Morning Star Builders
3. CONTRACTOR or BUILDER'S Address —J
a
Route 8 ¢,
Chestertown NY 12817
4. ARCHITECT'S Name
ct
3
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
0( )Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specificationsrri
No. 232'x48' Single family modular dwelling as per plot plan, specifica-
tions and application including septic system.
8. Proposed Use
Single family modular dwelling
$ 132.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 23 19 92
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the n-
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 23rd Day of April 19 91 0
2
SIGNED BY ii.;(/>, //Gl/�L . for the Town of Queensbury ro
/¢4d;Ifig and Zoning Inspector
TOWN OF QUEENSBURY
Vr‘ i/ '14( '4 ,
REVIEWED BY . [,
.. 1 FEE PAID $ �J
s % PERMIT NO. / ��fC TOWN ( r' QUEENSBURY
BUILDING PERMIT APPLICATION
APR 231991
• BLDG. & 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. f
• • • • * • • • • • • • * * • * * * * * * * * * * * • • /* * * • * * * * * * • * *
The owner of this property is: /tJi/1i'/)t/ , ` 1/ ,11 it-1y� r„Vi_';,;igt
P.O. Address �i,�/i- ®, ,.)�'.� ii. to a t's'?,r�<,- ,�a""*m„P'� 41 dc� .;?rf �V Tel. c/7 7,,7 Z .- 97e`c,'
Property Location OIN ?l r`'1711/ ,,.,.,,e.,A ' ��' V ;',•,a-,. 1;= ':a' T
(/ � Tax Map No. /,1_5 // �0-2�
Has there been any split of this property since October 1, 1988? / `7 Zd�Isc�1�" W&&T'
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVI ION OF WORK AS REGARDS TO BUILDING CODES IS:
•
NATURE OF PROPOSED WORK: * ESfIMATED MARKET VALUE OF •
- Construction of a new buildin * CONSTRUCTION: $ ,,,3i ("O
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property 150 ft x ' ft.
Alteration to a building * Existing Buildings(3) Size 0 ft. x ft.
(no change to exterior dimensions)
* Proposed building - distance from property line:
Other work (Describe) * Front yard $',5- ft. Rear yard ft.
*
*
Side yards 7a- ft. and R3® ft.
GROSS AREA OF PROPOSED STRUCTURE If on corner, setback from side street ft.
1st Floor i/ / Z8-- sq. ft. lle l •
* OCCUPANCY INFORMATION
2nd Floor -- sq. ft. • ' Primary Building -
Other Floors sq. ft. * One Family Dwelling
(not cellar or basement) Two Family Dwelling
TOTAL FLOOR AREA 2rs ft. • Multiple Dwelling/Number of units
Size of new structure a3'6�1 ft x yR'ft. •* Business
Foundation-pier/slab/c=.=. �'
� rtieii/a * Industrial
(circler►;: * Other
•
No. of stories (habitable space) / •
Height (grade to ridge) ' /3 '/Z, ft. * If addition, what will use be?
If residential, no. of families / •
No. of rooms(excluding baths) •
Accessory Building
No. of bedrooms 3 •
No. of bathrooms a. • _____Detached Garage ONE/TWO Car
Primary heating system 12 iSe-i • Attached Garage ONE/TWO Car
Type of fuel 0 Lt;P, * Private storage building
No. of fireplaces to be installed 0 *
• ___Other
Willa wood stove be installed 0
Central Air conditioning D •
OV• ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe, etc. (,Jo00 / ervol%
Will any second-hand or upgraded lumber be used? If so, for what? nj
Foundation wall material GOnle12-6-M- 1049425Y0 Thickness
Depth of foundation below grade (to bottom of footing) ' ( '�
Will there be a cellar? yLs Heated or unheated? /4-E_ y./-Tye' Floor sq. footage ))yc— sq ft.
Will there be a basement? yin Will any portion be used as living space? NO .
(If so, what portion? sq ft. Type of use?
Type of roof s ope)flat/shed/other S Material of roof ,"Y-WN 4-tr90/)4J6 fit;
Size, wood studs ca"x ( " spacing o24 " o.c. length $' ft.
Joists (floor beams) lst floor "x i" " spacing !, "o.c. span /� ft.
Joist (floor beams) 2nd floor "x " spacing "o.c. span ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters "x " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing n, " o.c. span e, ft.
Exterior wall finish ' • Vinm S l,niA16 of what material? 4" Y
Interior wall finish /j?_ Sht 'f,�3
ocJ — pi*mrl
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? If so will a Fire-rated door, enclosure,
self-closing device be provided?
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well /VI Uni/e, P4-1.—
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties ,2 ÷. ft.
(A separate application is necessary for any repair or new installation of septic system)
NAME OF BUILDER /(rRAM1/( .sae #LOdSADDRESS 1Q7k C s ,mart/ TEL. NO.
NAME OF PLUMBER Al'j, a,y Va--A/ ADDRESS ci7 f2 )a1iLf TEL. NO.
NAME OF MASON C.KI 421 ADDRESS 6L1a { ty5. TEL. NO.
NAME OF ELECTRICIAN /,4 D. itac . ADDRESS a ye eai[../ TEL. NO.
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 authorized by the owner.
Signatur /� ✓w� , �'i'�'sr7 1
Owner, owner's dent, architect, contractor
SPECIAL CONDITIONS OP THE PERMIT:
BY
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
TOWN OF OUEFN4URY
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwelling s P R 231991
Multi-Family Dwellings
(3 Stories or Less)
BLDG. & CODE DEPT.
PART 4 - Design By Component Performance Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
kliiPqq�jy„�pp�� ''rI,{{' ��!!��yy// (( p �fpyp_�)l /�w /i %�_' ,(� �;P ` (� /�,/y� `,.J "`'z.�U/4m - k y k:!1d10 f..-.e el filial (St /2.. yL���.s ���.�V "A S.'/ i% r.- I'
APPLICANT'S NAME (! P OPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - / ) Sq. Ft.
2. Type of Heat - I/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 REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 38'
B. Exterior Walls R
C. 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 /0
H. Basement/Cellar Walls (Below Grade) R /0
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code p YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
11;11,1, 6- AL......)41_ Li le 3 c-7 Z
APPL CANT'S SIGNATURE / DATE TELEPHONE NUMBER
I
INSPECTOR'S REMARKS :
REVIEWED BY
41114 TOWN OF QUEENSBURY 1
APPLICATIOtl FOR SEPTIC DISPOSAL PERMIT
TOWN OF gt_J=Fns IJRY
DATE: ►9rPf 7 Y. if ss ,
LOCATION OF PROPERTY FOR INSTALLATION V1-ni jj/
Owner's Name: Lail,"
ihfV ( t- `aCe.,f G' t Ai a 4 ximil@(&i 24i OEPT
Address: ,fie( ' 23aX ,,,773 A v7.6-1 i Pt/id dv-cx„...s.L,er)' ay., ',% ;", '-i
Installer' s Name: 76-Iz)j1'#v -e ` Jt,/GQmsrelephone: 4-/94-/- 73.j'
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) 44 s D
Topography: Circle one: ( l,it Rolling Steep Slope % of Slope
Soil Nature: Circle one: rand 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 well : •
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank / 1 O? D gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of c /Size each feet
by feet
Size of stone to be used # /Depth or Thickness / ,') feet
*****************************
' HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal :
*Alarm system and associated electrical work to be inspected by an approved
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.
/ J f `
SIGNATURE OF RESPONSIBLE PERSON: ,,1, ��.,_. � f r., ,,,,, - DATE: "d / A3 / is
111
•
•
Sestie system tnspecc.ions: •
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 scarc
of construction and shall include a plot plan showing:
1.). che proposed location of cha system
2.) location and distance co lot lines
3.-) location and distance co structures
- 4..) location and distance co any water supply •
5.) size and dimensions of all tanks. distribution boxes. .
cili fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the •
uuil4ing Inspuctor. Failure co comply with this requirement may
rizault in the uncoverinb of chid system by the installer and a fine
of up co $250.00.
C. An approved copy of the ploc plan shall be available on the construction
s".ce. Failure co produce said plot plan ac time of inspection say
rusulc in an immediate work scoppage.
•
D. Should unforeseen problems during construction prevent proper installs •
—
cion. alteration or r.:p.iir of an approved system. a new proposal must
bu submitcud co the Qu.runsbury Building Department before further
conacruccion.
Towns of Quesasbury
BUILDING and CODES DEPARTMENT
Bay and Naviland Roads
Queensbury, -New York 12804
•
Remarks: .
•
•
•
•
•
•
•
•
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED 1 s/
TEMP.tt DATE /// - /;.; ///
CITY OR VILLAGE i•--� TOWNSHIP COUNTY
( 'G( F) i .tc1)�7ce-Ia.../. tcJa-02)2rl(/
STREET AND NO.OR ROAD NUMBER ��,
G/{//1 ii l .DC/1;f'A/ /?I' II () 1 `_. -.:__ --- • - AIM 1#
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION �_ BLOCK
CO ' q -` LU'2f=I�'A/I= F:0 O . 2- /
OCCUPANTS NAME�'�,' ',/ BUILDING OCCUPANCY
/./2l/ /I4I' l fiji- /Tr/ 1)/ / /-/Vv//r 'l .
OWNER'S NAME AND ADDRESS / t-� r;}.U-,I .— / L. Ft-�?�;.,. ..HOME TELEPHONE NUMBER r_s,..�„ `
(�//�. II-I/1'I P4/%I11 (II I) }/� C.`-�' Lsl-''1=,trc..i: .-/Zt/ /7 c1;24 / 772 �• j.�--,- 6
CURRENT SUPPLIED BY FROM THEIR / OFFICE _ WORK TELEPHONE NUMBER
,/ , - = 1 . E(-- ///41l.6 II iUi1 PO`�i�/LT:. -- 6/.t'4I l;-4 ll.. C.'
BUILDING IS �/
NEW L OLD CIlie.WORK IS NEW lie. ADDITIONAL CI DEFECTS REMOVED Cl/ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
. lion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE / ,^
�^
SUB-
BASE
BASE-
MENT4,1..
1st -� 3 ,,/ '73 elf
FL.2nd
FL.
3rd
FL.
•
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
a
)t'i,-.•,; _ t r•s .-- Ile;/"Ir% — r )-!II 1(E-1--• ...I
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT
SIZE OF MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
1'I. . r. t I: .. i/✓;•�_ �CLr6•NCEALED
DATE WORK ro BE STARTED/ (} DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
D 0 /. /9 i
SERVICE ENTERS BUIL IN MANUFACTURER OF SIGN
O�OVERHEAD ❑ UNDERGROUND .
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS / c !
T LU 1 L 4. L.AL L IDENTIFICATION NUMBER I I I li (I et
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION SIGNATUREOF APPLICANT
I 1 r`' i..)P i//(/ J-o-F I',m f I I_1)43)2 s. •' //rl�. [ X i f ,• •}.Li ---._
STREET ADDRESS TELEPHONE NO. rl
/</I/i f(; .7. 11 1111 e G .44�'-/i(f- 75s 7.
CITY OR POST FFICE ,.` f / I ZIP CODE / LICENSE NO.WHEN APPLICABLE
/, :- /f/7/ Li'f ( l. l;~. I \. I'f� I /2/ 6 6,
❑ 85 John Street El 41 State Street 1 ❑ 570 Delaware Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO,NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
(212)227-3700 (518)463-2122 (716)884-1155 (716)254-0141 (315)463-8552
THE NEW YORK BOARD OF FIRE UNDERWRITERS
<ZiC TOIII OF QUEENSBURY
0j QUEENSBURY,BAY ROAD
NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
• FINAL INSPECTION
. REQUEST FOR INSPECTInON RECEIVED I
LOCATION c\•(\ p5 Q,.,,,
DATE . PERMITS 9 1 --Z-C1
TYPE ST TURE S � ,r,,,,,,I� M.)( a&v
RECHECK
IRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
/LFOOTING ./FOUNDATION ACKFILL FRAMING
ROUGH PL B NG FINAL ELECTRICAL SEPTIC
INSULATION WOOUSTOVE/FI' PLACE
SITE PLAN/VARI CE REQUIREME S YES NO
REMARKS
.APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCA
B VENT/LOCATION
PLUMBING VENT • t/
ROOFING �j
SIDING ��/
DECK/PORCH/STEPS/ ' ILINGS
RELIEF VALVES r //
FURNACE/HOT WA R OPERATING
BASEMENT INSU •TION/DUCTWOR
INTERIOR TRI•/PRIVACY DOORS
FINISH FLOG' :
BATH/KIT' EN WATERTIGHT ✓
OTHER F 'ORS SWEEPABLE
OTHER ' OORS CARPETED
STAIR C ARANCE/RAILINGS_
HANDIC' PED ACCESS
SMOKE TECTORS
BATHR' iM FANS/WHOLEHOUSE FANS
ALL P UMBING.FIXTURES OPERATI w
GARAr FIRE PROOFING
D00' CLOSERS
OT FIRE SEPARATION
FI' /DEMISE WALLS
D PSTER
NAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
•
67./e)/9/
ARRIVE
DEPARTc
IS
7),:„
_mown o/ Queeni(urtj
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
U
NAME_ ',.` \`
� \`CSC C / 11
LOCAT ION \f(a c\ (\_.S DAr 9(1)
DATE ((2 / L/PERMIT NO. / ----,c)j--()
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 r;
Depth of trenches 1 ;Y
Size of gravel'_
SEEPAGE PITS{Number.2of)
Size- Se---ft. X c- t. 4Gravel size .L ' , it
PIPING: 1Size Type
Bldg. to tank )i "VC'
Tank to dist. box V p PvP
Dist. box to field/pit4�, 1' P/A.,
Openings sealed? YES I. NO Partial
LOCATION/SEPARATIONS:
Foundation to tank �� / Lft.
li
Foundation to absorptioni a-`j ft. •
• Absorption to lot lime si6 ft.
Separation of pits , (. ) ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front 4 - Left/side Right side -
COMMENTS: . I '4,
'
f
•
SYSTEM USE APPROVER NO
• u ding Insp for
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME y 4J1 7 .11.41001,y_
LOCATION /Ha /s i.e./v4Lfi Id'
DATE, 4/1/Q/ PERMIT # �/�-�Z9
/
TYPE OF STRUCTURE 4,7 . f , ,q/,v � j� 'J / C/
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 SITE
FOUNDATION/WALL POUR'
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFIN'G ,
ACKFILL APPROVAL
OUGH PLUMBING
PLUMBING VENT/VENTS' IN `PLACE
PLUMBING UNDER SLAB \
FRAMING: ./
JACK STUDS/HEADERS `,
BRACING/BRIDGING
JOIST HANGERS ,
JACK POSTS/MAIN BEAM \
FIRES O PPING
WA LS 4,
CELING k
FIREWALLS
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:
S
ARRIVE �- 3
DEPART---'-0 4 --/e, /�/
INSPECTOr
} ' vo1) '30
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
• QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
/
REQUEST FOR INSPECTION RECEIVED �.//020/C
NAME €'`(\'(\eC,) V 1 �l l G V\,`_
LOCATION \)C\\ \
DATE PERMIT # 1
TYPE OF STRUCTURE - 1 c rn L Wu.,.
RECHECK I APPROVED
1 . N/A YE NO
,FOOTINGS/PIERS d ✓
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE /
THE CONTRACTOR IS RESPONSIBLE { ,/
FOR PROVIDING PROTECTION FROM I /
FREEZING FOR 48 HOURS FOLLOWING, '
THE PLACEMENT OF THE CONCRETE. j {'
MATERIALS FOR THIS PURPOSE ON SJITE
FOUNDATION/WALL POUR J ?,
REINFORCEMENT IN PLACE 4
FOUNDATION/DAMPROOFING 1
BACKFILL APPROVAL 1 1
ROUGH PLUMBING �Ir'
PLUMBING VENT/VENTS IN PLACE.;'
PLUMBING UNDER SLAB
FRAMING: / 1
JACK STUDS/HEADERS Jv 1
BRACING/BRIDGING 7
JOIST HANGERS ,P 1
JACK POSTS/MAIN BEAM 1
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 /
0
DEPART //
INSPECT R
ou—
�L % -z-2. -
n
.
_•_ /- 8 • 2a 3, J E TOWN OF OV7:-. 4.F."' 'RY
—x r
Zoo . 200 '
• APR 231991 ,�
o 1 ti
BLDG. ts. (,UL) DEPT. Y I as
ob
Sc.,
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V A
TOM OF QUENSBURY
,,. .: Zoning A r iristrat®�r
-, f;: Doff
r -' is