1991-274 b �y
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY,. NEW YORK
Date 110(AVInfi., 1019 91
This is to certify that work requested to be done as shown by Permit No. 91-274
has been completed.
This structure may be occupied as a Addition to ng
LocationLuzerne Road
Owner Gordon Palmer
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. ac Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY "
No. 91-274
WARREN COUNTY, NEW YORK
c)
it
PERMISSION is hereby granted to Gordon Palmer
OWNER of property located at Luzerne Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and -s
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. p
O
1. OWNER'S Address is
Same
CD
2. CONTRACTOR or BUILDER'S Name r-
C
Pliney Tucker
CD
3. CONTRACTOR or BUILDER'S Address
Box 425 RD04
Division Rd
Queensbury, NY 12804 •
4. ARCHITECT'S Name
O
O
ei
O
5. ARCHITECT'S Address O'
CD
co
6. TYPE of Construction—(Please indicate by X)
( ►Wood Frame ( I Masonry ( )Steel ( )
p
7. PLANS and Specifications
No. 492 sq ft Addition to dwelling as per plot plan specifications
and application
8. Proposed Use
Additional living space
$ 40.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 9, 19 92
(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.)
Dated at the Town of Queensbury this _9th Day o May 19 91
SIGNED BY r !�'� L i/ for the Town of Queensbury
Building and Zofii1ng Inspector
TOWN OF•QUEENSBURY F'
REVIEWED BY ,' �_ ..
j
FEE PAID $ 41 -PERMIT NO. 9f,.z 14 TOWN OF QUEENSBURY
RECEIVE[
BUILDING PERMIT APPLICATION MAY 91991
BLDG. & CODE DEPT.
A PERMITMUST 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.
* * * « * * * * * * * * * * * * * * * * * * * * * * * * * * * « * * * * * * * * *
The owner of this property is: c,, .J,3 „ 7�' f, ,
P.O. Address Jr,4 7,, ,fC qb,/ 4t c-,„c, Gl.,. , XJ,7 /1.ro>Tel. Z 9z .. 6 9
Property Location l_ c_,- 7 ,-,;.y ,ri, lc-, 4r,P�,.,,_-S_A t, v v . Tax Map No. 65_/ /// //
Has there been any split of this property since October 1, 1988? / A
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO. 1/
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Tiffir /
J *
NATURE OF PROPOSED WORK: ESf:MATED MARKET VALUE OF •
*
Construction of a new building * CONSTRUCTION: $27, dv.
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x ft.
Alteration to a building * Existing Buildings(3) Size ft. x ft.
(no change to exterior dimensions) •
Proposed building - distance from property line:
Other work (Describe) * Front yard ft. Rear yard ft.
•
Side yards ft. and ft.
*
GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft.
1st Floor 9 sq. ft. *
J _ OCCUPANCY INFORMATION
*
2nd Floor // sq. ft. • - Primary Building -
Other Floors /U/1-- sq. ft. " One Family Dwelling
(not cellar or basement) I, Two Family Dwelling
TOTAL FLOOR AREA sq. ft. • Multiple Dwelling%Number of units
Size of new structureft •x ft. * Business
Foundation-pier/slab/crawl/partial/full * industrial
(circle one) ii Other
•
No. of stories (habitable space) I *
Height (grade to ridge) /-3 ft. * If addition, what will use be?
If residential, no. of families / • 4 d i, 5 G - y,, ] i. 1-v ,X i rgc•
No. of rooms(excluding baths) a • Accessory Building
No. of bedrooms 7_ •" _Detached Garage ONE/TWO Car
No. of bathrooms / *
Primary heating system /-/Pr/41 • _Attached Garage ONE/TWO Car
Type of fuel o' / *
Private storage building
No. of fireplaces to be installed /1/ - " Other
Willa wood stove be installed A.,)2, . "
Central Air conditioning yL'/4 "
OV' ER
BUILDING PERMIT APPLICATION CONTENLED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe, etc. j2o-2a/
Will any second-hand or upgraded lumber be used? If so, for what?
Foundation wall material / /Oc„ S Thickness /o
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? yP Heated or unheated? -L ¢ �C� Floor sq. footage sq ft.
Will there be a basement? Will any portion be used as living space? ;,✓�
(If so, what portion? A)l , sq ft. Type of use?
Type of roof - sloped/flat/shed/otherS/,)p,?Alaterial of roof SGr ,.��/es c/y/
Size, wood studs ,,2 "x " spacing Z " o.c. length ft.
Joists (floor beams) 1st floor "x iD" spacing .i fo"o.c. span e-riv 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 �? " o.c. span/2- �-1 ft.
Exterior wall finish` h 90 /a , // ,� �, �( of what material? /,L', /2
Interior wall finish V-, r, ��DG
If a garage is to be attached, describe materials to be used for.FIRE SEPARATION: ,/71
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? -CO hq_Height above roof A)f.0- ft. /,/4
Depth of chimney foundation below grade a09-ft.
Depth of fireplace hearth n/J�_ft./din.
Water supply - Municipal or/private well , A, )
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 7/,,o /jam /L ADDRESS �`9h 26 i D �T 1
1J.v� ,.v s ,. ,�� EL. NO. t7/.�
49 e 4.9Si;ee
NAME OF PLUMBER S.¢rrL ' ADDRESS 7- TEL. NO.
NAME OF MASON rYl - - ADDRESS -sue/2-z e. TEL. NO.
70/-1, rz / �gmbe,- �� p Gl�c7l�
NAME OF ELECTRICIAN ADDRESS �u ze.c�� �, ,,� TEL. NO. a% — - 2-3
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 1I /
Ovtiner, owner's agent, architect, contractor
SPECIAL CONDITIONS OF THE PERMIT:
BY
I
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods: TOWN OF QUEENSBURY
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) RECEIVED
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family DwellingMY 9 1991
Multi-Family Dwellings
(3 Stories or Les�k��. & C®DE DEPT
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
/ i.zez e-.-- � � 1'(, 0�, , e,uA ti,- y A' 'y.
6 0�' c/o A, /Q",46,--z7,r Yr / -c>b ei
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - li'/?t.- Sq. Ft.
2. Type of Heat - '17---- -Efiec. Base Board Other --611- (III-
3. Is Building Mechanically Cooled? YES iNO
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 R3 0 Y='Z'/
B. Exterior Walls R L7
C. Glazed Area R 42.4e2 / 1,1
D. Exterior Doors Rq��e7 2°`�
E. Floors over unheated spaces R_______ ta"1'i
F. Edge of Slab on Grade (Heated Building) R AJ P�
G. Basement/Cellar Walls (Above Grade) R i'b /s TZ-lb
H. Basement/Cellar Walls (Below Grade) R ! -Z-10
I. Heating/Cooling - Ducts - Piping in Unheated Space R bl/ P -91.---
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code - YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140' - WILL NOT BE EXCEEDED
,1.- -- .-, � ��--,- -- --/� /q / �9-3 ' 7
/
APPLICANT'S SIGNATURE DATE TELEPHONE NUMBER
,
INSPECTOR'S REMARKS :
54,,k 0150 -
. , .. ,, .„
V ' 1 :
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED
TEMP.)? DATE %Pi _�: '1 ii
f
CRY OR VII I arE TOWNSHIP COUNTY
STREET AND NO.OR ROAD -
- - - POLE NUMBER 4 J
1 / _-£7
BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION _ BLOCK LOT
/ /
OCCUPANT'S NAME BUILDING OCCUPANCY
OWNER'S NAME AND ADDRESS /,J...2 c:,tr HOME TELEPHONE NUMBER
CURRENT SUPPLIED BY r T FROM THEIR OFFICE WORK TELEPHONE NUMBER .
BUILDING IS
NEW❑ OLD❑ WORK IS NEW❑ ADDITIONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
Loca- NUMBER OF OUTLETS LNo.of
F xturesles MOTORS HEATERS BRANCIRCUITS OFFICEONL USE
tion Side Attach't H.P. Watts A.W.G.
Ceiling wail Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st
FL.
2nd '
FL.
3rd
FL.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE.
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
_ ❑ CONCEALED
DATE WORK TO BE STARTED DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS ►
IDENTIFICATION NUMBER
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 SIGNATURE OF APPLICANT
}/''
fl - f A!1-:J `,)/`ii/Z./ s<� ' .�i...-..nn-. .%,/—r"—'- -
STREET. ADDRESS • TEL PHONE NO.
6 TA!) 1 k,/I'd = /'// j!i'4Li-« / CJ 7 / 3 2 -
CITY OR POST OFFICE ZIP CODE LICEBSE NO.WHEN APPLICABLE
❑ 85 John Street Z41 State Stree( El 570 Delaware Avenue o 217 Lake Avenue ❑ 202 Arterial goad
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 .,
t !(.":"."..A.01,4.".01,"_001!)0401,04.0)."—W4"..A,."."..Wi k".?�i,.�t�, 04.0, 1�?��.?�i,a�t,aii..?�r,atr,?tr1,i..1t1
Ei ji THE NEW YORK BOARD. OF FIRE UNDERWRITE S PAGE 1
�. It0179$=I BUREAU OF.ELECTRICITY
�; 41 STATE STREET,ALBANY,NEW YORK 12207 0=
iz; Date AUGUST 07,1991 Application No.on MO
fil�v� 777�1�01 q
(�� H 412721 0
THIS CERTIFIES THAT
-l.
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
0
1'HENRIETTA PALMER, LUZERNE RD. RD 3, BOX 258, OUEENSBURY, N.Y,
in the following location; II Basement Q 1st Fl. ❑ 2nd Fl. • Section Block . Lot
l; was examined on AUGUST 0 2, 19 91 and found to be in compliance with the requirements of this Board.
1 1
FIXTURE I FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;:
- - ECEPTACLES SWITCHES
OUTLETS INCANDESCENT-FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. •.i'.'
CI 9 16 15 5 . 4 .. 3 F
' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS :
SYSTEMS iAMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. • AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS
i;
ii; SERVICE DISCONNECT� NO.OF S E R - V I C E
: AMT. AMP. TYPE EQUIP 7.t 2W 1,e'3W 3 9"3W 3,B'IW NO.OFF C$COND. OF CC ..&ID. NO.OF HI-LEG Of.NI LEG NO.OF NEUTRALS Op NEUTGRAL
+G ®M
�' OTHER APPARATUS: . ®
1 •
�i
W. PADDLE FAN-1 •� .=
ELEC. ROOM I'IEATERS:1-1 .5 K.W. .
MOTORS:1--1 H.P.
PINELUOARDS:1--1 CIR. 50
G,F,C,I,-7.
j.
�, ?
HENRIETTA PALMER ' - _ _ ` ` LTA
.16 RD 3, BOX 358 -
d' BRANCH MANAGER
; LUZERNE ROAD
g. OUEENSBURV, NY, 12804 `-39
,c; Per
; 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. `I a
NM !I ® o NEW ® ® moo o 0 0 ® mar o maw o a ® o ® o M ® o ® ® o p ME !I II
COPY FOR BUILDING DEPARTMENT. THIS COPY OF ClERTU 9CATE MUST MO WE ALTEItwD H ANY MArahlkk. k
051ad s /2 S—/
TOWN OF QUEENSBURY
531 BAY ROAD
1,bArti QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTORS REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION _
DATE %2//0 /9,' _PERMIT#
TYPE OF STRUCTURE 41,4 d/Va t4,7
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)�
/zFOOTING L.-FOUNDATION BACKFILL 1- rRAMING
vROUGH PLUMBING t/F LNAL ELECTRICAL SEPTIC
z7NSULATION WOODSTOVE/FIREPLACE ic4I
REMARKS ,6,42., ,�, (` (/L
APPROVAL
N/AI YES NO
CHIMNEY HEIGHT/LOCATION v
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING • ,�—
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS ✓
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT �✓
OTHER FLOORS SWEEPABLE /
OTHER FLOORS CARPETED L.---
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING . --
DOOR CLOSERS
OTHER FIRE SEPARATION_
FIRE/DEMISE WALLS
DUMPSTER .✓
SITE PLAN/VARIANCE REQUIREMENTS L.—
FINAL ELECTRICAL \.
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART
INSPECTOR
P-S
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S 1'11. k REPORT
REQUEST FOR INSPECTION RECEIVED /J2/,jO C1 /
NAME qA ) l ` Ya(Il/\
LOCATION ) 2t'id'(\Q-
DATE C[J pOJ9 ( PERMIT I ( / ---a / 4/
TYPE OF STRUCTURE AVi .1'o-,.i 67.-Mi
RECHECK APPROVED V
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 /fi
THE PLACEMENT OF THE/CONCRETE. /
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR! I
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL /'
-AROUGH PLUMBING I
PLUMBING VENT/VENTS IN ,PLA'CE
PLUMBING UNDER SLAB /
FRAMING:
JACK STUDS/HEADERS I \
BRACING/BRIDGING ,?' \
JOIST HANGERS /
JACK POSTS/MAIN BEAM `*
FIRESTOPPING
WALLS R
CEILING
FIREWALLS /
HEATING ROUGH-IN)
INSULATION: /
FOUNDATION WALLS INTERIOR R- `„
FOUNDATION WP/LLS EXTERIOR R-
FLOORS R-
WALLS J R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
I I L Cv c)Obt_\A)A&IZLl9Vt-_S
jc1i (40 V C.- `A-Vt-,.//`i-S
7,7
ARRIVE
DEPART Z u j L , 3 -,
'I PE TOR
TOWN OF QUEENSBURY 11,'L'
BUILDING AND CODES DEPARTME
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED CQ l - I
NAME c4-7\VC A
LOCATION .l} Ze'
DATE PERMIT # "1 l - 7
TYPE OF S RUCTURE DX() GJe L I
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 FOLLOWIN
THE PLACEMENT OF THE CONCRETE/
MATERIALS FOR THIS PURPOSEpf7SITE
FOUNDATION/WALL POUR /
REINFORCEMENT IN PLACE V
FOUNDATION/DAMPROOFING ,t
BACKFILL APPROVAL
ROUGH PLUMBING F
PLUMBING VENT/VENTS IN P,LAC E
PLUMBING UNDER SLAB / �.
FRAMING: /
JACK STUDS/HEADERS /'
BRACING/BRIDGING ./
JOIST HANGERS /
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN i
INSULATION: /
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R •
-
FLOORS R-
WALLS R- `y
CEILING R- 36
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 3
DEPART
SPECT�
JaS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT .
531 BAY ROAD
QUEENSBURY,
NEW 0 4
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION R EIVED (p/i o)
NAME Goy()nA Cc 1 `'�QA I
LOCATION Cc'
�� �C)2 Q. YCLW
DATE te/JO MIT #
J ! � PER
TYPE OF STRUCTUREPiA4-i'r- 4-r) Dt1_3PA
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/DAMPROOFING
BACKFILL APPROVAL !
ROUGH PLUMBING ,4
PLUMBING VENT/VENTS IN ;PLACE
PLUMBING UNDER SLAB
;(FRAMING:
JACK STUDS/HEADERS '
BRACING/BRIDGING '>,
JOIST HANGERS `
JACK POSTS/MAIN BEAM, N
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:
!2 "
idopt zvkze Aad
ARRIVE /`) )�
DEPART L< pp"-,
INSPECTO
TOWN OF QUEENSBURY P-po
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY,
TELEPHONE (518)NEW 0R92-583K 4 2
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED , 1;/-31 9{
NAME C_GY r)rnr GA seA/
LOCATION Co e a- 1)-)-eN \ --k c .rQ\() c
DATE. /' PERMIT # / 7
TYPE OF STRUCTURE Cool i-1-�",M buie41 1 j^()Q,_
RECHECK APPROVED
N/A/ YES NO
FOOTINGS/PIERS •
MONOLITHIC POUR FORM )
REINFORCEMENT IN PLA E s'
THE CONTRACTOR IS RE PONSIBLE I
FOR PROVIDING PROTEC ION FROM ,�
FREEZING FOR 48 HOURS FOLLOWING /
THE PLACEMENT OF THE ONCRETE. /
MATERIALS FOR THIS PURPOSE ON ;SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE \ /
FOUNDATION/DAMPROOFING , / �✓
BACKFILL APPROVAL ; /
ROUGH PLUMBING V
PLUMBING VENT/VENTS IN IMCE
PLUMBING UNDER SLAB \
FRAMING: / \
JACK STUDS/HEADERS/
BRACING/BRIDGING / 1,
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, -
DEPART / " Ciodd'141./
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT �rn�s 6" 2
531 BAY ROAD c
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832 /,/ .P/I1
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEEIVED ->/--7 i/
NAME
LOCATION �az�?,�Q /2s,
DATE AY 9/ PERMIT # l 79'
TYPE OF STRUCTURE //�
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM 9�
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 PLACE,
PLUMBING UNDER SLAB '
FRAMING:
JACK STUDS/HEADERS 1
BRACING/BRIDGING
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 ?,;
f
DEPART � 371 � �'`-�--
I S' VETOR
()awn , 9od) L UZER/CE ROAD
contir/t.
•'�
-_- --
.v�_s�.zo4 ..44 67'- 4/= 3o= W i243.0o'
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