1991-776 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSORY
WARREN COUNTY, NEW YORK
Date 77fait/id 19
This is to certify that work requested to be done as shown by Permit No. Q1-776
has been completed.
This structure may be occupied as a Sinele Family
Location West Mountain Road
• Owner Phvlicq Alaffrpu ft, Is7,4 CR.,3a2,
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
,zffessfm,
BUILDING PERMIT -�
TOWN OF QUEENSBURY
No. 91-776
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Jeffrey & Lori Guay
OWNER of property located at West Mountain Road Street, Road or Ave.
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in the Town of Queensbury,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
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is
Phyliss Holtz
Lake George Road, Lake George NY
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2. CONTRACTOR or BUILDER'S Name
Tim Chase -n
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name —h
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5. ARCHITECT'S Address 0
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6. TYPE of Construction- (Please indicate by X)
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(X)Wood Frame ( ) Masonry ( I Steel ( ) c+
7. PLANS and Specifications
No. 1484 sq ft Single Family Dwelling as per plot plan specifications
and application
to
8. Proposed Use
Single family Dwelling m
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$ 199.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 16, 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.) to
Dated at the Town of Queensbury this 16th Day of December 19 91
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SIGNED BY 1 E��Ze; i.'✓ for the Town of Queensbury
Building and Zoijing Inspector
TOWN OF QUEENSBURY
`� REVIEWED BY: d„,„� / ` ,, gaaauuu
FEE PAID: r , / RECEIVED
PERMIT NO. : DEC
r%C. & CODE DEPT.
-Q 1/e-e-11 4_ rf a1ucui BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINEDAEFORE 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: _ P4 ks
s l4
P.O. Address: /j 4 c-trr z1 P %x i ar_ (T�va+-r Alt/ PHONE 773 k�'3
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Property Location: tu-/ , 13'/. (ci Tax Map No. 7'/ / / /&7' .J-
Has there been any split of this property since October 1, 1988? Yes No /lid
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Lot No.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
7 !'t'/l (áL7 _
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
7C, Construction of new building * CONSTRUCTION: $ all MTV .0)
Addition to building *
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: /01 ft. x 2 c,. ft.
Other work (describe) * Existing. Building Size:
* ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: -I * property line:
*
1st Floor `7,)--.Fe Sq. Ft. � * Front Yard 52) ft. Rear yard /2 y ft.
Side Yards a/ ft. and �O ft.
2nd Floor 7S:6 Sq. Ft. 0.9 * If on corner, setback from side street
Other Floors ‹,
Sq. Ft. O * ft.
(not cellar or basement) y \ OCCUPANCY INFORMATION:
TOTAL FLOOR AREA: ¢ Sq. Ft. A,04 `* Primary Building -
, g
x One Family Dwelling
Size of New Structure: 1 ( ft. x C, ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units
Pier/Slab/Crawl/Partial/ j (Circle One) * Business
* Industrial
No. of stories (Habitable space) 2. * Other
Height (grade to ridge) 2 ft. *
If residential , no. of families: / * If addition, what will use be?
No. of rooms (excluding baths) : ,5-
No. of bedrooms: 3 * .
No. of bathrooms: ! // . * Accessory Building:
Primary heating system: /4./- / (/z, * Detached Garage - One/Two Car
Type of fuel : /;`,yam * _ Attached Garage - Onrt wo
No. of fireplaces to be installed: /Jo ti c- * Private Storage Building
Will a woodstove be installed?: /U t- * Other
Central Air Conditioning: Yes No .x *
(OVER)
VI
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. tUcrbo � -r
Will any second-hand or ungraded lumber be used? If so, for what? /v ci) C
Foundation Wall Material : CO7u-e 2 &-- Thickness: /4
Depth of Foundation below grade (to bottom of footing) : 7
Will there be a cellar? Y e5 Heated or Unheated? NO Floor Sq. Footage: 7? '
Will there be a basement? - Will any portion be used as living space? ()
If so, what portion? Tvi Sq. Ft. Type of Use? 109--
Type of Roof: Sloped/Flat/Shed/Other S 4)-no Material of Roof LU oo.j r( 43p4q-4i-
Size, wood studs ? "- x (., " ; spacing /5 " o.c. ; length e ft.
Joists (floor beams) : 1st Floor off— " x /0 "-; spacing J " o.c. ; span /3 ft.
Joists (floor beams) : 2nd Floor L " x ,"6 "; spacing /' " o.c. ; span /3 ft.
Overlays (ceiling beams) : 2 " x " ; spacing I G " o.c. ; span /3 ft.
Roof rafters: a " x 0 " ; spacing ektifi o.c. ; span J' ft.
Roof trusses (pre-engineered) : spacing 2.r " o.c. ; span ,z ft.
Exterior Wall Finish: / �o r0 • of what material ? S,pQ-(c c° (-
Interior Wall Finish: Slcacr
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
S�ssm SAcen/r
Is there to be an opening between garage and dwelling? ffr.S If so, will a Fire-Rated door,
enclosure, self-closing device be provided? V
Will a flue-lined chimney be installed? Aid Height above roof ft.
Depth of chimney foundation below grade: A09 ft.
Depth of fireplace hearth: At/e- ft. V//)_ in.
Water supply - Municipal or private well : ,,4/1,-rr ,,,n./
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: it/d/oe:ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: Tr PHONE 7 3—.23//
NAME OF PLUMBER & ADDRESS: 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 i authori by the owner.
Signature
• Own r, owner s agent, architect
contractor
SPECIAL CONDITIONS OF THE PERMIT: ' -
By:
Code Enforcement Officer
1
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
" OF OUEEN�U,
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY) .ECER/ED
PART 6 - Thermal Rating - Component. Trade Offs - 1 & 2 Family Dwellings; Jr
Multi-Family Dwellings `�.0 ' 3 799�
(3 Stories or Less)
& CODE DEPT
PART 4 - Design By Component Performance - Commercial Buildings Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
(1/41 ,\46\--r-, oLci-4'13 c-c-f )(
APPLICANT'S NAME ( PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - f 45 �f DPP Sq. Ft.
I P, a
2. Type of Heat - Elec. Base Board Other .•L_ ' ..
3. Is Building Mechanically Cooled? YES V/ NO
4. Percentage of Area of Windows and Doors Over 17% V/ 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 - D
B. Exterior Walls R��,`9 ta- (8
C. Glazed Area R-3,O3 2--0
D. Exterior Doors R - W I Z 'Zr 2 'S
E. Floors over unheated spaces R - Tz-1 /
F. Edge of Slab on Grade (Heated Building) R RiA u- to
G. Basement/Cellar Walls (Above Grade) R i -fc7=-)
H. Basement/Cellar Walls (Below Grade) R 'A -!O
I. Heating/Cooling - Ducts -tPiping in Unheated Space R N/A
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code !�YES NO
EMPERATURE.CONTROL MAXIMUIM SETTING 140• - WILL NOT BE EXCEEDED
A LIC DATE rELEPHON NUMBER
INSPECTOR'S REMARKS:
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1067,1
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
?, tt
Date: J — I -G( 1 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: . (p)ec ri/A4 (24
Owner's Name: T5 cS U.kw,1
Owner' s Mailing Address: �� ALA . QuLtt ,.b\,,ri
Installer' s Name: ---at AD bYru Phone.#:
Number of bedrooms (if residential ).: 3.
Total daily flow (residential-compute @ 150 gal . per bedroom): 4.50 cr !
Topography-Circle One: Flat Roll 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: Munic Well Other
If domestic water supply is a -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 100C, gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s): Number of %�' / Size each: 1b ft. x b ft.
5\
Size of Stone to be used: # 3 / rt-q- a.r Thickness ) feet
**************
HOLDING TANK SYSTEM IF REQUIRED
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 Town of Queensbury Sanitary Sewage Disposal
Ordinance.SIGNATURE OF RESPONSIBLE PERSON: Lj8JY
DATE: 3`4(:)+(1 a
7
'44
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, tile 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:
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RECEIVED •
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�. ��: MAR 2 5 1992
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BLDG.•.8, CODE DEPT
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YOU ARE HEREBY REQUESTED TO -
INSPECT AND•ISSUE CERTIFICATES
• FOR THE FOLLOWING ELECTRICAL
EQUIPMENT, TO BE INSTALLED BY
THE UNDERSIGNED
TEMP.N DATE 1,tf )
/ f rr
f
CITY
OR VILLAGE 1 TOWNSHIP ' - COUNTY
f
STREET AND NO.OR ROAD' - / POLE NUMBER
O .--'r O-1,_ , , .)„I K , ,
BETWEEN WHAT TWO CROSS STREETS IS PR l
ISES LOCKED' SECTION BLOCK . LOT
f . ., F - - -4 0.4 -) i ( ., X :=i,,.r
OCCUPANTS NAME 1 BUILDING OCCUPANCY •
_1,VI[CI i , , r 1ii).1 ")am 1 I S /I' 1
OWNER'S NAME ANb ADDRESS / _ HOME TELEPHONE NUMBER
�'/i !! '7 .. 7 I I
I,
CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHO NUMBER
It vi,: iss \.,- i C. , i
BUILDING IS '-v _ V I—I
NEW-2OLD❑ WORK IS NEW VJ ADDmONAL❑ DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each NOV 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 /6 -3 FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
.m,f/) F1T.%)1) /1 l "' / / ? •
CHARACTER OF WORK ❑ EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
CONCEALED
DATE WORK TO BE STARTED DATE COMPI.E I EU SIZE OF SIGN(NUMBER) CAPACITY
/
SERVICE ENTERS BUILDING / • • MANUFACTURER OF SIGN
.2_OVERHEAD ❑ UNDERGROUND
DATE INSPECTION REQUESTED O (OR AS NEAR AS POSSIBLE) MUST DENT ENTER APPLICANT NUMBERS
•
AVOID DELAYS'By
AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS I ( )1,1 (\ 11 i. c— P.L1 t� n'�( �/) f ! 1 I(r//
NAME OF APPLICANT +/, -" DATE OF APPLICATION IGNAT.URE OF/APPLICAkI' �'
STREET ADDRESS . - TELEPHONET170.
CITY OR POST OFFICE CC 'ZIP CODE UCENSENO.WHEN�APPLICABLE
r_._f-,-:, :f,ti I) I! ‘ 7 / /0 I
0 85 John Street ( 0 41 State Street . 0 570 Delaware Avenue 0 217 Lake Avenue LI 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
TOWN OF QUEENSBURY C,_
531 BAY ROAD
�
QUEENSBURY, NEW YORK 1 804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION
n RECEIVED
NAME �,es," ' ,D �; 4/7
LOCATION 0th-- /7_71X, /
DATE , V,?* PERMIT#
TYPE OF STRUCTURE ,..-57,47J
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
XFOOTING _FOUNDATION sBACKFILL FRAMING
ROUGH PLUMBING )(FINAL ELECTRICAL ASEPTIC
71kINSULATION WOODSTOVE/FIREPLACE
REMARKS J
F/ APPROV L
N/A YES NO
CHIMNEY HEIGHT/LOCAT�ON `� (((///
B VENT/LOCATION o c //
PLUMBING VENT //
ROOFING ', / ,/
SIDING /
/
DECK/PORCH/STEPS/RAIL\ING,S
RELIEF VALVES 4 / f
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/DU"CTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: /
BATH/KITCHEN WATE TIGHT ✓
OTHER FLOORS SWOPABLE\ J
OTHER FLOORS CARPETED \ �/f _
STAIR CLEARANCE/,RAILINGS \
HANDICAPPED ACCESS /
SMOKE DETECTORS/ ',, t/
BATHROOM FANS/,WId W.Q NS. ✓f
ALL PLUMBING IXTURES OPERATING �/
GARAGE FIRE PROOFING
DOOR CLOSERS/
OTHER FIRE EPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS / _
FINAL ELECTRICAL !/
OK TO ISSUE\C/_O. OR C/C
COMMENTS:
`7//14:14' 3//0
ARRIVE /
DEPART /1 d
SPEC TOR
?own o Queeniur2
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC
DISPOSAL�` SYSTEM INSPECTION
"NAME ( �LGI LP J
LOCAT ION.��i �i' ¢yam. 4-e
DATE 4420 /f'a PERMIT NO. !�77 .
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'_
SEEPAGE PITS{Number of)
Size- 6 ft. X /l) ft.
Gravel size , 143
PIPING: Size,J Type
Bldg. to tank (fe
Tank to dist. box si
Dist. box to field/1 it /Sl" 4/Q
Openings sealed? YES p NO Partial
LOCATION/SEPARATIONS X
Foundation to tank {t !` ft.
Foundation to absorption ft.
Absorption to lot line
Separation of pit.' ft.
LOCATION OF SYST u. ON PROPERTY(circle one)
Front - Rear - %, Right side .-
COMMENTS:
z
•
•
•
•
•
SYSTEM USE APPROVE40 NO
• Bu' ing Ins ctor
01/86 and .vl
ELECTRICAL INSPECTIONS
DUPLICATE�y MUNICIPAL RECORD
Permit No. 9j�77.
Owner 77 L...(Y
Occupant /� �// ,/ ,�
Location f/,tea• !'r. �1AT M/✓4" /C17
K.4 -9 7Gf/Z Street
Town or City State -
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
' Installed by iI 6 '( �j
N .. 9‘6
Date 3 Jr spector
MIDDLE DEPARTMENT INSPECTION AGENCY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
/ /� ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
CJ I/7 Z WIRING &CONTROLS FOR 6/75 BURNER
S 6RECEPTACLESS TL H.P.PUMP F FIXTURES K.W.OVEN
�O 6J1MP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
�nAMP.SERVICE CONDUCTORS / K.W.DISHWASHER
K.W.SURFACE UNIT / K.W. DRYER
K.W. RANGE AMP. RECEPTACLE
.may
/ K.W.WATER HEATER / FRAC. H.P.VENT FANS
MOTORS M.P. 1/20 1/12 1/10 % 1 % % �/ 1 11/2 2 3 5 71' 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT C
`n
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /(irk z74?
NAME 0,e d em 0J ),
LOCATION "lei. 7x/1,
DATE /V./7/ I'� PERMIT # ql-`7 7(,
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\SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING ,;
BACKFILL APPROVAL
`/ROUGH PLUM .LNG , s
/'PLUMBINGCI{E LTA/VENTS IN PLACE I
PLUMBING UNDER SLAB_
FRAMING: ✓ _
JACK STUDS/HEADERS +�
BRACING/BRIDGING_ ,+ •
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN r
)(INSULATION:
i FOUNDATION WALLS INTERIOR R- //
FOUNDATION WALLS EXTERIOR R •
-
FLOORS / R-30 ✓.
WALLS 1 R-
CEILING I R- 3��
DUCT WORK OR PIPING/IN UNHEATED
SPACES
REMARKS: !+
11
r
ARRIVE
DEPART
NSPECTOR
TOWN OF QUEENSBURY �
BUILDING AND CODES DEPARTMENT f
531 BAY ROAD QUEENSBURY9 NEW YORK 12804 Z-0414-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR_ INSPECTIO4 RECEIVED •
NAME 8 1 / 'SDV
LOCATION! c5b i\
DATE PERMIT if I - / 71.E
TYPE OF STRUCT RE
RECHECK APPROVED;
)(FOOTINGS/PIERS
N/A YES,440
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 i
FOUNDATION/DAMPROOFING 1
BACKFILL APPROVAL f
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING: 4
JACK STUDS/HEADERS A' II
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAI . EAM
FIRESTOPPING
WALLS
CEILIN
FIREWA, S
HEATING ROUGH-IN //
INSULATION: I'
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE
DEPART
INSPECTOR
022
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 RECEIVED 1/��`7 -
NAME /40 I- 7-1 a1 L)/ 'S
LOCATION (1 D c.1- 71) UN)
DATE �ji j� PERMIT # /- 72 (()
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 FOLLOIING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE CN SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING \/ ,-
)FBACKFILL APPROVAL (
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLAC '-
PLUMBING UNDER SLAB_ ,�
FRAMING: I
JACK STUDS/HEADERS ,J
BRACING/BRIDGING_ I
JOIST HANGERS I
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION: I
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS
WALLS " R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE )• 61
DEPART 023- 7
INSPECTOR
/4,(0 /74 4
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� /REECCEIVED
NAME j���`�1 �` //`-
j>�-G /W 4
LOCATION /��,,
DATE /2 3%/i/ PERMIT # W 776
TYPE OF STRUCTURE
RECJIECK APPROVED
1 N/A Y7 NO
VFOOTINGS/PIERS •
MONOLITHIC POUR FORM ✓
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROT CT'ON FROM
FREEZING FOR 48 HO ' , FOLLOWING
THE PLACEMENT OF TH!. CONCRETE.
MATERIALS FOR THIS RPOSE ON SITE
FOUNDATION/WALL POU
REINFORCEMENT IN P / C
FOUNDATION/DAMPROO ING
BACKFILL APPROVAL
ROUGH PLUMBING 1
PLUMBING VENT/VENTS INPLACE
PLUMBING UNDER S AB_
FRAMING:
JACK STUDS/HE DERS
BRACING/BRIDG NG_
JOIST HANGER
JACK POSTS/ ' IN 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:
•
55
ARRIVE /e7
DEPART /// !� 01/
____
INSPECT
/I ti-K s
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 RECEIVED 1 7 1Y'
NAME H 0 L- Z_
LOCATION L )€S C 1MA-- (cL
DATE , l (p PERMIT # 9 1 1/4-11
TYPE OF STRUCTURE S 1�
RECHECK j" APPROVED
4 , ? „ N/A YES ` NO
OTINGS/PIERS • �/a 7 , V
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPO SIBLE� •
FOR PROVIDING PROTECTION FROj1
FREEZING FOR 48 HOURS F)LLi ING
THE PLACEMENT OF THE COV'.' TE. ;
' MATERIALS FOR THIS PURP- E ON SITE V
FOUNDATION/WALL POUR
REINFORCEMENT IN P ' E
FOUNDATION/DAMPRII -ING
BACKFILL APPRO = / .
ROUGH PLUMBI /
PLUMBING V /VENTS IN PLACE
PLUMBING DER SLAB /
FRAMING • /
JACI STUDS/HEADERS /
BRACING/BRIDGING I
JOIST HANGERS
JACK POSTS/MAIN BEA .
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:
•
JtAA
t
ARRIVE ; '. 4 ill
DEPART I ;/y;' i ;
v `J J'INSPECTOR
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