2006-229 TOWN OF QUEENSBURY
woro742 Bay Road,QueensburyNY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20060229 Date Issued: Thursday, July 12, 2007
This is to certify that work requested to be done as shown by Permit Number P20060229
has been completed.
Tax Map Number: 523400-296-012-0001-027-003-0000
Location: 44 WILLOWBROOK Rd
Owner. WILLOWS SENIOR RESIDENCES, LLC
Applicant: WILLOWS ADULT LIVING CENTER - THE COTTAG
This structure may be occupied as a:
Apartments By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the /
//.j.-
property owner of the responsibility for compliance with Site Plan, 4v / .--
Variance, or other issues and conditions as a result of approvals by the Code Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060229 Application Number. A20060229
Tax Map No: 523400-296-012-0001-027-003-0000
Permission is hereby granted to: WILLOWS ADULT LIVING CENTER-THE COTT
For property located at: 44 WILLOWBROOK Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance' Time of Construction Value
Owner Address: WILLOWS SENIOR RESIDENCES, l Apartments $140,000.00
536 BAY Rd Suite 2
QUEENSBURY,NY 12804-0000 Total Value $140,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
SCHERMERHORN RESIDENTIAL HOLD
536 BAY Rd Suite 2
QUEENSBURY,NY 12804-0000
Plans&Specifications
BP 2006-229 Building No. 2, 4 Apartments
Building No. 2 size: 3,940 sq, ft, (one floor only)
Apartment Numbers: 305, 306, 307, 308
Willows Adult Lliving Center-The Cottages
44 Willowbrook Road, Lot 8 Baybrook Professional Park
$551.60 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,May 24,2007
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To b W W e ay 24,2006
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
bLei A/6
OFFICE USE ONLY x ``A I'
TAX MAP NO. PERMIT NO.
P 2:.62on
•FEES: PERMITRECREATIONT4 _ENGINEERING
< (If applicable)
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION.APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER:.-.‹Z-1-/F/PP l .e f OWNER: 1.,10
ADDRESS: ()/A )"XP ADDRESS: Y�/11, '
PHONE NOS. 7 q - 19 PHONE NOS. /9
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: 27/9reeW PHONE:ao h:277:
LOCATION OF PROPERTY: //Ll 1Pt W 7 op )'t2,4i7
>422
SUBDIVISION NAME: / �Cri g 1411 j()a/c Ape/4;r ). /,
PLEASE INDICATE MEASUREMENTS AS REQUIREr
CHECK ALL THAT Z0
APPLY TO YOUR Z 0 c?
PROJECT op O • _
Z Q Q - o Nc 16 °-
SINGLE FAMILY
Pe
TWO-FAMILY ' AD
/T/ MULTI-FAMILY B+ c1 .I
(NO.of UNITS - � IOSr �. �/ `6,'
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
IF COMMERCIAL OR INDUSTRIAL—NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: NA�� FUEL TYPE: �S
HEAT TYPE: 1-74:"P *HOW MANY FIREPLACE(S): 0 AND/OR WOODSTOVES(S): c7
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE?
PROPOSED USE OF BUILDING OR ADDITION: ,r-
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
Town of Queensbury. Community Development D B3'L�L 1'/.0J
eE' • 742 Bay
2804
Road Queensbury,, NY 7
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?
ARE THERE EASEMENTS ON PROPERTY?
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting
complete statement/description of the work proposed, that ala wok will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read o• agree to the above.
Signed
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction
codes or septic systems)
'_oning Administrator: 761-8218 (for questions regarding required permits, the permit process,
pplication requirements or to schedule an appointment)
rmission is hereby granted to the above This application / proposed action described
nlicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
BUILDING & CODES APPROVAL ZONING APPROVAL
DATE DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(aaqueensbuni.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
416 TOUT of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
Z
77I S &-2
Foundation Inspection Report
Office No. (518)761-8256 Date Inspectionle I��- ••ived•
Queensbury Building&Code Enforcement Arrive:'..Z.!!.44 :4Lf, AL Depart: = + . opm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
' /
ERMIT#: q
NAME: r l D
LOCATION: - G c d IN SPECT ON: d�Ze�
TYPE OF STRUCTURE:
Comments
...77 N/A
Footings
Monolithic Slab
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/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
,4 mu iif1 l-off
Foundation Inspection Report
Office No. (518)761-8256 Date Inspectio ,equest r •d: �!
Queensbury Building&Code Enforcement Arrive: 7,V)p . ��� b epart:aqsa pm
742 Bay Rd., Queensbury,NY 12804 Inspector's
NAME: CGJ S . P'RMIT#: (2 -- 2<2
r
LOCATION: . i /D c.J S A � i) i SPECT ON: G
TYPE OF STRUCTURE: ;7
Comments
Y N N/A
Footings E bT
Piers
Monoli �' QPAITCCk-- �' � k)3R.A.\
Reinforcement ia Place '' '�
The contractor is re I;siore for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
tk)E2S0#06sbAl
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection r-' .t r: eiv-d• --, Ir
Queensbury Building&Code Enforcement Arrive: " •P. f.m Depart:
742 Bay Rd.,Queensbury,NY 12804 Inspector's Ini. :•:
NAME: f c RMIT#: 06-227.
LOCATION: i F�11 rot is INSPECT ON: 7- 6-- 04
TYPE OF STRUCTURE:
Comments
i
Y N N/A
Footings
Piers
Monolithic Slab Elk5 j oo
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/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 milpoly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\1nspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
/0 12 Fg ) 1)A .
Foundation Inspection Report
Office No. (518) 761-8256 Date Ins p tion r . '-st r: :
Queensbury Building&Code Enforcement Arrive: 1 Depart: m
742 Bay Rd.,Queensbury,NY 12804 Inspector's mit a s• .
NAME: IN ► 1 o G�7S ` . ' 1 T#: (3‘' 2
LOCATION: iJ; ,tow )nWcz4 i SPECT ON: •MMV
TYPE OF STRUCTURE:
Comments
Y N N/A
gs
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Mater._ or •se on site.
Founda i.on/Wallpour
Reinforcement in . ace
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forrns\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
/-3 . 71)-E5o/tyy 9-/cf ,
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection reques - 3, ed:
Queensbury Building&Code Enforcement Arrive:1-bI4Q am/t' Depart: a"".�,.lr
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: Oi j/Q/"..)GS PE' . IT#: a — � .
LOCATION: 1.J /Ing► brook _ IN 'ECT ON: -/ 9.- OO
TYPE OF STRUCTURE:
-
Z ` Comments
‘DIJ___
Y N N/A
Footings
Piers
Monolithic Slab
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/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
0/Footing Drain Stone:
12 inch width
6 inches above footing
6 '. •oly for wet areas under slab
Backfill A.proval `(J
• m•ing Under Slab
PVC Copper
---------
_�
{/ 4 F. .•ation Insu`la��In .. /Exterior /
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No. (518)761-8256 Date Ins.•ction r-• .-st - - -d: ? c
Queensbury Building&Code Enforcement Arrive: ►% ri Depart: ti •,
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initi.r :
NAME: V 1 ,ERMIT#: 06—
LOCATION: /-t-Ly (fp7_i�,�rol� INSPECT ON: �// / C,
TYPE OF STRUCTURE: ( /
Comments
Y , N N/A
Footings
E- w_9 V/
Piers
Monolithic Slab
Reinforcement in P ce
a contractor responsible for
o .'i- ppv id'. .tection from freezing
l for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No. (518)761-8256 Date Ins ection req . c d: l I Ja
Queensbury Building&Code Enforcement Arrive: }. l Depa . 'l. raj"
742 Bay Rd.,Queensbury,NY 12804 Inspector s Initia:.
NAME: t (TL) > UI—!-'-df P RMIT#: QVJ -D-c)-
LOCATION: ', n, t � I SPECT ON: ()
TYPE OF STRUCTURE:
,2-
comments
Y N N/A
Footings
Piers
Monolithic Slab
ippit'-/' forcement in I:'lace
The contractor is responsible for
providing protection from I. ezing
1r) for 48 hours followin: 4 e placement
of the concre
• . • '. or this purpose on site.
Foundation/Wallpour
‘\////
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
FouRnd `nsula0 tio Int • /Exteri
Rough Grade 6 ' drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
/0 AAx /o/ / . ,
Foundation Inspection Report
Office No. (518)761-8256 Date Ins ction •••uest r• -..
Queensbury Building&Code Enforcement Arrive: i. ,. ..' Depart: 9 '42m
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initi. s:
NAME: U //o�S . r l/o! 2 . ' I T#: 06 `G 7
.
LOCATION: - Or.// ^o&T INSPECT ON: tD —
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers
Monolithic Slab
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/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill A royal
bi Under Slab
(//// EDT oV,R11
PV CastCopper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
s -/ /Z)6 7
O , // /7/06
.
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection r-. est ec=' _,i:
Queensbury Building&Code Enforcement Arrive: Cl",. yj.. /p ' Depart: 3j::&. )_,1 :it?, 1
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initi. :. . I
NAME: tJI At--)3 XRflT#: ni, � ['��
LOCATION: 4.)i// Ls fo1ac ;k /j J INSPECT ON: \\---1—C)(.0
TYPE OF STRUCTURE:
r 1 Comments
Y N N/A
97
Footings
' _... \
eiMonolithic Slab
. : • - - 'lace J
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/Wallpour
Reinforcement in Place
7
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofmg
-Footing Drain Daylight or Sump
Footing Drain Stone:
012 inch width
6 in 1. % .• - footing
2 6 mil pol for wet areas under slab
Backfill Approva
Plumbing Under Slab
PV /Cast/Copper _
o
undation Insulatio terio Exterior / ,
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
/ —.3ri/2/67-
•
Framing/ Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection req i Te,eiv-0.
Queensbury Building&Code Enforcement Arrive: '7, ai p Si : y e P• : am/ n1
742 Bay Road,Queensbury,NY 12804 Inspector's Init : .
. 7.)
NAME: '
1 lD0 S 6/ PERMIT#:
a(67:::z77
LOCATION: • i-G INSPECT ON: ' — 7 --
TYPE OF STRUCTURE: ;,- J (4-,
Y N N/A COMMENTS
Framing
Attic Access 22"x 30"minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls }
Metal Strapping for Notches Top Plate
1 '/2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
ft. or less on center f
(__.61301,
Ice and waters eld 24 inches from wall V
}ire separation 1, 2,3 hour
Fire wall 2,3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
� mo1 jz VO 7
Framing/ Firestopping Inspection Re ort
Office No. (518) 761-8256 Date Inspection re• ,eived
Queensbury Building&Code Enforcement Arrive: t4D .y,! / •.rt: `I ;pOapm
742 Bay Road,Queensbury,NY 12804 Inspector's Initia '/
NAME: r 1 LJS PERMIT#: (O( 22— .�
LOCATION: W 2_ . INSPECT ON: —l -6 7
TYPE OF STRUCTURE:
0
7 ‘ \Ft
Y N N/A COMMENTS
Framing
Attic A ss 22"x 30"minimum J
7
Jack Studs/Headers
Bracing/Bridging N) kkA —
Joist hangers �
Jack Posts/Main Beams t"'G D �����
Exterior sheeting nailed properly � f
12"O.C. eit
Headroom 6 ft. 8 in.
Stairwells 36 in.or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
/
Metal Strapping for Notches Top Plate
1 %2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. �or trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
0f,70ire separation 1,2,3 hour
Fire wall 2, 3,4 hour I
iresto in /
ene ation sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side %2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in.(W)
5.7 sf above/below grade
5.0 sfrade
2- - 4 AI 4
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection reque iv-d:
Queensbury Building & Code Enforcement Arrive: 2.1-14-0I � •art: ? -i( am
742 Bay Road, Queensbury, NY 12804 Inspectors Initia
NAME: LI; //Obi j PER � #: � `�
LOCATION: adv -�#-�- INS' ON: gr
TYPE OF STRUCTURE:
• Y N N/A
Rough Plumbing, ail Plates
Plumbing Ver • - - ' - .ce
2 minimum Drain Size
Washing Machine Drain 2 inch minimum 'R\ ``Ik' 1°
Cleanout every 100 feet / change of direction f LE}j F�Pressure Test rzAkv . ,
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head
50 P.S.I for 15 minutes
Insulation / Residential Check / Commercial Check
Proper Vent, Attic Vent
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS:
LAPam Whiting\Building&Codes\Inspection Forms\Rough Numbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
2__-4'
, 4,130/0?--
Rough Plumbing / Ins la ion I spection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: '0'5 am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials P(--
NAME: /J.iiii9c‘.1-Th PERMIT #: 16��2cLOCATION: / .2 Ai,' J/ at INSPECT ON:
TYPE OF STRUCTU'
N N/A
Rough Plumbing / Nail Plates �/ �P��vkGC,e CSD i f5 Y�
Vent Vents in Pla r - - • f <<�✓z 0,ile
Plumbing / �, �C
1 1/2 inch minimum Drain Size AN / ,A,, 04i 4144.4-
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction
Pressure Test
Drain / Vent
Air / Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air H-ad
--1-1-. . for 1 minutes
Insulation / ' - idential Check / Commercial Check ' UA L' lC(
'roe- - , Attic Vent ✓/ CC--- k-Zo 38
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape ,
/ /4,0h ix)a, — -'-it,th - /Wilde/44(- -1--- 1%/0414,,,I A
COMMENTS:
L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
Inspection for Permit to Occupy
Fire Marshal's Office Request Recd Permit No. 4‘) -2-2_9
Town of Queensbury
742 Bay Road 7J '7, ��
Queensbury,NY 12804 Scheduled Inspection Date: Vah T Time: L
Phone: (518) 761-8206 Business Name: 1 - t4 '5 .f r/d ,?--•
Fax: (518) 745-4437 Location: '94" 2i> A 4.
Type of Inspection N/A Yes No
EXITS:
Exit Access COMMENTS
Exit Enclosure
Exit Discharge
EVAC Plan
AISLES: 3°4e
Main Aisle Width ›+ A/c'
Secondary Aisle Width
EXIT SIGNAGE
Sign-normal -44.--
Slgn-battery k
EVAC signs in rooms
TRUSS ID SIGNAGE
EMERGENCY LIGHTING . C--- ��//
FIRE EXTINGUISHER:
Hung .'
Inspection of extinguisher
Hydro extinguisher
FIRE ALARM SYSTEM
Fan Shutdown
IN-
Fire Sprinkler System "'"&-
Fire Suppression-kitchen X
Fire Suppression-Gas Island X
Hood Installation , -
Interior Finishes
Storage
Compressed Gas -k-
Clearance to Sprinklers X
Clearance to Electrical x
Electric Wiring Enclosed X
Combustible Waste --1-
Vehicle Impact Protection A
Fire Lane
F.D.Signage-Utility Rooms Sr .
No Smoking Signs A,
Maximum Occupancy Sign '('
Emergency Evacuation Plan -a
Approved (If no other approvals apply,the B&C Office will issue the Certifi rate of Occupancy)
❑ Denied
o Call for Recheck
Inspect: d By: ��
L:\FireMarshal\insptopermitto occupyform.doc
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No (518)761-8256J Arrive: ..2(67-1am/pm Depart: am/pm
Date Inspection request received: //�" �� Inspector's Initials:
NAME: L�M `I W A. PERMIT#: 0(a '
LOCATION: i— Lift k(OLL) ! COV, ( lac, 4 Z DATE: MtvI
TYPE OF STRUCTURE:
Comments
"'No N/A
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location /
Fresh Air Intake ,J/
3 inch Plumbing Vent through roof minimum 6 inches ✓/
Roof Complete/Exterior Finish Complete
Platform at all exterior doors ✓
Guards at stairs, decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more /
Guard at deck,porches 36 inches or more i//
Handrail Termination at Newell Post or Wall „//
Interior/Exterior Railings 34 inches to 38 inches i//
Interior Handrails @ stairs 2 or more risers ,/
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade f
Interior privacy/trim/doors/main entrance 36 inches ✓/
Bathroom/Kitchen watertight ✓
Safety glazing/Window in stairwells safety glazing
Interior Smoke D)ectors:
Every level: V Every Beyom:
Outside every bedroortyrea: c/ /
Inter Connected: V Battery backup: ✓ /'
Carbon Monoxide Detector ,!�
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area /
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq. ft. vents
Bathroom Fans, if no window
Plumbing fixtures ✓ /
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sq.ft. Vz
Emergency egress below grade / •7Gas Furnace shut-off within 30 feet or within line of site ✓ /
Oil Furnace shut-off at entrance to furnace area / �/
Futnace/Hot Water Heater operating ✓ /
Low water shut-off boiler s�
Relief Valve(s)installed/Heat Trap/Water Temp 110 �/ /
Enclosed Stairs Sheetrock Underside minimum%I"Gypsum _ ,//
Basement stairs closed rise>4 inches °
Garage Floor Pitched /
Gara:e fire.roofin_/'/4 hour fire door/door closer
V /./
Duct work Sealed properly '
Gas Logs in Sealed or Glass Enclosure
:,- ✓Final Electrical ✓
Final Survey Plot Plan ✓f
As Built Septic System/Sewer Dept. Inspection Sticker ✓ /
Site Plan /Variance required =J/
Flood Plain Certific ' , r uired f ,!
Okay to issue C/ or C/O emporary/ ermanent ✓
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc
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ZONE - PROFESSIONAL OFFICE QUEENSBURY UNIC
MIN. LOT SIZE - 20,000 SQ. FT. SCHOOL DISTRIX
RON ROD MARKERS TO BE SET AT MIN. LOT WIDTH - 80 FT.
;ORNER CR CHANGE OF DIRECTION. MAX. HEIGHT OF BUILDING 40 FT. and
SETBACK REQUIREMENTS THE QUEENSBURYLOT GRADING SHALL CONFORM TO FRONT - 50 FT. FIRE PROTECTION I
83-25 OF THE SUBDIVISION SIDE 20FT•
1S OF THE TOWN OF QUEENSBURY REAR - 20,FT.
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TATER DEPARTMENT APPROVAL BIG
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