2010-502 u
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20100502 Date Issued: Tuesday, November 15, 2011
This is to certify that work requested to be done as shown by Permit Number P20100502
has been completed.
Location: 11 MEADOWBROOK Rd
Tax Map Number: 523400-303-005-0001-004-000-0000
Owner: BRADLEY COLLETT
Applicant: SUSAN WRIGHT
This structure may be occupied as a:
Fireplace By Order of Town Board
Garage Attached TOWN OF QUEENSBURY
Single Family Dwelling
Issuance of this Certificate of Occupancy DOES NOT relieve the _..
property owner of the responsibility for compliance with Site Plan, p=4 '4
Variance,or other issues and conditions as a result of approvals by the
ti Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
Ali
` TOWN OF QUEENSBURY
F.4tha
erS 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100502 Application Number. A20100502
Tax Map No: 523400-303-005-0001-004-000-0000
Permission is hereby granted to: SUSAN WRIGHT
For property located at: MEADOWBROOK 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. Type of Construction Value
Owner Address: BRADLEY COLLETT
23 MAPLE Dr Fireplace
QUEENSBURY,NY 12804-0000 Garage Attached
Single Family Dwelling $105,000.00
Total Value $105,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2010-502
1320 sq ft single family dwelling&620 sq ft garage with 1 fireplace
$220.40 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,November 10,2011
(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 T wn o een ur / M ' esday,November 10,2010
r.\
SIGNED BY ° for the Town of Queensbury.
Director of Building&Code Enforcement
3035 , ! _ 3 OFFICE USE ONLY T i--1 -{ �''-0-V-E
TAX MAP NO. ;3.S -( - (0- 1
Pin�v�'�\� PERMIT NO. jij
FEES: PERMIT vCD,�4 RECREATION ENGINEERING :
(If applicable) ;
OWN utEE IVSBUR
'L` BU•ILf3114&&-COD•gS"
..... .-...
treilecA ,9-
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:5V 'c?d+ k / F // $ OWNER: Xk l� //e72-i'
ADDRESS: I C
A DV 1c e Gf ADDRESS:23�f9 ? /0 geevi
PHONE NOS. 6-7 T --3 657- `Y 9,5— PHONE NOS. ` i'� ,s//91/4.5--
CONTACT PERSON FOR BUILDING &CODES COMPLIANCEAC( 6!` PHONE: 3 g..5.---/5'9-5-
LOCATION OF PROPERTY:, '` 1 -r,..._ 3 -/-
17
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? 0 /NO /
. .ier' .-
YES �, NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z
APPLY TO YOUR z 0 cc o Ci W ♦—
PROJECT 0 ¢ O co
o rz l W � � � � w 0 = =
U
Z a Q � � N ° OOL~L. 0O I- Q- WZ
I— tL 0- = oti
SINGLE FAMILYI I OS - /4- ,
111 �Am
TWO-FAMILY /' 3.;-0 sgEE
MULTI-FAMILY `
(NO. of UNITS )
\ 'ii ' ' LI
III
TOWNHOUSE (V 0, 4 l
-"or r
:: S0E
ESFFIC >
L- � � ' !z
MERCANTILEIIP
FACTO ►- .'IND IAL , j
or
' ATTACHE, ( �1 _
(1,2,3) ` Q
/ 1. ! 4.,,4/"• 010 r. it PIA
OTHER ` �i?
IF COMMERCIAL OR INDUSTRIAL- NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: /Q4®cQ, U FUEL TYPE: /V �6 1 6 -
/ // / n.
B 3-LOL 1145'
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? A"
ARE THERE EASEMENTS ON PROPERTY? PIO
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work 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 and agree to the above.
Signed '
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction
codes or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Permission is hereby granted to the above This application / proposed action described
Applicant 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
codesCa queensburv.net
Office Use Only
VISIT OUR WEBSITE FOR MORE INFORMATION
irk ,', /6,/, C tG-.5v )--
•-•‘-)._ S ,,/,/,‘ � _
1.
Tp u�. ,' , ..I
Bth! ;ems .ODES' . . . -
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building&Codes Office for the issuance of a Building & Use Permit
pursuant to the New York State Fire Prevention & Building Code. The applicant or owner agrees to comply
with all applicable laws, ordinances,regulations, and all conditions that are part of these requirements anc
also will allow all inspectors to enter premises to perform required inspections.
IMPORTANT NOTE TO APPLICANT: ROUGH-IN AND FINAL INSPECTIONS ARE REQUIRED.Jt C
OWNER: eradley l_C//L at t- INSTALLER/BUILDER: ,4'k 4J_ Z.65 (5;100,4 ch4
ADDRESS: 02-3kt /e
�PgLf Z.'C/tS)k✓ ADDRESS: / 7 7Y Ai 9 a 44 44
PHONE NOS. CS ( 75/--3 6S'—/Yc3
PHONE NOS. S
/ f3"' )2-3-7-. 2'5)C
� k44/
LOCATION OF PROPERTYAC Afip3o •,
SUBDIVISION NAME:
.03,-5--1-4/
LOCATION OF PROPOSED CONSTRUCTION AND/OR IN L
IO76C m
• .30 .S- 13 ow/3o3.S-i-tJ
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: B//,4,/in V ra /very- F a0A ie,�,
PHONE: 34575--)y9S-
✓ FUEL BURNING APPLIANCE
INFORMATION WOOD COAL PELLET GAS OIL
STOVE ■_
FIREPLACE INSERT
FIREPLACE,FACTORY BUILT*
FIREPLACE,MASONRY
FURNACE(GARAGE ONLY)
IIII
*IF FACTORY BUILT,PLEASE PROVIDE: MANUFACTURER NAME: 'V trip lCOh 'DTIC.- MODEL NO/560"4-q0 -�
LISTED BY:
NUMBER:
QUESTIONS ?
CHIMNEY INFORMATION CALL 761-8205 or 761 X206
BLOCK BRICK STONE OR EMAIL:
MASONRY** �/ ���'= - t s
CHECK ONE '-�-
VISIT OUR WEBSITE
TILE STEEL SIZE IN FOR MORE INFORMATION
INCHES _. _:._'��-_F��F.=��
FLUE CHECK ONE I.
DOUBLE TRIPLE WALL INSULATED DIRECT VENT 1.
CHIMNEY
WALL LINER
CHIMNEY MATERIAL CHECK ONE ✓
**IF NON-MASONRY,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION&BUILDING CODE AND/OR
MANUFACTURERS REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED
INSPECTIONS.
January 7,2008; Reviseu orcwuo,r.c..au-.—--
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 141-7 [ [ .
NAME: _
LOCATION: It A4. `Al),0Wti2'nk-F2-t)
PERMIT#: 2 ("IC -573'2..
Final
- 32-
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has be •
Craig Brown, Zoning Administrator
Notes:
LASueHemingway\Building.Codes.Inspection.FORMSWinal Survey
Zoning Administrator.doc
(ear/ler / he Ver) 0 /v /V10 c,4",
Queensbury Building & Code Enforcement - Residential Final Inspeels n
Office No. (518) 761-8256 Arrive: am/pm Depart Y am/pm
Date Inspection requ t rec ved: , Inspector's Initials:
NAME: (Ql
1 1 �
/ PERMIT#: 0 v
LOCATION: • /fes 1. . . DATE: ^ AV/
-
TYPE OF STRUCTURE:
Comments:
Yes No N/A i
4" Building Number Address visible from road V
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake ii:
i
3 inch Plumbing Vent through roof minimum 18 inches '
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers /
Guards at stairs,decks,patios more than 30 inches above grade /A7L-1
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or WallL jSIC
Interior/Exterior Railings 34 inches to 38 inches h A_, v
Deck Bracing/Handicapped Ramp Compliant 11�1- �`�
Grade away from foundation 6 inches with 10 feet // L. — (-OM-
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches ti/ { ��`vlit,Okr 4:�
Bathroom/Kitchen watertight ,
Safety glazing/Wi in stairwells safety 'ng 7 T�rl1`- E " -Uzs
Interior Smoke '=ectors Carbon MJnoxi Detectors 140C-\1?) —
Every level: ery Bedrock /
Outside every bedroo area: ✓✓✓✓✓✓ T�
Inter Connected: Battery backup: J 1. ,03
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area / 2 �;�-
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents / t/ �1 t.,6_% ,-
Bathroom Fans,if no window 1/ C
Plumbing fixtures �/ t, '
Foundation insulation to floor/Sticker on Panel ✓�
Duct work sealed properly/ ✓ � �
Floor truss,draft stopping finished basement 1,000 sq.ft. va _ „,,...„,
Emergency egress below grade
I ��� ,A o
Gas Furnace shut-off within 30 feet or within line of site �,'t-�..v•-
Oil Furnace shut-off at entrance to furnace area _
Fumace/Hot Water Heater operating `�`/
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 + 41111 5 C3'
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches / ,c-
Garage Floor Pitched 1.7/. �/ `v v ��'
Garage fireproofing/' hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure ✓/ l"—�
Final Electrical;Energy Saving Light Bulbs 50% 10.
�GrFinal Survey Plot Plan Ai,„,
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles V/
Flex Gas Pipe Bonding ✓� ��!'�_ , 1 a
As Built Septic System/Sewer Dept. Inspection Sticker / 1 C._�/�+ d{,
Site Plan /Variance required p/'
Flood Plain Certification,if required
Okay to issue C/C or C I 0[Temporary/Permanent]
6)/
L:\Building&Codes Forms\Building&Codes\Inspection FormsResidential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6126/08; Revised 12/22/10,Revised 04/13/11
14-7
Rough Plumbing / Insulation nsction Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: _6449
NAME: f PERMIT#: 5-02—
LOCATION:1( - , RI INSPECT ON:
TYPE OF STRUCTURE:
N N/A
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 %inch minimum Drain Size
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
0 P.--.1 fo 15 minutes 4
Insulation/ ==idential Check/Commercial Check / / ,
.,_ - milar Exterior Sealant
Proper Vent,Attic Vent
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS: 1—c,17 t
C� � \fy %, U
Rough Plumbing Insulation Report.revised Nov 17 2003,revised February 15,2005, revised January 7,2008
Rough PlumbingI Insula
gtion`inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initiais& 9_ /43*4J,ll
NAME: C , /7� PERMIT#: �(���,c c'
LOCATION: It /�i�20,4z_-:t11-) ; - INSPECT ON:
TYPE OF STRUCTURE:
YN NIA
R• • Writhing / :it Plates
Plumbi '! = ents in Place
1 %inch minimum Drain Size
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/Head
50 P.S.I for 15 minutes
- • • /Residential Check/Commercial Check o/
(Tyvek or •imilar Exterior Sealant
ent, Attic Vent Y
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
a uct work sealed properly/No duct tape
COMMENTS: e /v ,e„
Rough Plumbing Insulation Reportrevised Nov 17 2003,revised February 15,2005, revised January 7,2008
Rough Plumbing I Insulation`Inspection Report
Office No. (518) 761-8256 Date ins• :«'• e- ed:
Queensbury Building &Code Enforcement Arrive: DI 07,.art: • L
742 Bay Road, Queensbury, NY 12804 Inspector's Initi- L.
NAME: Cil/ PE IT#: ;,�
11 `(.
LOCATION: ,- 77,),/,3reYC� /c. INSPECT ON: /e'7-- 2 /
TYPE OF STRUCTURE:
Y N N/A
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
1 %inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout eve 100 feet/chan.e 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 cJ'
Air/Head
50 P.S.I for 15 minutes
Insulation/Residential Check/Commercial Check
Tyvek sir r .xtenor Sealants
/Winda+v Sealed (No uistion)
Duct!Hot Water ' ' ation
�—If requi unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
?c•C\ '�
COMMENTS: �- ��-
V--C_-)Cyk*
Rough Plumbing insulation Report.rev'ised Nov 17 2003, revised FeMty 15,2005, revised January
Framing / FirestoppingInspection- e
p!�
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm • • m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ;.�:� '�
1/4•
NAME: 6) //t # PERMIT# / ,-
,.S 0
LOCATION: /1 f 1 F=�,, ,i�f INSPECT ON: /2
TYPE OF STRUCTURE: _ S -7
c
1 \
Y N A
Framing COMMENTS:
A ' ss 22"x 30" minimum �] (.3a4 ,1Jack Studs/Headers t\--)‘ Ada-»( "
Bracing/Bridging V
Joist hangers �� l
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. ored prc47
Exterior Deck Bracing I r ,
Headroom 6 ft. 8 in. VZ
•
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge (8) 160 nails each side < 'tea
Draft stopping 1,000 sq. ft. floor trusses
r_..._
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
irFire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side%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
L:1Buiiding&Codes Forms-OLDiBudding&Codes\1nspsction Fo ms'framing Firestopping Inspection Repod.doc Revised January 7,2008
13 !ti/e-X4- 75,1
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart:r„,587/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:_,t_tfe
NAME: (]O1/( 1f PERMIT#: _CJ
LOCATION: ii f 4 - )Ta INSPECT ON:
TYPE OF STRUCTURE:
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
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '%(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
6 ft. or less on center
Ice and water sty=Id 24 inches from wall w
sepax- . 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side%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 !rade
L:\Building&Codes Forms-OLDSuilding&Code&Jnspection FormsTraming Firestopping inspection Reportdoc Revised January 7,2008
Framing / Firestopping inspection Kep °
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm
Depart: t am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:eivt,T)
NAME: /44' PERMIT#: `�
LOCATION: if ; s01. '? rl INSPECT ON:
TYPE OF STRUCTURE:
Y N COMMENTS:
Framing
Attic Access 22" x 30" minimum
Jack Studs/Headers
Bracing t Bridging
Joist hangers
Jack Posts I Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
•
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 'A(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
An. •; - • = 6 ft. or less on center
ce and water s ield 24 inches from wall
moire saps = '= 1, 2, 3 hourcv„ic` f.,
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed ,��i�(,.� roq_ faiffrtki4
16 inch insulation in cavity min.
Garage Fire Separation
House side 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
L:1Buikrmg&Codes Fortes-OLD1BuiIding&CodesUnspection FormssFraming Firestopping Inspection Repot.doc Revised January 7,2008
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart'' , . am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:(I
NAME: (. 044-Or-
PERMIT#: 2.01 C— 5c3 2_
LOCATION: l 1 M.,Af)O t,oanc 2r7 INSPECT ON: 11 1-L1 \ .
TYPE OF STRUCTURE: 5 9
Con mit
Y ` N/A
Footings
Piers
Menoltthrab
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/Walliour
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 abovtto.
polrfoFwetareas under slab
E idppFeva�
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Buiiding&Codes Forms\Building&Codes\Inspection Forms\Foundatlon Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report �r 3
P�
Office No.(518)761-8256 Date Inspection request received: /i a 3/;-(9/0
Queensbury Building&Code Enforcement Arrive: am/pm Dep /// am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: • � �
NAME: PERMIT#: J/O - U 3
LOCATION: /,Afeaciolsi&ive/L— INSPECT ON: Ii I , /0-4A-e)
r p
TYPE OF STRUCTURE: .51
Comment%
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 AS'4,EkAk'5174 -6
Footing Dowels or Keyway in place —1 „:s1, z{1
Foundatio �proo g ,/ ic �4A- -
on aterproofing
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\Foundadon Inspection Reportdoc
Last printed 12/20/2005 9:24:00 AM
KGs
Foundation Inspection Report �
Office No.(518)761-8256 Date Inspection request received: 1 i/i 67/0
Queensbury Building&Code Enforcement Arrive: am/pm Depart:-2pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: Lhg_
Ct.'//
NAME: A.; GJ h / PERMIT#: /0 S° 2—
LOCATION: e 13ot r}:?NrINSPECT ON: /1//r/ 6/
TYPE OF STRUCTURE:
` Comment
Y N NSA
Footings
Piers 1C2<'1
Monolithic Slab 2.(71-k ?L S 71-4-
Reinforcement
Reinforcement in Place
The contractor is responsible for (_? `. << Tztz `T-05P 014-
providing protection from freezing
for 48 hours following the placement ---
of the concrete.
Materials for this purpose on site. rte>%-‘_,-5 X _
Foundation/Wallpour Z..
Reinforcement in Place Y G44Z- ,_.-
Footing Dowels or Keyway in placea.),�` 14.4 "2-
Foundation Dampproofing Z
Foundation Waterproofing �,�� C�- "{� r►
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:\Buliding&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
f -- '3
Tr' -
Foundation tion Report 7
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Dep:. :
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: C,C / PERMIT#: 10 _ sI 2
LOCATION: � ;h roc* INSPECT ON: /1-//, /C
TYPE OF STRUCTURE:
Comment
Cotings
Y N �L
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 k S
,lace
ooting Dowels o in pl
• :'. pproofing
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 Reportdoc
Last printed 12/20/2005 9:24:00 AM
Rough Plumbing I Insulation Inspection Report
Office No. (518)761-8256 Date Inspection request received: _
Queensbury Building &Code Enforcement Arrive: am/p Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ,.
NAME: (1 6L PERMIT#: 2°1°
LOCATION: `t . �� INSPECT ON: ( 2 g j to
1.
TYPE OF STRUCTURE: -- )(42
Y N NIA I
Rough Plumbing/Nail Plates
Plumbing Vent I Vents in Place
1 %inch minimum Drain Size
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 hi.hest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
50 P.S.I for 15 minutes
Insulation/Residential Check I Commercial Check
T :k or Similar Exterior Sealant
Proper Vent,Attic Vent / 1
Door/Window Sealed (No Insulation]
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS: 2A '`'
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Rough Plumbing Insulation Repat.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
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Fire Town of Queensbury Ft a Marshal
j 742 Bay Road
IIIP, Queensbury,NY 12804
761-82051761-8206
fax 745-4437
Factory Built Gas Fireplace/Stove Inspection Report
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
Permit# , _ , t..Schedule InspectionTime i0 yam pm anytime Inspector �'`1)
Name
2, • Address 4 /n .,-z_._; 10 Cbc, Rough In V.Final
Appliance Manuturer lok-.YF" 14._. Model# 'S(0. 1)� rOsi
Direct VentFactory Built Chimney Flue Size Double Wall Triple Wall WInsulated
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides) r
Firestop(s) Vertical Chase V
Wall Penetration . /r /
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve // _
Combustion Air
Hearth Extension (if any) 7
Mantel
i Height above f/p opening
Witness Operation i
Tank Placement(if LP)
CO Detection
z l&I
CSST Bonding
White—Building Dept. YeUon—Customer Pink—Fire Marshal