2015-171 ..:/./0111Aki TOWN OF QUEENSBURY
tivo742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20150171 Date Issued: Monday, June 29, 2015
This is to certify that work requested to be done as shown by Permit Number P20150171
has been completed.
Location: 123 QUAKER Rd
Tax Map Number: 523400-296-019-0001-002-000-0000
Owner: MRK COMMUNITY COLLEGE HOUSING, LLC
Applicant: COMMUNITY CARE PHYSICIANS
This structure may be occupied as a:
Commercial Alteration By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property /
owner of the responsibility for compliance with Site Plan, Variance, or 4494
other issues and conditions as a result of approvals by the Planning Board '�V
Director of Building&Code 'nforcement
or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150171 Application Number: A20150171
Tax Map No: 523400-296-019-0001-002-000-0000
Permission is hereby granted to: MRK COMMUNITY COLLEGE HOUSING, LLC
For property located at: 123 QUAKER 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: MRK COMMUNITY COLLEGE HOl Commercial Alteration $189,000.00
6 CHELSEA PI --
CLIFTON PARK,NY 12065-0000 Total Value $189,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2015-171 Community Care Physicians
Commercial Interior Alterations 2429 s.f.
$30 credit from voided demo application(2015-130) applied
$485.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,May 19,2016
(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 of ueen r} , ay 19,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
5-- <<_
DATE _ Received
Tax Map ID
TAX MAP ID 2 lG(b -�PAY 1 5 2015 Permit No 1.5-1l\
Permit Fee W.SD ?J O cxccg)
ZONING C F ;,Il it c.NSl3t.i . Rec Fee Ce5-10)
aSNC&CODES Site Plan#
HISTORIC SITE Yes No Subdivision#
BMs At)s CLP U�sC'LAA. Lot# atA
3UBII7'bY3f6N NAME
TOWN BD. RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS, INCLUDING SINGLE FAMILY DWELLINGS,
DUPLEXES OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR
MANUFACTURED&MODULAR HOMES,BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE.
APPLICANT Cv,NUh.ki (Au: OWNER 11(1-NV `PQL \ QiC6cQtri
ADDRESS /(1 \ i65' �GLe ftLt ADDRESS 4 CANc. . 0,PNEAE
PHONE/E-MAIL 3(6-33U- 332(0 jfvic,'�o®Cci•VM4-)c"`.c PHONE/E-MAIL 5( - i J v V c1S 1-k)
CONTRACTOR M1-- C'^54"a Skr`Ilcc T COST OF CONSTRUCTION(ESTIMATED): $ 1 CI GG v
ADDRESS: 30- W 2 4-N Nit. I:4'NTI h BUILDING ADDRESS: +2-5 0.'4 C L c c
"A-1J-1 N'1 \-L-Lt "L
`TJ;sc.° 2 8
PHONE/E-MAIL Jh16c-N.G610\ j\C`k.S L- 6t0() ` CY) c61-'1
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: 3 cl Ih ` `oS c' PHONE J61_
>e �fX35
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
New Addition Alteration 1st floor sq.ft. 2nd floor sq.ft. Total sq. ft. Height
Single Family N/A
Two-Family NIA
Multi-Family
(# of units ) NA-
Townhouse Kit\
Business Office 21421 5S,f}
Retail - Mercantile NIX
Factory- Industrial WA
Attached Garage N1o\
(# of )
Other N�
1
Town of Queensbury Building&Codes Principal Structure Application July 2014
If commercial or industrial indicate name of business CCP VA s Cln C.AA
Proposed use of building or addition �,�icq.L SPNcE
Source of heat (circle one) Gas Oil Propane Solar Other
Fireplace: complete a separate application for Fuel Burning Appliances &
Chimneys
Are there structures not shown on plot plan? Nrk
Are there easements on the property? Ng A
Site Information
a. Dimensions or acreage of lot
b. Is this a corner lot?
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well
e. Sewer or Private Septic System
Value of all work to be performed (labor or materials) $
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. 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.
4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of
occupancy.
5. 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: PRINT NAME: r , `'`VI uSA DATE 3-11 1
SIGNATURE: IfKf" DATE
r
FOR OFFICE USE ONLY
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
2
Town of Queensbury Building&Codes Principal Structure Application July 2014
Inspection Form
Town of Queensbury Fire Marshal CD Periodic Inspection Date:v/f Timei" l
742 Bay Road,Queensbury NY 12804P R nspection
518 761 8206/518 761 8205 0 Inspection Permit#: 4t—C-41 .
Fire Marshals Representative
MJ Palmer Business Name: ,d�r�d'!/9?i / ����i1..� �s•
Location: /72 �t�_
4K Stillman Contact:
Type of Inspection N/A Yes No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029
Locks and latches FC1008& FC1029.2 .�
Sign: Normal FC 1011 &FC1029
Sign: backup FC 1011.5.3&FC1029.7.5
AISLES:
Main Aisle Width FC 1024/1025&FC1029.11 /
Secondary Aisle Width FC 1025&FC1029.11__ _/ _
FIRE EXTINGUISHER: Hung FC 906
Inspection of extinguisher FC 906
EVAC Plan FC 404.2
TRUSS ID SIGNAGE FC 505.3
EMERGENCY LIGHTING:
Interior FC 1006.3&FC1029.8
Exterior FC 1006.3
Clearance to Electrical FC 605.3 /_
CElombc Wtibleq Ed/Labeled FC 605.3.1 ....'--
Combustibles
�
Combustibles in Equipment Rooms FC315.2.3
F.D.Signage- FC 510 A
PRWM
Storage FC
Signs FC FC 3150.3 �.2 � 'LIIM'�
Compressed Gas FC 3003 '
Vehicle Impact Protection FC 312.1
Interior Finishes FC 803-804 ./J
Smoke Detectors FC 907 /�
CO detectors FC 610
Clearance to Sprinkler/Ceiling FC 315.2.1 / - -
18" / 24" / .0.--"°..'"
„/
EVAC SIGNS IN Rooms FC 404.6(R1 &R2)
Fuel Pump Warning Signs FC2205.6
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 ” REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311
Emergency Disconnect FC 2203.2 .f / 21 DAYS
3rd Party Electrical
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Generator Annual
FM Type Suppression Semi Annual DATE: OK NC
Elevator Semi Annual
FIRE ALARM Annual 67 . _
/j
Paint Booth Suppression Semi Annual DATE: OK NC
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual ..--"--
Fuel Island Suppression Semi Annual
l/1 on 61.41g4Hood Cleaning 3-6-Annual y
Knox Box:installed/checked FC506
1,__ei-cfy 4‘46-7y---01,7
Operating Permit, if required will be issued after
Completion of Inspection
Town of Queensbury Building &Code Enforcement q—l/
`rice No. (518)761-8256
Commercial Final Inspection Report
Inspection request received: 1 (1I S
C ( ' ) Inspected on:(S-e- (HOU S ,.c
Name: ��,:w•��,. � �/ /►
Location: ( 2-.; ii-U-���--y_ - Arrive: 1 41 44 _ p.m.
Permit No.: - 1 Inspector's Initials: AWI'
•
COMMENTS
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6"in 10'or Equivalent
Interior/Exterior Guardrails 42 inch Platform/Decks _ _
Interior I Exterior Balusters 4 inch Spacing Platform/Decks
Stair Handrail 34 inch—38 inch/Step Risers 7"I Treads 11"
Vestibules For Exit doors>3000 sq.ft.
All Doors 36 inch w/Lever Handles I Panic Hardware, if required
Exits At Grade Or Platform 36"(w)x 44"(I)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight I Other Floors Okay
Relief Valve,Heat Trap 1 Water Temperature 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hour or Fire Extinguishing System
Fresh Air Supply for Occupancy/Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft.or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 1/2 doors > 10%> 1000 sq.ft.
%Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour,3 Hour Complete/Fire Dampers/Fire Doors
Ceiling Fire Stopping,3,000 sq.ft.Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan,if required
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroom Grab Bars/Sinks/Toilets/Mirrors J
Handicapped Bath/Parking Lot Signage �,/
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 inch, Checkout 36 inch
Handicapped Ramp/Handrails Continuous/12 inch Beyond [Both sides]
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded
Site Plan/Variance required
Final Survey, New Structure/Flood Plain certification, if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway 4" 179‘E W
Water Fountain or Cooler r 6V— `O
Building Access All Sides by 20'I Drivable Surface 20'wide
Special Inspections/Engineer or Architect Approval
Okay To Issue Temporary or Permanent C/O
Okay To Issue C/C
J
Commercial Final Inspection_11 27 12
..)ueensbury Building&Code Enforcement A
Office No. (518)761-8256 • —
1 /
Commercial Final Inspection Report
' Inspection request received: b 2;2 l ZcAs
Name: Qx Wn Y)+3\I c.v& Ph� tc av Inspected on: b
L /
oo "-11 . �
Location: lZ3 k L3 `4- Arrive: Arid;
Permit No.: \5- n'1 Inspector's Initials:
COMMENTS
Y N NA
Chimney/"B"Vent I Direct Vent Location
Plumbing Vent Through Roof 6"I Roof Complete — \*3171-11.Lti.. RN—k—
Exterior Finish/Grade Complete 6"in 10'or Equivalent
Interior!Exterior Guardrails 42 inch Platform I Decks c_oN}
Interior I Exterior Balusters 4 inch Spacing Platform/Decks VAN—W...17
Stair Handrail 34 inch—38 inch I Step Risers 7"I Treads 11"
Vestibules For Exit doors>3000 sq.ft.
All Doors 36 inch w!Lever Handles I Panic Hardware,if required
Jc_DetbvtAt,
Exits At Grade Or Platform 36"(w)x 44"(I)/Canopy or Equiv. ‘1 EvZ -. cT
Gas Valve Shut-off Exposed&Regulator(18")Above Grade To 6RAW. - ,Z
Floor Bathroom Watertight I Other Floors Okay
Relief Valve, Heat Trap I Water Temperature 110 Degrees Maximum
Boiler/Furnace Enclosure 1 hour or Fire Extinguishing System
Fresh Air Supply for Occupancy I Ventilation Combustion
Low Water Shut Off For Boilers
Gas Furnace Shut Off Within 30 ft.or Within Line Of Site
Oil Furnace Shut Off at Entrance to Furnace Area
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 1/2 doors > 10%>1000 sq.ft.
%Hour Corridor Doors&Closers
Firewalls I Fire Separation,2 Hour,3 Hour Complete I Fire Dampers I Fire Doors
Ceiling Fire Stopping,3,000 sq.ft.Wood Frame
Attic Access 30"x 20"x 30"(h),Crawl Space Access 18"x 24"
Smoke Vents Or Fan, if required
Elevator Operation and Signage/Shaft Sealed
Handicapped Bathroom Grab Bars I Sinks/Toilets/Mirrors
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 inch,Checkout 36 inch
Handicapped Ramp I Handrails Continuous/12 inch Beyond [Both sides]
Active Listening System and Signage Assembly Space
Final Electrical I Flex Gas Piping Bonded
Site Plan/Variance required
Final Survey,New Structure I Flood Plain certification,if req.
As-built Septic System Layout Required or On File
Building Number or Tenant Address on Building or Driveway 4" T \
Water Fountain or Cooler
Building Access All Sides by 20'I Drivable Surface 20'wide
Special Inspections/Engineer or Architect Approval
Okay To Issue Temporary or Permanent CIO
Okay To Issue C/C
Commercial Final Inspection_11 27 12
hc
architects
June 22, 2015
Attn: Town of Queensbury Building Department
742 Bay Road
Queensbury, New York 12804
Re: CCP Queensbury
123 Quaker Road
Queensbury, New York 12804
Building Permit No. A20150171
Dear whomever this may concern,
We have reviewed the construction at the above referenced project and find the work to be
complete and in conformance with the construction documents issued by our office.
The workmanship of the improvements completed to date has been reviewed and are satisfactory
to our office.
All life safety items(i.e. exit lights and emergency lights) have been installed and are operational.
(Test reports, if required will be issued under separate cover).
We are requesting that a Certificate of Occupancy be issued for this tenant.
Should you have any questions please call our office.
Very truly yours,
Benjamin J. Nassivera, AIA
cc: Joe Mosca -BBL Construction Services LLC
James P. Coleman, AIA Daniel Patane, AIA Joseph M. Riley, AIA,LEED AP Benjamin J. Nassivera, AIA,LEED AP
HCP Architects, LLP • 302 Washington Avenue Extension • Albany, New York 1 2203 • p: 518.21 8.0614 • www.hcpdesign.com
Town of Queensbury Fire Marshal Inspection Formc)Periodic Inspection Date:6/014 Time: "�
742 Bay Road,Queensbury NY 12804 o Inspection 5
518 761 8206/518 761 8205 D'CO Inspection Permit#: / /7/
Fire Marshals Representative �'� � �� ,Ar/41i/4r
Palmer Business Name: f S/41
Location: / 'a p - 1>orge
K Stillman Contact: Ds/ti 4
Type of Inspection N/A Yes/ No
EXITS: Exit Access FC 1014&FC1029 NOTES
Exit Enclosure FC 1020&FC1029
Exit Discharge FC 1024&FC1029 �
Locks and latches FC1008& FC1029.2 .
Sign: Normal FC 1011 &FC1029
Sign:backup FC 1011.5.3&FC1029.7.5 • '-1
AISLES: / "-- 4kiht14-- �ry11.- 460T ht)Main Aisle Width FC 1024/1025&FC1029.11 / �4 ��
Secondary Aisle Width FC 1025&FC1029.11
FIRE EXTINGUISHER: Hung FC 906 „/•
Inspection of extinguisher FC 906 ,y
EVAC Plan FC 404.2 r g. (,9�6 440
TRUSS ID SIGNAGE FC 505.3 Orrcf12a1 r * 0-r
EMERGENCY LIGHTING: r,�,,�,���
Interior FC 1006.3&FC1029.8 S Ctl e��"-`r--�
Exterior FC 1006.3 i
Clearance to Electrical FC 605.3
Electric Wiring Enclosed/Labeled FC 605.3.1e —
Combustibles in Equipment Rooms FC315.2.3llP - (C.41-_,
F.D.Signage- FC 510
No Smoking Signs FC 310.3 o
Storage FC 315.2 rR00)6C --47 t { ]JCC
Compressed Gas FC 3003
Vehicle Impact Protection FC 312.1 ./
Interior Finishes FC 803-804
Smoke Detectors FC 907 /� /'� /r ivril 5:61101 rk,�f�l Y1
CO detectors FC 610 / �Gr
Clearance to Sprinkler/Ceiling FC 315.2.1
18" / 24"
EVAC SIGNS IN Rooms FC 404.6(R1 &R2)
Fuel Pump Warning Signs FC2205.6 1
Fuel Station Emer Procedures FC2204.3.5
Exterior Storage FC 315.3 / REINSPECTION DUE APPROXIMATELY
Vacant Buildings FC 311 /
Emergency Disconnect FC 2203.2 Q 21 DAYS
y
3rd Party Electrical ✓
SYSTEMS: FC 901.6 Insp OK NC DATE: OK NC
Generator Annual
FM Type Suppression Semi Annual DATE: OK NC
Elevator Semi Annual
FIRE ALARM Annual 61/1( X DATE: OK NC
Paint Booth Suppression Semi Annual
Sprinkler System Annual
Sprinkler FDC
Kitchen Suppression Semi Annual
Fuel Island Suppression Semi Annual
Hood Cleaning 3-6-Annual
Knox Box:installed/checked FC506
Operating Permit, if required will be issued after
Completion of Inspection
Town of Queensbury Building & Code Enforcement ,1_5_ — 0-Ai
Office No. (518)761-8256
Framing / Firestopping Inspection Report
Inspection request received: \2 IS
15 •
Name: aur YY1 . � �v•_ ;,� � S Inspected on: �
nn ��, . .
Location: 123 �,�,�,(.,,>�Q � �l • Arrive: ♦ , �
Permit No.: 5" l�1 Inspector's Initials: MN
TYPE OF STRUCTURE: l -yy- c..& J
Y N NIA COMMENTS:
Fri _
Attic Access 22"x 30"minimum 5- OWI-
Jack Studs/Headers 'C
Truss Specification Provided
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly 4j�v� CAA\
`v`c\
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 '/2(w) 16 gauge(8) 16D nails each side — 6C--TQ
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center
- and water shield 24 inches from wall
r- all 2,3,4 hour
•
C�etration�sealed
16 inch insulation in cavity min. -c Q � ��
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) VV—EkA,
5.7 sf above/below grade
5.0 sf grade
Design Professional Sign-off,if required •
Framing/Firestopping Inspection Report
Town of Queensbury Building&Code Enforcement T1
Office No. (518) 761-8256 yvvi
Rough Plumbing I Insulation Inspection Report
Inspection request received: '31 1-'\ 3
Name: CCvYIal:y t\1 (G e, Phv ,cA04, Inspected on: 5 2' _
Location: l23 ko3cQ`y { . Arrive: `IAINAP •.m.
Permit No.: 15- l+1 Inspector's Initials:
Type of Structure: C,f,vy, ,
3 1 -5 a---ACOMMENTS
Y N NA
Plt bing under slab ))��\n` Jr3k - 3cD1(0
\,Rough Plumbing / Nail Plates c 70A2-r
ic* /
Plumbing Vent/Vents in Place
1 1/2 inch minimum Drain Size
7
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction / C_p t-\\--)\_. .
Pressure Test •i4 �-T �� �
Dr..1 /Vent �T� S �� ,
Ai '' .2
• '. : 0 ft. above highest connection for 15 minutes
' 'ressure Test
Water Sup• y Piping ,�
•� ,/
..$ . . or 15 minutes ,/
• ulation / Residential Check/Commercial Check
Window Sealing
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door I Window Sealed (No Insulation)
Duct/ Hot Water Piping Insulation
If required unheated spaces
mbustion Air Supply for Furnace
Duct work sealed properly/No duct tape
/ 1
Blower Door Test
Air Sealing
e'‘ I-- ' .-L.- -C--VR‘CANi__ 1 'it- 6VCS't 03
Rough Plumbing/Insulation Inspection Report
Town of Queensbury Building & Code Enforcement ►"k ,1
Office No. (518) 761-8256 1/1I
Framing I Firestopping Inspection Report
Inspection request received: 517)-A1�
Name: 60,WIY lv„Yn\ C \At Inspected on: r:31 1`l
Location: 12.6' �(�,kkCy k.Q.V-‘' C7 Arrive: "Aa a. p
Permit No.: Inspector's Initials: i��!
TYPE OF STRUCTURE: 0..bArywn
Y N NIA COMMENTS:
Framing i3 tsN c-2)E R2t,J6 V cv . tij
Attic Access 22"x 30"minimum b,,,`,� �33,,
Jack Studs I Headers �"' `
Trusification Provided
t- • �ging
oist 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 1/2(w)16 gauge(8)16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center
Ice and water shield 24 inches from wall
Fire 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
Design Professional Sign-off,if required
Framing/ Firestopping Inspection Report �'
Town of Queensbury Building &Code Enforcement
Office No. (518)761-8256
Rough Plumbing I Insulation Inspection Report
Inspection request received: \1..s\
Name: CC rn n (lrly� ►� S\Cxc Inspected on:
Location: 127j(- v,ckk 2.T Q Arrive: - AMOR m
.
Permit No.: '5— 171-1 Inspector's Initials:
Type of Structure:
COMMENTS
Y N NA
Plumbing under slab
Rough Plumbing / Nail Plates
Plumbing Vent/Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/ change of direction
c_a To g
Pressure Test L77.- i
Drain /Vent o
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
Window Sealing
Tyvek or Similar 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
Blower Door Test
Air Sealing
Rough Plumbing/Insulation Inspection Report