2012-475 01111104, TOWN OF QUEENSBURY
w742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120475 Date Issued: Thursday, December 13, 2012
This is to certify that work requested to be done as shown by Permit Number P20120475
has been completed.
Location: 14 CHARLTON Ln
Tax Map Number: 523400-308-006-0002-014-000-0000
Owner: CLUTE ENTERPRISES, INC.
Applicant: CLUTE ENTERPRISES, INC.
This structure may be occupied as a:
Garage Attached By Order of Town Board
Single Family Dwelling 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
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
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: P20120475 Application Number: A20120475
Tax Map No: 523400-308-006-0002-014-000-0000
Permission is hereby granted to: CLUTE ENTERPRISES. INC.
For property located at: 14 CHARLTON Ln
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: DENNIS & MARY GAZAILLE Garage Attached
14 CHARLTON Ln Single Family Dwelling $145,000.00
QUEENSBURY NY 12804-0000 Total Value $145,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-475 Bldg Lot 13
Single Family w/attached garage
1st Flr 624; 2nd Flr 676 sf; gar 400 sf
$320.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,October 02,2013
(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 Town of Queensbury; Tuesday,October 02,2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
i
•
OFFICE USE ONLY
TAX MAP NO. 3bS• -'.- )l PERMIT NO. ) -LI 15
FEES: PERMIT 3,9-10./
RECREATION 5 ENGINEERING SEP 26 2012
RD., (If applicable)
FEE'
PRINCIPAL STRUCTURE: APPLICA1 J1V 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. t
APPLICANT/BUILDER: ��...)� OWNER: CV-)4e
ADDRESS: (.p -CcA&.---.Nue j '-'y ADDRESS:
PHONE NOS. 7 727T7 PHONE NOS. -7
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: � LrCV1 PHONE: 7-L X3(0
LOCATION OF PROPERTY: I1--I Ccr- o.-. )off e (o- — I'-!
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? 'YES 0 NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL: \(DSc \, LuZC=-re s2.. ...
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT zz o H
APPLY TO YOUR ZO R. CO O CD CD w LL w
PROJECT F- g O � OJ - -' a = =
o w i w U_ 'l = F , o c7 c�
w 0 y O z O H ot- wE -
z a Q cn N co O LL t— u- a z ors C)
SINGLE FAMILY c/ o ? I lf/" ✓
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL ./
ATTACHES . (Lk (
GARAGE((e. \ 40o (-lot) t, 1
OTHER
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
IF COMMERCIAL OR INDUSTRIAL—NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: 1�� OOo FUEL TYPE: "Nc.� c7 ....
HEAT TYPE:gro!-t- *HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE? t•.Da
PROPOSED USE OF BUILDING OR ADDITION: ,nS\,‹ U-' C—e3SAde,--CP
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? o
ARE THERE EASEMENTS ON PROPERTY? 1Jo
"Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
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 provi• - .n as-edit survey by a licensed land surveyor of all newly
constructed facilities prior e ssuance of. certific. e of occupancy.
I have read and agr- to th- abovy
Signed leArillAiii.,
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)
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
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
codes(asmeensbunt.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
Operating Permit Issued: Yes No
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
3 0 3 . - I LI 14; ())atiC
Revised 4/14/2010
Town of Queensbury
Highway opii)A95 SEP 26 2012 Michael F. Travis
DepartmentHighway Superintendent
742 Bay Road, Queensbury, NY 12804 Home (518) 798-0413
Office Phone: (518) 761-8211 Thomas R. Vanness
Fax: (518) 745-4466 Deputy Superintendent
Home (518) 745-0929
www. Queensbuiy.net
DRIVEWAY PERMIT
Date: l bY(1
Applicant Name: C5, n �e�_� �e� .
Address to be inspected:
Return Address: `k-G.Ke\e"-N.
Applicant must show exact location and width of driveway(s) to be connected to the highway by placing
stakes at the specified location.
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following
action has been taken:
Step 1: ( ) Preliminary Approval
Need: ( ) Slight swale
( ) Deep swale
( ) Level with the road
( ) Level with the top of the paved wing
Size culvert pipe to be used (if necessary)
( ) 12" ( )15" ( ) 18" ( )24" ( )36"
Preliminary inspections completed by: Date:
Approved by Higway Supt: Deputy Supt.:
Upon completion, please resubmit this approved permit for a final approval.
Step 2: ( ) Final Approval
( ) Rejected
Date:
Michael F. Travis, Highway Superintendent
Thomas R. Van Ness, Deputy Highway Superintendent
Town of Queensbury* Community Development Office*742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
OFFICE USE ONLY
TAX MAP NO.30S ,(p—)•—) ` PERMIT NO. (D_...41 (itfERMIT FEE _
b
APPROVALS: ZONING TOWN CLERK SEP 2 2012
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT.
IT.
OWNER: C L - INSTALLER: w,,�\e (�
ADDRESS: ADDRESS: (c) ,r--,r--(a&e,--\ . }e
PHONE NOS. ` PHONE-� c NOS. 19r , 7-.7 7
LOCATION OF INSTALLATION: 1---1C1,-..0.1- 'N-o.- `�5: '- . (0 3- I'4
RESIDENCE INFORMATION:
NO. COMPUTATION
YEAR BUILT X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRIMJDER
1980 or older X 150 = INSTALLED?GRIM
1981 -1991 X 130 = SPA OR HOT T116
1992-present .S X 110 = 3 INSTALLED? j . z
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING > STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND><"/ LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi]
(Test to be completed by a licensed professional engineer or architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer
or architect(unless installed in a Planning Board approved subdivision).
TANK SIZE: \CrOO GALLON(MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM TYPE:
o ABSORPTION FIELD(WITH NO.2 STONE) Total length t Sb ft. Each trench - X J(•D
0 SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
o ALTERNATIVE SYSTEM Bed or other type?
o HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury,any permit or approval
granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or
circumstance known by or on behalf of an applicant,shall be void.
I have read the regu . ons with resp-ct to t.' .•.. ' .tion and agree
to abide by thes: -nd .II require - is • • n .f Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanitary Se -•e D':�:osal Or.' anc: / codesna.queensburv.net
/-YA VISIT OUR WEBSITE FOR MORE INFORMATION
Si.. rrepe
.• rson Responsible Date www•queensbury.net
r * CommunityDevelopment Office * 742 BayRoad, QueensburyNY 12804
Town of Queensbury p
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: '01am/pm
Date Inspection request received: Inspector's Initials: d it-i-()
NAME: ...1.4-1-A -: PERMIT#: 2-�1 •-- 21-1/
LOCATION: 1I- mac- �20-,N- 4-,. DATE: /'2. 'I Vlftz
TYPE OF STRUCTURE:
Comments:
Yes/No N/A
4" Building Number Address visible from road �/r
Chimney Height/"B"Vent/Direct Vent Location �j'
Fresh Air Intake /
3 inch Plumbing Vent through roof minimum 18 inches {,
Roof Complete/Exterior Finish Complete : /J
Platform at all exterior doors
Handrail 4 or more risers V
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
Handrail Termination at Newell Post or Wall //./
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet V
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors I main entrance 36 inches
Bathroom/Kitchen watertight /7
Safety glazing/Wi ..w in stairwells fety g : ing
Interior Smoke De.- ors/Carbon noxid• Detectors
Every level: Ev Bedro
Outside every bedroom rea: /
Inter Connected: Battery backup: 1,
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 f
Bathroom Fans,if no window V
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed property 1 Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft. / / $
Emergency egress below grade /
Gas Furnace shut-off within 30 feet or within line of site VOil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating �
Low water shut-off boiler ✓
Relief Valve(s)installed/Heat Trap/Water Temp 110 /
Enclosed Stairs Sheetrock Underside minimum%Z"Gypsum ` 1/
Basement stairs closed rise>4 inches //�
Garage Floor Pitched �/j
Garage fireproofing/%hour fire door/door closer ✓ /
Gas Logs in Sealed or Glass Enclosure /
Final Electrical; Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding ,�/�
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance requiredZ
Flood Plain Certification, if required
Okay to issue C/C or C/O[Temporary/Permanent] 10
L:1Building&Codes Forms\Building&Codesllnspection FormstResidential Final Inspection Form_revised_100405.doc; Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10, Revised 04/13/11
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 1A
NAME: u
LOCATION: / �) C h TINA
PERMIT #: / v (PI 5
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has been:
Craig Brown, Zoning Administrator
Notes:
L:\.SueHemingway\Building.Codes.Inspection.FORMS\Final Survey
Zoning Administrator.doc
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Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection test re• - •:
Queensbury Building & Code Enforcement Arrive: ,'• • - :
742 Bay Road, Queensbury, NY 12804 Inspector's Initia s:
fforNAME: 0_12.11±e) �__ PERMIT #:
LOCATION: / C )n Q INSPECT ON: Z
TYPE OF STRUCTURE:
Yla N/A
Rou,h Plumbin, /Nail Plates
Plumbing Vent/Vents in Place �==
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout eve 100 feet I 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
Air/Head
50 P.S.1 for 15 minutes
Insulation / Residential Check/ Commercial ChA\►.
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct I Hot Water Piping Insulation
If r- •uired unheated s•aces
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape
COMMENTS:
Rough Plumbing Insulation Reportrevised Nov 17 2003, revised February 15,2005, revised January 7,2008
1t� -1
Rough Plumbing if Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: flit/ a.ol
Queensbury Building & Code Enforcement Arrive: am/pr Depart: am/pm
742 Bay Road, Queensbury, NY 12804. Inspector's Initials: :+ :4)
v- l
NAME: / 4 r so• r� PERMIT #: 20/,
LOCATION: . � r� INSPECT ON: (M.
, o
13
TYPE OF STRUCTURE:
Y N NIA
Rough Plumbing / Nail Piates
Plumbing Vent I Vents in Place _
1 'A inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I 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. for 15 minutes
Insulation / R sidential Check/Commercial Check
yvek or,Similgr Exterior Sealant ^�—
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation) _
Duct I Hot Water Piping Insulation
if required unheated spaces -
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape _
COMMENTS:
i
Rough Plumbing insulation Report.revised Nov 17 2003, revised February 15, 2005, revised January 7, 2008
Framing / Firestopping Inspection Report N c i- 61°c
Office No. (518) 761-8256 Date Inspection request received: 1/-I
Queensbury Building &Code Enforcement Arrive: am/pm Depart(--
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: i 1.k
1 30am/pm
NAME: CQPERMIT#: /D-z-0:5
LOCATION: I `-f ..(2Lhoi,� INSPECT ON:
TYPE OF STRUCTURE: S Ft
N NIA COMMENTS:
Framing
Attic Access 22" x 30" minimum
Jack Studs/ Headers .I�
Bracing /Bridging V/
Joist hangers v (T n
Jack Posts/Main Beams r- �� L ' C - �.✓<�(�
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 _
L:\Building&Codes Forms-0LD\Building&Codes\Inspec tion Fomu\Framing Firestopping Inspection Report.doc Revised January 7,2008
CC D
Rough Plumbing I Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: n-13/3-1.k
Queensbury Building & Code Enforcement Arrive: am/p part: --3(-\cJ am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: �
NAME: CO---t-Gta, PERMIT #:
LOCATION: 1 /-4 0,h(uoi):1:-(TNN INSPECT ON: /%- / `/,Z
TYPE OF STRUCTURE: S F
_ �.. Y f N J
Rough Plumbing /Nail Plates V /
Plumbing Vent I Vents in Place V
1 '/z inch minimum Drain Size
Washingyachine 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
Insulation /Residential Check/Commercial Check
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
COMMENTS:
Rough Plumbing insulation Reportrevised Nov 17 2003, revised February 15, 2005, revised January 7, 2008
Framing I Firestopping Inspection Report ---( Lt 0- _; (--/-11
Office No. (518) 761-8256 Date Inspection request received: 02(1.1- . A)
Queensbury Building & Code Enforcement Arrive: am/pm Depart- ,. /-dam/pm 1,,o Qti-c fit)
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: l�I)
NAME:_ PERMIT#: c�, ;j
LOCATION: / -/ e INCA i I ---e_70 INSPECT ON: j/ - --/,'
n
TYPE OF STRUCTURE: )) 0
Y N N/A COMMENTS:
Framing -�
Attic Access 22" x 30" minimum --
Jack Studs/ Headers
Bracing I 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 'h(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Botts 6 ft. or less on center
Ice and water shield 24 inches from wall I
Fire separation 1, 2, 3 hour ,11M-
-
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 I Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/ below grade
5.0 sf grade _
L:16uilding&Codes Forms-OLD\Buikiing&CodesUnspection FocrrrslFraming Firestopping Inspection Report.doc Revised January 7,2008
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm epartri2. i ceam/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:(.
NAME: `_ti CL PERMIT NO.: / v2— 1
LOCATION: ( I 2 tc INSPECT ON: /L)
RECHECK:
Comments and/or diagram
Soil Type: -.A / Loam/ Clay
Type of Water: iI ,• '.. / Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
[150'to well required if NO]
Absorption Field: Total length `cb ft.
Length of each trench �'S' ft.
Depth of trenches ' .. ft.
.
Size of Stone
Seepage Pits: Number
Size: •x
Stone Size:
Piping Sze Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit 4A t :.:--4144.. t�1Z i F
Opening Sealed: kA, N
End Cap v N
Inlet/Outlet Pipes&Baffles vf N
Manholes 12"or less below grade _Y_N
[provide extension collar if Yes] Y_ N
Location/ Separations
Foundation to tank 1/ ft.
Foundation to absorption '2 L ft.
Separation of Pits IL .
Conforms as per Plot Plan Y—
Engineer Report and As-Built Y N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Use S .- s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report 03 29 10.doc
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Corporate Office
269 Ballard Road
r'" `- Wilton, NY 12831
.:..• Office: 518.584.2421 Fax: 518.584.4382
SAFETY, QUALITY, PRODUCTIVITY - WWW.DACOLLINS.COM
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Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received: °P(C%l
Queensbury Building&Code Enforcement Arrive: am/pm Depart: L\5 pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:G7
NAME: Ci C-L r PERMIT#: f 2- '
LOCATION: ) vAr L t /-Nn-f INSPECT ON: /0/j(/
7
TYPE OF STRUCTURE:
51z-r?
Comment
Y N NL
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 Dampproofmg
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:\Buliding&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 Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: ^1›.- am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials://JYT)
NAME: PERMIT#:
(Jr
LOCATION: / '41 "l6)c ` n INSPECT ON: /0 /, —/d,
TYPE OF STRUCTURE: S i
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/Wailpour
Reinforcement in Place \/ / �L
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 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 Fors\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
, PERMIT PLOT PLAN
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