2013-434 ditV
` TOWN OF QUEENSBURY
742 Bay Road,Qucensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130434 Date Issued: Friday, September 19, 2014
This is to certify that work requested to be done as shown by Permit Number P20130434
has been completed.
Location: 31 TWIN CHANNELS Rd
Tax Map Number: 523400-309-018-0001-012-000-0000
Owner: MARK D SHAW
Applicant: MARK D SHAW
This structure may be occupied as a:
Single Family Dwelling 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
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: P20130434 Application Number: A20130434
Tax Map No: 523400-309-018-0001-012-000-0000
Permission is hereby granted to: MARK D SHAW
For property located at: 31 TWIN CHANNELS 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: MARK D SHAW Single Family Dwelling $285,000.00
12 KEENAN St Total Value
GLENS FALLS NY 12801-0000 $285,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
PATRICK BURKE
222-9765
936 BAY Rd
OUEENSBURY,NY 12804-0000
Plans&Specifications
2013-434 HEIGHT& EXISTING GRADE TO BE VERIFIED BEFORE WORK COMMENCED
SFD 1st Fir 1,432; 2nd Fir 1,265 w/attached Garage 244 sq ft
$539.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, September 16, 2014
(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 Tow of Que/ sbu79 M a , September 16,2013
J r i9, ii _
SIGNED BY �'� ' '``' j ` for the Town of Queensbury.
Director of Building& Code Enforcement
Office Use Only
Town of Queensbury Building & Codes
Received:
PRINCIPAL STRUCTURE APPLICATION2(113 Tax Map ID: D" : – /–
Permit No.: wa es/
A permit must be obtained before beginning construction .*:
Permit Fee: $ –
*Rec Fee: $ c t r. .c � c s S47)
Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling `
units, including single-family dwellings, duplexes or two-family dwellings, multiple family Site Plan No.:
dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.:
homes,but not including mobile homes. This is in addition to the permit fee.
Date U po) \3 Applicant PG • l: . • _.
Tax Map ID 3ochig-1-19. Address .
Zoning
Phone/E-mail ~`1c-7?? 72C
y u
I
Property Owner �rh _c f% Contractor/Agent •L ; :A
Address ,'3,, TJ Address Sc,., 7„ n
Phone/E-mail — 4Phone/E-mail 1 rr rr
Contact Person for Building &Code Compliance: P�,�d i c k 1 • Day Phone: 2 J
Building Street Address: ,
Subdivision Name: Lot#: Historic Site: Yes No
Estimated cost of construction: $23
Type of Construction:
Check all that apply Please indicate measurements as required below:
0
0 g
1st Floor 2nd Floor Other Total Height
z Q a
Single Family �� „`r'
Two-Family
Multi-Family(#of
units )
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garages(# ) ✓ ,2 H�
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
•
If commercial or industrial indicate name of business
Proposed use of building or addition
Source of heat(circle one) Gas Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" Yes No
Are there structures not shown on plot plan?
Are their easements on the property? .
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 c `
Value of all work to be performed(labor and materials) $ <( (773 7'1
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval. 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.
Print Name:
Signature: Date: V.74
FOR OFFICE USE ONLY:
Operating Permit Issued: _Yes _No
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit:
Special Conditions:
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Office Use Only
Town of Queensbury Building & Codes Received:
SEPTIC DISPOSAL PERMIT Tax Map ID:
Permit No.:
A permit must be obtained before beginning construction
Permit Fee: 5
Approvals:
Applicant: V
Q(.4 i s {c l 1,4'c Installer/Builder
Address: CI f Address
Phone: ` Phone
Owner: Location of Installation
Address:
Phone
Contact Person for Building&Code Compliance: PCYlr L.rJ(.C, Day Phone:
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow
1980 or older x 150 = Garbage Grinder installed?
1981-1991 x 130 = Spa or Hot Tub Installed?
1992-Present x 110 = f;
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 Supply �� Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- 1;93 per minute per inch(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 `. .: gallon(minimum size 1,000 gallons),add 250 gallons to size of septic tank for each garbage grinder,spa or whirlpool tub
System Type: Absorption Field(with#2 stone) Total length ft. Each trench X
Seepage Pit(S)(with#3 stone) How many? Size?
Alternative System Bed or other type? 1 „ft\
'Holding Tank System Total required capacity? Tank size? #of tanks?
NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form
on Town website; 2) Effective as of March 23, 2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be
covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed system must match the septic system
layout on file. There will be no exceptions.
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 regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary
Sewage Disposal Ordinance.`
Print Name: p -\4- t-k 1.
1.,Ate- ( Date: 4-i13 O `11
Signature: .1-'n_ i.'/l t.t I Date: !S
Town of Queensbury Building&Codes Septic Disposal Permit 518-761-8256
Office Use Only
Town of Queensbury Building & Codes Received:
Tax Map ID:
FUEL BURNING APPLIANCE & CHIMNEY APPLICATION Permit No.: 13 3
Permit Fee: $
Application is hereby made to the Building & Codes Office for the issuance of a Building & Use Permit pursuant to the NYS 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 and also will allow all inspectors to enter premises to perform required inspections.
Important Note To Applicant: Rough-In and Final Inspections Are Required:
Date
Owner Installer/Builder
Address Address
Phone Phone
Location of proposed construction and/or installation: -swk..
Contact Person for Building&Codes Compliance: Ta. . f ?!` : +:cc
Subdivision Name:
Fuel Buming Appliance Information Wood Coal Pellet Gas Oil
Stove
Fireplace Insert
Fireplace,factory built*
Fireplace,Masonry
Furnace,(Garage Only)
*If Factory Built,Please Provide: Manufacturer Name: f ls1.1 c Model No. rA NS-5-11-td h5 C.
Listed By: P,s'� �n�c CO Number: LbgCI?CID
Chimney Information
Masonry** /check one _Block _Brick _Stone
Flue /check one Tile X Steel ?Size in Inches
Material ✓check one L Double Wall _Triple Wall _Insulated 'y! Direct Vent _Chimney Liner
**If Non-Masonry,please provide: Manufacturer Name: S '- Model No. t\ `1 S
Signatures: }}
Print Name: -90Yt(J OL\f
Signature:
Date: iv/3013
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION & BUILDING CODE
AND/OR MANUFACTURER REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING
REQUIRED INSPECTIONS.
Town of Queensbury Highway Department 9 3 -4/3 5/
DRIVEWAY PERMIT
Michael F. Travis, Highway Superintendent Thomas R. Van Ness, Deputy Superintendent
Home: (518) 798-0413 Home: (518)745-0929
Office Phone: (518) 761-8211 Office: (518)761-8211
Fax: (518) 745-4466
Building Permit#:
Date: In/ J7
Tax Map ID: , l 1.7-12/
Applicant Name: r.c ( i �.
Address to be inspected: I Ti- r rl'.. �,nrud s El
Return Address: 9_�i
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 Highway 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 Building&Codes Principal Structure Packet 518-761-8256
13 -934-i
Dennis L. Dickinson, LS/P ICKINSO (TEL) 5 18-668-4676
Devin T. Dickinson lel (FAX) 5 18-668-4674
ASSOCIATES
SURVEYORS* ENGINEERS* LAND CONSULTANTS
7 Irociuois Street P.O. Box 388 Lake George, New York 12845
28 August 2014
S (7 to 3 -ao ( 3
Mr. Craig Brown
Zoning Administrator
Town of Queensbury
742 Bay Road
Queensbury,New York 12804
RE: Mark Shaw •
QU: 309.18_1_12
Dear Craig:
I have inspected the above referenced project site and found the site to be in conformance
with the approved plans. The stormwater management devices have been installed and
appear to be functioning properly. A stone swale was installed on the southerly portion
of the property. However, it is my opinion that this will not affect the functionality of the
stormwater controls.
If you have any questions or would like to discuss this further, please do not hesitate to
contact my office.
Sincerely,
Devin T. Dickinson
Queensbury Building & Code Enforcement - Residential F a al Inspection ( o -
Office No. (518) 761-8256 `` Arrive: = _ : .e.- .•D= a ��
Date Inspection request received: Inspector's Irn ..'
NAME: S bat, P. •' IT#: 1 3 — I.3 �
LOCATION: �"�
I ` l^ ('iL •-
nAcolS D'yE: T a1`7---14(
TYPE OF STRUCTURE: 'S F ,1"
Comments:
Yes/No NIA
4" Building Number Address visible from road ;/�
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
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
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 I Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate / i
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight •
Safety glazing/Window in stairwells safety gl- ing
Interior Smoke Detvtors/Carbon Mo oxid- IIetectors
Every level: \••• Every Bedrockh:
Outside every bedroom rea: ✓
Inter Connected: V Battery backup: /
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area ; -----1-7Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents . 1-7` CE
� _
Bathroom Fans, if no window 0 - CAVIIStcF�
Plumbing fixtures 2 /
Foundation insulation to floor/Sticker on y,�
Duct work sealed properly lower-Door Test Certification / i 1 L�ti1�1�-
Floor truss,draft stopping in ?' aaseme O 5q. . p
Emergency egress below grade //7
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler l � \___
•
Relief Valve(s)installed/Heat Trap!Water Temp 110 .)��E_
Enclosed Stairs Sheetrock Underside minimum W Gypsum /
Basement stairs closed rise>4 inches •J
Garage Floor Pitched / t �� �L �
Garage fireproofing/3/4 hour fire door/door closer 1 /
Gas Logs in Sealed or Glass Enclosure �/
Final Electrical; Energy Saving Light Bulbs 50% "' �� �`A� �1��1 �
Final Survey Plot Plan / V"� `-+ . ---
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles �/
Flex Gas Pipe Bonding
i/ —
As Built Septic System/Sewer Dept. Inspection Sticker .\-->T,,v p lot
Site Plan /Variance required
Flood Plain Certification, if required
Okay to issue C/C or C/0[Temporary/Permanent]
L:1Buiiding&Codes Forms\Building&Codesllnspection Forms1Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008;Revised 6126108;Revised 12/22/10, Revised 04/13/11
(1,00
Queensbury Building & Code Enforcement - Residential Final I pection
Office No. (518) 761-8256 Arrive: a let,q:
Inspection request received: •art: •"� ) /pm
Date
Inspector's Initials �l..r.
NAME: ,-5 N A b.) - R IT#: 13 -,-- ,LA
LOCATION: 1 -r-u3\0 C-1-‘H I SW_L1) IAT : --2—c&-11-1
TYPE OF STRUCTURE: _1j En u31 (cr. CSA R -;E
Comments:
Y No N/A
4" Building Number Address visible from road V/ — R tL 1 �..VR LL 013
Chimney Height/"B"Vent/Direct Vent Location V
Fresh Air Intake f GRbE IA E1-7 ‘)JRc_Li7.
3 inch Plumbing Vent through roof minimum 18 inches V/ Et3 c Com- V_4E.Z i 'ZE 5
Roof Complete/Exterior Finish Complete
I 9.15 A , �9 TINE
Platform at all exterior doors
Handrail 4 or more risers t P� b \P-V1 JF___ 0ETAti\-) .
Guards at stairs, decks, patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Gard at deck, porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches ���t AV C o r
Deck Bracing/NewtctibappeffsRdfln liiinf ✓ L
Grade away from foundation 6 inches with 10 feet f j GI S C.)1T1 C1 J
6 inch clearance to sill plate V
Gas Valve shut-off exposed/regulator 18 inches above grade (i) ,,-jj 1--vcpLit GirtiNlaitAS
V
Interior privacy/trim/doors/main entrance 36 inches /
Bathroom/Kitchen watertight ✓ Z ,5v �, E cakl
Safety glazing/Window in stairwells safety glazing ,� �� 1 �L
Interior Smoke D tectors I Carbon Monoxi Detectors / 1 OJ bok.. T\o� I
rry
Every level: Every Bedrogm: / t PCS 09,01Y-C- �'`�
Outside every bedrooarea: `/ V
Inter Connected: N./ Battery backup: ribccz‘p_v_t ___ " „_1/4.\07.
Attic access 30 inches x 22 inches x 30 inches(height)in accessible areaF1 t1c--b��� � -�e11
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents // f
Bathroom Fans,if no window ✓ l
Plumbing fixtures 0 F 1►.)A 1_--- `J 1..)P,\("E••(
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification V & B
Y b-P1L-T �`� 1\C-
Floor truss, draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade N// th•-\61- _,i1/4-‘ ?u RAA13.
Gas Furnace shut-off within 30 feet or within line of site ✓ /
Oil Furnace shut-off at entrance to furnace area s/ e "VVV-
Furnace/Hot Water Heater operating /
Low water shut-off boiler / N �C ,V"`
Relief Valve(s)installed/Heat Trap/Water Temp 110 ✓ \ \)F
Enclosed Stairs Sheetrock Underside minimum W Gypsum V0 t %p te(
Basement stairs closed rise>4 inches 'f- iz`�
Garage Floor Pitched -T-
Garage fireproofing/3 hour fire door/door closer ✓ / 1 1 N�N CCS
Gas Logs in Sealed or Glass Enclosure �/ lr'�%C- C= 1\) 4
Y Final Electrical;Plot EnergyPlan `
Saving Light Bulbs 50% >I/ �/
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles ✓/ nI� 6�
/ Flex Gas Pipe Bonding V �/1'�
J As Built Septic System/Sewer Dept. Inspection Sticker
Plan /Variance required 'Ci-
Site '
Flood Plain Certification, if required --.-Y C
Okay to issue C I C or C/0[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\lnspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11
RAJ NY on u to ng, LLC
69 Hayden Point Loop
Diamond Point, NY 12824
518 221-3240
08/25/2014
Patrick Burke Construction
Glens Falls,NY 12804
Inspection Address: 31 Twin Channels Road, Glens Falls NY 12804
Report Number: 0825140
Dear Patrick:
At your request, the Blower Door Inspection of the post construction test to verify
infiltration rate of the house as per requirements of the NYS 2010 Energy Conservation
Construction Code of the above property was performed on 08/25/2014. GRAJNY
Consulting, LLC is pleased to submit the following report.
The following data was provided:
- Square Footage of the house, including conditioned basement=4.129 SF
- Volume of the house, including conditioned basement=35,896 CF
Based on above,the following test data was collected:
- Infiltration Rate, including conditioned basement at 50 Pascal =2,173 CFM
- ACH50, Actual Changes per Hour at 50 Pascal =2,173X60/35,896=3.6 <7
The Instruments used for test were provided by the Energy Conservatory Digital Gauge
DG-3 rated accuracy=+/- 1%,calibrated minimum once per year.
Thank you for selecting our company. We appreciate the opportunity to be of service.
Please call this office if there are any questions.
tg-o rsy
•Sincerely. ' %‘4,, Us
CS('‘. \irj‘..A4
Stan Grajny, PE r-
NYS HERS Energy Rater BER-041 f �4
NYS PE 065406-1 �b 65456 �
SSWi''
•
Builders Installed Products(345)
136 Tivoli Street
Albany,NY 12207
Insulation Certificate
Insulation is installed in the structure described below as follows:
Work Area Item Installed Bags / Sq Feet
Vents 11.25x48 Foam Baffles
Vents 11.25x48 Foam Bafes
Ceiling 4MIL 8'X100'CLEAR
Walls 4MIL 8'X100'CLEAR
Walls 4MIL 9'X100'CLEAR
Foundation Walls 4x50 R-11 Vinyl Faced 4'x 50'Wall Blanket
Foundation Walls 5x50 R-11 Vinyl Faced 5'x 50'Wall Blanket
Exterior Garage Walls 6MIL 10'X100'CLEAR
Exterior Garage Walls R-19 15"x 93"-Unfaced-Wood Framing
Garage Ceilings R-19 23"x 93"-Kraft-Wood Framing
Garage House Wall R-21 15"x 105"-Kraft-BIBE Batts
Walls R-21 15"x 105"-Unfaced-Batts
Cathdral Walls R-21 15"x 93"-Kraft-Wood Framing
Walls R-21 15"x 93"-Unfaced-Wood Framing
Blockers and Runners R-21 15"x 93"-Unfaced-Wood Framing
Basement Blockers R-21 15"x 93"-Unfaced-Wood Framing
Garage Ceilings R-30 16"x 48"-Kraft-Wood Framing
Overhang R-30 16"x 48"-Kraft-Wood Framing
Ceiling R-38 16"x 48"-Kraft-Wood Framing
Cathedral Ceiling R-38 24"x 48"-Kraft-Wood Framing
Ceiling R-49 InsulSafe SP-Blowing Insulation 35 / 1,400
*Fiberglass blow has no settling factor for R-values
Job Name: 31 TWIN CHANNELS
Job Address: 31 TWIN CHANNELS RD
QUEENSBURY,NY 12804
Date Completed: 2 _/f-`%
Insulation By: .gLl/ �/ •[. ![� S
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Queensbury Building & Code Enforcement - Residential Fi i al •,pection
Office No. (518) 761-8256 Arrive: Gc141D, D-.-rt: am/pm
Date Inspection request received: Inspector's Initial . _ A
NAME: �>��j 'E" IT#: ( 3—`13
LOCATION: 'R0113 C-1-\f10131J5 D E: 9 —19-1H
TYPE OF STRUCTURE:
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
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
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
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy 1 trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
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 to floor/Sticker on Panel
Duct work sealed properly/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
Oil 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'/2"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garag_e fireproofing/3/4 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 required / �/
Flood Plain Certification, if required / 1l 1 1663E CJ
Okay to issue C 1 C or C 1 0[Temporary/Permanent] n
L:\Building&Codes Forms\Building&Codes\lnspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11
Queensbury Building & Code Enforcement - Residential Fi -. - section
Office No. (518) 761-8256 Arrive: a ger - rt. am)
Date Inspection request received: Inspector's Initials: -r
NAME: l\t6 P" „ IT#: 3
LOCATION: \";1 -TAO 1 tv) C`,t 1 R ) ►. ' E:
TYPE OF STRUCTURE:
Comments:
Yes o N!A
4" Building Number Address visible frorm Qad
Chimney Height I"B"Ventrect Vent Location °f
Fresh Air Intake
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
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 I Handicapped Ramp Compliant
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
Interior privacy/trim 1 doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
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 to floor!Sticker on Panel r. R-zz-- 0
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft. FL-11 'Pt SLX E 7
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler �'Q►,
Relief Valve(s)installed/Heat Trap/Water Temp 110 F 1 REPt_PcE ` F('
Enclosed Stairs Sheetrock Underside minimum'/z"Gypsum , ��
Basement stairs closed rise>4 inches � ��n f� F
Garage Floor Pitched E_
Garage fireproofing/%hour fire door/door closer �.,{
Gas Logs in Sealed or Glass Enclosure r l i < P ..f
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 required c ��\ �
Flood Plain Certification, if re ---�--� i r'
Okay to issue C/C or C/O Tempo)!Permanent]
L:IBuilding&Codes Forms\Building&Codesllnspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection requ: • eiv• d:
Queensbury Building & Code EnforcementArrive: ti a ,i m !!
742 Bay Road, Queensbury, NY 12804 Inspector's Initial.: - -
NAME: ` 5/1—V-e. /.51i I•S PERMI ' #• - ..0 -- (put
LOCATION: j( `i LA (,(/\ j INSPE ON: c-1 M
TYPE OF STRUCTURE:
Y N N/A
Plumbing under slab
Rough Plumbing / Nail Plates
Plumbing Vent /Vents in Place
11/2 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. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head
50 P.S.I. for for 15 minutes
nsulation I Residential Check / Commercial Check ,9 ��C f�`E=�
►qij Ca 1 tJ� _521Z 1b;�
Window Sealing n �Z
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
COMMENTS:
Rough Plumbing_Insulation Inspection_02 05 13
W1 9—//
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Dep m/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials_p
NAME: S PERMIT#: / — 3
LOCATION: j -( Lh 6 h n r1 ( S. INSPECT ON: ,e-7—I y
t
TYPE OF STRUCTURE:
Comments
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 • �-
ti
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing fJ1)
Footing Drain Daylight or Sump -4b
Footing Drain Stone:
12 inch width
6 inches above footing ,, {?-0
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
Rough Plumbing / Insulation Inspection Report — (0
Office No. (518) 761-8256 Date Ins ection retest received: 1-0
Queensbury Building & Code Enforcement Arrive: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector' In' i s:
NAME: Nl YL+.) PERMIT#: 13 —
LOCATION:
I--� �y.� c( .ANNe(c {2--bINSPECT ON: ,
TYPE OF STRUCTURE:
Y N N/A
Plumbing under slab
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
11/2 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. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.I. for for 15 minutes
insulation / Residential Check/Commercial Check //,
Window Sealing \/
Tyvek or Similar Exterior Sealant V
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
COMMENTS: c?...N
���
`('` Jtpugh Plumbing_Insulation Inspection_02 05 13
1 "_�
i
k-A 10
••• 1111111111ft. Town of Queensbury Fire Marshal
f riP7742 Bay Road
Queensbury,NY 12804
761-8205/761-8206 pcds-6LteK 8.
fax 745-4437 ^ y9 r�V
C
Factory Built Gas Fireplace/Stove Inspection Report ( j,,)r
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# /3-13 , Schedule Inspection LI I'LL 11 Time 0 m anytime Inspector ' Y _v%/
Name S � it_UP Address 31 --(u3 (o 0.�Ykmek s Rough In V\ Final
Appliance Manufacturer -1-:::(4)0-Je Model# DO r 2.e SP 3D? b Q
Direct Vent Factory Built Chimney 2( Flue Size Double Wall Triple Wall Insulated
Yes No N/A Comments
/
Floor Protection `11111 ✓ (�`
Clearances to Combustibles (all sides) i `ia° �,,(2C TO c
u 4(9
Firestop(s) Vertical Chase7
Wall Penetration X L tk,
-.1%-•
s �n
Vent Clearances to Combustibles lilt& / ��
Vent/Chimney Termination qitt ,/
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible uk,
construction within 10 feet
Gas Shut-Off Valve —.
Combustion Air ul(1., V
Hearth Extension (if any) c'1)./ X
Mantel 1 (/_ r k t','"
Height above f/p opening '- Y ?„,
Witness Operation ,' 1 p-1--- X
Tank Placement(if LP) u(44
?( d...› 4.---
(Ain
CO Detection l/ f
) t-
q
X
CSST Bonding
White—Building Dept. Yellow—Customer Pink—Fire Marshal
Rough Plumbing / Insulation Inspection Report ?)
Office No. (518) 761-8256 Date Inspection re st received:
Queensbury Building & Code Enforcement Arrive: �;( a l i
742 Bay Road, Queensbury, NY 12804 Inspector Initials: AIA
NAME: S \-\C-tut. PERMIT#: /,3- <-/3
LOCATION: c3 I (I) v'1 G-\41\( [ INSPECT ON: `f- /?—/
TYPE OF STRUCTURE: S t
Y N N/A
Plumbing under slab
11111r/lumbing /Nail Plates
Plumbing Vent/Vents in Place
11/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain /Vent
Air/ Head \1H471
5 P.S.I. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.I. for for 15 minutes
Insulation /Residential Check/ Commercial Check
Window Sealing
Tyvek or Similar Exterior Sealant J
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
COMMENTS: * N-C-541"
F)
Rough Plumbing_Insulation Inspection_02 05 13
Town of Queensbury Building & Code Enforcement f 1 ►(J ()
Office No. (518) 761-8256 ( 1
Framing I Firestopping Inspection Report
Inspection request received:
Name: S (Q.L1-) n I Inspected on: 9-�`I'y
Location: _? j 1 I.v(v1 0.1'10 n,1 iS A1C Arrive: L-- , a.m.!p.m.
Permit No.: Inspector's Initials: _ MAI
TYPE OF STRUCTURE: F1
P(14
Y / N NIA COMMENTS:
Attic Access 22"x 30"minimum
Jack Studs/Headers
Truss Specification Provided ✓�
Bracing/Bridging
Joist hangers
Jack Posts 1 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
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 1 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 �v c\d a lv�I`2
Office No. (518) 761-8256 LC. a s )
Framing I Firestopping Inspection Report
Inspection request received:
Name: S\not Inspected on: 3 —Ef U---/11
Location: _3 / 1 w t' n C \C4/1 n c- I S Arrive: / ..r•'3�i-� a.m./p.m.
Permit No.: / 3 7 3 Inspector's Initials:•
C'J /\
TYPE OF STRUCTURE: S
Y N N/A COMMENTS:
Framing
Attic Access 22"x 30"minimum
Jack Studs l Headers
Truss Specification Provided
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 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 <`
iMillihte1d 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 j
Office No. (518) 761-8256 ` ` 3 pYiN
Septic Inspection Report
---7-7,,e0 ,-_,C1 (7-2
Inspection request received: / , 10-
Name:
1 -Name: it\(",..(.}` Inspected on: ( 1 t it/71-0/ `t
Location: 5 1 /,o; r 5 Arrive: a t. a.m.I p.m.
Permit No.: AO) 5 ,-43 41 Inspector's Initials: r_
`�• Comments andl/or diagram
Soil Type: a / Clay
Type of Water i al/Well Water 710+ge--
Waterline separation distance ft. �111/l eGr rr—
Well separation separation distance ft.
Other wells: ft. C. i la„(-- L�
Well Casing Length 50'+1 Y N411P Yl��" 9/ r 6 j c- J
[150'to well required if NO] 0-) J(P
Absorption Field: Total length ri., ft.
Length of each trench AD ft.
Depth of trenches ''3e ft.
Size of Stone /J j 'L, lt.lif 3
Seepage Pits: Number .)' h
Size:,' I — x
Stone Size: '
Piping Size Type
Building to tank tz. .a,a. 12P
ATank to Distribution Box ` -.)...,,, ,
Distribution Box to Field/Pit ,,4.,\ ;
Opening Sealed: N
End Cap ____V-11,, N
Inlet/Outlet Pipes&Baffles '_N
Manholes 12"or less below grade _Y11
[provide extension collar if Yes] _Y��lç252. i✓ �`
Location/Separations 1 • Cj V yL)-- ,I,AA
Foundation to tank /7, ft.
Foundation to absorption ft. �____
Separation of Pits
Conforms as per Plot Plan r 1' .4 .
Engineer Report and As-Built Y___VNI f\--
ETU Maintenance Contract provided Y_N f: �,� '� ' v
Location of•System on Property: ".)
(Front-/ Rear Left Side /Right SidQ/ MiddJ ront Middle Rear
System Use Status:
Aso
a / Partial Approve. .nd needs to be re-inspected, please call the Building &Codes Office
Septic Inspection Report
d a-6--
Foundation Inspection Report
-66
Office No.(518)761-8256 Date Inspection request received: l l-
Queensbury Building&Code Enforcement Arrive: am/pm Dep pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials•
-T, 1q(_03,) ()f) 5iA -
NAME: clAPTl) PERMIT#: 1 3 43
LOCATION: 3 l moi, v. (4,41-i S SPECT ON: I.3- 4J e 1 j'
TYPE OF STRUCTURE: re?,
Comments
Y N N/A
Footings
Piers
SlabN
Reinforcement in Place
ac or is re sible_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\Buulding&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No. (518)7614256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depar�� am/ m
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:e,„?
,L4
NAME: 3 k\4 D ry PERMIT#: 1 .3-- y
LOCATION: ; - „t2L
; �� ,: r INSPECT ON: / — O .-/ 3
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 Dampproofmg --°1C111
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
-fk) urS
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request r-M ' : 1:
Queensbury Building&Code Enforcement Arrive: Tom'-�� : • •*!art: � jam/rnn-
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials C`
NAME: S\r, PERMIT#: /:.3 - l-3
LOCATION: ,?) INSPECT ON: /oZ —/01,-/3
TYPE OF STRUCTURE:
Comments
Y EILA
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 Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Buliding&Codes\Inspectlon Forms\Foundatlon Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
(j4iVarh .
Foundation Inspection Report W .1)
Office No.(518)761-8256 Date Inspection request received: / �it ��
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials/2
(_-76
NAME: PA-T- = �a�-/1-746
L �'l,tf PERMIT#: 13" 3 7"
LOCATION: . < <. •
INSPECT ON:TYPE OF STRUCTURE: 17 murk
// /
C f mmenta •
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 Dampproofmg
Foundation Waterproofing
Foo : :r lay ., 'r Sump
Footing :Dram;.Stone:
12 inch .
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval t /
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
N\rf\d_cc%, g-k)
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: , ,
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: �(� 1am/pm
'�
NAME: S h PERMIT#: 13 -<"/
LOCATION: i UJ-(ice (4, \Q,. ,o LINSPECT ON: /)- i-/
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place ON/\' S)).
The contractor is responsible for `' — fRo-NR,7)4.--
providing
protection from freezing
for 48 hours following the placement � (
of the concrete. 61`� vim` (W2 ) f2L4./A4NI)
Materials for this purpose on site. _
Foundation/Wallpour
Reinforcement in Place !n 1 z J`--,6�
Footing Dowels or Keyway in place
— k
Foundation Dampproofing
Foundation Waterproofmg i
Footing Drain Daylight or Sump _ 7
Footing Drain Stone:
12 inch width f
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
iu.-fugA
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: , IL).1 am/piok, Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: L
NAME: PERMIT#: / 3`-I 3 7
LOCATION: •.3 I • Ir u t-(m 1/4-4 vo N.1� s; 1� INSPECT ON: /,-;)
TYPE OF STRUCTURE: S
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
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:\Bullding &Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
(\ \t)ir\A62 I-3 ESF +1
Foundation Inspection Report y
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pmI Depart\ am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial . ,�(
NAME: 1\(\61 R \(4._,L;) PERMIT#: /3--V 3 Ki
LOCATION: -1.0--).‘ 171 CA"\ ;.t;1rvi INSPECT ON: 1/ /&• •!.3
TYPE OF STRUCTURE:
Comments
Y7 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 •f
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&Codess\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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Deed Reference
Lands N/F of Rice (3507/23(5) James L. Shaw
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Town of Queen5bury County of Warren
State o New York Iron Pipe Found
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Scale: 1 " = 20 feet Date: I I October 2013
Survey ai d Map by
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Surveyors Engineers Mappinca Not f
LAKE GEORGE, N W YORK 12645
Note: Only title surveys bearmg the makers Unauthorized alteration or addition to a survey map
embossed seal should be retied upon since bearmcg a hcensed land surveyor's seal is a violation
QU: 133_ 1 _ 1 (old) other than embossed seal copies may contain of section 7209, sib-diusion2, of the New York State
QU: 309 18 1 12 now unauthorized and undetectable modifications, Education Law.
( ) 1 �u�13 deletions, additions, and changes.
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