98-732 Certificate of Occupancy
Town of Queensbury
Warren County, New York
Date February 28, 2000
This is to certify that work requested to be done as shown by Permit No. 98732
has been completed.
This structure may be occupied as a RESIDENTIAL ADDITION & ALTERATION
Location 11 FIELDING LANE
Isi)irter------- VAN-SCHAICK, PAUL THOMAS
TAX MAP NO. 12 . -1-11 By Order Town Board
• Trilly:2UEENSBys
t..240/P
Director of Building& Code Enforcement
BUILDING PERMIT
VALUE15000TOWN OF QUEENSBURY
$ No. 98732
TAX MAP NO. 12 .-1-11 WARREN COUNTY,NEW YORK
PERMISSION is hereby granted to VAN SCL A T['K►- pAxLL 'IHOMAS
OWNER of property located at 11 F
TF.T.flTNCt 'LAMP' Street,Road or Ave.
in the Town of Oueensbury,To Construct or place a RRSIDF'IL'ITAT-- .'-) ITI^N t AVTz'RATYeN
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance.
1. OWNER'S Address is
22 LOMOND AVE.
SPRING VALLEY, NY 10977
2. CONTRACTOR or BUILDERS Name
ROULIER,,_ CHARLES
3. CONTRACTOR or BUILDERS Address
CLEVERDALE, NY 0
4. ARCHITECTS Name
NEW YORK BOARD
5. ARCHITECTS Address
NEW YORK BOARD OF FIRE UNDERWRITERS
6. TYPE of Construction—(Please indicate by X)
RES.ALTERATION & ADDITION
i Wood Frame ( I Masonry I I Steel 1
7. PLANS and Specifications
103ao,sq ft ADDITION AND 1376 SQ FT ALTERATION AS PER PLOT
PLAN SPECIFICATIONS
8. Proposed Use
RESIDENTIAL ADDITION & ALTERATION
136 December 2 19 2000
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
ill a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the ewpitation date.)
2 December 1998
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Oueensbury
Building and Zoning Intpeetor
P" Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-8256]
-O BUILDING & . CODE ENFORCEMENT
NOTICE Requirements prior to issuance r
A permit must be obtained before
of this permit: PERMIT FILE NO. l
beginning construction. No inspections PERMIT FEE PAID$
will be made until applicant has received n Zoning Board Action •
a VAI1II) BUILDING PERMIT. All Area /Use RECREATION FEE PfID$
applicants" spaces on this application �� I
MUST be completed and the signature (� Planning Board Action REVIEWED BY:
of the applicant must appear crtt the SPR / Subdivision /Other Building Inspector
pplication form. max, .. J
--� •
Recreation Fee Payment
ApplicantL� .�r Owner: "e404 Z.,.os Lo.......c(a,c:•(-
' Address: /f o• 'S. .36' // ��1�.eid.4 i✓.KAddressa t 1,0 ..�,r�i :e .. s.o '-- :a/fo }r
/.t a�=) /,/o7'7
Phone # {,�2'd ) L,3Z -J )'�/ �j Phone # ( 9iy ) ,�,t - �777
�r
Property Location: /1 s4 .,.� �Owci GCe•►e„ eec— N
Subdivision Name: °+/i,► Tax Map Number__ ' I Z±
Section Block lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ /log . . �'
residence / commercial
)C Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial V Single Family Dwelling
Residence / Commercial Two Family Dwell,± ,ga
no change to exterior size Family Dwell:in-e A
Office
Other Work (describe below) Mercantile
Manufacturing
V
c'°
Other GROSS AREA OF PROPOSED STRUCTURE:
If ADDITION, what will use
1st Floor sq. ft. / of new addition be? :
2nd .Floor / 74v, sq. ft. b
Other Floors sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: dye 2 SQ. Attached Garage 1, 2 car
4 Private Storage Building
SIZE OF NEW STRUCTURE: J 07
3)- /1 , Commercial Storage Building
..34 FEET X Y.= FEET\,, I Other
Foundation. Type: e..•.....' ,Bex G.,,,....4:-X Will any second-hand or ungraded
Number of Stories : ...I lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : V .l7 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which applies)
to be installed: / Gas / Wood
Forced Hot Aif.> Baseboard / Other
Person respon 'ble o}; supervision of work as rGam�e9ar s to building
codes is: • ! ...G-e . C,. /3. 34/ , N•y /.Ara"
N me Addresss Phone
Builder: Sc e-4
Plumber: V•13,11
Mason: f.a.v--
Electrician: Jewel.-
DECLARATION: Please sign below after you have carefully read the statement.
To the best of my knowledge the statements contained in this application, together with the plans
and specifications submitted, are a true and complete statement of all proposed work to be done on
the described premises and that all provisions of the Building Code, the Zoning Ordinance and all
other laws pertaining to the proposed work shall be complied with, whether specified or noted, and
that such work is authorized by the owner. Further, it is understood that Uwe shall submit prior to a
Certificate of Occupancy"or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: —
(owner, owner' agent, architect, contractor)
•
- - �
_/ ‘H ENERGY CODE COMPLIANCE APPLICATION
F3 TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance Methods : PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings ( 3 stories or less)
PART 4* Design by Component Performance
Commercial Buildings-Hi Rise Residential
* quir s submission o wo ksheets
• / !� Alec /✓.r
Geer + .1. AP.' i .•� /� i✓ Awr
APPL CAN ' S NAME: PROPERTY LOCA ON:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - ml$015a square feet
2 . Type of Heat - Electric y Oil Gas Other
3 . Is building mechanically cooled? Y Yes No
4 . Percentage of area of windows and doors Over 17% y Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof R ..3'7
b . Exterior walls R /y
c . Glazed areas R ...,
d . Exterior doors R 7. - -
e . Floors over unheated spaces R
f . Edge of slab on grade (heated building) R -»
g. Basement/cellar walls (above grade) R
h. Basement/cellar walls (below grade) R —
i . Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code X Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
A p1 i ant ' ignature D to Phone Number
INSPECTOR' S REMARKS :
(51.13(
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury \\ A;)0
Permit No. /� "�/ 'j��Dept. of Community DevelopmentC‘t
Building &Codes Office C— _ \
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: // 4, /t)• Y
Property Owner's Name: ,oL .,.,..s f a,,, S ,.� -
Property Owner's Mailing Address: _4t? • ..,r241.04 ,' 4ero," i ./� ,t. y /L72,•
J
Installer's Name:4.4,,,111e lc.. Phone # 75:3 - o y 3/
Number of bedrooms (if residential): Total daily flow: 91''
(residential -compute @ 150 gal./bdrm.)
Topography: 1/flat, rolling, steep slope % of slope
Soil Nature: sand, ✓ loam, clay, other /depth:
Ground water: at what depth?lry feet / Bedrock or Impervious Material: at what depth?' feet
Percolation test: not required, required [rate min. per inch J
Domestic water supply: municipal, well, other
If domestic water supply is a WFT , water supply from any septic absorption is Nf feet.
PROPOSED SYSTEM
Septic tank•/•+►+r gallon (minimum size: 1,000 gal.)
Tile field: each trench 5 feet / Total system length: I(P2 feet
Seepage pit(s): number of / size each: . ft. by ft.
•
Size of stone to be used: # ` / depth or thickness feet
•
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
( lam system and associated electrical work to be inspected by a certified agency.
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 aryl all requirements of the Town of
Queensbury San;tary Sewage Disposal Ordinance.
Signature of responsible person: / Date: /11347
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement
Dept. of Community Development Arrive am/pm Depart am/pm
Town of Queensbury Inspector's Initials (sue
742 Bay Road
Queensbury,New York 12804
NAME PAoL —1-14,01-kfta Vikt3 he.1\A\C t. PERMIT# Cig—7',2._
LOCATION l 1 ) I3E 1.3E DATE Z— 1 --0C)
TYPE OF STRUCTURE (Z'E.j, FT) t�
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location '
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landin ' . or more
Interior Handrails stairs both sides 3 r moie\risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulato 18"above grade
Gas Furnace shut-off within 30 feet within line of site
Oil Furnace shut-off at entrance to ace area
Furnace/Hot Water Heater operating /
Relief Valve(s)installed
t
Headroom,6 ft.6 in. on stairs ``7'"`"--
Basement stairs,6 ft. 4 in. //
Handrail exterior stairs both sides ore than 3 risers
Interior privacy/trim/doors/main ce 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Lan g 18 in. or more
Railing across window in stairw is
Smoke Detectors:
every level
every bedroom
outside every bedroom }
inter connected
/
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
S ty glazing 18"or less from floor
a2te PlanNariance required (W
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. CIO(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
il . -"4 A.'
RESIDENTIAL FINAL INSPECTION REPORT
t Office No. (518)761-8256 Date inspection request received:
! Building& Code Enforcement
r Dept. of Community Development Arrive am/pm Depa
Town of Queensbury Inspector's Initial
742 Bay Road �--�
Queensbury,New York 12804 �Soe- e c
NAME Q t_ -ri-ko Niv6 Y1P41 AC kc C A RMIT# cr 'Zgl
LOCATION I l Ft E t C-, 1 DATE 'L.— —CC)
TYPE OF STRUCTURE RCS. FIn�Q it.Q-
N/A YES NO COMMENTS
Chimney Heighti'B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in. or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/r ator 18"a.,, e grade
Gas Furnace shut-off within 30 fee i .. 1- . site
Oil Furnace shut-off at entrance to furna area
Furnace/Hot Water Heater operating .
Relief Valve(s)installed
Headroom,6 ft. 6 in. on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs bo ides more than 3 risers
Interior privacy/trim/doo 'main entrance 36"
Floor Finish
Bathroom/Kitchen w ertight
Interior Handrails :alconies/Landing 18 in. or more
Railing across ., dow in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
*As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. CIO(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
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GENERAL INSPECTION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive 2/r am/pm Depart am/pm
Inspector's Initials '41_,
NAME: /-f/1( � �L PERMIT# J— 2
LOCATION: et (Ai,- DATE : 1
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours fol owing the place ent
of the concrete.
Materials for this pu se on si
Foundation/Wallpour ''
Reinforcement in Place
Foundation/Dampproofing t�
Backfill Approval t�
Plumbing Under Slab
Plumbing Vent/Vents in Place 1
Rough Plumbing
Heating Rough-In
Insulation_
Foundation Walls Interior R-
Foundat ion Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement p.
Dept. of Community Development Arrive 1=Z am/pm Depart
Town of Queensbury Inspector's Initial
742 Bay Road
Queensbury,New York 12804
NAME A Ili dC lc., PERMIT# G' —7` 7
LOCATION (=t E l D t Il DATE ( Z`7-
TYPE OF STRUCTURE i(
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location I/
Fresh Air Intake ✓
Plumb Vent through roof
Roof Complete I
Exterior Finish Co.. .lete
Interior/Exterior Rail •ts 30"to 3." ✓i
Exterior Handrails, ..1 , es,1. ...g 8 in. or more ,/
Interior Handrails •• •.1/4, Si.:s 3 or, ore risers
Grade 2%away from four•• on J
8"clearance to sill plate ,
Gas Valve shut-off exposed/re:ulator 18"above grade
Gas Furnace shut-off within 3, feet or within line of site ✓,
Oil Furnace shut-off at en II • . to furnace area d `
Furnace/Hot Water Heater o.• ating
Relief Valve(s)installed J
Headroom,6 ft.6 in. on •, /
Basement stairs,6 ft.4 in. �/
Handrail exterior stairs bo sides more than 3 risers ✓,
Interior privacy/trim/doors/main entrance 36" //
Floor Finish
Bathroom/Kitchen watertight I/
Interior Handrails Balconies/Landing 18 in. or more f
Railing across window in stairwells ✓ /
Smoke Detectors: J
every level
every bedroom
outside every bedroom /
inter connected ,/
Bathroom fans ✓/
Plumbing fixtures ✓/
Foundation insulation 43/4 hour fire door/door closer V/
Garage fireproofmg 'I
Garage penetrations sealed JFurnace in separate room protected(in garage)
Light ventilation per room Safety glazing 18"or less from floorij
Final Electrical
Site Plan/Variance required I/
Final Survey Plot Plan x/ li
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
q:61.1) _ (...1 ".2),,,3 o..........
RESIDENTIAL FINAL INSPECTION REPORT ' L..--37. --1--
Office No. (518)761-8256 Date inspection request received: 11%
Building& Code Enforcement
Dept. of Community Development Arrive q••'`1_ti),, m Depart",61®0j0
Town of Queensbury Inspector's Ini •: /,�►�`
742 Bay Road
Queensbury,New York 12804
NAME 4—SG i-e #:Lk PERMIT ® ���
J
LOCATION f oc.' ` -'• DATE � �� J�4
TYPE OF STRUCTURE - `
N/A YES NO CO S
Chimney HeightP'B"Vent/Direct Vent Location d, r I'i i
Fresh Air Intake J � t
Plumb Vent through roof I
Roof Complete
Exterior Finish Complete I/
Interior/Exterior Railings 30"to 36" ✓/
Exterior Handrails,balconies, : ding 18 •:. or 're
Interior Handrails stairs both sid• 3 or mo.e risers /
Grade 2%away from foundation t I
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18 ..$ve a .a e 1
Gas Furnace shut-off within 30 feet or within, $f site /f
Oil Furnace shut-off at entrance to furnace ar-: ✓
Furnace/Hot Water Heater operating f
Relief Valve(s)installed
Headroom,6 ft. 6 in. on stairs J
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 sers
Interior privacy/trim/doors/main entrance 36"
Floor Finish if
Bathroom/Kitchen watertight ✓/
Interior Handrails Balconies/Landing 18 in. or ore ✓ V
Railing across window in stairwells
Smoke Detectors: I
every level
every bedroom ✓i
outside every bedroom Vj
inter connected J/
Bathroom fans V/
Plumbing fixtures V
Foundation insulation (—n.) CZ.--cbT �5 IL Z . '`—V .��
%hour fire door/door closer df
Garage fireproofing V
i.
Garage penetrations sealed
Furnace in separate room protected(in garage) '/
Light ventilation per room ►/
Safety glazing 18"or less from floor ✓�
Final Electrical / 'Jr
Site Plan/Variance required ✓/
Final Survey Plot Plan ti /
As Built Septic System layout required J
Okay to issue C/C(Certif of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
GENERAL INSPECTION REPORT
Town of Queensbury 4/11
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road ,
Queensbury,NY 12804 Arrive W Depart I"4 `<,1,4 ,
Inspector's Init'.tom
% e
NAME: PERMIT# r •
LOCATION: \\S i o DATE : R 12-9
TYPE OF STRUCTURE: ? -
RECHECK
N/A YE O COMMEN
tings/Piers 3 5 C O ' �'�' I '- e TS pF
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from ing
for 48 hours following the i la ent
of the concrete.
Materials for this purpose on s -
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval\
Plumbing Under Slab\
Plumbing Vent/Vents in iace
Rough Plumbing �,
Heating Rough-In
Insulation
Foundation Walls Interior '
Foundation Walls Exterior R
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
---0-
GENERAL INSPECTION REPORT 91, h
Town of Queensbury
Dept.of Community Development Date inspection request received: �'-g`7
Building& Code Enforcement
742 Bay Road
�- - �
Quee u , Y 12804 Arriv ea m _Depart
spector's Initial
N _` Gw Sict.a.:c.k PERMIT# ).1-1' 3�-
LOCATION: /t 7'ic(c .e DATE : s►�` fry
TYPE OF STRUCTURE:
RECHECK ,
N/A YES NO COMMENTS
Footings/Pie I I
Monolithic Pou Form 1
Reinforcement in lace
The contractor i spo le for
providing protectio freezin
for 48 hours followin ment
of the concrete.
Materials for this pu pose on site
Foundation/Wallpour
Reinforcement in ace
Foundation/Dam roofing
Backfill Approval
Plumbing Under Slab .
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In V
emulation
/ Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- /
Walls R- ',/
Ceiling R- ,q
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
GENERAL INSPECTION REPORT
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive �i a r'" epart • :,i011 ----
Inspector's Initi
NAME: Gj1 PERMIT# •
LOCATION:\\ i e 61 n, DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers ( I
Monolithic Pour Form
Reinforcement in Place
The contractor is res •nsible for
providing pro - '•n fro s freezing
for 48 hours foil wing the ,lacement
of the concrete.
Materials for this urpose on to
Foundation/Wa •,•ur
Reinforcement in ' •v-
Foundation/Dam• troofing
Backfill Approval
Plumbing Under S
Plumbing Vent/Ven in Place f
1..1k6ugh Plumbing \ .T 4 21,3t0 i&► e- t\ -M NZ \
Heating Rough-In - �
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Pro r Vent, Attic Vent
naming 1.574 7-!3pFes--...
Jack Studs/Headerg
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
GENERAL INSPECTION REPORT
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive35 a 4121110 Depa
Inspector's Initials
NAME: it ` GG n �lif\o ciAc PERMIT#
LOCATION: \1 \p d Q DATE :
TYPE OF STRUCTURE: d ,,r-o>,N— l rr•
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for ~4
providing protection from freez.ig
for 48 hours following the place ent
of the concrete.
Materials for this purpose o site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
per Ve Attic Vent
naming y os s e
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
54-->s," 4---; 4, -
GENERAL INSPECTION REPORT
Town of Queensbury
Dept.of Community Development Date inspection request received: / S9 R
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 pm j Arrive ?/caam/pm Depart am/pm
Inspector's Initials c/)# ,4 0 70-/9g
NAME: k.46,-;4--L PERMIT# 9 -! 5 '
LOCATION: rg-ti--64-0E-,,,, , t.,..,5 ,....
a D TE : / V
,. �'�4e '
TYPE OF STRUCTURE.
RECHECK
N/A YES NO COMMENTS
Footings/Piers F I ,
Monolithic Pour Form �r, ; / " /, ���4 c'- `:�"
Reinforcement in Place - /t ' ` `
The contractor is responsible for -`t . t it,,/,
providing protection from freezing / ��
for 48 hours following the placement - :I' / (1 /-we ',,'rs '/ (1"```fit
of the concrete. ` e,- -.-
Materials for this p se on site ea �^"�'J
t
Foundation/Wallpour � ��/�, ` '
Reinforcement in Place / "'
Foundation/Dampproofing ______- A A ,,��L �?If c 4.�'""'
7ffackfill Approval - A '� `f x
Plumbing Under Slab r p._ /4c t
Plumbing Vent/Ve in Place ei.c-v"
Rough Plumbing' „� .
Heating Rough-In fiA,�.s 4 - f/.,, re-zi
Insulation
Foundation Walls Interior R- / r-,� �,p� ; s� 1--'Foundation Walls Exterior R- ` C"y�`s s
ie�
Floors R-
Walls R- ✓c c-"
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent r
Framing ✓vf'
Jack Studs/Headers '
Bracing/Bridging
Joist Hangers V >
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
f
GENERAL INSPECTION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart ' '1)am/pm
Inspector's Initials cv
NAME: bi-11-Ai &/(,1fC .X. PERMIT# 7 �--
LOCATION: r e �-�� �/ DATE : 27k.f 96
TYPE OF STRUCT :
RECHECK
N/A YE NO COMMENTS
ootings/Piers • 1 I
Monolithic Pour Form — ,ti 1 v��-
Reinforcement in Place �-
The contractor is responsible fo
providing protection from s :- ing
for 48 hours following th. .1a,went
of the concrete.
Materials for this purpo : on site
Founda n/Wallpour f
Reinforce -, in Place
Foundation/Dam.. -: g--
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i' Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
I !b
TOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ° 4 5CA4AC-K
Location _ h t I61,( (A)U Li
Date 4 "74 98 Permit # /�1 " 7
SOIL TY E: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIEL : Total Le gth
Length of each t ench
Depth of trenches
Size of stone
SEEPAGE PITS: Num
Size - ft x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank. to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS: feet
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
V�2\C T67—
/5s ieutia I1 •
ZN� ko) S (Mii
SYSTEM USE APPROVED: YES
Arrived: t
Departed: A
3C/c----"
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