93-723 CERTIFICATE OF .00CUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date C1�fliYt O 1 D 19 yam"
v
This is to certify that work requested to be done as shown by Permit No.
93-723
t has been completed.
single family dwelling with
This structure may be occupied as a turn r-ar at.t.anct-d garage
Location Lictoria'. Drive
Nicholas A. Orsini
Owner
55-1-31 .1
By Order Town Board
TOWN OF QUEENSBURY<
s Director of Bldg. do Code Enforcement
i-3
BUILDING PERMIT
TOWN OF QUEENSBURY ro
No. 93-723 Y z
WARREN COUNTY, NEW YORK
t
NICHOLAS A. ORSINI
PERMISSION is hereby granted to U-1
Victoria Drive
N
OWNER of property located at Street,Road or Ave. w
N
Single Family Dwelling
in the Town of Queensbury,To Construct or place a
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 Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 0
22 Elizabeth La
Queensbury NY 12804
H
2. CONTRACTOR or BUI LDER'S Name
Z
same
0
3. CONTRACTOR or BUILDER'S Address F'
>L
4. ARCHITECT'S Name
5. ARCHITECT'S Address
C
N-
0
rf'
0
6. TYPE of Construction—(Please indicate by X) I j
I-'•
( )XWood Frame ( ) Masonry ( )Steel ( )
CJ
�i
7. PLANS and Specifications F'
Q
721x33 ' T&O story Single Family Dwelling as per plot plan 0
No. specifications and application including two car attached
-garagem
8. Proposed Use
Single Family Dwelling '
w
ID
$ 255 . 00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 3 1994 131
sv
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the �1
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 3rd Day of December 1993 C7
ID
SIGNED BY for the Town of Queensbury ~
an oning Inspector I-
LQ
TOWN OF QUEENSBURY REVIEWED BY:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING & CODE ENFORCEMENT FEE PAID:
531 BAY ROAD
QUEENSBURY, NEW YORK 12804 PERMIT N0.
(518) 745-4447
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO ONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDI ^ ERMI -0
All applicants ' spaces on this application MUST be completed aft.d the 49
signature of the applicant MUST appear on the applicatiO3 form. ' ^�� �J
C
OWNER OF PROPERTY: � � S /-� + Aes �jAu ReGei o�
Mailing Address : 1-3 !,
Telephone Number(s) : Work f Hom `7L/'-��;,��' + he .Oe
/ ► a=
PROPERTY LOCATION: V e..h
Tax Map Number: Section Block / T
Subdivision Name: Lot No.
NATURE OF PROPOSED .WORK: ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ 166,M
N—E LDING:
RESIDENC COMMERCIAL OCCUPANCY INFORMATION:
TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL _ Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL Family Dwelling
(NO CHANGE TO EXTERIOR SIZE) Office
OTHER WORK (DESCRIBE BELOW) Mercantile
Warehouse
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE• ?O
1ST FLOOR 227 SQ. FT. X!,V
�x-IF ADDITION, USE OF NEW ADDITION:
2ND FLOOR `� SQ. FT. � }
OTHER FLOORS SQ. FT. A
(not unfinished cellar or basement) '���6 CCESSORY BUILDINGS:
Detached Garage - One/Two Car
TOTAL FLOOR AREA: / L1 SQ. FT.� Attached Garage - One wo
Private Storage Building
SIZE OF NEW STRUCTURE : Commercial Storage Building
Other
7A FEET X FEET
Foundation Type: Pe,,c�eeQ e'Bnc to Will any second-hand or ungraded
Number of Stories : �_ lumber be used? If so, for what?
(habitable space only) do
Height (grade to ridge) : Q— feet Type of Heating System:
Number of fireplaces and/or woodstove (circle all which applies)
to be installed: �_ Electri OI / Gas / Wood
orce Hot A' / Baseboard / Other
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
NAME OF BUILDER/ADDRESS/PHONE: AJ/ L/< a CZ S i ►�
NAME OF PLUMBER/ADDRESS/PHONE : r r L A L L- -
NAME OF MASON/ADDRESS/PHONE: I K) A-L Z) cn1 i nl
NAME OF ELECTRICAN/ADDRESS/PHONE : t?, r ��_�l L► c2t_:�_IAA
DECLARATION
To the best of my knowledge the statements contained in this appli-
cation, 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 I/we shall submit prior to a Certificate of
Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN
drawn to scale, showing actual location Yo '-elt o mises_. _
r• nneru,
( own e 's agent, architect, contractor)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
(-,--
1&2ENERGY CODE COMPLIANCE APPLICATIONTOWN OF QUEENSBURY, WARREN COUNTY \Jea9000 HEATING DEGREE DAYS �'e °§Compliance Methods : PART 5 - Acceptable Practice Metho Family Dwellings (onl
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
*Requires submission of worksheets
APPLICANT'S NAME: PRO ERTY LOCATION:
��11 G�l c�Ja S f� •���IICJ ,~ i Eho V I 0�c__D r f
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - /q q il square feet
2 . Type of Heat - Electric Oil X Gas Other
3 . Is building mechanically cooled? X Yes No
4 . Percentage of area of windows and doors Over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R _
b. Exterior walls R - f
c. Glazed areas . R 3.3
d. Exterior doors R 3. 3
e. Floors over unheated spaces R A/,
f. Edge of slab on grade (heated building) R i/,*—
g. Basement/cellar walls (above grade) R /o
h. Basement/cellar walls (below grade) R /D
i. Heating/cooling-ducts-piping in unheated space R IVj
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
i t' nature ate Phone Number
INS ECTOR'S REMARKS :
34 Se)
&9,
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT 0 P i #
° ®�C�Fe � i dce
N
sb
Date: _ l Red�e@FQy
LOCATION OF PROPERTY FOR INSTALLATION:
Owner's Name:
Owner's Mailing Address: aq�O
Installer' s Name: C tculj_0-1� CU�I�S Phone #: 77f,?-0M
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom) : 141�0
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: San Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other _
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 660 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench !Co feet//Total System Length a,O feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # / Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRE
No. of Tanks Size of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: � ,��-� DATE: ( R 3
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1) the proposed location of the system
2) location and. distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
a ° a
TOWN OF QUEENSBURY
531 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date " �. ,19 Permit No. U-173
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws; ordinances,regulations, and all conditions that are part of these,Kel uirement''and also will allow
all inspectors to enter premises to perform required inspections. 1
Please fill out additional form if more than one appliance and/or chimney.
l
Applicant r ,,� , � d �d. 9 ; APPLIANCEil.(check_.appropriate boxes)
'Ttk,
Address fg� ❑ STOVE: ❑Wood ❑ Coal ❑ Pellet ❑Gas
� ❑ FIEPLACE INSERT
Zip k: %,FI;RF-PLACE, FACTO RY-BUILT
°�. '- _� ¢ ,*Wood ❑ Gas '
Phone ��--- �� °�" ❑ FIREPLACE,"MASONRY:
'{ o Wood ❑ Gas
Ow , , g � ❑ FUMACE:1,"p�Wood ❑ Gas ❑ Oil
Address. IF NON-MASONRY APPLIANCE:
�� Manufacturer:
Zip 199, 6 Model:
Phones �� 1 6 IS�
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
❑ MASONRY: ❑ Block•;❑ Brick 0 Stone
t (1,h) � cam FLUE: ❑ Tile ❑ Steel
Size: inches
CONSTRUCTION /INSTALLATION MUST OFACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS ❑ Double Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS. ❑ Insulated ❑ Direct Venting
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Received
Code Number Title y
A 173 33.89- > :'(1-90) Publi6Safety
A 233 2655 (230) Minor Sales
Free Collected From ors Refunded to:
Address:
Dated: /2.11 N.? Town Clerk or Deputy:
White: Applicant Green:Fire Marshal Yellow: Bld`'.'Dept. Pink & Goldenrod:Cashier's Dept.
TOWN OF QUEENSBURY ALI-
QUEEUSBURYBUILDING & CODE ENFORCEMENT531 BhY ROAD_NY i*N04
(518)745-4447
ARRIVE: Z�Z� DEPART: s INSP
FINAL INSPECTION REPORT - RESIDENT L
DATR INSPECTION REQUEST RECEIVED:
NAMI9
LOCATION n /"
DATE 7 _(%'7 Jl PERMIT 1�/
TYPE OF STRUCTURE n iv
FOOTINGS 4- FOUNDATION �BAC FILli 1�F RAM
ING 7/
ROUGH PLUMBING _SEPTICNSULflTION
FINAL ELECTRICAL _ ,� WOODSTOVE OR FIREPLACE
N/A YES NO
1CHIIfJNEY HEIGI V EIG{T
PLUMBING VENT
OOFING
EXTERIOIL FINISH
DECK/FORCH/STEPS/RAILINGS
RELIEF VALVE
FURNACE }OT WATER ERATING
INTERIOR TRIM RIV C DOORS
FINISH ELOORS:
BATH KITCHEN WATERTIGHT
OTHER FLOG S SWEEPABLE
i
OTHER ELOO S CARPETED y�g
STIR CLEARANCE RA LING
SMOKE DE TEC ORS %
pAMILROM PANG
PLUMBING FIXTURES
fl.ULA�CE EIRF N
11 IR CLOSERS
z�
IflAL EL C C
,SITE PLAN/VARIAN E REO.
FINAL-9-URVEY PLOT
OK TO ISSUE C/O OR C C '
TOWN OF QUEENSBURY
FIRE MARSHAL
UEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME -
LOCATION
DATE PERMIT#_
APPROVED
EXITS N/A YES NO
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION( r
AUTO. SPRINKLER SYSTEM Y'
ALARM SYSTEM ` ri
f
r
a'
INTERIOR FINISHES s�
STORAGE: ^
CLEARANCE .TO SPRINKLERS
CLEARANCE TO HEATING UNITS`
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLACE-MASQNRY
IREPLACE-FACTORY BUILT
REMARKS: U OK TO THIS DATE
2/015 —MINSiPEURITOK
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 357 Elwyn Terrace — Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL/p
Pane!Beard No................... Cert. c �11
— 3 3 3 7 3 Cut-in Card No..........................
Owner.......N..��,..K O/�S' RJ
.........................................................................................................
Occupant............................................................................................................................
Location..Ul..�.�u. .���. ..- ��. ��-C��Z-W I�........
. .... ... ............... .... .........
Installation Consisting of..Z &0 r..-C t4...Y0 2e6eP 3�G/ T&—S:/............. .............../ . .. .. GUG .. ..a... ...C�... ..t...
c� f _. . f. ........�.�rt/� ..
.............
..................... e ... ..mod .. . rL�%. .c .................................................
Installed By......... . 1• .0 . ..T "........................... Lic.#.....................................
The conditions following governed the issuance of this certificate,and any certificate previously
issued is cancelled:—
This certificate only covers the electrical equipment and installation conditions as of date. Upon
-the introduction of additional equipment or alterations, application shall be promptly made for
inspection.
Inspectors of this Company shall have the privilege of maki inspec 'on at any time,and if its
rules are violated,the C�pany shall have the right to revoke ' ert qµQ
Date..5�:Z 3.J...../�/........... INSPECTOR. .... .............: .........�.\...
MPmhr N F P A 1 A_F 1
TOfi,? OF QUEEMSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518--745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 0i-S/^/
Location r �.
Date rl Permit # -R- 2aU
SOIL TYPE:-kp Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inches,
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length . -)b
Length of each trench
Depth of trenches Z
Size of stone 2--
SEEPAGE PITS: Number-
Size - ft. x / . ft.
Stone size
PIPING: ize Type
Bldg. to Tank Z/" pw'
Tank to Dist. Box
Dist. Box to Field/P'
Openings Sealed? Ye No Partial
LOCATION/SEPARATICTIS:
Foundation to Tank /Z feet
Foundation to Absorption feet
Separation of Pits ;, feed
Conforms as per Plot Plan Yes to)
LOCATION! OF NYSTEM ON PROPERTY:
(circle one)Front - Rear Avioc
Right Side
Middle Frontar
COMMENTS:
/;ht r--e U ��
SYSTEM USE APPROVED: � NO
Arrived:
Departed: ems '
Building Inspector
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804' ; .
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE PERMIT# 93-ZZ 3
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION ,
AUTO. SPRINKLER SYST M
ALARM SYSTEM
INTERIOR FINISHES ,
STORAGE: / '
CLEARANCE TO/SPRINKLERS\
CLEARANCE TO HEATING UNIITS
REQUIRLD SIG7GE
C IMNEY
W ODSTOVE
IREPLACE-MASONRY
IREPLACE-FACTORY BUILT
REMARKS: OK TO THIS DATE
r�
2/015 INSPECTOR
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED
4 _
NAME /
LOCATION
DATE_s PERMIT# i �-
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM;;
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRI( KLERS
CLEARANCE TO HLATI G UNITS
REQUIRED SIGNAGEI
v�
CHIMNEY
WOODSTOVE
/FIREPLACE-MASONRY
/ FIREPLACE-FACTORY BUILT
A 4126""
REMARKS: OK TO THIS DATE
"MzI .
2/015 INSPEC R
i
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, .NEW YORK 12804
TELEPHONE' ('518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED S
NAMES Iw1
LOCATION
DATE / PERMIT 1.
TYPE OF STRUCTURE Spa al Al
RECHECK APPROVED
N/A YES - NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
—PLUMBING-VENT/VENT-S, IN .PLACE - - - -
PLUMBING UNDER SLAB f
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM /•
HEATING ROUGH-IN
`INSULATION:
FOUNDATION WALLS IN7ERIOR R
FOUNDATION WALLS EXTERIOR Ra
FLOORS / R-i'"
WALLS I R-'
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
rztc,
ARRIVE
DEPART / -
INSP CTOR
�J�",AAnnarl���b � l Ci Yl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE' (518) 745-4447
BUILDING INSPECTORS REPORT ',, `
REQUEST FOR INSPECTION RECEIVED �. a-3�
NAME �I c� �d� /VC
LOCATIONn`(��
DATE �' PERMIT 0 ! 3-72 J
TYPE OF STRUCTURE
RECHECK ✓ U.)i,:�- br4Z,--- - APPROVED
N/A YES - NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 40 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE;
FOUNDATION/DAMPROOFINCJ I
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS It CE _
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADER _
BRACING/BRIDGIN.
JOIST HANGERS
JACK POSTS/hA N BEAMA
HEATING ROUGH=IN �t
INSULATION:~''
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
C.�..1�C Z l 12ilss�S
-� 21 061/ "fO CICi�v�,-
a
PL� R 9 LIAlf�c�t7�Lt�y� ��
ARRIVE
DEPART
• INSPE TO
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE' (_618) 745-4447
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED /
NAME
LOCATION
DATE. PERMIT I
TYPE OF STRUCTURE ,_�716
RECHECK APPROVED
N/A YES I' NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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 N SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOF NG
BACKFILL APPROVAL
.)eROUGH PLUMBING
PLUMBING- VENT/-VENTS- N PLACE
PLUMBING UNDER SLAII
)(FRAMING-
JACK STUDS/H DERS
BRACING/BRIE ING
JOIST HANGERS
JACK POSTS/MAIN BEAM
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
REMARKS:
z
ARRIVE �r
DEPART ,� r'
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT-
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE: (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME____J[ �� �f'f�r2fi�,c
LOCATIONN� -J/Q�
DATE / ` PERMIT if
TYPE OF STRUCTURE aN V
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
EINFORCEMENT IN PLACE
OUNDATION/DAMPROOFING
ACKFILL APPROVAL
ROUGH -PLUMBING - --
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB _
FRAMING: i
JACK STUDS/HEADERS "
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-I14
INSULATION:
FOUNDATION WALLS INTERIOR R- .
FOUNDATION WALLS EXTERIOR R- 1
FLOORS R- I `•a
WALLS R- a"
CEILING R- it
DUCT WORK OR PIPING IN UNHEATED
SPACES `k
REMARKS:
AA
ARRIVE `
DEPART
��ECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
~TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT �t
1EQUEST FOR INSPECTION RECEIVED L l 3
TAME (�1�-, f� C Irlt�
.00ATIO�W' `r"" ''���' !
)ATE U PERMIT # 9 � .
'YPE OF STRUCTURE 1GT�
o 1 a 11 a
tECHECK APPROVED
N/A YES NO
OTINGS/PIERS
10NOLITHIC POUR FORM
tEINFORCEMENT IN PLACE
fHE CONTRACTOR IS RESPONSIBLE
-OR PROVIDING PROTECTION FROM
=REEZING FOR 48 HOURS FOLLOWING
FHE PLACEMENT OF THE CONCRETE. .)
1ATERIALS FOR THIS PURPOSE ON SITE
'OUNDATION/WALL POUR
tEINFORCEMENT IN PLACE/
,OUNDATION/DAMPROOFING I
IACKFILL APPROVAL /
LOUGH PLUMBING
'LUMBING VENT/VENTS IN PLACE
'LUMBING UNDER SLAB '
'RAMING:
JACK ST DS/HEADERS
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MATN EAM
JEATING ROUGH—IN
INSULATION: ;� 1
FOUNDATION WAL S INTERIOR R—
FOUNDATION�ALLS EXTERIOR R—
FLOORS R—
WALLS / R—
CEILING ,a" R=
DUCT WORK OR PIPING IN UNHEATED
SPACES
ZEMARKS:
IRRIVE DO
)EPART (� i
j' INSPECTOR
e
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