92-716 Q
i L
-C, ERTIFICATE OF OCCUPANCY
w TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date January 13 19 93
This is to certify that work requested to be done as shown by Permit No.92-716
has been completed.
-single family dwelling (modular)
This structure may be occupied as a
Location _ Lot 39 Mockingbird Lane, Inspiration park
Owner
Ms. Marcia DeKalb
Issued for upper level only. By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
a
x
BUILDING PERMIT13
y�o
TOWN OF QUEENSBURY
No. 92-716
WARREN COUNTY, NEW YORK
N
PERMISSION is hereby granted to Ms. Marci a DeKal b
OWNER of property located at Lot 39 Mockingbird Lane Street, Road or Ave.
in the Town of Queensbury,To Constructor place a Single family dwelling (modular)
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 tn
Vf
3
c�
2. CONTRACTOR or BUI LDER'S Name
' r
m
3. CONTRACTOR or BUILDER'S Address y
r
co
4. ARCHITECT'S Name
r
C+
w
5. ARCHITECT'S Address
3
O
n
J.
6. TYPE of Construction—(Please indicate by X)
tT
J.
(X)Wood Frame ( ) Masonry ( )Steel ( ) O_
r
7. PLANS and Specifications
Model : 3B
No. 40'x25.42' Single family dwelling (modular) as per plot plan, speci
fications and application including septic system.
B. Proposed Use
Single family dwelling ,r N
J.
�Q
�J
220.00 November 9 93 1,
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 s"
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) 1G
a.
Dated at the Town of Queensbury this Day o ember 19 92 m
J
.J
J.
SIGNED BY for the Town of Queensbury
Building and Zoning In r
TOWN,C1!P'-QUEEMSSURY
-REVIEWED BY:
FEE PAID:
jWN OF QUEENSBUr-.
PERMIT NO. : 9,�- �/� RECEIVED
NOV 41992
BUILDING PERMIT APPLICATION BLDG. & CODE OEPT,
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
APPLICANT"HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application. .
Owner of Property: Ms. Marcia L. DeKalb - Lot .#39 - Model 3B
P.O. Address: Mockingbird Lane PHONE -
Property Location: Qaeensbury, NY 12804 Tax Map No48.7.1% 7.3 % 7.4
Has there been any .split of- this property since October 1, 1988? Yes x No
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Inspiration Park Lot No. .1,48.7.107:3&7.
Lot #39 - Model 3B
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
Cushing, Dybas Associates,. Architects, P.C.
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
x Construction of new building * CONSTRUCTION: $ 77,592
Addition to building.
-Alteration to building * COMPLETEINFORMATION REQUIRED BELOW:
(no changO` to exterior dimensions) * Size of Property: 80 ft. x -10 ft.
Other work (describe) . * Existing Building Size: (None) Re
* - ft. x - ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line: '
1st Floor 1017 Sq. Ft. � * Front Yard -9n ft. Rear yard 4B— ft.
I Side Yards 2_ ft. and _34._ ri.
21d Floor - Sq. Ft. * If on corner, setback from side street-
. * _ ft.
Other Floors - Sq. Ft.
(not .cellar or basement) OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: 1017 Sq. Ft. * Primary Building -
* , X. One .Family Dwel 1 i-ng
Size of New Structure: 404 ft. x 2s.42 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units
Pier/Slab/Crawl/Partial ull (Circle One) * Business
* Industrial
No. of stories (Habitable space) 1 * Other
Height (grade to ridge) 22 . ft.
If residential , no. of families: r, * If addition, what will use be?
No. of rooms (excluding baths): s;Y
No. of bedrooms: ThT
No. �of bathrooms: One * Accessory Building:
Primary heating system: Baseboard * Detached Garage - One/Two Car
Type of fuel : Electric * Attached Garage - .One/Two Car
No. of fireplaces to be installed: None * Private Storage Building
Will a woodstove be installed?: No * Other
Central Air Conditioning: 'Yes No
(OVER)
BUILDING NtKM1 i mrrLLURI iVir -61V11 i 111ULu-.
B,UILDI-,^!G SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. Wood Frame
Will any second-hand or ungraded lumber be used? If so, for what? No
-Foundation Wall Material : Poured concrete Thickness. R"
Depth of. Foundation below grade (to bottom of footing): Below V-0
Will there be a cellar? No Heated or Unheated? Unheated Floor Sq. Footage: 937
Will there be a basement? Yes , Will any portion be used as living space? No
If so, what portion? No Sq. Ft. Type of Use? No
Type of Roof: Sloped/Flat/Shed/Other Sloped Material of Roof Asphalt shingles
Size, wood studs 2 " x 6 "; spacing 16 " o.c. ; length s ft.
Joists (floor beams) : 1st Floor 2 " x 10 " ; spacing 16 " o.c:; span 13 ft. ma
Joists (floor beams) : 2nd Floor - " x - "; spacing - " o.c. ; span ft.
Overlays (ceiling beams) : - x - " ; spacing - " o.c. ; span - ft.
Roof rafters: - " x - " ; spacing - o.c. ;• span - ft.
Roof trusses (pre-engineered) : spacing 24 o.c. ; span 13 ft.
Exterior Wall Finish: clapboard Siding of what material? vinyl
Interior Wall Finish: 112" Gypsum Board
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
N/A
Is there .to be an opening between garage and dwelling? NIA If so, will a Fire-Rated door
enclosure., self-closing device be provided? N/A
Will a flue-lined chimney -be installed? No Height above roof N/A ft.
Depth of chimney foundation below grade: N/A ft:
Depth of fireplace hearth: N/A ft. N/A in.
Water supply - Municipal or private well : Municipal
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: f,00. f'
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: The Quinn company, Inc. - P.O. sox 6150-- Ratland, VT 05702 PHONE (802)747-70*'
NAME OF PLUMBER & ADDRESS: Sae as Above PHONE
NAME OF MASON & ADDRESS: same as Above PHONE
NAME OF ELECTRICIAN & ADDRESS: same as AbO1e PHONE
DECLARATION
To the best of my knowledge and belief 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 0
be complied with, whether specified or not, and that such work is authorized by the owner.
Signature
0 ner, ner s agent, architi
contrac r
- ------------------------------------------------------------------------------------------
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
' ENERGY CODE COMPLIANCE APPLICATION
y TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Meihdds:
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
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
Ms. Marcia L. DeKalb, Inspiration Park (Lot #39)
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD. OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - 1017 Sq. Ft.
2. Type of Heat - x Elec. Base Board Other
3.' Is Building Mechanically Cooled? YES x NO
4. Percentage of Area of Windows and Doors Over 17% x Under 17% (10-9x).
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO R E Q U I R E D
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 38 33 24
B. Exterior Walls R 19 23 18
C. Glazed Area R 3.45' 2.6 . 1.7
D. Exterior Doors- R 14.9 2.5 2.5
E. Floors over unheated spaces R 19 24 19
F. Edge of Slab on Grade (Heated Building) R N/A 10 10
G. Basement/Cellar Walls (Above .Grade) R' N/A to to
H. Basement/Cellar Walls (Below Grade) R N/A - -
I. Heating/Cooling - Ducts - Piping in Unheated Space R N/A - -
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code x YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 1400 - WILL NOT BE EXCEEDED
"l-kl p�2 �/� (518) 793-5183
AP C NT SIGNATURE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS:
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid
Date: 10123192 Reviewed By
LOCATION OF PROPERTY- FOR INSTALLATION: Inspiration Park, Queensbury, NY 12804
.Owner' s Name: Ms. Marcia L. DeKalb - Lot #34 - Model 3B
Owner' s Mailing Address: Mockingbird bane, Queensbury, NY 12804
Installer's Name: The Quinn Company, -Inc. Phone #: (802) 747-7010
Number of bedrooms (if residential ): Three
Total daily flow (residential-compute @ 125 gal . per bedroom): 375 Gals.
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth: +20'
Ground Water-At What Depth? +6'-0" Feet
Bedrock or Impervious Material-At What Depth? '20. Feet
Percolation Test-Circle One: Not Required Required/Rate 2 Min. Per Inch
Domestic Water Supply-Circle One: Munici a Well Other
If domestic water supply is a-we
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 1000 gal . (Mi-nimum size: 1,000 gal . )
Tile Field: Each Trench 27. feet//Total System Length 162 feet
Seepage Pit(s): Number of / Size each: ft. x ft.
Size of Stone to be used: 1/2" to 1-1/2"Depth or Thickness 1-0 feet
HOLDING TANK SYSTEM IF REQUIRED
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: _�A-a-�x�-� DATE: It a 3 jq-2—
UNAUTHORIZED ALTERATION OR ADDITION TO 1�AP. RtFSQ s lY c '.
THIS DOCUMENT IS A VIOLATION OF SECTION "11J 51?tRATtoU PAtLtc-SUC3DIV191043
7209 SUBDIVISION 2 OF THE NEW YORK STATE
EDUCATION LAW. ZI►Y OL]T PLre.l.1' PtZ•LDAR� 6Y MA.e.0 GfJ
'F-uJaj V MXILV 6),S/.G.T.MAL_1c.A530C.. P.G.
Lc% a e OWnerS Assocta�-ipr�
5 9'ot3'40" W
' U1 00
-0 0
0
_ a
N
m
22:7't
o LoT 3S
4•0.0'
ji2
ci oAA �_= t' N' �� �
N (09°08'40"F-
T r
I certify to the following Ca 4.-4I A>;rti ErsE`MQ•L1T GR,...3TlO
that this survey has been IO JJI.►GASt,, 1V10M ���
prepared in accordance with �••—80.�I C:ctsP t tJ.�(_T�yg, D TELp
the code of Practice for Land L 00'
surveys adopted by the X.Y.S. R.- �5'
7lssooiatioa of Professional o V K , G 81 RD Land surveyors as last
revised.
Marcia L. De Kolb (5C
5i'o}Gwida Funding Corp.
1+.5 Successors And/Or A-Ssign5
Chicago Ti+IG lmsuronce Go.npanoj
"ONLY COPIES OF THIS MAP SIGNED IN RED
INK AND EMBOSSED WITH THE SEAL.OF AN
OFFICER OF C. T. MALE ASSOCIATES.' P.C.,
C. .Son F'L5 49044 DCt{a OR'A DESIGNATED REPRESENTAnVt SWILL
BE CONSIDERED TO BE A VALID TRUE COPY" -
Dote RECORD OF WORK Appr• L o-' 39 - M o c K l N Gel RO LA tJ E.
12.22.92 Foundation Location 1 N SP 1 R XT 10 N 1K
m
E
oL Tower 0-F Queensbu.- µtor�en COUNTY, NEW YORK
rn
C.T. MALE ASSOCIATES, P.C. (�
50 CENTURY HILL DRIVE, P.O. BOX 727, LATHAM, NY 12110 '�-
(518) 786-7400 . FAX (518) 786-7299 W
Drafter: L.PtJ Checker: ENGINEERING • SURVEYING • ARCHITECTURE • LAND PLANNING
LANDSCAPE ARCHITECTURE • COMPUTER SERVICES d
m`
o Appr, by: Proj. No. `�2'���-'` SCALE: I" = 5 o DATE: Doc. 22, Ict92
U
QUEENSBUL .
'EIVED i
U V 41992
koo
ool
l__A0
R-275.00' \\ pF THE S
L-80.01 J,,�L'� 2
I �- --- 284
•,0 ' +
'.o01
A 'L'j�jr�'
Ar
39
ROVED
/APPlication
,r ,
6
i NOV -6 10
1
DATE: + CUSHING, DYBAS ASSOCIATES.
DRAWN: ARCHITECTS, P.C. PLOT PLAN
LOT . 39
I ` C"E`"`°' INSPIRATION PARK
i FNC _.,._,.s ex..
sCAIE: 1 =20 n�ear MAD.QLFJM rur. erne�menr,2Em vn�E -e,o—ns—s,e�
TOWN OF QUEENSBURY 130 �
BUILDING & CODE ENFORCEMENT
531 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENT
DATE INSPECTION REQUEST RECEIVE^D: /��
NAME Jv`h �� R-LtA,�� `9DE /r�tr 8 // /�.l
LOCATION "7 1 l`-k'�-gf k—P B p-p L ln&)
DATE PE/RMIT H 2-7fC6
TYPE OF TRUCTURE
i
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE 'OR FIREPLACE
N A YES NO
CHIMNEY HEIGHT B VENT HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK PORCH STEPS ILINGS
RELIEF VALVES
FURNACE HOT WATER OP RA ING
INTERIOR TRIM PRIVACY DOORS
FINISH FLOORS:
BATH KITCHEN W ERTIG T
OTHER FLOORS WEEPABLE
OTHER FLOOR CARPETED
STAIR CLEA CE RAILINGS
SMOKE TE TORS
BATHROOM ANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN VARIANCE REQ.
FINAL SURVEY PLOT PLAN —T
OK TO ISSUE C/O OR C C v/
T09Nd OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION in A
DATE /�. ,� PERMIT# r
TYPE OF STRUCTURE
RECHECK
_FIRE RSHAL APPROVAL (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
_INSULATION WOODSTOVE/FIREPLACE
REMARKS fr
APPROVAL
CHIMNEY HEIGHT/LOCATION N/A YES NO
B VENT/LOCATION 1
PLUMBING VENT +4
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGSA,
RELIEF VALVES `
FURNACE/HOT WATER OPERATING`,
INTERIOR TRIM/PRIVACY bOORS
FINISH FLOORS:
BATH/KITCHEN WATERTJ GHT
OTHER FLOORS SWEEPA'BLE
OTHER FLOORS CARPEJTED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS &
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS I
OTHER FIRE SEPARATTt1N
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART
INSPECTOR
Jown o f Que' enjdr�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
-Queensbury, New York 12801
SEPTIC DISPOSAL 'SYSTEM INSPECTION
NAME
LOCATION
DATE I bl PERMIT NO. Ll� 71�
SOIL TYPE Sand _ Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field.,'total length
Length of each trench oZ
Depth of trenches
Size of gravel_ k/oZ
SEEPAGE PITS{NUTer of)
Size- ft. X ft.
Gravel size I
PIPING: S;(ize Type
Bldg. to tank fy S',�j/2-3
Tank to dist. box' yc,
Dist. box to fieldYpi V Pic
Openings sealed? l( NO Partial
LOCATION/SEPARATION
Foundation to tank �f t.
Foundation to absor ticn eft.
.Absorption to lot 1 ne � Lift.
Separation of pits — ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - > a - Leff side - Right side -
COMMEN
1
a0-
SYSTEM USE APPROVED , YES' 0
UiJAi g Inspector
01/86 and vl
r;
Y01 OF QUEENSBURY
�31 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST //FFO�OR INSPECTION RECEIVED
i�"
NAME d,
LOCATIONS
DATE // PERNIT#
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
_INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES( NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT ,f
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT/
OTHER FLOORS SWEEPABLE 1
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILIN S
SMOKE DETECTORS 't
DOOR CLOSERS
BATHROOM FANS I
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFIN
DOOR CLOSERS
OTHER FIRE SEPARATIDN v
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
cy s
ARRIVE
DEPART
\ INSPECTOR
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. 1 /T � 6
Owner A , --Qc f —3
Occupant [�
Location
No. Street
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable codes.
Installed by 7
yn No. V
Date j G _ ! i Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood, NJ 08108
y7 ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
d� euML-GT-e WIRING &CONTROLS FOR BURNER
Z, RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
[p CJAMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
CAMP.SERVICE CONDUCTORS K.W.DISHWASHER
/-
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE '
K.W.WATER HEATER FRAC.H.P.VENT FANS
�TORs 1/12 1/10 lye V6 % Ifj y 1 IV, 2 3 11111110 115 120 125 130 40 50 75 l00
ARK NUMBER
EACH SIZE
PPARATUS
D l�
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
LOCATION
DATE - a PERMIT
TYPE OF STRUCTURE_
RECHECK APPROVED
N/A YES 0
FOOTING PIE
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/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING: tis
JACK STUDS/HEADERS R ;'
BRACING/BRIDGING G r�
JOIST HANGERS
JACK POSTS/MAIN BEAM A
HEATING ROUGH—IN
INSULATION: ¢"
FOUNDATION WALLS INTERIO�t'° R— l
FOUNDATION WALLS EXTERIOR R—:�T
FLOORS R—
WALLS / R—
CEILING R—
DUCT WORK OR PIPI G IN UNHEATED
SPACES
REMARKS:
J
ARRIVE
DEPART ? /42
INSPECTOR
TOWN OF QUEEWSBURV
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 4;2, f/.9 2
NAME
LOCATION
DATE l l l/—PERMIT I
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YESI NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FR®M
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR . f
REINFORCEMENT IN PLACE _
FOUNDATION/DAMPROOFING ,
BACKFILL APPROVAL t ��
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE I
PLUMBING UNDER SLAB r '
FRAMING: R
JACK STUDS/HEADERS ;i
BRACING/BRIDGING I a
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:
ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY f I �.51 C-)
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 1.211
NAME loaglh
LOCATION !„FAY--
DATE la � PERMIT #
TYPE OF STRUCTURE
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
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING ;?
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN J*
INSULATION: a t�
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- ;
WALLS R` i1
CEILING rR-
DUCT WORK OR PIPING IN U�HEATED
SPACES 'e
REMARKS:
ARRIVE
DEPART _
INS CTOR
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 / 5 Z
NAME ht K lz Q��
LOCATION ,��1 G G �
DATE PERMIT #
TYPE OF STRUCTURE S!�D
RECHECK APPROVED
N/A IYES NO
OOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCftTE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING_
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM :^
HEATING ROUGH—IN a.
INSULATION: /
FOUNDATION WALLS INTERIOR R—
FOUNDATION WAfS EXTERIOR R`'
FLOORS R—`
WALLS R—
CEILING R—
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE —�
DEPART
IN PEC R