2001-043 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010043 Date Issued: Thursday, May 30, 2002
This is-to certify that work requested to be done as shown by Permit Number P20010043
has been completed.
Tax Map Number: 523400-309-007-0001-025-000-0000
Location: 3 FELD Ave
Owner: LARRY CLUTE
Applicant: LARRY CLUTE
This structure may be occupied as a:
By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Director of Building&Code Enforcement
1
01" TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010043 Application Number: A20010043
Tax Map No: 523400-309-007-0001-025-000-0000
Permission is hereby granted to: LARRY CLUTE
For property located at: 3 FELD Ave
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: LARRY CLUTE Single Family Dwelling 50,000.00
13 DAWN Dr Total Value 50,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
CLUTE ENTERPRISES INC. COMMONWEALTH ELECTRICAL A(
13 DAWN Rd
OUEENSBURY,NY 12804
PO BOX 706
HAGUE.NY
Plans &Specifications
2001-043
LOTS 10 & 11 FELD AVENUE; Address: 3 Feld Avenue
864 SQ FT SINGLE FAMILY DWELLING AS PER PLOT PLAN SPEICIFICATIONS; Area Variance No.
33-2001
Approved,May 16, 2001
$108.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday,March 22,2003
(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 w f Qu sb. ; 'r ay,March 22,2002
SIGNED BY `_,� • for the Town of Queensbury.
Director of Building&Code Enforcement
"' ENERGY CODE APPLICATIONS
(7. 001-' 01-6
lKy, = COVED ENERGY CODE COMPLIANCE APPLICATION
- g05, B 0 6 2001 TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
TO t{I< OFQUEENSBURY
BUILDING AND C QE-PART
Ms _.
Compliance 9thods : 5 - Acceptable Practice Method - a.:,. ,. .
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
*Requires submission of worksheets
APPLICANT' S NAME: PROPERTY LOCATION:
L f--ci C L e` C� A%.l.L'
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - square feet
2 . Type of Heat - Electric Oil x Gas Other
3 . Is building mechanically cooled? Yes No
4 . Percentage of area of windows and doors Over 17% >S 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 \c
c . Glazed areas R
d. Exterior doors R
e . Floors over unheated spaces R 19
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
Conform to minimum efficiency per code Yes No
TE ERAT RE CONTROL XIMUM SETTING 140° - WILL NOT BE EXCEEDED
Applican s i natur Date Phone Number
9-NSPECTOR' REMARKS :
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 1761-82561
BUILDING & . CODE ENFORCEMENT
1OTICE Requirements prior to issuance i 1
1 of this permit: PERMIT FILE NO. toj , i- ip
A permit must be obtained before ,- /' Lc'
beginning construction. No inspections PERMIT FEE PAID$ V/A.i�i'
will be made until applicant has received 0 Zoning Board ll
a VALID BUILDING PERMIT. A11- Area /Use
applicants`spaces on this. application FEB cREA770N •FE' P i 6�
MUST be completed and.the signature El Boa Action ®S 2001 REVIEWED B
•
of the applicant must appear cat the SPR / Subdivision t gF
l plieatlon form. 7t�t B QUEENd tea, J Wing Inspector
J Recreation Fee Pay MVOs AND P
Applicant: \Cil,-- l Owner: ...t-�Q
' Address: \'' •.-. -,y Address:
QN, ems.--..4-,\- . --1
Phone # ( )`Zci 3 - 7"7 Phone # ( ) -
Property Location: ��k� 1-\JC_
Subdivision Name: Tax Map Number_ \ -1 / 9 l "a &- k1 Section Block 1 nt
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ S Q, 030
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Pr ary Building -
residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCt EQ •
1st Floor c(o`f If ADDITION, what will use
sq. t. of new addition be? :
2nd .Floor. . ., sq. ft.
Other Floors sq. ft.
(not unfinished cellar or basement) AC SSORY BUILDINGS:
etached Garage 1, ar
TOTAL FLOOR AREA: Y C`-1 SQ. FT. At ched Gara , 2 car
Priva St ge Building
SIZE OF NEW STRUCTURE: Commerci oraguilding
. . Li FEET X 3 (o FEET Other
Foundation Type: Fc�ceS ��� Will any second-hand or ungraded
' Number of Stories : . 1 lumber be used? If so, for what?
(habitable space on,i'ly) 1 -7°
Height (grade to ridge) : \\, feet TYPE OF HEATING SYSTEM:
Number of fireplaCe's .and/or woodstove (circle all which . ..lies)
to be installed:, C19 �1rtric Oil Gas / Wood
Forced Hot Air b Baseboard / Other
Person responsible for supervision of work as regards to building
codes is : L.cc-i—i-} C_5, e • ice 3 737?
Name Addresss Phone
Builder:
Plumber:
CA
. Mason: v Ce-� c3 PS 7 .-v" L.
Electrician: ,
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 pr sed work shall be complied with, whether specified or noted, and
that such work is authorizee owner. Further, it is understood that Uwe shall submit prior to a
Certificate of Occupancy•or Cer ficate of Compli e being issued, an AS BUILT PLOT PLAN by
a licensed surv• ,or; drawn to ale, showing ac location of project on premises.
Signature:
(owner, own 's a ent, architect, contractor)
Application for Permit—Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
Office Use
Location of installation: 17 c- P‘U`e • it,
Tax Map No. 1 t 7 / / to c,,,. t Filenri .
•Owner's Name: �,��—�; �� � Fee Pa �� ® 0 2001
Address: G OF
IL®IN A! D CODE
2. INSTALLER'S NAME : C:l�.� �t �� PHONE NO. —15 3 —7 a-7 7
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s)and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House; No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980— 1991 x 130 gal/bdrm =
1991 —present a x 110 gal/bdrm =
Garbage Grinder Installed yes / no X
Spa or Whirlpool Installed yes_- / no
4. PARCEL INFORMATION: (circle applicable information & indicate measurements)
Topograph,y_Soil Nature Ground Water Bedrock or Impervious Material Dom:. is Water Supply
_(y(uso rn at what depth at what depth 401121e1
Ro ling 115077T feet feet well
Steep slope clay if well; water supply
_%slope other from any septic-system
depth: absorption is ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch
5. 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). Add 250 gallons to the sire
of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub. _
Septic Tank: 1000 gallon (min. size 1,000 gal)
Tile Field: each trench ft. Total System Length: fl.
Seepage Pit(s): number of size of each: ft. by \. ft.
Size of Stone to be used: II 3, / depth or thickness fret
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
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 thegulattons with respect to this application and agree to abide by these and all
requiremen of the To of Queensbury S itary Sewage Disposal Ordinance.
:2-75-10
Signatu e of responsible person Date
• Inspector's No.
Date 19
2•
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
(Consulting and Fire Inspection Services)
(Incorporated in the states of Maryland,New York,Pennsylvania,Delaware and West Virginia)
Desiring Certification of Approval, application is made for inspection of electrical installation in the premises
described below. On demand,applicant agrees to pay for inspection service in accord with schedule of charges.
PLEASE PRINT .
i.
Owner CLV l;" A.,..Aje Type.Bldg. ❑ DWG ❑Other .•_
Occupant • : Building Permit NoC.��, 1, 'i - -
Job Location cf k..k N....../e City CO 4!.0�+:40s:a, z-:.i State
County 4'1.)t'.7A.a' C e-eN, Twp. M/C# Swimlning Pool-New❑Old❑
Directions to Job Site +P." '-c-!`� - -, ....Z. .4.,1.4:3 N.s-,, C--c-k.rk
•
Application ForRough Wiring❑ Fixtures Service❑ or
t.
•Work-Newt], Addition]❑ Bldp ew E Old❑ Ready for Inspection
APPLICANT'S /�'% I LICENSE It PERMIT M
SIGNATURE J� I_ i /' t
PRINT NAME / -, / COL_i r-J�..e `.---L PHONE x
ADDRESS APPLICANT'S/% ,.'12"f ..k NAME OF
{ r, ,,'�,{w� U UTILITY
OFFICE TO
CITY `_3`4,142._d1_� ! /.--.i_ STATE r.,_J 4. 4 ZIP CODE t' 13-y BE NOTIFIED
t SPACE BELOW FOR USE OF INSPECTORS ONLY
ROUGH WIRING AMP SERVICE
OUTLETS EQUIPMENT PUMP
SWITCHES • HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE ,
r
Inspector's Comments:
DON LOVELAND
Electrical Inspector
P.O.BOX 706
HAGUE, NY 12836
(518)543-6724 •
1-800-562.9934
OFFICE USE ONLY WORK INSPECTED REPOR- Q o
NOTIFIED TED ¢ JO FEE PAID
U
SERVICE DATE CON-
' Date Received: TRACTOR TOTAL $
R.W.DATE OWNER CHECK NO.
FINAL DATE OCCUPANT CHARGE
Certificate No.: •
CERTIFICATE NEEDED AGENT CASH
Date Sent: ❑ YES ❑DUP ELEC.
LT.CO.
INSPECTOR
Progress ❑
THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.I.S.INC.
WHITE/OFFICE PINK/INSPECTOR CANERY/OFFICER GOLD/CUSTOMER
TOWN OF QUEENSBURY
r -+ BUILDING & CODE ENFORCEMENT
a 1 742 BAY ROAD
QUEENSBURY NY 12804
." '"' i, ' (518) 761-8256
ARRIVE: DEPART: INSP: 09
FINAL INSPECTION REPORT
COMMERCIAL MULTIPLE DWELLING
(hotel, motel, apt. complex)
DATE INSPECCTIOON REQUEST RECEIVED:
NAME \c-c-
LOCATION c---e.A . ',A)tee_
I�
DATE d Lp.E4 S 30-0
TYPE OF STRUCT RE 111111
FOOTINGS BACKFILL FRAMING PLUMBING
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT/FIXTURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATE',
RELIEF VALVES
FLOORS •
FOUNDATION INSULATIO _
INTERIOR STAIRS/RAIL ''GS
STOCKROOM ENCLOSUR'
FIRE/DEMISE WALLS/PENS • TION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT DOOR HARDWARE _
EXIT_STAIRS/RAILS
PLATFORM/ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS
HANDICAPPED PARKING
FINAL ELECT CAL
SITE N/VARIANCE REQ.
NAL SURVEY PLOT PLAN, IF REQ (lb
OK TO ISSUE C/O OR C/C
TOWN OF QUEENSBURY
BUILDING _& CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name C C
_DAAAsz__
Location .j P \ AIULK__
D a t b e rm i t # 0 D-—OLL3
SOIL TYPE: Sand-L.am-Clay-
Results of Percola! 'on Test-
(if applicable) R., e inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD. Total Length
Length of each t -nch
Depth of trenches`.
Size of stone
SEEPAGE PITS: Nu .er-
Size - ft. x ft.
Stone Oze
PIPING: / Size Type
Bldg. tq Tank -
Tank to ist. Box
Dist. Bo to Field/Pitt
Openings ed? Y s No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorpti n . _ feet . .
Separation of Pits feet
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:
• /(_)5 at"-/q-
.4:::SQ/) 3(341N .
SYSTEM USE APPROVE . YE NO
Arrive
Depar ea:
4/4
ilding Inspec o
• _ 1 _ , I _ . _ ___. __ _ .
•-
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__.
111
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1r 19
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._____. _______ _
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RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: 3 U
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depa ` �pm7
Town of Queensbury Inspector's Ini is !/
742 Bay Road
Queensbury,NewYork 12804
NAME e/4 �=^-! ` PERMIT 4 v/.— v L 3
• LOCATION 3 ir"a 4,-,_. _ DATE 1
TYPE OF STRUCTURE
N/A YES/NO COMMENTS
Chimney Heigh 'B"Vent/D ect Vent Location 1 VFresh Air Intake
Plumb Vent throu. roof ,//
Roof Complete t/ 7
Exterior Finish Complete /
Interior/Exterior '.. • gs 30"tLdin
6" ` ��
Exterior Handrails, •. 'flies, g 18 in.or more //
Interior Handrails stairs •o sides 3 or more risers /
Grade 2%away from fo t •.tion ,/
8"clearance to sill plat-
Gas Valve shut-off expos:. regulator 18"above grade •
Gas Furnace shut-off withi 30 feet or within line of site 1/
Oil Furnace shut-off at entr. ce to furnace area +/ /
Furnace/Hot Water Heater o•erating �//
Relief Valve(s)installed / �/
Headroom,6 ft.6 in.on stair �f /
Basement stairs,6 ft.4 in. yf/
Handrail exterior stairs both sides more than 3 risers /
Interior privacy/trim/doors/main entrance 36" 177
Floor Finish >✓Bathroom/Kitchen watertight
/:Interior Handrails Balconies/Landing 18 in.or more /
Railing across window in stairwells
Smoke Detectors:
4
every level •
every bedroom V
outside every bedroom ✓/''
inter connected ✓ /
Bathroom fans 1,/ .
Plumbing fixtures ✓
Foundation insulation
ii
3 hour fire door/door closer
Garage fireproofing y
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per r ssm 7zSafety
glazing 18" ess in floor
Final Electrical �. UZ GC-��5
S'tePlan/Variance equired ' / V�U -4 `,q — galc-?
\, coal Survey Plot Plan -J /
✓As Built Septic System layout required , v6 `
6-fTii--
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_ /7
Okay to issue permanent C/O(Certif.of Occupancy)
TOWN OF QUEENSBURY .
BUILDING_ &CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name L-, PtP' P;? c.`k'
Location Fat \ ) - F
Date _,9j —(n-(j2 Permit # 7 001 — 3
SOIL TYPE: ,Sand Lo m-Clay-
Results of Percolat\on Test-
(if applicable) Rate-Minute/inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trend ti
Depth of trenches t
Size of stone
• SEEPAGE PISS: Number-\ J
Size - 4tj ft. x \itcLj ft.
Stone size �t
PIPING: Size Type
Bldg. to Tank t) 0
Tank to Qi^ ox i�j i
DiS ' o.x to Field �- ( 'i ,
Openings Sealed? • es N'o artial
LOCATION/SEPARATIONS:
Foundation to Tank VD feet
Foundation to Absorption - 7 feet
Separation of Pits feet
Conforms as per Plot Plan Ye o
152.____
LOCATION OF SYSTEM ON PROP.RTY:
(circle one)
Front ar Left ig t ide
Mi ddl a on dl a Rear
COMMENTS:
13 eE\O P6 ?7 Ni) .- &ffeci
OV_- o \37P\ LL
SYSTEM USE APPROVED: YES NO
Arrived• . .��,
Depar AWAIT"
/ /
AlAf/A/411 /
: "iding Inspe- tr.
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time: �?'�
Dept. of Community Development Request received: 1�/11/O �`" Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE\.2-� /pi .'-9 'P 'T I aD am/ m otes:
(518) 761-8256 Inspector's Initia s
NAME: L`�� 4..uy PERMIT# Z OQ 1 —O 41 3
LOCATION: INSPECT ON(date): i/ /v
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS •
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezi 7g •
for 48 hours following the place vent
of the concrete.
Materials for this purpose on site •
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
iyinsulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R- e \
Ceiling R- 3i]
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
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
•
Office Use
GENERAL INSPECTION REPORT Inspector:
Ready at time:
Town of Queensbury
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPA Tilt am/pm Notes:
(518) 761-8256 Inspector's Initials" 3
NAME: co„
\C� PERMIT# ( —
LOCATION: 3 1-6—C--12) /4UG-- INSPECT ON(date): 0/0Z-----
TYPE OF STRUCTURE:
RECHECK
N/• YES No COMMENTS
Footings/Piers r,
Monolithic Pour Form
Reinforcement in Place -AYI R 5
The contractor is responsible for
providing protection from freezing \ Arc T.t/170 itt"
for 48 hours following the placement
of the concrete. 10 u e /g " FRo Co/0064°(/-
s/
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
•
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plu .ing Vent/Vents in Place
' •ugh Plumbing
eating Rough-Inn -,4 4(,)c
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
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
•
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road /
&"
Queensbury, NY 12804 ARRIVE am/pm: DEPART l am/pm Notes-: -f' 5 (1
(518) 761-8256 Inspector's Initials
NAME: aa`X PERMIT# cgan l! 0q3
LOCATION: 3 ® P'1)-P J INSPECT ON(date): 1-1
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible 'or
providing protection from fie:,ing
for 48 hours following the pla ement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing l /1
Backfill Approval Oo / �/� A -
,
�/ 1
Plumbing Under Slab C
P1 •.' g Vent/Vents in Place /
*.3 d_h1P177-bin ✓
e .g gh 4 U// I' . . ►reilwa�
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Vent A • Ve}it 11—
IL11411111:ig
\71/
•
Jack-Seaders
Bracing/Bridging
Joist angers - t/Jo Posts/Main Beam •
of l ,avian :ala ier,. V
Fire epara on ;2;3 hour
Penetr tion Sealed
•
Fir a112,3,4 hour /
s'e nig ,4
lFei'
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
•
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:l 11011
Dept. of Community Development Request received: �� Meet:
Building& Code Enforcement / At time:
742 Bay Road • •
Queensbuiy, NY h2804 ARRIVE am/pm: DEPART Ili'• afm/pm Notes:
(518) 761-8256 Inspector's Initials
.---
/ /m C,C
NAME: Ott.--
Can��]];; in PERMIT# vv/!D `
LOCATION: 3 7- 44 INSPECT ON(date):
TYPE OF STRUCTURE: (�/�t_ .(/ -
•
RECHECK
N/A YES NO COMMENTS
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/Wallpour 1 I ,
Reinforcement in Place
Foundation/D amppro ofng
Bac ill Approv > I/
Plumbing Under Slab /\
Plumbing Vent/Vents in PI—ace - I
Rough Plumbing
\ . •
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R- ` •
Floors R- 1
Walls R- 1,
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
L:VSueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Offic Use
GENERAL INSPECTION REPORT hnspector`--
Town of Queensbury Ready a time: ( ��
Dept. of Community Development Request received: ��� a Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE \=\D am _ RT`- f ca m Notes:
(518) 761-8256 Inspector's_nit
NAME: 1/�j� PERMIT# V3
LOCATION: 1 3 PW,,7 INSPECT ON(date): • 0 —
TYPE OF STRUCTURE:
RECHECK
( is �l <�
_ N/A YE4 S i COMMENTS •
Footings7Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible f r
providing protection fro free2,ing
for 48 hours following th pla ment _
of the concrete.
Materials for this purpose on ' e •
Foundation/Wallpbu(
Reinforcement in Place
Foundation/D amppro offing
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-
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
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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MAP REFERENCE:
MAP OF A SURVEY MADE FOR
FLOYD R. & MARGARET A. BARNES
DATED: JUNE 13, 1979
BY: JOHN B. VAN DUSEN
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Steves
Land Surveyors , LL C
1169 Haviland Road Queenebury, New York 12801
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(518) 792-8474
New York Lic.
No. 50135
Map of a Survey made for `
CLUTE ENTERPRISES
Town of Queensbury, Warren County, New York
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1 5/24/02
NO. I DATE
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DESCRIPTION
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