2002-306 TOWN OFQUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
IFIrAT
CEn ., E OF OCCUPANCY
Permit Numbet: P20020306 Date Issued: Wednesday,February 05,2003
This is�ta certify that work requested to be done as shown by Permit Number P20020306
has been completed, . .
Tax Map Number: "523400-303-015-0001-006-000-0000
Location: 295 DIX Ave
Owner: OMALL FAMILY LIMITED PARTNERSHUI
Applicant: LINCARE
This structure may be occupied as a:
By.Order of Town Board,
Commercial Alteration` TOWN•OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020306 Application Number: A20020306
Tax Map No: 523400-303-015-0001-006-000-0000
Permission is hereby granted to: HEALTH FOCUS OF NY
For property located at: 295 DIX 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: OMALL FAMILY LIMITED PARTN commercial Alteration 40,000.00
36 DIX Ave Total Value 40,000.00
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name f Address Electrical Inspection Agency
TROMBLEY. WILLIAM
65 SAGAMORE STREET
Plans &Specifications
BP 1002-306
Health Focus of NY : Commercial Alteration as per plot plan and specifications.
$173.76 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,May 03,2003
(If a Ion ger period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the ri ay,May 03,2002
SIGNED BY rnyz� for the Town of Queensbury.
Director of Building&&e Enforcement
Building Permit Application
Town of Queerisbury-Dept of Community Development, 742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File N
No inspection Will be made until applicant has received a Fee Paid y,
valid building permit. All applicants' spaces on this Rec. Fee Paid W-74-71
application must be completed and must appear on the Reviewed By:
application form.
Applicant: Owner: lam, A/I 115141Y C--
Address: -4!;rl- 19 IJQ 1114A; F Address: alit;
Phone# Phone# (45-le-Y 793-
c
Property Location. Lot Number: i House Number
Subdivision Name: Tax Map Number:.
C3 New Building: residence /commercial Estimated Market Value of Construction:$ -7/()/�On 6
C3 Addition: residence/ commercial If an Addition, what will use of new addition be?*
Alteration: residence/ commercial
No change to exterior size: residence 1 com'l
C3 Other work(describe
Check OccupancyInformation I"Floor 2° Floor Other floor -TotAl
Below sq.ft. sq.ft. sq.ft. Square,Feet
q Single family dwelling
0 Two family dwelling
U Townhouse
C3 Multifamily dwelling
#of units
'X Office af
L3 .Mere the
U Manufacturing
0 1 car detached garage t
E E)
CI 2 car detached garage R E
Q 3 car detached garage
U I car attached garage APR 2 5 2002
0 2 car attached garage ��45DURY
�0 3 car attached garage
U Storage building-
commercial
U Storage building-
residential
U Other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?.
Type of Heating System: electric/ oil / gas wood forced hot a:ir-:/::b:�9eboard other: e��
Number of Fireplaces to be installed t5�' Number of Woodstoves to-be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address- Phone Number
Builder
Plumber
Mason
Electrician sc 'er
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,as requested by the Zoning
Administrator or Director of Building and Codes,an A s Built Survey by a licensed surveyor;drawn to scale,showin9 actual
location of all new construction.
Signature- owner,owner's agent,architee,-.—n—IEa--c—to,,-7��'
46
f A
BLDG. PERMIT NO. 002 a 6
APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY
A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property
located at; Z q r &e14MV_14—qA �°"'0 5
for the following uses: d,rrl m e rc I q(
DATE �SIGNATURE OAF A AN` —
TEMPORARY CERTIFICATE OF OCCUPANCY, 4
'y j` The TEMPORARY CERTIFICATE OF OCCUPANCY is hereby APPROVED f
rat (.)DISAPPROVED
with the following conditions: p��iLC.�•
I G� P/U S r C-b a L1
a
r
TEMPORARY CERTIFICATE OF OCCUPANCY FEE: O$10.00 DEP SIT: O$100.00
received on lb 6 Z
Date of Is§uan. a Director of Bldg. & Code Enforcement
T131S TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES Q DAYS
FROM THE DATE OF ISSUANCE.
NOTE: This Certificate: is NOT VALID unless'signed by the Directofi of BI'dg. &`Code
Enforcement or his designee
yl,
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518) 761-8205 Fax(518) 745-4437
�U
Fire Marshal's Inspection Report
Request SCHEDULE,
Received: Permit#. &-oOP 300 INSPECTION ON:
Name: M PM ANYTIME
Location': mo�, F--- I
APPROVED
N/A YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING U I n
FIRE EXTINGUISHERS I
FIRE ALARM SYSTEM k
FIRE SPRINKLER SYSTEIV
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
,
STORAGE 4L,:Q to LAJ I pip
COMPRESSED GAS
CLEARANCE TO SPRINKLERSil F NYP
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN
CHIMNEY
MASONRY ROUGHIN
CHIMNEY FINAL
FACTORY BUILT ROUGHIN
FINAL
WOOD
STOVE ROUGHIN
FINAL
VENTED GAS
APPLIANCE ROUGH IN
FINAL
FIREPLACE
0
MASONRY ROUGHIN OK THIS DATE 04K R LNOT OK
FINAL
FIREPLACE
FACTORY BUILT ROUGHIN INSPECTED BY
FINAL
COMDEV/CHRISJfWORD/LETTERS20OI/FIREMARSHALINSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
i
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC*
main Office 176 floe Run Road -Manheim, PA 17545
MUNICIPAL CERTIFICATE d ELECTRICAL APPROVAL
Perm!!No, }fN{##i!}iMMiM,I}ff},iM{f{MN#41f ertf794 -Cut-in Card No,,, r„!#iifiNMl}}}!}ff}i411@iMi#@
i
Ownerff f##fiiif orfii}}fffi#Nf! i if{fN4iiN tif@!! ffiillHif fii}i,pii4Nltfifffi/,4ilifHiiiH4t4i1,i1RN4Nii,iiff
Location .....Ion 11111#@lllf,i fill@ of X01"664141 ,IMII}}IHMliiiiiiii}i@fif�iiill@11@ fii@@@Mi11, �i114iiff}loli@i11M/Nliiii1N11iiliNll !I1lf/i11iN11
E_AJ
InstallationConsisting w i4,ifi,ti/ll,INlfifitffifil,ll l}I f 4111 i1i/q N4 f,i@1fi4f ItNfN lfi f i fti off 44 liffH!!f}Woo###to tom of too @off fftoo oil
toff!!too fM off oM f f Mi4M too M#too#mo04#fffM4fi}}}}fl,@o#o#61 No oft so MNltff too 00#0#11041„}iM#MMM i too oM#$ MMMoff#f#of iMft too 14M*of iota##off to off f of}i lit flf of 11
f oHOMM#lf}fMfoM ol@fMIMf#@@H,#IM,Rifo}}if}f MRfMii@MMff!#@@@#MM!##MiiMfitlff,Hi#I,Moflff Ffli#}IlHffif###MM}Mffoo#M@,#,ifi Ri q,Mf M#M4M!!lMlfffffNpiiMN
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1 #MI@f(ififffio@, l4fMifi#ItfiffMMM#Nli{MMOM Lic# of #ffofio#lilt!lfillfMMN/i400Mf4@I##fioM/itfof
Installed Byi#0131I .J.04/466
MtooMilMl,ifM
The conditions followinggoverned 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
y
introduction of additional equipment or alterations, application shall be promptly made for inspection.
of this Companyshall have thepitivilege of T
pectlons at any time, and if itsInspectors
rules are violated, the Company shall have the right to ev acate
14 t000l
Date,Mi M iMf@olio{MifiMff@INSPECTOR iM Mf # #;MMflNRftDoll}�}oM}}MMf4M@!loaf!##@@ii#,f1N@i}uio
Member N}i1P}Ao, I@A.EIII
Town of Queensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
Phone (518)761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request
1�2_ f�j Permit#-26()Z SCHEDULE
MY1 0
Received: 1/1 INSPECTION ON: Z
Name:
AM PM ANYTIME
Location:
APPROVED
N 1A YES NO COMMENTS
EXITS X
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES -Vppj�,
STORAGE c6c :�74
COMPRESSED GAS
CLEARANCE TO SPRINKLERS MY — +CYA ad e
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN
--
CHIMNEY
MASONRY ROUGH IN
FINAL
CHIMNEY
FACTORY BUILT ROUGH IN
FINAL j
WOOD
STOVE ROUGH IN
FINAL
VENTED GAS
APPLIANCE ROUGH1N
FINAL
FIREPLACE
af
MASONRY ROUGH IN I NOT OK
OK TH17S DATE OK FOR CO
FINAL
FIREPLACE
FACTORY BUILT ROUGH IN
INSPECTED BY
FINAL
COMDEV/CHFUSJIWORDILE77ERS20011FIREMARSHALINSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY YELLOW-OCCUPANT COPY
t � 6s's-;b ice,
RESIDDD INTIAL FINAL INSPECTION REPORT
"Ck
Office No.(518)761-8256 Date inspection request received:. j �7
Building&Code Enforcement "�/� ` C�
Dept.of Community Development Arrive Depart r ` 6 —a�` ` 3 —
Town of Queensbury ectoes Initials....
742 Bay Road (� U��C���' Ne,
Queensbury,New York 12804 j G
NAMEi 611A oc ud--: !"J PERMTT#
LOCATION ;`�q���4DATE -~-- ,rct�
TYPE OF STRUCTURE /0, 0
Ai
N/A YES NO CONBENTS
<�(--�0�
Chimney Height/'"Vent/Direct Vent Location �-- � � _\
Fresh Air Intake i 1=��0� `-�
Plumb Vent through roof ���
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balcon{p,landing 18 in.or more /
Interior Handrails stairs bl,sides 3 or more risers Q t�� �R�iH�j
Grade 2%away from foundation 1.'
8"clearance to sill plate
Gas Valve shut-off exposed/re ,ator 18"abovd de
Gas Furnace shut-off 34 f or within}' of site
Oil Furnace shut-off at entrance to ace 5�4 ,fl1
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 both sides in than 3 'sers
Interior privacy/trim/doors/main entiafice 36"
Floor Finish f .�
BathroorrilKitchen watertight /
Interior Handrails Baicorues/Lar�dmg 18 in.or more
Railing across window in stair,�) lls
Smoke Detectors: .
every level
every bedroom /
outside every bedroom!
inter connected t
Bathroom fans * ,'
Plumbing fixtures N
Foundation insulation l*3
3/a hour fire door/door closer 1f
Garage frreprabfmg , - ;
Garage penetrations sealed � J
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical G-' F '~
Site Plan/Variance required <¢ Y5
°Fa
Final Survey Plot Plan
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) � d
Town of Oueensbury
Fire Marshal's Office
742 Bay Road
Queensbury, NY 12804
L
(518) 761-8205 Fax(518) 745-4437
Fire Marshal's Inspection Report
Request SCHEDULE
Received: q Permit# 67boA' Xb INSPECTION ON:� �Z-
Name: OAV
f� _ AM PM ANYTIME
Location: ��c� Nit,
APPROVED
N dA YES NO CC?MB�IIENTS
EXITS �xUd'j �q1� L 7 6&d ^ -
AISLE WIDTHS
EXIT SIGNS—NORMAL- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
"/ �A C caa d" - f�, tflu�iC
STORAGE
COMPRESSED GAS
CLEARANCE TO SPRINKLERS—
CLEARANCE TO HEATING
��['UQ
UNITS
CLEARANCE TO ELECTRICAL n (OAA
REQUIRED SIGNAGE 'ti
EMERGENCY PLAN � g�]l bwgL 6Q- a
MAXIMUM OCCUPANCY SIGN � {I,{� CI `I'r I
CHIMNEY `� 2 �fe'� �O�n' `�tfJP c
MASONRY ROUGH IN c3Do e faa Al 11 hq
CHIMNEY
FINAL
ti
FACTORY BUIL ROUGH IN COI
FINAL1
wooD �
STOVE RO IN �{-�t^'l ' U 1 ru)
IN
VENTED GASQ
APPLIANCE OUCH IN [A(O if U010 W
FINAL
FIREPLACE ROUGH 1N
MASONRY OK THIS DATE OK CAR CO NOT
FINAL �<
FIREPLACE ��.�' t
FACTORY BUILT ROUGH IN INSPECTED
FINAL
CoMoEv/CHRISitWORDILETTERS2001/FIREMARS HALINSIPECTIONREPORT11022001
WHITE—BUILDING DEPARTMENT COPY YELLOW—OCCUPANT COPY
FINAL - COMMERCIAL INSPECTION REPORT
Request received: '
Office Use
Town of Queensbury (518) 761-8256 ARRIVEAI�b am/prn DEPART amlpm
742 Bay Road Ready at time:12 1
Queensbury, IVY 12804 .inspector's.Initials
Meet:
NAME 14'(A 1-01 i Fo C-0 S Q F h1f PERMIT# ?-GO?'- At time:
LOCATION C>i k ye-
TYPE OF STRUCTURE INSPECT ON(date): Notes:
N/Al YES NO
Chimney/"B"Vent/Direct Vent location
Plumbing Vent
Roof Complete COMMENTS
'Exterior finish grade complete
'`Interior/exterior guardrails 42 in.platform/decks
Interior/exterior balusters 4 in.spacing platform/decks
"Stair handrail 34 in, -38 in.
Step riser's 7'/a in.
Main door 44 in,
=Sin.
pxits at grade or platform
/Canopy to cover req.exit doors
/ Gas valve shut-off exposed®ulator(18 in.)above grade
-/ Floor bathroom watertight
Other floors okay
Hot water relief valve
Boiler/furnace enclosure
<250,000 BTU N/R
250,000 BTU to 1,000,000 BTU's(1 hour)
>1,000,000 BTU's(2 hour)
Gas furnace shut off within 30 ft. or within line of site
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),%hour door
Storage/receiving/shipping room(2 hour), 1 Vz doors
1 '/z hour doors and closers
%hour corridor doors and closers Flats
Firewalls/fire separation,2 hour,3-hour complete
Fire dampers,2-hour fire wall/separation or greater
Fire door/shutters 1 'I2 hour,3 hour
Ceiling fire stopping 3,000/5,000 sq.ft.
Fan shutdown,smoke vents or fan 1
Exit door/panic bars assembly hardware — faa r1ec t 1 c 5r
Elevators
Elevator signage -
Handicapped bathroom grab bars/sinks/toilets
Handicapped bath/parking lot signage Ai d'rde
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space a/,
Final Electrical I I
1 � /I+�'�jr•
Site Plan/Variance required ,. Urs 44Z�'S� .34
Final Survey,new structures rs j J jy4. J,-:�
As-built septic system layout required �•�, t� fat�`
h.oaG.
Okay to issue TEMPORARY C/O-Certificate of Occupancy yes no
Okay to issue PERMANENT C/O-Certificate of Occupancy yes no
Okay to issue C/C-Certificate of Compliance yes no
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 6�d am/pm: DEPART am/pm Notes:
(518) 761- 256 Inspector's Initials
NA PERMIT# 30
M 18 I
LOCA INSPECT ON(date):
TYPE 6F STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Wra
Reinforcement in lace
c P
Footings/Piers
0 ur 'o lace ce r i respon le C tr si f
protect
from
r
'Y
Reinforcement
m
The contractor i responsi le for
providing protect n from reezing
in
for 48 hours follo ' g the lacement
of the concrete.
f or this
e I
Materials for this p on site
Foundatio a our
Reinforcement in Place
Foundation/Dampproofmil
Backfill Approval
Plumbing Under Slab_
Plumbing Vent/Vents in Pla
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior JR-
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
Barrier Air Infiltration S14A..
Fire Separation 1,2,3,hour 0
Penetration Sealed
it a ,3,4 boMr���
Firestopping_
L:\SueHemingway\Biiilding.Codes.Inspection.FORMS\GENER,AL INSPECTION REPORT.doe
GENERAL EVSPECTION REPORT
( 518) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 ArriveA30 am/pin Depart am/pm
Inspector's Initials .�-
r.--
(4Z
NAME: PERMIT
LOCATION: DATE :
TYPE OF STRUCTURE:
RECHECK
N/A,YES NO COMMENTS
Footing ers
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�_ V
Reinforcement in Place
Foundation/Dampproofing___�_
Backftll Approval
Plumbing Under Slab
PlumbingVent/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/Bridgin�
Joist Hangers
Jack Posts/Main Beam
Air luffitrafton pa�der—
Fire Separatiodb),3,hour— V.
Penetration Scaled
Fire Wall 2,3,4 hour
GENERAL iNSPEC"TION REPORT
(518 )761--8256
'own of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road {�
Queensbury,NY 12804 Arrive T/P am/pm Depart am/pm
Inspector's Initiallsa
NAME: ! *4
Cc1S PERMIT# ''
LOCATION: 0 A.'-/J DATE: S
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 following the placemen
of the concrete.
Materials for this purpose on site
Foundafion/Wallpour
Reinforcement in Place
Foundation/Dampproafing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Hearing Rough-In
Insulation 4
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 Haugers
Jack Posts/Main Beam
Air Infiltration Barrier ��**
Fire Separatiofl.2,3,hour
Penetration Seared
Fire Wall 2,3,4 hour
Firestoppin • .
Office Use
GENERAL INSPECTION REPORT Inspector:L
Town of Queensbury Ready at time:
Dept. of Community Development Request received- Meet: M
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPART_amlpm Notes:
(518) 761-8256 Inspector's Initials
NTAMIE:
PERMIT
#.
LOCAT1 INSPECT ON(date):4(w
TYPE OF STRUCTURE:
?
RECHECK
N/A YES COMMENTS
Footings/Piers_
Monolithic Pour Farm
Reinforcement in Place
The contractor is respo ib for
providing protection ft in fre ing
for 48 hours following e plac ent
of the concrete.
Materials for this purpose n site
FoundationiWallpour
Reinforcement in Place
F o und a t i o n/D amp pr o o fimng/' -
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plac�
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior
Foundation Walls Exterior
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
e
Bracing/Bridgmig-
Joist Hangers
Jack Posts/Main Bearn
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:\SueHemingway\Bttilding.Codes.hispection.FORMS\GENERAL INSPECTION REPORT.doc
FINAL - COIVIMER.CIAL INSPECTION REPORT
Request received:
/ Office Use
Town of Queensbuty (518) 761-8256 ARRIVE
ain/pm: DEPART am/pm
742 Bay Road Ready at time:
Queensbury, NY 12804 Inspector's Initials
Meet:
NAME PERMIT# C At time:
LOCATION
TYPE OF STRUCTURE INSPECT ON(date): Notes:
N/A YES NO
Chimney/"B"Vent/Direct Vent location
F, Plumbing Vent
Roof Complete COMMENTS
Exterior finish grade complete
Interior/exterior guardrails 42 in.platform/decks
Interior/exterior balusters 4 in.spacing platform/decks
Stair handrail 34 in.-38 in.
Step risers 7'/4 in.
Main door 44 in.
All others 36 in.
Lever handles
Exits at grade or platform
Canopy to cover req.exit doors
Gas valve shut-off exposed®ulator(18 in.)above de
Floor bathroom watertight
Other floors okay
Hot water relief valve
Boiler/furnace enclosure
<250,000 BTU N/R
250,000 BTU to 1,000,000 BTU's(1 hour)
>1,000,000 BTU's(2 hour)
Gas furnace shut off within 30 ft. or within line of site
A4
Oil furnace shut off at entrance to furnace area
Stockroom enclosure(1 hour),%hour door
Storage/receiving/shipping room(2 hour), 1 %x doors
1 '/2 hour doors and closers
%hour corridor doors and closers
Firewalls/fire separation,2 hour,3-hour complete
Fire dampers,2-hour fire wall/separation or greater
Fire door/shutters 1 '/2 hour,3 hour
Ceiling fire stopping 3,000/5,000 sq. ft.
Fan shutdown,smoke vents or fan
Exit door/panic bars assembly hardware
Elevators
Elevator signage
Handicapped bathroom grab bars/sinks/toilets
Handicapped bath/parking lot signage
Handicapped service counters 34 in.,checkout 36 in.
Handicapped ramp/handrails continuous/12 in.beyond
Active listening system and signage assembly space
Final Electrical
Site Plan/Variance required
Final Survey,new structures
As-built septic system layout required
Okay to issue TEMPORARY C/O—Certificate of Occupancy yes no
Okay to issue PERMANENT C/O—Certificate of Occupancy yes no V
Okay to issue C/C—Certificate of Compliance yes no
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BUILDING & DOD DEPT.
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not be construed as indicating the
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comipliance with the code.
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