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2000-731 TOWN OF OUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761=8256 CERTIFICATE OF COMPLIANCE Pemut Number: P20000731 Date Issued: Tuesday, February 20, 2001 This is to certify that work requested to be done as shown by Permit Number P20000731 has been completed. S � ) _Ca Tax Map Number: 523400-03000-0001-051-000- 000 Location: 61 STATE ROUTE 149 Owner; JAMES & DIANE MARIE FOWLER Applicant: SBA TOWERS, INC. This structure may be occupied as a: By Order of Town Hoard Miscellaneous Structure TOWN OF QUEENSBURY Director of Building& Code Enforcement TOWN OF QUEENSBURY Ica 742 Bay Road, Queensbury, NY 12804-5902 (518) 761 -8201 t• Community Deyeloptnent - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P200O0731 Application Number: A20000731 'lax Map No: 523400-030-000-0001 -051 -000-0000 Permission is hereby ,granted to: SBA TOWERS, INC. For property located at: 61 STATE ROUTE 149 in the Town of Quipensbury, to construct or place at the above location in accordance with application together with plot plans and other information hereto tiled and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owner Address: JAMES & DIANE MARIE FOWLER Tyne of Construction Value 61 STATE ROUTE 149 Miscellaneous Structure 1$01W00 ],00 LAKE GEORGE, NY 12845 Total Value 180M00.00 Contractor or Builder's Name J Address Electrical Inspection Agency SBA TOWERS, INC. RANDY FRESCHLIN 860-334-5373 855 CENTRAL AVENUE ALBANY, NY Plans & Specifications 2000-731 P I TELECOMMUNICATION TOWER WITH EQUIPMENT BASE STATION AS PER APPLICATION $I00.00 PERMIT FEE PAID - THiS PERMIT EXPIRES: Friday, September 27, 2002 (If a longer period is required, an application for an extension must he merle to the code Enforcement officer of the Town of Queenshury before the expiration date.) f Dated at the Tow ueensb Wed sday, September 27, 2000 SIGNED BY for the Town of Queensbury. Director of Building & ode , forcement Buildings Permit Applicat-i.n T'Wn ofQUeenSbUr"J' - �'j�. r f Crarrrrrrrnriry !3r t r Jryuiie rrr, 142 14a.10 Rrrrul, NNnn B U ! L A ! N G c4 C D D E E N !•' C) !t N rrr r re.�lrrrry, Ni' 12XtW J7Ci!-.Y ShJ _ Requirements prier (o is, t�a�icc' L*illbo must be ofitruirxesl before of this permit: i� aO�l"1 RU,T hILE N+L7. �' �✓1 - C[]fi14U`llett[7f1" Na ut+4pectl(1nn U ,r,,� •.3 wtle until applicant hse roceiwett7�nfisg 8cxxsd Aticth !'lsltArt/Y ! 'h_"E !'AlL� Jt BUILDING PHRMIT. Ail � ' ' �Aim' Wma" sin thin applicntltxt ! 'fc'l�completed acid the signaturelicant must appear on the PlamnsLreg Board Action RE VIE WEI? B F.- �� SPR I Subdivision I Other Berl&ffrr�q lrcarnrcrr+r rn Recreation Fee Payment -- Applicant: Ot "1�oV+,►ERS �/UC Owner: SA+A ES AAD DI AOUC FOW1� T-!r 1�. R.�� A 31z.17 2 Address: _ 276C. f�,141e N r Fw- 33 itSfc Address: 517t't I'ZT IM Phone # ( Jr _} Phone # ( 514 } 93 - _ /5 Property Location; faI 1LT Subdivision Name: Wax Map Number r3b Section 13lock Vot NATURE OF PROPOSED WORK : ESTIMATED MARKET VALUE OF THE New Building : CONSTRUCTION : $ l ,' C7 C7fiD •residence / commercial -- Addition to Building : residence / commercial OCCUPANCY INFORMATION : Alteration to Building . Primary Building - residence / commercial Single Family Dwelling Residence / Commercial Two Family Dwelling no change to ,exterior site Family Dwelling Office Other Work ( describe below ) Mercantile Tel-tCewnnnur++ iaarrro.�! TpwNt. Manufacturing _ Other GROSS AREA OF PROPOSED STRUCTURE : 18t Elaor . . . . . sq . ft . If ADDITION , what will use 2nd FXo-qr . . .,,.'!�' . . . sq * fto of new addition be ? : Other Fluuts . . . . 0 sq , ft . �V/A ( not unfinished cellar or basement ) ACCESSORY BUILDINGS : Detached Garage it 2 car TOTAL FLOOR AREA : iatCOO SQ , FT . Attached Garage 1 , 2 car Private . Storage Building SIZE OF NEW STRUCTURE : Commercial. Storage Building 70 FEET X -70 � FEET 25 _ Other U J w+V 5 rr S Y7�T7®Y✓ Foundation Type : C,,onc ref c will ,any second- hand or ungraded Number of Stories : f lumber be used ? If so , for what ? ( habitable space onply ) , �PWew _ Height ( grade to ridge ) : {9 feet TYPE of BEATING SYSTEM : Number o fireplace and/ or woo stove ( circle all which applies ) to be installed :_ 0 Electric / oil / Gas / wood Forced Hot Air / Baseboard / other Person responsible for supervision of work as regards to building codes is % AnAr ' EV FAE C Llhl _.43 �; e .,tral Avt L J� lbkri llr4/ �Lv � 3'3 `! -S'373 Name Addresss Phone Builder * .513&* .-Fp WPK::s .s y!x C= <05_c� C-ev4+rrt,1 44. j 5`/5� Y5r9 l S y� Plumber * ul �fboar✓ it/u r2zc - '�i9G' �/ Mason : 8 Electrician : ,rDECLARA77ON-` Please sign below after you have carefully read the statemena 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 authorised by the owner. Further, it is understood that Uwe shall submit prior to a Certificate of Ocoupancy 'or Certificate of Compliance being issued, an AS BUILT PLAT PLAN by a licensed survey awn e, showing actual location of project on premises. Signature: '� (owner, owner's agent, architect, contractor) Shan., Ne�,e iJ SL3!°l f'! t7�P r 4�7 510 ,ea : ct 67 rr - Y3 5`- / 7 9 ? o r�rr�������r��r�rt;n� nGn�nrn� r��rcnCnor.r� r3®RU �n� r�nCnCn��r-���r�I-����I-��I-�I-��I-�I-�������������I-�� rod SBY THIS CERTIFICATE OF COMPLIANCE THE S S NEW YORK BOARD OF FIRE UNDERWRITERS S S BUREAU OF ELECTRICITY S 40 FULTON STREET -- NEW YORK , NY 10038 CERTIFIES THAT �� f Upon the application of upon premises Owned by / SBA NETWORK SERVICES, INC. * AT & T WIRELESS 6286 E. TAFT RD.S N- 4 SYRACUSE, NY 13212 QUEENSBURY, 2NY 12845 Located at 61 STATE RD 149 QUEENSBURY, 12NY 12845 S Application Number: 1178037 Certificate Number: 1178037 Cj 5 S Section: Block: Lot: Building Permit: BDC: A239 S �S S Described as a Commercial occupancy, wherein the premises electrical system consisting of Selectrical devices and wiring, described below, located in/on the premises at. outside, S Swas inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was S found to be in compliance therewith on the Sth Day of November, 2003. �SName OTY Rate Rating Circuit Tyne Alarm and Emergency Equipment C� Transfer Switch 1 0 Panels -1c l 200 24 T� SWiring and Devices S Receptacle 1 0 Special 5 P5S Service 1 Phase 3W Service Rating 200 Amperes SService Disconnect: 1 203 eb S Meters: 1 S � S S seal 5 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. S S I°7 r�rJ�rJ01�cJ�r1r 1rJ�rJ�rJcJ`rJ�rJ"rJ�rJ J"rJ"cJ"c.I�rJQj"rJ�rJ�rJWJ�rJ�rJ�rJ�rJ�rJ�rJrJ�rJ�eE�rJ�et�r�rJ�rJ�r�rJ�rJ�irJ�rJ�cJ�cJ�cJ�cJ�rJrJr�'rJ�rJ"rJ"rJ�cP�Pc I�cJ'sJ�rJ�rJ�� Q :u �'�y lVil Et IDLE I?EYA.RT1%4 NT Ir4 S PE CTI()N ACr ESC Y, INC* �}— � ?�3l.DG, DEFT. COPY D31E " Jan , ^LE r �2001 Certifies th.:t the electrical wiring to the electrical equipment listed below fias been examined and is approved as being in ,sccord with the 'National Electrical Code , applicable governmental, utility and Agency rules in effect on the date noted above and is issued Subject to the following conditions. Owner IWO Sprint Occupancy SBA Cell Tower G Same This Certificate applied c ar l y hO the e l uGl[iCal w i+in g t n I he alai:Cncdl aq u iprnaY+x I rsted below and the Occupant: 61 State fate 149 imia:'ation lnspracied as the above nosed data 0asad on a visual insq�nion, No warranty +s Location !�x oxprusa9d or �"Niti as to the rhuchanrcal Salely, aHiciency or fan" or the equ+pme the ait:rora not t tar any Q u en s bury r N , Y • pan:Cular purpoca. This Canil,cate shalt be vabd hor a.period of one year I romed dace. ShO ld the gl pCtr icah Sysl ens to which this Gan lficaie apple's be al tared in any way, including but EquTprrr$rht; not limited 10, the in uodu cl ion of add hianah alecl r�Cal eq u pmeal andror Iha replaCernenl of any of 100 Amp . Service Equipment , 1/0 he con °nanls e^ 'ailed es of ,he ataove noted data, this cedi noe shall re immed alritoyheroin- nun and voitl. "W neals hn. t applies as 9i'ly lU lha use, aaCupa:^.cy and ownarshQ as intl+Caled herein. f.lpon Meter Set On Y a change in the use. oceupan. y or owners hp of the proPeny mdtcarad alive.this aanA idle si an C ue n vi-ed+alely null and vox1, to the event Thal in* curleecato betide . invalid based upon lha aoovo Conditions. this o0rhlcale may be revalidan d upon rainspeehon by Midd is 0opanmi In. C �l speclion Agency, ;n+ An a0tilication lot Yhspoclon must be submitted la Middle Department ,Applicant: rE 1 c c t r i C Coyne 1 inspection Agency. Ir c. 10 inilia79 Ine insPecuon And ravandahon pha oss. A fee will be charged for This serVi09. 44 Highland Dr , 14- 98387 �7 E . Greenbushr NY 12011 140. rFGSl���..h..n�.rt� >h.�" �. � •�..:C. '.Z+".1�4,;1`.nw��a..w>r�r ',�c`.e�"'._..? Town of Queensbury Building & Code Enforcement Office No. (518) 761 -8256 Commercial Final Inspection Report Inspection request received: A" � zv�a 1 Name: 15?ZA t �^'c-- Inspected on: z nk Location: 1 Sc.. `�4 . . _ _ Arrive: m. 1 P.M. Permit No.: 2woa[s . '�- l Inspector's Initials: COMMENTS Y N NA Chimney 1 "B" Vent ! Direct Vent Location a' V�St_li.V� Plumbing Vent Through Roof 6" / Roof Complete Exterior Finish I Grade Complete 6" in 10' or Equivalent YQa+'�_Interior I Exterior Guardrails 42 inch Platform / Decks Interior I Exterior Balusters 4 inch Spacing Platform I Decks Stair Handrail 34 inch — 38 inch / Step Risers 7" 1 Treads 11" Vestibules For Exit doors > 3000 sq. ft. All Doors 36 inch w/Lever Handles / Panic Hardware, if required Exits At Grade Or Platform 36" (w) x 44" (l)I Canopy or Equiv. Gas Valve Shut-off Exposed & Regulator (18") Above Grade Floor Bathroom Watertight I Other Floors Okay Relief Valve, !-seat Trap I Water Temperature 110 Degrees Maximum Boiler I Furnace Enclosure 1 hour or Fire Extinguishing System Fresh Air Supply far Occupancy I Ventilation Combustion Low Water Shut Off For Boilers Gas Furnace Shut Off Within 30 ft. or Within Line Of Site Oil Furnace Shut Off at Entrance to Furnace Area StockroomlStoragelReceiving/Shipping Room (2 hr.), 1 '/2 doors > 10% > 1000 sq. ft_ 3/4 Hour Corridor Doors & Closers FirewaIIs / Fire Separation, 2 Hour, 3 Hour Complete I Fire Dampers I Fire Doors Ceiling Fire Stopping, 3,000 sq. ff. Wood Frame Attic Access 30" x 20" x 30" (h), Crawl Space Access 18" x 24" Smoke Vents Or Fan, if required Elevator Operation and Signage / Shaft Sealed Handicapped Bathroom Grab Bars 1 Sinks I Toilets I Mirrors Handicapped Bath I Parking Lot Signage Public Toilet Room Handicapped Accessible Handicapped Service Counters, 34 inch, Checkout 36 inch Handicapped Ramp I Handrails Continuous/12 inch Beyond [Both sides] Active Listening System and Signage Assembly Space Final Electrical / Flex Gas Piping Bonded Site Plan / Variance required Final Survey, New Structure 1 Flood Plain certification, if req. As-built Septic System Layout Required or On File Building Number or Tenant Address on Building or Driveway 4" Water Fountain or Cooler Building Access All Sides by 20' 1 Drivable Surface 20' wide Special Inspections I Engineer or Architect Approval Okay To Issue Temporary or Permanent C/O Okay To Issue C/C Commercial Final Inspection_11 27 12 COMNMRCIAL FINAL INSPECTION REPORT — Building & Cade Enforcement hate mspection request received: Office No. (518) 761-8256 - Dept. of Community Development Town of Queensbury Arriam4�ps� 742 Hay Road irtspectW s Initial Queensbury, NY 12804 NAB , 'S,�rAi��, PERMIT # L CAT SON R c3. ., DATE TYPE OF STRUCTURE [" E I E N/A YES NO COMMENTS Chmaney/"B" Vcnt/Lhrect Venn location Plumbing Vent. Roof Complete Exterior finish grade complete IrAct ior/exterior guardrails 42 in. platfarrn/docks InteriorYcxtmior ballastcrs4 in. spacingplatforn-Aideeks Stair handrail 34 in. - 38 in. Step risers 7 'i4 in. Main door 44 in. All others 36 in. Lever handles Exits at grade or platform Canopy to cover rest. exit doors Gas valve shut-off exposed &c ator 18 in.) above grad Floor ha watertight dsrrxmr Other floors okay Hot water relief valve Boiler/furnaceenclos ire _ <2504000 BTU N/R 250.000 BTU to 1*000.000 's (I hour) > 1,000,000 BTU's (2 hour) Gas furnace shut aft within fL or ithirr lute of site Oil £umace shut off at ce to ace area Stoekrok?nt enclosure (1 hour), '14 ho r door Stkxagelrcociving/shipp ngroom (2 h ur), I '/a doors 1 12 hour doors and closers ' . hour corridor doors attd a7crs Ftrtwalls/fire separation, 2 hour, 3 ho r oompleate Fire dampers, 2 hour fire wa11/separati or greater Fire door/shutters 1 '/,, hour, 3 hour Cci ing tire 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/sinkskoilets Handicapped bativ'parking Id sigjnage Handicapped service counters 34 in., checkout 36 in. Handicapped ramp/handrails continuous/ 12 in. beyond :'iCtive fisterting syst.ean and signage assembly space_ j'mal Electrical JSite P1anfVariance required Fatal Survey, new structures � As-twih septic system layout required Okav to issue temp. C/O (Ceatif: of Occupancy) — C*av to issue permanent CIO (Certif. of Ocuupanc^y) Okav to issue C/C (C.:ertif. of Compliance), 1.f r MIDDLE DEPARTNIF NT INSPJ errc��a t, cr;ivcY, INC. 00 Dale Del 22 r 2 00 Certifies that the electrical wiring to the electrical equipment listed below has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date noted above and is issued subject to the following conditions. Ownf3r; Nextell Occupant: Same Occupancy Cell Tower C LocahIon: yC' ty R t e 149 This cenllicate al"fak"only to the etottriaal wiring to the a ec[ncat o 7uiPrr a it l sled betaw and the S Qu een.�`i. bu rj r 't"� • Y • asPrussgd or ]r�"q�d U'e above noledl dare eaSW an a Visual inspg.;f,pn. No warranty a rnP a$ fo the meahan cal safely, etliciency ar fdness of iris e- No w d for any Equfpmenr; pafh� larpurpose. This Cendldsit"nall be Validforapenodol one year l+omlhe aDevendleddate. �S /� ,ry Shpatd the aLgalriaal system to wYiKVh this cDndkc nil appnoa be altorgd in any way. including but 2 V V Amp . Service Equipment , q u I pmen t 3/Q not llr,,,ted Ip, U,e vitroauctgn of addoIional olectncal ,qup,en,antlJor the roptaae,mnclOnt d any ul C the evrnponenrs instaxed as of the above noted data, this cenihcale,shair be immedatey nux and void. This Cendicaro applies any 1p the use,o Lllliahcy and awnershp as indicated herein. Upon a change in the use, occ upan Uy or owners hp of the properly indicated oe irnmediarely null and void. In the a�'✓e.this aondiaata shah C r� even[ Mat this upponCu�h ruin 4ecanies invalid based upon the Apphicank I dbove conditions, 1 IncGomrappliWAtO may be r inspection upon reins Pe ion by Middle 00parin i In. ��- e C t r 1 C Coyne � scwcrion Agency. nu An application for ins Inspect Kin Agency, Inc. la initiate the in Tian must be SuGrndted la Middle Defuen ont 4 4 Highland D r . for this sere ce spechon and revalidaatian prooeSs. A fee wiu be charged 4 I Ea Greenbush , NY 12061 _l 1 v r+•. No. 14- 97866 y 'r .r'r�, .ter .i-�•"iu . Fnrrw Ain Yn'i Ci T_A, �`rY" v • vv-. �. v V e:/'AVlF"�ARr c./ MIDDLE DEPARTMENT INSPECTION AGMF,NCY, INC. Si'C LLLEDI r. DEPTa CC"'N`I Date Dec . 22 ,Sa 2000 Certifies that the electrical wiring to the electrical equipment listed below has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in ettect on the date noted above and is issued subject to the following conditions- Owner: 'Cellular One Occupancy. Cell. Tower � me pccupanf: This Cerlirlcala dppties only to Sha slaartnal wurng tD the BlaCtritai rtn aqutpen[ fus[ed be4ow and the Location: C ty Rt e 149 lmiadalion rnsoecled as the above noted date based on a wsuat insOeGtron, No warranty Is u e e n s bu r y r N • Y . expressed or implied as to the miechancal sarely, efficiency or Iciness of Ina 69miomers lax any panicularpurpose. This ceniitcate shall be valid lox a period at one year from the above holed dale. Equi1Gm enr: Should the alactncal syslam to which this can skate applies be altered in any way, including cull not hrn1e0 to, Ina int rodeGtton of additional elarvit r earripmenl andlor the reuracernanI of any of 200 Amp . Service Equipment 3 /0 I ho oomoononls ins tailed asof t he above noteddae;Th is certificatesh a hbetmmeowury n nullad void- This ca apples only a onlyto the use.occupancy and ownership as indicated herein. Upon f. a change in the use, occupancy or ownership of his property indicated above, this cenilicate shad t be irrrnadiarety null and void. In the avant that the coArrPcaia bBGnn]Be invalid based upon the aoove conditions. Ihls coodicata may be revalida e [la 6 ed upon reinspection by Middlparl l In- oft IIcanl: sooctiom Agency, Inc An application for nspeciion must be submitted to Middle Oepaninent pp " 1. 1.e c t r i c' Coyne in s pecton Agency, 1nc, la initi de the inspoct ion and ray a iodation procas s- A I" will be charged 44 Highland Dr lot this sarvice. E . Greenbush , NY 12061 No. 14- 97865 a� /'>'x\ Fin, .f+ Ysi .. \w/ •. • I•rA\.fir/�.[� • , ,•~ n 'f'"'�../ ti..�/ Form No. 703 EL 7-94 GENERAL LNSPECTIQN REPORT ( 51 $ ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road. Queensbury, NY 12804 Arrive am/pm Depart L inxspector's Initials NAME: - ef > NJl C PERMIT # LOCATION: DATE TYPE OF STRUCTURE: RECHECK l A YES, 0 COMMENTS Footings/Piers t Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from f vexing for 48 hours following the placement of the concrete. Materials for this purpose on site Foundation/Wallpour Reinforcement in Place Foundatit Bacldill alPlumbin Slab PlumbinVents in Place Rough P Heating Rough-In Insulation Foundation Walls Interior R- Foundation 'Walls Exterior R- Floors R- Wails R- 1. Ceiling R- r Duct work or piping in unheated spaces R- Proper Vent, Attic Vent Framinx Jack Studs/Headers Bracing/Bridging, Joist Hangers Jack Posta/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firesatoppin / Za ./ GENERAL IN.SEEC.'TI©.N REPORT I/ ( 518 ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received. Building & Code Enforcement 742 Bay Road � '^y J,,� Queensb�ury, ICY 12804 Arrive am/pm Depart t - r .y� p , InsInspector'sInitialel"s /� STRUCTURE:NAME: S �!� � _/Y PERWr # R 1 LOCATION: DATE : -- t TYPE OF STRUCTURE: �--' RECHECK N/A YES O CON NIENTS F tings,F�iers.� �� , analithic Pour Fordi I { / Reinforcement in Place � � C �✓ry i G. `� i / 7 The contractor is responsible for provWing protection from freezing for 48 hours following the placemett of the concrete. Materials for this purpose on site FoundationlWaltpour Reinforcement in Place Foundation/Dampproofirte Backti ll Approval Plumbing Under Slab Plumbing Vent/Vents in Place ugh Pl 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 Framin 1 Jack Studa/tleaders Bracing/Bridgi joist Hangers Jack PostslMain Beam Air Infiltration Barrier Fire Separation 11 21 31 hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestopping 14) GENERAL INSPECTION REPORT ( 518 ) 761 - 8256 Town of Queensbury Dept. of Community Development Date inspection request received: Building & Code Enforcement 742 Bay Road �,, ��, Queensbury, NY 12804 ArrivegC : Depart / Inspector's suit' ^7 NAME: PERMIT # LOCATION: DATE TYPE OF STRUGTUR-E+ ` - RECHECK N/A YES N COMMENTS gS/Pieis C i •`1„ y-- ---- �r7 � 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. Reinforcement in Place Foundation/Dampproofiniz 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 Studsq-leaders Braciitg/Bridgin Joist Hangers Jack P6stsJMain Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wail 2, 3, 4 hour Firestapping A Division of Eastern M .a terials _ V Labaragtory FIEL,D REPORT JAWORSEG Project: SBA Tower #10145-001 Client: SBA, Inc. GEOTECH, INC. Qiueensbury, NY Contractor: Dempsey Construction Project No. : 00187C Weather: clear, 40's Date: September 29, 2000 Purpose: To review concrete construction, fabricate specimens for strength testing, and observe placement of reinforcing steel. Contractor Activities: During this writer's visit, general contractor Dempsey Construction excavated and formed the foundation for proposed tower. The excavated soil was field screened with a organic vapor meter. The field screening results range from 0.0 to 2.6 ppm. The foundation subgrade was observed to be undisturbed brown C-F Sand with some C-F Gravel, little Silt. Prior to concrete and reinforcing placement compactive efforts were applied with vibratory plate tamper. Subsequently Glen Falls Ready Mix delivered 20-cubic yards of 5,000-psi concrete. Concrete was placed in forms by chute, mechanically vibrated and hand troweled to finish. JGI Activities: Reinforcing steel was reviewed prior to today's concrete placement. The steel was observed to be placed in general accordance with project drawings. Concrete compressive strength test cylinders were fabricated from today's concrete placement in accordance with ASTM C 31 . Defer to the Concrete Strength Test Summary of this date for details. The General Contractor was notified of today 's results prior to JGI's departure from the site. - . . 4 . : Prepared by: E. Bishotx • ;' r Reviewed by: Date: 1 1/17/00 _ TEST RESULTS DO DO NOT COMPLY WITH SPECIFICATIONS ~� .s+ '- <fCe .ARE NOT COMPLETE OR X ARE NOT APPLICABLE ,y��`S�,j' • . ��� A DEVIATION REPORT IS ATTACHED X IS NOT ATTACHED HAS BEEN I IS ATTACHED OBSERVED CONSTRUCTION X DOES DOES NOT COMPLY WITH SPECIFICATIONS IS NOT COMPLETE NOT APPLICABLE The information stated on this report may not be reproduced except in its entirety without the express written consent of Eastern Materials Testing a division of Jaworski Geotech, Inc. Use of the NYLAP designation does not represent endorsement by the NISTor NVL✓tP. Reports are relevant only to items tested and no other attribution maybe made. A Division of Eagt.ern . 1Vlat� rials , � r''.- T biva FIELD REPORT °� x P Lataat.ory JAWORSKI Project: SBA Tower #10145-001 Client: SBA, Inc. GEOTECH, INC, Queensbury, NY Contractor: Project No. : 00187C Weather: sunny, 70's Date: October 1 , 2000 Purpose: To provide construction monitoring services to evaluate by observation whether work generally conforms to project plans. Contractor Activities: This writer observed the first section of the guy tower being erected. The first of the tower was assembled and set in place. The guy wires were attached to the tower and secured. Prepared by: J. O'Rourke Reviewed by: Rai ' Date: 11/ 17/00 TEST RESULTS DO DO NOT COMPLY WITH SPECIFICATIONS ARE NOT COMPLETE OR X ARE NOT APPLICABLE A DEVIATION REPORT IS ATTACHED X IS NOT ATTACHED HAS BEEN AMENDED AND IS ATTACHED OBSERVED CONSTRUCTION X DOES DOES NOT COMPLY WITH SPECIFICATIONS IS NOT COMPLETE NOT APPLICABLE The information stated on this report may not be reproduced except in its entirety without the express written consent of Eastern Materials Testing a division of Jauwrsla Geotech, Inc. Use of the NYLAP designation does not represent endorsement by the NI,ST or NVL.4P. Reports are relevant only to items tested and no other attribution may be made,