1988-152 lky
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 21 19 88
3)11 �') 1 `� 88-152
This is to certify that work requested to done as shown by Permit No.
has been completed.
This structure may be occupied as a One Fenily Dwelling
Lot 33 Judmar Lane - Peggy Ann Park (St. No. 6)
Location
Owner Michael Schus.teritsch
By Order Town Board
TOWN OF QUEENSBURY
,)
Building & Zoning Inspector
BUILDING PERMIT
- H
TOWN OF QUEENSBURY
No. 88-152
WARREN COUNTY, NEW YORK Pt)
0
PERMISSION is hereby granted to Michael Schusteritsch
Lot 33 Judmar Lane (St. No. 6)
OWNER of property located at Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One Family dwelling
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
Lady Slipper Drive
Queensbury, N.Y. 12801
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2. CONTRACTOR or BUILDER'S Name
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Same
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3. CONTRACTOR or BUILDER'S Address
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Same ,
4. ARCHITECT'S Name
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5. ARCHITECT'S Address c�
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6. TYPE of Construction—(Please indicate by X)
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(X)Wood Frame ( I Masonry ( )Steel ( )
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7. PLANS and Specifications rt
No. 65' x 28' as per p±xtxy±axx specifications and application including
septic system and attached two car garage.
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8. Proposed Use
One Family dwelling
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$5.90 C/O '�
136.00 November 1, 88
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 N.
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the cC
town of Queensbury before the expiration date.) a
Dated at the Town of Queensbury this 18th Day of April 19 88
/' )) on
SIGNED BY j a( G' Q , ' for the Town of Queensbury
Building and Zoning Inspector /LY`—
TO "BE COMPLETE? BY BLDG. DEPT.
�J / Application No. TOWN OF QUEc.N-
_Jotvn of Queeniburty Permit Issued 19 D T I
BUILDING and ZONING DEPARTMENT Permit Expires 19 �_ T k NI
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation 19: :®®,
Queensbury, New York 12801 Variance No. APR 5 • .
Site Plan Review No.
✓
D BUILDING & CODE OF T.
Approved A /` _ tz ..aro,:.? /2 APPLICA ,e_ .
TION FOR /� ���y�j0� /(y1 n,
•
BUILDING AND ZONING PERMIT e • s'u'
* * * * * . * * * * * * * * * * * * * * * * * * * * * *• * * * * * * . * ::.*.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description; plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
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The owner of this property is: y
�" _ v✓� G/� ��r
P.O. Address . ../l/ SCE/.4%9' 1 Tel. ������rn 7
Property Location:, .�%, '( '� `S : /(' Tax Map No. / /
Street number or build • lots- /
Subdivision name (if applicable) . ((� /�i , j ,09 k
•
THE PERSON RESPONSIBLE FOR SUPERVISIO((//NJOF WORK AS REGARDS BUILDING CODES IS:
Name ,P : Address Tel. No. r •
,� Tel. . -J C� �5 .
Name of builder + i - ddress / i/_� lr�� 7
Name of plumber ,x,�, % - ddress II 6/ C a' Tel.Tel. r
Name of mason . ., r �,,,, Address
NATUR F PROPOSED WORK: * . ZONING INFORMATION: •
_Construction of a new building . .. - * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building . . * drawn reasonably to.scale and attached hereto,
_Alteration to a building . . . .. * showing clearly and distinctly all buildings,
(no change to exterior dimensions) *.. whether existing or proposed and indicate all
_Other work (describe) . .. , ', . * set-back dimensions from property lines. Give
* street and number or lot number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
*
LOCATION OF STRUCTURES AFFECTED. * of water supply and location and configuration. : of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size-of property (., ---0 ft X Q ft.
* Existing building ) Size„24 ft X 6-K ft.
*
PROPOSED BUILDING AND USE: * Existing building(s) Use
Size of new structure Oft ft *
Foundation-pier/slab/crawl/partia�%fu ? * Proposed building, distance from property line
(circle one) * Front yard .3- ft39 7 ft
Rear yard /
No. of stories (habitable space) ? * Side yards / ', ft and !T ` ft •
Height (grade to ridge) 7 ft. * If on corner, setback from side street ft
If residential, no. of families /
No. of rooms(excluding baths) A{ •' * . OCCUPANCY INFORMATION
No. of bedrooms * Px-BUILDING -
No. of bathrooms * One family dwelling
Primary heating system r//0,{ / .rf� * Two •family dwelling
Type of fuel (-//odyy.,:
Multiple dwelling / Number of units
No. of fireplaces to binstalled / * permanent occupancy
Will a wood stove be installed? . •
*---Transient Transient occupancy
Central Air conditioning?
. Business
BUILDING STYLE, PRIMARY STRUCTURE ),' Industrial
. Other ' •
Ranch Contemporary Log cabin * If addition; what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow *
•
Cape—Go Cottage Other * ACCESSORY BUILDING-
,Colonial- Row Town House ' * ` ' Detached gage/one car/ two car/ car
•
( CIRCLE ONE PLEASE ). * j , t-ached garage,/o car/ two car/ ,. car
* * * * * * * * * * * * * * * * * * —•—Other
e storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING, PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATIONS
Type of construction, w cd frame fire. safe,etc. G:(i' -5,-�Q
Will any second-hand or ungraded lumber be used? If so, for what. th,-)
Foundation wall material %pii. Thickness
Depth of foundation below grade (to bottom of footii}•g) —�F
Will there,be a cellar?�% Heated•or. unheated? ;,ice. ,..* Floor.sq. footage sq ft
Will there be abasement? , Will any portion be used as living space? WO
(If so, what portion? sq.ft. - Type of use? ,
Type of roof lope /flat/shed%other` " `Material. of roof I u%= - A
Size, wood studs "X , " spacingy "o.c. length 2.. ft. ''6ir
Joists(floor beams) 1st. floor a "X /() " spacing / "o.c. span ft. .
Joists (floor beams) 2nd. floor ,2 "X O " spacing,/ "o.c. span, 0ft.
Overlays(ceiling beams) "X " ,spacing "o.c.' span ft.
Roof rafters "X " spacing o.c. span ft.
Roof trusses(pre-enginee ed) spacing(O� "o.c. span77 ft.
Exterior wall finish g�( Of what material?
Interior wall .finish ��
If a garage is to be at ached ,aescrybe• materials .to be used for FIRE ,SEPARATION: 4'
Is there to :be a •opening between garage and dwelling? A./0 If so will a Fire-rated
door, enclosure, and self-closing device j3e provided? '-
Will a flue-lined chimney be installed? /
'' Height above roof - ft.
Depth of chimney foundation' below grade f -ft.
Depth of fireplac hearth ft.6p in - -0 j, // ,
Water supply - Mu�nicipa or private well i1� A �. 4�:
SEPTIC SYSTEM _ Distance from ANY rivate'well(includin7adjoining.-properties
ft.
P
(A separate application is necessary for any repair or new installation. of septic system)
Town of Queensbury AFFIDAVIT C ;+t Tl A, 11 I 'r STATE OF NEW YORK
County of Warren A F 1 l L 11 Y
I swear that to the'• best of ,my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, area true and
complete statement of all proposed work' to be done ion; 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 a cified or ot, and that suchwork is
authorized by the owner. !. ,
SWORN TO BEFORE ME THIS Signature I z.( •
Owner, wner's ent,arcnitect,contractor
day of _ 19
Notary Public, Warren County, N.Y. •?'
* * * * * * * * * * * * .* * * * * * *. * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
�\•
By -
•
.JIlteft of atandefil.4
,„
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE !��.�.J / l�
LOCATION OF PROPERTY„FOR INSTALLATION
Owner's Name: I i C,V,;,,«,>> 4 Telephone: 79, --,Y;,,;(.,
1
Address: ,� 4,4 \ n,;:i r _,l A
Installer's Name: /�l�v6 �`'` C,CnX Telephone: LA, ',rv�
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom) <.
Topography: circle one:((lat) Rolling Steep Slope % of slope
Soil Nature: circle one: and Loam , Clay Other / Depth: feet
-a f
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test: circle ones-not required Jrequired / rate min. inch.
Domestic water supply: circle one: ,(Municipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank /(ft j= gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S): Number of / Size each feet by /} feet
Size of stone to be used # / Depth or Thickness feet
* * * * * * * * * * * * * * * * * * *.* * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II 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.
I have read the regulations above and agree to abide lTi he and ements
of the Town of Queensbury Sanitary Sewage/D" "o O ce
/
Signature of responsible person: / /.
Date: .
Town of Queensbury
Building and Code Department
•
Bay at Haviland Road
Queensbury, New York 12801 '
(518) 792-5832
•
rTLED 1753 . . . N' "r OF NATURAL BEAUTY . . • A C:':OC, 1 `CIE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work.
ANSWER ALL of the following:
1 . Gross floor area /7z/
2 . Type of heat 747 g)/?-t"f6
3 . Is the building mechanically cooled? yZ S
4 . Percentage of area of windows and doors „,/,_,F Z
A. Over 16% Only
1. Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? YES NO
1 . If YES , what is the R value?
3 . Slab on grade YES NO
a. If YES, what is the R value of insulation around
perimeter of floor?
4. Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1. R value/of roof and floors exposed to ambient conditions
2 . R value of exterior walls 2,,
3 . R value of glazed area /e g, 7
4 . R value of doors e �,.!
5 . R value of floors over unheated spaces (e /
6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab e l' ----
8. R value of heated basement/cellar walls (above grade) VV)0 ,A.:,g---
9 . R value of heated basement/cellar walls (below grade) 6(16,�_41
10 . Type of insulation ^ ,,___
C. Controls D
1 . Thermostat maximum heat setting 73
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES NO
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation
1. Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation.
F. Service Water Heating f/
1 . Performance efficiency /c ,. .<(- 4 '
2 . Temperature control setting maximum / 9 a
G. For Swimming Pool Only
1 . Maximum heating /"✓ 'j
Telephone No7(73 —.2.7,6 �� .:... (•
'(applicant ' s signture)
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INTERIM BUILDING PERMIT
rPERMIT APPLICANT Mir
CONSTRUCTION : LOCATION s ,• ,�
EFFECTIVE .DATE / gle
APPROVED BY j4. .
SPECIAL CONDITIONS
Q --Ries-
.F6 ,g_c_ (37
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This will certify that all submittals for _a Building
Permit have been received and fee has been paid .
During the processing of the Permit, the above named .
may begin construction per plans submitted . It is the
responsibility
P y of the applicant to obtain: the. Permit
from the Building Department, follo ' ng processing.
POST THIS INTERIM PERMIT; IN' A CON P ATION. ! !
wilding & Codes ":Department _
TOWN OF QUEENSBURY
flown of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
Queensbury, New York 12801
SEPTIC J/DISPOSAL SYSTEM INSPECTION
NAME I�ek:g-"
LOCAT I ON JvG�/f/ i%L
DATE if.% / PERMIT NO. ge-A5—c:77
SOIL TYPE -can > Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption fite^ld, total/1/'ength
Length of each`'�trench l✓
Depth of trenches . •
Size of gravel" \ , //
SEEPAGE PITS{Numl* of)
Size- ft. X \j/ft.
Gravel size
PIPING: �/ :� Size Type
Bldg. to tank j ' \\
Tank to dist. jiox ,„\ L/
Dist. box to field/ i \
Openings sealed? E ��; NO Partial
LOCATION/SEPARATIONS:
Foundation Ito ,to tank \\ ft.
Foundation to absorption'•. ft.
Absorption to lot line y, ft.
Separation of pits
LQGATION OF SYSTEM ON PROPERTY(circle one)
Front_ -Rear - Left side - Right side -
MENTS:
SYSTEM USE APPROVED YES NO
\
_
B
ui1 in4 Inspector
01/86 and vl
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT � /�
BAY & HAVILAND ROADS (mil/ �J JI
QUEENSBURY, NEW YORK 12801
/1L
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT/
REQUEST FOR INSPECTION RECEIVED //17
NAME ___ZJ,Ali1 'L� ./(/�/L,„,0_&L_ 6 ,
LOCATION p :33 g//�//7,75e l ✓�--71-(.
DATE A lF PERMIT # (ff-45 q
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING f'}'
ELECTRICAL R EGH-IN ✓✓
INSULATION: \
FOUNDATION �'t
FLOORS dr
WALLS N. ' £
CEILING k ',
(.iFINAL INSPECTION: `�
CHIMNEY HEIGHT d�, ✓
ROOFING
SIDING 1 \
EXTERNAL PORCHES/S •EPS \
STAIRS-CLEARANCE RAILS\
PLUMBING FIXTURE=/RELIEF VALVE
INTERIOR TRIM/P�IVACY DOORS\ ' ✓/
FINISHED FLOORS \II
• ✓
GARAGE FIREPROOFING
DOOR CLOSER(5) ✓
SMOKE DETEC/ORS ✓
FINAL ELECTRICAL INSPECTION ✓
FINAL APPROVAL OF CONSTRUCTION ✓
I -��
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: / /4 /
7004(twelay /,/,%'?
Y4. iilic4
INSPECTOR
MIDDLE DEPART EWT INSPECTION AGENCY, INC
� flectrical 6ul tng-Plumbing-Fire Inspections
Date_ I'`
ca I s ectar
T constitutes certification that the
` ice: above installation, but not the equip-
O ment itself, has been visually inspected
00 as of this date pursuant to the applic-
able codes. If additional equipment
should be introduced or alterations
made to the existing system or struc-
ture, application for inspection should
0 be submitted promptly to this Agency. ..
,z -
•
Jown o/ Queeniur,
. BUILDING and ZONING DEPARTMENT
• /TMay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC /DISPOSAL
SYSTEM
INSPECTION •
NAME / i,CG �G�iCc�/�� ✓1Ti�,
LOCATION, 0l/.1/1-22�/)
DATE,? /6 / PERMIT NO.
SOIL TYPE - Sand Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch of
r"
/
TYPE of SYSTEM:
Absorption ield, total length /
Length of ea. trench '
Depth of tren.'_ es
Size of gravel
SEEPAGE PITS{N n.er of)
Size- 9 ft. X ty ft. I
Gravel size tf /
PIPING: Size Type
Bldg. to tank } q /2d�
Tank to dist. box _ y ��
Dist. box to field/pi:; cF c r
Openings sealed? NO Partial
LOCATION/SE?ARATANS: �.
Foundation to link /a ft.
Foundation to adsorption\ /4/ft. .?a-G/'vj
Absorption to lot line 0 t.
Separation o pits \ ft.
LOCATION OF ..YSTEM ON. PROPERTY(circle one)
P-ront_ Read
- Left side - Right side -
COMMENTS: _L •
rr(T /O
•
/
•
S'
SYSTEM USE APPROVED YES NO
" / S
Buell f Inspector •
01/86 and vl
N
•
Jown of Queeniury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
�� Queensbury, New York. 12801
/ ,
BUILDING INSPECTOR S REPORT
NAME fiz_e y , /J Lrcd,aa)n_1 /I
LOCATION �7 3 p,,,,,edz->wet •
Date .7 / Permit No. f0
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing •
Backfill
Framing
Roofing
Siding
Masonry Venee
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar. Drain Tile
•
Concrete Floors
Plbg. Fixtures ,
Gar. Fireproof' g
Door Closers
Smoke Detecto s
Chj„mney
G.FISULATION: /
Foundation / Mitre 1.
Floors 114 /
Walls L1j �,� CC •
Ceiling ��'—
FINAL ELECTRICAL I'OPECTION /1
DRIVEWAY AP .ROVAL
Final Buildft Survey
Next scheduled inspection (call when ready)
Remarks-
•
•
--
Building inspector
6/86 md-vl
/, Jown f Queeniiurj
BUILDING and ZONING DEPARTMENT
44 • Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT /
NAME ck°GLw ea_
LOCATION ti t/d hrvyr_G
f
Date i� // Permit No. I-LON
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
)Rough PlumbingYN„,\
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings _
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproof in•
Door Closers
Smoke Detectors
Chimney
INSULATION: \
Foundation \
Floors \
Walls \
Ceiling \
FINAL ELECTRICAL INSPECTION \
DRIVEWAY APPROVAL \
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Building Inspector
6/86 and-vl
.awn o/ Queeraury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 4/640
LOCATION / „6",/�a,///
Dates --/,0/ ' 1d ,a? _ 5��2
Perms g� _,5-2
* * * * * * * * * * * * * * * * * * * * * * *
/0' = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
ckfill
Framing
Roofing
Siding
Masonry Venter
Rough Plumbin'
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Wails
Ceiling
FINAL ELECTRIC• L INSPECTION
DRIVEWAY APPRO'AL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
640
uildi g Inspector
6/86 and-vl
_town of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME 4i 4 5,4 avii3Oi,s6
LOCATION
Date y/ / i Permit No. S.;ikiVr
i/ = APPROVED - YES / NO
}Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL IN PECTION
DRIVEWAY APPROVAL
Final Building Surve
sJ
Next scheduled inspection (call when ready)
Remarks- 5 fah .!')e ,fie /6/0 r/
J,
4714 ,4& U aylet --
00 4/4 gL -Tj c 7 Me_
Buildi Inspector
/86 and-vl
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