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2011-577 TOWN OF QUEENSBURY0-4ifo . 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20110577 Date Issued: Monday, June 25, 2012 This is to certify that work requested to be done as shown by Permit Number P20110577 has been completed. Location: 347 CLEVERDALE Rd Tax Map Number: 523400-226-012-0001-048-000-0000 Owner: DAVID & LYNDA JOHNSON Applicant: DAVID & LYNDA JOHNSON This structure may be occupied as a: Garage - 1 Car Attached By Order of Town Board Residential Addition TOWN OF QUEENSBURY - ei-vP Issuance of this Certificate of Occupancy DOES NOT relieve the property 4 43t-- owner of the responsibility for compliance with Site Plan,Variance, or other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement or Zoning Board of Appeals. ��` TOWN OF QUEENSBURY sO 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: P20110577 Application Number: A20110577 Tax Map No: 523400-226-012-0001-048-000-0000 Permission is hereby granted to: DAVID &LYNDA JOHNSON For property located at: 347 CLEVERDALE Rd 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: DAVID &LYNDA JOHNSON Garage- 1 Car Attached PO BOX 280 Residential Addition $40,000.00 CLEVERDALE,NY 12820 Total value $40,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency W.D. WILLIAMS CONSTRUCTION 656-9496 656-3579 P.O. BOX 241 CLEVERDALE,NY 12820-0000 Plans&Specifications BP 2011-577 411 sq. ft. residential addition plus 528 sq. ft. garage addition(attached). Cross Ref. /Approvals AV 52-2011 and SP 56-2011 $161.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,November 30,2012 (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 Tow Qu nsbu • /1 w• r , , , �_ , ovember 30,2011 SIGNED BY �-h� �` . a for the Town of Queensbury. Director of Building&Code Enforcement ,9 ) (t) - - OFFICE USE ONLY ' TAX MAP NO. _./-� ^\ ,� ' PERMIT NO. '11—��"� n FEES: PE'1lz E 0 V E 7 1 O1 ,4%c -• CREATION________ENGINEERING ENGINEERING ........... .... .. 4.1',4.1', '�, 1 (If applicable) H ;Ula 2 1 2011 PRINCIPAL STRUCTUR : ; TOBUILOF D NQGU& CODES Y APPLICATION FOR ZONING APPROVAL & BUILDING A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONST PERMIT REVIEW BEFORE ISSUANCEPt) OF A VALID PERMIT FOR CONSTRUCTION. IS SUBJECT TO APPLICANT/BUILDER: • ��Ua (\11[.rn --^ r�) OWNER: v2 ''.1, - ./ _________/-1'3"-1 ADDRESS: 50 ,L1 -E.- . ._____161.6giRtg...ADDRESS: PHONE NOS. /S(e "2)51 ' CLUJphSi'4 PHONE NOS. CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: U,l S PHONE: LOCATION OF PROPERTY: .jq" CLO-V.,„.11411 - 1.-'40 HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? $ YES 0 N• IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL: (�(� 3 �i �� �o-20 -. l S -d-6// , PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT z APPPLY EC O YOUR 0 O o I= o O LULL I- :-:)c a Z Q Q Na F- ~ 01— � wz O u- F- ti n. I 06 SINGLE FAMILY \1(- diA [ 411 t /` -, TWO-FAMILY Cil MULTI-FAMILY D ` j (NO. of UNITS ) IIIIPP TOWNHOUSE Lynda Johnson BP 2011-577 -- 347 Cleverdale Road BUSINESS OFFICE Residential Addition & Garage Addition RETAIL- ---------------------- MERCANTILE FACTORY OR INDUSTRIAL / ATTACHED GARAGE(1,2,3) ( 1-1 OTHER I IF COMMERCIAL OR INDUSTRIAL- NAME OF BUSINESS: i IM TV ESTIMATED CONSTRUCTION COST 4Q, � . �hnna- B 3-LGL 11-05 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? +t ARE THERE EASEMENTS ON PROPERTY? I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application, plans, and supporting materials are a true and complete statement/description of the work proposed, that all work will be performed in accordance with the NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy. I have real a Id a• -e t � t e,aboye. Signed ,► 4 1 4 .,� 1 r . Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes or septic systems) Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process, application requirements or to schedule an appointment) c Permission is hereby granted to the above This application / proposed action described Applicant to erect or alter the building herein is found to be in accordance with the described herein in accordance with said zoning Laws of the Town of Queensbury. Application: e„ BUILDING & CODES APPR VAL ZONING APPROVAL DAT DATE QUESTIONS? CALL 761-8256 OR EMAIL Office Use Onl codesCa�gueensbury net VISIT OUR WEBSITE FOR MORE INFORMATION ODeratinn Pcrr„i+ i _�. Final Survey Inspection Dept. of Community Development Town of Queensbury 742 Bay Road Queensbury,NY 12804 Date received: t 0 %?-- NAME: LOCATION: PERMIT#:2,2t. Final Survey Plot Plan Approved Denied The attached final survey has been received by the Dept.of Community Development. Upon review the survey has been: C\21)\-H Craig Brown,Zoning Administrator L Notes: '(C(_0 I Cit.'[L a k . SJYUto WYDYM - riOk 5 ivAY) 010x3 6 . L:\SueHemingway\Building.Codes.Inspection.FORMS\Final Survey Zoning Administrator.doc MAP REFERENCE: MAP OF A SURVEY OF LANDS OF WALTER D. VAN DUSEN SHOWING PARCEL OF LAND TO BE CONVEYED TO ROBERT J. O'BRIEN DATED: OCTOBER 22, 1971 BY: JOHN B. VAN DUSEN L E G Eo�G� F r h I 1 IPF IRF MR N � � o Ln � IPF S87'05'00"E 231.14' w AREA 0.47 Acres a w a I o N I w of 1 STORY WOOD 0 = FRAME HOUSE N U 0 0 68.5 5' 8631' FOUNDATION ONLY 12-19-11 v P � o 227.56' N 30.0 IPF N 87'24'00"W i LEGEND: IPF = IRON PIPE FOUND IRF = IRON ROD FOUND UPDATED DECEMBER 19, 2011 TO SHOW LOCATION OF NEW FOUNDATION ONLY, AL OTHER INFORMATION EY SHOWN AS MAPPER JANUARY , 2 Datel JAIvuHR w zE " Scale 1'=20' D v` UNAUTHORIZED ALTERATION OR ADDITION TOA SURREY Map of a Survey made for S -- 1 S e MPP BEARING A LICENSED LAND SURVEYORS SEAL IS A SUB -DIVISION 2. OF THE VIOLATION OF SECTION 7209. �y O T Is, NEW YORK STATE EDUCATION LAW. 0 �� I\V� SHEET 1 OF 1 •ONLY COPIES FROM THC ORIGINAL OF THIS SURVCV LY N D A 11 M,uKtDI•nTHANGwGIN�0FTMEIp"°SDRVLY°� FOUNDATION LOCATION StevesSEAL SHALL BE CONSIDERED TO REIEE VALID TRUE COPIES.' 'Z 12-19-11 'CERTIFlCATIONS INDICATED HEREON SIGNIFY THAT JOHNSON THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE 1 1-28-0/1 ADDITIONAL SETBACK INFO. EXISTING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED New York U L DWG. N0. 01263 BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL hTarren County, DESCRIP TION a s u r V e y o Y. s LAND SURVEYORS SAD CERTFICATONS SHALL RUN ONLY Town of Queensbury, NO. DATE C-611 L TO THE PERSON FOR WHOM THE SURVEY G PREPARED, AND ("1 ON HIS BEHALF TO THE T1TLE COMPANY' GOVERNMENTAL Q A .Gy ANp LQJDING INSTITUI110N LISTED HEREON, AND New York 12 804 TO THE ASSIGNECS OF THC LENDING INSTITUTION Queensbury, 14_1-9.1 169 Haviland Road New York Lic. No. 50135 ;518) 792-8474 I fl Lt(S d ca / 3 Queensbury Building & Code Enforcement - Residential Final Inspection A Office No. (518)761-8256 Arrive: am/pm Depart: 2 f 2U am/pm Date Inspection request received: LQ----a Ha inspector's initials: NAME: ( ( PtJ ) utv)ot bhtAs©() PERMIT#: I b LOCATION: '� (l7 (JP. DATE: tv d I-I d TYPE OF STRUCTURE: s ii-c-I4 14- n n Comments: Yes No NIA 4" Building Number Address visible from road CdX121- (--t-)°-V) Chimney Height/"B"Vent/Direct Vent Location t� Fresh Air Intake �`1 Q 3 inch Plumbing Vent through roof minimum 18 inches 2 ..�.� Roof Complete/Exterior Finish Complete �� ` ` D Platform at all exterior doors Handrail 4 or more risers Guards at stairs,decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors I Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access,1 sq.ft.-150 sq.ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site �����- Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum W Gypsum Basement stairs dosed rise>4 inches Garage Floor Pitched Garage fireproofing/3/4 hour fire door/door closer Gas Logs in Sealed or Glass Enclosure Final Electrical;Energyig uibs o Final Survey Plot Plan Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles Flex Gas Pipe Bonding As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C/O[Temporary/Permanent] L:\Buiding&Codes Forms1Building&Codesllnspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11 JLt. es dct� �c- -I O Queensbury Building & Code Enforcement - Residdtial F• -1 Inspection Office No. (518)761-8256 Arrive: Jr' - .�: t . i Date Inspection request received: Jr— 1—I Inspector's Initia s: NAME: (.3Q tA Ae- t 111Qir��\,�© f;71 1)8 p - • #: I F 6 77 LOCATION: 3`l C1co.V rdF(e, f� II ' -5-- /S- /a TYPE OF STRUCTURE: KQrc l2 I.4c1ci.'t-t-i on J Comments: Yes No N/A 4" Building Number Address visible from road , 11 Chimney Height/"B"Vent/Direct Vent Location ���` W c��n� Fresh Air Intake 1/3 t`\L�/hs 3 inch Plumbing Vent through roof minimum 18 inches J o!'F Roof Complete/Exterior Finish Complete ✓ 11Q '-a) �� YJ Platform at all exterior doors / / , O V@ Handrail 4 or more risers ` h v,�q Guards at stairs,decks,patios more than 30 inches above grade J Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more tV ee-0 �EcatAkAE-; Handrail Termination at Newell Post or Wall Interior/Exterior Railings 34 inches to 38 inches 4\ Pt'Q-7 . +'. 4 \0i Deck Bracing/Handicapped Ramp Compliant %Grade away from foundation 6 inches with 10 feet � ��' 7 4- 6 inch clearance to sill plate � Gas Valve shut-off exposed/regulator 18 inches above grade �// Interior privacy/trim/doors/main entrance 36 inches `// Bathroom/Kitchen watertight / Safety glazing/Wi in stairwells safety gl ' g Interior Smoke Deet9rs/Carbo;:Monoxide 'etectors Every level: • // Eve ed / Outside every bedroom ea: / Inter Connected: Battery backup: / Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access,1 sq.ft.-150 sq.ft.vents ` Bathroom Fans,if no window '/ Plumbing fixtures .4 Foundation insulation to floor/Sticker on Panel j _,� CF---E-44\ F \p Duct work sealed properly/Blower Door Test Certification Floor truss,draft stopping finished basement 1,000 sq.ft. 3.i;SkTc — M ` Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site \ 33c�� , �o a k Oil Furnace shut-off at entrance to furnace area C...?-4k): Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum W Gypsum Basement stairs closed rise>4 inches / Garage Floor Pitched Garage fireproofing/%hour fire door/door closer .� t Gas Logs in Sealed or Glass Enclosure 1-t� �iIL. \ Final Electrical;Energy Saving Light Bulbs 50% /_______...s? Final Survey Plot Plan Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles / /4"(// ' Flex Gas Pipe Bonding As Built Septic System I Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C/O[Temporary/Permanent] / L:\Bulding&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11 3 . / 1 JUN ' 1 2012 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.. • Main Office 176 T oe Run Hoed-Manhelm,PA 17545 • ;I MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL' . Permit No. Cert. N9 20289 Cut-in Card No. • Owner Data:LA%..:A..4„r im a A S:a.b.lrns-ttne • Location 3.`.{ 1...•...C,.45vc-1+104 Installation Consisting of AA.l -/e.T!:4' tis.1-/..a.e. t.G.;,.......,2 a2 G Gr .....2. ,:.,5 wr 11 i-n.yi AZ ./:-`A..xt.3..,.......,la 1 c.,- Installed By ln.t..Kt..- /..•i.i,4lft.rrk.,S Lic.No. • • The conditions following governed 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 : tion e ptlY introduction of additional fhisCompany hallment rhave thens.privi privilege making ll hinspections atade for any time, and of its Inspectors of this Company • rules are violated,the Company shall have the right to revoke this certificate. '— INSPECTOR.,--.4,/.. Member N.FP.A.,l.h.E,1. TO 39bdo7swnW N0a 178S186L 0T:9T ZTOZ/TZ/90 Rough Plumbing I Insulation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Z- l Z-- Queensbury Building &Code Enforcement Arrive: am/pm Depart: a pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: t__ 9_ Pk • NAME: Ov% PERMIT #: / LOCATION: -e J INSPECT ON: d1 1/ i z TYPE OF STRUCTURE: CAQ-0.4 Y N N/A Rough Plumbing /Nail Plates Plumbing Vent/Vents in Place p1 1 %inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every 100 feet I change of direction Pressure Test Drain/Vent Air/Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/Head 0 P.S.I for 15 minutes sulation/Residential Check/Commercial Check T =k or Similar Exterior Sealant Proper Vent, Attic Vent Door/Window Sealed (No Insulation) Duct/Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape COMMENTS: � `1 ki )05 Q— cl Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspection request received: V,a4-1.01Queensbury Building &Code Enforcement Arrive: am/pm Depart: am 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: , , m NAME: •:i PERMIT#: LOCATION: / -20q? i P'/ 0. 47 INSPECT ON:• TYPE OF STRUCTURE: #44 o 4,, /420.04 Y N N/A Rough Plumbing /Nail Plates Plumbing Vent/Vents in Place 1 %inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout ever 100 feet I change of direction Drain/Vent Air/Head 5 P.S.I 10 ft. above highest connection for 15 minutes 3 ater Supply Piping Air/Head minutes Insulation/Residential Check/Commercial Check Tyvek or Similar Exterior Sealant Proper Vent, Attic Vent Door/Window Sealed (No Insulation) Duct I Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape ia` - COMMENTS: el „ �.- L v Z--/g Rough Plumbing Insulation Report.revised Nov 17 2003,revised February 15,2005, revised January 7,2008 cl . UO i /O- /2 ( r, a7 . Framing7 Firestopping Inspection tion Report Office No. (518)761-8256 Date I • - • '- . - -- •• _ Queensbury Building&Code Enforcement Arrive: '-'- 'r .,n• II • : \2°o� am/ 742 BayRoad, Queensbury, NY 12804Initia Inspector's Infix PERMIT ► " NAME: � r�S 0 #: LOCATION: : 7 L/' . K1INSPECT ON: -11:421 - _ OF STRUCTURE: 7____ Itt r- NyE-__.-.-,-,\I ‘4 Y/ 8, la COMMENTS:ilming Attic Access 22° x 30' minimum ` \rb-v(Vu c_c<.�ac.2--c‘c5 \Z Jack Studs/Headers �3.6 .-c- brn . Bracing/Bridging Joist hangers / ssW t PN 6Ec2._5 , Jack Posts I Main Beams �/� 1: - ����\ )7)M�14=0-- Exterior sheeting nailed properly 12"O.C. L Ar.- Headroom 6 ft. 8 in. 7 Stairwells 36 in. or more Exterior Deck Bracing Headroom 6 ft. 8 in. • ``z-E-5 og Qi ?IA tA e el) b L._ 6AECTk Notches/Holes/Bearing Walls ' w`AL . 7-Q; it. AM `i‘u-V- 5-vov-v Meted Strapping for Notches Top Platee.._.. 6 kV - 1 ' (w) 16 gauge (8) 16D nails each side — `.\- stopping 1,000 sq. ft. floor trusses - c`\cc�E FQ �(-, pF1 • ; ft. or less on center ?\_\),:•-w2, % cv(> F►R �,rP�hn� 24 inches from wall oft \A e 1, 2, 3 hour Fire wall 2, 3, 4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side 6 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above 1 below grade 5.0 sf grade L:1Buiidi g&Codes Forms-OLDBuiding&CodesUtapedbn Fonn&Fnrning Firestopping Inspection Repotdoc Revised January 7,2008 /-// �vr Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: //?fam/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:�� �✓l, film/pm NAME: C) / PERMIT#: LOCATION: -vp _ �e �' INSPECT ON: —/S-7-1/ TYPE OF STRUCTURE: ( .1<z-1 6c-t1 Comment Y N N/A Footings Piers Monolithic Slab 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump f Footing Drain Stone: 12 inch width , '' • above footing / 6 mi •ly for wet areas under slab ackfill • pproval P . i g Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundatlon Inspection Report.doc Last printed 12/20/2005 9:24:00 AM ; s Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pmm Dep am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:/J" _` `-/j J l NAME: T i. , PERMIT#: F; 7r LOCATION: - � ' „Air, ' INSPECT ON: /,TYPE OF STRUCTURE: Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement •,' a ec• ; rete. / Materials . this purpose on site. Foundation/ allpour Reinfo -nt in Place '%J Footing Dowels or Keyway in place ,\/ Foundation Dampproofing Foundation Waterproofing • Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspec0on Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM `r ,/r Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Dep . t am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: �; , .i---� � _ -r- ' PERMIT#: > LOCATION: y (4 ; -L INSPECT ON: / TYPE OF STRUCTURE: r ," tC- Comments 't Yf N Footings iers / Monolithic Slab 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 PlaceZ k 5 C v Footing Dowels or Keyway in place Foundation Dampproofmg Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Buliding&Codes Forms\Building&Codes\Inspectlon Forms\Foundattlon Inspection Report.doc Last printed 12/20/2005 9:24:00 AM