2010-535 TOWN OF QUEENSBURY
tom742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20100535 Date Issued: Thursday, June 28, 2012
This is to certify that work requested to be done as shown by Permit Number P20100535
has been completed.
Location: 311 WEST MT. Rd
Tax Map Number: 523400-307-000-0001-031-000-0000
Owner: ARTHUR & CHRISTINE HULL
Applicant: VERIZON WIRELESS
This structure may be occupied as a:
Miscellaneous Structure By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property
owner of the responsibility for compliance with Site Plan,Variance, or / 1
other issues and conditions as a result of approvals by the Planning Board Director of Building&Co. - Enfor -ment
or Zoning Board of Appeals.
TOWN OF QUEENSBURY
��`
Fo11)
ra! 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100535 Application Number. A20100535
Tax Map No: 523400-307-000-0001-031-000-0000
Permission is hereby granted to: VERIZON WIRELESS
For property located at: 311 WEST MT. 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: ARTHUR&CHRISTINE HULL Miscellaneous Structure $100,000.00
311 WEST MT. Rd Total Value $100,000.00
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2010-535
telecommunication facility-VERIZON WIRELESS
Z Psi--
� rot. PC1
$50.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,November 19, 2011
(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 thTo Qu , 1e ', , November 19,2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
a
3072 � /.-3
a f �lr 1 L�/ OFFICE USE ONLY �
[-
TAX MAP NO. PERMIT NO.
NOV 0 5 20;0
FEES: PERMIT RECREATION ENGINEERING ,
(If applicable) T g" OF QIJ NV ,BURY
lilL1JINC & CODES
PRINCIPAL STRUCTURE: APPLICATION FOR ZONING APPROVAL & BUILDING
PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALIDER IT FOR CONSTRUCTION.
CO l/c�' /�€r±rl s /V 1p Ct/Lb/G /
APPLICANT/BUILDER: Ve r J z% i1 twice to -SS OWNER: IA cH,.1 i
- -Ch/blue it iii
ADDRESS: 1 r1,6-Ca I K I WI •i RN A ?0''be kr, Ny /V6' DDRESS: 3D Lo. /110/14/00-1 Rd.
.
PHONE NOS. .Y 5-3 a/- /(,U PHONE NOS. 5/ -7 s3 - 91 Z y
ieobi lc
CONTACT PERSON FOR BUILDING&CODES OMPLIANCE: me n/ 0/G,vO?ri PH*NE: 5/C' 7 3"/b3L)
LOCATION OF PROPERTY: C� i I / k a_ r, , - 5/' / e .Y t k+
_
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? i4 YES ❑ NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL: 3(0- 2009 7 / 29/200
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT Z
APPLY TO YOUR Z 1= cc p O W W u,
PROJECT <
i= cK0I—: OJTccO = =
W _1 LL W LI-
W Q n- 0U
w WO °z C� 1- i- 01- CeWZ
Z Q Q .- CA NCA OLL I— U- Q. = 0.5
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER pea,1h),/ 3/0D , '
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
.
Revised 4/14/2010
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:010D 10D 14 r triefSiti p 0161a Ue et ID✓( /dire itS S
ESTIMATED CONSTRUCTION COST: 4 (Dri, Doo FUEL TYPE: 1 ,p I
HEAT TYPE: NIA *HOW MANY FIREPLACE(S): N/4 AND/OR WOODSTOVES(S): /1)//1
ZONING CATEGORY:SV,- ( ,4 ARE THERE WETLANDS ON THIS SITE? Nb
IS THIS A HISTORIC SITE? I0
PROPOSED USE OF BUILDING OR ADDITION: /e I'et,,n11 i/til a/i!cC .)-ok Fr c t It I
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? ND
ARE THERE EASEMENTS ON PROPERTY? ?e_5 Lt-fi'1 1-1 5eJo1 cc (114 e3
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
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 read and' gree toithe above.
l�
f
Signed � :�` con IEuOC TIT/ef- RA 1t_ IL i ��
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)
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
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:
BUILDING & CODES APPROVAL ZONING APPROVAL
DATE DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(a)queensburv.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
Operating Permit Issued: Yes No
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
Town of Queensbury * Community Development Office * 742 Bay Road, Queensbury NY 12804
Commercial Final Inspection Report
Office No.: (518) 761-8256 Date Inspection req -st r- _•
Queensbury Building &Code Enforcement Arrive: a pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspectors Initials.1 —
NAE: PE- "' #: \ —�
LOCATION: 2—7•—d Z
COMMENTS:
Y N NA
Chimney/"B"Vent/Direct Vent Location
Plumbing Vent Through Roof 6"I Roof Complete
Exterior Finish/Grade Complete 61 in 10'or Equivalent
Interior 1 Exterior Guardrails 42 in. Platform/Decks
Interior I Exterior Baliisters 4 in. Spacing Platform I Decks
Stair Handrail 34 in.—38 in./Step Risers T"I Treads 11"
Vestibules For Exit doors>3000 sq.ft.
All Doors 36 in.w/Lever Handles/Panic Hardware, if required
Exits At Grade Or Platform 36(w)x 441(l)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr.or Fire Extinguishing System
Fresh Air Supply for Occupancy/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
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 %doors
> 10%> 1000 sq.ft.
' Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 sq.ft.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/Sinks I Toilets
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 in., Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in.Beyond[Both
sides]
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded
Site Plan/Variance required
Final Survey, New Structure/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 b;OE_ C-0
Building Access AU Sides by 20'1 Driveable Surface 20'wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue CIC
L:1Building&Codes Forms\Buildding&CodesUnspection Forms%Commercial Final Inspection Report.doc Revised January 7,2008
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ELECTRICAL CERTIFICATE .' -"_
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4 1: :=+ COMMONWEALTH ELECTRICAL
. == INSPECTION SERVICE, INC.
176 DOE RUN ROAD, MANHEIM,PA 17545 '''`'
:%:rv' TELEPHONE: (717) 664-2347 ,_ :',,
v'gi-a New York Office: (585) 624-2380 �`'••
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~.--- Premises of:VERIZON as CELL TOWER ;
,...:.?,--z,7.. Address:311 WEST MOUNTAIN ROAD,QUEENSBURY NY II .?.
-:'==- County of: WARREN Permit#: -a 1
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g' Installed by: LANZ CONSTRUCTION INC. ::.
�ti Via! %1'
• -- Apparatus:400 AMP UG SERVICE `} �
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Inspected by: RON MUMBLO " '
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''`''":`»: ! The conditions following governed issuance of this certificate,and any certificate previously - '__?�
?r `^ issued is cancelled. Failure to have the property reinspected when additional equipment or wiring is ,•....0%.:.•,..,�y'
k.4:.;::-....f....- _.� added;or within one year from the date of the certificate shall void the certificate in its entirely and the "-r..�'v�
4.7 _ company shall not be liable for any damages whatsoever; .=—_-ray
€�:{::::1*>a1 This certificate does guarantee efficiency, wearing qualirics maintenance or repair and the "�'.of
�*ti.i;::=W_ company shah not be liable for any damages rcsutting from any defect or fault in the plans or specifica-
tions.
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of tions,including repair,reconstruction.personal injury or for the death of any person;and
and - r�e;�,e
This certificate only covers visual inspection of wiring and docs not cover manufacture or use--o }r
�,.a TT� of wiring. _ e
••$*:, Inspectors of this Company shall have the privilege of making inspections at any rima and if ;e„r'
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!.......:11:=:a its rules are violated.the Company shall have the right to revoke the certificate. =__z_z
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Commercial Final Inspection "eport
Office No.: (518) 761-8256 Date Inspection s - -ived:
Queensbury Building &Code Enforcement Arrive: •i At,"' Depart: a+r -,,,-
742 Bay Road, Queensbury, NY 12804 Inspector's I 4111-7-T,:
NAME: Ll E \a-Et EjPERMI I N
LOCATION: I�F_;S 1 tit i tlJ P ) DATE: .
COMMENTS:
Y N NA
Chimney/'B'Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete
Exterior Finish/Grade Complete 6"in 10'or Equivalent
Interior/Exterior Guardrails 42 in. Platform/Decks
Interior/Exterior Baffisters 4 in. Spacing Platform 1 Decks
Stair Handrail 34 in.—38 in./Step Risers 7"/Treads 11"
Vestibules For Exit doors> 3000 sq.ft.
All Doors 36 in.w/Lever Handles/Panic Hardware, if required
Exits At Grade Or Platform 36(w)x 44'(l)/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(181 Above Grade
Floor Bathroom Watertight I Other Floors Okay
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr.or Fire Extinguishing System
Fresh Air Supply for Occupancy/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
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 %doors
> 10%> 1000 sq.ft.
' Hour Corridor Doors&Closers
Firewalls l Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 sq.ft 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/Sinks/Toilets
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 in.,Checkout 36"
Handicapped Ramp/Handrails Continuous/12 in. Beyond[Both
sides]
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded E e_V> C
Site Plan/Variance required �` ��L �
Final Survey, New Structure/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'/Driveable Surface 20'wide
Okay To Issue Temp. or Permanent C/O
Okay To Issue C/C
L:\Building&Codes FormstBuilding&CodesUnspec*ion Fonns1Commercial Final Inspection Report.doc Revised January 7,2008
Commercial Final Inspection Re• •
Office No.: (518) 761-8256 Date Inspection • -'_ ived:
Queensbury Building &Code Enforcement Arrive: it i I •
Depart: am/pm
742 Bay Road, Queensbury, NY 12804 inspector's In l •
`-
NAME: \E-R ZO UJ\REA C=1 5 PERMIT# • —
LOCATION: \ _ r • D DATE: A. -- --
COMMENTS:
Y N NA
Chimney/"B'Vent/Direct Vent Location
Plumbing Vent Through Roof 6"/Roof Complete caFC jJ, Y(--C\S
Exterior Finish/Grade Complete 6'in 10'or Equivalent
Interior I Exterior Guardrails 42 in. Platform/Decks \ SVEC\D1. V—F2,fg
Interior!Exterior Banisters 4 in. Spacing Platform I Decks
Stair Handrail 34 in.-38 in./Step Risers 7"/Treads 11"
Vestibules For Exit doors>3000 sq.ft.
M Doors 36 in.wlLever Handles I Panic Hardware, if required
Exits At Grade Or Platform 36(w)x 44'(0/Canopy or Equiv.
Gas Valve Shut-off Exposed&Regulator(18")Above Grade
Floor Bathroom Watertight/Other Floors Okay
Relief Valve,Heat Trap/Water Temp.110 Degrees Maximum
Boiler/Furnace Enclosure 1 hr.or Fire Extinguishing System
Fresh Air Supply for Occupancy/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
Stockroom/Storage/Receiving/Shipping Room(2 hr.), 1 1/2 doors
> 10%> 1000 sq.ft.
' Hour Corridor Doors&Closers
Firewalls/Fire Separation,2 Hour, 3 Hour Complete/Fire
Dampers/Fire Doors
Ceiling Fire Stopping, 3,000 sq.ft.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/Sinks/Toilets
Handicapped Bath/Parking Lot Signage
Public Toilet Room Handicapped Accessible
Handicapped Service Counters,34 in.,Checkout 36"
Handicapped Ramp I Handrails Continuous/12 in. Beyond[Both oF--
sides] —
N EA) F 1 ZP
Active Listening System and Signage Assembly Space
Final Electrical/Flex Gas Piping Bonded F\-- C-�R\Let L
Site Plan/Variance required
Final Survey, New Structure I Flood Plain certification,if req. --
As-built Septic System Layout Required or On File E\ '� � \t
Building Number or Tenant Address on Building or Driveway 4'
Water Fountain or Cooler
Building Access All Sides by 20'/Driveable Surface 20'wide
Okay To Issue Temp. or Permanent CIO
Okay To Issue C/C
L.IBuilding&Codes Fomrs\Building&Codes\nspection Forms%Commercial Final Inspection Report.doc Revised January 7,2008
e 1
TECTONIC CORPORATE OFFICE
Mountainville, NY (800)829-6531
Practical Solutions,Exceptional Service
36 British American Blvd.; (518)783-1630 FAX:(518)783-1544
Latham,NY 12110 www.tectonicengineering.com
Town of Queensbury
Community Development—Building and Codes
Attention: David Hatin
742 Bay Road
Queensbury, NY 12804
June 20, 2012
RE: FINAL INSPECTION AND CONSTRUCTION CERTIFICATION
BUILDING PERMIT#P20100535
VERIZON WIRELESS SITE NAME: LUZERNE
VERIZON WIRELESS PROJECT NUMBER: 2005113050
311 WEST MOUNTAIN ROAD, QUEENSBURY, NY 12804
TECTONIC W.O.: 2248.13050
Dear Mr. Hatin:
Tectonic Engineering & Surveying Consultants, P.C. (Tectonic) conducted a final inspection of
the aforementioned site on May 11, 2012 to ensure general conformance with the Construction
Drawings (dated November 1, 2010) prepared by Tectonic. The conclusion of our site visit is
that, to the best of my knowledge, the site has been completed in accordance with the
approved drawings.
If you have any questions, please do not hesitate to contact the undersigned.
Sincerely,
TECTONIC ENGINEERING &SURVEYING CONSULTANTS, P.C.
2—
�--
G
,f%Steven M. atthews, PE, LEED- P- ' :.1
Project Manager V',I ' .
\',SE,.,‘,„
Cc: Robert Cooper—Verizon Wire 'v
PLANNING . ENGINEERING . CONSTRUCTION AND PROGRAM MANAGEMENT
An Equal Opportunity Employer
TECTONIC CORPORATE OFFICE
Mountainville, NY (800)829-6531
Practical Solutions,Exceptional Service
36 British American Blvd.; (518)783-1630 FAX:(518)783-1544
Latham,NY 12110 www.tectonicengineering.com
Town of Queensbury
Community Development— Building and Codes
Attention: David Hatin
742 Bay Road
Queensbury, NY 12804
June 20, 2012
RE: FINAL INSPECTION AND CONSTRUCTION CERTIFICATION
BUILDING PERMIT#P20100535
VERIZON WIRELESS SITE NAME: LUZERNE
VERIZON WIRELESS PROJECT NUMBER: 2005113050
311 WEST MOUNTAIN ROAD, QUEENSBURY, NY 12804
TECTONIC W.O.: 2248.13050
Dear Mr. Hatin:
Tectonic Engineering & Surveying Consultants, P.C. (Tectonic) conducted a final inspection of
the aforementioned site on May 11, 2012 to ensure general conformance with the Construction
Drawings (dated November 1, 2010) prepared by Tectonic. The conclusion of our site visit is
that, to the best of my knowledge, the site has been completed in accordance with the
approved drawings.
If you have any questions, please do not hesitate to contact the undersigned.
Sincerely,
TECTONIC ENGINEERING &SURVEYING CONSULTANTS, P.C.
n i
Steven M. Matthews, PE, LEEIT=P F
Project Manager
Cc: Robert Cooper—Verizon v 0 s
PLANNING . ENGINEERING . CONSTRUCTION AND PROGRAM MANAGEMENT
An Equal Opportunity Employer
TEC TONIC CORPORATE OFFICE
Mountainville,NY (800)829-6531
Practical Solutions,Exceptional Service
36 British American Blvd.; (518)783-1630 FAX:(518)783-1544
Latham,NY 12110 www.tectonicengineering.com
Town of Queensbury
Community Development— Building and Codes
Attention: David Hatin
742 Bay Road
Queensbury, NY 12804
June 20, 2012
RE: FINAL INSPECTION AND CONSTRUCTION CERTIFICATION
BUILDING PERMIT#P20100535
VERIZON WIRELESS SITE NAME: LUZERNE
VERIZON WIRELESS PROJECT NUMBER: 2005113050
311 WEST MOUNTAIN ROAD, QUEENSBURY, NY 12804
TECTONIC W.O.: 2248.13050
Dear Mr. Hatin:
Tectonic Engineering & Surveying Consultants, P.C. (Tectonic) conducted a final inspection of
the aforementioned site on May 11, 2012 to ensure general conformance with the Construction
Drawings (dated November.1, 2010) prepared by Tectonic. The conclusion of our site visit is
that, to the best of my knowledge, the site has been completed in accordance with the
approved drawings.
If you have any questions, please do not hesitate to contact the undersigned.
Sincerely,
TECTONIC ENGINEERING &SURVEYING CONSULTANTS, P.C.
,--even M. Matthews, PE, LEED-gl `' : -
Project Manager i c..-: .';. " >
\I;\.,:',\ - 41,1:-:' 2'
Cc: Robert Cooper—Verizon Wiest-=--.,, -~''
PLANNING . ENGINEERING . CONSTRUCTION AND PROGRAM MANAGEMENT
An Equal Opportunity Employer
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: / 1,,f0 am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: ;3 f2G
NAME: .-c_f 0tt.1C�2 PERMIT#: /0 /��3
LOCATION: G '). ' r` , r � INSPECT ON: e(-2 3/1/
TYPE OF STRUCTURE:
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 J
/Reinforcement in Place I -1-
Footing
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\Inspect9on Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building ht Code Enforcement Arrive: ' am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NX&&
NAME: CC /0061 PERMIT#: /DLOCATION: et.k `rr GHT; Ko, INSPECT ON: e/i5)5'36—
/
TYPE OF STRUCTURE:
CoWment
I NA
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. _ _
oundation/Wallpour 616,4_ F ? ` C H 6C1<- o IC- -Z'
Reinforcement in Place
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:\Buliding&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
77/ 7A orr
-,/,
Foundation Inspection Report •
Office No.(518)761-8256 Date Inspectio reque t received:
Queensbury Building&Code Enforcement Arrive: �'�( am/p Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector sInitials:
NAME: ref( e.t^ PERMIT#: /0—,5 L.53
LOCATION: 3/1" Weg ' INSPECT ON: 451=/1 jf
TYPE OF STRUCTURE:
Comment4
Y N NL
Footings
Piers
+.is Slab
Reinf• = ent in Place
•ntractor is responsible for t ��
providing protection from freezing Y() .)for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place — A-(6
Footing Dowels or Keyway in place
TKouio(
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\Inspection Forms\Foundatlon Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
/ L
/
/ ) -17-1A-4-\
Foundationon Report
Office No.(518)761-8256 Date Inspection request received S477
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: __
laSit)
NAME: V el', E (---eS S PERMIT#: J U 5- 3
LOCATION: a i l P5 7- m i r INSPECT ON: S/ //7
TYPE OF STRUCTURE:
Coepmeata
t
tonne' r--
'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 Place
Footing Dowels or Keyway in place t�• �' �`
Foundation Dampproofmg
Foundation Waterproofing l
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:\BtNcling&Codes Forrns\Buiiding&Codes\Inspecdon Fon ns\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM