2012-386 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120386 Date Issued: Thursday, October 18, 2012
This is to certify that work requested to be done as shown by Permit Number P20120386
has been completed.
Location: 21 GENEVA Dr
Tax Map Number: 523400-301-020-0001-078-000-0000
Owner: CLUTE ENTERPRISES, INC.
Applicant: CLUTE ENTERPRISES, INC.
This structure may be occupied as a:
Garage Attached By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
e.- avp
Issuance of this Certificate of Occupancy DOES NOT relieve the property ( 4
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
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120386 Application Number: A20120386
Tax Map No: 523400-301-020-0001-078-000-0000
Permission is hereby granted to: CLUTE ENTERPRISES.INC.
For property located at: 21 GENEVA Dr
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: ROBERT& REBECCA KIRKER
21 GENEVA Dr Garage Attached
QUEENSBURY NY 12804-0000 Single Family Dwelling $150,000.00
Total Value $150,000..00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-386
Single Fam Dwelling 1st Flr 1,092 sq ft with attached 2-car garage 400 sq. ft. Geneva Estates Lot 23
$278.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 16,2013
(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 Town of Queensbury; Thursday,August 16,2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
r _ "-"010
OFFICE USE ONLY Q/ _
TAX MAP NO,301 , -I -l--7Y PERMJ/NO. I a- 3 °Ulo
FEES: P RMITRECREATION /,I / EN EERING
,��at 1 P (If applicable)
II
PRINCIPAL STRUCTURE: A 'PLICATION FOR ZONING APPROVAL & BUILDING
PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER: Cs.Jco_ er7r Z5�✓'_.OWNER: C.N.) e_
ADDRESS: (c -> ,rte A1/4-iC-- Q ADDRESS:
PHONE NOS. —79 ---7 D--77 PHONE NOS.
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: t� PHONE: --e---1.0 ( ,�rS(o
LOCATION OF PROPERTY: �-k 6`-) _..zx._ 3 O i • O i l'� 7�
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? `RYES 0 NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL: ( e- el ���,/,l��
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW_i'
CHECK ALL THAT zp F-
APPLY TO YOUR z I O u)cc a C7 w u- w
PROJECT of O � ce a = i
o w i u- u- u- z H O c7 z
W a J C! z C7 H E-- off cc 1 -
z a a . u) NU) 0 L I- LI. 0. 206
SINGLE FAMILY X \09.) k,04a ' '
TWO-FAMILY
1
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
di
1 /
�
FACTORY OR li/"
INDUSTRIAL ����
GTTACH(, 400 �Dc7
GARAGE(b))
OTHER
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: FUEL TYPE: t'1 9 -- � )
HEAT TYPE: &r-c.._e_ *HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE? ��-
PROPOSED USE OF BUILDING OR ADDITION: 4—i
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? tii O
ARE THERE EASEMENTS ON PROPERTY? Z
*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 . . .' survey by a licensed land surveyor of all newly
constructed facilities prior to '. ance of a ce ' ' .)e of occupancy.
I have read and agr= - to the a••ve.
Signed
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:
/7.4t/
/lad
BUIL` G & CODES AP/OVAL ZONING APPROVAL
•
IL°
DATE DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(c�queensburv•net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.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
Oleo- beo- 3 c6t'
h Revised 4/14/2010
Town of Queensbury
Highway Michael F. Travis
Department AUG 0 8 2012 Highway Superintendent
742 Bay Road, Queensbury, NY 12804 Home (518) 798-0413
Office Phone: (518) 761-8211 Thomas R. Vanness
Fax: (518) 745-4466 Deputy Superintendent
Home (518) 745-0929
www. Queensbury.net
DRIVEWAY PERMIT
Date: S/Z I l�
Applicant Name: C_QV_
Address to be inspected:
Return Address: Co .l Ce,�
Applicant must show exact location and width of driveway(s) to be connected to the highway by placing
stakes at the specified location.
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following
action has been taken:
Step 1: ( ) Preliminary Approval
Need: ( ) Slight swale
( ) Deep swale
( ) Level with the road
( ) Level with the top of the paved wing
Size culvert pipe to be used (if necessary)
( ) 12" ( )15" ( ) 18" ( )24" ( )36"
Preliminary inspections completed by: Date:
Approved by Higway Supt: Deputy Supt.:
Upon completion, please resubmit this approved permit for a final approval.
Step 2: ( ) Final Approval
( ) Rejected
Date:
Michael F. Travis, Highway Superintendent
Thomas R. Van Ness, Deputy Highway Superintendent
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
OFFICE USE ONLY /y� AUG (}
2
TAX MAP NO.3 0 ),o�4-1ERMIT NO. ) 3 & ERMITFEE 2
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT.
OWNER: 0 3‘'e INSTALLER: C�3‘c.._ C'�'-i" �/�z __.
ADDRESS: ADDRESS: d \- 0 0
PHONE NOS. �PHONE NOS. (Q,S -7, 777
LOCATION OF INSTALLATION: 1 (mey%°-�.zL1/F'UP 3Ot...200—I — [ 6
RESIDENCE INFORMATION:
YEAR BUILT NO.OF X COMPUTATION = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older X 150 = INSTALLED? V-Dc3
1981-1991 X 130 = SPA OR HOT TUB
7 :2 O INSTALLED? ti
1992-present X 110 = J
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING >< STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?
✓ DOMESTIC WATER SUPLY: MUNICIPAL >cr WELL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH[mpi]
(Test to be completed by a licensed professional engineer or architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by a licensed professional engineer
or architect(unless installed in a Planning Board approved subdivision).
TANK SIZE: \000 GALLON(MIN.SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM TYPE:
❑ABSORPTION FIELD(WITH NO.2 STONE) Total length I. 'O ft. Each trench -2 x c7
0 SEEPAGE PIT(S)(WITH NO.3 STONE) How many? Size?
0 ALTERNATIVE SYSTEM Bed or other type?
❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury,any permit or approval
granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or
circumstance known by or •• ::•.If of an applicant,shall be void.
I have read th- -gulations with re •ect : i application and agree
to abide b ese and all require •- of th- m of Queensbury QUESTIONS? CALL 7614256 OR EMAIL
Sanita -ewage 9;,:••,•sal %j' . c codes(a?queensburv.net
�_k�Sgi VISIT OUR WEBSITE FOR MORE INFORMATION
ature Ryerson Responsible Date www.queensbury.net
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
i h Lull, Acs 10 �1 ,Z.
Queensbury Building & Code Enforcement - Residential - spection
Office No. (518) 761-8256 Arrive: al: II -part: am/
Date Inspection request received: 1 6 --1,9-/�� Inspector's Initia :: , vI
/
NAME: C( (L+ e PE"MI #: / ,-A—3 g
LOCATION: ,2 I ) en (S 00....- D•• / C, —/ I --/ j
TYPE OF STRUCTURE:
e--.1 —r-::...•b
Comments:
Yes/No NIA
4" Building Number Address visible from road ✓/
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches /
Roof Complete/Exterior Finish Complete
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 f
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 I Windo. in stairwells safety gI ing
Interior Smoke Det:,-, Bedroom/ors/C n Monoxid etectors / Q) J
Every level: Eve ✓✓✓ / � \`
Outside every bedroom ea: �/ ✓ ,/ ,P
Inter Connected: Battery backup: ,� � C?�"
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area / ki
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents 0-7\)
Bathroom Fans,if no window / Ni �
Plumbing fixtures �/ \ v
Foundation insulation to floor/Sticker on Panel ;�
Duct work sealed properly/Blower Door Test Certification i
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 / f
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 1%hour fire door/door closer /
Gas Logs in Sealed or Glass Enclosure ✓
Final Electrical; Energy Saving Light Bulbs 50% il'
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles f
Flex Gas Pipe Bonding
1 /
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:1Buiiding&Codes Forms\Building&Codeslinspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10, Revised 04/13/11
.Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: 7.='-10 a 400 - - . /pm
Date Inspection request received: JInspector's Initials:
NAME: �� 1 ITE �w�� \��`� p ; IT#: 1Z. — 7-,94()LOCATION: 7 1 E- SI
E4 A ( TE. 10— lt—l7
TYPE OF STRUCTURE:
Comments:
Yes No NIA
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
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 I Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/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(Jlower Door Test Certification
Floor truss,draft stopping finisTie'a basement-1,000 sq.tt.
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 closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure \
Final Electrical; Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
L)
Flex Gas Pipe Bonding `
As Built Septic System/Sewer Dept. Inspection Sticker
SitePlPVariance required
Flood Plain Certificatio • equi =•
Okay to issue C I C .r C/ • oremporary/P_ anent]
L:1Building&Codes Forms\Building&Codeslinspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10, Revised 04/13/11
GRAJNY Consulting, LLC
69 Hayden Point Loop
Diamond Point, NY 12824
518 221-3240
10/18/2012
Clute Enterprises,Inc.
6 Holden Avenue
Queensbury,NY 12804
Inspection Address: Lot 23-21 Geneva Drive, Queensbury NY 12804
Report Number: 1018122
Dear Pam:
At your request, the Blower Door Inspection of the post construction test to verify
infiltration rate of the house as per requirements of the NYS 2010 Energy Conservation
Construction Code of the above property was performed on 10/18/2012. GRAJNY
Consulting,LLC is pleased to submit the following report.
The following data was provided:
- Square Footage of the house, including conditioned basement=2,184 SF
- Volume of the house, including conditioned basement= 18,356 CF
Based on above,the following test data was collected:
- Infiltration Rate,including conditioned basement at.50 Pascal= 1,081 CFM
- ACH50,Actual Changes per Hour at 50 Pascal= 1,081X60/18,356=3.5<7
The Instruments used for test were provided by the Energy Conservatory Digital Gauge
DG-3 rated accuracy=+/- 1%,calibrated minimum once peryear.
Thank you for selecting our company. We appreciate the opportunity to be of service.
Please call this office if there are any questions.
Sincerely, OF NE6y
y 9
k\4CAA
Stan Grajny, PEe444
NYS HERS Energy Rater BER-041 �'�r r,`r,a`t c`"
NYS PE 065406-1 F 055406
Op90FESSIO+`t��'
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: / (.) —0—f a
NAME: Cr.e_DEE.
LOCATION: (� f — 42-,d (t lI
PERMIT#: 1 —3 6
Final Survey Plot Plan
Agnroved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has been:
Craig : own, Zoning Administrator
Notes:
L:\.SueHemingwayU3uilding.Codes.Inspection.FORMS\Final Survey
Zoning Administrator.doc
MAP REFERENCE
SUBDIVISION PLAN &
MAP OF A TOPOGRAPHIC SURVEY MADE FOR
LARRY W. CLUTE
BY. VAN DUSEN & SIEVES
DATED: JANUARY 29, 2007
LAST REVISED: AUGUST 15, 200E
GENEVA. DRIVE
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L a r� d S li r v e y o r s
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York Lie. No. 50135 1
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Map of a Survey made for
Roberti D. Kirker, Jr
j And
Rebecca J . Kirker
Town of Queensbury, Warren County, New York
1
llaYe� uc Yober 15, �Ulr'
Scale 1Y-20'
S 1
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KIRKER
DWG. N0. 95001-23
NO.
DATE
DESCRIPTION
301.20-1-78
Fr
Rough PlumbingI Insulation ins eetion Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm Depart:'? 1 �ym/pm
742 Bay Road, Queensbury, NY 12804 Inspectors Initials:ON) � '
NAME: C12_,ft_t_t2_, PERMIT #: i ,) --3 S L2
LOCATION: 3, (% f�R _ INSPECT ON: q: a
TYPE OF STRUCTURE: 3
Y N N/A I ) a 4-1un
Rough Plumbing /Nail Plates 4- CAS
Plumbing Vent I Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/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
50 P.S.I for 15 minutes
Insulation /Residential Check I Commercial Check
Tyvek 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:
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
f J L ---3 Caprc)
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Ins ectio -n eq r ce'� ed:
Queensbury Building & Code Enforcement Arrive: / ,IE) ere,•part: am rr�
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: C2J - PERMI le;)--3g&
LOCATION: , 3 ( pr— INSPECT ON: - AI-
TYPE
I--TYPE OF STRUCTURE: L� i
Y N N/AJ
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
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 l ‘6Vac, ,6
Water Supply Piping
Air/Head
50 P.S.1 for 15 minutes
Insulation/Residential Check/ Commercial Check _ vYNLN
Tyvek 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:
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 13,2005, revised January 7,2008
-r ttiT Qt-
Rough Plumbing I Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Budding & Code Enforcement Arrive: am/pm Depart: 1,40 am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: 00 Lc5 PERMIT #: / .;, - 3 S.'La
LOCATION: ,a 1 (-7 e_ocr_._ nk__ INSPECT ON:
TYPE OF STRUCTURE:
_ Y N Nle►
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place ‘.7
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout eve 100 feet/chan•e 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
50 P.S.I for 15 minutes
Insulation /Residential Check/Commercial Check
Tyvek 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:
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7, 2008
Framing / Firestopping Inspection Report Lt %s Q -i
Tz)
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart:q , c;am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME:_ PERMIT#: �,
LOCATION: _ a) Cr INSPECT ON: — ) -/c
TYPE OF STRUCTURE:
Y A N N/A
COMMENTS:
Framing MEI
Attic Access 22" x 30" minimum 41111�-
Jack Studs/ Headers
Bracing /Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12" O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches I Holes I Bearing Walls
Metal Strapping for Notches Top Plate
1 Y2(w) 16 gauge (8) 160 nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour 11111
Firestopping — _Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side %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 / below grade
5.0 sf grade _
L:\Building&Codes Forms-OLD\Euikiing&Coder inspection Farms'Framing Firestopping Inspection Report.doc Revises January 7,2008
Septic Inspection Report G}
Office No. (518) 761-8256 Date Ins ion r-• ed: ArmrC / 5 !?---
Queensbury Building &Code Enforcement Arrive: 11 -l.8 y /p /�
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia��/
—�
NAME: P •MIT NO.: ) Z- I`k
o� e�t C�J
��g ny l SPECT ON: `
RECHECK: l t
LOCATION: G
Comments and/or diagram
Soil Ty.-. oam / Clay
Type of Water: • •.- Water
Waterli -paration distance t\
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO]
Absorption Field: Total length i ft.
Length of each trench ft.
Depth of trenches _ ft.
Size of Stone ' 7
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank 9 y
Tank to Distribution Box
Distribution Box to Field/ Pit --� �.)L
\-?*C7•-?—
Opening Sealed: 2.,,,/N
End Cap
Inlet/Outlet Pipes&Baffles N
Manholes 12"or less below grade _ N
[provide extension collar if Yes] _Y_ N
Location/ Separations
Foundation to tank 1 in ft. ` \
Foundation to absorption 6 )ft. Nb
�
Separation of '. ft. '
Conforms as per PI. Plan Y_
Engineer Report and -s-:. ' _Y N
ETU Maintenance .ct _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report 03 29 10.doc
AU d 2012
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Framing / Firestopping Inspection Report S 10
Office No. (518) 761-8256 Date Inspection request received: ("7"
\ J;12
Queensbury Building &Code Enforcement Arrive: am/pmDrt: Itf-,,. i' am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: L
NAME: ( L " 1 C. PERMIT#: 2-
LOCATION: v,.1 -C INSPECT ON: < /b/17.
TYPE OF STRUCTURE:
NIA COMMENTS:
Framing
Attic Access 22" x 30" minimum
Jack Studs 1 Headers
Bracing 1 Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12" O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in. •
Notches/Holes /Bearing Walls
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses \
Anchor Bolts 6 ft. or less on center
ki>8-. and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side '/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/ below grade
5.0 sf grade
L:1Building&Codes Fomes-OLD\3uilding&Codes\Inspection Famts'Framing Firestopping Inspection Report.doc Revised January 7,2008
Septic Inspection Report
Office No. (518) 761-8256 Date Ins.- ion z.e. ' -•-iv-
Queensbury
iv-Queensbury Building &Code Enforcement Arrive: - 1' 0• D- rt: 9 9:7A3a-rtni
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia : A
NAME: C-LSJ i C •FZC �E 1 •E• IT NO.:
LOCATION: Z` CZr�uJ I -PECT ON: 01 - 1 -17 ,
RECHECK:
Comments and/or diagram
Soil Type: Sand / Loam/ Clay
Type of Water: Municipal/ Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' + / - Y N N/A
[150'to well required if NO]
Absorption Field: Total length __ft. FIK ,,. ,
Length of each trench ft. i 10 cr. fa
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: _Y_N
End Cap _Y_ N
Inlet/Outlet Pipes&Baffles Y N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] _Y_ N
Location / Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pi ft.
Conforms as per PI Ian ` / N
Engineer Report and -Bu' Y N
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspectlon Forms\Septic Inspection Report03 29 10.doc
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Foundation Inspection Report
Office No.(518)7614256 Date Inspection request received: ,waft
Queensbury Building&Code Enforcement Arrive: am/pm Dee; : i pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:0,Q)
NAME: �X (�t Q PERMIT#: - - 3 g
LOCATION: , t<,- ,n �� INSPECT ON:
TYPE OF STRUCTURE:
Comments
Y , IN 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 Dampproofmg V
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing ry 7--\
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under SIab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building &Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
( 2pr
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: - am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: � ,
NAME: C- 1 PERMIT#: I `3 (v
LOCATION: ,;.1 (7'en INSPECT ON: 3 —
TYPE OF STRUCTURE: 3
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
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour \77
,1
Reinforcement in Place z-A�
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:\Building&Codes Forms\Building&Codes\Inspectlon Fomes\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM