2013-445 F9." 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: P20130445 Date Issued: Tuesday, September 23, 2014
This is to certify that work requested to be done as shown by Permit Number P20130445
has been completed.
Location: 11 HICKS Rd
Tax Map Number: 523400-297-007-0001-020-000-0000
Owner: PETER DAVIS
Applicant: PETER DAVIS
This structure may be occupied as a:
Garage Attached By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property (7/)Gw 4
45(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
VTR742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130445 Application Number: A20130445
Tax Map No: 523400-297-007-0001-020-000-0000
Permission is hereby granted to: PETER DAVIS
For property located at HICKS 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: PETER DAVIS
686 WEST VALLEY Rd Garage Attached
ARGYLE NY 12809-0000 Single Family Dwelling $130,000.00
Total Value $130,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
PETER DAVIS CONSTRUCTION
518-791-4517
686 W VALLEY Rd
ARGYLE NY 12809-0000
Plans&Specifications
2013-445
SFD 1st Flr 1,050 sf; 2nd Flr 787 sf; Garage 484 sf
$440.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, September 27,2014
(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 ueensb ; F 's . Se s tember 27,2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
•
Office Use Only
Town of Queensbury Building & Codes
Received:
Tax Map ID: •
PRINCIPAL STRUCTURE APPLICATION �permit No.: 13'`� `7
A permit must be obtained before beginning construction Permit Fee: $ 'lib100
Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling
*Rec Fee: $ g5-0. 00
units, including single-family dwellings, duplexes or two-family dwellings, multiple family Site Plan No.:
dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.:
homes, but not including mobile homes. This is in addition to the permit fee.
Date ./Z ( L3 Applicant R7Lto/ Dc ` "'S
Tax Map ID Z?7. 7`/ "-2..0 Address 6 8r6 L V4/7*y &i
Zoning a �--T 7 41 0 fly/e /l/Y /z.2'y
Phone/E-mail 7V-5(5-'7
Property Owner Pe! �' U' -S Contractor/Agent Pee ()�.c),5 ,Sitz C/ib�
Address 66 c-/e / tl /l ey E c) Address 6 66 i•-•'`'St LA//e7 Pe)
e-rey/e NY l 24-c' c 4rfy/r 4/71- /z Ros
Phone/E-mail 7?/- X5/7 Phone/E-mail 75/-` %.,5--/2
Contact Person for Building &Code Compliance: Pe 7 C c.(.)` S Day Phone: 2 i'l- ', 7
Building Street Address: /1, 'C /4-S p.c.),
Subdivision Name: ,/V/4 Lot#: . Historic Site: Yes X No
Estimated cost of construction: $ /30, 000
Type of Construction:
Check all that apply Please indicate measurements as required below:
c =
0 g
gg ti 1st Floor 2nd Floor Other Total Height
F/ -
x a a
Single Family ®SU `--) -.'? 4 .32 2-7
Two-Family
Multi-Family(#of
units )
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garages(# / ) /
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business - $
Proposed use of building or addition 5 ' -/c F64/f-/y t?sed ec,Cc,
Source of heat(circle one) , Gas Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" )(Yes No
Are there structures not shown on plot plan? 70
Are their easements on the property? L)4 ef L,`�� e
Site Information
a. Dimensions or acreage of lot
f:
b. Is this a corner lot? d
c. Will the grade be changed as a result of construction: Yes
d. Public water or Private well
e. Sewer or Private Septic System
Pr. j e S F E'74 'C
Value of all work to be performed(labor and materials) $ /3! d C.)
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval. 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 agree to the above.
Print Name: T-rhe-
Signature: _ PPDate: VZ���
FOR OFFICE USE ONLY:
Operating Permit Issued: _Yes _No
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit:
Special Conditions:
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Office Use Only
Town of Queensbury Building & Codes Received:
Tax Map ID:
FUEL BURNING APPLIANCE & CHIMNEY APPLICATION Permit No.: 13-Y 445
Permit Fee: $
Application is hereby made to the Building & Codes Office for the issuance of a Building & Use Permit pursuant to the NYS Fire Prevention &
Building Code. The applicant or owner agrees to comply with all applicable laws,ordinances, regulations, and all conditions that are part of these
requirements and also will allow all inspectors to enter premises to perform required inspections.
Important Note To Applicant:
/Rough-IIn and Final Inspections Are Required:
(/
Date Tz l3
Owner
Pe !--5 Installer/Builder / 5/G /174-c ii r g
Address [Se `''`'5' v4flcy Address
Phone 7 9/_t/s`'12 Phonen �7 —0 2
1C 5 5
Location of proposed construction and for installation: Iz S I��� 4U e�'�� Uiy
Contact Person for Building&Codes Compliance: pow jc.V/-S
Subdivision Name: 1774
Fuel Burning Appliance Information Wood Coal Pellet Gas Oil
Stove
Fireplace Insert
Fireplace,factory built* .<
Fireplace,Masonry
Furnace,(Garage Only)
yv, 43- l,c/,4-i4 fite� R7-3/C° 0 �a PV
If Factory Built,Please Provide: Manufacturer Name: Model No. 71/
-� Listed By: Number:
Chimney Information
Masonry" ✓check one _Block _Brick _Stone
Fluff ✓check one Tile Steel _Size in Inches
Material /check one _Double Wall _Triple Wall _Insulated _Direct Vent _Chimney Liner
**If Non-Masonry,please provide: Manufacturer Name: Model No.
Signatures:
Print Name: C / � L�� v
Signature: Date:
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION & BUILDING CODE
AND/OR MANUFACTURER REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING
REQUIRED INSPECTIONS.
umce use umy
Town of Queensbury Building & Codes Received:
SEPTIC DISPOSAL PERMIT Tax Map ID:
Permit No.: / 3--4- 0/41
..
A permit must be obtained before beginning construction ,
; -
Permit Fee: $
Approvals:
Applicant: Pe-fr _D"..0 i _S Installer/Builder I ��` ')--)CL U' S Ca�f ('c- o
PP
Address: 6k6 (--7c64-(--7c64- (' /lej/ g_cil Address 6 S-6' L rS/ (JC /i-�y Pei' --,
4,/-yy/e .rly, /2 C7 /Y=-541/c. //-
Phone: 7 y/ - 5;_5''2 Phone 2 V-- VS/`7
Owner: f�e-f-c. /A C- !�.,a ULS Location of Installation / /CS d
Address: 6 c (-' F 0-./6v',,)
4-----yy/e ,2/),/ /a ir-a 9
Phone 71-/-/S`/7
Contact Person for Building&Code Compliance: IC 0)-S Day Phone: �/--"V5-12
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow
��
1980 or older x 150 = Garbage Grinder installed?
1981 -1991 x 130 = Spa or Hot Tub Installed? /1��/�-
1992-Present 3 x 110 = 33 0
Parcel Information:
Topography Flat Rolling _Steep Slope %Slope
Soil Nature )Sand Loam Clay _Other Gq- e(
Groundwater At what depth? /)"e-
Bedrock/Impervious Material At wh t depth? (7o""7
Domestic Water Supply 2f Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- /b per minute per inch(Test to be completed by a licensed professional engineer or architect)
ef1.4.-, /Zc.1/ -- S-O .-17°5 L:2a., 0- ---
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(minimum size 1,000 gallons),add 250 gallons to size of septic tank for each garbage grinder,spa or whirlpool tub
L Li '.
System Type: Absorption Field(with#2 stone) Total length /-/ ft. Each trench 2 f/ X - zy �J e-
Seepage Pit(S)(with#3 stone) How many? Size?
Alternative System Bed or other type?
Holding Tank System Total required capacity? Tank size? #of tanks?
NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form
on Town website; 2) Effective as of March 23, 2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be
covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed system must match the septic system
layout on file. There will be no exceptions.
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 on behalf of an
applicant,shall be void.
✓l have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary
Sewage Disposal Ordinance /,
Print Name: V
• Date:
I
Signature: C Date:
Town of Queensbury Building&Codes Septic Disposal Permit 518-761-8256
Z l Pgl-cf,7C&5
Town of Queensbury Highway p Hi hwa Department 6ri -1 , 5 r
DRIVEWAY PERMIT ‹c.
5
Michael F. Travis, Highway Superintendent Thomas R. Van Ness, Deputy Superintendent
Home: (518) 798-0413 Home: (518) 745-0929
Office Phone: (518)761-8211 Office: (518)761-8211
Fax: (518) 745-4466
Building Permit#:
Date:
Tax Map ID:
Applicant Name:
Address to be inspected:
Return Address:
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 Highway 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 Building&Codes Principal Structure Packet 518-761-8256
Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection
Office No. (518)761-8256 Arrive: am/p Depart: tO t I5:n/pm
Date Inspection request received: 4\18`15 Inspector's Initials:
NAME: V\103/1\r\Qy PERMIT it. t zJ`Z\ l
LOCATION: II" r C� DATE: A\19
Manufactured Home
4(..
Modular Home
Footings Foundation_ Backfill_ Framing_
Comments:
Yes o NIA
Foundation support, pier spacing,
Per manufacturer R,1 dr\ 2?)2- 01 I`t
Anchoring per manufacturer 2'from ends f lII
Water line shut off k- _
Sewer line support @ 4 feet Y
Heating Crossover[doublewide}off grd. // _ )1 ` `�
Dryer vented outside V "
Skirting ventilated 1 sq.ft.per 1,500 sq.ft. v
Hot water relief valve piping outside t'`N
Deck,porches, steps, railing Pc ` `, _� F6.144
-J
Fumace/hot water operating
Garage Fire proofing
Fire Door/Door closers ✓ y��'"' '",y,' j ���.�
Plumbing Fixture/3"Vent through roof[Modular] \ � �\ 1G��J � t. ""`-
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected f ''
Final Electrical f ciCklURZ
Variance required /' i A _/�
"
Data Plate okay / �v '
Manufactured HUD seal okay V 14)1? If't
Warran Seal after January 1,2006 N.Y.�_
IInstallers Warranty Seal
j244- 7.- 1 5,-(5-ki‘iki)
18ssess Qr 22' ttic access
f
Vapor retarder under home 6 mil poly or other / MIAZ-I (L_._ '�''Tv . C\CZ)v V ik
911 Street number 7 / ��Cr7 RoN
Okay to issue C/C or C/O[Temp./Perm.] Y t�.� `- . v , '�,
Model# t l'AM4 OD Serial# rL\A/ 1l i0
6‘93 -_____---------'
Manufacturer 1 d
O(Cek
Date of Manufacturer 3\ o \v--4)
L:1Pam Whiting120101Building Codes Forms\ManufacturedModular Final Inspection_03 04 10.doc \
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 1Z ,
..T.)
NAME: -A\itS
LOCATION:
PERMIT#: O
I3 - 5
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:
Craig Brown, oning Administrator
Notes:
L:1SueHemingway\Building.Codes.Inspection.FORM5\Final Survey
Zoning Administrator.doc
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CERTIFICATION:
I HEREBY CERTIFY T0:
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1) TAMMY PREHODA
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2) SUNMARK FCU, ISAOA
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3) WES"fCOR LAND TITLE INSURANCE COMPANY
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THAT THIS MAP WAS PREPARED FROM AN ACTUAL HELD
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SURVEY COMPLETED UNDER MY DIRECT SUPERVISION.
/ j
THIS SURVEY AND THE CERTIFICAI'ONS HEREON SHALL BE
5"',,
VALID ONLY TOTHE PARTY OR PARTIES HEREON NAMED AND
ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR
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TY 0 I �\,l P N ��� I 7 4
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SUBSEQUENT OWNERS, OTHER THANAS MAY BE OR EXPRESSLY
STATED HER
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DATE: 09/23/14
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SITE LOCATION MAP
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DEED REFERENCE:
315.15'
1) RUTH A. SMITH TO PETER DAVIS, FILED IN THE OFFICE OF THE WARREN
o
COUNTY CLERK IN BOOK 4836 AT PAGE 255, DATED AUGUST 22, 2013.
❑
`NOTES:
50.7'
sti
1) BASE MAP PREPARED FROM A SEPTEMBER 2014 FIELD SURVEY.
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_._ 2 NORTH ORIENTATION IS BASED ON MAGNETIC OBSERVATION 2013. ::...
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SUBJECT T AN EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD
IS THEREFORE UBJE T O Y E
ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE.
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NEW YORK STATE EDUCATION LAW.
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13) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE
LAND SURVEYORS SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES.
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7) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM
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SURFACE LOCATIONS AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY.
concrete
THERE MAY BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE,
TYPE AND LOCATION OF ALL UTILITIES AND STRUCTURES MUST BE VERIFIED BY
PROPER AUTHORITIES PRIOR TO ANY AND ALL CONSTRUCTION. CALL DIG SAFE PRIOR
TO ANY EXCAVATION.
45.4. "
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116.73' 90.49'
120.70'
T
N8735'49"W .• N8945'24"W
S89'10'16"W
El catch basin
concrete wn9
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asphalt toad
HICKS ROAD
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342 MainStreet, *-Hudson+Falls,New' °York `''12839
Russell E. Howard, ,P,LS ' N. S.
Lic., No.'''50540 ?Date: 09/12/14 Tax Map #;297.07-1-20
Date J,Se(Aled:` Scale: I
inch = 30 feet Revised: 09/23/14 ` Drawing #:13051F
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/p Depart: t.çamipm
Date Inspection request received: Inspector's Initials:
` ` �s�f
NAME: �n ( PERMIT#: "
LOCATION: R tcL r DATE: 9 123
I l�
TYPE OF STRUCTURE: l
Comments: -2 J,( ,41
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 I doors/main entrance 36 inches
Bathroom/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/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 I� Ccr It
Furnace/Hot Water Heater operating CcrA
t-\-)
Low water nff boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum 1/2"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%
0/9---"/
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/0[Temporary/Permanent I
L:\Building&Codes Forms\Building&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
Queensbury Building & Code Enforcement - Residential Final Inspection l 9 `4`-
Office No. (518) 761-8256 Arrive: am/pm Depart:I,�tlam/pm
Date Inspection request received: �1,3117 Inspector's Initials: 6L.4 11
NAME: 01// S PERMIT#: /3—LI 14.1--
LOCATION: It NI cKs !'D , DATE: 7/0 l.(
TYPE OF STRUCTURE:
Comments:
Yes LW N/A
,/(' Building Number Address visible from roar /7\/
'B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches V
Roof Complete/Exterior Finish Complete r 0 lie
Platform at all exterior doors ✓� 1
Handrail 4 or more risers - /
Guards at stairs,decks,patios more than 30 inches above grade V � )- � `'� y�
Guard at stairwell at 34 inches or more f �/
Guard at deck, porches 36 inches or more t Cay --SN—
Handrail Termination at Newell Post or Wall ` F- �.;�-r��
Int 'er/Eterior Railings 34 inches to 38 inches �°r+ k'
eck Bra ' /Handicapped Ramp Compliant
e away from foundation 6 inches with 10 feet 17/ ri: v' —
6 inch clearance to sill plate t/
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim I doors I main entrance 36 inches V _„ a 72.R,t55vtt..j, �. _i t L
Bathroom/Kitchen watertight
Safety glazing/Wind.w in stairwells safetyglazing yJRi �--
Interior Smoke De • 'ors I Carbon Monoxide�Detectors
Every level: Eve Bedr96m: fit// -,--
Outside every bedroom a a: ./ /
Inter Connected: Battery backup: t/
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 Y
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification - `-- �
t � _�
Floor truss,draft stopping finished basement 1,000 sq.ft. f/
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 / V
Furnace/Hot Water Heater operating �/
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 /
Enclosed Stairs Sheetrock Underside minimum'/2"Gypsum ✓`
Basement stairs closed rise>4 inches V /
Garage Floor Pitched V
Garage fireproofing/3/4 hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure ,/
Final Electrical; Energy Saving Light Bulbs 50% V
Final Survey Plot Plan /
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
�//
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker V
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/O[Temporary/Permanent] V
L:1Building&Codes Forms\Building&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
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Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: 1 _ h am/pm
Date Inspection request received: Inspector's Initials:
NAME: PERMIT#: 2c�73
LOCATION: 1\ DATE: 'I ;\OC'
TYPE OF STRUCTURE:
Comments:
(.....__14/1) No N/A
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
Platformat all exterior doors � 1-7\g".
Handrail
4 or more risersGuards at 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 �! `"�o-—
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/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 closed rise>4 inches
Garage Floor Pitched
Garage fireproofing I'/+hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical; Energy Saving Light Bulbs 50% v d40 01-
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles "–Ln -
Flex Gas Pipe Bonding rr �
As Built Septic System/Sewer Dept. Inspection Sticker
Site
--
Site Plan /Variance required
Flood Plain Certification, if required
Okay to issue C/C or C/O[Temporary/Permanent] �(
L:\Building&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
..t of Queensbury Building & Code Enforcement 1 hit is'g dQk g—/0
Office No. (518) 761-8256
Septic Inspection Report
Inspection request received:
Name: 0 QA t S Inspected on: 3 14
Location: /1 1 pc 1s Arrive: 20. ` Ei a.m.I p.m.
Permit No.: /6-1
- Inspector's Initials: ' ,
Comments and/or diagram
Soil Type: Sand 1 •, ii 1 y
Type of Water:(M I ell Water
Waterline separation distance ft.
Well separation distance ft.0(1/ -----
Other wells: ft.
Well Casing Length 50'+I- Y N N/A
[150'to well required if NO]
Absorption Field: Total length ,c .C3 ft.
Length of each trench -b __5V I e_. No ft.
Depth of trenches '1,-.. _ft.
Size of Stone '
Seepage Pits: Number
Size: /Alx
Stone Size:
Piping Size Type
Building to tank 41\ AA- l
Tank to Distribution Box EAc I. V 4Z)
Distribution Box to Field/Pit cC
Opening Sealed: N
End Cap N
Inlet/Outlet Pipes&Baffles VY._
Manholes 12"or less below grade _Y N n
[provide extension collar if Yes] _Y_NT
Location/Separations
Foundation to tank Aci ft.
Foundation to absorption ft.
Separation of Pits X Conforms as per Plot Plan _Y
Engineer Report and As-Built Y C/(1\--
ETU Maintenance Contract provided _Y N
Location , _ _tem on Prole-
ront Rear Left Side Right Side Middle Front Middle Rear
S stem Use Stat :
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Septic Inspection Report
30oWID1� L
PERMIT P •T P -4 -
I HAVE PERSONALLY MEASURED THE DISTANCE
FROM THE
PROPERTY
SRS R�R ( ) TOfi �
PR. l � ESOR �
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Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 2 L l)
Queensbury Building & Code Enforcement Arrive: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: /]yNtk
NAME: PERMIT #: / 3 YS5
LOCATION: (i -.-t Lt 2 Th INSPECT ON: S )•—/
TYPE OF STRUCTURE: s �
Y N N/A
Plumbing under slab
Rough Plumbing / Nail Plates
Plumbing Vent /Vents in Place
11/2 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. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head
50 P.S.I. for for 15 minutes
Insulation / Residential Check / Commercial Check
Window Sealing
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
Blower Door Test
Air Sealing
COMMENTS: (-7` l
Rough Plumbing_Insulation Inspection 02 05 13
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Ins ection r.quest received:
Queensbury Building & Code Enforcement Arrive: �(� "q,C , a /pm
742 Bay Road, Queensbury, NY 12804 Inspector's Inti s: �
NAME: P2*e•1- OCkvl t S PERMIT #: 13 J4iki6
LOCATION: j ics Ick' INSPECT ON:
TYPE OF STRUCTURE: S f
Y N N/A
Plumbing under slab
Rough Plumbing / Nail Plates
Plumbing Vent/Vents in Place
11/2 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. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.I. for for 15 minutes
Insulation / Residential Check/ Commercial Check
Window Sealing —�'
Tyvek or Similar Exterior Sealant V
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
Blower Door Test
Air Sealing
COMMENTS:
Rough Plumbing_Insulation Inspection 02 05 13
(ICS
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Ins ection request received:
Queensbury Building & Code Enforcement Arrive. ;� am/pm
742 Bay Road, Queensbury, NY 12804 Inspector s Inftialsc
NAME: P6ket f� J PERMIT#: 13-- ”5-
LOCATION:
5LOCATION: /1 1 CKs frior INSPECT ON: 3-//`"/ y
TYPE OF STRUCTURE: S F8
Y N N/A
Plumbing under slab
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
11/2 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. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.I. for for 15 minutes
Insulation / Residential Check/Commercial Check
Window Sealing
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
Blower Door Test
Air Sealing
COMMENTS: X' U
Rough Plumbing_Insulation Inspection_02 05 13
Town of Queensbury Building & Code Enforcement IA) d 1-3
Office No. (518) 761-8256
Framing I Firestopping Inspection Report
Inspection request received:
Name: Da 0 t . Inspected on:
Location: I I 44- l 6 K s_ Red Arrive: +`�r� a.m p.m.
Permit No.: I 3— -i&I 5 Inspector's Initials: �ir/
TYPE OF STRUCTURE: S F 0 /
Y N N/A COMMENTS:
*framing
Attic Access 22"x 30"minimum
Jack Studs I Headers
Truss Specification Provided l
Bracing I Bridging vT
Joist hangers
Jack Posts 1 Main Beams
Exterior sheeting nailed properly
12"0.0.
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 1/2(w) 16 gauge(8) 16D 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
.- /
Fi separation 1,2,3 hour
ie wall 2.3.4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side%2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space 1 Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above!below grade
5.0 sf grade
Design Professional Sign-off,if required
Framing ! Firestopping Inspection Report
Ldeel , I" J
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection r u•
Queensbury Building & Code Enforcement Arrive: 1— -r Mer-
742
r •
742 Bay Road, Queensbury, NY 12804 Inspector's Initials. W�
NAME: s PERMIT#: / 3 5
LOCATION: 7/ .W ('_ Ral INSPECT 0 . 3- 5-j
TYPE OF STRUCTURE:
Y N N/A
Plumbing under slab
Rough Plumbing / Nail Plates .�4c‘l -- '1
/V/
Plumbing Vent/Vents in Place
11/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction 1%
Pressure Test
ai Vents
.S.I for l;. above highest connection for 15 minutes UlD��
Pr re Test
Water Supply Piping
Air/ Head
50 P.S.I. for for 15 minutes
Insulation / Residential Check/ Commercial Check
Window Sealing
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
Blower Door Test
Air Sealing
COMMENTS:
Rough Plumbing_Insulation Inspection 02 05 13
Town of Queensbury Building & Code Enforcement s ` n 1''3
Office No. (518) 761-8256
Framing / Firestopping Inspection Report
Inspection request received:
Name: P . S Inspected on: 3 —,
Location: 11 44/0"( Arrive:
Permit No.: / 3'&1'15 Inspector's Initials: _ =�/
TYPE OF STRUCTURE: S j 13
N Nl,�
– — COMMENTS:
Framing %
4
Attic Access 22"x 30"minimum
Jack Studs I Headers
Truss Specification Provided
Bracing/Bridging
Joist hangers
Jack Posts I 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 1/2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center Y . �� `�� u C�O � `�
Ice and water shield 24 inches from wall
separation 1,2, 3 hour JT
- wall 2,3,4 hour
iping Y �J Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 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 I below grade
5.0 sf grade
Design Professional Sign-off,if required
Framing I Firestopping Inspection Report
N\D -3
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection reque •'i '#•d:
Queensbury Building & Code Enforcement Arrive: =c X ,
742 Bay Road, Queensbury, NY 12804 Inspector's Initials. 4
NAME: P7kf ao C4> PER ,` #: 13--4P1
LOCATION: /j CK S kti INSPECT ON:
TYPE OF STRUCTURE: S f 1
Y N N/A
Plumbing under slab
Rough Plumbing / Nail Plates ✓ — 105-r
PL tvvM
Plumbing Vent/Vents in Place z_NM) F�ca�g� �
11 inch minimum Drain Size ✓
Washing Machine Drain 2 inch minimum V
Cleanout every 100 feet/ change of direction
Pressure Test
Drain /Vent
Air/ Head ?‘)C_,
5 P.S.I. for 10 ft. above highest connection for 15 minutes
Pressure Test ✓
Water Supply Piping
Air/ Head
50 P.S.I. for for 15 minutes
Insulation / Residential Check/Commercial Check
Window Sealing
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
Blower Door Test
Air Sealing
COMMENTS:
Rough Plumbing_Insulation Inspection_02 05 13
CAI
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspectiiol3 request received:
Queensbury Building & Code Enforcement Arrive: y a '/pm
742 Bay Road, Queensbury, NY 12804 Inspector Initials:
n I
NAME: PERMIT#: 3 y yo
LOCATION: l 1 -J/' fl', s ROI INSPECT ON:
TYPE OF STRUCTURE: f 1v
Y N N/A - COMMENTS:
Framing
Attic Access 22" x 20" minimum
Jack Studs / Headers
Truss Specification Provided
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 / Holes/ Bearing Walls
Metal Strapping for Notches Top Plate
11/2 (w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
"Ice?ea: 4ts
from wall C-214 { —our VdRe
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 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
Design Professional Sign-off, If required
Framing Firestopping Inspection_Revised_02 05 13
/ 3
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Insp ction r quest received:
Queensbury Building & Code Enforcement Arrive: % 1 am/pm
742 Bay Road, Queensbury, NY 12804 Inspecto s nitials:
NAME: 1)61--d—bp'
v YL s PERMIT#: /3--9.Y5
LOCATION: // N- J°C k, s INSPECT ON: /
TYPE OF STRUCTURE:
Y N N/A COMMENTS:
Framing
Attic Access 22" x 20" minimum
Jack Studs/Headers
Truss Specification Provided
Bracing /Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12" 0.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
11/2 (w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center ✓� �
Ice ans water shield 24 inches from wall
C3-KV4-91,
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping �U
Penetration sealed r'
16 inch insulation in cavity min. K, —
Garage Fire Separation
House side 1/2 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
Design Professional Sign-off, If required
Framing Firestopping Inspection_Revised_02 0513
s,( 6. ; c ._ ii (IIc
Foundation Inspection Report
J
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm epart: pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initialsb, \ j
NAME: f)a. `1 PERMIT#:
LOCATION: %j / ( f> a INSPECT ON: /j- At;
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
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
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 ;
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\Inspection For ns\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&Code Enforcement Arrive: /.i.' am/pm Depart: amlpm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: '„t
NAME: /4/WI) PERMIT#: - C'y�
LOCATION: /`f Ze.,<, ,dam INSPECT ON: -///67/311��3
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
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
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 milyoly 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\Inspection Forms\Foundatlon Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
cuu\ 1)
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pmDepart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:r4 iJ_ /0;2GC)
V
NAME: Q1- PERMIT#: I
LOCATION: / K g R-f INSPECT ON: / v 3 j-I 3
TYPE OF STRUCTURE:
Comments
Y N NLA
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
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:\BulldIng&Codes Forms\Buliding&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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