2014-133 TOWN OF QUEENSBURY
` o 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
F
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140133 Date Issued: Tuesday, September 30, 2014
This is to certify that work requested to be done as shown by Permit Number P20140133
has been completed.
Location: 908 SHERMAN Ave
Tax Map Number: 523400-301-017-0003-064-000-0000
Owner: KELACO, LLC
Applicant: KELACO, LLC
This structure may be occupied as a:
Fireplace By Order of Town Board
Garage Attached TOWN OF QUEENSBURY
SingleFamily Dwelling
Issuance
off this Certificate of Occupancy DOES NOT relieve the property joi
te
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
` a 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140133 Application Number. A20140133
Tax Map No: 523400-301-017-0003-064-000-0000
Permission is hereby granted to: KELACO. LLC
For property located at 908 SHERMAN Ave
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: KELACO, LLC Fireplace
35 FRONT St Garage Attached
LAKE GEORGE,NY 12845-0000 Single Family Dwelling $190,000.00
Total Value $190,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
•
Plans &Specifications
2014-133
SFD 1602 sq ft w/Garage 476 sq ft
$391.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,April 23,2015
(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 Townnsbuty We •s/.y,April 23,2014
SIGNED BY t //,w/ (� 3.\ for the Town of Queensbury.
Director of Building& Co.e Enfo ement
Office Use Only
Town of Queensbury Building & Codes
Received:
Tax Map ID: ,30 . 1'1-3-(n'/
PRINCIPAL STRUCTURE APPLICATION Permit No.: 41- 133
A permit must be obtained before beginning construction
Permit Fee: $ .597 s�'��
1-28-2013 : $850 recreation fee for new dwelling 'Ret Fee: $ Z) °� !
Please read: *TB resolution 86-2013
tE �
( ) /wL
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 9�i7/i / Applicant CoMi'e C,, - f. 0-1C
Tax Map ID Address 3 aa- Ce/fefr Gv
Zoning Res,cgoAiki I SR I A fp)cwv)'i 1 f'
Phone/E-mail /nifaeile1:eJ4'i (life* CRS 4am.(
Property Owner KP 14 c O Contractor/Agent Ca62 S &�� s S d 2.
Address 3r fRostf 4• Address
L.40 c4bt9.a • ill .1
Phone/E-mail Phone/E-mail
Building Street Address: 9O g trpeit 5X ttn r) Ade'
Subdivision Name: eAte f.Ue5T Lot#: I7 Historic Site: Yes Alo
Estimated cost of construction: $ 19 0,rob
Type of Construction:
Check all that apply Please indicate measurements as required below:
C =
0 0
m v 1st Floor 2nd Floor Other Total Height
F a .1t-
Single
Single Family V 11 02- idoa a(4 '
Two-Family
te
Multi-Family(#of 4 �
units )
Townhouse
Business Office •
Retail-Mercantile
Factory-Industrial
Attached Garages Of 2. ) ✓ 117 L H dr/
Other 0
1 it
Town of Queensbury Building&Codes Principal Structure Packet a (.2\f,°`/ 518-761-8256 t/k-C k:
4i S) •
If commercial or industrial indicate name of business
Proposed use of building or addition 5]/�/r Finn•I y
Source of heat(circle one) Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" 1/Yes _ No
Are there structures not shown on plot plan?
A) D
•
Are their easements on the property? (a 2J LAA 1ug3p Etz e
Site Information Lst! — /litecOy -041e rIjl
a. Dimensions or acreage of lot 1 4cf.e ;$C x/5-6
b. Is this a comer lot?
es
c. Will the grade be changed as a result of construction: _Yes 1LNo
d. Public water or Private well v/0 r •C
e. Sewer or Private Septic System P126/1 ..
p2I Ud TP Sepik,
Value of all work to be performed(labor and materials) $ / Li/_Coti
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.
Signed War--.NC- & 3 Date: `7/17//1
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.:
�,:
Permit Fee: $ Aran
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-In and Final Inspections Are Required:
Date 'ihgsfiy / y�
Owner Ke 14to Installer/Builder (0//eftF Ganr,r Vile.
Address 2s- f RcA,j- Address 3?, (o//e; . 4v
tart ,Q.Y I2-?4S' / r,�cOn FA /s
C5:-LPhone Phone 3C5:-
Location
ocation of proposed construction and/or installation: 45t- I? Poir.P Punt - 90R- &rpmQ sl7 e/Un44
Contact Person for Building &Codes Compliance: ize N fey/@_fte
Subdivision Name: ed,1 IA)c Sf
Fuel Burning Appliance Information Wood Coal Pellet Gas Oil
L./
Stove
Fireplace Insert
Fireplace,factory built* 1/
Fireplace, Masonry
Furnace, (Garage Only)
* If Factory Built, Please Provide: Manufacturer Name: Hen rx 3/o Model No. 7 d ,01a
Listed By: Number:
Chimney Information
Masonry** /check one _Block _Brick Stone
Flue /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.
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.
Town of Queensbury Building&Codes Principal Structure Packet 518-761$256
Office Use Only
Received:
Tax Map ID:
Town of Queensbury Building & Codes Permit No.: 11 ' / 33
SEPTIC DISPOSAL PERMIT Permit Fee: $
A permit must be obtained before beginning construction Approvals:
Applicant:
Ca 17‘ ( &re— 70r-1 rit1C' InstallerBuilder Ce//elir Cc-vi fid
Address: 3 ( /kCAddress
N /tp A/l6 , A; ,y
Phone: 3cc $E?- — Phone
Owner: J<QIACO Location of Installation 9O Off PR s`]P.c c M/ be.'
Address: 2s mrAx �f
CAsep Geerge ti•r'
Phone 6/25'2 /I" // ,,yy
Contact Person for Building&Code Compliance: Kph 6�ie if, Day Phone: 36/
rSY 2a—
Residence Information:
Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow
1980 or older x 150 = Garbage Grinder installed? ND
1981-1991 x 130 = Spa or Hot Tub Installed? No
1992—Present ✓ x 110 = '; ?C)
Parcel Information:
Topography ✓Flat Rolling _Steep Slope %Slope
Soil Nature ✓Sand Loam Clay _Other
Groundwater At what depth? /4—� 1-
BedrocIdImpervious Material At what depth? Q k
Domestic Water Supply ✓Municipal Well(if well,water supply from any septic system absorption is ft.)
Percolation Test Rate- per minute per inch(Test to be completed by a licensed professional engineer or
architect) sLi6 D7r/Isf6M
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 /O DO gallon(minimum size 1,000 gallons), add 250 gallons to size of septic tank for each garbage grinder, spa or
whirlpool tub
System Type: Absorption Field(with#2 stone) Total length a1-0 ft. ' Each trench ss X a-
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.
✓I 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: Jee4J Ce//�eJJt' Date: y/7,E.,///y
Signature: I• &..4M '`� Date: y�/2//y
Town of Queensbury Building&Codes Prindpal Structure Packet 518-761-8256
Q
i50 � ,
Town of Queensbury Highway Department ki4`3'L\
DRIVEWAY PERMIT
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#: I y -133
Date: (i,I ieby
Tax Map ID:
Applicant Name: Co Chile- Cir 251; tdG rf
Address to be inspected: qit uPp9,2 S<�()gm Ar'a -��7 JL'r�jt )n1a
Return Address: ro/% 4'^'' lljscriv Fid,N .7' 02'37
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
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Date received: 9 S jy
NAME: k�,�QCc7
LOCATION: 90 S ,4.,,..c2fr,,
PERMIT#: ! 3 3
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the 16-2-l;(
survey has beedip
: _
Craig Brown, Zoning Administrator
Notes:
LASueHemingway\Building.Codes.Inspection.FORMSTinal Survey
Zoning Administ alor doc
Queensbury Building & Code Enforcement - Residential Final Inspectio
Office No. (518) 761-8256 Arrive: am/pm De am/pm
Date Inspection request received: Inspector's initials:
NAME: PERMIT#: " 2.014— V
LOCATION: tar DATE:
TYPE OF STRUCTURE:
Comments:
60 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
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at sfalrwell 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 aooessIble area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents ny
Bathroom Fans,if no window
Plumbing fixtures �y ,/
Foundation insulation to floor/Sticker on Panel ,� Y r, .J 4 l/--
012-
Duct work sealed properly/Blower Door Test Certification ��
Floor truss,draft stopping finished basement 1,000 sq.It
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
Fumace/Hot Water Heater operating
Low water shut-off boiler
Relief Valves)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum 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 / w/ J i\'�
41 Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles ��� , -
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Slicker
Site Plan /Variance required
Flood Plain Certification, if required
Okay to issue C/C or C/O[Temporary/Permanent]
•
L:1Building&Codes Forms\Building&Codes\Inspection Forms!Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 1222/10,Revised 04/13/11
STown of Queensbury Fire Marshal
��
742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Fireplace/Stove Inspection Report
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
��1,^, '` instructions or specifications is allowed.
Permit# r�-tl L4 l 33 Schedule Inspection L�(+c 3/i4 Time 1"-J ani 62)anytime Inspector(
Name see�L�j Address
��- C S1 ern--oeQ._, 4-c. C Rough In Final
Appliance Manufacturer Z "O�� Model# � ` 'a
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated_
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides) V/
Firestop(s) Vertical Chase tit
Wall Penetration ✓ ✓✓✓
Vent Clearances to Combustibles 7
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve
Combustion Air
Hearth Extension (if any)
Mantel ✓
Height above f/p opening
Witness Operation V
Tank Placement(if LP) ✓
CO Detection ✓
CSST Bonding
White—Building Dept. Yeno.,—Cust Amer Pink—Fire Marshal
Queensbury Building & Code Enforcement - Residential Final Inspection / 3$n1
Date InspeOffice No. c518) 761-8256 tion request received: -1 - I Y' Insppector's Initials:ive: wpm De rt:C— ��am/pm
NAME: oc I a co PERMIT�o20 I'Y - / 31
LOCATION: Id V ,Shannw. ,4,.c� DATE: 9u
- C a 4 3//ii
TYPE OF STRUCTURE: R "n, s Lc(2 i
o Comments:
Yes No N/A
4" Building Number Address visible from road /" a/G
Chimney Height!"B"Vent/Direct Vent Location t� (/
Fresh Air Intake /
3 inch Plumbing Vent through roof minimum 18 inches 1/109
l /
Roof Complete/Exterior Finish Complete %.",,,,.
l[`�ev` t�dC
Platform at all exterior doors s/; r / ..
Handrail 4 or more risers !ll��� C�'�
— Guards at stairs,decks,patios more than 30 inches above grade 1,,' 3 (p -. Cts.3-
Guard at stairwell at 34 Inches or more ve
Guard at deck,porches 36 inches or more NV
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches t�
Deck Bracing/Handicapped Ramp Compliant Nor
Grade away from foundation 6 inches with 10 feet V
6 inch clearance to sill platetordie ..
E.
Gas Valve shut-off /regulator 18 inches ess grade vole
Interior privacy/triim/doors/main entrance 36 inches volei—e--)c.. /LICe‘aareenne•—•
Bathroom/Kitchen watertight
Safety glazing/Wince in stairwells safetygl ng t✓ l�DI Z �5
Interior Smoke Deft tors/Carbon Monoxideodors ! ia ,ham A6 6....../�•-►1C�"
Every level: J Every BedjEm: �K7 �W�`+�
Outside every bedroo rea: /
Inter Connected: 4 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
Duct Foundatrks gdinsulation to floorStr on Panel \ bes � �:YC„ , „)
Duct work sealed properly Blower/ Door Test Certification ���
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade V ars--
Gas Furnace shut-off within 30 feet or within line of site h/ I
Oil Furnace shut-off at entrance to furnace area >/
water s14
Lo Water Heater operating 7 Q1rC—�O L!i� _) ~
Low water shut-off boiler
Relief Velvets)installed/Heat Trap/Water Temp 110 ✓
Enclosed Stairs Sheetrock Underside minimum''r4"Gypsumy cv ` "X' "
Basement stairs dosed rise>4 inches - IVV/
Garage Floor Pitched u/i
Garage /%hour fire door!door closer
GasLogs in Sealed or Glass Enclosure ver 4MF1 C"1/44-4-461°L
Final Electrical;Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles 9.38.4)4C1
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker t/
Site Plan I Variance required ved'
Flood Plain Certification,if required
Okay to issue C/C or C/O[Temporary/Permanent Ig)e
L:'Building&Codes Forms'Building&Codestlnspection Forms Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12122/10,Revised 04/13/11
f Queensbury
(518) 761-8256 Building & CodeWEnforcement
} jk
tce No.
w
Septic Inspection Report
Inspection request received:
Name: K 0,1 a m° Inspected on: V -13-('J
Location: cyp g G hca r ec .n Pr oe Arrive: f , 4'0a p. .
Permit No.: r'-1-I 33 Inspector's Initials: Lai
Comments andlor diagram
Soil Type: Sand I 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]
Absdrption Field: Total length ft.
Length each trench ft. Cie—At Depth off trenches ft. (—?,‘
Size of Stone
Seepage Pits Numberage
G j
Size: x t. /
Stone Size:
Piping Size Type .N., 1 j I
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 Pits ft i
Conforms as per Plot Plan _Y_N
Engineer Report and As-Built _Y_N
ETU Maintenance Contract provided Y N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
System Use Stat :
Approve.
'. ,pproved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
VISION Engineering CIVIL• STRUCTURAL • MUNICIPAL • ENVIRONMENTAL
8/13/14 rfr t 3 3
Building and Codes Department
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
RE: Collette Construction
908 Upper Sherman Avenue— Lot 17 Onsite Sewage System
VISION Engineering, LLC previously designed the Pointe West Subdivision which included the
individual household onsite wastewater disposal system (septic system) for the above location. This
letter shall serve as certification that, upon information obtained from inspections and/or the Contractor,
portions of work designed by our office appear to have been installed in general conformance with
approved plans and specifications.
Thank you and please do not hesitate to contact me if you have any questions or require additional
information.
Sincerely, ENGINEERS STAMP:
Digitally signed by Daniel W.Ryan P.E. Of �,��
Date:2014.08.13 08:35:27-04'00' fr
,��
Daniel W. Ryan, P.E. r� 9 ��
VISION Engineering, LLC s 4;t` a,':
v e Yom_ %7 fLf F_
11
lV
Rer ESSt V
16 Pearl Street•Suite 200•Glens Falls, NY•12801 •P: 518.792.9264•F: 518.792.9282
www.visionengineering.org
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date In , do I e'nest received:
Queensbury Building & Code Enforcement Arrive. am/pm
742 Bay Road, Queensbury, NY 12804 Insp:ctor's Ini s:f
NAME: 1)<SOLOo PERMIT#: /{{-133
LOCATION: Q7 S PI/04--- INSPECT ON: R- 7–/(/
TYPE OF STRUCTURE: S Eh
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 5/` /
Door/Window Sealed (No Insulation) /V/
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
Blower Door Test /J
Air Sealing
COMMENTS:
Rough Plumbing_Insulation Inspection_02 0513
Town of Queensbury Building & Code Enforcement e- to aft,r.
c-Officri No. (518) 761-8256 pe J "._,0 Li
Septic Inspection Report ivl
Inspection request received: E(4l,�Iii:
Name: Tl 67-1C_0 Inspected on: _1' i 3-4' (
�6 t 5 i�
Location: Arrive: `a, a.m.l p.m.
Permit No.: dC)f -/ 3 3 Inspector's Initials: C— /
Comments and/or diagram
Soil Type: a / Clay
Type of Water: ., '.I I Well Water
Waterline sepa . .n distance
Well separation distance
Other wells.
Well Casing Length 50'+/- Y N N/A
[150'to well required if NO]
Absorption Field: Total length ft.
Length of each trench -4.10—ft.
Depth of trenches Z. ft.
2SeepSize of Stone -412—
Seepage
age Pits. Number Y } ,I�
Size: . Fxx
Stone Size:
Piping Size Type
Buildinganko totank
u gii ILIA
Tank to Distribution Box __12-vi 9
Distribution Box to Field/Pitc
SalWrar—
Opening Sealed: N
End Cap Y_N
Inlet/Outlet Pipes&Bathes fr `-5�� / Gl C I
Manholes 12"or less below grade _Y y 1 ` {-
[provide extension collar if Yes] 7
_Y ` N { — ; ✓`_ " w O (ak
Location/Separations
Foundation to tank ft}tdFft.
Foundation to absorption ft.
Separation of Pits
Conforms as per Plot Plan
Engineer Report and As-Built Y N
ETU Maintenance Contract provided _Y_N
Location of System on Prop
Front Rear eft Side Right Side Middle Front Middle Rear
System Use Status:
pproved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
Septic Inspection Report
• ; A guilt series 90 lett s�, 22ih��� A
N S Ke.IA co
0-1111
j4ou3
has L ;w€
I Ilot '=i
sAeI
9 lNk Aue
r
6
Ip
F
'll 1-i 'IC'
is!{
i
XL �
i
a
3 '
6v i
i
i
I4
I i
I1
50
w 1
LAlrLIA) P e;
Rough Plumbing / Insulation Inspection Repor�f"� - a)
Office No. (518) 761-8256 Date Ins Iec 'on request received:
Queensbury Building & Code Enforcement Arrive SiA&,_ am/pm
742 Bay Road, Queensbury, NY 12804 Inspecto 7 In ials:
NAME: W PERMIT#:
LOCATION: 41 Q-S til Vt'M6 7 INSPECT ON: 3/44/
TYPE OF STRUCTURE: S F sb
Y N N/A
Plumbing under slab
Rough P uml bing /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 �f
Drain /Vent •i//
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:
Rough Plumbing_Insulation Inspection_02 0513
Rough Plumbing / Insulation Inspection Report olpm
Office No. (518) 761-8256 Date Ins ec ion request received:
Oueensbury Building & Code Enforcement Arrive: a am/pm
742 Bay Road, auueensbury, NY 12804 Inspecto 's Initials:
NAME: KNikQ G D PERMIT#: / C/'' /3.3
LOCATION: Ch2 g Shgrtt<N n INSPECT ON:
TYPE OF STRUCTURE: S T /J
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
I
��L '
COMMENTS: ik-^ ?- /
Rough Plumhing_Insulation Inspection_02 05 13
LUed , a-y
Rough Plumbing / Insulation Inspection Report (3 ?)
Office No. (518) 761-8256 Date Ins ection uest received:
Queensbury Building & Code Enforcement Arrive: am/p
742 Bay Road, Queensbury, NY 12804 Inspect Initi A .
NAME: K,Dl et) PERMIT#: r " 33
LOCATION: yo .SFcr'aaA INSPECT ON: 7-,'a
TYPE OF STRUCTURE: S FO
Y N N/A
Plumbing under slab
;'Rough Plumbing / Nail Plates
Plumbing Vent/Vents in Place
VA 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
litto*Cm
Pressure Test
Water Supply Piping v/
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 Plumhing_Insulation Inspection_02 0513
— Y_
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspect on equest received: 7/2-0y
Queensbury Building & Code Enforcement Arrive' am/pm
742 Bay Road, Queensbury, NY 12804 Inspect r s I ti Is: /
NAME: It(etIa CIS PERMIT#: 1 — 133
LOCATION: 96A She- 2.—n, Ue INSPECT ON: ti /Y
TYPE OF STRUCTURE:
Y N N/A
Plumbing under slab
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
11/ 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 — ktfl2�Ag — /
Iyvek 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 Inspeclion_02 0513
WC°k Iv
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart'Cfl�g�/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials-
NAME:
nitials {{ U
NAME: (/e.46-04-1-131
p PERMIT#: I
p
LOCATION: ` 0 VZ 9c or*t\c& INSPECT ON: 2' 3 di
TYPE OF STRUCTURE: S F/
Comments
Yf N N/A
Piers riarAdh,
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
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\Inspection Forms Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
W L S - lb
Town of Queensbury Fire Marshal
F4 1 742 Bay Road
�,•� Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Fireplace/Stove Inspection Report
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.pr �
�/
Permit# 14J —/ 33 Schedule Inspection'1t 23\VA" Time 1. /� l -pm anytime Inspected:
Name KEOda Address7/�S \C)ertcvar, 43 a r,fx'x inal_
Appliance Manufacturer 1 t Model#
Direct Vent Factory Built Chimney_ Flue Sizt÷kDouble WalX Triple Wall Insulated_
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides)
Firestop(s) Vertical Chase 2
Wall Penetration / y. ��Z— w�ac `�-�—�
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof i _r l ,
penetration;2 feet above any combustible w ` -' ---
construction within 10 feet `- JP s f t'' <t t .-1s S -
Gas Shut-Off Valve 17�7��
Combustion Air
Hearth Extension (if any)
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if LP)
CO Detection
CSST Bonding
White—Building Dept Yellow—Cust►mer Pink—Fire Marshal
Town of Queensbury Building & Code Enforcement /, a �vjla
Office No. (518)761-8256 (N
Framing I Firestopping Inspection Report
Inspection request received:
Name: 14 (4 ato Inspected on: 7- /
Location: 90g S Witur Q,..- Arrive: G - •
p.m.
Permit No.: Inspector's Initials: C. rrl)
TYPE OF STRUCTURE:
y N NIA COMMENTS:
rF-Attie n �
Attid Access 22"x 30"minimum
Jack Studs/Headers V
Truss Specification Provided /
Bracing/Bridging l<
Joist hangers V �? p
Jack Posts I Main Beams — N'C�=' � '1
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 1/2(w)16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses V
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
Firestopping V/
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) D
20 in.(W)
5.7 sf above/below grade 410%AJ 01— C r
5.0 sf grade
Design Professional Sign-off, if required
Framing / Firestopping Inspection Report
Town of Queensbury Building &Code Enforcement l(,fie, U,/6- 101
Office No. (518)761-8256
Framing / Firestopping Inspection Report
Inspection request received:
Name: Inspected on:
Location: q0y Sc-n-ma (I Arrive: a.m.1 p.m.
Permit No.: / 'y-/3.3 Inspector's Initials: .al�
TYPE OF STRUCTURE: B
Y N NIA COMMENTS:
Framing
Attic Access 22"x 30"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
1 '/z(w)16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 less on cefror EIY
etc _a-wer-shiathierdld-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
Design Professional Sign-off,if required
Framing /Firestopping Inspection Report
ref trie‘
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: KeTatt-D PERMIT#: /<-133
LOCATION: qSh&f"Mac INSPECT ON: £ c)b -f�
TYPE OF STRUCTURE: S FD
Comments
Y N N/A
Footings
Piers _
g • onolithi Slab f
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
Footing Drain Stone:
12 inch width
6
6 inches above footing
• '1 pol •for wet area under sl
pproval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Farms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
t Le e s 1 3
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection req ___ -d:
Queensbury Building& Code Enforcement Arrive: 12:-40• r� w it Depart: in- a (001
742 Bay Rd., Queensbury, NY 12804 Inspector's Initisa
— / ,
rr
NAME: �+K Ciao-4)Q,CC) PERMIT#: /<7 `/ aa
[
LOCATION: 0 g a F\J INSPECT ON: i 0 —ii>" 1%'
TYPE OF STRUCTURE: S F A
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
. ooting Dowels or Keyway in place
iIFoundation Dampproof=n
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
- wc:6 mil poly for wet areas under slab
/
t - 4 Backfill'Approval
1
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\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
1 k uAt. g - io
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p Depapm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials.Lo, !! 39Y'
NAME: l 6.t N b PERMIT_ #:
LOCATION: 9'Og S LOv..62 .t.. INSPECT ON: /o—/..24W
TYPE OF STRUCTURE: S F b
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 7"Wallpour `/�/
Reinforcement in Place
Footing Dowels or Keyway in place
V
/ CZ‘- -L\'°-.1t C
`' `-�_�/�J M
Foundation Dampproofing CYO �t 't 1
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\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
t hwt blot /o -
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 Initial2/l
NAME: ,O_ f0s°o PERMIT#:: 1 u"1 3 3
LOCATION: 90$ s INSPECT ON: t r c-/y
TYPE OF STRUCTURE: S ,J
Comments
Y N N/A
41 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/WallpourAt'S
C
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:\Building &Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
yng-fit/ kQ►ac_o - owtie.2
\'‘‘h Collet' Cak;,� !�
hlOf P/AAJ
1 01 16 (f,DL-it) DR.
PERMIT PL n•' 't4 Ifl S a Vi U..._U,-I-_-
I HAVE PERSONALLY MEASURED THE DISTANCE
FROM THE PROPERTY LINES TO THE
PRO OSED, E(S)OR
(4)1 l APR 21 2014
{ TURE
TOWN OF & CO
DATE BUILDING & CODES
•
i
zCv
ti d,(Vy EAsen, Nf1.
l
96. +J Leif or I
1
nSS' 1 ' Fila,., `
Ely
j C r� L, u� lGuo" t/«ue / r/R�rti
nil 7Afre , K.N\
'
{ ., , +-
it
Dit
I _ __ __
�- � Ives,
car rg
D SS
up P°t2 5 e A^' Af)C ' 5u�e,d�5+�• f0"
su+le I yb'�� �\flr� d .