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2014-603 TOWN OF QUEENSBURY F4TO742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20140603 Date Issued: Monday, March 23, 2015 This is to certify that work requested to be done as shown by Permit Number P20140603 has been completed. Location: 178 HUDSON POINTE Blvd Tax Map Number: 523400-315-007-0002-082-000-0000 Owner: GEORGE & ANNE MATHEWSON Applicant: GEORGE & ANNE MATHEWSON This structure may be occupied as a: Residential Addition By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property 4 Idtct. 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 (St 8)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140603 Application Number: A20140603 Tax Map No: 523400-315-007-0002-082-000-0000 Permission is hereby granted to: GEORGE & ANNE MATHEWSON For property located at: 178 HUDSON POINTE Blvd 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: GEORGE &ANNE MATHEWSON 178 HUDSON POINTE Blvd Residential Addition $70,000.00 QUEENSBURY,NY 12804-0000 Total Value $70,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2014-603 Res. Addition 345 sq.ft. $100.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, November 24,2015 (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 Town f Quee sbutyf / M aoxember 24,2014 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement PRINCIPAL STRUCTURE APPLICATION Office Use Only DATE IVCsU2r116.er 1 q c20(y Received 2 Tax Map ID _ TAX MAP ID 3/c ' 7- - Permit No. i LZ f r2 Permit Fee X71 ZONING Rec Fee V NOV 19 2014site Plan# HISTORIC SITE Yes No Subdivision# SUBDIVISION NAME Lot# TOWN BD. RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS, INCLUDING SINGLE FAMILY DWELLINGS, DUPLEXES OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR MANUFACTURED&MODULAR HOMES, BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE. APPLICANT 1 1 I t 1 Cr C,n� I'Ll.df(On OWNER Ccrqe IR ;4- ADDRESS 1 (1 (IC>10 k y I?C d ADDRESS ) 7g' o d5o Fn e g j u J I CE.(k Ny L LLe e as b i-c ry 1,88 i ra / 'y PHONE/E-MAIL q ( - 'J.3 C1 (a75 C- VL' PHONE/E-MAIL _P`S - 9-26 /Q`a" T CONTRACTOR1-L(� e-- COST OF CONSTRUCTION(ESTIMATED): $ /D 00 C� ADDRESS: BUILDING ADDRESS: 1 7g- J 1 '�t�+SUn IE' n le / 'd. PHONE/E-MAIL ` f } r� CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: I �' �� A I \� ( e (' 11 I PHONd et-? /C y TYPE OF CONSTRUCTION Check all that apply Please indicate measurements as required below New Addition Alteration 15t floor sq.ft. 2' floor sq.ft. Total sq. ft. Height Single Family 3q3-- — ,3 VS l y ' Two-Family Multi-Family (#of units Townhouse Business Office Retail - Mercantile Factory- Industrial Attached Garage (#of Other 1 Town of Queensbury Building&Codes Principal Structure Application July 2014 If commercial or industrial indicate name of business Proposed use of building or addition r,--)ed i oc-t,', / )ct` I 1 Source of heat (circle one) Gas) Oil Propane Solar Other Fireplace: complete a separate application for Fuel Burning Appliances & Chimneys nch Are there structures not shown on plot plan? rl C Are there easements on the property? fl C Site Information a. Dimensions or acreage of lot b. Is this a corner lot? c. Will the grade be changed as a result of construction Yes No d. Public water or Private well e. Sewer or Private Septic System Value of all work to be performed (labor or materials) $ DECLARATION: 1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and department approval. 3. 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. 4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. 5. 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 I have read and agree to the above: PRINT NAME: C1 n cf.y S R f b gee.(y4 DATE II- 19 - iv SIGNATURE: 24 (.0 L � i:t DATE ,_.-CAL4,( FOR OFFICE USE ONLY Operating Permit Issued: Yes No Occupancy Type Construction Classification Assembly Occupancy Limit Special Conditions 2 Town of Queensbury Building&Codes Principal Structure Application July 2014 SEPTIC DISPOSAL PERMIT / Al I i Office Use Only DATE ,Y ve��'l�'e►2 I CI ,?C/y Received t ' _� - �� Tax Map ID TAX MAP ID Permit No. — .1'C 1 '7? HLLa5o') ,�O I .�. L t Permit Fee , LOCATlONOFINSTALLATlON I r0 �1 t � Approvals�.,`w 1 9 _)uiii APPLICANT -H.I II I L Co(\ t1 - - 1 PHONE/E-MAIL 79 ° I& Q l[,7�2 75- ADDRESS `5 I C r2O L..�ley ROS s fiLtdSosn �CL I15 L CUP1 1NSTALLERBUILDER: PHONE/E-MAIL ADDRESS: p OWNER 6-) LaO(-E C I I I CL:1-1).e . • )011 PHONE/E-MAIL C I S `) .Qe) -I0.,7y Address I 71? dSon Poi ole 61(id, ✓✓✓ CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: /Gm 19/13 reFA PHONE 4aN 17e51 RESIDENCE INFORMATION Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow 1980 or older Garbage grinder installed _Y /N 1981-1991 Spa or Hot Tub installed _Y ' N 1992-Present 5 l / C, 5-( PARCEL INFORMATION / Topography _Flat rolling Steep slope %slope Soil Nature Sand Loam Clay Other Groundwater At what depth? Bedrock/Impervious Material At what depth? non -e- Domestic Water Supply ✓ Municipal Well (if well,water supply from any septic system absorption is ft.) Percolation Test Rate: I—.S per minute per inch (test to be completed by licensed engineering/architect) PROPOSED SYSTEM FOR NEW CQN TRUCTION -1-� x t rjil 6-- P-CQ C( f?'f -+ '0 /1hG f' Tank Size /OCC gallons(minimum size 1,000 gallons,add 250 gallom toi#e f.Qr!ach garbage grinder or spa or hot tub) System Type Absorption field with#2 stone Total length 5 ft.; Each trench x Seepage Pit with#3 stone How many: 110 Il '_ ;size Alternative System Bed or other type? X Holding Tank System Total required capacity? -X....Tank size #of tanks Notes: 1) Alarm system &associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer allow systems to be covered until such time as an As-Built plan is received & approved. The installed system must match the septic system layout on file-no exceptions. DECLARATION: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure to make a material fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations and agree to abide y,these and all reRuirements of the Town of Queensbury Sanitary Sewage.Disposal Ordinance. Print Name: I v,ciA( • e I b re c h-I-- Date: //–/l- /V Signature: �-c%i . ('t. 7,-t_,e--r-1' " Date: Town of Queensbury Building Codes Septic Disposal Permit July 2014 Queensbury Building & Code Enforcement - Residential Fir - r spection Office No. (518) 761-8256 Arrive: 2--P-7i) a' I. . I-; • • : �,_ a prr Date Inspection request received: 317.- 115 Inspector's Initialsar NAME: P. IT#: i\- OD') LOCATION: D• 'E: 3 12'', TYPE OF STRUCTURE: sC—� Comments: Yes No NIA 4" Building Number Address visible from road Chimney Height/"B"Vent/Direct Vent Location `-G`11 Fresh Air Intake (� 3 inch Plumbing Vent through roof minimum 18 inches ✓/ Roof Complete I Exterior Finish Complete V 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 '1 `Vth 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: Eery Bedroom: v/ Outside every bedroo area: ___ Inter Connected: j 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/3/,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 Flex Gas Pipe Bonding As Built Septic System/Sewer Dept. Inspection Sticker 1712 V Lam' Site Plan /Variance required d Flood Plain Certification, if required Q Okay to issue C/C or C/O[Temporary/Permanent] r u ss s teaD..D 15 A-r- R e. r- L:\Building&Codes Forms\Building&Codes\lnspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11 de, Town of Queensbury Building &Code Enforcement 1 U )v" 12-- Office No. (518)761-8256 Rough Plumbing I Insulation Inspection Report Inspection request received: ' 17-- `i 5 Name: N'11`-r Jy\I Q'Yl Inspected on: 3l F->I 1 5 Location: I b -A-t, , "Q'\vk-) Arrive: \ '''' .. 8. R� m. Permit No.: 11— bCa Inspector's Initials: Alik Type of Structure: S � '' ‘ 13 17,� =1 ) > COMMENTS Y N NA Plumbing under slab --i-\1\ -\-CT Rough Plumbing/ Nail Plates Plumbing Vent/Vents in Place j_ Oj 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 i 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 t� ��i AA / W @ fsi-. oSZ__ 2 ndow Sealing Tyvek or Similar Exterior Sealant � 'z1 ,��Au-`i Proper Vent, Attic Vent chi L‘►.x 7 Door I Window Sealed (No Insulation) Duct/ Hot Water Piping Insulation IA)\r 17 .-L9 If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape Blower Door Test Air Sealing Rough Plumbing/Insulation Inspection Report0 --1-4,cA Hwy Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Insctian r, quest received: P-/I Is J v l Queensbury Building & Code Enforcement Arrive: 742 Bay Road, Queensbury, NY 12804 Inspector,'s4nitib1 NAME: 41,I-1306a( { Pkig6�J�2r` PERMIT#: ` 4 -&O LOCATION: F r7 �0 [7 INSPECT ON: _ S TYPE OF STRUCTURE: TeA Y N N/A Plumbing under slab • ough Plumbing /Nail Plates- t- -C kL U ' 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 r` 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 • 1 � � 1 V tt COMMENTS: ! n '' ` v .' t I Rough Plumbing_Insulation Inspection_02 05 13 Towneensbury Building & Code Enforcement Office No. (518) 761-8256 d Framing I Firestopping Inspection Report Inspection request received: /â_O i 5 o vI Name: 14+✓Cl (0,,.. 1-- o,� Inspected on: ''-';' I► Location: 1 "— en- P .6l✓ci---• Arrive: •gfillf a.m. ' •.m. Permit No.: ) Iq---1(.2C7 3 Inspector's Initials: .15F^ w TYPE OF STRUCTURE: P/J /t j 1.�—t ��0-D� DOLS V N N/A COMMENTS: Framin C RZY-1 AL Attic Access 22"x 30"minimum �+�� �( j C�Jack Studs/Headers I -(54,i,,\'g / .1(‘'n<<n . a-7 I S Truss Specification Provided C..)1^- Bracing y`Bracing/Bridging // / / /� (,,c�c V Joist hangers G'.-- ?5 g .!'e:' cX d FE • Jack Posts 1 Main Beams -YqLk._Exterior sheeting nailed properly��� r7 /^�°�iA Fr_d_rzival 12"O.C. Headroom 6 ft.8 in. Stairwells 36 in.or more K3 EE t) LL T CO is-AVETE Exterior Deck Bracing 1 CD -�.\7 0 F V p.rN A` tom. Headroom 6 ft.8 in. VC-1v�t * '( F_1�� -� Notches!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 Anchor Bolts 6 ft.or less on center Ice and water shield 24 inches from wall Fire separation 1,2,3 hour ��10 1 ‘ 1.. v L' O� Fire wall 2,3,4 hour J �_ \ \---4\-VE , Firestopping 4 Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation _ House side 1/2 inch or 5/8 inch Type X 03 ,�� � � Lc\ V'" ,`.,' 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 r v` Town of Queensbury Building & Code Enforcement F- l O am Office No. (518) 761-8256 n, Framing I Firestopping Inspection Report 4-lerliel' V-'"t A)0/-3 Man Inspection request received: ( ( -(sl�I3;iS nNa- Name: .li ,' U . ..:/... ... �l•-- Inspected on: I - 7 o1.D 1. Location: (.7g— 1141^44S o v, d i 43I14% Arrive: .oisf llIP a. .I p.m. Permit No.: C`'1''(/0 3 ` Inspector's Initials /` TYPE OF STRUCTURE: �. d. ea # M4.44w Y N NIA COMMENTS: ming Attic Access 22"x 30"minimum Jack Studs/Headers Truss Specification Provided ' "" Bracing/Bridging Joist hangers 1 Jack Posts I Main Beams . EL-1 -_ t �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. 4 — 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 7 i \J chor Bolts 6 ft.or less on center e 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 ---2:-&-:". ...., House side 1/2 inch or 5/8 inch Type X ' 1?e L \ wit`z Garage side 5/8 inch Type X P‘V‘ _\ Ceiling/wall Windows Habitable Space/Bedrooms / 'b 24 in. (H) 20 in. (W) 5.7 sf above 1 below grade 5.0 sf grade Design Professional Sign-off, if required Framing / Firestopping Inspection Report 1066A . Foundation Inspection Report Office No. (518)761-8256 Date Inspection request received: I d-e I Queensbury Building&Code Enforcement Arrive: am/pm Depart:i Gm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initial NAME: - 7lEtZpic.t1 /_`eCtienMPA4 PERMIT#: ! -(o O 3 LOCATION: t o PF 1 SPECT ON: ll-7/c)-61c TYPE OF STRUCTURE: lAlQ( 1-16)-1(L Comments 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 placeCfK.C14- "C-- / dation Dampproofmg Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing fimil fbz et areas under slab � kfill Approv�L_�► Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 fl. L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 p(z_ Foundation Inspection Report Office No. (518)761-8256 Date Inspection request received: i/(o/Jits1 Queensbury Building&Code Enforcement Arrive: am/pm Depart:4.66 am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:/4 � ,, 6/ NAME: U 47p 6K-C RMIT#: /% [ 2- 0 3 LOCATION: � J — .r y� ( t d. / SPECT ON: //(P/fir ` TYPE OF STRUCTURE: 4 G�r4.6 ! "" -"--.7-Q4c41(y "MSSF Comments Order - N N/A /' i 7[6)/9C ‘547 C �--- Footings /� Piers �J Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. this ose on site. Foundation/Wall o Reinforcement in Place '2-_ `Zc- p-u-<-->- -) 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\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 Town of Queensbury Building & Code Enforcement / ,�� Office No. (518) 761-8256 �`' Septic Inspection Report Inspection request received: Name: Ner-it-4 ALLI OA Inspected on: Location: I 1/ C 4S c,n Pi' Arrive: a.m.I p.m. Permit No.: f 'y-- to 03 Inspector's Initials: Comments and/or diagram Soil Type San Loam/Clay Type of a er: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+I- Y N N/A [150'to well required if NO] Absorption Field: Total length ft. Ok_V 4g G Length of each trench ft. Depth of trenches ft. Size of Stone .�,� � Seepage Pits: NumberA.\\%"—Z-) C7--)Z.) Size: x 6 C\ Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/Pit Opening Sealed: /7 N End Cap _N ,,��(,� Inlet/Outlet Pipes&Baffles N I ./t ,çE C Manholes 12"or less below grade [provide extension collar if Yes] Y N i Location/Separations —1 Foundation to tank ft. Foundation to absorption ft. Separation of Pits f ft. Conforms as per Plot Plan N Engineer Report and As-Built Y N ETU Maintenance Contract provided Y N Location of Syste on P perty: Front Re Left Side Right Side Middle Front Middle Rear S stem Use Statu-. Approved 'artial Al.-.ved and needs to be re-inspected, please call the Building&Codes Office :..roved Septic Inspection Report