RC-000322-2015 TOWN OF QUEENSBURY
742 Bay Road Queensbury,NY 12804-5904 (518)761-8201
ot Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000322-2015 Date Issued: Tuesday,November 15, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000322-2015
has been completed.
Tax Map Number: 308.9-1-17
Location: 692 LUZERNE RD
Owner: Justin Blaise
Applicant: Justin Blaise
This structure may be occupied as a:2nd floor addition to attached garage
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the n
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-000322-2015
Tax Map No: 308.9-1-17
Permission is hereby granted to: Justin Blaise
For property located at: 692 LUZERNE 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 /
Owner Name: Justin Blaise Single Family-Addition $15,000.00 /
Owner Address: 692 Luzeme RD Total Value $15,000.00 ✓✓✓
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Justin Blaise
692 Luzeme RD
Queensbury,NY 12804
Plans&Specifications
2nd floor addition to attached garage
$168.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,November 13,2016
(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 To Queen ury; n /� Thr a�� her 19,2015
SIGNED BY: ('jI yj�l('/ /vf for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION
Office Use Only
i ; Received
U
Date: oliz 'lots— Tax Map ID
1 j — 1 C:jj, Permit No. RC --UCV .3 ZZ-
Tax Map ID 3400 Permit Fee 4 1 fob .OU
Zone 1 (zs-aa 4,a\ Rec Fee
Historic Site _Yes No Site Plan #
__.._.
Subdivision Name Lot# Subdivision#
Project Location 9a Lu ter r, e- ROLI-d
TOWN BD.RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family,
multiple family,apartments,condominiums,townhouses,and/or manufactured&modular homes, but not mobile
homes. This is in addition to the permit feels).
Applicant 7tSNAn ?6\alSe Owner StyS44r1 rz.� L045
Address qac fit) �nC mac] Address (oI a j, oZ*_-rne, Icl
I�Jeens 6u r ivy �ee>, a I_�y
Phone/E-mail _a _ (02�j O Phone/E-mail S $ a�a—l9 � O
f'�1 A S�32o l( G)Sct
Contact Person for Building&Codes Compliance: _7313,Si i r% fbl a;S Z Phone 5I8 -oVaL-6
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration 1s'floor sf 2nd floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(#of units_)
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attach(,Aage
m e
�" ce2 pl "I0�0nD 'lq � aH � t (oFT
(1, 3° 4+)
SX IS
Other
If commercial or industrial please indicate of business
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015
Proposed use of building or addition
Source of Heat(circle one) Gas Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys N A
Are there structures not shown on plot plan? ,V D
Are there easements on the property? lu C
Site Information
a. Dimensions or acreage of lot a• b y I P c ce-S
b. Is this a corner lot? yes
c. Will the grade be changed as a result of construction _ Yes _ No
d. Public water or Private well Pu b 1 C Wo4t� c-
e. Sewer or Private Septic System Pr"V0J4z Stp+iG S 5k0'wN
Value of all work to be performed (labor or materials) $ I Si o00
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 NYS Building Codes,local building
laws and ordinances, and in conformance with local zoning regulations
4. 1 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 have read and agree to the above:
PRINT NAME: mis-u i n e i o a s P DATE: I I 20(.5-
SIGNATURE:
0tSSIGNATURE: aoDATE: 1 2 ? S
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 Application Revised September 2015
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LUZERNE
ROAD
"I have seen or obseried, or believe I saw evidence of,
all objects - as ouses, wells, trees, fences, etc..
--hown this oacument. I ai ' rep sent that I have (���yy��
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on the diagrah."CJ
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alf objects s as ouses, wells, trees, fences, etc.,
shown this document I of � reo sent that I have
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REScheck Software Version 4.6.2
Compliance Certificate
Project BLAISE ADDITION
Energy Code: 2010 New York Energy Conservation
Location: Warren County, New York
Construction Type: Single-family
Project Type: Addition
Climate Zone: 6 (7635 HDD)
Permit Date:
Permit Number:
Construction Site: Owner/Agent: Designer/Contractor:
QUEENSBURY, NY BLAISE,JUSTIN BLAISE,JUSTIN
QUEENSBURY,NY QUEENSBURY, NY
Compliance: Passes using UA trade-off
Compliance: 2.9%Better Than Code Maximum UA: 102 Your UA: 99
The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
Envelope Assemblies
Gross Area avi Cont.
Assembly or U-Factor UA
Perimeter R- all e R-Value
Ceiling 1: Fiat Ceiling or Scissor Truss 440 38.0 0.0 0.030 13
Wall 1:Wood Frame, 16"o.c. 558 21.0 0.0 0.057 23
Window 1:Wood Frame:Double Pane with Low-E 150 0.320 48
Floor 1:All-Wood Joist/rruss:Over Unconditioned Space 440 30.0 0.0 0.033 15
Compliance Statement: The proposed building design described here is consistent with the building plans,specifications, and other
calculations submitted with the permit application.The proposed building has been designed to meet the 2010 New York Energy
Conservation Construction Code requirements in RESCheck Version 4.6.2 and to comply with the mandatory requirements listed In
the REScheck Inspection Checklist.
TVs+r� X31/41.«
Name-Title Si re Date
NOTICE
KRAFT PAPER INSULATION -
MUST BE COVERED BY
Priem Or OUriif
NON-COMBUSTIBLE BARRIER vizi oI r comments s ; hP n_,[V� 35
mlicalmg tihe plans and s-)-rdfcations are in 22 -2g1s
full compliance with the Building Codes of Daae
New York State. C
NOTICE
FOAM INSULATION MUST BE
COVERED BY A 15 MINUTF
THERMAL BARRIER
Project Title: BLAISE ADDITION Report date: 11/10/15
Data filename: C:\Users\stevef\Desktop\plans\BLAISE\BLAISE.rck Page 1 of 6
REScheck Software Version 4.6.2
Inspection Checklist
Energy Code: 2010 New York Energy Conservation Construction Code
Requirements: 0.0% were addressed directly in the REScheck software
Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each
requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception
is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided.
section Plans Verified Pield Verified
# Pre-inspection/Plan Review Value Value Complies? Comments/Assumptions
& Req.ID
103.2 Construction drawings and ❑Complies
[PR111 documentation sufficiently ❑Does Not
demonstrates energy code []Not Observable
compliance for the building
envelope. ❑Not Applicable
103.2, Construction drawings and ❑Complies
403.7 documentation sufficiently ❑Does Not
[PR311 demonstrates energy code ❑Not Observable
14 compliance for lighting and
mechanical systems.Systems ❑Not Applicable
serving multiple dwelling units
must demonstrate compliance
with the commercial code.
403.6 Heating and cooling equipment is Heating: Heating: ❑Complies
[PR212 sized per ACCA Manual S based Btu/hr— Btu/hr_ ❑Does Not
d, on loads per ACCA Manual J or Cooling: Cooling: []Not Observable
other approved methods. Btu/hr— Btu/hr— ❑Not Applicable
Additional Comments/Assumptions:
(_1g p (Tier 1) ]Medium Impact(Tier 2) 3 Low Impact(Tier 3)
1 Hi h Im ad ��_
Project Title: BLAISE ADDITION Report date: 11/10/15
Data filename: C:\Users\stevef\Desktop\plans\BLAISE\BLAISE.rck Page 2 of 6
Section
# Foundation Inspection Complies? Comments/Assumptions
& Re .ID
303.2.1 Exposed foundation Insulation ❑Complies
IF01112 protection. ❑Does Not
U' ❑Not Observable
❑Not Applicable
403.8 Snow melt controls. ❑Complies
[FO12]2 ❑Does Not
01' ❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
1 I High Impact(Tier 1) -[YMedium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: BLAISE ADDITION Report date: 11/10/15
Data filename: C:\Users\stevef\Desktop\plans\BLAISE\BLAISE.rck Page 3 of 6
Section pians Verified Field Verified
# Framing/Rough-in Inspection Value Value Complies? Comments/Assumptions
& Re .ID
402.4.4 Fenestration that Is not site built ❑Complies
[FR20]1 is listed and labeled as meeting ❑Does Not
AAMA/WDMA/CSA 101/l.5.2/A440 ❑Not Observable
or has infiltration rates per NFRC
400 that do not exceed code ❑Not Applicable
limits.
402.4.5 IC-rated recessed lighting fixtures ❑Com lies
[FR16]2 sealed at housingfinterior finish []Does Not
U and labeled to indicate&It;= 2.0 []Not Observable
cfm leakage at 75 Pa.
❑Not Applicable
403.2.2 All joints and seams of air ducts, ❑Complies
[FR13]1 air handlers,filter boxes, and ❑Does Not
9, building cavities used as return ❑Not Observable
ducts are sealed.
❑Not Applicable
403.2.3 Building cavities are not used as ❑Complies
[FR15]3 ducts or plenums. ❑Does Not
[]Not Observable
❑Not Applicable
403.3 HVAC piping conveying fluids R-_ R-_ ❑Complies
[FR17]' above 105 OF or chilled fluids ❑Does Not
J below 55 OF are insulated to R-3. []Not Observable
❑Not Applicable _
403.4 Circulating service hot water R-_ R-_ ❑Complies
[FR18]2 pipes are insulated to R-2. ❑Does Not
U, ❑Not Observable
❑Not Applicable
403.5 Automatic or gravity dampers are ❑Complies
[FR19]' installed on all outdoor air ❑Does Not
intakes and exhausts. ❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
I.1 jHigh Impact (Tier 1) 2]medium Impact(Tier 2) 3 1 Low Impact(Tier 3)
Project Title: BLAISE ADDITION Report date: 11/10/15
Data filename: C:\Users\stevef\Desktop\plans\BLAISE\BLAISE.rck Page 4 of 6
Section
# Insulation Inspection Complies? Comments/Assumptions
& Re .ID
303.1 All installed insulation labeled or ❑Complies
[IN13)' installed R-values provided. []Does Not
�! ❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
1 1 Nigh Impact(Tier 1) L41Medwm Impact(Tier 2) 13 11-ow Impact(Tier 3)
Project Title: BLAISE ADDITION Report date: 11/10/15
Data filename: C:\Users\steveADesktop\plans\BLAISE\BLAISE.rck Page 5 of 6
Section Plans Verified Field Verified
# Final Inspection Provisions Value Value Complies? Comments/Assumptions
& Re .ID
402.4.2, Building envelope tightness ACH 50=_ ACH 50 =_ ❑Complies
402.4.2.1 verified by blower door test result ❑Does Not
[FI17]2 of<7 ACH at 50 Pa.This
41 requirement may instead be met ❑Not Observable
via visual inspection, in which ❑Not Applicable
case verification may need to
occur during Insulation
Inspection.
403.2.2 Duct tightness via post- _cfm _cfm ❑Complies
[FI412 construction with maximum ❑Does Not
91 leakage of 8 cfm to outdoors, or ❑Not Observable
12 cfm across systems. For
rough-in tests,verification may ❑Not Applicable
need to occur during Framing
Inspection,with maximum
leakage of 6 cfm across systems
and 4 cfm without air handler.
403.1.1 Programmable thermostats ❑Complies
[FI9]2 installed on forced air furnaces. ❑Does Not
0 []Not Observable
❑Not Applicable
403.1.2 Heat pump thermostat Installed ❑Complies
[FI10]2 on heat pumps. ❑Does Not
V ❑Not Observable
❑Not Applicable
403.4 Circulating service hot water ❑Complies
[FIJI]2 systems have automatic or ❑Does Not
14 accessible manual controls. ❑Not Observable
❑Not Applicable
401.3 Compliance certificate posted. ❑Complies
[FI7]2 ❑Does Not
[]Not Observable
❑Not Applicable _
303.3 Manufacturer manuals for ❑Complies
[FI18]3 mechanical and water heating ❑Does Not
Q equipment have been provided. ❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
j 1 High Impact (Tier 1) _ - ��Medium Impact(Tier 2) 13 Low Impact(Tier 3)
Project Title: BLAISE ADDITION Report date: 11/10/15
Data filename: C:\Users\stevef\Desktop\plans\BLAISE\BLAISE.rck Page 6 of 6
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No.QL'�j22•Q�tS..art. N2 29159 Cut-in Card No.....................................
Owner..........//.....'T....1.%.L �. .......................n........................................../.........................................
Location... ...... .......l�i ...............................(.a..�4 ............
Installation Consisting of .1. ..�:�.y....C , _
...........................................................................................................................................
....................................................................................................................................................................................
InstalledBy.................�x&.6'....................................................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making ' p ctions at any time, and if its
rules are violated,the Company shall have the right to v this rt11.� at��%� �
Date.../'—..-. '.r ........... INSPECTOR.... .... ....... .........'//.........................................
Member N.F.P.A.,I.A.E.I.