RC-000570-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000570-2016 Date Issued: Wednesday, February 8, 2017
This is to certify that work requested to be done as shown by Permit Number RC-000570-2016
has been completed.
Tax Map Number: 265.-1-6
Location: 55 Ellsworth LN
Owner: Robin Ellsworth,Joel Monroe
Applicant: Joel Monroe
This structure may be occupied as a: Single-Family Dwelling 1,387 sq. ft. with
gas fireplace insert;240 sq.ft.deck;and new septic system. By Order of Town Board
Cross Ref. Area Variance PZ 151-2016 T VW ov&'
Issuance of this Certificate of Occupancy DOES NOT relieve the
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-000570-2016
Tax Map No: 265.-1-6
Permission is hereby granted to: Robin Ellsworth,Joel Monroe
For property located at: 55 Ellsworth LN
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
Tvce of Construction
Owner Name: Robin Ellsworth Single Family-New $160,000.00
Owner Address: 55 Ellsworth LN Total Value $160,000.00
Lake George,NY 12845
Contractor or Builders Name/Address Electrical Inspection Agency
Valued Homes
1572 Route 9
Fort Edward,NY 12828
Plans&Specifications
Single-Family Dwelling 1,387 sq.ft. with gas fireplace insert;240 sq.ft.deck;and new septic system.
Cross Ref. Area Variance PZ 151-2016
$1,127.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,September 8,2017
(If a longer period is required,an application for an extension most be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Fi day,, t; [et er 9 2016
r77J
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
a . I--- I �. vias va vaw aaaa a.ava aaa va i Vlllyu usu VIIIV
Pate: ey '1fI/6o Permit No.
Tax Map ID G[�, —/-6 Permit Fee 7.10
Zone / R-31q Historic? _Yes X'No Rec Fee SW
Subdivision Name Lot# Site Plan#
Subdivisio #
Project Location -ST94s1 kzr>y �L.tk£G�£o i1/,vM_4614'
AZ lv.1oi�0
TOWN BD.RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two ilMM-010 family,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the
permit fee(s).
Primary Owner(s)
OlG aiv/tdl �'� i�.� S,vd2Tf
Address S�St<LL r�onT L �� k� ,�tiv/z8
Phone/Email
Applicant
Address
Phone/Email
Contractor
Address 15-77- /ZlLf Azr 6WAAD /�/
Phone/Email 7 j —! 66
Contact Person for Building& Codes Compliance: 3042- Ylam"'r— Phone 36I yc5S,
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration 11 floor sf 2°a floor sf Total sf Height
Single Family VT
IS8 J7
Two-Family U tJ/ [�
Multi-Family
(#of units
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
Other_V4 l_ X'0 /
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business
Proposed use of building or addition SIN�G� � 5� �/.�Gt[Ti✓�
Source of Heat(circle one) Gas Oilropane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances & Chimneys
Are there structures not shown on plot plan? syn
Are there easements on the property?
Site Information:
a. Dimensions or acreage of lot S
b. Is this a corner lot? Yes _No
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well (circle one) Publicrtvate
e. Sewer or Private Septic System(circle one) SewerHate
Value of all work to be performed(labor or materials) $ d 000
DECLARATION.-
1.
ECLARATION.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. 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 have read and agree to the above:
PRINT NAME: 1-0 -MO'V t DATE: VZ
SIGNATURE: /i�� _ DATE: TT d
For office use onl
Operating Permit Issued: —Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
SEPTIC DISPOSAL APPLICATION Office Use Onlv
Received
DATE: oyzZ Z( Tax Map ID
TAxMAPID: z(of —14 Permit No. d.
C S'70 - 0/(0
Permit Fee
ZONE: /ZR 3A-
APPLICANT .Tpt=Gl wRa� �-n�! PHONE//E-MAIL c
ADDRESS Fel l�Jv/LLV�- k�d/:f&ni7r VtJ[Zs/-r
INSTALLER/ PHONE/EE-MAIL
BUILDER p
OWNER 914134tJF-llfL.*)ATH
ADDRESS Z& F jW,9 T '�5rT n .a'161i^'r Gy-�
CONTACT PERSON FOR BUILDDIING&CODE COMPLIANCE: /C 1 BW �L/
PHONE/E-MAIL 3lP�f/ V^`/154981 Cfi✓A�'�.[A•-,
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed Yes X No
1981-1991 Spa or Hot Tub installed —Yes _eNo
1992-Present 3 110 &P o 3 c9 6-PD
PARCEL INFORMATION
Topography Flat rolling _Steep slope %Slope
Soil Nature Sand _Loam Clay _Other
Groundwater At what depth: /1/0nN/y 1z-6, r v i.ERZ r 0
Bedrock/Impervious material At what depth: ii49WE 4 Oo !j T/L£JO
Domestic Water Supply Municipal _X_Well(if well,water supply from any septic system absorption is LW ft.)
Percolation Test Rate: mtW sL per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size jjgL gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length / O ft.;Each Trench
N4 Seepage Pit with#3 stone How many: _;Size
Nib Alternative System Bed or other type:
N,+- Holding Tank System Total required capacity? 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 known by or on behalf of an applicant,shall be void. I have read the regulations and agree to
abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
PRINT NAME: o, z- DATE: 8124;1116
SIGNATURE: /'®J DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
Fuel Burning Appliance & Chimnby Application Office Use only
Received
DATE: Tax Map ID
TAx MAP ID: Permit No. C 5--m l
3� Permit Fee
ZONE:
OWNER PHONE/E-MAIL
Ro lti F wo�r
ADDRESS Ss—��s A';l 123'Vs—
INSTALLER/ PHONE/E-MAIL
BUILDER 7ZTjA/ INp��rS`��N��L/JIkA/uF7[Tw({�
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: SHElI/1L gvzTbu ✓.FG 140 h6 Mk /
PHONE/E-MAIL BUILDING ADDRESS /572/1IAAr6L",tt2 /IIY
ZZ
ROOM OF INSTALL: LZ V N�Rck)ol PLANNED INSTALL DATE:
FUEL BURNING APPLIANCE INFORMATION WOOD COAL PELLET GAS OIL NOTE: ROUGH-IN&
STOVE FINAL INSPECTION ARE
FIREPLACE INSERT REQUIRED.
FIREPLACE,FACTORY BUILT* NOTE:
FIREPLACE,MASONRY MANUFACTURER'S
INSTALLATION MANUAL
FURNACE(GARAGE ONLY) MUST BE AVAILABLE AT
TIME OF INSPECTION
*If factory built provide manufacturer name: u o ra ; Model#:
Listed by: Number:
CHIMNEY INFORMATION
Masonry** (check one) . _BLOCK —BRICK _STONE
Flue _TIE _STEEL YPSize in inches
Material _ DOUBLE WALL _TRIPLE WALL _INSULATED
** If non-masonry provide manufacturer name: S u)7Cg r'o,Q ; Model#: 56 V3.5——ii/
DECLARATION: Construction/installation must conform to NYS Fire Prevention & Building Code and/or
manufacturer requirements. 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 inspector's to enter premises
to perform required inspections.
I HAVE READ AND AGREE TO THE ABOVE:
PRINTNAME: DATE: 9110fl1h
SIGNATURE: DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
7
265.00-1 -6 RC 570-2016
Joel Monroe & Robin Ellsworth
55 Ellsworth Lane
SFD (cross ref. AV PZ 151 -2016)
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77777771
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DIVISION OF BUILDING STANDARDS AND CODES
STATE OF NEW YORK
DEPARTMENT OF STATE
ONE COMMERCE PLAZA
99 WASHINGTON AVENUE ANDREW M.CUOIAO
ALBANY,NY 12231-0001 GoV_PIDP.
TELEPHONE:(516)474-4073 ROSSANA ROSADO
M".DOS.NY.GOV Aunm SECRETART OF STATE
May 23, 2016
Bozana Miladinovich
Compliance Manager
Champion Home Builders, Inc.
755 West Big beaver Road, Suite 1000
Troy, MI 48084
RE: Extension#1 to approved system M017-2010-123
Tracking Number for Renewal: M017-2016-013
Dear Ms. Miladinovich:
This letter is to inform the Code Enforcement Official that the New York State Department of State(DOS) has
granted the extension of the current expiration date of May 22, 2016 to allow the construction of factory
manufactured Detached One and Two-Family and Townhouse models under the system approval
designated M017.2010-123:The extension will allow additional time for review of the documents for
compliance to the newly adopted 2015 Codes.
The manufacturer shall be responsible for assuring that the dwelling units or components bearing insignias
issued during the extension period comply with the requirements of the Residential Code of New York State_,
2010 Edition.This extension will expire on October 3, 2016 unless sooner replaced by full approval r the
System renewal
When submitting an application for a building permit to the local code official, please provide a copy of this
letter along with the original approval letter, dated May 22, 2014 as well as the plans and specifications that
have been stamped approved by our office.
Sincerely,
Don Thomas Jr.,AIA
Division of Code Enforcement and Administration
Cc: Rick Wenner, PFS Corporation (email)
Tem Heckman, Glenco (emailed)
MA' F K Department
STATE OF
OPPORTUNITY of State
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION,
PRE-ENGINEERED WOOD CONSTRUCTION AND/OR TIMBER
CONSTRUCTION IN RESIDENTIAL STRUCTURES
(In accordance with Title 19 NYCRR PART 1265)
City of Lake George
TO: <Insert the name of the authority having jurisdiction here>
OWNER OF PROPERTY: Ellsworth (GC-16-539)
SUBJECT PROPERTY(ADDRESS AND TAX MAP NUMBER):
54 Ellsworth Lane
Queensbury NY 12804
PLEASE TAKE NOTICE THAT THE(CHECK ALL THAT APPLY):
X New Residential Structure
❑ Addition to Existing Residential Structure
❑ Rehabilitation to Existing Residential Structure
TO BE CONSTRUCTED OR PERFORMED AT THE SUBJECT PROPERTY REFERENCE ABOVE WILL UTILIZE
(check each applicable line):
X Truss Type Construction (TT)
X Pre-Engineered Wood Construction(PW)
Timber Construction (TC)
IN THE FOLLOWING LOCATION(5) (CHECK APPLICABLE LINE):
❑ Floor Framing,Including Girders and Beams(F)
❑ Roof Framing(R)
X Floor Framing and Roof Framing(FR)
SIGNATURE: DATE:
PRINT NAME:
CAPACITY(Check One): ❑ Owner ❑ Owner's Representative
REScheck Software Version 4.6.1
Compliance Certificate
Warning: It is a violation of the NYS Education Law Article 145 for any person,
unless he is acting under the direction of a licensed Professional Engine—
to alter this item in anyway.
Project GC-16-539-VALUED-ELLSWORTH-MOD19-663
Energy Code: 2010 New York Energy Conservation '
Location: Warren County, New York 3 X
Construction Type: Single-family • i I1O
Project Type: New Construction 1
Conditioned Floor Area: 1,387 111:2 / •��
Glazing Area 14%
CllmateZone: 6 (7635 HDD) ` 07/29/16
Permit Date:
Permit Number:
Construction Site: Owner/Agent: Designer/Contractor:
54 ELLSWORTH LANE VALUED HOMES CHAMPION HOME BUILDERS,INC
QUEENSBURY,NY 12804 1572 ROUTE 9 (DIVISION 19)
FORT EDWARD,NY 12828 P.O.BOX 177
518-793.1266 951 ROUTE 12 SOUTH
SANGERFIELD,NY 13455
315-841-4122
Compliance:Passes using UA trade-off
Compliance: 0.0%Better Than Code Maximum UA: 206 Your UA: 206
The%Better ar Worse Than code index reflects how close to compaance the house Is based on code tradeoff rules
It DOES NOT Pe Wde an estimate of energy use or cost relative to a mlNmum•code home.
Envelope Assemblies
Gross Area
Assembly or Cavity Cont
Ceiling 1:Flat Ceiling or Scissor Truss 1,387 30.0 18.0 0.022 31
Wall 1:Wood Frame,16"o.c. 1,259 24,0 0.0 0.054 58
Window 1:Vinyl/Fiberglass Frame:Double Pane with Low-E 109 0.310 34
Door 1:Glass 40 0.320 13
Door 2:Solid 21 0.280 6
Door 3:Glass 21 0.300 6
Floor 1:All-Wood joist/Truss:Over Unconditioned Space 1,387 22.0 0.0 0.042 58
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 4.6.1 and to comply with the mandatory requirements listed in
th REScheck Insp tion Checklist.
AmEP Lns� 1�vi��lslnov b�� '712516901&
Name-Tie nature a
Project Notes:
FLOOR INSULATION ON SITE BY OTHERS: ANY DEVIATION FROM THE ATTACHED PLANS AND RESCHECK SHALL BE
THE RESPONSIBILITY OF OTHERS AND NOT CHAMPION HOME BUILDERS, INC (DIVISION 19)OR THEIR AGENTS.THE
BUILDER/DEALER IS RESPONSIBLE TO PROVIDE THE BUILDING DEPARTMENT WITH A RESCHECK IF THE ASSUMTIONS
Project Title:GC-16-539-VALUED-ELLSWORTH-MOD19-663 Report date: 07/25/16
Data filename: M:\ENG\DWGS\New pinnacle series\MODS\MODULAR\12-DR-PDF\ELLSWORTH\Untitied.rck Page 1 of 2
IN THIS RESCHECKARE NOTADHEREDTOO.
Warning:Itis a violation of the NYS Education Law Article 145 for any person,
unless he is acting under the direction of a licensed Professional Engineer,
to after this item in anyway.
Project Title: GC-16.539-VALUED-ELLSWORTH-MOD19-663 Report date: 0725116
Data fifenanne: M:\ENG\DWGS\New pinnacle series\MODS�MODULAR\12-DR-PDF\ELLSWORTH1Untitled,rck Page 2 of 2
Jab True a T..Type any ply Champion Homes 212
81069 HMC38303 HINGE MONO 1 1
Unbarsel Foast P dune Inc.,Grand Rapids,MI 49525.Mika Paden 7.610 a Jan 292015 MRek Industries.nc Mon Nov 2311:05:53 2015 Pape 1 of 2
Copyright c�2015 Universal Forest Products,Inc.All Rights Reserved
0.68 2x-11 11-65 12
0x'8 11'
BIRDCAGE DETAILSMHIBB 8
�21x 5
xd=
23.1 I
14T2 (M-5
2xS\\
5.00 12 (ane face)
SMHIB0 j-
2.5x4\\4 1.5x4= 11 p
R 3 1x3 II
12 5� W
$ �I' B1 =_
10 9 g
3.5x5_ 1x3 II Uri II
2-3-11 5.45 5-68 4x7=
Plate Offsets 2:(Y1F20-0-14 3:0.2-00.1 d:6136}7 21, 5:66061-0 &o-2462 12:61-10.08
SPACING-:280 SPACING-:144 SPACING:1-0-0 SPACING- 280 CSL OEFL b poc) I/dell tM PLATES GRA
TOLL (psf) LC.cDING(pail TCULOAG(pefl Plate Grip DOL 1.15 TC 0.97 Vert(LL) 4.26 8.9 >586 240 MT20 197/144
TOLL 00) TCLL 89.3 TCU 92.4
(Ground 5navr-600.0 (Omura Snow=90.0) (Ground!Smvr1220) RepLumber em,I 1ES BC 0.91 Ve (TL -0.63 8-9 >21a 180 Mi16H5 197/1M
TCDL 10.0 TCLL 15.0 TCLL g0,0 Rep IBC2009f YES WB 0.73 Hoa(TL) 0.04 8 Na Na
BCLL 0.0• BCLL 0.0• BCLL 0.0• Code IBC2009RP1200] (I4ahix) Weight 586
SCOL 10.0 SCDL 15.0 BCDL 28.0 Fi•0%
LUMBER- BRACING.
TOP CHORD 2x4 SP No.1•Excepr TOP CHORD Structural wood sheathing directly appmrI, except end wrtecab. (P)
T2:210 SPF 10fi0F 1.5E,T3:a4 SPF No.2 BOT CHORD Rigid caNng diraWY applied or 2.2-0 oc bating.
8OTCHORD 2x4 SPF 1650E 1.SE WEBS 1R.at Maps 33
WEBS 2x3 SPF Stud'Excepr JOINTS 1Baco at Jt(a):11
W2:2.4 SPF Na.2,WB:2x8 SPF No.2
REACTIONS. (Homos) 2=1014038 (min.0.1-11),8-8251)38(mm.0.1-9),7--WerAaNeal
Max Haa2-203(LC 9),7=172(LC 14)
Max UpM2=221(LC 9),8•-242(1.0 9)
Max Grave-1092(LC 14),8=1008(W 14)
FORCES. (b)-Maximum ComprossimnlllnSnun Tension
TOP CHORD 1-2.020,2-14=-1988/330,1417=1883rJ38,11]=iBe7936,}15=7701%,415=]62/56,418�i63fJ],516=-480.45,58=-257/52,6-7=192/58,&11=]23/185
BOT CHORD 2-10--531/1588.9-10=332/1588,8-9=532/1586
WEBS 1,0.096/,}12•-1319M34,412=1321H]2,511=T/3285,&12.0165
REQUIRED MEW JOINT CONNECTIONS -Maximum Compmssion(b)/Maxknun Tanslon(by Maximum Shear Ob)/Maxknum MomentM4n)
e-2305592N,11=T73265275N
NOTES-
1)Dodo:0-2-10 length x 6412 deep dodo,65-B to tight edge from lent 4 on the by face.
2)Wind:ASCE 7-05;9Omph C24n ea;TCOL-3,W,,SCDL-3.Opst(AIL 110mph®18n a.o;TCOL=4.5peY,BCDL=4.5ps0;(AB 127mph®12in o.c:
TODL-6.0PS1.SCDL•6.0Ps0;he";CaL II;Ev G mooned;MINERS row-rise)gable errd zone send CC ENerim(2).;C-C far member and fomes 8
MWFRS for reaction,tlaAn;Lumber OOL•1.88 plata grip DOL=1.60
3)TCLL:ASCE 745;P9=60.0 psf(ground arrow);Ps=46.2 psf(root snau);Category 11;EV C;Partially Elp.;C1=1.1
4)Roof design snow bad has been mchicetl to account for slope. E-signed by KBvin Freeman
5)Unbalanced snow loads hew been careadenid for this design.
6)This Was has bean designed fro greater of mn roof iw bed of 19.0 psf or 2.00 dome fiat roof bad or 46.2 pad an owmangs noncanaannt with aIN4Y
other 9.e baa,. -a10ON W Eq�'ai.
8)Thbates has been dates udfor bask:load dens,which nrJutle ones with reductions for mdlyde conwrrcnlNw bads P- �.
8)N plans are LATE plates unkss plheaiseMet.indicated.
9)See FIINGE PLATE DETAILS forplate placement. O� flEBISTERFU
10)AN sakfido mustbemean ne Prevent oleo,mowmmt d hers memberta)during;tranaporla0arn.
11)Nstuss has been
s0. bepraddedbymherslood forces as eerrt V ROFESSIONAL 'n
12)This trust has been designed
far a 10.0 psf bottom NON Iw bed nonwncd!In wre any other aro bade.
13)•This hens has been any oche for a Bw bed d 20.OpMon the bottom NON n al areae when a rectangle 3-0-0Ial by 280 wide roil fit between
Ne idem NON and any other members.
14)Providemechanical has
connection(by others)ndgreor messtobearir9Cletecapable d.6, S INCSerbn80.10.2.uphill at 2antl 242b Wld at joint R.
15)TM,truss has been designed in ac amsu w ih Ne 2009180 Section 2303.4.8,2 IRC Sao
S 10802.10.2
18)This busshas been eep designedinas in plane,with Ne208,1ISO Sec offfia.22e plate Sst8(1210.2
1])Take rather W keep the Mads n plane,airy bendnp or design.
el Ne hire plate muatbe professional to spa before Na b=nq ti put nd t e porn
18)The orfs. N field members an an Magni pari of the fasti design.Retain a deignloadinot to buss. his flab cannelp2m,and temporary
1a
supports. Al Belbinstaletl member must bepropeayfaslenetl poor to appyinO any bailing to fin bus,.This design mtirlpafes the fuel set posilbn. y^/S YLV P'/i�
The Professional engineering seal ndicates that a Icented professional has revfe red Gsa design un lerthe aMntlards referenced within Nis document ++yNaa
rel necesscAy Na wren,state building rode.The engineering seal k rel an approval to usefin a specific state The final determ sten w whether 1/11/2016
a Vasa design b accepUNe wderthe bcaly adopted buatlhp cotle rest with the buNng ofBdY w designated appdnlee.
® WARNING -Verify design parameters and READ NOTES Universal Faretl Pradcts,kw 2601 EAST BELTUNE RD,NE
Truss Mal not be as or modified without appmwl ofthe bass design engineer PHONE(618)364.6161 FAX(616)3650060 GRAND RAPIJS,MI49525
This component has any been designed for the bads noted on this dmw q.ConsWdionand IhngforceshawnotbeenwnWdemd.Thebuild.risresponsible
for118ng methods and system design.Buatlaresponsibfkdes aro defined under TPli.This design is based only upon parameters shown,and is for
an bdivbuel bolding coaponanl W be insaped antl leaded wNcoly.Applcabli,y o1 design parameters and proper nwnpaatlon of wmpanant Is responWbBty of bulUbg
designer-not baaa deaigner.Bracing shown is farletersl support of in indaualwb members any.A ldNovl temporary bocing to insure aMdtiry Nrinp wn.Wd'an
k Na responsibility of the.moor.Additional permanent braWng arms gwrxl strum b Ne responsibility of the buildrn9 designer.Forgenenl9Wdence regarfing
fabrication,qualry coned,storage,delwry,emotion and bracing,consult BCS!1406 from the Wood Truss Cound of Ammiaa and Truss Plate Ins irde Recommendation awi sm.
from WTC .6300 Ent.mdse LN,Madison,WI53719 J:bupparOMhekSuppYemplaleaWfPtps
Job Truss Dy �/ Champion Homes 212
81069 HMC38303 HINGE MONO 1 1
Ualvaraal Forest P,tqductslnc.,Grand Rapids,MI 49525,Moo Fallen 7.610 a Jan 292015 Wt.k Industries,Inc Mon Nov 2311:05:532015 Pago 20 f2
CopyrightU2015 Universal Forest Products,Inc.All Rights Reserved
19)This Mass has been designed N aowrdenca with 2010 RCNVS See 8902.1(1.2
20)Based an HMCM302
21)Reduced worhoung ham 0.11-0,add"2006 code
The Professional engineering seat indiutiss Mat a licensed professional has nvimwtl the design under Me standards referenced within this doamenL
not necessally the anent stale budding code.The engineering seal is not an approval to use on a specific stats The final deletmeatioo an wMther
a Mass design Is acceptable under the Iooally adopted budding code rest mill Me building ofhoial or designated appointee.
® WARNING -Verify design parameters and READ NOTES Universal Forest Products,Inc. 2801 EAST 13ELTLINE RD,NE
Trust has not be at or modeled without appoW of Me was design engineer. PHONE(616)416C61611 FAX(616F365-0O60 GRAND RAPIDS,MI49525
This wrponenthas only been designed farina bads noted an Mia dowing.Cambadion and il0ing forceshave not been mnsieerotl.Thewiderbres,.vible
IordNng methatla and ayabm tleaipn. Buddarrospon,INGks are deMetl underTPll.This designbbaaatl any uponpwmeten shown,and is for
an individual building component b be installed and loaded vertically.Appsoabiilly of design parameters and proper Iron p ration of wm{wnent is responsibildy of bulling
designer-not bass designer.Boding sham is for island support of InalMdual carob members only.Atldhbnal temporary braving to insuro stabSy during consvudon
4 the resporooday of me ena3a,AdMhun l permanent bring of the owraa structure 6 Me napon i blit'of Me budding designer.For general guidance regarding
fabrice0on,quality consist,sewage,delivery,erodon and baoing,consult BC611-06 from to Woad Truss Cound of Amerfu and Truss Plate Inti Rewarnenda9an evadable
tom WfCA,6300 Enlarydn LN,Madison,WI53]79 J:UupportVrdekSuppVemleatealulp.tile
lab I
1W I
UNWERSAL FOREST PRODUCTS, INC.
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The professional engineering seal Indicates that a licensed professional has reviewed the design under the standards referenced within this document,not necessarily
the current state building code.The engineering seal is not an approval to use a design in a specific state.The final determination on whether truss design Is acceptable
under the locally adopted building code rest with the building official or designated appointee.
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2801 East Beldine,NE Grand Rapids, MI 49525-9736(616) 364-6161 Fax(616)365-0060
ufpi.Com
y STORMWATER MANAGEMENT PRACTICE SUMMAR VOLUME REOD SMP SMP AREA AREAS MANAGED IMPERVIOUS AREA VOLUME PROVIDED HOUSE,DRIVE,DECK 845 SF GRASSED (VAVERAGE DEPTH) 3978 SF 798 CF 845 CF DETENTION AREA ............EROSION CONTROL IMPLEMENTATION SCHEDULE ELLSWORTH PRACTICE IMPLEMENTATION TIME bURA TION OF PRA CTICE 44 PROP.2'W X 1'D ENTIRE PROJECT(REMOVE AFTER PRIOR TO CLEARING AND SOIL ROADSIDE SWALE FINAL SITE SEDIMENT CONTROL FENCE STABILIZ47YON AND DISTURBANCE VEGETA77ON ESTABLISHMENT)PROP.SILT FENCE 00 "S/O/V TEMPORARY SEEDING& UNTIL FINAL GRADING AND MULCHING ENT FFER INITIAL SITE GRADING A VEGETATION ESTABLISHM AREAS STORMWATER DETENTION 82o,?648",, PERMANENT 203-04' DURING FINAL SITE GRADING THER PERMANENT SEEDING&0 AFrER FINAL SITE GRADING VEGETATION STABILIZATION PROP.0 � WELL STANDARD SPECIFICATIONS FOR MULCHING DEFINITION 4,� _4P APPLYING COARSE PLANT RESIDUE Of? CHIPS, OR 07HER SUITABLE MATERIALS, TO COVER THE SOIL SURFACE.20' PURPOSE THE PRIMARY PURPOSE IS TO PROVIDE INITIAL EROSION CONTROL WHILE'A SEEDING-g&DWPL4rNG 4 -AND rOV16k -IS ESTABLISHING. MULCH MLL CONSERVE MOISTURE
SITE LO
OR SHRUB PLANTING PROP 24"WIDE PZPE-ZN-STONE -TEMPERATURE AND REDUCE FLUC A ON, OF BOTH.PARCEL 265.4-7 TU 77
MODIFY THE SURFACE SOIL'LANDS NIF OF ELLSWORTH ABSORPTION TRENCH, MULCH WILL PREVENT SOIL SURFACE CRUSTING AND AID IN WEED CONTROL. MULCH'DWEL4 (3)REQUIRED AT 60'LONG EA.
10— ISG SET, THS.
OACK TEMPORARY STABILIZATION IN NON-GROWING MON ISALSO USED ALONE FOR 180 LF TOTAL TO BE PROVIDED SYSTEM INSTALLATION NOTES
CONDITIONS WHERE PRAMCE APPLIES(SEE ABSORPTION TRENCH SECTION AND PROFILE FOR DETAILS) ON SOILS SUBJECT TO EROSION AND ON NEW SEEDINGS AND SHRUB 'PLANTINGS, CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWNG AND IN ACCORDANCE MTH THE N.Y.S. DEPARTMENT OF
MULCH IS USEFUL ON SOILS WITH LOW INFILTRATION RATES BY RETARDING HEALTH INDIWDUAL HOUSEHOLD SYSTEMS AND ASTM F481 INSTALLA77ON OF THERMOPLASTIC� PIPE AND CORRUGATED
RUNOFF. TUBING IN SEPTIC TANK LEACH FIELDS.CRITERIA 110.5'- SITE PREPARA77ON PRIOR TO MULCHING REQUIRES THE INSTALLATION OF NECESSARY
TRENCH AFTER EXCAVATION OF 24 VWDE TRENCH TO THE DEPTHS REQUIRED, THE WALLS AND FLOOR OF EACH
EROSION CONTROL OR WATER MANAGEMENT PRACTICES AND DRAINAGE SYSTEMS.
SHALL BE CLEANED AND RAKED IN ORDER TO LOOSEN SMEARED SECTIONS OF TRENCH.75'SID -AND SMOOTH THE SITE TO FIT NEEDS OF SELECTED MUL SLOPE, GRADE CH PRODUCTS.
REMOVE ALL UNDESIRABLE STONES AND OTHER DEBRIS TO MEET THE NEEDS OF THE PLACEMENT OF ABSORPTION TRENCH AGGREGATE SHALL BE AS SHOWN, AND CARE SHALL BE EXERCISED TO AVOID
ANTICIPATED LAND USE AND MAINTENANCE REQUIRED. INCLUSION OF FINE GRAINED SOILS AND WASTE MATERIAL IN THE ABSORPTION 'TRENCHES.99.5'DECK-PARCEL 265.4-6 APPLICA71ON RATES. THE PIPE AND STONE SHALL BE LAID AT THE GRADES INDICATED, MAINTAINING STRAIGHT CONTINUOUS GRADES CRE (2 BALES 1000 SF-±)LANDS NIF OF ELLSWORTH MULCH ��2 TONIA WTHOUT SAGS, [JUMPS,
SEPARATED JOINTS, OR OTHER UNSUITABLE CONDITIONS.
GARAGE 0.833-A C # ALL DISPOSAL r1ELDS SHALL BE GRADED TO :SHED RAINFALL -AND DIVERT ,SURFACE RUNOFF AWAY FROM' THE
DISPOSAL FIELD.TEST PIT SITE SOILS DATA
DO NOT USE HEAVY EQUIPMENT MTHIN THE ABSORPTION AREA AFTER TRENCHES HAVE BEEN INSTALLED.PARCEL 265.4-18 TP-1 - 7127116 BY: L.W. DOBJE, P.E.' - HUTCHINS ENGINEERING 100,6'DECK LANDS NIF OF STEVEN GARAGE 0-6" TOPSOIL THIS SYSTEM IS DESIGNED FOR WATER CONSERWNG FIXTURES AND IS NOT DESIGNED -TO ACCOMMODATE EXTREME
SON-- --- --- ---------- WATER USE OR EXTREME ORGANIC LOADING DEWCES SUCH AS JACUZZI TYPE SPAS OR GARBAGE GRINDERS.
6-36" RED-BROWN FINE SAND 0 36-54 BPowN vERYnNE SAND, TI CELLAR AND SURFACE WATER DRAINAGE MUST BE EXCLUDED FROM THE WASTEWATER TRACE SILT WISOME COBBLES SYSTEM.68.2'- 54-56" LIGHT BROWN VERY FINE SAND 56-68 RED-BROWN FINE SA SYSTEM MATERIAL SPECIFICATIONS 113.4' ABSORPTION TRENCH AGGREGATE BOULDERS @ 68", ROOTS TO 54"P P_
T. Cr TO 1 WASHED CRUSHED STONE.BOUNDARY CONDITION CONSIDERED @ 54" STONE IS TO BE 314 -112
EFFLUENT FILTER
SUITABLE WASTEWATER ABSORP77ON FIELD., EFFLUENT FILTER TO E, 1.116-INCH FILTRATION, POLYLOK PL-122.'�4 SEPARA TiON TO BOUNDAPY CONDITION, —EFFLUENT SEWER PIPE,STANDARD ABSORP77ON FIELD, MAINTAIN It INSTALL BOTTOM OF TRENCH 30" PIPING TO'K 4" SDR-35 OR.SCH 41 TH 118--PER FOOT MINIMUM-MAXIMUM INTO NATIVE GRADE -40-PVC.-INSTALL SLOPE.HOUSE IPERCOLATION TEST FILTER FABRIC
L.W. DOBIE, P.E. - HUTCHINS ENGINEERING WOVEN SEPAR I A TION FABRIC, ENCATE MIRAF1 14ON OR EQUIVALENT.PT-1 - 7127116 8 Y. FILTER FABRIC TO BE 4.8 OZISY NON STABILIZED PERCOLA71ON RATE' HOUSE SEWER PIPE MINUTES,- 15 SECONDS PER INCH INSTALL' KITH 114" PER FOOT MINIMUM SLOPE,E 40 PVC,PIPING TO BE 4 SDR-35 OR SCHEDUL
TOPSOIL WASTEWATER SYSTEM DESIGN PLACE 4 MINIMUM TOPSOIL OVER EN71RE BACKFILLAREA. SEED, MULCH, AND ESTABLISH TURF,—U U SMA25K_ co WATER SA WNG FIXTURES(W/ . (1.6 GPF MAX FLUSH, 3.0 GPM MAX FAUCETS)N EROSION & SEDIMENT CONTROL NOTES
IDESIGN FLOW - 110 GPDIBEDROOM.1 1. - s BEFORE ANY CL�ARING OR GRUBBING OF,THE 'S1 7E IS INI 77A TED, AND DURING EARTHWORK PHASES, SEDIMENT PROP.-40USESE E SYSTEM DESIGN FLOW - 330 GPD CONTROL FENCE SHALL BE INSTALLED AS SHOWN, ON THE PLAN.PROP,10q0AL, P 1000 CAL. PRECAST CONCRETE AL, P CONCRETE SEPTI SEP 77 C TANK AT THE CONCLUSION OF EACH DAYS WORK AND AFTER EVERY STORM EVENT, SEDIMI T CONTROL FENCE AND
N
LEACH FIELD STANDARD PIPE-IN-STONE TRENCHES-EFFL PROP.GRASSED DETENTION PRA LIEN E ANY 07HER EROSION CONTROL MEASURES SHALL:BE INSPECTED FOR FAILURES OR 'SEDIMENT ACCUMULATION.
AREA,845 SF X 1 ?,845 CF DESIGN PERCOLA77ON RATE 6-7 MINIIN ANY FAILURE SHALL BE IMMEDIATELY CORRECTED.IN RZP-RAP PROP.4' APPLICA77ON RATE 1.0 GPDISF ALL BARE EARTH 'AREAS SHALL BE SEEDED AND MULCHED KITHIN 7-DAYS OF COMPLETION OF WORK IN 7HE OUTLET WEIR ABSORP77ON AREA REQUIRED = 330 SF -DA
-1-5 24 MDE TRENCH LENGTH REQUIRED 165 LF AREA. ONLY AREAS WHICH AREA AC77VELY UNDER CONSTRUCTION MAY REMAIN OPEN FOR MORE THAN 7 YS.
PARCEL 265. IONCE CONSTRUCTION IS COMPLETED IN THESE AREAS, SEED AND MULCH SHALL BE INSTALLED WITHIN 7-DAYS.LANDS NIF OF JENKINS TEMPORARY EROSION CONTROL MEASURES, INCLUDING SEDIMENT CONTROL FENCE ANDIOR MULCH, SHALL BE
INSTALL '(3) 1RENCHES AT 60 -LONG 180 LF 100'NEZGHBORZNG WELL INSTALLED AND MAINTAINED FOR ANY TEMPORARY SOIL STOCKPILE AREAS THAT ARE TO BE LEFT FOR MORE§ETiACK ('WIW) ON-SI WELL -HOURS.POTABLE WATER UPPL. TO BE -TE THAN 24 NO LAND AREA MAY BE LEFT� DEVOID OF VEGETATION FOR MORE THAN 7-DAYS MTHOUT A PROTEC77VE-MAINTAIN 56'�MlNimum SEPARATION'tO 'SEPTIC TANK-MAINTAIN 100' MINIMUM SEPARA77ON TO ABSORP77ON FIELD COVERING SECURELY PLACED OVER THE EN71RE AREA ANDIOR EROSION CONTROL MEAS URES PROPERLY INSTALLED. -OCCURRING ,BETWEEN OCTOBER 15 & APRIL 15, IN -WHICH *-VEGETA 71ON FOR GROUND CLEARING ACTIV7TIES CANNOT BE ESTABLISHED, EXPOSED, ARTHEN AREAS SHALL BE COVERED KITH EITHER, A TARP COVER OR. AN 265.00-1-6 RC 570-2016 EXTRA HEAVY LAYER OF MULCH.Joel Monroe & Robin Ellsworth REVEGETATION MUST EXHIBIT A .-SURVIVAL OF A MINIMUM OF BOX THE VEGETA 77ON 55 Ellsworth Lane THROUGHOUT THE YEAR FOLLOKING REVEGETATION. REVEGETATE AS NEEDED TO MEET THIS�REQUIREMENT.-COMPLY THE- NEW YORK GUIDELINES FOR URBAN EROSION AND 'SEDIMENT THE CONTRACTOR SHALL
SFD (cross ref. AV PZ 151-2016) CONTROL AS PUBLISHED BY THE EMPIRE STATE CHAPTER OF THE SOIL AND WATER CONSERVA77ON SOCIETY,
SEPTIC PLOT PLAN ANY AREA OF REVEGETA71ON MUST EXHIBIT A SUROVAL 'OF A I WINIMUM. I OF 807. OF THE -VEGETA
TION I HAVE SEEN OR OBSERVE[) ALL OBJECTS REVEGETA I ASNEEDED TO MEET THIS REQUIREMENT.THROUGHOUT THE YEAR FOLLOMNG REVEGETATION.
S --H AS HOUSES, MLLS, TREES, FENCES, ETC IUC OOCUMENt I HP'AVF PERSONALLY SHOWN ON THIS IV, ASURED THE DIWAMCC SE I PORN ON MIS DIAGRAM. TAX MAP # 265.-l-6 r4 FEW ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL VATE ENGINEER IS A VIOLATION OF NYS EDUCATION LAW.SIGNATURE A�HOUSE co Uj z SITE DEVELOPMENT DATA 0196 ISSUED FOR:PERMIT NEIGHBORM 0 SITE AREA:0,833-AC(36,285,48 SF) WELL& No. Re, v,i s io'' n s Date EXISTING CHANGEIN PROPOSED IMPERVIOUS IMPERVIOUS IMPERVIOUS CORA COVERAGE SITE SETBACKS 4S. A ITE "I N v BUILDING AREA 0 SF j4,04 SF .404 SF REQUIRED FOR EXISTING PROPOSED SITE PLAN _preoared for ASPHALT DRIVEWAY 0 SF 91,34 SF 2334 SF WR ZONE HOUSE HOUSE SCALE. :1"=20' Joel Mohroe NO SF DECK WASTEWATER SYSTEM SETBACK SCHEDULE FRONT 100, 99.5' E11§Wotth Lane ---SC Diog FSafely. � '�G,i"PHIC ALE.,10 0 5 10 20 40 PROPERT)LINE BUILDING 75' Towqbt Oueensbur County, NY,Newp:' WELL NORTH SIDE 64..1'2York TOTAL IMPERVIOUS 0 SF 1978 SF 3978 SF MAP REFERENCE: Y,:Warren&ecked.-GTH Scale: N07ED ate:' 712612016'SEPTIC TANK 10, 10, 5 'INFORMATION TAKEN FROM "MAP OF
ED Call Before You Dig 01
EI Wait The Required Time PERCENT IMPERVIOUS 0% j0,96% SOUTH SIDE 75' 58.7 BASE SURVEY M Confirm Utility Response IN FEET A SURVEY SHOVWNG PROPOSED PLOT PLAN OF Drawn: L,WD:4TION
PERMEABILI' 100% 1 99,04% 89.04% ABSORPTION FIELD s WGR 7H, PREPA RED'B Y-W.J.20' 100, REAR .68.2' LANDS OF R013ERT ELL,Ej Respect The Marks 169 Haviland Road
IM Dig With Care 'ED ON JUNE 29, 2016 LICENSED LAND SET13ACK RELIEF GRAN7 ROURKE, ASSOCIA TES Queensbury, NY 12804 ED MA Y 9,800-962-7962 SURVEYORS, FORT EDWARD,� NY DA7 291049-01 S1 UNDER APPLICATION PZ-0151-2016 BY THE -0307 Phone
2016 (518) 745 www.digsatelynewyorkcom Hutchins Engineering TOM OF QUEENSBURY ZONING BOARD OFAPPEALS (518) 7,45-0308 Fox................ ...... ...........
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MAP REFEREA CES:
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1. MAP OF A SURVEY SHOWING SI TE IMPROVEMENTS PREPARED FOR "A L
FIN %-:UNVE T
RUBEN & bi ELLSWORTH DATED NOVEMBER 5, 2004 BY
C" E0 W C
DONALD L. PIDGEON L.L.S.
LANDS OF
2. WARREN COUNTY, TOWN OF QUEENSBURY, TAX MAP NO. 265-1-6
L. 448 P. 591 L.
Z s .20,7
CHARLES & SHiRLEY STEVENSON
TOWN OF QUEENSBURY
I COMMUNITY DEVELOPMENT-
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CERTIFICATION, O
o I HEREBY CERTIFY TO JOEL D.MONROE, SUNMARK FEDERAL
- ----
CREDIT TEEAAGUNLON' IN-ICA- O THIS MAP HAS BEEN PREPARED D PRIME
I 113.5'
ACCORDANCE WITH THE EXISTING CODE OF PRACTICE FOR LAND O
SURVEYORS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF
PROFESSIONAL. ---, LAN':D SURVEYORS,VEs_YORS,_A.SLAST-R�VEVIS
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APPROXIMA TE
W I LOCA I7ON I cra
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FOUND W1 THIN 100' OF
' PROPOSED LEACH FIELD
FOUND CAPPED ' I I
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1 W I + E WILLIAM J.ROURKE LS 49098 cy L --_
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C. DAVID & JANET JENKIIVS i -
L. 513 P. 441
,��,,,�: ROBIN M. ELLYSWORTH
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. UTILITY POLE TOWN OF QUEENSBURY, WARREN COUNTY, NEW YORK
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STONE WALL
-_-x-FENCE, L UPDA TED AUGUST 19, 2016
ONLY COPIES Fi OM THE ORIGINAL OF THIS SURVEY EACH FIELD —— UPDATED JANUARY 25,2017 TO SHOW RESIDENCE, WELL, ETC.
MARKED WITH IN ORIGINAL OF THE LAND SURVEYOR'S ADS f ffiT b,� �
EMBOSSED SEA! OR INKED STAMP SHALL BE W. J. ROURKE, ASSOCIATES
CONSIDERED TO BE VALID TRUE COPIES. - Licensed Land Surveyors •
t.. -
Unauthorizea Alteration to this map is a Alj GYr =jam- - 299 Reservoir Rood 16-19
violation of .'>ection 7209, Subdivision 2 Fort Edward, N.Y. 12828
of the New York State Education Law. WILLIAM J. r�01 RKE, Ll LASED LAND SURVEYOR NO. 49098 JOB LA0.
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