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2005-590 FF TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20050590 Date Issued: Tuesday, January 31, 2006 This is to certify that work requested to be done as shown by Permit Number P20050590 has been completed. Tax Map Number: 523400-289-011-0001-028-000-0000 Location: 5 GLEN HALL Dr Owner: LAWRENCE & KRISTINE SIPOWITZ Applicant: LAWRENCE & KRISTINE SIPOWITZ This structure maybe occupied as a: Residential Alteration By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the % /f 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&Co a Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY (2t 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050590 Application Number: A20050590 Tax Map No: 523400-289-011-0001-028-000-0000 Permission is hereby granted to: LAWRENCF, & KRISTME SIPOWITZ For property located at: 5 GLEN HALL Dr 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: LAWRENCE& KRISTINE SIPOW 156 E HUNTER St Residential Alteration $18,500.00 Total Value $18,500.00 GLENS FALLS, NY 12801 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2005-590 980 SQ FT RESIDENTIAL ALTERATION $98.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 28, 2006 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at,the To of eny�bury We nesday, September 28, 2005 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Itrincipal Structure BuildingPermit Application pp on Application & Plans subiect to review before issuance of a valid permit for construction Instructions: A permit must be obtained before beginning construction. No inspections will be made until the applicant has received a valid building permit. All applicants' spaces on this application must be completed and must appear on the application form. / s Applicant/Builder 1 LoQavc t? 3 i Ao ccS i c Z Owner Address: 1 12� � 1.� rc3 . Address: Home Phone: _S/!- 2 S3 ~V?01; Home Phone: Email Address: Email Address: Cell Phone: g a 6 o y o >d Cell Phone: FAX Phone: FAX Phone: Person responsible for supervision of work with respect to building and codes compliance: Name: (-^C S ' c,,_O ' Address: /„S /�Ct>v�cr 5 6,1,eovs AC, Phone Og�10 Location of proposed construction: Lot No. Legal Address: 6JeA) /Iq j/ -V.t sB�f✓�yr�tc Tax Map Number: a7 / l l - 02$ Subdivision Name: Estimated Cost of Construction: Proposed construction is for: Residential Use _Commercial Use Name of Business: if proposed construction is an addition, what will use of new addition be? New Addition Alteration Proposed Construction 10 Floor 2nd floor Other Total Proposed structure (Occupancy Type) Sq. Ft. sq.ff. Sq. Ft. Square feet Height Ft.&in. Single-family Dwelling Two-Family Dwelling Townhouse Multifamily Dwelling Number of Units: Office Mercantile Manufacturing Other: Attached Garage 1, 2, 3 Type of Heating System: Electric, Oil, Gas, Wood, Forced Hot Air, Baseboard, Other: 4,004joe. +Qo.V e if a fireplace and/or woodstove are being installed, please refer to a separate application. Applications are subject to Zoning Administrator, Code Compliance, and Structural Plan review. The Building and Codes Office will allow commencement of your proposed project only after issuance of your permit. Declaration: Please sign below after you have carefully read the statement: To the best of my knowledge, the statements contained in the application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the Building Codes, the Zoning Ordinance, and all other laws pertaining to the oroposed work shall be complied with,whether specified or noted, and that such work is authorized by the owner. =urther, it is understood that I/we shall submit prior to a Certificate of Occupancy or Certificate of Compliance peing issued, as requested by the Zoning Administrator or Director of Building and Codes, an As-Built Survey by a icensed surveyor, drawn to scale, showing actual location of all n construct n. Date: �f Applicant/Builder Signature: the application of dated i6reby approved and permission granted for the construction, reconstruction or alt ration f a building/and or accessory structure as set forth above. #1�: Date: OJAuthorized Signature: _:\Sue Hemingway\Building.Permit,FORMS\Principal Structure Permit Application.doc V:12/14/04 13 le NO Id e- ly 6 e P J4 c e o a r s w )'•v J6 U-) S /r u. c./tt t&,/ w e od 1h Q.,S DG mc,L -- b�/ wa-l-C r o r 5 j4,l/ oi a,.o R cL J/ f 4 R*1/g T- F L Application for Permit— Septic Disposal System Town of Queensbury 742 Bay Road Queensbury, NY 12804 (518) 761-8256 1. OWNER INFORMATION: .................................................. Location of installation: (�1( (X� ���� Office Use Tax Map No. ,` r / ,, // —/ - g File Permit No.C%� J �C� Owner's Name: Q s tc.�, 'C, Z Fee Paid Address: 5(� _ �7�c.c�t3�r/' S 61e `!S�� �� /) y�a 86� 2. INSTALLER'S NAME PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply #of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Dailv Flow 198PEI older _____ 0 x 150 gal/bdrm 8 x 130 gal/bdnn = 1991 —present x 110 gal/bdrm = Garbage Grinder Installed yes— / no Spa or Hot Tub Installed yes— / no 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Suppiv Flat sand at what depth at what depth municipal Rolling loam feet feet well Steep slope clay if well; water supphy slope other from any septic-system depth: absorption is other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. 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). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: gallon (min. size 1,000 gal.) Tile Field: each trench ft. Total System Length: ft. Seepage Pit(s): number of size of each: ft. by ft. Size of Stone to be used: # / depth or thickness faet Bed System Size: x Alternative System: length and%or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE & INFORMATION FOR RESPONSIBLE PERSON(please read) 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. Ik I have read the regulations with respect to this application and agree to abide by these and all requirements of' the Town of Qu nsbury it ry Sewage Disposal Ordinance. Signature V sp sible on Date Town of Queensbury Sewers and Sewage Disposal Chapter Appendix C ABSORPTION FIELD SEPARATION REQUIREMENTS SMAM �. r" �3is1b Appendix C ABSORPTION FIELD SEPARATION REQUIREMENTS PO "Z M,+r WAi[�.R�rxr stir. 'a'�c �6 ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY, WARREN COUNTY 9000 HEATING DEGREE DAYS (2pW Compliance Methods:Part 5 -Acceptable Practice Method—1&2 Family Dwellings(only) Part 6*-Thermal Rating—Component trade Offs 1&2 Family Dwelling- Multi=Family Dwellings(3 Stories or less) Part 4*-Design by Component Performance,Commercial Building,,In Rise Residential *Requires submission of worksheets APPLICANT'S NAME: PROPERTY LOCATION: PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area square feet 2. Type of heat- Electric . Oil— ras Other 3. Is building mechanically cooled? yes o 4. Percentage of area of windows and doors % Und °o 5. R-VALUES FOR INSULATION GIVEN BEL•OW MUST CORRESPO O R VALUES AS , SHOWN ON PLANS SUBMITTED: l a Roof ��� (Z-6 b. Exterior walls R C. Glazed areas R d. Exterior doors R e. Floors over unheated spaces R f. Edge of slab on grade(heated building) R g. Basement/cellar walls(above grade) R h. Basement/cellar walls(below grade) R i. Heating/cooling-ducts-piping in unheated space R 6. Service(domestic)hot water heating device Conforms to minimum efficiency per code Yes No TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED Ap icant's ign ure Dat Phone Number INSPE 'S REM S t Queensbury Building & Code Enforcement - Residential Final Inspection Office No.(518)761-8256 Arrive: am/pm Depa :�am/pm Date Inspection request received: _ Inspector's Initials: NAME: —�� Jw fL PERMIT#. LOCATION: l DATE: TYPE OF STRUCTURE: Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors 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 Interior Handrails @ stairs 2 or more risers 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 wat i ht Safe lazing/Winjdw in stairwells safety glaKhg Interior Smoke De ctors: Every level: Every Bedroom: 1z �� Outside every bedroom area: Inter Connected: Battery backup: Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, 1 s . ft,150 s .ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 s .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''/2'Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/3/4 hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan _ As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance required ��C 1 ' ) .3 L , Flood Plain Certification,if required Okay to issue C/C or C/O Temporary/Permanent L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised—100405.doc Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: am/pm Depart: In Date Inspection request received: Inspector's Initials: _ NAME: 0kd PERMIT#: LOCATION: DATE: TYPE OF STRUCTURE: Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location V ( r Fresh Air Intake ` llll 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Af Platform at all exterior doors Guards at stairs,decks,patios more than 30 inches ab-ovegrade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wallj Interior/Exterior Railings 34 inches to 38 inches Interior Handrails @ stairs 2 or more risers 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 gl4zing Interior Smoke D ctors: Every level: Ev Be oom: V1 Outside every bedroo rea: Inter Connected: Batte backu Carbon Monoxide Detector Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, 1 s .ft.-150 s .ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 s . 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 Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Tern 110 Enclosed Stairs Sheetrock Underside minimum%z"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/Y4 hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical 2 Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C/O [Temporary/Permanent L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/pm Depart: l", am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: 6jA, NAME: PERMIT #: LOCATION: INSPECT ON: c - 1 TYPE OF STRUCTURE: Y N N/A Rough Plumbing Nail Plates Plumbing Vent / Vents in Place 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 / Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping PAir Hea.S.I for �rmmnutes Ins ential Check Commercial Check Proper Vent Attic Vent Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly / No duct tape COMMENTS: LAPam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/p . Depart: ` am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: NAME: PERMIT #: � LOCATION: C_- E - INSPECT ON: _ —g TYPE OF STRUCTURE: Y N N/A Rou h Plumbing / Nail Plates � `-- Plumbing Vent / Vents in Place 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanou very 100 feet/ change of direction Pres,Wfe Test 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 Proper Vent Attic Vent Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly / No duct tape COMMENTS: LAPam Whiting\Building&CodesAnspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Framing / Firestopping Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: i` Jr`! NAME: \.� 1 PERMIT#: '— LOCATION: d INSPECT ON: TYPE OF STRUCTURE: A Framing Y N N/A COMMENT Attic Access 22"x 30"minimum Jack Studs/Headers 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 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 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 Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side '/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade ..�, Rough Plumbing / Insulation Inspection Report 1 Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: L, I t-*1 NAME: PERMIT #: LOCATION: INSPECT ON: I - TYPE OF STRUCTURE: Y N/A Rough Plumbing J Nail Plates Plumbing Vent J Vents in Place 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 / Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/ Head 50o,KS.I for 15 minutes sulation Residential Check J Commercial Check IN Proper Vent Attic Vent Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace �,. ���� Duct work sealed properly / No duct toe COMMENTS: w� �� �tion Forms�Rou h Plumbin Insulation Report.revise ov 17 2003.doc Revised Februa 15,2005 L:�Pam Whiting�Buil mg&CZfdes�Inspec g g Framing / Firestopping Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: NAME: rJ! co _ PERMIT#: LOCATION: ��=n3 J}c c, INSPECT ON: TYPE OF STRUCTURE: Y N N/A COMMENTS Framing Attic Access 22"x 30"minimum _ Ck Jack Studs/Headers Bracing/Bridging Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft. 8 in. FILE Stairwells 36 in. or more CO. Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 t/z(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq. ft.floor trusses Anchor Bolts 6 ft. or less on center F11—F 00PV Ice 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 House side '/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf Eade Framing / Firestopping Inspection Report Office No. (518) 761-8256 Date Inspection request received: t Queensbury Building& Code Enforcement Arrive: _arn/p Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: — NAME: C J ' t Z PERMIT#: LOCATION: C�C-/l K A-&X p INSPECT ON: 0 TYPE OF STRUCTURE: Y N N/A COMMEN S Framing Jack Studs/Headers 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 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 ft. or less on center Ice and snow 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 House side 1/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X l Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) i 20 in. (W) 5.7 sf above/below grade 5.0 sf grade L:\SueHeming\vay\Building.Codes.Inspection.FORMS\Framing Firestopping inspection Report.doc January 28,2003 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/ Depart: , am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: �l��_Q i Z� PERMIT#: LOCATION: !— '�xL p,-c.� ,0 INSPECT ON: _ TYPE OF STRUCTURE: Comments Y N N/A Footings �c<< 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 _ Foundation Dampproofing Foundation/Waterproofing Type of Dampproofing/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. I.:\SueHemingway\Building.Codes.InspectionSORMSWoundation Inspection Report.doc January 28,2003 r a . v a• v� 02 Cep) <<>> CC) . . . .. . ... - .. �C>> CC�;�y�...::;>�s�.�:;.�.;>i.;;•;s;:;s;•;•�•;•;>s;• �;• �;•;.;• �, ;s :, :>�:yam:y :y :, :, :, :yam:y :y ;y�.-�\y�>�;�,�,-.,-�\•,�:yam:; :, :,�,�,;,;,n>:y�y�,-,��;J�