2003-641 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 .(518)761-8201
Community.Development-Building&Codes (518)761.8256
CERLTIFICATHOF OCCUPANry
Permit Number: P20030641 Date issued: Tuesday,February 10,2004
This is to certify that work requested to be done as shown by Permit Number P20030641
has been completed.
Tax Map Number: 523400.301.012-0001-0.01-000.0000
Location: 21 BEINRICK Cir
Owner: PETER&JACQUELYN DZIEDZIC
Applicant: PETER&JACQUELINE DZIEDZIC
This structure may be occupied as a:
By Order of Town Board
Garage-2 Cars Attached TOWN OF QUEENSBURY
Single Family Dwelling
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queeiisbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030641 Application Number: A20030641
Tax Map No: 523400-301-012-0001-001-000-0000
Permission is hereby granted to: PF.TFR & JAC0TTFTF%ZFDZTFD71C
For property located at: 21 HEINRICK Cir
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: ROBERT &NORMA MALCOLM
19 BEINRICKCir Garage-2 Cars Attached
Single Family Dwelling $130,000.00
QUEENSBURY,NY 12804 Total Value $130,000.00
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
2003-641 PETER&JACQUELYN DZIEDZIC
1498 SQ FT MODULAR SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS
PER PLOT PLAN SPECIFICATIONS
$219.76 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,August 22, 2004
(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 Qluerb;?; August 22,2003
SIGNED BYfor the Town of Queensbury.
En Director of Building&Co forcement
Building Permit Application
Town of Queensbury-Dept of Community Development, 742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. - Permit File No.
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec. Fee Paid/�
application must be completed and must a "o
ppear on the Reviewed B f
application form. 1
Applicant: I t i tP-. Y-, ACCRU't tJ %1 007-16 Owner: -C rof
Address: n21f t¢,fl 2t c.K �.ti2 c L Address: IQ ttiiInsfLic,K. e tt2c iPL
/wP�r�s,btat^�( I(f fa- Al tl /-D804
Phone#(,jLl8 ) 774 - ;9 Z 9 Phone#Qi 5) lj 'X: :0 t_,
Email Address: c,j c-07, Email Address: e,�crek�a®new a�(.�0"I
Property Location: Lot Number: House Number ' I 1H-e i0��r�'c(< C�rC k e-
Subdivision Name: -�y � Tax Map Number: c7O-
New Building: residence commercial Estimated Market Value of Construction: $
❑ Addition: residence/ commercial❑ Alteration: residence/ commercial If an Addition,what will use of new addition be?
❑ No change to exterior size: residence/com'1
❑ Other work(describe )
Check OccupancyInformation I"Floor Z'd Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
U/ Single family dwelling Ytj tj/ a
❑ Two family dwelling
❑ Townhouse
cl Multifamily dwelling
#of units '
❑ Office wED
❑ Mercantile
❑ Manufacturing A U G 0 .003
❑ 1 car detached garage
❑ 2 car detached garage t ��C�tsEi ��U R Y
c7 3 car detached garage az. mi i�rtrvtj CODE
❑ 1 car attached garage
2 car attached garage sa
❑ 3 car attached garage
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other MY-7-7--
What is the proposed height of the structure r !6 a feet inches
Will any second-hand or ungraded lumber be used? If so,for what? 0 O
Type of Heating System: electric/ oil / gas/wood /forced hot-' baseboar /other:
Number of Fireplaces to be installed, 01 Number of Woodstoves to be installed a
List below the person(s)responsible for supervision of work as regards to building codes:
P�dQ,- (�ie( •��rakers j N t� /a 1(a�
Name Address t& . Phone Number
Builder re% /146D&fI-AAL /fear S- C RA 1 G J-, LA r' ✓w'- 61f)-`74,2-1t 110
Plumber c36(-Yis-Jrv,e A wS. r on-.1ctr -- IS3 rarI �(5t8�`i�_Cof83
Mason a I rzza co C&4s r uct i a vt— Pa+1e. FI i t 9 f�C( j!h �j r _tn 7�Al.
Electrician -3exr i _ ,S -r. pcnJ- 6rye5 L33 rte._, P't }-6c�5
poi 133 ,Fitt! RW.
Declaration; please sign below after you have carefully read the statement: A"-Y /a&'3 3'94 3
To the best of my knowledge the statements contained in this 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 Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is authorized by the owner. Further,it is understood that I/we shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued, as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction.
:' Le x".d.�.
Signature 14 owner,owner's agent,architect,contractor
Porch, Deck, Dock, or Boathouse Permit Application
Town of Queensbury-Dept of Community Development,742 Bay Road, Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. No Permit File No.
inspection will be made until applicant has received a valid Fee Paid $
building permit. All applicants' spaces on this application must be Reviewed By:
completed and must appear on the application form.
Applicant: RA7—fi,& + RLEC *J C(Ci7,EtiEtvm
Address: 7 1 1fAW-)rZ1(C1k- c4iz L Address: /Ci Heir ti-',"r-(<-' -
0, U /a-sov Q(A'eetxSbur%1 , Ill, 1J-WbL/
Phone#(&-/eJ 7cl - -76-z, Phone#
Email Address: aUctCk6o ate ,QC0Gcove Email Address: cLo •C-6 t-vt
1)
Person Responsible-for-Supervision of Work as Regards to Building Codes: &P 61)
,- ' ka ew-e- - 7-Ae=f'-&OW-;Ve 1-0711 e, - /9*Fla-ft ders oecf Al. 7&I I/ I I
Name on Jorv4s Address: 133 Ra Lz!V Phone -(6 7 N--&F�3
1911"wk;, e1ec-Jr1cv,1,
po tcA 71�e-C.,t</
Property Location: Lot Number.: 1 House Number ;Z #LO/094cK C,1 gzL,6-,
Subdivision Name: 6t4A0Utd 4���S Tax Map Number:
Estimated Market Value of Construction: $ AA v6 0
mr/Porch
V Deck
u Dock
R E D
c3 �Boathouse
p/ Other work(describe AUG 0 7. 2003
x 5;v/qge
Size of structure to be built square feet TOWN OF QUEENSBURY
BUILDING AND CODE
Submit along with this application:
1. Two plot plans drawn to scale,preferably using a survey map. Indicate proposed
structure showing setback dimensions from all property lines. Show location of
water supply and location and configuration of septic disposal area.
2. Two sets of structural drawings. Indicate size of posts or studs, floor joists,
decking or flooring material to be used. Show how the porch or deck will be
fastened to the building. If a roof will be constructed, indicate the size of posts or
studs,roof rafter spacing and span. Indicate type of roof. sloped, flat, shed,or
other. Indicate the type of material being used for the roof.
Declaration: please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this 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 Code,the Zoning Ordinance and all other laws
pertaining to the proposed work shall be complied with,whether specified or noted,and that such work is
authorized by the owner.
Applicant's signatur Date: V7
L-.\SueHemingNvay\Building.Pennit.FORMS\Porch.Porch.Permit-doc 8/13/02 revised per DH
Application for Permit—Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
........................ .......... .......................................................
Office Use
Location of installation:
Tax Map No. q& / File Permit No. a ,6b 3 6z-8
- Fee Paid
Owner's Name: V, 1'�,o
........... ...........................................................................
Address: _/I LI)UlUr-K-
2. INSTALLER'S NAME PHONE NO.7-
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 4 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 Daily Flow
1980 or older x 150 gal/bdrm =
1980- 1991 x 130 gal/bdrm =
1991 -present 3 x 110galfbdrm =
Garbage Grinder Installed yes_ no X-
Spa or Whirlpool Installed yes_ no
4:- PARCEL INFORMATION: (circle applicable information&indicate measurements)
Tonogrwly Soil Nature Ground Water Bedrock-gi ImRervious Material Domestic Water SUR121Y
Flat sand at w1lat depth at wh t depth Elunict a
ep. Wm'�41 2 10�Ia
Rolling Idam IVA- feet we f feet
Steep slope clay tfwell;water supply
410 %slope other from any septic-system
depth: absorption is_ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch
5. PROPOSED SYSTEM: For New Cons$ruction: 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: 1600 gallon(min. size 1,000 gal)
Tile Field: each trench Total System Length
Seepage Pit(s): number of size ofeach: fi. by_ft.
Size of Stone to be used: # depth or thickness feet
Bed System Size: x
Alternative System: length andlor size
6. HOLDING TANK SYSTEM: (if required)
Number oftanks: J 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 road)
For your protection,please note that pursuant to Section 13 6-29 of the Code of the Town
of Queensbury, any permit or approval ininted 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.
Signature of responsible person Defte
'!'c>tv[i of (Ztseetlsbtli-y
sq%vers :t:t(! :yew*i1;e Dis;>a:-al (:li:tlttt�r
11,j)! pith? C J
i
SPA'Alt.ATIONZZ
ltl:t2l.Iitii;t4llr:N'I`:;
n s� C ZJ
- - - ----
ti^t�t.L [ea i.IfiTF.'it' `i--•----�""� �r �v
---------------
[
ipaYt'
ca•�x
rzY.xrR.E�[>Gr t
7. SIGNATURE &,INFORMATION FOR Sysrur4btol z e„o-.--•�••,•,
Residential Final Inspection
C)
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: ani/p !!OPart: am/pm
742 Bay Rd.,Queefisbury,NY 12804 Inspector's Initials:
PERMIT NAME: 03- q)
LOCATION: &r Lc PL�t Q!zj DATE:
TYPE OF STRUCTUIM:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3'inch Plumb Vent through roof
Roof Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete
Interior/ExteriorRaih s 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30,ft. or within line of site
A0iI Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
-Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: l Battery baoku
Bathroom'Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
1/4hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq.ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C(Cert.Of Compliance) J
Okay to issue Temporary C 0(Cert.Of Occupancy)
Okay to issue Permanent C 0(Cert. Of Occupan y)
L:\SkieHerrin'gway\Building.Codes.Inspection,FORMS\Res.Final Insp.form 2.doc edited January 28,2003
S
3 Residential Final Inspection ;00 _I 3C
r-:a
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p epart: m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: o —6
LOCATION: ` DATE:
TYPE OF STRUCTURE: i7
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
uard at deck,porches 36 in.or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
I tenor Handrails stairs 2 or more risers
rade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft.or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
� n
Low water shut'-off boiler /���iQ�GL
Relief Valve(s)installed Kv t 1^
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors: A � � (��`►
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
tumbin fixtures
Foundation insulation 61W rbz;L,-
Floor truss,draft stopping fnushed basement 1,000 sf
Emer ency egress below grade
asement stairs closed rise>4 inches
/4 hour fire door/door closer
Garage fireproofing
uct work Sealed properly
Attic access 30 in.x 24 in,x 30 in.(ht.)In accessible area
,,,Crawl Spaces 18"x 24"access, l s .ft.-150 s . ft.vents
Building No./Address visible from road
Final Electrical .
Site Plan /Variance required-
Final Survey Plot Plan
As Built Septic System./Sewer Dept,Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C/O(Cert. Of Occupancy)
Okay to issue Permanent C/O(Cert. Of Occupancy)
L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.forni 2.doc edited January 28,2003
q
Residential Final Inspection
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: MW am/pm Depart: anilpm
742 Bay Rd., Queensbuiy,NY 12804 Inspector's Initials: Qk
NAME: PERMIT#: co(4,
LOCATION: a ! 0,tq V— DATE: I'S-12,q v
TYPE OF STRUCTURE:
Comments
Y N NI
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete 1110,
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall dal
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area V
Furnace/Hot Water Heater operating
-Low water shut-off boiler / (f
V Z x
Relief Valve(s)installed 4e I,A�-_
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen waterti&
Safety glazing
Window in stairwells safety glazing
Interior Smoke De,�Ptors: ✓
Every level: I / Every Bed rum:
Outside every bedroom 3pea:
Inter Connected: V / Battery backup:-,
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
%hour fire door/door closer
Garage fireproofing e t- lee
Duct work Sealed properly e,
e
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area F` if, 30
Crawl S2aces 18"x 24"access, 1 sq. ft.-150 sq.ft.vents AX
Building No./Address visible from road �>ry,y1-1
Electrical
Site Plan /Variance required
WIC.(711'ej,
4e,
Final Survey Plot Plan A
I As Built Septic System/Sewer Dept.Inspection Sticker
Z,Flood Plain Certification,if required
Okay to issue C/C(Cert.Of Compliance) C
ka to issue Temporary C/0(Cert. Of Occip_a e 761 S
Okay to issue Permanent C/0(Cert. Of Occupancy)
L:\SueHeri-ingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
Framing Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection re e receiv d
Queensbury Building&Code Enforcement Arrive: amlp D rt: a pm
742 Bay Road,Queensbury,NY 12804 Inspector's Ini ias! r
NAME: PERMIT#: ia
LOCATION: INSPECT ON:
TYPE OF STRUCTURE—.,
Y N N/A
Framing COMMENTS
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
'1211 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 V2(w) 16 gauge (8) 16D nails each sid4'
Draft stopping 1,000 sq. ft, floor trusses \
Anchor o ts 6 ft. or less on center
1"Iedoand -now 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 V2inch 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
L-.\Sueliemingway\]3uilding.Codes.Inspection.FORMS\FramingFirestopping Inspection Report.doe January 28,2003
Residential Final Inspection
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 Initials:
NAME: 2—\ PERMIT#:
LOCATION: 14 DATE:
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30.ft. 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
Interior privacy/trim,/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glaKjpj�
Window in stair-wells safety glazing
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area: _
Inter Connected: / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
ELn Urency egress below grade
Basement stairs closed rise>4 inches
3/4hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, I sq.ft.-150 sq,ft.vents
Building No./Address visible from road
Final Electrical , I
Site Plan /Variance required
Final Su ey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C I 0(Cert.Of Occupancy)
Okay to issue Permanent C J 0(Cert.Of Occup ncy
LASueHernin gway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
Framing /Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection' request received.-
Queensbury Building&Code Enforcement Arrive:—a m
pepart: p 4_1W
742 Bay Road,Queensbury,NY 1.2804 Inspector's Initials".
NAME: —_7 PERMIT#:
LOCATION: Cjtq_Cc_&— INSPECT ON: ;�0-3
TYPE OF STRUCTURE:
Y N N/A COMMENTS
Framing
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
QiMeadroffi 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 V2(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
ire wall 2,3,4 hour
117irestopping 9 7— -40
Penetration sealed
16 inch insulation in cavity min.
Garage FireSeparation
House side V2inch 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
L:\SueHemitigway\Building.Codes.Inspection.FORMS\rramingFirestoppingInspectionReport.doc January 28,2003
Framing Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received: .en '
Queensbury Building&Code Enforcement Ariive: am/p a rt: . m/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
NAME: �� Z PERMIT#: /
LOCATION: C INSPECT ON:`
TYPE OF STRUCTURE:
Y N N/A COMMENTSFraming
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 B 6 ft.or less on center
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 ''/z.inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable-Space 1 Bedrooms
24 in.(H)
20 in.(W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORMS%Praming Firestopping Inspection 12ep6rt.doc January 28,2003
Rough Plumbing / Insulation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive:-am/p axt m/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
to b
NAME: PERMIT#: C�
LOCATION: `7 / <a' �/� l�� INSPECT ON: j
TYPE OF STRUCTURE:
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain/Vents
Cast Iron,Copper Drain/Vent/Comm..
umbing Vent/Vents in Place
Rough Plumbing/Nail Plates ow6rrll
Head or Air Supply Test
Drain and Vents
5 PSI or 10 ft. above highest
Connection for 15 minutes
Water Supply,Piping
Copper Commercial
Copper,CPVC,Pex One&Two Family
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
COIMENTS:
-L:1SueHemingway\Building.Codes.Inspection.FORMS\Rough Plumbing Insulation Report.doe January 28,2003
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: "/A
Queensbury Building&Code Enforcement Arrive: am/p Depa an-/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: t � .
-3,
NAME: VZJ -J� PERMIT#:
LOCATION: I hle E094,INSPECT ON:
TYPE OF STRUCTURE:
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
o,fethe concrete.
aterials for this purpose on site-.
,foundation/Wall-pour
r
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.
L:ISueHemingwaylBuilding.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
Septic Inspection Report
Office No. (518)761-8256 Date,Inspection request received:
-
Queensbury Building&Code Enforcement Arrive: am/p Wart- am/pin
t
742 Bay Rd., Que ury,NY 12804 Inspector's Initial
NAME: PERMIT NO.:
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil T e: Sa Clay
Type of WatKr: Municip�A/Well Water
Waterline separkon tance
Well
separation distance
Other wells:
Absorption Field: Total length ft.
.....Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size:
Stone Size:
Piping Si*11 Type /,
Building to tank
Tank to Distribute Box
Distribution Box ' iie d Pit
Opening Sealed f Yj/NI Partial I
Location/Separations,
Foundation to tank
Foundation to absorption-
Separation of Pits ft.
Conforms as per Plot Plan I/Y N
Location of Sy gteN n Property:
Front URea' Left Side Right Side
Middle Front Middle Rear
System Use 4Stat
Approved
Partial Approved and needs to be re-inspected,please call the*Building&Codes Office
Disapproved
L:\SLicHemingway\J3uilding.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
Foundation Inspection Report C
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: a D art: rpm
,
742 Bay Rd., Queensbuly,NY 12804 Inspector's' S.
f ,71e,W J-,
NAME: J"e't D
A PERMIT#:
LOCATION: QfP INSPECT ON:
TYPE OF STRUCTURE:
Comments
Y N N/A
ootings
Piers
Monolithic Slab
Reinforcement in Place The contractor is responsible f?
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 Darripproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of 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:\SueHemingway\Building.Codes.hispection.FORMS\Foundation Inspection Report.doe January 28,2003
Foundation inspection Report
Office No. (518)761-8256 Date Inspection req s re iv. , d: _
Queensbury Building&Code Enforcement Arrive: a p Depart: is a in
742 Bay Rd,, Queensbury,NY 12804 Inspector's Initi s:
1
NAME: � i 1 Rmrr#:
LOCATION: Ck VA ffkQ INSPECT ON: =Z0
'
TYPE OF STRUCT RE:
Comments
Y N NIA ec0J)
s
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
ing Under Slab
VC [Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASuelierningway\Building.Codes.Inspection.FORMSToundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/prr part: 4 mlpm
742 Bay Rd., Queensbuiy,NY 12804 Inspector's Initials:
NAME: PERMIT#: 4 Ak/
LOCATION: INSPECT ON:
TYPE OF STR CTURE: J
Comments
Y N NIA
Footings
Piers
Monolithic Slab
Rei rcement in Place
T e contractor is responsible for
providing protection from freezing
for 48 hours following the placement
o he concrete.
aterials for this,p ose on site.
oundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump_
Footing Drain Stone:
1.2 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:\Suellemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
PK
Foundation Inspection Report
Office No. (5 18)761-825 6 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p Depart:6, am/pm
742 Bay Rd., Queenshury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
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.
V'Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Darripproofing/Waterproofing.
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Glade 6 inch drop within 101
LASuellerningway\Building.Codes.InspectionTORMSToundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: 44 f
Queensbury Building&Code Enforcement Arrive: am/pnAi Deparl/l/ -�-Imlpm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: its
NAME: Z j
.: PERMIT#: Coe//
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Comments
Y / N N/A
7--
Xootings
Piers
e—r—
Monolithic Slab
Reinforcement in Place
The contractor is responsible/
fo4r"f--( n
U
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 Darripproofirig/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of 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.,
LASucHerningway\Building,Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
N fh
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: —a tj�Depart: in
742 Bay Rd., Queensbury,NY 12804 Inspector's lnitial�p
NAME: I (Z-6 7—,� PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Comments
Y N "NIA
INI"Footings R6 C3 5
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement rCs
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing A)E t(
Foundation/Waterproofing
Type of Darapproofing/Waterproofing
Footing Drain Daylight or Sump.
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab -cK
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 'inch drop within-10 ft.
L:\Suellemingway\Building,Codes.Inspection.FORMS\Foundation Inspection Report doe January 28,2003
tv ,
_ I
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
REScheckSoflware Version 3.5 Release lb
4 Data filename:C:\BILL LAKE SYSTEMS APPROVAL\houseslRES-CKECKIUntitled rck
TITLE:PR-233
COUNTY:Warren
STATE:New York
HDD:7635
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric
DATE:66/04/0i3
DATE OF PLANS:06-03-03
i
PROJECT INFORMATION:
DZIEDZIC J
21 HEINRICK CIRCLE
QUEENSBURY,NY 1.2804.
(SHOWCASE HOMES)
COMPANY INFORMATION:
BILL LAKE MODULAR HOMES
188 FLANDERS ROAD
SPRAKERS NY 12166
NOTES:
FLOOR INSULATION BY OTHERS.
COMPLIANCE:Passes
Maximum UA=256-,
Your Home UA=256'
0.0%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 1494 38.0 0.0 45
Wall 1:Wood Frame, 16"o.c. 1291 19.0 0.0 60
Window:4257:Vinyl Frame,Double Pane with Low-E 116 0.370 43
Window: 8457:Vinyl'Frame,Double Pane with Low-E 66 0.370 25
Window:3037:Vinyl Frame,Double Pane 8 0.370 3
Window:4237:Vinyl Frame,Double Pane with Low-E 11 0.370 4
Window:4253:Vinyl Frame,Double Pane with Low-E 15 6.370 6
Door:2-8 9LITE:Solid 53 0.200 11
Door:3'-0":Solid 20 0.200 4
Floor 1:All-Wood_Joist/Truss,Over Unconditioned Space 1494 26.0 0.0 55
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans,
,specifications,and other calculations submitted with this permit application. The proposed systems have.been designed to meet the
New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and
signed this page,they are attest* that to the best of his/her knowledge,belief,and professional judgment,such plans or
specifications are in compliance e.
Rc
Builder/Designer Date��
Cam,,
02730'
R
Op NEW 't0
AUG-2172003 03:10P FROM: TO:7454437 P:2/6
k.
t er ber
0�
REScheck Compliance'Certiricate y to
New York State Energy Conservation Construction Co e�FChecked B te
REScheekSoftware Version 3.5 Release lb
Data filename:C:\ProgramFiles\Check\RESchetkTR-233.rck
TITLE:PR-233
COUNTY:Warren
STATE:New York
HDD:7635
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric
DATE:08/21103
DATE OF PLANS: 06-03-03
PROJECT INFORMATION.
DZIEDZIC
21 HEINRICK CIRCLE,
QUEENSBURY,NY 12804
(SHOWCASE HOMES)
COMPANY INFORMATION:
BILL LAKE MODULAR HOMES
188 FLANDERS ROAD
SPRAKERS NY 12166
NOTES:
FLOOR INSULATION BY OTHERS.
COMPLIANCE.Passes
Maximum UA=256
Your Home UA=256
0.0%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 1494 38.0 0.0 45
Wall 1:Wood Frame, 16"o.c. 1291 19.0 0.0 60
Window.4257:Vinyl Frame,Double Pane.with Low-E 116 0.370 43
Window: 8457:Vinyl Frame,Double Pane with Low-E 66 0.370 25
Window:3037:Vinyl Frame-,Double Pane 8 0,370 3
Window:4237:Vinyl Frame,Double Pane with Low-E 11 0.370 4
Window:4253:Vinyl Frame,Double Pane with Low-E 15 0.370 6
Door:2-8 9LITE:Solid 53 0.200 11
Door:T-0".Solid 20 0.200 4
Floor 1:All-Wood Joistfrruss,Over Unconditioned Space 1494 26.0 010 55
. AUG-21-,j2003 03:10P FROM: TOI:7454437 P:3/6
COMPLIANCE STATEMENT: The proposed building represented in this document isconsistent with the building plans,
specifications,and 'Other calculations submitted with this permit application. The proposed systems have been designed to meet the
New York State Energy Conservation Construction Code requirements. When a Registered Design Profess'ional has stamped and
signed this page,they are attesting that to the best of his/her knowledge,belief,and professional judgment,such plans or
specifications are in compliance with this Code'.
Builder/Designer
Date -
AUG-21-2003 -03:11P FROM: T0:7454437 P:4/6
5. 31
REScheck Inspection Checklist
New York*State Energy Conservation Construction Code
REScheck Software Version 3.5 Release lb
DATE:08/21/03
TITLE:PR-233
Bldg.
Dept.
Use
Ceilings:
1. Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation
Comments:
Above-Grade Walls:
I. Wall 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation
Comments:
Windows:
1. Window:4257:Vinyl Frame,Double Pane with Low-E,U-factor:0,370
For windows without labeled U-factors,describe features:
#Panes Frame Type- Thermal Break? Yes No
Comments:
2. Window:8457;Vinyl Frame,Double Pane with Low-E,U-factor:0.370
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
3- Window:3037:Vinyl Frame,Double Pane,U-factor:0.370
For,windows without labeled U-factors,describe features:
#Panes Frame Type _Thermal Break? Yes[ ']No
Comments:
4. Window:4237:Vinyl Frame,Double Pane with Low E,U-factor:0.370
For windows without labeled U-fact6rs,describe features:
#Panes -Frame Type_ Thermal Breakll Yes No
Comments:
5. Window:4253:Vinyl Frame,Double Pane with Low-E,U-factor:0.370
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes j No
Comments:
Doors-
1. Door: 2-8 9LITE:Solid,U-factor:.0.200
Comments:
L 1 1 2. Door:Y-0":Solid,U-factor: 0.200
Comments:
Floors.
1. Floor 1.All-Wood Joist/Truss,Over Unconditioned Space,R-26.0 cavity insulation
Comments:
Air Leakage:
Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed. I
Recessed lights must be 1)Type IC rated,or 2).installed inside an appropriate air-tight assembly
with a 0.5"clearance from combustible materials.If non-IC rated,the fixture must be installed with a
3 clearance from insulation.
AUG-21-2003 03:11P FROM: TO:7454437 P:5/6
s
4
Vapor Retarder:
[ ] I Required on the wam-in-winter side of all non-vented framed ceilings,walls,and.floors.
I
I Materials Identification:
[ ] Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
[ ] Materials and equipment must be identified so that compliance can be determined.
[ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be proNided.
[ ] I Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications.
Duct Insulation:
[ ] I Supply ducts in unconditioned attics or outside the building must be insulated to R-11.
[ ] Return ducts in unconditioned attics or outside the building must be insulated to R-6.
[ ] I Supply ducts in unconditioned spaces must be insulated to R-11.
[ ] I Return-ducts in unconditioned spaces(except basements)must be insulated to R-2.
Insulation is not required on return ducts in basements.
Duct Construction:
[ ] I All joints,seams,and connections must be securely fastened with welds,gaskets,mastics
(adhesives),mastic-plus-embedded-fabric,or tapes. Duct tape is not permitted.
Exception_Continuously welded and locking-type longitudinal joints and seams on ducts
( operating at less than 2 in.w'g.(500 Pa).
] I Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions.
[ ] I Cooling ducts with exterior insulation must be covered with a vapor retarder.
[ ] I Air filters are required in the return air system.
[ ] I The HVAC system must provide a means for Balancing air and water systems.
I
J Temperature Controls:
ti `• [' 'r Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
I
Electric Systems:
[ ] I Separate electric meters are required for each dwelling unit_
I _
Fireplaces:
[ ] J Fireplaces must be installed with tight fitting non-combustible fireplace doors.
[ ] Fireplaces must be provided with a source of combustion air,as required by the Fireplace construction
I provisions of the Building Code of New York State,the Residential Code ofNew York State or
9 the New York City Building Code,as applicable.
4
J Service Water Heating:
[ ] J Water heaters.with vertical pipe risers must have a heat trap on both the inlet and outlet unless the
J water heater has an integral heat trap or is part of a circulating system.
[ ] ( insulate circulating hot water pipes to the levels in Table 1.
I
J Circulating Hot Water Systems:
[ ] J Insulate circulating hot water pipes to the levels in Table 1.
I
J Swimming Pools:
[ ] J All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
I
Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 105 OF or chilled fluids below 55 OF must be insulated to the
levels in Table 2.
AUG-21-,2003 03:11P FROM: J0:7454437 P:6,6
Table 1: Minimum Insulation Thickness for Circulating Hot water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature(F) UP to V Up to 1.25" 1.5"to 2.0" Over 2"
170-180 0.5 1.0 1.5 2 0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minintunt Insulation Thickness for HVACPipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Ran e(F) 2"Runouts I"and Less .1.25"to 2" 2.5"to 4"
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0
and Brine Below40 1.0 1.0 1.5 1.5
NOTES TO FIELD (Building Department Use Only)
Code Compliance and Informational Sheet for Permit Use
Queensbury Dept. of Community Development
Project for: Permit No. 2003 61 I
LI
Applicant Name:
Tax Map No. _a)i. i �_� ' � Application,.
Lot No. 6�7 House No. �--21 ` ram( 12 2 03
road,street (4 n
Mobile Home Park:
Subdivision: iI—e�� C J7-..�- O Administrator
F QUEENSBURY
Planned Unit Dev. Z
Parcel Size: 0 S'7 acres
Current Zoning: (April 9,2002 Zoning Ordinance)at time of this Permit Application
Zoning Ordinance effective
at time of Subdivision approval by Planning Board: Note Regarding Approved Subdivisions:
EAR G b
1967 ................. -- Prior to November 23,1992;earner lot(2
1982 June 11............ front yards)did not apply to zoning.
1988 September 19....... All new development must conform to
2002 April 9,2002........ current zoning.
Setbacks: Existing Required Proposed Zoning Information
i
Front 1 3A The latest Zoning Ordinance
Front 2 is effective April 9,2002
(if corner and shoreline) ......... ..........•..._... f.,.. ........ !
Side 1
Side 2
Rear 1
Rear 2
AR
Shoreline � V
Travel Corridor Overlay Zone 1//�. ( A•
Buffer
Yes No
meets depth,width&square footage requirements
preexisting,nonconforming lot with proper setbacks
required frontage on public road
has required off-street parking.
permeable area is adequate(Requirement is %)
building does not exceed maximum height(Max. ft.)
Is lot in a Flood Zone?
Floor Area Ratio worksheet required?Zone: WR-lA(effective Z.Ordinance 1988)
Application appears to conform to the requirements of Section(s): of the local Town Code.
Town of Queensbury
Code Compliance and Informational Sheet for Permit Use
Queensbury Dept. of Community Development
Drawing Space and Comments:
Awa acyut.f,,- c r A lam, Mt,, Q A-4 �.
Parcel History
Additional review required by Zoning Board of Appeals
Planning Board
Town Board
comments:
Zoning Board of Appeals
File No. Action Resolution Date
Use Variance
Area Variance
Sign Variance
Other
Planning Board
File No. Action Resolution Date
Site Plan Review a
Subdivision
PUD(Planned Unit Dev.)
Other
.1
Recreation Fees Paid
Engineering Fees Paid ,.
Site Plan Maps on Pile.,
Subdivision Mylar Signed and Filed
REVIEWED
BY STAFF(initial) DAT NOTES
Town of Queensbury
NYS•Real Property System Subject Property Inventory Summary RPS030/VO4/LO01
County of Warren For Current Year File 2003 Date:8/11/03
Town of Queensbury Parcel ID 301.12.1.1 Sheet 1 of 14,
SWIS Code•523400 Active
t..
Parcel Information Parcel Land Size File Maintenance Info
Curr Owner:Malcolm,Robert Acct#: Front: 0.00 Acres: 0.57 Created: 11/20/1984
Location: 21 Heinrick Cir School Cd: 523402 Queensbury Un.f Depth: 0.00 Sq Ft: 0 Modified: 05/23/2003 03:30 P
Queensbury,NY Roll Sect: 1 Taxable RS/S: Grid Coordinates By: Mary
Prop Class: 311 Res vac land [East: 706238 North: 1636876 Folder: u_parcel_tab
Site Characteristics
Site No: 1 Nbad Cd: 162 Old B Grade Re Site Desire: 2 Typical DC Entry Type: 5 No entry Laser.Disk No:
Site Type: R Residential Sewer Type: 3 Comm/public Nl hd Type: 2 Suburban Zoning Cd: SFR.1A Sing Fam Re Data Mailer:
Prop Class: 311 Res vac land Water Supply: 3 Comm/public Nbad Rating: 2 Average last Phy Insp:
Route No: Utilities: 3 Electric Road Type: 3 Improved Reappraisal:
Land Breakdowns
Land Soil Wtrfrt Depth Infl Infl Infl InfI Land Unit Dim
Type Front Depth Acres Sq Ft Rating Type Factor Pct Cd 1 Cd 2 Cd 3 Value Price Code
01 Primary 0.00 0.00 0.00 24,829 0 0 22300 181.301
�. rr
v�I�
Mx 'a
f J
STATE Or NEW Y RK
Dr-PAR7'tVtENT OF STATE
41 5TATE STREET
1 t
GEOROE E. FarAKs Dccember?U,20C1 RANDY A.'DAtouz
rl GOVERNOR Smr,.ETARY aF s?RYa
Mr. William Lake
Bill Lake Modular Homes
188 Flanders Road
Sprakers, NY 12166
RE:M 117942-053
System approval-,CONDITIONAL
DeauMr.Lake.:
Issued herewith, in response to your September 25,2002 application far approval of Detached
One and. Two.@Family Dwellings System of Models is Factory hanufa.ct:ured Building Approval.
designated,I6I f f79-02-(l ,as authorized under part 1281 of the Uniform 'Fire Prevention and Building
Code.
Supplemental Conditions of Approval
,
n addition,the conditions under which system approval is nted are:
l.The manufacturer is to subzmit to the Division a duplicate ref the permit set for each dwelling to be
installed in belly"Fork State..Each permit sot is tot be sealed and signe d by art architect or engineer
registered.hi New,York State and is to bear thatarclike-et or ongineer's certification that`the plans
and specifications of the permit set are derived from and consistent with the plans .and
specifications associated with this approval on file V"ith the Division and this conditional
approval letter."*Ibe certifying architect or-engineer may not be affiliated car associated NNith the
manufacturer's clualig,assurance agency. The following are specific roquirements regarding the
contents of the permit set,
11.A set.of drawings comprising at a minimurn:
L I1 l Cover street which conuins information on:
project location..
Design c'rltex a: listing of applicable design loads such.as Ground Snov,=Lgad,
Seismic Design CategoM Wind Speed,lave Loads,Dead Loads,etc,
-Applicable building codes and design specifications
-p tie rgy code itiformation:: sytateniont by professional of compliance withEnergy
Conservation�"on0ruction Code of:r'Veio Y645`r`at , 2002 Edition. Method of
compiianoo and pertinent docunUmtation shall be provided,
Occupancy classification
-- VAVAV Ava STATE.N'r US �" E-NML' NY us
accrcu:a.�r+
Mr. William Lake
/f December 20,2002
Page 2
-Construction type classification
General notes
-Index ofdraNvings
-Manufacturer's title block-
-Certification,by design professional,of derivation from approved system set.
drawings and this conditional approval letter
1.1.2 Elevations
1.1.3 Floor plans which coney the inforniation on:
>� r Required and provided light,ventilation,egress,Nvindow and door schedules
-Unambiguous identification of structural members
-Smoke detectors and GFGI Interrupt protection
1.1A Foundation plau
I.1.5 wilding cross section with information on:
Building integration(module connections)details
Location of required fire stopping
Roof truss bracing mid structunal.connections
1.1,6 Roof system
-Special requirements addressed(such as sliding,drifting or unbalanced snow load
conditions)
1.1.7 Non-typical details(such as prow roofs cantilever beams,etc.)
1.2 Summary of references to system for selection of structural members.
1,3 Each page ofdraN%ings and calculations should be signed, scaled,and dated by New
York State registered design professional,
1 The manufacturer grill submit a weekly report summarizing (listing) all permit sets with
inflammation about project location,production serial number,and NYS insignia number_
3.The manufacturer will promptly address the deficiencies of submittals.
r
4. The system conditional approval is subject to termination upon evaluationofcomplianceN%ith the
provisions of-the Uniform Code.
5.,The Division will conduct quality control review of permit set submittals to evaluate compliance
Nvith the above conditions and Nvith the provisions of the Residential Cole of New York State.
Deficiencies will be reported to Manufacturer name and are to be promptly addressed.
The approval is indicated by the New York State Departtuent of State"Stamp of Approval"placed
on the accompanying set of plans and by the qualifying letter-dated December 20,2002
A copy of the first two pages of this letter shall accompany each set of plans submitted for a building .
permit and be deemed a duplicate original,
Sind ,
Geo E.C'•lark,Jr.
Director
Division of Code Enforcement and Administration
- Enclosure •
cc.TR Arnold&Associates,700 B Beardsley Ave,Elkart IN 46515
File 02-053.N-,pd,
Check Residential PIan Review: One &Two Family Dwellings
YIN/N/A
(2)Full sets of plans
Over 1,500 sq. ft.—Stamped
Design Loads On Plans:90 Wind Floor Loads 40 psf
70 Ground Snow Load Sleeping Areas and Attics 30 psf
Calculations:
Window Schedule With Glass Size
/ Door Schedule/Main Entrance 36"Door
t✓ Emergency Escape Or Bedrooms and Habitable Space
Above/Below grade,5.7 sq.ft.
Grade,5.0 sq-ft.
24"(h)x 20"(w)min.
44"Max.Height above floor
Residential Check Paperwork Compliance and Inspectors Checklist: OK
Dampproofing/Waterproofing Materials On Plans
Foundation Drainage On Plans,if required
6"Drop in 10' Exterior Grade
Framing Cross Section For Each Roof Line,Vertical Fire Stopping Every 10'Where
Required
Ice and Snow shield 24"Inside Exterior Wall/24"Inside Knee Walls
Platforms At Exterior Doors
Stairway Headroom 6' 8'All Stairs 36"Width
Stair Run and Rise ,
Winder Run and Rise
Spiral Not Allowed From 2'd Story
/ Smoke Detectors Battery Backup and Proper Location
Bathroom Fixtures Proper Clearance
Hall Width,36"min.
Handrails More Than One Riser On Open Sides
Railing and Guards>30"/Basement Stairs Included/Closed Risers More Than 4"in Ht:
Safety Glazing Notes For Required Areas
Garage Fire Separation
iV Garage Floor Sloped
Attic Access
Roof over 30"—22"x 30"/Crawl Spaces 18"x 24"Access
Carbon Monoxide Detector Lowest Sleeping Level
Soil Test Results,if required
Septic To Well Or Water Line Separation
All Paperwork Signed . -
r al
Town of Queensbury 742 Bay Road, Queensbury;NY--11 2 804
B-uRding & Code Enforcement Building pt ttnit#
phone.(518)761-8256
Fax: (518)745-4437
En vj- �des{a� tteensbory net
Dear
Yovrbw1dWg Pt n-at application has been reviewed aad fowd to be deficieot in the fa2towbg area
These detafs need to be added to or noted on both set ofplans. Please feet free to contact this office with MY Vtesttons
regarding this matfeir.
Simcex'ely,
BiJtLDING&COl:1E8 OFFICE
t,:l5ueticmingwaytBuiIdingl"c�mit.FORMSkle�ciant building permit:ian Zod3-
MAP REFERENCE:
EVERGREEN SUBDIVISION
SECTION THREE
DATED AUGUST 6, 1969
LAST REVISED DECEMBER 18, 1973 JUGN 10-AS pax MAP Mr—
BY JOHN B. VAN DUSEN
LAND SURVEYORS
PF
LOT 27
3
o -
CV a����-
LANDS N OF
NIAGARA HAWK 2 STORY
POWER CORP. WOOD FRAME
ROUSE
P O�Gr N
LOT 26
20,061 sq.fi.
0.46 acres
PF
WAl
i UTILITIES L E
SHED
r ti
A& .4, i MMMSY CMIrY TtIAT TM MAP WAS MMPARED
\ v FROM AN ACTUAL fELD SURVEY.
AV MIS GIRMICATION SMALL MM ONLY TO THE MRSONS
FOR WHOM THE SLRVEY WAS MtEPAMM. AND ON Tt1ER
LEGEND: srrED CORNER
o• W SWALF TO THE MnZ COMPANY. GOVERPft TAL AGENCY
ON LAVE O.7 $ AND LC'NIt7N14 NSTInl M USTLD 1"MON.
CERTIFICATIONS ARE NOT TR MNSfERANX TO AVI NTIONAL
O PF IRON PPE FOUND OVER f INSTITUTIONS OR SUBSEGRUENT.OM93RS. �
BASKETBALL �,,� c� lam/ ° °
- - FENCE LNNE HOOP
h Mr{ GERTIFIT TOm PETER 0° 4 D .
rrs .ASSMS
Nr1 CHK.!► C DWANY
0 LOT 25
MIA NYS;13
• s
DATm wn!PM 25. 2003
•� a e� ,
2003
u S ,w►n,aAm AL,e anoM at ro A ► SCaI@
D- l ) wr era A u�TAW WOOM Ix a A blap of a Survey made for
G4 WLAr M n Ana rmt PA-W40M;v ne
Mnr�asc RAIL mua►raM IA�e•
Steves
'0wrod+esnwneaaonwa�n[�Musc
rrseo M+n AM aAaMr a the ww ylortwaw
" 19 Peter L. & Jacquelyn L. Dziedzic S-- l
,RltlllCAt101R NddYilD MGM NOI/Y yNT P
11Ni�t M1!�Mlip N AOOa1DAlk[■111 M[
Land Surveyors °NMN°woc �m ,"",�°",�.,w
ry 1E 1EM/EIrC lfA7[ArOCNAON a lN�t�UL
1A110 away m aw�w01!MO""acy
to"rswMa tat ow va Wo"s PNV# ,AID
aM Ms owu,o m,mE a wmy.OOICMOfLLL SHEET 1 OF 1
169 Haviland Road Queensbury, New York 128m4 a,,,�, N M".°�°""'� Town of Quetnsbury, barren County, New York 1 4„2q-03 SELLING C"ANGE
DZ�DLG G44O
(518) 793--6474 New York Lie. No. 50135 NO. DA TE DESCRIPTION DWG. No. 023515
qO-4-26
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
t Main Office 176 Doe Run Road # Manheim, PA 17545 , T(0
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL ,
Permit No, 7 5 9 6 3� Cut-in Card Not Iff{ffffff{fffffftil/1i1t1! if
) z -P z K..
1
��+��riffflffff{tifffffi44}fflflN}}i44ii{iff{fi{{}f{ffiffifflfifff ffifiiifflfff{Niifff�iff}iiiifififliff}ififiifl}ff}{Nffff}ffNff If ffffifffifff l4l ii Ni4ff}ffiNlffiff
Location
� •1{11f14tt1 111a1Nf{uNti4t/u/lttitlMltttlt4•!41/l11fi41t1tt141I4f1fut11u1f{ft41f1u4t4111♦f{4futuf41fu11t4441111uf4f11#i1„{{{{fff 7, ..tfftt14111•/N1N
vi t4j 'iwa IM14 44 e
Installation Consisting of fi}{ }if{ff {I{ffifiHi{Iff11{ifff ff ifffi{ffi{ff{iff}�fiif}ff4ffi{{ f}If }Nlfff/f1f4Nf4f//44t1 1411iHNffiffflfff/Mfft!!f
ff��
41j,ry.
OV "� 1
411u41t1/{t1}ftfffNfiff�Iff{ffff ffift111}/}{/i014ii1liili}1fi}1}i///lfift*f/t iit it}}l}ff I10461#4161111it}}1114f{fiif a}}fiff1f11ifi}f}f}}}Ilfii}#ffflifffiilf}1}i/1{liii}f{ff}Ifi
}tuff!/Ht!/itl441u11{iuu1tuu144u4u I ofu4110 1/ftf 4tI mt}I##N/1}t114{if41 a ttf{fff 4414004}444f1f}}{{it144t1t11ttffuurlttttl!{M!/1111141u1ff1111}1}u}}}111101146164114 fit
�j �� 4
Installedyi11111 11ui1 14{141fi1 a{ff{u1f1Ifu14 u1iff u411f111u 1441tuflffi11u 1141ff 411u,1ui Lie, No. 4�ff�if.l4ff11.�1�4iNH{11i4u1441i4441r4ut4url
1
The conditions following governed the issuance of this certif cate, 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 omptly made for inspection,
Inspectors of this ompapy shall have the privilege of making nspec ions at any time, and if its
rules are violated, the Company shall have the right t re o e this c ificat 4
ute1 flit i4ii14uf11 }}u,u!!}utuufit{}}u}{,} INSPECTOR i/t4lttttl1114M/4u/fM tu1114f4uu{}11tut{{4uufu{tt114}}i1},lii/ti1u 4111u{11{111•
Member NAP/A1,ItA1E1i1