2002-138 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
~ Community Development-Building&Codes (518)'761.8256 r
CERVT IFICATE OF OCCUPANCY
Permit Number: P20020138 Date Issued: Wednesday,August 21,2002
This is to certify that work requested to be done as shown by Permit Number P20020138
has been completed.
Tax Map Number: 523400-297.013.0001-008-000-0000
Location: 123 CRONIN Rd
Owner: FRANCIS&DIANE STEVENSON
F
Applicant: FRANCIS&DIANE STEVENSON L E
This structure may be occupied as a:
By Order of Town Board
Garage- 1 Car Attached TOWN OF QUEENSBURY
Single Family Dwelling
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,.NY 12804-5902 (518) 761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020138 Application Number: A20020138
Tax Map No: 523400=297-013-0001 '008-000-0000
Permission is hereby granted to: FRANCIS &DIANE STEVENSON
For property�located at: 123 CRONIN Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the N-YS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type, of Construction Value
Owner Address: FRANCIS &DIANE STEVENSON Single Family Dwelling 129,000.00
6580 BROOKHURST Cir Garage- 1 Car Attached
LAKE WORTH,FL 33463-0000 Total Value 129,000.00
Contractor or Builder's Name Address Electrical Inspection Agency
Plans &Specifications
2002-138
$247.68 PERMIT FEE PAID - THIS PERMIT EXPIRES. Saturday,March 08,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the town of Queensbury; Friday,March 08,2002
fi
SIGNED A ----jor the Town of Queensbury.
/ - 4
Director
ev ��
rector of g
B ode Enforcement
Building Permit Application
y' 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 NOID—L-C2, L`J
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 appear on the Reviewed By.
application form.
Applicant: Owner: —Owner: D
rP P� Address: / Address:
"
Phone#{�ice) SF3 - s` Phone#Ap
(_)
er�� 'let rrl s TOWN OF QUEENSBURY
15 / BUILDING AND_CODE_
ytr Property Location: Lot Number: f House Number
rn ,,� ttpp� Subdivision Name: Tax. Map Number: ly /3
New Building: residence t commercial Estimated Market Value of Construction: S Z R 9,
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ No change to exterior size: residence/com'l
❑ Other work(describe )
_ Check 0ccupancyinformation V Floor 2" Floor Other floor - Total
Below sq.ft. sq.ft. sq.ft. Square Feet
v
�g Single family dwelling f
❑ Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile
^.. Manufacturing
❑ 1 car detached garage
❑ 2 car detached garage
❑ 3 car detached garage
1�( 1 car attached garage
❑ 2 car attached garage
❑ 3 car attached garage
❑ Storage building-
-- 1, commercial
Div ❑ Storage building-
� residential
Other
�L,0MCC ljE>7t cuiith G'FilGd-��e ofir��s
mil^ �o�
Ch of 1 What is the proposed height of the structure feet lG'l inches
�4t5 ,pN Will any second-hand or ungraded lumber be used? If so, for what? /70
QAX V � Type of Heating System: electric/ oil /`gaffs/wood I forced hot air baseboard/other:ze
_
S(/5 Number of Fireplaces to be installed Number of Woodstoves to be installed
1 List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
Plumber
Masonf,;-e
Electrician Aee/ g/8 7YZ-i`�2i
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 worse 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 Occupa o rtificate of Compliance being issued,as requested by the Zoning
Administrator br_Direzfo f B ' din es,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new c tructi
Signature. er,owner's agent,architect,contractor
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance 1jethods: PART 5 - Acceptable Practice Method
1&2 Family Dwellings (only) -', . "
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME: PROPERTY LOCATION:
/V
6.4exev7000
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area square feet
2 . Type of Heat - Electric oil Other
3 . Is building mechanically cooled? Yes No
4 . Percentage of area of windows and doors over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R
b. Exterior walls R
C. Glazed areas R
d. Exterior doors
R
e. Floors over unheated spacesl� R 1�9
OR- TC;*A'-.
,V/e, f . Edge of slab on grade (heated build i R
-ng) 'y
9. Basement/cellar walls (above grade) /R-
n. Basom e ent/cllar' walrs -(below grade) R
i . Heating/cooling-ducts-piping in unheated space R
W' ftC* -14_10ca 61-a
6 . Service (domestic) hot water heating device
Conforms to. minimum efficiency per code Yes No
TIE ERATURE CONTROL MAXIMUM SETTING 1400 WILL NOT BE EXCEEDED
p
Apo nt' si nature Date Phone Number
AINSPECTOR' S REMARKS :
�
Code Compliance and 'J"formationa( '5heet for Permit ZJSV
auveosbury 'Dept. of Community Development
Permit No. A2002 03 Project for: ,,"' �OL—\
Applicant Name: 'V
Old Tax Map No. T 1 APPoXUVs
New Tax Map NO Application,,
Lot No. House Notj /
road,street �A �#O
Mobile Home Park:
Subdivision:
Planned Unit Dev. -,Qnyig Iministrator
L
Parcel Size: acres TOWN 0 WEENSBURY _J_
Current Zoning: h Yti i at time of this Permit Application
Zoning Ordinance effective
at time of Subdivision approval by Planning Board:
YEAR ZONING
1967 .................
1982 June 11 th ..........
1988 September 19th......
2001 .......................
Setbacks: Existing Required Proposed
Front 1 0 J'7
Front 2 0 Note Regarding Approved Subdivisions:
(if corner and shoreline) ........................................... r* Prior to November 23, 1992;corner lot(2
Side 1 front yards)did not apply to zoning.
Side 2 All new development must conform to
current zoning.
Rear 1 —0 0 0
Rear 2
Shoreline
Travel Corridor Overlay Zone
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-1A(effective Z.Ordinance 1988)
Application appears to conform to the requirements of Section(s): of the local Town Code.
7own of Queensburo
Code ComptiAnce And %7nformAtionAl 5beet for Hermit Z4se
aueensbury .0ept. of Community .0evelopment
Drawing Space and Comments:
Parcel History
Additional review required by Zoning Board of Appeals
_Planning Board
con unents:
Town Board
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
Subdivision
PUD(Planned Unit Dev.)
Other
Recreation Fees Paid
Engineering Fees Paid
Site Plan Maps on File
Subdivision Mylar Signed and Filed
REVIEWED
BY STAFF(initial) DATE, NOTES
?own of Queensbury
01/0@M02 10:12. 5167793-0045 'COMM INS COMMERCIAL PAGE 01
OATS(MMIDONY)
ACD,�D.......: {' : : T, }F � in 4 �""�' xo , . :: . or oe 02
PROCUCGR THIS CERTIFICATE IS ISSUED AS A MATTER OF'INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Cor muni ty Insurance Agencies HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
89 Saratoga Ave,' PO Box 1369 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
South Glens Valli NY 12903 COMPANIES AFFORDING COVERAGE
Pater A. Seems, Sr. COAWANY
Pnan$Nd. 8-793-250 FaxMo. A Excelsior Insurance Covwany
WSURED COMPANY
8 Hartford Iris Co of the Midwest
Aca Kcaeo, Inc. COMPANY
ATTN: Thomas Case
3A Saratoga'Road COMPANY
Gansevoort NY 12831 D
THIS IS TO CERTIFY.THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN isSl+EO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDINOANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUfftNT WITH RESPECT TO WHICM THIS'
CERTIFICATE:MAY BE ISSVED.OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED MEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS
�OF"SUCH POLICIE3,LIMITS SHOWN MAY HA_VIE BEEN REDUCED BY PAID CLAWS. _
LTR I !'POLICY EFFECTIVE POLICY EXP:RA I
TYPE OF INSURANCE I POLICY NUMBER,
DATE jMMA)CIYL7 DATE NIMIDDl1^N) LIMITS�
GENERAL LIABLITY y I GENERAL AGGREGATE i 4000000
$ X COMMERCV—GENERAL 0ABILITY O1SBAGR2927 04/02/01 I 04/02/02 PRODUCTS.COMPIOPAGO '$ 4000000
CLAIMS MACE FX7OCCUR 1 PE�4AOVINJURY s2000000
OWNERS S CONTRACTOR'S PROT 'EACH OCCUR:RENC S .
x LOD +4 FIRE DAMAGE(Any one Iltn} i
Mt:OEXFwvan*pemcr} S 10 000
AUTOMOBiLIGLIABILRY ANY AUTO COMBINED$1NOLfIIMIT r
—�
I I ALL OWNED AUTOS BODILY INJURY R
SCHEOULEOAUTOS ( (P�cpr,ncrt)
HIRED AUTOS I+ BODILY INJURY _
NON-OWNEDAVTOS (Pvrtooident} -
i PROPERTY DAMAGE i
OARAOE LIABILITY AUTO ONLY-EA ACCIDENT S
ANY AVTO OrmER THAN AUTO ONLY:
EACH ACCIDENT S %\�
AGGREGATE S
6)(CCSS LIAOUrf EACH OCCL-ARENCE i
UMPRELLAFORM AGGREGATE S
OTHER THAN UMBRELLA PORM 3
w STATI)
WORKERS COMPENSATION AND f ER
EMPLOYFAW LIABILITY : i EL EACH ACCIDENT r
THE PROPRIETCR/ INC
l EL OiSEASG-PC21CY LIMIT r
PAiturmeexiCUTIYE
OFFICERS ARE: . ( EXCL EL DISEASE•EA EMPLOYEE %
OTHER
A., Zquipmnt Floater IM9294643 04/02/01 04/02/02 MOBILE 2SO,000
HOMES
:
DESCROMON OF OPERATiONiULOCATIONSNEWICL.ESISPECµL ITEMS
Mobile Ho>1sle Sales Office - CZRTIFICATz isst ED A8 PROOF OF- INSUFANCZ ONLY
:GER'!IFlCAT�:H�jtOEit: : ...:.. . _ .. ...;GAt�GE�a'dYtOt+t:�i:.�� €�� I:::> :=:t..�i.:..... °• : :•-;.. '::. ..
STEV--- SHOULD ANY OF THE ASOVS DESCROED POLICIES 8E CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE IABtANG COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE;TO THE GERTIFfCATE HOLDER NAMED TO THE LEFT.
>iP 6 j M4 S tevenraoa7
123 BUT FAILVAeTO MA UCH NOTICE SHALL IMP08E NO 08LIGArION OR LIABILITY
23 C Cronin litd:
Queendbury NY 12804 OFANYKINDUP THE MPANY IT3Ar T RREPRESENTATIVES.
AUTMORt2E0 RE N
IL CGRO •S'(�l�'.+)'. ".ACpR13GOFtl�ARilT14�N 1985 .
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arrive ► apart
Town of Queensbury tor's Iin Is
742 Bay Road
Queensbuny,New York 12804
NAME J PERMIT#
LOCATION 1 DATE — —CU
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney Height/'B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
InteriortExterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more ;
Interior Handrails stairs both sides 3 or more risers f
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to fiunace area
Furnace/Hot Water Heater operating
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs 1
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
-labundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 187'or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif:of Occupancy)
Okay to issue permanent C/O(Certif.of Occupancy)
0\1
i
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement .,.�
Dept.of Community Development Arrive LVpm Departz=���,�am/pm
Town of Queensbury Inspector's Initials s
742 Bay Road
Queensbury,New York 12804
NAME TE PERMIT#
LOCATION Ge0&)lIto R R DATE
TYPE OF STRUCTURE �r U
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 im or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to fiunace area
FurnacelHof Water Heater operating
Relief Valves)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level r
every bedroom
outside every bedroom `
inter connected ./
Bathroom fans G W
Plumbing fikhrres
Foundation.insulation NA
3/4 hour fire doorldoor closer r
Garage fireproofing
Garage penetrations sealedt � t G l (f pt1Fr�
Furnace in separate room protected(in garage) �J`►��� `�—
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical �� t
Site Plan/Variance required - r4 W.
*final Survey Plot Plan
As Built Septic System layout required �'j xx
Okay to issue C/C(Certif of Compliance) U
Okay to issue temp.C/O(Certif.of Occupancy) /�,
Okay to issue permanent C/O(Certif,of Occupancy) �'Q�L016 tdj""f{r�
111ES1UD1ENrYA_T_ FMI44-AIL XNSVIEC'17143Tq IR 1Pt3n'F to
qDmce No. 4(518>761-8256 Date inspection request received:
]Building Sk Code Enforcement
Dept. of Community Development
Town of Queensbury spe.toctor's Initia s
742 Bay Road
Queensbury, New Work"12804
NAME #
L:�j
_rYPr__OF S`I_P__UCILJR_V_
14/A YES WC3
' t Chimney bi-_ightP' Vent/Direct Vent cation
Fresh AirIna I3
kla- 1 —
:E>I.b -1,76_nt_W.F oof_ 1�1
Roof Complete i"1
Exterior Finish C
Interior/Exterior F-jailin 36-
lExterior Handrails,bal C. , Ian or more
Interior Handrails s oth sides 3 or risers RLI
.Aj
Grade 2%away fro uudation�_
8"clearance to s pte
Gas Valve shut ff exposed/reguiator 18"above grade
Gas Furnace s -off within 30 feet or-within line of site %
OilFurnace shut-off at entrance to furnace area
Furnace/Mot Water Heater
Relief Valves}instal-led
Headroom, 6 ft. 6 in. on stairs
Basement stairs,6 ft- 4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacyltrim/doors/main entrance 36"
Floor Finish Af
Bathroom/Kitchen watertight I I/ V--.
Interior handrails 7Balconies/1-anding 18 in. or more
Railing across window-in stairwells _001 Oe
Smoke Detectors:
every level
every bedroom
outside every bedroom-
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation_____
3/4 hour fire door/door closer
Garage fireproofing
Cyarage penetrations scaled s
Furnace in separate room protected(in garage)
Light ventilation per room C-N
Safety glazing IS"or less from floor
Final Electrical J
Site Plan/Variance required
Final Survey Plot Plan
.As Built Septic System layout required
Okay to issue C/C(Certif of compliance ..................................................................TI/
Okay to issue temp. CIO(Certif oEccupancy)_
Okay to issue permanent C/C>(Cer C>tif. ofC>ccupancy) u:> >
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC,
Main Office 176 Doe Run Road of Manheim, PA► 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
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the conditions following governed the issuance of this certificate, and any certificate previously issued i;
cancelled -
i r certificate one covers, the electrical equipment and installation conditions as of dater Up' the
This y
introduction of additional equipment or alterations, application shall he promptly made for inspection.
n ectors of thisCompanyshall have the revile a of makin a ections at any time, and if it1 sp privilege
rules are violated, the Company shall have the dght to r ke th ertif ate#
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DateM feet* Meaeiiitf{#iiaiiati,niHtit INSPECTOR H.iriii1 MMtre IM# itN#tiii.iMerieii#f iN+MiA 11 itieeMHiii.Mitri.rHtf
Mamhor N P.P.1_. 1.All
(� �T g���r �T �+ Office Use
GE ERALIly SPECTIO REPORT Inspector: l
Town of Queensbury Ready at time: ^
Dept. of Community Development Request received: Meet:
.building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE 9')U am/pm: DEPART am/pm Notes:
(518) 761-8256 Inspector's Initials
NAME: � ��'11-��Can PERMIT# 171060
LOCATION: 'a Croy, INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
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
Backfill Approval
Plumbing Under Slab
lambing VentlVents in Place
4 ough Plumbing
Heating Rough-In
Insulation _
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
.Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Franung
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:1SueHemingway\Building.Codes.tnspection.FORMStGENERAL INSPECTION REPORT.doe
Office Use
GENERAL INSPECTION DEPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, ATY 12804 ARRIVE am/pm: DEPART am/pm Notes:
(518) 761-8256 Inspector's Initials
NAME: Frg"� (i fe U&Csol— PERMIT# - 02_ - 139
LOCATION: I'L3 INSPECT ON(date): 7 2 FkZ—
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Forni
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/Dampproofmg_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place V
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping_
L:\Suel4emingway\Bttilding.Codes.Inspection.FORMS\GFNERAL INSPECTION REPORT.doc
cl�� � Office Use
GENERAL INSPECTION REPORT Inspector:
To win of Queensbury I
Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE]A �am/p PA a m Notes;
(518) 761-8256 Inspector's Init�
NAME: ��'�` �� r PERMIT#
LOCATION: c-', r P-o INSPECT ON(date): " I" Z.2—o z—
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMME S
Footings/Piers _
Monolithic Pour Form
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/W allpour
Reinforcement in Place
Foundation/D ampproo fing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
0sulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
�rProper Vent,Attic Vent In
ftaming i� b-A ti 1
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
*Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development ]Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NV 12804 Arrive am/pm Depart m/ m`
Inspector's Initial
NAME: �� �� � PERMIT# 33 —
LOCATION: C 1 K R C) DATE:
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers � 1
Monolithic Pour Form
Reinforcement in Place
The contractor is responsib a for
providing protection from eezing
for 48 hours following the acement
of the concrete.
Materials for this purpose on sit '
Foundation/Wallpour 1M DQ l ac-4) 1 o0b,
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing VentlVents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
Office Use
GENERAL INSPECTION REPORT Inspector:
Toivn of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
,742 Bay Road
Queensbury, NY 12804 ARRIVE 06 a Notes:
(518) 761-8256 Inspector's Ini i
Z r7t I
NAME: PERMIT#
LOCATION.1Z3 C-,9T t-t- INSPECT ON(date): SE—ZL4—OF
TYPE OF STRUCTURE:
RECHECK
N/A YES COMMENTS
V`F'ootings/Piers----S
Monolithic Pour Form
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_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing__
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging_
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping_
L.\SueHemingwayiBuilding.Codes.Inspection.FORMS\GENERAI,INSPECTION REPORTAOC
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GENERAL INSPECTION REPORT Inspector:
Town o ueensbur Ready at time:_��
Dept. of Community Development Request received.- `" " Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE a ~ In Notes:
(518) 761-8256 , - Inspector's Initi
NAME: PERMIT
LOCATION: INSPECT ON(date):
TYPE OF STRUCTURE: [ s`
RECHECK.
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsib fo
providing protection from ezi
for 48 hours following the p ace ent
of the concrete.
Materials for this_purpose on si
--
Foundatlon/Wallpour'
Reinforcement in Place" ",31
Foundation/Dampproofmg , :� .
Backfill Approval A {
Plumbing Under Slab
Plumbing Vent/Vents ace
ou h P lumbin
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls'Exterior R-
Floors R
Walls R- _
Ceiling R- I
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging ,
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
,L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
affice use-
QEW1ER--,k1. 1T",TSPFQrr10W PIEPOP,.-'r Inspector:
Y'own q Ready at time:
.f Queensbw-y
-Dept. of Comy-nunity Develop
ment -Request received: Meet:
Building cf-- Code Enfor
cement At time:
742 .Bqy Roezcl
Queensbu.--y, NY 12804 ARRIVE 7-
(518� 761-8256 Znit&ZIS
NTAME: szr-", PF-RMIF#
INSPECT ON ate):
It —C) D--
'rYPE OF S-rP-U=UP-U--:
RECIIECIC
W/-A, IZT-?S NO COMMETIZrs
Footinizs/Piers
Monolithic Pour Form.
Reinforcement in Place
The contractor is responsible for
providing protection from
l= ezing
8 for 4 hours following placement
of the concrete-
Mate-rrj6iAs for this purpose on si
--)�Reinforcement in Place ic:�
datiorj/Wallpour
F oundation/13arnpproofing_
Ilackfill Approval (D cs—,�— P,--v-c—, vA
Plumbing Under Slab
Plumbing 'Vent/Nrents in Place
Rough Plumbing_ A
Fleating aough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior P-- C—V\
Floors P-- --
Walls P--
Ceiling IZ-
]Duct work or piping in t
unheated spaces
Proper Vent, Attic Vent
Framing
Jack StudsMeaders
Bracing/Bridging
Joist Hangers
Jack Posts/Main 13carn
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestoppin
I-ASucHemingwayMBuilding.Codes.lnspection.FOP-M S\ORWER-A.1-INSPECTION REPORT-doe
Office Use
GENERAL INSPECTION REPORT Inspector: L`;
Town of Queensbury
Ready atn
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE a. 2�a „Z otes:
(518) 761-8256 Inspector'slniti a
NAME: <"— Iv�!'S PERMIT "v (
LOCATION: el J?-t INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES O COMMENTS
ootings iers ,v,
To no c our F
Reinforcement in P ce
The contractor is sponsib for �.
providing protecti from fr zing
for 48 hours follows ig the pla ement
of the concrete.
Materials for this purpos on si
Foundation/Wallpour _
Reinforcement:inPlace
Foundation/Daproo f
Backfill Appro
Plumbing Under Slab.
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors K
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging—
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:1SueHeminaway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE 7',ccw A anj� m Notes:
(518) 761-8256 Inspector's Initial
NAME: �-na Q F--t,)6c) PERMIT#
LOCATION: C—R-OL)IO INSPECT ON(date):
TYPE OF STRUCTURE: 6RD �j 7- C-ej& GfflP,.BC-,Z=
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Plac
The contractor is res onsib for V\�6" @-D
providing protection om fr ezing
la 0
for 48 hours followin the pl cement
of the concrete.
Materials for this p ose on sit
Foundation/Wall1po P1
Reinforcement e
in P,
Foundation/Damppro frog
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in lace
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inte, or R-
Foundation Walls Ext e or R
Floors R-
Walls R-
Coiling R-
Duct work or piping in,
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging_
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour_
Firestopping_
L:\SueHemingway\Bitilding.Codes.Inspection.FORMS\GF-NERAL INSPECTION REPORT.doc
•07/1-1/2002 16 52 5186953655 GARRY ROBINSON, PE PAGE 02
CONSULTIN6 ENGINEER
114 MONUMENT l RIVE° . SCHUYLERVILL . NY 12871
i5i'8} 696.3655
Judy 11,2002
John O'Brien,Building Inspector.
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Aear.John,
0e: Foundation'Construction
Stephenson Property
Town ofQueensbury, Washington County:
We Mently designed a foundation for a new pre manufactured home to be provided by
Are Homes for the subject family. Our design indicated that the garage foundation was
to be 20 feet deep when in actuality it was constructed at 24 feet deep. We inspected the.
site after the pour and its construction is acceptable.
Two other issues were brought up in an inspection report to the builder:
• Only two horizontal bars were installed in the walls.
• The top horizontal bar was cut for the basement windows to be installed.
Each of these items is 4�ceptable to us.-
If you have my questions or require any Rather information please do not hesitate to call
me.
Sin relt
Guciy Robinson;P,E.
Consulting Engineor
Cc Sharon Vein, Ace Domes
' Cat�toyLTomunmddAt�ti4lgCNbFo+mdofionLo?#Y '
05/02/2002 16:34 518-793-1994 ACE HOMES INC PAGE '01
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3 A Saratoga Ad: �-
•
COnsevoort, NY 12831
(518) 793-0153 •
(518) 793-1994 Fax
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03/20/2002 11:04 5186953655 GARRY ROBINSON, PE PAGE 01
' A TRANSMISSION
GAR 1 - ROBINSON9 P.E&
CONSULTING ENGINEER
114 Monument Drive .
Schuylerville,New York 12571
Phone and Fax, (518) 695-3655
DATE: ' TIME; ►�� A.L. P.M.
F PWGES
MOTE: If you did not receive all of the pages,please contact us at the above phone number.
TO: FROM:
CO.NAME: MAE: CARRY ROBINSON
ADDRESS: SiTH CT:
ATTENTION: ' r
FAX NO,:
hs et c-en car" c. . St � 6ue- 4& oel
160 � A� 7vr- aj 'Se_-f-'5 .4e
-Ale
�rl ' - r c gut
-Ae
Awe A7
�
STA7E'or: New YORK
DEPARTMENT OF . '
4 1`STATE.STREET..:::.,"
ALeANY,.•NY. r 2.23,1-000 f.
RANDY A. DANIELS
zeaRr t`iT cF 5TATt --
January 24, 2002
Mr. Robert Hoffman
Muncy Homes, Inc.
P4 Box 246- Route 442 East
Muncy, PA. 17756-0246
Re: Approval No. M 1387-97-024
Manufacturer No.' M 1367
Dear Mr. Hoffman:
Your request for an extension of the expiration date of Factory Manufactured Home Approval No.
M 1387787-024,'applicable to one and two"family dwellings, is hereby granted subject to the
.conditions of the initial.approvals.
} The manufacturer shall be responsible for assuring that-homes or components bearing insignias
issued doring the extension period also comply with the.current requirements of the NYS Uniform
Fire Prevention and Building Code.
This extension will expire on Marcia 19, 2002. A copy of this letter shall accompany plans or
- specifications submitted for a building permit and be.deemed a duplicate original.
i am hopeful that you wili.find this extension of assistance.
",Very tru -yours.
Geor" . Cia r.
Director, Codes Division
L; •
WWW.=S.5TATE.NY.US • E vWL; INFO&O.S.STATE.NY.US
• •- - ■rnrcua wva
STATE OF NEW YoRK
DEPARTMENT OF STATE
41 STATE STREET
ALBANY, NY -1 2 2 3 1-GCVO 1
RANvy A. DANIELS
* SECRETARY of STATL
December 19, 2001
Mr. Robert Hoffman
Muncy Homes, Inc,
PO Box 246--Route.442 East
Muncy, PA 17756-0246
Re: Approval No. M 1387-97-024
Manufacturer No. M 1387
Dear Mr. Hoffman:
Your request for an extension of the expiration date of Factory Manufactured Home Approval No.
M 1387-97-024, applicable to one and two family dwellings, is 'hereby granted subject to the
conditions of the initial approvals.
The manufacturer shall be responsible for assuring that homes or components bearing insignias
issued during the extension period also comply with the current requirements of the NYS Uniform
Fire Prevention and Building Code.
This extension will expire on February 19, 2002. A copy of this letter shall accompany plans or
specifications submitted for a building permit and be deemed a duplicate original.
I am hopeful that you will find this extension of assistance,
Very fr y.yours,
Sftark, Jr.
Director, Codes Division
J
Se
WwW,130S,5TATE,NY,uS E-MAIL; INFO@DOS.STATE.NY.US ~
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i
03/15/2002 13:19 5186953655 GARRY ROBINSON, PE PAGE 01
_F_A_X_ TRANSMISSION
GAR.RY ROBINSON F.E. C
CONSULTING ENGIlVEER MAR
114 Monument.Drive T 200,
SchuylerWle,New York 12871 Q7
�(poFQUF
Phone and fax: (518)695-3655 1VG� �p�RY
DATE; 2 TLVIE: A.M. P.M.
NOTE: 1f you did.not receive all of the Pages,Please contact us at the abcyve phone number. OF PAGES
TO: FROM:
CO.NAME: NAME:
ot�fP'1 - GjARRY ROBINSON
ADDRESS: SUBJECT.
.AlIENTXON: Do4m_
F.AX NO.:
RENLA s: r-c Shy e) llent I Armes
DA-Ve
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Madh
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03/15/2002 13:19 5186953655 GARRY ROBINSON, PE PAGE 02
s _ -
GA►RRY, R. ROBINSON, P.E.
CONSUL TING ENGINEER
114 MONUMENT DRIVE SCHUYLERVILLE NY 1 '
(518) 666-3665
ECEt\/I
D
March 15;2002 MAR -1
TOWN OF QUEENSBURY
BUILDING AND CODE
Dave Hatten,Building Inspector
Town of Queensbury
741 Bay Road
Queensbury,NY 12804
Dear Dave,
Re. Foundation Design
Stephens son Property
Town of Queensbury, Washington County
We recently designed a foundation for a new pre manufactured home to be provided by
Ace Homes for the subject family. Our design showed a keyway at the center ofthe
E footing with dowels being placed at every 6 feet on center to connect to the basement
wails.
The foundation contractor has requested that the keyways be eliminated from the design.
The keyways can be eliminated from the footing as long as the top of the footing is.
cleaned and roughed up prior to pouring the wall on it, The dowels need to be placed as
shown. This change will have no structural impact on the foundation structure.
If you have any questions or require any further information please do not hesitate to call
me.
Sincqely,
}
MY R 1 on,�►.�,
Consult g Engineer
Cc: Sharon Vein,Ace Homes
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