2001-085 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: P20010085 Date Issued: Monday, June 11, 2001
This is to certify that work requested to be done as shown by Permit Number P20010085
has been completed.
Tax Map Number: 523400-074-000-0002-083-000-0000
Location: 59 SARA-JEN Dr
Owner: GUIDO PASSARELLI
Applicant: MICHAELS GROUP
This structure may be occupied as a:
By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Garage - 2 Cars Attached
Fireplace avP
Director of Building&Code Enforcement
1
eithdoi TOWN OF QUEENSBURY
F4742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
erN
Community Development- Building& Codes (518) 761-8256
BUILDING: PERMIT
Permit Number: P20010085 Application Number: A20010085
Tax Map No: 523400-074-000-0002-083-000-0000
Permission is hereby granted to: . MICHAELS GROUP
For property located at: 59 SARA-JEN 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: GUIDO PASSARELLI Single Family Dwelling 179,900.00
40 LEHLAND Dr Garage-2 Cars Attached
QUEENSBURY,NY 12804 Fireplace
Total Value 179,900.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
NEW YORK BOARD OF FIRE UNDEI
Plans &Specifications
BP 2001-085 Lot 83, House No. 59 Sara-Jen Drive, Lehland Estates
Single Family Dwelling,2 car attached garage, and fireplace
as per plot plan and specifications.
$270.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,March 12,2003
(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 To I ensb ; Monda March 12,2001
SIGNED BY , for the Town of Queensbury.
-.- Q urY•
Director of Building& de orcement
Building Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road,
Q
NOTICEJ
'D BUILDING do . CODE ENI%ORCEME �rc�c�nabrrry, NY /2rSO4 /7G/ S2.SG/
Requirements prior to issuance r
of this permit: • PERMIT FILE NO,, 061-aiS
A permit must be obtained before ((//``beginning construction. No inspections �ZS
will be made until applicant has received Ti Zon in:g Board Actions PERMIT FEE PAID ' •
a VALID BUILDING PERMIT, All Arca / Usc `
applicants' spaces on this application RECREATION /-Er'•P.6I•'dlw
MUST be completed and.the signature El Planning Board Action / e.
of the applicant•must appear on the REVIEWED BY
typlication form. Thank SPR / Subdivision /Other / raiding Inspector
J n Recreation Fee Payment
Applicant: 1i-4>~ t�11 .(5 1p Up Owner: �Ji�'f't�5... -��•• /
' Address: %CS /_•.�r\t . , ►\-6,vslq, \-2p'2L5 Address:
Phone # (tj_l� ) eaa - ( l` Phone # ( ) -
Pro per ty Location: 5 ? dl-c` -Q ._ 1Qt $3
. Subdivision Name Alt �'lcAcw(1eRTNY f) ,]�uP � Wax Map Number /__I
l '\ y Section Mock f nl
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
X New Building: CONSTRUCTION: $ V-M aa,
residence / commercial
Addition to Building:
• residence / commercial OCCUPANCY INFORMATION :
Alteration to Building: Primary Building -
residence / commercial _x Single Family Dwelling
Residence / Commercial Two Family D . . �
no change to exterior size Family ,
Office
Other Work (describe below) Mercantile MAR opo®:2 2061
ManufacturTTOng�
GROSS AREA OF PROPOSED STRUCTURE:� •
Other BUILDING ��PUF Y
1st Floor �O If ADDITION, what will use
0'�� sq, ft as of new addition be? :
2nd .Floor S3"21 sq, ft> q •Other Floors sq. f t . ✓Q' `b'
( not unfinished cellar or basement))
ACCESSORY BUILDINGS :
� Detached Garage 1 , 2 c.
^
hV
TOTAL FLOOR AREA: rL SQ. FT. ?C Attached Garage 1 ,
111
Private Storage But "'.
SIZE OF NEW STRUCTURE : • Commercial Storage Building
t_ FEET X 5 1 FEET Other
•
•
Foundation Type : F�ZczE Will any second-hand or ungraded
' Number of Stories : 2 lumber be used? If so, for what?
(habitable space only) .D
Height (grade to ridge) : 29 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove ( circle all which a.plies )
to be installed: ORAL Electric / Oil / / Wood
Forced Hot 'Air 7 Baseboard / Other
Person responsible for supervision of work as regards to building '
codes is : 13tA �t.-4 .r-t aR ?s2vzt,k l-a-E1u1:Z.
Na' e A.dre s Phone '
Builder: M_( 1`
Plumber: . . .,.. , •• .r Low .».-. c. A_.. 2 0 - -
__ -
Mason : lo , .�. ,�'� _
• E e c:"r i C 1 aTi Y Q 2 ' k=�t..v�44�P rY YY _ �- -- -
•
DECLARATION' Please sign below afi`er 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, arc 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, an AS BUILT PLOT PLAN by
a licensed sun' or• drawn to scale, showing actual location of project on premises.
Signature: ,V
•
(owner, owner's agent, 'architect, contractor)
•
Application for Permit — Septic Disposal System
Town of QINCOI sbnl y 742 any Bowl Qnewishury, N)' 12804 (518) 761.8 2,S6
1. OWNER INFORMATION:
Location of installation: �� � ` iv Office use
Tax Map No. _ / / i File Permit No02661-06 5
i
Owner's Name: TRE 1r i Fee Paid
I •
Address: 1� �`L''C�. 'Y� .\I \ zE , 1c11--6 V.-.), C.)
2. INSTALLER'S NAME : CY1\ •YZ) v2`RY\r, PHONE N0, (.v2 L-,.).1C .
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate ll bedroom(s) and multiply 11 of
bedrooms with applicable gallons per bedroom to equal total daily flow)
•
Year of I-louse: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdnn = •
1980 - 1991 x 130 gal/bdrtn =
1991 -present -a x 110 gal/bdrrn = 37—O
Garbage Grinder Installed yes / no X
Spa or Whirlpool Installed yes __. / no X
'I, ,PARCEL INFORMATION: (circle applicable information & indicate measurements)
T _91.1raplry Soil Nature Ground Water 'Bedrock or Impervious Material Domestic Water Supply
•!'lnc (..land- '') at what depth at what depth
lzalling loam feet t—`/ nrnici--
Steep slope clay Ji ci —�
__%u slope ether
depth, if well; water supply
from any,septic-system
-' absorption i,s__ ,/i.
Percolation Test: (l'o he completed by licensed.prolessional engineer or architect) other ______
Rate, _._..j....._-._._.. minulc'per Inch
5. PROPOSED SYSTEM: For New Constriction: 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 Bgand leach field for each Garbage Grinder, Spa or Whirlpool Tub.
KX
Septic Tank: gallon (min. size 1,000 gal.)
Tile Field: each trench _ "ii /i, Total System Length: !1(.0 /1•
Seepage Pit(s): number of_ size of each: ^f). by_ ft. -
Size of Stone to be used: II -__ / depth or`thickness__.__._._.-._../L•ci
Bed System Size: r
•
. Alternative System: . • k.____ _ -� length ancUor size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: N,,, / Size of each: gallons /TOTAL Capacity: gallons
_ Note: Alarm System_and._ass.o.ciated-electrical-wer-k-mu-st be-inspected-by-a Fuwn-a-j roved -
electrical inspection agency,
•
•
7. ' SIGNATURE & INFORMATION FOR RESPONSIBLE PERSON (please read) .
For your protection, please note that pursuant to Section 136-29 of thre 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.
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.
/2 /0 1
Signature of res onsiblo person Date
Fire Marshal's Office Town of Quecnsburv, 742 Bay Road,Quecnsburv,NY
(518) 761-8205
Application for Fuel, Burning Appliances & Chimneys:
applicable to solid fuel & vented gas appliances .
�
Date••t ri,3'7,, ,, 20 0k ', Permit 900 og•
Application is hereby made to the Building& Codes Office for the issuance of a Building and Use
Permit pursuant to the New York State lire,Prevention and Building Code. 77re applicant or on-vier
agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part cif
these requirements and also will allow all i rspeclors'lb deer premises to perform required inspections.
NOTE to applicant: Rough-in and Final Inspections are required. •
Applicant Information Fuel Burning Appliance Information
°� "�,� (circle appropriate words)
Name: 1 1i'rkk 01c, revra +ei',i Stove: wood coal pellet gas
Fireplace insert
Address: 1. , a Fireplace, factory-built: wood
'' ,Rl .,,. 11.4 , (?rake Fireplace masonry: wood gas
Furnace: wood wa) oil
. Phone: 5 ...(,„1,,
• If non-masonary applicance, please provide
Owner: ,qo Manufacturer Name:
Address: • •
Model Number: '
Chimney Information {�
Phone: (circle appropriate Words) .
Masonry block brick stone
�� ,_ Flue tile size: inches.
Exact Address: ►r
of construction or installation • Factory-Built •
.. Manufacturer name:
Model Number: .
iVote: Listed By: Number:
Construction/Installation must
conform to NYS Fire Prevention &Building .! Indicate (circle) chimney material:
Code. Consult available Town of Queensbury i
Handouts regarding required inspections. , Double ti•all / Triple wall / Insulated / Direct venting
•
Chimney Liner •
1 C%aailEube "& ir3 .ciat—Toicsrsi of Que,ezaraZauz y, ISTewrr .1 ' I. .
t
Fire ltlar'S'lial Code# S Collected S Refunded Received li•ont (re irndcd to): 1 1 ) t j.1, t l- • YBf/ ?"..:f;
'= ¢,:.. address:
.a 173 3389 (190) Public Safety ,� •}i •--
1 233 3655 (230)Minor Sales '
DZ,9 ,. • ,-,. . .
,I
7 _E' :., _.3t ,
•
41�ILGNN1.G - T,,,, 664,/./01, t]GUN J?•
•
White(Applicant) ,- Green(Fire Marshal) / . Yellow(Bldg. Dept.) Pink&.-Goldenrod(Cashier's Dept.) -
010111KTOWN i F QUEUrNSBURY
4111 .1 BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
• ( (518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDE TI L
DATE INSPECTION RE UEST RECEIVED: 6, /I f -
NAME /��
LOCATION
/ 3 - y
DATE l/ j PERMIT oa/-6�'S
TYPE OF STRUCTURE h
FOOTINGS FOUNDATION _ BACKFI ,L FRAMING
ROUGH PLUMBING SEPTIC _ INS L ION •
FINAL ELECTRICAL WOODST'OVE OR REPLACE
N/A YES NO I
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT /
ROOFING
' EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERAT NG /
INTERIOR TRIM/PRIVACY D O /
FINISH FLOORS:
�-f
BATH/KITCHEN WATERTIG T
OTHER FLOORS SWEEPABL.
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILING
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO.
FINAL SURVEY PLOT PLAN Ok
•
OK TO ISSUE C/O OR C/C
FIRE MARSHAL
0/10•. TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INS ECTION REPORT
REQUEST RECEIVED // PERMIT#
NAME
LOCATION Lt- 83 3 'L4-d
SCHEDULE INSPECTION ON 6///frr1u/
,,,t-/59 ^l AM ANYTIME
j �' c APPROVED
N/A YES NO
EXITS ff
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYS EM
FIRE SPRINKLER S STEM
FIRE SUPPRESSION S
r
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLE"S
CLEARANCE TO HEATING U ITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY gy�pp
FIREPLACE-FACTORY BUILT M l C-
'DvR36,
REMARKS: OK TO THIS DATE
itc�� �x� �
INSPSLIP.PUB INSPECTOR
( <FN.-
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: j it )/
Building&Code Enforcement jj t,
Dept. of Community Development Arrive am/pm Depart 6 -I Rm/,pm
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury New Yor ,12804
1 I ) 0NAME 14(4, c� ° 0 PERMIT# V 6 S
LOCATION � �%I!�l�ilfr— DATE ////c)'OV/
TYPE OF STRUCTURE ' d-
01314 115 3 N/A YES/ NO COMMENTS
• J
Chimney Height/"B"Vent/Direct Vent Location /
Fresh Air Intake 1 `-- 41 6�--
Plumb Vent through roof /, N
Roof Complete ,,///
Exterior Finish Complete
Interior/Exterior Railings 30" i 36" a,
Ac"..
Handrails,balconies,1.I ding 18 in.or more !:
Interior Handrails stairs both s de 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate t� ,
Gas Valve shut-off exposed/re a or 18"above grade J//
Gas Furnace shut-off within 30 1 eet or within line of site /
Oil Furnace shut-off at entranc:to i .ce area ,/ /
Furnace/Hot Water Heater oper. ,1
✓�
Relief Valve(s)installed
Headroom,6 ft.�in.on stairs Z/
Basement stairs,6 err. -..,. ,/Handrail exterior stairs both side more than 3 risers ✓
Interior privacy/trim/doors/main : trance 36" f
Floor Finish f/
Bathroom/Kitchen watertight �/
Interior Handrails Balconies/Landi . 18 in.or more
Railing across window in stairwells /
Smoke Detectors: ./
every level
every bedroom
outside every bedroom
inter connected ✓�
Bathroom fans ✓j
Plumbing fixtures t/
Foundation insulation
3/4 hour fire door/door closer ti.X .
V/
Garage fireproofmg
Garage penetrations sealed
Furnace in separate room protected(in garage) r
Light ventilation per room /
Safety glazing 18"or ss fr floor /
Final Electrical ,5 y O/ C -'t-/i-g
1,------:7-
Site Plan/Variance r uire
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) .
/0M2
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT#
NAME t-C/ Q Ciy•OLia
LOCATION _ 59 —�I -o Q - �(
SCHEDULE INSPECTION ON 5 r / _7c
20 AM 'M ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTAL ,'TION
INTERIOR FINIS ES
STORAGE: •
CLEA' 'NCE TO SF INKLERS
CLEARA CE • HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY P�2C-v- \iesT
W D STOVE
/REPLACE-MASONRY (��
FI EPLACE-FACTORY BUILT 9'C, ✓
REMARKS: E] OK TO THIS DATE
Pee) '• >PE•
C�
OK 1-6' 6)U6A
INSPSLIP.PUd G INSPECTOR
s
Z.- 1 . ?E(___,--cAtA
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Qucensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive ai m Depart
nspector's Initivow
. 4
NAME: t ' pt ( -bov PERMIT# __lac—,r —c€,5
LOCATION: ci KtV0F � OE_ DATE: 1 .— - C)I
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1
Monolithic Pour Form
Reinforcement in Place
The contractor is respo sible or
providing protection m fre zing
for 48 hours following e placement
of the concrete. ./1
Materials for this purposi on .to
Foundation/Wall ur
Reinforcement in PI e P
Foundation/Dampproo g
Backfill Approval
Plumbing Under Slab
Plumbing VentiVents i Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inte .or 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-1 "(-<kThi2!7
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
•
_ APR-26-01 THU 02:14. PM BELL. TRUSS DEPT, FAX N0, 3551371 P. 02
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1y)
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive % an m Depart '-
Inspector's Initia
NAME: PERMIT CVS
LOCATION: DATE : L) ;--) t') j
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsi.1 a for
providing protection from --zing
for 48 hours following the pl:cement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place -
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing VentlVents in Place
Rough P mbing
Heati ough-In f
ulation V Tt'k
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- ej0 G ALL F6V_
Walls R- ( 9
Ceiling R-
Duct work or piping in
unheated spaces R- /
Proper Vent,Attic Vent
Framing csuoF FaAM 1 b V P F t�(�1�IrC� ic;\/ �.11/4
Jack Studs/Headers
Bracing/Bridging :J
Joist Hangers ✓,
Jack Posts/Main Beam ✓
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED PERMIT# 0 Y -N
S
NAME _ \0 \t c)cQ0 C-5r61,CAp.
LOCATION 5 ov.
SCHEDULE INSPECTION ON L -_ _♦ 06
n ►t AM "M ANYTIME
�"' APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM W
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS _
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
Fl EPLACE-FACTORY BUILT ‘,/
REMARKS: ❑ OK TO THIS DATE
INSPSLIP.PUB �/ .INSPECTOR/
1
GENERAL INSPECTION REPORT '3 O „..3 riv
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arriveani/-Depart : . `,
41°
Inspector's Initial'
NAME:\\\i,C�C3k Sz .c:) c-5-feDAt/ PERMIT# Of. RS _
LOCATION: ,01 .......Y0\�-Q1Y1 DATE : ,ri • 0 I
TYPE OF STRUCTURE: -NC--Th
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1 1 \
Monolithic Pour Form OH -00 F , n
Reinforcement in Place �{
The contractor is responsible fn Z l�-fl�F-TE� k t \LL
providing protection from leeezin
for 48 hours following the placements k-k" U- coaTh\0
of the concrete. /� \)��- Z�`y ��-NL�t�
Materials for this purpose on ite �°` t o
Foundation/Walipour ,
Reinforcement in Place
Foundation/Dampproofing — (�
Backfill Approval ` `'''' LC--� \-
E L, ?C _
Plumbing Under Slab / •
. V �`
Pl bing Vent/Vents in Place V e �� q T� �1 �
ough Plumbing ` -`47 7 Ft � �/`
Heating Rough-In c'- J i; v �L-A .L=k7. .j / Z.ZM
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R- \ \ �
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Pr per Vent, Attic Ven
7,ds�
` ming �i k�
Jack Studs/Headers ✓
Bracing/Bridging
Joist Hangers erlie
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3, hour
Penet ation Sealed
Fire all 2,3,4 hour
estppping \ai 7W 1,;•D?-..._
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804. Arrive 3f' ' am/pm Depart am/pm
Inspector's Initials 4--
// 1
NAME: /4i�l`6� JidAP PERMIT# rad)/- " ^v
LOCATION: ' - c , -J j.„-* DATE :
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers i I
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
Back ill 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
TOWN OF QUEENSBURY
BUILDING &_CODE ENFORCEMENT -- )C6
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name _____\ 1.447 Y rn
Location SQ\ ZPOICA QN./Y-41f//
Date 5 1- '0 Permit #
SOIL TYPE• San. Loam-Clay-
Results of Percolat'o Test-
(if applicable) Ra ,e-Mi ute/Inch !
TYPE OF SYSTEM:
ABSORPTION FIELD: otal Lenk th /4Z1
Length of each tre chi a
Depth of trencher 1,
Size of stone lAtialWANK '►g
SEEPAGE PITS: Number
Size - ft. x ft.
Stone size
PIPING: Sizg Type
Bldg. to Tank f&rr 33
Tank. to Dist. Box u /71_,0 C�
Dist. Box to Field/' ' .
Openings Sealed? (Yes No Partial
LOCATION/SEPARATIONS
Foundation to Tank J5 feet
Foundation to Absorp •ion — ' feet
Separation of Pits
Conforms as per Plot "l an No
LOCATION OF SYSTEM ON PROPERTY:
(circle
Front Rear- Left Side - Right Side
Middle ro t - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: NO
Arrived: Aki
Departed: imige
Building Inspe or
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depar(> )' rpm/
Inspector's Initials-(20..j)5?-
NAME: PERMIT#
LOCATION: 5 3 DATE: j
TYPE OF STRUCTURE: SF\�
RECHECK
N/A YES NO COMMENTS
Footings/Piers —�
Monolithic Pour Fo
Reinforcement in P1•ce 1
The contractor is -sponsible for
providing protection from freezing
for 48 hours folio ' ng the placement
of the concrete.
Materials for this p q.-•se cn site
Founatran/Wallpou
Reinforce
Found on/Damppr•ofing r�
11 Approval
Plumbing Under Sir•
Plumbing Vent/Ven s in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Wall Interior R-
Foundation Walls xterior 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
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received: t 3
Building&Code Enforcement
742 Bay Road '
Queensbury,NY 12804 Arrive am/pm Depart)---'
Inspector's Initials (�
-C>2406/rAC
NAME: jit,c1.4
/ PERMIT#
✓� DATE: 3
LOCATION: , '
TYPE OF STRUCTURE: t D
RECHECK
,ter 41CP3
N/A YES O COMMENTS
Fo 'ngs/PieIs
Monolithic Pour Form
Reinforcement in Place 4-4 •/
The contractor is responsibly
providing protection from eezi
for 48 hours following the •lacem•nt
of the concrete.
Materials for this purpose on ite
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing VentNents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior -
Foundation Walls Exterior
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
- CONSERVATION COLTS UMOI CODE .
PART 5 COMPLIANCE FORM
Building Design by Acceptable Practice
JI7 DING a
)DRESS: ' DATE: .F(s\Or A .3C\
QG
. JS y . COUNTY: -C R:Re/
aCHIITECT,ENGIh R OR 7j�-7-0���
3NTRACTOR: THE N/G jfti CO20 UP PHONE: 5 18-
=RMIT APPLICANT: 5,5 ri G PHONE:
0-0
d&S.
HEATING DEGREE DAYS (Table 2-1)
❑ 5000-6000 (X 1 7000-9000 MAR 0 2
2001
� UIL®F QUEENSBUR;�
[. BUILDING DESCRIPTION (Pre-qualifying Conditions)*
If the building does not meet all of the following pre-qualifying conditions,
Part 5 of the Energy Code may not be used.
I A Building is residential with'one or two dwelling units_
❑X Building is less than 5,000 gross square feet
X Building is three stories or less in height.• '_
( Y Ratio of glazing area to gross wall area is equal to or less than 17%_
111. PROJECT TYPE
n New construction I I Substantial renovation of existing building
n Addition to existing building ( Exempt(7810.6c) of Nat.
140
1V_ HEATING SYSTEM TYPE }
I Gas-fired l _1 Oil-fired I Heat pump ( ,Electric h y =.,
Joint Sealing: 7814_10(i)
Joint location I Sealant Type Specified I Plan/Spec_ Reference
Windows Polycell
Doors frames I weatherstripping
Walls at roof/ceiling ���f11 , I
Walls at floors/found. Polycell •
Wall panels N/A
Utility entrance Weatherstripping
Penetrations Polycel 1
Other
Other
Air Infiltration Barrier: 7814.100)
Location Required? 1 Specified I Plan/Spec_ Reference
. Walls yes[no No-Cedar Siding
Other yes/no
Fireplace: 7814.10(k), (m)
Required I Specified Plan/Spec,Reference
Outside combustion Yes-
air duct with damper
Flue damper with max.20 cfm, or damper ( 20 c_f_m_
damper and non-combustible doors
•
Gas fireplace ignition
VI. HVAC PERFORMANCE: 7814.11 (Table 5-3)
Equipment 1 Minimum Performance Specified Performance Plan/Spec.Reference
Furnace 70% AFUE 90%
Boiler
Heat pump
Central air
conditioner i
r
«VAU UUN i !-NUL: 7814.17
Temperature Control
Required 1 Specified • ( Plan/Spec_ Reference
Thermostat each Yes
dwelling unit
Shut off at each Yes
terminal unit
Thermostat
Required Specified ( Plan/Spec_ Reference
Minimum range ! Yes
45°F-85°F I
Deadband Yes
range ? 5°
Automatic - Yes •
capability
VIII. DUCT SYSTEMS: 7_814.13
Category Required Provided Plan/Spec.Reference •
Duct >_ 1"thick N/A in conditioned space
insulation R-33 in uncondtioned space
Transverse Sealed Yes.
•
jointsQ.
.
IX. VENTILATION SYSTEMS: 7814.14
•
System Type Required 1 Specified Plan/Spec_Reference
Supply Damper at envelope Ye s
Exhaust Damper at envelope Ye s
Supply on/off switch ( YQ s
I \
Exhaust - on/off switch I Yes
•
X- P.IPING INSULATION: 78141_15
Piping Type lnsul3tion Provided Plan/Spec.
Required I Reference
Heating distribution" >_ 11/2" N/A , I
Service hot water` " > 3/4" 1 N/A
'Does not apply to zunouts_
"Does not apply to piping with a diameter less than or equal to 3/4"inch.. -
XI. SERVICE'WATER HEATING: 7814.21 (Table 5-4)
Performance Requirements
Wacer Heaters Minimum Specified Plan/Spec.
P
Performance Performance Reference
Storage EF• > -93 -_00132V I > _93 •
Instantaneous N/A
Pool , N/A
Controls
Category Required Control Control Provided Plan/Spec_
Reference
System automatic control Yes
System temp_"setting range 140 degrees max_ •
Pool heater IID N/A
Pool heater on/off switch N/A
Electric water heaier separate switch N/A
Gas/Oil water heater separate valve Yes
XII_ ELECTRICAL POWER: 7814.31
Category I :Required I Specified Plan/Spec. Reference
Electric meters I E . dwellino unit
is
E.A. `LIJOR HALL •
OFA.GUE cRAKED kALL: vORKSYEE-
R-Value i R-Value
Insulated Construction Fenced -
Area - Cosoonent t AC 4a
' Nil : -
•` 0.68 i , .// -
Jct. A'ir Films 0.68
1/
r / `
.45 1 2" Gypsum Bd. t .45 (I IIP 1 � "1_ -
�
•
19.00_.
r
:;;:z::: ------- 2x6 @ 16" o.c. , 6.87 1r( -•
Studs •
li
' 111 �
�- -54 1/2" Waferwood • .54 ��
� Sheathing r 6l\
�{ 1 _65 . V1rlyStidicg :654[ 11
t 0.17
,—.____A Ext. Air F:l m t 0.17 ) l'
21_49 R-Total 1 9.36
U insuteted Fraction Franey Fraction',
R-Total Insulated R-Total Fraaeo
U 89 .15 •
it t
21.49 9.36 t • _056
i
•
-
t
* wall Stud Spacing I insulated Friction Frarea Fraction
12" 0.C. .83
• . 77
16" O. C. .ES
. 15
2' " 0_ C_ . 88 <
. 12
rr
EASEHENT/CELLAR KILLS: aORKSN££-
@ stairwells
R-Velue i R-Valve .
with Ext. ' Construction with Int. N
Insulation 1 Coaoonents - Insulation
a ( -
ill 0.17
j, 1 - HI Ext. Air Fi 1 a • ►��.
None
♦ _ Exterior Finish %
: .' ; I I. 7 8" Poured . . ( `-,,♦!.
�� .,
•
♦♦4 a ; Core Insulation . 1 ♦• ♦j:
= �♦�- ; (•t any) � - ���'
:j j -! .• - j-l12,R-max «�-• ►♦!:
I1L •♦! - Insulation l4-gjfl i-. ► 4:
��:E (axt. oc int. ) , '� '�! -
(*♦♦♦j - Interior Finish 1; 41.11
—I ♦4 : 0.68 I 0.68 n 40
. I♦♦ .. _ - ( (nt, Air Fi1e-,
-I •- ♦♦:
1 / -37
R-Totzl
3
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1
.t R-Total
I.
K /3 -37• -
Exposure Above Crade • .
.
r.
Dept 8cl o.r Craoe -. 48
EASEH£HT/CELiAR (ALLS_ eORKSH£E-
R-Value I R-Value
with Ext. Construction i with int_
•
•
-
insulation Coetoonsnts insulation
1 I
OW! I :1-� D:77 ( -.4-
_ Ext. Air Fi l c • t).17 ,.1 .-_ .
�� .♦4
�• •! l None -
W. • < Exterior Finish •�-
►.4 d : - Core insulation - •40
•
[r....4,� insulation 1.1i-41
o•. _-�.;:
(ext. or int. ) ��
�►���.- v.- None ` . s
t .' _ Interior Finish _ jV
II=►•i- • W.
: .
♦♦ - t, A.. , e65
1.1'1 ( -.N:
13.57
R-Total
• U w /
- .c R-Total ••
1 t,
U •
K w 13 .57 .C74
8
Exposure Above Crede
•
•
Depth 8clo.s Grade . 48 ., •
•
OPACIJE FRAKEJ F. GR- ItORKSi-IEET
J ��_/ff,-',",-' rj
r _. . .. . .kJ i.
_ .. . . i___________
- ik ii, ;;/t / I / . 2‘.....„ ; : I, :
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. . -;__, __t/. - I : ,, -_
R-Value R-Value
l ( '
( nsulataa Construction Fraaec
1
4 Area Ccrzcnents - - Area .
I 0.92t . 0.92* .
: I Ext. Air Film
19.00 6" Batt ----
. . . . . . . . Insulation
• ---_ ; ll 7/8" TJI's @ 24" o_c _
•
v .. .... Joists . 14.8
3/4" waferwood ,
1 _93 _ . . . Sub-Floor oor . ....P3. ; 1
•
I. carpet vinyl (
. n gg-1_ in. Floor . 1?egl..
! 0.92 0.92
(nt. Air Film
21.02 R-Total ! :16.86. . •
U insulated Friction + Framed Fraction -
0
• R-Total insulated R-Total Framed
'u = .95 - .05 -
0
t''.048
21.02 16.86 '
•
•
* For vented crawl space, usa R = 0.17 for ext. air film.
_= Floor Joist Spacing. Insulated Fraction Franeo Fraction !
12" 0.C. .87 !!
I . 13
16" 0.C_ 90 10 1
ROOF/CEILING ZVENTEC, : 'ORKSt?££: •
1 : I r = :
;7 • F � � � Jam;. 4• _ —'-
R-Value
R-Yalae
1 : Insulated Construction France
'• Irca 1
• CoYQOntQL3 ( Area
• t 0.17 Ext. Air Film 0.17 ' I
• • 30.00. 9" Batt ---- 12_00 Overlap -
- Insulation t -
2x4 bottom chord
---- @ 24" oc 4_35.
Joists •
_a5 1/2" Gypsum Fc1_ _45
.... Wallboard •
0.61 0.61
Int. Air Film
31_23 17.58
R-Total •
Insulated Fraction* Fraaced Fractionw
r
R-Total Insulated R-Total Framed
u _93 _07 . •
r _ _034
31.23 17_58
•
* Roof Joist Spacing Insulated Fraction Framed Fraction
12" 0.C.
.87 . 13
16" 0.C. .90 .10
214" 0.C. - .93 .07 •
• -
•
. ,----:77---..) ___, , , 4 -) &IP., .,,i.,'• .
k:e•-:;-;--72,'•S --;:j•-.) 11,.()ki'1 /1/i - 'c) (7-: •/.1,-.. it
Sic,•:;.:::..5., ..,........_ __. f
-------
I .
•
I , N0515150”E
I 100.00' NO CLEAR
L t.)
c..) . -__-------------.
.:...___q have seen or observed, o ieve I saw evidence of, .
"-roa-Ilohjects such as ho s, wells, trees, fences, etc..,
shown on this ment I also represent that I have
person ea e • ces set forth on thE iagra ." Cdczt... Liti,• iii.S--"/
.......st -T
,
SIGNATURE /. DAT i I
'4•
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MAP REFERENCE:
LEHLAND ESTATES SUBDIVISION
FINAL LAYOUT PLAN — PHASE 3
DATED: APRIL 27, 1999
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
I HEREDY CERTIFY THAT Tres NAP wA5 MrMLP
FROM AN ACTUAL MIX SURVEY.
THIS CERTMATION SHALL RUN ONLY TO THE PERSONS
rOR WHoM THE sURVEY wAs PREPARED. AND ON Tmw
MEHALf TO THE TITLE COMPANY. GOVERNMENTAL AGENCY
AND LENT NG NSTITUTION LISTED HEREON.
GERTM'ICATIOMs ARE NOT TRAN$FERADLE TO ADDITIONAL
INSTITUTIONS OR SMSeQUENT OWNERS.
GERTnm Ta Joseph P. Johanna M. Pak
5unmark FCU. its successors and/or assigns
Chicago Title Insurance Company
MATTMV G. STEWS. LLS NYs W135
DATM June 5. 2001
S ARAH J E N
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Land
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LLC
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Queensbury, New York 12801
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Barren County, New York
518) 792-8474 New York Lie. No. 50135
WIN
NO. I DA TE
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JUN 11 Z001
OF CUi=ENSRURY
��i �G �n�p_�— CODE
LEGEND:
oC.M.
= CONCRETE MONUMENT
= HYDRANT
= MAIL BOX
#
= LAMP POST
—�----
= STOCKADE FENCE
C
= CHAIN LINK FENCE
DESCRIPTION
4AN _s �0.
1 "= 30'
S —1
srEEi 1 OF 1
PAK
DWG. NO. LEHLAND-53