2001-164 / \ \ TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY„12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
ii
CjRtI ATE OF OCCUPANCY
Permit Number: . P20010164 • Date Issued: Thursday, May 16, 2002
This is to certify that work requested to be done as'shown by Permit Number P20010164
has been completed.
Tax Map Number: 523400-226-019-0001-016-000-0000
Location: 23 CHESTNUT Lri
Owner: MARY KILBURN
Applicant: MARY KILBURN
This structure may occupied ied as a: ?;
By Order of Town Board
Fireplace 4 TOWN OF QUEENSBURY
Garage - 2 Cars Attached
Single Family Dwelling
Direc or o Wilding&Q n cement
tt -
_ e
TOWN OF QUEENSBURY
VTO742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010164 Application Number: A20010164
Tax Map No: 523400-226-019-0001-016-000-0000
Permission is hereby granted to: MARY KILBURN
For property located at: 23 CHESTNUT Ln
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: MARY KILBURN Fireplace
85 SALEM Rd Garage-2 Cars Attached
ALBANY,NY 10512 Single Family Dwelling 150,000.00
Total Value 150,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
VALENTE HOMES. INC. NEW YORK BOARD OF FIRE UNDEI
50 COUNTRY CLUB Rd
OUEENSBURY,NY 12804
Plans &Specifications
2001-164
1871 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$245.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, September 10,2002
(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 e To of e u , , September 10,2001
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building .emit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 /761-8256/
BUILDING & CODE ENFORCEMENT
NOTICE Requirements prior to issuance r•
-- -�,,`,, 1
of this permit: PERMIT FILE NO GG) ( (çL
A permit must be obtained before vv 6
beginning construction. No inspectionID
q
will be made until applicant has received Tifl Zoning Board Action PERMIT FEE PAID
-v•w-, .
a VALID BUILDING PERMIT. All Area /Use
applicants' RECREATION FEE AID
pp spaces on this application
MUST be completed and•the signature El Plannb:g Board Action REVIEWED BY:
of the applicant must appear cal the
SPR / Subdivision /Other Witting Incpec or
eplication form. 77kmk y,. ) Recreation Fee Payment J
•
Applicant: VA &'i 1-1 t ..,T- ' Owner: rI/3rlY k t— , Ai.
Address: Go Couwl a<4� Address: c'r Sx�)cn-3 Iao4.�LI3A t�/(t/'.7eiG et../Y.
Phone # ( 5.)a ) •7 - 6. joo Phone # (e S) 7Z3i, - bz68 M ) t
Property Location: L0+5 `"2g 1 A yFsin• l L kjE, ' g q
Subdivision Name:. /4- 51'irl&Y 1wy�J -
Tax Map Number - / l
Section Block I.ot
NA/RE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Bui in : CONSTRUCTION: $ 15b,o0o
esidenc / commercial
Addi ' o Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial . .2( Single Family PfICENFE)
Residence / Commercial Two Family Dwelling
no change to exterior size . Family DweAponp 6 2001
Office
•
Other Work (describe, below) Mercantile TJ��1�NOFCfllEENSBtiRY
ManufacturingIji�OjlylyP�il) GOOD
j� Other
GROSS AREA OF PROPOSED STRUCTURE:
If ADDITION, what will use
1st Floor �I�S sq. t. of new addition be? :
2nd .Floor. . ., c:3 &, t sq. ft. 3
S
Other Floors sq. _ft��
(not unfinished cellar or ba ement-} �'�' •
oG ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: NY-21 S l ?C Attached Garage 1, dispra
Private-Storage Bui ding
SIZE OF NEW STRUCTURE: Commercial Storage Building
126 FEET X 5-9 FEET Other
Foundation Type: ..77°L(M� r.a: Will any second-hand or ungraded
' Number of Stories : • 7_ lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : 743 feet TYPE OF HEATINGSYSTEM:
Number of fireplaCe and/or wood stove (circle all which a lies)
to be installed:_ I Electric `"Gas Wood
Hot Air seboard / Other
Person responsible for supervision of work as regards to building
codes i s : ` (//ltE01-0 ' g-b 6.904Alsv 661)(S f . tR,r avru;
Name Addresss Phone
Builder: I)`/-lt.p/Arr 140n4E.s ix.vt_. 5b 6001.1-(u' ate, -,q6 -S-tc ,0
Plumber: •5;1-01- tpl,Mta,t,.. -e:, -- 'lig9
Mas o n:
Electrician: - � �q�,ov -Z';.,
DECLARATION: Please sign below a,fier 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 aut o ized by the owner. Further, it is understood that I/we shall submit prior to a
Certificate of Occu ,anc 'or Cer 'fi•ate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed survey ; d ,wn to s'a,, sho ng actual location of project on premises.
Signature: ./ /_ A / ,-`e.A,r„" f------- .
'a'ier, owner's agen. architect, contractor)
-= �, Application for Permit -Septic Disposal System •
•
Pewit of Queeiisbuty 742 Boy Road Queensbury,NY 12804 (518) 761-8256 -
I, OWNER INFORMATION:
L 1 � -
Location of installation: ; 1-0srNvT/ -NF offic '� •
/,T
Tax Map No. / (a; / �F (' —
_ �� File Pe - , o. Q — 6/-/ .
/3(r'Y ' )I�t��,iiJ. . .. Fee /�
Owner's Name: /✓1 ►— • -
Ad - : S- 57 - ;f-r Rom:/ L1g1cE et., , ti
k
2. • INSTALLER'S NAME : . - T: i--)oAES _ova 'HONE NO. t —5-20o
• 3. RESIDENCE INFORMATION: (circle ye . , dwellin , indicat, #bed 'on(s) and multiply ii of
bedrooms with applica o ,.,allons p.- �;--u m to equal total daily flow) •
•Year of House: No, of Bedrooms x Coln u,:
p Total Daily Flow
• 1980 or older - x 150 ga -t rnr =
• 1980— 1991 x 30 Arm
1991 —present x I 0 ..:I/bdrm =
Garbage Grinder In : ed yes / no r
Spa or Whirlpool stalled yes �4
•
4. PARCEL INFO.° ATION: • (circle applicable in formation & indicate measurements) •
IQPs! I ' c viUYitt4Lt9 - . Q.round_ '"...or-. _a.edr.ock..or ImPoryi t!s_Moterial_,_Uomestic Water_Supply
l'7 scold
at v/at pa/ at what depth municipal
n(717 g i loam /eel .
.- feel well
deep slope c ay if well; water supply
;_%slope other from any septic-system
depth: ��
absorption is fl.
other
Percolation Test: -(To be complete y licensed professional engineer or,architect) _ - -
- . w:-Ra : whale per it ch. - _ - -
•
• 5. PROPOSED SYSTEM: For New t onstructlen: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(in ess installed in a Planning Hoard approved subdivision). Add 250 gallons to the size
of the septic lank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: 1(7u0 Bally (min. size I,000gal)
•
Tile Field: each trench 4.5'1 ft. Total System Length: Zg0 fl.
Seepage Pit(s): number o . size of each: ft. by fl.
Size of Stone to be used: • i / 4'Z / depth Or thickness feet
Bed System Size: x
Alternative System: length and/or size • .
. 6. • HOLDING TANK SYS: EM: (if required) -
Number of tanks: / Size of each: ; 'gallons /TOTAL- Capacity: gallons .
• Note: Alarm System and associated electrical-work must be inspected by a Town approved
electrical inspection agency. •,
•
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) •
For your protection, please note that pursuant to.Section 136-29 of the Code of the Town
of Quoensbury,.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 rez ions with r .ect to this application and agree to abide by these and all
- requirements of own of kilt sbury .atiitary Sewage Disposal Ordinance. •
V . 4•Eirip
A ' /go of re ° e
-)
� ature spon:-ble person Date
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBIJRY, WARREN COUNTY
9000 HEATING DEGREE DAYS
, 06)-1(0'f
ComDli ance Methods: PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* .- Thermal Rating - Component Trade Offs
1&2 Feanily Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* = Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
A_PPL=C?NT' S NAME: PROPERTY LOCATION:
PART 5 t€TEOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 1,'7 1 scuare feet
2 . T-_rpe of Heat - Electric Oil Gas Other
3 . Is building mechanidally cooled? K Yes No
4 . Percentage of area of windows and doors AT Over 17% Under 17%
5 . R-V-LUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-V LtJES AS
S_OvvN ON PLANS SUBMITTED:
a : Roof R 1v52)
b . Exterior walls R /q.
.c . Glazed areas R
d . Exterior doors R.
e . Floors over unheated spaces R
_ . Edge of slab on grade (heated building) R A.41.
g. Basement/cellar walls (above grade) . R f1
Basement/cellar walls (below grade) . R J/
. Heating/cooling-ducts-piping in unheated space R ,it4
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code /V Yes No
PR EAT RE CONTROL MAXIMUM SETTING 14O° - WILL NOT BE EXCEEDED
a ,-- ___ S -✓ a "� a e Phone Number
��
` >'/F 7i g szoa
INS=EC OR' S REMARKS:
Fit•c Marshal's Office "Posen of Quecnsbury, 742 liar'Road,Quecnsburv, \l;
(518) 761-82O5
Application for Fuel Burning Appliances "& Chimneys
applicable to solid fuel & vented gas appliances
Date h.,. t 20 C: _ Permit No ( '/-_/, �� '
Application is hereby made to the 13uilding& Codes Office.for the issuance oIa Building and Ilse
Permit pursuant to the New York,State Fire Prevention and Building Code. The applicant or Corner
agrves•to comply with all applicable laws, ordinances regulations, and all conditions that,are part of
these requirements and also will allow all iirspectors'tcrente'pre,uises to perform required inspections.
.
NOTE to applicant:. Rough-in and Final Inspections are required. -
Applicant Information Fuel Burning Appliance Information
(circle appropriate words)
Name: l.lf;,',&VT F. 14 clAi lAde, . Stove: wood coal ,.pellet gas
Fireplace insert
Address: r , ,i""04,,011.' ` (1.- , c.°D , . Fireplace, factory-built: , wood gas ;
t' ^,yr ., �:;,tG: Fireplace, masonry: wood gas
Furnace: wood gas ' oil
Phone: 74 a g-s--1 t a •
-
If non-masonary applicance, please provide n
- Owner: 'Af2, t..Y '';ie,,,,,,,gt`t,.J', Manufacturer Name:
Address: 0 1 &i',4-,) ,��t ti \q;.,. Model Number ; fitj.
Chimney 'Information
Phone: c t,j t:., -17, ,z, . 02,6 t?., • (circle appropriate words)
Masonry block brick stone •
Flue tile steel size: ' irrclres
Exact Address:.I1.; } (A 5 t'. •ri"i` J I4v
of construction or installation Factory-Built
6,15eivoi"..d.>/tt gam,,;),)1 • Manufacturer name:
Model Number: t Y..
Note: • Listed By: Number: '`
Construction/Installation must
conform to NYS Fire Prevention &Building Indicate (circle) chimney Material:
Code. Consult-available Town of Quee rsbury
Handouts regarding required inspections. Double wall / Triple wall / Insulated / Direct renting . .
Chimney Liner
i 4G.A.0h1ex9' 'pep tzaaex=t—Troxsnre o f Qzace,ra,stbz=z'y, 1%Texiy.r V—c..x-fir 1
_ 1
r
•
Fire Marshal Code t I t t 1
SCollec•ted" 'S Refunded Receiscc�l/your treirnde(1 to). I "'f,F„_.,(t._r )f-' ^ �., d
w — —,
- .f1'1) address:
.4 173 33$9 (190) Public Safety , Y,)'`.., `---
A ?33 655 (230)Minor Sales —
,, 1
W . ''''t _ ( th ,i.._ .„---,„ - •
1.1,.. ,„Le. - T,.... Ge/4 02 o0„,N x.
.
. - White(Applicant) 1 ,,Green(Fire Marshal) . 1 Yellow(Bldit. Dept.) I Pink&Goldenrod(Cashier's Dept.)
TOWN OF QUEENSBURY
. : ,. j BUILDING & CODE ENFORCEMENT
F'?f 742 BAY ROAD
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART: INSP: C?
FINAL INSPECTION REPORT
COMMERCIAL MULTIPLE DWELLING
(hotel, motel, apt. complex)
DATE INSPECTION REQU ST RECEIVED:
NAME vIV i Ki(/6
LOCATION DATE ).--- PERMIT 6C,O�y
OI- /'f
6'TYPE OF STRUCTURE 7 4)
FOOTINGS BACKFILL_ FRAMING_ PLUMBING_
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT/FIXTURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES
FLOORS
FOUNDATION INSULATION
INTERIOR STAIRS/RAILINGS
STOCKROOM ENCLOSURE
FIRE/DEMISE WALLS PENETRATION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT DOOR HARDWARE ___
EXIT STAIRS/RAILS
PLATFORM/ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS
HANDICAPPED PARKING
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
a
'V FINAL SURVEY PLOT PLAN, IF REO
OK TO ISSUE C/O OR C/C
X
i0 C /Os
Fe-only SETMCk , - 30r 0,1,71
Pa Bo ILI- _ _ _ _ 2(. (0 ,
VAA-NJ cE O---E a.
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(! (518) 761-8256
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTIONS REQUEST REECEIVED:
NAME _ V V .te/1)
LOCATION &srA.1(/r
DATE T//V (dZ PERMIT #
TYPE OF((((STRUCTURE///
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC _ INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
5NOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FI L ELECTRICAL
S TE PLAN/VARIANCE REQ.
INAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
1_IC&N-56 Ue-A 10
4
p
Al I
WETLAND
BOUNDARY
A2 I
WETLAND BOUNDARY MARKED 5/0//0/
BY DANIEL M. SPADA. APA. WITH BLUE
FLAGS
SCUDDER ASSOCIA TES, CONSUL TING
ENGINEERS. PERFORMED A SURVEY ON
5/01/01 OF THE KILBURN PARCELS
[LOTS 8 A 9 OF SHORE COLONY]. TAX
MAP ID 226.19-1-16 AND L OCA TED THE
DELINEA TED WETLAND BOUNDARY AS
SHOWN HEREON.
NOTE: LOTS 8 AND 9 ARE
CONJOINED MAKING ONE LARGER
L 0 T - l00' x /50
A5
A3
A4
S
A7-f
THE LEAST DISTANCE OF ANY POINT /N
THE WASTEWATER ABSORPTION SYSTEM
TO ANY PART OF THE WETLAND BOUNDS
IS 135 FEET.
NO SEWAGE SYSTEM ON ANY LOT LIES
NEARER THAN /00 FEET TO THE PROPOSED
NEW KILBURN DRILLED WELL.
NO WELL ON ANY LOT LIES LESS THAN l00
FEE T FROM THE KIL BURN WA S TEWA TER
SYSTEM.
A 6�
I" - 20' SCUDDER ASSOCIA TES JUNE 20. 2001
CONSUL TING ENGINEERS REVISED 7-IJ-01
P.O. BOX 793-1475 REVISED 9-5-01
GLENS FALLS. NEW YORK 12801 AS-BUIL T 2-12-02
TAX MAP ID ! 226.19-1-16 1 518 / 793-1475 REVISED 3-28-02
FIRE MARSHAL
TOWN OF URY
`` j QUE NSB RY, NY 612804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST gEIVED PERMIT# ����y
NAME IL-burr) ()laY
LOCATION
SCHEDULE INSPECTION ON
L� AM&ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTE
HOOD INSTALLATION
INTERIOR FINISHES;
STORAGE:
CLEARANCE TO SPRINKL RS
CLEARANCE TO HEATING UNITS •
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE—MASONRY
FIREPLACE—FACTORY BUILT eT ?A1kZ_
Uri . z. Z^ 1
REMARKS: OK TO THIS DATE
INSPstIP.PUB INSPECTOR
FIRE MARSHAL
. TOWN OF QUEENSBURY
vrOfQUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST\RRECEIVED PERMIT# O/-/
NAME Nk BUY(\ 1,/�4 91''
LOCATION c _
SCHEDULE INSPECTION ON .2-1- - 9 -o-OO c�-
L) AM ( 1 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 INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLE'•S
CLEARANCE TO HEATING U ITS
REQUIRED SIGNAGE
CHIMNEY (1
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT /IV
REMARKS: TO THIS DATE
INSPSLIP.PUB INSPECTOR
.\(\\C) .
.1 .— 'LA P
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: R V
Building&Code Enforcement P. I ,�
Dept.of Community Development Arrive am/pm Depart , 1 `am/pm
Town of Queensbury Inspector's Initials/() (Z'
742 Bay Road
Queensbury,New York 12804
NAME 4`4411� �) Yam I) r L PERMIT e O / - ) /
LOCAT IOiV aj l u (\) c7v-r ..DATE 9 -Q=CCi2
TYPE OF S'rkUC
N/A YES, NO COMMENTS
Chimney HeighU"B"Vent/Direct Vent Location �/7
( Fresh Air Intake ✓/
Plumb Vent through roof ✓!
i Roof Complete 1,
Exterior Finish Complete /
Interior/Exterior Railings 30"t• 36 ✓/
Exterior Handrails,balconies,I. dint 18 in.or more 1 /
Interior Handrails stairs both side 3 o • ore risers J/
Grade 2%away from foundation V',
8"clearance to sill plate /
Gas Valve shut-off exposed/regulato 18' above grade '--
Gas Furnace shut-off within 30 feet o wi r in line of site / V
Oil Furnace shut-off at entrance to fern ce area J
Furnace/Hot Water Heater operating �/
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs r
Basement stairs,6 ft.4 in.
Handrail exterior stairs both ides m•-e . 3 risers
Interior privacy/trim/doors/ma i• . •ance 36 ,/
Floor Finish f
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or ore .
Railing across window in stairwells �/
Smoke Detectors: ✓ — k /�C -- //v- f-71-&(-6.- ( Jdz i
every level
every bedroom
outside every bedroom
inter connected /
Bathroom fans V
Plumbing fixtures ✓
Foundation insulation /
3/4 hour fire door/door closer �/`
Garage fireproofing ✓
Garage penetrations sealed f
Furnace in separate room protected(in garage) ✓
Light ventilation per oo /_
Safety glazing 18" 1 tr m fl r
Final Electrical G (,, L-�(� / `
Site nal Survey
Plot
requ ed / 194
/ r/i/� -Ve6t9 4PPPO f/4-�—
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). (,J U
Okay to issue permanent CIO(Certif.of Occupancy) li1 to/dC! . Prie4 0?-cy
AF•R-08—E2 MOH 15 :29 LOSS PREVENTION 518 893 7626 P.01
0.4
ii,NyJyse4ilmo,001Burglar Alarms
Fire Alarms
•Loss Prevention Experts UL FM Central Station
Capital District Office: Business Office
2070 Route 9N 31 North Street
t: reenield ~NY. 12833 Monticello • NY • 12701
(S 18) 869-4737 (914) 794-6133
ATTN: Ed Stano •
April S,2002
Ref: Fire Alarm System
Kilburn Residence
23 Chestnut Lane
Queensbury,New York 12804
Dear Sir.
•
This letter is to advise you that Loss Prevention Experts completed the installation of a
fire alarm system at the above referenced premise.
The system has a smoke detector in each bedroom and one on each level for a total of six.
One additional smoke detector is installed in a.room in the basement, Local annunciation
is via two sirens and is monitored by our UL,FM listed central station.
The system was installed in accordance with NY State Building Code,NFPA guidelines
and manufacturers' itxstruetions. The" system was tested and each device and the system
as a whole operated in a satisfactory.manner.
If you have any questions or need additional information concerning this installation,
please call me at 896-4737.
Sine-
�%PLc��d•cT�
'Edward Stan()Jr.
Serving the Capital District Since 1976
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Kt teMA `
Location c j/-7 Jir LA)
Date /5 /ôZ- Permit # Q( — /
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIE :. •tal Length
Length of each trenc'
Depth of trenc es
Size of stone
SEEPAGE PITS: umbe -_
Size - t. ,c ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fiel :/Pit
Openings Sealed? Yes No . .Partial
LOCATION/SEPARATIO S:
Foundation to Tank feet
Foundation to Abso •tion feet . .
Separation of Pits e feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPER •
(circle one)
Front - Rear - Left Side - Right Side
Middle Front -. Middle Rear
COMMENTS:
•
SYSTEM USE APPROVED: ES NO
Arrived: •`�
Departed:• ll
BuildingInspector
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# DIA109
NAME Y\ jO
LOCATION
SCHEDULE INSPECTION ON , I ' / _all
AM ' ANYTI
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS I
EMERGENCY LIGHTING \
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM i
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY `D1 LI-PI
WOOD STOVE
FIREPLACE-MASONRY ,1
FIREPLACE-FACTORY BUILT
cgfo
REMARKS: OK TO THIS DATE
p,-c - N La (OooCA 'P
INSPSLIP.PUB .INSPECTOR
IIIIIPECO
FIRE MARSHAL
t.4.1 TOWN OF QUEENSBU
` . QUEENSBURY, NY 12804
(518)761-8205
FIRE MARSHAL INSPECTION REPORT�
REQUEST RECEIVE /
PERMIT# J I -J ( -j
NAME \v.-30)(R
LOCATION 0 3 asko-vi\J- ckm-Q. -
SCHEDULE INSPECTION ON / -//-cOOc-
AM PM ANYTIME
eGko&z6
APPROVED
N/A YES NO
EXITS ,.
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIG ING
FIRE EXTINGUISHER
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTE
FIRE SUPPRES` SI� S M
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKL 'S
CLEARANCE TO HEATING ITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY'BUILT /
L e e_- `�`DU
REMARKS Q D OK TO THIS DATE
FROU D P-c _ 6 S
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INSPSLI .Pus INSPECTOR
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GENERAL INSPECTION REPORT = kJ' I .
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road /1-7�,
Queensbury,NY 12804 Arrive am/pm Depart ( p
Inspector's Initia s NAME: �\ Vk i /PERMIT# 0 1— / (
LOCATION: �C' '��' ` ( /',4ATE : 1 — Z-/ p
TYPE OF STRU TURF:
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible fo
providing protection from freezi
for 48 hours following the place -nt 1
of the concrete.
Materials for this purpose on site i
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
He ng Rough-In
\'Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R- JV t
Duct work or piping in
unheated spaces R-
oper Vent Attic Vent
✓Fiaxnin `�
J ck Studs/Headers ,I
racing/Bridging Coc.cq'2
Joist Hangers
Jack Posts/Main Beam `I
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Dire Wa112 -'4_hour
FirestoppingLL=--
FIRE MARSHAL
irlfft TOWN OF QUEENSBURY
c% .j QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVED PERMIT# (Q f` l 64
NAME k iL6U
LOCATION Ci-(W i/Uv 1 L'v t
SCHEDULE INSPECTION ON f 7 I-2-\. 6
AM PM ANYTIME
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SY ' -
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKL RS
CLEARANCE TO HEATING UNITS •
REQUIRED SIGNAGE 1
CHIMNEY d
WOOD STOVE
IfFPLACE-MASONRY FIREPLACE-FACTORY BUILT CQ t{. /A)
REMARKS5C IkL iSSj _30 I [] OK TO THIS DATE
INSPSLIP.PUB INSPECTOR
-- ` .
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kiery,
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road t ' 1_.,
Queensbury,NY 12804 Arrive am/pm Depar , / am/ m
Inspector's Initi Is
NAME: � '.'NU Y C� PERMIT# o O j
LOCATIONO_ o DATE : f -ryZ 1- 2(0
TYPE OF STRUCTURE: , 1�f
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezin
for 48 hours following the place ent
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab ,/_
Pluming VentNents in Place, /
NoRio - Pliamb'i g _1_. :I/
eating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
u eated spaces R-
Pro Vent, Attic Vent
,V/ ,.,
Jack Studs/Headd& ✓ //vS%.'� l_�eLL 4 /lC s )
Bracing/Bridging /'' P-4L3 6 C
Joist Hangers
Posts/Main Beam ✓ J�
r Infaltration Barrier_ �J
Fire Separation 17-2;7-3;_1i4_ur
Penetra' n Sealed /
Fire all 2, 3,4 hour /
jPnL ;.; t/ / ' 74‘,L1 Fi 19e�� 1 RA !''/5 J sic r5
r
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TOWN OF QUEENSBURY
(3
-- BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTI DI POSAL SYSTEM INSPECTION
\/\\ \IOU
Name
Location _
Date c) - d rmit # " (0
SOIL TYPE: San -Loa -Clay-
Results of Percolation Test-
(if applicable) Rate- nute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tota Length / `fi +
Length of each trench 41-1-
Depth of trenches
Size of stone C �- 1<t)
SEEPAGE PITS: Number
Size - ft. x / ft.
Stone size /
PIPING: Si eh Type
Bldg. to Tank y S ena e)
Tank to Dist. 'Box N
Dist. Box to Field/Pi
Openings Sealed? 4610 No Partial
LOCATION/SEPARATION
Foundation to Tank (0 feet
Foundation to Absorpt•on Zei feet
Separation of Pits _ofeet
Conforms as per P1 of P1 an No
LOCATION OF SYSTEM 0 PROPER
(circle
Front - Rear)- Left Side - Right Side
Middle ront - Midd' a Rear 12_5 G .1-Ak,L)
COMMENTS:
66 M) L. -r-
Ucc.4- sc)<
64.), i,t,l A -
SYSTEM USE APPROVED: tip NO
Arrived: /
Departed: imps
Building Inspector
•
Se: c,2
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 Depart pm
Inspector's Initial
NAME: Y"\\ , l PERMIT#
LOCATION: `� \y Ato '/ltiQ/ DATE : I
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers_
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing prole(tit from freezing
for 48 hours foil.wi+g the placement
of the concrete.
Materials for this p.rpos- on site
Foundation/Wallpoi r
Reinforcement in Pl.ce
Fo dation/Damppr..fi V` ckfill Approval
Plumbing Under Sla.
Plumbing Vent/Vent-in Place
Rough Plumbin:
Heating Rough-In
Insulation
Foundation Walls I fl terior R-
Foundation Walls E• erior R-
Floors R-
Walls R- _
Ceiling R-
Duct work or piping
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
( 3 uA -
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
ai il)
Queensbury,NY 12804 Arrive am/pm Depar ' am/p
Inspector's Initials ( P`
NAME: V PERMIT 11 n/ _ I Co 4
LOCATION: �,CQvp,p) DATE : 0—O
TYPE OF STRUCTURE:
a
RECHECK
N/A Y TI COMMENTS
otings/Piers 1 i I
onolithic Pour Form
Reinforcement in Place
The contractor is responsibe, for!
providing protection from fi eezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on s'tel
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
FIRE MARSHAL
-1111111111111/4 TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL INSPECTION REPORT
REQUEST RECEIVE PERMIT 4 O(-7 9
NAME �tc.28m€V
LOCATION Ck — o i 'Oi€-
SCHEDULE INSPECTION ON I I q f
AM PM 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 INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKL S
CLEARANCE TO HEATING NITS
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE /
FIREPLACE-MASONRY /
FIREPLACE-FACTORY BUILT /11.-4)
Fi,2c--52-oP
REMARKS: [I] OK TO THIS DATE
INSPsuP.Pus INSPECTOR
S C
U LDER CONSULTING ENGINEERS
ASSOCIATES Charles H. Scudder, PE
Robert J. Ganley, PE
J A
February 12, 2002
David Hatin, Director
Building and Code Enforcement
Town of Queensbury
742 Bay Road •
Queensbury,NY 12804-5902
Mary C. Kilburn As-Built Plan
Chestnut Lane, Assembly Point, Queenbury
Tax Map Ref. [226.19-1-16]
Attention: Joel Clugstone,
Code Enforcement Officer
Dear Sir/Madam:
Attached is the "as-built"plan for the Kilburn home. Mr. Valente is now
completing the finishing.
The APA put us through an inordinate amount of research and paperwork on this
project. In the process I neglected to submit papers to your office as I should have done
but Dan Valente, ever watchful, took care of it.
Sincerely,
2F
Charles H. Scudder, PE
Principal
CC: Valente Homes, Inc.
Attachment
P.O. Box 792 • Glens Falls, NewYork 12801 • (518) 793-1475 • FAX (518) 798-3747 • e-mail: cscuds@global2000.net
4-1 OO 1 / lL/ "I have seen or observed,or believe d saw evidence of,
all objects such as houses,wells,trees,fences,etc.,
shown on this document I also represent that I have
personally measured he istanr„Qs cet fnrth pn.#he dli gram"
•
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iss
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Aaarit o ,
GOOZ9TWI/
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Salmi i''= 7_5
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47; "
7 :3 `r.• •
' " • ! •
-.A •
•
•
NOW OR FORMERLY
SCOTT B. DUBIN & RITA D. SAUNDERS
8, 8661156
IRON
P FOUND\ — — B L 0 C K "D
/
WEST END OF
PAVED SURFACE
CHESTNUT
LANE
UTL. POLE
S
WATER VALVE
76*04' E (SHUT-OFF)
150.00 r
NM 2
CAPPED OUD"
ROD
BL 0 C K "C"
(SEE MAP REFERENCE)
ORNEwAY
m�
6' GISED
WELL
1
WOOD
7FP5
O
O
=
COVERED WOOD PORCH
i
O..........
NOW OR FORMERLY
JANE B. DUBIN & NANCY C. RINALDI
8771147
W
IRON
PIPE
FOUND
m
NOW OR FORMERLY
JOHN BRUENING
AREA:
15, 000 S.F.
2ND STORY -
WOOD DECK
— — — — — 50.6— — -- — — —
U
2 STORY
FRAME HOUSE
FRAME
CHIMNEY
t►,1LG. I r r .. r •.
i
O PROPANE
CYLINDER
COVER
CAPPED IRON
ROD FOUND
75. 0' l
.t
N 76'04' W
NOW OR FORMERLY
JOHN BRUENING do ROBIN TROMBLEY
1085110
FRAME
SHED
GARAGE
—_— J6.0'
_--
0 AC. UNIT
�I
75.0'I
150.00'
NOW OR FORMERLY
JANE B. DUBIN do RITA S. SAUNDERS
6411404
�121
UTL POLE
/NY 4 — —
\GIPPED IRON
ROD FOUND
rA
NOW OR FORMERLY
THOMAS W. & KRISTEN ✓. KRISTEN
8291196
- , aria
WILLIAM & LAUREL HOPPER
TO
MARY C. KILBURN
DTO. MARCH 17, 2000
RCD. MARCH 23, 2000
LIBER: 1159, PAGE 74
GIPPED IRON
ROD FOUND
MAP REFERENCE
AM44P OF THE SHORE COLONY ON
ASSEMBLY POINT — LAKE GEORGE ,,
MADE BY LESLIE W. COULTER, LS.,
DATED JUNE 12, 1957, REVISED
AUGUST 17, 1957, AND A'LED IN
TH£ WARREN COUNTY CLERK'S OFFICE
ON SEPTEMBER 5, 1957.
SURVEY & MAP BY MAP OF LANDS OF
DONAt.D L. PIDGEON, Jr. tiJ�gRY C. KILBURN
LICENSED LAND SURVEYOR
N.Y. S. LICENSE NO. 50372 BEING LOTS 8 & 9, BLOCK T " OF THE SHORE COLONY ON ASSEMBLY POINT
16 M/CHAEL ROAD SmAy N
FORT EDWARD, NEW YORK TOWN OF QUEENMURY, WARREN COUNTY, NEW PORK
12628
(518)792-4146 SCAJ.E.- 1 ' = 20 1 TAX MAP: 226.19-1-16 1 APRIL 14 2002
Q-121