2001-468 /, TOWN OF QUEENSBURY
. 41, 742 Bay Road, Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010468 Date Issued: Friday, March 22, 2002
This is to certify that work requested to be done as shown by Permit Number P20010468
has been completed.
Tax Map Number: 523400-295-010-0002-027-001-0000
Location: 115 MOUNTAIN VIEW Ln
Owner: PATRICK BURKE
Applicant: PATRICK BURKE
This structure may be occupied as a:
By Order of Town Board
Fireplace TOWN OF QUEENSBURY
Garage - 1 Car Attached
Single Family Dwelling /7-DatiP •1
Director of Building&Code Enforcement
V*744"
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010468 Application Number: A20010468
Tax Map No: 523400-295-010-0002-027-001-0000
Permission is hereby granted to: PATRICK BURKE
For property located at: .52 MT. VIEW 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: PATRICK BURKE Single Family Dwelling 140,000.00
14 MOUNTAIN Dr Garage- 1 Car Attached
LAKE GEORGE,NY 12845 Fireplace
Total Value 140,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency •
BBB CONSTRUCTION
14 MOUNTAIN Dr
LAKE GEORGE.NY 12845
Plans & Specifications
2001-468
1896 SQ FT SINGLE FAMILY DWELLING WITH 1-CAR ATTACHED GARAGE AS PER PLOT PLAN
SPECIFICATIONS
$263.62 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,July 17,2002
(If a longer period is requited,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 ..7
of Que sbu4ry; ue day,July 17,2001
SIGNED BY e
for the Town of Queensbury.
Director of Buil ' g& C e Enforcement
•
Building Permit Application
Town of Qucensbury-Dept of Community Development, 742 Bay Road, Qucensbury,NY
(5.18) 761-8256
A permit must be obtained before beginning construction. Permit File No l
No inspection will be made until applicant has received a Fee Paid L
valid building permit. All applicants' spaces on this Rec. Fee Paid i a- ' F•�•
application must be completed and must appear on the Reviewed By:
application form. t
Applicant: roc 4r1%-trk( u _ ^_ Owner:
Address: /-1 Address:
Phone If (rl 5,--) 7ti : = ; Phone# ( ) -
Property Location: Lot Number: / House Number _•" / 95 , —/O - — a-771
Subdivision Name: Tax Map Number: / , L/-7? f)
;o'er New Building: residence /commercial Estimated Market Value of Construction: $ /=. ft)
❑ Addition: residence/ commercial if an Addition, what will use of new additiP i '
i
❑ Alteration: residence/ commercials
U No change to exterior size: residence/com'I JUL
❑ Other work(describe ) 2001
TOWN oF
�G NSBUl�1P_
~G—
•
Check OccupancyInformation 0 Moor — 20IFloor Other Moor Total
Below sq. B. sq. fl. sq. IL Square Feel
LI Single family dwelling / 1 Lin Az/,
o Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office
o Mercantile
❑ Manufacturing
• 1 car detached garage
❑ 2 car detached garage
❑ 3 car detached garage
I car attached garage 3 h
❑ 2 car attached garage
❑ 3 car attached garage
u • Storage building-
conmercial
❑ Storage building- ---- ----------- —--- ---
residential
❑ Other
Will any second-hand or ungraded lumber be used? If so, for what?
Type of I-Ieating System: electric/ oil / gas/wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed — Number of IVoodsloves to be installed (.5
List below the person(s) responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder -f3 I.I >_Z c 4, / Li pi /41r - �r
Plumber 1 1,1Y `a
Mason t I
Electrician f-1 ', �. ;r -7(1
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 or all proposed work to be done on the described premises and that all
provisions of the Building Code, the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with, whether specified or noted, and that such work is authorized by the owner. Further, it is understood that I/we shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued, as requested by the Zoning
Administrator or Director o1•Building and Codes, an As Built Su,i'et by a licensed surveyor; drawn to scale,showing actual
location of all new construction.
Signature: /.1_. r -�. _; __ !` __._ owner,owner's agent,architect,contractor
' Application for Permit - Septic Disposal System
Tow,: of Qucellsbluy 742 Bay Road Queensbury, NY 12804 (518) 761-8256
I. OWNER INFORMATION
Office Use
Location of installation: `~) ) ;TI,-r ff, re f III
File Permit No. 1/—,'7(
Tax Map No.
• Foo Paid
Owner's Name: �, , . .a(
Address: .•.2 , L /t//, < ASV t u- �.`
2. INSTALLER'S NAME : r-`r•, PHONE NO. r!„
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate if bedroom(s) and multiply !! of
bedrooms with applicable gallons per bedroom to equal Iota!daily flow)
Year of House: No, of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980- 1991 x 130 gal/bdrm
1991 -present x 110 gal/bdnn = :cr)
Garbage Grinder Installed yes— / no ;71(
Spa or Whirlpool Installed yes / no _'z--
4, PARCEL INFORMATION: (circle applicable information & indicate measurements) •
IQD M1112lly 9.1L9un1_yyalor_ ._Dp 1.0.ck.or_)lnpotYa9mS.14aIecial_._Doinpslic Wat.cr.SuppIy
� '-=� ��ir►u1�� at what(1(70lr of what depth , irirr►rlclper `��
�olling `loam --^ feel feel well
Steep slope clay if well; water supply
%slope other front any.septic-system
depth: absorption is f).
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by it licensed
professional engineer or architect (unless installed in a Planning Board approved subdivision), Add 25(1 gallons to the size
of the septic lank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.
Septic Tank: ,:r r_r,.- gallon (min. size 1,000 gal.)
Tile Field: each trench`<,-.Y.3 ft. Total System Length: has, ft.
Seepage Pit(s): number of - size of each: - fl. by - ff.
Size of Stone to be used: ll � _ _ / depth or Ihlckrw,rx —_•-_,_•_....___/�'�'t
Bed System Size: x •
Alternative System: and/or size t c-,-
6, HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON (please read)
For your protection, please note that pursuant to Section 136-29 of the Code of the Town
of Quoonsbury, 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 knower by or on behalf of nu applicant, shall bo void.
I have road the regulations with respect to this application and agree to abide by those and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
•
•
Signature of responsible person `R -/ Date
4-/k3E/1
ENERGY CODE COMPLIANCE APPLICATION
61 /4-
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance Methods : 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:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - /;r" / square feet
2 . Type of Heat - Electric Oil ql Gas - Other
3 . Is building mechanically cooled? Yes 1 No
4 . Percentage of area of windows and doors Over 17% ender 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS"
SHOWN ON PLANS SUBMITTED:
a. Roof R 30
b. Exterior walls R )1
c . Glazed areas R
d. Exterior doors R —
e. Floors over unheated spaces R It
f. Edge of slab on grade (heated building) IA/AC R Ib
g. Basement/cellar walls (above grade) R lU
h. Basement/cellar walls (below grade) R
i. Heating/cooling-ducts-piping in unheated space R -
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per code MYes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Applicant' s ,Signature , Date Phone Number
INSPECTOR' S REMARKS:
Fire i\Iarshal's office Town of Queensbury. 742 Bay Road,Qucensburv, NY
(518) 761-$205
Application for Fuel Burning Appliances & Chimneys.,
applicable to solid fuel & vented gas appliances.
Date .0 " 20 0 i . Permit No. i --,,:iiici; r.
Application is,liereb)'made to the Building cc:. Codes °ili e/i -the i.S•suanc•e of a Building and U.se
Permit pursuant to the New York State Fire Prevention and Building Code. g7te applicant or owner
agrees to comply with all applicable laws, ordinances', regulations, and all conditions that are part of
these requirements and also will allow all inspectors to eater-premises to perform required inspections.
•
f' NOTE to applicant: Rough-in and Final Inspections fare required. -... ,
Applicant Information Fuel Burning Appliance Information
u w� (circle appropriate words)
Name ;'i ,� ,7,e, ,- _ ,,,e4 .. Sto c ii'ood coal pellet gas
Fireplace insert
Address ` --/y) i : ,,.�,;, a � �' Fireplace factory-built: wood gas
a .7. ,, - e,• r a`r•'a. a,.;;s R r a.y`: , ;tF%-- ''''- Fireplace, masonry: (----i ioo,c/ gas .
' Furnace: wood gas . oil'
Phone: (.' -'!/;,: ) ,i 41 ire, :� ' •,.
. If non-masonary applicance, please provide
Owner: ',err, ,, -1 e__ Manufacturer Name:
Address: t ' �.; ; " ' ., Model Number:
Chimney Information •
Phone: , , .F c (circle appropriate words)
Masonry block brick stone
,r, ', Flue tile steel size: inches
Exact Address: , '1 r ;`.'i;' t4R tis
of construction or installation Factory-Built
Manufacturer name:
Model Number:
Note: Listed By: Number:
Construction /Installation must
conform to NYS Fire Prevention &Building Indicate (circle) chimney material: •
Code. Consult available Town of Queensbury .
,Handouts regarding-required inspections. Double wall a Triple wall / Insulated / Direct venting
Chimney Liner .
C"a. ale r',6r 100e13131.1r1t721e22t e Xcpxisrm. cur Queerutat 5zwy, Neer Yoz-lic
•Fire Marshal Code# S Collected Refunded Received front trcfiended to): - irk<l r tl - ' s ' 1-
t address: /,,�
A173 3389 (190) Public Safety ,.�' — —
.4 233 3G3.i (230)Minor Saks J) f:
(C (i'i,.
0%p n.v�wLc — IDw.L (i(�(i D2 1/cyia.1J.
White(Applicant) Green(Fire Marshal) 1 Yellow(Bldg. Dept.) Pink &Goldenrod(Cashier's Dept.) -
ram,
x TOWN OF QUEENSBURY
:AWNS BUILDING & CODE ENFORCEMENT
=.Ss t 742 BAY ROAD
QUEENSBURY(5I8)745-4447Y 804
ARRIVE: DEPART: INSP: i
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED:
NAME cI { F-ACA 00 �
LOCATION -0 1-0
DATE _ ZZ.;-"-0 Z.- PERMIT 1 2,-.-0/k`^1"t,(,�,,
TYPE OF STRUCTURE A FI) Lo 7— c_1,-- (-• _
FOOTINGS FOUNDATION _ BACKFILL FRAMING _
ROUGH PLUMBING _ SEPTIC INSULATION •
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A _ YES NO
CHIMNEY HEIGHT/B ENT iEIGHT
PLUMBING VENT •
, ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RA LINGS
RELIEF VALVES
FURNACE/HOT WATER OP ' ING
INTERIOR TRIM/PRIV•' DOORS
FINISH FLOOR
BATH/KITCHEN WATERT FT
OTHER FLOORS 'SWEEPAB6
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS .
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION ___,
GARAGE FIRE PROOFING
, DOOR CLOSERS
FINAL ELECTRICAL
FITE PLAN/VARIANCE REQ.
INAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
l4 - ZCC) .
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept of CommunityDevelopment Arriv
P p =�7 epa si�aair
Town of Queensbury Inspector's Initi. s 4.
742 Bay Road
Queensbury,New York 12804 ‘ i __ __1116:3
��"
NAME PF— Z\C Y, c CIF PERMIT#- •� —ttV�
LOCATION `�C�L1 r� ,0\F Y LANK)E DATE -3—Z.1^c")
TYPE OF STRUCTURE E ) L.A ZC_Ae__ C11\
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location I
Fresh Air Intake NI I
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
*Interior/Exterior Railings 30"to 36" V
4.Exterior Handrails,balconies,landing 18 in.or more
Interior Handrails stairs both sides 3 or more risers /
Grade 2%away from foundation l,JttJ VER COOCWT1 br.1') ✓!
8"clearance to sill pla e +t 0 J/
Gas Valve shut-off e .)osed/re•. ator 18"above grade Gas Furnace shut-off thin 30 f•• or within line of site j V
Oil Furnace shut-off at:ntrance to ' 1.ce area /
Fumace/Hot Water Heat- operating J
Relief Valve(s)installed J
Headroom,6 ft.6 in.on s is irs J/
Basement stairs,6 ft.4 in. �
*Handrail exterior stairs both sides 1 ore than 3 risers •
Interior privacy/trim/doors/m:in : trance 36"
Floor Finish
Bathroom/Kitchen waterti:i
Interior Handrails B. :. es .i ding 18 in.or more
Railing across window in stairw: s
*Smoke Detectors: I
every level
every bedroom •Vi
outside every bedroom J/
inter connected J`
PlumbBathroom fans :\://
ing fixtures
oundation insulation
*3/4 hour fire door/door closer /
Garage fireproofing NO
Garage penetrations sealed J J
Furnace in separate room protected(pi garage) 1
Light ventilation per room I
Safety glazing 18"or less from flxxr
Final Electrical
Site Plan/Variance required
*Final Survey Plot Plan °ii / p' Qb Ci IL 'tA7
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance) i\ IDv iNI/
e• ,tg-iss tt (Gettif -06eupaiicy)_ /
•kay to issue permanent C/O(Certif.of Occupancy)
'
RESIDENTIAL FINAL INSPECTION REPORT
0
Office No.(518)761-8256 Date inspection request received: 9fy\-- 11 3
O
Building&Code Enforcement s + ,
Dept.of Community Development Arrive 1 am/pm Depart 7:1A (1
Town of Queensbury Inspector's Jmtia ,*°''--
742 Bay Road
Queensbury,New York 12804011ir ...._ , I 1
NAME G,..). \___ (e_.., P RMIT# Los'
LOCATION \ \c -} u ) e_e_Aj /VNR DATE -
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney HeightP'B"Vent/Direct Vent Location // '
Fresh Air Intake I// --CbN`'Q,.L 1 e F•1rDb?=- �jQ_l%Z,�f•
Plumb Vent through roof \ ;/ *'�
Roof Complete \ \ ✓ '� ;lb\ -v E��cb e, v
Exterior Finish Complete
Interior/Exterior Railings 30"to 6" \ �\��� U ���
ExteriorerorHandrails,ais balco both
i ding rmor or more / �� � �
Interior Handrails stairs both side 3 or more risers ✓ 6-\--
Grade 2%away from foundation "s \ '-r
8"clearance to sill plate 0 (1rVte l., �% 13J\ ?` Q � - e� ��{ ,_
Gas Valve shut-off exposed/regulat 18"above grade „//j `
Gas Furnace shut-off within 30 feet o wi�}}in line of site / 1rtb 0/
Oil Furnace shut-off at entrance to ace area ._ , -) ,,
Furnace/Hot Water Heater operating / 1�� �Al�" G 0
Relief Valve(s)installed ,/, •• C-0\)'_0- V-Q lr-i- ‘ v t-v t
Headroom,6 ft.6 in.on stairs ,//
Basement stairs,6 ft.4 in. / i/ / q q
€ 'S�' CIK\-\ %A)4L0 , v'
Handrail exterior stairs both sides mo e an 3 risers / r/ y�� � ���
Interior privacy/trim/doors/maince;6" J bt\.-Cip
Floor Finish f/ w MAC � `�
Bathroom/Kitchen watertight ��q i1 T 1 O 1:s git�( _
Interior Handrails Balconies/Landing 18 ' .or more / b (2.-�M ' IDK-- 17-- 7- 0E-O
Railing across window in stairwells
Smoke Detectors: ✓ �`�� �I (�t--e-
every level V, ,� Q qt:›J'il-b � tiCQ every bedroom 4
outside every bedroom v C—bj C). - Q
inter connected ��"
Bathroom fansI /ii--- Ve�4 ,,A17P 1( ..-- , o f
Plumbing fixtures I Id
Foundation insulation / M y
�Ci, j
-1-j>�� G�-r'PciP�
/4 hour fire door/door closet'/ toy 1 \i) l - /
Garage fireproofing ^ 4-\P t` )RR!•t_b -a t3 c '
Garage penetrations sealed J
Furnace in separate room protected(in garage) -b\Q --- OE.' 61-A 1 CC-Lt
Light ventilation per room `a C 4ti,-LAIDe17...-6.
Safety glazing 18"or less from floor9
Final Electrical / .)ram"- b.Mo fir_" C_TD2_ ‘
Site Plan/Variance required
1 '�i'�f;iJ�G�Z7E9�oa� .lam IA, ,V�
Final Survey Plot Plan / N �q� 111 ,•�
As Built Septic System layout required V A_L'.,4
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O permanent
(C erof Occupancy) `\, •T C•ti0 \),1k - ¢�
Okay to issue C/OO(Certif.of Occupancy)
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL pei
Permit No. Cert. No 7'9 O b. Cut-in Card No
Owner 134-'l< / e
Location ` m 77t7(' tit ) ie D let&l',
.... -`� N
Installation Consisting of.37 Flu or- t..6 6 66 4 3 "72-5;
/G(J r..42.. :"/ 4c:: U✓�i��e-
Installed By J�` efru Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of makin spections at any time, and if its
rules are violated,the Company shall have the right to r:'oke th' cer ficate.
Date a Q z'' INSPECTOR..
Member N.F.P.A..I.A.
TOWN OF QUEENSBURY .
BUILDING bCODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name P 11C V RO(-; E
Location Ll M1i i1�IEal �,R\C
Date 1—its(--02„ Permit # 2001 - (,
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) ': - inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD Total Length
Length of each t ench
Depth of trenches
Size of stone
SEEPAGE PITS: Num• -r-
Size - ft. / ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fie d/Pit
Openings Sealed? Yes o Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Ye No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
5R6 'T hR 1 tE6 D6u44
66 \ O r' b
6 63)--\-Ac____-TA
SYSTEM USE APP'! , 1 : YE NO
Arriv..d: ,/: —
Dep. t im,
, / 05 ,4
ding n szctor.
®°0RA
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road ! l
Queensbury,NY 12804 Arrive 6V2h--am071 . Depart g' iii7
ritipector's Initials9s`�
NAME: P, ta_ o Ek PERMIT## 3 ;^
LOCATION: $lc Mr:,
DA1'h :
TYPE OF STRUCTURE: c F l '
RECHECK
N/A YES NO COMMENTS
Footings/Piers I
Monolithic Pour Form
Reinforcement in Place 14
The contractor is responsible for
providing protection fron4 freezing �<<
for 48 hours following thf placement
of the concrete.
Materials for this purpose oh s to
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
eating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exte"or R-
Floors R-
Walls R vvi
-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers --�-- �'� 1�Naa 6 F�-C
Bracing/Bridging `%��,?� _ �� a- `�
Joist Hangers "Z" - k
Jack Posts/Main Beam p ` V\`
Air Infiltration Barrier )1‘), 1
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping_
) 30— ) I Aj\r)r
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 <- Depart AO
Inspector's
Imti..
NAMAZ PERMIT# 3
LOCATION: j DATE :
TYPE OF STRUC
RECHECK
N/A YES NO COMMENTS
Footings/Piers_
Monolithic Pour Form
Reinforcement in Place
The contractor is respoilsible'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 V
Foundation/Da p oo g t
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plae
Rough P bing
L__
Heati Rough-In /
I atiou L� 6r\-k t
Foundation Walls Interior " � �=\i R- . I
Foundation Walls Exterio R- \� et.
Floors
Walls
Ceiling 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
_ . U!Se\9 02
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 1Ci- a� Depart _a m
spector's Ini '
NAME: GO R Y1[= PERMIT# ` . _4t U
LOCATION: 115 �n C ��}6 l�j L \ DATE : -
TYPE OF STRUCTURE: F S) t,k. `Z GAP GA Rc A
RECHECK
N/A YES NO COMMENTS
Footings/Piers I I
Monolithic Pour Form
Reinforcement in Place \,\
The contractor is responsible •r
providing protection from freeing
for 48 hours following the pla = ient /10
\
of the concrete. \ I /
Materials for this purpose on site 1/
Foundation/Wallpour t
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 / /
Brac' g/Br"idgjn:_--' VA-t�h� i�+w �C-��,t�� •U
Joist"Hangers----- — / Nk,a tJ F
Jack Posts/Main Beam V —Cl-
Air Infiltration Barrier \«i u /C ove
Fire Separation 1,2, 3,hour
Penetration Sealed ��� VL;,c�� -6��.i� ��
Fire Wall 2, 3,4 hour M Pc.tJ FiNC e e O\L oics YlkisS CP_-
Firestopping
\‘ ` '`'''‘C•-•,„,„..„ lia h......_
,,„ b
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received: / %J -),..4.)/
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive 11:_t_ ri Depart
Inspector's Initials
NAME: -. �•• r PERMIT# /
.., I
TYPE OF STR ? I
RECHECK
\ N/A YES NO COMMENTS
Footings/Piers ; Imo- 1
Monolithic Pour Form ,
Reinforcement in Place i'
The contractor is responsible for
providing protection from freezing 1
for 48 hours following the plac}ment,j�
of the concrete. ,/
Materials for this purpose on site \,/
Foundation/Wallpour_._—
Reinforcement in Place 1
Foundation/Dampproofing
Backfill Approval
umbing Under Slab
zff
Plumbing Vent/Vents in Place ))/ '
F
Heating Rough-In � / �
\-\
Insulation �' "
Foundation Walls Interior R- 0 D 1
Foundation Walls Exterior R- 1
Floors R- T
Walls R-
Ceiling R- )
Duct work or piping in
unheated spaces R-
/ Proper
Proper Vent,Attic Vent /
t/ Y
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,‘ g 3
i/
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensburyc74.
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road _ �_�'
Queensbury,NY 12804 Arrive e- a Tn Depa p
�
spector'sIna
NAME: (\\ PERMIT#
LOCATION: ) )y • -a ��� F23(.0 DATE : ,C\ f
TYPE OF STRUCT :S 'CTh
RECHECK
N/A YES NO COMMENTS
Footings/Piers �— I
Monolithic Pour Form
Reinforcement in P .
The contractor•s respo ible for
providing protb tion froi freezing
for 48 hours fo lowing th- placement
of the concrete.
Materials for this ourpose o e site
Foundation/Wall..ur
Reinforcement in P ce
Foundation/Dampp .o tfg
Backfill Approval
Plumbing Under- lab
Plumbing Vent/Vents Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Int:t'or R-
Foundation Walls Extirior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in .
unheated spaces R-
Pro ent,Attic Vent
F ruing
Jack Studs/Headers
Bracin
ist Hangers
ac c 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
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ga/ZC
Location A/, /I/&(-/
Date gl//o/ Permit # Or' /e6)
c �
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: ota Length
Length of each t ench
Depth of trenche-
Size of stone
SEEPAGE PITS: Nu 1:'-
Size - . x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/P t
Openings Sealed? -s No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption . _ feet . .
Separation of Pits feet
Conforms as per Plot ' an Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
• rG /
/7'
SYSTEM USE APPROVED: YES, NO/
Arrived: '
Departed: 'C -U-
\kr
Building Inspector
•
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 Depa Ari/En
Inspector's
Initials
NAME: Z S\ PERMIT#�I CfL g
LOCATION: ,�ja - At 1) Q/Y�Q DATE : / &- O I
TYPE OF STRUCTURE:
RECHECK
N/A YES COMMENTS
otings/Piers Vf}'/ �, I
Monolithic Pour Form
Reinforcement in Place L— 5G
The contractor is responsible for
providing protection from fre zing
for 48 hours following the p ent
of the concrete.
Materials for this purpose on sit
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i lace
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
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name R(//e(f
Location g/,
Date ei/Ci/ Permit # 01— m
SOIL TYPE: and "Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length- kZ)
Length of each tre ch I t
Depth of trenches
Size of stone / r/L'' '9-07C
SEEPAGE 'ITS: Number-
Size - ft. x ft.
Stone siz:
PIPING: ' Size Type
Bldg. to Tank � 6.--0
Tank to Dist. Box u ;,
Dist. Box to Fiel ./Pit
Openings Sealed? Yes Partial
LOCATIONJSEPARATIINS:
Foundation to Tan ? feet
Foundation to Absorption _ feet".
Separation of Pit. _ eet
Conforms as per P of Plan Yes No
LOCATION OF SYS ;it ON PROPERT . A5 �u(c,l
(circle one)
Front .- Rear - .eft S-id- - Right Side
Middle Front - M . • - ;ear
COMMENTS:
ems% %7D•') — /67Y "
c & 10C_00eK
SYSTEM USE APPROVED: YES NO
Arrived: i
Departed: Ufa
Building Inspector
`rb
V —*) C_ "l have seen or observed,or believe I saw evidence of,
r., v all objects such as houses, wells,trees,fences,etc.,
I shown on this document. I also represent that 1 have
personally measured e distances set forth on the diagram."
i SIGN TURF AT
i,. J �'�' S T D E._ A �- Z
4. o—
•
.
t boo 3
t 0 /if •
• . >
0 2
..i.) p(Z\ 1 EW AN
2
2.0 !01 O
SEPTI C TANK zoo. IZ
.*'N '"%- 000 GAL,CMIN.)
F1
C'T10n1 Li�
C /11331.
a TP.�NCNE$, 7)°
FT �cMloo FT.�MIN FeoM S'TKC-A-M
17 .
t � D
6. g.
o
��uz �,, Q a
/ a1
v7 / SOWN 0F OUEENEBUAY
�'� BUILDING AND CODE
/ .
•
• PA-1- Nc.,K EV 2`,E REs\DEN c c .._.._
PT\GENERAL INSPECTION REPORT - LI
( 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 DeparP `• I p II
Inspector's Initialsq(03
-
NAME: 'C -C., C \ 0 PERMIT# ` —
LOCATION: PA A? i �DATE : -1-0? O' - 1
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1 I
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protecti• •m freezing
for 48 hours folio' • g th- .lacement
of the concrete.
Materials for this p 0Ise on s to
Foundation/Wallpour
Reinfo ement in Plac: /
Fo tion/Dampproo'n. �/
kfill Approval
Plumbing Under . .•
Plumbing Vent/Vents in 'lace
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inte or R- _
Foundation Walls Ext= 'or R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping n
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
711/1
GENERAL INSPECTION REPORT _/
( 518 )761-8256 A,
Town of Queensbury
Dept.of Community Development Date inspection request received: 't / d-02./
Building& Code Enforcement
742 Bay Road ,
Queensbury,NY 12804 Arrive m Depa y.. ��'•m
Inspector's Initi. '�'—�`
NAME: PERMIT# 'Or)f
LOCATION: ( e-UP oL .�- _- DATE: - 3
TYPE OF STRUC .
RECHECK
N/A YES O COMMENTS
Footings/Piers
ono ithic Pour Form
Reinforcement in Place t.0 VAc A
The contractor is respons'. e ,
providing protection fro freezin:.
for 48 hours following e placeme t
of the concrete.
Materials for this purpose n site
Foundation/Wallpour
Reinforcement in Place
Foundation/Damppro ofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i ' ac=
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
BracingBridging
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 (c(
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road R '
Queensbury,NY 12804 Arrive am/pm Depart / ` ' p�
Inspector's Initials \J
NAME: vl2 14_C PERMIT#
LOCATION: - (WO-) OR ' DATE : a Z d cr/
TYPE OF STRUCTURE:
RECHECK
N/A YES Ny COMMENTS
F tings/Piers
onolithic Pour Form //dr
Reinforcement in Place
The contractor is responsib e for
providing protection from fi\eezin:
for 48 hours following the p acemv nt
of the concrete.
Materials for this purpose on si -
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
07/12/01 16:37 FAX 518 583 7900 KINKO'S SARATOGA 0634 IZJ001/001
• RECEIV D
Raymond E. Sickles, P.E. J U L 1 3 2000
2367 River Road TOWN OF QUEENSBURY
Greenwich,New York 12834 PLANNING OFFICE
518.695.3384
11 July 2001
To whom it may concern:
I have performed a complete review of Patrick Burke's home plans"The Holland"and have made
the modifications necessary to comply with local and New York State structural requirements,
including a design snow load of 50 lbs/sq.&. Framing size modifications from the original design
provided by Frank Betz Associates Inc. are shown on the stamped plans issued to Mr_Burke.
Further questions regarding this matter may be addressed to the undersigned. I may be reached at
the above telephone number.
Regards,
Raymond E. Sickles,RE_
r 6C-6)j
03/22/2002 15:24 5187478239 B'2' , , ___________ zii OLSTER LAND SURVEY PAGE 03
4—_-__*,
IRf
Lands n/f of
Joel & Bonnie Holden
Book 1040 Page 14
MAP OF A SURVEY MADE FOR
, ,,,l,1,lllll.,,,,
PATRICK. BuRKE
.?.4,,,,,,,....s., ,1, 00.1.;6‘i.,... L::::.,
;'• ';6..A `'C'i t..«A'''.' /� 4 TOWN OF OUEENSBURY, COUNTY OF WARREN, STATE OF' NEW YORK
-t1'; t If sirr ;OF ',•'`<�. = .. DA VID J. B OL S TER
•/)1l1f11111t,5V LICENSED LAND SURVEYOR
342 MAIN STREET, HUDSON FALLS, NEW YORK 12839
.,,..,.,,�- — -
DAVID J. BOLSTER, LLS DATE: SEPTEMBER 13. 2Q01 SCALE: 1" = 50' NX.S. LiC. NO. 49534
RE14SED MARCH 21, 2002 TO SHOW RENSED MARCH 22. 2002 To SHOW DWG. NO. 01128 C
DATE SEALED CRUSHED STONE DR1W Om'BROOK sED OUEENSBURY 83-1--4.1
0 BOLSTER LAND SURVEY PAGE 02
3{22{2002 15:24 5187478239
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Lands n/f of
George do Sandra Bandura y
Book 933 Page 107
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185-1.3
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, •
43
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Book 903 Page 176
"I have seen or observed,or believe I saw evidence of,
3 all objects such as houses, wells,trees,fences,etc.,
r' = 4shown on this document t also represent that 1-have
personally measured e distances set forth on the diagram." .
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