2002-787 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICAT E OF OCCUPANCY
Permit Number: a20020787 Date Issued: Monday,May 19,2003
:-This is to certify that work requested.to.be done as showmby Permit Number a2002078T
has been completed.
Tax Map Number: 523400-265-000-0001-005-000-0000
Location: 51 ELLSWORTH Ln
Owner: C.DAVID&JANET JENKINS
Applicant: JANET JENKINS
This structure may be occupied as a:
By Order of Town Board
Garage- 1 Car Attached TOWN of QUEENSBURY
Single Family Dwelling
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: a2002O787 Application Number: a2002O787
Tax Map No: 523400-265-000-0001-005-000-0000
Permission is hereby granted to: JANFT JFNKNS,
For property located at:
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
Owner Address: C. DAVID & JANET JENKINS
91 ELLSWORTH LN
LAKE GEORGE,N.Y. 12845-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
TRI CROSS CONSTRUCTION ti
Plans&Specifications
2002-787 Lot 51,House 51
Construction of a 1,152 sq ft single family dwelling with a 280 sq ft attached one car garage per plot plan
and specifications.
$166.24 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,September 25,2003
(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 f Queen ury; Yeduesday, September 25,2002
/ A.—�lj 17 `
SIGNED BY ------�-jor the Town of Queensbury.
g -' 'kh F Lj -
Director of Building Co Enforcement
Building Permit Application
Town of Queensbury-Dept of Community Development,74;Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. - Permit File No.
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid
application must be completed and must appear on the Reviewed By' kkp-/
application form.
Applicant: . In nt-+ jei,11065 Owner: jant-V _�rwir)-,
Address: Cf I !Pjj.�,WD.YAh Address:Lci qj E11SAW*1 Lf.tr)E--
Ve Ge b rQ e, U9 12X4-' IV
V-? La ye. 6 e I)ra= Wj 11,2 SK14 OP
Phone#(6A)-IC12 - XTn Phone#(513)IC12 -`KTQY
Email Address: Email Address: Op
Property Location: Lot Nun-Ajer: 57 / House Number
Subdivision Name-, U Tax Map Number:: -
New Building: residence /commercial Estimated Market Value of Construction: $ ooD
u- Addition: residence/ commercial If an Addition,what will use of new addition-be?
0 Alteration: residence/ commercial
C3 No change to exterior size: residence com'l
ca OthiR�qtwork(describe
Check Occupancy1n formation I"Floor 2'd Floor Other floor Total
Below sq.ft. sq-ft. sq.ft. Square Feet
Single family dwelling X Z C P
0 Two family dwelling
C3 Townhouse
U Multifamily dwelling
#of units
0 Office'
o <Mercantile
Q: Manufacturing
b 1 car detached garage
C3 2 car detached garage
C3 3 car detached garage (_-7
)K I a=attached garage C30
0 2 car attached garage
0 3 car attached garage
0 Storage building-
commercial
0 Storage building-
residential
U Other
What is the proposed height of the structure I feet inches
Will any second-hand or ungraded lumber be used? If so,for what? /Vc?
Type of Heating System: electric/ oil wood baseboard othet:
Number of Fireplaces to be installed Number of Woodstoves to be installed C-)-2
List below the person(s)responsible for supervision of work as regards to building codes:
-Name_
___ Address Phone Number
Builder 3C'i2_,05S Coo-, &s- Jkfe. q 3 Acq:v le /u 7,Fb9 &_i ' � 02 S(
Plumber -;Z,s4- A. qC-1 S3
Mason eoik-WM 7 91-0(ic>7
Electrician 1 (4 k (7-1 Is �
war 4k kn Lr-Jr-P Goortgo 77'43-6-3-_3 'S>
-Declaration please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all proposed work to bt 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
Ad atr.,ar Director f B Lildi d Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
. f_11 _,n 0' 17 munstr9l r Irec or location, all ew constrac,
owner,owner's agent,architect,contractor
Sizzig r .1 �A
? �---7V7
Application for Permit—Septic Disposal System. -
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 76I-8256
1. OWNER INl ORMATION:
w.................�................................................M._ ......._...............
Location of installation 5� Tct�sY�orth Lane WK 1co orfi se
File Permit No.
Tax Map No. _ / ��/ _ ~
44
Owner's Name:, Q klet JCH1K1. Fee Paid� —'I 20 2
................_..............................al s.,..& •
- ..
U/ { ............._..
Address Q e �.J .Wr4b d bl�lft��l NsaQ Y
2. INSTALLER'S NAME : Ellswa }h Ex . at na PHOT-MNO.192•0150
3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No of Bedrooms x Computation = Total Daily Flow
1980 or older x _ 150 gal/bdrm =
1980-1991 x 130 gal/bdrm =
1941 —present x 11 b gal/bdrm =
Garbage Grinder Installed yes / no
Spa or Whirlpool Installed yes_ / no )K _
4: PARCEL INFORMATION: (circle applicable information&indicate measurements)
Tovoaraishy Soil Nature Groped Water Bedrock or Impervious Material Domestic Water Supply
Flat ® at what depth at what depth -municipal
Rolling loam feet feet
Steep slope clay A*c# *%,a^ ^are if well; water-supply
Vo slope other ,. from any septic-system
depth: absorption is s2ewo ft.
other
-Percolation Test: (Fo be completed,by licensed professional engineer or architect)
Rate: . minute per inch
5. PROPOSED SY"STEM:'Ibr New Cone rVgti��rn: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in a.Planning Board approved subdivision). Add 250 gallons to the size
of the septic tank and leach field for each Garbage.Grinder,,Spa or Whirlpool Tub.
Septic Tank: 1000 gallon(min. size.l,000 gal.) -
Tile Field: each trench ` O Total System Length:
Seepage Pit(s): number of size ofeach: f1. by fa
Size of Stone to be used: # / depth or thickness feet
Bed System Size: _ J d x
ab� .
J.Alternative System:�,,G'i{ &+0r length and/or-sfze 50
6. HOLDING TANK SYSTEM: (if required)
Numberoftanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspe6tioxi-Agency;. - -
7. SIGNATURE &INFORMATION FOR RESPO14SIBLE PERSON(please read)
For your protection,please Hate thatpursuasit to Section 136-29 o£the Coda 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.,
f. s � 07
Sig store of responsible person Date
sttwers.a)l(1 Sewage Disposal
Avi)( nciix C.
tlli.4it)II.I""ION. PIK-lil.)
-9I PAItA' ION ItI'�t2t.JIItI [�1T+:N'I';;
S rR,
rzY.xmr)x�s
7. SIGNATURE &INFORAIkTION FOR:R-'SYVr4bWl.n. 'wAwo---w-w
ENERGY CODE COMPLIANCE APPLICATION RJE(CEj
TOWN OF QUEENSBURY, WARREN COUNTY
9000 BEATING DEGREE DAYS SEP 16 2002
'0"OF 9Uc-EIVS13U�,y
Compliance Methods:Part 5 -Acceptable Practice Method— 1&2 Family Dwellings.(00A"i "'Aui,�
Part 6*-Thermal Rating—Component trade Offs 1&2 Family Dwelling;
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:
Vine. 51 Ellwadh Lane lgVe 6rorge
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:'
I Gross Floor Area ............. square feet
2. Type of heat-—Electric Oil ._Gas_Other
3. Is building mechanically cooled?—X--Yes No
4. Percentage of area of windows and doors Over 17% � Under 17%
5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED: R 3E
a,. Roof
b. Exterior walls
C. Glazed areas R 2.06.—
d. Exterior doors R 2.6--
e. Floors over unheated spaces R
f, Edge of slab on grade(heated building) R
9. Basement/cellar walls(above grade) R_LL—
h. ' Basement/cellar walls(below grade) R It
i. Heating/cooling-ducts-piping in unheated space R
6. Service(domestic)hot water heating device
Conforms to minimum efficiency per code------- Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL,NOT BE EXEEDED
ican�t�'s Sign e Date Phone Number
142-ZIDJ
p
SP
,CT 'S REMARKS:XMARKS.:
02.--N7 .
WAY
Richard A.1�Iissita
Highway Superintendent
PA RTMEN Home{518}-7 127
742 Bay Road • Queensbury,NY 128t14 el F. Travis
Off ce Phone: (5-18) 741-8211 MPtq H . }S"rintendent
Fax: (518) 745-4466 .� 8-0413of
f
-4-111
DRIVEWAY PERMIT ®*t1�Di1JG
DATE: R
APPLICANT NAME:
TELEPHONE NO::
ADDRESS TO BE INSPECTED: ��SWoc
RETURN ADDRESS: 9/ 616cao,44 lone. I.iu_ 6-ez�rje 4-.,r i2,Fqr
Applicant must show exact location and width of driveway(s)to be connected to the highway by
placing stakes at the specified location.
The Superintendent of.Highways of the Town of Queensbury has reviewed this application. The
following action has been taken: ,
STEP I: ( }Preliminary Approval
NEED: ( )Slight swale
( }Level with the road
( )Deep s%vale
Size pipe to be used(if necessary)
( )12" ( )I$" ( )1S" ( )24" - ( )36"
Preliminary inspection completed by DATE
• Approval by Highway Supt. Deputy Supt
Upon completion,please resubmit this approved permit for a final approval.
STEP 2: ( }Final Approval
{ )Rejected ,
DATE:
Richard A. lvtissita,Highway Superintendent
Project Name: BP# Z66
0 rVV r RYLIT
Address: ne 6ea'�P- &Y
Building Permit Submission
Single fa raly dudirg
Tuo-fxdy dwelling
Checklist
All items below must be checked either yes,no or not applicable prior to submission of any building
permit to the Town of QueensburyBuilding Department. If any of the below items are lacking,the permit
will not be accepted until such time as the application is deemed complete for submission.
1. Building Permit Application Completed ... ... ... ... ... ... ...... ... ...... ... . 491yes El no El n/a
2. Energy Form or CheckMate Energy Code Compliance Forms Cc)mplete .. yes ❑ no ❑n/a
3. Energy Code Inspector's Report from CheckNlate Program... ... ...... ... .. yes ❑no ❑n/a
4. Septic application. completely filled out(if applicable)... ... ... ... ... ... ... ... yes ❑no ❑n/a
5. Solid Fuel Burning or Gas Appliance Form... ... ... ... ... ... ... ... ...... ... ... .Qyes nno, Fln/a
6. Electrical Inspection Form... ... ...... ... ... ... ... ... ... ... ... ... ... ...... ... ... ...§4yes Flno [:]n/a
7. Two (2) complete sets of structural drawings... .. ...... ... ... ... ... ...... ... .... Ngyes []no E]n/a
a)floor plan;b) foundation plan;c)cross sections:d) elevations;
e)window anddoor schedule I
8. Two(2) site plans showing location of the structure to be built.... ...... ... Nyes Fjno E]n/a
location of well or water lines,location of septic system or sewer line.
9. Setbacks from property lines to new structure ... ...... ... ... ... ... ...... ... .. Wyes f-Ino Fln/a
--A
10. Setbacks to neighboring wells and septic systems,including onsite wen... . X]yes E]no E]n/a
and septic systems (if applicable)
11. DrivewayPermit... ... ... ...... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Vyes E]no E]n/a
Date:
Staff Initial.
L:\Suel-kmhigway\Building.pemaityoBAE\Generic Checklistdoc
A
Permit Number
MECcheck Compliance Report Checked By/Date
Proposed New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release lb
Data filename:Untitled
COUNTY: Warren
STATE:New York
HDD: 7635
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric
DATE:09/16/02
COMPLIANCE:Passes
Maximum UA=366
Your Home 24.7
32.5%Better Than Code
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 1488 38.0 0.0 45
Wall 1:Wood Frame, 16"o.c. 1548 19.0 0.0 85
Window 1:Wood Frame,Double Pane 51 0.333 17
Door 1: Solid 60 0,100 6
Door 2: Glass 24 0.400 10
Basement Wall 1:
Solid Concrete or Masonry,7.5'ht/6.5'bg/7.5'insul 1290 11.0 0.0 84
Furnace 1:Forced Hot Air, 90 AFUE
Air Conditioner 1:Electric Central Air, 10 SEER
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the
building plans,specifications,and other calculations submitted with this permit application. The proposed systems
have been designed to meet the Proposed New York State Energy Conservation Construction Code requirements.
Builder/Designer Date
MECcheck Inspection Checklist
hecklist
Proposed New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release lb
DATE:09/16/02
Bldg.
Dept.
Use
Ceilings:
1. Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation
Comments:
Above-Grade Walls:
1. Wall 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation
Comments:
Basement Walls:
1. Basement Wall 1: Solid Concrete or Masonry,7.5'ht/6.5'bg/7.Yinsul,
R-11.0 cavity insulation
Comments:
Windows:
1. Window 1. Wood Frame,Double Pane,U-factor:0.333
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Doors:
1. Door 1: Solid,U-factor:0.100
Comments: -
2. Door 2: Glass,U-factor:0.400
#Panes Frame Type Thermal Break? Yes No
Comments:
Heating and Cooling Equipment:
1. Furnace 1:Forced Hot Air, 90 AFUE or higher
Make and Model Number -
2. Air Conditioner 1:Electric Central Air, 10 SEER or higher
Make and Model Number
Air Leakage:
Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
Recessed lights must be Type IC rated and installed with no penetrations,or Type IC or non-IC
rated installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible
materials and 3"clearance from insulation.
Vapor Retarder:
Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
Materials Identification:
Materials and equipment must be installed in accordance with the manufacturer's installation
instructions.
Materials and equipment must be identified so that compliance can be determined.
Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on
the building plans or specifications.
Duct Insulation:
Supply ducts in unconditioned attics or outside the building must be insulated to R-11.
Return ducts in unconditioned attics or outside the building must be insulated to R-6.
Supply ducts in unconditioned spaces must be insulated to R-I I.
Return ducts in unconditioned spaces(except basements)must be insulated to R-2.
Insulation is not required on return ducts in basements.
Duct Construction:
I All joints, seams,and connections must be securely fastened with welds,gaskets,mastics
(adhesives),mastic-plus-embedded-fabric,or tapes. Duct tape is not permitted.
Exception: Continuously welded and locking-type longitudinal joints and seams on ducts
operating at less than 2 in.w.g. (500 Pa).
Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions.
Cooling ducts with exterior insulation must be covered with a vapor retarder.
Air filters are required in the return air system.
The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
Electric Systems:
Separate electric meters are required for each dwelling unit.
Fireplaces:
Fireplaces must be installed with tight fitting non-combustible fireplace doors.
Fireplaces must be provided with a. source of combustion air,as required by the Fireplace construction
provisions of the Building Code of New York State,the Residential Code of New York State or
the New York City Building Code,as applicable.
Service Water Heating:
Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the
water heater has an integral heat trap or is part of a circulating system.
Insulate circulating hot water pipes to the levels in Table 1.
Circulating Hot Water Systems:
Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
HVAC piping conveying fluids above 105'F or chilled fluids below 55 OF must be insulated to the
levels in Table 2.
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature(F) Uv to 1 Up to 1.25" 1.511 to 2.011 Over 2"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range(F) 2"Runouts 1"and Less 1.25"to 2" 2.51'to 411
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(forfeed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD(Building Department Use Only)
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
.Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depart Arn/pm
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New Yor 12904 ,!�y
NAME PERMIT# C/ 2
LOCATION DATE
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operatin
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers_
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors.
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy)
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Residential Final Inspection
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: arnAp
— part: pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: ' .
0 7 -*7 7
NAME: PERMIT#: ", el
LOCATION: DATE: tri
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake -
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30.ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
-Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level; / Every Bedroom:
Outside every bedroom area:
Inter Connected: — / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
-1/4 hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, I sq. ft.-150 sq. ft.vents
Building No./Address visible from road
Final Electrical
Site Plan Wariance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept,Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert. Of CoMliance)
Okay to issue TemRorary C 0(Cert. Of Occupancy)
Okay to issue Permanent C 0(Cert. Of Occupancy)
L:\SueHemifigNvay\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
Residential Final Inspection
."Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/: p �ep art: 4L I
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: am/pm
NAME: PERMIT#:
LOCATION: DATE: Lg —
TYPE OF STRUCTURE:
Comments
Y/ N N/A
Chinmey Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
i, 3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,2orches 36 in.or more
Exterior Finish Complete
Interior/Exterior Railirigs 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or mote risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing fpl
Interior Smoke Detectors:
Everylevel: _ / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery baLkg:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
34 hour fire door/door closer
Garage fireproofing
Duct work Scaled properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq. ft.vents
Building No./Addresj visible from road
Final Electrical D (mil
Site Plan /Variance r uir'ed
e Final Survey Plot Plan em
As Built Septic System/Sewer Dept. Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert. Of Compliance)
Okay to issue TeLnpoEHy C 0(Cert. Of Occupancy)
Okay to issue Permanent C 0(Cert. Of Occupancy)
L:\SueHen-dn-gway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
COMMONWEALTH ELECTRI.CAL INSPECTION SERVICE, INC,
Main Wee 176 Doe Ran Road -Manheim, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
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Lic. No.
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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 Companyshall have theprivilege of mak' inspections at any tithe, and if its
p
rules are violated, the Company shall have the right to ke rtific
INSPECTOR Date 3#e6fiNlf4flilfi!lfrrf11fi4iii4fi}„IIff1„i1l44iliN INPEC'i'O fNlfiiffififffiff4iiiMilli�fiff!lii4,4fi4illffllffil44liNi•fffliifirffti4#fffifffpifi4filif'
Mimho N FRA_. 1.A.F.1.
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received-
Queensbury Building&Code Enforcement Arrive: #M/pm Depart: )
I I...........I am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: i'KIMP�t,:,
NAME: PERMIT#: 7 79,1
LOCATION: INSPECT ON: l Z7 A51
TYPE OF STRUCTURE: 1-1
Y N N/A COMMENTS
Framing
Jack Studs Headers
Bracing Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in.or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 V2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center
Ice and snow shield 24 inches from wall
Fire 7paration 1,2, 3 hour
Fir all 2, 3,4 hour
e soo�pp in
-Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side V7.inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
r 20 in. (W)
5.7 sf above below grade
5 grade
0 sf
. OK
Li
Framing/ Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive:—am/pm Devart-57Y-4—) am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: A&A- J4),t,)-�; PERMIT#:
LOCATION: INSPECT ON: 1-1 .2-11103
TYPE OF STRUCTURE:
Framing Y N N/A COMMENTS
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6,ft. 8 in.
Stairwells 36 in.or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 V2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft.floor trusses
Anchor Bolts 6 ft.or less on center
Ice and snow shield 24 inches from wall
Fire separation 1,2,3 hour
ire wa112, 3,4 hour
\4 Firestopping L
Penetration sealed
16 inch insulation in cavity min. OF
Garage Fire Separation
House side inch or 5/8 inch Type X -Piz .4gioc— SC'J('Iq'
V2
Garage side 5/8 inch Type X o 1
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
��TT AA � Office Use
ij-21 ERALINSPECTION UPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request receive]�e2t---k:�, )-60 �
Meet:
Building& Code Enforcement / At time:
742 Bay Road
Queensbur�, NY 12804 ARRIVE amlpm: DEPAR Ib5anilpm Notes: �
(518) 761-8256 Inspectors Initials
NAME: �� h !h S PERMIT# c�2&��-79 7
LOCATION: /� " /I ur INSPECT ON(date): Cs.7,)&d 3
TYPE OF STRUCTURE:
. RECHECK
r
t
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
'Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbins in Place
' u �uml?ing
ea g . o -
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
a
Pr, ent,A "'c Vent
�l oj
ac ds/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier _
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wa l hour
J hest. Sin A19`1 �' t
L:\SueHemingwaylBuilding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
YOWN OF QUEEKSBURY
BUXILDING A CODE ENVORCEMEN-r
;i4-: Bay R"'act
Quka-iensbour-y MY X2004
(518�) -761-8256
SEP-rXC DISPOSAL SYSTEM INSPECTION
N am e-
Date
L:;,-, o r-m 1
SOIL -r`YPE:(! Sand- Loam-- 1a-A/-
Resul 7ts o-f Per-cola -tion Te-s-t-
( ! I:'- applicable ) Rate-M1nu-ta./1nch
TYPE OF SYS-rEM=
ABSORP- 'ION` FIEL-D : To-tal Leng-t
P
Length of:!' each -tv-en,ch -S.
Depth of -tr-enches. 25
Size o-F stone
SEEPAGE PI-FS : N um e Y--
size -F 7t X. -F-t -
Stone size
PIPING : 4ype
BI dg . to Tank �7 o
Tank- to Dist _ Box I-1k
Dlst - Box to Field/Pi -t
Open -frigs Seal ed yes—
JLOCA-F11OH,/SEPARA-r1OMS : Pay-t! al
Founda-tion to Tank -F ee-t
Founda-tion -to Absorption -Feet
Separation o-f P -ff--s
Con-For,ms as PO Plo-t Plan es No
per
LOCA-UION OF SYSTEMM ON PROPER-fY :! f5
( ci r-cl e 5 0
From t - Rear Rea - Lo-ft Side - Righ-t Side
MiddIL-- F t - Micldl *-- Rear-
COMMENTS
SYSTEM USE APPROVED= YES NO
D v-*--qE?a =
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� �Q
Office Use
-GENERAL INSPECTION REPORT Inspector:
Town ofQueensbuq Ready at time.
Dept. of Community Development Request received:
14� Meet:
Building& Code Enforcement At time:
742 Bay Road
-�Queensbury, NY 12804 ARRIVE am/pm: .DEPART an 1p m Notes:
(518) 761-8256 Inspector's Initials
77
NAME, PERMIT# 2-00 2-
7
l �� -
LOCATION: rj,
INSPECT ON(date): ItI Z_fh {
TYPE OF STRUCTURE: EJ
RECHECK pis
N/A YE/i NO COMMENTS dq1vI 6 9�
ootings/Piers
Monolithic Pour Form
Reinforcement in Place /Z/ -Ib,, V—
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
Foundati on/ID ampproo ling
_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
HeatingRough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
I unheated spaces R-
Proper Vent,Attic Vent
Framing_
Jack Studs/Headers
Bracing/Bridgmig—
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:1SueHemii)gwa3lBuilding.Codes.hispection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: I/ Y Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensburj,, AT 12804 ARRIVE amlpm: DEPART ,- amlpm Notes:
(518) 761-8256 Inspector's Initials
NAME: ��kptle_4_ Le L, s PERMIT#-c2zv,)-7
LOCATIO INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES i NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
e hi n
t ' 0 site
M r thi 0 site
daii n a r
lel-nforcement in Place
Fow(dation/Dampproofing
t,Rakckfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
HeatingRough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
CeiliAg R-
Duct work or piping in
. unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridgmig-
Joist Hangers
Jack Posts/Main Beam,
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour-
Firestopping_.
L:\SueHemingway'Building.Codes.Enspecdon,FORMS\GENERAL INSPECTION REPORT-doc
Office Use
.GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready attime.".
Dept, of Community Development Request received. Meet:
Building& Code Enforcement f At time: Y
742 Bay Road
Queensbu?y NY 12804 ARRIVE am/pm: DEPART mlpm Notes:
(518) 761-8256 Inspector's Initials
NAME:, PERMIT 2,6 6 -7
AL6,z, INSPECT ON(date): L L6 2,
LOCATION: ZS 1,
TYPE OF STRUCTURE: r-,D
RECHECK
N/A i YES i X/01 COMMENTS
00tingsFpiers
Monolithic Pour Form
Reinforcement in Place'
The contractor is responsible or
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing_
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Coiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridgmig-
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:\SueHemiiigway\Buildiiig.Codes.Inspection.FORMS\GENERAL INSPECTION REPORTA00
Dennis MacElroy,P.E.
112 Sunset Trail
Queensbury I,NY 12804 RECENED
dmacekoy@,adelphia.net SEP 16 2002
September 10,2002 TOWN OF QUEENSBURY
BUILDING AND.90DE
Michael Trombley
Ellsworth Lane
Queensbury,NY 12804
Re: Perc Tests
Dear Mike:
At your request I have conducted percolation tests at the site of proposed septic system
absorption fields for two lots off of Ellsworth Lane. The tests were completed in
compliance with the standards of the Town of Queensbury On-Site Sewage Disposal
Ordinance—Appendix F. The results are as follows:
Lot I —51 Ellsworth Lane
Stabilized rate of percolation—4V4minut&inch
Lot 2—80 Ellsworth Lane
Stabilized rate of percolation—61/2minutes/inch
Based on the minimum standards as prescribed by the New York State Department of
Health and the Town of Queensbury,the following design standards are required.
Septic Tank capacity:
3 bedroom home— 1000 gallons
4 bedroom home— 1250 gallons
Absorption Field size: Based on new construction with water saving fixtures— 110 gal./bdrm
51 Ellsworth Lane-<5 min/inch perc rate,
3 bedroom design— 138 If(min.)of 4"lateral
4 bedroom design- 184 If(min.)of 4"lateral
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Absorption Field size: (cont'd)
80 Ellsworth.Lane—6-7 min/inch perc rate
3 bedroom design— 165 If(min.}of 4"lateral
4 bedroom design—220 if(min.)of 4"lateral
This should provide the basic parameters of your system design. I would recommend
that your contractor install an effluent filter in the discharge tee of the septic tank and
speed Ie"velers in the inverts of the lateral pipes within the distribution box. If you have
any further questions please give me a call.
Sincerely,
Dennis MacElroy,P.E.
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