2002-976 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20020976 Date Issued: Wednesday, October 22,2003
This is to certify that work requested to be done as shown by Permit Number P20020976
has.been completed.
Tax Map Number: 523400-295-010.0001.012.000-0000
Location: 9 WO,ODCREST Dr
Owner: ROBERT GOVER
Applicant: ROBERT GOVER
This structure may be occupied as a:
By Order of Town Board
Fireplace TOWN OF QUEENSBURY
Garage-2 Cars Attached
Single Family Dwelling
Director of Building&Code Enforcement
�t TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P2002097.6 Application Number: A20020976
Tax Map No: 523400-295-010-0001-012-000-0000
Permission is hereby granted to: MILF,S CUSTOM HOMFS. INC.
For property located at: WOODCREST Dr
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: JAIVIES &EVELYN PARISI
3160 SOUTHERN OAKS Dr Fireplace
MERRITT ISLAND FL 32952 Garage-2 Cars Attached
Single Family Dwelling 175,000.00
Total Value 175,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
MILF,S CUSTOM HOMES. INC.
6 COTTACTF HILL Rd
G1.F,NS FAILS_NY 12801
Plans&Specifications
b�
2002-976 <<-
Construction of a 2,561 sq ft single family dwelling with a 618 sq ft attach=d two,Icar garage and on fireplace
per plot plan and specifications.
$369.12 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,November 27,2003
(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 ensb W n day,November 27,2002
SIGNED BY for the Town of Queensbury.
Director of Building& ode En orcement
---Building Permit.Application
Town of Queensbury.—Dept of Community:Development;-742 Bay Road, Queensbury,NY
I (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:
application farm.
Applicant:: .�es �ces� -� ,.ems c 6-caner
Address:
:" moo /
Phone#(5-ZA ? - 6t� Phone#(�) - Ee
Email Address: Email Address: NOV _P 2t?d2
Property Location: Lot Number: { / House Number $ I UJoo e v Taw C?F -
Subdivision Name: c5_+-z3 vu._ u- F-,se" '� -W" �- Tax Map Number ! j aL- BU1LaJ Alp C RY
New Building: e5ence
/commercial Estimated Market Value of Construction: $ �s,a Vlr
❑ Addition: res / commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
O No change to exterior size: residence t com'l
❑ Other work(describe )
Check OecupancyInformation I"Floor 2""Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
Single family dwelling gU pS)
❑ Two family dwelling Ur
a Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile
❑ Manufacturing,
❑ 1 car detached garage
❑ 2 car detached garage .
❑ 3 car detached garage
❑ 1 car attached garage- 6 `
2 car attached garage 412 t
❑ 3 car.attached garage
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other
What is the proposed height of the structure cAR ,ffeet ---- inches
Will any second-hand or ungraded lumber be used? If so,for what? AM—A
Type of Heating System: electric/ oil gas wood orced hot a_ir__., baseboard/othet:
Number of Fireplaces to be installed Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder �e 1;-lt s C e_. � 'f/ 7S'3-d'7Pd, s3G1=�2�?z�
Plumber j v 4-� 1 - . i�• l2..r �Za« ��` ., 7 4c.? -.r-4 7.
Mason �} �a •rff jZ� ra r7— r� G 3.a2
Electrician - ► y?3 --t 9 L3
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 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 of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all ne ¢ acto'n.i
Signature: oog er's agent,archite t,contractor_,.;
Application for Permit—Septic Disposal System , )2 -T7(Q_
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION: -0-5 ..... ......_..............................:... .............. ......
��p� x} (\�► Office Us�*>
Location of installation:�T«-
File Permit No. NO
Tax MapNa.,� 1°
Fee PaidU/ O0 2
Owner's Name: et -. t�jfOS�Ily-.. ......._............_._----
Address:
2. INSTALLER'S NAME
PHONE NO.
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 gallbdrm =
1980— 1991 x 130 gal/bdrm =
1991 —present x 110 gal/bdrm = �
Garbage Grinder Installed yes / no
Spa or Whirlpool Installed. yes�t �/ no ✓'
4. PARCEL INFORMATION: (circle applicable information&.indicate measurements) _
T—OROgraph Soil Nature Ground Water Bedrock or impervious Material Do Water SUPP1
Flat rEhe
at what depth at what depth municipal
Rolling P feet _ ?feet we '
Steep.slope� if well;water supply
o s ope from any septic-system
: absorption is ft_
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 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 Held for each Garbage Grinder, Spa or Whirlpool Tub.
.Septic Tank: j � gallon(min. size 1,000 gal.)
Tile Field: each trench ft. Total System Length: Z=Z J ft
Seepage Pit(s): number of size ofeach: _ft. by_moo ft
Size of Stone to be used: # 02 f depth or thickness feet
Bed System Size: x
Alternative System: length andlor size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: 1 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 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 ofthe Town of Queensbury Sanitary Sewage Disposal Ordinance.
�, It /0�-
Signature of responsible person Date
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 BEATING 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
7
Multi-Family Dwellings(3'Stori6s or Commercial Buildin less) s-, I op
Part 4*-Design by Component Performance, 9
Rise Residential
*Requires submission of worksheets
CA
APP CANTIS NAME: PROPERTY LO L XTION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE
I Gross Floor Area- square feet
2. Type of heat-_Electric oil Z,- Gas—Other
3. Is building mechanically cooled?--�es No
0
4. Percentage of area of windows and doors—Over 17 0 Under 171/o
5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND To R-VALUES AS
SHOWN ON PLANS SUBMITTED: R -79
a. Roof R /90
b. Exterior walls
C. Glazed areas R J,,S"
d. Exterior doors
e. Floors over unheated spaces R
f. Edge of slab on grade (heated building) R
9. Basement/cellar walls (above grade) R//
h. Basement/cellar walls (below grade)
i. Heating/cooling-ducts-piping in unheated space R d,--Z-
6. Service (domestic)hot water heating device Yes No
Conforms to minimum efficiency per code 1�1�
TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED
App * t,s Si nature Date Phone Number
,22c /1,/-Z x � g,?,9o, 3 61—Z 7 7b
,
INSPECTOR'S REMARKS:
TOWN OF QUEENSBURY
A.
Rickard toHIGHWA Highway Supedifenden t
DEPARTMENTHome(518)798-5127
742 Bay Road - Queensbury,NY 12804 Michael F. Travis
Deputy Highway Superintendent
Off:ce Phone: Sib+ ) 761-8211 (518)798-0413
Fax: (518) 745-4466
DRIVEWAY PERMIT
Nov ,,
DATE:
Jt/i I a 7'OVVN . - 2002
� BUI(p��U�FNSeUR
APPLICANT NAME:. .Ss
TELEPHONE NO.:
ADDRESS TO BE INSPECTED: s(4t U)O D"`Cr
RETURN ADDRESS: 1Rd (aC\xxl.
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 1: { )Preliminary Approval
NEED: { }Slight swale
{ )Level with the road
{ )Deep swale
Size pipe to be used(if necessary)
( )12„ ( )15" ( )IS" ( )24" ( )306"
-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. Missita,Highway Superintendent
Fire Marshal's office Town of Queensbury,742 Bay Road,Queepsb
f?ty
(S18)-761-8265
Appliances & Chimneys : /V A
Application for Fuel Burning pp � �,&
applicable to solid'fuel & vented gas appliances T(j 20pZ
Date 20 0 - Peirnit No C� U Nsg
1v0�p Y
Application is hereby made to,the Building& Codes Office for the issuance of a Building and Use
P&tnit pursuant to the New York State Fire Prevention and-Building Code. The 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 enter premises toperfrrin required inspections.
NOTE to applicant: Rough-in and. Final Inspections are required.
Applicant Information Fuel Burning Appliance Infor' mation
(circle appropriate words)
Name: � �s. �-�!{-e Stove: wood coal pellet
Fireplace insert
Address: c-��e_ /f xQ Fireplace, factory-built: wood gas
Fireplace,masonry: wood gas
Furnace: wood gas oil
Phone: 7T_? " 80OR , �3�/- 770
If non-masonary applicance,please provide
Uwner� Manufacturer Name: e-
Address: Model Number:
to
Chimney J�formation
Phone: 3 "33's-1 (circle appropriate words)
Masonry block •brick stone
Flue tile steel size: inches
Exact Address: V- f*/a
of construction or installation Factory-Built
Manufacturer name: c-
Model Number:
Note: Listed By: Number:
Construction/Installation'gust
can orm to NYS Fire Prevention,&Building Indicate(circle) chimney material:
Code. Consult available Town of Queensbur),
Handouts regarding required inspections: Double wall / Triple wall I Insulated / Direct venting
-Chimney Liner
C�,®�i�[ex-'ier Dep�rtr�iezit--To�itcrn. of Qsaceea,e�buzy, .�?r8�Yorl3: -
r
Fire Marshal Code# $Collected $Refunded Received fi oni(refunded to): S. �— A-" ..
acldres:s: _
A 173 3389 (190) Public Safety
A 233 2655 (2 0)Minor Sales
DATE 10j 0
.,cv�wu- Tww VLGL/o om d7
White(Applicant) t Green(Fire Marshal) / Yellow(B1dg..Dept.) 1 Pink R Goldenrod(Cashier's Dept.)
2,60 2--q
Permit Number
RECEIVED
MECcheck Compliance Report Checked By/Date'10V 2 1 2002
New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release I c OWN OF QUEENSBtiny
Data filename:C:\Program Files\Check\MECcheck\Gover.cck BUILDING AND CODE
TITLE:Family Residence
COUNTY: Warren
STATE:New York
BDD: 7635
CONSTRUCTION TYPE:Detached I or 2 Family
BEATING TYPE:Non-Electric
DATE: 11/11/02
DATE OF PLANS: 11/11/02
PROJECT INFORMATION:
Gover
Queensbury,N.Y.
COMPLIANCE:Passes
Maximum UA=591
Your Home=479
19.0%Better Than Code
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Raised or Energy Truss 1508 • 38.0 0.0 38
Wall 1:Wood Fratne,'16"o.c. 1885 19.0 0.0 113
Wall 2:Wood Frame, 16"o.c. 1200 19.0 0.0 36
Window 1:Wood Frame,Double Pane with Low-E 538 0.340 183
Door 1: Solid 65 0.110 7
Basement Wall 5:Masonry Block with Integral Insulation,7.6'ht/6.2'bg/7.6'insul
1599 11.0 0.0 102
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 New York State Energy Conservation Construction Code requirements. When a
Registered Design Professional has stamped and signed this page,they are attesting that to the best of his/her
knowledge,belief,and pr9f Ks6onal Jud ent,such Aans or specifications are in comp7n,7,this Code.
DIder esigner Date
Residential Final Inspection —/0
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: a rt:/Jl R.)lam/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials. .,f -y—
NAME: Q1AR-r1A PERMIT
LOCATION: !i-A \KOO KA�-2—�y k--)V DATE:
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: / Batter ybackup:
Bathroom Fans,if no window
Carbon Monoxide detector
f Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
ELnergenc egress below grade
Basement sernent stairs closed rise>4 inches
1/4 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
8uilding No./Address visible from road
Final Electrical
Site Plan [Variance required
Final Serve Plot Plan 1 jo..4j pelrZ-
As Built Septic System/Sewer Dept.Inspection Stick6r
Flood Plain Certification, if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C/0(Cert.Of Occupancy)
Okay to issue Permanent C/0(Cert. Of Occupancy)
L:\SueHen-dng%vay\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,21/3
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: 'am/pmDepart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: ✓ j ?7;
LOCATION: DATE:
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(L)installed
Interior privacy/trim/doors/main entrance 36 m' .
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery back-up:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stoppina finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
%hour fire door/door closer
Garage fireproofing
Duct work Scaled pwperly
Attic access 30 in.x 24 in.x 30 in.(ht)In accessible area
Crawl Spaces 18"x 247 access, I sq.ft.-150 sq.ft.vents
Building No./Address visible from road
Final Electrical
lan /.Variance 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 Compliance)
Okay to issue Temporary C 1 0(Cert. Of OccLipancy)
Okay to issue Permanent C 0(Cert. Of Occupanc
L:\SueHeninpvay\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
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NOTES:
1) THIS SURVEY WAS PREPARED WITHOUT THE
BENEFIT OF AN ABSTRACT OF TITLE AND IS
THEREFORE SUBJECT TO ANY EASEMENTS,
COVENANTS OR RESTRICTIONS OF RECORD
ANY STATEMENT OF FACTS SUCH DOCUMENT
WOULD DISCLOSE.
2) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY
MAP BEARING A LICENSED LAND SURVEYORS SEAL IS A
VIOLATION OF SECTION 7209, SUB -DIVISION 2, OF THE
NEW YORK STATE EDUCATION LAW.
\GE 48
ZEN COUNTY CLERK
TION TWO STONECROFT
THREW"
STEVES L.L.S.
A-SUDE 57
ZEN COUNTY CLERK
SUCCESSORS AND/OR ASSIGNS
COMPANY
ED FROM AN ACTUAL FIELD
;H 10, 2003.
FICATIONS HEREON SHALL BE
)R PARTIES HEREON NAMED AND
ADDITIONAL INSTITUTIONS OR
THAN AS MAY BE OR
97c--lp"
3) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY
MARKED WITH AN ORIGINAL OF THE LAND SURVEYORS
SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES.
�.�va
Residential Final Inspection loo
Office No. (518) 761-8256 Date Inspection request received: A3// A3
Queensbury Building&Code Enforcement Arrive: atn/p Depart: anVpm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
3 "
0--7- 3--�!,0
f-9ma �
NAME: PERMIT#:
LOCATION: DATE:
TYPE OF STRUCTURE:
Of V Comments
Y YN N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake IT
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 Railh�gs 34 in.to 38 in. 40rfoes
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 Vol'
8 inch clearance to sill plate poll
Gas Valve shut-off exposed/regulator 18"above grade t/
Gas Furnace shut-off within 30,ft. or within line of site
Oil Furnace shut-off at entrance to furnace area V/
Furnace/Hot Water Heater operating
-Low water shut-off boiler
Relief Valve(s)installed VO( N -7
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight T—A-tjf<
Safety glazig-�
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 insulationC/"�"fLt3'�G' �O�lVtV
Floor tniss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
1/4hour fire door/door,closer
Garage fireproofing V11 1,r4 C
Duct work Sealed 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./Address vi4iblelfrom road,
Final Electrical 9 124 1'C2 71 VV,- I A
Site Plan /Variance r6'qkrcdt
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Stic-rer
Flood Plain Certification,if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C 10(Cert. Of Occupancy) Lo
Okay to issue Permanent C 10(Cert. Of Occupancy)
L.\SueHen-dn'gway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
Town of Queensbury Fire Marshall G fCJ�
742 Bay Road
Queensbury,NY 12804 cY�
761-8205/761-8206
fax 7454437
Factory milt Gas Fireplace/Stove Inspection Report
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
—7 instructions or specifications is allowed.
w_---
Permit# / Schedule Inspection 1 d / 3 Time m anytime In
Name Address hough In Fin
Appliance Manufacturer Model#
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wald Insulated
Yes No N/A Comments
Floor Protection
Clearances to Combustibles (all sides)
Firestop(s) Vertical Chase
Wall Penetration
Vent Clearances to Combustibles
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve
Combustion Air
Hearth Extension (if any)
Mantel
Height above f/p opening
Witness Operation
Tank Placement(if'LP)
White—Building Dept. Yellow Cask mer Pink—Fire Marshal
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: a' in part—: am/pm.
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT NO.:
LOCATION: INSPECT ON: 3
X
RECHECK:
Comments and/or diagram
Soil Type: Sand Loam Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance
Other wells: ft.
Absorption Field: Total length
Length of each trench
Depth of trenches ft.
Size of Stone
-Seepage Pits: Number
Size: - x
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
istribution Box to Field Pit
Opening Sealed: Y/NI Partial
Locati
on/Separations
Foundation to tank
Foundation to absorption
Separation of Pits ft.
Conforms as_per Plot Plan Y N
Location of System on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
stem Use Stati
I S '�1"
-- :
Approved
Partial Approved and needs to be re-inspected,please call the'Building&Codes Office
Di8approved
LASuallerningway\Building.Codus.Inspection.FORMS\Septic inspection Report.doc January 28,2003
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received,
Queensbury Building&Code Enforcement Arrive: am/ m //Depart: - �m
742 Bay Rd.,Queensbury,NY 12804 Inspector's InitialsC -`�
NAME: Gm-� PERMIT NO.: P
LOCATION: R 0 INSPECT ON: -- 1
RECHECK: �—
Comments and/or diagram
Soil T e: an 1 la
Type of Water: unici a Well Water
_Waterline se ara on istance ft.
Well separation distance ft,
Other,wells: ft,
Absorption Field: Total length
Length of each trench ft.
Depth of trenches ft.
Size of Stone .�
See a e Pits: Number
Size: x
Stone Size:
Piping Si e Type,
Building to tank
Tank to Distribution Box y i
Distribution Box to F' /Pit �i t't
-Opening Sealed: Y N/ artial
Location/Separations
Foundation to tank
Foundation to abso tion t.
Separation of Pits ft.
Conforms as_per Plot Plan Y N ' .�/.- 4
Locatio o stem on Property:
Front Rear Left Side Right Side
Middle Front Middle Rear
System Use Status:
pproved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
-Disapproved
L:iSueHemingway\Building.Codes.Inspection,FORMSLSeptic Inspection Report.doc January 28,2003
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Town of-Queensbury
Fire Marshal's Office
742 Bay Road V
Queensbury, NY 12804 , 1
Phone (518)761-8205 Fax(518)745-4437 r
Fire Marshal's Inspection Report
Request SCHEDULE l p
Received: Permit# P INSPECTION ON: `Q
Name� � I V A!t!1 PM ANYTIME
Location: K_��_ C�a I2-A_��
APPROVED
N/A YES NO COMMENTS
EXITS
AISLE WIDTHS
EXIT SIGNS-NORMAL
- BATTERY
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTEM
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE "I
COMPRESSED GAS
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING
UNITS
CLEARANCE TO ELECTRICAL
REQUIRED SIGNAGE
EMERGENCY PLAN
MAXIMUM OCCUPANCY SIGN p/ '7� /�,�
C IMNEY c�L"J �V ✓(ec
SON ROUGH IN
CHIMNEY FINAL D2417jq j,
FACTORY BUI T ROUGH IN
C n1 FINAL
WOOD
STOVE ROUGHIN
FINAL
NTED GAS
APPLIANCE ROUGH IN
FIN L
FIREPLACE
MASONRY ROU H IN tK THIS DATE K FOR CO NOT OK
FINAL
FIREPLACE ,
FACTORY BUILT OUGH IN' J INSPECTED BY
FIN8LL_, 71,
COMDEV/CHiUSJMlORD/LETTERS2001/FIREMARSHALINSPECTIONREPORT11022001
WHITE-BUILDING DEPARTMENT COPY' YELLOW-OCCUPANT COPY
Rough Plumbing Insulation Inspection Report
Office No. (518)761-8256 Date Inspection reqfst received:,
Queensbury Building&Code Enforcement Arrive:-a_ Dopart: pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
r,nF"71
NAME: U PERMIT#:
LOCATION: INSPECT ON: 7A)
Y
TYPE OF STRUCTURE:
N N/A
PVC: R-1,R-2,R-3,R-4 Drain Vents
Cast Iron,Copper Drain/Vent Comm.
Plumbing Vent Vents in Place
Rough Plumbing/Nail Plates
Head or Air Supply Test
Drain and Vents
5 PSI or 10 ft. above highest
Connection for 15 minutes r"'S
Water Supply Piping
Copper Commercial
Pex One&Two Family
Insulation/ sidential Check/Commercial Check
-'Proper Vent,Attic Vent
Duct/Hot Water Piping insulation
If required unheated spaces
Combustiori Air Supply for Furnace
Duct Work Sealed Properly,
COMMENTS:
-L-\SucHemingvva)iBuilding.Codes.Inspection.FORMS\Rough Plumbing Insulation Report.doe January 28,2003
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Dat6 Inspection request received:
Queensbury Building& Code Enforcement Arrive: am/p Dpart: m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: PERMIT#: 2 770
LOCATION: INSPECT ON: 410///7/0
TYPE OF STRUCTURE:
Y N N/A
azning V COMMENTS
—haXcliuds/Headers 111—tz V5
racing
racing/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'dach side
Draft stopping 1,000 sq. ft. flo o r-trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall 4
Fire separation 1,2, 3,hour
z
ire wall 2, 3 4 houf
Z
Penetration sealed—�
16 inch insulation in ca ty min.
Garage Fire Separation
S
V
House side .inch r 5/8 inch Type X
Garage side 5/8/ich Type X
Ceiling/ 11
Windows Habi le Space/Bedrooms
24 in. (H
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report,doc January 28,2003
Framing )e 7ciKh:�e p�t
Framing In
Office No. (518) 761-8256 Date Inspection re t recei
Queensbury Building&Code Enforcement Arrive:
re Vtrelcei,
art:
742 Bay Road, Queensbury, NY 12804 Inspector's Initi I
NAME: G c>\�-y_- PERMIT#: -7. -p-50-7,�-1
LOCATION: INSPECT ON: — IZ7— >r—
TYPE OF STRUCTURE:
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 1�4:57
Metal Strapping for Notches Top Plate ON
1 2(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
Fire wall 2, 3,4 hour XjkA
irestopping
/Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side V2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
—Ceiling/wall %t7
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHeniingway\Buildin-..Cc)des.inspection.FORMS\Framin.-Firestoppin.-Inspection Report.doc January 28,2003
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Ins ection u rec
Queensbury Building&Code Enforcement Arrive: epa
742 Bay Road, Queensbury, NY 12804 Inspector's Initi
NAME: PERMIT#:
LOCATION: !IG INSPECT
TYPE OF STRUCTURE:
Framing .. Y N N/A COMMENTS
Jack Studs Headers
Bracing Bridging
Joist hangers \-2
Jack Posts/Main Beams
Exterior sheeting nailed properly OVN L-1
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in. CID vc�
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
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
,5.7 sf above/below grade
5.0 sf grade
L:\SucHemingway\Building.Codes.Inspection.FORMS\Fi-amingFirestoppiilg Inspection Repor"t.doc January 28,2003
Report
Rough Plumbing/Insulation Inspection
Office No. (518) 761-8256 Date Inspection requ c ed- A
Queensbury Building&Code Enforcement Arrive:VZ_a a
742 Bay Road,Queensbury,NY 12804 Inspector's Initial
NAME: PERMIT
C,
�'_D=oo;L
LOCATION: INSPECT ON: -D-,
TYPE OF STRUCTURE:
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain Vents
Cast Iron,Copper Drain 1 Vent Comm.
Plumbing Vent Vents in Place V/ I
��ugh Plumbing/Nail Plates q—V X\—C_�
Head or Air Supply Test
Dfain and Vents va
5 PSI or 10 ft. above highest
Connection for 15 minutes
Water Supply Piping
Copper Commerci
Copper,C-PVC ex One&Two Family
Insulation/Residen—illa T=hecMom�mercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces 1K
Combustion Air Supply for Furnace
n I
Duct Work Sealed Properly v
CONMENTS:
L:1SucHemingwa3ABuilding.Codes.Inspection.FORMS\Rotigh Plumbing Insulation Report.doe January 28,2003
�S,�-�- raining /F 7- --t o-p
p ing Inspection eport
Office No. (518) 761-8256 Date In pection reques
Queensbury Building&Code Enforcement Arrive: a pm art- Q
?.,� a p
742 Bay Road, Queensbury', NY 12804 Inspector's Init'
NAME:
PERMIT#:
r5m&4�_ '
LOCATION: �-1 LC_ _txe 9— INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A
COMMENTS
Framing
Jack Studs/Headers
Bracing/Bridging
Joist hangers 25WCA�6 6,1-_.)
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
I 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 vV\
Fire separation 1, 2, 3 hour
ire wall 2, 1, 4 hour R �0,
topping 11P
Penetration sealed vtc�
16 inch insulation in cavity min. —kD
Garage Fire Separation
House side Y2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
C)
Windows Habitable Space/Bedrooms c)
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
LAS ueHemin gway\Buildin&Codes.Inspection.FORM S\FramiDg Firestopping Inspection Report.doc January 28,2003 ZL'17
0
Foundation Inspection Report
Office No. (518)761-8256 Date Ins4ecn reques
Queensbury Building&Code Enforcement Arrive: a D part: � An
74TBay Rd.,Queensbury,NY 12804 Inspectotials:
NAME: 1 P PERMIT#: —
LOCATION: INSPECT ON: -r -
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the,placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofmg
Foundation/Waterproofing
e of D p roofu�. Waterproofing
Footing Drain Daylight or Sump � J �
Footing Drain Stone:
12 inch width
6 inches above footing ✓``
mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
0
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection re a r ve
Queensbury Building&Code Enforcement Arrive: n a Depart: � 'rD, in
742 Bay Rd,,Queensbury,NY 12804 Inspector's Init als:
NAME: } ERMIT#: 7 � / �Q
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers 40
Monolithic Slab
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
Foundation/Waterproofing
Type of Dampproofrng/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received: '! .I
Queensbury Building&Code Enforcement Arrive: —am/p De it: l am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: 1;^ ' INSPECT ON: —
TYPE OF STRUCTURE:
Comments
Y N N/A
,'Footings
Piers
Monolithic Slab
Reinforcement in Place Z
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
.Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofmg
Foundation/Waterproofing
Type of Dampproofmg/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper ,
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
G. Peter Jensen
17yWest Road
.,South Glens Falls
New York 12803 �
RECEIVSD
t-t.
" 4
Np V 2002
November 14, 2002 TOWN OF QU6E I�56U
BUILDING AND CODS Y
To Whom It May Concern:
I have reviewed a set of single-family residence plans, submitted by Steven Miles,
for the Gover Residence to be constructed in the Town of Queensbury, Warren.County
State of New York:
The 8"poured concrete foundation walls on lb"X 8" reinforced concrete footings
is adequate to support the imposed loads, assuming the 2 ton per square foot presumptive
soil bearing capacity is the basis for the-design. The built up beam(4 pc 2 X 12)spanning
approximately 7 feet, on steel columns, on 24"X 24"X 12"reinforced footings is
adequate to support the loads imposed, A Bearing wall on a 24'X 12" continuous footing
reinforced with 3 #4 bars will be required at the'V' stairs.
The floor system consisting of/4"T&G sub floor over 2 X 12 joist is adequate for
the spans indicated. All of the load bearing,headers appears to be adequately sized to
f carry the loads imposed.upon them. The roof system;consisting of shingles, on felt
paper, on 5/8 sheathing, on pre-engineered trusses,is adequate;providing the trusses are
:..k designed for the snow load anticipated for Queensbury.
d
..The insulation shown as R 38 in the ceiling(with raised heel trusses)and R-19 in
the sidewalls,will be adequate, however,R 19 insulation will have to be added to the
first floor joist since,the basement area will not be heated. The R 11 insulation at the
basement perimeter walls is not required by the energy code.
' It/would appear that the placement of the smoke detectors is adequate. The fire
separation between the.garage and the dwelling is appropriate. The square footage of
glass is adequate to satisfy the 8%requirement. Each living space is provided with an
emergency egress opening.
Sincerely,
G. Peter Jensen
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