2011-409 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: P20110409 Date Issued: Tuesday, May 22, 2012
This is to certify that work requested to be done as shown by Permit Number P20110409
has been completed.
Location: 90 ROCKHURST Rd
Tax Map Number: 523400-227-013-0002-039-000-0000
Owner: LARRY CLEVELAND
Applicant: LARRY CLEVELAND
This structure may be occupied as a:
Single Family Dwelling By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property
owner of the responsibility for compliance with Site Plan,Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
.411111bii TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
FIVO
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110409 Application Number: A20110409
Tax Map No: 523400-227-013-0002-039-000-0000
Permission is hereby granted to: LARRY CLEVELAND
For property located at: 90 ROCKHURST Rd
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: LARRY CLEVELAND
JOHN SHINE Single Family Dwelling $130,000.00
32 NORTHWAY Ln Total Value $130,000.00
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
A J CATALFAMO CONSTRUCTION
747-6659
5 SIXTH St
HUDSON FALLS NY 12839-0000
Plans&Specifications
2011-409
1987 sq ft single family dwelling
$397.40 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 23,2012
(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'I(own of °ueet hury, if u l August 23,2011
SIGNED BY `' v,;• Queensbury.
for the Town of
Director of Building&Code Enforcement
'.- .-r , , -010
''T.-7 72 i -7 -; ,-,OFFICE USE ONLY • • ._ , f W1
) —,/ - / /1 Lji
TAX MAP NO.' f PERMIT NO. i , ri
(� (�
-2 r-
FEES: PERMIT. )j RECREATION ENGINEERING 1 ,UG 1 1 2011
(If applicable) I
TOWN OF QUEENSB 'Y -
PRINCIPAL STRUCTURE: APPLICATION FOR ZONIN C AP'7' 1' 141; .: * •
PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION. jJ 41406
APPLICANT/BUILDER: Al C44I 1.¢vr10 CO rI s+1u ch iNER: L412(LY' cieNlaboO
• Kcemexembociouteawirr
ADDRESS: `> Si n--I1 sr ADDRESS: . 2iE i Ozi a fL 'f
PHONE NOS.(57£0 PI 7 - 60-1 PHONE NOS. Li lcib0
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: cm* O't1�NPHONE: 646•;511
LOCATION OF PROPERTY: go @nuc 3r 120• '1OufJ OF ei .,jl_ P&t2-` , {..Pr 12,x}
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? %YES 0 NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL: 41re, ftad mPV : o4.17•'i011
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT OZ cc d
o
LU APPLY TO YOUR Z i= cc p co co O co w
PROJECT O Q O • x O -- s
LL
L. Ili
NO)u) OZ < < r O u IL- d 1 oO
SINGLE FAMILY x G83 482• 819. 1987 lite
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: iJ//o
ESTIMATED CONSTRUCTION COST/ /30,000 FUEL TYPE: OTL
HEAT TYPE: -- // *HOW MANY FIREPLACE(S): Lk'L AND/OR WOODSTOVES(S): 1.101-16
ZONING CATEGORY: mita. ARE THERE WETLANDS ON THIS SITE? 'JO
IS THIS A HISTORIC SITE? }.O
PROPOSED USE OF BUILDING OR ADDITION: 4i '. rr4-4IL { O1.JLa(�(A�
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? II'.�o
ARE THERE EASEMENTS ON PROPERTY? Lib
*Please complete a separate Application for"Fuel Burning Appliances& Chimneys"available in our office
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and gr a .d e above.
Signed l
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes
or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
t
Revised 4/14/2010
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
BUILDING & CODES APPROVAL ZONING APPROVAL
DATE DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(aqueensbury.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
Operating Permit Issued: Yes No
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
OFFICE USE ONLY
TAX MAP NO. PERMIT NO. ,,I P '/, PERMIT FEE
APPROVALS: ZONING TOWN CLERK
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT.
OWNER: S[l j�1✓i e / C(C✓elk 14 INSTALLER: ((k c'4(1 e x C 4111-k✓1 j
ADDRESS: (O Roc(chv(St C ecosb(rv' ADDRESS: U/00 dcl-ivcIc hr(( ac4
PHONE NOS. 7 5 -2,a t/8" PHONE NOS. 753-0(1 3
LOCATION OF INSTALLATION:
RESIDENCE INFORMATION:
YEAR BUILT NO.OF COMPUTATION
X = TOTAL DAILY FLOW
BEDROOMS (Gallons per bedroom) GARBAGE GRINDER
1980 or older X 150 = INSTALLED? //e)
1981 -1991 X 130 = SPA OR HOT TUB
1992-present X 110 = INSTALLED? A)0
PARCEL INFORMATION: �/
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE �
✓ SOIL NATURE: SAND LOAM X CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? S e e eI F}'v
✓ BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? See elk Ill
✓ DOMESTIC WATER SUPLY: MUNICIPAL (If well:water supply from any septic system absorption is: ft)
✓ PERCOLATION TEST: RATE IS 5•ee ell-Ai PER MIINUTE PER INCH[mpi]
(Test to be completed by a licensed professional engineer or architect)
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).
TANK SIZE: a)1°dW 34'IdGALLON(MIN. SIZE IS 1,000 GAL.)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM TYPE:
14 ABSORPTION FIELD(WITH NO.2 STONE) Total length ft. Each trench X
❑SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM Bed or other type?
❑ HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
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 of the Town of Queensbury QUESTIONS? CALL 761-8256 OR EMAIL
Sanitarywage hiy/isal Ordinance. codesCa�queensburv.net
(41' '
7/d j/(( VISIT OUR WEBSITE FOR MORE INFORMATION
Signature o Person Responsible bate www.queensburv.net
Town of Queensbury * Community Development Office * 742 Bay Road, Queensbury NY 12804
Queensbury Building & Code Enforcement - Residential Final inspection
•
Office No. (518)761-8256 Arrive: am/ De part: am/pm
Date Inspection request received: Inspector's Initials: ��%G
NAME: SX a. / PERMIT#: ZO//— 7 5
LOCATION: <'' ii DATE: T /
TYPE OF STRUCTURE: /// /
Comments:
Yes/No N/A
4" Building Number Address visible from road ✓
Chimney Height I"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wail
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy 1 trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors 1 Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access,1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification ►/
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below 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 operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 t/r
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical;Energy Saving Light Bulbs 50% ` f
Final Survey Plot Plan V v� r.sf7 tf~//�� Cr
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles ` tor4
Flex Gas Pipe Bonding /' r
As Built Septic System/Sewer Dept. Inspection Sticker � -6//4 47°- cl h-
Site Plan I Variance required f�
Flood Plain Certification,if required gee/ cf154.Vfic17)fr' � vice f
Okay to issue C/C or C I 0[Temporary/Permanent]
L:1Building&Codes Forms\Building&Codes\Inspection Fonns Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
NORTH EAST BUILDING PERFORMANCE ADVISORS
Serving the Capital District, Saratoga and Adirondack Regions
January, 6 2012 Mailing Address: 15 Cobblestone Dr.
Queensbury,NY 12804
John Shine
90 Rockhurst Rd G M
Cleverdale,NY 12820 •0 5tZ
RE: Insulation Evaluation and Blower Door Test
Mr. John Shine:
After inspection of the insulation in your home and a depressurization test of 50
Pascal facilitated by the blower door, my observations are as follows:
❖ There is no evidence of a Thermal bypass.
❖ The Total volume of the house is 15654 cubic feet taking into consideration the
conditioned basement. The Cubic feet per minute @ 50 Pascal was 550 CFM. The
height correction factor for New York State is 15.4 for a two story building such as
the tested home @ 90 Rockhurst Road.
•S The blower door test indicates that currently the house has an air exchange rate of
0.137 air changes per hour. The US national average of air change rates, for existing
homes, is between one and two per hour. Standard homes built today usually have air
change rates from 0.5 to 1.0. Extremely tight new construction can achieve air
change rates of 0.35 or less. If your homes air change rate was below 0.20, I would
recommend some form of mechanical ventilation to bring in fresh outside air to
control the humidity and keep fresh air in the home for the occupants.
❖ My credentials are as follows:
➢ BPI Certified Building Analyst
➢ BPI Certified Envelope Specialist
➢ BPI Certified Heating Professional
➢ HERS Rater
❖ If you have any questions regarding my findings please feel free to contact me.
Sincerely,
Jack Towne
1.888.472.2774
7 Rocky Ridge Road 4A Vatrano Drive
Warrensburg,NY 12885 Albany,NY 12205
Phone(518)623.7016 Phone(518)350.2941
Fax (518)623.7015 Fax(518)694.0102
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 5—15 I
NAME: 5__A Ckellakla.A
LOCATION: 90 R v C IC h Grist
PERMIT#: — D
•
Final Survey Plot Plan
Anaroved Denied
The attached final
survey has been
received by the
Dept.of
Community
Development.
Upon review the
survey has been:
Craig rown,Zoning Administrator
Notes:
L:\SueHemingway\Building.CodesJnspection.FORMS\Final Survey
Zoning Administratordoc
I MAP REFERENCES 3
MAP OF A SURVEY OF A PARCEL OF LAND
MAP OF
TO BE CONVEYED TO Dr. ABRAMS, BEING
ROCKHURST ON LAKE GEORGE
THE SOUTHERLY PORTION OF LOT 25 OF
DEVELOPED BY
THE HOW -MAC DEVELOPMENT ON ROCKHURST,
HOW -MAC DEVELOPMENTS, INC.
SITUATE IN THE TOWN OF QUEENSBURY,
DATED: DECEMBER 20, 1955
WARREN COUNTY, N.Y.
LAST REVISED: JANUARY 24, 1956
BY: JOHN B. VAN DUSEN
BY. LESLIE W. COULTER
2
4
MAP OF PREMISES CONVEYED BY ROBERT A. ABRAHAM
MAP OFA SURVEY OF A PARCEL OF LAND TO BE
TO ANTHONY COVIELLO & MARGARET, HIS WIFE
CONVEYED TO DR. ABRAHAM
BY: JOHN B. VAN DUSEN
BY.• JOHN B. VAN DUSEN
DATED: JULY 17, 1970
DATED: JUNE 25, 1968
CIRF
Al
•
•
NOTE: AVERAGE BUILDING SETBACK TO LAKE
FOR ADJOINING PROPERTIES - 38.0'
34.7-
34.1
A5PHALT DRIVE
5
MAP OF A SURVEY MADE FOR
TONY DiBELLA
BY: VAN DUSEN & STEVES
Dus
DATED: APRIL 17, 2003
J
LAST REVISED: JUNE 18, 2003
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t e V e
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GARAGE
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1.65'
115.00'
7822 2t
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40.2'
PATIO 2.02'
AREA
9, 075.51 t sq. ft.
0.21± acres
LEGEND
LANDS N/F OF
BETOR
MLH - 317.74
DECK DECK
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CIRFO = CAPPED IRON ROD FOUND
IPIO = IRON PIPE FOUND
c'a, = UTILITY POLE
@=
LOTS AS PER MAP REFERENCE No. 3
Map of a Survey made for
John R. Shine
Larry J. Cleveland
Town of Queensbury, Warren County, New York
RAMP
LANDS N/F OF
LAMKINS
4 11130111
3 1/10/11
2 10/19/10
1 19123110
NO. I DATE
RETAINING
WALL
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COVERED DOCK
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ADDITIONAL LOCATION
TOPOGRAPHY
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—DESCRIPTION
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•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
I EW YOK STATE EDUCATION LAW'
ONLY COPIES THE ORIGINAL OF ,IM= SURVEY
S
t e V e
ORI
MARKED WITH AN ORIGINAL OF THE LANG SURVEYORS
SEAL SHALL BE CONSIDERED TD BE VALID TRUE COPIES."
"CERTIFICATIONS NTOCATED HEREON SIGNIFY THAT
Land
169 Haviland Road
Surveyors
Queensbury, New York 12804
Q yf
THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE
OF PRACTICE FOR LAND 71ON SURVEYORS ZONALADOPTED
BY THE NEW
BY INE NEW YORK STATE ASSOCIATION OF PROFESSIONAL
LAND SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR W M THE SURVEY IS PREPARED, AND
ON HIS BEHALF TG THE DRE COMPANY. GOVERMENT&
LISTED HEREON AIM)
AGENCY0THESSI `E"°"O ITHE LENDING
To � ASSIGNEES OF THE LENDNC RISRNTION.'
;518) 792-8474
New York
Lic. No. 50135
D
34.2'
40.2'
PATIO 2.02'
AREA
9, 075.51 t sq. ft.
0.21± acres
LEGEND
LANDS N/F OF
BETOR
MLH - 317.74
DECK DECK
DOCK
Ul
.G.AKE
�Ina �.tiw
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01 P-4
1
1;
1 RIP
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8°22' "W �.
6. 0�
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Q I S ti IBS
26 IRSO = IRON ROD SET / TO BE SET
CIRFO = CAPPED IRON ROD FOUND
IPIO = IRON PIPE FOUND
c'a, = UTILITY POLE
@=
LOTS AS PER MAP REFERENCE No. 3
Map of a Survey made for
John R. Shine
Larry J. Cleveland
Town of Queensbury, Warren County, New York
RAMP
LANDS N/F OF
LAMKINS
4 11130111
3 1/10/11
2 10/19/10
1 19123110
NO. I DATE
RETAINING
WALL
G A-0
-F (P 0 RG E
MWH - 320.20
COVERED DOCK
��
HOUSE LOCATION
ADDITIONAL LOCATION
TOPOGRAPHY
SETBACKS
—DESCRIPTION
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Lt l �1 �,-�
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.. Queensbury Building & Code Enforcement - Residential Final Inspection
al—fir
Office No. (518)761-8256 --4Arrive: ` 34 am/p, Depart: am/pm
Date Inspection request received: Inspector's Initials:
NAME: 1 K. 1 +s517 " _PERMIT#: I
LOCATION: 9( 3( P /'
DATE: j �r r
TYPE OF STRUCTURE:
Comments:*� ) ' f
Yes/'No N/A f � /// LL 1/cl'`^ /�f��». ,
4" Building Number Address visible from road I/ hs
Chimney Height/"B"Vent/Direct Vent Location ,/� % -i]., _
Fresh Air intake // ji
3inch Plumbing Vent through roof minimum 18 inchesRoof Complete/Exterior Finish Complete --
Platform
Platform at all exterior doors ✓ li C�1
Handrail 4 or more risers /
Guards at stairs,decks,patios more than 30 inches above grade r/ l 1
Guard at stairwell at 34 inches or more ✓ TA
Guard at deck,porches 36 inches or more / , ,
Handrail Termination at Newell Post or Wall r// it A,{e Lc �,( J 61,-t, (4 (4--) i
Interior/Exterior Railings 34 inches to 38 inches ///
Deck Bracing/Handicapped Ramp Compliant ✓ `l�I; U y„
Grade away from foundation 6 inches with 10 feet s// 'I�!�
6 inch clearance to sill plate ✓✓✓ "CP ^
Gas Valve shut-off exposed/regulator 18 inches above grade lt
L�Yw '/
Interior privacy/trim/doors main entrance 36 inches ✓/ ]j`� ct��� (_--- -6t
r.>t '
Bathroom/Kitchen watertight ✓ V% ''
Safety glazing/Window in stairwells safety glazing C Bruce, r
Interior Smoke Deaton;/Carbon Monoxid�Detectors
Every level: V Every Bedrooms: I/
Outside every bedroomarea: I/
Inter Connected: V Battery backup: .
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area / f(J�-�
t-el
Crawl Spaces 18 inch x 24 inch access,1 sq.ft.-150 sq.ft.vents r/ (J``��
Bathroom Fans,if no window r
Plumbing fixtures j1� „Jot- ( Ssvtc �' 0
Foundation insulation to floor I Sticker on Panel t-� � ,2
Duct work sealed property/Blower Door Test Certification V 1.(4 -1)L �� 17 id '5
Floor truss,draft stopping finished basement 1,000 sq.ft. / k� e c
Emergency egress below grade ✓
Gas Furnace shut-off within 30 feet or within line of site V Oily
Oil Furnace shut-off at entrance to furnace area t/ �.
Furnace/Hot Water Heater operating /
Low water shut-off boiler >/ C � '
Relief Valve(s)installed/Heat Trap/Water Temp 110 V / / // c .
Enclosed Stairs Sheetrock Underside minimum W Gypsum V f/'/Q tc (/ne/Q-Jilt a/ S'i''
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/' hour fire door/door closer 1/z,
Gas Logs in Sealed or Glass Enclosure
Final Electrical;Energy Saving Light Bulbs 50% ✓
Final Survey Plot Plan r/ 17r d."- f na//
Lrvry
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding /� �' * ,aAs Built Septic System/Sewer Dept. Inspection Sticker deei /D'J� J���
Site Plan /Variance required /7 ,�` J' �l,, ,...)7.1"-en 4 A.
Flood Plain Certification,if required /✓ r"�
Okay to issue C/C or C/01 Temporary/Permanent] ,/ J i k ivv
L:\Building&Codes Forms\Building&Codes\Inspection Forrns\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
4 °V ' '‘7 dg/9 )3' 0- 30 cd-r
.(ai\,;;-'• REVIEWED & STAMPED L:� t
TOWN OF QUEENSBURY :-t(1/ ZONING ADMINISTRATOR
Community Development Office
*Aiwa 742 Bay Road, Queensbury, NY 12804-5902 COPIES TO FILE, WILDING PERMIT,
CODE COMPLIANCE OFFICER&APPLICANT
Town of Queensbury Planning Board
)N 7 -�__�_�____
Resolution to Approve Site Plan 16-2011 John Shine/Carry-Cteigin4
A site plan application has been made to the Queensbury Planning Board for the following: Applicant proposes removal
of existing 538 +/- sq. ft. camp and construction of a new 1,990 +/- sq. ft. single family dwelling with new septic system
and stormwater management controls. Construction within 50 feet of slopes 15% or greater in a WR zone requires
Planning Board review and approval; and
A public hearing was advertised and held on 3/22/2011 tabled to 5/17/2011; and
This application is supported with all documentation, public comment and application material in the file of record;and
MOTION TO APPROVE SITE PLAN NO. 16-2011 JOHN SHINE/LARRY CLEVELAND, Introduced by Gretchen Steffan
who moved for its adoption, seconded by Thomas Ford:
1) Pursuant to relevant sections of the Town of Queensbury Zoning Code [Chapter 179-9-080]], the Planning Board has
determined that this proposal complies with the requirements as stated in the Zoning Code;and
2) Type II, no further SEQRA review is necessary; and
3) Final approved plans, in compliance with the Site Plan, must be submitted to the Community Development
Department before any further review by the Zoning Administrator or Building and Codes personnel. The applicant
must meet with Staff after approval and prior to issuance of Building Permit and/or the beginning of any site work.
Subsequent issuance of further permits, including building permits is dependent on compliance with this and all other
conditions of this resolution;and
4) As-built plans to certify that the site plan,is dev aceen tie 40 the appwavettptians to be provided nnor to
issuance of.the certificate of occupancy;and
5) The Sanitary Sewer connection plan must be submitted to the Wastewater Department for its review, approval,
permitting and inspection;and
6) The limits of clearing will constitute a no-cut buffer zone, orange construction fencing shall be installed around these
areas and field verified by Community Development staff; and
7) If curb cuts are being added or changed a driveway permit is required. A building permit will not be issued until the
approved driveway permit has been provided to the Planning Office;and
8) This is approved with the following condition: The applicant will satisfy engineering comments and obtain an
engineering sign-off;and
Duly adopted this 17th day of May 2011 by the following vote:
AYES: Mr.Schonewolf, Mr.Traver, Mr. Krebs, Mrs. Steffan, Mr. Ford, Mr. Hunsinger
NOES: None
ABSTAIN: Mr. Sipp
Cc: Tom Center, Nace Engineering; Curtis Dybas
"Home of Natural Beauty ... A Good Place to Live "
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am pm Depart:1.1243). .
" ` am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:(
NAME: PERMIT NO.: 2.
L• • k • vie_•_ ___ INSPECT ON: Mi
IOW
Comments and/or diagram
Soil Type: Sand/ Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50'+/- Y N N/A
[150'to well required If NO] /�
Absorption Field: Total length 64- ft.
Length of each trench Z +v1
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank � `°AAA
Tank to Distribution Box \i4"--rZ..v�k-R--'—.
Distribution Box to Field/ Pit °`
Opening Sealed: N
End Cap
Inlet/Outlet Pipes&Baffles �y_Nt_,
Manholes 12"or less below grade VY N
rt-N" <
[provide extension collar if Yesl Y N ���1�d�' �,�—!�.?,,0, i�Lj L (2JL.
Location/ Separations ,.- _ —
Foundation to tank J()+ ft.
Foundation to absorption %► 4S' t.
Separation of Pits _ 1! lj�
Conforms as per Plot Plan '-'
Engineer Report and As-Built Y N
ETU Maintenance Contract Y N
provided
Location of System on Property:
:''Front Rear Left Side Right Side Middle Front Middle Rear
em - .t
Approved
Partial Approved and needs to be re-inspected, please call the Building&Codes Office
Disapproved
LAPam Whiling\2010\Building Codes Formsunspection Forms\Septic Inspection ReporL03 29 10.doc
2 -y /h vl.S if/- .
Framing / Firestopping Inspection Re•y '
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: , am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: itutf ,T
C�
NAME: �/]J -� _ 7-
LOCATiON: PERMIT#:I) 4ar`/c A u r'c INSPECT ON: j
TYPE OF STRUCTURE: y , a
Framing Y it NA COMMENTS:
Attic Access 221x 30'minimum ''h ....
Jack Studs/Headers -
Bracing/Bridging
Joist hangers c -"Th ) /"-
Jack Posts/Main Beams .' 1 L-U V
Exterioresheeting nailed properly i _-------
12"O.C. Z.:2'Headroom 6 ft. 8 in. !WC-9 -C
oreStairwells 36 in. or m _
Exterior Deck Bracing �-.. --7'-- � C
Headroom 6 ft. 8 in. e
Notches/Hobs/Bearing Walls
Metal Strapping for Notches Top Plate <L:0-'1" ---~F_"
1 'A(w) 16 gage (8) 16D nails each skis C'
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
/.,-----L-----
Ice and water shield 24 inches from wall
Fine separation 1, 2, 3 hour
pI23 4 ' r
Firestopping f -c--,
16 inch insulation in cavity min. t-,
Garage Fire Separationl\-3,M154-
House side%inch or 5/8 inch Type X V�� n /--
Garage side 5/8 inch Type Xcr ((-1,44 v c
Ceiling/wall
Windows Habitable Space/Bedrooms / �'
24 in. (H) i li"G�
20in. (W) _
5.7 sf above/below grade
5.0 sf grade
L:\Buildi g&Codes Forms-OLDDBuiding&Codeslinspection Fonns1Frarning Firsdopping Inspection Reportdoc Revised January 7,2000
Framing / Firestopping Inspection Report I
Office No. (518)761-8256 Date Inspection request received: 1 . U I a-
Queers3bury Building&Code Enforcement Arrive: am/ • - �f r.-? am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: /': �� 4,•
o
JA,J
NAME: = �� I( �o
PERMIT#:
LOCATION: 0 - (,L k -c" W INSPECT ON: 1 , 1-1- 14-0
l * Iao
TYPE OF STRUCTURE: < )
Framing Y N COMMENTS:
Attic Access 22'x 30* minimum
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
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 36(w) 16 gauge(8) 16D Haus each side
Draft stopping 1,000 sq. ft.floor trusses
Anchor Bolts 6 ft. or lesson center
Ice and water shield 24 inches from wall .
Fire separation 1, 2 3 hour fyy ...41(
FI '' ..
hour f ,,
Firestopping
sealed _ �--�, r ,
16 inch insulation in cavity min. + \, - -- --
Garage Fire Separation ` `
House side IA 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:16uildIng&Codes Forrns-OLD Building&CodesWapection FomietFm rn ng Fire topping Inspection Report.doc Revised January 7,2008
v
Rough Plumbing / Insulation Inspection Report
r
Office No. (518) 781-8256 Date Inspection request received: / ,_!I
Queensbury Building &Code Enforcement Arrive: am/pm Depart: ifidi a pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
6.4D
NAME: /61eit,,L, �- PERMIT#:
LOCATION: c''6 . Lk htrq INSPECT ON: , ,p ,i
TYPE OF STRUCTURE:
Y N N/A
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
1 %inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.I. or 10 ft. above hrghest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
r 15 minutes
Insulatio Residential Check/Commercial Check \ ,
Similar Exterior Sealant
Proper Vent,Attic Vent
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
r- /^ ' /' "`lC
7s -tt,—)
COMMENTS: 1 t s `'
c)1 R \A4A,A7C, S--7----t,A-+A
t
vizty\i,a*-= aiN---wQf2T24Asacjk))
Rough Plumbing insulation Report.revised Nov 17 2003,revised February 15,2005, revised January 7,2008
: 3c
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart.' " , am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: PERMIT NO.: 4 L�� J
LOCATION: i`7 0? ,A,—y INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand/ Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft. �
Well Casing Length 50'+/- Y N N/A V 6r2 -\4 l
[150'to well required if NO]
CC-04rZ.-- 0"A-a --
Absorption Field: Total length ft. �\���� —'
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size:
Stone Size:
Piping ¢e
Building to tank
Tank to Distribution Box S --
Distribution Box to Field/ Pit C�
Opening Sealed: Y.�N
End Cap Y N
Inlet/Outlet Pipes&Baffles Y_N
Manholes 12"or less below grade Y N I/
[provide extension collar if Yes] Y N p
Location/ Separations C i ��� 6 � _ t
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y
Engineer Report and As-Built Y N
ETU Maintenance Contract Y N
provided —
Location of System on Property:
Front Rear Left Side Right Side fiddle Front Middle Rear
em S
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\InspectIon Forms\Septic Inspection Repor _03 29 10.doc
Rough Plumbing 1 Insulation Inspection Re ortARe,
Office No. (518)761-8256 Date Inspection request received: !l/iV/2ni,
Piz
Queensbury Building &Code Enforcement Arrive: am/pm am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: (�
NAME: „es PERMIT#: , 2c/(--`too
LOCATI•, RQ Gk kw4r INSPECT ON: //M01--6//
TYPE OF STRUCTURE: SRS
Y N N/A 79g'-1t4"G
Rough Plumb' /Nail Plates
ng Vent/Vents in Place
1 %inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I change of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.I. or 10 ft. above h'+hest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
50 P.S.I for 15 minutes
Insulation/Residential Check I Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent,Attic Vent
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMgNTS:
Rough Plumbing Insulation Reportrevised Nov 17 2003,revised February 15,2005, revised January 7,2008
Framing / Firestopping Inspection Report
/ :;) Ge` .
Office No. (518)761-8256 Date Inspection request received: /(72/3-1/i
Queensbury Building&Code Enforcement Arrive: am/pm Depart: - am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
jk
)
NAME:LOCATION: G y PERMIT#: //--9/C)
/a ,( ckAcci -, ,2/. INSPECT ON: it/4/ Cif
TYPE OF STRUCTURE: �`,
N 1E4 COMMENTS:
rami
Attic Access 22" x 30"minimum /
Jack Studs/Headers %. /
Bracing/Bridging V
Joist hangers
Jack Posts/Main Beams V
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 6(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 wate. 4 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'A 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:1Bulldkg&Codes Foims OLDrBuNdkg&CodesHnspedion Foams$Framing Firestopping Inspection Report.doc Revised January 7,2008
Framing / Firestoppin Inspection '
g pedlon R rt
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/. • • : ,.e,:t, pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: sror
s�
l
NAME: i PERMIT#:
LOCATION: >0 Jr,ACcil ki i)1,S+ INSPECT ON:
TYPE OF STRUCTURE:
Framing Y N J COMMENTS:
Attic Access 22"x 30' minimum
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
Exterior Deck Bracing
Headroom 6 ft. 8 in. •
Notches I Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge (8) 16D naus each side
Draft stopping 1,000 sq. ft.floor trusses
• : or less on center
Ice and water eh - • 24 inches from wall r
.,_.. ., . 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min. IAL-
Garage Fire Separation
House side%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 _
LABufding&Codes Fotms-OLDSuNding&Codeslinspection FonnsVFnmlnq Firestopping tnspWfon Report doc Revised January 7,2008
.)'-'9/(-( -://twormiii7,_. Fr.?__v & c
Foundation l&pection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart:01...
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: C�
NAME: C4e:c.,e_/t PERMIT#: 0 InnLOCATION: Ir9L, t1 INSPECT ON: .!
TYPE OF STRUCTURE: /
Coniment4
Y N TA
F. .,.
' /
Piers ----2___,� �
. ,o ithic Slab ,_—
'T> Lc�Qr'L 14),-A) 17742-
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the conc
Materialor this on site.
Foundation Wallpour
Reinforcement in Place / �_--,ice. A L
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation 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.
L:\Buikling&Codes Forms\Building&Codes\Inspectlon For ns\Foundation Inspection Reportdoc
Last printed 12/20/2005 9:24:00 AM
Rough Plumbing / Insulation mapin e
p
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p Depart:/m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: R. /1 � "� PERMIT#: // 4t)7
r
LOCATION: 0 'fi u S , Y INSPECT ON:
TYPE OF STRUCTURE:
O . N N/A
Roug Plumbing/ =' Plates a/
Plu 14! V ants in Place
1 %inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout eve 100 feet/than!e of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
50 P.S.1 for 15 minutes
Insulation/Residential Check/Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent,Attic Vent
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
ç -z 2jz A
COMMENTS: --
Rough Plumbing Insulation Reportrevised Nov 17 2003, revised February 15,2005, revised January 7,2008
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Departa_ m/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: L+ �
NAME: � kVA`-Il.�lr PERMIT#: 2t -4
LOCATION: 0 J pec k-cXZS5c- F ) INSPECT ON:
TYPE OF STRUCT :
Comment
Y N NSA
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
Footing Dowels or Keyway in place
Foundatio ' i.ppmofin
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width ✓ fie?) /"c:b 0(4?-4A'
6 inches above footing
6 mil poly for wet areas under slab v,
NA(Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspecuon Forms\Faundation Inspection Reportdoc
Last printed 12/20/2005 9:24:00 AM
/- j
Foundationtion Report
�P�
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart:/N4 )�am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
.47
NAME: C '' C.�-�fl PERMIT#:
�^ /141)7 .
LOCATION: trf l ti, tc-L i -- INSPECT ON: ?-7/7",
TYPE OF STRUCTURE:
Comment
Y N N/A //13 C. 74
Footings
iL
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 1 Gado
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation 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.
L:\Building&Codes Fors\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
— ���
Office No.(518)761-8256 Date Inspection request received: 9A1/
/1
Queensbury Building&Code Enforcement Arrive: am/pm Depart:FL am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: `'
NAME: G L V-e- ntJ) PERMIT#: _ CCI
LOCATION: °VI 12-Oc AD INSPECT ON: *WM
TYPE OF STRUCTURE:
Coglmeats
la WA
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. 4 i
,,1rfiFoundation/Waipour
"Reinforcement in Place Fi4k4
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation 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 I Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LABuliding&Codes Fonrns\Building&Codesunspection FormssFoundation Inspection Repo.tdoc
Last printed 12/20/2005 9:24:00 AM
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE --ELECTRICAL APPROVAL
Permit No........................................Cert. Na 19085 Cut-in Card No.....................................
Owner..................J% A,16;-- &I az��y
....................................................................................................................................................
Location... ...... ..................................6 e-e2'10z.:�-
.................... . ............
Installation Consisting of ........:1.....................I.............I........1........................ ...............
. ...................51...........
....................................................................................................................................................................................
Installed By.......
Z� 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 making spoctions at any time, and if its
rules are violated,the Company shall have the right to fey(ile t ate.
Date..: ................. INSPECTOR .........
.................. .. ................................
Member N.F.P.A.,I.A.E.I.