2011-125 TOWN OF QUEENSBURY
41,00111111ft
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110125 Date Issued: Wednesday, February 15, 2012
This is to certify that work requested to be done as shown by Permit Number P20110125
has been completed.
Location: 27 MEADOW Dr
Tax Map Number: 523400-297-017-0001-026-000-0000
Owner: DAVID ROBERTSON
Applicant: RES ALT PERMIT REQUIRED FOR GARAGE
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.
TOWN OF QUEENSBURY
f742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110125 Application Number: A20110125
Tax Map No: 523400-297-017-0001-026-000-0000
Permission is hereby granted to: RES ALT PERMIT REQUIRED FOR GARAGE
For property located at 27 MEADOW 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: DAVID ROBERTSON Single Family Dwelling $160,000.00
JESSICA ROBERTSON &LYNN ROB
27 MEADOW Dr Total Value 5160,000.00
QUEENSBURY NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agenc
1)6(
Plans&Specifications
2011-125 PERMIT RENEWED $50 PAID 7/5/12
single family dwelling(septic permit is included)
$312.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,July 07,2013
(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 Town u sbu 001 Th r:d ,July 07,2011
SIGNED BY �\ for the Town of Queensbury.
Director of Building&Code Enforcement
0411A- TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110125 Application Number: A20110125
Tax Map No: 523400-297-017-0001-026-000-0000
Permission is hereby granted to: DAVID ROBERTSON
For property located at: 27 MEADOW 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: GORDON &DONNA MC CAULEY
19 MEADOW Dr Single Family Dwelling $160,000.00
QUEENSBURY,NY 12804-0000 Total Value $160,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-125
1560 sq ft single family dwelling (septic permit is included)
$312.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,July 07, 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 Tow4n of Queensbury; %I�ur dray,July 07, 2011
SIGNED BY (� � i-1l 1/ t'� for the Town of Queensbury.
Director of Building&%Codforcement
rte.:- s---)010
:3 ' i 7 / 2 pFFICE USE ONLY
TAX MAP NO.' ! / rERMIT , •. //---/2,5-
FEES:
.;112
PERMIT f�`RECREATION /'i1 ENGINEERING
(If applicable)
PRINCIPAL STRUCTURE: APPLICATION FOR ZONING APPROVAL & BUILDING
PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER: VIS,v//� . _ _e�.S09/1
OWNER:6F1,41v6/�Oxr6O1 /2/ de(.
/�vS �ly f
ADDRESS: /70o1.cqarie,,, Meg+413 ADDRESS: �6teshet )1 4'V41(/
PHONE NOS. 67616e/}4e€17 �/Le°7 PHONE NOS.
571`- 793 6.5.67 or-& / 3x/- 3379
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: 5,(4r-1'/Ow.' PHONE: .795--0/53
fgee ht'rlief.LJc
LOCATION OF PROPERTY: :27 7/Yt'adeee/ )r/e,,+J, &4Ceei,5-6 ry ifr7 cf /L.io f
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? 0 YES B NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z 0 H
APPLY TO YOUR z j cc p a 0 w w
PROJECT 0 <
F w00 �O O = _
W
� � � Oa =< -- NO - a
SINGLE FAMILY /6 6O -- — /5
/ ,
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: -V/4
ESTIMATED CONSTRUCTION COST: ode " FUEL TYPE: 7//,-1 ' fZr-ix_
HEAT TYPE:f't DrA2*HOW MANY FIREPLACE(S): ////f AND/OR WOODSTOVES(S): 'V`?
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? y(-
/
IS THIS A HISTORIC SITE? ry
PROPOSED USE OF BUILDING OR ADDITION: %'L'e'�-G 14---4•••"/4-/ 'Lt srd"-/C '
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?
ARE THERE EASEMENTS ON PROPERTY? it/z)
`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 agree to the above.
•
Signed
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
v c F e b. 2 7. 2 012 9:54A +�,�.�MD I A, Wa t e r v 1 i e t, NY;�,% ,:;A,;;�,,•,;,;,�;,;��,,.,,�,,.- ,,,,,,;;,�;;,,;.,;,,i;�;; No. 1941',;;;, �,��
((.+yrs `�•'J — .•—•--- .J,�, � �.',;.�`%/�&Y •. ✓, �•.✓• ` �``-''},
-' DEPARTMENT INSPECTION AGENCY'; INC �,
MIDDLE D <<;
' .doceilos that the electrical wiring to the electrical equipment listed below has been examined and is approved pp oved as
being in accord with the National Electrical Code, applicablegovernmental, utility and Agency rules in effect on the date �i 1
AP� Y 9 Y t;?
i noted below and is issued subject to the following conditions. ;f
`'�� Owner. Date. //.......
�`� David Robertson 02/0312012 .
•t
�� Occupant: Same 27 Meadow Lane
�� Location• ;�,'.
Occupancy: Single Famii Dw . Queensbury, Warren Co. NY 4��
Y 9
Applicant: Beth's Electrical '.\
Service
271 Cardinal Lane .0."i•, • —� ,�,. y "V 1`�'. •
' »
Bennington,Vermo0-,c ,, r YrA �' -- '�' �y% ;;,
)I I' ..• .�.MF
''' L or 14.4.0 .:4;e„,,:.
'� • r• ( �..., 4., �,i • �''„ i
I. .
<.. Richard Moon �' -. �, �.% -'
(.;,. No. 11410 4 + ie.• ... . s I
„\ ✓Y3 4.5_,,,o.;„ ?� , J� Q♦ r• (. y�
�� Equipment: 0 ► •� .'' ',1',..''' f''�' `%,-4: •kt,.
, ,4r1. r;' - 1 t' i '
:; i t i^,n,,,, •:�.'aT,. . • e I 1'''' Al •r '
200-Amp. Service Equip*.w. 4/ 4 S '' .h• ti:?=� = l,,:� .p.,-”,� ,'s ft.` • `At *.
' ) 1 -Smoke Detector '�. J ep - - ixtures; Burne y Wiring&Controls Gas;
tact ., ...
is•) w •4� Y {�i
A, �jf.
`\�, ra AA G'1S�. ^�M 4'5'1'4.4 i�y ♦'fin;t:-.rr •• r7\f
• ,4 i'l
(•� '' A{+.a ter,„gi ci Irl 1: ��
' 1�;r4a fhg170 7. .117 �.. • 1! �;
!,�; ''•! 0.1 •��t1�c�S;raAt-.•r"y�.�..r-"7a`�"�} �•••"'•
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This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and •\!
•� above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change In the use,occupancy or ownership2)
'' p RS Ra cy C6
(�)) inspection. No warranty is expressed or implied as to the mechanical safety,effi- of the property indicated above,this certificate snail be immediately nun and void.
%., deny or Illness of the equipment for any particular purpose. This certificate shall En the event that this certificate becomes Invalid based upon the above conditions,
ts% be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
i;;?) system to which this certificate applies be altered in any way,including but not limit- Inspection Agency,Inc. An application for inspection must be submitted to Middle �f)
(; ad to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency.Inc.to initiate the inspection and revalidation j
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.
�� J • ,..�✓� �; \.l• t ^ \+
j ✓ ..' iTl�. ! � ., ��-:� �W,..-'':',":7� jri"S! 5�\/�i.:\S�i":. '`�;%,".;'.,.''i`��• `0:; \+l.T, - i �\ +\.% :it .:•,, % !i\f .�/ %•J%\r.\,i•� .\✓r.�✓_\� \;,\'';\!/,�,�/;\•,,1 6`✓:
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: / Ziam/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: (1 i\A-9 ` i )
NAME: S7 h F r'--S 0,1 PERMIT#: //— /2R,S
LOCATION: � f f rew_,pt/fk,,) 1,c),(yv. INSPECT ON:
TYPE OF STRUCTURE: S F C\
Contract*
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 I �,
Footing Dowels or Keyway in place / CZ°1-A-3<,
Foundation Dampproofing v14:1, 5 4(
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 Forms\Building&Codes\Inspectlon Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
h i - 3
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart. pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials.
NAME: ZZ) Pi-�' �1 PERMIT#: / l l �f
LOCATION: " !`(1(gypo.D ,r INSPECT ON: /a-(0 -/,D\
TYPE OF STRUCTURE: 6
Comments
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
Footing Dowels or Keyway in place /7/
Foundation Dampproofmg V
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:\Buiiding&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Septic Inspection Re• •
Office No. (518) 761-8256 Date Ins on -• - -iv:o.
Queensbury Building &Code Enforcement Arrive: 111' '-part: O am m
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia •
NAME: IRE B 1ff 'ERMIT NO.: \2-
LOCATION: 2 7 1 , 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
[150'to well required if NO]
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x �„—
Stone Size:
Piping Size Type
Building to tank
Tank to Distribution Box
Distribution Box to Field/ Pit
Opening Sealed: Y N /
End Cap Y > %lJ E -T-b
Inlet/Outlet Pipes& Baffles _ _Y kak S
Manholes 12"or less below grade Y—N /
[provide extension collar if Yes] _ Y N
Location/ Separations /
Foundation to tank _ ft.
Foundation to absorption ft.
Separation of Pits ft. 6\
Conforms as per Plot Plan _ N /
Engineer Report and As-Built Y N lt;l C—AO- CC7 \L
ETU Maintenance Contract _Y_ N
provided
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
S stem Us- Statu
'' S BiELI
Approved
Partial Approved and needs to be re-inspected, p -: - - : ding &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection forms\Septic Inspection Report03 2910.doc
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No.(518)761-8256 Arrive: am/pm De art Qm/pm
Date Inspection request received: Inspector's Initials: �{ I f
NAME: \ts.� rti �, �V PERMIT*
LOCATION: ? NV�- ���" � �� DATE: ? `l'�
Manufactured Home
Modular Home
Footings_ Foundation_ Backfill— Framing
Comments:
Yes No N/A
Foundation support,pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends •n �'S 1Q/`:Q
Water line shut off
Sewer line support @ 4 feet 152
Heating Crossover[doublewide}off grd. ! .CS �- dA
Dryer vented outside
Skirting ventilated 1 sq.ft.per 1.500 sq.ft.
Hot water relief valve piping outside
Deck,porches,steps,railing VFumace/hot water operating V�
Garage Fire proofing I
Fire Door I Door closers
Plumbing Fixture/3"Vent through roof[Modular] f
Foundation insulation[if applicable]
Smoke I Carbon Monoxide Detectors/Interconnected
Final Electrical
Variance required
Data Plate okay /
Manufactured HUD seal okay
Warranty Seal after January 1,2006 ,✓
Installers Warranty Seal
18"x 24"access or 22"x 30"attic access
Vapor retarder under home 6 mil poly or other
911 Street number
*Okay to issue CIC or CIO[Temp./Perm.]
Model# Serial#
Manufacturer ( . Lr(
1 ,
Date of Manufacturer A \
L:1Pam Whiting\20101Building Codes Forms\Manufactured_Modular Final Inspection 03 04 10.doc
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 2- —13-
NAME:
LOCATION: 27 Re&loc,) 131=
PERMIT#: 1 1
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has been:
M
Crai: : own, Zoning Administrator
Notes: �I I L OL as kL
�,\Ak i l • 4-\Cka. 15 V V-
6t/Z-,
�5 S
L:\SueHemingway\Building.Codes.Inspection.FORMSWina1 Survey
Zoning Administrator.doc
MAP REFERENCES:
LOOT 47
�w
LOT 48
z �
RIDGE
MEADOWS
LANDS N/F OF
o
BY. JOHN B. VAN DUSEN
ANGELA JACK
12/02/11
DATED. SEPTEMBER 4, 1956
3784/313
4
MAP OF A SURVEY MADE FOR
FOUNDATION/TOPOGRAPHY
w
ANGELA JACK
UPDATE PROPOSED HOUSE
_
DATED. OCTOBER 16, 2006
LAST REVISED., MAY 12, 2009
FENCE ENCROACHMENT
1
BY. VAN DUSEN & STEVES
PROPOSED IMPROVEMENTS
N
NO.
N
ON
N I
O
DEED REFERENCE:
HAROLD & NANCY HANSEN S53 ° 41 56"E 200.
TO
GORDAN & DONNA McCAULEY
DATEDWOVEMBER 9, 2005
BOOK 1480 PAGE 102
130.7
rP
H �
w*61
43.0
a u's
&
S t e V e S
and Surveyors
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York Lie. No. 50135
LOOT 47
Map of a Topographic Survey made for
David H. & Lynn M. Robertson
•1
-
Town of Queensbury, Warren County, New York
11aze1 uanuary it, Gull
Scale 1'=20'
6
AREA
AS—BUILT CONDITIONS
5
12/02/11
FOUNDATION LOCATION
S-1
SHEET 1 OF 1
4
30,000 sq. ft.
FOUNDATION/TOPOGRAPHY
w
5/12/11
UPDATE PROPOSED HOUSE
2
LANDS N/F OF
0.69 acres
1
o ?
PROPOSED IMPROVEMENTS
3
NO.
HOWARD GRUNDBORG
DESCRIPTION
N o
_
O c
A
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I HEREBY CERTIFY THAT THIS MAP WAS PREPARED
\
CP'U5hED STONE DR
FROM FROM AN ACTUAL FIELD SURVEY.
THI5 CERTIFICATION 5HALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
1— --.,
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
-- —,_
AND LENDING INSTITUTION L15TED HEREON.
-�
CERTIFICATION5 ARE NOT TRANSFERABLE TO ADDITIONAL
1N5TITUTION5 OR 5UB5EQUENT OWNERS.
200.00'
CERTIFIED TO: DAVID H
N53°41' 56"W
LYNN
—"
H U INS RATION,
1 AN IGN5
O PANY
r �
Shoo
- � BY: C7 � SII
C E a
LOT 46
MATTH 5 NY5
sF 5p1
LANDS N/F OF
FEB 13 202 D DEC 13
GORDAN & DONNA McCAULEY
Q
FEBRUARY 7, A NQ
�vv►. 1tA p
1480/102
TOWN OF QUEENSBURY �
BUILDING & CODES
a u's
&
S t e V e S
and Surveyors
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York Lie. No. 50135
""A`""DW'�DK'°t"'p"G"ADDRID"ro"
YAP BEAWND A LICENSED LANG SURIEYTIRS SEK IS A
NDLA,�N DP T z >,EE
NEN 1nWt STALE ECtICA1NIN uw.•
**LY COPIES PROM TiE OWf'*M DP TEAS SURVEY
YAKKSKL ED WTH AN 0100MONSWO a THE LAND suRVEYaRs
=E�BEroBEYA�TRCDP•
TUB s rP" r= AD
�"`�"� '�°I�" AM
E>OSTWG ooDE oP PRACTICE FOR LAND suRvnroRs ADOPTED
BY INE NEN YORK W C A59017A1igl CP PROiTiSSfONAL
T sAa �� R"N ONLY
ro TIE PERSON PCR rIIDM TIE SURYEY a PREPARED, AND
ON NIS BOW TO THE TITLE COMPANY, GOVEANMENTK
> " GP ,,"S°"' NO
Map of a Topographic Survey made for
David H. & Lynn M. Robertson
•1
-
Town of Queensbury, Warren County, New York
11aze1 uanuary it, Gull
Scale 1'=20'
6
1/24/12
AS—BUILT CONDITIONS
5
12/02/11
FOUNDATION LOCATION
S-1
SHEET 1 OF 1
4
"_. .
9/23/11
FOUNDATION/TOPOGRAPHY
3
5/12/11
UPDATE PROPOSED HOUSE
2
4/25/11
ADDITIONAL WETLAND INF..
1
4/18/11
PROPOSED IMPROVEMENTS
Robert5on
DWG. NO, 71 139
NO.
DATE
DESCRIPTION
L.7,. P, -P-« C2532
N
rn
N
(/O.vo) ?--// f i I,Queensbury Building & Code En orcement - Reslden la Fir I Inspection
Ofi le No. (518) 761-8256 Arrive: am/pm Depart: V` ��m/pm
Date Inspection request received: Inspector's Initials: I
NAME: g042r YiC)). -__D
PERMIT#:LOCATION: - - t Dr DATE:TYPE OF STRUCTURE: C `� Comments:
Yeti/No N/A
4" Building Number Address visible from road {//
Chimney Height/13"Vent/Direct Vent Location d —
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches t`,\4Arki
Roof Complete/Exterior Finish Complete
/
Platform at all exterior doors _
Handrail 4 or more risers 1'`�` �'��!wciA ` , {
Guards at stairs,decks,patios more than 30 inches above grade V p�y j
Guard at stairwell at 34 inches or more / fZj,3�" . t JV
Guard at deck, porches 36 inches or more V a
Handrail Termination at Newell Post or Wall �/
Interior/Exterior Railings 34 inches to 38 inches ✓ (` 4---(_.) ta-S —
Deck Bracing/Handicapped Ramp Compliantf
Grade away from foundation 6 inches with 10 feet Y /`
6 inch clearance to sill plate V/
,��
Gas Valve shut-off exposed/regulator 18 inches above grade --
Interior privacy/trim/doors/main entrance 36 inches ,t// 7 ,
Bathroom/Kitchen watertight d/
Safety glazing/Window in stairwells safety g ing ./
Interior Smoke Detictors/Carbon onoxid Detectors
Every level: J Ev ry Bed m:
Outside every bedroom rea.
Inter Connected: Battery backup: .
Attic access 30 inches x 22 inches x 30 inches height)in accessible area / �1- ��1 '� t-/ 1"
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents 1, _— � -
Bathroom Fans,if no window �/ j; ,�4. G` —► �'
Plumbing fixtures
d�f
Foundation insulation to floor/Sticker on Panel V -1-j-- 24A cc ✓
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft. ✓ / Pit-- t�,/� �.-5 VA %-
Emergency egress below grade / �'
Gas Furnace shut-off within 30 feet or within line of site ✓ / -��`�(fZ �
Oil Furnace shut-off at entrance to furnace area / b/ _------
Furnace/Hot Water Heater operating /
Low water shut-off boiler i/
/
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum W Gypsum /4 �/
Basement stairs closed rise>4 inches
Garage Floor Pitched V
Garage fireproofing 1%hour fire door/door closer `
Gas Logs in Sealed or Glass Enclosure r/
Final Electrical; Energy Saving Light Bulbs 50% k f
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles d
Flex Gas Pipe Bonding V
As Built Septic System/Sewer Dept. Inspection Sticker
SitePlan /Variance required N-1 \,-,_,
Flood Plain Certification, if required & _ ` ? _ "`�
Okay to issue C/C or C/O[Temporary/Permanent]
L:\Building&Codes Forms\Buiiding&Codesllnspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
/ -- 3
101,t,..
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection req Ali_ -.: / /
Queensbury Building &Code Enforcement Arrive: a • ►-part: °.o a p_�
742 Bay Rd., Queensbury, NY 12804 Inspector's Initial •Ma
NAME: (&C) `I 67°`I i _,'• RMIT NO.: / ' /
LOCATION: --7 M,v4 o[.;9 Nf t vt INSPECT ON: /11
RECHECK:
-1 - -�r Comments and/or diagram
Soil Type: Sand am / Clay ----
Type
Type of Water: Municipal / Well Water —1 ;=rtit't2c f:'CA i-`i ()ATE 2 L i ►)E I,✓Zo►ti`I k\F k(,1-2eCL
Waterline se.aration distance ......----{
ft---(..... ---0 C5E- \ .�,�-1--
�
. 0 �,
Well separation distance ft.
Other wells: ft. NL J(v a-'(-) \‘___ t.:tAT E_ v5 t tJ'j\HUE.
Well Casing Length 50' + / - Y N N/A 7A►J 5 Ve-t►\G ,
[150'to well required if NO] ��
Absorption Field: Total length fQ ft.
! Length of each trench z_ .:._-, HLA ft. E i-.--1-E,6 \rDQE‘k)
Depth of trenches 'Z-LI" -34c`i ft. -
Size of Stone LO IIC.2F ii 7- 1,i:.,I
7)----2 „...._
Seepage Pits: Number 1-\v�i wS k_� ‘;v,{\�
Size: x c�
Stone Size: C->Ca 00,� T
Piping Size Type ,
Building to tank t-11' hC-'t-1 L1l',
Tank to Distribution Box y" h. 2)- 1-1,ZA-1/4 LTC:
Distribution Box to Field / PiOpening Se ledt W N `--)V 17 T LA t t \'�"R F .4....
_co
EL`S€ \yeti,
End Cap y. N
Inlet/Outlet Pipes & Baffles .___7___Y N ---3 iz\ F,LTu_- D,,J DoT-LE---c
Manholes 12"or less below grade Y/_✓N
[provide extension collar if Yes] j/Y N - NEED Ex �t-t; CcL -9.±) Mn RC „,,A
Location / Separations
Foundation to tank V_,_ r ft.
Foundation to absor•tion -7 '_ _ ft.
Separation of Pits , , tom,
Conforms as per Plot Plan _Y unABL� V)��PPF-13
Engineer Report and As-Built Y N `�O E�\F`� ►�O 13G�
ETU Maintenance Contract , Y N N3 6 - _ _ _ I�`��
provided ___,..:,,e.----.EOM +-
°E- 3%' . _% L\IJ�� _I7 4 iv 5 \- ,l EA—
v
Location of System on Property: R _ \)tCr,
•
Front Rear Left Side Right Side = • Mid - •
S stem Use Statu-.
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 Report_03 29 10.doc
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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: f/l/1 r
NAME: 7PERMIT NO.: /1-)L5----
`
LOCATION: Z.---7" f)4 Li INSPECT ON: I 2--2/ '-l/
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
[150'to well required if NO] ,
i
Absorption Field: Total length ft.
Length of each trench t ft. ' c \ v 2M .11 C
Depth oftrenches ft. (174-0Z__ d�'�k.) "--
Sizeze of Stone i
Seepage Pits: Number' lM14- 7—
Size: ' C ��7 �^-L
Stone Size: \ _ ss _
—
Piping 'ze TypeJl� � �v �_efl
Building to tank 'A L` » ' P'"v"
Tank Distribution Box F_ 1---
Distributionn -Box to Field/ Pit ,----
--5 _____
Opening Sealed: L..
N
End Cap _iY '-N,
Inlet/Outlet Pipes & Baffles Atk, - N W
Manholes 12"or less below grade _4 ' N -7-6c12.40Aft-- --2-- 1�JGv `�
[provide extension collar if Yes] '4/Y N
Location / Separations _ ,---- -'
Foundation to tank ft.
Foundation to absorption _ ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Engineer Report and As-Built _Y N
ETU Maintenance Contract Y N
provided
Location of S stem on Property:
7
Front Rear Left Side Right Side Middle Front Middle Rear
Syste . e Status:
' Approved
•\f 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 Report_03 29 10.doc
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Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: I d-/q/ci O ll
Queensbury Building&Code Enforcement Arrive: am/pm Depart:itifoi/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: H(
LOCATION: �� til.ea & - INSPECT ON: 1,3.l )a 1 t r
TYPE OF STRUCTURE: ),� l
Comments
Y N N/A
Footings
Piers
onolithic Sla
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
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump •Zf
Footing Drain Stone:
12 inch width ti
6 inches above footing
6 mil poly for wet areas under slab
Backfill prov ''c�✓�r� `'�'
Plumbin
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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Foundation 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�,t q C)
NAME: lJ/ )fPERMIT#: z y_
LOCATION: 77 /1 'U,gcJ ryz, T INSPECT ON: 2—; /
TYPE OF STRUCTURE: �,�. ,"� -
Comments
Y N N/A 4
Footings
g
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the cone -
Materials .sr this purpos on site.
Foundation Wallpour
Reinforcement m -
Footing Dowels or Keyway in place
Foundation Dampproofmg OD<
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 Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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Foundation Inspection Report
office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart• ' iii _\ am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 2 •
NAME: -til
PERNIIT#. /
LOCATION:
;Tug/ INSPECT ON: — �--//
TYPE OF STRUC •
Comments
Y NL
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
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
AIM, • above footing
6 mil po for wet areas under slab
Backfill ,proval �� f
bing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Bu[tding&Codes Forms\Buflding&Codes\Inspection Forms\Foundatton Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: 13 G 1 \
Queensbury Building&Code Enforcement Arrive: /0 k. am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: --)/,I
NAME: !-� �/� � PERMIT#: aQl f
LOCATION: *1 r-1 2'C - e INSPECT ON: ` -(f)-- I 3-611
TYPE OF STRUCTURE: e„,7.17-0
Comments
Y N N/A
Footings �' /"
g 44 �f 7i ,64--, y --
Piers -r--
Monolithic Slab Ae5�I A 1017 7%;-1
ach/tAx. v8" p/4
Reinforcement in Place
The contractor is responsible for
providing protection from freezing n/ r� f 4- f�.. ,�,If'
for 48 hours following the placement T
of the concrete. J r`,4
Materials for this purpose on site.
Foundation/Wallpour / S A Z,‘1-€1/
A;//rnv ��:
Reinforcement in Place
A4`v
_ rL
Footing Dowels or Keyway in place 4't �� /r `
,y,-P ee / ci,re'l
Foundation Dampproofmg
{
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
fly for wet areas under slab
( Backfillpproval d S CO.1 ,
um ing Under Slab
PVC /Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Bullding &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
/14)-4 — -
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received: /l/, (1)-O`/
Queensbury Building&Code Enforcement Arrive: am/pm Depart: pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials::
tt9
NAME: PERMIT#:
LOCATION: /1-1 s r v-U INSPECT ON: ,ad'AeI1
TYPE OF STRUCTURE: c6.7
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-forthia rpose on site.
(Foundation/Wallpo� (F ;V
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg <�—,r� �-' Vk 'VS 2.
Foundation Waterproofing
Footing Drain Daylight or Sump LA-ji pQ 5
t,/ "J
Footing Drain Stone: 4 ��
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval 7 �,
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\Inspecdon Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report ( 6 r"`
Office No. (518)761-8256 Date Inspection request received: i i J ,}-e l i
Queensbury Building&Code Enforcement Arrive: am/pm Depart:9., am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:O\K7)
-Lc�
‘-)4 (1
NAME: �- PERMIT#: if —7( 3
LOCATION: (tri ; INSPECT ON: l I I
TYPE OF STRUCTURE:
Comments
N/A
(- :1':)oot
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 4 -6, -yz7-1='
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing V�-�ti'..f v
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab G
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\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:
Queensbury Building&Code Enforcement Arrive: A52 am/pn Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: H ) 0 J `1 cSQ PERMIT#: iZ
LOCATION: 7 JT�C)f� (�. INSPECT ON: /I 7
TYPE OF STRUCTURE:
Comment,
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing g/ /1104.
ar er
for 48 hours following the placement /J
of the concrete. /`ee MeX,1 / CDP-94/i<cA.
Materials for this purpose on site. j I/O,',
Foundation/Wallpour 41' sY4rr
Reinforcement in Place
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 Forms\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:
Queensbury Building&Code Enforcement Arrive: 2-/A) am/ Depart: am/pm
742 Ba�,Queensbury,NY 12804 Inspector's Initials:
beASCOI
i°diP
NAME: •► •- PERMIT#:
LOCATION: 7 Cc Uc - /^. INSPECT ON: / rAU2r
TYPE OF STRUCTURE:
Commenta
Footings a,
Piers �±
Monolithic Slab
fD „if- �Af 9‘
Reinforcement in Place f W j1,.
The contractor is responsible for /11
providing protection from freezing
for 48 hours following the placement P �J jf / i
P'
of the concrete. A �� S�/
Materials for this purpose on site. � fG4rii (iv— wL`
Foundation/Wallpour // /
ef
Reinforcement in Place
/o/ /t1 i/ /
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 Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report 3/6(-)
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: 3 i) am/pm Depart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: /
NAME: PERMIT#: '
LOCATION: INSPECT ON: OAtir
TYPE OF STRUCTURE:
Comments
V N/N/A
Footings
Piers
Monolithic Slab 1
Reinforcement in Place SVUbi -S6° h�
The contractor is responsible for
providing protection from freezing CG�1 fjr /L°firec d
for 48 hours following the placement
of the concrete. /N J :Cc G 47
Materials for this purpose on site. Vo�
Foundation/Wallpour ���`�� ,�,, pea
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampprooftng
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 Forms\Building&Codes\Inspection Fomes\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
r
Town of Queensbury
Community Development
pDepartment
Building&Codes Enforcement Office
742 Bay Road Queensbury, NY 12804
Phone:(518)761-8220 Fax:(518)745-4437
NOTICE
OF
STOP WORK ORDER
Date: September 13, 2011
Property Location: 27 Meadow Drive
Tax Map Number: Section 297.17 Block 1 Lot 26
Property Owner: David and Jessica Robertson
Building Contractor: Ace Homes
Building Permit File No. 2011-125
Date Building Permit Issued: July 7, 2011
The Town of Queensbury Department of Community Development,Buildings and Codes Office is
imposing a STOP WORK ORDER for the construction of a single family dwelling located
on the above premises.
This Order shall remain in effect until the following conditions are satisfied:
1.)Owner must satisfy Engineering requirments dated 9/13/11 in full
satisfaction of Enginner and provide follow up letter stating all
issues have been resolved. Owners and/or their Agents must resolve
all grading and erosion violations. Owner and/or Agents shall satisfy
any inspections that have not been called for with appropriate remedy
determined by the Director of Building and Code Enforcement.
If further clarification is required,please contact the Town of Queensbury,Building and Codes Office at
761-8256.
David A. Hatin, Dir-cto of BuyA• , . ode Enforcement
'� d
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pn Depart am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: PERMIT#: ^
LOCATION: `1.71, `t,f7 INSPECT ON: 6 "l V A
TYPE OF STRUCTURE:
Comments
,, Y. ' N N/A
Footings
�))lers 1
Monolithic Slab v?(1
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
Foundation Dampproofmg
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:\Buliding &Codes Forms\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: `I J 7 )-C) /I
Queensbury Building&Code Enforcement Arrive: am/pm Depart: i+ am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: g044/.1/4-1 °'-‘ / PERMIT#: /( a
LOCATION: .eJ'' • i -t - INSPECT ON: 9 i/ //
TYPE OF STRUCTURE:
Comments
11.
Y N N/AfL"
Footin
Piers
Monolithic Slab
Reinforcement in Place `5�. l
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
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 Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM