2010-352 TOWN OFQ UEENSBURY
�
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20100352 Date Issued: Monday, August 29, 2011
This is to certify that work requested to be done as shown by Permit Number P20100352
has been completed.
Location: 28 DARK BAY LANE
Tax Map Number: 523400-239-018-0001-047-000-0000
Owner: DEBARON ASSOCIATES
Applicant: DEBARON ASSOCIATES
This structure may be occupied as a:
Fireplace By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
---c1,2) ;
Issuance of this Certificate of Occupancy DOES NOT relieve the ( ,;1e
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
Temporary Certificate of Occupancy
90 Day
Building Permit No. : 2010-352
Property Location : 28 Dark Bay Lane
Approved for the following uses: Single Family Dwelling
Conditions of approval : 1) permanent stairs with guards & rails 2)
permanent guards at sliding doors 3) final survey 4) complete working
bathrooms 5) complete kitchen (o}) 5;1-e_ f Ith 114.10 Cove 0.-.e.---(S
$100 fee received on: June 22nd 201.1
90 Day Temporary CO expires on: September 22nd 2011
*A final inspection for this project must be scheduled before the expiration
of this Temporary Certificate of Occupancy— if your project is not complete
within this 90 day period you will be subject to additional fees*
/ / ,' ,
Signature of Applicant/ %jAre ,� �
Director of Building & Cods: 4
TOWN OF QUE E NSBURY
#111116koak' 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100352 Application Number. A20100352
Tax Map No: 523400-239-018-0001-047-000-0000
Permission is hereby granted to: DEBARON ASSOCIATES
For property located at: 28 DARK BAY LANE
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: DEBARON ASSOCIATES
79 N. FRANKLIN Tpke Fireplace
RAMSEY, NJ 07446 Single Family Dwelling $400,000.00
Total Value $400,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
HOWLAND CONSTRUCTION
Plans &Specifications
2010-352
2495 sq ft single family dwelling with 1 fireplace
$299.44 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, September 23, 2011
(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 own o ee u 1 , September 23, 2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY
TAX MAP NO. PERMIT NO. 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: '/9r ,r 5C.4,�, � L INSTALLER: Pit 1 C•atv44„t -4,€)/i/Ax/e014)514.c,44,1Lk-
.
ADDRESS: 46110 6.104s ) ADDRESS: 7 L.IgRjU/ S /28,105-
PHONE NOS. C6) 92?- '„343 PHONE NOS. �i�-3/'mac
LOCATION OF INSTALLATION: gpe.t4YEAR BUILTNO.OF RESIDENCE INFORMATION:
BEDROOMS X COMPUTATION= = TOTAL DAILY FLOW
1980 or older X 150 gallon per bedroom = GARBAGE GRINDER
INSTALLED? dt.,p
1981 -1991 X 130 gallon per bedroom =
1992-present SPA OR HOT TUB
X 110 gallon per bedroom = INSTALLED? oat)
PARCEL INFORMATION:
✓ TOPOGRAPHY: Flat rolling Steep slope %Slope
✓ SOIL NATURE: Sand Loam Clay Other
✓ GROUNDWATER: At what depth?
✓ BEDROCK/IMPERVIOUS MATERIAL: At what depth?
/ DOMESTIC WATER SUPLY: Municipal Well (If well: Water supply from any septic
system absorption is ft.)
✓ PERCOLATION TEST: Rate is minutes 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: GALLON (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:
❑ ABSORPTION FIELD (WITH NO. 2 STONE) Total length ft. Each trench X
0 SEEPAGE PIT(S) (WITH NO. 3 STONE) How many? Size?
❑ ALTERNATIVE SYSTEM Bed or other type?
tg HOLDING TANK SYSTEM Total required capacity? 4400O
Tank size? 2406 Number of tanks? 2,chfe4
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.
R,t'x..i<'ls' ij,r #t.t': Fire ,t'RF's , v;?:• ,_.� , - :
.. .• . :r•;t;t fir;,,h a}.-. .
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building&Codes Office for the issuance of a Building& Use Permit
pursuant to the New York State Fire Prevention &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 to perform required inspections.
IMPORTANT NOTE TO APPLICANT: ROUGH-IN AND FINAL INSPECTIONS ARE REQUIRED.
OWNER: 16 #4' S.ieidj L. INSTALLER/BUILDER: / i..�,4/a-s 4007
ZEAV
ADDRESS:4/10 Si�t16�i.Atri /Iy ////�D/3�D ADDRESS: / yvtd%S S7 4li�y�4 /rJ�/ li
PHONE NOS.Cso ) Vg �Q3/� ,
PHONE NOS(5453 ��;j/ej
LOCATION OF PROPERTY.�j dj tr Zrn,6 SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION: 239./8-f e'7 k dov
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE: V
✓ FUEL BURNING APPLIANCE
INFORMATION WOOD COAL PELLET GAS OIL
STOVE
FIREPLACE INSERT
A( FIREPLACE,FACTORY BUILT*
FIREPLACE,MASONRY
FURNACE(GARAGE ONLY)
*IF FACTORY BUILT,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
LISTED BY: NUMBER:
QUESTIONS?
CALL 761.820$or 761-8206
CHIMNEY INFORMATION BLOCK BRICK STONE OR EMAIL:
#;r��ar���i�c€u��:ssBu �.n�t
MASONRY°! CHECK ONE W." VISIT OUR WEBSITE
TILE STEEL SIZE IN FOR MORE INFORMATION
INCHES < vf.4s€ rs �sfV.r
LINER
FLUE CHECK ONE .7DOUBLE TRIPLE WALL INSULATED DIRECT VENT CHIMNEY
WALL
CHIMNEY MATERIAL CHECK ONE '7
"IF NON-MASONRY,PLEASE PROVIDE: MANUFACTURER NAME: �AtJ.r.6iiG MODEL NO.
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION&BUILDING CODE AND/OR
MANUFACTURERS REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED
INSPECTIONS.
2:3c7. ----/ i 7FFICE USE ONLY
TAX MAP NO. c Q `7
PERMIT NO. ll - S
FEES: PERMIT_ L RECREATION
ENGINEERING
(If applicable)
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING P
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SERMIT
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTIONUBJECT TO
APPLICANT/BUILDER: 4.70_
_._ . ,r,cl,, OWNER:
ADDRESS: 27 's44
j9° 54417Zigt
4- - =- 1%,,,r ADDRESS:
PHONE NOS.__��3j
PHONE NOS.
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: � �
/ PHONE: �g;3j_
LOCATION OF PROPERTY: ' i Zhu.
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? Cir YES 0 NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT Z
APPLY TO YOUR Z O cc 0 o
PROJECT O 0 O c� Cil W LL co
O F- •
I- co w
0 L amu- u_ u- W I- 0. _ _
W o J d o = I- O C`1 U
Z Q < �- cn z h- 1.-
0O � XwZ
SINGLE FAMILY u,0saw
SW. 8 7//.7 40,s,f 3�
0g18 '-'7,q% 28
TWO-FAMILY
MULTI-FAMILY
(NO. of UNITS ) ¢.h��� *)_9 C' y
TOWNHOUSE r 4,7-A)
2.
BUSINESS OFFICE _�> ? is/61.--)5
�7" ' 1C
RETAIL- CCI'"-Ste" ,6i' 614'
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED —
GARAGE 1,2,3
OTHER
IF COMMERCIAL OR INDUSTRIAL– NAME OF BUSINESS:
(r
ESTIMATED CONSTRUCTION COST: dit,e et50 FUEL TYPE: A�,yy,,e
B 3-LGL 11-05
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? NO
ARE THERE EASEMENTS ON PROPERTY? Al(,)
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 e to the above.
Signed , ,,�/1
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)
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:
•
e ..
BUILDING & CODES APPROVAL ZONING APPROVAL
X12 CO
DA E DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codesV?.queensbury.net
Office Use Only
VISIT OUR WEBSITE FOR MORE INFORMATION
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm De art: �3 yam/pm
Date Inspection request received: Inspector's Initials:
NAME: PERMIT#: <15
LOCATION: Quq-5-t - DATE: (CA t
TYPE OF STRUCTURE:
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height/"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 Wall
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/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/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/Insulation Certification/Sticker on Panel
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 �`J� �
Enclosed Stairs Sheetrock Underside minimum'/Z"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealed properly _S-
Gas Logs in Sealed or Glass Enclosure
Final Electrical
P ��` a
Final Survey Plot Plan cf"� d- tC)4
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
s eptic System/Sewer Dept. Inspection Sticker
Site P .• /Variance re•uired
ood Plain Certification, if required
Okay to issue C/C or C/0[Tempor. -- anent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10
r-/o ---7-t-, ,,,,--,/,, ,
Queensbury Building & Code Enforcement - ResidentiacFinal Inspection
Offi o. (518) 761-8256 Arrive: am/pm Depa�am/pm
Date I pection request received: Inspector's Initials:oukr)
NAME: ScAt ; IQ'e ' nc
PERMIT#: A_____ ___i=-LOCATION: >l 1 ( 1,�, DATE:
TYPE OF STRUCTURE: J
Comments:
Yes Pi N/A
4" Building Number Address visible from road
//'
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake "r/
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors / �«/
IRAS
Handrail 4 or more risers f
Guards at stairs,decks,patios more than 30 inches above grade �V/
Guard at stairwell at 34 inches or more /�
Guard at deck,porches 36 inches or more i/
Handrail Termination at Newell Post or Wall Y
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 V
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchenwatertight ✓� •,�
Safety glazing/WI low in stairwells afety gl ing _ _
Interior Smoke actors/C rbon onoxid Detecto �,.
Every level: Ev Bedr m: < CPC`-'43
Outside every bedroom ea:
Inter Connected: Battery backup: k_SSkYee —SCACIP'-'24-
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 r/
// -
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certifi /Sticker on Panel 7cation
Floor truss,draft stopping finished basement 1,000 sq.ft. 7Emergency egress below grade '
Gas Furnace shut-off within 30 feet or within line of site /l A� �S 1�
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating 4 / `,Z ��
Low water shut-off boiler �/
Relief Valve(s)installed/Heat Trap/Water Temp 110 /� t
Enclosed Stairs Sheetrock Underside minimum W Gypsum �/
Basement stairs closed rise>4 inches / CS� S?
Garage Floor Pitched ✓
Garage fireproofing/3/4 hour fire door/door loser / 40 -Cla
Duct work Sealed properlyt//� C -sl-� , 4R ,u►-
Gas Logs in Sealed or Glass Enclosure r/ am
Final Electrical +WileR.A.C.-�;�_�'
Final Survey Plot Plan f
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding V f
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required /'
Flood Plain Certification, if required V/
Okay to issue C/C or C/0[Tempora ermanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10
Queensbury Building & Code Enforcement - Residential al Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: am/pm
Date Inspection request received: Inspector's Initials:
NAME:
'4• ( PERMIT#:
LOCATION: �� � DATE:
TYPE OF STRUCTURS 7 -C_.0 (7r4/4• -f4.-
f
A..rAComments:
`
Yea; N/A
4" Building Number Address visible from road S"' 1-C (J OC k
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake ,/rl /
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete We-de
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks, patios more than 30 inches above grade l ' r, ::I_-
Guard
Guard at stairwell at 34 inches or more ;at deck,porches 36 inches or moreHandrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches /10
0 j�
Deck Bracing/Handicapped Ramp Compliant /J l C
enrZted
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 ///I
Interior privacy/trim/doors/main entrance 36 inches 6")\. 1/
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom: G
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/Insulation Certification/Sticker on Panel
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
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/O[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10
, / 9 _ c/ ., ‘ice--/,
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: Ili :it am/pm
Date Inspection request received: Inspector's Initials:
NAME:el-, PERMIT#: / /C9 -
LOCATION: r)/ _ r3.-.1-1 1....-K1 DATE: 7 MI i i
TYPE OF STRUCTURE: `
Comments:
1 /No N/A
4" Building Number Address visible from road �1/
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
inch ncch Plumbing Vent through roof minimum 18 inches i E---tk.) .\
Roof Complete/Exterior Finish Complete `
Platform at all exterior doors
�a ?
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 Wall --
Interior/Exterior Railings 34 inches to 38 inches /� CIL* '
Deck Bracing/Handicapped Ramp Compliant / v
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 q,/ ` VC-C
Interi c>a-/.ctooGs,Lmrain entrance, 6 inches �/ � (�
Bat oom n watertight t31`9' -1 Z -v^ -i-j -A-k-
Safety glazing/Win••w in stairwells safety gI.'ing
Interior Smoke De ors I Carbon noxid: Detectors
Every level: Every Bedr m Vk=�frC - -)'"
Outside every bedroo rea: ddd���ddd7
Inter Connected: V 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 / PA---
�p
Bathroom Fans,if no win K ,�J j T �V 'A"
Plumbing fixtures /
Foundation insulation/Insulation Certification/ ticker on Panel V - /
Floor truss,draft stopping finished basement 1,000 sq.ft. Y
Emergency egress below grade .a/ ____________,
Gas Furnace shut-off within 30 feet or within line of site ✓ / -.1)t )-‘,NA--
Oil Furnace shut-off at entrance to furnace area �/
Furnace/Hot Water Heater operating V
Low water shut-off boiler �L ,�'''\/IG '—
Relief Valve(s)installed/Heat Trap/Water Temp 110 7/ /
Enclosed Stairs Sheetrock Underside minimum'/"Gypsu �nkA4,
Basement stairs closed rise>4 inches "q"C.. W El V
Garage Floor Pitched � �v� 1,_AG-� ^'
Garage fireproofing/3/4 hour fire door/door closer L3 v
Duct work Sealed properly Y/ r:31Q ��)1) -'
Gas Logs in Sealed or Glass Enclosure
Final Electrical �/ j
�- '—'
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles � n
Flex Gas Pipe Bonding c r`it- ,�
i43
As Built Septic System/Sewer Dept. Inspection Sticker \"<„ 't'r"
Site Plan /Variance required _,
Flood Plain Certification,if requir-
Okay to issue C/C or C/ •4- emporary)ermanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10
INFORMATION FOR BUILDING DEPARTMENT ANDIOR
LENDING AGENCY
Atlantic-Inland, Inc. is in the process of issuing a Certificate of
Compliance for the electrical installation project as covered in an
application filed with our main office.
Application#: c 37®G -2./
Site Address: A" it Ba../
Date Electrical lnspectr
NEW YORK ATLANTIC-INLAND, INC.
MAIN OFFICE: (607)753-7118
-- C-/ 1 7 cd;
Queensbury Building & Code Enforcement - Residential Final Inspection
n t
Office No. (518) 761-8256 Arrive: am/p Depart ( l0am/pm
Date Inspection request received: Inspector's Initials:
NAME: Sid..4\ ,,kbe_A---
PERMIT#.
LOCATION: Arr2. k-l1 DATE:
TYPE OF STRUCTURE:
J Comments:
Yes/ No N/A
4- Building Number Address visible from road
Chimney Height/'B"Vent/Direct Vent Location ‘kir./
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches C7--- ..\---'__�
Roof Complete/Exterior Finish Complete
Platform at all exterior doors `.J
Handrail 4 or more risers 6-0'-�`
Guards at stairs,decks,patios more than 30 inches above grade A(//`
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more V�
Handrail Termination at Newell Post or Wall /
/ d_,,, � �
Interior/Exterior Railings 34 inches to 38 inches '1'� V
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet c
6 inch clearance to sill plate // VCI
wA�4�
Gas Valve shut-off exposed/regulator 18 inches above grade a ` !_ (� �,
Inte ' ain entrance 6 inches �/ t r2it
Bath /Kitchen watertight � Z V^�`'-`"' 'f-
Safety glazing/Win•• in stairwells safety gl•,ing
Interior Smoke De ors/Carbon noxid: 'etectors
Every level: Every Bed r VI,C-rLivtik-,k)7G- 31-.
Outside every bedroo rea: 7
Inter Connected: V 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 f ^
Bathroom Fans,if no win L 11 / i
J,/ /'�
Plumbing fixtures
Foundation insulation/Insulation Certification/ ticker on Panel
Floor truss,draft stopping finished basement 1,000 sq.ft.
y
/
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site 1/i, ,1
Oil Furnace shut-off at entrance to furnace area �/J
Fumace/Hot Water Heater operating Y
Low water shut-off boiler - J / s� e\/i� " / �-
Relief Valve(s)installed/Heat Trap/Water Temp 110 Y
Enclosed Stairs Sheetrock Underside minimum W Gypsu i
Basement stairs closed rise>4 inches Q'�
/ ..---------4
Garage Floor Pitched ��
Garage fireproofing 1' hour fire door/door closer /
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
VII Final
Electrical
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles V:/'
+ -
Flex Gas Pipe Bonding K G
As Built Septic System/Sewer Dept. Inspection Sticker �-
Site Plan /Variance required ,4
Flood Plain Certification,if requires. V 4•-_.++�" --�,.
Okayto issue C/C or C/ • em r a + " � _
Po ry ,permanent I ► w.
L:lBuilding&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10
N1001,\ /0_1,�
Queensbury Building & ode En orcement - Resid ial Final Inspection
I
O No. (518) 761-8256 Arrive: am/pm Depart: ta4 -Z-C-/rpm
Date nspection request received: Inspector's Initials:
NAME: ` er• PERMIT#: 4;77/2
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LOCATION: ):2/1-- LC-•y Li., DATE:
TYPE OF STRZT&E: p
Comments:
Yes #)/.6_
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
4
Fresh Air Intake A.-470 '/'0
3 inch Plumbing Vent through roof minimum 18 inches
yv,/,(co
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 Wall 1-2-<_YQ-(A)g:
Interior/Exterior Railings 34 inches to 38 inches r
Deck Bracing/Handicapped Ramp Compliant �(
Grade away from foundation 6 inches with 10 feet
' L... ._.s.._.A.....flikr5
6 inch clearance to sill plate � _l
Gas Valve shut-off exposed/regulator 18 inches above grade ? '/( JA\,"1r('°-��
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
\17-"-- ---;--.}_t_,z3...Q....c) -...._.
Safety glazing/Wiow in stairwells safety ing
Interior Smoke D ors/Carbon Mi�tt noxi Detect /
Every level: Ev Bedro9fn: /
Outside every bedroom rea: {V �/
Inter Connected: Battery backup: /
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area J/ „ O
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents V ✓ �l
Bathroom Fans,if no window W 1
Plumbing fixtures
Foundation insulation/Insulation Certification/Sticker on Panel _ �
Floor truss,draft stopping finished basement 1,000 sq.ft.
/ ri_44-4A-z_ski..1-1-Emergency egress below grade Z
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 �/
Enclosed Stairs Sheetrock Underside minimum W Gypsum ✓
Basement stairs closed rise>4 inches /
Garage Floor Pitched
Garage fireproofing/'/.hour fire door/door closer /
Duct work Sealed properly f
Gas Logs in Sealed or Glass Enclosure
Final Electrical
/
Final Survey Plot Plan
7„/
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required j
Okay to issue C/C or C/O[Temporary/Permanent] S
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10
Queensbury Building & Code Enforcement - Residential Final Inspection
o-
Office No. (518) 761-8256 Arrive: am/pm Depart: d') am/pm
Date Inspection request received: Inspector's Initials: 3
NAME: k4t ‘.%,C,--4.— PERMIT#: - \-Y. - �.3
LOCATION: 'SLS 1-...2czi2 c- LA> DATE: 611 I IA
TYPE OF STRUCTURE:
Comments:
Yes N/A
4" Building Number Address visible from road V
Chimney Height/"B"Vent/Direct Vent Location :
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches V /
Roof Complete/Exterior Finish Complete /r''
Platform at all exterior doors v' Iii f2 �
� t-
Handrail 4 or more risers ' 014 S -SG"
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more V.
i 4 u ��
Guard at deck,porches 36 inches or more ,r -
Handrail Termination at Newell Post or Wall V
Interior/Exterior Railings 34 inches to 38 inches
Ik -
Geckrad away
/ foundation Ramp Compliant10V �� ,
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate s S
Gas Valve shut-off exposed/regulator 18 inches above grade `
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing —
Interior Smoke Detectors/Carbon Monoxide Detectors Y ,- \ )
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 kirltk
�w
Bathroom Fans,if no window e_,A,,,Kct,K) n &Via7i.
Plumbing fixtures
Foundation insulation/Insulation Certification/Sticker on Panel
Floor truss,draft stopping finished basement 1,000 sq.ft. `; '�"Ac
�
Emergency egress below Conne14
Gas Furnace shut-off within 30 feet or within line of site C-I\ (>i j`,, 0 ����_; <
Oil Furnace shut-off at entrance to furnace area t
Furnace/Hot Water Heater operating v, �L e`ev,� �/k
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110 V t S l
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched ‘7,Cezk.- -
Garage fireproofing/'/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure j ��` ,
Final Electrical
. 41
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles-2.t itf Nv
—'
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/0[Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10
Rough Plumbing I Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 11/17/ //
Queensbury Building &Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: 4,44?.
NAME: e 5/5C /)u-.-e.4 ( PERMIT#:
LOCATION: y l„),-2 INSPECT ON: `/Aar
TYPE OF STRUCTURE: c W)
Y N N/A
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 14 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 highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
4415190uP.S. .i for 15minutesfation/Residential Check/Commercial Check
Tyvek or Similar Exterior Sealant 4�—
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation) Y
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS: c_L— '11414-4'5
x_ 4,0 Lc _
Rough Plumbing Insulation Report.revised Nov 17 2003,revised February 15,2005, revised January 7,2008
' J
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm • ;part: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: _
NAME: ? PERMIT#:
LOCATION: w i 4 1.57 f; INSPECT ON: 4,/
TYPE OF STRUCTURE:
Y N N/A COMMENTS:
Framing
Attic Access 22" x 30' minimum
Jack Studs/Headers t✓
11/
Bracing/Bridging
Joist hangers 0' c-(4`r} ,
Jack Posts I Main Beams , tto, okiisrirExterior 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 A(w) 16 gauge (8) 160 nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
(04
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
•
Fire wail 2, 3, 4 hour
Firestopping , f
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side inch or 5/8 inch Type X
Garage side 518 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:1Building&Codes Forms-OLD'Buiidmg&Codes inspection FomislFraming Firsstopping Inspection Reportdoc Revised January 7,2008
/ /c-`�
Rough Plumbing I Insulation Insction Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart:/64 -am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: bLet)
l
NAME: 4- r PERMIT#: L 4 �-_
LOCATION: Y
Ar% { � ��:_..�-.�- / , INSPECT ON: -
TYPE OF STRUCTURE:
Y N N/A
Rough Plumbing/Nail Plates
'PtutnbIngVents 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 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
COMMENTS:
Rough Plumbing Insulation Report.revised Nov 17 2003,revised February 15,2005, revised January 7,2008
(/z :Qc) /c - /
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:
f
rL t —_
NAME: �. PERMIT#:
LOCATION: NOM INSPECT ON: IIMN
TYPE OF STRUC 'i�i : F. , ;�, "
Con ment:I
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezingr i 'q
for 48 hours following the placement
of the concrete. \A
J.41,1-
. • _ 's purpose on site. _
Foundation/Walipou�
inforcem '. ' ce
Footing Dowel •( , a. _ lace
Foundation Dampproofing
Foundation Waterproofing d?,„_ CZ,C7-14-)-5 TA:3)
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\Inspectlon Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
I ON / / qeJ'
oundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Departam/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: 0, 7 1r i�
NAME: LAe PERMIT#: Jo - 2.
LOCATION: INSPECT ON: /2—j /
TYPE OF STRUCTURE: 9
Commentit
� � Y N N/A
Footings
( 4)-Ak°;"?
Monolithic Slab
c-4 - V"'" j'Cs'
Reinforcement in Place r:44 c \
The contractor is responsible for L.A00)111t4�
providing protection from freezing
for 48 hours following the placement #0. 1"."1"4"4°
of
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 l J
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Famdatieon Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
(0-6-- is heA-) ,. .--/0 (K/4'7
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: ' , PERMIT#: 63
LOCATION: , -' / - n a... /.�:.... INSPECT ON: /2 -1O -/G,'
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings +
Piers 4 Z '10.1..z......_
' -� `�� � /A c,P ON
Monolithic Slab 1Q1-- -J SZ -'"7
Reinforcement in Place ., V �i�
j ( c
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/Walipour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing0
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
'ri 'es above footing
6 mil ' 'ly for wet areas under slab
Backfill A. 'royal
Backfill
. nder Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Tnspectlon Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
( — iljec-2-4-ke ----1
Foundation Inspection Report
Office Na.(S 18)761-8256
bury'Building�Cade Enforcement Date Inspection request received:
Arrive:
742 W �,,Queensbury,NY 12804 am/pin Dept; m
Inspector's Initials: p
NAME:
LOCATION: r PERMIT#: ,,.��
TYPE OF STRUCTURE: ' INSPECT ON:
mak
goamsau
Footings Y N N A
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
" ` + =on site.
Fours, :,;.n/Wallpour��
Reinforcement in Pla
15# tl-t›r?v-u41-
Footing Dowels •
place d
�m
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil ••1 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\Foundatlat Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection eport
Office No.(518)761-8256
Queensbury Building&Code Enforcement Date Inspection request received: 1 214, //(
Rd. Inspector's Initials am/pmP :`;�am/pm
742 Ba
y ,Queensbury,NY 12804 • �
NAME: De 1�. 1�S jG�k LN-1 e7 LS PERMIT#:
LOCATION: �_ 1 ,�. r� 1 , ��. INSPECT ON:
TYPE OF STRUCTURE: 2-(
Comment-4
.4t Y NA
Piers l��
Monolithic Slab111
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this • •• on site.
Foundation/Wallpour
Reinforcement in Place
eir 4.:
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:\Bulding&Codes Forms\Buuding&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM