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RC-000193-2015 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 - Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-000193-2015 Date Issued: Wednesday, November 4, 2015 This is to certify that work requested to be done as shown by Permit Number RC-000193-2015 has been completed. Tax Map Number: 288.-1-18.4 Location: 375 GURNEY LN Owner: MICHAEL KASSAL, Susan Kassal Applicant: Susan Kassal This structure may be occupied as a: SFD 2378 s.£, 2-car attached garage, FP 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, /d Variance, dk- or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201 QL Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: RC-000193-2015 PjQ X015-1'}� Tax Map No: 288.4-18.4 REVISED Permission is hereby granted to: Susan Kassal For property located at: 375 GURNEY LN in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance Type of Construction Owner Address: 375 GURNEY LN Single Family-New $375,000.00 Queensbury,NY 12804 Total Value $375,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Ken Collette Plans&Specifications Single Family Dwelling PERMIT FEE PAID-THIS PERMIT EXPIRES: Monday,May 23,2016 (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 th xpi'm ion'd Dated at the To of Quee s /.J F i &ay2015 SIGNED BY: ��j�tyrjjj��YYYfor the Town of Queensbury. Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Fltrig Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150174 Application Number: A20150174 Tax Map No: 523400-288-000-0001-018-004-0000 Permission is hereby granted to: MICHAEL& SUSAN KASSAL For property located at: 375 GURNEY Ln 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: MICHAEL& SUSAN KASSAL Garage-2 Cars Attached 19 PINEWOOD HOLLOW Rd Single Family Dwelling $375,000.00 QUEENSBURY,NY 12804-0000 Total Value $375,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency COLLETTE CONSTRUCTION 38 COLLETTE Ln HUDSON FALLS.NY 12839-0000 Plans&Specifications BP 2015-174 Single Family Dwelling 2,378 sq. ft.; 2-car attached garage 624 sq. ft., 256 sq. ft. sunroom/porch and wood burning stove $569.20 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,May 22, 2016 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbu before thi xpiration t .)/ Dated at the To n of u `ns. ry r, ' ; , May 22,2015 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement FUEL BURNING APPLIANCE & CHIMNEY Office Use Only APPLICATION - ""'"'""""�';=' RecgFuecl `"J xlp''ID DATE 5/15/2015 i N o��/S-//74/ MAY 18 2015iP:r j -e TAX MAP ID 288.-1-18.4 TOWN OF QUEENSBURY ZONING RR-5A BUILDING& CODES OWNER: Susan and Michael Kassa! PHONE/E-MAIL (518)222-0102 susan@susankassal.com ADDRESS 19 Pinewood Hollow Rd. Queensbury. NY 12804 INSTALLER/BUILDER: Ken Collette PHONE/E-MAIL (518365-5822/ information@colletteconstructio ADDRESS: 38 Colette Lane, Hudson Falls, NY 12839 n rnm CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: Ken Collette PHONE BUILDING ADDRESS: 375 Gurney Lane, Queensbury NY 12804 Fuel Burning Appliance Information Wood Coal Pellet Gas Oil NOTE: ROUGH-IN & FINAL Stove INSPECTIONS ARE REQUIRED. Fireplace Insert Fireplace, Factory built* Fireplace, Masonry ' Furnace (Garage Only) *If Factory built provide manufacturer name: ; model#: Listed by: Number: Chimney Information Masonry** (check one) x Block Brick Stone Flue Tie Steel Size in inches Material Double wall Triple wall Insulated Direct Vent Chimney Liner **If Non-masonry provide manufacturer name: model#: DECLARATION: Construction / installation must conform to NYS Fire Prevention & Building Code and / or manufacturer requirements. 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 inspector's to enter premises to perform required inspections. I have read and agree to the above: Print Name: Sc S 4 k"� s s 4 Date: Signature: � Date: 5-1f 5/*S- 5 Town of Queensbury Building&Codes Principal Structure Application July 2014 PRINCIPAL STRUCTURE APPLICATION Office Use Only DATE 5/15/2015 Received Tax Map ID TAX MAP ID 288.-1-18.4Permit No. ZONING ' x 1 U Permit Fee '(020 40 rj RR-5A 'R RecFF 850" xl I MAY 182015 se ( cn HISTORIC SITE Yes X No # TC F QUEENSBURY SUBDIVISION NAME N/A Lot#NG n, CODES TOWN BD. RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS, INCLUDING SINGLE FAMILY DWELLINGS, DUPLEXES OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR MANUFACTURED&MODULAR HOMES, BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE. APPLICANT Susan Kassal OWNER Michael and Susan Kassal ADDRESS 19 Pinewood Hollow Rd ADDRESS same Queensbury, NY 12804 PHONE/E-MAIL (518)222-0102/susan@susankassal.com PHONE/E-MAIL CONTRACTOR Ken Collette COST OF CONSTRUCTION(ESTIMATED): $ 375,000 ADDRESS: 38 Collette Lane BUILDING ADDRESS: 375 Gurney Lane Hudson Falls, NY 12839 PHONE/E-MAIL (518)365-5822/information@colletteconstruction.com CONTACT PERSON FOR BUILDING 8, CODES COMPLIANCE: Ken Collette PHONE 36,5-5822 TYPE OF CONSTRUCTION Check all that apply Please indicate measurements as required below New Addition Alteration 1st floor sq. ft. 2"d floor sq. ft. Total sq.ft. Height Single Family X 1642 736 2378 Two-Family Multi-Family (#of units ) Townhouse Business Office Retail - Mercantile Factory- Industrial Attached Garage (# of ) X 624 Other optional porch x 256 (5„nraor4 p(‘t„1 1 Town of Queensbury Building&Codes Principal Structure Application July 2014 If commercial or industrial indicate name of business Proposed use of building or addition primary residence Source of heat (circle one) Propane and wood Gas Oil Propane Solar Other Fireplace: complete a separate application for Fuel Burning Appliances & Chimneys Are there structures not shown on plot plan? no Are there easements on the property? no Site Information a. Dimensions or acreage of lot 14.13 acres b. Is this a corner lot? no c. Will the grade be changed as a result of construction Yes X No d. Public water or Private well private well e. Sewer or Private Septic System private septic Value of all work to be performed (labor or materials) $ 350,000 DECLARATION: 1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed within a 12 month period. 2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and department approval. 3. 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. 4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of occupancy. 5. 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: PRINT NAME: Susan Kassa! DATE 5/1/5/15 SIGNATOR' : ` lz DATE / 5/;5 FOR OFFICE USE ONLY Operating Permit Issued: Yes No Occupancy Type Construction Classification Assembly Occupancy Limit Special Conditions 2 Town of Queensbury Building&Codes Principal Structure Application July 2014 Rough Plumbing I Insulation Inspection Report Inspection request received 6�311,2aS Name VaiSaltInspected on t 161 12.2a1.5 LocationL1, ) Arrive am 1 pm Permit No. t'5- 1-4. Inspector's Initials C S! Type of Structure Se COMMENTS Y N NA �/ c� �¢� Plumbing under slab lO,�' 36`-D- ��Cl ZZ-- Rough Plumbing /Nail Plates Plumbing Vent /Vents in Place 1 'A 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.I for 15 minutes Insulation / Residential Check/ Commercial Check Window Sealing 41 V Tyvek or Similar Exterior Sealant Proper Vent,Attic Vent '��j' �2i (r"13�t�j�,�� Door/Window Sealed (No Insulation) V Duct / Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/ No duct tape Blower Door Test Air Sealing Town of Queensbury Building & Code Enforcement Office No. (518) 761.8256 Queensbury Building & Code Enforcement n — 1 Office Na, (518) 761-8256 Septic Inspection Report r2 Inspection request received: q Name: /l k SA L Inspected on: f u / Location: j S N e?/1,_ft-Aie Arrive: .vraiwo m./pp.m. Permit No.: ‘.0 l / � Inspector's Initials: 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. <�c�'�`"" 4V Length of each trench ft. _-Q4-C35-5 I �� Depth of trenches ft. -.&V 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: N End Cap N Inlet/Outlet Pipes&Baffles N Manholes 12"or less below grade = N [provide extension collar if Yes] Y N Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conformsnineers per Plot P Y/ N Engineer Report d s-Built � N �-- ETU Maintenance on ract provided Y N Location of Systee. = •perty: Front 'ear Left Side Right Side Middle Front Middle Rear System Use Status' Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Septic Inspection Report 1 II r) I" e i 14 DUX. -- 1 I A / , / / la- tpt) 'I , I fj. 5`)1 LID 0\ f\ / 39 0 , 1 / ! . CD la5--c> 7 / c_,p _ _________________ o1 i ______,, • , 7 , I ‘ _ 0 • , b 1 1 _ g0 1 cA 10 I , I , 7 b 0 As i P yr -=)`-.!?tic- . I ..)( ) al 1-K-P 1 C(1.544) f(-:1'5314 1 7 5- 6c.,/zi-vg 7 L../j 9ticli_C Town of Queensbury Building &Code Enforcement 2 ` Office No. (518)761-8256 Septic Inspection Report Inspection request received: C Li / ---- Name: Name: ((o,S Sys L Inspected on: / (/ / S Location: 3-7 �_� L Arrive: r a.m .I p.m. Permit No.: Q S 17 ( Inspector's Initials: 161.11111 G Comments and/or diagram Soil Type: ran / oa /Clay Type of Water: Municipal I 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. Q Length of each trench _iso ft. Depth of trenches te6e-- -ftp 2- L' . Size of Stone Seepage Pits: Number Size: Stone Size: Pipingize Type Building to tank s = - 1V-1N Tank to Distribution Box Distribution Box to Field/Pit At Opening Sealed: _Y End Cap —)" Inlet/Outlet Pipes&Baffles _Y V N ..'--L., �_'C - ---- f .. Zv Manholes 12"or less below grade _Y_N 'k �' [provide extension collar if Yes] _Y_N 1 Location/Separations f iZS (�-(,� 4 Foundation to tank I ft. 5 v — Foundation to absorption ''LC ft. Separation of Pitsft. Conforms as per Plot Plan r N Engineer Report and As Built _Y_N >' -7 ETU Maintenance Contract provided _Y N Location of Svste n Pro ertv: 1 Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: k..A-i Approved Partial Approved needs to be re-inspected, lease call the Building &Codes Office —2- Disapproved V' Septic Inspection Report '' kiI OW Town of Queensbury Fire Marshal 742 Bay Road Queensbury,NY 12804 761-8205/761-8206 fax 745-4437 Masonry Chimney/Fi epla Inspection Report ✓ Permit# /7 Schedule Inspection b3 �� am m ytime Rough In Final Name / Address 3 7 5 �U/ /1510C Inspector/094 Yes No N/A Comments FOOTING Concrete or solid masonry / //91461, .5 Minimum 12"thickness -.. c1 Extends minimum 6"beyond f/p on all sides Below frost line Cleanout opening—noncombustible cover FIREBOX Walls must be solid—no hollow masonry allowed 8"minimum thickness—back/side walls Joints between firebricks—'/"max Refractory mortar used on firebrick Minimum depth 20" Fresh air intake Clearances to combustibles:4"rear, 'sides/from LINTEL/THROAT Non-combustible material yl�� ;' Dammum 4"lied,mi imumength ea8" ha end // ZC4'grK-6' Damper installed,minimum 8"above f/p opening / SMOKE CHAMBER Walls must be asolid—es hollow"inc masonrygallowe14700'0 Minimum wall thickness 6"including liner fi , / /7/2414""Firebrick lining laid with refractory mortar �/ 1/ ' CHIMNEY Minimum wall thickness 4"—solid masonry Must be lined with appropriate liner type Clay flue liner laid with refractory mortar Flue liner smooth surface inside,no mortar n Minimum masonry thickness between flues 4" PeizAt-r_.--, `j (,T ✓ -f/2.i Minimum clearances to combustibles 2"for interior chimneys, 1"for exterior Termination height minimum 3 feet above highest JPj�,� / W0 point of roof where it passes through,2 feet above any combustible construction within 10 feet Chimney cap installed HEARTH/HEARTH EXTENSION Constructed of concrete or masonry Supported by noncombustible material No combustible material on underside �,/' Minimum thickness 4"—hearth only `� VeAUMeN jj VLA,, '7 Minimum thickness 2"—hearth extension Hearth Extension—16"to the front,8"to sides NOTE: if F/P opening is greater than 6 sq.ft.,must extend 20"front,12"sides MANTEL/TRIM No combustibles within 6"of F/P opening Combustibles within 12 inches of F/P opening cannot project more than 1/8"for each inch distance from F/P opening Y 1ue,s, Cl Rough Plumbing I Insulation Inspection Report Inspection request received 2015 Name k _ Inspected on 6[7,51 2.-QX Location 5.9,5 6Auy J Arrive am/pm -- Permit No. 15- 1,2AA Inspector's Initials Type of Structure S COMMENTS Y N NA Plumbing under slab chnklioo N4-4 beyb Rough Plumbing /Nail Plates V Plumbing Vent /Vents in Place 1 Y2 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.I for 15 minutes Insulation / Residential Check / Commercial Check Window Sealing 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 Blower Door Test Air Sealing (ciLIA-2 L'1_,v7> Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256 ueS Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256 Framing I Firestopping Inspection Report Inspection request received: 81 1e)1 745 Name: VASS t-t__ Inspected on: e t b VAS Location: 6\UYYIL\ Lcwtti Arrive: 3\S° a.m.i p.m. Permit No.: 2-0 I — 1/1 Inspector's Initials: /t,( TYPE OF STRUCTURE: 5 ! , N NIA COMMENTS: 7y Framing 1 Attic Access 22"x 30"minimum Jack Studs I Headers 1 5(+2 Truss Specification Provided "V„.•Bracing/Bridging �S 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 1/2(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 ft. or less on center Ice and water shield 24 inches from wall Fire separation 1,2, 3 hour Fire wall 2,3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side 1/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade Design Professional Sign-off, if required Framing /Firestopping Inspection Report Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256 Framing 1 Firestopping Inspection Report Inspection request received: X21 l Name: ILA SS's L- / Inspected on: / Location: ?S G� / Liu Arrive: `�► m./p.m. Permit No.: 15 r 1 q. , Inspector's Initials: MA. TYPE OF STRUCTURE: Y N NIA COMMENTS: Framing Attic Access 22"x 30"minimum Jack Studs I Headers Truss Specification Provided 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 %(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 ft.or less on center Ae and water shield 24 inches from wall Fire separation 1,2, 3 hour Fire wall 2, 3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side''/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in.(H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade Design Professional Sign-off, if required (,) Framing I Firestopping Inspection Report Rough Plumbing I Insulation Inspection Report Inspection request received �� Name Inspected : /7//Location � Arriveam kpity) Permit No. c_ I7 C% Inspector's Initials Type of Structure t COMMENTS Y N NA Plumbing under slab Rough Plumbing /Nail Plates Plumbing Vent /Vents in Place 1 Y2 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.I for 15 minutes Insulation / Residential Check/ Commercial Check �� 441-9r— Window Sealing 'wC_ 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 Blower Door Test Air Sealing cp) ,, a7Ac yap'��,�► C4 M eY/,)7,c,-ep(hirce Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256 Town of Queensbury Building & Code Enforcement '/C' Office No. (518) 761-8256 Framing / Firestopping Inspection Report I Inspection request received: 5 /3/ Name: V S � Inspected on: �1 ,�n� 4 Location: ""5 ! � � � L Arrive: .. � a.m.l p.m. Permit No.: t 3 r 17 -/ Inspector's Initials: TYPE OF STRUCTURE: Y N N/A COMMENTS: Framing Attic Access 22"x 30"minimum Jack Studs I Headers Truss Specification Provided 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 '/2(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq.ft.floor trusses Anchor Bolts 6 ft. or less on center Ae and water shield 24 inches from wall le 1 v Fire separation 1,2,3 hour I v Fire wall 2, 3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side 1/2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade Design Professional Sign-off, if required Framing /Firestopping Inspection Report -'ti Town of Queensbury Building & Code Enforcement (LM_r_, / 13— Office No. (518) 761-8256 d0 Framing I Firestopping Inspection Report Inspection request received: p Name: , SS rxL, Inspected on: 36// S� Location: 31 ire- Arrive: • a.m./p.m. Permit No.: S' — 17 L( Inspector's Initials: mow`�� TYPE OF STRUCTURE: Y N NIA COMMENTS: Framing Attic Access 22"x 30"minimum Jack Studs/Headers Truss Specification Provided 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 'A (w)16 gauge(8)16D nails each side Draft stopping 1,000 sq.ft.floor trusses A6 or 4(1-Fire Ice andnchor Bolts water shieldft. 24less inchesoncenter from wall 4( Fire separation 1,2,3 hour Fire wall 2,3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. e\ � `�� Garage Fire Separation House side 1/2 inch or 5/8 inch Type X MOr4-14 Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in.(H) 20 in.(W) 5.7 sf above I below grade �r — 6Ke,ve__ 5.0 sf grade Design Professional Sign-off,if required Framing/Firestopping Inspection Report Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: -4]231 Queensbury Building&Code Enforcement Arrive: am/pm Depart: m/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials NAME: F{' O\ PERMIT#: 15-1 LOCATION: 3Gtk Y �� INSPECT ON: 2v`2 1 S TYPE OF STRUCTURE: l S Comments c N N/A 36 S —5627 . Footings Piers Monolithic Slab Reinforcement in Place hOA W 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 12/9/2014 Foundation Inspection Report • Office No. (518) 761-8256 Date Inspection request received: -7/4-S Queensbury Building&Code Enforcement Arrive: am/pm Depart: lc am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: ljtA NAME: V\ S 7 PERMIT#: S� LOCATION: . Ne` 7/�-0 INSPECT ON: -7/Z/, TYPE OF STRUCTURE: Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place 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 ackfill Approval r:9 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 12/9/2014 4 , ‘. i ( Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: /S Queensbury Building&Code Enforcement Arrive: am/pm Depart: a pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:C. NAME: 141) 55,4-- PERMIT#: 1 - ( 7 LOCATION: 3/ s G k-)».- `\,1 2,704-eINSPECT ON: _7///1 5 TYPE OF STRUCTURE: . D fr 1/ i Comments Y NN/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. oundation/Wallpour einforcement 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 12/9/2014 MAN 1-11 Foundation Inspection ReportxcAt-& Office No. (518) 761-8256 Date Inspection request received: b k7A 15 Queensbury Building&Code Enforcement Arrive: am/pm Depa . pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: I1XASSCO g ' PERMIT#: 15- 1 LOCATION: 5'1-5 VV ,v INSPECT ON: 121/11b045 TYPE OF STRUCTURE: t SC'D Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in lace t-.1(1'--1-..ti The contractor 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 12/9/2014 Foundation Inspection Report 2- 1 Office No. (518)761-8256 Date Inspection request received: 61251 15 Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials- NAME: 'ASSPERMIT#: 15— LOCATION: Clu,V oki INSPECT ON: (E[ 2 31 Z TYPE OF STRUCTURE: S Comments Y_ N N/A -bb�"� 5 2:2_ Footings Piers Monolithic Slab 12611/4.1A ‘1/ Reinforcement i lace The contracto 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 � Z 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 12/9/2014 W613 SD` P Report Inspection Re ort Office No. (518) 761-8256 Date Inspection reque -• e': to I I 1 .) Queensbury Building&Code Enforcement Arrive: Z t1 D a p=►�.a� Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials` NAME: V(,&SO4 P RMIT#: 20rD l-1-2.1 LOCATION: JAS Glu rvui L INSPECT ON: (Q)21j E 2-d-t S TYPE OF STRUCTURE: SP Comments %- fr 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 Rei forcement in Place OPnoting Dowels or Keyway in place Foundation Dampproofing undation Waterproo ng �Z� Drain % .. .r Sump 7oting otin Dr s . one: g 2 inch width Z. 6 inches above footing �i' ,V\'/ 6 mil poly for wet areas under slab �j Backfill Approval AP1u...in! nder Slab 'V' Cast/Copper 'CaJ \Rk._ b---\-- O \ oundation 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 12/9/2014 Me NI vprvI Foundation Inspection Report Office No. (518)761-8256 Date Inspection request received: 6\2=21\S Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials. NAME: It =A PERMIT#: 15 LOCATION: 51-5 C-Aair YLU..� ) INSPECT ON: 1012,247l`.� TYPE OF STRUCTURE: l SC Comments Y_ N N/A Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place FootingDowels or Keyway inplace 4 V 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:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 I Foundation Inspection Report Office No. (518)761-8256 Date Inspection request_,; ed: ( I 1 b I t5 Queensbury Building&Code Enforcement Arrive: -\) a ,f�f Depart:V.7..lb V.7.. a 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:WJ NAME: . 'ERMIT#: t 5- I LOCATION: 31-5�Uk✓ INSPECT ON: b 1 110 i z TYPE OF STRUCTURE: Sr-1 1 Comments tV �/- ' Y N N/A K�)Y1 51F 5 3 O 22- 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 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 Plumbing Under Slab P C/Cast/Copper 6)... Foundation Insulatio 410 "xterior R - Nu 'v` ‘ 10 ittki Rough Grade 6 inch drop within 10 ft. L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: m/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's NAME: '}53t PERMIT#: ac)-I5 -(14- LOCATION: �� - INSPECT ON: ( .1k-Z45- TYPE OF STRUCTURE: Comments Y N N/A //Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. —��-� Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place 7\71 Footing Dowels or Keyway in place A 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 12/9/2014 Z Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: to \ill l5 Queensbury Building&Code Enforcement Arrive: am/pm Depart: pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials. {J NAME: YOSSC3,A PERMIT#: 5 - LOCATION: 3VD61uvr\t1 LE - INSPECT ON: 1p 1 1? 0AS TYPE OF STRUCTURE: I S Comments Y N N/A 43r1 5t Z 2-- Footings —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 �� \t Footing Dowels or Keyway in place v 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 12/9/2014 Foundation Inspection Report /o H l etyk Office No. (518)761-8256 Date Inspection request received: col i I j d 1 S Queensbury Building& Code Enforcement Arrive: am/pm Depart: am/ 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: ) iii PERMIT#: I i 7`r • LOCATION: 37� i C�7�to 1-am-e..._ INSPECT ON: (ptl l/c)-6 IS TYPE OF STRUCTURE: Comments Y _ (N/A Footings 1111 Piers Monolithic Slab Reinforcement in Place R-C1A)F71 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 12/9/2014 1 Feb. 20. 201110: 10AM MDIR N0. 1057 P. 3/4 MIDDLE DEPARTMENT INSPECTION AGENCY, INC. 'e&wV s that the electrical wiring to the electrical equipment listed below has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date noted below and is issued subject to the following conditions. Owner; Collette Const. Date: 02/08/2017 Occupant: 1St 82Nd FIs/Basement Locatio%75 Gurney Rd Occupancy' I.ngle Family Dwg. Queensbury, Warren Co. NY Applicant: NSE Inc. 5 South Side Drive Suite.11-218 L Clifton Park, NY 12065 . J Joseph A.Holmes No. 145668194927EL _ ... Equipment: 200-Amp. Service Equipment 4/0; 49=Switches; 67-Receptacles; 59-'Fixtures; 1 -Water Heater; 1 -Air Conditioner; 1 -Pump; 1 - Dishwasher, 1 - Dryer, 1 -20 Amp. Receptacle; 3-Vent Fans; 8- Smoke Detectors 1ZC- tct6' 2p 15 1 p EC � v � FEB 2 2 2017 TOWN OF C IEENRY This certificate applies fo 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 dale based on a visual ownership as Indicated herein, Upon a change In the use,occupancy or ownership inspection. No warranty Is expressed of implied es to the mechanical safety,eff1. of the property indicated above,this certificate shall be immediately null and void. Cieney or fitness of the equipment for any particular purpose. This certificate shall In the event that this carddtale becomes Invalid based upon the about conditions, he valid for a period o}one year Irom the above noted dale. Should the electrical this cerfifltale May be revalitletetl upon reinspection by Middle Department system to which mis cerfificate applies be altered In any way,InnJutling but not limn- InspeUion Agency,me. Arc apprcadon for inspecdan must be submldeo to utldtlle ed lo,the introduptldn of edditlonel eledricEl equipment and/or the replacement of Depanmenl InEpeCtidn Apenty, Int.t0 initiate the inepedbon and revalidation any of the wmponentE installed as of the above noted date.this cemftCale shall ba process. A iee will he charged for this service. PROP- gp6 OrST. Box �! PROP. 4" PVC _-... - SDR -35 HOUSE SEWER- '3%MIN. SLOPE � 08- _ INV. 1 = 9I2.S* INV. 2 = 912,2* - PROP. 1250 GAL \ SF �- PRECAST CONCRETE SEPTIC TANK \ - PROP. SEDIMENT CONTROL FENCE PROP. ABSORPTION FIELD / (4) PIPE -IN -STONE TRENCHES AT 60' EACH, STEP TRENCHES -y0.33' EAC / -3 C zo 1 7 \ \\ SITE LOCATION — I LOCATION MAP DETAILED SITE PLAN SCALE: 1`30' GRAPHIC SCALE 10 0 10 30 60 nil si ( IN FEET) ZONING SUMMARY ZONE - RR -5A (RURAL RESIDENTIAL 5 -ACRE) MINIMUM LOT SIZE - 5 -ACRE PER DWELLING FRONT SETBACK -100' SIDE SETBACKS - 75' REAR SETBACK -100' SHORELINE/STREAM/WETLAND SETBACK - 75' AVERAGE LOT WIDTH - 400' \ \ ROAD FRONTAGE - 400' \ MAXIMUM BUILDING HEIGHT - 40' MINIMUM PERCENT PERMEABLE - 75% f17 fo AREA = 13.985 -AC `S"F / � I e .- _ _ Dig ®Safely New/York 0 Call Before You Dig ® Wait The Required Time 0 Confirm Utility Response 11 Respect The Marks IN Dig With Care 800.962.7962 www.digsafelynewyork,eom SITE SOILS DATA DEEP HOLE TEST PITS: I TP -1: 5/1/2013 BY T. HUTCHINS, P.E. 0-6" LEDGE TP -2: 5/1/2013 BY T. HUTCHINS, P.E. 0-12" LEDGE r - LP -3: 5/1/2015 BY T. HUTCHINS, P.E. 0-4" TOPSOIL x- 4-30" LIGHT BROWN COBBLY SANDY SILT, O COBBLES & BOULDERS N 30-47" OLIVE BROWN MEDIUM SAND, m S COBBLES & BOULDERS ROOTS TO 32" cu _ TP -4: 5/1/2013 BY T. HUTCHINS, P.E. to 0-36" LIGHT BROWN COBBLY SANDY SILT, U) d SOME BOULDERS, Y i LEDGE @ 36" TP -5: 5/1/2013 BY T. HUTCHINS, P.E. (U 0-48" LIGHT BROWN COBBLY SANDY SILT, cn Lf SOME BOULDERS, (n r LEDGE 0 48" PERCOLATION TEST PT -1: 5/1/2013 BY T. HUTCHINS, P.E. STABILIZED PERCOLATION RATE: 3 MINUTES PER INCH I d MAY T WN OF I''e "rtSBURY @LIILDING 3 CODES OVERALL SITE PLAN SCALE: 1 "==100' oaf 1 O a 6 S�' p N A p• / SITE DEVELOPMENT DATA TOTAL PARCEL AREA 13.985 -AC = 609,186 SF EXISTING PROPOSED HOUSE, DECK, PORCH ----- 2975 SF DRIVE 10' 7600 SF 50' ABSORPTION FIELD (TOE OF FILL) 10 TOTAL IMPERVIOUS ----- 10,575 SF PERCENT IMPERVIOUS 0% 1.74% PERMEABILITY 100% 98,26% WASTEWATER SYSTEM SETBACK SCHEDULE PROPERTY LINE HOUSE DRAINAGE DITCH WATERBODIES SEPTIC TANK 10' 10' 10' 50' ABSORPTION FIELD (TOE OF FILL) 10 20 2OF 100' MAP REFERENCE BASE SURVEY INFORMATION TAKEN FROM: "MAP OF LANDS OF RICHARD JENKS, DATED 3/31/2010, REVISED 4/2/10, PREPARED BY: DAVID F. BARRASS, CORINTH, NY "MAP OF A SURVEY MADE FOR ANN DEVLIN SCOTT ERWM," DATED APRIL 2, 2008, PREPARED BY: VAN DUSEN & SIEVES LAND SURVEYORS, QUEENSBURY, NY TAX MAP #'s 288.-l-18.4 ALTERATION OF THIS DOCUMENT EXCEPT BY A LICENSED PROFESSIONAL ENGINEER IS A VIOLATION OF NYS EDUCATION LAW. 0 1 ISSUED FOR BUILDING PERMIT 5/6/2015 No. I Revisions Date OVERALL & DETAILED WASTEWATER SITE PLAN prepared for: Michael & Susan Kassa! 375 Gurney Lane Town of Queensbury, Warren County, NY Drown:LWD Checked: GTH Scale: NOTED Date: 4/15/15 169 bury, N Road Queensbury, NY 12804 29888-01—S1 Hutchins Engineering (518) 745-0307 Phone g• g 518 745-0308 Fax -T .1 co Co 3 J co " L co • U s' . N ■, M