RC-000521-2016 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-000521-2016 Date Issued: Friday,November 18, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000521-2016
has been completed.
Tax Map Number: 301.15-1-53
Location: 12 ELK RIDGE DR
Owner: FOOTHILLS BUILDERS,LLC
Applicant: FOOTHILLS BUILDERS,LLC
This structure may be occupied as a: Single Family Dwelling w/FP 1605 s.f.,
Lot 3 By Order of Town Board
Garage 528 s.f. TOWN
^OF QUEENSSBBUR�YJ
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
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
Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000521-2016
Tax Map No: 301.15-1-53
Permission is hereby granted to: FOOTHILLS BUILDERS,LLC
For property located at: 12 ELK RIDGE DR
In the Town ofQueenshury,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 Name: FOOTHILLS BUILDERS,LLC Single Family-New $150,000.00
Owner Address: 9 Mountainside DR Total Value $150.000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
FOOTHILLS BUILDERS,LLC
9 Mountainside DR
Queensbury,NY 12804
Plans&Specifications
Single Family Dwelling w/FP 1605 s.f.,Lot 3
Garage 528 s.f.
$1,300.20 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,August 6,2017
(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 expi tion date.)
Dated at the Town of ueensbu 4urs y s 11,2016
SIGNED BY: for the Town ofQueenshury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
Date: _315 [ ILO
Permit No. P-c—" FD 2-1 20 1�o
Tax Map ID `` G3 Permit Fee �` -27
Zone 0 V, His� "Fib_Lot# � ny
Yes No Rec Fee ib 5-0
Subdivision Name IC
a � 1 •117�
IM
Subdivision#
Project Location Z MCI VC
TOWN BD.RESOLUTION 86-7013: $850 recreation fee for new dwelling units—single family,duplexes/two-family,multiple family,
apartments,condominiums,townhouses,and/or manufactured&modular homes,but not mobile homes. This is in addition to the
permit fee(s). II
Primary Owner(s)
Address
Phone/Email
Applicant I
SAMC
Address CA
Phone/Email
Contractor
Address
Phone/Email �
Contact Person for Building&Codes Compliance: Jot L c m L 1 Phone(S18)
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration I"floor sf 2"d floor sf TotaI sf Height
Single Family J r p� 2 '54
Two-Family
Multi-Family
(4 of units_)
Townhouse
Business Office `'''718 ZUT
Retail-Mercantile
Factory-Industrial
Attached Garage -7
(1,& 4+) 5_z_0
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business
Proposed use of building or addition Q S Q
Source of Heat(circle one) as Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances&Chimneys �f S «' S
Are there structures not shown on plot plan?
Are there easements on the property?
No-
Site Information:
a. Dimensions or acreage of lot a S Y'
b. Is this a corner lot? Yes No
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well(circle one) INUblic Private
e. Sewer or Private Septic System(circle one) Sewer 'vate
Value of all work to be performed(labor or materials) $
DECLARATION.-
1.
ECLARATION.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 1
description of the work proposed, that all work will be performed in accordance with the NYS
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 1 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: pp [
PRINT NAME: �} b�Q,O� uVi DATE:
SIGNATURE: C)�& ti� DATE: �J
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Fuel Burning Appliance & Chimney Application Office Use Only
Received
DATE: to Tax Map ID
TAx MAP ID: r 5_5 Pen-nit No.
ZONE: NNE
Permit Fee
Ad cm
OWNER PHONE/E-MAIL lNe-357-6
ADDRESSG An V
INSTALLER/ PHONE/E-MAIL
BUILDER Is SO 0--L
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE:
PHONE/E-MAIL Sift YVU BUILDING ADDRESS I
ROOM OF INSTALL: `�r(� + ]1 I PLANNED INSTALL DATE:
FUEL BURNING APPLIANCE INFORMATION WOOD COAL PELLET GAS. OIL NOTE: ROUGH-IN&
STOVE FINAL INSPECTION ARE
FIREPLACE INSERT REQUIRED.
FIREPLACE,FACTORY BUILT*
NOTE:
MANUFACTURER'S
FIREPLACE,MASONRY
INSTALLATION MANUAL
FURNACE(GARAGE ONLY) MUST BE AVAILABLE AT
TIME OF INSPECTION
*If factory built provide manufacturer name: ; Model#:
Listed by: Number:
CHIMNEY INFORMATION
Masonry** (check one) BLOCK BRICK. STONE � '8 2 0 5
Flue TIE STEEL Size in inches
Material DOUBLE WALL TRIPLE WALL INSULATED
** 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.
X HAVE READ AND AGREE TO THE ABOVE:
PRINT NAME: &(,�nY l 4 DATE: J
SIGNATURE: DATE:
SEPTIC DISPOSAL APPLICATION Office Use Only
Received
DATE: Tax Map ID
TAx MAP ID: $ — , — �j Permit No.
ZONE: Permit Fee
APPLICANT PHONE/E-MAIL --7q
ADDRESS NVC
INSTALLER/ PHONE 1 E-MAIL
BUILDER
OWNER
ADDRESS
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE:
PHONE/E-MAIL 1�a Mt AUG 0
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed —Yes XNo
1981-1991 Spa or Hot Tub installed Yes XNo
1992-Present �7
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 Supply Municipal _Well(if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: 1.:::�per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size 6 gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length ft.;Each Trench
Seepage Pit with#3 stone How many: -Size
Alternative System Bed or other type:
Holding Tank System Total required capacity? Tank size #of tanks
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will
no longer allow systems to be covered until such time as an As-Built plan is received&approved. The installed system must match the
septic system layout on file—no exceptions.
Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure
to make a material fact or circumstance known by or on behalf of an applicant,shall be void. I have read the regulations and agree to
abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Or nance.
PRINT NAME: lc'n�
1
1✓t V l b DATE:
SIGNATURE: DATE:
Town of Queensbury Thomas R.Van Ness
Highway Department Highway Superintendent
742 Bay Road, Queensbury,NY 12804 Home: 518-745-0929
Phone: 518-761-8211
Fax: 518-745-4466 David DuelI
Deputy Highway Superintendent
Home: 518-745-0938
DRIVEWAY PERMIT
Date: 16 Le
Applicant Name: f�� oh i�� �
S f rS
Telephone No.: J1 -1 G � ZW
Address to be Inspected ► 4'`�
Return Address: (,� �� -
Applicant must show exact location and width of driveway(s) to be connected to the highway by placing stakes
at the specified location
The Superintendent of Highways of the Town of Queensbury has reviewed this application. The following action
has been taken:
STEP 1: ( } Preliminary approval
NEED ( } Slight Swale
{ ) Deep Swale AUG 0 8 2016
( ) Level with the road
( ) Level with the top of the paved wing
Size culvert pipe to be used(if necessary)
( ) 12" ( ) 15" ( ) 18" ( ) 24" ( } 36"
Preliminary inspection completed by: Date:
Approval by Highway Supt.: or Deputy Supt.:
Upon completion please resubmit this approval permit for a final approval.
STEP 2: { } Final Approval { } Rejected
Date:
Thomas R. Van Ness, Highway Superintendent David Duell,Deputy Highway Superintendent
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
�o 44832
.. Cut-in Card No....................................
Permit No........................................Ceert.
Owner... ��J �L :..!�.:1�(Ln ........r..
......... ...... ... ........ ..... ................................................ . .
Location..Z..!f .... �...P..��.67....... ........................................../.... .... ......
Install t' Consistin of_5_ �!U. .. r f... �...�.!/I...l'1...
g ....
�.... 11�:�St.. .��........ ?-........�.,.. �Gl/f...............................................
............................. .....................................................................................................................................................
InstalledBy.....t.e..:.. .jrQ. ........................................Lic.No...................................................
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
rules are violated,the Company shall have the right-torev ke this ificate.
Date.....8-1-7-Z.
... G.......... INSPECTOR...... .t................. ............ . . ..........................
Member N.F.P.A.,I.A.E.1.
REScheck Software Version 4.6.2
Compliance Certificate
Project Foothills Builders �y
Energy Code: 2010 New York Energy Conservation
Location: Warren County, New York ET -,�
Construction Type: Single-family
Project Type: New Construction �4 079Ln
�3 �
Conditioned Floor Area: 1,605 ft2 &SS10N�� C
_ 00
Glazing Area 11% r,4
r-1
Climate Zone: 6 (7635 HDD) Lr)
�
Permit Date: Ln
Permit Number: G L3
Construction Site: Owner/Agent: Designer/Contractor: m
Lot 3 Vision Engineering LLC
Queensbury, NY 12804 206 Glen Street
Suite 56 d Vi
Glens Falls, NY 12801fl Lr)•' 0
LP1 m Q) Q0
t
ompliance: Passes using UA trade-off
t Cy� U_
Coinpliance: 1.4%Better Than Code Maximurn UA: 281 Your UA: 277 rel J
The i Better or worse Than Code Index reflects how close to compliance the house is based on Code trade-off rules. 0W ^
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. �r
0 0 r'4 L L
M ly r--1 C/7
Envelope Assemblies
Gross Area cavity Cant.
Per meter
Wall 1: Wood Frame. 16" o.c. 1,674 21.0 0.0 0.057 83
Window 1:Vinyl Frame:Double Pane with Low-E 141 0.340 48
Door 1: Glass 40 0.320 13
Door 2: Solid 18 0.140 3
Door 3: Solid 201- 20 0.250 5
Ceiling 1: Raised or Energy Truss AUG C� � 1,605 38.0 0.0 0,025 40
Basement Wall 1: Solid Concrete or Masonry 1,488 0.0 11.0 0.057 85
Wall height: 7.8'
Depth below grade: 6.8'
Insulation depth: 7.8'
Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other
calculations submitted with the permit application.The proposed building has been designed to meet the 2010 New York Energy
Conservation Constr tion Code requirements in REScheckVer 4.6.2 and to comply with the mandatory requirements listed in
the M�Iflnspeftion Checklist.
Name- le Signature Date
Project Title: Foothills Builders Report date: 08/06/16
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r
fZREScheck Software Version 4.6.2
Inspection Checklist
Energy Code 2010 New York Energy Conservation Construction Code
Requirements: 0.0% were addressed directly in the REScheck software
Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each
requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception
is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided.
section Plans Verified Field Verified
# Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions
& Req.ID
103.2 Construction drawings and ❑Complies
[PR1]1 documentation sufficiently ❑Does Not
demonstrates energy code
Y compliance for the building ❑Nat Observable
envelope.
❑Not Applicable
103.2, Construction drawings and ❑Complies
403.7 documentation sufficiently ❑Does Not
[PR3]1 demonstrates energy code
compliance for lighting and ❑Not Observable
mechanical systems.Systems ❑Nat Applicable
serving multiple dwelling units
must demonstrate compliance
with the commercial code. _
403.6 Heating and cooling equipment is. Heating: Heating: ❑Complies
[PR2]2 sized per ACCA Manual S based Btu/fir Btu/hr ❑Does Not
on loads per ACCA Manual J or Cooling: Cooling:
other approved methods, []Not Observable
Btu/hr Btu/hr ❑Not Applicable
Additional Comments/Assumptions:
1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low impact(Tier 3)
Project Title: Foothills Builders Report date: 08/06/16
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Section
# Foundation Inspection Complies? Comments/Assumptions
6r.Req.!®
303.2.1. Exposed foundation insulation ❑Complies
[FOI1]2protection. ❑Does Not
❑Not Observable,
❑Not Applicable
403.8 Snow melt controls. ❑Complies
[FO. 12]2, ;❑Does Not
❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
1 I High Impact(Tier 1) 2. Medium Impact(Tier 2) 3 Low Impact(Tier 3}
Project Title: Foothills Builders Report date: 08/06/16
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Section Plans Verified Field Verified
# Framing/ Rough-in Inspection Value Value Complies? Comments/Assumptions
6c Req.li} i
402,4,4 Fenestration that is not site built ❑Complies
[FR20]1 is listed and labeled as meeting ❑Does Not
AAMA/WDMA/CSA 101/LS.2/A440
1211 or has infiltration rates per NFRC ❑Not Observable
400 that do not exceed code ❑Not Applicable
limits.
402.4.5 IC-rated recessed lighting fixtures ❑Complies
[FR16]2 sealed at housing/interior finish ❑Does Not
and labeled to indicate&It;= 2.0
cfm leakage at 75 Pa. ❑Not Observable
❑Nat Applicable
40 3.2.2 All joints and seams of air ducts, ❑Complies
[FR13]1 air handlers, filter boxes,and []Does Not
building cavities used as return
ducts are sealed. ❑Not Observable
❑Not Applicable
403.2.3 Building cavities are not used as ❑Complies
[FR15]3 ducts or plenums. ❑does Not
J' ❑Not Observable
❑Nat Applicable
403.3 HVAC piping conveying fluids R- R- ❑Complies
[FR17]2 above 105 QF or chilled fluids ❑Does Not
below 55 QF are insulated to R-3.
❑Not Observable
❑Not Applicable
403,4 Circulating service hot water R- R- ❑Complies
[FR18]z pipes are insulated to R-2. ❑Does Not
❑Not Observable
❑Not Applicable
403.5 Automatic or gravity dampers are ❑Complies
[FR1912 installed on all outdoor air ❑Does Not
3 intakes and exhausts, ❑Not Observable
❑Not Applicable
Additional Comments/Assumptions:
I �High Impact(Tier 11 2 ]Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Foothills Builders Report date: 08/06/16
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'Section
# Insulation Inspection Complies? Comments/Assumptions
& Req,ID
303.1 All installed insulation labeled or ❑complies
[IN1312 installed R-values provided. ❑Does Not
❑Not observable
❑Not Applicable
Additional Comments/Assumptions;
1 [High Impact(Tier 1) 2' Medium Impact (Tier 2) 3 how Impact(Tier 3)
Project Title: Foothills Builders Report date: 08/06/16
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Section Plans Verified Field Verified Final Inspection Provisions Value Value Complies? Comments/Assumptions
& Req.113
402.4.2, Building envelope tightness ACH 50 = ACH 50 = ❑Complies
402.4.2.1 verified by blower door test result ❑Does Not
[FI17]' of<7 ACH at 50 Pa.This ❑Not Observable
requirement may instead be met
via visual inspection, in which ❑Not Applicable
case verification may need to
occur during Insulation
Inspection.
403.2.2 Duct tightness via post- cfm cfm ❑Complies
[F14]1 construction with maximum ❑Does Not
leakage of 8 cfm to outdoors, or
12 cfm across systems. For -]Not Observable
rough-in tests,verification may ❑Not Applicable
need to occur during Framing
Inspection, with maximum
leakage of 6 cfm across systems
and 4 cfm without air handler.
403^1.1 Programmable thermostats ❑Complies
[FI9]2 installed on forced air furnaces. ❑Does Not
❑Not Observable
_ .....�__...__._.-_:__--------_..._—:_____
❑Not Applicable
403.1.2 Heat pump thermostat installed ❑Complies
[FI1012 on heat pumps. ❑Does Not
❑Not Observable
❑Not Applicable
403,4 Circulating service hot water ❑Complies
[FI1112 systems have automatic or ❑Does Not
accessible manual controls.
❑Not Observable
❑Not Applicable
4013 Compliance certificate posted. ❑Complies
[F17 ❑Does Not
❑Nat Observable
❑Not Applicable
303.3 Manufacturer manuals for v ❑Complies
[FI 1813 mechanical and water heating ❑Does Not
Y, equipment have been provided.
❑Not Observable
[]Not Applicable
Additional Comments/Assumptions:
1 JHigh Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Law impact{Tier 3}
Project Title: Foothills Builders Report date: 08/06/16
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2010 New York
Energy Conservation
Construction Code
Energy Efficiency
Certificate
Insulation
Above-Grade Wall 21.00
Below-Grade Wall 11.00
Floor 0.00
Ceiling / Roof 38.00
Ductwork (unconditioned spaces):
Door,Glass&
Window 0.34
Door 0.32
Heating&Cooling,Equipment
Heating System•
Cooling System:
Water Heater:
Name: Date-
Comments
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