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2014-077 TOWN OF QUEENSBURY ow742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20140077 Date Issued: Monday, November 24, 2014 This is to certify that work requested to be done as shown by Permit Number P20140077 has been completed. Location: 451 LOCKHART Rd Tax Map Number: 523400-252-000-0001-028-001-0000 Owner: JAY R SALMON Applicant: JAY R SALMON This structure may be occupied as a: Fireplace By Order of Town Board Garage Attached TOWN OF QUEENSBURY Single Family Dwelling / n Issuance of this Certificate of Occupancy DOES NOT relieve the property ✓ .. owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Planning Board Director of Building tic Code Enforcement or Zoning Board of Appeals. a TOWN OF QUEENSBURY 9 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 VS Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140077 Application Number: A20140077 Tax Map No: 523400-252-000-0001-028-001-0000 Permission is hereby granted to: JAY R SALMON For property located at: 451 LOCKHART Rd in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: JAY R SALMON Fireplace 7146 LAFAYETTE Rd Garage Attached MIDDLE GROVE,NY 12850-0000 Single Family Dwelling $375,000.00 Total Value $375,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency JOHN A CLARKE 88 MOHAWK MTN Rd LAKE GEORGE NY 12845-0000 Plans&Specifications 2014-077 SFD 2,536 sq ft(1,268 sq ft 1st& 2nd Firs) Garage 1,400 sq ft(1st flr 896sf, 2nd Fir 504 sf) 1 Fireplace see STORM WATER MANAGEMENT PLAN as well $717.20 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,April 11,2015 (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 To of ens i i i -- • ii 11,2014 i SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement + 1 • .s • 1 ) Office Use Only Town of Queensbury Building & Codes Received: A , 2014 Tax Map ID: VIM A..5 -2A..5 - —/- are / PRINCIPAL STRUCTURE APPLICATION Permit No.: /q—0/77 A permit must be obtained before beginning construction Permit Fee: $ 7/`}r?D ASD' FP/atec *Rec Fee: $ ,5;0'n Please read: *TB resolution 86-2013(1-28-2013): $850 recreation fee for new dwelling Site Plan No.: units,including single-family dwellings,duplexes or two-family dwellings, multiple family dwellings, apartments, condominiums, townhouses, and/or manufactured and modular Subdivision No.: homes,but not including mobile homes. This is in addition to the permit fee. (� /f Date / /f )( Applicant JR"1 (� S fi t-rwcp I'd Tax Map ID a1.3-f — 13 • Lj t t 4 3 Address ?�� L t � /1 �{ Zoning /Q CA 2ot03C7 Qve� Ut55 )Z$v I Phone/E-mail \t 5. cCi n r�n c t, Ico-j (dio1/401 •&urn Property Owner '�.. • Contractor/Agent 7 GI ARXt. Cot's+. Zn c Address ;r E i- Address g`d Maho-wk /19in Rd A .or. . a .. Lak- Gco�jje. N5? ii'4S Phone/E-mail C . . ?'7ir►la+`s4wt Phone/E-mail 518 361 2668 Jsofac-k P/g?& COM Contact Person for Building&Code Compliance: J 0\\.K 3 3 o,-(Was Day Phone:�S1 34 I -02696ii Building Street Address: LJJ6I Lo�l- c-(L 1 ' e--D Qjveen5 t0 J� .N-}' 1 (01-�0 Subdivision Name: H e1e A) A, f t. -L/l Lot#: 10 Historic Site: Yes X No Estimated cost of construction: $ 37coaC) Sub NO • ( -02001, Type of Construction: Check all that apply Please indicate measurements as required below: 0 ci a d 1st Floor 2nd Floor Other Total Height a ? a a r Single Family Y f Z 64% / Z 6q. 25 3 6 3'—I Two-Family Multi-Family(#of units_) Townhouse Business Office Retail-Mercantile Factory-Industrial Attached Garages(# I ) x 8 9 6 S 0 /yoo Zg=g`' Other Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 I WINDOW SCHEDULE • CALCULATION SHEET / / y 0� JOB SITE ADDRESS: t/57Lock4a,rL AA47- t c�r �veen5✓0rj f oy DATE: 3/d-frA OWNER: q L- Sff-t v c 1 APPLICATION NO.: Window p or Letter Window Manuf. Window Unit or Stock Rough Rough Sq.Ft.Vent Sq.ft.egress! Clear opening Clear opening Special hardware or on Plan Name Model Type Call size Opening Width Opening clear opening width in inches height In instructions Height inches A ,lerson D11 —rw30116 31 27'4 t/gS k 5.73 S. 70 33 ��- 2N�N L3 f1,,,1ed-son T� 15 e" 1W3032.-3 9-S7i7-c _3 y-rt //. 55 3- 2_ 33Tit /6 G Aolersc--) DH 11W3032 3' Z 3-912t 3_ €5 3_R7._ _3s /64 /3 ,471/erson OH' 14 s 7309'6'2 6 -N �/ £s'ifr A. V6 4_70 a,<-1?3 t_ a,<-14 f An Litt-Sort? .Qs/", t 28/7 3- /3 7Sid Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 NATURAL LIGHT, VENTILATION, AND EMERGENCY EGRESS REQUIREMENTS /-Y-6-97 CALCULATION SHEET / - JOB SITE ADDRESS: �� Lo G4C.jt c,-(I A47--- 'Ia✓6ef5E3vnj /22b 9 DATE: / -�/t l OWNER: cJ .j I Ss4-1 v t- OA) APPLICATION NO.: NATURAL LIGHT, VENTILATION, AND EMERGENCY EGRESS REQUIREMENTS Habitable Room Area of Room Required light Actual light square footage Required ventilation Actual Ventilation Square Footage Square Foot Opening for Egress Remarks In Square Feet 8%of room area 4%of room area Gceast Room 74/0 54. z.._ 7! _ 416 2_9_ 4 S s _ 72" /6 . // Root. 29967 as-fl (, S . D ?_ /l_ 99 37. 61 /y, 7z sTc&oL( 7„57.2-7 20 - 5g30 - 93 /O. 29 _ / 7 . /9 5. 70 134-.t roe m y zol_ // /6 . 09 51 . SS E, 05 2.8. 65 5- 70 masr0r- etdrooM 2/Z-33 /6- 99 z.o_ 6 Z 8. SO //, 46 5 _ 70 Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 PLAN 14- 0102 7.<1 LOGfil ✓- � Revised 4/14/2010 _ 12--45-o 1/4( BUILDING PERMIT CALCULATION SHEET: NATURAL LIGHT, VENTILATION AND EMERGENCY EGRESS REQUIREMENTS Habitable Area of Required Actual light Required Actual Ventilation Square Foot Opening Remarks Room Room light square footage ventilation Square Footage for Egress In Square 8%of room 4%of room Feet area area R A0 740 59,2 73. 4( 2.9.6 SS;78 /0. 1t F�M gigs el 2.3.97 (,.5,02 I1.R9 3744 14. 72. Sneoy 257.29 2048 30.93 /0.gq ) 7, /9 S, 7'0 tot 2041, /6.0, s1,SSI 8.05 a8,l0.5" S.7a M RST,US e fie" 213.33 /4•.99 20.42 _ 8.s'v / 1.4+: 5,70 1 Town of Queensbury* Community Development Office *742 Bay Road, Queensbury NY 12804 Office Use Only Received: Tax Map ID: Town of Queensbury Building & Codes Permit Na: ) 4l o 79 SEPTIC DISPOSAL PERMIT Permit Fee: $ A permit—must be obtained before beginning construction Approvals: n Applicant: Jp.�f,�� 0.._ ocumm Installer/Builder C(�k. l-,G td- "c�c",.Sdvc - Address: 111(46K L 114 Address N%okc&"e A.A..-r-. 2Aaoesibtih\r3 %-t-fol6e.,orr,,��-- /J�.( la-S1( Phone: CI(if WdS/T (.U Phone ci FS 31-n C'o2to(oe`'S Owner: L. 6'. ('AU(3 Location of Installation j' Lor.tLL _(4 M( le `I Address: / • .. • . autoLi /1/45 t?1�UY Phone �. . (� f Contact Person for Building&Code Compliance: �1 \N C \ct, Day Phone: Ci 36 i a�6$ Residence Information: Year Built #of Bedrooms x Gallons per bedroom =Total Daily Flow 1980 or older x 150 = Garbage Grinder installed? A./O 1981-1991 x 130 = Spa or Hot Tub Installed? hi t 1992—Present x 110 = Parcel Information: r uQ�S Topography Flat Rolling _Steep Slope %Slope e/64511 0— Soil Nature _Sand 3C Loam Clay J( Other ETA a`.'"4 tot 8-301-144-65 Groundwater At what depth? L4 it e rest en- l.40.4, tA Scat 19 -t a rM Bedroddlmpervious Material At what depth? / Jim v l� 3b Domestic Water Supply Municipal T/Well(if well,water supply from any septic system absorption is /00+ft.) Percolation Test Rate- per minute per inch(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 00 0 gallon(minimum size 1,000 gallons), add 250 gallons to size of septic tank for each garbage grinder,spa or ,i,„4idpool tub 3 System Type: Absorption Field(with#2 stone) Total length f ifV ft. Each trench x Co d Seepage Pit(S)(with#3 stone) How many? f1/4)1, Pt Size? Altemative System Bed or other type? n) Pr Holding Tank System Total required capacity? j)IOr Tank size? #of tanks? NOTE: 1)Alarm system and associated electrical work must be inspected by a Town approved electrical inspection agency-see Certified Electrical form on Town website;2)Effective as of March 23,2006 Septic System-As Built Plot Plan: The Building Department will no longer allow systems to be covered until such time as an As-Built Plot Plan is received and approved by the Building Inspector. The installed system must match the septic system layout on file. There will be no exceptions. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant,shall be void. ✓I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Print Name: .. in-) Date: 3/d�f!� / S. Signature: i / Date: 3(n/ 1 Town of Queensbury Building : t es Pri dpal Structure Packet 518-761-8256 Office Use Only Town of Queensbury Building & Codes Received: Tax Map ID: Asa. -1- �9 p tl FUEL BURNING APPLIANCE & CHIMNEY APPLICATION Permit No.: RI-017 Permit Fee: $ Application is hereby made to the Building &Codes Office for the issuance of a Building&Use Permit pursuant to the NYS 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: Rouqh-In and Final Inspections Are Required: Date 3(fl/f J ( a�'n Q Owner UtLtl'fk1t.� N\I- +-7 Installer/Builder S GS c ar4 Address oau\ or ,J.lt tz45Q4- Address g5 01,0-uifr. itAfn Ra J Cl r P k)? 12sy5 Phone (I`iS $l`? u L 3`l Phone SIS 36 I 221.6€. LK' Lr Location of proposed construction and/or installation: Naitu ir '( U 1 Q Q,YXtS'9JryJ N• t 17 � Contact Person for Building & Codes Compliance: .)o`. i. Oa V...6 i Subdivision Name: N1oLkke,\\ Fuel Burning Appliance Information Wood Coal Pellet Gas Oil Stove / Fireplace Insert S( Fireplace,factory built' Fireplace, Masonry Furnace,(Garage Only) * If Factory Built, Please Provide: Manufacturer Name: Model No. Listed By: Number: Chimney Information Masonry" /check one _Block _Brick Stone Flue ✓check one /Tile feel (4 Size in Inches Material ✓check one %Double Wall Triple Wall _Insulated _Dinect Vent _Chimney Liner " If Non-Masonry, please provide: Manufacturer Name: (--C4-4)v)( Model No. Mtr k, 44161 ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION & BUILDING CODE AND/OR MANUFACTURER REQUIREMENTS. CONSULT AVAILABLE Town of Queensbury HANDOUTS REGARDING REQUIRED INSPECTIONS. Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 Town of Queensbury Highway Department DRIVEWAY PERMIT Michael F. Travis, Highway Superintendent Thomas R. Van Ness, Deputy Superintendent Home: (518)798-0413 Home: (518)745-0929 Office Phone: (518)761-8211 Office: (518)761-8211 • Fax: (518) 745-4466 n Building Permit#: // 6 d / 7 Date: 3 d41/7 d S Tax Map ID: — — '3 asa. I` ' Applicant Name: TA.i i2_ SAKI,kmio^) Address to be inspected: NSI (Kit,KILL, - t-tr- . auuasbo Ad iz,, uk-f Return Address: r)ti r_:05e, 48. no eta* r j tiJ r•t,�o t 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 ( ) Level with the road ( ) Level with the top of the paved wing Size culvert pipe to bLused (if necessary) ,e , ( ) 12" ( ) 15" �' 18" ( )24" ( )36" nmsnixiCi Preliminary inspections completed by: Date: Approved by Highway Supt: Deputy Supt.: Upon completion, please resubmit this approved permit for a final approval. Step 2: ( ) Final Approval ( ) Rejected Date: Michael F. Travis, Highway Superintendent Thomas R. Van Ness, Deputy Highway Superintendent Town of Queensbury Building&Codes Prindpal Structure Packet 518-761-8256 Checklist- Single family dwelling or Multiple dwelling / Commercial project SINGLE FAMILY DWELLING PROJECT CHECKLIST PROJECT NAME: A-Ltwo tJ Please include two(2)sets of the following documentation: Yes No NIA 1. Building Permit Application Completed 2. Energy Code Inspector's Report from ResCheck X 3. Septic application(if applicable) 4. Solid Fuel Buminq or Gas Appliance Form(if applicable) 5. Driveway Permit 6. Structural Drawings Floor plan(s) X Foundation plan yS Cross Sections Elevations Window and door schedule Natural Light,Ventilation and Emergency Egress Requirements Plans signed and sealed by registered architect or engineer 7. Plot Plans-Indicate proposed structure,showing setback dimensions from all surveyed property lines; p( Show location of all existing structures on the property; Show location of water supply(well or water lines); Show location and configuration of septic disposal system or sewer line PC 8. Electrical Inspection agency selected X MULTIPLE DWELLING OR COMMERCIAL PROJECT CHECKLIST PROJECT NAME: Please include two(2)sets of the following documentation: Yes No NIA 1. Building Permit Application Completed 2. Energy Code ComCheck and Inspectors Report Form 3. Septic application completely filled out(if applicable) 4. Solid Fuel Burning or Gas Appliance Form(if applicable) 5. Driveway Permit 6. Structural Drawings Floor plan(s) Foundation plan Cross Sections Elevations Design loads including floor,snow load and wind load Seismic design(required after January 2003) Plans signed and sealed by registered architect or engineer Window and door schedule 7. Plot plan: Indicate proposed structure,showing setback dimensions from all surveyed property lines Show location of all existing structures on the property Show location of water supply(well or water lines) Show location and configuration of septic disposal system or sewer line 8. Electrical inspection agency selected Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256 ELECTRICAL INSPECTORS IREvIsED May 20121 THE FOLLOWING ELECTRICAL INSPECTION AGENCIES ARE CERTIFIED BY THE TOWN OF QUEENSBURY TO PERFORM ELECTRICAL INSPECTIONS: Name/Address of Business Inspector Contact Number(s) Commonwealth Electrical Donald Loveland Local: 800-562-9934 Inspection Services Ron Mumblo Ron: 518-798-0905 176 Doe Run Road Manheim, PA 17545 Middle Department Ray Novak Main Office: 800-873-6432 143 Troy Schenectady Road Local Office: 800-479-4504 Watervliet, NY 12189 518-273-0861 Ray: 518-369-6614 The Inspector, LLC Douglas R. Hull Main Office: 800-487-0535 4755 McConchie Road Brian D. Sweet Galway, NY 12074 David J. Irwin PLEASE NOTE: WE CANNOT RECOMMEND AN INSPECTOR. PLEASE ASK YOUR CONTRACTOR WHICH AGENCY THEY PREFER TO INSPECT THEIR WORK. • STORMWATER MANAGEMENT APPLICATION INSTRUCTIONS A. GENERAL INFORMATION ;,2 2 8 2014 Lake George is a State-owned resource held in custody of the people of the State and protected under several State laws. Because the Lake has a relatively small and steep watershed, its water quality is highly susceptible to pollution caused by stormwater runoff. Development projects,when uncontrolled, can cause runoff problems during construction and after completion. In order to protect water quality, development projects are required to provide for the control of stormwater runoff. This is a general guide for those undertaking proje«f._::e:.- • ••- require a permit for the management of stormwater from development projects pursuant o Chapter 147; •tormwater Management, Town of Queensbury Zoning Ordinance. This is not a de s'• '•• • - - •plicable laws or regulations- other permits may be required for your project. It is the owners' responsibility to obtain all required approvals prior to commencing work. The Lake George Park is comprised of Lake George and, essentially, its land drainage basin. As such, the Park includes private lands some miles from the lake. If there is a question as to whether or not the project site is located within the Park, contact the Town of Queensbury Department of Community Development at(518) 761-8220 or the Lake George Park Commission at (518) 668-9347 for a determination. B. STORMWATER MANAGEMENT PERMIT REQUIREMENTS A permit must be obtained prior to commencing: 1. Projects involving the creation of more than 1000 square feet of impervious surface. Impervious surfaces include buildings, pavement, blacktop, macadam, packed earth and crushed stone. 2. Land clearing, grading or filling involving more than 5000 square feet. It is a violation of the Stormwater Management regulations to maintain a condition,which, due to a human disturbance of land, vegetative cover, or soil, results in the erosion of soil into any water body. If you are not sure if you need a permit you can submit a jurisdictional inquiry for a determination. Just send a cover letter with your name, address, phone number and tax map number of your property asking for a jurisdictional determination, along with a copy of your project plans. Be sure to include all proposed changes to the property including all structures to be removed and added, driveways, sheds, decks, garages, etc. C. PROJECT CLASSIFICATION Minor Projects (projects not falling into one of these categories are Major Projects): 1. Any building, land clearing or development activity affecting less than 15,000 square feet. 2. Creation of a two-lot, three-lot or four-lot subdivision which may result in the construction of no more than one single-family residential structure and related accessory structures per lot, and will require land clearing or alteration activities of less than 15,000 square feet per lot and less than 15,000 square feet total for any subdivision road. 3. My building, alteration or modification of a stormwater control measure, excluding maintenance, cleaning or repair of such stormwater control measure. r- 0 an Gl If your project site contains any of the following conditions it may be considered as a Major Project: L\CRAIG BROWN\TEMPLATES\STWATAPPS\TOWN STORMWATER INSTR.DOC page 1 of 3 1. Soils of high potential for overland.or through-soil pollutant transport. 2. An area with a slope of fifteen percent(15%)or greater when measured in any direction over a distance of one hundred (100)feet from the center of the proposed building site. 3. An area with a soil percolation rate slower than sixty (60) minutes per inch. D. FILING YOUR APPLICATION A pre-application meeting with the ionirig administrator may be desirable for large or complex projects. A complete application must include the following: ( �// Application form-completed and signed. ( L A general location map of the property sufficient to direct someone to your site. ( 1. Project plans (see below) For major projects only: ( The names and legal mailing addresses of all landowners within five hundred (500)feet of the project site. (this information may be obtained from the town tax assessment office). ( A complete list of all permits or approvals required from other agencies,the status of each application and the status of the action under the State Environmental Quality Review Act(SEQR). ( A completed Full Environmental Assessment Form. ( For Major Projects-A Stormwater Control Report. A Stormwater Concept Plan may also be required. See regulations for requirements. NOTE: Failure to include any one of these items will result in an incomplete notice and delay in processing your application. Common mistakes to avoid •• Information was omitted from the application form -the application was not signed by the owner. •• Vicinity or location maps not suitable to direct someone to the site. The map should reference a principal highway, road names,etc. Topographic maps or county highway maps are suggested. •• Vague, incomplete or poor quality plans. Plans should be to scale and show all pertinent distances and dimensions. • Incorrect mailing addresses for adjacent owners. • Section, block and lot number incorrectly given. This is the legal tax map number assigned to each property. LACRAIG BROWMTEMPLATESISTWATAPPSITOWN STORMWATER INSTR.DOC page 2 of 3 • PROJECT PLANS The project plans are the basis fdr review and approval of the project and typically consist of a site plan showing all new development and location of stormwater measures, erosion control plans and construction details for stormwater and erosion control devices. Construction must be in strict accordance with the plans. Applicants for minor projects should consult the Guide for Minor Projects Manual. Your local Soil &Water Conservation District may be able to assist you in the preparation of plans. A Site Plan-Have your builder, engineer, landscaper or architect provide you with a site plan.The plan should be an accurate drawing to scale showing property boundaries, streams, wetlands and lakes within-100 feet of the property, existing and proposed buildings, driveways,wastewater system,wells, patios and other hard surfaces and the areas to be cleared,filled or graded. Label all buildings as existing or proposed and note any existing buildings to be removed. A Erosion &Sedimentation Control Plan-Show locations of all temporary erosion control devices to be utilized during construction on a copy of the site plan. Minimize the disturbance to land by limiting the area to be cleared, cut or filled and the time period that the site will be worked and de-stabilized. Protect downgradient streams, lakes,wetlands with erosion control devices such as haybales, dikes, filter fabric fencing, etc. Stock piled earthen materials should be protected. Contact the Warren County Soil&Water Conservation District for assistance at 623-3119. A Stormwater Control Plan -Show locations of all permanent stormwater control devices on a copy of the site plan. A Construction Details-The stormwater control device details should include a profile view and construction details of such devices as dry wells, infiltrators, trenches, retention ponds, trenches, etc. (some detail drawings for typical devices are included in the Guide for Minor Projects) E. PERMITS FROM OTHER AGENCIES Other permits or approvals for projects may be required from Federal, State, Regional or Local agencies. Project sponsors should inquire at these agencies as to authorizations which may be necessary before commencing work. The list of agencies which follow is provided to assist project sponsors. It is not intended to mean that a permit is required from the agency, nor does the list include all agencies from which authorization may be required. Warren County Planning Dept Municipal Center Lake George NY 12845 (518)761-6410 Adirondack Park Agency PO Box 99 Ray Brook, NY 12977 (518)891-4050 NYS Department of Environmental Conservation P.O. Box 220 Hudson Avenue Extension Warrensburg, NY 12885 (518)623-3671 Lake George Park Commission Fort George Road, P.O. Box 749 Lake George, NY 12845-0749 (518)669-9347 L•1CRAIG BROWN\TEMPLATES\STWATAPPS\TOWN STORMWATER INSTR.DOC page 3 of 3 Permit Number (town use) Town of Queensbury Application for Stormwater Management Permit Under Chapter 147,Stormwater Management,LL 4-99 THIS APPLICATION IS FOR A Major Project C�Minor Proje 1. OWNER -INDIVIDUAL -PARTNERSHIP -ASSOCIATION -CORPORATION -MUNICIPALITY -AGENCY NAME / 541.4440 PHONE fig 77t 77/i MAILING ADDRESS / y v gl acne CITY Q)Cen5130r•./ STATE IL ZIP CODE Ias-c) q • 2. AGENT -SAMELAS OWNER -CONTRACTOR -ATTORNEY -CONSULTANT -CONTACT PERSON NAME PHONE MAILING ADDRESS CITY STATE ZIP CODE 3. CONTRACTOR -SAME AS AGENT NAME PHONE MAILING ADDRESS CITY STATE ZIP CODE 4. PROJECT LOCATION FACILITY NAME(if not residential) SECTION Z.3 BLOCK i LOT /3/41 STREET m45/ Loot/04,4R r nic ir7?f/A. Ro40 ZONING CLASSIFICATION PR' ' RTY IS PRESENTLY /J/45e74 -PART LY DEVELOPED -DEVELOPED&OCCUPIEDI IS PROPERTY PART OF A SUBDMSION'iNo Yes, ame of subdivision PI, 1 -A' 5. PROJECT DESCRIPTION PROJECT Si Ai&r-L PA-Mn-y T{eS;0c'4Gr PROJECT INVOLVES: Earthwork/Landscaping -Tree Clearing mouse Construction or Addition Driveway Construction Garage Construction -Detached Structure . Septic System -Modification of a Stormwater Device -Other L:ICRAIG BROWN ITEMPLATESISTWATAPPSITOWN STORMWATER APPL.DOC 11/2000 Page 1 of 3 PROPOSED USE kResidential (seasonal) -Residential(year-round) -Association -Public -Commercial PROPOSED STARTING DATE Art I i 2011 PROPOSED COMPLETION DATEPec ( / DESCRIBE THE M THE PROPERTY IN THE PROJECT AREA: 0-5%(Level) 5-10%(Gradual slo - 10-15% (Moderate slope) -Greater than 15% (Steep Slope) IS ANY P ON OF HIS ACTIVITY FOR WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETED? —Yes if yes,please explain) 6. CALCULATIONS &CONTROLS TOTAL AREA OF PROPERTY 310.39 CACR FT2 (circle one) TOTAL AREA OF LAND DISTURBANCE:l 16 O FT2(do not include area of stormwater controls) TOTAL AREA OF NEWLY CREATED IMPERVIOUS SURFACE: ,'&44 FT2 TOTAL VOLUME OF STORMWATER TO BE CONTROLLED: 9146 6 (see instructions) TYPE OF STORMWATER CONTROL MEASURES TO BE USED: V 724-n vt NLD i/a 1 HAS AN EROSION CONTROL PLAN BEEN PREPARED? Yesl Ian is attached PREPARED? --No If no, please contact your County Soil&Water Conservation District or assistance: Warren County 623-3119 7. SITE INSPECTION During the processing of this application town personnel may need to visit this site for the purpose of inspecting, measuring and/or photographing site conditions. I authorize town personnel to conduct such a site inspection.025 9 no I wish to be contacted prior to any site inspection yes 9 no 8. CERTIFICATION I hereby affirm that the information on this form and all attachments submitted herewith is true to the best of my knowledge and belief. As a condition to the issuance of a permit,the applicant accepts full legal responsibility for all damage, direct and indirect,or whatever nature,and by whomever suffered, arising out of the project described herein and agrees to indemnify and save harmless the town from suits, actions, damages and costs of every name and description resulting from the said project SIGNATURE OF 0�N917 / DATE 37g-Y1 /�y SIGNATURE OF AGENT GC // DATE 7v./acil JI INCLUDE WITH THIS F RM: 9 Site location map 9 Project plans on 81/2 X 11 size paper(Submit 4 copies of any plans larger than 11X17) 9 Names and legal mailing addresses of any co-owners of the property 9 Attachment A(for major projects only) 9 Stormwater Control Report(for major projects only) 9 Environmental Assessment Form(for major projects only) Failure to include any one of the required items will result in an incomplete notice and delay in processing your application. Permits and approvals may be required from other agencies. for town use only [SCRAG BROWN\TEMPLATES\STWATAPPS\TOWN STORMWATER APPL.DOC 11/2000 Page 2 of 3 : Ttie project is approved as shown on the attached approved plans and subject to the conditions listed on the attached Sched Approved by T v - on I I Aril 11 Permit Expires- a i s oning Administrator bate CONDITIONS OF PPROVAL /// Call ole Cr Sf-n4/2-•r, . ebAr f nigfn : ' (S wow) `f 1i1 Gid- co�i ems-- . ATTACHMENT A to Stormwater Management Permit Application Permits or approvals required from other agencies Agency Permit or Approval Date Applied Date Issued Adjoining Property Owners List all parcels within 500 feet Tax Parcel Number Name Mailing Address • L:\CRAIG BROWN\TEMPLATES1STWATAPPS\TOWN STORMWATER APPL.DOC 1112000 Page 3 of 3 Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: am/p De.-rt: ((•3 am/pm Date Inspection request received: Inspector's Initials: NAME: PERMIT#: I +to —0 LOCATION: 'S1 M9C1s T23) DATE: R TYPE OF STRUCTURE: Comments: Yes No_N/A_ 4" Building Number Address visible from road Chimney Height/'6°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 I trim 1 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 to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 �� Encloseded Stairs Sheetrock Underside minimum W Gypsum 1 Basement stairs closed rise>4 inches t � Garage Floor Pitched / ,. 31;d . . Garage fireproofing/"/.hour fire door/door closer / `�-k,�-'�`"f �" Qtf Gas Logs in Sealed or Glass Enclosure (� Final Electrical; Energy Saving Light Bulbs 50% `-�� 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 1 0[Temporary/Permanent] v L:\Building&Codes Forms\Building&CodesMnspection Forns\Residential Final Inspection Forn_revised_100405.doc;Revised January 7,2008; Revised 6/26/08;Revised 12/22110, Revised 04/13/11 Final Survey Inspection Dept. of Community Development Town of Queensbury 742 Bay Road Queensbury,NY 12804 Date received: NAME: Cil LOCATION: - a • ' • NNA-sn PERMIT#: J '1-o h7 Final Survey Plot Plan SINIE A• u roved Denied The attached final survey has been received by the Dept. of Community Development. Upon review the surve has been CraigZoning Administrator Notes: • L:\SueHemingv+ay\Bmlding.Codes Inspection.FORMS\Final Survey Zoning Administrator.doc Queensbury Building & Code Enforcement - Residential Final Inslpection Office No. (518)761-8256 Arrive: am/pm Depart: ( k am/pm Date Inspection request received: Inspector's Initials: fff / NAME: 9,6E9/454E3_0 PERMIT* I ''d!� f LOCATION: S/�/ 1. p e K hcod-:# DATE: TYPE OF STRUCTURE S F n Comments: Yes No N/A_ P 4" Building Number Address visible from road �✓/� caJt kA Chimney Height/"B"Vent/Direct Vent Location ✓ Fresh Air Intake ✓� 3 inch Plumbing Vent through roof minimum 18 inches Y Roof Complete/Exterior Finish Complete l Platform at all exterior doors Handrail 4 or more risers Guards at stairs,decks,patios more than 30 inches above grade isty Guard at stairwell at 34 inches or more Vy Guard at deck,porches 36 inches or more � � Handrail Termination at Newell Post or Wall Vj Interior/Exterior Railings 34 inches to 38 inches ✓ / Deck Bracing/Handicapped Ramp Compliant t/ Grade away from foundation 6 inches with 10 feet 6 inch clearance to sill plate V// �(� _ Gas Valve shut-off exposed/regulator 18 inches above •rade �/�r- .f 0. X7'3`." Interior privacy/trim/doors/main entrance 36 inches t� Bathroom/Kitchen watertight / Safety glazing/Window in stairwells safety glazing ✓ Interior Smoke ectors/Carbon noxi Detectors Every level: Eve Bed m. VVV��j/// Outside every bedroom a: / Inter Connected: Battery backup: V / Attic access 30 inches x 22 inches x 30 inches(height)in accessible area t/ / Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents / 1/ Bathroom Fans,if no window �// Plumbing fixtures 0// Foundation insulation to floor/Sticker on Panel \// Duct work sealed properly/Blower Door Test Certification V 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 V Oil Furnace shut-off at entrance to furnace area / V /2227`4C +\� -yba f'�31�-t- FumaceMot Water Heater operating Vy (� 0 Low water shut-off boilerv dw Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs losedSheetrock Underside minimum1.4"Gypsum i, A� 1_ _ _ ^ t`z` /h) Basement stairs closed rise>4 inches kV/f /ALJ,1 �3q•G...d' ,ter w ' Garage Floor Pitched il Garage fireproofing/V.hour fire door/door closer V/ ' 2,�� Gas Logs in Sealed or Glass Enclosure V0 `fes'�% Final Electrical;Energy Saving Light Bulbs 50% 1!V"t5ez— ES ,SIL— Final Survey Plot Plan / Arc Fault Breaker Habitable Spaces I Tamper Proof Receptacles �/ Flex Gas Pipe Bonding V As Built Septic System/Sewer Dept. Inspection Sticker VO / SitePlann Variance required Flood Certification,PlainCertification,if required Okay to issue C/C or C/0[Temporary/Permanent,)_ c— - L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised January 7,2008;Revised 6126/08;Revised 12/22/10,Revised 04/13/11 Town of Queensbury Fire Marshal f` i� 742 Bay Road IG Queensbury,NY 12804 761-8205/7614206 fax 7454437 Factory Built Wood Burning Fireplace/Stove Inspection Report Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's instructions or specifications is allowed. Permit# /4-0177 Schedule Inspection 1°i -111 j Time t U am pm anytime Inspector Name <7 pMb IAddress 4y El A b e f( ho,r'+ ✓1 Rough In Final t_ Appliance Manufacturer b(‘Vr-.-\ 451M Model# S a 311 Masonry Chimney Factory Built Chimney / Flue Size 13 Double Wall_Triple Wall Insulated_ Yes No N/A Comments Floor Protection Clearances to Combustibles (all sides) 1/V\ CoNAell 412) � Safety Strip Installation (fireplaces only) Firestop(s) Vertical Chase Wall Penetration Chimney Clearances to Combustibles "7" Chimney Termination 3 feet above roof penetration; 2 feet above any combustible construction within 10 feet Combustion Air Hearth Extension Mantel(height above f/p opening) Fireplace Doors /Screen (required) White—Building Dept. Yellow—Customer Pink—Pyre Marshal i uta Rough Plumbing / Insulation Inspection Report —36 Office No. (518) 761-8256 Date Inspection request received: c21M Queensbury Building & Code Enforcement Arrive: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: NAME: 3i /A1.cr\ PERMIT ft: LOCATION: 11S I L o G h H i'vt INSPECT ON: / TYPE OF STRUCTURE: Y N N/A Plumbing under slab Rough Plumbing /Nail Plates Plumbing Vent/Vents in Place 11/2 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. for 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/Head 50 P.S.I. for for 15 minutes 4nsulation /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 COMMENTS: n ` 'l4 Rough Plumhing_Insulation Inspeclion_02 05 13 /b-1 01 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Ins ction r quest received: Queensbury Building & Code Enforcement Arrive: J( am/pm 742 Bay Road, Queensbury, NY 12804 Inspectt(r's Initials: NAME: Q rr°6l PERMIT#: / 41 -0/>, LOCATION: of s/ cacKhir-i- INSPECT ON: g TYPE OF STRUCTURE: S fb Y N N/A Plumbing under slab i*Rough-Pluri mg / Nail Plates _ Plumbing Vent/Vents in Place 11/2 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. for 10 ft. above highest connection for 15 minutes Pressure Water Supply Piping 1•�,/ Air/Head 50 P.S.I. for 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 t!/ :_ Ewer Door Test gingILCk# COMMENTS Rough Plumhing_Insulation Inspection_02 0513 Town of Queensbury Building & Code Enforcement � / v-1-ae/ /Q-/3704, Office No. (518) 761-8256 Framing / Firestopping Inspection Report Inspection request r eived: 1/? %-d/ 1 Name: V t 50._(iv,on Inspected on: 7 dg��`,L Location: '967 461kAorq ,C -- Arrive: RENO a.m./p.m. Permit No.: iLf— 677 Inspector's Initials: TYPE OF STRUCTURE:_ED Y_ N NIA COMMENTS: Ataming Attic Access 22'x 30"minimum 1 / /arL Jack Studs/Headers L r� Truss Specification ProvidedBra / 1 _ l Joist hangers ersging / o� Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly Headroom 6 ft.8 A S �� Stairwells 36 in.or more Imo.+ � �—G< tefcu5 4 Exterior Deck Bracing Headroom 6 ft.8 in. Notches/Holes/Bearing Walls �7 Metal Strapping for Notches Top Plate � � 1 '/z(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 D). - 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 /03 a T R.L. Office No. (518) 761-8256 �g ,3 > t ! / Framing I Firestopping Inspection ort Inspection request received: 7/ f Djr y Name: CA I Jnr-tN--- Inspected on: :L4 Al, j, Location: vlic I La LV- t--h , r- M c, & Arrive: i:J;��s . . Permit No.: C L1/ L7 7-7 Inspector's4116-- Initials: TYPE OF STRUCTURE: , z -? : Y N N/A COMMENTS: Framing PV-ELy veli>tJPIa`? t Attic Access 22"x 30"minimum Jack Studs/Headers V7 / Truss Specfcation Provided ) t� CO PAB—ET to 1-P3 .9 BP-At t p._j Joist hangers / FL-0P--- BRI D6`3G, 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 I Bearing Walls Metal Strapping for Notches Top Plate V 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 r ce and water shield 24 inches from wall_ 1 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 I Firestopping Inspection Report Town of Queensbury Building &Code Enforcement h urs / -3 Office No. (518) 761-8256 Septic Inspection Report Inspection request received:,, //�� Name: cS ci evte r., Inspected on: (2 — /4--11 Location: `/ 57 L o e K her•+ Arrive: ‘t-0 a.m.I p.m. Permit No.: / '--d '''J Inspector's Initials: diff-a---)� Comments andlor diagram Soil Type l�l 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 1,6C> ft. Length of each trench --(5 ft. Depth of trenches Size of Stone — •� Seepage Pits' Number Size: Stone Size: Piping Size Type Building to tank 4a `,� . 1 Ni Tank to Distribution Box d i sj5 _ Distribution Box to Field I Pit `r f"t� Opening Sealed: N End Cap N (7C ! Inlet/Outlet Pipes&Baffles N V G (/q��1� Manholes 12"or less below grade Y A £ _n ez c [provide extension collar if Yes] Y_N J 4 Location 1 Separations Foundation to tank Zb ft. Foundation to absorption J.:to ft. Separation of Pits Conforms as per Plot Plan _ N„ Engineer Report and As-Built Y ETU Maintenance Contract provided Y N Location of Systema is erty: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Apt.. -d • e pproved .•. needs to be re-inspected, please call the Building&Codes Office e.-6 Septic Inspection Report ikes 9--if Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Ins cion r uest received: Queensbury Building & Code Enforcement Arrive: /(J?3r am pm 742 Bay Road, Queensbury, NY 12804 Inspecto 's Initla _ _ n 4t7 NAME: GF.Q rn67 /1 PERMIT#: .f - O ) LOCATION: C{ 5I Co C t< Y1P4' (`(\-\-(\ � INSPECT ON: Co --1O/4/ TYPE OF STRUCTURE: S F C) V PluN N/A mbing under slab gRough Plumbing /Nail Plates Plumbing Vent/Vents in Place 11/2 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. for 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/Head 50 P.S.I. for 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 f7 COMMENTS: �[ 1�; 1 C__ Ft5Q-e--AA —t� Rough Plumbing_Insulation Inspection_02 0513 Rough Plumbing / Insulation Inspection R portdQo--t -3 Office No. (518) 761-8256 Date Ins ectia quest received: Queensbury Building & Code Enforcement Arrive: , afipiv742 Bay Road, Queensbury, NY 12804 Inspector's nitiais: ,NAME: SQQ MOA PERMIT#: fl—D 1?7 LOCATION: 4-161 1-,DC k ,n &d INSPECT ON: 14 --(e—fl TYPE OF STRUCTURE: Y N N/A vllumbing under slab Rough Plumbing/Nail Plates Plumbing Vent/Vents in Place 11/2 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. for 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/Head 50 P.S.I. for 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 COMMENTS: Rough Plumbing_Insulation Inspection_02 0513 1h 1 -3 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection reJ4tpart: Queensbury Building&Code Enforcement Arrive: 4,o . * h am/ m 742 Bay Rd., Queensbury, (n NY 12804 Inspector's Initials n/� NAME: S CI..1 P&O A ERMIT#: /Y-0 / / LOCATION: (f 51 L 0' h{ h qr'-4 in-4-n INSPECT ON: J —.-779— I y TYPE OF STRUCTURE: 5 FD t _ , , 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 Wate . e a rl 11_ootin! D ra It ayli l .rump 71/ g� To�� VV NI Footing Drain Stone: �� --\M \ 12 inch width ' 'S'' LA6 inches above footing C�*lAv 6 mil poly for wet areas under slab ��t1\ ik T ac 111�Aprovalzjil 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 Forns\Foundation Inspection Report.doc Last printed 12/18/2013 2:44:00 PM d /--3 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/pm Depart: 1 On/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initial � 3 J NAME: S 4 MO ✓1 PERMIT#: 11- 6;t> LOCATION: q SI kno j( heft- (Ti-I->7 INSPECT ON: S- a B'(y TYPE OF STRUCTURE: S F 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 („(�.�..� 1Fc ' Footing Drain Daylight or Sump \A-3 !v FootingStone: VVV/r p ` �%_ N72 ` 12 inchh width N"t� G 6 inches above footing 6 mil poly for wet areas under slab / J orronnb-vroz4 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 12/18/2013 2:44:00 PM kte-sclayost? Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/pDepart%L/ m/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:: NAME: C( SM0/1 PERMIT#: P1- 0?) D2 LOCATION: ct 67 / ,d ate haze4 INSPECT ON: 5-aa-ry TYPE OF STRUCTURE: S F D 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/ in Pour 7,:k3 'a Reinforcement in Place � d� Footing Dowels or Keyway in place 7----446 �7-�, ' �JA., 5 VI_�_S 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 12/18/2013 2:44:00 PM Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: te//7i�C� Queensbury Building&Code Enforcement Arrive: am/pm Depart, gm/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's lnitialsy`l L '[L � NAME: SA- LOA/ PERMIT#: g -67 LOCATION: — 4% - INSPECT ON: 7. 1 TYPE OF STRUC -10 Comments Y d N N/A 4footings 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 I Wallpour ,f Reinforcement in Place 9� / Footing Dowels or Keyway in place Foundation Dampproofmg Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes forms\Bulfding&Codes\Inspedion Forms\Foundatfon Inspection Repo tdoc Last printed 12/20/2005 9:24:00 AM