2013-060 TOWN OF QUEENSBURY
ET
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130060 Date Issued: Wednesday, August 21, 2013
This is to certify that work requested to be done as shown by Permit Number P20130060
has been completed.
Location: 99 RICHMOND HILL Dr
Tax Map Number: 523400-308-007-0001-060-000-0000
Owner: TRA-TOM DEVELOPMENT INC
Applicant: TRA-TOM DEVELOPMENT INC
This structure may be occupied as a:
Fireplace By Order of Town Board
Garage Attached TOWN OF QUEENSBURY
Single Family Dwelling
Issuance of this Certificate of Occupancy DOES NOT relieve the property
owner of the responsibility for compliance with Site Plan, Variance, or -•,..52t
other issues and conditions as a result of approvals by the Planning Board Director of Building& Code Enforcement
or Zoning Board of Appeals.
1
TOWN OF QUEENSBURY
114,1*, 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130060 Application Number: A20130060
Tax Map No: 523400-308-007-0001-060-000-0000
Permission is hereby granted to: TRA-TOM DEVELOPMENT INC
For property located at: 99 RICHMOND HILL Dr
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: TRA-TOM DEVELOPMENT INC
677 STATE ROUTE 9 Fireplace
GANSEVOORT,NY 12831-0000 Garage Attached
Single Family Dwelling $125,000.00
Total Value $125,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
THOMAS FARONE & SONS INC.
RD#2 #36 FIELDSTONE
GANSEVOORT,NY 12831
Plans&Specifications
2013-060
Single Fam Dwelling- 1st Flr 948 sq ft; 2nd Fir 835 sq ft
Garage 144 sq ft; 1 gas fireplace
$406.60 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,February 26,2014
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town ofQ`e tYSu• i ,
•ary 26,2013
SIGNED BY - for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY
TAX MAP N0. g , II
Q l-Ca � PERMIT NO. / 3 '0 CaD _FEES: PERMIT � I'ORECREATION i�U ENGINEERING �`gate
tamp
fiA-4- S� (If applicable)
PRINCIPAL STRUCTURE:
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER: • i Ise f- ti S +`rte;J ;�� SokN,“DWNER: l
ADDRESS: G �:�` c.ic , IV) ,c 1 1 3 1. ADDRESS: (`i R c Y� ra�.�.�.`1
PHONE NOS. 86 - 3 (Q& - c T G: c_t= S )-ms3cpHONE NOS. . s;) -s o
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: ��,;, ��.��{\ PHONE:3.--5S- 3(,., (,_,
LOCATION OF PROPERTY: 9 9 k ,\• r n \..\\ D.f ,
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL?%YES ❑ NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT Z
�r � O o
UwAPPLY TO YOUR Z O O PROJECT E Q 02IT OO "-1ZIll Q a c
Z < <
N CO OLt Q Z 0.S
SINGLE FAMILY y
35. / 7s3 3� F }-
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: J:.V 1 oo L ac FUEL TYPE: N r\ :,\
HEAT TYPE:IAA .1'. *HOW MANY FIREPLACE(S): 1 AND/OR WOODSTOVES(S):
ZONING CATEGORY: RFs ARE THERE WETLANDS ON THIS SITE? Al/fl,
IS THIS A HISTORIC SITE? 41.)1,4_
PROPOSED USE OF BUILDING OR ADDITION: 1..',,,
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
B 3-LGL 11-05
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? AI
ARE THERE EASEMENTS ON PROPERTY? /Ur)
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above. _
Signed •
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes
or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
BUILDING & CODES APPROVAL ZONING APPROVAL
DAT DATE
-,
QUESTIONS? CALL 761.8256 OR EMAIL
codesa.aueensburv.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
Operating Permit Issued: Yes No www•queensburv.net
Occupancy Type: ''-2j Construction Classification: st() .,--V--
Assembly Occupancy Limit: Special Conditions:
t 1 3.o6U
Revised 4/14/2010
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building &Codes Office for the issuance of a Building & Use Permit pursuant to the
New York State Fire Prevention & Building Code. The applicant or owner agrees to comply with all applicable laws,
ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter
premises to perform required inspections.
Important Note To Applicant: Rough-In and Final Inspections Are Required:
Owner::Tti s c.:. e - Installer/Builder: 1\.c>!--o,-3
Address: 9`\ Address: 1 C7,4S.Jc0kan
r�, �Y
Phone Nos.: ��S .- �� �_ Phone Nos.: -7 -SO.
Location of Property: 11 tic\t•\\ '.-‘,Subdivision Name:- r,r r�.ctis �'�
Location of Proposed Construction and/or Installation: .1%-
Contact
Contact Person for Building &Codes Compliance:
- Fuel Burning Applicance Wood :Coal Pellet - Gas Oil
Information
Stove
Fireplace Insert
Fireplace,factory built*
Fireplace, Masonry
Furnace, (Garage Only)
* If Factory Built, Please Provide: Manufacturer Name: Model No.
Listed By: Number:
Chimney Information BLOCK BRICK STONE
Masonry** Check One,/
TILE STEEL SIZE IN
INCHES
Flue Check One ✓
DOUBLE WALL TRIPLE WALL INSULATED DIRECT CHMNEY
VENT LINER
Chimney Material Check One,/
** If Non-Masonry, please provide: Manufacturer Name: L.e..ni N o Model No.
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* Community Development Office*742 Bay Road, Queensbury NY 12804
tO }V`14"j61.6
bf) 13 'e/0v
Revised 4/14/2010
Town of Queensbury
Highway 2013Michael F. Travis
r
Department Highway Superintendent
742 Bay Road, Queensbury, NY 12804 Home (518) 798-0413
Office Phone: (518)761-8211 Thomas R. Vanness
Fax: (518) 745-4466 Deputy Superintendent
Home (518) 745-0929
www. Queensbury.net
DRIVEWAY PERMIT
Date: e h 7 101--
Applicant Name: MAc, e-- �e)+v,
Address to be inspected: 99 ,
Return Address: R a .a r � C cor4>-eu G 't N .
Y. 1 '1631.
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
(4 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 inspections completed by: Date:
Approved by Higway 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* Community Development Office* 742 Bay Road, Queensbury NY 12804
r -5 tt /� ; 1
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: I \ i am/pm
Date Inspection request received: Inspector's Initials:
NAME: .PERMIT#: / ,3�7(��(i
LOCATION: 67 / R , t� i-f--w DATE: y --A.,), --y. =i
TYPE OF STRUCTURE: S .F
Comments:
Yes/No N/A
4" Building Number Address visible from road t/,
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete!Exterior Finish Complete %J
Platform at all exterior doors V
Handrail 4 or more risers
Guards at stairs,decks, patios more than 30 inches above grade V
Guard at stairwell at 34 inches or more
Guard at deck, porches 36 inches or more
Handrail Termination at Newell Post or Wall Y
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant f
Grade away from foundation 6 inches with 10 feet V
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertightK .
Safety glazing/Window in stairwells safety g :r ing
Interior Smoke Det ors/Ca n MMonoxi• Detectors
Every level: J Eve ed m: /
Outside every bedroom a a:
Inter Connected: Battery backup: ��ff /
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 / Vi
Bathroom Fans,if no window 1/!
Plumbing fixtures t// Z -' \5&
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly I Blower Door Test Certification ✓ / qC)
��� �1Floor truss,draft stopping finished basement 1,000 sq.ft. ✓ L
Emergency egress below grade /
Gas Furnace shut-off within 30 feet or within line of site Y 1// .t?-5-rki4rj�A
Oil Furnace shut-off at entrance to furnace area /
Furnace/Hot Water Heater operating �/
Low water shut-off boiler /
Relief Valve(s)installed/Heat Trap/Water Temp 110 �J
Enclosed Stairs Sheetrock Underside minimum'/"Gypsum
Basement stairs closed rise>4 inches %Z., k.7
Garage Floor Pitched
Garage fireproofing/'/.hour fire door!door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical; Energy Saving Light Bulbs 50% ✓ 1
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles I/.
Flex Gas Pipe Bonding ✓
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification, if required If`]
J./
Okay to issue C/C or C/0[Temporary/Permanent]
L:1Building&Codes Forms\Building&Codeslinspection Fozms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08;Revised 12/22/10, Revised 04/13/11
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p Depart: ` am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: 1_A
L „At-
PERMIT
NAME: 2-✓ 1 lcs' �� PERMIT NO.: / (d" - s'." ' eP(67-
LOCATION: cri i2-t�% 'r"u�Iv) tV'�•�t.` INSPECT ON: 1.41418
RECHECK:
Comments and/or diagram
Soil Type: Sand / Loam/ Clay
Type of Water: Municipal/ Well Water
Waterline separation distance ft.
Well separation dista . e ft.
Other w= Is: ft.
Well Casing Le •i 50' / - Y N N/A
[150'to wel r- uired i NO]
Absorption Field: ota length ft.
Length of :a trench ft.
Depth if trenches ft.
Siz. of Stone
Seepage P' Number
Size: x
Sto e Size:
Piping Size Type
Buildi g to tank
Tank to Distri• ion Box
Distribution Box to eld/ Pit
Openin! Sealed: Y N
!End Cap N
Inlet/Outlet Pipes &Baffles •,�_,_Y N
Manholes 12"or less below grade _Y_ N
[provide extension collar if Yes] _Y N
Location/ Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
• . . per Plot Plan _N
E,gineer Re•.. and As-Built Y— N
-Nt u tenance Contract _Y_ N
/ provided
Location of Sy Property:
Front ear Left Side Right Side Middle Front Middle Rear
System Use Sta s:
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Bullding Codes Forms\Inspection Forms\Septic Inspection Report03 29 10.doc
RX Date/Time 08/2012013 15:40 P.002
- •;q?'2Q/2413 TUE 3: 38 FAX
002/043
•
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-8511
20/3 August 20,2013
Job#46170
New York State Dept. of Health
77 Mohican Street
Glens Falls,NY 12801
RE: Barringer Heights Subdivision- Queensbury(T)
99 Richmond Hill Drive(Lot#13)-Septic System
Dear Sir/Ma'am:
This letter is to inform you that we inspected the completed septic system for the house on 99
Richmond Hill Drive(Lot#13)in the Barringer Heights Subdivision on August 16,2013.
The septic system as installed was for a four bedroom house and consisted of a 1,250 gallon
septic tank and 225 lineal feet of absorption trench constructed with stone and perforated pipe.
The system conforms to the requirements of the approved subdivision design drawings.
PIease call me if you have any questions or concerns.
Sincerely,
Thomas R. Center Jr. ,PE
cc: Dave Hatin,Town of Queensbury
Tom Farone
RX Date/Time 08/20/2013 15:40 P.001
01720/2013 TUE 3: 38 FAX 21001/003
6
NACE ENGINEERING, P.C.
169 Haviland Road, Queensbury,NY 12804
Phone-518-745-4400 Fax -518-792-8511
Fax
To: Dave Hatin From: Tom Center
Firm: Town of Queensbury Pages: 2
Fax: 745-4437 Date: August 20,2013
Re: Barringer Heights Subdivision Job#: 46170
• Comments:
Inspection letter for Lot 5& 13 for the Barringer Heights Subdivision.
PIease feel free to give me a call if you have any questions.
Tom C
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury, NY 12804
Date received: S
NAME: *QI - _
LOCATION: 90 L° v..4,
PERMIT#: 3 ^b[G
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has been:
(JD
Craig Brown, Zoning Administrator
Notes:
L:1SueHemingway\Building.Codes.Inspection.FORMS\Final Survey
Zoning Administrator.doc
MAP REFERENCE:
SUBDIVISION MODIFICATION
SUBDIVISION PLAN
THOMAS SCHIAVONE
DATED: JANUARY 9, 2003
LAST REVISED: DECEMBER 17, 2009
BY.. NACE ENGINEERING P.C. and
VAN DUSEN & STEVES LAND SURVEYORS
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169 Haviland Road
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AGENCY AND I GINGIfjS1NUInQ4 BETS HEREON. AND
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(518) 792-8474
New York
Lic. No. 50135
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Septic
Inspection Report
Office No. (518) 761-8256 Date Inspects request received: 1 1 s-1( 3
Queensbury Building &Code Enforcement Arrive: it/ am/pm.A A Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ( �7
NAME: 0'1 - 2 - O( v PERMIT NO.: 1 )
LOCATION: CI R(at. rv,,c,.,,i (71-k L(pc- lLc, INSPECT ON: 3/j-I i 5
RECHECK:
Comments and/or diagram
Soil Type / Loam/ Clay
Type of Water: M ci / Well Water
Waterline separation distance a.4ft.
Well separation distance ft.
Other wells: A/4- ft.
Well Casing Length 50' + / - Y, ,/ N N/A
[150'to well required if NO]
Absorption Field: Total length _s72�6) ft.
Length of each trench 5.5` ft.
Depth of trenches 2-3 ft.
Size of Stone ',
Seepage Pits: Number _74,.
Size: A
Stone Size:
Piping Size illype
Building to tank 4,/` vc
Tank to Distribution Box y" j)(z
Distribution Box to Field/ Pit Y" 3 d1'-
Opening Sealed: (Y_N
End Cap Y_ N
Inlet/Outlet Pipes&Baffles ,Y , N // /^r ,4/ /2 a CO- iegr'
Manholes 12"or less below grade )6Y_ N /4 i fig- v
[provide extension collar if Yes] _Y X' N
Location/ Separations
Foundation to tank l a ft.
Foundation to absorption 3-7,-- ft.
Separation of Pits ft.
Conforms as per Plot PlanY N
Engineer Report and As-Built _Y'N
ETU Maintenance Contract _W/ N L -
provided �'" /Veld r
Location of System on Property:
Front Rear 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
L:\Pam Whiting\2010\Building Codes Forms\Inspecction Forms\Septic Inspection Report03 29 10.doc
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Rough Plumbing 0 Insulation Inspection ReP` rt
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm Depart: t /am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: I
NAME: . C m PERMIT #: 1.3 - op c)
LOCATION: `Le ' � � -1+= f' INSPECT ON: .6 -31- 13
TYPE OF STRUCTURE: 3 F A
Y N NIA
Rough Plumbing /Nail Plates
Plumbing Vent/Vents in Place
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain/Vent
Air/ Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
50 P.S.! for 15 minutes
Insulation/Residential Check/Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct I Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/ No duct tape
COMMENTS: (C-- `J7
Q- %1 uLyymivP
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
Rough Plumbing / Insulation Inspection Report 0"
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: _ am/pm Depart: .* ; m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: _4.
NAME: Ira_--1/ M _ PERMIT #: ( 3 - 0100
LOCATION: ?' f j INSPECT ON: S- (- L3
TYPE OF STRUCTURE:
Y N NIA
•
_Rough Plumbing / Nail Plates
Plumbing Vent/Vents in Place •
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I change of direction
Pressure Test
Drain I Vent
Air/ Head
5 P.S.I. or 10 ft. above hi hest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.I for 15 minutes
Insulation / Residential Check/ Commercial Check
_yvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct / Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
COMMENTS:
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7, 2008
Framing 0 Firestopping Inspection Report Gt( S I— 3
Office No. (518) 761-8256 Date Inspection request received: --a`)
Queensbury Building &Code Enforcement Arrive: am/pm Depart'? ._
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: jX & 9 C� u PERMIT#: j 3"o( o
LOCATION: • s ` I
� �� .. �: �A . ��IP r i INSPECT ON: e a
TYPE OF STRUCTURE: F
NIA COMMENTS:
Framing \/
Attic Access 22" x 30" minimum
Jack Studs/ Headers 71;-
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
Anchor Botts 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 '/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space 1 Bedrooms
24 in. (H)
20 in. (W) �'
5.7 sf above / below grade
5.0 sf grade
L:\Building&Codes Forms-OLDBuikiing&Code inspection Fstms\Framing Firestopping Inspection Repori.doc Revised January 7,2008
Iuas C1—
Town of Queensbury Fire Marshal
IftiM 742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas 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.
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Permit# /3--moo Schedule Inspection Time � am pm anytime Inspecto
Name (QL- t Addressccikci to
Na41 lI Rd Rough InX Final
Appliance Manufacturer t,, ` Model# 7 IJ(
Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated
Yes No N/A Comments
Floor Protection 1/
Clearances to Combustibles (all sides) V/
Firestop(s) Vertical Chase
Wall Penetration
Vent Clearances to Combustibles
Vent/ Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above any combustible
construction within 10 feet
Gas Shut-Off Valve /4(
Combustion Air
Hearth Extension (if any)
Mantel
Height above f/p opening
Witness Operation
-
Tank Placement (if LP)
CO Detection
r�
CSST Bonding
White—Building Dept. Yellow—Cust Amer Pink—Fire Marshal
e61 Ib is
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart/:fD 1 am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: V Lo
NAME: 1 R ��D (Y\ PERMIT#: /3- b too
LOCATION: C 1I-S. LPq„ ,,J 4-:' Le INSPECT ON: S-
TYPE OF STRUCTURE: 5'F,) g
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/Wailpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
} incheve footing
6 mil pol tot wet areas under slab j.
B:1 • pproval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Framing / Firestopping Inspection Report o n 6l C
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: _am/pm part: ,-- am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: �`�
NAME: , 1 !tom s PERMIT#: / 3 -0100
LOCATION: . INSPECT ON: A 3
TYPE OF STRUCTURE: `--
N N/A
COMMENTS:
Framing
Attic Access 22" x 30" minimum
Jack Studs/ Headers
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 Botts 6 ft. or less on center 7--.
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour `s
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity miry.
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 I Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above / below grade
5.0 sf grade
L:\euilding&Codes Fom s-CU:Muilding&Codeskinspe tion Fomts\Framing Firestopping Inspection Report.doc Revised January 7,2008
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Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: s m
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial
NAME: , r�C�� . PERMIT#: I Q (`;
LOCATION: C C a, „, a INSPECT ON: _ ___I
TYPE OF STRUCTURE:
Comments
Y N
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
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
� h uAA . 16-fa
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart:if. .� am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: r (/ U
NAME: t Q ►'Y1 PERMIT#: i 3 --,c)(0 6
LOCATION: 9 9 INSPECT ON: -y-- /3
TYPE OF STRUCTURE: .3 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 I
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
uD ecL g - 0
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Dep . ' - am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
92sC7
NAME: ltS-'� � D e.t of- PERMIT#: / 3 —04_0
LOCATION: (-tie? rs I(\ ��j INSPECT ON: 3 — a - LI
TYPE OF STRUCTURE: 6 Ffi
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
7-0
Reinforcement in Place (—L4
� #Lk
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 Fors\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Nona 615 - w
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: t :
NAME: COL -1 PERMIT#: ��D
LOCATION: Q Crlr OA/k, 47' INSPECT ON: ?, / g --13
TYPE OF STRUCTURE:
Comments
Y
Footings texiA
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for ✓� �
providing protection from freezing
for 48 hours following the placement U
••
;? eco►creta, R 6 ,L�
aterial• for this purpose on site.
F. 1. /Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R
Rough Grade 6 inch drop within 10 ft.
•
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM