RC-000472-2016 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-000472-2016 Date Issued: Monday, November 28, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000472-2016
has been completed.
Tax Map Number: 301.13-2-53
Location: 12 Whispering Pines Way
Owner: PATTEN PROPERTY DEVELOPMENT,LLC
Applicant: Chris Patten
This structure may be occupied as a: Single Family Dwelling w/FP 1843 s.f.
Garage 462 s.f. By Order of Town Board
Tyneswood Lot 51 TOWN OF QUEENSBURY
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.
r' TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
1
BUILDING PERMIT
Permit Number: RC-000472-2016
Tax Map No: 301.13-2-53
Permission is hereby granted to: PATTEN PROPERTY DEVELOPMENT, LLC
For property located at: 12 Whispering Pines Way
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
Tome of Construction
Owner Name: PATTEN PROPERTY DEVELOPMEN[713j4EFamily-New $160,000.00
Owner Address: 7 Jackon RD Total Value $160,000.00
South Glens Falls,NY 12803
Contractor or Builder's Name/Address Electrical Inspection Agency
PATTEN PROPERTY DEVELOPMENT,LLC
7 Jackon RD
South Glens Falls,NY 12803
Plans&Specifications
Single Family Dwelling w/FP 1843 s.f.
Garage 462 s.f.
Tyneswood Lot 51
$ 487.90 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,July 21,2017
(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 expiration date.)
Dated at the Town of�aeetrs ury; n 4Fuesd (J 26, 2016
SIGNED BY: ` ��1��/ for the Town of Queensbury.
Director of Building&Code Enforcement
PKINCIPAL STRUCTURE APPLICATION Office Use Only
Date: — ]' ZO ' 6
Permit No.
Tax Map ID301 , 13 -Z - S 3 Permit Fee �
Zone j'I/1 pfz�_ Historic? _Yes t,-fq_0 Rec Fee
Subdivision Name ( cgj Lot# Site Plan# �►vivo tt� In
Subdivision#
Project Location 12 Q ,a,
TOWN BD.RESOLUTION 86-2013: $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 feels).
Primary Owner(s) �7�.1 J _ Z
Address –7 ll� &
S � ` 3
Phone/Email �6 y�sy
Applicant //�� ��
Vin
Address
Phone/Email
Contractor 4a 411)
Address 1-7
Phone/Email /�
Contact Person for Building& Codes Compliance: (?)VO 0 Phone 16 –I/GJ�
TYPE OF CONSTRUCTION
✓Check all that apply New Addition Alteration 13'floor sf 2'floor sf Total sf Height
Single Family
Two-Family
Multi-Family
(#of units
Townhouse
J, .
Business Office J
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+) L
Other
Town of Queensbury Building&Codes Principal Structure Application revised January 2016
If commercial or industrial please indicate name of business /Vfi
Proposed use of building or addition 51 n-
Source of Heat(circle one) Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances & Chimneys
Are there structures not shown on plot plan? A6
Are there easements on the property? A4
Site Information: I
a. Dimensions or acreage of lot IL10 y/ a
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) FUR ic Private
e. Sewer or Private Septic System(circle one) ewer rivate
Value of all work to be performed(labor or materials) $
DECLARATION.
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. I certify that the application, plans and supporting materials are a true and complete statement /
description of the work proposed, that all work will be performed in accordance with the 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 /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:
PRINTNAME: AS it DATE:� )/ a6L
I U 16
SIGNATURE: DATE: VIS
For office use only
Operating Permit Issued: _Yes —No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
t°�,U5 Zt,w
Fuel Burning Appliance & Chimney Application Office use Only
Received
DATE: 1����� Tax Map ID
3-Z —S� Permit No. 9-C-4-4-2--LOA i
TAx MAP ID: NOl � Permit Fee
ZONE:
OWNER C PHONE/E-MAIL
ADDRESS !
INSTALLER/ PHONE/E-MAIL
BUILDER W14
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: �l
PHONE/E-MAIL -71(t 4 U N BUILDING ADDRESS PI Y`q
ROOM OF INSTALL: L I ✓ r I .gp-wv PLANNED INSTALL DATE: 7V r
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: . i ; Model#: Vy
Listed by: Number:
CHIMNEY INFORMATION
Masonry** (check one) _BLOCK —BRICK _STONE
Flue TIE OL STEEL �Sizein 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.
I HAVE READ AND AGREE TO THE ABOVE: �/
PRINTNAME: IJ DATE: / 11rll"5°
SIGNATURE: DATE: r��/c/
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
SEPTIC DISPOSAL APPLICATION Office Use Onlv
Received
DATE: I$ (O Tax Map ID
TAX MAP ID: `�b , 13-2 `S 3 Permit No. R-G- '1-L - Z'04(p
O
ZONE: Permit Fee
I��
APPLICANT �q /yu �,,— PHONE/E-MAIL
ADDRESS 'jwCl'tS� Q�
INSTALLER/ 0. ` ^ PHONE/E-MAIL
BUILDER /4S 6)0
OWNER
ADDRESS SfIm 0
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: ,3 t
PHONE/E-MAIL _716 LI(054'( 9/1$ '�944. ' p_ -
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older 3 I IC) Garbage grinder installed Yes K_No
1981-1991 Spa or Hot Tub installed Yes KNIO
1992-Present
PARCEL INFORMATION
Topography Flat rolling _Steep slope %Slope
Soil Nature oC Sand Loam Clay Other
Groundwater At what depth: ;VA 1Z,-'_
Bedrock/Impervious material At wh epth: *(
Domestic Water Supply Municipal Well(if well,water supply from any septic system absorption is_ft.)
Percolation Test Rate: ),-'2-r per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size LRD 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 I1,,b ft.;Each Trench
Seepage Pit with#3 stone How many: le�nA;Size
Alternative System Bed or other type: //X
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 Ordinance.�
PRINT NAME: rlj DATE: ( / /9-//&
SIGNATURE: DATE: :71116-11&
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
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 Duell
Deputy Highway Superintendent
Home: 518-745-0938
DRIVEWAY PERMIT
Date: wa kApplicant Name: u P lv —C� riS y'o'9
Telephone No.: -7
Address to be Inspected 7" LN hiSP '^I PlAt'i vlkl
Return Address: 7 ILL�36 k s[-GeA a :16 ���''�
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 301.13-2-53 RC-000472-2016
Patten Property Development LLC
12 Whispering Pines Way
NEED ( ) Slight Swale Tyneswood, lot 51
( ) Deep Swale SFD w/FP 1843 s.f., Garage 462 s.f.
O 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
Town of Queensbury Building&Codes Principal Structure Application Revised January 2016
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DAILY TIME SHEET
PROJECT NAME: DATE:
JOB#: . . LOTS
TBcM ,, . . CONTRACT. ,
SCOP PIT OTHMR
OR RATE
TtYr��
EOUIP1oiE1�'I' HRS 1iA TnT�i .
PREPARED BY: i r'
THERMAL Amm
Quality. Comfort. Satisfaction.
Thermal Associates
21 Thomson Ave.Glens Falls, NY 128ot
518.798.550o Fax 798.5620
Patten Property Management
7 Jackson Road
South Glens Falls, NY 12803
518-796-4654
We, Thermal Associates, performed a blower door test at the project at 12 Whispering Pine Way,
ueensbury, NY, to determine the air changes per hour, for Patten Property Management on November 22,
2016.
Testing procedure performed as per ASTM E779.
The result of the test is: ( 1,775 CFM50 x 60 Minutes) / ( 34,150 cubic feet ) _
3.11 ACH50
Test conditions were as follows:
35F outside air temperature
62F inside air temperature
1.5 PA baseline pressure
-46.8-51.7 PA testing pressure
1102.4.3.1 Testing option.Building envelope tightness and insulation installation shall be considered acceptable when tested air leakage is less
an seven air changes per hour(ACH)when tested with a blower door at a
lressure of 33.5 psf(50 Pa)as verified using instruments and procedures specified in ASHRAE/ASTM E779.The test shall be conducted by a
ualified person,who shall demonstrate competence to the satisfaction of the code
nforcement official for the conduct of such tests. For the purpose of this section,ACH50 shall mean air changes per hour of infiltration into a
ouse as measured with a blower door at 50 pascals of pressure, in accordance with
SHRAE/ASTM E779.Testing shall occur after rough in and after installation of penetrations of the building envelope, including penetrations
or utilities,plumbing,electrical,ventilation and combustion appliances.
uring testing:
1. Exterior windows and doors,fireplace and stove doors shall be closed,
ut not sealed;
7. Dampers shall be closed,but not sealed,including exhaust,intake, R-c .-A 2"b
akeup air,back draft and flue dampers; -1, ;—
. Interior doors shall be open; D IE (C' C I I
. Exterior openings for continuous ventilation systems and heat recovery -±-�
entilators shall be closed and sealed;
. Heating and cooling system(s)shall be turned off; -
HVAC ducts shall not be sealed;and
Supply and return registers shall not be sealed. TOWN OF OLJE=NSF '
BUILDING
Adam DeVit
Blower Door Tester
Thermal Associates
www.thermalassociates.com
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
?-C.-4'}Z. 7A I �0
Permit No........................................Cert.NO 44831 Cut-in Card No.....................................
Owner..........yP.........3�Z/GZCF- 2..................................................................
..............................
Location..J/...Z✓...4.161 A&. rn-./.... il.. ...../..�1 .....�!L�7 T ... 11..
Installation Consisting of.3..�..?... l..t it. -4;.- ..�;zln '�............
Fd j..., �/G,,....A.... ...�;e�.. �c�f.41is. ., .s.t?.............................
.................................................... Q......... ..................�.....................................................................................................
Installed By....�1..�k..17: PX-12-4a/ 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 'nspections at any time, and if its
rules are violated,the Company shall have the right to r v*e this ificate.
Date.... 1-1..a...:>/ ........... INSPECTOR.......:.. ,"....... .... ... ........
Member N.F.P.A.,I.A.E.I.
V6-jVoll V�
Capped Iron i
Rvd Found
ZONIIVGREQUlRhMENTS:• 1
Zoned.......................:..:......:MIJIZ
Lot Size........::::::::::.::::::::::::.2 acres
AfilziMum Lot Width::::::;,A0'
Minimum Setbacks
� Y1Llj�jam' er'Mg Pines �q� Front 30'
`S� YfC�� Side....
560,0'to Ca Iron WV Rear......:..........:.........:...25
peed fear Rdd Foitritl Rod Set o ,; Capped b-dii
5831.�do F ��
Cable 7 V .Electric Box 140.00' Rod Found — —
Pedestal Telephone
- �IaterShut DEEDREFERENCE.
Pedestal Offro
1�✓Z�'p Re€erertce 2 ----�-"�`-----_ �' ro•� +�Wood Stvrkade Fence •�i
Clear byL1-'4o
\ ~ 1, Conv .ancetoPatenPro er Development,LLCb
y p.. �,Develo p y deed
Covered "Q �y dated July 07,2016,hied M the Warren County Clerks
S� Concrete 151 Office on July,11,2016in BcokMV'ofDeeds atPage 68.
Cas Meter -01
Porch 00 �
I
22
N06045V0'B • o NGarage; N -'4 MAPREFEREIVCES.•
Lands Now of Fgrmerly p1- 15000' : :• Electric 20 70 SectiorrofLandOPJnes
Meter >29' Wood Stockade 1, Map entitled il4APbf
Res duce Pc� ` ence alongPraperfy Subdi[riston,prepared by Coulter and McConnaek,dated
James Baldauf Lorraipe Covdp
• BJackto,v:' M O O Line (2� (� (� f pecember8,1990,filediri the Ylrar'en CountyClerlF's Office
A!C Unit LE Vu L5 197D
Dnveivay,. {r on Derember2,3,
Book 3998 P.age 144 vim, Londa Now or FQrMerly
Driveway Comer'0,35 5 0'>: . ° r., ,
01.15]-2-54 ClearofPropertyLine • 41.8' O r ��, 2. Mapenttitled'AMPofSecdonNo:5,LandOTMes,
I Chimney iP Ile Mtilready, J4:_ Tin- a 'vov 2 2 ;� prepared by Coulter AridMcCormack,datedFebruary23
Wood Stockade Overhang 1.984,filed in the Warren County Clerk's Office on December
gook 1-176 Page 28- 18,1.4 ?
Fence Clearby0.55' TOWN OF QU ENSBURY
SepticArea 3D1.13T8- 2 BUILDING&I CODES
(approx per 1VIA1'NOTES
Coritractov Shed Corner
AREA=21-000+s R.. rClearby0.9
Wood Stockade Fence rFol
Rod ! L Boundarymformation sho. n hereon was eompiled from an actual held survey
Corner Clear by 0.75' d Capped Iron conducted on November 6 2012 acid Map References 1&2.Fisting improvements
_ 1 M°15'l>0 t 1w Rod Set shown hereon per field data collected on October 1,I 2016.
f 140.00' 2 North orientation and beam,,baseperMapRvkienc�s l&2.
Iron 13ipe Found,J Shed Corner —
5192155"W 1.25' Clear by 1.1'
j 3. Warren County tax porce1901.13 2-93
4U from Comer '
4. Thelocattonofundetgroundimptovem2ntsorencrdachments,rfanyexist,oras
shown hereon,are not certf ed There may be other underWro,and u#ilitW,the
existence of which are unknown. Size and locadon ofall underground utilities must
-102 be verifiedd by the gppropriate authorities The Underground Facilities Protecti ve
Organization mustbe notified prior to ms ndiucting test borings,excavatfon and
I
Lands Now or Formerly of Logds Now or formeNy of I L&7de Now or Formerly of construction.
RoLiert Randall James R. Drexel, At. Prancis L': Frepette � � 5. Ms survey waspreparedwithout the benefit ofanuptodateabstractoftide.
Book 6,56 Page 996 Book 700 page 844 Book ,37511 Page 265 �� 6 Reproduction or copying of ffi&documentmay be a violadon of copyrightl w
unlesselmis f - er is obtained,
A ropy of this document>without a proper applr'catiori f the surveyar's embossed
seal should be assumed t4 be an unauthorized copy.
FINAL SURVEY
71
KRISTIN M. DARRAH DATE REVISI•a '5 WGIDRD/DESCRIMON D - Kmwlon m
050803 R. .SIII'V@y
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_ '• F f Pipe Found ArrxovEu• 70WAIPFQUEEMBURY W,4RRENcOPN7YN,6WYORx
Pipe Pound
:'tin - -- Darrah Land Surveying PUC 16028-2
f` CHEPROf Iq leis 4 3764 North 5hore Roam Hedley,NeirYork 12835 '
SCALE:1'540' I A m?.(518)79&4692 SHEET, 10F1
'OVI.Y 11(111Af)\RI'SE'R\'1'1 A111'tilt'IIIITFIE SURYF.YOR5 t4f11O5>i.O -
sEALA,HE(iI:VI:INE'FR TA.0 C Ua RECC COPIES OF TIRE SIM EYOR s SCALE. /—, 0'
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