2009-601 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4E L Community Development- Building &Codes (518) 761.8256
E RTIFI�AT� OF OCCUPANI"v
Permit Number. P20090601 Date Issued: Monday, January 25, 2010
This is to certify that work requested to be done as shown by Permit Number P20090601
has been completed.
Location: 29 JAY RD WEST Rd
Tax Map Number. 523400-289-010-0001-020-000-0000
Owner. JAMES & LISA PUSHOR
Applicant- JAMES & LISA PUSHOR
This structure maybe occupied as a:
Residential Alteration By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the Hf'
property owner of the responsibility for compliance with Site Plan, m ' � ''
Variance,or other issues and conditions as a result of approvals by the
Director of Banding$t Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090601 Application Number. A20090601
Tax Map No: 523400-289-010-0001-020-000-0000
Permission is hereby granted to: JAMES & LISA PUSHOR
For property located at: 29 JAY RD WEST 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 Godes and the Queensbury Zoning
Ordinance. TTWe of Construction Value
Owner Address: JAMES &LISA PUSHOR
29 JAY RD. WEST Residential Alteration $70,000.00
LAKE GEORGE,NY 12801-0000 Total value $70,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2009-601
residential alteration- 1768 sq ft residential alteration
$176.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, December 17, 2010
(If a longer period is requited,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
f
Dated at the To �o teens rv, ,December 17,2009
SIGNED BYy'"� 1 ,/" '> for the Town of Queensbury.
Director of Building&Code Enforcement
.............................................................................. .. f• _.. _. .....r...
OFFICE USE ONLY /
TAX MAP N� PERMIT NO. ,
-fi o
FEES: PERMIT RECREATION ENGINEERING ;
(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: of A 1 fail Acc OWNER:
ADDRESS: 9-0I LA4 R4 n�t j- ADDRESS:
PHONE NOS. a�3a - PHONE NOS.
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: C. ,50- L Lttshcr PHONE: 0-
LOCATION OF PROPERTY: Cri �YV�S � I f
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? ❑ YES IV/NO
IF SO, INDICATE APPLICATION NO.AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT p o �-
APPLY TO YOUR z F- w O d W u- Co
PROJECT 0 W
J 0 _
W Q d
f� u- u- o O W 2 �-- 00
0
w 0 -j d z d P I— O F- E Cu-
z Q Q cn N cn O u- t- u- a = 06
SINGLE FAMILY ✓ j _ ��_ J (�
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 COSGb, FUEL TYPE:�lypG�-fib f ��C
B 3-LGL 11-05
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? &(D
ARE THERE EASEMENTS ON PROPERTY? NIQ
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 oo ; 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: 01
,
ir ' ;
% 1
, I
BUILDI G CODES ROYAL 0 ZONING APPROVAL
, ,
1 , , ,
% %DATE
% ; DATE
QUESTIONS? CALL 761-8256 OR EMAIL
codes(&aueensbu rynet
Office Use Only VISIT OUR WEBSITE FOR MORE INFnPu AT'r+u
Queensbury Building & Code Enforcement - Residential FirAl Inspection
Office No. (518)761-8256 Arrive: z-a am/p� Depart: amipm
Date Inspection request received: Inspector's Initials: f�c
NAME: PERMIT#: _v 1 0 _
LOCATION: DATE:
TYPE OF STRUCTURE:
Commands•
Y N WA
,C Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors _
Handrail 4 or more risers
Guards at stairs deckspatios more than 30 inchesi 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/Handica d Ramp Compliant
Grade away from foundation 6 inches with 10 feet _
6 inch clearance to sill !ate
Gas Valve shut-off Lxposec 1 re ulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen waterti ht
Safety lzin /Window in stairwells safe glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Batts —backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access 1 N.ft.-ISO sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation I Insulation Certification
Floor truss,draft stopp!M finished basement 1,000 s .ft.
Emergency ress 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 Valves installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock underside minimum'IV Gypsum
Basement stairs dosed rise>4 inches
Garage Floor Pitched
Garage fire roofi /%hour fire door/door closer
Duct work Sealed properly
Gas Logo in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance r Mired
Flood Plain Certification,if required a�` /
Oka to issue C/C or C 10 Tern ora ermanent I 1
L:\Building&Codes Forms\Buiiding&Codes\lnspection FormsWesidential Final Inspection Form—revised-1 00405.doc;Revised
January 7,2008;Revised SM08
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: -am/pm
Date Inspection request received: Inspector's Initials: L c}
NAME: RJ 0r PERMIT#: d l 0
LOCATION: vie-z DATE:
TYPE OF STRUCTURE:
Comments:
Yet, N A
4'° Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location -- ----
Fresh Air Intake / , f��
3 Inch PlumbingVent through roof minimum 6 inches ,�k.�,r`'4°�/ L�L'4-�tf� C
Roof Complete/Exterior Finish Com etc
Platform at all exterior doors s��t�r
Handrail 4 or more risers
Guards at stairs decks patios more than 30 inches above grade (� >
Guard at stairwell at 34 inches or more h�.
ee
Guard at deck porches 36 inches or more `
Handrail Termination at Newell Post or Wall vex
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/HandicappedRamp Compliant
Grade awayfrom foundation 6 inches with 10 feet
6 inch clearance to sill !a#e _
Gas Valve shut-off ex sed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Salfet
y glazing/Window in stairwells safety glazing
Interior Smoke on:I Carbon Monoxi electors
Every level: V Every Bedrocxrt':
Outside every bedroo area: ✓✓
Inter Connected: Baftery backu :
Attic access 30 inches x 22 inches x 30 inches I ei ht in accessible area
Crawl Spaces 18 inch x 24 inch access, i N.ft.-150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation[insulation Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emeraency earess below grade
Gas Furnace shut-off within 30 feet or within line of site V
Oil Fumace shut-off at entrance to fumaea area
Fumace/liot Water Heater operating
Low water shut-off boiler �'+ /" "� ��� t
Relief Valves installed/Heat Ira Water Temp 110 /'� r
Enclosed Stairs Sheetrock Underside minimum'N G sumC,FIN
Basement stairs dosed rise>4 inches
Garage Floor Pitched �"'
Garage fireproofingI%hour fire door/door closer J C>Q
Duct work Sealed pTperiyti 4 mat"
Gas Loge in Sealed or Glass Enclosure
r
Final Electrical e
Final Sure Plot Plan J
- f
Are fault Broker in Bedrooms ,,
Flex Gas Pi BondingI
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required --
Flood Plain Certification,if re uired '
Oka to issue C/C or C/® Tem a /Permanent
LABuilding&Codes FormslBuilding&Codesllnspecbon FormsWesidential Final Inspection Form revised_100405.doc;Revised
January 7,2008;Revised 6/26/08
��V-< —
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: 4m am/p , Depart: am/pm
742 Bay Road, Queensbury, NY 12804 inspector's Initials: .t!
NAME: PERMIT #: 'f
LOCATION: INSPECT ON: - D
TYPE OF STRUCTURE:
�- Y N N/A
Routh Plumbing Nail Plates
PluffWag Veit'?Vents in Place
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout eve 100 feet/change of direction
Pressure Test
Drain /Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
50 P.S.I for 15 minutes
Insulation/Residential Check/Commercial Check
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 riperly I No duct tape H
COMMENTS:
jj"eia
C+w^t'� ir• �0 Cd�� ��.11�/�jr ;,�:'.� J r�E:`
�� P
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
?-./f It(a
Framing / Firestopping Inspection Re
Office No. (518)761-8258 Date I ived:
Queensbury Building &Code Enforcement Arrive:� a part: ")am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initi
NAME: Ac bat,,A ERMIT#: _ 102—
LOCATION: INSPECT ON: fZ--2 -_®
TYPE OF STRUCTURE:
Y N NIA COMMENTS:
Framing
AVC'Kccess 27 x 30" minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jadc Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
StairweNs 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Hobs/Bearing Walls
Metal Strapping for Notches Top Plate
1 % w 16 gauge 8 16D nails each We
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wail 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side%inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceilingttmll
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. eM
5.7 sf above/below grace
5.0 of grade
LABUHding&Codes Fortes-OLDSUNding&CodesUnSpec Lion Foar►slFmnhV Fkatoppft Inspection Repott.doc Revised January 7,2008
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
Inspections per Permit
Permit# P20090601
Inspection Date Inspection Type
Approved/Denied Comments Pennit Type Person Responsible
12/17/2009 12:00:OOM Rough Plumbing Residential Alteration DAVID HATIN Staff
Denied 2009-601
NEED TO SCHEDULE PLUMBING TEST
1/6/2010 12:00:OOAM Plumbing Residential Alteration DAVID HATIN Staff
Approved 2009-601
1/6/2010 12:00:OOAM Plumbing Vents Residential Alteration DAVID HATIN Staff
Denied 2009-601
owner advised that system vent is undersized owner will add studor vent under kitchen and upstairs bathroom sink
1/6/2010 12:00:OOAM Pressure Test Vent Residential Alteration DAVID HATIN Staff
Approved 2009-601
1/6/2010 12:00:OOAM Pressure Test Supply Residential Alteration DAVID HATIN Staff
Approved 2009-601
1/15/2010 12:00:OOAM Final Inspection Residential Alteration DAVID HATIN Staff
Denied 2009-601
1) 2)i linder kj*.ehpr,,-w;nk 3)install relief valve on boiler system 4)
cover foam 5)seal drains in bathroom 6)final electrical 7)arc faults required in bedrooms 8)6 aut bond wire
required for gas piping
Icynene@
Insulation and Air Barrier Materials
Icynenew provides this structure with an insulation that controls both conductive heat
loss/gain and convection (air leakage) heat loss/gain. Icynenew is an environmentally
friendly foam that contains no BFC's or PBDEs. Due to the air sealing and insulating
characteristics of Icynenew, this structure
can enjoy the benefits of
• enhanced energy efficiency
• improved indoor air quality
• enhanced soundproofing
The manufacturer recommends that the insulation be installed at these overall thicknesses
to provide the levels of insulation conductive heat flow resistance (R-value). The air
sealing properties of Icynenew will provide insulation benefits over and above those
measured by R-value.
ICYNENE Icynene® ICYNENE ICYNENE
LD-C-50TM Pour Foam LD-R-50TM LD-R-200TM
R-13 3112" 3114" 3113" 2112"
R-14 4" 3 314" 3 %" 2 314"
R-19 5%" 5.0" 5.0" 3 314"
R-20 5112" 4 3/4" 5.0" 4.0"
R-22 6.0" 5 114" 5 1,12" 4 318"
R-29 8.0" 7112" 7 112" 5 314"
R-36 10.0" 9 114" 7.0"
In lieu of purely R-value based thicknesses, the Icynene Certified Installation Contractor
may utilize performance values to determine the correct thickness to be sprayed on each
location. Documentation on performance values should be attached to this Site Card.
Icynene LD-C has been installed in accordance with the manufacturer's instructions
in the amount of
Thickness
Ceilings/Roof _6.0"R-22
Walls: 3.5"R-13
Floors: 4.0"R-14
Address: 29 Jay Rd West Lake George Pushor Residence
Company (Icynene Licensed Dealer) North East Spray Foam
Authorized Signature DRK Date_6/10/2009
This building is insulated with Icynene®
C� - 0 /
'*Unauthorized alteration or additior.
to a survey map bearing a Lic4aae4
land Surveyor's seal is r violatici41
.46,WEe, Ciry Jr,4VIA r-'�4d� or se v otr �20t sub-ucatl on z,.ear
i the N a York State FAucation'Lau;ti
;w,Ze Iq/.tU,erQq/Cf CGtA'ilArl t/1/, T.�/.OT�i//1.NA.� l"only oo •a icwi. tt►a original or this
surrey ed with an original o! the
&wx .oIvAE'Ep LOW su yor's seal shall a• aoa4149
Or(/ TiS/E C/ZOUNO., .4C14WW,1NG'74 .eemao to be r treat gopies."
711
�`J' L/C .1/o. 3/7s� f r• ,�819�21�
C4 to e/V
sna f�a
Dept y ��
41/92/401V Z/C/,/ Q 0E
<699/37t� O �O-0G ; P�,E" �
`av oppolj' ; S�/A ON AU.e/L/ D
ic Poo I�A[L�S 7
c �,o.GYP 1 ��=• 9� �•��'�E ��PP� � r
C,+ rr
ZJ6 Mort,
4'GA�{i"t+'K.ELN.�N�
' A4 ;
� o:
Z.
� L~Z 1'r syLt.PEcyr � '�
'� 1 i .e are rMNty / �xlyg' 10 — DEED REFERENCE r
DO
Ellsworth C. 0+ Grace
rd s4,,4.0 we R. Simpson
clf / e to
�' a John W. & !Margaret B.
Calla a
OW rt xa.ro'3 0: 7/0/1961 411/99
R: 7/24/1961
••o G"; tY
OND
• � N •
•
• • •• 1 rrvwy,fa,.c�• '� N Off' 44V4 TO dE'4Wv IZYZO df/
• 0 '
••��5� �•(-M c�U �y�'d + 28.7 �� 1 �6LJlUO.PTif/C. � C.Qi4�.P
TD ..76WAI v.e—
a MAEG•A.eET B. Cxezw4, ,,
• �` i 4� p• 15 % ZJ+4740 IIIIII96/, .0,04E e
+y1739 � � woo r �► �� A;'.r: T.e�P�,.�.�. ee, III
�`�NE S�A4�`•' «Lx} P AV
v w.�,re►. /�oU,vey�'�E.eE''1
l
T3 �Fa2E
i��:�Y XiYY'1
1
/2
F5 ec�rJdY7 i
I
Roo
kt
i
TOWN OF QUEENSBURY
o aNi t1
R .. t s -o �uiL��N EPTe
Reviewed Y"
Da NOTICE Town„ - EN, __-
�F7 l
cCAo,,C,>-Q
'Fu_i 1
LO
tip
t3 u.114-
i n
i
Ft
........
bcj)
os A-3 F-,.-
Fvl t
� ` 41
a
k r ee 3rkx,i t
i
i
i
t
l
� y
Po's 4 ,tom,