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2008-390 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Pemut Number. P20080390 Date Issued: Thursday, October 07, 2010 This is to certify that work requested to be done as shown by Permit Number P20080390 has been completed. Location: 120 JENKINSVILLE Rd Tax Map Number. 523400-279-015-0001-072-000-0000 Owner. JOHN & CYNTHIA COULTER Applicant: JOHN COULTER This structure may be occupied as a: Residential Addition By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, V Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20080390 Application Number: A20080390 Tax Map No: 523400-279-015-0001-072-000-0000 Permission is hereby granted to: JOHN COULTER For property located at: 120 JENKINSVILLE 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. Tyne of Construction Value Owner Address: JOHN COULTER 120 JENKINSVILLE Rd Residential Addition $15,000.00 QUEENSBURY, NY 12804 Total Value $15,000.00 Contractor or Builder's Name / Address Electrical Inspection Agency Plans&Specifications 2008-390 393 SQ FT RESIDENTIAL ADDITION $75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, August 06, 2009 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Qurnof rati before th expion daw.) Dated at the To u s Aesday,August 06, 2008 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement OFFICE USE ONLY a TAX MAP N0. PERMIT N0. ERMIT FEE ' APPROVALS: ZONING TOWN CLERK I I , APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. -- i OWNER: _�J�h n �` l l`I f1CkL,,1� a � _ INSTALLER: \`.�uC�i Y 1�tY ADDRESS: G) -'st-1 ry1 v I ADDRESS: NO'rA-4-N UdSL1\ C1�S PHONE NOS._ ��'���a" �"t��� PHONE NOS, LOCATION OF INSTALLATION: �t✓Y�1L1�v11 1 I P C�S �� I.........«..................................................................................... .....................................................................................................................................:..................................... RESIDENCE INFORMATION: { YEAR BUILT I NO.OF X COMPUTATION= n TOTAL DAILY FLOW ................................................ .....«BEDROOMS...........<. GARBAGE ...........:...................................... I 1980 or older ; X 150 gallon per bedroom - INSTALLED? RIND .................................»........i................ .....................i...........'................. 1= 1981 -1991 X ; 130 gallon per bedroom 's................................................ ..................�.,.................. ................................I............................. 4... 3.. SPA OR HOT TUQ, . ............t..........................................................................i —LV 1992- resent X 110 gallon per bedroom ` _ INSTALLED? �U ............._.».»p...................................................................,........................................................................... . PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE %SLOPE 1S"Io ✓ SOIL NATURE: SAND_ LOAM CLAY OTHER ✓ GROUNDWATER: T WHAT DEPTH? J �'�, BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL (IF WELL:WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS 101 < 1 FT. ) ✓ PERCOLATION TEST: RATE IS �' 1O PER MIINUTE 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). Add 250 gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub. ✓ SEPTIC TANK: 1ICOO GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH 32 FT. ✓ TOTAL SYSTEM LENGTH: �FT. SEEPAGE PIT(S): HOW MANY? 0 ✓ SIZE OF EACH FT. X FT. G/�IV , ✓ SIZE OF STONE TO BE USED: # /DEPTH OR THICKNESS FT. ✓ BED SYSTEM SIZE: X ✓ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE ✓ HOLDING TANK SYSTEM:(if required) NO. OF TANKS: /SIZE OF EACH ✓ GALLONS.(TOTAL CAPACITY. GAL. :...:.....................:.....................:.:...:. ::.:.:.,:,::.::.:::,,.,:.,,::,,..,:..:..,..:....... ..: , ,: NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. ......:.......:..........r....�.....: :.,,......�..:...........,..:.....�. ......... ........ ......... ...........::...,...... .... ........:.:,..::.....,.::.. ..................... 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 QUESTIONS? CALL 761.8256 OR EMAIL Queensbury Sanitary Sewage Disposal Ordinance. codes Caueensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION -7A vc� www.gueensbury.net Sidniture of 115irton Responsible Dat � ' Town of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804 „ . , �,Q.,FFICE USE ONLY TAX MAP NO. PERMIT NO. 0 ' FEES: PERMIT��ECREATION 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: V0� t�l � �' C t � WLW-P-f OWNER: 1j\0 )A_) � u Cc &, A 0cJu i,kex ADDRESS: `-dQ)7 As V, Ae- ” C� .}'y( ADDRESS: OZ) Je n�-1 0Sy' v PHONE NOS. 1� �� ' . �lct�C PHONE NOS. 5�� --iQa- 5CICL(o CONTACT PERSON FOR BUILDING &CODES COMPLIANCE: �� � &W-PPHONE: - 5CAC04 LOCATION OF PROPERTY: `o� 2Y1k��1S��11� c� . Cy l.,l,tb S wx U, 14'iW SUBDIVISION NAME: PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT p o APPLY TO YOUR z0 1= p 70F O � �.-w PROJECT O = wOJ U. Q - � V Z Q u_ OzU �- 1- 0 1- w SINGLE FAMILY 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: f L Lell C _ FUEL TYPE: HEAT TYPE: t �- -HOW MANY FIREPLACE(S): AND /OR WOODSTOVES(S):�_ ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? IS THIS A HISTORIC SITE? t,�Q PROPOSED USE OF BUILDING OR ADDITION: 1-e. CLCO uyy, q - *Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office B 3-LGL t t-05 QTown of Queensbury - Community Development Office - 742 Bay Road, Queensbury, NY 12804 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? ARE THERE EASEMENTS ON PROPERTY? 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 state me nt/d escri ptio n 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 ,A, 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) ...................... o 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: 10 0 ; , , 411 � o B41tt N & CODES AcdAROVAL ZONING APPROVAL hkk�' ' bATV I ; DATE , 1 QUESTIONS? CALL 761-8256 OR EMAIL codesAmueensbu ry.net Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION _ Operating Permit Issued: Yes No www.gueensbury.net Occupancy Type: h 1 ►:;A Construction Classification: Assembly Occupancy Limit: Special Conditions: Town of Queensbunj - Community Development Office • 742 Bay Road, Queensburiy, NY 12804 PROJECT NAME: OFFICE USE ONLY STAFF INITIALS.- ' BUILDING PERMIT SUBMISSION DATE: CHECKLIST FOR: MULTIPLE DWELLING or COMMERCIAL PROJECTS 1. Building Permit Application Completed? YES NO N /A Energy Form or CheckMate Energy Code Compliance ► -r 2' Forms Complete? (2-copies) 1 3 - Energy Code Inspector's Report from Checkmate. Program? (2-copies) 4 Septic application completely filled out? (if applicable) I --------- AL - 5. Electrical Inspection Form complete? a I 6. , Two (2) sets of the plans each of the following: YES NO N /A , a. Floor plans (s)? I ; b. Foundation plan? 1 V I c. Cross sections (s)? jd. Elevations? 3 e. Design loads including floor, snow load, and wind load? v f. Seismic design (required after January 2003)? g. Plans signed and sealed by registered architect or engineer? h. Window and door schedule? I Two (2) site plans showing location of the structure to be ? ` built, location of well or water lines, location of septic system or sewer line with all setbacks and separation I distances shown, and all improvements to the pro_perty? 8. " Solid Fuel Burning or Gas Appliance Form (if applicable)? j9. ' Driveway Permit Town of Queensbury • Community Development Office - 742 Bay Road, Queensbury, NY 12804 ,_____ OFFICE USE ONLY PROJECT NAME: STAFF INITIALS: BUILDING PERMIT SUBMISSION DATE: ; CHECKLIST FOR: ' SINGLE FAMILY DWELLING 1. ' Building Permit Application Completed? YES NO N /A ......................-..........--......------......_....----.._._.._........._....._.._......_._..._..... -- _._..........-......_..._..... _............_._......_ ......... 2 Energy Form or CheckMate Energy Code Compliance Forms Complete? (2-copies) ies --- _ -- ).......--..--- --....- .._.._._._.......---.._...._......_._............_._ .- - - - .......-- _._...-._......__._._....-- 3 Energy Code Inspector's Report from Checkmate Program? (2-copies) -- ------- -...------___._......__..._.___._ ..-----.- Septic application completely filled out? 4' ; (if applicable) 1 5. Electrical Inspection Form complete? _ --- -----...-------- .........----.._.................. - - 6. Two (2) sets of the plans each of the following: YES NO N /A ; a. Floor plans (s)? { i b. Foundation plan? c. Cross sections (s)? 3 d. Elevations? f ! e. Window and door schedule? ----- ._._._.---------- f. Natural Light, Ventilation and Emergency Egress Requirements? g. Plans signed and sealed by registered architect or { L engineer? Two (2) site plans showing location of the structure to be 7. built, location of well or water lines, location of septic Sy stem or sewer line? 8. Setbacks from property lines to new structure? i 8 ; Setbacks to neighboring wells and septic systems, including onsite well and septic systems (if applicable)? 9. Driveway Permit? ..........._---__._._._..-.--._-___------_._..__.._..__......._........__..__.__._._. - Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 B 12-LTR 11-05 t esidential Final Inspection Queensbury Building & Code Enforcemen f ice No. (518) 761-8256 Arrive: am/pm Depart:2.�fam/pm to Inspection request received: Inspector's Initials: NAME: rn 0l� PERMIT#: LOCATION: DATE: TYPE OF STRUCTURE- Comments: Yes No N/A 4" Building Number Address visible from road Chimney Height/"B"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/trim/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 s .ft.-1 50 s .ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation/Insulation Certification/Sticker on Panel Floor truss,draft stopping finished basement 1,000 s .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 Furnace/Hot Water Heater operating �— Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum'/"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/%hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical 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/O Temporary/Permanent i LABuilding&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised January 7,2008; Revised 6/26/08; Revised 12/22/10 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 ((MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No...;-:...1...��``. ..?�"'C.........Cert. ND 112 3 5 Cut-in Card No..................................... Owner............ .... . .. .......................................................................................... tr . r............ Location../.Z C t ',G/V J�L 'V-s v,L c C /2D 6 LC�y ....................................... . .. ................................................................................... Installation Consisting of...�3..�����! i`" ,t. 7. G f-:_ / j L—/?Z�.......................... ..... .. ............... .. .................................................................................................................................................................................... .................................................................................................................................................................................... Installed By........M61®/2- ..................... ..........................................................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 ma g ections at any time, and if its rules are violated,the Company shall have the right to ev I certi a Date..... . 1�f�G/.��.............. INSPECTOR.......... :.... ............................. Member N.F.P.A.,I.A.E.1. Queensbury Building.& Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: am/pm Depart: am/pm Date Inspection request received: Inspector's Initial$: , b� NAME: U PERMIT#: LOCATION: DATE: TYPE OF STRUCTURE: - 1.-e t - , - e Comments- C Buildby Number Address visible from road Chimney,Height/*B'Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbina Vent through roof minimum 6 inches Roof Co /Exterior Finish Complete Platform at aN exterior doors Handrail 4 or more risers Guards at stairs decks ios more than 30 Inches above grade Guam at stairwell at 34 inches or more Guard at deck rches 36 inches or more Handrail-Termination at Newell Post or Wali later ffiAerior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from 1bundadon 6 Inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off !pMulator 18 inches above grade Interior privacy/trim/doors/main entrance 38 inches Bathroom/Kitchen watertight Sa /Window in stairwells safety g-w-ft Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Batt backu : Attic access 30 inches x 22 inches x 30 inches in accessible area Crawl Spaces es 18 inch x 24 inch access 1 sq.ft.-150 sq.ft.vents Bathroom Fans if no window Plumbina fixtures Foundation insulation/Insulation CertMcatlon Floor truss draft stoppina finished basement 1,000 sq.ft. Emergerw swess below arade Gas Furnace shut-off within 30 feet or within dine of site Oil Fumace shut-off at entrance to furnace area Fumace/Hot Water Heater opereft Low water shut-off boiler Relief Valve s installed/Heat TrW Water Temp 110 Enclosed Stairs Sheetrock Underside minimum W Gypsum Basement stairs dosed rise>4 inches Gareas Floor Pitched G§!pM fire roofi /%hour fire door/door closer Duct work Sealed Gas Loos in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc fault Brooker in Bedrooms Flex Gas Pipe Bonding As Built Septic System/Sewer Dept. Inspecton Stinker Site Plan /Variance required Flood Plain Certification If required Okay to issue C I C or C 10 Temporary/Permanent LABuilding&Codes FormslBuilding&Codes\lnspec ion FormsWesWendal Final Inspection Forn_revised_100405.doc;Revised January 7,2008;Revised 8126/08 Queensbury Building & Code Enforcement - Residential Final Inspection c Office No. (518) 761-8256 Arrive: am/pm Depart: am/pm Date Inspection request received:---� Inspector's Initials: NAME: � PE IT#: _ © LOCATION: " DATE: IL A TYPE OF STRUCTURE: Comments Y N /A ,V 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 inches above grade Guard at stainrell 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 Com tiant Grade away from foundation 6 inches with 10 feet 6 inch dearanoe to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacyj trim/doors I main entrance 36 inches _�- Bathroom/Kitchen watertight Safety glazing/Window in stairwells safe glazingv C interior Smoke Detectors/Carbon Monoxide Detectors V J/►^' Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: 2 Attic access 30 inches x 22 inches x 30 inches(height)in accessible area !� Crawl Spaces 18 inch x 24 inch access i .ft:150 ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation/Insulation 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 fumaoe area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum W Gypsum Basement stairs dosed rise>4 inches Garage Floor Pitched Gars a fire roofin /' hour fire door/door closer Dud work Sealed prop d Gas Loge 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. Inspectiion Sticker Site Plan /Variance required Flood Plain Certification if required Oka to issue C/C or C 10 Temporary/Permanent LABuilding&Codes Forms\Building&Codes\lnspeccti�on FormsWesidential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6126/08 �/o A/'ew Rough Plumbing 1 Insulation Inspe on Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/prey Depart: ` _am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: NAME: u / PERMIT #: 3 LOCATION: INSPECT ON: TYPE OF STRUCTURE: Y N NIA Rough Plumbing I 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 Wager Supply Piping Air/Head 50 P.S.I for 15 minutes Insulation/Residential Check/Commercial Check Tywek 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; ,_. (� C!'C 1 � Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2006, revised January 7,2008 Rough Plumbing / Insulation Ins coon Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: �am/pm Depart: r. Jv am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: �' NAME: PERMIT #: 481--3 V LOCATION: INSPECT Cft TYPE OF STRUCTURE, Y N NIA -Rough Plumbin /Nail Plates umwng 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.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 properly/No duct tape COMMENTS: Rough Plumbing Insulation Reportrevised Nov 17 2003, revised February 15,2005, revised January 7,2008 6, V /!vrsof Framing / Firestopping Inspection Report Office No. (518)761-8256 Date Inspection ed:_ Queensbury Building&Code Enforcement Arrive: kl)-- a part: 742 Bay Road, Queensbury, NY 12804 Inspector's I ' NAME: Cou—ker ERMIT#: !� LOCATION: INSPECT ON: - OF STRUCTURE: _ � 5 Y N I WA COMMENTS: 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 Wails Metal Strapping for Notches Top Plate 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 Q� ice and water shield 24 inches from wall 1 T '` ration 1, 2, 3 hour u � 2, 3, our aled � �,�• 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 Ceiling1wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade LABuildmg&Codes Forrns-k)ld\Builci ft&CodesUnspection FamsTrarning Firestopping Inspection RepoR.doc Revised January 7,2W8 Framing / Firestopping Inspection Report L Office No. (518)761-8256 Date In request received: Queensbury Building &Code Enforcement Arrive: Z am/pto Depart: am/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: NAME: PERMIT A LOCATION: INSPECT ON: " - TYPE OF STRUCTURE: r Y , N NIA COMMENTS: Framing K .�\ 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 Bolts 6 fit. 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%inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling1wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. OM 5.7 sf above/below grade 5.0 sf grade LABuilding&Codes Forms-OLDSuilding&Codesunspection ForrnsTra rning Firodoppft Inspection Repo tdoc Revised January 7,20M 1hur- Framing / Firestopping Inspection Repo Office No. (518)761-8256 Date In n req iv Queensbury Building&Code Enforcement Arrive: `® rt: arp�p 742 Bay Road, Queensbury, NY 12804 Inspector's Initia 91 ,o 1 — NAME: �� ERMIT#: /GCS - LOCATION: INSPECT ON: TYPE OF STRUCTURE: Y N NIA 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 '/z w 16 gauge 8 16D nails each side Draft sto'ppicxj4.,000 sq. ft.floor trusses r s 6 ft. less on center ice and water sh' Id 24 inches from wall ion 1, 2, 3 hour Fire wall 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 Ceilingfwall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. ('U1t) 5.7 sf above/below grade 5.0 sf grade LABuilding&Codes Forms-QLblBuilding&Codesjrmped ion FortrslFraming Firestopping inspection Repoltdoc Revised January 7,2008 x r ' Septic Inspection Report Office No. (518) 761-8256 Date Ins coon ;Ost r el d: Queensbury Building &Code Enforcement Arrive: epart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initia NAME: C0 o � j,�- P �'}1T NO.:LOCATION: 1 ZC7 til t lh, % lF RD, I SPECT ON: RECHECK: Comments and/or diagram Soil Type: Sand Loam/ Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50' + / - I Y N N/A Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: I N End Ca Y N Inlet/Outlet Pipes&Baffles Y N Location Separations Foundation to tank ft. Foundation to absorption ft.— Separation of Pits ft. Conforms as per Plot Plan N Engineer Report and As-Built V Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear Syjgm Use s: Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 U\Building&Codes Forms-01-1)\Building&Codes\Inspection Forms\Septic Inspection Report.doc Stephen T. Dean, P.E., P.c. Consulting Engineer 165 Akin Road,Johnsonville, NY 12094 PH (518)527-3867 September 12, 2008 Town of Queensbury Building Department c/o Mr. John O'Brien 742 Bay Road Queensbury,NY 12804 RE: As-Built Documentation—John Coulter— 120 Jenkinsville Road Mr. O'Brien, Please find the enclosed as-built information pertaining to the Eljen Trench system installed on lands of John Coulter,Jenkinsville Road, in the Town of Queensbury. I am submitting this based on my post construction field review and the requirements as set forth in 75-A of the NYSDoH and the Individual Residential Wastewater Treatment Systems Design Handbook. Please proceed with the issuance of any necessary approval documentation on behalf of my client, Mr. John Coulter. As always,thanks for your cooperation, and should you have any questions or comments, please contact me at(518)527-3867. Sincerely, 2 IL - Steph n T. Dean, P.E. Cc: John Coulter-Homeowner Tony Signorelli-Excavator • email:SDeanPE@msn.com • 150.0 POINT TO POINT MEASUREMENTS scale: 1 n=30' AS SHOWN ON DRAWING N POINT TO POINT PITCHES (AS MEASURED BY LASER LEVEL) PRPOSED AT HOUSE - SEWER LINE 103' — ADDITION TANK INLET 101'0" (PITCH>.25"/FT) EXISTING TANK AND TANK OUTLET 100'8" LEACH PIT TO BE DBOX INLET 96'6'> (splash baffle installed) /EXISTING- REMOVED DBOX OUTLET EXISTING — 15' 11000 — °A LOCAl10N) HOUSE TANK ^ # / GAL LATERAL 1 WEST 96'1" INLET PITCH 1" 50' LINE (PLASTIC) LATERAL #2 EAST 96'1"- INLET PITCH 1"/50' 105 \ 88' I °O ELJEN MATS HAVE BEEN INSTALLED WITH MINIMAL PITCH (FLAT) PER / ! MANUFACTURER'S 'INSTRUCTIONS \a`\\pONN\��NIUIIHIIIIIJJJyJJ��///,/ ��.o QRpFESS10* ...,% DRIVEWAYQNEN T a!F °may - -� - - — 87' _ _105— ROOF / >� ' aUN lb y07P501 --104-- — — — — — 5a' - - /102 \ EXPANSION \ AREA ENGINEER'S CERTIFICATION: THIS SYSTEM �p C PT#1 509 HAS BEEN INSTALLED IN SUBSTANTIAL 101 -\ #2 COMPLIANCE WITH NYSDOH 75—A. GDP 1 T 6 AS—BUILT 'ATE: 9/12/08 100 A' COULTER RESIDENCE -100— — — — — — — — — 16 — — 120 JENKINSVILLE ROAD 149.7' DIST TOWN OF QUEENSBURY, NY BOX/2 / j/ 279.015-0001-072 BENCHMARK BASE OFMETAL SPIKE 1 ELV. = 00 /, / STEPHEN T. DEAN, P.E. // / CONSULTING ENGINEER 165 AKIN ROAD- HN NVI Y 4- 1 -3 7 �AGR I C A JO SO LLE,N 1209 (5 8)527 86 f� // AG)C.75 Framing I Fir �•�• estopping Inspection Report Office No. (518)761-8256 Date Ins on request received: Queensbury Building &Code Enforcement Arrive:/am/T�A rt: am/pm 742 Bay Road, Queensbury, NY 12804 Ins es Initials: NAME: 0 �� ' -? PERMIT# ) LOCATION: !' INSPECT ON: TYPE OF STRUCTURE: Framing Y N N/A COMMENTS: Attic Access 220 x 30" minimum , t Jack Studs/Headers i S 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 nags each side Draft stopping 1,000 sq. ft. floor trusses n r#e or less on center Ice and water shi d 24 inches from wall on 1, 2, 3 hour 2c-Qui ec- 6-47 S Fire wall 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 Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 sf grade LABuilding&Codes Forms-01-MuNding&Codes4nspection Fomis'fran ing Fiestopping Irapedion ReporLdoc Revised January 7,2008 Septic Inspection Report Office No. (518) 761-8256 Date InspectiIre r eiv Queensbury Building &Code Enforcement Arrive: p part: 742 Bay Rd., Queensbury, NY 12804 Inspector's InNAME: CO� IT NO.:LOCATION: �112�T 1 ►��,� L�F RC7 ECT ON: — — — RECHECK: Comments and/or diagram Soil T Sand Lo T of Water: Murnci I II Water Waterline separation distance ft. Well separation distance Il�'i'ft. Other wells: p'r ft. Well Casing Length 50' + - Y N _N/A Absorption Field: Total length ft. Length of each trench Za&340 ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank ► 'v Tank to Distribution Box 41% Distribution Box to Field Pit I' (� Opening Sealed: N \ t? End Cap N Inlet/Outlet Pipes &Baffles 7Y N G Location Separations ��' Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. ��► F Conforms as per Plot Plan Y En ineer Report and As-Built Y N Location of SZ y: Fron Side Right Side Middle Front Middle Rear System s Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc /6) -1 Z Ino Foundation Inspection Report Office No.(518)761-8256 Date Inspection r st r d Queensbury Building&Code Enforcement Arrive: �- part: m 742 Bay Rd.,Queensbury,NY 12804 Inspector's huti NAME: (�(� ` PERMIT#: LOCATION: 126 INSPECT ON: TYPE OF STRUCTURE: 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 ooting Do r in place Found! on Dampproofmg Foundation erproo mg 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 (7 Foundation Inspection Report Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/ m Depart:ia*n. am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: CCU . 4 PERMIT#: x f LOCATION: p t~ INSPECT ON: TYPE OF STRUCTURE: , Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 98following the placement of the c ncrete. Materials for this on site. Foundation/Wallpour orcement' e Footing Dowels or Keyway in place A 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 i-3 -7�t)'� 1 - � Foundation Inspection Report Office No.(518)761-8256 Date Inspectio request received: Queensbury Building&Code Enforcement Arrive: �`, am/pm Depart: am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector s tials: NAME: tERMIT#: b-0 f / 0 LOCATION: i i INSPECT ON: TYPE OF K C Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in Place The contractor is responsible-for t 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 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 CREScheck Software Version 4.0.1 NJ( Compliance Certificate Project Title: New Home Addition Report Date:03/31/08 Data filename:C:1AutoCad DrawingslJohn&Cindy Coulter\REScheck.rck Energy Code: New York State Energy Conservation Construction Code Location: Warren County,New York Construction Type: Detached 1 or 2 Family Heating Type: Non-Electric Glazing Area Percentage: 14% Heating Degree Days: 7635 Construction Site: Owner/Agent: Designer/Contractor: 120 Jenkinsville Road John&Cindy Coulter Douglas Adams Queensbury,NY 12804 120 Jenkinsville Road Saratoga Engineering&Design Queensbury,NY 12804 74 Rolling Hills Drive 518-792-5996 Gansevoort,NY 12831 joncinl20@yahoo.com 518-587-2518 saratogaengndesign@nycap.rr.com •0Code ILIA) Gross Cavity Cont. Glazing UA Assembly Area or R-Value R-Value or D.. Perimeter U-Factor Ceiling 1:Flat Ceiling or Scissor Truss: 424 38.0 0.0 13 Skylight 1:Wood Frame:Double Pane with Low-E: 7 0.480 3 Wall 1-right side:Wood Frame,16"o.c.: 128 19.0 0.0 8 Wall 2-back:Wood Frame, 16"o.c.: 222 19.0 0.0 12 Window 1 -TW2046:Vinyl Frame:Double Pane with Low-E: 20 0.340 7 Window 2-TW20210:Vinyl Frame:Double Pane with Low-E: 6 0.340 2 Wall 3-left side:Wood Frame,16"o.c.: 128 19.0 0.0 5 Door 1-FWG6068:Glass: 42 0.330 14 Crawl 1:Solid Concrete or Masonry: 293 13.0 0.0 20 Wall height:5.2' Depth below grade:4.2' Insulation depth:5.0' Inside below-grade depth:0.0' The proposed building represented in this document is consistent with the building plans,specifications,and other calculations submitted with this permit application.The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements.When a Registered Design Professional has stamped and signed this page,they are attesting that to the best of his/her knowledge,belief,and professional judgment,such plans or ecifications are in compliance with this Code. !�otx��i4S 1'tCt�n^S -p f-, w CYigk 3 3D b� Name- itle Signat� Dat New Home Addition Page 1 of 4 r , r REScheck Software Version 4.0.1 Inspection Checklist Date:03/31/08 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1-right side:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments: ❑ Wall 2-back:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments:ANDERSEN ❑ Wall 3-left side:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window 1-TW2046:Vinyl Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments:TWO UNITS,ANDERSEN ❑ Window 2-TW20210:Vinyl Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes_No Comments: Skylights: ❑ Skylight 1:Wood Frame:Double Pane with Low-E,U-factor:0.480 #Panes Frame Type Thermal Break? Yes No Comments:VELUX Doors: ❑ Door 1-FWG6068:Glass,U-factor:0.330 Comments:ANDERSEN Crawl Space Walls: ❑ Crawl 1:Solid Concrete or Masonry,5.2 fit/4.2'bg/5.0'ext.insul/Off inside bg depth,R-13.0 cavity insulation Comments: Applies to walls of unventilated crawl spaces. Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible materials.If non-IC rated,fixtures are installed with a 3"clearance from insulation. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: New Home Addition Page 2 of 4 f , f Ll Materials and equipment are installed in accordance with the manufacturer's installation instructions. Lj Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Q Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the Insulation. Duct Insulation: Lj Supply ducts in unconditioned attics or outside the building are insulated to R-11. Lj Return ducts in unconditioned attics or outside the building are insulated to R-6. Ej Supply ducts in unconditioned spaces are insulated to R-11. Li Return ducts in unconditioned spaces(except basements)are insulated to R-2.Insulation is not required on return ducts in basements. Duct Construction: Lj All joints,seams,and connections are securely fastened with welds,gaskets,mastics(adhesives),mastic-plus-embedded-fabric, or tapes.Tapes and mastics are rated UL 181A or UL 181B. Exceptions: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). Lj The HVAC system provides a means for balancing air and water systems. Temperature Controls: Each dwelling unit has at least one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: Separate electric meters exist for each dwelling unit. Fireplaces: 0 Fireplaces are installed with tight fitting non-combustible fireplace doors. Fireplaces have a source of combustion air,as required by the Fireplace construction provisions of the Building Code of New York State,the Residential Code of New York State or the New York City Building Code,as applicable. Service Water Heating: Water heaters with vertical pipe risers have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. Circulating hot water pipes are insulated to the levels in Table 1. Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: Lj HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. New Home Addition ,� Page 3 of 4 r Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" Temperature("F) 170-180 0.5 1.0 1.5 2.0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2.Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range("F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low Pressureffemperature 201-250 1.0 1.5 1.6 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Page 4 of 4 New Home Addition� �