2003-174 40111116 TOWN OF QUE EN SB URY
tw742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20030174 Date Issued: Tuesday, July 01, 2003,
This is to certify that work requested to be done as shown by Permit Number P20030174
has been completed.
Tax Map Number. 523400-227-017-0001-012-000-0000
Location: 183 CLEVERDALE Rd
Owner. ROBIN INWALD
Applicant: ROBIN INWALD
This structure may be occupied as a:
By Order of Town Board
Residential Iteration (wh,%te barn) TOWN OF QUEENSBURY
Not : To ob Queewsbuny ("-- J4 jolit--
Ana Van. No. 77-2002
S ' e Phan Review NO. 4-2003
ity,v o nv eJtzio n o{y ex bst i.ng white baltn in-to z eaz o na2 Director of Building&Code Enforcement
oe eiden - aL ups e ww%th new 4 ep <.c 4ydtem
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
F4N
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030174 Application Number: A20030174
Tax Map No: 523400-227-017-0001-012-000-0000
Permission is hereby granted to: ROBIN INWALD
For property located at: 183 CLEVERDALE Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: ROBIN INWALD
119-19 83RD Ave Residential Alteration $60,000.00
Total Value $60,000.00
KAW GARDENS,NY 12820
Contractor or Builder's Name /Address Electrical Inspection Agency
HORNING CONSTRIJCTTON COMMONWEALTH ELECTRICAL A
10174 SARATOGA Rd
FORT EDWARD.NY 12878
PO BOX 706
HAGT 7E.NY
Plans&Specifications
2003-174
RESIDENTIAL ALTERATION AS PER APPLICATION
$217.50 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,April 29,2004
(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 of Qu sb Ty; uesday,April 29, 2003
SIGNED B for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application .
Town of Queensbury Department of Community Development, 742 Bay Rd.,Queensbury,NY 12804
(518)761-8256 /
A permit must be obtained before beginning construction. Permit No.: . ><.�� l7
No inspection will be made until applicant has received a Fee Paid: --7 �'
valid building permit. Form must be completed. Rec.Fee Paid ' / I
Reviewed By:
Applicant: t �. Owner:
is �0.21i../c. A/11)iri —L.na•,.)e,1d,
Address: ,0/2 4 S4 a4 oa.4 Qe. Address: i i e> • /, S3?O 4 v
Roc c Arto, 14-n 2826 1160 GAROG,ta.. 1.1 l 14s 5
Phone#: ?S. ..411 o2.02 Phone#: 7 45.6 44, - 44o2i _ •
aa�. i-7- i -/a &2) d A O 7 7- OO J
Tax Map Number: �.�� 4`a605
Subdivision Name:
(if applicable) ,�13 J?j 1� //, of I yED
Lot Number: /House Number: /Street Name(---Io� �!
OR
1 - ) APR.4(.1- 1 � ��nz
ld ('9-7(.'.Property Location: 't, f
TOWN OF QUEENSBUP"
11 g::5 �aC3�`C`�,r
o New Building: Residential/Commercial Estimated Market Value of Construction: et,
•
o Addition: =:•• . i• Commercial If an Addition,what will use of addition be?
Alteration: - ' - wyCommercial
A"`No change to V
Exterior size: Rsidential ommercial f �� l"
o Other work: escnbe ) r FaK I I _ 3
PC d'A.)
Check Below Occupancy Info 1"floor sq.ft. 2°d floor sq.ft. Other floor sq.ft. Total Sq.Ft. i
,' Single Family Dwelling 2/ 2 tb 2 / 7 6 f/i
Two Family Dwelling / z
Y
Townhouse n
Multifamily Dwelling
#of units ��-,/` r
���
Office
f,
Mercantile (4/l k_,
Manufacturing ) Y/ d
1 car detached ara e " r/ (//g g r r
D 4_ r
2 car detached garage �)
3 car detached garage ;,� J (.1/
1 car attached garage - ( (�
2 car attached garage \, ' �1 ti1
3 car attached garage k))
Storage Bldg.,Comm.
/J
Storage Bldg.,Res.
Other
What is the proposed height of the structure: feet inches .. Al
Will any second-hand or ungraded lumber be used? If so,for what? WA t•t, r+../•S N
No. of Fireplaces to be installed: 1.1 A •
No.of Woodstoves to be installed: NJ a
List below the person(s)responsible for supervision of work in regards to Building Codes:
•
Name Address Phone No.
Builder IJe4:.4•4e, 00.1.,i. 10/74 S34nieG.4 Po Fr E°' °. ,.(-Y /93.OZe2 •
Plumber •r
Mason •.
Electrician ..
Declaration: Please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application, together with the plans and
specifications submitted, are a true and complete statement of all proposed work to be done on the described
premises and that all provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to
the proposed work shall be complied with, whether specified or noted, and that such work is authorized by
the owner. Further, it is understood that I/we shall submit,prior to a Certificate of Occupancy or Certificate
of Compliance being iss ed,as requested y the Zoning Administrator or Director of Building and Codes,an
As Built Survey by a • ensed s ;drawn to scale,showing actual location of all new construction.
Signature: 44 G (circle one: owner,owner's agent,archite contractor
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury, NY 12804 (518) 761-8256
1. OWNER INFORMATION:
Location of installation: Office Use Tax Map No. / / File Permit No. 03-1-7 /
t
Owner's Name: JZir tuck' j Fee Paid
Address: /()3 Vearricf4 ',g
2. INSTALLER'S NAME : (e PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply#of
bedrooms with applicable gallons per bedroom to equal total daily y flow)
Year of House: No. of Bedrooms x Computation = Total Daily Flow
1980 or older x 150 gal/bdrm =
1980- 1991 x 130 gal/bdrm =
1991 -present / x 110 gal/bdrm =
Garbage Grinder Installed yes / no rV.
Spa or Hot Tub Installed yes / no
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
,,,,ToliAgranhy Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
FI t� sane at what depth at wh t depth municipal
Rolling , loa 3 Z`` feet /° feet well
Steep slope clay if well; water supply
%slope other from any septic-system
se
depth: tic
-system
absorption is ft.
Percolation Test: (To be completed by licensed professional engineer or architect) other
Rate: I" minute per inch
5. 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: /Uf j gallon (min.size 1,000 gal.)
Tile Field: each trench ,S0 ft. Total System Length: 266 ft.
Seepage Pit(s): number of size of each: ft. by ft.
Size of Stone to be used: # / depth or thickness feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
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 t 's application and agree to abide by these and all
requirements of the To of Que sb Sanitary Sewage Disposal Ordinance.
S.
Lam/
Sig a espo Bible person Date
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. ',�
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
'ermit No. Cert. 0 8 9 8 7 6 Cut-in Card No.
)wner . i4.D
.oration > �` + + ) S ,/1 /
624147
nstallation Consisting of 4' ( c l W. 20 ' L 6 7 BL S
f:2P -n�5_�f...A..,rcil,1�, 1 ,t'�� v Past��t--
g'Al s�......i tQ or s} )4-
nstalled By G/ :Z.(,. Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
ancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
ntroduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of ma inspections at any time, and if its
ules are violated,the Company shall have the rightavok ertifi te.
)ate . —C INSPECTOR
Member N.F.P.A.,I.A.E.I.
l,UPIMUIN W C.AL 111 L'Lt 1.1 RIVAL 11V3rr l.11U11 Jrttviun,LW. �y
Main Office 357 Elwyn Terrace — Manheim,PA 17545 C1
j
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL %
Panel Board No.e.NCert. 2 9 .i Cut-in Card No. N h
Owner 1-0..J.l n Xii v.)Ai-0
Occupant
Location ...1...8 3 C INCvc AGG /Lp Qjccr Vn `/
Installation Consisting of....rf2.Ci.?.Ctsr,6iTla n w/4,.l h G : 3 2 (ZGGI
1 .$uJ t Z ,_7.S� �....1=.eS.1 I.St...........s rn c , c / 7
Installed By....IlQ22./.fl Co..!. . Lic. #
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 inspections at any time, and if its
rules are violated,the Company shall have the right to revoke this rtificate.
Ls-Date .s- -03 INSPECTOR, ! ..
i ember N.F.P.A.,LA.E.1.
M0)(\a(lAj V
Septic Inspection Report
Office No. (518)761-8256 Date Inspection reques received:
Queensbury Building&Code Enforcement Arrive: am/ ep : am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME:
PERMIT NO.: 03-
LOCATION: \ t? INSPECT ON:
RECHECK:
G` Comments and/or diagram
Soil Type: Sand Loa Clay
Tpe of Water: Municipal/Well Water f -
Waterline separation distance �r ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length 'Zb ft.
Length of each trench ft.
Depth of trenches 1 ft.
Size of Stone #2/
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank 4G,
Tank to Distributio Box IN _
Distribution Box o'ield/Pit I. S4)t �5
Opening Seale Y N/Partial
Location/Separations
Foundation to tank L C/ ft.
Foundation to absorption Za ft.
Separation of Pits ft.
Conforms as per Plot Plan 7____N
Location of System on Property:
Front Rear Left Sid Right Side
Middle Front Middle Rear
System Use Sta>yf�s:
V Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
L:\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
MOY\C)Ct'L6
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement e7
Dept.of Community Development Arrive am/pm Depart am/pm
Town of Queensbury Inspector's Initials
742 Bay Road
Queensbury,New York 12804 NAME WO—Q-CS
�7 PERMIT#D / /
LOCATION I C^� a pc) DATE
TYPE OF STRUCTURE
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake /
Plumb Vent through roof ,//
Roof Complete ✓/
Exterior Finish Complete t/
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more ✓/
Interior Handrails stairs both sides 3 or more risers 4/
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade ,/l
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 ✓�
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36" -/
Floor Finish V
Bathroom/Kitchen watertight ,
Interior Handrails Balconies/Landing 18 in.or more
Railing across windo
•
Smoke Detectors: iy:wells
` D
every level t
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures ✓
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor ,tl��
Electrical tl7
/V &b
ite Plan/Variance required 142 D• K •
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_ / w
Okay to issue permanent CIO(Certif.of Occupancy) �/
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: .;ir /C am/pm Depart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: (pit-
NAME: l� PERMIT NO.: 0 7
LOCATION: C /tom 41_t 14,1 INSPECT ON: r
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.
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: Y/N/Partial
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
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:\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
f"
Framing / Firestopping Inspection Report tI
Office No. (518) 761-8256 Date Inspection request received: r
Queensbury Building & Code Enforcement Arrive: am/p art:3 . GDa m
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
IN 'Isle
r-L... — 1 i g
NAME: 1. Y\�X, ��I \. PERMIT#:
LOCATION: 1 j �r. v(:.r <�:,i, ._;., .`�-)'-' INSPECT ON: 5 --/ ci . (--
TYPE OF STRUCTURE: vc--,:.<, , r\ 1 k
y N N/A COMMENTS
V
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
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 ft. or less on center
Ice and snow shield 24 inches from wall
Fire separation 1, 2, 3 hour
ire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side V2 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
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Rough Plumbing / Insulation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p gam: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: UG`�
NAME: �. "� �1 �!Jrl\.` l °r11 �J PERMIT#: / ) L(
LOCATION: j C',��",c^c _ ' \ INSPECT ON: j /c'
TYPE OF STRUCTURE: f \ -
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain/Vents
Cast Iron,Copper Drain/Vent/Comm.
Plumb' Vent/Vents in Place
ough Plumbing/
Plates /1/
Head or Air Supply Test
Drain and Vents
5 PSI or 10 ft. above highest
Connection for 15 minutes
Water Supply Piping
Copper Commercial
Copper, CPVC,Pex One &Two Family
Insulation/Residential Check/Commercial Check
Proper Vent, Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct Work Sealed Properly
COMMENTS:
L:\SueHemingway\Building.Codes.Inspection.FORMS\Rough Plumbing Insulation Report.doc January 28,2003
/Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building& Code Enforcement Arrive: am/O.n, C Depart: - m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: (4)Att7 PERMIT#: .3 '---1 7
LOCATION: ( ( 6titiQ0 A - - INSPECT ON: O
TYPE OF STRUCTURE:
Y N N/A COMMENTS
Framing
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
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %2 (w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall
ire separation 1, 2, 3 hour
Fire wall 2, 3,4 hour J,
Firestopping .(-6___ C/�
_ K ,._ epU&-S
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
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
5062
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:Queensbury Building&Code Enforcement Arrive: am/pn�,p_� Depart:�'/..---- 7
am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: J
CI
NAME: . W0\f, 1•rdpop PERMIT#: 3 — 1 1 I
LOCATION: cg 3 Q, c G� INSPECT ON: — O v3
TYPE OF STRUCTURE: \e , v—
Comments
Y N N/A
Footings
Piers
t x Q4,tlie s -Ntex
Reinforcement in Place
The contractor is responsible for /17
providing protection from freezing •
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
r
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing V
Footing Drain Daylight or Sump 'Q�O�
Footing Drain Stone: e016
12 inch width `(L ,r
6 inches above footing <Dl o0
6 mil poly for wet areas under slab
Backfill Approval b10
Plumbing Under Slab
,riPVC/Cast/Copper
fatheletien Insulation Interior/Exterior
R- /6
Rough Grade 6 inch drop within 10 ft.
L:1SueHemingway\Building,Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
Foundation Inspection Report 1
Office No. (518)761-8256 Date Inspection request received: >')(i)
Queensbury Building&Code Enforcement Arrive: am/p Depart: ( am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: U
NAME: PERMIT#: c4OHI
LOCATION: L�3 � tIsk
INSPECT ON: LI — —03
TYPE OF STRUCTURE: PV
Comm, s
Y N N/A
Footings
Piers
Slab: _ Z U 'Z'}e
Reinforcement i Place
The contractor is responsible for
•
L ... — roviding protection from freezing /
• for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
•
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 in width
/P/
6 ches above footing
1y_ rwet areas under slab
BadlIIfilrApproval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
1 �
Foundation Inspection Report —j ( si
Office No. (518) 761-8256 Date Inspection request received: '
Queensbury Building&Code Enforcement Arrive: am/pm if, („yefiartiiZ �am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: J
NAME: 91 a 51/k PERMIT#: cDOC)3- / 7 l
LOCATION: y.A.N ,►ti>.(2,)/ INSPECT ON: II --a_ —03
TYPE OF STRUCTURE:
Comments
Y N N/A
ootings /
Piers - -- c1 � � tr
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
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil 'oly for wet areas under slab
Ba pproval •
g Under Slab
PVC/ east/Copper 410
oundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
b /1) fl
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection requ st received:
Queensbury Building&Code Enforcement Arrive: am/p Depa am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
1'k ` ) PERMIT#: 1 ` 9
NAME: � �./ ���'�NJLOCATION: l` ic....)21
� INSPECT ON: ki—a ci-- 3
TYPE OF STRUCTURE. \
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain/Vents
•
Cast Iron, Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
ad or Air Supply Test ,,
v)e
Drain and Vents 0/V
J ib D5 PSI or 10 ft. above highest '�lr 'J .ti
C, f.
Connection for 15 minutes
Water Supply Piping •
Copper Commercial
r Copper,CPVC,Pex One &Two Family
Insulation/Residential Check/Commercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces ,
Combustion Air Supply for Furnace
Duct Work Sealed Properly
COMMENTS:
•
L:\SueHemingway\Building.Codes.Inspection.FORMS\Rough Plumbing Insulation Report.doc January 28,2003
Job Site Address: I Fs 3 C.AcEo2oeLE 2a4D Date: 4. t 4.03
Owner: 203r.4 .J/I 14),(.p Application No. File No.
,, i..0)(5-3--- I 7 it
Building Peiiiiit — Calculation Sheet VED
Natural Light, Ventilation & Emergency Egress Requirements- Q,Qa 1 3 Zac33
Habitable Area of 8R°of Room Light
4Req. Vent Room Actual
Opening S . t for Remarks T �AiN®� ��"�� �
Room Room °
$ t - a4! lit°• e:&�t r_--
in �; Area Square Area Square 45 Egress � � �.---
Square Footage Footage
Feet
Fau,ar -
,,,{ ?o£, 4 SG.604 42.E 28.3z �U , ,' 8 Co 0002 4/o,c 4/a
;2ao,1 7 -
? `0 00#4230 - i g. 4 21.2d 5 . 2 3O 3o
orrice- 110 6.£. C..2; 4 .4 of p c,
` �,,� Z8Co x 22.66 2/.24 ' 9�.8�
//.44 30 Qooa 9/o x 2/
( 4f7) (04 6./2 4.2G ' 2.6L , ,
Zero
�,2►4NT� 4 S.t Z G.2� 2.SG. 9 C,
F«
LA,SueHemingway\Building.Permit.FORMS WatLight.Ventil.Calculation.Sheet.doc
Job Site Address: / Fa' Cc ayeii t>A to %ZoAD Date:
Owner: 2a.6,..i i,.4 w4 t.o Application No. File No.
WINDOW SCHEDULE
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THIS LINE HAS EXAMPLES OF SAMPLE ENTRIES
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Doable tl/tb" Glazing
Hung
L:\SueHemingway\Building.Permit.FORMS\Window Schedule.doc
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ABSORBTION TRENCH
ru MATERIAL SMALL Of of SAME (SEE STANDARD A05ORMION TRMM) INSTALLATION OF DISPOSAL FIELDS SEPTIC 5Y5T M DESIGN -KRMEADLITY 4EXISTING
LIMERLYMYG SOL
O Q
1. CONSTRUCTION SHALL BE AS SHOWN ON THIS DRAWING,
COX t0 DRAIN SEED GROWN AND SHALL BE IN ACCORDANCE WITH THE N.Y.S. DE51GN FLOW - EXISTING BARN STRUCTURE WITH DOWNSTAIR5 TO BE CONVERTED o c
AND SLOPES DEPARTMENT OF HEALTH, AND Z 00 i
INTO A 1 BEDROOM COTTAGE. DESIGN SYSTEM FOR P055BLE FUTURE
ASTM F481-76 INSTALLATION OF THERMOPLASTIC PIPE AND v� c�
pPti I CORRUGATED TUBING IN SEPTIC TANK LEACH FIELDS. EXPANSION TO 3 BEDROOMS CALL NEW FIXTURES) 330 GAL/DAY
t' " 5� ''' % s 2. NO HEAVY EQUIPMENT SHALL BE ALLOWED WITHIN THE LIMITS STONE c Q
DRAINAGE SWALE .' . SEPTIC TANK USE 1.000 GAL. TANK
" ' '♦"r• OF THE DISPOSAL FIELDS AFTER PIPE INSTALLATION HAS BEGUN.
ON UPMLL 50E 1 .•'•a••:.' :,:.::'-.• ��f
or SLOPED SITES •' ••`'•''' ` 3. AFTER EXCAVATION 2' WIDE TRENCH TO THE DEPTHS REQUIRED, ABSORPTION FIELD - TEST PIT SHOWS 32 INCHES TO SEASONAL HIGH GROUNDWATER a
' •'' �j�j�/�/�-/�� O O O LQJ
THE WALLS AND FLOOR OF EACH TRENCH SHOULD BE CLEANED
AND RAKED TO ACHIEVE AN EVEN SURFACE AND TO LOOSEN THEREFORE USE SHALLOW TRENCH SYSTEM WITH FILL Q cn
SMEARED SECTIONS OF TRENCH. AS REQUIRED TO MAINTAIN MN. 2 FEET OF SEPERATION FROM BOTTOM �-,--
24' M. TO HIGH GROUNDWATER, Of LEACH FIELD TO SEA50MAL HIGH GROUNDWATER.
ROCK OR IMPERVI Us SOL 4. PLACEMENT OF CRUSHED STONE, PERFORATED PIPE AND GEOTEXTILE - PERCOLATION RATE 1" IN G, MIN. 8 SEC.
REMOVE LEAVES ROOTS. PLANTS AND FABRIC SHALL BE AS SHOWN AND CARE SHALL BE
ORS DEI)RIS. FLOW �� PIWR EXERCISED TO AVOID INCLUSION OF FINE GRAINED SOILS AND - 1G5 LINEAL FEET OF ABSORPTION TRENCH REQUIRED. TIC 1 "� o
TO SPREADING fl.l MATERIALOTHER WASTE MATERIAL IN THE STONE AND PIPE. USE 4 LATERALS EACH 50' LONG 200 L.F. TOTAL. EXYSTING WNER�.
5. THE PIPE SHOULD BE LAID AT THE GRADES AND TO THE REPORTED N q
RELATIONSHIPS SHOWN ON THIS DRAWING, MAINTAINING STRAIGHT /�CAS '\ N
CONTINUOUS GRADES WITHOUT SAGS, HUMPS, SEPARATED JOINTS /
` OR OTHER UNSUITABLE CONDITIONS. THE PIPE SHALL BE LAID /�
WITH THE HOLES DOWN IN ALL CASES. G JOI L5 DATA
5HALLOW A55ORPTION TRENCH 5Y5TEM 6. ALL DISPOSAL FIELDS SHALL BE GRADED TO SHED RAINFALL
NOT TO SCAR AND TO DIVERT SURFACE RUNOFF FROM ADJACENT AREAS AWAY
eEtwUrl FROM THE DISPOSAL FIELD. TEST PJ'[ / NEW L O K Q
SEASCINAL MGM GROLMUTER.OmRM OR PfUrAWS *�a�h/
O 10 TOPSOIL -� �
SOL 15 LESS TMAN V 8UT GREATER YMAN 4'. fUUUTiOM 10-22' SLTY/CLAY LOAM / CRgD v� _
RATE or E>aTrw 50L MusT Of rASTtR nun GI)I�utES. 22-54' SILTY CLAY T£ L pw T4 �R cup = o
I✓£ST qR£q qI� r � ,`• � � , ,
MOTTLING AT 32" silk ON =o o
THESE PLANS HAVE BEEN APPROVED UNDER AUTHORITY NO WATER. ROOTS TO 32" ,_ �F IJ,prV °y�
OF A RESOLUTION ADOPTED 1/21/03 BY THE PLANNING
r-o•• 4*-0" - MIN. 2•-O'• 15Z MAX" BOARD OF THE TOWN OF QUEEN55URY. NEW YORK WITH PERCOLATION RATE - 1• IN 6 MINUTE. 8 SECONDS
G'-0•' RECOMMENDED CROSS SLOPE THE FOLLOWING CONDITIONS= /oVeRFLL TO ALLOW ON SLOPED SITES TEST PIT AND PERCOLATION TEST BY
FOR SETTELMENT 1. CHANGE THE WORD 'APARTMENT' TO DWELLING IN THE BY THOMAS MACE. 5/10/02
FIRST SENTENCE OF PREPARED RESOLUTION.
EARTH- 2. FLOOR PLAN SHOWING ONLY ONE BEDROOM TO BE Lu
18'• FILL GEOTEXTILE FABRIC SUBMITTED AS PART OF THE SITE PLAN FILE PRIOR TO c
SUBMITTING BUILDING PERMIT APPLICATION.
2" M. 4-- PERFORATED _
LATERAL 3. THE DWELLING WILL BE ONE BEDROOM AND THERE WILL
12.. BE NO RENTAL OF THE PROPERTY; PROPERTY 15 NOT rT'
3/4•• TO 1 1/2•' TO BE SUBDIVIDED. NEW 3/4" WATER
6'-011 - MIN. WASHED 4. THE SEPTIC SYSTEM WILL BE INSTALLED IN ACCORDANCE SERVICE FROM
W-0- RECOMMENDED 24" PIN. CRUSHED STONE WITH, AND APPROVED BY. THE TOWN BUILDING + CODES MAIN house0� A I�
DEPARTMENT. p ,� �+
MAXIMUM SEASONAL MGM -
GROUNDWATER ELEVATION = 5. SHALLOW AB50RPTION TRENCH DETAIL TO BE I3L❑CK z W
OR IMPERVIOUS SOIL OR ROCK CORRECTED TO SHOW 24' SEPARATION TO 5EA50NAL ,., SILO
HIGH GROUNDWATER. a rZ A
STANDARD AB50RPTION TRENCH SECTION o
G. DRAINAGE SWALE TO BE SHOWN IN 'L' SHAPE EAST OF i.000 GALLON
Nor To SCALE WOOD FRAME BARN AND SOUTH OF SEPTIC SYSTEM SEPTIC TANK z y,
INFILTRATION BED. a
o
U) 0 �
O Cu
M7=f
' ZONING ADMINISTRATOR DATE 4418' MAX.
30' WILL❑W ' E"4
30' MAX.
18' MIN. 2' MIN. O 6' MIN. O [a] E-
O - 5UBSURFACE ABSORPTION 5Y5TEM -`'"`^✓- ^
4 LATERALS AT 50` LONG EACH516 �L�,�.•
GAP ENDS OF LATERALS
cm?( 26NEW
4' PERFORATED PVC LATERAL O SNQRf � t LECTRIC
SLOPE 1/16 1/32 PER FT. OF SERVICE
BOTTOM c TRENCH LEVEL NQ LQI CF ��oRG� t✓4pD F `e�' U�
1. END OF UNLESS N�TERc°Ror�cTE MUST of R,gME �
B10
2. ALL LATERALS TO BE OF E01 A1. LENGTH. BOX
`` PT / r �� BOX WU W 0
LEVELER DCo
STANDARD ABSORPTION TRH PROFILE �2!;
NOT TO SCALE P
0
`r�OA,C rY MAPLE M� z
RECOMMEND ALL ACCESS \,� ...._ '
+ CLEANOUT OPENINGS
APPROXIMATE Be RAISED TO 6" BELOW CONCRETE OR STONE YpICq(.� �I/Vt
FIN15H ALL 0
GRADE FINISH GRADE. BL O E
ED R5 ' �",
RECOMMENDED' Site Statistics A COVED .0
plic n
TAX IHAP PARCEL - 227.17-1-12 6" MAPLE p
INLET BAFFLE 12" MN ZON14G, WATERFRONT RESIDENTIAL - 1 ACRE 2 1 2O 4�
. COVER OVER
SITE AREA, 2.38 OGRES C103.673 sf) CONSTRUCT SWALES TO )RAN SURFACE
ALL STRUCTURES T
WATER AWAY FROM ABSORPTION FIELD Z ing Administrator V
#1 DISTRIBUTION BOX 51TE UTILIZATION AND AROUND BARN. ALL 5URFACE DRAINAGE OF OUEENSBURY tom.
BY FORT MILLER OR BULDNG AREA, 7.325 sf - 7.1Z MUST BE KEPT ON PROPERTY AND OUTLET pG♦�.� w
3 EQUALWHERE EXISTING SURFACE RUNOFF OUTLETS.
PAVE14ENTS (inc. graveD, 3.727 sf - 3.67.
OWNER / APPLICANT
--•-�... DECKS. PORCHES. POOL 3.750 sf 3.6Z LIQUID LIEVEL H PERMEABLE AREA, 55.871 sf - 85.7Z (G5Z MN. REQUIRED) W 0
SLOPE 9
0 (� ROBIN INWALD w
1/4" PER FOOT
MM. SLOPE REQLIRED PARKING, - 2 PER DWELLING UNIT - 4 SPACES CLEVERDALE ROAD -0
1/8" PER FOOT PROPOSED PARKING - 2 EXISTING + 2 NEW - 4 SPACES CLEVERDALE, NY 12820 h� 0
0 0 °$° °pO ° ALL OUTLET INVERTS 518-793-8872 � Cd
c�000m TO BE SET AT EXISTING WATER SUPPLY 15 FROM LAKE AND WLL BE
1.250 GAL. SEPTIC TANK = o PEA EXACTLY THE SAME UTL12ZD FOR BARN APARTMENT WINTER ADDRESS
EQUAL GRAVEL ELEVATION. 119-19 83rd AVE.
BY FORT MILLER OR o o INLET + ouTLET 015TR1BUTION BOX (USE OF SPEED LEVELERS BUILDING SETBACKS G\ KEW GARDENS, NY 11415
BAFFLES ENCOURAGED) i;q 716-846-4622FROI% x NOT TO SCALE REQUIRED PROVIDED � �F�
o \SIDE IC50UTH), �• 19.1 existing
30.3 .exist.
a SEPTIC TANKS SIDE cNORTH), 25, lo8.r exist.
' O REAR, 25 133 exist. ` ►�
1. ALL UNITS .SHALL COMPLY WITH THE REQUIREMENTS OF THE NEW YORK \
STATE DEPARTMENT OF HEALTH AND SHALL BE PRECAST CONCRETE \
MINIMUM 2x WIDTM AS MANUFACTURED BY FORT MILLER OR EQUIVALENT. Date, AUGUST 12, 2002
MAXMUM 4x WIDTH 2. ALL STRUCTURES TO BE PLACED ON FIRM, COMPACT SAND OR l;
GRAVEL FOUNDATION. WHEREVER EXISTING FOUNDATION CONDITIONS Scale= AS NOTED
ARE UNSUITABLE, CRUSHED STONE SHALL BE PLACED AS �pPLAN
NECESSARY TO ACHIEVE A STABLE FOUNDATION. M1'�I- REFERENCE
000000 3. SEPTIC TANKS INSTALLED IN TRAFFIC AREAS SHALL BE EXTRA HEAVY PROPERTY AND STRUCTURE LOCATIONS BASED UPON A MAP TITLED Scale: 1"=2 '
PROVIDE 3" SAND OR-- 00� CONSTRUCTION DESIGNED FOR H-20 WHEEL LOADING. 'MAP OF A SURVEY OF OF LAND5 OF JO"N MCCALL AND PAULA 0
PEA GRAVEL UNDER TANK SEPTIC TANK 4. SEPTIC TANKS WITH JOINTS BELOW THE LIQUID LEVEL SHALL BE WATER- RA145 PREPARED BY WAYNE RAYMOND LICENSED LAND 5URVEYOR DATED 49092
NOT TO SCALE TIGHTNESS TESTED PRIOR TO ACCEPTANCE BY THE LOCAL CODE SEPTEMBER 1G. 1998 AND REVISED AUG, 9. 2002 TO 5hOW BUILDINGS.
ENFORCEMENT OFFICER.
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