2004-054 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
- Permit Number: _=P20040054 Date Issued: Monday, June 14, 2004
.. :This4s_ao_cerdfy that:wdrk requested_to be-done-as shown by Permit Number P20040054
has been completed. -
- - Tax Map Number: 523400-308-006-0001-031-000-0000
Location: 20- MICHAELS Dr
Owner: LARRY CLUTE
Applicant: CLUTE ENTERPRISES INC.
This structure may be occupied as a:
By Order of Town Board
Garage - 2 Cars Attached TOWN OF QUEENSBURY
Single Family Dwelling
Director of Building&Code Enforcement
,r
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040054 Application Number: A20040054
Tax Map No: 523400-308-006-0001-031-000-0000
Permission is hereby granted to: CT,T TTE F,NTF,RPRTSF,S INC.
For property located at: 20 MICHAELS Dr
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: JACOB POST INC
PO BOX 366 Garage-2 Cars Attached
GARDEN CITY NY 11530 Single Family Dwelling $125,000.00
Total Value $125,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
CLUTE ENTERPRISES INC.
13 DAWN Rd
OIJEENSBURY_ NY 12804
Plans&Specifications
2004-0054 20 MICHAELS DRIVE
1536 SQ FT SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE
$224.32 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, March 08, 2005
(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 T wn o jeet?� March 08, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Check Residential Plan Review: One&Two Family Dwellings
Y/N/N/A i
(2)Full sets of plans
Over 1,500 sq.ft.—Stamped
Design Load&On Plans:90 Wind Floor Loads 40 psf
70 Ground Snow Load Sleeping Areas and Attics 30 psf
Calculations:
indow Schedule With Glass Size
Door Schedule/Main Entrance 36"Door
mergency Escape Or Bedrooms and Habitable Space
Above/Below grade,5.7 sq.ft.
Grade,5.0 sq.ft.
24"(h)x 20"(w)min.
44"Max.Height above floor
esidential Check Paperwork Compliance and Inspectors Checklist: OK
D proofing/Waterproofing Materials On Plans
oundation Drainage On Plans,if required
V 6"Drop in 10'Exterior Grade
naming Cross Section For Each Roof Line,Vertical Fire Stopping Every 10'Where
e uired
Ice and Snow shield 24"Inside Exterior Wall/24"Inside Knee Walls
Platforms At Exterior Doors
Stairway Headroom 6' 8'All Stairs 36"Width
Stair Run and Rise ,
-/V/A_ Winder Run and Rise
Spiral Not Allowed From 2nd Story
i
Smoke Detectors Battery Backup and Proper Location
Bathroom Fixtures Proper Clearance
Hall Width,36"min.
andrails More Than One Riser On Open Sides.
Railing and Guards>30"/Basement Stairs Included/Closed Risers More Than 4"in Ht.
Safety Glazing Notes For Required Areas
Garage Fire Separation
Garage Floor Sloped
Attic Access
Roof over 30"—22"x 30"/Crawl Spaces 18"x 24"Access
Carbon Monoxide Detector Lowest Sleeping Level
Soil Test Results,if required
Septic To Well Or Water Line Separation
All Paperwork Signed
t. IT
Job Site Address: lc. Date: ����
Owner: �.G�..: C�J. � k'; � Application No. File No. onq
AKI RECEIVED
WINDOW SCHEDULE FEB 2,4 2004
r 1'�*;r-.+;r+,r 9 r+' G}'ry.'@'1•ry.r.t",: ♦:, kIs„re,;tlN 7 t t' •"°"r..; 7v. 7„ yry :.
Of III
,� ,): a•}„a^ 'E � «'� � �#sc�,fi��} ' r'Ft�O�50�1�1}�+1�PcE1�Cik�.0215�a,,�"�s t€ tEa`.� ..,.:.. :•!•O.VY7 V"Of"'�UE`.,.
EVSBURY
Window Window Mfg. Window Unit or '3qugh" RodgIi s T Q T Q ' - : Clear. :. ecial Hardware or
or
Number or Name Model Stock Opgntng ;�Ope tlig Glsslyts�b r fi ess/, Jea Op�nr�zg;.• ,Open4n HQight Instructions
i d
Letter on Or Type Number c��Ielgit +4 t9a b enmg Xtdth� c�i'n 1r�olaes
c c rt
Plan Call Size �I + Egf�t a i �� ay� {s Y'.rt11iC�1e5 r Sri
`0 .3f S�.Y
Lj
-THIS LINE HAS EXAMPLES OF SAMPLE ENTRIES
Temliered
:. • An e'rs"n Narrol�t5e r 3062 6 ;/t. 'IU , p
1
S b
•.r 4. .... ` �. .
,:\SueHemingway\Building.Permit.PORMS\Window Schedule.doc
Job Site Address: ]Date: 'Y
Owner: �- )Application No. File No.
Building Permit — Calculation Sheet
Natural Light, Ventilation & Emergency Egress Requirements
Habitable Area of ; Req. Light Actual ? Req, Vent Actual Sq.Ft. Remarks
8%of Room Light a 4%of Room Vent O enin Room Room ,yy g f p g for
in ? Area Square Area Square Egress
Square f Footage Footages
Feet ;n
Ing
+Vi M
V
WMIJ
y'� p
7?C: 9;'EYTi y�yy
1 � t
LASueHem•ingway\Building.Permit.FORMSW at.Light.Ven6I.Calculation.Sheet.doe
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance Methods:Part 5 -Acceptable Practice Method— 1&2 Family Dwellings (only)
Part 6*-Thermal Rating—Component trade Offs 1&2 Family Dwelling;
Multi-Family Dwellings(3 Stories or less)
Part 4*=Design by Component Performance, Commercial Buildings-Hi
Rise Residential
*Requires submission of worksheets
APPLICANT'S NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area 1 square feet
2. Type of heat- Electric Oil_ Gas Other
3. Is building mechanically cooled? yes_�No
4. Percentage of area of windows and doors Over 17% >S Under 17%
5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R
b. Exterior walls R �9
C. Glazed areas R 2.S
d. Exterior doors R i`-tS
e. Floors over unheated spaces R
f. Edge of slab on grade(heated building) R
g. Basement/cellar walls(above grade) R i l
h. Basement/cellar walls(below grade) R
i. Heating/cooling-ducts-piping in unheated space R L-f:S
6. Service(domestic)hot water heating device
Conforms to minimum efficiency per code Yes No
TE RA CONTROL IMUM SETTING 140—WILL NOT BE EXEEDED
A s Si atu Date Phone Number
- '7�X?
INSPECTOR'S REMARKS:
I
Application for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION:
.......................................................................................................................................
Office Use
Location of installation: ?cam
File Permit No.
Tax Map No.
Fee Paid
Owner's Name:
.........................................
Address:
2. INSTALLER'S NAME C,J � � /»� �-3'Y�_ PHONE NO. (�t
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply#of
bedrooms with applicable gallons per bedroom to equal total daily 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/bdnn
Garbage Grinder Installed yes_ / no K E NF
Spa or Hot Tub Installed yes_ / no ?
FEB 2A 2004
4: PARCEL INFORMATION: (circle applicable information&indicate measurement)?W'N OF QUEENSBURy
BUILDING AND CODE
Toi)ography Soil-Nature Ground Water Bedrock or impervious Material r SLipply
lat sand----' at what depth at what depth unici al
Rolling oam feet feet well
Steep slope clay if well; water supply
_%slope other from any septic-system
depth: absorption is ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: 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: gallon (min. size 1,000 gal)
Tile Field: each trench ft. Total System Length: `�400 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 re tions with respect to this application and agree to abide by these and all
requirements the Town o ensbu anitary Sewage Disposal Ordinance.
signatur&aWesponsible person Date
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.:
No inspection will be-made until applicant has received a Fee Paid:
valid building permit. Form must be completed. �'�-���'' WA ,Reviewed By
Applicant:. ` Owner:
Address:
Phone#: `7�77 Phone#:
Tax Map Number: 30-' 3 ,
Subdivision Name:
(if applicable)
Lot Number: /House Number: /Street Name �i r ✓
OR
Property Location: r ��
New Buildi�Resi�entiommercial Estimated Market Value of Construction:
u Addition: Residential/Commercial If an Addition,what will use of addition be?
a Alteration: Residential/Commercial
a No change to
'Exterior size: Residential/Commercial .
❑ Other work: (describe )
Check Below Occupancy Info 1' floor sq.ft. 2° floor sq.ft. Other floor sq.ft. Total Sq.Ft.
Single Family Dwelling `7(10.- `7 G<�
Two Family Dwelling Men
Townhouse
Multifamily Dwelling
#of units FE
Office
Mercantile EE%1SBURY
Manufacturing'
1 car detached garage
2 car detached garage
3 car detached'garage
1 car attached garage
2 car attached garage LOW
3 car attached garage
Storage Bldg.,Comm
Storage Bldg.,Res,
Other
What is the proposed height of the structure: 3?G feet inches
Will any second-hand or ungraded lumber'be used? If so,for what? SO 1D
No.of Fireplaces to be installed:
No. of Woodstoves to be installed:
List below the person(s)responsible for supervision of work in regards to Building Codes:
Name Address Phone No.
Builder '
-Plumber--- ----
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. Fu r;it is under that I/we shall su ,prior to a Certificate of Occupancy or Certificate
of C 1 0 h ce being issued, eq ested by the Z ng A inistrator or Director of Building and Codes,an
As B `t Survey byoa lice n u e awn sc owing actual location of all new construction. .
architect,contractor)
gnatur (circle one: owner,owner's agent,
TOWN OF QUEENSBURY
BUILDING '& CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPORT
COMMERCIAL ------ MULTIPLE DWELLING
(hotel, motel, apt. complex)
DATE INSPE ION REQUEST RECEIVED:
NAME /
LOCATION
DATE
DATE � ����L( PER,M/ITT A
TYPE OF STRUCTURE sy-y
FOOTINGS _BACKFILL_ FRAMING_ PLUMBING
INSULATION
N/A YES NO
CHIMNEY "B" VENT HEIGHT
PLUMBING VENT FIXTURES
ROOFING
EXTERIOR FINISH
HEATING HOT WATER
RELIEF VALVES
FLOORS '
FOUNDATION INSULATION
INTERIOR STAIRS RAILINGS
STOCKROOM ENCLOSURE
FIRE DEMISE WALLS PENETRATION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS CLOSERS
EXIT DOOR HARDWARE
EXIT STAIRS/RAILS
PLATFORM ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS
HANDICAPPED PARKING
FINAL ELECTRICAL
PbAlrIVAR `RE- .
FINAL SURVEY PLOT PLAN IF RE
OK TO ISSUE C/O OR C C
s
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: ants/ Depart. am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: O�
LOCATION: CSC. DATE:
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake C`CC���
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs, decks, atios
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in. or more
xterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30.ft. or within line of site
Pff Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
. Relief Valve(s)installed
In or privacy/trim/doors-/main entrance 36 in.
athroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
3/4 hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s .ft.-150 s .ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required r 9 fvc t / �`'2 k 6:
Final Survey Plot Plan "
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C/0(Cert. Of Occupancy)
Okay to issue Permanent C/0(Cert. Of Occupancy)
L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/p Depart: . am/pm
Date Inspection request received: & lGhv
Inspector's Initials:
NAME: ' PERMIT#:
LOCATION: DATE:
TYPE OF STRUCTURE: G,
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Com lete
Guard 30 in. or more @ stairs,decks,patios 01
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in. or more
Exterior Finish Complete V 7-
Interior/Exterior Railings 34 in. to 38 in. IAI fr,,(,C P�IjL�
Platform at all exterior doors
Interior Handrails stairs 2 or more risersA`�!� ��XtIQS"
Enclosed Stairs Sheetrock Underside minimum ''/z"
Gypsum
Grade away from foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade r(AeA)
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace areaVol
Furnace/Hot Water Heater operating
_
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight jor
Safety glazing/Window in stairwells safety glazing NSIrk 41(—
Interior Smoke Detectors:
Every level: / Every Bedroom:
i Outside every bedroom area:
Inter Connected: / Battery backup:
Carbon Monoxide Detector
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss, draft stopping finished basement 1,000 sf
Emer ncy egress below grade
Basement stairs closed rise>4 inches
Garage Floor Pitched _
I Garage fireproofing/'/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Attic access 30 in.x 22 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, I s . ft.-150 s . ft.vents
Building No./Addre v sib e from oad
Final Electrical
Site Plan /Variancd re uired
Final Survey Plot Plan
As Built Septic System/Sewer Dept. Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C or C/O [Temporary/Permanent]
L:\PamW\Building&Codes\Inspection Forms\Res. Final Ins]). form 2.docLast printed 2/12/04
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p epart: U• r� am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
� Q oS7
NAME: cc U� PERMIT#:
LOCATION: INSPECT ON:
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
R gh Plumbing/Nail Plates
Mead 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:\SueHemitigway\Building.Codes.Inspectiott.PORMS\Rough Plumbing Insulation 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/pin Depart: - am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: �Q� PERMIT #: 0 2-1-65cl
LOCATION: p ) INSPECT ON. G(
TYPE OF STR CTURE:
Y N N/A
PVC: R-1, R-2, R-3,R4 Drain/Vents
Cast Iron, Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
1 '/ inch min. Drain Size
Washing Machine Drain 2 inch min.
Head or Air Supply Test
rain and Vents
5 PSI or 10 feet above highest V C
connection for 15 minutes
eanout every 100 feet/than a of direction
ater Supply Piping
Cooper Commercial
Cooper, CPVC,Pex One and 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/No duct tape
COMMENTS:
L:\SueHemingway\Building.Codes.tnspection.FORMS\Rough Plumbing Insulation Report.doe November l 7,2003
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: /
Queensbury Building&Code Enforcement Arrive: am/pin Depart: 5 am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: y�2_
NAME: PERMIT #:
LOCATION:v INSPECT ON:
TYPE OF STRUCTURE: ��
Y N N/A
PVC: R-1,R-2,R-3,R4 Drain/Vents
Cast Iron, Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
1 % inch min.Drain Size
Washing Machine Drain 2 inch min.
Head or Air Supply Test
Drain and Vents
5 PSI or 10 feet above highest
connection for 15 minutes
Cleanout every 160 feet/change of direction
Water Supply Piping
Cooper Commercial
0o er,CPVC,Pex One and Two-Family
. sulation/Residential Check/Commercial Check A
Proper Vent,Attic VentJ\ L1 N 2
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS:
L:\SueHemingway\Building.Codes.Inspection.FORMS\Rough Plumbing Insulation Repod.doc November 17,2003
Rough Plumbing. /Insulation Inspection Report,—
Office'No. (518)761-8256 Date Inspection request received: 0
Queensbury Building&Code Enforcement Arrive: am/p epart: m/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT #:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A
PVC: R-1,R-2,R-3,R4 Drain/Vents
Cast Iron, Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
ail Plates
1 '/ inch min.Drain Size
Washing Machi a Drain 2 inch min.
ed o a Air Supply Test 74
Drain and Vents
5 PSI or 10 feet above highest
Cleanout every 100 feet/change of direction
Water Supply Piping
Cooper Commercial
Cooper,CPVC,Pex One and 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/No duct tape
COMMENTS:
L:\SueHemingway\Building.Codes.Inspection.FORMS\Rough Plumbing Insulation Report.doc November 17,2003
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received: o�
Queensbury Building&Code Enforcement Arrive: am!v�lyart: a p
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: �
ni
NAME: PERMIT#: ��, /
LOCATION: A INSPECT ON: a `ice
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
Fire separation 1, 2, 3 hour
Ir al , 3, ho �y116kc.�/a
Firesto
Penetration sealed ` N
16 inch insulation in cavity min.
Garage Fire Separation
House side ''/z 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
LASuel-Iemingway\Building.Codes.Inspection.FORMSTraming Firestopping Inspection Report.doe January 28,2003
Framing / Firestopping Inspection Report 3
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pDq(art: a pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: �—
NAME: t.0 PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Framing Y N N/A COMMENTS
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 %z(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
chor Bolts 6 ft. or less on center
Ice and snow 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 '/z 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
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement . Arrive: am/p D part: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: �Q.� PERMIT#: LI 'o
LOCATION: _ INSPECT ON: U
TYPE OF STRUCTURE: /
Framing 1V
Y N N/A COMMENTS
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 TA Q
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft, floor trusses
Anchor olts 6,ft. or less on center
and snow 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 '/z 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.FORMSTraming Firestopping Inspection Report.doc January 28,2003
l F OJ f
P
Septic Inspection Report
Office No. (518)761-8256 Date Inspection rerECT
d: 3
Queensbury Building&Code Enforcement Arrive: _apart: `,� a pi
742 Bay Rd., Queensbuly,NY 80 Inspector's Initials
NAME: I PE
LOCATION: _ S IN
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 'C>ft.
Depth of trenches ft.
Size of Stone . i
See a e Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank nj .. 1
Tank to Distribution Box
Distribution Box to-Fie /Pit
Opening Sealed; Y%I /Partial
Location/Separations
Foundation to tank ft.
Foundation to absorption ? F
Separation of Pits •
Conforms as per Plot Plan IVI Y N
Location of System on Property:
Front Rear` t Side fight Side
Middle Froiit Middle Rear
System Use St/tus:
V Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
LASueHen-ingway\Building.Codes.lnspcction.FORMS\Septic Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:Queensbury Building&Code Enforcement Arrive: am/ m Depart;�o
m/apm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initia
ok --
NAME: PERMIT#:
LOCATION: 2li / '11C NI SPECT ON: 3 �3
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers
Monolithic Slab y "� �,f' V
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 Dampproofmg/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
1.2 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.
LASueHemingway\Bui]ding.Codes.Inspection.FORMSToundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection reque t rece ved:
Queensbury Building&Code Enforcement Arrive: am/p L Depart: c. am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:`
NAME: R( PERMIT#: -05 q1,
l
LOCATION: V 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
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofmg/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
1.2 inch width
6 inches above footing
it ly for wet areas under slab
ckfill Approval ✓
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:1SueHemingway\Bui]ding.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
� 1
Foundation Inspection Report +
Office No. (518) 761-8256 Date Inspection request received: !!72
Queensbury Building&Code Enforcement Arrive: am/pm\ Depart: am/pm
742 Bay Rd., Queensbuiy,NY 12804 Inspector's Initials: 'y
NAME: PERMIT#:
LOCATION: _ ( INSPECT ON:
TYPE OF STRUCTURE: 1
Comments
Y N N/A
ootings �
Piers n
Monolithic Slab
Reinforcement in Place 2i
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:
1.2 inch width
6 inches above footing
6 mil poly for wet areas under slab
ackfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASueHemingway\Building.Codes.InspectionTORMSToundation Inspection Report.doc January 28,2003
BUILDING PLANNING R3062-FIGURE R307.2 .
R306.2 Kitchen.Each dwelling unit shall be provided with a SECTION R307
kitchen area and every kitchen area shall be provided with a TOILET,BATH AND SHOWER SPACES
sink.
R3063 Sewage disposal.All plumbing fixtures shall be con- R307.1 Space required.Fixtures shall be spaced as perFigure
nected to a sanitary sewer orto an approved private sewage dis- R307.2.
pow system. R307.2 Bathtub and shower spaces. Bathtub and shower
R306.4 Water supply to futures.All plumbing fixtures shall floors and walls above bathtubs with installed shower heads
be connected to an approved water supply.Kitchen suft,lava- andinshowercompadmcntsshallbefmishedwithanoaabsor-
tones,bathtubs,showers,bidets, laundry tubs and washing beat surface_Such wall surfaces shall extend to a height ofnot
machine outlets shall be provided with hot and cold water. less than 6 feet(1829 mm)above the floor.
--N It-4IN. WALL
—N N-4 IN. WALL 2 IN. s-- WALL WALL
it 11
TUB O 301N.
t21 IN.
WC 301N.
CLEARANCE MIN.
LAVATORIES
24 IN.C FARANCE IN
FRONT OF OPENING
SHOWER
WATER CLOSET
OR BIDET WALL
15IN. Wes- i5IN.
— TUB
121K 21ML t
CLEARANCE CLEARANCE
WALL
TUB
WATER CLOSETS WALL
For SkIinch 25.4mm
FIGURE R3072-
MINIMUM FIXTURE CLEARANCES -
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
REScheckSoftware Version 3.5 Release Id
Data filename:C:\Program Files\Check\REScheck\20 Michaels Drive.rck
PROJECT TITLE:Colonial 24 x 32 1536 Sq Ft
COUNTY:Warren
STATE:New York
HDD:7635
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric
DATE:02/24/04
DATE OF PLANS: 02/24/2004
PROJECT DESCRIPTION:
20 Michaels Drive
Queensbury,NY 12804
DESIGNER/CONTRACTOR:
Clute Enterprises Inc.
13 Dawn Road
Queensbury,NY 12804
COMPLIANCE:Passes
Maximum UA=603
Your Home UA=378
37.3%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 1536 30.0 0.0 54
Wall 1:Wood Frame, 16" o.c. 3584 19.0 0.0 208
Window 1:Vinyl Frame:Double Pane 49 0.490 24
Door 1: Solid 42 0.230 10
Door 2: Glass 21 0.490 10
Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1536 19.0 0.0 72
Furnace 1:Forced Hot Air,90 AFUE
COMPLIANCE STATEMENT: 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 Co .nation C nstruction Code requirements. When a Registered Design Professional has stamped and
signed this page,they attest' g to he best of his/her knowledge,belief,and professional judgment,such plans or
specifications are ' c mpli a th this Code.
Builder/D r Date 7
1
REScheck Inspection Checklist
New York State Energy Conservation Construction Code
REScheckSoftware Version 3.5 Release Id
DATE:02/24/04
PROJECT TITLE:Colonial 24 x 32 1536 Sq Ft
Bldg.
Dept.
Use
Ceilings:
[ ] 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation
Comments:
Above-Grade Walls:
[ ] 1. Wall 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation
Comments:
Windows:
[ ] 1. Window 1:Vinyl Fraine:Double Pane,U-factor:0.490
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? [ ]Yes [. ]No
Comments:
Doors:
[ ] 1. Door 1: Solid,U-factor:0.230
Comments:
[ ] 2. Door 2: Glass,U-factor:0.490
Comments:
Floors:
[ ] 1. Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation
Comments:
Beating and Cooling Equipment:
[ ] 1. Furnace 1:Forced Hot Air,90 AFUE or higher
Make and Model Number
Air Leakage:
[ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
[ ] Recessed lights must be 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,the fixture must be installed with a
3"clearance from insulation.
Vapor Retarder:
[ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
Materials Identification:
[ ] Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
[ ] Materials and equipment must be identified so that compliance can be determined.
[ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating
J equipment must be provided.
[ ] Insulation R-values,glazing.U-factors,and heating equipment efficiency must be clearly marked on
the building plans or specifications.
Duct Insulation:
[ ] Supply ducts in unconditioned attics or outside the building must be insulated to R-11.
[ ] Retum ducts in unconditioned attics or outside the building must be insulated to R-6.
[ ] Supply ducts in unconditioned spaces must be insulated to R-11.
[ ] Return ducts in unconditioned spaces(except basements)must be insulated to R-2.
Insulation is not required on return ducts in basements.
Duct Construction:
[ ] I All joints,seams,and connections must be securely fastened with welds,gaskets,mastics
(adhesives),mastic-plus-embedded-fabric,or tapes. Duct tape is not permitted.
Exception:Continuously welded and locking-type longitudinal joints and seams on ducts
operating at less than 2 in.w.g.(500 Pa).
[ ] Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions.
[ ] Cooling ducts with exterior insulation must be covered with a vapor retarder.
[ ] Air filters are required in'the return air system.
[ ] The HVAC system must provide a means for balancing air.and water systems.
Temperature Controls:
[ ] Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
Electric Systems:
[ ] Separate electric meters are required for each dwelling unit. .
Fireplaces:
[ ] Fireplaces must be installed with tight fitting non-combustible fireplace doors.
[ ] Fireplaces must be provided with 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 must 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.
[ ] Insulate circulating hot water pipes to the levels in Table 1.
Circulating Hot Water Systems:
[ ] Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
[ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 105 T or chilled fluids below 55 T must be insulated to the
levels in Table 2.
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 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" 2.5"to 4"
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 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, 40-55 0.5 0.5 0.15 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD (Building Department Use Only)
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
REScheckSoftware Version 3.5 Release I
Data filename:C:\Program Files\Check\REScheck\20 Michaels Drive.rck
PROJECT TITLE: Colonial 24 x 32 1536 Sq Ft
COUNTY:Warren
STATE:New York
HDD:7635
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric
DATE: 02/24/04
DATE OF PLANS: 02/24/2004
PROJECT DESCRIPTION:
20 Michaels Drive
Queensbury,NY 12804
DESIGNER/CONTRACTOR:
Clute Enterprises Inc.
13 Dawn Road
Queensbury,NY 12804
COMPLIANCE:Passes
Maximum UA=603
Your Home UA=378
37.3%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 1536 30.0 0.0 54
Wall 1: Wood Frame, 16"o.c. 3584 19.0 0.0 208
Window 1: Vinyl Frame:Double Pane 49 0.490 24
Door 1: Solid 42 0.230 10
Door 2: Glass 21 0.490 10
Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1536 , 19.0 0.0 72
Furnace 1:Forced Hot Air,90 AFUE
COMPLIANCE STATEMENT: The proposed building represented in this document is.consistent with the building plans,
specifications,and other calculation ubmitted with this permit application. The proposed systems have been designed to meet the
New York State Energy Co ati n C nstruction Code requirements. When a Registered Design Professional has stamped and
signed this page,they attestin tha o the bes f er knowledge,belief,and professional judgment,such plans or
specifications are' com liance this C e
Builder/D Date
REScheck Inspection Checklist
New York State Energy Conservation Construction Code
REScheckSoftware Version 3.5 Release Id
DATE: 02/24/04
PROJECT TITLE:Colonial 24 x 32 1536 Sq Ft
Bldg.
Dept.
Use
Ceilings:
[ ] 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation
Comments:
Above-Grade Walls:
[ ] 1. Wall 1: Wood Frame, 16"o.c.,R-19.0 cavity insulation
Comments:
Windows:
[ ] 1. Window 1:Vinyl Frame:Double Pane,U-factor: 0.490
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? [ ]Yes [ ]No
Comments:
Doors:
[ ] 1. Door 1: Solid,U-factor: 0.230
Comments:
[ ] 2. Door 2:Glass,U-factor: 0.490
Comments:
Floors:
[ ] 1. Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation
Comments:
Heating and Cooling Equipment:
[ ] 1. Furnace 1:Forced Hot Air,90 AFUE or higher
Make and Model Number
Air Leakage:
[ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
[ ] Recessed lights must be 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,the fixture must be installed with a
3"clearance from insulation.
Vapor Retarder:
[ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
Materials Identification:
[ ] Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
[ ] Materials and equipment must be identified so that compliance can be determined.
[ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
[ ] Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on
the building plans or specifications.
Duct Insulation:
[ ] Supply ducts in unconditioned attics or outside the building must be insulated to R-11.
[ ] Return ducts in unconditioned attics or outside the building must be insulated to R-6.
[ ] Supply ducts in unconditioned spaces must be insulated to R-11.
[ ] Return ducts in unconditioned spaces(except basements)must be insulated to R-2.
Insulation is not required on return ducts in basements.
Duct Construction:
[ ] I All joints,seams,and connections must be securely fastened with welds,gaskets,mastics
(adhesives),mastic-plus-embedded-fabric,or tapes. Duct tape is not permitted.
Exception:Continuously welded and locking-type longitudinal joints and seams on ducts
operating at less than 2 in.w.g.(500 Pa).
[ ] Ducts shall be supported every 10 feet or in accordance with the manufacturer's instructions.
[- ] Cooling ducts with exterior insulation must be covered with a vapor retarder.
[ ] Air filters are required in the return air system.
[ ] The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
[ ] Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
Electric Systems:
[ ] Separate electric meters are required for each dwelling unit.
Fireplaces:
[ ] Fireplaces must be installed with tight fitting non-combustible fireplace doors.
[ ] Fireplaces must be provided with 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 must 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.
[ ] Insulate circulating hot water pipes to the levels in Table 1.
Circulating Hot Water Systems:
[ ] Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
[ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
of the heating energy is from non-depletable sources. Pool.pumps require,a time clock.
Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 105 OF or chilled fluids below 55 OF must be insulated to the
levels in Table 2.
Table']: Minimum Insulation Thickness for Circulating Hot Water Pipes.
Insulation Thickness in Inches by Pipe Sizes
Heated Water Non-Circulating Runouts Circulating Mains and Runouts
Temperature(F) . Up to 1" Up to 1.25" 1.5"to 2.0" Over 2"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVACPipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4"
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 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, 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD (Building Department Use Only)
I I 'I
'I ICI
I
29E d P59 7 "�C.SC 4 53iA1 r -JO -Y/N SONt77 LO
8S8d t�S9 7 cc
NOSONIH 53WV!', d0 J/N SCNv7
\ ti
V I '�
a 4'
•
-a-
QL
00'69L l M •-•0O \'
- S 0-5 4
106 �3\ W CD mp
LL1
W
¢ 1
?-2 ci V.
\ LL.
jo
C �
W F-0
` CD,
\
O
I
7 ON
N
Q. V:
.00"Sf/ M„S�;S/,-LO-S' --"'-----�_..._ „ , s's.-2/ -S `n � I
lto
CC i
i (NI '
In
i
U
L,LJ --
a 1 C�...�.. . .. .-
�. ,00*OOZ 3
I
J i
i
�lJ r
c
1
o I _ � �\
z
W q
I N \
t
f
t'8"ZF'6 3 .-.S,tr;9I.Z0-N
----------------
-----
i i
Sg� d bi5£ LOc e £99
niunr _ t f� d 2£ 9 £GL C fi£ i
tn0LU
V J
o o o mow.. ._. ....
LIJU
' N L11 p
Z
.W.. �' Q
UJ
d�
rn
4 OF
ca
ul ��
0
i
� n
f`)
{ I
kJ
n
i
:� n
MAP REFERENCE:
SHERMAN ACRES PHASE ONE
MADE FOR FRANK PULSIFER
DATED SEPTEMBER 5, 1973
NY JOHN B. VAN DUSEN
LOT 24
S�3
0230„f
208 ),
w
0 . n7
O 0 N
Z LOT 23 N
21,993.8 sq. ft. i ~
r
cl) .� A
135.4' 00
~ .s O
v1 N N
� I Jc
.� `36.g' v1
i HEREBY CERTIFY THAT THIS MAP WAS PREPARED
W FROM AN ACTUAL FIELD SURVEY.
3TpNE 0r2�� THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
3 rr ,,I AND LENDING INSTITUTION LISTED HEREON.
199.63, N' 4`� o V CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
N�83 3,OMw OD to
INSTITUTIONS OR SUBSEQUENT OWNERS.
0 CERTIFIED TO: MARK A. LEFEBURE
CHARTER ONE BANK, N.A.,
IT'S SUCCESSORS AND/OR ASSIGNS
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
CERTIFIED BY:
LOT 22 MATTHEW C. STEVES, LLS NYS 50135
DATED: JUNE 9, 2004
Mimi
nD u s e UNAUTHORIZED ALTERA71ON OR ADDITION TO A SURVEY
�I a (� NAP BEMtlNO A LICENSED LINO SUREEYORS SEAL IS A Map of a Survey made for
1[ A ``� VIOLATION OF SECTION 72O9.SUB-DIVISION Z OF THE
`/J\/�/ NEW YORK STATE EDUCATION LAW.'
ONLY COPIES FROM THE ORIGINAL OF TINS SURVEY
MARKED WITH AN ORIGINAL OF THE LAND SURVEYORS
S t e v e S �SHALL BE*CERTIFICATIONSCONSIDEREDATE TD BEN SIG, COPIES S 1
"VEYAS PREPARED HEREON THAT Mark A. L e f e b u r e
THIS wRVEr WAS PREPARED W ACCORDANCE WITH THE
EXISTING CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED
Land Surveyors BY THE NEW ORS. STATE ASSOCIATION OF PROFESSIONAL
IAHT SURVEYORS.SAID OM TIHE SURVEY
SHALL RUN ONLY
TO THE PERSON FOR WHOM illE SURVEY IS PREPARED,AND
ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL
169 Haviland Road Queensbury, New York 12804 AGENCY AND LENDING WS„NITION LISTED HEREON,AND Town of Quee:nsbury, Warren County, New York
To THE Am LEN OF THE LENDING INSTITUTION LEFEBURE C-1254
(518) 792-8474 New York Lie. No. 50135 NO. DATE DESCRIPTION DWG. NO. 03125-B