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2004-108
TOWN OF QUE E NSB URY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20040108 Date Issued: Wednesday, June 21, 2006 This is to certify that work requested to be done as shown by Permit Number P20040108 has been completed. Tax Map Number. 523400-240-005-0001-007-000-0000 Location: 52-1/2 RUSSELL HARRIS Rd Owner. JAMES & NANCY WHITE Applicant: JAMES &NANCY WHITE This structure may be occupied as a: Single Family Dwelling By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the (- 4'f/P property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code E em Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY OIN742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040108 Application Number: A20040108 Tax Map No: 523400-240-005-0001-007-000-0000 Permission is hereby granted to: JAMES &NANCY WHITE For property located at: 52-1/2 RUSSELL HARRIS 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: JAMES &NANCY WHITE MARY BROWNELL Single Family Dwelling 12 CEDARWOOD Dr Total value QUEENSBURY, NY 12804 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-108 1450 SQ FT SINGLE FAMILY DWELLING $174.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, March 29, 2006 (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.) date.) Dated at the own o Que u /F. , March 29, 2005 SIGNED BY ` for the Town of Queensbury. Director of Building&Code Enforcement Permit No. O `/ " 4 / Building&Codes Office-Deportment of Community Development-Tow of Qt a jnsbvry i ee Paid + I i // a 742 Boy Rood,Guesensbury.NY 12804 Recreation Fee ___ Dave Hen,Director cndesPaueenshury net Phone: (5181 761-8256 FAX: (518)745-4437 Principal Structure Buildir g Permit Application Application& Plans subject to review before issuc ice of a validpermit for construction. Instructions: A permit must be obtained before beginning c onstruction. No inspections wit be made until the applicant has received c valid building permit. All applica is'spaces on this application must be completes or c7 must appear on the application form. f`99 Q Cv \Ju S fikiCtli W� 1 G.. .. IOCi> 1,tctr Apollca. /Builder a+! l ,.. 7: Owner: 1 1 Home Phone: - 4...• Hcme Phone: IRTRIEVAIIMPIIIMil <—, r { Email Address: ffi od , ,,' 1 Email Address: ,y �{� i 'b Cell Phone: �irLr` f : �n Cell Phone: 5 I iS )`--ig . --6a ``� \Ct,0 c.J FAX Phone: <cj' '1�-?j -0 4 a - FAX Phone: �" >1 S (critic-AS Person responsible for supervision of work with respect to b. din and codes compliance: / /}Name: Ct1 OS c�J-5 (C chi Gu ►�►() P U� !/� � 't2) 31P1-5L13`l Address: �1 C �r ` ✓ l(&'y`--- hone �t✓�_ Location of proposed construction: Lot No. t ;gal Address: csa... ,__ .t44e_R.L 'Lug__e 1t `' 1 --`--- Tax Map Number: (940. 5 I -'jam Sub ivisicn Name: Estimated Cost of Construction: 5 : 00,f Proposed construction is for: J Residential Use _Co imercial Use Name of Business: N/Fe —_ if proposed construction is on odditicn,what will use of ne add tion be8 i I , r —� I - i ' I New Addition I Altar cdlon I Proposed Construction 1-,Floc 2M+floor Other I Total Proposed ; structure , jOccupancy Type) 1 Sq.Ft. sq.ft. Sq.ft. 1 Squ t I Height II r�y— I Ft,&In.' �Rt ' I Stnglf-fam1N Dwelllny �'p�—t b[�� 111iJ +�/ %o�1 'wo-Famlly Dwelling —I _._! Townhouse T _, Rkutiitsemtly Dwelling ( I dumber of Units I f °nice T Mercantile —' Manufacturing Other. ) I _I , Attached Garage 1. 2, 3 I ± 1 I I Type of Heating System: Electric, Oil, Gas, Wood. Force )Ho' ir, Baseboard, Cher: is a fireplace and/or woodstove being installed,please refs to c separate application. _Yes o Applications are subject to Zoning Administrator, :ode Compliance, and Structural Plan re' a w. The Building and Codes Office will allow commer :errent of your proposed project only aft •r issuance of your permit. - Declaration: Please sign below after you have carefully read th ,stator-lent: To the best of my knowledge,the statements contained in le application,together with the plans and specifications submitted,are a true and complete stateme It of,5l proposed work to be done on the describ d premises and that all provisions of the Building Codes,the Z ning Ordinance,and all other laws pertaining to le proposed work shall be complied with,whether specified o note c.,and that such work is authorized by the o nY. Further,it is understood that I/we shall submit prior to a Cert '!cote f Occupancy or Certificate of Compliant being issued,as requested by the Zoning Administrator or C ectc r of Building and Codes,an As-Built Survey b a licensed surveyor,drawn to scale,showing actual location if all new,e6rystruction. ilder Signature: / Date: Applied /Builder Signature:_ The application of dated is hereby approved c ct permission granted for the construction,reconstruction or c erot cn of a building/and or accessory structure I forth above. Cate: Authorized Signature: L:\Sue I-lemingway\Suilding,Permif,FORMS\Principal Structure Permit Appl :otion dpc v:12/14/04 Z00/T001j uewdojeneq SLT' nu110.) boy Lett StL 812 WI 86:L0 nid SOOZ 31 el Application for Permit-Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: Location of installation: 5?/S,� t', �tiSsJt ,/i v f 5 Office Use , f t'tic_i ?4-le, /'Y File Permit N V l--/2 Tax Map No.i; / / Fee Paid Owner's Name u f ?+ t „,.,/ Address: -fw„°-'. a)• / Y� v, 2. INSTALLER'S NAME : )3 3 PHONE NO. 7 f? Pry 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 x 150 gal/bdrm = 19"0— 1991 x 130 gal/bdrm = 91 preseri J x 110 gal/bdrm = , 3 Garbage Grinder Installed yes— / no Spa or Hot Tub Installed yes— / no V 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply ( lat sand at what depth at what depth municipal Rolling loam / feet feet well Steep slope cgiD f t L-( if well; water supply %slope other from any septic-system depth: absorption is ft. other ,y► ?P Percolation Test: , (To be completed by licensed professional engineer or architect) Rate: ,J,4 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: 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 1 L TOTAL/ Size cf each: L gallons / 1 O.r AL Capacity: :7 4 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 to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. 1,4t,Q) Ct- erson gnature ofi res onsible p p /is/o ate '►I'osvtt of (�tit;4 Iu 1nary nh` $9Wt:1•4 Mitt :$c vStj a 1)441108it1 (•11:1()1C1'. n111xtIltli x (1. A•j3•:+t)RP•'t'iON 1'1 ELI.) . ' SIE,1'A1t4I'1ON ItP41.31ItI IVI1'IlN►1`S ' • ..%:\...t �, r s r# k MA � -......k. froi 5.4.)..\ ."77 likt V./r..)-t- t“ vii.urrk. �h1� / POND e\ ,.r **)I 'NNW GA51►1 c11 / • . 1 4 0/ e•'''. 411-4' /\ _,...,....,.,,,r i `' } 1buac 6 At. / - ,}u*r it'V$L G . } r �� w l 7 . it q MINI �' / .. / • Scr•ttcr • J4ttht . C.C.j) - \ t1 Rtib .. i.- . A • / „ a . 7. SIGN�ATUI E &IrtFO TIO `il�t1;'>ZF't.' r.._;�rr�vi�t env,.,«000.0.; P• 0 Application for Permit —Septic Disposal System Town of Qtte'eiisbuiy 742 Bay Road Queenshiiry NY 12804 (518) 761-8256 1. OWNER INFORMATION: Office Use Location of installation: Russell Harris Rd. , Cleverdale File Permit No. Tax Map No.240.5 / 1 / • Fee Paid 00014 160 Owner's Name:Jim & Nancy White Address: 12 Cedarwood Drive, Queensbury 2. INSTALLER'S NAME : IBS Septic PHONE NO.798-8194 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate ll bedroom(s) and multiply II of bedrooms with applicable gallons per bedroom to equal total daily flow) Your of House: No. of Bedrooms x Computation = Total Dal • :. . 1980 or older x 150 gal/bdrm = J U N R 7 2!03 1980— 1991 x 130 gal/bdrm = 1991 —present 3 x 110 6al/bdr►n = 330 TOW".' zY Garbage Grinder Installed yes / no Spa or Whirlpool Installed yes / no x 4. PARCEL INFORMATION: (circle applicable information & indicate measurements) To).gippliv Soil Naljrp crowid Water Bedrockor Impervious Material —Doiiicstic._Walcr Supply sand at what depth at what depth municipal Rolling loans 1 feet feet well Steep slope c ay si t Not Found if well; water supply _%slope other from any septic-system depth: absorption is• ft'. other Lake Percolation Test: (To be completed by licensed professional engineer or architect) • Rate: N/A 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 sirs of the septic tank and leach field for each Garbage Grinder. Spa or Whirlpool Tub. N/A Septic Tank: • gallon (min. size 1,000 gal.) Tile Field: each trench ft. Total System Length: Seepage Pit(s): number of size of each: ft. by• Sizo of Stone to bo used: II / depth or thickness fret Bed System Size: x • • Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: 2 / Size of each: 1250 gallons /TOTAL Capacity: 2500 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 to this application and agree to abide by these and all requirements of the To n Queensbury Sanitary Sewa posal Ordinance. Queensbury Building & Code Enforcement - Residential Final Inspection / �.1 Office No.(518)761-8256 Arrive: am/ r/r�epart:11 ' Vam/pm Date Inspection request received: Inspector's Initials:v V �--� NAME: , ,'� PERMIT#: a0011 40 V LOCATION: a-Z 04. _______-(A DATE: TYPE OF STRUCTURE: , 'lit t Comments ' Y N N/A Chimney Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 in h Plumb Vent through roof minimum 6" R f Complete/Exterior Finish Complete ward 30 in.or more�ir�,stairs,decks,patios / J Guard at stairwell at 34 in. or more I // Guard at deck,porches 36 in. or more Exterior Finish Complete Interior/Exterior Railings 34 in.to 38 in. - Platform at all exterior doors Interior Handrails stairs 2 or more risers Enclosed Stairs Sheetrock Underside minimum %2" Gypsum i 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 Gas Furnace shut-off within 30 ft.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 Valve(s)installed/Heat Trap/Water Temp 110 Interior privacy/trim/doors/main entrance 36 in. Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors: Every level: / Every Bedroom: Outside every bedroom area: Inter Connected: / Battery backup: Carbon Monoxide Detector Bathroom Fans,if no window PIumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf Emergency egress below grade _ Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/'/<hour fire door/door closer uct work Sealed properly as Logs in Sealed or Glass Enclosure G iAttic access 30 in.x 22 in.x 30 in.(ht.)In accessible area r- Crawl Spaces 18"x 24"access, 1 sq. fl.-150 sq. ft. vents Building No./Address visible from road tnal Electrical / Site Plan /Variance required / ,�// 4pficL v 7 As Built Septic System/Sewer Dept.Inspection Sticker Flood Plain Certification, if required Okay to issue C/C or C/0[Temporary/Permanent] L:\PamW\Building&Codes\Inspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04 renal Survey. pec#ion Dept. of Community Dove t nt Town of Queensbury 742 Bay Road # Queensbury,NY 12804 Date received: C r NAME• LOCATION: 00 PERMIT#: C4 0 0 4� Final,gurvey, Pleat Plan I Th&attached finil survey has been received by the - Dept.of Community Development. j Upon review the serve has been: Craig Brawn,Zoning AdniW' for i` i I Notes: d65e ` v i} s ore . f tY Ctc� l�v n" �o ��lr r i lit t k/ LASueHen injpmyABui4 CWes:tnspy ,�W- RMSWinal$mey ZoningAdagttW lor.doc DEED REFERENCE.- 1) SAUNDRA H. CUMMINGS TO JAMES M. WHITE, NANCY E. WHITE AND MARY W. BROWNELL, FILED IN THE OFFICE OF THE WARREN COUNTY CLERK IN BOOK 1195 AT PAGE 024, DATED NOVEMBER 10, 2000. MAP REFERENCE: 1) "MAP OF LANDS SURVEYED FOR JOHN CUMMINGS" LAST REVISED MARCH 14, 2002, PREPARED BY WAYNE R. RAYMOND, LICENSED LAND SURVEYOR. Lands n/f Matthew J. Bette F & Lisa K. Bette NOTES. 1) BASE MAP PREPARED FROM AN AUGUST 2005 FIELD SURVEY. 4 ,' ; L. 1077 P. 234 IPF 2) NORTH ORIENTATION IS BASED ON MAGNETIC MERIDIAN 2005. s 3) THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN ABSTRACT OF TITLE AND IS THEREFORE SUBJECT TO ANY EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD STONE '� ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE. PARKING 4) SUBJECT TO APPLICABLE LAWS AND APPROVALS OF THE TOWN, COUNTY, AND STATE 06,� ". / IPF REGARDING THE SUBDIVISION OF LAND. IPF� i 5) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND �o : SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE ASPHt NEW YORK STATE EDUCATION LAW. IPF � 0'7' • 'BARKING," ' �fds n ' 6) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE Lan ., ' , , IPF LAND SURVEYORS SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES. Michael T. Shearer / STONE & Glabrlelle Shearer / PARKING 7) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM SURFACE LOCATIONS AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY. L. 1034 P. :186 THERE MAY BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE, 05, ora V TYPE AND LOCATION OF ALL UTILITIES AND STRUCTURES MUST BE VERIFIED BY PROPER AUTHORITIES PRIOR TO ANY AND ALL CONSTRUCTION. CALL DIG SAFE PRIOR TO ANY EXCAVATION. /� �� 2 / SHED AREA /r- 0.14f ACRES/ ASPHALT ; n_ � n�tivE•• 7/N�i'�j1,�r1�t(,� I'llij!lllr/�N. 1100 io�� 1- ,lJlrJr ,i�i ,r,/� ,IJ�%fly, ,,1,r , ��r le,/I ,J fill jl,fill! �l I!!ji l .rin,�l�, ' llii,ll:/Jll ,i-l(•I:J 1,' rtr lJJN��f,�l,lu�lJ 1l:(•,1, ,;,,�,,Il,%�,1%J„J 11' " Lands nif LEGEND Barbara J. Tanis 'lI VIM,1;J 1, ���� �'�}, ";l%il1%•,, ,(% r;r,l" o I.R.F. IRON ROD FOUND i,lJ ��ti�lir%lJ,r; o I.P.F. IRON PIPE FOUND 'u•�!J%r. %%��1.�1,,/,1� o I.R.S. IRON ROD SET �! `� UTILITY POLE �!i! , ' I ' ,l l y o00o STONE WALL IPF WIRE FENCE 100 o CHAIN LINK FENCE o WOOD FENCE o POINT 9q O F.P. FENCE POST DECK 5 Ir`�J, a 'O i —ohw OVERHEAD WIRES n/f NOW OR FORMERLY IPF yc LAKE GEORGE MAP OF A SURVEY MADE FOR C)F NEW ytiN►METTFy1"p9� �, JAMES M, WHITE GRAPHIC SCALE 7(13-lye 20 0 10 20 40 e0 Town of Queensb ury County of Warren State of New York ` sFo os054° 'LAND s BOLSTER AND ASSOCIATES ( IN FEET ) PROFESSIONAL LAND SURVEYORS 1 inch = 20 ft. 342 Malin Street, Hudson Falls, New York 12839 Russell E. Howard, PLS N.Y.S Lic. No. 50540 Date: 09101105 Tax Map #. 240.05-1-7 Date Sealed:9 a7 Scale: 1 inch = 20 feet Revised: 916105 Drawing #: 05004C Queensbury Building & Code Enforcement - Residential Final Inspection bi-CP Office No.(518)761-8256 Arrive: am/pNn� depart: -®1-am/pm Date Inspection request received: - T Inspector's Initials: `^-'i - - �r NAME: /7 PERMIT#: 6 -- ) 3 f/ . LOCATION: re1/S�CZ.Z-- //442./e/-5 ,a-- DATE: TYPE OF STRUCTURE: f Comments \ Chimney Ht./"B"Vent/Direct Vent Location yLi NIAi'appe_ ��� `. L,)'`O f"/s Fresh Air Intake f 1 ®/< 3 inch Plumb Vent through roof minimum 6" ✓ 1 Roof Complete/Exterior Finish Complete Guard 30 in.or more @ stairs,decks,patios J 7 Guard at stairwell at 34 in. or more /vkeit 0 s _- r A460/ Guard at deck,porches 36 in. or more �tl /��L CJ Exterior Finish Complete 4. - Interior/Exterior Railings 34 in.to 38 in. �/ f Platform at all exterior doors Interior Handrails stairs 2 or more risers -7-' Enclosed Stairs Sheetrock Underside minimum '/2" Gypsum � VVV 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 Gas Furnace shut-off within 30 ft.or within line of site Oil Furnace shut-off at entrance to furnace area it Furnace/Hot Water Heater operating V i Low water shut-off boiler 1n1574LC.- `7 Ka -°F r e.--- f 4.G/ Relief Valve(s)installed/Heat Trap/Water Temp 110 .ii 7/ Interior privacy/trim/doors/main entrance 36 in. Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing . / Interior Smoke Detectors: Every level: / Every Bedroom: Outside every bedroom area: Inter Connected: / Battery backup: Carbon Monoxide Detector ✓/ Bathroom Fans, if.no window ✓/' Plumbing fixtures Foundation insulation 1 / Floor truss,draft stopping finished basement 1,000 sf / Emergency egress below grade ✓ Basement stairs closed rise>4 inches Garage Floor Pitched V/ Garage fireproofing/%hour fire door/door closer i Duct work Sealed properly 1/ Gas Logs in Sealed or Glass Enclosure / I - Attic access 30 in.x 22 in.x 30 in.(ht.)In accessible area ✓ / ��QbV 17& Arr.1 e- /4« C-4`) Crawl Spaces 18"x 24"access, 1 sq. ft.-150 sq. ft.vents Building No./Addres v'si le fr ro /Final Electrical i Site Plan /Variance req red Final Survey Plot Plan i 1/ i r "/1.)4vG Y As Built Septic System/Sewer Dept.Inspection Sticker Flood Plain Certification, if required Okay to issue C/C or C/0[Temporary/Permanent] 7 L:\PamW\Buildina&Codes\Inspection Forms\Res. Final Insp.form 2.docLast printed 2/12/04 13 Septic Inspection Report y`i • Office No.(518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/ n ` Depart: am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: c.:NAME: �� 1, f._ ` PERMIT NO.: Li I' O LOCATION: < C �� �*'� INSPECT ON: _ _-e'? RECHECK: Comments and/or diagram Soil Type: Sand/Loam/flay '7 _ Type of Water: Munici 1/Well Waters ,! I Waterline sepa istance ft. Well separation distance ft. s <- Other wells: ft. \ ( T) :-Ce` ) 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 ti << ; Tank to Distitibotiewbox 1/4.4.3 Distribution Box to Field/Pit Opening Sealed: Y/N/Partial End Caps Location/Separations 4-1 �,E j,` � t _ r-- Foundation to tank Foundation to absorption ft. -'' Separation of Pits �ft. Conforms as per Plot Plan \JY N Engineer Report and As-Built Y_N Location of System on Property: Front Rea 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 Last revised 1/6/05 1 , 00 3 n Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/pm\ `) Depart. a 'pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: \\A\ A d ));ft_RMIT#: LOCATION: Vcz Uv INSPECT ON: TYPE OF STRUCTURE: Comments N N/A tings 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 Dampproofing/Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil of 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:\SueHemingway\Building,Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003 Rough Plumbing I Insulation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/ y� epart: 2 ` m/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ( NAME: ovr PERMIT #: 0Li -- I 0 7 'LOCATION: vs c\l,.,IJ INSPECT ON: 4-{1 , N1 0 TYPE OF STRUCTURE: /-3/63122 Y N N/A Rough Plumbing / Nail Plates Plumbing Vent/ Vents in Place 1 1/2 inch minimum Drain Size _ Washing Machine Drain 2 inch minimum Cleanout every 100 feet/ change of direction Pressure Test Drain / Vent Air/ Head tIJM,t 10M4S i' 9) 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test �+� Water Supply Piping CC a L (N (2 -/Q 36 Air/ -. .S.I for 15 minutes / Calm iaL nsulation / Residential Check/ Commercial Check g.6- Proper Vent, Attic Vent Duct/ Hot Water Piping Insulation U ti)e3 e_v If required unheated spaces Combustion Air Supply for Furnace © ,ASS u6 Duct work sealed properly / No duct tape iti COMMENTS: L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart?,:'00 anima 742 Bay Road, Queensbury,NY 12804 Inspector's Initials NAME: t, PERMIT #: 4 LOCATION: ��- --t4-. ,. CZ,Ra.5 i-'�'Ai) INSPECT ON: , TYPE OF STRUCTURE: Y N N/A PVC: R-1,R-2,R-3,R-4 Drain/Vents Q„ 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 100 feet/change of direction Water Supply Piping Cooper Commercial Cooper,CPVC,Pex One and Two-Family V7 I sulatio&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.lnspection.FORMS\Rough Plumbing Insulation Report.doc November 17,2003 9 __ ,, Framing / Firestopping Inspection Report 1 Office No. (518) 761-8256 Date Inspection rue t r ceived: Queensbury Building&Code Enforcement Arrive: a part:ryelm/pm 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: E , C2 —------ NAME: -- \ iNtA �*)\:‘.. \ PERMIT#: _ LOCATION: ,,? c){��;� . .'\_f\, ,.i2 c INSPECT ON: (, -(fir6 "\. TYPE OF STRUCTURE: '°-�--� Y N N/A COMMENTS aming Jack Studs/ eaders 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 an snow shield 24 inches from wall F. e 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 %2 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.lnspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003 Framing / Firestopping Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/p , �/Dfepart: 4 / m/pm C. 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: A)S 71-3 NAME: Ci\ PERMIT#: O q7 LOCATION: INSPECT ON: �' TYPE OF STRUCTURE: Y N N/A ming 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 %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 ire wall 2, 3, 4 hour Firestopping B -I/ Penetration sealed ��� I Lr ��J �'�� /���� 16 inch insulation in cavity min. Garage Fire Separation �- (;� 1;' O C House side %2 inch or 5/8 inch Type X t� Garage side 5/8 inch Type X A 2 .416 A-r` 3 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.lnspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003 Rough Plumbing / Insulation Inspection eport iiv-51) Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arrive: am/p D part: am/pp 742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ` I- NAME: J' C it. \( PERMIT #: LOCATION: , '9 INSPECT ON: TYPE OF STRUCTURE: N N/A ugh Plumbing / Nail Plates Plumbing Vent/ Vents in Place �` 1 1/2 inch minimum Drain Size . Washing Machine Drain 2 inch minimum Cleanout every100 feet change of direction / 9 Pr Test 0ra'n /sure Vent Air / Head .S.I. or 10 ft. above highest connection for 15 minutes Pressure Test water Supply Piping 'otirl Head V/ P.S.I for 15 minutes 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:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building& Code Enforcement Arrive: ami M �) Depart: ' am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: fl'� PERMIT#: ©' LOCATION: /cUl 56'46— /44-RA5 _ INSPECT ON: __ 1 '�— TYPE OF STRUCTURE: Comments N N/A Footings T-- _ Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. .aterials for this purpose on site. ndation/ Wallpour r'einforcement in Place Me__ "`' /4-e-c- 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 poly for wet areas under slab Backfill Approval Plumbing Under SIab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\SueHemingway'iBuilding.Codcs.Inspection.FORMSU'oundation Inspection Report.doc January 28,2003 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: _ Queensbury Building& Code Enforcement Arrive: am/pm '► art: pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: � NAME: �_,) �,�j , PERMIT#: _ O LOCATION: O jC�- ,q 12✓Z(5 t '�� INSPECT ON: i Z C)'�'` TYPE OF STRUCTURE: Comments N N/A Footings —� T__-- —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. _ Found on/Wallpour R foreement in Place _ / / dafionDfingoun f / i �'n0 f Foundation/Waterproofing Type of Dampproofing/Waterproofing 1 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 I Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\SueHaetningway\&ulding.Codes.Inspection.FORMS\i'oundation Inspection Report.doc January 28,2003 ?)(\/) Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/pmp"..., Depart;r/• Janv'pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: C)Lt NAME: fNC) \k)1 y PERMIT#: 6� LOCATION: • INSPECT ON: O TYPE OF STRUCTURE: • Comments • Y IN I 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 / Reis 'orcement in Place IOU( Tho ' 4. - Voundation Dampproofing /ij7 /Foundation/WaterproofingFprif�! � Ar- Type of Dampproofing/Waterproofing �� ��� "" � Footing Drain Daylight or Sump 1—4'res1 �41& 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:\SueHemingway\Building,Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003 101 --3 &cis Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/ Depart: 'pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: 0 NAME: PERMIT#: LOCATION: uS� TSPECT ON: TYPE OF STRUCTURE: Comments �._ Y T _ N/A ;otings 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/Wall.pour Reinforcement in Place Foundation Dampproofing —vJ 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 Backfill.Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\SueHemingway\Building.Codes,Inspcction.FORMS\Foundation Inspection Report.doc January 28,2003 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: _ J L Queensbury Building&Code Enforcement Arrive: anv Depart/ I J am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's initials: NAME: �'�,t�G� PERMIT#: O "" ,P LOCATION: uhl � 1 INSPECT ON: k\ Ie D TYPE OF STRUCTURE: Comments Y N N/A Footings Pgo V k 9 C Piers 'F A)G tit) A 4.5Nc� s /� 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/Wall our Reinforcement in Place O5 I 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 poly for wet areas under slab BackfiIl Approval Plumbing Under SIab PVC/Cast i Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\SueHetningway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003 V ,....)Yrt%c ,eensbury Building.& Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: am/pm Depart: am/pm Date Inspection request received: Inspector's Initials: YY i r NAME: 4ti1�i 'T PERMIT#: ej 1' / C? LOCATION: •.S _ _/:Z y! 5'Se DATE: TYPE OF STRUCTURE: Comments: Yta . kt. I 4" Building Number Address visible from road �� / l k / B Chimney Height/" "Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches jR£ 3 10Roof Complete/Exterior Finish Complete / , ` Platform at all exterior doors Handrail 4 or more risers c 0 t.J C,c. S % ,- S t i `l 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 2- i -- (-) 6 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 is 4-6- 6 inch clearance to sill plate Gas Valve shut-off exposed(regulator 18 inches above grade ► .. Interior privacy l trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety /Window in stairwells safe' Pain glazing tY� g Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: YSfek_'. --;:',(\/ ) am, Outside every bedroom area: Inter Connected: Battery backr p:: Attic access 30 inches x 22 inches x 30 inches(height)in accessible area , C C\ Crawl Spaces 18 inch x 24 inch access, l sq ft.-150 sq.ft.vents t ` , Bathroom Fans,if no window Plumbing fixtures i /'f ` j Foundation insulation/Insulation Certification i '� , ` 1 �- 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 furnace area Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum 14"Gypsum Basement stairs closed rise>4 inches , Garage Floor Pitched ` Garage fireproofing/'A 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 in Bedrooms Flex Gas Pipe Bonding As Built Septic System I Sewer Dept. Inspection Sticker Site Plan /Variance required , Flood Plain Certification,if required , Okay to issue C/C or C I 0[Temporary/Permanent L:\Building&Codes Forms\Building&Codesllnspect$on Forms\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 8/26/08 r nt . Ca00q- Pe it N ber MECcheck Compliance Report • heck d By/Da e New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc Data filename: C:\Program Files\Check\MECcheck\WHITE RESIDENCE.cck TITLE:WHITE RESIDENCE COUNTY: Warren STATE:New York HDD: 7635 • CONSTRUCTION TYPE:Detached 1 or 2 Family HEATING TYPE:Non-Electric - DATE:03/05/04 • DATE OF PLANS: 03-04-04 PROJECT INFORMATION: JIM&NANCY WHITE CLEVERDALE ROAD LAKE GEORGE,NY COMPLIANCE:Passes Maximum UA=378 • Your Home=294 22.2%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor jA Ceiling 1: Flat Ceiling or Scissor Truss 460 30.0 0.0 16 Ceiling 2:Cathedral Ceiling(no attic) 552 30.0 0.0 19 Wall 1:Wood Frame, 16"o.c. 1306 19.0 0.0 78 Wall 2:Wood Frame, 16"o.c. 810 19.0 0.0 28 Window 1:Wood Frame,Double Pane with Low-E 309 0.330 102 Door 1: Solid 20 0.069 1 Door 2: Solid 20 0.069 1 Basement Wall 2: Solid Concrete or Masonry,8.0'ht/7.0'bg/5.0'instil • 690 0.0 11.0 49 Furnace 1:Forced Hot Air,92 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 Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this sage,they are attesting that to the best of his/her knowledge,belief, and professional jud nt,such plans or spec d .n are in compliance with this Code. Builder/Designer �, 1 Date �S /C161-f l i 5 j MECcheck Inspection Checklist New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release lc DATE:03/05/04 TITLE:WHITE RESIDENCE Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: [ ] 2. Ceiling 2: Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation . Comments: [ ] 2. Wall 2:Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: Basement Walls: [ ] 1. Basement Wall 2: Solid Concrete or Masonry,8.0'ht/7.0'bg/5.0'insul, R-11.0 continuous insulation Comments: Exterior insulation must have a rigid,opaque,weather-resistant protective covering that covers the exposed(above-grade)insulation and extends at least 6 in.below grade. Windows: [ ] 1. Window 1:Wood Frame,Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ]Yes[ ]No Comments: Doors: [ ] 1. Door 1: Solid,U-factor:0.069 Comments: [ ] 2. Door 2: Solid,U-factor: 0.069 Comments: Heating and Cooling Equipment: [ ] 1. Furnace 1:Forced Hot Air,92 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. • I S M ( Duct Insulation: [ j 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: [ ] 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°F or chilled fluids below 55°F must be insulated to the levels in Table 2. i 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 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 • NOTES TO FIELD(Building Department Use Only)