2004-488 r' TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development.- Building & Codes (518) 761-8256
CE.DL%_.".'vL1FI
CATE OFOCCUPANCY
Date Issued: Monday, December 12 2005
-- Permit Number: : P20040488 y�
This is to certify that-work.requested to be done as shown by:Permit Number P20040488
has been completed.
Tax Map Number:- 523400-301-017-0001-007-000-0000
Location: 515 WEST MT. Rd
Owner:. JPEK DEVELOPMENT, INC.
Applicant: JPEK DEVELOPMENT, INC.
This structure may be occupied as a:
Fireplace By order of Town Board
Garage - 2 Cars Attached TOWN OF QuEENSBURY
Single Family Dwelling
Issuance of this Certificate of Occupancy DOES NOT relieve the ,/�
owner of the responsibility for compliance with Site Plan, /Q►
property P tY P
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040488 Application Number: A20040488
Tax Map No: 523400-301-017-0001-007-000-0000
Permission is hereby granted to: FPFK DEVELOPMENT. INC;.
For property located at: 515 WEST MT. 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: FRED DICKENS III
TINA FOGLIETTA Fireplace
80 PARKHLTRST Rd Garage-2 Cars Attached
Single Family Dwelling $165,000.00
GANSVOORT, NY 12831-0000 Total Value
$165,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
.JPEK DEVELOPMENT. INC.
29 PERSHING Rd
OUEENSBURY. NY 12804-0000
Plans&Specifications
2004-488 HSE#515 WEST MTN. ROAD
1850 sq ft SINGLE FAMILY DWELLING
$266.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 18, 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 r7o )Q uee ury• nesday,August 18, 2004
SIGNED BY t� for the Town of Queensbury.
r .Y
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury-Dept of Community Development,742 Bay Road,Queerisbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No. q—L
No inspection will be made until applicant has received a Fee paid $' ( `
valid building permit. All applicants' spaces on this Roc.Fee Paid
application must be completed and must appear on the Reviewed By:
application form.
Owner: -VD 4-►� 7y�o�,..-~,"
Applicant. r•-
Address: aR -IZs, 4-u- a-6 Address:
yLc.( '00c,---sZoa,4 A• f
Phone#(QX)-)9r-9. (6`) Phone#(VW-) 7cr- 5r67
Property Location: Lot Number: / House Number / W C5 ►'"J`'"�'"`"O R�
Subdivision Name,'- Tax Map Numb er:3 y r , 1'7�- --7
ji New Building: residence /commercial 'Estimated Market Value of Construction: $ 1 b 5-0 o O
o Addition: residence/ commercial 1f an Addition,what will use of new addition be?
a Alteration: residence/ commercial
a No change to exterior size: residence/com'1
a Other work(describe )
Check OccupancyInformation 11 Floor 211d Floor Other floor Total
Below sq.ft. q.ft. _ sq.ft. Square Feet
a 01�
Single ihmily dwelling I i T-5,0
a Two famil dwelling
a Townhouse
o Multifamily dwelling
#of units
o Office
o Mercantile
a Manufact irin
a 1 oar detached garage '
n 2 car detached garage
a 3 car detached prageRIM
0 1 car attached garage
'% 2 car attached garage LI L y-to
a 3 car attached garage TOWN OF
a Storage building- AND CODE
commercial
a Storage building-
residential
a Other
What is the proposed height of the structure _feet _:. inches
Will any second-hand or ungraded lumber be used? If so,for what? ri o
Type of Heating System: electric/ oil /(O wood /forced hot air! baseboard/other:
Number of Firevkces to be installed 1 Number of Woodstoyes to be installed Q _ .
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
- Builder -- J - — - �n �D 7 9 S �6 7
Plumber b�, d.10)( 6.1 -7j'S -3r(<3
Mason b la«t. aonb
Electrician A i-VAb L, 66E 6 S>cl 0
Declaration please sign below after you have carefally read the statement.
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,axe 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 Ordinamce 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 Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new cons
Signatute:'� -Y° J owner,owner's agent,architect,contractor
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: i �5� �"c`'`''T � ' �2�
File Permit No. D 't_�
Tax Map No.101 / 0 / 1-1
Fee Paid
Owner's Name: "�D`A. -0uy+�o7wC^.,:'
Address: apt
2. INSTALLER'S NAME : 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 flow)
Year of House: No of Bedrooms x Commutation = Total Daily Flow
1980 or older x 150 gallbdrm =
1980—1991 x 130 gal/bdrm =
1991—present "� x 110 gal/bdrm = y
Garbage Grinder Installed yes _ / no.--)L
Spa or Hot Tub Installed yes_ / no
4: PARCEL INFORMATION: (circle applicable information&indicate measurements)
a h SoilNature Ground Water Bedrock or Im ervious Material . Domestic Water So ply
sa at what depth at what depth rmuniciRollin loam ,Feet �`�feet eepslope clay er supply
slope other ptic-system
depth: pn is ft.
other
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: 74" minute per inch A Q �- � V �L
'J � GjC-C 4ti1V�( A�6-A! D 7 �i �D1)l
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: of oO. gallon(min.size 1,000 gal)
Tile Field: each trench Total System Length: ,9oe ft.
Seepage Pit(s): number of of 2 size of each: ft, by ft.
Size of Stone to be used: # / depth or thickness feet
Bed System Size: ti 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 to this application and agree to abide by these and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person Date
t'awtt t�f <�ut:c�it�ttfue•y
S(avcr,c and Sowixg , Disposal tautjsirt•
• t
11'1�•�+t)It,�t''1'It)1`�I Ii'IIt31�I.� '
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7. SII�I,A►'I't3RS &A�FORivSA'TI� UIIaurrarsLre,��+ ��� �►a �.r..ti,:;
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' Fire Marshal's Office Town of Queensbury,742 Bay Road,Queeiisbury,NY
(518)761-8205
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel & vented gas appliances
Date 20 04 Permit No.
Applicationn is hereby made to the Building& Codes Office for the issuance of a Building and Use
Pertnit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner
agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of
these requirements and also will allow all inspectors to enter premises to per farm required inspections.
NOTE to applicant: Rough-in and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
(circle appropriate words)
Name: I<_ °�c�Er�,'� _ Stove: wood coal pellet gas
Fireplace insert
Address: ;)-Ct �11 ^t- N Fireplace, factory-built: wood gas
A `I Fireplace,.masonry: wood g s
�! Furnace: wood gas oil
Phone:
If non-masonary applicance, please provide
Owner: '�1 c� --'�'''``� Manufacturer Name:
Address: ACr yb Model Number:
Chimney Information
Phone: rt 6- -7 5'V 4 r67 (circle appropriate words)
Masonry block brick stone
Flue tile steel size: inches
Exact Address: 6,-S'py►`.��.,i/�+ �` (L1�
of construction or installation Factory-Built
Zc�-K— Manufacturer name: m J�0'>T% c_
Model Number: fy%'T
Note: Listed By: Number:
Construction/Installation must
con. orm to NYS Fire Prevention &Building Indicate(circle) chimney material:
Code. Consult available Town of Queensbury
Handouts regarding required inspections. Double wall / Triple wall / Insulated I Dlr'('Ct VG'1rtr11�T
Chimney Liner
21®w" ®f "6Z-":
f
Fire Marshal Code# S Collected S Re
Jiuuled Received fi'ora (refunded to): �� _
[Xj address: — �—
A 173 3389 (190) Public Safety
A 233 2655 (j230)Minor Sales
�/
DATE }_
N2G- rOHI_ 0 02 D,,} .v�i2
White(Applicant) / Green(Fire Marshal) / Yellow(Bldg. Dept.) / Pink&Goldenrod(Cashier's Dept.) O
r* .
Check Residential Plan Review: One & Two Family Dwellings
Igg
Y/`N/N/A
fO(2) ull sets of plans
ver 1,500 sq. ft.—Stamped
4, woor
esign Loads On Plans:90 Wind Floor Loads 40 psf
70 Ground Snow Load Sleeping Areas and Attics 30 psf
Calculations:
dow Schedule With Glass Size Schedule/Main Entrance 36"Door
E ergency 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
Dampproofmg/Waterproofing Materials On Plans
Foundation Drainage On Plans,if required
6'Drop in 10' Exterior Grade
Framing 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
VfPlatforms At Exterior Doors
10,
Stairway Headroom 6' 8'All Stairs 36"Width
Stair Run and Rise
Winder Run and Rise
Spiral Not Allowed From 2n Story
Smoke Detectors Battery Backup and Proper Location
B broom Fixtures Proper Clearance
3ailing
ll Width,36"min.
drails More Than One Riser On Open Sides
and Guards>30"/Basement Stairs Included/Closed Risers More Than 4"in Ht.
afety 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
VIf
Soil Test Results, if required
Septic To Well Or Water Line Separation r
All Paperwork Signed
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No.(518)761-8256 ) Arrive: am/pm epart: �9 am/pm
Date Inspection request received: I Inspector's Initials:
NAME: 1 PERMIT#:
LOCATION: i W e — Fes— DATE: I ZZ
TYPE OF STRUCTURE:
Comments
Ye No N/A
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade n
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight (nit°`
Safety glazing/Window in stairwells safety g zing
Interior Smoke De ciors:
Every level: Eve Bedro ri:
Outside every bedroom a:
Inter Connected: Battery backup:
Carbon Monoxide Detector
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s .ft,150 s .ft.vents
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum%z"Gypsum /
Basement stairs closed rise>4 inches
Garage Floor Pitched ^'
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealedproperly
Gas Logs in Sealed or Glass Enclosure l ►^'ty'4�- + S
Final Electrical eZ e3`—
Final SurveyPlot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Site Plan /Variance required
F ood Plain Certification,if re uired
Okay to issue C/C or C[0 [.Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form-revised-1 00405.doc
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 2
NAME:
LOCATION: 43- 5 We S-r A4 T
PERMIT#: D t j 8,?
Final Survey Plot Plan
Alwoved Denied
The attached final
survey has been
received by the /
Dept. of
Community
Development.
Upon review the
survey has be
Craig B oning Administrator
Notes:
L:\SueHemingway\Building.Codes.Inspection.FORMSTinal Survey
Zoning Administrator.doc
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Lands
Site Location MaP /'f
No Scale AudrrE�y Hoerning —Thomas
L• 951 P. 115
IwC�+ w Q,,+N O
2 (o
Lands n/f
Joann 0lnws 1006 P.Living
139 Trust
so�
L.
IRF
{
Lands n/f
JPEK Develops -wnt, Inc.
L• 1403 P. 074
AREA =
/ 1.86f ACRES
JOHN . STREET
s0y�3,• 36.5' IRF
N66�o` ` r
QD °
/N
\ POURED CONCRETE CIV
O
\ ♦ FOUNDATION
0
Lands n/f 29.8'
Richard Francis Dawson
\ \ & Christine Ann Dawson
L• 1425 P. 236 0•4' 3
/ OVER 37.1' w 3
/ N LEGEND
(0
w
o I.R.F. IRON ROD FOUND
o I.P.F. IRON PIPE FOUND
�Ri a o I.R.S. IRON ROD SET
"a. UTILITY o00o STONE WALL
E
x—�c x- WIRE FENCE
IRF o CHAIN LINK FENCE
o WOOD FENCE
\ O POINT
\
F.P. FENCE POST
a —ohw OVERHEAD WIRES
CERTIFICATION.•
n/f NOW OR FORMERLY
I HEREBY CERTIFY TO:
1) JPEK DEVELOPMENT, INC.
2) OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
3) CURTIS LUMBER CO., INC., MORNINGKIL FUNDING DIVISION, \ /
NOTES: IT'S SUCCESSORS AND OR ASSIGNSTHAT T \
FROM AN ACTUAL
1) BASE MAP PREPARED FROM A JANUARY 2005 FIELD SURVEY. URVEYiIS COMPLE COMPLETED UNDER MYMAP WASD DIRECT SUPERVISION.FIELD /
3
0
THIS SURVEY AND THE CERTIFICATIONS HEREON SHALL BE
2) NORTH ORIENTATION IS BASED ON DEED BOOK 1403 AT PAGE 074 AS RECORDED VALID ONLY TO THE PARTY OR PARTIES HEREON NAMED AND
IN THE OFFICE OF THE WARREN COUNTY CLERK ARE NOT ANSFER TO ADDITIONAL INSTITUTIONS OR
EQU T 0 S, 0 ER THAN AS MAY BE OR EXPRESSLY
3) THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN ABSTRACT OF TITLE AND A EREON. \
IS THEREFORE SUBJECT TO ANY EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD \
ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE.
4) SUBJECT TO APPLICABLE LAWS AND APPROVALS OF THE TOWN, COUNTY, AND STATE RUSSELL E. HOWARD o
REGARDING THE SUBDIVISION OF LAND. DATE 02/09/05
5) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND of: MAP OF A SURVEY MADE FOR
SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE
NEW YORK STATE EDUCATION LAW. \ �,
GRAPHIC SCALE JPEK DEVELOPMENT, INC.
6) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE
LAND SURVEYORS SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES. 30 o 15 30 so 120
7) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM Town of Queensbury County of Warren State of New York
SURFACE LOCATIONS EXISTENCES AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY.BE ( IN FEET ) ND � BOLSTER AND ASSOCIATES
THERE MAY BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE,
ED
PROPER AUTHORITYPE AND LOCAITI S PRIOR TO ANY AND ALLOF ALL UTILITIES AND •CONS RUCTION•CALL UCTURES US BE DIG i SAFEYPRIOR
1 inch = 30 tlw PROFESSIONAL LAND SURVEYORS
TO ANY EXCAVATION.
342 Main Street, Hudson Falls, New York 12839
Russell E. Howard, PLS MY.S Lic. No. 50540 Date: 01129105 Tax Map #:301.17-1-7
Date Sealed: Scale: 1 inch = 30 feet Revised: 02109105 Drawing #: 05037D
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/p- D art: am/pm
Date Inspection request received: _ Inspector's Initials:
NAME: PERMIT#: O
LOCATION: DATE:
TYPE OF STRUCTURE:
Comments
Yes N N/A UGr�
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location f� --------
Fresh Air Intake l
3 inch Plumbing Vent through roof minimum 6 inches Q U
I
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall /
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers
Grade away from foundation 6 inches with 10 feet t/
6 inch clearance to sill plate k
Gas Valve shut-off exposed/regulator 18 inches above grade ��, l
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Batte backu v)�
Carbon Monoxide Detector
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s . 1-150 s .ft.vents
Bathroom Fans, if no window Plumbing fixtures �0 C�ex) 0#781'e 1 rJ k i7-,
Foundation insulation
Floor truss,draft stopping finished basement 1,000 s .ft. IAI
Emergency egress below grade ✓J i
Gas Furnace shut-off within 30 feet or within line of site J �'U IV,l-e,
Oil Furnace shut-off at entrance to furnacearea
Furnace/Hot Water Heater operating
Low water shut-off boiler i ail vCa UJALL (o
Relief Valve(s)installed/Heat Trap//Water Temp 110
Enclosed Stairs Sheetrock Underside minimum%2"Gypsum `r
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or G ass clos re
Final Electrical c6
Final Survey Plot Plan V Y V 6
As Built Septic System/Sewer Dept.Inspection Sticker �/ C
Site Plan /Variance required %/�G
Flood Plain Certification,if required ,, /6
Okay to issue C/C or C/® [Temporary/Permanent ust- UG `� ��
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form—revised-1 00405.doc
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
Wo�that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the following conditions. -
Owner: J. Pek Date: 09/29/2005
Occupant: Unknown Location: Sherman & West Mtn. Rd.
Queensbury, Warren Co. NY
Occupancy: Single Family Dwg. i
Applicant Don Beagle
1 747 Hadley . Hill Rd --_
Hadley, NY 1 28�35" j
. 5 A y
No. 3180114 099 E
Equipment:
200 Amp. Service Equipment 4/0; 35 - Switches; 48 'Receptacles; 32
- GFCI Rec�eptacle,', 11 Range; 1 - Air ConditVbner,'..' 1 Burner,
Wiring & Contro'=ls, r1: = Dishwasher; 2 - 20. Amp� Recept Iles • 3 -
"LNf
Vent Fans; 6`-,- Srnc-)k,De:tL-ctors; 1 - Car'bonZ-MonoxjYd�t✓�Detector; 1. -
� ��,, ! r�� � t�`�'�
Dryer ``may>c •-y tif �
This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and
above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership
inspection. No warranty is expressed or implied as to the mechanical safety,effi- of the property indicated above,this certificate shall be immediately null and void.
ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions,
be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department
system to which this certificate applies be altered in any way,including but not limit- Inspection Agency,Inc. An application for inspection must be submitted to Middle
ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.
Rough Plumbing l Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm Depart: a 'm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: �� PERMIT #: 00d�} ' C( O�
LOCATION S INSPECT ON: ,z
TYPE OF STR CTURE:
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
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air / Head
5Il .S.I for 15 minutes
sulatioj�)/ Residential Check/ Commercial Check
kQpwent Attic Vent
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly / No duct tape
LAPam Whiting\Building&CodesUnspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection req est ec ived:
Queensbury Building&.Code Enforcement Arrive: a Depart: m/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initi ) �7
NAME: 0c K _1 PERMIT NO.: )1-/ L �?
LOCATION: �- INSPECT ON:
C
. RECHECK:
—7-- T—
Comments and/or dia ra
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.
F�LC`�
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank
Tank to Distributi4 Box
Distribution Bo Field/Pit
Opening Seale /N/Partial
End Caps
Location/Separations
Foundation to tank. ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan _Y N
Engineer Report and As-Built Y N
Location of Syste on Property: ��(7% CX T&A1
Front Rear Left Side Right Side
Middle Front Middle Rear V
System Use Staters:
proved
artial Approved and needs to be re-inspected, please call the Building& Codes Office
Disapproved
Last revised 1/6/05
Framing / Firestopping Inspection Report CQ —L
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building& Code Enforcement Arrive: al tpart: y k l am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials.
NAME: 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 % (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
Fire wall 2, 3, 4 hour
`� stopping
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.FCRMS\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: arrl/ art, 4am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initial
NAME: _ PERMIT#: -�d`�
14
LOCATION: ov - INSPECT ON:
TYPE OF STRUCTU
Y N N/A COMMI NT
raming
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
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side % inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received: r�
Queensbury Building&Code Enforcement Arrive: anI/- Depart: m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: -; j
NAME: k PERMIT NO.: �• r
LOCATION: - INSPECT ON: /
RECHECK:
Comments and/or diagram
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well Water
Waterline separation distance ft. 11 /
Well separation distance ft. CRC-Cr/�
Other,wells: ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number Ord �� �D J�✓1� L\ D
f� T C—L
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 I 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
LASueHemingway\I3uilding.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: - G
Queensbury Building & Cade Enforcement Arrive: am/p epart: ✓am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
'Z%
NAME:_ 2 C PERMIT #: Ov
LOCATION: Si 5- Ob-:5T k Ti / INSPECT ON: 7 6
TYPE OF STRUCTURE:
y ' N N/A
ou h Plumbing./ Nail Plates
`Plumbin Vent / Vents in Place
1 1/2 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
jlean=-eve 100 feet / change of direction
P,ressur
SSin- Vent
Hea
:I. or 0 ft. above highest connection for 15 minutes
'Pressure est
to Supply Piping
5S.I
Head
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:
LAPam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&.Code Enforcement Arrive: am/
s: qeepart: _am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initial
�- n
NAME: ' PERMIT NO.:
LOCATION: S INSPECT ON: — -
RECHECK:
�4__ Comments and/or diagram
Soil Type: S 0 Clay
Type of Water: unicip 1/Well Water
Waterline separ stance
Well separation distance ft. C>v j �;j 0 0
Other wells: ft.Absorption Field: Total length ft. � tl
Length of each trench ft I PC }' C S C
Depth of trenches ft.
Size of Stone f I Zt� l
Seepage Pits: Number `
Size: x 1�7 �UC`P�ltJ� T{}Nl•� �
Stone Size:
Piping Size,,,, Type
Building to tank 7�
Tank to Distribution Rox
Distribution Box to F' d/Pit 3 C;�( �� �IDC—
Opening Sealed: Y Partial
End Caps
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft
Conforms as per Plot Plan _Y N
Engineer Report and As-Built Y N
Location of SyC)Left
Property:
Front Side Right Side
Middle Front M' dle Rear
System Use Status:
pproved
Partial Approved and needs to be re-inspected,please call the Building& Codes Office
Disapproved
Last revised 1/6/05
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p�1 part: pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: PERMIT#: J (.J
LOCATION: INSPECT ON: 10 Q
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 opping 1,000 sq. ft, floor trusses
chor Bolts 6 ft. or less on center
ce 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 % 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
Framing / Firestopping Inspection Report f �,rn
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p Dep rt: m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: l� 4
PERMIT#: �00!
LOCATIO �— �. G INSPECT ON: =
TYPE OF STRU RE:
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 % (w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anch r Bolts 6 ft. or less on center
e and snow shield 24 inches from wall
Fire separation 1, 2, 3 hour �
Fire wall 2, 3, 4 hour DA
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side %inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\SueHerningway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Foundation Inspection Report )
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p 12C—,,,Depart. am/prii
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: C2, PERMIT#:
LOCATION: 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 nn
enforcement in Place
Fiqundati6n,,Dampproofing � �< � � (�06;
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inche ove footing
6 col for wet areas under slab
-B ' -fi1l.,Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASueHemingway\Building.Codes,Inspec tion.FORNISToundation Inspection Report.doc January 28,2003
10
Foundation Inspection Report ll
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: anr/p��pepart: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
II _ a� q�
NAME: y C— PERmrr#:
LOCATION: _ /� 'J _ INSPECT ON:
TYPE OF STRUCTURE:
Comments
--------- Y N/A
Footings J ^
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible or
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 Dampprooling/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASueHemingway\Building.Codes.Inspccti on.FORMS\Foundation Inspection Report.doe January 28,2003
Town of Queensbury Fire Marshal
742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Gas Firepl jCe/Stove h spection Retort
Notice:New York State requires that all UL.Fisted,factory built appliances be installed according to the instructions and
specifications contained in the installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
permit# bQ^L4 Schedule Inspection ��1 Time � am omnytime Inspector
Name a 410p�,•' `�t Address_��4 S �`��^- �"1 Rough In Final_
Appliance Manufacturer ° `� .L`��) Model# �
Direct dent Factory Built Chimney Flue Size Double Wall Triple Fall Insulated
Yes �Pio N/A Comments
Floor Protection
Clearances to Combustibles (a!! sides) • ,.
Firestop(s) 'vertical Chase_
Nall Penetration
Vera Clearances to Combustibles 0 (7j •�—G .c� .
Vent/Chimney Termination
Chimney height must be 3 feet above roof
penetration;2 feet above amy combustible
construction within 10 feet
r
Gas Shut-Off Valve
Combustion Air /
Hearth Extension (if any)
Mantel
Height above f/p opening
Fitness Operation
Tank Placement(if LP)
White—Building Dept. "— S'ellow Cust er Pink—Fire Marshal
i
Permit Number
MECcheck Compliance Report Checked By/Date
Proposed New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release lb
Data filename:Untitled
TITLE:J PEK DEVELOPMENT
COUNTY:Warren
STATE:New York
HDD:7635
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric RECElVEID
DATE: 06/15/04
DATE OF PLANS:3/10/04 JUN 9 2004
PROJECT INFORMATION: TOWN OF QUEENS9URy
02-19-04 BUILDING AND C®D
COMPLIANCE:Passes
Maximum UA=496
Your Home=394
20.6%Better Than Code
Gross Glazing
Area or Cavity .Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 925 30.0 0.0 32
Skylight 1:Wood Frame,Double Pane with Low-E 4 0.370 1
Wall 1:Wood Frame, 16"o.c. 2514 19.0 0.0 - 127
Window 1:Vinyl Frame,Double Pane with Low-E 256 0.350 90
Door 1:Glass 80 0.350 28
Door 2: Solid 58 0.100 6
Basement Wall 5:
Solid Concrete or Masonry,7.6'ht/6.8'bg/7.6'insul 697 11.0 0.0 44
Floor 4:Unheated Slab-On-Grade,2.6'insul. 92 10.0 66
Furnace 1:Forced Hot Air,90 AFUE
Air Conditioner 1:Electric Central Air, 10 SEER
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 Proposed New York State Energy Conservation Construction Code requirements.
—Bt4iderFDesigner Date `�
MECcheck Inspection Checklist
Proposed New York.State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release lb
DATE: 06/15/04
TITLE:J PEK DEVELOPMENT
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:
Basement Walls:
[ ] 1. Basement Wall 5: Solid Concrete or Masonry,7.6'ht/6.8'bg/7.6'insul,
R-11.0 cavity insulation
Comments:
Windows:
[ ] 1. Window 1:Vinyl Frame,Double Pane with Low-E,U-factor:0.350
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? [ ]Yes[ ]No
Comments:
Skylights:
[ ] 1. Skylight 1:Wood Frame,Double Pane with Low-E,U-factor: 0.370
For skylights without labeled U-factors,describe features:
#Panes . Frame Type Thermal Break? [ ]Yes [ ]No
Comments:
Doors:
Door 1: Glass,U-factor:0.350
#Panes Frame Type Thermal Break? [ ]Yes [ ]No
Comments:
[ ] 2. Door 2: Solid,U-factor: 0.100
Comments:
Floors:
[ ] 1. Floor 4:Unheated Slab-On-Grade,2.6'insulation depth,R-10.0 continuous insulation
Comments:
Slab insulation to extend down from the top of the slab to at least 2.6 ft.OR down to at
least the bottom of the slab then horizontally for a total distance of 2.6 ft.
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.
Heating and Cooling Equipment:
[ ] 1. Furnace.1:Forced Hot Air,90 AFUE or higher
Make and Model Number
[ ] 2. Air Conditioner 1:Electric Central Air, 10 SEER 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 Type IC rated and installed with no penetrations,or Type IC or non-IC
rated installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible
materials and 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.
Beating 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.
A
•. Fable 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 HVACPipes.
Fluid Temp. Insulation Thickness.in Inches by Pipe Sizes
Piping System Types Ran e 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 F1ELD(Building Department Use Only)
fjP r \
i
IRF
� 5ri' � ��(� }}� 1�� -r�}yl `n���- � y� � ..,;�,:��,�`i 1<<t Yr Y�r•/ �Jt' r�/
L;y��plt "I j� �}a y *5 �r +�j- y,•."r -, 31'"l,' J \r r
LLCV
RN
hl'�'.1r �t} !i rfi•�,5 _.` .1 � I-. � "`��,�:. �. t`'. �� l� '.�` - ` \
Site Location Map Lands n/f
No Scale Awirey Hoerning —Thomas
L. 951 P. 115
(O Q'
2
Lands n/f
Joann Holmes Living Trust sp4330., 0.
L. 1006 P. 139 �•
IRF
4Z
Lands n/f /
JPEK Developrrrent, Inc.
L. 1403 P. 074
AREA =_
/ 1.86t AC13ES
w
3
Or
°hw yy�b
604 3�, 36.5' IRF
N66 o� r
w � °
/ 3
p
\ POURED CONCRETE
\ FOUNDATION /
o
Lands n/f 29.8'
Richard Francis Dawson
\ \ & Christine Ann Dawson
L. 1425 P. 236 3
/ OVER 37.1' � 3
LEGEND
co M r"1
o I.R.F. IRON ROD FOUND
3 o I.P.F. IRON PIPE FOUND
'Qi o o I.R.S. IRON ROD SET
cu� UTILITY POLE
�F�qY o00o STONE WALL
x�c x- WIRE FENCE
IRF o CHAIN LINK FENCE
WOOD FENCE
\ o POINT
\ F.P. FENCE POST
3 -ohw OVERHEAD WIRES
CERTIFICATION. ° X
n/f NOW OR FORMERLY
•
I HEREBY CERTIFY TO: (�
1) JPEK DEVELOPMENT, INC. U�
2) OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
3) CURTIS LUMBER CO., INC., MORNINGKIL FUNDING DIVISION,
NOTES: IT'S SUCCESSORS AND OR ASSIGNSTHAT T \
1) BASE MAP PREPARED FROM A JANUARY 2005 FIELD SURVEY. URVEYiIS COMPLE COMPLETED UNDER MY DIRECT SUPERVISION MAP WAS PREPARED FROM AN ACTUAL �ELD o /
THIS SURVEY AND THE CERTIFICATIONS HEREON SHALL BE
2) NORTH ORIENTATION IS BASED ON DEED BOOK 1403 AT PAGE 074 AS RECORDED VALID ONLY TO THE PARTY OR PARTIES HEREON NAMED AND
IN THE OFFICE OF THE WARREN COUNTY CLERK ARE NOT TRAN RABLE TO ADDITIONAL INSTITUTIONS OR
T ERS, AN AS MAY BE OR EXPRESSLY
3) THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN ABSTRACT OF TITLE AND N \
IS THEREFORE SUBJECT TO ANY EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD \
ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE.
4) SUBJECT TO APPLICABLE LAWS AND APPROVALS OF THE TOWN, COUNTY, AND STATE RUSSELL E. HOWARD o
REGARDING THE SUBDIVISION OF LAND. DATE : 02/09/05
5) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND of N MAP OF A SURVEY MADE FOR
SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE ME
NEW YORK STATE EDUCATION LAW. \ \ ��M 9
GRAPHIC SCALE � �``� � � JPEK DEVELOPMENT,
6) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE � INC.
LAND SURVEYORS SEAL SHALL BE CONSIDERED TO BE VALID TRUE COPIES. 30 0 15 30 so 120 o o
7) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM
SURFACE LOCATIONS AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY. 540 J� Town of Queensbury County of Warren State of New York
THERE MAY BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE, IN FEET �'4 D sv� BOLSTER AND ASSOCIATES
TYPE AND LOCATION OF ALL UTILITIES AND STRUCTURES MUST BE VERIFIED BY ( )
1 inch
PROPER AUTHORITIES PRIOR TO ANY AND ALL CONSTRUCTION. CALL DIG SAFE PRIOR = 30 f PROFESSIONAL LAND SURVEYORS
TO ANY EXCAVATION.
342 Main Street, Hudson Falls, New York 12839
Russell E. Howard, PLS N.Y.S Lic. No. 50540 Date: 01129105 Tax Map #:301.17-1-7
Date Sealed: Scale: 1 inch = 30 feet Revised: 02109105 Drawing #: 05037D
MAP REFERENCE:
MAP OF LANDS PROP05ED
TO BE CONVEYED BY
MICHAEL G.H. 11OLME5
TO
DONNA + GARY MAILLE
DATED SEPTEMBER 29. 1987
BY COULTER + McCORMACK
LICENSED LAND SURVEYORS
Q,
CL
LL
K
LANDS N/F OF .n
HOE.RNING-THOMA5
o
0 `� � !/ a�v V
_ ti
S66°20'30"E O V e t' "CA,
604.37' 4
-.
CM
i J.
N 1 N
N p m ��"
o
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187 S ft. 0-12• TOP501L � ina
LANDS N/F OF !31 q 12-48" MED. SANDS z N HOLMES w 1.86 acres
PERG. RATE = 1' IN 30 SECOND O
N `t DATE: G-23-04 N C14
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604.37'
N66o20130"W
LANDS N/F OF
5iLVERNELL
ZONING INFORMATION:
5R-1A
SUBURBAN RESIDENTIAL - 1 ACRE
REQUIREMENT51
• • • MINIMUM LOT WIDTHS 150 FT.
0
EOF �y . MINIMUM LOT SIZE) 1 ACRE
S 5ETBACK51
"- FRONTi 30 FT.
51DE= 10 FT. MINIMUM. 30 FT. TOTAL
REAR, 20 FT.
+� TAX PARCEL
301.17-1-7
///���''��� Date; JUN 21, 2004
��. u S P SEARING
A LICENSED IONLAN OR ADDITION TO A SURVEY SCale 1'-50'
&n MAP 71ON OF ACTION7 9,S SURVEYORS SEAL IS A Plot Plan Made For/�/' NOtA710N OF SECTION 720•,SUB-DIVISION 2,OF THE
NEW YORK STATE EDUCATION LAW.'
S _T R 'ONLY COPIES FROM THE OF THE OF 5 SURVEY
V lL`...-Jl M RFtD WITH AN ORIGINAI.OF THE LAND SUP.VEl'ORS
SEAL$HALL BE CONSIDERED TO BE VAUD TRUE COPIES.'
'CERTIFICATIONSSURVEY
WAS INDICATED HEREON SIGNIFYDANCE MATHTHATJ P E K DEVELOPMENT S 1
7HI$SURVEY WAS PREPARED°H ACCORDANCE MATH THE
Land Surveyors By THE GOOF OF PRACTK FOR LAND SURVEYORS ONALADOPTED
BY THE NEW YORORS. STATE ASSOCIATION S PROFESSIONAL
ONLY
LAND SURVEYORS.SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR MHOM THE SURVEY IS PREPARED,AND
ON HIS BEHALF To THE TITLE COMPANY.GOVERNMENTAL
169 HaVlland Road Queensbur New York 12804 AGENCY AND LENDING WSTITINTION USTED HEREON,AND Town Of
y� TO THE A55IGNEE90F THE LENDING IN5TITUTION.• Queensbury, Warren County, New York
518) 792-8474 New York Lie. No. 50135 JPEK DEVELOPMENTN0. DATE DESCRIPTIONLLJ DWG. NO. 04142 C1276
301-17-1-7/123-1-25.352
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