2004-609 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-825.6
CERTIFICATE OF OCCUPANCY
Pemiit Number. P20040609 Date Issued: Wednesday, November 10, 2004
This is to certify that work requested to be done as shown by Permit Number P20040609
has been completed.
Tax Map Number. 523400-301-019-0001-028-005-0000
Location: 32 EVANNA Dr
Owner. CERRONE BUILDERS INC-
Applicant: CERRONE BUILDERS INC
This structure maybe occupied as a:
By Order of Town Board
Fireplace TOWN OF QUEENSBURY
Garage - 2 Cars Attached
Single Family Dwelling
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040609 Application Number: A20040609
Tax Map No: 523400-301-019-0001-028-005-0000
Permission is hereby granted to: CF,RRONF,B1 JH.DF,RS INC
For property located at: 32 EVANNA 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: CERRONE BUILDERS INC
66 SUNSET Trl Fireplace
Garage-2 Attached
QUEENSBURY, NY 12804-0000 Single Family Dwelling $210,000.00
Total Value $210,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2004-609
1984 sq ft SINGLE FAMILY DWELLING
$286.08 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 13, 2008
(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 Queen ury; F i y,August 13, 2004,
SIGNED BY for the Town of Queensbury.
Director of Building&Code triforcement
Check Residential Plan Review: One&Two Family Dwellings
Y/N/N/A
(2)Full sets of plans
VI Over 1,500 sq. ft.—Stamped
Design Loads On Plans: 90 Wind Floor Loads 40 psf
70 Ground Snow Load Sleeping Areas and Attics 30 psf
/ Calculations:
E/ Window Schedule With Glass Size
Door Schedule/Main Entrance 36"Door
Emergency Escape Or Bedrooms and Habitable Space
Above/Below.grade, 5.7 sq.ft.
Grade,5.0 sq. ft.
4"(h)x 20"(w)min.
44"Max.Height above floor
Residential Check Paperwork Compliance and Inspectors Checklist: OK
ampproofmg/Waterproofing Materials On Plans
oundation Drainage On Plans,if required
"Drop in 10' Exterior Grade
timing Cross Section For Each Roof Line,Vertical Fire Stopping Every 10' Where
R Hired
ce and Snow shield 24"Inside Exterior Wall/24"Inside Knee Walls
Platforms At Exterior Doors
tairway Headroom 6' 8'All Stairs 36"Width
tair Run and Rise
Winder Run and Rise
S fral Not Allowed From 2 nd Story
S eke Detectors Battery Backup and Proper Location
Bathroom Fixtures Proper Clearance
all Width,36"min.
andrails More Than One Riser On Open Sides
ailing and Guards>30"/Basement Stairs Included/Closed Risers More Than 4"in Ht.
fety Glazing Notes For Required Areas
--f9filrage Fire Separation
G age Floor Sloped
i0ffic Access
of 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
Building Permit Application
Town of Queensbury—1.Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. FPrmit File No
No inspection will be made untilpp . U l
applicant has received a Fee Paid
valid building permit. All applicants' spaces on this . Roc.Fee Paid XT—"""
application must be completed and must appear on the Reviewed BY:
`4'
application form.
Applicant:C •J 6- Owner:
Address• v t Address:.
Phone#(4 ) Phone
property Location: Lot Number: House Number
SubdivisionNarne: _ Tax Map Number:
/New Building: residence /commercial 'Estimated Market Value of Construction:$ `✓!�
o Addition: real ce/ commercial If an addition,what will use of new addition be?
0 Alteration: residence/ commercial
O No change to exterior size: residence/com'1
o Other work(describe
Check occuponcylnformation ill Floor 2"4 Floor Other floor Total
Below sq.it. sq.ft. sq.ft. Square Feet
Cl Sin a family dwelling Z�
o Two family-dwellin
o Townhouse
o Mui y dwelling
#of units
o Office
o Mercantile
o Manufactutin
o i car detached garage
o 2 car detached garage
a 3 car detached SamSe
a 1 car attached garage .
2 car attached garage
3 car attached g=ge
n Storage building-
commercial
o Storage building-
residential
o other
What is the proposed height of the structure feet inches
will any second-hand or ungraded Iumbcrbe used? If so,for what? X/10
Type of Heating System: electric/ oil CPS wood=forcedhotbaseboard/other:
Number of Fir enlaces to be installed Number of Woocistuve„s to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number. ---- --
Builder i�, - - - - a-6 off
-
Plumber '7
Mason i' )f- -
Elec"t4ft-n r
Declaration: please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and specifications
submitted,are a true and complete statement of all.proposed work to be done on the described premises and that all
provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with;whether specified or noted,and that such work is authorized by the owner. Further,it is understood that 7/we shall
submit,prior to a C cute of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or D ee or of Buildin and Codes,an As Zjulft Survey by a licensed surveyor;drawn to scale,showing actual
location of 7U, co coon.
Signature: - owner,owner's agent;architect,contractor
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 BEATING 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 MET
HOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
I. Gross Floor Area- square feet
2. Type of heat- Electric Oil Gas ,-1 Other
3. Is building mechanically cooled? yes X No
4. Percentage of area of windows and doors Over 17% Under 17%
5. R VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R VALUES AS
SHOWN ON PLANS SUBMITTED: 30
a: Roof R
b. Exterior walls R
C. Glazed areas R ,'
d. Exterior doors R/
e. Floors over unheated spaces. R ¢—
L Edge of slab on grade(heated building) R /0
g. Basement/cellar walls(above grade) R/
h. Basement/cellar walls(below grade) R
i. Heating/cooling-ducts-piping in unheated space R
6. Service(domestic)hot water heating device /
Conforms to minimum efficiency per code Yes . No
TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED
Ap is ignature Date Phon Number
c?/ /- ?yz�-
INSPECTOR'S REMARKS:
Project Name: ��� BP#
tr
Address: •�(/,
Building Permit Submission Checklist Multiple Dwelling
Commercial Projects
All items below must be checked either yes,no or not applicable prior to submission of any building
permit to the Town of QueensburyBuilding Department. If any of the below items are lacking,the permit
will not be accepted until such time as the application is deemed complete for submission.
1. Building Permit Application Completed............... ............ ........... plyes '[:]no ❑n/a
2. EnergyForm or Checkmate Energy Code Compliance Forms Complete... Pyes Ono Qn/a
(submit 2 copies)
3. Energy Code Inspector's Report from Checkmate Program........... ... [yes Ono ❑n/a
(submit 2 copies)
4. Septic application completelyfilled out(if applicable)... ............... ... [ yes Ono ❑n./a
5. Electrical Inspection Form... ...... Cayes Ono ❑
6. Two(2)sets of plans showing the following:......... ❑yes Ono ❑
6a. Floor plan(s)... .................. ... ... ...... ... .................. ... ... L Yes Ono ❑n/a
6b. Foundation plan............... ... .................. ... ......... ...... .... UU yes Ono On/a
6c. Cross section(s)... .................. ... .............................. ... ... yes Ono ❑n/a
6d. Elevations ... ... ............... ..................... ................ Ayes Ono a
6e. Design loads including floor,snow load,and wind load... ... [Ayes, Ono ❑n/a
6f. Seismic design(required.after Jan. 1,2003)...... ..................... Oyes Ono ❑n/a
6g. Plans signed by registered architect or engineer,signed.......... Qyes Ono ❑n/a
and sealed by a registered architect or engineer
6h. window and door schedule......... .......... .............I.... ... ... 9yes [--]no ❑n/a
7. Two(2)site plans showing location of the structure to be built,......... Oyes Ono ❑n/a
location of well or water lines,location of septic system or sewer line with
all setbacks and separation distances shown,and all improvements to
the property.
8. Solid Fuel Burning or Gas Appliance Form(if applicable)................ yes Ono ❑n/a
9. DrivewayPermit...... :.. ... ................................I................... yes ❑n ❑n/o a
Date:
Staff Initial:
L:\SueHemingway\Bading.Permit.FORMS\Generic Ched&t.doc Janu:uy28,2003
Fire Marshal's Office Town of'Queensbury,742 Bay Road,Queensbury,NY
(518)761-8205
Application for Fuel Burning Appliances & Chimneys
applicable to solid fuel &vented gas.appliances
Date t , 20 t Permit Nok
Application is Hereby made to the Building& Codes Office for the issuance of a.Buildi :and Use
Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or'bwni er
agrees to cotnply 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 perform required inspections"
NOTE to applicant: Rough-in and Final Inspections are required.
Applicant Information Fuel Burning Appliance Information
(circle appropriate words)
Stove: wood coal pellet gas
Name...
- Y — Fireplace insert
�J, r Fireplace, factory-built: wood gas
Address:'-5,,/ 12-1"
Fireplace, masonry: wood `gas
— (mil Furnace: wood gas oil
Phone: ,r If non-masonary applicance,please provide
Owner: Manufacturer Name:
Address:
Model Number: AY,,,
_ Chimney Information
Phone: (circle appropriate words)
Masonry block . brick stone
Flue tile steel size: inches
Exact Address:?
of constrisciion or tnsiallation Factory-Built
Manufacturer name:
Model Number:
Note: Listed By: Number:
Construction/Installation must f,y
con. orin to NYS Fire Prevention &Building Indicate(circle) chimney material:
SK _
Code: Consult available Town of Queensbury
Handouts regarding required inspections. Double wall / Triple wall Insulated Dti ect venting
Clunuiev Lurer
-�
C�,�ifer't�r��,pas-tme.�t-To�e�crxi of Qu����erbury, AT��York:
3
Fire Marshal Code# $Collected RcJiuzdcd lleceivedfronr (refiutdc,d to):_ r
{ culdress:
A 173 3 389 (190) Public Safety ( i
A 233 2655 (230)Minor Sales
DATE: -,;
White(Applicant) / Green(Fire Marshal) / Yellow(Bldg. Dept.) / Pink&Goldenrod(Cashier's Dept.)
Application for Permit ;-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. OWNER INFORMATION: ...................................................................................................................................
i
Office Use
i
Location of installation:z ---%,,� i Gi1/ ,Q �24,s ` (oO
File Permit No.W .9
Tax Map No. / /
' �,�Qel1� /U?1�� s� „Fee Paid......................................................................................................i
Owner's "Ae
e .c'oAddress• �/ 40 J�'.
d
2. INSTALLER'S NAME PHONE NO.��<f—A-96
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/bdrm =
Garbage Grinder Installed yes! / no '/
Spa or Hot Tub Installed yes ./ no 7
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
IgMgraphySoil Nature Ground Water Bedrock or Im ervious Material Dornes�er Su 1
Wo
Vam
at what depth at what depth municipal
g feet feet
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: /�a� gallon(min. size 1,000 gal.')
Tile Field: each trench s' ft. Total System Length: fl
Seepage Pit(s): number of size of each: ft. by ft.
Size�f Stone to be used: # / depth or thickness feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection,please note that pursuant to Section 136-29 of the Code of the Town
of Queensbury,any permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation or failure to make a material fact or
circumstance known by or on behalf of an applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all
requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
!)3
Signature of responsible person Date
• � :'1•ativit t)r t�ttl;t'llal3lit•� '
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71 SICNA.'I.•URB &STIFO�MATI4 kVi� usL r. vt� �yiow��.••••••,
i
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: 1 I /0 v0�j
NAME: (
LOCATION:
PERMIT#: (
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has be
Craig own, Zoning Administrator
Notes:
L:\.SueHemingway\Building.Codes.Inspection.FORMS\Fina1 Survey
Zoning Administrator.doc
MAP REFERENCE:
MAP OF A SUBDIVISION MADE FOR
MICHAEL DICKINSON
DATED: JANUARY 15, 2003 584 311'E
BY: DAVID J. BOLSTER
196.77•
584 39 29•E
25 WIDE NO CUT ZONE 122.45'
N
LOT #6 0 - LOT #7 /
N l 28,207 sq. ft. /
I 2
z fR
22.2� AME h Oqc'
� 1�A
1_ po�c / 20���•.�l
O
°�� � LOT #8 �
ow
0--3
° 1>_ O a
C 06
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rn
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of
CIF
- (P .
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Date, C
D u ,s 'UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY
MAP BEARING A LICENSED LAND SURVEYORS SEAL IS A Map of a Survey made for Scate 1`= 30'
VIOLATION OF SECTION 720D,SUB-DIVISION 2,OF THE
NEW YORK STATE EDUCATION LAW.'
S t e V e s roNEY cones OR mE ORIGINAL N mis VCYCR5
MAIMED N1TH AN ORIGINAL OF THE LAND SURVCYIMS
SEAL SHALL BE s INDICATED
TO E VALID,RUE COPIES.' - C e r r o n e Builders
S- 1
'CERTFICATp15 INDICATED HEREON SICNRY THAT
7 7` THIS SURVEY WAS PREPARED IN ACCORDANCE WTH THE
Lan d �A r v e y o r s BYTHEXISTING CODE OF PRACTICE A FOR LAND SURVEYORS ADOPTED
BY THE NEW YORI(STATE ASSOCIATION OF PROFESSIONAL
LAND SURVEYORS.SAn CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR YMOM THE SURVEY IS PREPARED.AND
ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL
Havlland Road Queensbury, New York 12804 THAGENCY AND
LENDING INSTTUITON LISTED HEREON.MID Town of Queensbury, Warren County, New York
TO E BEHALF
OF THE LENDING INSTITUTION.-
GERRONE
(518) 792-8474 New York Lie. No. 50135 NO. DATE DESCRIPTION DWG. NO. 03283-7
301.19-1-28.7
Queensbury Building & Code Enforcement - Reside 'a 4aIns,
ection
Office No. (518)761-8256 Arrive: _ p e pm
Date Inspection request received: \\ Inspector's Initials: - L f c�
NAME: �,�R v — P IT#:
LOCATION: t 7 _ — ti U� TE: L — --
TYPE OF STRUCTURE: (h -T�
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 Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
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 tninimum '/2"
Gypsum f
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 De t ctors: /
Every level: / Every Boom:
Outside every bedroom ea:
Inter Connected: P / Battery backup:
Carbon Monoxide Detector
Bathroom Fans, if no window
Plumbing 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/'/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, 1 s . ft.-150 s . ft. vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
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 Inso. form 2.docLast printed 2/12/04
Queensbury Building & Code Enforcement - Res' en al Inspection
_Office N&(518)761-8256 Arrive: pm part: am/pm
Date Inspection request �P—NA��
eceived: Inspector's Initial :
NAME: ` PE IT#:
LOCATION: — D TE: j— I
TYPE OF STRUCTURE: 7l
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 Complete C vko
Guard 30 in.or more a,stairs, decks,patios u�
Guard at stairwell at 34 in, or more � ���' �\
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
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 Valves installed/Heat Trap/Water Temp 110 ,Interior privacy rivac /trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazingV
Interior Smoke Dete ors:
Every level: / Every Bedr om:
Outside every bedroom rea:
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
Emergency egress below rade
Basement stairs closed rise>4 inches
Garage Floor Pitched ol
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 "INN
Crawl Spaces 18"x 24"access, 1 s . ft.-150 s . ft.vents 1 e J
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
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 Insp. form 2.docLast printed 2/12/04
Bldg. Permit File No.
l�
Final
0
Inspection
Approval
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No........................................Cert. 85390 Cut-in Card No..(i9.L/./�-.22.'?....
Owner................AJ=.........G.!; Am.c.......................................................................................................
Location........3 1' 11.A.12..R.......Ql. ...................... �/
Installation Consisting of...a.PoA...SL..C...... .....6.2...8:: �, �al. .....
..::Icl . .t..s;......3....... .n..sj........ ....:.F:..m...al.. .. ......F�. .r?. �.�....�. /��,y...
...........................................................................................................:...........................
Installed By....A3�()A44.C.V.... c c,.-..........................................Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
rules are violated,the Company shall have the right to revoke this certificate.
Date......f..t.-.a'4?.`�................. INSPECTORTT "YI ............................ ................................
Member N.F.P.A.,I.A.E.I.
Septic Ins ection Report
p p P
Office No.(518)761-8256 Date Inspection request received: �' d
Queensbury Building&Code Enforcement Arrive: am/ DepartJ �' arr/pm
742 Bay Rd.,Queensbury,NY 12804 _ Inspector's Initials: —
NAME: ,1U PERMIT NO.: (�
LOCATION:' INSPECT ON:
RECHECK: ,��
i�
Comments and/or diagram
Soil T e Sa /
T e of er: unicipal ell Water
Waterline separa ' ance ft.
Well separation distance ft.
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Pi ing Si T
Building to tank G
Tank to Distribution_Box u
Distribution Box 'eld/Pit Z�
Opening Sealed: Y N/Partial
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Location of Syst on]Property:
Front (Rear Left Side Right Side
Middle Front fiddle Rear
System Use
State
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
L:\SueHemingway\Building.Codes.Inspection.FORMS\Septic Inspection Report.doc January 28,2003
ra--
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request r ei ed:
Queensbury Building&Code Enforcement Arrive: pm D �: am/pm
742 Bay Road; Queensbury,NY 12804 Inspector's Initial
NAME: PERMIT #: A004 '09
LOCATION: J INSPECT ON: lot 2 104
TYPE OF STRUCTURE: S Fp
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain/Vents
Cast Iron, Copper Drain/Vent/ Comm.
Plumbing Vent/,Vents in Place
Rough Plumbing/Nail Plates
1 % inch min.Drain Size
Washing Machine Drain 2 inch nun.
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 Colinniercial - - -.
Cooper,CPVC,Pex One and Two-Family
sulation/Residential Check/Commercial Check t,i 133V
Proper Vent,Attic Vent F
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed ro erl /No duct tape
COMMENTS:
f
L:\SueHemingway\$uilding.Codes.lnspection.FORMS\Rough Plumbing Insulation Report.doc November 17,2003
IJ
Framing / Firestopping nspection Report
Office No. (518) 761-8256 Date Inspection re es re tv d: I D Lo O 3 nJOm.
Queensbury Building& Code Enforcement Arrive: a p part: '.Z am/pm f
742 Bay Road, Queensbury, NY 12804 Inspector's Initi
NAME: e PERMIT#: -uq
LOCATION: E. I INSPECT ON: �O -/9,;00
TYPE OF STRUCTURE:' S F�
Y N N/A
raming 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
Fire 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.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Framing / Firestopl i ns c ao ort
Office No. (518) 761-8256 Date Inspectioonreq
e S
Queensbury Building&Code Enforcement Arrive: art: a m
742 Bay Road, Queensbury, NY 12804 Inspector's Ini
NAME: C� (m ��v: �, S PERMIT#:
LOCATION: V131L Lp -F V v41v jv A 4�:)(�—ye INSPECT ON:
TYPE OF STRUCTURE-
Y N N/A COMMENTS
4Jack
ming
Studs/Headers
Bracing/Bridging
Joist hangers C 1z;c)�-Vn\n
Jack Posts/Main Beams Q\)LA
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in. /�
Stairwells 36 in. or more
Headroom 6 ft. 8 in. Mfi kk U� aC GW Q,�Q Q,Jt>jj
Notches/Holes/Bearing Walls nn
Metal Strapping for Notches Top PI to LZ
1 % (w) 16 gauge (8) 16D nails each de (A rr C�
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center y 'o,
Ice and snow shield 24 inches from wall �N\��
Fire separation 1, 2, 3 hour --�—
Fire wall 3, 4 hour �� k� �17 �tiJ � \��
irestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation \Av tz)c5v
House side '/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X c)vi_N)
Ceiling/wall
Windows Habitable Space/Bedrooms n`l
24 in. (H) j12 ' ;7�1 U�
20 in. grade
5.7 sf abobo ve/below
5.0 sf grade
LASueHerningway\Building.Codes.Inspection.FORM S\Framing Firestopping Inspection Report.doc January 28,2003
Rough Plumbing / Insulation Inspection Report
Office No. (518) 761-8256 , Date Inspection request received: /� Q
Queensbury Building&Code Enforcement Arrive: am/pm , epart: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials: �f/�
NAME: PERMIT #:
LOCATION: `7 .2 `V �- 7� '- INSPECT ON: l0 5 '
TYPE OF STRUCTURE:
Y N N/A
PVC: R-1,R-2,R-3,R4 Drain/Vents
Cast Iron, Copper Drain/Vent/Comm.
ent/Vents in Place ,
'Rough Plumbi /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
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:
LASueHemingway\Building.Codes.Inspection.FORMS\Rough Plumbing Insulation Report.doc November 17,2003
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection r e ec i etd: 0'�I 0
Queensbury Building & Code Enforcement Arrive: aI pa a
742 Bay Road, Queensbury, NY 12804 Inspector's Initi s -
NAME: CPERMIT#: Ce -60
LOCATION: tff ;- INSPECT ON: 0 -O0:00 3M
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 J
Metal Strapping for Notches Top Plate \J`�
1 %z (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 �� G
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.ASueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518) 761-82.56 Date Inspection reque t received:
Queensbury Building&Code Enforcement Arrive: am/p Depart: m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials.
00qNAME: PERMIT#: V
LOCATION: '1/ r—_---INSPECT ON: Q _
TYPE,OF STR T _
Comments
- — ---- �- Y N N/A
Footing
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible
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 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:\SueHen ingway\Building.Codcs.Inspection.FORMSV�oundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: ani/p 4e Depart: �'�am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
/ F NAME: �� PERMIT#: O ---6
_ � G
LOCATION: _ %Z Et r/ ►< 0�,Q, _ INSPECT ON: O�f —
TYPE OF STRUCTURE: —r
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 pu.Tose on site, _
F undation/Wallpour
einforcement in Place
Foundation`baiiipproofing
o ndation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
.Footing Drain Stone: d
12 inch width
6 inches above footing
/ 6 mil poly"for wet areas under slab
V Backfll°Appoval
Ji "Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASueHemingway%uiiding.Codes.Inspection.FORMS\1'oundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: � a
G �
Queensbury Building&Code Enforcement Arrive: anvpr�i n� Depart: pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: _ C e,�Z-12 UN C ��V i �JAr 5 PERMIT#: oc)
LOCATION: 3 Q.- E V A--v l- �;'l,�. _ INSPECT ON: U
TYPE OF STRUCTURE:
Comments
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
enforcement in Place
t Loundatfon I)ampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone: f
12 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\BuiIding.Codes.Inspecti on.FORMS\Foundation Inspection Report.doe January 28,2003
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: mg
Queensbury Building&Code Enforcement Arrive: am/pme k D pa am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: _ _ PERMIT#: -60
LOCATION: m�� _ INSPECT ON:
TYPE OF STRUCTURE: S F- I
Comments
___--- X 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 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.
LASueHemingway\BuiIding.Codes.InspectionTORMS\Foundation Inspeciion Report.doe January 28.2003
i' A
130
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NO
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it
"I have-seen or observed, or believe I saw evidence of,
all objects such as houses, Wells, trees, fences, etc.,
shown on th' ocument. I also represent that I have � (�� /
person all me s�,red t . distances set forth on th di ram." ( ((�
t SIGNATURE ATE
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:CERRONE BUILDERS, INC.
COUNTY:Warren
STATE:New York
N:7635 CO RECEIVE®
CONSTRUCTION TYPE:Detached 1 or 2 Family
HEATING TYPE:Non-Electric
AUG 0 4 2004
DATE: 07/29/04
DATE OF PLANS: 7/16/04 TOWN OF QUEENSBURY
PROJECT INFORMATION: BUILDING AND CODE
1543-F
COMPLIANCE:Passes
Maximum UA=536
Your Home=399
25.6%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 1120 30.0 0.0 39
Wall 1:Wood Frame, 16" o.c. 2541 19.0 0.0 135
Window 1:Vinyl Frame,Double Pane with Low-E 198 0.350 69
Door 1: Glass 40 0.350 14
Door 2: Solid 58 0.100 6
Basement Wall 1:
Solid Concrete or Masonry,7.6'ht/6.8'bg/7.6'insul 951 11.0 0.0 60
Floor 1:Heated Slab-On-Grade,2.6'insul. 105 10.0 76
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.
-$fti4der/Designer Date
MECcheck Inspection Checklist
Proposed New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release lb
DATE: 07/29/04
TITLE: CERRONE BUILDERS, INC.
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 1: 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:
Doors:
[ ] 1. 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 1:Heated 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 16 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 norm-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.
-Heating and Cooling Piping Insulation:
[ ] HVAC piping conveying fluids above 105 OF or chilled fluids below 55.017 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 HVACPipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Ping 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)
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