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2003-693 1 a, TOWN OF QUEENSBURY 742 Bay Road,Queensbmy,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 s CERTIFICATEOFOCCUPAN.C.N t Permit Number: P20030693 Date Issued; Wednesday,December 10,2003 This is to,certify,that work requested to be done as shown:by Permit Number P20030693 has been completed. . Tax Map Number: 523400-301.013.0001-004-002-0000 Location: 579.WEST MT. Rd Owner: JACK&FRANCES SIGNORELLI Applicant: JACK&FRANCES SIGNORELLI This structure may be occupied as a: By Order of Town Board Garage-2 Cars Attached TOWN OF QUEENSBURY . Single Family Dwelling Director of Building&Code Enforcement 7 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20030693 Application Number: A20030693 Tax Map No: 523400-301-013-0001-004-002-0000 Permission is hereby granted to: JACK &FRANCES STCTNORFTJJ For property located at: 579 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: JACK&FRANCES SIGNORELLI Garage-2 Cars Attached 32 HARRISON Ave Single Family Dwelling $120,000.00 FRANKLIN SQUARE,NY 11010 Total Value $120,000.00 Contractor or Builder's Name Address Electrical Inspection Agency ACE HOMES 3A SARATOGA ROAD GANSEVOORT. NY Plans&Specifications 2003-693 1508 sq ft SINGLE FAMILY DWELLING WITH 2-CAR ATTACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS $238.56 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 03, 2004 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated atAh of ;e b W�_ nes�day, September 03, 2003 SIGNED By � ber, for the Town of Queensbury. Director of Building&Code Enforcement , Building I'e °n7ii ,,,j ppl�ication, Town of Queensbury—Dept of Communzt jevelopment,7A2 Bay Road,Queensbury,NY l r A permit must be obtained before beginning'�lionstruction{{t a Feiinit File No. C� No inspection will be made until applicanteceivect �'�� 1 Fee Paid valid building permit. All applicants' spaces on this+' fI c'i� Et ec.Fee,Paid ii-application must be completed and must appear on'the i {9,f Reviewed By application form. +I { G �- " - Applicant: /a�/� c J�Ao': _P/lr 1 Sk 1 Qwner �i� c� Address: 5`7ii­ //�9 /A d_f 1`.��i'/GL rim✓�.�"�'�� ' � 'f { f�i tr �"dl f`i'p..L�GIGIF� //'-�f fi'�'.�t (_) y i 1 Phone# I 3 ?hone#( Z eiS� �( f F Property Location: Lot Number: Subdivision Name: - ,.'t t' ,•. �f r.alr�.i New Building xesidenc /commercial.;;'+. .-Estimatedi2arket'�Ja1ue of Construction: o Addition: residence/ commercial if anS' dditson;what will use of new addition be? 0 Alteration: residence/ commercial, o No change to exterior size: residence/con'1J: T. 0 Other work(describe Check OceapaneyInfotznation i° Floor I+jy 2a Tloo } ;Other floor Total Below ;lisq.ft. ( x"k i sqz ft sq.ft. Square Feet Single family dwelling o Two family dwelling Cl Townhouse 0 Multifamily dwelling #of units 0 Office {; :( 0 Mercantile IIN;%: 1 IN 4 Q Manufacturing 0 1 car detached garage 0 2 car detached garage d X Note: see BP 2003-650 Septic Alteration 579 West Mt.' Road Declaration please sign below after you have care ul2t y read theYstatement. Tar(_ ( I 0 , To the best of my knowledge the statements cantau�e ;in thx�applicattan,`together with the plans and specifications submitted,are a true and complete statement of allpro rle to be done'on the described premises and that all tit provisions of the Building Code,the Zoning Ordinance and all ot{ier lawspeitaining to the proposed work shall be complied with,whether specified or noted,and that such work is suthortzedJby the nowner. Portlier,it is understood that Uwe shall submit,prior to a Certificate-of Occupancy or Certificate of Cotripliance;bexxig:issued,as requested by the Zoning Administrator or Director of Building and Codes antis Built Survey by a•hcensed surveyor;drawn to scale,showing actual location of all new construction. Signatur i i a: ` owner i:iiW 's agent,architect,contractor ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY, WARREN COUNTY 9000 HEATING DEGREE DAYS _ Compliance Methods:Part 5 -Acceptable Practice Method—1&2 Family Dwellings (only) Part 6*-Thermal Rating—Component trade Offs 1&2 Family Dwelling; Multi-Family Dwellings(3 Stories or less) Part 4*-Design by Component Performance, Commercial Buildings-Hi Rise Residential *Requires submission of worksheets APPLICANT'S NAME: PROPERTY LOCATION: PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1. Gross Floor Area.-, square feet Electric.'- _ �Oii -:Gas_._ : Other YP, ._.3 Is building mechazucally cooled yes: _ No _ _4 _t_ Perceft4ge ofarea ofwindows and cipors �. = (?ver 17% ;Under 1 R-VALUES FOR INSULATION GIVEN BEL O.W MUST CORRESPONDt TQ R VALUES AS SHOWN'ON PLANS-SUBM-'-- � a Roof b. Exterior walls R C. Glazed areas R d. Exterior doors R e. Floors over unheated,spaces R f. Edge of slab on grade(heated building) R 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 Applicant's Signature Date Phone Number INSPECTOR'S REMARKS: l Application for Permit—Septic Disposal System Town'of Queensbury 742 Bay Road Queehsbury,NY-12804.(SI$) 761-8256 1. OWNER INFORMATION:. ...... ............................................... i Office Use Location of installation: File Permit No. rp Tax Map No. t ' Fee Paid Owner's Name- 1 .............................................................................................. Address: 2. INSTALLER'S NAME,: .. .- _ - __ _ __ _ PHONE NO. Note: see Bl'�2003=f 5OT ept c -fe_rat on 579 West Mt. Road »`r aasorptton is ft. z% other Percolation Test: (To be completed by lic6?sed 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'VVlurlpool 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 ice— Bed System Size: ,x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: 1 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 o=Tfailure 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 Oe/2Of2003 13:35 510-623=27-72 WARREN COUNTY 13 ) PAGE 02 ,. 15' 2443 81iAM 4IbOBY WATER WASTEWATER WARK M COUNTY DPW No.0745 pF 2 03 1NA tRFM COUNTY DFPARTMF14T t}F pUSUC WORKS I)t"I�-'�t3 '�YOlE�,K Ct�t3NTY&iJfC� 'T• F^W Y (ur,tkr Asticic 6,$motion 1J6 ZT.AL.vf fii lwtty'Low) *1t1e MOOS Suprtcl��l sxt of I'ti�t7�C O,t71is Zft1A ftce i WLTr*na'bia%N.Y. 14883 i3u�rersn"ndont Of�txbi o Works 6�8-7���'d536 or 63.E 3fi16-4��11 s I"roI 8 'f•377 Lxpaa►dan Date: 5' - d -y JPcmIt I Road 0 �'�� SQ. x4ovm /'t,� 1'CiNERRAS,l�C�lteett3+ is 1parto tale C+ URWRoad Srum and yy/�S �7`l ' our�5�r:�F �� G ` a'hvss cateplzotlt 'ra 'z ►teat leriu+ f � �' ..rcquascs?Orris lionto NtrW,.'CH9M00AI,pvlcoltIfsioa is gr'4*4 oo thr gppiicptst to do said weck subject 0 the f0110w10%onadidasss: A{Cvrtifud Cheetc}(89rtd)` blc m tls Cn4m 'Crassutesof v7Rzsen Cot�ney{s.{CJ+s itttle) tiro etlsh at S� R e ii pP (Tta Hr>popaJ+mA)as secudw c w&e miki-IF+v+ t+ea w ra q> l cestdltigo wl+ar4 dWbssbed at i6ls a wW 4 al a na much al'f so**to the vodc has bean,aosmpktd;Red**a!laid Cotttuj swesia of mblk twit"L k+t,eby�nrhgt�ad to exper�d al ar as rnixis a! sucli deposit do shay bt>accol:tary�r Owt pn,spes>i shoald$'io said sppliamsrt ao><lect a+tvichm to pt rfes+m the tits k OT- ' Sl'�C1lAT�CONY}�"i0:�9 a f><7 so �' tiT $'� ct�R"�nsigc:nd�encptsitst:l�t�cfnd'rtietts•dasccibcd;.....'... ... .__,,.,. 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PAGE 04 !PIC O :IIM 'ITY 11 `JlCC �'° x G1ht2.;iUt:DA�Y)' +o�Jzs/o� PRODUCER TH16 GEF{TIFIGRTBJS ISBUEiJ ABA MATTER Of INFORMATION _ ' : On ..•Jib CONFER$NO 10HYS UPON TH4CORTINCATE CcsBxt►unity tnsuftn�i'; geaail5at Ho 1EEi.•THISCOWTIMATIs 004E NOT AMEND,EXTEND OR 89 Sarat4at 19V6r:vo *;X 38'9 .ALFIwRTHECBVIRE$iAGE'AFFdRDED.EYTHEP06tGi1~8'ElEL.QYiE, So. Edens Lral40 RY 120*63-1389 I{VstilitEltSI4�F+<tR0{MGCQVIrRJt44E ph6ne:5Zl3-793w2vG`l"]Fatrt:.518�793�1538 MOM .,wr 1NSlRERf� 1vA2'• 024 3]I t3$ t IN"5V ER B'. }avid x ward .grl.,a HbveasCf'a•F,l���tvatinq INBLReaG: INSLRERtX ' QTx�nekiury'Nx izea�I 1 IIOY.T ftR COMA0E3 . 'NE P040EIS 0E 1NSURW�fCt:LISTStl BELOW HA'V_'BEEN]SWED TO THE.M.RURED NAMED A804$w T4 PQl rCY PERIOD VNCAMD NotWiTHSTumlrM ANY RECUWMW.Teau OR WOMOTSOFANY CONTRACT OR 0114ER DOCU�ETiTVVITM Tleen TTO NkrCY'I'MIS CERTIFICATE MAY FF.ISSUED OR MAY PERTAIN THE INSURANCE AFFORDto BV THE r ICIES bE9CRI8ED HEREIN IS ASIUS ECT Tq�i,THE TERM,EITCLUSIONS AW CONOrIONS OF SUCH PVF1CIEb:AT3GREGATE'L1MiTSE TIVAYNAPE'RF.E{RReDUCEffB'YpA16'LIAi%W ....._......_.._._........_.... . .. .......... ............ ..:.. . ... p TYPE OF INSURANCE ADLICY NUN IHOR A roMn3O PATE(M I7 UMR'8 DENERALLiABILItY CAC14OCCURRENGE A _ $ 1c00000 MaA 3I~ COERCIA4GRNBRALL FIR LITY b11 -9370 OS/07/03 05/07/64 FIRE c1r•{An . s 500000 ...aenn CLAWSMPDE OCCUR roI .—_ - _ ��¢P—vn) S 10000 PFRSorLnL&ADVINIURY $1000000 GENFRAL A00toAT. 42000000 CAM AGGRIEGATELIMITAPPLIE§ R; PRODUCTS•CCMPfOzAGG 12000000 X POLICY LOC ALITOM08It ei lABrt m COMBINED SINGLE LIMIT A ANY AUTO S1V05374 IEe"tontl $1,000000 ALL OWNED AUTOS BODILY OAIRY X SCtiSMA.EDAXOS (Parpomm) X WIRED ALRO$ (PeerjY X NOt*OWEDAVrOs ( r a aa t P OPEel' Y DAWGE• S GARAOSLIAIULm AUTO ONLY->:AACCIDENT I ANY AM FA= 4 oTTi�R N YI l AL'voNLr: AGa � EICE88LIl1SA.ITY EACHOCCURIREUCE 8 0{X;E1R �CLAIMS MADE , DEOXTIlm 6 RETMIOrt S 6 WORKPIRSCOMPEN9ATIONAND X LI TS ER EMPLav T9'urBILm WC"5374 05/09/03' 05f07/04 e L.BACH ACCID!Nt -- $100000 E.L.DIStASE•FA Et KOYEE 1 i'..... _ • 00000 El.DIWASe-PGmYLIMIr 1500000 orHER DEBCRI OP O gGAT10N8tV@ CI.E8A: •S ADDED GY ENO .NTAiPiCM4 PROYiSNSNB Ol►k�1iASZiD239: �>CCatraLt Last, 4xa83Ag Of Land; Septio Talnke 1I1etallati6a CERTIFICATE HOGR N it)WRONALINS�JRED:IN4UkjFtLL�T'IEAz - CgNCElt 'T R VL%RRE-8 SHOULD ANY OF"ABOVE OESCIIITIRD POLICIES VIE CANCEULEO BEFORE W9 SXPIRATtON DATETHGRSOF,THOMOUiNOINOURERWLLiNDEAVORTOMAIL LO VAYBYYAhM WA:CreQ CCrtiniry,D27P, NOTICE TO TME CERTIFICATE HOLDER NAMED TO TK LFT,BUT FAILURE TO 00 80$HALL 40L0 X in at zoot "POSE NO OBIIGAMON OR t,IASILM'OFANY 40ND UPON IHE INSURER,rm AGENTS OR sson 402@ 1Kai.ltf Bt.T;�i$ sff8rr6nAob=g'.39Y 22885 ar1't+BSEnIrzT(v Pefies sTrrA s t _ n don WeeaJve re of coverage. Tao it<es not'desined d' pQ*M*"es. J. Residential Final Inspection Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/p j)epa am/pm 4 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: -- NAME: 1) PERMIT#: —6CU'� LOCATION: DATE: TYPE OF STRUCTURI�: Comments Y N N/A Chimney Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof Roof 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. Platforin at all exterior doors Interior Handrails stairs 2 or more risers Grade away from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wall 8 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade as Furnace shut-off within 30.ft. or within line of site it Furnace shut-off at entrance to fumve area Furnace/Hot Water Heater o erating '14,Af -Low water shut-off boiler Relief Valve(s)installed Interior privacy krim/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: Bathroom Fans,if no window Carbon Monoxide detector Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf ,gmergency egress below grade Basement stairs closed rise>4 inches %hour fire door/door closer Garage fireproofing Duct work Sealed properly Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq. ft.vents Building No./Address visible from road Final Electrical Site Plan Wariance required Final Survey Plot Plan As Built Septic System/Sewer Dept.Impection Sticker Flood Plain Certification,if required Okay to issue C/C(Cert.Of Cam pfiance) Okay to issue Temporary C 0(Cert. Of Occupanc Okay to issue Permanent C 0(Cert. Of Occupan y) L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003 Residential Final Inspection Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: NAME: PERMIT# ` 617 LOCATION: lad l.r� - t _ DATE: 0-7, TYPE OF STRUCTURE: Comments ' Y N N/A Chi mne Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof Roof 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 Grade away from foundation 6 in.with 10 ft. Handrail Termination,at Newell Post or Wall 8 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30.ft. or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed 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: Bathroom Fans,if no window Carbon Monoxide detector Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf Emergency egress below grade Basement stairs closed rise>4 inches 3/a hour fire door/door closer Garage fire roofin Duct work Sealed properly Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, 1 s .ft.-150 s .ft.vents 8191ding No./Address visible from road inal Electrical . } .. Site Plan /Variance re uixed Final Surve Plat Plan ' As Built Se tic System/Sewer Dept.Inspection Sticker Flood Plain Certification,if required Okay to issue C/C(Cert. Of Compliance) Okay to issue Temporary C/O(Cert. Of Occupancy) Okay to issue Permanent C/O(Cert. Of Occupancy) L:\SueHemingway\8uilding.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003 Residential Final Inspection Offide No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Ar6e: a�,�epart: -W-'arn/prn 742 Bay Rd.,Queensbury,NY 12804 ,*. - Inspector's pector's Initials. t NAME: PERMIT#: LOCATION: 7-- DATE: TYPE OF STRUCTURE: Comments Y A N NIA Chimney Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof Roof Complete Guard 30 in.or more @ stairs,decks,patios Guard at stair-well at 34 in. or more j Guard at deck,porches 36 in.or more V/ I Exterior Finish Complete V/ Interior/Exterior Railings 34 in, to 38 in. 1A I Platform at all exterior doors -interior Handrails stairs 2 or more risers Grade away from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wall 8 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30 ft. or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating -r- —1-1eApe; dr Low water shut-off boiler Relief Valve(s)installed L tj e--s 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: Bathroom Fans,if no window Carbon Monoxide detector Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf Emergency egress below grade Basement stairs closed rise>4 inches -/4 hour fire door/door closer Garage fireproofing Duct work Sealed properly Attic access 30 in,x 24 in.x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq,ft.vents A Building No./Address via_ om road 1 Final Electrical . I V Site Plan [Variance requAd Final Survey Plot Plan As Built Septic System/Sewer Dept.Inspection Sticker Flood Plain Certification,if required Okay to issue C/C(Cert.Of CoLnpliance) Okay to issue Temporary C 1 0(Cert. Of Occiipancy) Okay to issue Permanent C 0(Cert. Of Occupancy) L:\SueHemifigway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003 Residential Final Inspection Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive. am/pm Depart: 1,y?"Am/prn 742 Bay R4.,Queensbury,NY 12804 Inspector's Initials: 'NAME: PERMIT#: 3 L0 ,ATION: DATE: C, TYPE OF STRUCTURE: Comments Y N N/A Chimney Ht. Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof Roof 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 Grade aw"from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wall 8 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30,ft. or within line of site Oil Furnace shut-off at entrance to furnace area Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed 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: Bathroom Fans,if no window Carbon Monoxidedetector Plunift fixtures Foundation insulation Floor truss,draft stopping fmished basement 1,000 sf Emergency egress below grade Basement stairs closed rise>4 inches 3/4hour fire door/door closer Garage fireproofing Duct work Sealed properly Attic access 30 in.x 24 in,x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, I sq. ft.-150 sq. ft.vents Building No,/Address visible from road Final Electrical Site Plan Wariance required Final Survey Plot Plan 80001 'As Built Septic System/Sewer Dept.Inspection Sticker Flood Plain Certification,if required Okay to issue C/C(Cert. Of Compliance) V 1 Okay to issue Temporary C 1 0(Cert. Of Occupa cy) Okay to issue Permanent C 1 0(Cert. Of Occupancy� LASueHemifi gway\Building.Codes.Inspectioii.FORMS\Res.Final Insp.form 2.doc edited January 28,2003 Foundation Inspection Report Office No. (518)761-8256 Date Inspection request received: Mve-3 �s Queensbury Building&Code Enforcement " Arrive: am/p Depart: m/pm 742 Bay Rd., Queensbury,NY 1.2804 Inspeetor's Initials: NAME: -PERMIT#: () 3 M f LOCATION: INSPECT ON: I D 42 TYPE OF STRUCTURE: Comme is Y N N/A Footings Piers Monolithic Slab Reinforcement in-Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place Foundation Dampproofing Foundation/Waterproofing Type of Dampproofing/Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing wet areas under slab f Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Cnade 6 inch drop within 10 ft. L;\SueHemingway\Building.Codes.Inspection.F'ORMS\Foundation Inspection Report.doc January 28,2003 Foundation Inspection Report Office No. (518)761-8256 Date Inspection req st r c ve Queensbury Building&Code Enforcement Arrive; a pm Depart: ,L, am/ in 742 Bay Rd., Queensbury,NY 12804 Inspector's Initial NAME: 1 1 #: LOCATION: SPELT ON: TYPE OF STRUCT Comments Y ,N.. NIA 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 p ose on site. Foundation/Wallpour Reinforcement in Place Foundation Dampproofing Foundation/Waterproofing Type of Dampproofmg/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:\SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003 30 Foundation Inspection Report Office No. (518)761-8256 Date Inspection re re ived: Queensbury Building&Code Enforcement Arrive: a part: am/ 742 Bay Rd., Queensbury,NY 12804 Inspector's Initia c NAME: P IT#: f LOCATION: SPECT ON: TYPE OF STRUCTURE: Comments Y N NIA ootings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place Foundation Dampproofing Foundation/Waterproofing Type of Dampproofmg/Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 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. LASucHemingway\Building.Codes.Inspection.FORMSToundation Inspection Report.doc January 28,2003 ProjectName: r BP# Address: Y- 5 Building Permit Submission SFD Checklist 2-Family kill 1<e�A�� An 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 lad*,the permit will not be accepted until such time as the application is deemed complete for submission. I Building Permit Application Completed ... ............ ...................... 9-yes [j no [:1 n/a 2. EnergyFonnorCheckM&te Energy Gcde Compliance Forms Complete- Ors 11 no n n/a (2 copies) Oele,,-.Y✓�"•. 3. Energy Code Inspector's Report from Checkh4ate Program... Oyes El no El n/a J2 copies) filled-out if n/a a' licatitin conipletely- b. A -S tic. S ...no < Electrical Inspeh Form... ...... ...... ..wI Lirs 0 E]tL/a-. -&f structural drawings:-. yes 40 7. Two(2).completeFset' a plan,01 -a) floor plan;--b),'.fp rele�Atio foundation p qqss:4ecqons:,d) us e)window and door schedule 8. Two(2)site plans showing location of the structure to be built.... ...... ... E)yes []no 'Fln/a location of well or water lines,location of septic system or sewer line. 9. Setbaclis from property lines to new structure............ .................. .. Elyes Ono Eln/a 10. Setbacks to neighboring wells and septic systems,including onsite well... . E]yes E]no []n/a and septic systems(if applicable) 11, DrivewayPermit... ............. ...... ...... ... ... .. ... ... ...... ............. ... ..I O yes�Elno E]n/a 3 . Date: Staff Initial: L-\Sucl*ni:wgway\BuAdingyermiElOR S\Geueiic ChecklistAoc januaryZ8,2003 Permit Number MECcheck Compliance Report Checked By/Date New York State Energy Conservation Construction Code MECcheck Software Version 3.3 Release I c Data filename: C:\Program,Files\Check\MECcheck\DefauIt Template.cck COUNTY:Warren .STATE:New York HDD: 7635 CONSTRUCTION TYPE:Detached I or 2 Family HEATING TYPE:Non-Electric DATE:07/14/03 APPROVAL LIMITED TO PROJECT INFORMATION:Job Number: 17136 CTORy BUILT PORTION Prepared By:Ed Milunic JUL 1. 7 COMPANY INFORMATION: Muncy Homes,A Division of Muncy Homes,Inc. N 1567 PA Route 442 East P.O.Box 344 Money,PA 17756 NOTES: 1-Calculations reflect only that portion.of unit assembled in the factory. 2w Builders or contractors may supply and install the required floor - 0761% and/or foundation wall insulation. EST 3-For basements remaining unconditioned spaces,the builder shall enclose the basement stairs.The walls surrounding the basement stairs shall be insulated and protected with a vapor barrier.The builder is responsible for supplying all materials.. COMPLIANCE:Passes Maximum UA=263 Your Home=263 0.0%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 1508 38;0 0.0 45 Wall 1:Wood Frame, 16"o.c. 1360 19.0 0.0 67 Window:-30 x 37(2)EA: Vinyl Frame,Double Pane with Low-E 15 0.330 5 Window:-42 x 57(8)EA: Vinyl Frame,Double Pane with Low-E 133 0.330 44 Window: -48 x 36 Casement: Vinyl Frame,Double Pane with Low-E 12 0.300 4 Door:-36 x 80 2 Lite: Solid 22- 0.270 6 Door:-32 x 80 9 Lite: Solid 19 0.350 7 Door:F79-72 x 80 Vinyl SGD:Glass 40 0.360 14 Floor,1:All-Wood Joist/Truss,Over Unconditioned Space 1508 C�9).O 0.0 71 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 page,they are, attesting that to the best of his/her-knowledge,belief, and professional judgment,such plans or specifications are in compliance with this Code. C Builder/Designer L ,,cryw U/1 /0,16wlllve-�F ja Date APPRVAL LIMITED TO FACTOORY BUILT PORTION -JUL 17 - 0761 ST i 3 MECcheck Inspection Checklist New,York State.Energy Conservation Construction Code MECcheck Software Version 3.3.Release lc DATE: 07/14/03 Bldg. Dept. - Use Ceilings: [ ] 1. . Ceiling l:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation APPROVAL LIMITED TO Comments: FACTORY BUILT PORTION Above-Grade Walls: JUL 17 21 [ ] 1. Wall.1:Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: � laN Windows: S G1' [ .] 1. Window::30 x,37'(2)EA:Vinyl Frame,Double Pane with Low-E,U-factor: 0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal•Break?[ j Yes [ j No Comments: [ j 1 1 Window:-42 x 57(8)EA:Vinyl Frame,Double Pane with Low-E,U-factor: 0.330 ©�o,0761"�1���� For windows without labeled U-factors,describe features: rAI gTA' ' #Panes . Frame Type Thermal Break?[ ]Yes [ ]No Comments: ] 3. Window: =48 x 36 Casement:Vinyl Frame,'Double Pane with Low-E,U-factor: 0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes [ ]No Comments: Doors: [ j 1. .Door:-36 x 80 2 Lite: Solid,U-factor:6.270 Comments: [ ] 2. Door:-32 x 80 9 Lite: Solid,U-factor:0.350 Comments: [ ] 3. Door:F79-72 x 80 Vinyl SGD:Glass,U-factor::0.360 Panes Frame Type Thermal Break?[* ]Yes [ ]No Comments: Floors: [ ] 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: Air Leakage: j 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 and glazing U-factors 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-1 1. 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 j ointsi 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. I 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: Fireplac6s,must be installed with tight fitting non-combustible fireplace doors. I Fireplaces must be provided with a source of combustion air,as required by the Fireplace construction provisions of the Building Code ofNew.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: ingulate'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 conveying4luids above 105-F or chilled;fluids below 55 V.must be insulated to the levels in Table 2. NAL ApPROVAL LIMITED TO FACTORY BUILT PORTION JUL 17 2003 0 07613A �n`lBSTi►'t��F t S Table I: 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) U to o V 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) APPRCNAL LIMITED TO FACTORY BUILT PORTION JUL 172003 2 No. �Q 076 �, observed,or believe I saw evidence of, psi= S P�'G SAS. I ave seen or ohs , 120� li bjects such as houses,wells,trees,fences,etc,, Ue shoe on this document.i also represent that C have diagram." a perso ally ure he distances set forth on the g II f TU UR RE DATE SIGNATURE R. �.. AUG 2, NO t� ,� OF Ql1EE COD�Y � Conc��� �ec� for EIJIII�,�,���1.�-�.—'"' . a� k'7\ } J �t ✓ t2onJ� YDKG,� v �Y AID We f0WA) 'Tr G e sr T .