2002-896 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERTIFICATE CIF OCCUPANCY
Permit Number: P20020896 Date Issued: Friday,February 28,2003
This is to certify that work requested to be done as shown by Permit Number P20020896
has been completed,
Tax Map Number: 523400-308-006.0001.072-002-0000
Location: q4 `XBURCH Rd
Owner: CHRISTOPHER CONNELLY
Applicant: CHISTOPHER CONNELLY
This structure may be occupied as a:
By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURX
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
Al
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20020896 Application Number: A20010896
Tax Map No: 523400"308-006-0001-072-000-0000
Permission is hereby granted to: CHISTOPHER CONNFLLY
For property located at: 42 BURCH 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: CHISTOPHER.CONNELLY I Single Family Dwelling 95,000.0Q-
42 BURCH Rd QUEENSBURY,NY 12804 Total Value 95,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
SERFNITY HOUSING SALES.
BALLSTON SPA.NY
Plans&Specifications
2002-896
Construction of a modular single family dwelling of 1,540 sq ft per plqtpw'�&ii%nd specifications.
V�
$184.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: W J,Te� November 12,2003
(If a longer period is required,an application for an extension must be made to the code Enforcem Officer
of the Town of Queensbury before the expiration date.)
Dated at the To?KVIIQ\Ueens November 12,2002
SIGNED BY for the Town of Queensbury.
Director of Building&-/Crode' forcemeat
Building Permit Application
Town of Queensbury-Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No. 21-0
No inspection will be made until applicant has received a Fee Paid
valid building permit. All applicants' spaces on this Rec. Fee Paid
application must be completed and must appear on the Reviewed By:
application form.
Applicant: Owner: RECEIVED
Address: vux Address: t4k-a 41 V-00-0
OCT 2 4 2002
Phone# AA - at Phone#QW) 7A3 - (o4,qO,
Email Address: Email Address: TOWN OF QUEENSBURY
BUILDING AND CODE
Property Location: Lot Number: House Number
Subdivision Name: Tax Map Number: 3 CDS-,ci-o
t�New Building: residence)commercial Estimated Market Value of Construction: $ C300
U Addition: residence/ commercial If an Addition,what will use of new addition be?
0 Alteration: residence/ commercial
0 No change to exterior size: residence com'l
0 Other work(describe
Check Occupancylnformation I"Floor 2"d Floor Other floor Total
Be
low ow sq.ft. sq.M sq.ft. Square Feet
Single family dwelling 164D q
Id _ 0k-..;
El Two family dwelling
E3 Townhouse
E3 Multifamily dwelling
#of units
0 Office
U Mercantile
U Manufacturing
C3 1 car detached garage
L3 2 car detached garage
13 3 car detached garage
0 1 car attached garage
0 2 car attached garage
0 3 car attached garage
U Storage building-
commercial
13 Storage building-
residential
0 Other
What is the proposed height of the structure 2:3 feet J inches
Will any second-hand or ungraded lumber be used? If so,for what? Vb
Type of Heating System: electric gas/wood f forced hot gaf/ baseboard othet:
Number of Fireplaces to be installed Number of.Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
Plumber
Mason
Electrician IL- 9!E� 7-A 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 I/we 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 construction.
Signature: owner,owner's agent,architect,contractor
Application,for Permit-Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,MY 12804 (518) 761-8256
1. OWNER INFORMATION:
...................... ..................
Office Use
Location of installation: kko
File Permit No.
Tax Map No. . ' 0W/ I / 7j'>_
Fee Paid
Owner's Name C-Anvtn"w 6-nKa1�,
Address: 4 8- R,,6 acca n .............................. RECEIVED
OCT 2 4-2002
2. INSTALLER'S NAME PHONE NO.
TOWN-OPIWEENSBURY
3. RESIDENCE INFORMATION:. (circle year of dwelling,indicate.#bedrooms) and niultirolatqrAND CODE
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 = 3 Cs
Garbage Grinder Installed no-,>/-
.yes
Spa or Whirlpool Installed yes V no
4.- PARCEL INFORMATION: (circle applicable information&indicate,measurements)
ToD2gtV_h_y Soij-Nature Ground Water Bedrock or Impervious Material Dqnwstic Water SuDply
(CIa <,sand at what depth at what depth'
Rolling loam 00 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: l gallon(min. size 1,000 gal.)
Tile Field: each trench -11;70
Total System Length: 2m
SeepagePit(s): number of._�'-" sizeofeach: by ft.
Size of Stone to be used: 21 f depth or thickness feet
Bed System Size: x
Alternative System: length andlor size
6. HOLDING TANK SYSTEM: (if required)'.
Number oftanks: 1 Size of each: —gallons /TOTAL Capacity: gallons
Note: Alarm-System.and-associatQd-electrical..w-ork must-be inspected by.a To)Nm_ap' prQved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PER-SON(please read)
For your protection,please note that pursuant to Section 136-29 ofthe-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 at 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 respoiisible person Date
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7. SIGNATURE-&INFORMATION FOR.F-14SPUr4bi sLr,rtsa%-.L%'—,
ENERGY CODE CONTLIANCE, APPLICATION RECEIVED
TOWN OF QUEENSBURY, WARREN COUNTY
9000 ]HEATING DEGREE DAYS OCT 2 4 2002
TBUILDING
SBURYCompliance Methods:Part 5 -Acceptable Practice Method— 1&2 Family Dwellings (Only) AND CODE
Part 6*-Thermal Rating—Component trade Offs 1&2 Family DWel9_ng_,
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: KO
Li6 i��ZZZ& C�2 9_ec,�
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE
I Gross Floor Area- square feet
2. Type of heat-—Electric Oil Gas—Other
3. Is building mechanically cooled? yes No
4. Percentage of area of windows and doors Over 17% Under 17%
5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO RVALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof
b. Exterior walls R 151-
C. Glazed areas R
d. Exterior doors R
e. Floors over unheated spaces
f. Edge of slab on grade (heated building) R
9. Basement/cellar walls (above grade) R.3_
h. Basement/cellar walls (below grade) RL3_
i. Heating/cooling-ducts-piping in unheated space R
6. Service(domestic)hot water heating device
Conforms to minimum efficiency per code ol, Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED
ANlicant's *gnature Date Phone Number
INSPECTOR'S REMARKS:
JGr-CI LfJNL iZ•./i vv✓`....+ y..,�........ -__ .-- _. ___ __
H
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STATE OF NEW YortK
DEPARTMENT OF STATE
41 STATE STREET
ALBANY, NY 1 22Z3 1-0001
GEbRQC E. PATAKI RANGY A. QANImi-s
G �OA SECRETARY Or 9rATC
SepteMber27,2002
Mr.Michael Roup
Excel Homes
RR#2,Box 683
Liverpool,PA 17045
VIA FACSIMILE TRANSMI'1"PAL
RE: M M0497-96-003,M0497-96-0.13,
and M049746-029Appr0ved System Extension
per M0497-02-18 Energy Modification
5 _
Dear Mr.Roup:
Your request for an extension ofthe expiration date ofFactory Manufacti red Home Approval no, M0497-96-003,
M0497-WO13,andM0497-96-029 applicable to one and two family dwelling-0'3' riultiple dwellings,is hereby granted
subject to the conditions of the original approval and the following: n ,�
1.A copy of this extension letter Shall accompany each factory manufactured structure plans derived from an
approved system that are submitted to local jurisdiction in connection with a building permit application and
be deemed a duplicate original. r
2.Documentation for each factory manufactured structure showing compliance with all pertinent requirements
of the Energy Conservation Construction Code of New York State-2002 Edition,shall be submitted to the
local code enforcement official as part of the building permit application.
3.Ws extension will expire on November 4,2002.
In addition,the manufacturer shall be responsible for assuring that houses_br components bearing insignias
issued during the extension period also comply with the current requirements of the NYS Uniform Eire Prevention and
Building Code.
l am hopefulRIFOENE- a ion of assistance.
OCT 24 2002 VC yours,
TOWN OF QUEENSBURY George .Clark,sr., •
BUILDING AND CODE Direct r
Division of Code Enforcement and Adminlstrption
cc:PFS Corporation,Mr.Rick Wenner
File 02-01$XL3.wpd
WWW.DOS.$T4TC.N`.^,US • E-MAIL. INFQ"=D05.5TATE NY.US
■C4•tttu i.+u.Cw
TOTPL P.01
Permit Number
MECeheck Compliance Report Checked By/Date
New York State Energy Conservation Construction Code
MECcheck Software Version.3.3 Release I c
Data filename:E:\MECcheck\Q2021196.cck
TITLE: Q2021196 SERENITY HOUSING SALES/CONOLLY JPF
COUNTY: Warren
STATE:New York
HDD: 7635
CONSTRUCTION TYPE: Detached I or 2 Family
HEATING TYPE:Non-Electric
DATE: 10/16/02
COMPLIANCAfosses
Maximum UA=263
Your Home=256
2.7% 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 1540 38.0 0.0 46
Wall 1: Wood Frame, 16"o.c. 13316 19.0 0.0 66
Window 1:Vinyl Frame,Double Pane with Low-E 157 0.370 58
Door 1: Glass 20 0.280 6
Door 2: Solid 22 0.170 4
Door 3: Glass 40 0390 16
Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 1540 24.0 0.0 60
COMPLIANCE STATEMENT: The proposed g building represented in this document is consistent with the building
9
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.
�igner Date
APPROVAL LIMITED TO
FACTORY BUILT PORTION
CP
Vo OCT 18 2002
F
MECcheck Inspection Checklist
New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release I c
DATE: 10/16/02
TITLE: Q2021196 SERENITY HOUSING SALES/CONOLLY JPF
Bldg.
Dept.
Use
I
Ceilings:
[ ] I 1. Ceiling 1: Flat Ceiling or Scissor Truss,R-38.0 cavity insulation
Comments:
Above-Grade Walls:
[ ] I 1. Wall 1: Wood Frame, 16" o.c., R-19.0 cavity insulation
Comments:
I
Windows:
[ ] I 1. Window 1: Vinyl Frame,Double Pane with Law-E,U-factor: 0.370
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? [ ]Yes[ ]No
Comments:
I
Doors:
[ ] I 1. Door 1:Glass,U-factor: 0.280
#Panes Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] I 2. Door 2:Solid,U-factor: 0.170
Comments:
[ ] I 3. Door 3:Glass,U-factor: 0.390
#Panes Frame Type Thermal Break? [ ]Yes[ ]No
Comments:
I
Floors:
[ ] I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space, R-24.0 cavity insulation
Comments:
I
Air Leakage:
[ ] I Joints,penetrations, and all other such openings in the building envelope that are sources of air
leakage must be sealed. 0F NE
�
[ ] I Recessed lights must be 1)Type IC rated,or 2)installed inside an appropriate air-tight ��- k,
with a 0.5" clearance from combustible materials. If non-IC rated,the fixture must be ' to I"
3"clearance from insulation.
I .
Vapor Retarder: tdt
2:
[ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls, and flo '�
Materials Identification:
[ ] Materials and equipment must be installed in accordance with the manufacturer's installatiot
[ ] I Materials and equipment must be identified so that compliance can be determined.
[ ] I Manufacturer manuals for all installed heating and cooling equipment and service water he
equipment must be provided.
[ ] I Insulation R-values and glazing U-factors must be clearly marked on the building plans ors eAW `sf6iL LIMITED TO
FACT Y BUILT PORTION
OCT 18 2002
+`r
a ~
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-I 1.
[ ] Return ducts in unconditioned spaces(except basements)must be insulated to R-2.
E Insulation is not required on return ducts in basements.
Duct Construction:
[ ] 3 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 Cade 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:
[ ] j 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.
E Heating and Cooling Piping Insulation:
[ ] E HVAC piping conveying fluids above 105°F or chilled fluids below 55 °F must b I
levels in Table 2. X; .
UJ_
p O
AP VAL LIMITED TO
FA RY BUILT PORTION
OCT 18 2002
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) U to o 1" Up to 1.25" 1.5"to 2.0" Over 2"
170-180 0.5 1.0 1.5 2.0
I40-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minimum hisulation 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)
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AP ROV L LIMITED TO
FAG ORY UILT PORTION
OCT 18 2002
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Residential Final Inspection
Office No. (518)761-8256 Date Inspection request ive 0 w-oso
Queensbury Building&Code Enforcement Arrive: a m epart
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial
G:�
NAME. i , P T#: J/
LOCATION: D TE:
TYPE OF STRUM
jg
Comme/ts
Y N NIA
Chimney Ht./"B"Vent/Direct Vent Location Iv,
Fresh Air Intake
27—
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
G 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
1/4hour fire door/door closer
Garage fireproofing
Duct work Scaled 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 /Variance required.
Final Survey Plot Plan
As Built Septic System/Sewer Dept. Inspection Sticker
Flood Plain Certification,if reqyired
Okay to issue C/C(Cert. Of Compliance)
Okay to issue Temporary C I 0(Cert. Of Occirpancy)
Okay to issue Permanent C 0(Cert. Of Occupancy)
L:\SueHen-dngNvay\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
Jam.
RESIDENTIAL FINAL INSPECTION REPORT V U%0
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement /
Dept,of Community Development Arrive am/pm Depart ^`
Town of Queensbury Inspector's Ini'
742 Bay Road
Queensbury,New York'12804 ��yy-�, G�
NAME PERMIT#O�J
LOCATION DATE
TYPE OF STRUC
N/A YES NO COMMENTS
Chimney HeightPT"Veni/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior F' "
Interior xterio " gs 30"to 36" '" C)
Exterior i s,Mmmes, anding 18 in.or more y
Interior Handrails stairs both sides 3 or more risers 1.. 1-
Grade 2%away from foundation ` ; "., -' "
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Fuanaw/Hot Water Heater operating ^�
Relief Valve(s)installed
Headroom,6 ft.6 in on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers 13,1
Interior privacy/trim/doors/main entrance 36"
Floor Finish
BathroomMitchen watertight
Interior Handrails Balconies/Landing 18 in.or more - -� �
Railing across window in stairwells
Smoke Detectors:
every level ..- --
every bedroom \ "�-- ' -(v,
outside every bedroom
inter connected ��� ��
Bathroom fans i,r��.{-
Plumbing fixtures , t \ 6J X�k\
Foundation insulation XZ
\t-7
3/4 hour fire door/door closer
Garage fireproofing L d
Garage penetrations sealed � a
Furnace in separate room protected(in garage)
Light ventilation per room _
� 'Safety glazing 18"or less from floor �1 ��
Final Electrical
Site Plan/Variance required Q�-V XQ-�'
Final Survey Plat Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance) _
Okay to issue temp.C/O(Certif.of Occupancy)_ C>V VS -T1
Okay to issue permanent C/O(Certif.of Occupancy),
Septic Inspection Report
Office No. (518)761-8256 Date Inspection request received: l/A _
Queensbury Building&Code Enforcement Arrive: am/pm Depart: + �am
pm
742 Bay Rd.,Queensbury,71e
1 4 spector's Initials:
NAME: drvl ,44-- PERMIT NO.:
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diam
Soil Type: Sand/Loam/Clay
Type of Water: Municipal/Well WaterCf� G'�
Waterline separation distance _ 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
See a e Pits: Number
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 Y N
Location of System gLeffttSide
Front RearRight Side
Middle Front Middle Rear
S stem Use St tus•
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
L:4SueHemingway\Suilding.Codes.Inspection.FORMSLSeptic Inspection Report.doc January 28,2003
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, !NC,
Main Office 176 Doe Run Road- Manheim, PA 17545
MUNICIPAL CE
RTIFICATE w ELECTRICAL APPROVAL
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Thefollowingconditions governed the issuance of this certificate, and any certificate previously issued is
cancelled. i
' certificate only covers the electrical equipment and installation conditions a� of date, Upon the
This yt
introduction of additional equipment or alterations, application shall be promptly made for inspection!
} „
Inspectors of this Companyshall have the wile e of makin inspections at any time} and if its
Inspec privilege
rules are violated, the Company shall have the right to r voke i ce fcate.
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Septic Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/prxi Depart. in
p
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT NO.: to
LOCATION: INSPECT ON:
RECHECK:
Comments and/or diagram
Soil e: San Clay or dia ram
Type okWaWMuniciAl/Well Water
Waterlines Fpar-aV`on distance ft.
Well separation distance ft.
Other wells:
Absorption Field: Total length
Length of each trench ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Typej
Building to tank
Tank to Distribution Box
Distribution Bo :Field 1 Pit
�Pening SealedkYJN/Partial
Location/Separations
Foundation to tank 70 ft.
Foundation to absorption 2-10 ft. xw,,&, &0 T-&(�-T-
Separation of Pits ft. �) A
Conforms as per Plot Plan Y N_j
Location of System on Property:
Front Rear Left Side Right Side
0 `
Middle Front Middle Rear
System Use Status:
roved-
i,
artial Approved and needs to be re-inspected,-please call the Building&Codes Office
Disapproved
Of Use
.GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept of Community Development Request received:
Meet.
Building& Code Enforcement At time: .14M
742 Bay Road � Notes:
Queensbury, AT 12804 ARRIVE am/pm: DEPAR a m1pm
(518) 761-8256 Inspector's Initials
NAME; PERMIT#
LOCATION: C.P, INSPECT ON(date): ll z
TYPE OF.STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection ftom freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
-Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing_
Backfill Approval
.k
Plumbing Under Stab
Plumbing Vent/Vents in Place
RoughPlumbing_
Heating Rough-In__
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
'Ceiling R-
Duct work or piping in
I unheated spaces R-
Proper Vent,Attic Vent
Fran,dng__
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4-hour_
Firesto i
pping-
L:\SueHemiiigway'@uilding.Codes.Inspcction.FORMS\GENERAL INSPECTION REPORT.doc
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive IA a� m Depart a
Inspector's Initial
_C L
NAME: PERMIT# 7 C,�
LOCATION: Pl Z— P21)R-CA-A F-0 pR� DATE:
TYPE OF STRUCTURE: tA off,ik -iN
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
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/WaRpour
Reinforcement in Place
Foundation/Dampproofin
9
Backfill Approval_
Plumbing Under Slab
Plumbing VentfVents in Place_
Rough Plumbing_
Heating Rough-Ink_
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing_
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Scaled
Fire Wall 2, 3,4 hour
Firestopping—
Office Use
.GENERAL INSPECTION REPORT Inspector:
Town of Queensbury
Ready at time.,•:".� •
Dept. of Community Development Request received: 1t Meet:
Building chi Code Enforcement At time:
742 Bay Road /
Queensbury, NY 12804 ARRIVE � am/ m: D A f ' irya ores:
(518) 761-8256 Inspector's Initia r
NAME: _Po-wite PERMIT J ?t
LOCATION: f t.y"a, INSPECT ON(date): &A 2j
TYPE OF STRUCTURE: O
RECHECK
_ N/A Y NO COMMENTS
tgs
ithic Pour Foi�n
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/W allpour`
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval__
Plumbing Under Slab_
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-�
Foundation Walls Exterior R-
Floors R-
Walls R-
eviling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing +
Jack Studs/Headers .
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2;3,,hour
Penetration Sealed 1
Fire Wall 2,3,4 hour
Firestopping
L:1SueHemingway\Building.Codes.Inspection.FORMS\GF.NERAL INSPECTION REPORT-doe
RECEIVED
OCT 2 4 2002
L&1� 46,44t, 40 P` Q' TOWN OF QUEENSB.URY
BUILDING AND CODE_
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Tax Map: 308.06 -1 - 71 A ,FyI
Taos Map: 308.06 -1- 70
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ro xo tr. woE aW.
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'- Lot No. t to have easement for
�t go
F V�o, r-A9sa ingress and egress over driveway-
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within 20-foot wide portion of Lot 2.
A9A,1.4L0 ,o S Avxelelw A. delZeAl
Tax Map: 308.06 -1 - 73
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ti
(Demo : t lcn
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h cow.
Je�
I�r
�90 • PS'
t]EIcD REFERENCE:
James M. and jo Ann Connelly
b
Christopher M. Comely
D 1201/1999
It OtW2000 1149258
Taos Yap: 308.06 -1 - 72
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T= Map: 305M -1- 76
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dote: Total area of lands to be
O!L subdivided = 2.01 Acres. _ a '�
Area: 1.285 Acres ± o '
Afta 4a ti4 �z 19FI✓d
N �
nEED REFERENCE: , 1n
Lawrence and Robbie Blackman
to _
James and Jo Ann Connally
D: 4/5/1995
R: 4/7/1995 944/80
A I:.w A4014WI.( �AELO : if /SO
A.YNO
Joan Combs Murray
ITax Map: 308.06 -1 - 68
IV- ?4'- 33 20 ' - w
Alvin Dean, Sr. &Virginia Dean
Tax Mao: 309.06 - 1 - 77
ZONING INFORMA71OND
Parcel is in SR -1A Zone.
Lot size: 1 Acre
Lot width: 150 ft.
Min. front yard: 30 Ft.
Min. side yard: 10 Ft. (Total 30 Ft.)
Min. rear yard: 20 Ft.
,Q 0.4 D
Unau&o iced aheraikm or addition m a
e survey map boating a lot aeed Led
xsurveyors seal is a violation of Section
7W9, subdivision 2, of the Nov Yak
State Edn Adw 1AW.
W
v only copes made f m the oripW of
this =NV map wbch are markh d with
amboaed wail Dead be amg the smvay&s
olWad *utury in rod ink &A be
cooddered vand and t= copies.
/473. SD '
Refer to'Map of a of lands to be conveyed to
James M. Connelly 8 JOM Connelly,' dated IMSM995,
revised 2/14/1995, Charles T. Nacy, L.S.
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`��p� �� � -Ar A 'l~ s)
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i472.4P'
W 0 0 a e
James and Jo Ann Connelly
to
Michael and Laren Le Blanc
D: 7/27/1999
R: 7/27/1999 1124/288
Poo. 40 '
A�
DOUGL,4,p 6 ltJE.✓OY X 4,We
('69,�1925)
DEED �PE/oE/PE�CE.I -
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It - 9/Z///ice►
I HEREBY CERTIFY to Christopher M. Connelly, Amy Connelly, Glens
Falls National Bank and Trust Company, its successors and/or assigns,
and Chicago Title Insurance Company that this map was prepared from
an actual survey on the ground, according to record descriptions, and
meets the standards set forth in'Code of Practice for Land Surveyors"
adopted by the N.Y.S. Association of Professional Land Surveyors, as
last revised.
November 21.2002
Charles T. Nac V, L.S., N.Y.S. Lis No. 491 (Date)
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showing a proposed subdivision of lands owned by
Christopher M.
Connelly
situated in
Town of Queensbury , Warren
Co. N.Y.
Scale: 1" = 50 `
,
May 15, 2002
SMVand M@p by
Map amended: Aug. 26, 2002
CHARLES T. NACY
Map Ate: Nov. 21, 2002
32 Jolar Street
to dww e1ae6i� foundatioon.
Owwosb", NY 12804