2002-955 'SOWN OF QUEENSBURY
742 Bay Road,Queeusbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8286
CERTIFIC OEOCCUPANCY- ATE
Permit Number: P20020955 Date,lssued: Thursday,May 29,2003
This:isaa certifyAat work requested`to be�-done as-shown.by�Permit Number �.P20020955.: : . :y
has been completed.
Tax Map Number: 523400.308-008.0001.043-000-0000
Location: 59 BURNT HILLS Dr
Owner: BURNT HILLS LLC
Applicant: CLUTE ENTERPRISES
This structure may be occupied as a:
By Order of Town Board
Garage- 1 Car Attached TOWN of QUEENsua
Single Family Dwelling
Directot of Building&Code Enforcement
TOWN' 0' F { UEENSBURY
LIJ 742 Bay Road,Queensbury,NY 12804-5902 -(518)761-8201
Community Development-Building&Codes (518) 761,8256
BUILDING PERMIT
Permit Number: P20020955 Application Number" A20020955
Tax Map No: 523400-308-008-0001-043-000-0000
Permission is hereby granted to: CI,IJTF,F,NTFRPRISF,S
For property located at: 59 BURNT HILLS Dr
in the Town of Queensbury,to constrict iir`pl'ace '
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: BURNT HILLS LLC
15 F BIRDIE Dr Garage- 1 Car Attached
LJEENSBL7RY,NY 12804-0000 Single Family Dwelling 110,000.00
Q Total Value 110,000.00
Contractor or Builder's Name J Address Electrical Inspection Agency
Plans&Specifications t"
2002-955 Lot 19, Burnt Hills
Construction of a 1,274 sq ft single family'-dwelling with a 352 sq ft one-car attached garage pe, of plan
and specifications.
$188.08 PERMIT FEE PAID-THIS PERMIT-EXPIRES: Thursday,November 20,2003
(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(fate.)
Dated at the Tow of Qu nsb November 20,2002
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
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. / •
No inspection will be made until applicant has received a Fee Paid $�16 S
valid building permit. All applicants' spaces on this Rec. Fee Paidy: �------ <.L'
application must be completed and must appear on the, Reviewed B
application form. p.
Applicant: �--Gx-f-4'�:4 Owner: , sa 4-&at,
Address: Address:
Phone#'3 ) - ;.Z Phone#
Email Address: Email Address:
Property Location: Lot Number: \'I / House Number 1 7c 77
Subdivision Name: Tax Map Number:
New Building: residenc commercial Estimated Market Value of Construction: $ . \ \0,0,0 0:
❑ Addition: < si ammerciai If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ No change to exterior size: residence/com'l /
❑ Other work{describe )
Check Occupaneylnformation 18C Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
Single family dwelling
❑ Two family dwellin
❑ Townhouse
❑ Multifamily dwelling ® /
#of units RECE@9
❑ Office
❑ ' Mercantile
❑ . ,Manufacturing
❑ i car detached garage , ND CODE
❑ 2 car detached garage
❑ 3 car detached garage
i car a#taehed garage
❑ 2 car attached garage
❑ 3 car attached garage
o Storage building-
commercial
❑ Storage building-
residential
❑ Other
What is the proposed height of the structure Z�;- feet inches
Will any second-hand or ungraded lumber be used? If so,for what? 1
Type of Heating System: electric/ oil / gas/ ood orced hot aiD/ aseboard/other:
Number of Fireplaces to be installed (V 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 C; "
Plumber
Mason IA -^"�
Electrician
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 Build' e Zoning Ordinance and all other laws pertaining to the proposed work shall be complied
with,whether s zed or no#ed,a d that such work is autho ' ed the owner. Further,it is understood that Ilwe shall
submit,prio o a Certificate of Occ ancy or Certificate o ompl}'anc@ being issued,as requested by the Zoning
Adminis for or Director.of Build and Codes,an ds Built Sur. ev by a licensed surveyor;drawn to scale,showing actual
locati of all new construction.
Si ature: er owner's agent,architect,contractor
Application for Permit—Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury,AT 12804 (518) 761-8256
1. OWNER INFORMATION:
Office Use
Location of installation: X Zn>k 700-Z
m oz — I t-f� i File Permit No.
Tax Map No.
Fee Paid
Owner's Name:
.......... ........................... .....................................
Address:
2. INSTALLER'S NAME �J PHONE No. —T-i 3 IJ-7 7
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: Na. 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 0
Spa or Hot Tub Installed yes 1 0_
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
Too ara-pliv Soil Nature Ground Water Bedrock or Impervious Materia Dt44awgtir—Water Supply
sand at what depth at what depth municipal
R-777ing --1&&M— —feet feet we
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.
RECENEU
Septic Tank: I gallon(min. size 1,000 gal.) NOV 1 4 2002
Tile Field: each trench � Q ft. Total System" Length: TOWN OF QUEENSBURY
Seepage Pit(s): number of size of each: ft. by_jr. BUILDING AND CODE
Size of Stone to be used: # depth or thickness feet
Bed System Size: x
Alternative System: length andlor 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 therations with respect to this application and agree to abide by these and all
requirern s of the Town bf Queensb Sanj, ewage Disposal Ordinance.
L
ure o r ponsible person Date
- - '. 'i i�wtt c�f C2uec��t,titu:•y .
.SoNvcrs :iirti_:�c�vsi'l:t [)i�;>ct�:tl" (.it:rtiit:•
AUSORVIIION MAY
- SII'I1�itA.'i'1C)1`�l
10
"^" Y•tgiL. to �/nTR'FZ� -. � tss -tt`rod
� tf�!�ittiL`tlttr•t
AtY,rxsPtrct:`
' F`1 Ci.t.Sa
A
.. }-'_.__-��_— '._..-<ZL1T I��•�l ....a..^'—_T^' .r--'—'ram-•ter w�^_.._+�
7. SpaNA.7VpU -1E &INFORMATION FU.I,R�.r`.Fur*4;.'"*l-r-J'nt�vx, �„crs+,••••••:; `
. HIGHWAY '
I HW ' Rickard A.hXissita
Highway Superintendent
EPARTMENT Nome(518)798-5127
742 Bay Road - Queensbury,NY 12804 Michael E Travis
Office Phones (518) 761-8211 DeWutY HI9hwaY Superintendent
Fax: (5!8) 745-4466
(518)798-0413
DRIVEWAY PERMIT
DATE: l `I l --:I t
APPLICANT NAME: CA sAk
TELEPHONE NO.: 77i —7:)7 7 "
ADDRESS TO BE INSPECTED: Or.
RETURN ADDRESS: 00`� ¢ l
w exact location and width of driveway(s)
Applicant must show ay(s)to be connected to the highway by
placing stakes at the specified location.
The Superintendent of Highways.of the Town of Queensbury has reviewed this application. The
following action has been taken:
STEP 1: O Preliminary Approval RECEIVED
NEED: ( }Slight swale NOV 14 2002
O Level With the road
{ )Deep swale TOWN OF QUEENSSURY
BUILDING AND CODE
Size pipe to be used(if necessary)
( )12" ( )1$" ( )IS" ( )24" ( )36
Preliminary inspection completed by DATE
Approval by Highway Supt_ Deputy Supt
-upon completion,please resubmit this approved permit for a final approval.
STEP 2: ( )Final Approval
O Rejected
DATE.:
Richard A. Missita,Highway Superintendent
7,002, TYJ
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
I["
�3 we 9000 EATING 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- \_-) -7 1,--[............... square feet
2. Type of heat- Electric oil >eGas Other
3. is building mechanically cooled?_yes_�No
4. Percentage of area of windows and doors Over 17% 'Under 17%
5. R-VALUES FOR IMULATION GIVEN BELOW MUST CORRESPOND TO R VALUES AS
SHOWN ON PLANS SUBMITTED: R RECEIVED
a. Roof
b. Exterior walls R kci NOV 14 2002
C. Glazed areas R._.J.4i'
d. Exterior doors R i TOWN OF QUEENSBURY
e. Floors over unheated spaces Rn BUILDING AND CODE
f. Edge of slab on grade(heated building) R
9- Basement/cellar walls (above grade) R
h. Basement/cellar walls (below grade) R
i. Heating/cooling-ducts-piping in unheated space
6. Service (domestic)hot water heating device es No
Conforms to minimum efficiency per code
TEMP RE C , TROL IMUM SETTING 140—WILL NOT BE EXEEDED
pplicant1
S, e Date Phone Number
INSPE OR'S MARKS:
Project Name:LJ � I BP#
Address: l���7°� -, r� ?,4
Building Permit Submission
Sia-fangy dvd1ing
Tien famly duaYbg
Checklist
All items below must be checked either yes,no or not applicable prior to submission of`aiiy 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 ... ... ... .:.... ... ......... ... ... ... . s no ❑n/a
2. EnergyForm or C heckM&te Energy Code Compliance Forms Complete , ❑no El n/a
3. Energy Code Inspector's Report from CheckMate Program.. ...... ... .... ❑no ❑n/a
4. Septic application completely filled out(if applicable)... ... .. ...... ... ... ... s Q no ❑n/a
5. Solid Fuel Burning or Gas Appliance Form... ... ... ... .... ❑yes ❑no a
6. Electrical Inspection Form... ... ...
7. Two (2) complete sets of structural drawings... .. ............ ... ... ...... ...... Ono ❑n/a
a)floor plan;b)foundation plan;c) cross sections:d)elevations;
' e)window and door schedule '
8. Two(2)site plans showing location of the structure to be built.... ... ... ... Ono ❑n/a
location of well or water lines,location of septic system or sewer line.
9. Setbacks from property fines to new structure ... ............ ...... ... ... ..... ❑no ❑n/a
10. Setbacks to neighboring wells and septic systems,including onsite well...: ❑no ❑n/a
and septic systems (if applicable)
11. DrivewayPermit... ......... ... ... ... ... ... ...... ... ... ...... ... ... ...... ... ... ... s Ono ❑n/a
Date:
Staff Initial:
L:\SueHemiugway\Buik6g.Perniit-FUR1vZS\Generic Check6t.doc
rmit Number
MECcheck Compliance Report Checked By/Date
Proposed New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release lb
Data filename:AAClute Colonial-lot 19 59 Burnt Hills.cck
TITLE: 1274 Sq.Ft Colonial
COUNTY:Warren
STATE:New York
HDD:7635 RECEIVED
CONSTRUCTION TYPE:Detached I or 2 Family
HEATING TYPE:Non-Electric
DATE: 11/I3/02 NOV 1 4 2002
DATE OF PLANS: 11/13/2002 TOWN OF QUEENSBURY
WIDING AND CODE
PROJECT INFORMATION:
Lot#19
59 Burnt Hills Drive
Queensbury,NY 12804
COMPANY INFORMATION:
Clute Enterprises,Inc
General Contractor
13 Dawn Rd.
Queensbury,NY 12604
COMPLLANCE:Passes
Maximum UA=242
Your Home=208
14.0%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 650 30.0 0.0 23
Wall 1:Wood Frame, 16"o.c. 1616 19.0 0.0 86
Window 1:Vinyl Frame,Double Pane 93 0.490 46
Door 1:Solid 41 0.069 3
Door 2:Glass 41 0.490 20
Floor to Bm:
All-Wood Joist/Truss,Over Unconditioned Space 624 19.0 0.0 29
Floor overhand:All-Wood Joist/Truss,Over Outside Air 26 19.0 0.0 1
Furnace 1:Forced Hot Air,82 AFUE
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building
plans,specifications,and other calculations submitted with this permit application. The proposed systems have been
Y
r
designed to meet the Proposed New York State Energy Conservation Construction Code requirements.
BuilderlDesigner Date
MECcheck Inspection Checklist
Proposed New York State Energy Conservation Construction Code
MECcheck Software Version 3.3 Release*lb
DATE: 11/13/02
TITLE: 1274 Sq.Ft Colonial
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:
Windows:
1. Window 1:Vinyl Frame,Double Pane,U-factor:0.490
For windows without labeled U-factors,describe features:
#Panes Frame Type Thermal Break? Yes No
Comments:
Doors:
1. Door 1: Solid,U-factor:0.069
Comments:
2. Door 2:Glass,U-factor:0.490
9 Panes Frame Type Thermal Break? Yes No
Comments:
Floors:
1. Floor to Bm:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation
Comments:
2. Floor overhand:All-Wood Joist/Truss,Over Outside Air,R-19.0 cavity insulation
-Comments:
Heating and Cooling Equipment:
J 1 1. Furnace 1:Forced Hot Air,82 AFUE or higher
Make and Model Number
Air Leakage:
Joints,penetrations,and all other such openings in the building envelope that are sources of air
leakage must be sealed.
Recessed lights must be Type IC rated and installed with no penetrations,or Type IC or non-IC
rated installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible
materials and 3"clearance from insulation.
Vapor Retarder:
Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors.
Materials Identification:
Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
Materials and equipment must be identified so that compliance can be determined.
[ ] J Manufacturer manuals for all installed heating and cooling equipment and service water heating
( equipment must be provided.
j ] J 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.
J Insulation is not required on return ducts in basements.
J
J Duct Construction:
[ ] J 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.
j ] J Cooling ducts with exterior insulation must be covered with a vapor retarder.
[ ] J 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.
{
J Electric Systems:
j ] J 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.
{
J Service Water Heating:
[ ] J Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the
J water heater has an integral heat trap or is part of a circulating system.
[ ] ( Insulate circulating hot water pipes to the levels in Table 1.
{
( Circulating Hot Water Systems:
[ ] ( Insulate circulating hot water pipes to the levels in Table 1.
( Swimming Pools:
[ ] ( All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
( of the heating energy is from non-depletable sources. Pool pumps require a time clock.
( Heating and Cooling Piping Insulation:
[ ] ( HVAC piping conveying fluids above 105°F or chilled fluids below 55°F must be insulated to the
( levels in Table 2.
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 two 1" Up to 1.25" 1.5"to 2.0" Over 2"
170-180 0.5 1.0 1.5 2.0
140-160 0.5 0.5 1.0 1.5
100-130 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches by Pipe Sizes
Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4"
Heating Systems
Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0
Low Temperature 120-200 0.5 1.0 1.0 1.5
Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0
Cooling Systems
Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0
and Brine Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD(Building Department Use Only)
TOWN O F QUEENS 8 U RY
BU=LD�NG 2� COI?E ENFORCEMENT
742 sAY ROAD
Q U E E N S S U R W N Y 1 2 8 0 4
4Ea�w (S18) 761-825C3
!"'+r^'tw'F!rr.,r e-.� _. .._.. *'„sy'�T rt*T'IG►1P �^+ !^J Rat•� '`� (hotel, rnc3tc2. apt. cc>rnplc--X)
DnTE x N S P E CT x O N E Qu E S T R E C E x'V E�► �
NAME �•
LocnTxC3N %
D1xTE
TYPE OF STRUCTUFZE
FOOTINGS SA C K F x LL FRAMING P LU M S I N G l
xNSUL71TxON
CHZMNEY " S `• 'VENTLFiExC3HT
PLUMS xiIG V'EN TfF'=XTURES
RO O F x N G
mm,rERxOR Fxt3 x SH
HEAT x NG fiOT WAFER
R E L x E F VALVE S
FLOOR S
FOUNDATION x N S U LAT x ON
xNTERxOR S`I'Ax RS IRAxLxNCiS
STOCKROOM EN C LO S U R E
FIRE/I3EM I S E WALLS PENETRA'r I ON
F=RE L?AMPERS
C E I L x NG FIRE
F'xRE L7C1C►RS./CL,CISiERS
x x T DC)C n HARL7WARE
Exx S':r Tns/RI%xLS
PZ,ATFtJI2Nt ELEVATOR
HAND=CAPPER AC C E S S
HANDICAPPER BATH S
HANDICAPPED PARK x N G
F x N AL C T R x CAL
S x T PLAN VA R x AN C E R E
NA L SURVEY P LOT P LAN I F RE
OK WC) ISSUE C O OR C C
MAP REFERENCE:
BURNT HILLS SUBDIVISION
DKC HOLDINGS, INC. -
- DATED: JULY 23, 2001
LAST REVISED: JANUARY 17, 2002
BY: VAN DUSEN & STEVES
LAND SURVEYORS, LLC
17
Im
ununes
SWO M 50"E
—710'.00
It I"I
w
�I
29.80
4tj7 �s I
\-V�
�— 25.36
19
28,163 sq ft
0.65 acres
61.36'
s8 ' 27 0
BURNT HILLS DRIVE
KC
21
V�" • a
Joi
Du
a� e
'n
Steves
Land S Ll r v e y o r s
169 Haviland Road Queensbury, New York 12804
(518) 792-8474 New York lAc. No. 50135
i1NAU11 OMM ALIM71011 OR ADDI1M M A SURVEY
MAP MIND A LICENSED LAND SIRVEYM SM 15 A
WOLAIMIL OF SWIM 7,M EUB- ft" z of IM
NEW YORK StAlt ILUCAIION LAM."
A -ONLY= A NORM THEM Or INt LAND KMeAl1C�'
MARK/:D YArM AN ORIGMIAL OF TH! UVD MADIL101ID
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AMD= AND WOW 1151"MM LIM NOIEOM. AMD
TO ME A55KH P� OF TIC LDVM SB11111I1OM.•
1
Map of a Survey made for
DAVID J & PETRA P . WINCHIP
1
Town of Queensbury, Warren County, New York
1
1 NO.
DATE
DESCRIPTION
4
I I "w50'
S --1
SHEEr1OF1
CLUTE
DWG. NO. gg241-iq
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection request received: �/C,
Queensbury Building&Code Enforcement Arrive: a Depart: a pm
742 Bay Rd,,Queensb ry,NY 12804 Inspector's Initials. '
NAME: Zt �'�U�/t�'" PERMIT#: � �S/
LOCATION: Lv , S DATE:
TYPE OF STRUCTURE:
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.
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 fumy ea
Furnace/Hot Water Heater operating ,tlC� `
Low.water shut-off boiler �
Relief Valves installed
Interior privac /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
'K hour fire door/door closer
Garage fireproofing
n
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
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(Cert. Of Compliance)
Okay to issue Temporary C 1 O(Cert. Of Occir anc )
Okay to issue Permanent C 1 O(Cert. Of Occu anc
L:tSueHemingwaylBuilding.Codes.Inspection.FORMSIRes.Final Insp.form 2.doe edited January 28,2003
L�
- Residential Final Inspection � � P
Office No. (518) 761-8256 Date Inspection request r ive 65
Queensbury Building&Code Enforcement Arrive: a In a In
742 Bay Rd.,Queensbury,NY 12804 Inspector's Ini ials-
�� r'I ''
r
NAME: �\% an ' j PE #: VQ
LOCATION: Lcm- 5- r X DA
TYPE OF STRUCTURE:
Comments
X a 1tiI/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.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation,
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade 110
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 ��V:VCA czp
Low water shutoff boiler
Relief Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safe lzin
Interior Smoke D�tors:
Every level: / Every Bedrpom:
Outside every bedroom ea: ✓
Inter Connected: ,,!! J Batter backu :
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
'l�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 4v
Crawl Spaces 18"x 24"access, 1 s ,ft.-150 s . ft.vents
Building No.1 Address visible from toad V v
Final Electrical —C
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(Cert.Of Compliance)
Okay to issue Temporary C J 0(Cert. Of Occir ane )
Okay to issue Permanent C/0(Cert. Of Occu anc )
L:\SueHemitigway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
Rough Plumbing/ Insulation Inspection Report
Office No. (518)761-8256 Date Inspection reque ceive e')
Queensbury Building&Code Enforcement Arrive: a pm De t. anyprn
742 Bay Road,Queensbury,NY 12804 Inspector's Init* s-
NAME: PERMIT#: ao()!
LOCATION: t v C INSPECT ON:
TYPE OF STRUCTURE:
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
Head or Air Supply Test
Drain and Vents
5 PSI or 10 ft. above highest
Connection for 15 minutes
Water Supply Piping
Copper Commercial
Copper,CPVC,Pex One&Two Family
Inrs`461ation/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
COMMENTS:
L.\PamW\Whiting\Ropgh Plumbing Insulation Report.doc
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Ins ection requ r ei
Queensbury Building&Code Enforcement Arrive: = a e qnlCpm
742 Bay Road, Queensbury,NY 12804 Inspector's Initi
NAME: PERMIT#: ac�q
LOCATION: r__510X INSPECT.ON:
TYPE OF STRUCTURE:
Framing Y N N/A COMMENTS 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 V2 (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
.estopping
SE 1�tA
Penetration sealed
. 16 inch insulation in cavity min.
Garage Fire Separation
'House side Y2inch 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
LAS ueHennin.-Nvay\Bui Iding.Codes.Inspection.FORMSTrarning Firestopping Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection a ei
Queensbury Building&Code Enforcement Arrive: ' a epart: am/
742 Bay Rd., Queensbury,NY 12804 Inspector's InitI
NAME: P #:
LOCATION: INSPECT ON: -a — -2 ._._C).
TYPE OF STRUCTURE:
Comments
Y N N/A
Footings
Piers
i
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 Dampproofmg
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 as /Copper
oundation Insulation Interior/Exterior
R- \T,> 'V'
Rough Grade 6 inch drop within 10 ft.
Foundation Inspection Report
Office No.(518)761-8256 Date Ins pee tion request received:
Queensbury Building&Code Enforcement Arrive: am/p m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: QA A Q-- r_ � PERMIT`#: ' �—,
LOCATION: =:�c� (?)ocj�—sX INSPECT ON:
TYPE OF STRUCTURE:
Comments
y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylightot,Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC s /Copper
Xtundation Ins i n InVtrioftxtenor
uxt 9
1A I Z ( / -
,C lez Ak Y7
Rough Grade 6 inch drop within 10 ft.
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received: p1
Queensbury Building&Code Enforcement Arrive: am/pm art: m/pm L
742 Bay Road, Queensbury,NY 12804 Inspector's Initials.
NAME: PERMIT
LOCATION: �jqt�;' U c2- INSPECT ON: 2. .-Z " c'1
TYPE OF STRUCTURE:
Y N N/A CONEWENTrS
Framing �5 � ,
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams �}
Exterior sheeting nailed properly J
12"Q.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Hales/Bearing Walls
Metal Strapping for Notches Top Plate
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
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 %z inch or 5/8 inch Type X
Garage side 5/8 inch'Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
Rough Plumbing / Insulation Inspection Report
Office No. (518)761-8256 Date Inspection request received: E
Queensbury Building&Code Enforcement Arrive: am/pm Depart- _ a
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
NAME: L Cf ._. _ PERMIT#:
LOCATION: 4 �z1����/ !0 G. (r- INSPECT ON:
TYPE OF STRUCTURE:
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
Head or Air Supply Test
Drain and Vents
5 PSI or 10 ft.above highest
Connection for 15 minutest/��
Water Supply Piping
Copper Commercial 1
Copper,CPVC,Pex One&Two Familyy A ' I
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
COMMENTS:
L:\PamWlwhiting\Rough Plumbing Insulation Report.doc
Rough Plumbing Insulation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:In p� .
Queensbury Building&Code Enforcement Arrive:--arn1pm art:. am/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
NAME: CPERMIT#:
LOCATION: -H3 LLUNY- INSPECTON:
TYPE OF STRUCTURE:
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
Ro"ugh Plumbing/Nail Plates
Head or Air Supply Test
Drain and Vents
5 PSI or 10 ft. above highest
Connection for 15 minutes
Water Supply Piping
Copper Commercial
Copper,-CPVC,Pex One&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
COMMENTS:
L:\PamW\Whiting\Rough Plumbing Insulation Report.doc
Framing / Firestopping Inspection Report 9--
Office No. (518) 761-8256 Date Inspection request received: .
Queensbury Building& Code Enforcement Arrive: am/pm Depa . wpm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
t
NAME: PERMIT#:
LOCATION: j1 INSPECT ON: oZ-C; /-O3
TYPE OF STRUCTURE: ' !�)o
COMMENTS
Jack Studs/Headers fiJfi
Bracing/Bridging `"
Joist hangers
Jack Posts/Main Beams
Exterior sheetingnailed properly e ^' C)
fc
P p y
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 'I2(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
10 P etration 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.FQRMS\I-raining Firestopping Inspection Report.doc January 28,2003
Septic Inspection Report
D\
Office No. (518)761-8256 Date Inspection request received: -no-',f)
Queensbury Building&Code Enforcement Arrive: am,/pm � VAUM/pm epart:
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT NO.: C�)Zo-,)Ass
LOCATION: INSPECT ON:
RECHECK-
A) Comments and/or diaeram
Soil Type: q d 1 , Clay
Type of W unicio/Well Water
Waterline seDarat-15-5-di-stance ft.
Well separation dis e
Other wells: r --ft.
Absorption Field: llptal length ft.
Length of each trenc ft.
Depth of trenches ft.
Size of Stone
Seepage Pits: Number
Size: x
Stone Size: y
Piping S'ze Type i
Building to tank
Tank to Distribution Bbx -!Z-o
Distribution Boxt,o,Field Pit
Opening Seale t Y 114/Partial
Location/Separations
Foundation to tank
Foundation toabsorption
Separation of Pits z ft.
Conforms as per Plot Plan VY N
Location of Syst U�--
o
R�J:m e
Front Rea _Left Side Right Side
r le Rear
Middle rout le R
System Use St/tus:
V Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
q
e
I .i!
r
Office Use
.GENERAL INSPECTION REPORT Inspector:
Ready at tiniZ.;'
Town ofQueensbury
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:.
742 Bay Road
Queensbury, AT 12804 ARRIVE am/pm: DERAR7 amIpm Notes:
(518) 761-8256 Inspector's Initials
NAME: PERMIT#
LOCATION, INSPECT ON(date):TYPE OF STRUCTURE:
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/Wallpour
Reinforcement in Place
Foi;xfttion/Dampproofing
\, kf11 Approval
vaPInb�gUr�ej
Slab
Plumbing Vent/Vents in Place
Rough Plumbing__
Heating Rough-In
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/Bridgmig-
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4-hour
FirestoppiIng-
L:\SueHemiiigway\Duildiiig.Codes.inspection.FORMS\GENIERAL INSPECTION REPORT-doe
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queenshury Ready at time,.,:
Dept. of Community Development Request received: Meet.
Building& Code Enforcement At time:
742 Bay Road Notes:
Queensbury, AT 12804 ARRIVE am/pm: DEPART amIpm
(518) 761-8256 Inspector's Initials
NAME: PERMIT#
LOCATION, INSPECT ON(date): 3
-SIR TYPE OF STRUCTURE:
RECHECK
N/A YES COMMENTS
VOO<9s/Pier8
Monolithic Pour Form
Reinforcement in Place —,,W► 41
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/D ampproofing_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
HeatingRough-In,.__
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
JackStuds/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
Firestopping_—
L:\SueHemizigway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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