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2006-800 TOWN OF QUEENSBURY ^w 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20060800 Date Issued: Friday, September 07, 2007 This is to certify that work requested to be done as shown by Permit Number P20060800 has been completed. Location: 103 TEE IIILL Rd Tax Map Number: 523400-289-007-0001-003-000-0000 Owner: STEPHEN & MELISSA HIPP Applicant: PACE BUILDERS, LLC This structure may be occupied as a: Fireplace By Order of Town Board Garage - 2 Cars Attached TOWN OF QUEENSBURY Single Family Dwelling Issuance of this Certificate of Occupancy DOES NOT relieve the property ( J 4 70t. owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Planning Board Director of Building& Code Enforcement or Zoning Board of Appeals. 44 TOWN OF QUE E NSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20060800 Application Number. A20060800 Tax Map No: 523400-289-007-0001-003-000-0000 Permission is hereby granted to: PACE BUILDERS, LLC For property located at: TEE HILL 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: PACE BUILDERS, LLC 243 RIDGE St Fireplace GLENS FALLS,NY 12801-0000 Garage-2 Cars Attached Single Family Dwelling $165.000.00 Total Value $165,000.00 Contractor or Builders Name/Address Electrical Inspection Agency Plans &Specifications '2006-800 2041 SQ FT SINGLE FAMILY DWELLING WITH 499 SQ FT 2-CAR GARAGE AND 1 FIREPLACE $294.82 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, November 20, 2007 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the To of ensb , 1V)orid�y,November 20,2006 SIGNED BY "ro'v 'V f for the Town of Queensbury. Director of Building&Code E orcement • Permit No. I- _ Aei Building&Codes Office-Department of Community Development-Town of Queensbury Fee Paid 742 Bay Road,Queensbury,NY 12804 Recreation Fee Dove Hatin,Director codes@aueensbury.net Phone: (518) 761-8256 FAX: (518) 745-4437 Principal Structure Building Permit Application Application & Plans subject to review before issuance of a valid permit for construction. Instructions: A permit must be obtained before beginning construction. No inspections will be made until the applicant has received a valid building permit. All applicants' spaces on this application must be completed and must appear on the application form. Applicant/Builder 12/SiCe I t.OIc a tA. - Owner: 5A M.6 Address: "t3 Address: Address: S 04u/S I\N 1210 Home Phone: -AS-464(0 Home Phone: Email Address: Email Address: Cell Phone: Cell Phone: FAX Phone: l Z- 1611 FAX Phone: Person responsible for supervision of work with respect to building and codes compliance: Name: i i-!A•r. . /31.L FOCA le-1 641 1,c Address: 62-1 h.?IIJ>pl AJC 9,,e-A`1tf • Sp12-4 s('S Phone 6ia� Vage� Location of proposed construction: Lot No. --- Legal Address: 1 gewuD '2P Tax Map Number: 61,1 — I —3 Subdivision Name: /A Estimated Cost of Construction: $ /66,000 Proposed construction is for: )4 Residential Use Commercial Use l' Name of Business: If proposed construction is an addition, what will use of new addition be? New Addition Alteration Proposed Construction 1"Floor 2nd floor Other Total Proposed structure (Occupancy Type) Sq. Ft. sq.ft. Sq. Ft. Square leet Height 3 e e, 1 F - Single-Family Dwelling 11 ' t� Two-Family Dwelling Townhouse Multifamily Dwelling Number of Units: Otfice Mercantile Manufacturing Other: Attached Garage 1,03 41S p- Type of Heating System: Electric, Oil, as Wood, orced Hot r, Baseboard, Other: If a fireplace and/or woodstove are being installed, please refer to a separate application. Applications are subject to Zoning Administrator, Code Compliance, and Structural Plan review. The Building and Codes Office will allow commencement of your proposed project only after issuance of your permit. Declaration: Please sign below after you have carefully read the statement: To the best of my knowledge, the statements contained in the 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 Codes, 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 n- truction. �/ e1 2 ��� l �,► r— , bio Date: Applicant/Builder Signature: / ►" f'�� 1' The application of date is hereby approved and permission granted for the_cons ruction, reconstruction or alterati n a b in./and or accessor structure as set forth above. Date: 1`/ Zb 6 4 Authorized Signature: L:\Sue Hemingway\Building.Permit.FORMS\Principal Structure Permit Application.doc V:12/14/04 Fire Marshal's Office Town of Queensbury,742 Bay Road,Queensbury,NY (518)761-8205 Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances Date /` OM , 20 4(D Permit No. Application is hereby made to the Building& Codes Office for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information Fuel Burning Appliance Information (circle appropriate words) Name: WE, BUl(4: (.1/C.- Stove: wood coal pellet gas Fireplace insert Address: 17Sr Fireplace, factory-built: wood 10 MO(_ Fireplace, masonry: wood gas Furnace: wood gas oil Phone: /677.-44 If non-masonary applicance, please provide Owner: 54 rie• Manufacturer Name: Quilpop –�1 Address: Model Number: AV —32. • Chimney Information Phone: (circle appropriate words) Masonry block brick stone Flue tile steel size: inches Exact Address: ` Vittk- ri O of construction or installation Factory-Built Manufacturer name: Model Number: Note: Listed By: Number: Construction/Installation must conform to NYS Fire Prevention &Building Indicate(circle) chimney material: Code. Consult available Town of Queensbury Handouts regarding required inspections. Double wall / Triple wall / Insulated / Direct venting Chimney Liner Czeila iex',er.Depr$rtmeztt—Toru or Qzzee lterbzzry, w York Fire Marshal Code# $Collected Refunded Receivedf om(refundec o): add ;;;,A 173 3389 (190) PublicSafetyMinor•Sles VV - Tww ce. /o 0. Dr.YsLr"", White(Applicant) / Green(Fire Marshal) / Yellow(Bldg.D pt.) / Pi Goldenrod(Cashier's Dept.) Application for Permit— Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: 1 Office Use Location of installation: -C,1RAO � File Permit No.2 3L-X/ LU Tax Map No. 2gq,'j/ I / 3 Owner's Name: 17pC. . Ulj (�(� k Fee Paid Address: 4L(-'? ?-to CJI' 6'( IS riti Nom( 125301 2. INSTALLER'S NAME : PAC ,t i IJDEfiti‘ wL PHONE NO. 1.12-4 1044, 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply #of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980- 1991 x 130 gal/bdrm = -presen L{- x 110 gal/bdrm = 440 &'p Garbage Grinder Installed yes— / no Spa or Hot Tub Installed yes_ / no 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) To ash Soil Nature Ground Water Bedrock or Imservious Material Domestic Water Su..l Flat asp at what depth at what depth municipal •o ling loam feet feet Steep slope clay rtONE 1•V:14 1= No& n' z well; water supply %slope other-(A y� FOIO.40& from any septic-system depth: g absorption is 125 ft. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: 5: 30 minute per inch By exp p &Lc )2.A. 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: 1,260. gallon(min. size 1,000 gal) Tile Field: each trench Sp ft. Total System Length: /2.0C) ft. Seepage Pit(s): number of size of each: ft. by ft. Size of Stone to be used: # / depth or thickness / feet Bed System Size: S© 1 x 24-1 Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements oft.- Town of P, eensbury Sanitary Sewage Disposal Ordinance. ogsefAl /leeor /`Signature of responsible person Date • • . . • t..........r out% .,,,c ria'/11'Srg KnARMI 2ICftI 0I.LYTNII.03143,'V SIMI d K-01S 'L f y-.. Nom.... I� �_• ' V. ... -••"•"'-'"\--- . crl'Ult1.$r t rxta,„„fy , ,„ ,.,..... ,..J„,,,..,:,,, , 4,, , ..,..,.;), . /L1}' ")tl till • 1:i/ .11 T at` •" 11.1.35- 3" • 9 �,c:J1 so(, -3t.19 - ..-•LY�...�.. .....___. ,... 1 .e ..... . . :i / . _ k.)1'1 SY) 1114.111. l''',11 11-1 ,......-N__....1/...--"- ..,,:-'ss'e.,------'-•-• •Vv.01/1 to -rram ea. NOd (ti -F---- SO • •.(<.,o ;.....„`'‘..z.._... .\\... 17- ---** _ wW Ailsa s 11 v. S.1,N;,I L J I'Z11f'1Z);:I31 NOI.l,V2LVd 1S (•IYI:!lI.NI 1\1()Ll',it1l0i'ii•C•V . ,tal(tt:tl;) p:socltit(I Wthtnos hitt: t;.t:tnti;)5 4 , 4.ctultawat)nz) S . ttmoil, , Final Survey Inspection Dept. of Community Development Town of Queensbury 742 Bay Road Queensbury, NY 12804 Date received: 7-‘--07 NAME: Pot Ce_. �� rs LOCATION: 0 'e PERMIT#: DO Final Survey Plot Plan Approved Denied The attached final survey has been received by the Dept. of Community Development. Upon review the survey has ,een: Craig :rown, Zoning Administrator Notes: L:\SueHemingway\Building.Codes.Inspection.FORMS\Final Survey Zoning Administrator.doc L./ Septic Inspection Report Office No. (518) 761-8256 Date In , ' ruest received: Queensbury Building &Code Enforcement Arrive: am/pm/ De : am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's nitials: J C_part— NAME: PA'ç& ,60,2S PERMIT NO.: c1 4 7 il/6'e) LOCATION: C /'- r c_ c— lefj INSPECT ON: 4,7/7(c 7 RECHECK: Comments and/or diagram Soil Type: Sand / Loam/ Clay Type of Water: Municipal/ Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Absorption Field: Total length ft. Length of each trench _ ft. Depth of trenches ._ ft. Size of Stone `t,'-'- 1.-A6/ft) & CC—ler Seepage Pits: Number Size: x Stone Size: C.✓) F/L- (- -- Piping Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: Y/ N/ Partial End Cap Inlet/Outlet Pipes&Baffles _-__.Y—N Location / Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan YT N Engineer Report and As-Built —Y—N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status. Approved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION- ® 3 DEC Wel]Number (1)COUNTY u �.r t 9 •,.) o ( ) (2)TOWN 1(t, ,.,t,.,. Now kkXRJ - \ q 1 d WATER WELL COMPLETION REPORT (4)OWNER • -1 Ck -? k.)I Gc r s (43) LOG (5)ADDRESS .. �1 Lr Surface-EL 'I 5") ft above sea level (6)LOCATION OF WELL(See Instructions On Reverse) -r L 1 'r` %r� )` Q�e�sLv ' Show taVLong if available r`t Y lS- Top Of Casing is located �fi - and method used: _ f3° ,2)' 3 1/ /o303c5y�Li--1ft bov or below(-)ground sce • CQlGPS ❑MaD Inteation '7 (7)DEPTH OF WELL BELOW (8)DEPTH TO GROUNDWATER DATE MEASURED TOP OF WELL LAND SURFACE(feel) (j 0 BELOW LAND SURFACE(feet) CASINGS :7 4Uu,=, (9)DIAMETER go4-,1'=SIRr5 c, in. I in. I in.I in. 0 10)LENGTH S 2- ft. I ft. I ft.I in. i (11)GROUT TYPE/SEALING (12)GROUT/SEALING INTERVAL NI CTO �� ` ��L9 >L Li.•-,._, �r (feel) FROM - SCREENS,r,!:.,;-: : -6r: , a „tc r;' :i'w^f: .',W1-5 CZ,—ke-`,x>.-. (13)MAKE 8 MATERIAL (14)OPENINGS far . • (15)DIAMETER /•I�� in I In. d" f, in. I 5c•4(16)LENGTH �� ft. I ft. I ft.I in. (17)DEPTH TO TOP OF SCREEN.FROM TOP OF CASING r (Feet) h t... rJ ply-- 1 YIELD TEST. -. (18)DATE (19)DURATION OF TEST f L - Z-i -v-7 /17 Y�t 1N,5-.. • (20)LIFT METHOD (21)STABILIZED DISCHARGE(GPM) ❑Pump Air Lift 0 Bail ,-;-zG j-- 1 (22)STATIC LEVEL PRIOR TO TEST (23)MAXIMUM DRAWDOWN(Stabilized) ( <�b 5 5?,) (feeldnches below top or casing) (feeUnches below top of casing) CCtSi.n. M (24)RECOVERY(Time in hours/minutes) (25)Was the water produced dunng the test C, discharged away from immediate area? Yes 1 No_ ( d y� 1 . i,•vr�'it a l 4 ?.4.. "'+i. Y'.. - ...•n;�'.Cv'.�T`jt1'n. .'0.K.. " (0 .- _..a,::c. . _ ...<:PUMR_lNSTAL[ATlON� . . ..-.. ; s >�s:��S,a-�'.__ �.r.-. (26)PUMP INSTALLED? . [ (27)DATE (28)PUMP INSTALLER YES_ NOA >h \ . (29)TYPE (30)MAKE (31)MODEL / I Ill (32)MAXIMUM CAPACITY(GPM) (33)PUMP INSTALLATION LEVEL FROM TOP OF CASING(Feel) .Q P"-' r Wit- 5.E1as'C�Se. ._,_ - -'• I - (34)METHOD OF DRILLING (35)USE OF WATER /� Rotary 0 Cable Tool 0 Other (See instructions for choices) /// J (36)DATE DRILLING WORK STARTED • (37)DATE DRILLING WORK COMPLETED S- 30- (.� - ' r l ED (39)REGIS N (38)DATE REPORT F1 YELL DRILLING . (40)DEC REGISTRATION NO. S_3t r 0-•-� 1175 PARLEY ROAD NYRD 1(�/f HUDSON FALLS, NY 12839 (41)CERTIFIED DRILLER(Pont name) (42)CERTIFIED DRILLER SIGNATURE' / 2 k. Ls— c 1\ _) BOTTOM OF HOLE *By signing this document I hereby affirm that: (1)I am certified to supervise water well drilling activities as defined by Environmental Conservation Law§15-1502; (2)this water well was constructed in accordance with water well standards promulgated by the New York State Department of Health; (3)under the penalty of OWNER COPY perjury the information provided in this Well Completion Report is true,accurate and complete,and I under- stand that any false statement made herein is punishable as a dass A Misdemeanor under Penal Law§210.45. ROSICK WELL DRILLING L.L.C. 1175 FARLEY ROAD HUDSON FALLS, NEW YORK 12839 �,3 Q - ©' (518)746-0173 Date Customer TO C 2 Site 7;- y 1/ ov GPS# / Ot0.4, l� 70? � Depth Depth Type Of Start Fin{ ish Formations Remarks 6o. c en-f-S- 309 c /-,/s--3', 2 Mc4�') • .(1) Static Level y Gals per min. 2p i - -- Well Depth - o' d � W Driller r"..)4ThAJti z N Helper of Sample Taken Remarks 1 Septic Inspection Report / Office No. (518) 761-8256 Date Ins ion\equest received: Queensbury Building &Code Enforcement Arrive: ., OZ am/p part: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspect is Initials:\7_ NAME: a? pec, )i PERMIT NO.: } LOCATION: lGL /--i1Lt- i29 INSPECT ON: / 07 RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/ Well Water Waterline separation distance _.P.�...._ft. Well separation distance ft. Other wells: ft. Absorption Field: Total length _ ft. Length of each trench ft. Depth of trenches ft. Size of Stone _ Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/ Pit Opening Sealed: Y/ N/ Partial End Cap Inlet/Outlet Pipes &Baffles _____.Y„_._.N Location/ Separations Foundation to tank ft. Foundation to absorption .. _ _, ft. Separation of Pits _ Conforms as per Plot Plan .N Engineer Report and As-Built _ Y—N 64/ r/L Location of System on Property: �a am! T- (,�3C-r.L �-,q-S!+ti% t L-�'"�� Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Ai proved " artial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 /62,(?- Septic Inspection Report Office No. (518) 761-8256 Date Ins orl.cequest received: Queensbury Building &Code Enforcement Arrive: 5 am/pt o, ,Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: /' NAM E: ile_.-4- o, PERMIT NO.: „, , _,,,,, i. LOCATION: •cW H(-c- 119 INSPECT ON: AML” RECHECK: Comments and/or diagram Soil T •-: Sand Loa Aglaila Type of Water: Muni v ipal/ Well Water 4--CH/4 Waterline separation vistance Jt), ft. Well separation distan - ft. Other wells: s ft. Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x Stone Size: Piping Size Type Building to tank nk to Distributio Box istribution Bo ield/ Pit Opening Sealed / N/ Partial 1/ End Cap Inlet/Outlet Pipes&Baffles ' Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. 'Conforms as per Plot Plan ^Y _ __ � ��/c'c�t� Engineer Report and As-Built —Y_,_L N 6Jz sv t 7' A-5— Ul L Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: proved Partial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 <.7-'- Q.? -4(/1- Septic Inspection Report 0-4ec 7 ) Spit- Office No. (518) 761-8256 Date InssectioR request received: zi_____4/__:..__1_ / Queensbury Building &Code Enforcement Arrive: 5 a ') am/pm,,, Depart: am/pm 742 Bay Rd., Queensbu , NY 12Inspector's Initials: �f�-- NAME: N C�i'r—c PERMIT NO.: '/�,1 LOCATION: 1(3. � C (' q.( (2/4 INSPECT ON: /$4&V 6)711/0 7 RECHECK: Comments and/or diagram Soil Type: Sand / Loam/ Type of Water: Municipal Well Water / V Waterline separation distance /�' Well separation distance ft. Other wells: ft. Absorption Field: Total length 7--ego ft. Length of each trench ft. Depth of trenches '1,---- ft. Size of Stone t y Seepage Pits: Number Size: x - Stone Size: Piping Siz Type I Building to tank // �� o Tank to Distribution Box u Distribution Box to ' / Pit u ,t 1_47 , Opening Sealed: Y N/ Partial ` Lj�,� �f� u.�c. )D.,q"7O, _c� nL .1..tJ End Cap V Inlet/Outiet Pipes&Baffles _Y IN /4/,1 4.‘,4.--- C Location/ Separations Foundation to tank yft• Foundation to absorption ft. Separation of Pits ._ ft. Conforms as per Plot Plan _Y Engineer Report and As-Built V N �2 pii i v6 .6%)C2 . AraPieo�'�L ;4"�`���.' Location of System on Property: A 5 — 63t _-- ft f)-A-) let; Rear Left Side Right Side Middle Front Middle Rear System Use Status: /Iroved artial Approved and needs to be re-inspected, please call the Building &Codes Office Disapproved Last revised 021006 Last revised 1/6/05 Rough Plumbing / Insulation Inspection Report Office No. (518) 761-8256 Date Inspection requ st received: / Queensbury Building & Code Enforcement Arrive:5 .. L/5 am/pm Depart: Virm 742 BayRoad, Queensbury, NY 12804 Inspector's Initials: 1 P �� NAME: 0 /9-e e_, D C12 S PERMIT #: ( ' --800 LOCATION: INSPECT ON: t o p TYPE OF STRUCTURE: 36,5 - C/ ( 99 :Mho Y N N/A ILA-J. Rough Plumbing / Nail Plates /k ' 42) Plumbing Vent/ Vents in Place 1 1/2 inch minimum Drain Size ( 3 4 ')': c bed-) Washing Machine Drain 2 inch minimum Cleanout every 100 feet/ change of direction Pressure Test Drain / Vent Air / Head 5 P.S.I. or 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping 3.g' LUh(�5 /Q ( Air / Head 50 P.S.I for 15 minutes / , —/Lk(� ,!� Insulation / Residential Check/ Commercial Check Proper Vent, Attic Vent Duct/ Hot Water Piping Insulation If required unheated spaces , Combustion Air Supply for Furnace Duct work sealed properly / No duct tape COMMENTS: L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 Town of Queensbury Fire Marshal j 742 Bay Road '��- e Queensbury,NY 12804 [L/ 761-8205/7614206 fax 7454437 Factory Built Gas Fireplace/Stove Inspection Report Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's �jjy� instructions or n cations is allowed. 02 Permit# el.-L� OSchedule Inspection o I Time am pm anytime Inspector (J - Name e" `6e:-0,e 5 —Address 12 kel'-C g Rough In_V nal_,__ Appliance Manuf cturer �L orT i LA--(00--- it/D3VP Model#!�A ), 57 4P 74 Direct Vent FactoryIBuilt ChimneyFlue Size Double Wall Triple Wali Insulated Yes No NIA Comments Floor Protection Clearances to Combustibles (all sides) Firestop(s) Vertical Chase ___. //, Wall Penetration Vent Clearances to Combustibles / . Vent/Chimney Termination Chimney height must be 3 feet above roof penetration;2 feet above any combustible construction within 10 feet Gas Shut-Off Valve Combustion Air Hearth Extension (if any) Mantel Height above f/p opening Witness Operation Tank Placement(if LP) White-Building Dept Yellow-easterner Pink-Fire Marshal Framing / Firestopping Inspection Report Office No. (518) 761-8256 Date Inspectign request received: / Queensbury Building&Code Enforcement Arrive: .`5v am/pm Depart: am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: �4-- NAME: PA-66 /3, c,'/2 s PERMIT#: 6 , -- LOCATION: "r(--<— /'(i 1'C) . INSPECT ON: ® 1, TYPE OF STRUCTURE: Y N N/A COMMENTS Framing Attic Access 22" x 30" minimum ac tads/Headers 7 e r racing/Brid inr LlfL''5 Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft. 8 in. Stairwells 36 in. or more Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 '/z(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq. ft. floor trusses Anchor Bolts 6 ft. or less on center Ice and water shield 24 inches from wall Fire separation 1, 2, 3 hour F. e wall 2, 3,4 hour 77 Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side ''A 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 Framing / Firestopping Inspection Report / Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: Cam/p Depart: am/pm 742 Bay Road, Queensbury,NY 12804 Inspector's Initials: 1-r-4-' NAME: /?9 5tLr-' PERMIT#: — 80 E) LOCATION: /1:::3 "1 PCt Hr/ iRc.4 INSPECT ON: 6/47 TYPE OF STRUCTURE: Y N/N/A Framing COMMENTS ,� Attic Access 22"x 30"minimum UV Jack Studs I Headers C 3he,r.e.tA,"). Bracing/Bridging Joist hangers 6 l e� Jack Posts/Main Beams lJ /� '.)gfz-k h-cs>6T" Exterior sheeting nailed properly GJ AA) �j u,)/�5 F`(,E'-�S 12"O.C. Headroom 6 ft. 8 in. A< Ji 15 L A-176 Stairwells 36 in. or more Headroom 6 ft. 8 in. 100M ;(._ 4:ft)1% Al' �1 V . 2 i.,. . Notches/Holes/Bearing Walls 14C-4.-t7C-1e. 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 water shield 24 inches from wall Fire separation 1,2, 3 hour te wall 2, 3,4 hour J Firestopping ✓ /464-t— (01(Z i✓ UCL Al" L ✓. 2`" Penetration sealed 16 inch insulation in cavity min. 6.) (KAVI-C- / 3'U Garage Fire Separation v c 1 House side 'A 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 / r2C%/2 - /6H .- lti ✓� ,tr r cj r� Foundation Inspection Report Office No. (518) 761-8256 Date Ins tion request received: / . Queensbury Building&Code Enforcement Arrive: • dam/p , Depart- am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector s itrals: i NAME: (Pt: PERMIT#: Q(o —ro6 Q LOCATION: 101,T 1-(n 1-u- 0 INSPECT ON: yt 1 v (�(`Ii o 7 TYPE OF STRUCTURE: V)FUN Comments Y N N/A (6\y- 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation 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:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM 81/Oar Frarnin / Firestopping Inspection Report Office No. (518) 761-8256 Date In .,.cti•. equest received: C , 0 Queensbury Building&Code Enforcement Arrive: i m/ ,,Depart: a pm 742 Bay Road, Queensbury,NY 12804 Inspector's I itials NAME: I [ PERMIT#: oc° rn1 LOCATION: (U� l�( (i( 1`d INSPECT ON- 17:4 TYPE OF STRUCTURE: -q7/Q •' Y N 1 rl/A COMMENTS Framing Attic Access 22"x 30"minimum Jack Studs/Headers Bracing/Bridging Joist hangers Jack Posts/Main Beams Exterior sheeting nailed properly 12"O.C. Headroom 6 ft. 8 in. Stairwells 36 in. or more Headroom 6 ft. 8 in. Notches/Holes/Bearing Walls Metal Strapping for Notches Top Plate 1 %2(w) 16 gauge(8) 16D nails each side Draft stopping 1,000 sq. ft.floor trusses Anchor Bolts 6 ft. or less on center ce and water shie 4 inches from wall • Fire separation 1,2,3 hour Fire wall 2, 3,4 hour Firestopping Penetration sealed 16 inch insulation in cavity min. Garage Fire Separation House side %2 inch or 5/8 inch Type X Garage side 5/8 inch Type X Ceiling/wall Windows Habitable Space/Bedrooms 24 in. (H) 20 in. (W) 5.7 sf above/below grade 5.0 shade Rough Plumbing / Insulation Inspection a ' ort Office No. (518) 761-8256 Date Inspection r9iquest received: a Queensbury Building & Code Enforcement Arrive: .- U—am/prep ,depart: Mr am/pm Ins ecto�s Initials: \--) �`*- 742 Bay Road, Queensbury, NY 12804 p C •CX, moo NAME: R6'6:: li/utt. PERMIT #: LOCATION: /65 r to LC /2-id . INSPECT ON: 3/ 7 TYPE OF STRUCTURE: ' ilic Y/ N N/A ough Plu ' Nail gmbVent/ Vents in Plates Place rie-— /,.J Vr/ 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum I ko r-i"3 F--- Cleanout Cleanout every 100 feet/ change of direction Drai- / =nt Air Head 5 P...I. a- 10 ft. above highest connection for 15 minutes /Pressure Test ��►•ter Supply Piping (;�% / Headti . P.S.I for 15 minutes Insulation / Residential Check / Commercial Check Proper Vent, Attic Vent Duct / Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace _ Duct work sealed properly / No duct tape COMMENTS: L:\Pam Whiting\Building&Codes\Inspection Forms\Rough Plumbing Insulation Report.revised Nov 17 2003.doc Revised February 15,2005 9- // 77-2ESZ)B1 /z/ /06 Foundation Inspection Report Office No. (518)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart::lc am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initialsy j NAME: �� PERMIT#: 06-860 LOCATION: /03 i/'/1 INSPECT ON: TYPE OF STRUCTURE: Comments Y N N/A F tir�� 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6inc es_above-footing 6-if-lir-poly for wet areas under slab 17r acicfill Appxoval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forrns\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM r*00r) 01R3 /2 /(06 Foundation Inspection Report Office No. (518)761-8256 Date Inspectio request received: Queensbury Building&Code Enforcement Arrive: _ Sm/pmDepart: am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's tials: ~� �' NAME: ,-� p PERMIT#: C�C� �� . LOCATION: /0 3 ,�� L�./I 1 INSPECT ON: TYPE OF STRUCTURE: l Comment 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/Walipour Reinforcement in Place Footing Dowels or Keyway in place Foundation Doffing Founds ' n Waterproofing Footing Drain Day i or Sump Footing Drain Stone: 12 inch width 6 inches above footing �6 ++i +•ly for wet areas under slab Backfill Aproval .mg Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM la-aikeS641 /216 Foundation Inspection Report pe Office No. (518)761-8256 Date Inspectiovfequest received: Queensbury Building&Code Enforcement Arrive:2 • j am/pn part: am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: F NAME: r . . . PERMIT#: Za)(' OCC . LOCATION: fl).` ( moi Il 1 ZJ 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 _Reinforte—ortiPlace ✓" Footing Dowels or Keyway in place Foundation Dampproofmg Foundation 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:\Building&Codes Forms\Building&Codes\Inspecdon Forms\Foundation Inspection Reportdoc Last printed 12/20/2005 9:24:00 AM Foundation Inspection Report Office No. (518)761-8256 Date Ins ctio request receix+ed: Queensbury Building&Code Enforcement Arrive: '\' .ta ,Ip ; Depart:" �'1a9Ipm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Init�`.�i`' : J NAME: NcE Bol\rOE ? jI J RMIT#: IDL --coon LOCATION: I D?) -FES -\L ta) INSPECT ON: 1.7—10'-0(Q TYPE OF STRUCTURE: Comments Y. N N/A N/Flootings Piers Monolithic Slab Reinforcement in Place v The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. \41i Foundation/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofmg Foundation 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:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM (.7-3 :30) 2 _z_./ • Esz),741/ Foundation Inspection Report Office (518) Building-8256 Date&Code Enforcement Arrivenspec n 1 •�." we . Queensbury g ,"'' Depart: TIE) 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial NAME: FZce BU PERMIT#: 17.- 0C) LOCATION: /,' INSPECT ON: 7 -- TYPE OF STRUCTURE: Comments �1 Y N N/A Footings ,-2 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation 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:\Building&Codes Forms\Building&Codes\1nspection Forms\Foundation Inspection Report.doc Last printed 12/20/2005 9:24:00 AM