2010-121 TOWN OF QUEENSBURY
Iwo 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20100121 Date Issued: Monday, September 20, 2010
This is to certify that work requested to be done as shown by Permit Number P20100121
has been completed.
Location: 105 FOURTH St EXT
Tax Map Number. 523400-309-011-0001-064-000-0000
Owner. CHRISTOPHER PATTEN
Applicant: CHRIS PATTEN
This structure may be occupied as a:
Garage Attached By Order of Town Board
Single Family Dwelling TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of :Wit" ''"c Co•e a
Planning Board or Zoning Board of Appeals.
��` TOWN OF QUEENSBURY
Ff/ro 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100121 Application Number. A20100121
Tax Map No: 523400-309-011-0001-064-000-0000
Permission is hereby granted to: CHRIS PATTEN
For property located at: 105 FOURTH St EXT
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: ANDREW&MARGARET URBAN
PO BOX 25 Garage Attached
BRANT LAKE, NY 12815 Single Family Dwelling $85,000.00
Total Value $85,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-121
1472 sq ft single family dwelling&484 sq ft garage
$225.04 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, April 08,2011
(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'. ' Quee ••ury;. 1 Th sday, April 08,2010
SIGNED BY ,; AAk. for the Town of Queensbury.
Director of Building : Code Enforcement
•
f.
64
,5:-.),74/_ /_ OFFICE USE ONLY m
TAX MAP NO. / O� PERMIT NO. �(1�� /�) L 0,y ,• LI Vii
„„ J� f
FEES PERMIT ZZ5'RECREATION I D NGINEERING '"� G6111 "g
? . _. 2010
L....... _i
PRINCIPAL STRUCTURE: TOWN Q:. :: N RUR
APPLICATION FOR ZONING APPROVAL &BUILDIN L - - . k.w:. ' OflFS
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER:R \ 11 (� \7-14e(\ OWNER: CA"I C J.Shfce-`J Pen-MTA
ADDRESS: 7 �-t(iC`C(1 1�' c),��"f j 't3 ADDRE `�Ole
PHONE NOS. )I'S'7`g"IC5)1 PHONE NOS. 4--
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE:" `-.c /Y7 PHON@r"' - p h
LOCATION OF PROPERTY: l CS F4."C'f ft Sfi-6 , tY414/7- Qv'er'Fc� n.( V 12rL''1
SUBDIVISION NAME: 656t
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z
APPLY TO YOUR I 0 o o LL; PROJECT O a O O
w
iz W °LL �� W S I
u. z r Oz
a ar
ci
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SINGLE FAMILY 1143Z i" J
i ,:_. /V71-- Z I /; fit
TWO-FAMILY �� 1
1 M(NOULTI-FAMILY
_)
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
y ya
ATTACHED ���/ 8
GARAGE(1 2 ') I /
OTHER
IF COMMERCIAL OR INDUSTRIAL-NAME OF BUSINESS: ( "/P
ESTIMATED CONSTRUCTION COST: 5.U I FUEL TYPE: 4i -4'i{ ,1 l c-i
HEAT TYPE? i-ICi alms `HOW MANY FIREPLACE(S) C AND(OR WOODSTOVES(S): C
ZONING CATEGORY: tut: ' r ARE THERE WETLANDS ON THIS SITE? t U L.
V
IS THIS A HISTORIC SITE? , C {,,
PROPOSED USE OF BUILDING OR ADDITION: �i 5 ( F-c\vvA.l� I(}y\..i
Town of Queensbury•Community Development Office•742 Bay Road,Queensbury,NY 12804
ARE THERE STRUCTURES NOT SHOVA4 ON PLOT PLAN? i Ur
ARE THERE EASEMENTS ON PROPERTY? Lit
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
I acknowledge no construction activities shall be commenced prior to issuance of a valid permit.
I certify that the application, plans, and supporting materials are a true and complete statement/
description of the work proposed, that all work will be performed in accordance with the NY
State Builidng Codes, local building laws and ordinances, and in conformance with local zoning
regulations. I acknowledge that prior to occupying the facilities proposed, I or my agents will
obtain a certificate of occupancy. I also understand that I /we are required to provide an as-
built survey by a licensed land surveyor of all newly constructed facilities prior to issuance of a
certificate of occupancy.
I have read agree to the a•• e.
Signed: L__ ' 4 .Vr.�
Director of Building&Codes: 761-8256(for questions QUESTIONS? CALL 761-6256 OR EMAIL
regarding Building Permits,construction codes or septic codesiueensburv.net
systems)
VISIT OUR WEBTE FOR MORE INFORMATION
Zoning Administrator: 761-8218(for questions regarding www.queensburv.net
required permits,the permit process,application requirements or to
schedule an appointment)
Permission is hereby granted to the above This application/proposed action described herein is
Applicant to erect or alter the building described found to be in accordance with the zoning Laws of
herein in accordance with said Application: the Town of Queensbury
BUILDING&CODES APPROVAL ZONING APPROVAL
DATE DATE
Office Use Only
Operating Permit Issued: Yes No
Occupancy Type:
Construction Classification:
Assembly Occupancy limit:
Special Conditions:
Revised 9/22/09
Town of Queensbury-Community Development Office-742 Bay Road,Queensbury,NY 12804
For an EPA homeowner's guide: htto://www.eoa.aov/nodes/nubs/homeowner cluic Inn," r,,r+^mizo, def �]y---
' LI 1?�
it
OFFICE USE ONLY n L s
f TAX MAP NO. PERMIT NO. /O /2) PERMIT FEE lam'o '
APPROVALS: ZONING TOWN CLERK = S l,ani
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PE Jai £ --r.., -.s S
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. f (► 'L -�
OWNER: ��1►r-1-S�TL I�✓ �,/G"1 rli '1 INSTALLER: -.J+ C,';7,Ce-( c Y I-7(k(C`T1
ADDRESS: �.(, CSC'(/L� 2 J, & ADDRESS: 1`J titL I'`d F^4, ,'1 1 i rL 113
PHONE NOS. ')r6- G?LII�k'S1 /PHONE NOS.
LOCATION OF INSTALLATION: jt)S ,.4k -i 4- ak 1
RESIDENCE
YEAR BUILT
NO. X COMPUTATION= = TOTAL DAILY FLOW INFORMATION:
BEDROOMS
1980 or older F-1 X 150 gallon per bedroom = 0 GARBAGE GR1IjQER
1981-1991 X 130gallon = INSTALLED? 4
per bedroom 0
1992-present 4 X 110 gallon per bedroom = 33
® SPA OR HOT TU
INSTALLED? _
PARCEL INFORMATION: �/
✓ TOPOGRAPHY: FLAT ROLLING/" STEEP SLOPE SLOPE %
✓ SOIL NATURE: SAND X LAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? l � BEDROCK(IMPERVIOUS MATERIAL: AT WHAT DEPTH?
I DOMESTIC WF,F.R SUPLY:
MUNICIPAL WELL (If well:
er
:water� supply from any septic system absorption is:( ft)
✓ PERCOLATION TEST: RATE IS /-a PER MIINUTE PER INCH(TEST TO BE COMPLETED BY A LICENSED
PROFESSIONAL ENGINEER OR ARCHITECT)
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).
TANK SIZE: fes° GALLON(MIN. SIZE IS 1,000 GAL)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM TYPE:
❑ABSORPTION FIELD(WITH NO. 2 STONE) Total length 100 ft. Each trench 2- X
❑SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM Bed or other type?
D HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL
INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
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 QUESTIONS? CALL 761.8256 OR EMAIL
to abid these and all require1ents of the Town of Queensbury codes4deueensburv.net
San ry Sewape Dispose 0 iId-nce.
VISIT OUR WEBSITE FOR MORE INFORMATION
r., / k www,queertsburv.net
• tuts of P rso Responsible a
'';:: ` Town of Queensbury • Community Development Office• 742 Bay Road, Queensbury,NY 12804
Town of Queensbury 20/0-12_ / Michael F. Travis
Highway Highway Superintendent
Home (518) 798-0413
Department
742 Bay Road-Queensbury,NY 12804 Thomas R. Van Ness
Office Phone:(518)761-8211 Deputy Highway Superintendent
Fax: (518)745-4466 Home (518) 745-0929
DRIVEWAY PERMIT
DATE: yljl�c
APPLICANT NAME: slittskkk1- ) moi% -z,A
TELEPHONE NO.: C-O' )'I " L (c Li
ADDRESS TO BE INSPECTED: IGS CAN
RETURN ADDRESS: 1 cC 15 A R J, cC (Zssc3
Applicant must show exact location and width of driveway(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: ( ) Preliminary Approval
NEED: ( ) Slight swale
( ) Deep swale
( ) Level with the road
( ) Level with the top of the paved wing
Size culvert pipe to be used (if necessary)
( )12" ( )15" ( )18" ( )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
( ) Rejected
Date:
Michael F.Travis, Highway Superintendent
Thomas R Van Ness, Deputy Highway Superintendent
Final Survey Inspection
Dept. of Community Development
Town of Queensbury
742 Bay Road
Queensbury,NY 12804
Date received: ! ib(t 9
NAME: ?AM-0\1
LOCATION: t oc 4 ' i -
PERMIT
#: 2016-1 2„9
Final Survey Plot Plan
Approved Denied
The attached final
survey has been
received by the
Dept. of
Community
Development.
Upon review the
survey has be, -
Craig :rown, Zoning Administrator
Notes:
LASueHemingway‘Building.Codes.Inspection.FORMSTina1 Survey
Zoning Administrator.doc
DL
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Iron Fipe
Found
_) (Deed- �)
(�
(Deed 509
--�
I -�T
1
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—
i I
Lands Now or Formerly of
I Herbert D. & Genevieve Garrant ( Lands Now or Former/y of MAPNOTES
I I I Book 475 Page 285 Iron pipe
Herbert D. & Genevieve Garrant 1. Boundary information shown hereon was compiled from an actual field survey conducted on Fir
Page / Lands Now or Formerly of /l Mach 31, 2010.
Book 453 Poe 313 2. North orientation and bearing base per Magnetic 2010.
Herbert D. &Genevieve Garrant 3. Warren County taxparce1309..111-64. l
b
i I I Book 579 Page 426 , 4. The location of underground improvements or encroachments, if any exist, oras shown
hereon, arenot certified. There maybe other underground utilities, the existence of which
/ arse unknown. Size and location ofall underground utilities must be ve i ied by the
appropriate authorities The Underground Facilities Protective Organization must be notified
I
prior to conducting test borings, excavation and construction. /
I I ( 5. This survey waspreparTed without the benefit of an up to date abstract of title. /
I I 6. Reproduc#ion or copying of th& document may be a violation of copyi#bt]a w unless
I / permission of the author and/ or copyright holder is obtained.
7. A copy of this document without a proper application of the surveyors embossed seal
I I should be assumed to be an unauthorized copy.
i I I
i Capped Imo
i _.
I(LWd_33.33) Rod Set
_
peed
(De+ed - 5v) peed = 0) _- Fd 726S66B9'
N80126'M ,,183.33 (Deed
(D+eo'I26, f6)
Iron FipeFound
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y Lands Now or formerly of
John F. Esmond
.N- I
800k 538 Page 73
I
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I Wooden
582944W -W 161. � =1620) _
Iron hI eFound
OHW
'ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYORS EMBUSSED
SEAL ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYORS
ORIGINAL WORK AND OPINION...
ONW
OHW
6'StockadeFeme
on .Line
6'stockadeFenm
on Lire
Wooden
Shed
Iron Rod
Found
Appmxrmate
Location of
Leach Field
Ga` cele
Fad-,
I.
I
I
Macadam
Drive
Wate, 46
Shut Off
Capp e d hon '368
Rod Set SII' _
Area= 0.44Aaw-t
/
Lands Now or Formerly of l
Russell M. & Angela B Cobb
UVAJmate Location
0Gaon S"rTank Book 810 Page 260
Concrete /
Pad
Sv
N Lark 0
0
1 Story Wood Frame
46.11'
13.9'_
comm.ponh ojr-
L--_«
Concrete Walk
.70' (Deed 108)
1_ 1
I� Roof
q�
erhan8•
b
Ifir_Airnor,�ng
Unit ti
IV-- c ricMeter Z0NINGREQUIREA1 V75: -
I rGasMeter
1+
FOURTHSTREET EXTENSION
1. Conveyance to Andrew Urban and MargairtM. Urban by deed dated Septemer25,195YI, filed
M the Warren CountyCerks Office on October 29, 1Mh2 Book W7ofDeeds atPage279.
/ Zoned...................................NR Neighborhood Residential
zp� / LotSize................................0.5Acre
Minimum Lot Width..................90'
Minimum Road Frontage: ......... 90'
Minimum PercentPermeable...35 %
Maximum BuildingHeight....... 40'
Minimum Setbacks
l Front..............................20'
/ Side................................10'
Rear................................15'
/
Capped Iron
lmnle
RodSt (Deed 57) Found
HertrcSrvke P
l
Underground UtrLty�(�eriLsp
from NewPole Pole l
Iron Pipe
Found
(8's' 3c) /0 l - ne ---t
:c .,
Queensbury Building & Code En orcement - Residential Fi Inspection
\floe No. (518)761-8256 Arrive: am/p Depart: 1g J amipm
Date Inspection re uest received: Inspector's Initials:
NAME: (idie 1 PERMIT#: ci-
/
LOCATION: R +- t DATE:
TYPE OF STRUCTURE:
Comments:
Y.e /M tgA I # r .
4" Building Number Address visible from road �! / C" (r/.
/ S
Chimney Height/11"Vent/Direct Vent Location _/
Fresh Air Intake � / ti p 0(1 Y" ., 0 �/e
3 inch Plumbing Vent through roof minimum 8 inches V , d
Roof Complete/Exterior Finish Complete �/ �,Jc "1 _ '
Platform at all exterior doors 1f/
Handrail 4 or more risers t!
Guards at stairs decks .: los more than 30 inches above !rade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
interior/Exterior Railings 34 inches to 38 inches /�
Deck Bracing I Handicapped Ramp Compliant V
Grade away from foundation 6 inches with 10 feet //I
8 inch clearance to sill plate , V
Gas Valve shut-off exposed I regulator 18 inches above grade V/
Interior privacy I trim/doors I main entrance 36 inches �//�
Bathroom/Kitchen watertight
r 7-03 k, , e
Safety glazing/Wi in stairwells safety g ,
Interior Smoke Detectors I Carbon oxi•,• Detectors
Every level: E Bed m: i
Outside every bedroo ares:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area_ / , / 1WPFZ-e-,\P"--
Crawl Spaces 18,Inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents r � �
Bathroom Fans,if no window // 6`�L
64
Plumbing fixtures VV
Foundation insulation I Insulation Certification / emomm........."..'............... ..,40
Floor truss drafts .ti.in. finished basement 1,000 =.,ft.
Emergency egress below grade Y
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area / V
Fumaue/Hot Water Heater operating V
Low water shut-off boiler `// 1
Relief Valves)installed/Heat Trap/Water Temp 110 /,
Enclosed Stairs Sheetrock Underside minimum W Gypsum /� V
;Basement stairs closed rise>4 inches V/ .
Garage Floor Pitched ,
Garage fireproofing/'/.hour fire door/door doser IV
Duct work Sealed properly t/
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built = S stem/Sewer D . Ins• i on Sticker
Site Plan /Variance required
Flood Plain Certification,if required oil pi
Okay to issue C I C or C I 0[Temporary I Permanent] f,f
L:\Building&Codes Forms\Building&Codes\Inspectlon FormslResidential Final inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 8/26/08
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection �; ;s � ed:
Queensbury Building&Code Enforcement Arrive: brary s- tart:
742 Bay Rd.,Queensbury,NY 12804 Inspector's In'•
NAME: er\ PERMIT#:
LOCATION: \-r6--- T1-} INSPECT ON: —
TYPE OF STRUCTURE:
Comments
Y N NL
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 Dkv, a_
Re' • Place
Footing Dowel ay 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
-/c7 --/Acirsc
Foundation Inspection Report
47-
Office No.(518)761-8256 Date tion == . .
Queensbury Building&Code Enforcement Arrive: 1. 17 f Depart:
742 Bay Rd.,Queensbury,NV 12804 Inspector's Ini
NAME: r av`- P; T#: �a ..
LOCATION: /i74.1.- 4' 6 f Jr - SPECT ON: 4/ --2-7--/c)
TYPE OF STRUCTURE:
Coa}ments
Arrow "13eV=C -,\N
.r Y N N A
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 Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 a..tea , .,, s :slab
I mg U nder Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Bufding&Codes Forms\Building&Codes\Inspecdon Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
21/ ft/(I/
Foundation Inspection '; ort
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart. pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: /Q ' /Z/
LOCATION: INSPECT ON: 2/—/f,
TYPE OF STRUC ' :
Comment'
Y N NA
FootWays
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 KZ)
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 mii poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior I 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
Foundation Inspection Report
Office No.(518)761-8256 Date In tion nest ��' ' ed:
Queensbury Building&Code Enforcement Arrive: . -part:
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial .
NAME: PP/1-7 E-1\ _ RMIT#: \ Z
LOCATION: r C) FT LAMbT )C INSPECT ON: — ZZ —t('‘
TYPE OF STRUCTURE:
Comments
N NA
/Footings
Piers 1
lytonolithic Slab
V 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\Inspectlon Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
7-c)e,-96.
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depar1- m/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: '
NAME: ti G'�`� PERMIT#: /(2•-/2.1
ON• Z• INSPECT ON:
LOCATION: /C S^ 5 Jce )c'&
TYPE OF STRUCTURE:
Comments
(Ma_ � Wire_ 7-Y N N/A
Footings r SfG' 0 5 ! de IA"`
Piers
Monolithic Slab
•
Reinforcement in Place ;
The contractor is responsible for
169
providing protection from freezing
for 48 hours following the placement
. = cone + .
Materials for this • ••• . site.
Foundation/Wallpour____ >
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing 2, tCk5
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:\Buliding&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Reportdoc
Last printed 12/20/2005 9:24:00 AM
Capped Iron I
d=33.339 Rod Set
•
•
Iron Rod I
` 9'02
Found ;36,, I
-726.66• I26.66f
r— —
I 1 � Capped Iron
__— _ _ Rod Set
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Wooden
shed I
ProposedrI
Leach Field 4
I /
I l Lands Now
I
I
I Area=0.44Acres f
I
It
/ Russell M. 4
N III l�,opo ___,-el Proposed
a Book 81
Ir, Distribution 1,000 Gallon firrit-j4– t/
CCC Box Septic Tank
~ I ��klh I
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0 220' ! '10 !E- / �
7291 NY
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I 1 Location I
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• T 10770' (Deed 1669 Capped Iron
Iron Rod I I Rod Set
Found I /
TH STREET EXTENSION
_ I DONALD C.050552 DATE I)ARRAH RI
Capped Iron I
d=33.339 Rod Set
Iron Rod I
Found S89gJ2 E
126.66 (r".. d126.�1 I
:e� I "'_____
� _ _ _ _ Capped Iron _
•
Rod Set
I 157, cl-
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Proposed I
Leach Field 4 /
I /
I /
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I Area=0.44 Acres f I
It I Russell At. A
q
5 Piv _�I 1I Book 81
N d No Distribution 1,000 Gallon /1',� �/
I Box Septic Tank ✓� '
o t I Ni
o
i 120' / J/ ) I
ts,129,± I �.��.._ ph_ !ilt
Deck 22o- b t� I ) ' P1
it s � , ,- .:, �..-, `
F�
�, ;:i
o
� I , ,-.
Garage .1 o, Fiv:vosed ii
AIl -
I
T I _:,>
o I tt' /
I 1 lr
I
S
I ' �' a p, �z I
I o CoveredPorrh o I
I i A � ' i 20 Id
PProx
I Location 1 I
I I DriveI /
I I I
I I /
I I20'Setlaack _J
� _r L I
I /
I /
I /
I / 582°0450"W J (Deed 57) —
• I l 10770' (Deed 1089 ped Iron
Iron Rod / Rad
Found 1 /
II _.__.T_,. ___.._.A __.. .- . __.�,.....
r STREET EXTENSION
DONALD C. DARRAH DATE RE
050552 I I
is bef�) v/sd
Rough Plumbing / nsu ation Insp 'on Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:eiL6,
Pa PERMIT #:NAME /2 /Z r
LOCATION: ./) 3 ur- c , INSPECT ON:
TYPE OF STRUCTURE: _ --�--
Y N N/A
Rough Plumbing /Nail Plates
Plumbing Vent I Vents in Place
1 34 inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I 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
P.S.I16- 15 minutes
Insulation -esidential Check/Commercial Check
T = • Similar Exterior Sealant
roper Vent, Attic Vent v//
Door/Window Sealed (No Insulation] V
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
I
COMMENTS:
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
111 ' . , 7---// 7/wac)(7_,
4
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm , .ZBepart: /.44.1,f.( am/pm
742 Bay Rd., Qu bury, NY 12804 Inspector's Initials: V ! /
NAME: PERMIT NO.: /0 ! 2-
LOCATION: /Q ,)r' cs'f. l�4N INSPECT ON: �-7Q-/)
RECHECK:
Comments and/or diagram
Soil Ty•.•,• - •d Loam/Clay
Type of Water: ''hf ittr-A I/ Well Water
Waterline separation distance ft.
Well separation distance ft.
Other wells: ft.
Well Casing Length 50' +/ - Y N N/A
[150'to well required if NO]
Absorption Field: Total length 4ft.
Length of each trench ft.
Depth of trenches �°- ft.
Size of Stone (�i�,�,i40,'II: A� t
Seepage Pits: Number
Size:
Stone Size: çu LL 11� q4- - tAc- n'k. -
Piping iztee Tyre
Building to tan \-`
0Tank to Distribution Box 4� 2
Distribution Box to Field/ Pit �'
Opening Sealed: Y/ N
End Cap _N
Inlet/Outlet Pipes&Baffles Y
Manholes 12"or less below grade _Y VII
[provide extension collar if Yes] Y V N
Location/ Separations
Foundation to tank in ft.
Foundation to absorption l ft.
Separation of Pits
Conforms as per Plot Plan _Y
Engineer Report and As-Built Y r.
ETU Maintenance Contract _Y V N
provided
Location of SystemProperty:
Front Re Left Side Right Side Middle Front Middle Rear
System Use S*, u-•
AritApp • •
;if •artial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
L:\Pam Whiting\2010\Building Codes Forms\Inspection Forms\Septic Inspection Report_03 29 10.doc
IN
Capped Iron I i=35 1) Rod Set
- •
bon Rod I
Found S89°02'367E
126.66( 12666?
I--- _ — Capped/ron •
e � I _ — _ Rod Set
_ _
I 15'whack-- —
ll ill
IS 1-3 (FT T -----7
. . L /
den I 'Proposed is�A` I
I 'J Leach Field % \ I
I v 1� ,..,..-1 I
I it � I
I 1 Lands Now
I Area=0..44Acres1- I
I I Russell M. 4
IProposed F"po�ed6e SII Book 81
N 17„90 1,AXIGallon 4cryI
I Box Septic Tank pI
O I eve, I J rl i I
120'
, i Proposed 11:1
Ik o 220' , ,. I
1 fay: 'u 44
129
..,,"
1 51, Thiosed
7.)
1/0171t-- I t\
P) 4 r rt f... r t2 f '``07'
, Garage I'm 1 . A I 49
.J, I
Vii;
r
I
0� ,
,,
I 1 ate a I � ��
Covered Porch q rr,
I Appro.:: 1 20.58' 1,
I V
I Location I I
I
Proposed I
IDrive
I
"'Ii 1 g ®. I
f I
—T - - - �-—_-- 20'Setback .� ---J
I I
I I
I I
I I 582°0450"W l (Deed 57)
• - - - -
• I f 107.70` (needlit j Iran
Rod Set
Iron Rod ( i
Found I I
T EXTENSIONTH,�'TR..��'
I DONALD C. DARRAH I I
nng � DATE F
• For an EPA,homeowner's guide: htto://www.epa.gov/npdesioubs/homeowner gui.-._ •• -y
OFFICE USE ONLY 1 '
•
Date.- , :1
■ TAX MAP NO. PERMIT NO. L/ r2r PERMIT FEE
/ , 1? :) .2, 2010 ;,
APPROVALS: ZONING TOWN CLERK 3tt�.m
tom
�� ��BU LDi`°�r a ?i~)r=S
APPLICATION FOR SEPTIC DISPOSAL SYS1 M PF1 l:���
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: C.41 fi 5S i1-u-/ T�C-% (!1 INSTALLER: 1c4 Ci- l .0 ii +Y-1:C+ C`l`
- ',2“)
f j
ADDRESS: 1 1,- ,kSC'A/ 2 j, S17� ADDRESS: t`�lii�L' '- Fes(;,, avl��l`11;`�j �,IS
�IIS
PHONE NOS. 716 it 94 �I 1 PHONE NOS.
/(;J
LOCATION OF INSTALLATION: S �l't._k .J7 '-t'/fG a:61
RESIDENCE
YEAR BUILT NO.OF X COMPUTATION= = TOTAL DAILY FLOW INFORMATION:
BEDROOMS
1980 or older r"--1 X 150 gallon per bedroom = Q GARBAGE GRI 9ER
1981-1991 X 130 gallon per bedroom = 0 INSTALLED? ,�G
1992-present NEM X 110 gallon per bedroom = ,33 61 SPA OR HOT TU
INSTALLED? f _
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING STEEP SLOPE SLOPE %
✓ SOIL NATURE: SAND X LAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH? A— BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH?
✓ DOMESTIC INN.ER S1JPLY:
MUNICIPAL WELL (If well:water supply from any septic system absorption is:( ft)
✓ PERCOLATION TEST: RATE IS - PER MIINUTE PER INCH(TEST TO BE COMPLETED BY A LICENSED
PROFESSIONAL ENGINEER OR ARCHITECT)
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).
TANK SIZE: ?() GALLON(MIN. SIZE IS 1,000 GAL)Add 250 gallons to the size of the septic tank for
each garbage grinder,spa or whirlpool tub.
SYSTEM TYPE:
❑ABSORPTION FIELD(WITH NO. 2 STONE) Total length �0O ft. Each trench 2- X
❑SEEPAGE PIT(S)(WITH NO. 3 STONE) How many? Size?
❑ALTERNATIVE SYSTEM Bed or other type?
❑HOLDING TANK SYSTEM Total required capacity? Tank size? Number of tanks?
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN APPROVED ELECTRICAL
INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
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 QUESTIONS? CALL 761-8256 OR EMAIL
to abid these and all require -nts of the Town of Queensbury codesiiikueensburvnet
San ry Sewage Di • nce.
/ VISIT OUR WEBSITE FOR MORE INFORMATION
rq www.queensburv.net
L`-,`/ 7/ Li/`/�f
ture of l rso Responsible Dat(`
'r Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804
2 : do
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depa • • am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:6149 J 4 /`i
NAME: � PERMIT#:
'
LOCATION: /o rH 57(- (~y)` INSPECT ON:
TYPE si STRUCTURE: SX?-1)
N N/A COMMENTS:
Framing
Attic A««: s 22"x 30" minimum
Studs/Headers /
Bracing/Bridging
Joist hangers
Jack Posts I Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
•
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge (8) 16D Haus 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
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side%inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\Bui ding&Codes Forms-OLOSuiIding&Codes inspection Fomis Framing Firestopping Inspection Repoct.doc Revised January 7,2008
/e)- /u�
Rough Plumbing I Insulation Ins tion Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
11110
NAME: A PERMIT #: /2 /2 /
LOCATION: M,�'. a'- INSPECT ON:
TYPE OF STRUCTURE: .1\--)
Y N N/A
Rough Plumbing ''Nail Plates
1.2111.44111:1intiV2_1Vents in Place
mum Drain Size
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
Air/Head
50 P.S.i for 15 minutes
Insulation/Residential Check/Commercial Check
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation) ~'
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Su • for Furnace
Duct work sealed properly/No duct tape
COMMENTS:
Rough Plumbing Insulation Report.revised Nov 17 2003, revised February 15,2005, revised January 7,2008
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date In Ar •:
Queensbury Building &Code Enforcement Arrive: › h a 0 • %_• -rt: / 12
742 Bay Road, Queensbury, NY 12804 Inspector's Initial=. Alf -
NAME: VFr-r C- (ERMIT#: t C- A Zi
LOCATION: 1 f��, L T1\ LTO ��C�6 NSPECT ON:
TYPE OF STRUCTURE:
Y N M/A COMMENTS:
Framing
Attic Access 22"x 30" minimum
Jack Studs/Headers
Bracing I Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed property
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Bolts 6 ft. or less on center
Ice and water shield 24 inches from wall
VNUN L.
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'r4 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:\Buiiding&Codes Forms-OL BuNding&CodesUnspection Forr s1Framing Firestopping Inspection Reportdoc Revised January 7,2008
/pier i s be �-� z— /(nd#
Framing ! Firestoppi g Inspectio 'e•-. /
Office No. (518)761-8256 Date I Pn -T,_ _ •:
Queensbury Building &Code Enforcement Arrive: -'-'611..) �•'u,1'. rt: a
742 Bay Road, Queensbury, NY 12804 I = • _. •is In'I di11f
� �
NAME: "MIT# /) /2
LOCATION: A. /jvri(_ `� -, .PECT ON:
TYPE OF STRUCTURE: S\4C*-747-Y N N/A •MMENTS:
Framing
Attic Access 22" �`
x30 minimum � t b
Jack Sheds 1 Headers \)"
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams l
Exterior sheeting nailed properly
12"0.C. la7.4XNY637
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes I Bearing Walls
Metal Strapping for Notches Top Plate
1 6(w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
•:• = • ,-, 6 ft• or less on center
loaandyster, ' • 24ktobes from wall �r
\Fire = _ • _ = • 1, 2, 3 hour t`7�\
Fire wal 2, 3, 4 hour ��–
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side%inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\Building&Codes Forms-OLDSuildl g&Codesllnspection FormsTraming Fwestopping Inspection Repaidoc Revised January 7,2008
(.'d _� �
r .
---
I sT
I ` 1
I _
)
I I _
I '
-
Found
i I
Lands Now or Formerly of ) /
I I i Herbert D. & Genevieve Garrant I Lands Now or Formerly of AMPNOTES
Book 475 Pae 285 imn.Mpe g Herbert D. & Genevieve Garrant 1. Boundaryinformation shown hereon was compiled from an actual field survey conducted on Found
NI
March 31, 2010
Book 453 Page 313 ) Lords Now or Formerly of / 2 North orientation and hearing baseperMagnetic 2010.
I I I Herbert �D. & Genevieve Garrant 3. Warner County taxparceOM111-i4. /
I I Book 579 Page 426 , 4. The location of underground improvements or encroachments, if any exist, oras shown /
I / hereon, are not cwtiffed. There may be other underground utilities, the existence of which
/ are unknown Size and location of all underground utilities must be verified by the
j appropriate authorities The Underground Facilities Frotective Organization must be notified
I I I prior to conducting test borings, excavation and construction.
I I I I 5. This survey was prepared without the benefit of an up to date abstract of title. /
I I 6. Reproduction orcopyingofb s documentmaybea violation ofcopyrightlaw unless
I ) / permission of the author and/ or ciopj*htholderis obtained.
7. A copy of this document without a proper application of the surveyors embossed seal
I I I should be assumed to be an unauthorized copy. /
I
I ; I Capped lin
I
peed -,V.339 Rod Set—
peed = 50)— — )
�t_501 — — hmRod
909
-18333) Found 1266 '
—6MT 1833'(D —
,-126.667
/
ImnhjveFound
I
i
I
I
�I
y Lands Now or Formerly of
John F Esmond
�I Book 538 Page 73
I
I
I
I
I
— — S82°04W'W 161.8 '(Deed_1620f — — —
\ brol%peFound
oNW
"ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED
SEAL ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S
ORIGINAL WORK AND OPMON. "
pNW
oNW
Capped Imn
Rod Set 63II'
WOOden l
Lands Now or Formerly of /
Russell H. & Angela B Cobb
sit l
s,d Book 810 Page 260 /
/
OfWoodsVdge
D
ZONINGREQ l 0
/ Zoned...................................NR--Neighborhood Residential
Lj
/ LotSize................................0.5Acrne
Minimum Lot Width 50'
Minimum Road Frontage .........50'
Minimum PerrentPermeable...39 %
Maximum BuildhWHeight....... 40' /
Minimum Setbacks /
/ l Front ................... ..20'
Side................................10'
/ Rear................................15'
(DeedST)
/ S82°45011Wpp e d km — —
Iron RodPe
Pi
Found -� — —
hvnHpe
REETEXTEN Found
FQURTHST
1. Conveyance to Andrew Urban and MargaretM. Urban by deed dated Septemex25,1-M filed
in the Warren County QerkF v Office on October 29,195bin Book807ofDleedsatPage2N..