Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2015-194
� � w r-� �D 0 W G N E� d V 9 r � o a �4 V ON o n © Q Q A 1 N 4 OO v id W � W C'4 O Q C/ w { V cz41 +� v Q O Go' rA Ln ++ 4+ ctl ++ TOWN OF QUEENSBURY 411111itoki 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150194 Application Number: A20150194 Tax Map No: 523400-297-017-0001-070-000-0000 Permission is hereby granted to: CHRISTOPHER& COLLEEN GECZY For property located at: 6 MEADOW VIEW 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: CHRISTOPHER& COLLEEN GECZ 6 MEADOW VIEW Rd Residential Alteration $17,410.00 QUEENSBURY,NY 12804-0000 Total Value $17,410.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2015-194 Residential Alterations for solar panels 545.91 s.f. $81.90 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday, May 29,2016 (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 .ate. Dated at the own o uee u4; .,.ay, May 29,2015 SIGNED BY for the Town of Queensbury. Director of Building& Code Enforcement ACCESSORY STRUCTURE APPLICATION Office Use Only 1111111 9T Received DATE 5 - 21- 15 l..\ g u U h Tax Map ID TAX MAP ID 297.17 - 1 - 70 Permit No. 2e1�' te1� ZONING MAY 22 2015 Permit Fee 8‘ .b9 Rec Fee HISTORIC SITE Yes No --rnNN! nc OUEENSBURY Approvals SUBDIVISION NAME Lot# 'ODE`' APPLICANT Loreen Meher OWNER Colleen Gzezy ADDRESS P.O. Box 670 ADDRESS 6 Meadowview Road Amsterdam, NY 12010 Queensbury, NY 12804 PHONE 518-332-0671 PHONE 518 - 791-2467 CONTRACTOR Solar City COST OF CONSTRUCTION(ESTIMATED): $ 17,410 00 ADDRESS: P.O. Box 670 BUILDING ADDRESS: 6 Meadowview Road Amsterdam, NY 12010 PHONE: 518-332-0671 CONTACT PERSON FOR BUILDING&CODES COMPLIANCE Loreen Meher PHONE 518-332-0671 TYPE OF CONSTRUCTION Check all that apply Please indicate measurements as required below Boathouse 1st floor sq.ft. 2nd floor sq. ft. Total sq.ft. Height Boathouse with Sundeck Deck Detached Garage (#of cars ) Dock Pole Barn Porch-open **Porch—3 season, Covered, Enclosed Shed Other Accessory Structure(s) 545.91 sq ft **Considered floor area& must comply with FAR(floor area ratio) requirements if located in the WR zone DECLARATION: 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 & complete statement description of the work proposed, that all work will be performed in accordance with the NY State Building 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. v have read and agree to the above: Print Name: Loreen Meher Date: 5 - 21 - 15 Signature: IMPS* . �_ Date: 5 - 21 - 15 1 Town of Queensbury Building&Codes Accessory Structure Application July 2014 Town of Queensbury Building & Code Enforcement Office No. (518) 761-8256 l Framing / Firestopping Inspection Report Inspection request received: Name: G Z '/ Inspected on: / Location: M P_ i, N GW V , Arrive: t _ $ a.m.l p.m. Permit No.: t Inspector's Initials: TYPE OF STRUCTURE: N N/A COMMENTS: YEraming Avir -Attic Access 22"x 30"minimum Jack Studs I Headers Truss Specification Provided Bracing/Bridging Joist hangers vw —()‘`AI/Q_ Jack Posts/Main Beams Exterior sheeting nailed properly IIP 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 '/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 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 1/2 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 Design Professional Sign-off,if required Framing/ Firestopping Inspection Report STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF NYS WORKERS'COMPENSATION INSURANCE COVERAGE (Signature) la.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of insures ( Q)963-5100 Client Service Coord SolarCity Corporation 3055 Clearview Way fcclisitiSrgidigipkgsrigeatelyogillightqpresentative or licensed al San Mateo,CA 94402 Pkettigo#13-4ktdgiittssttiftirNuarbiersafind their licensed age autiagitreiro issue it. Work Location of Insured(Only required if coverage is specifically 49-892777 limited to certain locations in New York State, i.e., a Wrap-Up C-105.2(9-07) Policy) ld.Federal Employer Identification Number of Insured or Social Security Number 3a. Name of Insurance Carrier 2.Name and Address of the Entity Requesting Proof of Coverage Liberty Insurance Corporation (Entity Being Listed as the Certificate Holder) 3b.Policy Number of entity listed in box"la" Building and Codes Department WA7-66D-066265-024 Town of Queensbury 3c. Policy effective period 742 Bay Rd. Queensbury, NY 12804 9/1/2014 to 9/1/2015 3d. The Proprietor, Partners or Executive Officers are D included. (Only check box if all partners/officers included) X all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "3" insures the business referenced above in box "I a" for workers' compensation under the New York State Workers'Compensation Law.(To use this form,New York(NY)must be listed under item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The Insurance Carrier will also not fy the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Theresa Fagan CA Licen 0C12887 (P 'nt name of authorized representative or licensed agent of insurance carrier) Approved by: PA.QIILJ • ' 9/1/14 (Signature) - (Date) Title: Client Service Coordinator Telephone Number of authorized representative or licensed agent of insurance carrier: 213-443-0775 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) www.wcb.state.ny.us STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed by Disability Benefits Carrier or Licensed Insurance Agent of that Carrier la. Legal Name and Address of Insured(Use street address only) lb.Business Telephone Number of Insured SolarCity Corporation 650-963-5178 3055 Clearview Way lc.NYS Unemployment Insurance Employer Registration San Mateo,CA 94402 Number of Insured I d.Federal Employer Identification Number of Insured or Social Security Number 02-0781048 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier (Coverage(Entity Being Listed as the Certificate Holder) Principal Life Insurance Company NAIC Code 332-61271 Building and Codes Department 3b.Policy Number of entity listed in box"I a": Town of Queensbury H 70953-1 742 Bay Rd. Queensbury, NY 12804 3c. Policy effective period: 2/22/11 through 3/31/16 4.Policy covers: a.x All of the employer's employees eligible under the New York Disability Benefits Law b. ❑ Only the following class or classes of the employer's employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits insurance coverage as described above. Date Signed 3/25/15 By (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number: 973-299-9111 x3019 Title: Product Director IMPORTANT: If box"4a"is checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If box"4b"is checked,this certificate is NOT COMPLETE for purposes of Section 220,Su bd.8 of the Disability Benefits Law. It must be mailed for completion to the Workers'Compensation Board,DB Plans Acceptance Unit,20 Park Street,Albany,New York 12207. PART 2. To be completed by NYS Workers' Compensation Board (Only if box"4b" of Part 1 has been checked) _ State Of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability Benefits Law with respect to all of his/her employees. Date Signed_ By (Signature of NYS Workers'Compensation Board Employee) Telephone Number Title Please Note:Only insurance carriers licensed to write NYS disability benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. DB-120.1 (5-06) A 09/16/22014014 CERTIFICATE OF LIABILITY INSURANCE D0TE / YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH RISK&INSURANCE SERVICES. PHON: PHONE FAX 345 CALIFORNIA STREET,SUITE 13004, (A/C,No,Ext): (A/C,No): CALIFORNIA LICENSE NO.04371530 E-MAIL SAN FRANCISCO,CA 94104.. ADDRESS: Attn:Shannon Scott 415-743-8334 INSURER(SI AFFORDING COVERAGE NAIC# 998301-STND-GAWUE-14-15 .Liberty Mutual Fire Ins Co 23035 INSURED h(650)9635100. INSURER El•Liberty Insurance Corporation 42404 SolarCity Corporation. INSURER C:N/A N/A 3055 Clearview Way. INSURER D: San Mateo,CA 94402 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002443171-10 REVISION NUMBER: 10 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY TB2-661-066265-014 09/01/2014 09/01/2015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $_ CLAIMS-MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO Deductible $ 50,000 JECT LOC A AUTOMOBILE LIABILITY AS2-661-066265-044 09/01/2014 09/01/2015 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ X ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) X Phys.Damage COMP/COLL DED: $ $1,000/$1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ — EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ W-11?--M0 pg p1 20,14 0,g p1 20,15 $ B AND EMPLOYERS LIABILITY Y/N (WI) 09/01/2014 09/01/2015 X TORY LIMITS OER t000,000_ BANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? 'WC DEDUCTIBLE:$350,000' 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION Building and Codes Department AUTHORIZEDREPRESENTATIVE of Marsh Risk&Insurance Services Town of Queensbury Charles Marmolejo 742 Bay Rd. ©1988-2010 ACORD Queensbury, NY 12804 CORPORATION. All rights reserved.The ACORQDame_and logo are I registered marks of ACORL� ... .."-<----7