RC-000269-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761.8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000269-2015 Date Issued: Monday, January 9,2017
This is to certify that work requested to be done as shown by Permit Number RC-000269-2015
has been completed.
Tax Map Number: 296.14-1-47
Location: 153 SWEET RD
Owner: Michele Ross,Tom Ross
Applicant: Tom Ross
This structure may be occupied as a:Residential Addition 611 s.f.,Porch,
Gas Fireplace By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
r )J4A�-
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
'*Vx _
F 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000269-2015
Tax Map No: 296.14-1-47 REVISED
Permission is hereby granted to: Michele Ross
For property located at: 153 SWEET 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
Owner Address: 153 SWEET RD Single Family-Addition $100,000.00
Queensbury,NY 12804 Total Value $100,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Dean Howland
7 IROQUOIS DR DR
Queensbury,NY 12804
Plans&Specifications
Residential Addition 611 s.f.
PERMIT FEE PAID-TIES PERMIT EXPIRES: Sunday,September 11,2016
(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 dat .)
Dated at the To bury;bury; /� eptember 17,2015
SIGNED BY: (( -L,F/1/\J /Vl for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150422 Application Number: A20150422
Tax Map No: 523400-296-014-0001-047-000-0000
Permission is hereby granted to: TOM AND MICHELE ROSS
For property located at: 153 SWEET 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: TOM AND MICHELE ROSS Fireplace
153 SWEET Rd Porch
QUEENSBURY NY 12804-0000 Residential Addition $100,000.00
Total Value $100,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
DEAN HOWLAND
7 IROOUOIS STREET
LAKE GEORGE.NY 12804-0000
Plans&Specifications
2015-422
Residential Addition 611 s.f.
Porch Addition 56 s.f
Gas fireplace
$133.40 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, September 17, 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 date.)
Dated at the To' o • eensb ; r,i ay, September 17,2015
Af
SIGNED BY .��� for the Town of Queensbury.
7 �
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
DATE ;./S- Received
/-) Tax Map ID
TAX MAP ID 2�� /4--/-4 / _ Parmit N•• 2.015 -4 2-2-- 1
'L.rm". -:e 4 ,4-6 . -P41--
ZONING /1 - ':kn#
tc- s 5 , (ccs SEP 1Q201
HISTORIC SITE Yes X No sten#
SUBDIVISION NAME /�`/ TOW QUEENS RY
: °'10F ING& CODES
TOWN BD. RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS, INCLUDING SINGLE FA Y DWELLINGS,
DUPLEXES OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWN • SES, N9/OR
MANUFACTURED&MODULAR HOMES,BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE. 4��) ci1k410 vi
(6:1 tis ill
APPLICANT ILS t TYU C 1.42C• OWNER /bm t/d4C Lul /C 6255 J ,.
.---6.3", 7
ADDRESS /r _Lel riat:5 S71. ADDRESS /5-3 622004.74.
Zi), e_i2i9f 1 /v J /2_19'171-5— (;bRcLk25 6u4,/V 1 /2861-I it
PHONE/E-MAIL CZe 3/ec `9clta`rlxve- av-HONE/E-MAIL 293- 908
CONTRACTOR $I?Ift #S /I&r/F COST OF CONSTRUCTION(ESTIMATED): $ 742M,IZ)0
ADDRESS: BUILDING ADDRESS: /53 )sed /&
=6� G�,h Mir
PHONE/E-MAIL / /�
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: i ni /LZoo V�[. PHONE ' 777
TYPE OF CONSTRUCTION
Check all that apply Please indicate measurements as required below
New Addition Alteration 1St floor sq.ft. 2nd floor sq. ft. Total sq. ft. Height
Single Family ‘,.// . i dk
A
Two-Family
Multi-Family
(#of units )
Townhouse
Business Office
Retail - Mercantile
Factory- Industrial
Attached Garage
(#of )
Other fU'ytcir fl G 0y1 .SC _6--Z� cU. -rdi
1
Town of Queensbury Building&Codes Principal Structure Application July 2014
If commercial or industrial indicate name of business
Proposed use of building or addition 5/,%4 .1.05444"e,
Source of heat (circle one) RX/5T7, I Oil Propane Solar Other
Fireplace: complete a separate application for Fuel Burning Appliances &
Chimneys J94s ox.). //
Are there structures not shown on plot plan? /OX/O sA�a/
Are there easements on the property? llJo
Site Information
a. Dimensions or acreage of lot /.6 Q�cccs
b. Is this a corner lot?
c. Will the grade be changed as a result of construction Yes x No
d. Public water or Private well Town to/4A,
e. Sewer or Private Septic System ; ,.lIR-
Value of all work to be performed (labor or materials) $ /oo o'
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. 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 Building Codes, local
building laws and ordinances, and in conformance with local zoning regulations.
4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of
occupancy.
5. 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 • cupancy.
I have read and agree to the above: PRINT NAME: L;z.r, i.o,‘) de._ DATE
SIGNATURE: i►l%1_% / DATE 9 -
FOR OFFICE USE ONLY
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
2
Town of Queensbury Building&Codes Principal Structure Application July 2014
FUEL BURNING APPLIANCE & CHIMNEY Office Use Only
APPLICATION
(� Received
DATE 9/U/.� -' lt,ri l(E OP A I+it
TAX MAP ID 246 , / /._.4
/ Permit Fee }(/
SEP 1 ) 2015 ,
ZONING /1/0/e ,
TOWN OF QUEENSBURY
/ >>,-, BUILDING & CODES /Y� �J/
OWNER: �Or3'1� GI, L!. OSS PHONE/E-MAIL 7%.7 -//w
ADDRESS /5- St-,-4e1 ie agen,szU /,v& /22D<L
INSTALLER/BUILDER: (.0Zto at.)54y)c/74.1.) PHONE/E-MAIL 77(o577‘
ADDRESS: '7 Eet'oa S? 4&/' e / A26.. /2 .5
CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: 1 f ?t. appal C-r�x)LJ PHONE 7Z-75-&/
BUILDING ADDRESS: /53 /file' !�G
Fuel Burning Appliance Information Wood Coal Pellet Gas Oil NOTE: ROUGH-IN & FINAL
Stove INSPECTIONS ARE REQUIRED.
Fireplace Insert
/ Fireplace, Factory built*
Fireplace, Masonry
Furnace(Garage Only)
*If Factory built provide manufacturer name: OA 471 s7c ; model#: 6-69-12e
Listed by: Number: Bi-Dlrt"-'OcAJSc7
Chimney Information
Masonry** (check one) Block Brick Stone
Flue Tie Steel . f. Size in inches
Material Double wall Triple wall Insulated r'\ Direct Vent Chimney Liner
**If Non-masonry provide manufacturer name: model#:
DECLARATION: Construction / installation must conform to NYS Fire Prevention & Building Code and / or
manufacturer requirements. 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 inspector's to enter premises to
perform required inspections.
I have read and agree to the above: Print Name: dre,iinn)of Date: 9‘1(1--
Signature:
Date: "'fei S
5
Town of Queensbury Building&Codes Principal Structure Application July 2014
8-10
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 10 I13 L2C1t5
Queensbury Building&Code Enforcement Arrive: am/pm Depart:.k am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: //4C)
NAME: IZSSPERMIT#: 20 IBJ- 22—
LOCATION: I'D5 S JLC Q-cl° INSPECT ON: l 01 I eil lc 4S
TYPE OF STRUCTURE: Lis krid
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
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 S2gRt\i\ --K-1---1) —2
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 12/9/2014