2012-342 TOWN OF QUEENSBURY
742 Bay Road,Qucensbury, 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120342 Date Issued: Wednesday, September 26, 2012
This is to certify that work requested to be done as shown by Permit Number P20120342
has been completed.
Location: 641 RIDGE Rd
Tax Map Number: 523400-297-010-0001-049-000-0000
Owner: DEAN & PAMELA ROMER
Applicant: DEAN & PAMELA ROMER
This structure may be occupied as a:
Garage - 2 Cars Detached By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property (---- e4,4P 4 1-115ti
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.
TOWN OF QUEENSBURY
742 Bay Road,Quccnsbury,NY 12804-5902 (518)761-8201
Vi$of
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120342 Application Number: A20120342
Tax Map No: 523400-297-010-0001-049-000-0000
Permission is hereby granted to: DEAN & PAMELA ROMER
For property located at: 641 RIDGE 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: DEAN&PAMELA ROMER
Garage-2 Cars Detached $18,000.00
50 QUEENSBURY Ave Total Value
QUEENSBURY,NY 12804-0000 $18,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-342
Detached Garage 950 sq ft
$142.50 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,July 24, 2013
(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 Town o uee bury; es , my 24, 2012
for the Town of Q ueensb
SIGNED BY � Q ury•
Director of Building&Code Enforcement
•
• • . - OFFICE USE ONLY - • • - . '
•
• TAX MAP NO.O `.q�r l'Ir/ - 1 PERMITNO.: /: .'. ."t, I .• ',JUL° G 20�Z :
•
FEE PAID BLDG:&CODES APPROVAL - ' • ;-i' ,-......:.,•—,--,--71,,,::3:1—:- ,,
•
- ACCESSORY STRUCTURE BUILDING PERMIT APPLICATION
Use this application for any structure other than the Principal Stricture•(house-) to include, but not'limited to: .
' - garage, shed, greenhouse, dock, deck, etc: Refer to Informational Eroctttire.No. 3 entitled Accessory•Structures
Sheds/Fences. : . .
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.NO INSPECTIONS WILL BE MADE UNTIL THE APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. - -
OWNER: /e✓c..A+ Fan+4„I. R o,v,n/cr-- •. ' INSTALLER/BUILDER: • : •
ADDRESS: 52 gU4-c...,i6v-a.r tlie. q.. ,1 • ADDRESS:. •
.
PHONE NOS. (1'1S:-tSo‘1 p n PHONE NOS. .. '
LOCATION OF PROPERTY: .41 kJ 4 1 Rt ,, Roe.4••'.Cyd, SUBDIVISION NAME~ *---•
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION:. .. . .. • .
ESTIMATED COST OF CONSTRUCTION: $/$ 000, ANY OTHER ACCESSORY STRUCTURES ON PROPERTY? A)0• •
IF YES,PLEASE UST: . J • . .
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: .rv,`C.. • PHONE: •
II 1ST FLOOR 2ND FLOOR • " PROPOSED
1 PROPOSED CONSTRUCTION I TOTAL HEIGHT
SQ.FT. .SQ.FT. SQ.FT •
. FT.&IN. •. .
•
OPEN PORCH
•
• DECK . •
•
3 SEASON,COVERED OR ENCLOSED PORCH' ,
BOATHOUSE .
BOATHOUSE WITH SUNDECK
DOCK.
SHED .
POLE BARN
DETACHED GARAGE(NO.OF CARS: L ) qco 9.•, • 2.a• O 4•
OTHER ACCESSORY STRUCTURE: S.
*CONSIDERED FLOOR AREA&MUST:COMPLY WITH FAR(FLOOR AREA RATIO]REQUIREMENTS IF THE STRUCTURE IS LOCATED IN
THE WATERFRONT RESIDENTIAL-ZONE.
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, arid all other•laws pertaining to
the proposed work shall be compiled 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 new construction.
I
have-z-;. '_ - . the above. -
Wi1/ • QUESTIONS.? CALL 761.8238 OR EMAIL
Signed.' - . ►�+ ._ Dated: 17--l6i O codesCfaueensburv.net:
t�
VISIT OUR WEBSITE FOR MORE INFORMATION
Name/Title(Printed) 'Dec:" Rp,yAU-- • www.queensburv.net ' .
•
,
(N'\ VA4c,k — l2
Queensbury Building & Code Enforcement - Residential Final lnspectior�
g, 3
Office No. (518) 761-8256 Arrive: am/pm Depart: t
Date Inspection request received: Inspector's Initials
NAME: R o \G r •
PERMIT#: ,S7 `I' a
LOCATION: 1Q '-f I acie, Ad DATE: Al-/;),
TYPE OF STRUCTURE: C{ (11'1
Comments:
Yes No N/A nn
4" Building Number Address visible from road j-.(`v- jO(o II `7-5
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake c e&A Me-r-
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
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/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors I main entrance 36 inches ---
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing \10-L")
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup: 01-Z— �
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents )
Bathroom Fans,if no window (l/,cv'c
Plumbing fixtures
Foundation insulation to floor I Sticker on Panel r
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed I Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical; Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/0[Temporary/Permanent] 01)
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6126/08; Revised 12/22/10,Revised 04/13/11
Septic Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/ m Depart: ti? am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:(.., )
l.V
NAME: (( S4--C-(-) Cle PERMIT NO.: / '3 "ID
LOCATION: .3 et) rct U P4 INSPECT ON: - Co-- /a
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. V44-7,X‘›-Me--'
Well Casing Length 50' + / - Y N N/A
Absorption Field: Total length / ft.
Length of each trench 3' 1:11.7. ft.
Depth of trenches t ft. -
Size of Stone 0 2 U`
fT` `
Seepage Pits: Number �)
Size: x
Stone Size:
Piping / ize Type ft..7T
Building to tank 1
Tank to Distribution Box DE4
Distribution Box to Field / Pit At' S-i.�--
Opening Sealed: VHF N
End Cap /
Inlet/Outlet Pipes &Baffles Y— N
Location/ Separations q
• Foundation to tank ft. / L� ' 4�N1 "
Foundation to absorption ft.
Separation of Pits ft. b, `
Conforms as per Plot Plan ✓Y
Engineer Report and As-Built Y , N
Location of System on Property:
Front Rear Left Side Right Side Middle Front Middle Rear
Approved
Partial Approved and needs to be re-inspected, please call the Building &Codes Office
Disapproved
Last revised 06/18/07 L:\Building&Codes Forms-OLD\Building&Codes\Inspection Forms\Septic Inspection Report.doc
Framing I Firestopping Inspection Report m U nC1(a 9-/%
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm •_• •.rt: .m/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: ti dr
NAME: R 0 fv, !\' PERMIT#: • �1'
LOCATION: urn,-/I <� f' _ INSPECT ON: q -,a, -/_)
TYPE OF STRUCTURE: Cr--a) '.,
N N/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
Exterior Deck Bracing
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
Fire wail 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
L:1Building&Codes Forms-0LD1Building&Codes\nspection Fomis'Framing Firestopping Inspection Report.doe Revised January 7,2008
PM
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm
� Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:j J't_n_
NAME: R/1 M r PERMIT#: C a- 3 y a
LOCATION: UP I t c_ INSPECT ON: g /O —/
TYPE OF STRUCTURE: J � �
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/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place 1 /
Foundation Dampproofing 1c'
Foundation Waterproofmg
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\Foundadon Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: mipm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: D !Yp_ r PERMIT#: a- �3�
LOCATION: lQ '-1 l 'R ' t INSPECT ON: $ -/
TYPE OF STRUCTURE: /(1 r aCIP,
Comments
Y N NA
Footings V/
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 CZ._) 5
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 Forrns\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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NOTES:
1) BASE MAP PREPARED FROM A SEPTEMBER 2004 HELD SURVEY.
2) NORTH ORIENTATION IS BASED ON MAP REFERENCE= 1.
3) THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN ABSTRACT OF TITLE AND
IS THEREFORE SUBJECT TO ANY EASEMENTS, COVENANTS OR RESTRICTIONS OF RECORD
ANY STATEMENT OF FACTS SUCH DOCUMENT WOULD DISCLOSE.
4) SUBJECT TO APPLICABLE LAWS AND APPROVALS OF THE TOWN, COUNTY, AND STATE
REGARDING THE DEVELOPMENT OF LAND.
5) UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED
LAND SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, SUB -DIVISION 2, OF THE NEW
YORK STATE EDUCATION LAW..
6) ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE
LAND SURVEYORS SEAL SHALL BE CONSIDERED TO BL VALID TRUE COPIES.
7) UNDERGROUND UTILITIES, STRUCTURES AND FACILITIES HAVE BEEN SHOWN FROM
SURFACE LOCATIONS AND MEASUREMENTS OBTAINED FROM A FIELD SURVEY. THERE MAY
BE OTHER UTILITIES WHICH THE EXISTENCE OF ARE NOT KNOWN. SIZE, TYPE AND LOCATION
OF ALL UTILITIES AND STRUCTURES MUST BE VERIFIED BY PROPER AUTHORITIES PRIOR TO
ANY AND ALL CONSTRUCTION. CALL DIG SAFE PRIOR TO ANY EXCAVATION.
DEED REFERENCE.•
1) DAVID M. SHULTZ
TO
DEAN F. & PAMELA S. ROMER,
DATED JUNE 24, 1994
IN BOOK 919 AT PAGE 45.
.,SAP REFERENCES:
1) "MAP OF LANDS OF ARZELIA H & DAVID M. SHULTZ-
DATED NOV. 3, 1989, PREPARED BY COULTER &
McCORMACK LICENSED LAND SURVEYORS.'
2) -MAP OF A PLOT PLAN SURVEY MADE FOR
DEAN F. ROMER' DATED 11/08/04, PREPARED BY
DAVID J. BOLSTER LICENSED LAND SURVEYOR.
Lands n/f
Robert A. & Margaret F. Reid
B. 904 P. 104
Lands n/f
Joan M. Reid
B. 896 P. 57
"I h�we seen, or observed, or belie,,
bn Ices Wells, :°
`. I also red;.
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25.0' 38.0
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gravel drive
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GRAPHIC SCALE
,0 80
( IN FEET )
1 inch = 40 fL
160
136.0'
Lands n/f
Maureen M Lynch
B. 940 P. 233
NG SETBACK LINE (TYP.)
I
SITE LOCATION MAP
PROPOSED I 1
STORAGE BUILDING
25.0' - }—
Lands n/f
I David M. & Doris Shultz
I B. 839 P. 16
I
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AREA = I 3
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I LOCATION I
-� EXISTING SEPTIC
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meter box
113' I _.
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o I.R.F.
IRON ROD FOUND
o I.P.F.
IRON PIPE FOUND
o I.R.S.
IRON ROD SET
1111
UTILITY POLE
STONE WALL
xx x-
WIRE FENCE
— o —CHAIN
LINK FENCE
— o —
WOOD FENCE
e
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F.P.
FENCE POST
—oh.—
OVERHEAD WIRES
n/f
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t.
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r'
Lands n/f
Maureen M Lynch
B. 940 P. 233
NG SETBACK LINE (TYP.)
I
SITE LOCATION MAP
PROPOSED I 1
STORAGE BUILDING
25.0' - }—
Lands n/f
I David M. & Doris Shultz
I B. 839 P. 16
I
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REPUTED i
I LOCATION I
-� EXISTING SEPTIC
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meter box
113' I _.
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o I.P.F.
IRON PIPE FOUND
o I.R.S.
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coon
STONE WALL
xx x-
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— o —CHAIN
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— o —
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e
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—oh.—
OVERHEAD WIRES
n/f
NOW OR FORMERLY
YAP O�FA SURVEY MADE FOR
DEA7 F. ROMER
Town of Queensbury County of Warren State of New York
EOLSTER AND ASSOCIATES
PROFESSIONAL LAND SURVEYORS
342 Mai a Street, Hudson Falls, New York 12839
Russell E. Howard, PLS N.Y.S. Lic. No. 50590 D¢te: 08/17/11 ., Tax Map 297.10-1-49
Date Sealed: 01 FIScale: 1 inch = 40 feet I Revised: 01/18/12 1 Drawing #:04193¢