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2013-214 sB�R� -V 2 t5�8)?61-8201 OWN QuNy 12804-590 "161-$2'6 eensbuzy> Codes (518) 142 Bay goad, peyeloprnent_Building Commun tY OCCVVANCY A1 , 0 `-r+� �.c Zp13 31 C-F � 1 esday mate ISSue d: W ed�' lot'30,114 pZp130214 erxnit�utnber: own by permit.Nun'ber be done as sh phis is to certify that Fork requested to s been completed• 25 0.v.� 00� Dr �~000„0000 0 ha 0001p0V1T`i 523q.00.29 r 062-CI�A�4'Y2E P Location umber: NSapTCT �'& boald pTTE ppT�1 oidez Of To T3SBUgY OR,ner: �T� �,L&C� TOS OF Q� N� / Applicant: a be occupied as a' St�Cttlre m Y &Code$nfaCcement 'xis erty the Prop wilding peck S Np^l rel eve or Director of B c plan,yar�anee� an Y Site in Board 'ficate of Qccupliauee With b the plane g ce of this Certi 'or�result of aperovals Issuan of the reSponsibilitys owner da ouditioen ls. other issues an r of APP or Zouiu% TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518)761-8256 BUILDING PERMIT Permit Number: P20130214 Application Number: A20130214 Tax Map No: 523400-290-062-0001-007-000-0000 Permission is hereby granted to: MITCHELL& CHARLOTTE POTVIN For property located at: 25 OVERLOOK Dr 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: MITCHELL& CHARLOTTE POTVI 25 OVERLOOK Dr Deck QUEENSBURY NY 12804-0000 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency DA213 BUILDERS LLC 85 ELM St HUDSON FALLS.NY 12839-0000 Plans&Specifications 2013-214 DECK 400 sq ft $50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,May 29,2014 (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 of QueMay 29,2013 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement ---------- _ _-----.._......._o.._._.,.._ a 0 P TAX MAP X40. l D -1 PERMIT No. �g01 FEE PAID L 2u CO ES APPROVAL ; o / a r a o ' e ACCESSOR S RUC URE BUILDING PERMIT APPLICATION Use this application for any structure other than the Principal Structure (house) to include, but not limited to: garage, shed, greenhouse, dock, deck, etc. Refer to Informational Brochure No. 3 entitled Accessory Structures- Sheds/Fences. A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VAUD PERMIT.NO INSPECTIONS WILL BE MADE UNTIL THE APPLICANT HAS RECEIVED A VALID BUB-DING PERMIT. OWNER:�'o-FU L� INSTALLERIBUILDER: T�Zl75-I LU", S ADDRESS: �� VC'X - C �- (P' ADDRESS: 44 Z 6d tewa'Ala. J PHONE NOS.—'3 L - S t?. PHONE NOS. ll LOCATION OF PROPERTY: Z� d SCA 14-71f e SUBDIVISION NAME ` U�Ir LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION: b �1 U R+'``l� U`�° GdJICJ- /4y - ESTIMATED ANY OTHER ACCESSORY STRUCTURES ON PROPERTY? ESTIMATED COST OF CONSTRUCTION: $ t�_� IF YES,PLEASE LIST: CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: VK,�A l-tri PHONE: -`7 -c5 PROPOSED CONSTRUCTION IST FLOOR 2ND FLOOR TOTAL PROPOSHEIGHED SQ FT SQ.FT SQ.FT FT.&IN. OPEN PORCH DECK jq 3 SEASON,COVERED OR ENCLOSED PORCH' BOATHOUSE BOATHOUSE WITH SUNDECK DOCK SHED POLE BARN DETACHED GARAGE(NO.OF CARS: OTHER ACCESSORY STRUCTURE: "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,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 s le showing actual location of all new construction. i have read an g et he ove. QUESTIONS? CALL 761-8256 OR EMAIL Signed ` Dated- L5VISIT OUR OUR WEBSITE FOR MORE INFORMATION Name/Tide(Printed) �Z:1' i�l fir-- -De.Z,6 W y r' -. .1'. �C Certificate of Attestation of Exemption From New York State Workers' Compensation and/or Disability Benefits Insurance Coverage MAY ! 2113 **This form cannot be used to waive the workers'compensation rights or obligations of any party.** The applicant may use this Certificate of Attestation of Exemption ONLY to show a government entity that New York State specific workers'compensation and/or disability benefits insurance is not required. The applicant may NOT use this form to show another business or that business's insurance carrier that such insurance is not required. Please provide this form to the government entity from which you are requesting a permit,license or contract. This Certificate will not be accepted by government officials one year atter the date printed on the form. In the Application of Business Applying For. (Legal Entity Name and Address): Building Permit DA211 BUILDERS LLC From:TOWN OF QUEENSBURY 85 ELM ST. HUDSON FALLS,NY 12839 PHONE:518-376-5895 FEIN:XXXXX6324 The location of where work will be performed is 25 OVERLOOK DR,QUEENSBURY,NY 1280L Estimated dates necessary to complete work associated with the building permit are from June 1,2013 to August 1,2013. The estimated dollar amount of project is $10,001-$25,000 Workers'Compensation Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE SPECIFIC WORKERS'COMPENSATION INSURANCE COVERAGE for the following reason: The business is a LLC,LLP,PLLP or a RLLP;OR is a partnership under the laws of New York State and is not a corporation. Other than the partners or members,there are no employees,day labor,leased employees,borrowed employees,part-time employees,unpaid volunteers(including family members)or subcontractors. Partners/Members: MATTHEW FRENCH Disability Benefits Exemption Statement: The above named business is certifying that it is NOT REQUIRED TO OBTAIN NEW YORK STATE STATUTORY DISABILITY BENEFITS INSURANCE COVERAGE for the following reason: The business MUST be either: 1) owned by one individual; OR 2) is a partnership(including LLC,LLP,PLLP,RLLP,or LP)under the laws of New York State and is not a corporation; OR 3) is a one or two person owned corporation,with those individuals owning all of the stock and holding all offices of the corporation(in a two person owned corporation each individual must be an officer and own at least one share of stock); OR 4) is a business with no NYS location. In addition,the business does not require disability benefits coverage at this time since it has not employed one or more individuals on at least 30 days in any calendar year in New York State. (Independent contractors are not considered to be employees under the Disability Benefits Law.) L MATTHEW W.FRENCH,am the Partner with the above-named legal entity. I affirm that due to my position with the above-named business I have the knowledge,information and authority to make this Certificate of Attestation of Exemption. I hereby affirm that the statements made herein are true, that I have not made any materially false statements and I make this Certificate of Attestation of Exemption under the penalties of perjury. I further affirm that I understand that any false statement,representation or concealment will subject me to felony criminal prosecution,including jail and civil liability in accordance with the Workers'Compensation Law and all other New York State laws. By submitting this Certificate of Attestation of Exemption to the government entity listed above I also hereby affirm that if circumstances change so that workers'compensation insurance and/or disability benefits coverage is required,the above-named legal entity will immediately acquire appropriate New York State specific workers' compensation insurance and/or disability benefits coverage and also immediately furnish proof of that coverage on forms approved by the Chair of the Workers'Compensation Board to the government entity listed above. SIGN Signature: Date: HERE Exemption Certificate Number Received 2013-029724 May 17,,2013 NYS Workers' Compensation Board CE-200 12/2008 Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518) 761-8256 Arrive: am/pm DepartC't_am/pm Date Inspection request received: Inspector's Initials:b, NAME: P"),+Q t A PERMIT#: 1,3 11 LOCATION: e-V I DATE: -743 TYPE OF STRUCTURE: 6 Ct K Comments: Yes No NIA 4" Building Number Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vgntt oo m 'mum 18 inches Roof Complete/ xtedor Finish Com to Platform at all e 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/main entrance 36 inches Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: 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 Plumbing fixtures Foundation insulation to floor/Sticker on Panel Duct work sealed propedy/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 Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum%z"G sum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/3/hour fire door/door closer Gas Logs in Sealed or Glass Enclosure Final Electrical;Energy Saving Light Bulbs 50% FinalPlot Plan C� Arc Faultult 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/O Temporary/Permanent L:\Building&Codes Forms\Building&Codes\Inspection FormsWesidential Final Inspection Form revised_100405.doc;Revised January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11 4�7- %,. Queensbury Building & Code Enforcement - Residential inal In pectio Office No. (518)761-8256 Arrive: am/pm art: - am/pm Date Inspection request received: Inspector's Initials: '"' NAME: Ott PER #: ( - -� LOCATION: DATE: TYPE OF STRUCTURE: Comments: Yes No NIA 4" Building Number Address visible from road Chimney Height/"B"Vent/Dlrect Vent Location Fresh Air Intake 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 silt plate Gas Valve shut-off"posed/regulator 18 inches above grade Interior privacy/trim/doors I main entrance 36 inches Bathroom/Kitchen waterfi ht Safety glazin /Window in stairwells safety glazing Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: 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 Plumbing fixtures Foundation insulation to floor/Sticker on Panel 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 Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum%"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 Piot 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 1 O Temporary/Permanent L:1Building&Codes FormslBuilding&Codesllnspection ForrrnsXResidential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08;Revised 12122/10,Revised 04/13/11 Foundation Inspection Report Office No.(5 18)761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pDepart: pm Y 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:�l NAME: PERMIT M LOCATION: 6 17 ZL INSPECT ON: Z� _V TYPE OF STRUCTURE: Cpm►n Y N MLA Footings ) yen-) ers" �WoQnolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. ALI,- Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing 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:\Bullding&Codes Forms\Building&Codes\lnspetuon FormsWoundation Inspeddon Report.doc Last printed 12/20/2005 9:24:00 AM Foundation bspection Report2 Office No.(518)761.8256 Date Inspection request received: Queensbury Building 8c Code Enforcement Arrive: am/pm Depart:�pm 742 Bay Rd.,Queensbury,NY 12844 Inspector's Initials:z� NAME:'t V )�I� ;. P6WT 4: r l LOCATION: '`Z . _ ) r V U INSPECT ON: n16, t TYPE OF STRUCTURE: Commega N NA Footings )— '�iersy� 7 / 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 pMose 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 po!y 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\Buliding&Codes\Inspection Farms\Foundatlon Inspection Report.doc Last printed 12/20/2005 9:24:00 AM � 1 ib TOWN OF QUEENSEVRY - BUII gtNG gEPARTMEt`1C mptiance Based on our limited exammat�on, trued a' our comments shaI,`°pe� bficaoons are n with the plans an Build+ng Codes Of indicating liance with the r full comp i tdew York State. 1 p ° gra° &c°° s t e\Aewed Daae. � a E Ski"e- ......... . ... ........... iA -1 �i' 2x10 PT LEDGER INSTALLED WITH STRUCTURAL SCREWS FLASHING PROVIDED AT LEDGER 2X10 PT JOISTS 16"OC 2X10 JOIST HANGERS'AT LEDGER ffqExisting Door Ae 11 11I O r r O i O ' N (3)2x10 PT Girt on 6"PT pos s 10"sonotube footing,BOF 4'below grace r `I� f of Lf Center Stairs on existing door 6'6"x610"Landing I� 2x8 PT joists 16"OC 1 (4)4x4 posts o pier blocks If � I o ' � io