2013-399 111111110
� ` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-59027
y Q n, (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130399 Date Issued: Friday, November 29, 2013
This is to certify that work requested to be done as shown by Permit Number P20130399
has been completed.
Location: 547 LUZERNE Rd
Tax Map Number: 523400-308-010-0002-013-000-0000
Owner: GEORGE RANNEY
Applicant: GEORGE RANNEY
This structure may be occupied as a:
Single Family Dwelling 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, Variance, or 4Y.,<other issues and conditions as a result of approvals by the Planning Board
Director of Building& Code Enforcement
or Zoning Board of Appeals.
"4 TOWN OF QUEENSBURY
..4 .
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130399 Application Number: A20130399
Tax Map No: 523400-308-010-0002-013-000-0000
Permission is hereby granted to: GEORGE RANNEY
For property located at: 547 LUZERNE 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: GEORGE RANNEY Single Family Dwelling $102,000.00
BEVERLY RANNEY Total Value $102,000.00
547 LUZERNE Rd
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
BP 2013-399
New Modular Home 28 ft. by 44 ft. to replace demolished SFD of
27 ft. by 37 ft. (septic system new in the year 2004)
$308.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, August 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 f Que sbu • 41 T i �; �•, ' ugust 29,2013
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Only
Town of Queensbury Building & Codes +`;. �eceived:
�,. 1 �Q TaxMaplD: 3 ( K. lam-,2}4 3
PRINCIPAL STRUCTURE APPLICATION Permit No.: / 3 - 9 9
A permit must be obtained before beginning construction Permit Fee: $_)ems
Please read: *TB resolution 86-2013(1-28-2013): $85 rec tion e for new dwelling *Rec Fee: $ f\(_(i
units, including single-family dwellings, duplexes or two mil well multiple family Site Plan No.: _
dwellings, apartments, condominiums, townhouses, a / a u ed and modular Subdivision No.:
homes,but not including mobile homes. This is inadditi n to th p mit ee.
Date �D �-� 7 Applicant ��e,/ ://4%PP � ,7Tax Map ID fAt:4d --fir-/fl Address J3/7 / fr7d_' U
ZoningLrice� /foPa1Y
Phone/E-mail -7X5-,,97,�
Property Owner �/,i' i - . A/ J Contractor/Agent
Address - I_A0 W._ z Address
Phone/E-mail = , Phone/E-mail //
Contact Person for Building&Code Compliance: _.Z/..// (2,Li.A-7, Day Phone: A-'� IJ�
Building Street Address: 5-17 / 1,'( /6
Subdivision Name: Lot#: Historic Site: Yes ✓ No
Estimated cost of construction: $ el,DV. 74' J!, Jo •
M--e6c7-6 L--,.i-‘ -11" /\. -t,
Type of Construction:
Check all that apply Please indicate measurements as required below:
c
o 0
d „d 1st Floor 2nd Floor Other Total Height
z a a
Single Family ,/ X--,W 4 (.?3 ,c-r
Two-Family •
Multi-Family(#of
units )
Townhouse
Business Office •
Retail-Mercantile
Factory-Industrial
Attached Garages(# )
Other
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Please include two (2) sets of the following documentation with the submission of a Completed application for a
Building &Zoning Permit
1. Principal Structure Application
2. Plot plan drawn to scale with the use of a survey map, if possible[40 scale-1 inch=40 feet[engineering scale]:
• Indicate proposed structure, showing setback dimensions from all surveyed property lines
• Show location of all existing structures on the property
• Show location of water supply(well or water lines)
• Show location and configuration of septic disposal system or sewer line
3. Structural Drawings to include:
• Floor Plan
• Foundation Plan
• Cross Sections
• Elevations
• Window and Door Schedule—see attachment
• Calculation Sheet for Natural Light, Ventilation&Emergency Egress—see attachment
4. Registered Architect or Engineer's Stamp (signed&sealed) under the following circumstances:
• Residential addition or alterations with construction costs over$20,000
• Single Family Dwelling 1,500 sq.ft. or greater
• Any commercial construction
5. Checklist for single family or multiple dwelling or commercial project
6. REScheck or COMcheck signed&stamped: Downloadable version-www.energycodes.gov.
7. Fireplace and/or woodstove solid fuel burning application (if applicable)
8. Septic Disposal Permit(if applicable)
9. Electrical Inspection Agency-Please see"Certified Electrical Form"on the Town's website
10. Driveway permit(if applicable)
11. Fee
Notes:
Certificate of Occupancy: Before a certificate of occupancy is issued for a new residential or commercial structure,an as-
built survey[plot plan]certified NYS licensed surveyor must be filed with our office.
Changes to Plan: Any changes prior to or during construction will require submittal of amended plans[review and re-
approval are necessary].
Withdrawn Permits: 20%of the initial fee is retainable by the Town of Queensbury. No fee is refundable after 1 year from
initial application date.
Additional Review: All Applications are subject to Zoning Administrator, Code Compliance,and Structural plan review
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
If commercial or industrial indicate name of business
Proposed use of building or addition L j//1 /'�
Source of heat(circle one) Gas Oil Propane Solar Other
Fireplace-complete a separate application for"Fuel Burning Appliances&Chimneys" Yes =No
Are there structures not shown on plot plan?
Are their easements on the property? rip
Site Information
a. Dimensions or acreage of lot
b. Is this a corner lot? /7/,
c. Will the grade be changed as a result of construction: —Yes /No
d. Public water or Private well
e. Sewer or Private Septic System
Value of all work to be performed(labor and materials) $
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval. 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. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a
certificate of occupancy. I also understand that Ilwe 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 and agree to the above.
Print Name: /,7
4,,/9/1
Signature: X� Date:
FOR OFFICE USE ONLY:
Operating Permit Issued: Yes No
Occupancy Type:
Construction Classification:
Assembly Occupancy Limit:
Special Conditions:
Town of Queensbury Building&Codes Principal Structure Packet 518-761-8256
Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: am/p De art2 3 am/pm
Date Inspection request received: Inspector's Inspector's Initials: GC,
NAME: R f C/ PERMIT#: 20V3 - l l
LOCATION: c A-1 I-, -22 "%r-</\V : R9 DATE: .Z`l k-7)
Manufactured Home
Modular Home
Footings_ Foundations--Backfill_ Framing
Comments:
Yes No NIVA
Foundation support, pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends Vl: yf
Water line shut off ,f
Sewer line support @ 4 feet
-Heating Crossover[doublewide)off grd. V
Dryer vented outside V
1.
Skirting ventilated 1 so.ft.Der 1,500 so.ft. _/'
Hot water relief valve piping outside
Deck,porches,steps,railing 7
Fumace/hot water operating f
Garage Fire proofing
Fire Door/Door closers V
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected
Final Electrical If
Variance required
Data Plate okay ___ `� _ fcLt._� •C)3
Manufactured HUD seal okay
-- -
Warranty Seal after January 1,2006
Installers Warranty Seal
18"x 24"access or 22"x 30"attic access
Vapor retarder under e 6 mil poly or other
911 Street number , ":j ...\
Okay to issue C/C C/O emp.I Perm.] A414-UL -00 =—S---41 LUZCIZ t
Model# Serial#
Manufacturer
Date of Manufacturer
L:1Pam Whiting120101Building Codes Forms\Manufactured_Modular Final Inspection_03 04 10.doc
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart am/pm
Date Inspection request received: Inspector's initials:
NAME: qi-A'l'`j1-V/ PERMIT it: P) .399 l I
LOCATION: 5-471 L LcJ,y, re-1) DATE: dict ( l.,
M c d Home
Mod Iar�Hom�e j
Footings_ Foundation_ Backfill Framing_
Comments:
Yes No N/A
Foundation support,pier spacing, /
Per manufacturer �/
lt....4-6.. (--3.A.1- 4--
Water
t� �1 .t_-
Anchoring per manufacturer 2'from ends t/ (r) f��/'(.� � � 7� � 5���� �
Water line shut off
1/.."
/ VW e(S� ���iy �1�) �i�'i",
Sewer line support @ 4 feet v_ /
Heating Crossover[doublewide}off grd. y ,r ,,,� y�
Dryer vented outside / (2:)
9�- 1� , s
Skirting ventilated 1 sq.ft.per 1.500 sq.ft. ✓ ✓/ (›/Q- `` r( 1 ' 044\11t -
Hot water relief valve piping outside t/ `
Deck,porches,steps,railing 4
L
Fumace/hot water operating f� L '
ig Garage Fire proofing l
Fire Door I Door closers t/ R,0-0-rd�-' tr
Plumbing Fixture/3"Vent through roof[Modular] V y (9 k``
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors 1 Interconnected 1//
Final Electrical
Variance required
Data Plate okay ✓
Manufactured HUD seal okay
Warranty Seal after January 1,2006 >/
Installers Warranty Seal V
18"x 24"access or 22"x 30"attic access
Vapor retarder under home 6 mil poly or other
911 Street number ,�
/
Okay to issue C/C or C/O[Temp.I Perm.]
Model# Serial#
Manufacturer
Date of Manufacturer
L:\Pam Whiting120101Building Codes Forms\ManufacturedModular Final Inspection_03 04 10.doc
-rues c)--`"(1
Foundation Inspection Report f20132At.."
r
Office No.(518)761-8256 Date Inspection requ- • =. iv,�:
Queensbury Building&Code Enforcement Arrive: :-z.p: , fp ,r ( Depart: ' ,-f _ : •m
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: 1 akiN n �' (. P ‘MIT#: /3 --3ci q
LOCATION: "1 '''-7 L.LI INSPECT ON: (t— q_
TYPE OF STRUCTURE: T y.,� _,ir FJ
Comments
Y /N NA
10 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
Re': orcement in Place
Age'voting Dowels or Keyway in place
'Z\ dation Dampproofing
Foundation Waterproofing
Foo ' g Drain Daylight or Sump
F g Drain Stone:
2 inch width
6 inches above footing
`7-6 mil poly for wet areas under slab
V Bili 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\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
i or o s. 1-3
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: t ram/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:6ipv, �j v
� L
NAME: R6sit NI) cuPERMIT#:
LOCATION: INSPECT ON: 9- ' A
TYPE OF STRUCTURE: ;
� ���
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/Walipour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg S
Foundation Waterproofing c`,
L -L,-)-5
Footing Drain Daylight or Sump t
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 �, ✓,,�
e__,Qhd`R
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 1--
-4 {N Lui_ cl Li-'i_ aci,\6_ c -1,1
Foundation Inspection Report
Office No.(S 18)761-8256 Date Inspection .• .. sir- -i • 4.
Queensbury Building&Code Enforcement Arrive: • I Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: E=�� PE' di T#: 1 ._� - cv9
LOCATION: ` e INSP TON: (-)- % ?- /3
TYPE OF STRUCTURE:
Comment
Y N N/A
Footings
Piers
Monolithic Slab o C2— `1\ A
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\Inspection Fors\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
oo1
Foundation Inspection Report
Office No.(518)761-8256 Date In�tioncr q r , •:
Queensbury Building&Code Enforcement Arrive: 1` l`;j : p.:� :epart: pn�
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME:
RAw)iJEPERMIT#: (3—C*1Y(
LOCATION: ('—j q L17 ��tJl_ RC) INSPECT ON: —1 9 -\3
TYPE OF STRUCTURE:
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
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 Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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