2014-528 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20140528 Date Issued: Wednesday, February 25, 2015
This is to certify that work requested to be done as shown by Permit Number P20140528
has been completed.
Location: 72 INDIANA Ave
Tax Map Number: 523400-309-009-0001-067-000-0000
Owner: RAE E. CLARKE
Applicant: RAE E. CLARKE
This structure may be occupied as a:
Garage Attached By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
Residential Alteration �.
Issuance of this Certificate of Occupancy DOES NOT relieve the property
owner of the responsibility for compliance with Site Plan, Variance, orav /.
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
`4i0 742 Bay Road,Queensbunv,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140528 Application Number: A20140528
Tax Map No: 523400-309-009-0001-067-000-0000
Permission is hereby granted to: RAE E. CLARKE
For property located at: 72 INDIANA Ave
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: RAE E. CLARKE Garage Attached $18,000.00
PO BOX 523 Residential Addition
GLENS FALLS,NY 12801 Residential Alteration
Total Value $18,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2014-528
Garage attached 528 sq ft. with 2nd Fir living space 314 sq. ft.
$139.20 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,November 26, 2015
(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 Tow_ , Queensb? ; •d� •sda ,November 26,2014
SIGNED BY �i�. for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION Office Use Only
DATE A y'o�/9` Received �/
<! Tax Map ID I l 5 a
C.)° ) ` ' ' Permit No.
TAX MAP ID ' ` — —67 �
Permit Fee 79,eZD poi
ZONING 1 , . Rec Fee
Site Plan#
HISTORIC SITE Yes x No Subdivision#
SUBDIVISION NAME Lot# x16 `-;9
TOWN Ba RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS,INCLUDING SINGLE FAMILY DWELLINGS,DUPLEXES
OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR MANUFACTURED &
MODULAR HOMES,BUT NOT MOBILE HOMES_ THIS IS IN ADDITION TO THE PERMIT FEE.
APPLICANT
G C-4-'4 OWNER �'- �G"f-
ick—
`�
ADDRESS -I Z- 1. N 17. /4-NNAA-V y— ADDRESS 7U'' I N171AN H/-AtiC-
r
PHONE/E-MAIL Q / PHONE/E-MAIL
CONTRACTOR .$\ Q.0 0 . O r\tilv-'t4 COST OF CONSTRUCTION(ESTIMATED): $
ADDRESS: Pre e AS I D A
t L4cuc!*i On BUILDING ADDRESS: 72 I Jj'/AVAlA Ai1 -
PHONE/E-MAIL
3.CONTACT PERSON FOR BUILDING&CODES COIIVII PLIANCE: 6 • 4 a - PHONE 74
_ (Cle/0 -ILO-Iffiz/zz./
TYPE OF CONSTRUCTION
Check all that apply
Please indicate measurements as required below
New Addition Alteration 1st floor sq.ft. 2nd floor s Total sq.ft. Height
Single Family
31 -
Two-Family
Multi-Family
(#of units )
Townhouse
Business Office
Retail- Mercantile
Factory- Industrial /
Attached Garage
\// �, 31
e54--Z'
1 6/1-61?'t
(#of ) I
Other
1
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
Source of heat(circle one) Gas Oil Propane Solar Other
Fireplace: complete a separate application for Fuel Burning Appliances &
Chimneys
Are there structures not shown on plot plan?
Are there easements on the property?
Site Information
a. Dimensions or acreage of lot t
b. Is this a corner lot? h
c. Will the grade be changed as a result of construction Yes X No
d. Public water or Private well
e. Sewer or Private Septic System F7 L v 1 z
Value of all work to be performed (labor or materials) $
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 occupancy.
I have read and agree to the above: PRINT NAME: 0_ I_f}L KI/
E Q DATE 16 2 / 1 u
SIGNATURE: - ATE i 2 ) ( i q
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
f-
10 /s
QueensburY Building & Code Enforcement - Residential inal Inspection
\
Office No. (518) 761-8256 Arrive: am/p art: /pm
Date Inspection request received: 4-4-3I)-61 Inspector's Initials:
NAME: PG,l, Part-. / PERMIT#: 1 4-S_ S'
LOCATION: _ -7,?. ` i r\CtA 4641,\Cc--�`4'ti� ' DATE: • , 'd I flallj I S
TYPE OF STRUCTURE:
Comments:
Y No N/A
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location _
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches v RO
JlRoof Complete/Exterior FWish Complete C I
Platform at all exterior doors ---____IHandrail 4 or more risers
Guards at stairs,decks, patios more than 30 inches above grade -744 -- 7 1
Guard at stairwell at 34 inches or more y
Guard at deck, porches 36 inches or more V
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant `'r
Grade away from foundation 6 inches with 10 feet �� c�
6 inch clearance to sill plate / __�N
-7- ---e--0 4--d.5
Gas Valve shut-off exposed/regulator 18 inches above grade / (�
Interior privacy/trim/doors/main entrance 36 inches ,V�JJ�
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: 1 Eve Bedroom:
Outside every bedroom a a: k/
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 s q.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 V A
4
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 1/,
Relief Valve(s) installed/Heat Trap/Water Temp 110 V,
Enclosed Stairs Sheetrock Underside minimum W Gypsum
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% _
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]
/1--ft u. S-s c 6 S 1gn e- tk0 t 5 6 r (N604..irl
L:\Building&Codes Forms\Building&Codesllnspection Fomis\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10, Revised 04/13/11 )
Town of Queensbury Building & Code Enforcement f �
Office No. (518) 761-8256
Framing I Firestopping Inspection Report
Inspection request received:
Name: Z1 \A"\ Inspected on: ` /i_ /S
Location: � ►1 41 Arrive: �'. :1`'►/ a.m.1 p.m.
��
Permit No.: �-.cs -5-2?) Inspector's Initials: QAT)
TYPE OF STRUCTURE:
1 ,
Y N NIA COMMENTS:
Framing
Attic Access 22"x 30"minimum
Jack Studs I Headers
Truss Specification Provided
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 '/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 IA inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/walli "A f of / "—& 3
Windows Habitable Space/Bedrooms �
24 in.(H) C
20 in.(W) (( 1.1 � ��►v `-' i
5.7 sf above/below grade �^
5.0 sf grade t `-t y�' 1Z- Y R f 'j�J <rK
Design Professional Sign-off,if required
Framing/ Firestopping Inspection Report «`., t •
Framing I Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: t 3(rm/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: t
NAME: e.---AuPERMIT#:
LOCATION: "'1 — �3 .► - `sem INSPECT ON: i j
TYPE OF STRUCTURE: 1.14--
N N/A COMMENTS:
Framing
Attic Access 22" x 30" minimum
Jack Studs 1 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 L
Metal Strapping for Notches Top Plate
1 %(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 %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:\Buiiding&Codes Forms-0LD\Building&Codes\Inspeetion Fc rns\Framing Firestopping Inspection Report.doc Revised January 7,2008
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Dep /pm
J'
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: < I)
NAME: PERMIT#: _v "C� ) 2-�
LOCATION: 9s \-)' A"I F INSPECT RN: 2—MI `A•
TYPE OF STRUCTURE: G
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 /4),31-1
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 Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
•
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart:-fl .4m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: _ [i
61. E
NAME: Rao C J2tJ LQ PERMIT#/ /+5a y
LOCATION: ' A 3 -c r Q, INSPECT ON: is "g --/41
TYPE OF STRUCTURE: R._-P1' t+-
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 ‘+// �-- J t.)
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 Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
,r� y
l1
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection request received: 3/4D-0 t a
Queensbury Building&Code Enforcement Arrive: am/pm Depart.3n/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials•
NAME: Ret.e... �4 G� PERMIT#: J a
LOCATION: 1 --I3A4Q' 4 INSPECT ON: I o1D/t/
TYPE OF STRUCTURE: :I .
Comments
Y ' N N/A 049e_.
ootings
Piers cbb0 O/ 5
Monolithic Slab
Reinforcement in Place �}
The contractor is responsible for FS?"' U QJ V
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 Forms\Foundation Inspection Report.doc
Last printed 12/18/2013 2:44:00 PM
Rough Plumbing / Insulation Inspection Report po-N
Office No. (518) 761-8256 Date Inspection quest received: C ��.�
Queensbury Building & Code Enforcement Arrive: � e am/pm 11:17/ 65
742 Bay Road, Queensbury, NY 12804 Inspect Ini als•
NAME: 6L-411-4-& PERMIT#:
LOCATION: b— .Ct-ezz) 8_ INSPECT ON: /
z36 l 5
TYPE OF STRUCTURE:
A-z-ed/Pei 44-
Y N N/A
Plum'. : . - . • 1 --r
61/0
•ou h Plumbi I Plates ��U16-1'\
Plumbing Vent/Vents in Place ••�11/2 inch minimum Drain Size 11114 r
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain /Vent
Air/ Head
5 P.S.I. for 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
5fP hfor for 15 minutes
Insulati Residential Check/Commercial Check
Window Sealing
Tyvek or Similar Exterior Sealant
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
(-0
Blower Door Test
Air Sealing
COMMENTS:
Rough Plumbing_Insulation Inspection_02 05 13
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: Jul k ` -am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: •
C A ) (L l
NAME: C! v PERMIT#:
LOCATION: 3>k INSPECT ON:
TYPE OF STRUCTURE:
Y / N NSA COMMENTS:
Framing V
Attic Access 2T x 30' minimum . -�.. - 4
Jack Studs/Headers I�
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 %(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 %inch or 5/8 in Type X
Garage side 5/8 inch Type
Ceiling/wall
Windows Habitable Space! Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
LABuikfing&Codes Forms-0LD\Buiidinq&Codes\inspethon Forms\Framing Firestopping Inspection Report.doc Revised January 7,2008
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