2009-133 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20090133 Date Issued: Wednesday, March 16, 2011
This is to certify that work requested to be done as shown by Permit Number P20090133
has been completed.
Tax Map Number. 523400-302-017-0001-045-000-0000
Location: 40 WINTERGREEN Rd
Owner. DONALD & DEIDRE OSTROM
Applicant: DONALD & DEIDRE OSTROM
This structure may be occupied as a:
Deck
By Order of Town Board
TOWN OF QUEENSBURY
�1 / !
Issuance of this Certificate of Compliance DOES NOT relieve the 1�vf
4property owner of the responsibility for compliance with Site Plan,
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
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090133 Application Number. A20090133
Tax Map No: 523400-302-017-0001-045-000-0000
Permission is hereby granted to: DONALD &DEIDRE OSTROM
For properly located at: 40 WINTERGREEN 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: DONALD &DEIDRE OSTROM Deck $6,000.00
40 WINTERGREEN Rd Total value $6,000.00
QUEENSBURY,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Plans &Specifications
2009-133
160 SQ FT DECK
$40.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,April 21, 2010
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Tq71 eensb Tuesday, April 21, 2009
/
SIGNED BY for the Town of Queensbury.
Director of Building & d nforcement
r---------------------------------------- _------.......... .....� r.---..-_..>...-----------.--,
OFFICE USE ONLY ' 01
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TAX MAP NO. ? ] _PERMIT NO. ' 1 '
/ / /
FEE PAID ; 5LDG.&CODES APPROVAL ; ; 11................... ---------------- ...-._ _____..�
ACCESSORY STRUCTURE BUILDING PERMIT APPLICATION
Use this application for any structure other than the Principal Structure (house) to include, but not limited to:
garage, shed, greenhouse, dock, deck, etc. Refer to Informational Brochure No. 3 entitled Accessory Structures-
Sheds/Fences.
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT. NO INSPECTIONS WILL BE MADE UNTIL THE APPLICANT HAS RECEIVED
A VALID BUILDING PERMIT. J
OWNER: Pea-f boa OS/rn h, INSTALLER/BUILDER: ``�c:G/G
ADDRESS: t/d k.is/7�cr- 4r$e,� ADDRESS: /9.Z tsjAr�po.-v 40v'-�' �i✓
PHONE NOS. 7,� _ PHONE NOS(_/ST
LOCATION OF PROPERTY: yo w.w4-ar4rdh.J SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION: kO
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? DYES W-NO
IF SO,INDICATE APPLICATION NO.AND DATE OF APPROVAL:
ESTIMATED COST OF CONSTRUCTION: $6,OOD• ANY OTHER ACCESSORY STRUCTURES ON PROPERTY? a. DPI/e- O�
IF YES,PLEASE LIST: '3AGILS;8e De-t+eus�
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: /4"a c� �i,,i�l�/� PHONE:/S�S�
1ST ND PROPOSED
PROPOSED CONSTRUCTION 1 FLOOR 2 FLOOR TOTAL HEIGHT
SQ.FT. SQ.FT. SQ.FT. FT.&IN.
OPEN PORCH
DECK �0 /60
tb Go. i✓�j
3 SEASON COVERED R ENCLOSED PORCH"
BOATHOUSE op-
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 scale, showing actual location of all new
construction.
QUESTIONS? CALL 761-8256 OR EMAIL
I have read and agree to the above. codes@aueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
Signed _ Dated: Of /Y`d� www.gueensbury.net
Town of Queensbury- Community Development Office - 742 Bay Road, Queensbury, NY 12804
Queensbury BuildingA Code Enforcement�-/Residentlal Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart: am/pm
Date Inspection request rgwived: Inspector's Initials:
NAME: ���- PERMIT
LOCATION: _�;�.L,- .�r.�:�: �c' DATE: /S—//
TYPE OF STRUCTURE
-� �- Comments:
4' Bukdhv Number Address visible from road ��� //,e 41—Z IC)
Chimney Height/'B'Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 indhes
Roof Co /Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs decks ios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deckporches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck BmdM/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off /regulator 18 inches above grade
Interior pnvacy/trim/doors/main entrance 36 Indies
Bathroom/Kltdien wate ht
Saglazft/Window in stairwells safe
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic aooesa 30 inches x 22 inches x 30 inches(helgLtj in acoessibie area
Crave Spaces 18 inch x 24 inch access 1 .ft.-150 sq.ft.vents
Bathroom Fans if no window _----
Plumbina fixtures
Foundation insulation!Insulation Certification
Floor truss draft stoppina finished basement 1,000 sq.ft.
Emeraency earess 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 Trao Water Teny 110
Enclosed Stairs Sheetrodk Underside minimum'A'GypNm
Basement stairs dosed rise>4 inches
Geroge Floor Pltched
Ga'ago fireproofing/%hour fire door/door closer
Duct walk Sealed Properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pi Bondi
As Built Septic System I Sewer Dept. Ins on Sticker
Site Plan /Variance required
Flood Plain Certification if re uired
Okay to issue C/C or C 10 1 Tem /Permanent
LABuildding&Codes FormsiBuilding&Codes\lnspection FormslRestdential Final Inspection Forrn_revised_100405.doc;Revised
January 7,2008;Revised 8/26108
Framing / Firestopping Inspection Repo
Office No. (518)761-8256 Date In �n req
Queensbury Building 8�Cade Enforcement Arrive: a
742 Bay Road, Queensbury, NY 12804 Inspector's Initial
NAME: S ERMIT#: —
LOCATI INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A Framing COMMENTS:
i 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 % w 16 gauge 8 16D naps 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
Ceiling1wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (MI)
5.7 sf above/below grade
5.0 sf grade
LASuilding&Codes Foens-0 SuNding&Codes\lnspedion Fora sTra►ning Flopping Inspection ReporLdoc Revised January 7,2006
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: a Depart: am/pm
742 Bay Road, Queensbury, NY 12804 inspector's Initials
NAME: qO PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
N NIA Framing COMMENTS:
--
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 '/ 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%inch or 518 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space t Bedrooms
24 in. (H)
20 in. (%M
5.7 sf above/below grade
5.0 sf grade
LABuilding&Codes Forms-OLD1Building&CodesUnspection Fomns\Frarning Firestopping inspection Report.doc Revised January 7,2008
—/—// rriae -7 (—
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depar;,—,.,,h c!,.am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: I� PERMIT#:
LOCATION: INSPECT ON: —
TYPE OF STRUCTURE:
Comments
Y N N/A
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
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\lnspection Forms\Foundation Inspection Report.doc
Last printed 12/20/2005 9:24:00 AM
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TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
n.
compliance with our comments shall
not be construed as indicating the
plans and specifications are in full
compliance with the Building Codes of
New York State,
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