2009-157 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090157 Application Number. A20090157
Tax Map No: 523400-266-003-0001-067-000-0000
Permission is hereby granted to: KEITH &KATHY JABLONSKI
For properly located at: 16 CLEMENTS 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. Tyne of Construction Value
Owner Address: KEITH & KATHY JABLONSKI porch $7,800.00
16 CLEMENTS Rd Total value $7,800.00
QUEENSBURY,NY 12804-9804
Contractor or Builder's Name l Address Electrical Inspection Agency
Plans &Specifications
2009-157
464 sq ft porch over existing deck
$46.72 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,May 15,2010
(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 To eensb F}�i a May 15, 2009
SIGNED BY f for the Town of Queensbury.
Director of Building& de E orcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Pennit Number. P20090157 Date Issued: Friday, June 11, 2010
This is to certify that work requested to be done as shown by Permit Number P20090157
has been completed.
Tax Map Number. 523400-266-003-0001-067-000-0000
Location: 16 CLEMENTS Rd
Owner. KEITH & KATHY JABLONSKI
Applicant: KEITH & KATHY JABLONSKI
This structure maybe occupied as a:
Porch
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Dirc3uilding&Code Enforcement
Planning Board or Zoning Board of Appeals.
----------------------------_-------------------_________��_�__� �_-__________________________,
o _OFELQE USE ONLY - -- -�—/�.-.
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TAX MAP NO. ( M PERMIT NO. D LE 0 V LE
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FEE PAID LIG•-7)-BLDG. &CODES APPROVAL ; AFR 2 8 2009 00
T SON"OF QUEENSBURY
ACCESSORY STRUCTURE BUILDING P L
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.
OWNER: INSTALLER/BUILDER: Kt ITN 5N3G04Sk1
ADDRESS: _L(D cucmr-w5 ROAb ADDRESS: I(a CLj---V�4EVTS 2D
PHO( NO � �« q PHONENOS_40 I -19a-a(oC7 (-i---LL 7 qV-3Zqq
LOCATION OF PROPERTY:1;a C AFm%"N S RUAfl SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION: QOOF ONE- (Zr'AfL.. 1E-kL!;-TjgG^1 PeE
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? ❑YES )�NO
IF SO,INDICATE APPLICATION NO.AND DATE OF APPROVAL:
dD
ESTIMATED COST OF CONSTRUCTION: $ ANY OTHER ACCESSORY STRUCTURES ON PROPERTY? `' Gez-
IF YES,PLEASE LIST: &�;- sty-�77 V .�^
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: �C I� �J ld/� �k� PHONE: 0,11 Z Y` -3-zq 9
sT ND PROPOSED
PROPOSED CONSTRUCTION 1 FLOOR 2 .FT TOTAL HEIGHT
SQ.FT. SQ.FT. SQ.FT. FT.&IN.
OPEN PORCH ,
DE(K
3 SEASON,COVERE OR ENCLOSE ORC
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
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Queensbury Building & Code Enforcement - Residential a spection
Office No. (518) 761-8256 Arrive: '" a m rt: a
Date Inspection request received: Inspector's Initials: /
NAME: ��6,
Rt PER '#: 9 —LOCATION: � � ri.-1-F OT ' t"'P�D___,_ DAT
TYPE OF STRUCTURE:
Comments:
N 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 6 inches
Roof Co late/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers _
Guards at stairs deckspatios 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 a sad/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: Bafte backup:..
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, l N.ft:150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss,draft stopping finished basement 1,000 s .ft.-
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to fumace area
Fumace/Hot Water Heater operating
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum'IV Gypsum
Basement stairs dosed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Duct work Sealed rl
Gas Logs in Sealed or Glass Enclosure
Final Electrical _ �-�-� C Lo �' L
Final Survey Plot Plan
Are Fault Breaker in Bedrooms Z -Fo C-L H"f-:0C V- a;
Flex Gas Pipe Bondingfit, t� ��\t T� !� flU
As Built is System 1 Sewer Dept. Inspection Sticker -
Site Plan /Variance required .L1 L�t l� 1lj
Flood Plain Certification,if required___
Okay to' t I pmIJLLI �L�h�
L:\Building&Codes Forms\Building&Codes\Inspection FormsWesidential Final Inspection Forrq_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08
QueensburY Buili�ln �6&12nforcelrnent
- Residential Final Inspection
9
Of ii No. (518) 761-8256 Arrive:
Date Inspection request re`c-eived: Inspector's Initials: ��
VS-7-
NAME: �- �J k'
LOCATION: E:
TYPE OF STRUCTURE:
Comments
No WA
4" Building Number Address visible from road
Chimney,Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbina Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs deckspatios more than 30 inches above grade I
Guard at stairwell at 34 inches or more
Guard at deck, es 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 may from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas valve shut-off exposed/regulator 18 inches above grade `h
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazingi Window in stairwells sa
jety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom: Cat -
Outside every bedroom area:
Inter Connected: Bette badc up: -to i`, Lj
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, i .ft.-150 s .ft.vents �� L _ '`C-t \
Bathroom Fans,if no window � ' a C �✓r `�1
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss draft stopping finished basement 1,000 s .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 Trapt Water Temp 110
Enclosed Stairs Sheetrock Underside minimum IN Gypsum___
Basement stairs dosed rise>4 inches
Garage Floor Pitched
Gara a fire roofin /%hour fire door/door closer
Dud work Sealed propedy
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final SurveyPlot Plan
Are fault Breaker in Bedrooms
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 I C or C 10 1 Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\inspection FormsWesidential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 8/26/08
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