2005-822 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. P20050822 Date Issued: Friday, January 12, 2007
This is to certify that work requested to be done as shown by Permit Number P20050822
has been completed.
Tax Map Number. 523400-316-010-0001-001-000-0000
Location: 328 BIG BOOM Rd
Owner. MARK NELSON
Applicant: MARK NELSON
This structure may be occupied as a:
Residential Alteration 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 other issues and conditions as a result of approvals by the Director of Building&Code L%forcelfilent
Planning Board or Zoning Board of Appeals.
'Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
Dept_ of Community Development Permit No. C` iL
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: _ `
kvltA,% Awl'
Property Owner's Name: 1A 44Q1k p
Property Owner's Mailing Address: lb Ln pl ti\€�c ukz
Installer's Name: XC 4VA7-16)G Phone # �� � �3
��J�tT✓ �
Number of bedrooms (if residential): Total daily flow: 5()
J (residential - compute @ 150 gal./bdrm.)
Topography: y flat, rolling, steep slope % of slope
Soil Nature: J sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? feet
Percolation test: 4 not required, required [rate min. per inch
Domestic water supply: y municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank: 1000 gallon (minimum size: 1,000 gal.)
Tile field: each trench 5 0 feet ! Total system Iength: feet
Seepage pit(s): number of / size each: R by ft.
Size of stone to be used: # / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm systems and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Qwensbury, any permit or
approval granted which,is based upon or is granted in reliance upon any material ins reprawatation or failure to make a
material fact or circumstance known by or on behalf of an applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queeusb—y Sanitary Sewage Disposal Ordiasaca.
Signature of responsible person: Date: -9/29M—
Permit No. 1.
3uilding &Codes Office-Department of Community Development-Town of Queensbury Fee Paid
742 Bay Road,Queensbury,NY 12804 Recreation F
Dave Hatin,Director codes@Queensburv.net
Phone: (518) 761-8256 FAX: (518) 745-4437
Principal Structure Building Permit Application
Application & Plans subiect to review before issuance of a valid permit for construction.
Instructions: A permit must be obtained before beginning construction. No inspections will be made until the
applicant has received a valid building permit. All applicants' spaces on this application must be completed and
must appear on the appiic do forXjt �
Applicant/Builder w-, Owner: - -3,�J Ck om .
Address: ). ` Address: r e/%)�1
�\1PIA ? ,
Home Phone: 5 t4s - 7 S-- -2 3 0 7 Home Phone: _5nxv+nr .
Email Address: Email Address:
Cell Phone: Cell Phone:
FAX Phone: FAX Phone:
Person responsible for supervision of work with respect to building and codes compliance:
Name: v k a .&)C I �--)()Y1
Address: -,,)cx Y`c-e- Phone ; ,x-
,, n 2
Location of proposed construction: Lot No. Legal Address: ,' ;6 )?=M f--r
Tax Map Number: l (0 •1 1-- f—Subdivision Name:
Estimated Cost of Construction: $ 6CCO.°c
Proposed construction is for: vResidential Use ,Commercial Use
Name of Business:
if proposed construction is an addition, what will use of new addition be?
New Addition Alteration Proposed Construction 10 Floor 2^d floor Other Total Proposed
structure (Occupancy Type) Sq. Ft. sq.ft. Sq.Ft. Square feet Height
Ft.&in.
Single-family Dwelling7
Two-family Dwellin
Townhouse
Multifamily Dwelling
Number of Units:
Office
Mercantile
Manufacturin
Other:
Attached Garage 1, 2, 3
Type of Heating System: Electric, Oil, Gas, Wood, Forced Hot Air, Baseboard, Other:
Is a fireplace and/or woodstove being instailed, please refer to a separate application. _Yes _No
Applications are subject to Zoning Administrator, Code Compliance, and Structural Plan review.
The Building and Codes Office will allow commencement of your proposed project only after
issuance of your permit.
Declaration: Please sign below after you have carefully read the statement:
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.
Date: �a i Sl o Applicant/Builder Signature:
The application of M raP 3/ L led
permission granted for the construction, reconstruction or al ratio o uild' -�Is hereby approved and
forth above. / d or accessory structure as set
Date: 1 X� 1—n�quthorized Signature:
L:\Sue Hemingway\Buiiding.Permit.FORMS\Principal Structure Permit Appli tion.doc
V:`2/14/04
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20050822 Application Number: A20050822
Tax Map No: 523400-316-010-0001-001-000-0000
Permission is hereby granted to: MARK NFL SON
For property located at: 328 BIG BOOM Rd
in the Town of Queensbury,to construct or place
at the above location ui 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: MARK NELSON
JOY BARTH Residential Alteration $3,000.00
Total Value $3,000.00
328 BIG BOOM Rd
QUEENSBURY, NY 12804
Contractor or Builder's Name / Address Electrical Inspection Agency
Plans&Specifications
2005-822
RESIDENTIAL ALTERATION TO BASEMENT
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, November 21, 2006
(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 of Queens ury; "Jo day, November 21, 2005
k
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement
Queensbury Building & Code Enforcement - Residential Final Inspection
Offic No. (518)761-8256 Arrive: am/pm Depart: 11;ZPm
Date Inspection request received: Inspector's Initials:
9
NAME: :�? �t�. PERMIT#: —
LOCATION: DATE:
TYPE OF STRUCTURE:
Comments
Yes No N/A
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 Complete/Exterior Finish Complete
Platform at all exterior doors
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
Interior Handrails @ stairs 2 or more risers
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/WindgN in stairwells safety glazing
Interior Smoke De t tors:
Every level: Ev Bedr m:
Outside every bedroo rea:
Inter Connected: Battery backup:
Carbon Monoxide Detector
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s .ft.-150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
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
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Tern 110
Enclosed Stairs Sheetrock Underside minimum%s"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required I OK
Okay to issue C/C or C/O[Tempor /Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc
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Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCT
Framing
Y N N/A 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
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '/z 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
e side 5/8 inch Type X
e' t ' wall
Windows Ha table Space/Bedrooms
24 in.
m.(W)
5.7 sf above/below grade
5.0 sf grade
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. 518
( )761-8256 Arrive: am/pm �D}e�part-: �amm/p
Date Inspection request received: Inspector's Initials:�^I_- /
NAME: PERMIT#:
LOCATION: DATE:
TYPE OF STRUCTURE:
Comments
Yes No N/A
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 Complete/Exterior Finish Complete
Platform at all exterior doors
Guards at stairs,decks,patios more than 30 inches above grade l�
Guard at stairwell at 34 inches or more �
Guard at deck,porches 36 inches or more c�
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers
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 P
Interior privacy!trim/doors/main entrance 36 inches C
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Carbon Monoxide Detector
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s .ft,150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
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 Valve(s)installed/Heat Trap/Water Tern 110
Enclosed Stairs Sheetrock Underside minimum'/z"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fire roofin /%hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
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 Forms\Residential Final Inspection Form revised I00405.doc
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�rirru vr�-utv�rrty vrrz.�r --_
TOWN (� QUEENS Y
INCLUDING CELLAR OR BASEMENT.ALL SMOKE F:
DETECTORS SHALL BE INTERCONNECTED.D�t,.AIL LEUELS.•°
-� ALL SMOKE DETECTORS MUST BE BATfERX',BACKUP. d" m
BUILDING & � CARBON MONOXIDE DETECTOR REQUIRED OUTSIDE
REVIEWED
D LOWEST SLEEPING LEVEL. �,�i � 4 Z005
DATE _ - „.y
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