2004-071 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
;_y._ CE_RTIF CATS OF _O-CCUPAN- - Y=_
- "Permit Number: Date Issued: Wednesday;=January 18, 2006
:This is to certify that-work requested to be-done as shown by Permit Number P20040071
has been completed.
Tax Map Number: 523400-309-009-0001-023-000-0000
Location: 42 MICHIGAN Ave
Owner:- PAULINE EDITH PALMER
Applicant: PAULINE EDITH PALMER
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 SiteTlan, 497
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: P20040071 Application Number: A20040071
Tax Map No: 523400-30.9-009-0001-023-000-0000
Permission is hereby granted to: PATJLTNR EDTTH PALWR
For property located at: 42 MICHIGAN 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 die NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Tvne'of Construction Value
Owner Address: PAULINE EDITH PALMER
42 MICHIGAN Ave Residential Alteration $8,000.00
Total Value $8,000.00
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address - Electrical Inspection Agency
Plans&Specifications
2004-071
RESIDENTIAL ALTERATION
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, March 09, 2005
(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 of Queensbury; Tuesday, March 09, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
'Building Permit Application
Town of Queensbury-Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No. y 7 o
No inspection will be made until applicant has received a Fee Paid
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By:
application form.'
Applicant: 40, u e - Owner: �c-r i-t,/, e �cg �r
Address: Address: Jig /11/`/X "C',g l
ti a 1A e S 4 r ti ti t/
Phone
Property Location: Lot Number: / House Number 1-1A /
Subdivision Name: Tax Map Number:
o New Building: residence /commercial 'Estimated Market Value of Construction: $
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
Alteration: residence/ commercial
❑ No change to exterior size: ,re idence/com'1
Other work( s a uc�o� ly
Check Qccupancyluformation i Floor 2° Floor Other floor' T tal
Below sq.ft. sq.ft. sq.ft. Square Feet,
o Single f dly dwelling
a Two family dwelling
❑- Townhouse
o Multifamily dwelling
#of units
❑ Office
❑ Mercantile
o Manufacturing
G 1 car detached garage
o. 2 car detached garage
u 3 car detached garage
❑ 1 car attached garage
❑ 2 car attached garage
a 3 car attached garage
❑ Storage building-
commercial
❑ Storage building-
residential
❑ Other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what? /VD
Type of Heating System: electric/ oil / gas/wood /forced hot air/.baseboard!other:
Number of Firoo aces to be installed Number of WoodstoYes to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address- Phone Number
Builder- - 6 evelm n ArIt
Plumber
Mason
Electrician
Declaration please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this 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 Code,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 Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual,
location of ne consffiuction.
Signature: i ' owner,owner's agent,architect,contractor
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: -r� am/ m Depart: m/pm
Date Inspection recitiest received: Inspector's Initials:/
NAME: Ci\ , PERMIT#: —�
LOCATION: U 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 V
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 C—AA7-- C
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/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 belowgrade
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 Temp 110
Enclosed Stairs Sheetrock Underside minimum''/2"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/'/a 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-re"uired
Okay to issue C/C or-C%"O QTempor /Permanent]
-E]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc
Wk
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/p Depart. �t arn/pm
Date Inspection r uest received: Inspector's Initials:
-71
NAME: WS -Q PERMIT#: 0
LOCATION: DATE: —
TYPE OF STRUCTURE:
Comments
Yes No N/A
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location r'
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete r /
Platform at all exterior doors
Guards at stairs,decks,patios more than 30 inches above grade v
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 ,, y
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
.--
Bathroom/Kitchen watertight [ '
Safe glazing/Window in stairwells safety glazing
Interior Smoke Detectors: vJ
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup: _ E
Carbon Monoxide Detector w ` IZ-
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 A _
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 s .ft. i2-5-
EmergencX 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 Temp 110
Enclosed Stairs Sheetrock Underside minimum%z"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched _
Garage fireproofing/3/a 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/® [Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: r
Queensbury Building&Code Enforcement_ Arrive: am/p 'Depart: an-/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: INSPECT ON: -
TYPE OF STRUCT
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
einforcement in Place
elation Dampproofmg
Foundation/Waterproofing
Type of Dampproofmg/Waterproofing
Footing Drain Daylight or Sump.
Footing Drain Stone:
12 inch width
6 ' ches above footing
mil poly for wet areas under slab
a e A Fo N`
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
i
Foundation Inspection Report
O
u p p
Office No. (518)761-8256 Date Inspection requ t r ceiv :
pm m
Queensbury Building&Code Enforcement Arrive: a epart: �
742 Bay Rd., Queensbury,NY 12804 spector's Initial : ��
NAME: �C�J� P IT#: j 1 71
LOCATION: SPECT ON: —
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.
erials for this purpose on site.
oundation/Wallpour
Reinforcement in Place
O
Foundation Dampproofing
Foundation/Waterproofing V"
Type of Dampproofing/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.
LASueHemingway\Building.Codes.Inspection.FORMSToundation Inspection Report.doc January 28,2003
l
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection re est r is
Queensbury Building&Code Enforcement Arrive: a pm epart: ,� pm
742 Bay Rd., Queensbuiy,NY 12804 Inspector's Initials.
NAME: C .�At`r�2 C�� 1� IT#:
LOCATION: r�+ � SPECT ON: 7 C�
TYPE OF STRUCT
Comments
Y N N/A
ootings
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
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofmg/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.
LASueHemingway\Building.Codes.InspectionTORMSToundation Inspection Report.doc January 28,2003
71 #RECEIVED
TOWN OF t U Na ii�Y MAR p 8 2004
TOWN 0 QU�ENseU
BUILDING D IT
UILDI�G ADD CODE Y
REVIEWED BY
DATE c
TOWN OF QUEENSBURY BUILDING DEPARTMENT
EXISTING HOUSE Based on our limited examination
OUTLINE compliance with our comments shah
not to construed as indicating the
Opy
plans and specifications are In full
F'.. W-0" covence Mth the Building Codes
14'-0" of New Yft State.
NEW RAILING FASTENED TO 5'-4•
=1gnu EXISTING HOUSECIO
=un_
I
■
\ p
n 3'-0" DOO 0 8" POURED CONCRETE
RETAINING WALL 3000 PSI
r 4'_0• 8' X 16" CONCRETE FOOTING
I 2X12 PT WOOD STAIRS I 3000 PSI MIN. W/ 2 - #4
3'
WITH 8" RISE & 11.25" RUN -8 1/4" E CONTINUOUS, DOWEL o ,*RDTO
SLOPE I #4 BAR 48' O.C. (TYP.) -t 7n
x x
GRAVEL DRAINAGE
UNDER STAIRS 8' HIGH BY 8" CONC
RETAINING WALL
4" THICK CONCRETE 3000 PSI MIN. AND
SLAB REIN. W/ W.W.F.. 3000 AN 8"X16" FOOTING
PSI MIN. W/ 2 #4 REBAR CONT.
FOR ACCESS TO BASEMENT
SCALE: 1/4" = 1'-0"
Oq -07
RECEIV D
MAR P 8 2004
TOWN OF QUEENSBURY
BUILDING AND CODE
i
i
s
CENTRAL AVENUE
X � x x
S83°J4'_Oi'E
�\ 100.00'
14.87'
DEGK
32.79' _
DECK LANDS OF
PALMER
WOOD 25TORY R ME 545/282
HOUS� 9,000 sq.ft.
PATIO 0.21 acres
W i
c�
• DECK
O CM) � CONI
2G.39' O�
COOASPHALT LANDS N/F OF
DRIVE DALY
GARAGE 555/45/455
2.14'
12.18' 2 78\ LSHEDEJ
H IPF N8303 '01'W
1 0�00'
LANDS OF 10.21'
N ,J PALMER
1 1205/247
HK ° 6,000 sq.ft. SHED
.,� 0.14 acres
:� 51.99'
fN WOOD FRAME
HOUSE O N�
2 m
27.42'
co 11.2G'
GRUSFiED
STONE r+ GARAGE
DRVIE I. i.
00.00' LANDS N/F OF
IPF 5.11' RU55ELL
3 34 0 IPF 543/452
LANDS N/F OF LEGEND:
BARR15FORD
1273/28 — x — FENCE
c b - UTILITY POLE
OIPF - IRON PIPE FOUND .
r
a et PAY 5, 200!
.
Du S 'INAUT 1MM AL/EUIM OR AWnM TO A"VEY � - Scale 1'=20'
�. MAP IEMIOF A CT4NSEO LAND SURE' TEAL IS A
Ala of a Survey made for
VIOLAliON OF SECTION 7405.H1B-DMSIMON R OF 11E
ITEM VON(STATE EDUCATION LAW
S t e v e s �"��'�`°W"`"�°�"
j NARItm waN AN oNONAL Of iK wo aAaeoro ��r 1
SW"MWW"MWXrAW, DD�* PAL LINE PALMER 1
'COtTIiTCA710NS NpCAIED IIFREQN SIGNET A1AT
I n ll%&Y 1PA3 NMPAAEO N AOOORDANCE MTN SE
Land surveyorsDQSMY THE°° 9AKWft AD"
��s� M OF PMFESSOM
LAND SURvErORi SAD CERTIFICATIONS 9NAt1 RUN ONLr �i { �!
TO DIE PERSON FOR TINON W SIRMr E4 PREPARED,AND •K"
OAGDXY N NIS MO L TO THE T11tE COi LW o&MCKNTO Town of Queensbury, Warren County, New York
169 Haviland Road Queensbury, New York 12804 10"tA SIGNM r LBVM "`W"°"`"`°" "°To Tne A9CY.IE'J a Tne IaolNe NMNII011.• PALMER
(518) 792-8474 New York Lie. No. 50135 [TO, DATE DESCRIPTION DWG. NO. 030
309.09-1-23 ♦ 24