2004-141 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Pen-nit Number. P20040141 Date Issued: Friday, November 14, 2008
This is to certify that work requested to be done as shown by Permit Number P20040141
has been completed. -
Location: 13 MALLORY Ave
Tax Map Number. 523400-309-006-0001-045-002-0000
Owner. JAMES HILL JR
Applicant: JAMES HILL JR
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 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: P20040141 Application Number: A20040141
Tax Map No: 523400-309-006-0001-045-002-0000
Permission is hereby granted to: TAMES HILL JR
For property located at: 13 MALLORY 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: TAMES HILL JR
13 MALLORY Ave Residential Alteration $12,000.00
QUEENSBURY, NY 12804 Total Value $12,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
BP 2004-141 Dave Hatin did not collect a fee as he stated the $85 fee was paid in the year 2003.
850 sq. ft. interior residential alterations (portion of the basement converted to living space).
$0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, April 08, 2008
(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 Q ens h rsd it 08, 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 liaAa4- l l
No inspection will be made until applicant has received a Fee Paid' $ y
valid building permit. All applicants' spaces on this Rec.Fee Paid $
application must be completed and must appear on the Reviewed By:
application form.
I
Applicant: �4 Owner: G
Address: Address o r
vi- l VP Al
Phone#( ) - 0677 Phone#Vjx) kir - ;
Property Location: Lot Number: / House Number /
Subdivision Name: Tax Map Number: 3
❑ New Building: residence /commercial Estimated Market Value of Construction:$ I.. 0 o 0
o Addition: re ' e/ commercial If an Addition,what will use of new addition be?
Alteration: 4:!e!sdenc/ commercial
CINo change to ext residence/com'1
O Other work(describe )
Check OccupancyInformation 1' Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
Single family dwelling
o Two family dwelling
o Townhouse _
❑ Multifamily dwelling
#of units
o Office
o Mercantile
o Manufacturing
0 1 car detached
❑ 2 car detached j..:
0 3 car detached
❑ 1 car attached:Yam,
0 2 car attached.1 =�z'`e'
u 3 car attached ; ,
❑ Storage building
commercial tiA
o Storage building-
residential
❑ Other
What is the proposed height of the structure feet — I inches
Will any second-hand or ungraded lumber be used? If so,for what? '
Type of Heating System: electric/ oil gaffs/wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed 2,g o Number of Moodstoves to be installed P6,n y
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
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 pecified 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
Admin�istrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
w loot on of all new construction.
a
AA
Signature: owner,owner's agent,architect,contractor
mac, ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBUR_ , WARREN COUNTY
9000 HEATING DEGREE DAYS '
Coma?fiance Methods : PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or less)
PART 4* - Design -by Component Performance --
Commercial Buildings-Hi Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME: PROPERTY LOCATION:
7Z� LA%L-L ?2 tAlak__U�6 Po3E_
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - square feet
2 . Tvve of Heat - Electric Oil Gas ----Other
3 . Is` building mechanically cooled? Yes 1. No
4 . Percentage of area of windows and doors Over 17% Under 17%
S . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES- AS
SHOWN ON PLANS SUBMITTED :
a . Roof R � 11
-. — .b_=--- -Exterior walls R tq
c . Glazed areas R
d. Exterior doors � Qp��a R 1 C- -
e . Floors over unheated spaces R
f . Edge of slab on grade ( heated building) R
g. Basement/cellar walls ( above grade) R
h . Basement/cellar walls (below grade) R
i. Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic') hot -water heating device
Conforms to minimum efficiency per code Yes. No
' TEMPERATURE CONTROL MAXIMUM SETTIITG 1400 WILL NOT BE EXCEEDED
App " cant' s 'gn ure D,to Phone GR mbe
IN CTOR S REMARKS:
t Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/ De art: am/pm
Date Inspection request received: Inspector's Initials:
NAME: PERMIT#:
LOCATION: a- DATE:
TYPE OF STRUCTURE:
Yes No NIA
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location 1
Fresh Air Intake ,l
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors `
Handrail 4 or more risers �e Cl
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 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/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
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 .ft.-150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency ress 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 Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum'/z"G sum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer r
Duct work Sealed properly
Gas Los in Sealed or Glass&ncloebre
Final Electrical
Final Survey Plot Plan
Arc 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 Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08
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�, BMnaent 13 Mallory Avenue To ili.of Queembury
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OWNERS NAME & ADDRESS , ` HQME TE�LEPI$TEf
CURRENT SUPPLIED BY y FROM THEIR tO FICE f "" WORKgEL`EPHO E �
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BUILDING IS INEW OLD, f
WORK IS NEW ADDITIQYyAL 1 `. , DFiFECTS REMOVED
Inspection or Electrical Premises Survey: We have attended at a premises named herein to inspect the el ctnca�Ihstallafio�a1i��e jiel tt�atl�tie cannot
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issue a certificateof compliance for the reason(s)listed hereunder,
Concealed woti�ij�t expel,sufficie�fDforynspeon. ditioa�raLic oBs@�ed with no epPl�catiotlto inspection being filed.
_Installation not completed sufficiently for inspection. _In tallation tin compliahce with the NEC%r�reasons lis hereu de g
Key:Code number printed under column A listed below combiped with code num;'W printed under column B liste�below indicates condition.
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Size of service APPLICANT ATTESTS THAT THERE IS NO OTHER APPLICATION PENDING
Feeders WITH A QUALIFIED ELECTRICAL INSPECTION AUTHORITY,FOR
Work is exposed INSTALLATION LISTED HEREIN.THIS APPLICATION IS VALID FOR A
Work is concealed PERIOD NOT EXCEEDING ONE YEAR FROM THE DATE RECEIVED.
Service enters the structure overhead MUST ENTER APPLICANTS IDENTIFICATION NUMBER
Service enters the structure underground
Date inspection requested
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PRINT NAME AND ADDRESS
NAME OF APPLICANT DATE OF APPLICATION SIGNATURE OF APPLICA�1Tf
STREET ADDRESS TELEPHONE#
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CITY OR POST OFFICE , ' LICENSE NUMBER
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Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive:am/pnr Depart: am/pm
Date Inspection request received: Inspector's Initials: ( 7 �)
NAME: P i I� 1 PERMIT#: `'y
LOCATION: DATE: _
TYPE OF STRUCTU E: �- -
�� Commen :
Yes No NBA
4° Building Number Address visible from road
Chimney Height I"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
Handrail 4 or more risers
Guards at stairs,decks,patios more Vian 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 Com liant
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/Window in stairwells safety glazing _
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom: _
Outside every bedroom area: _
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches hei ht 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/Insulation Certification
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency ress 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 Tra /Water Tem 110
Enclosed Stairs Sheetrock Underside minimum'W'G sum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical /(✓LZ ��
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if re uired
Okay to issue C I C or C 10 Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08
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OWN OF QULENSSURY BUILDING D�a R BENT
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BUOMING Ef IT.- REVIEWED BY
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