2007-201TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070201
Application Number. A20070201
Tax Map No: 523400-303-019-0001-030-000-0000
Permission is herebygranted to:
For property located at:
25 GREEN 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 QueensburyZoning
Ordinance.
Owner Address: NADA CLARK
PAUL NIESCEWSKI
25 GREEN Ave
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address
OVER & UNDER CONSTRUCTION
639-0040
301 HAWK Rd
COMSTOCK, NY 12821-0000
Type of Construction
Residential Addition
Total Value
Value
$s,ooo.oo
$5,000.00
Electrical Inspection Agency
Plans & Specifications
-201
110 sq ft addition (dormer)
$75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, May 24, 2008
(If a longer period is required, an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To eens ry; >J~ur,~day, May 24, 2007
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SIGNED BY for the Town of Queensbury.
Director of Building Code orcement
NADA CLARK
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OFFICE USE ONLY - ~ ~ - - - - ~ -
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TAX MAP NO. .-. ' ~ - - "
MIT NO. ~
FEES: PERMIT livf`~;t.:~ ..~ ~~.~,~~~:uhZY
RECREATION _____ENGINEERING BUGLQING ANA GCE ;
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PIZINCIPAL STR U'CT LAZE:
APPLICATION FOR ZONING APPROVAL ~ Bi,IILDING
A PERMIT MUST BE OBTAINED BEFORE BEGINf+FFNG CONSTRUCTI PERMIT
REVIEW BEFORE ISSUArnNCE OF A VALID PERMIT FOR CONSTRUCTOION. PPLICATION IS SUBJECT TO
APPLICANT/BUILDER: Uc ~2 d `.I jy~ ~(~ n ~j~,,,,
OV1tNER: ~~~~ _ p~~
ADDRESS: 30 l ~A-wI~( ~~ Co~S~~G~
I z$~ ( ~„ ADDRESS: ~~ ~~ ~ J
PHONE NOS. 1--5/ D " 63 ~ - Q p yt~ PHONE NOS. I ~ ~ ~~~ ~
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CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: /1D/y Mo t~s ~ PHONE: !-~ -3;i! s =3~ sy
LOCATION OF PROPERTY: __ ~i~ r"/~ ~ ~, ~-(/- ~
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SUBDIVISION NAME:
PLEASE I NDICATE ME ASUREMENT S AS REQUIR ED BELOW:
CHECK ALL THAT z
APPLY TO YOUR
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SINGLE FAMILY ~( ~ ,
TWO-FAMILY
MULTI-FAMILY
(NO. of UNITS_~
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
IF COMMERCIAL OR INDUSTRIAL -NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST:~~J~ ~ FUEL TYPE:
~_~~
HEAT TYPE: ~~"n, a *HOVV MANY FIREPLACE(S):_„ C'~ AND / OR WOODSTOVES(S):' 2~
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE? /I-~ v
IS THIS A HISTORIC SITE? j?jv
PROPOSED USE OF BUILDING OR ADDITION: .~' ~ h ~ ~' ~'_
*Please complete a separate Application for "Fuel Burning Appiiances & Chimneys" available in our office
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Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
I --3 Th vr`S
Queensbury Building & Code Enforcement -Residential final Inspection
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Office No. (518) 761-8256 Antive: am/prn Depart: \ ~.afNpm
Date Inspection request received: Ins or's Initials:
NAME: ~ / PERMIT #:
LOCATION: DATE: --
TYPE OF STRUCTURE:
Comments;
Y Alo WA
4' Brirlcti Number Address visible from road ~~ ,
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Chrm M / B Vent/Drt+ect Vent Locafion
Fresh Air intake
3 inch Plumbi Vent th h roof minimum 6 irx~res
Roof /Exterior Finish
Platform at all exterior doors
Handrail 4 or more risers
GuaMs at stairs decks, more than 30 inches above
Guard at stairwell at 34 indtes or more
Guard at deck rches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/E~derbr Rail' 34 indres to 38 inches
Deck Brad i Ra nt
Grade from foundation 6 indres with 10 feet
s find, ceararrce to sal
Gas Valve shut-off / ulator 18 ind~es above
Interior /trim /doors /main entrance 36 inches
Bathroom ! IGtchen wale ' ht
' / Wirxbw in stairvrefis
Interior Smoke Detectors / Carron Monoxide Detectors
Every level: Every Bedroom:
OUt81d@ every bedroORl ales:
Inter Connected: badku
Attic access 30 inures x 22 inches x 30 ind~es in aooessicte area
Crawl S 18 inch x 24 inch access 1 . ft.-150 . ft. vents
Bathroom Fans if no window
Plum ' fixtures
Foundation insulation
Floor truss, draft st finished basement 1,000 . ft.
E below reds
Gas Furnace shut-crff within 30 feet or wid~rin one d site
Oil Fumaoe shut-off at entrance to ftu'nace area
FumaoeMot Water Heater
Lowwatershut-off boiler
Relief Va s instaNed /Heat Tra /Water Te 110
Enclosed Stairs Sheetrodk Underside minimum'r4' G
Basement stairs dosed rise > 4 inures
Floor Pih~red
Gera a oofi /'/. hour fire door / door closer
Duct work Sealed
Gas Lar Seated or Glass Errdosure
Final Elechicerl
Final Su Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pi
As Built S /Sewer De .Ins n Sticker
Site Plan /Variance 'red
Food Plain Certification tf fired
to issue C / C or C ! O T / Permanent
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L:U3uilding 8 Codes FornrsU3utlding & CodesUnspectlon FortnsU7esidenttal Final Inspection Form revised_100~05.doc; Revised
January 7, 2008
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Rough Plumbing /Insulation Inspecti n Report
Office No. (518) 761-8256
Queensbury Building & Code Enforcement
742 Bay Road, Queensbury, NY 12804
Date In 'qp-request received:
Arrive: '. am/ t~ p~e~part: am/pm
Ins is Initials: _~_
NAME: i t`lC - PERMIT #: ~-
LOCATION: o INSPECT ON: D-
TYPE OF STRUCTURE:
Y N NIA
Rou h Plumb' /Nail Plates
bi ent i Vents in Place
1 %2 inch minimum Drain Size
Washin Machine Drain 2 inch minimum
ve 100 feet / chan a of direction
Pressure est
ent
Air /Head
or 10 ft. above hi hest oonnection for 15 minutes
Pressure Test
W upply Piping
Air /Head
50 P.S.1 for 15 minutes
Insulation i Residential Check /Commercial Check
T ek or Similar Exterior Sealant
Pro r Vent, Attic Vent
Door /Window Sealed No Insulation
Duct /Hot Water Piping Insulation
If r uired unheated aces
Combustion Air Su for Furnace
Duct work sealed ro eri / No duct to
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COMMENTS:
Rough Plumbing Insulation Report.revised Nov 17 2003, n3vised February 15, 2005, revised January 7, 2008
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Rough Plumbing !Insulation Inspec n Report
Office No. (518j 761-8256
Queensbury Building ~ Code Enforcement
742 Bay Road, Queensbury, NY 12804
Date Inspection request received:
Arrive: am/p > art: am/pm
Inspector's Initials: =~~!~:~.
NAME: ~~ ~'~/ ,r i /~ PERMIT #: Q
LOCATION: ~~ l / H INSPECT ON:
TYPE OF STRUCTURE:
Rou h Plumbin /Nail Plates Y N NIA
Plumbin Vent /Vents in Place
1 ~ inch minimum Drain Size
Washin Maurine Drain 2 inch minimum
Cleanout eve 100 feet / char a of direction
Pressure Test
Drain /Vent
Air /Head
5 P.S.I. or 10 ft. above h' hest connection for 15 minutes
Pressure Test
Water Supply Piping
Head
P. or 15 minutes
Insulation Residential Check !Commercial Check
T e imilar Exfierior Sealant
Pro er Vent, Attic Vent
Door /Window Sealed No Insulation
Duct /Hot Water Piping Insulation
If uired unheated aces
Combustion Air Su for Furnace
Duct work sealed roe / No duct to e
COMMENTS:
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Rough Plumbing Insulation Report. Nov 17 2003, revised February 15, 2005, revised January 7, 2008