2004-463 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OFCOMPLIANCE
Permit Number. P20040463 Date Issued: Wednesday, December 13, 2006
This is to certify that work requested to be done as shown by Permit Number P20040463
has been completed..
Tax Map Number. 523400-278-019-0001-002-000-0000
Location: 11 MARINTDALE Rd
Owner. CHARLES & MAURA MELLON JR
Applicant: CHARLES & MAURA MELLON JR
This structure may be occupied as a:
Shed/ Storage Sheds
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 Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
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742 Bay Road,Queen"sbu— NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20040463 Application Number: A20040463
Tax Map No: 523400-278-019-0001-002-000-0000
Permission is hereby granted to: C14AR1,F,S &MATTRA MF,TJ.0N TR
For property located at: I MARINTDALE 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. Type of Construction Value
Owner Address: CHARLES &MAURA MELLON JR
11 MARTINDALE Rd Shed/.Storage Sheds $4,731.00
' LAKE GEORGE, NY 12845 Total Value $4,731.00
Contractor or Builder's Name/Address Electrical Inspection Agency
ti
Plans&Specifications
2004-463
288 sq ft STORAGE SHED
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, June 30; 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 To ueens ry; d es ay, June 30, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code nforcement
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. '� -
No inspection will be made until applicant has received a Foe Paid $s1iL<:o
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: ba;,Jes r 1*1100 Tr Owner: C'/ter/�s T Gyl 16 Ti-
-Address: 717577,77//�� oa ��Addre`ss: "�1% 1'YaeAAdole �oadO
V� /,28�/s �_ �' GCt/CE' (�Pvsie,jyy
Phone#( 1361-1 zq 7 Phone#(s=8 )793 %3
Property Location: Lot Number: . / House Number /
Subdivision Name: Tax Map Number:
o New Building: residence /commercial 'Estimated Market Value of Construction:
o Addition: residence/ commercial If an Addition,what will use of new addition be?
• Alteration: residence/ commercial
C No change to exterior size: esidenc�'1 - -
Check Occupancylnformation 1` Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
v Single faulfly dwelling
v Two family dwellin
to Townhouse
o Multifamily dwelling
#of units
o Offioa U '
o Morcantile BURY
u Manufacturing QSOU
0 1 car detached garage
O 2 car detached garage
0 3 car detached garage
0 1 oar attached garage
0 2 car attached garage
0 3 car attached garage
0 Storage building-
commercial
o" Storage building-
residential -
G Other
What is the proposed height of the structure I D feet 0 inches
Will any second-hand or ungraded lumber be used? If so,for what? A/n
Type of Pleating System: electric/ oil / gas%wood /forced hot air/ baseboard/other: lUdn e
Number of F aylaces to be installed y Number of Wpodstoves to be installed
List below the persons)responsible for supervision of work as regards to building codes:
Name Address- Phone Number
Builder ersa ;Ie 51,e 5 ,(), ck °s w;(fch,A)Y n&3 r 5�8-Ssy��z6y
Plumber
Mason merles It-1EKm v144,44le F_ 70- 41-12y�
Electrician
Dr,claration; 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,priorto a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Bullt Survey by a licensed surveyor;drawn to scale,showing actual
-lo®ation of al cons coon.
t�� Signature owner,owner's agent,architect,contractor
nhf6r`�cefmpeant
Queensbury Building & Code - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart: am/pm
Date Inspection request received: ) Inspector's Initials: /1�
NAME: �l IC�1� PERMIT#:
LOCATION: / r j h, DATE:
TYPE OF STRUCTURE:
Comments
Yes No /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 inche r more
Handrail Termination at Newel Pot or Wall
Interior/Exterior Railings 34 inches o 38 inches
Interior Handrails @ stairs 2 or morA risers
Grade away from foundation 6 inde.N with 10 feet
6 inch clearance to sill plate , _
Gas Valve shut-off exposed/regulator 18 i ches above grade
Interior privacy/trim/doors/main ent ance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safeV 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(hei t)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s . ft.-1 A s .ft. vents
Bathroom Fans,if no window
Plumbing fixtures }
Foundation insulation
Floor truss,draft stopping finished se Ent 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 Temp 110
Enclosed Stairs Sheetrock Underside minimum%2"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/o [Temporary/Permanent]
L:\Building&Codes Forms\Building&CodesUnspection Forms\Residential Final Inspection Form revised 100405.doc
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