97-478 411% TOWN OF QUE E NSB URY
IFW742 Bay Road Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. 97478 Date Issued: Tuesday, January 30, 2007
This is to certify that work requested to be done as shown by Permit Number 97478
has been completed.
Tax Map Number. 523400-227-006-0001-012-000-0000
Location: 12 MAYFLOWER Ln
Owner. RICHARD AMBLER
Applicant: RICHARD AMBLER
This structure may be occupied as a:
Unknown By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the f�
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.
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY 97478
TAX MAP NO. 153. -1-15 No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to AMBLER, RICHARD & HAUGEN,
OWNER of property located at 12 MAYFLOWER LANE Street, Road or Ave.
in the Town of Queensbury,To Construct or place a 200 SQ FT RESIDENTIAL INTERIOR ALTERATI
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t' Pffif LSYA1dress10 MARILYN DR.
LAFAYETTE, LA 70503
2. CONTRACTOR or BUILDER'S Name
RIST CONSTRUCTION
3. fiaNjTR66T5JR frrftLI4LDERSAddress
LAKE GEORGE, NY 12804
4. ARCHITECTS Name
NEW YORK BOARD
5.1029HIAsRD OF FIRE UNDERWRITERS
6. TYPE of Construction—(Please indicate by X) RESIDENTIAL ALTERATIONS
( )Wood Frame ( )Masonry ( )Steel ( 1
7. PLANS and Specifications
200 U. FT RESIDENTIAL INTERIOR ALTERATIONS AS PER APPLICATION
8. Proposed Use
200 SQ FT RESIDENTIAL INTERIOR ALTERATIONS
8 August 29 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
29 August 97
Dated at the Town Qu nsbury this Day of 19
1
SIGNED BY iv - w for the Town of Queensbury
wild ng and Inspector
Building Permit ApplicatiOn
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 1761-82561
-0 BUILDING & .CODE ENFORCEMENT
NOTICE ' - Requirements prior to issuance ( ``
et
A permit must be obtained before
of this permit: PERMIT FILE NO. 7— 2?
beginning construction. No inspections PERMIT FEE PAID$
will be made until applicant has received 0 Zoning Board Action
a VALID BUILDING PERMIT. All 1 Area /Use
applicants' spaces on this application RECREATION FE .Pali�
MUST be completed and the signature PlanningEl Board Action
REVIEWED BY:
of the applicant must appear on the SPR I Subdivision /Other Itallding Inspector
a lication form. nag pa: L J
'
p / Recreation Fee Payment
Applicant:V1 S7'nn Ai i2..tut y J (n . Owner: in lvm R1 rz-p .A b I ..
•
• Address: 136$ RcNozia.<2.r-, Q‘t4-9.1s-Ati ,11,Address,l2. +uruo„.va rs '
`S"r5v_n i-ti laq„ I FBI •i A.
Phone # (Sly.._) i....Ji_ . 1.�.. a_.. Phone # (sled ) .11... .aa2....
Properly Location: tv. vlew 1-Q. tca-►*ssk,i.,:.... i /
Subdivision Name: _Tax Map Number /�� / 7 /--fl
Section 131ock Ir t
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ / /6QOO I
residence / commercial
Addition to Building: -
residence. / commercial OCCUPANCY INFORMATION:
Alterati Building: Primary Building -
.esid_enc / commercial Single Famil -Dwell ng��� `�__(
(Residen Commercial Two Family Dwellai!ng ,,
l no change to ex for s . . . Family Dwelling
Office AUG 22 1997
/ Other Work (describe below) Mercantile
0.4n7 3-.uVn31,vh' 4 Et . f.1 ex,t6 chi s Manufacturitig�c �P�s�s c.,?: -,,Is?:-e-,Y
Other 1L.1`1 1NIC:'.;040 . 9;'
f<i.�
GROSS AREA OF PROPOSED STRUCTURE:
1st Floor "2-O'O sq ft. ,If ADDITION, what will use
of new addition be? :
2nd .Floor sq.. ft.
Other Floors sq. ft. •
(not unfinished cellar or basement)
ACCESSORY :BUILDINGS: •
N r- i;-p .P.n Detached Garage 1, 2 car
TOTAL FLOOR AREA: a:" -7—"pYp SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
FEET X FEET .
Foundation Type: Will any second-hand or ungraded
' Number of Stories: lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) feet TYPE OF HEATING SYSTEM:
Number 'of fireplaces and/orr woo stove (circle all which appli s)
to be installed: Electric / Oil / Gas //Mood
Forced Hot Air / Baseboard -/ Other
Person responsible for supervision of work as regards to building vi,c1,_
codes is : .DoNAibC .vi'DaO 12-11 P,,nr ,s lm,tt, , '' �enAA-RFlNA .'q�-S9c40�'jT^)E,i11
Marne Addresss Phone
Builder: tRISer L-0, Ns' • 4368 3mtzo ‘..d.-k c 'Th4q- i9ssi
Plumber: 1G G .�r-te- `P ,r c Nen 1,_i.c Gv e,oil. 14n--5a01
Mason: ,
Electrician: i2, a. 13‘_.a N.. iR),_41,6.., A.v,G t'Q» ,,,_,,ctsotl i —4i 3.j
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 I/we shall submit prior to a
Certificate of Occu ncy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed survey drawn to scale, showin ctual location of project on premises.
Signature: a- "7 2/2o0. fig✓, Risr6S- T 3 .
(owner, owner's agent, ar itect, contractor)
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT 11i
742 BAY RD., QUEENSBURY NY 12804 .,, . ,
INSPECTOR'S REPORT: ARR�PARTLZI
REQUEST FOR INSPECTION RECEIVED:
NAME f t-'t[ �Q) '
LOCATION 1 Z Pq R_jL,)E LP F
DATE f-` f-c17 PERMIT,\ 1-I_t. -1?
TYPE OF STRUCTURE: T 6 t N , IAC t.
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE -
THE CONTRACTOR I RESPO. LE FOR
PROVIDING PROTE T 4N Mr 'EEZING
FOR 48 HOURS FOLLOW' `.G *LACE-
MENT OF THE CONCRETE. ........
MATERIALS FOR THIS PURPO•E ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
-BACKFILL-APPROVAL -
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
j( .
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS_
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS E'kTERIOR R-
FLOORS R- -
WALLS R-
CEILING R- i
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
Queensbury Building & Code Enforcement - Residential Final Inspection
Office'No. (518)761-8256 Arrive: j1)am/pm� art: am/pm
P
Date Inspection request received: Ins ecto 'st Initials: '
L L
NAME: PERMIT#: 9Y •
s.•
LOCATION: /7 kr,2 r-L � — DATE:
TYPE OF STRUCTURE:
C 1 , er.t l)r 41 , . Comments
1" Ot�lvc✓'`s i.;p . Yes No N/A
Building Number/ ddress 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/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 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sq.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/<hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enc osyr
Final Electrical ti '� tJ
Final Survey Plot Plan 4
As Built Septic System/Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/0[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc
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1 TOWN OF CA.IF:a-ISTY
OLDING AND Ccat,,i.:....._
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1368 Dunhants Bay Road
Lake GeOrgc NY:12845
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