2011-330 TOWN OF QUEENSBURY
T^� 742 BayRoad,Queensbury, 12804-5902 (518)761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110330 Date Issued: Monday, September 10, 2012
This is to certify that work requested to be done as shown by Permit Number P20110330
has been completed.
Location: OLD ASSEMBLY PT. Rd
Tax Map Number: 523400-239-012-0002-013-000-0000
Owner: SUSAN M CLERMONT
Applicant: SUSAN M CLERMONT
This structure may be occupied as a:
Dock By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property (--- avp 4
owner of the responsibility for compliance with Site Plan,Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
9_41 kis a I k TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110330 Application Number: a20110330
Tax Map No: 523400-239-012-0002-013-000-0000
Permission is hereby granted to: SUSAN M CLERMONT
For property located at: OLD ASSEMBLY PT. 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: SUSAN M CLERMONT
28 ASSEMBLY PT. Rd Dock $750.00
LAKE GEORGE,NY 12845-0000 Total Value $750.00
Contractor or Builder's Name/Address Electrical Inspection Agency
STEPHEN BEAN
758-2976 OR 2103513
76 BROAD St
KINDERHOOK,NY 00000-0000
Plans&Specifications
2011-330
48 sq ft dock
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 25,2012
(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.)
B A
Dated at the Tg Quee s u It. +ay,August 25,2011
SIGNED BY c. �,�° for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY ' '
TAX 7 NO. PERMIT NO. —330 ! , .. '.
FEE PAID ' I'/• y > 'LDG. &CODES APPROVAL ' '
„
ACCESSORY STRUCTURE BUILDING PERMIT APPLICATION
Use this application for any structure other than the Principal Structure (house) to include, but not limited to:
garage, shed, greenhouse, dock, deck, etc. Refer to Informational Brochure No. 3 entitled Accessory Structures-
Sheds/Fences.
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT. NO INSPECTIONS WILL BE MADE UNTIL THE APPLICANT HAS RECEIVED
A VALID BUIL ING PERMIT.
OWNER: /X^, 6fei,,,o,--l`1 INSTALLER/BUILDER: kefra -
ADDRESS: c 446144 ae. Lie-6 ADDRESS: '7 8✓GIc,�X �1 s 014 iicO
PHONE NOS. ( i ), 4 Cog —' �1 a- PHONE NOS. (-- ) a IO-3 5 l 3 J01l°4
LOCATION OF PROPERTY: SUBDIVISIONNAM/E:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION: 2 //C Irer 4 l led—
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL?n @'�`I=S 0 NO Q
IF SO,INDICATE APPLICATION NO.AND DATE OF APPROVAL: 7411 f !► v�°1 0g
y o0
ESTIMATED COST OF CONSTRUCTION: $ t — ANY OTHER ACCESSORY STRUCTURES ON PROPERTY?
IF YES,PLEASE LIST:
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE:
st ND PROPOSED
PROPOSED CONSTRUCTION 1 FLOOR 2 FLOOR TOTAL HEIGHT
SQ.FT. SQ.FT SQ.FT. FT.&IN,
OPEN PORCH
DECK 1
3 SEASON,COVERED OR ENCLOSED PORCH*
BOATHOUSE
BOATHOUSE WITH SUNDECK
, . C -4 844 �...4.4 e- deck(i )
SHED
POLE BARN
DETACHED GARAGE(NO.OF CARS: )
OTHER ACCESSORY STRUCTURE:
*CONSIDERED FLOOR AREA & MUST COMPLY WITH FAR [FLOOR AREA RATIO].REQUIREMENTS IF THE
STRUCTURE IS LOCATED IN THE WATERFRONT RESIDENTIAL ZONE.
To the best of my knowledge, the statements contained in the 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 Codes, 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 Occupancy or Certificate of Compliance being issued, as requested
by the Zoning Administrator or Director of Building and Codes, an As-Built Survey by a licensed
surveyor, drawn to scale, showing actual location of all new
constru tion.
QUESTIONS? CALL 761-8256 OR EMAIL
codes( auegnsbury.net
I hav read and agree to the above.
VISIT OUR WEBSITE FOR MORE INFORMATION
Signed � e Pkvy- g Atei\ Dated: -Q,36 2-0I www.aueensburv.net
i Alt
1 .
Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804
Queensbury Building & Code Enforcement - Residential Final Inspection}
Office No. (518) 761-8256 Arrive: am/p�q D art: >('L.0 m/pm
Date Inspection request received: Inspector's Initials: /
NAME: (', `"vim PERMIT#:
LOCATION: !��,,��,�Q €�� F V) DATE:
TYPE OF STRUCTURE:
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing V ro ' imum 18 inches
Roof Complete/ erior Finish Compl
Platform at all exter
Handrail more risers Guard
Guards att 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 6011/41F,
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 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification/Sticker on Panel
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'/"Gypsum
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
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan I 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; Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10
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TOWN OF QUEENSBURY .. `'" 7 .. . . . ,t�
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, Based on our limited examination,compliance " , ` 1 '' ; " - „Is
with our comments shall not be construed as
indicating the plans and specifications are inli-' r`
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full compliance with the Building Codes of
New York State. �•-^
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MAP REFERENCE
MAP OF A PORTION OF THE LANDS OF
LUECK, CLIFTON&GROCHMAL
ON ASSEMBLY POINT
BY.,JOHN B. VAN DUSEN
DATED.JUNE 6, 1959
[� ^IYserved, or believe I saw e;
/.,U �.KE
\� 5� t iPS, WQIIti ��c
GEORGE
7
ti
0.3�1
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18 IRS S 7� 48 wE Z t ) 6 �
7.43
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FACE OF WALL
—STEPS ON LINE
S670 10' 48 NE LANDS N/F OF
14.47 FARRY
�� Uv '� �
DOCK �' �l ,
• , NEW Y CONSTRUCTS --
DECK ' \ \
IPF
RS , N
DEC a'\CORN
4r LINE _
2.8`1: S190 07' 12RW
\ a
Area 10.04
235.311 sq`+ ft.
rs, 0.0it\Acres
PF
I ; G 2011
A L 2 0 2011
LANDS WF OF 0R I
LEGEND
RANDLES T0'VVN OF Q ko
PLANNW
IRSO = IRON ROD SET/TO BE SET -- -- - __
IPFO = IRON PIPE FOUND ��W C.
-�---o--- _ IRON ROD SET/TO BE SET ,
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a e: January 6. 2010
{� •UNAURIOro BE g ALTERATION OR ALTERAT OR ADDIVON TD A SURVEY
S �?' YAP Af W A LICENSED LAND SURVEYORS SEA.IS A Map of .a Survey made for Scale 1"=5'
VIOLATION OF SEQTWN nw.SUB-MIA"2 OF 1NE ..
.�\''"'�'y�' P P YElakyW YORK STATE EDUCARON LAW.'
�J �../ v \� s WM CVPIF3 FROM 7NE Or TNAL A .S SURVEY . .
YAKKED w1N AN ORIIDERE aF THE LAND,7RUEroRs —
SEAL 9TAtl BE CONSIDERED TO 8E VALID'TRUE COPIES'
aR,� >ED HEREON 0#X*MM VATHINA Susa Clermont
1311s s+wvEY WO PREPARED a AccORDANDE wR+iNE �
Land Surveyors E7O5W OOOE OF PRAC7IOE FOR lANO 5u PROFE ADOPTED
BY 1NE NEW PORK STATE A5 5 0 0 4111 0N OP PROFESSIONAL
LAND SURVEYORS SAID CER11flCATWNS$HALL RUN ONLY
TO T31E PERSON FOR w301E 131E SURVEY IS PREPARED,AND Q�,,c
ON WS BE3IAF TD TW NAE COMPANY OOV NWITAL �f7G�1OF 1
169 Haviland Road Queensbury, New York 12804 A`�ICY AID LDi01N0 019nTU110N LISTED HEREON.AM Town of Queensbtl y, Warren County, New York m nlE AS9pIEE$a THE LENgNO wsnNnaf.•
CLERMONT C2528
(518) 792-8474 New York Lie. No. 50l35 NO. DATE DESCRIPTION DWG. NO. 03009E
239, 1 2.2-13/ 5-1-37