2004-567 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20040567 Date Issued: Tuesday, April 03, 2007
This is to certify that work requested to be done as shown by Permit Number P20040567
has been completed.
Tax Map Number. 523400-296-009-0001-036-000-0000
Location: 40 TWICWOOD Ln
Owner. JEROME & DONNA DOLLY
Applicant: JEROME & DONNA DOLLY
This structure maybe occupied as a:
Shed/ Storage Sheds
By Oder of Town Bowl
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.
r
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040567 Application Number: A20040567
Tax Map No: 523400-296-009-0001-036-000-0000
Permission is hereby granted to: JEROME &DONNA DOLLY
For property located at: 40 TWICWOOD Ln
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: JEROME &DONNA DOLLY
40 TWICWOOD Ln Shed/Storage Sheds $2,000.00
Total Value $2,000.00
QUEENSBURY, NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2004-567
160 SQ FT STORAGE SHED
i
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, July 27, 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.) 11
Dated at the Town of Qu ensb "day iul 04
SIGNED BY for the Town of Queensbury.
r .Y
Director of Building&Code Enforcement
Building 1"crmit Application
Town of Queensbury-Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. 1 Permit File No: - ' 7
No inspection will be made until applicant has'received a Foe Paid $ '� '
valid building permit. All applicants' spaces on this Roc.Fee Paid $
application must be completed and must appear on the Reviewed By.
application form.
Applicant: r � Owner: �� m�� ��
Address: 46 'ems- a> 7;MX Address: -q&> rl,.n ='— x��71-4-4
Phone# ,MOO Phone#O '-
c5a, -do- - s
Property Location: Lot Number: / House Number lle,0 / ii " 7 }'t'
Subdivision Name: 7-Aea ,ui-y Tax Map Number: 27 - ,3(a
New Building: riience
[commercial 'Estimated Market Value of Construction: $ 1 �
O Addition: r commercial If an
o Alteration: residence/ commercial Addition,what will use of new addition be?
0 No change to exterior size: residence/com'1
o Other work(describe )
Check Occupancylnformation 1 Floor 2"Floor other floor Total
Below sq.ft. sq.ft, sq.ft. Square Feet
o Single finlily dwelling
o Two famil dwellin
v . Townhouse
o Multifamily dwelling
#of units
o Office
o Mercantile
864
0 Manufacturin
0 1 ear detached prage
0 2 car detached garago
0 3,car detached ge DE
0 1 car attached garage
0 2 car Attached S=ge
O 3 car attached garage
v Storage building-
commercial
0 !res Stodepntl� g
0 other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
Type of Heating System: electric/ oil / gas/wood /forced hot air/ baseboard/other: wit/
Number of Fireplaces laces to be installed Number of nodstoyes to be installed 0
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address- Phone Number
Builder
Plumber
Mason
Electrician
I241: 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 Vwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or irector of Building and Codes,an.&Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all w nstructt���J�L.� .
Signature: owner,owner's agent,architect,contractor
K-10C(-dv--
iw Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart: am/pm
Date Inspection received: Inspector's Initials:
requ7 0
1��
NAME: [i (} `C � O PERMIT#. — /
LOCATION: vU ir A DATE: � 7
TYPE OF STRUCTURE: yl
Corn en �;
Yes No N/A
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location dv,
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches `� n
Roof Com lete/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 s .ft.-150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 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
Fumace/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/Y4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical '-L-
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&Codes\Inspection Forms\Residential Final Inspection Form—revised-1 00405.doc
Queensbury Building & Code Enforcement - Resenti Fi 1 Inspection
\ J
Office No.(518)761-8256 Arrive: 'a p d rt:��a
Date Inspection request received: Inspectors ImtLalNAME: s:
LOCATION: Ln ( � Plj�- IT M �? �6
I L� 1-i a C_ rr>. l j D,/ATE. l7
TYPE OF STRUCTURE: �> �
Comments
Yes No N/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 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 s . ft.-150 s . ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 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%"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/Y4 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 f
Flood Plain Certification,if required
Okay to issue C/C or C/® [Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised 100405.doe
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TOWN OF QUEENSBURY
BUILDING AND CODE
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