2004-641 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: P20040641 Date Issued: Thursday, June 16, 2005
This is to certify that work requested to be done as shown by Permit Number P20040641
has been completed.
Tax Map Number: 523400-279-015-0001-028-000-0000
Location: 5 AZURE Dr
Owner: SCOTT & KATHLEEN MOULTHROP
Applicant: SCOTT & KATHLEEN MOULTHROP
This structure may be occupied as a:
Deck
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the �J
property owner of the responsibility for compliance with Site Plan, V
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.
` . TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040641 Application Number: A20040641
Tax Map No: 523400-279-015-0001-028-000-0000
Permission is hereby granted to: SC OTT &KATHT,F,F,N MOTT1,THROP
For property located at: 5 AZURE Dr
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: SCOTT &KATHLEEN MOULTHRC
5 AZURE Dr Deck $1,6.00.00
Total Value $1,600.00
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-641
380 sq ft DECK
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 19, 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 ToTm of Q ens ,August 19, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Porch, Deck, Dock, or Boathouse 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. No Permit File No.
inspection will be made until applicant has received a valid Fee Paid $ ', 0
building permit. All applicants' spaces on this application must be Reviewed By:
completed and�mu,,stt m
appear on the application for
Applicant: f�/( v1leeg MOUAy r Owner: SGZyy►+✓
Address: 6 hz -br Address:
Qid.�'frlS�.�t3 1U't'
Phone#(SI Y)7ri 3 - S'I Phone#( ) -
Email Address: Email Address:
Person Responsible for Supervision of Work as Regards to Building Codes:
Name ;v b'1� t o att 4" Address: s Zvi'"� � Phone 's
Property Location: Lot Number: / House Number -5- / � Ob-1
Subdivision Name: Tax Map Number:
Estimated Market Value of Construction: $
❑ Porch
Deck RECEIVE®
❑ Dock
❑ Boathouse AUG J 6 2004
❑ Other work(describe
z Size of structure to be built J square feet TOWN OF QUEENSBURYBUILDING AND CODE
Submit along with this application:
1. Two plot plans drawn to scale,preferably using a survey map. Indicate proposed
structure showing setback dimensions from all property lines. Show location of
water supply and location and configuration of septic disposal area.
2. Two sets of structural drawings. Indicate size of posts or studs, floor joists;
decking or flooring material to be used. Show how the porch or deck will be
fastened to the building. If a roof will be constructed, indicate the size of posts or
studs,roof rafter spacing and span. Indicate type of roof. sloped, flat, shed, or
other. Indicate the typo of material being used for the roof.
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.
Applicant's signature: Date: le,
L:\.SueHeming),vay\Building.Permit.FORMS\Porch.Porch.Permit.doe 8/13/02 revised per DH
Queensbury Building & Code Enforce en t - Res1d t1a,-i al Inspection
Office No.(518)761-8256 Arrive: �:� a p e rt:2�a pm
Date Inspection request received: Inspector's Initial '
NAME: r� � � Cf
P RM T#: 0 �
IV
LOCATION: ) AT
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Co m lete
Guard 30 in. or more a)stairs, decks,patios n
Guard at stairwell at 34 in. or more Guard at deck,porches 36 in. or more Gk
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
�� � j
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum ''/"
Gypsum
Grade away from foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
6 inch clearance to sill plate
` Gas Valve shut-off exposed/regulator 18" above grade ��
Gas Furnace shut-off within 30 ft.or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater o eratin
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Temp, 110
Interior privacy/trim/doors/main entrance 36 in.
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
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Attic access 30 in.x 22 in,x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s . ft.-150 s .ft. vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C or C/O Temporary/Permanent
L:\PamWlBuilding&Codes\Inspection FormslRes. Final Insp. form 2.docLast printed 2/12/04
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RECEIVED
' �►u� : AUG 16 2004
BUILDING AND CODEY
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TO'NN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
.compliance with our comments shall
not be construed as indicating the
plants. and specifications are in full '
---
compliance with the Building.Codes
of New York State. 2 V. 0
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REVIEWED BY
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TOWN OF QUEENSBURY
GtitC. BUILDING AND.CODE
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Z here certify tha
actual!i•a t this S&P was Prepared from an
•I'• Sis stification shall run only
to the persons for 'ion the survey was prepared,
his behalf to the Xitle CoaInt, �+eraMeatal and on
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S.Bg, 19, 30--E subs traasf•rabl• to aitioaal institutions or
e4+�•at onaers.
certified so, Scott T. & Kathleen K. Moulthrop
j M h T Mortgage Corporation, its
successors'and/or assigns
Chicago itleInsurance Company
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