2004-701 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE -OF- OCCUPANCY
Permit Number: P20040701' ._. Date Issued:,. Thursday, February 24, 2005
- -This is to certi that work-requested--to be.done as shown b Permit-Number
y P20040701
has been completed.
Tax Map Number: 523400-295-010-0001-042-000-0000
Location: 21 JACQUELINE Dr
Owner: CLARK & DONNA PERKETT
Applicant: . . CLARK &DONNA PERKETT
This structure may be occupied as a:
By Order of Town Board
Porch TOWN OF QUEENSBURY
Director of Building&Code.Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040701 Application Number: A20040701
Tax Map No: 523400-295-010-0001-042-000-0000
Permission is hereby granted to: CLARK &DONNA PERKETT
For property located at: 21'JACQUELINE•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. } !" Tvde of Construction Value
{ I
Owner Address: CLARK&DONNA PERKETT
21 JACQUELTNE Dr Porch $25,000.00
Total Value $25,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name /Address r ;Electrical Inspection Agency
ADTRONDACK SUNROOMS
TOM KURTSH 798-2261 '
10 HOLDEN Ave
OUEENSBTTRY_ NY 12804-0000 .
,
Plans&Specifications
2004-701
288 SQ FT PORCH
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, September 20, 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 o ueeris a eptember 20, 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 $-
building permit. All applicants'spaces on this application must be Reviewed By:
completed and must appear on the application form.
Applicant: 14 d r!'0.1 d,4 c.f C Owner: C.I fintG Pew��
Address: 5 3 (L.)• Address: �,..-
Qc�Q t.t-ec �(
Phone#(`+? ) —hP - )L-,� ( Phone# 7(e 1
Email Address: Email Address:
Person Responsible for Supervision of Work as Regards to Building Codes:
Name 7h.5417--.) ku^s Address: ,S 3 t Phone y7f 22-�- /
Property Location: Lot Number: / House Number _/
Subdivision Name: L-e—k (4-,,4 �s+q+e.3 Tax Map Number:
Estimated Market Value of Construction: $ $' 0�
❑ Porch
❑ Deck
❑ Dock
❑ Boathouse
6' Other work(describe Pbl-
Size of structure to be built IE':g square feet
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 type 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. q p
Applicant's signature: V- Date:
L:\SueHemingway\Building.Permit.FORMS\Porch.Porch.Permit.doc 8/13/02 revised per DH
Queensbury Building & Code En26r\cernent -RL1 ential i al Inspection
Office No.(518)761-8256 Arrive: m/pm a t:
Date Inspection request received: Inspector's Initi Is
NAME: P�(�1� �T PE IT#:
LOCATION: -D E: 7 —Z LA
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 Complete
Guard 30 in.or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in. or more
Exterior Finish Complete
Interior/Exterior Railings 34 in. to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum %Z"
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 operating
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/'/o hour fire door/door closer
Duct work Seated 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:\PamW\Building&Codes\Inspection Forms\Res. Final Insv. form 2.docLast printed 2/12/04
FEB-24-2005 03 :57 AM P. 01
FUpy �2c6q
7q.
Inspector's No I �_
;•' `°
Date
COMMONWEALTH E ECTRICAL INSPECTION SERVICE INC.
(Consuftli liq and Fife Inspection Services)
(Incorporated in the states of Oaryland,Now York,Pennsylvania,Delaware and west Virginia)
Desiring Certification of Approval, applic ition Is made for Inspection of electrical Installation In the premises
described below.On demand,applicant agreei to pay for inspection service In accord with schedule of charges.
PLEASE PRINT
Owner �... ,. ,.� .........,,.� ��..�.: .:� F3 DWG [.]Other Type Hldg.
Occupant .............................................................................................................................................................. Building Permit No.
Job Location!,J.............cX...4%rdrl
a ..Gl..i,./I. ,,. ...;A, ....City..............:.,...,..,,...,......:--..........,:....:...,........... State :..
county ., A.";........ ...............Twp............ .........M/C#.............................-........... Swi ming Pool—New 0 Old FI`., .... ............. .
Directions to Job Site
.................. ...............:::.......::::::I'll";......... ::: ::�.::�,i., �.y::: .:::::::::::::::::......:::::::::::::::::::::::......................... ................
..
Application For Rough Wiring❑ C Fixtures "Is rvice El or ... ................................................:.' -,... .........,............,..,................... .........
Work—New 11 Additional r1 Bldg.—New 11 Old 0 Ready for Inspection ..............................................................................
APKI AN 'e - LICENSE■ PERMIT N
PLE T E PHONE.of
APP I ANt e J UTILITY F f I
D
OFFICE TO
CITY STATE xlh CODE BE NOTIFIRD
ROUGH WIRING SPACE BEt W FOR USE OF INSPECTORS ONLY
AMP SERVICE PUMP
OUTLETS O IP
SWITCHES HEMP OVEN
RECEPTACLES DISPOSAL UNIT
tUM SASE RANGE DISHWASHER
MOGUL A E WA-T R DRYER
FIXTURES
LUORRESCENT AR T N AMP, RECEPTACLES
MEARC 2 Y VT OR OR WIRING a CONTROLS FOR BURNER A '
ENT AN
MOTORS:H.P. 1120 1112 1/10 1/6 1/6 1 114 113 112 3/4 1 IT773 6 11-1121 10 1 16 20 1 25 1 30 1 40 80 76 100
MARK NUMOGn
OFF,ACH SIZE
�.
RON MUM BLO
Fleatrical inepeator
1 State Street
Glens Falls, NY 12801
(518)788.0906
OFFICE USE ONLY WORK INSPECTED REPOR•
NOTIFIED TEG FEE PAID
SERVICE DATE CON• TOTAL S
Date Received: TRACTOR
R.W.DATE / OWNER CHECK NO.
FINAL DATE if OCQUPANT CHARGE
Certificate No.:
CERTIFICATE NEEDED AGENT / CASH
Date Sent: ❑YE6 CIDUP HLEO,
LT GG.
INSPECTOR
Progress ❑
THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.I.S,INC,
WHITE/OFFICE PINWIN PECTOR YELLOW/OFFICER COLD/CUSTOMER
�r
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection r ues eceiv d:
Queensbury Building&Code Enforcement Arrive: - i Depart:
742 Bay Rd., Queensbury,NY 12804 Inspector's Initi
NAME: ZIT#:
LOCATION: _ SPECT ON: — "—
TYPE. OF STRUCTURE: � ��i1'`/
Comments
Y N N/A
ootings `
Piers
Monolithic Slab
Reinforcement in Place _
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R- _
Rough Grade 6 inch drop within 10 ft.
LASucHemingway\BuiIding.Codes.Inspection.FORMS\foundation Inspection Report.doe January 28,2003
1y
INSTALLERS LAYOUT SKETCH .
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VERIFY ALL FILL MEASUREMENTS BEFORE CUTTING w
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NOTICE: oM
THIS JOB HAS NOT BEEN CONFIRMED. Q 0
PLEASE FAX AN APPROVAL WHEN READY TO ORDER. p 0)
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RELEASE APPROVED BY I I (n O
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O CUSTOMER: ADIRONDACK SUNROOMS
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JOB NAME: PERKETT, CLARK fl ��.--�-r�:� -�-,;��
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3" WALLS BUILDING & XLn
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DEALER IS RESPONSIBLE
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44.5 N-JU 44.5 [Pos°] 44.5 3 44.5 [
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TRAPEZOID GLASS MUST BE 5/8" OVERALL
ONE SURFACE MUST BE 1 /4" THICKNESS RECEIVED
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SEP 0 8 2004
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RECOMMENDED BEAM (SUPPLIED BY DEALER): Based on our limited examination, BUILDING AND CODE
COm Hance with our comments shall
0 3PLY X 11 1/4 LVL or not e construed as indicating the ICBO EVALUATION REPORT PFC-5176
3PLY x 11 7/8 LVL plans and specifications are in full ICBO EVALUATION REPORT ER 5262-P
compliance with the Building Codes NER-567
BASED ON A SNOW LOAD OF 70 P.S.F. of Ne`db)AYLT,6t%y: MIRHET MELKIC UL 58SL
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DEALER: ADRONDAK 04W11307 PH. ( ) TEMO SUNROOMS, INC. LYNN TWEDT, PE
PERKETT, CLARK 20400 HALL RD 20400 HALL RD
21 JAQUELINE DRIVE CLINTON TWP, MI 48038 CLINTON TWP, MI 48038
QUEENSBURY, NY 12804 PHONE: (586) 286-0410 (877) 218-8366 X287
DRAWN BY:MIRHET MELKIC DATE:08/27/04 1 SCALE:NONE FAX: (586) 286-5409 LIC # 063611
LEGEND: RECOMMENDED BEAM (SUPPLIED BY DEALER): Q CO N
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SIGNED AND SEALED
ON 09/03/04
DEALER:ADRONDAK 04W11307 PH. ( ) TEMO SUNROOMS, INC. LYNN TWEDT, PE
PERKETT, CLARK 20400 HALL RD 20400 HALL RD
21 JAQUELINE DRIVE CLINTON TWP, MI 48038 CLINTON TWP, MI 48038
QUEENSBURY, NY 12804 PHONE: (586) 286-0410 (877) 218-8366 X287
DRAWN BY: MIRHET MELKIC DATE:08/27/04 1 SCALE:1/4"=1' FAX: (586) 286-5409 LIC #063611.
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