2004-799 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: P20040799 Date Issued: Monday, November 15, 2004
This is to certify that work requested to be done as shown by Permit Number P20040799
has been completed.
Tax Map Number: 523400-295-010-0001-037-000-0000
Location: 77 SARA-JEN Dr
Owner: DAVID & JUDITH THOMAS
Applicant: DAVID & JUDITH THOMAS
This structure may be occupied as a:
By Order of Town Board
Residential Alteration 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: P20040799 Application Number: A20040799
Tax Map No: 523400-295-010-0001-037-000-0000
Permission is hereby granted to: DAVm & JiTDITH THOMAS
For property located at: 77 SARA-JEN 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. Tyne of Construction Value
Owner Address: DAVID & JUDITH THOMAS
77 SARA-JEN Dr Residential Alteration $14,000.00
Total Value $14,000.00
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-799
376 SQ FT RESIDENTIAL ALTERATION
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, November 05, 2005
(If a longer period is required,an application for an extension most be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Too n ZfDQee ns u ; // YrXdo ,November 05, 2004
SIGNED BY 7 '� for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Quemsbury,NY
(518)761-8256
A permit must be obtained before beginning construction. 'IFile No.
No inspection will be made until applicant has received a Fee d
valid building permit. All applicants' spaces on this Rec.Fee P 'd
application must be completed and must appear on the Reviewe B .
application form.
Applicant: !7 fl ` E Owner
Address; Address:
L Lr/ r>Pa--5
Phone#(2/L) _ - &99' Phone
Property Location: Lot umber: / House Number /
Subdivision Name: Tax Map Number. a 0 ) —37
` ted Market Value of Construction:$ TJO
.o New Building: residence /commercial 'Estimated _
':,0 Addition: residence/ commercial 1f an Addition,what will use of new addition be?
Alteration: residence/ commercial
':0 No cbange to exterior size: residence/com'1
j o Other work(describe' )
Check Oceupancylnformation 1 Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
cl Sin a tw:iIy dwelling
0 Two family dwellin
o Townhouse
0 Multifamily dweUing
#of units
0 Office
o Mercantile
0 Maaufacturin f�(�' � �
0 1 car detached pmgc
0 2 car detached gMe
-0 3 car detached age
0 1 oar attached garago nq ni iPPWAURY
o 2 oar attached garage N1,41, NG AND�
0 3 car attached garago
e Storaga building-
commercial
o .Storage building-
residential `
o other
What is the proposed height of the structure feet __,___inches
Will any second-band or ungraded lumber be used? If so,for what? mil)
Type of Heating System: electric/ oil / gas/wood / orced:1110t:a)irbaseboard/other:
Number of, entaces to be installed Number of WoodsQve�to be installed
Listbelow the persons)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
Plumber
;Mason
(Electrician
D'eclarW : please sign below after you have caret ly read the statement:
To the best of my kmowledge 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 dono.'on the described promises 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 D r of Buil odes, As juitt Survey by a licensed surveyor;drawn to scale,showing actual
location oft� all n.
Si Lure: !� owner,owner's agent,architect,contractor
Queensbury Building & Code Enforcement - Residential Final Inspection ` y
Office`No.(518)761-8256 Arrive:
Date Inspection request received: _ Inspector's In' ials:
NAME: P IT 4:
LOCATION: � � - ,* P�— ATE: -
TYPE OF STRUCTURE:
Comments
Y _ N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Com fete
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 %2"
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 I
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 f
Garage fireproofing/'/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&CodesUnspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04
Framing / Firestopping Inspection Report
Office No. (518) 761-8256 Date Inspection re est receiv
Queensbury Building& Code Enforcement Arrive: n/ D rt: ailm
742 Bay Road, Queensbury, NY 12804 Inspector's Initi
NAME: I PERMIT#:
LOCATION: r INSPECT ON: C►
TYPE OF STRUCTURE: I
Y N N/A C®lY MEND\rS
raming �
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 %z (w) 16 gauge (8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall
Fire separation 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side '/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
LASueHemingw•ay\Building.Codes.Inspection.FORM S\Frarning Firestopping Inspection Report.doc January 28,2003
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