2003-028 ,�■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: P20030028 Application Number:, A20030028
Tax Map No: 523400-296-017-0001-050-000-0000
Permission is hereby granted to: CHARLES F. MOORE
For property located at: 880 STATE ROUTE 9
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: CHARLES E. MOORE
30 GARRISON Rd Residential Addition $5,000.00
Total Value $5,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2003-028
200 SQ FT RESIDENTIAL ADDITION(ATTACHED STORAGE SHED)AS PER PLOT PLAN
SPECIFICATIONS
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,April 21,2004
(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 ri of; Bens o _ --April 21,2003
SIGNED BY �d for the Town of Queensbury.
Director of Building&Code Enforcement
r/
Building Permit Application
Town of Queensbury Department of Community Development, 742 Bay Rd., Queensbury,NY 12804
(518)761-8256
A permit must be obtained before beginning construction. Permit No.: r
No inspection will be made until applicant has received a Fee Paid:
valid building permit. Form must be completed. Rec.Fee Paid:
Reviewed By:
fo
Applicant:
/-
PP (� 4 J [._C. Owner: tf✓�' lao/�
Address: Address:
Phone#: #:
Phone�� ► O�dv
_ 4� -3�8� E10/E�
Tax Map Number;
Subdivision Name:
FEB 0 3 2003
(if applicable) TO_i�iV�O�F QUEENSBURY
Lot N imh r• !O /Nntyce_Numher / CtrPeLNa>��LVIa�L�'�t�s�_1_L 1t1 G AND 0E
OTHER TERMS AND CONDITIONS
�p,sert atn'otljer tenns or conditions below.)
' 1usha & Sons , LLC shall remove and dispose of the storage shed connected
� .,Fhe house at #10 Montray Road Queensbury, NY which borders the Queensbury
epot construction site. •In addition, Galusha & Sons , LLC shall furnish
new Storage shed approximately 1`21611 X 16 ' with gable roof to match the
:istilag building, sided with cedar shingles , 1 " X 4" corner boards and one
[try toor swinging in and two windows . The building will be placed on a
increte pad to grade. Galusha & Sons ,' LLC will also furnish and install a
w septic system at the same address including any inspection fees necessary.
lusha & Sons , LLC will install 64 linear• feet of stockade fence replacing
e existing fence . Upon completion of the. work, Galusha & Sons , LLC will
ovide and place topsoil and seeding to any areas disturbed by their work,
lusha & Sons, LLC will be responsible for and shall obtain all permits
quired by the Town of Queensbury, Warren County and New York State to be in
tal compliance with all applicable zoning regulations and building codes
plicable to this project . Upon completion, Galusha & Sons , LLC shall deliver
Charles E. Moore written proof that this project is completed in accordance
th Town of Queensbury, Warren County and New York State zoning statutes and
ilding codes .
This Agreement entered into as of the day and year first written above. ECE I VE D
rljrequired br law.insert cancellation perioil disclostu•es or otber rranri»•r;statements above tlu•signatures.l
F E B 012003
TOWN OF QUEENSBURY
BUILDING AND CODE
O\C NFR CONTRACTOR
rSrq»ctttu'el (Siquutrrrc'1
Charles F _ Moore — (lwnar Matthew Ga l usha — Member
rl'rituetl tur»tr.title ctnrl ttdches.;1 tl'rtrnrrl»ante. fit/L.elite/adth.c. J
30 Garrison Road Galusha & Sons, T•T,C'
i v 1lvonnc
ine proposes worx snail De compiiea with, wneuinr spc(.;iiinu ui iiuwu, Tutu uiaL ouvn wvaa as auuavitz,r%A v.7
the owner. Further, it is understood that Uwe 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 su eyor; drawn to scale, showing actual location of all new construction.
Signature; '(1dT1� ���.�'t'�i <i S J (circle one: owner,owner's agent, architectrontractor)
�
Project Name: //t'�" BP# j�?j C
Address:
Building Pa�ta�inission RECEIVED
-f y ��
Tuafarraly dwelling
Checklist F E B 0 3 2003
TOWN OF QUEENSBURY
All items below must be checked either yes,no or not applicable prior to subA 1 1 -ANTE
permit to the Town of QueensburyBuilding Department. If any of the below items are lacking,the permit
will not be accepted until such time as the application is deemed complete for submission.
1. Building Permit Application Completed ... ... ... ... ... ... ... ... ... ... ... ... . Hyes ❑ no ❑n/a
2. Energy Form or CheckMate Energy Code Compliance Forms Complete .. ❑ yes ❑no Eg /a
3. Energy Code Inspector's Report from CheckMate Program.. ... ... ... ... .. ❑ yes ❑ no [-n/a
4. ptic p ao y f� e t pEca ... ... .. ... .. .. ... s ❑no
5. Solid Fuel Burning or Gas Appliance Form... ... ... . [--]yes
6. Electrical Inspection Form... ... ... ❑ye ❑
7.J Two (2) complete sets of structural drawings... .. ... ... ... ... ... ..: S... ... ... ... . E Ono ❑n/a
a) floor plan;b) foundation plan;c) cross sections:d) elevations;
e) window and door schedule '
�81 Two (2) site plans showing location of the structure to be built. ... ... ... ... E:Ks ❑no ❑n/a
location of well_or-water--lines location of septic system or sewer line.
etbacks from property lines to new structure ... ... .. . ... . .. ... ... .. —
10. Setbacks to neighborin we c systems,including onsite well... . ❑no ❑n/a
an s sys ems TF applicable)
11. DrivewayPermit... ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ❑yes ❑no E� a
Date: b 3
l
Staff Initial: ac
LASueHenun,,,y B ddin.�.Pennit.FOR\,IS\Geucric ClteckL-t.doc
Residential Final Inspection ter_ &4 4"( `?6r O'IGI
Office No. (518)761-8256 Date Inspection request�eceivO z `)
Queensbury Building&c Code Enforcement Arrive: am/p� depa�'-4. a p5/`
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initiaks: -i' - '— `
NAME: �1,' V , P11:RNIIT
LOCATION: �-,c ,� DATE:
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof 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
Grade away from foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
8 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 Valve(s)installed
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: r
Inter Connected: / Battery backup: j
Bathroom Fans,if no window
Carbon Monoxide detector �r j
Plumbing fixtures
Foundation insulation i \�
Floor truss,draft stopping finished basement 1,000 sf %
Emergency egress below grade
Basement stairs closed rise>4 inches
%hour fire door/door closer
Garage fireproofing '
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area 3'
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 Plana Certification,if required Al
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C/O(Cert. Of Occiz ancy)
Okay to issue Permanent C/O(Cert. Of Occupancy)
L:1SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection requesj eceivev., 1 I S
Queensbury Building&Code Enforcement Arrive: ;TE
p rt: am/pm
742 Bay Rd., Queensb'ury,NY 12804 Inspector's Initit r d
NAME: C�KCG-�LFi� v !`�' T M 3—
LOCATION: : p ry
TYPE OF STRUCTURE:
X 1!T N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof 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
Grade awa from foundation 6 in. with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate V
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 e0 -Cp A irk
Fumace/Hot Water Heater operating
Y�
Low water shut-off boiler
Relief Valves installed
Interior privacy/trim/doors/main entrance 36 in. \>N-\ CNNo� �
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:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss, draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
'/4 hour fire door/door closer
Gara e fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 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(Cert. Of Compliance)
Okay to issue Temporary C/O Cert. Of Occupancy)
Okay to issue Permanent C/O(Cert. Of Occupancy)
L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doe edited January 28,2003
Foundation Inspection Report c
Office No. (518) 761-8256 Date Inspection reque rec
Queensbury Building&Code Enforcement Arrive: a m Depart:
742 Bay Rd., Queensbuiy,NY 12804 Inspector's Initia :
NAME: �-hnrLun `' RMIT#:
LOCATION: SPECT ON:
TYPE OF STRUCTURE:
Coents
Y N N/A
Footings
Piers
olithic Slab
'Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement '
of the concrete. SEP 12 LUUJ
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofmg/Waterproofing
Footing Drain Daylight or Sump.
Footing Drain Stone:
1.2 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.
L:\SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Reporkdoc January 28,2003
V\/\ it
Foundation Inspection Report
Office No. (51S) 761-8256 Date Inspection rERMI
Queensbury Building&Code Enforcement * Arrive: Depart:
742 Bay Rd., Queensbury,NY 12804 Inspector's Initi
�, D 3- 0;0
NAME: `�
LOCATION: INSPECT ON:
TYPE OF STRUCTURE: `J
Comments
Y N N/A
Footings
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
a
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width t"J�j
6 inches above footing
6 ' poly for wet areas under slab
cicfill Approval ill'
Plumbing Under Slab L.
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft. {
LASueHemingway\Building.Codes,Inspection.FORMS\Foundation Inspection Report.doc January 28,2003 7,
`' / �X
1
Foundation Inspection Report
Office No. (51-8)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm� Depart: m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initial
NAME: aw e � PERMIT#: 0 �®�
LOCATION: 4 SECT ON: 6
TYPE OF STRUCTURE:
Comments
Y N /A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for t`
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
Bacicfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASueHemingway\Building.Codes,Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
PTOW114 O QUEENS URY ~��1EyTU
BUILDING & DF1=Frr
REVIEWED BY <
DATE tJ�`
M a OF MEENSBURY BUILDING DEPARTMENT
1a d on our limited exaninakn,
C.;)mpiiai it C v�0;'�cr;1; ro!nmerrts shall —
Writ be construed as indicating the 72
pans and specifications are in full
ccmp,;ance vAtn the code.
aoo�.��iw��► ,
► � 1
►t T,
TO
G-'�'CIfTL f W T1..G
iFROt-l*.I)IJAYNE- DAIGLE GEt4ERAL CONTRACT FAX No. :51EG-6421834 Jan. 31 2:1003 01:00Pt•1 P2
i
oti� ij!/0 �.1
� __,� ± �d: tea.. '" • � r-
17
3
Li
F
""L f Y''• — � � �'' \� Cam..
r
• _ .. � . . � � 'moo
G
+ -
Pit, w
FROM :DWAYNE DAIGLE GENERAL CONTRACT FA;; NO. :518G-G421834 Jan. 31 2003 01:00PM P3
C"i 7
- � 1 3 � F
1l
' X
C..
! 't
i
,A
�a
R
ii
Glob'NoII/
M � M
i rvvyrvow
MMS�
spas
'71rd=5 -M9 0001
)ro ;Ky3N-3,Z
Aid 4 u
S' aw s
i
� N �
Lo CODsl O Z N
N W Q
LIj M vZ
lON7z =4
0 C13 1-eA >11" C)14 D
0 8.30 2Z ' Q0 E
ul
v
w
z
SEr45Ac� LINE-- -
' `9
C-D
00 202.10
0