2000-909 TOWN OF OUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20000909 Date Issued: Wednesday, September 19, 2001
This is to certify that work requested to be done as shown by Permit Number P20000909
has been completed.
Tax Map Number: 523400-296-010-0001-026-000-0000
Location: 42 WINCREST Dr
Owner: JOHN & COLLEEN SKINNER III
Applicant: JOHN SKINNER III
This structure may be occupied as a:
By Order of Town Board
Fireplace TOWN OF QUEENSBURY
Residential Addition
Director of Building& Code Enforcement
TOJ .OFQUE4� .
ENS N BiTRYY
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Yr ;
Community Development-.Building&Codes (518) 761-8256
BUILDING- PERMIT
Permit Number: P20000909, Application Number: A20000909
Tax Map No: 523400-066-000-0001-008-001-0000
Permission is hereby granted to: JOHN SKINNER III
For property located at: 42 WINCREST 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 (N ensbury Zoning
Ordinance. Type of Construction Value
Owner Address: JOHN SKINNER III Residential Addition 40,000.00
42 WINCREST Dr Fireplace
QUEENSBURY,NY 12804 Total Value
40,600.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
BP 2000-909; Lot 16, House No. 42 Wincrest Drive, Old Orchard Subdivision; 378 SQ. FT.
RESIDENTIAL ADDITION [FAMILY ROOM] AND FIREPLACE
$32.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,December 13,2002
(If a longer period is required, an application for an extension must be made to the code Enforcement
Officer
Dated at the Town Que bu ed December 13, 2000
/7
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
.wilding Permit Application
Town O,f Queensbury - Dept. of Community Development, 742 Bay Road, Queensbcuy,. NY 12804 [761-82561
BUILDING & . CODE ENFORCEMENT
oTjC�j Requirements prior to issuance
A permit must be obtained before Of this permit: PERMIT FILE NOr
beginning construction., No inspections pERM�7F�EI�i1 $
will be made until applicant has received Zonutg Board Action
a VALID BUILDING PERMIT. All Ara /Use NOV 2 &�j'X
applicants' spaces on this application RE EA FEE P' $
MUST be completed atd•the signature 0 Planning Board Action 7 IN OF OU UR
of the applicant must appear an the SPR / Subdivision /Other Wkling Grspector
lication form. , Recreation Fee Payment _
Applicant: ,v Owner:
Address: 28 //01JAK IAW4? . t 1"AA4011: Address:
Phone # -t2- Phone #
_9227-
Property Location: 0
Tax Map Number
Subdivision Name: Number.—
Subdivision Section Block Lot
NATURE OF PROPOSED WORK: ESTI TED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ 1fD,L�
residence / commercial
Addition to -Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial X Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
1st Floor. . . . . . . . 398 sq. ft. If ADDITION, what will useof new, addition be? :
2nd ,Floor.•. . . . . . . sq. ft. Fi��t� Q�M
Other Floors. . . . sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: 376 SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
2� X t _� r
6 x FEET X FEET Other
Foundation..Type: Rax/c Will any second-hand or ungraded
Number of Stories : oaL lumber be used? If so, for what?
(habitable space only) /tab
Height (grade to ridge) : /8 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle• all whic lies)
to be installed: / Electric / Oil Gas / Wood
Forced Hot Air / Baseboard / Other
Person res on ble for su,Pervision of work as re ards to buildin
codes is : PV&w �Lr W - 28Ai,o�L,r vc. Dv s6o�ui 128 713-61rv�
Name Pkddresss Phone
Builder: �rLw.)z/6x,-6/Ao,e4&ZLje
Plumber:
Mason: 4W S�r,rCr �/I�sr
_.Electri.c.ian:__J19 ��D,�.
DECLARA770N• 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 Uwe shall submit prior to a
Certificate of Occupancy*,or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed susve ; dr wn to scale, showing actual location of project on premises.
Signature•
(owner, owner's gent rchitect ontractor)
TOWN OF W"u"TEENSBURY
742 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
ICA
Date 1,9 Permit
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections.
Please fill out additional form if more than one appliance and/or chimney.
Applicant /_kuJ/
APPLIANCE (check appropriate boxes)
Address // , OSTOVE: E3Wood oCoal oPelletoGas
0 FIREPLACE INSERT
Zip FIREPLACE, FACTORY-BUILT:
[3 Wood 16 Gas
Phone 0 FIREPLACE, MASONRY:
[3 Wood [3 Gas
Owner [I FURNACE: [] Wood [] Gas [i Oil
Address IF NON-MASONRY APPLIANCE:
Manufacturer: ro 6,- ev
A-) zip Model:
Phone
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: 0 Block 11 Brick 0 Stone,`-...,
FLUE: 13 Tile c3 Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST "QFACTORY-BUILT:
CONFORM TO NYS FIRE PREVENTION & Manufacturer: Model:
BUILDING CODE. CONSULT AVAILABLE Listed By: Number:
TOWN OF QUEENSBURY HANDOUTS r3 Double Wall []Triple Wall
REGARDING REQUIRED INSPECTIONS. [I Insulated [3 Direct Venting
13 Chimney Liner
Cashier's Department Town of Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Refunded
Code Number Title
* 173 3389 (190) Public Safety
*233 2655 �21_0)_Minor Sales
Fee Collecte
d Fr Refunded Refunded to: fib a
Address:
Dated: Town Clerk or Deputy:
White: Applicant Green: Fire Marshal Yellow: Bldg. Dept. Pink & Goldenrod: Cashier's Dept.
Member d.F.P.A.&I.A.E.I. ECectricaf Certificate
ATLANTIC - INLA INLAND, INC. - NEW PORK
Electrical and Fire Inspection-Enforcing&Consulting Service
997 McLean Road,Cortland,NY 13045 DATE �d t' G/` C�l� CERTIFICATE NO.: C— 249639
OWNER: JGhn Skinner AS APPROVED FOR:
2 :inRcrest Dr. t�Gsi�e�cf�tE�Jr3s�at aa) e
ADDRESS:QUeemsbUg ys 13Y
26—sw.122—rec. l33—md.base fix-XXXXX
This certificate applies only to the electrical wiring and equipment listed above on the noted date. NI
ELECTRICIAN: ;, warranty is expressed or implied on this visual inspection.This certificate shall be valid for a period o
• ti Dion Inc.'-..:y � one year from the above noted date.Should the electrical system be altered in any way including,but no
�.j e �a,Z @S3 Dr. - limited to the introduction of additional electrical equipment this certificate shall become void. II
ADDRESS: addition,this certificate applies only to the occupancy use and ownership as indicated herein.Am
> r. ,;- . Glens Fa21;s, ,��! ,12�Q�?, change in the use, occupancy or ownership of the property indicated above the certificate shal
.4�Lvti
i me void.If for any reason this certificate becomes invalid due to the above mentionel
O on i n , r inspection by New York Atlantic-Inland,Inc.is necessary to validate the installation.
�4
AI-27
"1
FIRE MARSHAL
TOWN OF QUEENSBURY
QUEENSBURY, NY 12804
(518) 761-8205
FIRE MARSHAL4SPECTION REPORT
REQUESTRECEIVED 0PERMIT#OD ONAME
LOCATION
SCHEDULE INSPECTION ON
AM PM YTIME
APPROVED
N/A YES I NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
FIRE ALARM SYSTEM
FIRE SPRINKLER SYSTE
FIRE SUPPRESSION SYSTEM
HOOD INSTALLATION
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HEATING UNIT
REQUIRED SIGNAGE
CHIMNEY
WOOD STOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: OK TO THIS DATE
1.9 if Z ��t U . �$>?Ce2,
CL
LIA
INSPSURPUB INSPECTOR
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:
Building&Code Enforcement
Dept.of Community Development Arrive am�pDepart,
Town of Queensbury Inspector's Initial l
742 Bay Road
Queensbury,New York 12804 J�,` �JM
NAME PERM[T l/v !
LOCATION 11 C DATE d 1
TYPE OF STRUC
N/A YES • NO CONMENTS
Chimney Height/"3"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30' to 36'
Exterior Handrails,balconies landin 18 in.or more
Interior Handrails stairs both "des 3 o more risers
Grade 2%awayfrom foundati n
8"clearance toill plate
Gas Valve shut-off exposed/re ator 1 "above grade
Gas Furnace shut off within 30 eet or u"thin line of site
Oil Furnace shut bff at entrance o Rmqce area
Furnace/Hot Water Heater opera" g
Relief Valves)" talled
Headroom,6 ft 6 on stairs
Basement stairs,6 4 in.
Handrail exterior stairs ides ore than 3 risers.
Interior privacy/trim/doors/main en ce 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Lan " 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Cerdf.of Compliance) \l
Okay to issue temp.C/O(Certif.of Occupancy)_ � j�
Okay to issue permanent C/O(Certif.of Occupancy) EJ
�- VC)
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury / z
Dept.of Community Development Date inspection request received: I
Building&Code Enforcement_
742 Bay Road
Queensbury,NY 12804 Arrive : ��epart v m
pector's Initi
NAME: r\ PERMIT# "-
LOCATION: DATE : '1 -I-� )
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is res nsible for,
providing protection m free ing
for 48 hours followi g the pla ent
of the concrete.
Materials for this p se site
Foundation/Wallpo
Reinforcement in a e
Foundation/Damp ro fing
Backfill Approvq'
Plumbing Under/Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Hea 'ng Rought-
&kSulation 1
Foundation Walls nterior R-
Foundation Walls xterior R-
Floors R-
Walls R-
Ceiling R- qx0P�qs;) O t-s
Duct work or piping in
unheated spaces R- lo
Proper Vent,Attic Vent
Framing ,
Jack Studs/Headers_
BracingBridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestoppin
GENERAL INSPECTION REPORT
(518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road t-n
Queensbury,NY 12804 Arrive a m Depaspector's Initi s
NAME: — PERMIT#
LOCATION: Z l��jkY�T^ 5��, DATE
TYPE OF STRUCTURE: RF
RECHECK
/A S NO COMMENTS
Footings/Piers j
Monolithic Pour Fonn
Reinforcement in Place IfThe contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete. j
Materials for this purpose on site
N(
Foundation/Wallpour
Reinforcement in Place,
Foundation/Dampproofi=Place
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces '
Proper Vent,Attic Vent
Framing Ft � -
Jack Studs/Headers 02� Z�t
BracingBridging 0 OL C—"1
Joist Hangers 1 o —�6 01 ��,6iAE 1 tA;0
Jack Posts/Main Beam �L
Air Infiltration Barrier a PC?— CL 11J 1 l i�
Fire Separation 1,2, 3,hour
Penetration Sealed '4
Fire Wall 2,3,4 hour
Firestoppin
GENERAL INSPECTION REPORT
(518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road T
Queensbury,NY 12804 Arrive am/pm Depart ' m
Inspector's Initial
NAME: 11 L PERMIT
LOCATION: DATE : t `
TYPE OF STRUCtORE
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is resble for
providing protection�-Olfreezing
for 48 hours following a placement
of the concrete. I
Materials for this pu se on site
Foundation/Wallpour
Reinforceme m Plac
Foundation/Damp oo ng
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls I tenor R-
Foundation Walls terior R-
Floors R-
Walls R-
Ceiling R-
D t work or piping in
unheated spaces R-
per Vent, Attic Vent
raming
Jack Studs/Headers
Bracing/Bridging
Joist Hangers d>
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
GENERAL INSPECTION REPORT
( 518) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement `3/�
742 Bay Road ,� v
Queensbury,NY 12804 Arrive. i �ectorls
art pm
In
PERMIT
LOCATION• DATE : I =o'� 0 1
TYPE OF STRUCTURE: /
RECHE K
N/A YES
1NO COMMENTS
VFinj
s/Piersthic Pour Form'
_
Reinforcement in Plac 1.
The contractor is re nsibl for
providing protectio from zing
for 48 hours follo ng the lacement
of the concrete.
Materials for this p s n site
Foundatib allpou
Reinforcem a e
Foundation/Damppro ling
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents i Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Inte or R
Foundation Walls Ext -or R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppin