2003-320 TOWN OF QUEENSBURY
7423ay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF OCCUPANrA7
Permit Number: P20030320 Date Issued: Tuesday,February 22,2005
-This is to certi that work requested to be done as shown-by Permit Number
� q y
has been completed.
Tax Map Number: 523400-302-014-0002-027-000-0000
Location: 123 DIXON Rd
Owner: ROBERT&SANDRA ORGAN JR
Applicant: ROBERT&SANDRA ORGAN JR
This structure may be occupied as a:
By Order of Town Board
Commercial 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: P20030320 Application Number: A20030320
Tax Map No: 523400-302-014-0002-027-000-0000
Permission is hereby granted to: ROBFRT& SANDRA ORBAN.TR
For property located at: 123 DIXON Rd
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: ROBERT& SANDRA ORBAN JR
Commercial Alteration $10,000.00
9 HEINRICK St Total Value $10,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name Address Electrical Inspection Agency
SCOTT WEST
NY 12904-0000
Plans&Specifications
2003-320
522 SQ FT COMMERCIAL INTERIOR ALTERATION AS PER APPLICATION
$62.64 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 04,2004
(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 Tow p.4,C,Queens e June 04,2003
IQ ry, S SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury Department of Community Development,742 Bay Rd., Queensbury,NY 12804
(518)761-825-6
A permit must be obtained before beginning construction. Permit No.: ilz) 4
No inspection will be made until applicant has received a Fee Paid:valid building permit. Form must be completed. Rec.Fee Paid:
Reviewed By:
Applicant• b,Sco(� ._ Owner:
t r. �Ro be It r`Ci0.vt
Address: Address:
a3 has sr QID �l
Phone##: mot ' !g q 3 Phone#: -.) 3- to 3&`7 - ,z 8-S-0 15
Tax Map Number:
Subdivision Name:
(if applicable)
Lot Number: House Number: SIMNameOR
Property Location: 123 'B i Xy-rt R oct eA ,R AY
n New Building: Residential I Commercial TCN t� ;eLtblae of Construction:
oAddition: Residential/Commercial _'i" 1ddt i ,wha wi141 use of addition beir
teration: Residentia ommercial �;cc
a No change to
Exterior size: Residential/Commercial
u Other work: (describe )
Check Below Occupancy Info V floor sq.ft. I'd floor sq.ft. Other floor sq.ft, Total Sq.Ft.
Single Family Dwelling
Two Family Dwelling "
Townhouse
Multifamily Dwelling
#of units
Office
Mercantile
Manufacturing
1 car detached garage
2 car detached garage
3 car detached garage
1 car attached garage
2 car attached garage
3 car attached garage
Storage Bldg.,Comm.
i3
Storage Bldg.,Res.
Other
What is the proposed height of the structure: feet inches X�ST i`" t 4:, too V
Will any second-hand or ungraded lumber be used? If so,far what? NO
No.of Fireplaces to be installed: C3
No.of Woodstoves to be installed: G
List below the person(s)responsible for supervision of work in regards to Building Codes:
Name Address Phone No.
Builder tty. 5 c-o Tr u r e z a'3 B a s q 33 --) 3 - `- e V S
Plumber 1-eart LoL Pa ` _ 9 z 1 v . w �-0?9 3
-Mason
Electrician r T iC 5 T . a b to( ..
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. 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 surveyor; drawn to scale,showing actual location of all new construction.
Signature: III (eirel one: owner,owner's agent,architec contractor
Rough Plumbing /Insulation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p part: w am/pm
742 Bay Road,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Y , N N/A
PVC: R-1,R-2,R-3,R-4 Drain Vents
Cast Iron,Copper Drain/Vent Comm.
Plumbing Vent Vents in Place
Rough Plumbing/Nail Plates
Head or Air Supply Test
Dfain and Vents
5 PSI or 10 ft. above highest.
Connection for 15 minutes
Water Supply Piping
Copper Commercial
Copper,CPVC,Pex One&Two Family
Insulation/Residential Check/Commercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Pact Work Sealed Properly
COMMENTS:
,L.\SueHeming%va3ABuilding.Codes.bispection,FORMS\Rough Plumbing Insulation Report.doe January 28,2003
Rough Plumbing / Insulation Inspection Report AV14
Office No. (518)761-8256 Date Inspection request received: C,
Queensbury Building&Code Enforcement Arrive:_am/pm, Depart: a pm
742 Bay Road, Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A
PVC: R-1,R-2,R-3,R-4 Drain Vents
Cast Iron,Copper Drain/Vent Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
Head or Air Supply Test
Dfain and Vents
5 PSI or 10 ft. above highest
Connection for 15 minutes
Water Supply Piping
Copper Commercial
,Pex One &Two Family
U7777 U,03�,TR'Mfdg!i�q� eck/Commercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct Work Sealed Properly
Z
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11 IrISMA
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:L-.\SucHemingway\Building.Codes.Inspection,FORMS\Rough Plumbing Insulation Report-doe January 28,2003
r
. F amen / 2'sia,
Office No. (518) 761-8256. Date Inspection re receiv
Queensbury Building&Code Enforcement Arrive: p art: a pm
742 Bay Road, Queensbury, NY 12804 Inspector's Init' s:
NAME: PERMIT#: C
LOCATION INSPECT ON:
TYPE OF RUCTURE:
Y lv s N/A Framing COMMENTS
Jack Studs/Headers
Bracing/Bridgingl
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 Y2(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 5 t �
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 Y2 inch or 5/8 inch Type X t
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
L:\SueHemingwaylBuilding.Codes.Inspection.FORMS\FramingFirestapping Inspection Report.doc January28,2003
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC,
lain O i ce 176 Doe Run Road is Nlanhelm, PA 17545
MUNICIPAL CERTIFICATE m ELECTRICAL APPROVAL
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The conditions following governed the issuance of this certificate, and any certificate previously issued i
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cancelled;
This certificate only covers the electrical equipment and installation conditions as of date, Upon thl
introduction of additional equipment or alterations, application shall be promptly made for inspection,
Inspectors of this company shall have the privilege of maki e,tions at any time, and if it
rules are violated, the Company shall have the right to re oke this certif ate#
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