2003-673 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20030673 Date Issued: Wednesday,June 25,2008
This is to certify that work requested to be done as shown by Permit Number P20030673
has been completed.
Tax Map Number: 523400-290.014-0001.010-000-0000
Location: 6 CLEARVIEW Ln
Owner: ROBERT&JEANNETTE JENSEN III
Applicant: ROBERT&JEANNETTE JENSEN III
This structure may be occupied as a:
Deck
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner'of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
t
Y
'y;r'
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NI'12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20030673 Application Number: A20030673
Tax Map No: 523400-290-014-0001-010-000-0000
Permission is hereby granted to: RnRF,RT&JF,ANNF,TTF,.FNgF,N TTT
For property located at: 6 CLEARVIEW Ln
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 &JEANNETTE JENSEN I Deck $1,200.00
6 CLEARVIEW Ln QUEENSBURY,-NY 12804 Total Value $1,200.00
Contractor or Builder's Name/Address Electrical Inspection Agency
PAT TL YORK
309 ANCTEL Rd
CORINTH_ NY 12822-0000
Plans&Specifications
2003-673
288 sq ft DECK AS PER PLOT PLAN SPECIFICATIONS
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 26, 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 rj7 Quee s sday,August 26,2003
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 $ U
building permit. All applicants'spaces on this application must be Reviewed By:
completed and must appear on the application form.
APP licant: 11f a2 , Owner: 1i&��
Address: W►tf,�6-1- e,0 Address:
Phone#(Z�j Phone#(r78-) 2-F?- 7Y7J
Email Address: Email Address:
i
f
Person Responsible for Supervision of Work as Regards to Building Codes:
Name Address: Phone
Property Location: Lq�Number; oG. I House Number
Subdivision Name: Q Od_3 ¢ ; Tax Map Number:
Estimated Market Value of Construction W '"40 .
❑ Porc -
Deck V 2,a u ELj
❑ Dock
❑ Boathouse 4 2003
❑ Other work(describe l� 2 �� 11"t'
t
'. sBURY
Ai11D
Size of structure to be built square feet - ��G �BE
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. �J
Applicant's signature: Date:
L iSueHemingway\Building.Permit.FORMS\Porch.Porch.Permit.doc 8/13/02 revised per DH
Foundation Inspection Report
q1Office No. (5 18)761-8256 Date Inspection request received: 2, .6
Queensbury Building&Code Enforcement Arrive: —am/pn\ Depart: fir-ftIpm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: 3--�&73
LOCATION: D4>P7ECT ON: /-;
TYPE OF STRUCTURE:
Comments
Y N N/A
roo
t
ing
,
Piers
Monolithic Slab
Reinforcement in Place
The contractor is resplsibllr�
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 Darapproofing
Foundation/Waterproofing
Type of Danipproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of for wet areas under slab
Backfill Approval
Plumbing Under.Slab
PVC/Cast/Copper
Foundation Insulation Interior J Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LAS ueflerningway\Building.Codes,Inspcction.rORMS\Foundation Inspection ReporLdoe January 28,2003
' 1
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection rep eiv
Queensbury Building&.Code Enforcement Arrive: pm epart: pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's
NAME: IT#:
LOCATION: INSPECT ON: — 5<=02
TYPE OF STRUCTURE:-
—Comments
Y N N/A
otings 1 �,
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:
1.2 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC 1 Cast/Copper
Foundation Insulation Interior/Exterior
f
R-
Rough Grade 6 inch drop within 10 ft.
L\SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
r
3
T
e
Foundation Inspection Report -
Office No. (S 18)761-8256 Date Inspection request recei ed:
Queensbury Building&Code Enforcement Arrive: any/ Depa mipm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: Qn,-- PERMIT#:
LOCATION: > INSPECT ON: — D
TYPE.OF STRUCT
Comments
_------ Y IN N/A
Pi- r5 :.
4lithic Slab
Reinforcement in Place
The contractor is responsible for ti
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this puzgse on site.
Foundation/W allpour
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 rnil,poly for wet areas under slab
Backfill Approval
Plumbing Under SIab
PVC/Cast/Copper
Foundation Insulation~Interior 1 Exterior
R-
Rough Grade 6 inch drop within 10 ft.
G:\,SucHemingway\Building.C:odes.Inspection.FORMSV'oundation Inspe ion Report.doc January 28,2003
Foundation Inspection Report
Office No. (518)761-8256 Date Insp#ectionques r e' ed: 111A SOL
'3
Queensbury Building&Code Enforcement Arrive: a DepArt: apepm
742 Bay Rd.,Queensbury,NY 12804 Inspector's tial
!P73
NAME: PERfMrTr#:
LOCATION: eLMLVjojj J)'Q4Ue— INSPECT ON: I 1�10 /0-_/9:00
TYPE OF STRUCTURE:
Comments
N N/A
tings
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 Danipproofing/Waterproofing
Footing Drain Daylight or Sump,
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of 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:\SucHeniingway\Building.Codes.Inspection.FORMS\Foundation inspection Repoil.doc January 28,2003
Queensbury Building & Code Enforcement Residential R al Inspection
"a,kial Inspection
Office No. 518)761-8256 Arrive: a art: am/pm
Date inspection request received: Inspecws initials.
IT#_ <
NAME: PE T M
LOCATION: D E: -EY> 3
TYPE OF STRUCTURE:
Comments-
Yes No WA /� f/C-�'�1
47 Building Number Address visible from road ep
Chimney Height 1"B'Vent/Direct Vent Location
Fresh Air Wake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors H
Handrail 4 or more risers
Guards at stairs,decks,p!!tios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ra!Ep Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim I doors f main entrance 36 inches
Bathroom/Kitchen watertight
Safe lazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access,I N.ft:I 50 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within fine of site
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed f Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum W G sum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Built Septic System f Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C I C or C 10[TemporarA Permanent I
LABuilding&Codes FormsNBuilding&CodesXInspection FormsNResidential Final Inspection Foffn-revised-100405.doc,Revised
January 7,2008
I STORY
BRICK
BUILDING
NOW OR FORMERLY
BERNARD C & B£VERL Y ROGGE
1134120
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MAP REFERENCE
1) MAP EN777LED ICLEARNEW ESTA7FS� OWNED BY
RONALD & MARY RAVIVOR' MADE BY NORTHEAST
LAND SURVEY & LAND DEVELOPMENT CONSULTANTS,
P.C., DA7ED OCIOSE 22, 1991 AND FILED MI THE
WARREN COUNTY CLERICS OFFICE ON APRIL 13, 1992,
IN PLAT CAB. A-1, SUDE 182.
DEED REFERENCE
CHAD M RAYIVOR
70
ROBERT E. JIVSEN, N
& JEANNETTE JENSEN
DID. MAY 15, 1997
BK. 1024, PC. 130
MUTE "as AMP was PROwEv Wrpia f BMW
OF AM Up -In -DOE MEE lAVVW M ABSTRACT
AF TALE AND 6 SLOArT TO NF IFWW FACTS
MY BE REWAUD BY SAID DOCLNAV s.
.......... .
.......
N82'3339 "W 240.00'
NOW OR FORMERLY
WA YNE & SUSAN PELAK
1117/'141
TAX MAP: 54-5-6.511
LOT 1D
CLEARVIEW ESTATES
(VACANT PARCEL)
NOTES:
1) RESIRIC7IVE DEED COVENANTS SHOULD BE CAREFULLY
EXAMN ED BEFORE CONSTRUCTION TAKES PLACE ON
THIS PARCEL.
2) REFER TO MAP REFERENCE NO. 1 FOR OTHER
SUSO WSION NOTE'S AND FEATURES.
ZONING INFORMA 71ON
ZONE: SR -IA ONE ACRE MIN.
SINGLE- FAMILY D*-WNG
LOT WD IH. 150'
FRONT YARD SETBACK. • 30'
SIDE YARD SETBACK- 30' OR MORE
IW 7H A 10' MN.
REAR YARD SETBACK.- 20'
PERMEABLE AREA: 50% MIN.
BUILDING HEIGHT 40' MAX.
I HEREBY CER7IFY TO.
RO W r E. .,E/VSEN. If AND .rEANN£rTE ZNSEN,
AND M & T MORTGAGE CORPORATION, INAT
-- TN S ' WAS PREP-ARED AN_Aa7UAL _
nu rear r-Pru run a IRW Y ACCORDING TO
PALE
NM3
NYT3
u
. IRON
ROD
FOUND
(BENT)
3
POLE
NYr2
2
INOW OR FORMERL Y
MICHAEL R. do JANICE L BARDIN
9241222
LOT Q
CLEARNEW ESTA TES
TAX MAP: 54-5-6.1
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(BEN T)
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RECEIVED
`A
IRON RWN OF QUEENSBURY
FOUND _BUILDING AND CODE
NOW OR FORMERLY
JUDIIN PREIBERGER
7221155
TAX MAP.• 54-5-6.7
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NYT1
I(6
lrr IVED
I
MAP JAN t 4 2001
OF LANDS OF TOWN OF OUEENSBURY
BUAW CE
R08ER T E. JENSEN, lI
AND
JEANNETTE JENSEN
BEING LOT NO. 2, CLEARWEW EVA TES
SI7UA TED IN
TOWN OF OUEENSBURY, WARREN COUNTY, NEW YORK
SCALE: I" = 30' OCTOBER 25, 2000
SINVEYMAP BY