2001-001 TOWN OF QUEENSBURY
EENSBURY
��� Q742 BayRoad, ueensb NY 12804-5902 (518) 761-8201
�9�
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010001 - Date Issued: Tuesday, June 12, 2001
This is to certify that work requested to be done as shown by Permit Number : P20010001
has been completed.
Tax Map Number: 523400-119-000-0002-013-002-0000
Location: 10 LUPINE Ln
Owner: CYNTHIA.ALLEN
Applicant: CYNTHIA ALLEN
This structure may be occupied as a:
By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
woo 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010001 Application Number: A20010001
Tax Map No: 523400-119-000-0002-013-002-0000
Permission is hereby granted to: CYNTHIA ALLEN
For property located at: 10 LUPINE 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: CYNTHIA ALLEN Residential Addition 19,000.00
10 LUPINE Ln Total Value 19,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
BALOGH CONSTRUCTION COMMONWEALTH ELECTRICAL A(
20 JOHN STREET
PO BOX 706
OUEENSBURY,NY
HAGUE,NY
Plans & Specifications
•
2001-01
480 SQ FT RESIDENTIAL ADDITION(2 BEDROOMS) AS PER PLOT PLAN SPECIFICATIONS
$40.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,January 08,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town Que sbu dlon ' , nuary 08,2001
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
'u i la ing Permit Application
Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 [761-8256J
' BUILDING & CODE ENFORCEMENT
NOTICERequirements prior to issuance r
A permit must be obtained before
of this permit: PERMIT FILE NO.
beginning construction. No inspections PERMIT FEE PAID$
will be made until applicant has received n Zoning Board Action
a VALID BUILDING PERMIT. All Area /Use RECREATION FEE D$
applicants' spaces on this application
MUST be completed acid•the signature Planning Board Action REVIEWED BY:
of the applicant must appear on the SPR / S division /Ot r Building Inspector
,#pplication form. 7hank you.
J Recreat on ReAPlyment
Applicant: Y,•\ tie, �e,rn.��y lA, ,:
J
' Address: 10 t3 i,v\..e, 1~ P -e-tgch.n A ress:
Phone # (s l ) ''.)q3 - apL7 . Phone # ( ) -
Property Location: 10 1,-(_>I\>iv\n P \-Q , (R4.mC- - t ,/ I` `�
�� l O ?art_ Tax Map Number ec�/ `Subdivision Name: —
Section Block Tot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VA WE OF T
New Building: CONSTRUCTION: $ lx,1 0 Arl
residence / commercial
y Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: -Primary Building -
residence / commercial X Single Family Dwelling
Residence / Commercial Two Family Dwelli,n '' •
no change to exterior size Family DweI'ling - "` s .
Office 2111
Other Work (describe below) Mercantile
Oil Manufacturing TOWN��4 , UEENSBURy
AN Other _BugumG AND CODE
GROSS AREA OF PROPOSED STRUCTURE: •
1st Floor. . . ... . . . �7 g0 sq. ft. If ADDITION, what will use
of new addition be? :
2nd .Floor. . ., i . . . sq. ft. 2 /? J,/2oo/-eS
Other Flouts - sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
/� Detached Garage 1, 2 car
TOTAL FLOOR AREA: % O 0 SQ. FT. Attached Garage 1, 2 car
Private-Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
2t) FEET X FEET Other �J/, ;/ .
Foundation Type: POihseP CO1UC/zG'Th Will any second-hand or ungraded
' Number of Stories : • / lumber be used? If so, for what?
(habitable space onrly) J O
Height (grade to ridge) : /C feet TYPE OF HEATING SYSTEM:
Number of fireplaCe and/or woodstove (circle all which a. .lies)
to be installed: NUvtJt- Electric / Oil / e. ' / Wood
Forced Hot Ai. / : .seboard / Other
Person responsible for supervision of work as regards to building 5/voe f
codes is: Roger"?�- GDIr 2 0 co,e. „JS�CIS�/ 79,R-6 79i c I
Name Addresss Phone C 6.�v-STTvc7-a/U)
Builder: ��,*9- 7f' ('Cet rs % 'C?7.w
Plumber: ,\ -e' p 1\ e 1l,ev\
Mason:
Electrician: r?,v\\. C \Ae_'r.
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, an AS BUILT PLOT PLAN by
a licensed survey ; drawn to scale, showing actual location of project on premises.
H.
Signature: fi,rn�.� ' •
(owner, owner's agen architect, contractor)
r> CDC) 1 — 1
�� __ ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Comoli ance Methods: PART 5 - Acceptable Practice Method -
1&2 Family Dwellings (only)
PART 6* - Thermal Rating - Component Trade Offs
1&2 Family Dwellings; Multi-Family
Dwellings (3 stories or less)
P RT 4* Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Recuires submission of worksheets
APPLICANT' S NAME : PROPERTY LOCATION:
•
PART 5 'TEOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - L/ g 0 scuare feet
2 . T-_roe of Heat - Electric Oil 7c. Gas Other
3 . =s building mechanidaliv cooled? ) Yes No
4 . Percentage of area of windows and doors Over 17% Under 17%
5 . R-VU•ES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS ST3MITTED:
a . Roof R 3g
b . Exterior walls R
c _ Glazed areas R 2s"
d . Exterior doors R 3
e . Floors over unheated spaces R -
Edge of slat on grace (heated building) R
c . Basement/ce_=a_ wails (above grade) R /3
b . 3as ement/cell__ walls (below cr ace) R t 3
_ . Heating/cog_-ng-ducts-pipi nc in unheated space R - -
6 . Service (domestic) hot water heating device
Conforms to mini..-um efficiency per code X Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 1400 WILL NOT BE EXCEEDED
=t ' s Signature Date _ :c:e Number
INSPECTOR' S REMARKS:
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
Main Office 176 Doe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. Cert. No 7 3 414 Cut-in Card No.
Owner CWu 4 P G!/1 W /
Location ,l G-u-e L..A
Installation Consisting of /3 e 3l/29r--4 1 /64-i
Installed By Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations,application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
rules are violated,the Company shall have the right too,, e ke t .sAgp ificate.
Date...6 -It i1 / INSPECTOR
Member N.F.P.A..1.A.E.I.
TOWN OF QUEENSBURY
illilik
. f � BUILDING & CODE ENFORCEMENT
� 0 742 BAY ROAD
QUEENSBURY NY 12804
V (518) 761-8256
ARRIVE: DEPART: / e V INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPE TION REQUEST RECEIVED::
NAME C dilh,I,G, ` 1l�Vl .X DPI UN,
LOCATION /C-2 2_ (?0] � � _- 1 G.AII� �
DATE (S? -) a ) PERMIT #0 00(
TYPE OF STRUCTURE NN2)\ (21.),-----
FOOTINGS FOUNDATION BACKFILL FRAMING _
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B , T/HEIGHT
PLUMBING VENT
ROOFING
' EX RIOR FINISH
t' QQ
ECK/PORCH/STEPS ' iOi t--C.,C)
RELIEF VALVES
FURNACE/HOT WATER •PERATING
INTERIOR TRIM/PRIV•CY DOORS
FINISH FLOORS:
BATH/KITCHEN WATE"TIGHT
OTHER FLOORS SWEEP BLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILI GS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES _
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSU 01/POR C/C
(R6utoOS gL(P
_.
. .
Pqi
RESIDENTIAL,FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: /
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depart" , pt
Town of Queensbury Inspector's Initialst
742 Bay Road
Queensbury,New York 12804
NAME �) P, Qrr PERMIT r 6/ 6 0 (
LOCATION /O 1.) G). Z.......,-/ \Z DATE ('— //�(�D f
TYPE OF STRUCTURE ‘ ---e--y—\
YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof `
Roof Complete I/
Exterior Finish Complete ✓ V/t�4 (�
Interior/Exterior Railings 30"to 36" / fkl� ����-- � 11, /LGv
Exterior Handrails,balconies,landing 18 in.or more /'+
Interior Handrails stairs both sides 3 or more rise` _,��/�•�' /1
Grade 2%away from foundation ,/
8"clearance to sill plate /
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 feet or within line of site /;
Oil Furnace shut-off at entrance to furnace area v/
Furnace/Hot Water Heater operating /
Relief Valve(s)installed ,/
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36" /
Floor Finish f v/
Bathroom/Kitchen watertight ..J/ ` 33
Interior Handrails Balconies/Landing 18 in.or more 101/
Railing across window in stairwells
Smoke Detectors: /
every level ,//
every bedroom ,//
outside every bedroom V
inter connected ./
Bathroom fans /
Plumbing fixtures ✓� /
Foundation insulation
3/a hour fire door/door closer
4/
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
/
Light ventilation per room
Safety glazing 18"r o les, fro floo
Final Electrical L� IA. 0 1 6�17
Site Plan/Variance r quired
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Calif of Compliance)
/
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy)
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arriveai Depart
Inspector's Ini ' �_
NAME: � 1-S \ elv PERMIT#
LOCATION: 0 LAW()e o1- t e DATE: _
TYPE OF STRUCTURE: ci
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
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
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Hea ' Rough-In
sulation ��
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors �+ 1_, R-
Walls R- /
Ceiling R- '�✓/
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing i ,r-V) •
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier QERg..
Fire Separation 1,2, 3, hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping
, ‹,------__Qc) ,_,,
GENERAL INSPECTION REPORT G\��j ` 0
( 518 ) 761-8256 10i��f
Town of Queensbury Cl/` '/
Dept.of Community Development Date inspection request received:
Building&Code Enforcement 9,
742 Bay Rbad I `5
Queensbury,NY 12804 Arrive am/pm Depart , il m/
Inspector's Initials \ N
' PERMIT# ,- � e7 f a U f
NAME: C��� I
LOCATIO)----PAIWIY:Li'•,(\N\
/�7 )- i . _�(h f:r. DATE: L� - �`
TYPE OF STRUCTURE: i ��lr—1 \ _1- 71Y'�\
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsib a for
providing protection from eezin
for 48 hours following the acem8nt
of the concrete.
Materials for this purpose on s to
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing i ,
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plaee
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior •
Foundation Walls Exterior 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
Pe etration Sealed
F. e Wall 2, 3,4 our /�
/Firestopping ���—`-"r'
V
1 ,.1 .__DA., .
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road 5
Queensbury,NY 12804 Arrive am/pm Depart M.
Inspector's Initials '�/
NAME: \\Q'C\ PERMIT I— X
LOCATI : 1(3 DATE : L —�4 2 1
TYPE OF STRUCTURE: W\ Zr�
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respo i le for
providing protection fro freezing
for 48 hours following a plabement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour I _,
Reinforcement in Place 1
Foundation/Dampproofing
Backfill Approval. - 1
Plumbing Under Slab i
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In 1
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R •
-
Floors ; R-
Walls ; R-
Ceiling i R-
Duct work or piping in
unheated spaces \ R-
Pro r Vent, Attic Vent
i afiiing l
ack tuds/Headers ` i/z
Bracing/Bridging
oist Hangers
�� `� D��
/JackPoste4ain Beam 1✓C:ft��� ' `/hifiltration Barrier, d �'7' �'�,c��p t .
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
rce p "• , 76 4t et,we- bec6-5
ai.4 P E lip (Pc._ I 1;t� &cA<
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road `
Queensbury,NY 12804 Arrive am/pm Depart. 0 in
Inspector's Initials
NAME: tip `\Pm PERMIT#dCJC)/ -7)0 I
LOCATION: L t� Ai r\_ia DATE : �-f —JO 7eio
TYPE OF STRUM:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible fo
providing protection from freez ng
for 48 hours following the plac tent
of the concrete. 1 _
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place )
Foidation/Dampproofing fi/;
LBackfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
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 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
Firestopping
GENERAL INSPECTION REPORT( 518 ) 761-8256 v Q'
3---S2`
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804, Arrive \'cP Depart f D`•4(► '�
Inspector's Initiate
NAME.
PERMIT#
LOC ON: DATE :
TYP OF STRUCTURE: a/ei c f �y f
RECHECKejr ,�(�9 Q
N/A YE,$NO COMMENTS
Footings/Piers V
6 Mono it is 'our orm
Reinforcement in Place I," t,"/P � ��
The contractor is responsible for
providing protection fro ing
for 48 hours following e pla ment
of the concrete. / J�� 7k '71-1+C_—
Materials for this purpose n site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab i
Plumbing Vent/Vents M,1lace
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interi r R-
Foundation Walls Exteri r R-
Floors
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
Firestopping
•
Inspector's No.
Date. 19
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
(Consulting and Fire Inspection Services)
(incorporated in the states of Maryland,New York,Pennsylvania,Delaware and West Virginia)
Desiring Certification of Approval, application is made for inspection of electrical installation in the premises •
described below.On demand,applicant agrees to pay for inspection service in accord with schedule of charges,
PLEASE PRINT
Owner Type Bldg. ❑DWG E Other ......: .:.......
Occupant Building Permit No. ;..,..... If.,,
Job Location City......; State
County Twp. M/C# Swimming Pool—New❑Old
Directions to Job Site
T ,
Application For Rough Wiring ill Fixtures C. Service LI or
Work New El Additional❑ Bldg. —New❑ Old P. Ready for Inspection
APPLICANT'S
SIGNATURE , LICENSE# PERMIT P
PLEASE
PRINT NAME PHONE#
APPLICANT'S . NAME OF
ADDRESS _ UTILITY
' OFFICE TO
CITY STATE . , ZIP CODE BE NOTIFIED
ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY
AMP SERVICE
OUTLETS EQUIPMENT PUMP
SWITCHES HEAT OVEN.
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGULBASE WATER DRYER
FIXTURES HEATER
FLUORESCENT ' AIR AMP. RECEPTACLES
FIXTURES CONDITIONER ,
MERCURY VAPOR OR FRAC.H.P.
QUARTZ FIXTURES WIRING&CONTROLS FOR BURNER VENT FANS
MOTORS:M.P. 1/20 1/12 1/10 118 1/6 1/4 1/3 1/2 3/4 1 1-1/2. 2 3 5 7-1/2 10 15 20 25 30 40 50. 75 100
MARK NUMBER
OF EACH SIZE
Inspector's Comments:
DON LOVELAND
PA 00K 708
NY 12838 •
=672+l4934
OFFICE USE ONLY WORK INSPECTED REPOR- a.
NOTIFIED TED ¢ En FEE PAID
L.) O .
SERVICE DATE CON-
Date Received: TRACTOR_ TOTAL
R.W.DATE OWNER CHECK NO.
FINAL DATE OCCUPANT CHARGE
Certificate No.:
CERTIFICATE NEEDED AGENT - CASH
Date Sent: D YES 0 DUP ELEC.
LT CO.
INSPECTOR
Progress ❑ .
THIS APPLICATION EXPIRES ONE YEAR FROM DATE MAKE ALL FEES PAYABLE TO C.E.I.S.INC.
WHITE/OFFICE PINK/INSPECTOR . CANERY/OFFICER GOLD/CUSTOMER
TictmEs - i x-8.-101 ego./ -
IQ LUPUit)t.' 2.AN6
/cot
TOWN OF QUEEM[3. URY
BUILDING &
ArfLP3 *4 DEPT.„_T - --- -
BALOGH CONSTRUCTION
REVIEWED BY \ Illr'4.- " '------ FILE COPY • ' 20 JOHN STREET
QUEENSBURY, NY 12804
DATE -/ 7
TOWN OF QUEENSBURY Bll'_DING DEPARTMENT ,----
Based on our limited examination,
compliance with our comments shall
not be construed as i dicating the
plans and specificatio is are in full 5
compliance with the code.
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lifYfiCE • FOAM II\St.41,4TYJN MUST BE COVERE1)
BY A 1 ' MINUTE ThERMAL BARRIER
SMOKE DETECTORS AR REQUIRED IN BEDROOMS,
L
ADJACENT TO BEDROOM AND ON EACH FLOOR LEVE
INCLUDING CELLAR R BASEMENT. ALL SMOKE ' rim ICE
DETECTORS SHALL BE INT RCONNECTED ON AU.LEVELS. KRAFT APER INSULATION
MUST BE
COVERED ' Y NON-COMBUSTIBLE BARRIER v--;
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