2002-298 TOWN OF, OUEENSBURY
742 Bap Road,Queensbutq,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518)761-8256
CERDIIIIFICA" 'I"E0, MPLIANCE
Permit Number: P20020298 Date Issued: Thursday,April,25,2002
This is to certi£y that work requested to be done as shown by Permit Number P20020298
has been completed.
Tax Map Number: 523400-296-009-0001-010.000-0000
Location:. 11 SUTTON TERRACE
Owner: STEVEN&DONNA SUTTON
Applicant: SUTTON'S MARKETPLACE
This structure may be occupied as a:
By Order of Town Boatd-
Shed I Storage Sheds TOWN of QUEENSBURY
Director.of Building&Code EnIcement
Building 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. Permit File_No No inspection will be made until applicant has received a Fee Paid $ .
4
valid building permit. All applicants' spaces on this Rec.Fee Paid
application must be completed and must appear on the Reviewed By:.
application form.
Applicant• _ Owner:_
Address: Address:
Phone#( - Phone#{ )
Property Location: Lot Number: / House Number /
Subdivision Name: Tax Map Number:
❑ New Building: residence /commercial Estimated Market Value of Construction: $
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
UK Alteration: residence/tehmerc'
❑ No change to exterior size: rest om'l
❑ Other work(describe )
Check OCeupancyInformation V Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
❑ Single family dwelling
o Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units F=r,*a-P_
❑ Office t�
❑ Mercantile 3 2 t
'❑ Manufacturing
❑ _ 1 car detached garage_ --
-- ❑ 2 car detached garage at P#t_t?ONQ, AND (',ODE
❑ 3 car detached garage
❑ 1 car attached garage
,❑ 2 car attached garage
❑ car attached garage
Storage building-
commercial kk
❑ Storage building-
residential
❑ Other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so,for what?
Type of Heating System: electric/ oil t gas/wood /forced hot air f baseboard t other:
Number of Fireplaces to.be installed <''�—Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
Plumber
Mason
Electrician
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 sp elfified or noted,and that such'work is authorized by the owner. Further,it is understood that Itwe shall
su por to a ertificate of Oc. �r Certificate of Compliance being issued,as requested by the Zoning
Admimsnqutur or irector f Build' and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all n ; cons c '
Signature: owner,owner's agent,architect,contractor
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queens.bury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 ARRIVE VO am/pm: DEPART_am/pm Note,:
(518) 761-8256 Inspector's Initials,_
NAME: PERMIT#,
LOCATION: INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
;L
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
FoundationVaRpour
Reinforcement in Place
Foundation/Dampproofin
Backfill 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/1-leaders
Bracing/Bridgmig-
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppi 9
L:\SueHemingway\Building.Codes.Inspection.FORMSIGENERAT,INSPECTION REPORT.doc
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plans and specifications are in full
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