2002-740 TOWN OF QUEENSBURY
742 Bay Road,Queensbuty,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERLITA IFIr OF COMPLIANCE ATE
Permit Number: P20020740 Date Issued: Wednesday,April 23,2003
This is to certify that work requested to be done as shown by Permit Number P20020740
has been completed.
Tax Map Number: 523400.302.017-0001-044-000-0000
Location: 42 WINTERGREEN Rd
Owner: ALBERT&JULIE CARROW
Applicant: ALBERT&JULIE CARROW
This structure may be occupied as a:
By Order of Town Board
Shed I Storage Sheds TOWN OF QVEENSBURY
Director of Building&Code Enforcement
Al TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020740 Application Number: A20020740
Tax Map No: 523400-302-017-0001-044-00.0-0000
Permission is hereby granted to: ALBERT& MIJECARROW
For property located at: 42 WINTERGREEN 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: ALBERT&JULIE CARROW Shed/Storage Sheds 650.00
42 WINTERGREEN Rd Total Value 650.00
QUEENSBURY,NY 12804
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
BP 2002-740
Construction of a 160 sq. ft. storage shed to be added onto existing garage as per plot plan and
specifications.
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,September 13,2003
(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 theSeptember 13,2002
SIGNED BY far the Town of Queensbury.
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY / /
(518)761-8256 6
A permit must be obtained before beginning construction. Permit File No. Z Z-"7 6
No inspection will be made until applicant has received a Fee Paid $ ILO. a-0
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: be r c I. (�Q r rn W Owner:_ !s�_E
Address: &L,v�ay,!yeeiv R.6 QaUpLba,y Address*.,
Phone#(^)2 3 Phone#(_) -
Email Address: Email Address:
Property Location: Lot Number: I House Number 0- /_ t1IKJh ' ee� t�
Subdivision Name: /' Tax Map Number: q j
Ii
- l �
❑ New Building: residence 1 commercial Estimated Market Value of Construction: $ (060
❑ Addition: residence/ commercial
.Q' Alteration: residen commercial If an Addition,what will use of new addition be?
❑ No change to exterior size: residence t com'1
Cl Other work(describe )
Check OccupancyInformation I"Floor 2° Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
❑ Single family dwelling
❑ Two family dwellin
❑ 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 F
❑ 3 car attached garage \�_I
❑ Storage building- iS�
commercial
m' Storage building- ( Ci ��
residential
❑ Other
What is the proposed height of the structure _feet inches G�o�
,w
Will any second-hand or ungraded lumber be used? If so,for what? NC1
Y`
Type of Heating System: electric/ oil / gas/wood /forced hot air! baseboard/othet:
Number of Fireplaces to be installed Number of Woodstoves to be installed �9va
��Ui` �✓
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder 3 ` Fsq—
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 specified or noted,and that such work is authorized by the owner. 1~urther,it is understood that Vwe 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 a new c truCtio� �� - g �
Signature: ``11 11✓ V 1� owner,owner's a en architect,contractor
Project Name: Akff r Yotat BP# , ��G._���;-'b V (o L�
.Address: a, W
�
Building Permit Submission AUG a Zooz
Sk&family dulling Tcl"?",J Q
Tuofiarnily dvelling . r~`F'
Checklist
All items below must be checked either yes,no or not applicable prior to submission of any building
permit to the Town of QueensburyBuilding Department. If any of the below items are lacking,the permit
will not be accepted until such time as the application is deemed complete for submission.
1. Building Permit Application Completed ... ... ... ... ... ... ... ... ... ... ... ... . ❑yes ❑no ❑n/a
2. Energy Form or CheckM&te Energy Code Compliance Forms Complete .. ❑yes ❑no ET�n a
3. Energy Cade Inspector's Report from CheckMate Program. ❑yes ❑no Z<a
4. Septic application completely filled out(if applicable)... ... ... ... ...... ... ... ❑yes ❑no ETn'/-a
5. Solid Fuel Burning or Gas Appliance Form... ... ... ... ... ... ... ... ... ... ... ....❑yes Ono � a
6. Electrical Inspection Form... ... ... [-]yes ❑ UF'
7. Two (2) complete sets of structural drawings... .. ...... ... ... ... ... ... ... ... ... .L yes [:]no ❑nfa
a)floor plan;b)foundation plan;c) cross sections:d) elevations;
e)window and door schedule `
8. Two (2) site plans showing location of the structure to be built....... ... ... ❑yes Ono ❑n/a
location of well or water lines,location of septic system or sewer line.
9. Setbacks from property lines to new structure ... ...... ... ...... ... ...... ... .. es ❑na ❑n/a
10. Setbacks to neighboring wells and septic systems,including onsite well.... ❑yes ❑no Ef'nla
and septic systems (if applicable)
11. DrivewayPermit... ... ... ...... ... ... ... ... ...... ... ...... ... ... ... ... ... ... ... ... ❑yes •❑no �i1a
Date:
Staff Initial.
L:\SueHemingway\Building.Permit.FORMS\Generic Chedlist.doc
Residential Final Inspection
Office No. (518)761-8256 Date,Inspection request received: A
Queensbury Building&Code Enforcement Arrive: am/pm "part: '7am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: -N
LOCATION: t DATE:
TYPE OF STRU L
Comments
Y N N/A
Chinmey Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete 4
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete V
Interior/Exterior Railins 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/replator 18"above grade
Gas Furnace shut-off within 30.ft. or within line 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
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing
Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: - / Every Bedroom:
Outside every bedroom area:
Inter Connected: / Battery backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
%hour fire door/door closer
Garage fireproofing
Duct work Scaled properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq.ft.vents
Building No./Address visible from road
Final Electrical
Site Plan [Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,'if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Tea orary C 10(Cert.Of Occupancy)
Okay to issue Permanent C 1 0(Cert. Of Occupancy)
L:\SueHenin'gway\Building.Codes.Inspectioii.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
Offwe Use
.GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:';3 6
Dept. of Community Development Request received, Gp 3 Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, NY 12804 TT,,, %)aml Notes:
ARRIVE anilpin: DEPAR pin
(518) 761-8256 Inspector's Initials
NAME; NV lid W PERMIT# -�60 L/O
LOCATION: INSPECT ON(date):
TYPE OF,S'IRUCTURE:
V
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
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 Scaled
Fire Wall 2,3,4 hour_
Firestopping_
L:\SueHemingway\Buildiiig.Codes.Inspection.FORMS\GFNERAL INSPECTION REPORTAOC
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: 1(� 1f Q 2— Meet:
Building& Code Enforcement At time:
Qu2 Bay Road p )' �p
eensbur , NY 12804 ARRIVE am/c »fa: DEPAR yyt/ m Notes:
(518) 761-8256 Inspector's Initials v
NAME: CL� -6ZJ PERMIT#
LOCATION: V "v'1 INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECKc�,Gl
N/Ai YES O COMMENTS �� A�c
ootings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible toif
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
FoundatioWDampproofmg
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/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
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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BUILDING &
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DATE-
THIS N ��� N
PROJEar SITE AT
ALL TIMES FOR
THE DURATION- OF
CONS RUCTI"ON
TO',IN Cf� ;, 1= , v?y Ey'IL.C.s'v DEPARTMENT
8�,._,d on our 1hrlited examination,
Compliance with our comments shall
not ue construed as indicating the
Plans and specifications are in hail
condlance v tth she code.
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