2001-881 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: P20010881 Date Issued: Friday, October 08, 2004
This is to certify that work requested to be done as shown by Permit Number P20010881
has been completed.
Tax Map Number: 523400-297-006-0001-040-000-0000
Location: 18 COBBLESTONE Dr '
Owner: JOSEPH & DEBORAH LOSZYNSKI
Applicant: JOSEPH & DEBORAH LOSZYNSKI
This structure may be occupied as a:
Storage Building
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the j 4
f
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.
TOWN OF QUEENSBURY
f
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
v_ers
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010881 Application Number. A20010881
Tax Map No: 523400-297-006-0001-040-000-0000
Permission is hereby granted to: JOSEPH &DEBORAH LOSZYNSKI
For property located at: 18 COBBLESTONE Dr
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: JOSEPH &DEBORAH LOSZYNSKI Storage Building 1,500.00
18 COBBLESTONE Dr Total Value 1,500.00
QUEENSBURY,NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans &Specifications
BP 2001-881
Construction of a 192 sq. ft. storage shed as per plot plan and
specifications.
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PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,November 30, 2002
f a longe riod is required, an application for an extension must be made to the code Enforcement
Officer
Dated at the Town bu ida,, I, ember 30,2001
SIGNED BY for the Town of Queensbury.
Director of Building&Code E orcement
Building Permit Application
Town of Queensbury—Dept of Community Development, 742 :. Road, Queensbury,NY
wymirrs4tWF..„"
A permit must be obtained before beginning cor(figat12n8 200' Permit File No. , 4
No inspection will be made until applicant has received a e Paid $ J-J/i 04 /-�
valid building permit. All applicants' spac , 4l•i+{, Otill�5l�D1tec. Fee Paid $
application must be completed and must app �IQ�r}lh? ��.�� -
Reviewed B • % ' .V
application form. f
Applicant: Zms'ZP N F- LosayNs�,, Owner: SAME
Address: LES T)4 ,6.,. Address:
QtA 6-4s.-Auc.'/ Ny. zgcyt
Phone# (I) 1 '& - .S703 ' Phone# ( ) • -
Property Location: Lot Number: I g / House Number ie / �i�� zir
Subdivision Name: BUTT $2.N L l-` `-(-- Tax Map Number:. /(.. 2.6
e tr• '.t_,n1 i �n -
1F Si -IA:
❑ New Building: residence /commercial Estimated Market Value Of Construction: $ i coo•00
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ No change to exterior size: residence/com'l
ther work(describe?ii
St.Check OccupancyInformation 1st Floor , 2"d Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
❑ Single family dwelling
o Two family dwelling
o Townhouse
o Multifamily dwelling •
#of units
o Office
o Mercantile
o Manufacturing _
o 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 building-
commercial
torage buildin1� r�
/
residential p1 2 _ l q —
❑ Other
_'r i iti sz AaiJ
• What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so, for what? IV O
Type of Heating System: electric/ oil / gas/wood /forced hot air/ baseboard/other: ki A
Number of Fireplaces to be installed NI ik 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 ,MI1V.AAAEL LUIS/0S�_ C ttacik ,STPFPI n- Z 53-011 r
Plumber A IAN J�LLB• Nit i 2. q``i'
Mason NI
Electrician f k
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 I/we shall
j 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 c tructi-gn.
Signature: Q 2-4' r,owner's agent,architect,contractor
Residential Final nspection
. Office No. (518) 761-8256 Date Inspection re t cei • 16
Queensbury Building&Code Enforcement Arrive: art: • a m/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initiaitze
NAME: ljur . O5Z)n S kl P IT#: o��/"
LOCATION: /C l l�C_ ATE: 7 D/f/(]5/ ;
ciA)
TYPE OF STRUCTURE:
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @stairs,decks,patios
Guard at stairwell at 34 in. or more t
Guard at deck,porches 36 in. or more � t�A�, l"
Exterior Finish Complete C Y�
Interior/Exterior Railings 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/regulator 18"above grade
Gas Furnace shut-off within 30 ft. or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
•Low water shutoff 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 Sealed 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 Temporary C/0(Cert. Of Occupancy)
Okay to issue Permanent C/0(Cert. Of Occupancy)
L:1SueHenvngway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
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REopvED
NOV 2 8 2001
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BUILDING AND CODE
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