2000-549 TOWN OF +QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761 -8201
Community Development - Building & Codes (518) 761 -8256
BUIEIIIN+G PERMIT
Permit Number: P20000549 Application Number: A.20000549
Tax Map No: 523400- 125-000-0005-131 -000-0000
Permission is hereby granted to: G. TRAVIS & VALERIE WHITEHEAD
Owner of property located at: 22 BROOKSHIRE Tree
in the Town of Queensbury, to construct or place a Residential Addition
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.
Owner Address: G. TRAVIS & VALERIE WHITEHEAD
22 BROOKSHIRE Tree
QUEENSBURY, NY 12804
Contractor or Builder's Name 1 Address Electrical Inspection Agency
G. TRAVIS & VALER.IE WHrTEH
22 BROOKSHIRE Tree
QUEENSBURSi, NY 12804
Type of Construction: Residential Addition Value : $ 10,000.00
Plans & Specifications
516 SQ FT RESIDENTIAL ADDTION (GARAGE/WORKSHOP) AS PER PLOT PLAN
SPECIFICATIONS
$44.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday, August 25, 2002
(If a longer period is required, an application for an extension most be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the TownPf12vw,,ensbu rid y A gust 25, 2000
SIGNED BY for the Town of Queensbury.
Director of Building & ode En orcement
Butiain,g .Permit Application
Town of Queensbury � Drly. ofCurnntunily Development. 742 Bav Rrxul, Quo=ertsbuty, NY 128W 1761-82561
BUILDING & CODE ENFORCEMENT
NOTICE Requirements prior to issuance
A purnik must be obtairked before of this permit: PERMIT FILE NO�C '1
beginning construction. No inspections
?.eznbi Board AcMm 12EI?MIT FEG P.4t1U $
will be made anti[ applicant IurA received � $'
a 'VALID BUILDING PERIy+In All Area I Lhic RECREATION FEE IC
applicants" spy on this application
MUST be completed aad the sigrurture Q Pia ning Board" Action REVIEWED BY." r
of the applicant must appear on the SPR I Subdivimion I Other Brellefinq Imtrreelnr
Lication form. Pik wm T Recreation Fee Payment X, `
Applicant: . l ["G�- i Sy � ,. eo�� C?vuper: t-+� � J tS �. Qsti c3
Address: Z 17 r' 0 C Address: L2- 1160LS.`-^ .�
l'ltanc # { ) _�'� - ! `? Phone # { -----) �g 7 ' 5
Property Location: {
Subdivision Name: � � � lax Map Number C ice- o C
Section Block I Rrt
NATURE OF PROPOSED WORK : ESTIMATED MARKET VALUE OF THE
New Building : CONSTRUCTION , $ Id , 000
res -idence J commercial -
} ' Addition tv S ilding :
resldp commercial OCCUPANCY INFORMATION :
Alto a'Eion to Building : Primacy Building -
residence J commercial 2C Single Family Dwelling
Residence / Commercial Two Family Dwr_ llin �. e + g417' k x"
no change to exterior size Family Dwellyt14 i
Office
Other work ( describe below ) Mercantile JUL 2 6 2000
Manufacturing
. .
Other .
GROSS AREA OF PROPOSED STRUCTURE :
1st Floor . . . . . , . . sq . 1t . If ADDITION , what ! will use
2nd .Fl:oor . . .,�" . . . sq . ft . of new. addition tae ? .
G- A'R A tr F f W u 'LC S l d to P
Other FloUtB . . . . . sq . ft . --
( not unfinished cellar or basement ) ACCESSORY BUILDINGS :
Detached Garage 1 , 2 car
TOTAL FLOOR AREA * 1 5Q . FT . — Attached Garage (ID 2 car
Private-_ Storage Building
SIZE OF NEW STRUCTURE : Commercial Storage Building
-__I Ct _ FEET X ;L7'i' FEET Other
Foundation Type : g 6v4(AC. T" Will any second- hand or ungraded
Number of Stories . 1 1 lumber be used? If so , for what ? _
( habitable space or IucT vA � 17An
Height ( grade to r jr dge ) : feel: TYPE OF HEATING SYSTEM :
Number of fireplace and/ or woos3stove ( circle all which applies ) f�1Q1N �.
to be installed :_ Electric / Oil / Gas / Wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
codes is : G ro
Name Address Phone
Builder : NonaF
Plumber * Flow E
Mason : Motu i -
Electrician : ru ary
DECLr1.RAT70N.• Please sign below after you have carefully read the statentent.
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 withorircd by Elie owner. Further, it is understood that I/we shall submit prior to a
Certificate of Occupancy or Certificate of Compliance being, issued , an AS BUILT' PLOT PLAN by
a licensed surveyor; drawn tro�scca'le. showing actual location of project on premises.
Signature: ..-c- , � "�"(owner, owner's owner's agent, arc aitect, contractor)
RESII3ENTIAL FINAL INSPECTION REPORT
Office Nm (3I8) 761-8236 Date inspection request recei
ffi ved:
Building & Code Enforcement
Dept. of Community Development Arr'iveG IDepa
Tow �M ectox'
n of Queenshury s Ini ' s
742 Bay Road
Queeansbury, New York 12804 PFJUVftT #
NA11" DA TEt—
LOCATION
TYPE OF S'TR
N/A YES NO coNDAE `7T'S
Chimney RerghtrWB Vent0irect Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 3Q" 36"
Exterior Handrails, balconies, $ in. or more- .-
Interior Handrails stairs both m 3 more risers
Ca-ade 2% away from f0mA-AU
W, clearance to sill plate
Gas Valve shut-off exposedl ator 8" above grade_
Gas Furnace shut-off`Within 30 f t or thin line of site
Oil Furnace shut-off at entrance t area
Furnacie iot water Heater opera
Relief Valvc(s) i ad
Headroom, 6 ft. 6 ' on stairs
Basement stairs, 6 ft. in,
Handrail exterior stairs bo ssde more than 3 risers
Interior privacy/trirnldoorsfmain m ntrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Iandrails Bal 1 S in. or more
Railing across window in lls
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Pluanbuag fixtures
Foundation insulation
3/4 hour fire dooridoor closer
Garage fareproafin
Garage penetrations sealed
Furnace in separate room prOWZted (in garage)
Light ventilation per rcaonra
Safety glazing Is" or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required —
Okay to issue CIC (Certif. of Compliance) _
Okay to issue temp. C/O (Certif. of Occupancy).
Okay to issue permanent CIO (Certif. of 00cupsacy)
RESIDENTIAL FINAL INSPECTION REPORT
Office Nm (518) 761-8256 Date inspection request received:
Building & Code Enforcement
Dept. of Community Development Arrive = Depx
Town of Queensbury s
742 Bay Road
Queensbury. New York 12804
NAME F P
LOCATION DATE +
TYPE OF STRUCTURE,
NIA YES NO COMMENTS
Chimney HeightrD" VenMY: rest Vent Location
Fresh Air intake
Plumb *Dent through f
Roof Complete �]
.Exterior Finish Comple t �1t xj 1r tJ t v-% !1 �—
Interior/Extenor Rail' 3[I" tv d." �r
Exterior Handrails, bal 'es, land' I$ in. ar more _ �'7 O �-
Interior Handrails stairs sides 3 more risers
Grade 2% away from to tiaa►
S" clearance to sill plate
Gas Valve shut--off expo tar III^ above grade
Gas Furnace shut-off w' 30 or within line of site
Oil Furnace shut-off at en ce to furnace area
FmnaccMot Water
Relief V installed
Headroom, 6 ft. 6 in. on sta'
Hw;ernent stairs, 6 ft. 4 in.
Handrail exterior stairs both si more than 3 risers
Interior privacy/txim/doors/ entrance 36„
Floor Finish
Bat3room/kituhen watertight
Interior Handrails BalconicsfLandAg IS in, or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
f
Plumbing fixtures
Foundation insulation
3/4 how fire door/door closer.
Garage frrepmofm
Garage penetrations sealed
Furnace in separate room protected (in garage)
Light ventilation per room
Safety glazing M% or less from floor
Final Electrical
Site Plan Variance required
Final Survey Plat Plan
As Built Septic System layout required
Okay to issue CIC (Certif. of Compliance)
Okay to issue temp. C/O (Certif. of Occupancy)_
Okay to issue permanent CIO (Certif. of Ocxarpancy)
COMMONWEALTH ELEC'CRICAL INSPECTION sERVICE, INC.
Main Office 176 Doe Run Road - Manhettn, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAI
Panel Board No,....... -�.'Cert. Na 70146 Cut-in Card No. ......_.............,,,. .
C7wner.-.... /Z f} .. . ..... f r y��.-��......
............................«...,_...............t�..r.............
...�...................
Location Ifo?�� T ...?�...
nInstallation Consisti . _.
.. f.....L"...... °
_..... ......
j . ....................,.....,..
...... ......................... ...p =. ..........,................._......�.............._........
Installed B �tI?f[- Lic. No. .........�........................................
y........................»>............,........,...._.........-......._......._ ....,... .
The wnditions following governed the issuance of this ccFtiticatc, and any certificate praviousiv 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 he promptly made for inspection,
tnspectors of this Company shall have the privilege of makin = spections at any time. and if its
rules are violated, the Company shall have the right ua revoke ti jl'1cat I
Date. . INSPECTOR .. ............... ........, ............
....., member N,F.P.A., . .
LA . -
ENEI2AL INSPEACTION REPQRT
( 5I8 ) 761 - 8255
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road F
Queensbury, NBC 12804 Arrive � ��DePa initial
NAME:
` PERMIT #
LOCATION: BATE
'TYPE OF STRUCTURE:
RECHL;CK.
N/A NO COMMENTS
F�tjngs/Piers�
Monolithic Pour Form -.
Reinforoeunent in Place
The contractor is responsible r
providing protection from ing
for 48 hours following the p n
of the concrete.
Materials for this purpose on site
FoundationlWallpour.
Reinforcement in Place
F4tirldatliDrU��ampl�'a
Buckfiill Approval
plumbing Under Slab
Plumbing VentlVents in Place
Rough Plumbi
Heating Rough-In
Insulation
Foundation Walls Interior -
Foundation Walls Exterior
Floors R-
Walls R
Ceiling R
Duct work or piping in
spaces
r Vent, Attic Vent
Jack Studs/Headers _ 01,
BraJoist Hangers ing Pic c ded �c .�� u Ls�S� '_ PSP,t-e
Joist Bangers
Jack PostsfMain Beam
Air Infiltration Harrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 21 3, 4
Firestoppin + ,ti
�.
prk'ko �`7 Cam' . '
V
GENERAL L06XEUCTFON REP T
( 518 ) 7sz - 8256
Dawn of QueCommunity
mshary J rc7 J +3�
Dept. of Cammumity Development Date inspection request received: i DT�r..
Building & Code Emfarcement
742 Bay Road n ,-2r >
Queensbury, NY 12804 Arrive am/pnr Dep am/prn
LOW, Inspector's Initials
NAME: PERMIT 0 c z' iC? - �j
LOCATION: DATE
TYPE OF STRUCTURE:
RECHECK
NIA. YES NO COMWNTS
Footings/Piers ��
Monolithic Pour Form.
Reinforcement in Place
The contractor is responsible r
providing protection from ing
for 48 hours following the meat
of the concrete.
Materials for this purpose on site,
Foundatiou/LtJ'alipour
Reinforcement in ace
tionfl7am
III Approval
Plumbing Under Slab
Plumbing VentlVents in Place
Rough P7umbin
Heating Rough4n
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
Fraarni
Jack StruliSlHsaders
Bracing/Bridgin
Joist Hangers
Jack PostsJMam Beam
Air Infiltration Barrier
Fire Separation I, 2, 3, hour
Penetration Sealed
Fire Wall- 2, 3, 4 hour.
Firestoppin
GENERAL INSPECTION IMPORT
c�l
{ 51 $ ) 76 � —$ 256
Town of Queensberry
Dept. of Community Development Date inspection request received:
.Building & Code Enforcement
742 Say Road 00./
Queensberry, NY 12804 Arrive en Depart
Inspector's Ini
NAME: k. PERMIT
LOCA71 DATE : (�
TYPE OF STRUCTURE:
RECHECK
Iv%A S v COMMENTS
\OF�a ers I ►L Q ' c
Mono€ithic Pour Farm
Reutforcemern in Place
The contractor is responsible for ti
providing protection from freezing
for 48 hours following the placement
of the concrete. .. - €- ' '�` dt� �►;
Materials for this purpose an site
Foundation/Wallpotra
Reinforcement in Plaice 4' --
FoundationA 3ampproofiin
Backfill Approval Y
Plumbing Under Slab
Plumbing VentfVents in Place _
Rough Plumbing,
Heating Rough-In
Insulation `s Lj
Foundation Walls interior R-
Foundation Walls Exterior R.-
Floors R.-
Walls R-
Ceiling R- -- �7 1 1�---t,� C' l�Duct work or piping in t
unheated spaces R-
ProlpEr Vent, Attic Vent
Franui
Jack Studs(Fle tiers
Bracing/Bridging,
Joist Hangers
Jack Porsts/Mwn Beam
Air Infiltration Barrier
Fire Separation 1, 29 3, hour
Penctration Sealed
Fire Wall 2. 31 4 hour
Firestoppin
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