2006-654 ..0111111fti TOWN OFQ UEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20060654 Date Issued: Friday, October 26, 2007
This is to certify that work requested to be done as shown by Permit Number P20060654
has been completed.
Tax Map Number. 523400-289-017-0001-016-000-0000
Location: 74 ASH Dr
Owner. JAMES & VALORIE POLUNCI
Applicant: JAMES & VALORIE POLUNCI
This structure maybe occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the /
property owner of the responsibility for compliance with Site Plan, °
Variance, or other issues and conditions as a result of approvals by the D:
Direc`.+ i �ui•ing&Coivr'nfment
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
43,
Community Development- Building &Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060654 Application Number. A20060654
Tax Map No: 523400-289-017-0001-016-000-0000
Permission is hereby granted to: JAMES & VALORIE POLUNCI
For property located at: 74 ASH 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: JAMES & VALORIE POLUNCI
74 ASH Dr Demolition
LAKE GEORGE, NY 12845-0000 Total Value
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2006-654
DEMOLITION OF 8 X 36 SCREENHOUSE
$20.00 PERMIT FEE PMD- THIS PERMIT EXPIRES: Saturday, September 29, 2007
(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 Towg-o eensbu .i, Friday, September 29, 2006
SIGNED BY11 for the Town of Queensbury.
Director of Building : �. ri
e orcement
TAX MAP iN /7 —/'-/(p OFFICE USE ONLY ,
PERMIT NO. — FEE PAID
Permission is hereby granted to the above named Applicant to demolish the building(s)
described herein as set forth in the Application below.
Director of Building &Codes
Date I .;
•
APPLICATION FOR DEMOLITION PERMIT:
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads I streets. Show all existing structures
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities.
APPLICANT/B 9I fY1 2S �a�U r1 C,1 OWNER: _TG,Y`(lQS l
ur'�C.1
ADDRESS: a
ADDRESS:
PHONE NOS. S ,'_ '1 * j 2'1 k
PHONE:
PERSON RESPONSIBLE FOR WORK: T
2'n PHONE:_S I 2 �� ,),,
LOCATION OF DEMOLITION:
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? U } L M •„ , —
' - C . 1 y
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES
./ IL
If YES, our office needs the following information:
NO
o Name of firm removing the asbestos:
o License number of firm:
o Indicate where the asbestos material will be disposed:
NOTE:A copy of Asbestos Removal Report must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s)will be demolished: RESIDENCE GARAGE BUSINESS
I / STORAGE BLDG. OTHER
✓ Size of structure: X_3(n f Sc-t� ig��S�
✓ Number of stories:
✓ Foundation type: FULL C,EL A CRAWL SPACE
SLAB X
✓ Foundation: WILL BEWILL NOT BE REPLACED
V Structures(s): WILL BE REPLACED WILL NOT BE REPLACED
UTILITIES INFORMATION: ( Non()
✓ Indicate utilities for this structure: GAS ELECTRIC PROPANE
PUBLIC WATER ONSITE WELL-WATER PUMP PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NOB NM
Have all utilities been disconnected: YES NO '`
Ai
7 QUESTIONS? CALL 761-8256 OR EMAIL
codes( Oueensburv.net
9..
z ?_, - -fid VISIT OUR WEBSITE FOR MORE INFORMATION
SIGNATU E OF APPLICANT www.queensburv.net
til:it.'. Town of Queensbury• Community Development Office ■ 742 Bay Road, Queensbury, NY 12804
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/pm D art: �()am/pm
Date Inspection request received: Inspector's Initials: � _
NAME: ' 0/4i1(/t c f PERMIT#: i#4^ —
LOCATION: _�h �r DATE: •-- �� ,�
TYPE OF STRUCTU : _
Comments
Yes leo N/A d2W,0 O g-x
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location �� S C 1 2L f„
Fresh Air Intake -1\VL)
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Guards at stairs, decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade �`J�(�1,�[
Interior privacy/trim/doors/main entrance 36 inches / I�
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
i)/°)(1-1°
Interior Smoke Detectors:
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Carbon Monoxide Detector
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans, if no window
Plumbing fixtures _
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum'A"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer _—
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/0 [Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised 100405.doc
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: t t akpm •-.. .%_ai. pm
Date Inspection request received: Inspector's Initial .
4-)
NAME: (: ' RMIT#: —
LOCATION: Sr DATE: ! — —�
TYPE OF STRUCTURE:
Comments
Yes No N/A
Building Number/Address visible from road
Chimney Height/"B"Vent/Direct Vent Location n�
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
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:
Carbon Monoxide Detector
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating _
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum'A"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Duct work Sealed properly N 0T-
Gas Logs in Sealed or Glass Enclosure
7/./
Final Electrical
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker t]
Site Plan /Variance required
Flood Plain Ce ica a•n,if required
Okay to issu=C/C,; C/O[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Fi spection Form revised 100405.doc
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( have seen or observed,•or believe I saw.evidence of, ,
o. ; all objects such as houses, wells, trees, fences, etc.,
i —4 (Jo shown on this document. I also represent that I have .
3_ ' personal! measured the distances set forth on the diagram
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SIGNATURE
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