2015-191 6
A TOWN OF QUEENSBURY
Fors742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20150191 Date Issued: Monday, June 15, 2015
This is to certify that work requested to be done as shown by Permit Number P20150191
has been completed.
Location: 18 DORSET P1
Tax Map Number: 523400-295-014-0002-074-000-0000
Owner: PATRICK S LAHAISE
Applicant: PATRICK S LAHAISE
This structure may be occupied as a:
Residential Alteration By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property (DJ
owner of the responsibility for compliance with Site Plan, Variance, or �d
other issues and conditions as a result of approvals by the Planning Board Director of Building& Code Enforcement
or Zoning Board of Appeals.
TOWN OF QUEENSBURY
elV$1 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150191 Application Number: A20150191
Tax Map No: 523400-295-014-0002-074-000-0000
Permission is hereby granted to: PATRICK S LAHAISE
For property located at: 18 DORSET P1
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: PATRICK S LAHAISE
KATHERINE A LAHAISE Residential Alteration
18 DORSET P1 Total Value
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2015-191
Residential Alteration 53 s.f.
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,June 08, 2016
(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 To o eens ; A
1' ' "
ne 08,2015
SIGNED BY ` for the Town of Queensbury.
Director of Building&Code Enforcement
I
PRINCIPAL STRUCTURE APPLICATION Office Use Only
11 1 Received
,S
Date: 22I IS 1 flax Map ID d95cj+I- Q-1'f
/ I ..., 7 2 ��, Permit No. '-2)1 timet l
Tax Map ID 295. /4 2 7 - Permit Fee 0 'c\ .
Zone Rest DEuZi1.- , Rec Fee -hl
OWN OF QUEENSBURY
Historic Site Yes BUILDING & CODES Site Plan# --f l 11.
Subdivision Name Lot#
Subdivision# Crotonu)044 1:11',5
TOWN BD. RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS - SINGLE
FAMILY, DUPLEXES/TWO-FAMILY, MULTIPLE FAMILY, APARTMENTS, CONDOMINIMUMS,
TOWNHOUSES,AND/OR MANUFACTURED&MODULAR HOMES,BUT NOT MOBILE HOMES. THIS
IS IN ADDITION TO THE PERMIT FEE.
Applicant ?6.-r LAkr\q, S E Owner
Address bAS£T Pt- Address
4e1Nse1 rY ttia`(
Phone/E-mail ft 7 4l' 9 17 Phone/E-mail SAO%(e-
Ada
. C�
Contact Person for Building&Codes Compliance: ,/„. umuj- (,)Phone
TYPE OF CONSTRUCTION t C� ��� � �� D O0a-
✓Check all that apply New Addition Alteration S`floor sf 2nd floor sf Total sf Height
Single Family / 5 5
Two-Family
Multi-Family
(#of units )
Townhouse
Business Office
Retail-Mercantile
Factory- Industrial
Attached Garage
(1, 2, 3, 4+)
Other
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
If commercial or industrial please indicate of business
Proposed use of building or addition
Source of Heat(circle one) Gas Oil Propane Solar Other
Fireplace: Complete a separate application for Fuel Burning
Appliances & Chimneys
Are there structures not shown on plot plan?
Are there easements on the property?
Site Information
a. Dimensions or acreage of lot
b. Is this a corner lot?
c. Will the grade be changed as a result of construction Yes No
d. Public water or Private well
e. Sewer or Private Septic System
Value of all work to be performed (labor or materials) $
DECLARATION:
1. I acknowledge no construction shall be commenced prior to issuance of a valid permit and will be completed
within a 12 month period.
2. If work is not complete by the 1 year expiration date the permit may be renewed, subject to fees and
department approval.
3. I certify that the application,plans and supporting materials are a true and complete statement/description of
the work proposed,that all work will be performed in accordance with the NYS Building Codes,local building
laws and ordinances, and in conformance with local zoning regulations
4. I acknowledge that prior to occupying the facilities proposed, I or my agents will obtain a certificate of
occupancy.
5. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: ?4r k.14%-%141S f_ DATE: S t1h ISC
/ 1
SIGNATURE: 44--
4 DATE: cl t�`J (�
For office use only
Operating Permit Issued: Yes No
Occupancy Type
Construction Classification
Assembly Occupancy Limit
Special Conditions
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
I
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
t—t O
Framing ! Firestopping Inspection Report
Inspection request received: b \ 10\ 15
Name: tJ &, Inspected on: (e 1 l''LQ,1,5
Location: 16 rc i- kAti Arrive: �.�`/1I/1,' 9
Permit No.: t � 11 Inspector's Initials: _,� _
TYPE OF STRUCTURE: U.S. _Ask- • (s1 tat/4)
Z1 ct 3
Y N N/A
1=naming COMMENTS:
Attic Access 22"x 30"minimum
Jack Studs/Headers4)61j
Truss Specification Provided
Bracing/Bridging
Joist hangers C)')-8r
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft.8 in.
Stairwells 36 in.or more
Exterior Deck Bracing
Headroom 6 ft.8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 '/z(w)16 gauge(8) 16D nails each side
Draft stopping 1,000 sq.ft.floor trusses
Anchor Bolts 6 ft.or less on center
Ice and water shield 24 inches from wall
Fire separation 1,2,3 hour
Fire wall 2,3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side 1/2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in.(H)
20 in.(W)
5.7 sf above/below grade
5.0 sf grade
Design Professional Sign-off,if required
Framing/Firestopping Inspection Report