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RC-000318-2015 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 OL Community Development- Building& Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-000318-2015 Date Issued: Friday, May 27, 2016 This is to certify that work requested to be done as shown by Permit Number RC-000318-2015 has been completed. Tax Map Number: 289.14-1-6 Location: 59 FITZGERALD RD Owner: Philip Birmingham Applicant: Philip Birmingham This structure may be occupied as a: Res. Add. 1920 s.f. By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the e . 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 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518)761-8256 BUILDING PERMIT Permit Number: RC-000318-2015 t3P Tax Map No: 289.14-1.6 REVISED Permission is hereby granted to: Philip Birmingham For property located at: 59 FITZGERALD 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 Owner Name: Philip Birmingham Single Family-Addition $199,000.00 Owner Address: 42 MARGARET DR Total Value $199,000.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Kevin Maynard Construction Plans&Specifications Res.Add. 1920 s.f. $0.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 21,2017 (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 Tom of ens ; ^. -'/ 1 plond l�e15 SIGNED BY: ��'`�// /v/ r the Tom of Queensbury. Director of Building&Code Enforcement TOWN OF QUEENSBURY ;* 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20150065 Application Number: A20150065 Tax Map No: 523400-289-014-0001-006-000-0000 Permission is hereby granted to: PHILLIP& LORRAINE BIRMINGHAM For property located at: 59 FITZGERALD 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: PHILLIP& LORRAINE BIRMINGH) Septic Alteration Residential 42 MARGARET Dr Single Family Dwelling $199,000.00 QUEENSBURY,NY 12804-0000 Total Value $199,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2015-065 1920 s.f. new single family dwelling to be constructed/attached to pre-existing garage Cross Ref. SPR 62-2014 Approved 10/21/2014 $384.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,April 27, 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 Town of Queensbury; Monday,April 27,2015 SIGNED BY ✓ for the Town of Queensbury. Code Enforcement eY4) PRINCIPAL STRUCTURE APPLIC,ATLpt yf;lc Use Only *26 DATE /Z� LLS V V I ived ap ID TAX MAP ID MAK 2 6 2015 6- it No. ZO l S-OCOCj Per it Fee /ibgel vLL_\i ` TOWN OF QUEENSBURY ,� ZONING BUIL DING & CODES Rec ee �'11Gc L � �i,+cecictJp Site Plan# -_' ;„ HISTORIC SITE Yes ^ No Subdivision # Lai«CPQ P€€& SUBDIVISION NAME Lot# Woo nor TOWN BD.RESOLUTION 86-2013: $850 RECREATION FEE FOR NEW DWELLING UNITS,INCLUDING SINGLE FAMILY DWELLINGS,DUPLEXES OR TWO FAMILY DWELLINGS, MULTIPLE FAMILY DWELLINGS, APARTMENTS, CONDOMINIUMS, TOWNHOUSES, AND/OR MANUFACTURED & MODULAR HOMES, BUT NOT MOBILE HOMES. THIS IS IN ADDITION TO THE PERMIT FEE. APPLICANT M l l P OWNER (5'414 c / ,*t'//l/¢ ADDRESS `az 444-4 CAA-72ria, ADDRESS ,Jsev2 y ,,) y, � zEGr Pk 9wt/E-MAIL JEi.' 41/46I-- 4-A/9g5i.QJ PHONE/E=MA1L S /eF- 7Z7 CONTRACTOR n rE U/..v /4/4-y v, D C,,(-)5 COST OF CONSTRUCTION(ESTIMATED): $ /9f !/7T7? ADDRESS: O/d r y BUILDING ADDRESS: S/ 1"----/T2-6e4/9 iD ✓Z l� QL/4/vS . Li(II Mt./ / oL/ PHONE/E-MAIL - 6 -3ys8K€vl,U@/1 "i ii/k1,¢-y.,vtyt9A 7xticnDALcow CONTACT PERSON FOR BUILDING& CODES COMPLIANCE: PMI- 13/#141/0U1/144.144PHONE 72 9 -Ito0 TYPE OF CONSTRUCTION Check all that apply Please indicate measurements as required below New/ Addition Alteration 1$t floor sq.ft. 2"d floor sq.ft. Total sq.ft. Height Single Family n'U / 920 2-7 74 Two-Family Multi-Family (# of units ) Townhouse Business Office Retail - Mercantile Factory- Industrial Attached Garage (# of ) Other 1 Town of Queensbury Building&Codes Principal Structure Application July 2014 If commercial or industrial indicate name of business Proposed use of building or addition Source of heat (circle one) Gas Oil Proparl Solar Other Fireplace: complete a separate application for Fuel Burning Appliances & Chimneys 4/41- Are there structures not shown on plot plan? _ ND Are there easements on the property? y�fj Site Information a. Dimensions or acreage of lot v io3�G b. Is this a corner lot? NO c. Will the grade be changed as a result of construction Yes L'''7-No d. Public water or Private well E t( Y4-. e. Sewer or Private Septic SystemG Value of all work to be performed (labor or materials) $ uvv 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 NY State 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: ff/l/Lw' Ai !M1'/{SATE 3/2 372o'j 07 SIGNATURE: f: ) •yt &t DATE 3/Z j/ZOi,J— I FOR OFFICE USE ONLY Operating Permit Issued: Yes No Occupancy Type Construction Classification Assembly Occupancy Limit Special Conditions 2 Town of Queensbury Building&Codes Principal Structure Application July 2014 SEPTIC DISPOSAL PERMIT}} a ff se Only DATE 3/Z 3/i_ U/ R-oei d J MAK 2 6 2015 T: a ID TAX MAP ID 2 9• P•rmit o. OWN OF QUEENSE URFmit ee LOCATION OF INSTALLATION S / �I `TtraQDEr Is: APPLICANT I LI P 'I L`t I .C/ � PHONE/E-MAIL ADDRESS Zg n� -r tdAj A) ( I S- `f INSTALLER/BUILDER: l4 4-u LAI Y"`if s '�' GB�'S 1` /PHONE/E-MAIL ( (- —3 CIS O ADDRESS: 1--("14.1- I1-1�/U A-' ( Q �7 OWNER p TT (✓� (�` -,b I K I� Gf-4-" PHONE/E-MAIL .] I S- ?2 7 - /r)--en Address y2 Mot-ezzo .sr- 0,L- d CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PM IP 6'(4-144 1 1- PHONE 2 -7(3-0 RESIDENCE INFORMATION �!lL IP(�}HI_ Year Built #of bedrooms X Gallons per bedroom =Total Daily Flow 1980 or older Garbage grinder installed 1.Y N 1981-1991 Spa or Hot Tub installed Y )<N 1992-Present 3 PARCEL INFORMATION Topography Flat rolling Steep slope %slope Soil Nature Sand Loam Clay Other Groundwater At what depth? Bedrock/Impervious Material At what depth? Domestic Water Supply Municipal Well(if well,water supply from any septic system absorption is ft.) Percolation Test Rate: per minute per inch(test to be completed by licensed engineering/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION Tank Size gallons(minimum size 1,000 gallons,add 250 gallons to size for each garbage grinder or spa or hot tub) System Type Absorption field with#2 stone Total length ft.; Each trench x Seepage Pit with#3 stone How many: ;size Alternative System Bed or other type? Holding Tank System Total required capacity? Tank size #of tanks Notes: 1)Alarm system& associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer allow systems to be covered until such time as an As-Built plan is received & approved. The installed system must match the septic system layout on file—no exceptions. DECLARATION: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure to make a material fact or circumstance know by or on behalf of an applicant, shall be void. I have read the regulations and agree to abide by t s9 and all requj�ments of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Print Name: /-}1 L I p �✓ �1SI'-IAA I✓U 4 Date: Signature: c Date: 3M/id Town of Queensbury Building&Codes Septic Disposal Permit July 2014 Town of Queensbury Thomas R. Van Ness Highway Department Highway Superintendent 742 Bay Road, Queensbury, NY 12804 Home: (518) 745-0929 Phone: (518) 761-8211 Fax: (518)745-4466 David Duell Deputy Highway Superintendent Home: (518) 745-0938 DRIVEWAY PERMIT - Date: Applicant Name: Telephoneel0 No.: Address to Be Inspected: Return Address: q( CL6fApplicant must show exact location and width of driveway(s) to be connect : ighway by placing stakes at the specified location. The Superintendent of Highways of the Town of Queensbury has reviewed this .polication. The following action has been taken: STEP 1: ( ) Preliminary approval NEED ( ) Slight Swale lad" ( ) Deep Swale ( ) Level with the road ( ) Level with the top of the paved wing Size culvert pipe to be used (if necessary) ( ) 12" ( ) 15" ( ) 18" ( ) 24" ( ) 36" Preliminary inspection completed by: Date: Approval by Highway Supt.: (or) Deputy Supt: Upon completion please resubmit this approval permit for a final approval. STEP 2: ( ) Final Approval ( ) Rejected Date: Thomas R. Van Ness, Highway Superintendent David Duell, Deputy Highway Superintendent 7 Town of Queensbury Building&Codes Principal Structure Application July 2014 9-11 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: -3 2.51-4?QHS Queensbury Building&Code Enforcement Arrive: am/pm Depai9�m/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initia _� NAME: b V t-Y'\v PERMIT#: l —0405 LOCATION: 5°l INSPECT ON: 1-11-46,t24:115 TYPE OF STRUCTURE: J Comments N N/A P1,1\` - SO Footings Piers Monolithic Slab rReinforcement i 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building&Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 Town of Queensbury Building&Code Enforcement Office No. (518) 761-8256 C��. I Rough Plumbing I Insulation Inspection Report Inspection request received: 1A-2-01\5 Name: 1irY,gl,Ackvr1 _ Inspected on: 20 2Q.IS Location: -RcLk Arrive: ,. i . . 1 p.m. Permit No.: 1Gv—K)le S Inspector's ectors Initials: —P p irf► Type of Structure: S'l COMMENTS Ili Y/1 NA Plumbing under slab Rough Plumbing / Nail Plates Plumbing Vent/Vents in Place 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum � ? Cleanout every 100 feet/change of direction Pressure Test Dr.in /Vent A -.d 5 P_..!•r 10 ft. above highest connection for 15 minutes Pressure Test Water Supply Piping Air/Head 50 P.S.I for 15 minutes Insulation / Residential Check/ Commercial Check Window Sealing Tyvek or Similar Exterior Sealant Proper Vent, Attic Vent Door/Window Sealed (No Insulation) Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/No duct tape Blower Door Test Air Sealing Rough Plumbing/Insulation Inspection Report Ce,1� Foundation Inspection Report I Office No. (518) 761-8256 Date Inspection request received: _6-15- Queensbury Building&Code Enforcement Arrive: am/pm Depart: \ pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials NAME: 01611i�r`l (44/1 PERMIT#: 15+ 5 5G LOCATION: 1"1'1' �(old INSPECT ON: 1ro'15 TYPE OF STRUCTURE: Comments Y N N/A Footings y. Piers Monolithic Slab 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building&Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 Town of Queensbury Building&Code Enforcement � QB Office No. (518)761-8256 CJwSR, "1� Rough Plumbing I Insulation Inspection Report °` Inspection request received: 17415 Name: Si ')C,Yn Inspected on: 16- h — Location: 5 Q I ..� / P�G�r Arrive: - ©, a. I �� Permit No.: I�-065 Inspector's Initials: Type of Structure: J r J COMMENTS Y N NA Plumbing under slab Rough Plumbing /Nail Plates Plumbing Vent/Vents in Place 1 1/2 inch minimum Drain Size Washing Machine Drain 2 inch minimum Cleanout every100 feet/change of direction VENN .\/ Pressure Test Drain /Vent Air I Head (_,A 1)2—• &ig 5 P.S.I. or :o IL above highest connection for 15 minutes Pressure Test Water Supply Piping Air/ Head 50 P.S.I for 15 minutes Insulation / Residential Check/Commercial Check Window Sealing Tyvek or Similar Exterior Sealant Proper Vent, Attic Vent Door/Window Sealed (No Insulation) Duct/ Hot Water Piping Insulation If required unheated spaces Combustion Air Supply for Furnace Duct work sealed properly/ No duct tape Blower Door Test Air Sealing Rough Plumbing/Insulation Inspection Report 411 Foundation Inspection Report4'or Office No. (518) 761-8256 Date Inspection request received: 7/4,714,) f J Queensbury Building&Code Enforcement Arrive: am/pm Depart. m/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: /`.t( , Birt, ih an– PERMIT#: / C LOCATION: 5 Mre.A / INSPECT ON: 7/7/d--?ii S ed TYPE OF STRUCTURE: Comments Y_ N N/A Footings g Piers ct 0 7-3-9- 7a Monolithic Slab 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 CRe f rceme in Place ��'+ &If Footing Dowels or Keyway in place Foundation Dampproofing JEL — Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 1 Foundation Inspection Report 1_,E1___,e\ Office No. (518) 761-8256 Date Inspection reque I: -9 a--0 1.S Queensbury Building&Code Enforcement Arrive:` l_e-'-Oa ''p 'p Depart: `, I • r,pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initial . NAME: ((SI,,Prv. ke,t",— P :4 IT#: • LOCATION: �_l R-7 erg 1 INSPECT ON: & „ 01 TYPE OF STRUCTURE: *P6T:17 ak) Comments Y N N/A pkA rt., Footin k Piers n/s Monolithic Slab 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 Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\Building &Codes Forms\Building &Codes\Inspection Forms\Foundation Inspection Report.doc Last printed 12/9/2014 L Town of Queensbury Building &Code Enforcement Office No. (518) 761-8256 Septic Inspection Report Inspection request received: 6 'NS(tS Name: a f rylk yvArckwk Inspected on: (0 V3 ID; Location: ''l•C‘ C\�XG1C( Arrive: _ ori a.m./p.m. Permit No.: 15'0 , Inspector's Initials: _ /Ada Wilft Comments and/or diagram Soil Type: a /Loam/Clay Type of Water: Municipal/Well Water VAC-1C... b, 30 Waterline separation distance ft. Well separation distance ft. Other wells: ft. Well Casing Length 50'+/- Y N N/A [150'to well required if NO] Absorption Field: Total length iD ft. Length of each trench -BC . ft. Depth of trenches ft. Size of Stone ciA Seepage Pits: NumberCeR,t5rCt ' SlE— Size: x Stone Size: Piping Size Type Building to tank ��� Tank to Distribution Box � i-,er � � '0Vr" ` Distribution Box to Field/Pit Opening Sealed: N End Cap 111/ N/` , z t5 �� +��,l�1/:.4 Inlet/Outlet Pipes&Baffles Y ,/N Manholes 12"or less below grade Y_N cl-g`� [provide extension collar if Yes] Y N Location/Separations 0 t Foundation to tank ft. Foundation to absorption ft. ` � fLA-y--)Separation of Pits ft. Conforms as per Plot Plan Y N Engineer Report and As-Built Y N ETU Maintenance Contract provided Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: I[a - —_ Partial Approved .a: needs to be re-inspected, please call the Building &Codes Office :•-::: ..-i ' Septic Inspection Report Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart: k m/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: 1 i` (^,Oc PERMIT NO.: IS-6 LOCATION: ,1. ! rZd) INSPECT ON: ��VI RECHECK: Comments and/or diagram Soil Type: Sand/ Loam/ Clay Type of Water: Municipal/ Well Water Waterline separation distance ft. Well separation distance ft. nn� Other wells: ft. `� �T r vim= ... ... ._ .... Well Casing Length 50' + / - Y N N/A [150'to well required if NO] Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone V 1-c t,{.J1) � (543'0 Seepage Pits: Number A �41\ ^� Size: x ,°' v� Stone Size: Piping Size Type Building to tank Tank to Distribution Box `s r? Distribution Box to Field/ Pit l� - ► '� \� �`� � Opening Sealed: N / \ End Cap �' N / f ... Inlet/Outlet Pipes &Baffles �!Y N Manholes 12"or less below grade _Y N `-- [provide extension collar if Yes] Y N Location/ Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. 1'►� Conforms asr per Plot Plan _Y N 'I 135C"-Cl Engineer Report and As-Built �Y N V `- 01 C ETU Maintenance Contract Y_ N provided Location of System on Property: Front Rear eft Side Right Side Middle Front Middle Rear System Use Stat . PaPartial Approved Partial pproved and needs to be re-inspected, please call the Building &Codes Office Disapproved L:\Pam Whiting\2010 Buiidin Codes Forms Ins pection Forms\Septic Inspection Report_03 29 10.doc