RC-000427-2015 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000427-2015 Date Issued: Wednesday, June 15, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000427-2015
has been completed.
Tax Map Number: 290.6-1-4
Location: 1113 RIDGE RD
Owner: KENNETH CASSANT
Applicant: KENNETH CASSANT
This structure may be occupied as a: Residential Alteration 868 s.f. (attic)
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy 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 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-000427-2015 bJ3 90k'5—�kvj
Tax Map No: 290.6-1-4 REVISED
Permission is hereby granted to: KENNETH CASSANT
For property located at: 1113 RIDGE 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: KENNETH CASSANT Single Family-Alteration $12,000.00
Owner Address: 1113 Ridge RD Total Value $12,000.00
Queensbury,NY 12804
Contractor or Builder's Name I Address Electrical Inspection Agency
Plans&Specifications
Residential Alteration 868 s.f.(attic)
PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,October 2,2016
(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 ofueensb n hur 2015
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
PRINCIPAL STRUCTURE APPLICATION
Office Use Only
Received
Date:
Tax Map ID 290 .6) 1 �
d ,'tr e le"19.)30
Zone Reel e p
Historic Site Yes No SEP 3 0 201S Site
Subdivision Name divis on#
Q�C�1JJ" NSBU RI'
Project Location \3 I '� o`' '
TOWN BD. RESOLUTION 86-2013: $850 recreation fee for new dwelling units—single family,duplexes/two-family,
multiple family,apartments, condominiums,townhouses,and/or manufactured &modular homes, but not mobile
homes. This is in addition to the permit fee(s).
Applicant \K Et.) C A66 AT" Owner k4E3, CA n.-
Address n `v) Rc Address 2 2_6
B\€ oM RA)
a6ECSBovN A b c 13\
Phone/E-mail 1 � yr Phone/E-mail
\51c6.— zzZ��1Co3 5V'6--2-7.2:— 1Cn3
Contact Person for Building&Codes Compliance: ES Cc)1j&A131— Phone 2,71.-3 t(ci
TYPE OF CONSTRUCTION
,,Check all that apply New Addition Alteration 1"floor sf 2nd floor sf Total sf Height
Single Family 1.1111 • 9 Fifa __ T/
Two-Family
Multi-Family
(#of units )
Townhouse
Business Office
Retail-Mercantile
Factory-Industrial
Attached Garage
(1, 2, 3, 4+)
Other
If commercial or industrial please indicate of business
Town of Queensbury Building&Codes Principal Structure Application Revised September 2015
Proposed use of building or addition p
Source of Heat (circle one) 2 Gas Propane Solar Other
•
Fireplace: Complete a separate application for Fuel Burning
Appliances & Chimneys
Are there structures not shown on plot plan? 0
Are there easements on the property? . 0
Site Information
a. Dimensions or acreage of lot `-j 7
e
b. Is this a corner lot? tQ
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 6EQ 1lC- Z000-cile,
Value of all work to be performed (labor or materials) $ DO 0
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: (A),d10 645_54gr DATE: 94 OS-
SIGNATURE: /e DATE:
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 2015
Foundation Inspection Report
Office No. (518) 761-8256 Date Inspection r;' .-.t rete' -d:
Queensbury Building&Code Enforcement Arrive:< i . ;,•: Depart: 1,210
742 Bay Rd.,Queensb ',NY 12804 Inspector's Initials:
NAME: CAS S RMIT#: l c
LOCATION: F / L I 4 INSPECT ON: / LO_S
TYPE OF STRUCTURE:
Comments
C/--5' " l
`0- N N/A ,
Footings -0+111',-e- �*
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