2012-537 TOWN OF QUEENSBURY
742 Bay Queensbury,NY 12804-5902 (518)761-8201
Road,Q r},
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120537 Date Issued: Thursday, November 29, 2012
This is to certify that work requested to be done as shown by Permit Number P20120537
has been completed.
Tax Map Number: 523400-226-019-0001-042-000-0000
Location: 26 FOREST Rd
Owner: DAVID WILCOX
Applicant: DAVID WILCOX
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the /1-4
�f
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 Ro:ui,(),wcnsburv,NY 1280-4-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number P20120537 Application Number., A20120537
Tax i%lap No: 523400-226-019-0001-042-000-0000
DAVIDWILCOX
For property located at; 26 FOREST Rd
in the'['own Of QUCCIISI)Utw',to construct Or pLoze
at the above location ill accordance with application together with plot flans and other information hereto filed
and ',jpPrOj7 ed and in compliance with the NYS Uniform Building(odes and the Queensbury Zoning
Ordinance, Tyl)e.of Construction Valise
Owner \ddress: DAVID WILCOX
VICTORIA ZELDIN 'I'otal Value
26 FORESTRd
LAKE GEORGE NY 12845-0000
Contractor or Builder's Name / Address Electrical Inspection Agency
(,',RANDALI- EXCAVATING
793-0431
6�3 WOODCHUCK Rd
LAKE GEORGE NY 12845-0000
plans&Specifications
2012-537
Demolition - Shed and lean-to
S,30.00 PERMIT FEE PAID -Ti-iis PERMIT EXPIRES. Thursday, November 21, 2013
(1fa longer period is required,an application for an extension must be made to the code Enforcement Officer
of thcTown of Queensbury before the expiration(Lite.)
Dated at the Town of Queensbury; Wednesday, November 21, 2012
SIGNED BY for the Town of Quccnbury.
Director of Building& Code L'Inforceinerit
PtIE
TAX MAP NO. ca.D10.19 4-1-T CT NO. ONLY fa 3 SEE PAI ✓
Permission is hereby granted to the above amed Applicant to demolish the b "ding(s)
described herein as set fort ' p.l '•• belo
/tedy /lid i► � 2012
Director of Building& odes r,ate Nov
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/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/BUILDER: David Wilcx OWNER: David Wilcox and Vicki Zeldin
ADDRESS: Lb l-orest Ka, Hssy Imo, L.� ADDRESS: 26 Forest Rd, Assv Pt., LG
PHONE NOS. 01 0-'656-3146 PHONE: 616-65x5-3i46
PERSON RESPONSIBLE FOR WORK: uranaall excavating, Inc. PHONE: 518-794-0431
LOCATION OF DEMOLITION: 26 Forest Rd, Assembly Point, Lake George, NY 12845
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? LE4,i1, TC ' - 13c bETAllX1iiu613
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES NO ✓
✓ If YES, our office needs the following information:
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 tiled with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s)will be demolished: RESIDENCE GARAGE BUSINESS
STORAGE BLDG. ✓ OTHER ✓
✓ Size of structure: 20.0 X 22.0
✓ Number of stories: 1
✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB ✓
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED ✓
✓ StrUCtUreS(S): WILL BE REPLACED WILL NOT BE REPLACED ✓
UTILITIES INFORMATION:
✓ 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 NO
Have all utilitiesbeen isc nn cted: YES ✓ NO
QUESTIONS? CALL 761-8256 OR EMAIL
/_ —( Z- codes(cDqueensbury.net
4,11°. S ATUR OF APPLICANT VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.net
ctTown of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
(„) Ed ll E3.gdc
Queensbury Building & Code Enforcement - Residential Final inspection
Office No. (518)761-8256 Arrive: am/p Depart: t -I am/p
Date Inspection request received: Inspector's Initials:
NAME: (.3 Leafy,.fI PERMIT#: /;1—53
LOCATION: ( r_ DATE: LZw1
TYPE OF STRUCTURE: ��m • L v-,rld
Comments:
Yes No N/A ,,��
4" Building Number Address visible from road 2-0/I2
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake 10 5 L.Q.-3 a
3 inch Plumbing Vent through roof minimum 18 inches /
Roof Complete/Exterior Finish Complete /
cr&tie-c-a`a
Platform at all exterior doors
Handrail 4 or more risers
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
Deck Bracing/Handicapped Ramp Compliant
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/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
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 to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade i/
Gas Furnace shut-off within 30 feet or within line of site l
_Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating > J�
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum' "Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/4 hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical;Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification, if required
Okay to issue C/C or C I 0[Temporary/Permanent j
L:1Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10, Revised 04/13/11
MAP REFERENCES
#1
MAP OF A SURVEYMADEFOR
DAVID H. WILCOX & VICTORIA T. ZELDIN
BY: VAN DUSEN & STEVES
DATED: JULY 9, 199z
#2
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BY: LESLIE W. COULTER
FILED: SEPTEMBER 5,1957
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CIRF 0 = CAPPED IRON ROD FOUND
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Town of Queensbury, Warren County, New York
8,-1-32 $,y 33 / 226a9 -1-4z & 43
LEGEND
IPF 0 = IRON PIPE FOUND
CIRF 0 = CAPPED IRON ROD FOUND
CPF 0 = COPPER PIPE FOUND
CQ� = UTILITY POLE
® = WELL
2
3/28/12
UPDATE
1
8/19/11
ADD. LOCATION/TOP(
NO.
DATE
DESCRIPTION
VERTICAL DATUM: ASSUMED
CONTOUR INTERVAL FOOT
Date: January 31, 20(
Scale 1"=20'
S-1
SHEEP 1 OF 1
Wilcox C2007
DWG. NO. 92153
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