2004-310 -` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20040310 Date Issued: Wednesday, May 25, 2005
This is to certify that work requested-to-be done as shown by Permit Number P20040310
has been completed.
Tax Map Number 523400-308-008-0001-053-000-0000
Location: 11 BURNT HILLS Dr
Owner. RUSSELL & DARLENE PALMER
Applicant: RUSSELL & DARLENE PALMER
This structure maybe occupied as a:
Deck
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 Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040310 Application Number: A20040310
Tax Map No: 523400-308-008-0001-053-000-0000 .
Permission is hereby granted to: RTTSSF,T,T,&DART,FF,N PAT,MF.R
For property located at: 11 BURNT HILLS Pr
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: RUSSELL&DARLENE PALMER
11 BURNT HILLS Dr Deck $1,100.
Total Value $1,100. 0
00
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
' 1
Plans&Specifications _
2004-310 RUSSELL AND DARLEEN PALMER
128 SQ FT DECK
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,.May 21, 2005
(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 TowA of Queensb F ' 21, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Porch, Deck, Dock, or Boathouse Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. No Permit File No. 3 0
inspection will be made until applicant has received a valid Fee Paid $ do
building permit. All applicants'spaces on this application must be Reviewed B
completed and must appear on the
application fo y.
ts&Q2 �
Applicant: Owner:
Address: J/ 13tw ry,1 la; i I s l�h ;� Address:
GGu ee,,,s�LA-r A1AA1 y 12-- `r�
Phone#(Sl S)�1�- Phone#(_), ' ' -
Email Address: Tho c.kc y-R Z 0 6 I Email Address:'
Person Responsible for Supervision of Work as Regards to Building Codes:
Name_so—P AV-e— Address: Phone
Property Location: Lot Number: Z-!3 / House Number
Subdivision Name:_& ,,r nA. W;t�S Talc Map Number: O,'-/-s 3
Estimated Market Value of Construction: $ „ p
❑ Porch 1
Deck
❑ Dock
cv1H� 1 1 2004 .
❑ Boathouse
❑ Other work(describe
TOWN OF QUEENSBUR
SUl�.D11MG ADD.,(3®E
Size of structure to be built V8 square feet
Submit along with this application: -
1. Two plot plans drawn to scale,preferably using a survey map. Indicate proposed
structure showing setback dimensions from all property lines. Show location of
water supply and location and configuration of septic disposal area.
2. Two sets of structural-drawings.- Indicate size of posts or studs,floor-joistsi--
decking or flooring material to be used. Show how the porch or deck will be
fastened to the building. If a roof will be constructed,indicate the size of posts or
studs,roof rafter spacing and span. Indicate type of roof: sloped,flat, shed,or
other. Indicate the type of material being used for the roof.
Declaration: please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in this application,together with the plans and
specifications submitted,are a true and complete statement of all proposed work to be done on the
described premises and that`la 1 provisions of the Building Code,the Zoning Ordinance-and-all-other-laws-
pertaining to the proposed work shall be complied with,whether specified or noted,and that such work is
authorized by the owner.
Applicant's signature: Date: Jr
to 41_.
1-\SueHemingpvay\Building.Permit.FORMS\Porch.Porch.Permit.doe 8113/02 revised per DH
Residential Final Inspection
Office No. (518)761-8256 Date,Inspection request received:
Queensbuty Building&Code Enforcement Arrive: J/y am/pm Depart: am/pm
742 Bay Rd., Queensburyy,,NY 128044 Inspector's Initials: .NL
NAME: ,',(',I.j PERMIT#: o V.
LOCATION: Y r ,A DATE: S 2
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof Complete
Guard 30 in. or more @ stairs,decks, atios
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in. or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. 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
Interior privacy/trim/doors/main entrance 36 in.
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.
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
3/4 hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s . ft.-150 s .ft.vents
Building No./Address visible from road
Final Electrical .
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Flood Plain Certification,if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C/O(Cert. Of Occupancy)
-\Okay to issue Permanent C/O(Cert. Of Occupancy)
\1SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No.(518)761-8256 Arrive: ll),GJ am/pm Depart: am/pm
Date I.nspection requ(, received: _ 1 _ Inspector's Initials:
NAME: J _ G1 r' �LI'—� 1 v PERMIT#: � 1
LOCATION: �\ �_ A n �� - ) DATE:
TYPE OF STRUCTURE:
_ Comments
Y N N/A 10
Chimney Ht./"B"Vent/Direct Vent Location C41
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Com lete
Guard 30 in.or more a)stairs,decks,patios
Guard at stairwell at 34 in. or more
Guard at deck,porches 36 in, or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum '/"
Gypsum
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18" above grade
Gas Furnace shut-off within 30 ft.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 Valves installed/Heat Trap/Water Temp 110 _
Interior privacy/trim/doors/main entrance 36 in.
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
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade _
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
Attic access 30 in.x 22 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 s . ft.-150 s .ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan S,
As Built Septic System/Sewer Dept.Inspection Sticker " `
Flood Plain Certification, if required
Okay to issue C/C or C/O Temporary/Permanent 6110 Cjfsa-J C.// ?C,
L:\PamW\Building&Codes\Inspection Forms\Res. Final Inso. form 2.docLast printed 2/12/04
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REVIEWED BY
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TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on odr limited examination,
�� .() v compliance with our comment shall
,�F not a construed as indicating the
plans and specifications are.m full
compliance with the Building Codes
of Now Vnrk Qfnf-
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