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2009-315 TOVN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CE RT I F I CAT E OF COMPLIANCE Permit Number. P20090315 Date Issued: Tuesday, August 17, 2010 This is to certify that work requested to be done as shown by Permit Number P20090315 has been completed. Tax Map Number. 523400-226-012-0001-038-000-0000 Location: 325 CLEVERDALE Rd Owner. SERGAY & HOLLY SHISHIK III Applicant: SERGAY & HOLLY SHISHIK III This structure maybe occupied as a: Demolition By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the f property owner of the responsibility for compliance with Site Plan, s Variance, or other issues and conditions as a result of approvals by the Directo g& de re ent 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: P20090315 Application Number. A20090315 Tax Map No: 523400-226-012-0001-038-000-0000 Permission is hereby granted to: SERGAY & HOLLY SHISHIK III For property located at: 325 CLEVERDALE 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: SERGAY&HOLLY SHISHIK III 6 WESTMINSTER Dr Demolition GREENFIELD CENTER,NY 1283 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2009-315 DEMOLITION OF RESIDENCE $20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,August 04, 2010 (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 T Que,ru � August 04, 2009 SIGNED BY � �� ' for the Town of Queensbury. Director of Building&Code Enforcement IA��.1.2- OFFICE USE ONLY q ? T PERMIT NO. © !-J f FEE PAID_& D Permission is hereby granted to the above named Applicant to demolish the building(s) JUL U 0 2009 o described herein as set forth in the Application below. Director of Building&Codes Date TOWN OF QUEENSBURY0 BUILDING & CODES ................................................................. ......_...----- ._........ 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. C APPLICANT/BUILDER: ��e S� .5�:�� OWNER: ADDRESS: 6 `U � •:<<'te r�j`e` �'�� {f' ADDRESS: tz�3� PHONE NOS. PHONE: PERSON RESPONSIBLE FOR WORK: ` a 1 PHONE: LOCATION OF DEMOLITION: �S C\e� vc c&Q WHERE WILL DEMOLITION MATERIAL BE DISPOSED' g� ASBESTOS INFORMATION: ✓ Is there any asbestos within the building to b,: demolished? YES NO r ✓ If YES, our office needs the following informs ion: o Name of firm removing the asbestos: _ o License number of firm: o Indicate where the asbestos material 'dill be disposed: NOTE:A copy of Asbestos Removal Report must be filed with our office before demolition begins. STRUCTURE INFORMATION: ✓ Indicate which structure(s)will be demolishes RESIDENCE-& GARAGE BUSINESS_ STORAGE BLDG. OTHER ✓ Size of structure: a� X 36 ✓ Number of stories: I,S ✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB arVU N� ✓ 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 DI 101 It' lA/ATCD ^K101--r XAIrl f ..,.-...-.. .-. "'- .. ... . --'- -- 12. USE or-15, Y c R,L, R E r I C,'PIE "3�i 3 JUL 0 8 2009 I OWN OF QUEENSBURY PRINCIPAL STRUCFaR-E: BUILDING & CODES j7- A_PPL1 ' I.- F C()D 7 1 T �X, k,L V W-,f 9. AN Xx t-,a f V AL PPLIKCATION t- SUBjECT TO REVEMN' BEFORE ISSUANCE OF A' LIM PERIVIT-r, F"Of"R C01"JSTRUCTION. GI i r,,,,A N 1 T i ilf.r,r P A E,m c-sc7 A i� Sevy? 4 Dk 4sa.5, CONT At EP )P P' t 1 eA CCDDES C C)Mi PL.If��Vi 4 'S R.,-j'I V!S,;n N I N 11 NAT 7 nl IA PL EA CHECK ALL.THAT 1 10 PROJECT C, � U C3 X, 1 Mle-1 cAkflLY RETAiL, MER,(:AfvTiLE - ------------ FAC NDUSTMAL GARAGFIA, 2�) t Lif tl IF 1--t-DIVIIVIIERCIAL-OR U4C'Jt1STR I AL-11"VIA'IVIIE CDF BUSi INV'ES, ES T1 I V1 ATE CION?STRUCT 10' COST 66,ocDC) - - REPIS- N D R V0 C) T HEA rYPE? AHOV4MiANY RLACEt Q A0MVDS ESt'3I. (S ARE THERE WETLIANDDS �m t 1 -r 1-11 Q0 A M HISTORIC G- VrE? 1 I �- I . P R 0 P 0 S-E D U--E- ;fir B'U N-D!hN GD OR. A Lmj D 1 T 10, A r'�r- r I%rxc- I HEERE 1Sr,,rR1jh,--TURES NIG-1 S31,10/141N 101111 PL011F PLAN? V-k(5 ARE THERE, E-AS F-TV1[7 1h JI T CS 0 sh"11 nr FrZ 0 P E P 7-Y7 V10 1 acknowledge no construction activities shall be commenced prior to issuance of a valia, pernyrft. 1 certu fy-that th�e application, p2ns, and supporting mallefials are is IL.uc ow i UJI c-C;;;P;,- ta4 U of the iivork proposed,tbCat all vitork wid bbe performed in accordance v-l'jtb the an A j, NY State Builldinw- Cod4es, local ibuilding 'laws and Wordinc-minces, n ConforManr,e WV�A, ILI i iarF ariing edae WIH! nrior to occi wOrm 1ke T �d I oT rm, —en is vtAil obta'r, MVIS 1 aCKTmawi T-,rof)f-)S V ?V0.1 Cite f 6a vme, m w Jv i.t' I;- -9-" P 'Y y a licensed land surveyor of at! newly constructed facilities Pr or to issues-ce of a certificate of 0--Cuvancy. 1 have read and agree to 1a Zb 1 szmned D cf.�r F?v;'dmr, K 7,P',1, 8 2 dip, !7Fes-1,- QUESMONS tALL761-�2SIE OR EMAIL Duoldm- P I ,-�rSff OUR WEBSITE FOR MORE INFORMATION 7f,,nirffi Atit 0 a. VV -xW 1; scnhedi.Ale an appointrnic-Tv" ---------- --------- ------------ -------------------- This application /proposed action described Per-mission is hereby granted to the above he-rein is found to be in acc;ordance with the Akpplliaant to ereci or alter the buiidinq descdbed zoning Laws of Uie Town oil Queensbury. herem, in accordance with said'Ampmcativ-ln. DD U I L D I N G C'-'-0 D E S A P P R 0A L CATE Z011\4 RC)V A'L DATE p n ,71, For an EPA homeowner's guide: hltl=is/i4vty v. -r�r,_ ,v1n r s [trams E;orr ow^er -:i iide lr_ng cuslorf1;ze.13cf ...__....___.___..____a__a__ OFFICE USE ONLY 2 -` E TAX MAP NO. PERMIT NO. PERMIT FEE r APPROVALS: ZONING TOWN CLERK ..:__..a.._,...._.-____:____-___-.._..._s_.._ea_:..a_e.-a i_a__a.__e-_._-...-_e-.._:_.. F----------------------- APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT. A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMIT. OWNER: Q( 5���rr�' INSTALLER: ADDRESS: \,?ui-s&,`P ADDRESS: PHONE NOS.__ S I�- LI�� ���5 t PHONE NOS. LOCATION OF INSTP.LLATION- RESIDENCE NO.OF 1 YEAR BUILT X ! COMPUTATION= = TOTAL DAILY FLOW a INFORMATION: BEDROOMS 4---- __ - ----- - ---Imo- - -- ---— 1980 or older j X i 150 gallon per bedroom j = 0 GARBAGE GRINDER INSTALLED? Ab 1981-1991 ( X 130 gallon per bedroom jr = — 0 1992-present ® - X 310 gallon per bedroom _ -Q SPA OR HOT TUB INSTALLED? /VC — PARCEL INFORMATION: ✓ TOPOGRAPHY: FLAT ROLLING x STEEP SLOPE SLOPE % ✓ SOIL NATURE: SAND - LOAM_ CLAY OTHER______„ ✓ GROUNDWATER: AT WHAT DEPTH? r_� BEDROCKIIMPERVIOUS MATERIAL: AT WHAT DEPTH? ✓ DOMESTIC WATER SUPLY: MUNiCiPAL WELL _"if well:water supply frotr,any septic system absorption is:( fti w-e ✓ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH(TEST TO BE COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT) PROPOSED SYSTEM FOR NEW CONSTRUCTION. All individua:sawaae disposal systerns Enui;t be de-SI tQneu by a liuensed professional engineer or architect(unless installed in a Planning Board approved subdivision). TANK SIZE: ILc�U.__ -GALLON (MIN. SIZE IS 1,000 GAL.)Acid 250 gallons to the size of the septic tank for iM ._.. eac�ii garbage grinder, spa yr hir 1pool tub. SYSTEM TYPE: ABSORPTION FIELD(WITH NO. 2 STONE) Total length_ ft. Each trench X C SEEPAGE P!, , `. N`.1. 3 STONIE, ALTERNATIVE SYSTEM Bed or other type? E tiff vx 1�4's�van -# — S ❑HOLDING TANK SYSTEM Total required capacity?- Tank sire? Number of tanks? i'OTE. LA2ifi v .sTEN .. .f!AT Ei.i_LE CT ln 1Cl 1 v0an-1.IUlST BE!`,IS --.�rLC r I- rain r PP R.O ED E LEC-Tr'. INSPECTION AGENCY, PLEASE REVIEW LIST PROVIDED. For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Llueensbury,any permit or approval granted which:s Lased up-on or is granted in reliance upon any material misrepresentation or failure to"Hake a material fact or ..,_s';u-ic'a kno'wn h n­ , i ,S' !fit 61 an ardi%ir:n ;,.a{ tO ,.oi-; I have read the regulations with respect to this application and agree QUESTIONS? CALL 761.8256 OR EMAIL to abide by these and all requirements of the Town of Queensbury f Z1 4�m-4��M.r c'ef Sanitary Sewaas DiISMsal ordmance_ 16 301L- Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: _am/pm Depart f am/pm Date pspection requ t received: inspector's Initials: AL g ? NAME: PERMIT#: l `31 LOCATION: C DATE: TYPE OF STRUCTURE: Comments: 4" Building Number Address visible from road Y JK JEA Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches 0 ! A- -C— ®GAS Roof Complete/Exterior Finish Complete Platform at all exterior doors _ dO Handrail 4 or more risers Guards at stairs deckspatios 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 Bracin /Handicapped Ramp Compliant Grade awav from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off a sed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 Inches Bathroom/Kitchen waterti ht Safety lzin /Window in stairwells safe Pain Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery baccu : Attic access 30 inches x 22 inches x 30 inches eight in accessible area Crawl Spaces 18 inch x 24 inch access 1 .ft.-150 sq.ft.vents Bathroom Fans if no window Plumbing fixtures Foundation insulation/insulation Certification Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency Tess below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater o rati Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock underside minimum W Gypsum Basement stairs dosed rise>4 inches Gara a Floor Pitched Garage fireproofing/%hour fire door/door closer Duct work Sealed ro rl y Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc Fault Breaker in Bedrooms Flex Gas Pipe Bondin As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance regwired Flood Plain Certification,if required Okay to issue C/C or C 10 1 Temporary/Permanent LABuilding&Codes FormslBuilding&Codesunspection FormsWesidential Final Inspection Form—revised-1 00405.doc;Revised January 7,2008;Revised 6/26/08 0 M ¢ t 5• M EAD MASON L S N ro QVdZ TWGUHAR1 w a t to a 0 J cgt,0£o00S 1 � � z¢ � a a � Y �N -- 3 �' 3 �6501 6Z'2 i W U m faaod a3SOd0aa N c o � � W 0 iL � x WZ be9 ' C) O O z= W °° mom`'' a r� a L° a CD wK00 N OF N W W Zn. O t� _ tna _. W 0 SG6 a � � J I 0 �9b'bi snow 0350d0Z 't4 f l O Icr � W y W N a I ~ N C O co �£b' W W Wm?0 I 2 (A 3„0£ £Oagov p .��J t t _ 1 YJYY.9N9dRf dllf NYd SI�I19NaPlf - 0 d z O W Z 0 W O �� t1 Z Z O Z O W � W W � W t7 ~F—� Z Z R Q 0