2001-709 TOWN OF QUE E NSBURY
Fm 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20010709 Date Issued: Friday, May 31, 2002
This is to certify that work requested to be done as shown by Permit Number P20010709
has been completed.
Tax Map Number. 523400-279-018-0001-012-000-0000
Location: 1200 RIDGE Rd
Owner. JACKLYN BARRETT SHUTTS LE
Applicant JACKLYN BARRETT SHUTTS LE
This structure may be occupied as a:
By Order of Town Board
Carport TOWN OF QUEENSBURY
Director of Buil & e 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: P20010709 Application Number: A20010709
Tax Map No: 523400-279-018-0001-012-000-0000
Peiiuussion is hereby granted to: JACKLYN BARRETT SHUTTS LE
For property located at: 1200 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 Value
Owner Address: JACKLYN BARRETT SHUTTS LE Carport 1,500.00
JACKLYN BARRETT SHUTTS Total Value 1,500.00
GLENN SHUTTS
1200 RIDGE Rd
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
BALCKE, TAD
36 SHERRILL St
LAKE GEORGE,NY 12845
Plans &Specifications
2001-709
260 sq ft CARPORT AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday, September 25,2002
(If a bnger 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 own of Q eensbury; Tuesday, September 25,2001
SIGNED B for the Town of Queensbury.
Director of B g ode Enforcement
1111 Building Permit Application
Town of Quccnsbury—Dept of-Community Development, 742 Bay Road, Quecnsbury,NY
(518) 76l 825G 1,(J10 09 C i!I VED
%A permit must be obtained before beginning construction. Permit File N • ) 2001 'A
No inspection will be made until applicant has received a Fee Paid $ ��:�
valid building permit. All applicants' spaces on this Rec. Fee Paid OUVA10
application must be completed and must appear on the Qhl L- SBUR
l P P appear Reviewed By: " C rD CODE
application form.
R
Applicant: 191(✓1 �' Stf4— fs_—_ Owner: VYI IP°
/�Address: j2 (Z�de iZcl (y/�cer�J&Ay Address: u `
1 z46y
Phone# ( S(1) 151-S‘a Phone# (_) -
Property Location: Lot Number: / House Number I2W/
Subdivision Name: Tax Map Number:
o New Building: residence /commercial Estimated Market Value of Construction: $ __
Addition: !csidence - onunercial
If an ►Addition, what will use of new addition be?
o Alteration: residence/ commercial ork._
❑ No change to exterior size: residence/com'I S Z1 .
❑ Other work(describe )
Check Occupancylnformation I" Floor — 2I'd Floor Other floor Total
Below sq. ft. sq. ft. sq. ft. Square Feet
o Single family dwelling
o Two family dwelling
o Townhouse
o Multifamily dwelling
#of units
u Office
o Mercantile
o Manufacturing
❑ I car detached garage
❑ 2 car detached garage
o 3 car detached garage
❑ 1 car attached garage
❑ 2 car attached garage
❑ 3 car attached garage
u Storage building-
commercial _
❑ Storage building-
residential
❑ Other - — ' (9°
Will any second-hand or ungraded lumber be used? If so, for what?
Type of heating System: electric/ oil / gas/wood /forced hot air/ baseboard/other: AY., f
Number of Fireplaces to be installed ) Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder D 11- Cs s �z� �+�,1 f , ;!`a
Plumber / �- �
Mason
Electrician
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 all
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. Further, it is understood that I/we shall
submit, prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction.
,11
Signature: vad �r-��t'000Cl/ owne• owner's agent,architect,contractor
\C- 0
1
RESIDENTIAL FINAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received: ) 97
Building&Code Enforcement
Dept.of Community Development Arrive am/pm Depart
Town of Queensbury Inspector's Intl
742 Bay Road
Queensbury,New York 12804
NAME 11 U� PERMIT# v1-7o9
LOCATION 0 b tt‘, DATE
TYPE OF STRUCTURE gpY-\--
N/A YES NO COMMENTS
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake fg104/1/t) '" C5>(
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in.or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 18"above 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 operating
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than 3 risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or more
Railing across window in stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)_
Okay to issue permanent C/O(Certif.of Occupancy)
, .
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etiVN OF GUEENSBURY
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RECEIVED
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• =11. TOWN OF QUEENssu
BUILDING AND c RY! r
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