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2005-268 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Pernut Number. P20050268 Date Issued: Tuesday, March 08, 2011 This is to certify that work requested to be done as shown by Permit Number P20050268 has been completed. Tax Map Number. 523400-227-017-0001-009-011-0000 Location: 159 CLEVERDALE Rd Owner. JEAN HOFFMAN Applicant: JEAN HOFFMAN This structure maybe occupied as a: Shed/ Storage Sheds By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the .m�--- property owner of the responsibility for compliance with Site Plan, d m Variance, or other issues and conditions as a result of approvals by the Directorof 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: P20050268 Application Number. A20050268 Tax Map No: 523400-227-017-0001-009-011-000 i Permission is hereby granted to: JEAN HOFFMAN # For property located at: 159 CLEVERDALE R in the Town of Queensbury,to construct or place at the above location in accordance with application together with plo fans and o r information hereto filed and approved and in compliance with the NYS Uniform Buil es and the Que nsXu y Zoning Ordinance. Type of Cons it"tion Value Owner Address: JEAN HOFFMAN BOX 488 LAPP Rd Shed!Stor e Sheds $10,000.00 CLIFTON PARK,NY 1206 Total Val $10,000.00 Contractor r Builders ame/ Address ectrical Inspection Agency r s 7 l Plans &Specificatio 2005-268 170 SQ FT UNDERGROUND ROOT CELLAR $20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday,May 17,2009 (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 To d y, May 17, 2005 !:7/� T 1 SIGNED BY 77 for the Town of Queensbury. Director of Building& de E orcemeat TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050268 Application Number. A20050268 Tax Map No: 523400-227-017-0001-0 -011-0000 Permission is hereby granted to: JEAN HOFFMA For property located at: 159 CLEV ALE Rd in the Town of Queensbury,to construct or place at the above location in accordance with application toge er 'th plot plans and other information hereto filed and approved and in compliance with the NYS U ' Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: JEAN HOFFMAN BOX 488 LAPP Rd Shed!Storage Sheds $10,000.00 CLIFTON PARK,NY 065 Total Value $10,000.00 Contract r or B der's ss Electrical Inspection Agency Plans &Specifications 2005-268 170 SQ FT UNDERGROUND ROOT CELLAR $20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,May 17, 2008 (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 Quee ury„ 1 day,May 17,2005 SIGNED BY � for the Town of Queensbury. Director of Building&Code 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: P20050268 Application Number. A20050268 Tax Map No: 523400-227-017-0001-009-011-0000 Pemussion is hereby granted to: JEAN HOFFMAN For property located at: 159 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: JEAN HOFFMAN Shed/Storage Sheds $10,000.00 BOX 488 LAPP Rd Total value CLIFTON PARK,NY 12065 $io,000.00 Contractor or Builders Name/Address Electrical Inspection Agency Plans &Specifications 2005-268 170 SQ FT UNDERGROUND ROOT CELLAR $20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday;May 17,20 (If a longer period is required,an application for an extension must be made to the c e Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town ofQueensbury-, Tues ay,May 17, 2005 SIGNED BY 0g..-, for the Town of Queensbury. Director of Building&Co ement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050268 Application Number: A20050268 Tax flap No: 523400-227-017-0001-009-011-0000 Permission is hereby granted to: TF,AN HOFFMAN For property located at: 159 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: JEAN HOFFMAN BOX 488 LAPP Rd Shed/Storage Sheds $10,000.00 Total Value $10,000.00 CLIFTON PARK, NY 12065 Contractor or Builder's Name / Address Electrical Inspection Agency Plans&Specifications 2005-268 170 SQ FT UNDERGROUND ROOT CELLAR $20.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, May 17, 2006 (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 To n of Quee bury; Tu sday, May 17, 2005 SIGNED BYal 2 for the Town of Queensbury. Director of Buildin &Co Enforcement Building&Codes Office-Department of Community Development-Town of Queensbury Permit No. Fee Paid O� 742 Bay Road,Queensbury,NY 12804 Dave Hatin,Director codes@gueensburv.net Phone: (518)761-8256 FAX: (518)745-4437 Accessory Structure Building Permit Application Application & Plans subject to review before issuance of a valid permit for construction I Any structure other than the principal structure (i.e., house), typically a garage, shed, greenhouse, dock, deck, etc. (not necessarily limited to the list below). Refer to attached Informational Brochure No.3 Instructions: A permit must be obtained before beginning construction. No inspections,will be made until the applicant has received a valid building permit. All applicants' spaces on this application must be completed and must appear on the application form. r Applicant/Builder nA e_aL_v\, R , �, law Owner: Address: P. o : 1?�o X `h 1E K Address: P j, 0(r 12_0& Home Phone: ?(= T& aQ'3 Home Phone: Email Address: vri k aL-1�e1cc"Email Address: I2 0 2005 Cell Phone: Ct 5_- y Cell Phone: FAX Phone: 3 71 - (7 q O FAX Phone: U Y MIMI Person responsible for supervision of work with respect to building and codes compliance: Name: Address: �-►n�- Phone Location of proposed construction: Lot No. Legal Address: 159 Tax Map Number: 2 `7a ( 7 f Subdivision Name: iU/A Estimated Cost of Construction: $ Does an accessory structure currently exist on the property? _Yes / ,�No If YES, list all existing accessory structures: Proposed Construction 1st floor 2nd floor Total Proposed Height sq.ff. sq.ft. Sq.ft. ft.&in. Open Porch Covered or Enclosed Porch (considered floor area&must comply to FAR [Floor Area Ratio] requirements if the structure is located in the Waterfront Residential tone. 3-season porch is considered an enclosed porch. Deck Boathouse Boathouse with sundeck DOCK Shed Pole Barn ar 1, 2, 3 car �- Other Accessory Structure: /J E o m ` Applications are subject to Zoning Administrator, Code Compliance, and Structural Plan review. the Building and Codes Office will allow commencement of your proposed project only after issuance of your permit. Declaration: Please sign below after you have carefully read the statement: Fo the best of my knowledge, the statements contained in the 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 Codes,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. =urther, 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 icensed surveyor, drawn to scale,showing actual location of all new constru n. h: )ate: � - r�� `© S Applicant/Builder Signature: ` be application of dated is hereby approved and. )ermission granted for the construction, reconstruction or alteration of a building/and or accessory structure as set orch above. Date: Authorized Signature: :\Sue Hemingway\Building.Permit.FORMS\Accessory Structure Permit Application.doc V:12/28104 r � Foundation Inspection Report Office No. (518) 761-8256 Date Inspection re q r e' e . Queensbury Building &Code Enforcement Arrive: Depart: Z a 742 Bay Rd., Queensbury, NY 12804 Inspector's Intl NAME: �i, Ch�'�� Al IT LOCATION: QM9 SPECT ON: TYPE OF STRUCTURE: Comments Y N N/A Footings 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 Foundation Dampproofing t� Foundation/Waterproofing ype of Dampproofmg/Waterproofing �tG Footing Drain Daylight or Sump Footing Drain Stone: / 12 inch width Vj 6 in s above fooling ✓ milPoly for wet areas under slab _ ackfill Approval �� Plumbing Under Slab T� �I I PVC/Cast/Copper \ �► ��� �� Foundation insulation Interior/Exterior R- _ Rough Grade 6 inch drop within 10 ft._ I:�SueHem:ngway\Building.('odes.Inspcction.FORMS\Foundation Inspection Report.doc January 28,200 < Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: 1 v S Queensbury Building &Code Enforcement Arrive: am/p (� Depart: mr'pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: `�'1" NAME: C�CA�.. cam-- PERMIT#: CtU -�- LOCATION: _.. �g e INSPECT ON: TYPE OF STRUCTURE: 170 S C ents --^� Y A N N/A Footings Piers Monolithic Slab Reinforcement in Place 2— 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 Foundation Dampproofing Foundation/Waterproofing Type of Dampproofing/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:�SueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Repon.doc January 28,2003 Queensbury Building & Code Enforc ent - Residentia I Inspection No. (618)761-8256 Arrive: p part = rr Date Inspection request received: ins3 Initials:pr- yj NAME: LOCATION: e, D — —1 TYPE OF STRUCTURE: Comments•. 4' Building Number Address visible from road Chimney Height/'B`Vent/Direct Vent Location Fresh Air Intakei 3 inch Plumbina Vent through roof minimum 6 Inches Roof Co /Exterior Finish Complete Platform at ail exterior doors Handrail 4 or more risers Guards at stairs decks ios more than 30 inches above grade Guard at stairwell at 34 indies or more Guam at deck pordies 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 dearanoe to sill plate Gas Valve shut-off /Mulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/Kitchen watertight Safety /Window in stairwells safety glazina Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery bm*u Attic access 30 inches x 22 inches x 30 inches(height)in acoessible area Crawl Spaces 18 inch x 24 inch access 1 N.ft:150 sq.ft.vents Bathroom Fans if no window Plumbing fixtures Foundation insulation l insulation Certification Floor truss draft stopping finished basement 1,000 sq.ft. Emergency pgMss below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Fumac e/Hot Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Enclosed Stairs Shestrock Underside minimum W Gypsum Basement stairs dosed rise>4 inches Garage Floor Pitched Garage fireproofing/%hour fire door/door closer Duct work Sealed Gas Lom In Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc fault Breaker in Bed►oans Flex Gas Pipe Bondino As Built stem I Sewer Dept.Inspection Sticker Site Plan /Variance required r Flood Plain Certification if required Okay to issue C I C or C 10 1 Tem ermanent L:\Building S Codes Forms\Building&Codesllnspection FormsWesidendal Final Inspection Form_rev1se0_100405.doc;Revised January 7,2008;Revised 8/26/08 " � r THE INSPECTOR 5390 State Route 11,Burke,NY 12917 1-800-487-0535 www.theelectricalinspector.com J Date:December 20,2010 Application No.On File: 074880 THIS CERTIFIES THAT Jean Hoffman Only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of: 159 Cleverdale Road Town of Queensbury In the following location: Basement I"Floor 2nd Floor No.of Apt Ace Bldg.D Attic Outside Commercial Residence X Was examined on 10/19/10 and found to be in corn liance with the requirements of the National Electric Code. GFCI Fixture Outlets Receptacles Switches Fixtures Ran es Cookin Decks Ovens Dish Washers Exhaust Fans Smoke/Heat Incandescent Fluorescent I Other Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W. Amt. K.W. Detectors 2 Dryers Furnace Motors Dimmers Water Heaters Unit Heaters Multi Outlet Sys. Electric Heaters Amt. K.W. Oil H.P. Gas H.P. Amt. Watt Electric Oil Gas Amt. Rating No.of Feet Amt. K.w. Amt. K.W. Amt. I K.W. Amt. K.W. Transformers Alarm Systems Special Receptacle Panels Motors Signs Track Lighting Disposal Amt. KVA AN PS Det. I Panel Amt. I K.W. Amt. No.of circuits Rating Amt. H.P. Amt. No.of Lams No.of Heads Amt. I H.P. 3 ATF 200 Gen 1 100 1 5 100 Service Disconnect Equipment Service Amt. Amp. I Type Meter 1 Phase 1 Phase 3 Phase 3 Phase No.of CC. AWG. No.of AWG.of No.of AWG of 2W 3W 3W 4W Cond./phase CC.cond. Neutrals Neutrals HI-Les HI-Legs CV Other Apparatus L0 Z WManager �V This certificate must not be altered in any manner;return to the office of THE INSPECTOR if incorrect. Inspector's credentials can be verified U W 911 N pFID a0E pNCODE 1 S$7 S WE3. ,w 37.0' --- o a 16g,2� S64'57'00"E 30 21 vcn R ------�_ , 100.41 SOT 0 OiJs� Q°►K 43 824,sq.ft. 2 OC« 1.0 2 N b DRIVE o NS8-43 07'W N62'1 9 38'W N71 2eW 7 T t.95 ---- .12 foo� N63 39'S6`W �40 GARAGE S14ED pi t" v 2 CD 33 Q •cn o �r RECEIVED APR 2 0 2005 TOWN rb v n e.u OF EENSBURY ` BUILDING ANn- rn„� . i 7- Lq t C.dn cr of e_ s(a»6 } ING r , FILE COPY �mhC � e�a t,J�tl , TOWN OF QUENSBURY BUILDING DEPARTMENT Based on our limited examination, comp�ranee with our comments shall not be construed as indicating the plans and specifications are in full compliance with the Building Codes ` of New York State. cv y 8 E7<p_m b L �,rso5t ,�. -1RN SLt3 cc4 Q 600 r Wirt SA N '