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2005-353 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. P20050353 Date Issued: Wednesday, July 14, 2010 This is to certify that work requested to be done as shown by Permit Number P20050353 has been completed. Tax Map Number. 523400-289-019-0001-009-002-0000 Location: 5 BLACKBERRY Ln Owner. JOHN & KIMBERLEE POLUNCI Applicant: JOHN & KIMBERLEE POLUNCI This structure may be occupied as a: Porch 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, d Variance, or other issues and conditions as a result of approvals by the Director of Building&CoA Enforcement Planning Board or Zoning Board of Appeals. 4' TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050353 Ap 'cation Number. A20050353 Tax Map No: 523400-289-019-0001-009-002-0000 Permission is hereby granted to: JOHN &KIMBERLEE POL Cl For property located at: 5 BLACKBERRY n in the Town of Queensbury,to construct or place at the above location in accordance with application together wi of p and other' o tion hereto filed and approved and in compliance with the NYS Uniform Bud des and the Que nsb Zoning Ordinance. Type of Cons c 'on Value Owner Address: JOHN &KIMBERLEE POLUNCI 5 BLACKBERRY Ln Porch $8,500.00 QUEENSBURY, NY 12804-0000 Total vain $8,500.00 Contractor or Builder's Name/Address Electri 1 nspection Agency Plans &Specifications 2005-353 368 SQ FT OPEN PORCH pd on 9/ 08 xtend permit for 1 year $40.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,June 03, 2011 (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 of nsb */ mite03,2005 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement TOWN OF QUEENSBURY F .3742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20050353 Application Number: A20050353 Tax Map No: 523400-289-019-0001-009-002-0000 Permission is hereby granted to: JOHN & KIMBERLEE POLUNCI For property located at: 5 BLACKBERRY Ln 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: JOHN& KIMBERLEE POLUNCI 5 BLACKBERRY Ln Porch $8,500.00 QUEENSBURY, NY 12804-0000 Total Value $8,500.00 Contractor or Builder's Name / Address Electrical Inspection Agency Plans&Specifications 2005-353 368 SQ FT OPEN PORCH $40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, June 03, 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 wn of een, 4tne 03, 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: P20050353 Application Number: A20050353 Tax Nlap No: 523400-289-019-0001-009-002-0000 Permission is hereby granted to: JOHV& KTMBERT,EE POI J NCI For property located at: 5 BLACKBERRY Ln 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: ,JOHN& KIMBERLEE POLUNCI 5 BLACKBERRY Ln Porch $8,500.00 Total Value $5,500.00 QUEENSBURY, NY 12804-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2005-353 368 SQ FT OPEN PORCH $40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, June 03, 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 Town of Queensbury; Friday, June 03, 2005 SIGNED BY for the Town of Queensbury. hector of Buildi Enforcement Permit No. &Codes Office-Department of Community Development-Town of Queensbury Fee Paid Road,Queensbury,NY 12804 riatin,Director codesQaueensburv.net e: (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 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 iform. Applicant/Builder --�a�h ��J ty��G\ Owner: ��h A i r��©�u h c, Address: _S R1_C., C_-P r IL© e Address: )sa c c.,r e v ec.�,,tipvr.l >n �4�o u] 4lU ee h�bv�, lJ� ►a�o'�1 Home Phone: SI Sr oS5 Home Phone: Email Address: Email Address: Cell Phone: NZ Cell Phone: FAX Phone: FAX Phone: —� Person responsible for supervision of work with respect to building and codes compliance: y , Name: Address: c. Phone �� �4ti�63S Location of proposed construction: Lot No. Legal Address: Tax Map Number: Subdivision Name: No—nc- Estimated Cost of Construction: $_��Soo ,Do Does an accessory structure currently exist on the property? _Yes I No If YES, list all existing accessory structures: Proposed Construction 1st floor 2nd floor Total Proposed Height sq.ft. sq.ft. sqil ff. 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 r_ Residential zone. �J 3-season porch is considered an enclosed porch. Deck Boathouse Boathouse with sundeck Y Sg DOCK 14�� C Shed Pole Barn Detached Garage 1, 2, 3 car Other Accessory Structure: 5,pplications are subject to Zoning Administrator, Code Compliance, and Structural Plan review. 'he Building and Codes Office will allow commencement of your proposed project only after ssuance of your permit. )eclarotion: Please sign below after you have carefully read the statement: o the best of my knowledge,the statements contained in the application, together with the plans and pecifications submitted, are a true and complete statement of all proposed work to be done on the described )remises and that all provisions of the Building Codes, the Zoning Ordinance, and all other laws pertaining to the )roposed 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 ,eing issued, as requested by the Zoning Administrator or Director of Building and Codes, As-Built Survey by a. sensed surveyor, drawn to scale, showing actual location of all new construction. ate: �� — - Applicant/Builder Signature• ie application of _� 7�,D_VX�1�t dat is hereby approved and' ermission granted for the construction, reconstruction or alte io o ill /and or accessory structure as set )rth above. Date: t) Authorized Signature: Sue Hemingway\Building.Permit.FORMS\Accessory Structure Permit ication.doc V:12/28/04 ` Queensbuty Building & Code Enforcement - Residential Final Inspection �Office No. (518) 761-8256 Arrive: am/pm Depart:2—'4-()am/pm Date Inspection request received: Inspector's Initials: /�' NAME: PE IT#: l./ J LOCATION: DATE: 4*7 TYPE OF STRUCTURE: Commen Yes N A 4° Building Number Address visible from road 7 ChimneyHeight/"B'Vent/Direct Vent Location OT :5 // Fresh Air Intake 3 Inci Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors _ Handrail 4 or more risen; 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 Bracn /Handicapped Ramp Compliant Grade awa from foundation 6 inches with 10 feet 6 inch clearance to sill plate Gas Valve shut-off exposed I regulator 18 inches above grade Interior privacy/trim/doors i main entrance 36 inches Bathroom/Kitchen waterti ht Safetv glazina/Window in stairwells safety alazing Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: / Inter Connected: Better y backup: �c Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl Spaces 18 inch x 24 inch access, .ft.-150 s .ft.vents Bathreom Fans,if no window Plumbing fixtures Foustidation insulation l Insulation Certification Floor truss,draft stopping finished basement 1,000 sq.ft. l� Emeraency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Fumace/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 closed rise>4 inches Gars Floor Pitched Garage fireproofing/%hour fire door/door closer Duct work Sealed properly Gas Logo in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc Fault Brooker in Bedrooms Flex Gas Pipe Bondin As Built S is System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C 10 Temporary/Permanent I VF L:\Building&Codes Forms\Building&Codes\Inspection FormsWesidential Final Inspection Forrn_revise0_100405.doc;Revised January 7,2008;Revised 6/26/08 t Queensbury Building & e Enforcement - Residential Final" nspec ion O ice No. (518) 761-8256 Arrive: am am/pm Date Inspection request received: Inspector's Initials: �— NAME: E IT LOCATION: D E: TYPE OF STRUCTURE: Comments: f12- H —X2P— N N/A 4' Building Number Address visible from road 0 `� ChimneyHeight/'B"Vent/Direct Vent Location ' �% 3— / Fresh Air intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Co fete/Exterior Finish Complete Platform at all exterior doors _ Handrail 4 or more risers Guards at stairs decks ios more then 30inches 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 ex sed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 36 inches Bathroom/K'rtc hen waterti ht Safe Iazin /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, i .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 ress below grade Gas Furnace shut-off within 30 feet or within tine of site Oil Furnace shut-off at entrance to furnace area Fumace/Hot Water Heater op2ratingC t•=%� � w�� Low water shut-off boiler Relief Valves installed/Heat Trapt, Water Temp 110 � Enclosed Stairs Sheetrodk Underside minimum W Gypsum Basement stairs dosed rise>4 inches Garage Floor Pitched Garage fire roofs I'/.hour Erse door/door closer Duct work Sealed properl Gas Logo in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Are Fault Breaker in Bedrooms Flex Gas Pip2 Bondin As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required 04y to issue C i C or C 10 1 Tem ra /Permanent LABuilding&Codes FormslBuilding&Codesllnspection FormslResidential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08 Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/pm Depart. n 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: .. NAME: _ PERMIT#: LOCATION: _ �INSPECT ON: OV TYPE OF STRUCTU E: Comments Y N N/A otings 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 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. LASueHemingway\Building.Codes,InspectionTORMSToundation Inspection Report.doc January 28,2003 F11.F r RECEIVED 40py MAY 2-- 05 TOWN OF QUEENSBURY BUILDING AND COD I` z T_> W �lti �, ► , .,t ,� C� BUILDING � . REVIEWED B DATE < i TOWN OF OUEENSBURY BUILDING DEPARTMENT �I Based on our limited examination, com iianoe with our comments shall not construed as indicating the plans and specifications are in full compliance with the Building Codes of�w.. York State. . , ' . _ t XD y.. - f i VA `c 1 V o•�,k �, �,_ _ �•� � � , L� e _ U . J ti ll LG'¢ � � ��� :fit: � _ �s ✓``;t � f I v i i 's r