2005-570 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
4z Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLI-ANCE
Permit Number: P20050570 Date Issued: Wednesday, December 14, 2005
This is to certify that work requested to be done as shown by Permit Number P20050570
has been completed.
Tax Map Number: 523400-301-018-0001-069-000-0000
Location: 17 FAWN Ln
Owner: JOHN & JANICE URBAN
Applicant: JOHN & JANICE URBAN
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,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enkceme
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: P20050570 Application Number: A20050570
Tax Map No: 523400-301-018-0001-069-000-0000
Permission is hereby granted to: JOHN & JANICE URBAN
For property located at: 17 FAWN 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. Tyne of Construction Value
Owner Address: JOHN & JANICE URBAN
17 FAWN Ln Porch $15,000.00
Total Value $15,000.00
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name / Address Electrical Inspection Agency
ADIRONDACK SUNROOMS
TOM KURISH 798-2261
10 HOLDEN Ave
OIJEENSBIJRY- NY 12804-0000
Plans&Specifications
2005-570
140 SQ FT PORCH
$40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, August 08, 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 r7j�
1V�pnd 08, 2005
SIGNED BY //Q'J for the Town of Queensbury.
Director of Building&Code Enforcement
Permit No. _�5 `S/ 6
Building &Codes Office-Department of Community Development-Town of Queensbury Fee Paid i�QD C)
742 Bay Road,Queensbury,NY 12804
Dave Hatin,Director codes@aueensburv.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
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.
Applicant/Builder & t r-O e-,444 fC .�n�'.�J�) �I� Owner:
Address: QV l�v�@.ILdr !'+-�, Address: A-4
_JrA?U e--e-,►j to u ry a
Home Phone: Z25 1V --Z7-1- ( Home Phone: 7? Y-LZ 4 f
Email Address: Email Address:
Cell Phone: Cell Phone:
FAX Phone: FAX Phone:
?erson responsible for supervision of work with respect to building and codes compliance:
Name: 30 gro—A
Address: 3 2_�f (Q JR Y# C' ILA, Phone '74 �f-Z 24 f
-ocation of proposed construction: Lot No. Legal Address:
l n
fax Map Number: [2 Subdivision Name: Ac- Pc',
stimated Cost of Construction: $ ) S 0 u
Does an accessory structure currently exist on the property? _Yes / No
If YES, list all existing accessory structures: i``I1 �''or
i
Proposed Construction 10 floor 2^d floor Total proposed, #ght
sq.ff. sq.ff. ff. in
S .
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 zone. c ,
3-season porch is considered an enclosed porch.
Deck
Boathouse
Boathouse with sundeck
DOCK
Shed
Pole Barn
Detached Garage 1, 2, 3 car
Other Accessory Structure:
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:
To 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.
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 co struction.
Date: -" Applicant/Builder Signature:
The application of dated is hereby approved and
permission granted for the construction, reconstruction or alteration of a building/and or accessory structure as set
forth above. Z
Date: Authorized Signature:.
L:\Sue Hemingway\Building.Permit.FO RMS\Accessory Structure Permit Application.doc V:12/28/04
IML
Queensbury Building & Code Enforcement -
Residential Final Inspection
Office No. (518)761-8256 Arrive: p art: " a
Date Inspection request received:
Inspector's Initi s: - —
NAME: (J� P RMIT#: _ C�Qt� '1
LOCATION: r �/6ATE: Li
TYPE OF STRUCTURE:
Comments
Yes
Buildin Number/Address visible from road
Chirrmey Height/"B"Vent/Direct Vent Location
Fresh Air Intake Of
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete h 1
Platform at all exterior doors E
Guards at stairs,decks,patios more than 30 inches above grade Q h r
Guard at stairwell at 34 inches or more C\ '
Guard at deck, orches 36 inches or more f "�
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
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
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s .ft.-150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency egress 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 operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum''/z"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/o hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection-Slicker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/O[Tem or /Permanent OL
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised 100405.doc
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No.(518)761-8256 Arrive:�ap ,art: C '71 am/ m
Date Inspection request received: Inspector's In iaN:•NAME: - I�
LOCATION C )✓9RMIT#: -2O C� /
DATE:
TYPE OF STRUCTURE:
Comments
Yes No N/A
Buildin Number/Address visible from road s
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Guards at stairs,decks,patios more than 30 inches above grade '� �- �I`'+�� ',j h
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more 0�—__.
Handrail Termination at Newell Post or Wall _
Interior/Exterior Railings 34 inches to 38 inches ',
Interior Handrails @ stairs 2 or more risers
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
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
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 s .ft,150 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency egress 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 operating
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum''/z"Gypsum
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
Final Electrical
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C/C or C/O[Temporary/,Permanent 7
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential"ection Form revised 100405.doc
Foundation Inspection Report
r
Office No. (518) 761-8256 Date Inspection request"rQeei ed: j
Queensbury Building&Code Enforcement Arrive: am/pm`-°' Depart: ,� m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initial
NAME: _C� .�T� �L-o RMIT#:
LOCATION: _ _ ��� r ( yam ,� _ INSPECT ON:
TYPE OF STRUCTURE: _ Pcss�r
Comments
Y N N/A
otings
Piers woe
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.
LASucHemingway\Building.Codes.Inspection.FORMSToundati on Inspection Report.doc January 28,2003
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ICC LEGACY REPORT ER 5262-P
05W9459 07 16 05 ADRONDAK ICC LEGACY REPORT NER-567
FLORIDA PRODUCT APPROVAL 3857
DETAILED BY: MIRHET MELKIC FLORIDA PRODUCT APPROVAL 3521
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URBAN, JOHN 20400 HALL RD 400 HALL RD
17 fAWN LANE CLINTON TWP, MI 48038NTON TWP, M% 4so3a
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URBAN, JOHN 20400 HALL RD 20400 HALL RD
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QUEENSBURY, NY 12804 PHONE: (586) 286-0410 (877) 218-8366 X287
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DEALER:ADRONDAK 05W9459 PH ) TEMO SUNROOMS, IN ROBERT . WAL , PE
URBAN, JOHN 20400 HALL RD
17 FAWN LANE CLINTON TWP, MI 48038 CLINTON TWP, MI 48038
QUEENSBURY, NY 12804 PHONE: (586) 286-0410 (877) 218-8366 X287
DRAWN BY: MIRHET MELKIC DATE:07/16/05 1 SCALE:1/4"=1' FAX: (586) 286-5409 LIC #082300-1