2002-845 TOWN OF QUEENSBURY
Bay 742 Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20020845 Date Issued: Monday, March 31, 2003
This is to certify that work requested to be done as shown by Permit Number P20020845
has been completed.
Tax Map Number: 523400-239-007-0001-024-000-0000
Location: 133 ASSEMBLY PT. Rd
Owner: WILLIAM H BERNARD
Applicant: WILLIAM H BERNARD
This structure may be occupied as a:
By Order o Town Board
Storage Building ($ � ENi ./
4
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
FIM
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020845 Application Number: A20020845
Tax Map No: 523400-239-007-0001-024-000-0000
Permission is hereby granted to: WTLLTAM H BERNARD
For property located at: 133 ASSEMBLY PT. 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: WILLIAM H BERNARD
133 ASSEMBLY PT. Rd Storage Building 3,500.00
Total Value 3,500.00
LAKE GEORGE,NY 12845
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2002-845
Construction of a 480 sq ft storage shed per plot plan and specifications.
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, October 15,2003
(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 ensb ; T s y, October 15,2002
SIGNED BY for the Town of Queensbury.
�.'
Director of Building&Code Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
•
A permit must be obtained before beginning construction. Permit File No —Y J
No inspection will be made until applicant has received a.. Fee Paid $
valid building permit. All applicants' spaces on this Rec. Fee Paid $
application must be completed and must appear on the. Reviewed By:
application form. . ) ,
Applicant: 'it() (( içv �y fl d rcl Owner:
Address; -7) 3 Pc-S '.VY\ I Qn,rill' JaI- Address:
SAKE GQor6e- 1 1\01. i —s
Phone*( t) b56 -, OZ Phone#( ) -
Email Address: Email Address:
Property Location: Lot Number: / House Number 133 / 455"em 1 lig PO/ '
Subdivision Name: Tax Map Number: 4 3 q, 7-/ --e1,V
New Building: residence /commercial Estimated Market Value of Construction: $ d, Se D -
❑ Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial -
❑ No change to exterior size: residence/com'l
❑ Other work(describe )
Check Occupancylnformation 1't Floor 2°°Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
o Single family dwelling
c ' Two family dwelling -
❑ Townhouse
o Multifamily dwelling
#of units
o Office
o? Mercantile
o' Manufacturing
o 1 car detached garage
❑ 2 car detached garage -
❑ 3 car detached garage
❑ 1 car attached garage
q; 2 car attached garage
n 3 car attached garage
❑ Storage building-
commercial41(1 -
Storage building- 80 ' I��
'f;'`: residential _ `1
❑• Other
it
What is the proposed height of the structure 1 feet /f3 inches
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/othet: A.)
Number of Fireplaces to be installed IV Qtit Number of Woodstoves to be installed g Ofr
List below the person(s)responsible for supervision of work as regards to building codes:
- Name }} Address Phone Number
Builder V \I►fttkk\l' etlialrCt l 3 /'/�, ; Pti2d 11,56 -3 7•e 2-
Plumber 77! — 7 795 li Mason _ ,5' '7-396o £Xf 11550
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 df 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 Uwe shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director uilding and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new co on. -
Signature: 1 er,owner's agent,architect,contractor
r ,. . Residential Final Inspection
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/ m Depart: ) .'j'J am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: u ,\\C; r Q11( (\ci PERMIT#: o a- /
1_5-
LOCATION: ' 3 3 1` DATE: 1-- d
TYPE OF STRUCTURE: •
Comments
Y N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake C7 /
3 inch Plumb Vent through roof
Roof Complete J �
Guard 30 in. or more @ stairs,decks,patios
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in. or more
Exterior Finish Complete
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in. with 10 ft. ,t
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate ,
Gas Valve shut-off exposed/regulator 18"above grade
Gas Furnace shut-off within 30 ft. 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
Interior privacy/trim/doors/main entrance 36 in.
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:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
3/4 hour fire door/door closer /L)d `I ,64v2 Lot 6.'6 c Ay
Garage fireproofing
Duct work Sealed properly ekOA-eye j)
Attic access 30 in.x 24 in.x 30 in.(ht.)In accessible area '
Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq. ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept. Inspection Sticker
Flood Plain Certification, if required
Okay to issue C/C(Cert.Of Compliance)
Okay to issue Temporary C/0(Cert. Of Occupancy)
Okay to issue Permanent C/0(Cert. Of Occupancy)
L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
4 e----
J-64
• Residential r Inspection - ""�
Office No. (518) 761-8256 Date Inspection request rec • d: d1 S
Queensbury Building&Code Enforcement Arrive: a p epart: �, am/p
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial .
NAME: LL Bei'r P IT#:
LOCATION: 13 3 ATE: b L)&e'<—
TYPE OF STRUCTURE: alb/?)- , �w],., 01 Comments S�o t's
Y _ N/A A�J -�
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
C
3 inch Plumb Vent through roof Y
Roof Complete QA,
! -
Guard 30 in.or more @ stairs,decks,patios ��7 *'
Guard at stairwell at 34 in.or more
Guard at deck,porches 36 in.or more
Exterior Finish Complete �C—C>t-t t A��p �i itk \)
Interior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors V' P --�-Z 7 5 �z 1 t�f
Interior Handrails stairs 2 or more risers O C...!'"'v��- � �"�
Grade away from foundation 6 in.with 10 ft. 1 ' i
Handrail Termination at Newell Post or Wall
8 inch clearance to sill plate �� -_-_ C t.-) c C 1 1 0
Gas Valve shut-off exposed/regulator 18"above grade C Oie.-17 L F'i 5 '
Gas Furnace shut-off within 30 ft.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 Valve(s)installed
Interior privacy/trim/doors/main entrance 36 in. !/"
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:
Bathroom Fans, if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
3/,hour fire door/door closer
Garage fireproofmg
Duct work Sealed properly
Attic access 30 in.x 2 in. x 30 in. (ht.)In accessible area f\(`
Crawl Spaces 18"x 24"access, 1 sq.ft.-150 sq. ft.vents
Building No./Address visible from road
Final Electrical
Site Plan /Variance required �,
s.2 7
\f;'-,,-1,\,,,
Final Survey Plot Plan
t f. --,
As Built Septic System/Sewer Dept.Inspection Sticker � r IC-,v\,..,(-%L s , A`''1 ``
Flood Plain Certification,if required �' ` , --'V 1
Okay to issue C/C(Cert. Of Compliance) ,._(, (-'�\�_ �, 1 1
Okay to issue Temporary C/0(Cert. Of Occupancy) (�( '" # `` ?'k-1<
Okay to issue Permanent C/0(Cert. Of Occupancy) am' r E {
Office Use
GENERAL INSPECTION REPORT Inspector: ,j c I
Ready at time:
Town of Queensbury
Dept. of Community Development Request received: l C/2-j ,f 6: 2.._- Meet:
Building& Code Enforcement At time: j y1
742 Bay Road
Queensbury, NY 12804 ARRIVE am/pm: DEPART I/pm Notes:
(518) 761-8256 Inspector's Initials
) (R
NAME: _ 1/VI
y14 �r &'l-1: \ PERMIT# 2D O -4 7
LOCATION: .) �� INSPECT ON(date): /c'L±S /6 2.—
TYPE OF STRUCTURE: 3
RECHECK 7 cm q S
N/A YES COMMENTS
7 rF_ootings/Piers
onolithic Pour Form
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/W allpour_
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place_
Rough Plumbing_
Heating Rough-In _
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers_.
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
L:\SueHemingway`Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
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