2004-467 TOWN OF QUE E NSBURY
Ba� 742 y Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20040467 Date Issued: Monday, April 28, 2008
This is to certify that work requested to be done as shown by Permit Number P20040467
has been completed.
Tax Map Number: 523400-226-016-0001-008-000-0000
Location: 233 CLEVERDALE Rd
Owner. MRS NANCY D HAGAN
Applicant MRS NANCY D HAGAN
This structure may be occupied as a:
Dock
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 Enforcement
Planning Board or Zoning Board of Appeals.
� ` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
If*
.r. Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040467 Application Number: A20040467
Tax Map No: 523400-226-016-0001-008-000-0000
Permission is hereby granted to: MRS NANCY D HAGAN
For property located at: 233 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: MRS NANCY D HAGAN
Dock $S,000.00
39 LONGVIEW Dr
Total Value $5,000.00
APT. #203
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-467
210 SQ FT DOCK
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, June 29, 2005
(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; Tuesday, June 29, 2004
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Porch, Deck, Dock, or Boathouse 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. No Permit File No. 011- t/(Q
71.,------
inspection will be made until applicant has received a valid Fee Paid C;
building permit. All applicants'spaces on this application must be Reviewed By:�� 2
completed and must appear on the application form. jj �
Applicant: /VAL'7 /64 ALAI Owner: 1V,4,v' 7 /
Address• C c v 'e_. ,PO. ayr 3c 3 Address: •
CAJ-t.- 1e_ •`i - \T2 7% e VAL ,2 1..m
Phone#(5113)CS6 - colL Phone#(51'8)83�.- "73 f
Email Address: Email Address:
Person Responsible for Supervision of Work as Regards to Building Codes:
2.y fV Ar116e4.4
Name Ara-A-- /-�.4-se-i'Z Address: 81Ycz /3u.vy Phone ‘5T -33'Z5-
/N j 1 Zgay
Property Location: Lot Number: / House Number 12-3 ern-6/ - ?-/o
Subdivision Name: Tax Map Number: -7
l
7 Estimated Market Value of Construction: $ 3 C°CC J(/l�l
z
❑ Porch r87V4 0FQU e004
9❑at Dock iNG'ND C puURy
'❑ Boathouse F
❑ Other work(describe ✓" .
Z rp A IK
Size of structure to be built i` " square feet /C) ,
c7sk-
Submit along with this application:
/(____ 1
1./" Two plot plans drawn to scale,preferably using a survey map. Indicate proposed
structure showing setback dimensions from all property lines. Show location of
water supply and location and configuration of septic disposal area.
Cy. ` Two sets of structural drawings. Indicate size of posts or studs, floor joists,
decking or flooring material to be used. Show how the porch or deck will be
fastened to the building. If a roof will be constructed, indicate the size of posts or
studs,roof rafter spacing and span. Indicate type of roof: sloped,flat,shed,or
other. Indicate the type of material being used for the roof.
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.
Applicant's signature: ' 7 2 9., Date: G -..3- U tf
LASueHemingtivay\Building.Permit.FORMSWorch.Porch_Permildoc 8/13/02 revised per DH
a K..
Queensbury Building & Code Enforcement - Residential Final Inpection
Office No.(518)761-8256 Arrive: am/pm Depart:2 «_am/pm
Date Inspection request received: Inspector's Initials: A�
NAME: PERMIT#:
LOCATION: tom DATE:
TYPE OF STRUCTURE: _
K1�-- Comments k.:7/05—
Nc� N/A Building Number/Address visible from road �~
Chimney Height/"B"Vent/Direct Vent Location .
Fresh Air Intake ` P
3 inch Plumbing Vent through roof minimum 6 inches _ �i
Roof Complete/Exterior Finish Complete /r'' (fir
Platform at all exterior doors Y ��
Guards at stairs,decks,patios more than 30 inches above grade O� J6)/3°ice 1
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall KC f ah.... i
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 `b
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 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures _
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sq.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%2'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 I C or C/0[Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc
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