96-540 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date ucsvpmhpr 25 19 9h
This is to certify that work requested to be done as shown by Permit No. 96540
has been completed.
This structure may be used as a SHED
Location 8 BURNT RIDGE ROAD
Owner SIMMS , LENTON & BARBARA
•
By Order of Town Board
TAX Imp NO. 5 . -1-19 TOWN OF QUEENSBURY
/i52
Director of Building & Code Enforcement
•
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BUILDING PERMIT
VALUE $ 1500 TOWN OF QUEENSBURY No 96540
TAX MAP NO. 5 . -1-19
WARREN COUNTY, NEW YORK
SIMMS , LENTON & BARBARA
PERMISSION is hereby granted to
8 BURNT RIDGE ROAD
OWNER of property located at Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SHED
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
R.D. 1 ,BOX 1191
LAKE GEORGE , NY 12845
2. CONTRACTOR or BUILDER'S Name
SIMMS , LENTON
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
STORAGE SHEDS
( ►Wood Frame ( ► Masonry ( I Steel ( )
7. PLANS and Specifications
144 1430Q FT STORAGE SHED AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SHED
$ 15 PERMIT FEE PAID —THIS PERMIT EXPIRES September 1819 98
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
18
Dated at the Town of Queensbury this Day of September 19 96
SIGNED BY for the Town of Queensbury
Building a oningIn r
e partment of Community Development ili
Reviewed By: d( '
Building & Code Enforcement ilding Ins ect r
Town of Queensbury Vrir Permit No.742`Bay Road (-- 0 O
Queensbury, New York 12804 , Fee Paid $ / J)
( 518 ) 761-8256 Building Permit Application
plication
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants ' spaces on this application MUST be completed and the
signature of the applicant MUST appear on the application form.
Applicant: 4£v7oN SVI I/ 5 3/WAR4 51nd41 L E/V72W '_7yb
-7 /J3A i S/�Jfs
-,
Address: !� 4(rAt .1 /L�$Q f��• Address: ( 444)
eke GEC- )i. y. (2 'j 5--
Phone # (2 —) /S-6- _to 7Z. Phone # ( ) C►%vs' ,e
,fit 33 Fretic4 Al t.7. 7 r -
Property Location: S— � t /
55e'- /_/ faint
Tax Map Number —=/
9
Subdivision Named ,/,(� �J — Section Block Lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VA�LUEOF THE
New Building: CONSTRUCTION: $
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
C111F' 1
residence / commercial Single Family Dwellin" f
Residence / Commercial Two Family Dwelling AUG 301996
no change to exterior size Family Dwelling
Office ou1e; sb,
X Other Work (describe below) Mercantile Nuk., .,
Manufacturing .
Other
GROSS AREA OF PROPOSED,(.� STRUCTURE:/
1st Floor r 1 1 sq. ft . If ADDITION, what will use
2nd .Floor sq. ft. /V
of new addk� be? :
Other Floors sq. ft.
(not unfinished cell or basement)
ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: 1 - SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Buil ing
X._ Other 9'X/t Ska .di
41 FEET X / FEET
Type: -S'1 ' (s ikc. ) ieo
Foundation T e: Will anysec nd-ha d or ungrade.
Number of Stories : / luer be used? I,4 so, or w at?
(habitabYe space only) / it �- w- � mot. — Dr
Height (grade to ridge) : /3 2 feet TYPE OF HEATING SYSTEM: A /
Number of fireplaces anchor woodstove (circle all which applies) /�
to be installed: �CI` � Electric / Oil / Gas / Wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of wor as re ards to building
codes is : LcNTb/fr 5/4/14,S
Name Addresss Phone
Builder: --(C / rO,/ .S /44 _-
Plumber: . i✓
Mason: [�r��c. z�ivt S
Electrician: ' !t//A--
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. Further, it is understood that I/we shall submit prior to a
Certificate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed survey , drawn to scale, s ing actual location of project on premises.
Signature: 1>�G�/' 6-( —III '
owner, owner's agent, architect, contractor)
,� kj,, ,k4 (518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD. , QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR)a/ DEPARD'(/b INT '1s
REQUEST FOR INSPECTION RECEIVED: `\ a-4 ~ 4
NAME 'A'e311., S 1 m MS
LOCATION R egVOAA 9idC)Ct
DATE V a - r v PERMIT 1 vv L(O
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
;.- --- - - -
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR ----
REINFORCEMENT IN PLACE ,---
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLMBING UNDER SLAB ._ -
FRAMING: "
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS j
JACK POSTS/MAIN BEAM Y
AIR INFILTRATION BARRIER
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- - -
�� TOWN OF QUEENSBURY
s;1X BUILDING & CODE ENFORCEMENT
�� � 742 BAY ROAD
12
QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: DEPART:
INSP:
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPEC ION REQUEST RECEIVED:
NAME /Muk 5
LOCATION 3i (.i �I 1I Zo ,
DATE _ !C/ L'� j/`'f PERMIT N /6. 5*
TYPE OF STRUCTURE ��/Cid-!>
FOOTINGS FOUNDATION BACKFILL _ FRAMING _
ROUGH PLUMBING _ SEPTIC INSULATION
FINAL ELECTRICAL _ WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/,1EIGHT
PLUMBING VENT `
ROOFING
11/
EXTERIOR FINIS ` �/
DECK/PORCH/STEPS/RAILINGS-
✓/
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: --.---
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR5
v////
iork
(518) 761-8256
TOWN OF QUEENSBURY1611
BUILDING E. CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 (Jl �C®
INSPECTOR'S REPORT: ARRC/rw DEPART//_INTd"
REQUEST FFOO INSPECTION RECEIVED:
NAME l/A'M 6
LOCATION 0l//entY C' feb
DATE �l� PERMIT, � I fd—✓' e°
TYPE OF STRUCTURE: o�CAy l"4I ff. / /S7v•1 1
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE - _
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION WALL•OUR
REINFORCEMENT IN *LACE
FOUNDATION DAMPPR0IFING
BACKFILL APPROVAL
PLUMBI
ROUGH PLUMBING .
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
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