2004-445 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: : P20040445 " Date Issued: Thursday; June 23, 2005
This is to certify that work-requested to be,done as shown by Permit Number P20040445
has been completed.
Tax Map Number.: 523400-309-006-0001--012-000-0000
Location: 50 VETERANS Rd
Owner: JAMES M.COUGBLIN
Applicant: JIM COUGBLIN
This structure may be occupied as a:
Shed./ Storage Sheds
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.
Building Peirmit 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 NaE
No inspection will be made until applicant has received a Fee Paid valid building permit. All applicants' spaces on this Roc.Fee Paid
application must be completed and must appear on the Reviewed
application form.
APP1io=t:-J-,g m,es /h. Go�t_2 A Owner: Sys r
Address: Is'o L,n m 2 L Address:
Phone#O 2. -LPhone
Property Location: Lot Number: / House Numb
Subdivision Name: Tax Map Number: ��o 9, 0.t,,-!-I�
p.T New Building: osidence /commercial 'Estimated Market Value of Construction, $
G Addition: .; residence/ commercial If ail Addition,what will use of new addition b
residence/ commercial e?
O Altaratioa: .
O No change to exterior size: residence/com'1
ta Other work(describe )
Check Occupancylnformation 1 Floor 2° Floor Other floor Total
Below sq.ft. sq.ft, sq.ft. Square Feet
o Single family dwelling
0 Two family dwelling
o Townhouse
o Multifamily dwelling
#of units
o , Office JUN
o Mercantile
o_ Manufacturing
0 1 car detached garage
e 2 car detached garage
0 3 car detached garage
0 . 1 oar attached garage
0 2 car attached gars e
0 3 car attached garage
o Storage building-
commercial
o Storage.building-
residential
o Other
What is the proposed height of the structure feet 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/other:
Number of Ftret_ daces to be installed Number of Woodseoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address- Phone Number
Builder
Plumber
Mason
Electrician
Decl=tfou: 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 no as that such work is authorized by the owner, Further,it is understood that Uwe shall
submit,prior to a c c or Certificate of Compliance being issued,as requested by the Zoning
Administrator uil ' d Code As Built Survey by'a licensed surveyor;drawn to scale,showing actual
location of on.
Signature: owner,owner's agent,architect,contractor
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No.(518)761-8256 Arrive: am/pm Depart2 r V amo 7
Date Inspection request received: _ _ Inspector's Initials:
NAME: PERMIT#:
LOCATION: _ _ DATE:
TYPE OF STRUCTURE.
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof minimum 6"
Roof Complete/Exterior Finish Complete
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 Railin s 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers 2,
Enclosed Stairs Sheetrock Underside minimum '/" )
Gypsum `
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
6 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 Valves installed/Heat Tra 7 Water Tern 110
Interior privacy/trim/doors/main entrance 36 in.
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: i Every Bedroom:
Outside every bedroom area:
lnter Connected: / Battery backup:
Carbon Monoxide Detector
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation
Floor truss, draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
Garage Floor Pitched _
Garage fireproofing/3/<hour fire door/door closer
Duct work Sealed properly
Gas Lo sin Sealed or Glass Enclosure
Attic access 30 in x 22 in.x 30 in.(ht.)In accessible area
Crawl Spaces 18"x 24"access, 1 sq. ft.-150 s . 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 or C/O Temporary/Permanent
L:\PamW\Building&CodesUnspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04
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., FROM HEREBY
�AL FIELD SURVEY.FY THAT THIS P WAS PREPARED
o (,�
THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS
FOR WHOM THE SURVEY WAS PREPARED, AND ON THEIR
N83 BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY
76 4' 4"iy�,' AND LENDING INSTITUTION LISTED HEREON.
128.77, CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL
INSTITUTIONS OR SUBSEQUENT OWNERS.
w� CERTIFIED TO: JAMES M. COUGHLIN
COUNTRYNAgE.ROME LOANS, INC.,
In SU 'AAA/OR ASSIGNS
S VI ANCE COMPANY
JIJIV r
rpwN 0 CERTIFI
SUIZ p H QuEFh$ J . LLS NYS 50135
LAND CAGEY DATED: MAY 21. 200 �r36
Date: MAY 21, 2004
ALAUTHORRED AL7E72Ai1ON OR ADgiKw TO A SURVEY
MAP ""�' D I,%M-DI SM Z OF T " Map of a Survey made for Scale 1'=20'
VIOLATION OF SECTION LICENSED
L SD ND"VS10N z of THE
' NEW YDRK STATE EDUCATION LAW
-ONLY COPIES FROM THE ORICINAL OF THIS SURVEY
MARKED RLIH AN OM MAL OF THE LAND SURVEYORS
T �, S SEAL SHALL DE CONSIDERED TO BE VALID TRUE COPIES
-CERGFCODE OF PR CTI E HEREON THAT James M. Coughlin S 1
THIS SURVEY WAS PREPARED M DANCE MTH THE
E7OS7wG CODE OF PRACTICE FOR LAND SURVEYORS ADOPTED
r v e y o r s LA THE NEW Y M STATE ASSOCIATIONNS OF LL RLIN90M Y
LAND SURVEYORS;SAID CERTIFICATIONS SHALL RUN ONLY
TO THE PERSON FOR VNCM Off SURVEY IS PREPARED.AND
ON HIS BEHALF TO THE RTLE COMPANY.GON3aNENTAL
eensbury, New York 12804 AGENCY AND LEMING RMASTION LISTED HEREON,AM SHEET 1 OF 1
TG THE ASSKNEEs OF TIE mm,wsTITU7gN- Town of Queensbury, Warren County, New York
New York Lie. No. 50135 CLUTE
NO. nATF