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2004-677 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20040677 Date Issued: Friday, March 28, 2014 This is to certify that work requested to be done as shown by Permit Number P20040677 has been completed. Location: 11 ANDREW Dr Tax Map Number: 523400-239-018-0001-012-000-0000 Owner: DAVID BURNETT Applicant: STEPHEN & DAVID BURNETT This structure may be occupied as a: Dock By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy 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 Planning Board Director of Building&Code Enforcement or Zoning Board of Appeals. TOWN OF QUEENSBURY r 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 BUILDING PERMIT Permit Number: P20040677 Application Number: A20040677 Tax Map No: 523400-239-018-0001-012-000-0000 Permission is hereby granted to: STEPHF,N&DAVTD BURNETT i; For property located at: ANDREW Dr in the Town of Queensbury,to construct of: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. T3�a of Construction Value Owner Address: STEPHEN&DAVID BURNETT 9520 RETRIEVER Rd Dock $10, 00 Total Value $10,000. 0 00 BURKE,-VA,;22015-0000 Contractor or Builders Name:/Address i Electrical Inspection Agency Plans&Specifications 2004-677 (2)DOCKS AT 700 SQ FT EACH c i s � , $30.00 PERMIT FEE;PAID-.THIS PERMIT1 EXPIRES: Tuesday, October 04, 2005 (If a longer period is required,an applicatiotiifor.an;e'xtension(must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the own o Quee s uAda October 04, 2004 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement t Building Permit Application 0rk Vta 1 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. No inspection will be made until applicant has received a Fee Paid $ r valid building permit. All applicants' spaces on this Rec. Fee Paid $ application must be completed and must appear on the Reviewed By: application form. " i- Zu Applicant: ) Owner: S+e- . )i c r h-e Address: Address: -I)o v`t - Ln k- G-e rGv- Y1 Y Phone#(_) - Phone#(�Lfk) 6 6j�-_'-$' Property Location: Lot Number: / House Number / 7 A Lj' S Subdivision Name: Tax Map Number:. L39.18-/ —/'L (j PIP- L-octc c(--�- La,5p C,-e-F 2+- ei ❑ New Building: residence /commercial Estimated Market Value of.Construction: $ (00M ❑ Addition: residence/ commercial If an Addition,what will use of new addition be? ❑ Alteration: residence/ commercial ❑ No change to exterior size: residence/com'1 Other work(describe DOCK ) Check OccupaneyInformation 1"Floor 2 Id Floor Other floor Total Below sq.ft. sq.ft. sq.ft. Square Feet ❑ Single family dwelling ❑ Two family dwelling _ ❑ Townhouse ❑ Multifamily dwelling #ofunits ❑ Office - -u—Mercantile ❑ Manufacturing ❑ 1 car detached garage ❑ 2 car detached garage ❑ 3 car detached garage ❑ 1 car attached garage ❑ 2 car attached garage ❑ 3 car attached garage ❑ Storage building- SEE commercial ❑ Storage building- residential j s aa- t Other What is the proposed height of the structure feet 0 inches Will any second-hand or ungraded lumber be used? If so, for what? �9 `�t,U9l��4 ti1 ny Type of Heating System: electric/ oil / gas/wood. /forced hot air/ baseboard/other: Number of .FiAlk replaces to be installed Number of TK-odst�vas to-be inst»11ea? List below the person(s)responsible for supervision of work as regards to building codes: Name Address Phone Number Builder - J U 9S-0 Plumber Mason 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 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 Uwe shall ! submit,prior to a Certificate of Occupancy o`r Certificate of Compliance being issued,as requested by the Zoning Administrator or Director of Building and Codes,an As Built Vhrvey by a licensed'surveyor;drawn to scale,showing actual location of all new constructio . Signature: x onaier,owner's agent,architect,contractor Torch, 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 inspection will be made until applicant has received a valid Fee Paid $ building permit. All applicants'spaces on this application must be Reviewed B i completed and must appear on the application form pplicant: `tom.'r r eu Owner: Address: Address: f �lR ,r , A Z,w6' � Phone#( )6(�1 - 0-1 Phone#(9k) Z;$` Email Address: Email Address: Person Responsible for Supervision of Work as Regards to Building Codes_: Name -.ef ,IQA ,A- ��,.���1' Address: '��ndLeA2 pr Phone 60 Ids 61 cm Property Location: Lot Number: / House Numb / �?3�, 6 -/ /Z> Subdivision Name: Tax p Number: Estimated Market Value of Construction: $ ❑ Porch ❑ Deck Dock _ SEP ❑ Boathouse 12pp4 ❑ Other Work(describe ;;106 B(/ OF Q(/ Size of structure to be built Ss are feet I�GANp Cpp RY , Submit alongLwith this application: J 1. Two plot plans drawn to scale,preferably using a survey map. Indicate proposed structure showing setback dimensions frorn all property lines. Show location of water supply and location and configuration of septic disposal area. 2. 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: 4. Date: e) 6 Y L:\SueHemingway\Building.Permit.FORMS\Porch.Porch.Permitdoc 8/13/02 revised per DH / �c sbury Building & Code Enforcement - Residential Final Inspection Office No. (518) 761-8256 Arrive: arn/prr Depart: & am/pm Date Inspection request received:(� Inspector's Initials: NAME: u f-Cl,(1�'T1 P6 ERMIT#: - LOCATION: 1 ! } �1c�c- P�t� (�� DATE: TYPE OF STRUCTURE: Comments: Yes No NIA 4" Building Number Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 18 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs,decks,patios more than 30 inches above grade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall InteriorlExterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant 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/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Battery backup: 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 to floor/Sticker on Panel Duct work sealed properly/Blower Door Test Certification 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 W Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/%hour fire door/door closer Gas Logs in Sealed or Glass Enclosure Final Electrical;Energy Saving Light Bulbs 50% Final Survey Plot Plan Arc Fault Breaker Habitable Spaces/Tamper Proof.Receptacles Flex Gas Pipe Bonding , As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C/C or C 10 Temporary/Permanent LABuilding&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008; Revised 6/26/08,Revised 12/22110,Revised 04/13/11 y, , O cL F _ �6r�u ext h :ate e �L.-- - .- - ---- ----- Y i , _ . yp. 1 : : SS I , �'�� I ®�.!w..! V/VV• Vet ��Y�l �_ '-._._ _ ' -- _.__ .. 1 ' I , , • _a 1 • i _.. .. . ,. _- OCT 0 4 2004 .... TOWN OF QUEENSBURY / ' /�"� BUILDING AND CODE -.. .. ..:. . .. .. _;. ._.. ....__..__'.._. .- �� \` BUILDING C .� � .REVIEWED B �5' - TM DATE _ Y 'E b _ ..-.j.�ems.• ,�`-'V"Y�t4 .` RECEIVE® F. OCT 0 4 2004 -- TOWN QFQUEENSBURYBUIL D R E - Based on odr limited nindef. compliance with our co r �ntsSha9t TOWN OF QUEENSBURY not a construed as i t3ie plans and specificatio iss re BUILDING AND CODE compliance with the Bu I of.New York State.. _ ...:........ /27 S ' (? i �. 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