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2004-742 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: P20040742 Date Issued: Friday, November 12, 2004 This is to certify that work requested to be done as shown by Permit Number P20040742 has been completed. Tax Map Number: 523400-308-006-0001-070-000-0000 Location: 10 WARREN Ln Owner: ANDREW & BARBARA DARNELY JR Applicant: ANDREW DARNLEY JR This structure may be occupied as a: By Order of Town Board Single Family Dwelling TOWN OF QUEENSBURY Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040742 Application Number. A20040742 Tax Map No: 523400-308-006-0001-070-000-0000 Permission is hereby granted to: ANDRF,W DARNi,FY TR For property located at: WARREN Ln 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: ANDREW DARNLEY JR Single Family Dwelling $60,000.00 10 WARREN Ln Total value $60,000.00 QUEENSBURY,NY 12804-0000 Contractor or Builders Name/Address Electrical Inspection Agency Plans &Specifications 2004-742 1352 SQ FT MODULAR HOME $162.24 , PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, October 05,2005 (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 To of ensb s y,October 05,2004 SIGNED BY d° for the Town of Queensbury. my Director of Building&Code Enforcement Building Permit•Application Town of Queeasbury-Dept of Community Development,742 Bay Road,Quednsbury,NY (518)761'08256 -�� A permit must be obtained before beginning construction. Permit File No. No inspection will be znado until.applicant has received a Foo,paid $ al,} valid building permit. All applicants' $paves on this Rea.Fee Paid $ application mustbe completed and must appear on the Roviewed By: application form. Applicant: avo�(_o Owner:lmgew M,4au ­ Address: -Al S L 1 �..._.r�._.. Address;„ do- Phone#( ).?Y... •.2a!."3 a Phone#(s,,, 343 �r �I fi t-+ Crul s'ls -3Gi -aa�17� oatiosi: t . er: , o / House Number l o ../ N (- N S_ . Property Lo _�..._,.. SubdivisionName: Tax Map Numbev —� w New Buildin . es den a commercial Estlmatod Market Value of Construction: $ ---` C Addition: rest ence cormercial If an Addition,what will use of new addition be? o Alteration: residence/ commercial a 14 cbange to exterior size: residence/com'1 o Other waik(desodbe ) Check OCCupancyWorwation V Floor 2 Floor Other floor Total Below sq.it. sq.ft. sq.ft. Square Foot 44vle tbmil. dwellin o Two f=ily dwelling o Townhouse c Multifamily dwelling #of units o Of o .Mercaatlle o Manuthatut�l. 0 1 car 4ftahed smse n 2 oar dstaa., I a o 0 3 car detached V=age 0 I oar attached j=ge 0 2 var attsiahed ge 3 car.9tta4h4d gmge o Storage building- ��• ootrnneroial • o Storage building- residential o O er what is the proposed height of the structure r j I feet o inches Will any second hand or ungraded lumber be used? Tf so,for what? n12D e of Heatin System, electric/ of / t' _Type g y gas/wood baseboard other: Number of Fl=laces to be installed �C) Number of Woo&oEq to be installed COVED List below the nerson(s)responsible for supervision of work as regards to building codes: s E p 2 0 2004 :m�Aad*e$s' PhonaNtvAA1� OF QUEENSBURY - Builder- - -- wr - Q:r rt Cc� � ODE Plumber -- _ BUILDi�AND Mason .�s7. EloctriciaaI.A please signbelow after you have cateiblly read the statement To the best of my kmowledge tho statements contained in this application,together with the plans and specifications submitted,are a trao and ooatplete statement of all proposed work to be done on the described premises and that all provisions of the Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied with,whether specified or noted,and that such work is authorized by the owner, Further,it is understood that Vwe shall submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zonizig Administrator or Director of Building and Codes,an As Balle Survey by a licensed surveyor,&awn to scale,showing actual location of a//ll��now co cti Si$naturee[ owners owner's agent,ardbitect,contractor Application for Permit=Septic Disposal System 'To-vn of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: .................................................................................................................................. . Office Use Location of installation: l b L04CZC2,E," 1AQG ' File Permit No. Tax Map No. j Fee Paid Owner's Name: 4UDS?QbJ A-22AZZ49A Sub ................................................................................................................. .....................i Address: ?-I ©taEEV1St;W tJLk 2. INSTALLER'S NAME QLAIA-ZL WL TOL. . PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply#of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No of Bedrooms x Computation = Total Daily Flow r9$g-oar x 150 gal/bdrm = --499-1 x 130 gal/bdrm = 1991 -present x 110 gandrm = ?�30 Garbage Grinder Installed yes_ 1 no'_g_ Spa or Hot Tub Installed yes— / no V, 4: PARCEL INFORMATION: (circle applicable information&indicate measurements) Topography Soil Nature Ground Water Bedrock or Impervious Material . Domestic Water Supply Flat sand at u depth at what depth municipal "Town A o ,�k, Raping team feet (W t-feet Well .'weep slope clay _- o%slope rarer ftent any fflePHt=*=m depth:gyp'} -ear Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch - T-e. 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder,Spa or Whirlpool Tub. Septic Tank: gallon (min. size 1,000 gal.) Tile Field: each trench 1,p ft. Total System Length: 00 ft. Uol* TLAAD5 goega.goXh*): number of NQ.. size of each: M ft. by hlfa ft., Size�f Stone to be used: #1_ / depth or thickness feet . LJOT6 gANb Bed System Size: x 00-n- U-os Alte=ati�tem: lex r size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: N N I Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical-work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person Date .Tow» of (Isle llsb ry Srtivt::•s :uu1 4ctvsila: Disjs<s::al tass►islrs• AIspiai lix C. • A a�;(ll� '''1'ltlt� Iv I';1.01.) ' SI�:I'/11tA,'l'1Wh1 �1Z� �Zt:II1i,I [4TI���1`I'�i'` : .' '•�:� . 1 ' s rAW w .. n PQNo at ' . l+�'1r�t1ti1'iK1� Rom)ly 7. SIG'PI,ATURE &INFORMATION FOR USFVN;S; 1,4 rzAA, vt-i w'". Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: am/ rh epa Date Inspection request received: Inspector's)-niti . NAME: Ai C P IT#: ` LOCATION: 01 e— A TE: I 3— O 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 Railings 34 in.to 38 in. Platform at all exterior doors Interior Handrails stairs 2 or more risers 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 Trap/Water Temp 110 Interior privacy/trim/doors/main entrance 36 in. Bathroom/Kitchen watertight Safety glazing/Windo in stairwells safety zin - Interior Smoke Detec rs: Every level: / ery Be oom: • Outside every b room ea: J Inter Connected: / Batter back .. 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 j„ rl Garage Floor Pitched J Q Garage fireproofing/3/4 hour fire door/door closer Duct work Sealed properly Gas Logs in 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 s . ft.-150 s . ft. vents BuildingNo./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&Codes\Inspection Forms\Res. Final Insp. form 2.docLast printed 2/12/04 Final Survey Inspection Dept. of Community Development Town of Queensbury 742 Bay Road Queensbury,NY 12804 Date received: 0' Q' NAME: LOCATION: Lam PERMIT#: 0 Final Survey Plot Plan AiDuroved Denied The attached final survey has been received by the Dept. of y(/ Community Development. Upon review the survey has been: Craig ro oning Administrator Notes: l� L:\SueHemingway\Building.Codes.Inspection.FORMS\Fina1 Survey Zoning Administrator.doc Queensbury Building & Code Enforcement - Residential Final Inspection Office No.(518)761-8256 Arrive: am/p 4;rt- Date Inspection request received: — Inspector's Initi Is: C NAME: IT M a LOCATION: ATE: y 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 U Interior/Exterior Railings 34 in.to 38 in. y •p �t,L� Platform at all exterior doors Interior Handrails stairs 2 or more risers Enclosed Stairs Sheetrock Underside minimum '/2" m N Gypsum Grade away from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wallt)Ot5 6 inch clearance to sill plate n � Gas Valve shut-off exposed/regulator 18"above grade 1� 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 ® tJ��t✓ ��� E �� Low water shut-off boiler PL�too� Relief Valves installed/Heat Trap/Water Temp 110 Y Interior privacy/trim/doors/main entrance 36 in. � Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety Iazin Interior Smoke Det tors: Every level: very Bec�toom: ✓ Outside every bedroom ea: ,/ Inter Connected: / Batter backup: Carbon Monoxide Detector � Bathroom Fans, if.no window �! F�A�,�,� Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf t`LFj�J�t7 �.1 Emergency egress below grade 1_ )v Basement stairs closed rise>4 inches Garage Floor Pitched P�rt3�� CDJ Garage fireproofing/3/4 hour fire door/door closer r\ 0, G1�J Duct work Sealed properly1, Yl Gas Logs in Sealed or Glass Enclosure Attic access 30 in x 22 in,x 30 in.(ht.)In accessible area Crawl Spaces 18"x 24"access, I s . ft,150 s . ft.vents 0, h 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&Codes\Inspection Forms\Res. Final Inso. form 2.docLast printed 2/12/04 MIDDLE DEPARTMENT INSPECTION AGENCY, INC. that the electrical wiring to the electrical equipment listed below has been examined and is approved as being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date noted below and is issued subject to the following conditions. Owner: Darnley Date: 1 1 /09/2004 Occupant: Unknown Location: 10 Warren Lane Occupancy: Queensbury, Warren Co. NY Single Family Dwg. Applicant Darnley 21 , Westland Ave . �� Queensbury, NY --.. L- J Equipment: 2 — Switches; 2 — Receptacles; 8 — Fixtures; 1 — Burner, Wiring & Controls; 1, — Smoke Detector This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership inspection. No warranty is.expressed or implied as to the mechanical safety,effi- of the property indicated above,this certificate shall be immediately null and void. ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, be valid for a period of one year from the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department system to which this certificate applies be altered in any way,including but not limit- Inspection Agency,Inc. An application for inspection must be submitted to Middle ed to, the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. l Foundation Inspection Report Office No. (518) 761-8256 Date Inspection requ st received: _ 7 _ Queensbury Building&Code Enforcement Arrive: ani/pN Depart: am/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: _ �� PERMIT#: LOCATION: SPECT ON: TYPE OF STRUCTURE: Comments ---- ---- ^— Y N N/A s Footing Piers Monolithic Slab Reinforcement in Place ^1 U The contractor is responsible for 4 V providing protection .from freezing p gp g for 48 hours following the placement of the concrete. Materials for this pu—pr ose on site. Foundation/Wallpour enforcement in Place oundation Damppoofing � 4 Foundation/Waterproofing Type of Dampproofing/Waterproofing - J Footing Drain Daylight or Sump l ID 'V Footing Drain Stone: -} ) 12 inch width 3/- � I l O- 1 6 inch 3 above footing 6 pow for wet areas under slab �ac1�11Ap�tova1:�,� Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. L:\SueHemingway\Building.Codes.Inspection.FORMS\I-oundation Inspection Report.doe January 28,2003 Foundation Inspection Report Office No. (518) 761-82.56 Date Inspection request received: Queensbury Building&Code Enforcement Arrive: am/p Depart: Vpm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: PERMIT#: __k() LOCATION: _ INSPECT ON: t6ji-9104, J gviloo TYPE OF STRUCTURE: 3 rT) Comments Y N N/A Footings Piers Monolithic Slab Reinforcement in Place --Z The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this pu`pr ose on site. Foundation/Wallpour Reinforcement in Place Foundation Dampproofing Foundation/Waterproofing Type of Dampproofing/Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12inch width 6 inches above footing 6 mil poly for wet areas under slab Backfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- Rough Grade 6 inch drop within 10 ft. LASucHemingway\BuiIding.Codes.Inspection.FORMS\Foundation Inspeezion Report.doe .January 28,2003 FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement ` ► 742 Bay Road Queensbury, NY 12804�j (518) 761-8256 V'0 ~ ARRIVE: DEPART:��-U NSP: X; DATE INSPECTION REQUEST RECEIVED: NAME: L ATION: A /C) TE• U I / PERMIT# " OSILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFIM_ FRAMING N/A YES NO 1. foundation support, pier spacing permanuf. ........................ 2. anchoring per manuf. ............... — — — 3. water line shut off _ _ 4. sewer line support®4 feet ....... — — — 5. heating crossover (dblewide) off grd. — — — 6. dryer vented outside ...................... 7.• skirting_ventilated 8. hot water relief valve piping outside — — — 9. deck, potches,,steps, railing ........ 0. furnace/hot water operating ........ 1. garage fire proofing .................. 1 door closers ........................... — — — 1 plumbing fixture ...................... — — — 1 . foundation insulation (if appl.)...... 1 . smoke detectors ....................... 1 . final electrical ........................ 1 variance required ..................... — — — 1 .data plate okay ....................... — — — 19 mobile HUD seal okay .............. M 1# <06 LGI I �Serw# OV 405 M ufacturer Da of Manufacturer 2 Ov • � � KAY TO ISSUE C/O YES NO Comme xeua•ueld told i 3ldOS 0110 "I h ve seen or observe or bel' ve I saw evidence of, ail obje is such as hoe es, well ,trees, fences, etc., sho n n thi docum nt, f als represent that I have per n lly me ured he d' ances set forth on the diagram." J� SEP 0 Z004 SI AT DATE r ��►OF QUFE IV f U!L®lNG AND COD RY E HNV.L 011d3S .00C N011V9 000t j XO 8 Nouns1b181Q X9 ..f`.9L .09 it N'ANnSSN33fi0 .OE S3NIl "Ova-; .0.9.c 3NVI Ngbat%0� 2!P A31N21bQ M3U(jjVV AM3NFJ'1 N 2lat/M r i x'ua•ueld told 3"VOS O110N t - � ECEIVED I h pie seen or observe , or bel' ve I saw evidence of, all o je is such as hou es, well ,trees, fences, etc., SEP 2 0 2004 sho n n thi locum t. Val represent that I have T �� NN OF QUEENSBURy per n lly me ured he d' ances set forth on the diagram. 1«D1NG AND CpD f SI AT DATE I HNVL 0I1d3S -OQ£ NOIIV°J 0001 XOS � NOun8R11� SIO OL d � e 29 I t t s .09 `ot il'N'Aunes 33nb S3NI7 NVI N38HVM 0i . '0e HOV3l .09-6 3 -dr A3lNUVd M3NONV ,001 3NVI N MuVM