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2004-753 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: P20040753 Date Issued: Monday, May 15, 2006 This is to certify that work requested to be done as shown by Permit Number P20040753 has been completed. Tax Map Number: 523400-226-019-0001-057-000-0000 Location: 15 FOREST Rd Owner: GERALD & PATRICIA KILLEEN Applicant: GERALD & PATRICIA KILLEEN This structure may be occupied as a: Residential Alteration 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 Director of Building&Code V rce nt Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5962 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040753 Application Number: A20040753 Tax Map No: 523400-226-019-0001-057-000-0000 Permission is hereby granted to: GERALD & PATRTC'TA KTT,T,F,F,N For property located at: 15 FOREST 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 Orduiance. Type of Construction Value Owner Address: GERALD &PATRICIA KILLEEN Residential Alteration $8,000.00 19 CLYDE Ln Total Value $8,000.00 HILTON HEAD, SC 29926-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-753 NEW FOUNDATION $40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, February 08, 2006 (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 Tov�of Q, Lnsb s bruary 08, 2005 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement BLDG. PERMIT NO. QC)C)14 7 APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY A TEMPORARY CERTIFICATE OF OCCUPANCY is hereby requested for the property located at; s for the following uses: 1 5: DATE SIGNATURE OF APPLICANT TEMPORARY CERTIFICATE OF OCCUPANCY -- - - -The-T-EMPORAR-Y- CERTIFICATE-OF-OCCUPANCY-is hereby--- _ (i),14PPROVED ( )DISAPPROVED with the following conditions: - � �} e ` c � C c CC 1 � TEMPORARY CERTIFICATE OF OCCUPA CY F k— O $100.00 k received on Uo Date of Iss6ahce Director of Bldg. & Code Enforcement THIS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES 0 DAYS FROM THE DATE OF ISSUANCE. NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code Enforcement or his designee. Buul+ding'Pcrmxt Applicatlon Town of Queensbmy—Dept of Community Dcvelopment,742 Bay Road,Queensbury,NY (518)761-8256 i A permit must be obtained before beginning construction. Permit File No. 3 No inspection will be made until applicant has received a Feo Paid $.LLLL1 0 valid building permit. All applicants' spaces on this Ree.Fee Psi application must be completed and must appear on the Reviewed y: application farm. 01N Applicant: .a .G p� Owner: Address: r3 Address: f115 , Phone#G ) z Phone# cation: Lot Number: / House Number �/ �� /`✓�`a Property Location: � Subdivision Name: Tax Map Number: + ✓� / �0 New Building. residence /commercial . 'EstxmatedMarket Valuc of Construction: '0 Addition: residence:Y commercial If an Addition,what will'use of new addition be? i 0 Alteration: residence/-commercial Cl No change to exterior size: residence om'1 Othet work(describe mod&44 - I Check Occup=cy1nformatlon, 1' Floor 20a Floor Other floor Total Below sq.it. sq.ft. =q.ft. Soars Feet I o Single&=fly dwelling o Two fw:dly dwelling 2004 0 Townhouse 0 Multifamily dwelling TOWN BUILDING UEEN ODE Y #of uaits 0 Office o Mercantile 0 Manufaatmda o 1 car detached garage 0 2 car detached eme 0 3 car detached garage 0 1 car Attached garage 0 2 car attached garage 0 3 car attached garage 0 Storage building- Commercial o Storage building- St 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 Et Wtaces to be installed Number of laodltoves to be installed List below the person(s)responsible for supervision of work as regards to building codes- Name Address- Phone Number Builder Plumber IMason /Y em dly G &claratk : please sign below after you have carefhlly read the statement: To the best of my lmowled2a 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 promises 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 7lwe shall submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning Administrator or Director of Building and Codes,anAs But/t Survee by a licensed surveyor;drawn to scale,showing actual location of all new gonstruction. Signature: A �wner,owner's agent,architect,contractor Queensbury Building & Code Enforcement - Residential Final Inspection Office No.(518)761-8256 Arrive: am/p Depart: �am/pm Date Inspection request received: _ Inspector's Initials: _ r NAME: V—( PERMIT#: O' '"7 3 LOCATION: it yo,f�"j{-( L,n) DATE: 05_ 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 Com lete 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 3 Grade awayfrom foundation 6 in.with 10 ft. ✓� C 6Z., {a( t✓'�L— �I`,�5 /\/ \L Handrail Termination at Newell Post or Wall C12 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/Window in stairwells safety glazing Interior Smoke Detectors: Every level: / Every Bedroom: Outside every bedroom area: Inter 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 asement stairs closed rise>4 inches ara a Floor Pitched P Gara a fire roofin./%hour fire door/door closer ((%I(� Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure �� 2 0-se /Uo i Arp&016- 0 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 Building No./Address visible from road Final Electrical Site Plan /Variance required Final Survey Plot Plan As Built Septic System/Sewer D section Sticker Flood Plain Certification,if re fired Okay to issue C/C or C/O(Temporaiyl Permanent Q© �O / f� L:\PamW\BuildinQ&Codes\Inspection Forms\Res, Final Inst). form 2.docLast printed 2/12/04 C� V =Queensbury Building & Code Enforcement - Residential Final Inspection Office No.(518)761-8256 Arrive: am/ m part: mrIPm Date Inspection request received: -�- Inspector's Initials: NAME: ,� Qri` �f-�. PERMIT#: LOCATION: DATE: iv 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 1 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 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: / Every Bedroom: Outside every bedroom area: Inter Connected: / Battery backup: Carbon Monoxide Detector Bathroom Fans, if no window Plumbin 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/'/4 hour fire door/door closer Duct work Seated 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 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 i L:\PamW\Building &CodesUnspection Forms\Res, Final Insp. form 2.docLast printed 2/12/04 P/V - 3 ,P Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: $ S Queensbury Building &Code Enforcement Arrive: am/ �.Depart: anv`pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: �- NAME: ��=C�C ���— PERMIT#: ��U —7S 3 LOCATION INSPECT ON: TYPE OF STRUCTURE: C mments N N/A tings 1 Q ' Piers Mon ithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour Reinforcement in Place Foundation Dampproofing Foundation/Waterproofing Type of Dampproofing/Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch 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. I:�SueHemingway\Building.C:odes.Inspection.FORNISToundation Inspection Report.doc Januaiy 28,2003 Septic Inspection Report Office No. (518)761-8256 Date InspectiVreed: Queensbury Building&Code Enforcement Arrive: part: 742 Bay Rd., Queensbury,NY 12804 Inspector's InNAME: ����t�LOCATION: =y; : RECHECK: Comments and/or diagram Soil Type: Sand/Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: $, Absorption Field: Total length ft. Length of each trench ft. Depth of trenches $. Size of Stone -Seepage Pits: Number Size: x Stone Size: Piping Size Type Buildingto tank l% y J Tank to Distribution Box Distribution Box ld/Pit Opening Sealed: Y /Partial End Caps Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan _Y N Engineer Report and As-Built Y N Location of System on Property: Front Rear Left Side Right Side Middle Fr t Middle Rear S stem Use S tus: Approved Partial Approved and needs to be re-inspected, please call the Building& Codes Office Disapproved Last revised 1/6/05 3 , d eeA %\�(fL-) VIktej Septic Inspect-ion Report Office No. (518)761-8256 Date Inspection requ C ive z 05 Queensbury Building&Code Enforcement Arrive: a p epart: rn/pm 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials: NAME: 6- e,-ctd ERMTT NO.: o�O7��- �5`3 LOCATION: 1 Fob-- tZd-- INSPECT ON: 3 RECHECK: Comments an o dia ram Soil Type: Sand/Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance _ft. Well separation distance _ ft. Other wells: ft. Absorption Field: Total length ft. Length of each trench ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x �l Stone Size: �i Piping SizeN Type) Building to tank Tank to Distribution Boxes Distribution Box to Field/Pit Opening Sealed: Y/N/Partial End Caps Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. V� C_- �� \��\` f_ Conforms as per Plot Plan Y N N �`i Engineer Report and As-Built _ Y N `�'�' Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear System Use/Status:pproved artial Approved and needs to be re-inspected, please call the Building&Codes Office isapproved Last revised 1/6/05 Septic Inspection Report Office No.(518)761-8256 Date Inspection request received: a U Queensbury Building&Code Enforcement Arrive: am/ Depart: am/p 742 Bay Rd., Queensbury,NY 12804 Inspector's Initials. NAME: PERMIT NO.: LOCATION: �[���� ,� INSPECT ON: RECHECK: I v �� � �C+ `" l Comments and/or diagram Soil Type: Sand/Loam/Clay Type of Water: Municipal/Well Water Waterline separation distance ft. Well separation distance ft. Other wells: ft. Absorption Field: Total length ft. Length of each trench _ ft. Depth of trenches ft. Size of Stone Seepage Pits: Number Size: x_ Stone Size- Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/Pit Opening Sealed: Y/N/Partial End Caps Location/Separations Foundation to tank ft. / u � f Lr Foundation to absorption ft. G' Separation of Pits ft. / Conforms as per Plot Plan Y N Engineer Report and As-Built Y N / ¢c Location of System on Property: ' Front Rear Left Side Right Side Middle Front Middle Rear System Use Status: Approved Partial Approved and needs to be re-inspected, please call the Building& Codes Office YDisapproved Last revised 1/6/05 ey Foundation Inspection Report 361— Qo � Office No. (518) 761-8256 Date Inspectiot reque t ece' ed: Queensbury Building &Code Enforcement Arrive: am/ Depart: v`pm 742 Bay Rd., Queensbury,NY 12804 Inspector's iti NAME: c� QD � IT#: LOCATION: SPECT ON: TYPE OF STRUCTURE: Comments Y N N/A ootings Piers Monolithic Slab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48.hours following the placement of the concrete. Materials for this purpose on site. Foundation/Wallpour r Reinforcement in Place Foundation Dampproofing Foundation/Waterproofing �1-�` � 1 0 Type of Dampproofing/Waterproofing � � �� �q Vn P� Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width e� 6 inches above footing 6 mil poly for wet areas under slab Bacicfill Approval Plumbing Under Slab PVC/Cast/Copper Foundation Insulation Interior/Exterior R- _ Rough Grade 6 inch drop within 10 ft. LASueHemingway\Building.Codes.Inspection.FORMSToundation Inspection Report.doc January 28,2003 Queensbury Building & Code Enforcement - Residential Final Inspection 3 Office No. (518)761-8256 f •� / Arriv g %v am/pm / pa am/pm Date Inspection request received: / �j Inspector's Initials: NAME: , , PERMIT#: 7 LOCATION: DATE: TYPE OF STRUCTURE: Comments Yes No N/A Building Number/Address visible from road Chimney Height/"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete latform at all exterior doors 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 Interior xterior Railings 34 inches to 38 inches terior 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 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 s . 1-150 s .ft.vents Bathroom Fans, if no window Plumbing fixtures Foundation insulation 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 Valve(s)installed/Heat Trap/Water Tern 110 Enclosed Stairs Sheetrock Underside minimum%z"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/C or C/® [Temporary/Permanent] L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doe