2003-766 TOWN-OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes';(518)761-8256.
CERTIFICAT,
E OF, OCCUPAN" '
Pefrrut;Number:
12003O766 � � Date Issued:. Friday;June 25,2004
This is to certify that work requested to be done as shown;by Permit Number
�. r has been completed.
Tax_Map Number:. ' 523400-290-017-0001-016-000-0000
Location: 16 MASTERS COMMON SOUTH
owner: RALPH DE WITT ,
Applicant: .RALPH DE WITT
This structure may be occupied as a:
By Order of Town Board
Residential Addition TOWN of QUEENOURY
Director of Building&Code Enforcement ,
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: p20030766 Application Number: A20030766
Tax Map No: 523400-290-017-0001-016--000-0000
Permission is hereby granted to: RALPH DF.WTTT
For property located at: 16 MASTERS COMMON SOUTH
in the Town of Queensbury,.to:construct or place
at the above location in accordance with application together withplot plans and other infotrnation hereto filed
and approved"and in compliance,with the NYS Uniform Building Codes and the QQueensbury Zoning
Ordinance. Type of Construction Value
Owner Address: RALPH'DE WITT
16 MASTER COMMONS SOUTH Residential Addition $15,000.00
Total Value $15,000.00
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
TRI-CROSS
DANA CROSS
APWYLE
Plans&Specifications
2001-766
353 SQ FT DECK AND CELLAR AS P-ER PLOT•PLAN SPECIFCIATIONS
$40.00, ; PERMIT FEE PAID-THIS PERMIT EXPIRES; Sunday, September 26, 2004
(If a longer period is required,an application for an" extension must be made to the,code Enforcement Officer
of the Town of Queensbury before4he expiration date,)
Dated at the Tg Queen ury; Ilay, September 26,2003
SIGNED BY /" for the Town of Queensbixry.
Director of Building&Code nforcement"
Building Permit Application
Town of Queensbury-Dept of Community Development,742 Bay Road,Quecnsbury,NY.
(518)761-8256
A permit must be obtained before beginning construction. Permit File No. C-53--- -7
No inspection will be made until applicant has received a Fee paid $ t
valid building permit. All applicants' spaces on this Roe.Fee Paid -
application must be.completed and,must appear on the
application form. Reviewed By:
Applicant-.
, I _ trl , .� Owner: a
Address: _Ito 14 4"1 s to rs C'�a.,,,e „ �'a.. Address:
Phone# Phone*(—) 6'y
Property Location: Lot Number:;_ _I House Number Id" / M e s 4d_a s M z,o ui So C t.
Subdivision Names It r t ce,, p. j, Pc Tax Map Number: - a s?y o a-avri-1�i t 7_acac3 t-
4116 —Doc)^O oc>c>
o New Building: residence /commercial 'Estimated Market Value of Construction: $k5_, G AP0-'--
jq Addition: I residence/ commercial If an Addition,what will use of new addition be?
0 Alterations residence/ commercial
O No change to exterior size: residence/com'l
o Other work(describe
Check OccupaneyInformation i' Floor 2" Floor Other floor Total
Below sq.ft. sq.A
• sq.ft. Square Feet
o Single family dwelling i_}7"
o Twofkmily dwellin
o. Townhouse
0 - MuitiflMily dwelling "
#of units
cl a Office
o Mercantile
o Msaufacturirt. -
4 1 car detached garage
0 2 oar detached garage
o'-- 3 car detached garage
o l car attached garage
tz 2 car attached garage
ca 3 car attached garage
a Storage building-
commercial
0 Storage building-
residential
G Otherc " 1 ;.r 3
What is the proposed height of the structure feet.' " 2. inches c{
ear 9 aV\t✓+
Will any second-hand or ungraded lumber be used? If so,for what? /Yo "
Type of Heating System: electric/ oil / gas/wood./forced hot air/ baseboard/other:�&.0 it P_
Number of Firenlczces to be installed _Alo tt a Number of Wvodstaves to be installed m n c
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone1Number
Builder I ?'`." » vLi Plumber o IL c
Mason
Electrician L
Declaration: pioase sign below atter-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 11we shall
submit,prior to a Certificate of Occupancy or Certificate of&mpliance being issued,as requested by the Zoning
Administrator or Director of Building and Codes,an As Brrllt Starve:>by a licensed surveyor;,drawn to scale,showing actual
location of all new construction.
Signature: _�(i' �[l 0 O� - owner,owner's agent,architect,contractor o
Residential Final Inspection
Office No. (518) 761-8256 Date Inspection re u st re e' ed:
Queensbury Building&Code Enforcement Arrive: a In D rt: �m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: i2 ' P T#: 7 1 '"Z,?&
LOCATION: I tA TE: �--p _
TYPE OF STRUCTURE:
Comments
Y N N/A
Chimney Ht./"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumb Vent through roof
Roof 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
Inteiior/Exterior Railings 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Grade away from foundation 6 in.with 10 ft.
Handrail Termination at Newell Post or Wall
8 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 Valve(s)installed
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: ! Batteiy backup:
Bathroom Fans,if no window
Carbon Monoxide detector
Plumbing fixtures
Foundation insulation
Floor truss,draft stopping finished basement 1,000 sf
Emergency egress below grade
Basement stairs closed rise>4 inches
3J4 hour fire door/door closer
Garage fireproofing
Duct work Sealed properly
Attic access 30 in.x 24 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(Cert. Of Compliance)
Okay to issue Temporary C/O(Cert. Of Occii anc )
Okay to issue Permanent C/O(Cert. Of Occupancy)
LaSueHemingwaylBuilding.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC.
Main Office 176 Doe Run Road Go Manheim, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
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The conditions following governed the issuance of this certificate, and any certificate previously issued iL�
cancelled: -
This certificate only covers the electrical equipment and installation conditions as of date, Upon th(
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of.this Company shall have the privilege , maki pections at any time, and if it
p py
rules are violated, the Company shall have the right a
a thi ce ' lcatef
DatetffH}#/if#iffffit#t,Iiif{iNff#if#illttitft#p#fR INSPECTORfffff Mo#####1{ #fir ' # #{ill}if#ffi4lt#t#flffgliNtuuf{+
Member NIT.Af, I4AiEfii
Framing/Fireslopping Inspection Report
Office No. (518)761-8256 Date Inspection re u t r ceiv d:
Queensbury Building&Code Enforcement Arrive: �� a pm D art:
742 Bay Road,Queensbury,NY 1.2804 Inspector's Initial
NAME: PERMIT#:
LOCATION: 1(0 INSPECT ON:
TYPE OF STRUCTURE:
Y N N/A COMMEN TS
Framing
Jack Studs 1 Headers
Bracing Bridging V/
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 V2(K) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft, or less on center
Ice and snow shield 24 inches from wall
Fire separation 1,2, 3 hour
Fire wall,2, 3,4 hour
Firestopping
Penetration sealed
16 inch insulation in cavity min.
Garage Fire Separation
House side V2inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORMS\Framing Firestopping Inspection Report,doo January 28,2003
Af
Framing /Firestopping Inspection Report
Office No. (518)761-8256 Date inspection re received: /Ar)
Queensbury Building&Code Enforcement Arrive: P Dh: V,. Jkt
742 Bay Road,Queensbury, NY 112804 Inspector's Ini
Pe w.'T- I 4L,pp -7
NAME: PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
Y/ N'
N/A COMMENTS
Framing
Jack Studs/Headers
Bracing Budging
Joist hanger
JackPosts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 36 in. or more
Headroom 6 ft, 8 in.
Notches Holes/Bearing Walls
Metal Strapping for Notches Top Plate
I V2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall
Fire separation 1,2,3 hour
Fire wall,2, 3,4 hour
Firestopping
Penetration scaled
16 inch insulation in cavity min.
Garage Fire Separation
House side Y2 inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7'sf above/below grade
5.0 sf grade
L:\SueHemiiigway\Building.Codes,lnspection.FORMS\FramingFirestopping Inspection Report.doc January 28,2003
��\-
Framing / Firestopping Inspection Report
Office No. (518)761-8256 Date Inspection requ recei
Queensbury Building&Code Enforcement Arrive:ISL-720a p e rt: m/pMM'4��
742 Bay Road, Queensbury,NY 1.2804 Inspector's Initia
NAME: R,BN PIA PERMIT#:
2 7-2; C co
LOCATION: \to %J\p6yv:z j,)jAtA 0 INSPECT ON:
TYPE OF STRUCTURE:
Y N XA COMMENTS
Framing V
Jack Studs Headers
Bracing Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in.
Stairwells 3 6 in. or more
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 V2(w) 16 gauge(8) 16D nailseach side
Draft stopping 1,000 sq. ft. floor trusses
Anchor Bolts 6 ft.or less on center
Ice and snow shield 24 inches from wall
Fire separation 1,2,3 hour
Fire wall,2, 3,4 hour
Firestopping
Penetration scaled
16 inch insulation in cavity min,
Garage Fire Separation
House side V2inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Ceiling/wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above I below grade
5.0 sf grade
L:\SueHemingway\Building.Codes.Inspection.FORlv[S\Framing Firestopping Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No.(518) 761-8256 Date Inspection reque c d:
re ue c
Queensbury Building&Code Enforcement Arrive: a Depart:
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial
P MIT#.
NAME: FRMIT#:
LOCATION: V AT\ ZQ- 4^s 1 ayl\ . SPELT ON:
TYPE OF STRUCTIM:
Comments
Y N N/A
Footings
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
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump,
Footing Drain Stone:
12 inch width
6 1,p es above footing
,Vmil poly for wet areas under slab
Xackfill Apptoval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
LASueHerningway\Building,Codes.InspectionTORMSToundation Inspection Report.doc January 28,2003
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection re es r ei d:
es r gee i ?p
Queensbury Building&Code Enforcement Arrive: 7p, 1 Depart: AA��aml
P
742 Bay Rd.,Queensb NY 12804 Inspector's Initii I
I
NAME: ER MI TT#: 03
LOCATION: O SPECT ON:
TYPE OF STRUCTURE:
Comments
/X-
Y N N/A
-Footings
Piers
Monolithic Slab
Reinforcement in Place V/
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 Danipproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of 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.
L:\SucHeniingway\Buildir)g.Codmlnspection.FORMS\Foundation Inspection Report.doe January 28,2003