2003-822 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERT IFICATE OF,-OCCUPANCY
Permit Number: P20030822 Date Issued: Monday;December 22,2003
This is Ito cerrtlthat work re uestedao:be done as shown.li'� Permit Number
y+ y P20030822
has been completed,
Tax Map Number: 523400-289-015-0001.034-028-0000
Location: 55 SURREY FIELD Dr
Owner: RODNEY&DORIS BURNS
.:.Applicant: RODNEY&DORIS BURNS
This structure may be occupied as a:
By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
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: P20030822 Application Number: A20030822
Tax Map No: 523400-289-015-0001-034-028-0000
Permission is hereby granted to: RODNFV&DORTS B1-JRNS
For property located at: 55 SURREY FIELD Dr
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: RODNEY&DORIS BURNS Residential Addition $24,000.00
55 SURREY FIELD Dr Total Value $24,000.00
QUEENSBURY, NY 12804
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
2003-822
144 SQ FT 3-SEASON PORCH WITH 192 SQ FT DECK AS PER PLOT PLAN SPECIFCATIONS.
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, October 30, 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 before the expiration date.)
Dated at the of Q u sbunv; uysda October 30, 2003
SIGNED BY 4"9 for the Town of Queensbury.
Director of Building&Col Enforcement
Building 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. Permit File No.
No inspection will be made until applicant has received a Fee Paid
valid building permit. All applicants' spaces on this Rec.Fee Paid
Reviewed B
application must be completed and must appear on the Y
e
application form.
Applicant: Owner: 01:0 —4re-KS
Address: 40 L,1_ ��-- Address: Dp—.
_ WCta_5a7,,
Phone#(,Vg)�- 0,3-:-S Phone 9 z/
Email Address: Email Address:
Property Location: Lot Number: House Number65_._
Subdivision Name:bL-k-c e_' Ids Tax Map Number:
C3 New Building: residence /commercial Estimated Market Value of Construction: $ oZYt Odd
)Q Addition: residence.,I commercial IfanAddition, h will use of new addition b
r3 Alteration: residence/ commercial. w :A C�_je
_;Y_ ez_ki d We
U No change to exterior size: residence I com'l I
o Other work(describe U0%AVE V_\�
Check OccupancyInformation 1"Floor 2,d Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
k" Ez
-,5t Single family dwelling ,t( a a (.
0 Two family dwelling
c3 Townhouse
0 Multifamily dwelling
I #of units
0 Office
U Mercantile
C3 Manufacturing '
U 1 car detached garage
U 2 car detached garage
0 3 car detached garage
[a I car attached garage
❑ 2 car attached garage
U 3 car attached garage
0 Storage building-
commercial
U Storage building-
residential
C3 Other
What is the proposed height of the structure feet nchei
Will any second-hand or ungraded lumber be used? If so,for what? n
Type of Heating System: electric/ oil gas t wood 1 forced hot air/ baseboard othefAYMELL—
Number-of Fire Yacav to bedustalled - c _Number of W oodstoves to be installed 0-
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder F N
Plumber 0
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 Vwc 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,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of al ew construen.
Signature: owner,owner's agent,Architect,contractor
Building Permit Application
Town of Queensbury-Dept of Community Development, 742 Day Road,Queensbury,-NY
(518)761-8256
A permit must be obtained before beginning construction. Permit Fil
No inspection will be made until applicant has received a Fee Paid
valid building permit. All applicants' spaces on this Rec.Fee Paid
-application must be completed and must appear on the Reviewed By:
application form.
Applicant.ZZ:4�- y? Owner: 1god --ZFr
Address: Wllla wl (S-& Address: 56-5u rr-,e---,l F_,7e-195 ve
A-11s,W4102R_57 tc 2ehs6a_r-v
Phone#(,;U_R-)7-dam- Phone#(5/k) 19` -
Email Address: Email Address:
Property Location: Lot Number: a g t House Number�J
Subdivision Name:'Su- d _5 Tax Map Number:
L3 New Building: residence /commercial Estimated Market Value of Construction: $
;wl' Addition: residence commercial If an Addition,what will use of new -addition be?'
L3 Alteration: 'zresidence/ commercial.
E3 No change to exterior size: residence com'l
0 Other work(describe
Check OccupancyInformation 1"Floor 2'd Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
Add. e-de--
X Single family dwelling
0 Two family dwelling
C3 Townhouse
C3 Multifamily dwelling
#of units zn fln d-
0 Office
u Mercantile
U Manufacturnig
0 1 oar detached garage n�vcQP 01 JEENSBUF Y
0 2 car detached garage CCU{-Dll',IG AND_CODE
0 3 car detached garage
0 1 car attached garage
.0 2 car attached-garage
0 3 car attached garage
0 Storage building-
commercial
C3 Storage building-
residential
0 Other
What is the proposed height of the structure feet inches
Will any second-hand or ungraded lumber be used? If so, for what? 0
Type of Heating System oil gas/Wood /forc6dhot air/ baseboard/othet:
Number of Fire-places to be installed -Number-of Woodstoves to be installed- (9-
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder'
Plumber 9 -'0 3
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 Vwe 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,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction.
Signature: CiAl.'n" owner,owner's agent,architect,contractor
U
Residential Final Inspection
Office No. (518)761-8256 Date Inspection req st r eel
Queensbury Building&Code Enforcement Arrive: p rtrt: a pm
742 Bay Rd., Que rrsbury,NY .12804 Inspector's Initia
NAME: (.t= P IT#:
LOCATION: ATE:
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
Interior/Exterior Railiri s 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: f Battery 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
3/4 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
Buildin 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 10(Cert. Of Occupancy)
Okay to issue Permanent C/O(Cert. Of Occupancy)
L:\SueHemingway\Building.Codes.Inspection.FORMS\Res.Final Insp.form 2.doc edited January 28,2003
COMMONWEALTH ELECTMCAL INSPECTION SERVICE, INC,
Main Office 176Igoe Run Road - Manhezm, PA 17545
MUNICIPAL CERTHFICATE ELECTRICAL APPROVAL �
Nag 75960
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The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelled:
This certificate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of m ' inspections at any time, and if its
p p
rules are violated, the Company shall have the right to rry oke is ertifica .
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Member N.P.P.A., 1#A.E.I4
Rough Plumbing 1 Insulation Inspection Report--[�,,�
Office No. (518)761-8256 Date Inspection request ved:
Queensbury Building&Code Enforcement Arrive: pm De
742 Bay Road, Queensbury,NY 12804 Inspector's Ini als-
NAME: PERMIT #: V
LOCATION: ` _> INSPECT ON: 3
TYPE OF STRUCTURE:
Y N N/A
PVC: R-1,R-2,R-3,R4 Drain/Vents
Cast Iron,Copper Drain/Vent/Comm.
Plumbing Vent/Vents in Place
Rough Plumbing/Nail Plates
1 1/ inch min. Drain Size
Washing Machine Drain 2 inch min.
Head or Air Supply Test
Drain and vents
5 PSI or 10 feet above highest
connection for 15 minutes
Cleanout every 100 feet/change of direction
Water Supply Piping
r
ooper Commercial
Coo er,CPVC,Pex One and Two-Family Ll
nsulation/Residential Check/Commercial Check
Proper Vent,Attic Vent
Duct/Hot Water Piping Insulation � �
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS:
L-31
G:\SueHemingway\Building.Codes.Inspection.FQRMSVtough Plumbing Insulation Report.doc November 17,2003
Framing/Firestopping Inspectionv. ;0y"Y
Office No. (518)761-825 6 Date Inspection requ r ceived:
Queensbury Building&Code Enforcement Arrive: rrllpm Do
742 Bay Road,Queensbury,NY 12804 Inspector's Initi I
2
-0
NAME: PERMIT#: --4�
LOCATION: 77�5.s- z, INSPECT ON:
TYPE OF STRUCTURE:
Y /N N/A COMMENTS
aming
V
Jack Studs Headers
Bracing Bridging
Joist hangers 1--U S
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
I V2(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
An or Bolts 6 ft, or less on center
Xne and snow shield 24 inches from wall V/
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 Yz inch or 5/8 inch Type X
Garage side 5/8 inch Type X
CeilingAyall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
LASuellerni ngway\Building.Codes.Inspection.FORMSTrarning Firestopping Inspection Report.doc January 28,2003
do)
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/ Depart: _ a pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: 0
LOCATION: INSPECT ON: --
TYPE OF STRUCTURE: ' .z
Comments
Y N/A
of gs
Pier
onolithic 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
g� 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.
L:\SueHemingway\BuiIding.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
t
�Cliecl�; Residential Plan Review: One&Two Family Dwellings
Y/N/N/A
(2)Full sets of plans
Over 1,500 sq. ft.—Stamped
Design Loads On Plans: 90 Wind Floor Loads 40 psf
70 Ground Snow Load Sleeping Areas and Attics 30 psf
Calculations:
Window Schedule With Glass Size
Door Schedule/Main Entrance 36"Door
Emergency Escape Or Bedrooms and Habitable Space
Above/Below grade,5.7 sq.&
Grade,5.0 sq.ft.
24"(h)x 20"(w)min.
44"Max.Height above floor
Residential Check Paperwork Compliance and Inspectors Checklist: OK
Dampproofing/Waterproofing Materials On Plans
it Foundation Drainage On Plans,if required
k! 6"Drop in 10' Exterior Grade
Framing Cross Section For Each Roof Line,Vertical Fire Stopping Every 10' Where
Required
Ice and Snow shield 24"Inside Exterior Wall/24"Inside Knee Walls
Platforms At Exterior Doors
Stairway Headroom 6' 8'All Stairs 36"Width
Stair Run and Rise
Winder Run and Rise r�
cti Spiral Not Allowed From 2" Story
,t Smoke Detectors Battery Backup and Proper Location
Lt Bathroom Fixtures Proper Clearance
„ Hall Width,36"min.
Handrails More Than One Riser On Open Sides
Railing and Guards>30"/Basement Stairs Included/Closed Risers More Than 4"in Ht.
Safety Glazing Notes For Required Areas
Garage Fire Separation
Garage Floor Sloped
/0 1 Attic Access
of Roof over 30"—22"x 30"/Crawl Spaces 18"x 24"Access
t l Carbon Monoxide Detector Lowest Sleeping Level
B t Soil Test Results,if required
1; Septic To Well Or Water Line Separation
All Paperwork Signed
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47 WILLIAM STREET\HUDSON FALLS, NY 12839
(5 18)798-0338 FAX: (518)798-0338
SCALE /4.
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PRODUCT 204-1(VqlaSbods)205-1 VAA
JOS�12t-'y S
-r,\OV c)ONSTRUC
loV SHEET NO. OF
A Div.
a Of 00 CALCULATED BY DATE 26-0
Affirecht Man 3
_gmntcorp.
47 WILLIAM STREET\HUDSON FALLS, NY 12839 CHECKED BY DATE
(518)798-0338 FAX: (518)798-0338 SCALE
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2.
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4
Pt EtCf204-1
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WK