2003-845 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: P20030845 Date Issued.: Monday,December 19, 2005
This is to certify that work requested to be done as shown by Permit Number P20030845
has been completed.
Tax Map Number: 523400-297-QI0-000I-0I7-000-0000
Location: 33 WINCOMA Dr
Owner: PETER&LORI WERBLOW
Applicant: PETER&LORI WERBLOW
This structure may be occupied as a:
Residential Addition 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 wilding&Code ce nt
Planning Board or Zoning Board of.Appeals.
ry Y' TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development'-Building&Codes (518) 761-'8256'
BUILDING, PERMIT
Permit Number: P20030845- Application Number:. A20030845
Tax Map No: 523400-297-010-0001-017-000-0000
Permission is hereby granted to: PETER &LORT WERBLOW
For property located at: 33 WINCONIA 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: PETER&LORI WERBLOW
33 WINCOMA Dr Residential Addition $5,000.00.
Total Value $5,gg0.q0
QUEEENNSBURY,NY 1280470000
Contractor or Builder's Name/".Address Electrical Inspection Agency'.
Plans&Specifications
2003-845
RESIDENTIAL ADDITION AS PER PLOT PLAN SPECIFCATIONS
$75.00 PERMIT FEE PAID-THIS PERMIT"EXPIRES: Thursday; October 07, 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'To of Que sb T ' O��, 07, 2003
SIGNED BY for the Town of Queensbury:
Director of Building&Code Enforcement
Building.Permit Application ==
Town of Queensbury—Dept of Community Development,7.42 Bay-Road;Queonsbury,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 $---1>C>
valid building permit. All applicants' spaces on this Rec.Fee Paid -$ -
applieation must be completed and must appear on the Reviewed By:
application form.
Applicant:`P�t P.9, Owner: rZ uttF_ru3�o� �
Address: Address: trn/inicayNs ._,y ryE
C-14 1&A13>-1
Phone#(,57 8; Phone#(_) -
Property Location: Lot Number: / House Number !- cs1 t [ j
Subdivisionl-tame: Tax Map Number:
0 _,New Building: residence./commercial` 'Estimated Market Value of Construction:$ daze
Addition: residence/ commercial
ercial rcialIf at Alteration: residence comm an Addition,what will use of new addition be?
0 No change to exterior size: residence!com'i
n Other work(describe
Check OccupancyInformation 1' Floor 2° Floor Other noor Total
Below sq.ft. sq.ft.
sq.f#. Square Fee!
Single.faulily dwelling
ci Two family dwelling
o Townhouse
o Mulftu32ily dwelling
#of units
G office, " a��A:.� na a c• 13
o Mercantilo —
o Manufacfurin
P- I car detached garage
-
a 2 car detached garage-
0 3 car detached garage
o l car attached garage
0 2 car attached garage
0 3 car attached garage
e Storage building- -
commercial
o Storage building-
residential
a Other
What is the proposed height of the structure. l 2 feet' inches
Will any second-hand or ungraded lumber be used? If so,for what? 1'2'z:>
Type of Heating System electric/ oil./ s- o d /xOr d aseboasd/other: /4'47�
Number of Ftreffl es to be installed �Num er of o dsigves to be installed- <`
List below the person(s)responsible for supervision of work as regards to building codes:
Name . Address Phone Number
.Builder- � �vz: � . �
Plumber
Mason
Electrician
Daciaration: 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
ffi
with,whether spe ed or noted,and that such work is authorized by the owner. Further,it is understood that I/we shall
submit,prior to`a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator.or Diractor of Building and Codes,an As-.swift Suz=by a licensed surveyor,drawn to scale,showing actual
location of all new nstruction.J-
Signature: owner,owner's agent,architect,contractor
Queensbury Building & Code Enforcement - Residential Final Inspection
.Office No.(518),761-8256 Arrive: t l->am/pm Depart: —am/pm
Date Inspection`request received: Inspector' nitials: — �G-.. w
NAME: PERMIT#: 0�J✓
LOCATION: 4`?Z ---T o DATE: Z
TYPEOF STRUCTURE:
Comments
Y N N/A
Chimney Ht.1"B"Vent/Direct Vent Location / ,7
Fresh Air Intake /
3 inch Plumb Vent through roof minimum 6"
Roof Complete/_Exterior Finish Complete VT
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 Railin s 34 in.to 38 in.
Platform at all exterior doors
Interior Handrails stairs 2 or more risers
Enclosed Stairs Sheetrock Underside minimum '/z"
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/Window in stairwells safety glazing
Interior Smoke Detectors:
Every level: / Every Bedroom:
Outside every bedroom area:
Inter Connected: 1 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
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/'/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..S aces 18"x 24"access, I 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 I C or C/O Temporary/Permanent
L:IPamW\Building&Codesllnspection FormslRes. Final Insta.form 2.docLast printed 2/12/04
Framing /Firestopping Inspection Report
Office No. (518)761-8256 Date;Inspection request received- ..........
i
Queensbury Building&Code Enforcement Arrive: airv �rt: Uam/pm
742 Bay Road, Queensbury,NY 1.2804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: 35 '(t) INSPECT ON: r<
TYPE OF STRUCTURE:
Y N N/A
Framin2 COMMENTS
Jack Studs Headers
Bracing Bridging
Joist hangers rz 5
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(w) 16 gauge(8) 16D nails each side
Draft stopping 1,000 sq. ft. floor trusses
,! nchor Bolts 6 ft. or less on center
Ice and snow shield 24 inches from wall V/
Fire separation 1, 2,3 hour
e 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
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,lnspection.FORMS\FramingFirestopphig Inspection Report,doe January 28,2003
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received: 'ter
Queensbury Building&Code Enforcement Arrive: am/ Depart __dm/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initial : Tj,�7/
NAME: C�'l�J PERMIT#:
LOCATION: o _ INSPECT ON:
TYPE OF STRUCTURE:
Con nnents
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
oundation 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 1 Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:LSueHemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Reportdoc January 28,2003
jq
Foundation Inspection Report
Office No. (5 18)761-825 6 Date Inspection request received: a
Queensbury Building&Code Enforcement Arrive: am/prq D art: am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#:
LOCATION: SPECT ON: U f
TYPE OF STRUCTURE:
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.
----Afatm+xfs-��Trpose on site.
Foundation/Wallpo'ur
Reinforcement in Place
V
Foundation/Waterproofing
Type of Dampproofirtg/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:\SueHon-dngway\Building.Codes.Inspection.FORMS\Foundation Inspection Report.doc January 28,2003
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0
Foundation Inspection Report
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p
�sp-L Depart:6>,.Y ajVpm�7
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initial..
NAME: PERMIT#:
LOCATION: ehc, INSPECT ON:
12—r)2,
TYPE OF STRUCTURE:
Comments
Y N N/A
00 s ting 7—
Piers
Monolithic Slab
Reinforcement in Place The contractor is respon*le or I
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:1Sue,liemingway\Building.Codes.Inspection.FORMS\Foundation Inspection Report doc January 28,2003
B £ILDI G & C ., D Ek
RE VIEWED BY. � •.�
0 0A T
TOWN OF QUEEN'88URY-8U101i jG DEPARTMENT NT i
Based on our limi(ed examination,
30 compplianrn'AIP our comments shall �
not be construed as indicating the
plans and specifications are in fult f
Z compliance with the Building Codes ' '`
of New York State. - 00 C.-:
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