2002-305 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761.8256
CERLS.TIFICATE OF COMPLIANCE
Permit Number: P20020305 Date Issued: Monday,June 21, 2004
This is to certify that work requested to be done as shown by Permit Number P20020305
f
has been completed,
Tax Map Number: 523400-295-007-0001-006-000-0000
Location: 1176 WEST MT: Rd
Owner: CARL&MICHELLE BORGH III
Applicant: CARL&MICHELLE BORGH III
This structure may be occupied as a:
By Net of Town Board
Garage-2 Cars Detached 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: P20020305 Application Number: A20020305
Tax Map No:;, 523400-295-007-0001-006-000-0000
Permission is hereby granted to: CARL &MICHELLE BORGH III
For property located at: 1176 WEST MOUNTAIN 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
Ordinance. Type of Construction 'Value
Owner Address: CARL &MICHELLE BORGH III
1176 WEST MT. Rd Garage-2 Cars Detached 12,500.00
QUEENSBURY,NY 12804 Total Value 12,500.00
Contractor or Builder's Name Address Electrical Inspection Agency
Plans &Specifications
2002-305
672 SQ FT 2-CAR DETACHED GARAGE AS PER PLOT PLAN SPECIFICATIONS
$67.20 PERMIT FEE PAID - THIS PERMIT EXPIRES. Thursday,May 08,2003
(if a longer period is'requited,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at theednesday,May 08,2002
SIGNED Byfor the Town of Queensbury.
Director of Building&Code 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 _ S
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: /7� Gp G Owner:
Address: lc)t=' - _ Address:
Phone#(_) g - J_ Phone#( ) -
Property Location: Lot Number: / House Number /
Subdivision Name: Tax Map Number:c,9 7 5 — 0'
t
New Building: residence /commercial Estimated Market Value of Construction: $ �p O
o Addition: residence/ commercial If an Addition,what will use of new addition be?
❑ Alteration: residence/ commercial
❑ ,No change to exterior size: residence/com'1
❑ Other work(describe )
Check Oeeupaneylnformation I"Floor 2 Id Floor Other floor Total
Below sq.ft. sq.ft. sq,ft, Square Feet
❑ Single family dwelling
❑ Two family dwelling1
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile '_
❑ Manufacturin
❑ 1 car detached garage + f
❑ 2 car detached garage G 6$
❑ 3 car detached garage e 0�111111 C` m�Vn clo-=^'
❑ 1 car attached garage
❑ 2 car attached garage
❑ 3 car attached garage f
❑ Storage building-
commercial.
❑ Storage building-
residential
❑ Other
f
i
What is the proposed height of the structure feet inches i
Will any second-hand or ungraded lumber be used? If so,for what? y
Type of Heating System: electric/ oil / gas/wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed Number of Woodstoves to be installed
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder
Plumber
Mason
Electrician #
i
r
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 I/we shall
submit,prior to a Certificate of Occupancy or Certificate of Compliance being issued,as requested by the Zoning
Administrator or Director of Building nd Codes an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new ors coon
Signature: owner,owner's agent,architect,contractor
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No.(518)761-8256 Arrive: ,15)De rt--- 41 a pm
Date Inspection request received: Inspector's
NAME: T#:
LOCATION: N�k:� 122 L9 Ad XATT — =4�-
TYPE OF STRUCTURE:
F:""' 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 V2"
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 Valve(s)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
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door/door closer
Duct work Sealed property
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 sq. ft.-150 sq.ft.vents
BuildiU No./Address visible from road
Final Electrical
Site Plan /Variance required
Final Survey Plot Plan
As Built Septic System/Sewer Dept.Inspection Slilgker I
Flood Plain Certification, if required t I
Okay to issue C/C or C/0[Temporary fiermap�j I �j
Ll---*" -"'
L:\PamW\Building&Codes\Insvection Forms\Res.Final Insi).form 2.docLast orinted 2/12/04
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time: 14t,
Dept. of Community Development Request received: Z-- Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVE-amlpm: DEPAR amlpm Notes:
(518) 761-8256 Inspector's Initials
NAME: PERMIT#
LOCATION: INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
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_
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
Tack Studsffleaders_��. S-c44-� 4L
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppin
L:\SueHemingway\Bitilding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doe
Office Use
GENERAL INSPECTION REPORT Inspector:
To-wn of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVE I- T W:46"am/pm Notes:
E
Us
e
a EP R
(518) 761-8256 Inspector'sIni I
NAME: rz-f)agPAzT U6ti
PERMIT# CZ5'2— CS
LOCATION: INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
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/Darnpproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent,Attic Vent
�aming
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam__
Air Infiltration Barrier.
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour_
Firestopping
L:\SueHemingway\Building.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:�4e
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
I I -�ul Notes:
Queensbury, NY 12804 ARRIVE a m: !jR�C
(518) 761-8256 Inspector's Ini
NAME: Txl�/-
C � PERMIT#
LOCATION: INSPECT ON(date):
TYPE OF STRUCTURE:
RECHECK
N/A YE NO COMMENTS
Monolithic Pour Form
Reinforcement . e
The is res ible for
providing pr tection fi-o freezing
for 48 hours ollowing the lacement
t t r s
n
te
0
is ct�e o
s
e
n fi'o
ibl f
llowing the
e_s purpose on
0
o .0
f the concr e.
Materials for s purpose on ite
Foundation/Wa our It I P c
Reinforcement i Place)0)JW
Foundation/Damp roofi,
� v
Backfill Approval
Plumbing Under SlAb
Plumbing Vent/Vent N in Place
Rough Plumbing_ \
Heating Rough-In__�_
Insulation
Foundation Walls In erior R-
Foundation Walls Ex erior R-
ei:
Floors R-
Walls R-
Ceiling R-
Duct work or piping .
unheated spaces R-
Proper Vent,Attic Vent_
Framing
Jack Studs/Headers
Bracing/Bridging_
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppig-
L:\SueHemingway\Building.Codes.Inspcction.FORMS\GENERAL INSPECTION REPORT.doc
DEED REFERENCE.
MICHAEL do KATHLEEN WYKES
TO
MICHAEL W. WYKES ,5'$ f A".1
DATED FEBRUARY 23, 1978
IN BOOK 612 PACE 22 •� r`3� /1 a c�lp hAl
rD 0 u y
)cf ke K �d Cg10 /a /
P.F. IX
ki/�30 �/ �/� or °
56 gg r S 8357 .1 /ds T/o '< o
06.
AREA:( SAC f o
(4.76 Ael-
CRE
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N 9 46'00'
:� Eus�t� -rli.i STL1P )ao v'cC bi
JO U
LAst K...w a Nac. 1 0
LANDS OF
ANN C. & JOSEPH E. HOCKER 2 �\J
to
{ � W
MAP OF A SURVEY MADE FOR
C,ARL BDRGH
TOWN OF , OUEENSBURY COUNTY OF WARREN N.Y.
.SCALE- 1'=100' DATE� OCTOBER 4, 1991
VanDusen & Steves
LAND SURVEYORS,GLENS FALLS,NEW YORK
IA.F. IRON PIPE FOUND
N.Y. STATE LIC. NO. 35617 1RF.m IRON , FWNO
IRS. IRON ROD
74-1-36 RENSED OCTOBER 9•t991 MAP # 91286