2001-180 41
TOWN OF QUEENSBURY
���^r 742 Ba Road eensb NY 12804-5902 518 7 -
y ,Qu ury ( ) 61 8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010180 Date Issued: Monday, June 16, 2008
This is to certify that work requested to be done as shown by Permit Number P20010180
has been completed.
Location: 58 ELLSWORTH Ln
Tax Map Number. 523400-265-000-0001-018-000-0000
Owner. TODD STEVENSON
Applicant: TODD & CONNIE STEVENSON
This structure may be occupied as a:
Garage - 2 Cars Attached By Order of Town Board
Residential Addition TOWN OF F QUE NSBURY
(""- emp 4
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 Enforcement
Planning Board or Zoning Board of Appeals.
•
-�` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Wiil
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010180 Application Number: A20010180
Tax Map No: 523400-028-000-0001-017-000-0000
Permission is hereby granted to: TODD & CONNIE STEVENSON
For property located at: 58 ELLSWORTH 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: TODD & CONNIE STEVENSON Residential Addition
58 ELLSWORTH Rd Garage-2 Cars Attached 10,000.00
LAKE GEORGE,N.Y. 12845 Total Value 10,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2001-180
780 SQ FT 2-CAR ATTACHED GARAGE WITH 80 SQ FT BREEZE WAY AS PER PLOT PLAN
SPECIFICATIONS
$50.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday,April 27,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town Que sb lrida ', A , 'it 27,2001
SIGNED BY .' for the Town of Queensbury.
Director of Building&Code Enforcement .
Building Permit Application
Town of Queensbury - Dept. of Conunutzity Development, 742 Bay Road, Queensbuty, NY 12804 [761-8256J
BUILDING & CODE ENFORCEMENT
NOTICE Requirements prior to issuance r _ j -
A permit must be obtained before of this permit: PERMIT FILE NO. {={�)• 1 ç()
beginning construction. No inspections
will be made until applicant has received n Zoning Board Action PERMIT FEE PAI
a VALID BUILDING PERMIT. All Area /Use RECREA770N FE PAID$applicants' spaces on this application
MUST be completed and the signature 0PlanningBoard Action
of the applicant must appear on the
REVIEWED BY. __It--
SPR / Subdivision /Other Building fn.perror
lication form. Thma N„� Recreation Fee Payment
Applicant: / -/ / cN-) Owner: _ / ?n c(J
'�-t+
. ' Address: 3 ' /- - -'o( - ,ep Address: APR 1 7 2001
tOWN0F.
Phone # (5J q ) 7 y� - Kcj/U Phone # ( L. BUII� OU�ENSSURty
Property Location: 6�� El/Src.1o/�, ,Q /� mil;0 �
• Tax Map Number ass / I. / / 7
Subdivision Name: Section Block I nt
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
t/ New Building: CONSTRUCTION: $ /0 Oc 0
residence / commercial /
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing
t/ Other
GROSS AREA OF PROPOSED STRUCTURE:
If ADDITION, what will use
1st Floor 74Sv sq. ft. of new addition be? :
2nd .F1'oor. . ., sq. ft.
Other Flouts sq. ft.
(not unfinished cellar or basement) #‘4-_. i
. ... ACCESSORY BUILDINGS:
• Detached Garage 1, 2 . car
TOTAL FLOOR AREA: .2 V SQ. FT. 1/ Attached Garage 1, carfj
Private Storage Building 4 —
SIZE OF NEW STRUCTURE: g'�� Jpi Comme ;l--Storage- ding ,S •
o�Cn ' FEET X 301 FEET I at- e Corral—Storage-
e_ L`.../ozy'
-{K. lU C,1
Foundation T r
YPe: F�St fvo(/,')-yS - Will any second-hand or ungraded
' Number of Stories: • I lumber be used? If so, for what?
(habitable space ot3ily) r
Height (grade to ridge) : c,40 feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or wood stove (circle all which applies)
to be installed:, d Electric / Oil / Gas / Wood
Forced Hot Air / Baseboard / Other
Person reFiRggsible or supervision of work as regards to building
codes is : /d'c, -/ , civt, " •-//St.)04,; tO. -7cia-4fo 1 U
p me Addresss •
Phone
Builder:
c!/ /�,�e:-,fan
Plumber: ./2 _
• Mason: /o (S / •e �i'z-S
Electrician:,'- ockt )-c.✓•i-hK-c--,
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, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, showing actual location of project on premises.
Signature: U
(owner, owner's agent, architect, contractor)
Queensbury Building & Code Enforcement - Residential Final Inspection
,
Office No.(518)761-8256 Arrive: /0, m/pnp e art: am/pm
Date Inspection request received: Inspectors Initials: �:,,.
NAME: ,`Sty g _�, i,-� f PERMIT#:
LOCATION: E//S it.)Orti, ( i.. DATE:
T F ST U`�TRE:
.5,9,AA CR t`� /'P��C� Com en s
!� Yes LTV N/A
Building Number/Address visible from road .
Chimney Height/"B"Vent/Direct Vent Location /
Fresh Air Intake /,• '•-7 71G"�
3 inch Plumbing Vent through roof minimum 6 inches j `-7 J
Roof Complete/Exterior Finish Complete / •
Platform at all exterior doors fferrY14
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more ) red kik—
Guard at deck,porches 36 inches or more P
Handrail Termination at Newell Post or Wall 0 - 3/7/
Interior/Exterior Railings 34 inches to 38 inches
Interior Handrails @ stairs 2 or more risers 0- ,> �, �
—41
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate 0 1 ? /07.,
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches f• . _.'F.Ir'.,
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing 2 o
Interior Smoke Detectors: E I '" ` y
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 :RiePLilt/ O
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq. ft.vents _
Bathroom Fans,if no window
Plumbing fixtures /��'Ci
Foundation insulation N.
Floor truss,draft stopping finished basement 1,000 sq.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 Temp 110
Enclosed Stairs Sheetrock Underside minimum%"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/3/d 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/0[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form revised_100405.doc
Loy ( Pm
GENERAL INSPECTION REPORT
( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road 47
Queensbury,NY 12804 Arrive am/pm Depai /2at pm
Inspector's Initial
NAME: U PERMIT# 1—1 2C
LOCATION: DATE : b
TYPE OF STR TURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is re:•ins .le for
providing protecti n from -ezing
for 48 hours folio 'ng the •lacement
of the concrete.
Materials for this p i ••se o ite
Foundation/Wallpou
Rei orceme 'n Pl.•-
Fo dation/Damppro•fing
ckfill Approval • •
lumbing Under Slab
Plumbing Vent/Vents•i Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Int-rior R-
Foundation Walls E r-rior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
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
Firestopping
GENERAL INSPECTION REPORT AriA( 518 ) 761-8256
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive am/pm Depart 1_1!_l_rz&
�'� Inspector's initials
NAME: S A._0\)�'�N <2r/r'-() � PERMIT# 00(—7 �j 0
LOCATION: 6-&,) DATE: `7/—, 7CY(s)
TYPE OF STRUCTURE: - o.Q — ( no(
RECHECK b
N/A YES,)( COMMENTS
",Footings/Piers G r0 /
Monolithic Pour Form
Reinforcement in Place 7 r y L/
The contractor is responsi I
providing protection from g
for 48 hours following the ent
of the concrete.
Materials for this purpose on -
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Backfill Apprb .
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
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
Firestopping