2002-381 G TOWN OF'QUEEN'SBURY
742 B.ay Road,Queensbuiy,NY 12804-5902 (518)761-8201
Community Development--Building,&Codes. (518)761.8256
CERTIFICATE CIF OCCU'PANry
1
Permit Number: P20020381 Date Issued: Wednesday,June.,26,2002
This is to certify that.work requested to be done as shown by Permit Number P20026381
has been completed.
Tax Map Number: 523400-302-009-0001.031=000-0000
Location: 323 DiXON'Rd
Owner: DAVID&DEOLINDA VAN WINKLE
Applicant: DAVID&DEOLINDA VAN WIME
This structure may be occupied as a:
By.Order of Town Board
Residential Alteration. TOWN of QURRNssURY
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: P20020381 Application Number:, A20020381
Tax Map No: 523400-302-009-0001-031-000=0000
Permission is hereby granted to: DAVIT)&DF,OLTNDA VAN WTNKT,F
For property located at: 323 DIXON 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: DAVID &DEOLINDA VAN WINKL
323 DIXON Rd Residential Alteration 10,000.00
Total Value 10,000.00
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2002-381 RESIDENTIAL ALTERATION
(RAISE WALLS,NEW ROOF)AS PER APPLICATION,
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,May 29,2003
(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 d wn of eensbury• Wednesday,May 29,2002
1
SIGNED BY for the Town of Queensbury.
Director of B ding Code Enforcement
Building Permit Application
Town of Queensbury Dept of Community Development,742 Bay Road,Queensbury,NY
(518)761-8256
y
A permit must be obtained before beginning construction. Permit File No.
No inspection will be made until applicant has ieceived a .Fee Paid
valid building permit. All applicants' spaces on this Rec.Fee Paicy $
application must be completed and must appear on the Reviewed '
application form.
Applicant: Yr a%t� a ns ks ve��n Owner: 'l .y.e� n•.�n t�1 n �l� fi
._v, cam_{; Address: �
Address: Mn At �t:r iz�,ft
621.2vv5; "gills ._A7 2&DI �,ccnsbt�rci toy tzFrO�/
Phone 15t Phone#(6(k) 7 g
Property Location: Lot Number: / House Number
Subdivision Name: Tax Map Number:
❑ New Building: residence /commercial Estimated Market Value of Construction: $ /a .000 ao
❑ on residence/ commercial �I1t O-
Alteration residence commercial If an Addition,what will use a1dxhon[beT31"i
❑ o c ange o exte esidence/com'1
❑ Other work(describe }
Check OceupancyInformation 1"Floor 2n Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
❑ Single family dwelling
❑ Two family dwelling
❑ Townhouse i
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile
❑ Manufacturing
❑ 1 car detached garage
❑ 2 car detached garage
❑ 3 car detachedgarage
❑ 1 car attached garage
❑ 2 car attached garage
❑ 3 car attached garage
❑ Storage building- y
commercial f
❑ Storage building-
residential i
Other
F
What is the proposed height of the structure jW feet /0 inches
Will any second-hand or ungraded lumber be used? If so,for what? 4416,
Type of Heating System: electric/ oil /`*gas/wood /forced hot air/ baseboard/other:A.)1 f4
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 r
Plumber
Mason
Electrician n or-e-r- - \1 k e .Sr£r-7 f,:r-a4rs59
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 and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all ne onstruction.
Signature: owner,owner's agent,architect ontractor
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS
Compliance 4ethods: PART 5 - Acceptable Practice Method
1&2 Family Dwellings (only) OT,
PART 6* - Thermal Rating - Component Trade offs
1&2 Family Dwellings;. Multi-Family
Dwellings (3. stories or less)
PART 4* - Design by Component Performance
Commercial Buildings-Hi Rise Residential
*Requires ,submission of -worksheets
APPLICANTIS 'NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE...,PRACTICE:
1 . Gross Floor Area /,q eoa square feet
2 . Type of; Heat - Electric Oil K Gas Other
3 . Is building mechanically cooled? Yes -12( NO
4 . Percentage of area of windows and doors Over 17% b( Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST 'CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R _V0
b. Exterior walls R
C. Glazed areas R
d. Exterior do6rs.- R
e. Floors over unheated spaces R
f Edge of slab on grade (heated building) R
9
g. Ba8emenit/cellar walls (above grade) R
h. Basement/cellar walls (below -grade) R
i. Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heating- device
Conf orins to. minimum efficiency per code Yes No t)106-
TEMPERATURE CONTROL MAXIMUM SETTING 1400 WILL NOT BE EXCEEDED
Aprc nt I's S ture Date Phone Number
V!
INSPECTOR'iS REMARKS:
RESIDENTIAL FILIAL INSPECTION REPORT
Office No.(518)761-8256 Date inspection request received:'
Building&Code Enforcement
Dept of Community Development Arriv�--�+�m Depart t;--O
Town of Queensbury Insp�r's Initials
742 Bay Road
Queensbury,New York 12804
NAME \i ill\) t o t 1) _ P LOCATION �`3, �Vi-Q K) �A DATE
TYPE OF STRUCTURE
N/A YES NO CONMEENTS
Chimney HeightP'B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in,or more
Interior Handrails stairs both sides 3 or more risers
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off expos(Wregulator 1 "abo a grade
Gas Furnace shut-off within 30 feet or-i 'thin lin of site
Oil Furnace shut-off at entrance to fumy a area
Furnace/Hot Water Heater operating
Relief Valve(s)installed
Headroom,6 ft.6 in.on stairs
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides more than risers
Interior privacy/trim/doors/main entrance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/Landing 18 in.or mor
Railing across window in stairwells /
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer l
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif.of Compliance)
Okay to issue temp.C/O(Certif.of Occupancy)
Okay to issue permanent C/O(Certif.of Occupancy)
��., �� � Office
ff c_�-
GENEIAII.r INSPECTION REPGRT-'�_ :.: I�spe or: �D
Town of Queensbatry
Ready at time:
Dept. of Community Development Request receive& Meet:
.Building& Code.Enforcement At time:
742.Bay Road
Queensbury, NY 12804 .ARRIVE�A a �P�R �1s � am a Notes:
(518) 761-8256 Inspector's Initi .
NAME: �� ��� 1 lt�f-I PERMIT# Z -b
LOCATION: 7�, � INSPECT ON(date): j9 —pZ
TYPE OF STRUCTURE:
RECHECK _
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsib fo
providing protection from fr zi ig
for 48 hours following the pla ent
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 P ce
Rough Plumbing
Heating Rough-In
`6hsulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
*Valls 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 Queensbaary Ready at time:
Dept. of Community Development Request received: 3 6 Meet:
Building c& Code Enforcement At time:
742 Bay Road
Queensbury, .NY 12804 ARRIVE a F a Notes:
(518) 761-8256 .Inspector's.Ina as f
NAME: PERMIT# C�)6� v /
LOCATION: c r INSPE T ON(date):
TYPE OF STRUCTURE: tie
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 VentlVents 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-
er nt,Attic Vent
Fr Lack Studs/Headers f�jj�,�
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:tSueHemingwaylBuilding.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received: Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVB%,D a PA mIpm Notes:
(518) 761-8256 Inspector's Initi
NAME: PERMIT#
LOCATION: 2? 1 D OP Jjp INSPECT ON(date): —(5—C)Z--V-
tOF —
TYPE OF STRUCTURE: jAL n7EE!47�ffi�
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 purp se site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofin
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Plac
Rough Plumbing-_
Heating Rough-In
Place proinT
, 0 f g
'Jab
Vent/Vents
In Plac
Insulation
Foundation Walls Interior
Foundation Walls Exte * R
I
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Pp6per Vent,Attic Vent_
raining
Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam___
Air Infiltration Barrier
Fire Separation 1,2,3,hour FVDV\�-�
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppffig �ODC ,
L:\SueHemingway\Building.Codes.Inspcction.FORMS\GENERAL INSPECTION REPORT.doc