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2002-575 TOWN OF QUEENSBURY G 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)761-8256 CERT IFICAT E OF OCCUPANCY Permit Number: P20020575 Date,zssued: Friday,August 02,2002 This is to certify that work requested to.be done as shown by Permit Number P20020575 y has beeicompleted, Tax Map Number: 523400-295-019.0001-030-000-0000 Location: 12 PINEWOOD Ave Owner: FLORENCE SIMMONS LE Applicant: FLORENCE SIMMONS LE This structure may be occupied as a: By Order of Town.Board Residential Addition TOWN OF QUEENSBURY ! Director of Building&Code Enfor ement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020575 Application Number: A20020575 Tax Map No: 523400-295-019-0001-030-000-0000 Permission is hereby granted to: FLORENCE SIMMONS LE For property located at: 12 PINEWOOD Ave 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. . Tue of Construction Value Owner Address: FLORENCE SIMMONS LE Residential Addition KATHRYN SIMMONS Total Value 12 PINEWOOD Ave QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical inspection Agency ERICS CUSTOM CARPENTRY&PAINT NY 12804-0000 Plans&Specifications 2002-575 12 Pinewood Avenue, Westland, Section 3: 1956 zoning Residential addition-480 sq. ft. family room $75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 10,2003 (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 of do a Jul 10.2002 SIGNED BY rm 7 lw� .V r 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. No inspection will be made until applicant has received a Fee Paid $ !:�5,cv R3 Ec F� I f E D valid building permit. All applicants' spaces on this Rec. Fee Paid application must be completed and must appear on the Reviewed By: 'JUL 0 5 2002 application form. TOWN Or=QU /al fly, Dim. Applicant: Idt- 6'e- P CODE O.V. -C�= Address: 2,9 12• 10-/ 171s Address: L 3�tl-y Phone# 7 54- :0 `,a:7 Phone# bl,f-7 Email Address: lac_ Aor- eoi-1- Email Address: Property Location: Lot Number: '73 q1 House Number Subdivision Name: Tax Map Number: L3 New Building: residence /commercial Estimated Market Value of Construction: $ 4C ci Addition: residence commercial If an Addition,what will use of new addition be? u Alteration: residence commercial 0 No change to exterior size: residence r"I com'l r2o o Yin E3 Other work(describe Check Occup3incylnformation 1"Floor 2 Floor Other floor Total Below sq.ft. sq.ft. sq.ft. Square Feet -Single-family dwelling , c3 Two family dwelling C3 Townhouse L3 Multifamily dwelling #of units E3 Office Q Mercantile U 0 Manufacturing U I car detached garage U3 2 car detached garage L3 3 car detached garage 0 1 car attached garage 0 2 car attached garage 0 3 car attached garage L3 Storage building- commercial 0 Storage building- residential 0 Other What is the proposed height of the structure feet Q inches Will any second-hand or ungraded lumber be used? If so,for what? Type of Heating System: electric/ oil /(-gas wood /forced hot airjag�- -ar other: 94 S--0 A 12 IN 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 7 4 f-t-.c Plumber �Gcfr f-C 7 ;9 1 -2 4 Mason ck,cr2 et 7�4 f,r. ks- Electrician -4ee Ide- 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 1/vVe 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. Signatures" owner,owner's agent,architect,contractor ENERGY CODE COMPLIANCE APPLICATION TOWN OF QUEENSBURY, WARREN COUNTY,?O())..,5m 9000 :HEATING DEGREE DAYS Compliance Methods:Part 5 -Acceptable Practice Method— 1&2 Family Dwellings (on ) 1 V ED Part 6*- Thermal Rating—Component trade Offs 1&2 Family DwellirmX 0 5 2002 Multi-Family Dwellings (3 Stories or less) Part 4*- Design by Component Performance, Commercial Buildkgs-;, n F Q5j`E�SBUF3Y Rise Residential �Alp ®®� *Requires submission of worksheets APPLICANT'S NAME: PROPERTY LOCATION: tic., R1 r4 Fr-o f?vu�s y � PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: I. Gross Floor Area- q�-D square feet 2. Type of heat- Electric Oil Gas,�Other 3. Is building mechanically cooled? yes--X-- No 4. Percentage of area of windows and doors Over 17% Under 17% 5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TOR VALUES AS SHOWN ON PLANS SUBMITTED: a. Roof R b. Exterior walls R-9-1 C. Glazed areas R 3.b 0--- , L d. Exterior doors R— e. Floors over unheated spaces R:j'ram f Edge of slab on grade(heated building) R L O g. Basement/cellar walls (above grade) R % 0 h. Basement/cellar walls (below grade) R j o i. Heating/cooling-ducts-piping in unheated space R N 6. Service (domestic)hot water heating device Conforms to minimum efficiency per code _Yes No TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED A I' is Signature Date Phone Number INSPECTOR'S REMARKS: COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. Main Office 176 Doe Run Road - Manbeim, PA 1754 MUNICIPAL CERTIFICATE w ELECTRICAL APPROVAL Off, Cut-in Card No.}•# 1! # f f! ti11 foot Pennit No,lq•••t•1iilft#Nf•11111tiilf}•t••#1liiNO � • t ifftt#Iff#Ili/###fl11f!!li 11lill#ilii�ll �IHI}}i111!!i�!#It/ ��•#liiHft}} 1N fflf114111fififf##liflllli1 Iloilo foil fiillli1if Nff#!!lftfllll Ni1#!i/Iliillflii t! 1 �Ai 16-C Y Q 1 i •t!#Hi#f!!#f4fili111}4tiuffii/t4••••tr}}1###1.1# I�O�atlon��1�11/ulltlfill�Iliu#fr4nrlif1111if#l�IlNfif#flilt!lfnflffrfll#antifill/NlINIlfiff/f4flflipllfuf lf414 J/ 3 InstallationConsisting of I#1lf14!•f/•1•i11fliilifffiitt•t••yi4##/!#fl/1/#•li••i•t44#if11141•!1•�q!###f4#1•�••1#rl4Nlt4!•••t•il# fist•#•H#Ifll#4••1#•ltil f}Iu1•lfttufli•!•••uf lttfit#!f•#tit####fllf!llu/N}}}}i}}•}N•111N#!filf tila•lilllli#1ltfillNft••H•If##f#14tf11fi•flHfl!!Mi•tfrNll}p}••u•1#Nfllu•nN•1#41N•/i•Iffl4 ••1if111i•r•i•t#;11#fi11•01004f•#f#Ioff#•61//1 1#191•fittfilttleofl/1116 N tf/41ltommoftt##tff tell 11!•t•IIr#flfmmof•1#4001114141t6#f/#41}!t••}•}f#1f•4•*##M Mom love to iA 6/ t ' 1 Installed I •1liiiff#fif#ffr•rrilfifl}}i•ilifut4f44f11+1•Ilfwut•f•••i!#iftif#flMltii•f••r#•fN#1!/f I�11 Not tt•!/llfl/„ii••ilifiiti•tI•I#/fff41t1i!/1!1!#••# Y Inc conditions following governed the issuance of this certificate, and any certificate previously issue i cancelled: This certificate onlyavers the electrical equipment and installation conditions as of date. Upon th( t t introduction of additional equipment or alterations, application shall be ptly made for inspection} Inspectors of this Companyshall have thep�vilege of makin inspe tuns at any time, end if it rules are violated, the Company shall have the right to ev a this tet Datetall! #4•i•tlni•11114ttu.111f#llt+i•itr#fit#u•t INSPECTOR #fM 41f1#11fii+•• #uifN41••ta#rir4lfi♦ri4#a/f•t/4t1u•INtpt•hu}}}1!••}••Nf#If4•� Uamhar N FA A . 1.111. Cz RESIDENTIAL FINAL INSPECTION REPORT Office No.(518)761-8256 Date inspection request received: PM Building&Code Enforcement I Dept.of Community Development Arrive aT61relpart toe Town of Queensbury r's Initia 742 Bay Road Queensbury,New York,12804 NAME 0tfl PERMIT# cl,7 LOCATION I Z-F1 Xej,/�ecld DATE 7 TYPE OF STRUCTURE N/A YES NO COMMENTS Chimney HeightPB"Vent/Direct Vent Location Fresh Air Intake Plumb Vent through roof Roof Complete Exterior Finish Complete IJ hiterior/Exterior Railings 30"to 36" Exterior Handrails,balconies,landing 18 in.or more Interior Handrails stairs both sides 3 or more risers V- I Grade 2%away from foundation IV/ 8"clearance to sill plate V Gas Valve shut-off exposed/regulator 18"above grade_ Gas Furnace shut-off within 30 feet or within line of site OilFurnace shut-off at entrance to furnace area -J 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 3 risers. I/ Interior privacy/trim/doors/main entrance 36" Floor Finish BaftoomMitchen watertight Interior Handrails Balconies/Landing 18 in.or more_ Railing across window in stairwells Smoke Detectors: every level every bedroom outside every bedroom inter connected Bathroom fans Plumbing fixtures Foundation insulation V 3/4 hour fire door/door closer Garage fireproofing Garage penetrations scaled Furnace in separate room protected(in garage) Light ventilation per room_ Safety glazing 18"or I s from floor Final Electrical U Site Plan/Variance req ed 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) I �-CV\i� Office Use GENERAL INSPECTI(fN REPORT Inspector: Town of Queensbury Ready at time: '.Dept. of Community Development - Request received: Meet: Building& Code Enforcement At time: 742 Bay.Road Queensbury, NY 12804 ARRIVE VE a P a In Notes: (518) 761-8256 t Inspector's Initia NAME: s - ' PERMIT# �S 1 LOCATION: 10R ., 1`f�1 ti e WO o C INSPECT ON(date): —C� TYPE OF STRUCTURE:" RECHECK ; NIA YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place Y. The contractor is responsible for providing protection from freezing y for 48 hours following the placement - of the concrete. s . Materials for this purpose on site FoundationlWallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place. . Rough Plumbing \ Heating Rough-In ,3 tlnsulation Foundation Walls Interior R- Foundation Walls Exterior R- "4 Floors R- VWalls R- •` �� b .Ceiling R- Duct work or piping in unheated spaces R- Froper Vent,Attic Vent raming Jack Studs/Headers � Bracing/Bridging `'<; c Joist Hangers Jack Posts/Main Beare Air Infiltration Barrier ; ire Separation 1,2,3,hoer enetration Sealed Fire Wall 2,3,4 hour k Firestopping L:1SueHemingway\Building.Codes.Inspection.FORMSIGENERAL INSPECTION REPORT.doc GENERAL IN, PECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building&Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive Depart Inspector's Initi s NAME: PERMIT# LOCATION: VSN-�E_DXTE : e 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 C> of the concrete. Materials for this purpose on site Foundation/Wallpour�_ Reinforcement in Place Foundation/Dampproofing_ Backfill Approval Plumbing Under Slab Plumbing VentfVents 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, At Vent Framing Jack Studs/Headers 6AAN TA Bracing/Bridging A Joist Hangers__ Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1,2, 3,hour Penetration Scaled Fire Wall 2,3,4 hour Firestopping Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensbury im Ready at te L� Dept. of Community Development Request received: d?( Meet. Building& Code Enforcement At time: 742 Bay Road Queensbury, NY 12804 ARRIVE 7PEImT# �"�=C7U a m Notes: (518) 761-8256 Inspector's Initi NAME: � rwYs. (� '<✓r�,Jr LOCATION, 0006 t 1A INSPECT ON(date): 7 6 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 Voundation/W allpour Reinforcement in Place Foundation/Dampproofmg Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in Place Rough Plumbing Heating Rough-In Insulation °6 Foundation Walls Interior R- Foundation Walls Exterior R- Floors R- Walls R- Ceiling R- Duct work or piping m 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 f Fire Wall 2,3,4 hour Firestopping L:\SueHemingway\Bcii]ding.Codes.Inspection.FORMS\GENERAL INSPECTION REPORT.doe A. Office Use GENERAL INSPECTION REPORT Inspector: Town of Queensberry Ready at time: Dept. of Community Development Request received: Meet: Building& Code Enforcement At time: 742 Bay Road Notes- Queensbuiy, NY 12804 ARRIVE amIpm: DEPART am/pm (518) 761-8256 Inspector's Initials NAME: PERMIT# JOQo�- LOCATION: pc,iP� 00,& INSPECT ON(date): TYPE OF STRUCTURE: RECHECK N/A i YE NO COMMENTS *,Footings/Piers V- Monolithic Pour Form Reinforcement in Place '-Z 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/Dampproofin 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 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_— L:\SueHemingway\Building.Codes.hispection.FORMS\GENERAT,INSPECTION REPORT.doe