2000-787 TOWN OF OUEENSBURY
742 Bay Road, Queensburl, NIA 12804-5902 (518) 761-8201
Community Development = Building & Codes (518) 761=8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20000787 Date Issued: Friday, January 25, 2002
This is to certify that work requested to be doge as shown by Permit Number P20000787
has been completed,
Tax Map Number: 523400-289-008-0001-054-000-0000
Location: 6 LAKEVIEW Dr
Owner: RONALD W STEVENS
Applicant: RONALD W STEVENS
This structure may be occupied as a:
By Order of Town Board
Residential Addition TOWN OF QUEENSBURY
Director of Building & Code Enforcement
'I'C}WN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761 -8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
----------------
Permit Number: P20000787 Application Number: A20000787
Tax Nlap No: 523400-046-000-0003-011 -000-0000
permission is heresy granted to: RONALD W STEVENS
For property located at: 6 LAKEVIEW 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: RONALD W STEVENS Residential Addition M000.00
6 LAKEVIEW Dr Total Value 19,000.00
QUEENSBURY, NY 12804
Contractor or Builder's Name j Address Electrical Inspection Agency
plans 8s Specifications
288 sq. ft. residential addition
6 Lakeview Drive
, . Lake Sunnyside Estates, Section 1
Subdivision approval Feb. 21 , 1973
$24400 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday, October 30, 2002
(I f 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 rQue sbf 1}&on tuber 30, 2000
SIGNED BY / for [he Town of Queensbury.
Director of Building & Code Enforcement
Building Permit Application
WftTown C+,f QueeIZSb711y - Dept, of ca►rrmurrity Develappient, 742 Bay R(md, Qsiee nshury, NY 12804 1761-82561
gtg
BUILDING & CODE ENFORCEMENT
Requirements prior to issuance
Fog'
rmit must be obtained before of this permit: FRECREA7701V
FILE NO.
ixxg construction. No inspections E PAID $
be made until applicant has received Q $ Beard ACt�CNI
a 'VALoM BUILDING PERMIT. All Arca / Use
applicants* apeow on this application FEE PAID $
MUST be completbd xod- thte signature 0 Pkvvdng Board Actkm REVIEWED BY.-
of the applicant inuat appear an the SPR / Subdivision / Other 1 lGfing tnctxctor
lication form. rs ,*. Recreation Fee Payment
Applicant: /ece 7w r x?,4 IW&&io ' if &/ysmpe'�: lF
Oxi R LD kle� lv
Address: 2 a �'70'1y'/°}.t ..57;~ 4�rs' �` �'y Address: .a`- fq? C`_Vl&r_'d 4ae / kl T +
Phone # Phone # ( 7/8 _�_tfS ZY��
Property Location: »� V5 j
Subdivision Name: � AAC&r_ SkIAN/tIV5./19 � c, "Tax Map Number f
+ �
9 J Section Block i rrt
NATURE OF PROPOSED WORK : E TIMATED MARKET VALVE OF THE
New Building : C NSTRUCTION :
residence / commercial
Additi ilding : l
t're. dent f commercial OCCUPANCY INFQRMATION�
Alteration o Buildings Primary Building----
residence / comm al -k Single Family Dwelling
Residence / Connor 1 Two Family Dwelling
no change t i�rr-t9.j� zie Family Dwelling
t offices
?t Other rk ( c scribe belo �+ - Mercantile
K k !A-' Manufacturing
ffmOther
GRASS AR A OF PROPOSED STRVCTVr:
�~ If ADDITION , what will use
let Floor . 2 sq . fto o new addition be7 :
2nd .Floor . . . . . . ./#V
... A sq . ft. . � V At .2CJ( ^'4- � c��a�ct .5'�
other Fluufs . . sq . ft .
( not unfinished cellar or basement )
� ' Ur L ACCESSORY BUIDINGS :
Detached Garage 1 , 2 car
TOTAL FLOOR AREA : `Z 99 SQ . FT * Attached Garage If 2 car
Private - Storage Building
SIZE OF NEW STRUCTURE : 3e, ec 2 t rr Commercial Storage Building
to FEET X r FEET f other
Foundation Type : '�aU� � Cdhc/� c' 7� Will any second-hand or ungraded
Number of Stories : lumber be used? if so , for what ?
( habitable space or
yly )
Haight ( grade to rxdge ) : r-' 2 QL feet TYPE OF HEATING SYSTEM :
Number of fireplacer� and / or woo stove ( circle all which lies )
to be installed :, %Gey Electric / Oil / Gas / Wood
Forced Hot Air / aboard / Other
Person responsible for supervision of work as regards to building
codes i s : zeolge-' ;W2./'"' /3 -� s .�,�' 2 0 OF2J fe-� SC?` 62R y. ? ` -_G ? 9 Z f
Name Addresss Phone
Builder : / zjr r-yG r G d S - C1Cy7r5 .0
Plumber : /C' '/tf C 'Z--�S"' - G"z r3 -74 Z 3 eD cj '7"
Mason : C7 -o> 'L1,2
Electrician : kSO /3e"YZr` t4it cJ Ff LGtC .�k Gu 696 - F40/ 67
DECLARA77ON. 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 ompl' ing issued, an AS BU L.T PLOT PLAN by
a licensed surveyor; d to seal ng a ual lc �,ation of project on premises.
Signature:
(owner, owner's a t, o tractor
I i h� qi LR ilk W N w n
1 tL)
Ut [0 p 10
Irl 1-1 {1 N m �, 0 ID U1 ;d II! 1-1 Iy7 f,7
j sl !4 r i i t . r . C) I{ I I ul I1 i� ij.
{ ] t ► It1 I h ti i' '#� tt 1T @ In '''� 11 N
;t1 I I N0 1 1it W 111 I+! #+! !'} t� (#!
+ t 1 Il (D DI fb Ili 1-4 N t-s X 0 c! 11 la. 0
Ul ! iD Ill In (# If) 0 {t p# 0' 0 0 W {t f� Fir YY! U1
H {0 Ch tD {D {D 0 (D N m III 1 Ul N R• i-• rd ,
k I' la. f I Ij li m #i tf� N We Q
?d ih n.' P @ 0 0 Ut F,. fit. 1•" W ft] ID :3 {D 0 it
0 0 IQ 0 IJ rh 0 0 � 0 Iq �# IY y � �•
t� tD n to 11 tit a to qi
tt 0 1 in cs n n # @ n. SD En i-I (D I I-t in
ur #: r ; i , i c# Ib ID �u I 1 r� itt p# Sl Rt t� SD
• I i I 1 4 '• I '. I " ! • 1 4 } D I1r I t(1 t!r i { I r' IN a ••
III ;tl . 1 If I ., I..r # 0 Eli
.. #] II p-• C.' (.• 14 4#+ 1�
C" I to fu 14, I O
' SD O N. 44 £ In {lr t] 1-I 111 N C I H +-] H 4]
1bII' f: RI N It II 1-10 1-a I ' O W O 14
11. {y F� c ill N Itf ' , x; 4-' to „ i �] t'• . CIE lot t'+1
i-1 1 1, � 114� I-' f7� f�" U I "• t{; S1 �1j r'i apA sF O a
n R+ m in ur ID n [I SI {}F@ ft
a N•
QQ Qt O In ato . - . to � a
)-I I Lr fv a' AI tYl 0 n 10 In n a tJ t a H
En 0 lu (D IT m n m 0 0 m n nt }ti ' z {(D
111 0 H tr N n 0 (A d
H m 411 0 {t to W Iu ro w ID w (D m m H W X
t-3 la III to � m ID Ili II HEMP Phi 9 Ilia
U H (D 1-1 Ila kI A" 11 0 u► t1 Ij N• N H
t o ' I N I if) IO C] In II! la Ut 0 0 t N
I i G1 I 1 0 it it a• �; At Iq �f+! I_r. la, MO I-A. t V
tU n In III N 1; 0 a f• pd 14 ;j 0
w 0 f: n• , I.r. 1al
0 14"
Os p ID (D 1 C, it }- { ! Icy , n In ,
U ,m (D f3'v ()• (D �!
� � o Ino wClwt7ro v!
0 ti m 141 I j cy (l ( r htl r. ;� $ � 11m b
Imo' 0 iD 1-11 t] 0 He fn m !v
to m ro
t m Ftw o fn �`' tmD ro h H 0 it w H a tj z ro
rI 0 11 � ❑ Fame I w It t�
rt yHI H �i N• m FS HE N• HE t� t� H
@ �: Cr Ian In to In H
{� ti. r
I i1 Q Ito
(D # I ,� to M �! N O OaamaEao HOZ
i7 )J I.! I•� O� I rf i tab 11 � W p it# t 4.# t/� 4 I- Iv' 17 1- D
1-1 146
r + + Io w In f *3 t
I i tH
tit FEE
tj a
b
it {n
to w
aw Iti
�y
i
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
( 510 ) 745 •- 4447
h P.t? 1 `JE ' ' f C 1 -_ 2�3 It7�^.P .
FINAL INSPECTION REPORT - RESIDENT
DATE INSPECTION R(E'Q�UE'$'T RECEIVED !
NAME.,
I LOCATION
DATE — Cri� ' PERMIT rI a2 C35 -?R T
TYPE OF STRUCTURE `S^� ►
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRIC
AL � WOODSTOVE OR FIREPLACE
i no _
CHIMNEY HEIGHT N ZHEIGLFT
PLUMBING VENT
ROOFING
EXTERIOR INIS
DEC PO Cli ST S NGS
RELIEF VALVES
FURNACE /HOwr wA#Pvn P TIN
INTERIOR RIM I'VA DOO j
FINISH FLO S :
BATH /Kj T
OTHER FL ORS S WEEPAB
OTHER FLOORS CARPETE'�
z
STAIR Cf EARANCE RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION IN5 LATSON
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL.
SI[_F._,_P;_,AN/VARIAhICE REQ .
FINAL SURVEY PLOT PLAN
Oii TO z ssu •. p CSC
Nl�vpw�
RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518) 761-8256 bate inspection request received: J
Building & Code Enforcement
Dept. of Community Development Arrive �pm Depart
Town of Queeusbury 742 Bay Road Inspeatcsr's Initial
G—
Queensbury, New York 12804
NAME ',
I,l: -��
DATE
TYPEPE OF 1'ER11r1IT
OF S'fRLJC7[.1f�.E
N/A YES NO COMMENTS
Chimney Heightl"B" Vent/Direct Vent Location _._
Fresh Air Intake
Plumb Vent through roof
Roof Complete_ ;
Exterior Finish Complete
Interior/Exterior Rails 3W' to 36"
Exterior Handrails, balconies„ landing 18 in. or more
Interior handrails stairs both sides 3 or more Ge
Grade 2% away frotn foundation � 1� �r
8" clearance to sill plate
Gas Valve shut-off exposed/regulator 18" above grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-ofI'at entrance to furnace area
FurnacelHot Water Heater o
Relief Valve(s) installed
Headrooan, 6 ft. 6 in. on stairs
Basement stairs, 6 ft. 4 in.
FUndrail exterior stairs both sides more than 3 risers
Interior privacy/ftim/doors/main entrance 36"
Floor Finish
BathInterior
Handrails
watertight an(1__� PA
Interior Eiaudrails Balconi.PslLi ,+.0 18 in_ or more
Railing across window mi 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
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected. (in garage)
Light ventilation per room
Safety blazing 18" or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan _
As Built Septic System layout required
Okay to issue CIC (Certif of Compliance) —
Okay to issue temp. CIO (Certif. of Occupancy).
Okay to issue permanent C/o (Certif. of Occupancy)
GENE RAL INSPECTION REPORT
( 518 ) 761 - 8256
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building & Cade Enforcement
742 Bay Road
Queensbury, NY 12804 Arrive �l��p...,i�rs ; art
NAME: PERMIT #
LOCATION- DATE : +J
TYPE OF STR
RECI-MCK ,.
j
N/A YES NO COIvLMENTS
Footings/Piers
Monolithic Pour rtn
Reinforcement in ace
The contractor is nsible for
providing protectia from freezing
for 48 hours followin the placement
of the concrete,
Materials for this purpose site
Foundation/Wallpour
Reinforcement in Place FF
Foundation/Dampproofin
Backfiti Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing -- —�
Iie Roug;h-In �
latiatx
Foundation Walls Interior W
Foundation Walls Exterior
Floors R-
Walls
Ceiling ^�
Duct work or piping i
unheated spaces R-
Prgper Vent, Attic Ve
Framiin
Jack S
Bracing;/Bri
Joist hangers
Jack Po n Beam 'C=�1 SDI �C k -'j �. L'%
Air Infiltration er
Fire Separation 1 , 2, 3, hour L%e
Penetration Sealed { _VC) CC
J �
Fire Wall 2, 31 4 hour
Firestappin
GENERAL INSPECTION REPORT
( 518 ) 761 - 8256
Town of Queensbury
Dept, of Community Development Date inspection request received:
Building ,& Code Enforcement
742 Bay Road
Queensbury, NY 12804 Arrl •� .„ D Dept
Inspector's Initi
NAME:
LOCATION- DA # ���
TYPE OF STRUCTURE:
RECHECK ,.
R'FootingsJF'iers J fl A YES NO COMMENTS
iV/
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection front freezing
for 48 hours following the placement
of the concrete_
Materials for this purpose on site
Foundation[Wallpour
Reinforcement in Place
FoundationlDarnpproofm _.� —
Hackfill 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 per Vent, Attic Vent
raming �^{'�'
Jack StudsJHeadcrs
Bracing/Bridgi
Joist Hangers
Jack Posts/Mai m
Air Infiltration er
Fire Separation }; 2, 3, hour
Penetration Seal6d.
Fire Wall 2, 31 4 hour
Firestoppin
�4
_GE_1VERAL AW PECTION REPORT
( 51 o ) '7 t
Town of Queempbueensbury w
Dept. of Community Development Date inspection request received:
Building & Code Enforcement
742 Bay Road """"
Queensbury, NY 12804 o
1�r
° Arriv r Depart`
is Initf
r
NAME: tom'►--5
A A
LOCATION: �
TYPE OF S CTLTRE:
RE
REC'I-IEQ{
WA 'YES NO COMMENTS
Footings1piers
Monolithi&F'otu Form m —
Reinforcemem in place
The contractor is responsible for
��4Cling Prot action from freezing
8 hours fbIldWing the placement
of the concrete.
Materials for this purpose on site
Foundation/Walipour
Reintbrcententin place
Foundation/Dampproonng_.
untiring Under Slab QV--
Plumbing Vent/Vents in Place ^�
Rough Plumbi ,
Heating Rough-In
Insulation
Foundation Walls interior R-
Foundation Walls Exterior RA
Floors R_
Walls R-
Ceiling R_
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
lack Studs/Headers
Bracing/Bridgi
Joist Mangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 27 3, 4 hour
Firestoppin
! r
( 518 ) 751. - 8256
GENERAL IN.S'PEC'TIDN REPORT
C
Town of Queensbum
Dept. or Community Development � �" Date inspection request received.
Building & Code Enforcement ,
742 Bav Road rr.
Quecnsbury, NY I2804
Arrive an part
ector's I.nit'
NAME: PERMIT # - /
LOCATI rif; _ E . _ 1
TYPE OF STRUCTURE:
RECHECK
N/A YES COMMENTS
Monolithic Pour Farm
Reinforcement in Place _
The contractor is responsible for � ' p ,'-,,
providing protection from freezing
Li
for 48 hours following the placement Y-rC
{
of- the concrete.
Materials For this purpose on site__
Foundation/Wallpour_.. _ `
Reinforcement in Place
Foundation/Dampproof'rng
Backf-ill Approval -- f �
Plumbing Under Slab
Plumbing Vent/Vcnts in Placc_
Rough Plumbing_
Heating Rough-In
Insulation _
Foundation Walls Interior R-
Foundation Walls Ektcrior R- `
Floors R-
Walls R-
Ceiling R-
Duct work or piping in F
unhealed spaces R- --
Proper Vent, Attic Vent f
Framing._ --
Jack Studs/fleadcrs
Bracing/Brielging_- - -- -- --- — —
Joist Bangers PP -
Jack Posis/Main Beam _
Air Infiltration Barrier —
Fire Separation I . 2, 3. Our
Penetration Smiled
Fire Wall 2. 314 hour
Firestopping LL
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC_
Main Offiee 176 Roe Run Road - Manheim, PA 17545 o ^ 7 ir 7
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board No. .............................Cert. N2 70833 Cut-in Card No. -..... .......................
Owner,...... '4 11JAC :O --OW S p]
.
Location ... 2 (.-1 ,_�/c G_.s' C �t
Installation Consisting of ... ?.. .. .1 � �
?...y.r ..«<......«.... . ...... ..........................................................................................................................
...................................,.......,...,,,......,,..,,,,...,,,.._........................................
Installed By........................................................................................... Lic. No, _............................
......,,.............
The conditions following governed the issuance of this certificate, and any certificate previously issued is
cancelled. -
This cenifcate only covers the electrical equipment and installation conditions as of date. Upon the
introduction of additional equipment or alterations, application shall be promptly made for inspection.
Inspectors of this Company shall have the privilege of making inspections at any time, and if its
rules are violated, the Company shall have the right to revoke this certificate.
Date....................... INSPECTOR ......._.......w..........w.w-- .......................................... ................
Member N.F.P.A., LA E.I.
y y
r t :. :+
f
dd
Me
leg t
lee
he
I.
T
•• �Y � '
.s L
r `
,• .fA}x1C i °.r r`xe a . 6 S Ylf `'"' �` t �� y a
el I
17
It I
PIle ,
y /►
i
Ir
ee, or
Y ' Q
1 f Y
Mi
COD
NC Z;kV
on t
01 /�,� ' �1 •�, ,f 1
•,
too
• +
t {
1
ii a': t