2011-094 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110094 Date Issued: Monday, August 08, 2011
This is to certify that work requested to be done as shown by Permit Number P20110094
has been completed.
Tax Map Number: 523400-227-017-0001-008-000-0000
Location: 28 HILLMAN Rd
Owner: BENJAMIN & ANNE CAMPBELL
Applicant: BENJAMIN & ANNE CAMPBELL
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
.-- y
Issuance of this Certificate of Compliance DOES NOT relieve the Thcoap
property owner of the responsibility for compliance with Site Plan, G
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
lista
Firiyro 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110094 Application Number: A20110094
Tax Map No: 523400-227-017-0001-008-000-0000
Permission is hereby granted to: BENJAMIN&ANNE CAMPBELL
For property located at 28 HILLMAN 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: BENJAMIN&ANNE CAMPBELL Demolition
PO BOX 251 Total Value
CLEVERDALE,NY 12820-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
w
Plans&Specifications
2011-094
demolition of residence
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,May 04,2012
(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 Quee s u , W'i , • . 'ay,May 04,2011
SIGNED BY / .- for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY • • _
TAX MAP NO. PERMIT NO. _FEE PAID f
Permission is hereby granted to the above named Applicant to demolish the building(s)
described herein as set forth in the Application below.
Director of Building&Codes Date
APPLICATION FOR DEMOLITION PERMIT:
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads / streets. Show all existing structures
on the property and indicate which are to be ,demolished. Indicate on the plot plan the
location of all utilities. `
APPLICANT/BUILDER: -B(-24 CaW, `"X OWNER:
ADDRESS: Z8 �`,�1 wnc ckC. ADDRESS:
PHONE NOS. 6C 6 (4 "i B 1 26q-4142 PHONE:
PERSON RESPONSIBLE FOR WORK: rk-.f , S ` r C 1\c A. PHONE: 1 r 3 - 6 43/ /M7o 46 f
( k ` 1
LOCATION OF DEMOLITION: Z Z� 1`1`vvAcw-
WHERE WILL DEMOLITION MATERIAL BE DISPOSED �JeAcck e '"tr✓l f / (zil
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to b= demolished? YES NO X
✓ If YES, our office needs the following inform;? ion:
o Name of firm removing the asbestos:
•
o License number of firm:
o Indicate where the asbestos materia will be disposed:
NOTE: A copy of Asbestos Removal Report must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s) will be demolishe I: RESIDENCE X GARAGE BUSINESS
✓ �{1.1-
dSTORAGE BLDG, OTHER
Size of structure: I 1 X
✓ Number of stories: v
✓ Foundation type: FULL CELLAR /( CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED x WILL NOT BE REPLACED
✓ Structures(s): WILL BE REPLACED X WILL NOT BE REPLACED
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC PROPANE •
PUBLIC WATER ONSITE WELL-WATER PUMP X. PUBLIC SEWER
Have you notified the Town Water Dept, for public water and public sewer disconnect? YES NO
Have all utilities been disconnected: YES NO x
QUESTIONS? CALL 761-8256 OR EMAIL
�j � �i�/� ^ codes(a queensburY.not
I,( /^V/ `\ VISIT OUR WEBSITE FOR MORE INFORMATION
C�/ www.queensbury.net
$ A URE OF APPLICANT
:lip:,'. Town of Queensbury nsbury • Community Development Offic•c. • 742 Bay Road, Queensbury, NY 12804
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: 2• am/p D p rt: am/pm
Date Inspection request received: Inspector's Initials: \��
NAME: R 666 PERMIT#: /
LOCATION: / /Ic..4f4f1 IQ,-1 DATE: 1 r
TYPE OF STRUCTURE:
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height Pa'Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification/Sticker on Panel
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
Fumace/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/'A hour fire door/door doser 1•E%(-d
Cl;q;154t—
Duct work Sealed properly ‘-f6—f6—
Gas Logs in Sealed or Glass Enclosure (—CJ
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Buiit Septic System/Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay t t
L:\Building&Codes Forms1Building&Codes\Inspection Forms1Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 6/26/08;Revised 12/22/10
1-3 ,#o
Queensbury Building & Code Enforcement - Re dentia) Final Inspection
Office No. (518) 761-8256 Arrive: C\ am/pDepart: am/pm
Date Inspection request received: Inspector's Initials: •
C-
NAME: captilo,/( , „ PERMIT#: - •LOCATION: 7�-- //04*x 3 J DATE:
TYPE OF STRUCTURE: Dent!)
Comments:
Yes No N/A
4" Building Number Address visible from road — � �1 �� I all
re
Chimney Height I"B"Vent/Direct Vent Location ""T
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches ; �r ( `J/( j
Roof Complete/Exterior Finish Complete /l' V
Platform at all exterior doors d
Handrail 4 or more risers 5 c Q)1 neC
Guards at stairs, decks, patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom: Gt� r ��I, ^ /
Outside every bedroom area: �J "`LJ
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation/Insulation Certification/Sticker on Panel
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 W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing 1%hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification, if required 1. r,
Okay : ._ - - . - _ .. . - . - ] �MO
L:\Building&Codes Forms\Building&Codes\Inspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10
Rough Plumbing I Insulation inspection Repr °t
eusk
Office No. (518)781-8256 Date Inspection request received: 16 11
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
NAME: ' ' ) PERMIT#: .at '' 09
LOCATION: 362c) • i INSPECT ON: !�. _.( ' f5
TYPE OF STRUCTURE:
Y N NIA
Rough Plumbing/Nail Plates
Plumbinj Vent/Vents in Place
1 %inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet l change of direction
Pressure Test
Drain/Vent
Air/Head
5 P.S.1. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head ,
+ - •r 15 minutes
Insu = i /Residential Check/Commercial Check ,
ek or Similar Exterior Sealant
Proper Vent,Attic Vent
Door/Window Sealed (No Insulation)
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly I No duct tape
COMMENTS: R ---Lx
b-sk-1-4Y;
Rough Plumbing insulation Report.revlsed Nov 17 2003,remised February 15,2005, revised January 7,2008
�Rou h Plumbs finuftiiiIniptij' it
Office No. (518)761-8258 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: t /am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: of\
/i- -%
NAME: ffr2ft' 2! PERMIT#: ,6
LOCATION: q8 b INSPECT ON:
TYPE OF STRUCTURE:
Y N
Rough Plumbing I Nail Plates
Plumbinj Vent/Vents in Place
1 %inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain I Vent
Air/Head
5 P.S.I. or 10 ft. above h'•hest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
,,,r ,�r`��,•r 15 minutes P/
1_ Insulation : =j= t• - • i� ��:, ��=.. 1111111111LY/1�
r"r Similar Exterior Sealant .r•
P • • =r V+ - .�.1:� ieb..
i �111�
Door ndow Sealed (No nsulation) 1/01
Duct •of Water -;' •.: ulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly I No duct tape
COMMENTS: \lort • ri\Krzl
6,0„)k__
Rough Plumbing insulation Report revised Nov 17 2003,revised February 15,2005,revised January 7,2008
Rough Plumbing I Insulation I . ection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm De rt: 4'\ .-cp
am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials:
1 , IT #: n-07
NAME: ..�, c� , PERM
LOCATION: INSPECT ON: —
TYPE OF STRUCTURE:
Y N
Roug Plumbin //Nail Plates
Plumbin I Vents in Place
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet I change of direction
Pressure Test
Drain /Vent \/1'
Air/ Head
5 P.S.I. or 10 ft. above hi hest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/ Head
50 P.S.1 for 15 minutes
Insulation / Residential Check/ Commercial Check _
Tyvek or Similar Exterior Sealant y
Proper Vent, Attic Vent
Door/Window Sealed (No Insulation)
Duct/ Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace _
Duct work sealed properly/ No duct tape 1 4,
COMMFNTS:
Rough Plumbing insulation Report.revised Nov 17 2003, revised February 15, 2005, revised January 7, 2008