2011-104 TOWN OF QUEENSBURY
wow742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110104 Date Issued: Thursday, April 25, 2013
This is to certify that work requested to be done as shown by Permit Number P20110104
has been completed.
Tax Map Number: 523400-302-014-0003-028-000-0000
Location: 23 PARK P1
Owner: GEORGE I CONKLIN IRREVOCABLE TRUST
Applicant: GEORGE I CONKLIN IRREVOCABLE TRUST
This structure may be occupied as a:
Residential Alteration
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance 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 nforcement
Planning Board or Zoning Board of Appeals.
1
TOWN OF QUEENSBURY
742 Bay Road,Quccnsbury,NY 12804-5902 (518)761-8201
Fv/TO
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110104 Application Number: A20110104
Tax Map No: 523400-302-014-0003-028-000-0000
Permission is hereby granted to: GEORGE I CONKLIN IRREVOCABLE TRUST
For property located at: 23 PARK P1
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: GEORGE I CONKLIN IRREVOCAB: Residential Alteration $4,500.00
KATHLEEN T. MAICCCO,TRUSTE Total Value
23 PARK P1 $4,500.00
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-104
EGRESS WINDOW
$60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,April 13,2012
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To Queens ry;J, Ayes i esday,April 13,2011
SIGNED BY A/ IG .- for the Town of Queensbury.
Director of Building&Code nforcement
302c /11.- 3 OFFICE USE ONLY
TAX MAP NO. L. PERMIT NO. I /
FEES: PERMIT RECREATION ENGINEERING QP2 2011 �J
(If applicable)
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PRINCIPAL STRUCTURE: APPLICATION FOR ZONING APPROVAL & BUILDING
PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.
APPLICANT/BUILDER:jironi lc_ ► sErni-r4T"Sy yr.s OWNER: Carom CPrn��in�
ADDRESS: oNe.,S A .CI;�tua r 'j , I2."CADDRESS: 3 ( - _ Ft&c..-$ Q"cFivOz‘,n,y
PHONE NOS. 3/V-37/ -7477-I PHONE NOS. I
CONTACT PERSON FOR BUILDING &CODES COMPLIANCE:: .1 J & PHONE: 5—/cc-371-5(�2_/
LOCATION OF PROPERTY: 3 Pa-dc. ;Phc c ,
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? D YES '1I NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT p O a 1-
APPLY TO YOUR Z co O co o w
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PROJECT p OOO = _
w -� � ww C70
W o 7, U z ci owz
z < < c� cv co O LL I- LI- a 2 05
SINGLE FAMILY
TWO-FAMILY
MULTI-FAMILY
(NO.of UNITS )
TOWNHOUSE
BUSINESS OFFICE
RETAIL-
MERCANTILE
FACTORY OR
INDUSTRIAL
ATTACHED
GARAGE(1,2,3)
OTHER
Town of Queensbury* Community Development Office * 742 Bay Road, Queensbury NY 12804
Revised 4/14/2010
IF COMMERCIAL OR INDUSTRIAL—NAME OF BUSINESS:
ESTIMATED CONSTRUCTION COST: ,500 FUEL TYPE:
HEAT TYPE: *HOW MANY FIREPLACE(S): AND/OR WOODSTOVES(S):
ZONING CATEGORY: ARE THERE WETLANDS ON THIS SITE?
IS THIS A HISTORIC SITE? NO
PROPOSED USE OF BUILDING OR ADDITION: £c b7j1\ wit.-r-oicA) ffa- �.:►�'+ vrl.e f'
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? IVO
ARE THERE EASEMENTS ON PROPERTY? Ner
*Please complete a separate Application for"Fuel Burning Appliances&Chimneys"available in our office
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above.
Signed
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction codes
or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
Town of Queensbury* Community Development Office*742 Bay Road, Queensbury NY 12804
S••ram u s
Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518) 761-8256 Arrive: am/pe Depart: �' am/pm
Date Inspection request received: Inspector's Initials:
NAME: C ' • PERMIT#: ` •
LOCATION: AI,ZR , (� DATE: 41SZ91,
TYPE OF STRUCTURE: cStriteA Ci
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location �1
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 I doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing l 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 to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test Certification
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/3/4 hour fire door/door closer
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 1
Flood Plain Certification, if required
Okay to issue C/C or C/O[Temporary/Permanent]
L:1Building&Codes Forms\Building&Codesllnspection Forms1Residential Final Inspection Form_revised_100405.doc;Revised
January 7, 2008; Revised 6/26/08;Revised 12/22/10,Revised 04/13/11
a e� rs 4)e#'r) r i
Foundation Inspection Report
Offer No.(518)7614256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: i am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:c tZ
NAME: l? 1 �-- PERMIT#: .
HOP
LOCATION: A r-- .. INSPECT ON: AllefrAter
TYPE OF STRUCTURE:
Comments
Y res LA) h dco
Footings
Piers
Monolithic Slab
Reinforcement in Place ---.-I
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 611/1^1L-
Reinforcement in Place *F7
.
Footing Dowels or Keyway in place
Foundation Damplroofing
Foundation Waterproofing .
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poli for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L WN:ling&Codes Forms\Buliding&Codes\Inspettion FonnsWoundation Inspection Fteport.doc
Last printed 12/20/2005 9:24:00 AM