2010-550 ..011111A TOWN OFQ UEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20100550 Date Issued: Monday, February 28, 2011
This is to certify that work requested to be done as shown by Permit Number P20100550
has been completed.
Location: 72 INDIANA Ave
Tax Map Number. 523400-309-009-0001-067-000-0000
Owner. RAE E. CLARKE
Applicant: RAE E. CLARKE
This structure may be occupied as a:
Certificate of Occupancy(RES) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the j
propertyowner 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 Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100550 Application Number. A20100550
Tax Map No: 523400-309-009-0001-067-000-0000
Permission is hereby granted to: RAE E. CLARKE
For property located at: 72 INDIANA 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. Type of Construction Value
Owner Address: RAE E. CLARKE
PO BOX 523 Certificate of Occupancy(RES) $12,920.00
GLENS FALLS,NY 12801 Total Value $12,920.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-550
residential rehab-HUD
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,November 18,2011
(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 own o e ur / l . ,November 18,2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
„._.
47 „,,E_,.(:__ __ _,..
x,7: 7- i - 7 OFFICE USE ONLY
FAXI"APr�o. Yuv i
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_. _
�'ERMIT NO. - - /�1.. .-' JL. . _ LkMO u
FEES: PERMIT RECREATION RI CT- -
_
—".__" ENGINEERING
(If applicable) NSBURY
PRINCIPAL STRUCTURE: APPLICATION FOR ZONING APPROVAL & BUILDING
PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW
BEFORE ISSUANCE OFALID PERMIT FOR CONSTRUCTION.
Y� �' K7
APPLICANT/BUILDER:/ `5 i 0^w1 ;4'�¢' r1E, OWNER: `'��`_ 444.4._
ADDRESS: ! /""�r:n4 Av G44"rc:/4 ADDRESS: 7 --1-7-'354-14 4A.-: (P-k---7a"-5I6
PHONE NOS. 33-d- -7 gar PHONE/� NOS. 7c 3 /Y 3
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE:(U`'' Pt.---7-0 PHONE: 3 3;�-7`J 8(
LOCATION OF PROPERTY: 7 T-/'40-3---,1-t'4 /1(--<=":(.-(. 907.- 56.;P(
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? 0 YES 0 NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT z
APPLY TO YOUR z R. rt o g a Lii
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o a o co
PROJECT ~ O OJLL•
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O ZWE W= I-- n. _
J ro 0 o i
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 d agree to,.hey lho .
Signed d
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)
Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
/110/
1
itAir
BUILD NG & CODE -OVAL ZONING APPROVAL
( 11L
DAT DATE
•
QUESTIONS? CALL 761-8256 OR EMAIL
codes(@,queensbury.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
Operating Permit Issued: Yes No
Occupancy Type: Construction Classification:
Assembly Occupancy Limit: Special Conditions:
\S) -) —�/ r 7f`�,
a
Queensbury Building & Code Enforcement - Residtial Final Inspection
ifice No. (518) 761-8256 Arrive: am/ m Depart:4\ am/pm
Date Inspection request received: Inspector's Initials:
J / ,---
NAME: __ II_ (` ; PERMIT# :
/i��
LOCATION: f „ /-1,, --I i/.,-+! .-..-�. _ p %, ,e____ DATE: ff
TYPE OF STRUCTURE:
Comments:
Yes No NIA
4” Building Number Address visible from road
Chimney Height/"B"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/Wind• , in stairwells s ety glazing
Interior Smoke Det-- ors/Carbon noxide etectors
Every level: E ry Bedr m:
Outside every •-•roo area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches( eight)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'/"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing 1%hour fire door/door doser
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
0.'•i-,• *lain Certification, if required
Okay t,- issue C/C or C/O[Temporary/Permanent I
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
.......,n.ce iio voe Run Road-Manheim,PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Permit No. Cert. N2 7272 Cut-in Card No.
Owner .1--2/4 Liaag
Location J.. Ui9.*Lj .,4) ce, Oka cc-1,4.5 •?uteil
Installation Consisting of...../1.1. 72
S... %Ag.a Grt:244.?:Pc,..S .1 G.
smu 415aik SAPirkszA . c.a..ar
...
/ Liara.
Installed By /3.53/0 CanaZAK-ri.42 Cr— Lic.No.
The conditions following governed the issuance of this certificate,and any certificate previously issued is
cancelled:-
This certificate 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 97 / INSPECTOR. ...A4F/-47
Member N.F.P.A.,I.A.E.I.
•
—'' x,,rss,R mg,. -.P+'.1-7Cprx„ .. -,.. '�v a" ' -i... .-.{.i-TR. —"---' .7,., . q..
Inspector's No
Date N.t .' ;Q,Q 20 /I
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
(Consulting and Fire inspection Services)
(Incorporated in the states of Maryland.New York.Pennsylvania.Delaware and West Virginia)
Desiring Certification of Approval, application is made for inspection of electrical installation in the premises
described below.On demand,applicant agrees to pay for inspection service in accord with schedule of charges.
PLEASE PRINT
Owner 11 ,, . i-._, ) Type Bldg. AWG 0 Other
Occupant .... Building Permit No.
Job Location ...: . .,e::.., ..2 ..
`�1 .z ., ,. ,'.: \..City ..;4..:9:::. - ,...b..:'-',-7 State .....r
County .......Y.s...l :: ,,--•',... Twp- M/C# Swirfiming Pool—NewOld❑
Directions to Job Site
Application For Rough ging❑ 1="ixTures Service-0 or -� ,.., z� i,. ----
Work—New 0 Additional 0 Bldg.—New 0 Old❑ Ready for Inspection
APPLICANTS
SIGNATURE LICENSE• PERMIT•
PLEASE
PRINT NAME /3 el O'.3 ..,a':,%. l"';' • .....rt, : v 'a`""' PHONE.
APPLICANTS / 0. NAME OF
ADDRESS I L +../'S -:a..!i."o,.. UTILITY
CITY*.,_t j,, , .1; z:!w„,.__ STATE 'i 2IP CODE a 104 aEFNO IF D
ROUGH WIRING /PACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS AMP SERVICE PUMP
EQUIPMENT
1 SWITCHES HEAT
PUMP OVEN
"" RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASERMIMIOC
l 0 FIXTURES _ :_ = _a •,,i. 0,- DISHWASHER
MOGUL BASE ,. JWOOER 7 DRYER
FIXTURES _ <3 f 1` MilltafeR
FLUORESCENT AIR AMP. RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR FRAC.H.P.
QUARTZ FIXTURES WIRING&CONTROLS FOR BURNER VENT FANS
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/8 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
Inspector's Comments:
RON MUMBLO
Electrical Inspector
1 State Strlllet
Glens Falls,NY 12801
(518) 798-0905
Installed by(if other than applicant):
OFFICE USE ONLY---WORK INSPECTED NOTIFIED REPt>F1 FEE I
TED
ND
SERVICE DATE CON_
Date Received: TRACTOR TOTAL $ p _, ,
R.W.DATE
OWNER CHECK NO. ;, ,iii i
FINAL DATE42 JO d i OCCUPANT CHARGE
Certificate No.:
CERTIFICATE NEEDED AGENT t.r' CASH
Date Sent: OYES ODUP ELEC.
LT.CO.
Progress 0 "`�'
INSPECTOR
THIS APPLICATION EXPIRES ONE YEAR FROM DATE 7 MAKE ALL FEES PAYABLE TO C.E.I. .INC.
WHITE/OFFICE PINK/INSPECTOR YELLOW/OFFICER GOLD/CUSTOMER 0 '