2010-305 eat TOWN OFQ UEENSBURY
Bay R
742 B Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20100305 Date Issued: Thursday, September 16, 2010
This is to certify that work requested to be done as shown by Permit Number P20100305
has been completed.
Tax Map Number. 523400-301-009-0001-043-000-0000
Location: 5 WESTERN RESERVE Trl
Owner. WILLIAM & MARY ANN BERGMANN
Applicant: WILLIAM & MARY ANN BERGMANN
This structure may be occupied as a:
Shed/ Storage Sheds
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the ` / 4 1
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 Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
Forsi 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20100305 Application Number. A20100305
Tax Map No: 523400-301-009-0001-043-000-0000
Permission is hereby granted to: WILLIAM &MARY ANN BERGMANN
For property located at: 5 WESTERN RESERVE Trl
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: WILLIAM &MARY ANN BERGMA Shed/Storage Sheds $3,347.00
5 WESTERN RESERVE Trl Total Value or
QUEENSBURY, NY 12804-0000 $3,347.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2010-305
144 sq ft shed
$20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,June 30,2011
(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 T,rn o ueenIsQu u s i ay,June 30, 2010
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
3Q J " 7- /
// FFICE USE ONLY
TAX MAP NO elf
� }PERMIT NO. 10-305-- ,sk.
U" f 0
FEE PAID X BLDG. &CODES APPROVAL ,
•
•
•
ACCESSORY STRUCTURE BUILDING PERMIT APPLICATION- -
Use
PPLICATION- -Use this application for any structure other than the Principal Structure (house) to include, but not limited to:
garage, shed, greenhouse, dock, deck, etc. Refer to Informational Brochure No. 3 entitled Accessory Structures-
Sheds/Fences.
A PERMIT MUST BE OBTAINED BEFQRE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE
ISSUANCE OF A VALID PERMIT. NO INSPECTIONS WILL BE MADE UNTIL THE APPLICANT HAS RECEIVED
A VALID BUILDING PERMIT. /�
OWNER:V1!J14-LI 4 i C A c6�G-JA A u o INSTALLER/BUILDER: GI-1' R.„D L"J 1ve.A,C
ADDRESS:` IPVL-STL'C- L:3 ILrac /�A+L ADDRESS: '' 91/AILL1 „ r2d
/I4VPHONE NOS. L�i - ' /� - /�
LOCATION OF PROPERTY: S lti�C 3tG'�r� I-636. 11IIA
Ls.1 I- SUBDIVISION NAME: V L'3 Z C�Y"�� RCJ (41
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION: S WO 70'1/4d �L (wL iti&'L
HAS THERE BEEN A SITE PLAN REVIEW;VARIANCE OR SUBDIVISION APPROVAL? 0 YES 0 NO
IF SO,INDICATE APPLICATION NO.AND DATE OF APPROVAL:
ESTIMATED COST OF CONSTRUCTION: $3i j 1 ANY OTHER ACCESSORY STRUCTURES ON PROPERTY? /119
IF YES,PLEASE LIST:
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE:
1ST ND PROPOSED
PROPOSED CONSTRUCTION 1 FLOOR 2 FLOOR TOTAL HEIGHT
SQ.FT. SQ.FT. SQ.FT. FT.&IN.
OPEN PORCH
DECK
3 SEASON,COVERED OR ENCLOSED PORCH*
BOATHOUSE
BOATHOUSE WITH SUNDECK
DOCK
•
SHED / X �� l L ccP
POLE BARN
DETACHED GARAGE(NO.OF CARS: )
OTHER ACCESSORY STRUCTURE:
`CONSIDERED FLOOR AREA & MUST COMPLY WITH FAR [FLOOR AREA RATIO] REQUIREMENTS IF THE
STRUCTURE IS LOCATED IN THE WATERFRONT RESIDENTIAL ZONE.
To the best of my knowledge, the statements contained in the 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 Codes, 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 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.
QUESTIONS? CALL 761-8256 OR EMAIL
/ __ ltXerit e.;
Queensbury Building & Code Enforcement - ResidOtial Final Inspection
J �
Office No. (518)761-8256 Arrive: am/pm Depart: ti J am/pm
Date Inspection request received: Inspector's Initials:
NAME: tea--/t/4s.1 L/, PERMIT#:
LOCATION: ,c rt-- ='" A-7 DATE: 9`/�
TYPE OF STRUCTURE:
5A--",‘" Comments:
Yea Re NA
4" Building Number Address visible from road
Chimney Height/"B'Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 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 ,rade c712-A-k-t-NA?
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 Bradn, /Handica• Rem• Corn• ant
Grade away from foundation 6 inches with 10 feet
8 inch clearance to sill plate
Gas Valve shut-off exposed/ =,ulator 18 inches above •rade
Interior privacy I trim/doors I main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety$iaz ng
Interior Smoke Detectors I Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom ares:
Inter Connected: Bette badku•:
Attic access 30 inches x 22 inches x 30 inches = ,ht 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
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 I Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/Y4 hour fire door/door doser
Duct work Sealed properly
Gas Logs kh Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe BondinL
As Built Septic System I Sewer Dept.Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Okay to issue C I C or C/O j Temporary/Permanent]
L:\Buildding&Codes Forms1Building&Codeslinspection Forms%Residential Final Inspection Form_revised 100405.doc;Revised
January 7,2008;Revised 6/26/08
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