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2010-023 TOWN OF QUEENSBURY owBay Road,Queensbury,ueensbu ,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100023 Date Issued: Thursday, December 13, 2012 This is to certify that work requested to be done as shown by Permit Number P20100023 has been completed. Location: 389 CLEVERDALE Rd Tax Map Number: 523400-226-008-0001-002-000-0000 Owner: DONNA L SUTTON Applicant: DONNA L SUTTON This structure may be occupied as a: Fireplace By Order of Town Board Residential Alteration TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property l� owner of the responsibility for compliance with Site Plan,Variance, or ' other issues and conditions as a result of approvals bythe PlanningBoard pp Director of Building&Code Enforcement or Zoning Board of Appeals. 4011 ` TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100023 Application Number. A20100023 Tax Map No: 523400-226-008-0001-002-000-0000 Permission is hereby granted to: DONNA L SUTTON For property located at: 389 CLEVERDALE 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: DONNA L SUTTON 389 CLEVERDALE Rd Fireplace QUEENSBURY,NY 12804-0000 Residential Alteration $20,000.00 Total Value $20,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-023 900 SQ FT RESIDENTIAL ALTERATION $40.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday, February 03, 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 expira4tion date.) Dated at the To of eens !•s.ay, February 03, 2010 SIGNED BYApir a41 for the Town of Queensbury. Director of Building&Code Enforcement 2.2-6 . $-/-, OFFICE USE ONLY 2 �TAX MAP NO. PERMIT NO. —40Z"--, M C L I V E ~ , FEES: PERMIT RECREATION ENGINEERING 1111 1-1=B 0 3 2010 J (If applicable) TOW •-OF-OLIE-ENSBtrRY--- PRINCIPAL STRUCTUR • BUILDING& CODES APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF((A�� VALID PERIIIT Ff0 r'<)NSTRUCTION. APPLICANT/BUILDEF �/ '�'N� I G''y,. , ., _�`tSWNER: P o 19 n 4 c ..hior-) ADDRESS: 9 3 6 / r` A it A jl rye, iaADDRESS: ,3S9 coef-cW__id PHONE NOS. 73, Qa Q":2 yn PHONE NOS. 5771 Cse-6 ` 06 gT3a 9/98 CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: PHONE: LOCATION OF PROPERTY: 3 q C /er& , ,(� S bw _ i& , / (2 1 HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? 0 ❑ YES g NO IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL: PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW: CHECK ALL THAT z APPLY TO YOUR z O w 0 CJ o PROJECT 0 p o C'1 W W U) o LI!! oW • � � w -' 0 = = W p � � o I < pU_' U zl < < � u, N ° O � � Z SINGLE FAMILY kf q 0 O TWO-FAMILY MULTI-FAMILY (NO. of UNITS ) TOWNHOUSE BUSINESS OFFICE RETAIL- I — MERCANTILE FACTORY OR INDUSTRIAL ATTACHED GARAGE(1,2,3) OTHER i IF COMMERCIAL OR INDUSTRIAL- N, E OF BUSINESS: ESTIMATED CONSTRUCTION COS 1 a 07.0 Oa D FUEL TYPE: 0 ! 1 1A6--S . .— — i �/l -. 1 B 3-LGL 11-05 • 0 ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN? 1 0 ARE THERE EASEMENTS ON PROPERTY? C'O 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 an• .greto the above. Signed ///� -71 .' ....0,„ 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: t /4#, BUILDING COD' " '•OVAL ZONING APPROVAL K /d DAT DATE QUESTIONS? CALL 761-8256 OR EMAIL codesAqueensbury.net Office Use Only I VISIT OUR WEBSITE FOR MORE INFORMATION Fire Marshal's Office J wn of Qit nsbi r7f 742 Bay Roi-7,1 Qiiof'tlsbtlrti, ;Jew York 12804 - l chat-1 f. Paliner I ire Marshal• Gary ctill,uw;i, I kpitt,Ftrc:\iarital APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS Application is hereby made to the Budding &Codes Office for the issuance of a Building & Use Permit pursuant to the New York State Fire Prevention & Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances,regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. IMPORTANT NOTE TO APPLICANT:,Q� ROUGH-IN AND FINAL INSPECTIONS ARE RE UIRED. OWNER: O 'CA. �tJ-A 1Z�11 INSTALLER/BUILDER: e l11�/ir5iF/Litf ir� ADDRESS: air G 1r r R a Wtice."b�T I)/dRESS: %PS CO(1 f T� l fP��Lr 1 ipl fQ / [� 9-3' �j ^1 , PHONE NOS. J-1 a 6 6 f 26 ) � /93 PHONE NOS. 5 (2 /9 D.aao LOCATION OF PROPERTY:/7, U.• J SIq,„f i. .r N Y SUBDIVISION NAME: LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION:_li' ''j 5;,,1" /UP'P 103 0 LI CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: PHONE: ✓ FUEL BURNING APPLIANCE WOOD COAL PELLET GAS OIL INFORMATION STOVE _ FIREPLACE INSERT FIREPLACE,FACTORY BUILT* FIREPLACE,MASONRY FURNACE(GARAGE ONLY) *IF FACTORY BUILT,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO. LISTED BY: NUMBER: QUESTIONS Z CALL 7614205 or 7614206 CHIMNEY INFORMATION BLOCK BRICK STONE OR EMAIL: firemarshalOqueensbury.net MASONRY** CHECK ONE ✓ VISIT OUR WEBSITE TILE STEEL SIZE IN FOR MORE INFORMATION INCHES www.aueensbury.net FLUE CHECK ONE ✓ DOUBLE CHIMNEY WALL TRIPLE WALL INSULATED DIRECT VENT LINER CHIMNEY MATERIAL CHECK ONE ✓ **IF NON-MASONRY,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO. ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION&BUILDING CODE AND/OR MANUFACTURERS REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED INSPECTIONS. Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: any". Date Inspection request received: '5/1 am/pm rr // Inspector's Initials: NAME: LE�nn4 J, # PERMIT#: O- 0 LOCATION: ('/r.,€. < < DATE: /2. �/" z TYPE OF STRUCTURE: / 41/ Comments: Yes No N/A ePje /U,L' 4" Building Number Address visible from road Chimney Height/"B"Vent/Direct Vent Location / Fresh Air Intake 4Z' 3 inc[,t 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 Wail 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 to floor I 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 hour fire door/door closer Gas Logs in Sealed or Glass Enclosure Final Electrical;Energy Saving Light Bulbs 50% ✓ /) `c,/ Final Survey Plot Plan �U /7/.1,/`c� ' Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles Flex Gas Pipe Bonding As Built Septic System I Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required _ Okay to issue C/C or C l 0[Temporary L:\Building&Codes Forms\Building&Codes\Inspection Forrns1Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08;Revised 12/22/10,Revised 04/13/11 S /at ) l4r( 710 1,-- __.) Queensbury Building.& Code Enforcement - Residential Final Inspection O ;a 'o. (518)761-8256 Arrive: 7 -= am/p .„/ Depart: am/pm Da__'ainspectiion request received: Inspector's Initials: ,1).11- NAME: CU ` ly- NAME: CU PERMIT#: P 0Z3LOCATION: Ck e , / .14, DATE: TYPE OF STRUCTURE: . i - � Comments: 4" Build . Number Address visible from road e jP/ re 4 B` Chimney Height/' Vent/Direct Vent Location �� I Fresh Air Intake 3 inch Plumbin• Vent throw r h roof minimum 8 inches �� eZ/3 /1 Platform at all exterior doors IIIIIIIIII� Handrail 4 or more risers Ella. Guards at stairs decks •: los more than 30 inches above •rade rEll� Guard at stairwell at 34 inches or more ■IIII. Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall err J interior/Exterior Railings 34 inches to 38 inches �M� �I • �h/ n� �,r f Deck Brad /Handica.. Ram. Com•Ilant �� /" Grade away from foundation 6 inches with 10 feet � Viz ■ 6 inch dearance to sill .late - l ye'd-r Gas Valve shut-off exposed I regulator 18 inches above !rade interiorprivacy/trim/doors/main entrance 36 inches Bathroom I Kitchen watertight Safety glazing I Window in stairwells safety_giazing Interior Smoke Detectors/Carbon Monoxide Detectors Every level: Every Bedroom: Outside every bedroom area: Inter Connected: Batt backu•: Attic access 30 inches x 22 inches x 30 inches ei•ht in accessible areaul.) Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 =•.ft.vents ill t Bathroom Fans if no window 1111111111111� Plumbing fixtures Foundation insulation/Insulation Certification Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below wade 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 o•:rati • Low water shut-off boiler IIIIIIIIIII Relief Valve®installed/Heat Trap!Water Te • 110 1111111111111�/ Enclosed Stairs Sheetrock Underside minimum W G •sum Mill. Basement stairs closed rise>4 inches 11111111111111111 Garage Floor Pitched ��= Garage fireproofing 1%hour fire door/door closer Duct work Sealed property 111 1111 Gas L• in Sealed or Glass Enclosure // Final Electrical �, C/rci r:et Final Survey Plot Plan III . � �- Arc Fault Breaker in Bedrooms , oc i o Flex Gas Pi - Bondi . Mil� As Built Septic System/Sewer Dept. Inspection Sticker 111111� Site Plan /Variance .,•uired Flood Plain Certification,if required 11111111111111 Okay to issue C/C or C/0[Temporary!Permanent] L:\Building&Codes Forms\Building&Codes\Inspection Fonns\Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08 / r%P,'',`�T. ;P e'er 1l� f/ , r - ,forcement - Residential Final Inspection Arrive: am/pm Depart: am/pm Inspector's Initials: PERMIT#: //0 - , '', DATE: /12 --3 7 Comments: Yes . i 9 C ,,,, r </ ../ 27, // = --Pfa rm at all exterior doors Handrail 4 or more risers Guards at stairs decks los more than 30 inches above ,rade 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 Dedk Brad . /Handica•.:• Ram• Can• ant • Grade awe from foundation 6 inches with 10 feet 8 inch clearance to sill plate — Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors 1 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 K.ft.-150 sq.ft.vents Bathroom Fans,if no window - - . Plumbing fixtures Foundation insulation I Insulation Certification Floor truss draft s •,•i , finished basement 1,000 =•.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 Fumake/Hot Water Heater operating f44,1‘..._ (0/4C-I-- Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 � /� o Ke. 4Enclosed Stairs Sheetrock Underside minimum W Gypsum Basement stairs closed rise>4 inches • / D /'� `ie f Garage Floor Pitched S Garage fireproofing/Y4 hour fire door t door doser /4.y, �, Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc Fault Breaker in Bedrooms Flex Gas Pipe Bonding As Built Septic System I Sewer Dept Inspection Sticker Site Plan /Variance required L_–.Flood Plain Certification,if required v� Okay to issue C I C or C/O[Temporary I Permanent I L:Building&Codes Forms\Building&CodesMnspection Forms1Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 4x:eaCommunity Development-Building&Codes (518)761-8256 Inspections per Permit Permit# P20100023 Inspection Date Inspection Type Approved/Denied Comments Permit Type Person Responsible 03/08/2010 Final Inspection Residential Alteration DAVID HATIN Staff Denied 2010-023 told to contact Fire Marshal for fireplace inspection 03/12/2010 Fireplace Residential Alteration GARY STILLMAN Approved 2010-023 installed by First Flame-CO detector tested 09/30/2011 Status Inspection Residential Alteration JENNIFER HENDERSON Staff Misc 2010-023 made out status inspection slip 41.7 CcaN�Ac vZ.111fti >z Town of Queensbury Fire Marshal � 742 Bay Road Queensbury,NY 12804 761-8205/761-8206 fax 745-4437 Factory Built Gas Fireplace I Stove Inspection Report Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's instructions or specifications is allowed. Permit#< /O "O 2.3 Schedule Inspection at-4 I(7 Time/x.170 am pm anytime Inspector- Name ON/1/4- -174/k/ Address 3eCi ��i4',/LGFP1 �h� Rough In Final Appliance Manufacturer /VD/7655e--10 Model# L pi/% Direct Vent Factory Built Chimney Flue Size Double Wall Triple Wall Insulated Yes No N/A Comments Floor Protection — 79 zza0 Smg�� -f Clearances to Combustibles (all sides) y Firestop(s) Vertical Chase Wall Penetration Vent Clearances to Combustibles Vent I Chimney Termination Chimney height must be 3 feet above roof penetration;2 feet above any combustible construction within 10 feet Gas Shut-Off Valve )1"P Combustion Air Hearth Extension (if any) , ..e____ Fit;121, 0 Mantel ti Height above f/p opening ( +t l 1Ce"s Witness Operation Tank Placement(if LP) Cc D64-60-1-e4 �5 White—Building Dept. Yellow-Customer Pink—Fire Marshal Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518) 761-8256 Arrive: `/ii am/pa—)/Depart. am/pm Date Inspection reques —t,t ived: Inspector's Initials: NAME: PERMIT#: /D O 3 LOCATION: 3 kf 1' t:1 re,,, pi DATE: �'/v TYPE OF STRUCTURE: t Comments: 1212 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 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 S•aces 18 inch x 24 inch access 1 ..ft.-150 s•.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 Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum'A"Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/' 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 in Bedrooms J Flex Gas Pipe Bonding pt 1:/ / ` As Built Septic System/Sewer De Inspection Sticker ry `�' �� Site Plan /Variance required // / �' Flood Plain Certification,if re•aired IC( �`' c �l Okay to issue C I C or C I 0 j Temporary/Permanent] ' r /rte/ FF%��° /n J e L L:\Building&Codes Forms\Building&Codeslnspection Forms'Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/26/08 ,�g2-2oa Town of Queensbury 742 Bay Road Queensbury, NY 12804 Queensbury Community Development Office .250. FAX FROM THE DESK OF: Zoning/ Planning Building & Codes & Planning / GIS Administration Fire Marshal Animal Control _Craig Brown 761-8218 _Dave Hatin 761-8253 _Stuart Baker 761-8222 _Bruce Frank 761-8226 _John O'Brien 761-8255 _George Hilton 761-8217 _Keith Oborne 761-265 _Charles Dyer 761-8207 _Jim Fitzgerald 761-8202 _Sue Hemingway 761-8238 Carlene Ramsey 761-8256 _Pam Whiting 761-8220 _Michael Palmer 761-8206 _Maria Gagliardi 761-8219 _Gary Stillman 761-8205 Date: /A-3-/a No. of Pages [not incl. cover]: ) To: p n S u44-0 Fax No.: 3 - _3 CC: Fax No.: Subject: 2,) e,G y ns (19 Urgent For Review Please Comment Please Reply B 10 -03 COMMUNITY DEVELOPMENT OFFICE FAX 518-745-4437 *Animal Control: 518-761-8202 * Building & Codes: 518-761-8256 * Fire Marshal: 518-761-8206 * Planning: 518-761-8220 * Zoning: 518-761-8238 COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 UNICIPAL CERTIFICATE �} - ELECTRICAL APPROVAL Permit No.....:,wI•''� Cert. 29010 OwnerN 0 ` ....................... ..... .. Cut-in Card No....................... .... ........... > .......... ............................... Location....._ I �' •� c-v ....................................... ....../��.....:...:...... �t }� Installation Consisting of... ... """"""""""""" ' ................. .. ................ .................................................................................................................... Installed By...... ._M.._ ___� .................... 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 nspections at any time, and if its rules are violated,the Company shall have the right to r this / 3ficate. Datel.... .'.. C'.. ' ............ INSPECTOR......... '......: U ............................... r ................... Member N.F.P.A.,I.A.E.I.......................*"*'