2003-441 Building Per mitj{application
" Town of Queensbury—Dept of Community Development,742 Bay Road,Queensbury,NY
A permit must be obtained before beguiiiing construction Permit File No.
No inspection will be made until applicant has Yeceived ay Fee Paid $
valid building permit. All applicants' spaces on'" ! s V „` I Rec.Fee Paid $
application must be completed and must appear,on fihe•�,=s A ..;,,, Reviewed
application form. ;
Applicant: r—t�rt/I< ,� j�ll'.�!'rY jQv�}ner:
Address: lai DAndress: ✓ - �
Phone#(�) = <; Phone#(_) J��OF
C' Y
Property Location: Lot Number: J House Nunibeg / P.oc
Subdivision Name: ` !i Tax ap Number:
3 -1
❑ New Building: residence /commercial 'Es tima d Market Value of Construction:$
dor Addition: < idence commercial If an.Addition,what will use of new addition be?
❑ Alteration: nee/ commercial
❑ No change to exterior size: residence/com'l
❑ Other work(describe
Check OeeupaneyInformation A"Floor 2'd Floor Other floor Total
Below sq.ft.° �' sq.ft. sq.ft. Square Feet
❑ Single family.dwelling
❑ Two famil dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile '
❑. Manufacturingi.'
❑ 1 car detached garage
❑ 2 car detached garage '
.f. •E' '1 i�.
❑ 3 car detached garage
❑ 1 car attached garage #
❑ 2 car attached garage
❑ 3 car attached garage
❑ Storage building-
commercial
❑ Storage building- /� f � 2&-7L
residential /
What is the proposed he' t of the struetu e. �feet; in
Will any second-hand or ungraded lumber be used? If so,far what? N'12
Type of Heating System: electric/ oil / gas/wood /forced liot air/ baseboard/other:
Number of Fireplaces to be installed /L-r0��umber,of tTfo,dstoves to be installed77
List below the person(s)responsible for supervision of 'as regards to building nodes:
Name AAddress Phone Number
Builder /r/2-19''1-V1<
Plumber . i• �3��;
Mason
Electrician
Declaration please sign below after you have carefully read the statement:
To the best of my knowledge the statements contained in thissapplication,together with the plans and specifications
submitted,are a true and complete statement of all proposed cdk tq:be done on the described premises and that all
provisions of the Building Code,the Zoning Oriiinance and„all other jaws pertaining to the proposed work shall be complied
with,whether specified or noted,and that such work is'authoziiid by,the owner. Further,it is understood that Uwe shall
submit,prior.to a Certificate of Occupancy or Certificate of Coumpliance being issued,'as requested by the Zoning
Administrator or Director of Building and Codes,an.As Bulit Survev by a licensed surveyor;drawn to scale,showing actual
location of all new construction. / /�
Signature: ��I� .G p owners.owner's agent,architect,contractor
I
Foundation inspection Report
Office No. (5 1S)761-825 6 Date Inspection request received: 4 15
Queensbury Building&Code Enforcement Arrive: am/p3.,n g Depart:/ m
742 Bay Rd., Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT#: 0 3-` 1-1 t4
LOCATION: INSPECT ON:
TYPE OF STRU
�GCQ \���
Comments
4 cc —5
Y N N/A
Footings
tPiers
Monolithic Slab
Reinforcement in Place
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
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil of 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-.\SueHemingway�Building.Codes.Inspection.FORMS\Foundation inspection Report.doc January 28,2003
Foundation Inspection Report
Office No. (51,8)761-8256 Date Inspection request received-
Queensbury Building&Code Enforcement Arrive: a�p Depart: m/p
b V,od in
742 Bay Rd., Queensbury,NY 12804 Inspector's Initial
NAME: PERMIT#: IL
4
LOCATION: IV,1—i Cd-r, INSPECT ON:
TYPE OF STRUCTURE—'
Comments
Y N N/A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours followii-ig the placement
of the concrete.
Materials for this purpose on site,
Foundation/Wallpour
Reinforcement in Place
Foundation Dampproofing
Foundation/Waterproofing
Type of Dampproofing/Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
Ail of for wet areas under slab
Xackfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
-, R-
Rough Grade 6 inch drop within 10 ft.
L:\SueHemingway\Building.Codes.Inspection.FORMS\FouiidationInspectilonReport.doe January 28,2003
i �� ,, N 6$,27,12
. :. :.. M �o N . Eti
�� f a...
N
, `.. 5.
13040 _ .. .. . _ .
Poo ,
a I
FBI � . �,��• Gt . " �, .
ss.r
o II b,
- z �
223.68
,,• 254,27'
rkN, , '69'5628
. .
N -
� w '
w ,
VI
CD
OZ
x— _
irx�r '� .^ d f
M FIVEMPY
' � �'Jrrsrti� Pa17�
f
0 J . PSet 7t
TOWN OPOUEENSBURY BUILDING DEPARTMEN h
J_ ��N fit,
' <r Base!en out limits t examination, b
with Our cdnments sh lyl 2
constraed as indicatin 1
tyl ns�Md OeOcabom ar ell`
o cuinpliance with 1rw 9uNdin�'yy \ h
d
6t New Ybrk State. v � 6�d c�q, t p t t flD
t
.---
��
6TA 2 1 ua G}
117—
10T1! 3 ' ti? oU�V
41
I >>
01
i � o L ljoo
B1J9DIN
REVIEWED BY-
DATE