7907 C/O Paid
CERTIFICATE OF OCCU
PANCY
' OWN OF QUEENSBURY
WAkREN COUNTY, NEW YORK
Date 19 _
This is to certify that work requested to be done as shown by Permit No. 7 9 0 7
has been completed.
This structure may be occupied! as a Addition for garage and living area
Location __ Minnesota .Avenue
Owner Ronald C. tobinson
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE "INSTA" PRINTING. GLENS FALLS. N T 12S01 1I1I5I91797-SGSS
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 7907
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Ronald C. Robinson
OWNER of property located at Mi nnesfa Aup Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to mobile Home (garage-living 0
at the above location in accordance to pplication together with plot plans and other information he and N
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a
t. OWNER'S Address is Box 58 4B (Minnesota Ave.
Glens Falls, New York
0
rr
2. CONTRACTOR or BUILDERS Name
Sa Me O�
3. CONTRACTOR or BUILDERS Address
same
4. ARCHITECT'S Name
W
5. ARCHITECTS Address fD�
O
rr
ty
6. TYPE of Construction—(Please indicate b X)
Y', (D
(30 Wood Frame 1 )Masonry ( )Stool ( 1 G
tD
7. PLANS and Specifications
361x32'', per plot plan, specifications and
No. application. submitted.
B. Proposed Use
Mobile Home Dwelling - addition for garage and living area.
� a
n rl-
$5. 0 0 C/O Paid o
10. 00 PERMIT FEE PA16—THIS PERMIT EXPIRES January 1 1984 1 �
(If a longer period is required an applicatio H&
n for an extension must be made to the Building and Zoning inspector of the P.o
town of Queensbury before the expiration date.)
W 0
Dated at the Town of Queensbury this 13th . Day of June 19 83 N.
SIGNED BY for the Town of Queensbury M D'
Building and Zoni ..Q
M
TOWN OF QUEENSBURY ) (Space inside block to he filled in by-
WARREN COUNTY, NEW YORK • , Building Inspector)
Application for Application No.
Perini( Issued 19.
BUILDING AND ZONING PERMIT Perini( Expires. 19
/. nin•. District . -
. \ alIR of Work' .( )
THREE (3) Copies of a PLOT PLAN, Drawn to scale G6✓ -
showing the actual dimensions of the lot to be built Rc'niark
upon, The exact size, end location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
_/ _ / .` Z 6 f C, c''- ���"�O'W N OF I(OU EEN S 1+;.;��
/ (� DATE 'IJ E 0 Li U E. 11
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK . Jj
ANSWER ALL OF THE FOLLOWING. /s- oc) E°10 0 19'j
} ev
The undersigned hereby applies for a permit to do the following work �. �
which will be done in accordance with the description, plans and specifi- 7lg�g$lpl11I uz ��� cL�5.6
cations, and such special conditions as may be indicated on the permit.
The owner of this property is: .. e g _ oi
(NAV.E) _ (P.O.ADDRESS)
Theme person responsible forr -supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
f 04.. t 4 A.I.t.P `.t?/. z t 'f f7t. . . }`_':'` ! '. . ./J.-. .lo.1.6!'u 4-e 4--, , 6,4 1�?0�
lc�t�l �. . . �ti.N� tE). '. - . " !. . . .
(NAME) IP 0 ADDRESS)
Name of Builder. .f. .40t\f!;•lam-0. . . d� )l."t'6 .4.0 t'1 Address .il e:tVt `.•. . . f,!.t,..:. li • . 4-c-:l
r.r
�1 1
s• 1_i. �� e, ; Address . .'. . . . 5:t'l.- a-,.ice'
Name of Plumber. . .r\.,� ::}t<;6..�
Name of Mason Address
Lot Number Unit , - Estii��mated value of proposed work S. G94 i tr 0 •
Name of Village . :4 / . '. . . 1 t.. YY-. . . . .c"•...•4.a'-•,w':
!
d�tI I
Name of Street - .l•l '.':�& �` h •a. . . . . . . . . . . . . . . . . Side of street: north 0, east ❑, south ❑. west
Nearest Cross Street 1 l ' M. d r dr'' r Distance from this cross street :' Ft.
Property is north ❑,south ❑,east X, west. ❑from Cross Street
If on Corner,which corner, northeast ❑, northwest ❑, southeast Q. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
❑ Construction of a new building. Main Building
XI One-family dwelling gl
Addition to a building. Two-family dwelling ❑
❑ Alteration to a building. -family apartment house ❑
❑ Demolition of a building.
Store building ❑
-car attached garage ❑
Other:
• Accessory Building
4 C(. -c— . . One-car detached garage ❑
❑ Other work. Describe: Two-car detached garage ❑
(' ❑
t X -2;L ' Private chicken house
Private storage building
---- • Other:
ZONING SPECIFICATIONS. Fill in for new building, or addition to existing building,or a change of occupancy.
- Indicate on the plot plan street names, the location and
size of the property, the location, size and setbacks of pro-
posed buildings, and the location of all existing buildings.
NORTH Show proposed building(s) in'dotted line and existing
Le.t.j,o.1 1u E- re—o . building(s) in solid line. .
. Size of property • ft. x ft.
r - _ __a - Size and use of existing buildings, if any •
ul
r�, . ti W w �' ft.x �.. ft.
.,tiy; . Size of proposed building . .
• P��) 4' Height (from grade to ridge) ft.
Front yard
ft.
��
)' Side yards ft. and ft.
LT
i' 6_ 4/,,,,., A the3 Rear yard - ft.
.Z SOUTH If on corner,setback from side street ft..
-` Note: All distances are net, as measured from street side
line to nearest part of building.
(OVER)
•
7-73-M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . Qr'•1—'•rf ` •h
Will any second-hand lumber be used? Y'$ If so, for what?. G.e!e'52.44t
Material of foundation walls . Thickness . cF
Depth of foundation walls below grade " Continuous foundation? . .Xi7�. • •
Will there be a cellar? ./vG If so, material of cellar floor
Type of roof: Sloped of flat?; . S•LD�/=� Material of roof . . . .a`
Size, wood studs . .2X 6 e "x cP. ", spacing "o.c., length •
ft.
Size, floor beams, 1st floor . . .z)(Ga . . "x /Co ", spacing "o.c., span ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
Size, ceiling beams " x ", spacing "o.c., span ft.
Siie, roof rafters or beams . " x ", spacing "o.c., span ft.
Exterior finish . . !'-7-%!e' • '? • . '.k K re With what material?
Finish of interior walls /-',5', -c47
If garage is to be attached, of what material is wall between garage and main building to be constructed?
/moo C fk X
Is there to be an opening between garage and building? At-'¢
Kind of heating system GAS Oil burner or coal? GAS
Will a flue-lined chimney be provided? — Depth of chimney foundation below grade
Height of chimney above roof
Will there be a fireplace? Depth of fireplace hearth
Will a toilet be installed?
Will a kitchen sink be installed and connected to water supply?
Water supply (public water'supply or pump)
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt; ham(r of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.;.p lete statement of all proposed work to be done on the described premises and that atl provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the proposed work shall be complied with,whether specified or,not,
and that such work is authorized by the owner.
Sworn to before me this Signature
OWNE •0 R• GENT,ARC IT CT,CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
TOWN OF QUEENSBURY
•
WARREN COUNTY, NEW YORK
Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE •
A permit must be obtained before beginning work.
ANSWER ALL of the following:
1 . Gross floor area .571 4%r• Tr
2 . Type of heat \' 4Z\:trO ( i t5 •
3 . Is the building mechanically cooled? N1 (1
4. Percentage of .area of windows and doors
A. Over 16% Only
Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2. Floor over heated spaces YES NO'
a. Are foundation walls insulated? YES - NO •
•
1.` If YES, what is the R value?
. 3 . Slab on grade YES NO
a. If YES, what is the R value of insulation around
perimeterof floor?
4 . Is basement heated? YES , NO)
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions'ao
2 . R value of exterior walls
3 . R value of glazed area
4. R value of doors
•
5. R value of floors over heated spaces _ 3 °
6. R value of slab edge insulation - unheated slab
7. R value of slab insulation - heated slab
8. R value of heated basement/cellar walls- (above grade)
9. R value of heated basement/cellar walls (below grade)
10 , Type of insulation k" xe..,; _c__CI --..;
C. Controls V 0
1. Thermostat maximum heat setting
D. Duct Systems
1. Is duct system installed in unheated spaces? YES NO
• a. IfYE-S1 -R value of -duct installation
b. R value of duct in other areas
E . Piping Insulation
1. Size of hot water or cooling carryingagent 'pipe
2 R- value of-pipe risulatiori^
F. Service Water Heating
1. Performance efficiency
2. Temperature control setting maximum
G. For Swimming Pool Only
•
- 1 . Maximum heating
rte
Telephone No. —U CLVAWAIX, a
(applicant ' s signature)
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
CITY OR _
•VILLAGE 4 .' - rJr� TOWNSHIP COUNTY :',,.. :- ,1 L_Yl/
STREET AND NO.OR j
ROAD AND POLE NO. ,r '. .'!_� ±i f? _-. POLE NO.
BETWEEN WHAT TWO •
CROSS STREETS IS
PREMISES LOCATED?' {. SECTION BLOCK LOT
OCCUPANT'S BUILDING
NAME .f°- -
OWNER'S NAME i'"-7 (n_a ��� ( �/�
AND ADDRESS ,- - _ f/
CURRENT
SUPPLIED 1 J� ,< r_ ,1 - - !,.l FROM THEIR . OFFICE
BUILDING NEW❑ OLD[I] REMODELED ❑ WORKSNEW ❑ ADDITIONAL❑ REMOVED DEFECTS ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH LAMPS
Lamp Receptacles CIRCUITS
Loca-
tion Side Attach't H.P. Watts A.W.G. WATTS
Ceiling Wall Recept'Is Switch Pendent Bracket No. Type Each No. Each No. Gauge NO. EACH
Out-
side
Sub-
base '
•
Base-
ment
•
1st Fl.
2nd Fl.
3rd Fl.
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN
SERVICE MAKER
ENTERS
BUILDING OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS J (� (l
POSSIBLE lj ? , A NEW I I OLD I I
{
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF s DATE OF
APPLICANT ' '' - - - - - • ' APPLICATION
STREET ADDRESS ' - ----
CITY OR --- ZIP LICENSE NO.
POST OFFICE .,, ., •- .,.- "i' ` - -•'1 CODE I -= / WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
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