8013 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8013
WARREN COUNTY,NEW YORK
. G •
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PERMISSION is hereby granted to John Shahay 9
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OWNER of property located at Route 9L Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Addi.t'nn to dMl l j,Xjg (1 ;;x�area)
at the above location in accordance to application together with plot plans and odw information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is �?4, Oa 5c a A/
Cleverdale, N.Y.
1
2. CONTRACTOR or BUILDERS Name
Joseph Roulier
0
3. CONTRACTOR or BUILDERS Address it
M
Box 3 01 � }
Cleverdale, N.Y.
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
IN Wood From t )Masonry ( )Stool 1 ) a
Nr
7. PLANS and Specifications
rt
161x24' per plot plan, specifications and 0
No. application submitted.
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8. Proposed Use a
One-Family dwelling (additional living area added) a},
$5. 00 C/O Paid
$14. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES jj ch .2 1 _
of a b nger period is required an application for an extension must be made to the Building and Zoning inspector of the �
town of Quaensbury before the expiration date.)
Dated at the Town of Queensbury this 3rd Day of &gust 19-11_ `Q
SIGNED BY for the Town of Queensbury
IlluildiRg and Zoning Inlilloctorap
TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No.
!gyp Permit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. . ►g.
i' iiiii District
. \ ;iluc• "I Work
THREE (3) Copies of a PLOT PLAN, Drawn to scale ,\1'I'r"" I'y
showing the actual dimensions of the lot to be built Itrn';irKf
upon, The exact size, and location on the lot of the .
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. •
I l
-] — a - D It l� TOWN
DATE 11� OF QUEENSBURY
- (� �J �-�
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK IRII V E D
ANSWER ALL OF THE FOLLOWING. AUG I 1983 /
The undersigned hereby applies for a permit,to do the following work M: j� [� -e GN
A.
which will be done in accordance with the description, plans and specifi- 7 I P.M.•
A- i
cations, and such 'special conditions as may be indicated on the permit. ,, I 8s s 9) q ,I r!,1) ,2 J s3 I s4 J ,5 J6
The owner of this property is: . i/S h 61 l'icAj-1\ :"'; CY° .1 /AO-
mil= �� �" !-,i. t/
(NA`•:E) (P.O.ADDRESS),
The person responsible for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
Z,,,) ,,
a/
NAME) (P.0 ADDRESS)
Name of Builder -.e' Address
Name of Plumber 'ice Address
Name of Mason Address
Lot Number Unit j, Estimatedti value of proposed work S -7 6�� f i
Name of Village ( f Al-Y'
Name of Street r �/-/•<� Side of street: north 3, east 0, south 0. west 0
Nearest Cross Street . . ��C': /((9 �• • • •. Distance from this cross street °`' 7 u--4- Ft.
Property is north 0,south 51.,east i i, west. 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑, southwest
(Designate by marking with an "X" in the correct space.)
• NATURE OF PROPOSED WORK -OCCUPANCY
❑ Construction of a new building. Main Building
61 Addition to a building. One-family dwelling Cr
❑ Alteration to a building. Two-family dwelling ❑
• ❑ Demolition of a building. -family apartment house ❑
Store building ❑
-car attached garage ❑
. Other:
Accessory Building
. One-car detached garage •
Ell
El Other work. Describe:: Two-car detached garage ❑
/i V- a r-e mot_ ;L ,b,-,oi,- ' ' Private chicken house ❑
Private storage building El
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, site and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH
Show proposed building(s) in clotted line and existing
• buildings) in solid line.
Size of property ft. x . . . .� J . ft.
Z . • Size and use of existing buildings, if any
&G x ;y1
m / / 9 G . . . . . ft.
s s��`,c W Size of proposed building f ft.x .
h� j
�• Height(from grade to ridge) �/ /Y' ft.
% 7k \ Front yard -' / v ft.
Side yards ft. and / ft.
\ �g i'' Rear yard -4 3 .s'6- ft.
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. •
LOVER) '
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7-73-M
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.' 4.47 „'—"'.--%
Will any second-hand lumber be used? A-,O_ If so, for what?
Material of foundation walls e_d"'c. � '<' X Thickness r
T/
Depth of foundation walls below grade ' Continuous foundation? .
Will there be a cellar? /1.10 If so, material of cellar floor
Type of roof: Sloped or flat? . ... .'�12 5{°�'� . M rial of roof .���r+Z! s4) fie.
Size,wood studs " x ", spacing /e. "o.c., length P ft.
Size, floor beams, 1st floor " x P7. ", spacing ,lam "o.c., span . . . . . .r . . . . ft.
Size, floor beams, 2nd floor "- " x ", spacing -- "o.c., span — ft.
Size, ceiling beams 11 j5• ", spacing G•l'r "o.c., span . . . .off. ft.
Size, roof rafters or beams a _�x ", spacing c� Y' "o.c., span . . . .� . . . . . ft.
Exterior finish • 7�'�6/ -S..'�'--' ' With what material?
Finish of interior walls. . . . . . 1.=� ,,.`.e
If garage is to be attached, of what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building?
Kind of heating system e�f < g Oil burner or coal? r----
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? )/C-S
Will a kitchen sink be installed and connected to water supply? -,-Jc
Water supply(public water supply or pump) /0-72• (c.e.4
()
Distance of cesspool from any private well _ feet
Will drainage system be provided with required traps, cleanouts, and vents? ems
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to tr. Dcr 1 of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.l. Iete statement of all proposed work to be done on the described premises and that all 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 .( ✓
OWNER,.OWNER'S AGENT,AR CONTRACTOR
/ day ofg7,9
19... :3
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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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 bef_ore . beginning work. -.
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ANSWER ALL of the following: .
1. Gross floor area 3o -5 /��
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2 . Type of heat �C�c'f c er • `l�� i-<.r
- 3 . Is the building mechanically cooled? 4-4-, •
4 . Percentage of. Varea of windows and doors
•
• A. Over 16% Only
• 1 . U.o 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 -
perimeter, of floor? •
• 4. - Is basement heated? YES NO
a. R value of insulation -
• 5. Type of insulation
• . •
der Under 16.% Only
1. R value of roof and floors exposed to ambient conditions
w p. .d
2 . R value of exterior walls •••-'' z_ j.`
3 . R value of glazed area °"`' , •
4 . R value of doors Ai 6-7— 147'
5 . R value of floors over unheated spaces .ti7� /
6. R value of slab edge insulation - unheated slab ' •1-- S
7 . R value of slab insulation - heated slab V .
8 . R value of heated basement/cellar . walls (above grade)
9. R value of heated basement/cellar walls (below. grade)
10. . Type of insulation t// J� —/mi-
l'� ass S�/st -.��
1
C. Controls
1 . Thermostat maximum heat setting . ,
D. Duct Systems
1. Is duct system installed in unheated spaces? YES NO
a. If YES , R value of duct installation
b. R value of duct in other areas •
E. Piping Insulation
._.,4:___,CL
1. Size of hot water or cooling carrying agent pipe Co
. 2 . R value of pipe insulation
F. Service Water Heating .
1 . - Performance efficiency
2. Temperature control setting maximum
G. For Swimming Pool Only
• 1. Maximum heating r^
- • Telephone No. G(-01.�- -5 0/ /4\11:17. /&-.L._... ' -
(applicant ' signature)
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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 %� <--r,/ firs-, TOWNSHIP COUNTY/./e,.,,e,,,,
STREET AND NO.OR `
ROAD AND POLE NO. 7,fJ POLE NO.
BETWEEN WHAT TWO ) /f
CROSS STREETS IS "/'• ff i`
PREMISES LOCATED? t",„J�-•r,f,-q i! /.� Ld r ,4,.:�.<iO L • SECTION BLOCK LOT
OCCUPANT'S-----f--_,"�/ / BUILDING
NAME c� r`'1 / OCCUPANCY ..4.,/
OWNEF(S NAME /
f
AND ADDRESS J r 'j
r
CURRENT -
SUBYPPLIED /J Y3/42 FROM THEIR fr OFFICE
BUILDING WORK DEFECTS
IS NEW❑ OLD❑ REMODELED J❑ IS NEW JR ADDITIONA IIIL REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED -
No. Fixtures& BRANCH
NUMBER OF OUTLETS LampfReceptacles, MOTORS HEATERS CIRCUITS
NUMBER OF LAMPS
Loca-
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wa11 Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge I F M.V.
-Out-
side
Sub-
base
Base- -
ment
1st Fl.
2nd Fl.
3rd Fl. -
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). REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
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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 OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS •
POSSIBLE NEW OLD TI
r
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS Vi/T7NAME OF / �.-�� •�� DATE OF
APPLICANT_ — _e Ate APPLICATION
STREET ADDRESS f.-T'a r
CITY OR __ j/_ f ZIP =';3 LICENSE NO.
POST OFFICEe '~»!C -tt='r�T,'" C� �`'•f' f' CODE J WHEN APPLICABLE
46 EL(REV. 1/82) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
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TOWN OF QU•EENSBURY
Building Department
Inspectors Report Date 79
Name ✓fir //y�
Location A-10
Permit No. R 7/ Weather
F/414 /V:SrIJ Remarks
Excatia t on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves l _
Wall Board
Ext. Porches 41,4
Finished Floor
Interior Trim f _
Stairs & Railings 4/14'
Cellar Dr. Tile •
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing �S
Door Closers 1/
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
";,/,IdZ2&11-.J
Building Inspector
REMARKS
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TOWN OF•QUEENSBURY '
Building Department
Inspectors Report Date (l-7`g_r •
Name •
Location /ek—" � f r�c�. r�b
Permit No. 8o/ Weather
• Remarks
• Excaftton •
Footing Forms
Footing & Piers
Foundation
- Cement Coat •
• Waterproofing
Backfill
Final Survey j
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves •
Wall Board •
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors.
Plbg. Fixtures •
Gar. Fireproofing
Door Closers •
Chimney
Water Meter Inst. •
Septic Approval
Floors
Insulation Foundation
"Ceiling �-
•
, Building Inspector
-REMARKS •
TOWN OF QU•EENSBURY
Building Department
Inspectors Report Date 4(4,5 c71 43
Name S� q�/ •
Location L
Permit No. XO 1 7 Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing \si\:;,(1\
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors _
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
i1 i Inspector
REMARKS
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C(�
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A:2Z-414./ 771 e
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