8486 C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work requested to be done as shown by Permit No. 8 48 6
has been completed.
This structure may be occupied as a Addition to one—family dwelling
Location Cleverdale Road
Owner Judith Cushing
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE "INSTA" PRINTING. GLENS FALLS. N Y 12801 1518/793-5656
•
• - BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8486
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Judith CushingcA
OWNER of property located at Cleverdale Road • Street, Road or Ave.
• N
in the Town of Queensbury,To Construct or place a Addition to dwelling fi ti
at the above location in accordance to application together with plot plans and other information hereto filed and •
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. n
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1;owNER's Address is P. O. Box 133
Cleverdale, New York
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2. CONTRACTOR or BUILDER'S Name
Dale Clothier
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3. CONTRACTOR or BUILDER'S Address F-'
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N
Lake George, New York
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4. ARCHITECT'S Name
O
fat
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
(XWood Frame ( ) Masonry ( )Steel ( ) - -
IZ
H--
7. PLANS and Specifications rt
addition to dwelling per plot plan,
No. specifications and application submitted
and Variance No. 827. granted 5-18-83 0
8. Proposed Use
t2,
One-Family Dwelling (additional living area)
N
H.
$5. 00 C/O Paid
$ 12. 00 PERMIT FEE PAID.—THIS PERMIT EXPIRES December 1 19 84
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 14th Day of May 19 84 •
-ThSIGNED BY c r • /0:e„ for the Town of Queensbury
Building and Zoning Inspector e` .
TOWN:OF QUEENSBURY - BUILDING DEPARTMENT
R. D. #1 BAY AND HAVILAND ROADS
GLENS FALLS, NEW YORK
Phone 792-5832
DATE: March 11, . 1986 . •
TO: Judith Cushing
Cleverdale, N.Y..-12820
Our records indicate that you were issued a building permit number 8486
on May 14, 1984 for the construction of
addition to dwelling
Our files show that the required inspections are incomplete. If still under
construction please contact this office for an extension of your building permit,
or if completed please contact us so we can take your card out of the active file.
The next required inspection final -
FOR ALL NEW CONSTRUCTION TOWN LAW required a Certificate of Occupancy to be
isued by. this Department before occupancy. Noncompliance may result in legal
action.
To avoid further delay and possible legal action, contact this office to
make arrangements to update your file.
QUEENSBURY BUILDING DEPARTMENT
s
t�) .2 j',:1� ,
Asst. Building Inspector
TOWN OF QUEENSBURY (Space inside block to lx filled in by
WARREN COUNTY, NEW YORK • ' , Building Inspector)
Application for Application No. : •
M'� i'crmit Issued - 19. .
BUILDING AND ZONING PERMIT Permit Expires. • lg.
/.,niin District
. \ aloe nl Work
•
THREE (3) Copies of a PLOT PLAN, Drawn to scale •\i'I".""i'c1 b
showing the actual dimensions of the lot to be built 1ti'ni ii Kf
upon, The exact sire, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
TOWN Or QUEENSBURY
DATE Fin
IE
,! JJJ��1�����r JJJ
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK MA 1 2 j9$../ �
ANSWER ALL OF THE FOLLOWING. AM. / 7 60 /- e e !'c
7 a s F 1ji2)z)2)3)4)5l�.
The undersigned hereby applies for a permit to do the following work i
which will be done in accordance with the description, plans and specifi- ' ' ` , ,
cations, and such special conditions as may be indicated on the permit. . /co i
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The owner of t jis propert is: �i d t " .4
. . . 4g6. . �/ G:�' GG:S/t/i-) 0.'/.). ' / 3 ai:1/-721P)9L /./Yy/2472 zi
(NA:E) IP.O.ADDRESS)
The person respopsibie for pervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
!/61,,,r,L 6 Gv:5/,�/,&G� Al iCiffl3. . . . . . . . U L�IZ., 1444/704.- G&M. f:-'.. .;. /V Y/ j.l'/. . .
(NAME) (P 0 ADDRESS)
Name of Builder �14-/ GG./fy/L7 Address L/-4: :- 0.e7/-'«1—
Name cif Plumber Address
Name of Mason Address
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Lot Number Unit Estimfed valueproposed work S 6W
Name of Village �GL� %7 G-• ,, . Oh[i,1. . ..E...G G"2 57.�v✓�7'
Name of Street , ./ �'f Side of street: north 0, east 15, south 0. west CI
v' .
Nearest Cross Street . . /.7/.�_-x11/ Distance from this cross street l� Ft.
Property is north ❑,south a east i i, west 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast 0, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
❑ Construction of a new building. Main Building
• pci. Addition to a building. . . . One-family dwelling
El Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. family apartment house ❑
Store building ❑
-car attached garage ❑
Other:
• Accessory Building
:� t� (��4 7 - . One-car detached garage ❑
0 Other work. Describe Two-car detached garage ❑
/ Y/k.3 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, size and setbacks of pro-
NORTH posed buildings, and the location of all existing buildings.
' Show proposed building(s) in dotted line and existing
huilding(s) in solid line.' G7 J 44. ,
65
•
Size of property ft. x /ft.
Size and use,�of existing buildings, if any
F . .61/= /• 17/ y ; �/.�z7�, ',
I. m Size of proposed building .l r ft.x 0. . - - . ft.
Height (from grade to ridge) ft.
Front yard . . . . . 4 !.......... /' ...d.` ft.
Side yards rl ft. and // 7 ft.
Rear yard ry 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.
(OVER)
7-73-M -
(coned.)
BUILDING SPECIFICATIONS., //
Kind of construction: Wood frame, fire safe, etc.?. . . . . . .l/�/, :e�• - 0. . . . . . . . . .. . . . . . . . . . . . . . . .
Will any second-hand lumber be used? . ./Vt7 j i i If so..for what
Material of foundation walls . .(4'.v4•,.,9(�l>_ . '.�` . .63r'�✓'l . ..1 ,# Thickness . . . .5. . . ��1/C� `
Depth of foundation walls below grade . . . .4/0 '` Continuous foundation? . . . . .
Will there be a cellar? Aid If so, material of cellar floor
Type of roof: Sloped or flat? Gw,! Material of roof /f /. . .a %4744e
Size, wood studs Fy " x b ", spacing 77 "o.c., length. . �lG.-1A. . . . ft.
Size, floor beams, 1st floor �/ "x & ", spacing 7G L� "o.c., span -6" ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
" x G.
", spacing (a• "o.c., span . .O.ev."-
Size, ceiling beamsft.
Size, roof rafters or beams . . . . . . .)/ x (‘ ", spacing /6 "o.c.,�., span /''e '— ft.
Exterior finish . . . . r. V�.✓. • G:Gr ,f�%3.G : 7. . . .. With what material? l '
Finish of interior walls 77. Gy- o":� , 0
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 byilding? '
Kind of heating system . . .L�'(. %•• • •(6 '5 / Oil burner or coal? . . . .�J<.G,—
W i 1 1 a flue-lined chimney be provided? . . . . `•�/ . . • . Depth of chimney foundation below grade 5' /.S j.
Height of chimney above roof. . . elk./5/
Will there be a fireplace? L ( / Depth of fireplace hearth . . . /5T
Will a toilet be installed?
Will a kitchen sink be installed and connected to water supply? 7c
Water supply (public water supply or pump) M/.e27.i15 (G. '4
4' .t 'G;c
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 th jda 1 of my knowledge and belief the statements contained in this pptcatio?together with then and specifications sub-
mitted, are a true and co...plete statement of all proposed work to be done on the descri.,.. premises and th ill 'roviaions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the p po: . o k sha l�e corn 'Wed wi whethez specified or not,
and that such work is authorized by the owner. s
Sworn to before me this Signature 1 /0 NER. • NEWS AGEN .ARCHITECT,CON CTOR
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: q
1. Gross floor 'area . 14�/ r
��G .
2 . Type of heat (gr �� U"iL' tiz. o
3 . Is the building mechanically cooled? /'Y=el •
. 4 . Percentage of area of windows and doors
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed t•o 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
•
B. Under 16% Only -
1. R value of roof and floors: exposed to ambient conditions
2 . R value of exterior walls1 I9 •
. a
I �• 3 . R 'value, .of glazed area -- ,/: 7-2/
4 . R value of doors
5. R value of floors over unheated spaces
� ( I 6. R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
S . R value of heated basement/cellar walls . (above grade) ,14;
9 . R value of heated basement/cellar, walls (below grade) - IV'
10 . Type of insulation ,1 6 /4 ,e , , /
C. Controls V v
1 . Thermostat maximum heat setting
8 677 / 7lA 6 C7
/ /
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
1. Size of hot water or cooling carrying agent pipe '
2 . R value of pipe insulation --
F. Service . Water Heating
•
1 .. Performance efficiency /4;67
2. Temperature control setting maximum -
G. For Swimming 'P-ool Only
1 . Maximum heating i
Telephone No. /
(applica is signat re)
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 / ✓ TOWNSHIP IC7Z.9 %—✓,? pi:4, e . COUNTY „if/i7,y,C,_
STREET AND NO.OR ,/
ROAD AND POLE NO. POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS
PREMISES LOCATED? SECTION BLOCK LOT-
OCCUPANT'S -BUILDING -
NAME /� l' OCCUPANCY •
•OWNER'S NAME]j, '% / i. i / j % .i i /// /
AND ADDRESS/%M.Imo/e. ,L...„,,, (.�— .`� („44� /% .."[ v', ./,L/1./ / /,1'//�f� ✓I)
CURRENT r I
SUPPLIED / FROM THEIR /
BY OFFICE
B -
W
• DEFECTS
SUILDING NEW III OLD❑ REMODELED El SORK NEW ❑ ADDITIONAL III REMOV D ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED .
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH LAMP S
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 OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW n. OLD 111
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
. /
NAME OF ,' '"" : i" DATE OF
APPLICANT "---�`���-/� '.;>f� f Lam?--"' APPLICATION
STREET ADDRESS /- '
CITY OR ZIP • LICENSE NO.
POST OFFICE CODE WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
•
i __• / / • • • • • •. • ! V. • • ". • • ., • • • .1... .I. A.4a
,Y
THE NEW YORK BOARD. OF FIRE UNDERWRITERS ,Y
Y
BUREAU OF ELECTRICITY ,r
Y;
41 STATE STREET,ALBANY,NEW YORK 12207 ''
- f„a r
y Date �+n r= wZ , _ n Application No.on file L A j ;)
== THIS CERTIFIES THAT , ��� � I � �, a ,T
only the electrical equipment'as described{ below and introduced Eby the applicant namedd on the above application number in the premises of .Y
Paul Cushing, UL",�t erda.1 e,, Cleve.Lda1e, New ,..ork �r
.Y
in the following location; Basement E 1st Fl. El2nd FL. out s 1..C.5 Section Block Lot .Y
was examined on and found to be in compliance with the requirements of this Board.
2/19/85 ,)-
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;
OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY AMT K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P: '''
VAPOR
,Y
1 10 4 2 1 1o6 1 1,, r
-- - DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ;�
._ 'AMT. K.W. OIL ' H.P. , GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET -AMT.' WATTS ,Y
_ 'r
y ''� RS 1.. g.- U iY
-SERVICE DISCONNECT NO. S E R V I C E ;T
AMT. AMP. TYPE EQUIP 1,2'2W I,B'3W 3,e•3W 3,8.4W NO,OPER gCOND. OF CC.COND. NO.OF HI-LEG OF.HI LEG NO.OF NEUTRALS OF NEUTRAL ')-'
.Y -
j
.Y
-< OTHER APPARATUS:
�' Panels : i_ Ocireuit3- 100 amps ,Y
_ .r
Y
,Y
1T -
INSPECTION FEE P
Paul
77 Cushing / .
Cl 'rver -I � Road 239
r P.O. BolK 133 BRANCH MANAGER ,
<. Per 'r
•- -tile YeYeYYeYtierreYeYeYYe'YeYYeYeYe'YeYYALYYam\-41-4YY�YYiYYiYYiYYeYitYY� ® ® 0 r r ", Y .
- COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT-BE ALTERED IN ANY MANNER.
•
TOWN OF QUEENSBURY
Building Department
Inspectors R Date l if ''
•
Name
Location r"
Permit No. S'`I K Weather
•
Remarks
Excat'aton
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
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
Walls '
Ceiling
•
r f�/
Building Inspector
REMARKS