97-048 ._ _. isuilaing Permit Application . •
Town of Queensbury - Dept. of Community Development,' 742 Bay Road, Queensbury, NY 12:/, 6I-8256J
'O BUILDING & CODE ENFORCEMENT r �
NOTICE - �� �,As __Requirements prior to issuance Sr
A permit must be obtained before -' of this permit: PERMIT FILE S. ♦ t
beginning construction. No inspections o
will be made until applicant has received Zoning Board Action PERMIT FEE PAID$ /
a VALID BUILDING PERMIT. All Area Tblc,:,, 0)_l %
applicants' spaces on this application RECREATION FEE PAID$ A I£k-,'
MUST be completed and.the signature n Maiming Board Action
of the applicant must appear on the REVIEWED BY:
SPR / Subdivision /Other
`pplication form. n nt 3..,.
Building Inspector
J Recreation Fee Payment J
Applicant: ,LL 4 RNdryaiZ1) 2-0-( Owner: S:LL I AZ C ICY-I 20 LOrn
Address: c10-1 i)cQ �C L) ' Address:
Phone # ( 5) ) 2 L 4 - 3L) Phone # ( ) -
Property Location: l -t ` Jt)y�o-� P;Lo3 knch ?I")�'� e g{ �'"�' ° �� 1'ax Map Number —.—/ / /
Subdivision Name: _
Section Block Tnt
NATURE OF PROPOSED WORK: STIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $
residence / commercial
Addition • :uilding: -
residence . commercial ____ -
Alt- - . :uilding: Primary Building -
residence / commercial ✓ Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other Work (describe below) Mercantile
Manufacturing '
Other
GROSS AREA OF PROPOSED STRUCTURE: •
If ADDITION, what will use
1st Floor sq. ft.
2nd .Floor of new addition be? :
sq. ft. i S cke�
Other Floors sq. ft. t_
(not unfinished cellar or basement)
s ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL R A E : SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SI97OF NE`W� STRUCT E: ` IT- Commercial Storage Building
Other
C FEET X FEET i p 54 i -
Foundation Type: , Will any second-hand or ungraded
Number of Stories : lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which . . .lips)
to be installed: Electric / Oil iambi/wood
Forced Hot Air / Baseboard / Other
Person responsible for supervision of work as regards to building
codes i s : 'C2. \('aC ei? D ) v(1c, t i\ PO Leo--3I5 7 �\J alb`? (��
N m Addresss Phone
Builder:
Plumber: I )
Mason: 1 �, j
Electrician: \/' \}
DECLARATION Please sign below after you have carefully read the statement.
To the best of my knowledge the statements contained in this application, together with the plans
and specifications submitted, are a true and complete statement of all proposed work to be done on
the described premises and that all provisions of the Building Code, the Zoning Ordinance and all
other laws pertaining to the proposed work shall be complied with, whether specified or noted, and
that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a
Certificate of Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed survey1, drawn to scale, show' actual location of project on premises.
Signature: QkU
owner, owner's agent, architect, contractor)
GENERAL INSPECTION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement 3pir
742 Bay Road f
Queensbury,NY 12804 Arrive am/pm Depart , (i_ pm
Inspector's Initials J
NAME: ` . \ 'C�Y' PERMIT#41721A-
LOCATION: 1_\( i c) DATE :
TYPE OF STRUCTURE: t ��
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is respons. or
providing protection ing
for 48 hours folio •ng the placement
of the concre .
Materials f •s purpose on site
Fours. ' n/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
rHea ' g Rough-In
ation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R- k
Ceiling RR:
work or piping in
unheated spaces R- ,
Proper Vent, Attic Vent �/
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2. 3, 4 hour
Firestopping
r
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‘ FEB 21 .1997 i
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_APPROL
Application
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