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91-484 Ct4 4 .4 .A pod
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3
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date // f/ 19 q/ '
•ka
This is to certify that work requested to be done as shown by Permit No. 91-484
has been completed.
4
This structure may be occupied as a Alteration to dwelling
(2nd Floor Bathroom and Alteration to roof line)
Location Box 70 Ridge Rd
Owner Mr. & Mrs. Robert Rudolph
By Order Town Board
TOWN OF QUEENSBURY
CGG/i'"
Director of Bldg. & Code Enforcement
BUILDING PERMIT a
TOWN OF QUEENSBURY No. 91-484
WARREN COUNTY, NEW YORK
I
PERMISSION is hereby granted to Mr. & Mrs. Robert Rudolph
ry
OWNER of property located at Box 70 Ridge Rd Street, Road or Ave.
70
in the Town of Queensbury,To Construct or place a Alteration to Dwelling
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.
c
a
1. OWNER'S Address is O
Box 70 Ridge Rd 'v
Queensbury, NY 12804 7•
2. CONTRACTOR or BUILDER'S Name �'•
Ralph Underwood Sr
Hudson Falls NY 12839
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name 0
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O
a
5. ARCHITECT'S Address
7
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6. TYPE of Construction—(Please indicate by X)
(X 1 Wood Frame ( 1 Masonry ( 1 Steel ( )
7. PLANS and Specifications
No.300 sq ft Alteration to dwelling as per plot plan specifications
and application
8. Proposed Use
2nd floor bathroom and alteration to roof line
$ 37.00 PERMIT FEE PAID—THIS PERMIT EXPIRES July 10, 19 92
(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,th Day of i July 19 91
SIGNED BY for the Town of Queensbury
Building and Zoni Inspector •
TOWN OF QUEENSBURY
REVIEWED BY(1)14,14///,/
1 1� FEE PAID: / / e//0?/4-; -:P QUEEE
NVSBUI-s
PERMIT NO. : a/
JUL 8 1991
BUILDING PERMIT APPLICATION DGDG. t CODE DEP
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS WILL BE MADE UNTIL
APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Owner of Property: Me Alps Rob fR' ,' Uc/a1 ph
P.O. Address: 1'D / 4/,00 ,E j , PHONE 7?‘2,72,
Property Location: , „ � �,j , 1 Tax Map No. ,5t / .5/ /1,
Ha
s there been any split of this property since October 1, 1988? Yes No '
If yes, Planning Board Review is necessary.
Subdivision Name, if applicable: Lot No.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
/f,t 1P/ ///D.� /'
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ 50 vo
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: 3o -a ft. x 3 cif-=ft.
Other work (describe) * Existing Building Size:
* ye- ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
*
1st Floor Sq. Ft. * Front Yard 'o ft. Rear yard -z 'o ft.
* Side Yards ;�i0 ft. and q gyp/ rft.
2nd Floor 13 Q(3 Sq. Ft. * If on corner, setback froth side street-
* ft.
Other Floors Sq. Ft.
(not cellar or basement) * OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: --_3/V Sq. Ft. * Primary Building -
✓ One Family Dwelling
Size of New Structure: /4 ft. x 30 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) * Other
Height (grade to ridge) , j g _9' ft. *
If residential , no. of families: / * If addition, what will use be?
No. of rooms (excluding baths) :
No. of bedrooms:
No. of bathrooms: * Accessory Building:
Primary heating system: ,S1o7" J//? * — Detached Garage - a we .36'ar
Type of fuel : lJ,j * Attached Garage - One/Two Car
No. of fireplaces to be installed: 4767/10 * Private Storage Building
Will a woodstove be installed?: * Other
Central Air Conditioning: Yes o 1/
`'e'ez/d4:--42/7,-:
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. /. ii,, /.,e /li1.c:
Will any second-hand or ungraded lumber be used? If so, for what? 1/41
Foundation Wall Material : Thickness:
Depth of Foundation below grade (to bottom of footing) :
Will there be a cellar? Heated or Unheated? Floor Sq. Footage:
Will there be a basement? Will any portion be used as living space?
If so, what portion? Sq. Ft. Type of Use?
Type of Roof: Sloped/Flat/Shed/Other f; /c',I/J O Material of Roof _ ;'he4/445
Size, wood studs " x " ; spacing j :" o.c. ; length '' ft.
Joists (floor beams) : ist—F400-r x-- " ; spacing " o.c. ; span ft.
Joists (floor beams) : 2nd Floor " x ,j " ; spacing j e " o.c. ; span m ft.
Overlays (ceiling beams) : - " x . " ; spacing /4 " o.c. ; span /el ft.
Roof rafters: ?_ " x /d " ; spacing /6 o.c. ; span /5 ft.
Roof trusses (pre-engineered): spacing " o.c. ; span ft.
Exterior Wall Finish: 43 - j -,h ci nv74, of what material ? L',E G'442_
Interior Wall Finish: ' " ,S/YL-;,F 7 /IEc'A't P T Pi-r) Y- /_=/4//51/ `)
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to be an opening between garage and dwelling? If so, will a Fire-Rated door,
enclosure, self-closing device be provided?
Will a flue-lined chimney be installed? _- Height above roof ��._---- - ft.
Depth of chimney foundation below grade: 7ft.
Depth of fireplace hearth: ft. in.
Water supply - Municipal or private well :
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: ft.
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: /[JIP, >�//afte /. ,-`-e%' ��1,t5 PHONE fiJ7>�57
NAME OF PLUMBER & ADDRESS: 57 / /`/,L J ✓t,77 ,�')j1/ PHONE %y7 'c _i
NAME OF MASON & ADDRESS: f il, /r,/ i ,, l 1dj 1iGiii2,,` ) PHONE :WfrL)�74''
NAME OF ELECTRICIAN & ADDRESS: 04f'91 G/b7A6 ?,' V /460.9Wfyki9 PHONE J/j';'
DECLARATION
To the best of my knowledge and belief 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 not, and that such work is au,tho 'zed by the owner.
SignatureI ,. ` ==�-1� �
Ow architect
'contrae777.7 ----
---
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
a OWN OF Olimivjjjk,
Compliance Methods: RECEIVEP
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (CtIADI 8 1991
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Fami1, R,lllii OE
Multi-Family rr'11 DEFT
(3 Stories or Less)
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
ft / /y L�/V Aid/ /C'l u' 47 is 27 Pp / �` ,'iC iieJ r ll f f Pe"/� c%C'c'-%G'`',', AY�
APPLICANT'S NAME PROPERTY LOCATION l( /
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - ,� Sq. Ft.
2. Type of Heat -,6 7 i Elec. Base Board Other
3. Is Building Mechanically Cooled? YES j.-'` NO
4. Percentage of Area of Windows and Doors Over 17% /7Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 3 5
B. Exterior Walls R / 57
C. Glazed Area R 3. 2.
D. Exterior Doors R
E. Floors over unheated spaces R
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R
H. Basement/Cellar Walls (Below Grade) R
I. Heating/Cooling - Ducts - Piping in Unheated Space R.
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
�' 7` 4" ice/ : ''Z�f - R
APPL )zi , (
NT SIGNATURE 21
DATE IELEPHONE NUMBE
INSPECTOR'S REMARKS:
REV I Y
TOWN OF QUEENSBURY
Bay at Haviland Roads,Glueensbury,N:Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date 6) 19 7 1 Permit No. 9/- f1{
APPLICATION IS HEREBY MADEto the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code.The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and.all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's Name RA 1 pit u,vok-ReceD APPLIANCE TYPE
y Stove Coal Wood
•,3 f /� A/e.�/ /,/�- Furnace Hot Air 1--- �., ,, Boiler
Address /�,� � r�� x
Zero Clearance u tii r g Unit
h/b/APSO, P i s ,y Zip i 7 ,I
Phone .is) 7y7 rye If Non-Masonry:
Owner'same /14 I- '14 M P 5 /PO 6*IT Add j
o r Manufacturer
Address
'7 x , D fiDCE RD Model Outlet Size
ep, Ar P_14/ $ .8 to 4 Zip / ''d y Listed by Number
Phone
�93� 6
•2.. 7 CHIMNEY TYPE
Masonry: Block b. Brick Stone
Pro �ertylo ation of proposed construction Flue: Tile ow' Steel
et ' Rol( 74 iP/ r ,r O Size: /.L X 1.2---
Q
UscA-w3 8 U + 4t d�P k /280 Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS
Height , Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type:Double Whit Triple Wail
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost$
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$ ,gam-;
SONRY FIREPLACE$ AND CHIMNEYS. '�f
CASHIERS DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department: Fire Marshal Amount Collected Amount Refunded
Code Number. Title
A 173 3389 (190)Public Safety ,'
A233 2655 (230) Minor Sales
ec C()ticcted fron efunded to: �'� "� e yt-i-e-
4/1
Address: ,
Dated: Town Clerk or Deputy (c2-----`
White:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
/lam- S` '
TOWN OF QUEENSBURY J�'
'0110► 531 BAY ROAD
ObrQUEENSBURY, NEW YORK 12804
v'` TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION /„
REQUEST FOR
INSPECTION� RECEIVED '/e
NAME ` �c'Y�21.,✓( ;�/614 O ,
/
LOCATION gr( 'e7 A-2C/
DATE /5/32) PERMIT# 2/- 7' 7
TYPE OF STRUCTURE �/, - , -
i`',->-,7 / d'-* s/',r rJ!'' /J
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ ODROUGH PLUMBING FINAL ELECTRICAL--_SEPTIC
INSULATION WOSTOVE/FIREPLACE
REMARKS
/ APPROVAL
N/AI YES' NO
CHIMNEY HEIGHT/LOCATION ,/ 1
B VENT/LOCATION _
PLUMBING VENT ✓/
ROOFING ,//
SIDING
DECK/PORCH/STEPS/RAILI, S
RELIEF VALVES
FURNACE/HOT WATER OP RATING
BASEMENT INSULATIO /DUCTWORK
INTERIOR TRIM/PRI 'CY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE ►if
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS 1
HANDICAPPED ACCESS /
SMOKE DETECTORS /
BATHROOM FANS/WHOLEHOUSE FANS
4LL PLUMBING FIXTURES OPERATING vf
SARAGE FIRE PROOFING
DOOR CLOSERS
DTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS . 6/
FINAL ELECTRICAL V
OK TO ISSUE C/O OR C/C
COMMENTS:
-2/jr;-14----61/e114' 3- 64
_4'--
e d ,� ,/e. /� ,ems,
// ,- i r d
0
ARRIVE
---2DEPART :1 ; W
INSPE OR
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED /0///q/
NAME ,/ X ear. i
LOCATION / e_, ..1 ��11 `�
DATE /p / /f/ PERMIT# 7�44`7"
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM/
HOOD INSTALLATION �/.
AUTO. SPRINKLER SYSTEM,
ALARM SYSTEM
INTERIOR FINISHES fI'
STORAGE:
CLEARANCE TO SPRINKLERS
CLEARANCE TO HATING UNITS.
REQUIRED SIGNAGE ,
XCHIMNEY '����
WOODSTOVE
FIREPLACE-MASONRY
FIREPLACE-FACTORY BUILT
REMARKS: U OK TO THIS DATE
ARRIVE
DEPART ("'
INSPECTOR
- opt" ekwY ai- kCdge — /�h
TOWN OF QUEENSBURY ff/�'( 0
PP?
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT /7/
REQUEST FOR INSPECTION RECEIVED 7///////
NAME Rd�ti, G ettd
LOCATION I-1 ti9f''
DATE Q/ /A/9/ PERMIT # q, - 4f4
TYPE OF STRUCTURE au ? ,y/1
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING /
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN AACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS '
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN:BEAM
FIRESTOPP ING
WALLS
CEILING f'
FIREWALLS
HEATING ROUGH-IN
(INSULATION:
" FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R- //
CEILING R- _ V
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
I
ARRIVE /
DEPART/ 411--
/5) /
TRSPE TOR
\)3V\-\/\NSLIN
L-�YI`o, v\
OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT s??1,
REQUEST FOR INSPECTION RECEIVED
l
NAME �L)C�1 lc.) ;)\ IcPAj t?A
LOCATION �\ c?f_ (
DATE C PERMIT
TYPE OF STRUCTURE Al)"
RECHECK �� ^ APPROVED
40101 N w N/A YES , NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING ✓
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB /
FRAMING: ✓
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
111 ARRIVE J (ro
DEPART (193 11111y
-NS'r`CTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY,
TELEPHONE (518)NEW 0RK 4
792-5832
BUILDING INSPECTOR'S REPORT ("
REQUEST FOR INSP CTION RECEIVED /. S>/ i/
NAME � cl- Okpotv-t-
1
LOCATION i) c)
DATE c►( PERMIT # ) i-'-tR L:
TYPE OF STRUCTURE /A I T . .03e-1 I[,
Y SS ayr
RECHECK t".4\Es4#t Ot- 41 C : APPROVED
d N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
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/WALL,POUR
REINFORCEMENT Ifs PLACE r"
FOUNDATION/DAMPROFING
BACKFILL APPROVAL°•,
ROUGH PLUMBING .
PLUMBING VENT/VENT; IN PLATE
PLUMBING UNDER SLAB;,
*FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INT'RIO R-
FOUNDATION WALLS EXT RIO R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING' IN UN TED
SPACES
REMARKS:
ARRIVE
/I/
DEPART
I SPECTOR
C%fit i m ekkJ Z ect-cn-\
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED ') 2'/1 I
NAME `� l UC40I61X
P LOCATIONc:)\." 1:,)c* R> 1
DATE 5Tallil PERMIT# / C) L
C�eSS -c�cv� ^nr�1 `APP
EXITS 40\0/-2-Inv' YZ07;� N/A YES NO
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLER ,
CLEARANCE TO HEATING FITS
REQUIRED SIGNAGE
1
IMNEY `,
-WOOBSTOVE
FIREPLACE-MASONRY /
FIREPLACE-FACTORYBUILT
REMARKS: %� aOK TO THIS DATE
t�r,
Pi Our ,TrAf,)
L
` ' � (--/ %dimcd J2c �C
/fY
ARRIVE
DEPART s J C
INSPECTOR
f`'6`�� I TOWN OF
QUEENSBURY
Pr-
es to s..d ' BUILDING ,& CODS DEP
4Pf REVIEWED By .
SP/o 5..3 , E' E
.
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O _--l ' ' I HEREBY CERTIFY TO �1
•=�� I t-q \). JANICE L. CORNETT
II k j W HOAE AND CITY SAVINGS BANK,IT•S SUCCESSORS AND ASSIGNS
jr�`r� AMEC,cA►1 T,-[�.c ...is Gut P 1.
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