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95-102 1 CERTIFICNrE OF COMPLIANCE TOWN OF QUO,ENSBURY WARREN COUNTY, NEW YORK Da to May 26 19 0 95102 This is to certify that work requested to be done as shown by Permit No. has been completed. This structure may be used as a RESIDENTIAL ALTERATIONS �+ Location CLEVERDALE RD. — Owner BETTE, MARY ANN By Order of Town Board TOWN OF QUEENSBURY Director of Building Code Enforcement BUILDING PERMIT VALUE $ 3000 TOWN OF QUEENSBURY 95102 TAX MAP NO. 13. -3-7 No. WARREN COUNTY, NEW YORK BETTE, MARY ANN PERMISSION is hereby granted to CLEVERDALE RD. OWNER of property located at Street, Road or Ave. REPAIR SAGING ROOF in the Town of Queensbury,To Construct or place a 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. 1. OWNER'S Address is it CHESTNUT LANE CLIFTON PARK, NY 12065 2. CONTRACTOR or BUILDER'S Name PARKER, BILL 3. CONTRACTOR or BUILDER'S Address 0 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) RESIDENTIAL ALTERATIONS ( )Wood Frame ( )Masonry ( )Steel ( ) 7. PLANS and Specifications REPArTR SAGING ROOF AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use REPAIR SAGING ROOF $ 30 PERMIT FEE PAID—THIS PERMIT EXPIRES March 19 19 97 (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 30 Day 'f March 19 95 SIGNED BY for the Town of Queensbury Building and Z n' In or Department of Community Development Reviewed By: lxk Building & Code Enforcement Building Inspector _Town of Queensbury Permit No. - jL 742 Bay Road Queensbury, New York 12804 Fee Paid $ (518) 745-4447 Building Permit Application 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 application form. Applicant: / / z�r- e— Owner: /mil tkC 0677LiC Address: /f 2 �u /��/�ddressA'a mete✓ere- U. G`10WYWA Phone # ( 5�8 _) �$ Phonc # ( ��-) 3?!_ - _!o5`�3_ Property Location: 1' / Tax Map Number — ,-/ Subdivision Name: Section Block Lot NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF T�E� New Building: CONSTRUCTION: $ 3,000. e residence / commercial Addition to Building: "' 122' residence / commercial OCCUPANCY INFORMATI". �9 ♦ Alteration to Building: Primary Building residence / commercial Single Family YinjAR 1995 Residence / Commercial Two Family Dw , n6 11 m no change to exterior size Family lineeCelVed Town ofOffice w / Queensbury cs V Other Work (describe below) Mercantile cs e 13idg. Dept. &AdaGf>8t� 0"4 !z f_ �� r�, Manufacturing_ �, � e;: -I& • dl Other '� ° ; X° GROSS AREA OF PROPOSED STRUCTURE: �SG�y►-11,l� 1st Floor. . . . . . . . s ft. If ADDITION, what wi"1- use "F q• of new addition be? : 2nd7loor. . . . . . . sq. ft . Other Floors . . . . sq. ft. (not unfinished cellar or basement) ACCESSORY BUILDINGS: Detached Garage 1 , 2 car TOTAL FLOOR AREA: SQ. FT. Attached Garage 1 , 2 car Private Storage Building SIZE OF NEW STRUCTURE : Commercial Storage Building Other FEET X FEET 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 applies ) to be installed: Electric / Oil / Gas / Wood Forced Hot Air J Baseboard / Other Person responsible for supervision of work as regards to building codes is : _ &1(, JV4&1Z;6(L jl2 kagts V. 5/S ggSD�IB Name Addresss Phone Builder: - Plumber: Mason: Electrician:_ DECLARATION To the best of my knowledge the statements contained in this appli- cation, 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 drawn to scale, showing actual location of project on premises . Signature: .1,� (,5,n ° ft)IUA - (owner, owner' s agent, architect, contractor) TOWN OF QUEENSBURY BUILDING PERMIT NUMBER uHx MR 2 7 L) 4 s-- lo ,2 1. BASIC/BUILDING PERMIT INFORMATION: oringAdministrator�� A licant/Name & Address Agent/Name & Addre applicant agent w A TAX MAP�NUMBBEIR: 2. PROJECT DESCRIPTIU � --------- lot plan (2 copies) ------ ------------- -- ❑ building plan (2) sewage disposal ❑energy code 3. PROPERTY INFORMATION: [electrical inspection [jdriveway permit cot eted/signed k E PAID Front Yard Front (if corner) " "'Side..Side Yard (1) N�- SZ? � t ❑ NEW CONSTRUCTION Side Yard (2) ox Lj ADDITION Rear Yard [l ALTERATION Width PST � ❑ MODIFICATION Depth ❑ SIGN YES NO NIA PROPERTY IS IN APPROVED SUBDIVISION Meets depth, width & square footage requirements Preexisting, nonconforming lot with proper setbacks Required road frontage on public road Has required off-street parking Permeable area is adequate / E equirec % Building does not exceed maximum height / Max. Required setbacks from stream, lake and/or travel corm or meets requirement Buffer zones required Is lot in a Flood Plain Zone? 4. STAFF DETERMINATION: As per Section(s) of theme Zoning [ 1 Sign Subdivision Ordinance Ordinance Regulations • 5. REVIEW REQUIRED BY ZONING BOARD OF APPEALS: ` ACTION FILE NUMBER RESOLUTION DATE ❑ Use Variance C7 Area.Variance �- ❑ Sign Variance [—] Other Comments: 6. REVIEW REQUIRED BY PLANNING BOARD: ACTION FILE NUMBER RESOLUTION DATE ❑ Site Plan Review ❑ Subdivision ❑ Planned Unit Dev. ❑ Other Comments: ----------------------------------------------------------- MAI � S TOWN OF QUEENSBURY' v BUILDING & CODE ENFORCEMENT 531 BAY ROAD _ QUEENSBURY NY 12804 c L (518)745�-{44c4,77 �^ ARRIVE: V DEPART: d '' V'� INSP: FINAL INSPECTION REPORT - RESIDE IAL DATE INSPECTION UEST R CEIVED: 7 L1 NAME LOCATION DATE / PERMI # V r t v TYPE OF ST UCTURE f� FOOTINGS FOUNDAT ON BACKFILL ING ROUGH PLU_MBING PTIC INSULATI N FINAL ELECTRICAL WOODSTOVE OR FIR PLACE N A YES NO CHIMNEY HEIGHT B VENT EIGHT LUMBING VENT ROOFING EXTERIOR FINISH DECK PORCH STEPS RAILINGS RELIEF VALVES- FURNACE/HOT-WATER OPERATIN INTERIOR TRIM PRIVACY DOORS FINISH FLOORS: BATH KITCHEN WATERTIGHT �t OTHER FLOORS SWEEPABL i x' OTHER FLOORS CARPETS STAIR CLEARANCE RAILI GS SMOKE DETECTORS BATHROOM FANS PLUMBING FIXTURES FOUNDATION INSULAtrION GARAGE FIRE PROD ING DOOR CLOSERS FINAL ELECTRICAL SITE PLAN VARIANCE RE . FINAL SURVEY PLOT PLAN OK TO ISSUE C/O OR C C TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 BAY ROAD QUEENSBURY NY 12804 (518)745-4447 IdARRIVE: ` K DEPART: A .d INSP: 4 FINAL INSPECTION REPORT - RESIDENTIAL DATE INSP,CCjTIO�N REQUEST RECEIVED: 2 NAME LOCATION vdQ AX-V DATE II�EiRpMIT /n# ./� 0 TYPE OF STRUCTURE i� ll� FOOTINGS_ OUNDATION BACKFILL _ FRAMING ROUGH PLUMBI SEPTIC INSULATION FINAL ELECTRI AL WOODSTOVE OR FIREPLACE N/A YES NO CHIMNEY HEIGHT B VENT HE1 HT PLUMBING VENT ROOFING EXTERIOR FINISH DECK/PORCH/STEPS/RAILI S RELIEF VALVES FURNACE HOT WATER OPE T G INTERIOR TRIM PRIVACY DOOR FINISH FLOORS: BATH KITCHEN WATE IGHT OTHER FLOORS SWE ABLE OTHER FLOORS CA ETED STAIR CLEARANCE ILINGS SMOKE DETECTORS 4FIRE ANS FIXT ES N I ULATION RE ROOFINGERCT ICAL/ ARIANCE REQ_ FINAL SURVEY PLOT PLAN OK TO ISSUE C/O OR C C s PA TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 BAY RD., QUEENSBURY NY 12804 INSPECTOR'S REPORT: ARR £ D DEPART ' INT REQUEST FOR INSPECTION RECEIVED: NAME LOCATION DATE 3- PERMIT Mv- TYPE OF STRUCTURE: RECHECK AP OVED N/A YES NO FOOTINGS PIERS r MONOLITHIC POUR FORM REINFORCEMENT IN PL E THE CONTRACTOR IS R SPONSIBLE F R PROVIDING PROTE TI01 FROM FREEZ NG FOR 48 HOURS FOLLOW G THE PLA - MENT OF THE CONCRETE MATERIALS FOR THIS PU POSE ON ITE FOUNDATION WALLPOUR REINFORCEMENT IN PLACE FOUNDATION/DAMPPROOFING BACKFILL APPROVAL PLUMBING VENT VENTS IN PLAC ROUGH PLUMBING PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADEIIS BRACING BRIDGING JOIST HANGERS JACK POSTS MAIN EAM EAIRINEFTLTRATION BARRIE OUGH-IN INSULATION: FOUNDATION WALLS IN ERIOR R- FOUNDATION WALLS EXTERIOR R-_ FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES R- TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 BAY RD., QUEENSBURY NY 12804 INSPECTOR'S REPORT: ARR/LV.`JO DEPART)O f c INT REQUEST F ;ZECTION RECEIVED: NAME LOCATION -' A `6 DATE Q PERMIT # O TYPE OF TRU SURE: RECHECK APPROVED N A I YES^' NO FOOTINGS/PIERS MONOLITHIC POUR FORM f REINFORCEMENT IN PLACE ' THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTE TION FROF FRR ZING FOR 48 HOURS FOLLOWING T .ACE - MENT OF THE CONCRETE. MATERIALS FOR THIS PURP E ON SITE FOUNDATION WALLPOUR REINFORCEMENT IN ACE FOUNDATION DAM $ROOFING r` BACKFILL AP -f2OVAL PLUMBING ENTIVENTS IN LACE ROUGH PLUMBING PL rBING UNDER SLAB %VA MING: JACK STUDS H ADERS BRACING BRID ING J013T HANGERP JACK POSTS IN BEAM AIR INFILTRATION BJRRIER 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 R- ago 792122 4 co Lo HAR 1995 }. Received ', r Town of Queensbury `J Bldg. t Dep �w it 9917 fi a T N;c w RSA NMICEw�4i AK coA+ 3Da Ms f MUST BE E uNrgR vQvu+cDj BY A 151VIKR THERM BA � R co,��Ng 1?E Maw ALL., P+ fivJo 'Ra'kTJL�G e�i L'�u� So i s'E'g , A`r 1�3 5�A>us NOTICE KRAFt rrrtK IN-builtAPTION MUST BE lRok t COVERED BY NON-COMBUSTIBLE BARRIO 1V 2X 1� 41D �tp ou Zx (� ��Ar2i � � � �x►�-��r� v�� I i Idaa �P! \ �`� � �.tngsu�a�� pan�0 SM UK j