87-054 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. 87-54
has been completed.
This structure may be occupied as a One-Family Dwelling - Second Story Addition
Location Hanneford Road
Owner John Shafer
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 87-54
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to John Shafer
OWNER of property located at Hanneford Road Street,Road or Ave. 0"
rn
in the Town of Queensbury,To Construct or place a Second Story Addition to One—Family 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.
1. OWNER'S Address is
21 Bennett Drive
Delmar, New York
2. CONTRACTOR or BUI LDER'S Name
Joe Roulier
x
3. CONTRACTOR or BUILDER'S Address p
Box 301 ra
Cleverdale, NY 12820 rt
a.
4. ARCHITECT'S Name p
p
a
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
Ix)Wood Frame ( 1 Masonry ( 1 Steel ( )
7. PLANS and Specifications
24'x32' second story addition per specifications and application
No. submitted.
rt
8. Proposed Use
ro 0
Second story Addition to one family dwelling rt
wo
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$5.00 C/O o
$ 20.00 PERMIT FEE PAID—THIS PERMIT EXPIRES October 1 19 87 v
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0+
town of Queensbury before the expiration date.)
a
Dated at the Town of Queensbury this 4th Day of March 19 87
SIGNED BY a. 'er for the Town of Queensbury
CfQ
Building and Zoning Inspector
�] TO BE COMPLETED BY BLDG. DEPT.
_town of Queen 3ur1 Application No. I TOWN OF QUEEN SFiY
Permit Issued 19 n
BUILDING and ZONING DEPARTMENT Permit Expires 19 i t
2 1 U W i, 0
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation L. -/A k 2 1987
Queensbury, New York 12801 Variance No. FEB
Site Plan Review No. /_ /_' us /=R.e.
q — / ` 1 Approved by• I BUILDING & CODE DE A'.
APPLICATION FOR )
3
t
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this property is: ` %., -5/l R f e '
P.O. Address e✓! e....�+o ✓�l . .e+.. . C.Z"r2,4• 014 . Tel.,- y.31"e#2-
•
Property Location: /10,441 ;1 ..r3,0/ 4eo.+se,.„ Tax Map No. / /
Street numb r or building lot umber
Subdivision name (if applicable) --•
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name JJ P.O. Address Tel. No.
Name of builder 4‘6,c. Address Tel.
Name of plumbers1-E7,C„ ,/ „) Address , 4 .,, PCs Tel. 79,7-. .$
Name of mason — Address Tel.
NATURE OF PROPOSED WDRK: * ZONING INFORMATION:
_Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building * drawn reasonably to scale and attached hereto,
fVAlteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines. Give
* street and number or lot number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELQW.
* Size of property ft X ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE:
* Existing building(s) Use
Size of new structure .,Jai ft X3Q ft *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
*
(circle one) * Front yard ft Rear yard ft
No. of stories (habitable space) -Z
Height (grade to ridge) ..‘9.$ ft. * Side yards ft and ft
If residential, no. of families * If on corner, setback from side street ft
No. of rooms(excluding baths) 3 * OCCUPANCY INFORMATION
No. of bedrooms *
No. of bathrooms * PRIMARY BUILDING -
Primary heating system o��. * One family dwelling
Type of fuel * Two family dwelling
No. of fireplaces to be installed * Multiple dwelling / Number of units
Will a wood stove be installed? * Permanent occupancy
Central Air conditioning? -• * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex * If addition, what will use be?
Split level • Bungalow *
Cape Cod Cotta.- Other * ACCESSORY BUILDING-
Colonial -.n Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION q *
$------lam 4r-V 0_,
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS: /
Type of construction, wood frame, fire safe,etc. eoc(
Will any second-hand or ungraded lumber be used? If so, for what? do
Foundation wall material AL/4 Thickness � �4
Depth of foundation below grade (to bottom of footing) q
Will there be a cellar?._ Heated or unheated? Floor sq. footage sq ft
Will there be a basement? _. Will any portion be used as living space?
(If so, what portion? sq.ft. - pe of use?
Type of roof sloped lat/shed/other )Z.. Material of roof ,6 6--- 4 47e..
Size, wood stuas "X ,G " spacing "o.c. length d' ft.
Joists(floor beams) 1st. floor -- "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. floor 1 "X 6r " spacing/4 "o.c. span /4.,, ft.
Overlays(ceiling beams) .2. "X y " spacing ery "o.Jr,, span /,t. ft.
Roof rafters 2 "X G " spacing .j y o.c. span l3 ft.
Roof trusses(pre-engineered) spacing ---• "o.c. span ft.
Exterior wall finished -/.31e.a-4 iCOf what material? e.4,4640/
Interior wall finish li
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, and self-closing device be provided?
Will a flue-lined chimney be installed? -- Height above roof — ft.
Depth of chimney foundation below grade ft.
Depth of fireplace hearth * ft. in.
Water supply - Municipal or private well .Awoic 4,044e
SEPTIC SYSTEM Distance from ANY private ell(including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Qbury AFFIDAVIT STATE OF NEW YORK
County off Warren
I swear that 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
authorized by the owner.
SWORN TO BEFORE ME THIS Signature_
er, owner' gent,arcnitec ,contractor
0,/ day of .72 19 77
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:
1. Gross floor area ~' 7-e d .7
2 . Type of heat —Cc�� ,.
3 . Is the building mechanically cooled? /t/�
4. Percentage of area of windows and doors /-Z /%
A. Over 16% Only
1. Uo 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
B. Under 16% Only
1. R value of19 - r,o
of and floors exposed to ambient conditions
2. R value of exterior walls /' /f
f
3 . R value of glazed area �^ �• �
,..--
4. R value of doors /r " .4 . ,
•
ti/A
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 'v/'p
8. R value of heated basement/cellar walls (above grade) 14
9. R value of heated basement/cellar walls (below grade)
10. Type of insulation .21;71.•s.s
C. Controls �s� '
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 e�
1. Size of hot water or cooling carrying agent pipe Z-- c 1
2 . R value of pipe insulation
F. Service Water Heating
1 . Performance efficiency r."'--
2 . Temperature control setting maximum'
G. For Swimming Pool Only
1. Maximum heating
Telephone No. .,..4Y C_ 3)1H
(applicant ' signature)
Jown o/ Queensburc/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION `A1027"7',Of
Date�_
� Permit No. 8 7 ..�
= APPROVED
Footing/pier Forms - YES NO
Foundation
Waterproofing _
Backfill
Framing _
Roofing _
Siding _
Masonry Veneer
*Rough Plumbing
Relief Valves _
Ext. Porches
Finished Floors _
Interior Trim
Stairs & Railings _
Cellar Drain Tile _
Concrete Floors Al
Plbg. Fixtures A_
Gar. Fireproofing
Door Closers
Smoke Detectors _
Chimney ��
INSULATION: ' �i•�
Foundation
Floors AIIIIME1111
Walls
Ceiling _
FINAL ELECTRICAL INSPECTION _
DRIVEWAY APPROVAL _
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
7
Buildi g Inspector
6/86 and-vl
_Down of Queen.iur 1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 'lj/49FffK
LOCATION C7'�/V/VC O/C' l2b I2-r7/
Date 4/ Mr Permit No. g7-�".�l
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
n(Framing
v Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings \\\
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers 1,
Smoke Detectors
Chimney
INSULATION:
4/1
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INS CTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Bui ing Inspector
6/86 and-vl
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