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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date ,1 19
This is to certify that work requested to be done as shown by Permit No. R4=A112
has been completed.
This structure may be occupied as a New foundation under dwel l i na,
Location #7 Holly Lane - Assembly Point m Lake Gemae
Owner Florence Connor ( linnie Nielson)
By Order Town Board
TOWN OF QUEENSBURY
PaLta• cija tk---kJ/1A. _
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 89-802
0
WARREN COUNTY, NEW YORK ;,
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PERMISSION is hereby granted to Florence Connor (Minnie Nielson)
OWNER of property located at #7 Holly Lane - Assembly Pt.-Lake George Street, Road or Ave.
in the Town of Queensbury,To Construct or place-a new foundation under 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
12 Cedar Street
Lexington, MA. 02173
m
2. CONTRACTOR or BUILDER'S Name r—
to
Ken Collette -11
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3. CONTRACTOR or BUILDER'S Address z m
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1-1
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4. ARCHITECT'S Name -
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
0
( )Wood Frame ( )() Masonry ( )Steel ( )
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7. PLANS and Specifications
No. 1000' new foundation as per plot plan, specifications and fD
application. n
8. Proposed Use S
m
s
New Foundation Under Dwelling.
er
$ 30.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 1990
(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 Queensbur • 20th Day of . October 19 89 n
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SIGNED BY for the Town of Queensbury
Building an Zoning Inspector - -
N
TOWN OF QUEENSBURY
REVIEWED BY ?'O/e,
1 FEE PAID $ OpV ly
PERMIT NO. f �� 00�_.q .-ikse-bc,ii 4� ,
BUILDING PERMIT APPLICATION 0 Q.
.T�.
Q Tw8.9 .
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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.
* * * • .* * * * * * • * * * • * • • • * * * * * * * * * * • * • * * * * * * * * *
The owner of this property is:4/n P euc v ( ,N ait (/1J );12) 4)i-/ e )
P.O. Address f2- Cek., St Lexri c1M ,4t va1 '73 Tel.
Property Location * 7 lio//c, LJQ A sse,), fir' Pt, L L . 6 . Tax Map No. 6, /3/ of
Has there been any split of this property since October 1, 1988? / i
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
teen) Ga//et1®5-_3l/jIG
* � 7y7e
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF � � •
Construction of a new building * CONSTRUCTION: $ jo') ezrO
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x / 77 ft.
✓ Alteration to a building , *
(no change to exterior dimensions) Existing Buildings(3) Size '36 ft. x 3Y ft.
* Proposed building - distance from property line:
Other work (Describe) * Front yard ft. Rear yard ft.
RA/ s . 6o /a,. ;n ��// /vew )Pi P4.S * Side yards ft. and ft.
Re t 6 41 •
GROSS AREA OF PROPOSED STRUCTURE •
If on corner, setback from side street ft.
•
1st Floor — sq.. ft.
OCCUPANCY INFORMATION
*
2nd Floor sq. ft. • Primary Building -
Other Floors sq. ft. * One Family Dwelling
(not cellar or basement • Two Family Dwelling
TOTAL FLOOR AREA /"i3b sq. ft. • Multiple Dwelling/Number of units
Size of new structure_ft x ft.. * Business
Foundation-pier/slab/crawl/partial/full • Industrial
(circle one) • Other
•
No. of stories (habitable space)= •
Height (grade to ridge) /2. ft. • If addition, what will use be?
If residential, no. of families •
I
BUILDING PERMIT .APPLICATION CONTINUED -
BUILDING 'SPECIFICATIONS:
Type of construction, wood frame, fire safe, etc. F�i sfrj
Will any second-hand or upgraded lumber be used? If so, for what? A0
Foundation wall material Pl /Zs eti/y Thickness / 6
Depth of foundation below grade (to bottom of footing)
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. Type of use? f'
Type of roof - sloped/flat/shed/other — Material of roof
Size, wood studs "x " spacing " o.c. length ft.
Joists oor be ms 1st floor x) " " pacing
(fl "o.c. span ft.
Joist (floor beams) 2nd'fl0000r "x 1--� " spacing "o.c. span ft.
Overlays (ceiling beams) - --x " spacing " o.c. span ft.
Roof rafters "x " spacii g o.c. span ft.
Roof trusses (pr-eengineered) spacing " o.c. span ft.
A
Exterior wall finish N,. of what material? `
Interior wall finish
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 ft.
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 k'Pfrii //dt9 ADDRESS 7 1///t- 4,th TEL. NO. 7 y ) ` 7(/,P'l
NAME OF PLUMBER ADDRESSTEL. NO.
NAME OF MASON ie Ai CB//e7/710 ADDRESS TEL. NO.
NAME OF ELECTRICIAN ADDRESS TEL. NO.
DECLARATION
To the best of my Irnowledge 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
•II A*haw lisle fi..wfm:w:ww •— ass— ------- .. .
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280i
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ,
NAME \ /yW,L. 09-701.00- 1 1// /
LOCATION J/' Ot G�C1 LP/lu'.,f 161.1J_lC f (yee-.
DATE S/ /11 PERMITI# �7-d��.Z�
f.
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POURIFORMS
FOUNDATION/DAMP PROOFING,
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING a
ELECTRICAL ROUGH—IN
INSULATION: `.
FOUNDATION 1
FLOORS. i.
WALLS 1 /
CEILING?( '
FINAL INSPECTION•
CHIMNEY HEIGHT
ROOFING r
SIDING
C
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCE & RAILS
PLUMBING FIXTU�RLS/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROO$dTNG
DOOR CLOSER(, ) C
SMOKE DETECTORS a
FINAL ELECTRICAL INSPECTION * *
.FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/0 OR ./C
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BU {DING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
REMARKS: ' 6
t
•
ARRIVE
DEPART 1
-TOWN OF QUEENSBURY / �
BUILDING AND CODES DEPARTMENT /
BAY & HAVILAND ROADS j / /l�l
QUEENSBURY, NEW YORK 12804- �_
TELEPHONE (518) 792-5832 021.6-0
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 1 v
LOCATION 1 7 /U 7 IL --
DATE / /1//4-h3 l "PERMIT #
APPROVED.
YES ENO
e. 'DOTING/PIERS
MONOLITHIC POUR FORMS
•
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING '
ELECTRICAL ROUGHr'IN
INSULATION: r'
FOUNDATION ke
FLOORS
WALLS /. \ .
CEILING , '\
FINAL INSPECTION: 'a
CHIMNEY(HEIGHT \ •
ROOFING`
SIDING' • •
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING 1
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION • .
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
•
`INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT // I
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804- it cM
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECT ONREECEIVED
NAME /�/( (...8 / 0 .
LOCATION %/ j;n /�/
/ vI
DATE ///k'� �� / PERMIT # �� �. �
/ /APPROVED
•
/ / YES :NO
FOOTING/PIERS •./it
MONOLITHIC POUR FORMS ,;°
FOUNDATION/DAMP—PROOFING / .
BACKFILL APPROVAL
ROUGH PLUMBING /
FRAMING 'a., i
ELECTRICAL ROUGH—IN I
INSULATION: ..
FOUNDATION
FLOORS }� . .
WALLS
CEILING i .
FINAL INSPECTION: is
CHIMNEY HEIGHT .,
N"
ROOFING / \
SIDING I \.
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY 'DOORS
FINISHED FLOORS \N,
GARAGE FIR PROOFING Ri
DOOR CLOSE (S) �> •
SMOKE DETE, TORS \,
FINAL ELECTRICAL INSPECTION ..
FINAL APPROVAL OF CONSTRUCTION ' "
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
•
•
C:1
•
0\i'•° \\\\__
1 INSPECTOR
own ° �een� �� BUILDING & CODES DEPT .
THE PLANS SUBMITTED HAVE BEEN REVIEWED AND
HAVE BEEN FOUND TO LACK SUFFICIENT DETAIL
FOR PROPER PLAN REVIEW.
WE HAVE ISSUED THIS PERMIT WITH THE
FOLLOWING STIPULATIONS :
1 . THE WORK WILL BE INSPECTED AND MUST CONFORM
TO ALL PROVISIONS OF PREVAILING CODES .
2 . IF DEFICIENCIES ARE FOUND THEY MUST BE COR-
RECTED BEFORE WORK CONTINUES .
3 . FAILURE TO COMPLY WILL RESULT IN REVOCATION
OF THE BUILDING PERMIT
Code Enforcement Officer
/t/c2t1/4-7
Da t e
Building Permit #
COMMENTS:
0412 �'zv! 1 `�-e ���� Lin'
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• TELEPHONE: 747-9451
COLLETTE CONSTRUCTION, INC.
9 COLLETTE LANE HUDSON FALLS, NEW YORK 12839
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TELEPHONE: 747-9451
COLLETTE CONSTRUCTION, INC.
9 COLLETTE LANE HUDSON FALLS, NEW YORK 12839
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