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Application TOWN OF QUEENSBURY REVIEWED BY: COMMUNITY DEVELOPMENT DEPARTMENT BUILDING & CODE ENFORCEMENT FEE PAID: /'rcl 531 BAY ROAD QUEENSBURY, NEW YORK 12804 PERMIT NO. (518) 745-4447 BUILDING PERMIT APPLICATION — A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTIO .�'NO INSPECTIONS WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID LDING RMIT ' All applicants' spaces on this application MUST be c ' plet nd the, signature of the applicant MUST appear on the applicotior�i"fffrdY�' OWNER OF PROPERTY: -rhe ' v 1 f i rhaoLs rnr-n� Inc Mailing Address: EL Sox `1 RR La�l.d �,.,;_ N�� i2tt`o„ Telephone Number s):w k -y3 _gj q1, Home PROPERTY LOCATION: 39 61 d ml ( ( y_��tY i�j nJT Tax Map Number: Section B o k Lot Subdivision Name: �� Xt7rl FF( �� Lot No. NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE CONSTRUCTION: $ 791 S®Q — N ING: ESIDENCE OCCUPANCY INFORMATION: D TO BUILDING: PRIMARY BUILDING - RESIDENCE/COMMERCIAL L/ Single Family Dwelling ALTERATION TO BUILDING: Two Family Dwelling RESIDENCE/COMMERCIAL Family Dwelling (NO CHANGE TO EXTERIOR SIZE) Office OTHER WORK (DESCRIBE BELOW) Mercantile Warehouse Manufacturing GROSS AREA OF PROPOSED STRUCTURE: Other 1ST FLOOR J ,Q/, SQ. FT.(3Mj. 1-Caryatdr- 2ND FLOOR SQ. FT. IF ADDITION, USE OF NEW ADDITION: �— OTHER FLOORS N�k SQ. FT. (not unfinished cellar or basement) ACCESSORY BUILDINGS : Detached Garage 0 Two Car TOTAL FLOOR AREA: /c3 SQ. FT. _ Attached Garage - One wo Car Private Storage ui ing SIZE OF NEW STRUCTURE: Commercial Storage Building FEET X FEET Other Foundation Type: d4 A4_ Will any second-hand or ungraded Number of Stories : lumber be used? If so, for what? (habitable space only) Height (grade to ridge) : sfeet Type of Heating System: Number of fireplaces and/or woodstove (circle all which applies) to be installed: — Electric / Oil / Gas / Wood Forced Hot Air / Baseboard / Other -PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: FRIP TohwsOn o Thy Y)Iit r o Ine- NAME OF BUILDER/ADDRESS/PHONE: („o _�Y1C, py of l I If 7R3-%,y NAME OF PLUMBER/ADDRESS/PHONE : }era I )% b04� 67 , l < esa � NAME OF MASON/ADDRESS/PHONE: { NAME OF ELECTRICAN/ADDRE S S/PHONE: 92 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 projec- mises. Signature (Owner, owner's agent, itect, contractor) FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE: 4' H BUILDING PERMIT TOWN OF QUEENSBURY ro No. 93-261 z O WARREN COUNTY, NEW YORK Y PERMISSION is hereby granted to THE MICHAELS GROUP INC. w I OWNER of property located at 39 Old Mill Lane Street, Road or Ave. ~ in the Town of Queensbury,To Construct or place a 1/2 of duplex 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'SAddress is i-3 PO Box 887 x en Latham NY 12110 H n 2. CONTRACTOR or BUILDERS Name kC t�7 same 3. CONTRACTOR or BUILDER'S Address 'n 0 O C ro H 4. ARCHITECT'S Name C� 5. ARCHITECT'S Address w O N 01 6. TYPE of Construction—(Please indicate by X) r• k )Wood Frame ( 1 Masonry 1 1 Steel 1 1 ti IL 7. PLANS and Specifications MASTER PLANS ON FILE m No.1/2 of Duplex-1386 sq ft Single floor as per plot plan, specifications and application including one car attached 8. Proposed U Single family dwelling//1/2 of Duplex F- N O 179 .00 JUNE 10 94 r' $ PERMIT FEE PAID —THIS PERMIT EXPIRES 19 t7 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the R7 town of Queensbury before the expiration date.) (D X Dated at the Town of Queensbury this 10th Day of June 1993 SIGNED BY for the Town of Queensbury Building and Zoning 1 or CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date n*- I 19 This is to certify that work requested to be done as shown by Permit No. 93-261 has been completed. single family dwelling This structure may be occupied as a Locarion 39 Old Mill Lane one car attached garage The Michaels Group Inc. Owner 95-3-17 By Order Town Board TOWN OF QUEENSBURY Director of Bldg. do Code Enforcement l a 33 - r'9All E 30 mm C w mD n ° y :Qn o � a , ° ic D0 C ''' T o > q v ° ti m 3Aj m . s n e N 4 4 „ m t S ri Q 30 4 x N c 2 CC. E THE NEW YORK BOARD OF FIRE UNDERWRITERS CERTIFICATE NO DO NOT WRITE HERE-FOR OFFICE USE ONLY BUILDING PERMIT NO TEMP i DATE CITY OR NLIAGE 2 IZIRCoDF 2$04 (TOWNSHIP `WhVen u¢¢nd5t1AU 1 tYR/G�1 STREET IF 3 91d DPt �Qne. POLE NUMBER BETWEEN WHAT MU CROSS STREETS IS PREMISS LO $UED4 SECTION BLOCK LOT GThT'S NGuzetb BUyM G-tou , Inc.. C19E'tE ir" VNA7e> ING URK`lNiV ¢ LQA.FL". NY 12710 ROME TELEPHONE NUMBER CURRENT NISIJ LIED BY FROM THEIR OFFICE WORK TELEfflfy1#1gE mo BUILDING Is yyyy yyyy rr as `� NEW L�1` OLD El WORK IS NEWLT ADDITIONAL El DEFEGiS REMOVEDC LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED LOGa- NUMBER OF OUTLETS lamp ReNo.of lxtures&ceptacles MOTORS HEATERS CIRCUITS BRANCH OFFICEONLY USE ton Sitle ABachY H.P Wads A.W.G. Ceiling Wall Recep'Is Switch Pentlant Bracket No Type Each No Each NO, Gauge INSPECTION OUT- SIDE SUB- BASE BASE MENT in FL 2ntl FL. 3rtl FL. RR MAT OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE. Ete efti e E GQb THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT,AS PROVIDED BY THE APPLICANT. SIZE OFF AN S.P FEEDERS EgfXC SIGNSAAMPS TOTAL WATTS 150 CHARACTER OF WORK EXPOSED GAS USE SIGN?RANSFORMERS OF `zA ❑ CONCEALED N(A DATE WORK TO BE STARTED WE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY N/A SERVICE ENTERS BUILDING y� MPNIJF�Y'fURER OF SIGN ElA OVERHEAD i. UNDERGROUND QE INSPE=N REQUESTEDMUSTp p O ON(OR AS NEAR AS POSSIBLE) IDENTIFICATION NUMBER 0- 4 V 11 I /T O 1 e AVOID OELA* IBY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE U RNED. PRINT NAME AND ADDRESS NAME OF APPLICANT DATE OF APPLICATION SIGNATURE OF APPLICANT Boet E.teeta.i-e X STREETADD SS TELEPHONE NO 7446 Q�S�ehy stAeet 37J-9922 CITY OR POST OFFICE ZIP CODE LICENSE NO WHEN APPLICABLE S d NY 12309 203 85 John Street ��7�t1 State Street 570 Delaware Avenue 217 Lake Avenue 202 Arterial Road NEW VORK NY 1l)038 I `ALBANY,NY 12207 El BUFFALO,NY 14202 ROCHESTETTI /4808 I SYRACUSE,NY 13206 (212)22- 3-00 (518)463-2122 (716)884-1155 (716)254-0141 (315)463-8552 TI I wlr1AI vt-�rw M0'%A 1111 r%r— r-1r1177 11 A I M C MI A 10 1 rC 0 0 TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED j NAME LOCATION 3 q ad�kCU �u 1 DATE /! PERMIT # TYPE OF STRUCTURE YZ 61u,&14 RECHECK APPROVED N/A IYES1 NO FOOTINGS/PIERS MONOLITHIC POUR FORM T T— 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 PLAtE PLUMBING UNDER SLAB_ FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BFJAM HEATING ROUGH-IN INSULATION: FOUNDATION WALL INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: / g /VO �{L�/1i�.o�i / JF4{/p,��"/ ✓{//J� ARRIVE *INSTOR— DEPAR T 1) TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME �Glcctc%s' � LOCATIONA5� DATE PERMIT # 9 3 ' c.Z6 TYPE OF STRUCTURE RECHECK APPROVED N/A IYES1 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 AGBACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLACE PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERI R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: 9 1! i ARRIVEDEPART It �I S CTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION a DATE 7a9/ 53 PERMIT i a �/ TYPE OF STRUCTURE RECHECK APPROVED _ N/A YESI NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN,PLACE THE CONTRACTOR I$ RESPONSIBLE FOR PROVIDING PWTECTION FROM FREEZING FOR 48 OURS FOLLOWING THE PLACEMENT OPTHE CONCRETE. MATERIALS FOR TH S PURPOSE ON SITE FOUNDATION/WALL OUR REINFORCEMENT IN PLACE FOUNDATION/DAMPR FING BACKFILL APPROVAL oROUGH PLUMBING PLUMBING VENT/VEN, IN PLACE PLUMBING UNDER SA _ ,FRAMING: JACK STUDS/HE DERS, BRACING/GRID ING JOIST HANGS _ JACK POSTS/ IN BEAM-.. HEATING ROUG IN INSULATION: FOUNDATIO WALLS INTERIOR R- FOUNDATIO WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT W RK OR PIPING IN UNHEATED SPACES REMARKS: Root Cod �Oea(c. ARRIVE 3,cro DEPART /0 INSPECTOR �vat tv ram— (--)I V� 6 . "I A TOHN OF QUEENSBURY BUILDIMG 6 CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name dh 14 J Location Date 1 � �_ Permit f iLy� Z��S1 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Number- Size - ft. x —__-- ft. Stone size _ PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit openings Sealed? Yes No artial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits _ feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front: - Middle Rear COMMENTS: SYSTEM USE APPROVED: YES NO Arrived: Departed: Building Inspector TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED 3 11 NAME LOCATION DATE 7/a PERMIT i �3 .7k / TYPE OF STRUCTURE du� RECHECK APPROVED ,N/A I YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM _/ FREEZING FOR 48 HOURS F LLLOWIN THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE _r FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT/VENTS IN PLA PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEM BRACING/BRIDG JOIST HANGERS JACK POSTS/MA HEATING ROUGH-I INSULATION: FOUNDATION WAFOUNDATION WAFLOORS R- WALLS CEILING R 30 - DUCT 'WORK OR PIPING I UNHEATED SPACES REMARKS: ARRIVE DEPART INSP TOWN OF QUEENSBURY � / BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 'TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED NAME Lei LOCATION �3 y i DATE 7 .2 93 PERMIT / 93 -,Z& TYPE OF STRUCTURE RECHECK APPROVED N/A YESI 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 HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INT IOR R- FOUNDATION WALLS EX RIOR R- I/ FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES REMARKS: S�p�� 9cerL ARRIVE ��Q DEPART I S ECTOR TOWN OF QUEENSBURY Gd�'rijh{v BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT REQUEST FOR INSPECTION RECEIVED�a 7/5& NANE�_ I it LOCATION DATE- PERMIT / TYPE OF STRUCTURE llzzt law RECHECK APPROVED N/A YESI 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 HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR' R- It FOUNDATION WALLS EXTERIO R- FLOORS R- WALLS R- CEILING R- DUCT 'WORK OR PIPING; N UNHEATE SPACES REMARKS: ARRIVE DEPARTTIq 3. ECTOR TOWN OF QUEENSBURY !7 531 BAY ROAD T QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745-4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED ]p 1p S NAME LOCATION < DATE TYPE OF STRUCTURE / RECHECK FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE) LFDOTING CJOUNDATION 1� BACKFILL �RAMING Z-RdUGH PLUMBING FINAL ELECTRICAL �WTIC _INSULATION _WOODSTOVE/FIREPLACE REMARKS_ AA,6�I APPROVAL CHIMNEY HEIGHT/LOCATION N/A YES NO B VENT/LOCATION -- PLUMBING VENT ROOFING SIDING DECK/PORCH/STEPS/RAILINGS RELIEF VALVES FURNACE/HOT WATER OPERA ING BASEMENT INSULATION/DUCTWORK INTERIOR TRIM/PRIVACY DOORS FINISH FLOORS: BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEPABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS HANDICAPPED ACCESS SMOKE DETECTORS BATHROOM FANS/WHOLEA ALL PLUMBING FIXTUR GARAGE FIRE PROOFIN DOOR CLOSERS OTHER FIRE SEPARA I FIRE/DEMISE WALLS DUMPSTER SITE PLAN/V RI NCE FINAL ELECTRICAL OK TO ISSUE C/O OR COMMENTS: I rO / ARRIVE DEPART \ I SP TOWN OF QUEENSBURY BAY ROAD QUEENSBURY, NEW YORK 12804 TELEPHONE (518) 745_4447 BUILDING INSPECTOR'S REPORT FINAL INSPECTION REQUEST FOR INSPECTION RECEIVED LOCATION DATE �/�/��; PERKNIT# F/3 -2& / TYPE OF STRUCTURE Y� oai RECHECK _FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE) _FOOTING FOUNDATION BACKFILL FRAMING ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC _INSULATION _WOUDSTOVE/FIREPLACE REMARKS APPROVAL N YES NO CHIMNEY HEIGHT/LOCATIO B VENT/LOCATION PLUMBING VENT ✓ ROOFING SIDING DECK/P RCH/STEPS/RAILING RELIEF VALVES FURNACE/HOT WATER OPERfrING INTERIOR TRIM/PRIVACY OORS FINISH FLOORS: 1 BATH/KITCHEN WATERTIGHT OTHER FLOORS SWEEVABLE OTHER FLOORS CARPETED STAIR CLEARANCE/RAILINGS SMOKE DETECTORS DOOR CLOSERS BATHROOM FANS ALL PLUMBING FIX URES OPERATING GARAGE FIRE PROOFING DOOR CLOSERS OTHER FIRE SEPARATION FIRE/DEMISE WALLS FINAL ELECTRICAL OK TO ISSUE C/O OR C/C COMMENTS: Aw f;.w� G ARRIVE DEPART /S IN PECTOR