2002-800 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020800 Application Number: A20020800
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: DFLLA BRASSART
For property located at: 183 PITCHER Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. T Value
Tie of Construction
Owner Address: ARC4BFND,L.L.C. Residential Addition 500.00
PO BOX 13244
PROPERTY TAX DEPARTMENT Total Value 500.00
EL PASO,TX 79913-3244
Contractor or Builder's Name Address Electrical Inspection Agency
Plans&Specifications
2002-800 Lot 16,#16 Briwood Circle, Della Brassart
Construction of a 126 sq ft residential addition per plot plan and specifications.
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, October 07,200
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Quee bury; M nday,October 07,2002
SIGNED BY for the Town of Queensbury.
V W/1V r,
Director of Building&Co e Enforcement
Building Permit Application
Town of Queensbury—Dept of Community Development, 742 Bay Road, Queensbury,NY
(518)761-8256
A permit must be obtained before beginning construction. Permit File No.
No inspection will be made until applicant has received a Fee Paid $
valid building permit. All applicants' spaces on this Rec.Fee Paid
application must be completed and must appear on the
application form. Reviewed By:j
-Applicant: -DI54AA9 Owner: ttcz tdras91_`1
Address: _&, & i lAfood Cr Pc tc Address: Ito /5r2i we od C i k'c le c prz�s9 i�7ola%1t'
0 c,Luos Lai i Aitw Uo e i' Z3 u z e Yrs bar n c,& qc Lg/c
Phone#(45] 4s- - o 143, Phone# (578) `7� -_of 42
Email Address: Email Address:
Property Location: Lot Number: 1(o / House Number /(p C`c 2c(2 Quoevtsbaot f 1�(-t/. t boa/
Subdivision Name: Tax Map Number:
❑ New Building: residence /commercial Estimated Market Value of Construction: $
Addition: esidence commercial
< If an Addition,what will use of new addition be?
❑. Alteration: residence/ commercial ^y��dtr0o'm
❑ No change to exterior size: residence t com'l
❑ Other work(describe )
Check Occupancylnformation 1"Floor 2'd Floor Other floor Total
Below sq.ft. sq.ft. sq.ft. Square Feet
Single family dwelling
❑ Two family dwelling
❑ Townhouse
❑ Multifamily dwelling
#of units
❑ Office
❑ Mercantile
❑ Manufacturing
o 1 car detached garage
u 2 car detached garage
❑ 3 car detached garage
❑ 1 car attached garage
❑ 2 car attached garage
❑ 3 car attached garage
❑ Storage building-
commercial -
❑ Storage building-
residential
Other �yti
What is the proposed height of the structure feet 1�p inches
Will any second-hand or ungraded lumber be used? If so,for what? Vl e e( "M(off
Type of Beating System: electri oil gas/wood /forced hot air/ baseboard/other:
Number of Fireplaces to be installed N o ryE Number of Woodstoves to be installed N oNc
List below the person(s)responsible for supervision of work as regards to building codes:
Name Address Phone Number
Builder (per 4 e 6fRi C i f u/ nlU 174,S-c>i 4 a.
Plumber -
Mason --> —��
Electrician �^
Declaration: please sign below after you have carefully read the statement: N
To the best of my knowledge 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 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,as requested by the Zoning
Administrator or Director of Building and Codes,an As Built Survey by a licensed surveyor;drawn to scale,showing actual
location of all new construction. {'
Signature:Q�& 6"4ak owner,owner's agent,architect,contractor
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF.QUEENSBURY, WARREN.COUNTY
9000 HEATING DEGREE DAYS ►" +
Compliance Methods:Part 5 -Acceptable Practice Method— 1&2 Family Dwellings (only)
Part 6*-Thermal Rating—Component trade Offs 1&2 Family Dwelling;
Multi-Family Dwellings (3 Stories or less)
Part 4*-Design by Component Performance, Commercial Buildings-Hi
Rise Residential
*Requires submission of worksheets
APPLICANT'S NAME: PROPERTY LOCATION:
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area 1 7-to square fee/G,
2. Type of heat- Electric Oil —Other
1. Is building mechanically cooled? yes
4. Percentage of area of windows and doors Over 17% ✓ Under 17%
5. R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TQ R VALUES.AS ,
SHOWN ON PLANS SUBMITTED:
a: Roof R—
b. Exterior walls R—I-
c. Glazed areas R�
d. Exterior doors I —
e. Floors over unheated spaces R.�
f. Edge of slab on grade(heated building) R
Basement/cellar walls (above grade)
g
R -A'
R '
h. Basement/cellar walls(below grade) ,.
i. Heating/cooling-ducts-piping in unheated space R
6. Service(domestic)hot water heating device
Conforms to minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140—WILL NOT BE EXEEDED
j icant's Signatufe--__ Date Phone Number
INSPECTOR'S REMARKS:
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