97-484 CLI�.��IFICAT OF COMPLIANCE
TOWN OF QUEENSBURY
• WARREN COUNTY, NEW YORK
Date (bpr 4 19 n7
This is to certify that work requested to be done as shown by Permit No. 978
4
has been completed.
• This structure may be used as a 240 SQ FT ADDITION (STORAGE ROOM ONLY)
Location 3 AMY LANE
Owner GOLLDMAN , HARRY & RUTH
TAX MAP F�s�. � 7-; By Order of Town Board
TOWN OF QUEENSBURY
&!",
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 5000 TOWN OF QUEENSBURY No. 97484
TAX MAP NO. 121 . -7-34
WARREN COUNTY, NEW YORK
GOLDMAN, HARRY & RUTH
PERMISSION is hereby granted to
3 AMY LANE
OWNER of property located at Street, Road or Ave.
240 SQ FT ADDITION (STORAGE ROOM ONLY)
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. VitifP'St8dnYtiAsYLANE
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
GOLDMAN, HARRY
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) RESIDENTIAL ADDITION
( )Wood Frame ( 1 Masonry ( )Steel ( 1
7. PLANS and Specifications
240 SQ FT RESIDENTIAL ADDITION. (STORAGE ROOM ONLY) AS PER PLOT PLAN
SPECiVICATIONS
8. Proposed Use
240 SQ FT ADDITION (STORAGE ROOM ONLY)
25 September 8 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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.)
8 September 97
Dated at the Town o teensbury this Day of 19
SIGNED BY f 2.
for the Town of Queensbury
f� Building nd onirg Inspector
Building Permit Application
'Town of Queensbuiy - Dept. 4-Community Development, 742 Bay Road, Queens bury, NI' 12804 (761-8256]
"O BUILDING & . COLIC ENFORCEMENT
NOTICE Requirements prior to issuance r
A permit must be obtained before
of this permit: PERMIT FILE NO. 7..J(�
beginning construction. No inspections
will be made until applicant has received E] Zoning Board Action PERMIT FEE PAID$ �„ 11 O
a VALID BUILDING PERMIT. All • Area /Use
applicants' spaces on this application RECREATION FEE r
MUST be completed and.the signature r] Planning Board Action �y
of the applicant must-appear on the REVIEWED By: ./.----
�pplicalion form. rh.,t�,„,. SPR / Subdivision /Other
Building 1wprcror" J
\ - Recreation Fee Payment
Applicant: \�1G:•`c't •.\ Cs--a v,,, 4,..� Owner: �`\'��" L. C� •, fit eI
' Address: �� v� �
`/ Cit.v`,sz___ Address: 3 Y`A Lk '^crol-
Phone # ( 5—tr ) 7rL_ ( ou3 Phone # (5(y- ) ?A2 - ► Go3
•Properly Locution: �� •t, �.ce.v�� l
• ;1iiIiiI vlalun Nnnlal • 'fnx Mnh Nunilwr al-4-2-4---,1/4.1
..._. ...,_.... :. -.. . Ntiullun Wok I44
NATURE OF PROPOSED WORK:
ESTIMATED MARKET VALUE OF, IIE
New Building: CONSTRUCTION: $ -,
residence / commercial 6
Addition to Building:
residence / commercial .00CUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial \c Single Family Dwelling
Residence / Commercial Two Family Dwelling
A no change to exterior size Fami-1_y,-Dwel3rng-
Office I t--,...T=v'' ' ; , .. 1--
Other Work (describe below) Mercantile ' '• --
ManufacturigJG 25 1997
Other
GROSS AREA OF PROPOSED STRUCTURE: •
u
1st Floor a. 4 . If ADDITION, _ what, %wiohl' _'_ se_
2 F1 ssq. ff of new addition be7 :
s q. f t. S"C�Acct Q v`���.
(not unfinished cellar or basement)
ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: - I.. K U SQ. FT. Attached Garage 1,L ca
4c Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
/ 2 FEET X �l7 FEET Other
Foundation Type: ( v�•'C� Will any second-hand or ungraded
Number of Stories: ( . lum er be used? If so, for what?
(habitable space only) b
Height (grade to ridge) : /2-- feet TYP BEATING YSTEM:
Number of fireplace and/or woodstove (c' r e" all w ' ch a 1' s)
to be installed: Ele tric 1 / Gas ood
F rce H Air - ebo rd / Other
Person responsible for supervision of work as regards to building '
codes is : ra6Lv-,t. k&k„' ,,,.--1
Builder: 'Aatne(? > Cal dr ss Phone
Plumber: o V&, �
Mason: l J 5ux, \4v�t-„ su.�y„�.�1
Electrician: ,OvV-f;L__ .
DECLARATION Please sign below ajler you have carefully read the statement.
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, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale showing actual location of project on premises.
Signature: C-V\(q Inowner, owne 's agent, ect, contractor)
� TOWN OF QUEENSBURY
L' . "• BUILDING & CODE ENFORCEMENT5 742 BAY ROAD
-' QUEENSBURY NY 12804
(518) 761-8256
ARRIVE: ./'DEPART:. 3, 25 INSP: •C.
____YFINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST� RECEIVED:
NAME 60Z0M✓y4)
LOCATION Ai✓1 141 L�
DATE / -) PERMIT 1 q 7 c._ Gly
TYPE OF STRUCTURE ' . 12 ��f aL06,,0 /
FOOTINGS V FOUNDATION _ /BACCKFILL /FRAMING i//
ROUGH PLUMBING SEPTIC ' INSULATION
FINAL ELECTRICAL _ WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT �/
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER O'ERATING
INTERIOR TRIM/PRIVAC• DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIG !-
OTHER FLOORS 'SWEEPA: E
/
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS _
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
/
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
, -2).AP
q4'./6 Ai 6,,,D (518) 761-8256
•
TOWN OF QUEENSBURY3
BUILDING & CODE ENFORCEMENT
•
742 BAY RD., QUEENSBURY NY 12804 .wA. .f r
INSPECTOR'S REPORT:, AR -U(/ DEPARg(v V�'`
INT
REQUEST F .,,..INSPECTION RECEIVED: /( 7''? 7
NAME c5`)l;' p `�1 \' (LTV-") ,,
LOCATION +�, , AT 16 ii ,sA,�Sz�V
DATE / 0 ~x PERMIT A R i 4 q
I
TYPE OF STRUCTURE: \0\ `�
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS-FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL 1
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PL BING UNDER SLAB
RAMING:
JACK STUDS/HEADERS
/
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM 0//"
AIR INFILTRATION BARRIER
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 •
-
e ' (518) 761-8256
TOWN OF QUEENSBURY ' e •
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 �t 4 :a' ;,fir ,.
i i' i
INSPECTOR'S REPORT: ARR` v- DEPART° ' � INT`
Yea
REQUEST INSP CTION yRECEIV�ED: a LC) ?` U 7
NAME �I�I�o e--\ ) c ' "'`Y`Ae•-
LOCATION <J 11\ Cr\A.J� -
DATE C\"' - PERT fl 1 -i
TYPE OF STRUCTURE: c�CIV--(`A. ,r�t /r.!
1 V a
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC *OUR FO'
REINFORCEMEIN PLA E
THE CONTRACTOR IS S'ONS.:LE FOR
PROVIDING PROTE TION FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPO E ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOU DATION/DAMPPROOFING
ACKFILL APPROVAL ,
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS '
BRACING/BRIDGING • _
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
Pf-jrY\
� 16 Rfl ) 76l8256
• TOWN OF QUEENSBURY ''•
BUILDING & CODE ENFORCEMENT A
742 BAY RD., QUEENSBURY NY 12804 Jw4 ..44.
INSPECTOR'S REPORT: ARR/ .t DEPART DdOINT\JI _
REQUEST F INSPECCTION RECEIVED: L\ f 13_C
NAME LcC) \. as ,-,-,,,, ,,--\-1/4.,
LOCATION '�" ""`,-r
DATE ��.1--\-oq PEAR , c\ L fl - 3 9
-.N. L
\
TYPE OF STRUCTURE: AlQr -- 19"
RECHE K APPROVE �
N/A YE NO
OOTINGS PIERS 40' /�
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE -rd
THE CONTRACTOR IS RESPONSIBLI/ F'>R
PROVIDING PROTE TION FROM FR -'ING:
FOR 48 HOURS FOLLOWING THE PACE-f
MENT OF THE CONCRETE. f
MATERIALS FOR THIS PURPOSE 0 :ITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB •
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING __
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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-
e•
e .
flLE COPY
TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
compliance with our comments shall
not be construed as indicating the
plans and specifications are in full
compliance with the code.
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zoning AdMinistrator
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