1986-613 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN. COUNTY, NEW YORK
Date 19
86-613
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a Solar Room added to One-Family Dwelling
Mason Road, Cleverdale
Location
Owner Francis and Judith Heisler
By Order Town Board
• TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-613
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Francis and Judith Heisler
OWNER of property located at Mason Road, Cleverdale Street,Road or Ave. frt
in the Town of Queensbury,To Construct or place a Addition to dwelling (solar room)
at the above location in accordance to application together with plot plans and other information hereto filed and v'
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
0
1. OWNER'S Address is Cleverdale, N.Y.
a.
rr
2. CONTRACTOR or BUILDER'S Name
r•
to
Roger Mosher
n
3. CONTRACTOR or BUILDER'S Address
Box 49
Valley Road
Warrensburg, New York
4. ARCHITECT'S Name
w
CD
0
0
5. ARCHITECT'S Address
0
P-.
H
6. TYPE of Construction—(Please indicate by X)
co
n
Pc I Wood Frame ( ) Masonry ( )Steel ( )
H
m
7. PLANS and Specifications
No. 10'x14' per plot plan, specifications and application submitted.
8. Proposed Use a
One—Family Dwelling (solar room added) CO a
0 rt
1 r•
w 0
n
rt
$5 00 C/O o o
$ 16.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 87
0 0
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the '' 4
town of Queensbury before the expiration date.)
r•
Dated at the Town of Queensbury this 23rd Day of- September 19 86 ova
SIGNED BY / / !a' a for the Town of Queensbury
Building and Zoning Inspector f Cg)
•
TO BE COMPLETED BY BLDG. DEPT. .
_ac� • // Application No. 'TO OF 4 URY
wn of Queen3bur y Permit Issued 19 aEl. CEIVE
BUILDING and ZONING DEPARTMENT Permit Expires 19Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation A• 1 6
Queensbury, New York 12801 Variance No.
Site Plan Review No. j P` L P•
. . . / ` 1` :•'a t i .I ;y1213,4 5
13 - ._ L7 O\ Approved by: 1 ie e
APPLICATION FOR f, !d'L./ 1 r_, _
, . ,'tt .
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 thy Permit.
pre /S�ef ,,-- I-i_ L
The owner of this property is: } I'CLI''lC i S r. �• �-��1 5 �� - d— `JLL +k A , I �l cisic,
P.O. Address Mason Rd CIev�.rdaale, . \J . la YDQ Tel. LI8-- .6-saga
Property Location: IAu i I dl ii1G 1-3f . g . 04.- oaa z Tax Map No. . Y' / /
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS .REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder Rogger (YlosIler Address Bo -i G Tel. �,L 3 �i� L' {!`.
Name of plumber Re n n O Sh Y Address Va I Lai ccL.. Tel:.
Name of mason 6 ex 171051,1 ej- Address (on yrulsb cucci
-1Tel.6 7 �>-, r',� ,
NATURE OF PROPOSED WORK: * ZONING INFOORMATION:
cpnstruction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, ..
Addition to a building 5 olc0- RO(41 * drawn reasonably to scale and attached hereto, '
Ai *
_ reration- to_-a building- _ showing clearly and distinctly all'biildings,
(no change to exterior dimensions) * whether existing or proposed and indicate ell
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. .
*
* COMPLEPE INFORMATION REQUIRED BELOW.
* •
Size of property , - 1 ft X .. .__ �, ft.
' * Existing building(s)' Si e ft X__ _, i-- ft.
PROPOSED BUILDING AND USE: /'
17
* Existing building(s) Use S"/
Size of new structure/a_ ft X f 9 ft * iY id
Foundation-pier/slabecrla/parti l/full *.Proposed building, distance from propetty line
*
(circ'le one) * Front yai d �(7 ft Rear yard �� ,3 ft
No. of stories (habitable space) * Side yards j "'"- ft and 4r, .i/ ft
Height (grade to ridge) / •ft. * If on corner, setback from side street --..__ ft
If residential, no. of families /
No. of rooms(excluding baths) ` * OCCUPANCY. INFORMATION
No. of bedrooms • *
No. of bathrooms •
•
* PRIMARY BUILDING -
heatingsystem j ^ "c * ne family dwelling
Primary Y r, / j�-i'� / �_�% * --Two family dwelling
Type of fuel (7)1c - -
No. of fireplaces to be installed * M�ultiple dwelling / Number of units
Will a wood stove be installed. * rrmanent occupancy
n
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 Old style Bungalow , rlp d'* „l}� _ `
,Cape Cod 'Cottage OtherfO �', ACCESSORY BUILDING- ,
Colonial ' Row Town House *' .. Detached garage/one car/ two car/ car ,
• ( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car .
* * * * * * * * * * * * * * * * * * Private storage building �� r�' f
ESTIMATED MARKET VALUE OF * - Other_ .t,�j�.0,. : ,0'- 2.. �-- c' - 'iL- ...=r'
CONSTRUCTION �, * �` _ �, �.
INFORMATIONN ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl . -
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS: t;� /
Type of Construction, wood frame, fire safe,etc. / - .-a-0�='.41IJA1.4&-
Will any second-hand or ungraded lumber be used? If so, for what? /� I
i, If
Foundation wall material Thickness '
Depth of foundation bel w grade (`Lb bottom of footing) f' i z` - " -7
Will there be a cellar?j 4 Heated or unheated? ,-p_,Floor sq. -footage / ,,/O ' sq ft
Will there be a basement"? /,h Will any portion be used as livin space? , ' I v„.,_ez
(If so, what portion??a sq.ft.00- Type of use? So 24/c CAA /
Type of roof - sloped/flat/shed/other . Material,-of roof ,f�-'' ,> ''4....oG 5h 1. y -
.SZ®.r�. '
Size, wood studs 2 "X t " spacing -. I"o.c. length f£. a
Joists(flc?or bums) 1st floor: 2_ "x ' " spacing 7_V"o.C. span/0 ft.
Joists (floor beams) 2nd. floor "X_ " spacing /V "o.c. span/ ft.
Overlays(ceiling beams) "X • spacing 0/ "o.c_./span , ft.
Roof rafters . "X spacing i o.c. span/a ft. -
Roof trusses (pre-engin e red) spat'n4/ "o.c. s56n ft.
Exterior wall finish ..j' Of what material? --e".2.
Interior wall finish 'X _�..,r(X ,"•�% Ci(TZ..
If a garage is to be atf-_"-adirdd, describe materials to-be used for FIRE` SEPARATION: A'.,
Is there to be an opening between garage and dwelling-IWO If so will a Fire-rated
door, enclosure, and self-closing device be provided?f/d
Will a flue-lined chimney be installed? A/6 Height above roof J)e, ft.
Depth of chimney foundation below grade 4),(p ft.
Depth of fireplace hearth ft. in.
Water supply - Municipal or private well r' 0
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ,2'),",) ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
•I swear that to the best of my knowledge and belief the statements contained
in this application, together with -he plans and specifications submitted, are a true and
complete statement of all._prnnosecR__wr k, to .be_ done '-on-=the-dcsc�:,:_e -p-::eiauses and -that:aril-- ` -
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 ,',6' --„2 ' �� 2!_-`/ . •
Owner, ner,.s vagent architect,contractor
day of 19
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 / �1 •_CY . /f/,/, ./_
2 . Type of heat //1, ri I✓ ,✓ X�,_..- ()L�- j ,�ry--.�rt-""4 /
3 . Is the building mechanically cooled? F ,�
• 4 . Percentage of area of windows and doors_ L-_(') /f,,--
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 . 4-;/ •
1.• If YES , what is the R value?
•
• 3: Slab on grade YES NO/
a. If YES, what is the value of insulation around .
perimeter of floor ? �-r,, n .n / v7 /�� n
` G G-/ F / i '. v `'
4 . Is basement heated? YES NO . .
a. R value of insulation .
5. Type of insulation • •
_ 9y 61)�
B. Under 16% Only • ��
• ' 1. R value of roof and floors exposed to ambient conditions
. . . 2. R. Sla.iu? - ,f--`-'v_}�? _of walls. p "-P I))
' (' r --
•
3 . R value of glazed area ,(] ?__ j ,)_" V / ./' c /i,/ ,.,,a ,-A/
ti
_ 4 . •R value of ' doors ° i2
"---- - --._"_____-- _ . ----- .
5. R value of floors over unheated spaces j v
6. R value of slab edge insulation - unheated slab
7•. R value of slab insulation -., heated slab LJ!
8. R value of heated-basement/cellar walls (above grade)./r
9.. R value of heated basement/cellar wah.s (below grade)' •
-_
10. Type of insulation ;" /
C. Controls I
1. Thermostat maximum heat setting ) i //C .
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 ether areas
•
E . Piping Insulation ' - - • - .
1• . Size of hot water or cooling carrying agent pipe _Pj/
" 2. R value of pipe insulation ;i,, jig-:, ./ ;�
-� - -
F, Service Water Heating .
• 1••. Performance efficiency g6`76 '
2. Temperature contre1 petting MA)aMUM - 0 r ,
•
, ,. -/I-677
G: For Swimming Pool Only .___7--
1 •
. Maximum heating
Telephone No. (�4 2. c•J'? � � ,, i),4--" 1' r
(akaica.,t s signature)
•
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS. •
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. - -
ITEMP.# (DATE %/;-) _ i.0 -
I (
CITY OR
VILLAGE - - - TOWNSHIP•_ _ 1. COUNTY r•';'' ' -
STREET AND NO.OR s —:
ROAD AND POLE NO. 14 i-:, '>.1,, /6`,, " • POLE NO.
BETWEEN WHAT TWO' I
CROSS STREETS IS / r .1 / t Ai f
PREMISES LOCATED? L., . _ f ) 1"i• -•y;:. -' SECTION / BLOCK --'-. LOT `I% l
OCCUPANT'S_..— '( !s. ice. BUILDING „ ,?:f --•`'
NAME �.-o i- t1 . �;Jr .. ', i f{ {� OCCUPANCY `
OWNER'S NAME ,��'"� p� `
ANDADDRESS/`c-i .1._� _;;. ii b. Ica ., t 1 r ' Vq' f TEL.# .. ...
CURRENT
SUPPLIED t,.�
BY FROM THEIR OFFICE
_
BUILDING WORK - - DEFECTS
IS NEW E.• OLD❑a IS-- NEW ❑ ADDITIONALi❑ : REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED - •
NUMBER OF OUTLETS Lampo. fReceptacles MOTORS HEATERS BRANCH CIRCUITS OFFICE USE
Loca- ONLY
tion Side Attach't H.P. Watts ; A.W.G.
Coiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each ,1d°• Gauge INSPECTION
Out-
side j
f(
Sub-
base
Base-
ment
1st Fl. •
/
2nd Fl.
3rd Fl.
-
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: / DO NOT USE THIS SPACE.
•
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 OF ELECTRIC SIGN TOTAL
MAINS .;# ,,,y:FEEDERS LAMPS WATTS -
CHARACTER EXPOSED GAS TUBE SIGN ' - - - --
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE - (NUMBER) (CAPACITY) ,
STARTED COMPLETED SIZE OF SIGN
SERVICE OVERHEAD UNDERGROUND MAKER
ENTERS OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD 1-1
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. APPLICATION
PRINT NAME LAND ADDRESS/ , r,r
NAME OF / //' V SIGNATURE
APPLICANT ?Li.'f�l�- ? �,^� -1 'IL OF APPLICANT
Jl4:. C,!' rF l lfr.ri j:'.'--'j 4-.'-.�-+ TELEPHONE# i�.r% - `- f-
I STREET ADDRESS f• 7 � -
CITY OR -f""� ZIP LICENSE NO.
17
POST OFFICE ,l '-'s-------; .e../ -'""`? 0 1 CODE WHEN APPLICABLE
f
46 EL (REV. 1/86) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
_own o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME5L6iZ
LOCATION ��O � ����,� /�
Date ?Pi/ Permit No. 13
* * * * * * * * * * * * * * * * * * * * * * *
A'd2- = APPROVED - YES / NO
XFooting/Pier Forms C.*
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
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled inspection(call when ready)
Remarks- -
(Afi26,44- -2)
Building Inspector
6/86 and-vl
C I e-4 cc1o/p 13
_awn of Queeni‘ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME Frce,.% ci H /pi-
LOCATIONS R1
Date l° / p, Permit No. -to L3
* * * * * * * * * * * * * * * * * * * * * * *
i/ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
)( Framing Sy, c ..a.. em.0
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
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
f)-40/4,,a-t
Building Inspector
6/86 and-vl
, - -
A "
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