1987-039 +CE .'TIF`ICA 1 E CIF -
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
Ilatc 19
�3D1 I k Ptrrs►it No. 87-39
This is to certify that work requested to be doge as shown by
hss been cotnPleted.
Addition to one family dwelling
This structure may be occupied as a
4 Centennial Drive
IIIIIIII
Location
Arthur and N
Owner
By order Town Board
TToWN of QUEENSSURY
Building N Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-39
WARREN COUNTY, NEW YORK
Arthur and NanCY Yannotti
PERMISSION is hereby granted to
G
OWNER of property located at 4 Centennial Drive Street, Road or Ave. rt
Addition to dwelling ( living area) a
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 w
approved and in compliance with the Town of Queensbury BulIding and Zoning Ordinance. n
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F2.
WNER'S Address is 4 Centennial Drive w
Queensbury , NY 12801
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Y
ONTRACTQR or BUI LDER S Name
L . F . Rourke
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3. CONTRACTOR or BUILDERS Address
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Leonard St . M ro
Gansevoort , NY
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4_ ARCHITECT'S Name Ly
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S. ARCHITECTS Address
6. TYPE of Construction — (Please indicate by x)
{ 1 Wood Frame l ) Masonry ) Steel [ } CIA
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7. PLANS and Specifications
16rxl4t per plot plan , specifications and application submitted . 0
No_ h
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B. Proposed Use a
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One—FatnilY Dwelling (+dining room addition) �
no
$5 . 00 C /O Sept . 1 1987
$ 21 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES �
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(If a longer period is required an application for an extension must be made to the RuiIding and Zoning inspector of the
town of QueensbuwV before the expiration dste.l
N
of Feb . 19 87
Dated at the Town of Queensbury this 25th Da Y
SIGNED BY /// �_ 't 4 for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BL;DG . DEFT .
lC'� Application No . TOWN Os Ye..1�r\ i3i is i
aw" o/ Queenigury Permit Issued 19 [ ( ] Tlj7 {? ����--�``jj���}}
BUILDING and ZONING DEPARTMENT Permit Expires 19
# 1.�J
Bay and Fiaviland Road, R. D. 1 Box 98 Zoning Designation
Oueensbury, New York 12801 variance No . FF B X ?98
Site Plan Review Now i
proved
1 BUIL Dil 1. ,at L:00E DEp'r.
Ap
APPLICATION FOR
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 the Permit .
The owner of-this-property Tis . A ut fz < 'PNON Fay .1 Y616LAA
P . O. Address Car S 5 Tel .
Property Location : pn Tax Map No . L0./�^,r}�
Street number or building lot number
Subdivision name ( if applicable) _ Vim'-A6
THE PERSON RESPONSIBLE FOR SUPERVISION /OF WORK AS REGARDS BUILDING CODES IS :
t' C* fn. Ioe1ls " 5 -Z - 07 c( i
Name P . O . Address Tel . No .
Name of builder A04a-4 r)r.' Address Lcr>)Iard gnsrucacr Tel .- '7 q-i �3 jja
Name of plumber A/p n4.a Address Tel .
Name of mason . F ur fC P Address f Po rtaYul $ 6"Qn.Sevr,o d f Tel . - ? ce3 '
NATURE OF PROPOSED WORK : * ZONING INFORMATION :
Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
" < Addition to a building drawn reasonably to scale and attached hereto ,
Alteration to a building showing clearly and distinctly all buildingsr
� (no change to exterior dimensions ) * whether existing or proposed and indicate all
Other work (describe.) set-back dimensions from property lines . Give
* street and number or lot number and indicate
* whether interior or corner lot . Show location
FOR DEMOLITION PERMIT , STATE SIZE AND of ,,,later supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. * of septic disposal area .
COMPLETE INFORMATION REQUIRED BELOW .
* Size of property J ['7C1 ft K Ir .s Of
* Existing building s) Size ZCo ft x ft .
PROPOSED BUILDING AND USE : * Existing building ( s ) Use C'aj nc*
Size of new structure 1 (n ft Aft
Foundation-pier/slab/crawl/partial/full Proposed building , distance from property line
ft
(circle one) * Front yard [� � ft Rear yard �
No . of stories (habitable space) ft and ��.w ft
-----�-- Side yards ac F37
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 PRIMARY BUILDING -
No . of bathrooms }' One family dwelling
Primary heating system F_I Ir+r. * Two family dwelling
Type of fuel Multiple dwelling / Number of units
No . of fireplaces to be installed 0 Permanent occupancy
Will a wood stove be installed?
,� Transient occupancy
Central Air conditioning? Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Other
Ranch Contemporary Log cabin * If addition , what will use be?
Raised ranch Mansion Duplex Q6,
s evel Old style Bungalow '� "-- 1e
Cape Cc Cottage Other ACCESSORY BUILDING-
a Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) Attached garage/one car/ two aX/ car
* * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * —Other
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED :
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc .
Will any second-hand or ungraded lumber be used? I £ so , for what'21
Foundation wall materials
�Wr(.'� {� �p�^�.ThlCkneSS r+C�
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? e�-!>Heated or unheated? Floor sq . footage sq ft
Will there be a basement? Will any portion be used as living space?
( I£ so , what portion? sq. ft . - - Type of use?
Type of roof - sloped/flatfshed/other -- Material of roof
Size , wood studs_ _ - •7{ ,^ spacing 1 (0"o . c . length $ ft .
Joists ( floor beams ) 1st . floor g ",X_ip spacing_ 12, ^o . c . span �ft .
Joists (floor beams ) 2nd . floor + "'X ,• spacing ""o . c _ span ft .
Overlays ( ceiling beams } Z '"X 8 spacing 14b "a . c . span 141- ft .
.Roof rafters _ 7 49X_ _Sq spacing 1E," o . c . span 10Aft .
Roof trusses (pre-engineered) spacing " o . C . span_.�ft .
Exterior wall finish klw v:.� Of what material ?
Interior wall finish 1y � witt_[ �,
If a garage is to be attached , describe mates als to be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling? If so will a Fire-rated
door , enclosure , and 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)
Town of Queen sbury t Y r T
County of Warren A F F I D A 1 T STATE OF NEW YORK
I swear that to the best of my knowledge 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 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 . �n
SWORN TO BEFORE ME THIS Signature ----- -
day of lg Clwner , owner agent , architect, contractor
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 1T
2 . Type of heat
3 . Is the building mechanically cooled ?
4 . Percentage of area of windows and doors '
A . Over 16 % OnIY
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 NO
1 . If YES , what is the R value ?
3 . Slab on grade YES NO
a . if YES , what is the R value of insulation around
perimeter of floor ?
4 . Is basement heated ? YES NO
a . R value of insulation
5 . Type of insulation
B . Under 16 % Only-
1 . R value of roof and floors exposed to ambient conditions_
Kf _ Y L/ �^�"
2 . R value of exterior walls 0 `
3 . R value of glazed area II
4 . R value of doors i
5 . R value of floors over unheated spaces
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8 . R value of heated basement/ cellar walls ( above grade )
9 . R value of heated basement/cellar walls (below grade )
10 . Type of insulation e>6 e-&L
Co Controls o
1 . Thermostat maximum heat setting 5
Dm 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 other areas
E . Piping Insulation
1 . Size of hot water or cooling carrying agent pipe
2 . R value of pipe insulation
F . Service Water Heating ...
1 . performance efficiency k .
2 . Temperature control setting maximum ---� --
G . For Swimming Pool Only
1 . Maximum heating
Telephone No .
( applicant ' s signature )
gown o� �r��,�n .s6ure�
BUILViNG and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR " S REPORT
NAME
LOCAT I O ,/{/]
+ r
Date_/, �'� _ Permit No
APPROVED YES NO
Footing/Pier Forms ^
Foundation
Waterproofing
Backfill
Kraminq
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
Ire SULATION :
Foundation
Floors
�alls
k qecling
�FINAL 'ELECTRICAL II35PECTIClti
DRIVEWAY APPROVA
Final Building Survey
Next scheduled inspection (tail wttien ready )
Remarks-
Building Inspector
6/66 and-vl
. J'aurn of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Maviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT +
(Anno
NAME �r
LOCATION
Date_3 / 4!� Permit No .
P VED - YES NO
Doting/Pier Forms
Foundation
Waterproofing
Backfili
F rami.ng
Roo f1ng
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
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready
Remarks-- . 4� Y � - {
Buildi. g Inspector
6/86 and-vl
HuiLD1NG DEPT- COPY OF APPLICATION FORM 46-EL, NEW OF BOARD O FIRE LfJNDERWRJTERS.
FILE THIS COPY WITH BUJLDING PORK B
OEPT. WHEN ARD RED,
CITY OR
VILLAGE f
STREET AND i
ROAD ANb NO. OR TOWNSHIP
POLE NO, .r' ?•' COUNTY
CRO�STREETS Is O
PREMI POLE N .
OCCUPANT'S !! ` _ °. "��.
NAME f '} SECTION
OYYIYERS NAME + BUILDING /„ : I BLOCK
AND ADDRESS o -^ s OCCUPANCY /1
t i C t
BY�LfEb TEL. #
Is FROM!FROM THEIR
NEw� OLD .® WORM '� `"�'� OFFICE
LJST BE LOyy d
I5 NEw ADDITIONAL DEFECTS
ALL [�
Loot NUMBER OF OUTLETS Na of Eisler&& EOUIPMENT WHICH YOU INSTALLED REMOVED IJ
don LAMP RaoaadM MOTORS
HEATERS BRANCH
gilNq >w� RA t SVA.� t Brpta�H C1RCum OFFICE USE
3 No. TyPa H Each Na W N ONLY
sideAa
G. INSPECTION
e5a+�.
Bart
m&at
In FI.
'z
2nd FL
3rd FL
REMARKS: LIST OTHER ELECTRM=AL DEVICES NOT SET FORTH ABOVE:
DO NOT USE THIS SPACE,
This apPlica flan is intended
You era &other£ Io cower iha &bows-IistW+sd to malls the inspaction and adjust tIb Ira ent o 'nutted bct if at times SIZE OF to corer tha additional a ui of inaPection tharc is found MAINS V pmsnt. at prowided by the a additional e4uipmant not ahova !
CHARACTER FEEDERS
ELECTRIC SIGN PPlicant. .atad,
OF WORK LAMPS TOTAL
WORK TO BE EXPOSED GAS TUBE SIGN WATTS
CONCEALED TRANSFORM
STARTED ERS OF
SERVFCE OVERHEAD CiC'IMPLETED INUliIBERi VA
ENTERS UNDEflGROUNb SIZE OF SIGN U L I (CAPACITY)
INSPECTION REQUESTED MAKER
ON OR AS NEAR AS OF 51GN
P0=4BLE
AYOlO DELAY BY low an FUL6 AN8 ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NENf OLD Q
PRINT NAME AND ADDRESS NAME OF DATE OF
APPLICANT �" } ' . . -' APPLICATION
- c: C7i SIC{NATUAav
STREET ADDRESS �F
CITY OR F APPLICANT7 .I .
{5 l
POST nrr. /"' }
,:_ _ �}' •i—�_-- TELEPHONE
ZIP
/ CODE� l cr__„7_r J_�WHFN APPLObABLE
` APPLICATION MUST 13E FILED FOR EACH SEPARATE BUILDJNG
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