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1987-181 CERTIFICATE OF C�CCUPAN CY TOWN 4F +QUEENSBURY WARREN COUNTY, NEW YORK Date 19 This is to certify that work requested to be done as shown by Permit No, 87-181 has been completed. This structure may be occ�up`i[e�d-, ss a Addition to one family dwelling L,ocarion West Mountain Road Owner William Trombley By Order Town Board TOVVW OF QUEENSSURY Building & Zoning Inspector �. BUILDING PERMIT TOWN OF +QUEENSBURY No. 87-181 WARREN COUNTY, NEW YORK W PERMISSION is hereby granted to William Trombley r- w OWNER of property located at West Mountain Road Street, Road or Ave. y M in the Town of Olueensbury, To Construct or place a Addition to dwelling (living area) ¢ at the above location in accordance to application together with plot plans and other information hereto filed and F ro approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1 . OWNER'S Address is RD #2 Queensbury , NY 12801 2. CONTRACTOR or 13t1! LDERS Name same uo cot 0 3. CONTRACTOR or BUILDER'S Address rt e-� G 4_ ARCHITECT'S Name P. 5. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by XI (X } Wood Frame i } Masonry I ) Steel I } 7. PLANS and Specifications 12 ' x24 ' per plot plan , specifications and application . a„ N o. H rt B. Proposed Use HO One—Family Dwelling (additional living area) b rt 0 5 . 00 C/o ro $ 24900 PERMIT FEE PAID — THIS PERMIT EXPIRES Nov . 1 19 87 1_� p# 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.i Dated at the Town of Queensbury this 20th Day of April 19 87 a SIGNED BY //! for the Town of Queensbury w Building and Zoning Inspector - V TO BE COMPLETED BY BLDG . DEPT , C� Application No . _Jouin v iReen l(aurr� Permit Issued 19 TOWN OF QUEENSBURY BUILDING and ZONING DEPARTMENT Permit Expires 19 e nr7 Bay and Haviland Road, R.D_ 1 Box 98 zoning Designation IlY1F Queensbury, New York 12801 Variance No . � Site Plan Review Na . Approved by : BUILDING & CODE DEPT: 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 . _-.-_____-__._________..._--___. : �,,,� +- ! Ir�l �,.,, --- � � -- -..........___........... The owner of this property is t P. O. Address ,T z} '2. +.,fr'' 5 l .fa-> . - , . , ,t�} fs x 1 ' Tel " Property Location : Tax Map No . Street number or building lot number Subdivision name (if applicable) THE PERSON RESPONSIBLE FOR SUPERV�I/SION OF WORK AS REGARDS BUILDING CODES IS : �/ l / r +�J-',rs a .r✓ ��I*'t �J7 +�--�- J _ __ _ Name /P . O. Address - Tel . No . Name of builder S �> Zr Address Tel , Name of plumber Address Tel . Name of mason r ry Address Tel . NATURE OF PROPOSED WORK : * ZONING INFORMATICN : Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , P4dditlon to a building drawn reasonably to scale and attached hereto , Alteration to a building showing clearly and distinctly all buildings , (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 water, supply and location and configuration LOCATION OF STRUCTURES AFFECTED . * of septic disposal area . x * COMPLETE INFORMATION REQUIRED BELOW . * Size of property ;9 C.- 1 ft X 3,6 Existing buildin g ( s) Size_ w72�`ft X PROPOSED BUILDING AND USE : * Existing buildings ) Use Aft Size of new structure ! 1 - ft Xjft Foundation--pier/slab "raw partia /full * Proposed building, distance from property line (circle one) * Front yard . ft Rear yard 'I ft No . of stories (habitable space - -_ * Side yards ''�{`=" ft and J Jl ft Height (grade to ridgy ) _ l� ft - * ' 'Q f t If residential , no , of families~ If on corner , setback. from side street No , of rocros ( excluding baths ) OCCUPANCY INFORMATION No . of bedrooms No , of bathrooms * PRIMARY BUILDING - Primary heating system * one family dwelling Type of fuel * Two family dwelling No . of fireplaces to be installed * Multiply dwelling / Number of units Will a wood stove be installed . Permanent occupancy Transient occupancy Central Air conditioning? * p y _Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial r Ranch Contemporary g ray Log cabin Raised ranch mansion Duplex * Sher � - If addition , what will use be? R r ¢'t Split level Old style Bungalow � � Cape Cod Cottage Other * 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 ESTIMATED MARKET VALUE Oa * Other CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS . Type of construction , wood frame , fire safe , etc . ' ��' 40 r O^A0& � Will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material �"� w' e , Thickness Depth of foundation below grade (to bottornCof footing ) Will there be a cellar?AYW Heated or unheated? F1� o q. footage sq ft Will there be a basement? Q Will any portion be used as living space? ( I€ so , what portion? sq . ft . - - Type of use? Type of roof - sloped/flat/shed/other ,j Lty:llr 7 Material of roof Size , wood studs /" " x l � spacin^gX „o . c . length ft . Joists ( floor beams ) 1st .` i�loor "% �' �h spacing_ "o . c . span t . ,foists ( €loon beams) 2nd . floor "x s acing "o . c . span ft . Overlays ( ceiling beams ) �"x�" spacing `"o . c . span�ft . Roof rafters _ +' "X �� r to spacing _/ r o . c . span_.- d �lft . Roof trusses (pre-engineere spacing '"o . c . span ft . . M Exterior wall finish � Lfj1�'f�p,re �I"� Of what material? pG�/PLCyk /S�,s1 $ r** '•' r Interior wall finish If a garage is to be attached , describe materials 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 Queensbury A F F I D A V I T County of Warren 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 . /.-�.. � G " SWORN TO BEFORE ME THIS Signaturrc.-�� „---_ ---- _ _ Owner , owner ' s agent , arcm m ect, contr or- day of 19 Notary Public , Warren County, N . Y . * * * * * * * It * * * * * * * * * * * * * * * * * It * * * At At * * * * It It It * * It SPECIAL CONDITIONS OF THE PERMIT : . Jason a/ Q"eenj "ry BUILDING and ZONING DEPARTMENT Bay and Hawiland Road, R-D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S rREPORT NAME LOCATION Date 7 Permit No . '� -- ra'J * * * * * * f* * * * * * * * ✓ = A.PPRC3VEI3 - YES NO /Footing/Pier Forms 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 DRIVEWAY APPROVAL Final Building, Survey Next scheduled inspection (call when ready ) Remarks-- Building Inspector 6/86 and-vl a 4 4 1 �� 17 ��