1987-635 BUILDING PERMIT �
TOWN OF +QUEENSBURY No, 87-635
WARREN COUNTY, NEW YORK 0
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PERMISSION is hereby granted to Marilyn Potenaa {
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OWNER of property located a b
yt 1 Miller Hill Mall — Rte 9 Street, Road or Ave. r�
in the Town of Queensbury, To Construct or place a Alterations — Interior
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.
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1 . OINN E R'S Address is r
7 Moorwood Dr .
Queensbury , N . Y . 12801 ;h
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2. CONTRACTOR or BUI LDER'S Name
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Leone Construction
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3. CONTRACTOR or BUILDER'S Address
428 Saratoga Rd . Y
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S . Glens Falls , N . Y . 12801
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4. ARCHITECT`S Name
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S. ARCHITECT'S Address
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B. TYPE of Construction — (Please indicate by X)
(K4. wood Frame { ) Masonry { ) Steel { )
7. PLANS and Specifications
No. 80 ' x 150t per plot plan , specifications and application .
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S. Proposed Use
Alterations to existing building ( interior ) . 0
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$5 . 00 C/O @
Apri , yg88
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$ 18 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspeetar of the
town of Oueensbury before the expiration date.)
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Dated at the Town of Queensbury this 22nd Day of Sept 19 87
SIGNED BY +� 4� �'- 2;,f, '� for the Town of Queensbury
Building and Zoning Inspector
TO BE COMPLETED BY BLDG . DEPT . T(DWN �0
/ Application No . C
Jouin o / ]
uee►nx ury Permit Issued 19 1 , I
BUILDING and ZONING DEPARTMENT Permit Expires 19 �i�JJLL�� SEtP 161987
- �
Bay and Haviland Road, R.0- 1 Box 98 Zoning Designation
Queensbury, New York 12801 Variance No.
,r I Site Review N Kp I--, _
1� App d y : S C;V C-. :3
P• 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 p opertY is : f 7 sv
P . O . Address Tel . fit
Property Location : �.-ZGf1z Tax Map No .
Street number or building lot number
Subdivision name ( if applicable) h I LL. L-V 41LA . MA- (... t CI �i~( C-�=' +% la .
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK. AS REGARDS BUILDING CODES IS :
Name -f P . O . Address Tel . No . 7
Name of builder �� Y3'E (' x$;fiUC-b6yJ Address , E " � L�A5F6LZ !' . > '1
Name of plumber Address Tel •
Name of mason 5a! yt + Address Tel *
NATURE OF PROPOSED WORK : ZONING INFORMATION :
_Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
_Addition to a building drawn reasonably to scale and attached hereto ,
[Alteration to a building showing clearly and distinctly all buildings ,
(no change to exterior dimensions) whether existing or proposed and indicate all
Other work (describe) set-back dimensions from property lines . Give
Nl._ IC:Ii c=sc `? street and nil er or lot number and indicate
whether interior or corner lot . Show location
of water supply and location and configuration
of septic disposal area .
■.1 at LCD (^ ; COMPLETE INFORMATION REQUIRED BELOW .
Size of property 2, 4? (G ft X 7 ft .
Existing building ( s ) Size , '3'�� ft X ! ft . 3t
!:w` �►n 1cr� Q diU -c tt-4� 1tfet rlitk� ►�SiGF s
PROPOSED BUILDING AND USE :
Existing building ( s ) r se 7 . 7d
Size of _+rew structure SO ft X /sr) ft 4 ch42 L-,` F }
oundation pier/slab/crawl/partial/full Proposed b .ildin+t distance from property line
» 1CrSi ! 1 to
( circle one ) Front yard ft Rear yard ft
No . of stories (habitable space) f Side yards ft and ft
Height ( grade to ridge ) rf~ 3 ft • * If on corner , setback from side street AIA - ft
If residential , no . of families u Q,/,¢
No , of rooms ( excluding baths ) VA OCCUPANCY INFORMATION
No . of bedrooms AvA -
New s-Q c�M * PRIMARY BUILDING -
No . of bathrooms � One family dwelling
Primary heating system G',f$ Tswo family dwelling
Type of fuel rl' Ai . ErA
�, Multiple dwelling / Number of units
No . of fireplaces to be installed Fat- Permanent occupancy
Will a wood stove be installed? Ao0r+
Transient occupancy
Central Air conditioning? Ajj'A * usiness
BUILDING STYLE, PRIMARY STRUCTURE Industrial
Other
Ranch Contemporary Log cabin If addition , what will use be? A
Raised ranch Mansion Duplex
split level Old style Bungalow
Cape Cod Cottage C((�qr,," CLW . t t- "r '" 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 OF Other
CONSTRUCTIQTJ
INFOTION 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 . I krRa2ACPL — L,} i} � (401-140 WAAC
Will any second-hand or ungraded lumber be used? If so , for what ?
Foundation wall material C p ;? Thickness )
Depth of foundation below grade (to bottom of footing )
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft
Will there be a basement? �u Will any portion be used as living space ? A/ 0
( If so , what portion? sq . ft . - - Type; of use?
Type of roof - sloped/ lat hedfother Material of r/oof
Site , woad studs ? spacing' "o . c . length 10 ft .
Joists ( floor beams ) ist . floor l/•€( "x IN
spacing "o . c . span ft .
Joists ( floor beams ) 2nd _ floor A;rd _ "X Is spacing "o . c , span ft .
Overlays (ceiliing beams ) "X 70 " spacing "o . c . span ft ,
Roof rafters " X " spacing IA- O . C . span ft .
Roof trusses (pre-engineered) spacing ,(,+f'4 " o . c . span ft .
Exterior wall finish VPf- Of what material?
Interior wall finish 4j1 'C f Vi
If a garage is to be attached , describe materials to be used for FIRE SEPARATION : AV
Is there to be an opening between garage and dwelling? f4 If so will a Fire-rated
door , enclosure , and self-closing device be provided? 0 _
Will a flue-lined chimney be installed? Height above roof ft .
Depth of chimney foundation below grade ( I ft .
Depth of fireplace hearth_ ft _ in .
Water supply -,, -Municipal epr private well
SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining properties j' ft .
(A separate application is necessary for any repair or new installation of septic system)
Town of ae A F F I D A V I T STATE OF NEW YORK
n County off Warren
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 .
SWORN TO BEFORE ME THIS Signature _ ---_ r - CG_6Gli_G ]� ........
C? - er, o ' s agent , arcnr ct , contractor
day of &;�&W7043EK19 F a
Notary Public , Warren County, N . Y .
* * * * * If * * * * * * * * Of * * * * * * * * * * * * * * * * * * * * * »
SPECIAL CONDITIONS OF THE PERMIT :
aZ A , T` r—O rz— jtzrz r0 J�C.
I't az s 0 - k UAJ S , 6( t,l t )D I AJ fa 1 .A J TO �J -+�1� 5 /t 03 44. Sr!'A-<_&-S
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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 ay
2 , Type of heat. Fj`1• �
3 * is the building mechanically cooled ?
4 _ P-ercenta area of windows and doors
�A _ r Over 16t Only
-/ 1 . U value of gross area of walls , roof / cellinq and floors
exposed to ambient conditions i ' L> ; Ut 4 LL w' (V
2 , Floor over heated spaces YES
a . Are foundation walls insulated ? YES N )
1 , If YES , what is the R value ?
30 Slab on grade YES NO
a , If YES , what is the R value of insulation around
perimeter of floor ? � I.`. i� o")
40 Is basement heated ? YES NO
a . R value of insulation 1w11
5 , Type of insulation � hyPke ,y� ucj< t.'eiiif�100' lG' 0l jjQ4a4 4 y
i 1S [2� w4 N1 k� I�iG?( T4S5 4C1 !Tt( C� vt
ry
B . Under 16 % only hfsE:1 �act�i �y
1 . R value of roof and floors exposed to ambient conditions
2 , R value of exterior walls
3 , R value of glazed area
4 . R value of doors
5 . R value of floors over unheated spaces
60 R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
$ , R value of heated basement/ cellar walls ( above grade )
9 , R value of heated basement /cellar walls ( below grade )
10 , Type of insulation
C , Controls
1 . Thermostat maximum heat setting
D , Duct Systems _
1 , Is duct system installed in unheated spaces ? YES kC
a . If YES , R value of duct installation
b , R value of duct in other areas
E , Piping Insulation A
1 . Size of hot water or cooling carrying agent pipe mh
2 . R value of pipe insulation
F , service Water Heating
1 , Performance efficiency ,(A
2 , Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating .
Telephone No .
( s lic ' s signature )
TOWN OF Ql[.J EENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
¢UEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION r
DATE PERMIT # '
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH- IN
INSULATION': �
FOUNDATION
FLOORS
WALLS
CEILING
L,PfNAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORC S/STEPS
STAIRS^CLEA CE & ,FAILS
PLUMBING FIJC URESJRELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED Fr�OORS
GARAGE FIREPROOFING
DOOR CLOSI'R (S)
SMOKE DETECTORS
FINAL ELECY�)IRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
-
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS.
INSPECTOR
TOWN OF QUEEINSBURY
BUILDING AND CODES DEPARTMENT
BAY 6 HAVILAND ROADS
QUEENSBURY, NEW YORK 12809-
TELEPHONE (518 ) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATIONS 4
DATE J PERMIT #_ f
APPROVED
YES NO
FOOTINGIPIERS
MONOLITHIC POUR FORMS
FOUNDATIONIDAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION
FOUNDATION
FLOORS
WALLS
CEILING_
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCWI & RAILS
PLUMBING FIXTUI.,Y9S/RELIEF VALVE
INTERIOR TRIM 14IVACY DOORS
FINISHED F S
GARAGE FIREF hOOFING� -...
DOOR CLOSED,t S)
SMOKE DETE� TORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FRAM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS. 1 $ [�1 /✓5
ois
ocr t f t3 & CLeos ls* cti ej T,
rNSPECT R
THE NEW YORK BOARD OF FIRE UNDERWRITERS
r. ry BUREAU OF ELECTRICITY
41 STATE STREET. AL8ANY. NEW YORK 12207
i .Application No- on fife n� - 3 A I.� � �y � J�
note l? GCob�'; ? r :t i ? 7 i ]—:7rt: K b V 45
THIS CERTIFIES THAT
Maly the afectricel equipment a• described beftwe and introduced by the applicant taaaaad two the WhoseapyAiicatiaan number is the Promises of
Mall , Upper Cp10_rk , Glp'nrm roalA.:� ,
in thefollowing focation; ❑ Basement ® lat FY. ❑ 2nd Ft. .u.C;]1d Section Buck Lnt
g t r. 318? ant!found to be in compliance with the requirements of this Board,
was examined on
RXTtJRES RAM0E3 QDOtfEMta0110CS OPENS WSM WASHERS EXHA
tT]tTURE AT. UST TANS
RXIUOWLI S EC'EATAC.IES s%nicttaS IwCANPtSCENr nlrrerENT Y AMT. K. W. M K. W. AMT.
1 $ 2 ' V Ei
04"RS iMRNACE MOTORS FUTURE APPUANCE PEIDERS SPIMAL REC'PT TIME CLACKS REIt UMIT t1EATE1IS MtULT1 tltiTlET pIMMERS
57STEM5 AMT. WATrS
AMT. K. W. Oft N. P. GAS N. P. AMT. NO, A. W. G- AM7. A/AP. AMT. A1Nr . TRAM$. AMT. N. r. leU. EtP 1'[ET
SERVICE WSC0114MI Md. OF S E R V 1 C E
NtRTER Nt}, tll/ CC. COND- A.W. G- NO. Of NI-lFG An W. G. NO. OP NEIk►RATS of NHfrllAl
AMT. AMP. TYPE E17atM. T +� ShAV` 1 1' 8W 3 X 9W 3.e' tW /M x Of GC. CCEND. . Or MIlEG
cb � 300
MIMI APPARATUS:
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This certificate must not be aherad in any manner, return to the office of the Board if incorrect. Inspectors may be identified by their cr:dsntiola.
E ALTERED 1N ANY MANNER.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT B - Y
THE NEW YORK BOARD OF FIRE UNDERWRITERS
l�AWL 64 r� BUREAU OF ELECTRICITY
A{I L1 STATE STREET. ALBANY, NEW YORK 12207
j Application -' a an�fe 02037y A U66a74
THIS CERTIFIES THAT nurraber in the pre+rslser of
only than electrical equipment ae described beloae a" introduced by the yytaiaent named am the above application.
Al P'c IIIIII za „ UIPPe-r {.IkI (Old Garvey
Bloc Lot
in the following focls"OK: step +nt ❑ an+�I,{a
tat F'd. ❑ jo F1.
Sanction k-i ! und to be in compliance with the requirements of this Board,
urea exar+siawtid on
FIXTURES RANr3ES QObtCtltiLDec" OVENS WS1I1NASHlRS EXHAUST FANS
F�XT1llE ACLES SWITCHES AMT. K. W. AMT, K.W_ AMT- K.W. AMT, K, w. AMT- X. R �
CA"UM NC+.NbESCEN't FlL10eE5GENT v
IUiUEE ASKIANCE PEEOERS SPECIAL WC'FT TIME C40CK5 am tJtMT ttEATEEt MLII. STMA LET DIMIiRERS
DRYERS FURNACE MOTORSYSTEMS AMr, wwrrs
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M. S E It 1 C E
SERVICE DISCIpNNECT No. OF A. W. a. "M aF NeurtALS A.w. cA. .
s �� 1 X 2W T Ar ]w 8 I' 3W 3 0 4W NO" #rER Ica" OF CC C�. NO. OF HI-ltG OF XIAE0 COF NEUTML
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OTHER APPARATUS-
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104 Mi t . ;�]!_�Tr! 'x1` k"1L'£ BRANCH &Ii/1NACiER
=� So . Glens ,,aIIF; . I2803
Per
ThiL certificate must not be attered in any moro+er return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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