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1987-618 f �E�,TIFIC A�TE +C.►F C�► +C tJPAT�T+ Y TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK Date September 17 19 90 87-618 This is to certify that work requested to be done as shown by Permit No. has been can+ple"- d as a one-Faiui '!y Dwelling - Addition (Bedroom) This structure may be occupied Location 29 prospect Drive Winifred Waldron Owner By Order Town Board a TOVYN OF GIUEENSBURY r ,- ; ri ti I Building N Zoning Inspector BUILDING PERMIT TOWN OF QUEENSBURY No. 87-618 Fd WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Winifred Waldron I w OWNER of property located at 29 Prospect Drive Street, Road or Ave. 1 in the Town of Queensbury, To Construct or place a Addition to One family dwelling (Bedroom) 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 . OWNE R's Address is µ 29 Prospect Drive Queensbury , N . Y . 12801 H, rt ro r� 2- CONTRACTOR or BUILDER'S Name Christopher Ford 29 Prospect Dr . A' r-A cx. 3. CONTRACTOR or BUILDER'S Address O A_ ARCHITECT'S Name �cl 5. ARCHITECT'S Address H 0 a) b ro h rY 6. TYPE of Construction — {Please indicate by X) L7 N• ( x$ wood Frame { Masonry { I Steel ( ) C SV F7 =PLANIS5pecifiartions 1 +6 ' x 20 ' per plot plan , specifieations and application . Proposed Use Addition to one family G' N• n 0 $ 5 . 00 C/0 April 1 , 79 '88 0 a $ 27 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES rya (if a longer period is required an application for an extension must be rnade to the Building and Zoning inspector of the (p town of Clueensbury before the expiration date.) i !y .Se t 87 Dated at the Town of Queensbury this 15th Day of p 19 l— SIGNED BY " 'v a- for the Town of Queensbury Building and Zoning Inspector J.(�J TO BE COMPLETED BY BLDG . DEPT . Application No . gown 0/ �teee►� 96etrt�f Permit Issued 19 "syl 04F BUILDING and ZONING DEPARTMENT Permit Expires 19 �� �( } � V1 N Bay and Haviland Road, R, D. 1 Box 98 toning Designation ! } € [V1 b Queenury, New York 12801 Variance No . SEP 10 WIT Site Plan Review Na . /J1 Approv by : MUILDING & II C)EPT. APPLICATION FOR BUILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING . applies for a Building Permit to do the following work which will The undersigned hereby be done in accordance with the description , plans and specifications submitted , and such special conditions as may be indicated on the Permit . ------------------- ' � �11 iPG The owner of this property is : _ G '7 Tel . 7 f P. O. Address_ T s^i S �e L ak ► li "� Property Location : [ ?�L? ! Tax Map No . Street number or building lot number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Tel . N P . O . Address o . Name f ,D � I r z s Address t7e _ _Tel . 9z $ Name of builder r r f t •j1: ram' - - --v Tel . Name of plumber Address � � Address Tel ' Name of mason NATURE OF PROPOSED WORK : * ZONING INFORMATION : C struction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED , ddition 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 . * COMPLETE INFORMATION REQUIRED BELOW . * Size of property g .,I�� ft X /t7'� _ft . * Existing buildins ) i� ze..5_q .ft ) * PROPOSED BUILDING AND USE : '" Existing building ( s ) Use Size of new structure ^ft X PV ft Foundation-pier/ slab/crawl/partial/full " Proposed building , distance from property lineline * A rI�'J I N J f t (circle one) * Front yard ft Kear ya No . of stories (habitable space) l 1 * Side yards ft and it: Height (grade to ridge ) SFr ft If on corner , setback from side street fL If residential , no . of families * OCCUPANCY INFORMATION No . of rooms ( excluding baths) No . of bedrooms % * PR RY BUILDING - No . of bathrooms 0 One family dwelling Primary heating system I.! Two family dwelling Type of fuel Multiple dwelling / Number of units * No . of fireplaces to be installed * Permanent occupancy Will a wood stove be installed? eti :J * Transient occupancy Central Air conditioning? 0 U * Business BUILDING STYLE, PRIMARY STRUCTURE * Industrial other Ranch Contemporary Log cabin * If addition , what will use be? t' cou ry Raised ranch Mansion Duplex Split level Old. style Bungalow * ACCESSORY BUILDING- Cape Cod Cottage Other car * Detached garage/one car/ two car/ Colonial Row Town house two car/ car ( CIRCLE ONE PLEASE ) * Attached garage/one car/ Private storage building ESTIMATED MARKET VALUE OF other. * CONSTRUCTION INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDS Form BPA 4/86 md--vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . eoua rfi Will any second-hand or ungraded lumber be used? If so , for what ? ar, o Foundation wall material E �CfST 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? _�-- Will any portion be used as living space? ( I£ so , what portion? sq . ft _ - - Type of use? Type of roof - oped flat/shed/other Material of roof Size , wood stud _"X��._._•, spacing ''o . c . length _ 1_ft . / Joists ( floor beams ) lst . floor _," it spacing _""o . c . span / ft . Joists ( floor beams ) 2nd . floor _ _"'X '" spacing "'o . c , span�ft * Overlays (ceiling beams ) ""X '" spacing "' _ _ span ft . Roof rafters —.9_"?t /� " spacing_ L<* o _ c , o .span�ft , Roof trusses (pre-engineered) spacing "o . c . span ft . Exterior wall Finish—I Of what material? Interior wall finish If a garage is to be attached , a S ribe materials to be used for FIRE SEPARATION : Is there to be an opening betwee garage and dwelling? If so will a Fire-rated door , enclosure , and self- closing device he provided? Will a flue-lined chimney be installed? Height above roof ft _ Depth of chimney foundation below grade Depth of fireplace hearth ft . an . 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 County of Warren A F F I D R V I 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 . y�A SWORN TO BEFORE ME THIS Signature _ J +___ _____�• Ts �e �=z^^-_____ _ Owner , � • wn day of er�` s agent , arctiitect , contractor 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 2 . Type of heat ec o2c { : C 3 . Is the building mechanically cooled ? Na 4 . Percentage of area of windows and doors . ,C;' 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 qto: % 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 so Type Of insulation B . Under 16 % Only 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 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 f 6� L �"'r--+' co Controls 6 1 . 'Thermostat maximum heat setting 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 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 - 2 . Temperature control setting maximum G . For Swimming Pool Only 10 maximum heating Telephone Na . ( applicant ' s signature ) TOWN OF QUEENSBURY /`- - BUILDING AND CODES DEPARTMENT ,BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I .2804- TELEPHONE (528 ) 792- 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED 42 4S1 NAME LOCATION 00 / r � DATE /, P RMIT #� i7- APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOF BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH- IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION, CHIMNEY HEIGHT _. ROOFING SIDING EXTERNAL PORCHES/STEP " y STASRS-CLEARANCE RA / PLUMBING FIXTURES/RE VALVE INTERIOR TRIM/PR-TVA D RS FINISHED FLOORS GARAGE FIREPROOFS G DOOR CLOSER (S) X SMOKE DETECTOR FINAL ELECTRICA INSPECTIO LT FINAL APPROVAL F CONSTRUC ION_ OK TO I S SUE C OR C/C A SIGNED CE TIFICATE OF OCC PANCY MUST BE OBTAINED F OM THE BUILDING EPARTMENT BEFORE THESE PRE ISES ARE OCCUPIED REMARK t` " , E w r s ARRIVE / DEPART //' ' INSPECTOR TOWN OF QUEENISBURY BUILDING AND CODES DEPARTMENT BAY 6 HAVILAND ROADS QUEENSBURY, NEW YORK I280& TELEPHONE (518) 792-5832 BUILDING INSPE R' S REPORT REQUEST FOR INSPECTION R EIVED MANE LOCATION DATE "fr1 PERMIT APPROVED YES NO FOOTING/PIE MONOLITHIC PO FO S FOUNDATIONJD -PR PING BACKFILL APPRO L ROUGH PLUMBING FRAMING ELECTRICAL ROUG IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECT ON: CHIMNEY HE HT ROOFING SIDING EXTERNAL RCHES/S PS STAIRS-C RANCE & ILS PLUMBING XTURES/RE IEF VALVE INTERIOR IM/PRIVAC DOORS FINISHED LOOKS GARAGE FI EPROOFING DOOR CLOS R (S) SMOKE DET CTORS FINAL ELEC ICAL INSPECTI FINAL APPR L OF CONSTRUC ON OR To ISSUE /O OR C/C A SIGNED CE TIFICATE OF OCCU NCY MUST BE OBTAINED FIRM THE BUILDING DE RTMENT BEFORE THESE PREMI ES ARE OCCUPIED! REMARKS: F ARRIVE DEPART ___ } INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 13AY & HAVTLAND ROADS QUEENSBURY, NEW YORK 1280& TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LICATION DATE a J' —'p ix T #� '/ � APPROVED YES NO FOOTING/PTERS MONOLITHIC POUR FORMS FOUNDATION/DAMP-PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT w#• ROOFING 1/SIDING EXTERNAL PORCHES/S EPS STATES-CLEARANCE f 'RAILS PLUMBING FI.YTURESj1R LIEF VALVEh> INTERIOR TRIM/PRiVAC Y DOORS_ FINISHED FLOORS GARAGE FIREPROOF I NG _ DOOR CLOSER {S) _�._- ----- �— SMOKE DETECTORS FINAL ELECTRICAL NSPEC ON ✓- FINAL APPROVAL F CONSTR=TION r 1 A SIGNED CERTFTCATE OF UPANCY MUST BE OBTAINED FROM THE BUILDING \DEPARTMENT .BEFORE THESE PREMISS ARE OCCUPIED r RE ARKS: y e SIL7C.�'� lwa w - ' I G+'32-- ,r?_M �r'��'',�C✓`G]�''� l,.J+ rrJ".i''�--'CT c Ag c 5- fir. I'Gc--7yy-�tC 4VPECTOR BUILDING DEPT, COPY OF APPLICATION FORMAG-EL, NEW YOHK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BIJ I LOINGPEPT. WHEN REQUIRED. 1 j ,, _ .� DATE VILLAGE �' (� l i .. TOIMNBHIP COUNTY P./ :--{' STREET AND ND.. OR ROAD AND POLE NO S ( I{"t . y '/'If t ldL WILE R4- BETI EEN MIRIAT TWO � CROSS ST all WETS IS 1� / Y r I 1'iF �` ! I , KIN BLOCK _ LOT f' OC *WARTwS Dun-EWNG NAME '�. .� , e; �� Y\ 1 a. C.� d J OCCUPANCY ryt S OWNEWS NAME TEL. SXWee— FPLIEO f #` 'l FROM THEIR C I i/- f �`i OFFICE BIlILO1NCFECTS a NEWII ❑ OLD IS RK NEW El ADDITIONAL REMOVED ❑ LIST BELOW ALL. EQUIPMENT WHICH YOU INSTALLED BRANMOTORT HEATERS -. . CIRCUITS OFFICE USE N/f1YMER OF OUTLETS LaaalP NMe�ltMpiMl ONLY Lapr mido dd1l s is TfrPa Mr. Now �` INSPECTION f6tMGhia Pirailal! lbMairt I+a. OMaI�M Oro- •lab Sub, bow 6a1M• ar.ad Iat M ZMd Ft. 3rd FL REMAR KS: LIST OTHER IC ELECTRAL DEVICES NOT SET FORTH ABOVE: OD NOT USE THIS SPACE. TI" application K in aaalMid to tsMwaN the abPaa4mied agMaPwmMMt to be 1aaa1 cod b..t if at IiaaliM a1E iarPMCbpa1 db if fawind Mdditipnd aqi it r of no% abg" Bated" you ape artltorjMad to mmko 0 kwipaTb9n mind atbuMa 16a 4w to Cp"rIa the additlpntl agwipm lattt. w PtMatdMd bV the MPPbcanc SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER EtanrctCSD GAS TORTE. SaC.M OF WORK CONCEALEDI TRANSFORMERS OF VA WORK TO BE (NUMBERI ICAPACITYI S7TARTEO GOMBRETED SIZE OF SIGN - 161V E OVERHEAD UNDERGROUN D MAKER ENTERS OF SIGN ILDI INSPECTION REQUESTED DI $AS NEAR AS New OLD 'POSSIAVOID DELAY BY GI VINO FULL AND ACCURATE INFORMATION. ALL SPACES DATE OF MUST BE FILLED IN OR APPLICATION MAYBE RETURNED. APPLICATION PRINT NAME AND ADDRESS SIGNATURE NAME OF /y XOF APPLICANT • , •�7 ' fa -A APPLICANT f STREET ADDRESS TELEPHONE CITY OR — ZIP LICENSE LIICiENSE NO. cASLE POST OFFICE as �L (Itev. a/eel A SEPARATE APPLICATIOIht•MUST BE FILED FOR EACH SEPARATE BUILDING