1989-005 . CERTIFICATE OF OCCUPANCY
1
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK -/ (]
Late_ ` 7J�;f*. i C d + i 7 iq 1133 1
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This is to certify that work requested to be done su shown by Permit IS —
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has been completed. Si �����1 i ` ``�, • _ , �€ I�'"rl�
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'lxis structure may be occupied a . a y = T' a �' �r iil�' DN
ry
Location V &%c 1
1 Owmer ram Ca: c3�xxaic
By Order Town Board
TOWN OF QUEENSBURY
ILL
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{ Director of Bldg. do Code Enforcement
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} BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8 9 - C15
WARREN COUNTY, NEW YORK �
�4D f _ °
PERMISSION is hereby granted to Jon Cardinale o
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OWNER of property located at Street, Road or Ave. i
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in the Town of Queensbury, To Construct or place a _ T rn t r ; nr Al terra t i on
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. OWNER'S Address is
Same
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2. CONTRACTOR or BUI LDEWS Name ~
Same p'
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3. CONTRACTOR or BUILDER 'S Address
Same
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4. ARCHITECT'S Name
T�
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S. ARCHITECT'S Address Cb
6. TYPE of Construction --- (Please indicate by X)
[ } wood Frame I ) Masonry I I Steel I ) r-t
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7. PLANS and Specifications
Interior alterations to existing dwelling as per ' H•
No. plot plan. , specifications , and application . �
8. Proposed Use U
D,
Single Family Dwelling/Alterations m
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25 . 00c/o ~
120 . 170 August 1 �9 89 ,�
$ 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 inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury t 3th bay f January Tg R
r
SIGNED BY for the Town of Queensbury
Building and Zo i Inspector
TOWN OF ,'►UEENSBUI Y APPI. I TTON FOR BUILDING AN
I] ZONING PERMIT v
Va.te-
RecIed ID _94
.,`-AA• 140 �XU Revieuted
Fee. Poid
I,UILDINC AND CODES UFTAIMI(ENT Date T.a.aued
413AY and HA VITL.AND ROADS RD I BOX 943 p �h No
.
pUEE'NSaURy0Xrjv yopK 12804
?'c2 . (5363 792—$833 EXt -20 IN
4
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A PERMIT MUST Bq OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS
- WILL BE, MADE UNTIL APPLICANT IIAS RECEIVED A VALID BUILDINC PERMIT .
A11 applicable spaces on this application must be completed and the
+ L7 t * re of * t * e * appllicaAt *mxs pPe*r * o * h* * e*e* } * l o * o this * s�*o * t *
'rlte owner of this Property is ; �er.„j '-" �� �
�i�C— � - TEL .
P .O . Address
*�� �� TAX MAP NO .
property location � C
klas there been any split of this property since October 1 , 19BB ? yes / no
if yes . Planning Board Review is necessary . LOT NO .
SUBDIVISION NAMEr IF APPLTCABLE
'rhe person responsible for supervision of work as regards Building Codes
� . a . ADDResS , TfL . Na .
NAME - Tel
14ame of builder Address 4C APIP
l
Name of Plumber ddress Tel
Name of Mason Addrass
fiATURE OF PROPOSED sera. : w ZONING INI-RORAIJ'�TION fOT - foe U50 only )
Can:: truction of itow building? r ZONING DESIGNATION OF PROPERTY
" PERMITTED PRINCIPAL PERMITTED ACCESSORY
�AddiFion to a building #
�Altec:ation to :a 1uilding 'REVIEW REQUIRED •- PLANNING BOARD]IIIIIIIIIIIIIIIIIIII
ZONING D3aRRD
OLo clt"Ilg� to axtorior dimension, )
40clier work C"la.crilaul _ SITE PLAN REVIEW H APPROVED DATE
w VARIANCE V.
APPROVED DATE
GROSS AREA or PROPOS2D]s =i `TicL1C "L' L1ftF�
1st Floor
sq f It Remarks
^,
2 nd Floor sq f t * W C01IIII.DiTe ifJl'OD:1hlt'L'lON itL:OU11cl:It uL l�C1tiJ
' Bie.: of prolaurty f t X f t .
ather Floors scl ft . Lxi::tiltg buildliu] E ::S S1::Lt� ft X� 1, 1° t .
{ not collar or laa � . mentl
TOTAL FLOOR AREA ��sq f t ' i:xiacillg b►aildincj (a: ) Use C %I
of now struCzuro ft X ft `
1'ra431►Glacier{-,picr/:laL/cra►+l/L7artiul/ Euil " 3'ra,(w::r_d building . di::t:ancv frou► �:ir+�llerty lino
IIIIIIIft
(Cirel.s one) „ Front yurd fit Rear yard
No * of stories (habitable Space) � � Side yard& _ ft and ft
a
iluight ( grade to vidg4j ) ft * If on corner , ::uC]3"k from sidu wtra+ct ft
It" r►:sidential . noo of fumil "ti 51 OCCUPANCY 'INFORHATICN
No . of rooma ( excludinq b"ths )
Itoo of bedrooms prblldAllY DUILDINC
No * or b:atitroarrW:a__�_- . „ ",,, `I IIIIOne family dwelling
pri%l" ry h6. ►. incl . tc LU!: r� ��_ 'l�o faULLly dwelling
Tyiw of fuel rl1 L � Multipla dwcllin+g / Number of tutus __
rt :talluci
No, of fix 'i ' ' lieru►aneut oCcup:u+Cy
Will :a wood st:Gv+3 b is►sG:.liucl?_.. * '1'r:art :iot►t oacop arnc y
G .:nta^:al Air cae►+.Litianirrg':, f � I3usins:ys
LiU1t.DINC STYLC, PRIKkRY STRUCTURE ,c Industrial
Ocher
1�►�►c1► fi4n>~+amlxasury L.Un c .lsin It .addition, whut will
1c.► is:cl ra"Ch M:ansiosk Duyalux
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]Lalit 1"4V tl old style Uud ►.Ialow W ACCESSORY DUIL.DTNG�
tYa ,,��od._ Cattar� u ocRwx czar
Col oni:ii Liow 'L'awrr }fause w' S1r- cached y:a.r:.ige/ona c�tr/ two car/
( CIRiCL.L: ONL: PLEASE 1
'* Actaclt+-gl c1:arwgu/o13a car/ two czar/ _c:ai'
• w * * • x f • w R w * '!i * ; Privut►: :tLoruga building
l '"s 'L' I11A'L't: D MhRKF'1' VALUI;i. OF
r �woche r
COlN :+'L' l+.UC'L' IUN � k ��• �' Gj . G'��
7NFOft1•IATION ON L3UILDINC SI►fCli' ICATIONS , ON REVERSE: SIDE_ OF THIS Sf11'ZCTo TO BE COMPLVrEDL
Form SPA I0/68 vI
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS :
Type of construction , wood frame , fire safe , etc .
Will any second-hand or ungraded lumber be used? If so , for what?
h in
Foundation wall material �} , ry r .; _ Thickness 611
b �.�
Depth of f anon below grade {to bottom of footing}
Will t�a cellar? Heated or unheated? Floor sqw footage sq ft
W�\1 e a basement? �-Will any portion be used as living space? {,xa
( what portion? sq . ft . - - Type of use?
Ty of roof - sloped/flat/shed/other� �' Material of roof
Size , wood studs ' X_ .�" spacings" o . c . length _-"'� ft ,
Joists ( floor beams ) 1st . floor "X �yry'� " spacing lea "o . c . spanhl�ft .
Joists ( floor beams ) 2nd . floor _-v "'X 45 '" spacing,(:, '"o . c . span f t _ ft .
Overlays ( ceiling beams ) .2"x x-" s---accccinng (,X ""o . c . span.'- ..ft .
Roof rafters "'X -_" spacing o . c . span.L'i!>..ft .
Roof trusses (pre-engi.neered) spacing " o _ c . span ft .
Exterior wall finish�,� i a. /fit 01 of what material?
Interior wall finish _4r144• 1? et (' tc
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)
D E C L A R A T I O N
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 shell be complied with, whether specified
or not, and that such work is authorized by the owner. _ � +
Signature
Own ow is agent, archi ect, contractor
SPECIAL CONDITIONS OF THE PERMIT :
i'
gy-- __---_ -_--_ --- ............. -----
TOWN OF QtmenusaURY
WARREN COUHTYo NEW YORK
Application fort BUILDING PERMIT IN COXPLIANCF WITH TUE NEW YORK
STATE ENERGY CONSERVATION CODE.
A permit must be obtained before 'beginning work .
ANSWER ALL Of the following :
I * Gross floor "- r e a V C//p � ( `.��----.—
2 . Type of heat CA
3 . Is the building mechanically cooled ?_ � D
a , percentage of area of windows and doors
A , Over LG % Only
1 . Uo value of gross area of walls , roof/ ceiling and floors
exposed to auibient conditions
2 . Floor over heated spaces YES NO
a . Are foundation walls insulated ? YES No
1 . If yeS , what is the R value ?
3 . Sl :jLU an grade YES NO
a . if YES * what is the R value of insulation around
parxmetur of floor ?
4 . x5 basement heated ? YES NO
a , {t valuu of insulation
5 . Type of insulation
k3 . Under 16 +. Only
1 . t v .aluC t roof and floors exposed t i d
nt cranitions�
2 . R value of exterior walls t�
3 . R value of glazed ar ja
4 . R value of doors
5 . R value of floors over unheated spaces _
£✓ R value of slab edge insulation - unheated slab
C
R value of slab insulation - heated slab
00 R value of heated basament/Cellar walls, ( above '. grada ) �
9 . R value of heated basement/cellaa`' w{ afflls ( below grade ) ,
to a Type o irisulation�. � ' A I' � . .
C . Controls
1 . Tti4cmastac maximum heat setting,
D , Duct Systems
1 . Ia 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 . 5s3ryic4- Wat ar tigacin2
1 . Y .: rforut"nc &= articiency
20 4rujjiperature- control setting maxlmus
G , For Swimming pool. Only
14 Mvxi %n ► la heating
Telephone No .
d�yppyjcantsgg signature )
TOM OF QUEENSBURY '/
531 BAY ROAD
QUEENSBURY : NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447
BUILDING INSPECTOR' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED�y/ n
NAM
TION
DATE PERMIIT# �I J. `D 'J
' +QGLd - err cQ ca26(
TYPE OF STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE )
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL^ SEPTIC
INSULATION WOVUSTOVE/FIREPLACE
REMARKS
APPROVAL
N/Al YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/p7DRCH/STIEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OP
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/ PRIVACY DOORS
FINISH FLOORS :
BATH/KITCHEN WATERTIGHT ✓
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILING
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOCEHOUSE
ALL PLUMBING FIXTURE OPE ATI
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPA ATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN V N
FINAL ELECTRICAL
OK TO ISSUE C/O D {
OMMEH got
ARRIVE fO '
Off
DEPART f I
/vz" .2 - 6
TOW OF QUEENSBURY
531 BAY ROAD
NEWTTELEPHONEYO ( 518 ) 07451444i
BUILDING INSPECTOR ' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION r+
DATE PERMIT# J'G S
TYPE OF STRUCTURE
RECHECK '•• r_.. � "rr"
FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE )
FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL_ ELECTRICALSEPTIC
INSULATION WOODSTOVEVFIREPLACE
R
REMARKS
A ROVAL
N/ YES ' NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILING
RELIEF VALVES
FURNACE/HOT WA RE OPERAT NG _
BASEMENT INSULATION/DUCT 0
INTERIOR TRIM/ PRIVACY DO
FINISH FLOORS :
BATH/KITCHEN WATERTIG
OTHER FLOORS SWEEPAB
OTHER FLOORS CARPET _
STAIR CLEARANCE/ RAIL GS
HANDICAPPED ACCESS _
SMOKE DETECTORS
BATHROOM FANS/WH H USE ANS
ALL PLUMBING FIX RES OP ATING
GARAGE FIRE PRO ING
DOOR CLOSERS
OTHER FIRE SEP RA ION
FIRE/DEMISE W LLS
DUMPS TER
SITE PLAN/V IANCE EQUI NTS
FINAL ELEC . ICAL
OK TO ISSUE C/O OR C/C
COMMENTS :
ARRIVE
DEPART INSP
" SENDER: l shoo wish to receive the
+ complete items 1 andlor 2 for sdditionsl es.
• Complete items 3, and 4a 9 b. following services (for an extra
• Print your name and address an the rawrn of thia form so that we can fee):
rewm this card to you.
• Attach thin form to the front of tha mailpiecs, or on the back if space 1. Q Addresses's Address
does not permit.
• write"Rswm Receipt Reouasted"on the maepim below this enlcle number 2, ] Restricted Delivery
. Tha O= Reol will show to whom the ardele was dalivered and the data
e delivered. Consult postmaster for fee. ' R 0 C N. G ;d Ip c C4
° 3. Article Addressed to: 4a. Article plumber C �+ :3 z iD M 0100
m fl
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4b. Service Type a n ro -
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C: Registered Insured IZK 3 a � X 3 to H 0 x
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>k�t- ) ❑ Express Mail ❑ Return
trch Receipt for `D M rt ft ft Do 0 1, Ib W : 4 � Ali
9 71 Date of Delive °*0 0 a z M 000 01 11&
It 5. Signature+ (Addressee) S. Addresses's Address (Only if requested m it iiih ro
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and fee is paid) gr 9 W tD o 0 0 0
6. Signature (Agentl W • I+ 3 •• 1 M C
T PS Form 3811, December 1991 u.sARQ; ta>w M7�0 DOMESTIC RETURN RECEIPT �, K � � n m Q
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