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1989-096 �Wj�"We ?10 777��.7-�' CERTIFICATE CIF COMPLIANCE TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK Date May 31 1989 c L This is to certify that work requested to be done as shown by Permit No. Fo 9 , has been completed. 7Sied I This structure may r I II dd kL 9 Location ci-Z N Chmer 3 ag -- W -' � W By Order Town Board TON" OF QUEENSBURY A Director of Bldg, & Code Enforcement T BUILDING PERMIT TOWN OF QUEENSBURY No. 89 - 96 WARREN COUNTY, NEW YORK 0 Lr PERMISSION is hereby granted toyhr� rry C'n Yn PrS I OWNER of property located at f nr Rev Y-e 1 A 9 Street, Road or Ave. � in the Town of Queensbury, To Construct or place a PCInf 0.%Ter recLl- nll '^a +�i 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 . OWNER'S Address is Mike Legault tr 16 Sylvan Avenue Iz t= 2_ CONTRACTOR or BUILDER'S Name .c .x Richard Jones Assoc . r C 3_ CONTRACTOR or BUILDER'S Address G Ll 119 Aviation Road u Queensbury , N . Y . 12804 4. ARCHITECT'S Name C C S. ARCHITECT'S Address f t 6. TYPE of Construction — (Please indicate by X) G ( } Wood Frame l ? Masonry I i 'Steel 7. PLANS and Specifications No. 231 x 261 roof over restaurant ( existing ) as per plot plan specifications , and application . 8. Proposed Usa Restaurant 10 * 00 PERMIT FEE PAID - THIS PERMIT EXPIRES -_ N'KMX C7ntnlag� r (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.) Dated at the Town of Queensbury th' Day of Marc}-h _19$g_._ SIGNED BY u Mots for the Town of Queensbury Bu ilding and ZoKiN Inspector TO BE COMPLETED BY BLDG . DEFT . At _J] / Application No . olts 0i Q" een3 h"ry Permit Issued g BUILDING and ZONING DEPARTMENT Permit Expires .-TZ-) 19 Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation iJ-C,;74777f] Queensbury, New York 12601 Variance No, Site Plan Review No . App ed by : APPLICATION FOR BUILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALI_ 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-is - ! / ! / e A r P . O . Address tV / Tel . 7��JZPf04 Property Location : 6 ,�r' 1-e4pi egoo- el�Tax Map No . / / / / Street number or building lot number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORKAS REGARDS BUILDING CODES IS !Name P . O. ddress j ,�� Tel . o _ Name of builder c>4,7 � �Yp4ogV r� Address ` _�� ./ IGu OP4:j Tel . _/ E22aE Name of plumber Addressm4 U(fgoir.. O& Tel . Name of mason 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 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 300 ft X ft . " Existing building ( s) Size ft X ft . PROPOSED BUILDING AND USE : * ,Tx isting buildIng (s ) Use ✓Size of new structure Z3 ft X (+ ft Fo'undation-pier/ slab/crawl/partial/full * Proposed building , distance from property line (circle one ) Front yard ft Rear yard ft No , of stories (habitable space) * Side yards _ft and ft ✓Refight (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 o£ fuel * Two family dwelling , Type * Multiple dwelling / Number of units No . of fireplaces to be installed Permanent occupancy Will a wood stove be installed? * Transient occupancy Central Air conditioning? ✓BUILDI ]NG STYLE, PRIMARY STRUCTURE Tndustrial �. Other Ranch Contemporary Log cabin If addition , what will use be? Raised ranch Mansion Duplex Split level ld style Bungalow Cape Cod Cot age Other * ACCESSORY BUILDING- Colonial Row Town House '" Detached garage/one car/ two carf car ( CIRCLE ONE PLEASE } * Attached garage/one car/ two car/..car * Private storage building ✓ ZSTIMATED MARKET VALUE OF * ^Other CONSTRUCTIONS c5o INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED ! Form BPA 4/86 and-vl k BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe , etc . kypp C1 -� Will any second-hand or ungraded lumber be used? If so , for what ? Foundation wall material C.�(4,r ; PJ F V,0' Thickness --- Depth of foundation below grade (to bottom of footing ) Will there be a cellar? Ht2 Heated or unheated? Floor sq, footage sq ft Will there be a basement? Will any portion be used as living space ? p ( If so , what portion? _-sq . ft . - - Type of use? 'Type of roof - slo a /flat/shed/other Material of roof Size , wood studs 20 " X spacing ",a " o . c . length 2..7ft , JOists ( floor beams ) lst . floor --- " X — " spacing "o , c , span ft . .joists ( floor beams ) 2nd . floor "X - - "" spacing --- "o . c . span ft . Overlays ( ceiling beams ) "- "X " spacing-__- "o . c . span ft . Roof rafters 2 It -" spacing,,&& o . c , span.].!?ft . Roof trusses (pre- engineered) spacing- - "o . c . span ft . Exterior wail finish A1/©0't0 i,- 1 IL�jri yl Uf what material? -� 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 A F F I D A V I T STATE OF NEW YORK eensbury Warren 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 donelon 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 . /i SWORN TO BEFORE ME THIS ' Signature _ �___ 1 Owner , owner ' s agent , arcn_4V �ect , contractorR �._•.•___._—.day 19 Notary Public , Warren County , N . Y . * * * * * * * * * ■ * * * * * * * * * * * * * * * It * * * * * * * It * * * * * * » At SPyE�CIAL CONDITIONS OF THE PERMIT : {�0 sr 0 R _D-^- --C E R T^I F I C A T E --O«F ; N 9 iJ R-A-N-C E - Date-11f2818B--- ; _--«...........------------------------------_ -----_-__-__- -___--------_------------_-- -------- _ _ ___------- .......... ' PRODUCER Oper , IO ! This certificate is issued as a matter of information only and confers no ' 1 Associates of Glens Falls frights upon the certificate holder . This certificate does not a■end ,extend ; 220 Glen 5t PO Box 140 . or alter the coverage afforded by the policies below, ; 3 Glens Falls NY 12001 ; 1 1 M ----------_ _________ C 0 N P A N I E S A F F 0 R D I N 6 C 0 V E R A G E-----_—_--_------___--- p INSURED ; 1 11COMPANY LETTER A: Excelsior Insurance Co. G ; Don Maynard ;COMPANY LETTER B: General Accident Insurance Co, 17 Honey Hallow Lane 'COMPANY LETTER C: ; Glens Falls NY 12801 COMPANY LETTER D: ; ( COMPANY LETTER E: 1C0 V E R A B E S----------------------------...........------------------........-----------------........««__......_--_______-- ; This is to certify that policies of insurance listed below have been issued to the insured named above for the policy veriad ; indicated , notwithstanding any requirement , term or condition of any contract or other document with respect to which this certificate may be Issued or may pertain,the insurance afforded by the policies described herein is subject to all the terms, 1 exclusions, and conditions of such paliries, ; tl -«--------------------------«------------------------------.........--------------...............--------- _ ------------ _---- 1CO LTR ' TYPE OF INSURANCE 'POLICY NUMBER 1EFF DATE 1EXP BATE ' ALL LIMITS IN THOUSANDS ; -«--------------- - ----------- - ------------.........---------------...............«----------_--........ --_ -----------------'1 . GENERAL tI#DILiTY 16ENERAL AGGREGATE 500 A 11X]COMMERCIAL GENERAL LIABILITY CCO3916631 05/01 /88 05/01/89 'PRODUCTS-COMP/OPS AGSRESATE 500 ; ' ( ] { )CLAIMS MADE IXI[ECCURRENCE I 1 'IPERSONAL6ADVERTISING INJURY ; ' I IOMNER 'S & CONTR. PROTECTIVE f I 1 J I ; EACH DCCt1RRENCE 500 I ] I I 1 1 ' FIRE DAMAGE {ANY ONE FIRE} s I ] f I { 1 ' KED EXPENSE (ANY ONE PERSON) ' -_----- »--------------------- --------------------.,__---------__ -_-------- ---------- ......---_«__-___________ _-----__-___ C ' AUTOMOBILE LIABILITY ; B 11XIANY AUTO 1 BA0019693 1 06/20/88 ' OB/20189 1 ; ' 1I ]ALL OWNED AUTOS CSL 300 'it )SCHEDULED AUTOS E 1 ! I J 19ODILY INJURY (PER PERSON) i EXIHIRED AUTOS ; BODILY INJURY (PER ACCIDENT) 'ItXINON-OWNED AUTOS E J J I I %PROPERTY DAMAGE ' ' I ]GARAGE LIABILITY 1 1 [ ] 1 1 I F I ! 1 _ _ _.-........ ........ ___ ____ _______ _ ' EXCESS LIABILITY --_-- 1 of ]UMBRELLA FORM i J J I I 11EACH OCCURRENCE ; ' I ]OTHER THAN UMBRELLA FORM f I ) I I 'AGGREGATE p 1 1 ' STATUTORY , 'I #ORiKER ' S COMPENSATION 11 100 LEACH ACCIDENT ) A AND WC3916631 07/21 /88 1 07I21189 500 (DISEASE-POLICY LLMIT) ; ' EMPLOYER 'S LIABILITY 11 1 I J 100 ( DIS€ASE-EACH EMPLOYEE) ------------- ------------------------------------------------- --------------............---------- -------------- ------------- 1 ' ' OTHER , F 10ESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS--------------------------------------___-_--_------ I 1 ) 1 i 1 S 3CERTIFICATE HOLDER--------------------CANCELLATION---------------------------------------------_ -----------_---------___-------- ' Town of 8ueen5bury Should any of the above described policies be cancelled before the expiration date thereof ' 1 Stephen Barqas, Supervisor the issuing company will endeavor to mail days written notice to the certificate holder ' Bay Road named to the Ieft ,but failure to mail such notice shall impose no obligation or liability 1 @ueensbury NY 12804 1 of any kind upon the campany, its agents or representatives, ; 1 AUTHORIZED REPRESENTATIVE , 1==ACORD 25-9fl1l85l ====w__________________________________________________________ _____________________________________________ ) TOWN OF QUEENSSURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS YORK I280 QUEENSBURY, NEW TELEPHONE ( 518 ) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVEDI' NAME LOCATION PERMIT # - ---� DATE APPROVED YES NO FOOTING IERS MONOLITHIC POUR FORMS FOUNDATIONIDAMP-PROOFING:�_�-- BACKFILL APPROVAI. ROUGH PLUMBIN f` ,FRAMING ELECTRICAL ROU -IN - -^�-�- INSULATION: ; FOUNDATION FLOORS WALLS EILING INAL INSPECTIO CHIMNEY HEIG TY��� ROOFING SIDING CHESISTEPS EXTERNAL STAIIE RANCE & RAILS ' PLUMBING IXTURESIRELIEF R LIVE INTERIOR IMIPRIVACY DOO _��--- FINISHED LOORS GARAGE F REPROOFING DOOR C ER CS I SMOKE D TECTORS FINAL ELE TRICAL INSPECTION FINAL AP ROYAL OF CONSTRUCTION CATE OF OCCUPANCY MUST BE A SIGNED CEF2TIFI THESE P1 FROM THE OCCUPIED,ING DEPARTMENT BEFORE OBTAINED PIEI)P ,REMARKS NSPECTOR MIDDLE DEPARTMt *► AGENCY, INC. 900.tlslidfirf 14xenula,_, may° ' aatc April, 6 , 1989 c�errlfito that lectoca[ equipment listed has been exarnzr]ed and s approved as being in accord with the National Elect C04e, applicable governmental , utility and� Agency Axles- frt fJRCL � Couuuerc i a I Bayberry Corr _ s w 3Cupatt&y: Owner: ki Commercial ran Occupant: Q nfi yn n 'r. N: �... 66 . ' aV f'to ad ,� '� ^r"'Q 'v " •` Sc9rt11iCate tOi}B I'd SM1eleGtliea +Wu+pmenr and ins[allanen ingpectea this L.ocatfon: ✓ date. It additional equt "S ahoulo ae Introduced or allaratlons mad¢ to e%Iating Sy97em Sh 1! CMS icate efw be nuo and Vold. and application for +1 fP.. 71 to Shls Agency. 4 Rec@ tac 1 j �2 F:Lkt ores _ nePectton ahpultl 49 9ubmtttad Rr?j!�P Y h y' Equipment p i i a %� 4x14 rZ 4of der of this ce ttlficate sh= At Same to his RfOQa ly IneurOn Ca carrier tag a At or Go m Pany) as e++ldeflp Cart 171G$SIpM1 4t 01BCYr1Cel eA ulpmenl appro++ed as specified: . ' C rpon Maynard Co` c 4-on Applicant_ 17 Honey Hollow Dr —=-� 0 • 15 -021646 L. Glens Falls , 13X 12801 Y to yNq %si, 7W EL 1 43 TOWN OF QU 'BEN SBU RY ,BUILDING AND CODES DEPARTMENT BAY Se HAVXLAND ROADS O Yr NEW TELEPHONE (51 8) Y792-5832ORK 0¢ BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME 041 LOCATION DATE ' 4e _PERMIT # APPROVED YES NO FOOTINGIPIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACK ILZ. APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL RUGf1 +D ::IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ---- ROOFING SIDING EXTERNAL PORCHESISTEPS STAIRS.CLEARANCS & RAILS PLUMBING FIXTURIBSIRELIEF VALVE INTERIOR TRIMIPRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (.4) SMOKE DETECThRS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDS REMARKS : xNSP TOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2809- TELEPHONE (518) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST R INSPECTIO RECEIVED NAME LOCATION DATE J PERMIT # PPROVED ES I NO FOOT2'NG/PTERS MONOLITHIC POUR FORMS FOUNDA TXONID'A PROOFING BACKFILL APF VAL ROUGH P BING4 AMING 5e.�er et ELECTRTCAL ROUGH- INSULATTON: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ! ROO XNG SIDING EXTERNAL PORCHES/STEPS f STAIRS-CLEARANCE & RATL9 PLUMBING FIXTURES/RELIEF' VALVE INTERIOR TRTMIPRSVACY 000RS FXNTSHED FLOORS ' GARAGE FSREPROOFING DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL SNSP�g ON t FINAL APPROVAL OF CONSTRUCTXON A .SIGNED CERTTFSCATE OF OCCUPANCY MUST BE OBTAINED FROM THE BU.ILDI'NG DEPARTMENT .BEFORE THESE PREMISES ARE OCCUPSEDI REMARKS: INS OR