1989-085 I
+CER'�I 'IF
ICAT C]F C0- MPLI Al'�TCE
TOWN OF QUEENS13URY
WARREN COUNTY, NEW YORK �l
1
Date September 21 19 89
lk
This is to certify that work requested to be done as shown by permit No. w — = �
has been completed.
'i This structure may be occupied as a i
1
Location
Owner Loa o� Ba �l, & F•Lr>re
. By Order Town Board
TOWN OF QUEENSBURY
4
Director of Bldg• & code Enforcement
I
1
i
BUILDING PERMIT X
TOWN OF QUEENSBURY
No. 8 9-8 5
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Lox of Baer & M re I"
to
l I
FVVVOWNER of property located at Main Street Street, Road or Ave. 1 1'
in the Town of Queensbury. To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and } '
0o
approved and in corn pliance with the Town of Queensbury Building and Zoning Ordinance.
FlOW7NERwSddresses
Nauman Senarck
Main StreetGlens Falls B1 , Y _ 12801 0ONTRACTOR or BUILDER'S Name
O
Cecil Vopleus ( Mail c/o to Cecil ) ~'
Gtl
3. CONTRACTOR or BUILDERS Address
R1
371 High Street
m
Athol , NVVY . 12810
a+
4_ ARCHITECT'S Name
0
M
M
5. ARCHITECT'S Address
Iy
6. TYPE of Construction — {Please indicate by X1 F+
i ) Wood Frame 11 Masonry ( 1 Steel I } En
7. PLANS and Specifications ro
l'D
No• Roof over existing building as per speclfications , and
ap-plication ,s
8. Proposed Use
Retail Store ; 7d
0
0
rri
$ _ 10 V, 00 cfc _ PERMIT FEE PAID — THIS PERMIT EXPIRES 0
(if a longer period is required an application for an extension must be rrtada to the Building and Zoning inspector of the CD
town of Queensbury before the expiration date,)
ro
Dated at the Town of Queensbury this -I S -h _Day of March 198.q -
�---
rt
SIGNED BY for the Town of Queen 'ry
Building and Zoning inspector
0"
L3
s
TQ NI- OF QUEENSBURY APP ), ICATTON FOR BUILDING AND ZONING PERMIT
-
P.ec ieved TOWN OF QUEENSBURY
l�eviewet[ c �- RECEIVED
/
J Fee Pa,4d $ [C) c-,ft G�,�3 �c MAR 13 1989
SUILDINC AND CODES MPART111ENP Dante I.aaued BLDG. & CODE DEPT.
BAY and /lAVTLAJVD .ROADS RD 1 Box 93
OUEENSOURY, NEW rORK 12804 pit NO .
Tel . ( 518) 792-SB32 Ext •204
= ,.
A 111MU-IIT MUST D4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS
VILL BE MADE UNTIL APPLICAhIT HAS RECEIVED A VALID BLILDINC PERMIT ,
All applicable spaces on this application must he completed and the
xi1* >lature of the applicant must aI3 ear ' on the reverse side of this sheet .
# ik a # e o � etc c �c *must
'rhe owner of this property is :
P . O . Address TCL . �r}f" J
a
Property location � ;. ls -_': � � `PAX MAP NO . _11 /11-Z4l'
tlas there been any split of this property since October 140 19BB '?
yes no
If yes , Planning Board Review is necessary .
SUBDIVISION NAME , II" APPx.. ICAL3L>r
sy' LOT N0 .
The pars responsible for supervision of work as regards Building Codes is :
c
NAME --IP . 0 . ADDRESS TEL . NO .
Fume of builderee .l s Address r . & Xx cs- A:Ihe� G rz Ire Tel s � --
Name of Plumber l.ddress Tel
Name of Mason Address Tel
NATURE Of-PROPOSED V*GRK: ZONING INFOIt IATION ( O-efice use only ;
Con:rtructiori of a ilding ZONING DESIGNATION OF PROPERTY
�Additian to :a laui.lLSing # PERMITTED PRINCIPAL PERMITTED ACCESSORY
Alc4r acicsii i7 a l:uiIding
( no clL:li►q� to axc �T•r-i`-� REVIEW REQUIRED - PLANNING BOARD ZONING BOARI]
or_.. climens• ions) —
eo other work (dsscrilao) p, 4 �� ^^ SITE PLAN REVIEW N APPROVED DATE
+r
GROSS AREA OF PROPOSED1 taTUUC`1' URE • VARIANCE # APPROVED DATE
lst Floor sq ft . Remarks :
r
2 n d F Loo r sq f t . COML'r.L'1"l;: _ I{a}'OfaMll'.VlON EtUQU lRED idE WW .
Other Floors sq f t . " Sixa of pr'ol'orty, rt X fC .
c builJil►�
( not cellar or basement } Existing 1 ( u) 5i -xu r x rc .
TOTAL FLOOR AREA sq f t . kxl.acing bLj.L1d-Lng (w ) Use / CIE ; 42 -
c' ixu caf new structuro f t x f t
1'csuaad;rtion-gicrJslai,/cxawl/I�a,rCial/ Full ' Vropoard builuing , die: cancu from prul-jurcy lifLu
(Circle one) Front urd i't Rear urd ft
NO , of stories (It"ble"- bla wl�ace } Side yards rt land y fc
It.:ight ( grade to riclq,= ) Gj ft .
If residuntinl . no. of famili s . If on cornar, ;;Qcb"ok .train side: tscr"c fc
No* of room:; I, excluding bath:: ) OCCUP*A"CY 6INFORP ATION
Iao. of bedrooms F"TtIMAIty fsUILDIIaG
Na . of b:xtl►raau►:; One tily dwelling
C rltWAry Eu:atirurj sy:.; te aa►
iLt Two faxi ly wulliny
wypu of fuel * Multiple dwelling J NLunbcr of units
No. of firQpl "U4 to bu lnzcailed i5erinuneiit Occupancy
:a word t:LowQ k,u i.i►ULallud?_ �
'1"ran::iurrt occu a
Cwntrul Air cor,clitionirrg? ��r•-�, it i `.u►c
1
r ilusinc5s
BUILDING STYLE, PRIMARY STRUCTURE ,. Induuurlal
lea►► it Con rr.%jji%x.r:ary Leah cabin . Ocher
rnvao
it,ais.:d ranch Mana i.c.a► Dul"Ic:x r If :additions whit will u::e b.s?
:llnlic level old atyla: uu, ►;j..Iow -
c"PU Cool Cottaq%4 Otiaer ' ACcu2 0'RY BUILDTWG-
L'oioni:il Scow Arown House • Ea.:caah d Cjar"g-a /one cart two oar/ aar
It CIRCL.L•' ON'L PLEASE ) ' ACX:aahu.l rJariaguJor]w cur/ two car/ aat*
a r r a r rt ■ y� a ,. r r • vs rt s • '�' Prlv" Lt storage building
k: S0r1MATKD MARKET VAI. UIi OF r —otiwr
) Nf ORHATTON ON BUILDING SPRCIPTCATIONS , 00 REVENSE SIDE: OF THIS !:UE ETO TO EdC COKPLE'rEiDI
Form BPA 10/88 v1
1 .
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 , £or what ? h-0
Foundation wall material Thickness
Depth of foundation below grade ( to bottom of footing )
Will there be a cellar? Heated or unheated? Floor sq . footage sg ft
Will there be a basement? Will any portion be used as living space?
( If so , what portion? sq. ft . - - Type of use?
Type of roof - sloped/flat/shed/other Material of roof
Size , wood studs " x " spacing " o . c . length ft .
Joists ( floor beams ) lst . floor "X spacing " o . c . span ft .
�soists ( floor beams) 2nd . floor " X IN
spacing "o . c . span ft .
Overlays ( ceiling beams ) "X " spacing " o . c , span ft .
Roof rafters " X 11 spacing o . c . span ft .
Roof trusses (pre- engineered) spacing tj'� "o . c . spank- ft .
Exterior wall finish of 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)
D E C L A R ATION
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.
Signature
Owner, owner's agent , chitect, contractor
It III
SPECIAL CONDITIONS OF THE PERMIT :
1 L�f 6 t v �e c �i[ Aic, lag
Sre- E- GLR-ems ' D f f r ,vC L a S .
By_________ _ ____________ _____
TI�, , &sa s sack i`plyy ak : . . -
r'p rr+e ISSUE DATE (f.1 AklDDlYY)
kkkk r 3 ^` J
PRODUCER ---_. -.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Barber �r fs� NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND
B ,
arber Howe & Morrison r i s$ o n EXTEND CA ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
E Quaker Rd . PO Box 763 _
Glens Falls , IVY 12801 COMPANIES AFFORDING COVERAGE
I-ETTTER COMPANY AState Insurance Fund
INSURED LETTERNY
COMPAN
Cecil iVopl eus LETTER Y
Hi f h Street COMPANY
Atha ] , New York 12810 LETTER
COMPANY gE
LETTER
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INUICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH F/ESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIOEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CQNpI-
TIONS OF SUCH POLICIES.
r
CO TYPE OF INSURANCE POLICY NUMBER RIh ICY FFIECT:VE PODL.Y EXPIRATION LIABILITY LIMITS IN THOUSANDS
L-T Ci.:IE {i.U.Lr4'vYi DALE iPA(AAjWYYl CAC.1 %+GGFiEG.1Tt
—'— (]t:r UiUiARFr.CF
GENERAL LIABILITY — '�"- --. '
COMPREHENSIVE FORM BODILY
1-
PRE MISES)OPE RATIONS YF<Crr F.q iv
UNDERGROUND DAMAGE
'y
EXPLOSION & COLLAPSE HAZARD ,FA
.µ PRODUCTSICOMPLETED OPFRATION$
",. CONTRACTUAL Fat &. PC
- ? INDEPENDENT CONTRACTORS �
BROAD FOAM PROPERTY DAMAGE _ !
PERSONAL INJURY PERSONAL INJURY
.yFyss -- �;
AUTpM08iLE LIABILITY r:
.r; ANY AUTO �NJURV
ALL OWNED AUTOS (PAIN. PASS-) - f -
� ALL OWNED AUTOS uuUk_Y .
(OTHER ASS IAA01 r
l PRIV. PA55. I ��En ,rwueMTl `�.. .
HIRED AUTOS k
'i NON.DWNEO AUTOS U.4M1.i..r'E ^ '`
�. GARAGE LIA&ILITY rat w ap
EXCESS LIABILITY —'
UMBRELLA FORM
iil N. Vp
F .. OTHER THAN UMBRELLA FORMSIATUTORY
WORKERS' COMPENSATION 920 86 7 g
AND 9 - 23 - 89 _ $ sIAUH AccIDENa- - y "
5TL"9
EMPLOYERS' LIABILITY $ (UIy£ASE-POLICY LIMIT)
} a $ (OJSEASE-EACH EMPLOYEE)
-r& OTHER -
'k
DESCRIPTION OF OPERATIONSYLOCATIONSIVEHICLESISPECIAL ITEMS
Carpentry
.. is r n4...
Q ue e n S b u ry Building Dept . SHOULD ANY OF THE ABOVE DESCRIFIEO POLfCiES BE CANCELLED BEFORE THE EX- I
BayITTEN
p d • PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL DAYS W8 n FT, BUT FAILURE 7 RE RM IL SUCH NOTkCE SMALLNOTICE TO THEERTIFICATE IMPOSE NO OBLIGATION ORHOLDERD
TO THE
Qt1 @@nLIABILITY '�,k'-�
s b V ry , M [y 12 $ L14 _LEFT,
ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES: _ y
AU T��y/y'��IY REPRESENTATIVE
' � j. . :: ;i f1 i .3 .. IMF iF• • Y• i ° T"
„ s
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804i
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION }
DATE - I - PERMIT #
y APPROVED
/ YES NO
FOOTING P!:PXVAL
AS
MONOLITHI UR FORMS
FOUNDATIODP—PROOFXNG
BACKFILL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH N . :
INSULATION:
FOUNDATION
FLOORS d
WALLS Aw
CEILING
FINAL INSPECTION: .
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PO HES/STEPS _
STAIRS-CLE NCE & RAILS
PLUMBING XTURES/RELIEF V rVE
INTERIOR RIMfFRIVACY DOORS
FINISHED FLOORS _
GARAGE IREPROOFING
DOOR C SER (S)
SMOKE ETECTORS
FINAL E ECTRICAL INSPECTION
, A
FINAL PPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED)
REMARKS.
9
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURYr NEW YORK 12805
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR TNSPECTION RECEIVED
NAME
LOCATION
DATE 13 - Ka PERMIT # ! s
rT7r 7 APPROVED
_ _ ! YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATTON/DAMP-PROOFING
BACKFI'LL APPROVAL
ROUGH PLUMBING �
�RAMING
ELECTRICAL ROUGH-TN
INSULA TTON.
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING +
SIDING
EXTERNAL PORCHESISTE r
STAIRS-CLEARANCE
L
S
PLUMBING FIXTURES/ L F VALVE
INTERIOR TRIM/FRIV CY D7ORS
FINISHED FLOORS
GARAGE FIR PR
tNGm
DOOR CLOSER (S)
SMOKE DETECT
O
FINAL ELECTRICA INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERT±FTCATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISE'S ARE OCCUPIED!
REMARKS:
INSPECTOR
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