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1989-218 CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 19 � � - lf k3 is is to certify that work requested to be done as shown by Permit No. has been completed. This structure may be occupied as a Single Family Dwenirg w/ addition / LAxation k Owner 'Scott Williams By Carder Town Board TOWN OF QUEENSBURY Director of Bldg. do Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No 89-21$ WARREN COUNTY, NEW YOiRK CA PE R M I SSI ON i s hereby granted to Scott WERIamsw OWNER of property located at 1 Martell- Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a Addition to dwellhW 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 SAME 2. CONTRACTOR or Bl.li LDERS Name wtn SELF a 3_ CONTRACTOR or BUILDER'S Address SAME 4. ARCHITECT'S Name S. ARCHITECT'S Address r� 6. TYPE of Construction — (Please indicate by X) 0. ( ) Wood Frame ( } Masonry l ) steel S ? 7. PLANS and Specifications No. 5t x 16' addition to dwellingm per plot plax4 specifications, and application. 8. Proposed Use ga. Single Family Dwelling (Addition) 08 r. 0 10.00 c/C q $ 8.00 PERMIT FEE PAID - THIS PERMIT EXPIRES December 1 19 89 ro (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 this Day of Maw 1989 SIGNED BY for the Town of Queensbury Building and Zoning nspector T N OF � UEENSI3UPY APPLICATION FOR BUILDING AND ZONTNC PERMIT !^ ec.�ev eri ;'�r-'-'�-c— Rev-r.ekved /�' CTO�F QUEENSBURY 'Y' '} Fr - - ,pJRECEIVED F Fai /�—_— APR 2 .. 148_9 WILDING AND CODES w :I'ARftT: "r Vate Ibaued AY and fiAYIr�AND ROADS AD 1 BOX 93 BLDG, & Cor)E ©Ep'ro To] . (518 ) 792-5833 Exc - 204 A PEZI kIT ]MUST Up OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS VILL. BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDINC PERMIT . All applicable spaces on this application Insist be completed and the 40vpature of * the * applicant must appear on rthe re verso side of this * s ecto 't' lze owner of this property is � C �J I{ l 'j l hl r ry G, M S P40a Address e'r �' / fiEL . ! � Property location f n1l► l PAX MAP N4 . y __/ 1 tlas there been any split of this property since October 1 , 1988 ? 14 yes no If yes , Planning Board Review is necessary . SUBDIVISION NAME , IF APPLICAaLE LOT 134 . The person responsible tar supervision of work as regards Building Codes is : C�E> C 01) 1 + ,-to l ( C , A -1 Ci NAt+ L P . O . ADDRESS IIEL . NU . tJume o i builder i Add re ss JCe, Kf�'4 - N"ama of Pllxmber ---�- address Tel Name of Mason Address 77 cc ✓K - 'ref "A-A. f ATURE OF PROPOSED W RK : ZONING INI#L7 {tAklM1TION ( Office ua' u only ) C n :: truccior, of a ifuw building ;BONING DESIGNATION OF PROPERTY Adition to :a Uuilclirag ` PERMITTED PRINCIPAL PERMITTED ACCESSORY Altwr"tion to a Luilding ` 4 � (eka Cku4ncj� to axeurior climenf ion:a) } REVIEW REQUIRED - PLANNING BOARD ZONING DOARD� l Ock4ur work SITE PLAN REVIEW # APPROVED DATE ---- Jr t kDSS AR ! A Ot' PROP4SCO, :.; TTtUCTURi; VARIANCE # APPROVED DATE 1st Floor � sq ft . W Remarks - . A - ? nd Floor sq f t . r COIt['[.L''1'a: Sr11"c]ir1lti'riON Ju.:QUISCI_D 14i; L-06J . Other Floors sq fcy sixa of praL4urty rt X Fc . snot cellar ar basement ) k:xi.stiruj lauil�li4r�] { :: l Si ::a � 7 fv- x art . ^� ; TOTAL FLOOR AREA^ iJ sq f t . Lxlialg nuil+iincj {:: ) u�.: S � r &j f i2e.Q oe new struo a t t a (jo ft " t`caau�d:ation-pier :la /crawl/L�arci:al/ roll ' laroLao tad building , di::tancia Prow L.rQl.Aurcy iirsu (cir�lu one ) Front yard , ft [tear yard Q ft No . of stories (hub.Lc+:.hla space ] 1 � Sida yards CC :and re ll�ighc ( Urada to ridge: ) y6 ft * If an corner „ :.:r.: tb"0K .from side scrL:Qc ec IL' ra:sida:ntial , nayo of farnilies_�_ } OCCuPA"c:Y INFOWgATION No , of rooms (Qxcluding bathal ( 42 144. of budroolitu _ # Pl2 Y fiUILD1NG - NO * of bacliroaws � Ona tank.ily dwelling ilriuury 1kuac16kij �y;; tuau _ r r lec-iyt - ,�� M +iw.,o f aMlly dwullinU •rylus of f uel No Multiijla: alwalling / Number of units =:p No . of fir4lac4aaT to l.�a i1t::C .11L:d Permanent accu,natkcsy Will 4 wood .::Lava: Loa illst:all4.:d? dowwwwwwo � +Crap :ic:rrc ac4:lalti:ancy L`aanGx"l Air cor4ditiraning :° + au.inoss r WIt_DINC STYLE, PRIMARY STRUCTURE „ Incluscrial wakach Caat4jmpQc& ry Lon cabin ► 4chcr i" isud ranch M:ansica4r Daalalux Ir It .addition , w1'uac will usa b>=:' j )Olic 1 01 Old ycyla 1Aura4j.,. low " e_';+ .aQ +Cott:aga Och" r " ACCESSORY BUXLDI"C- COLOniul Row +rar+rrr ltause ' Uacachad garr4go/ono cur/ two czar/ p"r { CIRCLL: ONL PLEA SZ I '� Act ached cjuruqu/ana czar/ two c.;4r/ C" a' ■ 1 ■ w 'i ■ ■ * ■' l4r.ivu cAwt storage building L S 'l' IMA"t' t: D MARNoroP VA14UV� 4F �Other cON +141{UC'r10N f INFORtkATION ON BUTLDTNG SPFCIFTCATTONSe ON REVERSE: SIDE OF TkiTS 'F%HV "T, TO BE C4MPL-GT'Zo ! Form FPA 10189 V1 BUILDING PERMIT APPLICATION CONTINUED BUILDING SPECIFICATIONS : Type of construction , wood frame , fire safe etc . L`^)G& �s t GtVI.A--Z Will any second-hand or ungraded lumber be used? If so , for what ? rr Foundation wall material Co--Acut e T'-. ickness `} Depth of foundation below grade ( to bottom of footing ) Will there be a cellar ? 0 Heated or unheated? Floor sq. footage _ sq ft Will there be a basement? ) Will any portion he used as living space? ( If so , what portion? sq . ft . - - Type of use ? Type of roof - sloped/flat/shy !. '<�ther 410� Material of roof Size , wood studs '2 " X�a '" _}pacing_J_C.P " o . c . length 8 ft . 1 + Joists ( floor beams ) lst . floor ---- "X " spacing "'o . c , span ft . Joists ( floor beams ) 2nd . floor - - " X spacing "o . c .r span ft . Overlays ( ceiling beams ) 2.- "'X_�"' spacing " o , c , span_ fe . Roof rafters " X_J'(.�.) " spacing iC o . c . span ft . Roof trusses ( pre- engineered) spacing " o , c , spai ft . Exterior wall finish t�"y { 7 + + n('jt'oce. Of what material ? Cj (1,+� � ] GQ,_ Interior wall finish { �C; � � k If a garage is to be attached scribe 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 prov , id? Will a flue-lined chimney be installed? Height above roof ft , Depth of chimney foundation below grade ft , Depth of fireplace dearth 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) DECLA RATIO N To the best of my knowledge and belief ti : e 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. _ Signatures Owner, owner's agent, architect, contractor SPECIAL CONDITIONS OF THE PERMIT : By---------------------- ---------------_ TOWN OF QUEENSSURY WARREN COUNTY , NEW YORK Application for : BUILDING PERMIT IN COMPLIANCE WITH THE NEW PORK 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^ i)(7sif ki cz:c rec { t T I C-- -- 3 . Is the building mechanically cooled ? E'"") 'r.) 4 . Percentage of area of windows and doors 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 NO 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 5 . Type of insulation B . Under 16 % Only 1 . R value of roof nd oors exposed to ar+ hient conditions ki 6)cf { 2 . R value of exterior walls !{, _ 2 C7 ��' o -5 �1''`_Q��, `1 3 . R value of glazed area 2-- C\41 ` �1 + G I�' yld-f/Sa-rt ll�j Ji 4 . R value of doors 0� y 5 . R value of floors over unheated spaces it 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab ('2 �ti { 1in 8 . R value of heated basement / cellar walls ( above grade ) 9 . R value of heated basement / cellar walls ( below grfaid, e ) �—ILD 10 . Type of insulation h `✓ -C° (C' as � �uJ} � Stq � t � �Y + t+� C . Controls 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 1 . Maximum heating -. Telephone No . � ��F applicant ' s signature ) TOw OF 11UEEIISBURX BU I LD I NG 53 D BAY ROAD PARTMENT zeo 'l ORK TELEPHONEi ( 518)NEW 0792- 58324 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED "ME DATE 4 PERMIT # d� r TYPE OF STRUCTURE .r�' 'a '' �'"" �~ APPROVED RECHECK MIA I YES NO FO INGS/ IER .�. MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CpNTRACTOR IS RESPON ISLE FOR PROYIOING P TECTI FROM FOLLOWING FREEZING FOR RS THE PLAC OF THE CONCRETE . MATEIO=NT OUERIALS FOR R T POUR ON SITE REINFORCEMENT IN PLACE FOUNDAT I ON/DAMPROOF ING BACKFILL APPROVAL ROUGH PLUMBINPLUMBING VENT G V IN PLACE PLUMBING UNDER SLAB FRAMING : JACK S IS HEAD R BRACING/BRIDGING JOIST HANGERS �--- JACK POSTSIMAII BERM HEATING ROUGH- IN INSULATION : FOUNDATION L I E R FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS _ CEILING I NG INUNHE E DUCT WOR SPACES No rA d e r ARRIVE DEPART P YOU ARE HEREBY REQUESTED TO INSPECT AND ISSUE CERTIFICATES FOR THE FOLLOWING ELECTRICAL EQUIPMENT TO BE INSTALLED BY THE UNDERSIGNED TEMP k CITY On VILLAGE TOWNSHIP COUNTY STREET'AN0 Npf qTt. {`. ` POLE NUM 0.CR BETWEEN WHAT TWO CROSS STREETS 1S PREMISES LOC4V'Ea? SECTION BLOCK �~ LOT � { r �'/� -. 1� OGCUFAN'T'S NAME BUILDING OCCUPANCY WNER'S NAME AND ADDRPS ++ FAME TELEM 0"E'N�MBMF - [ .... lI 7 1 i C I. [.y `li t -" 41 C1 CVPF4FNT SUPPLIED SY FTSOM THEIR OFFICE WORK TELEPHONE NUMBER i lir_ t # wl -G { � � BUILDING M ,�,/ I NEW EloLD L4(' (Y�.. �.. +' �%+ WORK IS NEW ❑ ADDITIONAL [Sro� ' ' DEFECTS REMOVED i�❑ LIST BELOW ALL UIPMENT WHICH YOU INSTALLED L.Dca NUMBER OF OUTLETS No. of Fixtures & MOTOR HEATERS BRANCH OFFICE USE Lamp Receptacles CIRCUITS ONLY flan Blde AftCh't H"P watts A.w_(i_ Ceiling LIYIIII Recep1s SWhch Pendant Brscko No, Type Each No. Each No" Gauge iNSPE-GnON OUT- r SIDE I SUB- BASE BASE- MENT } y J/ Cat -"} L- C- KP FL. G 2nd FL. 3rd FL. REMARKS: LI ST OTH ER ELECTRICAL DEVICE$ NOT $ET FOR7F1 ABOVE THIS APPLICATION IS INTENDED TO COVER THE ABCVVE-LISTED EQUIPMENT TO BE INSPECTED, BUT IF AT TIME OF INSPECTION, THERE IS FOUND 40DITIONAL EQUIPMENT NOT ABOVE LISTED, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER THE ADDITIONAL EQUIPMENT, AS PROVIDED EY THE APPLICANT. SIZE OF MAMTS FEEDERS ELECTRIC SK314STLAM PS TOTAL WATTS CHAR�IF„TER a/FrrW�O�l1�K ❑ EXPOSED GAS TUBE SIGNITRANSFGRMERS OF \14 i i. C. 4 " g (..;• j'l, NvCQNrEALCP ogre K^I]D BE ST RFED DATE COMPLETED SIZE OF SIGN[NVMeERI c'N'AGTTY 4 fir" SERVICE NTSIRS B MDINO MANUFACTURER OF SIGN oveRHEAD N<ON�WAGROUND DATE INSPECTION STEDION TOR AS NEAR AS POSSIBLE MUST ENTER APPLICANTS F I I I + IDENTWICAT10N NUMBER A'OOW DELXfS BY GIVING PULL AND ACCURATE INFORMATION. ED IN 001 APPILICATIONMAY SE RMWRNED- _ PRINT NAME AND ADDRESS NAME OF APPLICANT } j DATE APPLI ION srnETT/ S TELEfPfHO, N47. C.I 7 CITY OR POST OFFI E kk SIP CODE �y LICENSE NC- WHEN APPLICABLE. O 85 John Street C9- 1 State Street + F-I 570 Delaware Avenue I 0 217 Lake Avenue ❑ 202 Arterial Road NEW YORK, NY 10038 ALBANY, NY 12207 I BUFFALO, NY 14202 ROCHESTER, NY 14&M SYRACUSE, NY 13206 THE NEW YORK BOARD OF FIRE UNDERWRITERS