1988-713 r I ,
'CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
August 24 90
Date 19
This is to certify that work requested to be done as shown by Permit No. RA-711
has been completed.
This structure may be occupied as a Addition to One Family Dwelling
Location 12 Hummingbird Lane
Owner James & MaryAnn Urch
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY No 88-713
• WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to James & Mary Ann Urch '
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OWNER of property located at 12 Hummingbird Lane Street,Road or Ave. I
in the Town of Queensbury,To Construct or place a Addition—Screened porch
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
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2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
No. 15' x 16' as per plot plan, specifications and application.
p.
8. Proposed Use
Addition of screened porch to deck onto one family dwelling
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$5.00 C/O Cn
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 89 CD
(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.) CD
Dated at the Town of Queensbrtbis\ 28th D y of September 19 88
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SIGNED BY i��� for the Town of Queensbury
Building and Coning Inspector
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BUILDING and ZONING DEPARTMENT 7 WLIEE'NSF,i�.,�
Day an lJ d Haviland Road. R.D. 1 Box.98 N ( It/ h .
Queensbury, New York 12801BUI u
-s A roved by: SEP /9. )99
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46'' • APPLICATION I'OR � G,,(/
BUILDING AND 7.ONING PERMIT �'' � _�o
it it it it it it * * it * it * * it * it * it * * , * * it * it * * * it _—*--.e_:*--�fi * * * it ::•*F
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL 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
n,�is:
tt�r ,Jpot •4Q,Nr,�tm �/V V e i -' 7 4r-ys -
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P.U. Address !2 i-IVUY i J�0Sf�. ? 1ue,. .�,��La�IvU[.avlwl Tel. r'1' O1O
Property Location: (012- WI-S-6V IfiM6 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:
Name P.O. Address Tel. No. �••
Name of builder -IN L7/4, (/� Address 0 -Z (2V Tel. 7[3`4-1.6'i
Name or plumber Address Tel.
Name of mason Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction of a new building .* TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED,
,/1i'Idicion 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
FORDEMOLITIONPER1dI'1', S'1'AfPI: SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCPU1ws AFFECTED. * of water supply and location and configuration/ -/Xik,/ c P� 4 * of septic disposal area.
*
/s,1/.5JJ7H/h /Obe----- * COMPLETE INFORMATION REQUIRED BELOW.
. * Size of property ft X ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE: * Existing building (s) Use
•
Size of new structure /5 ft X lb ft ' . *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line -
(circle one) *
No. of stories (habitable space) * Front yard ft Rear yard ft
Height (grade to ridge) ft. * Side yards ft and ft
If residential, no, of families * If on corner, setback from side street ft
No. of rooms(excluding baths) * OCCUPANCY INFORMATION .
No. of bedrooms . *
* PRIMARY BUILDING -
No. of bathrooms * One family dwelling
Primary heating system Two Tamil dwelling •
Type of fuel * ' Multiple dwelling ./ Number of units
,No. of fireplaces to be installed * __Permanent occupancy
Will a wood stove be installed? * Transientermarmannn occupy
'Central Air conditioning? * occupancy
. * Business
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
- Other '
Ranch Contemporary Log cabin *w If addition, what will use be?
ised ranch Mansion Duplex *
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING- '
Colonial ' Row ' Town House * ' Detached garage/one car/ two car/ . car
('CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/_ car
* * * * * * * * * * * * * . * * * * • * Private storage building
ESTIMATED MARKET VALUE OF . * Other
CONSTRUCTION $ ]s'°1
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INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl .
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BUILDING 1'EIiI•MIT APPLICATION COI•ITINUED - •
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WILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. 404 L -
Will any second-hand or ungraded lumber be •used? If so, for what?
Foundation wall material4+vVAPAi 0l/ 2" 21/6/"m ickness
Depth of foundation below grade (to bottom of footing) I/P
Will there be a cellar? AID Heated or unheated Floor Floor sq. footage „21j9 sq ft .
Will there be a basement? AK}Will any portion be used as living space? //,
(If so, what portion? sq.ft. - - Type of use? •
Type of roof - ,sloped/flat/shed/other S4pp E04?Material.•of roof .KA -�
Size, wood studs "X " spacing "o.c. length ft.
Joists(floor beams) 1st. 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 • "X " spacing o.c. span ft.
Roof trusses (pre-engineered) spacing "o.c. span ' ft.
Exterior wall finish Of what material? ,S.-/2 z-' J O #-
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? efeb If so will a Fire-raced
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? 17,9 Height above roof • ft.
Depth of chimney foundation below grade ft. .
Depth of fireplace hearth . ft. in.
Wacer 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 nuecnsbury AFFIDAVIT STATE OF NEW YORK
County of 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 done 'on the described premises and that all
provisions of the BUILDING CODE, uH E ZONING ORDINANCE d a Cher laws pertaining to
the proposed work shall be• complied with, whether c ifie o - not, and that such work is
authorized by the owner. *
SWORN TO BEFORE ME '1'IIIS Signature__ -
0 Lr, owner's agent,arcnitect,contractor
day of 19 _
/ •
Notary Public, Warren County, N.Y. •
* * * * * * * * * * * * *
SPECIAL CONDITIONS .OF THE PERMIT:
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• By
INTERIM BUILDING PERMIT
PERMIT APPLICANT TAAIES UR. Cg.
CONSTRUCTION LOCATION //Uflfl AV4 Jnull A tit Er
EFFECTIVE DATE ;'
APPROVED / .
BY °
SPECIAL CONDITIONS :
This will certify that all submittals for a Building
Permit have been received and fee has been paid .
During the processing of the Permit, the above named.
may begin construction per plans submitted . It is the
responsibility of the applicant to obtain the Permit •
from the Building Department, following processing .
POST THIS INTERIM PERMIT IN A '• S. .CUOUS ON ! !
T U.riv O� C'4 SAC P,1, Ems:.. •DF.L. U1I!!11, 4aWW1
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SEP 221988 Building & Cv : es Department
BUILDING & CODE DEPT. TOWN OF QUEENSBURY
r. !! F. Copy
REQUIRED INSPECTIONS: 24 HOURS NOTICE REQUIRED!!
1. Foundations Footings, before pouring concrete.
2. . Foundations Inspections and Waterproofing, before Backfill.
3. Rough Plumbing, Heating and Frame Inspections before Closing in the Framework.
4. Insulation - Foundation, Floors, Walls, Ceiling.
5. Inspection of Electrical Installations before covering (rough in) and on completion
of job.- Final inspection certificate is necessary for issuance of CERTIFICATE OF
OCCUPANCY.
6. All new septic systems or repairs before covering any work.
7. Final Inspections before Certificate of Occupancy is issued.
THERE IS TO BE NO OCCUPANCY OF THE BUILDING WITHOUT APPROVAL.
OF THE BUILDING DEPARTMENT.
TOWN OF QUEENSBURY •
BUILDING AND CODES DEPARTMENT •
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804.
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIV D e r/e%J
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NAME 944,1teriik .i. ,:yz,z,...i., .1r✓ /f' ",/9
LOCATION �� �-1J.,,, `per
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DATE 4 9�) PERMIT # �P-71 i'
APPROVED
7 ' (_6 (‘'4-_9_,;_e, Z,d{' YES NO
FOOTING/PIERS \ r
MONOLITHIC POUR IORMS 1
FOUNDATION/DAMP-*ROOFING r
BACKFILL APPROVAL j
ROUGH PLUMBING f
FRAMING j '
ELECTRICAL ROUGH- N . I '
INSULATION: I
FOUNDATION
FLOORS ( .
WALLS
CEILING ' '
` FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING ' 1
SIDING 1 }C
EXTERNAL PORCHES/'•TE'PS
STAIRS-CLEARANCE . ••ILS
PLUMBING FIXTURES °ELIEF VALVE
INTERIOR TRIM/PRI j:CY DOORS
FINISHED FLOORS _
GARAGE FIREPROOF'?
DOOR CLOSER(S)
SMOKE DETECTORS 1
FINAL ELECTRICAL I SPDCTION '
FI_ NAL .APPROVAL OF ON 'RUCTION
OK TO ISSUE C/O OR C/ '
A SIGNED CERTIFIC TE O" OCCUPANCY MUST BE
OBTAINED FROM THE BUI i' NG DEPARTMENT BEFORE
THESE PREMISES AR OCCU'•IED!'
REMARKS: Ritaoam p 6_1766 .
CLE9s� o
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ARRIVE / /
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DEPART �`T,� /(•�� Allif i
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IN' •ECTOR
TOWN OF QUEENSBURY
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1. Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832
qam,ted i A -V71 //,� /{ �/ July 26, 1990
./.Z XTee,n G ffiV 9 -- `
G a-a-4- Y i'ir / r'YI
RE: Building Permit #if'i-7/3 �dd taerLalt--
Tax Map # --',i ;Sr
Dear '. ''/V"- 4"cA . _
The Building Permit noted above has expired. All required inspections have not been.
not been completed.
Please contact this office no later than August 9, 1990 to (1) arrange for one our
inspectors to complete the necessary inspections, or (2) to apply for renewal of the permit.
Very truly yours,
DAVID HATIN, DIRECTOR
BUILDING do CODE ENFORCEMENT
DH:lm
IN5eXlitmi
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