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CERTIFICATE "JV Cl'31VIFLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Late June 29 19 89
This is to certify that work requested to be done as shown by Permit No. 89-412
has been completed.
I
This structure may be occupied as a }S'XJZ laming Fily Dw�eliina wJSkyliflbtLocation {J �i c ain Road
' C7wncr Anthony Theresa Wetherby
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By Carder Town Hoard
4 TOWN OF +QUEENSBURY
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Director of Bldg. do Code Enforcement
BUILDING PERMIT
01
TOWN OF QUEENSBURY
No. 9—¢]?
WARREN COUNTY, NEW YORK
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PERM(SSI0N is hereby granted to Anthony a Theresa Wetherby
OWNER of property located at Rnx aig me4qt mountain Road Street, Road or Ave.
in the Town of Queensbury, To Construct or place a .- Skylights 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.
t . OWNER'S Address is rn
Same =
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70
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2. CONTRACTOR or BUI LVER'S Name
Sel f
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3_ CONTRACTOR or BUILDER'S Address
!ie
Same
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4. ARCHITECT'S Name
6, ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
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( } Wood Frame l ) Masonry I } Steel
W
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7. PLANS and Specifications
No. Three skylights as per plot plan , specifications , and application .
B. Proposed use . +
Skylights in Single family Dwelling `
woev, 040;; nrtf r$ :� PERFEE PAID --- THIS PERMIT EXPIRES JANUARY 1 19 90
(If a (longer period is required an application for an extension must be made to the Building and Zoning inspector of the �
town of O.ueensbury before the expiration date.) �t
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Dated at the Town of Queensbury t th Day f June 19 89
ci+
SIGNED BY for the Town of Queensbury
Building andZ o ing Inspector
1C) LV:V OF f,� UEE.�,'Si3L' RY , nn I ^; , � t' rr� r `, C a �rD = ' vTvc- PI Z �rTT
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1 'C
TOWN OF QUEENSBURY
FeC F'a,cd JUN S _ 1989
FU I LD INCH AND CODES U1 .! 'A[MfE T Date Ies,sued
JAY :, nd ffr1VILAND ROADS RD I Dox 33 � ��� BLDG. & CODE DEPT,
F7UEEhISAL1RY , NEiJ Y(7Rri l2dd-f Ch1n.c.� NU . _
Tel ( 518 ) 792 -533.� Exc 204
a ,r t ■ w ■ .t ■ : • * t f . R ■ ■ f a ■ • ■ r ■ ■ • . w • • • • it x • w
A 11EW1IT MUST BID 0AT'AI �jFD 13C. FORE BEG INPIINO CONSTRUCTION * NO INSPI: C"I' IONS
VI LL BE MADE UNTIL APPLICANT HAS PECEIVED A VALID BI; ILDTNC PERMIT .
All applicable Spaces on this application must be conlplleted and the
ipaatare of the alplicant must appear on the reverse sick of this sheet ,
* * k k * Ilk 'It A * * k * * x *
The owner of this property is t'X-124r-1 Tf Y1PYP � �r � � O L[AiP tiQ it
r O . Address t yriCr3frY1 I ----TEL .
Property location f-00 TAX MAP NO . z1 I / e)
alas there been any split of this property since October 1 , 1988 ?
yes no
1f yes , Planning Board Review is necessary . LOT NO ,
. UBDIVI5ION NAMC , Ir APPLTCA5LE
The person responsible for sup %a. rvision Of work as regards Building Codes is :
NPAIE P wO . ADDRESS T No ,
rrame of builder Address Tel l
[4"mo of Plumber )'*ddress Tel
Name of Mason Tel
r4,tiTuf2l= OF f'ROr'4I� L=❑ W )l.b: : ZONING IN ! C3RmATION ( o f .ice use only )
rnrl : tructi :n of a roc w buildir�7 'LONINc, OCSICNATION OF PROPERTY
AdUics.on to a ltuilalinq + PERMITTED PRINCIPAL PERMITTED ACCESSORY
�A1L %jC"r_ i0a to is Luilding
,^+110 CF,.a, u] , to a:xc � ri,Dr airncnv- iona ) REVIEW REQUIRED - PLANNING BOARD ZONING BOARD
work (..1u ::cribc! ) 5y IL3nft.. ' SITE PLAN REVIEW # APPROVED DATE
"KOSS ARL:A O!' 11ROPOSCE). : 'PfrUi: 'L' Likli + VARIANCE # APPROVED DATE
1st floor sq ft , Remarks :
nd Floor sq ft Cd1t['I.1:"1L: LMI {SirVk'1'LOIv 1c4r�uI1cLD uLi.�+41 .
Ocher Floors sq . fr .. 3ir'u of Esrol,Lrty t_ t x rC
( not cellar .jr basQma: ne )
"isCiA1y tauil�(Lll�l � ) 5 � � 4 1_ L X rz ,
TOTAL FLOOR AREA ^ sq f c ' Lxy .cylrg ria. a l ltny Imo ) Uau
t. i '4" of new s' crucruru ft a ft
1'uus,d:+ cion-rsiar/ s1aL/Cri+wl/l}3res�.1/ full ` NroI34 .cd builurng , cli . c :►ncu craru L, rotaurty 11 (5+:
Icirt;1Q one ) r1wt ft
N.L . of ocorierm (tkal iic:•bla: ::'lance ) l S40- ' Front y:, rd r L Rear yard
11%; ighc ( urado to ridq%j ) ft . If
ycQrnrdu— rc om is
1f r04id0ncial , noo of f:amilie : If an cc.rnar , ;,a; cl].►C�c Pram side szcucc fc
No . of b"chss ) ' OCCuPA"L;Y IINFORMAT ION
Ire0 of budrooras FRZ13 RY f+L12LD3NC:
NO , of b+ac)Irocasl::� 1 - ■ Onn ia,au.ly dwelling
I'ri16:arry 11u.aciruj UYULwn_ 0 +. 1 1-f0 # % * '1'wt3 it-Am-ily dwulliriy
'rylru asf C%LQI � r t y Multiljl%s alw`llinq / Number of units +
No , of firuirlac.: x to Lr- in;:t:.11ed � S,erlrtia�riL:rft occupw4cy
WtLI :. wuaial s4t1Vr3 � irr�t:. 11a.:+3?��^ '
* 'Lr«►n::ia:r�t truculx:•r�cy
ctAntrwl Air l3usinubs
BUILDING STYLC, PRIMARY STRUCTURE . 1' nrsusLx131
Iurrc LW►ta:uil+Grwry "49 cabin Oth,.r
I:.Az'"d VaAch M"n■tit+�1 D6yl,la:x r Ir ,,ad3itiun , rr( u.aC will u::a: bast
-------------------
:ALsliC IUVQI Old .icyla: uu4uj%A1Qw
C: pu Cod Coct"4rjj Or. Iwr * ACCLSSORY UWILDINC-
CaLoni •1 itow i'4w+� House " l►astaChdtt y,ariago/one car/ two c:r< r/ car
( ClaCLL•• +Ome PLEASE ) ' r +cctac r1a l U"r"Sw/Qs14 C&r/ two ca:r/�caa r'
• ■ ■ ■ • . ■ fr ■ . • ■ ■ + ■ +r ■ ■' Priv4c" stor"gQ builtLing
LSTIMATED MARKror VALUE OF ' r—Oche r
CON :.:TkUCTT (jN •
INFORMATION ON ourLDINC SPCCIFTCATIONS , ON REVERSE: SIDr_ OF •rltTS CFtLE'l`, 10 Be COMPLC'TE01
Form ,BPA I0/88 v1
BUILnIrNC PERMIT APPLICAT!,:_ N C :: T '_NUE -
BUILDING SPECIFICATIONS :
;ype cf constructioni wood frame , _ re safe etc .
'o,` ill any second- hand or ungraded iu; tr be uved : If so , for what ?
Fcl,mdation wall material Thickness
Depth of foundation below grade ( to bottom of footing )
will there be a cellar ? Heated cr snheated ? Floor sq . footage sq 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 fr .
Joists ( floor beams ) lst , floor " K " 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 ?
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)
DEC LA RATION
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 pE'emises 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 , architect , contractor
SPECIAL CONDITIONS OF THE PERMIT .
By
..........
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS ! '
QUEENSBURY . NEW YORK 228016
TELEPHONE ( 528 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR ,INSPECTION RECEIVED
NAME
LOCATION
ATE, #
APPROVED
YES I NO
FOOTING/PIERS
MONOLITHIC R FORMS
FOUNDATION/D —PROOFING
BACKFILL "PRO L
ROUGH PLUMBING
FRAMING
ELECTRICAL�ROUGH-14y. f
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
t.ef.TNAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
SXTERNAL PORCHE /STEPSr�_
STAIRS^CLEARANC & RAILS
PLUMBING FIX TU ES/RELIEF VALVE
INTERIOR TRIM PRIVACY DOORS dd
FINISHED F S
GARAGE FIREP COPING
DOOR CLOSER ( )
SMOKE DETEC RS
FINAL ELECTRI AL ,INSPECTION
FINAL APPROV L OF CONSTRUCTION
A SIGNED CER FICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED'
REMARKS: —�
t/
J1?XNSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSSURY. NEW YORK I.280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INS ECTION RECEIVED ` �
NAME
LOCATION
DATE ��� — ��i PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL
.RO GH PLU Blm(x
RAINING
ELECTRICAL ROUGE—IN '
INSULATION:
FOUNDATION
FLCk7RS r
WALLS
CEILING s
FINAL INSPECTION:
CHIMNEY ,HEIGHT kJ �----�—
ROOFING��_ — --�—
SIDING
EXTERNAL PORCHES STE �.
STAIRS—CLEARANC & RA LS
PLUMBING FIXTU SfRELI VALVE
INTERIOR TRIMf RIVACY DOORS
FINISHED FLOG S
GARAGE FIRED FING
DOOR CLOSER ( )
SMOKE DETEC ORS
FINAL ELECT RI AL INSPECTION
FINAL APPROV L OF CONSTRUCTION
A SIGNED CE IFICATE OF OCCUPANCY MUST BE
OBTAINED FR THE BUILDING DEPARTMENT BEFORE
THESE PREMIS S ARE OCCUPIED!
REMARKS:
pe,
i o
INSPECTOR
5own O u e E'm 3 kt r B U I L D I N G & C Q D E S D E P T .
THE PLANS SUBMITTED HAVE BEEN REVIEWED AND
HAVE BEEN FOUND TO LACK SUFFICIENT DETAIL
FOR PROPER PLAN REVIEW ,
WE HAVE ISSUED THIS PERMIT WITH THE
FOLLOWING STIPULATIONS :
1 , THE WORK WILL BE INSPECTED AND MUST CONFORM
TO ALL PROVISIONS OF PREVAILING CODES .
2 . IF DEFICIENCIES ARE FOUND THEY MUST BE COR -
RECTED BEFORE WORK CONTINUES .
3 . FAILURE TO COMPLY WILL RESULT IN REVOCATION
OF THE BUILDING PERMIT
Co e Enforcement f.tce.r
' ' _--
Da t e
C Z� _
Building Permit #
COMMENTS :
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SCALE: f/ I' f� �� APPROVED BY; DRAWN BY: � f
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DATE: REYISEO:
DRAWING NUMBER TOWN OF D E PT.
F.. i i 41 61)
DATE
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