1988-942 R ' Y
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY -
WARREN COUNTY, NEW YORK -
Date P1a rc h 30 19 90
This is to certify that work re uested to be done as shown by Permit No. 88-942
has been completed.
This structure may be occupied as a One Family Dwelling - Addition & Deck
Location Cleverdale Rd. 3oo �� 5k a -/1-
Fred Alexy .
Owner
By Order Town Board
/ TOWN OF QUEENSBURY
t /) _f .
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Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-942 a
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Fred Alexy
OWNER of property located at Cleverdale Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition— and deck
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
Cleverdale, N.Y. 12820
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2. CONTRACTOR or BUILDER'S Name
Joe Roulier
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name C�
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5. ARCHITECT'S Address (D
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( I.Masonry ( ) Steel ( )
7. PLANS and Specifications pa,
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No. 12' x 16' addition with deck as per plot plan, specifications and application.
Variance #1436 STTF. PT,AN 57—RR _ R°
8. Proposed Use d
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Addition and deck to one Family Dwelling
25.00 C/O
$ 24.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 1 19 89
(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.)
Dated at the Town of Queensbury thi 28th Day of December 19 88
SIGNED BY for the Town of Queensbury
Building and Zoni g Inspector
TOWN OFiQUEENSBURY' APPLICATTON FOR BUILDING AND •ZONING 'PERMIT
Va.- e- .
. • Peci.eued A �q, e: TOWN OF QUEENSBURY
rye � f - RECEIVED •
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.' s` F y• , .-A: � � DEC 1 1988
Fee .F, S �9
BUILDINC AND CODES 'UI:PARTPiF)(I' Date Idaued BLDG& CORE DEPT. '
,3AY and NAVILAND ROADS RD 1 Box 98
pUEENSDURY,NEW YO/K 12804 Pewit N0.gg-94/ ' _ O � C,d..
Tel . (518) 792-5832 Ext •209 t
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' A PERMIT MUST B4 OBTAINED 'BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS .
• I+'ILL . BE MADE UNTIL` APPLICANT .IIAS RECEIVED A VALID BUILDINC PERMIT.
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All. applicable spaces on this application must be completed and the
s•iivature of the applicant must appear on the reverse side of this sheet .
7: * t * '* * * * * • * 7: 7: A * * * *.- *. is * * .* * * • * * * 7: 7. * * *
The: owner , of this property is : �� ---; ...1(` �r.
P . a. 'Address �G// <
< , V . ' /.10720 TEL. Cr-4 -
CvcM� -
Property location s-7"--- /7;---jdo eZ.„,./, TAX MAP N O /r / L--/ 2-- ..
Y Has theresplit Of this ropertyy -since October 1, 1988? /, 1/..
iIf yes , .Planning Board Review is necesSar/Y
SUBDIVISION- NAME., IF APPLICABLE
�//II• LOT NO. yes no
The -pers n responsible for supervision.. of work as regards Building .Codes -is :
NAME. )�(// P O . ADDRL/BS TEL. NO.
Tel
Name of builder. 54�7� Address. Tel
'Name of.Plumber ,vft Address •
Name of Mason ,IG �,_ Tel �r9- e.7as
�. sa.�e. Address �� 1.,.�
NATURE OF PROPOSED. WORK,: ZONING INFORMATION (Office use only)
cructior► of, a new building * ZONING DESIGNATION OF PROPERTY (�,41 0r n:.
addition to a building * PERMITTED PRINCIPAL PERMITTED ACCESSORY
Alteration to a building , REVIEW REQUIRED - PLANNING BOARD ZONING BOARD—
(no change to exterior dimensions) �,•
Oci�ur work (describe) ; SITE PL•AN REVIEW '#( 7"$g APPROVED )C DATE G
VARIANCE # APPROVED DATE
CROSS • AREA OF PROPOSED, STRUCTURE * . /
Remarks: „jet. .4 :'i,.:4/s 4i c.., a /.o,.,e /
lst • Floor %9� sq ft . . �jA
2 nd Floor . ' sq f t . .. COmPLE'PE •.IN1�O1artA'E'ION REQUIRED uELOW. . .
* Size of property ' ./d .$ ft X r /ter ft.
Other 'Floors sq ft • . Existing .building(::) Siz.:4.7i ft X ,fie rc.
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( not cellar or basement) „
TOTAL FLOOR AREA_/9.� sq f t . '� Lxi::cing. uuilaincl (s) Use .
laze of new structure 44 ft X/G ft . '
t•'ou,idation-pier/Slab/crawl/partial/tell * Proposed building,, distance from property line
(circle one) r Front yards�T /7 u t Rear yard-✓ Vo ft
No. of stories (habitable space) ' l Side yards -- ft- ft and ^=-tT it
Ueight (grade to ridge) ^-/•Z ft. . w It on corner, setback from side street ft
1 f residential, no. of fainilies •
OCCUPANCY INFORMATIONNo. of rooms(excluding b• ths) ' / -*
tto. of bedrooms Al +q ; PR Y BUILDINC .-
No. of bathrooms v •G One family dwelling
'i'rivary heating sy::tem .i. S f Two family dwelling
�ryhu uP fuel '� +� x Multiple dwelling ./ Number of units '
No.. of fireplaces to be installed., 4 R •
Permanent occupancyWill :� .wouJ :;rove be inst:,llc:.. ,✓o Transient occupancy '
Central Air conditiuning? APa *4. business
• BUILDING STYLE, PRIMARY STRUCTURE „.._ _Industrial
, ocher
t‘►nch. Conteui�GYLir n cabin M It addition, ,what will use be?
tied ranch -ion . -Duplex
• split level Old .style bungalow
' Cape Cod ' Cottage Ocher ' ACCESSORY BUILDING-.
Colonial _ • l:ow, Town House • Detached garage/one cur/ two car
.car
. ( CIRCLE ONE: PLEASE ) ' Attached garage/one car/ two car/ • Cur
' A * A * * * * * I .A * *- * * * * .* * Private.storage building
ESTIMATED MAR1:ET VALUE OF * .Ocher
CONSTRUCTION - s
6P%sos
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET,' TO BE COMPLETED:
' Form BPA 10/88 vl -
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BUILDING PERMIT APPLICATION CONTINUED - •
BUILDING SPECTFICATIONS: •
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Type of• construction, wood frame, fire safe,etc. oea e •
• Will any e:econd-hand; or ungraded lumber be used? If 'so,'' for .what? .✓o
Foundation' wall material /se< Thickness /o '
Depth of foundation below grade (to bottom of. footing) ye' " ' i "
Will there be a cellar? doa, Heated or unheated? Floor sq. footage /9.Z sq ft
Will there be a basement? Will any portion be used as living space?
(If so, what porti n? sq.ft. - - Type of use?
Type of roof /flat/shed/other Material, of roof
Size, wood studs .4 "X G " spacing /, "o.c. length F ft. •
Joists(floor beams) 1st. floor /1//p "X " spacing "o.c. span ft.
Joists (floor beams) 2nd. flo r ,v/.a "X " spacing "o.c. span ft.
Overlays(ceiling beams) N7)x " spacing "o.c. span ft.
Roof rafters J "X /e " spacing /4 o.c. span "2. ft. .
Roof trusses (pre-engineered) spacingA,./* "o.c. span ft.
Exterior wall finish / '...e�„44 Of what material? /6• Le
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 Distanc,e from ANY private well(including .adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
DECLARATION
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. $UILVING CODE, THE ZONING ORDINANCE, and all
other laws pertaining to the prop'dsed work shall be complied with, whether specified
or not, and that such work is authorized by the owner.
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Signature
O _r, owner's agent, a itect, con
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SPECIAL CONDITIONS OF THE PERMIT:
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By •
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK ..
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. Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW- YORK'
STATE ENERGY-CONSERVATION CODE.'" .
A permit must- be obtained before beginning- work
' • ANSWER ALL of- the following: •
_ 1.. Gross floor area /lr..l
2 . Type of heat .S•Ciar — • 1, ` / .G7o/ ,
• '3 . Is the building mechanically cooled? -i/O
4. Percentage of area of windows and doors .
A. Over 161 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 .
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perimeter of floor?
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4 . Is basement heated? YES • NO .
a. R value of insulation
5. Type of insulation
B. Under 161 Only '
1 . R value of oof and floors exposed to -ambient conditions ;
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. 2 . R value of exterior walls c ' /
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•3 . R value of glazed": area .,.3'
4 . R value of doors 41./'4 •
5. R value of floors over unheated spaces
6. R value of slab edge insulation - unheated slab .
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7 . R value of slab insulation - heated slab
8. - R value of heated basement/cellar walls, (above :grade) ,✓��
9 . R value of heated basement/cellar' walls (below grade) 46.1
10. Type of insulation L/.</ev::. - �-.u was
C. Controls . ..
1.- Thermostat maximum heat setting ' N� - . '
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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 Gsficiency
• 2.. , Temperature control setting maximum'
G. For Swimming Pool Only - •
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1. Maximum heating •
Telephone No. /7-e e- 3cYy
(applicant s signature) "
JCLCI..I tlu JIIVCJJ rt.)FiIVIJ IOU ) LGtl-7/70
APPLICATION FOR ELECTRICAL INSPECTION
PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES
��w�..� a ; MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
_/ i National Headquarters
900 Haddon Ave., Collingswood, N.J. 08108
APPLICANT COMPLETES THIS_SECTION' Date:
City, Town or Township I1 r_s County�//a....._ State X.
Location/Address ��.e.-7- .,,,,1
)If Looted in raI Area - Please Attach Directions) Pole #
Owner ^.. 'c Permit # c1--" G/e/7-'
Occupied As - s •,: " 1:91"1 ec.e,rur•i'
Building: New❑ Old❑
Occupant w IrS. .
Work Area in Building (Floor #,etc.):
App. for: Wiring n Service❑ or: Ready for Inspection:
Fee Remitted-$ Cash n Check M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat
Switches
Lighting Amp. Service Surface Unit Dishwasher Range
Receptacles Water Heater Air Conditioner Dryer Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
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MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's
Signature License # Permit #
T/A Utility:
Applicant's Address: ....�4 4! ,3•/ (NAME) (OFFICE LOCATION)
(City)���w...4 (State) .01,'. Y. (Zip)/2? L.. Service Request #
Phone # .1� e re -j,�y Electrician:
NIDIA USE ONLY DATE RECEIVED:
DATE INSPECTED:
Correct Location: Same as Above n or:
Red Notice Label n
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer
Amp. Service Equipment Burner, Wiring &Controls for Amp. Receptacle
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 1 30 40 50 75 100
Mark Number
of Each Size
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat
CERTIFICATIONS , USE FOR INITIAL VISIT ONLY ,NOTIFIED .' DATE '; CORRECT.: FEE PAID
.. ... ., . . , . P , • . , FEE...
❑ RW Progress: Inc.❑ LKD❑ Contractor
El CFT Violation: Work Comp.El Inc. El
n L/A Owner CASH El
CI L/A Fee CHK #
TI IPA Due MO #
Municipal
INV #
Applicant 0
Date: Other Side❑ Utility Owner
Cut in Card n Temp # Date
11 .-•_ , � .. . INSPECTORS SIGN ATI IRU
' rJ•I• cJ ttJ LAIN, t/44 J J ,\ �\ ,` ,-
MIDDLE DEPARTMENT,INSPECTION AGENCY, INC. �,//)
900 NadwenuerColtlngswood N'J�08108 '
,55s,,. � ,.,.. .trig
f ' . Ci.'„ Date November 3, 1989.f�
Certlfle�that ttle;elec�Car_equipm ne t listed has been xam r]ed-an 1 approved as being in accord
P with the National Electrical Glode applicable governmental utility and,Agency`miles.,
0 / of .' . 'ya
�p� d p y1A . -sites C'
7 'Ar „, . 4 .DWei In
Owner: Fred Alexy * � 7� *,,� i acpupan' g y , IOccur ant: Same o " ,, g`Y [�i...._ �"'f,-V' P'V, A )�,..sw.an.'.'.a7 A[xi1'n- FSrM� ili 1 `-� � Y,J East Ti Cleverda].e Queensbinrryc�i iWarrehs�Co), N\ i .Location: P f Qmt �J� s certificate covers ttiQ�lectnceF equipment antl installation inspected thistdate. If additional a:qui�rrtent(shou be introduced or alterations made to
y existing system this certificate sha I be null and void. and application for
23 Outlets• =, O\Itb Rece tacles• 5 t res inspection should lab submitt�promptlytothisAgency.
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Equipment: � P � �u�, a rr'older of this certificate shoUld�pf dent same to his property insurance carrier
�:-. fagentorcompany)asevidenceOf ertificationafelectricalequipmentapproved
h as specifie � � `
Fred Alexy ` - r„ :j1 ,P3 _ -.—i:''
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Applicant: General Delivery
w r NO. 15-020830 `
L Cleverdale, NY 1282� ""' � ��
a1 n nMf'1u-1.aA.n *rocs.. /'. - Ann. o1.*.l1nd./sr1 {� Anr\ ru sa rl + rk.41106. 4r 111•0
6;)'--
TOWN OF Q,UEENSBURY
BUILDING AiD CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURYJi NEW YORK 12801.
TELEPHONE ',(518) 792-5832
j
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BUILDING INSPECTORS REPORT
REQUEST FOR'1INSPECTION RECEIVED ,i' (�� ; �
NAME red it
LOCATION el eil era 4,,p_ei Rs
DATE 3pq 1 4:b P RMIT # eg _*401
4 I APPROVED
Add¢ --D2C YES NO
FOOTING/PIERS I
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING 1
FRAMING I
ELECTRICAL ROUGH-2*
INSULATION: &
FOUNDATION
FLOORS '°; I
WALLS .. •
P. �"
CEILING ;, i.
X FINAL INSPECTION: p ek -
CHIMNEY HEIGHT I
ROOFING ' s L/
SIDING V-
,
EXTERNAL PORCHES/STEPS V
STAIRS-CLEARANCE & RAILS a/.
PLUMBING FIkTUR4/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS ✓
FINISHED FLOORS ':\ V
GARAGE FIREPROOFING -
DOOR CLOSER(S) ,
SMOKE DETECTORS '1 -
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
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A SIGNED ERTIFICATE OP`kOCCUPANCY MUST BE
OBTAINED ROM THE BUILDING DEPARTMENT BEFORE
THESE PRELISES ARE OCCUPIED!
J. N
REMARKS:
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/D ) INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280�
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME .R (26 (
LOCATION (4_,./C f iA,,e-A (/ ) .;,
DATE 17- 6 -XI PERMIT # Or- 9 Y a
' APPROVED
C/ 4--- CAL/:/-e c, // e-77 YES NO
FOOTING/PIERS
MONOLITHIC POUR 'FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL '
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION 1, ,
FLOORS 1,
WALLS i .1'
CEILINGIrr
NAL INSPECTION: /
CHIMNEY HEIGHT •, /
ROOFING i/
SIDING V
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EXTERNAL PORCHES/STOPS (/
STAIRS-CLEARANCE &j RAILS I. )�-
PLUMBING FIXTURES/RELIEF VALVE 0)A-
INTERIOR TRIM/PRIVACYDOORS
FINISHED FLOORS y# ✓
GARAGE FIREPROOFIPG '°+, IJJA'
DOOR CLOSER(S) 1 ,, kv -
SMOKE DETECTORS 1 1 G�
FINAL ELECTRICAL INSPECTION �
FINAL APPROVAL OF CONSTRUCTION V/
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A SIGNED CERTIFICATE OF OCCUPANCMUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED! N
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REMARKS:
C1)AkED Altr6-5 VM < JfAhe Befi-t+ 5:p�s o .
044_4, z , I4.)5 p2-r1°It 4(14-'2'
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INSPECTOR
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 RECEIVED 2"/E-
NAME _
Ifs
LOCATION E,.0 � (
DATE o`^) 7—cs 1 PERMI`Z # 992-
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING \ �>
FRAMING
ELECTRICAL ROUGH-IN +.
INSULATION: -t
FOUNDATION
FLOORS rK
WALLS � .
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT �.
ROOFING• r
R
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RA''ILS . •
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS /
GARAGE FIREPROOFING
DOOR CLOSER(S) 6`
SMOKE DETECTORS
FINAL ELECTRICAL. INSPECTION
FINAL APPROVAL :OF CONSTRUCTION
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A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
REMARKS:
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✓ ' 4,
INSPECTOR
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TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280i-
TELEPHONE (518) 792-5832 -121(6
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED /_�.2--.
NAME ��
LOCATION ( � Y
DATE /,5•-- PERMIT #
APPROVED
YES NO
/4O0TING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN -
INSULATION:
FOUNDATION
FLOORS •
WALLS
CEILING
FINAL INSPECTION:\,
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS/
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS ; •
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS/
FINAL ELECTRICAL INSPECTION ','
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
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INSPECTOR
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