1989-541 H Y . . . R' :..-..,@y1�.�•"" rtft+^_r .,T., -moow.. .. . .., ,. .4P TOW
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I
CERrnnCA r CIF OCCUPANCY
I TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
This is to certify that work requested to be done as shown by Permit No. 89--541
has been completed.
This structure may be occupied sue a Addition to Single Family
l Location .—_ —�� Pest Mountain Road
1f der David Schreckenberger
k
By Order Town Board
TOWN OF 4UEENSDURY
Director of Bldg. i3t Cade Enforcement
i
BUILDING PERMIT
TOWN OF QUEENSBURY No. II9-541
WARREN COUNTY, NEW 'YORK y
1
1
PERMISSION is hereby granted to nayi d Crhrocenberger 5 f
OWNER of property located at Box, 149 West fhrintain Road Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Addition to Single Fami i y
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 y
Same
ty
2. CONTRACTOR or BUI LDER'S Name �
rn
Steven Miles m
as
M
3. CONTRACTOR or BUILDER 'S Address
G
4C
RR#2 Box 2435
Lake George , R . Y . 12845
4. ARCHITECT'S Name
S. ARCHITECT'S Address
}t
6. TYPE of Construction — (Please indicate by X) U0
( ) Wood Frame ( ) Masonry i l Steel ( ? TD
to
eh
7. PLANS and Specifications
c
No. 14 ' x 16 ' addition to single family XiXX as per plot plan ,
specifications , and application . �•
8. Proposed Use
Addition to Single Family
a
rz
$ 16 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES February 1 1990
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Ciueensbury before the expiration date.)
4r+
O
Dated at the Town of Queensbury this 13th Day of July 19 89 C=
SIGNED 13Y for the Town of Queensbury ly
wilding and ZonibTl nspector
V
lO 'M i✓.�`ryfr r - V'EE;tiSF LYl�. i rj rrrli^ r �: r: ,,. 'J ?l ,• -• , Pr 7 �� • �•
l ' til
TOWN OF OUEEWSBURY
RECEIVED
FaC Paid fi JUL 10 1989
rAJ I LD I NC .1h'.D CODES ui .! 'AWDIENT Dace I.sa +.aed
AY and UAVrtL 4ND ROADS RD 1 BOX 9d �� BL.DG. & CODE DEPT,
nUEENSBLIRY , NEW YORK 3 ?d o .i PcAjn4t t NO . "�� / f I _
Tel . 153d ) 792 - 5832 Eve 204
■ ■ • At • • r • : ■ IN r ■ • AN ■ ■ r ■ • IN ■ IN ■ ■ • No IN • ■ ■ ■ a IN a IN a
A PEEWIT MUST DO OBTAINED Ur- it ORE EECINNINC CONSTRUCCTION . NO INSPUC`rIONS
VILL BL MADE UNTIL j\ PPLICANT HAS P.ECCIVED A VALID B ILDINC PERMIT .
All applicabl4 spaces on this application must be completed and the
i nCa cure of the JVPl icant roust appear on the reverse sick of this sheet .
The owner of this property is : u ' �r_
tr . U . Address C� TEL ,
rroperty location 'TAX MAP NO ,
teas there been any split of this property since October 1 . 1988 ' /
y ,as no
If yes , Planning Board Review is necessary .
SUBDIVISION WAME , IF APPLTCAnLC A/--/� LOT lit] .
: , he person responsible for supervision of work as regards Suilding CodesNAME
�I F . G . ADDRCSS TEL . No
;t.amts of builder_ ddress o� �✓�' r s}. G. c� Sa
04..maa of Plumber bf _ Fdaress 'Tel
reams of McasRan a A i ."+13rca Tel
„1TuRE Or- M:OPOSCO 6t III. : + FREVIEW
IN1 0t i.,%,rrLON foffice usra only )
4
_.:tsn : truccior, of a r ,4w bui1R11n7 • SICNATION OF PROPERTY
4A4WLtion to .:A 1auilaitig • PRINCIPAL PERMITTED ACCESSORY
AILuCrLion to ,a l.uildincl
� Oto c1 ,.+Rr,] . to uxt � rior ctiinanALinn� ) • QUIR.CD - PLANNING BOARD ZONINC B ARD�
SITE PLAN REVIEW 0 A1210ROVED DATE
+
L` .1 0V to R0POSi D. . 'r [LUL'PI.J k b7. " VARIANCE IF APPROVED GATE
KQSS Aft
. st floor sq ft . Remarks
and Floor sq f t . . iCOmPLL"s'►: 101'OkMANVIOV 140 :UL"LQ ut.; LLjWo
q f
--- ' Sirs o f peopurty. /vim/ r c x f c .
;ithcr Floors sq ft r
not cellar ar b4sementl eaei:.Lis"J L' uil.di, o+� ; � 1 ai _w a c x
r' c .
TOTAL FLOOR ARZA1 22 2�sq f t • Lx1 :. Lial�] Du + 1 .tLnJ ( � 1 u �sw
L' iau of new zcructur,: .ft x
1 'ucs.d:+ tion-Ixiccf�lst./Crawl/ ;sarti.al tul ' YrRalsoaea tau �laarsq , d.L eanc,; iroin l,rol-surty L3*ItU
(cirri.: one ) - "� � fc
'N3 ^s. of tories (1"bic:ahl. to: p4acc ) . i'rOnt yaard ft Rear yard
Sidoa yardu r t ;anu it
tt. ighC ( Yradu to ric39u ) ft . • ri an cUrnar , ;.uci "4k frosa sirlu atruLL cc
Ii rsaiwssntial . e^►o. of rb',:►miiiGs��
tic . of rows3 [ uxcludin4j b:..cha) I ' OCCuf'WNc:Y INFOrtr1ATION
tto * of budroomu D '
PrUMARY 2I
ra & of pachroomu Qus fawAly dwelling
.
••risr+ ry
+ Ltiro fasaily dW.alliny
"ivvu of Lu ll Gfw � * Mults.yal4 ,lwulling f Numbar of units���
woo of firoo;lilacosa: tQ 4W ingt"14=n 114tra■:ncsnC OCv'u[s:Yocy
trail r wuu.i aicOvu l++a ir�a:c :.11..it ' ' '1'x"Auiwsic aucut' "t4t:y
L;9SAt.CRrl Air CO9Jdo"tiGkni49k4j:" 1t b + D"zi.nums
WILDING STYLE,, PRImAAY STRuCTUAE * lnrsuscrial
l,;arlcll c:ontooms c.r..ry LoQq c:.WL8% + Other
c+.■ iaiwd riilCbl lR1.ar►Rii4�i Deal,l.:x r = � "4diLioA * rt ,rat Will u:,,;e boo?��
:ib�liC lssv.sl Old rcyl.s 1a4awJ.aloW • — ^
Cotcatjo 4ttwr • ACCESSORY UUILOIWC-
CRxi0ai .1 IRJ; W 1'OW�, tbGus• "- tacheu y.ar.Ago/one Ciar/ tWO Cal czar
I. CIRCL4. C)HU PLUASI: I • Attach.:,1 C&r/ two Car/ Ctaaw
a ■ • • • r • a ♦ r • • ■ r s • • ► loriv" c.: scot aga building
LSR' Ill ^%ova 94ARKc4r yAt.Ue: or • Othsr
INFOR ATIOer ON nUILDtHC SPECIFICATIONS . ON ncvrmse slDr_ OF TttIS c"tEL+r, a1r0 Se COMPLETCOR
Form aPA 10/80 v1
' w
�LILDINiG7 SPE � FICA7IONS :
construction , wood frame . _ Ire ssf � , etr . __ ,sar.0
rywll a.ny se . ond-hand or ungrade3
JLir.dSt Ion wall material
Gepth Of foundation below grade ( _ c bottcm of foot'in )
Will there be a cellar ?� H?ra$ te-.' or un` d �
:eate ? 'Floor sq . footage sq ft
Will chars be a basement ? will any portion Ice used as living space -".
,/:17
t If so , what portion? .�&pV~e_ sq . ft . - - Type of use ? /mac
T . re of roof - sloped/ flat/shed/otr. er�_ titatarial of roof �h.ay�nit�
Size , wood studs " xT�_" spaCIng o . c . langth ft .
Solsts ( floor beams ) 1st , floor " x spacing " n . c . span ft .
Joists ( fioor beams ) 2nd . floor "
,.:verlays ( cezling beams ) " X spacing " o . c . span ft .
Roof rafters 2 " X " spacing ,� c . c . sF.an ft ,
Roof trusses (pre- engineerred ) y spacing "' o . C . stria [4�, ft .
Exterior wall finish_ ma`s Of what material ?
Interior wall finish ; y ,p,�
If a garage is to be attached , describe materials to :e used for FIRE SEPARATION :
Odle* R
Ts there to be an opening be wee. garage r.d dwelling ? if so will a Fire - raced
door , enclosure , and self-closing device be provided?
will a flue - lined chimney be installed? ,.� rp Height above roof .. ft .
Depth of chimney foundation below grade — ft .
Depth of fireplace hearth ft ---------o%n .
Water supply - Municipal or private well ^../C7
SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining propertiesdta.f . 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 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 ti _ S ,V�,,,.
Owner, owner's agent, architect , conttketor
* * * * * * Al * * * R * OFt M ■ * * * r * * < x * * * * r rt fr * Or * * * • * * * * * * •
SPECIAL CONDITIONS OF THE PERMIT :
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
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 ,r� T '
2 , Type of heat 404
3 . Is the building mechanically cooled ? o
4 . Percentage of area of windows and doors c; �
A . Over 16 % Only
1 . Uo value of gross area of walls , roof / ceiling and floors
exposeei� t am 3. ent condittiions
2 . Floor over heated spaces YES
a . Are foundation walls insulated ? YES , NO
1 . If YES , what is r�t�he,, R value ? ,7 �i s1} cast
3 , Slab on grade YES � _QJ
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 ni' /' ooAr
5 , Type of insulation
B , Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions _
2 . R value of *exterior walls
3 . R value of glazed area
4 . R value of doors
5 . R value of floors over unheated spaces
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
s , R value of heated basement/ cellar walls ( above grade )
9 , R value of heated basement /cellar walls ( below grade )
10 , Type of insulation
C . Controls
1 . Thermostat maximum heat setting %.sue
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 / //4 _
2 . R value of pipe insulation
F . Service Water Heating � ]
1 . Performance efficiency /Y
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating
Telephone N o . 6 •�� �i o-r ! �a�t7 ,e _ }�,. -c , � + ? ca_ ' £' r'
( applicant ' s sig aturd )
TOWN OF t1UEENSBURY
BUI-T,DING }AND C DES DEPARTMENT
BAY & HAVIL DS
AND ROA
ydRiC I2$f7�
QUEENSBURI'. N 792-5832
TELEPHdNR (57
BW-1 ING INSPECTOR' REPORT
D
XQUEST FOR IN PECTION RECE
w
NAME
LOCATION
PERM T
DATE ,APPROVED
YES NO
FOOTINGIPIERS
MONOLITHIC POUR ROOFING
FOUNDATION/DAMP-
BACKFILL APPROVA
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH^ N
�y INSULATION:
FOUNDATION
FLOORS
WALLS - 3
CEILING
FINAL INSPECTION :
CHIMNEY HEIGHT
ROOFING
SIDING TEPS
EXTERNAL pORCHESI
STAIRS-CLEARANCE RAILSV E
LIEF VALVE
PLUMBING FIXWRE
DOORS
INTERIOR TRIM/PR V CS'
FINISHED FIlJORS
GARAGE FZ) EPROd ING
DOOR CLOSER (S)
SMOKE DETECTORS
FINAL ELECTRICAL NSPE ION
FINAL APPROVAL Q CONS tJCTIdN���
OK ToI SS[5E C/0 R C/C �-�-~
A SIGNED CERTIF CATS OF
CUPANCY MUST BE
OBTAINED FROM HE BUILDIN DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPI
REMARKS: ¢'/
CA
DEPART s-- INSPECTOR
rroWN OF QUEFINS" '
BUILDING AND CODES DEPARTMENTBAY & HAVILAN ROADSYORK 128174
QUEEN.SBURY, 792_5832
TVLEPHONE ( 518)
WII33ING INSPECTOR S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
PERMIT #
DATE APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS_^_�. --
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL��.�__�---^—J`
ROUGH PLUMBING
1'�FRAMING
ELECTRICAL ROUGH—IN
INSULATION:
FOUNDATION s :
FLOORS
WALLS
CEILING
FINAL INSPECTION : �+
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORC CE & RAIsIs�
STAIRS—CLEA
PLUMBING F.I RES/RELIEF VALVE
INTERIOR Tktm1PRIVACY DOORS_ --�--
FINISHED FOORS
GARAGE FI"EPROOFING
DOOR CLOSER (S)
SMOKE DE#'ECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL Of CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED
T AI N D F-RO14 THE OCCUPIED BUILDING EPARTMENT BEFORE
REMARKS :
r'
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAy r HAVILAND ROADS
QUEENSBURY, NEW YORK I280+I
TELEPHONE (528 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED �_,�..__- -.
NAME
L�7 TONS �r �ry
DATE �/_ tS _ PERMIT #_ 7 J -
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
�UNDATXONIDAMpIIIIII.PROOPING
BACKFILL APPROVAL
ROUGH PLUMBING
Fp.AMI NG l
ELECTRICAL ROUGH--IN
INSULATION: f
FOUNDATION
,FLOORS
WALLS
r
CEILING
FINAL INSPECTIONz
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PO,RCHES/STE
STAIRS-CLEARANCE di IL5
PLUMBING FIXTURES/ LIEF VALVE
INTERIOR TRIM/PRICY DOORS_.. _�_�
FINISHED FLOORS
GARAGE FIREPROOFANG
DOOR CLOSER (S) _r
SMOKE DETECTOR
FINAL ELECTRI''CA CONSTRUCTION
FINAL APPROVAL F CONSTRUCTION
A SIGNED CERT FICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED ?
REMARKS:
r/
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT /
BAY 6 HAVILAND ROADS
QUEENSBURY, NEW YORK 1280L6
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
ppDATE ? - / `?5 PERMIT #^ �I I
l� d1 R�C1A.� Ti] uJ Le. 1 Rf Gr APPROVED
YE4J NO
*DOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFSNG_
BACKFI.LL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION,-
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION.-
CHIMNEY HEIGHT Y
ROOFING
SIDING
EXTERNAL PORCHES/ST S
STAIRS-CLEARANCE & LS
PLUMBING FIXTURES/REL F V LVE
INTERIOR TRIM/PRIVACY
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL INSP S ,�
TION
FINAL APPROVAL OF CO TRUCTION �
A .SIGNED CERTIFICA E OF OCCUPANCY MUST BE
OBTAINED FROM THE HE
DEPARTMENT BEFORE
THESE PREMISES AR# OCCUPIED
z
REMARKS : /q
r
INSPECTOR
SELECT BUSINESS FORMS (609) 848-5203
APPLICATION FOR ELECTRICAL INSPECTION
PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
900 Haddon Ave., Collingswood, N.J. 08108
APPLICANT COMPLETES THIS • { Date:
City, Town or Township �]�CA�o + t 1213�, Count} j_�� State
Location/Address ` *� ow a_S6
If Located in Rural Area - Please Attach Directions) Pe��,y� # �~y„'�
Qwner4 rl Tr
Occupied As 44o%A % Building: NeZJE�l pid0
Occupant C32
Work Area in Buildin Floor #, etc. ) :
A . for: WiringW Service Q or: Ready for Inspection :
Fee Remitted - S Cash El Check F-1 M.O. 0 Make Payable To: M.D, I.A.
504 754 1D44 1250 3544 1754 2444 2250 2500 2750 34G4
Number of Rough Wiring Outlets Elect. Heat
Switches 2
Lighting Amp. Service Surface Unit Dishwasher Range
Water Heater Air Conditioner Dryer Pump
Receptacles ,Oven Garbage Disposal Wiring and Controls for Burner
Number of Fixtures
Amp, Receptacles Fractional H.P. Vent 'Fans
Other Equipment:
MOTORS H.P, 1/2 1/12 1/10 1/8 1 1/6 1/4 1 1/3 1/2 3/4 1 Li/7 2 1 3 1 5 1 7112 10 1 15 1 20 1 25 30 1 40 1 50 1 75 1 100
Mark Number
of Each Site
Applicant's
Signature License # rmit
T/A Uti l i ty :
Applicant's Address: NAME QF 1C L T1C1
(City) (Stal ce Request #
Phone *. Electrician
• ` USE ONLY GATE RECEIVED: DATE INSPECTED:
Correct Location : Same as Above j::] or-
Red Notice Label
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/B 1/fi 1/4 1/3 1/2=11Va 3 5 711z 10 15 20 25 30 40 SO M 104
Mark Number
of Each Size
Elect- Heat
50o 754 l004 1250 1506 1754 2440 2254 2544 2750 3044
.,. . ?
1llflTW .7iff��T"131 :.«ti IWD! 1? oAT� •
RW Progress: Inc. LKD 0 Contractor
Q CFT Violation : Work Comp. 0 Inc- ED CASH
L/A Owner Fee CHK #
Q L/A Due MO #
0 IPA Municipal INV #
Other Side Applicant
Date : Utility Owner
Cut in Card C] Temp # Date
�nico crTnac car.nleri �s�F
Z4 X 24e`
3 r-r r A 1_c> c. . I>vi.% u E w •+�y ram`
9 'r hl R i�c a vwx +�1 C Kh 13r ' r
Iq 1rc +.. [s a M T
tv szsc-1r, S •'� c�� H a . s TOWNOf: C1L1F �`'�
:honing Administr r
_ Date, .. --. .
4 .
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�f fCI
77
•$� 00 '
T> LA 1< L1L. Ll 1 2
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