1989-562 `.7Y"Tt{r'�-. .�,....yr.�.�..,,..
i
'OF.. A. iM VNAT
TOWN OF +QUEENSBURY
WARREN COUNTY. NEW YORK
July 31 �� 90
DateC --� -
This is to certify that work requested to be done as shown by Permit Irla. 89- 562
i
i has been completed.
This structure may be occupied as a Addition to Single Family Dwelling.
3 �
Locatio n P ' l v Ro a d
!I OwnerJoe Tanner
l
j By Order Town Board
ETOWN OF QUEENS$URY
l '
f Director of Bldg. & Code Enforcement
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BUILDING PERMIT �
TOWN OF QUEENSBURY s
No. 89- 562
WARREN COUNTY, NEW YORRK •ai
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1
PERMISSION is hereby granted to aloe Tanner �
cr'fs.
OWNER of property located at 383 Pinel to Road Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Addition to Single family Dwel 1 i ng
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 -y`
m
2. CONTRACTOR or 9UI LOE R"S Name
r
J . Rothermel
3. CONTRACTOR or BUILDER'S Address
West Mountain Road
Queensbury. N . Y . 12804
4_ ARCHITECT'S Name �a
W
W
5. ARCHITECT'S Address
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6, TYPE of Construction — (Please indicate by X) D
I ) Wood Frame ( ) Masonry I ) Steel [ }
7. PLANS and Specifications
No. 15 ' x ll2 20 ' Addition to Single Family Dwelling as per plot plan ,
specifications , and application _
cam.
a
8_ Proposed Use
e-t
Addition to Single Family Dwelling
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ev,
$ —24 . GO PERMIT 'FEE PAID — TEAS PERMIT EXPIRES February 1 19 0
c�
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ausensbury before the expiration date.)
per,
Dated at the Town of Queensbury this 25th D f July 19 89 �-
I+'� �
SIGNED BY for the Town of Queensbury
Building and Z Inspector ....i
a
to
T N [ F � UEENSI3UTtY APPLICATION FOR BUTLI) ING AND ZONING PERMIT
� L�atrr-
ectev TOWN OF QUEENSBURY
ed RECEIVED
JUL 17 1989
Fee Mid
MI LDINC AND CODES Dj .iAirDTImr Date Iaaued BLDG. & CODE. DEPT.
DAY and ]1AVXLAJVD ROADS RL l BOX 93
pURENSBVRY, NRIV Y08K 12804 PeAxtit N0 .
Tel * ( 518) 992-5832 E'xt 209
.rr * is s w wr '■ w f w w w w w r. s ► w r • r w r w w la w • w w w w w w x
A I"E1ZIIIT MUS'P P4 OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIQNS
L+' I LL BE HADE UNTIL APPLICANT 11AS RECEIVED A VALID BUI LDINC PERMIT .
All applicable spaces on this application Inust be con1pleted and the
ti � I< � atuTe of the ;applicant must appear on the rcveT > c side of this Sheet .
llc h h R w ak at Yr y: A %t A Jk �k ak 7k 7k 7t 7k X * :k * * tik 91C YC ik * is
'The owner of this ,property is : �
l' . Q . Address ' c TCL . � l:a� - C2/ f _
7 d x MAP No _ 147_1 _ J .l
lroperty location a s
alas there been any split oC this proPerty Since October 1 , 1988 ? yys/ x.X
if yes , Planning Board Review is necessary . LOT NOo
fo
SunD "IVISION HAMEo IF APPLICABLE uildi
The person responsible for supervision of work as regards nuingCade�s :�
41 rc l S 7�y �a x + y. �� i� t • _ _'i�'
NA AIL: ADL] RCSS `Pk L . NO
P . O . .
Name of builder_n • ��, �I p ,.• r,4 Addresses c^ s;t 71y_ ' (! 1 / J t G -g "lel
Address Tel
Name of Plumber Tit
Name of Akasan AddCCay
14ATURE OF PROPOSCO 'WOPK : 7ONINCo 1N1w'0101A.`r1QN ( Of' tice u . an -19 )
ron:itructiorf of a new buildir•g ZONING DESIGNNrION OF PROPERTY
Addition to a buildinq r PERMITTED PRINCIPAL PERMITTED ACCESSORY
Alcur:.ation to a 1Luilding '
ONO clr:.xffrIv to exc " rior eliman:: ions) � REVIEW REQUIRED -- PLANNING BQARI3 �... ZONING pQARD�
OLlfvr ►.ork (,3e :criUae) ; SITE PLAN REVIEW Ii APPROVED DATE
r
VARIANCE APPROVED DATE
GROSS AREA OV PROPOSCD, t 'TFcUC `I' UIt�
1st Floor 3 `s sq ft . l7emarks : �
nd Floor - sq f t „ CQI.11+ f.1;'s'L Slvi'al:o-xA'1'LOl1 icl r 3U I1sL LY use LLriI
"' Si:ru of I�roLrurty t=a c� f t x =>I.CsL� F t .
Other Floors sq ft . Exiftiflcl bu ` 4 x� Kr rc .
{ noc cellar or basaamencl r
TOTAL FLOOR ARLA_•lQL sq f t . Lxiing builrlina { : ] usu � t rz�
oc new t;tructuru rt 5+_ac) ft ~
►•of;rfd:acian-pier/:;laL raw }Lxarti .l} full ' propo:;ud builaing , di:; cancu trauf �.raal�urty lirtu
(airclu one: ) ft
Front yard I't Rear yard
No . of scorien (1k;A4.i. L"blQt s613cace ) Side: yardu _ 4 ` 3 " ft and a1 . ft
lluighc ( Urads to ridg4j ) ft . If on corner , uetback froja side scr.:et r' c
1f re!:iduntial , no . of f"Wailies
No . of roolnx ( axeluding b:.atha) 21 ` OCcuppi4 :Y INFQRI SA"TION
S1o . of Li4droofu5 ""' - �
„ PRIMALtY GUII.DINC
No . of baLllroou►J (Ona fancily dwalling
1'rimo:Ary 114ja r i.&krl y y:' tuuf «' Lwo P:au>ily dwulliny
I' 3u of f uQ1 �
' yi „ tiulti1310 ,welling / Number of units
No . of firuplacua to bL iJl :c.rlleu --^
r ParM anetlt occupwkcy
will :a ML1Jd ::LOYh: tru occ"JuAncy
,r r
C"atoral Air corfriiLicfniny 13usinass
r
tAUIL.DING STYLE, PRIKA.RY STRUCTURE lr►du :trial
Ocher
1"Itch Con castipc4ruryf Lon c �L�in Ir .addzr wl &"t will u;:.: ba:? 4- r' =VO4,
1 .. isud rancil Asansic.f. OtApla=x Q.
.z. t11-xM1 L i'.n+.
al3lit luv.:l Old scylo Lsur1Lj....1aw
CaAvw Cod COL"q%2 QClaur ' ACCESSORY L3uTi.Dxwc-
C olrrrzi:� 1 ItAw 61:owsr House • L+ecachad y:xrz,gefano cEar/ two c" 19 / c:+r
{ CIRCLE ONE PLLIArC ) " Astachou yuraqu/ona: car/ two car/ cur
■ w r • a w w 7. r storuga building
MARIGF:•1• VALU I, a� r QC'h'" C
CON S;*r hucorTUN "� r
INVOSMATION ON DuTI.Dimc spcciprcATIONS , ON R.EV7=Lick: SIDE: OF T11IS ."+ReCT, TO SO CCIMPLCTEDI
Form DPA 20/89 V2
BUILDING PERMIT "PLICATION CONTINUED
BUILDING SPECIFICATIONS :
Type of construction , wood frame ,} fire sa£e , etc .
Will any second-hand or ungraded lumber be used? If so , for what ?
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing )
Will there be a cellar?_Heated or unheated? ?OK(J5` Floor sq . footage �C7 sq ft
Will there be a basement? W,Ib Will any portion be used as livi g space ?
( If so , what portion? noo sq , ft . - - Type of use? "0r µ q
Type of roof - lope /flat/shed/other Material of roof afi w�lp
Size , wood studs X "
_J21 Ca spacing Ir
^o , c . length C_ft .
Joists ( floor beams ) lst , floor IL "x spacingjk `"o , c , span_ft .
Joists ( floor beams ) 2nd . floor "X +-= - " spacing "o . c . span ^ ft ,
Overlays ( ceiling beams ) Z- "X spacing 1 tp " o .O . C . span �p `f � ,
Roof rafters �r " X spacing o . c . span 1p ft .
Roof trusses (pre-enginee ed) spacing " o , c . span �- ft .
Exterior wall finish I �,1 t L. 45 f bj L14 Of what material ?
Interior wall finish �— ' T , �
If a garage is to be attached , escribe materials to be used for FTRC SEPARATION :
L1
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 r ft ,
_.
Depth of chimney foundation below grade .i'" ft ,
Depth of fireplace hearth — ft . in .
Water supply - Municipal or private well ti I-
SEPTIC SSYSTLM _ Distance from ANY private l ( including adjoining properties ft .
(A separate application i N wel
s necessary for any repair or new installation of septic system)
D E C L A R A T I O N
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,
/7
Signature—rJC !
owner, owner's agent, architect, contractor
J
SPECIAL CONDITIONS OF THE PERMIT :
By
_.__________ ...........
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 Q , (
2 . Type of heat
3 . Is the building mechanically cooled ? AAJ0
4 . Percentage of area of windows and doors
A . Over 16 % Only
1 . U value of gross area of walls , roof / ceiling and floors
o
exposed to ambient conditions
2 ' F over heated spaces YES NO --
a . Are dation walls insulated ? S NO
1 , If YE at is the R e ?
3 . Slab on grade YES
a . If YES , what he R val f insulation around
perimeter floor ?
4 . Is base t heated ? YES NO
a , slue of insulation
5 , ype of insulation
B , Under 16 % Only
1 , R value of roof and floors exposed to ambient conditions _
2 . R value of exterior walls r
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 /t/' �*-
7 , R value of slab insulation - heated slab &
8 . R value of heated basement/ cellar walls ( above grade )
90 R value of heated basement/ cellar walls ( below grade )
10 . Type of insulation '� fir' j
Co Controls �}
Y . Thermostat maximum heat setting
DV Duct Systems
1v is duct system installed in unheated space ? YES NO
a . If YES , R value of duct installation
b . R value of duct in other areas
E . Piping Insulation
Y . Size of hot water or cooling carrying a n i
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 .
r
( apgli
C77an s signature )
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND Rfn2lDS
QUEE'NSBURY, NEW fTXON
K 1280kTELEPHONE (518) 2-5032BUILDDIINSPECTOR ' S REPO
REQUEST FOR INSP RECEIVED (}
NAME
UCATI . 1
L N 4
DATE PERMIT" #
APPROVED
~ YES NO
FOOTING/PIERS
MONOLITHIC POUR FO S
FOUNDATION/DAMP—PR PING
BACYFXZL APPROVAL
ROUGH PLUMBING
PRANING
ELECTRICAL ROUGH—I
INSULATION a
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/S PS
STAIRS—CLEARANCE ILS
PLUMBING FIXTURES R LIEF VALVE
INTERIOR TRIM/PR A Y DOORS
FINISHED FLOORS
GARAGE FIREPRO0 ING -
DOOR CLOSER (S)
SMOKE DETECTOR
FINAL EL.ECTRICA XNSPEC
ION ........
FINAL APPROVAL CONS2 2UCTION
OK TO ISSUE C/ OR C/C
A SIGNED CERT ICATE OF CUPANCY MUST BE
OBTAINED FROM THE BUILDI G DEPARTMENT BEFORE
THESE PREMIS ARE OCCUP "r
REMARKS:
ARRI / 1
DEPAR + f
INSPECTOR
r
fJ THE NEW YORK BOARD OF FIRE UNDERWRITERS
• BUREAU OF ELECTRICITY
41 'STATE STREET, ALBANY, NEW YORK 12207
Date i Application ,Vo. on file
THIS CERTIFIES THAT
only the electrical egtsiptnent as 4mcribeel below ,and introd"ced by the applicant named on the above application near nher in the prWasiaes of
in thefollowing location; ❑ Dosetnent 0 Ise Fl. ❑' 2nd Fl. .'Section Block Lot
was examined as + ;' ! ! - • . and found to be in compliance with the reil"irements of this Board,
FIXTURE EPTACLES SWITCHES FIXTURES RANGES COOKING COCKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLLICMESCWT GTHER AMT. K- W- ANT. K. W- AMT. K-W. AMT. K. W- AMr. N_ P.
DRYER'S FURNACE MOTORS FUTURE APVUANCE PEELERS SPECIAL R VPT TIME CLOCKS WELL LRMT HEATERS MiAT1.OU LET DIRMIM,ERS
ANT. K. W. OIL H. P. GAS H. P. ANT. NO- A. W. G. ANT. AMP, ANT. AMpS. TRANS. ANT. N- F- 7TE
� T AMTEMS r. WkTTS
SERVICE DISCOFiNECT MO. Of S E ItV i C E
ANT. AMP. TrF'E. MITRE
EQUIP. I / ?W I 1 F 3W 3 .e 3W 3 .e nv ACdND. �C. COND, s18. C1F /MI-LEG #•M G woo. GE NEUTRALS OF L1WEIffGRAI
OTHER APPARATUS:
f F' . I
$RANCH MANAGER
. f p .
Per J
This certificate must not be altered in any manner return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TOWN OF QUEENSBU'RY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEEN.SBURY. NEW YORK 32804
TELEPHONE (5I8) 792- 5832
BUILDING INSPECTOR' S DEPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION /
DATE �� PERMIT ## �--
APPROVED
YES NO
XFOOTING/PIERS
MONOL HIC POUR FORMS
FOUNDA ON/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PL BING
FRAMING
ELECTRICAL OUGH-IN
INSULATION:
FOUNDATIO �f
t
FLOORS
WALLS
CEILING
FINAL INSPECTIO r
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES TEPS J
STAIRS-CLEARANCE & RAIDS
PLUMBING FI.XTURESIR GF VALVE
INTERIOR TRIMIPRIVAC DOORS
FINISHED FLOORS
GARAGE FIREPROOFI G
DOOR CLOSER (S)
SMOKE DETECTOR
FINAL ELECTRIC INSPECTION
FINAL APPROVAL ,OF CONSTRUCTION _
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMA�R�rKS: �/
INSPECTOR
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED
TEMP. M DATE
TOWNSHIP
RC O1' MT VILLAGE ! ..
Lh5 � FIr Lf
K POI..E NUMBER
STREET D NA7 OR RCND
BETWEEN WHAT TWO CROSS STREETS+' IS PREMISES LOCATED? SEGTK]N BLOCK
LOT
OCCUPANT'S NAME BUILDING OCCUPANCY
HOME 1TLEPHDNE NUMBER
OWNEH'S NAME AND ADDRESS
FF67M THEIR OFFICE WC.1RK TELEPHONE NUMBER
O NT SUPPLIED W _ 1! '' E
BUILDING IS ,� , ,// ADDITIONAL ❑ DEFECTS REMOVED ❑
NEW I_Y' OLB ❑ WORK IS NEW I�
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
BRANCH OFFICE U3E
No. of Fixtures & CIRCUITS ONLV
NUMBER OF OUTLETS M[7R7R5 HEATERS
Loca- Lamp Receptacles
tiara Side AtISCc 'T H.P. No. Each N4- Ga 19 ��SP + SON
Oa Iin9 Wam Recep'Is Swi4ch Pendarn Bracket No. TYPO Each
OUT-
SIDE
SUB-
SASE
BASE-
MENT
Tsl
FL.
2rkd
FL.
3Td
FL.
REMARKS: LIST OTHER ELECTRIGAL DEVICES NOT SET FORTH ABOVE. �.w 4. f, �, ov
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED, BUT IF AT TIME OF INSPECTION. THERE IS
FOUND ADDITIONAL EQUIPMENT PME 7 AS PROV DED E LISTED,
, YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE TO COVER
THE AD
FEEDERS ELECTRIC SIG"SA,AM PS TOTAL 3Wl"1;
SIZE OF [�
GA£TUBE SK9WTRAN SEEP MER9 OF
CHAR E OF WORK ❑ E SED
CONCEALED CAPACITY
DATE WORK TO SE SUR1.Eo DATE COMPLETED SIZE OF SIGN INUMaERI
MANUFACTVRER OF SK3N
SERVICE ENTERS R UILDING
❑ OVERHEAD NDERGROUND
DATE INSPECTION REOUk.iTED ON {OR AS NEM PS PCE'SIBLEI kDENTiFiCATkOIi NkAMB£RR Moo,
y f
►I@WDkp YS ti�IfING LLANDACCURATE TION. ALL. M BE FHAJEID IN OR APPI mATKm
R
PRINT NAME AND ADORES$
Ojai:777E �;; N
NAME ICANT
/ s
E NO
ST ET ADDRESS$
Z1P CODE LIGENSE NO WHEN APPLICABLE
C O ST OFFIGE .217 LakeJ
Ej 202 Arterial Road
B5 Jahn Street 41 Stake Street ❑ 570 DelawareNYAvenue 14202 1 ROCHESTER,u
❑ NY 146081 SYRACUSE, NY 13206
NEW YOR44, NY 10030 � ALBANY, NY 12207 M BUFFALO,
THE NEW YORK BOARD OF FIRE UNDERWRITERS
T�
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