1989-611 P � r
... . Y C
it I
CERrnMCAPq 00CCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
1 Date May 20 1991
This is to certify that work requested to be done as shown by Permit No. 89-6 i 1
has been completed.
This structure may be occupied as a Addition ol+e Family
a�` s] i xon Road
(pruner Thomas do Linda Rudell
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
y BUILDING PERMIT
TOWN OF QUEENSBURY
Na. 8 9-s 11
WARREN COUNTY, MEW YORK 0
k C.,
PERMISSION is hereby granted to Thomas & Linda. Rude].).
ao
OWNER of property located at 569 Dixon Road Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a Addition to Single Family
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. �;d
G
t_ OO WNE WS Address is
Same t"
H
2. CONTRACTOR or BUILDER 'S Name 0
PO
Self
C"
3. CONTRACTOR or BUILpER"S Address �•
A.
l:D
Same
4. ARCHITECT'S Name
cn
S. ARCHITECT'S Address '
ca
.y.
7S
c7
B. TYPE of Construction — (Please indicate by X) O
Ao
( ) Wood Frame I I Masonry [ ? Steel f I
7. PLANS and Specifications
No. 341 x 121 Addition to single fA%X*1X.41X family as per plot plan, specifications,
and application.
B. Proposed Use
n.
Garage Bc Addition to Single Family
o`
8.00 Addition
$ 25.00 Garage PERMIT FEE PAID — THIS PERMIT EXPIRES %larch 1 19gip___.._ �
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Gueensbury before the expiration date.)
rt
Dated at the Town of Queensbu Jqth Day Ali�rylCt 79 gcL °P
SIGNED BY for the Town of Queensbury
Buildingand Zoni Inspector
TOWN OF QUEENSi3URY APPI. TCATTON FOR RUTLD1HCi ANn ZONTNC PERMIT
,if 4
oca
? TOW of QUEENSBURY
reviewed RECEIVED
Fee i'a.id { �' AUG 1 1989
w I LD I NG AND CODES u! :l '1tI1 IEN T Data Tess ued
jAY .end HAVILAND ROADS- RD 1 Box 9,3 BLDG. & CODE DEFT.
PUE$NS8VRY, NEIJ YORK 12804 PeAunZt Na .
Tel . ( sle ) 792-5832 Exc 209
• r r ! r IN a r 7 r r r fe • r r • • w r x • • r i R IN ■ / r s IN i • • a
A PE~ RMT Niu5'f DO OBTAINED BEFORE BEGINNING CONSTRUCTION @ NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID I3UILDINC PERMIT .
All applicable spaces on this application must be conipleted and the
% •i punrure of the applicant must altiricar on the reverse sicic of this sheet .
'A *
The owner of this. Property is :
t° . 4 . Address �� ,� J--� f.,r''c�-c /^C.G C�'E.c'cc;. rl..+��.�� +-�"i �•'Y T E L . ��r",�rvs�fcr Q � vl�v'
1' raperty location •- « "TAB TAX MAP NO ,
3LG Cf 02cc
klaS there been any split of this property since October 1 , 1988 ? yes / no
If yes , Planning Board Review is necessarya r
suBDIV151ON NAME , IF APPLICABLE !� LOT NO .
The e work as regards Building person responsible ror supervision of wo Codes is :
,�t _ a./C_ � '�-e--�. .._[f./��'u�_ Z. 7 �'�'� �'
NAME • FOO . ADDRESS r TEL . NO .
Tel
tdame of builder Address
N"me of Plumber l.ddress Tel
Name of Mason Address Tel
14ATURE Or Pr%OPOO L-:D lAORK : 2l7NItJt INFO10IA`1' ION ( office use anIV )
rw.Sn : Gruction u+of a lie buildin ] r 20NING DESICNATiDN OF PROPERTY
,• 'Ad,.licion to a lauil .2ing # PERMITTED PRINCIPAL. PERMITTED ACCESSORY
�Altaer Lion tO a Luilding
'
� Ch.a�u] u to &2xc . rior climcnE. ionsi ` REVIEW REQUIRED PLANNING BOARD ZONING BOARD_
( , so :
0Cjk4.er wort: (aasrriUk! ) ' SITE PLAN REVIEW #! APPROVED.DATE }
VARIANCE q .J! _� PPROVE0 DATE
ktO5S ARL.1 OF i' RCiPOSCD. S+"�LA. v >c��
l5t Floor sq ft . J Remarks :
2nd Floor sq i t COItPI.1_"1'Li INi'Uk7•tl+.'1'ION JL4(JLSLUrLID UCL.G4l . �
SfI J r4n
y - '► 31"1.4 of larOl)+r. rty JJ� " / T ---rt x ft .
other Floors ft -s..�YI.,C_.. �t � 1:_aa i.i t.i.Ilt1 r; il.i ill�� ( :: ) � a _�' ..� �I` 1: % r C .
( not cellar ar bas4ma n r j o }� "j (b
TOTAL FLOOR ARnA� 40 y sq f t ' LxisGiiig b4il�linal ( :: ) Use IL
car new :Gructur. 3�' ft k fz. ft
L'oastd:ac ion- plor) ;;laL rare parei..al/ full ' laropo::rad bualu .Lng , di;; tancu lr
irOW , al":rty lirtu
(c:ircla one) ` •at3 ' Front yard -31 �- *ofrt hear yard 70 f t
No . of scorieu (habit.,.ble !;p ace ) } S %de yard u ' r 'f" et :and c� L''t
lt� ight ( Uradaa to ridg0 .r6a ft . If on cornar , yutbwo&ck from side straaut CC
If ressidajntial , no . Of families '
Noo of rocuns ( excluding b"th* ) OCCUPAINLY INFORMATICN
Noo of ba:drootns _ pP,Zb6NRy+ LsUILDINC
Noo of b"tlrroOuta j f' Ono fanLily dwelling
t•rim:ary 1ru"rirul IlLwo f;arni,ly dwall .iny
4rypQ of fuul E5- amowmMoxwo
Multjopl.s ,.lwulling / Number of units_
No . of firel>lacw4 tta la.: snsG:allea d V
paYirL.►atGLLt oct:up:aaaCy
Will :+ %A>Q" SL QVQ t+.: i1k!; L allMd? , Jc> ~ '1`r;anr.iu[MC Lac:Cula;afac:y
Luntr"l Air CGIadAtiQniiag *:� N M businuus
BUILDING STYLC, PRIMARY STRUCTUREat
Industrial
1u� �ah Cantjufil:C,rury Lora c:alain ,asi3acio wla t wi..
1:.ai�ud ranch MLlnulic.«
1YaliG luvul Old style Lauaayalow
.� L „ ,C,o,t,t;, ge Otlwr r ACCL3SOLtY IiU2L INC-
CGlani.al LipV lo..�L� }louse ' Wiucachad yaFuga/one car/ two car/ car
( CIfICLL C"L PLEASE ) • Acc4chtja 9"rtaqu/OJIQ Car/ two Czar/ C7a L'
r • r ■ ■ r r r + . • ■ ■ w + w r r Vriv" tu s,�t1orugo hui.lding
L' S '1' 3Mh'1' h: A MARKETVA1. UL OF ' Otha: r ,�^�.F. 0 2 � ' ft SC ` Cau�r�.�►..
.s
7NVOtZMATYON Oh[ BUIL131Nc gpr.cxvrcATToNs , ON RcVERSE •sloe OF Tkll"a sFncET* f1ba SC COKPLeTcol
Form BPA 10188 V2
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS : f
Type of construction , wood frame , fire safe , etc . ;.Qc>ca [S 1� 72 f� i - :{{ M 3. U11Aj
Will any second-hand or ungraded lumber be used?
ed? if so , for what ?
Foundation wall materia ' 71 K d/� ty�{24,tws� Thickness
Depth of foundation below grade ( to bottom of footing )
Will there be a cellar? ti4 Heated or unheated? Floor sq . footage N/ sq ft
Will there be a basement? �41 Will any portion be used as living space ? .V1.4;:y
{ If so , what portion? sq , ft . - - Type of use ? /ti/ A -- '-
Type of roof - slope flat/shed/other -- _ Material of roof
Size , wood studs '" X C4 " spacing / o . c . length VAOf-w, ft ,
,joists ( floor beams ) 1st . lour A?-- X . C.! spacing r {� '"o . c . span ! 2_- ft .
Jolsts ( floor beams ) 2nd . floor •x spate= '• . ft .
Overlays ( ceiling beams ) t/ r lox .. spacing "o . c . span - ft .
Roof rafters h.' 1 "X -`7 spacing o . c . span ft .
Roof trusses (pre-engineered) spacing-2-7 ""o . c . span 3 o�/ ft .
Exterior wall finish A-Ltkrk , S. ,p . ,n,,+'C..- Of what material ?
,,.Interior wall finish ? t. -8
if a ara e is to be attacheA , 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? 1597S Height above roof ft . fit= � •!
Depth of chimney foundation below grade /V in. ft .
Depth of fireplace hearth ft .
Water supply - Municipal or private well
SEPTIC SYSTEM Distance from ANY private well { including adjoining properties /may 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
Owner, owner's age t, architect , contractor
* It It .
SPECIAL CONDITIONS OF THE PERMIT :
............. _ _- _-__-__--
TOWN OF ¢UEENSBURY
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 areaa CJ S �T L � � 67.40�i ��
2 . Type of heat { �'� �'yZ•[ � � �� ' t ``
3 . Is the building mechanically cooled ? . { C
4 . Percentage of area of windows an� doors
A . Over 16 % Only
1 . Uo value of gross area of walls , roof / ceiling and floors
exposed to ambient conditions
.T
f ._
2 . Floor over heated spaces YES ND
a . Are foundation walls insulated(: YES NO
1 . If YES , what is the R value ?
3 . Slab on grade YES ( "_.-
a . If YES , what is the R value of insulation around
perimeter of floor ? 1
4 . Is basement heated ? YES NO
a . R value of insulation
5 . Type of insulation ti/p
By, Under) 16 % Only
'---I: - R value of roof and floors exposed to ambient conditions '
2 . R value of exterior walls Z 2-
3 0 R value of glazed area L ; /wnrscl �_ . vaDcw� (VkA"
4 . R value of doors NIA
5 . R value of floors over unheated spaces - A_ f !
6 . R value of slab edge insulation - unheated slabdr
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 ) ^AZP
10 . Type of insulation CXAjtLKf - 13L bz�c ok6et.
C . Controls r' it3ILc $�(d
1 . Thermostat max////i % heat setting
Do Duct Systems NZJ '
1 . Is duct syste 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 rI /�1 . Size of hot water ` or cooling carrying agent tripe
2 . R value of pipe insulation
F . Service Water Heating ,�
1 . Performance efficien y(I
2 . Temperature control setting maximum
G . For Swimming Pool Only A'Kp
1 . ^maximum heating
Telephone No . 7i
( pplicant ' s signature )
o �
TOWN OF QVEENSBURY AW
say gt N8v++8"d Road, C"Of3sbury. NY 12B04-Q725 -51s-792-5832
Buil c3 din & Coders Department
tVSPEC TOR # S prPORT
19
PRO'PERR'X"s' IOCATIOti d
OWi3ER OR ANT
� r
BDII,DINGY, ,SE EWAG $_ OT � C>Lo �
REMARKS : y
e
CONTACT THIS OFFICE WITIA
SPEC TOR
HOME Of NATUAAL BEAUTY A Goof) PLACE TO LIVE"SETTLED 1763
TOWN OF QUEENSBURY
BUXLDING AND CODES DEPARTMENT
DS
BAY & HAVILAND ES BOA
1280,, NSBURY, NEW
TELEPHONE (518 ) 792-5832
KjILDING INSPECTOR' S REPORT
REQU'ES� INSPECTION RECEIVEDNAME
LOCATION c - f
PE
DATE T #
DATE ' , G Q. — € APPROVED
{ YES NO
FOOTING/ ERS 9
MONOLTTHI POUR FORMS
FOUNDATION P—PROOFIN �-
BACKFILL AP VA
ROUGH PLUMB'N
L�•RAMING ,
ELECTRICAL ROUG IN���—�—�
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL XNSPECTI'ON:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHBOISTEPS
STAIRS—CLEARAN(IS & RAT
PLUMBING FIXTUMESIRELIEF ALVE
INTERIOR TRIX1PRIVACY DOO
FINISHED FLO(*S
GARAGE FIRED pOFING
DOOR CLOSER (
SMOKE DETEC RS
FINAL ELECTRI AL INSPECTION
FINAL APPROV L OF CONSTRUCT-TON
R IFICATE OF OCCUPANCY MUST
A SIGNED CE BE
OBTAINED FROM THE �gUICDING DEPARTMENT" BEFORE
THESE PREMISES ARE OCCUPIED'
REMARICS
f
NSSPECTOR
TOWN OF QUEENSBURY /
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12SOk
TELEPHONE (518 ) 792-5832
BUILDING INSPECTOR' S REPORT
OORT
REQUEST FORf< 04
EC'TO,/N ECE1�"VED b
NAME ; '_1/ J 7
LOCATION 3 Cs ok
PATE PERMIT # !� —
APPROVED
YES NO
FOOTI NGI PI ERS
MONOLITHIC POUR FORMS
j_...-FOUND.ATION/DAMP—PROOFING
{,. tACKFILL m.APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL '+tRO+UGH—IN
INSUTAATION: '.
FOUNDATION .
FLOORS
WALLS
CEILING
FINAL INSPECTION!
CHIMNEY HEIGH — - —
ROOFING —
SIDING
EXTERNAL RCHES/STEPS
,STAIRS--C ARANCE & RAILS
PLUMBING IXTURES/RELIEF VALVE
INTERIO TRIM/PRIVACY DOORS
FINISHE FLOORS -
GARAGE FIREPROOFING
MOOR OSER (S)
SMOKE DETECTORS —
FINAL E, CTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED !
REMARKS :
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT ��
BAY & HAVILAND ROADS
QUEENSBURYr NEW YORK 1280k
TELEPHONE ( 516) 792- 5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED ✓+� 7 d ./
NAME �LLL
LOCATION {
DATE tII6 � ` PERMIT #_J S }
APPROVED
' YES NO
C/FOOTING/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/ 6 RAILS '_
PLUMBING FIXTURVS/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 :
INSPECTOR
SELECT BUSINESS FORMS 1609) 848-520.3
APPLICATION FOR ELECTRICAL INSPECTION
PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES
;y`' �► MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
.� 900 Haddon Ave.r Collingswood, N.J. 08108
COMPLE TES TH IS SECTI ON
City, Town or Township.
Countyft/ rz-►Z C 7`" State 1t'
Location/Address ( 7 ' dYt PO
cated in Rural Area - Please Attach Directions) Pole -V
Owner. ( If oirto Permit # f
Occupied As "� 1 P�Z70t' � e Building: New Old
Occupant ' '"`" `
p , e-M 1 z' .2 " a C Work Area in Building Floor #, etc_ ) :
for : WiringlZ Service 0 r: Ready for Inspection :
Fee Remitted Cash Check Q M.Q. = Make Payable To : M,D. I.A.
Number of Rough Wiring Outlets Elect. Heat saa 750 100a 125o s5na 175a 2a0a 225a 25aa 2
Switches
Lighting Amp. Service Surface Unit Dishwasher Range
Receptacles C5 Water Heater Air Conditioner ❑ryer Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
Amp_ Receptacles Fractional H.P. Vent Fans
Other Equipment :
MOTORS H,P. 1/2 1112 1/10 1/e 1/6 1/4 1/3 1/2 314 1 lvz 2 3 5 7L+r 10 15 20 25 30 411 50 75 100
Mark Number
of Each Size
Arrpl icant's
Signature License # Permit #
T/A Utility :
Applicants Address : (NAME] IOFFlCE LOCATION
(City) (State) (Zip) Service Request #
Phone # Electrician :
r DATE RECEIVED: DATE INSPECTED:
Correct Location : Some as Above 0 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 1/8 1/6 1/4 1/3 1/2 3/4 1 11h 2 3 5 7bz 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
aeet. Heat 50
0
7
50
laaa 125a 15Ua 1750
20001 2250 25aD 2750 saau
Patprpicgk�J Dshnaw
n Nudsn FaF?sxx W 12839
G ::' SE81?98-3�73
E.._: . .:... . . ELECTRICAL INSPECTOR
ORECT
�; "a l lilC/rr, , . L/ Ii1117r .V!il�T PO"IrIED DATE ,. C FEE FEE PAID
El RW Progress: Inc. L K D Q Contractor
Ej CFT Violation : Work Comp. 0 Inc. CASH 0
] L/A Owner
Q Due
Fee 0 #
M hAO #
0 IPA Municipal
fNV #
Date : Other Side 0 Utility Applicant
Owner
Cut in Card Temp # Date