1989-695 a
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+CER,TIFICATE 0 . 'CO►MPLIAM-Mi
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TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
Date 19
,
4
This is to certify that work requested to be done as shown by Permit No* 89-695
i
has been completed.
I
This structure may be occupied as a I F.+ ti 1
La�eatioss
Lot #12 Led evi ew Village
O
„ner John Hughes
1 By Order Town Board
TO`NN OF QUEENSBURY
Enforcement
Director of Bldg. 15c ode
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BUILDING PERMIT �=
TOWN OF QUEENSBURY Noja _ ��5
WARREN COUNTY, NEW YORK c
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PERMISSION is hereby granted to anuNJUIGHES
OWNER of property located at LOOT. #12 xIt6 aNyIILKARR I EDGIEV I W V II I AGLStreet. Road or Ave_
in the Town of Queensbury. To Construct or place a ONE CAR GARAGE
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_
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1. OWNER% Address is �
RRIMOXX8I8IXI 375 Bay road v
XXXXXXXXXXXXXXX Queensbury , N . Y . 12804
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2. CONTRACTOR or BUILDER'S Name
Self
3. CONTRACTOR or BUILDERS Address
Same
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4. ARCHITECT'S Name H
W
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5. ARCHITECT'S Address C
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fi_ TYPE of Construction — (Pleesa indicate by X)
} wood Frame i t Masonry { I Steel I l o
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7. PLANS and Specifioations '
No. 16 ' x 22 ' One Car Garage as per plot plan , specifications , and
application
S. Proposed Use
One Car Garage
$ 25wOO PERMIT FEE PAID -- THIS PERMIT EXPIRES April 1 1990 i
Cif a longer period is required an application for an extension must be made to the Building and Zoning inspector of the I
town of Queensbury before the expiration date.) 7
u
Dated at the Town of Queensbury this Day of September 19 89
SIGNED BY Zo for the Town of Queensbury
:Bu;i1i4ngk&nd ning 1 ctor
�uuvn u� �isks•:rsbur� FvyyrK ��'�E����URY
BUILDING and ZONING DEPARTMENT (� � ('� � RP C'WVGI>
Bay and Haviland Road, R, D. 1 Box 98 /1 W •LL7
Queensbury, New York 12801 A �� 0
CODE DEP7;
APPLICATION FOR
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING .
The undersigned 'hereby applies for a Building ]Permit to do the following work which will
be done in accordance with the descriptions plans and specifications submitted , and such
special conditions as may be indicated on the Permit .
The owner of this property is : -, � -J �. ► �
P . O. Address � �' � � �' P � =Y'a1 9d"► � � '1'el .
Property Location : �; .: .� ./�/fa o� 1- .d akP` /: _ Tax Map Wow j.
stre t number or building lot number
Subdivision name (if applicable)
' III PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
Nano: P * O* Address Tel . No .
Name of builder Z:r,& &,00 14/ s ZJC Addre:ss., ).�' e�S av tcr � Tel . I?o� • { � r #a
Naiau of plumber Address Tel
Name of mason Address-
NATURE .
NATURE OF PROPOSED WORK : * ZONING INFORMATION
_Construction of a new building + TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED ,
Addition to a building " drawn reasonably to scale and attached hereto .
Alteration to a building * showing clearly and distinctly all buildings ,
� (no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines . Give
* street and nuiabar or lot number and indicate .
" whether interior or corner lot . Show location
POR DEMOLITION PERMIT , STATE SIZE AND * of water supply and location and configuration
LOCATION OV STRUCPUR"S AE'FECTED. * of septic disposal area .
*
COMPLETE INFORMATION REQUIRED BELOW .
Size of property f t X f t .
* Existing building ( s) Size ft x fr. , '
PROPOSED BUILDING AND USE : Existing building (s ) Use
Size of new structure r ,! ft Xa2a;Lft
Foundation-,pier/slab/crawl/partial/full. * Proposed building , distance frog► property line
(circle one )
* Front yard £t Rear yard ft
No * of stories (habitable space) ft
Height: ( grade to ridge ) ft . . Side yards £t and
* If an corner , setback from side street ft
If residential, no. of families
No * of rooms (excluding baths) * OCCUPANCY INFORMATIflN
Noo of bedrooms
* pR 4ARY BUILDING '-
No . of bheating One family dwelling
Primary heating system * Two family dwelling
Type of fuel ,� Multiple dwelling / Number of units
No . of fireplaces to be installed pg,-,nanent occupancy
will a wood stove be installed? * Transient occupancy
Central Air conditioning?
* Business
BUILDING STYLE, PRIMARY STRUCTURE " Industrial
Ranch Contemporary Log cabin » Other '
If addition , what will use
Raised ranch Mansion Duplex ,r be?
Split level Old style: Bungalow
Cape Cod Cottage Other ' ACCESSORY BUILDING-
Colonial Raw Town House " Detached garage/one car/ two car/_r�akv �_ca:c
,_
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* : . + * * * * Private storage building .
ESTIMATED MARKET VALUE OF f _Other
CONSTRUCTION "
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETEDI
Form BPA 4/86 and-vl
IsUILDINC; PET(MIT APPL,ICivr1 ala CONTIriUEO -
BUILDING SPECIFICATIQN1:
Type of construction , wood frame , fire safe, etc . 4� �d"/ 404 s" s-
Will way second-hand or ungraded lumber be used? If so , for what?
/S" Q
Foundation wall mater!"I [r r�r � .�.� 6 Thicknc:::s V r ' �/ .V r
Depth of foundation below grade ( to bottom of footing )
Will there be a cellar? ofi , Heated ar unheated? f. ,,=� Floor sq. footage � sq ft
will there be a basement? .A ., -Will any portion be: used ax living spsace?_
( If so, what portion? sq . ft . - - Type of use?
Type of roof - slopcd/tlat/shed/other_ �� Material. of roof
Situ , wood studs.�'X. f i'o spacLncj / "o . c � length mfifimx�LLL•
,Ioista ( floor be:auss) lst. floor "X is spacing "o . c . spun ft .
Joists ( floor beams) 2nd . floor "x. of spacing "4 . c . span f t. '
Overlays (ceiling baamzj ) a"X e. spacing_ �"o . c . span a G. ft .
I+vof rafters � "X_ C spacingo. c . spank-ft .
Roof trusses (pre-engineurad) spacing "o . c . span ft.
Exterior wail finish ei�„ 6 ,eras;.gR Of what material?
Interior wall finish =
If a garage is to b+is attached , describe materials to Yoe useck for FIRE. SEPAIWrlow :
Is them: to be an opening between garage and dwelling? If so will a Fire-riatud
door , enclosure , and uwlf-closing device be provided?
Will a flue-lined chimney be installed? Height abov.s roof ft .
Dupth of chigiwicy foundation below grad@ ft .
Depth or' fireplace hearth fte in.
w.atur 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 *uptic ;system)
Town of Qur:unsbury County or Warren A F F :I I] A -V I T
STATE OF NEW YORK
I .wear that to the best of my knowledge and belief the statentQnts contained
in this application , together with the plans and spccificationa submLtted , area a true and
complete statemeut, of all proposed work to be dons `on the d45cribud pre "ses and that all
prov!:;Ions of the BUILDING CODE , 41HE ZONINC ORDINANCE , and all other laws pa:rtaining to
Lhc proposed work sh"11 be complied with, whether specified or not , asrd that "ch work is
authorica;d by the owner .
SWORN TO BEFORE ME T'lllS Signature _-_--___---
ar, owner ' :: yent , urC nit ect , Contractor
day of 19
Notary r'ubilat Warren County, N _ Y ,
r . * ■ . r IN s * • 116 a a t lor ■e a of If If If If Of * If * w yr . x M If If of ♦ If a 0 ■ or r ♦ * . r •
SPECIAL CONDITIONS OF THE PERMIT :
T OUN OF CODES QUE S DEPARTMENT
BUILDING AND CO
DAY HAVILAND ROADS 12so"k
QUEEIVSBURYr NEW YOR.K
TELEPHONE ( 518 ) 792�5832
,,, I�xNd Y1v5PECTOR' S gEPORT , �
REQUEST FOR
NSPSCTION RECEIVED
NAME
xATIDN T P.ERMI
G .----- p1PpgOVED
DATE YES . NO
�j )TINGIPZERS
MONO
LITHIC POUR Mp-� FIND
FOUNDATIOW D'
BACKPILL AppROVAL
ROUGH
FRAMNG
ING
I,ECTRL ROUGH—IN
g ICA
rNSULATION' --
FOUNDATION a
FLOORS �
WALLS
CEILING TTON =
FINAL INSP IGHT
CHIMNEY
ROOFING
SIDING PORCHE 5TEP5�
EXTERNAL & RAILS��� -�
STAIRS-.cLEARAN
ESI RELrEF' VALVE
PLUMBING FIX PRIVACY DDORS--- ��-�
INTER-T TRI RS
FINISHED F ROOFING
GARAGE FIRE
!s)
DOOR CIpSE
SMOKE DETE TORS ON
ELEC ICAL
FINAL AL OF CONSTRUCTION
FI NAL APIP
OCCUPANCY MUST BE
A SIGNED CERTIFY BUr�
ING DEPARTMENT BEFORE
OBTAINED FROM THE OCCUPIED !
THESE PREMISES A"RE
REMARKS
NSPECTOR
rd�3N dF CODES DEPA
Q�} ET+15B��Y
BUILDING AND RGADS
FtTMENI
& HAVILA yDRK 1280+
A1' 5832
QVESNSBURX ' l 5I.8 ) 7 92
pC1RT
TELEPHONE
II35pECTdR`
INSPEC
ON
FOR
REgUEST
L
LOCATION PERMI
APPROVED
y YES NO
DATE
FOOTINGlPIE � oRMs_�-- -�-��
,N(7LSTH P�X?a FING_
,
FOUNDATION/n"AM
BACKFILL APPROVAL f----��
ROUGH PLUMBIGN
FRAMING 14OUGH�I - ---
ELECTRICAL
.INSULATION
FOUNDATION
FLOORS
WALLS
CEILING TION :
FINAL INSP H
CHIMNEX EIGHT
ROOFING �--- �- -
SIDING PO RC $/STE :LSD
EXTERNAL CE
STATRS�CLEARA URESITTRAjEF VA
PLUMBING FIX M/PRIVAC'I P
INTERIOR TF` ORS
x F AGE FIR PROOFING _r_-
DOOR CLOS ( S )
CTORS PECTION
SMOKE DET ICAI, INS UCTION
FINAL ELEC L OF CONSTR
FINAL APPR VA �- - T BE
OC PACU NCX BEFORE
ggT2FICATN OF DEPARTMENT
A SIGNED 0,ROM THE BUILDING
OBTAIN p SM-ISES ARE
OCCUPIED, �-----._
THESE
REMARKS
}
_ TOR
Taw 0',
ERSBURT
53 SAY ROAD
QUEENSBURY , NEW YORK 12804
1 2
BIL " +� 0RUDIG INSPECTOR
FINAL INSPECTION
FM INSPECrIOK RECEIIIEp
NAME
LOCATtom L O T tom ' f [7 . L
DA'iE qt q j PERl4ITi _ * I
TWE OF sTNN�r'n�E
RECHECK
FIRE 14ARSHAL APPROVAL (CO�ERCLL STRUCTURE)
4
FOOTING FOUNDATION
- R�,H PLEB I MG FINAL ELECTRICAL~ SEPTIC
~INSULATION WO-MSTOVE/FIREPLACEYES No
}}
STTE PLAN/VARIXRCE REQUIREMENTS
JOS
REMARKS
G- -
N/ YE NO
CHIMEYHEIGHT/LOCATION
L ;k
PLUMBING VENT
ROOFING
SIDING
DECK/P
RELIEF VALVES
FURNACE/HOT W TWOR '
BASEMENT INSULATION/ C TWOR _
INTERIOR TRIM/PRIVA
RS
FINISH FLOORS :
BATH/KITCHEN WAT TI HT
OTHER FLOORS SWE PEAR E
OTHER FLOORS CA ILING
STAIR CLEARANCE/
PPED ACCE
S14OKHANDIE DETECTORS Ks
BATHROOM FANS/
ALL PLUMBING .FIXTURES OPERATIR :_
GARAGE
EFIREPROOFINGDOOR CLOSERS ,.�..-
OTHER FIRE S
FIRE/OE14ISE WALLS
DU14PSTER
FINAL EL
OK TO ISSUE C/O /
IS livt5
ow
ARRIVE Imo, Zk)
DEPART .I .
•
-ax I N OF QUUASBUR1ll
%
Date