1990-795 A
170,
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY -
WARREN COUNTY, NEW YORCC
Date November 26 . 19 90
This is to certify that work requested to be done as shown by Permit No. 90-795
has been completed.
This structure may be occupied as a Alteration to mobile Home ; new roof over
Nation 5 Briwood Circle
Owner Frank Peri 11 o Tenant Kathl Pn stark
By Order Town Board.
TOWN Oi• QUEENSBURY
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Director of Bldg. &:Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-795
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Kathleen Stark
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OWNER of property located at . 5 Briwood Circle Street, Road or Ave. •
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in the Town of Queensbury,To Construct or place a Alteration to Mobile home
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 Peri l l o Frank
215 Ballard Rd, Gansevoort
2. CONTRACTOR or BUILDER'S Name John J. Randall
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address c'+
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6. TYPE of Construction—(Please indicate by X) fD
(X)Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
No. 770 sq. ft. alteration to mobile home as per plot plan specification
and application. 0
8. Proposed Use 0
Roof over mobile home
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$ 32.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 19 19 91
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.) --h
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Dated at the Town of Queensbury this 19th Day of November 19 90
SIGNED BY for the Town of Queensbury
Building nag d Zoning In ctor —�
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TOWN OP QUEENSBURY
REVIEWED BY OWN OF QUEENSSURY
FIECEIVEn
,111�, FEE PAID $ Ap\—
PERMIT NO. g(9- 795 NOV 19 1990
BUILDING PERMIT APPLICATION i3LDG. Coos DEFT,
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants spaces on this application MUST be completed and the signature of the
applicant MUST appear on the reverse side of this application.
• • • • • • • • • • • • • * • • • • • • • • • • • • • • • • • • • • * * • * • • •
The owner of this property is: A:474,fi:e
P.O. Address, �/3` -17)01&rd- /LG� aosei/9t)l /ZL/Tel.
Property Location • ,Vi.•Gu'oo c/ &rC/e- Tax Map No.
Has there been any split of this property since October 1, 1988? _ /
If yes Planning Board Review is necessary. yes no k� Th/rc-x. ,e�
SUBDIVISION NAME, IF APPLICABLE LO - _ _-
THE SU
PERVISION PERSON RESPONSIBLE FOR SUPER ISION OF WORK AS REGARDS TO BUILDING'CQQES_IS: �.
*
NATURE OF PROPOSED WORK: • • ESEMATED MARKET VALUE OF •
Construction of a new building * CONSTRUCTION: $
Addition to a building • COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x ft.
Alteration to a building * Existing Buildings(3) Size ft. x ft.
(no change to exterior dimensions)
Proposed building - distance from property line:
Other work (Describe) 75(9 O •
f •
Front yard ft. Rear yard ft.
1/0 r �/1��5h le /1,MP • Side yards ft. and ft.
*
GROSS AREA OF PROPOSED STRUCTURE • If on corner, setback from side street ft.
1st Floor sq. ft. * OCCUPANCY INFORMATION
•
2nd Floor sq. ft. • Pimary Building -
Other Floors sq. ft. * One Family Dwelling
(not cellar or basement 17'70fzi * Two Family Dwelling
TOTAL FLOOR AREA sq. ft. • Multiple Dwelling/Number of units
Size of new structure ft x ft. • Business
Foundation-pier/slab/crawl/partial/full • Industrial
(circle one) • Other
No. of stories (habitable space) •
•
Height (grade to ridge) ft. • If addition, what will use be?
If residential, no. of families •
No. of roonns(excluding baths) •
Accessory Building
No. of bedrooms ' _Detached Garage ONE/TWO Car
No. of bathrooms •
Primary heating system • Attached Garage ONE/TWO Car
Type of fuel • _Private storage building
No. of fireplaces installed_ •
• ___Other
Will a wood stove be installed_
Central Air conditioning *
OV• ER
BUILDING PERMIT APPLICATION CONT[NLED -
BUILDING 3PECIF'ICATIONS:
Type of construction, wood fram , fire safe, etc.
(Will any second-hand or upgraded lumber be used? If so. for what? �6 '
Foundation wall material Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated?
Floor sq, footage sq ft.
Will there be a basement? Will any portion be used as living space?
(If so, what portion? sq ft. Type of use?
Type of roof - sloped flat/shed/other Material of roof)(
Size, wood studs a "x l " spacing, " o.c. length ,F ft.
Joists (floor beams) 1st floor "x " spacing "o.c. span ft. , ;., '
Joist (floor beams) 2nd floor "x " spacing "o.c. span ft.
Overlays (ceiling beams) "x �' " spacing,5/ " o.c. span ft.
.Roof rafters e73 "x " spacing _' o.c. span ft.
Roof trusses (pre-engineered) spacing " o.c. span ft.
Exterior wall finish of what material?
Interior'wa11 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,
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 Distance from ANY private well (including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
JAME OF BUILDER J�, y,Y / ,e4,vD4// ADDRESS /-X ,t, 4aar TEL. NO. 5/ .
MAME OF PLUMBER ADDRESS TEL. NO.
4AME OF MASON ADDRESS TEL. NO.
SAME OF ELECTRICIAN ADDRESS TEL. NO.
DECLARATION
To the best of my knowledge and belief the statements contained in this application, together with the
tans and specifications submitted, are a true and complete statement of all proposed work to be done on
'ie described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
U other laws pertaining to the proposed work shall be complied with, whether specified or not, and that
4ch work is authorized by the owner.
Signature),-
0 ner owner's agen , architect, contractor
pECIAL CONDITIONS OF THE PERMIT:
BY
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280i
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 0/9/9d
NAME fj GP.f4ie„.J
LOCATION `,{DATE /f1/9 t9Q PERMIT # 90 ,11`y//��5
APPROVED
f L-,-/ L(� YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING '• �/"'
xFRAMING • tf
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS. .
WALLS .
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING / 1.�
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF'.VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS > .
GARAGE FIREPROOFING I ,
DOOR CLOSER(S) •
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION ‘
FINAL APPROVAL OF CONSTRUCTION:, •
- OK TO ISSUE C/O OR C/C I "? •
A SIGNED CERTIFICATE OF/OCCUPANCYMUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!.
REMARKS:•
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ARRIVE y�� fry
DEPART
• INSPECTOR
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