1989-921 CERTIFICATE C►F COMPLIANCE
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
Hate Jt."Iz is
[[has
. 14
s to certify that work requested to be done as showtx by Permit No. 89-42L
eer► completed.
This structure may be occupied as ji exterior alterations`
Main Street A Bran Street
Owner Cumberland Farms
BY Order Town Board
TOWN OF QUEEN5BURY
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Director of Bldg. & Coda Enforcement
BUILDING PERMIT
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TOWN OF QUEENSBURY �
No. 89'-921 �
WARREN COUNTY, NEW YOiRK v
PERMISSION is hereby granted to Cumberland Farms +�
OWNER of property located a Main Street & Ryan Street street, Road or Ave. w
w
in the Town of Queensbury, To Construct or place an extc?rior alteration
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
VSH REALTY
777 Dedham Street
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2. CONTRACTOR or BUILDER'S Name
Larry Dickerson �+
3" CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
6. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
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( I Wood Frame ( l Masonry ( 1 Steel ( }
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7. PLANS and Specifications —i
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No. Exterior alterations to business
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B. Proposed Use
Exterior Alterations �o
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•-1
$ 20 , 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES XXXXXXXXX November 29 19 XX 90
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date-)
M
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Dated at the Town of Queensbury this./ 29th Day of November 19 89
SIGNED BY for the Town of Queensbury
Building and Zoning I nspector
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taa
TOWN OF QUEENSBURY
REViE W ED BY
FEE PAID # C6, rC Op
PERMIT NO. R Q Via S&IJPv
BUILDING PE1tNIPr APPLICATION NOV ,9 - 10PQ
cooe
A pERKrr MUST BE OBTADMD BEFORE BEGINNING CONST" UCTION. NO INSPECTIONS
MILL BE MADE UNTM 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.
* * w * * * r w * s * w * r w rckA
The owner of this property is: �5I '*� +� ; '"" �1 t- _ �rr, ��
P . O. Address 7 7 '7 z2w 6No r.) m iq _ c2 4. 2r l Tel. _ (& r J'
Property Location hhAt `l _^ y` A Tax Map No. I�I
Has there been any split of this property since October 1 . 1988 ? /
If yes Planning Board Review is necessary . yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSOt1 RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING D S IS:
NZ3 C 1< e 6 .-r- — 4, I I A.
4
NATURE OF PROPOSED WORK: 4
ESTIMATED 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: COM
Other work (Describe) ' Front yard ft. Rear yard ft.
* Side yards ft. and ft*
+r
GROSS AREA OF PROPOSED STRUCTURE If on corner, setback from side street ft.
Ist Floor sq* ft. OCCUPANCY INFORMATION
•
2nd Floor sq. ft. Primary Building
Other Floors sq, ft. One Family Dwelling
(not cellar or ement) Two Family Dwelling
TOTAL FLOOR AREA sq. ft. * Multiple DweLUng/Number of units
Size of now structure ft x ft. * Business
Industrial
Foundation-pier/dab/crawl/partial/fuU • Other X
(circle one) V
No. of stories (habitadl r space)
Height (grade to ridge) If addition, what will use be?
If residential, no* of families •
No. of rooms(ertclu4Ing baths) • Accessory Building
No. of bedroom a Detached,eeoage O WO Car
No* of bathrooms •
Car
Primary heating system w At herd ONE/TWO
Type of fuel ' P ter storag+er i
No* of fireplaces to be lnstalled
Other ^ _
Will a wood store be instal'
•
Central Air conditioning
O11°` ER
BL' ILDIN PERtiiIT -OFF LlC -\J1 N C09TIN L" ED
,.3 a
B1L' 1LDf'NG ';PFCIFICATI0 `1S.
Ttipe of construction, wood frame, fire safe . etc ,
Will any second-hand or upgraded lumber be used ? If so, for what ?
Foundation wail material � ,rlf� Thickness
Depth of foundation below grade (to bottom of footing)_ rJ ) p
Will there be a cellar ? Heated or unheated ? _ _ r31 />" Floor sq. footage sq ft .
W411 there be a basement ? r�-JZ5 Will any portioei be used as living space ?
( so, what portion ? sq ft . Type of use ?
kpe of roof - sloped/ flat/shed/other vaterial of roof .j 0-
Uwood studs "x " spacing." o. c. length ft. tJ 1' i
ionsts ( floor beams) 1st floor "x " spacing "'o. c, span. ft. ,rJrl,°j
&ist (floor beams) 2nd floor."x " spacing "o. cv span ft.
1OVerlays (ceiling beams ) "x " spacing " o. c, span ft,
.aMbef rafters "x "' spacing o. c. span ft. r.3
r, 0of trusses (pre-engineered) spacing " o. c. span ft, 1i fi 1
`xterior wall finish ) of what material? I /
terior wall, finish
�. garage is to be attached, describe materials to be used for FIRE SEPARATION,
there to he an opening between garage and dwelling? ti ) 1 If so will a Fire-rated door, enclosure,
%lf-closing device be provided?
6 1 a flue-lined chimney be installed?Height above roof ft,
,Depth of chimney foundation below grade �ft.
;opth of fireplace hearth ft. in. ,A.)
'Ater supply - Municipal or private well r S
4EPTIC SYSTEM Distance from ANY private well (including adjoining properties4�,yj. ,"s7 ; ..t ft.
separate application is necessary for any repair or new installation of septic system )
�nl� t� Z-
NA'� OF BUILDER c, r�. � rz �. ADDRESS Q .a . I Zc ? l'EL. NO* J o ) 4� GaIIL
NXME OF PLUMBER ADDRESS TEL. NO.
1WAME OF MASON ADDRESS TEL. NO,
N$6.JE OF ELECTRICIAN ADDRESS TEL. NO.
DEC LA RAIMON
`.To the best of my knowledge and belief the statements contained in this application, together with the
plans and specifications submitted, are a true and complete statement of all proposed work to be done on
the descr t _ � ',.*Mises and that all provixisrr� of the BUILDING CODE. THE ZONING ORDINANCE, and
all other Laws pertaining to the proposed work shall be complied with, whether spocifI or not, and that
such work is authorized by the owner.
SWIStu
Owner, s aEen h,itoct, contractor
------------
SPECIAL CONDITIONS OF THE PEItWr:
BY
TOWN OF QUEENSBURY
531 BAY ROAD
ORK 12BO4
QUEENSBORY , K 518 ) 745- 4447
TELEPHONE
BUILDII46 INgpECTOR S REPtfRT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
AJ
,� r
LOCATION �-
PERMIT# `�_--�DATE Arjzl!5 � `=
TYPE OF STRUCTURE .-
R£CRECK
FIRE MARSHAL APPROVAL ( CBACKR. FILLL STFRAMING)
`FOOTING FOUNDATIO1NAL ELECTRICAL`SEPTIC
ROUGH PLUMB1NGWOODSTOVE/FI REPLACE
INSULATION
ALL
REMARKS � ! � !-��„�___
APPROVAL
N /A YES NO
CHIMNEY HEIGHT/ LOCA ION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/ STEPS/RAIL1 S
RELIEF VALVES
FuRNACEIHOT WATER OP A G
AS INSULAT10 DUCTW K------
INT ERIOR TRIM/ PRIV CY DOOR
FINISH 'FLOORS : TERTIGHT
BATH/ KITCHEN
OTHER FLOORS WEEPABLE
OTHER FLOOR CARPETED
STAIR CLEARA E/RAILINGS
HANDICAPPED CCESS
SMOKE DETECYORS
BATHROOM FANSIWHOLEHOU E FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING__�� ---
DOOR CLOSERS
0R FIRE SEpARA/OEMISE WALLS ION
ON
Du MPS TER
SITE PLAN/VARIANCE REQU REMEN
FINAL ELECTRICAL
OK TO ISSUE CIO OR C/C
COM NTS :
(jS) V1
DEPART,,,.__._ -- I�NSF '���~
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TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 51$ ) 745- 4447
BUILDING INSPECTOR' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
LOCATION It4fil .4�f
DATE PEMITi ( 1 92, /
TYPE OF STRUCTURExTi EII 2 c— f( r}T�tc7
RECHECK
_FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE )
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL mm SEPTIC
INSULATION WOOASTOVE/ FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCA ION
B VENT/LOCATION
PLUMBING VEli l
ROOFING
SIDING
DECK/PORCH/ STEPS /RAILINGS'
RELIEF VALVES
FURNACE/ HOT WATER OPER ING
BASEMENT INSULATION fDUU
INTERIOR TRIM/ PRIVACY FINISH FLOORS :
BATH/ KITCHEN WATERT GOTHER FLOORS SWEEP LOTHER FLOORS CARPE EDSTAIR CLEARANCE/RAIL NG
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLE OUSE F Bms
ALL PLUMBING FIXTURES OPERA IN
GARAGE FIRE PROOFING
DOOR CLOSERS _
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/ VARIANCE REQUIREMENTS. . .
FINAL ELECTRICAL _
OK TO ISSUE C/O OR C/C
COMMENTS .
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INSVECTUR
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Zoning Administrator
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RECEIVED
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3 - s000
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BLDG. CODE DEFT.
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6dMP OV-A ZO'-O" POL$ . (3)
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