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+CER.TIFICA.TE C)F COMPLIANCE
TOWN OF +QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 1. 9 , 19 91.
This is to certify that work requested to be done as shown by Permit No. 89- 92n
has been completed. -
This sna=ture may be occupied as a n xterf r a1 r ion to t�i� s3filPss
lnac;tio`r„ Route 9 - Kendrick Road
Owner Cumberland Farms
I BY Ordcr Town Board
TOWN OF QUEENSBURY
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Director of Bldg. c5C Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY x
No. 89-920
WARREN COUNTY, NEW YORK "Cl
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PERMISSION is hereby granted to Cumberland Farms . .
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OWNER of property located at Route 9 - Kendrick Road street. Road or Ave. F
1
in the Town of Queensbury. To Construct or place an exterior 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. OWNE ::Address is Vsh Realty
777 Dedham Street
Canton : MA 02021
'2. CONTRACTOR or BUI LDEWS Name l't7
70
Larry Dickerson
tw
a CONTRACTOR or BUI LDE WS Address a
4. ARCHITECT'S Name
S. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X) M
4Q
( ) Wood Frame 1 ? Masonry { ? Steel I 1
7. PLANS and Specifications 91L'
No. Exterior Alterations to Business
cs
13. Proposed Use
t7
Exterior Alterations
$ 20400 PERMIT FEE PAID — THIS PERMIT EXPIRES November 293, 113 90
(if a longer period is required an application for en extension must be made to the Building and Zoning inspector of the
town of CQueensbury before the expiration date.] f+R
:NEC
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Dated at the Town of Queensbury this., 29th Day of November 19 89
SIGNED BY r for the Town of Queensbury
Building and ntng nspector —1
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TOWN OF Quin NSBURY
R E VTE W E D BY E
FEE PAID
a�S'Y
PERM UT NO, iU
BUILDING PERMIT APPLICATION ' COdk�
,A pEp,Krr ,MUST BE OBTAI. MD BEFORE BEGIN'NDiG CONSTRUCTION`. NO INSPECTIONS
NILL 88 MADE UNTIL APPLICANT HAS RECEIVED A VALID BU LDING 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: l/ h4?je '1 - x cr. k�L VN^ )o p. c r+" 1 igkc ry isl)
P.U. Address '7 2 -7 L�,j =S r. 4'� 7DA3 M P4 . 6 0e j Tel. ra / 7 1�?P - 4 00
Property Location"Ma C/ )"4& ^-' � 12 ; c K 4= - - --- Tax Map No.
Has there been any split of this property since October 1 . I9889 /
if yes Planning Board Review is necessary . yes no
SUBDIVISION NAME. IF APPLICABLE LOT NO-
THE PERSO?f RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
C3�4-) c;?
NATURE OF PROPOSED WORK : # ESTIMATED MARKET VALUE OF
Construction of a new building * CONSTRUCTION: 3
* COMPLETE INFORMATION REQUIRED BELOW:
Addition to a building
* Size of property ft x ft.
11L�Alteration to a building " Existing Buildings( 3 ) Size fte x ft.
(no change to exterior dimensions) «
Proposed building - distance from property line:
Other work (Describe) " Front yard ft. Rear yard ft.
* Side yards ft. and ft.
w
GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street tt.
1st Floor sq. OCCUPANCY INFORMATION
2nd Floor sq. ft. „ Primary Building
Other Floors s ft. * One Family Dwelling
¢
(not cellar or ement . Two Family Dwelling
TOTAL FLOOR AREA sq. ft. ` Multiple Dwelling/Number of units
Size of new structure ft x ft. 'Ind"t
Foundation-pi
er/slab/craw;/partial/full
E Irtde�striai
(circle one) -C~ ` Other
Noe of stories (habitable sMgo%1 .-
Height (grade to ridge) it: If addition, what will use bra!
If residential, nos of familles
No6 of roones(excludlret bathe? * Accessory BuWkw
Noo of bedrooms ` Dotached Garep !Two C
Noe of bathrooms •
Primary heating system s _�Attac sra�a U w0 Car
Type of fuel` " P to s bu
No, of fireplaces to be installed � . Oth �
Will a wood stow be lnstallod
Central Air conditioning
01l* ER
a
1l
BI= iLD [NG PERMIT APPLIC -% TIOv C0NT4oNvLE13 -
BL' ILD [NG ;PEC [FICATI0 %4S:
Type of construction, wood frame, fire safe, etc,
Will any second-hand or upgraded lximher be used? If so, for what ? A) Z2
Foundation wall material ^J ! 2 — Thickness
Depth of foundation below grade (to bottom of footing) /Q J Vol
Will there be a cellar ? Heated or unheated?_ i Floor sq. footage sq €t ,
Will there be a basement ? !i Will any portion be used as living space?
(If so, what portion? sq ft . Type of use ?
Type of roof - sloped/ fiat /shed/other 'Material of roof
Size, wood studs ""x " spacing "' o.c. length ft. #J r }
Joists ( floor beams) 1st floor . "'x " spacing "o. c, span ft. /
Joist (floor beams) 2nd floor "x spacing "o. c. span ft. ,wl / /;
Overlays (ceiling beams ) `"x It spacing " o. co span ft. /Jj
Roof rafters "x "" spacing o. c. span ft. J )I
Roof trusses (pre-engineered) spacing " O. C. span ft.
Exterior wall finish r^ of what material?
Interior wall finish AJ
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to hP an opening between garage and dwelling?..LiLA If so will a Fire-rated door, enclosure,
self-closing device be provided?
W i I I a flue-lined chimney be installed? t_q Height above roof ft.
Depth of chimney foundation below gradeQlLft.
Depth of fireplace hearth ft. in. . f Iq
Water supply - Municipal or private well I• -4 ,• ,A...
SEPTIC SYSTEM Distance from ANY private well {including adjoining proper t ies&l, S1, ,., ft.
(A separate application is necessary for any repair or new installation of septic system)
NAME OF BUILDERRc, y "t7J �� C2 � ADDRESS (7 " X `7 TEL. NO*
NAME OF PLUMBER ADDRESS TEL. NO.
NAME OF MASON ADDRESS TEL. NO.
NAME OF ELECTRICIAN ADDRESS TEL. NO.
DECLARATiUN
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 dorm on
� �scribed premises and that all provisi+wr- of the gUILDING CODE, THE ZONING ORDINANCE, and
all other laws pertaining to the proposed work shalt be eompliod with, whether specified or not, and that
such work is authoriXed by the owner.
Eignat . ee
Owner, eV er's gVen architect, contractor
:SPECLAL 'CONDMONE OF THE PERMrr:
By
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745- 4447
BUILDING INSPECTOR' S REPORT
FINAL INSPECTION
REQUEST FOR/INSPECTION
RECEIVED
NAME G f7. len
LOCATION
DATE PERMIT# �~/ �
TYPE OF STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL ( COMMERCIAL STRUCTURE )
FOOTING FOUNDATION BACKFILL FRAMING
u ROUGH PLUMBING FINAL ELECTRICAL SEPTIC
INSULATION �WOdDSTOVE/ FIREPLACE
REMARKS
APPROVAL
N /A YESy NO
CHIMNEY HEIGHT/LOCATION ]---
B VENT/LOCATION_
PLUMBING VENT
ROOFING
SIDING
DECK/P RCH/S PS/RAILI S
RELIEF VALVES
FURNACE/HOT W E OPE A IN _
BASEMENT INSULATION/DUC K�
INTERIOR TRIM/ PRIVACY D S
FINISH FLOORS :
BATH/KITCHEN WATERT H
OTHER FLOORS SWEEP LE
OTHER FLOORS CARP ED
STAIR CLEARANCE/R INGS
HANDICAPPED ACCE
SMOKE DETECTOR
BATHROOM F H LEH U E ANS
ALL PLUMBING FIXTURES OP ATING
GARAGE FIRE PROOFING
DOOR CLOSERS —
OTHER FIRE SEPARA ION
FIRE/DEMISE WALLS
DUMPS TER
SIT£ PLAN/VA IANC REOUIREMENTS�
FINAL ELECTRICAL
OK TO ISSUE C /O OR/�-
COMMEN S :
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(RECEIVED
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BLDG. & CODE DEPT.
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aevieww av OCT 28 589
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