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CERTIFICATE +(JF CO- MPLIANCE
I
1 TOWN OF CIUEENSSURY
WARREN COUNTY, NEW YORK
Date July 13 1990
This is to certify that work requested to be done as shown by Permit No. 89- 972
I
has been completed.
This structure may be occupied as a
replacement of studing
riot' Meadowbrook Road
Owner Carol n & Gary P . Moore
i
By Order Town Board
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TOWN OF QUEEN58URY
{ Director of Bldg. do Code Enforcement
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BUILDING PERMIT 4,
TOWN OF QUEENSBURY -�
No. -
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CAROLYN & GuARY P . MOORE
OWNER of property located at 153 Meadowbrook Road street, Road or Ave.
in the Town of Queensbury, To Construct or place a Replacement of Rotted Studi n
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 . OYME R'S Address is O
Po
RR #5 - Box 415 v' '
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2. CONTRACTOR or BUILDER'S Name O
Self
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3. CONTRACTOR or BUILDER'S Address A
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction — (Plans& indicate by x)
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Q( ) Wood Frame I I Masonry I I Steel I T C
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O
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7. PLANS and Specifications
O
No- Replace rotted from work to receive new windows and front door as
per application and plot plan .
S. Proposed Use O-
Replacement of Rotted Studing .
$ 15 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES December 19 19 90
CD
+Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the W
town of Queensbury before the expiration date.) CD
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Dated at the Town of Queensbury this 19th Day of December 1989
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SIGNED BY for the Town of Queensbury cco
Building and Zoning Inspector 'C$
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TOWN OF QUEENSBURY
REVIEWED BY
ca FEE PAM
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P E R MI'T' NOw gr�' to l 000
- t BUILDING PERMIT APPLICATION
A PERrMT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
WILL BE 1MTADE UNTIL APPLICANT HAS RECEIVED A VALID BUELDING 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.
■ # F i # • R # M # # ill # * • # # # iF • # # • # • # 7M F ■ # # • # # # # # # # # #
The owner of this property is: � QdLylV C'. �•�24� '1C3C 'C'r
P.Q. Address Q - Fox V/ - Tel• '7 r7' Z - ZI�5 72_
Property Location I`-,� j Tax Map No.
Has there been any split of this property since October 1 , 198a ?
If yes Planning Board Review is necessary . yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES ISs
NATURE OF PROPOSED WORK: ESI';MATED MARKET VALUE OFF
s
Construction of a new building ,. CONSTRUCTIONS St7LZa c�C
Addition to a building ' COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x ft.
Alteration to a building • Existing Buildings0 ) Size ft* x ft.
(no Change to exterior dimensions)
I+Ovrl Dc>oc 1� Proposed building - distance from property line:
Other work (Describe) WIA3TilCxt] 1 .1 I {� rE" Front yard ft. Rear yard tt.
V•JaZ tA.> 0&3W; . Side yards ft. and ft.
GROSS AREA OF PROPOSED STRUCTURE „ If on corner, setback from side street ft.
ist Floor sq. ft. * OCCUPANCY INFORMATION
•
2nd Floor sq4 ft. Primary Building -
Other Floors &, , tt. . ';✓ One Family Dwelling
(not cellar or ement) Two Family Dwelling
TOTAL FLOOR AREA sq. ft.. • Multiple DwelUnglNurnber of units
Size of now structure ft x ft.
• Business
Tc .- eFl�r:s-pzc.-lslaiu+lcrawlilp�artiallfull °' IndwAria4
(circle one) " Other
•
Now of stories (habitable space)
Height (grade to ridge) ft* . If addition, what will use tie?
If residentlaL now of families
No* of rooms(excluding baths) • Accessory Building
Nos of bedrooms` •
ag
w Detached Gara ONEI'dr1MC3 Car
No. of bathrooms
Primary heating system . _Attached GerWe ONR/TWO Cat
'type of fuel _ ' _,,,,Private storage building
No* of fireplaces to be installed +
,+ Other
Will, a wood stow be installed
Central Air conditioning
O V* ER
SUfLDfNG PERNIIT APPLICaTIO .N CONT : `: 4ED -
BUILD NG }PECIFICATIONIS:
Tape of construction, wood frame, fire safe, etc. [� ?
Will any second-hand or upgraded itimherbe used? If so, for what ?
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 .
WiII 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 "K�" spacing" o. c4 length r -6v" ft. ,05-FIAcz
Joists (floor beams ) 1st floor „x op spacing "o.c. span 1_ ft.
Joist (floor beams) 2nd floor "x " spacing "o. c. span ft.
Overlays (ceiling beams ) "x " spacing " o. c, span ft,
Roof rafters "x " spacing o. c. span ft,
Roof trusses (pre-engineered) spacing " o. co span ft.
Exterior wall finish of what material ?
Interior wall finish
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
Is there to he 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)
NAME OF BUILDER � ,r
- ADDRESS f5-7 �t'� Cfi)--,►Z✓r"f� ,�'r,�f TEL. �--
NAME OF PLUMBER ADDRESS TEL. NCI. ww
NAME OF MASON ADDRESS TEL. NO.
NAME OF ELECTRICIAN ADDRESS TEL, NO.
DECLARA T'IOW
To the best of my knowledge and belief the statements contained in this appuCetiotl. together with the
Plans and specifications submitted. are a true and cornptet• statement of all properced work be done on
Rh• euiscrfbed premises and that all provisil*r. .of the BUILDING CODE, THE ZONING ORDINANCE, and
A" other laws pertaining to the proposed work shall be complied witho whether specified or not, and that
such work is authorized by the owner.
54roture
Ow4er, #`wn4b, rr8s` 40nt, architooU contractcw
SPECIAL CONDITIONS OF TINE PERMIT:
BY
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 area �
2 . Type of heat ga udm&j
3 . is the building mechanically cooled ?
4 . Percentage of area of windows and doors U1Jk4,W Ill
A . over 16 % only
1 . Uo value of gross area of walls , roof / ceiling and floors
exposed to ambient conditions
2 . Floor over heat - 3 spaces YES
a . Are found & ' on walls insulated ? YES NO
1 . If YES . what is the R value ?
3 . Slab on grade YES NO '
a . If YES , wh . t is the R value of insulation around
perimeter of floor ?
4 . Is basement heated ? YES No
a . R value of insulation
5 . Type of insulation ; VqF1A3✓� 14t ---
B . Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions_
2 . R value of exterior walls (
3 . R value of glazed area
4 . R value of doors Ak.LI-17G�#77'c � ""' )
5 . R value of floors over unheated spaces w0 Y,� L1YC TI
6 . R value of slab edge insulation - unheated
7 . R value of slab insulation - heated slab '+�'' � r+�
B . R value of heated basement/ cellar walls ( above grade )
9 , R value of heated basement / cellar walls ( below grade )
10 . Type of insulation
C . Controls ' ..�
1 . Thermostat maximum heat setting
D . Duct systems
ftawftVPomm
1 . is duct system installed in unheated spaces ? YES No
a . If YES . R value of duct installation
b . R value of duct in other areas
E . Pipina Insulation
I . Size of hot v*^* ^ tV or cooling Carr ing agent pipe ,
2 . R value of pipe insulation c: P WOK h1 r57/ rI bh ' risA �'1
F . Service Water Heating
1 . Performance efficiency
2 . Temperature control setting maximu1ft f-
G . For Swimming Pool Only
1 . maximum heating
Telephone No
pp c n s gnature )
BUILDING
OF QD CODES
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BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY. NEW Y RK 1260k ✓1�.
TELEPHONE (519) 92-5832 f7
BUILM INSPECTOR' S REPORT
REQUEST FOR INSPE SON RECEIVED
NAME
LOCATION
DATE 71,t I PERMIT #
APPROVED
YES NO
FOOTINGJPIERS
MONOLITHIC POUR FO S
FOUNDATION/DAMP-PR ING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNSY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST S
STAIRS-CLEARANCE & I S
PLUMBING FIXTURES/RE F VALVE _
INTERIOR TRIM/PRIVAC DOORS
FINISHED FLOORS _
GARAGE FIREPROOFING
DOOR CLOSERS)
SMOKE DETECTORS
FINAL ELECTRICAL IN ER ON
FINAL .APPROVAL OF C STR TION
OK TO ISSUE C/O OR /C
A SIGNED CERTIFIC TE OF UPANCY MUST BE
OBTAINED FROM TH BUILDING DEPARTMENT BEFORE
THESE PREMISES E OCCUPIE
REMARKS:
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AWUV$ZjC
INSPECTOR
TOWN OF Q
BUILDING ,ANDD CODES
DEPARTMENT
BAY A HAVILAND ROADS
QUEENSBURY, NEW YORK 1280¢
TELEPHONE (518 ) 792- 5832 f �Jj
BUILDING INSPECTOR ' S REPORT ( 6
REQUEST FOR INSPECTION RECEIVEDy
NAME
LOCATION - 4el 1/4ol ry
DATE ERMIT #
APPROVED
YES NO
FOOTING/fPIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFIN
BACKFILL APPROVAL
ROUG PLUMBING
MIND
ELECTRICAL ROUGH-IN
INSULATIo
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/ST PS
STAIRS-CLEARANCE RAIk
PLUMBING FIXTURES ELILVE
INTERIOR TRIM/PRI ACY
FINISHED FLOORS
GARAGE FIREPROOF NG
DOOR CLOSERS)
SMOKE DETECTOR
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL F CONSTRUCT-TdPN
A SIGNED CERTI ICATE OF OCCUP NCY MUST BE
OBTAINED FROM THE BUILDING DE RTMENT BEFORE
THESE PREMISE ARE OCCUPIED+ t
REMARKS:
?fit -� �'' • , 6
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TOR
TOWN OF Q UEENSB UR Y
BOY a1 MaWland Road, q� MY 7280a-9725--518.792-5832
Building & Cades Department
XNS'PECTOR 'S REPORT
PR[3PERTY LOC TIC/N
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OWNER OR TENANT `
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BUILDING` L SEWAC31E SIGN OTHER
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REMARKS :
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// " E OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE"
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