1991-135 CERTIFICATE OF COMPLIANCE
•
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date e/77�..0,, .2 19 9/
This is to certify that work requested to be done as shown by Permit No. 91-135
has been completed.
This structure may be occupied as a POLE BARN for storage
Location RR 3 Box 225 Dean Drive
Owner Russell . Melanie Cooper •
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91-135
WARREN COUNTY, NEW YORK �O
0
PERMISSION is hereby granted to Cooper, Russell & Melanie
OWNER of property located at RR#3 Box 225 Dean Drive Street, Road or Ave. FI-'
1-1
in the Town of Queensbury,To Construct or place a Pole Barn
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.
n
1. OWNER'S Address is 0
Same
-
2. CONTRACTOR or BUILDER'S Name
to
Same �^
120
3. CONTRACTOR or BUILDER'S Address
CD
-r
CD
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 728 sq ft Pole Barn as per plot plan specifications and
application
8. Proposed Use
Pole Barn
$ 30.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 9, 19 92
(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.)
Dated at the Town of Queensbury this
9th Day of. ,- April 19 91
C �
SIGNED BY ` �/�?f, for the Town of Queensbury
Building and Zonindy spectoh r�
_TOWN OF QUEENSBURY
REVIEWED BY ifif.
,` FEE PAID $ TOWN OF QUEENBE3URN
FO,T PERMIT NO. qi_13`j RECEIVED
BUILDING PERMIT APPLICATION APR 1.1991
BLDG..& CODE DEPT.
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.
# * # * •. # * * * # # # * # * * # * * * * # * # * # i # # * * # * * * # * * # # #
The owner of this property is:
P.O. .Address T! 3 Q A : +v E- 6)sA_ElPf- .P24,AY Tel. 6--/2- 7`)ep. gz-cs
52,3yc6
Property Location Z.5 elfiC- pa .2-ba�� Tax Map No. /OW®J��/,�.
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 /f/,A LOT NO. `
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
*
NATURE OF PROPOSED WORK: VJ. ESC:MATED MARKET VALUE OF •
Construction of a new building * -
CONSTRUCTION: $ 2,•
Addition to_a.building _ _ • COMPLETE_INFORMATION REQUIRED.BELOW:-
* Size of property /° ,r ft x sift
Alteration to a building * awe
Existing Buildings(3) Size iy" ft. x 66 11 "ft.
(no change to exterior dimensions)
Proposed building - distance from property line:
Other work (Describe) * Front yard ft. Rear yard 8� ' . ft.
* Side yards / 7 ` ft. and ?' ft.
* If on corner, setback from side street //A ft.
GROSS AREA OF PROPOSED STRUCTURE • —�--
1st Floor sq. ft. '
* OCCUPANCY INFORMATION
2nd Floor sq. ft. * - Primary/ Building -
Other Floors sq. ft. * !� One Family Dwelling
(not cellar or basec^.ent Two Family Dwelling
sq. ft. • Multiple Dwelling/Number of units
TOTAL FLOOR AREA .
� • Business
Size of new structure .-(_ . ft x 2.4 ft.
Foundation--p slab/c ;u:= ; rtiai/full * Industrial
circle ur►�; • Other
No. of stories (habitable space) NVA *
Height (grade to ridge) )y-`7 ft. If addition, what will use be?_ 5%o#'4G6
If residential, no. of families w/,q •
No. of rooms(excluding baths) / " ' Accessory Building
No. of bedrooms A/A •
No. of bathrooms sue/ • Detached Garage.ONE/TWO Car
Primary heating.system , • _Attached Garage ONE/TWO Car
Type of fuel IV,A • =_Private storage building
No. of fireplaces to be installed ' jt ••
/
Will a wood stove be installed /V ll / •
• Other
Central Air conditioning ///
OV' ER
. I .
- 1.
BUILDING PERMIT APPLICATION CONTINUED - -
BUILDING SPECIFICATIONS:
Type of_constructi.on, wood frame, fire safe, etc.?0(2. •
Will any second-hand or upgraded lumber be used? If so, for what? No
Foundation wall material Cp,,,cte_�%'v
Thickness "
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? &U c Heated or unheated? Likkec,.zeb Floor sq. footage sq ft.
Will there be a basement? xoo • Will any portion be used as living space? i\J o
(If so, what portion? ad'!4, sq ft. Type of use?
Type of roof o e . flat/shed/other Material of roof I CT AL.. c.p LL)Ar.?r L(Gl'
Size, wood studs "x " spacing " o.c. length ft.- "
Joists (floor beams) 1st floor AJ/w "x " spacing "o.c. span ft.
Joist (floor beams) 2nd floor'/3 "x " spacing "o.c. span ft.
Overlays (ceiling beams) "x " spacing " o.c. span ft.
Roof rafters Z "x- " spacing 2,1 o.c. span - ft.
Roof trusses (pre-engineered) - spacing " o.c. span - ft.
Exterior wall finish LA:, Slaok"c' of what material? - II I `
Interior wall finish ki A.
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: I A
Is there to be an opening between garage and dwelling? ve c- If so will a Fire-rated door, enclosure,
self-closing device be provided? D
Will a flue-lined chimney be installed? r-) -o Height above roof ft.
Depth of chimney foundation below gradew/,a ft.
Depth of fireplace hearth )(//.4 ft. in..
Water supply - Municipal or private well 4ARouv
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 - �2-L- ADDRESS TEL. NO. -
NAME OF PLUMBER ADDRESS TEL. NO.
NAME OF MASON ADDRESS TEL. NO.
NAME OF ELECTRICIAN ADDRESS TEL. NO.
DECLARATION
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 described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
all other laws pertaining to the proposed work shall be corn lied with, whether specified or not, and that
such work is authorized by the owner.
Signature
Owner, owner's agent, architect, contractor
SPECIAL CONDITIONS.OF THE PERMIT:
BY
�°.��� '``. MIDDLE DEPARTMENT.INSPECTION AGENCY., INC.
'_~ I National Headquarters
\ 1337 West Chester Pike,West Chester, PA 19380 ..
APPLICANT COMPLETES THIS SECTION' ' - Date: i f /; / / ( ,
. ,
City, Town or Township ; County . .:,f,,• t r'--, , State ';/
i
Location/Address .I ,I,. - nl ; , . /7D "- -7' "irr<'c,r" —0 F=' t; 7.6-72/ )
• (If Located in Rural Area - Please Attach Directions) Pole #
Owner ' .r.', _ , ( , , - , ' Permit # ' CJ/_ / j S
Occupied As. ,` Building: New® .— Old, I
Occupant
Work Area in Building (Floor #,etc.):
V
App. for: Wiring ElI- Service ri or: Ready for Inspection:
Fee Remitted-$ Cash n Check n M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250,1500 1750 2000 2250 2500 2750 3000
Number of Rough,Wiring Outlets Elect. Heat: _ . ., _ _ V '
•
Switches i-/
Lighting /.. Amp. Service Surface Unit Dishwasher Range
Receptacles l
Water Heater Air Conditioner Dryer. Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment: > ' - ! . , { , -
MOTORS H.P. 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/z 10 15 20 25 30 40 50 75 100
Mark Number •
of Each Size ,
Applicant's
Signature V. - . License # Permit #
T/A Utility:
Applicant's Address: (NAME) (OFFICE.LOCATION)
(City) — " - :_ ,_'" ' (State) / (Zip) I •y. : Service Request #
Phone # , — v/`• - - - .Electrician:
MDIA USE ONLY 'DATE RECEIVED: DATE INSPECTED: - // '' 7 (- J
Correct Location: Same as Above I I or:
Red Notice Label n • .
2 Rough Wiring Outlets Surface Unit Oven
Switches Range ' Garbage Disposal '
/ 7 Receptacles Water Heater _ Dishwasher
_7 Fixtures Air Conditioner - Dryer
5 ) Amp. Service Equipment <!//3 Burner,Wiring &Controls for Amp. Receptacle '
Amp. Service Conductors Pump Vent Fans
MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 31- 5 7'/z 10 15 20 25 30 40 50 75 100 '
Mark Number
of Each Size -
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Elect. Heat -
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE RECOFEECT FEE PAID
�"W Progress: Inc.❑ LKD❑ Contractor V. L.J,4 .-LCFT Violation: Work Comp.❑ Inc. ❑
n L/A -. Owner CASH 1
Fee
I I L/A CHK #/3 So
Due MO #
n IPA Municipal ,
, INV # � .�
1 / / d - Applicant I`I
Date: t I- Z V. / Other Side Utility ❑
Owner
Cut in Card Temp # Date f/) ,,�' �— '7 Q F'
n t(' f. c',f _'. , I: / .,�,.,;.tf�,r r. C}
Final# YV '� Date ii t`'� . INSPECTORS SIGNATURE
APP-LICATIO.N_FQRM_NO_25QEL 11/89 -__.
•
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. Q
Owner "e 1 �D / ��` r_
Occupant
Location -3)er N /7
C cL 2-21- ✓S a Y Street
Town or Cary State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by 5, Ca Q/41-2L
r' r' o 9' o
///
Date /(, �'� `9 / 1/ L�%C t -- e ector
MIDDLE DEPARTMENT INSPECTION AGENCY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
75 OAS (J ( �/ WIRING &CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
7 AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VENT FANS
MOTORS H.P. 1/20 I/12 I/IO 1 1/6 % h 1/2 1 1'/1 2 3 5 7h 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
.dPc � `/i' r 0
j7 TOWN OF QUEENSBURY 1 T1(
531 BAY ROAD / 9_ 73L)
vM QUEENSBURY, NEW YORK 12804 ` x/4
s . ;,f„Y:Yr TELEPHONE (518) 745-4447
;A. BUILDING INSPECTOR'S REPORT
FINAL INSPECTIONN
REQUEST FOR INSPECTION RECEIVED
NAME (/_co �Z-
LOCATION 1J:6-.f '.�Z at)K Z Z_
DATE f 0/2-1 ) (7f ER_PMIT ` qi, 13'
TYPE OF STRUCTURE `1,1n-v 1',-'1_A66-
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL--_SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
/
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING r _
SIDING ,' _
DECK/PORCH/STEPS/RAILINGS I.
RELIEF VALVES
FURNACE/HOT WATER OPERATING'
BASEMENT INSULATION/DUCTW0
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS: >�
BATH/KITCHEN WATERTIG'HT _
OTHER FLOORS SWEEPAB'LE _
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAII/INGS ;
HANDICAPPED ACCESS!
SMOKE DETECTORS /
BATHROOM FANS/WHO;LEHOUSE FANS ;.,
ALL PLUMBING FIXTURES OPERATING \
GARAGE FIRE PROOFING_
DOOR CLOSERS 1
OTHER FIRE SEPARATION_
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS _
FINAL ELECTRICAL
SC OK TO ISSUE C/O OR C/C
I
COMMENTS: n , r t C�
( 2+ IMT�G - d `v
/Vo E -ru CA--L -
.r�- -I o rz C oM iLe-rz'b i r(,(/fs 1f nco
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ARRIVE -3).-�js--
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DEPART 3 _ -
INS E y
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT y�
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR°S REPORT
REQUEST FOR INSPECTION RECEIVED 1/1//f7
NAME 4.1441111 61114,
LOCATION / /OQll/Li1 /&
, ( ao�f t t
DATE 41140 ( PERMIT # 9/-Ag
TYPE OF STRUCTURE / LLL AAik
RECHECK APPROVED
N/A YE NO
)( FOOTINGS/PIERS 1 K
MONOLITHIC POUR FORM /
REINFORCEMENT IN PLACE ;1
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR ;r
REINFORCEMENT IN PLACE]
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING '
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS r. R-
WALLS ? R-
CEILING 1 R-
DUCT WORK;OR PIPING IN UNHEATED
SPACES
REMARK % r, ��
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/ i W--S 62A-44 w
ARRIVE (0; Z�
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Q. �•� ( 7./g01/64 0 E4Se2S) APR 11991
j �. \ � 7 2)&, Gip. R INS 1L� BLDG,
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70WN Of QUEE'USBUi3Y BillLD3�lf,DEPARTMENT
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, till . Based on our limited rhrtr>Hn LL
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;'a compliance with our comments �f��c�,�ei c
' CO-PY riot be construed as irtdica�ng tfle /D St.�b FILE 10 >- F I plans and specifications
m aremfuU
^ . compliance with the code.
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