1992-105 +CER,TIFICATE OF +Q%`%C- PAN" r
TOWN Of QUEENSSURY
WARREN COUNTY, NEW YORK
I
Date Zdjaa 19 .Lr�
!This is to certify Ahatork requested to be dose as shown by Permit No. 92-105
has been completed.
This amucture may be occupied as a Family 'ROOM
1...ocation Meadowbrook Rd
C WrWr Jams b Sharon Piper
By Order Town Board
TOWN OF {QUEENSBURY
J
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF Q►UEENSBURY No. 92-10� k
WARREN COUNTY, NEW YORK
PERMISSION is 'hereby granted to James A Sharon Piper
OWNER of property located at MleadowBrook Road Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Alteration to Dwelling
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-
t . OWNER'S Address is
RR5 Box 411
Meadowbrook Rd
Queensbury. MY 12W4
2. CONTRACTOR or BUILDER 'S Name
Don Jones
3_ CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
S. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
J Wood Frame I ) Masonry 1 ) Steel ( 1
7. PLANS and Specifications
No. 416 sq ft Alteration to dwelling as per plot plan specifications
and application
S. Proposed Use
Family Room
$ 16000 PERMIT FEE PAID — THIS PERMIT EXPIRES March 31 , 19 93
(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 Qu this sir � �!—Day of March 19 92
4.
SIGNED BY . for the Town of Queensbury
BuiJcWQ and Zoning Inspector
TOWN OF QUEENSOURY
REVIEWED BY : NIAR
FEE PAID . cam ( 0010A QEPT.
PERMIT NO . :
BUILDING PERMIT APPLICATION
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 .
Owner of Property : =) rEs n
P . O . Address : P'e4;r 2?"' PHONE
Property Location : � d''4. '4� Tax Map No .
Has there been any split of this property since October I , 1988? Yes No
If yes , Planning Board Review is necessary .
Subdivision Name , if applicable : Lot No .
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
NATURE OF PROPOSED WORK : * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION : $ f 1
Addition to building
u Alteration to building * COMPLETE INFORMATION REQUIRED BELOW :
( no change to exterior dimensions ) * Size of Property : c;2W ft . x /36 ft .
Other work ( describe ) * Existing Building Size :
* 5-7o ft . x ft .
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE : * property line :
Ist Floor �/`/ Sq . Ft . * Front Yard fate/yard ft .
Side Yards ftft .
2nd Floor Sq . Ft . * If on corner , setb k ide street-
* ft .
Other Floors Sq . Ft .
(not cellar or basement * OCCUPANCY INFORMATION :
TOTAL FLOOR AREA : Sq . Ft . * Primary Building - !
* ✓ One Family Dwelling
Size of New Structure : .. ft . x ft . * Two Family Dwelling
Foundation : * Multiple Dwelling/No . of Units
Pier/Slab/Crawl /Partial /Full ( Circle One ) * Business
* Industrial
Nov of stories ( Habitable space ) * Other
Height ( jFade to ridge ) ti — ft .
If residential , no . of familie : * If addition , what will use be? ,
Noe of rooms ( excluding baths ) :
No . of bedrooms :
No . of bathrooms : ,r * Accessory Building :
Primary heating system : r * Detached Garage - One/Two Car
Type of fuel : * Attached Garage - One/Two Car
No . of fireplaces to be installed : Private Storage Building
Will a woodstove be installed? : Other
Central Air Conditioning : Yes No
( OVER ) --
~ BUILDING PERMIT APPLICATION CONTINUED :
BUILDING SPECIFICATIONS :
Type of construction : wood frame , fire safe , etc . /r40".a le
Will any second- hand or ungraded lumber be used ? If so , for what ?
Foundation Wall Material : I Thickness :
Depth of Foundation below grade ( to bottom of footing ) : ,c
Will there be a cellar? Heated or Unheated ? � Floor Sq . Footage :
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 _ '" x a� +' ; spacing �"
X. o . c . ; length ft .
Joists ( floor beams ) : Ist Floor 2 x 19 spacing _ /� "' o . c . ; span ft .
Joists ( floor beams ) : 2nd Floor �" " ; spacing IN o . c . ; span ft .
Overlays ( ceiling beams ) : x " pacing o . c . ; span ft .
Roof rafters : IN
x " ; spa ng o . c . ; span ft ,
Roof trusses ( pre-engineered ) : s " o , c . ; span ft .
p aa�ing
Exterior Wall Finish : ,3, �. , of what material ?
Interior Wall Finish :
If a garage is to be attached , describe materials to be used for FIRE SEPARATION :
Is there to be an opening between garage an dwelling ? If so , will a Fire- Rated door ,
enclosure , self- closing devi a be provided
Will a flue- lined chimney instal ed? eight above roof ft .
Depth of chimney foundar below rade ft .
Depth of fireplace he t : f in .
Water supply - Munic ' 1 ivat wel
SEPTIC SYSTEM : DisVnce from an private well ( including adjoining properties : ft .
(A separate application is nec nary for any repair or new installation of septic system . )
NAME OF BUILDER & ADDRESS : ,+ /r.. �s PHONE
NAME OF PLUMBER & ADDRESS : PHONE
NAME OF MASON & ADDRESS : PHONE
NAME OF ELECTRICIAN & ADDRESS : PHONE
DECLARATIOR
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 p ing to the proposed work shall
be complied with , whether specified or not , and that su work is authoriz the owner .
S i gnat � � rA ~
her , owner s nt , Xrchitect
contractor
SPECIAL CONDITIONS OF THE PERMIT :
By :
Code Enforcement Officer
TOWN OF QUEENSSIIRY • 3o
531 SAY ROAD �I
QUEENSBURY , NEW YORK 12804 ` ,
TELEPHONE (518) 745-4447
BUILDING INSPECTOR' S REPORT
FIML INSPECTION
REQUEST FOR INSPECTION RECEIVED
2d 4
NAME /
LOCATION
DATE b y + _ PEFAMIT#
TYPE OF STRUCTURE ' K
RECHECK
FIRE MARSHAL APPROVAL ( COMMERICIAL S RUCTURE )
`FOOTING �FOUNDA7 BA�CKFILL FRAMING
UGH PLUM FINAL E ECTRIC L� SEPTIC
T,.1SULATION W0ODST0VE/ F EPLA
em -r 3 Cepk
REMARKS
APPROV L
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/P RCH/S E S/ IL IN �.......
RELIEF VALVES -
FURNACE/HOT WA R-Off tG_ --
INTERIOR TRIM/PRIVACY OO
FINISH FLOORS :
BATH/KITCHEN WATE IGHT
OTHER FLOORS SWE ABLE
OTHER FLOORS CAR ETEO
STAIR CLEARANCE LINGS
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS ALL PLUMBING FI URES OPERA INS_
GARAGE FIRE PROOFING
DOOR CLOSERS --
OTHER FIRE S PA I N
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O /
COMMENTS :
ARRIVE
r [ .
DEPART E
TOWN OF QUEENSBURY
BUILDING AND CODES
531 BAY ROAD DEPARTMENT
12804
RK
QUEENSBURYTELEPHONEy ( 518)NEW 0745 4447
BUILDING INSPECTORIS REPORT
REQUEST FOR INSPECTION RECEIVE
NAME
LOCAT ION n -
DATE�,��-�-PERMIT
TYPE OF STRUCTURE APPROVED
RECHECK N A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMETOR IS LRESPO SIBLE
THE CONTRAC
FOR PROVIDING PROTECTION FROM
EE PLACEMENT OF THEOURS FOLLOWING
THE
CONCRETE*
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATiION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE ek4 �
PLUMBING LENDER SLAB 4
FRAMING :
JACKS UD5/HEADS 5
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN 8EAM
HEATING ROUGH- IN
� q NSULATION : R R-
aT FOUNDATION ALLS N E
FOUNDATION WAILS EXTE IOR RR`
FLOORS I R-
WALLS R-
CEILING
DUCT WORK OR PIPI G H 11NHEA ED
SPACES
REMARKS :
ARRIVE
DEPART ArNl�OR �
TOWN OF QUEEMSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 792. 5832
BUILDING INSPECTOR ` S REPORT
REQUEST FOR INSPECTION RECEIVED N..whI
NAME f 15 xP .C2A-I
LOCAT I ONL 4
DATE PE�}RMIT # q 2 1V r]
TYPE OF STRUCTURE
RECHECK APPROVED
N /A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
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
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL -
ROUGH PLUMBING -
PLUMBING VENT/VENTS N P ACE M °
PLUMBING UNDER SLAB
JFRAMING : `
JACK STUDS /HERDERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS /MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH- IN
INSULATION:
FOUNDATION WAL IN ERIOR R-
FOUNDATION WA S EXTERIOR R-
FLOORS R-
WA LLS R-
CEILING R-
DUCT WORK DR PIPING IN UNHEATED
SPACES
REMARKS :
ARRIVE
DE PART r
NSPECTOR