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• ,-. . CERTIFICATE OF COMPLIANCE .
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F , .. .:TOWN OF QUEENSBURY
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WARREN COUNTY,. NEW YORK
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. Date /11-.014,N4,1:47/4 19 `2..
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• This is to certify that work requested to be done as shown by Permit No. 91-251
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has been completed. •
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Poch
This structure may be occupied as a
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Location 55 nilenesn NA cry Fihri va • . '
_ . .Owner Edward thmburg
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..i . , By Order Town Board •
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Director of Bldg. & Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-251
WARREN COUNTY, NEW YORK •
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IN)
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PERMISSION is hereby granted to Edward Humburg N
OWNER of property located at 55 Queen Mary Drive Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Porch
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 Q
Same
tin
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O.
2. CONTRACTOR or BUILDER'S Name a
Same
3. CONTRACTOR or BUILDER'S Address
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fD
4. ARCHITECT'S Name
Cu
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5. ARCHITECT'S Address <
fD
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1
6. TYPE of Construction—(Please indicate by X)
( )(Wood Frame ( 1 Masonry ( )Steel (
7. PLANS and Specifications
No. 168 sq ft Porch as per plot plan specifications and application
8. Proposed Use
Porch
$ 16.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 30, 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 30th Day of April 19 91
SIGNED BY ` � � �ttr
� for the Town of Queensbury
Building and Zoning I nspe�_/�r
TOWN OF QUEENSBURY Fee Paid / 2
BUILDING & CODES DEPARTMENT permit #\AY APPLICATION FOR: PORCHES-DE KS-DOCKS & BOATHOUSES Est. Cost// I
A PERMIT MUST BE OBTAINED. BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FOLLOWING:
The undersigned hereby appl
ies for a Building Permit to do the following work which will be
done in accordance with the description, plans and specifications submitted, and such special
conditions as may be indicated on the permit. TWO SETS OF STRUCTURAL PLANS SHALL BE SUBMITTED
plITHTHIS APPLICATION.
Owner of Property: ,Lbw A R d l +11J
un1b tin _
P.O. Address es Q(.1e ew m102 DR UT Oode 3 bidtyPhone # 7y NOR
e
y / Tax Map. # See /2/ /31� /1
Property Location L dT 31,
Subdivision Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name:
Address Phone#
BUILDING SPECIFICATIONS:
Type of work to be done: Porc Deck Dock Boathouse (Circle one)
Size of Structure to be built (square footage) : /6 8 S1g i
/ TOWN OF QUEENSBUM
Foundation Material : Width Thickness RECEIVED
Depth of Footing, below grade: W Feel
Size of Posts or Studs: L x x Long APR 2 9 1991
Size of Floor Joists: Z x g x /� Span BLDG. & CODE DEFT.
Decking or Flooring Material :
How will Porch or Deck be fastened to building? NAIL
If Roof Will Be Installed, Answer Following Questions:
Size of Posts or Studs: x x - , Long
t fB
Roof Rafters: tZ x Co Spacing 10 Span -7
Roof Trusses (pre-engineered spacing) : NA Span tM.
Type of Roof: Slope Flat Shed Other (Circle one)
Material of Roof: /7. ' ileac o c
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale and attached
yhereto, showing clearly and distinctly all buildings, whether existing or proposed and
indicate all set back dimensions from property lines. Show location of water supply and
location and configuration of septic disposal area.
Size of Property: 76 ft. x ft.
Existing building(s) : Size 36 ft. x '-Its ft.
Size ft. x ft.
Use of Existing building(s) :— (Les [ depc7.4/ •
Proposed structure, distance from property line:
Front yard ft. Rear yard ft.
Side yards ft. and ft.
If on corner, setback from side street: ft.
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 complied with, whether specified or not, and that such work is authorized by the
owner. l�J
DATE: I/ g 9 SIGNATURE c &0 d / •
/ A chitect, Contractor
Owner, Owner s Agen
APPROVED BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE
i'''„,- MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
i
1337 West Chester Pike,West Chester, PA 19380
APPLICANT COMPLETES THIS SECTION Date: /� Y/ /'/
•City, Town or Township i/ (:�"! ' �' -' L+lye' �11/92,1:�G,y State iVy
Location/Address t .' 0 . Pi .4 , 7,, /...
(If Located in Rural a Please -
Attach Directions) Pole # -
i �:
Owner /=/>.�.'!i."- ;�/�':;,F':f G
Permit # 77 ,�
Occupied As /?_ _ -•,, 7 1 .9L /2 ., ,I Building: New> Old❑
Occupant , l�7 ( �- '
------ Work Area in Building (Floor #,etc.):
App. for: Wiring - Service n or: Ready for Inspection:
Fee Remitted-$ Cash n Check F, M.O. I J 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
Switches / - Amp. Service• Surface Unit Dishwasher Range
Lighting Water Heater Air Conditioner Dryer ` Pump
Receptacles - Oven Garbage Disposal Wiring and Controls for Burner
Number of Fixtures
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 71/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's t
Signature I. :"+Jf..`C=t!' ( - 1" `.. License # Permit #
T/A \ R Utility:
Applicant's Address: — (NAME) (OFFICE LOCATION)
(City) (State) - (Zip) Service Request #
Phone # Electrician:
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above n or:
Red Notice Label n
Rough Wiring Outlets Surface Unit Oven
Switches Range Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer -
Amp. Service Equipment 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 3 5 71/2 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 CORRECTFEE FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
n L/A _ Owner CASH ❑
❑ L/A Fee CH K #
Due MO #
n IPA Municipal
• INV # '
Date: Other Side❑ Utility Applicant ❑
Owner '. n
Cut in Card I I Temp # Date li,+
n Final # Date •
INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 11/89 -
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
Permit No. 972.57
Owner -Oa
Occupant -
Location SS LE.e�� ,i4-174/
1G^Y Street
Town or City State
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by
Date <� Y/ d_aLegi. Q •.�" ns ector
MIDDLE DEPARTMENT INSPECTION AGENCY,INC.
FORM NO.18 EL. 1337 West Chester Pike,West Chester,PA 19380
SROUGH WIRING OUTLETS H.P.AIR CONDITIONER
'9CTCETS curiye WIRING &CONTROLS FOR BURNER
{,j RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
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 N.P. I/20 I/I2 I/IO % % % '/a ''/ '% 1 11/2 2 3 5 71,i 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
r, •,. ._ TELEPHONE (518) 792-5832
DUILDIM INSPECTOR'S REPORT
FINAL INSPECTI s:'
REQUEST FOR INSPECTIOGI RECEIVED
—C�q�.h/�i�!G2yi�l�U'O Y
LOCATION .75 ,.. _cam 7)(6c,e1 -
DATE 5I f 43 J PERMIT,
TYPE OF,STRUCTURE /‘)-Cr?.4_
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
✓✓FOOTING '.FOUNDATION BACKFILL FRAMING
ROUGH PLT.DMB;ING FINAL ELECTRICAL SEPTIC
INSULATION WONSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS YES NO
REMARKS �. > 7r�
/ APPROVAL
N/' YES NO
CHIMNEY HEIGHT/LOCATION 1
B VENT/LOCATION 1
PLUMBING VENT
ROOFING /
SIDING
DECK/PORCH/STEPS/RAILINGS V
RELIEF VALVES
FURNACE/HOT WATER OPERATING,
BASEMENT INSULATION/DUCTWORK.
INTERIOR TRIM/PRIVACY DOORS ''c:
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT '&
OTHER FLOORS SWEEPABLE �,..
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS \
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
FINAL ELECTRICAL /�
OK TO ISSUE C/O OR C/C r/
COMMENTS:
ARRIVE" --
DEPART /
TOWN OF QUEENSBURY �j
BUILDING AND CODES DEPARTMENT ��''//
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME M--0(94 d J41c,tt-e4
LOCATION, T5 O?J/ ' - U )2 Lk
DATE ,_47/fr/ PERMIT
TYPE OF STRUCTURE r 74/
RECHECK APPROVE)
N/A YES/ NO
X FOOTINGS/ELKS ,/
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/WALLFOUR
REINFORCEMENT IN, PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL,
ROUGH PLUMBING'
PLUMBING VENT/VENT yS IN PLACE;'
PLUMBING UNDER SLAB �t
FRAMING: A
JACK STUDS/HEADERS,
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM, ,; %
FIRESTOPPING ,,�f
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION: I
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIORkR-
FLOORS ," \,R-
WALLS ,J
CEILING f • R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
r
ARRIVE -0--
DEPART or- ����
INSPECT •
N 42-381 50 SHEETS 5 SQUARE
42.382 100 SHEETS 5 SQUARE G
A 42.389 200 SHEETS S SQUARE
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