1991-391 ' - -- • ' ,--; . - - .
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CERTIFICATE OF COMPLIANCE
TOWN .OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date /f19
91-391
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a Pnnii Shawl
Location 39 Helen Drive
James V. Lauricella
Owner
By Order Town Board
TOWN OF QUEENSBURY Iv
Director of Bldg. & Code Enforcement
BUILDING PERMIT
x
TOWN OF QUEENSBURY No. 91-391
0
WARREN COUNTY, NEW YORK •
0
PERMISSION is hereby granted to
James V. Lauri cel 1 a421
OWNER of property located at
39 Helen Drive Street, Road or Ave. 411.
in the Town of Queensbury,To Construct or place a Shed
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.
•S
1. OWNER'S Address is
fD
Same
2. CONTRACTOR or BUILDER'S Name
Same fD
N
3. CONTRACTOR or BUILDER'S Address
W
CD
4. ARCHITECT'S Name
CD
5. ARCHITECT'S Address
co
a
6. TYPE of Construction—(Please indicate by X)
(X►Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. 120 sq ft Shed as per plot plan specifications and application
8. Proposed Use
Storage
$ 15.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 4, 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 thiis 4th pay of .• June 19 91
SIGNED BY , for the Town of Queensbury
Bu li ding and Zorfog Inspector
TOWN OF QUEENSBURY
REVIEWED BY /!iii,
•� %1 FEE PAID $ // ci O>O' TOWN OF QUEEN i�= _ _`
,41 PERMIT NO. Q/ / -- 3 9 / D P
,, W F.;_,'
BUILDING PERMIT APPLICATION JUN 41991 I
_
BIA.D$NG & 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.
* * • • * • * • • • * * * * • * * • * * * a * * * * • * * • • • * a a • * * • * a
The owner of this property is: v rrvki=S V, L d-(,-)e( c /1 A
P.O. Address g,& I pea - .. TeL 2 --22(3
Property Location 39 14.4_ piz_ Tax Map No. 2O i /
Has there been any split of this property since October 1, 1988? / ci
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 IS:
*
NATURE OF PROPOSED WORK: • ESTIMATED MARKET VALUE OF -
Construction of a new building * CONSTRUCTION: $ �
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x ft.
Alteration to a building * Existing Buildings(3) Size ft. 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.
GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street ft.
*
1st Floor sq. ft. OCCUPANCY INFORMATION
*
2nd Floor sq. ft. * ' Primary Building -
Other Floors sq. ft. • One Family Dwelling
(not cellar or baset Two Family Dwelling
TOTAL FLOOR AREA s ft. •* Multiple Dwelling/Number of units
_1� q•
Size of new structure o ft x 2 ft. * Business
Foundation-pier slab -;:.;' rtiai/full • Industrial
(circ e %;r,;;; • '° Other
•
No. of stories (habitable space) •
Height (grade to ridge) / p ft. • If addition, what will use be?
If residential, no. of families •
No. of rooms(excluding baths)
• -
Accessory Building
No. of bedrooms • __Detached Garage ONE/TWO Car
No. of bathrooms *
Primary heating system • _____,Attached Garage ONE/TWO Car
Type of fuel * _Private storage building
No. of fireplaces to be installed * ' /
• !/ Other ,e6 0 4 3//db
Willa wood stove be installed
Central Air conditioning •
OV* ER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING-SPECIFICAVIDNIS:
•
f construction;4o0 frame, fire safe, etc. /th9 J
14illany :econd:hared oi,-upgraded lumber be used? If so. for what? y"o
a .`: ;fir• :,:
Foundation wall material 4``.eo,u c:- s G.,a 3 Thickness
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated? Floor sq. footage sq ft.
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 " spacing " o.c. length ft.
Joists (floor beams) 1st floor "x " spacing "o.c. span 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.c. 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 be 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 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 complied with, whether specified or not, and that
such work is authorized by the owner.
Signature . U
• er, owner's agent, architect, contractor
SPECIAL CONDITIONS OF THE PERMIT:
BY
`7ZO Cyr
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTIIONN RECEIVED )
NAME � !� . tea.-/.C/�.(e-taiz
LOCATION
DATE G/ PERMIT # 9/-& /
TYPE OF S RUCTURE ,lf ,v1-/u7d
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 IN PLACE .;
PLUMBING UNDER SLAB
FRAMING: !m
JACK STUDS/HEADERS ?
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM r' t
FIRESTOPPING
WALLS ` 1
CEILING F
FIREWALLS
HEATING ROUGH-IN 1
INSULATION: I 'r
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS / R- \
WALLS T R-
CEILING I R-
DUCT WORK OR PIPING IN UNHEATED
SPACES /
REMARKS:-7-v/l/�
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