1991-437 CERTIFICATE OF OCCUPANCY -
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date AVM/4 /9 19
This is to certify that work requested to be done as shown by Permit No. 91-437
has been completed.
,i
This structure may be occupied as a Alteration to dwelling
Location Kattski l l Bay
Owner John Serbal i k
By Order Town Board
TOWN OF QUEENSBURY
(D-
60
V
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-437 a
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to John Serbal i k • co
OWNER of property located at Kattski 11 Bay Street, Road or Ave.
1-1
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.
CJ
1. OWNER'S Address is
53 WEst Street
Nechani cvi 1 l e, NY
0
2. CONTRACTOR or BUILDER'S Name O
Same
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( ) Steel ( ) ...+
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7. PLANS and Specifications
No. 160 sq ft Alteration to Dwelling as per plot plan specifications
and application
8. Proposed Use
Alteration to Dwelling
$ 8.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 24, 1992
(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 Day of ,lime 19 91
SIGNED BY ' / �;7�//.✓z� for the Town of Queensbury
Building and Zoning In ector
TOWN OF QUEENSBURY
41111116 REVIEWED BY: /� '��
�C.')
TOW OF OUE . :..
FEE PAID: 16glgaVVII
PERMIT NO. : 9I- �
JUN
2 '991
BUILDING & CODE DEPT.
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: {
P.O. Address: t St Me r_h4 ;Gu,i/e `(y. / j .ti p PHONE S/c usai
Property Location: C'.9 Ke �6 `�9 4' Tax Map No. / /
Has there been any split of this property since October 1, 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:
Jo �t i\(. Se 4/ ,/7‘‹
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ ,2} D o
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: ro ft. x /c7 ft.
Other work (describe) * Existing Building Size:
* Z 5- ft. x 41,0 ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
*
1st Floor Sq. Ft. * Front Yard ft. Rear yard ft.
* Side Yards ft. and ft.
2nd Floor p Sq. Ft. * If on corner, setback from side street-
* ft.
Other Floors Sq. Ft.
(not cellar or basement) * OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: /40, o• Sq. Ft. * Primary Building -
* X 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
No. of stories (Habitable space) * Other
Height (grade to ridge) ft. *
If residential , no. of families: _ * If addition, what will use be?
No. of rooms (excluding baths) :
No. of bedrooms:
No. of bathrooms: * Accessory Building:
Primary heating system: * 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.
Will: any°;'second-.hand` or:�ungraded lumber be used? If so, for what?
Foundation: WallPMaterial : Thickness:
Dep__th•4,of bFoun,dat ,?n,::bl::ow grade (to bottom :of footing) :
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 " ; spacing " o.c. ; length ft.
Joists (floor beams) : 1st Floor " x "; spacing " o.c. ; span ft.
Joists (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: PHONE
NAME OF PLUMBER & ADDRESS: PHONE
NAME OF MASON & ADDRESS: PHONE
NAME OF ELECTRICIAN & ADDRESS: PHONE
•
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 �
o ner, owner' s agent, architect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
•
By:
Code Enforcement Officer
// -/-/9
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT •
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME Op o7 ,/�rig 2 1 b--- th
LOCATION / l Li `,g czy
DATE 9/ ?' /9/ PERMIT #
TYPE OF STRUCTURE (),Q,' ,,x2,)„f",„,
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/DAMPROOF;ING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE /
PLUMBING UNDER S AB \
A FRAMING: d-4 7/ Jql` 4L,1e /
JACK STUDS/HEADERS /
BRACING/BRIDGING �'
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
X INSULATION:
FOUNDATION WALLS NTERIOR R-
FOUNDATION WALLS EXTERIOR R=
FLOORS R=
`/,.WALLS 614, / /q
CEILING / R- \
DUCT WORK OR IPING IN UNHEATED
SPACES
REMARKS:c/L• (
,
lP
ry V"
ARRIVE 7/ 3
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED r /�j
r'�
NAME 1 1 ► k �Y�lY� J
LOCATION \ LA_V Q f�
DATE 1/0-/9 1 PERMIT # ) - 3 7
TYPE OF STRUCTURE AI+ 'I" \`')L )2 ,
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 r 7
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLCE
PLUMBING UNDER SLAB
FRAMING: f
JACK STUDS/HEADERS
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN BEAM /
FIRESTOPPING +'
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION: ti
FOUNDATION WALLS INTERIOR RA
FOUNDATION WALLS EXTERIOR R-'', /
FLOORS R- \ L./
WALLS R- p(
CEILING R-
DUCT WORK OR PIPING IN UNHEATED'.
SPACES
REMARKS:
`
ARRIVE
DEPART
1 ' ' ECTOR
1
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT`/cQ7/
REQUEST FOR INSPECTION RECEIVED (p /
NAAME J lI'1 \:\ 4
LOCATION -Sk,` >>
DATE n PERMIT # L 3 7
TYPE OF ST UCTURE NI �-� \--)koePn
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/DAMPROOF NG
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS AN PLACE /
PLUMBING UNDER SLAB I
FRAMING: 1 ��-
JACK STUDS/HEADERS
BRACING/BRIDGING /
JOIST HANGERS fit'
JACK POSTS/MAIN BEAM ,,
FIRESTOPPING !'
WALLS
CEILING 1 h
FIREWALLS ' 1
HEATING ROUGH-IN /
INSULATION: r 1
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALILS EXTERIOR\ R-
FLOORS r� �R-
WALLS /
CEILING / R-
DUCT WORK 0 PIPING IN UNHEATED
SPACES ( �,
REMARKS:
ARRIVE
DEPART
INSPECTOR
BUILDING & CODES DEPT,
own o QtteertJktfry
THE PLANS SUBMITTED HAVE BEEN REVIEWED AND
HAVE BEEN FOUND TO LACK SUFFICIENT DETAIL
FOR PROPER, PLAN REVIEW.
WE HAVE ISSUED THIS PERMIT WITH THE
FOLLOWING STIPULATIONS :
1 . THE WORK WILL BE INSPECTED - AND MUST CONFORM
TO ALL PROVISIONS OF PREVAILING CODES .
2 . IF DEFICIENCIES ARE FOUND THEY MUST BE COR-
RECTED BEFORE WORK CONTINUES .
3 . FAILURE TO COMPLY WILL RESULT IN REVOCATION
OF THE BUILDING PERMIT
//r"
Co.e l •rcement Officer
Ole /9PV
Building Permit #
COMMENTS: -
TOWN attENINOINIMUMNIMATIENT
• 11 *Pit WlN4
owes* 0.0.10101
plum sad 40011Miss Wife,
alecismothfie
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