1992-303 s
-�, CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSSURY
WARREN COUNTY , NEW YORK
Date s czc 19 570
This is to certify that work requested to be done as shown by Permit No . _qp�An_q
has been completed .
This structure may be used as a MudrooWGarage
LocaUlUn 3 Queensbury Avenue
Owner Steven A Linda Bush
By Order of Town Board
TO,W-N� OF QUEENSBURY
Director of Building A Code Enforcement
.1
BUILDING PERMIT
TOWN OF QUEENSBURY o
No. 92-3(l3
WARREN COUNTY, NEW YORK o
I
Iv
PERMISSION is hereby granted to Steven & Linda Bush ro
OWNER of property located at 43 Queensbury Avenue Street, Road or Arne_
in the Town of Oueensbury, To Constructor place a Addition to Dwelling incl . 2—Car Garage Co
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.
erg
t. OWNER'S Address is pp
Sane
as
2- CONTRACTOR or BUILDER'S Name —10��.
Ken Mattson moo,
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3. CONTRACTOR or BUILDER'S Address
A
W
4. ARCHITECT'S Name fp
C
C
tC
5. ARCHITECT'S Address ms
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f4
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#tY
6. TYPE of Construction -- [Please indicate by KY
( X) Wood Frame 1 ) Masonry [ ? Steel
e*
7. PLANS and Specifications
No. Addition to dwelling including 2-Car Garage as per plot plan
specifications and application �. w
8. Proposed Use tp
,a.
mud room/Ga rage
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$ 43- 1O PERMIT FEE PAID — THIS PERMIT EXPIRES June 3 , jg93
t
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the e'y
town of Queensbury before the expiration date.)
Ali
Dated at the Town of Queensbury t Day June 1g 92 ._
m
2
SIGNED BY for the Town of Queensbury
Building and ZtpCong Inspector
T'0 'b N OF QiIBEN58UR Y
REVIEWED BY : f �
FEE PAID : I4, 3 aCOWfl1
PERMIT NO . :
JUN ti 1992
BUILDING PERMIT APPLICATION 13I_D(3. $ 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 .
* * * * * * * * * * * * * * * * * * * * * * * It * nk ,► * * * *
Owner of Property :P . O . Address : PHONE
Property Location : S ) t" -\�f� Tax Map No . /ic / / / 2
Has there been any split ofthis roperty 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 :
K/ /
NATURE OF PROPOSED WORK : yw' ESTIMATED MARKET VALUE OF THE
Construction of new building CONSTRUCTION : $
-- Addition to building r �`V-11 * —�
Alteration to building "J * COMPLETE INFORMATION REQUIRED BELOW :
( no change to exterior dimensions ) * Size of Property : 2- ft . X '�g ft .
Other work ( describe ) Existing Building Size :
* Z4#zt-)o ft . x SSo ft .
� * Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE : V * property line :
,,.�tt -f aU a --q � ,�-�^
Ist Floor � �s""�'"' Sq . Ft , ,43 * Front Yard Cam ft . Rear yard ZLOOft .
* Side Yards ft , and 10C) ft .
2nd , Floor 4 Sq . Ft . If on corner , setback from side street-
* � l bv ft .
Other Floors Sq , Ft .
( not cellar or basement ) OCCUPANCY INFORMATION :
TOTAL FLOOR AREA : '7 Orll ' Sq . Ft . * Primary Building
* ><�t_ One Family Dwelling
Size of New Structure : �-s ft . x � 4- ft * * Two Family Dwelling
Fou G>` x Multiple Dwelling/No . of units
Pie / Craw artial /Full ( Circle One ) * Business � -
* Industrial
No . of stories ( Habitable space ) * Other
Height ( grade to ridge ) 2 ( ft .
If residential ,( e cl i families : * If aid QOZ~ at, will
1 I� e?
Na . of rooms { excludin_g baths ) :
No * of bedrooms : 23
No . of bathrooms : ,} * Accessory Building :
Primary heating stem : - M �+L1+2p(tM� * Detached Garage - One/TrYar�
Type of fuel : ems" _K 'z " Attached Garage - One wo Car
No . of fireplaces to be installed :- Private Storage Building
Will a woadstave be installed ? : * Other
Central Air Conditioning : Yes ��
( 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 ? t4o
Foundation Wall Material : C-Thickness : `
Depth of Foundation below grade ( to bottom of footing ) : ,•,
Will there be a cellar? 7 Heated or Unheated ? Floor Sq . Footage :
Will there be a basement ? V. Cam Will any portion be used as living space ?
If so , what portion ? Sq . Ft . Type of Use ?
Type of Roof : Sloped/ Flat/ Shed/Other S5 Q Ems. Material of Roof ?A:. )
Size , wood studs or
x ^" ; spacing o . c . ; length ft .
Joists ( floor beams ) : 1st Floor 2r x spacing o . c . ; span 1Q ft -
Joists ( floor beams ) : 2nd Floor . x e> Is ; spacing — o . c . ; span I Z.-__ ft .
Overlays ( ceiling beams ) : "'�- '" x &:;)o It ; spacing o . c . ; span 10 ft .
Roof rafters : x CD spacing o . c . ; span I eel ft .
Roof trusses ( pre-engineered ) : spacing o . c . ; span ft .
Exterior Wall Finish : IA' W 0c) of what material ? G
Interior Wall Finish : Cv ` { � • --
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 ? *%`t<5
Will a flue- lined chimney be installed ? %14�p 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 1 Z 13 `7¢-
NAME OF PLUMBER & ADDRESS : PHONE
NAME OF MASON & ADDRESS : PHONE 7iqZ - I3 -7
NAME OF ELECTRICIAN & ADDRESS : awt �` �. iL PHONE 1::�J Z t5-t -
DECLARATION
To the best of my knowledge and belief the statements contained in this applicationt
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 pertai in to the proposed work shall
be complied with , whether specified or not , and that such work i auth ized the owner .
Signature
' Owner , owner s agent , architect
contractor
SPECIAL
- ONS OF H--FERMI- :
By :
Code Enforcement officer
Membsr hl.F.P.A. 8 f.A.E.I. i.,,tG, vicar. certificate
ATLANTIC = INLAND, INC. - NEW YORK
Efectdcal a rid Fire lnspec"ion-En forcing& Consulting Service
997 MCLean Road, Cortland, NV 13045 DATE: .Ct f S76 CERTIFICATE 6 -----
AS APPROVED FOR :
OWNERS stepb4a fiustt
Residential Garages
ADDRESS: 3 = county Litle ltd
(}t eenslyu� y , 7Y � '7r G - sw . / 4 -recept. . /� _; d * Uase £ ix . / XXX
ELECTRICIAN :
3:eTxT:etlt Mattson
64 Biind Rack g"
ADDRESS: C7 NY 12804
ueeTsataury � The cai70 iL Dns 1011a wing govemetl the issuance 01 th's cerP' C ate. and any Cerlrlicale Ur4viDUs y issu
is cancelled
This CertHicate Only covers :he BIeCL'iCal vqu�pmrDC lis LkC and ihall e Dn t-y made for nsp[ COO
the intnoduc• on of sd C•'i9nal equipment or annra11on5 aOpC'CaliOn shall cj p o p y
Inspectors 01 this Company shall have The priv lege of making ins podinns at any ^,ime. =%rid if its ru
a.c v,o a7ed. !')e Company shall have the right to revoke This Oer;i7i C*�le.
AI - 27 ..._ ._._ ..—
TOHM OF (JUEERSBURY
531 BAY ROAD 12804
QUEENSBURY . N538)EW O745-4441
TELEPHONE
gUII.OINCs INSPECTOR' S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED ✓`�
NAME f
LOCAT I I1N!7� ��v-i2
DATE •, n PEKKIT#
TYPE OF STRUCTURE p - }
RECHECK
FIRE MARSHAL APPROVAL (COMCKFILL L F"MING�
.NTING FOUNDATIFINAL-*EELECTRIC- �SEPTIC
ROUGH PLUMBINGwfl�STOVE/��PLACE
`I�+iSULAT I ON f 0 �
REMARKS -
i`rx''� t7A ROVAL
N/A YES �O
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING -�
DECK/PORCH/ TEPS/RAILINGS, --
RELIEF VALVES
FURNACE/HOT WA ER OF RA 3G
BASEMENT INSULATION/DUCT fl
INTERIOR TRIM/ PRIVACY OO Rs
FINISH FLOORS :
SATH/KITCHEN WATERTIGH
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS �-
BATHROOM FANS/WHO H SE $
UMBING FIXTURES OF Ai IN
GARAGE FIRE PROOFING
DOOR CLOSERS a
I N
OTHER FIRE SEPA
FIRE/DEMISE WALLS
DUMPSTER UIREM N 5
SITE PLAN/VAR NCE Q
FINAL ELECTRICAL v
OK TO ISSUE C/O OR C/C��-� ,
COMMENTS : ; h fis D C l A: C 4.J
ARRIVE Z'
DEPART Zc — S
TOW OF QHEENSBURY ,rJ
BUILDING A D N CODES DEPARTMENT
BAY ROAD
4UEENSBURYTELEPHONE� ( 518) 745.4447
BUILDING INSPECTORS REST
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE
PERMIT # f-• ` . / -j
TYPE OF STRUCTURE APPROVED
RECHECK N A YES NO
E ---�---
MONOLITHIC FOUR
REINFORCEMENT IN PLACE SI_~--
7HE CONTRACTOR IS RES
FOR PROVIDING HOURS IFOLN_NN,IiN6
OTEC
FREEZING FOR OF THE CONCRIKTE-
THE PLACEMENT
MATERIALS FOR THIS PURPOSE ;ON TE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLAC
FOUNDATION/DAMPROOFIHG
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT1 N IN
PLUMBING UNDER SLAB
FRAMING :
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MA
HEATING ROUGH- IN
rJ INSULATION * E _
r+'1 FOUNDATION L
FOtfHNV1TION WALL EXTERIOR R-
R- Y�
FLOORS R_
WALLS
CEILIN I = N UNHE
DUCT WORK
SPACES
K
ARRIVE j
DEPART ;-J
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 SAY RO
QUEENSBURYTELEPHONE � NEW 0( 518 ) 745-- 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED�—
lIAl1E
LOCATION cl _
DATE �PERMIIT #
TYPE OF STRUCTURE —C-e%�-\ C,�y�"'. P( )OVED
RECHECK N A YES HO
FOOTINGS/PEERS
MONOLITHIC POUR F RM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RES BIBLE
FOR pROVIDING PROTECTION FROK
FREEZING FOR 48 HOUftS
Cfl LLOWING
ME
THE PLACENT
MATERIALS FOR pUNDATION/WALL THIS PURPOSERPOSE ON SITE
REINFORCEMENT IN PLAC
FOUNDATION/DAMPROOFING_
BACKFILL APPROVAL
ROUGH PLUMBINPLUMBING VENT/ N G
PLUMBING UNDER IN P A
SLAB E
.-VRAMING :
J AC K S -- ---�"~
BRACING GRID
JOIST HA
JACK POSTS/MAl B ------
HEATING ROUGH- IN
INSULATION : E I
FOUNDATION L
FOUNDATION 'WALLS EXTERIOR R_
FLOORS R_
MALLS
CEILIN
DUCT WORK R PI IN IN UNHEA E
SPACES
R I �►�' e'er-�.,�,�_` � '�,r�"� '� _..-
ARRIVE
DEPART �+_.�=- i F . nR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT -
532 BAY ROADQUEENSBURY s
12804
TELEPHONE ! ( 518 )NEW0RK 745 4447
BUILDING INSPECTOR' S REPORT
REQUIEST FOR INSPECTION RECEIVED
NAME ,�,/,��.g,rr�r-7 ►r �/.-s•-rr�_11 �_ r' ..c
LOCATIONr
r J�
DATE _ PERMIT If
TYPE OF STRUCTURE
RECHECK APPROVED
N/A IYES1 NO
F O IHGS/ IERS
MONOLITHIC POUR F0 M
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBL
—
FOR PROVIDING PROTECTION FRO4
FREEZING FOR 48 HOURS FOL1- NG
THE PLACEMENT OF THE CONCR E
MATERIALS FOR THIS PURPOS ON SITE
FOUNDATION/WA L POUR
REINFORCEMENT IN PLAC
V FOUNDATION/DA PROOFING
'�C BACKFILL APPR VAL --
ROUGH PLUMBIN
PLUMBING VENT/ EN N CE
PLUMBING UNDER LA
FRAMING :
JACK S /HEA
BRACING/BRIDG
JOIST HANGER
JACK POSTS/ N A
HEATING ROUG IN
INSULATION :
FOUNDATI L E I R -
FOUNDAT N WALLS E ERIOR RR^
FLOORS R-
WALLS R-
CEILI G
DUCT OR R I N I , UNHE TE
SPA S
R 1�1FIC11111,1� VS go
n
ARRIVE
DEPART - SPFCTnR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 SAY ROAD /?
QUEENSBURY , NEW PORK 12804
TELEPHONE ( 518 ) 745- 4447
BUILDING INSPECTOR' S REPORT /
REQUEST FOR INSPECTION RECEIV,ED..
WME
LOCATION S
DATE PERMIT
TYPE OF STRUCTURE
RECHECK tf APPROVED
N/A I YES NO
X FOOT IN S/PIERS !
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CRETE .
MATERIALS FOR PHIS PUR OSE ON E
FOUNDATION/WALL POUR
REINFORCEMENT IN PLAC _
FOUNDATION/DAMPROO F I NG
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VEN IN PLACE
PLUMBING UNDER S
FRAMING :
JACK sTuus7ffUAKRs
BRACING/BRIDGING
JOIST HANGER'S
JACK POSTS/MATH B AM
HEATING ROUGH— IN
INSULATION :
FOUNDATIONINTERIOR
W L —
FOUHDATION WALLS EXTERIOR R—
FLOORS R—
WALLS R'
CEILING
DUCT WORK PI G IN UNHEA E
SPACES
REMARKS :
ARRIVE-- -
DEPART fl ilanCL
TNSPFf: R
P997MAJN OFFICE
McLean Rd. ATLANTIC-INLAND, INC.
Cortland, New York 13045 NEW YORK
L- Phone: (607) 753-7118 MEMBER OF N.F.PA AND iA.EI.
(607) 753-7809 FIRE UNDERWRITERS
(607) 753-1396 (Electrical and Fire Inspection-Enforcing and Consulting Service)
+G1o1671
IHtcarporeted in the State of New York)
DesirInSP0 ti Gservi'c e i of Approval, apmdw o f is made trx irls}tectlon of-electrical installation in the premises described below. On demand applicant agrees to pay for
inapfeodora service in aoa:orCf with schedule p} dlsyrpeg,
AFfVCATl`ON FOR ELECTRICAL INSPECTION — PLEASE PRINT OR TYPE lqq
THM SECTION TO'9E-00MPLETED By APPLICANT pNaE of ARPUCATIGIN '�•
CrrY. TOWN, L.J # .�'e COUNTY
STREET STATE f r
RAL
AOr.IftESS '
RU P . SUILDG. No,
WRECTIONB
� POLE NO.
NAME R'SAi&
/� OCCUPIED AS
tFOR
It It •�- � �
BUILDING — Now n OW n WORK — Newnftlonml tot
OUGH.wIRING IXTURES n OR READY FOR INSPECTION
1D— S BY CHECK n cABH 0 MONEY ORDER ❑ MAKE PAYABLE TO ATLANTIC-INLANW YORK
Number of Rough Wiring Outlets Flxaree Adel Instsllaftpn
jSwtchlU`1ng Flbopp. Hee_ Base FtaA1f. 31.1R 750 1DOD 125G1 15Dp 175e 20DIU 223D 1i+ge 2Elect IN9at. �"") Amp. Serwoo Wat r Htr. Burner Air Cond.
Surface Unit Oven - Range Gir. DIAP. plah w OrYar H.P. Pump Ex. Fan Hood
OTHER EOUIPMENT(SPedtY Type Am CaPacitlaal
I TYPE OF I /
WIRING OPEN n D &Y O ER MIUNSO OF SUB, } 'o i"W BRANCHES NO. OF
APPL►cANrs MCI CIRCUITS
MNATURE
APP NT'g f_ /_ - _ a PERMIT�a
*-+�. y �, NAME OF
[[ UTILITY
Cnlr STATE 1 . 22P COPE OFFICE TO
BE NOTWOM
FIGUGH WIRING# AMP SERVICE .
OUTLETS EQUIPMENT UNrr SURFACE
SWITCH" AMP SERVICE UNFT
GA?NDLICTORS K.W. OVEN
RECEPTACLES H.P. PUMP - H,P.GARaAGE
MEDIUM BASE DISPOSAL UNIT l
fT FpUREB K.W.
Kw. DRYER EMSINWASHER
FUCT URES MOGUL BASE Kw. WATER
HEATER
RANGEW. RANE
FLUORESCENT
T H.P. AIR AMP. RECEPTACLES
CONDITIONER
MERCURY F VAPO"URE OR WIRING A CONTROLS FOR BURNER SMOKE � FRAC. H.P.
QUARTZ FIXTURES DETECTORS WENT FANG
MOTORS, H.R. 14 2 1114 1/a 1/6 t14 113 t!Z S/4 1 11t 2 S S 71>r YD . t5 20 26 SS 4D 6D 75 tfV
MARK NUMBER
OF EACH SIZE
SDD 75e low 1250 law t75O agoo 2250 25M 27M SDDD
APPARATUS Etec1. Fteat
MISC. INFO. Recelwad Inspect" FEE PAID
n FRovResB -
TOTAL s
n DEFEGTiYE
D:Rptgh tiring CaNlicate Check Na.
n Temporary aervfce man" Cater
. �. .. ❑ FWAL CEIMFOCATE .
❑ Opp. den. Rew. rash .
13 MUNICIPAL Charge
IOUK. ADDRESS -
ATTN:
Temp. Out-Includ.Np. FIFUd CUI-in Card No,
Al-ot iMONICIPALITY