1991-564 , •••,,‘
r
' CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date • del } 19 V
• This is to certify that work requested to be done as shown by Permit No. 91-564
has been completed.
This structure may be occupied as a Alteration to Dwelling (New Pittuirp Windgw)
Location • RD13 Box 259 Rhode Island ATIMMON
Owner Blanche Smith, & Gertrude Shinuee
By Order Town-Board' '
TOWN OF QUEENSBURY
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• Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-564
WARREN COUNTY, NEW YORKco
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PERMISSION is hereby granted to Smith, Blanche & Shippee, Gertrude ~
OWNER of property located at RD#3 Box Rhode Island Avenue 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.
1. OWNER'S Address is a.
Same `D
2. CONTRACTOR or BUILDER'S Name
US Windows
Don Butler
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3. CONTRACTOR or BUILDER'S Address
DJ
Clifton Park, NY
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4. ARCHITECT'S Name
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0.
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5. ARCHITECT'S Address
a.
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. Alteration to Dwelling as per plot plan specifications and ='
application 0
8. Proposed Use
New Picture Window
0
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 7, 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 Queensbur F 7th ,!, Day of August 1991
SIGNED BY -G-2G" for the Town of Queensbury
Building and/Zoning Inspector
TOWN OF QUEENSBURY l'
Oak
REVIEWED BY: IOWN OF RECEIVED
SDUR-,
1P .r FEE PAID: j
� � AUG 61991
PERMIT NO. : 91 - 5
BLDG. & 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: /S/4 gL/ 5,14 ;th G-iet ice A r(fie-eE'
P.O. Address: %/03 //cSSc zs-7 f/Jo4 .141/4-k✓, PHONE 2u y5-2(�
Property Location: lar/eeyi. / -0," Tax Map. No.) , / r) / ////
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 PE. ON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO }UILDING CODES IS:
(3fi (C/71--/a -- ••• .. •. • . •. . . , N‘
NATURE OF PROPOSED WORK: - . ,-= = . ESTIMATED MARKET VALUE OF THE
Construction of new building - * CONSTRUCTION: $
Addition to building *
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: ft. x ft.
Other work (describe) * Existing Building Size:
rfe..1 (,/0h006Y5 * ft. x 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 Sq. Ft. * If on corner, setback from side street-
* ft.
Other Floors Sq. Ft. *
(not cellar or basement) * OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: Sq. Ft. * Prirpary 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
No. of stories (Habitable space) * Other
Height (grade to ridge) ft. *
If residential , no. of families: * If addition, what will u e be?
No.. of rooms (excluding baths): * . I&W Fri-vas? ,W�ndrnO
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 Wall Material : Thickness:
Depth of Foundation below 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 Fihish: 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: (J__S U—�G21'` i�/S J�����/ PHONE . 7/6/://7d
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 t he proposed work shall
be complied with, whether specified or not, and that such work is aut o• zed by the owner.
Signature 7"(
0 e wn61 s agent, architect
c ntractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
1,
OWN OF SBURY I t
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR`S REPORT (�
REQUEST FOR INSPECTION RECEIVED bJ (° /C),,
NAME C ) \AU ( 1\1VP‘_% 7)_„/
LOCATIOI4959 c4 �e'.
-4(DATE PERMIT # S o
TYPE 0 STR CTURE
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 1
FRAMING: l - - .l
JACK STUDS/HEADERS i
BRACING/BRIDGING I
JOIST HANGERS \ /
JACK POSTS/MAIN BEAM I
FIRESTOPPING V
WALLS
CEILING /
FIREWALLS /
HEATING ROUGH-IN
INSULATION: \
FOUNDATION WALLS INTERIOR R4\
FOUNDATION WALLS ,EXTERIOR R- \
FLOORS R- \
WALLS R- \
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
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DEPART frS '30 A,C.
IN PEC OR
2,���TOWN OF QUEENSBURY
1� BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT / /rN/
REQUEST FOR INSPECTION RECEIVED
NAME -YU Ce, ��1
LOCATION -Y 5 9 F11(Yk)P- Sr� nf'J
DATE U7 % / PERMIT # 1 -kit)
TYPE OF STRUCTURE , ,
RECHECI
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MO O V0
OTI cS
REINFO 1lT}C1h DG.IVk_ \SS\ti��£c
THE CO I
FOR PP v� W i N,Ndl>J`
FREEZI y l
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FOIND( �0o C��v k, ,`REF
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PLUMB G \ --v lnt5v‘ . 1
PLUMB
FRAMI 1 tiC 'Y� I
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BRA�ti�u/onavv�i.. _ 1
JOIST HANGERS I
JACK POSTS/MAIN BEAM,
FIRESTOPPING
WALLS `
CEILING
FIREWALLS I' \
HEATING ROUGH-IN 4"
INSULATION: { • k
FOUNDATION WALLS INTERIOR R.-
FOUNDATION WALLS EXTERIOR R\�,
FLOORS a R-\,
WALLS r R- \
CEILING 1 R- \
DUCT WORK OR PIPING IN UNHEATED\
. SPACES
REMARKS: (
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TOWN OF QUEENSBURY BUILDING DEPARTMENT
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Based on our limited exanination,
compliance with our comments shall
nit be construed as indicating the
pions and specifications are in full ._,
compliance with the code.
TOWN OF EENSBURY
BUILDING ES DEPT.
FP1LEr ' �48 RCiflE1li/E BY
DATE —