1991-601 ,
CERTIFICATE ' OF .00CUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 19 19 96
This is to certify that work requested to be done as shown by Permit No. a i r_r,,
has been completed.
This structure may be occupied as a
ADDITION TO . DWELLING
PITCHER RD.
Location
Owner LAMERE;, RUSSET,T. f'T;ART^A
By Order Town Board
TAX HAP NO. 12 5 . -2-14.2
TOWN OF QUEENSBURY
,P7-A7
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No. 0106111
WARREN COUNTY,NEW YORK
fi
fit RMISSION is hereby granted to Russtl 18111 ta Ldchre
4 ;1
P
OWNER of property located at ' t"°' sr 'il F' u Street, Road or Ave.
in the Town of Queensbury,To Construct or place a PAditficm
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
Pltemr Rd
2. CONTRACTOR or BUILDERS Name
r; to
3. CONTRACTOR or BUILDER'S Address
ash
1
Pre
4. ARCHITECT'S Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( )Masonry ( )Steel ( ) 7-
7. PLANS and Specifications
No. sq f ti di le to lli �� as per plot p ac s`� w.ri -ztfi� �
5, { nit ,
mid application
8. Proposed Use
;.ram
Dining RIam
4wi
16. ` R ^ter F s U
$ PERMIT FEE PAID —THIS PERMIT EXPIRES' r ,, 19 _` t.
(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.)
r�J
Nr,:.fir,'S
�; _ .
Dated at the Town of Queensbury this - ` �': Day of � �;-��� 19 3a
y t,
SIGNED BY ^` ' for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY TOWN O
F QUEENsb,
n Wi,�to0/1111% REVIEWED BY: I.. jf.��bli,1��� FEE PAID: _ `'�'�
/(0/ AUG 20199�
PERMIT NO. : CI 1 —6.O / 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: {icLSSC',1 / Li. 'F- C/Ar H/-19 V L a,/ /4 /Y
P.O. Address: 1 E43 Pi'+CAr r- fa - 42ll,A1<S4yr , AA Ki &L., PHONE 7Qa ri3
Property Location: & SId. PtclNer- Rd. Tax Map No. /02,5'./ ,2 / ) '/,2
Has there been any split of this property since October 1, 1988? Yes No 1,//'
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:
9LJSSP,/ ) kit.,in°_r-e_.}
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ 30 �, /'
\/ Addition to building *
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW
(no change to exterior dimensions) * Size of Property: lc 't ft. x 3,15 ft. 12
Other work (describe) * Existing Building Size: f 1 S
` • * ft. x y!'14'I ft.
* Proposed building - distance from
GROSS AREA OF' PROPOSED STRUCTURE: * property line:
*
1st Floor ,1-k-3 Sq. Ft. * Front Yard 13,-ft. Rear yard a, ft.
* Side Yardsocp-h ft. and .81 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: /3 Sq. Ft. * Primarry Building -
* \/ One Family Dwelling
Size of New Structure:' left. x /.2 ft. * Two Family Dwelling
Foundation * Multiple Dwelling/No. of Units
Pier/Slab Crawl' Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) 1 * Other
Height (grade to ridge) ] ft. *
If residential , no. of "families: J * If addition, what will use be?
No. of rooms (excluding baths) : 1 * th n;n� rr,+>rc\
No. of bedrooms: - * .
No. of bathrooms: I * Accessory Building:
Primary heating system: 6 rorm/1 Ai)--- * Detached Garage - One/Two Car
Type of fuel : 6; ( , * Attached Garage - One/Two Car
No. of fireplaces to be installed: - * _ Private Storage Building
Will a woodstove be installed?: AA) * Other
Central Air Conditioning: Yes No 1/ *
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING ,SPECIFICATIONS:.
Type of construcn: wood frame, fire safe, etc. U)bOLL
Will any second=liana or ungraded lumber be used? If so, for what? rl ›
Foundation Wall Material : I3loG‹, Thickness: g X ILo
Depth of Foundation below grade (to bottom of footing) : -! F+.,
Will there be a cellar? pig Heated or Unheated? tipc34-071, Floor Sq. Footage: c2y3
Will there be a basement? n Q Will any portion be used as living space? (1;r1;n rto
If so, what portion? 21-1,' Sq. Ft. Type of Use? (-1;ni rnr�M_
Type of Roof: Sloped/Flat/Shed/Other S lbi3PC. Material oY Roof piy.wbud 4 6hi,n /gL.5
Size, wood studs " x (o
spacing 140 o.c. ; length .g ft.
Joists (floor beams) : 1st Floor ,2 " x I D ";.: spacing 140 " o.c. ; span ICI ft.
Joists (floor beams) : 2nd Floor " x — " ; spacing - " o.c. ; span - ft.
Overlays (ceiling beams) : " x- " ; spacing :g& ---" o.c. ; span - ft.
Roof rafters: " x — " ; spacing o.c. ; span ft.
Roof trusses (pre-engineered) : spacing R L1 " o.c. ; span )fi ft.
Exterior Wall Finish: poi wbo(1 of what material ? 4111v V;ny !
Interior Wall Finish: ,SIB+ f--pO ,
,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? )6 S If so, will a Fire-Rated door,
enclosure, self-closing device be provided? V a S
Will a flue-lined chimney be installed? n r, Height above roof _ ft.
Depth of chimney foundation below grade: ft.
Depth of fireplace hearth: - - ft. - in.
Water supply - Municipal or private well : . t1 ill Addi- oi))
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: jar ft.
(A separate application is necessary for any repair or new installation of septic system.)
NAME OF BUILDER & ADDRESS: RL\cee I I 14,Mert , (uorp y---) PHONE `74;?-Of13
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 evi.6_4_03,Q. 13e.
,• 'Owner, owner s ,den architect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
C Enforcem 't Officer
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY - 9000 HEATING DEGREE DAYS
Compliance Methods:
PART 5 - Acceptable Practice Method - 1 & 2 Family Dwellings (ONLY)
PART 6 - Thermal Rating - Component Trade Offs - 1 & 2 Family Dwellings;
Multi-Family Dwellings
(3 Stories or Less)
PART 4 - Design By Component Performance - Commercial Buildings - Hi-Rise Residential � ..
PART 4 & 6 - Compliance Methods Require Submission of Worksheets
APPLICANT'S NAME PROPERTY LOCATION
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1. Gross Floor Area - Sq. Ft.
2. Type of Heat - Elec. Base Board Other
3. Is Building Mechanically Cooled? YES NO
4. Percentage of Area of Windows and Doors Over 17% Under 17%
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Baseboard
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures
B. Exterior Walls R j9
C. Glazed Area R
D. Exterior Doors R
E. Floors over unheated spaces R 3
F. Edge of Slab on Grade (Heated Building) R
G. Basement/Cellar Walls (Above Grade) R
H. Basement/Cellar Walls (Below Grade) R
I. Heating/Cooling - Ducts - Piping in Unheated Space R
6. Service (Domestic) Hot Water Heating Device
A. Conforms to minimum efficiency per code YES NO
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
ge74„,e/14 : 79ao / 73
APPLICANT'SHai NATURE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS:
REVIEWED BY
Cr'
MIDDLEDEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
=�• 1337 West Chester Pike,West Chester, PA 19380 •
APPLICANT COMPLETES THIS SECTION Date: 1 ri i
City, Town or Township 0 Im J County IDAFr/"f) State / /
1
Location/Addressl RA:2. Pr-1-C1/\P �r
r (If.Located in Rural Area - Please Attach Directions) Pole #
Owner 1?U(:r./' ) I ' C__Il R I-t-F b- /01)(-!' 1.-, Permit # l
Occupied As I FArr\, I I.) - Building: NewI/I Old
Occupant- K, ti' ` C ) 1 q C. /Air; -'E) / /)/ lt' ,' /_----1
Work Area in Building (Floor #,etc.):
App. for: Wiring 7/ Service❑ or: i[V 10„-li -{'I /;f1 Ready for Inspection:
Fee Remitted-$ Cash n Check n • M.O. n 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
Lighting Amp. Service Surface Unit Dishwasher Range
Receptacles /1 _ Water Heater Air Conditioner Dryer Pump
Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner
a. _
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 Pk 2 3 5 7'/2 10 15 20 25 30 40 50 75 100
Mark Number
of Each Size
Applicant's ! , In
/yn,
Signature �0.-„- ‘ �1 ' L. 1 License # Permit #
T/A . U'tility:1 b_r.r%.,-ram ID✓ l_-J .
Applicant's Address: �'a� (�,-f'(I_! '1_.. KS I(NAM ) (OFFICE LOCATION)
(City) (-�)1,`6(-w�- ':lL'1"( (State) N y ' (Zip) / ) <L r I Service Request #
Phone # r .11_)' G)' t -21 Electrician:
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Aboven 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 1P/2 2 3 5 7,/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 CORRECT FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
n L/A Owner CASH ❑
Fee CH K #
❑ L/A Due
n IPA Municipal MO #
INV #
Date: Other Side El Utility Applicant ❑
Owner
Cut in Card n Temp # Date
naFinal # Date INSPECTORS SIGNATURE
APPI.IrATInIAI PAPM WI 'J ri n PI 11/RQ
!(,.....l!,.,l,?„!.,ol,.(;,t,•,.b,?.l,.,,ii,t(..\.!,.\t.,.,f l O,.,•).,„1... .?,I..,i.i„,,.., .. !(,?tt.„,,}./,,.,.m,,!.l,b,t¢>..,A,,.,,,,{.,,,,,,,,-.....,•,-,,,,,,".."."......,,,,,i,."7 •,J.,-??
: THE NEW YORK BOARD OF FIRE UNDERWRITERS 's,i,;' I
•�. �3f 25991 BUREAU F"ELE.pTRICITY ,
41 STATE STREET-.ALBANY, EW YORK 12207
- Date A}11.II, 22,1 992 Ap ication No.on fi t)9fl.'sr-�_7',/92 ' if43 6110
tc. r9
' THIS CERTIFIES THAT 9/!6'd i 9v—/ff/ ' '3)
•-. only the electrical equipment as described below and int ed by the applicant named on the above application number in the premises of
i tt,,yi f qq 73� ��qp 77�� 7nt��tt 77 i t, - 'i
�:• !S-1f.5 i:'I SCd .lt T�l.,i, ���� ITCH,ER iT.t�L13,r i)Ii t�;�,A`l -ii)f{T. �`t� '`J ,i
in the following location; ❑ Basement ❑� 1st Fl. ❑ 2nd Fl. GAR - •Section Block Lot '...
►1 was examined on AP Id I 1 06,199 Y; and found to be in compliance with the requirements of this Board. '�
e
FIXTURE • FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS e
-< OUTLETS. SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
.
llill11= 5 6 ..1..
"(, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS !
MIT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS.. TRANS.® H.P. NO.OF FEET AMT. WATTS ';SYSTEMS .
►, SERVICE DISCONNECT NO.OF '
-, S E R V •I C E ':
METER
ii,: AMP. TYPE EQUIP. 1,e'2W 1if3W 3,QI3W 304W NO.ORC.gCOND. OF CC.COND.. NO.OF HI-LEG OF•HI•LEG NO.OF NEUTRALS OF• EN UTRAL
i;e' OTHER APPARATUS: ::�
if, •
I
1
�, —
- i
!' w
•
-C, `i.
'"D
,
t'
C.
•; BD U
�' BRANCH MANAGER
' Per
i:::(; This certificate must not be altered in any manner;return to the office'of the Board if incorrect. Inspectors may be identified by their credentials. •`:
b�qr rar'4f'i•\'r•Y-4Y'r•r Y•i'rp''I•r i•r'4r7e7•r'iiY'isY 7e"rr'grY•r Y•r'4 'rr'4Y Yv rr'i•"i•,-'i•7 i•r'r•C',•?'i•i 7•i'i•i',• 'r•i'i•r',•j'r•Y'47 r•i",•r-q(7•Y-r•f'r•r7•r7W-• 'gr'r•r-,•i • • W.'.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
c�/^ TOWN OF QUEENSBURY
. Y,, 531 BAY ROAD
44 • QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INNS'PECTION RECEIVED
NAME
LOCATION Pi vck\l-CZ- fir'?
DATE ' �yz PERMIT/ r>ly (,,
TYPE OF STRUCTURE \'',) i=(/l ►{L 1�/nT`).i1(j{�E. (Ij f'/)(
RECHECK f-1���c=� �' l�2,� [0,v -
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL-- SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS 1-n'73 i ',A .��l;� 1 - /.2/5/q/
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT /
ROOFING
SIDING g /'
DECK/PORCH/STEPS/RAILINGS n'
RELIEF VALVES
FURNACE/HOT WATER OPERATING /
BASEMENT INSULATION/DUCCkTWORK'
INTERIOR TRIM/PRIVACY DOORSt
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED, '
STAIR CLEARANCE/RAILING'S \
HANDICAPPED ACCESS 0
SMOKE DETECTORS
BATHROOM FANS/WHOLEHDUSE FANS \
ALL PLUMBING FIXTURES. OPERATING \
GARAGE FIRE PROOFING ‘,
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPS TER
SITE PLAN/VARIANCE REQUIREMENTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS: 4
ARRIVE
DEPART
INSP
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
LOCATION
DATE /,/��Q/ PERMIT f
TYPE OF STRUCTURE ddQ' 4 4ea,4Pe,/,:/✓7".
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS /f///
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 atit-OW4Ke
BACKFILL APPROVAL ray'
ROUGH PLUMBING /
PLUMBING VENT/VENTS IN PLACE /
PLUMBING UNDER SLAB d
FRAMING: 6-1 9/1G? // cQ
JACK STUDS/HEADERS I O
BRACING/BRIDGING
JOIST HANGERS /
JACK POSTS/MAIN BEAM I
FIRESTOPPING
/1
WALLS f
CEILING '
FIREWALLS /
HEATING ROUGH-IN/
INSULATION: /
FOUNDATION WALLS INTERIOR R- \
FOUNDATION WALLS EXTERIOR R- \
FLOORS R- \
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
71,7'./6a.f4,;,*,,eit47 40,2e di)-6,...e
ARRIVE
DEPART
INSP OR
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 RuALL.t.e. y
` �� /l�.1.4
LOCATION Q Pc(
DATE q) (61q PERMIT 1 91 -(p 6
TYPE OF STRUCTURE
RECHECK APPROVE
N/A YE , NO
(FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE r`
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 F
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL "
ROUGH PLUMBING e
PLUMBING VENT/VENTS IN PLACE /
PLUMBING UNDER SLAB /
xFRAMING: 't; /
/ JACK STUDS/HEADERS /4
BRACING/BRIDGING ;7' i/
JOIST HANGERS / 11
JACK POSTS/MAIN BEAM / 1
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN A
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALL EXTERIOR R-
FLOORS R- y
WALLS R- 1
CEILING R- A
DUCT WORK OR PIPING IN UNHEATED\
SPACES
A
REMARKS:
ev
ARRIVE /�
DEPART
INSPECTS
1
110111111
f_. o . TOWN OF QUEENSBURY
Bay at Haviland Road, Queensbury, NY 12804-9725—
Building & Codes Department
INSPECTOR'S REPORT
• t?P 9 199t
• Va-C(
PROPERTY LOCATION
I�. L I'4&
OWNER OR TENANT
BUILDING SEWAGE SIGN OTHER
REMARKS:
PL G-AS i& 0 a No A-130 rrlo Jv A-L
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CONTACT THIS OFFICE ;g,tf F� h
INSPECTOR
• 74fs- Lp-ii-r7
•
"HOME OF NATURAL BEAUTY.. .A GOOD PLACE TO LIVE"
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TOWN OF QUEFN
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,
RUG 20 1991 L'-71.
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AUG 2 01991
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BUILDING & CODE DEPT.
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