1993-417 `� �< :'•' .'mot �� :1i•. ) �'
CERTIFICATE OF OCCUPANCY
TOWN. OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date (2, ,e./ / 19
This is to certify that work requested to be done as shown. by Permit No. 9 3 4-1-7
has been completed.
This structure may be occupied as a - • i ''.edroom and .bathroom
116 Meadowbook
Location
Priscilla .
Priscilla Roof
Owner
5 9—2—4 By Order Town Board
TOWN OF IQUEENSBURY':
Director of Bldg. & Code Enforcement.
k �i M
BUILDING PERMIT
ro
TOWN OF QUEENSBURY No 93-417 0
WARREN COUNTY, NEW YORK
to
PERMISSION is hereby granted to PRISCILLA ROOF
116 Meadowbrook Road
OWNER of property located at Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition 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
same
J
2. CONTRACTOR or BUILDER'S Name
fi
Plain & Fancy ~-
Arthur Lamb
H-
3. CONTRACTOR or BUILDER'S Address
ly
PO Box 1161
Bolton Landing NY 12814
4. ARCHITECT'S Name
5. ARCHITECT'S Address
(D
6. TYPE of Construction—(Please indicate by X) 0
)Wood Frame ( ) Masonry ( )Steel ( )
O
0
7. PLANS and Specifications
24 ' x16 ' Addition to dwelling as per plot plan, specifi—
No. cations and application.
8. Proposed Use
Bedroom and bathroom
$ 32 . 00 PERMIT FEE PAID —THIS PERMIT EXPIRES JULY 30 1994 rt
O
(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.)
(D
Jul'h H
Dated at the Town of Queensbury t 30t Day o 19 93
N-
SIGNED BY for the Town of Queensbury
Building and Zoni ' Inspector
TOWN OF QUEENSBURY "t';x� REVIEWED BY: ( .1
��
COMMUNITY DEVELOPMENT DEPARTMENT •.' , •"' JA -
BUILDING & CODE ENFORCEMENT
',' ' .i: FEE PAID:
J
531 BAY ROAD ..Jt .-,..
QUEENSBURY, NEW YORK 12804 PERMIT NO. c% z/, 7
(518 ) 745-4447 �, 242S2a,
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCT OR. NO IPE ONS '
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID ! UIL FERMI .
All applicants ' spaces on this application MUST be flmpl i01. . t
ill
signature of the applicant MUST appear on the appli •o
eotiw ,Ay
r� .,• il/
OWNER OF PROPERTY: l/,5(1 7F ,'• �,'�
Mailin Address : //6 /nEagf��c34dc9i+ 1 'ed, o 1 i
Telephone Number(s ) : Work • Home ".?- 3023 'O fear
PROPERTY LOCATION: J(6 /Y)rah?A_S /796K a. CdcP-..- ,,A)Block Lot
Tax Map Number: Section $G�
Subdivision Name: Lot No.
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
CONSTRUCTION: $ /s,e/7.4")—
cr
NEW BUILDING:
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
X
ADDITION TO BUILDING: PRIMARY BUILDING -
RESIDENCE/COMMERCIAL k Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL Family Dwelling
(NO CHANGE TO EXTERIOR SIZE) Office
OTHER WORK (DESCRIBE BELOW) Mercantile
Warehouse
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
1ST FLOOR , ;•�C SQ. FT.
IE ADDITION, USE OF NEW ADDITION:
2ND FLOOR SQ. FT. .9\f: r /VY►/ 2cCf"lt
OTHER FLOORS / SQ. FT.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage - One/Two Car
TOTAL FLOOR AREA: 3F 16 SQ. FT. Attached Garage - One/Two Car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other `
dZy FEET X / 6 FEET
Foundation Type: " 2incf Will any second-hand or ungraded
Number of Stories : / lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : /7 feet Type of Heating System:
Number of fireplaces and/or woodstove (circle all rich applies)
to be installed: 6 Oi / Gas / Wood
Forced Hot Al_) / Baseboard / Other
PER,SVN RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS :
NAME OF BUILDER/ADDRESS/PHONE: PA 1,6 (- GA rY /2 • -go Y /W �/x��Z A, .
NAME OF PLUMBER/ADDRESS/PHONE: c'�..,,' J
NAME OF MASON/ADDRESS/PHONE: cCsa�,�
NAME OF ELECTRICAN/ADDRESS/PHONE : rSrrivrLe.
DECLARATION
To the best of my knowledge the statements contained in this appli-
cation, 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 noted, and that such work is authorized by the owner.
Further it is understood that I/we shall submit prior to a Certificate of
Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN
drawn to scale, showing actual location of��"ect n pr fiises
Signature 7.--4/ ,�, -��
(Owner, owner' s agent, 'architect, I ontrac-'or)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
If `PN3
.,r��,j ENERGY CODE COMPLIANCE APPLICATIO ��p /J� wo
F` 4.---v. TOWN OF QUEENSBURY, WARREN COUNTY ; A e•• `gi
7 9000 HEATING DEGREE DAYS r /d6S ofeQf
•Compliance Methods : PART 5 - Acceptable Practice Method!7g 0c>
1&2 Family Dwellings (onlrir) --_---
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
*Requires submission of worksheets
APPLICANT' S NAME: PROPERTY LOCATION: /�
AL-!,/A. 06X- fie; /n7 4Po Xi-i�;r� /0
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - :3cP square feet
2 . Type of Heat - Electric t( Oil Gas Other
3 . Is building mechanically cooled? Yes b( No
4 . Percentage of area of windows and doors Over 17% X Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED:
a. Roof R 2c
b. Exterior walls R /9
c. Glazed areas R 3•3
d. Exterior doors R
e. Floors over unheated spaces R /9
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 4,l�
6 . Service (domestic) hot water heating device A)/1
Conforms to minimum efficiency per code es No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
A lica-nt'-s S%gnat e D to Phon Numbed
- rim- 0/,,96./ .1
. 6G�� ��j = Z3A
INSPECTOR' S REMARKS:
"�r. �' MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
1337 West Chester Pike, West Chester, PA 19382-6422
APPLICANT COMPLETES THIS SECTION Date: /_ . .
City, Town or Township / •- i , - - County State fAr
fr"
Location/Address :r r:- (;, : ,fir -- 1•
(If Located-in Rural Area - Please Attach Directions) Pole #
Owner - . .'/' .7
Permit # V', -/1
Occupied As Building: NewRi Old
Occupant
Work Area in Building (Floor #,etc.): -, , .. R
App. for: Wiring n Service[1 or: Ready for Inspection:
Fee Remitted-$ Cash❑ Check❑ M.O. I--I 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 Water Heater Air Conditioner Dryer Pump
Number of Fixtures Oven. Garbage Disposal Wiring and Controls for Burner
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 11h 2 3 5 71h 10 15 20 25 30 40 50 75 1 100
Mark Number
of Each Size
r .
Applicant's
Signature -/- �`., -�) License # - Permit #
T/A `—';' - ~. Utility:
Applicant's Address: f`','' 1 it': (NAME) (OFFICE LOCATION)
(City) `_ i f r-` (State) (Zip) ;' Service Request #
Phone # •-- 1= - Electrician:
MDIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above n 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 1'k 2 3 5 '71/1 10 15 20 25 30 40 50 75 100
Mark Number .
of Each Size
Elect. Heat 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
CERTIFICATIONS • USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECTFEE FEE PAID
❑ RW Progress: Inc.a__ LKD❑ Contractor
I I CFT Violation: Work Comp.❑ Inc. ❑ CASH El
❑ L/A Owner Fee
I1 L/A CHK #
Due MO #
I I IPA Municipal
INV #
r . Applicant ❑
Date: Other Side l 1 Utility Owner I-I
Cut in Card n Temp # Date
❑ Final # Date INSPECTORS SIGNATURE
RM NO.250 EL 11/89
TOWN OF QUEENSBURY
531 BAY ROAD
' QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED 1- t )S
NAME Rn
LOCATION m V
DATE .fit \t JS 4, PERMIT# C13 --Lj t 7
TYPE OF STRUCTURE JCr\K\[ t(I tVAtO
RECHECK,
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
CHIMNEY HEIGHT/LOCATION N/AN/ ES NO
B VENT/LOCATION
PLUMBING VENT
ROOFING ,
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING," v
BASEMENT INSULATION/DUCTWORK �,,✓
INTERIOR TRIM/PRIVACY DOOIS
FINISH FLOORS: \
BATH/KITCHEN WATERTIGHT '
OTHER FLOORS SWEEP/}BLE `\, ,
OTHER FLOORS CARPFjTED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS %,/"�
ALL PLUMBING FIXTURES OPERATING �"
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS t/
DUMPSTER
SITE PLAN/VARIANCE REQUIREMENTS V .
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART f r�' �
" - INSPECT U
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. 93-y(7
Main Office 357 Elwyn Terrace —:4Ianheim,PA 17545 7
MUNICIPAL CERTIFICATE=-- ELECTRICAL APPROVAL
Panel Board No. Cert. N° 3 0 7 6 4 Cut-in Card No.
OwnerAgairfiged LLB 1 -
Occupant �,,1
Location../(..!!6 inchix w&2dic 62 tt.c,-ew i/
Installation Consisting of..7.. � ' Sr 2 r S yl
Installed By r,i,fi-`frille,V Lic.#
The conditions following governed the issuance of this certificate,and any certificate previously
issued is cancelled:—
This certificate only covers the electrical equipment and installation conditions as of date. Upon
the introduction of additional equipment or alterations, application shall be promptly made for
inspection.
Inspectors of this Company shall have the privilege of making inspe ' s at any time,and if its
rules are violated,the Company shall have the right to revokeet/thh}* certif.a .
Date "(r INSPECTOR. %
Member N.F.P.A.,1.A.E.I.
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT /4(._
531 BAY ROAD /U
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 0j�//, .�
NAME g/u-iie,e _e,�/C[%`2'
LOCATION / /r, - i_./L.;7.U4'2 G'7J-eL "d
DATE 0//9_6 PERMIT I 9 4 -41/ T
TYPE OF STRUCTURE �j/mil .: 4/2zipW47.
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 iq /
REINFORCEMENT IN PLACE 1
FOUNDATION/DAMPROOFING ) /
BACKFILL APPROVAL !1 /
ROUGH PLUMBING i /
PLUMBING VENT/VENTS IN PL�1'CE
PLUMBING UNDER SLAB ��✓✓
X FRAMING: 64 / A
JACK ST DS/HEADERS /
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN BEAM \
HEATING ROUGH-I
INSULATION:
FOUNDATION LLS INTERIOR R-
FOUNDATION ALLS EXTERIOR. R-
FLOORS .;R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
I I 5 S 1-ell tiasi- c00 "
Vc k. Q :'I° .
_____________J________________I
L-----
ARRIVE 1 •9 ! / 0 54
DEPART 5 V I
INSPECTOR
TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 1-2/
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 9//k5.
NAME /y IA,(� P�l_v�9 r.2(
LOCATIONUU�)2G�"
DATE 9//l .2 PERMIT I 93-4//7
TYPE OF STRUCTURE /.�dp! i (f ',lithe)
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 r�
REINFORCEMENT IN PLACE ./
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL 1 /
ROUGH PLUMBING ! f
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB 1,OO
RAMING: 1.I
JACK STUDS/HEADERS '( /
BRACING/BRIDGING 11
JOIST HANGERS V
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN 1 1
)"INSULATION: / k
/ FOUNDATION WALLS INTERItOR R\
FOUNDATION WALLS EXTER/IOR R
FLOORS / R4 /
WALLS / R-\ Jq f 7
CEILING / R- 1 -p
DUCT WORK OR PIPING IN UNHEATED
SPACES 1
REMARKS:
LE-60"-c- VcDp tpk6/1 den,v,L9-' dr{
ARRIVE . 3 G ^
DEPART } °11)
INSPECTOR
TOWN OF QUEENSBURY .
BUILDING AND CODES DEPARTMENT //t_-
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ��,5/93
NAME
LOCATION //e. �0�/�C��G'�%'LG�I ,cfeJ
DATE J ' f%4 PERMIT I � - /7
TYPE OF STRUCTURE /7 d, 61./6Jefr,,,
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 FO,LLOWING :
THE PLACEMENT OF THE CONCRETE. °,
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALL POUR 1 1
REINFORCEMENT IN PLACE 9 /
FOUNDATION/DAMPROOFING /
BACKFILL APPROVAL /
ROUGH PLUMBING ;.,° 1.7
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB / `t
!FRAMING:
JACK STUDS/HEADERS / '
BRACING/BRIDGING 1
JOIST HANGERS p
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN i
INSULATION: 1
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
eacA_ G/e.:44.7
ARRIVE 3 `to
DEPART 77/1(//1
NSPECTOR
- TOWN OF QUEENSBURY •
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION'RECEIVED
NAME NAME (,ride- �O-rs-
LOCATION I /d��e (F-6��
DATE fis ! %13 PERMIT # !3 /I
TYPE OF STRUCTURE LLC 6 ' / ,i
RECHECK APPROVED
- . N/A YES NO
FOOTINGS/PIERS i1-r.- rt)
MONOLITHIC POUR FORM T6� `
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:
JACK STUDS/HEADERS I
BRACING/BRIDGING i
JOIST HANGERS g'
JACK POSTS/MAIN BEAM
HEATING ROUGH—IN •
INSULATION: - .
\;-
FOUNDATION WALLS INTERIOR R—./A
FOUNDATION WALLS EXTERIOR R2 \•
FLOORS A- \
WALLS / R— \
CEILING / R— \
DUCT WORK OR PIPING INN UNHEATED \,
SPACES I
REMARKS: `i � ''+ nA.�i Q, U.;1. `�.f :,t__p )\1 Z
Alus T- f3,& 4 c Al.o v$.ter u €--t u.,)
f;&J t.S i44.�f') z Lit)j k,%Wu �. <<-A-F-0�
N./-\-ram : ( A_r i;t e)V! ' j� J, �%'`
ARRIVE 1—
DEPART 7,7`% • /
INS ECT
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