95-551 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
September 25 97
Date 19 _
This is to certify that work requested to be done as shown by Permit No. 95551
has been completed.
RESIDENTIAL ALTERATION (FAMILY ROOM)
This structure may be occupied as a
37 MEADOWBROOIi RD.
Location
Owner FITZGERALD, WILLIAM III • '
TAX MAP NO. 10S, -°1--4. 1 By Order Town'Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING -PERMIT
VALUE $ 11000TOWN OF QUEENSBURY No 95551
TAX MAP NO. 108.-1-4. 1
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to - FITZGERALD, WILLIAM III
37 MEADOWBROOK RD.
OWNER of property located at Street,Road or Ave.
in the Town of Queensbury,To Construct or place a RESIDENTIAL ALTERATIONS/GARAGE INTO FAM
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
37 MEADOW BROOK ROAD
QUEENSBURY, NY 12804 12801
2. CONTRACTOR or BUILDER'S Name
HUGHES, KENDALL
3. CONTRACTOR or BUILDER'S Address
1 HUGHES DRIVE
HUDSON FALLS, NY 12839
4. ARCHITECT'S Name
CEIS
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
RESIDENTIAL ALTERATIONS
( )Wood Frame ( ) Masonry ( )Steel (
7. PLANS and Specifications
528N6Q FT INTERIOR ALTERATIONS TO SINGLE FAMILY DWELLING AS PER
PLOT PLAN SPECIFICATIONS
8. Proposed Use
RESIDENTIAL ALTERATIONS/GARAGE INTO FAMILY RM
$ 20 PERMIT FEE PAID—THIS PERMIT EXPIRES October 2 97 19
(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 R 3 Day of October 19 95
SIGNED BY ,e?‘g ,tnv, for the Town of Queensbury
Building and Zoninge6 spector
r .-.-,. -_.- _,.
} ��
De partrne�f o f Community Development 4,"e 4';"
Reviewed By:
Building & Code Enforcement `.. ,• uildin Inspector
Town o Queensbury (
742 Bay Road y �: Permit No. 9. ?--s5
Queensbury, New York 12804 Fee Paid $ JO ' a
(518) 745-4447 uilding
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 application form.
/1 l( / /�//�/vS�i.Y. �/ �Giefc'f4IQ 7
Applicant: •P.v�r� Owner:
Address: t GG,h�.S De, /21F Address: (3 2 nE'aG�4IeUGIC
Phone # ( ,s'-/0 ) 7 V?- _77�8 Phone # ( 5"/ v) 2 9 63 - 64(C7g
Property Location: 9 2 nelet/ cVlO/ 6%. - '
Subdivision Name: �" Tax Map Number �� /
Section Block Lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET ALUE OF THE
New Building: CONSTRUCTION: $ /1 OZ6
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building:
�(' e'si ence / commercial X Single a ly; D.Neto m, .
/� Residence / Commercial Two Fam' lym Dwellin'
no change to exterior size F mil Dwelling
Office SYEP 2Z 1995
Other Work (describe below) Mercan ile
Manufactirin . :.)UEENSSURY
Other 0L, i G AND CODE
GROSS AREA OF PROPOSED STRUCTURE: •
sq. ft . If ADDITION, what will use
1st Floor ��
2nd .Floor sq. ft, of new ad iti n be?
Other Floors F-sq. ft , / /� ram
(not unfinished cellar or basement)
ACCESSORY BUILDINGS:
Detached. Garage 1 , 2 car
TOTAL FLOOR AREA: SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SIZE OF NEW STRUCTURE : Commercial Storage Building
Other
FEET X FEET
Foundation Type : Pot e eA Will any second-hand or ungraded
Number of Stories : 2- lumber be used? If so, for what?
(habitable space only) Q
Height (grade to ridge) : feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which . ..lies )
to be installed: At Electric / Oil / Gas / Wood
Forced Hot Air / laseboard / Other
Person responsible for supervision of work as regards - to building - -- -
codes is :
NAhl 1-14e, /i s4e ,ve. . Phone
5/75 -Builder: - �� -- -.__________
Plumber:
Mason: •
Electrician:
DECLARATION: Please sign below after you have carefully read the statement.
/
To the best of my knowledge 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 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 by
a licens . s l';eyor; drawn to scale, showing actual location of project on premises.
Signature:- j
(owner, owner's agent, architect, contractor)
` _ _ .�. f.. o...y+...,n„ �'►iS"k'i4'�'ii'..r.L.F._.. irk"-.-�f.:y'o": .,:T
TOWN OF QUEENSBURY
531 Bay Rd., Queensbury, NY 12804
APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS
Date f /1 ,19 1 Permit No. ! S c
S 1
APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with
all applicable laws, ordinances, regulations, and all conditiothat are part of these requirements and also will allow
all inspectors to enter premises to perform required inspections. , •
Please fill out additional form if more than one appliance and/or chimney. .
Applicant s/j ., "f ` �C ..�1 APPLIANCE (check appropriate boxes)
,;,....,:)/,
•
Address �J q E ',, .. ,,, ❑ STOVE: ❑Wood ❑ Coal ❑ Pellet ❑ Gas
�5 i t s ;F-rlF i'1_ ,
,, ❑ FIEPLACE INSERT
l.{d'-4.0< .'vtt r /UPZ ip /e p f pr FIREPLACE, FACTORY-BUILT:
Phone ❑ FIREPLACE, MASONRY:0 Wood
A'`' ❑ Wood ❑ Gas
Ownii ;,,i E.. 4 -. . .,` ,- . ,° --- .. ,4 ,�- „..,,....,,. „❑ FURNACE: ❑ Wood ❑ Gas ❑ Oil
Address IF NON-MASONRY APPLIANCE:
Manufacturer:
,Zip , �_ 'Mode.I _ _ ._ / / ..
Phone yf=� F' Via!: ;4, :� _ ,_.t ,
CHIMNEY (check appropriate boxes)
*EXACT ADDRESS of proposed construction
0 MASONRY: ❑ Block 0 Brick 0 Stone
Zr I }"i €" ._. 'I.. r . ' ° .. '- i --�- FLUE: 0 Tile 0 Steel
Size: inches
CONSTRUCTION / INSTALLATION MUST 0 FACTORY-BUILT:.
CONFORM TO NYS FIRE PREVENTION & Manufacturer: ' Model:
BUILDING CODE. CONSULT AVAILABLE j,l4s.' ied-By: Number:
TOWN OF QUEENSBURY HANDOUTS a l• ' 'g 't�'-Double Wall ❑Triple Wall
REGARDING REQUIRED INSPECTIONS: ' � 0 Insulated 0 Direct Venting
Cashier's Department Town "X Queensbury, New York
Dept: Fire Marshal Amount Collected Amount Received
Code Number Title
A 173 3389 (190) Public Safety C.
A 233 2655 ._z r(230) Minor Sales ‘
mow.
Fee Golde edrV'From ors Refunded to: art f;j': -(,. ( tt' ij ,J LL`}}'�
Address: 14.:.., ,, ao- ' i`.,;,-- :..,_.,. j. I.: r- " `, '' (~ ,' j
Dated: . )D/ 3/c cf` , , ut * s �� `7:'
Town Clerk or Deputy: !'�d ..��...� ` ''j,,,�.� :
White:Applicant Green: Fire Marshal Yellow: Bldg. Dept Pink& Goldenrod: Cashier's Dept.
�
Date No.
a /;_ 19
COMMONWEALTH ELECTRICAL INSPECTION SERVICE INC.
•
(Consulting and Fire Inspection Services)
(Incorporated in the States of MAIN OFFICE:357 Elwyn Terrace, Manheim, PA 17545 • (717)664-2347
New York,Maryland,Pennsylvania,Delaware) 800-732-0043
LOCATION
Please give full and accurate directions in order to avoid delay
(Use back of sheet if needed)
Desiring Certification of Approval, application is made for inspection of electrical installation in the premises
described below.On demand,applicant agrees to pay for inspection service in accord with schedule of charges.
PLEASE PRINT,r #.. ,t DATE
Owner , i it'r s./ t T i Cr ' •,, .. '""3`)
""3`' r Type Bldg. ❑DWG ❑Other
Occupant J 't
' •/4Building Permit No. 5;." 5
Job Location..:.,) 11'it r ':,-- .,,J : -t.c-t city . s.+u K- "' ;'_ s.t. State ., i' .
County ....i�. t't ' v' C 1+ Twp ^g ,+..wimming Pool—New❑Old❑
.
Owner's Address -),'t ..+1 C Pool Permit No.
Directions to Job Site L-1 C," wj--- !`r fc-'+ , ,
Application For Rough Wiring❑ Fixtures❑ Service❑ or
Work—New ❑ Additional 17 Bldg.—New. Old❑ Ready for Inspection
Fee Remitted Check X Cash❑ Make Payable To C.E.I.S.,Inc.
LIST ALL EQUIPMENT AND WIRING
NUMBER OF ROUGH NUMBER OF ELEC.,HEAT-AIR CONDITIONERS-BURNERS-DRYERS-HEATERS-RANGES,ETC.
WIRING OUTLETS FIXTURES NUMBER i T`pE OF DEVICE H.P.OR K.W. NUMBER TYPE OF DEVICE H.P.OR K.W.
SWITCHES MERCURY
LIGHTING ' SODIUM
RECEPT. FLUORESCENT
ELEC.HEAT QUARTZ
'MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
OTHER EQUIPMENT
APPLICANT'S
SIGNATURE LICENSE# PERMIT#
PLEASE
PRINT NAME PHONE#
APPLICANT'S NAME OF
ADDRESS UTILITY
OFFICE TO
CITY STATE ZIP CODE BE NOTIFIED
ROUGH WIRING SPACE BELOW FOR USE OF INSPECTORS ONLY
OUTLETS AMP SERVICE PUMP
EQUIPMENT
SWITCHES HEAT OVEN
PUMP
RECEPTACLES SURFACE GARBAGE
UNIT DISPOSAL UNIT
MEDIUM BASE RANGE
FIXTURES
MOGUL BASE WATER DRYER
FIXTURES HEATER
FLUORESCENT AIR AMR RECEPTACLES
FIXTURES CONDITIONER
MERCURY VAPOR OR WIRING&CONTROLS FOR BURNER FRAC.H.P.
QUARTZ FIXTURES VENT FANS
MOTORS:H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 1-1/2 2 3 5 7-1/2 10 15 20 25 30 40 50 75 100
MARK NUMBER
OF EACH SIZE
APPARATUS
MISC.INFO. DATE INSPECTED RE- ❑ ' p
NOTIFIED POR- ¢ w —I FEE PAID
DON LOVELAND TED o _z O
Electrical CON- TOTAL $
TRACTOR
P.O.BOX 706 WORK INSPECTED
HAGUE,NY 12836 ❑R.W. 0 SERV OWNER CHECK NO.
(518)543-6724 0 FINAL OCCUPANT CHARGE
1-800 562-9934 CERTIFICATE NEEDED AGENT CASH
❑YES ❑DUP ELEC. H.O.
LT.CO.
TEMP CARD# DATE INSPECTOR
FINAL CARD#
BP/9627 Rev.1/95 APPLICATION EXPIRES ONE YEAR FROM DATE.
WHITE/Office CANARY/Officer PINK/Inspector GOLD/Customer
�; TOWN OF QUEENSBURY
e` BUILDING & CODE ENFORCEMENT -'
531 BAY RD., QUEENSBURY NY 12804 '' ts.
�% INSPECTOR'S REPORT: ARRji DEPART/�0 5 IN I
°'
'4 REQUEST FOR I SP CFO RECEIVED' 0 /�
NAME
qi. LOCATION l\ e
V. DATE a PERMIT #
ik
4 TYPE OF ST UCTUR. :
ss,`, A
ui N/A YES NO
;, RECHECK I APPROVED
-1 FOOTINGS/PIERS
/
V
klIt''. MONOLITHIC POUR ORM
REINFORCEMENT IN LACE
*"` THE CONTRACTOR IS RESP SIDLE FOR
PROVIDING PROTE T ON FOM FREEZING
FOR 48 HOURS POLL ING THE PLACE-
A.!, MENT OF THE CONCRE E.
MATERIALS FOR THIS URPOSE ON SITE
4" FOUNDATIONJWALLPOUR,
1.; REINFORCEMENT IN PLAXE
"a FOUNDATION DAMPPROOFI '?
BACKFILL APPROVAL
PLUMBING VENT VENTS IN ACE
;� ROUGH PLUMBING
PLUMBING UNDER SLAB ''
FRAMING: \�
JACK STUDS/HEADERS \,
BRACING/BRIDGING 'u: '''
JOIST HANGERS 'I: '
JACK POSTSJMAIN'A'BEAM '
W.
AIR INFILTRATION BARRIER Et-'-_-__17 -
HEATING ROUGH-IN
SULATION: .
e
FOUNDATION WALLS INTERIOR R- a
FOUNDATION WALLS EXTERIOR R- �i
FLOORS R- _ i
WALLS R-
CEILING R-`
• DUCT WORK OR PIPING IN
a,
UNHEATED SPACES R- x'•
P.
k
TOWN OF QUEENSBURY =4
BUILDING & CODE ENFORCEMENT '
531 BAY' RD., QUEENSBURY NY 12804 ��"'` ' ,yti
INSPECTOR'S REPORT: ARR/ t( DEPAR '" INT
REQUEST FOR INSSPECTION RECEIVED: g J,i) -17- l 5
��`�E�,`8:
NAME 1 7161 i�C) k v'i i Ili .
LOCATION -3 7 Y11 ( c ) kO r)
DATE /� -/5 -95 PERMIT J�# s c 1
TYPE OF STRUCTURE: \e c Ali-
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS p ._
MONOLITHIC POUR FORM % 1
REINFORCEMENT IN PLACE\ 2/
THE CONTRACTOR IS RESPON IDLE FO!
PROVIDING PROTE TION FRO FREE2 G
FOR 48 HOURS FOLLOWING TH PLAC -
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE \N ITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL if
PLUMBING VENT/VENTS IN PLACE \
ROUGH PLUMBING j ",;
PLUMBING UNDER SLAB
RAMING: ..1N4(
JACK STUDS/HEADERS
BRACING/BRIDGING al
JOIST HANGERSItr
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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 R-
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804 'P
a/5
INSPECTOR'S REPORT: ARRP DEPART( IN
REQUEST FOR INSPECTION RECEIVED: / 0
NAME nAAP -C tki ha 00111
LOCATION
DATE
TYPE OF STRUCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THEtPLACE—
MENT OF THE CONCRETE. , /
MATERIALS FOR THIS PURPOSE ON SITE J7
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
-5ACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE/
ROUGH PLUMBING _
PLUMBING UNDER SLAB /4
FRAMING: //
JACK STUDS/HEADERS
BRACING/BRIDG4NG
JOIST HANGERS
JACK POSTS MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH—IN
)(INSULATIOZ7i
FOUNDATION WALLS INTERIOR R-
4/-
FOUNDATION WALLS EXTERIOR R—
WALLS R—
CEILING R—
DUCT WORK OR PIPING IN
UNHEATED SPACES R—
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TOWN OF QUEENSBURY wg�
BUILDING & CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR//(}DEPART" : NN) "-
REQUEST FOR INSPECTION RECEIVED: /0/a47 -
NAME / 6- 4 (J L
LOCATION ?7 IML6'1WA) 0&1‹
DATE a ' 2- - PERMIT # 715
TYPE OF ST UCTURE:
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSI BLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THEtPLACE-
MENT OF THE CONCRETE. �{
MATERIALS FOR THIS PURPOSE ;ON SITE
FOUNDATION WALLPOUR \ f/
REINFORCEMENT IN PLACE J
FOUNDATION DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLE
R UGH PLUMBING if
LUMBING UN R SLAB
FRAMING:
JACK STUDS/H'EADERS
BRACING/BRI+DGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN _
INSULATION: I
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
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TOWN OF QUEENSBURY i
BUILDING & CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804 4' ;}" •;4
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INSPECTOR`S REPORT: AR :a DEPART /
EC - INT'-d% y1 II
REQUEST FOR INSPECTION EIVED: /2jl g
J
NAME ! ` j �J=-C �J240
LOCATION . *A&A,) ^
DATE /07 /pcT , I
r PERMIT $ ��r"` �'"� .
TYPE OF STRUCTURE: Al'IT '
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM f t ,
REINFORCEMENT IN PLACE(
THE CONTRACTOR IS RESPO SIDLE FOR
PROVIDING PROTE TION FRAM FREEZING
FOR 40 HOURS FOLLOWING HE PL CE-
MENT OF THE CONCRETE. y�I
MATERIALS FOR THIS PURPO E 01 SITE
FOUNDATION/WALLPOUR \
REINFORCEMENT IN PLACE _
FOUNDATION/DAMPPROOFINGJf
BACKFILL APPROVAL /i PLUMBING VENT/VENTS 14 PLAC �
ROUGH PLUMBING /)t -____
P UMBING UNDER SLAB _
"' FRAMING: /F/ 0r J 6"- I
JACK STUDS/HEADERS a
BRACINGI//BRIDGING
JOIST DANGERS a
JACK BOOSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
a
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R- i _ �
FLOORS R- _
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
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TOWN OF QUEENSBURY •
BUILDING & CODE ENFORCEMENT
,
531 BAY RD., QUEENSBURY NY 12804 • •
INSPECTOR'S REPORT: ARTIOITDEPAR \ '
REQUEST FOR SPE TION REWTVit: \
NAME 4/ 1 I A a 4.1
„ALT vw-
LOCATION sw
DATE SY ,,
fr )
TYPE OF ‘TR CT RE: * i(4,Jr _AA/
- -
RECHECK APP•OVED
NA YES NO
MOTIN,btagtOMilli
MONOLITHIC PRUR FORM
REINFORCEMENT N PLACE
THE CONTRACTOR 'S RESPONSIBLE FO'
ION FROM FREEZ 'NG
PROVIDING
FOLLOWING THE PLACIA-
MENT OF THE CONCiTS.
MATERIALS FOR THIS PURPOSE ONLITE
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FOUNDATION/DAMPPROOFI G
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN LACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEIRS
BRACING/BRIDGINa--
JOIST HANGERS
JACK POSTS/MAIIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS FIXTERIOR
FLOORS R-
WALLS J R-
CEILING 1 R-
DUCT WORK OR PIPI IN
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