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CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date February 22 19 9
This is to certify that work requested to be done as shown by Permit No.
91-552
has been completed.
This structure may be occupied as a Addition to Dwelling - increased size of
bedroom
Location Fernwood Road, Glen Lake
Owner William Fosbrook
43-2-10/11 By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg.'& Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91-552
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to William Fosbrook w
OWNER of property located at Fernwood Road, Glen Lake 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 H
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. Cr
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1. OWNER'S Address is 7^
RR#1 Box 1702
Lake George, NY 12845
2. CONTRACTOR or BUILDER'S Name Cu
Sherwood Acres Corp.
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3. CONTRACTOR or BUILDER'S Address 1
X
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4. ARCHITECT'S Name C7
5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X)
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( X Wood Frame ( ) Masonry ( ) Steel ( ) 8
X
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7. PLANS and Specifications .-.i
_J.
Plan
No. 344 sq ft Addition to Dwelling as per plot specifications
and application
8. Proposed Use
Bedroom area increased
$ 24.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 1, 19 92
(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 1s Day o August 19 91
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SIGNED BY for the Town of Queensbury
Building and Zoning Inspe or
TOWN OF QUEENSBURY i
TOWN OF UEEW;t '
`gibi REVIEWED BY: Vy,- � "l
II: s (W
�� ''FEE PAID: p9Lit t I ij j
PERMIT NO. : 9J5sL LI JUL 199
1 Li
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: _ L t t L / if i l t ,,1�d S 2 )?d O 1-
Gt/
P.O. Address: _Igljn .4 I 13d� 1�V L-&( e. 6-P0 c= NI ONE 3 —X'a
Property Location: *-. o ,OD O Tax Map No. /.3/ Q / 2
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: / J Lot No. /
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ G ` U L 6-
_ 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 Buil in Size:
* ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
1st Floor j q a Sq. Ft. * Front Yard 'jOO ft. Rear yard :06 ft.
* Side Yards )') ft. and j ;?ft.
2nd Floor ) 5 o. Sq. Ft. * If on corner, setback from side street-
* ft.
Other Floors Sq. Ft. *
(not cellar or basement) * OCCUPANCY INFORMATION:
TOTAL FLOOR AREA: , 2 ySq. Ft. * Primary Building -
* One Family Dwelling
Size of New Structure: ft. x ft. * Two Family Dwelling
Foundation: !J O N j * 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 use be?
No. of rooms (excluding baths) : ,/ * _ 4 r 0 R in 4
No. of bedrooms: a * TI'V C l? ( A C C(
No. of bathrooms: * Accessory Building:
Primary heating system: I-I o T A ) k * Detached Garage - One/Two Car
Type of fuel : I L * Attached Garage - One/Two Car
No. of fireplaces to be installed: NO * Private Storage Building
Will a woodstove be installed?: IN) (7 * Other
Central Air Conditioning: Yes No V *
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. LicJ ci c, 2 F Rii-ri E
Will any second-hand or ungraded lumber be used? If so, for what? /) eo
Foundation Wall Material : F x) s 1 i IQ G Thickness: g/I 13 L. o C LJji-L.(...
Depth of Foundation below grade (to bottom of footing) : /
Will there be a cellar? 1.-:,IlicTiOrleated or Unheated? H Floor Sq. Footage:
q
Will there be a basement? //Q p Will any portion be used as living space? 1 c)
If so, what portion? Sq. Ft. Ty e o e?
Type of Roof: Sloped/Flat/Shed/Other S' Material of Roof AS pA/A LT
Size, wood studs " x C " ; spacing " o.c. ; length ft.
Joists (floor beams) : 1st Floor , " x k "; spacing A; " o.c. ; span Yft.
Joists (floor beams) : 2nd Floor 9-- " x " ; spacing / " o.c. ; span ft.
Overlays (ceiling beams) : ' " x ? " ; spacing �� " o.c. ; span _ /" Y �ft.
Roof rafters: " x " ; spacing Xp o.c. ; span / '/ft.
Roof trusses (pre-engineered) : spacing " o.c. ; span ft.
Exterior Wall Finish: C LAP 6d.4 i ' 17 S of what material ? C On- ( ,
Interior Wall Finish: /- I( S' 14- r T' e0 C., I(
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
kl C _
Is there to be an opening between garage and dwelling? t ci -) ifiso,will a Fire-Rated door,
enclosure, self-closing device be provided? it X( c. 7 I N G'
Will a flue-lined chimney be installed? A) 0 Height above roof ft.
Depth of chimney foundation below grade: / ,,) „, ft.
Depth of fireplace hearth: U ft. in.
Water supply - Municipal or private well : Lam- t-,(7
SEPTIC SYSTEM: Distance from any private well (including adjoining properties: L;,,i Ili;./:
(A separate application is necessary for any repair or new installation of septic system. )
NAME OF BUILDER & ADDRESS: ,S-_N ,_,, Cl.-C,-,QJ C„,, 6-- PHONE ? g 2/0 j-
NAME OF PLUMBER & ADDRESS: 5"ca,/ PHONE / /
NAME OF MASON & ADDRESS: , � PHONE
NAME OF ELECTRICIAN & ADDRESS: `_—_--__g 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 p a' 'ng to t pr p s d work shall
be complied with, whether specified or not, and that such wo auth iz d b t e o ner.
Signature )_____, I
Owner, owner' s ,agent, architect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
i0j TOWN OF QUEENSBURY
531 BAY ROAD
46e4 QUEENSBURY, NEW YORK 12804
Aw-Av TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME Ip�(3izco(�-
LOCATION /'LIZAJOA C L2 20- (LkAl L-/N4a_'
DATE Z)2Z-/9.3 PERMIT#
TYPE OF STRUCTURE moolcut-i omat-L A-az
RECHECK
FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
A.,ZiFOOTING FOUNDATION BACKFILL )(FRAMING
pROUGH PLUMBING ZCFINAL ELECTRICAL SEPTIC
)c,INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION 1
PLUMBING VENT
ROOFINGK
SIDING
DECK/PORCH/STEPS/RAI\INGS 2C
RELIEF VALVES
FURNACE/HOT WATER OPEATING
INTERIOR TRIM/PRIVACY OORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGIkT
OTHER FLOORS SWEEP LE\
OTHER FLOORS CARPETED xC ,
STAIR CLEARANCE/RAILNGS \
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS!!
FINAL ELECTRICAL
.X OK TO ISSUE C/O OR C/C
COM NTS:
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DEPART Ct.()
OR
45-‘72 CI-
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 ,, ,,-�, ./ `
LOCATION hr 61d � 4-4
DATE 2403 03 PERMIT I 9/6��
TYPE OF STRUCTURE e -
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 0-4, q/ / t 1/4..
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING: mac. </a/Q, 1/L
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
vWALLSL.-CEILINGa SI.?g141! VL R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
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DEPART //;-00
I SP CTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT n' In/
REQUEST FOR INSPECTION RECEIVED `7
NAME ("1 c:_00 Y(0 L W i I GGvw.
LOCATION cF*t t\ e
DATE Cl I PERMIT # 61 1 _5 .SC.)
TYPE OF STRUCTURE Aped 4-0 Q }CS
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 .1
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-Lk
FOUNDATION WALLS INTERIOR R-
FOUNDATI N WALLS EXTER OR R-
FLOORS G 4.4,1) R-3 if/
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
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E ' Y '
T Z- -'l
I PEC R
TOWN OF QUEENSBURY //9fr
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR` INSPECTION RECEIVED
NAME �j( i i hF-46-407--L.,
LOCATION 1 ed LLY
zit
DATE fr/0,/ PERMIT # �-
TYPE OF STRUCTURE 4"
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION F2OM
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
BRACING/BRIDGING .
JOIST HANGERS
JACK POSTS/MAIN BEA
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-,/
INSULATION: ,
FOUNDATION` WALLS INTERIOR R- X(
FOUNDATION WALLS EXTERIOR R- X
FLOORS.:itlo-t- R-
WALLS Wig+ I F4I E_ R-
CEILINGT?- ¢-3o R- X
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
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DEPART tor?
I NS PE TOR
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 gli70
NAME O`, ,yf)(*}
LOCATION R t<0 t r,>,
DATE I PERMIT # C-1 —
TYPE OF TRU TURE )i, �J �,, �\
RECHECK APPROVED Li
, 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
8BACKFILL APPROVAL K
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM;:-'
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
REM 4A.R,KS:
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5Pi4,Rtric P-PczosciAJ1 -
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DEPART T o
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