92-798 - 4
AP.1 memmannommonn .
ri -FICAll---.
W!.A E OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 42da.4.-7,_ /9 19 12
This is to certify that work requested to be done as shown by Permit No. 612- 19g
has been completed.
This structure may be used as a roo-F (addi'Hor) -iv on jiri,a )
Location 4t Alonfray Pd.
Owner aeo roe. E, kou,ag_
By Order of Town Board
TOWN OF914ENSBURY
Director of Building & Code Enforcement
R
BUILDING PERMIT
TOWN OF QUEENSBURY rl p
No. qz" ! q8
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to EOFZt'a'P. E, !IOURA
o<
OWNER of property located at 411 MONT71:/&l /1 '7 Street, Road or Ave.
in the Town of Queensbury,To Construct or place a oiC DI)1- Dts1 TO I'JV11 LL..J
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 roe.
CP
2. CONTRACTOR or BUILDER'S Name
5ame,
3. CONTRACTOR or BUILDER'S Address
irc
Pr
4. ARCHITECT'S Name
5. ARCHITECT'S Address
J
6. TYPE of Construction— (Please indicate by X)
( 1 Wood Frame ( ) Masonry ( )Steel ( ) C
7. PLANS and Specifications
No. 308 �,,�'t 00-c add,6f—►'on - dwe i l l'r as "ter plO+ ?tar) c
SpecVJ aJions and ripp1i'ced-i'on .
8. Proposed Use
$ £2), QQ PERMIT FEE PAID —THIS PERMIT EXPIRES Te_Cember 30 19 q3
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 6 T
town of Queensbury before the expiration date.) fn
r
Dated at the Town of Queensbury this 30 th Day of Det'emb&d 19 Q2... z y
�/� D
SIGNED BY tY1� 117j for the Town of Queensbury g
Buildi and Zoning Inspector
TOWN OF QUEENSBURY
41111111960111
REVIEWED BY: -
114*-1 FEE PAID: iIty* • �")
PERMIT NO. : q;?-7fI Ec
P� C�Sa� EP-
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: G. r 1 E: &. /s<.;a a.
P.O. Address: _ PHONE 7 q& -CPJ$O
.231o0
Property Location: 4/ n'J� 6 i) . Tax Map No. 71- / 3 / P.•Z-
Has there been any split of this property since October 1, 1988? Yes No X
If yes; Planning Board Review is necessary.
Subdivision Name, if applicable: /101- Lot No.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS: ee,,,E,
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION: $ /f4
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: i56 ft. x /7-S ft.
Other work (describe) * Existing Building Size:
noii ft. x300ys- ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
1st Floor . yi 'r Sq. Ft. * Front Yard gri ft. Rear yard `a ft.
* Side Yards 7S ft. and _cv ft.
2nd Floor Sq. Ft. * If o corner, setback from side street-
* Nv,q ft.
Other Floors Sq. Ft.
(not cellar or basement) * OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: Sq. Ft. * Primary Building -
A 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 use be?
No. of rooms (excluding baths) :
-e)---f)tX
No. of bedrooms: * ✓�
No. of bathrooms: * Accessary Build ng:
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)
7/-s Iva P-A (*.e,7 3�� 7Z 6,Ad » t OT Gz U r 11 o/
`JouSo ?b ', Al GN d Fx � 71 740 C'v a Exis 71i.x/
C4hvf7 ov(Y a FxiS i.-, 017f cocci.
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc. <5 d
Will any second-hand or ungraded lumber be used? If so, for what? /1/0
Foundation Wall Material : Thickness:
Depth of Foundation below grade (to bottom of footing) :
Will there be a cellar? /i'; Heated or Unheated? r17,44 Floor Sq. Footage: '''/ -
Will there be a basement? /1//4 Will any portion be used as living space?
If so, what portion? Sq. Ft. Type of Use?
Type of Roof: Sloped/Flat/Shed/Other `1 't i Material of Roof S 4,-7y 1 -1
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 2 L " o.c. ; span z 2 Y ft.
Exterior Wall Finish: ^e./ 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? '12/(17- 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: PHONE
NAME OF PLUMBER & ADDRESS: PHONE
NAME OF MASON & ADDRESS: PHONE
NAME OF ELECTRICIAN & ADDRESS: PHONE
DECLARATION
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
not, 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 project on premises. �` n
Signature —' sxy L ��
owner, cvner' s agent, architect
contractor
:CIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
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TOWN OF EENSBURY `"a
531 BAY ROAD
Aft
;41 QUEENSBURY, NEW YOR 12804
�► TELEPHONE (518) 745-4447
INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR I SPECTION RECEIVED /f/f Am
NAME lam' LI
LOCATION l )7z t '
DATE /4940 PERMIT# 9c2-791
TYPE OF STRUCTURE
RECHECK
_FIRE MARSHAL APPROVAL (COMMERICIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING FINAL—ELECTRICAL—_SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
CHIMNEY HEIGHT/LOCATION
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OP TING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABL
OTHER FLOORS CARPETED'
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C L
COMMENTS:
ARRIVE ' )
DEPART 1
►h1
17 INSPECTOR
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 //7,/q,JG
NAME , '
LOCATION �/ l �' >�
DATE // 7 /93 PERMIT # q49 - 70
TYPE OF STRUCTURE / ��~,i"
RECHECK APPROVED
N/A YES _NO
-'5'00TINGS/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/DAMP ROOFING
BACKFILL APPROVAL
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 INTERIIR '-
FOUNDATION WALLS EXTERII' R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPIN► IN UN ATED
SPACES
REMARKS:
ARRIVE__
DEPART
I PEC OR
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TOWN OF QUEENSBURY BUILDING DEPARTMENT r--,
Based on our limited shall omn natiofn,
compliance with our commen TOW" OF QUEENSBURY
t: •
not be construed as indicating the
plans and specifications are in full BUILDING CODES DE PT.
compliance with the code.
REVIEWED BY _-F1LE 'C0%PY
DATE I -- FILE COPY 76'&