91-589 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-589
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Ronald & Gayle LaCross
OWNER of property located at 201 Fifth Street Ext. 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
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2. CONTRACTOR or BUILDER'S Name
Same
7
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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I.
6. TYPE of Construction— (Please indicate by X)
( X Wood Frame ( ) Masonry ( )Steel (
C
7. PLANS and Specifications
No. 144 sq ft Addition to Dwelling as per plot plan specifications
and application
8. Proposed Use
Additional bedroom space
$ 8.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 19, 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 19th Day of August 19 91
.\\0
SIGNED BY
for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY
REVIEWED b �;` ,! �s �7
FEE PAID $ �v�i R '`i A�
,''�c % PERMIT NO. — G 4 6 1991
� � - LDGa
BUILDING PERMIT APPLICATION CODE DEPT.
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.
• • • • • • • • * * • • * • • * * t * * * * * * * * * * * * * • R * * * * * ♦ * I
The owner of this property is: <e)"*Y1 ( . - _f,_./ec`' 10 ` .. (0,9 , �
P.O. Address •.
Tel. `y ' ° `.
Property Location i c I ! 3/ `
'�4✓ Tax Map No. �. /
Has there been any split of this property since October 1, 1988? /,.
If yes Planning Board Review is necessary. yes no
SUBDIVISION NAME, IF APPLICABLE LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
*
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF
Construction of a new building I CONSTRUCTION: $
Addition to a building * COMPLETE INFORMATION REQUIRED BELOW:
* Size of property ft x `" "'l ft.
Alteration to a building * Existing Buildings(3) Size ft. xj/ ft.
(no change to exterior dimensions) *
Proposed building - distance from property line:
Other work (Describe) * Front yard 3 2 ft. Rear yard ft.
* Side yards ' 2_ ft. and 411r ft.
GROSS AREA OF PROPOSED STRUCTURE * If on corner, setback from side street rt.
1st Floor sq. ft. * OCCUPANCY INFORMATION
*
2nd Floor sq. ft. * Primary Building -
Other Floors sq. ft. • One Family Dwelling
(not cellar or basemcnt) - Two Family Dwelling
TOTAL FLOOR AREA •
` =isq. ft. • Multiple Dwelling/Number of units
Size of new structure _ ft x ft. • Business
_
Foundation-pier/slab/c:=,,. rtiai/full * Industrial
(circle %h.:. '' Other
No. of stories (habitable space) I •
Height (grade to ridge) t ft. • If addition, what will use be? '-e°04
If residential, no. of families *
No. of rooms(excluding baths) r. ;►
No. of bedrooms • Accessory Building
_Detached Garage ONE/TWO Car
No. of bathrooms ' *
Primary heating system idyegt j ,,'',, • __Attached Garage ONE/TWO Car
Type of fuel (i; r * _Private storage building
No. of fireplaces to be installed 0 *
* Other
Will a wood stove be installed 6
•
Central Air conditioning
OV' ER
_ 1
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING 'SPECIFICATIONS:
Type of constructior fire safe, etc.
Will any second-hand or upgraded lumber be used? If so, for what?
-/J
Foundation wall material 457,-c, Thickness /Liif -
Depth of foundation below grade (to bottom of footing) - --'
Will there be a cellar? rj Heated or unheated? ifrA f i/., -�� Floor sq. footage � sq ft.
Will there be a basemen ,e .:f) Will any portion be used as living space?
(If so, what portion? sq ft. Type of use?
Type of roof sloped/flat/shed/other Material of roof 15 fit, / -)/ r vi _ I�
Size, wood studs 1 "x l . " spacing / " o.c. length 3 ft.
Joists (floor beams) 1st floor "x ' " spacing/ "o.c. span / ft.
Joist (floor beams) 2nd floor __ _"x .__ "o.c. span ft.
Overlays (ceiling beams) i "x .' spacing /) ,'" o.c. span ft.
Roof rafters '.,Z "x " spacing j o.c. span/f ft.
Roof trusses (pre-engineered) spacing_ _.._,__.,".o.-c�.---span ft. "
Exterior wall finish -/—fi •ca-'l j„,1_/ of what material? i/Xe,t7e 7--Interior wall finish 72 . �� ��ex
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? If so will a Fire-rated door, enclosure,
self-closing device be provided?
Will a flue-lined chimney be installed? / c"� Height above roof ft.
Depth of chimney foundation below grade ft.
Depth of firepl ft. in. ..
Water su l '� p private
pp y(�- `Munici _aor rivate 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)
SAME OF BUILDER ,mac:'�CI./ ,t
� ��/��- LA�DRESS ,�16'4--5 74- TEL. NO. ''s7�(' --- (c7�(
SAME OF PLUMBER // ADDRESS TEL. NO.
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SAME OF MASON ADDRESS TEL. NO.
SAME OF ELECTRICIAN // ADDRESS TEL. NO.
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
he described premises and that all provisions of the BUILDING CODE, THE ZONING ORDINANCE, and
LU other laws pertaining to the proposed work shall be complied with, whether specified or not, and that
uch work is authorized by the owner. % ) ,/
Signature" �"`z
`` ----z-i%-
Owner, owner's agent, architect, contractor
;PECIAL CONDITIONS OF THE PERMIT:
BY
t
1
' 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
- ,,UNC.. , 1.-- 1,2,1 <5 2,0 I , e":..4c74-7 '--4--.APPLICANT'S ,4";41.-
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% X Under 17%
/�' ,
THE R-VALUES GIVEN ON THIS SHEET MUST CORRESPOND TO REQUIRED
THE R-VALUES SHOWN ON PLANS SUBMITTED!
Basebear '
5. Insulation Values: Actual Shown Elec. Heat Other
A. Roof & Floors exposed to ambient temperatures R 3b
B. Exterior Walls R // v/e13
C. Glazed Area R
D. Exterior Doors R
E. Floors over unheated spaces R '"
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
e-' 70/
i
,1 ir - , '.....7.:1"*./
99c;i
APPLICANT'S SIGNATURE DATE TELEPHONE NUMBER
INSPECTOR'S REMARKS :
REVIEWED BY
1
THE NEW YORK BOARD OF FIRE UNDERWRITERS
ii288€ t BUREAU OF ELEC CITY
.1 1 41 STATE STREET,ALB .NEW ORK 12207
1 Date -T1 1 PY I '. 2`1' Applicati No.on file
THIS CERTIFIES THAT
1 ,_
only the electrical equipment as described below and introduced ant named on the above application number in the premises of
_ 1,(44 I,7) (' (1:' '-)'a Ste_{ -_n„,r -,e 1il ri-1;'Lttlfi',' N.y.
1 in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
-,
was examined on DFX 1 BEIR' 31,1992 and found to be in compliance with the requirements of this Board.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS _
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
-c
-.
1
-.< DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
-) AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. NAP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS
�` NO. FEET AMT. WATTS
_ ,"
1
-
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC.COND. A.W.G. A.W.G. A.W.G.
AMT. AMP. TYPE EQUIP l,B'TW 1 9'3W 3,B'3W 3,9 4W NO.OF HI-LEG NO.OF NEUTRALS
�_ PER.B' OF CC.COND. OF HI-lEG OF NEUTRAL
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-( OTHER APPARATUS:
"(b1LL ONL` ' is is not a
Certificate This is a Bill
for Ser'vic._ * -ndex-ed Only.
'D--vr•--,.,-;--- (._..
I RONQ ALD C. ',CROSS
_ cry•
201 FIFTH ST.
GLENS FALLS, NY, 1280 1 BRANCH MANAGER
Per ."
., 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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
t TOWN OF QUEENSBURY
T BUILDING & CODE ENFORCEMENT \
f 531 BAY ROAD 1
QUEENSBURY NY 12804
(518)745-4447
ARRIVE: , `• 3b DEPART: ,D.4(�, INSP• , -{
FINAL INSPECTION REPORT - RESIDEN IAL
DATE INSPECTION REQUEST RECEIVED: %E, Cirt)4)
NAME R p►J PiL[) L.ACRc16.4)
LOCATION C i _.�_.J 1 F,�T (�
DATE ZI ‘5 E PERMIT # "1`xT
` "
TYPE OF STRUCTURE ROOD;`00
FOOTINGS FOUNDATION BACKFILL FRAMING
ROUGH PLUMBING EPT3 INSULATION
FINAL ELECTR L WOODSTOVE FIREPLACE
N YES NO
CHIMNEY H IGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR NISH /
DECK/PORCH/1TEPS/RAILINGS
RELIEF VALVE
FURNACE/HOT WTER OPERATING f
INTERIOR TRIM/RRIVACY DOORS //
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILIN
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURE
FOUNDATION IN LATION
GARAGE FIR PROOFING
DOOR OSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C \`
AMR l._A(.c65 Feast_ c r -T OuV
11D sT1 Lk_ Doti 7\13 AL x ti
TO 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 fit ) %/
NAME if76-y//�l d -' vi9fi.ly o. Q47,4- J
LOCATION / �� 4i-
DATE i/ 4-11q/ PERMIT I 9/-I9
TYPE OF STRUCTURE a /hit
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
x BACKFILL APPROVAL
ROUGH PLUMBING
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-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
- Pt.A4 rPn-Dor(
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ARRIVE ( /'<�. 3 j
DEPART
l / "()
IN P TOR
3 : 30
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST OR INSPECTION RECEIVED Lc 1" 9 j
NAME aCk ecoo
LOCATION 0 b) �� �� [; "
DATE PERMIT I 62) / -529
TYPE OF RUC URE (Ac, )*i5.1-1 iJ ..oe\l
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
PLUMBING VENT/VENTS IN P CE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
X-INSULATION:
FOUNDATION WA S INTERIOR R-
FOUNDATION W LS EXTERIOR R-
FLOORS R- /
WALLS R- ti ,/ _
CEILING R-, L
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE •
DEPART
CTOR
Ci1.t, C.1' � yt
TOWN OF QUEENSYBURY 33 0'0))
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 5
NAME Gl Cyr; .S S qxmcS-S-t-
LOCATION �0 ? 1 (4-)r7Q_
DATE C PEE��RMIT # I —-S1
TYPE OF STRUCTURE A-)a I-0 `C/1r;(tc,
RECHECK APPROV )
• 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
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
A-FRAMING:1 , c4, t/
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
REMARKS:
LIS (Aida- U-4,1CL P4c
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ARRIVE
DEPART
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD 1�
QUEENSBURY, NEW YORK 12804 , 0
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT Q
REQUEST FOR INSPECTION RECEI17a,
ED ] t
NAME C ,
LOCATION 2(2
DATE 91,941i / PERMIT I ( --
TYPE OF STRUCTURE c J-T) Otuej)
RECHECK APPROVED
1 N/A YES j F00TINGS/PIERS
NO
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
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-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE 3:
DEPART
S CTR "r`