93-086 +F"
- `CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date aI. 3D 19 9-2
This is to certify that work requested to be done as shown by Permit No. 93-086
has been completed.
This structure may be occupied as a master bedroom
Location Upper Bay Road
Owner Stephen and Sandra Jabaut
22-1-19
By Order Town Board
TOWN OF QUEENSBURY
41/md
✓i --
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY F
No. 93-086
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to STEPHEN & SANDRA JABAUT
OWNER of property located at Upper Bay Road 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 co
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
--I
1. OWNER'S Address is
RD#1 Box 1437 `"i
Lake George NY 12845
rn
2. CONTRACTOR or BUILDER'S Name Q'
to
Tim Graham
v
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
q( 1 Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. 31'x17' Addition to dwelling as per plot plan, specifications and
application. a
8. Proposed Use -I.
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Master bedroom
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$ 56.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 9 19 94 m
(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 9th Day of April 19 93
SIGNED BY 4L/Lt .i , ,st, for the Town of Queensbury
B Z ' Inspector
TOWN OF QUEENSBURY REVIEWED BY:
COMMUNITY DEVELOPMENT DEPARTMENT r1111110! elf
BUILDING & CODE ENFORCEMENT A q FEE PAID:
531 BAY ROAD QUEENSBURY, NEW YORK 12804 .14 QfE> ' NUA !C
O,
(518) 745-4447 RECEIVED
BUILDING PERMIT APPLICATION
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CdJ RUC t. NO INSPECTIONS
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT.
All applicants ' spaces on this application-Ngq& Cffl Egoft leted and the
signature of the applicant MUST appear on the app7ica` ion form.
OWNER OF PROPERTY: fc Ji.Oet, .yi,) Y°od, x4 j
Mailing Address : z N 3 7 15
Telephone Number(s) : Work '2 , 0 %( Home 7 'r b L6 ;`{" Other 7:73 '(/
PROPERTY LOCATION: OP AO et 0
` ') Block �, Lot •-1 - ;-,f
Takap Number Section ,5�3 ,�_,_.
Subdivision Name: i 1 Lot No. n/
NATURE OF PROPOSED WORK: ESTIMATED M1>tRCEifi� ° Tl�
CONSTRUCTION: ($ __. .
NEW BUILDING:
RESIDENCE/COMMERCIAL OCCUPANCY INFORMATION:
ADDITION TO BUILDING: PRIWY BUILDING -
RESTDFNCF/COMMERCIAL ' Single Family Dwelling
ALTERATION TO BUILDING: Two Family Dwelling
RESIDENCE/COMMERCIAL Family Dwelling
1 (NO CHANGE TO EXTERIOR SIZE) Office
OTHE WORK (DESCRIBE BELOW) Mercantile
!le._ Warehouse
Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
1ST FLOOR 3 1 1? " , el/ SQ. FT. yb
IF 4DDITION, U E OF NEW ADDITION:
-2ND FLOOR- SQ. FT. ,G/ f , 'l
-GTHE.R-_-FLOORS ,.°VAL SQ. _FT. 90®
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage - One/Two Car
TOTAL FLOOR AREA: . 7 SQ. FT. Attached Garage - One/Two Car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
3
1 FEET X / 7 FEET
Foundation Type: , ° 4 1011 rt Will any second-hand or ungraded
Number of Stories : 't'i s41d r.. -( lumber be used? If so, for what?
(habitable space only) ri m- V C2
Height (grade to ridge) : feet Type of Heating System:
Number of fireplaces and/or woodstove (circle all ch applie
to be installed: el Electric / • )/ G.a
Forced Hot it / aseboa / Other
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
NAME OF BUILDER/ADDRESS/PHONE: // 6I"4.44,,,..^ - 2/ z �=, Sr _i-
NAME OF PLUMBER/ADDRESS/PHONE:
NAME OF MASON/ADDRESS/PHONE :
NAME OF ELECTRICAN/ADDRESS/PHONE:
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 UILT PLOT PLAN
drawn to scale, showing actual location of pr j c off"} ms�'s . `�--
Signature , A
(Owner, owner' s /agen , architect, contractor)
FOR ANY SPECIAL PROVISIONS - SEE REVERSE SIDE:
1
01 OF QUEENS !
RECEIVED
/ 111... ENERGY CODE COMPLIANCE APPLICATION
`tO TOWN OF QUEENSBURY, WARREN COU1 1993
9000 HEATING DEGREE DAYS
�.r,, &CODE DEPT
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
*Requires submission of worksheets
APPLICANT'S NAME: PROPERTY LOCATION: dti37 t'y/1-e') ilu7 /? J
cf r 4 c=) P Uir ba 1F t.es fc (t— iV 'Z. 7 .P`f i—.
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - 3 ► x t i cl7 square feet Uki0dJ
2 . Type of Heat - Electric V//Oil Gas Other- L'' '-
3 . Is building mechanically cooled? Yes 1 No
4 . Percentage of area of windows and doors Over 17% Under 17%
5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS
SHOWN ON PLANS SUBMITTED: R
a. Roof
b. Exterior walls R 0
c. Glazed areas R
d. Exterior doors R
e. Floors over unheated spaces R 11
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
Conforms to minimum efficiency per code Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Appic n ' s u e Phone Number
,/,, t .7 ,./ ,s-----, - 'ilie,/, -3 -74 ki 6)6?
INSPECTOR' S ` EMARKS :
TOWN OF QUEENSBURY
531 BAY ROAD
#� j QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION cy/ -v-7 /5.13
REQUEST FOR INSPECTION RECEIVED
NAME j,ri 3A u t
L TION li(-iode,,,-J-fTelici_____)1/,� 37U7,5uS7.3 PERMIT ' 3
YPE OF SDWCTURE
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 i ./
ROOFING ./.
SIDING
DECK/PORCH/STEPS/RAILINGS +, f
RELIEF VALVES /',
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS ;,'
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT • •_/'
OTHER FLOORS SWEEPABLE .�
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS i' i�
SMOKE DETECTORS
DOOR CLOSERS
BATHROOM FANS ,/
ALL PLUMBING FIXTURES OPERATING'',
GARAGE FIRE PROOFING
DOOR CLOSERS f✓x'�S ,% J
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
FINAL ELECTRICAL 9'7
OK TO ISSUE C/O OR C/C
COMMENTS:
n
Ail ._ , ( -- il4¶,:2
Stig-17 _1)
7 V 'e5'+ ko p L i Wt X l4-1 , 1'? a/i. 4d'Ui�t
ARRIVE : J 1 •
DEPART f',1
IN ECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR INS�PECCTION RECEIVED
-�Ai'_
NAME •Rp,,n C \ock,vj
LOCATION -)0 1 £..0 711?(1
DATE ( i a. 1973 PERMIT # C1 3 -O
TYPE OF STRUCTURE
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 ONJSITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING ? I-
PLUMBING VENT/VENTS IN PLACE !
PLUMBING UNDER SLAB /
FRAMING: 1
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
HEATING ROUGH-IN
,INSULATION: '
FOUNDATION WALLS INTERIO R-'<
FOUNDATION WALLS EXTER,XOR R-
FLOORS R-
WALLS R- 7
CEILING R- 315
DUCT WORK OR PIPING/IN UNHEATED,
SPACES
REMARKS:
ARRIVE `42 :
DEPART t7
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUES INSPECTION RECEIVED
NAME
LOCATION ,/ ,,z_/7"2 9
DATE 2:5 PERMIT [ 3-110O
TYPE OF TRU URE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE fr;
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING /
THE PLACEMENT OF THE CONCRETE. f�
MATERIALS FOR THIS PURPOSE ON SITE'
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE �F
4'LUMBING UNDER SLAB
RAMING: ✓
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:
ARRIVE (I . 40
DEPART 9.`5 w
I PECTOR
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•W • v r r . APPROVEDter,- & CODE DEFT.
A t "Ccriifications in
•• . f CI 4 -Q Application Co survey was prrpe
.a a 3 'sting Cote of Pn
0APR by the New York
Lax)Surveyors..
- to the person for
t and on his behalf t
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Zoning Administrator
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HOT AiTD CITY IT'S SUCCESSORS 21i:D SS!..1!
TITLE USA INSURANCE CORPORATIQN :0? I EW YORIC,
THAT THIS MAP WAS .MADE FROM AN ACTUAL SURVEY ON
THE GROUND ACCORDING TO,RECORD DESCRIPTIONS AND
SHOWS LOCATIONS OF BOUNDARIES AND IMPROVEMENTS400110040.
• •U. .ES AND THERE ARE NO ENCROACHMENTS
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tcration or addition to a survey •
.nscd land surveyor's seal is a
to 7209, subdivision 2, of the
Education Law."
>m the original of this survey MAP o c A S•3 t2 1`t M AO t 2
onbinal of the land surveyor's 5T tE,P x C f l. P t S AS•LDRA A . 5A13AUT
tiered to be valid true copies."
dicated hereon signify that this "Tow Q Al SB��C✓ G�.4 ee'CN Casvairy ►►.`(. .
red in accordance with the'ex- S c A L{r: / ". 5o ' DA-r e: /14 Y 2V, /t y G
,dice for Land Surve;"•adopted
atc Association of P russitxtal •
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Said certifications sha I run only
whom the survey is r rcparcd, l.Aa o S a*ov/a R.c, C t-goat . ,,J,y,
o the tide company,goicrmten-
;ling institution listed hereon,and N.`1. 5TA-rye t.t c.. A/o. 3sb l7 /'� S• • //ea,✓ goo S`�-
the lending institution.
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TOWN OF QUEENSBURY
A z __ . .
wDEPARTMENT OP COMMUNITY DEVELOPMENT z Applicittion
BUILDING PERMIT NUMBER < APR - 8 1993
0 ...rt— AMET - •
W Zoning Administrator
1-1 I. BASIC/BUILDING PERMIT INFORMATION: TOWN OF QUEENSBURY
Ap•licant/Name & Address Agent/Name & Address n applicant gent
41/
r ) H
}T i--� TAX MAP NUMBER:
Z Cr 1'I ieI is ,tiie.Adddt t'.ss 0, — /—
0 LIMLA_� Pt. ?erty Address I� : // .'357.2
ir_ ti h R
2. PI�ECT D,SCRIPTION: _ _ ' F..' `e ���
—� ' -- -- _ -- —_raft__ plot plan (2 copies)
/. building plan (2)
a sewage disposal
energy code
3. PROPERTY INFORMATION: electrical inspection
driveway permit
SETBACIS REQUIRED ACTUAL 1j11 , ompleted/signed
_-__(,..-P.FEE PAID
Front Yard /D-e �J
Front ( if corner) /'�
Side Yard (1) /D V ❑ NEW CONSTRUCTION
Side Yard (2) / . -" ADDITION
�
Rear Yard / ❑ ALTERATION
Width ❑ MODIFICATION
Depth Li ON
YES NO NIA
PROPERTY IS IN APPROVED SUBDIVISION
,. ti mie.
• Meets depth, width & square footage requirements
Preexisting, nonconforming lot with proper setbacks
`A Required road frontage on public road
J Has required off-street parking
Permeable area is adequate /'Required: 9-5'
Building does not exceed maximum height / Max.
Required setbacks from stream, lake and/or travel corn,or
meets requirement
Buffer zones required
`ll Is lot in a Flood Plain Zone?
0 V E R
A i
4. STAFF DETERMINATION:
As per Section(s) of the Zoning ❑ Sign l 1 Subdivision
Ordinance Ordinance Regulations
O
LL
11= 5. REVIEW REQUIRED BY ZONING BOARD OF APPEALS:
o
ACTION FILE NUMBER RESOLUTION DATE
❑ Use Variance
❑ Area Variance
El Sign Variance
❑ Other
Comments:
6. REVIEW REQUIRED BY PLANNING BOARD:
ACTION FILE NUMBER RESOLUTION DATE
❑ Site Plan Review
❑ Subdivision
❑ Planned Unit Dev.
❑ Other
Comments:
REV I BY STAFF DATE C 0MMENT
\......
pp,,,A1 . ..•
THE NEW YORK BOARD OF FIRE UNDERWRITERS
•
BUREAU OF ELECTRICITY
P
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. t ;0r ...,1 1,4,,, 41 STATE STRE ET.ALBANY.NEVI 119.60,Ri.1 ,41,?,97
,
Date Application No.on file
ii....,: THIS CERTIFIES THAT .
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of .•
if' rn
:,: STEPHEN f,4 ShNDI-tirl, JAB/ )T. f ii-'Y NO. BOX i 4.:37, liAEE k.3110B(1.11, 1,1
., .
„,' in the following lecatirti604 Daseru4t, El let Ft. 0 2nd FL Section Block Lot .
was examined on and found to be in compliance with the National Electrical Code. a
it: a
•;,: RXTURE . RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS :.
EPTACLES SWITCHES
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. '',,,
1 '•
4
DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS '
i SYSTEMS
-;' AMT. K.W. OIL M.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. No.of ffic AMT. WATTS .
P:„: •
'..,: I '''1{,'..gi •
4': •
: SERVICE DISCONNECT NO.OF S E R V I C E
I .4
METER
ei'. AMT. AMP. TYPE gawp 1///2W 1.11 3W 3//3W 3/1 AW Na ClefiraMD• oF A.W.G. NO.OF HI-LEG A.W.G. NO.Of NEUTRALS OF A.WU.G.AL III
OF HI-LEG NETR,
I X 1
o.' •
P •
i'• OTHER APPARATUS:
•'..:. CEILING FP.,,N- 1
,:
140TOP8.. 1-F H .P .
61: •
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LhEE GEOBGE, NV 12)345 BRANCH MANAGER a
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Per
#1 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. 6
• • • • • • •• • • • • • • • • • • • • •- • a • ,• • • • 4- • • • • • • • 6-A • • •- • • • • ,.. • • • • • • • • • • • i.
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.