95-410 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a
Location
Owner
By Order Town Board
TOWN OF QUEENSBURY
cti
Director of Bldg. & Code Enforcement
•
Department of Community Development Reviewed By: ' l
Bt i.l<, tg & Code Enforcement
ent riltial wilding nspeetor
Town of Queensbury Permit No. '" l rj L//Q
742 Bay Roa U_..
Queensbury, New York 12804 '� Fee Paid $ ��� �y
(518) 745-4447 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 application form.
Applicant: 4,DiJt444.7 4_ '7 40. C. Owner: ESTR P. b tt , S'Irritep 3,
I� ! p- m G d l�l ttl P4 �' Frei
';
Address: �d. 00x d31 CLtu5 l`I$L/��', Address: Z. 8-i" GLk� 57: C.:44/43 /`r Ls
s ' 4110, ' O /
Phone # ( St b) j1l- 32E2-- Phone # ( S i�
) I -1� 1/
-
Property Location: i\I0&tr SAID 4 ChM 1 5� 41 lax Map Number J /
Subdivision Name: '"—' Section Block Lot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE
New Building: CONSTRUCTION: $ /� 4441, t00
residence / commercial
Addition to Building:
residence / commercial OCCUPANCY INFORMATION:
Alteration to Building: Primary Building -
residence / commercial ✓ Single Family Dwelling
Residence / Commercial Two Family Dwel • DIVED
no change to exterior size Family Dw 1
Office
Other Work (describe below) Mercantile JUL 2 01995
7Fc.Rfl'UTfr., Vi¢-/P46- 4.I ',4/Q Manufacturing
Other TOWN OF QUEENSBURY
GROSS AREA OF PROPOSED STRUCTURE: BUILDING AND CODE
1st Floor 6s ft . If ADDITION, what will use
q• of new addition be? :
2nd .Floor sq. ft .
Other Floors sq. ft .
(not unfinished cellar or basement)
ACCESSORY BUILDINGS:
Detached Garage 1 , 2 ca
TOTAL FLOOR AREA: 0270 SQ. FT. Attached Garage 1 , 2 car
Private Storage Building
SIZE OF NEW STRUCTURE : Commerc;-i1 Storage Building
Other
FEET X FEET
Foundation Type : CON C . 8c. 0C-lC. _ Will any second-hand or ungraded
Number of Stories : / lumber be used? If so, for what?
( habitable space only) / 140 tit E.-
Height (grade to ridge) : , f feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove ( circle all which applies )
to be installed: - b - Electric / Oil / Gas / Wood
Forced Hot Air / eboard / Other
Person responsible f r supervision of work as regar s to building
q cJ _ __
codes is : Roc-t& &4 4 ..wL.k.Zr 1� 4), e�'X 3f A1,1Wrf -0,49 2-3�Z.
Na - Address,,. Phone
Builder i 7 v14- 7'"4 G. 4. a�r 57-, itt kC(; t _�. 4 L-3Z rZ
Plumber: [E_RDM�. 734�t m / /N-
Mason : 7r.r- ( Os/
Electrician: S'w .r' , ..L,e..Gr; 7r8" D 3/0
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 BUILT PLOT PLAN
drawn to scale, showing actual locon .f proj - t on premises .
F _ _
Signature:" ati
(owner, ,�owner' s agent, architect, contractor
qo
ENERGY CODE COMPLIANCE APPLICATION
•�a
'TOWN OF QUEl?:NSI-IURY, WARREN COUNTY
{=':,y+: •�:� 9000 HEATING DEGREE DAYS
Compliance Methods : PART 5 -- Acceptable Practice Method -
. I &2 P'am.i..l.y Dwel 1 inq.s (only )
I.'1\RT 6A -- '.t'Iiei.ma.1. Rating - Component: Trade O.Cf.:.
1.&2 Family Dwellings; -Multi-Family
Dwellings ( 3 stories or less )
PART 4 * - Design by Component Performance
Commercial Buildings-Iii Rise Residential
*Requires submission of worksheets
APPLICANT' S NAME : PROPERTY LOCATION :
-- ---- - - I\1 k_c9_-0_ ! 616044 'Li
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE :
1 . Gross Floor Area - / /O5 square feet
2 . Type of Heat - __- Electric Oil L- Gas - Othe.r.
3 . Is building mechanically cooled? ✓ Yes ^_- No
4 . Percentage of area of windows and doors Over 17% k Under-- .17%
5 . R-VALUES FOR .INSULATION GIVEN BELOW MUST CORRESPOND TO R--VALUES AS
SHOWN ON PLANS SUBMITTED:
a . Roof
• b . Exterior walls
c . Glazed areas
d . Exterior doors; R
e . Floors over unheated spaces R
f . Edge of slab on grade ( healed building)
g . Basement/cellar walls (above grade) R
h . Basement/cellar walls (below grade ) R _�
1 . Heating/cooling-ducts-piping in unheated space
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per. code Yes _ No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
App ' cant ' r S ' ;aLurc D,. :e 1--^ Phone Number
INSPECTOR' S REMARKS : ,
NW
")
TOWN OF QUEENSBURY
- J# __ BUILDING & CODE ENFORCEMENT
` # O 742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
ARRIVE: V ) DEPART: `` INS G
FINAL INSPECTION REPORT - RESIDEN
DATE INSPECTIO� REQUEST RECEIVED:
NAME i`+ heM
�j 1
LOCATION ` ! ' a 9L'& 0C'2;\--\.
DATE 8 - I Cs-'q c PERMIT
^�II CI� �0
TYPE OF STRUCTURE + ,y-\l 1 Any e11
FOOTINGS FOUNDATION BACKFILL F NG _
ROUGH PLUMBING _ SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N/A YES NO
CHIMNEY IGHT/B VENT/HDIGHT
PLUMBING V T
ROOFING
EXTERIOR FINIS,
DECK/PORCH/STEP I' . ;LINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
ACINTERIOR TRIM/PRI .CY DOORS 4
CFINISH FLOORS: d
BATH/KITCHEN ATERT GHT
OTHER FLOORS SWEEPABL.
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS /
0CFINAL ELECTRICAL ✓/
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O OR C/C
„ '1
TOWN OF QUEENSBURY =,
BUILDING & CODE ENFORCEMENT ,-5
531 BAY RD., QUEENSBURY NY 12804 41- IOW
INSPECTOR'S REPORT: ARR,�` DEPART{`'.c#1
�,
REQUEST FOR INSP TION RECEIVED: 7 I Li -1.5
NAME _ SIC--
LOCATION ^^ � (� •
C 1_��
DATE 7"pt 9_S'__ PERMIT # "" CIS- !O
TYPE OF STRUCTURE: PeS A l t
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS v
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSI:LE FOR
PROVIDING PROTE TION FROM 'REEZING /
FOR 48 HOURS FOLLOWING THE '•LACE-
MENT OF THE CONCRETE. /
MATERIALS FOR THIS PURPOSE 0 SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE fii
FOUNDATION/DAMPPROOFING d
DACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
\\\\
ROUGH PLUMBING f
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS /
-
BRACING/BRIDGING +
-
JOIST HANGERS
JACK POSTS/MAIN BEAM! w
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INT$RIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- -- —
WALLS _
CEILING R— -DUCT WORK OR PIPING IN -
UNHEATED SPACES R-
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804 -
INSPECTOR'S REPORT: ARR J�JDEPART/<J" IN'1 f
ik
REQUEST FOR INSPECT�J,QN_ )RECEIVED:
NAME t a�C` of 4 Le d 0p-
LOCATION C.(a4.- . Celt_
DATE 1,/.5" PERMIT # c// � 50dTYPE OF STRUC
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM\
REINFORCEMENT IN PLAC
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FR M FREEZING
FOR 48 HOURS FOLLOWING E PLACE
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOS ON SITE
FOUNDATION WALLPOUR
i"
REINFORCEMENT IN PLACE
FOUNDATION DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING -
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTER OR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- i
WALLS R- -
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
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