91-080 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date June 28 19
This is to certify that work requested to be done as shown by Permit No. 91-080]
has been completed.
— This structure may be occupied as a Single FAmily Residence
Location Fit7gera1d Rd, 61pn 1ap
Owner Mike Hogan
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-080
WARREN COUNTY, NEW YORK
—I
PERMISSION is hereby granted to Michael Hogan
3
OWNER of property located at Fitzgerald Rd, Glen Lake Street,Road or Ave.
0
in the Town of Queensbury,To Construct or place a Single Family Residence
at the above location in accordance to application together with plot plans and other information hereto filed and 1-4
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
trt
1. OWNER'S Address is
Same 3
fD
2. CONTRACTOR or BUILDER'S Name 'r
Cifone Construction Co.
0
to
3. CONTRACTOR or BUILDER'S Address
PO Box 684 N
GlensFalls
4. ARCHITECT'S Name --'
V
C,
5. ARCHITECT'S Address
r
6. TYPE of Construction—(Please indicate by X) �•
yy tC
(^►Wood Frame ( )Masonry ( )Steel ( )
-9
7. PLANS and Specifications
No. 1,724 sq ft Single Family Residence as per plot plan specifications
and application
8. Proposed Use
Single Family Residence
$ 178.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 14, 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 the 14th Day of March 19 91
SIGNED BY �7 for the Town of Queensbury
uilding and Zoni Inspector
TOWN OF QUEENSBURY
REVIEWED BIOW URX
FEE PAID $ '7
114,; )
PERMIT NO. !� r`
MAR b 1991
BUILDING PERMIT APPLICATION
BLGia. & CODE DEPT.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
ILL 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.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
'he owner of this property is: ////CAL Pf1-1/
.0. Address,ICJ 7r im/1' 4✓/C, ' Doe /O,P_G9-W/7o 4 4/17 Tel ?op'—J f7 -,Pcf 7 n
roperty Location /€o/I-A .i¢- ,- Tax Map No. 4'/l l l
as there been any split of this property since October 1, 1988? /
yes Planning Board Review is necessary. yes no
UBDIVISION NAME, IF APPLICABLE LOT NO.
HE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
CP6`o ere aon-s'✓ //1/�i
•ATURE OF PROPOSED WORK: '
ESI'aMATED MARKET VALUE OF •
• CONSTRUCTION: 0
v Construction of a new building •
• COMPLETE INFORMATION REQUIRED BELOW:
Addition to a building
• Size of property /UQ ft x eft.
alteration to a building •
(no change to exterior dimensions) Existing Buildings(3) Size J. ft. x ft.
•
Proposed building - distance from property line:
_Other work (Describe) • Front yard_ft. Rear yard a D ft.
• Side yards_ ft. and e-cf ft.
3OSS AREA OF PROPOSED STRUCTURE • It on corner, setback from` �et 7S ft.
as )f
1st Floor ,908' sq. ft. OCCUPANCY INFORMATION
2nd Floor ,r‘ sq. ft.t C '7 Primary Building -
Other Floors sq. ft. •
+� One Family Dwelling
(not cellar or err--Mn • ' Two Family Dwelling
(' • _Multiple Dwelling/Number of units_
)TAL FLOOR AREA/ _sq. ft.
to Of new structure'ft x ` ft. • Business
wndatiot-piertcrawl/partial/full
• _Industrial
(eire one) • Other
•
s. of iiteble space)
(grade- aR !b 2 •
tight (g ' o ridge) / ft. • If addition, what will use be?
residential, no. of families / •
). of roonts(excludtng bath) ' •
Accessory Building
). Of bedrooms c 3 •
0. 4/4-Detached• etached Garage ONE/TWO Car
of bathraonr •
binary heating system ffr9✓4'//e • it 44 Attached Garage ONE/TWO Car
fps of fuel Di L ' //,_Private storage buildhlg
s. of fireplaces to be installed •
/f/8other
i l a wood stove be installed_
e Air conditioning •amidi
OVER
3LILD[NC PERMIT ..PPLICA,T[ON -
BULDENG ;PECIFIC.aTIONS:
Type of construction, wood frame, fire safe. etc. /t' OL2
Will any second-hand or upgraded lumber be used? If so. for what?
Foundation wall material .0,0d/4/co Thickness
Depth of foundation below grade (to bottom of footing) j ?6'7 f/ '
Will there be a cellar? /frO Heated or unheated? Floor sq. footage sq ft.
Will there be a basement? Will any portion be used as living space?
(If so, what portion? /1,2)- sq ft. Type of use?
Type of roofopec4✓flat/shed/other Material of roof day,
Size, wood studssl ,? "x " spacing" o.c. length �" ft.
Joists (floor beams) 1st floor "x " spacing "o.c. span ft. pv II-09-5
Joist (floor beams) 2nd floor. .. "x /0" spacing / "o.c. span /- ft.
Overlays (ceiling beams) .Z "x /0" spacing " o.c. span /*ft.
Roof rafters oZ.. "x /0 " spacing /4 o.c. span , ft.
Roof trusses (pre-engineered) spacing " o.c. span ft.
Exterior wall finish f/ 44. 6'/D J4,-e of what material? -
Interior wall finish c5', 8 2- jev
If a garage is` to be attached, describe materials to be used for FIRE SEPARATION:
��7
Is there to he an opening between garage and dwelling? A./A- 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. Q e,z__. ,,f-/ -(
Depth of fireplace hearth ft. in.
Water supply - Municipal ooteriiiiii Vei. ie fgv i
SEPTIC SYSTEM Distance from ANY private well (including adjoining properties 442 ft.
(A separate application Is necessary for any repair or new installation of septic system)
YAME OF BUILDER afi'ie GPPAAr ADDRESS /70. 2.37 TEL. NO. 772.. --
DAME OF PLUMBER ADDRESS TEL. NO.
TAME OF MASON ADDRESS TEL. NO.
•
LAME OF ELECTRICIAN ADDRESS
TEL. NO.
DECLARATION
To the best of my knowledge and belief the statements contained in this application, together with the
tans and specifications submitted, are a true and complete statement of all proposed work to be done on
he described premises and that all provision-.of the BUILDING CODE, THE ZONINft ^""!:7:'''CE,and
11 other laws pertaining to the proposed work shall be complied with, whether ed or not, and that
uch work is authorized by the owner.
Signature
Owner, owner's agent, architect, contractor
PECIAL CONDITIONS 01P THE PERMIT:
BY
WARREN COUNTY , NEW Y:RK
Application for : BUILDING PERMIT IN COMPLIANCE WITH THE -NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
ANSWER ALL of the following: TOM! OF QUEEN
1 . Gross floor area / 7 2
F?�r�QUEEN
'N SOURY
2 . Type of heat B/L 6/iv;. l/l MARS
3 . Is the building mechanically cooled? 'VC
4 . Percentage of area of windows and doors •
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions -
2 . Floor over heat i spaces YES NO
a. Are foundat on walls insulated? YES NO
1. If YES , what is the R value?
3 . Slab on grade YES NO •
a. If YES, wh .t is the R value of insulation around
perimeter of floor?
•
4. Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions_
le-c3O
2. R value of exterior walls 1 / - 7
3 . R value of glazed area A C•
4 . R value of doors e -
lar
lt://C41
5. R value of floors over unheated spaces
6. R value of slab edge insulation - unheat - -
7. R value of slab insulation - heated slab
8. R value of heated basement/cellar walls (above grade)
9. R value of heated basement/cellar walls (below grade)
10. Type of insulation / / 7 ,L;- /C7/Bge d4 ss
C. Controls y 0
1. Thermostat maximum heat setting
D. Duct Systems
1. Is duct system installed in unheated spaces? YES NO
a. If YES, R value of duct installation
b. R value of duct in other areas
E. Piling Insulation
1. Size of hot water or cooling carrying agent pipe_,��
2. R value of pipe insulpt ""'
F. Service Water Heating
1. Performance efficiency
2. Temperature control setting maximum
G. For Swimming Pool Only
1. Maximus heating
Telephone No.
(applicant' s signature)
TOWN OF Q UEENSB URY
Bay at Haviland Roads,Oueensbury,N.Y.12801-9725
APPLICATION FOR SOLID-FUEL BURNING APPLIANCES AND FIREPLACES
Date o 3 o t-'` 19P/ Permit NO.%/ -AO
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building and Use Permit
pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all
applicable laws, ordinances, regulations and all conditions that are part of these requirements and also will allow all
inspectors to enter premises for the required inspections.
Applicant's Name ,�/ -09 ,4-/7/ APPLIANCE TYPE
Stove Coal Wood
Address /Zt!of�.-4) /Z Furnace Hot Air Boiler
Zero Clearance Circulating Unit
! .G ("Ay ..Zip
Phone If Non-Masonry:
Owner's Name 54-oi
Manufacturer
Address Model Outlet Size
Zip Listed by Number
I'hone
CHIMNEY TYPE
Masonry: Block Brick Stone
Property location of proposed construction Flue: Tile Steel
94,4.y0' Size:
Factory Built:
Manufacturer Model Size
COPY OF MANUFACTURER SPECIFICATIONS IS Height Listed By Number
REQUIRED FOR FACTORY-BUILT APPLIANCES Type: Double Wall Triple Wall
AND CHIMNEYS. MUST BE INSTALLED Insulated
ACCORDING TO SPECIFICATIONS. COPY OF Estimated Cost$
CONSTRUCTION DETAIL REQUIRED FOR MA- Fee$
SONRY FIREPLACES AND CHIMNEYS.
CASHIERS DEPARTMENT
TOWN OF QUEENSBURY, NEW YORK
Department:. Fire Marshal Amount Collected Amount Refunded
Code Number Title 4
d5-
A173 3389 (190)Public Safety
A233 2655 (230) Minor Sales
,ee Collected fro e unded to: d'en/6466(1 )-C/ .I
Address:
Dated: 444j Town Clerk or Deputy
White:Applicant Yellow and Pink:Cashier's Department Goldenrod:Fire Marshal
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a4
1
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
FIRE MARSHAL INSPECTION REPORT
REQUEST FOR INSPECTION RECEIVED ' ;7/61
NAME [ Ih ' r AkoX
LOCATION
)
DATE l p / 7/ `)1 PERMIT# 9 / -- oc-)C�
APPROVED
N/A YES NO
EXITS
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO. EXTINGUISHING SYSTEM
HOOD INSTALLATION
AUTO. SPRINKLER SYSTEM
ALARM SYSTEM fi
INTERIOR FINISHES
STORAGE:
CLEARANCE TO SPRINKLRS
CLEARANCE TO HEATING UNITS
REQUIRED SIGNAGE
CHIMNEY `
WOODSTOVE `p
FIREPLACE-MASONRY'
--)'FIREPLACE-FACTORY' BUILT
REMARKS: Li OK TO THIS DATE
ARRIVE --
DEPART // =?
NSPE OR
\ \ fk\\\ f
TOWN or
531 BAY
QUEEaSBURY, NEW YORK 12804
TELEPHONE - (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
taw ' .01.h /Io9 J
LOCATION
DATE //2 7/q/ PERMIT# %/ hi
TYPE OF STRUCTURE 44)(' Li (III"LL - c y
RECHECK Pad
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL i-FRAMING
,,ROUGH PLUMBING FINAL ELECTRICAL_SEPTIC
,INSULATION WODUSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS YES _ NO
REMARKS _ : ' ' i i` 40
//
CHIMNEY HEIGHT/LOCATION +: / Y NO
B VENT/LOCATION ��
PLUMBING VENT =�
ROOFING M
SIDING
rin
DECK/Pi ' H/S ' /' ' L GS ��►,�
RELIEF VALVES
FURNACE/HOT WA E' +P NG ' !=
BASEMENT INSULATION/DUCTWOR.
INTERIOR TRIM/PRIVACY DOORSJIIIMIII_
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT III
OTHER FLOORS SWEEPABLE1111Mirel
OTHER FLOORS CARPETED =I
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS =�
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE1 ANS Emu
ALL PLUMBING .FIXTURES OPERATI ==
GARAGE FIRE PROOFING
DOOR CLOSERS =_
OTHER FIRE S •7 e _
FIRE/DEMISE WALLS __
DUMPSTER
FINAL EL RI ��
OK TO ISSUE C/O OR C/C _M
MINIMM
491
ARRIVE //1
DEPART "/ cj ,dam
\\ (1\1\)
Jocun o� Queen Jurf14
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
C�tik 2- 1C1 r rr� S �''` °A' '
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION C
-_- ,,l
DATE (0 /alp PERMIT NO. 1/-(, C
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS{Number d ')
Size- ft. X ft.
Gravel size
PIPING: S e Type
Bldg. to tank
Tank to dist. box
Dist. box to field/pit
Openings sealed? YE`S �1i0 Partial
LOCATION/SERARATIQNS:
Foundation to tank ft.
Foundation to absorption ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS: faZ/,,e
elea*Wad:YeAd/eW.4,14Le411,24---
,_,./4/1144). 7;74
SYSTEM USE APPROVED NO
B ing Inspe or
01/86 and vl
,4
o own � Queeni1ur,
,�'
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
C)ueensbury, New York 12801
SEPTIC DISPOSALSS/YSTEM INSPECTION
NAME i��'i�CZ'.�_4..f/
LOCAT I/ON c• ?(_,A L r
DATE /7/9/ PERMIT NO.
SOIL TYPE - Sand - Loam - Clay -
Percolation Test,Required? YES - NO
Percolation rate Min/Inch
TYPE of SYSTEM:
Absorption field, t tal length
Length of each tren h
Depth of trenches '
Size of gravel_
SEEPAGE PITS{Number )
Size- ft. X _ /t.
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. ox
Dist. box to field/pit
Openings sea ed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation' to tank ft.
Foundation to absorpti n ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
ref /6)/4
SYSTEM USE APPROVED YES NO
Bui ng Inspe or
01/86 and vl
•
ELECTRICAL INSPECTIONS
DUPLICATE MUNICIPAL RECORD
q�'
Permit No. -_ --Y)
Owner Die• ' ./ 4''`
Occupant ----)n v3C
Location F j72_ G c,ft 61-z,%) /2[)
Town or City Stare!
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes.
Installed by c=k e f4/ 2-4C: /
Date ...6 — 9 J �� t/�<!�l- No.
.>
l ( '1 � pector
FORM No.18 EL. MIDDLE DEPARTME NSPECTION AGENC , .
1337 West Chester Pike,West Chester,PA 19380
ROUGH WIRING OUTLETS H.P.AIR CONDITIO$cR
OUTLETS WIRING 8 CONTROLS FOR BURNER
RECEPTACLES H.P.PUMP
FIXTURES K.W.OVEN
AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W.SURFACE UNIT K.W. DRYER
K.W.RANGE AMP. RECEPTACLE
K.W.WATER HEATER FRAC. H.P.VEN.CANS
'C-0,Ai6 T Al A.4—/2 RA
L a Air 1
MOTORS H.P. 1/20 1/12 1/10% % '/ Ih 1 ' 1 11/ 2 3 5 71/2 10 15 20 25 30 40 50 75 10
MARK NUMBER
OF EACH SIZE
APPARATUS
TOWN 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 (( (G/� /
NAME14 'vim ) CJICU .k'
LOCATION c' c 61-eih l�.
DATE 61319
) PERMIT I / --0Rl
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 ON SITE I
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
ROUGH PLUMBING r
PLUMBING VENT/VENTS IN P .ACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
FIRES TOPPING
WALLS
CEILING :
FIREWALLS
HEATING ROUGH-IN '
NSULATION:
FOUNDATION WALLS /INTERI( R R-
FOUNDATION WALLS?EXTERIt R-
FLOORS / R- ✓,
WALLS R- /
CEILING / R- 3 1
DUCT WORK OR/PIPING IN UN EATED
SPACES
REMARKS:
\..
l-�
ARRIVE
DEPART/ fti�
INSPECT
TOWN 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 �/, 41//
NAME 122.theif.) /6e
LOCATION (gip
DATE / ( PERMIT # 9/-6/cf
TYPE OF STRUCTURE 4yb ton J// jii/i .
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
X. ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACEv
PLUMBING UNDER SLAB
X FRAMING:
IW JACK STUDS/HEADERS
BRACING/BRIDGING I
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:
J �
ARRIVE f/ `J
Je
DEPART�%��
INSPE OR
TOWN 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 /7/4://
NAME - `'7
LOCATION r
/ �
0/92'DATE =PE IT # 9//6 4
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE t
FOR PROVIDING PROTECTION FROM /
FREEZING FOR 48 HOURS FOLLOWING I
THE PLACEMENT OF THE CONCRETE. /
MATERIALS FOR THIS PURPOSE ON $ITE
FOUNDATION/WALL POUR /
REINFORCEMENT IN PLACE
FOUNDATION/DAMPROOFING
BACKFILL APPROVAL
BHGH PLUMBING
PLUMBING VENT/VENTS IN PLA
PLUMBING UNDER SLAB
FRAMING: 1
JACK STUDS/HEADERS
BRACING/BRIDGING 11
JOIST HANGERS
JACK POSTS/MAIN BEAM/
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALL INTERIOR R
FOUNDATION WALL EXTERIOR RI-
FLOORS R
WALLS R.
CEILING R
DUCT WORK OR PIPING IN UNHEA_ ED
SPACES /t
}
REMARKS: /
JJ 5-0
ARRIVE 0
DEPART // 5 LA,�/
INSPECTOR