91-541 ,u .x;
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
This is to certify that work,requested to be done as shown by Permit No. 91-541
has been completed.
This structure may be occupied as a roof over porch
Lot 13 Homesteed Village
Location
Owner Mendel/Lavi n
Tenant/Mary Lou Orton
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 91-541 s
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to MARY LOU ORTON
OWNER of property located at Lot 13 Homestead Vi i i agP Street, Road or Ave. N
in the Town of Queensbury,To Construct or place a alteration 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
tmeAftsx Mendal/Lavin
0
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2. CONTRACTOR or BUILDERS Name
Kenneth J. Orton
3. CONTRACTOR or BUILDER'S Address r
O
4. ARCHITECT'S Name
5. ARCHITECT'S Address `+
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6. TYPE of Construction—(Please indicate by X)
cf.
CD
( x)Wood Frame ( ) Masonry ( I Steel ( )
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7. PLANS and Specifications
No. Roof over existing porch (alteration) as per plot plan, specifications
and application.
8. Proposed Use
Roof over existing porch
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$ 16 00 PERMIT FEE PAID—THIS PERMIT EXPIRES July 29 19 92 0
(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.) J
J.
Dated at the Town of Queensbury this 29th Day of July 19 9 1 `a
' ✓�SIGNED BY �°. �j for the Town of Queensbury
Build' a .Zoning Inspector
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TOWN OF QUEENSBURY
firnc ur
MREVIEWED BY.
VOW FEE PAID: JUL 2 6 1 1
4011.
PERMIT NO. : C) I "3L / 9LDG. & CODE DEPT.
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: 1
P.O. Address: / ill T��J�Z �/�, 'l 49 PHONE 79,4-'J"7/6
Property Location: i - /3 )4 4 /11 5./L e Q,t Tax Map No. / /
Has there been any split of this property since October 1, 1988? Yes No k
If yes, Planning Board Review is necessary.
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 THE
Construction of new building * CONSTRUCTION: $ `" 3
Addition to building *
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
,.. ., (no change to exterior dimensions) * Size of Property: to ft. x co ft.
/,y ,Other work (describe) * Existing Building Size:
* lb ft. x )-o ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
*
1st Floor [0 x w Sq. Ft. * Front Yard qb ft. Rear yard O ft.
* Side Yards aro ft. and cib ft.
2nd Floor Sq. Ft. * If on corner, setback from side street-
* ft.
Other Floors Sq. Ft. *
(not cellar or basement) * OCCUPANCY INFORMATION:
*
TOTAL FLOOR AREA: Sq. Ft. * Primary Building -
* ,` One Family Dwelling
Size of New Structure: IC? ft. x 20 ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) i * Other Vi O (3.JL-e_ tina✓ne._
Height (grade to ridge) ft. *
If residential , no. of families: * If addition, what will use be?
No. of rooms (excluding baths) : 00 O//e/L PEc,!<
No. of bedrooms: *
No. of bathrooms: * Accessory Building:
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 * ROOD= C. e-r� 0 e G(
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS: ,✓/
Type of construction: wood frame, fire safe, etc. (jtjooj- i✓ L f3Y)1 k_OO('
Will any second-hand or ungraded lumber be used? If so, for what? rj/O x
Foundation Wall Material : Thickness:
Depth of Foundation below grade (to bottom of footing) : fy0
Will there be a cellar? YVo Heated or Unheated? Floor Sq. Footage:
Will there be a basement? ill/d Will any portion be used as living space?
If so, what portion? Sq. Ft. Tyse of Use? -
Type of Roof: 1Sl oped)Fl at/Shed/Other 5/:-0 "- Material of Roof
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 6 spacing 4, o.c. ; span ft.
Roof trusses (pre-engineered) : spacing " o.c. ; span ft.
Exterior Wall Finish: 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? 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 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 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.
Si nature 17C
Owner, owe ' s agen , architect
contractor
SPECIAL CONDITIONS OF THE PERMIT:
By:
Code Enforcement Officer
TOWN OF QUEENSBURY
0100. 531 BAY ROAD
jr"" QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
-BUILDING INSPECTOR'S REPORT
FINAL INSPECTION,---)
REQUEST FORINSP T ON RECEIVED ip(�1 CI
NAME Qr,�ryl I i v� i
LOCATION -' 13 AIMS -t-P in 9.
DATE 8[92/ 9 1 PERMITS 9 I 54tr
TYPE OF STRUCTURE A , to bo_lI i'4
RECHECK rocA `�f"� p�
FIRE MARSHAL APPROVAL (COMMERCIAL TRUCTURE)
_FOOTING FOUNDATION BACKFILL FRAMING
_ROUGH PLUMBING FINAL ELECTRICA _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
REMARKS
APPROVAL
N/A YES NO
:HIMNEY HEIGHT/LOCATION
3 VENT/LOCATION r j
)LUMBING VENT 1
ROOFING /
SIDING I
)ECK/PORCH/STEPS/RAILIGS
RELIEF VALVES
=URNACE/HOT WATER OPFATING
3ASEMENT INSULATION/AUCTWORK
INTERIOR TRIM/PRIVACY DOORS
=INISH FLOORS:
BATH/KITCHEN WAXERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS , ARPETED
STAIR CLEARANC /RAILING
-ANDICAPPED A CESS
SMOKE DETECT RS
3ATHROOM FA /WHOLEHOUSE NS
\LL PLUMBI FIXTURES OPER TING
SARAGE FIR PROOFING ,,
)OOR CLOSERS
)THER FIRE SEPARATION
=IRE/DEMISE WALLS
)UMPSTER
SITE PLAN/VARIANCE REQUIREMENTS
=INAL ELECTRICAL
)K TO ISSUE C/O OR C/C
:OMM NTS:
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Ct L-05i aY 4- P ✓A it
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ARRIVE (t/Rs
DEPART /O1e4 J4L- L--
' N
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT PP/
REQUEST FOR INSPECTION RECEIVED NAME 'f6/y L-� OL)
LOCATION, 1es\atO I6v
DATE f is Cj l PERMIT # 9 1 —)'I"I Sckl
IC
TYPE OF STRUCTURE) 1-- -le , ` -ll(ro b CON '\\)t>t-1
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/DAMPROOING
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN PLACE
PLUMBING UNDER SLAB
)RAMING:
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
DEPART
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