88-899 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. 8R-899
has been completed.
This structure may be occupied as a Single Family Dwelling/Addition
Location New Assembly Point Road
Paul & Marie Laursen
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
w
TOWN OF QUEENSBURY
No. 88-899
WARREN COUNTY, NEW YORK
0
V
PERMISSION is hereby granted to Paul & Marie Laursen
N
OWNER of property located at New Assembly Point Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Addition
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
t-.1
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2. CONTRACTOR or BUILDER'S Name 0
r•i
tD
Joel Clugstone
b
3. CONTRACTOR or BUILDER'S Address 113
Box 159 Star Route
Glens FAlls,New York 12801
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4. ARCHITECT'S Name
w
5. ARCHITECT'S Address
N
4
6. TYPE of Construction—(Please indicate by X)
( ►Wood Frame ( )Masonry ( )Steel ( ) - 0-'
7. PLANS and Specifications
No. 12' x 16' addition as per plot,specifications, and application. rt
SEE VARIANCE #1417
0
8. Proposed Use
a
Single Family Dwelling/Addition
25.00 C/O
$ 20.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 1 19 89
(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.)
a
Dated at the Town of Queensbur • 14th Day of November 19 88 rr
0
SIGNED BY fLtl tffir for the Town of Queensbury
Building and Zoning I -ctor
TO' BE COMPLETED BY BLDG. DEPT.
c�
TOWN OF QLlE NssL r?
'own o/ Queenibure Application No.
Permit Issued 19 Q M. 1 ,T I N�
BUILDING and ZONING DEPARTMENT Permit Expires 19 �,(
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation 1 ' i s `
Queensbury, New York 12801 Varianc o. u "
0( ' Site P an vi N .
�,t 14.)7 cif t BUILDING & CODE DEFT.
.0 ``� +� .. 7 APpr e;1„
J
APPLICATION FOR ,7 - ..' ' — rL'6! i t�
BUILDING AND ZONING PERMIT . 4/ ' .
* * . * * * * * * * * * * * it * * it * * * * * * * * * if * * * * * it * * * * .;'#
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies fora Building Permit to do the following work which will
)e done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit. •
'he owner of this property is: P \ tk kV ' e_ L-a - i.
).0. Address A5St, z P L j z ov'- ' NY Tel. 6 "- 2851
,roperty Location: k)Q. ..., , A 5S°Q.`hrJj'/ y ?C r\ }- -R 4 , Tax Map No. -7 / / i2 .7
Street number or building lot number ,
subdivision name (if applicable)
'HE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: '
' oeX -1054oLo . '\ ism - (-. 61e,.s• -s il 2 'P ‘ ?C2 o
Name P.O. Address Tel. No.
lame of builder . - k - d'dress O. I130i( 70 kd ktit 843Tel. 56-347 2-0
lame of plumber ,/•~ A ress Tel.
lame of masons Address Tel.
IATURE OF PROPOSED WORK: * ZONING INFORMATION:
_Construction of a new building •` * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
_Addition to a building * drawn reasonably to scale and attached hereto, ,.,,
_Z Iteration to a building .' * showing clearly and distinctly all buildings,
(no change to exterior dimensions));, ' * whether existing or proposed and indicate all '
Other work (describe) f i!7 * 'set-back dimensions from property lines; Give ,
r OCAris 4. U'ef iL _ * street and number or lot number and indicate -
'OR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner. lot. Show location
.00ATION OF STRUCTURES AFFECTED. of water supply and location and configuration •
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property /e19 ft X 4750 ft.
* Existing building(s) Size •ZZ ft X7- ft..., .
* . k,I c3. X'l6` uc� -o it"t tcsz d Li l2 tip x
ROPOSED BUILDING AND USE: * Existing building(s) Use S u,�.rr�-. /Cc Cti
>ize of new s ucture /z ft X 1 .ft * . . ' ' '
'onndation slab/crawl/partial/full * Proposed building, distance from property line
(circle one) / * Front yard (Z ft Rear yard `t2 . ft
lo. of stories (habitable space) I * Side yards ft and / ft'
ieight (grade to ridge) -%�® ft. If on corner, setback from side street ft •
Lf residential, no. of families ' t *
Jo. of rooms(excluding }baths). la * OCCUPANCY INFORMATION
Jo. of bedrooms ' / * PRIpARY BUILDING -
Jo. of bathrooms *' One family dwelling
?rimary heating system /Uou * Two family dwelling
i'ype of fuel �--
Jo. of fireplaces to be installed ' * Multiple dwelling / Number of units
dill a wood stove be installed? ,'t- ' * Permanent occupancy
*' xTransient occupancy
2entral Air conditioning? ,.�0t, . .
.. * Business •
•
BUILDING STYLE, PRIMARY STRUCTURE * Industrial .
•
Ranch Contemporary Log cabin * Other
Raised ranch Mansion Duplex * If addition, what will use be? ..
� ) )1it6 v
Split level Old le Bungalow * �
Cape Cod otta Other * ACCESSORY BUILDING-
Colonial Row Town House * • . Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) *" Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * ' Private storage building
_
ESTIMATED MARKET VALUE OF ' , . * Other '
CONSTRUCTION $ Q,��,o,, _ *
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS: •
Type of construction, wood frame, fire safe,etc. t1d444 •
Will any second-hand or ungraded lumber be used? If so, for what? s1
Foundation. wall material C'i7fi.+C���� pie& 5 Thickness e uc°i l,-.t4 +
Depth of foundation belowArArade (to bottom of footing)
Will there be a cellar? /D Heated or unheated? - Floor sq. footage sq ft
Will there be a basement? 44 Will any portion be used as living space? ./
(If so, what portion? sq.ft. - - Type of use?
Type of roof - - ope. flat/shed/other Material. of roof tier qti i5 •
Size, wood studs 2."X 1 " spacing IL, "o.c. length ft. . cJ
Joists(floor beams) 1st. floor IL, "X A72 " spacing /(p "o.c. span J Z-ft. .
Joists (floor beams) 2nd. floor "X " s acing "o.c. span ft.
Overlays(ceiling beams) 2 - "X " spacing "o.c. span /Z-ft.
Roof rafters ''- "X /o " spacing /4a o.c. span /i ft.
Roof trusses(pre-engineered) spacing "o.c. span ft.
Exterior wall finish it $ ikj, Of what material? V�'r.:r •
•
Interior wall finish tp.,c-r,1-_9 tv.. __
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 j
door, enclosure, and self-closing device beprovided?
Will a flue-lined chimney be installed? Height above roof ft.
Depth of chimney foundation below grade ./ ft. •
Depth of fireplace hearth ./ ft. _iihow t
Water supply - Municipal or privatt €it ,(_ ,ii �Q -"` ,
SEPTIC SYSTEM Distance from ANY private �+ell(including adjoining properties fV ft. ,•
(A separate application is necessary for any repair or new installation of septic system).
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
I swear that to the best of my knowledge and belief the statements contained
in this a' lication, together with the plans and specifications submitted, are a true and
complete s .tement of all proposed work to be doneion the described premises and that all .
provisions • , the BUILDING CODE, THg ZONING ORDINANCE, and all other laws pertaining to
the proposed ork shall be complied with, whether specified or not, and that such work is
authorized by • he o 'ner..SWORN TO BEFORE THIS Signatureleed0/0,0> c orOwner, owner ., ag�nt,arcn�cect,contra t
day 19
Notary •ublic, Warren ounty, N.Y. • .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *-* * * * * * * * * * * *
SPECIAL CONDITIONS OF TH. PERMIT:
__ , --�e0412- a L �
t,-r re; l3G � .
By •
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME 41 V� /'//.U.1L pet.1,lil�1, V l J
LOCATION c/14 � / 2,j
DATE .7`�/�p / PERMIT # fe-efff
APPROVED
d YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
OK TO ISSUE C/O OR C/C
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: j"
17 iK
ARRIVE /%as
DEPART " 34)
INSPECTOR
T-: �s I I
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