91-831 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date �l1hi l ( 19
This is to certify that work requested to be done as shown by Permit No. 91-831
has been completed.
This structure may be occupied as a Storage Building
Location Brayton Road, Cleverdale
Owner Steven b JoAnne Chwiecko
By Order Town Board
TOWN OF QUEENSBURY
{,r%�-
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-831
WARREN COUNTY, NEW YORK
v I
PERMISSION is hereby granted to Steven & Joanne Chwiecko
OWNER of property located at Brayton Rd, Cleverdale, NY Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Stora gp Rui 1 di no
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. n
O
1. OWNER'S Address is
Star Rt Box 201 C
Brayton Rd
Queensbury, NY 12804 IT
2. CONTRACTOR or BUI LDER'S Name pe
Peter Imperiale
3. CONTRACTOR or BUILDER'S Address O
337 Norningside Circle
Queensbury, NY 12804
4. ARCHITECT'S Name
W
c�
e�F
O
5. ARCHITECT'S Address
a
6. TYPE of Construction—(Please indicate by X) N
et
O
( XWood Frame ( ) Masonry ( )Steel
fD
7. PLANS and Specifications A W
.r
a
No. 10' x 30' Storage Building as per plot plan specifications and t°
application '
8. Proposed Use
Storage
$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES November 29. 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 t ay of November 19�]_
SIGNED BY , for the Town of Queensbury
Building a oning Inspector
TOWN OF QUEENSBURY
REVIEWED BY: A'
k_jvvN OF QUEENSb�.
FEE PAID: �~
PERMIT NO. : f � �` j`. JV 2 ? 1991
& 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: 4 c j e e-�j i4leck
P.O. Address: �?_ -�i, �, n� �� I . t�r G a c ( lY� �t PHONE6,6 3 306 ?
Property Location: _ `= _����?, ��1 �� �/ Tax Map No./ _/ /
Has there been any split of this property since October 1, 1988? Yes No s/
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:
_A C (2- �TLf,', Ry 4 9'e PHONE
NATURE OF PROPOSED WORK: * ESTIMATED MARKET VALUE OF THE
c- Construction of new building * CONSTRUCTION: E U --�-
Addition to building
Alteration to building * COMPLETE INFORMATION REQUIRED BELOW:
(no change to exterior dimensions) * Size of Property: ACV ft. x 1i-,i—ft.
Other work (describe) * Existing Building Size:
* ft. x ft.
* Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE: * property line:
*
1st Floor Sq. Ft. * Front Yard /5 "ft. Rear yard _ ft.
* Side Yards ft. and 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. * Primar,,4--8uilding -
* t/ One Family Dwelling
Size of New Structure: /J ft. x - C) ft. * Two Family Dwelling
Foundation: * Multiple Dwelling/No. of Units _
Pier/Slab/Crawl/Partial/Full (Circle One) * Business
* Industrial
No. of stories (Habitable space) / * Other
Height (grade to ridge) ft.
If residential , no. of fam es: * If addition, what will use be?
No. of rooms (excluding baths): * _ '` l Ld
No. of bedrooms:
No. of bathrooms: * Accessory Building:
Primary heating system: * Detached Garage - One/Two Car
Type of fuel: * ached Garage - One/Two Car
No. of fireplaces to be installed: * r rivate Storage Building
Will a woodstove be installed?: * Other
Central Air Conditioning: Yes No
(OVER)
BUILDING PERMIT APPLICATION CONTINUED:
BUILDING SPECIFICATIONS:
Type of construction: wood frame, fire safe, etc.
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation Wall Material : C LO - Thickness:
Depth of Foundation below grade (to bottom of footing) : V
Will there be a cellar? Heated or Unheated? Floor Sq. Footage:, GAG --
Will there be a basement? Will any portion be used as living space?
If so, what portion? Sq. Ft. Type of Use?
Type of Roof: Sloped/Flat/Shed/Other Material of Roof XG - /1
Size, wood studs x " ; spacing /,4-- " o.c. ; length ,,� ft.
Joists (floor beams) : 1st Floor If
x spacing o.c. ; span ft.
Joists (floor beams): 2nd Floor It
x "; spacing o.c. ; span ft.
Overlays (ceiling beams) : is
x spacing " o.c. ; span ft.
Roof rafters: x spacing o.c. ; span ft.
Roof trusses (pre-engineered): spacing _L�/ o.c. ; span �/U ` ft.
Exterior Wall Finish: -; S �e �! i;,r P"(�L 511 / of what materi al ?
—V
Interior Wall Finish: nrGh�Q_
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: VZ ( 2 1WCG1UA%(K .r / PHONE 2 , S7-1
NAME OF PLUMBER & ADDRESS: PHONE
NAME OF MASON & ADDRESS: 0Ib(5d - 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.
Signature G--+
owner, owrCerlt agent, architect
contractor
-----N ---------
--------------------------- -------
CONDITIONS OF THE PE04IT:
By:
Code Enforcement officer
TOWN OF QUEENSBURY I
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
FINAL INSPECTION
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION ,
DATE PERMIT#
TYPE 0 STRUCTURE
RECHECK
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
j�90OTING FOUNDATION BACKFILL _FRAMING
_ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOO_DSTOVE/FIREPLACE
REMARKS
APPROVAL
N/Al YES NO
CHIMNEY HEIGHT/LOCATION _
B VENT/LOCATION
PLUMBING VENT
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
BASEMENT INSULATION/ISUCTWORK
INTERIOR TRIM/PRIVACY', DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETEII
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE ,FANS
ALL PLUMBING FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
SITE PLAN/VARIANCE REQUIREM NTS
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
CO ENTS
ARRIVE
DEPART 5:
INtPEC
l / /-C fT v/,' kzi�vo 1
TOM OF QUEENSBURY ,
BUILDING AND CODES DEPARTMENT Ak/t .
531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME
LOCATION
DATE 1'"Z S <J PERMIT #
TYPE OF STRUCTURE
RECHECK APPROVED
N/A YES NO
FOOTING PIERS
MONOLITHIC-POW M
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURSJOLLOWING
THE PLACEMENT OF T%,CONCRETE.
MATERIALS FOR THIS P RPOSE ON SITE
FOUNDATION/WALL POUR '
REINFORCEMENT IN PLAC
FOUNDATION/DAMPROOFINd,
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VENTS IN ACE
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS 7
BRACING/BRIDGING
JOIST HANGERS c
JACK POSTS/MAIN BEAM
FIRESTOPPING
WALLS
CEILING
FIREWALLS
HEATING ROUGH,-IN
INSULATION: '
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WA LLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS:
ARRIVE /d
DEPART /d � *TO !—
I NSPE
5rEV&J 4 ?oANx1Z (!HoiEc,(o
STAR. Ro"T25 40A 2�1
tJ%VN OF QUEENSbL,
QI�tEEI�$,a�vt e.1 N7 /L-"c( RECEIVED
NOV 2J- 1991
71' DC. & CODE DEPT.
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