87-063 TEMPORARY
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 17th, 19 87
This is to certify that work requested to be done as shown by Permit No. 87-63
has been completed.
This structure may be occupied as a Addition to one family dwelling
Burnt Ridge Road, Assembly Point
Location
Myron Rapaport
Owner
TEMPORARY C/O ISSUED FOR 30 DAYS By Order Town Board
PENDING FINAL ELECTRICAL INSPECTION
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY 87-63
No.
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Myron Rapaport
OWNER of property located at Burnt Ridge Road, Assembly Point Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Addition to one—family dwelling rt
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 RD #1 Box 1190A
Lake George, New York
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2. CONTRACTOR or BUILDER'S Name 7y
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( 1 Masonry ( 1 Steel (
7. PLANS and Specifications
6'x30' addition per plot plan, specifications and application
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8. Proposed Use rt
One—Family Dwelling (additional living area)
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$5.00 C/O o
30.00 October 1 19 87
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
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(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.) H.
Dated at the Town of Queensbury this 11th Day of March 19 87
SIGNED BY 7m for the Town of Queensbury
Building and Zoning Inspector 44
T )WN it.31- '../u-.c.04.01 , -
TO BE COMPLETED BY BLDG. DEPT. M ili11r [E LI VY 1..3 It
/ Application No.
�/7 lJ
,lown of Queenibur y Permit Issued 19 MAR 101987
BUILDING and ZONING DEPARTMENT Permit Expires 19
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation BUILDING & CODE DEPT.
Queensbury, New York 12801 Variance No.
Site Plan Review No. _ y�'�"
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Approv b
APPLICATION FOR Z:/_) (1/ "/ 0 S-1 t C/a
BUILDING AND ZONING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF- THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this property is: M y2(:N AP/JP-0z r
P.O. Address e1:7 / AW // 904 ,L J . £e-eve-.E /4" V /,1.. ✓f Tel. -22 9, )9
Property Location: Tax Map No. ) / ! / a/
Street number or building lot number
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
MY29/V /SSJ/-7AP&ei
Name r•1 . Address Tel. No.
Name of builder 6-A ".X i/f rA, Address Tel.
Name of plumber Address Tel.
Name of mason Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
j(Addition to a building * drawn reasonably to scale and attached hereto,
Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines. Give
* street and number or lot number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED. of water supply and location and configuration
* of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property f ft X / i r ft.
* Existing building(s) Size / ft X 30 ft.
*
PROPOSED BUILDING AND USE:
* Existing building(s)
Size of new structure 6; ft X3b ft *
Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line
(circle one) *
No. of stories (habitable space) * Front yard ft Rear yard �� ! ft
Height (grade to ridge) /,( ft. * Side yards ft and 7� ft
If residential, no. of families I * If on corner, setback from side street ft
No. of rooms(excluding baths) ,g * OCCUPANCY INFORMATION
No. of bedrooms — *
* PRIMARY BUILDING -
No. of bathrooms * `,One family dwelling
Primary heating system 4;4.E(f, * "two family dwelling
Type of fuel
* Multiple dwelling / Number of units
No. of fireplaces to be installed CD * Permanent occupancy
Will a wood stove be installed? A/c,
Central Air conditioning? No * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporar Log cabin
* Other
Raised ranch Mansion Duplex * If addition, what will use bp/ (fe litw S
Split level Old style Bungalow * d /ff67c- re r?s rC4 '
Cape Cod Cottage 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 *
$-- 1
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.
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall materialC - .� 1°P /
e feJ
Depth of foundation below grade (to bottom of footi
Will there be a cellar? Heated or unheat Floor sq. footage sq ft
Will there be a basement? Wil portion be used as living space?
(If so, what portion? s .ft. - - Type of use?
Type of roof - sloped/flat/shed/other 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 spacing 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 dwell If so will a Fire-rated
door, enclosure, and self-closing device be p ded?
Will a flue-lined chimney be installed? - Height above roof ft.
Depth of chimney foundation below j a6e ft.
Depth of fireplace hearth c in.
Water supply - Municipal 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)
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 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.
SWORN TO BEFORE ME THIS Signatu t
Owner owner's ag t,arcnitect,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
awn of Queenibur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
el/PA Po K
LOCATION 16)vg.AJT i b e ii-c5e-k, >
Date. fA9,7 Permit No. 1--lp 3
* * * * * * G* * * * * * *
✓ = APPROVED - YES NO
footin / ie Forms
Foundati
Waterproofing
Backfill
Oaraming /9A0,07L L'
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings t (
Cellar Drain Tile F ;
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- Atv/exas g, fz yk/6,eel_
_ e 0 5 .4.4o-ay-e-ofe-4-
Build'ng Inspector
5/86 and-vl
awn o/ ?ueenihur#
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME ,C
Arfr/W
LOCATION SUgivr n�ASE�` p•
Date 5/4/ 7 Permit No. if) —�13
✓ = APPROVED - YES , O
Footing/Pier Forms
Foundation
Waterproofing
Backfill •
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
ellar Drain Tile7Q 86//V57A1 e1)
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing •
Door Closers
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
(\
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- �AV Av5, 70 J3epgock
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Buil ing Inspector
6/86 and-vl
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