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97-595 • CERTIFICATE OF OCCUPANCY ( ' TOWN OF QUEENSBURY• ; . ..WARREN COUNTY; NEW',YORK May '5 9 9 ± Dte 19 • This is to'certify"that work requested to be done:as shown by Permit NO.:, • 'has been completed. RESIDENTIAL, ADDITION,:(DORMER ` • :This structure may'be occupied as'•a. 6 9 l SON ROAD Location BURKE, , PATRICIA Owner; '.:TAX MAP NO, 13 -.1-11 2 ' By Order Town,Board TOWN OF QUEE BURY J Director or Bldg. do Code Enforcement BUILDING : PERMIT VALUE; $ ?:4000 TOWN OF QUE"ENSBURY Na TAX MAP NO. 13. —1-11. 2 WARREN COUNTY, NEW YORK 97595 PERMISSION is hereby granted to RURKEr-THOHAS PATRICI OWNER of property located at 69 MASON ROAD Street,Road or Ave. in the Town;of Queensbury,To Construct or place a at the above location in accordance to application together with plot p ans an of er in orma ion ere o filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is. 24 LONGWOOD DR. DELMAR. NY 12054 2. CONTRACTOR or BUILDERS Name CLOTHIER. DALE • 3. CONTRACTOR or BUILDER'S Address 3...DEER ,RUN LAKE GEORGE, NY 1245 4. ARCHITECT'S Name 5. ARCHITECT'S Address , 6. TYPE of Construction—(Please indicate by X) REFTDENTIAL..ADDITION ( )Wood Frame ( I Masonry l 1 Steel 7. PLANS and Specifications 4$ SQ!°FT DORMER...IN>'•.UNFINISHED ATTIC AS PER APPLICATION,. B. Proposed Use 1: j _ ..r r, .Y,i 'r�tir;Y-^a•:- .....�cA-n:;..n _ - _ ... '%�.�'+dth�gi3;+° - x,�5' �', rb k.,� ,F.�-in•y�:��'�- _- .:f•,:: .�.�= i�:ete - -- $.:._ , ..::kp' ititr .t.'kc,,. _ ;,�• :.:4 3'`ucYa�;+.;?.•,4 1.4 .0,c.: -'k' '1t-11 - ziis ?9 $ �R 1'"FE'E-P�fiO�? .�'Hf�'.�Pf=FtKIIfT ,i`^SEPtR'E�--�,��.„_ .__. __. dh��29�,��, �'f9��,:,,,,�,..�:99`.vt�hy.4. (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 7 town of Queensbury before the expiration date.) t 4 i is vaf<�' �.r..•,' s ax`.= C. "'" = ?;::;:.-.,. ., Dated at the Town of Queensbury this �-=4�:,., ..�.: - t•,0 t01?e:r;�.- _- - �_{:.•.;c�,����,;>..;;,P;,. \ SIGNED BY -- C3kA.AQ-- for the Town of Queensbury Building and Zoning Inspector "I'---- Building Permit Application Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 1761-82561 q BUILDING & . CODE ENFORCEMENT NOTICE Requirements prior to issuance of this permit: PERMIT FILE NO. 9 ".95 A permit must be obtained before Q* beginning construction. No inspections PERMIT FEE PAID$ t ,' ©C will be made until applicant has received 1-1 ZoningBoard Action a VALID BUILDING PERMIT. All Area /Use RECREATION FEE PAID$ applicants' spaces on this application MUST be completed and.the signature n Planning Board Action REVIEWED BY: i i of the applicant must appear on the SPR / Subdivision /Other Building Inspector Qapplication form. rnanx-,-w. �^y p_^ t Recreation FeePayment J Applicant: O1M&S H .01.A f , Owner: i i O.Y as. & • r 69)143ON, 2 ) CO ) - ',�y� 9n,�,q n ` �`" n ,l Address: Vt't�.StYl �' L 0.t:-ICtY Zd • Address: M& O n q- LaeleY =l�k e r?i M/ cieoe vdo Ltv ,N1 t-2A-2 .) Phone # . (5I'g ) t Phone # l Property Location: MOW II a. L[iei y 4 WIA-et'SEC ,il0 Subdivision Name: Tax Map Number - • 1/ 1 i /l Section Block I nt NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE New Building: CONSTRUCTION: $ 7 ooe, • , (U(rytQ1416- residence / commercial 36m "to c%izt-rixyV. o.c,c,vnn,., e Addition to Building: residence / commercial OCCUPANCY INFORMATION: _Alteration to Building: A DoRtiE. Primary Building - residence / commercial 201,i( f , ,,/ Single Fami Residence / Commercial lo /�, , Two Family w g no change to exterior sizet tiNtr6.4 Famil Ilwb ing Office ®C.�, ® ���� Other Work (describe below) Mercantile Y Manufactur• ng ,�D� TJuR — Other TOViN j�lfi kW GOB GROSS AREA OF PROPOSED STRUCTURE: DU`LD 1st Floor sq. ft. If ADDITION, what will use of new addition be? : 2nd .Floor y/8' sq. ft. App S'> Sk)es -o BA-rt¢ Other Floors sq. ft. (not unfinished cellar or basement) ACCESSORY BUILDINGS: Detached Garage 1, 2 car TOTAL FLOOR AREA: 7 SQ. FT. Attached Garage 1, 2 car Private Storage Building SIZE OF NEW STRUCTURE: Commercial Storage Building `T:S FEET X /0 FEET Other Foundation Type: PDtcieol() CO®voer/ Will any second-hand or ungraded Number of Stories : ,/ -f; lumber be u.s,d? If so, for what? (habitable space only) /L/ Height (grade to ridge) : lc, feet TYPE OF. HEATING SYSTEM: Number of fireplaces and/or woodstove all which applies) to be installed: 4108131116 / Oil / Gas Wood Force. Hot Air / Baseboar / Other Person responsible for supervision of work as regards to building codes is : DALE k, (.ie M;ed? ? beef Pun, +'e6 nkt.e.9 e. (068g6S3 Name Addresss Phone _ Builder: S.4-Aft•e_. h-S' A-Ad V'2. Plumber: / t . Mason: Electrician: st DECLARATION: Please sign below after you have carefully read the statement. To the best of my knowledge 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 noted, and that such work is authorized by the owner. Further, it is understood that llwe shall submit prior to a Certificate of Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by a licensed surve ; drawn to scale, shown j ctu 1 aj n of project on premises. Signature: �i �� r' wnerAgragal4 architect, contractor) - /i �-- ENERGY CODE COMPLIANCE APPLICATION tt _ TOWN OF QUEENSBURY, WARREN COUNTY =` 9000 HEATING DEGREE DAYS Compliance Methods : PART 5 - Acceptable Practice Method - 1&2 Family Dwellings (only) PART 6* - Thermal Rating - Component Trade Offs 1&2 Family Dwellings; Multi-Family Dwellings (3 stories or less) PART 4* - Design by Component Performance Commercial Buildings-Hi Rise Residential *Requires submission of worksheets , PPLICANT' S AME: PROPERTY LOCATION: alli rico. 4JI�Gaa f / (4,_ ovi/18-6.fifq PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area t-���' square feet VE5V2 . Type of Heat - - Ellectr�icG Oil Gas Other YP 3 . Is building mechanically cooled? Yes No 4 . Percentage of area of windows and doors Over 17% Under 17% 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED: a. Roof R ` j b. Exterior walls R __a__ c. Glazed areas R d. Exterior doors R e. Floors over unheated spaces R f . Edge of slab on grade (heated building) R g. Basement/cellar walls (above grade) R h. Basement/cellar walls (below grade) R i. Heating/cooling-ducts-piping in unheated space R 6 . Service (domestic) hot water heating device/ - Conforms to minimum efficiency per code Yes No TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED Ap icant4s. i nature Date Phone Number INSPECTOR' S REMARKS : GENERAL INSPECTION REP T 3(0° 14 hi\ Town of Queensbury Dept. of Community Development Date inspection request received: JO— Building& Code Enforcement 742 :;'ay Road ) 6 Queeusbury,NY 12804 Arrive\\-2 p,�. Depart " 6 Inspector's Initials NAME: , G S � ^'Y PERMIT# — S LOCATION C DA — TYPE OF STR • C? RECHECK N/A YES NO COMMENTS Footings/Piers I I Monolithic Pour Form Reinforcement in Place The contractor is responsib:e for (' ,� v providing protection from r:- ing � v for 48 hours folio /.410 of the concrete. Materials for this purpose en site Foundation/Wallpour f� Reinforcement in Place Foundation/Dampproofi.cg _ Backfill Approval Plumbing Under Slab Plumbing VentNen in Place Rough Plumbing 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 R- _ Proper Vent, Attic Vent Framing Jack Studs/Headers Bracing/Bridging Joist Hangers Jack Posts/Main Beam Air Infiltration Barrier Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestopping (518) 761-8256 4 TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT '4 %, 742 BAY RD., QUEENSBURY NY 12804 ,"r rl`;,:7 (le (� �!. INSPECTOR'S REPORT: ARf2'6,LM,DEPAR'1" '� IN REQUEST FOR INSPECTION RECEIVED: / NAME F r IA % &`` a ., [ LOCATION 0 (�° �\ i QP ) DATE 1 1 a'' �S l PERMIT(� 0 1 1��9.`) TYPE OF ST UCTURE: �JbfamPa RECHECK APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE / THE CONTRACTOR IS RESPO ='ISLE FOR PROVIDING PROTE TION FRO , ;EEZING FOR 48 HOURS FOLLOWING TR P • MENT OF THE CONCRETE. MATERIALS FOR THIS PURPOS ON SITE FOUNDATION/WALLPOUR REINFORCEMENT IN PLACE/ FOUNDATION/DAMPPROOFING _ BACKFILL APPROVAL PLUMBING VENT/VENTS IN PLACE _ ROUGH PLUMBING PLUMBING UNDER SLAB FRAMING• JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS _ JACK POSTS/MAIN BEAM AIR INFILTRATION BARRIER _ ATING ROUGH-IN INSULATION: _ Vrr • FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- % FLOORS R- Vf —CELLS � R- 4 CEILING tc r��`p..�s.z��1/�♦♦♦ R- ' DUCT W K OR PIPING IN UNHEATED SPACES R- LA-1-1 (518) 761-8256 TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 5+. 742 BAY RD., QUEENSBURY NY 12804 - '1 P ,,x,v INSPECTOR'S REPORT: ARR//((/JDEPART INT�k REQUEST FOR INSPECTION RECEIVED: / - '""-9 7 NAME pith ?L,(-f fr , LOCATION (J/ tqC/A0D 1 Cikloa01/ C Pv ( � DATE � - ` � ERRMII T7�J,�e/J��C TYPE OF STRUCTURE: , ® -7 Lh / !---- RECHECK DOTYKG APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM Allk REINFORCEMENT IN ' ACL THE CONTRACTOR IS .4. 'ONSIBVE FOR PROVIDING PROTE TION ROM F•EEZING FOR 48 HOURS FOLLOHINe HE •LACE- MENT OF THE CONCRETE. MATERIALS FOR THIS PUR'OSE ON SITE FOUNDATION/WALLPOUR REINFORCEMENT IN PLACE FOUNDATION/DAMPPROOFING BACKFILL APPROVAL PLUMBING VENT/VENTS IN PLACE ROUGH PLUMBING PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM AIR INFILTRATION BARRIER HEATING ROUGH-IN SULATION: FOUNDATION WALLS INTERIOR R- _ FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R-026 CEILING R-7) DUCT WORK OR PIPING IN UNHEATED SPACES R- 'HI:). �A^"C2-___ (518)761-8256 :r TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT I;S` 742 BAY RD., QUEENSBURY NY 12804 L' OriINSPECTOR'S REPORT: ARR`` DEPART N , rif STS C. REQUE &bINNSSPECTION R EIVED: NAME �(� \ V6 r 1h AO ,. �' LOCATION • (\. NIP OW r r- DATE PERMIT t �__ TYPE OF STRUCTURE: e ;;,cAt Os RECHECK APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM -. REINFORCEMENT IN PLACE _ THE CONTRACTOR IS RESPONSIBLE OR PROVIDING PROTE TION FROM F•' NG FOR 48 HOURS FOLLOW NG THE "LAC - MENT OF THE CONCRE E. MATERIALS FOR THIS •URPO%E ON TE FOUNDATION/WALLPOUR ,- REINFORCEMENT IN PLA . _i FOUNDATION/DAMPPRO' ING _ BACKFIyL APPROVAL /_ _ PLU BING VENT/VENTS IN PLACE _. OUGH PLUMBING _ L PLUMBING UNDER SLAB ING• _ JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS MAIN BEAM - AIR INFILTRATION BARRIER 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 R- - S Pro I've+Y OS- i+ a?PPcrrs . i " +May KM(' r 59. _. x..... .k.... . - I RECEIVED 0 s. 3 o OCT 1 01997 4 4 --BCTIC�I TOWN Nb AND CODE 24 � ` � I I , PF d O 1 j r A-p.�:) ! O T /3 •• Q W — by E d✓e . f�;#e ✓ AsbCetr04 - ,1 f ,! Laa HOuSE (,_Ql /‘ c- - ,.v 34. . ,, tr' \ 1 "' aI t ' /15/4- ,,.. /..P 1 s8 NI /�. I x .21 ( WI ' 1 �.� ' . - I._ ¢ V�I \ __— - o r y a nQpC \ \ \ I.PF. Etzi 4 2 8..7 41" N 1 . a3.5o' - 41t US JI 1 .PF- �d� of -5 psi n o If ds I Gi r- Orr) Lo 15 MAP SHOWING PREMISES PROPOSED TO BE CONVEYED from THOMAS & ELSIE RAVE to_ - THO S &' PATRICIA BU TOWN OF QUE IESSSURY WAR.RIt*1 COUNTY.N.Y. SCALE 1' = 30' DATE juty 7 l9$0 al0MN $,VAI4 DUSEN • LAND SURVEYORS. GLENS FALLS.N.Y. LOTJ 1.7 /•F, et-c,. erre parr of' I.P.S. • IRON PIPE SET F Ripkys Pout t Sue/Lksfon I.P.F.• IRON PIPE FOUND fet✓er Ufa/e) 4