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kiE i•._TIFIC:',
' 11E OF GPLIANGIP M id',
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TOWN OF QUEENSBURY
, . WARREN COUNTY, NEW YORK
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Date &Wet/....4 19 ZZ ,
This is to certify that work requested to be done as shown by Permit No. 92-599
has been completed. . .
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This structure may be used as a dock _
. . Location Kattskill Bay
Owner - John Serbalik
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. By Order of Town Board
.TOWN OF QUEENSBURY •
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- Director of BUilding & Code Enforcement
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BUILDING PERMIT
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TOWN OF QUEENSBURY 92-5991
No.
WARREN COUNTY, NEW YORK /A 00
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PERMISSION is hereby granted to JOHN SERBALIK
OWNER of property located at Kattski 11 Bay Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Rebuilt existing dock
at the above location in accordance to application together with plot plans and other information hereto filed and cn
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. cri
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1. OWNER'S Address is1-1
53 West St
Mechanicville NY 12118
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2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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J.
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5. ARCHITECT'S Address —�
too
6. TYPE of Construction—(Please indicate by X)
( bfflood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. Rebuilt existing 230 sq ft dock as per plot plan, specifications
and application. m
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8. Proposed Use c
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Dock
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$ 30.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 13 19 93
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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.) 0
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Dated at the Town of Queensbury this 13t , ,y of _ October 19 92
SIGNED BY c-- "MP. for the Town of Queensbury
Building a-d :�ning Inspector
i
' TOWN OF QUEENSBURY 14i,
Fee Paid 0BUILDING & CODES DEPARTMENT' Permit # ,-
APPLICATION FOR: PORCHES-DECKS-
DOCKS & BOATHOUSES Est. Cost
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. PLEASE ANSWER ALL OF THE FOLLOWING:
The undersigned hereby applies for a Building Permit to o® � �ow ng 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. TWO SETS QFrSTRUG1 PLANS SHALL BE SUBMITTED
WITH THIS APPLICATION. QL0 (' ` .
BLDG. & COuh DEFT. -
Owner of Property: 1r7-4,-,-- -14J7--42,--4
P.O: Address 3"3 1�/.�a4,P)t-•�hJ ,l� Al /z/�e Phone # (‘/,( 5-�'/9
Property Location 9-ai��� ,Q, ) - / Tax Map #
Subdivision Name (If applicable)
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES:
Name: if}-74._31.,_,-zj,,,,e,AAddress je _ Phone#6f 4--sror,
BUILDING SPECIFICATIONS:
Type of work to be done: Porch Deck loc. Boathouse (Circle one)
Size of Structure to be built (square footage): 2. 3 0
Foundation Material : Width Thickness
Depth of Footing, below grade:
Size of Posts or Studs: )) x G n x Z o Long
Size of Floor Joists: ,Z" x : 4' " x ' Span
Decking or Flooring Material : /". , 4 "
How will Porch or Deck be fastened to tag? 'V J
a -o57? "
If Roof Will Be Installed, Answer Following Questions:
Size of Posts or Studs: x x Long
Roof Rafters: x , Spacing Span
Roof Trusses (pre-engineered spacing) : Span
Type of Roof: Sloped Flat Shed Other (Circle one)
Material of Roof:
ZONING INFORMATION:
TWO PLOT PLANS MUST BE PREPARED AND SUBMITTED, drawn reasonably to scale and attached
hereto, showing clearly and distinctly all buildings, whether existing or proposed and
indicate all set back dimensions from property lines. Show location of water supply and - -
location and configuration of septic disposal area.
•
Size of Property: t Q ft. x d / ft.
Existing building(s): Size .Z.�O ft. x 30 ft.
.4 Size ft. x ft.
Use of Existing building(s) :
Proposed structure; distance from property line:
Front yard ft. Rear yard ft.
Side yards ft. and ft.
If on corner, setback from side street: ft.
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.
DATE: /Z C 7 7 - SIGNATURE
__,_ / yner, Owner's Agency, Architect, Contractor .
: REVIEWED'BY CODE ENFORCEMENT OFFICER, DATE SIGNATURE
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
• 531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 745-4447
BUILDING INSPECTOR'S REPORT
REQUEST FOR
(INSPECTION RECEIVED
NAME �� S. ,4`
LOCATION A4- 4/
DATE PERMIT #
TYPE OF STRUCTURE I .
RECHECK I t� APPROVED
I , N/A YES NO
FOOTINGS/PIERS • I
MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE ./
THE CONTRACTOR IS RESPONSIBLE /
FOR PROVIDING PROTECTION FROM )i
FREEZING FOR HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.'
MATERIALS FOR THIS PURPOSE ONISITE
FOUNDATION/WALL POUR
REINFORCEMENT IN PLACE d/
FOUNDATION/DAMPROOFING A
BACKFILL APPROVAL /' '\
ROUGH PLUMBING I
PLUMBING VENT/VENTS IN PLACE 1\
PPLUMBING "UNDER SLAB I \\ r
,FRAMING: /
JACK STUDS/HEADERS / \1
BRACING/BRIDGING /
JOIST HANGERS /
JACK POSTS/MAIN BEAM/
HEATING ROUGH-IN .
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION 1,
WALLS EXTERIOR R- •
FLOORS / R-
WALLS / R- �• _
CEILING / R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS: '•�
ARRIVE /PO
DEPART //2e
SPF .T(1R
Epieeu517,.1
1 6x6 Pok 6i&
zeife
1 TOWN OEQUE:Ei-ISBUR.Y
BUILDtiiG, - CO -S DEPT.
FaVIEWZD BY
DATE i ft---