1992-251 TOWN OF QUVEMSBURY
REVIEWED BY :
FEE PAID :
PERMIT NO . : I ,
F �
1 _ � ►
BUILDING PERMIT APPLICATION
c^4, y` �4►
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPECTIONS W I IL
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 : _ -' ty Q L (,Q (A e e w s b c#*o*
P . O . Address : PHONE
E4/JT / QQH
Property Location : &'ef' J ' __Tax Map No . 60 /.2 /
Has there been any split of this property since October I , 19887 Yes No
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 :
NATURE OF PROPOSED WORK : * ESTIMATED MARKET VALUE OF THE
Construction of new building * CONSTRUCTION : $
Addition to building
�r Alteration to building * COMPLETE INFORMATION REQUIRED BELOW :
( no change to exterior dimensions ) * Size of Property : ft . x ft ,
Other work ( describe ) * Existing ` Building Size :
.c a 4%!**,�,L1r- ;/ t 4,w. +" CAr Jcj lea r 04 ordhotssc
I ` * Proposed building - distance from
GROSS AREA OF PROPOSED STRUCTURE : * property line :
*
1st Floor Sq , Ft . * Front Yard 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 T' * OCCUPANCY INFORMATION :
*
TOTAL FLOOR AREA : Sq , Ft , * Primary Building -
* One Family Dwelling
Size of New Structure : ft . x ft . * Two Family Dwelling
Founda on : * Multiple Dwelling/No . of Units
Pier lab Crawl /Partial /Full ( Circle fine ) * Business
* Industrial
No . of stories ( Habitable space ) * v Other �,I,3 o " owr+ Cmv , -
Height ( grade to ridge ) ft ,
If residential , no . of families : * If addition , what will use be ?
No , of rooms ( excluding baths ) :
No . of bedrooms :
No . of bathrooms : * Accessory Building :
Primary heating system: * Detached Garage - One/Two Car
Type of fuel : * Attached Garage - One/Two Car
Nov of fireplaces to a installed : * Private Storage Building
Will a woodstove be installed ? : * Other
Central Air Conditioning : Yes No
( OVER )
BUILDING PERMIT APPLICATION CONTINUED
BUILDING SPECIFICATIONS :
K; :J.
nstrtit�tion : wood frame , fire safe , etc .
any second- hand or ungraded lumber be used ? If so , for what ?
6undaltion Wall Material : Thickness :
Death of Foundation below grade ( to bottom of footing ) :
wil 'fFthere be a cellar? Heated or Unheated ? Floor Sq . Footage :
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 _
Size , wood studs " x " ; spacing o . c . ; length ft .
Joists ( floor beams ) ; Ist Floor " x if ; spacing it o . c . ; span - ft .
Joists ( floor beams ) : 2nd Floor It
x spacing o . c . ; span ft .
Overlays ( ceiling beams ) : x spacing It
o . c . ; span ft .
Roof rafters : " x " ; spacing o . c . ; span ft .
Roof trusses ( pre-engineered ) : spacing IN
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 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 : firth fh.nV k t e& e v 4 J! 72 J5 ��r�`��i PHONE 7f3 _ ? .S L/
NAME OF PLUMBER & ADDRESS : _ PHONE
NAME OF MASON & ADDRESS : 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
Owner , owner s agent , architect
contractor
SPECIAL CONDITIONS OF THEPERMIT :
By :
Code Enforcement Officer
>• A&A Electric A&A Construction r __w I Nf .
hlrtr{'!7 ,t y 1 !tst ? r ri KhR ji12
r-tec held a'
4h
Btrildi�yJ"Gcrw+'+� �+,
' 3 ddd
3 T
LZ
Al1r"rng4,rlry 'fns,�i, t ': . iir t
Glenwood Averl" O
yueensbury , New Yol
Dear Strain
For tltr Ri,m of t , VC t t,r ,tiS #1T1 rrir,e 1,u11s1rrci eigtlf do ) l fit
( $5 , 983 . A() ) , r+� t+t : ,I+r,4< t cr R,t1,1, 1 y It,lasrr nerd mnteri n I I'r , r i lie ro 1 ! 4 ,sl; i , is!
work .
36 ' _ 2 " x 4 "" wit ] 1
3 5/89" Frict, 1oit Fit ir, Rl, Int: inrl in wnllr;
1 /2 "" Dry wal i t r ood ntrri innde r ",tly rnr Fraitit. ing
Prime walla nrrel 1"niIII t%-10 [ 2 } r " , nt.R to r17RtCIl exi st it,^
— 1 , 0" X 43s11 " 14r' ( • I++, t,r; hollow r,ol- + birch h sic)nr with i � ; Itred x R p r+ s t.r, r!r
lockset.
I - 3 ' 8 "' x 6 W' r,rof„ ig moo } icl c carry tr.irc lr cir�or wit. l, + R 1„s .z, ;, nr
loc:kc;VL
Rubber bas(l t mn t + - h x i R t. i arsd
1 3/4 " cove mcllcli , ig nt c-ri I ittg rrI' flew 1%pn I 1 rti,cl t' tit et1, ! i rr cnc3 r, f
existing walls
l - cllrnl L,t+n+l tine rrr'rlc' � 1 it{Ilt fiYt.ure
l wa 1 1 ex i L t i %4111 f i x t.+e re
Relocate ( 1 } 4 ' flric, regt• rrrt, cet ] it19 fix Lit re.�
commerr. tal grnde (- !, rt,rt. t11r•"rlsthrrut: r%neloged t!1111rt rr ,r ,rrt , 1,I, 1'r ) Yim .1tr ! }
33 ' x 42 ' - Al lovnn(-0 111Cl , tctitlg itr *3tatllnti011 - 2yftln , s€rt
Re Ir)c* ate e l reset_ rtz,, , r t.< , ni�ixns i t elltl y f ram`
rlt ,ci rzlr ^�°
opertilig
ReIoent.e re� t ,It'll Kri 1 lrR tr, Ikew wnll
f;ui; port, inrl r, f ,# ",r#rsrys; lrr r,c h nnc! witness 1143x npproximrNt ^ ty .1 l.r,
e Xis titlK c"rrlrtlt.r r t. ri hr* ig11t rrrrrl rrpince� a% istittsZ trim
ReglrecIt f111 1 y s,ti,m i t t r cl ,
A.FS Ftrterprisf-s lrtc•. .
/ t
f "
Ant it -my A . I ,(,f 'ar;t- i o
Fier; i rlen t:
mk
I
- --•__-_. I iicllr ! tr,ci Ave., CUIC r�r Falls, Now York 12601 CI i €t] i g:1 - i561
TOWN OF QUEENSBURY
FIRE MARSHAL
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518 ) 745-4424
FIRE MARSHAL INSPECTION REPORT
REQUEST ,.FOR INSPECTION RECEIVED
NAME�,,II a2ryz„ J�•Gf�}� _ ___
LOCATION
DATE /rg?ZZ'S Y,�2 PERMIT#
APPROVED
EXITS N/A YES Nil
AISLE WIDTHS
EXIT SIGNS
EMERGENCY LIGHTING
FIRE EXTINGUISHERS
AUTO . EXTINGUISHING SYS EM
HOOD INSTALLATION
AUTO . SPRINKLER SYSTEM
ALARM SYSTEM
INTERIOR FINISHES
STORAGE :
CLEARANCE TO SPR KLERS _
CLEARANCE TO HE ING UNI
REQUIRED SIGNAGE
CHIMNEY
WOODSTOVE
FIREPLAGE-MASONFY
FIREPLACE- FACT(WY BUILT
REMARKS : Lj OK TO THIS DATE
C4 J
C
2/015 INSPErCTOR