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1999-100 a()(1 ,1A1 BUILDING PERMIT TOWN OF QUEENSBURY VALUE $ 4000. No. 99100 TAX MAP NO. 55.—1-18 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to LEWIS, KARL & DEBORAH OWNER of property located at 12 HICKS RD. Street.Road or Ave. in the Town of Queensbury,To Construct or place a CH) 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 12 HICKS RD. QUEENSBURY,NY_.... 12804; 2. CONTRACTOR or BUILDERS Name LEWIS. CONSTRUCTION 3. CONTRACTOR or BUILDERS Address 12 HICKS .ROAD QUEENSBURY, :NY . :.12.804 4. ARCHITECT'S Name COMMONWEALTH ELECTRICAL AGENCY 5. ARCHITECT'S Address PO BOX 70.6 . HAGUE, NY 12836 6. TYPE of Construction—(Please indicate by X) RESIDENTIAL ADDITION 1 1 Wood Frame ( )Masonry ( )Steel ( 1 - 7. PLANS and Specifications., 300NSQ. FT RESIDENTIAL ADDITION. (3. SEASON PORCH) AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use RESIDENTIAL. ADDITION:. (3. SEASON PORCH) $ 24 2001 PERMIT FEE PAID —THIS PERMIT EXPIRES April 7 19 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.) Dated at the Town of Queensbury this 7 Day of Apr i 1 . 19 1999 • SIGNED BY 1� for the Town of Queensbury Building and Zoning Inspector Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Dept. of Community Development •Permit No. •qv!' 06 Building &Codes Office 742 Bay Road Fee Paid $ Queensbury, NY 12804 Location of property for installation: /2-- me--to 5 /2,..L._ _ Property Owner's Name: Aa-z, L - t�/� - Property Owner's Mailing Address: $'A /f, </W S /2 Installer's Name: Rip-Li - /.�1�Gr��.5 Phone # 2 5' Z -2--/o Number of bedrooms (if residential): 3 Total daily flow: -,j C.) (residential -compute @ 150 gal./bdrm.) Topography: flat, rolling, steep slope % of slope • Soil Nature: sand, <loam, clay, other /depth: Ground water: at what depth? / feet / Bedrock or Impervious Material: at what depth? feet Percolation test:P not required, required [rate min. per inch j Domestic water supply: municipal, X well, other If domestic water supply is a WFT T, water supply from any septic absorption is el,- feet. • PROPOSED SYSTEM • Y /0&0 Septic tank- gallon (minimum size: I,D00 al.) 30 2 Tile field: each trench 010 feet / Total system length: feet • Seepage pit(s): number of 4//y� / size each: . ft.by ft. Size of stone to be used: # . / depth or thiclmess , feet • • HOLDING TANK SYSTEM: (if required) Number of tanks: : Size of each: gallons CA.arm system and associated electrical work to be inspected by a certified agency.J For yotz protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted is reliance upon any rn t.:rial r isrepresentabon or failure to make a material fact or circumstance known by or on behsdf of an applicant, chs It be void. I have read the regulations with respect to this application and agree to bide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person: Date: �� . ' 4 , ,,,0.6 9 _/ : _ ENERGY CODE COMPLIANCE APPLICATION 0.041A�jW 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 APPLICANT' S NAME: PROPERTY LOCATION: ' � 1_ �� �s I / L ,Y C-ic 12G, ' PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE: 1 . Gross Floor Area - j o ° square feet 2 . Tvoe of Heat '0 - -Electric Oil Gas Other 3 . Is building mechanically cooled? Yes k No 4 . Percentage of area of windows and doors V Over 17% Under 17% 5 . R-VALUES FOR INSULATION GIVEN BELOW MUST CORRESPOND TO R-VALUES AS SHOWN ON PLANS SUBMITTED: a . Roof R 3 Y. b . Exterior walls R / `" c . Glazed areas R -3 d . Exterior doors R �3_____. e . Floors over unheated spaces R _e_ f . Edge of slab on grade (heated building) R .•.e g. Basement/cellar walls (above grade) R A h . Basement/cellar walls (below grade) R i . Heating/cooling-ducts-piping in unheated space R a, f� 6 . Service (domestic) hot water heating device Conforms to minimum efficiency per code Yes )D No TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED Apply :.t' s Signa re Date Phone Number INSPECTOR' S REMARKS: Building Permit Application Town of Queensbury - Dept. of Community Development, 742 Bay Road, Queensbury, NY 12804 1761-82561 . ° • BUILDING & CODE ENFORCEMENT NOTICE Requirements prior to issuance r / A permit must be obtained before of this permit: PERMIT FILE NO. 99 - (1(..-1 beginning construction. No inspections 6 will be made until applicant has received n Zoning Board Action PERMIT FEE PAID$ a VALID BUILDING PERMIT. All Area /Use applicants' spaces on this application RECREATION FEE Al $ • MUST be completed arid•the signature n Planning Board Action REVIEWED BY.of the applicant must appear an the SPR / Subdivision /Other in ding Inspector plication form. nma�,. Recreation Fee Payment Applicant: l9A- 2- /e GtJ .5 . • Address: /(92 / CRS /7,G/ Address: Phone # (57 ) 29_z - ,z/o tJ Phone # ( ) _ Property Location: / ,/ C-/es /Ze ( ,6-75---/ • y� • Tax Map Number ,, / �: Subdivision Nanie: ..•. Sect. / lIm e t„t NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF THE New Building: CONSTRUCTION: $ J caw 0 `f residence / commercial 1( Addi o 2 ilding: • • Lresidenpe-y commercial OCCUPANCY INFORMATION: Alteration to Building: Primary Building - residence / commercial -Vs Single Family Dwelling Residence / Commercial Two Family Dwel r . r--����� no change to exterior size . Family Dwi .'. Office Other Work (describe below) Mercantile APR 02 1999 Manufacturing — • Other TOWN OF t5UEENSBURY — GROSS AREA OF PROPOSED STRUCTURE: • BUILDING AND CODE • 1st Floor 3 00 sq. ft. If ADDITION, what will use of ne 2nd .Floor sq. ft. w addition be7 : Other Floors sq. ft. 3S-+--.4seo Al /00ri (not unfinished cellar or basement) ACCESSORY BUILDINGS• • • Detached Garage 1, 2 car TOTAL FLOOR AREA: SQ. FT. Attached age 1, 2 car Private ge Building SIZE OF NEW STRUCTURE: Commercial forage Building FEET X AO FEET Other Foundation Type: • 8 afU/4/ Will any second-hand or ungraded ' Number of Stories : / lumber be used? If so, for what? �fi'c: (habitable space only) • Height (grade to ridge) : feet TYPE OF HEATING SYSTEM: Number of fireplaces a d/or d wOostove (circle all which applies) to be installed: d}/ k Electric / Oil / Gas / Wood 'e2 .- Forced Mot Air / Baseboard / Other Person responsible for supervision of work as regards to building codes is : LI a vi • • Ntiine ) Addresss Phone Builder: J7iq`,L o2 Z%/�r�/- S 2?'X - 2- I a V Plumber: A/// • Mason: jf /1.-c. - -/ ' .. Electrician: Afiln L `�� f 5 • 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, arc a true and complete statement of all proposed work to be done on the described premises and that all provisions of the Building Ccxle, 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 I/we shall submit prior to a Certificate of Occupancyor Certificate of Com lance being issued, an AS BUILT PLOT PLAN by a licensed surveyor; drawn to scale, showing's ual location of project on premises. 1/4 Signature: �.2' - (owner, owner's agent, ar hitect, contractor) > _ �. .1 ♦.. N tip...- - .J Y- i 1 .• ,. ..- - - a r-!-"V ."Y •- x Fire Marshal's Office • • . Town of Quecnsbury,742 Bay Road,Queensbury,NY (518)761-8205 . Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances . I 20 Permit No. f lv • Date1 • , C,C I • Application is hereby made to the Building& Codes Office for the issuance of a Building and Use- Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. NOTE to applicant: Rough-in and Final Inspections are required. Applicant\Information Fuel Burning Appliance Information �, - (circle appropriate words) Name: ;'.•!4: ‘, K= .IStove: wood coal pellet \�. Fireplace insert Fireplace, factory-built; wood gas,; ' Address 1 $> ,. T_ .;, Fireplace, masonry: wood gas f" . t Ni Furnace: wood gas oil Phone: 2. ,. - 2 ;t -1 t . \ If non-masonary applicance,please provide' • Owner: =:1 :-;,, 6 Manufacturer•Name: LSz„1., l , , Address: Model Number: - Chimney Information, . Phone: 7 G - 2 c {7' (circle appropriate words) " Masonry block brick stone , f Flue tile steel size: . inches d J, Exact Address: fd ,. -t .-.4;$ . �/ Jd?/ -c2c . L`.... r • -of construction or installation Factory-Built ' Manufacturer name: , Model Number: ' . • - Note: Listed By: - Number: • Construction/Installation must conform to NYS Fire Prevention &Building Indicate(circle) chimney material: Code. Consult available Town of Queensbury ,. --,...kp_ • Handouts regarding required inspections. Double wall,l Triple wal / Insulated / Direct venting A, . Chimney Liner '°""""� • CYigaii.ie e',s.Degartmerrct—To of Queezi bury, New W mk Fire Marshal Code# $Collected $Refunded Received_from (refunded to):T _ ' address: . _ A 173 3389 (190) Public Safety a--• • A 233 2655 (230)Minor Sales t DATE: • ) t1. �� t ) - 1 ,-\Pw •0 -r') ..... i $ 44*-14✓.2c w — /On. 6424 2 D , White(Applicant) / Green(Fire Marshal) / Yellow(Bldg.Dept.) IPink&Goldenrod(Cashier's Dept.) O . /I COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL'CERTIFICATE - ELECTRICAL APPROVAL ,/Od Permit No. Cert. No 75887 Cut-in Card No Owner , L'-2.e) l / cam ._S /� , /,/_ ,v.. Location f� � G.����r Installation Consisting of..5- w" raf 6 /-6-6 rJ 5 4'I 7 Si l/4I'J Installed By 44 v Lic.No. The conditions following governed the issuance of'this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall b omptly made for inspection. Inspectors of this Company shall have the privileg- .f mak' g ins ctions at any time, and if its rules are ��77violated, Jthe Company shall have the right to ,•v.ke th' certi cate. • Date...h �`� i' d, w,/ INSPECTO'/. .... / Member N.F.P.A.,I.A.E.I. via" q 14y.)--\_ TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION C0 Name yC.PAL L.- - Location 0,, (-{tic(4s 2_ Date 1 It I Permit # y c1—1UU SOIL TYPE: Sand-Loam-Clay Results of Percolation Test- (if applicable) Rate-Mi ute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Tota Length ' L; (f) Length of each trench t)\Q_At_h Depth of trenches al Size of stone SEEPAGE PITS: Numb- - Size - ft. ft. Stone size PIPING: Size Type Bldg. to Tank �.�,Ib�‘6(r, Tank to Dist. Box kill Dist. Box to Fiel ,�/e:2: 4ff t' Qt1i� To ctS Openings Sealed? o Partial LOCATION/SEPARAT ON Foundation to T. k ems; feet Foundation to At sorpti on = - .feet . . Separation of P 'ts fe- Conforms as pe Plot Plan Yes o/ LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear -ft Side - eight Side Middle Front ,. Middle Rear COMMENTS: V I'�j.`• > r- . w q� � SYSTEM. 6 USE APPROVED: 1 ! 0 Arri =d: / `„ ,) ,,i 4 ! AO/.i v3D ir 'tii' di g Ins. 'tor \ 1 \\ FIRE MARSHAL TOWN OF QUEENSBURY QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED PERMIT 9rl OD NAME ,LkQ, oL. .) i 5 LOCATION )01- Hi(`-KS O SCHEDULE INSPECTION ON �— / 2_AB()1 NI AM I6 ANYTIME APPROVED NIA YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHT;dG FIRE EXTINGUIS FIRE ALARM SYSTEM FIRE SPRINKLER SYS EM FIRE SUPPRESSION S STEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE 0 SPRINKLERS CLEARANCE TO HEATING UNITS REQUIRED SIGNAGE CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT LI REMARKS: icAOK TO THIS DATE Vve Lire c5F S V k.k 631/41:46(S INSPSLIP.PUB ,INS CT Z ' ' 013 ,0 GENERAL INSPECTION REPORT ( 518 ) 761-8256 Town of Queensbury Dept.of Community Development Date inspection request received: Building& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive7;a an Depart Inspector's I ' i NAME: ��tO\) PERMIT# LOCATION: !-k t RDBODATE : Lf-C TYPE OF STRUCTURE: POp)C't-k- RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsi3le for providing protection from freezing for 48 hours following the placemen of the concrete. Materials for this purpose on site Foundation/Wall ur Reinforcement in Place Foundation/Dampproofi ng Backfill Approval Plumbing Under Slab Plumbing VenUVents in Pl* e Rough Plumbing Heating Rough-In Insulation Foundation Walls Interi r R- 1 \ c tiler iZV_ Foundation Walls Exteri r R- Floors - Walls R- ._19 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 GENERAL INSPECTION REPORT �! Town of Queensbury Dept. of Community Development Date inspection request received: Building& Code Enforcement . 1 742 Bay Road Queensbury,NY 12804 Arrive \7:,v- d�i pm Depart / j spector's Initials ofor NAME: Lew' 1 PERMIT# � c LOCATION: �jLc i 2 c 49 DATE : z GeV TYPE OF STRUCTURE: firel RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place\ j The contractor is re •• ible ;s r providing protection fro for 48 hours following the p1.cement of the concrete. Materials for this purpose on s'.- Foundation/Wallpour t Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab Plumbing Vent/Vents in P1 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 f, `Framing F Jack Studs/Headers Bracing/Bridging Joist Hangers 55: tc5 v‘ Jack Posts/Main Beam l �Ti Air Infiltration Barrier `1 EAN, 1 Fire Separation 1, 2, 3, hour Penetration Sealed Fire Wall 2, 3, 4 hour Firestopping GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Buildi rig& Code Enforcement 742 Bay Road Queensbury,NY 12804 Arrive = ''. - Depart _ __ sm Inspector's Initi+f� NAME: ASi-/ PERMIT# %l— LOCATION: /2c1 DATE : TYPE OF STRUCTURE: RECHECK N/A YES NO COMMENTS Footings/Piers Monolithic Pour Form Reinforcement in Place The contractor is responsible for providing protection from freeziing for 48 hours following the placement of the concrete. Materials for this purpose on ite Foundation/Wallpour Reinforcement in P Foundation/Dampproofin yBackfill Approval Plumbing Under Slab Plumbing Vent/Vents i 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 GENERAL INSPECTION REPORT Town of Queensbury Dept. of Community Development Date inspection request received: Building& Code Enforcement 742 ;,•ay Road Queensbury,NY 12804 Arrive? k-b. 'epart Inspector's Initi NAME: i�'�NC`� \ € *,C� PERMIT# LOCATION: c,K DATE : i-- TYPE OF STRUCTURE: `�c� li`c-1 RECHECK N/A YES1O COMMENTS ootings/Piers Monolithic Pour Form Reinforcement in Place Z- 1,j • The contractor i responsible fo• providing protect h n from Ping for 48 hours folio . g the pl.cement of the concrete. Materials for this purpose ,n to Foundation/Wallpour Reinforcement in Place Foundation/Dampproofing Backfill Approval Plumbing Under Slab- - - Plumbing Vent/Vents in 'lace 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