2000-320 BU UDING PERMIT
Town of Queensbury,742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 8750 Building Permit No. 20)00)210
TAX MAP NO, 90. -7-6
Permission is hereby granted to FREDERICK, MARK
Owner of property located at 12 LADY -SLIPPER DR.
in the Town of Queensbury,to construct or place a 2—CAIR DETACHED rxARArw
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the NYS Uniform Budding Codes and the Queensbury Zoning Ordinance.
Owner's Address:
12 LADY SLIPPER DR.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
FREDERICKr—MARK,
Contractor or Builder's Address:
Electrical Inspection Agency:
Type of Construction:
7-CA47
Plans and Specifications:
Proposed Use:
—CAR"DETACHED,,
PERNHTIFEEPkb 4,THISsPERNHT,'
(If a longer period is required,an application for an extension must be made to the Code Enforcement
Officer of the Town of Queensbury before the expiration date.)
Dated at thel5ownp Qutensb this -Till-:"--;'
SIGNED BY for the Town of Queensbury
Enfbr&me Officer
isurtaung -permit App cat an
7b .f Q
LLG'G'f1SbGl1 y - Dcpr, of co,JrJJJru,iry DevernprJrc:J,r, 742 13a31 Itvart, Quec'Jta•bruy, NY 12804 /761-825rJ "
BUILDING cQc CODE BNFORCCMENT
NOTICE Requirements prior to issuance
A rwrmil must be obtained bal'bro or UiI5 permit: PCRMI7'I tI C NO. +t }G
Iwgiiiniug c,nxnlruc[Ioii, No ineiwaticiun gam. 2 �
will tw ixuid,i until nppticunt Iins receive,! rIrl'�1v_ tt J'LiltAdtJ'J•'Lil I itrU 3C "JJ ✓
a VALID BUILDING PERMIT'. All u
Area J use RECREATION ICF PAID$
npplicntils' sFinces au Uxis npplicntiori ��l/ ZQ00 iV1(UST'be complete,,r tlto siguiUur° I-t j�I�uttJtg Gi3ogUld ACtioit
of rho upplicnnh m.t.nppenr oax,llxa" `+� �1'�2 1-j REVIEWEU I3I:
f I �St� t1,&.Yisla+,7�i,r"�niCr Urtt Jinti h4c,,r.rt�r
pIicntign form: n...+� �
Applicant: ��
Address: �. •� �Us1dra®t� Address: —_t L-e KS1 � . L,
Phone # (El�--) ' _ �� 1'llolte # M
6
Property Location: t;2 1 r� ,
.Subdivision Name: 1'nx Map N,nxiber_ ---z�--�-- �-
- Section Block Vol
NATURE OF PROPOSED WORK: EST I TE D M AIRKET VALUE OF THE
New Building: CON RUCTION: $_ 49 sn
residence /
Addition to Building:commercial
residence / commercial OCCUPANCY INFOrtMATION:
Alteration to Building: Pr* ry Building -
residence / commercial ingle Family Dwelling
Residence / Commercial Two Family Dwelling
no change to exterior size Family Dwelling
Office
Other work (descr.�be below) Mercantile
�'ceheve -L11`3lns' Manufacturing
Other
GROSS AREA OF PROPOSED STRUCTURE:
1st Floor. . . . . . . . sqi ft. If ADDITION, what will use
2n'd .Floor... . . . . . sq. ft .- of new, addition be7 :
Other floors . . sq. ft.
(not unfinished cellar or basement) ACCESSORY BUILDINGS:
Detached Garage 1, 2 car---
TOTAL FLOOR AREA: Y� SQ. FT. Attached Garage 1, 2 car
-- �"- EW STRUCTURE: Private .Storage Building
IZE OF N Commercial Storage Building
F X Other
EET (� FEET
Foundation Type: }�®� 9, Lpca.v- Will any second-hand or ungraded
' Number of Stories: lumber be used? If so, for what?
(habitable space only)
s��2 '�iC�-51,:�
Height (grade to ridge) : oC,7 � :Feet TYPE or. rIEATING SYSTEM:
Number of fireplaces and/or woo stove (circle all which applies)
to be installed: Electric / Oil / Gas / Wood
Forced Hot Air / Baseboard j Other
Person responsible for supervision of work as rds to building *
codes is: to SI b egar P 13 — & ,
Name Add esss Phone
Builder:
Plumber:
Mason:
Electrician: -
DECLARATION.- Please sign below after yore 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 eoinplied witli, whether specified or noted, and
that such work is authorized by the owner. Ftirther, it is understood that llwe slialI submit prior to a
CertilC ate of Occupancy'or Certificate of Compliance being .issued, an AS BU LT PLOT PLAN by
,used; surveyor; drawn to scale, sitowing actual'location of project on premises_
Signature:
(owner, owner's agent, architect, contractor)
1=
GENERAL INSPECTION REPORT
(518)761-8256
Town of Queenshury
Dept.of Community Development Date inspection request received:
/ ,?, -
Building&Code Enforcement ��
742 Bay Road lit ' ��
Queenshury,NY 92804. Arrive am/pm DepartG�f:
Inspector's Initials O
NAME: f C . e PERMIT#
LOCATION: r DATE:
TYPE OF STRUC`f`URE:
RECHECK
N/A YES NO COMMENTS
mgs/Piers
onolithic Pour Form
Reinforcement in Place
The contractor is re spo ible for
providing protection am freezing
for 48 hours followi the placement
of the concrete.
Materials for this p se on site
Foundation/Waln"WPI
ur
Reinforcement a _
Foundation/Damppr fing
Backfill Approval
Plumbing Under Sl
Plumbing Vent/Ven ' Place
Rough Plumbing
Heating Rough
Insulation
Foundation Wall Interior R
Foundation Walls xterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping i
unheated spaces -
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack PostsA ain Beam
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestopping
Office Use
GENERAL INSPECTION REPORT Inspector:
Town of Queensbury Ready at time:
Dept. of Community Development Request received. d Meet:
Building& Code Enforcement At time:
742 Bay Road
Queensbury, AT 12804 ARRIVE-am/pm: DEPARTIZ6 amIpm Notes:
(518) 761-8256 Inspector's Initials
NAME: PERMIT � C;2
V
LOCATION: a4t���INSPECT ON(date):
0 —
TYPE OF STRUCTURE: C�2 C4,(t-
U
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour A
Reinforcement in Place
Foundation/Dampproofing_ 7Z—
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents 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
ramm
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Bearn
Air Infiltration Barrier
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2,3,4 hour
Firestoppmig—
L:\SueHemingway\Building.Codes.Inspection.FORMSkGFNERAL INSPECTION REPORT.doc