1999-289 BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 2000 No. 213
TAX MAP NO. 121 .-2-12 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to RABINE Jrnai & PEARL
OWNER of property located at 669 SHERMAN AVF Street,Road or Ave.
in the Town of Oueensbury,To Construct or place a s-rnFN_ T.AT.----AnDITI^N AND 2 CAR GARAGE
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 Oueensbuty Building and Zoning Ordinance.
1. OWNERS Address is
669 SHERMAN AVE.
QUEENSBURY.,.• NY 12804
2. CONTRACTOR or BUILDERS Name
• RABINE, JOHN
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
5. ARCHITECTS Address
• 6. TYPE of Construction—(Please indicate by X)
RESIDENTIAL ADDITION
I Wood Frame I )Masonry ( I Steel I 1
7. PLANS and Specifications
I.I.24: SQ FT RESIDENTIAL ADDITION AND 2-CAR ATTACHED GARAGE AS PER ,
PLOT PLAN SPECIFICATIONS
El. Proposed Use
RESIDENTIAL ADDITION AND 2-CAR GARAGE
PERMIT FEE PAID —THIS PERMIT EXPIRES August 2 19 2001
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueonsbury before the expiration date.)
2 August • 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Gueensbury
Building and oning Inspector, , ''
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury •Dept- of Community Development •Permit No. qq—C>14C-6/
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: r 4 l upp2.4e, Sh inP
Property Owner's Name: )-,n A. Ye-,J1_ X,4.13.;s)Z -
Property Owner's Mailing Address: .4 upp.e Sh-ee'rr7pe+-,
Installer's Name: �('{� c �3rn 1 Phone # I q 13
. Number of bedrooms (if residential): Total daily flow: '/ b
(residential - compute @ 150 gal./bdrrn.)
Topography: )1 flat, rolling, steep slope % of slope
Soil Nature: )p sand, loam, clay, other /depth:
Ground water: at what depth? 8 feet / Bedrock or Impervious Material: at what depth? feet
Percolation test: not required, required [rate min. per inch J
Domestic water supply: municipal, )' well, other
If domestic water supply is a WTI T, water supply from any septic absorption is I/O feet.
PROPOSED SYSTEM
Septic tank aeon (minimum size: 1,000 gal.)
Tile field: each tre?fcfi-"1-IC feet / Total system length: 'VD() feet
Seepage pit(s): number of / size each: . ft.by ft.
Size of stone to be used: # / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: g Uons
Alarm system and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or
approval al- d which is based upon or is wed is reliance upon any material raisrepre-sent&ion or failure to make a
material fact or circumstance known by or on behalf of an applicant, chAIl be void.
I have rid the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queensbt.-y Sanits,ry Sewage Disposal Ordinance.
Signature of responsible person: . —%�j - Date: . )c ( 9
1
CP-D2(1)7
t _ ENERGY CODE COMPLIANCE APPLICATION
s v 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:
abn A, a Pew) /069 uppee
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - square feet
•
2 . Type of Heat - Electric Oil Gas Other
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
b . Exterior walls R 6 i
c . Glazed areas R
d. Exterior doors R =laE
e . Floors over unheated spaces R '790
f . Edge of slab on grade (heated building) R
g. Basement/cellar walls (above grade) R
h . Basement/cellar walls (below grade) R
1 . Heating/cooling-ducts-piping in unheated space R
6 . Service (domestic) hot water heating device
Conforms to minimum efficiency per cod Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Applicant's ignature Date Phone Number
,� 11/ 9 9/ 97 .79.67-1z39
INSPECTOR' S REMARKS :
BuildingPermit` Application ��' —
Town of Queensbul y -
° Dept. c f Community Development, 742 Illy Road, Quc'en.t•Gm y, N' 12804 /7O1-8256/ 3 8
BUILDING �+< . CODE ENFORCEMENT
NFO1i' CEMEN7'
r____ Requirements prior to issuance a,.
A portrait must be obtained boforo \ of this permit: PERMIT!1!_E NO. •� �a
beginning construction. No inspections 4.
will 1,0 mado until applicant has received El Zoiting Board Action PERMIT FEE PAID$ Jj
a VALID BUILDING PERMIT. All Area /Use 00
applicants` spaces on this application RECREATION FEE I'
• MUST be completed and.the signature E i
of the applicant must appear on the.
Planning Board ActionREVIEWED !I}:
1 1�pllCRliUrt fUrm. n�.a�a+ silt / SubJivlsitm /Other
��ifdi� &Team.
). J Recreation Pee Payment ) i
Applicant' 1 1(1 N i�R;trI .1 191 h1/1€ Owner: JC I) I i 4_nn , if , 'C
Address: 10 t 1�'Per t5 ;((Y1C e /r'1(.t v-e Address: L)PPer
Prjyyp ai f• Lgji
Phone # 11 ��jj —2 4 3 )3,01( '
� � &._ - 15_3Q_ Phone # (57 i ) ) 8 -4)3
Property Location: f' ,rn t°.r t ,p Q,r '1,P,C act r� PO SCOj� ue
Subdivision Name;' Tax Map Number. I�f I _l
Secliun mock I nt
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE OF New Building: CONSTRUCTION: $
residence / commercial (
X Addition to Building:
tCesiden.ce) / conunercial OCCUPANCY INFORMATI N:
Alteration to Building: Primary Building -
residence / commercial. Single Family Dwelling
Residence / Commercial Two Family Dwelling
no change, to exterior size Family Dwelling
• Office
Other Work (describe. below) Mercantile
Manufacturing
. Other •
GROSS AREA OF PROPOSED STRUCTURE: ..3`3 i r
1st Floor l3 . ItjOi 3 .Lzf ADDITION, what will use
2nd .Floor of new addition be7 :
f t CC�x-C �1
Other Floors � sq. IL• . �- �"�t ��c� coca,. ..--
(not unfinished cellar or basement) /
ACCESSORY BUILDINGS:
• Detached Garage , Aar75
TOTAL FLOOR AREA: \ \ cLf SQ. FT. Attached Garage car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
i u . a co Other
0 (A FEET X 6 4 FEET
•
Foundation Type: (MUCK Will any second-hand or ungraded
' Number of Stories : 0lumber be used? If no, fo - fiat?
(habitable space only) ( )
Height (grade to ridge) : feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all ti h applies)
i
to be installed: ) 1 e Electric / / Gas / Wood
Forced Hot Ain/ Baseboard / Other
Person responsible for supervision of work as regards to building
codes is : .1 1T r\ kc %NJ? 0(tq u PPer crate r,,u•e. '74%-G-- Q
Name Addr sys Phone
Builder r,. .�(\ ( Qc r� 1't? u PIS- 1e,ir"Ylet.nc..6e: `—'ict 3r1
Plumber: ' yYl(\ (a- Qcx4oino iv bet 001q2ir 51'1P.r t�l 2 S. ,a3
� �� 7t 9
Mason: &car c tir doled o S)�Prr ,nc(ur -7gc, t )q
Electriciani- ( it q_ Op er Nhermcan ogle. —Kt$ Id-')c1
DECLARATION: Please sign below after you have carefhdly read Ilse 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 sill proposed work to be dome on
the described premises and that all provisions of the Building C:cxle, 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 Occupancy'or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by
a licensed surveyor; drawn to scale, sho. ing actual location of project on premises.
4
Signature: i -_ •
•
finer, owner's agent, architect, contractorrr
J.�l' !l' !l:l._l' 9_1;ka.1'IOC �_l .. ;1IP_l9... :JAW J!_l' . J_.._.I J.P_l'JP__l' ..1 ALI J_ILl'At_l tALI AL:�I Al'J_tk:I�_l'J �._l' � XI,�1 ..J. �_l•M"l-L._l' ,_l' .. A._l':,!l J!_l' .. �c.r" ),.x.,,
THE NEW YORK BOARD OF FIRE UNDERWRITERS 1a54 )_, , i
rc; 0;IN'1:; BUREAU OF ELECTRICITY` ;),
40 FULTON STREET, NEW YORK, NY 10038 1r
j, Date l.)l!;C:Eili:!) t 1.2,2.000 Application No. on file a ',,; "3t4)730t)/t}O S3. !R 2968 '
THIS CERTIFIES THAT �`
jJ only the electrical equipment as described below and introduced by tHeppliccint narfted on the above application n ber is in the premises of r
:' ':
i i ° is t I"s'3 ;" ' ( MVP:,
�� e e %44.04(toot .� 'w' C j!c ,i'{l HU C ES13:141,, 669 tE ia_k-t illtilEtt44 HVP:, C)ttio,faiSN 4Y, s3Y 0 MA , �'1 1f �r r
in the following location; ❑ Basement ;1st Fl. ❑ 2nd Fl. ram. Section Block Lot ;T
mo was examined on C'y�;(''y;;t{3i,;.E 0 1, 00 o and found to be in compliance with the National Electrical Code. . Ir
't,
,=;<' FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ii
_' OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. i
ii'
fc' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
� 'Yr
SYSTEMS
i AMT. K.W. OIL H.P. H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. H.P. NO.OF FEET AMT. WAITS
ii6ii
ll■_■ Y
' SERVICE DISCONNECT No.OF TER S E R V I C E
=t' AMT. AMP. TYPE EQUIP. 1 0 2W�3 0 3W 3 0 4W NO.OF CC COND. A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W G. IF
�� PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL ,j}}�
IN r)-7.'
•
OTHER APPARATUS: W� / 1y
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This certificate must not be altered In any manner; return to the office of the Board If incorrect. Inspectors may be identified by their credentials.
Y.0 Y4Y 5.5 Yes i Y415 SAY Y.Y 7.Y Y�i-,-.Y,Y,i;Y.Y.Y.Y,.s.i Y.,s.Y.i: .Y Y.,?. .Y Y,.Y Y Y,ir,Y,,Y Y.l,Y.Y YW(.7.Y Y�Y 4Y YeY Y.Y YiiY;iiir,YiY 4'?Y�Y 7 Y l':Y Y Y Y.,T,4Y YAK Y.Y Y�Y SWY Y..4il
rnov Gna R!III nIMr, nGo t CTI•ACKIT Tt-JIC rnpv nr rFrTIFIC ATP MI IST Nrir RF Al TFRFr) IN ANY MANNER.
P16A-Ck tAe_
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. Arrive 310amjmL Depart Z.:. s
Inspector's Initial
NAME: pt-It1,\ P1 PB 1 l.�E PERMIT#C fr
LOCATION: �L- t-\A)� 9E DATE: -- 0 ,
TYPE OF STRUCTURE: 010--Vk
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
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place •
Rough Plumbing '1 •
Heating Rough-In '
`insulation
Foundation Walls Interior R-
Foundation Walls E�'�erior R-
Floors R-
Walls R- `A 1,4?
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent 1,
Framing
Jack Studs/Headers •
BracingBridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier i
Fire Separation 1,2,3,hour
Penetration Sealed
Fire Wall 2, 3,4 hour
Firestopping