97-016 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 5 19 __99
Nk,\ )),
This is to certify that work requested to be done as shown by Permit No. 4 7 61 7 A
. has been completed.
• This structure may be occupied as a RESIDENTIAL INTERIOR ALTERATIONS
Location 64 DIXON RD.
Owner "PCVPTH !Pr1TT.T. T,FF: A TZORREN
TAX MAP NO. 114 -2-21 By Order Town Board
TOWN OF QUE NS URY
Director of Bldg. 6c Code Enforcement
BUILDING PERMIT
VALUE $ 1500TOWN OF QUEENSBURY No. 9701
TAX MAP NO. 114 . -2-21 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to FATHERGILL, LEE & DOREEN
OWNER of property located at 72 DIXON RD. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a RESIDENTTAT, TNTF:RTOR ALTERATIONS
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. OWNERS Address is
72 DIXON ROAD
GLENS FALLS , NY 12801 •
2. CONTRACTOR or BUILDER'S Name
DUVALL, DENNIS
3. CONTRACTOR or BUILDERS Address
1 HAVILAND AVE
SOUTH GLENS FALLS , NY
4. ARCHITECTS Name
NEW YORK BOARD
5. ARCHITECTS Address
NEW YORK BOARD OF FIRE UNDERWRITERS
6. TYPE of Construction—(Please indicate by X)
RESIDENTIAL ALTERATIONS
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
240NCQ FT RESIDENTIAL INTERIOR ALTERATIONS AS PER PLOT PLAN
SPEICIFICATIONS
8. Proposed Use
RESIDENTIAL INTERIOR ALTERATIONS
8 PERMIT FEE PAID —THIS PERMIT EXPIRES January 30 19 99
$ (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.)
30 Da f January 19 97
Dated at the Town of Queensbury this Y o
SIGNED'BY (ryLU'12- ' for the Town of Queensbury
Building and Zoning Inspector
°u Building Permit Application
8' b-tPd
Town of Queensbury - Dept. of Community Development,' 742 Bay Road, Queensbury, NY 12804 /761-8256J
NOTIC"O BUILDING c& . CODE ENFORCEMENT
E Requirements prior to issuance
A permit must be obtained before of this permit: PERMIT FILE NO. (:) 1_1LO- lia-.
beginning construction. No inspections
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 iD$
MUST be completed and•the signature
of the applicant must appear on the n Planning Boar d Action REVIEWED BY. d
4pplication form. n„v,t,.,„. SPR / Subdivision /Other / Build'g Inspector
//�� Recreation Fee Payment N.. J
Applicant: De.///7/1. d‘i---i-er /j � �/n
// Owner: �e� E/`edo/, /CD l'- et�fi//
' Address: / �711�/6- ✓ _j i .e ..5.7;/i'1-' Address: 7.- 0/X en, R d,
•
Phone # ( ) )h's- 701L// Phone # ( ) 77-3 - z/d'.'d
Property Location: ''‘,2 D / X v,-, g 1 u' / ✓) 1
Subdivision Name: Tax Map Number 1_ 1 I oC
Section Block T.ot
NATURE OF PROPOSED WORK: ESTIMATED MARKET VALUE FHE
New Building: CONSTRUCTION: $ / 5—�o. T, d
residence / commercial •
Addition to Building: _-
residence / commercial OCCUPANCY INFORMATION:
t/--Alte - ' on to Building: Primary Building -
resid-nee . commercial Single Family Dwelling
Residence / Commercial wo Family Dwelling
no change to exterior size Famil Dwe .
Office :``
Other Work (describe below) Merca tjlb.. 1-"-•-
Manuf ctur' '
Other JAB 2 01997 •
GROSS AREA OF PROPOSED STRUCTURE: • . PV
1st Floor o� �/U sq. ft. If ADD ITIO , BlWilit•GMe):,DO e'
of ne
2nd .Floor sq. ft. w addi ion e7 :
Other Floors sq. ft.
(not unfinished cellar or basement)
ACCESSORY BUILDINGS:
Detached Garage 1, 2 car
TOTAL FLOOR AREA: r/d SQ. FT. Attached Garage 1, 2 car
Private Storage Building
SIZE OF NEW STRUCTURE: Commercial Storage Building
Other
FEET X FEET
Foundation Type: Will any second-hand or ungraded
Number of Stories : lumber be used? If so, for what?
(habitable space only)
Height (grade to ridge) : feet TYPE OF HEATING SYSTEM:
Number of fireplaces and/or woodstove (circle all which a pli s)
to be installed: Electric / Oil / //Wood
Forced Hot Air / Baseboard / Other
Person respon ible for upervision of work as regards to building
codes is : G i4,s � e, // / /7/‘/"1" c/ /9j e 51 /:-' 7 !/5--7 d.V.P
Builder Na Addr ss Phone
B u1 r id(-7 //'67l7 gee/ /r✓rkll/ or- v1ei'l cOoi&//s .
Plumber: 1/
. Mason:
Electrician:
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, 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 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, showing actual location of project on premises.
Signature: ae ////7/.S /2
(owner, ownergent, architect, contractor)
•
•
ENERGY CODE COMPLIANCE APPLICATION
TOWN OF QUEENSBURY, WARREN COUNTY
9000 HEATING DEGREE DAYS S{ - - -`•
JAN 2 0 1997
Compliance Methods : PART 5 - Acceptable Practice Me h d;,,,
1&2 Family Dwellings n1 on.•t y {
PART 6* - Thermal Rating - Component�Tra` e��00-frs----•-
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
D w7� e!`
APPLICANT' S NAME: PROPERTY LOCATION:
Zee D ree i / Aei ,// ?a )9 / x Rd
PART 5 METHOD OF COMPLIANCE BY ACCEPTABLE PRACTICE:
1 . Gross Floor Area - '/Q square feet
2 . Type of Heat - Electric Oil ZGas 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 • C ///n R / /
b . Exterior walls R 15
c . Glazed areas R
d_ Exterior doors • R
e. Floors over unheated spaces - R
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 code • Yes No
TEMPERATURE CONTROL MAXIMUM SETTING 140° - WILL NOT BE EXCEEDED
Applicant's ignature Date ^ Phone Number
INSPECTOR'S REMARKS:
raQQ../t- C4.7 ..,
- RESIDENTIAL FINAL INSPECTION REPORT „c)ct.u\
1
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement :O 0Dept. of Community Development Arr°ive�/�'`,'I.rt pm 'i rt
3 Town of Queensbury 7 .ector's Ini
742 Bay Road 3, l6 7
Queensbury,New York 12804 �'LJ
NAME �C7 eJNeC:),,,I ` \ PERMIT# DI-1 —6
LOCATION Lp� l�,�� ( -� DATE —
TYPE OF STRUCTURE Jam- \A- .
N/A YES NO COMMENTS
Chimney Heightl"B"Vent/Direct Vent Location 1
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 in. or more
Interior Handrails stairs bo •• e 3 or more risers
Grade 2%away from fo dation \
8"clearance to sill plate
Gas Valve shut-off ex sed/regul for 18"above grade
Gas Furnace shut-off within30 f or within line of site
Oil Furnace shut-off at tran o furnace area
Furnace/Hot Water t ating
Relief Valve(s)install
Headroom,6 ft. 6 in. o stairs
Basement stairs,6 ft. in.
Handrail exterior sta• s both sides more than 3 risers
Interior privacy/trim/ oors/main entrance 36"
Floor Finish
Bathroom/Kitchen atertight
Interior Handrails Balconies/Landing 18 in. or more
Railing across window in stairwells
Smoke Detectors'
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
•
3 hour fire door/door closer
Garage fireproofing
Garage penetrations sealed
Furnace in separate room protected(in garage)
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
arn (518) 761-8256
TOWN OF QUEENSBURY
BUILDING 5 CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: AR \.. DEPARWCO IN �'
REQUEST FOR IN P CTION RECEIVED: ), 97
NAME {eN ),
LOCATION / a 0 , J((n'\ 0-
DATE 11---a3 7 PERMIT 7-67�
TYPE OF STRUCTURE: _.: n -!!!! /*II
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS ti
MONOLITHIC POUR FORM
REINFORCEMENT IN PLAC
THE CONTRACTOR IS R PON BLE FOR
PROVIDING PROTE TIO FROM REEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB •
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
HE ING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R- _
WALLS w ITC - J R- 1.
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRO 9b DEPART
REQUEST FOR INSPECTION RECEIVED:
NAME F6t HE 6 vLL
LOCATION Cb i EP__ cF R61-1A i Y.Qm
DATE I \ 2r 7 PERMITI ( --s t-On`Q
TYPE OF STRUCTURE: I01-EQ-�(�� tr-�L►T KltliC
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR F0P141
REINFORCEMENT I$ PLAC
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION ROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
$ACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING _
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER
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- •
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT �a
742 BAY RD., QUEENSBURY NY 12804
r/
INSPECTOR'S REPORT: ARFFj�•TJ�j DEPART
REQUEST FOR INSPECTION RECEIVED:
NAME
LOCATION CD(4.2ec o E �� � ����
DATE t \ ri I97 PERMIT A `l1 --C),I C?
TYPE OF STRUCTURE:) 1IZTF_ t A L�E�E 11�Ct-.4?
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS lir
MONOLITHIC POUR FORM AL _
REINFORCEMENT IN PLA _
THE CONTRACTOR RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PICE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPOSE ON SITE,_
FOUNDATION/WALLPOUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB '
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS MAIN BEAM
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
NSULATION• E E
FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R- •
� ,.12--S0 o�� Lt VACS kw Cq
c-4C:?..!:a�.cA.tC')..9A?/'Jn•s_N:!.C.I.•AJ.7Al.n')"._C'a�.lJ.".lad-P..AgJIn'.).�.C�� a.9,C11,9-_C7,v.CAS(.:. .C7.1'._.:?,CJ��4�n-,..ti:,�.::?,.,,,,sn J." 1_�.l....,Ax:.CJne....J__z,.4�..,,.,s l•J..C,,,cC9,,AJ9,.. A'JJ.l7v�ti�S-L' �.1'7A.,�l_..l'a�F
Ji IY
THE . NEW YORK BOARD OF FIRE UNDERWRITERS AGE 1. 'Y
• 11-7)0 ;.'1 BUREAU OF ELECTRICITY
ti
111 WASHINGTON AVE., SUITE 704, ALBANY,. NY 12210 y
+t
• Date k'I;, t ;.ta`1"s �' <:1 i, l�t�l#3 Application No.on file tt J 4,95.4 1')/9 i A I. I `:3.1- ;T
So THIS CERTIFIES THAT Th! —Di IT
only the electrical equipment as described below and introduced by the applicant name on he above application number in the premises of ;y
-o
kG Pry°'{{:3 q5y iC"}fit �" y Eq°i":IL'1 T' T1`: Y
F 4' ER ILL.I,. .<.. S:1. + 1 BO, t-d�11•AI.'...13.;�R s ,T
•, in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot r
was examined on 1Ami,j 15,ii ;c,6 and found to be in compliance with the National Electrical Code. ,T
-,' IT
1 FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;T
j, SWITCHES
{ OUTLETS INCANDESCENT•FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. �,�
�: DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 'r
1• SYSTEMS Ors
' AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS.11:21 H.P. NO.OF FEET AMT. WATTS °
10
SERVICE'DISCONNECT NO.OF S E R V I C E ,;
i AMT. AMP. TYPE METER } if 2W 1.3 3W 3 St 3W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A.W G. NO.OF NEUTRALS A.W.
EQUIP. PER 0 OF CC.COND. OF HI-LEG OF NEUTRAL
j' OTHER APPARATUS: 'i
• ROUGH ONLY-1
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�! i:.Ai l`14J Y..l`1Fit'CC.L RD. i1 >>" 4.(J. !FS. '1 G i
Vl)1'il;i`d;-.�l'C�P t ,. 12804 ` .'yam, '; GENERAL MANAGER 'a
- i� .• - _ S Per Y
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. ;
- - - -
-- --- -'{-i At'pY:i�Y'i�f+��.i�iYA(ip"iflfi'%�ii.Y'iA(Y.(Y.j r�\'Y��•%Ai Y�C'iif.Y.�'Y.YY�Y,/�Y'i�i:'i.f.Yi(YAt•Yp'.Y�Y7�?`/.f'i�C'Y�fY.`C/f(.Y�YY�Y.YrY.Y�YYAYYA�YA(YAY.Y.Y.'?i�.YAYYA°FY�YY.`Y.Y.YAY'%�Y'%i'(YifY.Y
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Member N.F.P.A.&I.A.EI• Etectrtcat Certificate
ATLANTIC - INLAND, INC. - NEW YORK .
Electrical and Fire Inspection-Enforcing&Consulting Service • .
997 McLean Road,Cortland,NY 13045 DATE: ' _.O1--1• / CERTIFICATE NO.: C-19328
OWNER: • Lee f'O i'herV L A �' AS APPROVED FOR:
• 72 D i.xon Residence(r,:i tchen) . `.
1
ADDRESS: Qui?€ n ThUr _
4—cw. l$—recept. /6—md. base fix. /is—
vent .' t,nXX
•
•
This certificate applies only to the electrical wiring and equipment listed above on the noted date. I
DennisDa V ii13. warranty is expressed or implied.on this visual inspection.This certificate shall be valid for a period
ELECTRICIAN: one year from the above noted date.Should the electrical system be altered in any way including,but n
1 ...(4 l V i i.D lid A V E, - limited to the introduction of additional electrical equipment this certificate shall become void.
ADDRESS: "., Faith,`�'i�-�u o MY. 12;303 addition,this certificate applies only to the occupancy use and ownership as indicated herein.Al
change in the use, occupancy or ownership of the property indicated above the certificate sh;
' immediately become void.If for any reason this certificate becomes invalid due to the above mention.
condit ns,a r -i spection by New York Atlantic-Inland,Inc.is necessary to validate the installation.
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