1988-250 j
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19 _
r)A t \ok Crbb)'
This is to certify that work requested to be done as shown by Permit No. 88-250
has been completed.
This structure ma be occupied as a Addition - One Family Dwelling
Location
Owner John Matthews
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-250
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to John Matthews w
OWNER of property located at 9L East Side Lake George Street, Road or Ave. ti
in the Town of Queensbury,To Construct or place a Addition — One Familq Dwelling
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 ti
0
R.D.#1 - East Side
Lake George, N.Y. 12845
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2. CONTRACTOR or BUILDER'S Name n'
Same
3. CONTRACTOR or BUILDER'S Address
Same
4. ARCHITECT'S Name
(11
H.
Q
5. ARCHITECT'S Address O
h
W
O
6. TYPE of Construction—(Please indicate by X)
W
kx)Wood Frame ( ) Masonry ( )Steel ( 1 (p
7. PLANS and Specifications
No. 16' X 20' as per plot plan, specifications and application
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8. Proposed Use ti
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ADDITION — ONE FAMILY DWELLING N'
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(D
5.00 C/o
$ 28.00 PERMIT FEE PAID —THIS PERMIT EXPIRES DecemhPr 7 19_88
(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.)
Dated at the Town of Queensbury this 18th Day of May 19 RR CD
SIGNED BY ill i 0 s'L%,.LLCiI2_, for the Town of Queensbury
Building and Zoning Inspector ,71.15‹. .
. TO BE COMPLETED BY BLDG. DEPT. O r
�] Application No. tom. i F( Pn 7, ,
_Jo[uri oI Queni/,ur1 Permit Issued 19 1 `-' 111 ',
BUILDING and ZONING DEPARTMENT Permit Expires 19 • 1. PR 2� � -)
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ,
Queensbury, New York 12801 Variance No.
!v i -b Site Plan Review No. r_'•UP-DiN:: do CODE DE T
`�V ) %� � Approved by: • /'L r � �v
/y J\
iJh APPLICATION FOR "—r'
r
BUILDING AND ZONING PERMIT 3 �k S7z
* * * * * * * * * * * * * * * * * * * *. * * * * * * * * * * *j * * * * * * * *
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
The owner of this property is: ,1,:'r11t/ t', 4ui T"i/&sti
. P.O. Address R.0=14 EftST ,Si )G OW* I�# 011= 4). y Tel. lv�js-.5 3C
1 Jl a�
Property Location: 1 i Acr Sill �.•� F Lt:1°T T6 JobvS I�tly��J Map No. / /
• Street number or building lot nuer
Subdivision name (if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
Name P.O. Address Tel. No.
Name of builder j'„r}-m e Address Tel.
Name of plumber 5!,9-v✓1`P Address Tel.
Name of mason S -,vy4 Address • Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
„Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
L/Addition to a building * drawn -reasonably to scale and attached hereto,
Alteration to a building * showing clearly and distinctly all buildings,
_
(no change to exterior dimensions) * whether existing or proposed and indicate all
Other work (describe) * set-back dimensions from property lines. Give
_
* street and number or lot number and indicate
* whether interior or corner lot. Show location
FOR DEMOLITION PERMIT, STATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED. * of septic disposal area.
*
* COMPLETE INFORMATION REQUIRED BELOW.-
* Size of property ,D /i-(,C.tS ft X ft.
* Existing building(s) Size ,Q./( ft X 44,2 ft.
* _
PROPOSED BUILDING AND USE: * Existing building(s) Use j7 47t.,
Size of new structure /tea ft X - C7 ft *
F6'undation-pier/slab/crawl/partial/full) * Proposed building, distance from property line
(circle one) *
1 * Front yard Gl/c ft Rear yard (�0 ft
No. of stories (habitable space) •
* Side yards f' ft and 727 ft
Height (grade to ridge) d / ft. * If on corner, setback from side street ,///9ft
If residential, no. of families .
No. of rooms(excluding baths) Z * OCCUPANCY INFORMATION
No. of bedrooms 3 *
* PRIMARY BUILDING -
No. of bathrooms .2 *' I/One family dwelling
Primary heating system i &,S/L Two family dwelling
Type of fuel �j/j` ryl/J * Multiple dwelling / Number of units
No. of fireplaces to be installed /, Permanent occupancy
Will a wood stove be installed? /2 * —Transient occupancy
Central Air conditioning? C.) * Business
*
BUILDING STYLE, PRIMARY STRUCTURE *' Industrial
y * Other •
Ranc Contemporary Log cabin * If addition, what will use he?
ised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * 1/hetached garage/one car/ o c / car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * - * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION $-- � /l� �y
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl ,
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING'.SPECIFICATIONS: . .
Type of :construction, wood frame, fire safe,etc. v�/r�rJi� F,Avyr
Will any second-hand or ungraded lumber be used? If so, for what? /V')
Foundation wall material
6rnl(/lerp '64,4,4 Thickness /(J et
Depth of foundation below grade (to bottom of footing) 5 ' • -
Will there be a cellar? • s. Heated or unheated? Ulp IOrea' Floor sq. footage ,' j sq ft
Will there be a basement!? ,' Will any portion be used as living space? 4,97
(If so, what port' n? sq.ft. - - Type of use?
Type of roof - sloped lat/shed/other Material, of roof A/y;17.r SVi,L i es
Size, wood studs "X (', " spacing /h "o.c. length 5 ft. . ,
Joists(floor beams) 1st. floor o "X g " spacing J, "o.c. span /41 ft.
oasts floor s1 -2nd—#floor- "X_____" spacing_`__ "o.c. span ft.
Over-la s ceiling eam " spacing " an----f
Rgo-f-rufLeL spas-i span -ft
Roof trusses(pre-engineered) spacing y "o.c. span,2 O ft.
Exterior wall finish/i N-of what material? ,J, c &-rkov- /7,47. ` ill
Interior wall finish /� 5 fre 1- ,i.& .-lc
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: ,y/�,9
Is there to be an opening between garage and dwelling?A� j If so will a Fire-rated
door, enclosure, and self-closing device be; provided? %%
Will a flue-lined chimney be installed? Height above roof jJ/,/a ft.
Depth of chimney foundation below grade ,i ft.
Depth of fireplace hearth /y/ft. in. '
Water supply - Municipal or private well . e 4/
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties j/0 -i' ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
I swear that 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.
SWORN TO BEFORE ME THIS Signature_a. , � ��
011.1e , owne :s agent;arcnit ect,contractor .
day of 19 r '
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
INTERIM BUILDING PERMIT
PERMIT APPLICANT 360 /�T--�-� {._,�r
CONSTRUCTION LOCATION L . EAs-r-sf06- •
EFFECTIVE DATE • /3/?
APPROVED BY •
SPECIAL CONDITIONS :
•
•
This will certify that all submittals for a Building .
Permit have been received and fee has been paid .
During the processing of the Permit, the above named
may begin construction per plans submitted . It is the `
responsibility of the applicant to obtain the Permit -
from the Building Department, following processing .
POST THIS INTERIM PERMIT IN A C SPICUOU L ATION ! !
Building & odes Department
. TOWN OF QUEENSBURY
•
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
TEMP.# i 4M I
- D E
8 ,7) 0
•
CITY OR f
VILLAGE (�j:,_Jt;l=;,(l)�."i� t, .`y Lii��'`TOWNSHIP - COUNTY ' % �'., . _,
STREET AND NO.OR (j
ROAD AND POLE NO. POLE NO.
BETWEEN WHAT TWO r'; -- (�
CROSS STREETS IS r
PREMISES LOCATED? SECTION `""• '''' BLOCK LOT
OCCUPANT'S i BUILDING f 1 (`, i? . ' {( '- , )1
NAME lJt OH Ai f. ill rn•T i rf k0) OCCUPANCY ��C�z_?a 1„..).tif<',Y'', 6 !...�- ._:i.' P,,,f"f^-l_1,,
OWNER'S NAME •
' j
AND ADDRESS f"r j 1 l> - - d'' r TEL.# .1 "
CURRENT ,+
SUPPLIED r/ �7 '< f FROM THEIR 'V ) i'' CI OFFICE
BUILDING .- WORK DEFECTS
IS NEW❑ OLDJ IS NEWixi ADDITIONAL J' REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No.of Fixtures& BRANCH OFFICE USE
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS
Lam- ONLY
lion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recepis Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
Out-
side
-
Sub- .
base
Base-
ment
•
1st Fl.
2nd Fl.
3rd Fl.
•
REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE •
(NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN _
SERVICE OVERHEAD - UNDERGROUND MAKER •
ENTERS
BUILDING OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR ASIIIPOSSIBLE , NEW OLD
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES DATE OF
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. - APPLIC TIO.
r
- PRINT NAM AND ADWIESS
NAME OF 0plcaeJ i f rri/41 s="(;� ...5 V SIGNATURE ?, ~.., _.
APPLICANT /lk OF APPLICANTS- •,' .riLf <-�,.--
STREET ADDRESS > Y 1 -<--, �pZ�-'� ',`� TELE r NE# �' �--•-�3,
•
LICENSE NO.
CITY OR ('(�N t f CODE ZIP r=, � WHEN APPLICABLE
POST OFFICE
46 EL (REV. 1/86) A SEPARATE APPLICATION UST BE FILED FOR EACH SEPARATE BUILDING
awn o/ Queeni‘ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
•
NAME (7 . ji/
LOCATION 9/ Ci2�� �f . •
Date q/7 / Permit No. ( �C S�
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Roofing
Siding
Masonry Veneer
,R gh Plumbing :x
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke/ Detectors
C 'imney
sULATION:
Foundation r� •
Floors e—j-j
Walls ✓ - j Gj'
Ceiling lc—h'3
FINAL ELECTRICAL/INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
•
7;14 "/4--
Building Inspector
6/86 and-vl
Jown of Qurj
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME
LOCATION
Date 1. I / Permit No. •
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES ,/ NO
'(Footing/Pier Forms ad; v-.-,
Foundation lam/
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofi g
Door Closers
Smoke Detecto s
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELEITRICAL INSPECTION
DRIVEWAY A'PROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
l"G/
Building Inspector
6/86 and-vl
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