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1987-764 ' A S - . �✓ i R l • w CERTIFICATE OF +OCCUP.Ar NkoseY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK _ DaftAugust 6 ig 90 Thin is to certify that work requested to be done as shown by Permit No. 8 7— 7 6 4 has been eotnPleted. This structure may be occupied as a Addition to Ong Faintly dwe 11 ing I 6 Arbutus Dr . I- cation Owner Richard Whitmore i By Order Town Board TOWN OF QUEENSBURY `} Suiiding 6 Zoning inspector BUILDING PERMIT TOWN OF +QUEENSBURY No. 87- 764 � WARREN COUNTY, NEW YORK o Richard Whitmore - PERMISSION is hereby granted to 1 6 Arbutus Dr . Street, Road or Ave. " OWNER of property located at in the Town of Queensbury, To Construct or place a Addition to one f-0tn-i 1 7 elwe. 1 i rig r� 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 same :a w n w 2. CONTRACTOR or 13UI LDER S Name Lee Murphy w 3_ CONTRACTOR or BUI LDER'S Address ri fb Bay Rd . Glens Falls : N . Y . 121301 4. ARCHiT'ECT'S Name S. ARCHITECT'S Address rat Cr C r°t G w 6. TYPE of Construction — (Please indicate by X) d �i ( x) Wood Frame I ► Masonry { I Steel ( ) 7. PLANS and Specifications No. 16 ' x 20 ' as per plot plan , specifications and application . C�. 8. Proposed Use rV Addition to one family dwelling b C $5 . 00 C/O $ 14 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES June 1 , 19 $$ IIIa longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Qateensbury before the expiration date.) Dated at the Town of Queensbury this loth Day of November 19 87 SIGNED BY for the Town of Oueensbury Building and Zaning Inspector To BE COMPLETED By BLDG . DEFT , Application No . /+7w►t Of permit Issued 19 BUILDING and ZONING DEPARTMENT Permit Expires 19 Bay and Haviland Road, R.D. 1 Sox 98 Zoning Designation NOV o 1 No . ° 1981 Queensbury. New York 12801 Variance �,JV ,. Site Plan Review No . T'= 1S ' ._. } APPLICATION FOR P3UILDING AND ZONING PERMIT A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION . ANSWER ALL OF THE FOLLOWING * for a Building Permit to do the following work which will The undersigned hereby applies 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 : Tel, �� _ S . P . O . Address ' Tax Map Property Location : s� Street number or building lot number Subdivision name ( if applicable) THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS : Name P . O_ Address Tel _ Noo n r� �j ./ �' I' r+� 2 Address e� /SC~. Tel . Name of builder � ,� Tel . Name of plumber Address �v I" f -- _—_.._,, �— Tell Name of mason /yyofx K ES�'acvrr� Address - — NATURE OF PROPOSED? WORK : ZONING I NFORMAT I CAN : Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED , * drawn reasonably to scale and attached hereto , Addition to a building all buildings , Alteration to a building showing clearly and distinctly existing or proposed and indicate all � (no change to exterior dimensions) whether exist 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 . C� ft 'K ft . Size of property_ --- — Existing building ( s ) Size a ft X 3ew ft . PROPOSED BUILDING AND USE : � Existing building ( s ) Use 'HDvs � Size of new structure 6 ft X 070 ft ert line Foundation-pierJsla raw partial/full Proposed building , distance from prop y * /I f t (circle one) Front yard ,,.�ZAy ft Rear yard /r No . of stories (habitable space) _ _._ * Side yards /� ft ft and y� ft Height ( grade to ridge) 1 f41 ft . if on corner , setback from side street If residential , no . of families I? OCCUPANCY INFORMATION No . of rooms ( excluding a hs ) Ar No , of bedrooms PRIMARY BUILDING - No . of bathrooms - o'^ one family dwelling Primary heating system Two family dwelling Type of fuel k multiple dwelling / Number of units_.,_ No , of fireplaces to be installed fJ Permanent occupancy Will a wood stove be installed?' :L Transient occupancy Central Air conditioning? 'v Business BUILDING STYLE, PRIMARY STRUCTURE Industrial �, Other n- Contemporary Log cabin If addition , what will use be? Raised ranch Mansion Duplex Split level Old style Bungalow ACCESSORY BUILDING- Cape Cod Cottage Other tom, car/ car Town House * Pc- Detached garage/one car/ Colonial Row two car/ Gar" ( CIRCLE ONE PLEASE } '� Attached garage/one cart Private storage building ESTIMATED MARKET VALUE OF 'Other CONSTRUCTION $ � p +4 - - _ ._ _ _ _ _ _ _ _ _ _ _ _ INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE SIDE of THIS SHEET . TO BE COMPLETED . Form SPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - BUILDING SP'ECIF"ICATIONS . Type of construction , wood frame , mire safe , etc . Wood Will any second-hand or ungraded lumber be used? if so , for what ? Foundation wall materia , /57/fach „ct, Thickness Depth of foundation below grade (to bottom of ) _ oftin Will there be a cellar? /V O Heated or unheated? ,M' o F1 or sq. footage -3 2v s ft Will there be a basement? N � Will any portion be used as living ? r3 ( If so , what port ' n? sq . ft . - - Type of use > space -? Type of roof - slope /flat/shed/other Material of roof u � p � � ; g lr�S Size , wood studs ^ ++ it"� X br spaaingo . c . length -?ft . joists ( floor beams ) 1st . floor "X " spacing__ no . c . span_,/ 6 ft . Joists ( floor beams ) 2nd . floor "x " spacing pro . C . span ft . Overlays (ceiling beams "X spacing ` "o _ span___ ft . IiP. j�� A f- Roof rafters P.,.�-„?C spacing o . c _ span �h ft . Roof trusses ( re-engineered) s ac� '+ p g_ o . c . spa ft . Exterior wall finish C; q+', Of what material? Lvrac cp Interior wall finish 5 re 4 4� ¢G If a garage is to be attach d , describe materials to be used for FIRE SEPARATION : Is there to be an opening bletween garage and dwelling?_ If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? 410 Height above roof ft . Depth of chimney foundation below grade ft _ Depth of fireplace hearth �_�t . in . Water supply - Municipal or iv well C��•,� Ss � �J��� � � + .� SEPTIC SYSTEM Distance from ANY private well ( includin adjoining properties ¢'� ft _ (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury County of Warren A F F I D A V I T STATE OF NEW YORK 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 Owner owner ' s agent , arcni,cect , contractor - day of 19 Notary Public , Warren County , N . Y . * * * * * * * * * * * * * * * * * * * * * * * * * IF IF * * * * * * * SPECIAL CONDITIONS OF THE PERMIT : By TOWN Ole QU EL:1 N:iUUi" WARREN COUNTY , NEW YORK Application fort BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK STATE ENERGY CONSERVATION ( ' ODE Ok A permit must be obtained k, cforc: beginning work . ANSWER ALL of the following : 1 . Gross floor area 2 . Type of heatlGGft'"i C. 3 . Is the building mechanically coaled ? A167 4 * Percentage of area of windows and doors / Z : l� 1 A . over 1 +6 % Only 1 . Uo value of gross area of walls , roof / ceiling and floors exposed to ambient conditions 2 . Floor over heated spaces YES NO AV Are foundation walls insulated ? YES NC ' 1 . If YES # what is the R Value ? 39. Slab on grade YES NO A . If YES * what is the R value of insulation around perimeter of .floor ? 4e In basement heated ? YES NO A . R value of insulation 5 . Type of insulation av Under 16 % Only 1 . ft value of roof and floors exposed to ambient conditions y 2 * R value of exterior walls ZS" 3 . R value of glazed area , /• 4 . R value of doors 5 . R value of floors over unheated spaces Z 6 . R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab - so R value of heated basement/ cellar walls ( above grade ) 9 . R value of heated basement /cellar walls ( below grade ) 10 . Type of insulation 4 C . Controls 1 . Thermostat maximum heat setting �fl D . Duct Systems_ � 1 . Is duct system installed in unheated spaces ? YES 'C a . If YES , R value of duct installation b . R value of duct in other areas E . Piping Insulation 19 Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation re Service Water Heating 1 . Performance efficiency 2 . Tsmpara.ture control 06ttincf maximtlm,_,_ G . For swimming Pool Only 1 . Maximum heating Telephone No . ( applicant ' s signature ) TOW RY BUILDING OF QD CODES DE BUILDSNG AND CODES DEPARTMENT SAY & AV ILANE ROADS paph QUEEN URYr NEW YORK I280 , X TOLE NE (528 ) 792-5832 BUILDING INSPECTOR.' REPORT REQUEST R INSPECTION RECEI D �_ NAME LOCATION DATE PERMIT #- / ;r/z� -- APPROVED r i YES I NO F003SNGIPIER MONOLITHIC PO R FORMS FOUNDATXON/D -PROOFING BACKFILL APPRO AL ROUGH PLUMBING FRAMING ELECTRICAL ROUG -SN INSULATION: FOUNDATSON FLOORS WALLS CEILING FINAL INSPECTION: CHXMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES T PS STAIRS-CLEARANCE XLS�_ PLUMBING FIXTURES LIEF VALVE INTERIOR TRIMIPRIV Y DOORS FINISHED FLOORS GARAGE FIF2EPROOFI G DOOR CLOSER (S) SMOKE DETECTORS FINAL ELECTRICAL SFE SON FINAL APPROVAL OF CONST UCTION OK To ISSUE C/o 'CSC _.. �....�� A SIGNED CERTIFI ATE OF CUPANCY MUST BE OBTAINED FROM T BUILDS DEPARTMENT BEFORE THESE PREMISES RE OCCUPX D! REMARKS: 7 ARRIVE �,rm-� SPECTOR � r ��- � � _.Down a� �iseerrdhcerr�r J� BUILDING and ZONING DEPARTMENT Bay and I-laviland Road, R. D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR ' S REPORT NAME LOCATION Date // f Permit N04 ✓ = APPROVED - YES NO Footing/Pier Forms 00( Ljres�n elation 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 _ Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling - FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- r A Buildin nspector 45/86 and-vl l/f I .10 + BUILDING and ZONING DEPARTMENT ] G' Bay and Haviland Road, RrO. 1 Box 98 oueensbury, New York 12801 ` BUILDING INSPECTOR ' S REPORT NAME LOCATION Date z/ Permit No . � APPROVED - YES NO �,,Y'ooting/'Fier Forms' �f Foundation 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 . Fireproofing Door Closers Smoke Detectors Chimney INSULATION : Foundation Floors Walls Ceiling FINAL ELECTR CAL INSPECTION DRIVEWAY APPR VAL Final Building Survey Next scheduled inspection ( call when ready ) Remarks- 44 Building Inspector Fa/8€� and-vl ■ M OOLE ;8EFART fiKT. 1#$ftC"Fj0N AGENCY, INC. National Headquarters 9W) Heddon Ave., Collingswood, N.J. 08108 Data: City, Town or Township r^S f� f� �V ' �JI " "* '> County XIAFAP PV State r Location/Address e 13 1-:,.,g QQ, r., s } [� (If Located in Rural Area - Please Attach Directions) Pole # Owner.... '1�S C "e44 SJ (4A IT MOrte . 'Permit # Occupied. As HQA� BiAiildi:t l: , Nawc. Occupant 2' Old El Work Area in Buildi Floor #. etc..):. for: Wirin []!�- Service E3 or: Ready for Inspeatiotiz Fee Remitted- $ Cash E Check [] A4A:Cf. Make Pa a IN.D.1_A Number of Rough Wiring Cutlets Elect. Heat O 7°O 1Oaa t isoe 173a xoaa xx5a xsoa x�sa soon Switches Lighting Amp. Seivict Surface Unit Dishwasher Range Receptacles Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and ContrbAslbr: Burner Arrlp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTORS H.P. / 111 x/lo 1/8 F ns 1/4. 1/3 1!2 3/4 1 IYs 2 3 d 5 1 71 10 15 20 25 ae 40, 50. .79 loD Mark Number of Each Size - Applicanes gnature License # Perni t # F /A "� Utility: • ;ApprlcanYs-Adidress: AM F (City) (State) (Zip) Service Request # Phone # Electrician: PATE RECEIVED: DATE INSPECTED: Garrett Location : Same as Above Q or: Red Notice Label Rough Wiring Outlets Surface Unit Oven ' f Switches Range Ghrb , D'espbsi l Receptacles Water !-leafier DisifWasher F' Air ciiti Iaer Dryer Amp. iice Egwpment Burner, WIrrn Contro s for ArMp. acle " Amp. Service Conductors Pump Vent t nits' MOTORS H.P. IMM11/121IL/10 We x/e i/a 1/3 1/2 3/4 t ivy 2 3 5 7+h 10 is 20 25 3e O 5e115 1 Mark Number - 1 . of Each Size Elect. ,Reef soo Aso toao Isso Isoo tiso ,xooa xnl ga x�e<a soap. 0 RW Progress: Inc. 0 LKD 0 Contractor 0 CFT Violation: Work Comp. Inc. Q Q L/A Owner CASH Q Q L/A Fee CH K # Glue MO # Q . IPA Municipal , ..:. 1 N V a:' -Applicant '- Q Date : Other Side 0 Utility Owner o Cut in Card Q Temp # Date .,. .. . . - [] Final # bate INSPECTORS SION• URE APPLICATION FORM NO. 256 E'Li ljbe