1987-764 ' A S - . �✓ i R l
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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
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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
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2. CONTRACTOR or 13UI LDER S Name
Lee Murphy
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3_ CONTRACTOR or BUI LDER'S Address
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Bay Rd .
Glens Falls : N . Y . 121301
4. ARCHiT'ECT'S Name
S. ARCHITECT'S Address rat
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6. TYPE of Construction — (Please indicate by X) d
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( 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
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$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