1987-766 ar
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+CERTIFI+CA.TE +�]F +C�CCUi'AI'�T+C`A'
TOWN OF QUEENSBURY ,
WARREN COUNTY, NEW YORK
U+rte_ July 27 , 19 $
This is to certify that work requested to be dons as shaven by Permit Now
has been eotnPleted.
occupied as a Doctor ' s Of f 1ce-
1 This structure 3,� P
.� Bay RdLocation
tamer Robar Brasses
By Order 'Town Board
VI OF QUEENSDURY
Suildi¢Il & ZI lnspsator
BUILDING PERMIT �
TOWN OF QUEENSBURY Iw t
o. 87- � � o
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Roger Brass
I
Street, Road or Ave.
OWNER of property located at 382 Ba Rd .
'
N
in the Town of Queensbury, To Construct or place a Addition— Dr ' s Office
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.
F2.
wNE WS Address is Same 7d
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H
ONTRACTOR or BUILDER'S Name W
w
John Hughes
3. CONTRACTOR or BUILDER'S Address
375 Bay Rd .
Glens Falls , N . Y . 12801
4. ARCHITECT`S Name LO
Oo
N
Co
`C
5. ARCHITECT'S Address
a
[7. P
PE of construction — (Please indicate by Xi
( x} Wood Frarne ( ) Masonry i ) Steel ( )
ANS and Specifications
Na28 ' x 72 ' as per plot plan , specifications and application/
oposed Use Addition to Dr ' s off ice a
0
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rir
a
$ 5 . 00 C/O June 88 0
160900 M
�, PERMIT FEE PAID — Tl-il5 PERMIT EXPIRES a,
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ChAeonsbury before the expiratian date.)
�-n
W
n
Dated at the Town of Queensbury this 16th J Day of I3overaber
SIGNED BY ` .�c.� f for the Town of Queensbury
Building and Zoni nsp ng Iector �/�1j
TO BE COMPLETED BY BLDG . DEPT
// Application No .
flown Jown o f Queenshury Permit Issued 19
BUILDING and ZONING DEPARTMENT Permit Expires 1g ry �q
zoning Designatio
Bay and Haviland Road, R. D. 1 Box 9$
Variance No . '
Queensbu y, New York 12801
Site Plan Review No'.
,
r� Approved by :
�} APPLICATION FOR re 5--CW ��
�
�
BUILDING AND ZONING PERMIT
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
tion , plans and specifications submitted , and such
be done in accordance with the descrip
special conditions as may be indicated on the Permit . _--_ .......
The owner of this property is . OL& t"
Tel _
P . O. Address 3 �
Tax Map No .
Property Location :
Street number or building lot number
Subdivision name ( if applicable)
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
` a'" r2 e ti r 7 z-
Name P . O. Address Tel . No .
Name of builder `�+✓' �"�� Address Tel * 792 - y7t? C,�
o�n.n !7 � Tel .
Name of plumber � " 7a6 j(?W Address Tell Fs' Coe
Name of mason_ ,K',�� � .,�
Address -�
NATURE OF PROPOSED WORK : ZONING INFORMATION :
Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED ,
ddition to a uxlding
* drawn reasonably to scale and attached hereto ,
Alteration to a boil incg 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 , SPATE SIZE AND * of water supply and location and configuration
LOCATION OF STRUCTURES AFFECTED . * of septic disposal area .
COMPLETE INFORMATION REQUIRED BFLOW . ��
/q/. 7'wr
Size of property ft X 411MUROL ft .
* Existing building ( s ) Size 80 __ft X G+ £t .
*
PROPOSED BUILDING AND USE : * Existing building ( s ) Use 0
Size of new structure Zgj ft X7Z ft property line
Foundation-pier/slab craw partial/full Proposed building , distance from prop y
(circle one ) Front yard Gaar ft Rear yard Q5 ft
Noe of stories (habitable space ) * Side yards _ ft and Z ft
Height (grade to ridge) Z,L-- ft If on corner , setback from side street ft
if residential , no . of families OCCUPANCY INFORMATION
*
No * of rooms ( excluding baths ) "
No . of bedrooms PRIMARY BUILDING
No . of bathrooms One family dwelling
Primary heating system ,eay]", _-...�C Two family dwelling
Type of fuelIac - k P� Multiple dwelling / Number of units
No . of fireplaces to be installed k. * permanent occupancy
Will a wood stove be installed? * Transient occupancy
Central Air conditioning?J� � * Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
other
Ranch Contemporary Log cabin * If addition , what will use be? a 'r
Raised ranch Mansion Duplex
Split level old style Bungalow
Cod Cottage Other ACCESSORY BUILDING-
CCape
* Detached garage/one cars' two car/ car
Colonial Row Town Rouse car
( CIRCLE ONE PLEASE )
* Attached garage/one car/ two car/
Private storage building
ESTIMATED MARKET VALUE OF `Other
CONSTRUCTION)(.� .
S , ON REVERSE SIDE OF THIS SHEET , TO BE COMPLETED !
INFORMATION ON BUILDING SPECIFICATION
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS : 1
Type of construction , wood frame , fire saferetc . (A)"a o-✓r+ 2
Will any second-hand or ungraded lumber be used? If so , for what ? Nc�
Foundation wall materal i co Thickness
3 /& "
Depth of foundation below grade (to bottom of footing ) gJ3it Will there be a cellar ? Alo Heated or unheated? Floor sq . .footage sq ft
Will there be a basement? /V'�, Will any portion be used as living space ?
{ If so , what portion? sq. ft . - - Type of use?
Type of roof - sl0 a flat/shed/other Material of roof (� , af�f + ZY
_7/e .15
_
Size , wood studs + K �2 spacing. /� "'o . c . length ft .
Joists ( floor beams ) lst . floor "X '" spacinq____Z.& "o . c . spans/ ft .
Joists ( floor beams ) 2nd . floor Z "X- spacing_ r�''o . c . span�ft .
Overlays ( ceiling beams ) 'Z_ "X ,�> " spacing_��"o . c . span /G ft .
Roof rafters X_ a__ spacing____Z7 ,�0 . c . span_+q_ft .
Roof trusses (pre-engineered) spacing '' o . c . Span ft .
Exterior wall finish &)Ood S,�Q,• Of what material ?
Interior wall finishIf a garage is to be attached', describe materials to be used for FIRE SEPARATION :
Is there to be an opening between garage and dwelling? If so will a Fire-rated
door , enclosure , and self-closing device be provided?
Will a flue-lined chimneys be installed? AJO Height above roof ft ,
Depth of chimney foundation below grade ft .
Depth of fireplace hearth ft . in . /
Water supply - Municipal or private well Aa r4c A
SEPTIC SYSTEM _ Distance from ANY private well ( i eluding adjoining properties ft .
{A separate application is necessary for any repair or new installation of septic system}
Town of Queensbury I D A ,` I T
County of Warren A F F V I 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 .
SwOR.N TO BEFORE ME 'PHIS X Signature
err owner ' s gens
day of 19 , arCniLeCt , COntraCtOr
Notary Public , warren County , N . Y .
SPECIAL CONDITIONS OF THE PERMIT :
By
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Application for ! BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work .
ANSWER ALL of the following .
1 . Gross floor area t
2 , Type of heat_
3 . Is the building mechanically cooled ? TE- 1r
4 . Percentage of area of windows and doors !> oca
A . over 16 % Only
1 . U value of gross area of walls ,
a roof / ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a . Are foundation walls insulated ? YES NO
1 . If YES , what is the R value ?
3 . Slam on grade YES NO
a . if YES , what is the R value of insulation around
perimeter of floor ?
4 . Is basement heated ? YES NO
a . R value of insulation
5 . Type of insulation
B . Under 16 % Only
1 . R value of roof and floors exposed to ambient conditions_
2 . R value of exterior walls ,
3 . R value of glazed area Q +
4 . R value of doors
S , R value of floors over unheated spaces /
6 . R value of slab edge insulation - unheated slab //
7 . R value of slab insulation - heated slab
S . R value of heated basement / cellar walls ( above grade ) NJr�
g . R value of heated basement / cellar walls ( below grade )
10 . Type of insulation
C . Controls
1 , Thermostat maximum heat setting
D . Duct Systems es
NO1 . is duct system installed in unheated spac ? 3 YE
a . If YES ■ R value of duct instal
lationu
b . R value of duct in other areas
E . Piping Insulation agent pipe ,�� �
1 . Size of hot water or cooling carrying
2 . R value of pipe insulation - Zpqpqpq
F . Service Water Heating t? 3 `fa
1 . Performance: efficiency. --
2 . Temperature control setting maximum
G . For Swimming Pool Only
1 . Maximum heating
r
Telephone No . applicant " S signature )
4000532 _ THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
41 STATE STREET, ALB ANY, NEW YORK 12207
,p11 % 1ely 21 F 1988 Applieation Na. on Jile !3 {} 2 9 5 ] /� R $ A 7019284
THIS CERTIFIES THAT
only the electrical" equipment a deeerlbed below and introduced by the applicant named on the above applications number in the premseee of
Dr . Brassil 382 nay Rd . Glens Falls , NL ew York
in thefollowing location; ❑ m ri_
Base ent ® let Ft. _I 8nd Fi. outs1da Section Block Lot
leas examined an � "' � � �� $ and found to be in compliance with the requirements of this BOOM-
RANGES ISGSRS sWeTCF1E5 RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS MNCAIrDESClNT FLLJOEESRE S MAT- K- w- AM7. K. W, AMr- K-W, AM1T. K. W. AMT- H, r-
r
35 9 €3 41 12 23
DRYERS FURNACE MOTORS FurURE A"UANCE FEEDlift SF%0AL REC'FT TIME MOCKS me" LiNeT HEATERS, M SYSTEMS
DIMUNERs
AMr. WATTSAMT, K. W. p AS L H. F. GASH r- AµT. rro, A- W. G. MAT- M+YP- MAT, AMPS. TRANS. AMr. H- P. no. OF FEET
2 hwt 10
E R V 1 C
METER E
SERVICE DISCONNECT era. of cc. corn. A. w G. NO. OF HI-LEG A• W. o Ho. of HELITEAIS A W, G-
AMt. AAW, TTFE Eourlr. I .X 2w I Ar sw s At sw 310 4w F c - of cc. ca►w. of HI-LEG of HEurw
2 200 b 3 x 4 / 0
OTHER APPARATUS:
Sam w . Corhouse
11 Potter Rd . BRANCH MANAGER
Gansevoortr T-ly 12831
Per ,
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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
' Down o� �ueertsbure�
y BUItC)11VG and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
/y] Queensbury. New York 12801
p BUILDING INSPECTOR ' S REPORT
•/� NAME
LOCATION vs;F�
Date I�i►/ Permit No . f
APPROVED YES NO
Footing/pier Farms
Foundation
waterproofing
Backf. ill
Framing
Roofing
Siding
Masonry veneer
Rough Plumbing
Relief Valves
F,Xt . Porches
Finished Floors
Interior Trim
Stairs & Railings _
Cellar Drain Tire
Concrete Floors
Plbq . Fixtures
Gar . Fireproofing
i >aor closers
Sm(3ke Detectors
chimney
LNSVLATION :
Foundation
Floors
Walls
Ce i I Ing
FINAL, E FCTtlCP,L INSPECTION_
i)RIVEWAY APPROVAI,
Final Building Survey -
[3ext scheduled inspection (call when ready }
Rc.snarks- /
A/1
Building Inspector
6/86 and-vl
'Joeeii1 0j Queerest ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.O . 1 Sox 98
Oueensbury. New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION -
Date •s.� Permit
* * * * * * * �✓'* * APPROVED YES NO �
Footing/Pier Farms
Foundation
Waterproofing
Backfill
4kraming
Roofing
Siding
Masonry* Veneer
)dT,Lough Plumbi
Relief Valves
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Til
Concrete Floors
Plbg . Fixtures
Gar . Fireproo ing
Door Closers
Smoke Detect rs
chimney -
iN SL7I,AT I ON
Foundation
Floors
Walls
Ceiling
FINA14 FL ' ICAL INSF'ECTIC7N
DRIVEWAY APPROVAL
Final 'Building Survey
Next scheduled inspection ( call when ready )
^ Huildin Inspector
G/86 and-VI
too
7awn o/ Qaeeri .Sitery
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCAT I ON
slate-AIL � 'Permit No .
APPROVED - ]CFS NO
Forms �J --
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Ven er
Rough Plumbi g
Relief Valves
Ext . Porches
Finished Floor
Interior 'Trim.
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg . Fixtures
Gar , Fireproofing
Door Closers
Smoke Detectors
Chimney
ti INSULATION
Foundation
Floors
Walls
Ceiling
FINAL ELECT CAL INSPECTION
DRIVEWAY AP ROYAL --
Final Build ng Survey
Next scheduled inspection (call when ready3
Remarks-
Building Inspector
6/86 and-vl
BUILDING DEPT. COPY OF APPLICATION FORM 46-EL, NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT. WHEN REQUIRED.
TEMP. iF DATE
VILC c-.
TOWNSHIP COUNTY
STREET AND MO. DR .
ROAD AND POLE NO. '.i !
n emwl IYMU r
�[ r�r POLE NO
PCR C�S�STRLEETSTEO7 � �� - •y—
OCCUPANT'S SFtiCT10N BLOCK /� LOT
NAME BU ILDINO
'coon t7CCUPANCY t r
OWNER'S NAME
AND ADDRESS �. J .� rt TEL. #
BSUPPLIEb FROM THEIR '6F 1'+'4,,"(r S OFFICE
SU+;� WORK DEFECTS
NE OLOX iS NEW ADDITIONAL Q REMOVED I�l
L157 BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No. of Fixtures At BRANCH
Lam, Lamp FlwalptNMs MOTORS HEATERS CIROI,JlT$ OFFICE use
dam ONLY
Owung Well R up'1t Swiad Pendant Bracket No. Type E� No. E� No. A.W.G.
etloa INSPECTION
owe
Sbasee
Barr
mart
tat FL
?nd FI.
Said Fq_
REMARKS: LIST OTHER ELECTRICAL EVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE.
This application is intended tb cower the abt "Acted equiPmanl to be inspected but it at time of inapectibn thery is fbond additional equipntant not above listed,
You are awtilorized to make the inspection and adjust the Fee to cower the additional equipment, as provided by the applicant.
SMAINSIZE OF ELECTRIC SIGN TOTAL
FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED 512E OF SIGN
ENTERS OVERHEADRS UNOERGROVNp MAKER
ILOt OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD
AVOID DELAY BY GIVING FULL ARD ACCURATE INFORMATION. ALL SPACES
MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. DATE OF
PRINT NAME AND ADDRESS APPLICATION ._`
NAME OF r r V SIGNATURE f :-
APPLICANT '� �'� f ler(` /F\ r r '
OF APPLICANT '"" . ,""'` :�.•" •..._-
` I
STREET ADDRESS "� . - "� y+ y +:.-' C7o TELEPHONE # - r '�•r .r
CITY OR
POST OFFICE r' ri - f y ^ // �,- f CODE - , f WHEN APPLICABLE
46 6L (REV. 1/66) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
-i
_ .�. r Wn OlQueen4lary
CZUEENSBURY TOWN OFFICE BOILblNG
BAY AT HAYILAND ROAD
QUEENSBURY, NEW PORK , 12801
TELEPHONE : (518) 792- 3832
0
TO : The Building Department
Town of Queensbury
FROM : N . W . / Bode/nweiser , Fire Marshal -
DATE s 7I ,q cl I ��
SUB : Certificate of Occupancy
Name : .
Address :
It is the opinion of this office that the above
named premises has complied with all sections of the
N . Y . S . Fire & Building Code regarding fire prevention
N . W . Bodenweiser
Fire Marshal
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A 0000 PLACE TO LIVE
B
50WIZ
V QUEEaN SB�UY�K/ Y,�V(T�/(///—//'+O N OFFICF BUILDING
BAY AT HAVILAND ROAD
QUEEN5BURY , NEW YORK , 12801
TELEPHONE : (518) 792-5832
TO : Dr . Roger Brassel
382 Bay Road
Glens Falls , New York L2801
FROM : No W . Bodenweiser , Fire Marshal
DATE : July 6 , 1988
SUB : Fire Prevention Section of the New York State
Fire and Building Code
Prior to issuance of your Certificate of Occupancy , it
will be necessary to complete t'-ie following :
1 . Erect lighted exit sig - is .
A . Main south wall directional exit sign pointing
to main entrance .
B . Outside face of '.�raura ' s office wall directional
sign to main entranc'e .
Co Sign up over waiting roam door on the interior
side .
2 . A . Place a " NO EXIT " sign on north hall door .
B . Place a " NO EXIT' °' sign on east wall ,
3 . Emergency lights .
Am One ( 1 ) unit - main reception room area .
B . One ( 1 ) unit - main hallway .
C . One ( 1 ) unit main waiting room .
N . W. Bodenweiser
Fire ,Marshal
NWB/gP
SETTLED 1763 . . HOME OF NATURAL BEAUTY . . A GOOD PLACE TO LIVE
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MS!G.t BY:
LANDSCAPE MAMENANCE CORPFORAMN
i l -1 S KATHERIIVE SITM I GLENS FALLS, NEW YORK 12801 (518) 792-2021