1989-090 r
+ MTIF"IC.ATE OF +(JNiPLiAN' E
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
Date February 13 iq 90
ac
This is to certify that work requested to be clone as shown by Permit No._
has been completed.
This structure may be occupied a
location +4 C0131) 1 e�S U erne J y v c:
C)wmer F.cy u �: & :a� ii1 semen Ta:aloxas .c
By Order Town 'Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF Q.UEENSBURY No. 89 - 90
WARREN COUNTY, NEW YOR K o
PERAA1551pN is hereby granted toKat- 1^il �c=n �JA h Q D Sk i �
I
to
OWNER of property located at Tint # 6 4 C`nhhl PS f r311e r ; isa Street. Road or Ave. I
in the Town of Queensbury, To Construct or place a D c-k
at the above location in accordance to application together with plot plans and other information hereto filed and o
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance-
F2CONTRACTOR
ER'S Address is
4 Cobblestone Drive RD # 1
Queensburyr New York 12804
ci
or BUI LSERM Name
tl
c7
Self
En
3. CONTRACTOR or BUILDERS Address
Same m
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4. ARCHITECT'S Name tmr
R'+
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r6- ARCHITECT'S Address [D
TYPE of Construction — (Please indicate by %I
t''
i ) Wood Frame l ] Masonry f 1 Steel l ] 0
ry"
GSA
7. PLANS and Specifications
No. 672 sq . ft . as per specifications and application . "
n
0
Or
B. Proposed Use
Single Family Dwelling w/Deck M
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0
10 . 00 c/c ro
$ C; rf rno PERMIT FEE PAID - THIS PERMIT EXPIRES t�$-9-- C
(lf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the N
town of Queensbury before the expiration date-) C
(t
Dated at the Town of Queensbury this 15tt1 Day r March _ 1989
SIGNED BY for the Town of Queensbury
B Ilding and Zan Inspector
n
TOWN OF ClUEENSBURY
TO BE COMPLETED BY BLDG. DEFT . RECEIVED
C� Application Noe
fouvn o ueQrt�IL�esrr Permit Issued 19 MAR 15 1989
BUILDING and ZONING DEPARTMENT Permit Expires 19 f
Zoning Designation L'r
Bay and Haviland Road, R.D. 1 Box 98 i BLDG. & CODE DEPT.
Oueensbury, New York 12801 Variance
site P1 Review No .
Appr „: 91'wvf
APPLICATION FOR [Q Co. Y
FUILDING 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
be done in accordance with the description , plans and specifications submitted, and such
special conditions as may be indicated an the Permit .
The owner of this property is : AC40 *4 62�� Ti 3tA//51C
P . O . Address /d!J-W / +c-ws B u � . o Tel . -lei 'L-2Lgvol �
Property Location : LDT Ca Tax Map No .
Street number or building lot number
Subdivision name ( if applicable) u + " 11-k'-
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
tl'k � +a,.5'� Cc+►v S� Sc..n, rG 4S 1� C3ou G L- 2
Name P . O . Address Tel . No .
Name of builder �>AkAk-. -AS Address Tel .
Name of plumber /JJA Address Tel .
Name of mason w a Address Tel ,,
NATURE OF PROPOSED? WC]RK : * ZONING I NFORMAT I ON :
_Construction of a new building A PLOT PLAN MUST BE PREPARED AND SUBMITTED •
_Addi.tion 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) __f' . 4s svz u * set-back dimensions from property lines . Give
C �� 2 � C ptp 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 s ` i b ft X 3t L4 ft .
* Existing building ( s ) Size -# o ft X %Ab ft .
PROPOSED BUILDING AND USE: 2 * Existing building ( s ) Use rstk>N , - CA
Size of new structure ft x_ ct
Foundation-pier/slab/crawl/partial / ` .ill Proposed building , distance from property line
(circle one ) * Front yard 1L £t Rear yard 1 -LLI ft
No . of stories (habitable space ) * Side yards ?iS ft and .I is ft
Height ( grade to ridge ) t . if on corner , setback from side street ft
If residential , no . of families
No . of rooms ( excluding baths ) OCCUPANCY INFORMATION
Now of bedrooms PRIMARY BUILDING -
*
N4 . 4f bathroomsOn� family dwelling
Primary heating system
Two family dwelling
Type of fuel Multiple dwelling / "number of units
No . of fireplaces to be installed permanent occupancy
Will a wood stove be installed?
Transient occupancy
Central Air conditioning? Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
* Other
Ranch Contemporary Log cabin If addition , what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow
Cape Cod Cottage Other ACCESSORY BUILDING-
Colonial Row Town House Detached garage/one car/ two Car/ car
( CIRCLE ONE PLEASE ) Attached garage/cane car/ two car/.car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF !Other
CONSTRUCTION $ -._ " '� _ _
INFORMATION ON BUILDING SPECIFICATIONS , ON REVERSE 'SIDE OF THIS SHEET , TO BE COMPLETEDI
Form BPA 4/86 and-vl
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING S PEC I F I CAT IONS : �,�— � .4 r-rua r_�_� P ► -A, O 4 C=70
Type of construction , wood frame , fire safe , etc . Wooy . �C .4tsrE
Will any second-hand or ungraded lumber be used? If so , for what ? Al U
Foundation wall material sv/.4 Thickness AP'IA$-
Depth of foundation below grade (to bottom of footing ) e,1 •_ cs ,
Will there be a cellar? - Heated or unheated? .� Floor sq. footage sq ft
Will there be a basement? Will any portion be used as living space ? /Va
( If so, what portion? sq . ft . - - Type of use?
Type of roof - sloped/flat/shed/other Material of roof
Size , wood studs — "x of It
Y "o . c . length ft . _
Joists ( Boor beams ) 1st . floor " Xt " spacing ir: / "o . c . span-ft .
Joists ( floor beams ) end . floor "x spacing "o . c . span ft ,
Overlays (ceiling beams ) "x spacing "o _ c . span ft .
Roof rafters "x " spacing o . c . Span ft .
Roof trusses (pre-engineered) spacing "o . c , span ft .
Exterior wall finish Of what material?
Interior wall finish
If 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 chimney be .installed? Height above roof ft .
Depth of chimney foundation below grade ft .
Depth of fireplace hearth _ft , in .
Water supply - Municipal or private well
SEPTIC SYSTEM _ Distance from ANY private well, ( including 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 , 171E 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
day of 19 owner , owner ' s ag = t , arcn.Lrect , contractor -
Notary Public , Warren County, N . Y .
* * * * * * * * * * It * It * * * * * k * * * s, ,t * It * it ,t * * It * * !r aF * fi Not It It * * * It
SPECIAL CONDITIONS OF THE PERMIT
By
! `�' � °
TOWN OF QD COD BURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENS.BURYI, NEW
YORK 1280&t
TELEPHONE
832
BUILDING INSPECTOR' S REPORT
REy,1UEST FOR INSPECTION RECEIVED
NAME '
L40CATZO �
DATE „ 1 ) PERMIT #, y y�
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
r
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT �--
ROOFING
.SIDING
EXTERNAL PORCHES/ BPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTUR /RELIEF V VB
INTERIOR TRIM/ IVACY DOORS
FINISHED FLOO
GARAGE FIRED FING
DOOR CLOSER }
SMOKE DETEC RS
FINAL ELECTR CAL INSPECTION
FINAL APPRO L OF CONSTRUCTICIN i
A SIGNED C RTIFICATE OF OCCUPANCY MUST BE
OBTAINED F M THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!'
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT / )✓ }
BAY & HAVXLAND ROADS !�
QUEENSBURY, NEW YORK Z280&
TELEPHONE (518 ) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED J CJ -7� _ {�
NAME
LOCATION r a
DATE C _ 3 - . ,PERMIT
APPROVED
YES NO
FOOTINGIPIEIW,
MONOLITHIC PWR FORMS
FOUNDATIONIDA -PROOFING _
BACKFILL APPRO ,4L
ROUGH PLUMBING
FRAMXNG
ELECTRICAL ROUGH- N
INSULATION: ✓
FOUNDATION
FLOORS
WALLS
CEILING !
,_�INAL XNSPECTION,- r
CHIMNEY HEIGHT
ROOFING '
SIDING
EXTERNAL PORCHESI EPS
STAIRS-CLEARANCE RAIL
PLUM.BXNG FXXTURF IRELXEF VALVE
INTERIOR TRIMIP VACY D S
FINISHED SHED FLOG _....._
GARAGE FIRED FING
DOOR CLOSER { )
SMOKE DETEC RS
FINAL ELECTR CAL INSPECTION
FINAL APPRO AL OF CONSTRUCTION
A SIGNED ERTIFICATE OF OCCUPANCY ST BE
OBTAINED FROM THE BUILDING DEPARTMEN EFORE
THESE P EMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
SAY & HAVXLAND ROADS
QUEENSBURY. NEW YORK 3280fk
TELEPHONE (518) 792-5832
BUILDING INSPECTOR ' S REPORT
REQUEST FOR INSPECTION RECEIVED _ /
NAME
LOCATION
DATE PERMIT # -
D.,2, i APPROVEDT
�[., YES NO
4. l' OOTING f
MONOLITHIC} POUR FORMS
FOUNDATION AMP-PROOFING
BACKFXLL AP ROVAL
ROUGH PLUMB G 3'
FRAMING
ELECTRX,CAL R GH-IN %
INSULATIONr
FOUNDATION
FLOORS 1p
WALLS
CEXLING
FINAL INSPECTION:
CHIMNEY HEXGHT
ROOFING
SIDING
EXTERNAL PORCHES/ T S
STAXRS-CLEARANCE! & ZS
PLUMBING FXXTUR /REL F VALVE
XNTERIOR TRIM/P XVACY RS
FXNISHED FLOOR
GARAGE FIREPR FXNG
DOOR CLOSER (s
.SMOKE DETEC S
FXNAL ELECTRI L XNSPECTION
FINAL APPROV OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIEDf
REMARKS:
INSP TOR