1988-552 C `ri C ,A,TE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Auciust 17 19 89
This is to certify that work requested to be done as shown by Permit No. 88-552
has been completed.
One Family Dwelling - Alterations
This structure may be occupied ac a
tio XHunter
L1 Lane
Loca
•
John Kubricky •
Owner
By Order Town Board
TOWN OF QUEENSBURY
• Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-552
WARREN COUNTY, NEW YORK �o
PERMISSION is hereby granted to John Kubricky :N
OWNER of property located at 20 Hunter Ln. Street,Road or Ave.
Alterations
in the Town of Queensbury,To Construct or place a
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 p
Same
o'
2. CONTRACTOR or BUILDER'S Name
A J S Enterprises, Inc.
3. CONTRACTOR or BUILDER'S Address
6 Highland AVe. o
Glens Falls, N.Y. 12801 x
in
4. ARCHITECT'S Name CD
�t
•
CD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) I�-
rt
CD
( )1 Wood Frame ( I Masonry ( ) Steel ( ) rt
Iv
rt
7. PLANS and Specifications
No. 22' X 28' (garage) & 12' X 10' (walk—in closet) as per plot plan
specifications and application.
8. Proposed Use
Attached Garage and walk—in closet
5.00 C/0
$ 20.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 1 19 89
(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 3rd D of August 19 88
c
SIGNED BY for the Town of Queensbury
Building and ning Inspector
t i 4 1
TO BE COMPLETED. BY BLDG." DEPT.
i :
c_ ;'Application No
.Down o nueenibury Tw: :'''I '(--- Q 1 f
"� Permit Issued '19'BUILDING and ZONING DEPARTMENT Permit Expires 19 [� _
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ` ' V
jil _
Qusensbury, New York 12801 Variance No L..l
Sit® PlantReVa.ew N � � � ��
Appr ed Y DUILDING,& CODE DEPT
APPLICATION FOR /GL,Lt ,
BUILDING AND ZONING PERMIT .
* * * * * *. * * * * :* * .* .* * *. * *' * * ,11 .*: *. .*" *_ *'.* *: * * * * * * *. *,: * - .
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"Pero t. ,_
The owner of this property is: 1; a • kt.f.4b4.1
P.O. Address 2.0 RIO b � .:: a �.. Tel:. Ie�,% f
Property Location: ��- I Tax Map No.26 /.2_:f/S . '
k
Street number or building lot number -. -:
Subdivision name (if applicable) ..
THE PERSON RESPONSIBLE FOR SUPERVISION OF,WORK-AS', REGARDS'"BUILDING CODES IS:
1 :E •fit; ` FOR 1 1 ;-,1
4 p A
Name P.O. Address : 1 -.. . Tel. NO. , ''
Name of builder gt id Viko ' Address. : � Tel. e
Name of plumber wioi Address ,: , ) , Tel. i ®
Name of mason sk , a! ' Address ,. .
°� Tel. ! . . ..
NATURE OF PROPOSED WORK: * - :>y' ZONING` INFORMATION:
Construction of a new building. !;*- A PLOT PLAN MUST BE PREPAtED AND SUBMITTED,
Addition to a building *:drawn reasonably to scale and attached hereto,
i' Alteration to a building * showing clearly and distinctly all buildings,
(no change to exterior dimensions)': "...-whether existin or proposed g' and indicate all
Other work (describe) x*:. set-back dimensions: from property lines. Give:
* street and number or lot number and indicate
FOR DEMOLITION PERMIT, STATE SIZE AND . *' whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED.• * o water suppl and location and configuration :'
*;of septic 'disposal area:
• * COMPLETE INFORMATION REQUIRED BELOW.
*`Size>.of property tooiofj ° ft X $ ,ft
Existing building(s) Size 6 2 ft X '. ft.
': PROPOSED BUILDING AND Ui-EZ X 2S`CArn.A i
* Existing building(s). Use'. 9
Size of new structure -
Foundation-pier/slab/ /partial/f41 *::Propo'sed building, distance from property line,
�"'
(circle one) Front; and
No. of stories (habitable space) ' I * ' y- ft Rear yard �,� ft
• Height (grade to ridge) l ai ft * Side,yards ' ',1 ; ft and `, ' ° ` ft
If residential, no, of families" *•If on corner_,. setback from side street ft
No, of rooms(excluding baths) 'A ' '* OCCUPANCY 'INFORMATION
No. of bedrooms Noilit
,�
* PRIMARY BUILDING -
No. of bathrooms NI
Primary heating system p „ * '� One family-,dwelling
Type of fuel ,,,q g (4,e,, * Two family dwelling
* Multiple dwelling / Number of units
NU. of fireplaces to be installed ® I --
Will a wood stove be installed? * Permanent occupancy
Transient occu anc
Central Air conditioning?. p*;� * p y
*: i3uslness
•BUILDING. STYLE, PRIMARY STRUCTURE
* - " Industrial ' ;�
Ranch Other
o;h emporar_ Log cabin
Raised ranch Mansion Duplex * If add on, at will use 'be? (, aP t,lt., !( e..IrA$ .
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 ) '''.'-* 5� Attached garage/one car/ cam,/ - car
* * * * * * * * * * * * * * * * *'' ''I' "3 Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
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, ! •o• f awe, fire safe,etc. _
Will any second-hand or ungraded lumber be used? If so, for what?
Foundation wall material pay, , ikness
Depth of foundation below grade (to bottom of footing) -11,4, 4e
Will there be a cellar??40 Heated or unheated? Floor:sq.
q. "footage sq ft
Will there be a basement? 4440Willany.portion 'be. used as living space?
(If so, what portion? 014 sq.ft. - Type of use?
Type of roof - s10 edyflat/shed/other 'Material.'Of:roof I �
Size, wood studs ', "X .to spacing tte "o c length '. �
• ft.. Qg
ea • . reo nr T"X " spacing ' a "o.c span ft. .,.
Joists (floor eams) 2nd, floor "X "',spacing "o.c span ft.
Overlays(ceiling beams) , ° "X �� " spacing �� "o c. s an
Roof rafters "X " Spacing ., : .',
- P g Q Qre. o.c. span ft. Obe,tilvi, ORDQ rat
Roof trusses((pre-e
ngineered)gineered). spacing o:c. span ft. •
Exterior wall finish 14.,0 ; t q Of what material? a.5 p L
Interior wall' finish ViL,b1; Vt-totf° rtty‘
If a garage is .to,.be attached,describe materials to be;. used: for RIRE' SEPARATION:k°
Is there to be an opening between garage and dwelling? 4, . If so will a bare-rated
door, enclosure, and self-closing:-device: be .provided? ,."
Will a flue-lined chimney be installed? :-LHeight "above 'roof
Depth of chimney foundation below :grade' j1 ft
Depth of fireplace .hearth iv)Aft. in. —
Water supply - Municipal or gr'fvate w� „
SEPTIC SYSTEM Distance from ANY .private wel;l(including_ adjoining properties ft
(A separate application is necessa for, any
ry repair or new ,installation of septic system)
Town of Queensbury
County of Warren AFFIDAVIT STATE OF NEW YORK
I swear that to the best o'f '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 ..
Own r,' owner's agent,architect.co tractor
__day of 19
Notary Public, Warren County, N,.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * :* * *. * * * *. * * *' * * * * *. * - * .A
PECIAL 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
2. Type of heat 0`'�,
3. Is the building mechanically cooled? klb
4. Per*ontage of area of windows and doors ,4.0
A. Offer 16% Only .
1. U value of gross area' of :w� ls, roof/ceiling and floors
exposed to ambient .condi.tic3"ns
2 . Floor ove heated .' . aces YES NO .
a. Are l fouation -walla insulated? YES NO
1. If YES what is the . R value?
3. Slab on gr de YES -NO
a. If YES-, what is th" R: value of insulation around
pe - meter of,. floor?
4. Is basement heated? YES NO
SssL
of R value of insulation
5. Type of insulation
B. Under 16% Only R
1. R value of roof and floors exposed to ambient conditions .
2 . R value of exterior walls 1e ,
3 . R, value of glazed area .s;
4. R value of doors tr
5. R value of floors over unheated spaces raggsaarr
6. R value of slab edge insulation unheated slab LA jk
7 . R value of slab insulation - heated slab Nig
8. R value of heated bagement/cellar walls (above grade) "
9. R value of heated basement/cellar walls (below grade) Nir
10. Type of insulation {
C. Controls
1 . Thermostat maximum heat. setting Tr
D. Duct Systems
1 . Is duct system installed in unheated spaces? YES sr
a. If YES , R value of duct '.installation aA
b. R value of duct in other areas INWA
E. Piping Insulation
1. Size of hot water or cooling carrying agent pipe y
2. R value of pipe insulation Gout
F. Service Water Heating
1. Performance ;efficiency '`,.; MMIAllikAr
2. Temperature control setting maimum -
G. For Swimming Pool Only
1. Maximum heating.
Telephone No. - 1r1
( PPlicant ' s signatk e)
✓ • 1
YOU ARE HEREBY REQUESTED TO
INSPECT AND ISSUE CERTIFICATES
FOR THE,FOLLOWING ELECTRICAL
EQUIPMENT TO BE INSTALLED BY
THE UNDERSIGNED •
•
TEMP.N DATE
CI OR VILLAGE ,� _ , C TOWNSHIP COUNTY ,//
kW
STREET AND NO.OR ROAD
POLE NUMBER
'an �--t ) z t„ - r �/r
BETWEEN WHAT TW CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANTS NAME • BUILDING OCCUPANCY
. i`)t-{iJ I ct),,,,3 iJ �.;U O i C.t6y t,�l--t_t* \—r�--,-1,�t I +-`d
OWNER'S NAME AND ADORES OME TELEPHONE NUM ER
L
Ca'1 ir�t� � 9�f_-a:i )
CURRENT SUPPLIED BY A FROM THEIR OFFICE WORK TELEPHONE NUMBEB
BUILDING IS- -
NEW❑ OLD WORK IS NEW 511' ADDITIONAL DEFECTS REMOVED❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& MOTORS HEATERS BRANCH OFFICE USE
Loca- Lamp Receptacles CIRCUITS ONLY
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recep'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION
OUT-
SIDE
SUB-
BASE
BASE-
MENT
1st } / J
FL. _� %rIy
2nd
FL.
3rd •
FL.
REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:
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 MAINS FEEDERS ELECTRIC SIGNS/LAMPS TOTAL WATTS
CHARACTER OF/ WORK N.EXPOSED GAS TUBE SIGN/TRANSFORMERS OF VA
Y-I-"l¢� 1 1 ) `fl t\1 L''t.--- ❑ CONCEALED
/
DitTE WORIS TO BE STA� DATE COMPLETED SIZE OF SIGN(NUMBER) CAPACITY
! 1 ;` 6 ti is
SERVICE ENTERS BUILDING MANUFACTURER OF SIGN
❑ OVERHEAD .,44NDERGROUND
DATE INSPECTION�,, eg REQUESTED ON(OR AS NEAR AS POSSIBLE) MUST ENTER APPLICANTS f I
Itj \ L I (_- "� IDENTIFICATION NUMBER ► I� I �/ f i
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS 7- ') _
NAME OF APPLICANT ti DATE���PPLICAT v SIGN ITU E 0 APPLICJtNT "I(
{t ,r1 1j / ��/ x -t-
t�fi�_\ � t"�YUi i<-1 t����� t`�'t.°✓ � � ' "' 1.
STREET ADDRESS J TELEPHONE NO! `
/� i f I�;-;-s'!_i‘ -)0 ,(A.._/! 7 -/_S 7/
CITY OR POST OFFICE-- 1 ZIP CODE LICENSE NO.WHEN APPLICABLE
•. ( -I I - 1\-'S I--�`-1-�i:c ) �' I 1n:) VD✓L f - Z F�r
❑ 85 John Street ❑ 41 State Street ❑ 584 Delaware Avenue ❑ 217 Lake Avenue ❑ 202 Arterial Road
NEW YORK,NY 10038 ALBANY,NY 12207 BUFFALO, NY 14202 ROCHESTER,NY 14608 SYRACUSE,NY 13206
TI-JC M AI vnRV Rnann np PIPP I IN IPRWRITPRq
•
r------
PAGE J
i F
THE NEW YORK BOARD. OF FIREUNDERWRITERS - �
BUREAU OF ELECTRICITY• -
ii E PTE 1lli1�11 0$,1�1 4891 STATE STREET;ALBANY,NEW YORK 12207.. • iri _
Date Application No on file0230638/88 tll. ()?=�
_ THIS CERTIFIES THAT
I O-
-c only the electrical equipment as described below and introduced by the applicant named on_.the,above application number in the premises of
JOHN & SUZANNE FUBRICEV; 20 HUNTER LANE, GLENS FALLS, N.Y.
o
in the following locot'o,nj ❑ B asery}efit ❑ 1st Fl. ❑ 2nd Fl. . Section Block Lot
was examined on • ,and found to be in compliance with the requirements of this Board.
FIXTURE ECEPTACLES I SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
� � OUTLETS INCANDESCENT.FLUORESCENT _ OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. _ H.P. 1::1
3 3 ' • 4 .
o
-
DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS SELL. UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I • C. E
Pi
AMT. AMP. TYPE METER 1 J 2W 1 Jr 3W 3 i'3W 3 i'4W NO.OF CC.COND. A.W.G. NO.OF HI-LEG A•W G• NO.OF NEUTRALS A.W.G.
. mum. PER B OF CC. OND.. Of HI-LEG OF NEU'TRAI Ma
•
_ 1 OTHER APPARATUS: •
11
E
•
T 77--• Trr TT T, ram-//�J :
IqES
6 HIGHLAND AVE . El
GLENS FALLS• , NY,• 12801 BRANCH MANAGER El
El•
• - . Per ._' F aJ
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. ': I
Au AZ/Aitvatvat11tmittwall(Alit,,Qttyrlitvat]lltift'utttatattAarlfft]itlf[moarv♦tlltattAware-ft1Et1111[v[AftIllt AZ/-ihet lit IN/Ant Alit mfltvr lilt AMU vitae auwrvrarrt., 7.-,
' COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. .
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS -V
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED - l (4 -
NAME _�(0 -� N
f I '
LOCATION ac.)
DATE SS-- , s - S-') PERMIT # SS
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL •
ROUGH PLUMBING
FRAMING •
ELECTRICAL ROUGH-IN
INSULATION: \
FOUNDATION \
FLOORS •
WALLS •
CEILING
(-FINAL INSPECTION: N/
CHIMNEY HEIGHT " N, ' 4
ROOFING
SIDING
EXTERNAL PORCHES/STEPS `,,
STAIRS-CLEARANCE & RAILS'. -.
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS,
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECiTORS --
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION V/
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS�e F_ /�g4C-
1
•
•
INSPECT R
TOWN OF QUEENSBURY •
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED WI1
4
NAME
e9
LOCATION
DATE 3 L ' PERMIT #
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING •
ELECTRICAL ROUGH-IN •
1.,e3'NSULATION:
FOUNDATION
FLOORS
WALLS
CEILING V
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING ?" '•.,
EXTERNAL PORCHES/STERS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS '`,,
FINISHED FLOORS s,
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS!'
FINAL ELECTRICAL,'INSPECTION
FINAL APPROVAL OF CONSTRUCTION • " '
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!•
REMARKS:
) r\
•
INSPECTOR
TOWN OF QUEENSBURY A/12
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTIONQ RECEIVED //Q
NAME ��1/Il/
LOCATIO - , 24/ 2k2-
DATE /' - /-cy- PERMIT #
al51:21z049-7L/1 _ „ �L ��yJ APPROVED
('l�G �' J/ �/YES NO
FOOTING/P.IERS (/
MONOLITHI& POUR FORMS
FOUNDATIO4'DAMP-PROOFING
BACKFILL A PROVAL
ROUGH/ PLUMBING
L4AMING
ELECTRICAL R'OUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS \
CEILING
FINAL INSPECTION
CHIMNEY HEIGHT N,
ROOFINGV
SIDING
EXTERNAL PORCHE:/S 'PS
STAIRS-CLEARAN r E & ILS
PLUMBING FIXT,RES/RE IEF VALVE
INTERIOR TRIJ /PRIVACY OORS
FINISHED F °ORS
GARAGE FI•/PROOFING
DOOR CLO R(S)
SMOKE D , ECTORS
FINAL EL TRICAL INSPECTION
FINAL A' ROVAL OF CONSTRUCTION
A SIG ED CERTIFICATE OF OCCUPANCY ST BE
OBTAINED FROM THE BUILDING DEPARTME BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: YV
/6761/611'
ie
/ , 6
,erg
INSPECTOR
awn of Queen.bur
y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
AQueensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
\CAA-k/4--
LOCATION `
Date p / Permit No.
* * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - Y NO
' Footing/Pier Forms (welt
Foundation
Waterproofing
Backfill
_Framing
Roofing
Siding
Masonry Veneer
Rough Plum:'ng
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofin*
Door Closers
Smoke Detecto •s
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
- i�'�'
Bui` .;' g Inpector
6/86 and-vl
ol
m,3 CYI - v a
ol
0
:A