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CERTIFICATE C3F COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date June 15 lq 89
This is to certify that work requested to be done as shown by Permit No. 89- 443
has been completed.
This structure may be occupied as a Single Family f5P11 i nu.( RP1 oratPd Oncir )
Location ` � 4 Dixon Road
NJ
Ones Ron Hotmer
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
L = BUILDING PERMIT
TOWN OF QUEENSBURY o
No. 89- 443
WARREN COUNTY, NEW YORK �-•
PERMISSION is hereby granted to RON HOIMER
OWNER of property located at fib DIXON ROAD Street, Road or Aye_
in the Town of Queensbury, To Construct or place a AI TERATIONS ( HRIN HOVE DOOR )
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
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SAME
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2. CONTRACTOR or BUI LDE R'S Name rt�
SELF
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3. CONTRACTOR or BUILDER'S Address
SAME
A_ ARCHITECT'S Name
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5. ARCHITECT'S Address •-
G'S
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6. TYPE of Construction — (Please indicate by X)
i ) Wood Frame f I Masonry I ) Steel f 1
T. PLANS and Specifications
No_ 3 ` x 6 ' relocation of entrance door as per plot plan and rn
application
8. Proposed Use , Cm)
ALTERATIONS ( MOVE DOOR )
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$ 30 00 cJconl y PERMIT FEE PAID — THIS PERMIT EXPIRES January 1 19 90 ""4
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Vf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rTr
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 15th Day of June 19 89 m
SIGNED BY for the Town of Queensbury CDC-..
Building a Ad Zoning I rnpector
7C7LV:ti' C► L'EE:*:'S }3L ' IZY � ' !' . [ � .iT = , �: � o � � Urr� T �; c t. vn � vrNt^ n � atilrT
1
` c.e, �lv eki fv ' l TOWN OF QUEBNSBURY
Reviewed`�' � RECEIVED
JUN 14 198C
Fee 'raid $ ��
WILDING Al�D CODES Ljl ,PARDT.AT Date IabuCd�� BLDG. & CODE DEPT■
_�.'LY ,:end HAVILAND ROADS RD BOX 93 PC! /[IR� ��
nUEEN56UR Y , NE(J E:YOR 1 .. d 4�
Tel ( 5181 732 -5832 Exc 204
■ t t r r * t r r t t ■ r ■ ■ t r ■ ■ w r r t ■ r • t + ■ ■ + w ■ ■ r
A PE- WIITi MUST Oil OBTAINED BEFORE B,ECINNINC CCINSTRUC:TION . NO INSPI: C'rIONS
(`' ILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BL; ILDINC PERMIT ,
All applicablo spaces on this application must be completed and the
Puacure of the applicant Piust appear on the reverse side of this sheet
x * K * R ik * X * * InA X * * A * * * * * X 1% * X
The owner of this Property is : tj
(' . O . Address — TEL ,
io roper ty location TAX MAP NO .
leas there been any split of this property since October 1 , 1988 ? /�
yes no
If yes , Planning Board Review is necessary .
SUBDIVISION NAME , IF APPLTCAr" LC LOT NO .
The person responsible for supervision of work as regards Building Codes is :
NAME t , c, . ACORESS T NO .
1t�ame of builder Address Tel l
r4"mc of Plumber T.,ddress Tel
Name of M"S4n Aadreas Tel
taATuRE Or I' ZOPOSOD 4.JJ1 . . : ; ZONING, iNJ : 0101tiTION ( Orfice use only )
k_renatrL4ction of a ekuw buil4jin7 * ZONING DESIGNATION OF PROPERTY
�AdJicion to :a Ltuil .litrg * PERMITTED PRINCIPAL PERMITTED ACCESSORY
::R:A1Lt.; C"Li4n to .a Luildin9 `
( ifai ClL.e, Ls) u t❑ r# itnCns' iansl * REVIEW REQUIRED - PLANNING BOARD ZONING OOARD_
Ucl ,� r wore: ( JQ CrLbV : ) ' SITE PLAN REVIEW $ APPROVED DATE
�� *
.: AOSS ARLA 01 ' VROPOSLU, � 'TLtUCTU14 & " VARIANCE q APPROVED ❑ATE
1st floor ) sq ft , * Remarks :
2nd Floor '— '' sq ft . . COmVf.L.T INS'Of.rui'L'LON #RIl7U11c1:D LYLL{ e41 .
of lzrale.: ety I C7 r' t x C�L' 0-0 re ,
Other Floors sq ft
( not cellar or s :asamanc )
TOTAL FLOOR AREA sq f t * L:xsL: Citlg t]ua, 'i6LLf'9 ( 4a )
or nCw ft k_MLLft •
's�u� �daLian-r. icr/ sl.lY.�/crukl/L�3rLs..l./ cull 1'roi}a�cct Guiis �ng , r3� :: Lancu croe« I.ral+urcy lLnu
Wirclu ant: ) � ft
# Front yard i s 1' c Acar yard 1
Na , of stories ( h:al,ic:+lsl.: Glace ) rdufC +
l#,jighc ( grades to ridge ) lido ycQza fc oin ft
ft . � Is on carnar , sucU..ck (rota 51t1L• !;cruc: c r' c
If rauichuncisl , noa of fumilivwti
No , of rooun3jQxcludinq b"thss1 ��,_ ' QCCUf'ANLY INFORMATION
t1ow of budroomu pRZmA6RY DUILDINC:
Noo of b"th,roou►u 1 * ones fanu,ly dwelling
1' rita.ry 1sr:.ati/uj UYULwn, b { {, " ! ot�wnFrR ,5o f:&Mj ly dwQlliny
Wryra,,s of fuel 2 t- Multtlil" +twilling / Number of units, _
No . Of fitu;1l aCus: tO L 4 inm:t:all :ed l0drltt4Afw9,t OCQUPQi Cy
+Mali ;+ wu.kJ ycovu L.: it,ut:allwd? ` 'Prun4iur� 1: aecu{a:■ncy
L'untr"l Air cof&d.LLiun:.#tq'? O +
* 8usinus.s
uUILDING STYLE, PR1h1ARY STRUCTURE � Inclustriai
iu,rch COntQ"kj.Gr"ry "Q c:abin ; Ochar
&..aisu�d ranch, M.Ane3i4&4 00Ala1. %;x . IY udaieion , w1e at will u :�s b.:'l
uPlu.c lr:val old Utyl.: L4uaiy%&IOW
+: cocz"cyy Ottwr * AC LSSORY LiUIL.QING�
Coloni.. l IrAV i'Qw�i HouseGw hard yar:,gc/ona cur/ two cae/ c"r
( CIRCLL•: QHL: PLtASC b r l►CtuChL c .ar:agu /4a1a car/ two c"r/ cue'
r • • ■ ■ ■ ■ • • • ■ ■ ■ r • • N * t' riV.aLa= .t. tG n building
L: STIMATED MARKF't` VA U6: OF
IwFORA,ATION ON OUILULNC SPECIFrCATTONS . ON RL'VCRSE : Till: OF TItIS Sf10ET„ TO 9E COMPLCTC03
Form [SPA .I0/88 V1
BUI -.DING PEP-MIT APPLICATION
BUIuDING SPECIFICATIONS : pn �i ( gyp
1"ype of Cori5t rL3Ctlon , wood fralme , _ ; re saife , etc . �� � CJ / f �� f��" `✓
Wl11 any second-hand or ungraded luLber be used.? if so , for what ? --!
Foundation wall material S _T UnQ, Thickness - ti
Depth of foundation below grade ( to bottom of footing )
Will there be a cellar ? Heated or unheated? Floor q footage sq ft
Will there be a basement ? will any portion Le used as iving space ?
( if so , what portion? sq . ft . - - Type of use ?
T /pe of roof - slop d/ fl shed/other Matarial of oof
Size , wood studs spacing " o . c . length ft .
Joists ( floor beams ) lst . lour vmx spacinv O . Q . span ft .
Joists ( floor beams ) 2nd . lour " x " spacing "o . c . span ft *
overlays ( ceiling beams ) " x spacing " o . c . span fr
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? ^/ 0 If so will a Fire- rated
door , enclosure , and self- closing device be rcavided?
will a flue -lined chimney be installed? Height above roo= 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 app_lication is necessary for any repair or new installation of septic system )
DEC LA RATION
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.
Signature -
Owner, owner's agent, architect , contractor
SPECIAL CONDITIONS OF THE PERMIT ;
Ry- --- ----------- -- ---.
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY HAVILAND ROADS /)vj
QUEENSBClRY, NEW PORK 1280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED 44
NAME
LOCATION cS
DATE &> — /� S- cS" r PERMIT }_ c /
{^� APPROVED
jJ YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL RTGH—IN
INSULATION_
FOUNDATION
FLOORS
WALLS
� ��r''CEILING
LOFINAL INSPECTION:
CHIMNEY HEIGHT '
ROOFING
SIDING
EXTERNAL PORCHES/SIE
STAIRS—CLEARANCE RA-fZS
PLUMBING FIXTURRELIEF VALVE
INTERIOR TRIM/F VACY DOORS
FINISHED FLOORS
GARAGE FIREPR PING_
DOOR CLOSER (S)
SMOKE DETECTO S
FINAL ELECTRIC INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERT FICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISE ARE OCCUPIED!
REMARKS:
INSPECTOR
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