1990-059 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date March 9 19 92
a � 3 - 3V
This is to certify that work requested to be done as shown by Permit No. 90-59
has'been completed.
This structure may be occupied as a bathroom-upstairs bedroom
Location 16 Broadacres Road
Paul Buchman
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code.Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY x
No. 90-59
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to BRIAN S. NELSON •
•
OWNER of property located at 16 Broad Acres Road Street, Road or Ave.
�l ~
in the Town of Queensbury,To Construct or place a Interior Alteration
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
17)
Paul Buchman
Same I-
2. CONTRACTOR or BUILDER'S Name W
- C
Brian S. Nelson
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name r—
Vf
5. ARCHITECT'S Address
F—k
01
t70
6. TYPE of Construction—(Please indicate by X) C
(XX Wood Frame ( ) Masonry ( )Steel ( ) O'
r1
7. PLANS and Specifications ft)
NI
No. 5' x 13' addition of bath in upstairs bedroom as per application,
and plans. ra.
8. Proposed Use -
i
Interior Alterations.
4.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 15 19 90
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the e+
town of Queensbury before the expiration date.) co
'S
Dated at the Town of Queensbury this 15th Day of March 19 90
SIGNED BY C i ,t6PP for the Town of Queensbury.
Building and Zoning Inspector
O
TOWN OF QUEENSBURY
�� REVIEWED BY WN OF QUEENSBUR`�'
. " � FEE PAID $� RECEIVED
IPA*, PERMIT NO. �l�r`�i 990
� MpR12 �
BUILDING PERMIT. APPLICATION
4 'S BLDG• & CODE DEPT.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS., , �y.,
WILL BE MADE UNTIL APPLICANT HAS RECEIVED A VALID BUILDING PERMIT. .P /,)•'�'
!,
All applicants spaces on this application MUST be completed and the signature of the,.
applicant MUST appear on the reverse side of this application.
a a • a • • • • • • * a '• • • a • * • a a • • a • ' • *• a • •. • • • • * a a * • • •
The owner of this property is: tu.A\ ` 'cylei,n
P.O. Address
Property LocationL %cc \, ttras ZzN (J — - Tax MapNo! ��,1 /ll/ 3
Has there been any split of this property since October 1, 1988? _/ . .
If yes Planning Board Review is necessary. yes.. no .
SUBDIVISION NAME, IF APPLICABLE 4v4
LOT NO.
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS TO BUILDING CODES IS:
%eZA.,x---5 S S) ASo.vi
NATURE OF PROPOSED WORK: • ESI':MATED MARKET,V--ALUE OF •
Construction of a new building „ CONSTRUCTION:4 '3 J,c pj—
• COMPLETE INFOR�VI-A-TIE
O QU D BEL a
Addition to a building
• Size of property ft ft.
_ILAlteration to a building , •
(no change to exterior dimensions) Existing dings(3) Size ` ft. x ft. -
��")S\1Ai0.��wv� Ck- • -P sed.building - dis - ce from property ' e:
V Other work (Describe)` fir\ ), s\c02\c5; • Front yard- ft. Rear yard ft.
RDe..ko:,n•
Side y: • ft. an• ft.
•
GROSS AREA OF PROPOSED STRUCTURE • If on corner, set•:ck •m side street ft.
�
2 sl Q
� '�
1st Floor sq. ft. • .
` OCCUPANCY INFORMATION
2nd Floor ^`] sq. ft vc2 • Primary Building
Other Floors . -------- sq..ft. -5 f / • One Family Dwelling
(not cellar or basement * Two Family Dwelling
TOTAL FLOOR AREA ®� sq. ft. • Multiple Dwelling/Number of units •
Size of new structure S ft x__ft. •- Business
g • Industrial
. • Other
•
No. of stari.!� r..bitab spat _. • . • •
Height ( de to ri ) ft • If addition, what will use be? -
If resi ntial, no. famlil ,, • �p��
No. f rooms(ezc ding the
Accessory Building
. of bedeoo • Detached Garage ONE/TWO Car
.No. of bathr ms •
Primary h tins sy etn • Attached Gar ONE WO Car
Type of a • - Private storage building
No„ of replac to be inst ed' •
Will woods vs be Wit lid • ___Other
Central Air onditioni •
OVER
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING 3PF.,CIFICATIONS:
Th,pe of constructions:wood frame, fire safe, etc.
Will any second-hand or upgraded lumber be used? If so. for what? aO
Foundation wall material .Thickness.
Depth of foundation below grade (to bottom of footing)
Will there be a cellar? Heated or unheated? Floor sq. ootage sq ft.
Will there be a basement? Will any portion be used as living space?
(If so, what portion? sq ft. Type of.use?
Type of roof - sloped/flat/shed/other Material of roof
Size, wood studs "x " spacing " o.c. length ft.
Joists (floor beams) 1st floor "x " spacing "o.c. span: ft.
Joist (floor beams) 2nd floor. "x " spacing "o.c. span ft. /x`ST�6
Overlays (ceiling beams) "x. " spacing " o.c. span ft. �/ . r J a
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 he an opening between garage and dwelling? If so will a Fire-rated door, e closure,
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 a well i,ay-1,;c,y ,.A
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)
NAME OF BUILDER l ran�n, c1/2./cOrtADDRESS Sara\, aci k TEL. NO — i
NAME OF PLUMBER V\• c),(r I Qc, C ADDRESS`\evr,\ PA. TEL. NO. Iqa-36cfl
NAME OF MASON ADDRESS TEL. NO.
NAME OF ELECTRICIANaArk' , •A rN ADDRESS TEL. NO.
DECLARATION
To the best of my Ia owledge 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 dons on
the described premises and that all provisions of th' PUTT r'""'CODE,.THE ZONING ORDINANCE, and
ail other laws pertaining to the proposed ork snan Us complied with, whether specified or not, and that
such work is authorized by the owner. c '.
Signature .,
Owner, owner's agent, architect, contractor•
SPECIAL CONDITIONS OF THE PERMIT: - ROOT cJ6 ir,,T1-k 0,Ln_ I AJ &Xis i Tim
n
BY
'„ MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
National Headquarters
_ On.“..,....„--) 900 Haddon Ave., Collingswood, N.J. 08108
APPLICANT COMPLETES THIS SECTION Date: 1 _ 70
City, Town or Township '? County ks,Yorce_4-1 State y
Location/Address it ), 0 • CC" C;vflesOc ..i A VI N
(If Located in Rural Area-Please Attach rections) Pole #
Owner \Cck.k,\ oL\C'1C von.v1 Permit # 1. L;'" C(1
Occupied As us‘c‘e•s-r-e • Building: New'• l Old®
Occupant C1lrs 4.yNlt'Ss .9c.`L\ t# - "-,7` t.Ac or r,Cl
Work Area in Building (Floor #,etc.):
App. for: Wiring❑ Service n or: Ready for Inspection:
Fee Remitted-$ Cash n Check ri M.O. n Make Payable To: M.D.I.A.
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000
Number of Rough Wiring Outlets Elect. Heat S -
Lightingw Amp. Service Surface Unit- Dishwasher Range
Water Heater Air Conditioner Dryer Pump
• Receptacles -
Number of Fixtures- Oven - - - Garbage Disposal Wiring and Controls for Burner
Amp. Receptacles Fractional H.P. Vent Fans
Other Equipment:
MOTORS H.P. . 1/201/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 11/2 2 3 5 71/2 10 15 20 25 30 40 50 75 100
Mark Number - -
of Each Size -
Applicant's •
Signature y'-i�t' }',1 11(• =Y1 • License # Permit #
T/A Utility:
Applicant's Address: /9 5,yy, /."A 4t', (NAME) (OFFICE LOCATION) -
(City) Co riv h `f (State) /7 r (Zip) / ?- R Service Request #
Phone # 5 Fs- 6 g-2/7Y Electrician:
M DIA USE ONLY DATE RECEIVED: DATE INSPECTED:
Correct Location: Same as Above n or: '
Red Notice Label n
Rough Wiring Outlets Surface Unit - Oven
Switches Range - Garbage Disposal
Receptacles Water Heater Dishwasher
Fixtures Air Conditioner Dryer •
Amp. Service Equipment Burner, Wiring &Controls for Amp. Receptacle
Amp. Service Conductors - Pump- - Vent Fans
-MOTORS H.P. 1/20 1/12 1/10 1/8 1/6 1/4 1/3 1/2 3/4 1 P/2 2 3 5 71/2 10 15 20 25 30 40 50 75 1100
Mark Number
of Each Size / . •
500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000 •
Elect. Heat
i
i
CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECTFEE FEE PAID
❑ RW Progress: Inc.❑ LKD❑ Contractor
❑ CFT Violation: Work Comp.❑ Inc. ❑
n L/A Owner CASH ❑
Fee CHK #
n L/A
Due MO #
n IPA - Municipal
INV #
Date: Other Side❑ Utility• Applicant
;- - . . Owner ❑
Cut in Card n Temp # Date
l i Final # Date • INSPECTORS SIGNATURE
APPLICATION FORM NO.250 EL 4/89
-- - -- - --
•
5
•
TOWN OF QUEENSBURY
• Bay at Haviland Road, Queensbury., NY 12804-9725-518-792-5832
0.' 97 it& /A
Date: ,r,,/,0 2
•
dCW
RE: Tax Map #
Building Permit # a_
Dear 9A2.. •
The inspections for the building permit indicated above have been completed
by this Department. However, the final electrical inspection has not been
made, or if it has, we have not received an indication of this from the
electrical inspection agency to whom you applied.
Please contact your contractor, or the electrical inspection agency
representative for this area, list attached, to finalize this inspection as
soon as possible. A Certificate of Occupancy or Certificate of Compliance
cannot be issued for this project until such time we receive this notification ;
and therefore, .the,-dwelling, addition, garage, etc. for which you applied,
cannot be legally used in the Town of Queensbury.
We anticipate your cooperation in this matter. -
Very truly yours,
//,
/
DAVID HATIN, HIRECTOR
BUILDING & CODE ENFORCEMENT
DH:lm
•
"HOME OF NATURAL BEAUTY. . . A GOOD PLACE TO LIVE
SETTLED 1763
(.M)/7?nt,e.i - v 3 c-- �nt.
µ` , t TOUR OF QUEEN DRY
� ... 531 BAY ROAD
raj• . QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
FINAL INSPECTIO1 ��
REQUEST FOR INSPECTION RECEIVED 4//F -//
NAME 7J / 0,r,olbY7(,---)?___---
LOCATION / t, I54 /Y(i d ('9/l,. �'
DATE /ll /9/ � PERMIT# L9D 5S J
TYPE OF STRUCTURE . 2{./ C(.�.f,P)a-tt )
RECHECK
_FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
FOOTING FOUNDATION BACKFILL :—FRAMING
ROUGH PLUMBING FINAL ELECTRICAL_SEPTIC .
INSULATION WOODSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREMENTS / YES NO
REMARKS 1/400 „ fl7 / - ( rt4_.e
APPROVAL
J N/A YES NO
CHIMNEY HEIGHT/LOCATION 4
B VENT/LOCATION i
PLUMBING VENT / ;
ROOFING /
SIDING r/
DECK/PORCH/STEPS/RAIL/INGS!
RELIEF VALVES /
FURNACE/HOT WATER O ERATI'NG
BASEMENT INSULATION/DUCTWORK
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN W TERTIGHT
OTHER FLOORS WEEPABLE1
OTHER FLOORS CARPETED I
STAIR CLEARAN /RAILINGSI
HANDICAPPED CESS y
SMOKE DETECTORS
BATHROOM FA S/WHOLEHOUSE FANS _
ALL PLUMBING .FIXTURES OPE TING
GARAGE FI E PROOFING
DOOR CLOS RS \
OTHER FI E SEPARATION
FIRE/DE SE WALLS
DUMPSTE
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS:
ARRIVE
DEPART �---
R
A/6-6-T-gim Azrzf g7114-
TOWN OF QUEENSBURY
4, 41111t14 531 BAY ROAD
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT ,
FINAL )ISPECTIO(
REQUEST OR ION RECEIVED
NAME Ls°
LOCATION P c 24$
DATE [v f D/9) PERl1IT# �1;Gj
y
TYPE OF STRUCTURE / fl(7d7 -Lr6-1p_ltsrt10,J�
RECHECK ,
;f .5
FIRE MARSHAL APPROVAL (COMMERCIAL STRUCTURE)
_FOOTING FOUNDATION BA'CKFILL FRAMING •
ROUGH PLUMBING FINAL ELECTRICAL _SEPTIC
INSULATION WOODSTOVE/FIREPLACE
SITE PLAN/VARIANCE REQUIREINTS YES - NO
REMARKS
Ifs
APPROVAL I.
N/A YES NO
CHIMNEY HEIGHT/LOCATION i a'
B VENT/LOCATION y ri
PLUMBING VENT e fi
ROOFING
SIDING
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OP.RATINGI'
BASEMENT INSULATION/bUCTWORK
INTERIOR TRIM/PRIVACY DOORS '.
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
HANDICAPPED ACCESS
SMOKE DETECTORS
BATHROOM FANS/WHOLEHOUSE FANS
ALL PLUMBING .FIXTURES OPERATING
GARAGE FIRE PROOFING
DOOR CLOSERS
OTHER FIRE SEPARATION
FIRE/DEMISE WALLS
DUMPSTER
FINAL ELECTRICAL
OK TO ISSUE C/O OR C/C
COMMENTS: � l '
• ' 20 irl�- O.( '
pL.GA5 s c rLL E. •6)i-
�-o Z . /\1 3 1&Ci7 DAT
•
ARRIVE LfsC)6
DEPART I 20
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS )71?-1)
QUEENSBURY, NEW YORK 12804
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED 7 dQ
•
NAME `riA l,v
LOCATION JI *0-21.4(,
DATE �J,? lfr/ PERMI # •- -
APPROVED
6P71,112.4,64;C, .}-. YES NO
FOOTING/PIERS
MONOLITHIC POU' FORMS
FOUNDATION/DAM'-PROOFIN
BACKFILL APPRO
ROUGH PLUMBING I ' 1,1 ' V
XFRAMING
ELECTRICAL ROUG -IN
INSULATION:
FOUNDATION j
FLOORS
WALLS
CEILING Nil
FINAL INSPECTION.,
CHIMNEY HEIGHT ).
ROOFING I'.
SIDING 1
EXTERNAL PORCNI'!ES STEPS
STAIRS-CLEARA, CE ',& RAILS
PLUMBING FIXIJURE RELIEF. VALVE
INTERIOR TRIj/PRI ACY DOORS
FINISHED F *ORS
GARAGE FIREPROOF'
DOOR CLOSER!(S)
SMOKE DETEiTORS
FINAL ELECTRICAL INSP CTION
FINAL APPRO y'L OF CON'TRUCTION
1
A SIGNED CIRTIFICATE 0 OCCUPANCY MUST BE
OBTAINED F'OM THE BUILD NG DEPARTMENT BEFORE
THESE PRE /tSES ARE OCCU' ED!
REMARKS:
P
INSPECTOR
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST F R INSPE TION RECEIVED 4,1 16)00
4/1
NAME NOR) (V//144.J l
LOCATION' [0 \af)JOM( 0,01M ( L
DATE +II 9 I 0 PERMIT # q�
t \
, APPROVED
I7YES NO
FOOTING/PIERS •':' •
MONOLITHIC POUR FORMS
FOUNDATION/DAMP—PROD ING
BACKFILL APPROV L \ . f
ROUGH PLUMBING(] A
FRAMING e
ELECTRICAL ROUGH—IN ' \ . z%
INSULATION:
FOUNDATION fr
FLOORS \ •
WALLS
CEILING • \ /
FINAL INSPECTION: \;±
CHIMNEY HEIGHT N
ROOFING r
SIDING rj'
EXTERNAL PORCHES/STEPS
STAIRS—CLEARANCE & RAILS;' N.
PLUMBING FIXTURES/RELIEFII VALVE'k
INTERIOR TRIM/PRIVACY DOORS ,
FINISHED FLOORS t' ti1
GARAGE FIREPROOFING ' s
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION '
_.FINAL APPROVAL OF CONSTRUCTION
- OK TO ISSUE C/O OR C/C
A SIGNED CERTIFICATE OFiOCCUPANCY MUST BE
r
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE -
THESE PREMISES ARE OCCUPIED!'
REMARKS: {
•
•
?(/
ARRIVE )t
DEPART /1 Z'`2-
.INSPECTOR
VOWWARMWARNMA�
FILE COPY
4Ma
)Wt
-ty
F, T.
i;v
MAR 12 1990
BLOG. & CODE DEPT.