5878 C/O P.Eid
"1
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date if-c*:. ?• 19717i
gOit 42'7-9/
This is to certify that work requested to be done as shown by Permit No. 777.
has been completed. •
This structure may be occupied as a A"e - 4,4,7,
(,:ff
Lorstion 922_ //e/-e't110 )
•
Owner M61,-6.1
By Order Town Board
TOWN OF QUEENSBURY
,
• ; ' •;
Building & Zoning Inspector
CREATIVE •INSTA•• PRINTING. GLENS FALLS N V 121101 1518)793465S
BUILDING PERMIT
TOWN OF QUEENSBURY 5878
No. •
WARREN COUNTY, NEW YORK
Iv
PERMISSION is hereby granted to Martin C. Mosher
N
OWNER of property located at Lot 50 Helen Drive (St. #22) Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One—Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. cn
CD
1. OWNER'S Address is
4 Helen Drive
Glens Falls, N. Y.
2. CONTRACTOR or BUILDER'S Name.
Same.
3. CONTRACTOR or BUILDER'S Address L�
Same
rt
01
0
4. ARCHITECT'S Name
(D
N
(D
5. ARCHITECT'S Address G
l�-
6. TYPE of Construction—(Please indicate by X)
X )Wood Frame ( 1 Masonry ( )Steel ( )
7. PLANS and Specifications
26 'x40 ' per plot plan, specifications and application
No. submitted including sewage system and two—car attached
0
garage.
8. Proposed Use N
One—Family Dwelling
iJ.
$5. 00 C/O Paid
i0. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Jan. 1 19 80
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the (D
town of Queensbury before the expiration date.)
F-'
Dated at the Town of Queensbury this 13th Day of June 19 79
SIGNED BY `g-rn for the Town of Queensbury
Building and Zoning Inspector (57
TOWN OF QUEENSBURY •
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
• Application for Application No. .
•
. - Permit Issued I9.
BUILDING AND ZONING PERMIT Permit Expires. IfI.
%Awing District
\ ;i l i to 1,1 Work/
THREE (31 Copies of a PLOT PLAN, Drawn to scale \►'►"'keel by
showing the actual dimensions of the lot to be built 1ti'n,,ii Ks
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
./9.y T OV N �r QUEENSBURY
94....,14,-.4-,. I2j3.ATE �
. JflflE
A PERMIT MUST BE OBTAINED BE
FORE Flif-ik34 BEGINNING WORK - `l ,ANSWER ALL OF THE FOLLOWING. / jUN .1 a l�1
The undersigned hereby applies for,a permit to do the following work A.M. P.M.
which will be done in accordance with the description, plans and specifi- L7l I9t10,11112111213i41516
cations, and such special conditions as may be indicated on the permit.
T e owner of this property is: . /' / ' _
. r`i% ✓,� . . . . . . .7• r`� �t1. . '•(P.O.AD RESS �S: / .�
(NA . . .
The person responsible for , _upervision of the work insofar as the Building Code and the Zoning Ordinance apply is:/"`d"D/
J
(NAME) DRESS)
Name of Builder. . ... - . . Address
Name of Plumber Address
9r Name of Mason ._.c '` `� •
Address _
Lot Number �62 Unit • Estimated value of proposed work S . . v --v
fit( Name of Village T � �D} C- Gr-'0-4‘
Name of Street . . . . � 1�. . 1 Side of street: north 0, east 0, south west ❑
Nearest Cross Street . . .. -i- 4. �). . . .-S%� /- Distance from this cross street / 0 4.969 Ft.
Property is north 0,south east i i,west ❑from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑, southwest
• • (Designate by marking with an"X in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY "
Construction of a new building. Main Building
❑ Addition to a building. . •. One-family dwelling .
❑ Alteration to a building. Two-family dwelling ❑
• ❑ Demolition of a building. -family apartment house ❑
Store building ❑
• A.,-car attached garage ❑
Other:
Accessory Building
One-car detached garage ❑
❑ Other work. Describe Two-car detached garage ❑
Private chicken house El
, • Private storage building El
• Other:
ZONING SPECIFICATIONS. Fill in for new.building, or addition to existing building, or a change of occupancy.
Indicate on the plot plan street names, the location and
. size of the property, the location, sire and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
/ �.• Iuilding(s) in solid line. .
Size of property / Ge-C ft. x . . ./2 . . . ft.
•
Size and use of existing buildings, if any
• = •
F••
m Size ofP°proposed building ft.x . . y O. • . ft.
Height (from grade to ridge) ' ft.
Front.yard �� ft.
Side yards / T. • . ft. and /4— ft.
Rear yard � 5✓ ft.
SOUTH If on corner,setback from side street ft..
Note: All distances are net, as measured from street side
. line to nearest part of building.
(OVER) . .
7-73-M . .
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . . • C"`` • • • • • • • • • • • • • • . . . . . . . . . . . . . .
Will any second-hand lumber be used?��� � If so, for what?
Material of foundation walls (.Y/P71GvL�— �, Thickness . . ./
Depth of foundation walls below grade t 7 0 b Continuous foundation? . . . .
Will there be a cellar? V-C-4/ If so, material of cellar floor . . . . . . . .e
Type of roof: Sloped or flat? 2 j� C...4. , Material of roof
Size, wood studs A " x ", spacing / "o.c., length Ce ft.
Size, floor beams, 1st floor x / i2 ", spacing /4 "o.c., span j/. . . ft.
Size, floor beams, 2nd floor . " x l C ", spacing . ./. "o.c., span ft.
Size, ceiling beams 7�LGr�x� ", spacing "o.c., span ft.
Size, roof rafters or beams . . . ,/o,!�-ti��Lx' ", spacing "o.c., span ft.
Exterior finish . • With what material?
Finish of interior walls. . . . //�2
If garage is�to be attached, of what material is wall between garage and main bui.Jding to be constructed?
/
d,
Is there to be an opening between garage and building? `.'
Kind of heating system . . . . o% Oil burner or coal?
Will a flue-lined chimney be provided? . . . Depth of chimney foundation below grade .G,
Height of chimney above roof. . . . .02. .�. . . . . . . . . . . . . . . . . . . . . . . . .
Will there be a fireplace? Depth of fireplace hearth /6
Will a toilet be installed?
Will a kitchen sink be installed and connected to ater supply? . . .�
Water supply (public water supply or pump)
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents?
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt, Ada r of my knowledge and belief the statements contained in this application,together with the plane and specifications sub-
mitted, are a true and co.a.p•lete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the proposed work shall be complied with,whether specified or not,
and that suchb work is authorized by the owner. l__—�_ ���-- ))1--•/—a•-'41.t,4,/
S' ature �YL ( L' J Sworn to before me this OWNER,OWNER'S AGENT•ARCHITECT.CONTRR
day of 19
NOTARY PUBLIC. WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
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TOWN OF OUEENSBURY
BUILDING AND ZONING DEPARTMENT
BAY AND HAV ILAND ROADS, F.,D o.I
GLENS FALLS, NEW YOR r 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE
DISPOSAL SYSTEM WITHIN THE TOWN OF OUEENSBURY
OCCUPANT'S NAME �� ADDRESS g- A 4-1/1
TELEPHONY:_ 7 9 c2— / . s—0 OWNER'S NAME_tizj 44,, � � ��__
ADDRESS Xa.1 &` NUMBER OF BEDROOMSr__ M�y
GARBAGE GRINDER4 (YES OR NO) TOPOGRAPHY: FLAT ROLLING, STEEP,
SLOPE, GENTLE SLOPE, OTHER
NATURE OF SOIL: CLAY, SANDY I,OAM, GRAVEL, ROCKS, ETC e
PERCOLATION TEST WATER SUPPLY: '[[JNICIPAL, WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
OTHER PERTINENT INFORMATION 7--4
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED, •
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN
DATE %,A/7,p SIGNATURE OF APPLICANT •
LAKE GEORGE PARK coycrassTom APPROVAL:
(siR ature)
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THE NEW YORK BOARD. OF FIRE UNDERWRITERS ,,..
BUREAU OF ELECTRICITY
F. 41 STATE STREET,ALBANY,NEW YORK 12207
.4!
.:,•: .. ; ,-
Date Application No.on file .
.>:
A 4,..
THIS CERTIFIES THAT
4!
only the electricateguiprnent'qsdescribed below and introduced by,the applicant named on the above application number in the premises of ‘)-1
:.:....i..':',.•:::::..1: .:.•:-1... ...'.::-... .-,1:. •-r:‘ ;I:.; -:.-,* ,:l.. ,11.?: ..,,,..,::::-.•1,',, , r.:•:1 '•,_1..::::_ . ts
.>.-
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in the following location; 'El Basement •E 1st Fl. El 2nd Fl.C'1-;.:1--j:::•-•;•,:2 Section . Block Lot •
• was examined on 1,!,.7.1;1)i 7,. :,.: and found to be in compliance with the requirements of this Board.
0! •
:)...>ii ,.
FIXTURE . FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLES SWITCHES
INCANDESCENT FLUORESCENT MERCURY
VAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P. lr
•---(,
1-k, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
e SYSTEMS
-0 'AMT. K.W. OIL ' H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. Ara. H.P.
'•.<, .AMT. WATTS
NO.OF FEET
-,,`.. ,. r;
WTh . ,
..'..::...!.
i0 SERVICE DISCONNECT NO.OF . .'.:.:.;.'_,. 5 ';'''2.'... E R V I C E
METER
AMT. AMP. 1.0 2W 1..0 3W 3 0 3W 3,i3''4W NO,OFpECeCOND.
OF t .''o:S.1.4D. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G.
TYPE EQUIP. OF HI-LEG OF NEUTRAL
. ... .
• ..- '' — -. , ,
w OTHER APPARATUS:
iRI _ 11
•-
2 . .
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. - ?•--7 ., t
4,4
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BRANCH MANAGER
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4.1
...Per
Ntetvetva Wit AU vitt vitt vit miet virt wit 114 Ulu NhAiltaltt_lei liet Awls/At/vitt mlecust Ifil Alt vet mlet veils!vet%Iv Armlet vercutt Art Wu AU ult(wallet um(Iht let ale vitt Nat'Mt
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
ri
TOWN OF E N B .
Building Dapartsnent
Inspectors Repr m,;''ta 5?- 7..
Name / -ioS
•
Location .44, . , _ /�, S�
Permit No. S 7 g Weather
• Remarks
Excavation
Footing Forms
Footing & Piers ——�
Foundation
Cement Coat
Waterproofing j ieiet.
Backfill
Final Surveti
Framing
Sheathing
Roof Felt
Roofing _
Siding
Masonry Veneer :
Rough Plbg.
Relief Valves , '
Wall Board
Ext. Porches
Finished Floor
Interior Trim I
Stairs & Railin s
Cellar Dr. Ti e
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing 1 ;;; ; l
Door Closers _
Chimney
Water Meter Inst. j
Septic Approval ;
F1 c;o s J
Insulation —
j i
L„t_1_,yng Ins . ct•cr
REMARKS
S
TOWN OF QUEENSBURY
Building- Department.
Inspectors Report Date 7/9/6-
Name
d
Location Go f—S7,
Permit No. A . '?cT Weather
Per Cent Remarks
Complete
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
_Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer
Rough Plbg. t✓ 1
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval Loo'' �d(/
1)6(7
Building Inspector
REMARKS
(0-rll
l �dr
OWN OF QUEENS$URY- .
Building Department
Inspectors Report Date C 2 7-2.
Nan:.: /ram ;),
Location _ ,
Permit No. S 0 Weather
7
Per Cent •
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat Waterproofing G. CY
Backfill �"
Final Survey ,...
Framing ,
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves /
Wall Board /
Ext.Porches
Finished Floor / \
Interior Trim
Stairs&Railings
Cellar Dr.Tile l-
Concrete Floors
Plbg.Fixtures
Gar.Fireproofing
Door Closers
Chimney _
Water Meter Inst.
Septic Approval
ilding Inspector
REMARKS
17Z6-44z-ip/kpo4
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date
Location 0/ �!
Permit No. ' ^ Weather
� Per Cent
S (" Complete Remarks
Excavation
Footing Forms
Footing & Piers b"-
Foundation
Cement Coat •
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plhg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Nlv
Building Inspector
REMARKS
- III
- I
• 1
� I
•
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414 . .
L72-) c.