5211 C Paid
CERTIFICATE 4F OCCUPANCY
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TOWN OF Q E NSeMy
WARM E . NEW YtyRK m
Dose Sept. 27 19 78 '
This b to cen* drat work d to be done as shown by Permit No.5211 V
has been compieft&
This stractwe M, be occupied as a ONE FAMILY DWELLING
LOT' 98 HEL EN STREET STREET N
tlwwnr MARTIN C. MOSH ER
Bp Order Town Board
TOWN OF QUMNSSURY
wilding & Zoning tw
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CMATIV[ "Ift9TA" PR/fIT/No. OL[Nf FALLS. N V Itffl 111f17f!•ffff
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BUILDING PERMIT
TOWN OF QUEENSBURY . No. 5211
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Martin C. Mosher
OWNER of property located at Lot 98 Helen St. (St. #11) Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One-Family Dwelling . g
at the above location in accordance to application together with plot plans and other information hereto filed and H-1
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
0
1. OWNER'S Address is R. D. #3 Upper Sherman Ave.
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
Same
4. ARCHITECT'S Name
CO
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
(x)Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
26' x54' per plot plan, specifications and application
No. submitted including sewage system and two-car attached
garage.
8. Proposed Use 0
Crl
One-Family Dwelling
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$5.00 C/O Paid r'
$ 70. lQ PERMIT FEE PAID —THIS PERMIT EXPIRES December 1 1978
(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.) rrl
Dated at the Town of Queensbury this 19th Day of May 19 78
SIGNED BY '- el At- � ,:ram\.1 for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY -
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector) ' •
Application for Application No.
Permit Issued 19.
BUILDING AND ZONING PERMIT • Permit Expires 19.
i. iniii District
• Value of Work S '
THREE (3) Copies of a PLOT PLAN, Drawn to scale -\1'I)T•')k(II I)y..
showing the actual dimensions of the lot to be built Rcni:n•k'. . .
upon, The exact size, 'and location on the lot of the
building to be erected or altered MUST BE. SUB-
MITTED WITH THIS APPLICATION.
DATE D n
•
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK IIJI L jJ
ANSWER ALL OF THE FOLLOWING. will( 1 ?) '�`9t8 •
The undersigned hereby applies for a permit to do the following work A.M. .
which will be done in accordance with.the description, plans and specifi- 7I8I9$1011111211 2 3 4 5 6.
cations, and such special conditions as may be indicated on the permit. I ,), I, I, Ia,
The owner of this property is:
. .(,,/.'. .�F�!hlit� "Z-!. .- ./_, /���/�J tr.L ... : .DTI.'. . . . . . . . . . . .
. (NA''E) L/�y' r/ (P.O.ADDRESS)
The person responsible for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) (P.O.ADDRESS)
Name of Builder. . ./ 'tt-L., Address
Name Of Plumber Address Address
Name of Mason (--S-C.rkh c� Address
Lot Number /ne./71 Unit Estimated value of proposed work$ o �c-J •
Name of Village-��-1". -u:\:t!.`.' .fit-. . . . . . //,,,
Name of Street , --1": � . x4v-Alice of street: north 0, east south 0. west
Nearest Cross Street . ,_.-d-ii - Distance from this cross street e`e Ft.
Property is north 0,south g east Li, west 0 from Cross Street
If on Corner, which corner, northeast 0, northwest 0, southeast 0, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Builtiing
❑ Addition to a building. One-family dwelling .
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house ❑
Store building ❑
. . . . -car attached garage ❑
• Other:
' Accessory Building
• - One-car detached garage ' ❑
Q Other work. Describe Two car detached garage El
Private chicken house . . ❑
Private storage building • ❑
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, site and setbacks of pro-
NORTH posed buildings,and the location of all existing buildings.
Show proposed building(s) in dotted line and existing
I uilding(s) in solid line.
•
Size of property . . . . . ./0. 0. . . . ft. x . . /. ?:. . . . ft
i
Size and use of existing buildings, if any
F ri
W Size of proposed building . . . .a L. : ft..x c-X ft.
Height (from grade to ridge) /F ft.
•Front yard ft.
�/�/ Side yards /6- ft. and &cS ft.
-�� S/1''• � Rear yard 4 0 ft.
SOUTH 1i 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)
. 4 -
(cont'd.)
BUILDING SPECIFICATIONS., ,
Kind of construction: Wood frame, fire safe, etc.?. . . 1:-.2-i-i,.v`.�✓.-rL.,,,—.
Will any second-hand lumber be used? �'1--0 If so, for what
Material of foundation walls . . . . . . . . . . . . ./0. .`.,�! --&-mil Thickness
Depth of foundation walls below grade 6 d ` Continuous foundation?
Will there be a cellar? If so, material of cellar floor
Type of roof: Sloped or flat? . . .� . . Material of roof . A o Ce-. .c5f2s.4-v:4-
Size, wood studs ,,Z "x `,f ", spacing / "o.c., length c? ft.
Size, floor beams, 1st floor "x /4 ", spacing / "o.c., span /3 ft.
Size, floor beams, 2nd floor " x / 0 ", spacing / "o.c. span /3 ft.
Size, ceiling beams ` ��/-.-uao. . . . " x ", spacing "o.c., span ft.
Site, roof rafters or beams ti.c.a e. . " x ", spacing "o.c., span ft.
Exterior finish - - / � With what material?
Finish of interior walls L -
If garage is to be attached, of that material is wall between garage and main building to be constructed?
i
. . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . .!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Is there to be an opening b tween garage and bu' ding? `�. .
Kind of heating system . t �'OCr-�'. . . . . . . . . . . . . . . Oil burner or coal?
Will a flue-lined chimney be provided? iz ��
Depth of chimney foundation below grade 6
Height of chimney above roof
Will there be a fireplace? Depth of fireplace hearth /( `
Will a toilet be installed?
Will a kitchen sink be installed and connected to wa supply?
Water supply(public water supply or pump) . . . A�
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 ss.
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 sub-
mitted, are a true and complete statement of all proposed work to be done on the described premises and that ail 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 such work is authorized by the owner. _ t.
Sworn to before me this Signature OWNER.OWNER'S AGENT,ARCHITECT.CONTRACTOR
day of 19
NOTARY PUBLIC,WARREN COUNTY. N. Y. _
SPECIAL CONDITIONS OF THE PERMIT:
By
TOWN OF QUEENSBURY
BUILDING & ZONING DEPT.
QUEENSBURY TOWN OFFICE BUILDING
BAY & HAVILAND ROADS, R''#i �v
GLENS FALLS, NEW YOR1 12DO/
,c,PP ICATTON FOR A PERMIT TO CONSTRUC t , ALTER OR ENLARGE
i. SEWAGE DISPOSAL SYSTEM WITHIN. THE TOWN OF QEENSRURYQ
C.: UPANTI S NAME :`DDRESS ,o C� .� y <���_' (24
CLL- �:Latva:�Y-v1 diaaRrtaYia]YQ3.ffi-!�" iTVt^fYJ YYY�
" Eq EMONE a iaa---0 OWNE °S NAME
ADDRESS c nJ f Nth E OF 13 ED '.O' aiS
(YESGARBAGEl NO) TOPOGRAPHY?, FLAT;, ROL ST ldEP
sm��nss.:s•� a��e
SLOPE, GENTLE SLOPE, OTHER
NATURE OF SO!Lt CLAY? SANDY? LOAM, GRAVEL, ROCK, ETC. 0•�� ��,
PERCOLATION TEST ___ WATER SUPPLY: ? E:TC lei :LL, OTHER-
DIAGRAM OP PROPOSED SEPTIC SYZTEM
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fit
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OM ER PERTINENT INFORMATION
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IT IS HEREBY AGREED THAT IF THIS APPLICATION ION AND PLANS ARE APn ROATf D c
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
DANCE
WITH DETAILS SHOWN„
"'E'eM T FEE IS S5OOOv
cme .. ......_.._............ ... ........,....'_-. �_..
DATE vim=/ 9- 7 SIGNATURE OF APPLICANT
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THE NEW YORK BOARD. OF FIRE UNDERWRITERS r
10 BUREAU OF ELECTRICITY.--' - T
41 STATE STREET,ALBANY,NEW YORK 12207
: Date Application No.on file dt► •4,
i THIS CERTIFIES THAT A 64
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of e
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in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
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was examined on and found to be in compliance with the requirements of this Board. ;
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS %
OUTLETS RECEPTACLES SWITCHES MERCURY
�� INCANDESCENT FLUORESCENT VAPOR AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P. %
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DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS I
r SYSTEMS'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 0.Y
5--tr y,
65
% SERVICE DISCONNECT NO.OF S E R V I C E '
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METER cQ AMT. AMP. TYPE EQUIP. �'2W ,B'3W 3.B'3W 3,B-4W NO.OPER COND. OF CC COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL
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OTHER APPARATUS:
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11 BRANCH MANAGER
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COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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TOWN, OF QUEENSBURY.
Building. Department cq�
Inspectors Report - Date
Name illas er- .
Location ,Lo/ %- /tic)
Permit No. f I Weather
Per Cent
•
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing.
Backfill •
Final Survey V I
Framing
Sheathing n
Roof Felt /tJ / A
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
Plbg.Fixtures
Gar.Fireproofing f�
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS
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TOWN OF QUEENSBURY
Building Department
Inspectors Report Date. '3
Nam, . elGSdt! /`-
Location MIL,, L oi 9$
Permit No. a/4 Weather
Per Cent •
em
Complete Rrj
Excavation
Footing Forms
Footing & Piers
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
Plbg.Fixtures P
Gar.Fireproofing f,/
Door Closers �
Chimney '
Water Meter Inst.
Septic Approval
t P
Building Inspector
REMARKS
•
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date ,l/,�1f�`7
Nate, 1/i:.41.��.. ''
Location j ,,L 4 J ems,. 5/—
Permit No. .3)- I I Weather
Per Cent •
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat •
Waterproofing
Backfill
Final Survey
Framing ,
6(4/
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor ,f
Interior Trim
Stairs&Railings
. Cellar Dr.Tile /
Concrete Floors
Plhg.Fixtures /
Gar.Fireproofing ,rd
•
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS
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TOWN OF QUEENSBURY
Building Department
Inspectors Report • Date Li 9/ 7/
Name 2/2/ -
Location
Permit No. 52 l2 Weather M
Per Cent •
Complete Remarks
Excavation d/
Footing Forms !�
Footing & Piers , f
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
/7 )
B7 ldin Inspector
REMARKS