6331 C/C Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW. YORK
Date ?) ' '
1920
2.
This is to certify that work requested to be done as shown by Permit No. 67.4) ./
has been completed.
Thu structure may be occupied as a O ;114:1_0_ Lel
/17
"Z.3-77:3 1 :/k14;j1 "Ii'--)11714/7
Location
Owner TV/19:.aS
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
r '
CREATIVE "INSTA• PRINTING. GLENS FALLS. N• 12S01 (51E11793-56Se
BUILDING • PERMIT
TOWN OF QUEENSBURY No. 6331
•
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Martin C. Mosher
(St. #37)
OWNER of property located at Lot 85 Helen Drive Street,Road or Ave.
rt
N•
in the Town of Queensbury,To Construct or place a One—Fermi 1 y nwp1 1 i rig
at the above location in accordance to application together with plot plans and other informati'on.hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 0
R. D. #3 cn
Glens Falls, N. Y.
2. CONTRACTOR or BUILDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
same r,
- o
rt.
4. ARCHITECT'S Name co
Ui
ID
H
5. ARCHITECT'S Address lD
ri
N.
6. TYPE of Construction—(Please indicate by X) (D
(x)Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
36'x28 ' per plot plan, specifications and application
No. submitted including two—car attached garage and sewage •
system.
8. Proposed Use 0
One—Family Dwelling
$5. 00 C/O Paid
$ 150. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 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 C7
town of Queensbury before the expiration date.)
1-1
•Dated at the Town of Queensbury this 8th Day of May. 19 8 0
SIGNED BY ���te p .l1tL� '� for the Town of Queensbury
Building a d Zoning Inspector
��e
) � _
TOWN OF QUEENSBURY . � �-
(Space inside block to b filled in by
WARREN COUNTY, NEW YORK Building Inspector)
• Application No.
' Application• forI'rrtuit Issued 19. .
BUILDING AND ZONING PERMIT Permit Expires. Ig. .
/Amine District
•
• Viilue 01 Work
THREE (3) Copies of a PLOT PLAN, Drawn to scale 'I'I ""•`' 1i•
showing the actual dimensions of the lot to be built kvinal'}CS'
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB- •
MITTED WITH THIS APPLICATION. G7/ -%77-2 •
q 0 - — 25 'A ay , / 9,o Tot N OF QUEENSBue._
DATE R
� � tea � 1/ I.�
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
ANSWER ALL OF THE FOLLOWING. MAY 81988
The undersigned hereby applies for a permit, to. do the following work A.M. �✓ e� te a.j c _
which will be, done in accordance with the description, plans and specifi- 7 $ gt10I11I12IY�2�3I415��
cations, and such special conditions as may be indicated" on the permit. ® �. .I, . . 4 ; . .,
T e owner of this property is:
. . . . . ,a/M,; • C . L7s,‘,..L.:..1-4,L- -R D 44(c.? e"1-444'31-401 -A4A.1 ,•A•••X•
(NAVE)
The rsontresponsible for ...supervision of the work.-insofar as the Building Code and the Zoning Ordinance apply.is:
•q61
• (NAME) (P.O• ADDRESS)
Name of Builder Address . .....144►4
Name of Plumber. . .. - Address
Name of Mason • �4.1."4-i-• Address pp _
P..5. Unit Estimated value of proposed work 3 6O.,,CQQO. .'. . . S .-r ./91-.O
Lot Number. . . . . . . . .. P P � -.�
Name of Village . . 7-.-4G4.-!'s.-.' s---/L-i •
Name of Street . .lel-f---&1-!. A Side of street: north 0, east X south 0. west El
Nearest Cross Street - Distance front this ^ross street ye o Ft.
Property is north 0,south (2t,east i 1, west 0 from-Cross Street
•
If on Corner, which corner,northeast 0, northwest ❑, southeast ❑. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK • • -- OCCUPANCY
Igl Construction of a new building. Main Buitding
❑ One-family,dwelling Two-family dwelling Addition to a building. ❑
❑ Alteration to a building. . • • , . . . .-family apartment house ❑
CI Demolition of a building. Store building ❑
• ' - <=t-car attached garage gg
Other:
• Accessory Building
' One-car.detached garage El
❑ Other work. Describe• . Two-car detached garage
Private chicken house t]
•
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, sire and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH Show proposed building(s) in dotted line and existing
luilding(s) in solid line. •
Size of property. . . . . . . . . . ft. x / 7, ft.
•
Size and use of existing buildings, if any
•
i w Size of proposed building'. . . ?.. . ft.x . .a2. P. . . ft.
- Height (from grade to ridge) . a ® • ft.
Front yard �.0 ft.
• Side yards . AC- ft. and l-1r ft.
- , - _ it.t1 • Rear yard 7i 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.?. . . a '!`' !• 4� '`r
Will any second-hand lumber be used? c-1til7 If so, for"what
Material of foundation walls . . . . . . . .P. Thickness . . . . .
Depth of foundation walls below rade e r Continuous foundation? . . O .
Will there be a cellar? If so, material of cellar floor 'c.c.T-4..
Type of roof: Sloped or flat? . . . . . Material of roof A.A.iz.f." . . .� �" -
c:A . x ", spacing . . . . . .. /.�'. . . o.c., length ��
"
Size,wood studs / � �'• ft.
Size, floor beams, 1st floor " x /O ", spacing "o.c., span /V ft.
Size, floor beams, 2nd floor vg " x / 6 spacing / "o.c., span / / ft.
Size, ceiling beams c,? " x 6 ", spacing / 4 "o.c., span /$/ ft.
Size, roof rafters or beams oZ " x ci4 ", spacing . . . . . . ./6 "o.c., span /3/ ft.
Exterior finish / ' -'-' With what material?
Finish of interior walls / "
If garage is to be attached, of what material is wall between garage and main building to be constructed?
/42 .". . . S. . . . .
Is there to be an opening between garage and building? k7.-O
Kind of heating system . . . . 6,( - Oil burner or coal?
Will a flue-lined chimney be provided? . . -e-1,1-?• • • • • • Depth of chimney foundation below grade . .6..7'
Height of chimney above roof o2 e
Will there be a fireplace? `` Depth of fireplace hearth ./. "
Will a toilet be installed?
Will a kitchen sink be installed and connected to water 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 ta"nea j of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.e,plete 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 such work is authorized by the owner. /'
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 AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS RD ,#1
GLENS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSI3URY
CCCUPANT9 S NAMEE ADDRESS ' S2.r Atc.4.✓ L* .
TELEPHONE 79a-- zfeso OrINERQS NAME .,G}g,% 1i,_
ADDR ES S (�?'( � ,,/ ,-�,✓ NUMBER OF BEDROOMS 34
GARBAGE GRINDER? -o (YES OR NO) TOPOGRAPHY: FLAT ROLLING STEEP, SLOPE,
GENTLE SLOPE, OTHER
NATURE OF SOIL: CLAYS, SANDY, LOAM, GRAVELS ROCKS, ETC.���__�
PERCOLATION TEST WATER SUPPLY: P�SUNICIPA WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC SYSTEM
•
OTHER PERTINENT INFORMATION .
1.T IS HEREBY AGREED THAT IF THIS APPLICTION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN
DATE J5B SIGNATURE OF APPLICANT,�� �
LAKE GEORGE PARK COMMISSION APPROVAL:
signature
tdate)
7. ,in mpi....v..Ca��J....1,,,Jd,V.,AJJ. ,,A..._".4. e,,..,,.Ca,.Ca�._CJ_._CJ.%�_lS_.14..A_V_��lJ-.�_l'J.��_C}J.C).�._Cad._C _lJ._U_TtU.�n.,..�k��.C��....7._V_y.CJ.�_CAl.1. IJ_�_Call_,a�k�.n.,,,xne..!.. 17,C ne. .!C.�
THE NEW YORK BOARD OF FIRE UNDERWRITERS ,T
i.1 -s,/,. BUREAU OF ELECTRICITY
41 STATE STREET,ALBANY,NEW YORK 12207
Date December w" J� P 1980 APPlication No.on file "fY' ti i�'3�!..S�' A F' =j a �3 y
THIS CERTIFIES THAT
only the electrical equipment'as described below and introduced by the applicant named on the above application number in the premises of
Martin Mosher, �Ioncn Drive, Q7.1e"'. m a s .t -e ,� %�i3 y r New.
1� in the following location; 0-Basement (Jilt— 5 e �'J�`'1st Fl. 2nd Fl. Section Block Lot
• , was examined on 10 `? 30 and found to be in compliance with the requirements of this Board. ,r .
W; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;50
-j OUTLETS RECEPTACLES SWITCHES MERCURY
�, INCANDESCENT FLUORESCENT VW AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P:
c
lk' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS ,>•
j,, 'Y
'AMT. K.W. OIL ' H.P. , GAS H.P. •T AMT.)- F PNO. , A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT.- WATTS i
�i _ e° ,r
1 I':r'S t' 1 0
�, d __ 1 TT S S. .
�, SERVICE DISCONNECT NO.OF `s✓_' 4 c
' E R V I C E
S{(i AMT. AMP. TYPE METER
1 A 2W 1,B'3W 3 1B'3W 3 A 4W NO;OPER%COND. OF CC.COND. NO.OF HI-LEG OF.HI LEG NO.OF NEUTRALS OF NEUTRAL
1
�' 1 n0 rry l „„ _ 4/07 '0�
OTHER APPARATUS:
q �.3 q J
�� Smoke Detector Elec. Heaters; �.,� q 5 :` 7
E'A: ? i.c, ;3MD G ± Lrna .. r...i O kw
q' 3-2. `✓' kw
•a
•
Jo
jai
1
C(1 —
io
CCU R79 2 �.,,', .i
p
i-o�, s.._�:i D ° a 3 C++ BRANCH MANAGER
' , o
,
k, Per
r
''CYYYYY FYYY Yl'YYYY`CY YYYY YYYY YYYYYYYY YY YY YYYY YYYY YY YY YY YYYY YYYY YY YY YYYY YY'es?YYYY YY'CY YY YY YY YY'CY-Y YY YY`fY'YYYY YY YY YY YY YY.Y
C'FP'( FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
• TOWN OF QUEENSBURY
Building Department
Inspectors Report Date ��-- S;coo
Name
Location LGf .4;5- .) / 1
. Permit No. 0, 3 31 Weather
Remarks
Excatia ton
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer •
Rough Plbg. /
Relief Valves
Wall Board
Ext. Porches '
Finished Floor \j/e/
Interior TrimStairs & RailingsCellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney •
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation '
. Walls
Ceiling
Building n pector
REMARKS
/(4eA I •
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date P--- pi
Name OSA.er--
Location L.rr rs '<5` Ale e !}
Permit No. (o 3 3 / Weather
Remarks
Excaation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim f
Stairs &Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval v/
Floors
Insulation Foundation
Walls
Ceiling ' f
it/
Building Inspector
REMARKS
4
TOWN OF QUEENS•BURY
Building Department
Inspectors Ret Date -7-7_3/-At)
Mane /Llo er
Location .40/ .:9S—izkif9J A I Z
Permit No. l P 3,3/ Weather
Remarks
Excafta ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing •
Backfill �
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor \/7
Interior Trim
Stairs &Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation '
Walls
Ceiling
Building Ins ctor
REMARKS
/-teed/ va, 1-- ` P. /04
Gbh e.rL
e- ecAio
TOWN OF QUEENSBURY
Building Department
Inspectors Deport ate L 6
Name Location �" 4=57 /�,P r�/,
Permit No. Lo r ? Weather '4'! -
3 3( d d A)e OLr�'Remarks
c
Excavation
Footing Forms
Footing & Piers L�
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation
Foundation
Walls
Ceiling
Buil ing Inspector
REMARKS
TOWN OF QUEENSBURY
STATE OF NEW YORK RECE [IVE
DEPARTMENT OF HEALTH
% . 5tN 41980 DISTRICT OFFICE
21 BAY STREET A.M.
P.M.
DAVID AXELROD, M.D. 71 1.011ppI 31
4 $ FjP.E.
Commissioner GLENS FALLS, NEW YORK 12801 Actfngnistrict btrector
1
Tel. 793-3893 Area Code 518
6,33
Septembv 2, 1980
MA. Stephen Lynn
Qieenthu&y Town Hatt
R.D. #1 Re: Evengxeen Subd.Lv,bs.Lon, Sect. III
G.Penz `Fatbs, N. V. 12801 , Lot #85
QueevusbuAy (T), £Va Aen County
Dean Mac.. Lynn:
Thy 2etten .vs -to con{JAm ow necen-t -etephone convehzat.Lon negaxd.Lng
the uz..e 06 /seepage p-i t.6 .Lnz.ead oU a .i,2e {.Lead on Lot #85.
.The jsubdiva on map approved December 18, 1973, -showed tite'6.LeJd4
as the on.2y means 06 isewage dLpooa.J. It a acceptable to .thiz o{.U,Lce
. that seepage pits be empto yed, pxov.Lded that it 'a done undex your
d-ucectJon and in accottdance with the New.Yox!z State Depcur. rent oU Heatth
• Standand4.
Very t'w y younis,
i0a
DSM/mh Dan S. Machete, P.E.
Azzatant San.LtaAy Eng.Lneen