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86-535
CERTIFICATE IFICATE OF OCCUPANCY PA_ \CY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date J.Z9 JAIa 6 19 This is to certify that work requested to be done as shown by Permit No. 86 535 has been completed. This structure may be occupied as a "" i �'' Liaocia Road, a(?vorC a ,e, Location Dukmc.lel 9 Jr. Owner By Order Town Board TOWN OF QUEENSBURY p o. Building & Zoning Inspector _ II BUILDING PERMIT TOWN OF QUEENSBURY No 86-535 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Donald Rozell, Jr. OWNER of property located at Mason Road, Cleverdale 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. 1. OWNER'S Address is 6207 Regency Park Glens- Falls, New York S 2. CONTRACTOR or BUI LDER'S Name HFH Construction • 3. CONTRACTOR or BUILDER'S Address Dix Ave. Glens Falls, New York w i 4. ARCHITECT'S Name 0 5. ARCHITECT'S Address ma's rD IL ri 6. TYPE of Construction—(Please indicate by X) E1 1 *Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications 40'x64' per plot plan, specifications and application submitted No. including sewage system and two—car attached garage. 8. Proposed Use PER VAR. 1056 granted March 1986 One=Family Dwelling zv N• $5.00 C/O $ 164.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 7987 - (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.) F'• 4th September 86 Dated at the Town of Queensbury this /� Day of P 19 SIGNED BY Y/2 a /0"'.�7� for the Town of Queensbury Building and Zoning Inspecto 1eft.�-• - TO BE COMPLETED BY BLDG. DEPT. cam/ Application No. �� a,�, Jown DiQueenaurl� Permit Issued 19 TOWN N OF QUEEN ,- , BUILDING and ZONING DEPARTMENT Permit Expires 19 `, 1,11-:F iii '; t Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation La- 11.�.. - ` t` i t Queensbury, New York 12801 Variance No. /d J Ce - hs. ti liFr, ,• j • ` • • Site Plan Review No. a amc -/- Approved by:, i ( :'; 1"3 ` g a 01 zm �s��� II APPLICATION FOR U/r/43 (6 • BUILDING AND ZONING PERMIT *. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * # * * * * * * A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING. The undersigned hereby applies for a Building Permit to do the following work which will be done in accordance with the description, plans and specifications submitted, and such special conditions as may be indicated on the Permit. 4 The owner of this property is: ,-Throici RD-2e J/ Y', P.O. Address 62D 17 •Re9Ghcv ° :"af- f C'r lops r,-//s , I\I. f Tel. 793 -76 ?/ Property Location: f sc JR50?d CIevZ'rc- !P N. > Tax Map No. 1.1, / 1 / 24-, Street number or building lot 'nu,mber Subdivision name (if applicable) • THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS: (-)/2 /J ter`ze f 1 I!'. — 6 d`7 tc,9r=)rii c v Por/(2 G fpti c r,---,4t_j -79. --7 "/ Name P.O. Address f Tel. No. Name of builder- F-44 a,,,g Address Di X /lye, Tel. 792 _6,294 Name of plumber/, ,i s,�erg '7 14 Address ¢J,/,9`/, hd Alm,i G. F. Tel. 79 y— 2,5 29 Name of mason,7rr,, McVv n rd Address(,`3 )--)-e ton Dr;ve)1 6 F Tel. 79. -3,57 2r NATURE OF PROPOSED WORK: * ZONING INFORMATION: Construction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED, Addition to a building * drawn reasonably to scale and attached hereto, Alteration to a building * showing clearly and distinctly all buildings, " (no change to exterior dimensions) * whether existing or proposed and indicate all Other work (describe) * set-back dimensions from property lines. Give * street and number or lot number and indicate FOR DEMOLITION PERMIT, STATE SIZE AND * whether interior or corner lot. Show location LOCATION OF STRUCTURES AFFECTED. ' of water supply and location and configuration * of septic disposal area. e "�� * COMPLETE INFORMATION. REQUIRED BELOW. • A`{` . . * Size of property c/O ft X l6 5 ft. . � * Existing building(s) Size ft X 2 , ft. * ' Gas,a9.e - trr i c. �- PROPOSED BUILDING AND EapP}STvra?e-36x2-4-* Existing building(s) Use Size of new structure 40 ft X 24, ft x• ' ' ' ' ' ' ' ' ' Foundation-pier/slab/crawl/partial/full * Proposed building, distance from property line (circle one) *- * Front yard ' '4--®' ft Rear yard `i c-" ft No. of stories (habitable space) Z * Side yards J ft.and • 3'1 ft Height (grade to ridge) - ' ft. If residential, no. of families * If on corner, setback from side street ft No. of rooms(excluding baths) 'R OCCUPANCY INFORMATION -- No. of bedrooms No. of bathrooms @2�� * PRIMARY BUILDING - � ' >cOne family dwelling Primary heating system F iawi- es"i-- • * Two family dwelling Type of fuel — No. of fireplaces to be installed ' I * Multiple dwelling / Number of units Will a wood_stove be installed? No * 'Permanent occupancy y Central Air conditioning? NO * Transient occupancy Business BUILDING STYLE, PRIMARY STRUCTURE x. Industrial *' Other . . . . Ranch Contemporary Log cabin If addition, what will use be? " Raised ranch Mansion Duplex Split level Old style Bungalow . Cape Co Cottage Other * ACCESSORY BUILDING- Colonial Row Town House * Detached garage/one car/ two car/ car ( CIRCLE ONE PLEASE ) * --Attached garage/one car/ wo car car * * *_ * * * * * * * * * * * * * * * ' 'Private storage building . ESTIMATED MARKET VALUE OF * Other CONSTRUCTION- ?�� ©rJa. �? INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED! Form BPA 4/86 and-vl BUILDING PERMIT APPLICATION CONTINUED - • BUILDING SPECIFICATIONS: - Type of construction,Good frame fire safe,etc. Will any second-hand or ungraded lumber be used? If so, for what? �Jp Foundation wall materialouPe4 Thickness�On C 6'�1� Depth of foundation below grade (to bottom of footing) Will there be a cellar? No Heated or unheated? Floor sq. footage 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 - slopedlflat/shed/other Material- of roof F 4,p��J�S.S' Size, wood studs 4— "X 4 spacing le„'' "o.c. length c / ft. Joists(floor beams) • l Gt floe-r Z "X- '=-sacincr Joists (floor beams) 2nd. floor ,7 "X 17 " spacing )e "o.c. span )4 ft. Overlays(ceiling beams) "X (, " spacing 24- "o.c. span it ft. Roof rafters "X j7_ " spacing , q-"o.c. span is ft. Roof trusses(pre-engineered) spacing "o.c. span ft. Exterior wall finish t,L)ej©A Of what material? Interior wall finish Sheep oc.{T . If a garage is to be attached, describe materials to be used for FIRE SEPARATION: 5/8 ' FiC& Cc7�6' Is there to be an opening between garage and dwelling? yos If so will a Fire-rated 7/ door, enclosure, and self-closing device be provided? _ yes Will a flue-lined chimney be installed? ye S Height above roof ft. Depth of chimney foundation below grade Lj. ft. Depth of fireplace hearth fft. )(in. Water supply - Municipal or private well La Ked SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties Z 5-0 ft. (A separate application is necessary for any repair or new installation of septic system) Town of Queensbury AFFIDAVIT STATE OF NEW YORK County of Warren T swear that 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, whet el' specified or not, and that such work is authorized by the owner. SWORN TO EFORFd ME THIS Signature- / _ _ _ Owner, owner's agent,arcnitie ,con a for day 19 Notary Public, Warren County, N.Y. * * * */* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * SPECIAL CONDITIONS OF THE PERMIT: • B �� Y I own oir clueen3bur'y APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 DATE ' / �d • • LOCATION OF PROPERTY FOR INSTALLATION tin- 0-,-7 Pd — c(,evero i • OWNER'S NAME T)(571M,A �", a 1/ - 1 f , ADDRESS 2 / �'-;TICS( chi (` //S - TEL c7/'3 `•"7,�*,'71 l / INSTALLER' S NAME f TEL _Sewer TEL 79 ,. 4-8 ��--�� V 1 . J Number of bedrooms(residential only) 3 Total daily f 7.ow(compute @ 150 gal per bedroom) 145-0 Topography: Flat. - Rolling - Steep slope - (circle one) % of slope Soil nature: Sand - Loam - Clay - Other . .Depth ft. (9 Ground' water -At what depth? g7z ft. Bed-rock or impervious material - At what depth? çVJ577 Q�ft. Percolation test - Not required - Required - -Rate min-inch. Domestic water supply - Municipal - Well - Other .1,,,, kk, Separation - Watersupply(if well) from Septic absorption 2_0(../ f`fr T7 �-- Proposed System: Septic tank )d-oO gal. ( Minimun. size, 1000 gal. ) r Tile Field - Each trench ,,_31D ft. Total system legnth 'moo J /t. 25O Seepage pit(s) Number of . . Size each ft X ft 1, Size of stone to be used # 3 Depth or thickness ) ft. vndg,^ 4 )6p I* *MPOR*TANT* * ! !* * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * On a separate piece of paper, submit a diagram of the proposed system with all dimensions shown; including distance from any structure , distance from property lines and from ANY DOMESTIC WATER SUPPLY or shore-line of lake, stream,pond or wet-lands/ Include all dimensions of the system, itself . * * * * * * * * * * * * * * * * * * * * * * *• * * * * * * * * * * * * * * T hare read the reoulations on the reverse side of this sheet and agree to abide by these and aZZ requirements of The Town of Queensbury Sanitary Sewage Disposal Ordin. Signature of responsible person, 0,) Q.,,, -' 05/86 and/v1 • Section II Septic System Inspections: • . A. All applications for septid system installation, alteration or repair, as reauired by the Town of Queensbury Sanitary Sewage Ordinance, shall: be . submitted to the Building Department at least 24 hours before start of construction 'and shall • include a plot plan showing: 1) the proposed location of the system 2) location and distance to lot lines 3) location and distance to structures 4) location and distance to any water supply 5) size and dimensions of all tanks, distribution . boxes, tile fields and/or drywells B. No system shall be covered before inspection and • approval by the' Building Inspector. Failure to comply with this requirement may result in the uncovering of the system by the ,installer and a • fine of up to $250.00. C. An approved copy of the plot plan shall he • available on the construction site. Failure 'to produce said plot plan at time of inspection may result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installation, alteration or repair of an approved system, a new proposal a must be submitted to the Queensbury Building • Department before further construction. .. ,- ---- - - --- -----7-- - - -__NN. --_:-_- --- ,,,E151/K6r ,ger-ddem ce, . To'w n oF- Qua:p.(901'1:1Y . -.....,....1 , . -- -I 5.4".c K dc a, _ ,„. 1.,, ._00 I , . -,....1:se-rbp,K /I. I in— R ft)roc, 2.0° ,.:- • -- ocfr io a' _ _____..... 4.— , .. • 1^1,‘LeLz.s..,x7va ix.e. --..a'' iIx f id z ,... a „ —,-;;1-. ) erf zs-o i . - was —X' I gerTic LI it 0 , 0-. . I:CP It • A I 11 poowl, 1°°°(ia 1 I 1 PiS17:ituT:ervi I 00)( II . . serTecTe'i if Porno r,kr- I ...,. ! i i.,,, . ! lit v_.:'''. ' if 5 er-so' E fCett- . 1 . 1 .-------r—H • \ . . . •. ..... • - \\,\. \ t . „ . . . oc.si i. R0 Z Ev1— - R.EC i f2ENCE- \\. . m/4501,4 Roft.r) ...Ael-: F:oF6-E* r.,,f,y, ) i ' ‘, . .. . . . - . , . 4,......,.............______:. . . 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' . . -t, c_r 11'ec( /// _louin of Queen 3 urty BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 2/) i nsp ecri d4 BUILDING INSPECTOR' S REPORT NAME Dan4ls 1iO2ce d/ LOCATION mason flocI Date da g 7 Permit No. 4 5-75 * * * * * * * * * * * * * * * * * * * * * * * APPROVED - YES / NO Footing/Pier Forms 'Foundation Waterproofing Backfill Framing Roofing ' Siding Masonry Veneer Rough Plumbing Relief Valves e Ext. Porches Finished Floors \ /� Interior Trim \ '' r✓'� Stairs & Railings . Cellar Drain Tile \ y Concrete Floors l„' Plbg. Fixtures Gar. Fireproofing / \ l/;/ Door Closers Smoke Detectors J`. Chimney INSULATION: Foundation Floors • Walls Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL anal Building Survey Next scheduled inspection (call- when. ready) Remarks- i0A.; • ••-&""11,44/ Buil ing Inspector 6/86 and-vl Jown of Queeniturcy BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR'S REPORT NAME C51 6.L4 LOCATION `/* A CZE A,444." Date///2-/ el Permit No. * * * * * * * * * * * * * * * * * * * * * * * V - APPROVED - YES / NO Footing/Pier Forms 1 Foundation - Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings \ Cellar Drain Tile � / • Concrete Floors \,/ Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls 7 '7� 71 //'le- Ceilin0 �` ` 4' Al/ "3/f s, FINAL EL C �TRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - 4-:;'k0-'*//' Building Inspecto 6/86 and-vl iv,o- 102--- 4'-30 API . . Jown of Queeniburcy BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME /20 Z- L LOCATION Alfsd 4� Date /0 Permit No. 3 - 5 * * * * * * * * * * * * * * * * * * * * * * * 00/ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill XFraming 14 Roofing Siding Masonry Veneer )Rough Plumbing Relief Valves . Ext. Porches Finished Floors • Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors ' /N\ Chimney / \ - INSULATION: t` Foundation • Floors Wails Ceiling FINAL ELECTRICAL INSPECTION DRIVEWAY APPROVAL Final Building Survey Next scheduled inspect on (call when ready) Remarks Ai, &dr- • Building Inspector 6/86 and-vl ----------------------------------------- - ter. awn o/ Queeniur, BUILDING and ZONING DEPARTMENT n iA Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME .b a v,. / 1v-? `7 LOCATION h 4 S a-k R DATE 430/gC PERMIT NO. 36 ;- 3_' SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length Length of each trench Depth of trenches Size of gravel_ SEEPAGE PITS-ENumber of) Size- ft. X ft. Gravel size ' PIPING: Size Type Bldg. to tank I Tank to dist. box �_-_D_ist..__box --to--f-field/wit - ----- — Openings sealed? YES N Partial LOCATION/SEPARATIONS: Foundation to tank fat. Foundation to absorption ft Absorption to lot line ft\ Separation of pits ft. LOCATION OF SYSTEM ON ROPERTY(circle one) Front - Rear - Left si e - Right side - COMMENTS: ILg ry J.., �►� . t0 '� c- • 5'66 6k Alm t-(A 6 biz to mm41 to F-(164 `T'A-L 2 5o rT-.. SYSTEM USE APPROVED Y NO • Building Insp ctor 01/86 and vl • awn of sQueenJburu BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCAT ION /:fie,;OA)) )2o DATE /d,4/ PERMIT NO. ( - SOIL TYPE - Sand - Loam - Clay - ' Percolation Test Required? YES - .NO Percolation rate - Min/Inch TYPE of SYSTEM: _ Absorption field, total length � 0 Length of each trench 5 0 Depth of trenches . f • Size of gravel _ SEEPAGE PITS er of) _ r--- Size- t. x ft. • Gr el size IPING: Size Type Bldg. to tank • Tank to dist. box _ -Dist:^'box--to-=field/pi N1 Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank ft. • Foundation to absorption \ ft. Absorption to lot line \ft. Separation of pits \ft. LOCATION OF SYSTEM ON ROPERTY(circle one) Front - Rear - Left s'de - Ri1\t side - COMMENTS: it OWL/--2fo2c 44 -W • • CAL./C (APO O ri& a ' '&Prf c._ PuyP0:0-44 L • SYSTEM USE APPROVED YES NO • Building Insp-"ct• Ol/86 and vl Cat/ i//57,05 /,./d /"" Jouin o� Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR` S REPORT NAME pohalJ Raze LOCATION C` d /C Date ! /G /fG Permit No. 0 -5",3,j-• ✓ = APPROVED - YES / NO Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer re-Rough Plumbing ,u,1/44Cr. s/qf Relief Valves Ext. Porches Finished Floors . Interior Trim Stairs & Railings _ Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney INSULATION: Foundation Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - • 14/7113 14111 Building Inspector 6/86 and- 1 Jown of Queeni4ur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME J? (d _ 'JLC)2 Q. 1 J L- . LOCATION [lusoin C l'Q d Q1 `QL Date (/I J/ /8 C- Permit No. ne * * * * * * * * * * * * * * * * * * * * * * * VII= APPROVED - YE / NO 1/Footing/Pier Forms Foundation Waterproofing Backfill Framing Roofing Siding Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors Interior Trim Stairs & Railings Cellar Drain Tile Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Smoke Detectors Chimney \ /" INSULATION: X Foundation ir Floors Walls Ceiling FINAL ELECTRICAL INSPECTION Final Building Survey Next scheduled Inspection(call when ready) Remarks- - • Building Inspector 6/86 and-vl . arum ol! Queenibury BUILDING and ZONING DEPARTMENT . Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 BUILDING INSPECTOR' S REPORT NAME A/vi,i4,q ` • LOCATION 47 421 Date 9 V' / �7 Permit No. glp 5-3 * * * * * * * * * * * * * * * * * * * * * V , ARP VED - YES / NO noting/Pier Forms �� ,.K Foundation Waterproofing Backfill Framing ' Roofing Siding • _ Masonry Veneer Rough Plumbing Relief Valves Ext. Porches Finished Floors ► , ,' Interior Trim �. Stairs & Railings � Cellar Drain Tile ? , _ . Concrete Floors Plbg. Fixtures / \ • • Gar. Fireproofing ../ \ • Door Closers Smoke Detectors Chimney . INSULATION: Foundation Floors Walls Ceiling • _ FINAL ELECTRICAL INSPECTION Final Building Survey : " • • ' Next scheduled inspection(call when ready) Remarks- - Q / i CYO-��- iU nt i rLti7-;,, uvazeQ YJ cr.,-L. • • • (, sue► Building Inspector 6/86 and-vl