87-359 t N.
TEMPORARY
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 27, 19 87
This is to certify that work requested to be done as shown by Permit No. 8 7_35 9
has been completed.
This structure may be occupied as a ONE—FAMILY DWELLING
Lot 71 Willow Road (St. No. 42)
Location
Owner Richard & Judy Mates
TEMPORARY 30 DAY C/O ISSUED PENDING
By Order Town Board
FINAL ELECTRICAL, "--
,„.20
TOWN OF QUEENSBURY ` 1
ad 6-_) 11444 *-/I
Building & Zoning for
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 87-359
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Richard and Judy Mates
OWNER of property located at Lot 71 Willow Road (St_ No_ 42) 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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
2. CONTRACTOR or BUILDER'S Name
Martin C. Mosher
3. CONTRACTOR or BUILDER'S Address
26 Sugar Pine Road
Queensbury, New York 12801
4. ARCHITECT'S Name
5. ARCHITECT'S Address
H
6. TYPE of Construction—(Please indicate by X)
(x)Wood Frame ( )Masonry ( )Steel (
m
7. PLANS and Specifications
26'x64' per plot plan, specifications and application including
No. sewage system and two-car attached garage. .o
CD
m
8. Proposed Use w ,
One-Family Dwelling
$5.00 C/O
$ 164.00 PERMIT FEE PAID-THIS PERMIT EXPIRES January 1 19 88
(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.)
Dated at the Town of Queensbury this 17th Day of June 19 87
i l G%�ft� /V
SIGNED BY i for the Town of Queensbury
Building and Zoning Inspector
10 Dr., Lumr.ur I'r,L rn 0.1.,uu. 1JL'1''1'.
Application No.
own o f QueenturQueetaury Permit Issued 19 _ NSB v
OWN OF QUEENS
EL.
and ZONING DEPARTMENT Permit Expires 19 �`
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation RU iQueensbury, New York 12801 Variance No. 7iii
Site Plan Review No. JUN UN 8 1 /
7 �j 1 e
6 Cl l Approved �' IIII
UILDING & CODE DEPT.
APPLICATION FOR
BUILDING AND ZONING PERMITc /
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.
The owner of this property is: /[mac. liGEA cd-
P.O. Address s q Tel.
Property Location: . G J '6°'7/ . ��_,_,,x,,,,,.., R d . t /. Q. Tax Map No. / /
Street number or building lot number
Subdivision name (if applicable) /'L, p t-, i Al c;7(f,'1
THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
f, ,- ..7? 4 - AA_ / /QV, ,A 4e. 79..2-A
Name P.O. Address Tel. No.
Name of builder Address Tel.
Name of plumber Address Tel.
Name of mason_24. Address Tel.
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.
*
* COMPLETE INFORMATION REQUIRED BELOW.
* Size of property /2Q ft X / 7 e2 ft.
* Existing building(s) Size ft X ft.
*
PROPOSED BUILDING AND USE:
* Existing building(s) Use
*
Size of new structure 42, ft X c, ft
Foundation-pier/slab/crawl/partial/AMP * Proposed building, distance from property line
(circle one) • Front yard 6 p ft Rear yard 9-4/ ft
No, of stories (habitable space) 4?0041> ** Side yards D ft and 17(4. ft
Height (grade to ridge) o1 O ft.
If residential, no. of families * If on corner, setback from side street ft
No. of rooms(excluding baths) A * OCCUPANCY INFORMATION
No. of bedrooms 4/ *
No. of bathrooms o� �a_ * PRIMARY BUILDING -
Primary heating system AL., _.,/, * One
family dwelling
Type of fuel��� vJ Twwoo family dwelling
No, of fireplaces to be installed Multiple dwelling / Number of units
Will a wood stove be installed? '2j� • Permanent occupancy
Central Air conditioning? � * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin • Other ?
Raised ranch Mansion Duplex If addition, what will use be.
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * VAttached garage/one car/ two car/ v2 car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION UP
$l/f7_I, DQ ' --
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, wood frame, fire safe,etc. i2�4 c,
Will any second-hand or ungraded lumber be used? If so, for what? --
Foundation wall material /D Thickness
Depth of foundation below grade (to bottom of footing) (A ,0 'I
Will there be a cellar? 1 Heated or(u,unheatedV Floor sq. footage / 6--7..—pe_ 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 - loped flat/shed/other Material of roof &4 4 5Jc .re
Size, wood studs "X 41 " spacing / "o.c. length ,7 ft.
Joists(floor beams) 1st. floor a "X /D " spacing /4 "o.c. span /_-' ft.
Joists (floor beams) 2nd. floor A "X /Q " spacing / , "o.c. span /3 ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing 'q "o.c. span 7 ft.
Exterior wall finish 7 ' Of what material?
Interior wall finish //2" 5 <4,- c-ram
If# garage is to be attached, describe materials to be used for FIRE SEPARATION:
Sl,1„,; +
Is there to be an opening between garage and dwelling? ).p-- If so will a Fire-rated
door, enclosure, and self-closing device be
provided?
Will a flue-lined chimney be installed?Z/ __ Height above roof ft.
Depth of chimney foundation below grade 3- ft.
Depth of fireplace hearth ft. /(pin.
Water supply - Municipal or private well ,,,,;,,,�
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)
Town of Queensbury AFF IDAV IT STATE OF NEW YORK
County of Warren
I 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, whether specified or not, and that such work is
authorized by the owner.
L'A
SWORN TO BEFORE ME THIS Signature C
Owner, owner's agent,arcnitect,contractor
day of 19
Notary Public, Warren County, N.Y.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
alletWIL o
awarepy
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE �� ,j2" / 7
LOCATION OF PROPERTY FOR INSTALLATION X 7/ �� Tz d .
Owner's Name: /6t:c ,a,c.4. 9/1‘11221_4 ____ Telephone:
Address:
Installer's Name: a,/ (�• 7 Telephone: 7 9a
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) a e
Topography: circle one: la Rolling Steep Slope % of slope _
Soil Nature: circle one:(an) Loam Clay Other / Depth: _ feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test: circle one: not required required /rate min. inch.
Domestic water supply: circle one: Municipal Well Other _7
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank / Oa D gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench S-p feet / Total system length a�"O feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness _ feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required 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 be 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 must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: 41;y._•
Date: //ff`k/
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NEW YORK
STATE ENERGY CONSERVATION CODE
A permit must be obtained before beginning work.
ANSWER ALL of the following:
1. Gross floor area
l20
2 . Type of heat C, s H-oT "'ATiS12,
3 . Is the building mechanically cooled 1/1.6
4. Percentage of area of windows and doors 2 . �
A. Over 16% Only
1 . Uo value of gross area of walls , roof/ceiling and floors
exposed to ambient conditions
2 . Floor over heated spaces YES NO
a. Are foundation walls insulated? YES NO
1. If YES, what is the R value?
3 . Slab on grade YES NO
a. If YES, what is the R value of insulation around
perimeter of floor?
4 . Is basement heated? YES NO
a. R value of insulation
5. Type of insulation
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
2 . R value of exterior walls
3 . R value of glazed area I. 0
4 . R value of doors lC7
5. R value of floors over unheated spaces
6. R value of slab edge insulation - unheated slab \A
7 . R value of slab insulation - heated slab
8. R value of heated basement/cellar walls (above grade) \b
9 . R value of heated basement/cellar walls (below grade) \O.
10 . Type of insulation
C. Controls
1 . Thermostat maximum heat setting 7
D. Duct Systems
1. Is duct system installed in unheated spaces? YES NO
a. If YES , R value of duct installation
b. R value of duct in other areas
E. Piping Insulation /i
1. Size of hot water or cooling carrying agent pipe 3fy
2 . R value of pipe insulation
, F. Service Water Heating
1 . Performance efficiency � Glo
2 . Temperature control setting maximum i4-0
G. For Swimming Pool Only
1 . Maximum heating
Telephone No. 79Z - ,.Z5O
(applicant ' s signature)
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awn of Queenihur y
t��eli,if.{ BUILDING and ZONING DEPARTMENT
Bayand Haviland Road, R.D. 1 Box 98
p�
ri
Queensbury, New York 12801
DD
BUILDING INSPECTOR ' S REPORT
JreL.e1,5:1 / /7,"
CATI0NLG �/4r %4) ��
Date 07/j7 Permit No. F7- 3 59
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing f/`
Siding ✓
Masonry Veneer
Rough Plumbing
Relief Valves AV
Ext. Porches
Finished Floors V
Interior Trim e./
Stairs & Railings V
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures 1/
Gar. Fireproofing
Door Closers
Smoke Detectors // -
Chimney l
INSULATION:
Foundation
Floors '
Walls
Ceiling
INAL ELECTRICAL _INSPECTION
RIVEWAY APPROVAL - •
F•kzil Building Survey
text scheduled inspection (call when ready)
emarks-
en j/7 e7;,C
c‘ma--7,,,,,,)
oC ft'/i
4*1' i'ld
Buildin•rInsP ector 0�.
6/86 and-vl
I/P 1
yil _Down of Queeni ur
Ji.// / BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
1'Y Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME IK/rkz,4'di M.----e-re--1:7----
LOCAT I ON),/ /-• ,e.,40/-(./
DATE .7 iii2 PERMIT NO. S 7- _
SOIL TYPE -OI
- Loam - Clay - .+
Percolatio =st Required? YES Art
Percolation rate - Min/Inch
TYPE of SYSTEM: l
Absorption field, total leng eLtt O
Length of zach trench 1
Depth of t -nches , (
Size of gra el
SEEPAGE PIT -N_ er of)
Size- f. X ft.
Gravel size
PIPING: S ze Type
Bldg. to tank it ROWE VO
Tank to dist. •ox '! />.(f,L ,
Dist. box to f eld/` 'K P,v,C ,
Openings sealed' ' :0,10 NO Partial
LOCATION/SEPARAT ,•N ,:
Foundation to tan /3 ft.
Foundation to abs. ption t.
Absorption to to l'ne J ft.
Separation of pi s - ft.
.a_ ± ON OF SYS 0 PROPERTY(circle one)
ront Rear - eft s de - Right side -
-:, c NTS:
SYSTEM USE APPROVE YES NO
ee/C)74
Building Inspector
01/86 and vl
ltti//1
1 4' own o Queenihur,
' BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
,tip/ Queensbury, New York 12801
,._ :BUILDING INSPECTOR' S REPORT �)
_ , -Cl,,
NAME � 'C-172•d /
LOCAT I ONii / l.2,G„ ; L ,
Date 7/„.„q /17 Permit No. f; ',-9,5-g
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing 4 /, • Q,c
Roofing
Siding
Masonry Veneer
ugh Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofi
Door Closers
Smoke Detecto
coney ---fie •
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
)RIVEWAY APPROVAL
Final Building Survey
Vext scheduled inspection (call when ready)
temarks- A
, dgel
(Y)///k3s
Building Inspector
5/86 and-vl
.Down o Queeniur
BUILDING and ZONING DEPARTMENT
SU Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME , 4?S7/efa5.,Ar,
ái )p/'S
rlLOCAT I •A
D.to ��'" / Permit No. i- 3
* * * * * * * * * * * * * * * * * * •* * * *
✓ = APPROVED - ,/ NO
Footing/Pier Forms 24444ye.
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
)RIVEWAY APPROVAL
Final Building Survey
Vext scheduled inspection (call when ready)
Zemarks-
Buil ing Inspecto
5/86 and-vl
C'—mac,6[ cY [ •V/ 0 / / /7 Y)I
own o f Queenatur y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
NAME PI e f'es in 63 it—e-.
LOCATION L° r . Alf OJ
8.7- 3s7
Date (di 5/'7 Permit No.
* * * * * * * * * * * * * * * * * * * * *
r✓-= AP o -1 YEs No
(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:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- `
f---)0--ttAa
reti — 0,
(>0 1?) 013
Building Inspector
6/86 and-vl