7987 C/O Paid
CERTIFICATE OC%,w P:ANCY x
TOWN OF t", UIENSSURY
WARREN COUNTY, NEW YORK
Date November 16 19 S 3
�a.
,W
This is to certify that work requested to be done as shown by Permit No. 7987
has been completed.
This structure may be occupied as a One-Family Dwelling
Location Lgt 8Pi.ne Wood go1jM Road
Owner C. G. Woodbury
By Order Town Board
TOWN OF QUEENSBURY
Building & Zon o'inspector t X
CREATIVE "INSTA PRINTING, GLENS FALLS N V 12001 151S17030030
BUILDING PERMIT
TOWN OF QUEENSBURY
NO. 7987 x
WARREN COUNTY, NEW YORK
PERMISSION is hereby ranted to C. G. Woodbury y
sr Xo 4�0 .
OWNER of property located at Lot 8 Pine Wood H011OW Road Street,Road or Ave.
(Pine Wood Hollow Subdivision)in the Town of Queensbury,To Construct or place a One— am i 1 mmll i ng. o�
at the above location in accordance to application together with plot plans and other information hereto filed and R+
approved and incompliance with the Town of Queensbury Building and Zoning Ordinance. '
1. OWNERS Address is
M
679 Upper Gleri- St.
Glens Falls, New York
2. CONTRACTOR or BUILDERS Name
Same o
ct
00
3. CONTRACTOR or BUILDERS Address b
W
Same
m
4. ARCHITECT'S Name
0
O
Qj
x
o
S. ARCHITECT'S Address I"'
I-+
O
E
0
6. TYPE of Construction-(Please indicate by X) a �`
(x)Wood Frame ( 1 Masonry ( )Steel
7. PLANS and Specifications 50'x26' per plot plan, Specifications and
No. application submitted including two-car attached
garage and sewage system.
B. Proposed Use
One-Family Dwelling
r-
$5. 00 C/O Paid L4
$_115. 0 PERMIT FEE PAID—THIS PERMIT EXPIRES February 1 19 8$ 8
(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.) l-1
114
F+-
Dated at the Town of Queensbury this 25th Day of July 19 83
SIGNED BY for the Town of Queensbury
Bui and Zoning inspector
1
TOWN OF QUEENSBURY (Space inside block to lx filled in by
WARREN ApplicationCOUNTY, NEW YORK ' , Building Inspector)
for .\pplication No. .
a Permit Issued • 19.
BUILDING AND ZONING PERMIT Permit Expires. . Ig.
Y.cnlin;.: District
. \ alttc nl Work ,%
•
THREE (3) Copies of a PLOT PLAN, Drawn to scale \PI'I"`ed by
showing the actual dimensions of the lot to be built ►tt'I„arKS'
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
-' I TOWN OF QUEENSBURY
o — S -k 1 -
_F 7 - 1 2 I0EOVE 11
DATE
•
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK JUL 1 19t33
ANSWER ALL OF THE FOLLOWING. A.M: P.M.
The undersigned hereby applies for_ a permit. to do the following work 7Iglg11O11112)1)2)3`4,5I6
which will be done in accordance with the description, plans and specifi- dp ,u�,,w,_
cations, and such special conditions as may be indicated on the permit. '. •
6
(;,n•1aU
eA,13
The owner of this property is. t .\ (j
INA''1E) )P.O.ADDRESS)
The person res _ nsihic.or }ssU vision of the work'ins° arr�a's the Building Code and the Zoning Ordinance apply is:
(NAME) "" (P.O.ADDRESS)
�`��--)-7'',' \l''.tti`�t Address
Name of Builder. .
A:-..,..:(‘''') (;�> 1'VL S Address
Name Of Plumber �-L Name of Mason,' �. _\ -�,�_) Address
Lot Number s Unit Estimated value of proposed work S ��4 D I L, t�
Name of Village 1__\_\.,7 ,._ 4:3 F r`—
Name of Street\3 --;'1777-�i i �L 1 G�Z� Side of street: north 0, east ❑, south ❑. west �\
Nearest Cross Street Distance from this cross street 1•t.
Property is north ❑,south ❑,east [—I, west ❑from Cross Street
If on Corner, which corner, northeast 0, northwest ❑, southeast Q. southwest
(Designate by marking with an "X" in-the correct space.)
•
• NATURE OF PROPOSED WORK OCCUPANCY
, 61 Construction of a new building. Main Building \ ,•
❑ Addition to a building. . . . . One-family dwelling .Eis.
❑ Alteration to a building. Two-family dwelling • ❑
❑ Demolition of a building. -family apartment house ❑
Store building ❑
•
. . . .Z,-. .-car attached garage IIR
Other:
• Accessory Building
One-car detached garage ❑
(] Other work. Describe Two-car detached garage -
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
• l;uilding(s) in solid line.
. , Size of property ft. x ft.
Size and use of existing buildings, if any
I" y
I-
s m Size of proposed building S.O ft.x '6 ft.
Height(from grade to ridge) ft.
Front yard • ft.
- Side yards ft. and ft.
Rear yard 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.?. . . . • • . . . . . . . . . . . . . . . . . . • • • • • • . . . . . . . . . . . . . . . .
Will any second-hand lumber be used? f so,_r what' � 1
Material of foundation walls �� `� `-'yi Thickness
Depth of foundation walls below/grade ,„Coltin uuss foundation?
Will there be a cellar? If so, material of cellar floor ` ‘-'° L� .
Type of roof: Sloped or flat? . f :7M12 Material of roof ` I i') 4
Size,wood studs " x • • • ", spacing . . . . . l-�. . . . . ."o.c., length .�:. . ft.
Size, floor beams, 1st floor "x • • • • • • . . • • •", spacing 1 (c, "o.c., span >n_� ft.
Size, floor beams, 2nd floor " " x . . . .( . ", spacing C,0
"o.c., span ) S ft.
Size, ceiling beams �•" x t• ", spacing "o.c., span ft.
Size, roof rafters or beams . .� j •": X •��� "spacing "o.c., span ft.
Exterior finish `�`✓.1-r• • • • r" =• •1 �� r.With what material?
Finish of interior walls 3VLA
If garage is to be attached, of what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building?
Kind of heating system Oil burner or coal?
Will a flue-lined chimney be provided? . Depth of chimney foundation below grade
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 water supply?-� �4 r ./
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? er—
��
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt: ba r of my know,ledge and belief the statements contained in this application,together with the plane and specifications sub-
mitted, are.a true and co.,.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 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 jC��
7.6
WARREN COUNTY, NEW YORK 66
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:Q
1 . Gross floor area I
2 . Type of heat
. IL �,
3 . Is the building mechanically cooled? '� v`
4 . Percentage of area of windows and doors
13 A. Over 16% Only roof/ceiling and floors
1 . Uo value of gross area of walls ,
. exposed to ambient conditions
2 . Floor over heated spaces YES NO NO
a. Are foundation walls insulated? YES
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 anfloors exposed to ambient conditions
3
2 . R value of exterior walls
lazed area �"
3 . R value of g
4 . R value of doors I~1
5. R value of floors over heated spaces
6 . R value of slab edge insulation - unheated slab
7 . R value of slab insulation - heated slab
8 . R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade)
10 . Type of insulation
C., . Controls r .
1 . Thermostat maximum heat setting
D. Duct Systems YES (NO„) ,
Is duct system installed in unheated spaces?
a. If YES , R value of duct installation
b. R value of duct in other areas
E . Piping Insulation agent pipe
1 . Size of hot water or cooling carrying
22 . R value of pipe insulation
F. Service Water Heating
1 . Performance efficiency maximum
2 . Temperature control setting
• G . For Swimming Pool Only I
1 . Maximum heating /
)-et--1-D—C--
/
Telephone No . � (applicant ' s signature)
TOWN OF QUEFNSBURY
BUILDING& ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
\ 1
1. Owner' s. Name
Address
Telephone No. 7` I -11-
2. Property location -r7 jJ Ate kc,,,-r-
3 . Name of person or firm responsible for installing system
Telephone No. '9 4)3 --S- �e.
Address
4 . Number of bedrooms (residential buildings only) --�
5.. Daily flow . 4KQ. gallons/day
6. Septic tank c pa_ ity gallons
7 . Topograph : flat, rolling, steep
of slope
8 . Nature of soil and depth c ��
•
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
, 10. Percolation test: A is required
B is not required
C If required what is the rate minutes/inch
11. Water supply- municipal, well, other
12.. Type of system prop drywell, tile field, Other
Any contractor,. corporation, individual, etc. engaged in the construction
of a. sanitary sewage disposal system who covers thesame before inspection,
does not have an approved permit, o varies from th pproved application
will be subject--to a penalty of $250 as provided or in Secti n . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date ��!!
signature of -applicant
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. Include all dimensions of
the system. itself.
Form 3-82
•
•
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
VILLAGE +, i. 1{.<- ('..,,_) ( i, )4 its•_"^r+' TOWNSHIP COUNTY .1 t-. �,�i NI
STREET AND O.OR �T - _(�f♦ � t� ,� t:! Y_;r„�
ROAD AND POLE NO. i I` ti.:rs,.-._-\,,,: - '�- `! ,.,� 1��r'�.�I °,E .cZ d POLE NO.
BETWEEN WHAT TWO yCROSS STREETS IS _
PREMISES LOCATED? SECTION BLOCK LOT
OCCUPANT'S BUILDING
NAME OCCUPANCY „4.<',
OWNER'S NAME ( ;r W tt ,,
AND ADDRESS ._ i` -�\ .J \> ,'_7,*1 ):�.„`''/
CURRENT
SUPPLIED BY FROM THEIR OFFICE
BUILDINGDEFECTS
NEW'Q OLD❑ REMODELED El SORK NEW , ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No. Fixtures& BRANCH
NUMBER OF OUTLETS LampfReceptacles MOTORS HEATERS CIRCUITS
NUMBER OF LAMPS
Loca-
tion Side Attach't H.P. Watts A.W.G.
Ceiling Wall Recp'Is Switch Pendant Bracket No. Type Each No. Each No. Gauge I F M.V.
Out-
side
Sub-
base
Base-
ment
1st Fl.
2nd Fl.
3rd Fl.
k REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: •
DO NOT USE THIS SPACE.
This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed,
you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant.
SIZE OF ELECTRIC SIGN TOTAL
MAINS FEEDERS LAMPS WATTS
CHARACTER EXPOSED . GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE (NUMBER) (CAPACITY)
STARTED COMPLETED SIZE OF SIGN
SERVICE MAKER
ENTERS OF SIGN
BUILDING
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE • NEW El OLD
• AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND ADDRESS --�
NAME OF r�"-'•.---„• j P 1 '� ..,,S_.._ 11:,,,T� f�• '"t' DATE OF
APPLICANT "" I APPLICATION
STREET ADDRESS j 4 -) (j j-_2 Y 1.-- 1-,""i
CITY OR �`---k •+• I" ' 4,(.r ) ZIP LICENSE NO.
POST OFFICE ---- `'��' ''-� V�'"E�''� ( tl CODE WHEN APPLICABLE .
46 EL(REV. 1/82) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
4001387 THE NEW YORK BOARD. OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
1- 41 STATE STREET,ALBANY�NEW YORK 12207
pets _ �.� 983 .Application No.on fUe 031508-83 A 612032
4 THIS CERTIFIES THAT
a*the electrical equipa3aet as described bobs!and intredw ed by dm*MVUcnm named on the abet oppNextion nnnskr in timpmusises *.
C.G. Waod g,ftsewm d Mellow RaW, Quessobtury,ftv fork
in thefallossinN location; IN.aveoment A lot m. ❑ and P. Outside ' section !Nock Lot 8
smexaninedon en
1119183 dfountltobeincompliawes.oiththere"iratta►esgthleSmog.
} "Krim RA"M 0/Q(i
` Ounes A OKAMMMWI MAkKE T. AMT. K W. AMT. K.W. AMT. K.W._ AMT. LW. Na. k P:
t
20 48 28 20
A!M PUPM I ftwlCwals ,IEt„ If1NtN l
OL ' N.P. "s PLO. AeT. NO .G. AMT. AMP. T.POW8
AMP4 AitT. y t.. 1 AMT. WATtS
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fMVICf 98COUNKT ItO.ew 1 5 R It V 1 C E
AMr. AMP. iTPE 1 x 2W 1 X 3W 3 Ar 3W ;IW . MD.0►qi r0 Y
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1 #0 C 1 X 1 4/0 1 2/0
Lg MO ARVA►n
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121 Radom
i Sao Xirolo lallo,Xav Tork 12801
a COPY FOR 8UXD11e 90VW III W' .T k OF CERTIF rA ' 1 1�NtN .
TOWN OF•QUEENSBuRY
Building- Department
inspectors Rep t- --- • Date /l 9-83
Name L. D T'
Location • '04 Pl L- D()1) 17V LDI '
. Permit No. " R Xi Weather
Remarks
Excavation •
Footing Forms •
Footing & Piers
• Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt Roofing 22)K/\::
Siding // .
Masonry Veneer
Rough Plbg.
•
Relief Valves
Wall Board n{� ,,,99
Ext. Porches VII/ S l iZ. Na49b90
Finished Floor / ,
Interior Trim j
Stairs & Railings/
Cellar Dr. Tile
Concrete Floors V �,�
Plbg. Fixtures
Gar. Fireproofing// (1
Door Closers l/ 0 ,---
Chimney
Water Meter Inst.
Septic Approval •
Floors
Insulation Foundation
Walls
'Ceiling "
•
(017,1
Building Inspector
REMARKS •
• S/14-d IKE 1 J -C Z? -- NA
Ls d _ - RP1L,A/6 W M 619-1 r0vi
K 11(15-ie Dom .
TOWN OF QUEENSBURy •
Building Department
Inspectors Report Date g
Name &.h ih/9rl. f'
Permit No. `7 7 b'7 Weather
Remarks
Excalra 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 _
Interior Trim
Stairs & Railings /
Cellar Dr. Tile d
Concrete Floors _
Plbg. Fixtures _
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Buz ding Inspector
ector
REMARKS
J.)/61-el ..
/tea 2P- &-
•
TOWN OF QU•EENSBURY
Building Department
Inspectors Report Date °'2-Z
Naane Psl`?/) '
Location Gr tom' <' AiA167 1 + l�f tires
. Permit No. I 9 %1 Weather
Remarks
Excat7a 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 r
Finished Floor
Interior Trim \ IStairs & Railings N
Cellar Dr. Tile
Concrete Floors /
\
Plbg. Fixtures
Gar. Fireproofing f N.
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation 'FOundation •
Walls
' 'Ceiling
(-12C-"-
• Buildingspector
•
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date 7 2-6. v 9'
Name //
Location 40 7- c /17,14e0Velel' (4 t4eep .)
Permit No. Weather
Remarks
Excatation
Footing Forms � ��i✓ems /4iv
Footing & Piers / (n is9r, dX/�'
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
uildi
nspector
REMARKS
23i
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