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8015 C Paid CERTIFICATE OFOCCUPANCY ` TOWN OF QMNSBURY r WARREN COUNTY, NEW YORK Date November 16 Iq 83 _ 4 `I This is to certify that`work requested to be done as shown by Permit No. 8 015 has been completed. This structure may be occupied as a One—Fermi 1 m nme1 1 I ng Location Lot 18 Pine Wood Hollow Road Owner C. G. Woodbury__ By Order Town Board TOWN OF QUEENSBURY Building 6kiiing Inspector Q „ CREATIVE "INSTA" PRINTING GLENS FALLS. N Y 12601 15101793.9636 y BUILDING PERMIT TOWN OF QUyESBURY No 8015 7= WARREN COUNTY, NEW YORK PERMISSION is hereby granted to C. G. Woodbury sr. I'Y4. �s OWNER of property located at Lot 18 Pine Wood Hollow Road Street,Road or Ave. �} Pine Wood Hollow Subdivision in the Town of Queensbury,To Constructor place a One Family Dwelling O at the above location in accordance to application together with plot plans and other information hereto filed and 04 approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNE R'S Address is 679 Upper Glen St. Glens Falls, New York 2. CONTRACTOR or BUILDERS Name Same 3. CONTRACTOR or BUILDERS Address 0 Same :rt M Ir co 4. ARCHITECT'S Name OO to Q, N. xo 5. ARCHITECT'S Address O ic f 1+ 0 0 6. TYPE of Construction—(Please indicate by X) r 130 Wood From ( )Masonry ( 1 steel ( 1 •�` r O 7. PLANS and Specifications 281x621 per plot plan, specifications and � a No. application submitted including two-car attached garage and sewage system. 8. Proposed Use One-Family Dwelling 0 $5. 00 C/O Paid 1 $ 94.00 PERMIT FEE PAID—THIS PERMIT EXPIRES March l 1984 (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the F,} town of Queensbury before the expiration date.) f.+ "C Dated at the Town of Queensbury this 3rd Day of August 1983 fD N SIGNED BY for the Town of Queensbury N BuWdhV and Zoning Inspe TOWN OF QUEENSBURY (Space inside block to be filled in by WARREN COUNTY, NEW YORK Building Inspector) Application for Application No. : Permit Is,uc•d• 19. BUILDING AND ZONING PERMIT Permit Expires. . Ig. Zoning. District • . \ ;ilcic nl Work $ . THREE (3) Copies of a PLOT PLAN,.Drawn to scale •\i'I'im c•cl bY showing the actual dimensions of the lot to be built lac iluirKf • upon, The exact size, and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. TOWN OF QUEENSBURY DATE • A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK �UL 18 983 ANSWER ALL OF THE FOLLOWING. pMitB: GELIVEvr) The undersigned hereby applies for a permitto do the following work 7g,10111�12)11213141516 which will be done in accordance with the description, plans and specifi- a . a ' ' ' ' ' ,cations, and such special conditions as may be indicated on the permit. . � .ego igG0/ 0 The owner of this property is: /`) C,' ��'i �INA'' (P.O.ADDRESS) The person responsible for •supervision of the work insofar as the Building Code and the Zoning Ordinance apply is: (NAME) IP 0.ADDRESS) Name of Builder C' -''\-'"-i) '7-�� VC7. • •.• • • • •Address Name of Plumber 1--17C'I' c' 9V1 k-:)/1'(,---� Address ' Name of Mason �� - llauF' . r `'`J("�). :. �u,�,. . . ... . . .Address �_ Lot Number I (°J UnitpI ne ��0`( • AEstimated value of proposed work f `G---, Name of Village �` , r -'' - t•- U bA� �,.� \A-)';7 rj `l`�'--7 '�`- '' n `% Side of street: north ,v,, east 0, south 0. west ❑ Name of Street � ' Nearest Cross Street Distance from this cross street - Ft. Property is north ❑,south 0,east [1, west. 0 from Cross Street If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑. southwest (Designate by marking with an "X" in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY ' - Construction of a new building. Main Building •-i ❑ 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 ❑ ❑ 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, size and setbacks of pro- posed buildings,and the location of all existing buildings. NORTH Show proposed building(s) in.4otted line and existing building(s) in solid line. Size of property r ft. x r '9 ft. Size and use of existing buildings, if any . .t • G ..S2.. r-Ift it y~y W Size of proposed building ft.x 1 " ft. Height(from grade to ridge) . /(.C:, ft. Front yard ft. - Side yards .( 9 ft. and ( , ft. Rear yard . . . . . .1.I. .-... .....- 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? J' 7 If so, for what Material of foundation walls 1 Y Thickness Depth of foundation walls below grade t / Continuous foundation? Will there be a cellar? If so, material of cellar floor . . . Type of roof: Sloped or flat? . . . Material of roof . . r ' .�� tZr �-1 . ' C-4 =' Size, wood studs "x . .L ", spacing . . .I .... . ... . . . ."o.c., length. . . ...• . . . . ft. Size, floor beams, 1st floor " x ", spacing '7 "o.c., span ' ft. Size, floor beams, 2nd floor " x — ", spacing "o.c., span ft. Size, ceiling beams . . ... . . x ", spacing . . . "o.c., span ft. Size, roof rafters or beams "x ", spacing 7 "o.c., span ft. Exterior finish . . ...,.\ . . $•1 • • • • • With what material? Finish of interior walls. . . . . . . �l•ti��' . �^ 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? �! L F — :N��;i. ..; . . . . . . Oil burner or coal? Kind of heating system � �.-• • 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? . yam• Will a kitchen sink be installed and connected to wat supply? , Water supply (public water supply or pump) (1 0.'a Distance of cesspool from any private well . c 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 tt e,c,of my knowledge and belief the statements contained in this application,together with the lane and specifications sub- mitted, are a true and co,i.p'lete statement of all proposed work to be done on the described remises and that allprovisions of the BUILD- ING CODE,THE ZONING ORDINANCE,and all other laws pertaini to the proposed- or hall mplied wt ,whether specified or not, and that such work is authorized by the owner. / Sworn to before a this Signature ����� �^ OWNER.OWNER'S AGENT.ARCHITECT,CONTRACTOR day of t") 19 .) NOTARY PUBLIC, WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: • By TOWN OF QUEENSBURY ( 1 6 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 2 . Type of heat 3 . Is the building mechanically cooled? 4 . Percentage of area of windows and doors 3 4 /t A. Over 16% Only and floors • 1 . U . value of gross area of walls , roof/ceiling exposed to ambient conditions 2 . Floor over heated spaces. YES 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 of and floors exposed to ambient conditions 6 7 2 . R value of exterior walls Rry 7 3 . R value of glazed area 4 . R value of doors — 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 `-' -; � 5.5 C. Controls 1 . Thermostat maximum heat setting D. Duct Systems C NO � 1 . Is duct system installed in unheated spaces? YES a. If YES , R value of duct installation b. R value of duct in other areas E . Piping Insulation 1 . Size of hot water or cooling carrying agent pipe 2 . R value of pipe insulation F . Service Water Heating ti 1 . Performance efficiency y_ 2. Temperature control setting maximum G. For Swimming Pool Only 1 . Maximum heating -47:7) Telephone No. 7 (applicant ' s signature) TOWN OF QUEENSBURY BUILDING & ZONING DEPARTMENT . SEWAGF DISPOSAL PERMIT APPLICATION 1. Owner ' s Name` * � Address Telephone No. --' 2. Property location( : (:=7J 3 . Name of person or firm responsible for installing syste�pm (. 1 "J`e1�� Telephone No. 1 Address 4. Number of bedrooms (residential buildings only) - - � 5. Daily flow - et5w gallons/day 6. Septic tank capacity.. gallons 7 Topography:' flat, oiling,_ steep % of slope 8 . Nature of soil and depth 9. If ground water, bedrock or impervious material is apparent at what depth does it begin? f t. 10. Percolation test: A is required B is not required - I-f—required what is the rate minutes/inch 11. Water supply: municipal, well, other 12 . Type of system proposed: drywell, (lie field, ther Any contractor, corporation, individual, etc. engaged in the construction of a sanitary sewage disposal system who covers the same before inspection, . does not have an approved permit, or varies from the appro dd application will be subject to a penalty of $250 as"provided for in Section-6:(3- 0 of the Queensbury Sanitary Sewage Ordinance. . Date �� / — y . 7 . 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. CITY OR VILLAGE }l 'k^�>ti,j_A -d-� (,) �`) TOWNSHIP COUNTY % .1d STREET AND O.OR-"^7 # - 7 ROAD AND POLE NO POLE NO. BETWEEN WHAT TWO -` CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT ► f OCCUPANT'S BUILDING NAME OCCUPANCY 1.�_� %,• _ OWNER'S NAME }}gy, 6r •- `-� �.� + AND ADDRESS -._�, t 1 .• `/'\� ., ' 6.1�.}Y et_ -� -�_) =''.i '...-.I �� F_.-. •. CURRENT BYPPLIED �{ `'ei FROM THEIR �7� OFFICE BISUILDING NEW.L' . l OLD❑ REMODELED ❑ WORK NEVI , ADDITIONAL❑ REMOVED FECTS ❑ 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 Recep'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. • • 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 n POSSIBLE NEW l l OLD ri • 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 " ' 'L :r, � { r C�'/',.,,_ DATE OF J 1 S '- APPLICANT APPLICATION NtSTREET ADDRESS •;�_ c co CITY OR S �---^ A y-7 1L$. ZIP LICENSE NO. POST OFFICE -� L ^"y---" 3; ' 1 .�-" CODE WHEN APPLICABLE „46 EL(REV " c'r-^-"o E APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING ... IIII •�: THE NEW YORK BOARD. OF FIRE UNDERWRITERS 001387 BUREAU OF ELECTRICITY 12 41 STATE STREET,ALBANY,NEW YORK 1.2207 rbDate November 18, 1983 4plication No.onfile 03140743 A 612033 THIS CERTIFIES THAT only the deotrical eeuipn ent as dsecrdwd below and introdacod by the oppBaawt named on fit abew applleatiaw number I*thepPamises Of C.G. Wooddury, Pinewood Hollow Road, Queensbury, New York in the following location; IJ Basement [I Bat n. ❑ 8nd R. outside Section Mock Lot 18 was examined on 21 9—$3 and found to be in compliance with the requirements of tide Board. .'.. MTM ... OUTtlTt ACUIS SMNTCMM FNJD R AMT. K.W. AMT. K W. AMT. K.w.. AMC K.W. AMT. K►. 19 41 18 1 +► DRY<MS PMACII MOTORS PUTliti!A}lEiAldCi 1 AIM "NA CLOCK 16kt WW qM M OIL K P. OAS N.P. AMT. NO. A.W.O. AMT. AMP. "T. AMPIt. TRW. AMT. K P. -AMT.- WATTS 1 .. 4 SRRVIO DKCONNI1 T pD.OF S E, /R� V I C R AMT. AMP. TYPE � 1, 2W 1 A'SW 9/SW S 0 4W NO.OP Cc'U No.OF M-M O w NO oP IIEIITRAtS OF s 1 200 JCB 1 1 1 4101 2/0 a OTM AMARAnm ,+ Elea. Room Heater/s.1-.25,1-1.0,1-1.25,2-1.5,2-2,5 kw. 1-Smoke deteotor s Dave Kobon 121 Hudson > South Glens falls, New York 12801 239 J a�lalr�oER . - , .Per • COPY FOR BUILDING DEPARTMENT.THIS Ct P1l OF CERTIFICATE MU "t' kT �IN ANY 0"NER- TOWN OF•QUEENSBURY Building- Department Inspectors Report Date / 1 /3 Name l d F i L)0 6 ci r ti Location !'/iUL O 0 //1L Lille . Permit No. 80 1.; Weather Remarks Excavation Footing Forms Footing & Piers • Foundation Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Relief Valves / \\1:\: Wall Board , r Ext. Porches V / U Finished Floor �f Interior Trim Stairs & Railings 6) Cellar Dr. Tile Concrete Floors /' Plbg. Fixtures Gar. Fireproofing (I j Door Closers 0 Chimney Water Meter Inst. Septic Approval • Floors Insulation Foundation Walls • Ceilir5g • Bu lding Insp ctor REMARKS • sYul l)K DEarMi s — OK • TOWN OF QUEENSBURY Building Department Inspectors Report Date Name 2 /(,A_•V Location.Gdr7 ,-W F A3 fr.l ,t_e> Permit No. ;s? cri / ,c Weather - Remarks Excavation Footing Forms Footing & Piers • Foundation Cement Coat Waterproofing Backfill • Final Survey Framing • Sheathing Roof Felt N\ Roofing K Siding Masonry Veneer Rough Plbg. Relief Valves Wall Board ! Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile Concrete Floors P1bg. Fixtures _ Gar. Fireproofing Door Closers • Chimney Water Meter Inst. • Septic Approval Floors Insulation Foundation Walls Ceiling Building Inspector REMA.19;e.L.: TOWN OF QUEENSBURY Building Department Inspectors Report Date 9 Name Location p'PW' Permit No. ,(7��i - Weather - . Remarks Excavation Footing Forms Footing & Piers Foundation j/ ©/t- Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Relief Valves i 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 Building Inspector REMARKS TOWN OF QUEENSBURY Building Department Inspectors Report Date 0-5- 5-5 Name /; Y ZGJ,/ Pr'i1c- Location GorT/,Q / 1e&)9-)2) lfoLG - ' Permit No. ?6 /- Weather - Remarks Excafia 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 Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls Ceiling B.•ding Inspector REMARKS