8031 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8 031
WARREN COUNTY, NEW YORK
x
PERMISSION is hereby granted to Norman Benack M
OWNER of property located at Lot 151 PMy Ann Road Street,Road or Ave. sy
Land O'Pines Subdivision
in the Town of Queensbury,To Construct or place a one—Family Dwelling
ts
at the above ration 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. Q
1. OWNER'S Address is
2. CONTRACTOR or BUI LDERS Name
Gary Baker r
M Q
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3. CONTRACTOR or BUILDERS Address H�
20 Alden Ave. :$ I-
Glens Falls, New York s b ,°�
1 �l
4. ARCHITECT'S Name
5. ARCHITECTS Address
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(3 fa
(D a
4!
6. TYPE of Construction—(Please indicate by X) W
(x)Wood Frame ( )Masonry ( )Steel ( )
N.
C
F,.
7. PLANS and Specifications
26'4"x 59'8"' per .plot plan, specifications and H.
No. application submitted including two-car attached
garage and sewage system. 0
8. Proposed Use !�
One-Family Dwelling
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$5. 00 C/O Paid "C
$ 115. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1 19 84 E
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the FM•�
town of Ousensbury before the expiration date.)
W
Dated at the Town of Queensbury this th Day of August 19 83
SIGNED BY � f-•� -Act
for the Town of Queensbury
Building and Zoning In
i
TOWN OF QUEENSBURY
(Space inside block to be filled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application for Application No. .
Permit Issued - 19.
BUILDING AND ZONING PERMIT pc.,-„,it Expires. lg.
Zwiing District .
• • \ aloe „l work.%
THREE (31 Copies of a PLOT PLAN, Drawn to scale .\1)1"r"‘c11 b\•
showing the actual dimensions of the lot to be built Itcluarkc
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
nn
/c7 / 'TOWN OF QUEENSBURV
I a / — s-- /5a �l t l Ll✓ DATE 4�
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK AUG 71 1983
ANSWER ALL OF THE FOLLOWING. PA-
The undersigned hereby applies for a permit•to do the following work
j$i �p13,1 1 2`3 4]51 .
which will be done in accordance with the description, plans and specifi- 1 -'"� '`' ,
cations, and such special conditions as may be indicated on the permit. i /2C)•
The owner/of this property is:
'��l� �r✓s•' fG
A O/�'r 1.4/� . j3 t/ f/ I IP.O.ADDRESS) /
(NA AE)
The person responsible for supervision of the work insofar as.the Building Code and the Zoning Ordinance apply is:
A i(KY t. A) -1 •
(NAME) (P 0 ADDRESS)
Name of Builder. . . . TAl .y. .S 4-ir g A Address O. . -.4 LC'E,1/.4 Vg- a/4A'YC kc.'6U1C
Name of Plumber a'ct.--"'--C Address
Name of Mason u'Y' - Address
of Ski Bo\U.
Lot Number. . . .1.C. /. . Unit 55--• Estimated value of proposed Work S ? j�. e 0
Name of Village p_a& L 1 / 6 " i '/
Name of Street . . .1 .E 66. r. • •V� • • R.O•4 0 Side of street: north 0, east Q, south 0. west ❑
Nearest Cross Street W45T N'VIl... zo JVD Distance from this cross street d®(-.t2) Ft.
Property is north 0,south ❑,east ;west ,from Cross Street
If on Corner, which corner, northeast ❑, northwest 2., southeast Q, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
0" Construction of a new building. Main Building /
❑ Addition to a building. . One-family dwelling c❑•
❑ Alteration to a building. Two-family dwelling
• ❑ Demolition of a building. -family apartment house ❑
Store building El
. • 2 -car attached garage ❑
Other: '
• Accessory Building
- One-car detached garage ❑
❑ Other work. Describe• Two-car detached garage ❑
Private chicken house El
Private storage building El
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
huilding(s) in solid line.
Size of property 14 '-a' ' ft. x 1 6b.63 ft.
Size and use of existing buildings, if any
I
N -
i W Size of proposed building . .v!6/ '/ft.x 5�, �• • . ft.
Height (from grade to ridge) 2g't ft.
Front.yard `3 ® ' ' ' ft.
Side yards > Er 1 ft. and . 3 f3 ft.
Rear yard 1°' (}) ft.
SOUTH If on corner,setback from side street 5° 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 �;fire safe, etc.?. • . . . . . . . • • • • . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • • •
Will any second-hand u ber=be used? Al 0 If so, for what.' _
Material of foundation walls Thickness
Depth of foundation walls below grade '`LC ' continuous foundation? . .Z.4. $,.
Will there be a r? If so, material of cellar floor V-S' r" tl, ,
Type of roof lopecl or flat? Material of roof J !1 --.j'irfi �� v`Z.•`.•.,-G;
>,x
oN
Size,wood stu s • • • ", spacing , `T "o.c., length. . . . ? • ft.
Size, floor beams, 1st floor x • • • ", spacing / L "o.c., span .� . ft.
Size, floor beams, 2nd floor " x . . '�-.' ", spacing I C? "o.c., span i AL ' ft.
Size, ceiling beams . . . , " x h— ", spacing . . . . . . . J. . . ."o.c., span . . . . ./'.®?.` / .. ft.
�, / 21 , l
Size, roof rafters or beams I ' x 1' �� ', spacing % �� "o.c., span o ft.
Exterior finish . . . . .f 4. X •—/ 1' With what material?
Finish of interior walls. ...S•+• f,
If garage is to be attached, of what material is wall betw en garage and main b n to be constructed?
. . . . . . . . . . . c.'C.n./0. . . . r. /. ,^4i1ii r /A) i-V c' , . . . . r
Is there to be an opening between garsg e and building? / f"S
Kind of heating system . . . .� t C' r7f ( e_ Oil burner or coal? . ,41 4
Will a flue-lined chimney be provided? . . ..(4.E.Y'4.1-- D 1 chimney foundation below grade
Height of chimney above roof It 5' "
Will there be a fireplace? ,L Depth of fireplace hearth ii/4:
Will a toilet be installed? y L
Will a kitchen sink be installed and connected to water supply? `t G g
Water supply(fpublic water'supp)?pump)
Distance of cesspooflrom any private well JA /� feet
Will drainage system be provided with required straps, cleanouts, and vents? 7 5 K
Town of Queensbury AFFIDAVIT
County of Warren
State of New York ,
I swear that to te, ae Iof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co,,. lete statement of all proposed work to be done on the described premises and that a[1 provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the proposed work s it be complied with,whether specified or not,
and that such work is authorized by the owner. N f ,D�
Sworn to before me this Signature Z
OW OWNERS AGENT,ARCHITECT,CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
•
By . •
•
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 ) 1 '
L\\) L(c ; 52.6 ' ) 4114111-1 G,t
2 . Type of heat L tC
3 . Is the building mechanically cooled? N 0 •
4. Percentage of area of windows and doors ��•� `�o
A. Over 16% Only
1 . U 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? NO
1. If YES , what is the R value? Q jo-41- •
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 MA,
5. Type of insulation
•
B. Under 16% Only
1. R value of roof and floors exposed to ambient conditions _
Rb P 7- VT. p,FIRS.— a-3® ;
2 . R value of exterior walls R- E9
3 . R value of glazed area .0•!05 •
• 4 . R value - of doors R 1
5 . R value of floors over unheated spaces 12,— I cP
•
6. R value of slab edge insulation - unheated slab 171A
7 . R value of slab insulation - heated slab MJA.. . •
8 . R value of heated basement/cellar walls (above grade) NJh ,
9 . R value ,o-f heated basement/cellar walls (below grade) NJA,
10 . Type of .insulation :SEL DIGS_ Frog• (Wt C. s.PEC('r(C toNts
• C. Controls,
- 1 . Thermostat maximum heat setting l 80 f•
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
1 . Size of hot water or cooling carrying agent pipe LJ
2 . . R value of pipe insulation .
F. Service Water Heating •
1 . Performance efficiency •
• 2. Temperature control setting maximum
•
- G. For Swimming Pool Only
1. Maximum heating . help,
Telephone No. 3 . �` 6 l / A c '
(appl ` n st signature)
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
1. Owner ' s Name Al I) R ,/JA A1/ l £IV 4 C/ c
Address gl fib i/VC ), f4.4/
Telephone No.
2. Property location. Pe: {, A9/if i t i?
3 . Name of person or firm responsible for installing system
Rk<- LGE Telephone No. 1 3- 236`3
Address
4. Number of bedrooms (residential buildings only) Z
5. Daily flow ?QC) gallons/day
6. Septic tank capacity 000 gallons
7 . Topography: 111110 rolling, steep
% of slope o
8 . Nature of soil and depth II'3i `(EL.�ow S/k S J 3-l0�`{c(,�®WG�p�p SAND
9. If groundwater, bedrock or impervious material is apparent at. what
depth does it begin? - -- ft.
PER ( Liep.,4 is\4C3R,,,r,cic
10. Percolation test: A is required cm,cs Fo9- SvpbtVlSloN_
B is not required
C If required what is the rate minutes/inch
11. Water supply: municipal, well, other
12 . Type of system proposed: , d _ � �. ile fie other
c
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 approved application
will be subject to a penalty- of $250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date /
signatu 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 , I
VILLAGE }'i , .! I. /- II% Iram' // "`, L/ TOWNSHIP COUNTY
STREET AND Nd.OR ;�, ` 77 "t !
ROAD AND POLE NO. .f'�-- z.�'ti i_-, / :`31A1 f i.i A" i-mil POLE NO.
BETWEEN WHAT TWO - `
CROSS STREETS IS i - �L �-• r') h L ;
PREMISES LOCATED? 1,1 t _ �_ !" f '1 /j .' •''I 1� SECTION -�- BLOCK LOT
OCNACUPANT'S e 1 ,ff ,14
.t r7 /j ( J%:-. l j2 ( OCCUPANCY --) 1 -
OWNER'S NAME f �,,,,,
AND ADDRESS /Lirt,tti ,-, r-r.",,i.• i=; J-. tV /jr: iS.
CURRENT - '' t
SUPPLIED r .-! /I•I 1 I ' ��1 1 [ -.l
gy 1,17! i ! ; I'} ,f f ti,n j C)\ FROM THEIR OFFICE
BUILDING WORK DEFECTS
IS NEW N. OLD ElREMODELED El IS NEW ,® ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
& BRANCH
NUMBER OF OUTLETS ampf t Recepeeles 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 j '� j A/)) t.) FEEDERS LAMPS WATTS
CHARACTER EXPOSED GAS TUBE SIGN
OF WORK CONCEALED TRANSFORMERS OF VA
WORK TO BE c- 3,.G•; ,--, ,.� „;/ (NUMBER) (CAPACITY)
STARTED .ti /, -`1 :-T < COMPLETEQ:55.4 j'/{�,,c'R.,IZE OF SIGN
SERVICE / / /' f'-"'4
ENTERS i MAKER
BUILDING OF SIGN
INSPECTION REQUESTED / .'
ON OR AS NEAR AS CV J `7 .- i 9 NEW OLD
POSSIBLE (; / /
• AVOID DELAY BY GIVING FULL/AND AC URATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT NAME AND_ADDRESS . / 77 r r
NAME OF .� ,/ .1-�'-' ,%� DATE OF
—! ' / �
APPLICANT r--•--Aft"'�'9 - -3 .7-Y' --'�i APPLICATION !
STREET ADDRESS %'/ () i.!.rj i//b.-Z-_ %-14/"
POST OFFICE iITY ORt/I i.)/i('1-).-,)//--r r /1�:, CODE t . I'. ,I WHEN APPLICABLE
46 EL(REV. 1/82) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date 2- 2 -g.3
Namej `-'✓�'C
Location /- 1e f',, (1/LI
Permit No. F 0 3 r Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg. LZ 3�`
Relief Valves ��
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile )(11
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers ✓
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
'7
-7uilding Inspector
REMARKS
•
•
TOWN OF QUEENSBU RY
Building Department
Inspectors Report Date2/ .3
Name
Location 76 V
Permit No. Weather
• Remarks
Exca)ation
- 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 J
Gar. Fireproofing /
Door Closers /
Chimney f
Water Meter Inst./
•
Septic Approval
Floors '
Insulation Foundation '
Walls
Ceiling
Arlf
( f
Bui ding Inspector
. REMARKS
%/& c. ,/60(T— TMvc214`
f��cP-
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date .7`-/7-'/5"
Name _ �Al/ice
Location R.4
Permit No. O 5/ Weather
Remarks
Excatia 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
\\\\\/\/. 1
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railings /
Cellar Dr. Tile /
Concrete Floors /
Plbg. Fixtures /1
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
'Ceiling
Building Inspector
REMARKS
TOWN OF QUEENS U Y •
Building. Department
Inspectors Report • Date g
Name
I.oeatioir/ o s - 1AA1 b
Permit No. � Weather
Remarks
Excatra tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing i7
Ba ckfi l l
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
05/0
•
• `Building Inspector
REMARKS