8040 C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF CEENSBURY
WARREN COUNTY, NEW YORK
Date 19 —
This is to certify that work requested to be done as shown by Permit No. 8040
has been completed.
This structure may be occupied as a One—Family Dwelling
Location Pinello Road
Owner Michael P. Tngleston
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE "INSTA" PRINTING, GLENS FALLS, N.V 12801 ISIS)7973fSS
,r F M P O R A R Y
CERT114CATE -OF OCCUPANCY
TOWN Of '
WA INN COWITY, OW YORK
Aaaust 21
This is to cerdft that work requemed to be done to shown by Permit No. 8040
has been counAe"
This be s One--Family Dwellinq
I Pinello Road
Michael P. Ingleston
owner
TFMPORARY CERTIFICATF OF OCCUPANCY FOR � Order To" Bosrd
60 DAYS
TOWN OF QUSBNSBURY
ewt�tiwc Nsrw ►wnTsas s�tt+s sA w r :sg►JPIkAst1N
i
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8040
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to _ Michael P. Ingleston
8;
OWNER of property looted at P inel to Road Street,Road or Ave. Q
in the Town of Queensbury,To Construct or place a One—Family Dwelling Y
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. OWNERS Address is BOX 483 R. D. #2 Pinello Road
Glens Falls, New York
to
rA
rt
.2. CONTRACTOR or BUI LDER'S Name O
O
Same
3. CONTRACTOR or BUILDERS Address
Same
r-
4. ARCHITECT'S Name (p
N
F-+
O
O
5. ARCHITECT'S Address Ai
f1+
0. TYPE of Construction—Misuse indicate by X)
(3d Wood Frame 1 )Masonry ( )Stool ( ►
PLANS and Specifiostions 28 r x32 r per plot plan, specifications and o
application submitted existing No. PP :us n�g sewage system. M
will remove existing mobile home upon--completion of dwelli
>#. Proposed Use
one-Family Dwelling FA
C Paid
$ 133. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 1
1984
N
(If a to pp :J'"longer period is required an application for an extension must be made to the Building and Zoning inspector of the � � �f� D
town of Queensbury before the expiration date.) K
Doted at the Town of Queensbury thisl5th Day of August 1983 (dj
SII_
I�NED BY � T � Z for the Town of Queensbury
Building and Zoning In or
TOWN OF QUEENSBURY • (Space inside block to be filled in by
WARREN COUNTY. NEW YORK Building Inspector)
A lication for Application `o.
pp Permit IsstiNi 19.
BUILDING AND ZONING PERMIT Permit Expires. 19. .
'foiling. District
\";clot c►I Work 2 _,z P
THREE (31 Copes of a PLOT iWAN, Drawn to"scale. ' \picim u(I by
showing the actual dimensions of the lot to be built Itc't»,c"Kf'
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 00 QUEENSBURY
l T7— I — d /p DATE
. 12A PERMIT MUST BE.OBTAINED BEFORE BEGINNING WORK• -
ANSWER ALL OF THE FOLLOWING. Ally. l9 3d
�
The undersigned hereby applies for a permit to do the following.,work " A.M. P.M.
ZOz��12 12 3 4 5 6
which will be done in accordance with the"description, plans and specifi 718 ag 1 ,1 , ,c 1 ,1 c 1. 1 . I
cations, and such special conditions as may be indicated.on the permit. • c • •
The owner of this-property is: • q i .o•cc ! LJp
r
.7.11.e.ad.t . e.. !1'(G. 5 d't' . a.,-.k5 3. U.. / t.e j G.L. o I?C)4j.�}14( 5•7• ;. !", 57.--4 s• */
(NA'4E1 J IPA.ADDRESS . f. 1'SO
The person responsible for •supervision of the work insofar as the Buildipg:Code and the Zoning'Ordinance apply is:
/'.7 !4 fi4f e'.,F.i'-"GG=:S fq4 k 5.3 . �0-2 r°'.. h;Z4 �C��i ,,,„�y iv %5•r aG- S �i'e S- ,h4
(NAME) J (P.O AODBE551 i,S41 J
Name of Builder//C�4b. .�.C.%!%�G,� <o•c� Address• l�.('" a /'20MR ki Cal. '(7' Y.
Name of Plumber/At.At FI/42: . .e• �'•`kk S rT�, --- Address f/w/F t C a R0,4 / lvl f ''y
Name of Mason/e/am '(/:Co.4-5lie,:t4 T(o.v GO, /'"r Address I'/ .450 /1.Ot t 57. .4-✓t;J 5,.4.q4 TOI/..1'•X�-Y,/'C6
Lot Number Unit Estimated value of proposed work 5 . 6 6 670 °
Name of Village W fh 5 '3 u1e v ' " :. ' .' • "
"Name of Street . ... . ez't!&ie:4?. . Pt9/.. P. . . . . :. . . . . . . . Side of.etreet: north. 0, east. 0, south 0. west ❑,
Nearest Cross Street &f2R/4-F "Qr P Distance from this ^ross street . { 23 "? Ft. .
Property is north jEr south ❑,east ii,west 0 from Cross Street•
If on Corner,which corner,northeast ❑, northwest ❑, southeast C southwest
(Designate by marking with an"X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
(21" "Construction of a new building. • Main Building
❑ Addition to a building. One-family dwelling ,n'
❑ Alteration to a building. Two-family dwelling Cl
❑ Demolition of a building. . .-family apartment house ❑ "
Store building ❑
-car attached garage ❑
Other:
• Accessory Building
• One-car detached garage 0
❑ Other work. Describe:. .ittemo✓)G.• • • e'<- tii),L.Gt . _ •.• Two-car detached garage
-A.& r • • .l_ve-• • •� • •..0 �,eLc •rp•-• Private chicken house • 0
L�0 Private storage building • ❑
.F Ke.:-. #.5;^.5:. . .2<%.S.ri07. .c3-.'6,ri-:- . .,cy:crem "Other:
ZONING SPECIFICATIONS. Fill in fornew building,or addition to existing building,or a change of occupancy.
Indicate on the plot plan street names,the location and
.:____I size of the property,the location,size and setbacks of pro-
. posed buildings,and the location of all existing buildings.
NORTH
Show tiroposed building(t) in dotted line and existing
Cog/A.7 - C1,-P tluilding(s).in solid line.
D Size of property /5 ft. x� � ' ft.
Size and use of existing buildings, if any . . • . . • • • • • • •.• •
1- y e,,. . it k .90
IA
•
s Ili ". / w Size of proposed building . :. • •.1• vim. • ft.x .7 2- ft.
( /� Height(from grade to ridge) . .2 .' ft.
' t� - Front yard 41 / " ft.
( ���'d Side yards tf' ft. and •7 ft.
Rear yard / 3 / ft.
7 SOUTH • If opp corner,setback from side street ft..
Note: All distances are net, es measured from street side
line to nearest part of building.
• (OVER) .
7-73-N S
•
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. . . . V .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .% • • • • • . . . . . • • . .
Will any second-hand lumber be used? /'` If so, for what?
Material of foundation walls 'aqrC o G°`-G6-7-/5-- Thickness e
Depth of foundation walls below grade . . . . . Continuous foundation?
Will there be a cellar? y 2 If so, material of cellar floor 4 i> CeV'e
Type of roof: Sloped or flat? 5 ��!� <Material of roof
Size,wood studs re PI!c' ",spacing -2 � "o.c., length •Y ft.
Size, floor beams, 1st floor "x �;� ",spacing . . , l "o.c.,span /'' ft.
Size, floor beams,2nd floor . . . . . .• "x •�' ", spacing / "o.c., span . . . . . . f . . . ft.
f{ :L1.
Size, ceiling beams "x ', spacing �' I "o.c., span / 9' ft.
2- "x /
Site, roof rafters or beams ", spacing � � "o.c., spanft.
Exterior finish With what material? ! '//
Finish of interior walls. . . l. . 5./.4-/......... •i• 0.i
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 . i i i C- Oil burner or coal?
Will a flue-lined chimney be provided? . Depth of chantey 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?
Water supply (public water supply or pump) . fwai,C ,4 5 u,'tG
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents? •
AFFIDAVIT •
Town of Queenshury
County of Warren
State of New York .
I swear that to tt i -,r of 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 des ibed premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the pro w V shell b milled with,whether.specified or not,
and that such work is authorized by the owner. / ��
Sworn to before me this Signature .,//� ���
/ OWNS , AGENT,ARCHITECT.CONTRACTOR
(:..`j. .. . ... ... . . day of. `!4i ! 2 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 ,r 5 . `F 5 7-,
•
2 . Type of heat F/J=GT%( C
3 . Is the building mechanically cooled? /C)
4 . Percentage of area of windows and doors /)-7o
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
. Under 16% Only
1. R value of roof and floors exposed to ambient conditions
R®oi"' - e FG one - -i C,
2 . R value of exterior walls A9 -- (
3 . R value of glazed area /) 7 ,
4 . R value of doors 8 '
5. R value of floors over heated spaces re/A 4 -/ r-i"2671 i2
W,L'r)TTiri2
6. R value of slab edge insulation - unheated slab ,(jA-
7 . R value of slab insulation - heated slab /G/4-
8. R value of heated basement/cellar walls (above grade) AA
9 . R value of heated basement/cellar walls (below grade) //A
10. Type of insulation J-i `772 CGia 5 5
C. Controls
1 . Thermostat maximum heat setting
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
Piping Insulation
?! Size of hot water or cooling carrying agent pipe
R value of pipe insulation
F. Service Water Heating
Performance efficiency .
2. Temperature control setting maximum / v
y For Swimming Pool Only
1 . Maximum heating ,
Telephone No. 3 Y 3 y � /�� 6,
(applicari signature)
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1. Owner ' s Name /l/// � �/?-/; d�v
Address /O Cf4- -5 /p. 2- 7/4, /-L/ god
S'7 S y.4 5 ; -za?, / Telephone No. 7 e 7 3 Sl
2. Property location ?/-02-7'-t 0 Q4-/ •
3. Name of person or firm responsible for installing system
FX% 5 '7`i,v Telephone No.
Address
4. Number of bedrooms (residential buildings only)
5. Daily flow 6-0 gallons/day
6. Septic tank capacity gallons
7. Topography: flat, rolling, steep
of slope f"Gf1--r
8 Nature of soil and depth 7 fr-/2/
•
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? /e/Q'.lij ft. '
10. Percolation test: A is required
is not 'required
C If required what is the rate minutes/inch
11. Water supply: municipal, well, other /(U!
12. Type of system •proposed: drywell, tile field, other L 4
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
signature af-�ap-plicant
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 �j
VILLAGE :" j 1 j 'f ! TOWNSHIP f Ji r�•- A COUNTY / 27r—✓r1 P A/
STREET AND NO.OR _ P_
ROAD AND POLE NO. < POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS
PREMISES LOCATED? c�.�— �,--••-'. SECTION BLOCK LOT
OCCUPANT'S BUILDING
NAME . ?/ •, i .`� - i 'Y OCCUPANCY -"•7f A. / f"��.��/al c
--
OWNER'S NAME
AND ADDRESS /'i i r. ' °�" �.' l '+ -
CURRENT
/ /f V
SUPPLIED 1�+ /�+ f->> l-J i y- FROM THEIR L 14 1 Cy -�'-_]_>'.r�Cj OFFICE
BUILDING `"\• WORK DEFECTS
IS NEW1.1F— OLD❑ REMODELED ❑ IS NEW Qr--_ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures& BRANCH NUMBER OF LAMPS
Lamp Receptacles MOTORS HEATERS CIRCUITS
Loca-
tion Side Attach't . . Watts A.W.G.
Ceding 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
BUILDING OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW OLD 1-1
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 li .. DATE OF ^3
f ✓ J�•
APPLICANT - '✓ i APPLICATION
r + ZIP j' LICENSE NO.
POST OFFICE CODE - .• -ice% WHEN APPLICABLE
46 EL(REV. 1/82) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
TOWN OF-QUEENSBU RY
Building Department /�
Inspectors Report Date /t/-'/ 2 77/
Name y}1 ; C-k c e / l_n I e
Location I" I 1 ZS o-
. Permit No. 0 1740 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. 1/ (
Relief Valves
Wall Board /
Ext. Porches C
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
7;/ \\*4.
Septic Approval
Flod s
• Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
•
TOWN OF•QUEENSBURY
Building Department
Inspectors Date /ZSA
Name_ <--�.%
Location /����,� /J.,
Permit No. FOY) Weather
Remarks
Excavation
• Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
•
Backfill
• Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg. I
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
Foundation
Insulation Walls
'Ceiling
/
)�
1• Buildin Inspector
• REMARK •
S
otirtt ittj", /)"ZU, (
--
— s `
•
•
TOWN OF'QUEENSBURY
Building Department
Inspectors Report Date
Name .l Q5 ro),
Location ird/ =
Permit No. G Weather
Remarks
Excatiation
Footing Forms ���
Footing & Piers �' p /J
e4c
Foundation
Cement Coat
- Waterproofing
Backfill •
Final Survey
• Framing •
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer
Rough Plbg.
Relief Valves /
Wall Board j
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
'Ceilin
o
Btrlding Inspector
REMARKS