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8123 TFMPORARY SIXTY DAY CER' nm-CATE Of rvNCU P� ANCT ww WtARION CO MY, IOW YORK Bate July l 9 19 84 This is to certify that work ram,to be d e so shown by Permit No. . 8 3.2 3 has been conk & This stnwm* may be nccupW s a One-Family Dwelling Location Lot l West Mountain Road (Pine Wood Hollow Subdivi*ion) Owner Glens Falls Kwanis Club (BOCES) THIS IS A TEMPORARY CERTIFICATE OF OCCUPANCY FOR 60 DAYS, Ely Order Town Hoard TOWN of QurtNsK RY Zoning bupeftw _ elk" w�i saruro 44 rwi «e ,„?a�Fi r BUILDING - PERMIT TOWN OF QUEENSBURY No. 8123 a_ WARREN COUNTY, NEW YORK PERMISSION is hereby granted to GLENS FALLS KIWANIS CLUB (BOCES) OWNER of property located at Lot 1 West Mountain Road Street,Road or Ave. � in the Town of Queensbury,To Cons(P atne place od Hollow Subdivision) I ' One-Family Dwelling at the above location in accordance to application together with plot plans and outer information hereto filed and W approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ►V t3i A+ 1. OWNER'S Address is Glens Falls, New York w W w 2. CONTRACTOR or BUILDERS Name A► BOLES ' t7 3. CONTRACTOR or BUILDER'S Address ~ C Dix Avenue Hudson Falls, New York 4. ARCHITECT'S Name 100 0• Cf 5. ARCHITECT'S Address (D I-+O O W R� rt 6. TYPE of Construction n—(Plea indicate by XI O 00 k 1 Wood Frame ( 1 Masonry ( )Steel ( ) O rh W 7. PLANS and Specifications 24'x68 ' per plot plan, specifications and application 0 No. submitted including two-car attached garage and sewage c a, system. 8. Proposed Use W One-Family Dwelling $5. 00 C/O Paid $ 87. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 1 1984 'D (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 daft.) F-+ �C Dated at the Town of Queensbury this 23rd Day of_ September 1983 ti fD SIGNED BY for the Town of Queensbury l�� Building and Zoni or F,, • r 1 •w TOWN OF QUEENSBURY (Space inside block to lx filled in by WARREN COUNTY, NEW YORK • Building Inspector) Application for Application No. Permit Issued 19. BUILDING AND ZONING PERMIT Expires. 1cl. imning District . \ altie nt Work, t'- THREE (3) Copies of a PLOT PLAN, Drawn to scale - .'l'l "�`'`1 by "v�% /� showing the actual dimensions of the lot to be built- In: l f upon, The exact size, and location on the lot of the building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. 1 . 766 " / - DATE TOWN I(IG�nF CIUEE(\��PJ�,ISBURY • DATE i-j-li E 3A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ANSWER ALL OF THE FOLLOWING. er5L"I-) 'Z V 1'83 The undersigned hereby applies-for a permit; to do ,the following work A.M. ee) M. which will be done in accordance with the description, plans and specifi- 7I8)9I10I141211 2I3 4 516 - I a i ,, t I -I I l cations, and such special conditions as may be indicated on the permit. � The owner of_this property is: . . C�.� 59,-•(.S• iicv/9-,--►i " C1--6-+3 . (NA'4E) • . (P.O.ADDRESSI The person responsible for -supervision of the work insofar as the Building Code and the Zoning Ordinance apply is: . . . r. PL?- . . .). .Sc. J. i iO,cfr( f/y • (NAME) (P.O.ADDRESS) • Name of Builder J G� Address P/x i9c—e—, . 1-jv4M—� `-- f9c`-5 Name of Plumber } ( Address ` 4 • Name of Mason ' Address L 1 Lot Number. . . ./. .•. . . . . Unit Estimated value of proposed work S yS660 Name of Village 0)0 e:,-,-.5 Dok.y 7y Y Name of Street . • 121 1 20 Side of street: north 0, east Or, south O. west ❑ Nearest Cross Street Distance from this cross street Et. Property is north 0,south ❑,east Fi., west 0 from Cross Street If on Corner, which corner, northeast -0, northwest • ❑, southeast 0, southwest • (Designate by marking with an "X" in:the correct space.) • NATURE OF PROPOSED WORK OCCUPANCY Construction of a new building. Main Building TIC to a building. , ••. •. . . One-family dwelling . • Two-family dwelling ❑ ❑ Alteration to a building. -family apartment house ❑ 0 Demolition of a building. Store building ❑ - . . R -car attached garage . Other: • Accessory Building . . • . . - One-car detached garage ❑ 0 Other work. Describe • .Two-car detached garage • Private chicken house ❑ . . Private storage building 0 . 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 dotted line and existing building(s) in solid line.- Size of property /0° ft. x c I ft. • Size and use of existing buildings, if any 110)^° I- s m Size of proposed building `, ft.x �G ft. Height (from grade to ridge) kr t ft. Front.yard -0 yard Side yards c2 f ft. and 6 y ft. Rear yard • / `/© ft. SOUTH If on corner,setback from side street 1119 ft. Note: All distances are net, as measured from street side line to nearest part,of.building. • (OVER) . 7-73-M (coned.) BUILDING SPECIFICATIONS., Kind of construction: Wood frame, fire safe, etc.?. . . . . .t 'p •/2 - Will any second-hand lumber be used? . . .VI 2. . . . If so, for what' Material of foundation walls C��., Thickness 0 VCcek.c'-74 . Depth of foundation walls below grade 7 I Continuous foundation? .yc.S. . . . Will there be a cellar? . . . .. . . . . . . If so, material of cellar floor C� Type of roof: Sloped or flat? C c' Material of roof . . ., }5,,,1./9e---1— Size, wood studs " x 6 ", spacing 16 "o.c., length rr• ft. Size, floor beams, 1st floor oZ "x $/ ", spacing /6 "o.c., span /Z ft. Size, floor beams, 2nd floor " x ", spacing "o.c., span i , ft. Size, ceiling beams 0Z " x G ", spacing /6 "o.c., span J 2- ft. Siie, roof rafters or beams -1'412.0.-S ", spacing a Y "o.c., span . . . . 2 V ft. Exterior finish J.? 1 - ' ' With what material? Finish of interior walls. . . . 5.&5= -T.2CX X If garage is to be attached, of what material is wall between garage and main building to be constructed? . . .cOC... . . .. . .l''. c.. . . . ...... ..`.....%. . . . . . . . . . . . . . . . Is there to be an opening betweep.,garage and building? 4g 'Y z Kind of heating systemL��?7LC �' Oil burner or coal? Will a flue-lined chimney be provided? 11- C3 • Depth of chimney foundation below grade Height of chimney above roof ,I,e Will there be a fireplace? Depth of fireplace hearth Will a toilet be installed? yes Will a kitchen sink be installed and connected to water supply? 3 , Water supply (public water supply or pump) -P� c-i Distance;of cesspool from any private well /CO r feet Will drainage system be provided with required traps, cleanouts, and vents? ye-_ AFFIDAVIT Town of Queensbury County of Warren State of New York I swear that to th bard my knowledge and belief the statements contained in this application,together with the plans and specifications sub- mitted, are.a true and co.,.plete 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 pro work s complied with,whether specified or not, and that such work is authorized by the owner. Sworn to before me this Signature R.OWNER'S AGENT.ARCHITECT,CONTRACTOR day of 19 t NOTARY PUBLIC, WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: • • By . TOWN OF QUEENSBURY BUILDING & ZONING DEPARTMENT SEWAGF DISPOSAL PERMIT APPLICATION 1. Owner ' s Name C(. ,.,_5 hie, i4rS CL� Address C/b 7/ipf CO2c4 , �,Ptrs: C�-�-5 f 9(4_� 17��T- 1��•7i� Telephone No. -L1/,2 2. Property location Le.), 11n7- c q,'-' 3 . Name of person or firm responsible for installing system �� . Telephone No. . Address �/ y 449S" �;5 4. Number of bedrooms (residential buildings only) j 5. Daily flow gallons/day 6. Septic tank capacity / 0 gallons 7 . Topography: flat rolling, steep % of slope 8 . Nature of soil and depth (c�� ? )91-(y_4T5 r7- 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 Jr1J11(C f7",y C- 12 . Type of system proposed: drywell, tile fiel� other 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 121 C ski natu` e of -pplicant 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 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 fjd • ' 2 . Type of heat 3 . Is the building mechanically cooled? no • • • 4 . Percentage of area of windows and doors I (1, � . 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 ac)O r ' ;3(2) .f • . 2 . R value. of exterior walls 3 . .R value of glazed area /� a S . 4 . R value of doors / J • 5. R value of floors over unheated 'spaces fe / / • 6. R value of slab edge insulation - unheated slab 7 . R value of slab insulation - heated slab b/ 8 . - R value of heated basement/cellar walls (above grade) P/4 9 . R value of heated basement/cellar walls (below grade) P1/9 10. Type of insulation 5,6 CLA S.3 C. Controls a . 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 - E. Piping Insulation 1 . Size of hot water or cooling carrying agent pipe J'//9 2 . R value of pipe insulation • F. Service "Water Heating 1 . Performance efficiency 2. Temperature control setting maximum /a.6J F G. For Swimming Pool Only 1 . . Maximum heating f • Telephone No. .) 3 -3/iY (a icant ' s s ' natiure). • 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 �— _• ;•` TOWNSHIP fi•• • ' - %� ;' COUNTY ( • '?�;'/ `G, STREET AND NO.OR ROAD AND POLE NO. _ s ._ .� � - -- � ��r•/f/c-lf .`I ! POLE NO. BETWEEN WHAT TWO CROSS STREETS IS - PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'Sr BUILDING _ --- NAME r` _. J - 'l r%.-- :�`/( __ t ?: OCCUPANCY /yi I :__3._./ - OWNER'S NAME AND ADDRESS h% {i i1- i I CURRENT SUPPLIED f %. .,;:'1 c--} J' .: ' FROM THEIR OFFICE BUILDING WORKSNEW ''I� ADDITIONAL❑ REMOVED ❑ IS NEW� El❑ REMODELED LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS No.of Fixtures& HEATERS BRANCH LAMPS Lamp MOTORSReceptaclesCIRCUITS Loca- tion Ceiling Side Attach't Switch Pendent Bracket No. Type H.P. No. Watts No. A W.G. NO WATTS Wall Recept'ls YP Each EachGauge EACH 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 ENTERS MAKER BUILDING OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE NEW OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF �T- /� DATE OF APPLICANT JJ--'i;-. i -i -1 ;S, �iti, '' APPLICATION STREET ADDRESS CITY OR / r ZIP LICENSE NO. POST OFFICE --:• • CODE WHEN APPLICABLE A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING Poo TOWN OF QUEENSBURY Building Department /f, Inspectors Report Date %Z-/6e 3 Name CCU �-a� Location Permit No. Kf 2 2) Weather Remarks Excavation Footing Forms ' Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing i • 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. V\ Septic Approval ' Floors Insulation Foundation Walls 'Ceiling B ilding Ins ector REMARKS • - bey I( K c. F t )4( / TOWN OF QUEENSBURY Building Department Inspector Report Date I . 2&'— . Nam (e /- p ,r , Location 1',r/.a�../ji-t i.- .(. . Permit No. '/ _3 Weather Remarks Exca)ation • Footing Forms Footing & Piers Foundation / 0 IL Cement Coat r Waterproofing (�bL Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer i Rough Plbg. i Relief Valves i Wall Board 1 Ext. Porches / Finished Floor % Interior Trim • 1 Stairs & Railings ,/ Cellar Dr. Tile / Concrete Floors I Plbg. Fixtures Gar. Fireproofing Door Closers - Chimney Water Meter Inst. • Septic Approval Floors • Insulation Foundation Walls 'Ceiling - - Bu 'l Ing Inspector ' 71.REMARKS TOWN OF QU•EENSBURY Building Department Inspectors Report Date / O /6 /3 3 Name G 1 e.1s r el lb ;46144 (Ro c s ) Location LvT /rJ e.sf ) '1 Permit No. S/ a 3 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 Ext. Porches Finished Floor Interior Trim Stairs & Railings . Cellar Dr. Tile Concrete Floors /s/ (4A Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls 'Ceiling J // Building Inspector REMARKS TOWN OF QU•EENSBURY Building Department Inspectors Report Date /7 7 Location ft�-ic �"v Name a- G� Permit No. L 2-3 Weather n _ I I I,VA 0/1/L Remarks Exca)iation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing I �_ Siding Masonry Veneer Rough Plbg. Relief Valves, IL Wall Board o � Ext. Porches Finished Floor ✓ fc)-1(.1 Interior Trim cc:/mil Stairs & Railings ✓`q Cellar Dr. Tile Concrete Floors Plbg. Fixtures 0/_,, Gar. Fireproofing 0-4.1 , Door Closers ✓ ,,; i Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation Walls Ceiling Building Inspector REMARKS G�/✓1�� %/ cs / rr gtiJv L Pt kJ L CO TOWN OF Qi EENSBURY Building Department Report Date �]�// `e `7 Name /V -/t'c y &I/LK 4j 0 d. , 44.3-e Location r r2 , Permit No. 7,9'2,3 Weather ret/ifo 2,rit_y 0 eMarks Excatation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing • Sheathing Roof Felt Roofing ,' Siding j Masonry Veneer Rough Plbg. Relief Valves Wall Board 1-< --L Ext. Porches V/ Finished Floor Interior Trim Stairs & Railings 04--- Cellar Dr. Tile Concrete Floors Plbg. Fixtures 1, - n14_ex7 S F n.-.p la-T i cir Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors ' Insulation Foundation Walls Ceiling Building Inspector REMARKS SYnbi(C_ Oe7C — 19�� R.,/.�-L 1.e cGL• ,_�C�v not Q. '11 NONE s- Wo n TA 4'm wo V1 Qj 0, via lot "Al NAT 100 00 top V ago awn Q�fw -20 ."sr�` - ... e ....................... C, ell - silo lit A , K-N ,-07 BY SCALE PRAWN 5V I I 11�- .1—j— —) REVISED ltk