8155 BUILDING PERMIT
TOWN OF QUEENSBU Y
No. 8'l55
WARREN COUNTY, NEW YORK
0
w
H David M. Harvey
PERMISSION is hereby granted to Y
OWNER of property located at Russell Hill toad (Lockhart Mt, )Street,Road or Ave. �
in the Town of Queensbury,To Construct or place a One—Family Dwelling
at the above location in accordance to application together with plot plans armi other information hereto filed and K
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 3 Second St.
West Glens Falls, New York
2. CONTRACTOR or BUILDERS Name
Same
G O
3. CONTRACTOR or BUILDER'S Address 0,
Same
�H
rf
4. ARCHITECT'S Name H'3
O 'Al
5. ARCHITECTS Address
JAI
O
)y
a
6. TYPE of Construction—(Please indicate by X)
(k)Wood Frame ( )Masonry ( )Steel ( )
7. PLANS and Specifications
281x37 ' per plot plan, specifications and
No. application submitted including sewage system.
This includes a 13 'x201 ore-car attached garage.
8. Proposed Use
One-Family Dwelling 0
M
I
$5. 00 C/O Paid 41
$100. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 1 19_I84 j
N.
(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.) C
t7
Dated at the Town of Queensbury this 13 th Day of October 19 8�
<, N
SIGNED BY a. ear for the town of Queensbury
Building and Zoning Inspector W
C/O Paid
CERTIFICATE OF OCCUPANCY ~
TOWN OF QUEFNSBURY
WARREN COUNTY, NEW YO K
pate July 2 5 1084
This is to certify that work requested to be done as shown by Pv rmit No. 8155
has been completed.
This structure may be occupied as a ONF FAMILY WFLUNG
Location RUSSELL HILL ROAD
Owner
By Order Town Board
TOWN OF QUEENSBURY
T i
1
Building d Zoning lnspector
L:.... C REAT iY ,../MN!T=,A -►PR, MTIM6 . . yttl i!t*)rt!} ttA .LrN
THE NEW YORK BOARD. OF FIRE UNDERWRITERS
I*- BUREAU OF ELECTRICITY
v 41 STATE STREET,ALBANY,NEW YORK 12207
Date July 10, 1984 Application No.on file 03908 '-83
THIS CERTIFIES THAT 624072 R
j only the electrical equipment as described below and introduced by the applicant named on the above application number in the promises of {
David M. Harvey, Lockhard Mountain Read Queenebury, New York
in the following location; C Besement 1� lst FT. ❑ 2nd Fl. outside Section Block Lot
was examined on and found to 6e in compliance .:�
7/3/84 f pl ance wi h the requirements of this Board.
RXTURE ACtES SWITCHES FIXTUM RANM SHERS
RECEPT
S OVIM DISH WA EXHAUST FANS
OUTLETS WANDESCENT FLUOUSCENT T AMT. K.W. .W. AMT. K.W. AMT. K.W. AMT. I H.P.
14 37 16
2 FR
low
DRYERS FURNACE MOTORS IUTURE AFF1iAN4E 1!lDRIlS SMCIAI RRC'FT TIAM MU, UNIT HEATERS MUtTi-OUTtIT
+ 'AMT. K.W. OIL H.P. GAS H.P. Ort NO. W.G. AMT. AMP. AMT. AW,S TRAM: AMT. H.P. NO.�OF FRETAMT. WATTS
MA
#10
SERVI0 DISCONNECT NO.OF R V 1METER
AMT. AMP. TYPE now. 1 X 4W 1 r/3W 3 0 3W 3 0 4W NO,OmCgCOND. A.0 COND. .OF NMEG � '' NO.OF NEUTRALS O UAL
1 200 CB 1 R 1 4/0
OTHER AMARATUS:
1 Smoke Detector
pp 1-15 amps GFCI Breaker
j
IN"PE ON FEE PAID
E:
David M. Harvey
3 Second St.
West Glens Falls,Nelw York 12801 BRANCH MANAGER
Der v ,
,.
COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE M N 09 ALTERED IN ANY MANNER.
TOWN OF QUEENSBURY (Space inside block to be tilled in by
WARREN COUNTY, NEW YORK Building Inspector)
Application No.
Application for lssned 19.
BUILDING AND ZONING PERMIT . Permit Expires. 'g
%iniinL District
• \ attic• ad Work,%
THREE (31 Copies of a PLOT PLAN, Drawn to scale "\1'1"""`('cl l')' .V S —
showing the actual dimensions of the lot to be built. Itc mar)(.S'
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 )OWN. '2l_f EENSiiU Y
0 S-^ I _ ' 9/as/8� OF
DATE [D C C, E Ind (
II i1 E rj
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORKOCr .� .i ),� 3
ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a ermit,to do the following work P.M. F S°U P.Fee Pd. roM.
which will be done in accordance with he description, plans and specifi- 7p Nj e9-L1)1 )4"Pi3l'IM
cations, and such special conditions as may be indicated on the permit.
The owner of this property is:-D ( I ckr U 8 j SeGoel k S f• li e s l` Gl e 0 s l j f; /\i,�
(NA".4E) (P.O.ADDRESS)
The person responsible for • supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
a ck si i Ck I'Vk I �� -r--v� Sa,ovt, e �,s • a b o u e
(NAME) (P.O.ADDRESS)
•
Name of Builder `� rl �' r . Address
Name of Plumber Address
Name of Mason o `"' '� e Address
Lot Number Unit Estimated value of proposed work I ' C', 000
Name of Village pp
Name of Street Loc,k1,- �x-� f" +' 11G1 • Side of street: north 0, east ®, south 0. west ❑
Nearest Cross Street 6 R°c k. - Distance from this cross street 900 1/• Ft.
•
Property is north ❑,south ❑,east K, west. 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest 0, southeast 0, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY -
Construction of a new building. Main Builtiing
❑ Addition to a building. One-family dwelling
0 Alteration to a building. Two-family dwelling ❑
•
0 Demolition of a building. -family apartment house ❑
Store building ❑
- " 1 -car attached garage /3 2 a R.
Other:
Accessory Building
014 W
.. One-car detached garage 1
❑ Oth •
• er 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 dotted line and existing
• huilding(s) in solid line.' . -$ o cr—c S
Size of property APer°x• 50 O ft. x 3
5 0 ft.
•
• Size and use of existing buildings,if any `''••••e
I- -
in In
s W Size of proposed building . . .a7 3. .-. ft.x . . .3.7. . . ft.
Height(from grade to ridge) oZ F ft.
Front.yard ' 10 I"-e 9.j ft.
•
Side yards
1a kf 1i'ne.E S5 ft. and ' i� `•. .75. ft.
Rear yard . .q.R2n. ?).c q 0 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., fr
Kind of construction: Wood frame, fire safe, etc.?. . . . . . ...•. .a r' .G'
Will any second-hand lumber be usedl 0 If so, for what'
Material of foundation walls Co n"-Q+Z (0 G kc Thickness /0 ''
Depth of foundation walls below grade Continuous foundation?
Will there be a cellar? QS If so, material of cellar floor Go.1 c_r e`1-4
Type of roof: Sloped or flat? . . . .9.1p.P e&• • • • . Material of roof a.S p h..`)1" S (-1 I'�� 1 e S
Size,wood studs " x D ", spacing 6 "o.c., length i • ft.
Size, floor beams, 1st floor "x ", spacing "o.c., span ft.
Size, floor beams, 2nd floor °\. " x / O ", spacing / 6 "o.c., span I R ft.
Size, ceiling beams " x ", spacing "o.c., span / 0 ft.
Size, roof rafters or beams " x ", spacing /C "o.c., span ft.
Exterior finish e'n fa SI Cry •"•-, • • • • . • •1 With what material?
Finish of interior walls. . . . . . .1'.—') ?'4 c G .`�`.'N•ekwa �'e ( ,'‘
If garage is to be ached, of what material is wall between garage and main buiing to be constructed?
Is there to be an opening between garage and building? 0 5
Kind of heating system e le G C, bSZbcmr. Oil burner or coal?
Will a flue-lined chimney.be provided? )( .'S Depth of chimney foundation below grade 71-c' ce/)cr oa
Height of chimney above roof
Will there be a fireplace? 0 Depth of fireplace hearth
Will a toilet be installed? - e 5
Will a kitchen sink be installed an connected to water supply? `� e 5
Water supply (public water supply or pump) a� �G1l 5} C('( o P)
Distance of cesspool from any private well feet
Will drainage system be,provided with required traps, cleanouts, and vents? (3 e S
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt: A r j 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 described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the prop work shall be complied with,whether specified or not,
and that such work is authorized by the owner. ( M � ��
Sworn to before m this Signature
h L 9 - LL /� 19. ?S OWNER.OWNERS AGENT.ARCHI •ONTRACTOR
--GUI)14),--- -T- i-k-cduyto .41" q(70 (-7(5.3 ' / (-6)-Yurvt_- '‘,(r.1.(A6.Th 03 /,3 0 /s7L5'
say of �•.�JJ.Lr{("��!r�M{-VN)
NOTARY PUBLIC, WAI6REN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
By
' TOWN OF QUEENSBURY '
WARREN COUNTY, NEW YORK •
•
• Application for: BUILDING PERMIT IN COMPLIANCE WITH THE NW YORK
STATE ENERGY CONSERVATION CODE
•
•
A permit must be obtained before beginning work ..
•
ANSWER ALL of the following:
1. Gross •floor area ' / ? a 0 -
2 . Type of heat e1edAlC bGSt Oa0.r-1 '
3 . Is the building mechanically cooled? rm O
. 4. Percentage of area of windows and doors / 5 3 170
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 ex o e to ambient conditions_
CD
'2 . R value of exterior walls /� a. s
3 . R value of glazed area � . 5 . •
•
•
4. R value of doors ' 0\ • ✓ ,
5 . R value of floors over unheated 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 ... .' -
• 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
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
f '. .Telephone No. 79 3 --7/ S o D ':0� M
(applicant ' s signature)
TOWN ..OF.;.OUEFNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1.. Owner ' s Name ck_ O •
�..
Address 3 Se, St.
k),(2 e (-\s � LS N• y, Telephone No. —79 / s a
2. Property location i..S S e 1 ( 6L0 /'✓1 o
3 . Name of person or. firm. responsible for installing system
Telephone No. .. •
Address
4 Number of bedrooms (residential buildings only)
5. Daily flow {O.O ' gallons/day •
6.. Septic tank capacity /O O gallons
7. Topography:. flat, rolling, 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? • ft.
10. Percolation -test: A X is recruired
B. is not required
C If required what is the,.rate minutes/inch
11 Water supply: municipal, well, other
12 .' Type of system proposed: drywell, tile field, other c r-
L.
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.. 010of the ,
Queensbury Sanitary Sewage Ordinance
Date /c /j
signature:.of applicant t. ..
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 TOWNSHIP(p1 y\j j ..'(J R. COUNTY (j`)9 is
STREET AND NO.OR -
ROAD AND POLE NO. ' r f�71. .POLE NO. _
BETWEEN WHAT TWO i ,. /i'.,
CROSS STREETS IS //l,- / • i i- `'
PREMISES LOCATED? SECTION BLOCK LOT
BUILDING
- NAME .� ,_1.. •�` OCCUPANCY :7 f i'
OWNER'S NAME
AND ADDRESS ' •tl t ` " S�; I f' — r:1,I .- ( • f ! !'.:r „;
CURRENTBY //, fy /� y�` _
SUPPLIED i ��. �(/ FROM-THEIR �s�(E/} OFFICE -
BIS NEW
NEW VI OLD❑ REMODELED ❑ WORK NEW L�'J" ADDITIONAL❑ REMOVED DEFECTS ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No.of Fixtures& BRANCH
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS LAMPS
Loca-
tion Side Attach't H.P. Watts A W.G. WATTS
Ceiling Wall Recept'Is Switch Pendent Bracket No. Type Each No. Each No. Gauge NO. 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 MAKER
ENTERS
BUILDING 'OF SIGN
INSPECTION REQUESTED
ON OR AS NEAR AS
POSSIBLE NEW 111 OLD
• El
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF , - AALEIOAT ION •
/
APPLICANT
STREET ADDRESS - � •
1\ `\ ZIP f �f ) LICENSE NO.
POST OFFICE • .��z•) - (-`1 -"1'' `• ) ! ' Y CODE ;{ `: - I WHEN APPLICABLE
• A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
•
TOWN OF QUEENSBURY
Building Department Inspectors Report Date 7✓f a /l
• 0`4
Name / 4'1); v( 'Ha v V i
Location /49,/<s g_t/ /•Ii // e cl
Permit No. ,Jr'/ 5 Weather
Remarks
Excavation
• Footing Forms
Footing & Piers
Foundation (.)
Cement Coat
Waterproofing
Backfill I il..j-1, ec-fist
Final Survey 17 •
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
t Board
i
Ext. Porches •
Finished Floor
Interior Trim C/' (r)("'
Stairs & Railings L (r}
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures //- ;�°
Gar. Fireproofing Aiy'�
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
g •
Building Inspector
REMARKS
TOWN OF•QUEENSBURY
Inspectors Building Department
In s Report Date
Name d-2.i/°6
. Permit No. k i 55 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 •
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
cV(Z7°_ ,/f /1/---1/
Building Inspector
REMARKS •
6�GG�i
13 y r
7 ,> 8
/eg —zy �
•
TOWN OF•QUEENSBURY
Building Department
•
Inspectors Report Date A'XS7"
Name, P%/://' e7
Location r„� .%�P� /777kr '
. Permit No. Y/ .S Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
. Waterproofing
Backfill
Final Survey
Framing f�'Q •
Sheathing
Roof Fel t
Roofing
Siding
Masonry Veneer t 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 In t.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
/� . REMARKS e*
TOWN OF QUEENSBURY
Building Department
Inspectors }trait Date
Name MeiFY
Location Go(hL-M T / - .ir,/..
Permit No. / .5- Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey �4, J
Framing f •
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
Building I Spector
REMARKS
TOWN OF'QUEENSBU RY
Building Department
Inspectors Report Date
Name -9/ P•1=-'•
• LocationJs�G•C.Z, '1G �
. Permit No. ,/5 Weather
Remarks
ExcatYa tion
Footing Forms
Footing & Piers , ,✓^
Foundation G!
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
Building Inspector
REMARKS
• '
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