8227 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8227
WARREN COUNTY, NEW YORK �
S
PERMISSION is hereby granted to Tint Chagey
OWNER of property located at Lot 23A North Wood Drive
Street,Road or Ave.
Court House Estates Subdivision
in the Town of Queensbury,To Construct'',or place a Qne—Fam i 1 y Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Tow t of Queensbury Building and Zoning Ordinance.
1. OWNER'S address is Rt. 9 Iaake George road Box 62
Glens Fulls, New York
2. CONTRACTOR or BUI LDERS Name N
Same ,ot I
N
W
3. CONTRACTOR or BUILDERS Address
z
Same rt
rt.
4. ARCHITECT'S Name
o ppO
0
ty
5. ARCHITECT'S Address
C}
M
6. TYPE of Construction—(Please indicate by�)
k )Wood From ( 1 Masonry ( )Steel 1 )
7. PLANS and Specifications
28'x52' per plot plan, specifications and
No. application submitted including two-car
garage ) (under) and sewage system.
8. Proposed Use ti
One-Family Dwelling I
$5. 00 C/O Paid
$ 169. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES June; 1 1984
0
(if a lon
ger period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the exp ion date.) (9
N
F�•
Dated at the Town of Queensbury this 14-h Day of November 19 83 �
W
SIGNED BY Q for the Town of Queensbury
Building and Zoning 1
•
TOWN OF QUEENSBURY
(Space inside block to lx• filled in by
WARREN COUNTY, NEW YORK Building Inspectr)
Application for Application No. . •
Permit issued 19. .
•
BUILDING AND ZONING PERMIT Permit Expires. 19.
\alw.• District
- \ aluc• nt \1'nrk
THREE (31 Copies of a PLOT PLAN, Drawn to scale •\1'1 "`e'el ►"' /I
showing the actual dimensions of the lot to be built ►le:,nar)Gc
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 .
32- r/ // ' p� 67: TOWN O r QUEENSEURY
DATE ;
12 .: 3
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK NO',! ,; 0 19 .
ANSWER ALL OF THE FOLLOWING. , t° an,
The undersigned herebyapplies fora permit to do the followingworkA.M° ��� ?iv
9 PPP8 J 11t�Ic): ��� ��5��
which will be done in accordance with the description, plans and specifi- ,7 I e . '1. ' '
,�j
cations, and such special conditions as may
,beindicated on,the permit. -� c,
The owner of this property is: ` , ( �C��
)NA`AE) J (P.O.ADDRESS)
The person responsible for supervision of the work insofar as the Bt tiding Cods apd the Zoning Ordinance apply is:
// /
Name of Builder . ,�l/t'c' `fir Address
i l it
Name of Plumber Address
Name of Mason t ` t + Address
Lot Number. . .2 'A . . Unit Estimated value of proposed work 3 . 'v j O U o.
�f G Name of Village . . . .��-4C� �-�-� -"`
Name of Street �✓� c "'� t��' z� Side of street: north 0, east 0, south 0. west
Nearest Cross Street .. N? . .1`-. Distance from this cross street 9-c-4 Ft.
Property is north south ❑,east i i, west 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast ❑. southwest
. (Designate by marking with an "X" in the correct space.)
,1 NATURE OF PROPOSED WORK .00CUPANCY
-" Construction of a new building. Main Building
❑ Addition to a building. . . One-family dwelling •
❑ 'Alteration to a building. Two-family dwelling ❑
• ❑ Demolition of a building. -family apartment house ❑
Store building ❑
'l' -car attached garage tx tnJ-ee.• ❑
Other:
• Accessory Building
One-car detached garage
0 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 dotted line and existing
huilding(s) in solid line.
Size of property / `'--o ft. x / , b ft.
Size and use of existing buildings, if any
s ) �, -_ •- > m Size of proposed building 1- Si ft.x ft.
-r: Height (from grade to ridge) "1. -� ft.
A. Front yard ' i4.0 t ft.
\ Side yards 1- ` ift. and 2 C. ft.
Rear yard . Si - / 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.2
Will any second-hand lumber be used . . . .ili. OJ, . . • . If so, for what7
Material of foundation walls Thickness
r
Depth,of foundation walls below grade `/- Continuous foundation?
Will there be a cellar? /if ib If so, material of cellar floor `'
Type of roof: Sloped or flat? . . : '�•.
. . . . Material of roof t,,-6 '
Size,wood studs f.-. "x •q ", spacing 14 "o.c., length. . . .• . . . ft.
Size, floor beams, 1st floor . " x (:v ", spacing I "o.c., span /q ft.
Size, floor beams, 2nd floor " x „ spacing r/ "o.c., span ft.
Size, ceiling beams 2-. " x • L . ", spacing ( G "o.c., span / / ft.
Size, roof rafters or beams p "x ", spacing "o.c., span ft.
Exterior finish Gl�l ....v.u' ','►"`"' With what material?
Finish of interior walls 5L
If garage is;Dees attached, of what m/atterial is w�all�bbet^wee� garage and main budding to be constructed?
Is there to be an opening between garageand building? . . . .
Kind of heating system . . . . ...ei . 9 r. Oil burner or coal?
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?
Will a kitchen sink be install d and connected to wy�tely? `o�-l��`—
Water supply (public water supply or pump) r u p
Distance of cesspool from any private well 7 feet
Will drainage system be provided with required traps, cleanouts, and vents? 17--
2 AFFIDAVIT
Town of Queetisbury
County of Warren
State of New York
I swear that to tt, bcj j of my know,Iedge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are.a true and co.a. 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 proposed work shall be complied with,whether specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature OWN OWNER'SAGENT,ARCHITECT,CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY. N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
By
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT .
SEWAGE DISPOSAL PERMIT APPLICATION
‘)
1. Owner ' s Name ✓{ . ��—
Address AJ 4 9 ;Gvk2._ ./al�„,
Telephone No.
2. Property location Zff2- %j if - lia
3 . Name of person or firm responsible for installing system
—r—"
Telephone No. 7 -
Address (/'c// .(Z%9 i r-- 0/1
4. Number of bedrooms (residential buildings only) j
5. Daily flow �� . gallons/day
6. Septic tank capacity / gallons.
7 . Topography: flat, rolling, steep
% of slope
8. Nature of soil and depth . Ci
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
12 . Type of system proposed: drywell, tile field, other �G - /
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 If / o 1' 5
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
I 1 li o; 0i17 QUI Et+Sbu Y
11 !1, 1 11, I I;• WARREN COUNTY , NEW YORK
plicati'on fort BUILDYNG P&P.M.IT !N COMPLIANCE WITH THE NEW YORK
I e R STATE E E1 Y . CONSERVATION CODE
•
l' III A permit must be obtained before beginning work . .
'A 4Sh"ER' ALL of the following :
i w ,1i 1
. ' Gsc�€ all f l os area _! _
, .•,I, 'I I 'I
2 . ' pe, "Of heat
-
: 11
TY •
I
I •
Is' t'hIei building mechanically cooled? "z
I i I
I Percle'r age of - area of windows and doors ) -
HI A .'i Over 16% Only
' I 1, ,I; ll';:' I U value of gross area of walls , roof/ceiling and floors
.
'; ,;� exposed to ambient conditions
12''I Floor over heated spaces YES NO
1 l a. Are foundation walla insulated? YES NO
,i 1 ' 1 . If YES, what is the R value?
! I 3 . Slab on grade YES NO
I I I1 a. If • YES, what is the R value of insulation around
, 1, i ,I perimeter of floor?
'i I ,1'
A111l Is basci;fent heated? YES NO
�I 1 I a , R value of insulation
I i. .
•
11 HI 5J� Type of insulation
B .:, ilnder 16% Only
j !11.i R value of roof and, floors exposed to ambient conditions
1
0 ;'111 R value of exterior walls _ � )
; II L'
. ' ;3 ' 1! R value of glazed area 1_1
'II r
,i 4 . I! R value, of doors )5 i )
H 5. !, R value of floors over heated spaces
l i ii �.
e I II
6:��11 R value of slab edge insulation - unheated slaby)/)A
7 .,
' R value, of slab insulation - heated slab112.)Le.._
Ili
T
II ,II III 8:' R value of heated basement/cellar walla (above grade) 8
' Ii' R value of heated basement/cellar walls (below grade) U
,. ,L 1,1
' 10 , Type of insulation .CL z;ii-b ,-- -- 1 -
li C. H Controls '
1 • i Thermostat maximum heat . setting 7'
1 h I': 1
OH puc;,t Systems
1 . Is duct) systtm installed in unheated spaces? YES , r:0
I, ,i ; a . If 'YES , R value of duct installation
r 9. ; b. R value of duct in other areas T� '
E . I' Pipeine Insulation
1 ' 1 :1 Size of hot water' or cooling carrying agent pipe
I . 2 :, R value of pipe insulation
Ii M1, 11
1 F. Service Water Heating
I 1 . _ Performance efficiency' ; . . , 7o
2 •;I Temperature control setting maximum L U
I', 1 -i G, , For,; Swimming Pool OnlpA ',...,, '•
' : 1 . i Maximuml.heating "•
iTlqlephon1 I /' '.\
11 ..:I ,1 1 ' I "I ....� I. ( applicant ' s signs ure )
•
•
BUILDING DEPT.COPY OF APPLICATION FORM 46-EL.NEW YORK BOARD OF FIRE UNDERWRITERS.
FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED.
•
V'L;T )
lll E • j TOWNSHIP COUNTY (/,;.-a_,:• •--••
STREET AND NO.OR
ROAD AND POLE NO. 3 •.,-.,,;,,.;' ,. I '' , •-.--'"-- POLE NO.
BETWEEN WHAT TWO �. r.. -2"7.... :, ..r
CROSS STREETS IS
PREMISES LOCATED? ..- ,--<-_L'-'_-.�,,•'-- ,z'"%F' . .'"�.f'( SECTION BLOCK LOT
OCCUPANT'S BUILDING
NAME • „--' •-- i f.L '• OCCUPANCY .
OWNER'S NAME /
AND ADDRESS , - •-,: E------
CURRENT "
SUPPLIED --BY �. 1_ l ,�;-..7 FROM THEIR I�-.: !1:�=,:-. .., OFFICE
SBUILDING DEFECTS NEW Lam' OLD❑ REMODELED ❑ SORK NEW ❑ ADDITIONAL❑ REMOVED ❑
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
No.of Fixtures& BRANCH
NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS LAMPS
Loca-
tion
Ceiling Side Attach't Switch Pendent Bracket No. Type H.P. No•
Watts No. A W.G. NO, WATTS
Wall Recept'Is Each Each Gauge 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 I I OLD
• AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
I
NAME OF -1 �_ _ ��..�_ ` DATE OF ! , !�- `)
APPLICANT - " APPLICATION ' ' _ _
I •
`.f
�'.��r iI !
._ " :c._ `- ,...' : ,/ -STREET ADDRESS
CITY OR • it• - J,,(• ZIP LICENSE NO.
POST OFFICE _- L. . .,, . . "--.',- CODE WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
O1k
TOWN OF'QUEENSBURY
Building- Department
Inspectors Report • Date 7/q%
Name '
Location - 3 A,4101, / eir>b .1>
. Permit No. Weather
Al 5 S Ff 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 c ,4A(.k'- t)
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 ' '
Building Inspector
REMARKS
TOWN OF CLUE ENS B U RY
Building Department
Inspectors Report Date 6 J,21 Pe(
me Na C 1�� 3 �A
Location en r)�TffacJ T7P: 7 (Q102Ti' . iz
Permit No. 22_-7 Weather
Remarks
Excatia ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey C
Framing / •
Sheathing I
Roof Felt
Roofing
Siding f
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches 11‘--;!"_%
Finished Floor o%() .
Interior Trim /,/ /97,-
Stairs & Railings/� �
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures 1„,/0J/",
Gar. Fireproofing /e2X-
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceilin
Building Inspector
REMARKS
L �
g -3a AM
TOWN OF QUEENSBURY
Building Department Q
lnmpeeten Report p Date 3 c� ('
Name C�/,,,p,,
Location 11./(n2,J (4470-11 /d-t e
Permit No. ?v-.2 ,2-7 Weather
Remarks
Excatia tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill ,
Final Survey /' 014(
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief ValvesLV:
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
4/1-
Building al
I spector
REMARKS
•
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date rj,�s 7.;
Name e
Location ji/c_A-AM4Gt I �', z4,57-7--a,4
Permit No. f'1 ,`I_2,7 Weather
Remarks
Excavation
Footin5 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. Ti e /
Concrete Floor /
Plbg. Fixtures /
Gar. Fireproofing X
Door Closers
Chimney
Water Meter In t.
Septic Approv 1 �/
Fly
Foundation 3
Insulation Wa115
Ceiling '
Building Inspector
•
REMARKS
•
-65
(crwei
-€14
1 .;-1-H-LUct9:1)