8447 C/O Paid
F
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY ► '
WARREN COUNTY, NEW YORK
Date Aucust 20 1984
an• gr ."11.1.14,
This is to certify that work requested to be done as shown by Permit No. 8 d47
has been completed.
is stPO
cture may occupied One-Family Dwelling
This
G�eoU r h oaSG Did.
Location Lot 11A Courthouse Drive (St. No. 21)
1
Owner Donald Sipp
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
vF .NCT• POINTING r FNc F�1 l c N V IJPfII IS1P1.]G i_SfiSH
BUILDING PERMIT
•
TOWN OF QUEENSBURY
No. 8447
WARREN COUNTY; NEW YORK :1
PERMISSION is hereby granted to Donald Sipp
(Courthouse Estates Section One)
OWNER of property located at Lot 11A Courthouse Drive Street, Road or Ave.
Street No. 21
in the Town of Queensbury,To Construct or place a One—Family Dwelling o
at the above location in accordance to application together with plot plans and other information hereto filed and
1-1
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. p,
co
1. OWNER'S Address is 24 Roosevelt Ave. 1-0
Glens Falls, New York 1-0
2. CONTRACTOR or BUILDER'S Name
• Valente Builders, Inc.
3. CONTRACTOR or BUILDER'S Address
Box 167
•
Lake Luzerne, New -York o
rt
4. ARCHITECT'S Name Cn H
rt >1
o
o
• 5. ARCHITECT'S Address
N
0
• o
6. TYPE of Construction—(Please indicate by X)
(x)Wood Frame ( ) Masonry ( )Steel ( ) C'
6)
7. PLANS and Specifications
55 'x7 0' per plot plan, specifications and application
No. _ submitted including sewage system and two-car attached
garage. - -
8. Proposed Use
One-Family Dwelling - -
0
$5. 00 C/O Paid
$157. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 1 19 84
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the i.,.
town of Queensbury before the expiration date.) - f✓
Dated at the Town of Queensbury this 3 0th Day of April 19 84 t7
fD
SIGNED BY a.a -2 for the Town of Queensbury ~_
Building and Zoning Inspecto
W
TOWN OF QUEENSBURY
(Space inside'block to lw tilled in by
WARREN COUNTY, NEW YORK • Building Inspector)
Application for Application No.
Perin it Issued. 19.
BUILDING AND ZONING PERMIT „it Expires. 1.
%(piing District .
\ aluc of Work,f
THREE (31 Copies of a PLOT PLAN, Drawn to scale •\1,I,ro‘c•c1 b
showing the actual dimensions of the lot to be built 12cniarKf'
upon, The'exact size, and location on the lot of the .
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. .
37- / / �� TOWN OF QUEENSBURY
• R
DAT CCU EI ►1
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK An 2 7 984
ANSWER ALL OF THE FOLLOWING. Alt
u•: P M
The undersigned hereby applies for a permit to do the following work A.M. / 12
1] l!1 2
which will be done in accordance with the description, plans and specifi- 7I 9�1q -) .1 s ) )� ), I , 1
cations, and such special conditions as may be indicated on the permit. .,J,-�,p 0
The owner of this property is: �"'�
b jge v)aiuir1) S' ,/ep `r l2'fi osUve- -/-ri6 6.-&: s -
(NA`.)E) (P.O.ADDRESS)
The person r nsibN for. supervisi n of the work insofar as the Building Code and the Zoning Ordinance ap Iv is:
(NAME) (P 0 ADDRESS) .
Name of Builder G! ��`!' /l � S e' Address GZ �� L
Name of Plumber 0® S — Address j cry-- -e•ef'-.
(ej-/r}(!_.• • , • f: Address
Name of Mason. . . . / � •p�`o f �'�f fir. r
•
�1 // Unit.' 13 -tyc) Estimated value of proposed work 3 . . f"" Jam'
,� Lot Number �`��� Q.
Lcr' P P • •�• ,
A'' Name of Village
Name of Street Od u f1°'`�� 2• Side of street: north 0, east 0, south O. westAl
Nearest Cross Street `"'"Lv 2 ' Distance from this cross street 2-0 c) Ft.
Property is north jEr,south ❑,east ri, west. ❑from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast Q. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
g) Construction of a new building. Main Buitding
Addition to a building. One-family dwelling
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house ❑
Store building ❑
. . . .-car attached garage W
• Other:
• Accessory Building
• . One-car detached garage ❑ •
Q 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 buildings) in dotted line and existing
• /S-7 Ituilding(s) in solid line.•
IA
_
!it
W
Size of property l .1 ft. x 1 ft.
ca t.Uo -- -
F GAP( .. c s--f„� \ Size and use of existing buildings, if any
I 0
i F' 1 1 W Size of proposed building S'S ft.x 5 L ft.
Height(from grade to ridge) I� ft.
{�{ 'iv' Front yard `�,-- ft.
d. • /s ° i/NN* Side yards 3 Z. S ft. and 3 ` 1 ft.
5 S� ft.
� . (��c•wov� A�� Rear yard
S. 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 7 `��� (2`'—
Will any second-hand lumber be used? INZA3 If so, for what?
It cw:) c-rwt—
Material of foundation walls I Thickness
Depth of foundation walls below grade Continuous foundation? .y. '.•
Will there be a cellar? Y err' If so,material of cellar floor ctu"
Type of roof: Sloped or flat? . . . ...Li 4.... • . • Material of roof - i ?'`'iZf J r rq-s- ,/X.
Size, wood studs "x 6'" ", spacing / "o.c., length II- ft.
Size, floor beams, 1st floor - "x /® ", spacing ./ 6 "o.c., span / 4 ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span -- - ft.
Size, ceiling beams " x (e.) ', spacing ce "o.c., span / ft.
Site, roof rafters or beams ,,— "x P ", spacing /6 "o.c., span G ft.
Exterior finish . . . . 413 0 0 z`" With what material? . . .Lit.).-911 a
Finish of interior walls -�I'- 'rr __,
If garage is to be attached, of what material is tall_bbAtween garage nd m in building to be constructed?
Is there to be an opening between gars a apd building? A
Kind of heating system L ..A,C Oil burner or coal? .r
Will a flue-lined chimney be provided? .. . : •G'3`. . . . Depth of chimney foundation below grade . . S.
Height of chimney above roof. . . .-3
Will there be a fireplace? `1 1 Depth of fireplace hearth . . .`t U
Will a toilet be installed? V. 19 ��
Will a kitchen sink be installed and connected to water supply?
Water supply (public water supply or pump) P t,�e� C
Distance of cesspool from any private well l•f/0 l feet
Will drainage system be provided with required traps, cleanouts, and vents? y <--3
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt•ba 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 escnbed premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the p sed work l mplied with,whether specified or not,
and that such work is authorized by the owner. ^ .
Sworn to before me this Signature lJ
OWNER.OWN R•S GENT.ARCHITECT,CONTRACTOR
day of 19
NOTARY PUBLIC, WARREN COUNTY, N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
•
•
•
By
•3 '7 - 1 - 1 . 5
TOWN OF QUFFNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE' DISPOSAL PERMIT APPLICATION
1. Owner' s Name 4) S pep
Address Of&�L"f— , V
Telephone No. /mg _ W
2. Property location �4- 1/f 6- Q (Zt UL
3 . Name of person or firm responsible for installing system
Ao � to-r Telephone No. 14(12- M
Address I 7 Coe.ud ,, pr Ih -- /4-10fa.,1
4. Number of bedrooms (residential buildings only)
5. Daily flow gallons/day
6. Septic tank capacity / 61-u gallons
7. Topography: fla , rolling, steep
% of slope •
8. Nature of soil and depth -.07.4%,
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,ckfiel:R 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 4`2'-`7--e i/i-:/ 1-
1. 4
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
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 2Ia0
2 . Type of heat_ �' � �Z l • •
3 . Is the building mechanically -cooled? o•&Zl
4 . Percentage of area of windows and doors
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
2 . R 'value of exterior walls iq
3 . R value of glazed area (2- l c S 2
4 . R value of doors Z lilt3 •
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 21 7`' 6 ` e f Y� c.
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 • ' -
•
, •
Telephone No. eg
/1012P , 444
(applicant ' s signature)
1
•
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 i i ; C ,- , S q TOWNSHIP COUNTY =`.-.+)<' -�
STREET AND NO.OR
ROAD AND POLE NO, i^ i< r POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS ^t
PREMISES LOCATED? :•
i SECTION BLOCK LOT
OCCUPANT'S BUILDING
NAME • OCCUPANCY
OWNER'S NAME
Ci �6f � 7
AND ADDRESS i,.':='. -f i -
CURRENT
SUPPLIED _BY FROM THEIR OFFICE
IS BUILDING S
NEW El OLD❑ REMODELED ❑ WORKSNEWfO ADDITIONAL❑ REMOVDEFECED
D ❑
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 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 he 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 , . I ' 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 El OLD
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
NAME OF DATE OF
APPLICANT • APPLICATION
r
STREET ADDRESS - I
CITY OR -_ ; I ZIP , •�;' LICENSE NO.
POST OFFICE /- r + CODE, WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
•
ArrNawaivinlimmvinnn nit WALK lnm+4KmmAcm 7PLIC7IIRm W. m[RSminmm71110 mMit m I A ia k ).a 4 A)A.�Jr!.a{.1)),tia),a)�f,a tia J .
002102 THE NEW YORK BOARD. OF FIRE UNDERWRITERSs.
i BUREAU OF ELECTRICITY
k 6t 41 STATE STREET,ALBANY,NEW YORK 12207
August 20, 1984 051205d�4s /� ' w
Date A Application No.on file 6 2( 9
G THIS CERTIFIES''j' /kT �'1 �l
' i only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of' Y
» Mre Donald. Sipp 9 Lot 11A Courthouse Drive, Queencbury,9 Neu York
1r Outside
9▪; in the following location; I Y
Basement ❑ 1st Fl. ❑ 2nd Fl. Section Block Lot
was examined on 8/9/84 and found to be in compliance with the requirements of this Board:
?; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MERCURY AMT. K.W. AMT. K.W. AMT. K.W.. AMT. K.W. AMT. H.P. v
3 18 48 2 18 3 Fr
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS o-
- x, SYSTEMS
.AMT. K.W. OIL " H.P. GAS H.P. AhlT. ,�NO,rr 1 A.WTG. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET .AMT.- WATTS :i
± 1 dryer. 01 C
1 1GYT,YrP 41l! r`
) SERVICE DISCONNECT NO.OF S E R V I C E 'y
METER NO,OF CC COND. A W G A.W.G. A.W.G.
�, AMT. AMP. TYPE EQUIP. ,I,"2W 1 A'3W 3 JB'.3W 3,B'4W PER% OF CC.COND. NO.OF HI-LEG of HIDE NO. NEUTRALS OF NEUTRAL
Y
1 1 200 CB 1 x 1 4/0 1 2/0 ;
k OTHER APPARATUS: i
ELECTRIC HEATERS : 30 1. 0 kw, 2- 1e5kw, 3-. 75 kw, 1- . 5 kw i
• 5, 1 m Smoke detector . v
_. !, 1 d 15 amp GFI Breaker i
A
i
.
W Ray Perry ,
k Old Stage Road 2239 •
• Lake Luzerne s Neu York 12846BRANCH MANAGER •
Per ��
7 i
COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
/ 9'
TOWN OF• UEENSBURY
Building Department
Inspectors Report Date V/i,t) 3'/
Name nO c . ,,pO
Location /�,= L'�.��n- J t'� /c�, �71-16 U J
. Permit No. 7/5/7 w ther
•
F',i/4L Remarks
Excat,a 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 Uy Ir
Ext. Porches r w
Finished Floor 3f,_
Interior Trim
Stairs & Railings c,,�
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers (9'�=
Chimney c,-' c�z•�
Water Meter Inst.
Septic Approval
FloOi`s •
Insulation Foundation
Walls
Ceiling " '
•
Building Inspector
REMARKS
f C /"(-- ��-
0—n1-02£ . roc 7`c , A�
TOWN OF•QUEENSBURY
Building Department
Inspectors Report Date II
Name boss/
Location Ca, 1I T tt, 2 dam 571" .a I
Permit No. cv-pi`7 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 J�
Stairs & Railings
Cellar Dr. Tile A"
Concrete Floors
Plbg. Fixtures /
Gar. Fireproofing r
Door Closers •
Chimney
Water Meter Inst.
Septic Approval rf-,
Floats
Insulation Foundation
Walls
• Ceiling - '
wilding nspector
REMARKS
GJ U-1)CD
r /
TOWN OF'QU•EENSBIJRY
f Building Department
1
Inspectors Report . Date 7��,6-
Name PPl c' `
Location C w Y*)vge 1>le—
. Permit No. i-oT //, - Weather
Remarks
Excatia tion
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
Foundation
Insulation
Walls
Ceiliri '
•
Building Inspector
•
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date________
Name v)0 Ai e l cJY S`r p
Location C000am }().iea ') ram, 407 ////-
Permit No.. t/ `/Y 7 Weather
Remarks
Excat>a ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing �/ 0 ("r0 T 7 543
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 f
Door Closers
Chimney
Water Meter Inst.
Septic Approval
FloOi`s
Insulation
Foundation
Walls
Ceiling
c�
Building Inspector
REMARKS
•
• TOWN OFQUEENSBURY
Building Department
Inspectors Report Date 7/9, ,d
Name S l pp /tr�fz .�w 1'
Location Co c,
. Permit No. Pp.AJ h Aitc Weather
V7`7 Remarks
Exca a"tion
Footing Forms
Footing &
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. Fireproofi
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls '
Ceilin
•
C-*2/9 f
Building Inspector
REMARKS
Valente Builders, Inc.
Route 9N Pride and Workmanship is
Lake Luzerne, N.Y. 12846 the Foundation of Our Homes Phone (518) 696-2689
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