8641 BUILDING PERMIT
TOW'UN OF QUEENSBURY
No. 8641
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to `7• Michael Blackburn 4
OWNER of property located at Upper Ridge Road .
Street,Road or Ave.
N.
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 and other information hereto filed and N approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
30 W. Notre Dame Street
Glens Falls, New York x
a
0
n
2. CONTRACTOR or BUILDERS Name
Same
3. CONTRACTOR or BUILDERS Address
Same
4. ARCHITECT'S Name (ropp
f'1
5. ARCHITECTS Address a
W
M
W
O
6. TYPE of Construction—(Please indicate by'X) W
a
(x)Wood Frame ( )Masonry ( )Stool ( )
7. PLANS and Specifications
361x40' per plot plan, specifications and
No. application submitted including sewage system,
0
8. Proposed Use
fD
One-Family Dwelling
F�•
$5. 00 C/O Paid *C
$ 126. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES February 1 1985 E
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the M
town of Queensbury before the expiration date.) I
Dated at the Town of Queensbury this_ 116th Day of "I 19—_ tq
SIGNED BY a• for the Town of Queensbury
Build ng and Zoning Inspector
• ' TOWN OF QUEENSBURY (Space inside block to be filled in by
WARREN COUNTY, NEW YORK - ' • Building Inspector)
A plication for Application No.
p Permit Issued 19.
BUILDING AND ZONING PERMIT Permit Expires. 19.
/mI1II1:: District
�("
' THREE (31 Copies of a PLOT PLAN, Drawn to scale '\1'1"''"`•c1 by � )
showing:the actual dimensions of the lot to be built_ Rc•nn;irKS'
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB •
-
MITTED WITH THIS APPLICATION.
eo0 /Lo 6- ()Al &ib . ,7//3 / 1 TON OF QUEENSDLIRY
b 1 C., . 1 A 2.^ g. .Y o
¢ ll 5d V f'a 1M11`a {t��
A PERMIT 1UST-BE OBTAINED BEFORE BEGINNING WORK .111 :,v,0;,
ANSWER ALL OF THE FOLLOWING. "i i, ± : )�+ua
The undersigned hereby applies for a permit._ to do the following works �� t C q E v=., l"
which will be done in accordance with the .description, plans and specifi- 1 a11 $ „ jr,.1 34'!5�Io
cations, and such special conditions as may be indicated on the permit. ?
The owner of this pr perty is: .
.j, AIch1i62. gCk6vt 30 k9, /J r2C 6/9Mt sT• (•AEit3 F91.es VW/26'0/
(NA''4E) (P.O.ADDRESS)
The person responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) IP.0.ADDRESS) ,
Name of Builder . StAC Address
_
Name Of Plumber SAP Address
Name of Mason 5/9 in t Address (�
Lot Number Unit Estimated value of pro osed work S rT ,c Q�.00
Name of Village p p /O&M OF CPUEE/aSPOQ5)
Name of Street . . I�Io6 -. . . . '.0, Side of street: north 0, east 0, south 0. west 0
Nearest Cross Street Distance from this cross street Ft.
Property is north 0,south ❑,east iii, west,. 0 from Cross Street
If on Corner, which corner, northeast ❑, northwest ❑, southeast 0, southwest
(Designate by marking with an"X" in the correct space.)
. NATURE OF PROPOSED WORK OCCUPANCY -
X Construction of a new building. Main Building
. ❑ Addition to a building. 1 One-family dwelling (
❑ Alteration to a building. Two-family dwelling ❑
❑ Demolition of a building. -family apartment house E.
Store building ❑
-car attached garage ❑
Other:
• Accessory Building
• One-car detached garage ❑
(] Other work. Describe: Two-car detached garage ,��CJ ❑
cP
Private chicken house l ❑
Private storage building j'cT � ❑
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, site 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 lliine.
Size of property /5?) ft. x , y6 ft
Size and use of existing buildings, if any
H N /
i m Size of proposed building . . 3.`'. • • . ft.x . . .17.0. . . . ft.
Height(from grade to rid e) /2 8 ft.
Front yard £ 0 . ft.
• Side yards 5O ft. and 600 ft:
Rear yard 960 ft.
SOUTH If on corner,setback from side street ft..
Note: All distances are net, as measured from street side
line to nearest dart ofbuilding.
(OVER)
7-73-M
•
•
(cont'd.)
BUILDING SPECIFICATIONS.,
fDO 6 PR g g
Kind of construction: Wood frame, fire safe, etc?! j-A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will any second-hand lumber be flso, for wh#0
Material of foundation walls u CO) thickness
Depth of foundation walls below grade P_.>ES ST:(P. .F.-c-"Y)ta
. . . . . . . Continuous foundatiop)
Will there be a cellar? If so, material of cellar floor . .S4fi6 . 60V.e. . . . .z•e/ CoPc,t c-n--
Type of roof: Sloped or flat? Material of roof
Size, wood studs
" x ", spacing -2,17; "o.c., length e • ft.
Size, floor beams, 1st floor x / 2- ", spacing / ' "o.c., span / /y ft
floor .
Size, beams, 2nd floor " x ;2 t
, ", spacing /1-7 "o.c., span ft.
Size, ceiling beams " x ", spacing "o.c., span ft.
Siie, roof rafters or ben . " x / ", spacing "o.c., span ft.
Exterior finish . . b ri°d6v6 CA0c904-5- With what material?
Finish of interior walls /221 'Veer Rock
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 bei,Teen garage and,huildine,
Kind of heating system . . . rcA.CtP 1-f-or
Oil burner or coal? . . K.2000. roP://ef.ct, ,..u1.).7`12,.0t_J.< pe,k'eciA
Will a flue-lined chimney be provide ?.. . . . . . . . . . Depth of chimney foundation below grade /0 /“7(--'
Height of chimney above roof , -2 /-60v F PEnk.
Will there be a fireplace? T5
Depth of fireplace hearth /NAM MUM
Will a toilet be installed7 YES
Will a kitchen sink be installed and connected to wateA supply? Ye:5
Water supply (public water supply or pump) romp
Distance of cesspool from any private well / feet
Will drainage system be provided with required traps, cleanouts, and vents?
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to th bcifrrof my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.liplete statement of all proposed work to be done on the described premises and that all rovisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the prqbaed wo shalljbe compli ,w er specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature
0 NER.OWNERS AGENT. RCHITECT.CONTRACTOR
/ 3 day of j gi 1 - 19 W
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 /79s" .a . ,
2 . Type of heat L&ooO PUm4' n6
3 . Is th.e building mechanically cooled?
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/6(5F - ( Oc7, 3
tJ�r'zis - (� = C9:b� Fcof - !/ ` C3r 61-I
•
2 . Floor over heated spaces NO
a. Are foundation walls insulated? YE NO
_
1 . If YES, what is the R value? 8
3 . Slab on grade 4211, NO
a. If YES , what is the R value of insulation around
perimeter of floor? 1\- 6
4 . Is basement heated? 4335 NO
a. R. value of insulation
5. Type of insulation Fie ERC.C/957-7
B. Under 16% Only
1 . R value of r of�and floors exposed to ambient conditions
2 ., R value of exterior walls /9
3 . R value of glazed area
4 . R value of doors ,mac
5. R value of floors over unheated spaces 3�/ '
6. R value of slab edge insulation - unheated slab /I .
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 (belowgrade)
10 . Type of insulation FRIi'l4- �PO 61�.ss
C. Controls p8
1 . Thermostat maximum heat setting 7C� F
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 3 "
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. 7 ��`' �� / ., r-///
applicant ' s signature)
TOWN OF QUFFNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE. DISPOSAL PERMIT APPLICATION
1. Owner ' s Name J. Mictoc L 61.4Ct 3 U(Q/U
Address 3O W. Nort� Nine 5 1 6A,e/)S �
/ (j9 r28 Telephone No. e-/z/.SC/
2. Property location OPPCk kIDGE Po
3 . Name of person or firm responsible for installing system
Telephone No.
Address
4. Number of bedrooms (residential buildings only), Z
5. Daily flow ,5 gallons/day
6. Septic tank capacity f e5°C7 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 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: drywel]tile fls1.74 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. �J�
Date d /3 /gc/ �
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
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 a )� t` i `., i d- COUNTY (.�t.�/`/f A�/� L. /4 •
L/
STREET AND NO.OR y� r
ROAD AND POLE NO. I (-•R j`•\ ) (" j`i_i. (,L ,\Ji., ) POLE NO.
BETWEEN WHAT TWO
CROSS STREETS IS <` �l h / J
PREMISES LOCATED? �.,,,J• )1)te �;_ 7 SECTION ti-- d- BLOCK LOT (
OCCUPANT'S i BUILDING
NAME OCCUPANCY
OWNER'S NAME r- _ __ 4-
AND ADDRESS I\lI, k`�r-� �i-ir F/.,,..�ij. •,_ r ,.. /. - ��i�l .
CURRENT
SUPPLIED 4). / ?' �� ,i U��l FROM THEIR OFFICE
BY ✓- -ice if; ,r)�' �i�
BUILDING (� WORK DEFECTS
IS NEWJ J OLD❑ REMODELED ❑ IS NEW ❑ ADDITIONAL❑ REMOVED 1-1
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
NUMBER OF OUTLETS No.of Fixtures fy MOTORS HEATERS BRANCH LAMPS
Lamp Receptacles CIRCUITS
Loca-
tion
CeilingSide Attach't Switch Pendent Bracket No. Type H.P. No. Watts No A.W.G. NO. WATTS
Wall Recept'Is yp Each Each GaugeEACH
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 ri OLD Ell
• AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
APPLICANTNAME OF ) ii l i( �� ?(`J .i_ Yf�- 1 q { /�' DATE OF
APPLICATION // /j
STREET ADDRESS' �.(..\- ..:!� ! % fif211_
CITY OR - f ! ( ZIP �.';. / LICENSE NO.
POST OFFICEi ( .. ! r`�[„� ! '! - � CODE - r- WHEN APPLICABLE
A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date Q? I/ 3/3 6
Name T. b ; CJa e l GI cc ckh4 ti
Location U p p e R. � e fdod-t
Permit No. �C / 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 XS-
Finished Floor
Interior Trim
6.1X7
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing \
Door Closers
Chimney ,/
Water Meter Inst. / \
Septic Approval / 'a
t
f Floors
Insulation Foundation
Walls '
Ceiling
Building Inspector
REMARKS
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A11-'5.1 t:9 `,Z'JA t Al-44 v"k"f 'J 6." (J
TOWN OF•QUEENSBURY
Building Department
Inspectors Report Date /
Name /1'Wi146- uetir
Location a?-A Q & /Z 7 r`'e.;r PGA)
Permit No. / Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey �j ;�.
FramingL/�'� •
• Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg. 00
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim \\A/c
Stairs & Railings
Cellar Dr. Tile
Concrete Floors \
Plbg. Fixtures / \
Gar. Fireproofing
Door Closers •
Chimney
• Water Meter Inst.
Septic Approval
FloOrs '
Insulation Foundation '
Walls
Ceiling
j-r 12 , Zit-Cc - OAK ` %G ! ,l�e�`-'
• Building Inspector
•
REMARKS
e .
TOWN OF•QUEENSBU RY
Building Department
Inspectors Report Date //7/e-9-5"
Name 5.-Zfl fc <s
Location cam-t?t7&lam LP E ZRA
. Permit Weather
-6 6 tf( Remarks
Excatia tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
• Waterproofing
Ba ckfi ll •
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
V/11
Interior Trim
Stairs & Railings
Cellar Dr. Tile 1/11 \\\
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval f). (<
Floors
Insulation Foundation
Walls
Ceiling
r./0 /1 ,
• :1)
wilding Inspector
REMARKS
t,c
f.L.-eiz,
,-----•
TOWN OF QUEENSBURY
l •
Building Department
nspectorS Report Date /, .
Name Y�G/Qc'��/3 '.eitl ` l
Location Uzio&,e r r � 2.b
Permit No. -74( Weather
Remarks
Excayatlon
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 /2, \<\:(1
Ext. Porches
Finished Floor Jj
Interior Trim
Stairs & Railings
Cellar Dr. Tile ry C.
Concrete Floors
P1bg. Fixtures �f
Gar. Fireproofing V
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
--)
•
Buildi?rg Inspector
•
,y���/A,�..// //�1/�REMARKS�J
GGG
•
TOWN OF•QUEENSBURY
Building Department
Inspectors Report Date 2/)2-/7 t'f
Name (n- ! 1.q-
e ►2c i<v3 0rzr�J I
Location Oro() .y v, cI _ rn ( / r►Y-F3,,.� /z,
. Permit No. 6 +1 `J Weather
Remarks
Excatia tion
Footing Forms �9
Footing & Piers
Foundation i✓ Vlr
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 "
11r,T
Buil:ing Inspector
REMARKS
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