1986-527 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 18 19 86
This is to certify that work requested to be done as shown by Permit No. 86-527
has been completed.
This structure may be occupied as a One—Family Dwelling
Location Lot 9 Upper Sherman Ave. (Sherman Acres Subdivision
Owner Kim Oahn Nguyen
By Order Town Board
TOWN OF QUEENSBURY
Building &Zoning Inspector
==� BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-527
WARREN COUNTY, NEW YORK+ ', p
1 Kim Oanh Nguyen
PERMISSION is hereby granted to
OWNER of property located at lot J-Upper Sherman Ave. Street, Road or Ave.
(Sherman Acres Subdivision)
in the Town of Queensbury,To Construct or place a One-Family Dwelling - U
at the above location in accordance to application together with plot plans and other information hereto filed and p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 46 Schuyler St.
Ticonderoga, New York
2. CONTRACTOR or BUILDER'S Name
Wm. Davidson
Davidson Const. o
rt
3. CONTRACTOR or BUILDER'S Address 1°
197 Sherman Ave.
Glens Falls, New York
rt
4. ARCHITECT'S Name
m
5
0
5. ARCHITECT'S Address
CD
6. TYPE of Construction-(Please indicate by X) rat
B
X p
( 1 Wood Frame ( ) Masonry ( I Steel ( ) 0
n
7. PLANS and Specifications
64')(28' per plot plan, specifications and application submitted w
No. including two car attached garage and sewage system.
cr.
8. Proposed Use
One-Family Dwelling
0
0
CD
$5.00 C/O
94.00 March 1 87 N
$ PERMIT FEE PAID-THIS PERMIT EXPIRES 19
(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 date.) t 7
Dated at the Town of Queensbury this 28th Day of August 19 -86
SIGNED BY ///CL 1„2- for the Town of Queensbury
Building and Zoning Inspector (45
TO BE COMPLETED BY BLDG. DEPT.
awn
No. f
Jown of Queen 34ur Permit Issued 19 j TOWNOF . �a �'
I,J�'iLa'���.�F"t
BUILDING and ZONING DEPARTMENT Permit Expires 19 (f� V `� �
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation ri) `, j (-E
Queensbury, New York 12801. Variance No. a „�,
C Site Plan eview AUG I 9,1 ;�a
APprov t1 i c � P.M.
APPLICATION FOR 7I `9i1'v11 �1 ):115�
BUILDING AND ZONING PERMIT ___ * * * * * * * * * * *
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL-OF THE'FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and such
special conditions as may be indicated on the Permit.
//��
The owner of this property is: k M C)? 1J I- 36 vi -0 u e�
P.O. Address �- �� v �j"— -�_Lo ►��`�oV h �1= ��'�0 Tel. s �• G733
Property Location: L4) r *kg vet° Tax Map No. 11(7 7 / 7
Street number or building lot number
Subdivision name (if applicable) S f‘,1 a-guk A-,,&) �-C THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:
De L IM - y t p s b.� 2���y� w cal o-> — (-kct. N.A r-3 .1 'L Ug y t+J'.'i -101-2
Name P.O. Address Tel. No.
Name of builderD.A0%-9SL,-. C a l Address T`t.,,,..„ti 1s . - Cuz- t s S Tel. 19 3-331-4
Name of plumbeA Address SWuN..e.a Av - (,l iS -`1,S Tel.
Name of mason G-CIAA ,1- Address Tel.
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
Lonstruction of a new building * A PLOT PLAN MUST BE PREPARED AND SUBMITTED,
Addition to a building * drawn reasonably to scale and attached hereto,
Alteration to a building showing clearly and distinctly all buildings,
(no change to exterior dimensions) * whether existing or proposed and indicate. all
Other work (describe) set-back dimensions from property lines. Give
street and number or lot number and indicate
FOR DEMOLITION, PERMIT., STATE SIZE AND * whether interior or corner lot. Show location
LOCATION OF STRUCTURES AFFECTED: of water supply and location and configuration
* of septic disposal area.
*
- * COMPLETE INFORMATION REQUIRED BELOW.
* Size of property j /O. S 7 ft X �F 7 ft.
* Existing building(d) Size J„eft X ,- 3 ft.
PROPOSED BUILDING AND USE:
/' * Existing building(s) Use
Size of new structure W ti ft
Foundation-pier/slab/crawl/partial full * Proposed building, distance from property line
(circle one) * Front yard ft Rear yard ft
No. of stories (habitable space) * Side yards ft and ft
Height (grade to ridge) ft. * If on corner, setback from side street ft
If residential, no. of families 1.
No. of rooms(excluding baths) * OCCUPANCY INFORMATION
No. of bedrooms n *
* PRIMARY BUILDING -
No. of bathrooms rL .t c , ne family dwelling
Primary heating system � ,ck.
r' * Two family dwelling
Type of fuel �c`T^t_c- * Multiple dwelling / Number of units
No. of fireplaces to be installed —
Will a wood stove be installed? N-p * Permanent occupancy
* Transient occupancy
Central Air conditioning? N-0
* Business
BUILDING STYLE, PRIMARY STRUCTURE Industrial
*. . Other
("_Ranch Contemporary Log cabin * If addition, what will use be?
Raised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage Other * ACCESSORY BUILDING-
Colonial Row Town House * Detached garage/one car/ two car
( CIRCLE ONE PLEASE ) * 7-c4ttached garage/one car/ two ca / car
* * * * * * * * * * * * * * * * * * 'Private storage building
+ESTIMATED MARKET VALUE OF * Other
CONSTRUCTION
INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form BPA 4/86 and-vl '
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. c ME
Will any second-hand or ungraded lumber be used? If so, for what? '�p
Foundation wall material /b/1 `\J l ocjc Thickness �
Depth of foundation below grade (to bottom of footing) l 7 ! •
Will there be a cellar? -Heated or unheated? Floor sq. footage sq ft
Will there be a basement? V.-Will any portion be used as living space? N O
(If so, what portion? sq.ft. - - Type of use?
Type of roof oped)flat/shed/other Material of roof
Size, wood studs -"X c, " spacing "o.c. length y, t.
6'
Joists(floor beams) 1st. floor "X /, " spacing Me "o.c. span t.
Joists (floor beams) 2nd. floor "X " spacing "o.c. span ft.
Overlays(ceiling beams) "X " spacing "o.c. span ft.
Roof rafters "X " spacing o.c. span ft. •
Roof trusses(pre-engineered) ( .spec' g ,,V-/no.c., span c9 f't:
Exterior wall finish c l two- Of w at material? ;
Inter or-Wall finish
If a garage is to b attac , describe aterials to be used for FIRE SEPARATION:
\� If
Lam, VZb
Is there to be an Aning between garage and dwelling? Li�s If so will a Fire-rated
door, enclosure, and self-closing device be 'provided? "rS
Will a flue-lined chimney be installed? `--Height above roof
;,,Depth,pf,chimney foundation below grade ft.
Depth of fireplace hearth`---
Water supply - Municipal or private well VA.At.HNe t,k QAL'
SEPTIC -SYSTEM -foistance from:.ANY private.well(including adjoining properties ft.
(A separate application ls•.necessaryfor_any .repair or new installation of. septic system)
Town of Queensbury AFFIDAVIT STATE OF NEW YORK
County of Warren
I swear that to the best of my knowledge and belief the statements contained
in this application, together with the plans and specifications submitted, are a true _and
complete statement of all proposed work to be done on the described premises and that all
provisions of the lUJILDING 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 AP‘0 -0.427-k
Owner, owner's agen ,'arcnicect,contractor
day of 19
•
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 1\/`li ( S i "-
2 . Type of heat G� T
3 . Is the building mechanically cooled? O
4. Percentage of area of windows and doors
A. Over 16% •Qnly
• 1 . Uo value of gross area of walls ,. roof/ceiling and floors.
exposed to-4,ambient conditions
_L
2 . Floor over heated�s,�paces YES NO •
a. Are foundation n�,,,'a°lls insulated? YES NO
. 1. If YES', w air IN the R value?
3. Slab on grade YES NO
• a. If YES,,, hat is the'.R vaNue of insulation around
perimeter of floor?
4. Is b cement heated? YES NO -N\
a. R value of insulation
5 Type of insulation
B. Under 16% Only
1. R value oroof and floors exposed to ambient conditions
• 2 . R value of exterior walls - vc
3 . R value of glazed area - ' P--
•
4 .' R value of doors — ! 7'' �—
5. R value of floors over unheated spaces .
' 6. R value of slab edge insulation - ""heated slab
7 . R value of slab insulation - heated slab
8 . R value of heated basement/cellar walls (above grade) r`r�
9 . R value of heated basement/cellar walls (below grade)
10 . Type of insulation If SS •
C. Controls I
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 ' C�
Telephone No.
'applicant ' s si nature)
•
Jocun„o/ Queeni1ury APPLICATION FOR SEPTIC DISPOSAL PERMIT
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 DATE EV /
LOCATION OF PROPERTY FOR INSTALLATION
OWNER' S NAME n cc, )
ADDRESS (4) S(1�� u LcK-) S. \ TEL S b &- -(/
INSTALLER' S NAME TEL
Number of bedrooms (residential only) z
Total daily flow(compute @ 150 gal per bedroom) 3� '
Topography: 4RIP Rolling - Steep slope ,- (circle one) % of slope
Soil nature41110- Loam - Clay - Other Depth ' ft.
Ground water -At what depth?
• Bed-rock or impervious material - At what depth? ft. .
Percolation test ►- requed' Required -Rate min-inch.
Domestic water supply Well - Other
Separation. - Watersupply(if well) - from Septic absorption • ft.
Proposed System: Septic tank `O gala: .(: Minimun _size, 1000 gal. )
'01-- Tile Field - Each trench KS ft. .Total system' legnth 7O ft. •
113 Seepage pit(s) Number off Size each
Size of stone to be used. # Depth or thickness D---' ft.
IMPORTANT ! !
On a separate piece of paper, submit a diagram of -the proposed system
with all dimensions shown; including distance from any structure , -
distance. from property lines and from ANY DOMESTIC WATER SUPPLY or
shore-line of lake, stream,pond or wet—lands . Include all dimensions of
the system, itself .
* * * * * * * * * * * * * * * *•--* * * * * * * * * * * * * * * * * * * * *
I have read the regulations on the reverse side of this sheet and agree ;
to abide by these and aZZ requirements of The Town of Queensbury
Sanitary Sewage Disposal Ordinance . -
Signature of responsi.ble person
Date ___En
05/86 and/vl
Section II Septic System inspections:
• A. All .applications for septic system installation,
alteration or repair, as required by the Town of
Queensbury Sanitary Sewage Ordinance, shall be
submitted to the Buildina Department at least
f 24 hours before start of construction and shall
include a plot plan showing:
1) the..proposed' location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and
approval by the Building Inspector. Failure to
comply with this requirement may result in the
uncovering of the system by the installer and a
fine of up to $250. 00.
C. An approved copy of the plot plan shall be
available on the construction site. Failure
• to produce said plot plan at time of inspection
may result in an immediate work stoppage.
D. Should unforeseen problems during, construction
prevent proper installation, alteration or
repair of an approved system, a new proposal
must be submitted to the Queensbury Building
Department before further construction.
�1.30Pin
JoJowl' of Queen.itur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
fie; hsreL:7 i 694 fay G /6
BUILDING INSPECTOR ' S REPORT
NAME l\1`
r M5(4 )/ h
LOCATION
L 7` 7 Z.1rp ar sA
Date /a /26, Permit No. 8 ( _ ; rJ
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
xt. Porches o,k
Finished Floors
Interior Trim
L,Stairs & Railings I (2,k
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
I/Gar. Fireproofing Q,K�
c..f?bor Closers Q.K,
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
LRTNAL ELECTRICAL INSPECTION �7,Y
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Building Inspector
6/86 and-vl
G4 ii4e442 / 2- f l“
awn wn of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801•
�f
/ H S(17.
BUILDING INSPECTOR ' S REPORT
NAME fsM7 ,c% 1.4.Nrc-n
LOCATION Lot"
7 u i per Sh cp. t�
Date / 2//e /X- Permit No. Zf � -3-27
* * * * * * * * * * * * * * * * * * * * * * *
= APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
•
Roofing \I\
ding 04
Masonry Veneer
Rough Plumbing
//Relief Valves O rt
t. Porches Ajh
1-14Enished Floors 0/c
•
�t erior Trim ra K
Stairs & Railings (30 hAr 4,,z4 zl
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
, G Fireproofing nw7- bJrt.<</'�
yD000r Closers 4h5/505
(Smoke Detectors /j)t
Chimney Ne/�
j/INSULATION:
LFoundation r-.,sw® J,o,�r 0_�
Floors
LWa Il s f rt yo 2 •
Ceiling
FINAL ELECTRICAL INSPECTION 7:1--/
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- n
E-1. 614 f 7)..Stm
•
///11/15
Building Inspector
6/86 and-vl
_ LAri o/ Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPO(SAL SYSTEM INSPECTION
NAME mil)�t�l
LOCATION Q k1 A l j
> �(°
l
DATE () / �l PERMIT NO. 3 (c — S �
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench/ t(
Depth of trenches Z
Size of gravel 7---
SEEPAGE PITS4Number of)
Size- ft. X _ ft.
Gravel size
BIdING: Se/
Bldg. to tank
Tank to dist. box I/11 7 2/(,,
Dist. box to field/fir. //
Openings sealed? .'AYES NO Partial
LOCATION/SEPARATIONS: /
Foundation to tank
Foundation to absorption 2j) ft.
Absorption to lot line
Separation of pits ft.
ON OF SYSTEM ON PROPERTY(circle one)
(Front Rear - Left side - Right side -
OMMENTS:
c-Zru
SYSTEM USE APPROVED %YES NO
, 6-u-Abit,u
Building Inspector
01/86 and vl
Jocun o/ Queenatury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT u
NAME
/ft//ADI/L)ZIA
LOCATION
G;, JV9-- 60y0„,41vp
Date / (�/ cU Permit No. s-5,�7
* * * * * * * * * * * * * * * * * * * .„
I/ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
Backfill
<Framinq
Roofing
Siding
Nlarsonry Veneer
.._Rough Plumbing Otk.
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers V
Smoke Detectors
Chimney
INSULATION: I
Foundation
Floors %
Walls /
Ceiling f
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
Buil ing nspector
6/86 and-vl
u
b` 4 A ca c7
1�7` _awn o/ Queenihurti
Win BUILDING and ZONING DEPARTMENT
Oil Bay and Havilarid Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR'S REPORT' I
NAME �� u e ti 614 chm-)
LOCATION Lot j11p -C.v•
���
Date jb / Xt Permit No. $6 - jj v^�
* * * * * * * * * * * * * * * * * * * * * * *
V = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing/
Backfill
Framing
Roofing
Siding
Masonry/Veneer �
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim s
Stairs & Railings
Cellar Drain Tile
Concrete Floors S /' •
..
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Smoke Detectors
Chimney
INSULATION: /n
Foundation
Floors
Walls •
Ceiling
•
FINAL ELECTRICAL INSPECTION
Final Building Survey
•
Next scheduled Inspection(call when ready)
Remarks- - C-
/1)1:- �l�yu✓t/@?� /00
•
L4/9140
Building Inspector
6/86 and-vl
Jocun o� Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Havilarid Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME 1 uI •e v1 ( Qa O c S
LOCATION 01- 7 S
Date 1 / / 6 Permit No. g(,-c
* * * * * * * * * * * * * * * * * * * * * * *
i� = APPROVED - YES / NO
Footing/Pier Forms
Foundation
kWaterproofing
XBackfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile \
Concrete Floors
Plbg. Fixtures \ /
/
Gar. Fireproofing
Door Closers /`
Smoke Detectors \
Chimney \\
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
/14r
Buildin nspector
6/86 and-vl
�U t-7:5
// g/q
.own of Queenibur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION 5/,7,( /0 4/ / v
Date 91/./ ,4 Permit No. B_ s�1
* * * * * * * * * * * * * * * * * * * * * * *
00/ APPROVED - YES / NO
Fp�o ""t�ang/Pier Forms
GFoundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves •
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings .�
Cellar Drain Tile
Concrete Floors
Plbg. Fixtures /
Gar.. Fireproofing /\
Door Closers /
Smoke Detectors
Chimney
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
i
,Z-- /
Building Inspector
6/86 and-vl
Jown of QueeniLry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME D 4 (NI iA e� )
y /
LOCATION Ceo-mid
Datee u/ 0 Permit No. 3 6 -S 27
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES /,NO
noting/Pier Forms I f
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Veneer
Rough Plumbing
Relief Valves
Ext. Porches
Finished Floors
Interior Trim r
Stairs & Railings //
Cellar Drain Tile /
Concrete Floors
Plbg. Fixtures ,
Gar. Fireproofing IN
Door Closers / \\
Smoke Detectors
Chimney l
INSULATION:
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
Final Building Survey
Next scheduled Inspection(call when ready)
Remarks- -
i
A
O4Lt.( A
Bu1lall'ig Inspector
6/86 and-vl
5CALE; IIi zo'
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