86-867 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-867 •
WARREN COUNTY, NEW YORK
Catheter- and Instrument Div. of c. R. Bard, . Inc.
PERMISSION is hereby granted to
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OWNER of property located at Bnfigray Road Street,Road or Ave.
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in the Town of Queensbury,To Construct or place a Storage Building
at the above location in accordance to application together with plot plans and other information hereto filed and 0'
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a.
1. OWNER'S Address is P• 0. Box 787 - cn
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266' Bay Road
Glens Falls, New York E
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2. CONTRACTOR or BUILDER'S Name rt
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Glens Falls Insulation -
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3. CONTRACTOR or BUILDER'S Address
9 Marion Ave.
Glens Falls, New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry (x)Steel . -( )
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7. PLANS and Specifications a
No.
32'x32' per plot plan, specifications and application submitted.
8. Proposed Use
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Storage' Building for Light Mgr. Plant rt
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$ 84.00 PERMIT FEE PAID—THIS PERMIT EXPIRES July 1 19 87
' (If a longer period is required an application for-an extension must be made to the Building and Zoning inspector of the N
town of Queensbury before the expiration date.) - ty
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19th December 86
Dated at the Town of Queensbury this Day of 19
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SIGNED BY . ` for the Town of Queensbury
Building and Zoning Inspector Q.7 -
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TO BE COMPLETED BY BLDG. DEPT. {
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// Application No. .- m;''
awn of Queensbur y Permit Issued 19 i .1 : E.� .; 7,
BUILDING and ZONING DEPARTMENT Permit Expires 19 u t 4s' 4j
Bay and Haviland Road, R.D. 1 Box 98 Zoning Designation
Queensbury, New York.12801 Varianc o. i p C 1 to +'
Site an Revie a ;� °% r=� ��.
Appr10: � , a i R 9 t a
APPLICATION FOR
a
BUILDING AND ZONING PERMIT s _.__.
* * * * * * * * * * * * * * * * * * * * * * # * * * * *• * * * * * * * * * ::
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: CA7R-CDE 2. 4- �a54'+run,R DW. Of C.R . gAe D Sti c
P.O. Address P.0 go 7 3"7 Tel. 9 5 3 1531
Property Location: .(0(,e+ S3A'i 6LET.)S Fit-US 1\1 4 . Tax Map No. /06/ 3/ /
Street number or building lot number
Subdivision name (if applicable) -----
THE PERSON RESPONSIBLE FOR `SUPERVISION OF WORK AS REGARDS BUILDING CODES IS :
K 1714 :',660,t..or.1 Stci pn. SoX '1$-7 -)613-ZS31
Name P.O. Address Tel. No.
Name of builder ra IlVIS uSS►+sq\..-to.1 Address q./laq vi o AcW- Cj,F ply Tel. -]q L-/fo S Z
Name of plumber Address Tel. --
Name of mason ',,-ct...k. k g.Kck.\.e.1 Address P p, fs pk 22.01 C.. - Hy Tel. l q 'S- S O 4+q
NATURE OF PROPOSED WORK: * ZONING INFORMATION:
)(Construction 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 JJJ INFORMATION REQUIRED BELOW.
( �j�-1✓ P l o T �LAr..�
* Size aao¢ff property ft X ft.
* Existing building(s) Size ft X ft.
PROPOSED BUILDING AND USE: * 1/4.,(2_10uS (.SF PLOT)
* Existing building(s) Use oFYICE i WO-PT
Size of new structure 2 32. ft X 32.. ft * t\-{/ ta.FAtt.'rtuR.i N CI
Foundation-pier/ ab crawl/partial/full * Proposed building, distance from property line
(circle one) * o
* Front yard '1
- 00 ft Rear yard ',,.200 ft
No. of stories (habitable space) 1 * Side yards -,-1..11i' ft and ,.. 2S0' ft
Height (grade to ridge) 12 ft. * If on corner, setback from side street — ft
If residential, no. of families —
No. of rooms(excluding baths) — * OCCUPANCY INFORMATION
No. of bedrooms _ *
* PRIMARY BUILDING -
No. of bathrooms — * One family dwelling
Primary heating system NO6J E
Type of fuel hiati E * Two family dwelling
No. of fireplaces to be installed _ * Multiple dwelling / Number of units
Will a wood stove be installed? * —
Permanent occupancy
Central Air conditioning? _ * Transient occupancy
* Business
BUILDING STYLE, PRIMARY STRUCTURE * Industrial
Ranch Contemporary Log cabin * )( Other CD 1 d S 1ro'Z-a G k� ���'`` '
* If addition, what will use be?.
Raised ranch Mansion Duplex
Split level Old style Bungalow *
Cape Cod Cottage OM * ACCESSORY BUILDING-
Colonial Row Town House * Detached garage/one car/ two car/ car
( CIRCLE ONE PLEASE ) * Attached garage/one car/ two car/ car
* * * * * * * * * * * * * * * * * * Private storage building
ESTIMATED MARKET VALUE OF * Other_
CONSTRUCTION $
42 000� *
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INFORMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
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Fnrm Rttgf Q /s2F ,,,,a_._1 Y��' k ..
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BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. ST(2-4•� 61 L. 1 (v G- .L COaUST.
Will any second-hand or ungraded lumber be used? If so, for what? N pt\I
Foundation wall material l)N Crt.thL (:(000 PSI)Thickness S a
Depth of foundation below grade (to bottom of footing) y
Will there be a cellar? hju Heated or unheated? VNI.kail0 Floor sq. footage (02,4 sq ft
Will there be a basement? A4 Will any portion be used as living space? }�Q
(If so, what por '•.., sq.ft. Type of use?
Type of roof - oped flat/shed/other Material of roof 4 AzJ
Size, wood studs ,/"X —" spacing - "o.c. length % ft.
Joists(floor beams) 1st. floor 1 "X .— " spacing r". "o.c. span --- ft.
Joists (floor beams) 2nd. floor - "X - spacing "o.c. span ft.
Overlays(ceiling beams) "X _ " spacing "o.c. span "—ft.
Roof rafters f"X ..-- " spacing o.c. span ft.
Roof trusses(pre-engineered) spacing — "o.c. span --ft.
Exterior wall finish k),) _ Of what material?
Interior wall finish
If a garage is to be attached, describe materials to be used for FIRE SEPARATION: -.------.
Is there to be an opening between garage and dwelling? If so will a Fire-rated
door, enclosure, and self-closing device be provided?
Will a flue-lined chimney be installed? -----Height above roof - ft.
Depth of chimney foundation below grade --ft.
Depth of fireplace hearth mot. in.
Water supply - Municipal or private well ----
SEPTIC SYSTEM _ Distance from ANY private well(including adjoining properties ft.
(A separate application is necessary for any repair or new installation of septic system)
Town of Qbury AFF IDAV IT STATE OF NEW YORK
County off 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 BUILDING 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.
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SWORN TO BEFORE ME THIS Si nature---, .
Owner, owner's" ent,arcni-ect,contractor
S day of -mac 19 p. GAYLE E. SMITH _
Notary Public, State of New York --
V9�f Residing in Washington County
NotaryC Public, Warren County, N.Y My Commission Expires March 30, 19 '?_..
Number 4509790-
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * -* * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
a.
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 102.`-‘
2. Type, of heat 'MOU
3. Is the building mechanically cooled?, Nd
0
4. Percentage of area of windows and doors . . �o
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 €:\A P E}CCE- -OS A .)4S cue Cob€ ,
1. R value of roof and floors exposed to ambient conditions
TZ-13 2 . R value of exterior walls R 2O. 9/
3 . R value of glazed area 2- 10
` \ 4. R value of doors
5. R value of floors over unheated spaces /1/A
6. R value of slab edge insulation - unheated slab /4241
7. R value of slab. insulation -. heated slab .------
8. . R value of heated basement/cellar walls (above grade) /(//jQ
9. R value of heated basement/cellar walls (below grade) .,4' 4
10. Type of insulation? Fi o6,,,oJS Undo eodP.) w?tl
C. Controls
1 . Thermostat maximum heat setting IION6-
D. Duct Systems
1. Is duct system installed in unheated spaces? YES
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 '
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Telephone No. 1i 3-253) ra •
(appli nt ' s signature)
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�to Que0/141
APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE 12_I i2 / SC,
Nok - vker.,k Cola 5 ,2► e,� QUA ,
LOCATION OF PROPERTY FOR INSTALLATION
Own-r's Name: Telephon-.
Address:
Installer's Na e: Te ephone:
Number of bedrooms esidential only)
Total daily flow (compute 150 gal per bedroo• )
Topography: circle one: Flat oiling Seep Slope % of slope __
Soil Nature: circle one: Sand Loa lay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material. At what de th? feet
Percolation test: circle one. not required requi ed /rate min. inch.
Domestic watersupply: •ircle one: Municipal Wel Other
P
IF domestic wa -r supply is-a Well:
Separation: W.tersupply from"Septic absorption _ feet
PROPOSED SYS. EM: Septic Tank _gal. (minimum si.e: 1,000 gal.)
TILE FIELD: ach Trench feet / Total system length feet
SEEPAGE 'IT(S): Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * ** * * * * * * * * * * * * *"* * * * * * * * * * * * * * * * * *
(over)
-S
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 Building Department at least 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.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD,PLACE TO LIVE
4 cc�� //
,loom of QueenJbur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME
LOCATION �A-, rol f L0 �".
Date`/ 3 / ' fJ Permit No. 7
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES / NO
Footing/Pier Forms
Foundation
Waterproofing
ackfill !t
gaming eNk
Roofing
Siding
Masonry Veneer
Rough Plumbing '
Relief Valves
Ext. Porches
Finished Floors
Interior Trim
Stairs & Railings
Cellar Drain Tile
Concrete Floors \
Plbg. Fixtures 7
Gar. Fireproofing X
Door Closers _
Smoke Detectors /
Chimney
INSULATION:
Foundation
Floors
malls a
/tEeiling �•
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
liot6
Building Inspector
6/86 and-vl
flown of QuQenitur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S REPORT
NAME C
LOCATION (, C r6u.I /1 01
Date J /30 mo Permit No. O p ‘7
* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - YES NO
Footing/Pier Forms
:foundation
vWaterproofing
Vackfill -L r ��
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 j
Smoke Detectors /'
Chimney f
INSULATION: /
Foundation
Floors
Walls
Ceiling
FINAL ELECTRICAL INSPECTION
DRIVEWAY APPROVAL
Final Building Survey
Next scheduled inspection (call when ready)
Remarks- .4J-e-e--6
66/pa el(
60/4
Building Inspector
6/86 and-vl
e ail e. ccA/ 31J(c- 3 , s//-s' G'�
_Jorun of Queeniurj
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR ' S Ri-EpPORT -
Cq
NAME L. I` n61r1 J ,
LOCATION ( G 3
Date /3,/a3 46 Permit No. F6 _ 0 7
* * * * * * * * * * * * * * * * * * * * * * *
✓ = 5
PPROVED - YES / NO
m`1, Footing/Pier Fors(paiRE PL(_g6/E ccN2ou' "L
"Foundation "/ \V 2 PIe.-T/aiv Q 1.s
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
DRIVEWAY APPROVAL _
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
!/ /''6
Building Inspector
6/86 and-vl