1851 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date — —19
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be occupied as a
Location
Owner
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 1851
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to James L. Glugstone .
OWNER of property located at Ridge Road Street, Road or Ave. 0
Z
in the Town of Queensbury,To Construct or place a Q2A_Fami 1 y Dwel 1 ing Sewage System m
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
rn
1. OWNER'S Address is cn
'21 Hartford Avenue r'
Glens Falls, New York 12801
2. CONTRACTOR or BUILDER'S Name
Owner
3. CONTRACTOR or BUILDER'S Address
Same as above.
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( Wood Frame ( )Masonry ( )Steel ( )
7. PLANS and Specifications
I--1
28tX24' as per plot plans and specifications submitted enc.
sewage system rn
8. Proposed Use
One-Family Dwelling Sewage System
C/O 5.00 �Yr--
$ 40.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 1-1_ 19 73
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the /-7)
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 13 Day of June 19 79
SIGNED BY Jed �®J for the Town of Queensbury
—"TIT Building and Zoning Iasps CZ, �7. )
•
TOWN OF QUEENSBURY ;'Ipace inside block to he filled in b.
'VARREN COUNTY, NEW YOFK I Building Inspef tor)
Application for :;.,,i,,,it,„„t No
permit I„lied I°t
BUILDING AND ZONING PERMIT 1',,,,,,nt F.pin., I't
int_ 1)1.16(1
1 aim 4)1 11'iUrl. '�
THREE (3) Copies of a PLOT PLAN, Drawn to scale 11)I"""I by .
showing the actual dimensions of the lot to be built h, :»..1: ,
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB- _
MITTED WITH THIS APPLICATION. TOWN
OF QUEENSSUR7
410 rk_e -.,. `9,Z U ^ 7 f�
DAT ¢Gt • fere pitioto
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK at)UN 131g7k
ANSWER ALL OF THE FOLLOWING. A.M. ise G pave
The undersigned hereby applies for a permit to do the following work 7I8I9I10I11I12I1I2I3I4I5I6
which will be done in accordance with the description, plans and specifi-
cations, and such special conditions as may be indicated on the permit.
Tlywner of this properly is:
. 14 A Nk C S. .Lis CC., 6 G S. .�. C.,t\L. t R o, i t c 2 6 A v e_ -
,NA-,c) tP() ADDRESS)
The son responsible for supervision of the work insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) IP 0 ADDRESS)
Name of Builder . . . . . . .Q. .N L R Address _ _ .
Name of Plumber � 'E�I�(-'c7 MCC, �i,.% Address 103 MI`PLv2 'J C% ° ,
(l lc 1< 1c
Name of Mason Address
Lot Number Unit Estimated value of proposed work$ d} Goo
Name of Village
Name of Street 'RCV---L Ps, , Side of street: north 0, east ❑, south ❑, west
Nearest Cross Street Distance from this cross street Ft.
Property is north ❑,south ❑,east i i, west 0 from Cross Street
If on Corner, which corner, northeast D, northwest ❑, southeast ❑, southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
Construction of a new building. Main Building /
0 Addition to a building. One-fatuity dwelling Lam'
D Alteration to a building. Two-family dwelling ❑
0 Demolition of a building. -family apartment house ❑
Store building . ❑
-car attached garage ❑
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, site and setbacks of pro-
posed buildings,and the location of all existing buildings.
NORTH
Show proposed buildingis) in dotted line and existing
l;uilding(s) in solid line.
1 -, Size of property °--CD ft. x Z SG ft.
Size and use of existing buildings, if any . . . N.(t
Ate
N 375 3/1 N r-/
aa ..► m Size of proposed building . -. . . ft.x . .2•.. • • ft.
Height(from grade to ridge) 2 C, ft.
I Front yard Hl ft.
1 sC% i Side yards ft.ft. and ft.
RcDc,C 12O(SD " Rear yard /( ft.
SOUTH If on corner,setback from side street ft.
Note: All distances are net, as nstasaired from street side
line to nearest part of building.
(OVER)
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe. etc.?. . . . . . . •WC . . • • -R a
Will any second-hand lumber be used? M.0 If so, for while If
Material of foundation walls C=-(vCL r� t Co LOC. K. Thickness
r
Depth of foundation walls belowl grade Continuous foundation? ". �. .
Will there be a cellar? \(6-S If so, material of cellar floor 1.--a t4 Roc
Type of roof: Sloped or flat? '(-,c e(- 0 f Material of roof 5 pH Kt- S i-i- t('( L. S
Size,wood studs -- " x . . '`k ', spacing 1 Co "o.c., length. .. . 7.•. . . . . ft.
Size, floor beams, 1st floor -Z " x ir t 0 ", spacing t (3 "o.c., span 1-7 ft.
Size, floor beams, 2nd floor 4 " x . . . 6 ", spacing 2 4 "o.c., span `Oi ft.
Size, ceiling beams x ", spacing "o.c., span ft.
Site, roof rafters or beams 2, '• x G ", spacing (Co "o.c., span 4 2- ft.
Exterior finish ?A 1 w- C With what material? . . Q..)4L.CQ. P(.1.-k-I--c L
Finish of interior walls. . . . . . . ....QC?. . . . . . . ....A r$c L-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If garage is to he attached 9If what material is wall between garage and main building to be constructed?
Is there to be an opening between garage and building?
Kind of heating system . .0c0 ` 111101.EMSL Jul R.. Oil burner or coal? o L.--
1
Will a flue-lined chimney be providef . .'O.S• • • . . • Depth of chimney foundation below grade
Height of chimney above roof. . . ..3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will there be a fireplace? N.0 5 Depth of fireplace hearth \D'.C= �H ''M ' A.L __
Will a toilet be installed? . .. . . . ...ram .• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Will a kitchen sink be installed and connected to water supply? 't 6,5
Water supply (public water supply or pump) # "i �'k-- �� vt
Distance of cesspool from any private well i 6C) feet
—Will drainage system be provided with required traps, cleanouts, and vents? � CF S
Town of Queenshury AFFIDAVIT
County of Warren ss.
State of New York
I swear that to the best of my knowledge and belief the statements tanned in this ap! icati. ,together w'" . and specifications sub-
mitted, area true and complete statement of all proposed work to . ••ne on the d `• • . • toes a i ' ions of the BUILD-
ING CODE,THE ZONING ORDINANCE.and all other laws perta to the propo. . . k corn . specified or not,
and that such work is authorized by the owner.
Sworn to before me this Signature .... .
NI , „,
OWNER.OWNER4 'S A T.ARC �ECT.CONTRACTOR
fZ dg of 'v`--`SL---- 197
1 t (/ N"T. CARSON
NOTARYU`i� 7 i*1t (•State of New T rk
Beaming in Warren County
SPECIAL CONDITIONS OF THE PERMI ��Ceitunln Ezpire8 March 3e, 197,�
By
TOWN OF QUEENSBURY
WARREN COUNTY, NEW `'OF;K
Application for
A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE
DISPOSAL SYSTEM. FOR A PRIVATE RESIDENCE WITHIN THE
TOWN OF QUEENSBURY
Mail or bring this application to:
Building & Zoning Department
Queensbury Town Office Building
R.D. 1 Bay Road
Glens Falls, New York 12801
This application for a Sewage Disposal Permit must be
accompanied by a plot plan drawn reasonably to scale
showing all dimensions , the size of the lot, the location
on the lot of the water supply and sewage system.
1. Name and ailing address of applicant :
ailing address
C ( ,- 0G t 3 C-
'2... N cZ-C, F-o Nu G._-*. 1.,N,3(.ts cr-ALA.,S -
2. Specific location of property: -ll7F.E
( STREET AND NS1 .BER)
3. App cation is for:
("Mew construction of private dwelling .
Alteration or enlargement of existing sewage disposal system.
4. Description of building: 2
a . number of bedrooms _
b. garbage grinder KO
(YES OR NO)
e K i L- .., S mac_pL Rc3 c lL LL OG
5. Topography: o
(flat, rolling , steep slope, gentle e slope, etc. )
6. a. Nature of soil. ( Describe to a depth of 5 fepits if tile
field is to be used or 10 feet if leaching r
proposed, giving thickness of various strata such as
top soil , clay, loam, sand, gravel , rock, etc . )
Lb? ' wlk. c-� c, (kt\U _ Tct3A-_-. --c j-__ tK
b. How determined? E Xe•
7. a . Soil percolation test made by _ _ N0 n "e-..
(Refer to Part III , Bulletin 1 , 1\Lv.S . Department of Health)
b. Percolation test notes submitted? --- Es OR NO)
8. Proposed sewage disposal system indicated on attached plan or
sketch? \( E5
(YES OR NO)
9. Date when construction will commence
, 014E L5' 1 k g-1-L
It is hereby agreed that if this application and attached plans
dated _ or any amendment or revising, thereof ,
are approved, installation of sewage disposal facilities will be
made in accordance with the details thereof as shown on such
approved plans.
Installed By: Contractor m `,ignature of p icant H
Owner
\ -‘4-1-- , , G. 1.- Z
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r , A • 1) 12..OVED
DATED - - -
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BUI DING & ZONING INSPECTOR
TOWN O' QUEENSBURY
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