7474 BUILDING PERMIT
TOWN OF QUEENSBURY 7474
No.
WARREN COUNTY, NEW YORK
R. Barber
PERMISSION is hereby granted to Daniel
OWNER of property located at
P P tY Lot 4__Hall Road Street,Road or Ave.
in the Town of Queensbury,To Construct or place a One—Family Dwelling �d
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.
rD,
1. OWNER'S Address is
R. D. #1
Glens Falls, New Yoek
2. CONTRACTOR or BUILDER'S Name
same
0
3. CONTRACTOR or BUILDER'S Address h'
same
Iv
4. ARCHITECT'S Name
0
Sv
cJ
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( *Wood Frame ( ) Masonry ( )Steel ( 1
7. PLANS and Specifications p
24 'x36' per plot plan, specifications and
No.application submitted including one-car attached garage
and sewage system.
8. Proposed Use
One-Family Dwelling �C
$5. 00 C/O Paid N
95. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Feb. 1 1983
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 30th Day of July 1982
SIGNED BY S ,. ' for the Town of Queensbury
• Buildin and Zoning Inspector
TOWN O`F QUEENSBURY
(Space inside block to Ix. filled in by
WARREN COUNTY, NEW YORK Building Inspector)
2.... ---e-l'
Application for 11,1►lication No. ;
Pcrn►it Issued 19
BUILDING AND ZONING PERMIT Penult Expires 1g
%unin, District
• \ uln►• of Work
THREE (31 Copies of a PLOT PLAN, Drawn to scale \Min)" by
showing the actual dimensions of the lot to be built Il(qua 1Ks"
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION. R [E' ',',6EttiVE
f �r
-7 TOW E
HATE
A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ,,}lAL,_ 131982 P.C.
� � 11
ANSWER ALL OF THE FOLLOWING. �, ut14. 71O1 2 3�4- PC.
The undersigned hereby applies for a permit to do the following work `l�$) I l, ) -l , , ' ' ►
which will be done in accordance with the description, plans and specifi- " ' Yl c� .
cations, and such special con as v�b i -c ted on the permit. � � I " 10
The owner of this prerty is‘
1 ) , f ptt 1 •
INA.'F IP O.ADDRESS)
The person respo bic�� for %• is n Ate w insofar as the Building Code and the Zoning Ordinance apply is:
(NAME) IP O ADORE 1
Name of Builder • • Address —� �:
Name of Plumber C'": w, Address ---)�
Name of Mason
Address
� z,t--�� -
Lot Number Unit s • ated value of proposed work S f G'a er
Name of Village
Name of Street .
e • . . . . . '. . . Side of street: north 0, east ❑, south 0. west 0
�
Nearest Cross Street ) t'7 'stance from this '^ross street Ft.
Property is north ❑,south (,�,east i i, west 0 from Cross Street
If on Corner, which corner, n6rtheast 0, northwest ❑, southeast Q. southwest
(Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSED WORK OCCUPANCY
TK Construction of a new building. Main Building
❑ Addition to a building. One-family dwelling 0
❑ Alteration to a building. Two-family dwelling
❑ Demolition of a building. . . -family apartment house ❑
Store bppilding ❑
. . . .I. .-car attached garage ❑
Other:
Accessory Building
One-car detached garage Li
❑ 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 ar dd existin.t
`��. . c ,� huilding(s) in solid line. 44�� J .5 ,
iliSize of property . . . ./- . . ft. x . . . . . . . ft.
.` Size and use of existing buildings►,`if'any
,
Ilion :pc
in
i ► W Size of proposed building . . . • ft.x . .. d• • ft.
Height(from grade to ridge) // 1 -� ft.
Front yard 7 0 /� ft.
Side yards . . . . . . .3. . . ft. and ` r ft.
Rear yard I-KO ft.
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 SPECIFIC • `.r,
Kind of constructi: : Wood frame, 're safe, etc.?" d
Will any second-hon. . : used? . . , "C" If , for what? i
Material of foundation walls d • • . . Thickness
Depth of foundation walls below grade C Continuo oundation?
Will there be a cellar? '",;,/ If so, material of cellar floor .
Type of roof: Sloped or flat? / Material of roof f
"x v! ", spacing / "o.c., length
Size,wood studs . • ft.
'; spacing "'
Size, floor beams, 1st floor "x / ."o.c., span ft.
Size, floor beams, 2nd floor " x ", spacing "o.c., span ft.
"x spacing ceiling beams "o.c., span ft.
Size, roof rafters or beams "x ", spacing "o.c., span ft.
Exterior finish With what material?
Finishof interior walls
If garage is to be attached, of what material is wall between garage and main buil& to et� cti ?
Is there to be an opening between garage and buildin '
Kind of heating system X � ' Oil burner or coal?
/ "4'1 . Depth of chimney foundation below grade
Will a flue lined chimney be provided?
Height of chimney above roof '
4-
Will there be a fireplace? �Z.3 Depth of fireplace hearth
Will a toilet be installed? - 7,�s,„,
Will a kitchen sink be installed and connected to water supply? y--y` -
Water supply(public water supply or pump) �`-' ` d /
Distance of cesspool from any private well /el C, feet
Will drainage system be provided with required traps, cleanouts, and vents? X,-.. ----
AFFIDAVIT
Town of Queensbury
County of Warren
State of New York
I swear that to tt bra of my knowledge and belief the statements contained in this application,together with the pla and specifications sub-
mitted, area true and co.a.plete statement of all proposed work to be done on bed pre= d 40 ail) ' ions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertaining to the pro ork shall with, titer specified or not,
and that such work is authorized by the owner. ;P
Sworn to before me this Signature
OWNER. ER'S AGE T; IQ T.C 'T
day of 19
NOTARY PUBLIC. WARREN COUNTY,N.Y.
SPECIAL CONDITIONS OF THE PERMIT:
•
By
TOWN UY S)UEENSBURY
is ` ' BUILDING & ZONING DEPARTMENT
SEWAGE DISP L PERM A PLICATION
1. Owner ' s Name at—y-,1 5 -
. e_<,__ .; ) r-
Address Fp /4 I (--,-' Q:2 1::\) ,\,_ A)
."
_0 c, ),-_.1
i el ephone No. 9 `�
2. Property location l -('- ', .41k /
3 . Name of person or irm responsible for installing system
5' ...\01.1,,,,,,n-z. , et<n).1c7..0 y<' Telephone No._� s
Address
4. Number of bedrooms (residential buildings only)
5. Daily flow '),n 0 gallons/day
6. Septic tank capacity / d gallons
7 . Topography: flat, rolling, steep
% of srope
8 . Nature of soil and depth 1., ,- . j
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? PE5ft.
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 �v- ? ___
12. Type of system proposed: drywell,` tile field, 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 p v d for ' c 'on 6 . 010 of the
Queensbury SAnitary Sewage Ordinance.
PP
of
Date2 ') -"
applicant
,� signature
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 9' o
2 . Type of heat
_�� 4.
3 . Is the building mechanically cooled? Ai
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 floods expo� d to ambient conditions_
/ .a,
2 . R value of exterior walls A)-- 1 C7
3 . R value of glazed area C"- / (
4 . R value of doors ---- ' ").-
5. R value of floors over heated spaces P---
1
6. R value of slab edge insulation - unheated slab C5--,_�,
7 . R value of slab insul_144106.. heated slab Y -
8. R value of heated basement/ e4 . ,-� -lik, s (above grade)
9 . R value of heated basement cellar wa is (below grade)
10 . Type of insulation
C. Controls / C5
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 ipe /�
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:::::1 42 i
Telephone No. 9 R�� U�
(applicant ' s signatur )
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date 3 fop 83
Name 06,44054g.Z.
Permit No. � �
'-f� Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation P2449-4
Cement Coat
Waterproofing /.46 3":7
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board / �}
Ext. Porches 1/ 6//<�
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors _
Plbg. Fixtures � .
Gar. Fire roofin -----
Door Closers � ..�,._._._
Chimney /
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
—¢sec2/et t
Building Inspector
REMARKS
��� = .
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date
Location /eD c 7`174
Permit No. —7 'f7(f Weather
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey f��
Framing G/ •
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 ApprovalY!
Floors
Insulation Foundation
Walls
Ceiling
'.e ;4
4 c/LI V
l!'e9-eBuilding Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Inspectors Repoict Date 7--/e; —F??
Name Peze-ber-
Location ,,i f/ .AtiA1,1 I-.t 4
Permit No. -7 ff Weather
Per Cent / Remarks
Complete
Excavation rt•-. f
Footing Forms /VO 9h l si-2 9#3
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill _
_Final Survey
Framing
Sheathing ,
Roof Felt
Roofing
Sidin
Veneer
g-
g
slues
Wall Board
Ext.Porches
Finished Floor
Interior Trim
: .\ \
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Piing.Fixtures
Gar.Fireproofing
Door Closers ,
Chimney
Water Meter Inst. _
Septic Approval
t.....5- ,"C5:....:1
Building Inspector
REMARKS
i
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