88-898 E+
CERTIFICATE 'OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date April 6 19 90
This is to certify that work requested to be done as shown by Permit No. 88-898
has been completed.
This structure may be occupied as a Single Family Dwelling
Location Corner Knox & Assembly Point Road
Owner William Bernard
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
z
b
TOWN OF QUEENSBURY
No. 88-898
WARREN COUNTY, NEW YORK
V
PERMISSION is hereby granted to William Bernard
rn
OWNER of property located at Corner Knox & Assembly Point Road Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Single Family Dwelling
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.
1. OWNER'S Address is
Box 4103
Glens Falls, New York 12801
2. CONTRACTOR or BUILDER'S Name C7
SAME
r-
w
3. CONTRACTOR or BUILDER'S Address 0
SAME
4. ARCHITECT'S Name 0
n
0
m
r{
5. ARCHITECT'S Address a
a
rn
6. TYPE of Construction—(Please indicate by X)
$XXWood Frame ( 1 Masonry ( 1 Steel ( )
7. PLANS and Specifications 0
p
rt
No. 24' x 32' Single Family Dwelling as per plot plan, specifications,
and application,including septic and attached two car garage.
8. Proposed Use
Single Family Dwelling
cn
25.00
$ 211.00 C/0 PERMIT FEE PAID—THIS PERMIT EXPIRES June 1 19 89
(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.) 11)
W
I-
Dated at the Town of Queensbury t ' 22nd Day of November 19 88 1/44
to
SIGNED BY e for the Town of Queensbury
Building and Zoning In ctor
OQ
TOWN OF QUEENSBURY APPLICATION FOR BUILDING ANIMONTI;f 'l NSBURY
@ 0 W 14' D
.N a , Rec ieved 17
;��----- Reviewed Az + :,:
..a
„? � F,y of
M Fee Paid $ 6 59- BUILDING & CObE DEFT.
BUILDING AND CODES DEPARTMENT Date Ieaued
Y and HAVILAND ROADS RD 1 Box 98
PUEENSBURY,NEW YORK 12804 PeAna.t No. es - 8 ,45)
—
Tel . (518) 792-5832 Ext 204
. * * * * * * '* * , * * * * * * * * * * * * * * * * *- * * A * A * * * * * A
A PERMIT MUST 114 OBTAINED BEFORE BEGINNING CONSTRUCTION. NO INSPECTIONS
t''ILL BE MADE UNTIL APPLICANT 1-!AS RECEIVED A VALID BUILDINC PERMIT.
All applicable spaces on this application must be completed and the
souature of the applicant must appear on the reverse side of this sheet .
* 'A * A * * * A * A * * * * * * * * * * A j* * * * * * * * * * :k W * * * *
'he owner of this property is : �^iiW (
r �l (A kt • bernar�
' . O. Address `B11x 4 ( 3 Levvs c o k 1 A.y , TEL. 74'3•- 7a- 4o3
'roperty location Corner 0'P- 'Kt+1oX. E A55e►1191 P'' "`tTAX MAP NO. 9 / / / /6,G,
las there been any split of this property since October 1 , 1988? / /7
yes no
It yes, Planning Board Review is necessary .
>UBDIVISION NAME, IF APPLICABLI. LOT NO.
'he person responsible for supervision of work as regards Building Codes is :
tiO I l 1 i`A M 4: leer rta re) Box 4(a 3 C iei) CA lls, AY' 7 93 , 7?6 3 _
NAME P .O . ADDRESS TEL. NO.
lame of builder Same Address Tel
lame of Plumber 5,01€ . Address Tel
lame of Mason 5 Am Address Tel
r
%TORE OF PROPOSED WORK: ZONING INFORMATION (Office use only)
SCConstruccion of a new building • ZONING DESIGNATION OF PROPERTY Al'Q-/A
_Addition to a building ; PERMITTED PRINCIPAL ,C PERMITTED ACCESSORY
Alteration to a building * ,
(no change to exterior dimensions) • REVIEW REQUIRED - PLANNING BOARD ZONING BOARD_
Ocher work (describe) # SITE PLAN REVIEW # APPROVED DATE
•
ROSS AREA OF PROPOSED, STRUCTURE • VARIANCE it APPROVED DATE
st Floor 761 sq ft . * Remarks: . • '
�7 *
nd Floor `� sq f t . • COt•tPLE'1'!: INFOfatA'rION REQUIRED UELOW.
ther Floors sq ft . * Size of property 321k09'.3 ft X f.5.•.5S.ft.
not cellar Jr basement) * Existing building(::) Size Et X rc.
OTAL FLOOR AREA l6-'3 (p sq f t . •
l::Xl.::Cing building(6) U.+e y //- ?L
ize of new structure I ft X ',...ft *
oundation-pier/slab/crawl full • Proposed building, distance from property line
(circle on- • Front yard / ;� r ft Rear yard / ,0 t ft
a. of stories (habitable ::pa e)
S cj‘i't. * Side yards c3"3 , ft and / fc
eight (grade to ridge) ga,
f residential, no. of families • If on corner, - etback from side street 3. arc
o. of rooms(excluding baths) b • OCCUPANCY INFORMATION .
o. of bedrooms 37 • PRIMARY BUILDING -
o. of bathrooms • k Onc family dwelling
u riury heating system gel- f-f /',2
ype of fuel G, L/Elef. • Two family dwelling
o. of fireplaces to be installed / • multiple dwelling / Number of units
ill a wood stove be installed? /vb ' * Permanent occupancy
• Transient occupancy
entrel Air conditioning?
• business
UILDING STYLE, PRIMARY STRUCTURE * Industrial
.duck Concewpor Lon cabin * Ocher
.,isud ranch Mansion Duplex • if addition, what will use be?
split level Old style Uunyalow •
'ape Cod Cottage Ocher • ACCESSORY UUILDINC-
!oloni:;l Row Town Nouse • Detached garage/ono car/ two car! car
( CIRCLE ONE PLEASE ) * X Attached garage/one cA two car -cue•
* A A A * A * * • A A A A " * a • Private storage building
LS't'IMATRD MARKET VALUE OF • Ocher
::ON::'rRUCTION •
S
NFoRMATION ON BUILDING SPECIFICATIONS, ON REVERSE SIDE OF THIS SHEET, TO BE COMPLETED!
Form DPA 10/88 vi
BUILDING PERMIT APPLICATION CONTINUED -
BUILDING SPECIFICATIONS:
Type of construction, wood frame, fire safe,etc. Wtrod '4 01m €-
Will any second-hand or ungraded lumber be used? If so, for what? AdO
�� rr
Foundation wall material ('ESN Gref e Thickness
Depth of foundation below grade (to bottom of footing
Will there be a cellar? Heated or unheated? C;{ JJ Floor sq. footage 746 sq ft
Will there be a basement? Will any portion be used as living space? No
(If so, what portion? sq.ft. - - Type of use?
Type of roof - sloped/flat/shed/other 5Toped Material of roof Ifs p h4 ,f
Size, wood studs a "X & " spacing 10 "o.c. length ft.
Joists(floor beams) 1st. floor 2. "X (b " spacing I (p "o.c. span /a ' ft.
Joists (floor beams) 2nd. floor o) "X (D spacing /4 "o.c. span !,2# ft.
Overlays(ceiling beams) A "X g " spacing l6 "o.c. spanfa,, ft.
Roof rafters "X Jf- " spacing o.c. span ft.
Roof trusses(pre-engineered) ac ng ),z4 "o.c. span jt/ ft.
Exterior wall finish aiANWELA I5-T1/4C Of what material? tOobe
Interior wall finish sh‘at POCK
If a garage is to be attached, describe materials to be used for FIRE SEPARATION:
R ae4e Se -t -Oc
Is there to be an opening between garage and dwelling? l es If so will a Fire-rated
door, enclosure, and self-closing device be provided? 5
1
Will a flue-lined chimney be installed? Height ab6ve roof 3 ft.
Depth of chimney foundation below grade LI ft.
Depth of fireplace hearth "3 ft. in.Water supply - Municipal or private well koA e
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)
DECLARATION
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.
Signature V �� cl
:2461.4,6,ea
Owner, owner s agent, architect, contractor
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
SPECIAL CONDITIONS OF THE PERMIT:
By
•
TOWN OF QUEENSDURY
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 /5 2
2 . Type of heat Od % / (/
3 . Is the building mechanically .cooled?
4 . Percentage of area of windows and doors
A. Over 16r, 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 161 Only
1 . is value of roof and floors exposed to ambient conditions
2 . R value of exterior walls /Q•-/9
R value of glazed area
4 . R value of doors �°r /7
5 . R value of floors over unheated spaces
6. R value of slab edge insulation - unheated slabre-/1;
• 7 . R value of slab insulation - heated slab .4"./4
Of
U. R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade)101.
•
10. Type of insulation 7.78 e/e 45-
C. Controls a
'Th
ermostat hermostat maximum heat setting l`iv
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 . P6zrform40ce .iiiciency
2. Temperature control setting maximum
C. For Swimming Pool Only •
1. maximum heating
Ae- ,tA
Telephone No. '•' �i��`Z�`
(applicant ' s signature)
TOWN OF QUEENSBURY
APPLICATION FOR
' � SEPTIC DISPOSAL PERMIT
DATE / �/ l 14 /
LOCATION OF PROPERTY FOR INSTALLATION j- (QC' A SSevAco( 1' tut a.dk`
Owner's Name: W i t i Pt v . • e ryAR rcl Telephone: 1 ( 3 — 1 at (j
Address: 61)K t t 63 S S WA,
Installer's Name: Telephone: 75 3 - 7a 6.3
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) �� �A �- - l �� L �`'`� ���}�r��J
Topography: circle one: Flat Rolling Steep slope % of slope HA I
Soil Nature: circle one: Sand Loam Clay Other 5Anxl / Depth: b feet
Ground Water: At what depth? lv1- (VOID- feet
Bedrock or Impervious Material: At what depth? --- WA feet
Percolation test: circle one: not required required/rate min.inch.
Domestic water supply: circle one: Municipal Well Other /
1-4Ke l ,l"QS$i rcY zC
If domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank (1b)o gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 4' feet / Total system length ISO feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # /Depth or Thickness feet
******************************************************
I have read the regulation on the reverse side of this sheet and agree
to abide by these and all requirements of the Town of Queensbury Sanitary
Sewage Disposal Ordinance.
Signature of responsible person: /fit /g��7 /2-01
l�
Date:
(OVER)
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 installa-
tion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks: - ti,
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280i
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED ,il,2,9AQ
NAME Ildttia,ry,
LOCATION (ink. ^n , rj 11 &avyl.i
DATE ,s//f 00 PERMIT # ?Q-cqg
.�M APPROVED
St14Qi yYi.dG{ Jo /j, 1 YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS `-
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING ✓
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING ✓
DOOR CLOSER(S)
SMOKE DETECTORS ✓
FINAL ELECTRICAL INSPECTION ✓/
FINAL APPROVAL OF CONSTRUCTION ✓
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS: , / g - �?
i
NSPECTOR
P5 cc''77
�� /own o1 Queenibur y /1
,411
a BUILDING and ZONING DEPARTMENT /
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIICCC DISPPOSSAL SYSTEM INSPECTION
NAME
LOCATION /(ff-fze,
DATE ,-9 PERMIT NO.
•
SOIL TYPE - Sand Loam) Clayr
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length 45 S
Length of each trench
Depth of trenches ' a?=3 •
Size of gravel
SEEPAGE PITS{Number fifif)
Size- ft. X ft.
Gravel size
PIPING: ' Size Type
Bldg. to tank ®t/L
Tank to dist. box Y er
Dist. box to field/pit '/ to
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation!to tank /5 ft.
Foundatiori to absorption ft.
Absorption to lot line /b ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
erront ) Rear - Left side - Right side -
COMMENTS: �/
J f5 r/fed aS' ,Qe/L
0;// G/use Spc_s
SYSTEM USE APPROVE YES N
Buil ng Inspector
01/86 and vl
TOWN OF QUEENSBURY //`, ,
BUILDING AND CODESES DEPARTMENT ('/
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME Y�t
LOCATION
DATE ,� - / PERMIT #
• APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL J
ROUGH PLUMBING ,
FRAMING
ELECTRICAL ROUGH-IN r
MIS/ULATION: /
FOUNDATION /
FLOORS
WALLS
CEILING
FINAL INSPECTION: ff \
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/,STEPS
STAIRS-CLEARANCE 4 RAILS
PLUMBING FIXTURES/RELIEF VALV
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS ;
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
'PM
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED,,
NAME �j, e/R.1,//l KliC
LOCATION .4, 5_ety7�/ , r
DATE 47i?6 'PERMIT # 77 gq
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING t! '
;FRAMING ✓
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS,
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF.VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER($)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
4 SIGNED CERTIFICATE OF OCCUPANCY MUST BE
DBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
C;, 7
INSPECTOR
TOWN OF QUEENSBURY
/// // / c'
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT �j
REQUEST FO INSPECTIO RECEIVEDW5- a y
NAME ,�D�f�l�
LOCATION / 1 // q/ /44J1,97/-/2,/.
DATE # 7/if PERMIT #_- -w'7F-
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS i
FOUNDATION/DAMP-PROOFING /
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
INSPECTOR
TOWN OF QUEENSBURY ( `�
BUILDING AND CODES DEPARTMENT I/
BAY & HAVILAND ROADS �;�
QUEENSBURY, NEW YORK 12804- 11(TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME / .,(1);.er,/knLOCATION
DATE
DATE TPERMIT'# - 9
APPROVED
YES NO
/OOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DEFECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
4 SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
/i
,.s
4f:
INSPECTO
-g
Oo
0-1 ,
1 _
/ k7 wh�rn-an, CC
M 4t C rrCCtt :Y-_
tPs a"..o'ab"P3
vr9� S�MIG-7in9
J p —,00/
:'
y 0 0CD
o � _
I
69L99
-�