8507 C/O Paid
w"
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
•
WARREN COUNTY, NEW YORK
Date January 30 19
This is to certify that work requested to be done as shown by Permit No. 8507
has been completed.
This structure may be occupied as a One-Family Dwelling
Location Mason Road, Cleverdale
Owner Peter and Deborah Frederick
By Order Town Board
TOWN OF QUEENSBURY
/ 1/(/,,' _J_ '41/. ;
Building & Zoning Inspector
roc ATIUE INSTA PNINTING GI ENS FALLS. N Y 12801 15181793-5656
r =� BUILDING PERMIT -
TOWN. OF QUEENSBURY . �o. g .o�. '
WARREN COUNTY, NEW YORK ,I
. ro.
Peter and Deborah Frederick
PERMISSION is herebyV
granted to n
OWNER of property located at '. Mason Road, Cleverdale Street, Road or Ave.
in the Town of Queensbury,To Construct or place a One—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. 0
1. OWNER'S Address is Box 302
Cleverdale, New York
cD
CD
2. CONTRACTOR or BUILDER'S Name _ K
-Edward P. Carr
3. CONTRACTOR or BUILDER'S Address
244B RD #1
Lake George, New York
4. ARCHITECT'S Name
0
7J
0
5. ARCHITECT'S Address P.)
o
6. TYPE of Construction—(Please indicate by X)
(D
Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications (D
26'x40' per plot plan, specifications and
No. application submitted including sewage system. .
8. Proposed Use
One—Family Dwelling p
$5. 00 C/O Paid V
$ 147 . 00 PERMIT FEE PAID =THIS PERMIT EXPIRES December 1 19 84
- (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 18 th Day of May 19 8 4
SIGNED BY U�C'L Q.• for the Town of Queensbury 1-6
Building and Zoning Inspector e
TOWN OF '• tJEENSBURY
(Space inside block to be filled in by
WARREN COUNTY, NEW_ YORK Building Inspector)
Application for Application No.
pp Permit issued 19.
. BUILDING AND ZONING PERMIT Permit Expires. lg.
7.unin4 District
THREE •
(3) Copies of a PLOT PLAN, Drawn to scale \1'I"'"c cl by
. `,,showing the actual dimensions of the lot to be built Itc•mar)'C`'
upon, The exact size, and location on the lot of the
building to be erected or altered MUST BE SUB-
MITTED WITH THIS APPLICATION.
a^ a}t v
/ RE., GE
�� DATE TOWN OF
4
•A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK MA I z30
ANSWER ALL OF THE FOLLOWING. C Fes- C• 0 - M.
The undersigned hereby applies for a permit.to do the following work ,, � ] l ���3�4� l6
which will be ;done in accordance with the description, plans and specifi- R i ,: ir,-�' R a
cations, and such special conditions as may be indicated on the permit. ,, /�`J�`(.r
The owner of this property is: .
Ptu.. A.. .and. Deborah. A. .Frederick Box.3.0.2, .C1ever oa ei .NSY 1282.0
' (NA•..E)
The person responsible for ' supervision'of the work insofar as the Building Code and the Zoning Ordinance apply is:
Edward P. Carr 244B. . RD1 . .Lake •George,•o ADDRE12845 .,
(NAME) •
Name of Builder n Address It.
•
Name of Plumber " Address " '
Name of Mason �� Address �� 2
Lot Number 13-30+13- Milt Estimated value of proposed work s .7..1, .0 oO
29.nZ
Name of Village Queensb.ury
Name of Street Mason Rd. ,Side of street: north 0, east 0, south 0. west 0
Nearest Cross Street .Cleverdala..Rd. Distance from this cross street . .150 Ft.
Property is north 0,south ❑,east [a, west. 0 from Cross Street
If on Corner, which corner, northeast 0, northwest ❑, southeast ❑, southwest
' (Designate by marking with an "X" in the correct space.)
NATURE OF PROPOSE D WORK OCCUPANCY '
® Construction of a new building. Main Bunning
❑ Addition to a building. . , • One-family dwelling
•
Two-family dwelling 0
❑ Alteration'to a building. -family apartment house ❑
El of a building. Store building ❑
. -car attached garage ❑
Other:
• • Accessory Building
. .. . One-car detached garage ❑
❑ 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 buildings) in dotted line and existing
huilding(s) in solid line.
Size of property see survey ft. x ft.
Size and use of existing buildings, if anyNone
(cont'd.)
BUILDING SPECIFICATIONS.,
Kind of construction: Wood frame, fire safe, etc.?. .Wo.od.frame
Will any second-hand lumber be used? No If so, for what
Material of foundation walls .B.lcc1 . walls Thickness 1Q"
Depth of foundation walls below grade .5 f t. Continuous foundation? ,Yes
Will there be a cellar? yes If so, material of cellar floor . .concrete
Type of roof: Sloped or flat? . ..sloged, , , . . , , . . Material of roof asphalt. shingle
Size,wood studs Nominal "x ", spacing 16 "o.c., length 7'8" ft.
Size, floor beams, 1st floor 2 "x 10. . .", spacing .16 ."o.c., span 13 ft.
Size, floor beams, 2nd floor 2 "x 10 ", spacing 16 "o.c., span 13 ft.
Size, ceiling beams 2 "x 6 ", spacing 16 "o.c., span 17 ft.
Size, roof rafters or beams 2 "x 8 ", spacing 16 "o.c., span 18 ft.
Exterior finish Clapboard With what material? 1/2 'x 6" rough sawn clapboard
Finish of interior walls. .sheetrock. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If garage is to be attached, of 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 electric Oil burner or coal?
Will a flue-lined chimney be provided? yes . Depth of chimney foundation below grade 5ft.
Height of chimney above roof 3ft.Will there be a fireplace? yes. Depth of fireplace hearth .9-1/4"Will a toilet be installed? -yes
Will a kitchen sink be installed and connected to water supply? . yes
Water supply (public water supply or pump). . P.UP
Distance of cesspool from any private well feet
Will drainage system be provided with required traps, cleanouts, and vents? . . ye$
Town of Queensbury AFFIDAVIT
County of Warren
State of New York
I swear that to tt;• ba i of my knowledge and belief the statements contained in this application,together with the plans and specifications sub-
mitted, are a true and co.i.�lete statement of all proposed work to be done on the described premises and that all provisions of the BUILD-
ING CODE,THE ZONING ORDINANCE,and all other laws pertai ' to the pro or sheet be complied with,whether specified or not,
and that such work is authorized by the owner. `/
Sworn to before me this Signature .
-
OWNER.OWNERS AGENT,ARCHITECT,CONTRACTOR
day of 19 .
NOTARY PUBLIC, WARREN COUNTY:N. Y.
SPECIAL CONDITIONS OF THE PERMIT:
1 - :, TOWN OF OUFFNSBURY
. BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION
1. Owner ' s Name peter A. and Deborah A. Frederick •
Address Box 302, Cleverdale, NY 12820
Telephone No.656-3613
2. Property location Mason Rd. , Cleverdale, NY
3 . Name of person or firm responsible for installing system E. Peter Carr
Telephone No. 793-0941
Address 244B, RD1, Lake George, NY 12845
4. Number of bedrooms (residential buildings only) 3
5. Daily flow 114 0 gallons/day
6. Septic tank capacity 1000 gallons
7. Topography: flat, rolling, steep."
% of slope 5% •
8 . Nature of soil and depth Clay Loam loft'.
9. If ground water, bedrock or- impervious material is apparent at what
depth does it begin? 7 ft.
10. Percolation test: A - required
B - is not required
C Ifrequired what is the rate minutes/inch
11. Water supply: municipal, well, other -pump from lake
12. Type of system proposed: drywell, tile field, other tile field
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±ovided for in Section 6 .010 of the
Queensbury Sanitary Sewage Ordinance.
•
Date
signature of applicant
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.
t'e22) "1'44)—
Form 3-8 2 c _
TOWN OF QUEENSBURY
• WARREN COUNTY , NEW YORK
Application for"s 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 1080
2 . Type of heat eLECTe/L e95E.6ofi-ram
3. Is the building mechanically cooled?
Sp -
4 .. Percentage of area of ' windows and doors 9/'2
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 floors exposed to. ambient conditions'
e: 19 sc:ae6 -
2 . R value of exterior walls '
3 . R. value of glazed area f2`
4 . R value of doors e 1
5. R value of floors over unheated spaces 149
6. R value of slab edge insulation - unheated slab.
7 R value of slab. insulation - heated 'slab
8. R value of heated basement/cellar walls (above grade)
9 . R value of heated basement/cellar walls (below grade) '
10 Type of insulation... '•:P I I EJe(rL AG
C. Controls U
'1. Thermostat maximum heat setting -7 S
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- duet in other areas
E.. Piping Insulation `I'L
1. Size of hot water or cooling ca rying agent pipe -
2 . R value :of pipe insulation, f(- //
TOXIN OF QUEENSBURY
% aiding Department
Inspectors Report Date / ,�2 �
Name /f-=tS' / C. .
Location - ✓f/'
Permit No. e S d'7 Weather
//v r01 J5 P Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor —
Interior Trim
Stairs & RailingsQ
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing .4'/r4
Door Closers /.
Chimney (/CZ, �.
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Building nspector
REMARKS
TOWN OF QUEENSBURY
Building Department
inspectors Report Date d`?`/ 2Jr`
Name ,- /, 6 r/ !/
Location iyC o ��i /ti.� /
Permit No. ; r, o'7 tither
Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
��Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer ,,�
Rough Plbg. i/ ,
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 Approval
Floors
Insulation Foundation
Walls
'Ceilin
Building Inspector
REMARKS
TOWN OF•QUEENSBU RY
Building Department
inspodmraReport Date ?/3/6 4
Name .fire-'L�rJf�/C,j+
Location ✓1, 4,/7:j CZ, ,1,�-z. Ae-:eL
Permit No. 61�D 7 Weather
Remarks
Excavation
Footing Forms .
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
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 I
Door Closers
Chimney
Water Meter Inst., Ki,-,.
Septic Approval �//‹ .
Floors '
Insulation Foundation
Walls '
'Ceiling
y--7;4 &(?4(6./.4(!---J-" frt."
Building Inspector
REMARKS
TOWN OF•QUEENSBURY
Building Department
Inspectors Report Date 7%/ A
Name rr P/ /,�.
Location'• ,
Permit No. k ,G 7 Weather
Remarks
Exca fia ti on
Footing Forms
Footing & Piers
Foundation Lire
Cement Coat ,
Waterproofing
Backfill
Final Survey
Framing •
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 'r
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors v -
Insulation Foundation -
Walls c' lr T'�oyLr
'Ceiling '
//4.o///..
Building Inspector
REMARKS
TOWN OF QUEENSBURY
Building Department
Ingo Report Date ?/2-/7 `'`Name peru ,E o2. lc. - i
Location' in,,q 5o,/ n-c-Y C/C_c1P l2.6J4te
Permit No. 9) S07 eather
Remarks
Excatia ti on
Footing Forms
Footing & Piers _/r_( )
Foundation �/
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
\\<\/:
Interior Trim a�
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures ‘\N
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation
Foundation
Walls
Ceiling
Bull _mg Inspector
REMARKS