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8768 C/r Paid CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date r r i 1- 3 19 ' This is to certify that work requested to be done as shown by Permit No. 8 7 F 8 has been completed. This structure may be occupied as a addition to one-family dwelling (second story acctect) Location Pilot Knol Road Owner Rorert Kahn By Order Town Board TOWN OF QUEENSBURY CAZ,d4J./41) ?.L4t Building 6 Zoning Inspector CREATIVE "INSTA" PRINTING GLENS FALLS, N T 12801 (518)793-5658 BUILDING PERMIT - TOWN- OF QUEENSBURY . No. 8768 WARREN COUNTY, NEW YORK . o _ tr PERMISSION is hereby granted to Robert Kahn n it OWNER of property located at _ Pilot Knob Road Street, Road or Ave._ in the Town of Queensbury,To Construct or place a Addition to dwelling/sewage alteration - 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 131 Brunswick Road . Troy, New York 12180 _ ro . r. H • 2. CONTRACTOR or BUILDER'S Name cot ' Fregoe Construction - x O 3. CONTRACTOR or BUILDER'S Address tY . - Middle Road - a - , Lake George, New York a 4. ARCHITECT'S Name - 5. ARCHITECT'S Address - 6. TYPE of Construction—(Please indicate by X) ()i Wood Frame ( ) Masonry ( )Steel ( ) - • - _ 7. PLANS and Specifications F-i•IZ add second story to dwelling utilizing existing . a - ' No. attic" space per specifications and application - , fi - submitted and including addition to existing o- 8. Proposed Use - septic system. • . P. . kg rt - - One-Family Dwelling (second story. added) - o in CD fl - $5. 00 C/O Paid • $ 16. 0.0 PERMIT FEE PAID —THIS PERMIT EXPIRES. April 1 . 19 85 CD H :Nk (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the :AI town of Queensbury before the expiration date.) I—' CI rt (D Dated at the Town of Queensbury this 18th Day of September 19 84 • - • - p �^ /J /� rt . . - �/I GL�v CSC • ��?J%� Oa SIGNED BY �' for the Town of Queensbury Building and Zoning Inspecto TOWN OF QUEENSBURY - -(Space inside block to he filled in by WARREN COUNTY, NEW YORK - ' , Building Inspector) Application for Application No. ; Permit Issued 19. . BUILDING AND ZONING PERMIT p,.t-mit Expires. lg.. • %�ntin� District • • \ aloe ni Work,l _ / THREE (3) Copies of a PLOT PLAN, Drawn to scale .\itltro��.(1 b �f showing the actual dimensions of the lot to be built. Rem:u)( 1 i 7�� - upon, The exact size, and location on the lot of the v ` �./ building to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. TOWN OF QUEENSBURY /53- 1 - 6 :. . . :....r... 4-. . DATE . . . . . . REGEllvED A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ANSWER ALL OF THE FOLLOWING: AM: :���Ibe35 ,/• 1'p�r 'The undersigned hereby applies for a permit.,to do ,the following work ' which will be done in accordance with the description,. plans and specifi- :•71f3M101 & I3I4i l? cations, and such special conditions as may be indicated on the permit. _ 6, ' • 0 ._->okt -K-- The,wn,er of this aperty is: . tlObc'.v'`'- LLtn . . . .'. . . . . .'. . . . . . . . . . . . . . . .1.�..t ...tr.i —cu;��c.y�. •p t a 1\t`(. .( �.i. -0. . . . INA'4E) (P.O!ADORESS) • • .�`. . . .' ' The person responsibleperson fo i supervision of the work insofar as the•Building Code and the Zoning Ordinance apply is: icrweS (NAME) (P.O.1ADDRESS). Name of Builder.1tf 3Q� - -^s `a,. Address Nf do . Q t -�=c�s U.P Name Of Plumber Address Narrhe of Mason. . . We,, Address .t:{. n a> _jj jj Lot Number .5 ..�l'�.b. Unit , Estimated value of proposed work S $00,0 Name of Village `, Name of Street . .-P!I G ii x'o Y o—Pb Side of street: north 0, east ❑, south ❑. west Nearest Cross Street :4 ` ash i Ca,.' cSi Distance from this cross street Ft. Property is north,,D,south" 0,east i 1, west 0 from Cross Street If on Corner, which corner, northeast 0, northwest ❑, southeast 0, southwest (Designate by marking with an "X"•in the correct space.) NATURE OF PROPOSED WORK OCCUPANCY : �C-onstruction of a new building. Main Building 'big Addition to a.building. One-family dwelling -EJ'� ❑ Alteration to a building. Two-family dwelling • ❑ ❑ Demolition of a building. -family apartment house E. Store building - ❑ -car attached garage ❑ • • Other: Accessory Building Ld�� 6� /> � One-car detached garage ❑ CJ Other work. Describe:. a G�� a "Two-car detached garage _ LAY �,�GJ �r,,4 Private chicken house ❑ a ��. v/ Private storage building El .. 7; . 02:. .c.,7 -�'%'d' Other: ZONING SPECIFICATIONS. Fill in for new.building, or addition to existing building, or a change of occupancy. Indicate on the plot plan street names, the location and size of the property, the location, size and setbacks of pro- NORTH • posed buildings,and the location of all existing buildings. Show proposed building(s) in dotted line and existing building(s) in solid line ,K .'( G . WO Y Sc:)l��x l t Size of property ft. x ft. Size and use of existing buildings, if any mI.; w 3Zetga-fs t .��Z$.tc'4c ) 211a" ?A ceSie . m Size of proposed building- '4 '41'. t.x t la ft. - Height (from grade to ridge) �` ft. Front yard la( ft. Side yards 12.i ft. it id, 6 G ' ft. • . Rear yard4 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 SPECIFICATIONS., Kind of construction: Wood frame, fire safe, etc.?. . . . . « fgJ. . . . . . . . . . . . . . . . . • • . . . . . . . . . . . . . . . . . . . • • Will any second-hand lumber be used? n If so, for what? e/ Material of foundation walls . ^�=� g�t bl` f'" Thickness Depth of foundation walls below grade U 36" Continuous foundation? .1C Will there be a cellar? aK r.S'4!qq 1 If so, material of cellar floor Gew, Type of roof: Sloped or flat?S.@ta >'. . Material of roof . .GS 5 . s Size,wood studs 2. x 6 ", spacing ! ."o.c., length • ". . . ft. Size, floor beams, 1st floor "x PrF( d� ", spacing "o.c., span r ft. . �. n�. • • Size, floor beams, 2nd floor " x% I ` 10 ", spacing 16 "o.c., span 6 (Di ft. Size, ceiling beams ►n ��` ✓55 ", spacing . . . ."o.c., span ft. Size, roof rafters or beams 4r4.25z .n •=fix(' ", spacing . . . . . . .24. . . ."o.c., span ft. Exterior finish . n`=qbt/ tf )..c. b .�. . . . . . . . . . . . . . . With what material? Finish of interior wa is. . A . .S)'!f�C pcK 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 gars a and building? — Kind of heating system . �7�i.` i r .Q�.1. .6 ,� Oil burner or coal? Willa flue-lined chimney be provided? .pXa ''c' . Depth of chimney foundation below grade Height of chimney above roof NC7 Will there be a fireplace? .e.,61S''' Depth of fireplace hearth Will a toilet be installed? Will a kitchen sink be installed and connected to water supply? %cis'4-' rl Water supply(public water supply or pump) . . . .pt' Distance of cesspool from any,private well . eXi'541.4-1_ feet Will drainage system be provided with required traps, leanouts, and vents? . Town of Queensbury AFFIDAVIT County of Warren State of New York I swear that to tt bra r of my knowledge and belief the statements contained in this application,together with the plans and specifications sub- mitted, are a true and cos.p"lete statement-of all proposed work to be done . the described premises and that all provisions of the BUILD- ING CODE,THE ZONING ORDINANCE,and all other laws pertaining II. ,posed work be complied with,whether specified or not, and that such work is authorized by the owner. Sworn to before me this Signature OWNER, WNE • AG/`'.ARCHITECT.CONTRACTOR day of 19 ' NOTARY PUBLIC. WARREN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: ' • • • By ^1 . - TOWN OF -QUEENS,BURY • • WARREN COUNTY, NEW YORK . 'Application for: . BUILDING PERMIT INCOMPLIANCE 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 2 . Type of heat 435c1S �'�P ,�r •X lfs3 .. 3 . Is the blindingmechanicallycooled? �$' ' ' ' 0 `n�a�-+-wear • 4 . Percentage of area of windows ' and 'doors A. Over 1.6% 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 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 . 2 . R value of exterior walls R01 - 3,. R value of glazed area 1L45 :. . • ' . • 4 . R value of doors Atot . . ' . -- 5. R value Of floors over unheated spaces 0(0n 6. R value of slab' -edge insulation -._unheated 'slab. lil-a. - 7 . -R value of slab insulation - heated slab . HLk,: 8 . R value of heated basement/cellar -walls (above grade) nI4 9 . -R value, of heated basement/cellar walls (below gradeW:Ak - 10: Type of -insulation ' �-�be llir' - • C.' Controls -4 • 1 . Thermostat maximum heat. setting • 75 . - D. Duct Systems 1 .. Is duct system installed- in unheated spaces? YES t - -a. If Y-- ES-, -R- v`alue--o-f -d-uc't installation_ b. R value of duct in other areas • . E . Piping_ Insulation ' .. 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 • • Telephone No. (p(ryc5-5 ''4' /- �'6, 4 f . ' • (applicant/' -stg' C.ature) , • 3 ' ' . lW-1 o v-t 4.rj 1(f Sti i TOWN OF QUFFNSBURY ��'C � e r BUILDING & ZONING DEPARTMENT. l SEA?AGF DISPOSAL PERMIT APPLICATION 1. Owner ' s Name job tkn,r% Address 791.04 Ky b2i .c•f ,. a Telephone No. &74.---/ tv 2. Property location` 6-1- cl c 3 . Name of person or firm responsible for installing system Dik,o VC/ C--et' Telephone No. Ot4`¢`6 . _ Address takie-51i10i 0�*' 1. Lair) CCU-n, - Q 4. Number of bedrooms (residential buildings only) 1 5. Daily flow Ma , gallons/day / 6. Septic tank capacity ' (,x(O Lo\c(0 -xG(slc�- gallons 7 . Topography: olling, steep , r • - . of slope 8 . Nature of soil and depth - ,Y;GL 9. If ground water, bedrock or impervious material is apparent at what depth does it begin? 'PeA- cy ~l ft. 10. Percolation test: A is required B r/ is not required. C If required what is the rate minutes/inch 11. Water supply: municipal , well, other • • !A 12., Type of system proposed: drywell, tile- field, .other arrett 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 $250 as provided to in Section 6 . 010 of the Queensbur-y Sanitary Sewage Ordinance. �r Date 00/64' li/)2Za AlC signature f�pplicant On separate sheet of paper submit a diagram of the proposed septic system with all dimensions, including distance from any structure, distance from property line and domestic water supply, etc. Include all dimensions of the system itself.. . Form 3-82:- - - - - TOWN OF QUEE 3sBU y Binding Depa tment InspeetoraDate J'/6" '4*4 Name Mi/ Location ID,r/ O7 0_9 Permit No. LSf-1 Co g Weather Remarks Excaf7a ti on Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Ba ckfi l l Final Survey Framing . Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Relief Valves Wall Board Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile /// Concrete Floors Plbg. Fixtures Gar. Fireproofing Door Closers Chimney Water Meter Inst. , • Septic Approval Floors Insulation Foundation Walls Ceiling ,,,,o/vz _OfbA__ Building Inspector REMARKS J o � �' � � 5f2,t.t.t. / •-i L. i( TOWN OF QUEENSBURY Building Department • Inspectors Report Date /l /6' • Name Location p/i o, - /&A . Permit No. 6 7 Weather t/AM L /U$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 & Railings Cellar Dr. Tile Concrete Floors ,✓ Plbg. Fixtures / Gar. Fireproofing / Door Closers Chimney Water Meter Inst. Septic Approval Floors Foundation Insulation Wa11s Ceilin Buildin Inspector REMARKS ��T�� ft)j • TOWN OF QU'EENSBURY Building Departinent Inspectors Report Date / /29- / Name Location pi Ze,7 Kiti0 jj R i . Permit No. R 7 6/, Weather .r''` 9 / GJ. Remarks Excatia tion 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 /�j/41 Finished Floor Interior Trim Stairs & Railings 1,//;e2A Cellar Dr. Tile Concrete Floors Plbg. Fixtures ( Gar. Fireproofing 4/ Door Closers �i l,,Q Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation ' Walls Ceilin Buil ing nspector P REMARKS Zeia 0 //5 4z Fixbete, TOWN OF"QUEENSBURY Building• Department Inspectors Report Date 9 � Name /lc-4 i71 N Location /P9/o A A to/ Permit No. R 7 to A Weather Remarks Excatia tion 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 f\ Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile Concrete Floors P1bg. Fixtures Gar. Fireproofing Door Closers Chimney • Water Meter Inst. Septic Approval Flodrs Insulation Foundation Walls Ceilin 714#: Building Inspector REMARKS