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85-359 CERTIFICATE OF OCCUPANCY TOWN OF QUEENSBURY ' WARREN COUNTY, NEW YORK Date nctch er <c 19 L`5 This is to certify that work requested to be done as shown by Permit No.gt —3 E n has been completed. This structure may be occupied as a One -F1aTr.ily Dwellin(T Location West fl9nun rain Rcad Owner Sue .inn Flint By Order Town Board TOWN OF QUEENSBURY Building & Zoning Inspector CREATIVE "INSTA" PRINTING. GLENS FALLS. N Y 12801 15181793-5658 BUILDING PERMIT TOWN OF QUEENSBURY No. 85-359 WARREN COUNTY, NEW YORK PERMISSION is herebySue Ann Flint m granted to ]y OWNER of property located at West Mountain Road Street, Road or Ave. hi 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. 1. OWNER'S Address is 10 Ridge St. Glens Falls, New York 2. CONTRACTOR or BUI LDER'S Name Robert J. Allison (D fi 3. CONTRACTOR or BUILDER'S Address O 615 Call St. Corinth, New York 12822 N- 4. ARCHITECT'S Name 0 P) 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) (A Wood Frame ( 1 Masonry ( )Steel ( ) 7. PLANS and Specifications 28 'x42 ' per plot plan, specifications and O No. application submitted including sewage system. ::1 0 I 8. Proposed Use F-' One-Family Dwelling �C t7 $5. 00 C/O Paid $ 84 . 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Feb. 1 19 86 N N (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.) W Dated at the Town of Queensbury this 15th Day of Ju ly 19 85 SIGNED BY Add C� for the Town of Queensbury Building and Zoning Inspector TOWN, OF QUEENSBURY (Space inside block to ix- filled in by WARREN COUNTY, NEW YORK Building Inspector) Application for application No. Permit Isslwd 19. . BUILDING AND ZONING PERMIT „it FXpires. . 19. %o nin, District l Am- nl Work THREE (3) Copies of a PLOT PLAN, Drawn to scale Ai'I"n)"cd by �1L showing the actual dimensions of the lot to be built kcillarks- upon, The exact size, and location on the lot of the wilding to be erected or altered MUST BE SUB- MITTED WITH THIS APPLICATION. TOWS[ OFQUEEN' 81JI: y DATE D A PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK ANSWER ALL OF THE FOLLOWING. J�' �} C,(D a�, The undersigned hereby applies for a permit to do the following work 1A, � `�'�Z which will be done in accordance with the description, plans and specifi- ce B ° ' r cations, and such special conditions as may be indicated on the permit. Theo er of th' property J. : -n t. ��. . . . �. . . F. ,h.f. . . . I . . . . . . . . . . . . . . . . . . lo. .el.d�jq e-. .Y. .,& k . (NA'�E) The rson res nsible f supervision of the work insofar as the Building Code and the Zonin Ordinanc appl ti � . . Cli�.o.n . . . . . . . . . . . . . . . . . . . . .his �or�n�1 / i�Z�a.� (NAME) (P O ADDRESS) I' Name of Builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . .Address . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Plumber. . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Mason. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Address,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lot Number. . . . . . . . . . . . Unit . . . . . . . s yed value of ro osed work 3 7 (/ d. .Name of Village . . .0! (CIS, * .�� �. .!�(. . : . .J. . . . . . . . . . . . . . . ... . . . . . Name of Street . .UIPS . . 2.1(�.f�( /!'J . . . . .. .�. . . . . . . . . Side of street: north ❑, east south ❑, west ❑ Nearest Cross Street :"l.rl!? SAG . " /lU.t(> G?h. .C��Distance from this cross street . . . . . . �J�v. . . . . . . . . . Ft. Property is north K south C1,east i 1, west ❑from Cross Street If on Corner, which corner, northeast ❑, northwest ❑, southeast Q, southwest (Designate by marking with an"X" in the correct space.) . NATURE OF PROPOSED WORK OCCUPANCY ' Construction of a new building. Main Building ❑ Addition to a building. One-family dwelling ❑ Alteration to a building. Two-family dwelling ❑ El Demolition of a building. . . . • • family apartment house Store building [l . . . . . . . .-car attached garage ❑ Other: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . Accessory Building One-car detached garage l 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- NORTH posed buildings, and the location of all existing buildings. Show proposed building(s) in dotted line and existing l;uilding(s) in solid line. Size of property . . .. . . . . ft. x . . . . . . . ft. Size and use of existing buildings, if any . . . . (. ❑- W Size of proposed building . . . .02.J�7. . ft.x . . . . . !. ft. �L Height(from grade to ridge) . ./.�' . . . . . . ft. Front yard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ft'. Side yards . . . . . . . . ft. and . . . .`Jt.o2: . . . . . . ft. Rear yard . . . . .0 5�. . . . . . . . . . . . . . . . . . . . . . . . . . . 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., wodKind of construction: Wood frame, fire safe, etc.?. . . . . . ©. . . . a ✓�` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Willany second-hand lumber be used? . . . . /L.o . . .J. .`. . If so, for what?. . . . . . . . . . . . . . . . . . . . . . . ./ . . . . . . . . . . . . . . . Material of foundation walls . . . . . . . . . . . . . . . . . . . . . . . . Thickness . .t Q . . . . . . . ., . . . . . . . Depth of foundation walls below grade . . . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . Continuous foundation? . . . Will there be a cellar? . . . . .,&S . . . . . . . Ifs , material of cellar floor . . . . .(!.2n'l-en. .f. . . . . . . . . . . . . . . . . . . . . . Type of roof: Sloped or flift? . . . .c 14�t. . . . . . . Material of roof . . . . .a.-Sio 1R I I. , Size,wood studs . . . . . . . . . . . . . . . . . . . . ..x . o� %F. . . . . . . . :", spacing . . . . . .'P..`.. . . . . o.c., length. . . . .6... . . . ft. Size, floor beams, 1st floor . . . . . . . . . . . . " x P. . . . .", spacing . . . . lX . . . . . . ."o.c., span . . . . .l.Y. .`. . . . ft. Size, floor beams, 2nd floor . . . . . . . . . . ... x . . . . . . . . . . . . . . .", spacing . . "o.c., span . . . . :. . . . . . . . . ft. Size, ceiling beams . . ... . . . . . . . . . . . . . . " x . . -. . . . . . . . . .", spacing . . .1. .«. . . . . o.c., span . . . .f'. . . . . . . ft. Size, roof rafters or beams . . . . .. . . . . . . " x . .!,Z. .4?. . . . . .... spacing . . . . . . . . ."o.c.t span . . . O. J ft. / 1.Exterior finish . . .noy J. 1, G]. .. • • . . • • • • • • • • • • • • With what material? . . . .vl nii.j. . . . . . . . . . . . . . . . . . Finish of interior walls. . . . .CNe .M-cl.-•. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . .C�T'.-��.-rl.e-) . . . . . . . . . . . . . . . . . . . Oil burner or coal? . . . . . :-%-7. . . . . . . . . . . . . . . . . . . . . Will a flue-lined chimney be provided. . . . . • • • • • • Depth of chimney foundation below grade . . . ... . . . . . . . . . Height of chimney above roof. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . Will there be a fireplace? . . . . . .17,0 . . . . . . . . ... . . . . . Depth of fireplace hearth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a toilet be installed? . . . . . 'PS. . . . . . . . . . . . . . .'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will a kitchen sink be installed and connected to water supply? . . . . .>/ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water supply (public water supply or pump) . . . �.�/. . . . . . . . . ... . : . . . . . . . . . . . . . . . . . . . . . . . . Distance of cesspool from any private well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . feet Will drainage system be provided with required traps, cleanouts, and vents? . . . . . L°S. . . . . . . . . .. . . . . . . . . . . . . . . . . Town of Queensbury AFFIDAVIT County of Warren State of New York I swear that to tt; bda 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.a.plete 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 pertain i to the posed work all be complied with,whether specified or not, and that such work is authorized by the owner. Sworn to before me this Signature .... ...... .... OWNER.OWNER'S AGENT,ARCHITECT.CONTRACTOR ey ..................................................19........ ........:...... . . . ..:................................. . NOTARY - BLIC. EN COUNTY. N. Y. SPECIAL CONDITIONS OF THE PERMIT: TOWN OF QUEENS BURY Building Department Inspector- Report Date A-- Location Permit No. -- Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Ba ckfi l l Final Survey Framing Sheathing, Roof Felt Roofing , Siding Masonry Veneer Rough Plb . 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 0 _ Floors Insulation Foundation Walls Ceilin ti B i ding Inspector REMARKS TOWN OF QUEENSBURY Building Department Inspectors Report ®ate ICD x 1 5 Name Location Permit No. Ys- `t Weather Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing 0 Siding !' Masonr.Y Veneer Rough Plb . Relief Valves 0 A. Wall Board d Ext. Porches S , Q y:, Finished Floor (� Interior Trim (p Stairs & Railin s Cf: j��zcr.z Cellar Dr. Tile Concrete Floors PZ . Fixtures p, Gar. Fireproofing— Door Closers Chimne �} Water Meter Inst. Septic Approval Floors Insulation Foundation Walls ' Ceilin Building Inspector REMARKS 11� a,K i� r tZvur ovb2 No NF6D %A11LS 'r Qfi-1L1Ive 'U TOWN OF QUEENSBURY Building Department In4m tors Report Date Zj Name ,, �L r.�✓ - Location— Pereait No. X S - �� Weather Remarks Excavation 1 4 _ Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framin Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plb9r. Relief Valves / Wall Board \, _ Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile Concrete Floors Plbq. Fixtures Gar. Fireproofing Door Closers Chimney . Water Meter Inst. ^ Septic Approval Floors Insulation Foundation_ Walls C fling Build g Inspector REMARKS TOWN OF QUEENSBURY Building Department hLgmetam Report Date Z Ai Name_ Li T`- . Locaeion w6sr 7,77 s YE E Permit No. ��'� _� �� Weather Remarks Excat7a ti on 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. Tiler \ Concrete Floors Plbg. Fixtures \ Gar. Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval Floors Insulation Foundation ` Walls Ceiling B ild ng Inspector REMARKS TOWN OF QUEEMBURy hopoetms Repent Narn Location Pig AI®. Az.�_...�.�.�. � d? r s Excavation Footing Forms Footing & Piers Foundation _ ~ Cement Coat _ Waterproofing, Backfill Final Survey Framing _ Sheathing Roof Felt Roofing a 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 fWalls_. Ceilirig� ualding inspector REMARKS BUILDING DEPT.COPY OF APPLICATION FORM 46-EL,NEW YORK BOARD OF FIRE UNDERWRITERS. FILE THIS COPY WITH BUILDING DEPT.WHEN REQUIRED. TEMP.# DA�EI CITY OR ' f 1 VILLAGE r � �� JAI TOWNSHIP COUNTY �-�ra, STREET AND NO.OR / ROADANDPOLENO. / POLE NO. BETWEEN WHAT TWO n CROSS STREETS IS J 7 �� PREMISES LOCATED?1-({");U„L'Cr� )+�1 �7 j.L� �V ni SECTION BLOCK LOT OCCUPANT'S!:t j� BUILDING r . NAME k �t.� a l r�f F/ 1 rr OCCUPANCY + l tfi ak; - f 7// OWNER'S NAME e'l i _ �•- r l _ •- fir. -� —7 t _ AND ADDRESS ._.j i ) �J W 1 1 �l li I�d jfJ �?( �� TEL.# j � 1 CURB NT SUPPLIED BY FROM THEIR OFFICE DEFECTS SUILDING NEW OLD El Is NEW ADDITIONAL❑ REMOVED ❑ LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED No.of Fixtures& BRANCH OFFICE USE NUMBER OF OUTLETS Lamp Receptacles MOTORS HEATERS CIRCUITS Loca- ONLY tion Side Attach't H.P. Watts A.W.G. Ceiling Wall Recep'ls Switch Pendant Bracket No. Type Each No. Each No. Gauge INSPECTION Out- side Sub- base Base- ment 1st FI. 2nd FI. 3rd Fl. REMARKS: LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: DO NOT USE THIS SPACE. This application is intended to cover the above-listed equipment to be inspected but if at time of inspection there is found additional equipment not above listed, you are authorized to make the inspection and adjust the fee to cover the additional equipment,as provided by the applicant. SIZE OF ELECTRIC SIGN TOTAL MAINS FEEDERS LAMPS WATTS CHARACTER EXPOSED GAS TUBE SIGN OFWORK CONCEALED TRANSFORMERS OF VA WORK TO BE (NUMBER) (CAPACITY) STARTED' COMPLETED SIZE OF SIGN SERVICE OVERHEAD UNDERGROUND MAKER ENTERS BUILDING OF SIGN INSPECTION REQUESTED ON OR AS NEAR AS POSSIBLE I NEW OLD AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SP�bS�UST 8E FIJ_L ED 4-.O APPOPAZIHN MAY BE RETURNED. PRINT NAME�,AND AD5D�RESS (J j G' ;! r I` J( j� // _ Gl, � �'< ; CC APPLNAME ANT '.-if-1 V ,41�F 0 ��� DATE OF k- � j APPLICATION STREET ADDRESS , /i �t-(�X' 19T (I!( �) aAs V! TELEPHONE# r! ��{� ✓ ` CITY OR / �11 �-� ZIP LICENSE NO. POST OFFICE ( I�� U! / � CODE J� WHEN APPLICABLE 46 EL(REV.1/84) A SEPARATE APPLICATION MUST BE FILED FOR EACH SEPARATE BUILDING TOWN OF QUE:FNSBURY BUILDING & ZONING DEPARTMENT SEWAGF DISPOSAL PERM-IT APPLICATION 1. Owner ' s Name suie." Aho Fl/'r�✓ . Address *`45 Telephone No. 7g�J,77s 2. Property locationDo? 3 . Name of person or firm responsible for installing system elz.,rt- J "Seyt_ Telephone No. Address 4. Number of bedrooms (residential buildings only) a 5. Daily flow 7 S gallons/day 6. Septic tank capacity 0 y gallons 7 . Topography: fla rolling, steep % of slope 8 . Nature of soil and depth 94 i u, 9. If ground water, bedrock or impervious material is apparent at what depth does it begin? ft. 10. Percolation test: is required is not required, C If required what is the rate minutes/inch 11. Water supply: unicipa well, other 12. Type of system proposed: drywell tile field other Any contractor,. corporation, individual, etc. engaged in' the construction of a sanitary sewage disposal sy.stem. 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 for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance. Date d4,&J,, ignature of a plicant 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 C/ ® 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 2 . Type of heat 3 . Is the building mechanically cooled? 4. Percentage of area of windows and doors 1 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 -Y-E'S' NO a. Are foundation walls insulated? -y`E-S- NO 1. If YES , what is the R value? 3 . Slab on grade 'Y-B-Sl- NO a. If YES, what is the R value of insulation around perimeter of floor? 4 . Is basement heated? -3-E-S 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_ K,- �a 2 . R value of exterior walls rL-,-j q 3 . R value of glazed area. 2- �, 2- 4 . R value of doors n _ o- 5. R value of floors over unheated spaces 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 C. Controls 1 . Thermostat maximum heat setting Q 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 . Performance efficiency 2 . Temperature control settin maximum G. For Swimming Pool Only _ 1 . Maximum heating Telephone No. dr-327s (applicant ' s signature) J- i<sd"g, L�o��rn sub '-fir►r� t l r�✓1 F/of Flan a.S. x q,�- ho a s� by �a.�Q�e__ �000Q�C- 1 SZi - INN 0